Autobiographical Memory Functi

Autobiographical Memory Functioning Among Abused, Neglected and
Nonmaltreated Children:
The Overgeneral Memory Effect
by
Kristin Valentino
Submitted in Partial Fulfillment
O f the
Requirements for the Degree
Doctor of Philosophy
Supervised by
Professor Sheree L. Toth
Department of Clinical and Social Sciences in Psychology

The College
Arts and Sciences
University of Rochester
Rochester, NY
2007
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Curriculum Vitae
The author was bom in Manhasset, New York on December 8, 1980. She
attended Georgetown University from 1998 to 2002, where she was awarded Phi Beta
Kappa honors as well as the Sebastian Brennikmeijer Medal for excellence in
psychology. She graduated Magna Cum Laude with a Bachelor of Arts degree in
2002. She came to the University of Rochester in the Fall of 2002 and began
graduate studies in Clinical Psychology. She pursued her research in Psychology
under the direction of Dante Cicchetti, Ph.D. and received the Master of Arts degree
from the University of Rochester in 2005. In December 2005 she received the Alfred
Baldwin Award for Excellence in Research from the Department of Clinical & Social
Sciences in Psychology. She has pursued her dissertation research under the
guidance of Sheree Toth, Ph.D. at Mt. Hope Family Center in the Department of
Clinical & Social Sciences in Psychology at the University of Rochester.
Acknowledgements
This research was supported by grants from the Office of Child Abuse and
Neglect to Dante Cicchetti, and the Spunk Fund, Inc. to Dante Cicchetti and Sheree
Toth.
I wish to thank Dante Cicchetti and Sheree Toth for their invaluable guidance
as advisors to this work. I forever will be grateful for their unmatched dedication to
my mentoring, both in challenging me to grow as a scientist and in providing me with
support to do so. I also express gratitude to Patrick Davies and Wendy Nilsen for
their thoughtful and insightful feedback as members of my dissertation committee. In
addition, I thank Fred Rogosch for generously sharing his expertise and enthusiasm
with me, Jody Todd Manly for her assistance with maltreatment classification, and
Janice Lomibao and Meghan Mitchell for their devoted coding. I give special thanks
to my parents, for giving me the courage to pursue my highest aspirations, and to my
husband, for helping me to enjoy every step of the way. Finally, I thank the all of my
colleagues at Mt Hope Family Center, and all of the children and families who
participated in this research.
Abstract
Research on the relation of trauma to memory has yet to determine how the
experience of trauma affects memory, if at all. Despite a proliferation of research
focusing on recall of traumatic experiences, much less attention has been paid to the
examination o f memory processes for nontraumatic stimuli with traumatized
individuals and to the conduct of research with maltreated children. Therefore, the
current investigation addresses significant gaps in the literature to ascertain whether
there are differences in the form and content of autobiographical memory recall as a
function of maltreatment, and to examine what roles self-system functioning and
psychopathology play in autobiographical memory processes among maltreated
children. Autobiographical memory for positive and negative nontraumatic events
was evaluated among abused, neglected, and nonmaltreated school-aged children
using the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). In
Part I of this investigation, a comprehensive analysis of children’s autobiographical
memory performance was conducted; this included assessment of children’s ability to
recall specific autobiographical memories, the number of prompts elicited from the
interviewer, children’s response latency and the length of their memories. Positive
and negative self- and maternal- representations contained within children’s memory
narratives were also examined. Part II focused on overgeneral memory, a pattern of
memory retrieval characterized by difficulty in recollecting specific autobiographical
V
memories, and evaluated children’s self-representations as well as children’s
depressive and dissociative symptomatology in relation to children’s memory.
Results revealed that abused children recalled more overgeneral memories and
elicited more prompts from the interviewer to retrieve specific memories than did the
neglected and the nonmaltreated children. Abused children’s memory narratives also
contained more negative self-representations than did those of the nonmaltreated
children. Negative self-representations were significantly related to overgeneral
memory, but did not mediate the relation between abuse and overgeneral memory.
Abused children demonstrated more depressive and dissociative symptoms than did
the nonmaltreated children; however, depressive and dissociative symptoms did not
mediate the relation of abuse to overgeneral memory. The meaning of these findings
for models of memory and for the development of overgenerality is emphasized.
Moreover, the clinical implications of the current research are discussed.
Table of Contents
Introduction 1
Chapter 1 Background & Significance 3
1.1 Memory & Trauma 3
1.2 Development of Autobiographical Memory 11
1.3 Self Development and Maltreatment 14
1.4 Depression and Autobiographical Memory 17
1.5 Dissociation and Autobiographical Memory 20
Chapter 2 Hypotheses 22
Chapter 3 Research Designand Methods 25
3.1 Participants 25
3.2 Maltreatment Determinations 27
3.3 Procedure 29
3.4 Measures 30
3.5 Coding 33
Chapter 4 Results 36
4.1 P arti 36
4.2 Part II 42
Chapter 5 Discussion 46
5.1 Aspects of Autobiographical Memory 46
5.1.1 Overgeneral Memory 46
5.1.2 Interviewer Prompts 51
5.1.3 Response Latency 52
5.1.4 Length o f M em ory 53
5.1.5 Gender Effects 55

5.1.6 V alence Effects 55
5.1.7. Age Effects 58
5.2 Content of Memories: Self & Maternal 60
Representations
5.3 Relationship Effects: Controllingness 63
& Warmth
5.4 Mediation of Overgeneral Memory 65
5.4.1 Affective Representations 65
5.4.2 Depression & Dissociation 68
5.5 Limitations and Future Research 70
5.6 Clinical Implications 73
References 77
Appendix 107
List of Tables
Table 1 Demographic Characteristic Means and Standard 99

Deviations for Abused, Neglected and Nonmaltreated
Children
Table 2 Reliability Analyses 100
Table 3 Control/Opposition Scale 101
Table 4 Global Warmth/Friendliness of Interaction 102
Table 5 Correlation Matrix: Gender & Cognitive Performance 103

with Dependent Variables
Table 6 Means and Standard Deviations by Maltreatment Subtype 104

Group, Controlling for Gender and PPVT-III Standard
Score
Table 7 Mediation of the Relation of Abuse to Overgeneral 105

Memory: Negative Self- Representations
Table 8 Mediation of the Relation of Abuse to Overgeneral 106

