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Theses and Dissertations
2010
The two sides of posttraumatic growth : a study of
the Janus Face Model in a college population
Darren R. Jones
The University of Toledo
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A Dissertation
entitled
The Two Sides of Posttraumatic Growth: A Study of the Janus Face Model
In a College Population
by
Darren R. Jones, M.A.
Submitted to the Graduate Faculty as partial fulfillment of the requirement for
The Doctor of Philosophy in Psychology
________________________________________
Committee Chair: Mojisola F. Tiamiyu, Ph.D.
________________________________________
Committee member: Wesley A. Bullock, Ph.D.
________________________________________
Committee member: Jeanne H. Brockmyer, Ph.D.
________________________________________
Committee member: Alice Skeens, Ph.D.
________________________________________
Committee member: Janis Woodworth, Ph.D.
________________________________________
Dr. Patricia Komuniecki, Dean, College of
Graduate Studies
The University of Toledo
August 2010
Copyright © 2010, Darren R. Jones
This document is copyrighted material. Under copyright law, no parts of this document
may be reproduced without the expressed permission of the author.
An Abstract of
Darren R. Jones
Submitted to the Graduate Faculty as partial fulfillment of the requirements for
The Doctor of Philosophy Degree in Psychology
The University of Toledo
August 2010
The concept that people can have positive changes as a result of dealing with
adversity is an ancient concept. In contrast, Posttraumatic Growth is a relatively recent
addition to our understanding of people’s response to life’s struggles. Posttraumatic
Growth (PTG) is conceptualized as positive changes in a person’s life that they attribute
to having faced a traumatic and/or stressful event. However, PTG research is still in its
youth and there are several major unanswered questions about the construct and its
utility. Part of this is due to conflicting findings related to the relationship between PTG
and psychological distress and adaptive significance. The Janus Face Model of PTG is a
theory that attempts to unify the competing theories and findings into a cohesive whole.
This study examined possible support for the Janus Face Model in a college population.
In addition, the study investigated the rates of reported trauma experiences and levels of
posttraumatic growth in relation to those events. Results indicated that there was only
weak support for the Janus Model in the sample. In general, participants reported small to
large amounts of positive growth related to their stated traumatic or stressful event.
Notably, a small minority of participant’s reported negative growth related to their
experience. The results suggest that participants experienced PTG in relation to a wide
range of events, with bereavement being the predominant reported traumatic event.
iii
Acknowledgements
I would like to thank the following people for their support and input throughout the
dissertation process. First, I wish to acknowledge my chair and advisor, Dr. Tiamiyu,
who has been a strong supporter of this project since it began. Her enthusiasm and
guidance played an important role in the completion of this dissertation. Second, I wish to
thank Dr. Brockmyer, whose input was invaluable throughout the writing process. Third,
I want to thank the other members of the committee, Drs. Bullock, Skeens, and
Woodworth, for their assistance and support. I would also like to thank the treasures of
my life, my wife Ann, our son Jacob, and our daughter Sophie. Their love and patience
inspired and sustained me throughout the entire dissertation process.
iv
Contents
Abstract …..………………………………………………………………………………iii
Acknowledgements ………………………………………………………………………iv
Table of Contents …………………………………………………………………………v
List of Tables …….………………………………………………………………………vii
List of Appendices …..…………………………………………………………………viii
Chapter 1: Introduction ……………………………………………………………………1
Chapter 2: Literature Review …..…………………………………………………………5
Definitions …………..……..……………………………………………………5
Negative Effects of Trauma ……….….…………………………………………6
Posttraumatic Growth……………………………………………………………9
Posttraumatic Growth Model …..………………………………………………10
Posttraumatic Growth in Children ……….……………………………………16
Assessment of Posttraumatic Growth …………………………………………18
Previous Research on Posttraumatic Growth …………..………………………21
Unresolved Issues in Posttraumatic Growth ……….….………………………28
Janus Face Model of Posttraumatic Growth ………….………………………30
Statement of the Problem………………………………………………………32
Exploratory Research Questions ……………………………………………….33
Chapter 3: Method …….…………………………………………………………………35
Participants …….………………………………………………………………35
v
Procedure ……………………………………………………………………... 36
Measures ……….………………………………………………………………38
Trauma Events Inventory (TEI) …………………….…………………………38
Purdue Posttraumatic Stress Scale-Revised (PPTS-R) ………….……..………39
Stress-Related Growth Scale-Revised (SRGS-R) …………..…………………39
Illusory and Constructive Scales ………………………………………………40
Chapter 4: Results ……….………………………………………………………………42
Participants ………………………………….…………………………………42
Preliminary Analysis ………….………………………………….……………42
Total Scores ……………………………………………………………………43
Stress-Related Growth Scale-Revised (SSRGS-R) Scores ……………………43
International Personality Item Pool (IPIP) Scores ……………….……………47
Bivariate Correlations ……….…………………………………………………52
Rates by Reported Trauma……..………………………………………………54
Traumatic Events Inventory (TEI) Scores ……....…………………………….54
Purdue Posttraumatic Stress Scale-Revised (PPTS-R) Scores…………………58
Primary Analysis ……….………………………………………………………60
Regression ……………………………………………………………………60
Chapter 5: Discussion ……………………………………………………………………67
Limitations .…………………………………………………………………….73
Clinical Implications …………………………………………………………..74
Research Implications …………………………………………………………76
Future Directions ……………………………………………………………...77
vi
References ………………………………………………………………………………..79
vii
List of Tables
Table 1. DSM-IV Posttraumatic Growth Disorder Diagnostic Criteria ….……………….8
Table 2. Item Means for Stress-Related Growth Scale-Revised: Full Scale .……………44
Table 3. Stress-Related Growth Scale-Revised: Scale Scores for Overall Sample .……..46
Table 4. International Personality Item Pool Item Scores .………………………………48
Table 5. The International Personality item Pool Scale Scores .…………………………51
Table 6. Bivariate Correlations Between Major Study Variables..………………………52
Table 7. Response Rates for Potentially Trauma Events on the Traumatic Events
Inventory (TEI) ..………………………………………………………………55
Table 8. Reported Focal Trauma Events ……….………………………………………..56
Table 9. Item Means on the Purdue Posttraumatic Stress Scale—Revised ..…………….58
Table 10. Predictors of Time Elapsed Since Trauma Event ..……………………………61
Table 11. Predictors of Purdue Posttraumatic Stress Scale-Revised Distress Scores ..….62
Table 12. Predictors of Full Scale Stress-Related Growth Scale-Revised Scores ..……..63
Table 13. Predictors of Capacity For Love Scale Scores ...………………………………64
Table 14. Predictors of Resourcefulness Scale Scores ..…………………………………65
Table 15. Predictors of Wisdom Scale Scores ..………………………………………….66
viii
List of Appendices
Appendix A. Informed Consent Form ………………………. .…………………………86
Appendix B. Trauma Debriefing Information Sheet ..…………………………………..87
Appendix C. Traumatic Events Inventory (TEI) ………………………………………..90
Appendix D. Purdue Posttraumatic Stress Scale-Revised (PPTS-R)…………………….95
Appendix E. Stress-Related Growth Scale-Revised (SRGS-R) …………………………97
Appendix F. International Personality Item Pool Measures (IPIP) ….…………………..99
Appendix G. Complete Study Protocol ..………………………………………………102
Appendix H. Stress-Related Growth Scale-Revised Scale Scores by Trauma Event …121
Appendix I. International Personality Item Pool Scale Scores by Focal Event Type …125
Appendix J. Trauma Distress Scores by Focal Trauma Events ………...………………129
ix
Chapter One
Introduction
―
What does not destroy me, makes me stronger.‖
Friedrich Nietzsche (Nietzsche, 1990, p. 33)
This oft-quoted line from Nietzsche distills the central notion that will be explored
in this study. This study examines the idea that people can not only survive adversity, but
can perhaps experience growth as a result of dealing with life’s struggles. More
specifically, this study endeavors to investigate aspects of this phenomenon that remain
unclear.
The topic of trauma has been prominent in both popular culture and academic
circles for the past 30 years (Shephard, 2000). In particular, posttraumatic stress disorder
(PTSD) has garnered a great deal of interest since its addition to the third edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 (American
Psychiatric Association, 1980). In general, the focus on trauma has revolved around the
negative effects of exposure to traumatic events. This is both understandable and
intuitive. There are many well-documented adverse effects that trauma exposure can
potentially have on people. However, some theorists argue that there may be positive
effects of trauma exposure, as well. These positive consequences, while not receiving
nearly as much attention as the negative effects, have begun to recently garner interest
from the research community.
The idea that people can experience positive changes related to adversity in their
lives is hardly new (Calhoun & Tedeschi, 2006). There is ample evidence going far back
in history that indicates that this concept has been part of the human psyche since ancient
times. There are numerous notable examples of this phenomenon, with those from the
world of religion being perhaps the most influential. The themes of attempting to
understand suffering and persevere through it, plays a major role in Christianity, wherein
the tortures that Jesus endured are given transcendent symbolic value to its adherents.
There are also examples from Islam, Buddhism, and other influential religious
movements. These ideas are also well-represented in literature, both in high-brow and
popular contexts (Zoellner & Maercker, 2006).
Though these ideas are clearly quite old, the topic’s appeal to researchers is a
significantly more recent development (Calhoun & Tedeschi, 2006). Though many terms
have been used to describe the construct, perhaps the most widely used term is
posttraumatic growth (PTG). Posttraumatic growth has been defined as ―p
ositive change
that the individual experiences as a result of the struggle with a traumatic event (Calhoun
& Tedeschi, 1999, p. 11).‖ Researchers have identified three main areas in which people
generally report PTG in their lives. These areas consist of their relationships with others,
their sense of self, and their philosophy of life. Though scholarship in the area of PTG
has increased markedly in the previous decade, many basic questions remain.
Among the important questions regarding PTG is whether it represents mainly a
positive cognitive perspective regarding the traumatic event or if it translates to
substantial, observable behavioral changes in the person’s life (Zoellner & Maercker,
2006). Theorists are divided on this issue. Also, it is unclear if PTG is related to
2
adjustment. We would expect that positive changes would be reflected in more adaptive
functioning among trauma survivors (Westphal & Bonanno, 2007). Currently, there are
conflicting research findings on this important point (Zoellner & Maercker, 2006).
Another issue that needs to be addressed is whether there is a dose-response effect with
PTG. In other words, does the severity of the trauma positively correlate with larger
amounts of PTG? In order to maximize the benefit of PTG for people, these key issues
will need to be better understood.
There are a variety of implications and applications for PTG (Calhoun &
Tedeschi, 1999). First, it is beneficial for therapists to help their clients identify and
maximize any positive impact that adverse life experiences may have had on them. This
approach is at odds with traditional techniques that often focus exclusively on the
pathological elements of trauma. Second, PTG can be incorporated into existing trauma
treatments. It is not necessary to deviate from already empirically-supported trauma
treatments, such as prolonged exposure therapy. Rather, PTG therapy work can be a
valuable adjunct to these treatments, which may lead to improved outcomes. Third,
increased research in PTG will add to our still-evolving understanding of the impact of
trauma. This is particularly relevant at this time, in which the impending publication of
the fifth edition of the DSM will perhaps modify our diagnostic approach to PTSD for
years to come. For example, there are those in the trauma field who argue that a
dimensional approach to PTSD would be preferable to our current dichotomous
diagnostic criteria (McNally, 2004).
However, there are still many aspects of PTG that are unclear (Zoellner &
Maercker, 2006). First, there is a debate among researchers in the field as to whether PTG
3
is a coping strategy or an outcome (Hobfoll, et al., 2007). Second, researchers have
reported conflicting findings on the relationship between PTG and psychological distress,
in particular PTSD-related symptoms. Some argue that the construct and utility of PTG is
called into question when those reporting growth are not showing corresponding levels of
reduction in distress (Hobfoll, et al., 2007). Third, the bulk of the research has focused
almost exclusively on the possible constructive aspects of PTG, while largely ignoring
the potential for less adaptive manifestations. This oversight has contributed to the
theoretical questions surrounding the PTG construct.
The chief goal of this study was to examine a theory of PTG that attempts to
reconcile these contradictory research issues. As conceptualized by Zoellner and
Maercker (2006) in their ―
Janus-Face‖ model, PTG consists of two cognitive
components, one constructive and the other illusory. Specifically, the Janus-Face model
recognizes a self-deceptive aspect of PTG, while also acknowledging a functional
component. If support is found for this theory through research, it could provide an
important framework that is currently lacking in our understanding of PTG.
First, the past literature on PTG research will be reviewed. Second, the methods
of the study will be reviewed, including a discussion of participants, procedures,
measures, and analysis. Third, the results will be presented and explored. Finally, the
findings will be discussed. This will include a discussion of the significance and
limitations of the study, clinical and research implications, and future directions.
