L’impact d’une interaction sociale centrée sur le trauma sur la réactivité physiologique d’individus avec un état de stress post-traumatique, en fonction de leurs symptômes et de leur soutien social

Introduction: Les personnes ayant développé un état de stress post-traumatique (ÉSPT) évitent systématiquement d’aborder avec leurs proches le sujet du trauma ainsi que tout élément y étant associé. Cette forme d’évitement peut entraver le processus naturel de rétablissement. Les hypothèses suivantes peuvent être énoncées à cet égard. Tout d’abord, une discussion avec une personne proche et centrée sur le trauma peut être vécue comme étant anxiogène et, par conséquent, provoquer une augmentation de la fréquence du rythme cardiaque, d’ailleurs communément connue sous le nom de réactivité du rythme cardiaque. La réactivité provoquée par une telle situation peut positivement varier en fonction de l’intensité des symptômes d’ÉSPT. Cette association entre les symptômes et la réactivité peut, à son tour, varier en fonction des perceptions de la personne anxieuse du soutien social de la part de son proche et/ou de son entourage. Il en va de même pour les individus ayant développé un trouble anxieux comparable, soit le trouble panique (TP). Toutefois, toutes ces hypothèses n’ayant pas été jusqu’à maintenant vérifiées empiriquement, la présente thèse a eu pour objectif de les tester. Méthodologie: Un total de 46 personnes avec un ÉSPT et de 22 personnes avec un TP ont complété des entrevues diagnostiques et des questionnaires auto-rapportés concernant leurs symptômes ainsi que leurs perceptions des interactions sociales soutenantes et non soutenantes ou négatives avec leur proche significatif et leur entourage. Elles ont également participé à une interaction sociale avec une personne proche et centrée sur leur trouble anxieux, situation qui incluait également des mesures continues du rythme cardiaque. Résultats: Les résultats ont démontré qu’une interaction sociale centrée sur le trauma avec une personne proche provoquait une augmentation significative de la fréquence du rythme cardiaque des participants en comparaison à une interaction sociale non conflictuelle et non anxiogène avec cette même personne. Cette réactivité du rythme cardiaque corrélait de façon significative et positive avec l’intensité de leurs symptômes d’ÉSPT. Les résultats ont également permis de constater que l’hypothèse de modération concernant les perceptions d’interactions sociales positives était partiellement confirmée, soit pour les symptômes d’évitement; les perceptions d’interactions sociales négatives étant quant à elles associées de façon significative et positive à cette réactivité (c.à.d. suivant un effet principal). Quant aux personnes avec un TP, une atténuation significative dans la fréquence de leur rythme cardiaque fut observée dans le contexte analogue, atténuation qui était positivement liée à la sévérité de leurs attaques de panique. Certaines dimensions de leurs perceptions de soutien social étaient significativement et négativement liées à cette atténuation (c.à.d. suivant un effet principal). Discussion: La présente thèse a notamment démontré qu’il existait des liens entre les symptômes d’ÉSPT et la réactivité du rythme cardiaque dans le contexte d’une interaction sociale avec un proche et centrée sur le trauma. Elle a également permis de constater que les symptômes d’ÉSPT et les perceptions d’interaction sociales positives et négatives peuvent prédire cette réactivité. Dans l’avenir, des devis longitudinaux pourront informer davantage à propos de la direction des liens ici explorés.Introduction: Individuals who have developed a posttraumatic stress disorder (PTSD) commonly make efforts to avoid trauma-oriented conversations with their significant others, which may interfere with the natural recovery process. The following hypotheses can be formulated. A trauma-oriented conversation with a significant other can be experienced as physiologically arousing by individuals with PTSD and, consequently, trigger an increase in their heart rate. Heart rate reactivity in this context can positively vary in function of the intensity of individuals’ PTSD symptoms. In addition, this association between symptoms and physiological reactivity can vary in function of anxious individuals’ perceived social support from their significant other and/or their network. The same can be conceptualized regarding individuals with panic disorder (PD). The objective of the present thesis is to empirically verify all these hypotheses. Methods: A total of 46 individuals with PTSD and 22 individuals with PD completed diagnostic interviews and self-report measures of symptoms and perceived supportive and unsupportive or negative social interactions with their significant other and their network. They also participated in an anxiety-oriented social interaction with a significant other, which included continuous heart rate measures. Results: Results showed that trauma-oriented social interaction with a significant other triggered a significant elevation in participants’ heart rates when compared to a non-anxious and non-contentious discussion with the same person. This heart rate reactivity was significantly and positively correlated with intensity of their symptoms of PTSD. Some evidence was found for the relationship between increased heart rate reactivity and the interaction between perceived social support and PTSD symptoms (e.g., symptoms of avoidance). The study also found that perceived unsupportive or negative social interactions were related to increased heart rate reactivity while talking about one's trauma (i.e., as a main effect). Regarding individuals with PD, a PD-oriented social interaction was associated with a significant decrease in mean heart rates, which positively correlated with intensity of their panic attacks. Some dimensions of perceived social support were significantly and negatively associated with this decrease, as a main effect. Discussion: This study has particularly showed that there are links between PTSD symptoms and heart rate reactivity in the context of a trauma-oriented social interaction with a significant other. It has also showed that PTSD symptoms and perceived supportive and negative social interactions can actually predict this heart rate reactivity. In the future, longitudinal designs could be used to give a more precise portrait of the directions of the links explored here

Assessment of the psychosocial predictors of health-related quality of life in a PTSD clinical sample

