How do the types of appraisals people make in response to traumas relate to distress? Posttraumatic distress has been linked to a range of beliefs and emotions, such as fear, anger, shame, and self-blame (e.g., Andrews et al., 2000; Brewin et al., 2000; Feeny et al., 2000; Filipas & Ullman, 2006; Kaysen et al., 2005).  

Over the last few years, we have been developing a measure of posttraumatic appraisals, guided by the narratives of trauma survivors (DePrince, Zurbriggen, Chu, & Combs, under review). Item development began with interviews of 72 community participants who described their beliefs, behaviors, and feelings following a range of trauma exposures (51% reported on interpersonal traumas). From the interviews, we generated items that were later tested among undergraduate and community adult samples.

We are now using the TAQ to explore differences in appraisal processes between women who report single and multiple victimizations. For example, in an ethnically-diverse community sample, multiply-victimized women made significantly higher ratings of appraisals than singly victimized women, even though both groups were appraising a single event (Chu & DePrince, 2006). Because multiply-victimized women are at higher risk of more severe mental health problems than their peers (Classen et al., 2005), we are interested in how better understanding appraisal processes can inform interventions with this group. In a related approach, Stephen Shirk and I have applied this appraisal work to a proposal (now under review at NIMH) to modify standard cognitive-behavioral treatment (CBT) for depressed adolescents exposed to interpersonal trauma. Specifically, we have proposed to augment the standard CBT approach by addressing trauma-related appraisal, including self-blame and shame. 

  Ann Chu leads a team meeting with undergraduate research assistants

Related Ongoing Projects: Emotion Communication and Understanding in the Development of Dissociation (Collaborators: Dr. M. Saylor, Vanderbilt University; A. Chu, DU); Trauma and Appraisals.

Relevant Research Funding: "Development of the Trauma Appraisal Questionnaire", National Institute of Mental Health.

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Dissociation, Trauma Exposure, and Cognition

Although central to the psychology of trauma, dissociation is one of the least understood correlates of trauma exposure. Our research group is interested in both theoretical and empirical advances in understanding dissociation. In recent theoretical papers (e.g., DePrince, Chu, & Visvanathan, 2006; DePrince & Cromer, 2006a; DePrince & Freyd, 2006), we have addressed topics related to dissociation’s definition; function and etiology; and cognitive correlates. DePrince's recent edited volume (DePrince & Cromer, 2006b) took up these issues with both theoretical and empirical contributions from international scholars.

Our empirical work on dissociation has focused on cognitive correlates, with several studies pointing to interactions between dissociation and attention. For example, using the classic Stroop task, we found that undergraduate participants who scored high on a dissociation measure showed less Stroop interference when dividing their attention and more when focusing their attention; participants who scored low on dissociation showed the opposite pattern (DePrince & Freyd, 1999). This finding has since been replicated in dissociative patients relative to both depressed and healthy controls (Simeon et al., 2006), demonstrating that, even in a patient population, dissociation can be associated with relative advantages under some conditions. In a similar line of research, Elzinga et al. (2006) reported that dissociative disorders patients showed less of a decline in performance at higher levels of the n-back task (which requires keeping track of multiple pieces of information at one time) than healthy controls. Extending this approach to memory tasks, we found that participants who scored high on a measure of dissociation tended to recall more neutral and less trauma-related information under divided attention conditions, relative to those who scored low and showed the opposite pattern (DePrince & Freyd, 2001, 2004; DePrince, Freyd, & Malle, 2007). We recently extended this work to school-aged children to examine the developmental assumptions of and implications for this line of research (DePrince, Weinzierl, & Combs, in press). 

More recently, we have been asking questions regarding how attention processes relate to trauma-exposure more generally. In several studies, we are now examining how executive function (EF) processes relate to some of the challenges faced by children exposed to violence. We are interested in whether EF problems may provide one route via which maltreated children become at risk for peer, academic, and behavior problems.

Building on our interests in attention and EF , Dr. Stephen Shirk and I will begin an initial evaluation of a modified CBT for depressed adolescents exposed to interpersonal trauma. Treatment modifications will include interventions targeting EF (e.g., attention control training, mindfulness-based cognitive interventions) and specific trauma-related appraisals.

  Melody Combs works on Cognition and Trauma projects in our offices.

Related Ongoing Projects: Processing of public service announcements for intimamte partner abuse (PI: Courtney Mitchell; Collaborator: Daniel McIntosh, PhD). Processing mental health information in Latina mothers (PI: Rheena Pineda).

