Original Article
The trauma of peer victimization: Psychophysiological and emotional characteristics of memory imagery in subjects with social anxiety disorder
Lisa M. Sansen,
Benjamin Iffland,
Frank Neuner,
Corresponding Author
Lisa M. Sansen
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Christoph-Dornier-Stiftung für Klinische Psychologie (Christoph Dornier Foundation), Bielefeld, Germany
Address correspondence to: Lisa M. Sansen, Department of Clinical Psychology and Psychotherapy, Bielefeld University, P.O. 100 131, 33501 Bielefeld, Germany. E-mail: [email protected]Search for more papers by this authorBenjamin Iffland
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Search for more papers by this authorFrank Neuner
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Search for more papers by this authorLisa M. Sansen,
Benjamin Iffland,
Frank Neuner,
Corresponding Author
Lisa M. Sansen
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Christoph-Dornier-Stiftung für Klinische Psychologie (Christoph Dornier Foundation), Bielefeld, Germany
Address correspondence to: Lisa M. Sansen, Department of Clinical Psychology and Psychotherapy, Bielefeld University, P.O. 100 131, 33501 Bielefeld, Germany. E-mail: [email protected]Search for more papers by this authorBenjamin Iffland
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Search for more papers by this authorFrank Neuner
Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
Search for more papers by this authorThe authors would like to thank Nicole Hippe and Mira Sander for their assistance with data collection, Annika Jungwirth for her assistance with data preparation, and Katy Robjant for editing. Research was funded by means of the Young Researchers' Fund of Bielefeld University and Christoph Dornier Foundation.
Abstract
The study investigated the role of an associative information network as a mechanism underlying the relation of peer victimization and social anxiety disorder (SAD). A sample of N = 80 was divided according to diagnosis (SAD vs. no diagnosis) and amount of peer victimization (low vs. high). Responses to memory of a personally experienced aversive social situation and to imagining a standardized negative social situation were assessed. In terms of skin conductance level, subjects with SAD and peer victimization were more reactive to the memory script than the other three groups while responses to the standardized script did not vary. As to heart rate, there were no differences between the groups. Emotional responses presented with an inconsistent pattern. The results provide a first indication that associative memory structures resulting from aversive social experiences might play a role in the development and maintenance of SAD, but further research is needed.
References
- American Psychiatric Association (Ed.). (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR (Revised). Washington, DC: APA.
- Amin, N., Foa, E. B., & Coles, M. E. (1998). Negative interpretation bias in social phobia. Behaviour Research and Therapy, 36, 945–957.
- Benjet, C., Thompson, R. J., & Gotlib, I. H. (2010). 5-HTTLPR moderates the effect of relational peer victimization on depressive symptoms in adolescent girls. Journal of Child Psychology and Psychiatry, 51, 173–179. doi: 10.1111/j.1469-7610.2009.02149.x
- Bernstein, D. P., & Fink, L. (1998). Childhood trauma questionnaire: A retrospective self-report questionnaire and manual. San Antonio, TX: The Psychological Corporation.
- Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of post-traumatic stress disorder. Psychological Review, 103, 670–686. doi: 10.1037/0033-295X.103.4.670
- Carney, J. (2008). Perceptions of bullying and associated trauma during adolescence. Professional School Counseling, 11, 179–188.
10.5330/PSC.n.2010-11.179 Google Scholar
- Cuthbert, B. N., Lang, P. J., Strauss, C., Drobes, D., Patrick, C. J., & Bradley, M. M. (2003). The psychophysiology of anxiety disorder: Fear memory imagery. Psychophysiology, 40, 407–422. doi: 10.1111/1469-8986.00043
- Dempsey, A. G., & Storch, E. A. (2008). Relational victimization: The association between recalled adolescent social experiences and emotional adjustment in early adulthood. Psychology in the Schools, 45, 310–322. doi: 10.1002/pits.20298
- Derogatis, L. R. (1977). The SCL-90 manual I: Scoring, administration and procedures for the SCL-90. Baltimore, MD: Johns Hopkins University School of Medicine, Clinical Psychometrics Unit.
- Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35. doi: 10.1037/0033-2909.99.1.20
- Franke, G. H. (2000). Brief symptom inventory (BSI). Göttingen, Germany: Beltz.
