Perception of threat and safety at work among employees in the Norwegian ministries after the 2011 Oslo bombing

Background and objectives: Terrorism can heighten fears and undermine the feeling of safety. Little is known, however, about the factors that influence threat and safety perception after terrorism. The aim of the present study was to explore how proximity to terror and posttraumatic stress reactions are associated with perceived threat and safety after a workplace terrorist attack. Design and methods: A cross-sectional questionnaire survey was administered to employees in 14 of 17 Norwegian ministries 9–10 months after the 2011 bombing of the government headquarters in Oslo (n = 3520). Results: About 198 of 1881 employees completing the survey were at work when the bomb exploded. Regression analysis showed that this high-exposed group had elevated perceived threat (β = 0.36; 95% CI = 0.19 to 0.53) and reduced perceived safety (β = ?0.42; 95% CI = ?0.62 to ?0.23) compared to a reference group of employees not at work. After adjusting for posttraumatic stress reactions, however, proximity to the explosion no longer mattered, whereas posttraumatic stress was associated with both high perceived threat (β = 0.55; 95% CI = 0.48 to 0.63) and low perceived safety (β = ?0.71; 95% CI, ?0.80 to ?0.63). Conclusion: Terror-exposed employees feel more threatened and less safe after a workplace terrorist attack, and this is closely linked to elevated levels of posttraumatic stress reactions.     

A latent profile analysis of coping responses to individuals’ most traumatic event: associations with adaptive and maladaptive mental health outcomes

ABSTRACT

Background & Objectives: This study explores how empirically-derived coping response patterns influence mental health.

Design: Emerging adults, currently enrolled in college and aged 18–24 (N?=?432; M_age?=?19.66; SD?=?1.65), completed self-report measures of trauma exposure, coping responses to self-selected most traumatic event (MTE), resilience, posttraumatic growth (PTG), depressive symptoms, and posttraumatic stress symptoms (PTSS).

Methods: Eight coping subscales were included as indicators in a latent profile analysis. Then, associations between established profiles and mental health outcomes were examined, covarying for demographic and trauma-related variables.

Results: Considering fit statistics, class size, profile patterns, and theory, the four-class model was deemed most appropriate: High Overall Coping (HCOPE; n?=?146, 34%), Low Overall Coping (LCOPE; n?=?92, 22%), High Engagement Coping (HENG; n?=?115, 27%), and High Disengagement Coping (HDIS; n?=?73, 17%). HENG participants endorsed above-average resilience and PTG, coupled with below-average depressive symptoms and PTSS. Compared to the sample average, HDIS participants endorsed lower resilience and PTG, coupled with higher depressive symptoms and PTSS. LCOPE participants endorsed low levels of all outcomes. HCOPE participants endorsed high levels of all outcomes.

Conclusions: Findings suggest that clinicians who promote engagement coping and discourage disengagement coping among trauma-exposed individuals may engender the most desirable constellation of mental health outcomes.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

Natural Disasters in Indonesia: Relationships Among Posttraumatic Stress,Resource Loss,Depression, Social Support,and Posttraumatic Growth

ABSTRACT

Indonesia is at significant risk for catastrophic natural disasters, including earthquakes, volcanic eruptions, and tsunamis. Few studies have examined psychological functioning following disaster exposure in Indonesia, the fourth most populous country in the world. This study assesses variables associated with posttraumatic stress and posttraumatic growth following a devastating earthquake in Central Java that ranks as one of the costliest in Indonesia. The participants were 85 men and women living in rural farming villages. Almost all (95%) experienced major home damage or total home destruction. Posttraumatic stress symptoms were associated with resource loss, depression, and concerns about future earthquakes. Participants reported moderate posttraumatic growth. Posttraumatic growth was associated with energy resource loss and social support. The findings support conservation of resources stress theory. The implications of the findings for intervention and recovery programs are discussed.     

Secondary traumatic stress and adjustment in therapists who work with sexual violence survivors: the moderating role of posttraumatic growth

ABSTRACT

Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who work with sexual violence survivors completed measures of secondary traumatic stress, posttraumatic growth and a range of adjustment indicators. Hierarchical multiple regression analyses demonstrated that posttraumatic growth moderated the negative impact of secondary traumatic stress on therapist depression, anxiety, personal meaning and satisfaction with life. Posttraumatic growth sustained positive affect through a direct effects model only. This study provides support for the protective role of posttraumatic growth in adjustment to secondary traumatic stress.     

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.     

