Social constraints

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In psychology, social constraints can be defined as "any social condition that causes a trauma survivor to feel unsupported, misunderstood, or otherwise alienated from their social network when they are seeking social support or attempting to express trauma-related thoughts, feelings, or concerns." [1] Social constraints are most commonly defined as negative social interactions which make it difficult for an individual to speak about their traumatic experiences. [2] The term is associated with the social-cognitive processing model, which is a psychological model describing ways in which individuals cope and come to terms with trauma they have experienced. [3] Social constraints have been studied in populations of bereaved mothers, individuals diagnosed with cancer, and suicide-bereaved individuals. [4] [5] [6] There is evidence of social constraints having negative effects on mental health. They have been linked to increased depressive symptoms as well as post-traumatic stress disorder symptoms in individuals who have experienced traumatic events. [7] [2] There seems to be a positive association between social constraints and negative cognitions related to traumatic events. [7] Social constraints have also been linked to difficulties in coping with illness in people who have been diagnosed with terminal illness such as cancer. [3]

Contents

Social-cognitive processing model

The social-cognitive processing model is a psychological model which posits that recovering from a traumatic event involves discussing important thoughts and feelings about the event with others who can provide support and guidance to the affected individual. [3] The social-cognitive model has been discussed as a model to explain thinking patterns which occur in people experiencing being diagnosed with cancer. [3] Receiving a cancer diagnosis can often be a distressing source of news for terminally ill individuals, and the model posits that they often turn to important sources of social support in order to maintain healthy perspectives on self-worth and safety, as well as accurate accounts of the traumatic event which minimize trauma-related negative thoughts. [2] Similarly, social constraints can negatively impact thoughts and feelings related to the negative event by invalidating and minimizing an individual's experience. [3]

Measurement

In research studies, social constraints have been defined and measured by the Social Constraints Scale (SCS). [2] Items on this measure evaluate social interactions which negatively impact individuals' expression of thoughts and feelings related to traumatic events. [2] Items are assessed over the period of the past month, and questions such as "How often in the past month did your family/friends... minimize your problems?" and "Not seem to understand your situation?" [4]

Effects

Social constraints have been studied in populations of bereaved mothers, individuals diagnosed with cancer, and suicide-bereaved individuals. [4] [5] [6] They have been linked to increased symptoms of mental illness and poor coping with terminal illness in these populations. [7] [2] High levels of social constraints are also linked to an increase in negative thoughts or feelings about traumatic events in individuals. [7]

Depression

Social constraints have been linked to increased depressive symptoms. [7] Researchers found that in a study of bereaved mothers, mothers experiencing social constraints reported more depressive symptoms than mothers who were receiving adequate social support. [4] Presence of social constraints and depressive symptoms were also positively associated in individuals who were in remission from breast cancer. [7]

Post-traumatic stress disorder

Social constraints have also been linked to increased post-traumatic stress disorder symptoms. [2] In a study of breast cancer survivors, individuals experiencing social constraints in the form of being unable to speak to loved ones about their diagnosis were less likely to report gratitude for life, an easy time relating to others, and positive spiritual growth after recovery. [7] A study with trauma survivors revealed that individuals who experienced "inhibiting, invalidating, and/or critical interpersonal reactions to trauma disclosure" were likely to exhibit exacerbated post-traumatic stress symptoms. [2]

Adjustment to medical diagnoses

Research has shown that terminally ill individuals harboring optimistic thoughts and attitudes towards their diagnoses experience fewer social constraints in the form of negative interpersonal interactions with sources of social support. [1] Individuals harboring pessimistic attitudes experienced greater social constraints and lower self-reported mood as a result. [1]

Thoughts

Social constraints may interact with intrusive thoughts and negative cognition. In a study of bereaved mothers, higher levels of social constraints were associated with more intrusive thoughts or worries surrounding their loss, as well as depressive symptoms. [7] Trauma survivors experiencing less supportive social environments were more likely to report thoughts of self-blame and guilt surrounding their traumatic experience. [2]

Future directions of research

There is little research regarding therapeutic work with social constraints in psychological treatment. Further research into the effects of social constraints on mental health can help tailor treatment to individuals' needs, such as referring trauma survivors to support groups or counseling services to target negative thoughts and feelings related to their trauma. [1]

Thus far, research has also largely focused on patients experiencing stressors related to medical diagnoses. [2]

Related Research Articles

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.

Acute stress reaction and acute stress disorder (ASD) is a psychological response to a terrifying, traumatic or surprising experience. Combat stress reaction (CSR) is a similar response to the trauma of war. The reactions may include but are not limited to intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).

Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

<span class="mw-page-title-main">Writing therapy</span> Technique for self-guided improvement

Writing therapyis a form of expressive therapy that uses the act of writing and processing the written word in clinical interventions for healing and personal growth. Writing therapy posits that writing one's feelings gradually eases feelings of emotional trauma; studies have found this therapy primarily beneficial for alleviating stress caused by previously undisclosed adverse events and for those suffering from medical conditions associated with the immune system. Writing therapeutically can take place individually or in a group and can be administered in person with a therapist or remotely through mailing or the Internet.