Relevant Research Funding: "Child Maltreatment, Attention and Memory", DU Professional Research Opportunities for Faculty. "Deployment-focused development of depression treatment for victimized youth," National Institute of Mental Health (1 R34 MH080102-01A1)

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Why are people exposed to violence early in life at risk for later exposure? Why is revictimization associated with serious health consequences? Victimization (and revictimization) is an interpersonal process in which one human being engages in violence against another. While the responsibility necessarily lies with the perpetrator, our recent work has sought to identify disruptions in the typical processing of interpersonal information that may be relevant to understanding revictimization. We are particularly interested in identifying factors that predict revictimization to create opportunities to augment intervention programs.

Revictimization and Social Cognition. To examine interpersonal correlates of revictimization, we first examined reasoning abilities. Deontic reasoning involves reasoning about "what one may, ought, or may not do in a given set of circumstances" (Cummins, 1996a, p. 161), whereas descriptive reasoning involves reasoning about descriptions of some aspect of the world (Ermer et al., 2006).  Deontic reasoning is critical to navigating social relationships and institutions (Cummins, 1996b).  Indeed, impoverished deontic reasoning abilities may place individuals at high risk for being taken advantage of in relationships or failing to protect against harm (Stone et al., 2002). Thus, deontic reasoning performance may be particularly relevant to the deleterious interpersonal consequences associated with child victimization, such as peer victimization in childhood (e.g., Shields & Cicchetti, 2001) and physical and/or sexual revictimization in adolescence and young adulthood (for review, see Arata, 2002).  

We found that young adults who reported histories of victimizations both before and after age 18 made significantly more errors detecting violations of if-then deontic rules than their peers; however, the groups did not differ in descriptive reasoning abilities (DePrince, 2005). Interestingly, pathological dissociation explained unique variance in deontic reasoning performance after controlling for other trauma-related factors. Extending this work to children, we developed stimuli that kept the same basic if-then form as the conditional reasoning task used with adults (DePrince, Chu, & Combs, in press). Rules were read to children who were then asked to solve the problems using a set of visual pictures (rather than reading the response choices as in the adult task). Dissociation explained unique variance in deontic reasoning errors after controlling for estimated IQ, socio-economic status, and child age.

Thus, in both children and young adults, dissociation is associated with specific problems in deontic reasoning, but not global reasoning deficits (i.e., no relationship to descriptive reasoning errors). Working memory and processing speed are implicated in both dissociation (e.g., DePrince & Weinzierl, 2006) and deontic reasoning (e.g., Klaczynski et al., 2004), suggesting a possible mediator of the dissociation-deontic reasoning link.  

We are currently examining other dimensions of social cognition and revictimization risk using the lexical decision making task (DePrince, Combs, & Shanahan, under review).

Revictimization and Executive Function (EF). We are interested in whether alterations in EF may disrupt detection of and response to threat at many different points in potentially victimizing situations (not just the ability to detect risk). Notably, EF problems may disrupt individuals’ abilities to orient and/or maintain attention to and update information regarding threat in potentially dangerous situations. For example, impaired attention may increase risk that women miss threat cues, increasing risk of revictimization. Additionally, EF deficits may interfere with women’s abilities to generate, plan, and initiate behavioral responses in potentially victimizing situations. In partnership with the Denver Police Department’s Victim Assistance Unit, we are currently testing the impact of EF performance (e.g., working memory, interference control, etc.) in relation to revictimization  among women recently exposed to crime.  

Revictimization and Psychophysiology. We also apply psychophsyiological methods to the problem of revictimization. For example, as part of her dissertation, Aimee Reichmann-Decker examined emotional responsiveness and revictimization in college women (Reichmann-Decker, DePrince, & McIntosh, 2009). Using an affective startle paradigm, we found that women who reported experiences of revictimization startled less to negative interpersonal images (e.g., images of men and women fighting) relative to women who reported childhood-only abuse or no abuse, suggesting that some early defensive responses may be dampened in that group. In an ongoing dissertation, Ann Chu is examining how discrepancies between self-perceptions of and objective physiological arousal contribute to interpersonal risk detection problems that have been observed among revictimized women (Marx et al., 2001).

