Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship?

In the immediate aftermath of a traumatic event, many individuals experience physiological reactivity in response to reminders of the traumatic event that typically lessens over time. However, an overreliance on avoidant coping strategies may interfere with the natural recovery process, particularly for those who are highly reactive to trauma reminders. In the current investigation, we examined avoidant coping as a moderator of the association between heart rate reactivity to a trauma monologue measured shortly after a traumatic event and severity of posttraumatic stress disorder (PTSD) symptoms measured several months later. Fifty-five female survivors of assault completed PTSD diagnostic interviews and a self-report coping measure and participated in a trauma monologue procedure that included continuous heart rate measurement. These procedures were completed within 1 month of the assault and again 3 months postassault. After we controlled for the effect of initial symptom levels, the interaction of heart rate reactivity to the trauma monologue and avoidant coping measured at Time 1 was associated with PTSD symptom severity at Time 2. Individuals who are relatively highly reliant on avoidant coping strategies and relatively highly reactive to trauma reminders may be at greatest risk of maintaining or potentially increasing their PTSD symptoms within the first few months following the trauma. These findings may help inform early intervention efforts for survivors of traumatic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The victim and the psychologist: Changing perceptions of Israeli holocaust survivors by the mental health community in the past 50 years.

The article focuses on the changing themes of psychological theory in regard to posttraumatic effects of the Holocaust on its survivors in the course of the past 50 years. An examination of pertinent changes in the Israeli society during that time period helps clarify these themes. Three stages of change have been identified, each with its different concerns, key issues, consensual answers, and attitudes toward Holocaust survivors. These concerns are (a) who survived? (b) are survivors psychologically healthy or sick? and (c) have the posttraumatic effects extended beyond the survivors (e.g., to their families)? The analysis reveals similarity between the concerns that guided the development of psychological theory and those that governed social discourse on the Holocaust and its survivors in Israeli society. The implications of this analogy for the development of psychological theory and the understanding of societal coping with massive social traumas are discussed. The analysis draws on psychological literature on posttraumatic stress and on sociohistorical analyses of Israeli society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life circumstances and personal resources as predictors of the ten-year course of depression

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.     

Correlates of Levels and Patterns of Positive Life Changes Following Sexual Assault.

This study builds on previous work suggesting that many survivors report positive life changes soon after a sexual assault and that those who retain those changes over time report the least distress 1 year post-assault (P. Frazier, A. Conlon, & T. Glaser, 2001). The purposes of this study were to assess correlates of early reports of positive life changes and individual trajectories of self-reported positive changes over time among female sexual assault survivors (n = 171) using hierarchical linear modeling. The factors most related to reporting positive life change soon after the assault were social support, approach and religious coping, and perceived control over the recovery process. Increases in these factors also were associated with increases in self-reported positive life changes over time. The relations between social support and positive change also were mediated by coping strategies and control appraisals, particularly perceived control over the recovery process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Amish way of death: A study of family support systems.

Discusses the fact that coping with death is becoming increasingly difficult in society today. Science and technology have replaced belief and ritual, most deaths take place in institutional settings rather than in the home, and the high rate of mobility of the nuclear family lessens the opportunities for experiencing life and death within an extended-network support system. The author considers that the centrality of the family in Amish society and the unchanged function of the family unit present a rare opportunity to study relational support systems that have been successful in coping with death for the past 400 yrs. 24 Amish families were interviewed in 5 areas: family structure, group structure, funeral customs and rituals of mourning, personal experience with death, and personal feelings about death. Implications are presented for psychosocial issues in contemporary society in terms of improving the quality of life and death for the dying, their families, and the professionals involved in their care. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping, stress, and social resources among adults with unipolar depression.

