Fear of happiness among college students: The role of gender, childhood psychological trauma, and dissociation.

AIMS: This study aimed to evaluate the fear of happiness among college students and its relationship to gender, childhood psychological trauma, and dissociation. SETTING AND
DESIGN: College students were addressed as study population, and a relational screening method was implemented.
MATERIALS AND METHODS: Among 184 participants, 93 (50.5%) were women. The Fear of Happiness Scale (FHS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Experiences Scale (DES) were administered to all participants. STATISTICAL ANALYSIS USED: Mann-Whitney-U and Student's t-tests were implemented for comparison of groups. Pearson correlation and stepwise multiple regression analyses were conducted to identify associations between variables.
RESULTS: There were no differences on DES, FHS, and CTQ total scores between genders. DES was associated with CTQ total scores in both genders. Women had higher scores than men on childhood emotional abuse and fear of "cheerfulness ends up with bad faith." Compared to nonmembers, female dissociative taxon members had higher scores on all childhood trauma types except sexual abuse, and on all types of fear of happiness except "good fortune ends up with disaster" which was the only type of fear significantly elevated among male dissociative taxon members. A stepwise regression analysis revealed that depersonalization, childhood emotional neglect, and physical abuse predicted fear of happiness among women which was predicted by absorption among men.
CONCLUSIONS: There is a relationship between childhood psychological trauma, dissociation, and fear of happiness. Women seem to be more vulnerable in this path of obsessional thinking which affects different realms in male and female genders.

INTRODUCTION

Fear of happiness is the belief that happiness may have negative consequences[1] implying that it should be avoided.[2] There is a rising belief that considers happiness as an internal state to be achieved and controlled by the individual. Paradoxically, this stance may cause distress due to the perceived pressure to achieve happiness.[34] Thus, positive emotions such as happiness are not experienced as pleasurable in clinical populations.[5] These emotions may even perceived as terrifying because happiness may be considered a merely transient experience which may end up by something bad. Suggesting a type of superstitious thinking, there are people who believe that being overhappy may attract a bad event.[6] They may think that if they are happy, they will be more likely to be exposed to the evil eye, invite rivalry, or envy[7] or be punished in the afterlife.[8] On the other hand, such ruminations resemble obsessions obviously that a culture-sensitive differential diagnosis may be intrigued in some cases.

Fear of happiness is negatively correlated with subjective well-being[1] and positively correlated with depression.[5] In fact, fear of happiness is correlated with fear of negative emotions overall. For example, fear and avoidance of sadness and anger are associated with fear of happiness.[9] On the other hand, suggesting an association rather than contradiction between avoidance of positive and negative emotions, fear and avoidance of sadness and anger is also related to fear of receiving compassion from others, and to fear of giving to oneself.[9] Hence, fear of happiness seems to be a type of mental operation which tries to avoid emotions overall.

Childhood psychological trauma has become a subject of research in almost all domains of psychiatry and even general medicine as an example of developmental stress. Dissociation is one of the well-known consequences of childhood psychological trauma.[10] Dissociation is characterized by disruptions or discontinuities in usually integrated psychological functions such as memory, consciousness, perception, sense of self and agency, and sensorimotor abilities (American Psychiatric Association, 2013).[11] Constituting disorders on its own, dissociation may accompany almost every psychiatric disorder.[12] When it does, dissociation is usually correlated with childhood adversity in the investigated population.[13]

Potential association of childhood trauma and dissociation with fear of happiness has not been studied yet. For example, children who have been punished by adults following an enjoyment learn not to feel good about positive emotions (Gilbert, 2007). Thus, the purpose of this study was to examine possible relationship between childhood adverse experiences, dissociation, and fear of happiness among young adults in Turkey. A particular emphasis has been put on inquiries about possible gender differences in the prevalence and correlates of fear of happiness. Three hypoteses were examined: (1) Childhood trauma and dissociation predict fear of happiness; (2) women experience fear of happiness more frequently than men; (3) there is a relationship between denial of childhood trauma and fear of happiness.

