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Reduced specificity of negative autobiographical memories in repressive coping
J. Behav. Ther. & Exp. Psychiat. 43 (2012) S32eS36
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Reduced specificity of negative autobiographical memories in repressive coping Elke Geraerts a, *, Barbara Dritschel b, Ute Kreplin b, Liv Miyagawa b, Joanne Waddington b a b
Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands University of St Andrews, St Andrews, United Kingdom
a r t i c l e i n f o
a b s t r a c t
Article history: Received 15 May 2010 Received in revised form 8 April 2011 Accepted 25 May 2011
The current study examined memory specificity of autobiographical memories in individuals with and without a repressive coping style. It seems conceivable that reduced memory specificity may be a way to reduce accessibility of negative experiences, one of the hallmark features of a repressive coping style. It was therefore hypothesized that repressors would show reduced specificity when retrieving negative memories. In order to study memory specificity, participants (N ¼ 103) performed the autobiographical memory test. Results showed that individuals with a repressive coping style were significantly less specific in retrieving negative experiences, relative to control groups of low anxious, high anxious, and defensive high anxious individuals. This result was restricted to negative memory retrieval, as participants did not differ in memory specificity for positive experiences. These results show that repressors retrieve negative autobiographical memories in an overgeneral way, possibly in order to avoid negative affect. Ó 2011 Elsevier Ltd. All rights reserved.
Keywords: Repressive coping Autobiographical memory AMT Memory specificity
1. Introduction People are constantly confronted with emotions, which makes it vital for them to find good ways for dealing with these emotions and how to regulate them. As it turns out, individuals can control nearly each aspect of emotional processing, including how emotion directs their attention, the cognitive appraisals that form an emotional experience, the physiological result of their emotions, as well as how they remember emotional events throughout their lifetime (Gross, 2007; Koole, 2009). People obviously differ in how well they are able to regulate their emotions. Individuals with a repressive coping style seem a special case, as they appear to be very good at regulating their emotions. That is, so-called repressors are able to engage in a variety of self-deceptive manoeuvres to avoid awareness of threat and negative affect (see Myers, 2010, for a review). For instance, when faced with threatening information, repressors may increase their attention to positive information (Boden & Baumeister, 1997). Accordingly, they show lower levels of self-reported distress following self-threatening or stressful events. Interestingly, repressors’ memory for negative events seems to be impaired as well. In several experiments, it was found that repressors recall fewer negative childhood memories compared to control participants (Myers & Brewin, 1994) and show a greater tendency to recall fewer negative than positive experiences (Newman & Hedberg, 1999). Moreover, in the laboratory they seem to be especially skilled in suppressing negative materials (Barnier, * Corresponding author. Tel.: þ31 10 408 9532. E-mail address: [email protected] (E. Geraerts). 0005-7916/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jbtep.2011.05.007
Levin, & Maher, 2004; Geraerts, Merckelbach, Jelicic, & Smeets, 2006; Hertel & McDaniel, 2010; Overwijk, Wessel, & de Jong, 2009). At first sight, this coping style might seem useful as it reduces everyday emotional distress. Yet, many long-term outcomes linked to repressive coping are negative, which is manifested in several ways. First, repressors posses less insight into their own emotional states (Barger, Kircher, & Croyle, 1997). Second, repressors’ difficulty remembering negative events may be associated with costs as the past often serves as a guide for action in the present and future, affecting their adjustment (Davis, 1990). Third, their enhanced suppression of negative autobiographical events can lead to longterm increases in negative intrusions (Geraerts et al., 2006). Finally, and probably most importantly, repressive coping is associated with adverse health outcomes, such as heightened susceptibility to infectious disease, inhibited immune function, and increased risk for coronary heart disease, cancer, and asthma (see Myers, 2010 for a review). Indeed, the notion that psychological factors, in particular personality characteristics, contribute to the development of cancer has been proposed by a number of scientists over the past 30 years (e.g., Greer, Morris, & Pettingale, 1979). Little is known, however, about psychological conditions that may be related to repressive coping. Overall, repression can best be considered as a trait, reflecting a habitual style of coping with aversive events. One of the most influential approaches to study repression as a trait was introduced by Weinberger, Schwartz, and Davidson (1979). These authors distinguish between repressors (low anxiety, high defensiveness), low anxious (low anxiety, low defensiveness), high anxious (high anxiety, low defensiveness), and
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defensive high anxious (high anxiety, high defensiveness) people (see Fig. 1). These four subgroups are commonly defined by using a combination of anxiety and defensiveness self-reports. Mostly, the MarloweCrowne Social Desirability Scale (MC; Crowne & Marlowe, 1960) is used as an index of defensiveness while the Taylor Manifest Anxiety Scale (TMAS; Bendig, 1956) is often used for measuring anxiety. Defensiveness is the core construct of this taxonomy and has been defined in terms of habitually avoiding threatening material and minimizing negative affect (for a review, see Weinberger, 1990). Accordingly, people scoring high on defensiveness tend to bias their self-evaluations in a positive direction. Most studies that adopted Weinberger’s taxonomy confirmed that repressors who are confronted with stressful situations report lower anxiety levels than their behavioral or physiological reactions suggest. In Weinberger’s words (1990, p. 338), “Repressors are people who fail to recognize their own affective responses.. Repressors as a group seem actively engaged in keeping themselves, rather than just other people, convinced that they are not prone to negative affect.” Clearly, cognitive avoidance may not be “the way to go”. In another line of research, Williams et al., noticed that traumatized individuals regulate their negative affect by recalling autobiographical events in a less specific way (e.g., without any details) to protect themselves from emotional distress related to their traumatic memories. This relative inability to recall specific autobiographical memories has been termed overgeneral memory (Williams & Broadbent, 1986). At first this overgeneral retrieval strategy may be restricted to the traumatic memory, but later on generalizes to the entire (negative) autobiographical memory base, resulting in reduced memory specificity (Williams et al., 2007; Williams, Stiles, & Shapiro, 1999). At present, many studies have confirmed the link between reduced specificity and trauma, indicating its function of cognitive avoidance. Findings of reduced memory specificity range from childhood abuse (Hauer, Wessel, Geraerts, Merckelbach, & Dalgleish, 2008) to combat (McNally, Lasko, Macklin, & Pitman, 1995). Moreover, Hermans, Defranc, Williams, Raes, and Eelen (2005) found that memory specificity correlates with several measures of avoidant coping. Other evidence for its role of cognitive avoidance comes from experimental work. Raes, Hermans, De Decker, Williams, and Eelen (2003) compared individuals displaying a lack of memory specificity with individuals who were highly specific in their autobiographical
Fig. 1. Fourfold classification introduced by Weinberger et al. (1979).
