Skip to main content
Erschienen in: Psychiatric Quarterly 1/2019

05.12.2018 | Original Paper

Posttraumatic Stress and Interpersonal Sensitivity: Alexithymia as Mediator and Emotional Expressivity as Moderator

verfasst von: Gulnara Kobylanovna Slanbekova, Man Cheung Chung, Baizhol Iskakovich Karipbaev, Raikhan Shaikhishevna Sabirova, Roza Togayevna Alimbayeva

Erschienen in: Psychiatric Quarterly | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

This study examined 1) the link between PTSD from past trauma, interpersonal sensitivity and psychiatric co-morbidity, 2) mediational effects of alexithymia on 1), and 3) moderated mediational effects with emotional expressivity as the moderator. Five hundred and fifteen Kazakh students completed the Posttraumatic Stress Diagnostic Scale, General Health Questionnaire-28, Toronto Alexithymia Scale-20, Berkeley Expressivity Questionnaire and Interpersonal Sensitivity Measure. The results showed that 28% met the criteria for full-PTSD. Controlling for academic year, age and university major, PTSD from past trauma was significantly correlated with interpersonal sensitivity and psychiatric co-morbidity. Alexithymia mediated the impact of PTSD on interpersonal sensitivity and psychiatric co-morbidity. Alexithymia, however, did not interact with type of emotional expressivity to influence outcomes. Moderated mediational effects were not found. To conclude, following trauma, Kazakh students can experience heightened levels of interpersonal sensitivity and psychological symptoms. These problems are particularly severe for those who have difficulty getting in touch with their emotions.
Literatur
1.
Zurück zum Zitat Boyce P, Parker G. Development of a scale to measure interpersonal sensitivity. Aust N Z J Psychiatry. 1989;23(3):341–51.PubMedCrossRef Boyce P, Parker G. Development of a scale to measure interpersonal sensitivity. Aust N Z J Psychiatry. 1989;23(3):341–51.PubMedCrossRef
2.
Zurück zum Zitat Gluck TM, Tran US, Lueger-Schuster B. PTSD and trauma in Austria's elderly: Influence of wartime experiences, postwar zone of occupation, and life time traumatization on today's mental health status-an interdisciplinary approach. Eur J Psychotraumatol Vol 3 2012, ArtID 17263. Gluck TM, Tran US, Lueger-Schuster B. PTSD and trauma in Austria's elderly: Influence of wartime experiences, postwar zone of occupation, and life time traumatization on today's mental health status-an interdisciplinary approach. Eur J Psychotraumatol Vol 3 2012, ArtID 17263.
3.
Zurück zum Zitat Hauff E, Vaglum P. Chronic posttraumatic stress disorder in Vietnamese refugees: a prospective community study of prevalence, course, psychopathology, and stressors. J Nerv Ment Dis. 1994;182(2):85–90.PubMedCrossRef Hauff E, Vaglum P. Chronic posttraumatic stress disorder in Vietnamese refugees: a prospective community study of prevalence, course, psychopathology, and stressors. J Nerv Ment Dis. 1994;182(2):85–90.PubMedCrossRef
4.
Zurück zum Zitat Favaro A, Maiorani M, Colombo G, Santonastaso P. Traumatic experiences, posttraumatic stress disorder, and dissociative symptoms in a group of refugees from former Yugoslavia. J Nerv Ment Dis. 1999;187(5):306–8.PubMedCrossRef Favaro A, Maiorani M, Colombo G, Santonastaso P. Traumatic experiences, posttraumatic stress disorder, and dissociative symptoms in a group of refugees from former Yugoslavia. J Nerv Ment Dis. 1999;187(5):306–8.PubMedCrossRef
5.
Zurück zum Zitat Sun X-y, Zhao L, Chen C-x, Cui X-l, Guo J, Zhang L-y. Mental health of Chinese peacekeepers in Liberia. The European Journal of Psychiatry. 2014;28(2):77–85.CrossRef Sun X-y, Zhao L, Chen C-x, Cui X-l, Guo J, Zhang L-y. Mental health of Chinese peacekeepers in Liberia. The European Journal of Psychiatry. 2014;28(2):77–85.CrossRef
6.
