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The Cognitive and Emotional Characteristics of College Students with PTSD and Resilience

Author: LeiMing
Tutor: ZhangQingLin
School: Southwestern University
Course: Developmental and Educational Psychology
Keywords: Psychological trauma Resilience Emotion regulation Posttraumatic stress disorder
CLC: B844.2
Type: PhD thesis
Year: 2011
Downloads: 365
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Abstract


Resilience refers to the phenomenon that an individual has the achievement of positive adaptation following significant adversity or trauma. The two key factors in resilience are significant adversity and positive adaptation. Resilience is mainly discussed from the view of ability, outcome and process. Accumulating literatures indicated there have been personal ability-based approach and developmental result-based approach to identify the cognitive and neural mechanism of resilience.Accumulating studies in personal ability-based approach selected high-resilient and low-resilient individuals by scales, such as the resilience scale and the Conner-Davidson scale, and explored the cognitive and neural mechanism of trait resilience by comparing their different performance in cognitive tasks. Positive emotionality and emotion regulation were of great importance in the studies of trait resilience, and dual-process models of resilience and emotion flexibility hypothesis was proposed based on these research findings. The researchers of developmental result-based approach suggested that resilient or non-resilient individual can be distinguished by the criterion of positive adaptation under adversity, including the state of adaptation, posttraumatic stress disorder (PTSD) symptoms. Cognitive bias to trauma related stimulus and emotion associated with trauma event were payed close attention. The representation of traumatic memory, cognitive emotion regulation, and positive emotion had close relationships to state resilience.Based on the previous research findings, the brain structure and function of earthquake survivors were influenced by trauma exposure; resilience exposured to traumatic events depend on whether the individual can be quickly recovered from negative emotion; cognitive emotion regulation, and upward spirals of positive emotion experience have close relationships to resilience. Many problems still unresolved, such as how to integrate the study results of resilience came from the ability view and the outcome view? Is there a cognitive bias to earthquake-related words in resilient individuals? Whether the resilient individuals have more positive emotion compared with PTSD individuals? And what did the role of emotion regulation strategy play in the resilient process?The present article aims to explore the cognitive and emotional characteristics of the resilient survivors exposured to Wenchuan earthquake by four studies, compared with PTSD survivors, and pay close attention to automatic process of traumatic words, implicit emotion experience and cognitive emotion regulation.Study 1 aimed to ascertain the role of trait resilience and emotion regulation to Wenchuan earthquake exposure and posttraumatic stress disorder (PTSD) respectively. The Resilience Scale (RS) was revised based on the survey of 888 undergraduates living in the Wenchuan earthquake epicenter. A series of scales were used, including the post-traumatic stress disorder self-rating scale (PTSD-SS), the Zung self-rating depression scale (SDS), the Zung self-rating anxiety scale (SAS) and the Eysenck personality questionnaire short scale for Chinese (EPQ-RSC). The results suggested that the Chinese version of the RS had four dimensions:controllability, persistence, efficiency, independence. The four-factor model of the RS had good construct validity, and the total resilience score was correlated negatively with PTSD, depression, anxiety, and Neuroticism (p s<0.01), positively with Extraversion (p<0.01).The Cronbach a coefficient of the RS was 0.94 (P<0.01), and the test-retest reliability coefficient was 0.82 (p<0.01). The Chinese version of the RS was demonstrated to be a reliable and valid measurement to assess resilience of Chinese adolescents in the Sichuan earthquake epicenter. In Study lb, another set of scales were used to measure 433 undergraduates experienced Wenchuan earthquake, including the Earthquake Exposure Questionnaire (self-designed), the emotion regulation scale (ERS), the Positive Affect and Negative Affect Scale (PANAS), RS, PTSD-SS, SDS, SAS. The results indicated that the Recovery group performed better in positive emotion and expressed less pathological symptoms comparing with the PTSD group; both trait resilience and cognitive reappraisal strategy were mediator, which demonstrated that the survivors to maintain relatively stable, healthy levels of psychological and physical outcome (i.e. state