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memory recall. They found that an experimental stress manipulation was significantly less distressing in low-specific individuals. Related work from their lab has confirmed that people with a less specific retrieval style are also less emotionally aroused by a negative personal experience (Raes, Hermans, Williams, & Eelen, 2006). The whole of these findings strongly suggests that reduced memory specificity can act as a way to reduce the accessibility of negative experiences. This avoidant memory style might have beneficial effects in the short run (less emotional impact of stressful events) but may be detrimental in the long run. The link with repressive coping becomes especially apparent: It may well be the case that reduced memory specificity is a way for repressors to avoid negative affect. Indeed, a few studies indicate that there is a correlation between reduced memory specificity and repressive coping or repressive defensiveness (Dickson, Moberly, Hannon, & Bates, 2009; Raes et al., 2006). Yet, these studies did not select their participants on the basis of Weinberger’s fourfold classification so no comparison was possible between the different groups. Therefore, the current study was conducted to examine whether people with a repressive coping style would show reduced specificity of negative autobiographical memories, relative to the other three (control) groups, and relative to positive autobiographical memories. Also, by now a large series of studies has demonstrated positive correlations between overgeneral memory, intrusions and effort to avoid memories of traumatic events (e.g., Hauer, Wessel, & Merckelbach, 2006; Kuyken & Brewin, 1995; Schönfeld, Ehlers, Böllinghaus, & Rief, 2007; Stokes, Dritschel, & Bekerian, 2004; Wessel, Merckelbach, & Dekkers, 2002). Williams (2006) suggested that having intrusions and/or effortful avoidance of memories about an earlier trauma might contribute to overgeneral memory as they reduce the available executive resources to seek specific memories. Likewise, he suggested that a traumatic experience may cause people to have overgeneral memories through avoidance of (negative) specific memories. This is again consistent with the idea that recall of fewer specific memories may be a way to avoid negative affect. Recent research has started to examine which mechanisms may underlie the finding that overgeneral memory and (trauma-related) intrusions are connected. As intrusive thoughts and memories are common in the aftermath of a traumatic experience, most trauma survivors habitually employ avoidance of anything related to the trauma. Indeed, the symptoms of posttraumatic stress disorder (PTSD) include not talking about the trauma, avoiding reminders of the trauma, and social withdrawal (APA, 2000). Attempts to avoid traumatic memories in order to reduce the negative affect accompanying these intrusions may also result in overgeneral recall of other non-trauma related autobiographical memories. Schönfeld et al. (2007) found that when traumatized individuals actively suppressed trauma-related thoughts during the autobiographical memory test (AMT), they were more overgeneral than subjects who did not actively suppress their trauma-related thoughts. This effect was especially pronounced in individuals with PTSD. Schönfeld et al. (2007) suggested that a socalled misguided suppression effect might be into play in PTSD patients. Intentional suppression of a traumatic memory may impede emotional processing and integration of the traumatic memory, might make the memory more available and potentially might even increase inhibition of memory formation itself. This may lead to a vicious circle between intrusive memories, thought suppression, overgeneral memory and a deficient integration of the traumatic memory. Avoidance may be responsible for the finding that intrusions and reduced memory specificity are linked. Therefore, the current study also examined parameters of reported intrusions and avoidance to inspect the link with reduced memory specificity and repressive coping. Previous research namely has shown that repressive copers are skilled at suppressing
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negative intrusive thoughts (Geraerts, Merckelbach, Jelicic, & Habets, 2007). Such findings may be important to explain how repressors cognitively avoid negative affect and provide clues about links between repressive coping, thought suppression and autobiographical memory retrieval, and may predict long-term consequences of a repressive coping style. 2. Method 2.1. Participants Individuals were differentiated by their coping styles on the basis of the above-mentioned fourfold classification by Weinberger et al. (1979). As indicated above, individuals are said to have a repressive coping style when they are highly defensive, but also low in trait anxiety. Accordingly, repressors can be contrasted with low anxious (low anxiety, low defensiveness), high anxious (high anxiety, low defensiveness) and defensive high anxious (high anxiety, high defensiveness) individuals. A total of 103 undergraduate students participated in this study. They were selected on the basis of their scores on the MarloweeCrowne social desirability scale (MC; Crowne & Marlowe, 1960), and the Taylor manifest anxiety scale (TMAS; Bendig, 1956) from a pool of 492 undergraduates who completed the two scales during mass testing sessions. These two scales are the most often used in repressive coping research as they reliably discriminate the four groups. To identify these four groups, tertiary splits need to be made so the extreme scoring (low and high) individuals on both questionnaires can be selected. Repressors (n ¼ 30) scored 5 or under on the TMAS and 17 or over on the MC; low anxious participants (n ¼ 24) scored 5 or under on the TMAS and 12 or under on the MC; high anxious participants (n ¼ 24) scored 13 or over on the TMAS and 12 or under on the MC; defensive high anxious participants (n ¼ 25) scored 13 or over on the TMAS and 17 or over on the MC. There were 79 women and 24 men, with a mean age of 20.8 years (range: 17e36 years); the groups were matched in terms of gender and age. The TMAS and MC were completed again during the actual experiment to check whether scores had not changed significantly across test sessions: results showed that there were no significant differences between the scores of TMAS and MC in the first and second session. Also, none of the subjects belonged in a different group across both sessions. The Ethical Committee of the University of St. Andrews approved the study. 3. Materials The Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) was used to measure participants’ memory specificity. The AMT contained 10 words, 5 positive and 5 negative, matched for frequency and emotionality (happy, safe, interested, surprised, successful, sorry, angry, clumsy, hurt and lonely). Participants were instructed to recall in response to each cue a different specific memory about a personally experienced event that happened at a particular time and place, and that lasted less than one day. The cues were orally and visually presented with positive and negative words alternating. Participants first practiced with neutral words until they understood the task correctly. They were required to respond with a specific memory within 60 s. If participants gave a non-specific answer before this time period, they were prompted one time with ‘Could you be more specific?’ Once the time limit was reached, the experimenter presented the next cue. The response was tape-recorded. An independent rater assessed the first responses participants gave. Each response was coded as either a specific memory (i.e.
referring to an event at a particular time and place, lasting less than a day), a non-specific memory (i.e. categoric memory, an event that was about repeated occasions; extended memory, an event lasted longer than a day; no memory, a statement not being a memory), or as an omission (i.e. no response). The total number of specific memories on the AMT was the dependent variable in this study (e.g. Raes et al., 2006) and defined as all memories that referred to an event at a particular time and place, lasting less than a day. The latency to the first word of each response was recorded as well. Additionally, in order to check whether repressors would respond with subjectively similar positive or negative memories relative to the other groups, participants were required to assess pleasantness ratings for their memories (with anchor 1: extremely unpleasant; anchor 5: extremely pleasant). To determine inter-rater reliability, a second rater scored all responses of all participants to the AMT. Inter-rater reliability for coding a memory as specific or nonspecific was good; k ¼ .87. 4. Questionnaires 4.1. Impact of event scale (IES) The IES (Horowitz, Wilner, & Alvarez, 1979) was administered to measure the frequency of intrusions of memories related to participants’ most negative stressful experience. Participants reported a variety of negative stressful experiences, such as death or illness of beloved persons, as well as interpersonal problems like divorce of their parents or break up with their partner. 4.2. The cognitive behavioural avoidance scale (CBAS) The CBAS (Ottenbreit & Dobson, 2004) is a multidimensional measure of avoidance. It consists of four factors reflecting combinations of cognitive/behavioural and social/non-social dimensions of avoidance: behavioural social (e.g. ‘I tend to make up excuses to get out of social activities’), behavioural non-social (e.g. ‘I quit activities that challenge me too much’), cognitive social (e.g. ‘I try not to think about problems in my personal relationships’) and cognitive non-social (e.g. ‘I distract myself when I start to think about my school/work performance’). A higher score on the CBAS indicates more avoidance. The initial validation study indicated that the CBAS has good internal consistency and strong test-retest reliability. Also, the CBAS possesses good convergent and divergent validity: CBAS scores correlate positively with a range of self-report avoidance measures, and negatively with an index of approach coping (Ottenbreit & Dobson, 2004). 4.3. Procedure Participants were tested individually. They provided written informed consent. Firstly, the TMAS and MC were filled in again. Then the AMT was administered, after which the IES and CBAS were filled in. 5. Results 5.1. Autobiographical memory specificity Table 1 presents the autobiographical memory specificity data for the four groups. There were no differences in the type (categoric, extended, no memory) of non-specific memories participants reported, so analyses were collapsed, inspecting non-specific memories as one kind. As almost no omissions in the four groups were observed, no analyses were conducted (highest number of omissions per group was 1).
