Latent classes of posttraumatic stress and growth

Background and Objectives: Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment. Design: This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N = 1970). Methods: We applied latent class analyses with covariates to extract subgroups of individuals. Results: Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: “High stress/high growth” (27% and 11%, respectively), “Low stress/high growth” (74% and 42%, respectively), and “Low stress/low growth” (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning. Conclusions: Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.     

Posttraumatic Stress and Depression Reactions Among Survivors of the Istanbul November 2003 Terrorist Attacks

This study investigated posttraumatic stress and depression reactions among survivors of the Istanbul November 2003 terrorist bombings that destroyed synagogues, an HSBC bank, and the British General Consulate. One hundred and forty-nine survivors completed a questionnaire measuring exposure, current posttraumatic stress, and depression responses 6 months after the blasts. This study showed that the prevalence rate of posttraumatic stress disorder (PTSD) among survivors was 35.6%?and the rate of depression was 23.5%. PTSD was strongly predicted by perceived life threat, whereas depression was strongly predicted by death of a close friend. Overall, female survivors were found to be more vulnerable to developing posttraumatic stress as well as depression after the terrorist bombings.     

Follow-up of victims of one terrorist attack in Israel: ASD, PTSD and the perceived threat of Iraqi missile attacks

The first aim of the study was to examine the relationships between acute stress reactions and post-traumatic reactions following exposure to a terrorist attack. The second was to examine whether exposure to a terrorist attack increases the perceived threat and fear of renewed Iraqi missile attacks. Data were collected at two points in time: during the first month after the exposure to a terrorist attack (N = 54), and four months later (N = 44). Twenty-four percent of the exposed group had acute stress disorder (ASD), and a similar percentage had PTSD. Among participants who had ASD, the chances of developing PTSD were three times greater than among those who had never experienced ASD. Among participants who had been exposed to a terrorist attack and developed PTSD, the perceived threat of an Iraqi missile attack was greater than among those who had been exposed to a terrorist attack but did not develop PTSD, or among the participants in the control group. The discussion deals with the findings in light of the current controversy regarding ASD and the current situation in Israel.     

The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = ?0.38, p < 0.01) and anxiety sensitivity (AS; β = ?0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.     

The pivotal role of perceived emotional synchrony in the context of terrorism: Challenges and lessons learned from the March 2016 attack in Belgium

Since the September 11, 2001 terrorist attack against the World Trade Center in New York City, terrorism has become one of the most distressing large‐scale societal threats. The March 22, 2016 terrorist attack in Brussels, the capital of Belgium undermined the collective sense of perceived security and social cohesion. The present research investigates Belgian civilians’ (N = 202) terrorist threat perception, personal emotions, and the role of perceived emotional synchrony in the construction of the perceived socioemotional climate in Belgium. The main purpose of the current study was to examine the role of perceived emotional synchrony emerging in collective gatherings as a regulatory mechanism improving the perceived socioemotional climate of the country. Additionally, the precise components (personal vs. collective) shaping the perceptions of terrorist threat were also examined. This study was conducted by a questionnaire during the collective gatherings in Brussels 1 week after the terrorist attack. The main results suggest that the terrorist threat has been perceived at the collective level rather than at the personal level. Furthermore, the perceived emotional synchrony with others mediated specifically the relationship between positive personal emotions and the perceived positive socioemotional climate in Belgium. Such findings point to the importance of considering the perceived emotional synchrony in order to provide a better understanding of lay people's psychosocial responses to terrorism and the subsequent construction of collective macro‐social phenomena in post‐terrorist contexts.     