<span class="mw-page-title-main">Grief counseling</span> Therapy for responses to loss

Grief counseling is a form of psychotherapy that aims to help people cope with the physical, emotional, social, spiritual, and cognitive responses to loss. These experiences are commonly thought to be brought on by a loved person's death, but may more broadly be understood as shaped by any significant life-altering loss.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

In psychology, posttraumatic growth (PTG) is positive psychological change experienced as a result of struggling with highly challenging, highly stressful life circumstances. These circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to the individual's way of understanding the world and their place in it. Posttraumatic growth involves "life-changing" psychological shifts in thinking and relating to the world and the self, that contribute to a personal process of change, that is deeply meaningful.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

<span class="mw-page-title-main">Transgenerational trauma</span> Psychological trauma

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary mode of transmission is the shared family environment of the infant causing psychological, behavioral and social changes in the individual.

Emotional abandonment is a subjective emotional state in which people feel undesired, left behind, insecure, or discarded. People experiencing emotional abandonment may feel at a loss. They may feel like they have been cut off from a crucial source of sustenance or feel withdrawn, either suddenly or through a process of erosion. Emotional abandonment can manifest through loss or separation from a loved one.

Emotional approach coping is a psychological construct that involves the use of emotional processing and emotional expression in response to a stressful situation. As opposed to emotional avoidance, in which emotions are experienced as a negative, undesired reaction to a stressful situation, emotional approach coping involves the conscious use of emotional expression and processing to better deal with a stressful situation. The construct was developed to explain an inconsistency in the stress and coping literature: emotion-focused coping was associated with largely maladaptive outcomes while emotional processing and expression was demonstrated to be beneficial.

Race-based traumatic stress is the traumatic response to stress following a racial encounter. Robert T. Carter's (2007) theory of race-based traumatic stress implies that there are individuals of color who experience racial discrimination as traumatic, and often generate responses similar to post-traumatic stress. Race-based traumatic stress combines theories of stress, trauma and race-based discrimination to describe a particular response to negative racial encounters.

Trauma-sensitive yoga is yoga as exercise, adapted from 2002 onwards for work with individuals affected by psychological trauma. Its goal is to help trauma survivors to develop a greater sense of mind-body connection, to ease their physiological experiences of trauma, to gain a greater sense of ownership over their bodies, and to augment their overall well-being. However, a 2019 systematic review found that the studies to date were not sufficiently robustly designed to provide strong evidence of yoga's effectiveness as a therapy; it called for further research.

<span class="mw-page-title-main">Post-traumatic stress disorder and substance use disorders</span> Association of PTSD and substance dependencies

Post-traumatic stress disorder (PTSD) can affect about 3.6% of the U.S. population each year, and 6.8% of the U.S. population over a lifetime. 8.4% of people in the U.S. are diagnosed with substance use disorders (SUD). Of those with a diagnosis of PTSD, a co-occurring, or comorbid diagnosis of a SUD is present in 20–35% of that clinical population.

<span class="mw-page-title-main">Trauma and first responders</span> Trauma experienced by first responders

Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.

<span class="mw-page-title-main">Dual representation theory</span>

Dual representation theory (DRT) is a psychological theory of post-traumatic stress disorder (PTSD) developed by Chris Brewin, Tim Dalgleish, and Stephen Joseph in 1996. This theory proposes that certain symptoms of PTSD - such as nightmares, flashbacks, and emotional disturbance - may be attributed to memory processes that occur after exposure to a traumatic event. DRT proposes the existence of two separate memory systems that run in parallel during memory formation: the verbally accessible memory system (VAM) and situationally accessible memory system (SAM). The VAM system contains information that was consciously processed and thus can be voluntarily recalled or described. In contrast, the SAM system contains unconsciously processed sensory information that cannot be voluntarily recalled. This theory suggests that the VAM system is impaired during a traumatic event because conscious attention is narrowly drawn to threat-related information. Therefore, memory of the trauma is heavily focused on fear, which affects information processing. This gives rise to PTSD symptoms such as trauma-related cognitions, appraisals, and emotions. The SAM system captures vivid sensory information during the traumatic event, which is automatically recalled through exposure to trauma-related triggers. This system is thought to be responsible for the presence of flashbacks and nightmares in PTSD symptomatology.

References

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  2. 1 2 3 4 5 6 7 8 9 10 Belsher, Bradley E.; Ruzek, Josef I.; Bongar, Bruce; Cordova, Matthew J. (2012). "Social constraints, posttraumatic cognitions, and posttraumatic stress disorder in treatment-seeking trauma survivors: Evidence for a social-cognitive processing model". Psychological Trauma: Theory, Research, Practice, and Policy. 4 (4): 386–391. doi:10.1037/a0024362. ISSN   1942-969X.
  3. 1 2 3 4 5 Lepore, Stephen J. (2001), Baum, Andrew; Andersen, Barbara L. (eds.), "A social–cognitive processing model of emotional adjustment to cancer.", Psychosocial interventions for cancer., Washington: American Psychological Association, pp. 99–116, doi:10.1037/10402-006, ISBN   978-1-55798-734-1 , retrieved 2021-10-10
  4. 1 2 3 4 Lepore, Stephen J.; Silver, Roxane Cohen; Wortman, Camille B.; Wayment, Heidi A. (1996). "Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers". Journal of Personality and Social Psychology. 70 (2): 271–282. doi:10.1037/0022-3514.70.2.271. ISSN   1939-1315. PMID   8636882.
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