Predicting post‐traumatic growth and post‐traumatic stress in firefighters

Emergency service workers (e.g., firefighters, police, and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e.g., post‐traumatic stress disorder (PTSD)) and/or positive outcomes (e.g., post‐traumatic growth (PTG)). Research had implicated trauma, occupational and personal variables that account for variance in post‐trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi's model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 firefighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self‐care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.     

社会支持、创伤后应激障碍与创伤后成长之间的关系:来自雅安地震后小学生的追踪研究

本文采用追踪研究的设计,在雅安地震后的6、12和18个月三个时间点,采用社会支持问卷、儿童创伤后应激障碍症状量表、DSM-5的PTSD核查表和创伤后成长问卷对303名小学生进行调查。通过建立交叉滞后模型,考察社会支持、创伤后应激障碍(PTSD)与创伤后成长(PTG)三者之间的关系,结果发现在震后6至18个月之间,PTG对PTSD没有显著的预测作用,震后6个月的PTSD对震后12个月的PTG具有显著的跨时间点的正向预测作用,但是该作用在震后12至18个月之间不再显著;震后6至12个月之间,社会支持对PTSD发挥单向的缓解作用,但与PTG之间不存在显著的预测作用;在12至18个月之间,PTSD可以单向地降低社会支持,且社会支持与PTG之间也存在显著的正向相互预测作用。     

Social support, coping, life events, and posttraumatic stress symptoms among former peacekeepers: a prospective study

This study examined both cross-sectionally and longitudinally the relationship between social support, coping strategies, additional stressful life events, and symptoms of posttraumatic stress disorder (PTSD) among Dutch former peacekeeping soldiers. Two groups of peacekeepers were investigated: 311 peacekeepers who participated in the peacekeeping operation in Lebanon between 1979 and 1985, and 499 peacekeepers who were deployed after 1990. These peacekeepers completed a questionnaire in 1996 and again in 1998. The results show that more negative social contacts and fewer positive social contacts were associated with more PTSD symptom severity. More use of the coping strategies ‘wishful thinking’ and ‘accepting responsibility’ was related to more PTSD symptoms. Conversely, more planful problem solving and seeking social support was related to less PTSD symptom severity. In addition, a bilateral relationship was found between additional stressful life events and PTSD symptom severity. The results indicate that social support and coping strategies may be valuable aspects of prevention and intervention programs.     

Posttraumatic symptoms and growth of Kosovar war refugees: The influence of hope and cognitive coping

Research on war trauma has been dominated by a pathological focus for decades. Researchers have now counterbalanced studies of trauma with a new focus, positive changes following crisis. This prospective study examines how specific psychological factors might influence post-war adaptive outcomes (the coexistence of posttraumatic growth [PTG] and posttraumatic stress disorder [PTSD] symptoms) in a sample of 50 Kosovar war refugees. Individual differences in positive attitude and coping strategies were explored. Hope assessed during resettlement, and cognitive coping strategies, employed between resettlement and follow-up, were associated with PTG, controlling for war-related trauma and baseline symptoms. PTG and symptoms were unrelated. No predictors for present symptoms were identified. Future mental health practice with refugees should address both positive and negative aspects.     

Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

Bereaved African American Adults: The Role of Social Support,Religious Coping,and Continuing Bonds

The present study identified relationships between social support, religious coping, continuing bonds, prolonged grief disorder (PGD) symptoms, and the quality of life among bereaved African American adults (N = 154). Perceived social support and less use of negative religious coping strategies predicted a higher quality of life and fewer PGD symptoms. Also, greater perceived social support, less use of negative religious coping strategies, and less use of continuing bonds significantly predicted fewer PGD symptoms. Implications suggest that the conceptualization of grief and loss for African Americans might include social support, religious coping, and continuing bonds.     

Responses of Clergy to 9/11: Posttraumatic Stress, Coping, and Religious Outcomes

This study examines posttraumatic stress, religious coping, and nonreligious coping in relation to positive religious outcomes following the tragedies of 9/11. In November 2001, a mailed survey of 814 active, ordained ministers in the Presbyterian Church (U.S.A.) measured posttraumatic stress, perceived threat, coping activities, positive and negative religious coping, positive religious outcomes, and perceived congregational responses. A majority of the respondents (75 percent) experienced some posttraumatic stress symptoms, with 63 percent feeling threatened for their personal safety. Nonreligious coping behaviors included contributing money (60 percent) and displaying the flag (56 percent). Looking to God for strength, support, and guidance was the most frequently used strategy; increased prayer was second. High stress was associated with higher frequency of coping strategies, both religious and nonreligious. More frequent positive religious coping was related to less severe stress symptoms of numbness and avoidance, and higher positive religious outcomes. Although religion failed to provide protection against stress in a population of religiously dedicated individuals, it provided a pathway for positive and effective coping strategies that resulted in positive religious outcomes .     

