Support Schemas Influence Reactivity for Adult Survivors of Childhood Maltreatment

Abstract

Adult survivors of childhood maltreatment can be resilient when they have adequate psychosocial resources to cope with maltreatment-related sequelae; however, interpersonal problems may influence the effectiveness of such resources. This study used a schema activation experimental paradigm to test the benefit of social support cognitions on emotional reactivity in adult survivors, while also testing for the moderating role of interpersonal problems and the mediating role of stress appraisal. Young women (N = 126, ages = 18-23) with histories of childhood maltreatment were administered an anger provocation stressor task while their cardiac activity, state anger, and stress appraisals were assessed. Prior to the stressor, women were randomly assigned to either a support schema condition or an acquaintance schema (control) condition, in which they were asked to think and write about either a supportive person or casual acquaintance. The support schema condition demonstrated the least emotional reactivity as evidenced by subjective anger and heart-rate variability, and this outcome was strongest for those with high interpersonal problems. Also, stress appraisals, particularly feeling intimidated, partially mediated the support schema and emotional reactivity relationship. These findings suggest that maltreated women can regulate anger by activating their social support schema. Moreover, support schema may be an important focus of intervention for adult survivors with high interpersonal problems.

Keywords

child maltreatment social support emotion emotion regulation

Early child maltreatment is associated with later social and emotional problems (Briere & Jordan, 2009; Greif Green et al., 2010). The early, atypical caregiver–child relationship is believed to be a key factor that creates a vulnerability to maladjustment (Cicchetti & Toth, 2005; Cloitre, Cohen, & Koenen, 2006). According to attachment and social-cognitive views, adult survivors’ early jeopardized development is partly attributable to stored knowledge about interpersonal relationships that is formed early and carried forward across the survivor’s life, limiting one’s capacity for meaningful interpersonal relations and emotional stability (Cloitre et al., 2006).

Despite these challenges, supportive relationships can foster resiliency by shielding survivors from adverse outcomes; yet, the relationship between social support and adult survivor adjustment is somewhat complex. As a moderator, greater perceived support in adulthood is associated with decreased depression and posttraumatic stress symptoms (Powers, Ressler, & Bradley, 2009; Schumm, Briggs-Phillips, & Hobfoll, 2006). In contrast, social support can also function as a mediator, given that child maltreatment can have a deleterious effect on support, which diminishes adjustment (Punamäki, Komproe, Qouta, El-Masri, & de Jong, 2005; Runtz & Schallow, 1997). Taken together, these findings indicate that adult survivors who have uncertain beliefs about social support have difficulty adjusting, whereas those adult survivors who have firmer beliefs about support are likely to be resilient.

Few conclusions can be made about the aforementioned non-experimental, cross-sectional studies concerning the relationships between survivorship, social support, and adjustment. For example, these studies do not demonstrate a cause and effect relationship between social support and adjustment. Without an experimental design, one cannot infer whether social support beliefs lead to poor adjustment or vice versa. Many studies also fail to explain or test how social support influences survivor adjustment. Moreover, studies should incorporate a social-cognitive view: Social support influences the appraisal of stress that subsequently determines adjustment (the stress-appraisal hypothesis; Lakey & Cohen, 2000; Ratnasingam & Bishop, 2007; Sandler, Wolchik, MacKinnon, Ayers, & Roosa, 1997).

Furthermore, all survivors do not benefit equally from support. Some individuals with tumultuous interpersonal pasts may interpret current relationships negatively and have poor perceptions of support availability (Smith, Ruiz, & Uchino, 2004). In this respect, degree of interpersonal problems determines the relationship between support and adjustment. This has been shown in studies concerned with social support in the form of stored knowledge about supportive relationships—support schema (Ptacek, 1996). For example, Smith and colleagues’ (2004) randomly assigned participants to either write and think about a supportive person in their lives or a casual acquaintance. This methodology was believed to activate the schema in working memory. Then subjects were presented with an evaluative speech stressor while their cardiovascular activity and self-reported affect were recorded. Support schema significantly reduced emotional reactivity, as evidenced by cardiovascular activity and self-reported anxiety.