Zurück zum Zitat Wagner SL, McFee JA, Martin CA. Mental health implications of fire service membership. Traumatology. 2010;16(2):26–32.CrossRef Wagner SL, McFee JA, Martin CA. Mental health implications of fire service membership. Traumatology. 2010;16(2):26–32.CrossRef
7.
Zurück zum Zitat Wagner SL, Martin CA. Can firefighters' mental health be predicted by emotional intelligence and proactive coping? J Loss Trauma. 2012;17(1):56–72.CrossRef Wagner SL, Martin CA. Can firefighters' mental health be predicted by emotional intelligence and proactive coping? J Loss Trauma. 2012;17(1):56–72.CrossRef
8.
Zurück zum Zitat Wang L-P, Zhang B, Jiang T, et al. A clinical study of posttraumatic stress disorder caused by Tangshan earthquake. Chin Ment Health J. 2005;19(8):517–20. Wang L-P, Zhang B, Jiang T, et al. A clinical study of posttraumatic stress disorder caused by Tangshan earthquake. Chin Ment Health J. 2005;19(8):517–20.
9.
Zurück zum Zitat Cwikel JG, Abdelgani A, Rozovski U, Kordysh E, Goldsmith JR, Quastel MR. Long-term stress reactions in new immigrants to Israel exposed to the Chernobyl accident. Anxiety Stress Coping. 2000;13(4):413–39.CrossRef Cwikel JG, Abdelgani A, Rozovski U, Kordysh E, Goldsmith JR, Quastel MR. Long-term stress reactions in new immigrants to Israel exposed to the Chernobyl accident. Anxiety Stress Coping. 2000;13(4):413–39.CrossRef
10.
Zurück zum Zitat Solomon Z, Iancu I, Tyano S. World assumptions following disaster. J Appl Soc Psychol. 1997;27(20):1785–98.CrossRef Solomon Z, Iancu I, Tyano S. World assumptions following disaster. J Appl Soc Psychol. 1997;27(20):1785–98.CrossRef
11.
Zurück zum Zitat Dias A, Sales L, Hessen DJ, Kleber RJ. Child maltreatment and psychological symptoms in a Portuguese adult community sample: the harmful effects of emotional abuse. Eur Child Adolesc Psychiatry. 2015;24(7):767–78.PubMedCrossRef Dias A, Sales L, Hessen DJ, Kleber RJ. Child maltreatment and psychological symptoms in a Portuguese adult community sample: the harmful effects of emotional abuse. Eur Child Adolesc Psychiatry. 2015;24(7):767–78.PubMedCrossRef
12.
Zurück zum Zitat Messman-Moore TL, Long PJ, Siegfried NJ. The revictimization of child sexual abuse survivors: an examination of the adjustment of college women with child sexual abuse, adult sexual assault, and adult physical abuse. Child Maltreat. 2000;5(1):18–27.PubMedCrossRef Messman-Moore TL, Long PJ, Siegfried NJ. The revictimization of child sexual abuse survivors: an examination of the adjustment of college women with child sexual abuse, adult sexual assault, and adult physical abuse. Child Maltreat. 2000;5(1):18–27.PubMedCrossRef
13.
Zurück zum Zitat Figueroa EF, Silk KR, Huth A, Lohr NE. History of childhood sexual abuse and general psychopathology. Compr Psychiatry. 1997;38(1):23–30.PubMedCrossRef Figueroa EF, Silk KR, Huth A, Lohr NE. History of childhood sexual abuse and general psychopathology. Compr Psychiatry. 1997;38(1):23–30.PubMedCrossRef
14.
Zurück zum Zitat Hinson JV, Koverola C, Morahan M. An empirical investigation of the psychological sequelae of childhood sexual abuse in an adult Latina population. Violence Against Women. 2002;8(7):816–44.CrossRef Hinson JV, Koverola C, Morahan M. An empirical investigation of the psychological sequelae of childhood sexual abuse in an adult Latina population. Violence Against Women. 2002;8(7):816–44.CrossRef
15.
Zurück zum Zitat Otsuka A, Takaesu Y, Sato M, Masuya J, Ichiki M, Kusumi I, et al. Interpersonal sensitivity mediates the effects of child abuse and affective temperaments on depressive symptoms in the general adult population. Neuropsychiatr Dis Treat. 2017, ArtID 2559-2568;13:13.CrossRef Otsuka A, Takaesu Y, Sato M, Masuya J, Ichiki M, Kusumi I, et al. Interpersonal sensitivity mediates the effects of child abuse and affective temperaments on depressive symptoms in the general adult population. Neuropsychiatr Dis Treat. 2017, ArtID 2559-2568;13:13.CrossRef
16.