Used a stress and coping paradigm to guide the development of indices of coping responses and to explore the roles of stress, social resources, and coping among 424 men and women (mean age 40.7 yrs) entering treatment for depression. An expanded concept of multiple domains of life stress was used to develop several indices of ongoing life strains. A variety of measures were obtained from Ss, family members, and treatment staff. Two questionnaires completed by Ss included the Health and Daily Living Form and the Work Environment Scale. Although most prior studies have focused on acute life events, results of the present study show that chronic strains were somewhat more strongly and consistently related to the severity of dysfunction. The coping indices generally showed acceptable conceptual and psychometric characteristics and only moderate relationships to Ss' sociodemographic characteristics or to the severity of the stressful event for which coping was sampled. Coping responses directed toward problem solving and affective regulation were associated with less severe dysfunction, whereas emotional-discharge responses, more frequently used by women, were linked to greater dysfunction. Stressors, social resources, and coping were additively predictive of an S's functioning, but coping and social resources did not have stress-attenuation or buffering effects. (72 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The scientific development in dermatology in Germany in relation to the emigration of Jewish dermatologists during national socialism

The anti-semitic laws let to the persecution of the Jews in Germany during the time of National Socialism. About 600 Jewish dermatologists had to suffer from the prohibition of their profession. 63% of them left Germany. The emigrants mainly preferred to move out to the U.S. The policy of coordination and elimination of the National Socialists led to the reappointment of dermatological chairs in universities. The National Socialists also forced the change in the boards of dermatological societies and the change of the editorial boards of dermatological journals. All papers of the three leading dermatological journals were analysed for the evaluation of the development of science. The assessment included the number of articles, the origin of the authors and the contents of articles (research, clinics, diagnostic, therapy). From 1933 to 1945 the number of papers per year decreased consequently, especially during the Second World War. During the whole time the number of German authors increased and the number of abroad living authors decreased. There was a very good and interesting international exchange of information in the journal "Archiv für Dermatologie und Syphilis". The activity reduced clearly after the beginning of the Second World War in 1939. The analysis of contents resulted in a reduction of basis science research and an orientation to the clinical research. Papers about therapeutical possibilities were always published. The emigration of Jewish dermatologists led to a continuous reduction of scientific activities and to an extensive international isolation.     

Measuring occupational stress: development of the pressure management indicator

The study of occupational stress is hindered by the lack of compact and comprehensive standardized measurement tools. The Pressure Management Indicator (PMI) is a 120-item self-report questionnaire developed from the Occupational Stress Indicator (OSI). The PMI is more reliable, more comprehensive, and shorter than the OSI. It provides an integrated measure of the major dimensions of occupational stress. The outcome scales measure job satisfaction, organizational satisfaction, organizational security, organizational commitment, anxiety--depression, resilience, worry, physical symptoms, and exhaustion. The stressor scales cover pressure from workload, relationships, career development, managerial responsibility, personal responsibility, home demands, and daily hassles. The moderator variables measure drive, impatience, control, decision latitude, and the coping strategies of problem focus, life work balance, and social support.     

Making sense of posttraumatic stress disorder: Illness perceptions among traumatic injury survivors.

More than 1.5 million persons in the United States sustain traumatic physical injuries each year. A significant proportion of traumatic injury survivors develop serious mental health problems, such as posttraumatic stress disorder (PTSD), yet few obtain professional mental health care. According to the commonsense model of self-regulation (Leventhal, Diefenbach, & Leventhal, 1992), illness-related perceptions can influence coping responses, including the use of professional treatment. Using the commonsense model as a guiding framework, we conducted semistructured interviews with nontreatment-seeking trauma injury survivors with PTSD (N = 23). Illness perceptions regarding the following key conceptual dimensions were examined: PTSD symptoms (identity), experienced or perceived consequences of PTSD symptoms, and beliefs about the causes, controllability, and course of PTSD symptoms. Results revealed that no respondents identified their symptoms as indicative of PTSD. Common illness perceptions included believing that symptoms would be short-lived, that symptoms were reflective of poor physical health or were a natural reaction to life in a violent community, and that symptoms were functionally adaptive. Respondents also reported exerting some limited control over symptoms by relying on religious forms of coping. None of the respondents perceived professional treatment as being able to completely control symptoms. Findings indicated that respondents' conceptualizations of PTSD symptoms might have inhibited the recognition of symptoms as a serious mental health condition that warrants professional treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Contribution to the history of gerontology in Germany in the 2nd half of our century

