A Critical Review of Negative Affect and the Application of CBT for PTSD

Abstract

Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

Keywords

PTSD treatment Hx of child abuse sexual assault

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References

Allen

R. J.

Schaefer

Falcon

(2014). Recollecting positive and negative autobiographical memories disrupts working memory. Acta Psychologica, 151, 237–243.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.

Anderson

A. K.

Phelps

E. A.

(2002). Is the human amygdala critical for the subjective experience of emotion?: Evidence of intact dispositional affect in patients with amygdala lesions. Journal of Cognitive Neuroscience, 14, 709–720.

Banks

S. J.

Eddy

K. T.

Angstadt

Nathan

P. J.

Phan

K. L.

(2007). Amygdala-frontal connectivity during emotion regulation. Social Cognitive and Affective Neuroscience, 2, 303–312.

Banks

J. B.

Welhaf

M. S.

Srour

(2015). The protective effects of brief mindfulness meditation training. Consciousness and Cognition, 33, 277–285.

Barlow

D. H.

Allen

L. B.

Choate

M. L.

(2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.

Barrett

L. F.

Bliss-Moreau

Duncan

S. L.

Rauch

S. L.

Wright

C. I.

(2007). The amygdala and the experience of affect. Social Cognitive and Affective Neuroscience, 2, 73–83.

Beauregard

Levesque

Bourgouin

(2001). Neural correlates of conscious self-regulation of emotion. The Journal of Neuroscience, 21, 6993–7000.

Beck

A. T.

Baruch

Balter

J. M.

Steer

R. A.

Warman

D. M.

(2004). A new instrument for measuring insight: The Beck Cognitive Insight Scale. Schizophrenia Research, 68, 319–329.

10.

Beck

A. T.

Steer

R. A.

Brown

G. K.

(1996). Beck depression inventory II. San Antonio, TX: The Psychological Corporation.

11.

Beck

A. T.

Ward

C. H.

Mendelson

Mock

Erbaugh

(1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

12.

Bisby

J. A.

Burgess

(2014). Negative affect impairs associative memory but not item memory. Learning & Memory, 21, 760–766.

13.

Blanchette

Richards

(2010). The influence of affect on higher level cognition: A review of research on interpretation, judgement, decision making and reasoning. Cognition & Emotion, 24, 561–595.

14.

Boals

Banks

J. B.

Hathaway

L. M.

Schuettler

(2011). Coping with stressful events: Use of cognitive words in stressful narratives and the meaning making process. Journal of Social and Clinical Psychology, 30, 378–403.

15.

Bowers

K. S.

Regehr

Balthazard

Parker

(1990). Intuition in the context of discovery. Cognitive Psychology, 22, 72–110.

16.

Bradley

M. M.

Lang

P. J.

(1994). Measuring emotion: The self-assessment manikin and the semantic differential. Journal of Behavior Therapy and Experimental Psychiatry, 25, 49–59.

17.

Braver

T. S.

Gray

J. R.

Burgess

G. C.

(2007). Explaining many varieties in working memory variation: Dual mechanisms of cognitive control. In Conway

Jarrold

Kane

M. J.

Miyake

Towse

(Eds.), Variation in working memory (pp. 76–106). Oxford, England: Oxford University Press.

18.

Bridgett

D. J.

Oddi

K. B.

Laake

L. M.

Murdock

K. W.

Bachmann

M. N.

(2013). Integrating and differentiating aspects of self-regulation: Effortful control, executive functioning, and links to negative affectivity. Emotion, 13, 47.

19.

Brose

Schmiedek

Lövdén

Lindenberger

(2012). Daily variability in working memory is coupled with negative affect: The role of attention and motivation. Emotion, 12, 605.

20.

Brown

W. J.

Bruce

S. E.

Buchholz

K. R.

Artime

T. M.

Sheline

Y. I.

(2016). Affective dispositions and PTSD symptom clusters in female interpersonal trauma survivors. Journal of Interpersonal Violence, 31, 407–424.

