The Korean Journal of Health Psychology
- KOREAN
- P-ISSN1229-070X
- E-ISSN2713-9581
- KCI
The Moderation Effect of Attention Control on the Relationship between Post-Traumatic Stress Symptoms and Intrusive Rumination
Abstract
Attention control in known to be a protective factor against attentional bias for threat stimuli. This study examined the role it plays in the relationship between post-traumatic stress symptoms (PTSS) and intrusive rumination. To this end, a total of 276 students from a university located in Gyeongnam completed a self-report survey. The questionnaire included an Impact of Event Scale-Revised, an Event Related Rumination Inventory, an Attention Control Questionnaire, and a State-Trait Anxiety Inventory. The final analysis was conducted on the data from 189 students who experienced a trauma event rated as being shocking, fearful, and helpless. The Process macro for SPSS was used to analyze the moderation effect. As a result, the moderating effect of attention control was significant in the relationship between sleep disturbance/emotional dullness and dissociation and intrusive rumination. Attention control worked as the protective factor in the relationship between these PTSS and intrusive rumination. The analysis of the relationship between other PTSS (e.g. hyperarousal, avoidance, and intrusive symptoms) and intrusive rumination in the range of attention control using the Johnson-Neyman technique revealed that there was a region in which the significance of the relationship changes. Specifically, the hyperarousal symptom in a group above 3.70% of attention control was not significantly related to intrusive rumination. Furthermore, the avoidance symptom in a group above 29.63% of attention control was not significantly related to intrusive rumination either. These results suggest that improving attention control may be useful in mitigating PTSS and intrusive rumination.
- keywords
- 외상 후 스트레스 증상, 침습적 반추, 주의조절력, 수면장애/정서적 둔마 및 해리, Posttraumatic stress symptoms, Intrusive rumination, Attention control, Sleep disturbance/emotional dullness and dissociation
Reference
구훈정, 이종선 (2016). 소방대원들의 외상 후 스트레스증상에 미치는 인구통계, 직무특성 및 심리사회 요인들. 한국심리학회지: 일반, 35(1), 65-88.
송승훈, 이홍석, 박준호, 김교헌 (2009). 한국판 외상후성장 척도의 타당도 및 신뢰도 연구. 한국심리학회지: 건강, 14(1), 193-214.
안현의, 주혜선, 민지원, 심기선 (2013). 한국판 사건관련 반추 척도(K-ERRI)의 타당화. 인지행동치료, 13(1), 149-172.
윤선아, 김현택, 최준식 (2007). 주의력조절 척도의 신뢰도 및 타당화 연구. 한국심리학회지: 임상, 26(1), 185-199.
은헌정, 권태완, 이선미, 김태형, 최말례, 조수진 (2005). 한국판 사건충격척도 수정판의 신뢰도 및 타당도연구. 신경정신의학, 44(3), 303-310.
이강희, 윤선아, 김세영, 이태호, 김기성, 김현택 (2009). 개인의 주의조절 수준에 따른 정서정보처리를 위한뇌활동의 차이. 한국심리학회지: 일반, 28(1), 83-101.
이동훈, 이수연, 윤기원, 김시형, 최수정 (2017). 성별에따른 외상사건 경험이 PTSD 증상 및 외상 후 성장과의 관계에 미치는 영향. 한국심리학회지: 상담및 심리치료, 29(1), 227-253.
전겸구, 김교헌 (1991). 대학생용 생활 스트레스 척도의개발: 제어이론적 접근. 한국심리학회지: 임상, 10(1), 137-158.
정선호, 서동기 (2016). 회귀분석을 이용한 매개된 조절효과와 조절된 매개효과 검증 방법. 한국심리학회지: 일반, 35(1), 257-282.
주혜선, 민지원, 안현의 (2013). 외상 사건관련 침습적반추는 재경험 증상과 구별되는가? 한국심리학회 연차 학술발표논문집, 2013(1), pp.284-284. 8월 23일. 대전: 컨벤션센터 1층 전시실.
주혜선, 안현의 (2008). 외상후 위기 체크리스트: 개발및 타당화 연구. 한국심리학회지: 일반, 27(1), 235-257.
최현정 (2015). ‘PTSD 시대’의 고통 인식과 대응: 외상회복의 대안 패러다임 모색. 인지과학, 26(2), 167-207.
한덕웅, 이장호, 전겸구 (2000). Spielberger. 상태-특성불안검사 YZ 형 실시와 사용설명서. 서울: 학지사.
