The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies

Chun, Charlotte A.

doi:10.1007/s10862-016-9540-3

Cited by 35 publications

(31 citation statements)

References 49 publications

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“…Replicating prior EEG studies in traumatized samples (for review, see Meyer, Smeets et al, 2015), we explored the association between PTSD symptoms and frontal asymmetry at rest and in response to emotional provocation, including a condition where participants viewed a trauma‐related picture. Our study extends prior findings by supplementing retrospective measures with ambulatory symptom assessment and a laboratory provocation, providing a closer look at various PTSD symptoms in daily life (Chun, ). A particular interest was in reexperiencing symptoms, including intrusive trauma memories and their ensuing cognitive‐emotional reactions.…”

Section: Discussionsupporting

confidence: 70%

Frontal EEG asymmetry during symptom provocation predicts subjective responses to intrusions in survivors with and without PTSD

et al. 2017

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Studies suggest that frontal alpha asymmetry is closely linked to psychological adjustment following stressful experiences, such that more left-sided frontal activation during symptom provocation might predict lower levels of posttraumatic stress disorder (PTSD). Here, we tested whether frontal asymmetry at rest and during exposure to neutral, positive, negative, and trauma-related images would be associated with PTSD, and particularly with characteristic reexperiencing symptoms. Symptoms were assessed in trauma victims with (n 5 24) and without PTSD (n 5 15), using both retrospective measures and 1-week ambulatory assessments with a diary and a smartphone. While resting frontal asymmetry was unrelated to all retrospective measures, left-sided activation in response to the negative picture correlated with lower levels of psychopathology. Left-sided activation in the trauma-related picture condition was more specifically associated with less emotionally intense intrusions and responses to viewing the picture, even when corrected for other symptoms of psychopathology. These effects tended to increase when participants with possible overreporting tendencies were removed from the analyses. Moreover, trauma victims without PTSD (i.e., relatively more resilient individuals) displayed higher left-sided frontal activation in response to the negative picture, also when compared with a third group of healthy, trauma-free individuals (n 5 15). Our findings suggest that statedependent changes in frontal asymmetry could serve as a biological marker of PTSD symptoms and could eventually be used for diagnostic purposes or as a target for neuromodulation interventions. Future studies should establish whether this marker can serve as an early predictor of psychopathology in recently traumatized individuals. K E Y W O R D Sdiary, frontal alpha asymmetry, intrusions, posttraumatic stress disorder, symptom provocation | IN TRO DUCT IO NA small, yet nontrivial proportion of individuals who have experienced aversive life events develop trauma-related psychopathology, such as posttraumatic stress disorder (PTSD). These trauma victims suffer from severe reexperiencing symptoms (e.g., intrusions, nightmares), avoidance of cues related to the trauma, altered mood and cognition, as well as exaggerated general arousal and reactivity (American Psychiatric Association, 2013). Since the diagnosis of PTSD essentially depends on self-report (Rosen & Lilienfeld, 2008) and its symptoms are only modestly related to objective trauma severity (

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Section: Discussionsupporting

confidence: 70%

Frontal EEG asymmetry during symptom provocation predicts subjective responses to intrusions in survivors with and without PTSD

et al. 2017

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“…Inconclusiveness could be related to the assessment methods used in assessing PTSD symptoms which mostly rely on retrospective questionnaires and interviews (Chun, 2016). As a consequence, assessments of PTSD symptoms are exposed to inaccuracy and retrospective biases such as underestimating (Chun, 2016). Furthermore, some instruments only assess distress related to the symptoms and not their frequency (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Another drawback related to traditional assessments of PTSD symptoms is incomplete ecological validity – especially as intrusive memories are highly contextual. To overcome these drawbacks and to provide stronger ecological validity, there is a shift towards using ambulatory assessment (AA) during the usual life of the patient both for the assessment of psychopathology in general (FDA, 2009; Trull & Ebner-Priemer, 2013) and for the assessment of PTSD symptoms in particular (Chun, 2016; Walz, Nauta, & Aan Het Rot, 2014). Currently, the two major assessment strategies when using AA are (1) Time-Based Sampling (TBS), in which participants respond to signals emitted by the device; and (2) Event-Based Sampling (EBS), in which participants initiate a diary entry when a pre-specified event occurs (Fahrenberg, Myrtek, Pawlik, & Perrez, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…While frequent assessments had only little impact on pain ratings in patients with chronic pain (Stone et al, 2003), intrusive memories related to PTSD are easily triggered by external cues (Elzinga & Bremner, 2002) and might therefore be influenced by frequent assessment. Furthermore, Chun (2016) hypothesized that the settings in which intrusive memories are assessed may also influence the data. This is in line with our previous study (Priebe et al, 2013) that found the highest recorded number of intrusive memories occurred within a sample of patients with PTSD that were assessed during an ongoing trauma-focused psychotherapy in a residential setting.…”