Guest referees for 17(4)

Background and objectives: Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. Design: A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Method: Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Results: Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. Conclusions: In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.     

Predicting adolescent posttraumatic stress in the aftermath of war: Differential effects of coping strategies across trauma reminder,loss reminder,and family conflict domains

Background and Objectives: The vast majority of youth who lived through the Bosnian war were exposed to multiple traumatic events, including interpersonal violence, community destruction, and the loss of a loved one. This study examined factors that predict post-war psychological adjustment, specifically posttraumatic stress, in Bosnian adolescents. Design: Regression analyses evaluated theorized differential relations between three types of post-war stressors – exposure to trauma reminders, loss reminders, and intrafamilial conflict – specific coping strategies, and posttraumatic stress symptom dimensions. Methods: We examined 555 Bosnian adolescents, aged 15–19 years, to predict their long-term posttraumatic stress reactions in the aftermath of war. Results: Findings indicated that post-war exposure to trauma reminders, loss reminders, and family conflict, as well as engagement and disengagement coping strategies, predicted posttraumatic stress symptoms. Secondary control engagement coping responses to all three types of post-war stressors were inversely associated with posttraumatic stress symptoms, whereas primary control engagement coping responses to family conflict were inversely associated with hyperarousal symptoms. Disengagement responses to trauma reminders and family conflict were positively associated with re-experiencing symptoms. Conclusions: These findings shed light on ways in which trauma reminders, loss reminders, and family conflict may intersect with coping responses to influence adolescent postwar adjustment.     

The role of repetitive thought in determining posttraumatic growth and distress following interpersonal trauma

Background and Objectives: Repetitive thought (RT) strategies have been linked to a range of negative outcomes following traumatic interpersonal events but are proposed to serve an adaptive function under particular circumstances. This study examined outcomes following RT within a transdiagnostic framework, and explored the potentially adaptive nature of trait-like and event-related RT. Design: The centrality of a traumatic event to one's identity was explored as a context under which the adaptive nature of RT might change. Young adults with interpersonal violence experiences (N = 163) reported use of trait-like and event-related RT, centrality of the event, depressive, anxious, and posttraumatic stress symptoms (PTSS), posttraumatic depreciation and posttraumatic growth. Methods: Hierarchical multiple regression analyses were used to examine main and moderating effects of four types of RT and event centrality on outcome variables. Results: Centrality positively predicted depressive symptoms and PTSS, depreciation, and growth. Brooding RT positively predicted all negative outcomes. Reflecting RT positively predicted anxious symptoms and PTSS and depreciation. Only deliberate RT positively predicted growth. Centrality did not moderate any examined relationships. Conclusions: Findings highlight the importance of addressing specific types of RT in interventions with survivors and of considering centrality as a robust contributor to outcomes following interpersonal violence.     

Treatment Adherence Among War Veterans with Posttraumatic Stress Disorder: A Concept Analysis

Aim: This study was made to analyze the concept of treatment adherence among war veterans who suffer posttraumatic stress disorder.

Methods: This concept analysis was done using Walker and Avant’s concept analysis model. Online English and Persian databases were searched using keywords such as “posttraumatic stress disorder,” “mental disorder,” “compliance,” and “adherence.” Finally, 11 eligible documents were included in the analysis. The retrieved articles were perused word-by-word, line-by-line, and paragraph-by-paragraph in order to arrive at an in-depth understanding about their contents. Then, the obtained excerpts from the articles, which were relevant to the study subject matter, were coded. The codes were then grouped into the antecedents, consequences, and attributes of the concept.

Findings: In total, 122 primary codes, 19 subcategories, 8 main categories, and 4 main themes were extracted. The main antecedents of the treatment adherence concept are patients’ personal health background and the attributes of posttraumatic stress disorder and its treatments while its main outcome is the changes in the quality of life. Moreover, the main attribute of adherent veterans is that they take responsibility for their own health and subsequently attempt to plan for health promotion.

Conclusion: The concept of treatment adherence among war veterans who suffer from PTSD is a complex and relative concept which depends on patients’ personal health background as well as the attributes of the afflicting disorder and its treatments. The concept is manifested by patient’s attempts to plan for receiving or parting with treatments and can result in changes in health-related quality of life.     

