Showing posts with label reactivity. Show all posts
Showing posts with label reactivity. Show all posts

Sunday, October 20, 2013

Best Predictor of PTSD Diagnosis Is Trauma-Related Psychophysiologic Reactivity

 

Researchers from Boston University School of Medicine, the National Center for PSTD, VA Boston Healthcare System, Suffolk University, Massachusetts General Hospital, Harvard University, and other institutions conducted a meta-analysis of five prior studies with 150 study participants (78 diagnosed with PTSD and 72 who had experienced trauma but did not develop PTSD) and found that "psychophysiologic reactivity to trauma-related, script-driven imagery procedures" is a potential "biological predictor of a post-traumatic stress disorder (PTSD) diagnosis."

A summary of the research findings Medical News Today is below, followed by the abstract from the original article (which is behind a paywall).

Full Citation:
Pineles, SL, Suvak, MK, Liverant, GI, Gregor, K, Wisco, BE, Pitman, RK, and Orr, SP.  (2013, Aug). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychology, Vol 122(3), 635-644. doi: 10.1037/a0033942

Best predictor of PTSD diagnosis is trauma-related psychophysiologic reactivity


Sunday 13 October 2013

Researchers from Boston University School of Medicine (BUSM) and several other institutions including the National Center for PSTD, VA Boston Healthcare System, Suffolk University, Massachusetts General Hospital and Harvard University, have determined that psychophysiologic reactivity to trauma-related, script-driven imagery procedures is a promising biological predictor of a post-traumatic stress disorder (PTSD) diagnosis. These findings appear online in the Journal of Abnormal Psychology.

Approximately seven to 12 percent of the general adult population in the U.S. suffers with PTSD. This disease develops after an inciting trauma. PTSD commonly affects military personnel who have faced combat, victims of sexual assault, people from conflict-ridden areas of the world, and patients who have survived intensive care unit admissions.

The researchers analyzed data from five prior studies with 150 study participants: 78 diagnosed with PTSD and 72 who had experienced trauma but did not develop PTSD. Researchers studied four main predictor classes including the measurement of psychophysiologic reactivity to trauma-related scripts; psychophysiologic reactivity to other stressful but non-trauma related scripts; self-reported distress in response to trauma-related scripts; and self-reported distress to other stressful but non-trauma-related scripts. Of the four indices examined, psychophysiologic reactivity to trauma-related cues appeared to be the most robust predictor of PTSD.

The researchers believe that these findings have significant implications for the field of psychiatry. "Psychophysiologic reactivity to script-driven imagery is a potential experimental paradigm that could be used to index an individual's fear response," explained principal investigator Suzanne Pineles, PhD, assistant professor of psychiatry at BUSM and clinical psychologist at the National Center for PTSD at the VA Boston Healthcare System. "Future research may extend the use of this paradigm to other populations. For example, it is possible that individuals with other fear-based disorders, such as phobias or panic disorder, would exhibit similar patterns of reactivity to scripts describing their fear."

* * * * *

Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis



Abstract


Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.

Monday, May 06, 2013

Tara Brach - It's Not What's Happening, It's How You Respond


Tara Brach is a clinical psychologist and Buddhist teacher. She is the author of Radical Acceptance: Embracing Your Life with the Heart of a Buddha (2004) and True Refuge: Finding Peace and Freedom in Your Own Awakened Heart (2013). This short article is adapted from Radical Acceptance, a book that I found quite useful when I first read it.