Memory: Depressive Symptoms
1
Introduction
Fueled by a lack of consensus on how the experience of trauma may exert its
effect on memory, if at all, researchers continue to debate about the relation of trauma
to memory processes (Howe, Cicchetti, Toth & Cerrito, 2004; Howe, Toth, &
Cicchetti, 2006). Some contend that traumatic experiences, as distinctive and
emotionally salient events, enhance memory for the trauma (e.g., Howe, Courage &
Peterson, 1994,1995; Cicchetti & Toth, 1998). Others highlight evidence of brain
structure alteration in response to prolonged stress (e.g., Bremner & Narayan, 1998;
DeBellis, Keshavan, Casey, Clark, Giedd, Boring, et al., 1999; Sapolsky, 1992) and
impaired memory performance among adults who were traumatized as children (e.g.,
Henderson, Hargreaves, Gregory & Williams, 2002) to suggest that trauma may
adversely affect memory. Clearly, this is a critical area o f research because of the
immense clinical and forensic implications that would be associated with evidence of
memory deficiencies among maltreated children.
Most research to date has focused on recall of the traumatic event, whereas
less attention has been paid to the examination of memory processes for nontraumatic
stimuli. Furthermore, little is known about basic memory functioning among
maltreated children (Eisen, Qin, Goodman & Davis, 2002; Howe et al., 2004).
Although a small body o f literature is developing with regard to semantic memory for
neutral stim uli, and neuropsychological functioning am ong maltreated children, far
less research exists on episodic, autobiographical memory for nontraumatic events.
Furthermore, the limited research that has been conducted on maltreated children’s
2
autobiographical memory has failed to differentiate maltreatment effects from
psychopathology such as depression (Johnson, Greenhoot, Glisky & McCloskey,
2005).
In this investigation, we sought to address significant gaps in the literature on
the relation between trauma and autobiographical memory among maltreated
children. First, the literature on the association between trauma and memory are
reviewed, contrasting the adult literature with findings from research on children.
This review examines both direct and indirect effects of trauma on memory. Next, an
overview of the development of autobiographical memory is presented. After
highlighting the influence of self- development upon autobiographical memory, the
literature on self- development among maltreated children is reviewed. This section
underscores maltreated children’s increased risk for the development of self- related
psychopathologies, such as depression and dissociation. Finally, the literature on the
relation of depression and of dissociation to autobiographical memory is presented.
The goals of the present investigation are:
(1) To ascertain whether there are differences in the form and content
of autobiographical memory recall as a function of maltreatment;
(2) To examine what roles self-system functioning and
psychopathology play in autobiographical memory processes
among maltreated children.
These specific aims are addressed through the conduct of an investigation
with school-aged maltreated and nonmaltreated children. The first part of the study
3
provides a comprehensive assessment of autobiographical memory processes among
abused, neglected and nonmaltreated children. The second part of the study focuses
on one aspect o f autobiographical memory, the overgeneral memory effect, and
examines the relation of self- representations, as well as dissociative and depressive
symptomatology, to this phenomenon.
Chapter 1 Background and Significance
1.1 Memory and Trauma
In order to clarify the relationship between trauma and memory, researchers
have operationalized trauma and stress in various ways. Across studies, the defined
trauma has ranged from laboratory-controlled stressful experiences with
nonmaltreated children at one extreme, to research among children with
maltreatment- related PTSD at the other. Utilizing this first approach of assessing
memory for analog traumas, evidence supports the notion that increased levels of
stress generally lead to better memory for the event (for review see Howe 1998,
2000). Research findings have converged across various analog stressors such as
expected medical procedures (e.g., Brack, Ceci, Francouer, & Barr, 1995; Goodman,
Hirschman, Hepps & Rudy, 1991; Goodman & Quas, 1997), and unanticipated
emergency room visits (e.g., Howe et al., 1994,1995), to demonstrate that stress has a
positive impact on children’s ability to recall the central elements of the event.
In contrast, some researchers argue that stress impairs children’s memories
and increases children’s susceptibility to suggestion leading to recall of
4
misinformation (e.g., Bugental, Blue, Cortez, Fleck, & Rodriquez, 1992; Peters,
1987; but see Merritt, Omstein & Spicker, 1994). However, closer examination of
these studies reveals that reports of memory deficiencies are limited to the recall of
information that is peripheral to the central event. This pattern of findings is
consistent with Christianson’s (1992) theory that during stressful events, children’s
attention becomes hyper-focused on the main stressor to the detriment of attention to
more peripheral information. Therefore, memory for the traumatic event may be
facilitated, whereas memory for peripheral information may be impeded.
(Christianson, 1992; Goodman et al., 1991.)
However, despite the high level of emotionality and stress that may
accompany recollections of unanticipated emergency room procedures (Howe, et al.,
1994, 1995) or hospital experiences that involve genital touching (e.g., Goodman &
Quas, 1997), it is unclear whether or not the intensity of these emotions is comparable
to that which accompanies the experience of physical or sexual abuse, or the
experience of chronic neglect. Thus, although these analog-trauma studies provide
important information regarding the relationship between stress and memory, further
research is needed among populations of traumatized children.
Unfortunately, little research exists on how maltreatment affects memory,
particularly among children (Eisen et al., 2002). In fact, much of our knowledge is
derived from studies of memory functioning among adults who report abuse histories,
where findings on memory performance have been inconsistent. On the one hand,
evidence that maltreated adults experience hyperarousal that may generalize beyond
5
stressful situations (Carlson, Furby, Armstrong & Shales, 1997) provides support for
the notion that maltreatment may lead to enhancement in memory performance. On
the other, examinations o f autobiographical memory and general cognitive processing
among adult women suggest that the experience of child maltreatment is associated
with poorer memory for autobiographical events (Henderson et al., 2002). In addition
to the problematic applicability of research conducted among adults to children, these
studies’ reliance on retrospective reports of abuse weakens the strength of their
conclusions.
One major obstacle to conducting research on memory for trauma is the
inherent difficulty in verifying the accuracy of memory reports of trauma, especially
when they are retrospectively recalled years after the traumatic event occurred. In
response to this problem, some recent studies have emerged in which children who
recalled recent traumatic experiences were then tracked longitudinally to assess for
memory o f the trauma at a later point in time (Alexander, Quas, Goodman, Ghetti,
Edelstein, Redlich, et al., 2005; Eisen, Goodman, Qin & Davis, 2005; Greenhoot,
McCloskey & Glisky, 2005). For example, in a longitudinal study o f long-term
memory for child sexual abuse (defined as memory for abuse that occurred at least 12
years ago), CSA victims who had more Post-Traumatic Stress Disorder (PTSD)
symptoms remembered the abuse particularly well, even when reporting on abuse that
occurred up to 21 years earlier (Alexander et al., 2005). Another longitudinal follow
up study of children who experienced an invasive hospital procedure revealed that
being a victim o f childhood sexual abuse (CSA) is associated with better memory for
6
the event (Eisen et al., 2005). In sum, research with maltreated children has not
supported deficiencies in memory performance for recall of the traumatic event.
Despite the lack of an association between maltreatment and memory deficits
uncovered by the literature reviewed thus far, it should be noted that this research has
all focused on memory for the traumatic event itself. However, there are reasons to
suspect that maltreatment might have a more generalized impact on basic memory
functioning. For example, child maltreatment may impact memory processes
because o f physiological changes to brain regions related to memory processes (e.g.,
Bremner, Krystal, Southwick & Chamey, 1995; Cicchetti & Rogosch, 2001a, 2001b).
Until recently, investigations on basic memory processes (i.e., encoding,
storage and retrieval of neutral, nontraumatic stimuli) were virtually nonexistent. In
fact, to date very few investigations of basic memory among maltreated and
nonmaltreated children have been conducted (Howe et al., 2004; Porter, Lawson &
Bigler, 2005). In a foundational study, Howe and colleagues (2004) utilized Deese-
Roediger-McDermott (DRM) lists to assess true and false memory processes among
children 5-12 years o f age. Recall and recognition measures revealed no differences
between maltreated and nonmaltreated children’s semantic memory functioning for
neutral stimuli. Similarly, a recent examination o f the neurobehavioral sequelae of
child sexual abuse found no significant differences in memory function between
sexually abused and nonabused children (Porter et al., 2005), despite elevations in
psychopathology and diminished performance on tests of attention and executive
function for the abused group. Research conducted with children who had
7
maltreatment-related PTSD is consistent with these findings, such that maltreated
children with PTSD performed more poorly on measures of attention and abstract
reasoning/executive function, whereas memory problems were not identified (Beers
& De Beilis, 2002, but see Moradi, Taghavi, Doost, Yule, & Dalgliesh, 1999).
However, a trend in the data of Beers and DeBellis suggests that maltreated children
with PTSD may have difficulties in long-term memory for verbal information.
Because this investigation lacks a control group of maltreated children who did not
manifest symptoms o f PTSD, it is unclear whether any of these effects can be
attributed to maltreatment, PTSD, or both.
Although the conduct of research on memory for neutral stimuli has been a
necessary first step towards a comprehensive analysis of basic memory functioning
among maltreated children, there is a missing link in the memory literature between
semantic memory for neutral information and autobiographical memories recalled in
response to emotion-evoking prompts. Specifically, it remains unclear how
emotionally valenced and nontraumatic autobiographical memory functions among
maltreated children. It is critical to develop a better understanding of
autobiographical memory processes in maltreated children, especially in light of
findings that have revealed that measures of nontraumatic autobiographical memory
are positively related to memory for the trauma (Greenhoot et al., 2005).
Autobiographical m em ory research am ong adults w ho report childhood
trauma suggests that childhood maltreatment may be associated with difficulty in
recollecting specific autobiographical memories in response to cue words, a
8
phenomenon known as the overgeneral memory effect (Brittlebank, Scott, Williams
& Ferrier, 1993; Henderson et al., 2002; Kuyken & Brewin, 1995). Moreover, some
studies have demonstrated that child trauma is associated with difficulty in specific
memory retrieval in adulthood over and above the effects of depression (de Decker,
Hermans, Raes, & Eelen, 2003; Henderson et al., 2002; Kuyken & Brewin, 1995). In
contrast, other studies have demonstrated a null effect of maltreatment on
autobiographical memory retrieval (Orbach, Lamb, Sternberg, Williams, & Dawud-
Noursi, 2001; Wessel, Meeren, Peeters, Amtz, & Merchelbach, 2001). One limitation
of the aforementioned research is its reliance on retrospective reporting, or self-
reporting of child abuse in the absence of alternate sources of information to
corroborate these experiences. Thus, in order to better understand the impact of
childhood trauma on autobiographical memory, research conducted among samples
of maltreated children is necessary.
Researchers have just begun to investigate autobiographical memory
functioning for non-trauma related stimuli with maltreated children and adolescents
(e.g., deDecker et al., 2003; Johnson, et al., 2005). For example Johnson and
colleagues (2005) examined the relative effects of self-reported childhood sexual
abuse, current exposure to family violence, and depressive symptomatology on
autobiographical memories among adolescents. Results indicated that recent family
violence w as associated with overgeneral m em ories, shorter m em ories and lower
rates of negative memories, while sexual abuse in childhood was related to the need
for an increased number o f prompts to elicit memories. Overall, overgeneral memory
9
problems were more consistently related to current circumstances (e.g., domestic
violence) than to self- reported childhood abuse history. Closer examination of
adolescents’ use of internal state language during autobiographical recall indicated
that adolescents with child abuse histories used fewer emotion terms than did any
other teens, but only for memories related to conflict or punishment (Greenhoot,
Johnson, & McClosky, in press). Taken in tandem, these two studies suggest that
sexually abused children and adolescents display an avoidance of negative emotion in
autobiographical memory recall. Depression in this sample was also related to
overgeneral autobiographical memory recall; however, it was unclear whether
depression was a result, cause, or correlate of this pattern of memory recall.
DeDecker and colleagues (2003) also investigated the relationship between
autobiographical memory specificity and trauma among adolescents. Results showed
that higher levels of trauma were associated with reduced autobiographical memory
specificity. Because this study was conducted among adolescent inpatients and relied
on self-reported accounts of trauma, it again remains uncertain how psychopathology
relates to autobiographical memory. In summarizing the research on
autobiographical memory among maltreated children, it is unclear how basic memory
processes, self- system processes (e.g., processes related to the development of a
coherent self) and/or psychopathology might account for overgeneral memory effects.
The literature review ed so far coheres to suggest that maltreatment m ay not
have a direct effect on children’s memory. It is possible, however, that some kinds of
psychopathology and coping that are associated with experiences of maltreatment
10
may be related to alterations in memory processes (Goodman, 2005). For example,
some theorists contend that maltreatment may lead to poor memory as a result of
stress and dissociation (e.g., Putnam, 1997). This has been supported by research
among adults that has demonstrated a positive association between dissociation and
suggestibility (e.g., Hyman & Billings, 1998). In addition, several studies have
demonstrated a link between depression and difficulty in the retrieval of specific
autobiographical memories (e.g., Williams & Broadbent, 1986; Williams & Scott,
1988) (see sections on dissociation and depression for further elaboration). Elevated
rates of depressive symptomatology have been consistently found among maltreated
children in comparison to nonmaltreated children (Kim & Cicchetti, 2004; Sternberg,
Lamb, Greenbaum, Cicchetti, Dawud, Cortes et al., 1993; Toth & Cicchetti, 1996;
Toth, Manly, & Cicchetti 1992). Therefore, maltreatment may have an indirect effect
on autobiographical memory processes via dissociation and/or depression.
Overall, research on the relation between trauma and memory to date has not
consistently supported deficiencies in memory performance among maltreated
children, despite contrary evidence among adults. However, the majority of studies
with children have focused on memory for the traumatic event rather than on basic
memory performance for nontraumatic stimuli. In particular, there is a paucity of
research on autobiographical memory processes among maltreated children.
Although the literature does not tend to support a direct relationship betw een
maltreatment and memory performance, maltreated children are at increased risk for
psychopathology, such as depression, as well as for the development of dissociation,
11
each of which has been associated with alterations in memory function. In this
investigation, several aspects of autobiographical memory performance, including
measures of form and content, will be analyzed among abused, neglected and
nonmaltreated children. In particular, this investigation will focus on examining
overgenerality in autobiographical memory retrieval and the mechanisms that might
underlie this phenomenon. Children’s self-representations as well as depressive and
dissociative symptomatology will be assessed and examined in relation to
maltreatment in predicting autobiographical memory performance.
1.2 Development o f Autobiographical Memory
Autobiographical memory is defined as an explicit memory o f an event that
occurred in a specific time and place in one’s personal past (Nelson & Fivush, 2004).
Several component factors have been associated with the emergence and development
of autobiographical memory, including basic memory systems and representation of
the self, as well as the acquisition of complex spoken or signed language, narrative
comprehension and production, temporal understanding, style of parent talk, and
overall scaffolding of narratives. A key development is the emergence of the self,
which can be used as a schema to interpret and organize incoming information
(Greenwald & Banji, 1989; Klein & Kihlstrom, 1986). The ability to have a sense of
recollection of the self at a particular time in the past distinguishes autobiographical
m emory from other memory processes such as semantic memory recall (Siegel,
2001 ).
12
During the second year of life, children develop a sense of the physical world,
time and sequence, and o f the self, all of which form the foundation of
autobiographical memory (Wheeler, Stuss, & Tulving, 1997). Autobiographical
memory begins as early as 18-24 months of age (see Howe, 2000, 2004a; Howe &
Courage, 1993, 1997; Howe, Courage & Edison, 2003), when children acquire a
sense of self that organizes memories as autobiographical. Once children can use the
self to organize events, autobiographical memory emerges and children’s memories
of events that happened to them become more stable and durable (Howe & Courage,
1993,1997).
Beyond its influence on the encoding and organization of memory, recent
models of autobiographical memory emphasize the self as central to the process of
retrieval. For example, Conway and Pleydell-Pearce’s self- memory model (2000)
highlights the relationship between an individual’s sense of self and autobiographical
memory, particularly as it relates to the guidance of goal-directed activity. In this
model, autobiographical memories are stored in three hierarchical levels of
representation: event specific memories, general event descriptions, and lifetime
periods. Consistent with earlier models of autobiographical memory (e.g., Burgess &
Shallice, 1996), retrieval is conceptualized as a top down process whereby general
descriptions are activated early and become index points for the retrieval of the
specific event. C onw ay and Pleydell-Pearce (2000) add that retrieval requires
supervisory executive processes to progressively refine the pattern of activation and
to inhibit irrelevant information. In addition, this model emphasizes that many of the
13
intermediate descriptions used to aid in the retrieval of autobiographical memory are
conceptually based self-representations, including personal semantic memories, self-
referential attributes and/or abstracted representations of generic aspects of the self
and experience (Conway et al., 2004).
Although this predominance of conceptual self-relevant information in the
early stages o f memory search typically facilitates autobiographical memory retrieval,
there is some evidence that individuals who possess highly activated or elaborated
repertoires of emotion-related self-representations, and individuals prone to
rumination (repetitive and passive thinking about one’s problems and the possible
causes and consequences of these problems; Nolen-Hoeksema, 1991) are at risk for
overgeneral autobiographical memory retrieval (Williams, Crane, Hermans, Raes,