- Geisheim, C., Hahlweg, K., Fiegenbaum, W., Frank, M., Schröder, B., & von Witzleben, I. (2002). Das Brief Symptom Inventory (BSI) als Instrument zur Qualitätssicherung in der Psychotherapie [The German version of the Brief Symptom Inventory (BSI): Reliability and validity in a sample of outpatient psychotherapy patients]. Diagnostica, 48, 28–36. doi: 10.1026//0012-1924.48.1.28
- Gren-Landell, M., Aho, N., Andersson, G., & Svedin, C. G (2011). Social anxiety disorder and victimization in a community sample of adolescents. Journal of Adolescence, 34, 569–577. doi: 10.1016/j.adolescence.2010.03.007
- Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behavior Research and Therapy, 38, 601–610. doi: 10.1016/S0005-7967(99)00161-8
- Hackmann, A., Surawy, C., & Clark, D. M. (1998). Seeing yourself through others' eyes: A study of spontaneously occurring images in social phobia. Behavioral and Cognitive Psychotherapy, 26, 3–12.
10.1017/S1352465898000022 Google Scholar
- Hardt, J., & Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. Journal of Child Psychology and Psychiatry, 45, 260–273. doi: 10.1111/j.1469-7610.2004.00218.x
- Harvey, A. G., Ehlers, A., & Clark, D. M. (2005). Learning history in social phobia. Behavioural and Cognitive Psychotherapy, 33, 257–271. doi: 10.1017/S1352465805002146
- Hautzinger, M., Keller, F., & Kühner, C. (2006). Das Beck Depressionsinventar II. Deutsche Bearbeitung und Handbuch zum BDI II [The Beck Depression Inventory II. German version and manual for the BDI II]. Frankfurt, Germany: Harcourt Test Services.
- Hawker, D. S. J., & Boulton, M. J. (2000). Twenty years' research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies. Journal of Child Psychology and Psychiatry, 41, 441–455. doi: 10.1111/1469-7610.00629
- Heim, C., Newport, D. J., Mletzko, T., Miller, A. H., & Nemeroff, C. B. (2008). The link between childhood trauma and depression: Insight from HPA axis studies in humans. Psychoneuroendocrinology, 33, 693–710. doi: 10.1016/j.psyneuen.2008.03.008
- Heim, C., Plotsky, P. M., & Nemeroff, C. B. (2004). Importance of studying the contributions of early adverse experience to neurobiological findings in depression. Neuropsychopharmacology, 29, 641–648. doi: 10.1038/sj.npp.1300397
- Heinrichs, N., Hahlweg, K., Fiegenbaum, W., Frank, M., Schröder, B., & von Witzleben, I. (2002). Validität und Reliabilität der Social Interaction Anxiety Scale (SIAS) und der Social Phobia Scale (SPS) [Validity and reliability of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS)]. Verhaltenstherapie, 12, 26–35. doi: 10.1026//0084-5345.28.1.28
- Iffland, B., Sansen, L. M., Catani, C., & Neuner, F. (2012). Emotional but not physical maltreatment is independently related to psychopathology in subjects with various degrees of social anxiety: A web-based internet survey. BMC Psychiatry 12, 49. doi: 10.1186/1471-244X-12-49
- Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C., & Eaves, L. J. (1992). The genetic epidemiology of phobias in women: The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry, 49, 273–281. doi: 10.1001/archpsyc.1992.01820040025003
- Kessler, R. C., Stang, P., Wittchen, H.-U., Stein, M., & Walters, E. (1999). Lifetime co-morbidities between social phobia and mood disorders in the US National Comorbidity Survey. Psychological Medicine, 29, 555–567.
- Kingery, J. N., Erdley, C. A., Marshall, K. C., Whitaker, K. G., & Reuter, T. R. (2010). Peer experiences of anxious and socially withdrawn youth: An integrative review of the developmental and clinical literature. Clinical Child and Family Psychological Review, 13, 91–128. doi: 10.1007/s10567-009-0063-2
- Klinitzke, G., Romppel, M., Häuser, W., Brähler, E., & Glaesmer, H. (2012). Die deutsche Version des Childhood Trauma Questionnaire (CTQ)—psychometrische Eigenschaften in einer bevölkerungsrepräsentativen Stichprobe [The German version of the Childhood Trauma Questionnaire (CTQ)—Psychometric characteristics in a representative sample of the general population]. Psychotherapie, Psychosomatik, Medizinische Psychologie, 62, 47–51. doi: 10.1055/s-0031-1295495
- Kühner, C., Bürger, C., Keller, F., & Hautzinger, M. (2007). Reliabilität und Validität des revidierten Beck-Depressionsinventars (BDI-II). Befunden aus deutschsprachigen Stichproben [Reliability and validity of the Revised Beck Depression Inventory (BDI-II): Results from German samples]. Nervenarzt, 78, 651–656. doi: 10.1007/s00115-006-2098-7
- Kuo, J. R., Goldin, P. R., Werner, K., Heimberg, R. G., & Gross, J. J. (2011). Childhood trauma and current psychological functioning in adults with social anxiety disorder. Journal of Anxiety Disorders, 25, 467–473. doi: 10.1016/j.janxdis.2010.11.011
- La Greca, A. M., & Harrison, H. M. (2005). Adolescent peer relations, friendship, and romantic relationships: Do they predict social anxiety and depression? Journal of Clinical Child and Adolescent Psychology, 34, 49–61. doi: 10.1207/s15374424jccp3401_5
- Lang, P. J. (1979). A bio-informational theory of emotional imagery. Psychophysiology, 16, 495–512.