It's Not What's Happening, It's How You Respond

Posted: 05/03/2013


By Tara Brach, Clinical Psychologist, Author, Teacher of Buddhist Mindfulness

One of my favorite stories took place a number of decades ago when the English had colonized India and they wanted to set up a golf course in Calcutta. Besides the fact that the English shouldn't have been there in the first place, the golf course was not a particularly good idea. The biggest challenge was that the area was populated with monkeys.
The monkeys apparently were interested in golf too, and their way of joining the game was to go onto the course and take the balls that the golfers were hitting and toss them around in all directions. Of course the golfers didn't like this at all, so they tried to control the monkeys. First they built high fences around the fairway; they went to a lot of trouble to do this. Now, monkeys climb -- so, they would climb over the fences and onto the course... That solution just didn't work at all.
The next thing they tried was to lure them away from the course. I don't know how they tried to lure them -- maybe waving bananas or something -- but for every monkey that would go for the bananas, all their relatives would come into the golf course to join the fun. In desperation, they started trapping them and relocating them, but that didn't work, either. The monkeys just had too many relatives who liked to play with golf balls! Finally, they established a novel rule for this particular golf course: The golfers in Calcutta had to play the ball wherever the monkey dropped it. Those golfers were onto something!
We all want life to be a certain way. We want the conditions to be just so, and life doesn't always cooperate. Maybe it does for awhile, which makes us want to hold on tight to how things are, but then things change. So sometimes it's like the monkeys are dropping the balls where we don't want them, and what can we do?
Often we react by blaming -- ourselves, or others or the situation. We might become aggressive. Or perhaps we feel victimized and resign. Or sometimes we soothe ourselves with extra food or drink. But clearly, none of these reactions are helpful.
If we are to find any peace, if we are to find freedom, what we need to do is learn to pause and say, "Okay. This is where the monkeys dropped the ball. I'll play it from here, as well as I'm able." So, how do we do that?
What if you pause right now, and take a moment to be quiet. Can you think of a place in your life where things are not cooperating with how you would like them to be? Whatever unfortunate place the monkeys have dropped a ball in your life, bring your focus to that. It could be something that happens in a relationship with another person, where you get reactive. What would it mean to "play the ball" here? If you could tap into your deepest wisdom, your true compassion, how would you like to respond to these circumstances?
One of the great teachings in spiritual life is this: It doesn't matter what is happening. What matters is how we respond. How we respond is what determines our happiness and peace of mind.
So how might you respond with presence, when you find the monkeys have dropped the ball in a difficult spot?
Enjoy this talk on: Surrender to the Monkeys
Adapted from my book Radical Acceptance (2003)
For more information visit: www.tarabrach.com
For more by Tara Brach, click here.

Sunday, July 08, 2012

The Role of Self-Distancing in Enabling Adaptive Self-Reflection


There was a recent article in Medical News Today on self-distancing to temper aggressive reactions, based on research conducted by Dominik Mischkowski, Ethan Kross, and Brad J. Bushman. Kross is from the University of Michigan's Emotions and Self-Control Laboratory (more on this below). Their findings appear online in the Journal of Experimental Social Psychology. [NOTE: The other two researchers are from Ohio State University, proof that differing tribes - who often express mortal hatred on the sports field - can indeed work together in peace.]


With this research, and a whole collection of similar studies, psychology has essentially (re)discovered the Buddhist teachings on non-attachment. If we can avoid becoming identified with our thoughts and feelings, we can remain non-reactive and more able to respond appropriately to the circumstances.

There several other similar studies abstracted below.

Here is the report on the study from Medical News Today. The original research is also available online and the link is at the bottom.

Aggressive Reactions Can Be Tempered By 'Self-Distancing'

Article Date: 04 Jul 2012

A new study reveals a simple strategy that people can use to minimize how angry and aggressive they get when they are provoked by others.

When someone makes you angry, try to pretend you're viewing the scene at a distance - in other words, you are an observer rather than a participant in this stressful situation. Then, from that distanced perspective, try to understand your feelings.

Researchers call this strategy "self-distancing."

In one study, college students who believed a lab partner was berating them for not following directions responded less aggressively and showed less anger when they were told to take analyze their feelings from a self-distanced perspective.

"The secret is to not get immersed in your own anger and, instead, have a more detached view," said Dominik Mischkowski, lead author of the research and a graduate student in psychology at Ohio State University.

"You have to see yourself in this stressful situation as a fly on the wall would see it."

While other studies have examined the value of self-distancing for calming angry feelings, this is the first to show that it can work in the heat of the moment, when people are most likely to act aggressively, Mischkowski said.

The worst thing to do in an anger-inducing situation is what people normally do: try to focus on their hurt and angry feelings to understand them, said Brad Bushman, a co-author of the study and professor of communication and psychology at Ohio State.

"If you focus too much on how you're feeling, it usually backfires," Bushman said.

"It keeps the aggressive thoughts and feelings active in your mind, which makes it more likely that you'll act aggressively."

Mischkowski and Bushman conducted the study with Ethan Kross of the University of Michigan. Their findings appear online in the Journal of Experimental Social Psychology and will be published in a future print edition.

There were two related studies. The first involved 94 college students who were told they were participating in a study about the effects of music on problem solving, creativity and emotions.

The students listened to an intense piece of classical music while attempting to solve 14 difficult anagrams (rearranging a group of letters to form a word such as "pandemonium"). They had only seven seconds to solve each anagram, record their answer and communicate it to the experimenter over an intercom.

But the plan of the study was to provoke the students into anger, which the experimenters did using a technique which has been used many times in similar studies.

The experimenter interrupted the study participants several times to ask them to speak louder into the intercom, finally saying "Look, this is the third time I have to say this! Can't you follow directions? Speak louder!"

After this part of the experiment, the participants were told they would be participating in a task examining the effects of music on creativity and feelings.

The students were told to go back to the anagram task and "see the scene in your mind's eye." They were put into three groups, each of which were asked to view the scene in different ways.