In this paper some trends of gerontology during the last 45 years in Germany are described. A survey of the development of gerontology in the former GDR is followed by an analysis of the "Zeitschrift für Alternsforschung" from 1980-1990. The main result is the predominance of publications on the care system since the middle of the 1980s. With regard to the development of gerontology in the western part of Germany, an analysis of publications in the "Zeitsschrift für Gerontologie" from 1968-1991 shows changes in the main topics during this period. Until the middle of the 1970s there was a predominance of publications in the field of: intelligence, learning, memory and perception. The emphasis of publications from 1977-1985 was on stress and coping. In the middle of the 1980s there was an increasing interest in the analysis of social network and competence in the elderly. The paper discusses these trends of gerontological research in the eastern and western parts of Germany.     

Sexual abuse trauma among Chinese survivors

OBJECTIVE: As an initial effort to examine Chinese sexual abuse trauma in relation to the cultural construction of sexual victimization of women, this study applies Finkelhor and Browne's (1985) traumagenic dynamics model to examine post-abuse trauma among Chinese child and adolescent survivors in Taiwan. In analyzing sexual abuse trauma in the context of Chinese patriarchal familialism and cultural fetish for female chastity, this study attempts to explore cultural constructional process of sexual abuse in Chinese society. METHOD: This study conducted in-depth interviews with 19 survivors of, and three social workers on, sexual abuse in Taiwan. These interviews were guided by a semi-structured questionnaire on sexual abuse incidents and post-abuse responses/concerns, and had generated a total of 84 pages of written reports, which serve as the text-data for the analysis. RESULTS: This study identifies sexual stigmatization and senses of disempowerment and betrayal as the most pervasive trauma complex among Chinese sexual abuse survivors in Taiwan. This study found that, in addition to lowering self-esteem, sexual stigmatization results in polarized sexuality among adolescent survivors, as manifested in aversion to and preoccupation with sexuality. The abuse-induced disempowerment is manifested in the survivors' fear for personal safety and heightened sense of vulnerability to re-victimization. The sense of betrayal results in interpersonal difficulties as manifested in self-imposed isolation from others and/or suspicious attitudes toward others, which further impair the survivor's efficacy in meeting her abuse-induced clinging need. CONCLUSIONS: Overall, this study observes similar traumatic symptoms between Chinese survivors and their American counterparts as documented in the literature. Nevertheless, this study observes the sexual stigmatization represents the most prevailing post-abuse trauma among Chinese sexual abuse survivors, and reflects the patriarchal fetish for female chastity in the Chinese cultural construction of sexual victimization.     

Stress and coping among Russian and American early adolescents.

Self-reported stress, coping, and depression were compared between 270 Russian and 270 American early adolescents, 10 to 14 years of age. Russian and American adolescents reported equal levels of major life stress, but Russian adolescents reported greater levels of everyday life stress. Russian adolescents reported that they were less likely to use externalizing coping and more likely to use social support and problem-solving coping compared with American adolescents. Russian adolescents also reported that they were more depressed. However, LISREL path model analyses examined the relationships among these variables and showed that Russian and American adolescents coped with stress in similar ways. A buffering effect for social support on depression was found for both national groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial predictors of AIDS risk behavior and drug use behavior in homeless and drug addicted women of color.

The present study examined a causal model consisting of personal and social resources, threat appraisal processes, coping styles, and barriers to risk reduction as predictors of general AIDS risk and specific drug use behaviors among homeless African American (N?=?714) and Latina (N?=?691) women. The model, which was based on a stress and coping framework, supported many of the hypothesized relationships. Active coping was associated with fewer general AIDS risk behaviors for both groups and less specific drug use behavior among African American women. Specific drug use behavior was predicted by high threat appraisal and avoidant coping for both groups. Ethnic differences and implications for intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From "Anna O." to Bertha Pappenheim: Transforming private pain into public action.