4
Chapter Two
Literature Review
Definitions
A discussion about the impact of trauma must first address the question; what
constitutes a traumatic event? Based on the DSM-IV diagnostic criteria for PTSD, an
―
extreme traumatic stressor‖ involves ―dir
ect personal experience of an event that
involves actual or threatened death or serious injury, or other threat to one’s physical
integrity; or witnessing an event that involves death, injury, or a threat to the physical
integrity of another person; or learning about unexpected or violent death, serious harm,
or threat of death or injury experienced by a family member or other close associate
(APA, 2000, p. 463).‖
This definition of a traumatic event takes into account a variety of incidents,
including, but not limited to, combat, sexual assault and other violent crimes, serious car
accidents, and the diagnosis of a fatal disease, such as cancer (APA, 2000). It should be
noted that the trauma event criteria were made more inclusive with the publication of
DSM-IV. In contrast, DSM-III required that the trauma event be an experience that is
uncommon for most people, which could be interpreted to exclude a number of the
aforementioned events that are currently acceptable to meet the stressor criteria. The
DSM-III criteria were developed primarily with combat exposure in mind, therefore
common societal events such as sexual assault and automobile accidents were not a
central focus (McNally, 2004).
5
Theorists studying PTG generally take a broader and more subjective view of
what constitutes a trauma event. Tedeschi and Calhoun (2004) favor a more inclusive
definition of trauma that they describe as ―lifecrisis.‖ While they include the more
serious types of events that are mentioned in the DSM-IV PTSD criteria, they also
include events that may be viewed as of a less fatal nature, such as dealing with a nonlethal, yet debilitating, medical condition, such as rheumatoid arthritis. Calhoun and
Tedeschi (1999) conceptualize PTG as resulting from seismic events, which are those
incidents that have a profound impact on the person’s worldview and emotional
functioning. It should be noted that PTG is not dependent on meeting the diagnostic
criteria for PTSD, however, it is likely that many people who report PTG have met the
PTSD criteria at some point.
A critical difference between PTG and traditional approaches to trauma is the
focus on strens, which are experiences that bolster a persons psychological functioning
(Tedeschi & Kilmer, 2005). This emphasis on salutogenesis, the processes that are
associated with healthier outcomes, is in contrast to the conventional trauma practices,
which are geared toward pathogenesis processes. This focus on salutogenesis is not the
province of PTG exclusively, however. Theorists that study similar constructs, such as
resilience also work from this perspective (Tedeschi & Calhoun, 2005).
Negative Effects of Trauma
The negative effects of trauma have been well-researched and they form the basis
for most trauma-related treatments today (Calhoun & Tedeschi, 1999). First, the
experience of a traumatic event leads to a heightened risk of developing psychiatric
disorders, most notably PTSD. See Table 1 for the complete DSM-IV diagnostic criteria
6
for PTSD. The PTSD diagnostic criteria include three main aspects: a reexperiencing of
the event through thoughts, images, or perceptions; a persistent avoidance of the stimuli
associated with the event and numbing of general responsiveness; and persistent
symptoms of hyperarousal, such as difficulty sleeping, irritability, hypervigilance, or
concentration problems. For PTSD diagnostic criteria to be met, at least one month must
have elapsed since the event took place. If less than one month has passed since the
event, and the other diagnostic criteria are met, a diagnosis of acute stress disorder (ASD)
is given. In addition to developing ASD or PTSD, trauma exposure makes people more
vulnerable to other disorders, as well. In particular, depression and substance abuse are
common comorbid disorders among people with an ASD or PTSD diagnosis (APA,
2000).
A second potential negative outcome of trauma exposure is distressing emotions
and/or thoughts (Calhoun & Tedeschi, 1999). There is variability in the types of
emotional reactions and thoughts that trauma survivors experience. This variance is due,
at least in part, to individual differences, and the severity and type of trauma event
experienced. However, common emotional reactions include anxiety, fear, sadness, guilt,
anger, and irritability. Common distressing thoughts include shock, disbelief, and
numbness. One common trauma reaction, especially among those who have PTSD, is
intrusive thoughts that permeate the consciousness of the individual. These intrusive
thoughts often appear even as the individual is attempting to avoid thinking about the
event.
7
Table 1: DSM-IV Diagnostic Criteria for Posttraumatic Stress Disorder (PTSD)
(American Psychiatric Association, 2000, p. 463-468)
A. The person has been exposed to a traumatic event in which both of the following were
present:
1) the person experienced, witnessed, or was confronted with an event or events that
involved actual or threatened death or serious injury, or a threat to the physical integrity
of self or others
2) the person’s response involved intense fear, helplessness, or horror
B. The traumatic event is persistently reexperienced in one (or more) of the following
ways:
1) recurrent and intrusive distressing recollections of the event, including images,
thoughts, or perceptions
2) recurrent distressing dreams of the event
3) acting or feeling as if the traumatic event were recurring
4) intense psychological distress at exposure to internal or external cues that
symbolize or resemble an aspect of the traumatic event
C. Persistent avoidance of stimuli associated with the trauma and numbing of general
responsiveness (not present before the trauma), as indicated by three (or more) of the
following:
1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
2) efforts to avoid activities, places, or people that arouse recollections of the trauma
3) inability to recall an important aspect of the trauma
4) markedly diminished interest or participation in significant activities
5) feeling of detachment or estrangement from others
6) restricted range of affect
7) sense of foreshortened future
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated
by two (or more) of the following:
1) difficulty falling or staying asleep
2) irritability or outbursts of anger
3) difficulty concentrating
4) hypervigilance
5) exaggerated startle response
E. Duration of the disturbance is more than 1 month
F. The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning
8
Another negative outcome related to trauma exposure is problematic behaviors
(Calhoun & Tedeschi, 1999). In particular, the attempts to avoid reminders of the trauma
event often lead to social isolation and the use of alcohol and drugs among trauma
survivors. Another possible behavior problem is aggression. Some trauma survivors,
especially those who have been physically or sexually abused in childhood, are at a
higher risk for impulsive, aggressive behaviors. This is especially true when the
individual is using excessive amounts of alcohol.
Finally, some people exposed to trauma experience distressing physical reactions
(Tedeschi & Calhoun, 1999). Due in part to the overactivity of the body’s stress response
system, trauma survivors may experience a range of physical complaints, such as feeling
fidgety, tense, lethargic, gastrointestinal problems, and having breathing difficulties.
Posttraumatic Growth
Tedeschi and Calhoun (2004) posit that a number of positive effects of trauma
exposure take place in some people. They suggest that people who experience PTG,
generally report growth in three areas: a changed sense of relationship with others,
changed sense of self (feeling more vulnerable, yet stronger), and changes in life
philosophy.
In the area of a changed sense of relationships with others people report feeling an
increase in intimacy and closeness with their loved ones (Tedeschi & Calhoun, 2004).
This is an especially notable phenomenon since trauma reactions can have a detrimental
impact on a person’s relationships. Furthermore, individuals with improved relationships
often report feeling more open to self-disclosure. Also, people reporting PTG may
9
experience an increase in empathy and compassion towards those that are dealing with
adversity themselves.
Another major change in PTG is a changed sense of self that includes feeling
increased vulnerability, but also feeling stronger at the same time (Tedeschi & Calhoun,
2006). On its face, these may seem to be incongruent concepts. However, some people
report that their traumatic event illustrated to them that they are not impervious to harm
and that this serves as a corrective experience, in that, they are less likely to take
unnecessary risks. At the same time, they report feeling stronger at having lived through
the event and, though it has been a struggle, they are better able to handle future setbacks
or adversity.
The third major area of growth is in the area of changed philosophy of life
(Tedeschi & Calhoun, 2006). In this aspect of PTG, people report a greater appreciation
of their life. This often leads to the person reconsidering the priorities in their life. For
example, some people alter their schedule in order to focus less time on their work and
more on their families. Another common experience in PTG is an increased pleasure in
the everyday experience’s of life that previously may have been unnoticed or taken for
granted. Religious and spiritual beliefs are also sometimes strengthened by traumatic
experiences. Adversity has been viewed by some as creating a thin place, a celtic
mythological term describing situations in which it is more likely to experience
supernatural phenomenon (Tedeschi & Calhoun, 2006).
Posttraumatic Growth Model
Tedeschi and Calhoun (2004) have outlined a theory as to how PTG occurs.
Figure 1 illustrates the basic components of PTG. The authors stress that PTG is not a
10
direct result of the trauma event. Rather, PTG results from the person’s struggle with the
impact of the event on their worldview. This struggle includes challenges to the
individual’s sense of understanding, decision-making, and meaning regarding their life
and the world around them. Tedeschi and Calhoun posit that this struggle is akin to
rebuilding a city after an earthquake, in which the person is attempting to reconstruct
their cognitive world after a seismic event.
At the beginning of the Tedeschi and Calhoun PTG schematic is the individual in
their pretrauma existence. This, of course, includes the person’s current resources, both
strengths and weaknesses regarding coping with stressors. Next, is the seismic trauma
event itself. The event leads to a variety of challenges for the individual. First, the person
must manage their emotional distress. This may include a variety of reactions, including
anxiety and mood-related symptoms. A second challenge is to the person’s beliefs and
goals. Here, the individual’s sense of themselves and the world around them are under
strain from the fallout of the event. Third, the narrative of a person’s life, a detailed script
of their personal history, presents a challenge, as well. Often, a traumatic event splits a
person’s life story into a before and after mindset. It is important for the person to
develop a life narrative of the event that takes into account both their pre and post trauma
event selves. Some theorists believe that this is vital in order for the person to be able to
incorporate the trauma into their life story and make it possible for them to process and
make sense of the event in the context of their history.
11
PERSON PRETRAUMA
SEISMIC EVENT
CHALLENGES
MANAGEMENT
OF EMOTIONAL
DISTRESS
FUNDAMENTAL SCHEMAS:
BELIEFS
AND
GOALS
RUMINATION
LIFE NARRATIVE
SELF DISCLOSURE
WRITING, TALKING, PRAYING
MOSTLY AUTOMATIC & INTRUSIVE
REDUCTION OF EMOTIONAL DISTRESS
MANAGEMENT OF AUTOMATIC RUMINATION
DISENGAGEMENT FROM GOALS
Sociocultural Influences
MODElS FOR SCHEMAS, COPING,
POSTTRAUMATIC GROWTH
RUMINATION (MORE DELIBERATE)
SCHEMA CHANGE
NARRATIVE DEVELOPMENT
ENDURING
DISTRESS
POSTTRAUMATIC
GROWTH
(5 DOMAINS)
Figure 1. Tedeschi and Calhuon’s Model of Posttraumatic Growth
12
NARRATIVE AND
WISDOM
These challenges lead to rumination about the event, in which the person is
cognitively engaged in repetitive thoughts regarding the incident (Tedeschi & Calhoun,
2006). The authors note that the term rumination is often used in a negative manner, often
denoting maladaptive thought patterns related to a specific event or situation. In contrast,
Tedeschi and Calhoun use rumination in their model in a neutral way that is intended to
describe the process of trying to make sense of the event. The rumination that occurs in
the early stages of PTG involves mainly automatic and intrusive thoughts about the event
that are consistent with the reexperiencing diagnostic criteria of both acute stress disorder
and post traumatic stress disorder. This early phase of rumination is distinct from the later
stage, which involves different processes.
This early rumination phase is related to two parallel components of the PTG
model, self- disclosure and a cluster that includes reduction of emotional distress,
management of automatic rumination, and disengagement from goals (Tedeschi &
Calhoun, 2006). The self-disclosure component relates to the amount and type of
information that the person shares about the trauma event with others. It is posited that
the development of PTG is facilitated, in part, by this sharing of the event through talking
or writing because the attitudes and responses of the person’s primary reference group are
important in the development of their post-trauma perspective. The parallel cluster
includes three parts, the first of which is reduction of emotional distress. The model
posits that the early rumination leads to less emotional distress, as well as increased
control over the automatic intrusiveness of the event. This increased management of
automatic rumination, the second part of the cluster, allows for the person to process their
thoughts about the trauma event in a self-controlled manner. The third part,
13
disengagement from goals, involves the attempt by the individual to reconcile their pretrauma life goals with their post-trauma experience. Some people find discord between
these two aspects of their self-concept and may believe that they cannot achieve their pretrauma goals. This reflects damage to their worldview, including their self-efficacy. By
disengaging from their pre-trauma goals the individual is able to incorporate the trauma
into their life narrative and develop new goals.
Sociocultural influences are a connected component of self-disclosure and the
emotional distress/management of automatic rumination/disengagement from goals
cluster (Tedeschi & Calhoun, 2006). The role of sociocultural factors includes both
proximate and distal aspects. The proximate factors include the people with whom an
individual interacts on a regular basis, which may include friends, co-workers, family
members, and neighbors. In contrast, distal influences are broader and consist of the
cultural themes that exist in one’s larger society, such as countries or vast geographic
zones. The influence of one’s culture on their post-trauma experience can be positive,
negative, or a combination of both. For example, the post-Vietnam experience for many
American soldiers was made more difficult by the cultural responses that they
experienced, which in some cases included invalidation and even outright aggression. In
contrast, the cultural responses to Iraq war soldiers seems to have been more supportive
and positive, perhaps, in part, due to lessons learned from the Vietnam experience.
