A meta-analysis of the role of defeat and entrapment in depression, anxiety problems, post-traumatic stress disorder and suicidality
BACKGROUND Accumulating research indicates posttraumatic stress disorder (PTSD) is a universal phenomenon. However, it remains substantially unknown as to whether the processes implicated in the aetiology and maintenance of PTSD are culturally similar. AIMS This study investigated the impact of cultural differences in self on negative cognitive appraisals in those with and without PTSD. METHOD Trauma survivors with PTSD and without PTSD from independent and interdependent cultures (N = 106) provided trauma narratives. Narratives were coded for negative cognitive appraisals (mental defeat, control strategies, alienation and permanent change) as in Ehlers and colleagues' previous work. RESULTS Replicating Ehlers and colleagues' work, trauma survivors with PTSD from independent cultures reported more mental defeat, alienation, permanent change and less control strategies than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, only alienation appraisals differentiated between trauma survivors with and without PTSD. Those with PTSD had more alienation appraisals than those without PTSD. CONCLUSIONS The findings suggest cultural differences in self impact on the relationship between appraisals and posttraumatic psychological adjustment. Theoretical and clinical implications are discussed.