In a replication study, Ratnasingam and Bishop (2007) similarly activated support schema. To induce negative affect, however, subjects were asked to recall an anger-eliciting event. Subsequently, subjects reported their stress appraisal associated with the anger-recall task. Stress appraisal involved a cognitive assessment about the stressfulness of an event, which exacerbated or mitigated the effects of the event (Lazarus & Folkman, 1984). Again, support schema significantly reduced emotional reactivity, as evidenced by cardiovascular activity and self-reported anger (Ratnasingam & Bishop, 2007). Support schema was also associated with reduced stress appraisals, which supports the stress-appraisal hypothesis. These studies are consistent with the possibility that the support schema construct may benefit adults with maltreatment histories. Clearly, the stress-appraisal hypothesis needs to be further explored.

The present study examined conditions under which social support resulted in stress-buffering for adult survivors and the role, if any, of interpersonal problems. The study used support schema activation methodology and the support-reactivity paradigm as a context for short-term adjustment (Lepore, 1998; Smith et al., 2004). This approach would offset the limits of prior studies with survivors by using a randomized controlled design to examine social support effects. The participants were all adult survivors who were presented with an interpersonal provocation for anger: They performed mental arithmetic while being pestered by an unfriendly experimenter. Before the provocation, participants were randomly assigned to schema condition: support or acquaintance.

This study also attempted to clarify and provide further support for the role of stress appraisals. Support schema are believed to have their effect through appraisal processes, such that when stressors are encountered, support schema decrease feelings of intimidation and challenge (primary appraisal) and increase feelings of control (secondary appraisal). A reduction in primary and secondary stress appraisals should lead to a reduction in emotional reactivity (Lazarus & Folkman, 1984).

A multi-method approach was used in this study to assess reactivity. In particular, the study assessed emotional reactivity through self-report and physiological indicators, heart-rate (HR) and heart-rate variability (HRV). Indeed, studies have shown differential outcomes for laboratory stressors when relying on self-report alone (Ratnasingam & Bishop, 2007).

We hypothesized a moderation effect such that the benefits of support schema would differ between those with high versus low interpersonal problems; however, the direction of this effect was not specified given that extant literature is unclear. In comparison with a control condition, if the relationship between support schema activation and reactivity is weaker for survivors with high interpersonal problems, this would suggest that interpersonal difficulties interfere with the ability to benefit from perceived support. If the relationship between support schema activation and reactivity is stronger in survivors with high interpersonal problems, this would suggest that these women may have more to gain from perceived support. Finally, we hypothesized that stress appraisals would mediate the relationship between schema activation and reactivity.

Method

Participants

We screened 1,249 women (age = 18-29; M = 19, SD = 1.28) enrolled in psychology courses at a large university. To eliminate variance due to gender differences in anger regulation, only female participants were used (Timmers, Fischer, & Manstead, 1998). Almost half (597; 47.8%) met at least one of the eligibility criteria: positive endorsement of any child sexual abuse act and/or any child physical abuse act, and/or pervasive child neglect. Of the 597, only 126 (21%) agreed to participate in the laboratory phase. There were no statistically significant differences between participants who did or did not choose to participate in the laboratory phase on several variables: age, degree of interpersonal problems, endorsement or severity of child maltreatment, ethnicity or race, marital status, or social class. Among the 126, only data from 119 were used for analyses (i.e., 7 were removed because of HR outliers). The majority of the participants for the laboratory phase were European American (83.2%), single (77.3%), and from middle-class families (44.5%). All screening and laboratory phase participants received extra credit toward psychology courses, and laboratory phase participants also received a US$10 payment.

