Ceiling Effects and Floor Effects of the Posttraumatic Growth Inventory

The current study investigated the effects of a brief psycho-educational presentation about posttraumatic growth (PTG: positive changes that may occur as a result of psychological struggle with a highly stressful life event) on the self-reported PTG by using the PTG Inventory (PTGI). Few empirical studies have investigated the possible ceiling or floor effects of the PTGI, despite researchers indicating the necessity of longitudinal studies to reveal the PTG processes. This study used a pre-test, brief presentation, and post-test longitudinal design to examine the effects of intervention among adolescents by considering the floor and ceiling effects of the PTGI. Participants, 54 high school students (37 females, 17 males, Mean age?=?15.92 years), completed the PTGI at three weeks interval. Results using the Latent Rank Theory approach demonstrated ceiling effects in students who reported a high degree of PTG at Time 1, and floor effects in students with low PTG at Time 1. Presentation effects were not evident even in those who reported a moderate degree of PTG at Time 1. These findings suggest that it is important to be aware of the ceiling/floor effects while measuring changes in PTG perception over time and that explaining the phenomenon of PTG is not likely to be enough to affect the PTG perceptions.     

The effects of mortality reminders on posttraumatic growth and finding benefits among patients with life-threatening illness and their caregivers

Individuals confronted with a life-threatening illness often report posttraumatic growth (PTG) or finding benefits in disease. These positive evaluations of personal strength, perceptions of improved personal relations and new possibilities may represent a defensive response (cf Janus-face model). Three studies investigated the effects of mortality reminders on reports of PTG or benefit findings among people living with life-threatening illness or their caregivers. 80 people living with HIV (Study 1), 164 breast cancer survivors (Study 2) and 50 family caregivers for a patient with Huntington Disease (Study 3) were randomly assigned to the experimental (mortality reminders) or control conditions. Across three studies, those exposed to mortality reminders reported lower PTG or benefit finding, compared to the controls. These effects were moderated by time elapsed since diagnosis: mortality reminders led to lower PTG/benefit finding among those who received the diagnosis more recently. The results provide an insight into the defensive character of PTG/finding benefits in illness and changes in the function of these beliefs over time elapsing since diagnosis.     

Relationship Between Miscarriage and Dysfunctional Cognitions About Trauma,Coping Mechanisms,and Posttraumatic Growth

Many studies have described grief and psychiatric symptomatology as a typical feature following miscarriage. How women who had a miscarriage (MG) respond to trauma in terms of negative cognitions about their selves and the world, the coping strategies they employ to overcome the effects of the trauma, and what factors might be indicative of posttraumatic growth (PTG) in this population have not been extensively studied so far. We aimed to identify whether women who had a miscarriage (N = 74 vs. N = 82 control subjects) exhibited higher levels of psychological distress symptoms, dysfunctional cognitions, and maladaptive coping strategies, and whether women with lower PTG employed more maladaptive coping strategies, and reported higher levels of dysfunctional cognitions. Group comparisons according to the diagnostic groups based on self-report measures for depression, anxiety, posttraumatic stress disorder and according to the level of PTG, and stepwise linear regression analyses with PTG as the outcome were performed. Our study demonstrated that the MG does not necessarily differ from the control group on some measures of psychopathology, coping mechanisms, dysfunctional cognitions, or PTG. Yet, the MG who exhibited higher levels of PTG had specific predictors, and women with a psychiatric diagnosis differed from participants with no diagnoses on some measures of dysfunctional cognitions, coping mechanisms, and PTG. Further studies with a prospective design could further clarify the needs of the MG requiring psychotherapeutic interventions.     

Instrumental learning and cognitive flexibility processes are impaired in children exposed to early life stress

Children who experience severe early life stress show persistent deficits in many aspects of cognitive and social adaptation. Early stress might be associated with these broad changes in functioning because it impairs general learning mechanisms. To explore this possibility, we examined whether individuals who experienced abusive caregiving in childhood had difficulties with instrumental learning and/or cognitive flexibility as adolescents. Fifty‐three 14–17‐year‐old adolescents (31 exposed to high levels of childhood stress, 22 control) completed an fMRI task that required them to first learn associations in the environment and then update those pairings. Adolescents with histories of early life stress eventually learned to pair stimuli with both positive and negative outcomes, but did so more slowly than their peers. Furthermore, these stress‐exposed adolescents showed markedly impaired cognitive flexibility; they were less able than their peers to update those pairings when the contingencies changed. These learning problems were reflected in abnormal activity in learning‐ and attention‐related brain circuitry. Both altered patterns of learning and neural activation were associated with the severity of lifetime stress that the adolescents had experienced. Taken together, the results of this experiment suggest that basic learning processes are impaired in adolescents exposed to early life stress. These general learning mechanisms may help explain the emergence of social problems observed in these individuals.     

