Psychological adaptation to life-threatening injury in dyads: the role of dysfunctional disclosure of trauma

Abstract

BackgroundCertain modes of trauma disclosure have been found to be associated with more severe symptoms of posttraumatic stress (PTS) in different trauma populations: the reluctance to disclose trauma-related thoughts and feelings, a strong urge to talk about it, and physical as well as emotional reactions during disclosure. Although social-contextual influences gain more and more interest in trauma research, no study has yet investigated these “dysfunctional disclosure tendencies” and their association with PTS from an interpersonal perspective.Objective(1) To replicate previous findings on dysfunctional disclosure tendencies in patients with life-threatening injury and their significant others and (2) to study interpersonal associations between dysfunctional disclosure style and PTS at a dyadic level.MethodPTS symptom severity and self-reports on dysfunctional disclosure tendencies were assessed in N=70 dyads comprising one individual with severe traumatic brain injury and a significant other (“proxy”) 3 months after injury.ResultsRegression analyses predicting PTS symptom severity revealed dysfunctional disclosure tendencies to have incremental validity above and beyond sex, age, and trauma severity within the individual (both patient and proxy), with moderate effect sizes. The interaction between patient's and proxy's disclosure style explained additional portions of the variance in patients’ PTS symptom severity.ConclusionsFindings suggest that dysfunctional disclosure tendencies are related to poorer psychological adaptation to severe traumatic brain injury. This intrapersonal association may be exacerbated by dysfunctional disclosure tendencies on the part of a significant other. Although the results require replication in other trauma samples without brain injury to further generalize the findings beyond the observed population, the study contributes to the expanding literature on the crucial role of interpersonal relationships in trauma recovery.

Association Between Social Acknowledgment And Trauma Disclosure

“…Men were more reluctant to disclose traumatic events. These results are in line with the previous studies that revealed gender differences in posttraumatic stress reactions (18) and disclosure of trauma (19). We also found gender differences in types of experienced traumatic events, which might be closely related to gender differences in trauma disclosure and social acknowledgment.…”

Childhood trauma and complex posttraumatic stress disorder symptoms in older adults: A study of direct effects and social-interpersonal factors as potential mediators

“…In a sample of political prisoners, DTQ scales showed good internal consistency (α = .82 -.88) and test-retest reliability (r tt = .76 - Müller & Maercker, 2000). The short-form had previously also demonstrated good psychometrics (Pielmaier & Maercker, 2011). For the present sample, it achieved good internal consistency, Cronbach α = .84.…”

A socio-interpersonal approach to adjustment disorder: the example of involuntary job loss

“…Dysfunctional Disclosure was measured using the Disclosure Questionnaire (Mueller & Maercker, 2006) in an abbreviated form (Pielmaier & Maercker, 2011). The 12 items can be divided into three subscales: urge to talk, reluctance to talk , and emotional reactions while disclosing .…”

“…Likewise, the quality of social support resources seems to influence the psychological adjustment outcome after stress exposure (Ajrouch, Abdulrahim, & Antonucci, 2013; Brewin, Andrews, & Valentine, 2000). Disclosure of stressful experiences has been shown to facilitate recovery from severe stress (Freedman, Gilad, Ankri, Rozier, & Shalev, 2015; Pennebaker, 1989; Pielmaier & Maercker, 2011). The third level includes societal and cultural factors.…”