Bernice Andrews

Summary: Commentators have raised important points, including the relative contribution of false beliefs versus false memories and the issue of how findings in the laboratory can be generalized to the real world, which we have addressed here. However, some of the commentaries misrepresent what we said, make criticisms that are unfounded, or imply that our article should not have been published in Applied Cognitive Psychology. We relate these responses to a more general literature on the suppression of unwanted scientific findings and suggest that the study of false memory would be better served by more openness to alternative perspectives. Copyright © 2016 The Authors Applied Cognitive Psychology Published by John Wiley & Sons Ltd

Differences in symptoms, trauma exposure, dissociative and emotional reactions to trauma, and subsequent life stress in war veterans reporting immediate-onset or delayed-onset posttraumatic stress disorder (PTSD) or no PTSD were investigated. The role of life stress in delayed-onset PTSD was also studied. Retrospective interviews were conducted with 142 United Kingdom veterans receiving a war pension for PTSD or physical disability. Immediate-onset and delayed-onset PTSD were similar in the number and type of symptoms reported at onset, but the delayed-onset group differed in showing a gradual accumulation of symptoms that began earlier and continued throughout their military career. They were more likely to report major depressive disorder and alcohol abuse prior to PTSD onset. Both groups described similar amounts of trauma exposure, but those in the delayed-onset group reported significantly less peritraumatic dissociation, anger, and shame. Veterans with delayed onsets were more likely than veterans with no PTSD to report the presence of a severe life stressor in the year before onset. In conclusion, the results suggest that delayed onsets involve a more general stress sensitivity and a progressive failure to adapt to continued stress exposure.

Objective: Since the diagnosis of delayed-onset posttraumatic stress disorder (PTSD) was introduced in DSM-III, there has been controversy over its prevalence and even its existence. The authors sought to resolve discrepant findings concerning the prevalence of delayed-onset PTSD by conducting a systematic review of the evidence. Method: A literature search was conducted for case reports and group studies with adequate measurement of delayed-onset PTSD according to DSM criteria. Studies that met inclusion criteria were examined for the defined length of delay for delayed-onset PTSD, presence of symptoms before full diagnostic criteria were met, length of follow-up, prevalence estimates, and other variables. Studies were also examined for differences between immediate-onset PTSD, delayed-onset PTSD, and no-PTSD cases. Results: Ten case studies and 19 group studies met criteria for inclusion in the review. Studies consistently showed that delayed-onset PTSD in the absence of any prior symptoms was rare, whereas delayed onsets that represented exacerbations or reactivations of prior symptoms accounted on average for 38.2% and 15.3%, respectively, of military and civilian cases of PTSD. Conclusions: The discrepant findings in the literature concerning prevalence can be largely, but not completely, explained as being due to definitional issues. Little is known about what distinguishes the delayed-onset and immediate-onset forms of the disorder. Continuing scientific study of delayed-onset PTSD would benefit if future editions of DSM were to adopt a definition that explicitly accepts the likelihood of at least some prior symptoms.

This study investigated the hypothesis that the negative effect of life difficulties on examination performance in university students (Andrews & Wilding, 2004 Andrews, B. and Wilding, J. M. 2004. The relation of depression and anxiety to life stress and achievement in students. British Journal of Psychology, 95: 509–521. [Crossref], [PubMed], [Web of Science ®] [Google Scholar] ) can be explained by impairment of working memory efficiency. UK-based students were given an extensive interview covering recent life stressors, and carried out a task testing working memory span, in which they had to judge the truth of arithmetic expressions while retaining words. Students reporting one or more life difficulties in the preceding 12 months recalled significantly fewer words than those reporting no such difficulties, but showed no difference in processing time on the task. However, while the number of words recalled was unrelated to examination performance at the end of the year, students who took longer on the task did significantly less well in the examination. This relation was more marked in Science than in Arts students. A number of possible explanations for this pattern of results are considered, which need to be explored in further research. In particular it is suggested that the number of words retained in the working memory span task reflects current state, and is reduced by intrusive thoughts provoked by current life difficulties, while time on the task reflects more permanent efficiency of the processing system and, therefore, efficiency in study and examinations.

Objectives: An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance. Method: 351 UK‐domiciled undergraduates completed questionnaires one month before university entry and mid‐course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid‐course. Results: By mid‐course 9% of previously symptom‐free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre‐entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid‐course predicted a decrease in exam performance from first to second year. Conclusions: This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre‐existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.

Gender differences in social support levels and benefits were investigated in 118 male and 39 female victims of violent crime assessed for PTSD symptomatology 1 and 6 months postcrime. Within 1 month postcrime both genders reported similar levels of positive support and support satisfaction, but women reported significantly more negative responses from family and friends. Women also reported an excess of PTSD symptoms that was similar at 1 and 6 months postcrime, and negative responses mediated the relationship between gender and later symptoms. Overall negative response and support satisfaction, but not positive support, were significantly associated with PTSD symptoms. However, the effects of support satisfaction and negative response on 6‐month symptoms were significantly greater for women than men. The findings are consistent with previous studies of predominantly female assault victims concerning the stronger impact of negative over positive support, and might help explain women's higher PTSD risk in civilian samples.

Objective. To investigate whether previous findings from interview studies of a prospective relationship between shame and psychopathology (e.g. Andrews, 1995) could be replicated using questionnaires. Design. A total of 163 university students participated in a longitudinal questionnaire study. Method. The Experience of Shame Scale (ESS), a questionnaire based on a previous interview measure, and an established shame scale (TOSCA), were considered in their relation to depressive symptoms assessed at two time points 11 weeks apart. Results. Both scales made significant independent contributions to depressive symptoms at time 1. However, only the ESS predicted additional significant variance in time 2 symptoms when time 1 symptoms were controlled. Conclusions. It was concluded that the reason for the differential performance of the two scales was that the ESS, like the shame interview, assesses specific areas of shame related to self and performance, whereas the TOSCA assesses general shame and may therefore be more prone to mood‐state effects.