21.

Bush

Luu

Posner

M. I.

(2000). Cognitive and emotional influences in the anterior cingulate cortex. Trends in Cognitive Science, 4, 215–222.

22.

Christiansen

D. M.

Elklit

(2008). Risk factors predict post-traumatic stress disorder differently in men and women. Annals of General Psychiatry, 7, 24.

23.

Clark

L. A.

Watson

(1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336.

24.

Cloitre

(2009). Effective psychotherapies for Posttraumatic Stress Disorder: A review and critique. CNS Spectrums, 14, 32–43.

25.

Cloitre

Koenen

K. C.

Cohen

L. R.

Han

(2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70, 1067–1074.

26.

Cloitre

Miranda

Stovall-McClough

K. C.

Han

(2005). Beyond PTSD: Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behavior Therapy, 36, 119–124.

27.

Clore

G. L.

Huntsinger

J. R.

(2007). How emotions inform judgment and regulate thought. Trends in Cognitive Sciences, 11, 393–399.

28.

Cohen

J. A.

Mannarino

A. P.

(1998). Interventions for sexually abused children: Initial treatment outcome findings. Child Maltreatment, 3, 17–26.

29.

Cohen

J. A.

Mannarino

A. P.

Deblinger

(2006). Treating trauma and traumatic grief in children and adolescents. New York, NY: Guilford Press.

30.

Cohen

J. A.

Mannarino

A. P.

Rogal

(2001). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25, 123–135.

31.

Constans

J. I.

(2001). Worry propensity and the perception of risk. Behaviour Research and Therapy, 39, 721–729.

32.

Costa

P. T.

McCrae

R. R.

(1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO Five Factor Inventory (NEO-FFI) professional manual. Odessa, FL: Psychological Assessment Resources.

33.

Cremers

H. R.

Demenescu

L. R.

Aleman

Renken

van Tol

van der Wee

N. J.

… Roelofs

(2009). Neuroticism modulates amygdale-prefrontal connectivity in response to negative emotional facial expressions. NeuroImage, 49, 963–970.

34.

Cukrowicz

K. C.

Smith

P. N.

Hohmeister

H. C.

Joiner

T. E.

(2009). The moderation of an early intervention program for anxiety and depression by specific psychological symptoms. Journal of Clinical Psychology, 65, 337–351.

35.

Davis

(1992). The role of the amygdala in conditioned fear. In Aggleton

J. P.

(Ed.), The amygdala: Neurobiological aspects of emotion, memory and mental dysfunction (pp. 255–305). New York, NY: Wiley.

36.

Davis

Whalen

P. J.

(2001). The amygdala: Vigilance and emotion. Molecular Psychiatry, 6, 13–34.

37.

Dejean

Courtin

Rozeske

R. R.

Bonnet

M. C.

Dousset

Michelet

Herry

(2015). Neuronal circuits for fear expression and recovery: Recent advances and potential therapeutic strategies. Biological Psychiatry, 78, 298–306.

38.

Delis

D. C.

Kaplan

Kramer

(2001). Delis-Kaplan executive function system. San Antonio, TX: Psychological Corporation.

39.

Dhinakaran

De Vos

Thorne

J. D.

Kranczioch

(2014). Neuroticism focuses attention: Evidence from SSVEPs. Experimental Brain Research, 232, 1895–1903.

40.

Diekhof

E. K.

Geier

Falkai

Gruber

(2011). Fear is only as deep as the mind allows: A coordinate-based meta-analysis of neuroimaging studies on the regulation of negative affect. Neuroimage, 58, 275–285.

41.

Evans

D. E.

Rothbart

M. K.

(2007). Developing a model for adult temperament. Journal of Research in Personality, 41, 868–888.

42.

