Responses to the September 11, 2001, Terrorist Attacks: Experience of an Indirect Traumatic Event and Its Relationship With Perceived Benefits

Little is known about how people might benefit from an indirectly experienced traumatic event. The authors examined the relationship between perception of benefit and trauma symptoms in response to a relatively severe, but indirectly experienced, traumatic event. The authors sampled from 2 colleges located in the southeastern United States (N = 136). Individuals responded to questionnaires that assessed perceived benefits and trauma symptoms 1-2 weeks after the terrorist attacks of September 11, 2001, and again approximately 10 weeks later. Participants did perceive benefits from witnessing this event, although their perception of benefit declined over time. Level of trauma symptoms correlated positively with perception of benefit, and experiencing a previous trauma also correlated positively with perceived benefits. Additional analysis indicated that level of trauma symptoms mediated the relationship between previous trauma and perception of benefit. These findings help to elucidate understanding of the development of perceived benefits in response to indirectly experienced events.     

Gaining Control Over Traumatic Experiences: The Role of Guilt in Posttraumatic Stress Disorder

The present study explores the relationship between guilt, sense of control, and posttraumatic stress disorder. Seventy-eight participants who had experienced a traumatic event completed the following self-report measures online: the Posttraumatic Stress Diagnostic Scale, the Guilt Cognitions subscale of the Trauma-Related Guilt Inventory, the Posttraumatic Cognitions Inventory, and Sense of Control During the Trauma. Results revealed that “behavioral self-blame” that refers to functioning during the trauma, positively correlated with posttraumatic stress symptoms. However, when Sense of Control During the Trauma was introduced into the analysis, this correlation appeared only for participants who had experienced lack of control during the traumatic event. Among the participants who had experienced a sense of control, no such link was found. Results suggest that guilt may be produced to avoid feelings of helplessness following the trauma, because guilt conveys a sense of control.     

大学生主观童年创伤症状对抑郁的影响:抗挫折能力和外向性的多重中介效应

本研究将"童年创伤"定义为"个体14岁以前所经历的,站在主体的角度主观感受到的创伤性事件"。采用问卷调查法对302名大学生进行调查,通过定量加定性的方式探索了童年创伤与抑郁之间的关系。相关分析表明：主观童年创伤症状、外向性、抗挫折能力、抑郁之间两两显著相关;结构方程模型表明：主观童年创伤症状通过外向性、抗挫折能力完全、多重中介作用间接预测抑郁。本研究结果在理论和实践层面对大学生抑郁问题的预防和干预工作提供重要的借鉴依据。     

大学生主观童年创伤症状对抑郁的影响:抗挫折能力和外向性的多重中介效应

本研究将"童年创伤"定义为"个体14岁以前所经历的,站在主体的角度主观感受到的创伤性事件"。采用问卷调查法对302名大学生进行调查,通过定量加定性的方式探索了童年创伤与抑郁之间的关系。相关分析表明：主观童年创伤症状、外向性、抗挫折能力、抑郁之间两两显著相关;结构方程模型表明：主观童年创伤症状通过外向性、抗挫折能力完全、多重中介作用间接预测抑郁。本研究结果在理论和实践层面对大学生抑郁问题的预防和干预工作提供重要的借鉴依据。     

Measurement differences from rating posttraumatic stress disorder symptoms in response to differentially distressing traumatic events

The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate their most distressing and second most distressing traumatic events experienced. Using the PTSD Checklist, participants rated their PTSD symptoms separately from these worst and second worst events. Using the four-factor emotional numbing PTSD model in confirmatory factor analysis, results demonstrated evidence supporting separation of PTSD symptom rating sets from two differentially distressing traumas-specifically, the worst and second worst events. Measurement invariance tests revealed that factor loadings did not vary between the worst and second worst event PTSD ratings; item thresholds (indexing symptom severity) differed. Results generally support the recommended PTSD assessment protocol instructing participants to rate PTSD symptoms from a single, worst index event.     

Centrality of Event and Symptoms of Posttraumatic Stress Disorder After the 2011 Oslo Bombing Attack

It has been proposed that a highly integrated trauma leads to more accessible and vivid memories of the traumatic event, in turn heightening symptoms of posttraumatic stress disorder. The relationship between the centrality of a traumatic event and symptoms of posttraumatic stress disorder after the 2011 Oslo bombing attack was investigated in the present study. A high degree of perceived centrality was associated with higher symptom levels of posttraumatic stress as shown in the results. This association was found after controlling for gender, age and educational background. The relationship between types and level of trauma exposure, peritraumatic reactions and centrality of event was also investigated in the present study. Higher levels of trauma exposure and peritraumatic reactions were associated with higher levels of centrality of event as shown in the results. When a traumatic event becomes a reference point in the individual's life story and central to their identity, this is associated with an increased risk of symptomatology as suggested in the findings. Copyright © 2013 John Wiley & Sons, Ltd.     

