loss, trauma, and resilience - rehpa loss, and trauma_by george bonanno pavi 25... · driven by the...
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Frequency of stressors across 4 years of college - weekly on-line survey - 50 events from 4 categories
. . . frequently
Lalande & Bonanno (2011) Psychological Trauma
Driven by the poignancy and cost of these events, both clinical and scientific inquiry has focused primarily on psychological damage 1.Psychopathology 2.Average impact of the event itself
But . . . the picture is incomplete
Two Common Approaches
Bonanno (2004) American Psychologist; Bonanno, Westphal, & Mancini (2011) Annual Review Clinical Psychology
1. Focus on extreme: psychopathology • chronic grief and depression (10%-65%) • Posttraumatic Stress Disorder (PTSD) (5%-90%)
• Limitations – Emphasis on pathology can result in sampling bias
The limits of diagnoses and the problem of averages
Bonanno (2004) American Psychologist; Bonanno, Westphal, & Mancini (2011) Annual Review Clinical Psychology
1. Focus on extreme: psychopathology • chronic grief and depression (10%-65%) • Posttraumatic Stress Disorder (PTSD) (5%-90%)
• Limitations – Emphasis on pathology exacerbates sampling bias – Uninformative about the underlying distribution
The limits of diagnoses and the problem of averages
Bonanno (2004) American Psychologist; Bonanno, Westphal, & Mancini (2011) Annual Review Clinical Psychology
PTE
Chronic Psychopathology (PTSD, MDD, etc.)
1 year 2 years
Hea
lth
p
atho
logy
Non-psychopathology?
?
?
?
1. Focus on extreme: psychopathology – chronic grief and depression (10%-65%) – Posttraumatic Stress Disorder (PTSD) (5%-90%)
2. Focus on average: impact of the event • Compare groups exposed vs. non-exposed • Compare across different types of events
The Limits of diagnoses and the problem of averages
Bonanno (2004) AP; Bonanno, Westphal, & Mancini (2011) ARCP
• Averages are potentially misleading – often mistaken for mode – may be driven by extreme groups
• The problem with averages is that they . . . • “average out the interesting effects”
– (Bloembergen & Zewail, 1984, Journal of Physical Chemistry)
• “often do not describe reality at all” – (Banholzer, 2010, Research Technology Management)
• “are misleading” – (Parkinson, 1989, Climate Dynamics; B. F. Skinner, Journal of General
Psychology, 1936; Nissan & Shahmoon, 1993, Journal of Economics and Finance; Gaut et al., 2007, Nature Reviews, Genetics; Boyd, 1984 and Haigh, 1994; Mathematical Gazette; Day, 2008, Business Law Brief; Gregson et al, 1993, Biological Psychiatry . . . . . . . )
• can mask changes in the majority – (Casselli & Cunningham, 2009; Oxford Economic Papers)
• Averages are curious statistics that are meant to make
poor people happy. Averages tell us you will eat at least one chicken a year. But if you can’t afford a chicken, don’t worry; someone else will eat two
– paraphrased from La Statistica by Trilussa*
• "I really don't trust statistics much. A man with his head
in a hot oven and his feet in a freezer has statistically an average body temperature ”
– Charles Bukowski
* Paraphrased from archaic Italian by Antonio Malgaroli
PTE
1 year 2 years
Hea
lth
p
atho
logy
Average response
Psychopathology
? Super-coper? Pathological?
A broader approach: 20 years of mapping heterogeneity
• Part I: Identifying trajectories of outcome
�Bonanno et al., (1995) JPSP; Bonanno et al. (2002) JPSP; Bonanno (2004) American Psychologist
PTE
Chronic 5-30%
1 year 2 years
Hea
lth
p
atho
logy
modal response Recovery 15-25%
Delayed 0-15%?
Resilience 55-65%
A broader approach: Mapping heterogeneity
• part I: Identifying trajectories of outcome – Limitations:
• Unsophisticated (“by hand” or primitive algorithm) • Theory driven • Not sensitive to parameters of heterogeneity
Changing Lives of Older Couples (CLOC): A prospective study
• 1,532 married individuals from Detroit area • 205 lost a spouse during the 7-year course of
the study, – interviewed prior to bereavement (on average 3
years pre-loss), – Interviewed at least twice after bereavement (6 and
18 months post-loss).