Zurück zum Zitat Murphy S, Shevlin M, Elklit A. Psychological consequences of pregnancy loss and infant death in a sample of bereaved parents. J Loss Trauma. 2014;19(1):56–69.CrossRef Murphy S, Shevlin M, Elklit A. Psychological consequences of pregnancy loss and infant death in a sample of bereaved parents. J Loss Trauma. 2014;19(1):56–69.CrossRef
17.
Zurück zum Zitat Allen JG, Coyne L, Huntoon J. Trauma pervasively elevates brief inventory profiles in inpatient women. Psychol Rep. 1998;83:499–513.PubMedCrossRef Allen JG, Coyne L, Huntoon J. Trauma pervasively elevates brief inventory profiles in inpatient women. Psychol Rep. 1998;83:499–513.PubMedCrossRef
18.
Zurück zum Zitat Huang G, Zhang Y, Momartin S, Cao Y, Zhao L. Prevalence and characteristics of trauma and posttraumatic stress disorder in female prisoners in China. Compr Psychiatry. 2006;47(1):20–9.PubMedCrossRef Huang G, Zhang Y, Momartin S, Cao Y, Zhao L. Prevalence and characteristics of trauma and posttraumatic stress disorder in female prisoners in China. Compr Psychiatry. 2006;47(1):20–9.PubMedCrossRef
19.
Zurück zum Zitat Hagenaars MA, Fisch I, van Minnen A. The effect of trauma onset and frequency on PTSD-associated symptoms. J Affect Disord. 2011;132(1–2):192–9.PubMedCrossRef Hagenaars MA, Fisch I, van Minnen A. The effect of trauma onset and frequency on PTSD-associated symptoms. J Affect Disord. 2011;132(1–2):192–9.PubMedCrossRef
20.
Zurück zum Zitat Bell KM, Naugle AE. The role of emotion recognition skills in adult sexual revictimization. The Journal of Behavior Analysis of Offender and Victim Treatment and Prevention. 2008;1(4):93–118.CrossRef Bell KM, Naugle AE. The role of emotion recognition skills in adult sexual revictimization. The Journal of Behavior Analysis of Offender and Victim Treatment and Prevention. 2008;1(4):93–118.CrossRef
23.
Zurück zum Zitat Taylor GJ, Bagby RM, Parker JD. Disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press; 1997.CrossRef Taylor GJ, Bagby RM, Parker JD. Disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press; 1997.CrossRef
29.
Zurück zum Zitat Kupchik M, Strous RD, Erez R, Gonen N, Weizman A, Spivak B. Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non PTSD subjects. Depress Anxiety. 2007;24(4):244–50. https://doi.org/10.1002/da.20189.PubMedCrossRef Kupchik M, Strous RD, Erez R, Gonen N, Weizman A, Spivak B. Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non PTSD subjects. Depress Anxiety. 2007;24(4):244–50. https://​doi.​org/​10.​1002/​da.​20189.PubMedCrossRef
30.
Zurück zum Zitat Guenole F, Mallet J-F, Baleyte J-M. Alexithymia in severe idiopathic scoliosis: findings from a cross-sectional study of adolescents who have or have not had operations. J Nerv Ment Dis. 2012;200(3):274.PubMedCrossRef Guenole F, Mallet J-F, Baleyte J-M. Alexithymia in severe idiopathic scoliosis: findings from a cross-sectional study of adolescents who have or have not had operations. J Nerv Ment Dis. 2012;200(3):274.PubMedCrossRef
31.
Zurück zum Zitat Scher D, Twaite JA. The relationship between child sexual abuse and alexithymic symptoms in a population of recovering adult substance abusers. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders. 1999;8(2):25–40.CrossRef Scher D, Twaite JA. The relationship between child sexual abuse and alexithymic symptoms in a population of recovering adult substance abusers. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders. 1999;8(2):25–40.CrossRef
32.