Measures

Child abuse

A modified version of the Child Abuse Survey (CAS; Esposito & Clum, 2002), was used to screen both child sexual abuse and child physical abuse. Based on Finkelhor’s (1979) criteria, child sexual abuse was defined as sexual experiences that occurred at the age of less than or equal to 14 when the perpetrator was greater than or equal to 5 years older than the child: kissing and hugging in a sexual way, touching body parts (except for sex organs) in a sexual way, touching sex organs in a sexual way, inserting sex organs in one’s mouth, having sexual intercourse, having anal intercourse, and receiving threats of harm. Child physical abuse was defined as the participant endorsing caregiver-inflicted hand strikes, object strikes (e.g., belt), kicking, stabbing, throwing down, or other physical assault that resulted in physical marks, breaks to skin, bruises, or injury that warranted medical treatment prior to the age of 14. The current study uses a conservative definition by focusing only on caregiver perpetrated abuse, consistent with the theoretical basis of this study.¹

Child neglect

The Multidimensional Neglectful Behavior Scale (MNBS): Adolescent and Adult-Recall Version (Straus, Kinard, & Williams, 1995) is an eight-item questionnaire used to assess adult recall of child neglect among five dimensions, physical needs, emotional needs, supervision needs, and cognitive needs. In comparison with child sexual abuse and child physical abuse, scientists have noted the ambiguity of operationalizing child neglect (Straus & Kaufman-Kantor, 2005). For example, one sexual abuse act or physical abuse act would deem a caregiver as “abusive,” whereas one neglectful act may not deem a caregiver as “neglectful.” Therefore, the MNBS is more useful for observing the pervasiveness of neglect (Straus, 2006). A pervasive pattern of neglect is probable when three or more neglectful acts on the MNBS are endorsed by a participant, and this cutoff was used to determine eligibility for the current study.

Interpersonal problems

The 28-item version of the Inventory of Interpersonal Problems (IIP) was used to assess interpersonal problems (Scarpa et al., 1999). Items are presented to the respondent in two general forms: inhibitions (“It is hard for me to [do something]”) and excesses (“I [do something] too much”). Respondents answer each item on a five-point scale ranging from “not at all” to “extremely distressing.” Items on the modified IIP are summed to obtain a total score (present study α = .94).

Emotional reactivity

Participants rated “I feel angry” via a single-item using an 11-point Likert-type scale, ranging from 0 (none) to 10 (extremely; Mauss, Cook, & Gross, 2007).²

Stress appraisal

Several key terms were selected from the early works of Lazarus and Folkman (1984) to capture the stress-appraisal construct. For primary appraisal, participants answered whether they felt challenged or intimidated using 11-point Likert-type scales, ranging from 0 (none) to 10 (extremely). Similarly, for secondary appraisals, participants answered whether they felt in control. The control variable was reverse scored such that higher scores reflect feeling less in control. Appraisals were assessed following the provocation period.

Physiological reactivity

HR and HRV were used as objective indicators of emotional reactivity, particularly autonomic nervous system reflections of state anger. HR is a measure of cardiac rhythmic movements expressed in beats-per-minute and is jointly determined by the sympathetic and parasympathetic branches of the autonomic nervous system. The inclusion of HRV facilitates separating the sympathetic versus parasympathetic contributions to emotional experiences (Bernston et al., 1997). HRV refers to the beat-to-beat alterations in HR and has been used as an indicator of parasympathetic activity (Mauss et al., 2007). Reduced HRV (parasympathetic withdrawal) has been shown in relation to provocations in cognition and emotion studies (Marci, Glick, Loh, & Dougherty, 2007). The root mean square of successive differences (rMSSD) is a time domain measure of HRV used for the current study. The rMSSD reflects variability in time between heartbeats.