Bonanno, Wortman et al. (2002). JPSP
-1
-0.5
0
0.5
1
1.5
2
2.5D
epre
ssio
n (C
ESD
)
Bonanno et al. (2002). JPSP
3 yrs pre-loss
6 mo. post-loss 18 mo. post-loss
Resilience
Depressed-Improved
Recovery
Chronic grief
Chronic depression
9% 17%
11% 12% 45%
-1
-0.5
0
0.5
1
1.5
2
2.5D
epre
ssio
n (C
ESD
)
3 yrs pre-loss
6 mo. post-loss 18 mo. post-loss
Resilience
Depressed-Improved
Recovery
Chronic grief
Chronic depression
9% 17%
11% 12% 45%
Bonanno et al. (2002). JPSP
-1
-0.5
0
0.5
1
1.5
2
2.5D
epre
ssio
n (C
ESD
)
3 yrs pre-loss
6 mo. post-loss 18 mo. post-loss
Resilience
Depressed-Improved
Recovery
Chronic grief
Chronic depression
9% 17%
11% 12% 45%
Bonanno et al. (2002). JPSP
-1
-0.5
0
0.5
1
1.5
2
2.5D
epre
ssio
n (C
ESD
)
3 yrs pre-loss
6 mo. post-loss 18 mo. post-loss
Resilience
Relief
Recovery
Chronic grief
Chronic depression
9% 17%
11% 12% 45%
56%
Bonanno et al. (2002). JPSP
A broader approach: Mapping heterogeneity
• part I: Identifying trajectories of outcome – Limitations:
• Unsophisticated (“by hand” or primitive algorithm) • Theory driven • Not sensitive to parameters of heterogeneity
• part II: Latent trajectory modeling
Posttraumatic stress
Posttraumatic stress/ grief
Normality and Homogeneity
- assumption that data should be normal - most conventional statistical approaches require normality
Posttraumatic stress Posttraumatic stress/grief
PTSD/CG
resilience
Positive skew with arbitrary cut-offs
Posttraumatic stress/grief
Heterogeneity Latent Growth Mixture Modeling (LGMM): unique distributions: trajectories with random effects
Clark et al. (2008)
German Panel Data Nationally representative sampling of German Households followed 19 years (1984-2003) N = 16,795 DV = life satisfaction EVENTS: unemployment layoff marriage divorce death of spouse birth of child Clark, Diener et al. (2008) The Economic Journal
Clark et al. (2008) Mancini, Bonanno, & Clark (2011) J Individual Diffs
bereavement Widowhood (4 latent growth trajectories)
58.7%
21.0%
Years before and after loss
4.4% 15.9%
Divorce (3 latent growth trajectories)
Years before and after divorce Mancini, Bonanno, & Clark (2011) J Individual Diffs
9.1% 71.8%
19.1%
PARENTHOOD
Increasing 4.3%
Galatzer-Levy, Murzursky, Mancini, & Bonanno (2011). Journal of Family Psychology
Stable high 84.2%
Decreasing 7.2% Stable low 4.2%
Traumatic injury (US) • 330 men and women • Single-incident traumatic injury (motor vehicle
crash, fall, gun-shot) • Taken to level 1 trauma center • required emergency surgery • PTSD and depression
– Hospitalization – 1 month – 3 months – 6 months
DeRoon-Cassini, Mancini, Rusch, & Bonanno (2010) Rehabilitation Psychology
Spinal Cord Injury
• 233 SCI patients recruited from spinal cord centers in England, Switzerland, Sweden, Germany, Austria, and Ireland.
• Data collected soon after injury and at 3 months, 12 months, and 24 months
Bonanno, Kennedy, Galatzer-Levy, Lude, & Elfstrom (2012), Rehabilitation Psychology
Bonanno, et al. (2012), Rehab Psych
Depression at hospitalization, 3, 12, and 24 months post-injury
Population norm 3.5 Haug et al (2004)
Bonanno et al., (2012), Rehab Psych
Anxiety at hospitalization, 3, 12, and 24 months post-injury
Population norm = 3.9 Haug et al (2004)
2008 NIU mass shooting (n = 660)
Orcutt, Bonanno, Hanna, Miron (2014) Journal of Traumatic Stress
Pre- 27 days 6 mo. 12 mo. 18 mo. 24 mo. 30 mo.
The Psychological Cost of War
• The Millennium Cohort Study (Tyler Smith et al.) – Prospective, with pre- and post-deployment data – Large pool (Ongoing enrollment targets 140,000;
77,047 enrolled in initial panel, 30% deployed) – Confidential/anonymous
Bonanno & Geraci (2013)
Flexibility During and After Combat Deployment
Prospective study of US army soldiers deployed in Afghanistan
81.5%
7.3%
11.2%
base deployment 6 mo. 12 mo. 18 mo.