These components in the model then lead to further rumination, but the process is
now more deliberate and less automatic (Tedeschi & Calhoun, 2006). This stage of
rumination includes changes to the person’s schemas, their cognitive template of their
beliefs and attitudes, and the development of a life narrative that incorporates the trauma
14
in a linear fashion (as opposed to the before and after style of early rumination). The
authors posit that this more deliberate rumination phase leads to the development of PTG,
which encompasses five domains, including, an increased appreciation of life, more
meaningful interpersonal relationships, an increased sense of personal strength, change
priorities, and a richer existential and spiritual life.
An associated component of PTG in the model is enduring distress (Tedeschi &
Calhoun, 2006). The authors conjecture that the development of PTG does not
necessarily mean that the person does not experience distress related to their trauma
experience. They argue that this is not a shortcoming of their conceptualization of PTG,
rather, they view distress and PTG as separate dimensions that are not necessarily
connected. That is, they believe that the two dimensions can coexist. What is more, the
authors suggest that trauma survivors may require unpleasant cognitive and emotional
reminders of the event in order for them to maintain their growth by remaining aware of
both the losses and gains of their experiences.
The final facet of the PTG model is narrative and wisdom (Tedeschi & Calhoun,
2006). The narrative portion refers to the achievement of the previously addressed
process of developing a linear and trauma-inclusive life story. In particular, the person at
this stage has constructed meaning through their trauma experience and has developed a
narrative that includes personal, interpersonal, and social dimensions (Neimeyer, 2006).
At the personal level, the individual incorporates stories from various episodes in their
life in a manner that facilitates a linear sense of their self concept. At the interpersonal
level, the trauma event is conveyed to others via verbal or written mediums. As noted
earlier, PTG is more likely to occur when the other person provides empathy and support,
15
rather than invalidating the person’s experience. Finally, at the social level, there are both
individual and societal implications. The individual can benefit from feeling the support
of their society. For example, the survivors of the September 11th attacks were largely
met with an outpouring of empathy and assistance. At the societal level, PTG in
individuals can contribute to broader changes, in which the society is better able to deal
with national crises. One example would be during World War II, when many people lost
loved ones and there were countless sacrifices made at the individual and societal level in
order for the nation to survive that trying period of history. In addition to the narrative, it
is proposed that individuals who develop PTG also gain wisdom through their struggle
with adversity. Though it has been defined in a myriad of ways, in this context wisdom is
viewed as ―
the ability to balance reflection and action, weigh the known and the
unknowns of life, be better able to accept some of the paradoxes of life, and to more
openly and satisfactorily address the fundamental questions of human existence
(Tedeschi & Calhoun, 2004, p. 12).‖
Posttraumatic Growth in Children
Kilmer (2006) argues for a distinct PTG model for children. He notes that the
developmental implications of children require a modified PTG approach in order to
understand the phenomenon among younger people. In particular, the author posits that
PTG in children is best informed by an ecological perspective that can consider the multilayered influences in a child’s life. Though the Kilmer model deviates from the Tedeschi
and Calhoun approach in important ways, it largely mirrors the main facets of the adult
conceptualization of PTG. First, the child’s pretrauma beliefs, characteristics, and
functioning are considered. This takes into account a wide variety of factors, including
16
the child’s temperament and their relationship with their parents and caregivers. Next, is
the exposure to the trauma, which often includes shattered assumptions, loss, and grief.
Among the potential mediators of trauma experiences are the severity, duration and type
of trauma. Central to the child’s post trauma experience is the caregiver’s response to the
event. This response is moderated by the parents or caregivers own mental health status,
their pre-existing relationship with the child, their own stress reactions and coping
resources. Sadly, many of the most trauma-vulnerable children in our society, those in the
lower socioeconomic strata, are also more likely to have parents or caregivers whose
ability to respond to the trauma event is compromised.
The next phase of the model involves two parallel components,
relationships/support and appraisals, rumination and cognitive reprocessing (Kilmer,
2006). In the relationships/support phase, the child’s environment facilitates emotional
expression and discussion of problems, provides validation, and assistance when
necessary. This includes a range of environmental influences, including caregivers,
parents, family members, and school and other community members. The parallel
component of appraisals, rumination, and cognitive reprocessing involves the child
experiencing recurrent trauma-related cognitions in an attempt to understand, resolve, and
make sense of the experience. This process will vary depending on the child’s
developmental level and maturity.
The appraisals, rumination, and cognitive reprocessing phase has a parallel
component of cognitive resources: realistic control attributions (Kilmer, 2006). In the
cognitive resources phase, the child attempts to reach an accurate perspective on what
can and cannot be controlled in a person’s world. These two components lead to self-
17
system functioning, in which the child achieves a sense of competency related to their
ability to deal with problems. In addition, the child has the perception of increased selfefficacy and ability to handle social and interpersonal situations. Also, the child in this
phase possesses hope and optimism about the future. Kilmer hypothesizes that these
aforementioned components facilitate the attainment of the final stage in the model,
posttraumatic growth.
Assessment of Posttraumatic Growth
Posttraumatic growth has been assessed in a variety of ways, utilizing both
qualitative and quantitative methods (Park & Lechner, 2006). The qualitative methods
generally consist of semi-structured questioning of the participant about growth-related
issues. This approach has taken a variety of different forms, including written essays, lifestory narrative development, focus groups, and more commonly, individual interviews.
Proponents of these qualitative methods to measure growth argue that quantitative
methods do not capture the domains of PTG as well as qualitative methods. In contrast,
those that favor quantitative methods argue that qualitative methods are of limited value
because they do not possess adequate psychometric properties for comparing and
contrasting findings in a consistent manner.
Currently, there are three psychometrically validated quantitative measures that
are used to measure PTG (Park & Lechner, 2006). These measures consist of the
Posttraumatic Growth Inventory (PTGI), the Benefit Finding Scale (BFS), and the StressRelated Growth Scale (SRGS). The most widely used and researched of these measures is
the PTGI, which was developed by Tedeschi and Calhoun. The PTGI is a 21-item selfreport inventory that assesses the person’s perception of positive changes that they have
18
experienced in the aftermath of a traumatic event. The PTGI uses a 6-point Likert scale
ranging from 0 (I did not experience this change as a result of my crisis) to 5 (I
experienced this change to a very great degree as a result of my crisis). The PTGI’s five
subscales include Relating to others, New Possibilities, Personal Strength, Spiritual
Change, and Appreciation of Life. The range of possible scores is 0 to 105 and the total
score is achieved by summing all the item responses. Higher scores on the PTGI are
indicative of greater amounts of PTG. Tedeschi and Calhoun developed and normed the
PTGI using a college student population. Research has shown that the full scale PTGI
scale has acceptable psychometric properties (a = .90), while the five domain model has
received less support from studies (Sheikh & Marotta, 2005). The PTGI has also been
adapted for use with children by rewording the items to be appropriate for children as
young as 8 years of age. A common criticism of the PTGI is that it only allows people to
report positive growth experiences, while not assessing possible negative life changes
related to trauma.
The Benefit Finding Scale (BFS) was developed by Antoni et al (2001) for use
with breast cancer survivors, though it has also been utilized with people with other types
of cancer and HIV/AIDS. The BFS has 17 items and each one begins with the phrase
―
Having cancer….,‖ which is then followed by a possible area of gain derived from the
experience. The content of the scale items includes areas such as handling responsibilities
and acceptance. The BFS utilizes a five-point Likert scale that ranges from ―
a little‖ to
―
extremely.‖ Though its use has been relatively limited to cancer and HIV/AIDS
survivors, the BFS has been shown to have acceptable psychometric properties (a = .82).
19
The Stress-Related Growth Scale (SRGS) was developed by Park, Cohen, and
Murch (1996) and was validated using multiple college student samples. The SRGS has
50 items and examines participants’ growth in personal resources, social relationships,
life philosophy, and coping skills. The participants are given choices to respond from 0
(not at all) to 2 (a great deal). Research on the SRGS indicates that it measures a unitary
construct and, thus, should be viewed as providing a single, global growth score. There is
also a short form of the SRGS that was constructed using the 15 highest loaded items
from the long form. In addition, Armeli, Gunthert, and Cohen (2001) have published a
43-item revised version (SRGS-R) of the measure that includes both negative and
positive changes related to the trauma. The authors reported a seven factor structure with
good psychometric properties for the SRGS-R that includes the following scales; affect
regulation (a = .67), religiousness (a = .90), treatment of others (a = .75), selfunderstanding (a = .74), belongingness (a = .79), personal strength (a = .78), and
optimism (a = .78). In developing the SRGS-R Armeli (2009) and his associates viewed
growth scores as a continuous outcome. Growth scores on the SRGS-R were
conceptualized either as decreases, no change, or increases.
An important question in the study of PTG is, ―
how much growth represents
PTG?‖ In other words, what levels of growth constitute a person being deemed as having
achieved PTG? There are a number of issues, both theoretical and measurement-related,
that need to be addressed in order to resolve this dilemma. Tedeshi and Calhoun (2006)
have recognized this quandary and have taken the position that the answer does not lie in
establishing cutoff scores. They argue that there is variability in the PTG scores across
individuals and populations that contraindicate setting cutoff levels, since the variance
20
may be related to the highly personal and relativistic nature of growth. At the same time,
some researchers argue that in order for PTG to be further developed as a theory,
guidelines must be established so that comparisons and inferences can be drawn from the
data.
Previous Studies on Posttraumatic Growth
The question of prevalence of the phenomenon of PTG in the population has also
been raised. Tedeschi and Calhoun (2006) have cited research on PTG prevalence that
ranges from 3% to 100% in various samples. However, they maintain that it is more
common for rates of PTG to fall between 30% to 80% in published studies. Clearly, this
is an area of PTG research that requires further exploration.
In their meta-analysis of benefit finding and growth, Helgeson, Reynolds, and
Tomich (2006) examined 77 articles. They found that growth was related to less
depression and increased well-being. However, they also found that growth was
associated with more intrusive and avoidant thoughts about the trauma event. Intrusive
and avoidant thoughts are diagnostic symptoms of PTSD. The authors reported that time
since the trauma event was a moderator, in that, people generally reported more growth
the longer the span of time since the trauma. In addition, they found that women,
minorities, and younger people reported the most growth. Importantly, in terms of the
present study, the authors suggest that PTG may perhaps be best viewed as a coping
strategy for more proximal events and growth for more distal events.
Posttraumatic growth has been studied in a variety of populations (Park &
Lechner, 2006). Cancer survivors are a commonly researched population in published
PTG studies (Stanton, Bower, & Low, 2006). Stanton, Bower, and Low reviewed the
21
published PTG studies with cancer survivor populations and found there were 29
independent studies and seven sub-studies, in which the cancer survivors were not the
exclusive population under examination. There were a variety of measures used in these
studies, but the majority included either the PTGI or BFS. Only one of the studies
(Cordova et al., 2001) reviewed used a control group and the results of that study
indicated that women diagnosed with cancer reported significantly higher amounts of
growth than those without cancer in the PTGI domains of relating to others, spirituality,
and appreciation of life, but not in the areas of new possibilities or personal strength.
Overall, the 29 studies reviewed found that participants reported small to moderate
amounts of perceived growth that they related to their experience with cancer. The
authors reported that their analysis indicated that, in general, breast cancer survivors of
higher socioeconomic status (SES) who had completed treatment were more likely to
report growth than those in lower socioeconomic strata. However, the opposite was true
in cancer patients who were still engaged in treatment: in that, higher SES was actually
related to decreased growth in that group, and the authors note that the PTG-SES
relationship is still unclear.
Of the 29 studies reviewed, 10 addressed the issue of PTG and ethnicity (Stanton,
Bower, & Low, 2006). The authors found that in three of the studies ethnic minorities
reported higher levels of PTG than white breast cancer patients. This finding held true
even when controlling for SES. The other seven studies that addressed ethnicity reported
nonsignificant findings in relation to PTG, but the reviewers noted that those studies had
smaller samples and fewer minority participants, which may have impacted the findings.
The authors suggest that PTG may be more common in minorities due to earlier age at
22
diagnosis and an increased impact due to higher rates of mastectomy and chemotherapy
treatment in that population.
PTG has also been reported in studies of human immunodeficiency virus (HIV)
and acquired immunodeficiency syndrome (AIDS) patients (Milam, 2006). HIV and
AIDS present complicated psychological issues, in part, due to the stigma that is attached
to the disease and the corresponding psychosocial impacts. In his review of three studies
in this population, Milam found that 59% to 83% of the participants reported PTG as a
result of their experience with HIV/AIDS.