E. Geraerts et al. / J. Behav. Ther. & Exp. Psychiat. 43 (2012) S32eS36 Table 1 Memory specificity (mean and standard deviation) for negative and positive events for each group.
Specificity negative events Specificity positive events
Repressors
Low anxious
High anxious
High anxious defensive
3.07 (1.72)
4.17 (.70)
4.58 (.58)
4.40 (.58)
4.20 (.71)
4.13 (.45)
4.33 (.56)
4.20 (.65)
There was a significant group difference for memory specificity of negative memories, F(3, 99) ¼ 11.38, p < .001, h2 ¼ .26. As hypothesized, repressors showed significantly lower memory specificity for their negative memories, relative to the other groups. Post-hoc LSD tests revealed that this difference was significant with the low anxious group, t(52) ¼ 2.94, p ¼ .005, the high anxious group, t(52) ¼ 4.13, p < .001, as well as with the defensive high anxious group, t(53) ¼ 3.70, p ¼ .001. The other three groups did not differ from each other, ps > .05. Two raters evaluated whether the memories reported on the AMT and IES were related: only four people reported a memory on the AMT that was similar to the memory they reported on the IES; this was equally distributed across groups, p > .05. As expected, there were no differences between groups in memory specificity for the positive memories, F(3, 99) ¼ .49, p ¼ .69, h2 ¼ .015. Importantly, univariate analyses showed that repressors selected subjectively similar negative and positive memories as pleasantness ratings did not differ between groups for both negative (M ¼ 1.94; SD ¼ .40) and positive (M ¼ 4.24; SD ¼ .41) memories, both ps > .05. Moreover, groups did not differ in response latency for retrieving negative and positive memories, F(3, 99) ¼ .18, p ¼ .91, h2 ¼ .005 and F(3, 99) ¼ .23, p ¼ .88, h2 ¼ .007, respectively. 5.2. Link between memory specificity and intrusion/avoidance measures There was a significant group difference for self-reported intrusions of participants’ most negative stressful experience on the IES, F(3, 99) ¼ 4.83, p ¼ .005, h2 ¼ .21. That is, repressors reported significantly fewer intrusions than the other three groups, all ts > 2.16, all ps < .038. Likewise, there was a significant group difference for reported avoidance on the CBAS total score, F(3, 99) ¼ 12.94, p < .001, h2 ¼ .41, with repressors scoring significantly lower than participants in the other three groups, all ts > 5.06, all ps < .001. Similar patterns were found for the CBAS subscales. Table 2 shows correlations between intrusions and avoidance measures with memory specificity for negative and positive experiences. A significant correlation was found between self-reported intrusions (IES) and memory specificity for negative events. That is, the higher memory specificity, the more intrusions were reported. Similarly, higher memory specificity for negative events was positively correlated with self-reported avoidance. There was no significant link between the intrusion/avoidance measures and memory specificity for positive events.
Table 2 Pearson correlations between self-reported intrusions (IES)/avoidance (CBAS) and memory specificity.
Specificity negative events Specificity positive events *p < .05 **p < .01.
IES
CBAS
.27* .16
.35** .013
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6. Discussion Our results clearly show that individuals with a repressive coping style retrieve negative autobiographical memories in an overgeneral way. That is, relative to our three control groups, repressors show the lowest number of specific negative memories when being cued with a negative word. This pattern of results only holds for negative memories. When repressors are being cued with a positive word, they are equally specific in retrieving positive memories compared to the other participants. Importantly, these differences cannot be explained by variations in response latency or selection of emotional memories: Repressors responded within the same time period as controls and selected memories that were equally negative/positive relative to the memories selected by other participants. Finally, our study also indicated that memory specificity for negative events was positively linked to self-reported intrusions and avoidance. Our findings are in line with suggestions from previous research by Hermans, Raes and colleagues (Hermans, Raes, Iberico, & Williams, 2006; Raes et al., 2006) that repressors may retrieve overgeneral memories in order to deal with their negative memories. In this way, repressors may be able to reduce the negative affect associated with their negative memories (Williams et al., 1999). Remarkably, repressors rated their memories as being as (un) pleasant relative to controls. That is, they are well able to perceive that their memory is unpleasant; yet, they retrieve the unpleasant memory in an overgeneral fashion. This finding fits well with Derakshan, Eysenck, and Myers (2007) view on how repressors process emotional information. In their vigilance-avoidance theory, they state that repressors have an initial rapid vigilant response, which triggers behavioural and physiological responses. This stage mainly involves attentional and interpretive biases to self-relevant threat stimuli. This initial vigilant stage is then followed by an avoidance stage involving avoidant cognitive biases that inhibit the conscious experience of anxiety. This stage mainly involves verbally accessible knowledge. It is possible that especially in this latter stage repressors retrieve less specific negative memories in order to not consciously experience anxiety. Whether this bias is limited to selfrelevant material, needs to be investigated in future research. Interestingly, repressors showed the lowest number of selfreported intrusions related to their most negative stressful experience on the IES. Yet, they also reported the lowest amount of avoidance on the CBAS. Moreover, a higher number of intrusions as well as avoidance were positively linked to memory specificity. These results are in contrast with the affect regulation hypothesis, which posits that overgeneral memory represents a cognitive strategy to block or disrupt access to the details of a distressing autobiographical event (e.g. Williams et al., 1999; Williams et al., 2007). This premise explains why persons with a history of trauma show reduced memory specificity. A further prediction of the affect regulation hypothesis is that, among traumatized individuals, those who are more disturbed by their traumatic memories will show reduced memory specificity. For instance, Moradi et al. (2008) showed that, in a sample of refugees with a diagnosis of PTSD, reduced memory specificity was associated with an increased frequency of trauma-related intrusions but with reduced use of effortful avoidance to deal with trauma-related intrusions. This indicates that a compromised access to specific autobiographical material in distressed trauma survivors reflects a process of affect regulation. Clearly, more research is needed to examine the links between repressive coping, intrusions, avoidance and memory specificity. In the current study it may have been the case that repressors filled in our self-report measures in a socially desirable way, leading to an underestimation of their intrusions and avoidance. Also, this reporting bias may even have influenced their lack of memory specificity. Future research should relate