Zurück zum Zitat Gross JJ, John O. Revealing feelings: facets of emotional expressivity in self-reports, peer ratings, and behavior. J Pers Soc Psychol. 1997;72(2):435–48.PubMedCrossRef Gross JJ, John O. Revealing feelings: facets of emotional expressivity in self-reports, peer ratings, and behavior. J Pers Soc Psychol. 1997;72(2):435–48.PubMedCrossRef
34.
Zurück zum Zitat Amstadter AB, Vernon LL. A preliminary examination of thought suppression, emotion regulation, and coping in a trauma-exposed sample. J Aggress Maltreat Trauma. 2008;17:279–95.PubMedPubMedCentralCrossRef Amstadter AB, Vernon LL. A preliminary examination of thought suppression, emotion regulation, and coping in a trauma-exposed sample. J Aggress Maltreat Trauma. 2008;17:279–95.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Pennebaker JW. Emotion, disclosure & health. Washington DC: American Psychological Association; 1995.CrossRef Pennebaker JW. Emotion, disclosure & health. Washington DC: American Psychological Association; 1995.CrossRef
36.
Zurück zum Zitat Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003;85:348–62.PubMedCrossRef Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003;85:348–62.PubMedCrossRef
39.
Zurück zum Zitat Karukivi M, Hautala L, Kaleva O, Haapasalo-Pesu K-M, Liuksila P-R, Joukamaa M, et al. Alexithymia is associated with anxiety among adolescents. J Affect Disord. 2010;125(1–3):383–7.PubMedCrossRef Karukivi M, Hautala L, Kaleva O, Haapasalo-Pesu K-M, Liuksila P-R, Joukamaa M, et al. Alexithymia is associated with anxiety among adolescents. J Affect Disord. 2010;125(1–3):383–7.PubMedCrossRef
43.
Zurück zum Zitat Tolmunen T, Honkalampi K, Hintikka J, Rissanen M-L, Maaranen P, Kylma J, et al. Adolescent dissociation and alexithymia are distinctive but overlapping phenomena. Psychiatry Res. 2010;176(1):40–4.PubMedCrossRef Tolmunen T, Honkalampi K, Hintikka J, Rissanen M-L, Maaranen P, Kylma J, et al. Adolescent dissociation and alexithymia are distinctive but overlapping phenomena. Psychiatry Res. 2010;176(1):40–4.PubMedCrossRef
44.
Zurück zum Zitat Borrill J, Fox P, Flynn M, Roger D. Students who self-harm: coping style, rumination and alexithymia. Couns Psychol Q. 2009;22(4):361–72.CrossRef Borrill J, Fox P, Flynn M, Roger D. Students who self-harm: coping style, rumination and alexithymia. Couns Psychol Q. 2009;22(4):361–72.CrossRef
51.
Zurück zum Zitat Karukivi M, Hautala L, Korpelainen J, Haapasalo-Pesu K-M, Liuksila P-R, Joukamaa M, et al. Alexithymia and eating disorder symptoms in adolescents. Eating Disorders: The Journal of Treatment & Prevention. 2010;18(3):226–38.CrossRef Karukivi M, Hautala L, Korpelainen J, Haapasalo-Pesu K-M, Liuksila P-R, Joukamaa M, et al. Alexithymia and eating disorder symptoms in adolescents. Eating Disorders: The Journal of Treatment & Prevention. 2010;18(3):226–38.CrossRef
56.
Zurück zum Zitat Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto alexithymia scale-I: item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38:23–32.PubMedCrossRef Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto alexithymia scale-I: item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38:23–32.PubMedCrossRef
57.
Zurück zum Zitat Gross J, John O. Facets of emotional expressivity: three self-report factors and their correlates. Personal Individ Differ. 1995;19:555–68.CrossRef Gross J, John O. Facets of emotional expressivity: three self-report factors and their correlates. Personal Individ Differ. 1995;19:555–68.CrossRef
58.
Zurück zum Zitat MacKinnon DP, Lockwood CM, Williams J. Confidence limits for the indirect effect. Distribution of the produce and resampling methods. Multivar Behav Res. 2004;39:99–128.CrossRef MacKinnon DP, Lockwood CM, Williams J. Confidence limits for the indirect effect. Distribution of the produce and resampling methods. Multivar Behav Res. 2004;39:99–128.CrossRef
59.