Feinstein

J. S.

Buzza

Hurlemann

Follmer

R. L.

Dahdaleh

N. S.

Coryell

W. H.

… Wemmie

J. A.

(2013). Fear and panic in humans with bilateral amygdala damage. Nature Neuroscience, 16, 270–272.

43.

Ferrier-Auerbach

Erbes

C. R.

Polusny

M. A.

Rath

C. M.

Sponheim

S. R.

(2010). Predictors of emotional distress reported by soldiers in the combat zone. Journal of Psychiatric Research, 44, 470–476.

44.

Fetterman

A. K.

Robinson

M. D.

(2011). Routine cognitive errors: A trait-like predictor of individual differences in anxiety and distress. Cognition and Emotion, 25, 244–264.

45.

Fiedler

(2001). Affective influences on social information processing. In Forgas

J. P.

(Ed.), The handbook of affect and social cognition (pp. 163–185). Mahwah, NJ: Erlbaum.

46.

Foa

E. B.

Keane

T. M.

Friedman

M. J.

(2009). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (1–388). New York, NY: Guilford.

47.

Foa

E. B.

Kozak

M. J.

(1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.

48.

Foa

E. B.

Rothbaum

B. O.

Riggs

D. S.

Murdock

T. B.

(1991). Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723.

49.

Foa

E. B.

Zoellner

L. A.

Feeny

N. C.

Hembree

E. A.

Alvarez-Conrad

(2002). Does imaginal exposure exacerbate PTSD symptoms? Journal of Consulting and Clinical Psychology, 70, 1022–1028.

50.

Forgas

J. P.

(2007). When sad is better than happy: Negative affect can improve the quality and effectiveness of persuasive messages and social influence strategies. Journal of Experimental Social Psychology, 43, 513–528.

51.

Frazier

Keenan

Anders

Perera

Shallcross

Hintz

(2011). Past, present, and future control and adjustment to stressful life events. Journal of Personality and Social Psychology, 100, 749–765.

52.

Gable

Harmon-Jones

(2010). The blues broaden, but the nasty narrows attentional consequences of negative affects low and high in motivational intensity. Psychological Science, 21, 211–215.

53.

Garfinkel

S. A.

Liberzon

(2009). Neurobiology of PTSD: A review of neuroimaging findings. Psychiatric Annals, 39, 370–381.

54.

Gerger

Munder

Gemperli

Nüesch

Trelle

Jüni

Barth

(2014). Integrating fragmented evidence by network meta-analysis: Relative effectiveness of psychological interventions for adults with post-traumatic stress disorder. Psychological Medicine, 44, 3151–3164.

55.

Gerstadt

C. L.

Hong

Y. J.

Diamond

(1994). The relationship between cognition and action: Performance of children 3 1/2–7 years old on a Stroop-like daynight test. Cognition, 53, 129–153.

56.

Gilbert

B. D.

Christopher

M. S.

(2010). Mindfulness-based attention as a moderator of the relationship between depressed affect and negative cognitions. Cognitive Therapy & Research, 34, 514–521.

57.

Glaser

van Os

Portegijs

P. J. M.

Myin-Germeys

(2006). Childhood trauma and emotional reactivity to daily life stressors in adult frequent attenders of general practitioners. Journal of Psychosomatic Research, 61, 229–236.

58.

Goldberg

L. R.

(1999). A broad-bandwidth, public domain, personality inventory measuring the lower-level facets of several five-factor models. Personality Psychology in Europe, 7, 7–28.

59.

Gray

J. R.

(2001). Emotional modulation of cognitive control: Approach–withdrawal states double-dissociate spatial from verbal two-back task performance. Journal of Experimental Psychology: General, 130, 436–452.

60.

Gros

D. F.

(2014). Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Psychiatry Research, 220, 275–282.

61.

Gross

J. J.

John

O. P.

(1995). Facets of emotional expressivity: Three self-report factors and their correlates. Personality and Individual Differences, 19, 555–568.

62.

