Personal resources of mastery–optimism,and communal support beliefs,as predictors of posttraumatic stress in uprooted Israelis

Abstract

The study aims to assess the personal resources of mastery–optimism, and communal support beliefs, as predictors of posttraumatic stress and adaptation in uprooted Israelis following Israel's disengagement from the Gaza Strip and northern Samaria in the summer of 2005. A telephone interview of a sample of 104 respondents slated to be uprooted was conducted several weeks before the disengagement (T1), and again 9 months after the event (T2). At T1, respondents answered a questionnaire which included assessments of dispositional optimism and mastery, beliefs in the availability of community–family and governmental–societal support, nation-related anxiety, and demographic data. Posttraumatic stress levels were assessed at T2. The main findings showed that high levels of mastery–optimism and low nation-related anxiety at T1 predicted a low severity of total posttraumatic stress scores at T2. A high educational level and a secular identity also predicted low posttraumatic stress. In contrast, communal support beliefs were not related to posttraumatic stress. These findings point to the importance of personal resources and education as protective factors against posttraumatic stress following an event such as forced uprooting.     

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.     

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 Stress,Posttraumatic Growth,and Satisfaction With Life in Military Veterans

Objective: Military veterans are more likely than civilians to experience trauma and posttraumatic stress disorder (PTSD). Research suggests, however, that some people who experience trauma, including veterans, report posttraumatic growth (PTG), or positive personal changes following adversity. In this study, we tested a comprehensive model of PTG, PTSD, and satisfaction with life in a veteran population, exploring the roles of challenges to core beliefs, types of rumination, sex, and time since event. Method: Data were collected via Amazon’s Mechanical Turk, an online crowdsourcing website, from veterans (N = 197) who had experienced a stressful event within the last 3 years (M = 16.66 months, SD = 12.27 months). Structural equation modeling was used to test an integrated conceptual model of PTG, PTSD, and satisfaction with life. Results: Results showed that challenge to core beliefs was directly associated with both deliberate and intrusive rumination. Deliberate rumination was positively related to PTG; intrusive rumination was positively related to symptoms of PTSD. PTG and PTSD, in turn, mediated the relationship between rumination styles and satisfaction with life; PTG was related to higher satisfaction with life; and PTSD was negatively related to satisfaction with life. Results failed to show differences on any model variables as a function of time since event or sex. Conclusion: Results indicate that the intentional facilitation of PTG may be a complementary and alternative option to the reduction of PTSD symptoms for improving satisfaction with life. Findings suggest that efforts to facilitate PTG should be focused on strategies for promoting deliberate rumination.     

Posttraumatic Reactions among Firefighters after Critical Incidents: Cross-National Data

The presence of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) following a critical incident were examined among firefighters from eight predominantly European countries. A sample of 1916 firefighters completed the Impact of Event Scale–Revised (IES–R) and the Posttraumatic Growth Inventory–Short Form (PTGI–SF) with reference to a critical incident they had experienced. Analyses indicated both negative and positive posttraumatic outcomes could derive from experiencing critical incidents in the line of duty. The analyses also showed country differences exist regarding firefighters’ PTSD symptoms and PTG. It is recommended that future researchers examine factors that could evoke such national differences.     

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.     

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.     

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.     

负性生活事件、社会支持和创伤后应激障碍症状：对汶川地震后青少年的追踪研究

创伤后应激障碍是灾难后常见的心理病理问题, 灾后继发负性生活事件和社会支持是影响创伤后应激障碍症状的重要因素。该研究采用追踪设计, 历时2年对汶川地震后都江堰地区1573名青少年进行3次测查, 考察震后继发负性生活事件、不同类型社会支持与创伤后应激障碍症状之间的相互作用关系。研究发现：不同类型的社会支持与震后继发负性生活事件、创伤后应激障碍症状存在不同的作用关系; 震后继发负性生活事件不仅直接影响个体的心理健康还对个体的社会支持系统有损害; 震后负性生活事件、主观支持与创伤后应激障碍症状存在联动效应, 即三者中任一方面的变化都可能引起其他方面的变化。     