Watkins, & Dalgliesh, 2007). For example, Williams and colleagues (2007) posit
that individuals who are depressed represent a group in whom emotion-related
conceptual self-representations are in a heightened state of activation. Rather than
aiding the memory search, this may result in individuals becoming “captured” at the
level of negative self-representation, resulting in difficulties in progressing to the
retrieval of specific autobiographical memories. Because children who have been
maltreated are at risk for a number of impairments in self-system functioning,
including the development o f negative self- representations and depression, the
centrality o f self-representations to the retrieval o f autobiographical m em ory is
particularly relevant to our understanding of this process among maltreated children.
14
1.3 Self Development and Maltreatment
Deviations in normative self- system development and functioning are among
the most well documented sequelae of child maltreatment (see Cicchetti & Valentino,
2006 for review). Developmentally, the earliest evidence for self-system deviation
among maltreated children emerges in response to viewing the self at 18 months of
age. Despite the fact that maltreatment does not appear to impede the timing or
emergence o f visual self-recognition, maltreated toddlers are more likely to show
negative emotion when viewing the self than are nonmaltreated toddlers (Schneider-
Rosen & Cicchetti, 1991). Therefore, despite evidence that the timing or emergence
o f a cognitive self may be highly canalized (see Howe, Toth, & Cicchetti, 2006 for
review), environmental factors are influential in shaping the development of the self.
Moving into late toddlerhood, the ability to talk about the self, label emotions
and discuss feelings o f self and other emerges, allowing for observations of more
overt expressions o f self- representation. Self-other differentiation can be reflected in
children’s self-descriptions, use of personal pronouns and active agency during
symbolic play (Beeghly & Cicchetti, 1994; Kagan, 1981). During observations of
mother-child play, delays in maltreated children’s self- systems have been noted
through the analysis o f verbal communicative abilities and internal state language.
Specifically, maltreated children talk less about themselves and about their internal
states than do nonmaltreated children, show less differentiation in their attributional
focus, and are more context -bound in their use of internal state language (Beeghly &
Cicchetti, 1994; Coster, Beeghly, Gersten & Cicchetti, 1989).
15
Examination o f maltreated preschool children’s narratives reveals that
maltreated preschoolers have more negative representations of the self and of their
caregivers than do nonmaltreated preschoolers (Toth, Cicchetti, Macfie & Emde,
1997; Toth, Cicchetti, Macfie, Maughan & Vanmeenan, 2000). Specifically, the
narratives o f children who had been physically abused demonstrated the most
negative maternal representations and high levels of negative self- representations. In
contrast children who had been neglected evidenced the lowest levels of positive self-
representations (Toth et al., 1997). Indeed, maltreated children may not have
received the parental support necessary to develop a sense of the self as worthy,
leading to a sense of inner badness (Harter, 1998). In addition to high levels of
negative representations of the self and of parents, maltreated preschool children also
display evidence o f grandiose self- representations (Toth et al., 2000). Moreover,
Toth and colleagues found that maltreated preschool children portrayed more
grandiose self- representations over a one- year interval, whereas nonmaltreated
children portrayed fewer.
Research conducted with school age maltreated children provides further
evidence for self- system deviation. Maltreated children are consistently rated by
teachers as having low self- esteem, and as having less positive self- concepts than do
nonmaltreated children (Bolger, Patterson, & Kupersmidt, 1998; Cicchetti &
R ogosch, 1997; Egeland, Sroufe & Erickson, 1983). There also is evidence that
younger maltreated children overestimate their own sense of competence and peer
acceptance (Black, Dubowitz, & Harrington, 1994; Vondra et al., 1989) and have
16
inflated levels of perceived self- efficacy in conflictual peer interactions compared to
young nonmaltreated children (Kim & Cicchetti, 2003). Both of these patterns of
behavior are consistent with the juxtaposition of negative and grandiose self
representations noted in maltreated preschool children’s narratives (Toth et al., 2000).
Some have suggested that younger maltreated children may be engaging in defensive
processing to increase their sense of personal control and competence (Vondra et al.,
1989). However, as children get older, this overly positive sense of self is no longer
present; instead, maltreated children perceive themselves as being less competent
than do nonmaltreated children (Kim & Cicchetti, 2003; Vondra, Barnett & Cicchetti,
1989). Corroboration of children’s self- evaluations with teachers’ ratings reveals
that children’s perceptions may in fact become more accurate and realistic as they
grow older and view themselves in a more negative light. In addition, prospective
longitudinal research with maltreated children demonstrates that abused and
neglected children are at elevated risk for the development of major depressive
disorders in young adulthood (Widom, DuMont & Czaja, 2007.)
Finally, the development of more complex disturbances in self- functioning
may emerge as maltreated children enter adolescence. For example, research
supports a connection between affective splitting of self- representations and chronic
sexual abuse. Furthermore, the risk for the development of dissociation is high
among maltreated children (M acfie, Cicchetti & Toth, 2001a, 2001b; O gawa, Sroufe,
Weinfield, Carlson, & Egeland, 1997, Putnam, 2000).
17
Given the extensive theoretical and empirical support for self- system
impairments among maltreated children, and the critical role that the self plays in the
organization o f memory, it is important to assess how the experience of maltreatment
might alter autobiographical memory for nontraumatic information. In particular, the
affective valence o f maltreated children’s self- representations may influence the
encoding and retrieval of positive and negative life events. Furthermore, child
maltreatment increases the risk for the development o f depression and dissociation,
each of which are associated with alterations in autobiographical memory.
1.4 Depression and Autobiographical Memory
Over the past several decades, research with adults has supported a clear
association between depression and overgeneral memory, defined as difficulty in
retrieving specific autobiographical memories (e.g., Brewin, Watson, McCarthy,
Hyman, & Dayson, 1998; Brittlebank et al., 1993; Burnside, Startup, Rollinson, &
Hill, 2004; Wessel et al., 2001; Williams & Broadbent, 1986; Williams & Scott
1988). In this literature, autobiographical memories are typically assessed through a
test where participants are asked to generate/recall specific personal memories in
response to cue words. When compared to control participants, depressed or suicidal
adults consistently demonstrate a tendency to recall overgeneral memories, that is,
memories referring to repeated events (e.g., every Sunday when I go to church...”),
or referring to events that lasted for a longer period o f tim e (e.g., the tim e I lived in
London), rather than recalling specific episodes in their personal past.
18
Depressed or suicidal adults also demonstrate a slower response latency in
comparison to nondepressed adults, which further reflects difficulty in the retrieval of
specific memories (Brittlebank et al., 1993; Williams & Broadbent, 1986).
Additionally, differences in autobiographical memory retrieval in response to positive
and negative cue words have been noted among depressed adults. For example,
Williams & Scott (1988) found that depressed patients, unlike controls, took longer to
respond to the positive cue words than they did to the negative cues. Depressed
patients were also less specific in their memories, particularly in response to positive
cues.
The overgeneral memory effect has been noted among depressed adolescents
as well (Orbach et al., 2001; Park, Goodyear & Teasdale, 2002). For example Park
and colleagues (2002) reported that adolescents with clinical depression were more
likely to recall categoric, rather than specific memories. Moreover, categoric
responses to negative cue words were positively correlated with measures of
depression severity.
Beyond the association between depression and difficulty in retrieving
specific autobiographical memories, overgeneral memory has significant clinical
implications. Specifically, there is empirical evidence that demonstrates the extent to
which an individual recalls overgeneral autobiographical memories, particularly in
response to positive cues, is predictive o f the severity o f future depressive episodes
(Brittlebank et al., 1993). Notably, neither the level of dysfunctional attitudes nor the
severity of depressive symptoms at baseline was predictive of later depression in this
19
investigation. Moreover, the predictive quality of overgeneral memory to future
depression has been replicated several times among depressed samples. For example
Dalgleish, Spinks, Yiend, & Kuyken (2001) found that the number o f general
memories generated in response to positive cue words predicted the severity of
depression at followup. Similarly, Peeters, Wessel, Merchelbach & Boon-Vermeenen
(2001) demonstrated that the number of specific memories recalled in response to
negative cues predicts the severity of depression at follow-up assessment. In addition
to the relationship between overgeneral memory and clinical depression, overgeneral
memory also has been associated with subsequent increases in subclinical depressive
symptomatology (Gibbs & Rude, 2004). Furthermore, overgeneral memory has been
associated with impaired problem solving (e.g. Goddard, Dritschel & Burton, 1996;
1997, Raes, Hermans, Williams, Demyttenaere, et al., 2005) such that specificity of
memory moderates the effect o f negative mood disturbance on problem-solving
performance (Williams, Bamhofer, Crane, & Beck, 2005).
It should be noted that several studies of the overgeneral memory effect and
depression have been conducted among depressed individuals who have experienced
trauma. Some studies have shown that childhood trauma is related to difficulty in
retrieving specific autobiographical memories, even after controlling for levels of
depression (e.g., deDecker et al., 2003; Henderson et al., 2002; Kuyken & Brewin,
1995). H ow ever, other studies have failed to find a direct association betw een
childhood trauma and overgeneral autobiographical memory (Orbach et al., 2001;
Wessel et al., 2001) and have suggested that the effect o f child trauma on
20
autobiographical memory may be mediated by depression. Perhaps contributing to
the lack of consistency among studies, all but one of these investigations (Orbach et
al., 2001) were conducted among adults and relied on retrospective reports of child
abuse to assess trauma. This raises questions about the accuracy of their reports in
the absence of additional, more objective measures of trauma (Widom, 1989).
Nonetheless, the current literature supports a clear association between depression
and difficulty in retrieving specific autobiographical memories; it remains unclear,
however, how, if at all, child maltreatment is associated with the development of
overgeneral memories.
1.5 Dissociation and Autobiographical Memory
Dissociation may be conceptualized as the opposite of an integrated self
(Ogawa et al., 1997), and refers to a disruption in the normal integration of memories,
perception and identity (American Psychiatric Association, 1994). Dissociation has
been described as both a failure of information processing in the face of trauma
(Bower & Sivers, 1998) and as a psychological mechanism that aids an individual’s
ability to cope with extreme stressors (see Cordon, Pipe, Say fan, Melinder &
Goodman, 2004 for review). In addition, dissociation has been conceptualized as a
combination o f both failed information processing and defensive processes (Liotti,
1999), as dissociation may become an automatic and unconscious response to stress
that m ay generalize over tim e (Post, W eiss, Li, Smith, Zhang, X ing, et al., 1998).
With respect to memory, some individuals experience temporary dissociative
states during and immediately after the occurrence of a traumatic event (e.g., Dancu,
21
Riggs, Hearst-Ikeda, Shoyer & Foa, 1996), which may lead to isolated memories for
the event. If these memories are not integrated into the self, then the memory for the
trauma will be less accessible to conscious recollection (Marmar, Weiss, Metzler &
Delucchi, 1996). In adults, a number of memory impairments have been linked with
dissociation, including episodes of time loss, recall delays for abuse-related
information, total memory loss for traumatic events, and gaps in autobiographical
memory (Goodman, Bottoms, Rudy, Davis, & Schwartz-Kenny, 2001; Henderson et
al., 2002; Putnam, 1997, 2000).
Despite research indicating a connection between dissociation and poor
memory for the trauma among adults, research among children has failed to support
such an association. For example, studies of maltreated children have shown that
higher dissociation scores are related to more detailed memories of abuse (Eisen et
al., 2002), as well as to the expression of more negative emotion when asked about
the abuse (Sayfan, Mitchell, Goodman, Eisen, Qin, & Davis, 2002). However, as Foa
and Riggs (1994) point out, there may be important differences between the manner
in which maltreated children remember trauma-related and nontrauma-related
information (see also Toth & Cicchetti, 1998). Thus, it is important to assess the role
of dissociation in maltreated children’s memories for non-trauma related stimuli.
Moreover, according to Howe and Courage (1997), when the self becomes a
viable cognitive entity w ith recognizable features, the encoding o f such features into a
functional memory trace becomes possible. However, events can remain
depersonalized if features of the self are not sampled and encoded. Therefore,
22
memory may be affected if the self is not well integrated, without a coherent set of
features describing the self. This possibility is particularly relevant to child
maltreatment, where the risk for the development of dissociation is high (Macfie et
al., 2001a, 2001b; Ogawa, et al., 1997; Putnam, 2000).
Chapter 2 Hypotheses
Based upon the literature reviewed and in order to address significant gaps in
our extant knowledge o f autobiographical memory functioning among maltreated
children, this investigation aimed to examine the following:
P a r ti
(1) To provide a comprehensive analysis of abused and neglected children’s
autobiographical memories in comparison to nonmaltreated children, the
present study examined additional elements of autobiographical memory
responses, including latency to respond, number o f prompts (for specific
memories) elicited from the experimenter, and the length of memories
generated. This investigation extends the extant literature by focusing on
additional subgroups of maltreated children (physical abuse and neglect), and
by including more rigorous methods for assessing child maltreatment
experiences. It was expected that abused children in particular would (a)
demonstrate more overgeneral m em ories, (b) need increased prompting for
specific memories, (c) take longer to verbally respond, and (d) provide less
23
detailed (shorter) autobiographical memory responses in comparison to
nonmaltreated children.
(2) To extend prior research by including children of a younger age range (7-13),
this investigation is able to address developmental influences upon
autobiographical memory. We anticipated that the older children would
demonstrate more overgeneral memories than will the younger children
(Johnson et al., 2005; Rubin 1986).
(3) To examine the content o f children’s autobiographical memories this
investigation assessed the affective valence of children’s self- and caregiver-
representations. We expected that the memories of abused children would
contain the most negative self- representations, whereas the memories of
neglected children would contain the least positive self- representations. A
similar pattern was expected for caregiver-representations.
(4) To determine whether children’s levels of controllingness and relationships
with the examiner differ as a function of maltreatment experiences. In light
of evidence that maltreated children are more controlling and have less
positive relationships with the examiner during similar paradigms in which
children are asked to narrate responses (e.g., Toth, et al., 1997), we expected
that both the abused and neglected children would demonstrate more
controlling behaviors and would exhibit less positive relationships with the
examiner.
24
Part II
(5) To evaluate the role of self- representations in children’s memory, self-
representations were evaluated as a mediator of the relationship between
trauma and overgeneral autobiographical memory. Because we expected that
abused children would evince higher rates of negative self- representations
than will nonmaltreated children (Hypothesis 3), it was predicted that
negative self-representations would mediate the relationship between abuse
and overgeneral autobiographical memory. Given our focus on clarifying the
relationship between trauma and memory, this analysis was conducted
between the abused and nonmaltreated groups only.
(6) To address the role of psychopathology in the relation between trauma and
autobiographical memory, depressive and dissociative symptomatology were
assessed between abused and nonmaltreated children. It was expected that
the abused children would evince higher rates of depressive and dissociative
symptoms than would the nonmaltreated children.
(7) In light of normative decreases in dissociative symptoms and increases in
depressive symptoms during the transition from middle to late childhood
(Angold & Costello, 1993; Putnam, 1996; Putnam, Helmers & Trickett.,
1993), it was predicted that younger children would demonstrate more
dissociative and less depressive sym ptom atology than would older children
(8) To evaluate the role of depression and dissociation in children’s memory,
depression and dissociation were evaluated as mediators of the relation
25
between maltreatment and overgeneral autobiographical memory. It was
expected that depression and dissociation would mediate the effect of
maltreatment on memory, and that this effect would differ by age.
Specifically, we expected that dissociative symptoms would mediate the
relation between maltreatment and overgeneral memory for the younger
children, whereas depressive symptoms would mediate this relation for the
older children.
Chapter 3 Research Design and Methods
3.1 Participants
Participants in this study consisted of 185 children (70 maltreated and 115
nonmaltreated) between 7 and 13 years of age (average age = 10.61, SD = 1.55).
Children attended a research program in upstate New York that was designed to
provide children from low socioeconomic status families a recreational experience in
which maltreated and nonmaltreated children’s behavior could be observed in an
ecologically valid context (see Cicchetti & Manly, 1990, for a description of the camp
context).
The maltreated children who participated in this investigation were recruited
from those reported to the local Department of Human Services (DHS) because of
concerns associated w ith child maltreatment. Maltreatment status was determined via
examination of Child Protective Service (CPS) and Preventive Services records at
DHS, for which parents provided consent. Families’ maltreatment history also was
26
investigated through maternal interviews, during which research assistants inquired
about a history o f abusive and/or neglectful acts. Utilizing the Maltreatment
Classification System (Barnett, Manly & Cicchetti, 1993), the presence or absence of
four subtypes of maltreatment was determined for each child.
Maltreated children were assigned a primary subtype classification based
upon a hierarchy that assesses the degree to which a particular experience of
maltreatment violates social norms (Manly, Cicchetti & Barnett, 1994). Primary
subtype classifications, in descending order of deviation from societal norms, are
sexual abuse, physical abuse, neglect and emotional maltreatment (see later section
on maltreatment classification for a detailed description). These primary subtype
effects were further conceptualized as acts of commission (e.g., sexual abuse and
physical abuse) versus acts of omission (e.g. neglect), based on the knowledge that