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memory specificity to more objective measures of intrusions and/or avoidance as previous research in normal undergraduates has shown that intrusions are linked to a reduced memory specificity (Geraerts, Hauer, & Wessel, 2010; Neufeind, Dritschel, Astell, & MacLeod, 2009). The current study highlights yet another time that repressive coping is not a good strategy to deal with negative events. In their dual presentation theory of posttraumatic stress disorder, Brewin, Joseph, and Dalgleish (1996) argued that individuals who prematurely inhibit the processing of an upsetting event have a tendency to display a repressive coping style. This style has been related to PTSD, a condition that is far from adaptive. Accordingly, retrieving negative events in an overgeneral way has consequences, certainly on the long term. For instance, clinical research has shown that the avoidance of specific memories may have dysfunctional consequences such as reduced problem solving and planning abilities in the longer term (Williams et al., 2007). Also, an overgeneral autobiographical memory retrieval style has been shown to be a vulnerability factor for future depressive symptoms (Kleim & Ehlers, 2008). Moreover, Watkins (2008) has demonstrated that repetitive thoughts based upon an overgeneral, abstract understanding of negative situations may have negative consequences. Clearly, just as the behavioural avoidance of anxious situations can attenuate anxiety in the short term, it may intensify anxiety dysfunction in the long term. All in all, by examining retrieval strategies this study clearly shows that repressive coping is not an efficient mood-regulation strategy. Future research should focus on prevention of negative long-term consequences for individuals with a repressive coping style and how their cognitive biases may be adapted. Acknowledgments We thank Dirk Hermans and Filip Raes for their suggestions regarding the design of our study. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.- revised) (DSM- IV). Washington, DC: APA. Barger, S. D., Kircher, J. C., & Croyle, R. T. (1997). The effects of social context and defensiveness on the physiological responses of repressive copers. Journal of Personality and Social Psychology, 62, 851e862. Barnier, A. J., Levin, K., & Maher, A. (2004). Suppressing thoughts of past events: are repressive copers good suppressors? Cognition and Emotion, 18, 513e531. Bendig, A. W. (1956). The development of a short form of the manifest anxiety scale. Journal of Consulting Psychology, 20, 384. Boden, J. M., & Baumeister, R. F. (1997). Repressive coping: Distraction using pleasant thoughts and memories. Journal of Personality and Social Psychology, 73, 45e62. Brewin, C. R., Joseph, S., & Dalgleish, T. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670e686. Crowne, D. P., & Marlowe, D. A. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349e354. Davis, P. J. (1990). Repression and the inaccessibility of affective memories. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health. Chicago: University of Chicago Press. Derakshan, N., Eysenck, M. W., & Myers, L. B. (2007). Emotional information processing in repressors: the vigilance-avoidance theory. Cognition and Emotion, 21, 1585e1614. Dickson, J. M., Moberly, N. J., Hannon, E. M., & Bates, G. W. (2009). Are repressors so special after all? Specificity of negative personal events as a function of anxiety and defensiveness. Journal of Research in Personality, 43, 386e391. Geraerts, E., Hauer, B., & Wessel, I. (2010). Effects of suppressing negative memories on intrusions and autobiographical memory specificity. Applied Cognitive Psychology, 24, 387e398. Geraerts, E., Merckelbach, H., Jelicic, M., & Habets, P. (2007). Suppression of intrusive thoughts and working memory capacity in repressive coping. American Journal of Psychology, 120, 205e218. Geraerts, E., Merckelbach, H., Jelicic, M., & Smeets, E. (2006). Long term consequences of suppression if intrusive anxious thoughts and repressive coping. Behaviour Research and Therapy, 44, 1451e1460. Greer, S., Morris, T., & Pettingale, K. (1979). Psychological response to breast cancer: effect on outcome. Lancet, 2(8146), 785e787.
Gross, J. J. (Ed.). (2007). Handbook of emotion regulation. New York: Guilford Press. Hauer, B. J. A., Wessel, I., Geraerts, E., Merckelbach, H., & Dalgleish, T. (2008). Manipulating autobiographical memory specificity in adults reporting childhood sexual abuse. Journal of Abnormal Psychology, 117, 444e453. Hauer, B. J. A., Wessel, I., & Merckelbach, H. (2006). Intrusions, avoidance and overgeneral memory in a non-clinical sample. Journal of Clinical Psychology and Psychotherapy, 13, 264e268. Hermans, D., Defranc, A., Raes, F., Williams, J. M. G., & Eelen, P. (2005). Reduced autobiographical memory specificity as an avoidant coping style. British Journal of Clinical Psychology, 44, 583e589. Hermans, D., Raes, F., Iberico, C., & Williams, J. M. G. (2006). Reduced autobiographical memory specificity, avoidance, and repression. Behavioral and Brain Sciences, 29(5). Hertel, P., & McDaniel, L. (2010). The suppressive power of positive thinking: aiding suppression-induced forgetting in repressive coping. Cognition and Emotion, 24, 1239e1249. Horowitz, M. J., Wilner, N., & Alvarez, W. (1979). Impact of event scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209e218. Kleim, B., & Ehlers, A. (2008). Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma. Journal of Consulting and Clinical Psychology, 76, 231e242. Koole, S. L. (2009). The psychology of emotion regulation: an integrative review. Cognition and Emotion, 23, 4e41. Kuyken, W., & Brewin, C. R. (1995). Autobiographical memory functioning in depression and reports of early abuse. Journal of Abnormal Psychology, 104, 585e591. McNally, R. J., Lasko, N. B., Macklin, M. L., & Pitman, R. K. (1995). Autobiographical memory disturbance in combat-related posttraumatic stress disorder. Behaviour Research and Therapy, 33, 619e630. Moradi, A. R., Herllihy, J., Yasseri, G., Shahraray, M., Turner, S., & Dalgleish, T. (2008). Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder. Acta Psychologica, 127, 645e653. Myers, L. B. (2010). The importance of the repressive coping style: findings from 30 years of research. Anxiety, Stress & Coping, 23, 3e17. Myers, L. B., & Brewin, C. R. (1994). Recall of early experience and the repressive coping style. Journal of Abnormal Psychology, 103, 288e292. Neufeind, J., Dritschel, B., Astell, J., & MacLeod, M. D. (2009). The effects of thought suppression on autobiographical recall. Behaviour Research and Therapy, 47, 275e284. Newman, L. S., & Hedberg, D. A. (1999). Repressive coping and the inaccessibility of negative autobiographical memories: converging evidence. Personality and Individual Differences, 27, 45e53. Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: the construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42, 293e313. Overwijk, S., Wessel, I., & de Jong, P. (2009). Repressors report fewer intrusions following a laboratory stressor: the role of reduced stressor-relevant concept activation and inhibitory functioning. Anxiety, Stress & Coping, 22, 189e200. Raes, F., Hermans, D., De Decker, A., Williams, J. M. G., & Eelen, P. (2003). Autobiographical memory specificity and affect regulation: an experimental approach. Emotion, 3, 201e206. Raes, F., Hermans, D., Williams, J. M. G., & Eelen, P. (2006). Reduced autobiographical memory specificity and affect regulation. Cognition and Emotion, 2/3, 402e429. Schönfeld, S., Ehlers, A., Bölinghaus, I., & Rief, W. (2007). Overgeneral memory and suppression of trauma memories in Posttraumatic Stress Disorder. Memory, 15, 339e352. Stokes, D. J., Dritschel, B. H., & Bekerian, D. A. (2004). The effect of burn injury on adolescents autobiographical memory. Behaviour Research and Therapy, 42, 1357e1365. Watkins, E. R. (2008). Constructive and unconstructive repetitive thoughts. Psychological Bulletin, 134, 163e206. Weinberger, D. A. (1990). The construct validity of the repressive coping style. In J. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology and health (pp. 405e434). Chicago: University of Chicago Press. Weinberger, D. A., Schwartz, G. E., & Davidson, R. J. (1979). Low-anxious, highanxious, and repressive coping styles: psychometric patterns and behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369e380. Wessel, I., Merckelbach, H., & Dekkers, T. (2002). Auto- biographical memory specificity, intrusive memory, and general memory skills in Dutch-Indonesian survivors of the World War II era. Journal of Traumatic Stress, 15, 227e234. Williams, J. M. G. (2006). Capture and rumination, func-tional avoidance and executive control (CaRFAX): three processes that underlie overgeneral memory. Cognition and Emotion, 20, 548e568. Williams, J. M. G., Barnhofer, T., Crane, C., Hermans, D., Raes, F., Watkins, E., et al. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133, 122e148. Williams, J. M. G., & Broadbent, K. (1986). Autobiographical memory in suicide attempters. Journal of Abnormal Psychology, 95, 144e149. Williams, J. M. G., Stiles, W. B., & Shapiro, D. (1999). Cognitive mechanisms in the avoidance of painful and dangerous thoughts: elaborating the assimilation model. Cognitive Therapy and Research, 23, 285e306.
