Understanding the relationships between personality and trauma. Stephen Snider & Elana Newman Ph.D.
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1 Understanding the relationships between personality and trauma Stephen Snider & Elana Newman Ph.D.
2 Learning objectives Define personality Identify at least one personality trait involved in each the risk and resilience of developing PTSD Explain one reason why personality is relevant to the treatment of PTSD Name and describe modern personality measures that are useful for the diagnostic process involved with PTSD
3 What is personality? A dynamic organization, inside the person, of psychophysical systems that create the person s characteristic patterns of behavior, thoughts, and feelings Carver & Scheier, 2004
4 Trait theory of personality Individual, unique personality constructs (traits) exist on dimensions Major personality models Big 5 PSY-5 HEXACO Costa & McCrae (2008), Harkness & McNulty(1994), Lee & Ashton (2004)
5 Personality & PTSD Why does it matter? Provides the lens through which the client sees and experiences the world Identify factors that increase RISK of and RESILIENCE to developing PTSD after trauma exposure Certain traits - active contributors to the identity and maintenance of PTSD
6 Vulnerability/Risk factors Neuroticism Negativity & Psychopathology Externalization of behavior, Anxiety, & Detachment Harm-avoidance and persistence, Self-directedness Bramson et al. (2000), Daud et al. (2008) Egeress et al. (2009), Jakšić et al. (2012)
7 Resiliency/Protective factors Extraversion Comprehensibility Manageability Frustration Tolerance Hardiness Neuroticism Edwards et al. (2005)
8 Personality and the treatment of PTSD Helpful: Therapeutic alliance Psychoeducation Therapeutic Assessment? Potentially disruptive: Personality disorders Resistance to treatment Rademaker et al (2008), Finn (1996)
9 Assessing personality Self-report Broad: Not PTSD/trauma specific Most widely used assessments: Minnesota Multiphasic Personality Inventory 2 & Restructured Form (MMPI-2/MMPI-2-RF) Personality Assessment Inventory (PAI) Ben-Porath & Tellegen (2008) Morey (2007)
10 Using the MMPI-2-RF Restructured Clinical Specific Problems Interpersonal PSY-5 Demoralization (RCd) Low Positive Emotions (RC2) Ideas of Persecution (RC6) Dysfunctional Negative Emotions (RC7) Self-Doubt (SFD) Inefficacy (NFC) Helplessness/Hopel essness (HLP) Stress/Worry (STW) Anxiety (AXY) Behavior Restricting Fears (BRF) Social Avoidance (SAV) Disaffiliativeness (DSF) Negative Emotionality/ Neuroticism (NEGE-r) Introversion/ Low Positive Emotionality (INTR-r) Aberrant Experiences (RC8) Ben-Porath & Tellegen (2008) Sellbom et al., 2012
11 Using the PAI Clinical Scales Anxiety (ANX-C, ANX-A, ANX-P) Anxiety Related Disorders (ARD-T) Treatment Scales Stress (STR) Treatment Rejection (RXR) Paranoia (PAR-H) Morey (2007)
12 Conclusions Personality is a complex, organized, and active psychological phenomenon Many traits are risk and resilience factors for the development of PTSD Understanding the client s personality can be beneficial for treatment Personality measures contain a wealth of clinically useful information
13 Questions?
14 References Bramsen, I., Dirkzwager, A. J. E., & van der Ploeg, H. M. (2000). Predeployment personality traits and exposure to trauma as predictors of posttraumatic stress symptoms: A prospective study of former peacekeepers. The American Journal of Psychiatry, 157(7), doi: /appi.ajp Ben-Porath, Y.S., & Tellegen, A. (2008) Minnesota Multiphasic Personality Inventory -2 Restructured Form: Manual for administration, scoring, and interpretation. Minneapolis, MN: University of Minnesota Press. Carver, C.S., & Scheier, M.F. (2004). Perspectives on personality. Boston, MA: Allyn & Bacon Costa, P., & McCrae, R. (2008). The revised NEO personality inventory (NEO-PI-R). In G. Boyle, G. Matthews, & D. Saklofske (Eds.), The SAGE handbook of personality theory and assessment: Volume 2 Personality measurement and testing. (pp ). London: SAGE Publications Ltd. doi: Daud, A., af Klinteberg, B., & Rydelius, P.-A. (2008). Trauma, PTSD and personality: The relationship between prolonged traumatization and personality impairments. Scandinavian Journal of Caring Sciences, 22(3), doi: /j x Edwards, D., Sakasa, P., & van Wyk, G. (2005). Trauma, resilience and vulnerability to PTSD: A review and clinical case analysis. Journal of Psychology in Africa; South of the Sahara, the Caribbean, and Afro-Latin America, 15(2),
15 References Egeressy, A., Butler, T., & Hunter, M. (2009). Traumatisers or traumatised : Trauma experiences and personality characteristics of Australian prisoners. International Journal of Prisoner Health, 5(4), doi: / Harkness, A. R., & McNulty, J. L. (1994). The personality psychopathology five (PSY-5): Issue from the pages of a diagnostic manual instead of a dictionary. In S. Strack & M. Lorr (Eds.), Differentiating Normal and Abnormal Personality (pp ). Springer, New York. Jakšić, N., Brajković, L., Ivezić, E., Topić, R., & Jakovljević, M. (2012). The role of personality traits in posttraumatic stress disorder (PTSD). Psychiatria Danubina, 24(3), Lee, K., & Ashton, M. C. (2004). Psychometric properties of the HEXACO Personality Inventory. Multivariate Behavioral Research, 39(2), Morey, L. (2007). The Personality Assessment Inventory professional manual. Lutz, FL: Psychological Assessment Resoruces. Personality [Def. 1]. (n.d.). Oxford Dictionaries Online. Retrieved from Rademaker, A. R., Vermetten, E., Geuze, E., Muilwijk, A., & Kleber, R. J. (2008). Self-reported early trauma as a predictor of adult personality: A study in a military sample. Journal of Clinical Psychology, 64(7), doi: /jclp Sellbom, M. Lee, T. T. C., Ben-Porath, Y.S., Arbisi, P.A., & Gervais, R.O. (2012). Differentiating PTSD symptomatology with the MMPI-2-RF (Restructured Form) in a forensic disability sample. Psychiatry Research, 197(1-2), doi: /j.psychres Sue, D., & Sue, D. (2013). Understanding abnormal behavior. Belmont, CA: Wadsworth/Cengage Learning.
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