these experiences may exert differential impacts on children’s development (Shields
& Cicchetti, 1998, 2001; Smetana, Toth, Cicchetti, Bruce, Kane & Daddis, 1999). In
this sample, co-occurring subtypes were present in 65% of the maltreated children.
Furthermore, the decision to classify children into commission/abused and
omission/neglected groups allows for the examination of memory processes among
neglected children, a population o f maltreated children that are often ignored in the
literature (Hildyard & Wolfe, 2002), especially with regard to memory. Thus, any
child who experienced physical or sexual abuse, regardless of concomitant neglect,
was classified into the abused group (N = 36), whereas the remaining maltreated
children who experienced neglect (N = 34) were placed in the neglected group.
27
Children who experienced emotional maltreatment, but not any other form of
maltreatment (N = 7) were dropped from further analyses. Although the commission
of emotional maltreatment is associated with several maladaptive developmental
sequelae for children, this experience substantially differs from the commission of
other forms of child maltreatment that involve physical trauma; therefore, we chose to
limit the abuse group to children who experienced physical or sexual abuse.
For demographic comparability to the maltreatment sample, low- SES
nonmaltreated families were recruited from families receiving public assistance in the
form of Temporary Assistance to Needy Families (TANF). All families also
participated in maternal interviews in order to inquire about a history of maltreatment
(Cicchetti, Toth & Manly, 2003). Parental informed consent and child assent were
obtained for participation in research and parental permission allowed researchers to
examine CPS records. Nonmaltreatment status was confirmed by an absence of CPS
or Preventive Services records for the family and via maternal interview.
3.2 Maltreatment Determinations: Maltreatment Classification System (MCS; Barnett
et al., 1993)
Dimensions of family maltreatment were determined by trained coders using
the MCS (Barnett et al., 1993). Rather than relying solely on child protective agency
designation, multi-informant reports of the children’s experiences, as documented in
child protective and preventive records, were coded. U tilizing the w ell- validated
MCS (e.g., Bolger et al., 1998; Dubowitz, Pitts, Litrownik, Cox, Runyan & Black,
2005; English, Bangdiwala, & Runyan, 2005; Manly, 2005; Manly et al., 1994),
28
coders classified children’s maltreatment experiences according to subtype(s). The
MCS contains operational definitions of each subtype and these definitions were
utilized to determine the presence or absence of each subtype; multiple subtypes
could be coded for each report.
Maltreatment subtype categories include sexual abuse, physical abuse,
physical neglect, and emotional maltreatment. The presence of sexual abuse is coded
when any sexual contact or attempted sexual conduct occurred between the child and
an adult. These behaviors range from exposure to inappropriate sexual activities to
forced intercourse. Physical abuse is determined by injuries that had been inflicted
upon a child by nonaccidental means. These incidents could range from excessive
corporal punishment leading to bruising, to permanently disfiguring injuries.
Physical neglect is coded “when the primary caregiver failed to meet a child’s needs
for food, clothing, shelter, medical, dental, or mental health care, education, hygiene,
or physical safety” (Manly, Kim, Rogosch, & Cicchetti, 2001). Typical neglect
incidents included leaving young children at home alone, maintaining unsanitary
living conditions, and providing inadequate nourishment. Emotional maltreatment is
coded for chronic or extreme neglect or disregard of children’s emotional needs. This
includes the need for acceptance and self-esteem, psychological security, and age-
appropriate autonomy. Examples of emotionally maltreating events included serious
threats to injure a child, exposure to violent acts among fam ily m em bers, and
abandonment by primary caregivers. (See Barnett et al., 1993 for a detailed
description of the nosological system used to code incidents of maltreatment).
29
Coding of DHS records for maltreatment subtype was conducted by trained research
assistants and Ph.D. level psychologists, among whom adequate reliability was
established (weighted k = .78- .94).
Abusing, neglecting and nonmaltreating families did not differ on a number of
important demographic characteristics (see Table 1). The three groups were
equivalent with respect to child age, F(2, 182) = .47, n.s., child gender, x (2) = 4.5,
n.s., and ethnic composition x2 (2)= 4.52, n.s.; with 69.4% of the abused group,
79.4% of the neglected group, and 85.2% of the nonmaltreated group represented
ethnic minorities. In addition, the groups were comparable on family marital status,
X2 (2) = 2.32, n.s., and socioeconomic status, x2 (2) = 3.19, with 86.1% of the abused
group, 68.8% of the neglected group and 73.5% of the nonmaltreated group falling
within the lowest two social strata (Hollingshead, 1975). In contrast, significant
differences emerged among groups regarding cognitive performance as assessed by
the Peabody Picture Verbal Test (PPVT-R and PPVT-III; Dunn & Dunn, 1981;
1997), F(2, 182) = 8.98,/? < .001. Bonferroni corrected post-hoc comparisons
revealed that the abused children (M = 86.78, SD = 10.2) performed significantly
lower than both the neglected children (M = 93.85, SD = 10.6) and the nonmaltreated
children (M = 96.52, SD = 12.9). Cognitive differences were controlled for in all
subsequent analyses.
3.3 P r o c e d u r e
Data for the current investigation were collected during a 6 week- long
recreational program where research was conducted. Children were assigned to
30
same-age, same-sex groups of peers and were supervised by adult counselors who
were unaware of the children’s maltreatment status and of the research hypotheses.
Children attended the summer camp for one of the six weeks, and were observed for
approximately 35 total hours during the week by trained research assistants who were
unaware of group status. During the program, children were interviewed by trained
research staff, who were also unaware of child maltreatment status and study
hypotheses, in order to obtain assessments relevant to memory and self
representation. Child interviews took place in a quiet, private context so that children
would feel comfortable discussing their memories honestly. Extra care was taken to
ensure that the child was familiar and comfortable with the interviewer. Additionally,
the counselors completed assessment instruments at the conclusion of their time with
the children.
3.4 Measures
Demographics Interview (Carlson & Cicchetti, 1979)
This interview assesses marital status, parental occupations and income, level
of education, and family composition. It was completed by the primary caregivers
(generally the mother) o f all children. Based upon this interview, the Hollingshead
Four Factor index (Hollingshead, 1975) of socioeconomic status can be derived.
Autobiographical Memory Test (AMT; Williams & Broadbent, 1986)
The Autobiographical M em ory Test (AM T) consists o f 10 em otional cue
words, five positive and five negative. The cues are simultaneously presented orally
and visually in a fixed order, alternating positive and negative cues (happy, sorry,
31
safe, angry, interested, clumsy, successful, hurt, surprised and lonely). Children are
asked to generate a specific memory in response to each cue word (e.g. “ tell me about
a time when you felt ).” Children are given 1 minute in each case to retrieve a
specific personal memory in response to a cue word. If the child responds with a
memory that is not specific, then he/she is prompted to do so (e.g., “Can you think o f
a specific time or event when you f e lt . ? Tell me about it). This prompting can be
repeated if the children’s responses remain inappropriately general. Specific,
standard prompts were also provided to clarify the meaning o f some of the cue words
in cases where children did not understand the cue word. If the child did not retrieve
a specific memory within 60 seconds, then the experimenter proceeded to the next
item. The AMT was audiotaped, and all verbatim responses were transcribed.
Peabody Picture Vocabulary Test (PPVT-R, PPVT-III; Dunn & Dunn, 1981,
1997)
Because the recall and narration of autobiographical memories may be related
to general intelligence and language abilities, a cognitive assessment was
administered to all participants. The PPVT-R and the PPVT-III are individually
administered, multiple- choice tests designed to assess the receptive vocabulary skills
of persons aged 2.5 through 90+ years. Both versions of this measure correlate
highly with several measures of intelligence: the correlation of PPVT-R and WISC-R
= .70 (Dunn & Dunn, 1997) and the correlation o f PPVT-III and W ISC-III ranges
from .82 to .92. Different versions of the test were administered because study
32
participants were drawn from two separate time points. All PPVT-R scores were
transformed into equivalent PPVT-III standard scores for analyses.
Child Depression Inventory (CDI; Kovacs, 1981)
The CDI contains 27 items that assess the cognitive, affective and behavioral
sequelae of depression. Scores on the CDI may range from 0 to 54, with higher
scores indicating more severe depressive symptomatology. Typically, scores greater
than 12 on the CDI are conceptualized as reflecting mild depression, whereas scores
of 19 or greater signify clinical levels of depression (Smucker, Criaghead, Wilcoxan
Craighead, & Green, 1986). The CDI has acceptable reliability and validity (Kovacs,
1992).
Teacher’s Report Form o f the Child Behavior Checklist (TRF; Achenbach,
1991); Dissociation Subscale (Ogawa et al., 1997)
Counselors, who were unaware of children’s maltreatment status or of the
study hypotheses, used the TRF to rate children’s behaviors after approximately 35
hours of observation. The TRF is a well-validated instrument that includes 118 items
rated for frequency of occurrence. Ogawa and colleagues (1997) constructed a scale
to assess dissociative symptoms in childhood and adolescence based on 12 TRF
items, similar to those assessed by Putnam’s Child Dissociative Checklist (Putnam et
al., 1993; see Appendix). Individual child scores for dissociative symptomatology
reflect the sum o f the average o f three counselor’s scores for each o f the 12 items.
Adequate reliability among coders was established. Interrater reliabilities (intraclass
correlations) ranged from .66 to .84.
33
3.5 Coding
Participants’ responses to the AMT were audiotaped and subsequently
transcribed. The memory narratives were then coded for the number of overgeneral
and specific memories, the number of interviewer prompts requited to elicit each
memory, the latency o f first response per cue word, and the length of the narratives.
In addition, the content o f children’s memory narratives was coded for the number of
positive and negative child and maternal representations by cue word. Finally, coders
rated the controllingness of the child, and the global warmth/friendliness of the
relationship between the child and interviewer. Two research assistants who were
unaware of group status or study hypotheses completed the coding. For reliability,
each coded 10% o f the others’ work (totaling 20%). Intraclass correlations ranged
from .71 to .99 (M = .88, see Table 2). Details of the coding procedures are described
in the following sections and are adapted from the coding schemes of Johnson and
colleagues (2005) and Williams & Broadbent (1986).
Overgeneral and Specific Memories
All memories were coded as either specific or overgeneral. Overgeneral
memories were defined as “memories that did not contain at least one specific detail
that identifies an event as a distinct episode” (Johnson et al., 2005). The total number
of overgeneral and specific memories in response to positive and negative cue words
were calculated. The total number o f nonresponses to positive and negative cues
were also recorded.
Prompts
34
Prompts are defined as statements by the interviewer that request a more
specific memory (e.g., “Can you think o f one time in particular when that
happened?”), or additional information (e.g., “How old were you?”). The total
number of prompts was calculated in response to positive and negative cue words.
Latency to Respond
The latency to response was assessed by timing the interval between the
interviewer’s verbal presentation of the cue word and the participant’s first word of
response. Participant verbalizations such as “ummm” or “hmm” were not evaluated as
the first word of response, and timing continued until the first word of memory recall.
Memory Length
Memory length was measured using a raw word count procedure (Dickinson
& Poole, 2000), in which all words in a narrative were counted, except for off-topic
non-memory statements (e.g. “I ’m tired”). Anticipating that some parts of the
narratives may be muffled or unintelligible, coders added 1 to the raw count when
they judged that one or two words were missing. If it seemed that more than two
words were missing from the transcript, then the memory was coded as unintelligible
and not used in the raw count analyses.
Child and Maternal Representations (Adapted from the MacArthur narrative
coding manual- Rochester Revision, MNCM-RR; Robinson, Mantz-Simmons,
Macfie, & MacArthur Narrative Working Group, 2000)
35
The presence/absence o f positive and negative representations of self(child)
and of mother was recorded for each cue word. The total number of positive and
negative representations was then summed for positive and negative cue words.
Positive self- representations include instances where the child describes the
self as displaying or receiving affection (engages in hugs, kisses or praise), displaying
empathy/helping (exhibits an understanding of the thoughts or feelings of another, or
helps another), compliance (follows rules), and affiliation (engages in a positive
activity with another). Negative self-representations involve instances of aggression
(behaving in hostile, destructive behaviors, either verbally or physically),
noncompliance (ignores rules or does something in opposition to the rule), and shame
(exhibits signs o f embarrassment or makes self-reproaching statements). Positive
maternal representations include behaviors that are protective, caretaking,
affectionate, and helpful. Negative maternal behaviors were coded for behaviors that
are harsh, rejecting, or ineffectual.
Child Control/Opposition (Adapted from the MacArthur narrative coding
manual- Rochester Revision, MNCM-RR; Robinson et al., 2000)
After listening to the entire AMT, coders rated participants’ controlling or
oppositional behaviors on a 12-point Likert-type scale. At the low end of the scale
scores of 1-3 were rated for no controlling or oppositional behavior. For example, a
score of 3 would be given to a child who may be initially mildly resistant but
becomes truly engaged with the task. At the high end of the scale, scores of 10-12
were rated if the child is openly hostile, rude or provocative in behavior, criticizing of
36
the task, and refusing to co-operate such that the task is not completed, despite
attempts on the examiner’s part to redirect the child to the task (see Table 3)
Engagement with Interviewer/Global Warmth or Friendliness o f Child
(Adapted from the MacArthur narrative coding manual- Rochester Revision,
MNCM-RR; Robinson et al., 2000)
This scale is designed to provide a “macro” impression of the child’s
friendliness, warmth and engagement with the examiner. Immediately following the
memory prompts, and the controllingness rating, the coder rated the quality of the
interaction between the examiner and the child on a 12-point Likert-type scale. This
includes the degree to which a connection was present between examiner and child,
as well as the degree to which the examiner and child liked each other, and had a
sense of comfort and positive relating. It is less a measure of the child’s behavior or
engagement with the task than it is the overall level of positive feelings experienced
with the child in the session. The rating ranges from a conflictual, uncomfortable
interaction, through more neutral relating, to a feeling of warm connectedness (see
Table 4).
Chapter 4 Results
4.1 Part I
First a correlational analysis was conducted on all dependent variables with
child cognitive performance (PPVT-III scores) and child gender (Table 5). Gender
was included in this analysis because there is evidence that females have more
37
accessible and extensive autobiographical memories than do males (Buckner &
Fivush, 1998; Johnson et al., 2005). Children’s PPVT-III standard scores had a
significant inverse relationship with the number of positive overgeneral memories (r
= -.31,/? < .001) and negative overgeneral memories (r = -.17, p < .05) recalled as
well as with the number o f prompts elicited for positive (r = -.26, p < .001) and
negative (r = -.18,/? < .05) cue words. In addition, children’s cognitive performance
was positively related to children’s warmth in their interactions with the interviewer
(r = .24, p < .01). Gender was significantly associated with the length of children’s
memories such that females provided longer memory narratives to both positive (r = -
.19,/? <.01) and negative word cues (r = -.28,/? < .001). Male gender was associated
with increased overgenerality (r = .15,/? < .05). Additionally, female gender was
associated with higher ratings of warmth (r = .22, p < .01) and lower ratings of
controllingness (r = -.28, p < .01). Because child cognitive performance and gender
were significantly related to several of the dependent variables of interest, child
cognitive performance and gender were used as covariates in order to minimize their
role in subsequent analyses.
Given the normative developmental changes in self- development and
memory that are associated with the transition from middle to late childhood (e.g.,
Harter, 2006; Howe et al., 2004; Greenhoot et al., 2005; Rudolph, Hammen and
Burge, 1995) age group w as evaluated as an independent variable in memory
analyses. Age grouping follows Hammen & Zupan (1984), and Rudolph, Hammen
and Burge (1995), such that children ages 7-9 were compared to children ages 10-14.
38
The 10-year cut-point allowed the sample to be divided somewhat evenly, and it also
roughly marks the end of concrete-operational thinking (Piaget, 1962). In addition,
from a conceptual, self-development perspective, this age grouping is consistent with
that of Vondra and colleagues (1989), where maltreated children demonstrated a shift
in self- perceptions at approximately the age of 9-10 years.
To evaluate the first set of hypotheses (la-d) concerning autobiographical
memory, the design utilized a series of 2(age group: 7-9 years vs 10-13 years) x
3(status: abused vs. neglected vs. nonmaltreated) x 2(valence of cue: positive vs.
negative) repeated measures analyses of covariance (ANCOVAs) on the number of
overgeneral memories, the number of prompts, latency to respond, and length of
memories. The repeated measure was valence of cue type (positive vs. negative).
Based upon the prior correlational analysis, PPVT-III scores and gender were entered
into the four analyses as covariates (Table 6).
The results of the first repeated measures ANCOVA on the number of
overgeneral memories demonstrated no significant within-measures effects of
valence. However, the between subjects analysis revealed a significant effect of
subtype, F(2, 177) = 4.62 , p < .05, Partial r\ = .05. Consistent with Hypothesis 2,
there also was a significant main effect of age group, F (l, 177) = 8.26, p < .01,
Partial r\2 = .05; however, the direction of effect was opposite to that which was
predicted, such that younger children demonstrated more overgeneral memories (M—
2.8, SD = 1.2) than did the older children (M = 2.3, SD - 1.3). The interaction of
subtype by age was nonsignificant, F(2, 177)= 1.00, n.s. Gender and PPVT-III scores
39
were each significant covariates, F( 1,177) = 3.98,p <.05 and F (l, 177) = 12.68, p <
.001, respectively. Subsequent pairwise comparisons, Bonferroni corrected, to
investigate the significant subtype main effect revealed that the abused children
demonstrated more overgeneral memories (M = 3.00, SD = 1.2) than did the
neglected children (M = 2.26, SD =1.1 ,p <.01) and the nonmaltreated children (M =
2.39, SD = 1.2, p < .01), thus confirming Hypothesis la.
A similar pattern of results emerged from the ANCOVA regarding the number
of prompts elicited by the children during the memory task. No significant within
subjects effects of valence were detected. However, consistent with the prior
analyses, the main effect of subtype was significant, F{2,177) = 5.50, p < .01, Partial
y < t