Gutner

C. A.

Gallagher

M. W.

Baker

A. S.

Sloan

D. M.

Resick

P. A.

(2016). Time course of treatment dropout in cognitive–behavioral therapies for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 115.

63.

House

A. S.

(2006). Increasing the usability of cognitive processing therapy for survivors of child sexual abuse. Journal of Child Sexual Abuse, 15, 87–103.

64.

Hur

Miller

G. A.

McDavitt

J. R.

Spielberg

J. M.

Crocker

L. D.

Infantolino

Z. P.

… Heller

(2015). Interactive effects of trait and state affect on top-down control of attention. Social Cognitive and Affective Neuroscience, 10, 1128–1136.

65.

Izard

C. E.

Dougherty

F. E.

Bloxom

B. M.

Kotsch

N. E.

(1974). The differential emotions scale: A method of measuring the meaning of subjective experience of discrete emotions. Nashville, TN: Vanderbilt University, Department of Psychology.

66.

Jacob

G. A.

Arendt

Kolley

Scheel

C. N.

Bader

Lieb

… Tuscher

(2011). Comparison of different strategies to decrease negative affect and increase positive affect in women with borderline personality disorder. Behaviour Research and Therapy, 49, 68–73.

67.

Jefferies

L. N.

Smilek

Eich

Enns

J. T.

(2008). Emotional valence and arousal interact in attentional control. Psychological Science, 19, 290–295.

68.

Johnson

L. R.

McGuire

Lazarus

Palmer

A. A.

(2012). Pavlovian fear memory circuits and phenotype models of PTSD. Neuropharmacology, 62, 638–646.

69.

Kalisch

Wiech

Critchley

H. D.

Seymour

O’Doherty

J. P.

Oakley

D. A.

… Dolan

R. J.

(2005). Anxiety reduction through detachment: Subjective, physiological, and neural effects. Journal of Cognitive Neuroscience, 17, 874–883.

70.

Kazén

Kuhl

Quirin

(2015). Personality interacts with implicit affect to predict performance in analytic versus holistic processing. Journal of Personality, 83, 251–261.

71.

Kehle-Forbes

S. M.

Meis

L. A.

Spoont

M. R.

Polusny

M. A.

(2016). Treatment initiation and dropout from prolonged exposure and cognitive processing therapy in a VA outpatient clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 107–114.

72.

Korner

(1995). Risk management and the resolution of treatment destructive resistances or consulting with patients to prevent malpractice. Psychotherapy in Private Practice, 13, 33–48.

73.

Kross

Davidson

Weber

Ochsner

K. N.

(2009). Coping with emotions past: The neural bases of regulating affect associated with negative autobiographical memories. Biological Psychiatry, 65, 361–366.

74.

Kunst

M. J. J.

Bogaerts

Winkel

F. W.

(2011). Type D personality and posttraumatic stress disorder in victims of violence: A cross-sectional exploration. Clinical Psychology & Psychotherapy, 18, 13–22.

75.

LaBar

K. S.

Cabeza

(2006). Cognitive neuroscience of emotional memory. Nature Reviews, Neuroscience, 7, 54–64.

76.

Lanius

R. A.

Bluhm

Lanius

Pain

(2006). A review of neuroimaging studies in PTSD: Heterogeneity of response to symptom provocation. Journal of Psychiatric Research, 40, 709–729.

77.

Lang

P. J.

Bradley

M. M.

Cuthbert

B. N.

(1999). International affective picture system (IAPS): Technical manual and affective ratings. Gainesville: University of Florida, Center for Research in Psychophysiology.

78.

Lazar

Kaplan

Sternberg

Lubow

R. E.

(2012). Positive and negative affect produce opposing task-irrelevant stimulus pre exposure effects. Emotion, 12, 591–604.

79.

Levesque

Fanny

Joanette

Paquette

Mensour

Beaudoin

… Beauregard

(2003). Neural circuitry underlying voluntary suppression of sadness. Biological Psychiatry, 53, 502–510.