Zurück zum Zitat Friedman M, Keane T, Resick P, editors. Handbook of PTSD: science and practice. New York: Guilford; 2007. Friedman M, Keane T, Resick P, editors. Handbook of PTSD: science and practice. New York: Guilford; 2007.
60.
Zurück zum Zitat Vogt D, King D, King L. Risk pathways in PTSD: making sense of the literature. In: Friedman M, Kean T, Resick P, editors. Handbook of PTSD: science and practice. New York: Guildford; 2007. p. 99–116. Vogt D, King D, King L. Risk pathways in PTSD: making sense of the literature. In: Friedman M, Kean T, Resick P, editors. Handbook of PTSD: science and practice. New York: Guildford; 2007. p. 99–116.
61.
Zurück zum Zitat Ehring T, Quack D. Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity. Behav Ther. 2010;41:587–98.PubMedCrossRef Ehring T, Quack D. Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity. Behav Ther. 2010;41:587–98.PubMedCrossRef
62.
Zurück zum Zitat Lilly MM, Lim BH. Shared pathogeneses of posttrauma pathologies: attachment, emotion regulation and cognitions. J Clin Psychol. 2013;69:737–48.PubMedCrossRef Lilly MM, Lim BH. Shared pathogeneses of posttrauma pathologies: attachment, emotion regulation and cognitions. J Clin Psychol. 2013;69:737–48.PubMedCrossRef
63.
Zurück zum Zitat Westphal M, Olfson M, Bravova M, Gameroff MJ, Gross R, et al. Borderline personality disorder, exposure to interpersonal trauma, and psychiatric comorbidity in urban primary care patients. Psychiatry. 2013;76:365–80.PubMedCrossRef Westphal M, Olfson M, Bravova M, Gameroff MJ, Gross R, et al. Borderline personality disorder, exposure to interpersonal trauma, and psychiatric comorbidity in urban primary care patients. Psychiatry. 2013;76:365–80.PubMedCrossRef
64.
Zurück zum Zitat Miller MW, Kaloupek DG, Dillon AL, Keane TM. Externalizing and internalizing subtypes of combat related PTSD: a replication and extension using the PSY-5 scales. J Abnorm Psychol. 2004;112:636–45.CrossRef Miller MW, Kaloupek DG, Dillon AL, Keane TM. Externalizing and internalizing subtypes of combat related PTSD: a replication and extension using the PSY-5 scales. J Abnorm Psychol. 2004;112:636–45.CrossRef
65.
Zurück zum Zitat Keane TM, Brief DJ, Pratt EM, Miller MW. Assessment of PTSD and its comorbidities in adults. In: Friedman MJ, Keane TM, Resick PA, editors. Handbook of PTSD. New York: The Guilford Press; 2007. p. 279–305. Keane TM, Brief DJ, Pratt EM, Miller MW. Assessment of PTSD and its comorbidities in adults. In: Friedman MJ, Keane TM, Resick PA, editors. Handbook of PTSD. New York: The Guilford Press; 2007. p. 279–305.
66.
Zurück zum Zitat Briere J, Runtz M. The inventory of altered self-capacities (IASC): a standardized measure of identity, affect regulation, and relationship disturbance. Assessment. 2002;9:230–9.PubMedCrossRef Briere J, Runtz M. The inventory of altered self-capacities (IASC): a standardized measure of identity, affect regulation, and relationship disturbance. Assessment. 2002;9:230–9.PubMedCrossRef
67.
Zurück zum Zitat Briere J, Spinazzola J. Phenomenology and psychological assessment of complex posttraumatic states. J Trauma Stress. 2005;18:401–12.PubMedCrossRef Briere J, Spinazzola J. Phenomenology and psychological assessment of complex posttraumatic states. J Trauma Stress. 2005;18:401–12.PubMedCrossRef
68.
Zurück zum Zitat Foa EB, Ehlers A, Clark DM, Tolin DF, Orsillo SM. The posttraumatic cognitions inventory (PTCI): development and validation. Psychol Assess. 1999;11:303–14.CrossRef Foa EB, Ehlers A, Clark DM, Tolin DF, Orsillo SM. The posttraumatic cognitions inventory (PTCI): development and validation. Psychol Assess. 1999;11:303–14.CrossRef
69.
