Coping Strategies Form Systems that Regulate PTSD Symptoms in Children and Adolescents: Exploring the Regulatory Hypothesis
This study investigated the potential regulatory effects of various coping strategies on Posttraumatic Stress Disorder (PTSD). It first divided PTSD symptoms and selected coping strategies into cognitive, social/motivational, and emotional types. The study then conceptualized each of the preceding types of coping strategies as being controlled stress responses and the PTSD symptoms as being semiautomatic stress responses. It lastly proposed that coping strategies be further divided into activating controlled stress response and deactivating controlled stress response. Controlled stress responses are coping strategies that are consciously initiated and implemented. Semiautomatic stress responses are PTSD symptoms that spontaneously emerge without conscious intent. Activating controlled stress responses consisted of the following coping strategies: seeking understanding, avoidant actions, and expressing feelings. Deactivating controlled stress responses encompassed: positive cognitive restructuring, emotion-focused support, and physical release of emotions. Semiautomatic stress responses entailed: reexperiencing, numbing, and arousal symptoms. It was proposed that cognitive, social/motivational, and emotional activating controlled stress responses would increase corresponding cognitive, social/motivational, and emotional semiautomatic stress responses. In the same vein, it was expected that cognitive, social/motivational, and emotional deactivating controlled stress responses would decrease respective semiautomatic stress responses. To illustrate, it was predicted that with regard to the cognitive regulatory system, its activating cognitive controlled stress response (seeking understanding) would exacerbate the frequency of associated cognitive semiautomatic stress responses (reexperiencing PTSD symptoms) whereas its deactivating cognitive controlled stress response (positive cognitive restructuring) would ameliorate it.
Path analyses were conducted on correlation matrices whose elements represented two coping strategies (e.g., an activating controlled stress response: seeking understanding, and a deactivating controlled stress response: positive cognitive restructuring) and one PTSD symptom cluster of the same nature (e.g., the semiautomatic stress response: reexperiencing). Data were obtained from a sample of sixty-four children and adolescents ages 8-18. The coping strategies were assessed via ratings on items included in the How I Cope Under Pressure (HICUPS) instrument and the PTSD clusters through the use of the Diagnostic Interview for Children and Adolescents (DICA).
Only one hypothesis was partially supported. It was found that the social/motivational activating controlled stress response (avoidant actions) indeed increased social/motivational semiautomatic stress responses (numbing symptoms).