80.

Liberzon

Taylor

S. F.

Amdur

Jung

T. D.

Chamberlain

K. R.

Minoshima

… Fig

L. M.

(1999). Brain activation in PTSD in response to trauma-related stimuli. Biological Psychiatry, 45, 817–826.

81.

Lightsey

O. R.

Jr Maxwell

D. A.

Nash

T. M.

Rarey

E. B.

McKinney

V. A.

(2011). Self-control and self-efficacy for affect regulation as moderators of the negative affect-life satisfaction relationship. Journal of Cognitive Psychotherapy, 25, 142–154.

82.

Lilly

M. M.

Valdez

C. E.

(2012). Interpersonal trauma and PTSD: The roles of gender and a lifespan perspective in predicting risk. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 140.

83.

Lindquist

K. A.

Wager

T. D.

Kober

Bliss-Moreau

Barrett

L. F.

(2012). The brain basis of emotion: A meta-analytic review. Behavioral and Brain Sciences, 35, 121–143.

84.

Linehan

M. M.

(1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford.

85.

Lissek

Grillon

(2012). Conditioning models of PTSD. In Beck

J. G.

Sloan

D. M.

(Eds.), The Oxford handbook of traumatic disorders (pp. 175–190). New York, NY: Oxford University Press.

86.

Lonergan

(2014). Cognitive behavioral therapy for PTSD: The role of complex PTSD on treatment outcome. Journal of Aggression, Maltreatment & Trauma, 23, 494–512.

87.

Lundqvist

Flykt

Öhman

(1998). The Karolinska directed emotional faces. Pictoral face set available from the Department of Neurosciences, Karolinska Hospital, Stockholm, Sweden.

88.

MacLean

M. H.

Arnell

K. M.

Busseri

M. A.

(2010). Dispositional affect predicts temporal attention costs in the attentional blink paradigm. Cognition and Emotion, 24, 1431–1438.

89.

Markowitz

J. C.

Milrod

B. L.

(2011). The importance of responding to negative affect in psychotherapies. American Journal of Psychiatry, 168, 124–128.

90.

Marshall-Berenz

E. C.

Morrison

J. A.

Schumacher

J. A.

Coffey

S. F.

(2011). Affect intensity and lability: The role of posttraumatic stress disorder symptoms in borderline personality disorder. Depression and Anxiety, 28, 393–399.

91.

Matsumoto

Ichikawa

Kanayama

Ohira

Iidaka

(2006). Gamma band activity and its synchronization reflect the dysfunctional emotional processing in alexithymic persons. Psychophysiology, 43, 533–540.

92.

Mednick

S. A.

Mednick

M. T.

(1967). Manual, the remote associates test, Form I. Boston, MA: Houghton-Mifflin.

93.

Melcher

Born

& Gruber

(2011). How negative affect influences neural control processes underlying the resolution of cognitive interference: an event-related fMRI study. Neuroscience Research, 70, 415–427.

94.

Melcher

Obst

Mann

Paulus

Gruber

(2012). Antagonistic modulatory influences of negative affect on cognitive control: Reduced and enhanced interference resolution capability after the induction of fear and sadness. Acta Psychologica, 139, 507–514.

95.

Milad

M. R.

Pitman

R. K.

Ellis

C. B.

Gold

A. L.

Shin

L. M.

Lasko

N. B.

… Rauch

S. L.

(2009). Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder. Biological Psychiatry, 66, 1075–1082.

96.

Milad

M. R.

Quirk

G. J.

(2002). Neurons in medial prefrontal cortex signal memory for fear extinction. Nature, 420, 70–74.

97.

Miller

G. A.

Levin

D. N.

Kozak

M. J.

Cook

E. W.

III McLean

Jr Lang

P. J.

(1987). Individual differences in imagery and the psychophysiology of emotion. Cognition and Emotion, 1, 367–390.