Zurück zum Zitat Janoff-Bulman R. Shattered assumptions: Towards a new psychology of trauma. New York: Free Press; 1992. Janoff-Bulman R. Shattered assumptions: Towards a new psychology of trauma. New York: Free Press; 1992.
70.
Zurück zum Zitat Kesebir P, Luszczynska A, Pyszczynski T, Benight C. Posttraumatic stress disorder involves disrupted anxiety-buffer mechanisms. J Soc Clin Psychol. 2011;30:819–41. Kesebir P, Luszczynska A, Pyszczynski T, Benight C. Posttraumatic stress disorder involves disrupted anxiety-buffer mechanisms. J Soc Clin Psychol. 2011;30:819–41.
75.
Zurück zum Zitat Ahrens S, Deffner G. Empirical study of alexithymia: methodology and results. Am J Psychother. 1986;40(3):430–47.PubMedCrossRef Ahrens S, Deffner G. Empirical study of alexithymia: methodology and results. Am J Psychother. 1986;40(3):430–47.PubMedCrossRef
80.
Zurück zum Zitat Taylor GJ, Bagby RM. The alexithymia personality dimension. In: Widiger TA, editor. The Oxford handbook of personality disorders. Oxford: Oxford University Press; 2012. p. 648–73. Taylor GJ, Bagby RM. The alexithymia personality dimension. In: Widiger TA, editor. The Oxford handbook of personality disorders. Oxford: Oxford University Press; 2012. p. 648–73.
85.
Zurück zum Zitat Ehlers A, Clark DM. Predictors of chronic posttraumatic stress disorder: trauma memories and appraisals. In: Rothbaum BO, editor. Pathological anxiety: emotional processing in etiology and treatment. New York: The Guilford Press; 2006. Ehlers A, Clark DM. Predictors of chronic posttraumatic stress disorder: trauma memories and appraisals. In: Rothbaum BO, editor. Pathological anxiety: emotional processing in etiology and treatment. New York: The Guilford Press; 2006.
88.
Zurück zum Zitat Amir M, Sol O. Psychological impact and prevalence of traumatic events in a student sample in Israel: the effect of multiple traumatic events and physical injury. J Trauma Stress. 1999;12(1):139–54.PubMedCrossRef Amir M, Sol O. Psychological impact and prevalence of traumatic events in a student sample in Israel: the effect of multiple traumatic events and physical injury. J Trauma Stress. 1999;12(1):139–54.PubMedCrossRef
89.
Zurück zum Zitat Sabina C, Straus MA. Polyvictimization by dating partners and mental health among U.S. college students. Violence Vict. 2008;23(6):667–82.PubMedCrossRef Sabina C, Straus MA. Polyvictimization by dating partners and mental health among U.S. college students. Violence Vict. 2008;23(6):667–82.PubMedCrossRef
90.
Zurück zum Zitat Yeomans PD, Forman EM. Cultural factors in traumatic stress. In: Eshun S, Gurung RAR, editors. Culture and mental health. Chichester: Wiley-Blackwell; 2009. p. 221–44.CrossRef Yeomans PD, Forman EM. Cultural factors in traumatic stress. In: Eshun S, Gurung RAR, editors. Culture and mental health. Chichester: Wiley-Blackwell; 2009. p. 221–44.CrossRef
92.
Zurück zum Zitat Holland P. Statistics and causal inference (with discussion). J Am Stat Assoc. 1986;81:945–70.CrossRef Holland P. Statistics and causal inference (with discussion). J Am Stat Assoc. 1986;81:945–70.CrossRef
Metadaten
Titel
Posttraumatic Stress and Interpersonal Sensitivity: Alexithymia as Mediator and Emotional Expressivity as Moderator
verfasst von
Gulnara Kobylanovna Slanbekova
Man Cheung Chung
Baizhol Iskakovich Karipbaev
Raikhan Shaikhishevna Sabirova
Roza Togayevna Alimbayeva
Publikationsdatum
05.12.2018
Verlag
Springer US
Erschienen in
Psychiatric Quarterly / Ausgabe 1/2019
Print ISSN: 0033-2720
Elektronische ISSN: 1573-6709
DOI
https://doi.org/10.1007/s11126-018-9612-5

Weitere Artikel der Ausgabe 1/2019

Psychiatric Quarterly 1/2019 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.