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Journal of Behavior Therapy and Experimental Psychiatry journal homepage: www.elsevier.com/locate/jbtep
Reduced specificity of negative autobiographical memories in repressive coping Elke Geraerts a, *, Barbara Dritschel b, Ute Kreplin b, Liv Miyagawa b, Joanne Waddington b a b
Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands University of St Andrews, St Andrews, United Kingdom
a r t i c l e i n f o
a b s t r a c t
Article history: Received 15 May 2010 Received in revised form 8 April 2011 Accepted 25 May 2011
The current study examined memory specificity of autobiographical memories in individuals with and without a repressive coping style. It seems conceivable that reduced memory specificity may be a way to reduce accessibility of negative experiences, one of the hallmark features of a repressive coping style. It was therefore hypothesized that repressors would show reduced specificity when retrieving negative memories. In order to study memory specificity, participants (N ¼ 103) performed the autobiographical memory test. Results showed that individuals with a repressive coping style were significantly less specific in retrieving negative experiences, relative to control groups of low anxious, high anxious, and defensive high anxious individuals. This result was restricted to negative memory retrieval, as participants did not differ in memory specificity for positive experiences. These results show that repressors retrieve negative autobiographical memories in an overgeneral way, possibly in order to avoid negative affect. Ó 2011 Elsevier Ltd. All rights reserved.
Keywords: Repressive coping Autobiographical memory AMT Memory specificity
1. Introduction People are constantly confronted with emotions, which makes it vital for them to find good ways for dealing with these emotions and how to regulate them. As it turns out, individuals can control nearly each aspect of emotional processing, including how emotion directs their attention, the cognitive appraisals that form an emotional experience, the physiological result of their emotions, as well as how they remember emotional events throughout their lifetime (Gross, 2007; Koole, 2009). People obviously differ in how well they are able to regulate their emotions. Individuals with a repressive coping style seem a special case, as they appear to be very good at regulating their emotions. That is, so-called repressors are able to engage in a variety of self-deceptive manoeuvres to avoid awareness of threat and negative affect (see Myers, 2010, for a review). For instance, when faced with threatening information, repressors may increase their attention to positive information (Boden & Baumeister, 1997). Accordingly, they show lower levels of self-reported distress following self-threatening or stressful events. Interestingly, repressors’ memory for negative events seems to be impaired as well. In several experiments, it was found that repressors recall fewer negative childhood memories compared to control participants (Myers & Brewin, 1994) and show a greater tendency to recall fewer negative than positive experiences (Newman & Hedberg, 1999). Moreover, in the laboratory they seem to be especially skilled in suppressing negative materials (Barnier, * Corresponding author. Tel.: þ31 10 408 9532. E-mail address: [email protected] (E. Geraerts). 0005-7916/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jbtep.2011.05.007
Levin, & Maher, 2004; Geraerts, Merckelbach, Jelicic, & Smeets, 2006; Hertel & McDaniel, 2010; Overwijk, Wessel, & de Jong, 2009). At first sight, this coping style might seem useful as it reduces everyday emotional distress. Yet, many long-term outcomes linked to repressive coping are negative, which is manifested in several ways. First, repressors posses less insight into their own emotional states (Barger, Kircher, & Croyle, 1997). Second, repressors’ difficulty remembering negative events may be associated with costs as the past often serves as a guide for action in the present and future, affecting their adjustment (Davis, 1990). Third, their enhanced suppression of negative autobiographical events can lead to longterm increases in negative intrusions (Geraerts et al., 2006). Finally, and probably most importantly, repressive coping is associated with adverse health outcomes, such as heightened susceptibility to infectious disease, inhibited immune function, and increased risk for coronary heart disease, cancer, and asthma (see Myers, 2010 for a review). Indeed, the notion that psychological factors, in particular personality characteristics, contribute to the development of cancer has been proposed by a number of scientists over the past 30 years (e.g., Greer, Morris, & Pettingale, 1979). Little is known, however, about psychological conditions that may be related to repressive coping. Overall, repression can best be considered as a trait, reflecting a habitual style of coping with aversive events. One of the most influential approaches to study repression as a trait was introduced by Weinberger, Schwartz, and Davidson (1979). These authors distinguish between repressors (low anxiety, high defensiveness), low anxious (low anxiety, low defensiveness), high anxious (high anxiety, low defensiveness), and
E. Geraerts et al. / J. Behav. Ther. & Exp. Psychiat. 43 (2012) S32eS36
defensive high anxious (high anxiety, high defensiveness) people (see Fig. 1). These four subgroups are commonly defined by using a combination of anxiety and defensiveness self-reports. Mostly, the MarloweCrowne Social Desirability Scale (MC; Crowne & Marlowe, 1960) is used as an index of defensiveness while the Taylor Manifest Anxiety Scale (TMAS; Bendig, 1956) is often used for measuring anxiety. Defensiveness is the core construct of this taxonomy and has been defined in terms of habitually avoiding threatening material and minimizing negative affect (for a review, see Weinberger, 1990). Accordingly, people scoring high on defensiveness tend to bias their self-evaluations in a positive direction. Most studies that adopted Weinberger’s taxonomy confirmed that repressors who are confronted with stressful situations report lower anxiety levels than their behavioral or physiological reactions suggest. In Weinberger’s words (1990, p. 338), “Repressors are people who fail to recognize their own affective responses.. Repressors as a group seem actively engaged in keeping themselves, rather than just other people, convinced that they are not prone to negative affect.” Clearly, cognitive avoidance may not be “the way to go”. In another line of research, Williams et al., noticed that traumatized individuals regulate their negative affect by recalling autobiographical events in a less specific way (e.g., without any details) to protect themselves from emotional distress related to their traumatic memories. This relative inability to recall specific autobiographical memories has been termed overgeneral memory (Williams & Broadbent, 1986). At first this overgeneral retrieval strategy may be restricted to the traumatic memory, but later on generalizes to the entire (negative) autobiographical memory base, resulting in reduced memory specificity (Williams et al., 2007; Williams, Stiles, & Shapiro, 1999). At present, many studies have confirmed the link between reduced specificity and trauma, indicating its function of cognitive avoidance. Findings of reduced memory specificity range from childhood abuse (Hauer, Wessel, Geraerts, Merckelbach, & Dalgleish, 2008) to combat (McNally, Lasko, Macklin, & Pitman, 1995). Moreover, Hermans, Defranc, Williams, Raes, and Eelen (2005) found that memory specificity correlates with several measures of avoidant coping. Other evidence for its role of cognitive avoidance comes from experimental work. Raes, Hermans, De Decker, Williams, and Eelen (2003) compared individuals displaying a lack of memory specificity with individuals who were highly specific in their autobiographical
Fig. 1. Fourfold classification introduced by Weinberger et al. (1979).