함진선, 이장한 (2012). 특질 불안 경향자의 위협자극에대한 주의편향연구: 안구운동 추적장비를 이용하여. 한국심리학회지: 임상, 31(1), 355-371.
Aiken, L. S., West, S. G., & Reno, R. R. (1991). Multiple regression: Testing and interpreting interactions. New York: Sage.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Babson, K. A., & Feldner, M. T. (2010). Temporal relations between sleep problems and both traumatic event exposure and PTSD: a critical review of the empirical literature. Journal of Anxiety Disorders, 24(1), 1-15.
Bardeen, J. R., Fergus, T. A., & Orcutt, H. K. (2015). Attentional control as a prospective predictor of posttraumatic stress symptomatology. Personality and Individual Differences, 81, 124-128.
Bardeen, J. R., & Orcutt, H. K. (2011). Attentional control as a moderator of the relationship between posttraumatic stress symptoms and attentional threat bias. Journal of anxiety disorders, 25(8), 1008-1018.
Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & Van Ijzendoorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: a metaanalytic study. Psychological Bulletin, 133(1), 1-24.
Baron, R. M., & Kenny, D. A. (1986). The moderator –mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of personality and social psychology, 51(6), 1173.
Bennett, H., & Wells, A. (2010). Metacognition, memory disorganization and rumination in posttraumatic stress symptoms. Journal of Anxiety Disorders, 24(3), 318-325.
Bomyea, J., & Amir, N. (2011). The effect of an executive functioning training program on working memory capacity and intrusive thoughts. Cognitive Therapy and Research, 35(6), 529-535.
Bomyea, J., & Lang, A. J. (2016). Accounting for intrusive thoughts in PTSD: Contributions of cognitive control and deliberate regulation strategies. Journal of Affective Disorders, 192, 184-190.
Borders, A., Rothman, D. J., & McAndrew, L. M. (2015). Sleep problems may mediate associations between rumination and PTSD and depressive symptoms among OIF/OEF veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 76.
Brewin. C. R., & Beaton, A. (2002). Thought suppression, intelligence, ad working memory capacity. Behaviour Research & Therapy, 40(8), 923-930.
Brewin, C. R., & Smart, L. (2005). Working memory capacity and suppression of intrusive thoughts. Journal of Behavior Therapy and Experimental Psychiatry, 36(1), 61-68.
Cann, A., Calhoun, L. G., Tedeschi, R. G., Triplett, K. N., Vishnevsky, T., & Lindstrom, C. M. (2011). Assessing posttraumatic cognitive processes: The event related rumination inventory. Anxiety, Stress, & Coping, 24(2), 137-156.
Chan, M. W., Ho, S. M., Tedeschi, R. G., & Leung, C. W. (2011). The valence of attentional bias and cancer related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer. Psycho-Oncology, 20(5), 544-552.
Dagan, Y., Lavie, P., & Bleich, A. (1991). Elevated awakening thresholds in sleep stage 3–4 in war-related post-traumatic stress disorder. Biological Psychiatry, 30(6), 618-622.
De Lissnyder, E., Koster, E. H. W., Goubert, L., Onraedt, T., Vanderhasselt, M. A., & De Raedt, R. (2012). Cognitive control moderates the association between stress and rumination. Journal of Behavior Therapy and Experimental Psychiatry, 43, 519-525.
Derryberry, D., & Reed, M. A. (2002). Anxiety-related attentional biases and their regulation by attentional control. Journal of Abnormal Psychology, 111(2), 225-236.
Derryberry, D., & Rothbart, M. K. (1997). Reactive and effortful processes in the organization of temperament. Development and psychopathology, 9(4), 633-652.
Deykin, E. Y., Keane, T. M., Kaloupek, D., Fincke, G., Rothendler, J., Siegfried, M., & Creamer, K. (2001). Posttraumatic stress disorder and the use of health services. Psychosomatic Medicine, 63(5), 835-841.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behavior Research and Therapy, 38(4), 319-345.
Ehring, T., Frank, S., & Ehlers, A. (2008). The role of rumination and reduced concreteness in the maintenance of posttraumatic stress disorder and depression following trauma. Cognitive Therapy and Research, 32(4), 488–506.
Eldar, S., & Bar-Haim, Y. (2010). Neural plasticity in response to attention training in anxiety. Psychological Medicine, 40, 667-678.