Lev-Wiesel and Amir (2006) studied PTG among Jewish people (N = 97) who
were children during the holocaust. The participants (48% male) were all children in
Europe during World War II and were living in areas under Nazi command. At the time
of the study their average age was 67.90 (SD = 4.65). The findings indicated that the
participants reported a small amount of growth and PTG was positively correlated with
social support from friends and PTSD arousal symptoms. Interestingly, the authors noted
that participants appeared to channel their increased arousal into adaptive behaviors.
Grubaugh and Resick (2007) examined PTG among female assault victims who
were seeking mental health treatment. The participants (N = 99) had experienced either a
physical (36%) or sexual assault 64%) and their average age at the time of the study was
32.34 (SD = 11.24). Almost all of the participants (90.9%) met DSM-IV diagnostic
criteria for PTSD and 54.4% met criteria for both depression and PTSD. The authors
reported the following PTG amounts in the sample: no growth (1%), very small (22%),
small (32%), moderate (24%), great (11%), and very great (10%). There were no
23
statistically significant differences reported in the amount of PTG among the physical and
sexual assault groups.
In a study of survivors of Intimate Partner Violence (IPV), Cobb, Tedeschi,
Calhoun, and Cann (2006) examined the dose-response theory of PTG. In the doseresponse theory it is posited that as the amount of trauma increases, including both
duration and severity, there will be corresponding increases in the amount of PTG. The
participants (N = 60) were all women who were living in domestic violence shelters. The
average age of the women was 33 (SD = 10) and included white (48.3%), AfricanAmerican (38.3%), and Hispanic (1.7%) participants, as well as some who did not report
their ethnicity. The findings indicated that the participants reported a moderate amount of
PTG and the authors noted that these levels were higher than those reported in many
other populations studied, including breast cancer survivors. In relation to the doseresponse issue, the authors reported that of the six domains that were examined (relating
to others, new possibilities, personal strength, spiritual change, appreciation of life, and
total PTG) only appreciation of life had a significant correlation with severity of abuse,
such that women who reported higher levels of abuse also reported more PTG.
Milam, Ritt-Olson, and Unger (2004) examined PTG among adolescents at a
Southern California high school. The participants (N = 435) had an average age of 15.80
(SD = 1.52) and were balanced by gender (55 % female). The sample was made up
ethnically of Hispanic (n= 373), multiethnic (n = 27), identified as ―othe
r‖ (n = 23), and
white (n = 12). The participants primarily reported experiencing difficult life events in the
following areas: death of close friend (34%), moved to a new home (16%), loss of a close
friend (11%), major illness/injury to a close family member (10%), parents/guardians
24
divorced/separated (10%), held back a grade (6%), and major illness/injury (5%). The
participants reported moderate amounts of growth in relation to the events. There were no
differences found between males and females, or between Hispanics and non-Hispanics.
The highest average PTG score was associated with the death of a close family member
and the lowest average score with a move to a new home. The study also addressed
substance use and found it to be negatively correlated with PTG.
Ickovics, et al. (2006) examined PTG over an 18-month period in urban
adolescent teens. At the start of the study, the ages of the participants ranged from 14 to
19 (M = 17.24, SD = 1.49). The majority of the participants were ethnic minorities,
including African American (43%), Hispanic (35%), white (10%), and other/mixed (2%).
The researchers asked the teens to name the hardest thing that they ever had to face and
319 (97%) reported an event. The traumatic life events reported by the participants
included pregnancy/motherhood (29.4%), death of a loved one (22.6%), relationship
problems (17.1%), another person’s problems (12.4%), health problems (9.6%),
socioeconomic problems (5.6%), crime (1.7%), and sexual abuse/harassment (1.1%).
The participants were studied at baseline and at an 18-month follow-up. The findings
indicated small levels of PTG, with the appreciation of life domain having the highest
levels. In addition, pregnancy and motherhood were associated with the most growth and
interpersonal problems with the least. The authors reported that white participants had
lower long-term distress and that short-term distress was significantly more severe than
long-term distress. This finding provides support for the idea that distress generally
subsides over time.
25
In contrast to other areas of psychological research, college student samples have
not been used often in PTG research. This may be due to PTG researchers’ tendency to
focus on specific populations of trauma survivors. However, Wild and Paivio (2003)
conducted a study at a Canadian University that examined whether psychological
adjustment, active coping, and emotion regulation predicted PTG. The participants (N =
193) were predominantly female (n = 170) and had an average age of 19.97 (SD = .32).
The ethnic makeup of the sample included white (76.2%), African-Canadian (8.3%), East
Indian (4.1%), Latin-American (3.1%), Native-Canadian (0.5%), and those that described
themselves as ―othe
r‖ (6.7%). The findings indicated that the participants reported an
average amount of traumatic events (M = 2.62, SD = 1.68). The range of events reported
ranged from 1 to 9, with 66 % of participants reporting multiple trauma events. The
average amount of time since the trauma event was 1.30 years (SD = .13) and ranged
from 0 to 5 years. The events reported included an ―
other‖ (44%) category
(encompassing suicide/death of close friends or non-immediate family members, and
accidents not involving a permanent disability), life-threatening illness of family member
(32%), serious illness of a family member (31%), death of family member (28%), breakin (16%), rape (14%), family member’s disability (14%), physical assault (12%),
childhood emotional abuse (11%), natural disaster (10%), disability of self (10%),
witness to a murder or life-threatening injury (8%), childhood physical abuse (6%),
robbery involving force (4%), life-threatening illness of self (3%), divorce (3%),
childhood sexual abuse (3%), and combat experience (1%). The results indicated that the
participants, on average, reported moderate amounts of PTG. Also, higher levels of PTG
were associated with higher amounts of trauma, more proximal traumas, and higher
26
levels of distress at the time of the event. The amount of PTG was associated with higher
levels of active coping and greater subjective well-being. The authors note that social
desirability was independent of PTG, which they argue supports the notion that PTG is
not simply the result of the responder attempting to create a positive impression.
Kleim and Ehlers (2009) addressed the relationship between PTG and
psychological distress in a UK study of assault survivors. The authors investigated these
issues in two different studies, one involving 180 people who had been treated for assault
injuries at an inner-city hospital in the prior two weeks, and another that examined 70
assault survivors that had been treated in the same emergency room 3 to 15 months
before data collection. The findings indicated a curvilinear relationship between PTG and
depression in the first study, and a curvilinear relationship between PTG and PTSD
symptoms in the second study. The authors reported that the assault survivors with low or
high amounts of PTG endorsed lower distress levels than those reporting moderate
amounts of PTG. It is posited that this is due to some people not viewing the event as
traumatic and, therefore, not experiencing growth or distress in relation it. Conversely,
people who do view the event as seismic in their life are more likely to experience growth
and distress in relation to the event. The authors suggest that this high PTG/high distress
group supports the hypothesis that PTG is adaptive for most people and that it ultimately
leads to better adjustment. However, they also note that some assault survivors reported
moderate levels of PTG that were related to distress at 6 months post-event. They suggest
that this may be indicative of a possible positive illusion, in which PTG serves a
palliative function and does not result in what Hobfoll (2007) termed ―
action growth,‖
meaning growth that has both cognitive and behavioral manifestations.
27
Shakespeare-Finch and Enders (2008) addressed the issue of improving the
manner in which PTG is generally measured, including how to capture action growth.
Specifically, they asked 61 Australian trauma survivors and a significant other to
complete the Posttraumatic Growth Inventory (PTGI). The authors reported that the
trauma survivors’ PTGI scores were corroborated by the significant other’s report. They
suggest that this provides support for the notion that PTG is not simply a cognitive
illusion and is, in fact, manifested behaviorally. They do note, however, that there is a
possibility that their findings alternatively reflect a cognitive illusion shared by the
survivor and their significant other.
Unresolved Issues in Posttraumatic Growth
There are a number of unresolved issues regarding PTG (Park & Lechner, 2006).
This may be due, in part, to its relative youth as a construct and focus of research.
However, there are also divergent views within the field about both the theoretical and
practical aspects of PTG.
One of the issues in PTG that remains controversial relates to semantics. Some
critics of PTG argue that it is not distinct from other salutogenic constructs, such as
resilience. These critics charge that these constructs are mining the same ground, but
simply using different terminology. Tedeschi and Kilmer (2005, p. 231) argue that
ffective coping and adaptation in the face of major life
resilience can best be defined as ―e
stress,‖ and that, in contrast, PTG goes ―
beyond resilience‖ and is related to people who
have not only adjusted to the stressor, but have actually been ―
transformed by their
struggles with adversity.‖ Furthermore, Lepore and Revenson (2006) note that some
theorists believe that people who are resilient may actually be less likely to experience
28
PTG, since they are perhaps not as stressed by the event as others who are less resilient.
While this issue will likely remain a point of contention in the field, PTG has established
itself as a construct that has been widely researched and is currently the predominant
theory addressing the positive impact of adversity.
Another issue that remains unclear is whether PTG is an outcome or coping
strategy (Zoellner & Maercker, 2006). Tedeschi and Calhoun (2006) maintain that PTG is
an outcome of the individual’s trauma experience. Essentially, the growth is an
unintentional byproduct that is created through the coping processes of the person and is
described in their model of PTG. In contrast, Davis, Nolen-Hoeksama, & Larson (1998)
argue that PTG is an example of ―
meaning making,‖ in which the individual attempts to
adapt to a trauma by attributing growth to the adversity.
Some theorists question the adaptive utility of PTG in general. Hobfoll, et al.
(2007) argue that PTG as Tedeschi and Calhoun conceptualize it is a positive illusion of
sorts that seldom translates to adaptive ―
action growth.‖ The authors cite work conducted
in New York after 9/11 and in Israel. In the 9/11 study (Bonanno, Rennicke, & Dekel,
2005) the results indicated that PTG was a cognitive coping strategy for survivors that did
not lead to adaptive changes in functioning at 18-month follow-up. In their work in Israel
(Hobfoll et al., 2006) during the Intifada they found that participants with higher levels of
PTG also had higher amounts of functional impairment, PTSD symptoms, and greater
outgroup bias. In a study they conducted in Gaza, PTG was indicative of positive
adaptation only when it was associated with action and not simply cognitive coping
mechanisms.
29
The Janus Face Model of Posttraumatic Growth
Zoellner and Maercker (2006) proposed a two component model that was
intended to provide a unified theory that takes into account the contradictory issues
surrounding PTG. The Janus Face model, named after the Roman God Janus who was
generally illustrated with two faces gazing in opposite directions, proposes that the
contradictory findings in PTG research are due to the nature of the construct itself.
Specifically, the Janus model suggests that PTG has both illusory and constructive
components and that the length of time since the trauma event is a moderator in the
trajectory of PTG. Also, Zoelner and Maercker posit that PTG can be both an outcome
and a coping strategy. It is proposed that short-term, PTG is a coping strategy that serves
a palliative function. During the proximal phase, it is expected that there will be more
illusory aspects of PTG and fewer constructive aspects. See Figure 2 for an illustration of
the proximal phase. Conversely, as the trauma becomes more distal, it is expected that
there will be more constructive aspects and less of the illusory aspects. In addition, the
Janus model predicts that distress will be greater in the proximal phase and reduced in the
distal phase. See Figure 3 for an illustration of the distal phase.
Only one study was found that attempted to test the Janus model. Zoellner, et al.
(2008) conducted a study among motor vehicle accident survivors in Germany. They
operationalized the illusory side of PTG as optimism and the constructive component as
openness to experience and intense feelings. The study used the personality measures of
the Life Orientation Test-Revised (LOT-R) and the NEO Personality Inventory-Revised
(NEO-PI-R) to capture these constructs. The authors reported that there were no
significant relationships between the optimism or the openness facets and PTG.
30
Proximal to Trauma Event
Less
Constructive
Thinking
More
Illusory
Thinking
g
Higher
PTG
Levels
Higher
PTSD
Symptoms
Figure 2: Janus Model of Posttraumatic Growth: Proposed Trajectory of PTG: Proximal
to Trauma (Zoellner & Maercker, 2006)
Distal to Trauma Event
More
Constructive
Thinking
Less
Illusory
Thinking
Higher
PTG
Levels
Lower
PTSD
Symptoms
Figure 3: Janus Model of Posttraumatic Growth: Proposed Trajectory of PTG: Distal to
Trauma (Zoellner & Maercker, 2006)
However, there was support for the Janus model in that optimism and openness played
roles in the prediction of PTSD. In keeping with the model, participants with high levels
of PTSD symptoms also had higher levels of optimism and higher levels of PTG. In
contrast, those with lower PTSD symptoms also had higher levels of openness and PTG.
The authors also reported a small dose-response effect, in which more severe trauma was
31
associated with higher levels of PTG. The authors noted that the PTG levels reported by
the participants were generally very low and they suggested this may be due to cultural
differences. They argue that in America there is a ―
tyranny of positive thinking‖ that may
pull for higher scores in the United States. They contrast this with Germany, where
people may be less likely to follow this ―
cultural script.‖
Statement of the Problem
It should be clear by this point that there are many unresolved issues in PTG
research. The present study was designed to address some of the central issues to
contribute to a better understanding of PTG. In addition, the present study improved on
some of the shortcomings of previous research.