Posttraumatic growth: why do people grow from their trauma?

In two experimental studies we found that participants who recalled a highly traumatic autobiographical event (trauma recall) compared with a lesser traumatic event (stress recall) reported having increasingly grown (posttraumatic growth, PTG). Moreover, participants who recalled a traumatic (vs. stressful) event perceived more death-related thoughts (Study 1) and reported coping with this event in a more emotion-focused and in a less problem-focused way (Study 2). Mediation analyzes revealed that the effect of trauma versus stress recall on PTG was mediated by emphasizing the positive, a subscale of emotion-focused coping. These results imply that growth resulting from traumatic events can be traced back to an illusion. No evidence was found that real PTG took place or that the effects shown resulted from death-related thoughts (terror management theory).     

Manipulation of thinness and restricting expectancies: further evidence for a causal role of thinness and restricting expectancies in the etiology of eating disorders.

To test the eating disorder expectancy theory contention that expectancies for reinforcement from thinness play a causal role in body dissatisfaction and eating disorder symptoms, the authors manipulated expectancies in 2 studies. Participants were exposed to either a psychoeducational intervention or an experimental manipulation of thinness and restricting expectancies. Study 1 participants were symptomatic college women who attended 3 experimental sessions and 1 follow-up session, each 1 week apart. Study 2 participants were high school girls who received the 3 experimental sessions clustered into 2 meetings; they completed symptom measures at baseline and at follow-up. In both samples, the thinness expectancy manipulation produced greater declines in thinness expectancies and body dissatisfaction than did the psychoeducational intervention. For high school girls, the thinness expectancy manipulation also produced a greater decline in overall eating-disordered attitudes. These results provide further support for the role of expectancies in the etiology of eating-disordered behaviors.     

Examining the Potential of Community-Based After-School Programs for Latino Youth

Results are presented from two pilot studies examining the potential influence of community-based after-school programs (ASPs) on regionally diverse Latino youth of varying ages. Study 1 examined relations between dimensions of ASP attendance and content, and ethnic identity development, and self-worth in urban Latino adolescents. In this study, higher ratings of the ASP’s emphasis on ethnic socialization were associated with a more developed ethnic identity, while greater intensity of ASP participation and perceptions of ASP quality were associated with higher levels of self-worth. Study 2 examined relations between ASP participation and development of concentration and emotion regulation skills in rural Latino grade-school youth. In this study, youth who regularly attended the ASP demonstrated significantly better concentration and regulation skills than those who did not regularly attend, if they exhibited preexisting concentration and regulation problems. Findings illustrate how ASPs with varying strategies, activities, and assessment tools can be evaluated in the interest of designing future large-scale investigations into ASPs and Latino positive youth development.     

Perceptions of Cognitive-Behavioral Therapy and Antidepressant Medication for Depression After Brief Psychoeducation: Examining Shifts in Attitudes

The majority of people with depression in the United States either never seek treatment or gravitate exclusively to antidepressant medication (ADM), despite the existence of other effective treatments, such as cognitive-behavioral therapy (CBT). Reluctance to use psychotherapy is partly due to lack of appropriate mental health literacy and perceptions of low treatment acceptability (appropriateness for a given problem) and credibility (treatment logicalness, and whether the patient expects improvement). In the current investigation, we examined whether providing psychoeducation about CBT for depression would change participant perceptions of the treatment’s acceptability and credibility. We recruited 554 (female n = 314; 57%) participants across two online studies, and assessed their baseline perceptions of CBT and ADM using modified Treatment Acceptability (TAAS) and Treatment Credibility and Expectancy (CEQ) scales. Participants were subsequently presented with evidence-based, expert-vetted psychoeducational materials describing CBT and ADM, and were asked to recomplete the TAAS and CEQ. In Study 1, participants endorsed significantly higher CBT-CEQ (credibility/expectancy) scores postpsychoeducation. In Study 2, participants endorsed significantly lower CBT-TAAS (acceptability), and among those with no exposure to depression treatments, endorsed significantly higher CBT-CEQ scores postpsychoeducation. In both studies, there were no perceptual changes of ADM after the psychoeducation. Finally, in Study 2, endorsement of a biological model of depression and depressive symptoms were negatively predictive of CBT’s acceptability and credibility and expectancy postpsychoeducation. Perceptions of credibility and expectancy of CBT for depression appear malleable even after exposure to brief psychoeducation, whereas shifting perceptions of CBT’s acceptability may require more extensive intervention.     