Violence Exposure and Psychopathology in Urban Youth: The Mediating Role of Posttraumatic Stress

Understanding the mechanisms underlying the development of violence exposure sequelae is essential to providing effective treatments for traumatized youth. This longitudinal study examined the mediating role of posttraumatic stress in the relationship between violence exposure and psychopathology, and compared the mediated models by gender. Urban adolescents (n=1,358) were surveyed using the Social and Health Assessment. The proposed relationships were examined using Structural Equation Modeling. Posttraumatic stress fully mediated the relationships between victimization and depression and anxiety in girls, and partially so in boys. In addition, posttraumatic stress partially mediated the relationships between violence exposure and commission of violence in boys. Current findings support the longitudinal effects of violence exposure on adolescent mental health. Posttraumatic stress represents a unique mechanism for the development of psychopathology in girls and is also related to negative outcomes in boys. These findings have direct implications for prevention and rehabilitation efforts among violence exposed youth.     

Post-combat adaptation: improving social support and reaching constructive growth

Background and Objectives: Posttraumatic stress disorder, a commonly researched mental health outcome associated with trauma, does not develop in the majority of survivors. More common trajectories of adaptation include resilience, and posttraumatic growth (PTG). The objectives of the current study were to: (1) describe posttrauma adaptation profiles in a sample of Israeli male military veterans (N?=?448); and (2) to explore the protective factors that promote constructive PTG within two profiles of posttrauma adaptation.

Methods: The study used secondary data to estimate latent profile mixture models and a series of logistic regression analyses.

Results: Demographic controls, combat related variables, endorsement of coping strategies, and reports of improvement in social support were not significant predictors of constructive growth in the resilient class. However, those in the struggling growth subset of the sample who reported improvement in perceived social support increased the odds of reaching constructive growth.

Conclusion: These findings highlight the importance of tailored clinical interventions that account for more complex profiles of posttrauma adaptation; and further, provide evidence that adaptation takes place over time. Finally, these findings call for future research to continue to explore the quality of PTG and the contexts in which protective factors promote positive adaptation.     

Frequency of Interpersonal Trauma Types,Avoidant Attachment,Self-Compassion,and Interpersonal Competence: A Model of Persisting Posttraumatic Symptoms

Given limited knowledge about how psychosocial factors interact to modulate posttraumatic stress symptoms, this study evaluated an integrative model proposing that experiencing more interpersonal trauma types (e.g., abuse, assault, rape, etc.) leads to greater avoidant attachment and lower self-compassion, which limits the development and use of effective interpersonal skills. In turn, lower levels of self-compassion and interpersonal competence perpetuate posttraumatic symptoms. Anonymous trauma-experienced adults (n = 132) completed self-report measures in an online study hyperlinked on trauma support websites. Data were subjected to confirmatory factor analysis and structural equation modeling, which provided support for the hypothesized model. Specifically, higher frequency of interpersonal trauma types experienced was linked to higher avoidant attachment and lower self-compassion, which in turn were associated with lower interpersonal competence, which correlated with greater posttraumatic stress symptoms. Although cross-sectional data cannot address directionality of associations, this study’s findings emphasize the potential utility of future longitudinal research designed to examine possible causal relationships among these specific psychosocial factors. For example, study findings suggest that those who experience more types of interpersonal trauma and who are characterized by avoidant attachment and lower self-compassion and interpersonal competence may be the most susceptible to experiencing severe posttraumatic symptoms. However, findings also suggest that efforts to increase self-compassion and interpersonal skills may help reduce symptoms.     

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.     

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.     