Some students were told to adopt a self-immersed perspective ("see the situation unfold through your eyes as if it were happening to you all over again") and then analyze their feelings surrounding the event. Others were told to use the self-distancing perspective ("move away from the situation to a point where you can now watch the event unfold from a distance - watch the situation unfold as if it were happening to the distant you all over again") and then analyze their feelings. The third control group was not told how to view the scene or analyze their feelings.

Each group was told the replay the scene in their minds for 45 seconds.

The researchers then tested the participants for aggressive thoughts and angry feelings.

Results showed that students who used the self-distancing perspective had fewer aggressive thoughts and felt less angry than both those who used the self-immersed approach and those in the control group.

"The self-distancing approach helped people regulate their angry feelings and also reduced their aggressive thoughts," Mischkowski said.

In a second study, the researchers went further and showed that self-distancing can actually make people less aggressive when they've been provoked.

In this study, 95 college students were told they were going to do an anagram task, similar to the one in the previous experiment. But in this case, they were told they were going to be working with an unseen student partner, rather than one of researchers (in reality, it actually was one of the researchers). In this case, the supposed partner was the one who delivered the scathing comments about following directions.

As in the first study, the participants were then randomly assigned to analyze their feelings surrounding the task from a self-immersed or a self-distanced perspective. Participants assigned to a third control group did not receive any instructions regarding how to view the scene or focus on their feelings.

Next, the participants were told they would be competing against the same partner who had provoked them earlier in a reaction-time task. The winner of the task would get the opportunity to blast the loser with noise through headphones - and the winner chose the intensity and length of the noise blast.

The findings showed that participants who used the self-distancing perspective to think about their partners' provocations showed lower levels of aggression than those in the other two groups. In other words, their noise blasts against their partner tended to be shorter and less intense.

"These participants were tested very shortly after they had been provoked by their partner," Mischkowski said.

"The fact that those who used self-distancing showed lower levels of aggression shows that this technique can work in the heat of the moment, when the anger is still fresh."

Mischkowski said it is also significant that those who used the self-distancing approach showed less aggression than those in the control group, who were not told how to view the anger-inducing incident with their partner.

This suggests people may naturally use a self-immersing perspective when confronted with a provocation - a perspective that is not likely to reduce anger.

"Many people seem to believe that immersing themselves in their anger has a cathartic effect, but it doesn't. It backfires and makes people more aggressive," Bushman said.

Another technique people are sometimes told to use when angered is to distract themselves - think of something calming to take their mind off their anger.

Mischkowski said this may be effective in the short-term, but the anger will return when the distraction is not there.

"But self-distancing really works, even right after a provocation - it is a powerful intervention tool that anyone can use when they're angry." 
* * * * * * *

Flies on the wall are less aggressive: Self-distancing “in the heat of the moment” reduces aggressive thoughts, angry feelings and aggressive behavior

Dominik Mischkowski, Ethan Kross, Brad J. Bushman
ABSTRACT:

People tend to ruminate after being provoked,which is like using gasoline to put out a fire—it feeds the flame by keeping aggressive thoughts and angry feelings active. In contrast, reflecting over past provocations from a self-distanced or “fly on the wall” perspective reduces aggressive thoughts and angry feelings. However, it is unclear whether people can self-distance “in the heat of the moment” (i.e., immediately after being provoked), and if they can, whether doing so reduces actual aggressive behavior. Two experiments addressed these issues. The results indicated that provoked participants who self-distanced had fewer aggressive thoughts and angry feelings (Experiment 1) and displayed less aggressive behavior (Experiment 2) than participants who self-immersed or were in a control group. These findings demonstrate that people can self-distance in the heat of the moment, and that doing so reduces aggressive thoughts, angry feelings, and aggressive behavior.
* * * * * * *

This feels like an important skill to teach clients - and perhaps an approach that feels less Buddhist (being mindful, non-attachment) or spiritual (the observing self, or witness). Some clients seem to have a harder time when the idea is presented in that kind of terminology.

But self-distancing? Makes perfect sense.

So I did a little Googling and found that Ethan Kross is the primary researcher in this field, and that many of his articles are freely available online from the U of Michigan's Emotions and Self-Control Laboratory.

Here are some of the papers and links - abstracts only (in no particular order).