Negative Life Events and Substance Use Moderate Cognitive Behavioral Adolescent Depression Prevention Intervention

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age = 15.5, SD = 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.     

Post-traumatic stress symptoms and post-traumatic growth in children and adolescents 12 months and 24 months after the earthquake and tsunamis in Chile in 2010: A longitudinal study

On 27 February 2010, Chile experienced one of the strongest earthquakes in recorded history. The study aimed to evaluate post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in children and adolescents 12 months (T1) and 24 months (T2) after the earthquake and tsunamis in Chile in 2010. Three hundred twenty-five children and adolescents (47.4% girls; 52.6% boys) between the ages of 10 and 16 years participated in the study. The instruments included the Revised Post-traumatic Growth Inventory for Children by Kilmer et al., the Childhood PTSD Scale by Foa et al. and the Rumination Scale for Children by Cryder et al., as well as a scale to assess the severity of the event and a sociodemographic questionnaire. The PTSS and PTG scores decreased at T2. In addition, the main predictors of PTSS and PTG were disruptive experiences, losses after the event and intrusive and deliberate rumination during the previous year. These results enhance understanding of factors related to PTG, improve the ability to predict PTSS and PTG in children and adolescents following natural disasters, and inform the design of intervention strategies to promote better mental health in those affected.     

Reducing HIV risk-associated sexual behavior among african american adolescents: Testing the generality of intervention effects

This randomized controlled trial tested the effects of a theory-based culture-sensitive HIV risk-reduction intervention among 496 inner-city African American adolescents (mean age = 13 years) and examined the generality of its effects as a function of the facilitator's race and gender and the gender composition of the intervention group. Adolescents who received the HIV risk-reduction intervention expressed more favorable behavioral beliefs about condoms, greater self-efficacy, and stronger condom-use intentions postintervention than did those who received a control intervention on other health issues. Six-month follow-up data collected on 93% of the adolescents revealed that those who received the HIV risk-reduction intervention reported less HIV risk-associated sexual behavior, including unprotected coitus, than did their counterparts in the control condition. Self-reported sexual behavior and changes in self-reported behavior were unrelated to scores on a standard measure of social desirability response bias. There was strong evidence for the generality of intervention effects. Moderator analyses testing eight specific interaction hypotheses and correlational analyses indicated that the effects of the HIV risk-reduction intervention did not vary as a function of the facilitator's race or gender, participant's gender, or the gender composition of the intervention group. This research was supported in part by grants from the National Institute of Child Health and Human Development (R01-HD24921), the National Institute of Mental Health (R01-MH45668), and the Social Science and Humanities Research Council of Canada. The authors gratefully acknowledge the contributions to this research of Margaret Bleier, Daria Boccher-Lattimore, Nancy L. Moore, Tatiana Perrino, Paul Pintella, and Fran Rosenfeld and the helpful suggestions of Isabel Fernandez, Caryn Lerman, and Ann O'Leary regarding an earlier version of this article.     

Emotional responding in NSSI: examinations of appraisals of positive and negative emotional stimuli,with and without acute stress

Non-suicidal self-injury (NSSI) is commonly used by young adults to regulate emotional responses. Yet, experimental examination of how people who self-injure appraise and respond to emotional stimuli is limited. We examined appraisals of, and responses to, emotive images in young adults who did and did not self-injure, and assessed whether these were impacted by exposure to a stressor. Study 1 (N?=?51) examined whether participants differed in their appraisals of emotional images. Study 2 (N?=?78) assessed whether appraisals of images changed after exposure to the Trier Social Stress Test. Ratings of emotional valence and arousal were collected in both studies; skin conductance was measured as an indicator of physiological arousal in Study 2. In Study 1 participants reporting NSSI rated positively valenced images as less pleasant than participants not reporting NSSI. In Study 2, after acute stress, participants reporting NSSI displayed dampened physiological reactions to positive images whereas participants who did not self-injure displayed heightened physiological reactions to these and rated them as more pleasant. Individuals who self-injure seem less able to engage in strategic mood repair after exposure to stress compared to people who do not self-injure.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

A preventive,psychoeducational approach to increase perceived social support

Investigated the effects of a 13-week preventive, psychoeducational intervention program to improve perceived social support. Fifty-one, low-perceived support, community residents were randomly assigned to an intervention or wait-list control condition. Intervention subjects received training in social skills and cognitive reframing regarding the self and social relations. The intervention led to increased perceived social support from family, but not from friends. As hypothesized by social cognition models, increases in perceived support appeared to be mediated by changes in self-esteem and frequency of self-reinforcement. Further, such changes in cognition about the self were larger than the changes observed for perceived support, suggesting that it may be easier to change cognition about the self than perceptions of support.     