- Lang, P. J., Greenwald, M. K., Bradley, M. M., & Hamm, A. 0. (1993). Looking at pictures: Evaluative, facial, visceral, and behavioral responses. Psychophysiology, 30, 261–273. doi: 10.1111/j.1469-8986.1993.tb03352.x
- Lang, P. J., Levin, D. N., Miller, G. A., & Kozak, M. J. (1983). Fear behavior, fear imagery, and the psychophysiology of emotion: The problem of affective-response integration. Journal of Abnormal Psychology, 92, 276–306. doi: 10.1037/0021-843X.92.3.276
- Lang, P. J., & McTeague, L. M. (2009). The anxiety disorder sprectrum: Fear imagery, physiological reactivity, and differential diagnosis. Anxiety, Stress, and Coping, 22, 5–25. doi: 10.1080/10615800802478247
- Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonara, I., Sheehan, K. H., … Dunbar, G. C. (1997). The mini international neuropsychiatric interview (MINI). A short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12, 224–231. doi: 10.1016/S0924-9338(97)83296-8
- Lieb, R., Wittchen, H. U., Höfler, M., Fuetsch, M., Stein, M. B., & Merikangas, K. R. (2000). Parental psychopathology, parenting styles, and the risk of social phobia in offspring: A prospective-longitudinal community study. Archives of General Psychiatry, 57, 859–866. doi: 10.1001/archpsyc.57.9.859
- Lissek, S., Levenson, J., Biggs, A. L., Johnson, L. L., Ameli, R., Pine, D. S., & Grillon, C. (2008). Elevated fear conditioning to social relevant unconditioned stimuli in social anxiety disorder. American Journal of Psychiatry, 165, 124–132. doi: 10.1176/appi.ajp.2007.06091513
- MacDonald, G., & Leary, M. (2005). Why does social exclusion hurt? The relationship between social and physical pain. Psychological Bulletin, 131, 202–223. doi: 10.1037/0033-2909.131.2.202
- Marteinsdottir, I., Svensson, A., Svedberg, M., Anderberg, U. M., & von Knorring, L. (2007). The role of life events in social phobia. Nordic Journal of Psychiatry, 61, 207–212. doi: 10.1080/08039480701352546
- Matos, M., & Pinto-Gouveia, J. (2009). Shame as a traumatic memory. Clinical Psychology and Psychotherapy, 17, 299–312. doi: 10.1002/cpp.659
- Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470. doi: 10.1016/S0005-7967(97)10031-6
- McTeague, L. M., Lang, P. J., Laplante, M.-C., Cuthbert, B. N., Strauss, C. C., & Bradley, M. M. (2009). Fearful imagery in social phobia: Generalization, comorbidity, and physiological reactivity. Biological Psychiatry, 65, 374–382. doi: 10.1016/j.biopsych.2008.09.023
- Miller, G. A., & Chapman, J. P. (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology, 110, 40–48. doi: 10.1037/0021-843X.110.1.40
- Mynard, H., Joseph, S., & Alexander, J. (2000). Peer victimisation and posttraumatic stress in adolescents. Personality and Individual Differences, 29, 815–821. doi: 10.1016/S0191-8869(99)00234-2
- Neuner, F., Schauer, M., & Elbert, T. (2009). Narrative exposition [Narrative exposure]. In A. Maercker (Ed.), Posttraumatische Belastungsstörungen (pp. 301–318). Heidelberg, Germany: Springer.