Bertha Pappenheim ("Anna O.") was treated for hysteria by J. Breuer when she was a young adult. As a mature adult she became a leading social worker, writer, and feminist activist in the German Jewish community. This article examines her therapy with Breuer, her own struggle for recovery, and some links between her earlier and later life, in particular the lack of intimate relationships in her life and her work against the victimization of women. Throughout the article psychoanalytic interpretations, social history, and feminist analyses are integrated to provide a contextualized examination of Pappenheim's life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowing and Not Knowing About Trauma: Implications for Therapy.

Levels of awareness for trauma and their consequences for research, treatment, and prevention within professional psychology and society are considered. When people must endure chronically traumatic environments, it may be adaptive to isolate from awareness information that would produce cognitive dissonance and threaten necessary relationships. Unawareness may also facilitate functioning in environments that invalidate the prevalence and impact of trauma. In addition, characteristics of the posttraumatic environment can promote or impede individuals' awareness of trauma and their psychological functioning. Though often initially adaptive, unawareness for trauma is linked to intergenerational transmission of trauma and its effects and may preclude public and professional attention to trauma treatment and prevention. Understanding the processes through which individuals become unaware or aware of traumatic experience is therefore essential to conducting effective psychotherapy with trauma survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting posttraumatic growth in breast cancer survivors.

Wide variability exists with respect to how breast cancer survivors respond to common psychological and psychosocial challenges of their disease, ranging from posttraumatic stress disorder to posttraumatic growth. This cross-sectional study examined contextual, disease-related, and intraindividual predictors of posttraumatic growth in 224 randomly selected breast cancer survivors. A series of hierarchical regression analyses found that age at diagnosis, marital status, employment, education, perceived intensity of disease, and active coping accounted for 34%, 35%, and 28% of the variance in growth in relationships with others, new possibilities, and appreciation for life. These findings suggest that a more comprehensive model of growth will be helpful in understanding the various factors that play a role in breast cancer survivors' perception of psychological and psychosocial growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of a model of psychosocial determinants of occupational health of geriatric nurses

The purpose of this study was to verify a model of relationships between psychosocial factors and health for 8066 francophone nurses working in geriatric care in Québec. A random sample of 1990 subjects was drawn and a participation rate of 77.9% and 55% was obtained for the two-time study taken twelve months apart. Based on the theory of Maddi and Kobasa (1984), the model was reproduced for the two-time periods with the aid of structural equations. The analyses showed that three variables exert a direct influence on psychological distress: professional burnout, occupational stressors and hardiness. Also, variables have a direct effect on burnout: listed in order of importance, these are hardiness, occupational stressors, work support, active strategies of coping and employment status. In dealing with the work stressors, the nurses who are hardy make use of active strategies of coping and look for support form their colleagues. The results of the study help to better understand the psychological and social resources that best favor adaptation of working women in highly demanding work environments. The fallout of the study converges towards the quality of life of helping professionals and towards the cost and quality of health and social services.     

Personal and contextual determinants of coping strategies.

This study examined personal and contextual predictors of active and avoidance coping strategies in a community sample of over 400 adults and in a sample of over 400 persons entering psychiatric treatment for unipolar depression. Sociodemographic factors of education and income (except for active-cognitive coping), personality dispositions of self-confidence and an easy-going manner, and contextual factors of negative life events and family support each made a significant incremental contribution to predicting active and avoidance coping. Among both healthy adults and patients, active and avoidance coping were positively associated with negative life events. Individuals who had more personal and environmental resources were more likely to rely on active coping and less likely to use avoidance coping. Moreover, for both groups, most of the predictors continued to show significant relations with active and avoidance coping strategies even after the stable component in coping was controlled in a longitudinal design. A comprehensive framework to understand the determinants of coping can be of practical value in suggesting points for therapeutic interventions aimed at fostering more adaptive coping efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)