MATERIALS AND METHODS

Participants

A group from graduate students of the Trakya University School of Educational Sciences participated in the study. The campus of this university is in Edirne-City which is a town located in western border (Thracien) of Turkey. The majority of the participants and their families were residents of the city. There were 1000 students enrolled for the spring semester of 2015–2016. Only those students were considered for participation who were available in their classrooms before the lecture during a single visit by the study investigator (TT). They were studying in five diverse teaching training programs. The participants filled the questionnaires privately in the presence of the study investigator in the classroom. Among invited students, only 3 men and but no women rejected to participate in the study. All participants provided written informed consent. The study was approved by the academic directorate of the School of Educational Sciences.

Assessment instruments

Fear of Happiness Scale

This five-item self-report measure was developed by Joshanloo.[1] It is a 7-point Likert-type scale with possible total score between 7 and 35. The Fear of Happiness Scale was adapted into Turkish by Turk et al.[14]

Dissociative Experiences Scale

This self-report scale evaluates the severity of dissociative symptoms (Carlson and Putnam, 1993).[15] The scale consists of 28 items each with possible scores between 0 and 100. The Dissociative Experiences Scale (DES) was adapted into Turkish by Yargic et al.[16] There is also a taxon form of the scale (DES-T) derived from eight of the original items. Taxometric analysis of these items yields a high probability that an individual is in one of two discrete categories: Normal or suffering from pathological dissociation.[17] The DES-Taxon may also be used as a categorical index of high and low dissociators.[18]

Childhood Trauma Questionnaire

This scale was developed by Bernstein et al.[19] The Childhood Trauma Questionnaire (CTQ) consists of 28 items each with possible scores between 0 and 5. The scale has five subscores: emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse. Minimization (denial) of childhood adversity is also assessed. Turkish version of the scale has been shown as valid and reliable (Şar, Öztürk, and İkikardeş, 2012).

RESULTS

Characteristics of the participants

Average age of the participants (n = 184) was 21.82 (df = 1. 40, range = 20–27). Among participants, 93 (50.5%) students were female. Age of women (x̄ = 21.56 df = 1.21, range 20–26) and men was (x̄ = 22.08 standard deviation = 1.55, range = 20–27) The socioeconomic status for women was reported as low (n = 13, 14%), middle (n = 77, 82.8%), and upper (n = 3; 3.2%). These rates were 8 (8.8%), 81 (89.0%), and 2 (2.2%) for men, respectively.

Childhood trauma and dissociation

Among men, 5 (6.10%) participants reported childhood sexual abuse, 12 (14.64%) physical abuse, 13 (15.85%) emotional abuse, 19 (23.17%) emotional neglect, and 33 (40.24%) participants physical neglect scores above cut-off scores determined in Turkish culture for CTQ previously. Among women, 16 (14.41%) participants reported childhood sexual abuse, 16 (14.41%) physical abuse, 29 (26.13%) emotional abuse, 27 (24.35%) emotional neglect, and 23 (20.72%) participants physical neglect. Nevertheless, there were no significant differences between genders on childhood trauma and dissociation total scores. However, women had higher scores of emotional abuse than men [Table 1]. In addition to this and alongside CTQ total scores, women who belonged to the dissociation taxon reported more physical abuse and neglect [Table 2]. Consequently, they had also elevated CTQ scores. Women who were not dissociation taxon member had significantly elevated minimization of trauma scores. Among men, the dissociative taxon was related to emotional abuse only.

Table 1

Childhood trauma and dissociation: A comparison between genders

Scale	Women (n=93)		Men (n=91)		Student’s t-test
	Mean	SD	Mean	SD	t (df=182)	P
CTQ scores
EA	7.53	3.71	6.42	2.89	2.42	0.017
PA	5.50	1.22	5.34	1.04	0.92	0.358
PN	6.55	2.42	6.75	2.08	0.60	0.552
EN	9.87	3.67	9.55	3.53	0.61	0.546
SA	5.45	1.38	5.18	0.75	1.36	0.094
Minimization of trauma	1.10	1.11	1.05	1.10	0.26	0.798
Total score	34.89	9.37	33.23	7.10	1.36	0.176
DES scores
Absorption	33.08	18.62	30.24	16.83	1.09	0.280
Amnesia	16.29	16.25	16.78	15.70	0.21	0.834
Depersonalization	21.32	18.18	20.36	18.13	0.36	0.720
Total score	25.42	16.27	23.17	15.24	0.58	0.564