The present study built on the Zoellner, et al. (2008) study by testing the Janus
Face model through examining facets representing the illusory and constructive
components of PTG. The illusory component was measured by the constructs of
optimism, self-deception, and locus of control. The constructive components were
addressed by measuring capacity to love, resourcefulness, and wisdom. These six
constructs were chosen in order to capture the illusory and constructive facets under
study, and because they are well-researched personality domains. This represents a
revision and expansion of the constructs used in the only previously published study
identified in which the Janus model was investigated.
The following hypotheses are proposed:
1) Level of event-related psychological distress, conceptualized as PTSD symptoms (as
measured by the Purdue Posttraumatic Stress Disorder Scale-Revised) will contribute to
32
the prediction of scores on the illusory and constructive scales (using six scales drawn
from the International Personality Item Pool).
1a: Specifically, the illusory (optimism, locus of control, and self deception)
scales will be positively related to higher levels of PTSD-related distress.
1b: The constructive scales (capacity for love, resourcefulness, and wisdom) will
be negatively related to lower levels of distress.
2) There will be a positive relationship between PTG, as measured by the Stress-Related
Growth Scale-Revised, and trauma severity. Trauma severity is conceptualized here as
being related to two constructs. First, whether the person reported having perceived a
threat to their physical safety at the time of the event. Second, the number of potentially
traumatic events that the individual reported having experienced.
3) PTG levels will be positively correlated with both the illusory and constructive scale
scores.
Exploratory Research Questions
1) The relationship between reported event- related distress (as measured by the Purdue
Posttraumatic Stress Scale- Revised), trauma severity (as measured by the number of
reported potential traumatic events and the reported number of times that the participant
was in physical danger during such an event), and the reported time that has elapsed since
the focal trauma event will be explored.
2) The relationship between posttraumatic growth (as measured by full scale scores on
the Stress-Related Growth Scale-Revised), trauma severity (as measured by the number
of reported potential traumatic events and the reported number of times that the
participant was in physical danger during such an event), and the constructive constructs
33
(as measured by the Capacity For Love, Resourcefulness, and Wisdom scales) will also
examined.
3) Finally, the relationship between the Posttraumatic Growth subscales (as measured by
the Changes To Self, Changes To Relationships With Others, Changes To Perspective On
Life, and Changes in Religiosity subscales of the Stress-Related Growth Scale- Revised),
and the constructive constructs (as measured by the Capacity For Love, Resourcefulness,
and Wisdom scales) will be investigated.
34
Chapter 3
Method
Participants
One hundred twenty six undergraduate students (55% women and 45% men,
mean age 19.7 years) volunteered to participate in the study. Participants were recruited
through the University of Toledo psychology participant pool system. The system is webbased and students are able to review the various research opportunities available and
sign up for studies of their choice. Approval was obtained from the Institutional Review
Board (IRB) at the University of Toledo prior to posting the study for students to sign up
The participants were undergraduate students who received course credit for their
participation in the study. The students are given the option of earning the credit in an
alternate manner if they choose to not participate in a study. Of the 127 participants that
signed up for the study only one did not participate. All the data was collected in the
University of Toledo psychology department during the month of April 2009. See
Appendix A for the consent form.
Researcher
The researcher was a 41-year-old male, fourth-year graduate student in a clinical
psychology doctoral program. All research sessions were run by the researcher and all
data was secured by him exclusively. The researcher had training and experience in
research methods and clinical issues.
35
Procedure
The research sessions were posted on the subject pool website and interested
participants signed up for a time slot of their choosing. The description of the study
indicated that it included questions about traumatic events and/or life struggles they may
have endured and how it impacted them. It was anticipated that participants would be
able to finish the study in an hour or less. Five participants were scheduled for each
session at half hour increments. Since participants sometimes took longer than thirty
minutes to complete the study, there was some overlap between sessions. However, this
did not lead to any difficulties with the procedures or data collection.
Once a participant arrived they were given a consent form. The researcher gave
them a brief description of the form and asked if they had any questions or concerns.
Once the participant signed the form (no participants declined to sign) they were given
the first section of the study, which included a brief demographic section (consisting of
age, gender, ethnicity, and marital status) and a modified version of the Trauma Events
Interview (TEI), a trauma screener that was designed to determine if they reported having
experienced any potentially traumatic events. See Appendix G for the complete protocol.
These events were considered to be possible common sources of traumatic responses, but
certainly not in all people. After completing the second section of the protocol they
turned it into the researcher, who reviewed it. Based on past research, it was expected that
the majority of participants would report some type of potentially traumatic event.
However, if they did not report any such events, they were given a debriefing form and
told that their participation in the study was complete. The reasoning for this procedure
was that if no potentially traumatic events were reported, including the item that allows
36
the respondent to list an event that was not present on the list, then proceeding further
with the growth items was deemed unnecessary. In the present study, 85% of the
participants endorsed at least one potentially traumatic event. A total of 18 participants
(15%) were excluded after the second part of the study.
If the participant did endorse a potentially traumatic event they were given the
second section that contained the other measures in the protocol. These consisted of a
trauma symptom measure (PPTS-R) intended to capture distress related to the reported
event, the 43-item Stress-Related Growth Scale-Revised (SRGS-R) and a 68-item
measure culled from the International Personality Item Pool (IPIP) that examines the six
constructs of optimism, locus of control, self-deception, resourcefulness, wisdom, and
capacity to love. After turning the measures into the researcher, the participants were
asked if they had any questions and were given a debriefing information sheet. See
Appendix B for the debriefing sheet. The information sheet provided information about
common questions about and reactions to traumatic events. The researcher stressed to
each participant to contact him via provided contact information if they had any questions
or concerns after leaving the study. No participants contacted the researcher.
It was not anticipated that any participant would have a severe adverse reaction to
taking part in the study, but these precautions were put in placed to provide reasonable
assistance if such a situation arose.
The confidentiality of the participant and their data was of the utmost concern. In
order to maintain confidentiality, all data was collected and analyzed using a number
code assigned by the researcher. The number code was not associated with the
participant’s name and the consent forms were filed separately from any data. The paper
37
data was secured by the researcher in a University psychology department office. The
analysis of the data took place on a secure computer and the researcher was the only
person with access to that data.
Measures
Demographic questions were included in the first section. All measures were
administered in paper and pencil form. The demographic section requested the
participant’s age, gender, ethnic affiliation, and marital status.
Traumatic Events Interview (TEI). The Trauma Screener used the first 13 items of the
Traumatic Events Interview (TEI) (Sprang, 1997). These items are part of an interviewbased measure that has been adapted to written form for the purpose of this study. See
Appendix C for the original scale and Appendix G for the revised version included in the
complete protocol. Participants are asked if they have experienced various potentially
traumatic events, such as a natural disaster or a life-threatening illness. The participant
responds using a scale from 0 = no, 1 = witnessed, 2 = experienced, 3 = confronted with,
4 = some combination of 1, 2, and / or 3. Then, the participant is asked to list how many
times the event happened. Next, they are asked, ―
how old were you at the time of the
worst incident?‖ The structure of the TEI was slightly modified by the researcher in order
to increase face validity with the population under study. It was projected that these
changes would not negatively impact the construct validity of the measure. Specifically,
the TEI previously contained an item asking if the respondent experienced fear, horror, or
helplessness during the event. This item is based on DSM-IV diagnostic criteria and is
addressed in this study by the PPTS-R measure. For the present study the item was
deemed redundant and removed.
38
In order to measure trauma severity, an item was added that asked the respondent,
―
During the worst incident, were you in physical danger of injury or death? The
respondents are asked to respond yes or no. A response of yes contributed to a positive
score on the item. The participant’s scores on the item were summed with the number of
potentially traumatic events that the participant reported to arrive at a trauma severity
scale score. Higher scores are indicative of greater trauma severity.
Purdue PTSD Scale-Revised (PPTS-R). The Purdue PTSD Scale-Revised (PPTS-R)
was used to measure the participants’ PTSD symptoms. See Appendix D for the complete
measure. The PPTS-R (Lauterbach & Vrana, 1996) is a17 item self-report measure that
reflect the symptoms within the DSM-IV PTSD criteria B, C, and D. Most participants
were able to complete the measure in 10 minutes or less. At the beginning of the measure
the participant is asked to identify the most traumatic and/or stressful event they have
ever experienced and to complete the PPTS-R in relation to that identified event.
Participants were also instructed to rate the frequency of symptoms within the previous
month for each item. The response format is a Likert scale that ranges from 1 (not at all)
to 5 (often). The PPTS-R has been shown to have good psychometric properties; total (a
= .91), reexperiencing (a = .84), avoidance (a = .79), and hyperarousal (a = .81).
Stress-Related Growth Scale-Revised (SRGS-R). The Stress-Related Growth ScaleRevised (SRGS-R) was administered to measure posttraumatic growth. See Appendix E
for the complete scale. In its original form all the items were positively worded. The
measure was revised by Armeli, Gunthert, and Cohen (2001) in order for participants to
be able to report both negative and positive change related to trauma events. By using this
measure it was possible to obtain less restricted and more nuanced data from the sample.
39
The revised version contains 43 items that the participant is instructed to answer in
relation to a trauma event, such as ―M
y belief in how strong I am.‖ The response format
is a Likert scale that ranges from 1 = greatly decreased to 7 = greatly increased. In
comparison to the PTGI, which has tended to yield a one-dimensional growth score in
factor analyses, the authors reported that the SRGS-R resulted in seven distinct domains.
These domains consist of treatment of others, religiousness, personal strength,
belongingness, affect-regulation, self-understanding, and optimism. The authors reported
that the revised scale had acceptable psychometric properties, with internal consistency
scores ranging from .67 to .90.
Illusory and Constructive dimensions. The constructs representing the illusory (selfdeception, optimism, and locus of control) and constructive (capacity to love,
resourcefulness, and wisdom) dimensions were measured using individual scales from
the International Personality Item Pool (Goldberg, 1999). The International Personality
Item Pool (IPIP) is a freely available web-based test bank that was developed to provide
no-cost personality measures for researchers. The impetus for the IPIP was the
proliferation of proprietary research measures, such as the NEO-PI-R, that charge fees
and are generally restrictive in their research use even when one purchases access to the
measures. Researchers involved in the IPIP project have developed comparable versions
of proprietary measures that have good psychometric properties with the following
internal consistency scores; self-deception (a = .80), optimism (a = .86), locus of control
(a = 86), capacity to love (a = .70), resourcefulness (a = .83), and wisdom (a = .75). See
Appendix I for the IPIP complete items that were used. The self-deception scale consists
of 10 items (five positively worded and five negatively worded), the optimism scale
40
consists of 10 items (four positively worded and six negatively worded), the locus of
control scale consists of 20 items (ten positively worded and ten negatively worded), the
capacity to love consists of 9 items (six positively worded and three negatively worded),
the resourcefulness scale consists of 10 items (five positively worded and five negatively
worded), and the wisdom scale consists of 9 items (six positively worded and three
negatively worded). A PsycINFO search in September of 2008 showed that the IPIP had
been used as a measure in a total of 138 published studies since 2001. This included 132
peer-reviewed articles, five dissertations, and one book chapter.
41
Chapter Four
Results
Participants
The participants (N = 126) represented a largely homogeneous sample, with
limited diversity in age, race, and marital status. Age ranged from 18 to 42 years. Gender
favored females slightly (70 females and 56 males, mean age = 19.7), and the sample was
overwhelmingly European American(85.7%), though other groups were represented to
some degree (African-American = 5.6%, Asian = 4.8%, Biracial = 1.6%, Other = 1.6, and
Hispanic = .8%). The sample was also almost entirely single and never married (96.8%).
The sample that endorsed at least one potentially trauma event represented 85%
(n= 108) of the population and was, not surprisingly, very similar in makeup. The trauma
sample was slightly more even in gender (57 female and 51 male) and the ages ranged
from 18 to 42 (mean age = 19.65). The trauma sample was again overwhelmingly EA
(86.1%), with other groups represented to some degree (African-American = 6.5%, Asian
= 3.7%, Biracial = 1.9%, Other = .9, and Hispanic = .9%). The trauma sample was again
also almost entirely single and never married (97.2%).
Preliminary Analyses
SPSS version 17 was used in the analysis. Once entered into a data base, measures
of central tendency were calculated for the variables. Bivariate correlations and a series
of regression analyses were then completed.
42
Total Scores
Stress-Related Growth Scale-Revised. Posttraumatic growth was measured using the
Stress Related Growth Scale- Revised (SSRGS-R). Total scale scores were computed by
summing all 43 items together. See Table 2 for the item means and standard deviations.
In their revision of the original SSRGS Armeli et al (2001) reported that a seven factor
solution was preferable to viewing the measure as a unitary construct. These seven
domains consisted of treatment of others, religiousness, personal strength,
belongingness, affect-regulation, self-understanding, and optimism. Theirs is the only
published study addressing the psychometric properties of the revised version. However,
in the present study, some of these domains did not show acceptable internal consistency.