r| = .06. Confirming Hypothesis lb, Bonferroni- corrected pairwise comparisons,
revealed that abused children elicited more prompts (M = 7.41, SD = 3.5) than did the
neglected children (M= 5.35, SD = 3.4, p = .01) and the nonmaltreated children ( M -
5.15, SD = 3.5, p < .001). The main effect of age group F (l, 177) = 5.24, p < .05,
Partial r\ = .03, was also significant, such that younger children elicited more
prompts (M = 6.64, SD = 3.8) than did the older children (M = 5.30, SD = 4.0).
Next, an ANCOVA on latency to respond was conducted. The within subjects
comparisons of valence were nonsignificant, F (l, 177) = .006, n.s., as were all
between subjects effects. Thus, no differences emerged among subtypes, F(2, 177) =
.59, n.s., or between age groups, F( 1, 177) = .02, n.s., regarding the amount of time
children took to respond to each memory cue, disconfirming Hypothesis lc.
40
Finally, an ANCOVA on the length of children’s memories was performed.
Unlike the prior three analyses, a within subjects trend for the effect of valence
emerged, F ( 1, 177) = 2.98, p - .086, Partial r\ = .017, such that children’s memory
narratives in response to negative cue words (M = 25.10, SD = 16.9) were
significantly longer than were children’s responses to positive cues (M = 21.09, SD =
14.14). The interaction of valence by subtype and age group were each
nonsignificant. Between subjects analyses also revealed no significant main effects
for subtype F(2, 177) = .53, n.s., age group, F (\, 177) = 1.11, n.s., or their interaction,
F(2,177) = .63, n.s, disconfirming Hypothesis Id.
Next, to evaluate differences among abused, neglected and nonmaltreated
children with respect to their self- and maternal- representations, as well as their
controllingness and relationship with the examiner, a multivariate analysis of
covariance (MANCOVA) was conducted. Specifically, a MANCOVA was run on
positive and negative self- representations, positive and negative matemal-
representations, controllingness and relationship with the examiner with maltreatment
subtype (abuse, neglect, nonmaltreatment) and age group (younger and older) as the
between subjects factors. Consistent with our prior set of analyses, child gender and
PPVT-III scores were entered as covariates. A significant multivariate effect of
subtype emerged, F ( 12, 346) = 2.81,/? < .01, Partial r\2 = .09. The main effect of age
group w as nonsignificant, F (6, 172) = .84, n.s., as w as the interaction o f age group
and subtype, F(12, 346) = .66, n.s.
41
To further evaluate the significant multivariate effect of subtype, univariate
analyses revealed a significant main effect of subtype for negative child
representations, F{2,177) = 7.10,/? = .001, Partial r\ = .074, controllingness, F (2,
177) = 3.15,/? <.05, Partial r|2 = .034, and warmth, F( 1, 177) = 5.46,/? < .01, Partial
r) = .058 . Subsequent pairwise comparisons, Bonferroni corrected, revealed that
abused children’s memories (M = 1.79, SD = 1.1) contained more negative self
representations than did those of the nonmaltreated children (M = .98, SD = 1.1,/?<
.01). The neglected children’s memories (M - 1.36, SD = 1.1) did not significantly
differ from either the abused or the nonmaltreated children’s memories regarding
negative self- representations. These findings are partially consistent with Hypothesis
3 where it was predicted that abused children would have more negative
representations than both the neglected and nonmaltreated children. Predictions
among maltreatment subtypes regarding differences in maternal positive
representations, F (l, 177) = .23, n.s., and maternal negative representations, F (l, 177)
= 1.27, n.s., were not supported as (Table 6).
Regarding controllingness, the abused children were rated higher (M = 3.84,
SD = 2.1) than were the neglected children (M = 2.60, SD = 2.1, p < .05). Abused
children not significantly differ from the nonmaltreated children (M = 3.12, SD = 2.1)
on controllingness. Concerning warmth, the neglected children were rated higher on
warmth ( M — 9.17, S D = 2.4) than both the abused children ( M = 7.20, S D = 2.5 , p <
.05) and the nonmaltreated children (M = 7.67, SD = 2.5,/? < .01). This finding was
unanticipated, as Hypothesis 4 predicted that abused and neglected children would be
42
rated lower on warmth and higher on controllingness than would nonmaltreated
children (Table 6).
4.2 Part II
Analysis for Part II o f this study was conducted with a subset of 93 children
between the ages of 7 and 13 years for whom the self- report measures necessary for
this analysis were available. In addition, this sample included children from the
abused (N = 27) and nonmaltreated (N = 65) groups only because of our goal of
understanding the effects of physical trauma upon autobiographical memory.
Unlike Part I o f the investigation which examined several aspects of
children’s autobiographical memory recall, Part II focused on one particular aspect of
children’s memory (overgeneral memory) in relation to self-representations as well as
depressive and dissociative symptomatology between abused and nonmaltreated
children. Children’s scores on the Children’s Depression Index (CDI) were used to
assess depressive symptomatology and scores on the Dissociation Scale, derived from
a subset of responses on the Child Behavior Checklist, were used to assess
dissociative symptoms. A square-root transformation was performed on both CDI
and Dissociation Scale scores to correct for skewness of the distribution.
First, children’s self-representations were evaluated as potential mediators of
the relationship between abuse and overgeneral memory (Hypothesis 5). Because the
affective valence o f children’s overgeneral m em ories w as not a significant within
subjects factor (as demonstrated in Part I) the current regression analysis was
performed on the total number of overgeneral memories children produced, rather
43
than via separate parallel regressions on positive and negative overgeneral memories.
As established by the earlier MANOVA, children’s negative self-representations were
significantly related to maltreatment subtype. Specifically, a history of abuse
accounted for a significant proportion of variance in the amount of negative self
representations contained within children’s memory narratives, F (1, 86) = 7.00,/? =
. 01 .
Next, the relationship between children’s negative self-representations and
total overgeneral memory was assessed via regression. Negative self-representations
accounted for a significant portion of variance in predicting overgeneral memory,
AR2 = .076, F( 1, 83) = 6.81,/? = .01. Higher levels of negative self-representation
were positively associated with overgeneral memory, p = .28.
To complete the mediation analyses, a hierarchical regression was conducted
to determine the role o f negative self- representations in the relationship between
abuse and overgeneral memory (Table 7). Gender, age, and cognitive test scores
were entered into the regression analysis as covariates at the first step, AR2 = .22, F(3,
81) = 7.61,/? < .001. Next, maltreatment subtype (abused vs. nonmaltreated) was
entered into the model, accounting for a significant portion of variance, AR = .057,
F (l, 80) = 6.26,/? < .05. At the third step, children’s negative self- representations
were added to the model; however, negative self-representations did not account for a
• • 'y •
significant amount o f variance, AR = .023, F (1, 79) = 2.60, n.s. Finally, the
interaction term between subtype and negative self- representations was entered into
the model in the final step, accounting for a nonsignificant change in variance.
44
Although negative self-representations did not account for a significant proportion of
variance in predicting overgeneral memory, the strength o f the relationship between
abuse and overgeneral memory decreased in the presence of this variable, Ap = -.066.
Nonetheless, the findings o f current regression demonstrate that negative self
representations do not predict overgeneral memory when controlling for abuse.
Therefore, children’s negative self- representations did not mediate the pathway
between abuse and overgeneral memory, discontinuing Hypothesis 5.
To evaluate Hypothesis 6 regarding differences between abused and
nonmaltreated children with respect to their depressive and dissociative
symptomatology, a MANCOVA was conducted on square-root transformed CDI
scores and Dissociation Scale scores with maltreatment subtype
(abuse/nonmaltreatment) as the between subjects factor. Because no significant
interaction effects of age group with maltreatment subtype emerged in the prior
analyses, child age was entered as a covariate rather than as a between subjects factor.
A significant multivariate effect of subtype emerged, F(2, 88) = 3.62, p < .05.
Univariate tests revealed a significant effect o f subtype for square-root transformed
depressive symptoms, F (l, 89) = 3.86, p < .05 such that abused children
demonstrated more depressive symptoms ( M - 2.14, SD = 1.2) than did the
nonmaltreated children (M = 2.14, SD = 1.4). Also consistent with Hypothesis 6,
there was a significant effect o f subtype for square-root transformed dissociative
symptomatology, F (l, 89) = 5.59, p < .05, such that abused children demonstrated
more dissociative symptoms (M = 1.69, SD = .7) than did the nonmaltreated children
45
(M = 1.22, S D - .8). Age group was not a significant covariate, F(2, 88) = .25, n.s.;
therefore, predictions regarding differences in depressive and dissociative
symptomatology (Hypothesis 7) were not supported.
Next, to evaluate Hypothesis 8 regarding the association between depressive
and dissociative symptomatology in relation to overgeneral memory, a regression
analysis was conducted. At the first step of analysis, transformed CDI scores and
Dissociation scale scores were entered into the model. Together, CDI and
Dissociation scores accounted for a significant portion of variance in predicting
overgeneral memory, AR2 = .085, F(2, 90) = 4.18, p < .05. Individually, depressive
symptomatology accounted for a significant portion of variance, p = .22, F (1,90) =
4.32, p < .05, whereas Dissociative scores did not, P = .13, F{ 1, 90) = 1.52, n.s.. At
the next step, the interaction o f CDI and Dissociation scale scores was entered into
the regression, accounting for a nonsignificant portion of variance AR2 = .002, F (l,
89) = .22, n.s.
Next, depressive symptomatology was evaluated as a mediator of the
relationship between maltreatment and overgeneral autobiographical memory.
Dissociative symptomatology could not be evaluated as a mediator as predicted
because the prior analysis failed to demonstrate a significant relationship between
dissociative symptoms and overgeneral autobiographical memory.
The role o f depression as a possible mediator o f overgeneral autobiographical
memory was evaluated via hierarchical regression analysis (Table 8). Gender, age,
and cognitive test scores were entered into the regression analysis as covariates at the
46
first step, AR2 = .22, F(3, 86) = 8.13, p < .01. Next, maltreatment subtype (abused vs.
nonmaltreated) was entered into the model, accounting for a significant portion of
variance, AR2= .07, F (l, 85) = 8.59,p < .01. At the third step, children’s CDI scores
were added to the model, accounting for a nonsignificant amount of variance, AR2 =
.01, F (1, 84) = 1.28, n.s. Finally, the interaction terms between subtype and
depressive symptoms were entered into the model in the final steps, also accounting
for a nonsignificant change in variance. The addition of depressive symptoms to the
model did not significantly decrease the strength of the relation of abuse to
overgeneral memory (Ap = .002), therefore, depressive symptomatology did not
mediate the relationship between trauma and overgeneral memory as predicted in
Hypothesis 8.
Chapter 5 Discussion
5.1 Aspects o f Autobiographical Memory
5.1.1 Overgeneral Memory
This investigation addresses several significant gaps in the literature on the
relation between trauma and autobiographical memory by providing a comprehensive
analysis o f the form and content of children’s autobiographical memory recall.
Additionally, the examination of children’s self-system functioning through the
analysis o f self- representations and psychopathology informs theoretical accounts o f
the mechanisms which underlie the overgeneral memory effect.
47
A central finding of this research is that abused children demonstrated more
overgeneral memory than did nonmaltreated children. Establishing that children who
have been abused experience difficulty in retrieving specific personal memories adds
to the extant literature on the association between trauma and overgeneral
autobiographical memory. Despite the plethora of studies that have linked
overgeneral autobiographical memories to trauma among adults (see Williams et al.,
2007 for review), this investigation provides the first evidence of overgeneral
memory as a function of trauma among a sample of children with documented
histories o f abuse.
Prior to the current investigation, only two other studies had examined the
role of trauma in autobiographical memory processes among samples of children or
adolescents (deDecker et al., 2003; Johnson et al., 2005). Consistent with the relation
between abuse and overgeneral memory identified in this investigation, DeDecker
and colleagues (2003) found that higher levels of childhood trauma were associated
with reduced autobiographical memory specificity among a sample of adolescents in
an inpatient setting; however, this investigation relied on adolescents’ retrospective
reports of abuse. Therefore childhood abuse determination was not independent of
the participants’ current recall abilities or of their willingness to disclose trauma.
Moreover, the effect of participants’ current psychopathology on memory retrieval
could not be differentiated from the effects o f self-reported abuse.
The study conducted by Johnson and colleagues (2005) represented an
advance in the literature by assessing overgeneral autobiographical memory in a
48
nonclinical sample of children and adolescents and by avoiding retrospective
reporting o f childhood abuse; however, abuse was assessed via child self-report and
was limited to reports of sexual abuse. Therefore, children’s willingness to report
abuse experiences remained a potential confound. In contrast to the findings of the
current investigation, Johnson and colleagues found no association between
children’s self-reported abuse histories and overgeneral memory. Rather, recent
family violence was associated with overgeneral memories and lower rates of specific
memories. In interpreting these findings, it is difficult to disentangle the impact of
abuse on autobiographical memory apart from participants’ current mental health
conditions, such as depression, which was also prevalent in their sample. Moreover,
family violence was operationalized as the total frequency of child-reported exposure
to mother-directed violence as well as exposure to violence towards the child him or
herself, thus preventing the authors from differentiating the effects of domestic
violence from that o f child physical abuse on children’s memories.
Therefore, this investigation is the first to demonstrate an association between
child abuse and overgeneral autobiographical memory among a sample of children
for whom multiple sources of information regarding maltreatment experiences were
available and utilized to inform maltreatment classification. Corroboration of
maltreatment experiences independent of self- report is particularly critical for
investigations of the impact of trauma on memory, given the inherent flaw in relying
on participants’ memories to both identify abuse and provide evidence of memory
deficiency.
49
The finding that children who have been abused demonstrate overgenerality in
their autobiographical memory recall is important for informing theoretical
perspectives on the development of overgeneral memory. Perhaps the most widely
stated account o f overgeneral memory is that of Williams (1996), who proffered that
children who experience early trauma/adversity adopt a generic style in retrieving
autobiographical memories as an affect-regulating strategy. According to this
functional-avoidance theory, being less specific reduces the risk of confrontation with
painful memories, i.e., trauma. Labeling the process mnemonic interlock, Williams
asserted that memory retrieval is truncated at an intermediate stage of retrieval and
the tendency to stop the memory search is reinforced (negatively) by the avoidance of
negative affect attached to painful memories. These intermediate memories are
closely related to categoric labels or self-descriptors. Because overgenerality in
autobiographical memory recall was first noted among adults with depression
(Williams, 1996; Williams & Broadbent, 1986, Williams & Scott, 1988), Williams’
theory o f overgenerality included a relative focus on linking overgeneral memory to
depression. According to his theory, persistent use of functional-avoidance strategy,
with one overgeneral categoric memory leading to another, is a ruminative, self
focused processing style. This cognitive style is thought to increase an individual’s
vulnerability to depression because an inability to recall the details of past
experiences impairs problem solving ability and the use of an overgeneral retrieval
style will result in an endless stream of attempts to think through such problems.
50
Several aspects of Wiliams’ (1996) theory have been supported with empirical
evidence, including the relation o f overgenerality to rumination (Nolen-Hoeksema,
1991; Raes et al, 2005) and problem solving ability (e.g., Goddard et al., 1996, 1997)
among depressed samples. However, one significant gap in the literature supporting
Williams’ theory has been the lack of evidence of overgenerality among abused
children, despite the centrality of early trauma to his model. Instead, empirical work
demonstrating a link between trauma and overgeneral memory has mainly relied upon
retrospective reporting of childhood abuse experiences among adults. Therefore,
evidence that children who have been abused demonstrate more overgeneral memory
than do nonmaltreated children supports Williams’ theoretical perspective and
provides much needed evidence that such a pattern of memory retrieval also is
associated with memory overgenerality in childhood.
Furthermore, the demonstration of overgeneral autobiographical memory
among a sample of maltreated children adds to the literature regarding the impact of
trauma on memory for nontraumatic stimuli in children. As reviewed in the
introduction, extant research examining basic memory processes (i.e., the encoding,
storage and retrieval of neutral, nontraumatic stimuli) among maltreated children is in
its infancy, whereas studies that have focused on traumatic memories have
burgeoned. For the most part, foundational work on basic memory processes
suggests that maltreatment does not have an impact on children’s mem ory. For
example, maltreatment does not appear to have an effect on true and false recall for
neutral stimuli, nor does it affect children’s memory for positive and negative words
51
when encoded under self-referent instructions (Howe et al., 2004; Valentino et al., in
press). However, one recent investigation suggests that under certain conditions,
children who have been abused demonstrate poorer semantic recall; under matemal-
referent encoding conditions abused children recall fewer positive and negative words
than do nonmaltreated children (Valentino et al., under review). Thus, the current
research provides a second example of alterations in memory performance among
children who have experienced abuse. In addition, this investigation augments the
literature on nontraumatic semantic memory through the comprehensive assessment
of nontraumatic autobiographical memory processes.
5.1.2 Interviewer Prompts
Beyond the frequency with which children retrieve overgeneral
autobiographical memories, this investigation examined several additional aspects of
autobiographical recall. For example, analysis of the number of interviewer prompts
to encourage retrieval of specific memories during the Autobiographical Memory
Test (AMT) revealed that abused children elicited more prompts from the interviewer
than did the nonmaltreated and the neglected children. This finding is consistent with
prior research conducted by Johnson and colleagues (2005), who found that teens
with abuse histories received more prompting by the interviewer than did teens
without an abuse history. Notably, this was the only memory variable significantly
related to childhood trauma in their study. It is logical that those who are having
difficulty recalling specific memories will elicit more prompts from the interviewer
because the interviewer is instructed to prompt if the child initially responds to a cue
52
word with an overgeneral memory. Given our finding that the abused children