DES – Dissociative experiences scale; CTQ – Childhood trauma questionnaire; SD – Standard deviation

Table 2

Childhood trauma history among men and women according to the dissociative experiences scale taxon status

Scale	Taxon positive		Taxon negative		Man-Whitney U-test P
	Mean	SD	Mean	SD
Men	n=26		n=65
EA	6.77	2.38	6.28	2.40	0.040
PA	5.12	0.59	5.43	1.16	0.103
PN	7.50	2.27	6.45	1.94	0.055
EN	9.62	3.86	9.52	3.43	0.979
SA	5.00	0.00	5.25	0.88	0.148
Minimization of trauma	1.54	1.19	1.01	1.07	0.663
CTQ total	34.00	7.39	32.92	7.01	0.625
Women	n=27		n=66
EA	10.85	4.67	6.17	2.07	0.001
PA	5.96	1.37	5.30	1.11	0.002
PN	8.48	3.37	5.76	1.25	0.001
EN	11.59	4.39	9.17	3.11	0.010
SA	5.60	1.74	5.40	1.21	0.073
Minimization of trauma	1.04	1.13	1.12	1.11	0.719
CTQ total	42.48	12.27	31.79	5.49	0.001

DES – Dissociative experiences scale; CTQ – Childhood trauma questionnaire; SD – Standard deviation; PN – Physical neglect; EN – Emotional neglect; SA – Sexual abuse; PA – Physical abuse; EA – Emotional abuse

Correlational analyses yielded positive associations between CTQ and DES total scores in both genders with higher correlation scores for women [Table 3]. Interestingly, there were no significant correlations between childhood sexual abuse and any dissociation scores in either gender. Unlike women, experiences of absorption did not significantly correlate with any childhood trauma scores among men. Women's minimization of trauma scores were negatively correlated with dissociative amnesia.

Table 3

Correlations (Pearson) between scale scores

	FHS total		DES total		Absorption		Amnesia		Depersonalization
	Women	Men	Women	Men	Women	Men	Women	Men	Women	Men
CTQ	0.48**	0.03	0.60**	0.28**	0.48**	0.20	0.65**	0.29**	0.58**	0.29**
EA	0.35**	0.02	0.64**	0.27**	0.49**	0.30	0.70**	0.25*	0.65**	0.19
PA	0.42**	0.08	0.38**	−0.07	0.25*	−0.07	0.45**	−0.12	0.40**	−0.14
PN	0.46**	0.03	0.57**	0.29**	0.46**	0.17	0.62**	0.31**	0.53**	0.37**
EN	0.40**	0.01	0.37**	0.24**	0.46**	0.15	0.54**	0.27*	0.57**	0.26*
SA	0.09	−0.11	0.05	0.08	0.01	−0.13	0.07	−0.02	0.06	−0.04
Min	−0.24*	−0.14	−0.12	0.12	−0.03	−0.14	−0.23*	0.02	−0.13	−0.14
FHS	-	-	0.55**	0.27*	0.47**	0.30**	0.52**	0.13	0.53**	0.27*

*P<0.05, **P<0.001. DES – Dissociative experiences scale; FHS – Fear of Happiness Scale; CTQ – Childhood trauma questionnaire; PN – Physical neglect; EN – Emotional neglect; SA – Sexual abuse; PA – Physical abuse; EA – Emotional abuse

Fear of happiness

There was no difference on fear of happiness total scores between genders [Table 4]. However, women had higher scores than men on one item: “cheerfulness may end up in bad faith.” In correlational analyses [Table 3], there was a significant association between childhood trauma and fear of happiness total scores among women but not men. Among women, all childhood trauma types; however, sexual abuse was significantly correlated with fear of happiness. There was a negative correlation between fear of happiness and minimization of trauma among women. Among men, experiences of absorption and depersonalization but not dissociative amnesia were correlated with fear of happiness. In a comparison based on DES-Taxon membership, women with pathological dissociation had significantly elevated scores on all items of the Fear of Happiness Scale except fear of “good fortune ends up with disaster [Table 5].” Interestingly, the same item was the only type of fear of happiness which was significantly elevated among men who belonged to the dissociation taxon.

