Top

Cognitive Therapy and Research

Gepubliceerd in:

Open Access 13-03-2020 | Original Article

Daily Worry in Trauma-Exposed Afghan Refugees: Relationship with Affect and Sleep in a Study Using Ecological Momentary Assessment

Auteurs: Theresa Koch, Alexandra Liedl, Keisuke Takano, Thomas Ehring

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2020

Abstract

Background

Repetitive negative thinking—and worry as a common variant—have been suggested to be transdiagnostic maintaining factors of psychopathology in refugees. Using an ecological momentary assessment (EMA) approach, this study tested the feasibility of EMA and the hypothesis of a self-reinforcing relationship (a) between worry and affect and (b) between worry and sleep in refugees. Additionally, we examined whether worry interacts with postmigration stress to impact on affect and sleep.

Methods

For 1 week, 45 trauma-exposed Afghan refugees received five prompts per day asking them to report on momentary levels of worrying and negative as well as positive affect. In addition, sleep quality was assessed in the morning and the occurrence of postmigration stress at night.

Results

Our findings did not indicate a bidirectional relationships (a) between worry and affective experiences and (b) between worry and poor sleep quality. However, worry experienced on a given day predicted increased negative affect on the next day; in turn, positive affect predicted decreased worrying on the next day. Hypotheses on the interaction between worry and stress in predicting affect and sleep were not supported.

Conclusion

These preliminary findings suggest unidirectional effects of daily worry on negative affect and positive affect on daily worry. However, the low compliance rate and the small sample size precludes drawing firm conclusions. Implications for further EMA research among refugees are discussed.

vorige artikel Hostility and Suicide Risk Among Veterans: The Mediating Role of Perceived Burdensomeness

volgende artikel Exposure and Reactivity to Repetitive Thought in the Neuroticism–Distress Relationship

Alleen toegankelijk voor geautoriseerde gebruikers

R_KF is a between-subject reliability coefficient, estimating the reliability as an average over k time points for fixed coefficients, and is indicative of the consistency of item responses over time and across people (Shrout and Lane 2012).

R_C is a within-subject reliability coefficient, and is indicative to evaluate sensitivity to within-person change (Cranford et al. 2006).

Alemi, Q., James, S., Cruz, R., Zepeda, V., & Racadio, M. (2014). Psychological distress in Afghan refugees: A mixed-method systematic review. Journal of Immigrant and Minority Health, 16(6), 1247–1261. https://doi.org/10.1007/s10903-013-9861-1.CrossRefPubMedPubMedCentral

Bardeen, J. R., Fergus, T. A., & Wu, K. D. (2013). The interactive effect of worry and intolerance of uncertainty on posttraumatic stress symptoms. Cognitive Therapy and Research, 37(4), 742–751. https://doi.org/10.1007/s10608-012-9512-1.CrossRef

Bates, D., Mächler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 48.CrossRef

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059.CrossRefPubMed

Bontempo, R. (1993). Translation fidelity of psychological scales: An item response theory analysis of an individualism-collectivism scale. Journal of Cross-Cultural Psychology, 24(2), 149–166. https://doi.org/10.1177/0022022193242002.CrossRef

Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21(1), 9–16. https://doi.org/10.1016/0005-7967(83)90121-3.CrossRefPubMed

Chen, J., Liu, X., Rapee, R. M., & Pillay, P. (2013). Behavioural activation: A pilot trial of transdiagnostic treatment for excessive worry. Behaviour Research and Therapy, 51(9), 533–539. https://doi.org/10.1016/j.brat.2013.05.010.CrossRefPubMed

Connolly, S. L., & Alloy, L. B. (2017). Rumination interacts with life stress to predict depressive symptoms: An ecological momentary assessment study. Behaviour Research and Therapy, 97, 86–95. https://doi.org/10.1016/j.brat.2017.07.006.CrossRefPubMedPubMedCentral

Cranford, J. A., Shrout, P. E., Iida, M., Rafaeli, E., Yip, T., & Bolger, N. (2006). A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably? Personality and Social Psychology Bulletin, 32(7), 917–929. https://doi.org/10.1177/0146167206287721.CrossRefPubMed

Ehring, T., & Behar, E. (in press). Transdiagnostic view on worrying and other negative mental content. In G. A.L. & G. A.T. (Eds.), Generalized anxiety disorder and worrying: A comprehensive handbook for clinicians and researchers. Chichester: Wiley-Blackwell.

Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1(3), 192–205. https://doi.org/10.1680/ijct.2008.1.3.192.CrossRef

Emmer, M., Richter, C., & Kunst, M. (2016). Flucht 2.0: Mediennutzung durch Flüchtlinge vor, während und nach der Flucht [Flight 2.0: Refugee’s use of media pre, post and during the flight]. Retrieved March 10, 2020, from http://www.polsoz.fu-berlin.de/kommwiss/arbeitstellen/mediennutzung/forschung/Flucht-2_0/index.html.

Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: The posttraumatic diagnostic scale. Psychological Assessment, 9(4), 445–451. https://doi.org/10.1037/1040-3590.9.4.445.CrossRef

Genet, J. J., & Siemer, M. (2012). Rumination moderates the effects of daily events on negative mood: Results from a diary study. Emotion, 12(6), 1329–1339. https://doi.org/10.1037/a0028070.CrossRefPubMed

Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., et al. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27(1), 191–197. https://doi.org/10.1017/S0033291796004242.CrossRefPubMed

Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40(8), 869–893. https://doi.org/10.1016/S0005-7967(01)00061-4.CrossRefPubMed

Harvey, A. G., Tang, N. K. Y., & Browning, L. (2005). Cognitive approaches to insomnia. Clinical Psychology Review, 25(5), 593–611. https://doi.org/10.1016/j.cpr.2005.04.005.CrossRefPubMed

Heron, K. E., Everhart, R. S., McHale, S. M., & Smyth, J. M. (2017). Using mobile-technology-based ecological momentary assessment (EMA) methods with youth: A systematic review and recommendations. Journal of Pediatric Psychology, 42(10), 1087–1107. https://doi.org/10.1093/jpepsy/jsx078.CrossRefPubMed

Hinton, D. E., Barlow, D. H., Reis, R., & de Jong, J. (2016). A transcultural model of the centrality of ‘thinking a lot’ in psychopathologies across the globe and the process of localization: A Cambodian refugee example. Culture, Medicine, and Psychiatry, 40(4), 570–619. https://doi.org/10.1007/s11013-016-9489-4.CrossRef

Hinton, D. E., Nickerson, A., & Bryant, R. A. (2011). Worry, worry attacks, and PTSD among Cambodian refugees: A path analysis investigation. Social Science and Medicine, 72(11), 1817–1825. https://doi.org/10.1016/j.socscimed.2011.03.045.CrossRefPubMed

Kaiser, B. N., Haroz, E. E., Kohrt, B. A., Bolton, P. A., Bass, J. K., & Hinton, D. E. (2015). “Thinking too much”: A systematic review of a common idiom of distress. Social Science and Medicine, 147, 170–183. https://doi.org/10.1016/j.socscimed.2015.10.044.CrossRefPubMed

Kircanski, K., Thompson, R. J., Sorenson, J., Sherdell, L., & Gotlib, I. H. (2018). The everyday dynamics of rumination and worry: Precipitant events and affective consequences. Cognition and Emotion, 32(7), 1424–1436. https://doi.org/10.1080/02699931.2017.1278679.CrossRefPubMed

Koch, T., Ehring, T., & Liedl, A. (2020). Efficacy of a transdiagnostic group intervention to enhance emotion regulation in refugees: A pilot randomized controlled study. (Manuscript submitted for publication).

Kuiper, R. M., & Ryan, O. (2018). Drawing conclusions from cross-lagged relationships: Re-considering the role of the time-interval. Structural Equation Modeling, 25(5), 809–823. https://doi.org/10.1080/10705511.2018.1431046.CrossRef

Li, S. S. Y., Liddell, B. J., & Nickerson, A. (2016). The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Current Psychiatry Reports, 18(9), 82. https://doi.org/10.1007/s11920-016-0723-0.CrossRefPubMed

Llera, S. J., & Newman, M. G. (2014). Rethinking the role of worry in generalized anxiety disorder: Evidence supporting a model of emotional contrast avoidance. Behavior Therapy, 45(3), 283–299. https://doi.org/10.1016/j.beth.2013.12.011.CrossRefPubMed

Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: A meta-analysis and review. Clinical Psychology, 16(4), 383–411. https://doi.org/10.1111/j.1468-2850.2009.01178.x.CrossRef