In particular, the Treatment of Others scale was particularly weak (a = .411). The other
scales ranged from moderate to high internal consistency; religiousness (a = .89),
personal strength (a =.69), belongingness (a = .60), affect-regulation (a = .69), selfunderstanding (a = .68), and optimism (a = .82). The full 43-item scale showed high
internal consistency (a = .92).
Next, scales were developed to mirror the primary theorized posttraumatic growth
subcategories of changed sense of relationship with others, changed sense of self (feeling
more vulnerable, yet stronger), and changes in life philosophy. These scales were
analyzed and found to have high internal consistency (relationship with others (11 items,
a = .86), sense of self (14 items, a = .84) and life philosophy (12 items, a = .81). The life
philosophy scale had one problematic item (―
Not taking things for granted‖) and by
deleting the item the consistency of the scale went from .68 to .81. No other items were
deleted.
43
However, a fourth scale with four items reflecting religious content was also
developed and showed the highest internal consistency (a = .91). The inter-item
correlations for the scales were as follows; relationship with others (.11 to .64), sense of
self (-.01 to .54), life philosophy (-.04 to .70), and religiosity (.63 to .90). Based on the
acceptable psychometric properties of these newly developed scales they were used,
along with the total score, as the measures of growth. See Table 2 for the newly
developed subscales, which are noted in superscript. See Table 3 for the subscale means
and standard deviations.
Table 2
Item Means for SRGS-R: Full Scale
________________________________________________________________
Item
M
SD
________________________________________________________________
1. My belief in how strong I am. a
1.06
2. Acceptance of others. b
1.34
.70
1.27
3. Respect for others feelings and beliefs. b
1.28
1.32
4. Treating others nicely. b
1.14
1.18
5. My satisfaction with life. c
.71
1.47
6. Looking at things in a positive way. c
.88
1.41
7. Faith in God. d
.69
1.75
8. Taking responsibility for what I do. a
1.14
1.13
9. Not taking things for granted. e
2.19
4.33
10. Trust in God. d
.80
1.71
11. Ability to make my own decisions. a
.85
1.15
1.12
1.19
.85
1.67
12. Feeling that I have something of value to teach
others about life. a
13. Understanding of how God allows things to happen. d
44
14. Appreciation of the strength of others who have
had a difficult life. c
1.71
1.05
15. Not ―
freaking out‖ when a bad thing happens. a
.41
1.26
16. Thinking about the consequences of my actions. a
.94
1.06
17. Not getting angry about things. c
.21
1.23
18. Being optimistic. c
.59
1.29
19. Approaching life calmly. c
.80
1.22
1.01
1.24
.79
1.24
22. Taking life seriously. c
1.31
1.35
23. Working through problems and not just giving up. a
1.22
1.27
.72
1.27
25. Not taking my physical health for granted. c
1.26
1.31
26. Listening more carefully when others talk to me. b
1.13
1.24
27. Reaching out to help others. b
1.40
1.24
28. Openness to new information and ideas. c
1.06
1.23
29. Communicating more honestly with others. b
1.05
1.19
.56
1.33
1.01
1.34
32. Not letting little things upset me. c
.48
1.45
33. Standing up for my personal rights. a
.94
1.15
1.63
1.10
1.20
1.50
36. My sense of belonging. b
.65
1.15
37. Feeling as if I am part of a community. b
.56
1.27
38. My belief in a supreme being. d
.60
1.41
39. Ability to deal with hassles. a
.90
1.09
40. The meaning in my life. c
.94
1.35
20. Being myself and not what others want me to be. a
21. Accepting myself as less than perfect. a
24. Confidence in myself. a
30. Ability to deal with uncertainty. a
31. Feeling that it’s okay to ask others for help. b
34. My understanding that there are many people
who care about me. b
35. My understanding that there is a reason for everything.
45
c
41. The meaningfulness of a prior relationship
with another person. b
1.14
1.67
42. Ability to express my feelings. a
.68
1.58
43. Feeling as if I have a lot to offer other people. b
.82
1.26
___________________________________________________________________
Note. a = Changes in Sense of Self, b = Relationships with Others, c = Changes in Life Philosophy, d =
Changes in Religiosity, e = Item Deleted From Life Scale
Table 3
Stress-Related Growth Scale-Revised: Scale Scores for Overall Sample
__________________________________________________________________
M
Subscale
SD
__________________________________________________________________
Changes in Sense of Self
12.34
10.08
Changes in Relationships with Others
12.49
9.94
Changes in Life Philosophy
13.35
10.50
2.92
5.86
41.11
31.04
Changes in Religiosity
Total Scale
__________________________________________________________________
As stated earlier, Armeli (2009) views the SSRGS-R as a continuous measure and
there are no established cutoffs for growth. This is consistent with other PTG-related
measures. For the purposes of analysis, item responses were recoded to reflect either
decreases, no change, or increases in growth areas. The recoded responses ranged from -3
to +3, with higher scores indicating positive growth. A score of zero reflected neither an
increase or decrease in growth. The highest score possible on the SRGRS-R is +/- 129.
See Table 2 for overall means and standard deviations of the scales.
46
Overall, participants reported small to large amounts of growth on the individual
items, ranging from a low of .21 (―
Not getting angry about things‖) to a high of 2.19
(―
Not taking things for granted‖). The scores indicated a wide variation in the reported
growth. The scales also reflect small to large amounts of reported growth with large
standard deviations, suggesting that there was considerable variability in how participants
responded to items. See Appendix H for Stress-Related Growth Scale-Revised Scale
Scores by Trauma Event.
International Personality Item Pool
The illusory and constructive constructs were measured by three scales each. The
illusory scales consisted of optimism (10 items), self deception (10 items), and locus of
control (20 items). The constructive scales were resourcefulness (10 items), capacity for
love (9 items), and wisdom (9 items). Reliability analysis for the present study indicated
generally good internal consistency; optimism (a = .86), self deception (a = .78), and
locus of control (.83), resourcefulness (a = .87), capacity for love (a = .71), and wisdom
(a = .60). All six scale items were randomly placed in one full measure. A total of 28
items were reverse scored. There were six items that loaded on more than one scale. The
scale was designed to include 59 items, however, item 26 (―
I see difficulties
everywhere‖) was repeated as number 43 in error. This unintentional validity measure
indicated close agreement on the two measures (item 26 mean = 3.00 item 43 mean 2.88).
A score of 3 indicated that the item was‖ neither accurate or inaccurate‖ and any score
over 3 reflected a positive contribution to the scale total. As previously noted, these
scales were developed and made freely available online as part of the International
Personality Item Pool. See Table 4 for item content, means and standard deviations.
47
Table 4
International Personality Item Pool Item Scores
______________________________________________________________________
Item
M
SD
______________________________________________________________________
1) I feel comfortable with myself. a,b,c
3.89
1.01
2) I know that my decisions are correct. b
3.47
.94
3) I panic easily (R). d
3.38
1.33
4) I make a decision and move on. c
3.19
1.11
5) I am less capable than most people (R). c
4.30
.84
6) I am not always honest with myself (R). b
3.14
1.23
7) I am good at many things. d
4.06
.77
8) I believe that my success depends on
ability rather than luck. c
4.30
.77
9) I complete tasks successfully. d
4.14
.75
10) I worry about what people think of me (R). b
2.79
1.28
11) I always know why I do things. b
2.99
1.04
12) I can express love to someone else. e
4.21
1.47
3.69
1.21
14) I act comfortably with others. c
3.92
.95
15) I am rarely consulted for advice by others (R). f
3.95
1.00
16) I am willing to take risks to establish a relationship. e
3.78
1.13
17) I formulate ideas clearly. d
3.75
.86
3.59
1.11
13) I feel that my life lacks direction (R).
a,c
18) I like to take responsibility for making decisions.
48
b,c
Table 4 (continued)
International Personality Item Pool Item Scores
______________________________________________________________________
Item
M
SD
______________________________________________________________________
19) I know that I will be a success. a.b,c
4.19
.89
20) I am easily discouraged (R). d
3.44
1.25
21) I am not good at figuring out what
really matters (R). f
22) I believe some people are born lucky (R). c
3.40
1.13
2.84
1.23
23) I often feel depressed (R). a
3.52
1.29
24) I have difficulty accepting love from anyone (R). e
3.96
1.15
25) I have an excellent view of the world. f
3.38
.95
26) I see difficulties everywhere (R). a,c
3.00
1.09
27) I face problems directly. d
3.58
.95
28) I know that some others accept my shortcomings.
3.58
.81
29) I love life. c
4.24
.94
30) I consider myself to be a wise person. f
4.03
.74
31) I come up with good solutions. c
4.05
.74
32) I am the most important person in
someone else’s life. e
33) I have a low opinion of myself (R). b
3.80
1.25
3.74
1.21
34) I sometimes have trouble making up my mind (R). b
2.22
1.05
35) I take the initiative. c
3.50
.97
36) I feel up to any task. c
3.45
.96
37) I feel isolated from other people (R). e
3.57
1.22
38) I feel that I am unable to handle things (R). c
3.94
.97
39) I believe that unfortunate events occur
due to bad luck (R). c
3.87
1.15
49
Table 4 (Continued)
International Personality Item Pool Item Scores
______________________________________________________________________
Item
M
SD
______________________________________________________________________
40) I know that there are people in my life
who care as much for me as for themselves. e
41) I can’t make up my mind(R). d
4.46
1.27
2.94
1.22
42) I have a broad outlook on what is going on. f
3.69
.75
43) I see difficulties everywhere (R). a,c
2.88
1. 10
44) I am easily intimidated (R). d
3.51
1.19
45) I lose sight of what is important in life (R). f
3.90
1.03
46) I believe that the world is controlled
by a few powerful people (R). c
47) I know someone who I really care
about as a person. e
48) I am considered to be a wise person. f
3.34
1.26
4.63
.81
3.84
.73
49) I constantly blow my chances (R). c
3.47
1.08
50) I do not easily share my feelings
with others (R). e
51) I dislike myself (R). a,b,c
3.06
1.29
4.32
.98
52) I have a dark outlook on the future (R). a
4.07
1.10
53) I have been described as wise
beyond my years. f
54) I can handle complex problems. d
3.45
1.06
3.79
.86
3.14
1.37
55) I seldom feel depressed.
a
56) I dislike taking responsibility for
making decisions (R). c
57) I have a mature view on life. f
3.50
1.11
4.21
.74
58) I look at the bright side of life. a
4.02
.98
59) I wait for others to lead the way (R). d
3.34
1.09
60) I am often in a bad mood (R). a
3.85
1.10
_______________________________________________________________________
Note. a = optimism, b = self deception, c = total locus of control, d = resourcefulness, e = capacity for
love, f = wisdom, R = Reverse Coded.
50
In general, participants responded in a positive manner to the items, in the sense that most
of the mean responses asserted a positive view of themselves. This response style
suggests an overall positive skew in the sample toward the items. The item means ranged
from 2.22 (―
I sometimes have trouble making up my mind‖) to 4.63 (―
I know someone
who I really care about as a person‖). See Table 5 for the scale means and standard
deviations.
Table 5
The International Personality item Pool Scale Scores
_______________________________________________________________
Scale
M
SD
_______________________________________________________________
Illusory Scales:
Optimism
37.56
7.55
Total Locus of Control
74.53
10.12
Self Deception
34.35
6.31
Resourcefulness
35.90
6.47
Capacity for Love
35.05
5.85
Wisdom
33.76
4.10
Constructive Scales:
_______________________________________________________________
The scale scores also illustrate the positive skew of the responses. It is notable that the
standard deviations for the IPIP scales are far below those of the SSRGS-R scale. See
appendix I for International Personality Item Pool Scale Scores by Focal Event Type,
which is the main trauma event reported by the participant.
51
Bivariate Correlations
Pearson’s correlations were calculated for all the scales and demographic
variables in the data set. See Table 6 for bivariate correlations of major study variables.
There was a significant positive correlation between age and trauma severity (.23, p <
.05.), suggesting that the older a participant was, the more likely they were to have
experienced an event in which they were in physical danger.
Table 6
Bivariate Correlations Between Major Study Variables
_______________________________________________________________________
Measure
1
2
3
4
5
6
7
8
9
10
_______________________________________________________________________
1. PPTS-R
2. PTG
3. Opt.
4. Self
---
-.08
-.34** -.24** -.22* -.24* -.09
-.11
.18
.23**
---
.24*
.16
.30**
.05
.05
---
.69** .79** .48** .50** .57** -.16
.08
---
.26** .45** .02
5. TLC
6. Cap.
.79** .29** .69** .61**
.04
-.09
---
.04
-.02
.14
.34** -.03
-.00
---
.58**
.10
.01
---
.09
.04
---
.15
.46** .71** .65**
---
7. Res.
8. Wis.
9. Sev.
10. Time
--________________________________________________________________________
Note. PPTS-R = Purdue Posttraumatic Stress Scale-Revised total score, PTG = StressRelated Growth Scale-Revised total score, Opt. = Optimism scale score, Self = Self
Deception scale score, TLC = Total Locus of Control scale score, Cap. = Capacity for
Love scale score, Res. = Resourcefulness scale score, Wis. = Wisdom scale score, Sev. =
Trauma Severity scale score, Time = Time elapsed since trauma event
* p < .05. ** p < .01.