Analyzing Negative Experiences Without Ruminating: The Role of Self-Distancing in Enabling Adaptive Self-Reflection


Ozlem Ayduk and Ethan Kross
Social and Personality Psychology Compass 4/10 (2010): 841–854.
doi: 10.1111/j.1751-9004.2010.00301.x

ABSTRACT:

Both common intuition and findings from multiple areas of research suggest that when faced with distressing experiences, it is helpful to understand one’s feelings. However, a large body of research also indicates that people’s attempts to make sense of their feelings often backfire, leading them to ruminate and feel worse. In this article, we describe a program of research that focuses on disentangling these seemingly contradictory sets of findings. The research program we describe proposes that psychological distance from the self plays a key role in determining whether people’s attempts to understand their feelings lead to adaptive or maladaptive self-reflection. It suggests that people’s attempts to understand their feelings often fail because they analyze their feelings from a self-immersed perspective rather than a self-distanced perspective. Empirical evidence from multiple levels of analysis is presented to support this prediction. The basic science and clinical implications of these findings are discussed.

* * * * * * *

From a Distance: Implications of Spontaneous Self-Distancing for Adaptive Self-Reflection

Ozlem Ayduk and Ethan Kross
Journal of Personality and Social Psychology, 2010, Vol. 98, No. 5, 809–829.
DOI: 10.1037/a0019205

ABSTRACT

Although recent experimental work indicates that self-distancing facilitates adaptive self-reflection, it remains unclear (a) whether spontaneous self-distancing leads to similar adaptive outcomes, (b) how spontaneous self-distancing relates to avoidance, and (c) how this strategy impacts interpersonal behavior. Three studies examined these issues demonstrating that the more participants spontaneously self-distanced while reflecting on negative memories, the less emotional (Studies 1–3) and cardiovascular (Study 2) reactivity they displayed in the short term. Spontaneous self-distancing was also associated with lower emotional reactivity and intrusive ideation over time (Study 1). The negative association between spontaneous self-distancing and emotional reactivity was mediated by how participants construed their experience (i.e., less recounting relative to reconstruing) rather than avoidance (Studies 1–2). In addition, spontaneous self-distancing was associated with more problem-solving behavior and less reciprocation of negativity during conflicts among couples in ongoing relationships (Study 3). Although spontaneous self-distancing was empirically related to trait rumination, it explained unique variance in predicting key outcomes.
* * * * * * *

Boosting Wisdom: Distance From the Self Enhances Wise Reasoning, Attitudes, and Behavior

Ethan Kross and Igor Grossmann
Journal of Experimental Psychology: General. Advance online publication, July 4, 2011.
doi: 10.1037/a0024158

ABSTRACT:

Although humans strive to be wise, they often fail to do so when reasoning over issues that have profound personal implications. Here we examine whether psychological distance enhances wise reasoning, attitudes and behavior under such circumstances. Two experiments demonstrate that cueing people to reason about personally meaningful issues (Study 1: Career prospects for the unemployed during an economic recession; Study 2: Anticipated societal changes associated with one’s chosen candidate losing the 2008 U.S. Presidential election) from a distanced perspective enhances wise reasoning (dialecticism; intellectual humility), attitudes (cooperation-related attitude assimilation), and behavior (willingness to join a bipartisan group).
* * * * * * *

Making Meaning out of Negative Experiences by Self-Distancing

Ethan Kross and Ozlem Ayduk
Current Directions in Psychological Science, 2011, 20(3) 187-191.
DOI: 10.1177/0963721411408883

ABSTRACT:

Both common wisdom and findings from multiple areas of research suggest that it is helpful to understand and make meaning out of negative experiences. However, people’s attempts to do so often backfire, leading them to ruminate and feel worse. Here we attempt to shed light on these seemingly contradictory sets of findings by examining the role that self-distancing plays in facilitating adaptive self-reflection. We begin by briefly describing the ‘‘self-reflection paradox.’’ We then define self-distancing, present evidence from multiple levels of analysis that illustrate how this process facilitates adaptive self-reflection, and discuss the basic science and practical implications of this research.
* * * * * * *

The Relationship Between Self-Distancing and the Duration of Negative and Positive Emotional Experiences in Daily Life

Philippe Verduyn, Iven Van Mechelen, Ethan Kross, Carmen Chezzi, and Femke Van Bever
Emotion. Online First Publication, May 28, 2012. 
doi: 10.1037/a0028289

ABSTRACT:

Extant research suggests that self-distancing facilitates adaptive self-reflection of negative emotional experiences. However, this work operationalizes adaptive self-reflection in terms of a reduction in the intensity of negative emotion, ignoring other important aspects of emotional experience such as emotion duration. Moreover, prior research has predominantly focused on how self-distancing influences emotional reactivity in response to reflecting on negative experiences, leaving open questions concerning how this process operates in the context of positive experiences. We addressed these issues by examining the relationship between self-distancing and the duration of daily negative and positive emotions using a daily diary methodology. Discrete-time survival analyses revealed that reflecting on both daily negative (Studies 1 and 2) and positive events (Study 2) from a self-distanced perspective was associated with shorter emotions compared with reflecting on such events from a self-immersed perspective. The basic science and clinical implications of these findings are discussed.