Positive Metacognitions and Meta-Emotions as Predictors of Posttraumatic Stress Disorder and Posttraumatic Growth in Survivors of a Natural Disaster

ABSTRACT

Exposure to natural disasters can lead to both negative and positive mental health consequences (i.e., posttraumatic stress disorder [PTSD] and posttraumatic growth [PTG]). While there is evidence linking metacognition to these outcomes, the focus is mostly on maladaptive metacognitions. The present study investigated the role of positive metacognitions and meta-emotions (i.e., confidence in extinguishing perseveration [Extinguishing], confidence in interpreting emotions as cues [Interpreting], and confidence in setting flexible and attainable hierarchies of goals [Setting]) on PTSD and PTG among Filipino typhoon survivors. Findings supported a model wherein Extinguishing and Setting, but not Interpreting, predicted PTSD and PTG through posttraumatic cognitions.     

Examining Trajectories of Early Adolescents’ Life Satisfaction in South Korea Using a Growth Mixture Model

Various aspects of early adolescence can have a key impact on adult life satisfaction. This study applied a growth mixture model to examine the trajectories of early adolescents’ life satisfaction and test the effects of individual (sex, subjective achievement, and self-esteem) and social factors (school adjustment and peer attachment) thereon. For this purpose, a growth mixture model was used on the fifth- (grade five), sixth- (grade six), and seventh- (grade seven) year panel data of 1917 grade one students from the Korean Children and Youth Panel Survey (2010–2016, National Youth Policy Institute), excluding missing samples. Participants were 990 boys (51.6%) and 927 girls (48.4%). The results indicated that the trajectories of life satisfaction could be categorized into three groups: “High Level-decreasing” (57.19%), “Moderate Level-stable” (37.62%), and “Low Level-increasing” (5.19%). Predictors for each class exhibited that female students and individuals with higher levels of self-esteem and school adjustment were more likely to be in the “Low Level-increasing” and “Moderate Level-stable” groups compared to male students and those reporting lower levels of self-esteem and school adjustment. Moreover, students with higher peer attachment were more likely to be in the “Low Level-increasing” group compared to the “High Level-decreasing” group. Educational implications to achieve positive life satisfaction by determining the influence of the predictors for each trajectory are outlined.

     

Work Motivation in “Post-Socialist” Industrial Organizations

Abstract

This article describes a study into the needs and behavioural reaction patterns in a sample of 715 workers in Bulgarian industrial firms during the “post-Socialist” period. The findings from this study cast doubt on some popular views of the typical motivation and reactions to work in the former “Socialist society”. Our data suggest that higher order needs are dominant in the motivational hierarchy and are significant in determining work outcomes, such as satisfaction, tendency to leave, and stress. We found no evidence for a motivational stereotype characterized by a low level of work involvement, lack of initiative, obedience, etc. hypothesized by other authors. In order to gain a better understanding of work motivation, it is useful to differentiate needs from the opportunities to satisfy those same needs, as well as work motivation from behavioural reaction patterns that actualize the opportunities and relate them to personal outcomes. A specific behavioural reaction pattern seems to exist among Bulgarian workers as an adaptation reaction to the specific environment of the “(post-) Socialist” industrial organization. This pattern, identified as “egocentrism in work”, combines a high involvement in work with partial alienation, i.e. detachment from the organization and income.     

Psychological Impact of Terrorism on Children and Families in the United States

Summary

This article reviews the literature on the psychological impact of terrorism on children and families in the United States. It includes studies of the 1993 World Trade Center bombing in New York City and the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, as well as the September 11 attacks. These studies explore the impact of various forms and degrees of exposure to terrorism on children across the development spectrum and on the relationships between parental and child reactions. The article concludes with a framework for future research on children's adaptation following mass trauma.     

The Launching and Ensnaring Effects of Construing a Traumatic Event as Central to One's Identity and Life Story

Construing a traumatic event as central to one's life story and identity is associated with posttraumatic stress. The longitudinal relationship between centrality of event and trajectories of posttraumatic stress was examined. Data from ministerial employees were collected 10 months, 2 years, and 3 years after the 2011 Oslo bombing (N = 259). Using structural equation modeling, the launch and the snare hypotheses were tested. Support for the launch hypothesis was found; higher levels of event centrality 10 months after the attack were associated with higher levels of posttraumatic stress across time. Support for the snare hypothesis was also found; higher levels of centrality 10 months and 2 years after the bombing were related to higher levels of posttraumatic stress, beyond what could be anticipated based on the individual's general trajectory. This suggests that event centrality can influence the overall trajectory, and may also have additional time‐specific effects on posttraumatic stress.Copyright © 2016 John Wiley & Sons, Ltd.     

