انعطاف پذیری روانشناختی و ارتباط بین ترومای اوایل زندگی و علائم روانی
Abstract
1- Introduction
2- Method
3- Results
4- Discussion
5- Limitations and future directions
6- Conclusions
References
Abstract
Early Life Trauma (ELT), trauma before the age of 18, often has a negative psychological impact, even into adulthood. ELT has been linked to a variety of psychopathologies in adulthood including anxiety, depression, substance abuse, and PTSD (e.g., Bremner et al., 2007). However, not all individuals who experience ELT report psychological issues. Few studies have examined factors contributing to this discrepancy. The present study examines psychological flexibility against development of depression and PTSD following ELT among a sample (N = 240) of undergraduates who have experienced at least one trauma. Results suggest that ELT (number of traumas and negative impact of traumas) is positively associated with depression and PTSD. Individuals with more traumas reported higher psychological flexibility; psychological flexibility was also associated with less negative impact. As expected, psychological flexibility was associated with fewer psychological symptoms (both depression and PTSD). Further, psychological flexibility partially mediated the association between negative impact of traumas and symptoms, although no mediation was supported for models including number of traumas. This suggests that psychological flexibility is a protective factor for individuals who are negatively impacted by ELT, pointing to the importance of examining impact of trauma and not just number of traumas.
Introduction
Early life trauma (ELT) has been identified as a public health concern because of the alarmingly high rates and long-term negative health consequences (e.g., Green et al., 2010). Green et al. reported that 53.4% of English-speaking adults in the U.S. report having experienced at least one ELT. ELT is defined as any trauma occurring prior to age 18 and includes general trauma (e.g., serious accident, death of a parent or sibling) as well as physical, sexual, or emotional abuse. Research suggests that the impact of ELT can be far reaching and profound. ELT has been linked to a variety of psychopathologies in adulthood that includes personality disorders, anxiety, depression, substance abuse, and PTSD (e.g., Bremner, Bolus, & Mayer, 2007; Mandelli, Petrelli, & Serretti, 2015). Studies have even linked ELT with changes in brain structure and function as well as hypothalamic-pituitary-adrenal (HPA) axis (the physiological stress system) dysfunction. These changes may be at the root of increased psychopathology among those who have experienced ELT (Van der Kolk, 2003). Interestingly, though, not all children who experience trauma demonstrate high levels of psychopathology (Schulz et al., 2014). In fact, a meta-analysis by Hiller et al. (2016) reported that between 11% and 20% of individuals who are exposed to trauma as children or adolescents experience PTSD. Research has investigated a number of protective factors such as parental/caregiver support, parental/caregiver mental health, child temperament, and child cognitive ability (for review, see Masten et al., 1999; Tiet et al., 1998) that may help to explain this discrepancy. Another factor that may play a role in the development of PTSD following ELT is experiential avoidance, a tendency to avoid private emotional events such as traumatic memories. For example, Shenk, Putnam, Rausch, Peugh, and Noll (2014) reported that experiential avoidance mediated the relationship between ELT and PTSD; those with higher levels of experiential avoidance had higher levels of PTSD following ELT. Despite the importance of these factors, another avenue for understanding why some individuals develop psychological symptoms following trauma and others do not focuses on traits that an individual either possesses prior to the trauma, or develops as a result of trauma, which enables her/him to experience well-being despite a traumatic experience (e.g., Bonanno et al., 2002; Nugent, Sumner, & Amstadter, 2014).