98.

Mineka

Watson

Clark

L. A.

(1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.

99.

Monson

C. M.

Schnurr

P. P.

Resick

P. A.

Friedman

M. J.

Young-Xu

Stevens

S. P.

(2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898–907.

100.

Najavits

L. M.

(2015). The problem of dropout from “gold standard” PTSD Therapies. F1000prime Reports, 7(43), 1–8.

101.

Niedenthal

P. M.

Setterlund

(1994). Emotion congruence in perception. Personality & Social Psychology Bulletin, 20, 401–411.

102.

Noguchi

Gohm

L. C.

Dalsky

J. D.

(2006). Cognitive tendencies of focusing on positive and negative information. Journal of Research in Personality, 40, 891–910.

103.

Norton

P. J.

(2008). An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder. Behavior Therapy, 39, 242–250.

104.

Norton

P. J.

(2012). Randomized clinical trial of transdiagnostic cognitve-behavioral treatments for anxiety disorder by comparison to relaxation training. Behavior Therapy, 43, 506–517.

105.

Ochsner

K. N.

Bunge

S. A.

Gross

J. J.

Gabrieli

J. D.

(2002). Rethinking feelings: An fMRI study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience, 14, 1215–1229.

106.

Oehlberg

K. A.

Revelle

Mineka

(2012). Time-course of attention to negative stimuli: Negative affectivity, anxiety, or dysphoria? Emotion, 12, 943–959.

107.

Pagura

Stein

M. B.

Bolton

J. M.

Cox

B. J.

Grant

Sareen

(2010). Comorbidity of borderline personality disorder and posttraumatic stress disorder in the U.S. population. Journal of Psychiatric Research, 44, 1190–1198.

108.

Parsons

R. G.

Ressler

K. J.

(2013). Implications of memory modulation for post-traumatic stress and fear disorders. Nature Neuroscience, 16, 146–153.

109.

Phelps

E. A.

Delgado

M. R.

Nearing

K. I.

LeDoux

J. E.

(2004). Extinction learning in humans: Role of the amygdala and vmPFC. Neuron, 43, 897–905.

110.

Pissiota

Frans

Michelgard

Appel

Langstrom

Flaten

M. A.

Fredrikson

(2003). Amygdala and anterior cingulate cortex activation during affective startle modulation: A PET study of fear. European Journal of Neuroscience, 18, 1325–1331.

111.

Post

L. M.

Zoellner

L. A.

Youngstrom

Feeny

N. C.

(2011). Understanding the relationship between co-occurring PTSD and MDD: Symptom severity and affect. Journal of Anxiety Disorders, 25, 1123–1130.

112.

Powers

M. B.

Halpern

J. M.

Ferenschak

M. P.

Gillihan

S. J.

Foa

E. B.

(2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30, 635–641.

113.

Quirin

Kazén

Kuhl

(2009). When nonsense sounds happy or sad: The implicit positive and negative affect test (IPANAT). Journal of Personality and Social Psychology, 97, 500–517.

114.

Rademaker

A. R.

van Zuiden

Vermetten

Geuze

(2011). Type D personality and the development of PTSD symptoms: A prospective study. Journal of Abnormal Psychology, 120, 299–307.

115.

Ramon

Geva

Goldstein

(2011). Trait and state negative affect interactions moderate inhibitory control performance in emotionally loaded conditions. Personality and Individual Differences, 51, 95–101.

116.

Raymond

J. E.

Shapiro

K. L.

Arnell

K. M.

(1992). Temporary suppression of visual processing in an RSVP task: An attentional blink? Journal of Experimental Psychology: Human Perception and Performance, 18, 849–860.

117.

Resick

P. A.

Nishith

Weaver

T. L.

Astin

M. C.

Feuer

C. A.

(2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867.

118.

Resick

P. A.

Schnicke

M. K.

(1993). Cognitive processing therapy for rape victims: A treatment manual (Vol. 4). Thousand Oaks, CA: Sage.