Examining posttraumatic growth among Japanese university students

To determine the underlying factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J), a principal components analysis was performed on data from 312 Japanese undergraduate students who reported growth due to their most traumatic event within the last 5 years. Results showed the PTGI-J has high internal consistency and, of the original five factors reported by Tedeschi and Calhoun (1996), three were replicated: Relating to Others, New Possibilities, Personal Strength, and a fourth factor integrating Spiritual Change and Appreciation of Life emerged. There were neither gender differences nor relationships with time since trauma. PTGI-J scores were positively associated with posttraumatic symptoms and correlated with type of traumatic event experienced. These results and future directions are discussed from a cross-cultural viewpoint.     

A study of posttraumatic stress in a student population

The authors examined the incidence of posttraumatic stress (PTS), with respect to levels of exposure to traumatic events, in a British student population. Respondents (N = 700) completed a standard questionnaire booklet that contained a posttraumatic stress disorder interview. The questionnaire collected personal demographic information and was used by researchers to ascertain whether respondents had experienced a traumatic event. Consistent with previous American studies, PTS was found to be relatively common; 23.3% of the sample showed either current or past PTS. Female participants had a significantly higher incidence of PTS than did male participants, although the latter were more likely to report having experienced a traumatic event. The experience of trauma was significantly associated with the likelihood of PTS. The authors discuss implications of their results in terms of long-term consequences of unresolved trauma.     

Examining posttraumatic growth among Japanese university students

Abstract

To determine the underlying factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J), a principal components analysis was performed on data from 312 Japanese undergraduate students who reported growth due to their most traumatic event within the last 5 years. Results showed the PTGI-J has high internal consistency and, of the original five factors reported by Tedeschi and Calhoun (1996), three were replicated: Relating to Others, New Possibilities, Personal Strength, and a fourth factor integrating Spiritual Change and Appreciation of Life emerged. There were neither gender differences nor relationships with time since trauma. PTGI-J scores were positively associated with posttraumatic symptoms and correlated with type of traumatic event experienced. These results and future directions are discussed from a cross-cultural viewpoint.     

A Study of Posttraumatic Stress in a Student Population

The authors examined the incidence of posttraumatic stress (PTS), with respect to levels of exposure to traumatic events, in a British student population. Respondents (N = 700) completed a standard questionnaire booklet that contained a posttraumatic stress disorder interview. The questionnaire collected personal demographic information and was used by researchers to ascertain whether respondents had experienced a traumatic event. Consistent with previous American studies, PTS was found to be relatively common; 23.3% of the sample showed either current or past PTS. Female participants had a significantly higher incidence of PTS than did male participants, although the latter were more likely to report having experienced a traumatic event. The experience of trauma was significantly associated with the likelihood of PTS. The authors discuss implications of their results in terms of long-term consequences of unresolved trauma.     

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.     

Characteristics of memories for traumatic and nontraumatic birth

Evidence for memory characteristic differences between trauma and other memories in non‐clinical samples is inconsistent. However, trauma is frequently confounded with the event recalled. This study compares trauma and nontrauma memories for the same event, childbirth, in a non‐clinical sample of 285 women 4–6 weeks after birth. None of the women met diagnostic criteria for post‐traumatic stress disorder. Traumatic birth, defined by the DSM‐5 event criterion, was reported by 100 women. The ratings of some memory characteristics did not differ between memories for traumatic and nontraumatic birth: All were rated highly coherent and central to women's lives, with moderate sensory memory. However, women who experienced traumatic births reported more involuntary recall, reliving, and negative/mixed emotions. Thus, trauma memories differed from nontrauma memories. In this non‐clinical sample, this is likely to be due to encoding during trauma rather than the distinctive memory profile for memories retrieved by those experiencing trauma symptoms.     

The Relationship Between Secondary Traumatic Stress and Personal Posttraumatic Growth: Personality Factors as Moderators

This present study examined the relationship between secondary traumatic stress, personality factors, and personal posttraumatic growth for persons indirectly exposed to traumatic life events. A sample of 162 nurses and physicians completed the self-report measures describing symptoms of secondary traumatic stress, personality factors and vicarious posttraumatic growth. The results indicated that secondary traumatic stress negatively correlated with vicarious posttraumatic growth. Moreover, this relation is moderated by personality factors. A low level of secondary traumatic stress symptoms is associated with a higher level of perceived posttraumatic growth for participants with a high level of openness, agreeability and conscientiousness. These findings emphasize the differences in perceiving posttraumatic growth in the context of secondary exposure to traumatic life events.     

Attentional control as a prospective predictor of posttraumatic stress symptomatology

Attentional control may be used by trauma survivors to temporarily disengage and shift attention from threat salient information, allowing individuals to remain in, and habituate to, trauma-relevant contexts rather than using less adaptive regulatory strategies. Thus, greater attentional control abilities may be one factor that differentiates those who recover from trauma exposure from those who do not. In the present study, we examined attentional control as a prospective predictor of posttraumatic (PTS) symptoms over the course of two assessment sessions (T1 and T2). Consistent with the hypothesis that attentional control can be used to alleviate trauma-related distress, we predicted that an inverse relation between T1 attentional control and T2 PTS symptoms would be significantly stronger among participants who had experienced a traumatic event between time points (24% of the total sample: N = 85). Pre-T1 trauma history and T1 PTS symptoms served as covariates in regression analysis. Results revealed that T1 attentional control only predicted T2 PTS symptoms for participants who had experienced a traumatic event between time points. Thus, attentional control may be a protective factor against the development of PTS symptomatology in the aftermath of a traumatic event.     

