International Society for Traumatic Stress Studies

Self-Regulation Shift Theory: A New Perspective on Traumatic Stress Adaptation

08/24/2017
by Charles Benight PhD, Kotaro Shoji PhD & Edward Delahanty PhD
The article entitled “Self-Regulation Shift Theory: A Dynamic Systems Approach to Traumatic Stress” is a new perspective on how people cope with trauma over time (Benight, Shoji, & Delahanty, in press).  Self-regulation shift theory (SRST) is an extension of social cognitive theory (Bandura, 1997) and suggests that certain individuals following trauma will experience a critical threshold where their perception of self-determination moving forward is shattered (self-determination violation effect).  This “breaking point” results in a drastic negative shift in functioning.  The new state is experienced as an “impaired self” leading to elevated levels of posttraumatic stress symptoms, chaotic coping, and a major drop in perceived capability to manage posttraumatic stress demands.  The findings from two separate samples of motor vehicle accident survivors supported a non-linear shift in functioning 3 months after the accident.  In both samples the individual’s early perceived coping self-efficacy appeared as a driving force for the shift.  In the first sample the shift was seen in those with less peritraumatic dissociation whereas in the second sample the shift was seen in those who had less severe injuries.  Importantly, it appears that in both samples those who would be considered less affected by the trauma, and therefore less scrutinized for possible psychological difficulties, were most at risk for this shift at 3 months.  SRST offers a new lens for understanding unique trajectories of coping with traumatic stress providing a framework for theoretically driven hypotheses.  The findings from the present set of studies have important implications for clinical interventions and public health surveillance.  Delayed onset PTSD has been identified in a number of samples (cf., Bonanno, 2005; Bryant et al., 2015) with approximately 10% of trauma victims showing this pattern.  In the two studies reported in Benight et al. (in press) around 20% demonstrated an increase in symptoms at around 3 months.  Bryant et al. (2015) also showed this increase at around 3 months.  It is important to determine if there are clinically different presentations for individuals who show this drastic upward shift and to determine whether these individuals would respond to different clinical approaches.  In some ways this self-determination violation may be experienced as a second trauma where the individual is faced with a deep sense of personal helplessness and a realization that it’s not going to get any better.  One could predict that these individuals would experience a much higher incidence of co-morbidity with PTSD and Depression suggesting a more complicated clinical picture.  One interesting question is whether our trauma focused interventions (e.g., CBT-Prolonged Exposure) provides the grounding needed to re-establish self-control and increased mastery, or whether new approaches might be needed.   From a public health perspective, the individuals in the two samples of MVA survivors who showed the non-linear negative shift are most likely not viewed as an “at risk” group for possible future serious problems.  Given the “low intensity” of initial exposure and reactivity most, if not all, are likely sent home without follow-up.  The data suggest, however, that early low coping self-efficacy perceptions may provide an omen that problems are on the horizon.  It is too early to know if such negative shifts will show up in other samples of trauma survivors.  This awaits future research.  Yet, if such studies demonstrate these effects in, for example, disaster victims, then the public health implications are more robust. With the possibility of around 10% to maybe 20% demonstrating this delayed upward shift, having a prognostic indicator (early screening) would be very valuable.  Clearly, this study is only the first step in a long journey of testing specific hypotheses derived from SRST.  Its utility will be based on the generality and replicability of the initial findings.

References

Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Henry Holt.

Benight, C. C., Shoji, K., & Delahanty, D. L. (in press). Self-regulation shift theory: A dynamic systems approach to traumatic stress. Journal of Traumatic Stress.

Bonanno, G. A. (2005). Resilience in the face of potential trauma. Current Directions in Psychological Science, 14(3), 135–138. doi:10.1111/j.0963-7214.2005.00347.x

Bryant, R. A., Nickerson, A., Creamer, M., O’Donnell, M., Forbes, D., Galatzer-Levy, I., … Silove, D. (2015). Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up. The British Journal of Psychiatry, 206(5), 417–423. doi:10.1192/bjp.bp.114.145516

Discussion Questions:

  1. How does a non-linear approach to traumatic stress provide a different perspective than our more typical linear methods? 
  2. Does the self-determination violation effect have different timing for different classes of survivors of trauma (e.g., childhood abuse survivors versus military combat veterans)?

Reference Article

Benight, C. C., Shoji, K. and Delahanty, D. L. (2017), Self-Regulation Shift Theory: A Dynamic Systems Approach to Traumatic Stress. JOURNAL OF TRAUMATIC STRESS, 30: 333–342. doi:10.1002/jts.22208

Author Biography

Dr. Benight completed his Ph.D. in Counseling Health Psychology at Stanford University in 1992.  He has served as Associate Editor for the Journal of Traumatic Stress.  His primary research focus is on the importance of self-appraisals of coping as a key determinant of adaptation following trauma. 
 
Dr. Shoji earned his Ph.D. in social and health psychology from University of Wisconsin-Milwaukee in 2012.  He has been a research associate at Trauma, Health and Hazards Center at the University of Colorado at Colorado Springs since 2012. His work focuses on post-trauma recovery and the cross-generational transmission of trauma to offspring.
 
Dr. Delahanty completed his Ph.D. at the University of Pittsburgh in 1997. He is a professor of Psychological Sciences and Associate Vice President of Research Faculty Development at Kent State University.  His research focuses on early identification of, and intervention with, trauma victims at risk for persistent post-traumatic distress.
 

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