119.

Robinson

M. D.

Cervone

(2006). Riding a wave of self-esteem: Perseverative tendencies as dispositional forces. Journal of Experimental Social Psychology, 42, 103–111.

120.

Roediger

McDermott

(1995). Creating false memories: Remembering words not presented in lists. Journal of Experimental Psychology: Learning, Memory, and Cognition, 21, 803–814.

121.

Rossi

Pourtois

(2012). State-dependent attention modulation of human primary visual cortex: A high density ERP study. Neuroimage, 60, 2365–2378.

122.

Rossi

Pourtois

(2013). Negative affective state mimics effects of perceptual load on spatial perception. Emotion, 13, 485–496.

123.

Rothbaum

B. O.

Astin

M. C.

Marsteller

(2005). Prolonged exposure versus eye movement desensitization and reprocessing (EMDR) for PTSD rape victims. Journal of Traumatic Stress, 18, 607–616.

124.

Rozeske

R. R.

Valerio

Chaudun

Herry

(2014). Prefrontal neuronal circuits of contextual fear conditioning. Genes, Brain and Behavior, 14, 22–36.

125.

Russell

J. A.

Weiss

Mendelsohn

G. A.

(1989). Affect grid: A single-item scale of pleasure and arousal. Journal of Personality andSocial Psychology, 57, 493–502.

126.

Schaefer

Philippot

(2005). Selective effects of emotion on the phenomenal characteristics of autobiographical memories. Memory, 13, 148–160.

127.

Schaefer

S. M.

Jackson

D. C.

Davidson

R. J.

Aguirre

G. K.

Kimberg

D. Y.

Thompson-Schill

S. L.

(2002). Modulation of amygdalar activity by the conscious regulation of negative emotion. Journal of Cognitive Neuroscience, 14, 913–921.

128.

Schottenbauer

M. A.

Glass

C. R.

Arnkoff

D. B.

Tendick

Gray

S. H.

(2008). Nonresponse and dropout rates in outcome studies on PTSD: Review and methodological considerations. Psychiatry, 71, 134–168.

129.

Shalev

A. Y.

Segman

R. H.

(2007). Commentary: Biological findings in PTSD—too much or too little? Progress in Brain Research, 167, 187–199.

130.

Shallcross

A. J.

Troy

A. S.

Boland

Mauss

I. B.

(2010). Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behaviour Research and Therapy, 48, 921–929.

131.

Shin

L. M.

Handwerger

(2009). Is posttraumatic stress disorder a stress-induced fear circuitry disorder? Journal of Traumatic Stress, 22, 409–415.

132.

Sobel

A. A.

Resick

P. A.

Rabalais

A. E.

(2009). The effect of cognitive processing therapy on cognitions: Impact statement coding. Journal of Traumatic Stress, 22, 205–211.

133.

Souza

W. F.

Figueira

Mendlowicz

M. V.

Volchan

Mendonca-de-Souza

A. C.

Duarte

A. F. A.

… Coutinho

(2008). Negative affect predicts posttraumatic stress symptoms in Brazilian volunteer United Nations peacekeepers in Haiti. Journal of Nervous and Mental Disease, 196, 852–855.

134.

Spachtholz

Kuhbandner

Pekrun

(2014). Negative affect improves the quality of memories: Trading capacity for precision in sensory and working memory. Journal of Experimental Psychology: General, 143, 1450–1456.

135.

Storbeck

(2013). Negative affect promotes encoding of and memory for details at the expense of the gist: Affect, encoding, and false memories. Cognition & Emotion, 27, 800–819.

136.

Storbeck

Watson

(2014). Verbal makes it positive, spatial makes it negative: Working memory biases judgments, attention, and moods. Emotion, 14, 1072–1086.

137.

Tedeschi

R. G.

Calhoun

L. G.

(2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.

138.

