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

项目摘要/摘要。美国约有1400万女性将患上创伤后 在身体或性侵犯或虐待(人际创伤)后的一生中的应激障碍(PTSD [IPT]))。创伤后羞耻感--一种源于创伤后对自我的苛刻态度的情绪--是 对于许多女性来说，这是IPT后创伤后应激障碍的核心。然而，关于频率、强度、稳定性和触发因素的知识 有IPT病史的女性在日常生活中缺乏羞耻感。此外，尽管羞愧和内疚(一种情感 由对自己行为的负面情绪定义)由研究人员单独研究，没有任何工作进行评估 有IPT病史的女性是否会做出类似的区分，并将羞耻和内疚视为不同 影响他们从IPT中恢复。虽然一些研究已经开始探索特定于羞耻的情绪调节 (呃)，或旨在改变情绪反应以满足特定目标的过程，目前尚不清楚哪些-如果 任何-ER策略在减少羞愧的频率或强度方面都是有效的。其他可能影响 创伤后羞耻感调节--包括急诊室策略的感知有效性、急诊室目标和创伤后应激障碍 严重性--也有待探索。解决这些差距可以加强对羞耻感和 创伤后应激障碍。该项目将使用顺序混合方法设计来探索1)日常体验 创伤后羞耻感(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； 随着时间的变化；以及区分羞耻和内疚的因素)和2)创伤后羞耻的调节 (包括急诊室策略的使用、感知有效性和适应性以及创伤后应激障碍症状和 ER在羞耻规则中的目标)。这两个目标都将进行定量评估(研究1)和定性评估(研究2)。 研究1将对获得的羞耻感和ER的生态瞬时评估数据进行二次分析 每天5次，连续14天，来自60名有IPT病史和不同程度创伤后应激障碍症状的女性。研究2 将对20-35名女性进行关于创伤后羞耻感的体验和调节的定性访谈 有IPT的历史。预计更高的创伤后应激障碍症状预示着更高的随后的羞耻感， 羞耻感预示着更频繁的沉思、情绪压抑、分心和较少的情绪。 在人内和跨天分享、情感反思和重新评价。羞耻与羞耻的关系 在有更严重创伤后应激障碍症状的女性中，急诊室策略预计会更强，并相反 模型(ER预测羞耻)将进行测试。关于诱因的主题，羞耻和内疚的区别， 羞耻的后果以及创伤后应激障碍症状的作用是可以预料的，新的主题可能会出现。更大 了解创伤后羞耻感的体验和规律有助于提高羞耻感的治疗效果 以及有IPT病史的女性的创伤后应激障碍，这将是推动PI研究的关键。这笔培训补助金 将促进PI迈向独立的、由赠款资助的研究生涯，审查 有IPT病史的女性创伤后应激障碍的情绪脆弱性。

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.