Structural Validity of the World Assumption Scale.

The World Assumption Scale (WAS) is a frequently used measure in trauma research. The 32 items of the WAS are intended to represent eight assumptions about the benevolence of the world, the meaningfulness of events, and the worthiness of the self. Debate about the validity of the WAS is ongoing, particularly in terms of its empirical factor structure; some studies have confirmed a model of eight correlated factors whereas several other studies have not. The WAS items were administered to a clinical sample of patients who sought professional help because of posttraumatic complaints (n = 1,791) as well as a sample of healthcare professionals (n = 236). We split the clinical sample into three subsamples, then performed exploratory factor analysis using data from one subsample and tested the factor structure with confirmatory factor analysis using the other two subsamples. A consistent model of eight correlated factors was demonstrated, with almost all factors showing acceptable reliability, Cronbach's αs = .68-.84. We tested this factor model against data from the sample of healthcare professionals with increasingly stringent levels of invariance and found it to be scalar invariant (same structure, loadings, and thresholds). In a regression analysis, five factors showed significant associations with posttraumatic stress disorder (PTSD) symptoms, and two factors had unique associations with PTSD symptoms after we controlled for traumatic events: Self-Worth, ß = -.31; and Luck, ß = -.15. Future research should aim to distinguish between different assumptions and their individual influences on posttraumatic complaints.

Dealing with man-made trauma: the relationship between coping style, posttraumatic stress, and quality of life in resettled, traumatized refugees in the Netherlands.

This study investigated the relationship between coping style, posttraumatic stress disorder (PTSD) symptoms, and quality of life in traumatized refugees (N = 335). Participants had resettled in the Netherlands on average 13 years prior and were referred to a Dutch clinic for the treatment of posttraumatic psychopathology resulting from persecution, war, and violence. The majority (85%) of the research sample met diagnostic criteria for PTSD. Path analysis suggested a model in which PTSD symptoms (ß = -.61, p < .001), social support seeking (ß = .12, p < .05), and emotion-focused coping (ß = .13, p < .01) have a direct effect on quality of life. The role of avoidant and problem-focused coping could be interpreted in 2 ways. Either these coping styles are influenced by PTSD severity and have no effect on quality of life, or these coping styles influence PTSD severity and therefore have an indirect effect on quality of life. Intervention strategies aimed at modifying coping strategies and decreasing PTSD symptoms could be important in improving the quality of life of traumatized refugees.

The psychological mindedness assessment procedure - validation study of a Dutch version.

OBJECTIVE: The Psychological Mindedness Assessment Procedure [PMAP; McCallum, M. & Piper, W. E. (1990)] operationalizes psychological mindedness as a participant's understanding of the problem presented by two videotaped enacted patients. To possibly enhance predictive power for psychotherapy outcome, we added two video scenarios with emotionally high-impact. This article describes psychometric properties of the Dutch translation of the PMAP and the extended version, the PMAP-plus. DESIGN: A therapy-analogue study with non-clinical participants (N = 100). METHODS: In individual sessions, participants watched the four video-scenarios and responded to the PMAP-question 'What seems to be troubling this woman?'. Emotional reactions were measured using the Positive And Negative Affect Schedule [PANAS; Watson, D., Clark, L. E. & Tellegen, A. (1988)]. RESULTS: The PMAP and the PMAP-plus had good interrater reliability. As expected, PMAP-levels were lower for the newly added high-emotional scenarios. Validity was further supported by a negative relation of PMAP-scores with the Negative Affect subscale. CONCLUSIONS: The Dutch translation of the PMAP and the added scenarios of the PMAP-plus are reliable instruments. The predictive power for psychotherapy outcome needs to be investigated in a patient group. The variation in presented clinical problems could also make it a useful instrument to assess psychological mindedness in psychotherapists.

How therapists cope with clients' traumatic experiences.

An initial finding of high emotional stress in trauma therapists working in a specialized trauma institute led to three empirical studies on trauma-related therapist reactions. The purpose of these studies was to investigate the relation between high emotional burden and burnout, and the trauma-specific processes described by the concepts "secondary traumatic stress", "vicarious traumatization" and "traumatic countertransference". The initial qualitative/quantitative study examined how a group of specialized trauma therapists (N=63) coped with clients' traumatic experiences. The results on trauma-related reactions were inconclusive. This motivated a qualitative study of expert psychotherapists (N=11). Interviews with expert trauma therapists and other expert therapists were focused on reactions to the confrontation with traumatic experiences and differences between both groups of experts. Results indicated a specific reaction pattern to traumatic situations, but revealed no other differences between trauma specialists and other experts. To further examine trauma-specificity of this reaction pattern, a third study was conducted with psychology students (N=100) using an experimental design. The results suggest the existence of a trauma-specific reaction pattern, characterized by shock, anxiety and the experience of being carried away by strong emotions. The relation of trauma reactions with traumatic situations is endorsed by results on differential reactions to traumatic and interactionally difficult situations, although results suggest that other kinds of situations with high emotional impact may also evoke trauma-reactions. In the discussion the results are considered in relation to the limitations of the studies are followed recommendations for further research. Our results thus far support the high emotional impact of confrontation with traumatic material, but nuances psychopathological or other long-term negative changes that are suggested by the terms secondary or vicarious traumatization.