Gender differences in loss of psychological resources following experimentally-induced vicarious stress

Abstract

The present research focuses on gender differences in resource loss, perceived threat, and negative affective reactions induced by experimental manipulation of vicarious stress. Israeli students (54.7% women) were randomly allocated to one of two conditions: (1) Threat Condition (n=98), in which participants were exposed to a video film depicting terror attacks and (2) Control Condition (n=30), in which participants viewed a video film depicting a series of non-emotive news broadcasts. Participants also completed measures of mastery, optimism, and self-esteem. The data indicated that whereas under the Threat Condition women scored lower on psychological resources and higher on perceived threat than men, no significant gender differences were observed under the Control Condition. A path analysis revealed that gender was directly related to perceived threat and resource loss, which, in turn, were related to negative affect. In addition, a greater sense of mastery was related to lower resource loss. Overall, these experimental findings suggest that gender and mastery bear prominent effects on cognitive and emotional reactions to vicarious life threat.     

Retrospective coping strategies during sexual identity formation and current biopsychosocial stress

Background: Lesbian, gay men, and bisexual individuals (LGBs) often experience distress related to the recognition, self-acceptance, and disclosure of their sexual orientation. Objectives and Design: Retrospectively reported coping strategies enacted during sexual identity formation among LGBs were assessed in relation to current stress indices measured using environmental (frequency of perceived daily hassles), psychological (perceived distress), and biological (allostatic load [AL] levels representing physiological dysregulations) perspectives. Methods: Forty-six healthy LGBs between the ages of 18 and 45 (M = 23.91, SE = .80) participated. Questionnaires included the Ways of Coping Checklist adapted to disclosure milestones, Daily Hassles Inventory, and Perceived Stress Scale. AL was calculated using 21 biomarkers of neuroendocrine, immune, cardiovascular, and metabolic functioning. Results: Avoidance coping during sexual identity formation was positively associated with frequency of daily hassles (β = .598, p < .001), perceived stress (β = .361, p = .015), and AL (β = .405, p = .006). By contrast, seeking social support was negatively associated with perceived stress (β = –.598, p = .048). Conclusions: Emotion-focused coping strategies during LGB sexual identity development are associated with current indices of biopsychosocial stress.     

Authoritarian reactions to terrorist threat: Who is being threatened,the Me or the We?

Endorsement of authoritarian attitudes has been observed to increase under conditions of terrorist threat. However, it is not clear whether this effect is a genuine response to perceptions of personal or collective threat. We investigated this question in two experiments using German samples. In the first experiment (N = 144), both general and specific authoritarian tendencies increased after asking people to imagine that they were personally affected by terrorism. No such effect occurred when they were made to think about Germany as a whole being affected by terrorism. This finding was replicated and extended in a second experiment (N = 99), in which personal and collective threat were manipulated orthogonally. Authoritarian and ethnocentric (ingroup bias) reactions occurred only for people highly identified with their national ingroup under personal threat, indicating that authoritarian responses may operate as a group‐level coping strategy for a threat to the personal self. Again, we found no effects for collective threat. In both studies, authoritarianism mediated the effects of personal threat on more specific authoritarian and ethnocentric reactions. These results suggest that the effects of terrorist threat on authoritarianism can, at least in part, be attributed to a sense of personal insecurity, raised under conditions of terrorist threat. We discuss the present findings with regard to basic sociomotivational processes (e.g., group‐based control restoration, terror management) and how these may relate to recent models of authoritarianism.     

Workplace ostracism And workplace behaviors: A moderated mediation model of perceived stress and psychological empowerment

Background and objectives: Workplace ostracism research has examined numerous underlying mechanisms to understand the link between workplace ostracism and behavioral outcomes. Ostracism has been suggested to be an interpersonal stressor; however, research has not investigated workplace ostracism from a stress perspective. Therefore, the study investigated the mediating effect of perceived stress for the relationships between workplace ostracism and helping behavior, voicing behavior, and task performance. The study also investigated the moderating effect of psychological empowerment for the relationships between perceived stress and behavioral outcomes.

Design: The study design was a three-wave self-reported questionnaire.

Method: The study sampled 225 full-time employees in South Korea and regression analyses with bootstrapping were conducted to test the moderated mediation models.