Although a wide array of the scientific literature explores the links between posttraumatic stress disorder (PTSD) symptoms, coping strategies, and social support and health-related quality of life (HRQoL) as an outcome variable, their connections remain unclear. It is unknown whether PTSD symptom severity, coping strategies, and social support explain each a unique portion of variance of HRQoL of individuals with PTSD. In the current study, based on pretreatment results of a broader study assessing a specific intervention for PTSD, 94 individuals with PTSD were screened for psychiatric disorders and completed several questionnaires concerning social support, coping strategies, PTSD symptoms, and HRQoL. Coping strategies, social support, and PTSD all appeared to be predictors of HRQoL; however, PTSD seemed to constitute the major predictor among these variables. Indeed, coping strategies and social support did not explain a unique share of variability of HRQoL beyond that of PTSD symptomatology. A causal pathway integrating these variables should be tested in future studies

Overt social support behaviors : Associations with PTSD, concurrent depressive symptoms and gender

Women are twice as likely as men to develop a posttraumatic stress disorder (PTSD). Gender differences in social support after a traumatic event might partially explain this disparity. However, the portrait of the links among PTSD, depression, social support, and gender is still unclear. This study examined behaviors of individuals with PTSD and their significant other in relation to PTSD and concurrent depressive symptoms, and tested gender as a moderator of these associations. Observed overt supportive and countersupportive behaviors of 68 dyads composed of an individual with PTSD and a significant other in a trauma-oriented discussion were coded with a support coding system and analyzed according to gender. Gender was revealed to act as a moderator of the links between interactional behaviors of individuals with PTSD and their concurrent depressive symptoms. More specifically, women were less implicated and less likely to propose positive solutions compared with men. On the other hand, men were more implicated and less likely to criticize their significant other than were women. PTSD and concurrent depressive symptoms were related to poorer interpersonal communication in women. Hence, women and men with PTSD and concurrent depressive symptoms might benefit from gender-tailored interventions targeting symptoms and dyadic behaviors

The buffering power of overt socially supportive and unsupportive behaviors from the significant other on posttraumatic stress disorder individuals’ emotional state

Social support is one of the three strongest predictors of posttraumatic stress disorder (PTSD). In the present study, we aimed to assess the buffering power of overt socially supportive and unsupportive behaviors from the significant other, in a group with PTSD and a comparison group. Design and methods: A total of 46 individuals with PTSD and 42 individuals with obsessive-compulsive disorder (OCD) or panic disorder (PD) completed diagnostic interviews and an anxiety-oriented social interaction with a significant other. Heart rate of participants was continuously measured during this interaction and overt social behaviors from the significant other were recorded on videotape and coded using a validated system. Results: Changes in heart rate in PTSD participants correlated negatively with changes in overt socially supportive behaviors from their significant other (r from −.36 to −.50, p  .05). No such statistically significant association emerged in the group with OCD or PD (r from .01 to −.27, p > .05). Conclusions: This study sustain the buffering power of overt supportive behaviors from the significant other on heart rate changes in PTSD

The effect of talking about psychological trauma with a significant other on heart rate reactivity in individuals with posttraumatic stress disorder

Individuals with posttraumatic stress disorder (PTSD) commonly make efforts to avoid trauma-oriented conversations with their significant others, which may interfere with the natural recovery process. Trauma-oriented conversations can be experienced as physiologically arousing, depending on the intensity of PTSD symptoms and perceptions of social support. In the current investigation, changes in heart rate responses to a trauma-oriented social interaction with a significant other were assessed. Perceived supportive and unsupportive or negative social interactions were examined as moderators of the association between heart rate changes to this context and intensity of PTSD symptoms. A total of 46 individuals with PTSD completed diagnostic interviews and self-report measures of symptoms and perceived supportive and negative social interactions during a trauma-oriented social interaction with a significant other. Heart rate was continuously measured during this interaction. Results showed that engagement in a trauma-oriented social interaction was predictive of elevations in heart rate that positively correlated with intensity of PTSD symptoms. The moderation hypothesis was partially supported. In addition, perceived negative social interactions positively correlated with elevations in heart rate. These findings can inform social intervention efforts for individuals with PTSD

How do social interactions with a significant other affect PTSD symptoms? An empirical investigation with a clinical sample

Social support and coping are both related to posttraumatic stress disorder (PTSD) symptoms, but the mechanisms underlying their relationships remain unclear. This study explores these relationships by examining the perceived frequency of supportive and countersupportive interactions with a significant other in PTSD patients. Ninety-six participants with PTSD were recruited and completed questionnaires assessing social interactions, ways of coping, and PTSD symptoms. Associations of social interactions (r2 = 4.1%–7.9%, p < .05) and coping (r2 = 15.9%– 16.5%, p < .001) with symptoms were independent, and suggested a direct association between social interactions and PTSD. Countersupportive interactions were more associated to symptoms than supportive interactions. Our findings suggest the development of psychotherapies that integrate social support interventions

The Mann-Whitney U: A Test for Assessing Whether Two Independent Samples Come from the Same Distribution

It is often difficult, particularly when conducting research in psychology, to have access to large normally distributed samples. Fortunately, there are statistical tests to compare two independent groups that do not require large normally distributed samples. The Mann-Whitney U is one of these tests. In the following work, a summary of this test is presented. The explanation of the logic underlying this test and its application are presented. Moreover, the forces and weaknesses of the Mann-Whitney U are mentioned. One major limit of the Mann-Whitney U is that the type I error or alpha (?) is amplified in a situation of heteroscedasticity