Étude des victimes des attentats du 13 novembre 2015, pris en charge au centre du psychotrauma de l’institut de victimologie

The care of a victim is a multidisciplinary care. However, we have few data regarding the impact of these different supports on the terrorist attacks victims, especially in France. Thus, we’ve carried out a clinical survey in order to assess the psychopathological development among 27 patients regarding to their perception of the sociomedical, psychological, judicial and police support they got. An assessment has been made based on the sociodemographic and psychopathological data of the subjects we included. We made the assessments 3 and 12 months after the terrorist attack, regarding to depressive, traumatic, peritraumatic (dissociation and distress) symptoms, sleeping disorders and the perceived quality of social support. Otherwise, they answered a subjective inventory of the quality of the help, support and care they were offered after the attack. Those data confirmed that the traumatic, peritraumatic, depressive and sleeping disorders were severe after such a traumatic event. We stated the fact that the clinical development was partly positively correlated with the favourable perception of the different supports. The welcoming and support from the various actors in victimology are key features in lowering the avoidance and improving the perception of the social support, which we know are two essential criteria in the traumatism development. We propose lines of thoughts to find a proper grasp of those extreme situations, likely to affect any segment of the population.     

Children's narrative memory for accidents and their post‐traumatic distress

This study examines how the quality of children's memory for a traumatic event is related to trauma‐related distress and adjustment. Four to 7 weeks after an accident requiring hospitalisation, 80 children aged 7–16 were asked to provide a narrative memory of the event. Age and the quality of the memory report based on its lexical and cohesive structure accounted for a significant and sizable proportion of the variability in the children's intrusive symptoms about the event after considering trauma severity and the child's language ability and gender. There was no significant relationship between memory quality and event specific avoidant symptoms. Children who were troubled by intrusive symptoms at 4 to 7 weeks continue to seek personal control and mastery by cognitively making sense of their experiences. The study's implications for understanding the process of children's adaptation to such events and for the development of chronic problematic adjustment are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Interpersonal Violence,Depression, and Executive Function

This study considers links between the number of types of violence to which women have been exposed, depression, and executive functions (EFs). Substantial research has established EF deficits among depressed individuals as well as individuals exposed to trauma. Studies have also indicated a relationship between trauma exposure and depressive symptoms across a range of traumatic events, such as combat exposure, motor vehicle accidents, natural disasters, and assaults. This study examines this relationship in an ethnically diverse community sample of 93 women exposed to interpersonal violence who completed a battery of EF tasks that assessed processing speed, working memory, response inhibition, and set shifting. Women reported an average of 5.8 types of interpersonal violence events. The number of types of interpersonal violence events was significantly related to depressive symptoms, although not EF performance. Specific EFs, such as working memory and response inhibition, were positively related to depressive symptoms.     

Exercise and Diet as Potential Moderators Between Trauma,Posttraumatic Stress,Depression, and Relationship Quality Among Emerging Adults

Exercise and diet have not been examined as potential protective factors between trauma and trauma-related sequelae. Using data collected from emerging adults (N = 321), we tested a path analysis to determine if exercise and diet would moderate the association between the number of potentially traumatic life events experienced and posttraumatic stress, depression, and relationship quality. More exercise was directly associated with higher posttraumatic stress and depressive symptoms. A healthier diet was directly associated with lower posttraumatic stress, lower depressive symptoms, and higher relationship quality. Results suggest there may be value in highlighting exercise and diet in family therapy.     

The psychology of ongoing threat: relative risk appraisal, the September 11 attacks, and terrorism-related fears

There are now replicated findings that posttraumatic stress disorder (PTSD) symptoms related to the September 11, 2001, attacks occurred in large numbers of persons who did not fit the traditional definition of exposure to a traumatic event. These data are not explained by traditional epidemiologic "bull's eye" disaster models, which assume the psychological effects are narrowly, geographically circumscribed, or by existing models of PTSD onset. In this article, the authors develop a researchable model to explain these and other terrorism-related phenomena by synthesizing research and concepts from the cognitive science, risk appraisal, traumatic stress, and anxiety disorders literatures. They propose the new term relative risk appraisal to capture the psychological function that is the missing link between the event and subjective response in these and other terrorism-related studies to date. Relative risk appraisal highlights the core notion from cognitive science that human perception is an active, multidimensional process, such that for unpredictable societal threats, proximity to the event is only one of several factors that influence behavioral responses. Addressing distortions in relative risk appraisal effectively could reduce individual and societal vulnerability to a wide range of adverse economic and ethnopolitical consequences to terrorist attacks. The authors present ways in which these concepts and related techniques can be helpful in treating persons with September 11- or terrorism-related distress or psychopathology.