Prevalence and Predictors of Posttraumatic Growth in Accidentally Injured Patients

This study examined prevalence and predictors of posttraumatic growth in 180 accidentally injured patients of mainland China in their convalescence stage, investigating its relationships with demographic and accidental injury variables, personality, posttraumatic stress disorder (PTSD) symptoms, and coping styles. Our results showed that posttraumatic growth (PTG) presented mostly in the domain of Relating to Others and indicated that PTG was significantly related to marital status, educational level, personality, coping styles, and PTSD symptoms. Avoidance of PTSD symptoms, Openness to experience, and positive coping were significant predictors of PTG. The findings emphasize that when promoting PTG of accidentally injured patients, healthcare providers should facilitate patients utilizing personal resources, understand PTG coexists with PTSD symptoms, and adjust interventions based on the coping styles the patients have adopted.     

Best friends and better coping: Facilitating psychological resilience through boys’ and girls’ closest friendships

This is a novel investigation of whether, and how, a single close supportive friendship may facilitate psychological resilience in socio‐economically vulnerable British adolescents. A total of 409 adolescents (160 boys, 245 girls, four unknown), aged between 11 and 19 years, completed self‐report measures of close friendship quality, psychological resilience, social support, and other resources. Findings revealed a significant positive association between perceived friendship quality and resilience. This relationship was facilitated through inter‐related mechanisms of developing a constructive coping style (comprised of support‐seeking and active coping), effort, a supportive friendship network, and reduced disengaged and externalising coping. While protective processes were encouragingly significantly present across genders, boys were more vulnerable to the deleterious effects of disengaged and externalizing coping than girls. We suggest that individual close friendships are an important potential protective mechanism accessible to most adolescents. We discuss implications of the resulting Adolescent Friendship and Resilience Model for resilience theories and integration into practice.     

Type D personality,physical symptoms and subjective stress: The mediating effects of coping and social support

Coping style and social support may represent mechanisms to explain the relationship between Type D personality and ill-health. This study investigated whether Type D is associated with physical symptoms and perceived stress in a non-cardiac population, and if these relationships are mediated by coping and social support. In a cross-sectional study, 304 participants (110 males, mean age 22.1 years) completed measures of Type D, physical symptoms, coping, perceived stress and social support. Results showed that Type D, the interaction of negative affectivity and social inhibition (NA?×?SI), was positively correlated with physical symptoms, perceived stress, and avoidant coping, and negatively correlated with social support, problem-focused coping and emotion-focused coping. A series of bootstrapped multiple mediator tests showed that social support and avoidant coping fully mediated the relationship between Type D and physical symptoms. Furthermore, social support and emotion-focused coping partially mediated the relationship between Type D and perceived stress. These findings demonstrate for the first time that Type D personality is associated with physical symptoms in a non-cardiac population. Social support and coping style represent mechanisms that can, in part, explain the relationship between Type D and physical symptoms, and Type D and perceived stress.     

Type D personality, physical symptoms and subjective stress: the mediating effects of coping and social support

Coping style and social support may represent mechanisms to explain the relationship between Type D personality and ill-health. This study investigated whether Type D is associated with physical symptoms and perceived stress in a non-cardiac population, and if these relationships are mediated by coping and social support. In a cross-sectional study, 304 participants (110 males, mean age 22.1 years) completed measures of Type D, physical symptoms, coping, perceived stress and social support. Results showed that Type D, the interaction of negative affectivity and social inhibition (NA × SI), was positively correlated with physical symptoms, perceived stress, and avoidant coping, and negatively correlated with social support, problem-focused coping and emotion-focused coping. A series of bootstrapped multiple mediator tests showed that social support and avoidant coping fully mediated the relationship between Type D and physical symptoms. Furthermore, social support and emotion-focused coping partially mediated the relationship between Type D and perceived stress. These findings demonstrate for the first time that Type D personality is associated with physical symptoms in a non-cardiac population. Social support and coping style represent mechanisms that can, in part, explain the relationship between Type D and physical symptoms, and Type D and perceived stress.     

Is Religious Coping Related to Better Quality of Life Following Acute Myocardial Infarction?

Although few studies have examined the extent to which religiousness is related to better well-being following acute myocardial infarction (AMI), studies from the broader literature suggest that positive religious coping may be helpful while more negative forms of religious coping may be related to poorer well-being. To assess the relationship between positive and negative religious coping and depressive symptoms in patients with AMI, we collected data twice over a 1-month period from 56 patients hospitalized with a first AMI. Controlling for demographic variables and social support, both positive and negative religious coping were independently related to higher levels of depressive symptoms both in hospital and at a one-month follow-up. Further, even when controlling for baseline depressive symptoms, religious coping predicted higher subsequent depressive symptoms. These results suggest that religious coping appears to be maladaptive in dealing with acute MI, perhaps because this type of recovery requires more active forms of coping.     