Tull

M. T.

Jakupcak

McFadden

M. E.

Roemer

(2007). The role of negative affect intensity and the fear of emotions in posttraumatic stress symptom severity among victims of childhood interpersonal violence. Journal of Nervous and Mental Disease, 195, 580–587.

139.

Unsworth

Heitz

Schrock

Engle

R. W.

(2005). An automated version of the operation span task. Behavior Research Methods, 37, 498–505.

140.

VanElzakker

M. B.

Dahlgren

M. K.

Davis

F. C.

Dubois

Shin

L. M.

(2014). From Pavlov to PTSD: The extinction of conditioned fear in rodents, humans, and anxiety disorders. Neurobiology of Learning and Memory, 113, 3–18.

141.

Vastfjall

Peters

Slovic

(2008). Affect, risk perception and future optimism after the tsunami disaster. Judgment and Decision Making, 3, 64–72.

142.

Vermeulen

(2010). Current positive and negative affective states modulate attention: An attentional blink study. Personality and Individual Differences, 49, 542–545.

143.

Waddington

Ampelas

J. F.

Mauriac

Bronchard

Zeltner

& Mallat

(2003). Post-traumatic stress disorder (PTSD): The syndrome with multiple faces. Encephale, 29, 20–27.

144.

Wager

T. D.

Feldman Barrett

(2009). From affect to control: Functional specialization of the insula in motivation and regulation. Published online at PsycExtra.

145.

Watson

(2005). Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V. Journal of Abnormal Psychology, 114, 522–536.

146.

Watson

Clark

L. A.

(1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465–490.

147.

Watson

Clark

L. A.

(1993). Behavioral disinhibition versus constraint: A dispositional perspective. In Wegner

D. M.

Pennebaker

J. W.

(Eds.), Handbook of mental control (pp. 506–527). New York, NY: Prentice Hall.

148.

Watson

Clark

L. A.

(1999). The PANAS-X: Manual for the positive and negative affect schedule-expanded form. Retrieved August 1, 2012, from Iowa Research Online: http://www.psychology.uiowa.edu/faculty/clark/panas-x.pdf

149.

Watson

Clark

L. A.

Tellegen

(1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

150.

Watts

S. E.

Turnell

Kladnitski

Newby

Andrews

(2015). Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression. Journal of Affective Disorders, 175, 152–167.

151.

Weems

C. F.

Pina

A. A.

Costa

N. M.

Watts

S. E.

Taylor

L. K.

Cannon

M. F.

(2007). Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina. Journal of Consulting and Clinical Psychology, 75, 154–159.

152.

West

Choi

Travers

(2010). The influence of negative affect on the neural correlates of proactive and reactive cognitive control. International Journal of Psychophysiology, 76, 107–117.

153.

Whittle

Allen

N. B.

Lubman

D. I.

Yucel

(2006). The neurobiological basis of temperament: Towards a better understanding of psychopathology. Neuroscience & Biobehavioral Reviews, 30, 511–525.

154.

Wolfsdorf

B. A.

Zlotnick

(2001). Affect management in group therapy for women with posttraumatic stress disorder and histories of childhood sexual abuse. Journal of Clinical Psychology, 57, 169–181.

155.

Young

A. W.

Perrett

D. I.

Calder

A. J.

Sprengelmeyer

Ekman

(2002). Facial Expression of Emotion—Stimuli and Test (FEEST). Bury St. Edmunds, England: Thames Valley Test Company.

156.

Zayfert

Deviva

J. C.

Becker

C. B.

Pike

J. L.

Gillock

K. L.

Hayes

S. A.

(2005). Exposure utilization and completion of cognitive behavioral therapy for PTSD in a “real world” clinical practice. Journal of Traumatic Stress, 18, 637–645.

157.

Zimmerman

Coryell

Corenthal

Wilson

(1986). A self report scale to diagnose major depressive disorder. Archives of General Psychiatry, 43, 1076–1081.