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01-02-2019 | Original Article

Maladaptive Post-traumatic Cognitions in Interpersonally Traumatized Adolescents with Post-traumatic Stress Disorder: An Analysis of “Stuck-Points”

Authors: Janina Botsford, Maja Steinbrink, Eline Rimane, Rita Rosner, Regina Steil, Babette Renneberg

Published in: Cognitive Therapy and Research | Issue 1/2019

Abstract

This study investigated maladaptive post-traumatic cognitions, so-called “stuck-points”, from forty-three adolescent survivors of interpersonal traumatization. Thematic content and relationships between stuck-points and trauma characteristics as well as symptom severity were analyzed. Guilt, esteem and trust were the most frequently named themes. Physical abuse was related to stuck-points in the categories trust and control, sexual abuse was related to the categories safety and guilt. Penetration, female sex, an older age at trauma onset and a closer relationship to the perpetrator were related to the category guilt. Injuries through physical violence were related to the category trust. Physical violence and a longer duration of the index trauma were related to a higher number of stuck-points overall. Last, a higher number of stuck-points in the category trust was related to higher post-traumatic stress disorder symptom severity. Therapists should pay attention to these different themes in order to provide the best possible treatment for each patient individually.

Ackerman, P. T., Newton, J. E., McPherson, W., Jones, J. G., & Dykman, R. A. (1998). Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both). Child Abuse & Neglect, 22(8), 759–774. https://doi.org/10.1016/S0145-2134(98)00062-3.CrossRef

American Psychological Association. (2001). Understanding child sexual abuse: Education, prevention, and recovery. Retrieved March, 9, 2005 from https://urldefense.proofpoint.com/v2/url?u=http-3A__www.apa.org_pi_families_resources_understanding-2Dchild-2Dabuse.aspx&d=DwIDaQ&c=vh6FgFnduejNhPPD0fl_yRaSfZy8CWbWnIf4XJhSqx8&r=cijxKIUfIjh6xB35XSxKelnSNfz2185wGO_qFr-DFH8&m=hdom8PoRDgMUoD2Oz7TISd0FxZagxX3PjizWZmqLMQk&s=pJ815JE_bBunb4mCdgGsjj6T1SG-Iaqc5NlKpJLpijg&e=.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Arata, C. M. (2002). Child sexual abuse and sexual revictimization. Clinical Psychology: Science and Practice, 9(2), 135–164. https://doi.org/10.1093/clipsy.9.2.135.CrossRef

Ateah, C. A., & Durrant, J. E. (2005). Maternal use of physical punishment in response to child misbehavior: Implications for child abuse prevention. Child Abuse & Neglect, 29(2), 169–185. https://doi.org/10.1016/j.chiabu.2004.10.010.CrossRef

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II: Manual (2nd edn.). San Antonio, TX: Pearson PsychCorp.

Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670–686. https://doi.org/10.1037/0033-295X.103.4.670.PubMedCrossRef

Briere, J., & Runtz, M. (1988). Symptomatology associated with childhood sexual victimization in a nonclinical adult sample. Child Abuse & Neglect, 12(1), 51–59. https://doi.org/10.1016/0145-2134(88)90007-5.CrossRef

Chemtob, C. M., Roitblat, H. L., Hamada, R. S., Muraoka, M. Y., Carlson, J. G., & Bauer, G. B. (1999). Compelled attention: the effects of viewing trauma-related stimuli on concurrent task performance in posttraumatic stress disorder. Journal of Traumatic Stress, 12(2), 309–326. https://doi.org/10.1023/A:1024728626505.PubMedCrossRef

Collin-Vézina, D., & Hébert, M. (2005). Comparing dissociation and PTSD in sexually abused school-aged girls. The Journal of Nervous and Mental Disease, 193(1), 47–52.PubMedCrossRef

Dunmore, E., Clark, D. M., & Ehlers, A. (1999). Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault. Behaviour Research and Therapy, 37(9), 809–829. https://doi.org/10.1016/S0005-7967(98)00181-8.PubMedCrossRef

Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0.PubMedCrossRef

Elhai, J. D., Layne, C. M., Steinberg, A. M., Brymer, M. J., Briggs, E. C., Ostrowski, S. A., & Pynoos, R. S. (2013). Psychometric properties of the UCLA PTSD reaction index. part II: Investigating factor structure findings in a national clinic-referred youth sample. Journal of Traumatic Stress, 26(1), 10–18. https://doi.org/10.1002/jts.21755.PubMedCrossRef

Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Behavior Therapy, 20(2), 155–176. https://doi.org/10.1016/S0005-7894(89)80067-X.CrossRef

Fuhrmann, D., Knoll, L. J., & Blakemore, S. J. (2015). Adolescence as a sensitive period of brain development. Trends in Cognitive Sciences, 19(10), 558–566. https://doi.org/10.1016/j.tics.2015.07.008.PubMedCrossRef

Hagenaars, M. A., Fisch, I., & van Minnen, A. (2011). The effect of trauma onset and frequency on PTSD-associated symptoms. Journal of Affective Disorders, 132(1–2), 192–199. https://doi.org/10.1016/j.jad.2011.02.017.PubMedCrossRef

Harter, S. (1990). Developmental differences in the nature of self-representations: Implications for the understanding, assessment, and treatment of maladaptive behavior. Cognitive Therapy and Research, 14(2), 113–142. https://doi.org/10.1007/BF01176205.CrossRef

Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social cognition, 7(2), 113–136. https://doi.org/10.1521/soco.1989.7.2.113.CrossRef

Janoff-Bulman, R. (1992). Shattered assumptions: Toward a new psychology of trauma. New York: Free Press

Kadushin, A., Martin, J. A., & McGloin, J. (1981). Child abuse—An interactional event. New York: Columbia University Press.

Kelley, L. P., Weathers, F. W., McDevitt-Murphy, M. E., Eakin, D. E., & Flood, A. M. (2009). A comparison of PTSD symptom patterns in three types of civilian trauma. Journal of Traumatic Stress, 22(3), 227–235. https://doi.org/10.1002/jts.20406.PubMedCrossRef

Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617.PubMedPubMedCentralCrossRef

König, J. (2012). Therapeutische praxis. In von Julia König Posttraumatische Belastungsstörung: Ein Manual zur Cognitive Processing Therapy. Göttingen: Hogrefe.

Kühner, C., Bürger, C., Keller, F., & Hautzinger, M. (2007). Reliabilität und Validität des revidierten Beck-Depressionsinventars (BDI-II). Befunde aus deutschsprachigen Stichproben [Reliability and validity of the Revised Beck Depression Inventory (BDI-II). Results from German samples]. Der Nervenarzt, 78(6), 651–656. https://doi.org/10.1007/s00115-006-2098-7.PubMedCrossRef

Litz, B. (1989). Information processing in anxiety disorders: Application to the understanding of post-traumatic stress disorder. Clinical Psychology Review, 9(2), 243–257. https://doi.org/10.1016/0272-7358-89-90030-5.CrossRef

Matulis, S., Resick, P. A., Rosner, R., & Steil, R. (2014). Developmentally adapted cognitive processing therapy for adolescents suffering from posttraumatic stress disorder after childhood sexual or physical abuse: A pilot study. Clinical Child and Family Psychology Review, 17(2), 173–190. https://doi.org/10.1007/s10567-013-0156-9.PubMedCrossRef

McCann, I. L., Sakheim, D. K., & Abrahamson, D. J. (1988). Trauma and victimization: A model of psychological adaptation. The Counseling Psychologist, 16(4), 531–594. https://doi.org/10.1177/0011000088164002.CrossRef

McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 815–830. https://doi.org/10.1016/j.jaac.2013.05.011.CrossRef

Mechanic, M. B., & Resick, P. A. (1993, October). The personal beliefs and reactions scale: Assessing rape-related cognitive schemata. In Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.

Owens, G. P., & Chard, K. M. (2001). Cognitive distortions among women reporting childhood sexual abuse. Journal of Interpersonal Violence, 16(2), 178–191. https://doi.org/10.1177/088626001016002006.CrossRef

Owens, G. P., Chard, K. M., & Ann Cox, T. (2008). The relationship between maladaptive cognitions, anger expression, and posttraumatic stress disorder among veterans in residential treatment. Journal of Aggression, Maltreatment & Trauma, 17(4), 439–452. https://doi.org/10.1080/10926770802473908.CrossRef

Palosaari, E., Punamäki, R.-L., Diab, M., & Qouta, S. (2013). Posttraumatic cognitions and posttraumatic stress symptoms among war-affected children: A cross-lagged analysis. Journal of Abnormal Psychology, 122(3), 656–661. https://doi.org/10.1037/a0033875.PubMedCrossRef

Rabenau, C. (2014). Stuckpoints (Hängepunkte) und deren Zusammenhang mit der Art und dem Schweregrad traumatischer Erfahrungen im Jugendalter.

Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76(2), 243–258. https://doi.org/10.1037/0022-006X.76.2.243.PubMedPubMedCentralCrossRef

Resick, P. A., Monson, C. M., & Chard, K. M. (2014). Cognitive processing therapy: Veteran/military version: Therapist’s manual. Washington, DC: Department of Veterans Affairs.

Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70(4), 867–879.PubMedPubMedCentralCrossRef

Resick, P. A., & Schnicke, M. (1993). Cognitive processing therapy for rape victims: A treatment manual (Vol. 4). Newbury Park: Sage Publications.

Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60(5), 748–756. https://doi.org/10.1037/0022-006X.60.5.748.PubMedCrossRef

Rosner, R., König, H.-H., Neuner, F., Schmidt, U., & Steil, R. (2014). Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: Study protocol for a randomized controlled trial. Trials, 15, 195. https://doi.org/10.1186/1745-6215-15-195.PubMedPubMedCentralCrossRef

Rousseau, D. M., Sitkin, S. B., Burt, R. S., & Camerer, C. (1998). Not so different after all: A cross-discipline view of trust. Academy of Management Review, 23(3), 393–404.CrossRef

Simpson, J. A. (2007). Psychological foundations of trust. Current Directions in Psychological Science, 16(5), 264–268. https://doi.org/10.1111/j.1467-8721.2007.00517.x.CrossRef

Sobel, A. A., Resick, P. A., & Rabalais, A. E. (2009). The effect of cognitive processing therapy on cognitions: Impact statement coding. Journal of Traumatic Stress, 22(3), 205–211. https://doi.org/10.1002/jts.20408.PubMedPubMedCentralCrossRef

Steil, R., & Ehlers, A. (2000). Dysfunctional meaning of posttraumatic intrusions in chronic PTSD. Behaviour Research and Therapy, 38(6), 537–558. https://doi.org/10.1016/S0005-7967(99)00069-8.PubMedCrossRef

Steil, R., & Füchsel, G. (2006). IBS-KJ Interviews zu Belastungsstörungen bei Kindern und Jugendlichen: Diagnostik der akuten und posttraumatischen Belastungsstörung. Manual, Testmappe komplett. Göttingen u. a.: Hogrefe Verl. f. Psychologie.

Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences, 9(2), 69–74. https://doi.org/10.1016/j.tics.2004.12.005.PubMedCrossRef

Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992. https://doi.org/10.1037/0033-2909.132.6.959.PubMedCrossRef

Tyler, K. A. (2002). Social and emotional outcomes of childhood sexual abuse: A review of recent research. Aggression and Violent Behavior, 7(6), 567–589. https://doi.org/10.1016/S1359-1789(01)00047-7.CrossRef

Ullman, S. E., & Peter-Hagene, L. (2014). Social reactions to sexual assault disclosure, coping, perceived control and PTSD symptoms in sexual assault victims. Journal of Community Psychology, 42(4), 495–508. https://doi.org/10.1002/jcop.21624.PubMedPubMedCentralCrossRef

Vaile Wright, C., Collinsworth, L. L., & Fitzgerald, L. F. (2010). Why did this happen to me? Cognitive schema disruption and posttraumatic stress disorder in victims of sexual trauma. Journal of Interpersonal Violence, 25(10), 1801–1814. https://doi.org/10.1177/0886260509354500.PubMedCrossRef

Wenninger, K., & Ehlers, A. (1998). Dysfunctional cognitions and adult psychological functioning in child sexual abuse survivors. Journal of Traumatic Stress, 11(2), 281–300. https://doi.org/10.1023/A:1024451103931.PubMedCrossRef

Wolfe, D. A., Sas, L., & Wekerle, C. (1994). Factors associated with the development of posttraumatic stress disorder among child victims of sexual abuse. Child Abuse & Neglect, 18(1), 37–50. https://doi.org/10.1016/0145-2134(94)90094-9.CrossRef

Title: Maladaptive Post-traumatic Cognitions in Interpersonally Traumatized Adolescents with Post-traumatic Stress Disorder: An Analysis of “Stuck-Points”
Authors: Janina Botsford
Maja Steinbrink
Eline Rimane
Rita Rosner
Regina Steil
Babette Renneberg
Publication date: 01-02-2019
Publisher: Springer US
Published in: Cognitive Therapy and Research / Issue 1/2019
Print ISSN: 0147-5916
Electronic ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9928-3

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Maladaptive Post-traumatic Cognitions in Interpersonally Traumatized Adolescents with Post-traumatic Stress Disorder: An Analysis of “Stuck-Points”

Abstract

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