Table 4

Fear of happiness among women and men

Scale	Women (n=93)		Men (n=91)		Student’s t-test
	Mean	SD	Mean	SD	t (df=182)	P
FHS scores
Joyfulness - sadness	2.91	1.78	2.66	1.83	0.96	0.340
Cheerfulness - bad thing	2.81	1.75	2.25	1.62	2.23	0.027
Good fortune - disaster	2.61	1.63	2.58	1.75	0.12	0.903
Joy and fun - bad thing	2.64	1.86	2.24	1.54	1.60	0.111
Joyfulness - bad consequence	2.78	1.82	2.55	1.58	0.94	0.350
FHS total score	13.76	8.00	12.28	7.03	1.33	0.185

FHS – Fear of happiness scale; SD – Standard deviation

Table 5

Fear of happiness among women and men according to the dissociative experiences scale taxon status

FHS scores	Dissociative taxon positive (n=27)		Dissociative taxon negative (n=66)		Mann-Withney U-test
	Mean	SD	Mean	SD	Z	P
Women
Joyfulness - sadness	4.22	1.55	2.38	1.60	4.39	0.000
Cheerfulness - bad thing	3.96	1.56	2.33	1.61	3.88	0.000
Good fortune - disaster	3.11	1.63	2.41	1.60	1.83	0.067
Joy and fun - bad thing	4.15	1.90	2.03	1.46	4.74	0.000
Joyfulness - bad consequence	4.33	1.71	2.15	1.45	4.93	0.000
FHS total score	19.78	7.34	11.30	6.92	4.22	0.000
Men
Joyfulness - sadness	2.96	2.04	2.54	1.73	0.92	0.359
Cheerfulness - bad thing	2.76	2.03	2.05	1.39	1.58	0.114
Good fortune - disaster	3.46	2.40	2.23	1.27	1.96	0.050
Joy and fun - bad thing	2.50	2.01	2.14	1.32	0.29	0.773
Joyfulness - bad consequence	2.62	1.90	2.52	1.45	0.25	0.807
FHS total score	14.30	9.34	11.48	5.76	0.94	0.347

FHS – Fear of happiness scale; SD – Standard deviation

In a stepwise linear regression analysis among women, fear of happiness total score taken as dependent variable and five subscores of CTQ and three subscores of DES as independent variables (R2 = 0.37, df = 3; 89 F = 38.50, P < 0.001), only depersonalization (t = 3.95 P < 0.001), childhood emotional neglect (t = 2.59 P < 0.05), and physical abuse (t = 2.22 P < 0.05) predicted fear of happiness. Among men, only absorption (t = 2.95 P < 0.05) was a significant predictor (R2 = 0.09, df = 1; 89 F = 6.98, P < 0.05) of fear of happiness total score.

DISCUSSION

Overall findings of this study suggested that there was a relationship between childhood psychological trauma, dissociation, and fear of happiness. There was no significant difference between genders except the elevated total score on fear of happiness and one type of experience which were elevated among women: “cheerfulness may end up with bad thing.” In general, the associations between childhood adversity, dissociation, and fear of happiness were more explicit among women compared to men and among those who were members of the dissociation taxon. Nevertheless, there were important qualitative differences between genders which deserved further discussion.