Event centrality and posttraumatic outcomes in the context of pervasive violence: a study of teachers in El Salvador

It is well established that the importance assigned to a trauma can affect one's recovery and psychological health in numerous ways. Event centrality is an increasingly popular construct that captures the tendency among survivors to reevaluate and possibly accommodate their worldviews posttrauma. The centrality given to trauma appears to serve as a “double-edged sword” in that this construct might factor prominently in both posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). Focusing on 257 violence-exposed teachers from educational departments throughout El Salvador, we examined whether the centrality assigned by the teachers to stressful life events uniquely predicted both PTSD symptomatology and PTG. Results revealed that event centrality was positively related to both PTSD and PTG, even when controlling for demographic factors, violence exposure, and depression. In addition, PTSD symptomatology and PTG were not associated with one another in this sample. In summary, these findings support the role of event centrality as a contributing factor for PTSD and PTG among persons exposed to pervasive trauma.     

Are Individuals Always Aware of Their Trauma-Related Intrusive Thoughts? A Study of Meta-Awareness

Individuals are not always aware of their mental content. We tested whether lack of awareness occurs in those who have experienced trauma, with and without posttraumatic stress disorder (PTSD). We also examined the role of proposed cognitive mechanisms (working memory and inhibition) in explaining unnoticed intrusions. Individuals with PTSD (n = 44), and varying levels of symptoms (high posttraumatic stress [PTS]: n = 24; low PTS: n = 37) reported on intrusive thoughts throughout a reading task. Intermittently, participants responded to probes about whether their thoughts were trauma related. Participants were “caught” engaging in unreported trauma-related thoughts (unnoticed intrusions) for between 24 and 27% of the probes in the PTSD and high PTS groups, compared with 15% of occasions in the low PTS group. For trauma-related intrusions only, participants lacked meta-awareness for almost 40% of probes in the PTSD group, which was significantly less than that observed in the other groups (～60%). Contrary to predictions, working memory and response inhibition did not predict unnoticed intrusions. The results suggest that individuals who have experienced significant trauma can lack awareness about the frequency of their trauma-related thoughts. Further research is warranted to identify the mechanisms underpinning the occurrence of unnoticed intrusions.     

An Evolutionary Account of Suicide Attacks: The Kamikaze Case

Explanations for suicide attacks abound. Yet the literature remains conceptually fragmented, with different authors focusing on different attitudes, incentive structures, values, psychological processes, strategic imperatives, and cultural, historical, and personal circumstances. Curiously, however, there have been few efforts to cast suicide bombing within the extensive evolutionary literature on human altruism—in which it clearly belongs. Neither have there been more than occasional efforts to mobilize the distinction between “proximate” and “ultimate” explanations, with most proposed explanations being proximate. Here we draw on content analyses from materials written by Japanese Kamikaze pilots to propose an evolvable cognitive algorithm—by hypothesis, species typical—that (1) specifies environmental circumstances under which such “heroic” behavior is likely; (2) is consistent at the proximate level with the Japanese data; and (3) that is not inconsistent with many of the diverse proximate attitudes, values, and psychological mechanisms that dominate discussions of contemporary suicide campaigns. The evolutionary perspective is not an alternative to most of the proximate explanations offered in discussions of contemporary cases but is, rather, a paradigm around which diverse proximate explanations can be organized.     

Self-reported posttraumatic growth predicts greater subsequent posttraumatic stress amidst war and terrorism

Background and objective: This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. Design and method: A nationally representative sample (N?=?1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. Results: Results were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss. Conclusions: Our results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.     

Posttraumatic growth after childbirth: A prospective study

A growing body of research has examined the potential for positive change following challenging and traumatic events, this is known as posttraumatic growth (PTG). Childbirth is a valuable opportunity to extend previous work on PTG as it allows the role of different variables to be considered prospectively. The aim of this study was to prospectively examine correlates of PTG after birth, including sociodemographic and obstetric variables, social support and psychological distress, using a prospective, longitudinal design. A total of 125 women completed questionnaires during their third trimester of pregnancy and 8 weeks after birth. At least a small degree of positive change following childbirth was reported by 47.9% of women; however, average levels of growth were lower than generally reported in other studies. A regression model of age, type of delivery, posttraumatic stress symptoms during pregnancy and general distress after birth significantly predicted 32% of the variance in growth after childbirth. The strongest predictors of growth were operative delivery (β 0.23–0.30) and posttraumatic stress symptoms in pregnancy (β 0.32). These findings emphasise the importance of assessing pre-event characteristics when considering the development of PTG after a challenging event.