Section: Introductionmentioning

confidence: 99%

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Trauma-related memories in PTSD after interpersonal violence: an ambulatory assessment study

Kleindienst

Priebe

Petri

et al. 2017

European Journal of Psychotraumatology

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Background: Ambulatory assessment (AA) is increasingly recommended for assessing symptoms of posttraumatic stress disorder (PTSD). Previous AA studies provided new insights into the phenomenology of trauma-related memories, but also divergent findings. Notably, the range of trauma-related memories (a major target of psychotherapeutic interventions) reported in AA studies was as wide as 7.3 to 74.5 per week which might result from different methods used in these studies. Objective: We aimed at assessing the frequency of trauma-related memories in PTSD related to interpersonal violence and investigated whether this frequency is dependent upon the method. Method: For each patient trauma-related memories were assessed using two variants of smartphone-based AA: (1) Event-based sampling (EBS), i.e. participants entered data on each intrusive memory as it occurred; (2) Time-based sampling (TBS), i.e. participants reported the number of trauma-related memories they had experienced during the last two hours after they had been alerted by the smartphone. The numbers reported during the TBS-block were either analysed as reported by the participants or restricted to one per hour (rTBS). The impact of smartphone-assessments on trauma-related memories was assessed during a post-monitoring questionnaire. Results: While trauma-related memories were frequent across assessments, the methodology had a huge impact on the numbers: EBS (median = 7) and rTBS (median = 6) yielded significantly lower weekly numbers of intrusive trauma-related memories than TBS (median = 49). Accordingly, the possibility to report unrestricted numbers of trauma-related memories clearly impacted the results. The post-monitoring questionnaire identified another source for the divergent findings: while feeling disrupted by the smartphone-assessments was unrelated to the numbers reported during EBS, feeling disrupted was related to an increase of trauma-related memories during TBS and rTBS. Conclusions: The method clearly impacts the recorded number of trauma-related memories. Future research should clarify whether other variables (e.g. the subjective stress related to intrusive memories) are less dependent on the methodology.

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“…A number of studies have previously utilized ESM for exploring PTSD symptoms in daily life (Chun, 2016), whereas other studies have investigated general emotional reactivity to daily stressors (Bylsma, Taylor-Clift, & Rottenberg, 2011;Wichers et al, 2007), negative affect as a mediator between PTSD and drinking behavior (Cohn et al, 2014), and emotional reactivity to stress as a predictor of future psychopathology (Vaessen et al, 2017). To our knowledge, however, no studies have yet used ESM to examine the association between PTSD symptom clusters and specific negative emotions.…”

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confidence: 99%

Dynamic Network Analysis of Negative Emotions and DSM‐5 Posttraumatic Stress Disorder Symptom Clusters During Conflict

Greene

Gelkopf

Fried

et al. 2019

Journal of Traumatic Stress

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Investigating dynamic associations between specific negative emotions and PTSD symptom clusters may provide novel insights into the ways in which PTSD symptoms interact with, emerge from, or are reinforced by negative emotions. The present study estimated the associations among negative emotions and the four DSM‐5 PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and arousal) in a sample of Israeli civilians (n = 96) during the Israel–Gaza War of July–August 2014. Data were collected using experience sampling methodology, with participants queried via smartphone about PTSD symptoms and negative emotions twice a day for 30 days. We used a multilevel vector auto‐regression model to estimate temporal and contemporaneous temporal networks. Contrary to our hypothesis, in the temporal network, PTSD symptom clusters were more predictive of negative emotions than vice versa, with arousal emerging as the strongest predictor that negative emotions would be reported at the next measurement point; fear and sadness were also strong predictors of PTSD symptom clusters. In the contemporaneous network, negative emotions exhibited the strongest associations with the NACM and arousal PTSD symptom clusters. The negative emotions of sadness, stress, fear, and loneliness had the strongest associations to the PTSD symptom clusters. Our findings suggest that arousal has strong associations to both PTSD symptoms and negative emotions during ongoing trauma and highlights the potentially relevant role of arousal for future investigations in primary or early interventions.

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The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies

Cited by 35 publications

References 49 publications

Frontal EEG asymmetry during symptom provocation predicts subjective responses to intrusions in survivors with and without PTSD

Frontal EEG asymmetry during symptom provocation predicts subjective responses to intrusions in survivors with and without PTSD

Trauma-related memories in PTSD after interpersonal violence: an ambulatory assessment study

Dynamic Network Analysis of Negative Emotions and DSM‐5 Posttraumatic Stress Disorder Symptom Clusters During Conflict

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