Intimate Partner Violence (IPV). Among the many deleterious outcomes associated with IPV is risk of future revictimization. In the face of billions of dollars spent on IPV annually, cost effective programs that improve victim safety and criminal legal system outcomes are sorely needed. The Denver District and City Attorneys' Offices, Denver Police Department and several community-based agencies who serve IPV victims recently began implementation of a coordinated outreach program to IPV victims. Specifically, criminal justice and community-based victim advocates collaborate to make outreach to IPV victims within 24-72 hours of case inception (i.e., arrest) to connect victims as soon as possible to relevant community and criminal justice resources. Given limited resources, the rigorous evaluation of innovative programs, such as this one, is necessary for advancing coordinated system responses to IPV. 

 In collaboration with Drs. Joanne Belknap and Angela Gover as well as system- and community-based partners, we are evaluating the effectiveness of the program. Incorporating several themes from our larger program of research (e.g., appraisals, psychological distress, revictimization), we are testing mediators and moderators of outreach success on longitudinal outcomes. Specifically, we have three primary goals for this interdisciplinary project. First, we will evaluate the effectiveness of the outreach program in improving criminal justice and victim safety and empowerment outcomes for IPV victims using a longitudinal, randomized control design. Second, the project will identify victim and case characteristics that mediate and moderate program effects on victim support for official action. Third, geospatial analyses will assess the contribution of spatial variables (such as distance to and time/effort required to access services) to outcomes.

    Aimee Reichmann-Decker presents research on revictimization at our 2005 Returning Research to the Community event.

Related Ongoing Projects: Healthy Adolescent Research Project (HARP), a randomized control trial comparing two approaches to revictimization prevention with teen girls in the child welfare system. To read more, visit our HARP page. The Triage Project: Outreach following police-reported intimate partner abuse (Collaborators: Joanne Belknap, Susan Buckingham, Angela Gover, Jennifer Labus). Attention processes, risk detection, and avoidance following intimate partner violence (PI: Ryan Matlow).

Sample Related Funding: "Revictimization Risk & Executive Function in Recent Female Crime Victims: A Prospective Evaluation", Professional Research Opportunities for Faculty, DU. "A Multimethod Approach to Understanding Risk Detection Following Trauma", NRSA (NIMH) to Ann Chu. "The Effectiveness of Coordinated Outreach in Intimate Partner Violence Cases: A Randomized, Longitudinal Design", National Institute of Justice.

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We are interested in how participants perceive trauma-related research (e.g., Cromer, Freyd, Binder, DePrince, & Becker-Blease, 2006; DePrince & Freyd, 2004). Studies of trauma research participants have demonstrated favorable benefit-to-cost ratios across a range of sample (e.g., undergraduate, community, and inpatient participants) and trauma-exposure (e.g., from serious injuries to interpersonal violence) types (Newman & Kaloupek, 2004). Absent in this literature, though, are studies focusing on the minimal risk standard; factors that predict perceptions of benefits; and methodological influences on perceptions. Further, little research has been done to examine children’s perceptions of research.

 To examine the minimal risk standard in trauma research, we recently developed questions to tap participants’ perceptions of the distress caused by answering questions about trauma relative to other things encountered in daily life (DePrince & Freyd, 2004). More than 500 undergraduate and community participants indicated that, on average, questions about trauma were neutral compared to day-to-day experiences. Further, participants reported that, on average, research asking about stressful life events is important; and good relative to the potential for distress.  

Under the umbrella of the NIMH-funded project on appraisals, we evaluated adults’ responses to research participation across four samples (DePrince & Chu, 2008), two of whom completed a consent "quiz" and an interview about responses to traumas. Consistent with previous findings, the benefit-to-cost ratio was favorable in all four samples. Importantly, participating in the interview not only predicted greater perceptions of benefits (after controlling for demographic and trauma-related factors), but also predicted greater benefit-to-cost ratios than completing questionnaires. Thus, this study provides an important first step in identifying methodological factors that can help us maximize benefits while minimizing costs in trauma research.

Expanding this work to children, we recently evaluated perceptions of research participation in a sample of 7-12 year old community participants who were reported by their guardians to have been exposed to no, non-interpersonal, or interpersonal traumas (Chu, DePrince & Weinzierl, 2008). Children’s perceptions (including ratings of costs-relative-to-benefits) did not vary as a function of trauma exposure (either type of exposure or number of events). These findings are important in showing that trauma-exposed children do not appear more vulnerable in the research process than their non-exposed peers.

Rheena Pineda explains our research on ethics at the 2005 Returning Research to the Community event. 

Related Ongoing Projects: Women's responses to participating in research on intimate partner abuse (Collaborators: Claire Hebenstreit, Joanne Belknap).

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