provided more overgeneral responses than did the nonmaltreated children, it is
understandable that these children would also receive more interviewer prompts
overall.
5.1.3 Response Latency
Abused, neglected and nonmaltreated children evidenced no differences in
their response latencies, thus disconfirming our hypothesis that abused children
would require more time to generate memories following cue word presentation.
Assuming that abused children would have difficulty retrieving specific
autobiographical memories, we additionally anticipated that abused children would
spend more time engaged in memory search for a specific memory before responding
with one that is overgeneral. However, the findings here suggest that although
abused children demonstrate more overgenerality in their memory recall, they do not
utilize more time for their memory search. Although this lack o f differences was
unexpected, it is consistent with the findings of the only other investigation to
measure response latencies during the AMT among abused children (Johnson et al.,
2005). In fact, all of the evidence supporting increased response latency during
autobiographical memory retrieval has been conducted among adults with depression
(Brittlebank et al., 1993; Williams & Broadbent, 1986). Therefore it is possible that
increased response latency is indicative o f the psychom otor retardation that is
associated with depression and is not characteristic of overgeneral memory retrieval.
53
5.1.4 Length o f Memory
Abused, neglected and nonmaltreated children also demonstrated comparable
length in their memory narratives. Given our prediction that abused children would
be more overgeneral in their autobiographical memory responses, we also
hypothesized that abused children would be less detailed in their memory narratives,
resulting in shorter memories. However, abused, neglected and nonmaltreated
children did not exhibit differences in the length of memory narratives generated
during the AMT, which fails to support our hypothesis. Only one previous study has
connected length of memory to exposure to current family violence (Johnson et al.,
2005); however, it is noteworthy that a history of self-reported child maltreatment
was not associated with memory length in that same sample.
One possible explanation for the lack of differences in memory length is that
the average length of narrative for participants in this investigation was rather short
(M = 11.63, SD = 7.8). Therefore, floor effects could have precluded the detection of
differences as a function of maltreatment. Nonetheless, the lack of differences in
memory length suggests that the abused, neglected and nonmaltreated children did
not differ in expressive language abilities or verbal fluency. Although it would have
been ideal to include a direct measure of language abilities so that any differences
could be controlled for statistically, the findings regarding length of memory suggest
that verbal fluency is not a significant confound.
Despite a lack o f differences in memory length as a function of maltreatment
experience, differences were revealed as a function of the valence of cue type.
54
Specifically, children generated longer memories in response to negative cues than to
positive cues. This finding is consistent with the literature on autobiographical
memory and reminiscing among typical and atypical samples (Fivush, Hazzard,
Sales, Sarfatti & Brown, 2003; Sales, Fivush, & Peterson, 2003). For example, in a
study of children aged 5-12 living in violent neighborhoods, children talked about
their thoughts and emotions more when recalling negative than positive events
(Fivush et al, 2003). Whereas positive experiences can generally assimilate into self
representations with ease, negative experiences potentially threaten one’s sense of
personal competence. Thus, in order for children to understand the personal meaning
of negative experiences, and integrate them into a coherent autobiography, a more in
depth discussion of the causes and consequences of emotion may be needed to
mitigate against feelings of vulnerability (Bird & Reese, 2006). Often, parent-child
conversations serve as a medium through which children can begin to understand the
personal meaning o f past experiences. At least among normative samples, there is
evidence that parents are more elaborative when discussing a negative event,
compared to a positive event, and are more likely to include an explanation for the
emotion in the negative event (Sales et al., 2003). Although not directly assessed in
this investigation, it is possible that the children’s memory narratives were longer in
response to negative cues than to positive cues due to a similar desire to reconcile
negative experiences w ith their sense o f self.
55
5.1.5 Gender effects
Associations between gender and aspects of autobiographical memory
processes also replicated some well-established patterns in the memory literature. For
example, females had longer memory narratives than did males in response to both
positive and negative cue words. In addition, males demonstrated more overgeneral
memory overall. This is consistent with a number of studies that cohere to suggest
that females have more extensive and accessible autobiographical memories than do
males during childhood and adulthood (Buckner & Fivush, 1998; Davis, 1999). Most
explanations of the difference in autobiographical memory between males and
females focus on gender differences in the socialization of autobiographical memory.
For example, there is evidence that mothers reminisce differently with female
compared to male children in that they are more elaborative with their daughters
(Reese, Haden & Fivush, 1996). Moreover, there is a large body of literature
demonstrating a connection between maternal elaborative reminiscing and their
children’s developing autobiographical memory skills (see Fivush, Haden & Reese,
2006 for review).
5.1.6 Valence effects
In contrast to a significant effect of valence on the length of memories
generated, valence differences were not found for overgenerality, the number of
prompts elicited from the interviewer, or response latency during the AM T. The lack
of differences in the number of overgeneral memories between those that were
generated in response to positive and negative cues is consistent with some, but not
56
all, of the extant literature. A recent synthesis of the research on the overgeneral
memory phenomenon by Williams and colleagues (2007), reviewed 12 studies that
examined the relation of trauma to overgeneral memories, including adult and child
samples. O f these studies, two reported that overgenerality in response to negative
cues (but not positive cues) was associated with trauma (Dalgleish, Tchanturia,
Serpell, Hems, Yiend, DeSilva, et al, 2003; Peeters, Wessel, Merchelbach, & Boon-
Vermeenan, 2002), and one reported the opposite pattern, such that negative cues
elicited more specific memories (Burnside et al., 2004). In contrast, nine studies
reported that trauma history is associated with overgenerality in response to both
valences, a finding that is consistent with the current results.
Examination of the research on overgeneral memory recall among samples of
individuals with depression reveals a somewhat different pattern of results. Although
the predominant finding is that overgenerality is found in response to both positive
and negative cues, several studies of adults with depression indicate that positive cues
elicit more overgeneral memories than do negative cues (e.g., Dalgleish et al., 2001;
Williams & Broadbent, 1986; Williams & Dritchel, 1988; Williams & Scott, 1988).
Thus, the major difference between studies among depressed samples and samples of
those with a trauma history is that none of the trauma studies show significantly
increased overgenerality for positive cues. Because depressed mood is associated
with reduced availability of positive m nem onic material (Eich, 1995; W iliam s, Watts,
MacLeod, & Matthews, 1997), it is possible that increased overgenerality for positive
cues might be explained by mood congruency effects. Nonetheless, it is important to
57
highlight that the two aforementioned studies, which identify a valence effect in the
relation of trauma to overgeneral memory, were conducted among clinical samples
with comorbid psychopathology (eating disorders in the Dalgleish et al., 2003 study
and depression in the Peeters et al., 2002 study).
Across the body of literature regarding overgeneral autobiographical memory,
the lack of a consistent valence effect is problematic for Williams’ functional-
avoidance theory. If autobiographical memory search is truncated at a categorical
level of memory in order to avoid the recall of aversive experiences and their
associated emotions, then one would expect overgenerality to occur more frequently
in response to negative cues then to positive cues. Thus, it seems that the notion of
functional-avoidance alone cannot explain all of the data (Williams et al., 2007).
Consistent with advancements in models of autobiographical memory, which
now include the role o f central executive control in the activation and inhibition of
memory components, and emphasize the role of the self (e.g., Conway & Pleydell-
Pearce, 2000; Howe & Courage, 1997), revised models of overgeneral
autobiographical memory recognize that overgenerality may represent a truncated
hierarchical search that is exacerbated by conceptual structures (of the self). These
impairments are further compounded by reduced processing resources and the
continuing impact of early trauma and adversity on the self-memory system
(W illiam s et al., 2007). A s explained in the follow ing sections, central executive
activation and inhibition, and self- representations play critical roles in the
interpretation o f the findings of this investigation.
58
5.1.7 Age effects
Age was also related to autobiographical memory performance; however, the
direction of this effect was opposite than that which was predicted. In particular
younger children (aged 7-9) produced more overgeneral memories than did older
children (aged 10-14). Drawing from the developmental and cognitive literature on
the emergence o f autobiographical memory, there are several potential explanations
for the higher rates o f overgeneral memory among the younger in comparison to the
older children. For example, several theories of autobiographical memory
development place the self as central to the encoding, storage and retrieval of
autobiographical memories (e.g., Conway& Pleydell-Pearce, 2000; Howe &
Courage, 1997). Therefore, until the self becomes a viable entity with developed
features, the encoding o f memories that are attached to the self (autobiographical
memories), is difficult. However, as the self becomes more developed and the
number of features associated with the self multiplies, the likelihood that these self
features will be activated becomes greater, allowing event memories to be encoded as
part of one’s personal past (Howe & Courage, 1997). Therefore, increased
overgenerality among younger children may be accounted for by a relatively
restricted set o f self-features from which to sample in comparison to older children.
Alternately, Conway & Pleydell-Pearce emphasize the importance of
executive control during autobiographical m em ory search in their self-m em ory m odel
(Conway & Pleydell-Pearce; 2000). In this model, supervisory processes are
necessary for generative retrieval by establishing intermediate search descriptions to
59
direct the memory search towards activation of appropriate event specific knowledge
and to inhibit irrelevant autobiographical information. Considering that inhibitory
control is a skill that is developed throughout childhood, increased overgenerality in
autobiographical memory among younger children might be related to difficulty in
inhibiting information that is activated at the intermediate description level of
memory search.
If overgenerality is related to inhibitory control, then levels of overgenerality
should correlate with performance on executive tasks that provide a measure of errors
due to interference from irrelevant information that should have been inhibited.
Recent work by Dalgliesh and colleagues (Dalgliesh, Williams, Golden, Barnard, Au-
Yeung, et al, in press) supports such a hypothesis by demonstrating that overgeneral
memory correlated with a task in which irrelevant material needed to be inhibited (the
emotional stroop test) and not with a task that merely required sufficient executive
capacity overall (a test of explicit memory).
In contrast, Johnson and colleagues (2005) demonstrated that age was
positively related to overgeneral memories in their sample of 12 to 18 year old
adolescents. However, a methodological difference between the administration of the
AMT in the Johnson study and the protocol utilized in this investigation renders a
comparison o f the two investigations difficult. Specifically, Johnson and colleagues
asked their adolescent participants to recall “childhood m em ories” (defined as prior to
age 9), whereas children in the current investigation were not restricted in the time
period from which they could recount memories. Therefore, the difficulty older teens
60
in the Johnson study experienced in retrieving specific memories might be accounted
for by memory decay and reduced accessibility of memories that typically may occur
overtime (e.g., Rubin, 1986).
In sum, the findings of this investigation regarding the relation of age to
overgeneral memory revealed that younger children display more overgeneral
memory than do older children. Although this pattern of results is inconsistent with
prior work among adolescents, overgeneral autobiographical memory among younger
children may be accounted for by developmental processes related to the self and
inhibitory control.
5.2 Content o f Memories: Self and Maternal Representations
The content o f the memory narratives children produced during the AMT
were coded for positive and negative self- representations as well as for positive and
negative maternal representations. This in itself represents advancement in the use of
the AMT, as the vast majority of prior research with this paradigm has reduced
autobiographical memory performance to a single number: the total number of
overgeneral memories produced upon initial response to each cue word. In addition
to providing a richer account of children’s autobiographical memory, the analysis of
children’s representations allowed us to better address the role of the self in
overgeneral memory.
A s predicted, abused, neglected and nonmaltreated children differed with
respect to self- representations. Specifically, abused and neglected children’s
narratives contained more negative self- representations than did the narratives of
61
nonmaltreated children. Furthermore, abused children demonstrated more negative
self- representations than did the neglected children, confirming our hypothesis that
abused children would have the most negative self-representations. The presence of
elevated rates of negative self- representation among children who have been abused
is consistent with several prior studies of self- system functioning among maltreated
children. For example, analysis of maltreated preschool children’s narratives in
response to the MacArthur Story Stem Battery revealed that the narratives of children
who had been physically abused contained high levels of negative self-
representations (Toth et al., 1997). Research among school-aged children reveals that
maltreated children have lower self-esteem, and have less positive self- concepts than
do nonmaltreated children (Bolger et al., 1998; Cicchetti & Rogosch, 1997; Egeland,
et al., 1983; Kim & Cicchetti, 2003, 2004). Taken together, the current finding that
abused children’s autobiographical memories contain more negative self-
representations than do the narratives of neglected and nonmaltreated children confers
the presence of self-system deviation among physically abused children in particular.
The presence o f positive and negative maternal- representations also was
examined in this investigation. Unlike our findings regarding self-representations,
there were no differences in positive or negative matemal-representations among
abused, neglected and nonmaltreated children. This lack of findings might be
attributable to floor effects given the low base rates o f the appearance o f matem al-
representations within children’s autobiographical memory narratives. On average,
children within all three subgroups of maltreatment history included positive or
62
negative maternal- representations in one of ten memory narratives. Thus the low
frequency and lack o f variance in children’s positive and negative matemal-
representations precluded our ability to detect differences as a function of
maltreatment history. Because the current investigation is the first to examine
representations in the memories produced during the AMT, normative data on the
frequency with which children include matemal-representations in their
autobiographical memory narratives is not available. To better understand the
impoverished rates of maternal- representations contained within the memories of
children in this investigation, it will be important for future research to determine
normative rates among a group of typically developing children.
Additionally, the role of maternal- representations in children’s
autobiographical memory is worth further investigation because prior research with
maltreated children suggested an association between the activation o f children’s
maternal- representations and their semantic recall abilities (Valentino et al., under
review). Specifically, abused children demonstrated poorer recall during an
incidental recall task where children encoded adjectives under maternal referent or
nonmatemal referent conditions. In contrast, research with a similar memory
paradigm in a different sample revealed that abused children demonstrated
comparable memory performance during a recall task that encoded words under self
referent or nonself-referent conditions (Valentino et al., in press). Therefore, it is
possible that the activation of maternal schema might have a unique impact on
memory encoding and retrieval.
63
J.3 Relationship Effects: Controllingness and Warmth
Because the majority o f prior research on the overgeneral memory effect has
relied on retrospective reporting of abuse, adults’ willingness (or lack thereof) to
disclose information and share memories may have influenced earlier research
findings. The current investigation addresses this issue in a number of ways. First, by
independently coding maltreatment records for incidences of abuse and neglect, we
were able to corroborate information gained via maternal interview regarding
children’s maltreatment histories. In addition, we included measures of child
controllingness and the quality of the child- interviewer relationship to determine
whether relationship/interaction variables might impact memory findings. For
example a child who is rated high on controllingness might refuse to answer the
questions, or attempt to alter the course of the paradigm (see Table 3 for operational
definitions). Thus, we wanted to ensure that overgeneral memories were not
accounted for by differences between abused, neglected, and nonmaltreated
children’s interaction abilities and styles.
Despite our hypothesis that abused children would be more controlling than
the nonmaltreated children during the administration of the AMT, no such differences
emerged. Theoretically, this controlling style is thought to emerge from disorganized
attachment relationships, characterizing interactions where the child utilizes
controlling behaviors as a coping strategy when attachment concerns are aroused
(Carlson, 1998; Hennighausen & Lyons-Ruth, 2005). Given the very high prevalence
of disorganized attachment relationships among children with abuse histories (up to
64
80-90%; Bamett, Ganiban & Cicchetti, 1999), we predicted that children who were
abused would be more controlling with the interviewer during the AMT, a task that
could activate attachment organization via recollection o f aversive memories. Prior
research among maltreated children has found abused children to be more controlling
during narrative paradigms that are similar to that used in this investigation (Toth et
al., 1997). However, consistent with the principles of multifinality (Cicchetti &
Rogosch, 1996), not all children with atypical attachment organizations develop a
controlling interaction style. Nonetheless, it is possible that children’s participation
in the AMT did not lead to sufficient emotional-arousal for activation of children’s
attachment systems, in response to which controlling behaviors might emerge. In
fact, one important difference between the story-stem narrative paradigm utilized in
the study by Toth and colleagues (1997) and the AMT, is that the story-stems are