Posttraumatic Stress Symptoms of Chinese Rural Children and Adolescents Surviving the 2008 Wenchuan Earthquake Assessed Using CRIES

Posttraumatic stress symptoms in Chinese rural children and adolescents were examined after the May 2008 Wenchuan earthquake. Analysis showed that three factors were identified, namely, avoidance, intrusion, and arousal, resembling those in the studies with Western samples. Gender differences in posttraumatic stress symptoms were not significant. Moderate negative correlation coefficients between posttraumatic stress symptom scores and mental health scores were found, indicating that the more severe the posttraumatic stress symptoms, the worse the person's mental health.     

PTSD,Posttraumatic Growth,and Coping Among Ultra-Orthodox Jewish Battered Women in Israel

This study examined the association between posttraumatic stress (PTS) symptoms, posttraumatic growth (PTG), and coping styles in a very unique and difficult-to-access Jewish ultra-Orthodox population. The study was conducted with 88 women who spent time in the only shelter in Israel for battered women from the ultra-Orthodox Jewish community; data were collected almost 6 years on average after they left the shelter. No association was found between PTS symptoms and PTG. In addition, coping style was not found to have an indirect effect on the relationship between these variables. The theoretical and clinical implications of these findings are discussed.     

Visual Feedback in Written Imaginal Exposure for Posttraumatic Stress: A Preliminary Study

This study investigated the visual feedback hypothesis, which states that visual feedback from written trauma narratives contributes to the efficacy of written imaginal exposure for posttraumatic stress via the reuptake of traumatic content during production of the narrative. We tested a college sample (n = 61) with clinically elevated posttraumatic stress as measured with the Impact of Events Scale. Participants were randomly assigned to a writing with visual feedback condition, a writing without visual feedback condition, or a control condition. The hypothesis was not supported: Writing with and without visual feedback equally reduced intrusion and avoidance symptoms. Exploratory analyses, however, showed increased intrusion symptoms immediately after writing with visual feedback, which was in contrast with decreased symptom levels in the other conditions. These findings are in line with previous findings regarding immediate symptom development following writing interventions for posttraumatic stress and call for further exploration of the visual feedback hypothesis.     

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.     

Development of a Scale to Assess Posttraumatic Stress Disorder

This study presents a newly developed self-report Posttraumatic Stress Scale (PTSS) based on the DSM-IV (American Psychiatric Association, 1994). The scale assesses the trauma experienced by people via the specific criteria of reexperiencing, numbing and avoidance, hyperarousal, and functioning. The instrument was validated on 52 Vietnam veteran subjects diagnosed with posttraumatic stress disorder (PTSD), 64 subjects who were attending professional counseling for trauma-related incidents, and 176 subjects who had never been diagnosed with PTSD or had professional counseling. The test survey comprised the PTSS, Beck's Anxiety Inventory, Beck's Depression Inventory, Impact of Events Scale, the 12-item General Health Questionnaire, Inventory of Depressive Symptomatology, and Symptoms Checklist–90R. The test-retest reliability of the scale was assessed over a four- to six-week period. The scale had a high test-retest reliability and showed high convergent and concurrent validity. Construct validity as assessed through the comparison between the three groups was high; however, factor analysis revealed only two factors instead of the three factors assumed in the DSM-IV. Overall, the scale may be used by clinicians or clients.     

Obsessive Compulsive Symptoms Predict Posttraumatic Growth: A Longitudinal Study

Although posttraumatic growth (PTG) has received growing attention, the relationship between PTG and distress remains unclear. This longitudinal study examines the relationship between posttraumatic obsessive-compulsive (OC) symptoms and PTG. Israeli veterans were followed over 17 years using self-report questionnaires of OC symptoms, posttraumatic stress disorder (PTSD), and PTG. Hierarchical regression analyses demonstrated that OC symptoms predicted PTG, even when initial PTG levels and PTSD symptoms were controlled for in the combatants group. These preliminary findings suggest that OC symptoms may play an important role in facilitating psychological growth. Future research is warranted to explore the mechanisms responsible for this relationship.