Parents’ Beliefs about High School Students’ Spatial Abilities: Gender Differences and Associations with Parent Encouragement to Pursue a STEM Career and Students’ STEM Career Intentions

In the present study, we investigated whether parents’ beliefs about their high school aged adolescents’ spatial abilities (i.e., spatial visualization, mental manipulation, and navigation abilities) differed based on their child’s gender. We also examined whether these beliefs related to parents’ encouragement of their child to pursue a Science, Technology, Engineering, or Mathematics (STEM) career as well as students’ actual STEM major and career intentions. Data were collected from 117 pairs of U.S. high school students and one of their parents. We found that parents of young men thought their child had higher mental manipulation and navigation abilities than did parents of young women, even after statistically controlling for adolescents’ actual spatial abilities. Parents who perceived that their child had higher mental manipulation ability were more likely to encourage their child to pursue a STEM career, and those students were more likely to report that they intended to pursue a STEM career. These findings suggest that parents’ beliefs about how good their child is at spatial tasks may be based more strongly on gender stereotypes than on their child’s actual spatial abilities. Helping to make parents aware of these beliefs could be a potential lever of intervention to increase women’s participation in STEM careers.

     

Religious Orthodoxy and the Complexity of Thought about Religious and Nonreligious Issues

Two studies examined the relationship between religious orthodoxy and the complexity of thinking about religious and nonreligious issues. In both studies, participants who were high or low in religious orthodoxy wrote a paragraph outlining their thoughts about a religious issue (life after death in Study 1; existence of God in Study 2) and/or a nonreligious issue (capital punishment in Study 1; free trade between Canada and the U.S. in Study 2). The results of both studies indicated that participants who were high in religious orthodoxy were less complex in their thinking about religious issues than those low in religious orthodoxy, but did not differ in the complexity of their thinking about nonreligious issues. These results do not support the notion that orthodoxly religious individuals are dispositionally inclined to think in simpler or more rigid ways overall, but they do suggest a tendency to think less complexly about religious issues.     

Negative life events and substance use moderate cognitive behavioral adolescent depression prevention intervention

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n?=?173) in which adolescents (M age =?15.5, SD =?1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.     

Acute stress disorder among civilians during a war and post-traumatic growth six years later: the impact of personal and social resources

Background and Objectives: Various studies suggest a link between stress response to a traumatic event and post-traumatic growth (PTG), but little is known about their long-term relationship. In this study, the relationship between acute stress disorder (ASD) among civilians during a war on the home front and PTG six years later was examined for the first time. Based on the conservation of resources (COR) theory, the role of personal and social resource loss and gain as moderating factors was investigated. Design and Methods: At Time 1 of the research (the Second Lebanon War in 2006), a structured questionnaire was administered to 370 civilians living within rocket range. At Time 2, 6 years later, 301 participants from Time 1 were again examined. The data analysis refers to the 301 respondents who participated at Time 2. Results: The findings indicate a significant relationship between ASD and PTG. Examination of the interaction revealed that resource gain (but not resource loss) moderates (strengthens) the relationship between the two. Conclusions: These findings are not consistent with the COR view that resource loss has a greater effect on stress responses than resource gain.     

Cognitive effects of life stress and learned helplessness

Abstract Stressful life events and learned helplessness attributional styles have been shown to impact a variety of personal outcomes. This study examined how these factors influence two classes of cognitive behaviors: the occurrence of intrusive thoughts and performance in memory and verbal-spatial reasoning tasks. Negative life change and attributions for negative events predicted different types of cognitive responses. Individuals reporting higher levels of life stress were more likely to experience distracting thoughts that were unrelated to the current task, whereas individuals with learned helplessness attributional styles tended to have more worrisome thoughts about their task performance. In general, individuals reporting high levels of negative life stress tended to perform more poorly in tasks, whereas individuals with learned helplessness attributional styles tended to perform better than those who did not share this explanatory style. These results suggest that life stress and attributional style have important influecnes on cognitive processes, and that a learned helplessness attributional style can have beneficial effects on behavior in some situations.