structured scenarios created to elicit emotions (e.g., injury) whereas the AMT is more
open-ended. Alternately, abused children may have regulated their emotional
response and reduced their arousal to normative levels via their use of overgeneral
memory recall as a functional avoidance strategy.
In addition to controllingness, we included a measure of the warmth of the
relationship between child and interviewer throughout the AMT paradigm. Felt
warmth during the AMT is likely to have an impact on the degree to which children
are comfortable sharing private m emories. Therefore, it w ould be important to
control for potential differences in warmth as a function of maltreatment subtype
experiences. We predicted that interactions between the interviewer and abused
65
children would be less warm than interactions with nonmaltreated children; however
the findings did not support this hypothesis. Instead, an unanticipated pattern
emerged such that neglected children’s interactions with the interviewer were rated as
higher in warmth than were those of the abused and nonmaltreated children, who did
not differ from one another. In retrospect, these findings are consistent with what one
could expect from neglected children, who are likely to crave the positive attention
from adults that they lack in their caregiving relationships. Additionally, increased
warmth among neglected children’s interactions with the interviewer may be related
to a caretaking behavior style that is common among children who displayed
disorganization in their attachment relationships, in which children become overly
attuned to the needs o f others during interactions to elicit a positive response
(Hennighausen & Lyons-Ruth, 2005). Even so, given the overall pattern of findings
regarding relationship variables, with no differences in controllingness or warmth
between the abused and nonmaltreated children and only evidence of increased
warmth among neglected children, it was not necessary to control for these relational
variables in subsequent analyses.
5.4 Mediation o f Overgeneral Memory
5.4.1 Affective Representations
Whereas the first part of this investigation provided a comprehensive review
o f several aspects o f abused, neglected and nonmaltreated children’s autobiographical
memory recall, including aspects of both the form and content of memory, Part II was
more narrowly focused on identifying mediators of the pathway between abuse and
66
overgeneral memory. This analysis is informative for the understanding o f memory
processes among maltreated children, as well as for theories regarding the emergence
of overgeneral memory.
First, children’s self-representations were evaluated as potential mediators of
the relationship between trauma and overgeneral memory. Because a significant
relationship between abuse history and child representations emerged for negative
self-representations, and not for positive self-representations, only negative
representations were evaluated as a mediator. Regression analyses revealed that
negative representations did not mediate the relationship between abuse and
overgeneral memory. Although negative self-representations were significantly
related to overgeneral memory, negative self- representations did not independently
account for a significant proportion of variance in predicting overgeneral memory
when controlling for the effect of abuse. However, the strength of the relationship
between abuse and overgeneral memory decreased in the presence of negative self
representations.
Although negative self- representations do not mediate the relationship
between abuse and overgeneral memory, the finding that negative self representations
are related to overgeneral memory has important implications for theories of
autobiographical memory, as well as for models of overgeneral memory
development. In particular, our findings corroborate the notion that conceptual self-
representations play a significant role in autobiographical memory, as theorized in
modem models o f autobiographical memory (e.g., Conway & Pleydell-Pearce; 2000;
67
Howe & Courage, 1993, 1997). Moreover, these findings support Williams and
colleagues’ (2007) updated model of overgeneral memory, CaR-FA-X. In this model,
elements of Conway & Pleydell-Pearce’s self-memory theory are integrated with
William’s (1996) functional avoidance (FA) theory by adding that capture and
rumination (CaR) and impaired executive control (X) might also contribute to
overgeneral memory. In particular, Williams asserts that individuals with activated
negative self- representations may become captured in their memory search at the
level of conceptual self- representations, resulting in overgeneral memory. Noting
that these conceptual representations are essentially the same as the negative self
schemas described by traditional cognitive theorists of depression (Beck et al., 1979),
Williams and colleagues point to evidence of overgeneral memory among individuals
with depression to support a capture mechanism. However, no investigations to date
have directly examined the relationship between negative self- representation and
overgeneral memory. Therefore, the current investigation adds to the literature by
providing empirical support for the association of negative self- representations to
overgeneral memory.
Nonetheless, it is important to acknowledge that despite the significant
relationship between negative self-representations and overgeneral memory, negative
self-representations were not a significant predictor of overgeneral memory when
controlling for abuse in the current sample. Although the strength o f the relationship
between abuse and overgeneral memory decreased when negative self-representations
were entered into the regression model, it seems that experience of abuse is uniquely
68
related to overgeneral memory. Moreover, the data suggests that the relationship
between negative self-representations and overgeneral memory may be accounted for
through the strong relation of child abuse to negative self-representations. Because
high levels of negative self-representations were closely associated with abuse in the
current sample, it was difficult to ascertain the relation of negative self
representations to overgeneral memory independent of child abuse. It will be
necessary for future research to continue to investigate the role of negative self-
representations in the development of overgeneral memory independently among
samples of maltreated and nonmaltreated children.
5.4.2 Depression and Dissociation
Depressive and dissociative symptoms were also examined as potential
mediators of the relationship between abuse and overgeneral autobiographical
memory. First, to establish the conditions necessary for mediation, depressive and
dissociative symptoms were evaluated as a function of subtype, revealing a
significant multivariate effect. As predicted, abused children demonstrated more
depressive and dissociative symptomatology than did the nonmaltreated children; this
pattern of results is consistent with several other investigations that have identified
internalizing symptomatology and dissociation among the sequelae of child
maltreatment (e.g., Kim & Cicchetti, 2004; Macfie et al., 2001a; Ogawa et al., 1997;
Putnam, 2000; Toth & Cicchetti, 1996; Toth, M anly & Cicchetti, 1992). Contrary to
our hypotheses, age was not significantly related to depressive or dissociative
symptoms. This finding conflicts with evidence of age-related increases in
69
depression and decreases in dissociation over time (Angold & Costello, 1993;
Putnam, 1996; Putnam et al., 1993). However, it should be noted that the
symptomatology demonstrated by most children in the current investigation was not
in a clinically-significant range, whereas evidence of age related changes in
symptoms have focused on clinical populations.
Next, the relation of depressive and dissociative symptoms to overgeneral
memory was assessed. In partial support of our hypotheses, depression was
significantly related to overgeneral memory, thus confirming a well-established
pattern in the literature (see Williams et al., 2007 for review). However, dissociative
symptoms were not significantly related to overgeneral memory recall as predicted.
Nonetheless, this investigation adds to our understanding of overgeneral memory by
being the first to examine whether dissociation might be a mechanism related to
overgeneral memory recall. Given the centrality of the self to autobiographical
memory processes, in addition to evidence of overgenerality among individuals with
PTSD (McNally et al., 1995), where the incidence of dissociation is high (e.g., Briere,
Scott, & Weathers, 2005; Ehlers, 2006) it seemed possible that dissociation might
contribute to overgeneral memory as a functional avoidance mechanism. However,
the findings of the current research do not support such an account. In contrast,
additional investigations of overgeneral memory among adults with PTSD suggest the
extent to w hich people experience intrusive m em ories o f negative events predicts
difficulty in retrieving specific personal memories (McNally et al., 1995). Taken
together with our findings regarding increased overgenerality among those with
70
negative self-representations, it appears that heightened accessibility of, or
preoccupation with, negative representations (of specific events or of the self) hinders
the ability to recall specific personal memories.
Finally, depressive symptoms were evaluated in the relationship between
abuse and overgeneral memory. Dissociative symptoms were not considered further
because of their lack of relationship to overgenerality. Contrary to our hypothesis,
hierarchical regression did not support a significant indirect pathway between abuse
and overgeneral memory via depressive symptoms. Therefore this investigation adds
clarity to our understanding of the mechanisms that underlie overgeneral memory by
demonstrating that trauma is associated with overgeneral memory, independent of
depression. This finding corroborates several other investigations that have linked
childhood trauma to overgeneral memory, even after controlling for levels of
depression (DeDecker et al., 2003; Henderson et al., 2002; Kuyken & Brewin, 1995).
However, all prior work relied on retrospective report or self-report to identify
childhood trauma among depressed samples. Therefore, the current research
validates the association between abuse in childhood and overgeneral memory, which
cannot be accounted for by depression, with a sample of children for whom
maltreatment experiences were determined independently of children’s memory and
willingness to disclose abuse.
5.5 L im ita tio n s a n d F u tu re D ire c tio n s
There are limitations to this investigation that should be addressed. For
example, although a general measure of language abilities that is highly correlated
71
with IQ was included and controlled for throughout our analyses, the lack of an
additional measure of memory performance or executive control precludes our ability
to differentiate overgeneral memory processes from broader deficits in general
memory performance. However, several studies have illustrated that
autobiographical memory deficits linked to trauma and depression are not accounted
for by measures of working memory (deDecker et al., 2003), general episodic
memory (e.g., immediate or delayed story recall, deDecker et al., 2003), semantic
memory (Raes, Hermans, Williams, Demytetenaere et al., 2006) or intrusive thoughts
(Henderson et al., 2002, Kuyken & Brewin, 1995). Moreover, several studies that
have controlled for additional cognitive abilities such as semantic processing speed,
semantic fluency, and IQ (Park et al., 2002; Williams & Broadbent, 1986; Williams
& Scott, 1988) found that group differences in overgeneral memory remain even
when matching for these variables. In tandem with research that supports a lack of
alterations in basic memory functioning among maltreated children (e.g., Howe et al.,
2004; Valentino et al., in press), it seems unlikely that differences in generalized
memory ability have confounded the overgeneral memory findings of the current
investigation.
Also, the current research was unable to evaluate the role of matemal-
representations in children’s memory. Unfortunately, children in this sample rarely
included their mothers in the m em ory narratives they generated during the AM T, thus
preventing analysis o f positive and negative maternal- representations in relation to
children’s overgeneral memory. The lack of maternal- references in children’s
72
spontaneous autobiographical memories suggests in itself that matemal-
representations may not play an important role in autobiographical memory.
However, an alternative explanation is that children’s memories did not often include
their mothers as an additional avoidance strategy to reduce the risk of experiencing
negative affect. Together with evidence that abused children display poor semantic
recall performance in comparison to nonmaltreated children when words are encoded
under matemal-referent conditions (Valentino et al., 2007), but demonstrate
comparable recall to nonmaltreated children under self-referent conditions (Valentino
et al., in press), further investigation of the role of maternal- representations in abused
children’s memory is warranted.
In addition, it should be highlighted that the data presented in this
investigation are not longitudinal in nature, thus preventing the establishment of
temporal precedence that is ideal for mediational analyses. In particular, we assumed
that child maltreatment preceded the development of negative self- representations,
when we examined negative self-representation as a potential mediator of the
relationship between abuse and overgeneral memory. Certainly, several prior
investigations have demonstrated that negative self- representations are among the
developmental sequelae o f child maltreatment, and of physical abuse in particular
(e.g. Toth et al., 1997). Nonetheless, longitudinal research will be necessary to
determine whether negative self-representations are a mediator or moderator in the
relationship between child abuse and overgeneral autobiographical memory recall.
73
Longitudinal research would also allow us to evaluate the transactional
relationship of depressive and dissociative symptoms to overgeneral memory recall
over time. The findings of the current investigation demonstrate that depressive
symptoms do not mediate the relationship between abuse and overgeneral memory.
However, it should be noted that most of the depressive symptomatology
demonstrated by the children in this sample was in the subclinical range; therefore, it
remains unclear how clinical depression might play a role in overgeneral memory
recall. Given the high rate of negative self-representations among the abused children
in this sample, there is reason to anticipate the development of clinically significant
levels of depression, particularly as these children reach adolescence, where the
incidence o f depression is high (e.g., Lewinsohn, Rohde, & Seeley, 1998). Thus,
prospective longitudinal research would inform our understanding of the role of
depression in overgeneral memory, and of overgenerality as a potential marker of
vulnerability to the development of depression.
5.6 Clinical Implications
The main findings o f this investigation, which demonstrate that overgeneral
autobiographical recall is more frequent among abused children in comparison to
nonmaltreated children possess important clinical implications. The finding that child
abuse is associated with overgeneral memory is particularly significant, considering
evidence that overgeneral m em ory is itself associated with several important aspects
of psychological functioning. For example, quite a few studies have demonstrated
that overgenerality is predictive of delayed recovery from episodes of affective
74
disorders (Brittlebank et al., 1993; Dalgliesh et al., 2003; Harvey, Bryant, & Dang,
1998; Peeters et al., 2002). Moreover, overgeneral memory is clinically significant
because memory remains overgeneral in those with a history of emotional disorder,
even if they are not currently in an episode (e.g., Mackinger, Pachinger, Liebetseder
& Faracek, 2000; Williams & Dritchel, 1998). Therefore, overgeneral memory might
serve as a marker for future vulnerability for depression. In fact, there is evidence
that overgeneral memory when one is not depressed predicts later symptomatology
(e.g., Gibbs & Rude, 2004; Mackinger et al., 2000). However, no investigations to
date have prospectively examined overgenerality in childhood in relation to later
emotional disturbance. Thus, a longitudinal follow-up of the current sample could
address whether overgenerality is a risk factor associated with the development of
depression.
Theoretically, overgenerality is thought to increase an individual’s
vulnerability to depression because an inability to recall the details of past
experiences impairs problem solving ability. In fact, lack of memory specificity is
related to deficits in interpersonal problem solving and poorer outcomes for
individuals in therapy (Brittlebank et al., 1993; Evans, Williams, O’Loughlin, &
Howells, 1992; Sidley, Whitaker, Calam, & Wells, 1997; Williams & Dritschel,
1988), as well as problems in imagining future events, such that overgenerality for
past events predicts overgenerality in specifying future events (W illiam s, Ellis, Tyers,
Healy, Rose, & MacLeod, 1996). Therefore, interventions that target memory
specificity for day-to-day experiences have been proposed to improve outcomes
75
(Johnson et al., 2005). For example Serrano, Latorre, Gatz, and Rodriguez (2004)
examined the impact o f a 4-week intervention designed to increase specificity of
positive memories in depressed elderly patients. Results revealed that overgenerality
was reduced following intervention, as were symptoms of hopelessness and
depression. Thus, it seems that overgeneral memory is an important factor in
maintaining depression and its modification can positively impact its course.
Finally, it is important to discuss the implications of the current investigation
for the forensic arena. Research on children’s memories often effects decisions
regarding the viability o f child testimony in the courtroom as well as whether officials
are confident in relying on child report to substantiate abuse and neglect (Toth &
Valentino, in press). However, it is essential to acknowledge that studies that assess
children’s memory and suggestibility for mundane events may have little applicability
to our understanding of children’s reporting of significant, often traumatic, events in
their lives. In fact, because forensic interviews are mainly interested in the recall of
central details regarding salient emotional experiences, empirical evidence supports
the accuracy o f traumatized children’s memory reports (e.g., Alexander et al., 2005,
Howe, Courage & Peterson, 1994,1995). Therefore, the finding of the current
investigation, that abused children have more difficulty retrieving specific
autobiographical memories than do nonmaltreated children in response to non
trauma-related prompts, should not be generalized to abused children’s ability to
accurately recall traumatic memories. That being said, law officials should be
sensitive to impairments in abused children's ability to recall specific memories and
76
should be careful to not misinterpret abused children’s recollection of overgeneral or
vague memories as indicative of a lack of cooperation to disclose personal
experiences.
In summary, this investigation addresses significant gaps in the extant
literature on the relation of trauma to memory among maltreated children by
providing a comprehensive assessment of abused, neglected and nonmaltreated
children’s autobiographical memories for non-trauma related experiences. The
findings revealed that abused children, but not neglected children, demonstrated
difficulty in retrieving specific autobiographical memories compared to the
nonmaltreated children. The examination of additional mechanisms that may
contribute to overgeneral autobiographical memory among abused children
demonstrated that negative self-representations, as well as depressive and dissociative
symptomatology, did not mediate the relation of abuse to overgeneral memory.
These findings substantiate theories that have emphasized the role of early trauma in
the development of overgeneral memory by providing the first evidence of
overgeneral memory among a sample of maltreated children. It will be important for
future research with maltreated children to further investigate the affect of children’s
internal representations on the development of adaptive functioning, and for clinical
interventions to target the reduction of negative self-representations in particular.
77
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Table 1
Demographic Characteristic Means and Standard Deviations for Abused, Neglected