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memory recall. They found that an experimental stress manipulation was significantly less distressing in low-specific individuals. Related work from their lab has confirmed that people with a less specific retrieval style are also less emotionally aroused by a negative personal experience (Raes, Hermans, Williams, & Eelen, 2006). The whole of these findings strongly suggests that reduced memory specificity can act as a way to reduce the accessibility of negative experiences. This avoidant memory style might have beneficial effects in the short run (less emotional impact of stressful events) but may be detrimental in the long run. The link with repressive coping becomes especially apparent: It may well be the case that reduced memory specificity is a way for repressors to avoid negative affect. Indeed, a few studies indicate that there is a correlation between reduced memory specificity and repressive coping or repressive defensiveness (Dickson, Moberly, Hannon, & Bates, 2009; Raes et al., 2006). Yet, these studies did not select their participants on the basis of Weinberger’s fourfold classification so no comparison was possible between the different groups. Therefore, the current study was conducted to examine whether people with a repressive coping style would show reduced specificity of negative autobiographical memories, relative to the other three (control) groups, and relative to positive autobiographical memories. Also, by now a large series of studies has demonstrated positive correlations between overgeneral memory, intrusions and effort to avoid memories of traumatic events (e.g., Hauer, Wessel, & Merckelbach, 2006; Kuyken & Brewin, 1995; Schönfeld, Ehlers, Böllinghaus, & Rief, 2007; Stokes, Dritschel, & Bekerian, 2004; Wessel, Merckelbach, & Dekkers, 2002). Williams (2006) suggested that having intrusions and/or effortful avoidance of memories about an earlier trauma might contribute to overgeneral memory as they reduce the available executive resources to seek specific memories. Likewise, he suggested that a traumatic experience may cause people to have overgeneral memories through avoidance of (negative) specific memories. This is again consistent with the idea that recall of fewer specific memories may be a way to avoid negative affect. Recent research has started to examine which mechanisms may underlie the finding that overgeneral memory and (trauma-related) intrusions are connected. As intrusive thoughts and memories are common in the aftermath of a traumatic experience, most trauma survivors habitually employ avoidance of anything related to the trauma. Indeed, the symptoms of posttraumatic stress disorder (PTSD) include not talking about the trauma, avoiding reminders of the trauma, and social withdrawal (APA, 2000). Attempts to avoid traumatic memories in order to reduce the negative affect accompanying these intrusions may also result in overgeneral recall of other non-trauma related autobiographical memories. Schönfeld et al. (2007) found that when traumatized individuals actively suppressed trauma-related thoughts during the autobiographical memory test (AMT), they were more overgeneral than subjects who did not actively suppress their trauma-related thoughts. This effect was especially pronounced in individuals with PTSD. Schönfeld et al. (2007) suggested that a socalled misguided suppression effect might be into play in PTSD patients. Intentional suppression of a traumatic memory may impede emotional processing and integration of the traumatic memory, might make the memory more available and potentially might even increase inhibition of memory formation itself. This may lead to a vicious circle between intrusive memories, thought suppression, overgeneral memory and a deficient integration of the traumatic memory. Avoidance may be responsible for the finding that intrusions and reduced memory specificity are linked. Therefore, the current study also examined parameters of reported intrusions and avoidance to inspect the link with reduced memory specificity and repressive coping. Previous research namely has shown that repressive copers are skilled at suppressing
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negative intrusive thoughts (Geraerts, Merckelbach, Jelicic, & Habets, 2007). Such findings may be important to explain how repressors cognitively avoid negative affect and provide clues about links between repressive coping, thought suppression and autobiographical memory retrieval, and may predict long-term consequences of a repressive coping style. 2. Method 2.1. Participants Individuals were differentiated by their coping styles on the basis of the above-mentioned fourfold classification by Weinberger et al. (1979). As indicated above, individuals are said to have a repressive coping style when they are highly defensive, but also low in trait anxiety. Accordingly, repressors can be contrasted with low anxious (low anxiety, low defensiveness), high anxious (high anxiety, low defensiveness) and defensive high anxious (high anxiety, high defensiveness) individuals. A total of 103 undergraduate students participated in this study. They were selected on the basis of their scores on the MarloweeCrowne social desirability scale (MC; Crowne & Marlowe, 1960), and the Taylor manifest anxiety scale (TMAS; Bendig, 1956) from a pool of 492 undergraduates who completed the two scales during mass testing sessions. These two scales are the most often used in repressive coping research as they reliably discriminate the four groups. To identify these four groups, tertiary splits need to be made so the extreme scoring (low and high) individuals on both questionnaires can be selected. Repressors (n ¼ 30) scored 5 or under on the TMAS and 17 or over on the MC; low anxious participants (n ¼ 24) scored 5 or under on the TMAS and 12 or under on the MC; high anxious participants (n ¼ 24) scored 13 or over on the TMAS and 12 or under on the MC; defensive high anxious participants (n ¼ 25) scored 13 or over on the TMAS and 17 or over on the MC. There were 79 women and 24 men, with a mean age of 20.8 years (range: 17e36 years); the groups were matched in terms of gender and age. The TMAS and MC were completed again during the actual experiment to check whether scores had not changed significantly across test sessions: results showed that there were no significant differences between the scores of TMAS and MC in the first and second session. Also, none of the subjects belonged in a different group across both sessions. The Ethical Committee of the University of St. Andrews approved the study. 3. Materials The Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) was used to measure participants’ memory specificity. The AMT contained 10 words, 5 positive and 5 negative, matched for frequency and emotionality (happy, safe, interested, surprised, successful, sorry, angry, clumsy, hurt and lonely). Participants were instructed to recall in response to each cue a different specific memory about a personally experienced event that happened at a particular time and place, and that lasted less than one day. The cues were orally and visually presented with positive and negative words alternating. Participants first practiced with neutral words until they understood the task correctly. They were required to respond with a specific memory within 60 s. If participants gave a non-specific answer before this time period, they were prompted one time with ‘Could you be more specific?’ Once the time limit was reached, the experimenter presented the next cue. The response was tape-recorded. An independent rater assessed the first responses participants gave. Each response was coded as either a specific memory (i.e.
referring to an event at a particular time and place, lasting less than a day), a non-specific memory (i.e. categoric memory, an event that was about repeated occasions; extended memory, an event lasted longer than a day; no memory, a statement not being a memory), or as an omission (i.e. no response). The total number of specific memories on the AMT was the dependent variable in this study (e.g. Raes et al., 2006) and defined as all memories that referred to an event at a particular time and place, lasting less than a day. The latency to the first word of each response was recorded as well. Additionally, in order to check whether repressors would respond with subjectively similar positive or negative memories relative to the other groups, participants were required to assess pleasantness ratings for their memories (with anchor 1: extremely unpleasant; anchor 5: extremely pleasant). To determine inter-rater reliability, a second rater scored all responses of all participants to the AMT. Inter-rater reliability for coding a memory as specific or nonspecific was good; k ¼ .87. 4. Questionnaires 4.1. Impact of event scale (IES) The IES (Horowitz, Wilner, & Alvarez, 1979) was administered to measure the frequency of intrusions of memories related to participants’ most negative stressful experience. Participants reported a variety of negative stressful experiences, such as death or illness of beloved persons, as well as interpersonal problems like divorce of their parents or break up with their partner. 4.2. The cognitive behavioural avoidance scale (CBAS) The CBAS (Ottenbreit & Dobson, 2004) is a multidimensional measure of avoidance. It consists of four factors reflecting combinations of cognitive/behavioural and social/non-social dimensions of avoidance: behavioural social (e.g. ‘I tend to make up excuses to get out of social activities’), behavioural non-social (e.g. ‘I quit activities that challenge me too much’), cognitive social (e.g. ‘I try not to think about problems in my personal relationships’) and cognitive non-social (e.g. ‘I distract myself when I start to think about my school/work performance’). A higher score on the CBAS indicates more avoidance. The initial validation study indicated that the CBAS has good internal consistency and strong test-retest reliability. Also, the CBAS possesses good convergent and divergent validity: CBAS scores correlate positively with a range of self-report avoidance measures, and negatively with an index of approach coping (Ottenbreit & Dobson, 2004). 4.3. Procedure Participants were tested individually. They provided written informed consent. Firstly, the TMAS and MC were filled in again. Then the AMT was administered, after which the IES and CBAS were filled in. 5. Results 5.1. Autobiographical memory specificity Table 1 presents the autobiographical memory specificity data for the four groups. There were no differences in the type (categoric, extended, no memory) of non-specific memories participants reported, so analyses were collapsed, inspecting non-specific memories as one kind. As almost no omissions in the four groups were observed, no analyses were conducted (highest number of omissions per group was 1).