52
In terms of gender, males reported a significantly (z = -24, p < .05.) longer period
of elapsed time since their trauma event than females (the mean for males was 6.06 years
(SD = 6.02) and the mean for females was 3.54 (SD = 3.73). Males also scored higher
(.26, p < .05.) on the IPIP resourcefulness scale (the mean for males was 37.72 (SD =
6.11) and the mean for females was 34.28 (SD = 6.40).
Correlations suggest that distress was not related to PTG scores but was positively
correlated (.23, p < .05.) with time elapsed since trauma. This suggests that the younger a
person was when they experienced their trauma event, the more they are currently
distressed by it. In relation to this finding, distress was also highly positively correlated
(.64, p < .01.) with trauma severity, indicating that the younger a person was when their
event occurred the more likely they were to be in physical danger.
The posttraumatic growth scales were not significantly related to distress but were
significantly positively correlated with the IPIP scales of optimism, total locus of control,
capacity for love, and wisdom. Interestingly, PTG was not significantly correlated with
resourcefulness, suggesting that the resourcefulness scale is measuring something less
related to PTG than the other IPIP scales.
The International Personality Item Pool scales of optimism (-.33, p < .01.), total
locus of control (-.21, p < .05.), self deception (-.22, p < .05.), and capacity for love
(-.23, p < .05.) were significantly negatively correlated with distress. This suggests that as
participant’s reported more distress, they were less likely to endorse feeling positive
about the future and their ability to control the outcomes of events in their life. However,
in the case of the capacity for love scale, they were also less likely to report feeling a
capacity for developing, maintaining, and enjoying loving relationships.
53
Rates By Reported Trauma
Trauma Events Inventory. On the TEI, participants reported experiencing a wide
range of potentially traumatic events. Participants generally reported experiencing more
than one potentially traumatic event (M = 2.26, SD = 1.43) with a range of 1 to7
endorsed. See Table 7 for the TEI items and response rates.
When asked whether they have experienced any other traumatic event that was
not listed, 16% replied that they had. Of those that endorsed the item, 20% reported that
they were in danger during the event. When asked how many times they experienced an
event of this type, the responses ranged from 1 to 3, with 73.7% reporting one such
incident (mean age at time of incident = 13.56) The events listed consisted of (in
participants own words) death of four family members in one year, parent’s divorce,
house fire, best friend’s abortion, house hit by lightning, boyfriend’s suicide attempt,
family member’s cancer, having to physically stop a suicide, witnessing a serious car
accident, mother’s death from cancer, brother’s open heart surgery, witnessing friend
being hit by car, family car catching fire (no one inside), mother’s death, machine falling
on father, brother fell down steps, and grandfather died in front of participant.
54
Table 7
Response Rates for Potentially Trauma Events on the Traumatic Events Inventory (TEI)
______________________________________________________________________
Type of Potential Trauma Event
Percentage of Endorsement Mean Age
______________________________________________________________________
Natural Disaster
41%
19.73
Serious Accident/Injury
32%
20.03
Sudden Life Threatening Illness
10%
19.58
Combat Exposure/War Zone
.8%
22.00
Accidental Death/Murder of other
22%
20.37
Suicide of other
27%
20.47
Attacked/Witnessed Attack (no weapon)
10%
21.75
Attacked/Witnessed Attack (with weapon)
10%
21.83
As Child Beaten/Witnessed Family Violence
17%
19.76
7%
22.76
11%
22.07
6%
19.63
16%
19.55
Before Age 13, coerced sexual activity
Unwanted Sexual Contact (no force)
Unwanted Sexual Contact (with force)
Other Trauma Event
_____________________________________________________________________
The participants who endorsed at least one trauma were asked to report the most
traumatic and/or stressful life event they have ever experienced. They were instructed to
complete the PPTS-R and the SRGS-R items in relation to the focal event they specified.
Participants reported a wide range of events, encompassing 30 different categories. See
55
Table 8 for a complete listing in ascending order of response (Note: When more than one
event has the same number of responses, they are in alphabetical order). In general, the
death of someone close to them emerged as the most common event listed. However,
there were 12 traumatic events that only one person reported. There was also a wide
variation in the reported amount of time (M = 4.71 years, SD = 5.07 years) since the focal
event occurred, with responses ranging from 0 years (indicating that the event occurred in
the past 12 months) to 35 years.
Table 8
Reported Focal Trauma Events
_________________________________________________________________
Event Type
Number of Participants Reporting
_________________________________________________________________
Death of Grandparent
16
Death of Friend
15
Car Accident
11
Sexual Assault/Molestation
7
Death of Other Family Member
5
Parent’s Divorce
5
Serious Illness of Loved One
5
Other Serious Accident
4
Physical Abuse
4
Serious Illness of Self
4
Incarceration of Parent
3
56
Table 8 (continued)
Reported Focal Trauma Events
_________________________________________________________________
Event Type
Number of Participants Reporting
_________________________________________________________________
Assault
2
Flood
2
Suicide Attempt of Loved One
2
Witnessed Domestic Violence
2
Witnessed Serious Accident (non-relation)
2
Witnessed Violence
2
Best Friend’s Abortion
1
Combat
Death of Sibling
Eating Disorder
Hospitalization for Depression
House Fire
Lengthy Separation from Family
Period of Loneliness and Fear
Pet Died
Robbery
Witnessed Serious Accident (relation)
____________________________________________________________
Note. n = 108.
Trauma severity was measured by summing the number of events on the TEI that the
participant reported as being a threat to their physical safety (involving possible injury or
death) and the number of potentially traumatic events the participant endorsed. Results
indicated that on average participants reported slightly less than one (M = .71, SD = 1.09)
event in which they were in physical harm or received an injury. The responses ranged
57
from 0 to 7. Participants endorsed experiencing slightly more than two potentially
traumatic events (M = 2.26, SD = 1.43)
Purdue Posttraumatic Stress Disorder Scale-Revised. The Purdue PTSD Scale
(PPTS-R) was used to measure distress related to the focal trauma event. Analysis
indicated that the internal reliability of the measure was good (a =.88). In general,
distress scores across the sample were low to moderate. See Table 9 for item means and
standard deviations. The original scale was recoded for analysis so that a score of zero on
an item meant no distress at all. Consequently, the recoded scale is as follows; 0 = Not at
all, 1 = Rarely, 2 = Sometimes, 3 = Regularly, and 4 = Often. Higher scores indicate
more distress. The item means ranged from .31 (―
Have you lost interest in or more of
your usual activities since the event?) to 1.45 (―
Did you feel very upset when something
happened to remind you of the event?‖). Total scores for each participant were obtained
by summing each score together.
Table 9
Item Means on the Purdue Posttraumatic Stress Scale--Revised
_____________________________________________________________________
M
SD
Item
______________________________________________________________________
1) Were you been bothered by memories or thoughts of the
even when you didn’t want to think about it?
.95
1.20
2) Have you dreamed about the event?
.57
.86
3) Have you suddenly felt as if you were experiencing the
event again?
.50
.92
4) Did you feel very upset when something happened to
remind you of the event?
1.45
1.43
5) Did you avoid activities or situations that might remind
you of the event?
1.11
1.42
58
Table 9 (cont.)
Item Means on the Purdue Posttraumatic Stress Scale--Revised
_____________________________________________________________________
Item
M
SD
______________________________________________________________________
6) Did you avoid thoughts or feelings about the event?
1.22
1.37
7) Did you have difficulty remembering important
aspects of the event?
.40
.93
8) Did you react physically (heart racing, breaking
out in a sweat) to things that reminded
you of the event?
.51
.97
9) Have you lost interest in one or more of your
usual activities (examples: work, hobbies, entertainment)?
.31
.79
10) Have you felt unusually distant or cut off from people?
.44
.93
11) Have you felt emotionally ―
numb‖ or unable to
respond to things emotionally the way you used to?
.59
1.03
12) Have you been less optimistic about the future?
.46
1.00
.52
1.13
.60
1.09
15) Have you had more trouble concentrating?
.43
.88
16) Have you found yourself watchful or on guard,
even when there was no reason to be?
.72
1.15
17) Are you jumpy or easily startled by noises?
.72
1.22
Since the event……….
13) Have you had more trouble sleeping?
14) Have you been more irritable or angry?
_______________________________________________________________________
Note. n = 108.
59
With some trauma groups encompassing only one participant, it is difficult to make
comparisons between them. However, it is worth noting that those reporting a flood as
their focal event (n = 2) reported the lowest amount of distress (M = .51), while the
participants that listed suicide attempt of a loved one (n = 2) reported the highest distress
(M = 37.50). Across the sample, the mean was 11.51 and the standard deviation was
10.88. The maximum score on the PPTS-R is 68. The range of distress scores was 55
with a low of 0 and a high of 55. Given the large standard deviations of PPTS-R scores,
median scores were reported, as the median full scale score was 9.00 and the item scores
indicated that the median for 13 of the 17 items was zero. This indicates that a subset of
higher scores on the PPTS-R was significantly raising the mean scores. See Appendix J
for PPTS-R Scores by focal trauma events.
Primary Analysis
A regression analysis was planned to investigate whether distress scores on the
PPTS-R would contribute to the prediction of scores on the illusory and constructive IPIP
scales. Specifically, a linear relationship was predicted. It was projected that distress
scores would increase as the illusory scale scores increased. It was also predicted that as
distress scores increased the constructive scores would decrease. Correlational analysis
indicated that this relationship as predicted did not exist in this sample. Consequently, the
planned regression analysis was not completed.
A series of regression analyses was carried out to examine various other predictor
models. All regressions were linear analyses and a level of .05 was used for entry and .10
was put in place for removal from the model.
60
Table 10 shows the results of a regression examining PPTS-R distress scores and
trauma severity as predictors of time elapsed since trauma event. Analysis indicated that
the model had small predictive properties, accounting for 17% of the variance in the time
elapsed since the trauma event (F = 10.84, p < .01).
Table 10
Predictors of Time Elapsed Since Trauma Event
___________________________________________________________________
Time Elapsed Since Trauma Event
________________________________
Predictor
Δ R2
β
____________________________________________________________________
Step 1
PPTS-R Distress Score
.05*
Step 2
PPTS-R Distress Score
Trauma Severity
.12**
Total R2
.17**
-.23*
-.31**
.35**
n
106
_____________________________________________________________________
Note. * p < .05. ** p < .01.
A second regression analysis was conducted investigating age at the time of the
trauma event and trauma severity as predictors of distress scores on the PPTS-R. See
Table 11 for the results. The results indicated that the model had small predictive
qualities, accounting for 17% of the variance in the time elapsed since the trauma event
(F = 11.08, p < .01).
A third regression analysis was conducted examining the three IPIP constructive
scales (capacity for love, resourcefulness, and wisdom) and trauma severity as predictors
61
of full scale PTG scores on the SSRGS-R. See Table 12 for the results. The analysis
indicated that the model had moderate predictive qualities, accounting for 26% of the
variance in the PTG scores (F = 9.07, p < .01).
Table 11
Predictors of Purdue Posttraumatic Stress Disorder Scale-Revised Distress Scores
___________________________________________________________________
Purdue Posttraumatic Stress Disorder Scale-Revised Distress Scores
_______________________________________________________
Predictor
Δ R2
β
____________________________________________________________________
Step 1
Trauma Severity
.06*
Step 2
Trauma Severity
Age At Time of Event
.12**
Total R2
.18**
.24*
.27**
.34**
n
106
_____________________________________________________________________
Note. * p < .05. ** p < .01.
62
Table 12
Predictors of Full Scale Stress-Related Growth Scale-Revised Scores
___________________________________________________________________
Full Scale Stress-Related Growth Scale-Revised Scores
____________________________________________
Predictor
Δ R2
β
____________________________________________________________________
Step 1
Trauma Severity
.01
Step 2
Trauma Severity
Capacity For Love
.22**
Step 3
Trauma Severity
Capacity For Love
Resourcefulness
.00
Step 4
Trauma Severity
Capacity For Love
Resourcefulness
Wisdom
.04*
Total R2
.18**
.08
.06**
.46**
.06
.47
-.04
.06*
.40*
-.18*
.24*
n
107
_____________________________________________________________________
Note. * p < .05. ** p < .01.