Eysenck, M. W., & Derakshan, N. (2011). New perspectives in attentional control theory. Personality and Individual Differences, 50, 955-960.
Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance:attentional control theory. Emotion, 7(2), 336-353.
Golby, J., & Sheard, M. (2004). Mental toughness and hardiness at different levels of rugby league. Personality and Individual Differences, 37, 933-942.
Hagenaars, M. A., & Putman, P. (2011). Attentional control affects the relationship between tonic immobility and intrusive memories. Journal of Behavior Therapy and Experimental Psychiatry, 42(3), 379-383.
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis. A Regression-Based Approach. New York: Guilford Press.
Hayes, A. F., Glynn, C. J., & Huge, M. E. (2012). Cautions regarding the interpretation of regression coefficients and hypothesis tests in linear models with interactions. Communication Methods and Measure, 6(1), 1-11.
Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41(3), 924-936.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41(3), 209-218.
Johnson, P. O., & Neyman, J. (1936). Tests of certain linear hypotheses and their application to some educational problems. Statistical Research Memories, 1, 57-93.
Judah, M. R., Grant, D. M., Mills, A. C., & Lechner, W. V. (2014). Factor structure and validation of the attentional control scale. Cognition &Emotion, 28(3), 433-451.
Kazak, A. E., Barakat, L. P., Meeske, K., Christakis, D., Meadows, A. T., Casey, R., ... Stuber, M. L. (1997). Posttraumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers. Journal of Consulting and Clinical Psychology, 65(1), 120-129.
Keele, S. W., & Hawkins, H. H. (1982). Explorations of individual differences relevant to high level skiil. Journal of Motor Behavior, 14, 3-23.
Kubany, E. S., Leisen, M. B., Kaplan, A. S., Watson, S. B., Haynes, S. N., Owens, J. A., & Burns, K. (2000). Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the Traumatic Life Events Questionnaire. Psychological Assessment, 12(2), 210.
Kim, Y. S., & Lee, J. S. (2017). The effect of trauma and intrusive rumination on posttraumatic stress disorder symptoms: The moderated moderated mediation of future perspective cognition and gender difference. Korean Journal of Clinical Psychology, 36(3), 325-338.
Koster, E. H. W., de Lissnyder, E., Derakhshan, N., & de Raedt, R. (2011). Understanding depressive rumination from a cognitive science perspective:the impaired disengagement hypothesis. Clinical Psychology Review, 31(1), 138-145.
Koster, E. H., Crombez, G., Verschuere, B., Vanvolsem, P., & de Houwer, J. (2007). A time-course analysis of attentional cueing by threatening scenes. Experimental Psychology, 54(2), 161-171.
Lancaster, S. L., Rodriguez, B. F., & Weston, R. (2011). Path analytic examination of a cognitive model of PTSD. Behaviour Research and Therapy, 49(3), 194-201.
Lim, H. K., Woo, J. M., Kim, T. S., Kim, T. H., Choi, K. S., Chung, S. K., ... Chae, J. H. (2009). Reliability and validity of the Korean version of the Impact of Event Scale-Revised. Comprehensive Psychiatry, 50(4), 385-390.
Litz, B. T. (1992). Emotional numbing in combat-related post-traumatic stress disorders: a critical review and reformulation. Clinical Psychology Review, 12(4), 417-432.
Maaranen, P., Tanskanen, A., Honkalampi, K., Haatainen, K., Hintikka, J., & Viinamäki, H. (2005). Factors associated with pathological dissociation in the general population. Australian and New Zealand Journal of Psychiatry, 39(5), 387-394.
Maes, S., & Karoly, P. (2005). Self‐Regulation assessment and intervention in physical health and illness: A review. Applied Psychology, 54(2), 267-299.
Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24(5), 307-317.
Morillas-Romero, A., Tortella-Feliu, M., Balle, M., & Bornas, X. (2015). Spontaneous emotion regulation and attentional control. Emotion, 15(2), 162-175.
Ohayon, M. M., & Shapiro, C. M. (2000). Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population. Comprehensive Psychiatry, 41(6), 469-478.
Pacella, M. L., Hruska, B., & Delahanty, D. L. (2013). The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. Journal of Anxiety Disorders, 27(1), 33-46.