10.1007/978-3-540-88489-7_18 Google Scholar
- Nilsson, J. E., Lundh, L. G., & Viborg, G. (2012). Imagery rescripting of early memories in social anxiety disorder: An experimental study. Behaviour Research and Therapy, 50, 387–392. doi: 10.1016/j.brat.2012.03.004
- Orr, S. P. (1994). An overview of psychophysiological studies of PTSD. PTSD Research Quarterly, 5, 1–7.
- Pitman, R. K., Orr, S. P., Forgue, D. F., de Jong, J. B., & Clairborn, J. M. (1987). Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. Archives of General Psychiatry, 44, 970–975. doi: 10.1001/archpsyc.1987.01800230050009
- Prinstein, M. J., Boergers, J., & Vernberg, E. M. (2001). Overt and relational aggression in adolescents: Social-psychological adjustment of aggressors and victims. Journal of Clinical Child Psychology, 30, 479–491. doi: 10.1207/S15374424JCCP3004_05
- Sansen, L. M., Iffland, B., Catani, C., & Neuner, F. (2013). Entwicklung und Evaluation des Fragebogens zu belastenden Sozialerfahrungen in der Peergroup (FBS) [Development and evaluation of a questionnaire on stressful social experiences in peer groups (FBS)]. Zeitschrift für Klinische Psychologie und Psychotherapie, 42, 34–44. doi: 10.1026/1616-3443/a000184
- Sansen, L. M., Iffland, B., & Neuner, F. (2014). Peer victimization predicts psychological symptoms beyond the effects of child maltreatment. Manuscript submitted for publication.
- Siegel, R. S., La Greca, A. M., & Harrison, H. M. (2009). Peer victimization and social anxiety in adolescents: Prospective and reciprocal relationship. Journal of Youth and Adolescence, 38 (8), 1096–1109. doi: 10.1007/s10964-009-9392-1
- Simon, N. M., Herlands, N. N., Marks, E. H., Mancini, C., Letamendi, A., Li, Z., … Stein, M. B. (2009). Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder. Depression and Anxiety, 26, 1027–1032. doi: 10.1002/da.20604
- Stangier, U., Heidenreich, T., Berardi, A., Golbs, U., & Hoyer, J. (1999). Die Erfassung sozialer Phobie durch die Social Interaction Anxiety Scale (SIAS) und die Social Phobia Scale (SPS) [Assessment of social phobia by the Social Interaction Anxiety Scale and the Social Phobia Scale]. Zeitschrift für Klinische Psychologie, 28, 28–36. doi: 10.1026//0084-5345.28.1.28
- Stein, M. B., & Kean, Y. M. (2000). Disability and quality of life in social phobia: Epidemiologic findings. American Journal of Psychiatry, 157, 1606–1613. doi: 10.1176/appi.ajp.157.10.1606
- Stopa, L., & Clark, D. M. (2000). Social phobia and interpretation of social events. Behaviour Research and Therapy, 38, 273–283.
- Storch, E. A., & Esposito, L. E. (2003). Peer victimization and posttraumatic stress among children. Child Study Journal, 33, 91–98.
- Tangney, J. P., Wagner, P. U., & Gramzow, R. (1992). Proneness to shame, proneness to guilt, and psychopathology. Journal of Abnormal Psychology, 101, 469–478. doi: 10.1037/0021-843X.101.3.469
- Wild, J., & Clark, D. M. (2011). Imagery rescripting of early traumatic memories in social phobia. Cognitive and Behavioral Practice, 18, 433–443. doi: 10.1016/j.cbpra.2011.03.002
- Wilhelm, F., & Peyk, P. (2006). Psychophysiology analysis software, Anslab version 4.0 [Computer software]. Boston, MA: Free Software Foundation.
- Wingenfeld, K., Spitzer, C., Mensebach, C., Grabe, H. J., Hill, A., Gast, U., … Driessen, M. (2010). Die deutsche Version des Childhood Trauma Questionnaire (CTQ): Erste Befunde zu den psychometrischen Kennwerten [The German version of the childhood trauma questionnaire (CTQ): Preliminary psychometric properties]. Psychotherapie, Psychosomatik, Medizinische Psychologie, 60, 442–450. doi: 10.1055/s-0030-1247564
- Wittchen, H.-U., Stein, M. B., & Kessler, R. C. (1999). Social fears and social phobia in a community sample of adolescents and young adults: Prevalence, risk factors and co-morbidity. Psychological Medicine, 29, 309–323.
- Wright, M. O., Crawford, E., & Del Castillo, D. (2009). Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse and Neglect, 33, 59–68.
Citing Literature
