فقدان لذت، کرختی عاطفی و علائم حاکم بر گزارشگری در جانبازان مبتلا به PTSD مردان

We used measures of positive affect and emotional expression to distinguish and better understand veterans with PTSD with symptom overreporting presentation styles. Based on prior research, symptom overreporting was defined as scores greater than eight on the Fp (Infrequency-Psychopathology) scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Data were drawn from an archival dataset of 227 combat veteran outpatients. Results were consistent with theory and research on the distinction between negative and positive affect. Major findings indicated that (a) veterans endorsing greater anhedonia had a greater likelihood of being classified as a symptom overreporter (controlling for PTSD symptoms), and (b) compared to non-symptom overreporting veterans, overreporters showed greater congruency in their presentation of diminished positive affect and their expression across self- and clinician-ratings. Our data suggest that diminished positive emotions and their behavioral expression are uniquely associated with veterans’ psychological experiences, providing insight into the nature of symptom overreporters.

Despite an innovative framework proposed by Litz (1992), it is only recently that emotional numbing and anhedonia have received empirical attention in studies of post-traumatic stress disorder (PTSD). In contrast to PTSD symptoms that focus on negative affect (e.g., re-experiencing, avoidance, and hyperarousal clusters; depressed mood), emotional numbing and anhedonia focus on (diminished) positive affect. Anhedonia reflects a relative absence of enjoyment and reduced motivation to engage in pleasurable life activities (American Psychiatric Association, 1994). Emotional numbing is a constellation of PTSD symptoms including markedly diminished interest in usual activities that produce pleasure, feelings of detachment from others, and restricted emotional expression (APA, 1994). However, more recent experimental studies suggest that emotional numbing primarily reflects diminished positive affect and a reduced tendency to express emotion behaviorally (Litz et al., 2000 and Orsillo et al., 2004). Emotional numbing and anhedonia may be important dimensions of psychopathology as data suggest that the experience and expression of positive and negative affect are relatively independent with different correlates and functions (Fredrickson, 1998). Unlike negative emotions, which narrow people’s responses to specific behaviors like fight or flight, positive emotions appear to broaden people’s momentary thought-action repertoires (e.g., more efficient, creative, and fluid thinking) and build durable resources such as social bonds and greater resilience to difficult life circumstances. Further examination of diminished positive affect and emotional expression may provide insight into the underlying nature of PTSD. We examined whether diminished positive emotions and their behavioral expression provide unique information in understanding the self-presentation style and psychological functioning of veterans with PTSD above and beyond negative emotions, thoughts, and behaviors.