McEvoy, P. M., Watson, H., Watkins, E. R., & Nathan, P. (2013). The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct. Journal of Affective Disorders, 151(1), 313–320. https://doi.org/10.1016/j.jad.2013.06.014.CrossRefPubMed

McGowan, S. K., Behar, E., & Luhmann, M. (2016). Examining the relationship between worry and sleep: A daily process approach. Behavior Therapy, 47(4), 460–473. https://doi.org/10.1016/j.beth.2015.12.003.CrossRefPubMed

McLaughlin, K. A., Borkovec, T. D., & Sibrava, N. J. (2007). The effects of worry and rumination on affect states and cognitive activity. Behavior Therapy, 38(1), 23–38. https://doi.org/10.1016/j.beth.2006.03.003.CrossRefPubMed

Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the penn state worry questionnaire. Behaviour Research and Therapy, 28(6), 487–495. https://doi.org/10.1016/0005-7967(90)90135-6.CrossRefPubMed

Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24(5), 307–317. https://doi.org/10.1002/da.20228.CrossRefPubMed

Moberly, N. J., & Watkins, E. R. (2008). Ruminative self-focus, negative life events, and negative affect. Behavior Research and Therapy, 46(9), 1034–1039. https://doi.org/10.1016/j.brat.2008.06.004.CrossRef

Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The harvard trauma questionnaire: Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180(2), 111–116. https://doi.org/10.1097/00005053-199202000-00008.CrossRefPubMed

Myin-Germeys, I., Oorschot, M., Collip, D., Lataster, J., Delespaul, P., & van Os, J. (2009). Experience sampling research in psychopathology: Opening the black box of daily life. Psychological Medicine, 39(9), 1533–1547. https://doi.org/10.1017/S0033291708004947.CrossRefPubMed

Newman, M. G., Jacobson, N. C., Zainal, N. H., Shin, K. E., Szkodny, L. E., & Sliwinski, M. J. (2019). The effects of worry in daily life: An ecological momentary assessment study supporting the tenets of the contrast avoidance model. Clinical Psychological Science, 7(4), 794–810. https://doi.org/10.1177/2167702619827019.CrossRefPubMedPubMedCentral

Newman, M. G., & Llera, S. J. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychological Review, 31(3), 371–382. https://doi.org/10.1016/j.cpr.2011.01.008.CrossRef

Nickerson, A. (2018). Pathways to recovery: psychological mechanisms underlying refugee mental health. In N. Morina & A. Nickerson (Eds.), Mental health of refugee and conflict-affected populations: Theory, research and clinical practice (pp. 91–109). Cham: Springer International Publishing.CrossRef

Palmier-Claus, J. E., Myin-Germeys, I., Barkus, E., Bentley, L., Udachina, A., Delespaul, P. A. E. G., et al. (2011). Experience sampling research in individuals with mental illness: reflections and guidance. Acta Psychiatrica Scandinavica, 123(1), 12–20. https://doi.org/10.1111/j.1600-0447.2010.01596.x.CrossRefPubMed

Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. Journal of the American Medical Association, 294(5), 602–612. https://doi.org/10.1001/jama.294.5.602.CrossRefPubMed

Rintala, A., Wampers, M., Myin-Germeys, I., & Viechtbauer, W. (2019). Response compliance and predictors thereof in studies using the experience sampling method. Psychological Assessment, 31(2), 226–235. https://doi.org/10.1037/pas0000662.CrossRefPubMed

Robinson, M. S., & Alloy, L. B. (2003). Negative cognitive styles and stress-reactive rumination interact to predict depression: A prospective study. Cognitive Therapy and Research, 27(3), 275–291. https://doi.org/10.1023/a:1023914416469.CrossRef

Roussis, P., & Wells, A. (2008). Psychological factors predicting stress symptoms: Metacognition, thought control, and varieties of worry. Anxiety Stress and Coping, 21(3), 213–225. https://doi.org/10.1080/10615800801889600.CrossRefPubMed

Satterthwaite, F. E. (1946). An approximate distribution of estimates of variance components. Biometrics Bulletin, 2(6), 110–114.CrossRefPubMed

Shrout, P. E., & Lane, S. P. (2012). Psychometrics. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 302–320). New York, NY: The Guilford Press.

Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V., & Steel, Z. (1997). Anxiety, depression and PTSD in asylum-seekers: Assocations with pre-migration trauma and post-migration stressors. The British Journal of Psychiatry, 170(4), 351–357. https://doi.org/10.1192/bjp.170.4.351.CrossRefPubMed

Spinhoven, P., van Hemert, A. M., & Penninx, B. W. (2018). Repetitive negative thinking as a predictor of depression and anxiety: A longitudinal cohort study. Journal of Affective Disorders, 241, 216–225. https://doi.org/10.1016/j.jad.2018.08.037.CrossRefPubMed

Steel, Z., Silove, D., Bird, K., McGorry, P., & Mohan, P. (1999). Pathways from war trauma to posttraumatic stress symptoms among Tamil asylum seekers, refugees, and immigrants. Journal of Traumatic Stress, 12(3), 421–435. https://doi.org/10.1023/a:1024710902534.CrossRefPubMed

Takano, K., Sakamoto, S., & Tanno, Y. (2014). Repetitive thought impairs sleep quality: An experience sampling study. Behavior Therapy, 45(1), 67–82. https://doi.org/10.1016/j.beth.2013.09.004.CrossRefPubMed

Thielsch, C., Andor, T., & Ehring, T. (2015a). Do metacognitions and intolerance of uncertainty predict worry in everyday life? An ecological momentary assessment study. Behavior Therapy, 46(4), 532–543. https://doi.org/10.1016/j.beth.2015.05.001.CrossRefPubMed

Thielsch, C., Ehring, T., Nestler, S., Wolters, J., Kopei, I., Rist, F., et al. (2015b). Metacognitions, worry and sleep in everyday life: Studying bidirectional pathways using Ecological Momentary Assessment in GAD patients. Journal of Anxiety Disorders, 33, 53–61. https://doi.org/10.1016/j.janxdis.2015.04.007.CrossRefPubMed

Thompson, E. R. (2007). Development and validation of an internationally reliable short-form of the positive and negative affect schedule (PANAS). Journal of Cross-Cultural Psychology, 38(2), 227–242. https://doi.org/10.1177/0022022106297301.CrossRef

Turrini, G., Purgato, M., Ballette, F., Nosè, M., Ostuzzi, G., & Barbui, C. (2017). Common mental disorders in asylum seekers and refugees: Umbrella review of prevalence and intervention studies. International Journal of Mental Health Systems, 11, 51. https://doi.org/10.1186/s13033-017-0156-0.CrossRefPubMedPubMedCentral

UNHCR. (2017). From a Refugee Perspective: Discourse of Arabic speaking and Afghan refugees and migrants on social media from March to December 2016. Retrieved from https://data2.unhcr.org/en/documents/download/58018.

Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134(2), 163–206. https://doi.org/10.1037/0033-2909.134.2.163.CrossRefPubMedPubMedCentral

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD checklist for DSM-5 (PCL-5). Boston: National Center for PTSD.

Weise, S., Ong, J., Tesler, N. A., Kim, S., & Roth, W. T. (2013). Worried sleep: 24-h monitoring in high and low worriers. Biological Psychology, 94(1), 61–70. https://doi.org/10.1016/j.biopsycho.2013.04.009.CrossRefPubMed

Titel: Daily Worry in Trauma-Exposed Afghan Refugees: Relationship with Affect and Sleep in a Study Using Ecological Momentary Assessment
Auteurs: Theresa Koch
Alexandra Liedl
Keisuke Takano
Thomas Ehring
Publicatiedatum: 13-03-2020
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-020-10091-7

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Background

Methods

Results

Conclusion

Log in om toegang te krijgen

Andere artikelen Uitgave 3/2020

Evaluation of Exposure Instructions to Pain: Should Therapist Focus on Fear Reduction or Expectation Violation?

Increased Direct Retrieval of Overgeneral Categoric Memory in Individuals with Dysphoria and a History of Major Depression

Cognitive Bias Modification for the Induction of Negative Versus Benign Interpretations of the Self in Individuals with Elevated Social Anxiety: Effects on Self-related and Anxiety Outcomes

Hostility and Suicide Risk Among Veterans: The Mediating Role of Perceived Burdensomeness

Neural Correlates Supported by Eye Movements of Self-Focused Attention and Other-Focused Attention in Social Situations

Social Avoidance as a Predictor of Psychosocial Functioning in Body Dysmorphic Disorder: A Prospective Longitudinal Analysis