Bereavement Bonanno et al. (1995, 1999)
bereavement Bonanno et al. (2002, 2004)
bereavement Galatzer-Levy & Bonanno (2012)
bereavement Mancini et al. (2011)
Terrorist attack (9/11) Bonanno et al. (2005)
Terrorist attack (9/11) Bonanno et al. (2006, 2007)
SARS (bio-disaster) Bonanno et al. (2008)
Traumatic injury deRoon-Cassini et al. (2010)
Breast cancer surgery Lam et al. (2010)
Mass shooting Orcutt et al. (2013)
Job loss Galatzer-Levy et al. (2010)
divorce Mancini et al. (2011)
Birth of a child Galatzer-Levy et al. (2011)
Combat deployment Bonanno et al. (2012)
Spinal cord lesion Bonanno et al. (2012)
Resilient Chronic
Bereavement 53% 14% Bonanno et al. (1995, 1999)
bereavement 56% 17% Bonanno et al. (2002, 2004)
bereavement 66% 14% Galatzer-Levy & Bonanno (2012)
bereavement 59% 21% Mancini et al. (2011)
Terrorist attack (9/11) * 35% 29% Bonanno et al. (2005)
Terrorist attack (9/11) 56% 6% Bonanno et al. (2006, 2007)
SARS (bio-disaster) * 35% 42% Bonanno et al. (2008)
Traumatic injury 61% 21% deRoon-Cassini et al. (2010)
Breast cancer surgery 66% 15% Lam et al. (2010); Burton et al (2014)
Mass shooting 62% 8% Orcutt et al. (2013)
Job loss 69% 4% Galatzer-Levy et al. (2010)
divorce 72% 19% Mancini et al. (2011)
Birth of a child 84% 7% Galatzer-Levy et al. (2011)
Combat deployment 83% 7% Bonanno et al. (2012)
Spinal cord lesion 53% 12% Bonanno et al. (2012)
Resilient Chronic
Resilience and positive adjustment • Absence of symptoms and distress • Subjective well-being and life satisfaction • Level of mental health and functioning
– Less cortisol dysregulation (diurnal profile)(Ong et al., 2011)
• Positive adjustment as rated confidentially by close friends-relatives – Bereaved partners (Bonanno et al., 2005)
– High-exposure survivors of 9/11 (Bonanno et al., 2005).
• Positive emotion and experiences – Positive body image after cancer surgery (Lam et al., 2012)
– Comfort from positive memories of deceased (Bonanno et al., 2004)
A broader approach: Mapping individual differences
• phase I: Identifying trajectories of outcome • phase II: Latent trajectory modeling • phase III: Predictors
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice, shared cultural norms) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – distal exposure (loss of economic, personal, or health resources) – Reduced search for meaning, worry, rumination – Reduced ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (age, gender, education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Representative sample of New Yorkers first 6 months after 9/11 (N = 2752)
Bonanno, Galea et al. (2006, 2007) Psychological Science; JCCP
Representative sample of New Yorkers first 6 months after 9/11 (N = 2752)
Bonanno, Galea et al. (2006, 2007) Psychological Science; JCCP
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (age, gender, education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatoryflexiblity
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatoryflexiblity
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatoryflexiblity
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
* Resources * – Conservation of Resources (COR) theory (Hobfoll,
1998, 2002)
– Resources help buffer the impact of adversity • Material: income, financial reserves • Work: employment, possibility of livelihood • Energy (health): absence of disease, health insurance,
availability of care • Interpersonal: Social support, affinity groups
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatoryflexiblity
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Optimism
• Expectation of positive events in the future when there is no evidence to support those expectations (Scheier & Carver, 1985; Carver et al., 2010)
• Trait optimism: – General health and well-being: proactive health-
related coping (Carver et al., 2010, Clinical Psychology Review).
– Neural mechanism: imagining positive future events associated with amygdala and rostral anterior cingulate; greater in trait optimism (Sharot et al. 2007, Nature)
Optimism and depression before and after a heart attack
Galatzer-Levy & Bonanno (2014)
63.8%
17.6%
9.9%
8.7%
increased mortality
Baseline optimism: “In future, likely that I will . . .”
+ “live past 75” + “leave inheritance -“see double-digit inflation
Controlling for income
heart attack
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatoryflexiblity
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Bonanno,Kennedy, Galatzer-Levy, Lunde, & Elfstrom (2012), Rehab Psych
Depression, Anxiety and Spinal Cord Lesion
Population norm 3.5 Haug et al (2004)
Challenge (vs. threat) appraisals (adjectives)
Multiple, unique predictors with small effect sizes • Pre-event context
– Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – loss of resources (economic, personal, or health) – search for meaning, worry, rumination – ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
Regulatory Flexibility
• Theories of coping and emotion regulation emphasize their dynamic nature (Cole, Lazarus, Folkman, Gross et al…..)