Cardiac activity was monitored and collected using the Polar HR Monitor model S810i (Polar CIC, USA). This monitor is considered a valid measure of HR and HRV during stationary laboratory tasks and provides results comparable with those from the electrocardiogram (Gamelin, Baquet, Berthoin, & Bosquet, 2008; Gamelin, Berthoin, & Bosquet, 2006; Goodie, Larkin, & Schauss, 2000; Nunan et al., 2009; Vanderlei, Silva, Pastre, Azevedo, & Godoy, 2008). For this study, the inter-beat interval (IBI) data were analyzed with Kubios HRV software (Version 2.0; Biosignal Analysis and Medical Imaging Group, 2008) that converts the IBI data into time domains for HR (in beats per minute) and HRV (rMSSD in milliseconds). The time series was sectioned to reflect “baseline,” “schema priming,” and “provocation,” which allowed assessing change in cardiac activity across important stages of the laboratory phase.

Procedure

On arrival to the laboratory, a female research assistant helped participants attach the HR monitor. The participant then viewed an emotionally neutral, 3-min film-clip that served as a baseline period. At the end of the film, the participant rated her state anger. The research assistant indicated that she would leave the room to join “the experimenter,” and all participant–experimenter communication would take place through an intercom system. Later, an audio recording of the male experimenter informed the participant that she would perform two tasks, one linguistic and one mathematic. Participants assigned to the support schema condition were asked to think for 2 min and then write for 5 min about a close, supportive other, whereas participants assigned to the acquaintance condition were asked to think and then write about a casual acquaintance. Once participants completed this schema-priming period, the participant rated her current state anger.

After schema priming, the provocation period began. Participants were asked to count backward quickly in increments of 7 or 13 from a large number. There were a total of 7 counting trials, each 60 s long. Between each trial, the experimenter’s voice asked participants for their results (e.g., What number are you at?). The experimenter’s voice had a “grouchy” tone and gave participants finicky feedback (e.g., “count faster,” and “speak louder”). After the provocation period, the participant rated her state anger and stress appraisal (i.e., intimidated and challenged). Then, the participant removed the HR monitor and was given a debriefing to assess the extent that she was aware of the true nature of the linguistic task (schema priming) and the mathematics task (provocation; Bargh & Chartrand, 2000).

Results

Randomization Check

As shown in Table 1, at baseline, the support schema group and acquaintance schema group did not significantly differ on any of the variables of interest, including HR, rMSSD, state anger, interpersonal problems, or stress appraisals (i.e., challenged, intimidated, and control). Furthermore, the Levene’s test was not significant for any of the variables, which indicates similarity of variance between groups.

Table 1.

Dependent Variable by Schema Activation by Experimental Section.

		Task
Measure	Schema Activation	Baseline	Anger Provocation	Paired t Statistic
Heart rate	Support	78.99 (10.03)	91.45 (13.92)
	Acquaintance	82.70 (11.25)	93.74 (12.49)
	Total sample	80.80 (10.76)	92.56 (13.24)	12.89***
rMSSD	Support	46.70 (24.90)	34.48 (15.48)
	Acquaintance	43.56 (25.95)	31.74 (14.72)
	Total sample	45.17 (25.36)	33.15 (15.12)	−7.34***
State anger	Support	0.36 (0.91)	2.49 (2.52)^a
	Acquaintance	0.43 (1.08)	3.59 (2.49)^a
	Total sample	0.39 (0.99)	3.03 (2.56)	11.15***
Interpersonal problems	Support	1.77 (0.10)	—
	Acquaintance	1.76 (0.11)	—
	Total sample	1.76 (0.10)	—	—
Challenged	Support	1.24 (1.89)	5 (3.08)^b
	Acquaintance	1.60 (1.93)	6.18 (2.98)^b
	Total sample	1.42 (1.91)	5.59 (3.08)	14.23***
Intimidated	Support	0.92 (1.61)	3.38 (3.37)^c
	Acquaintance	1.06 (1.51)	4.46 (3.02)^c
	Total sample	1.02 (1.56)	3.92 (3.23)	10.19***
Control	Support	4.89 (3.11)	3.24 (2.77)
	Acquaintance	4.52 (2.56)	3.44 (2.37)
	Total sample	4.71 (2.85)	3.34 (2.57)	4.91***

Note. Values are means; Shared superscripts indicate that mean differences were statistically significant per independent samples t tests; Standard deviations are in parentheses; Paired t test column reflects changes in total sample from baseline to anger provocation. rMSSD = root mean square of successive differences.

p < .05. **p < .01. ***p < .001.