Gender role stereotypes may lead to radically divergent expectancies from women and men as experienced in interpersonal domain. In conservative societies, while socializing women are expected to maintain a reserved manner to prevent “violation” of the codes of “decent behavior.” This is understood as deliberate limitation of the full expression of positive emotions. Consequently, the fear of “cheerfulness may end up with bad thing” was elevated among women. Among men, expression of pessimism may undermine the image of a “strong performer” as reflected, for example, by the fear of “good fortune ends up with disaster.” A study suggested that, in fact, men were slightly less optimistic than women while there was no gender difference in pessimism.[20] Nevertheless, this does not prevent men from keeping their “eyes open” for “threats” to their gender role.

In the present study, the differences about fear of happiness among women and men were more prominent between dissociative taxon members and nonmembers. Namely, four types of fear about positive emotions (i.e., cheerfulness and joyfulness) were significantly elevated among women in dissociative taxon. Among men, the same was valid for a rather pessimistic attitude: “good fortune may end up with disaster.” This shift in findings suggests that pathological dissociation (which is related to childhood adversities) makes fear of happiness more explicit.

There is growing interest on clinical consequences of minimization of trauma (MacDonald et al., 2016).[21] The present study brought clues about possible impact of denial (minimization) of childhood trauma, dissociative amnesia, and absorption on fear of happiness. For example, there were negative correlations between minimization of childhood trauma and both fear of happiness and dissociative amnesia among women, i.e., minimization of childhood trauma and dissociative amnesia seemed to be coping mechanisms to alleviate the impact of childhood adversities. Interestingly, women who were member of dissociative taxon had lower minimization of trauma scores than those of nonmembers, i.e., they seemed to be more aware about their traumatic childhood.

Paradoxically, there was also a negative correlation between dissociative amnesia and minimization of trauma scores among women. Namely, in contrast of minimization, dissociative amnesia was significantly and positively correlated with fear of happiness among women. Dissociative amnesia and minimization of trauma seem to be two distinct paths of coping with trauma. Apparently, with its double consequences, dissociative amnesia does not only lead to diminished awareness but to re-enactment (“return of the dissociated”) of traumatic experiences in the form of fears, while minimization uniformly leads to avoidance.

In contrast to the common assumption that dissociation is usually based on fragmentation,[22] Schimmenti and Şar[23] propose that absorption trance is also a type of dissociation. Indeed, absorption was the only predictor of fear of happiness among men. However, in contrast of depersonalization and dissociative amnesia, it was not correlated with childhood trauma reports. Thus, experiences of absorption may play a role for men which are similar to that of dissociative amnesia among women. Unlike women and among men, neither dissociative amnesia nor minimization of childhood trauma seemed to play a significant role in this regard. Overall, we speculate that denial of childhood trauma assist women in defeating fear of happiness while absorption (an alternative mechanism of avoidance of traumatic memories; i.e., alteration and/or narrowing of the consciousness) increases those fears among men as dissociative amnesia did for women.

Thus, fear of happiness seems to be a cognitive reenactment of nonintegrated childhood trauma, i.e., a trauma-related or posttraumatic obsession (Öztürk and Şar, 2016).[24] Interestingly, in regression analysis, depersonalization (but not absorption) predicted fear of happiness among women (but not men) while dissociative amnesia did not. Hence, in the final analysis, depersonalization (self-detachment or self-estrangement) seems to trump dissociative amnesia while leading to a disturbance of sense of self.[252627] With their tendency to absorption, men seemed to be less affected by such self-estrangement.

These considerations touch ideas about possible links between childhood trauma, dissociation, and obsessions. Dissociative symptoms and disorders have been reported in patients with obsessive-compulsive disorder.[28293031] Depersonalization disorder had the highest prevalence among them (Belli et al., 2013).[32] Studies on patients with obsessive-compulsive disorder have also reported childhood psychological trauma frequently.[3334] Thus, in the present study, traumatic antecedents and dissociation may have determined the content of obsessions. They targeted the concerns of “happiness,” the very idea which related to the experience of pleasure.

CONCLUSIONS

There is a relationship between childhood psychological trauma, dissociation, and fear of happiness. Seemingly one of the ways of coping with childhood psychological trauma, fear of happiness can be considered as a trauma-related obsession. While women seem to be more vulnerable than men in this realm, gender roles seem to affect the psychopathogenesis and expression of this experience.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.