The Experience and Regulation of Posttraumatic Shame among Women with Histories of Interpersonal Trauma

项目概要/摘要。在美国，大约有1400万女性会患上创伤后 在他们的一生中，在身体或性攻击或虐待（人际创伤）之后， [IPT]）。创伤后羞耻--一种源于创伤后对自我的苛刻态度的情绪--是一种 创伤后应激障碍的核心然而，对频率、强度、稳定性和触发因素的了解， 在日常生活中，有IPT病史的妇女缺乏羞耻感。此外，虽然羞耻和内疚（一种情绪） 定义为对自己行为的负面感受）由研究人员单独研究，没有工作评估 是否有IPT病史的女性也能做出类似的区分，并将羞耻和内疚视为不同的 影响其从IPT中恢复。虽然一些工作已经开始探索特定的情绪调节 (ER)，或旨在改变情绪反应以达到特定目标的过程，仍然不清楚如果 任何- ER策略都能有效降低羞耻感的频率或强度。其他可能影响 创伤后羞耻调节-包括ER策略的感知有效性，ER的目标和PTSD 严重性-也有待探讨。解决这些差距可以加强对羞耻感的治疗， 创伤后应激障碍本专题将采用序贯混合方法设计，探讨1） 创伤后羞耻（包括触发因素;频率、强度和稳定性;与创伤后应激障碍症状的关系; 随着时间的推移而变化;区分羞耻和内疚的因素）和2）创伤后羞耻的调节 （包括ER策略的使用、感知有效性和适应性，以及PTSD症状和 羞耻调节中的ER目标）。将对这两个目标进行定量（研究1）和定性（研究2）评估。 研究1将涉及二次分析的生态瞬时评估数据的耻辱和ER获得 每天5次，持续14天，来自60名有IPT病史和不同程度PTSD症状的女性。研究2 将对20-35名妇女进行定性访谈，探讨创伤后羞耻的经历和调节 具有IPT历史。据估计，较高的PTSD症状将预示着较高的后续羞耻感， 羞耻感会预测更频繁的沉思、情绪抑制和分心以及更少的情绪 分享、情感反思和重新评价。羞耻感与 在PTSD症状更严重的女性中，ER策略预计会更强， 模型（ER预测羞耻）将被测试。关于触发因素的主题，羞耻和内疚之间的区别， 羞耻的后果，以及创伤后应激障碍症状的作用是预期的，新的主题可能会出现。更大 了解创伤后羞耻的经历和调节可以改善羞耻的治疗 和创伤后应激障碍的妇女与IPT的历史，并将是关键，以推进PI的研究。培训补助金 将促进PI的发展，使其成为一个独立的、由赠款资助的研究职业， 有创伤后应激障碍病史的女性中创伤后应激障碍的情感脆弱性

Project Summary/Abstract. Approximately 14 million women in the United States will develop posttraumatic stress disorder (PTSD) during their lifetime following physical or sexual assault or abuse (interpersonal trauma [IPT]). Posttraumatic shame – an emotion stemming from harsh attitudes about the self after trauma – is central to PTSD for many women post-IPT. Yet, knowledge of the frequency, intensity, stability, and triggers of shame in the daily lives of women with IPT histories is lacking. Further, though shame and guilt (an emotion defined by negative feelings about one’s actions) are studied separately by researchers, no work has assessed whether women with IPT histories make similar distinctions and see shame and guilt as differentially influencing their recovery from IPT. While some work has begun to explore shame-specific emotion regulation (ER), or processes aimed at changing emotional responses to meet specific goals, it remains unclear which – if any – ER strategies are effective in reducing the frequency or intensity of shame. Other factors likely to shape posttraumatic shame regulation – including perceived effectiveness of ER strategies, goals of ER, and PTSD severity – also have yet to be explored. Addressing these gaps could strengthen treatments for shame and PTSD. This project will use a sequential mixed methods design to explore 1) daily experiences of posttraumatic shame (including triggers; frequency, intensity, and stability; relations to PTSD symptoms; changes over time; and factors distinguishing shame from guilt) and 2) regulation of posttraumatic shame (including use, perceived effectiveness, and adaptiveness of ER strategies and roles of PTSD symptoms and ER goals in shame regulation). Both aims will be assessed quantitatively (Study 1) and qualitatively (Study 2). Study 1 will involve secondary analysis of ecological momentary assessment data on shame and ER obtained 5 times per day for 14 days from 60 women with IPT histories and varying levels of PTSD symptoms. Study 2 will involve qualitative interviews on the experience and regulation of posttraumatic shame with 20-35 women with IPT histories. It is expected that higher PTSD symptoms will predict higher subsequent shame and that shame will predict more frequent rumination, emotion suppression, and distraction and less frequent emotion sharing, emotional reflection, and reappraisal within persons and across days. Relations between shame and ER strategies are expected to be stronger among women with more severe PTSD symptoms, and reverse models (ER predicting shame) will be tested. Themes regarding triggers, distinctions between shame and guilt, consequences of shame, and the role of PTSD symptoms are expected and new themes may emerge. Greater understanding of the experience and regulation of posttraumatic shame could improve treatments for shame and PTSD among women with IPT histories and will be key to advancing the PI’s research. This training grant will facilitate the PI’s progression toward an independent, grant-funded research career examining the role of emotional vulnerabilities in PTSD among women with IPT histories.