Reactivity

To assess reactivity, changes in HR, rMSSD, state anger, and stress appraisals were calculated by subtracting their baseline scores from their respective provocation scores, such that positive scores reflect increases after provocation. Although there are different methods for assessing change (Willett, 1989), change scores were used because of their ease of use with regression (described below). Evidence suggests that change scores are as stable and valid as reactivity scores obtained by more complex methods (Llabre, Spitzer, Saab, Ironson, & Schneiderman, 1991).

Main and Moderation Effects

A dummy variable was created to reflect (schema activation) condition assignment: 0 = acquaintance schema and 1 = support schema. As shown in Table 2, bivariate correlations were examined for all variables in the study. Then, regression analysis was performed such that state anger change was regressed on the schema activation, interpersonal problems, and schema activation by interpersonal problems interaction.³ The interpersonal problems scores were grand mean centered and used as a continuous variable.

Table 2.

Bivariate Correlations.

Variable	1	2	3	4	5	6	7	8
1. Schema activation	—
2. Interpersonal problems	.05	—
3. State anger reactivity^a	−.20*	.17	—
4. Heart rate reactivity^a	.07	−.13	.07	—
5. rMSSD reactivity^a	−.01	.11	−.17	−.55**	—
6. Challenged	−.20*	.05	.40**	.18*	−.18*	—
7. Intimidated	−.18*	.14	.48**	.21*	−.12	.65**	—
8. Control	.05	−.05	.17	.07	−.09	.18*	.09	—

p < .05. **p < .01.

Represent change scores.

Based on the moderation approach outlined by Baron and Kenny (1986) and Aiken and West (1991), the schema activation variable was entered in the first block, the interpersonal problems variable was entered in the second block, and the schema activation by interpersonal problems interaction variable was entered in the third block. The overall model was significant, F(3, 118) = 4.45, p < .01; R²Δ = .03, p < .05. There was a significant main effect for schema activation (β = −.22, p = .01), such that there was less magnitude of increase in state anger for the support schema (M = 2.13) versus acquaintance schema (M = 3.16). There was a significant main effect for interpersonal problems (β = .35, p < .01), such that increases in interpersonal problems predicted more change in state anger. In addition, there was a significant schema activation by interpersonal problems interaction (β = −.24, p = .05), which indicated that the simple slopes representing the association between schema activation condition and state anger reactivity differed as a function of interpersonal problems.

The interaction effect was explored with post hoc probes as outlined by Holmbeck (2002). Specifically, two separate post hoc regressions were conducted that involved the creation of two conditional moderator variables (low vs. high interpersonal problems). Then, each conditional moderator variable was, respectively, multiplied by the schema activation variable, thus resulting in two interaction terms: schema activation by low interpersonal problems and schema activation by high interpersonal problems. Subsequently, two regression analyses were conducted such that state anger change was regressed on schema activation, each conditional moderator, respectively, and the respective interaction variables or the conditional moderators.

The relationship between schema activation and state anger reactivity was significant for survivors with high interpersonal problems (β = −.39), t(115) = −3.080, p < .01. In contrast, the relationship between support schema activation and state anger reactivity was not significant for survivors with low interpersonal problems (β = −.04), t(115) = −307, p = .76.

Cardiac reactivity did not clearly parallel the self-report findings. The regression model for HR, F(3, 118) = 1.12, p = .34, was not significant. Therefore, moderation analyses were not conducted for HR. Model parameters for rMSSD, however, did suggest a linear trend, F(3, 118) = 1.94, p = .13. When examined further, the main effects for schema activation and interpersonal problems were not significant; however, there was a significant schema activation by interpersonal problems interaction (β = .26, p < .05). Therefore, post hoc probes were performed for rMSSD. The relationship between support schema activation and rMSSD reactivity differed in direction depending on interpersonal problems, such that greater reactivity (i.e., decrease in rMSSD or more HRV withdrawal) was observed for individuals in the support schema condition with low interpersonal problems (β = −20, p = .12), but less reactivity (i.e., less of a decrease in rMSSD or less HRV withdrawal) was observed for those in the support schema condition with high interpersonal problems (β = .18, p = .18).