Results: The bootstrapped 95% CI around the indirect effects did not contain zero; therefore, perceived stress mediated the relationship between workplace ostracism and helping behavior (–.06), voicing behavior (–.07), and task performance (–.07). Further, the moderated mediation analyses found perceived stress mediated the relationships between workplace ostracism and behavioral outcomes only when individuals perceived low levels of psychological empowerment.

Conclusion: The findings suggest that workplace ostracism is a stressor and psychological empowerment can mitigate the negative effects of ostracism on behavioral outcomes.     

Post-traumatic stress reactions following the March 11, 2004 terrorist attacks in a Madrid community sample: a cautionary note about the measurement of psychological trauma

Posttraumatic stress reactions related to the Madrid March 11, 2004, terrorist attacks were examined in a sample of Madrid residents (N = 503) 18-25 days after the attacks, using multiple diagnostic criteria and different cut-off scores. Based on the symptoms covered by the Posttraumatic Stress Disorder Checklist-Civilian (PCL-C; Weathers, Litz, Herman, Huska, and Keane, 1993), rates of probable posttraumatic stress disorder (PTSD) ranged from 3.4% to 13.3%. Taking into account additional criteria from the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 200; i.e., the impact of initial reaction and problems in daily functioning as a consequence of the traumatic event), only 1.9% of respondents reported probable PTSD. These results suggest that inferences about the impact of traumatic events on the general population are strongly influenced by the definition of traumatic response. Our findings also revealed that the magnitude of posttraumatic reactions is associated with several risk factors, including living close to the attacked locations, physical proximity to the attacks when they occurred, perception of one's life being at risk, intensity of initial emotional reactions, and being a daily user of the attacked train lines. The use of different cut-off scores did not affect the pattern of risk to develop traumatic stress. The implications of these results for public health policies related to terrorist attacks are discussed.     

Combined effects of workplace bullying and perceived organizational support on employee behaviors: does resource availability help?

Background and Objective: This research examines the detrimental effects of workplace bullying as a social stressor on employees’ job performance, organizational retaliatory behaviors, and organizational citizenship behaviors and how the availability of support can reduce the negative impact of bullying. Using social exchange theory and the conservation of resources theory as theoretical frameworks, we propose that workplace bullying drains personal resources, leading to reduced job performance, low citizenship behaviors, and increased organizational retaliatory behaviors. We also propose that perceived organizational support acts as moderator, such that it reduces the detrimental effects of bullying on employee behaviors.

Research Design and Methods: We tested our hypotheses in two field studies (N?=?478 and N?=?395) conducted in Pakistan.

Results: The results of both studies supported the assertion that workplace bullying exacerbates employees’ job performance, reduces organizational citizenship behaviors and intensifies organizational retaliatory behaviors. The idea that perceived organizational support would moderate the bullying-work behavior relationships found mixed support. While perceptions of organizational support reinforced the bullying-job performance and bullying-retaliatory behaviors relationships, it did not moderate the bullying-citizenship behaviors relationship in the suggested direction.

Conclusion: The findings show that workplace bullying leads to more organizational citizenship behaviors when employee’s perceptions of organizational support is high.     

Inconsistencies in the Reporting of Perceived Trauma Severity Among Acute Physical Injury Survivors

This study aimed to identify and predict inconsistency in perceived trauma severity reports over time among trauma survivors. Hospitalized adult survivors of a traumatic injury completed trauma exposure assessments within 40 days post-injury and 6 weeks later (n = 77). The following trauma severity characteristics were examined: (1) threat of loss of life, (2) threat of loss of a body part, (3) threat of serious injury, and (4) peritraumatic emotionality. Potential predictors of inconsistency were also examined. About half of the reports regarding perceived trauma severity characteristics were inconsistent between the baseline to 6-week assessment. The inconsistent reports were mostly small and equally likely to be either more or less severe over time. Increases in posttraumatic stress disorder (PTSD; especially avoidance) predicted increases in severity of life threat and threat of loss of a body part. Thus, acute reports of perceived trauma severity vary and are influenced by PTSD symptoms.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients’ illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline – cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?<?0.05). In multiple regression analyses, controlling for demographic, clinical and psychological factors (age, gender, ethnicity, social deprivation, ACS severity, negative affectivity and cardiac symptom recurrence), more intense emotional representations (β?=?0.146, p?=?0.041) and reduced illness coherence (β?=??0.133, p?=?0.029), emerged as independent predictors of posttraumatic symptom severity at six months. There was a near significant effect for personal control (β?=??0.113, p?=?0.058). These results demonstrate the importance of illness representations of ACS in predicting longer-term posttraumatic stress symptoms.     