E. Geraerts et al. / J. Behav. Ther. & Exp. Psychiat. 43 (2012) S32eS36 Table 1 Memory specificity (mean and standard deviation) for negative and positive events for each group.
Specificity negative events Specificity positive events
Repressors
Low anxious
High anxious
High anxious defensive
3.07 (1.72)
4.17 (.70)
4.58 (.58)
4.40 (.58)
4.20 (.71)
4.13 (.45)
4.33 (.56)
4.20 (.65)
There was a significant group difference for memory specificity of negative memories, F(3, 99) ¼ 11.38, p < .001, h2 ¼ .26. As hypothesized, repressors showed significantly lower memory specificity for their negative memories, relative to the other groups. Post-hoc LSD tests revealed that this difference was significant with the low anxious group, t(52) ¼ 2.94, p ¼ .005, the high anxious group, t(52) ¼ 4.13, p < .001, as well as with the defensive high anxious group, t(53) ¼ 3.70, p ¼ .001. The other three groups did not differ from each other, ps > .05. Two raters evaluated whether the memories reported on the AMT and IES were related: only four people reported a memory on the AMT that was similar to the memory they reported on the IES; this was equally distributed across groups, p > .05. As expected, there were no differences between groups in memory specificity for the positive memories, F(3, 99) ¼ .49, p ¼ .69, h2 ¼ .015. Importantly, univariate analyses showed that repressors selected subjectively similar negative and positive memories as pleasantness ratings did not differ between groups for both negative (M ¼ 1.94; SD ¼ .40) and positive (M ¼ 4.24; SD ¼ .41) memories, both ps > .05. Moreover, groups did not differ in response latency for retrieving negative and positive memories, F(3, 99) ¼ .18, p ¼ .91, h2 ¼ .005 and F(3, 99) ¼ .23, p ¼ .88, h2 ¼ .007, respectively. 5.2. Link between memory specificity and intrusion/avoidance measures There was a significant group difference for self-reported intrusions of participants’ most negative stressful experience on the IES, F(3, 99) ¼ 4.83, p ¼ .005, h2 ¼ .21. That is, repressors reported significantly fewer intrusions than the other three groups, all ts > 2.16, all ps < .038. Likewise, there was a significant group difference for reported avoidance on the CBAS total score, F(3, 99) ¼ 12.94, p < .001, h2 ¼ .41, with repressors scoring significantly lower than participants in the other three groups, all ts > 5.06, all ps < .001. Similar patterns were found for the CBAS subscales. Table 2 shows correlations between intrusions and avoidance measures with memory specificity for negative and positive experiences. A significant correlation was found between self-reported intrusions (IES) and memory specificity for negative events. That is, the higher memory specificity, the more intrusions were reported. Similarly, higher memory specificity for negative events was positively correlated with self-reported avoidance. There was no significant link between the intrusion/avoidance measures and memory specificity for positive events.
Table 2 Pearson correlations between self-reported intrusions (IES)/avoidance (CBAS) and memory specificity.
Specificity negative events Specificity positive events *p < .05 **p < .01.
IES
CBAS
.27* .16
.35** .013
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6. Discussion Our results clearly show that individuals with a repressive coping style retrieve negative autobiographical memories in an overgeneral way. That is, relative to our three control groups, repressors show the lowest number of specific negative memories when being cued with a negative word. This pattern of results only holds for negative memories. When repressors are being cued with a positive word, they are equally specific in retrieving positive memories compared to the other participants. Importantly, these differences cannot be explained by variations in response latency or selection of emotional memories: Repressors responded within the same time period as controls and selected memories that were equally negative/positive relative to the memories selected by other participants. Finally, our study also indicated that memory specificity for negative events was positively linked to self-reported intrusions and avoidance. Our findings are in line with suggestions from previous research by Hermans, Raes and colleagues (Hermans, Raes, Iberico, & Williams, 2006; Raes et al., 2006) that repressors may retrieve overgeneral memories in order to deal with their negative memories. In this way, repressors may be able to reduce the negative affect associated with their negative memories (Williams et al., 1999). Remarkably, repressors rated their memories as being as (un) pleasant relative to controls. That is, they are well able to perceive that their memory is unpleasant; yet, they retrieve the unpleasant memory in an overgeneral fashion. This finding fits well with Derakshan, Eysenck, and Myers (2007) view on how repressors process emotional information. In their vigilance-avoidance theory, they state that repressors have an initial rapid vigilant response, which triggers behavioural and physiological responses. This stage mainly involves attentional and interpretive biases to self-relevant threat stimuli. This initial vigilant stage is then followed by an avoidance stage involving avoidant cognitive biases that inhibit the conscious experience of anxiety. This stage mainly involves verbally accessible knowledge. It is possible that especially in this latter stage repressors retrieve less specific negative memories in order to not consciously experience anxiety. Whether this bias is limited to selfrelevant material, needs to be investigated in future research. Interestingly, repressors showed the lowest number of selfreported intrusions related to their most negative stressful experience on the IES. Yet, they also reported the lowest amount of avoidance on the CBAS. Moreover, a higher number of intrusions as well as avoidance were positively linked to memory specificity. These results are in contrast with the affect regulation hypothesis, which posits that overgeneral memory represents a cognitive strategy to block or disrupt access to the details of a distressing autobiographical event (e.g. Williams et al., 1999; Williams et al., 2007). This premise explains why persons with a history of trauma show reduced memory specificity. A further prediction of the affect regulation hypothesis is that, among traumatized individuals, those who are more disturbed by their traumatic memories will show reduced memory specificity. For instance, Moradi et al. (2008) showed that, in a sample of refugees with a diagnosis of PTSD, reduced memory specificity was associated with an increased frequency of trauma-related intrusions but with reduced use of effortful avoidance to deal with trauma-related intrusions. This indicates that a compromised access to specific autobiographical material in distressed trauma survivors reflects a process of affect regulation. Clearly, more research is needed to examine the links between repressive coping, intrusions, avoidance and memory specificity. In the current study it may have been the case that repressors filled in our self-report measures in a socially desirable way, leading to an underestimation of their intrusions and avoidance. Also, this reporting bias may even have influenced their lack of memory specificity. Future research should relate