and Nonmaltreated Children
Abused Neglected Non-Maltreated

(N= 361 (N= 341 (N= 115)
Mean Child Age

Years 10.69(1.6) 10.78(1.7) 10.51(1.5)
Child Gender
Male 66.7% 55.9% 47%
Female 33.3% 44.1% 53%
Family Marital Status

Single 61.1% 78.1% 67.3%
Ethnicity
Minority 69.4% 79.4% 85.2%
SES(Hollingshead)
Lowest two social strata 86.1% 68.8% 73.5%
Cognitive Performance**
PPVT-III(standard score) 86.78(10.2)a 93.84(10.6)b 96.52(12.9)b
a Indicates significant group differences, see text for explanation;

*p < .05* (2-tailed), **p <.01
100
Table 2
Reliability Analyses
Variable Aloha
Positive Overgeneral Memories .86
Negative Overgeneral Memories .83
Positive Prompts .88
Negative Prompts .92
Positive Response Latency .98
Negative Response Latency .99
Positive Memory Length .99
Negative Memory Length .99
Positive Child Representations .81
Negative Child Representations .74
Positive Maternal Representations .83
Negative Maternal Representations .89
Controllingness .91
Warmth .71
101
Table 3
Control/Opposition Scale
(Adapted from the MacArthur narrative coding manual- Rochester Revision, MNCM-
RR; Robinson, Mantz-Simmons, Macfie, & MacArthur Narrative Working Group,
2000 )
Rating
(1-3) No controlling or opposition behavior, child shows appropriate

engagement. At the lower end, the child is co-operative, engaged
throughout; at the higher end of the band, child may be initially mildly
resistant but becomes truly engaged with the task
(4-6) Child is resistant, requires some prompting to complete the task, may
express dislike for the prompts, completes them in a minimal or
avoidant way but without changing the essential nature of the task or
threatening refusal in any way. At the low end is the child who
resists more passively or quietly, gives minimal responses in order to
hurry up and finish so he/she can move on to something else; at the
high end of the band is the child who resists but without much
prompting finishes the task
(7-9) Child’s resistance to the task requires much prompting and

encouraging from the examiner in order to complete it, however the
child does complete the task. The child attempts to take over, control
the task and stories, may change essential nature of the task by
attempting to introduce new materials not on the table or changing the
prompts. At the low end, the child is quite resistant or controlling but
there is no risk that the task will not be completed in some form; at the
high end o f the band the child barely finishes the task
(10-12) Child is openly hostile, rude or provocative in behavior, criticizing of

the task, and refusing to co-operate such that the task is not
completed, despite attempts on the examiner’s part to redirect the
child to the task.
102
Table 4
Global Warmth/Friendliness of the Interaction

(Adapted from the MacArthur narrative coding manual- Rochester Revision, MNCM-
RR; Robinson, Mantz-Simmons, Macfie, & MacArthur Narrative Working Group,
2000)
Rating
(1-3) Cold, unfriendly relating between child and examiner such that they do
not like each other
(4-9) Neutral relating, the child and examiner could “take or leave” each
other
(10-12) Warm, positive relating between the child and examiner, a significant
connection and engagement is noted
103
Table 5
Correlation Matrix: Gender and Cognitive Performance with Dependent Variables
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1. Gender -.0 2 .15* .13 .13 .14 -.0 1 -.07 -.19** -.28** -.14 -.07 -.14 -.08 .23** -.28**
00
*
2. PPVT-III -.31** -.17* -.26** -.08 -.06 .04 .01 -.14 -.08 .04 -.08 -.34** .24**
1
3. PGeneral 44 ** .34** .32** .1 2 .1 2 -.41** . 36** - 1 9 ** .05 -.1 2 -.0 1 .40** -.33**
4. NGeneral .32** .51** .1 1 .1 2 -.19* -.18* -.14 .15* -.09 -.07 34 ** -.27**
5 .PPrompt .6 8 ** -.04 .05 .08 .09 -.01 .2 0 ** -.09 .04 .46** 19**
6 . NPrompt .05 .1 2 .1 0 .15* -.05 .28** -.07 -.0 2 .39** -.1 2
- 2 2 ** -.18* ** i **
*
*
On
29
00
7. PLatency .04 -.05 -.15* .07 . 2
n
©
3 Q * *
. NLatency -.13 -.15*
0
1
1
8 -.0 1 -.1 0 .0 1
O
9. PLength 83 ** 28** .16* .41** .24** -.37** .46**
10. NLength .29** .2 1 ** .36** 34 ** _ 2 0 ** 41**
11. Pchild -.03 .2 1 ** .1 0 -.19* .23**

12. Nchild -.03 .07 -.0 2 .1 0
13. PMom -.2 2 ** .2 1 **

14. NMom -.1 1 .09
15. Control -. 6 6 **
16. Warmth
(Note: PGeneral = Overgeneral memory to positive cues; NGeneral = Overgeneral memory to negative cues; PPrompt = number o f prompts to positive cues;
NPrompt = number o f prompts to negative cues; PLatency = average response latency to positive cues; NLatency = average response latency to negative cues;
PLength = average length o f memory to positive cues; NLength = average length of memory to negative cues; Pchild = number of positive self-representations;
Nchild = number of negative self-representations; PMom - number o f positive maternal representations; NMom = number o f negative maternal representations,
Control = Controllingness rating’ Warmth = Warmth of interaction rating); *p < .05* (2-tailed), **p <.01
104
Table 6
Means and Standard Deviations by Maltreatment Subtype Group, Controlling for Gender and PPVT-III standard score
Dependent Variable Abused Neglected Nonmaltreated F p Partial Eta2
Overgeneral Memory** 3.00(1. 2)a 2.26(1. l)b 2.39(1.2)b 4.62 .011 .051
Number o f Prompts** 7.41(3.5)a 5.35(3.4)b 5.15(3.5)b 5.50 .005 .059
Response Latency 2.93(2.6) 3.43(2.6) 3.53(2.6) 0.59 .55 .007
Length of Memory 23.36(15.3) 25.56(14.7) 22.89(15.3) 0.53 .59 .006
Positive Self- Representations 1.17(1.1) 1.40(1.1) 1.04(1.1) 0.86 .47 .010
Negative Self- Representations** 1.75(1.l ) a 1.41(1.1) .097(1. l ) b 7.10 .001 .074
Positive Matemal-Representations 0.73(.79) 0.58(.79) 0.65(.93) 0.23 .79 .003
Negative Maternal- Representations 0.29(.76) 0.62(1.0) 0.42(.78) 1.27 .29 .014
Controllingness 3.28(2.0) 2.39(1.9) 3.1(2.0) 3.15 .046 .034
Warmth** 7.20(2.5)b 9.17(2.4)a 7.67(2.5)b 5.47 .005 .058
aE--------------------------------------------------------------------------------------------
Indicates significant group differences, see text for explanation;
*p < .05* (2-tailed), **p <.01
105
Table 7
Mediation of the Relation of Abuse to Overgeneral Memory: Negative Self-
Representations
Step P F AR2 Adjusted R2 sr2
1 7.61** .22 .191

Gender .18 .03
PPVT-III -.33 11**
Age -.27 07**
2 7.64** .06 .24
Gender .15 .02
PPVT-III -.27 07**
Age -.29 .08**
Abuse .25 .06*
3 6.75** 023 .255
Gender .15 .02
PPVT-III -.24 .05*
Age -.29 08**
Abuse .21 .04*
NSelfRep .16 .02
Note: PPVT-III = PPVT-III standard score; NSelfRep = Negative Self-
Representations
*p < .05* (2-tailed), **p <.01
106
Table 8
Mediation of the Relation of Abuse to Overgeneral Memory: Depressive Symptoms
Step P F AR2 Adjusted R2 sr2
1 8.11** .22 .19

Gender .15 .02
PPVT-III -.36 .13**
Age -.24 .05*
2 8.77** .07 .26
Gender .12 .01
PPVT-III -.28 .07**
Age -.27 Q7**
Abuse .28 .07*
3 7.30** .01 .26
Gender .12 .01
PPVT-III -.25 .05*
Age -.26 .06**
Abuse .27 .06**
CDI .11 .01
Note: PPVT-III = PPVT-III standard score; *p < .05* (2-tailed), **p <01
107
Appendix
Child Behavior Checklist Items for the Dissociation Scale (Ogawa et al., 1997)
1. Acts too young for his/her age

8. Can’t concentrate, can’t pay attention for long
13. Confused or seems to be in a fog
17. Day-dreams or gets lost in his/her thoughts
18. Deliberately harms self or attempts suicide
36. Gets hurt a lot, accident-prone
40. Hears sounds or voices that aren’t there
76. Explosive and unpredictable behavior
78. Inattentive, easily distracted
80. Stares blankly
87. Sudden changes in mood or feelings
91. Talks about killing self

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Autobiographical Memory Functioning Among Abused, Neglected and

The Overgeneral Memory Effect

Submitted in Partial Fulfillment

Requirements for the Degree

Professor Sheree L. Toth

Department of Clinical and Social Sciences in Psychology

ProQuest Information and Learning Company

Kappa honors as well as the Sebastian Brennikmeijer Medal for excellence in

graduate studies in Clinical Psychology. She pursued her research in Psychology

Clinical & Social Sciences in Psychology at the University of Rochester.

my mentoring, both in challenging me to grow as a scientist and in providing me with

their thoughtful and insightful feedback as members of my dissertation committee. In

to my parents, for giving me the courage to pursue my highest aspirations, and to my

participated in this research.

experience of trauma affects memory, if at all. Despite a proliferation of research

examination o f memory processes for nontraumatic stimuli with traumatized

current investigation addresses significant gaps in the literature to ascertain whether

function of maltreatment, and to examine what roles self-system functioning and

psychopathology play in autobiographical memory processes among maltreated

children. Autobiographical memory for positive and negative nontraumatic events

was evaluated among abused, neglected, and nonmaltreated school-aged children

Part I of this investigation, a comprehensive analysis of children’s autobiographical

memory performance was conducted; this included assessment of children’s ability to

narratives were also examined. Part II focused on overgeneral memory, a pattern of

memory retrieval characterized by difficulty in recollecting specific autobiographical

memories, and evaluated children’s self-representations as well as children’s

depressive and dissociative symptomatology in relation to children’s memory.

contained more negative self-representations than did those of the nonmaltreated

children. Negative self-representations were significantly related to overgeneral

for models of memory and for the development of overgenerality is emphasized.

Moreover, the clinical implications of the current research are discussed.

5.1.5 Gender Effects 55

Table 1 Demographic Characteristic Means and Standard 99

Table 2 Reliability Analyses 100

Table 3 Control/Opposition Scale 101

Table 4 Global Warmth/Friendliness of Interaction 102

Table 5 Correlation Matrix: Gender & Cognitive Performance 103

Table 6 Means and Standard Deviations by Maltreatment Subtype 104

Table 7 Mediation of the Relation of Abuse to Overgeneral 105

Table 8 Mediation of the Relation of Abuse to Overgeneral 106

Cicchetti, 2006). Some contend that traumatic experiences, as distinctive and

memory deficiencies among maltreated children.

stimuli. Furthermore, little is known about basic memory functioning among

less research exists on episodic, autobiographical memory for nontraumatic events.

autobiographical memory has failed to differentiate maltreatment effects from

psychopathology such as depression (Johnson, Greenhoot, Glisky & McCloskey,

In this investigation, we sought to address significant gaps in the literature on

the relation between trauma and autobiographical memory among maltreated

overview of the development of autobiographical memory is presented. After

highlighting the influence of self- development upon autobiographical memory, the

literature on self- development among maltreated children is reviewed. This section

psychopathologies, such as depression and dissociation. Finally, the literature on the

relation of depression and of dissociation to autobiographical memory is presented.

The goals of the present investigation are:

of autobiographical memory recall as a function of maltreatment;

(2) To examine what roles self-system functioning and

psychopathology play in autobiographical memory processes

among maltreated children.

These specific aims are addressed through the conduct of an investigation

provides a comprehensive assessment of autobiographical memory processes among

on one aspect o f autobiographical memory, the overgeneral memory effect, and

examines the relation of self- representations, as well as dissociative and depressive

symptomatology, to this phenomenon.

Chapter 1 Background and Significance