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.     

Social anxiety and post-event processing among African-American individuals

Background: Social anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to social anxiety in predominantly White samples are related to social anxiety among historically underrepresented groups.

Design: We tested whether one such vulnerability factor, post-event processing (PEP; detailed review of social event that can increase state social anxiety) was related to social anxiety among African-American (AA; n?=?127) persons, who comprise one of the largest underrepresented racial groups in the U.S. Secondarily, we tested whether AA participants differed from non-Hispanic White participants (n?=?127) on PEP and social anxiety and whether race moderated the relation between PEP and social anxiety.

Method: Data were collected online among undergraduates.

Results: PEP was positively correlated with social anxiety among AA participants, even after controlling for depression and income, pr?=?.30, p?=?.001. AA and White participants did not differ on social anxiety or PEP, β?=??1.57, 95% CI: ?5.11, 1.96. The relation of PEP to social anxiety did not vary as a function of race, β?=?0.00, 95% CI: ?0.02, 0.02.

Conclusions: PEP may be an important cognitive vulnerability factor related to social anxiety among AA persons suffering from social anxiety.     

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Objective: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.

Design: Cross-sectional survey of 1258 population-based adults (58–70 years) in England.

Main outcome measures: Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.

Results: A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07–1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49–3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65–5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004–1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.

Conclusion: Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.     

Anxiety, depressed mood, self-esteem, and traumatic stress symptoms among distant witnesses of the 9/11 terrorist attacks: transitory responses and psychological resilience

Posttraumatic stress related to the September 11, 2001 terrorist attacks and general psychological distress were examined in six cohorts of college students (N=5412) enrolled at an American public university between Spring 2000 and Fall 2002 some 2,500 miles from New York. Consistent with data from Schuster et al.'s (2001) national survey, which used a very low threshold criterion, our findings revealed that 44% of women and 32% of men experienced at least one symptom of posttraumatic stress 6-17 days after the attacks. In contrast to these results, depression levels showed only small differences, and self-esteem and trait anxiety showed no changes. Findings indicate that 9/11-related stress responses among distant witnesses were very mild, transitory and focused in scope, suggesting resilience with respect to broader psychological and psychopathological reactions. Findings are discussed with respect to the role of physical and psychological proximity on the reactions to traumatic events in the general population.     

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.     

Encountering the Body at the Site of the Suicide: A Population‐Based Survey in Sweden

Encountering the body of a child who died by suicide at the site of death is believed to be especially harmful for bereaved parents. We investigated the association between encountering the body at the site of the suicide and psychological distress in 666 suicide‐bereaved parents. Parents who had encountered their child's body at the site of the suicide (n = 147) did not have a higher risk of nightmares (relative risk [RR] 0.95, 95% confidence interval [CI] 0.67–1.35), intrusive memories (RR 0.97, 95% CI 0.84–1.13), avoidance of thoughts (RR 0.97, 95% CI 0.74–1.27), avoidance of places or things (RR 0.91, 95% CI 0.66–1.25), anxiety (RR 0.93, 95% CI 0.64–1.33), or depression (RR 0.94, 95% CI 0.63–1.42) compared with parents who had not encountered the body (n = 512). Our results suggest that losing a child by suicide is sufficiently disastrous by itself to elicit posttraumatic responses or psychiatric morbidity whether or not the parent has encountered the deceased child at the site of death.