Active Coping and Perceived Social Support Mediate the Relationship Between Physical Health and Resilience in Liver Transplant Candidates

Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N?=?120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience. Findings revealed that physical functioning, active coping, and perceived social support were positively associated with resilience; maladaptive coping was negatively associated with resilience. Perceived social support and active coping partially mediated the relationship between physical functioning and resilience. Transplant center care providers should promote active coping skills and reinforce the importance of effective social support networks. These interventions could increase psychological resilience among liver transplant candidates.     

A double‐edged sword: Event centrality,PTSD and posttraumatic growth

Previous research has demonstrated negative mental health consequences (including PTSD symptoms) of construing a potentially traumatic event as central to one's identity. In the current paper, we replicated an association between event centrality and PTSD symptoms. We also found event centrality similarly predicts posttraumatic growth (PTG) even after controlling for PTSD symptoms, depression, DSM‐IV A1 and A2 status of the event, coping styles and cognitive processing of the event. Because predictive relationships between event centrality and PTSD symptoms, as well as event centrality and PTG were positive, construing an event as central to one's identity can indeed become a double‐edged sword, allowing for both debilitation and growth. Copyright © 2010 John Wiley & Sons, Ltd.     

中小学教师PTSD和PTG的影响因素研究：灾难前-中-后的视角

采用事件影响量表、创伤后成长问卷、社会支持问卷、应对方式问卷等对汶川地震1年后极重灾区的106名中小学教师进行调查,考察前灾难因子、灾难当下因子和后灾难因子等对教师创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响。结果发现：（1）灾后中小学教师的PTSD处于中低水平、PTG处于中上水平,其中女教师的PTSD和PTG水平高于男教师,班主任教师PTSD水平高于非班主任教师,有过被困经历的教师PTSD水平高于没有被困经历的教师,有亲朋或学生受伤的教师其PTSD和PTG水平均高于无亲朋或学生受伤的教师;（2）社会支持对PTSD没有显著的预测作用,社会支持中的信息支持可以促进PTG,而情感支持和实质性支持对PTG没有显著的影响;（3）逃避的应对方式能显著地正向预测PTSD,问题解决的应对方式能显著正向地预测PTG,而寻求帮助的应对方式对PTSD和PTG都不具有显著的影响。     

Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients

The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.     

社会支持对震后青少年创伤后应激障碍和创伤后成长的影响:自我效能感的中介作用

本研究采用创伤暴露问卷、社会支持问卷、自我效能感量表、创伤后应激障碍症状核查表和创伤后成长问卷,在汶川地震8.5年后对地震极重灾区的1185名中学生进行调查,考察社会支持对创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响,并检验自我效能感在其中的中介作用。结果发现：在控制创伤暴露程度、性别和年龄等变量后,社会支持不仅可以直接负向预测PTSD、正向预测PTG,也可以通过自我效能感的中介作用负向预测PTSD、正向预测PTG。这表明,自我效能感在社会支持与PTSD、社会支持与PTG的关系中都具有部分中介效应。     

Perceived social support,coping, and symptoms of distress in American and Spanish students

Abstract

The aim of this study was to test whether coping responses mediated the influence of perceived social support on symptoms of anxiety/depression, social withdrawal, and aggressive behavior in American (N=349) and Spanish students (N=437). Participants completed measures of perceived support, social stress, coping, and distress. Coping partially mediated relations between perceived support and distress, with coping mediation most evident in individuals facing high levels of social stress. Decreased use of disengagement coping by individuals with high perceived support appears to partially explain the protective value of perceived social support. Multiple group covariance structure analysis showed that models linking perceived support, coping, and distress were very similar across cultures, suggesting that the mechanisms underlying decreased risk for individuals with high perceived support may be relatively independent of cultural context, and that interventions designed to increase perceived support and decrease disengagement could be appropriate in both cultures.     

Resilience and coping in trauma spectrum symptoms prediction: A structural equation modeling approach

Resilience is increasingly recognized as a relevant factor in shaping psychological response to natural disasters. Aim of the study is to examine in the context of a natural disaster the potential effects of resilience on the relation between coping and trauma spectrum symptoms, using structural equation modeling.A sample of 371 students who survived the earthquake in L’Aquila (Italy) were cross-sectionally evaluated using Resilience Scale for Adolescents, Brief Cope and Trauma and Loss Spectrum scale.The model shows a direct path of positive and emotional coping styles on resilience. Emotional coping shows also a direct impact on the outcome; positive and emotional coping results to be positively correlated as well as emotional and disengagement coping styles. Resilience directly affects the PTSD symptoms, partially mediating the impact of the coping styles. The model explains 30% of the variance in the outcome, i.e. the Post-Traumatic Stress Disorder (PTSD) symptoms, with very good fit indexes.Resilience operates as a protective factor from stress symptom development. It is likely that emotional and disengagement coping skills are rapidly involved after a traumatic exposure but when problem focused coping intervenes, resilience allows it to buffer the stressors or even guides toward a more successful outcome.