Systematic Review Research suggests that alienation appraisals, defined as feeling disconnected from the self and others, mediate the relationship between traumatic events and subsequent PTSD symptoms. A systematic search of 6 databases found 463 studies, 9 met full inclusion criteria. Studies were quality assessed using the QATSDD. A random effects meta-analysis for the relationship between alienation appraisals and PTSD symptoms showed a total effect size of r = .57, with 95% confidence intervals between .46 and .66 (Z = 8.41, p < .001). The effect size was large, suggesting that as alienation appraisals increase, PTSD symptoms increase. Although a strong, positive relationship was found between alienation and PTSD symptoms, the mechanism of this relationship remains unclear. Limitations included significant heterogeneity and correlational data. Large-scale Cognitive models highlight the importance of negative trauma appraisals in maintaining symptoms of PTSD. The current study explored the role of alienation appraisals across student and clinical samples, assessing if alienation appraisals significantly mediated the relationship between cumulative trauma and trauma-related distress. Secondly, this study explored if alexithymia, social support and loneliness could also mediate the relationship between cumulative trauma and distress, clarifying the role of alienation. Mediation and hierarchical regression models were tested with questionnaire data from student (N = 100) and clinical samples (N = 93). In the student sample, alienation (B = 1.27) fully mediated the relationship between cumulative trauma and posttraumatic stress, but not depression. When alexithymia, social support and loneliness were entered as parallel mediators, only alienation appraisals (B = 1.03) were significant. For the clinical sample, alienation appraisals (β = .53) were the only significant predictor of posttraumatic stress symptoms whilst alienation appraisals (β = .75), and to a lesser extent, social support (β = .19) and loneliness (β = .30), significantly predicted depression. Clinical implications and limitations are discussed.
|Date of Award||Dec 2019|
- Queen's University Belfast
|Supervisor||Donncha Hanna (Supervisor) & David Curran (Supervisor)|