Paunovic, N., Lundh, L. G., & Öst, L. G. (2002). Attentional and memory bias for emotional information in crime victims with acute posttraumatic stress disorder (PTSD). Journal of Anxiety Disorders, 16(6), 675-692
Petersen, S. E., & Posner, M. I. (2012). The attention system of the human brain: 20 years after. Annual Review of Neuroscience, 35, 73-89.
Pine, D. S., Mogg, K., Bradley, B. P., Montgomery, L., Monk, C. S., McClure, E., ... Kaufman, J. (2005). Attention bias to threat in maltreated children: Implications for vulnerability to stressrelated psychopathology. American Journal of Psychiatry, 162(2), 291-296.
Redick, T. S., Broadway, J. M., Meier, M. E., Kuriakose, P. S., Unsworth, N., Kane, M. J., & Engle, R. W. (2012). Measuring working memory capacity with automated complex span tasks. European Journal of Psychological Assessment. 28(3), 164-171.
Schäfer, J., Wittchen, H. U., Höfler, M., Heinrich, A., Zimmermann, P., Siegel, S., & Schönfeld, S. (2015). Is trait resilience characterized by specific patterns of attentional bias to emotional stimuli and attentional control? Journal of Behavior Therapy and Experimental Psychiatry, 48, 133-139.
Schoorl, M., Putman, P., Van der Werff, S., & Van der Does, A. J. W. (2014). Attentional bias and attentional control in posttraumatic stress disorder. Journal of Anxiety Disorders, 28(2), 203-210.
Sheih, G. (2011). Clarifying the role of mean centering in multicollinearity of interaction effects. British Journal of Mathematical and Statistical Psychology, 64(3), 462-477.
Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety inventory. Palo Alto, California: Consulting Psychologists.
Susa, G., Pitică, I., Benga, O., & Miclea, M. (2012). The self regulatory effect of attentional control in modulating the relationship between attentional biases toward threat and anxiety symptoms in children. Cognition & Emotion, 26(6), 1069-1083.
Tang, Y. Y., & Posner, M. I. (2009). Attention training and attention state training. Trends in Cognitive Sciences, 13(5), 222-227.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18.
Valdez, C. E., & Lilly, M. M. (2017). Posttraumatic rumination: content, correlates, and processes. Journal of Clinical Psychology, 73(6), 707-721.
Verwoerd, J., de Jong, P. J., & Wessel, I. (2008). Low attentional control and the development of intrusive memories following a laboratory stressor. Journal of Psychopathology and Behavioral Assessment, 30(4), 291-297.
Verwoerd, J., Wessel, I., & de Jong, P. J. (2009). Individual differences in experiencing intrusive memories: the role of the ability to resist proactive interference. Journal of Behavior Therapy and Experimental Psychiatry, 40(2), 189-201.
Verwoerd, J., Wessel, I., & de Jong, P. J. (2012). Fewer intrusions after an attentional bias modification training for perceptual reminders of analogue trauma. Cognition and Emotion, 26(1), 153-165.
Verwoerd, J., Wessel, I., de Jong, P. J., & Nieuwenhuis, M. M. (2009). Preferential processing of visual trauma-film reminders predicts subsequent intrusive memories. Cognition and Emotion, 23(8), 1537-1551.
Wadlinger, H. A., & Isaacowitz, D. M. (2010). Fixing our focus: Training attention to regulate emotion. Personality and Social Psychology Review, 15(1), 75-102.
Wagner, A. W., Wolfe, J., Rotnitsky, A., Proctor, S. P., & Erickson, D. J. (2000). An investigation of the impact of posttraumatic stress disorder on physical health. Journal of Traumatic Stress, 13(1), 41-55.
Weiss, D. S. (2007). The impact of event scale:revised. In Cross-cultural assessment of psychological trauma and PTSD (pp. 219-238). New York: Springer US.
Wessel, I., Overwijk, S., Verwoerd, J., & de Vrieze, N. (2008). Pre-stressor cognitive control is related to intrusive cognition of a stressful film. Behaviour Research and Therapy, 46(4), 496-513.
Williamson, J. B., Porges, E. C., Lamb, D. G., & Porges, S. W. (2014). Maladaptive autonomic regulation in PTSD accelerates physiological aging. Frontiers in Psychology, 5(1571), 1-12.
Zhou, X., Wu, X., Fu, F., & An, Y. (2015). Core belief challenge and rumination as predictors of PTSD and PTG among adolescent survivors of the Wenchuan earthquake. Psychological Trauma:Theory, Research, Practice, and Policy, 7(4), 391.
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