Mediation Effect

INDIRECT (Preacher & Hayes, 2008) was used to test reports of stress appraisals, measured through feelings of being challenged and intimidated, as mediators between schema activation and state anger reactivity. INDIRECT is a software macro used to generate bias-corrected bootstrap confidence intervals (CIs) to test mediation paths. Bootstrapping is the preferred method for testing mediation, in comparison with the Sobel test (1982) or the classic causal steps approach, due to appropriate Type I error rates and increased power (MacKinnon, Lockwood, Hoffman, West, & Sheets, 2002; MacKinnon, Lockwood, & Williams, 2004).

The 95% bias-corrected CI obtained from bootstrapping were [−.8654, −.0218] for intimidated. Because the CI does not contain zero, the indirect effect of schema activation through intimidated is statistically significant and supports partial mediation. The 95% bias-corrected CI obtained from bootstrapping were [−.4559, .0376] for challenged. Because the CI did contain zero, the indirect effect of schema activation through challenged is not statistically significant and does not support partial mediation. See Figure 1 for all paths in the mediation model. The model containing schema activation, challenged, and intimated accounted for 27.04% of the variation in state anger reactivity.

Figure 1.

Path diagram for the stress appraisal (i.e., challenged and intimidated, respectively) mediation effect on the relationship between schema activation and state anger reactivity.

Discussion

This study provides evidence that support schema activated in short-term memory can alleviate emotional reactivity in adult women survivors of child maltreatment. These findings parallel studies showing that support schemas can attenuate the stress response (Ratnasingam & Bishop, 2007; Smith et al., 2004). The study also extends research involving adult survivors by using a randomized, controlled experiment.

Importantly, high interpersonal problems did not inhibit the influence of support schema on anger reactivity. That is, support schemas were able to buffer anger during an adverse interpersonal exchange, despite dispositional factors that would appear to impede support. Individuals with high interpersonal problems demonstrated the most benefit from the support intervention. This finding suggests that survivors with high interpersonal problems have more to gain from thinking about supportive others in their lives.

Support Schema, Interpersonal Problems, and Cardiovascular Reactivity

In comparison with the subjective data, the physiological data were less clear and less robust than anticipated. The findings contrasted with studies showing the positive influence of support on HR (for a review, see Lepore, 1998). In the present study, perhaps the stress was not substantial enough to result in significant support stress-buffering for HR. Indeed, Lepore (1998) suggests that support effects are most pronounced under high stress.

The HRV finding, however, was meaningful. Individuals who received the support schema activation and had high interpersonal problems experienced the least parasympathetic withdrawal relative to the acquaintance condition. This HRV performance, in light of the HR outcome, suggests that support schemata are most influential on parasympathetic (vagal) versus sympathetic components of autonomic reactivity. As such, support schema activation seemed to be most effective in preventing vagal withdrawal for individuals with high interpersonal problems.

Stress Appraisals Mediate the Support Schema and Emotional Reactivity Relationship

As hypothesized, stress appraisals, as measured by feeling challenged or intimidated during the provocation task, mediated the support schema effect. In comparison with the acquaintance group, those individuals who received the support intervention experienced less change in their experiences of being intimidated during the negative interpersonal exchange. This difference highlights the ability of social support to protect individuals against the harmful effects of stressors by helping them interpret situations less negatively (Lakey & Cohen, 2000).