– Person-situation interaction – “fit” with shifting nature of situational demands
• in practice, we tend toward static categorization of strategies as adaptive (e.g., reappraisal, finding meaning) or maladaptive (e.g., avoidance, suppression)
• “Fallacy of uniform efficacy” (Bonanno & Burton, 2013)
Bonanno, 2012, Memory; Bonanno et al. 2004, Psych Science; Bonanno & Burton, 2013, Perspectives
Costs and benefits in nature
• There is no such thing as a perfect adaptation • Every adaptation in nature has both benefits and
costs • the peacock’s colorful tail
Costs and benefits in nature
• There is no such thing as a perfect adaptation • Every adaptation in nature has both benefits and
cost • the Cheetah’s speed
Context sensitivity Repertoire Feedback
Evaluate demands and opportunities
Select regulatory strategy
Monitor and modify as needed
Maintain strategy
Cease strategy
Adjust strategy
Select a new strategy
stre
ssor
Re-evaluate demands and opportunities
Bonanno & Burton (2013), Perspectives on Psychological Science
What is happening? What do I need to do? What am I able to do? Is it working?
Context sensitivity Repertoire Feedback
Evaluate demands and opportunities
Select regulatory strategy
Monitor and modify as needed
Maintain strategy
Cease strategy
Adjust strategy
Select a new strategy
S
tres
sor
Re-evaluate demands and opportunities
INDIVIDUAL DIFFERENCES
Coifman & Bonanno (2010) JAP, Gupta & Bonanno (2011), JAP; Burton et al., (2012) Depress &Anxiety
Emotion Context Sensitivity • Emotions are functional . . evolved as solutions to
specific threats and opportunities • The functions of emotions are “context bound” (Cole et al.,
1994)
• Match between contextual demands and specific functions of an emotion facilitates adaptation
sadness
match adaptive benefits
• Attention inward • Facilitates reframing • Evokes
sympathy/care from others
Emotion functions
Emotion Context Sensitivity • Emotions are functional . . evolved as solutions to
specific threats and opportunities • The functions of emotions are “context bound” (Cole et al.,
1994)
• Match between contextual demands and the specific functions of an emotion facilitates adaptation
Emotion functions
mismatch maladaptive
anger
• prepares to physically defense the self
• signals to warn off others
Emotion Context Insensitivity and Psychopathology
• Depression (MDD) – Report more sadness overall, but do not vary sadness
across contexts (e.g., sad versus other films) – Context sensitivity in former depressed predicted less
likelihood of relapse
Rottenberg et al., 2002, 2005 , Emotion, JAP
Emotion Context Insensitivity and Psychopathology
• Complicated Grief (CG) – Less context sensitivity across interview and film tasks – Evidence of context sensitivity early in bereavement
predicted reduced depressive symptoms later in bereavement
– Context insensitivity limited primarily to expression
Coifman & Bonanno, 2010, JAP Bullock & Bonanno, 2012, JEP Diminich & Bonanno, 2014, JAP
Expressive Flexibility
1
2
3
4
5
6
7
Enhancement Suppression control
Expressive regulation condition
Affe
ct ra
tings
• View evocative photos on computer, rate emotion • “Person in other room will try to guess your emotion” • Three within-subjects conditions
Bonanno et al., 2004, Psych Science
1
2
3
4
5
6
7
Enhancement Suppression control
expressed emotion (observer ratings)
Expressive regulation condition
Affe
ct ra
tings
Expressive enhancement ability enhancement – no monitor (control)
Suppression ability No monitor (control) -- suppression
expressive flexibility (EF) and adjustment
• NYC freshmen beginning college just days before the September 11th terrorist attack.
9/11
W1 distress
2003 2001 2002
W2 distress
EF task Expression ability * Suppression ability *
Flexibility score*
Difference (polarity) ns
Bonanno et al., 2004, Psych Science
Estim
ated
Mar
gina
l Mea
ns4.5
4.0
3.5
3.0
2.5
2.0
1.5
Estimated Marginal Means of MEASURE_
Married asymptomatic Complicated bereaved grief
Expression condition
Control condition
Suppression condition
Expressive Flexibility and Complicated Grief
Cod
ed e
xpre
ssio
n of
em
otio
n
Gupta & Bonanno (2011) Journal of Abnormal Psychology
Multiple, unique predictors with small effect sizes • Pre-event context
– Demographic factors (older, male, greater education) – Preparation and prior exposure – Economic resources (employment, income). – Beliefs (acceptance of death, justice, shared cultural norms) – Social resources (support, social network) – Personality (trait self-enhancement, optimism, hardiness, coping self-
efficacy, perceived control, etc). – Genetic disposition (G X E)
• Proximal exposure – Witnessing death, serious injury to others – Objective danger to self – Extent of loss (death, loss of property)
• The aftermath (distal exposure) – distal exposure (loss of economic, personal, or health resources) – Reduced search for meaning, worry, rumination – Reduced ongoing stress – Coping and appraisal – Positive emotion and regulatory flexibility
Bonanno et al., (2010). PSPI; Bonanno et al., (2011), Annual Review of Clinical Psych
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