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memory specificity to more objective measures of intrusions and/or avoidance as previous research in normal undergraduates has shown that intrusions are linked to a reduced memory specificity (Geraerts, Hauer, & Wessel, 2010; Neufeind, Dritschel, Astell, & MacLeod, 2009). The current study highlights yet another time that repressive coping is not a good strategy to deal with negative events. In their dual presentation theory of posttraumatic stress disorder, Brewin, Joseph, and Dalgleish (1996) argued that individuals who prematurely inhibit the processing of an upsetting event have a tendency to display a repressive coping style. This style has been related to PTSD, a condition that is far from adaptive. Accordingly, retrieving negative events in an overgeneral way has consequences, certainly on the long term. For instance, clinical research has shown that the avoidance of specific memories may have dysfunctional consequences such as reduced problem solving and planning abilities in the longer term (Williams et al., 2007). Also, an overgeneral autobiographical memory retrieval style has been shown to be a vulnerability factor for future depressive symptoms (Kleim & Ehlers, 2008). Moreover, Watkins (2008) has demonstrated that repetitive thoughts based upon an overgeneral, abstract understanding of negative situations may have negative consequences. Clearly, just as the behavioural avoidance of anxious situations can attenuate anxiety in the short term, it may intensify anxiety dysfunction in the long term. All in all, by examining retrieval strategies this study clearly shows that repressive coping is not an efficient mood-regulation strategy. Future research should focus on prevention of negative long-term consequences for individuals with a repressive coping style and how their cognitive biases may be adapted. Acknowledgments We thank Dirk Hermans and Filip Raes for their suggestions regarding the design of our study. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.- revised) (DSM- IV). Washington, DC: APA. Barger, S. D., Kircher, J. C., & Croyle, R. T. (1997). The effects of social context and defensiveness on the physiological responses of repressive copers. Journal of Personality and Social Psychology, 62, 851e862. Barnier, A. J., Levin, K., & Maher, A. (2004). Suppressing thoughts of past events: are repressive copers good suppressors? Cognition and Emotion, 18, 513e531. Bendig, A. W. (1956). The development of a short form of the manifest anxiety scale. Journal of Consulting Psychology, 20, 384. Boden, J. M., & Baumeister, R. F. (1997). Repressive coping: Distraction using pleasant thoughts and memories. Journal of Personality and Social Psychology, 73, 45e62. Brewin, C. R., Joseph, S., & Dalgleish, T. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670e686. Crowne, D. P., & Marlowe, D. A. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349e354. Davis, P. J. (1990). Repression and the inaccessibility of affective memories. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health. Chicago: University of Chicago Press. Derakshan, N., Eysenck, M. W., & Myers, L. B. (2007). Emotional information processing in repressors: the vigilance-avoidance theory. Cognition and Emotion, 21, 1585e1614. Dickson, J. M., Moberly, N. J., Hannon, E. M., & Bates, G. W. (2009). Are repressors so special after all? Specificity of negative personal events as a function of anxiety and defensiveness. Journal of Research in Personality, 43, 386e391. Geraerts, E., Hauer, B., & Wessel, I. (2010). Effects of suppressing negative memories on intrusions and autobiographical memory specificity. Applied Cognitive Psychology, 24, 387e398. Geraerts, E., Merckelbach, H., Jelicic, M., & Habets, P. (2007). Suppression of intrusive thoughts and working memory capacity in repressive coping. American Journal of Psychology, 120, 205e218. Geraerts, E., Merckelbach, H., Jelicic, M., & Smeets, E. (2006). Long term consequences of suppression if intrusive anxious thoughts and repressive coping. Behaviour Research and Therapy, 44, 1451e1460. Greer, S., Morris, T., & Pettingale, K. (1979). Psychological response to breast cancer: effect on outcome. Lancet, 2(8146), 785e787.
Gross, J. J. (Ed.). (2007). Handbook of emotion regulation. New York: Guilford Press. Hauer, B. J. A., Wessel, I., Geraerts, E., Merckelbach, H., & Dalgleish, T. (2008). Manipulating autobiographical memory specificity in adults reporting childhood sexual abuse. Journal of Abnormal Psychology, 117, 444e453. Hauer, B. J. A., Wessel, I., & Merckelbach, H. (2006). Intrusions, avoidance and overgeneral memory in a non-clinical sample. Journal of Clinical Psychology and Psychotherapy, 13, 264e268. Hermans, D., Defranc, A., Raes, F., Williams, J. M. G., & Eelen, P. (2005). Reduced autobiographical memory specificity as an avoidant coping style. British Journal of Clinical Psychology, 44, 583e589. Hermans, D., Raes, F., Iberico, C., & Williams, J. M. G. (2006). Reduced autobiographical memory specificity, avoidance, and repression. Behavioral and Brain Sciences, 29(5). Hertel, P., & McDaniel, L. (2010). The suppressive power of positive thinking: aiding suppression-induced forgetting in repressive coping. Cognition and Emotion, 24, 1239e1249. Horowitz, M. J., Wilner, N., & Alvarez, W. (1979). Impact of event scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209e218. Kleim, B., & Ehlers, A. (2008). Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma. Journal of Consulting and Clinical Psychology, 76, 231e242. Koole, S. L. (2009). The psychology of emotion regulation: an integrative review. Cognition and Emotion, 23, 4e41. Kuyken, W., & Brewin, C. R. (1995). Autobiographical memory functioning in depression and reports of early abuse. Journal of Abnormal Psychology, 104, 585e591. McNally, R. J., Lasko, N. B., Macklin, M. L., & Pitman, R. K. (1995). Autobiographical memory disturbance in combat-related posttraumatic stress disorder. Behaviour Research and Therapy, 33, 619e630. Moradi, A. R., Herllihy, J., Yasseri, G., Shahraray, M., Turner, S., & Dalgleish, T. (2008). Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder. Acta Psychologica, 127, 645e653. Myers, L. B. (2010). The importance of the repressive coping style: findings from 30 years of research. Anxiety, Stress & Coping, 23, 3e17. Myers, L. B., & Brewin, C. R. (1994). Recall of early experience and the repressive coping style. Journal of Abnormal Psychology, 103, 288e292. Neufeind, J., Dritschel, B., Astell, J., & MacLeod, M. D. (2009). The effects of thought suppression on autobiographical recall. Behaviour Research and Therapy, 47, 275e284. Newman, L. S., & Hedberg, D. A. (1999). Repressive coping and the inaccessibility of negative autobiographical memories: converging evidence. Personality and Individual Differences, 27, 45e53. Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: the construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42, 293e313. Overwijk, S., Wessel, I., & de Jong, P. (2009). Repressors report fewer intrusions following a laboratory stressor: the role of reduced stressor-relevant concept activation and inhibitory functioning. Anxiety, Stress & Coping, 22, 189e200. Raes, F., Hermans, D., De Decker, A., Williams, J. M. G., & Eelen, P. (2003). Autobiographical memory specificity and affect regulation: an experimental approach. Emotion, 3, 201e206. Raes, F., Hermans, D., Williams, J. M. G., & Eelen, P. (2006). Reduced autobiographical memory specificity and affect regulation. Cognition and Emotion, 2/3, 402e429. Schönfeld, S., Ehlers, A., Bölinghaus, I., & Rief, W. (2007). Overgeneral memory and suppression of trauma memories in Posttraumatic Stress Disorder. Memory, 15, 339e352. Stokes, D. J., Dritschel, B. H., & Bekerian, D. A. (2004). The effect of burn injury on adolescents autobiographical memory. Behaviour Research and Therapy, 42, 1357e1365. Watkins, E. R. (2008). Constructive and unconstructive repetitive thoughts. Psychological Bulletin, 134, 163e206. Weinberger, D. A. (1990). The construct validity of the repressive coping style. In J. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology and health (pp. 405e434). Chicago: University of Chicago Press. Weinberger, D. A., Schwartz, G. E., & Davidson, R. J. (1979). Low-anxious, highanxious, and repressive coping styles: psychometric patterns and behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369e380. Wessel, I., Merckelbach, H., & Dekkers, T. (2002). Auto- biographical memory specificity, intrusive memory, and general memory skills in Dutch-Indonesian survivors of the World War II era. Journal of Traumatic Stress, 15, 227e234. Williams, J. M. G. (2006). Capture and rumination, func-tional avoidance and executive control (CaRFAX): three processes that underlie overgeneral memory. Cognition and Emotion, 20, 548e568. Williams, J. M. G., Barnhofer, T., Crane, C., Hermans, D., Raes, F., Watkins, E., et al. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133, 122e148. Williams, J. M. G., & Broadbent, K. (1986). Autobiographical memory in suicide attempters. Journal of Abnormal Psychology, 95, 144e149. Williams, J. M. G., Stiles, W. B., & Shapiro, D. (1999). Cognitive mechanisms in the avoidance of painful and dangerous thoughts: elaborating the assimilation model. Cognitive Therapy and Research, 23, 285e306.