resilience) can go through trait resilience or cognitive reappraisal strategy after exposured to Wenchuan earthquake, and the resilient survivors possessed both healthy levels of psychological and physical outcome and high level of trait resilience.Modified Stroop test and subliminal priming test used in Study 2, to explore how earthquake experience impacts on automatic processing of the resilient and PTSD survivors. The behavioral data of modified Stroop test (Study 2a) showed that significant earthquake interference effect in PTSD group, which is the longer RTs for DRW (disaster-related words) than EUW (earthquake-unrelated words), and Scalp ERP datum showed there have significant differences in the resilient and PTSD survivors in N1. In PTSD group, DRW elicited a more negative ERP deflection than did EUW in P2, then elicited a more negative ERP deflection than did RRW (rescue-related words) and EUW in the 230-370 ms. In the subliminal priming test (Study 2b), the stimulus elicited different ERP deflection in the PTSD group, DRW elicited a more positive ERP deflection than did EUW in P2, then elicited a more negative ERP deflection than did RRW and EUW in P3. The result of Study 2 indicated that the automatic process of earthquake-related words was found in the PTSD group, not in the Resilient group.In Study 3, emotional Stroop test was adopted to explore the implicit emotion of the resilient college students. In Study 3a, the valence, arousal, dominance and familiarity of emotional words were appraised by 65 undergraduates.267 emotional words were selected from the dictionary, which represent the state of experienced emotion, such as happy, fear, sadness. The results showed that the emotional words were cognized by the valence, arousal, dominance and familiarity dimensions, and the valence of emotional words consisted of positive and negative dimension. In the modified Stroop test (Study 3b), the behavioral data showed that the longer RTs for negative words than that of positive words in the Resilient group, and the longer RTs for positive-low arousal words than that of positive-high arousal words in the PTSD group. Scalp ERP datum showed positive words elicited a more positive ERP deflection than did negative words in P2, N2, LPP (360-450ms) in the Resilient group, and positive-low arousal words elicited a more positive ERP deflection than did positive-high arousal words in LPP. Dipole source analysis of the difference wave (positive words-negative words) showed that a generator of N2 was localized in the anterior cingulated gyrus, and a generator of P360-450 was localized in the caudate body of striatum. The result of Study 3 indicated that the PTSD individuals experienced more positive emotion both in explicit and implicit emotion state. Study 4 aimed to investigate the implicit attitude to cognitive reappraisal strategy (CR) and expression suppression strategy (ES) (Study 4a), and the individual difference in the voluntary emotion regulation process under cognitive reappraisal strategy, expression suppression strategy and see condition (Study 4b). In Study 4a, the result of the implicit association test (IAT) showed that, although the behavioral data indicated that all participants responded relatively rapidly in the congruent condition than the incongruent condition, the ERP data indicated the congruent condition (cognitive reappraisal strategy and positive target words) elicited a more negative component at N2, LPP than the incongruent condition (cognitive reappraisal strategy and negative target words) in the PTSD group. In Study 4b, the results showed that there had significant differences between the Resilient group and PTSD group in the cognitive reappraisal strategy; there was significant differences in the valence of earthquake pictures under the expression suppression strategy and see condition in the Resilient group, and under the cognitive reappraisal strategy, the expression suppression strategy and see condition in the PTSD group; the ERP data showed that the cognitive reappraisal and expression suppression condition elicited a more negative deflection in N2 than the see condition in the PTSD group. Dipole source analysis of the difference wave (CR-See; ES-See) both showed that a generator was localized in the cingulated gyrus. The result of Study 4 showed that the resilient undergraduates were inclined to use the cognitive reappraisal strategy, making negative emotion and cognitive conflict subdued.In conclusion, the resilient survivors are different from college students with PTSD: they have no cognitive bias to earthquake-related words, have explicit and implicit positive emotion, and give priority to cognitive reappraisal strategy to modulate the stress responses. Such cognitive and emotional characteristics of the resilient survivors were close related to resilience.

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