Indicators of primary appraisal versus secondary appraisal emerged as mediators of the support schema → reactivity relationship. This suggests that support schema mostly influenced the perception of threat versus personal agency. Indeed, supplementary analyses suggested that support schema activation resulted in individuals feeling less afraid, an emotion similar to primary appraisal. Taken together, one could assume that support schemas provide the “felt security” and feeling of being cared for that is needed to navigate stressful situations. Overall, this finding highlights the significance of cognition in the support schema and reactivity relationship.

Limitations and Future Directions

As students attending a major university full-time were solely used, the findings may not generalize to adult survivors outside this setting. In comparison with the present sample, individuals with significant interpersonal disturbances or personality disorders may have responded differently to the support schema intervention and the provocation task. For example, the task may have resulted in exaggerated emotional and physiological reactivity. Therefore, an extension of the present design could involve either controlling for or examining the importance of clinical features in the support schema → reactivity relationship.

In addition, cardiac activity was the only objective measure used. In the future, additional physiological measures (e.g., cortisol assay or galvanic skin response) as well as different stressful tasks should be incorporated to generalize the findings.

The study extends knowledge about emotion and emotion regulation in the lives of adult survivors. For example, cross-sectional studies that have examined the buffering effects of social support on emotional maladjustment are limited in their ability to confidently assert direction of causality and the temporal relationship between social support and anger. Examining the momentary changes following an experimental manipulation with random assignment provides confidence about the causes for these changes. The present design allows one to assume more confidently that support schemas have the regulatory capacity to lessen anger.

Support schemas may be particularly helpful for individuals who often find themselves engaged in interpersonal conflict. For them, support schemas can function like the voice of a loved one gently saying “keep calm” or “it’s not worth it.” Interventionists should promote factors that foster healthy relationships, generating healthy and accessible support schema. Likewise, interventionists should encourage individuals with high interpersonal problems to access and reflect on their support schema during times of stress.

The present study has drawn attention to significant problems faced by many adult survivors: interpersonal problems and the experience of anger. The findings from this study show that support schemas are resources that can help ameliorate emotional reactivity, and may be particularly helpful for those with interpersonal difficulties. In addition, support schemas help maintain a physiological state that inhibits the experience of stress via reduced vagal withdrawal during anger provocation. Support schemas appear to exert these effects by decreasing feelings of threat and fear. These findings imply that if adult survivors can summon positive knowledge about at least one person in their lives who provides support, the reactivity that leads to mental and physical health difficulties may be minimized.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: For Anthony O. Wells, this project was funded by the following grants and awards: (a) Graduate Research Development Project, Graduate Student Assembly, Virginia Tech (US$600); (b) Clinical Child Research Fund, Department of Psychology, Virginia Tech (US$300).

Notes

Author Biographies

Anthony O. Wells, PhD, is a licensed clinical psychologist whose private practice in Roanoke, Virginia, focuses on providing therapeutic services to children and families. He is also an adjunct professor at Virginia Western Community College. His research endeavors have focused on interpersonal violence victimization and associated outcomes, in addition to dispositional and violence exposure factors related to revictimization.

Angela Scarpa, PhD, is an associate professor of psychology at Virginia Tech (VT), a licensed clinical psychologist, director of the VT Center for Autism Research, and founder and co-director of the VT Autism Clinic. She conducts research and treatment related to the mental health of children, adolescents, and young adults, with a focus on autism spectrum disorders as well as disruptive behavior problems. Her work integrates biological and social perspectives to understand and treat emotional and social functioning in individuals with and without autism spectrum disorder (ASD), with a key focus on emotion regulation as an underlying process.

Jonathan C. Waldron, MS, is a fourth-year clinical psychology graduate student at Virginia Tech. He received his master’s degree in 2012. His thesis examined the role of interpersonal problems in the relationship between child abuse experiences and health in adult survivors. His general research interests are examining the psychophysiological factors associated with victimization and violence perpetration. More specifically, he is interested in the relationship between autonomic/immunologic activity and social factors. These include changes in cardiac activity as a consequence of victimization and how this may be related to an increased risk of revictimization. He is currently examining physiologic indices of empathy in psychopathic individuals.

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