Three separate regression analyses were conducted investigating the four SSRGSR subscales (changes to self, changes in relationships with others, changes in philosophy
of life, and changes in religiosity) as predictors of scores on the IPIP constructive scales
(capacity for love, resourcefulness, and wisdom). See Tables 13, 14 and 15 for the
results. The analysis indicated that the models had small to moderate predictive qualities,
accounting for 31% of the variance in the capacity for love scores (F = 11.43, p < .01),
63
12% of the variance in the resourcefulness scores (F = 3.80, p < .01), and 16% of the
variance in the wisdom scores (F = 5.00, p < .01).
Table 13
Predictors of Capacity For Love Scale Scores
___________________________________________________________________
Capacity For Love Scale Scores
_______________________________
Predictor
Δ R2
β
____________________________________________________________________
Step 1
SRGS-R: Self
.12**
Step 2
SRGS-R: Self
SRGS-R: Others
.19**
Step 3
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
.00
Step 4
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
SRGS-R: Religion
.00
Total R2
.31**
.34**
-.11
.62
-.12
.62
.02
-.12
.58
.00
.08
n
107
_____________________________________________________________________
Note. ** p < .01.
64
Table 14
Predictors of Resourcefulness Scale Scores
___________________________________________________________________
Resourcefulness Scale Scores
_______________________________
Predictor
β
Δ R2
____________________________________________________________________
Step 1
SRGS-R: Self
.02
Step 2
SRGS-R: Self
SRGS-R: Others
.10**
Step 3
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
.00
Step 4
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
SRGS-R: Religion
.00
Total R2
.12**
.15
.48**
-.46**
.46
.47
.04
.46
-.45
.05
-.06
107
n
_____________________________________________________________________
Note. ** p < .01.
65
Table 15
Predictors of Wisdom Scale Scores
___________________________________________________________________
Wisdom Scale Scores
_______________________________
Predictor
β
Δ R2
____________________________________________________________________
Step 1
SRGS-R: Self
.08**
Step 2
SRGS-R: Self
SRGS-R: Others
.00
Step 3
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
.08**
Step 4
SRGS-R: Self
SRGS-R: Others
SRGS-R: Life
SRGS-R: Religion
.00
Total R2
.16**
.27**
.37
-.13
.16
-.25
.41
.16
-.24
.41
.02
107
n
_____________________________________________________________________
Note. ** p < .01.
66
Chapter 5
Discussion
In general, there was weak support, at best, for the Janus Model in this sample.
The results indicated that the Janus model fit the data poorly. Specifically, the
correlations between distress and the illusory scales were not only in the opposite
direction than predicted, but were different to a statistically significantly degree.
The Janus Face Model and the Present Study
The Janus Face model of posttraumatic growth represents an unconventional
viewpoint in the still developing field of PTG research (Zoellner & Maerker, 2006).
However the findings of the present study are more consistent with conventional thinking
and previously published research on PTG. In particular, the relationship between
trauma-related distress and illusory constructs were completely opposite to what would
be predicted in the Janus Model. That is not to say that there was no support for the Janus
Model in this sample. There were some, albeit weak, indications that the findings were in
line with the Janus Model. For example, the constructive constructs were negatively
correlated with distress, as predicted by the model. However, only one of those three
relationships, between distress and capacity for love, were statistically significant. The
other two relationships, distress correlated with resourcefulness and wisdom, were
negative as would be predicted by the Janus Model, but were very weak.
There are a variety of possible reasons why the Janus Model was not strongly
supported by this study. First, it may be that the focal trauma events reported by
participants were not of the type or intensity that would be associated with the type of
67
distress measured in this study. This is a difficult possibility to assess due, in part, to the
highly individual nature of trauma response (Tedeschi & Calhoun, 2004). The use of a
PTSD measure in assessing distress may have contributed to this possible effect, since
PTSD represents a highly specific clinical manifestation of trauma-related symptoms that
are most associated with lower base rate events such as combat exposure and sexual
assault. Though events of this nature were present in the sample, they were in the
minority. For example, the median scores for 13 of the 17 PPTS-R items were zero,
indicating no experience of symptoms at all. Given this, a more neutral distress measure
many have captured the phenomenon better. In addition to the wide variance of
experience reflected in the reported events, it should be noted that on the PPTS-R, where
they are asked to list the most traumatic and/or stressful event that they have ever dealt
with, some participants reported a focal trauma event that they did not report on the TEI.
It is unclear if the lack of reporting on the TEI was an intentional oversight, or if some
participants misunderstood or misread the directions, or for other unknown reasons.
Second, most PTG research has been conducted on specific trauma populations
(Westphal & Bonanno, 2007). In the present study, participants were asked to report the
most traumatic and/or stressful event they have ever been faced with. This resulted, not
surprisingly, in a wide range of reported events. It is possible that having such a wide
variance in focal event type influenced the overall scores, especially the distress and PTG
scores. This may be due to individual differences, but could also be influenced by the
nature of the events themselves. It is possible that certain type of stressful events have a
similar trajectory or form. For instance, bereavement figured prominently in the sample.
Bereavement as a trauma event is unique in the sense that there are cultural practices in
68
place which are designed to assist the person in the grief process (Tedeschi & Calhoun,
2004)). When someone experiences the death of someone close to them, it is not
uncommon for them to be given time off from school or work responsibilities. In
addition, many people experience the sympathy of family, friends, and perhaps even their
community when they are working through their loss.
Contrast this with experiencing a crime, such as sexual assault or a robbery.
Though it has likely improved in recent decades, crime survivors may be ―
revictimized‖
by the criminal justice process, ranging from initial police contact through court
proceedings (Tedeschi, 1999). Poor resources and lack of support that many crime
survivors experience likely contribute to how well they are able to handle their distress.
This is particularly relevant in relation to combat-related trauma. One could argue that
our society learned the hard way that when soldiers return from war they require
resources from both their loved ones and the larger society. When this does not occur, as
it often did not with Vietnam veterans, the already difficult process of dealing with
trauma becomes much harder (Shephard, 2000). To return to the original point, it is
possible that the Janus Model would be supported in a more specific, less varied, trauma
population with a larger amount of shared characteristics.
Third, there may be developmental issues involved in the results. The present
study had a very limited sample in terms of age, with the most common age being 19.
Given that the present sample is almost exclusively young adults, the developmental
aspects that influence their responses are different than those that would be found in a
study with a wider range of adults. For example, the average age when most of the
participants experienced their focal trauma event was 14.90 years, with the median being
69
16 years. However, the reported ages of a sexual trauma event ranged from 3 years to 22
years of age. Given that young adulthood is in itself a unique developmental phase, the
sample may view their experiences differently than older individuals who are more
established in their adult roles. This is not to discount the possible growth in young
adults, but rather, to highlight the role that an age range restriction may play in this
sample. Tedeschi and Calhoun (2004) suggest that younger people may be more likely
than older persons to report growth due to a greater openness to learn from their
experiences. They argue that older individuals may be more likely to have already gained
important insights into their life prior to their trauma event and that their capacity for
change is reduced in comparison.
Finally, the Janus Model may have not been better supported in this sample due to
the measures used. As previously noted, the PTSD measure may have not best captured
the event related distress present in the sample. In addition, the scales used to capture the
illusory and constructive constructs may have measured a general, unitary factor, and
may not have captured the hoped-for nuances. The generally high, positive correlations
between the scales indicate that they may be measuring similar constructs. In addition,
the response style of the respondents suggested an overall positive skew. For example,
the sample responded almost overwhelmingly in a positive direction to all the illusory
and constructive items. This may reflect demand characteristics, in which the respondents
thought it would be normative to respond in a positive, self affirming manner to the
items. This might also explain the overall small to high amount of posttraumatic growth
reported in the sample. Though there are no clinical cutoffs published for PTG, the
sample generally reported substantial levels of PTG.
70
The results of the present study are consistent with some previous PTG research,
but differ from others. Consistent with Helgeson et al. (2006), women in the present
study reported higher levels of PTG on the full scale (female mean = 44,38, male mean =
37.48), though the difference was not statistically significant.
Tedeschi and Calhoun (2004) reported in a review of published PTG research that
the rates of reported growth generally ranged from 30% to 80%. In the present study, a
much larger 95.4% of the sample reported some amount of positive growth. This raises
the previously mentioned issue of cutoff scores. One of the potentially difficult aspects of
PTG research is the lack of published norms. In the present study, a conservative
approach is suggested. If only participants who averaged at least a full scale score of 43
(averaging at least a score of plus one on each of the 43 items), are included in the PTG
category, a much smaller 38% of the sample is included. This would place the present
study on the lower end when compared to published PTG rates.
The present findings are similar to aspects of Wild and Paivio’s (2003) study of
college students. As noted, college students have not been widely studied in PTG
research. The authors reported a wide range of reported trauma events in their sample that
was consistent with the array in the present sample. Specifically, bereavement also
figured prominently in the Wild and Paivio (28%) sample. In the present study,
bereavement as the focal trauma represented 38% of the cases.
As previously noted, the present study’s conceptualization of trauma severity
appears to have been inadequate. This is largely due to the difficulty of assessing the
construct given the highly individual nature of trauma experience. Nonetheless, there was
virtually no relationship (r = .08) between PTG and trauma severity in this sample. It was
71
hypothesized that there would be a positive relationship between these variables but that
did not emerge. This hypothesis was based on a dose-response theory of PTG, which
suggests that as trauma exposure and severity of threat increases, there is a corresponding
greater possibility of PTG occurring. The present findings differ from those of Zoellner,
et al. (2008), who reported a significant positive correlation between PTG and trauma
severity in their study of accident survivors. This discrepancy in findings highlights the
difficulties measuring trauma severity. It is easier to measure subjective and objective
trauma severity in a single incident trauma such as a car accident, in which there is
generally both a perceived and real threat to the physical integrity of the person. It
becomes more problematic when one is studying a trauma such as bereavement, in which
there is unlikely to be a physical threat to one’s safety. Though, there is no simple
solution to this problem, more novel approaches to conceptualizing and studying trauma
severity are needed.
The Importance of Measuring Negative Growth
What did emerge in this sample was the finding that participants will endorse
negative growth experiences when given the opportunity. As previously noted, a common
criticism of PTG research is that almost all measures that are used only allow respondents
to report positive growth (Armeli, et al., 2001). One of the potential problems with that
design is that it may pull for respondents to over-report their positive growth. The present
study was designed to address this shortcoming by allowing participants to report
negative, neutral, or positive growth reactions. The results indicated that, though in the
minority, some participants reported overall negative growth on the PTG scales (Full
scale PTG (n= 5), PTG Self scale (n = 3), PTG Others scale (n= 4), PTG Life scale (n =
72
6), PTG Religiosity scale (n = 22). This was particularly striking on the PTG religiosity
scale, in which 22 participants reported negative growth. On one PTG item, as many as
22% of participants endorsed a negative response. These results indicate that PTG is not
simply a positive response to trauma events, but rather, involves complex responses that
need further study.
Limitations
There are a number of limitations to the present study. First, there may have been
a pre-selection bias in the sample. Out of concern for the welfare of possible participants,
it was deemed important to state in the sign-up posting that the study involved being
asked about traumatic events. It is possible that some potential participants did not take
part in the study based on this information. Conversely, some participants may have
taken part in the study because of this disclosed information. It is possible that there were
characteristics of both of these groups that impacted the results in some unknown
manner. For example, it may be that people who have experienced growth may be more
likely to sign up for a study in which they are going to be asked about their trauma
history. Cromer, Freyd, Binder, De Prince, and Becker-Blease (2006) reported that
undergraduates perceive questions related to their trauma history as being more important
and having greater cost-benefit advantages than other types of personal information
requests in research settings. Conversely, people who are distressed by a traumatic event
may be less likely to want to participate in a study of this nature. These conditions might
lead to higher growth scores and lower distress scores.
Second, all the data collected relied on self-reported, recalled information.
Consequently, the accuracy of responses cannot be verified. Self-report data is prone to a
73
wide variety of confounds, including memory problems and demand characteristics
(Elmes, Kantowitz, & Roediger III, 1999). In addition, no corroborating information was
obtained that would have supported the participant’s responses, such as third party
reports.
Third, there may have been a priming effect, such that participants were more
likely to respond in a certain way based on the presentation of the material. In general,
knowing that a study is attempting to measure your responses to a trauma event, may
make some participants wish to present themselves in a falsely positive (or negative) light
(Elmes, Kantowitz, & Roediger III, 1999). In particular, after having been presented with
the positively worded items related to growth on the SRSG-R, participants may have
been more likely to respond in a positive manner to the items on the illusory and
constructive scales.
Finally, the study did not have a large enough sample to allow specific event
categories to be meaningfully compared. A much larger sample in a college population
would likely be needed to have enough people in the various categories to make
reasonable statistical comparisons.
Clinical Implications
Present findings have a variety of clinical implications. First, participants
overwhelmingly reported experiencing growth as result of struggling with an event or
situation in their life. Even if the sample over-reported their growth, as previously
suggested, it appears that this phenomenon is likely to be occurring in a large number of
people. More importantly, it is apparently occurring in response to a wide array of events
and situations. As clinicians, it is important to consider that people face struggles with
74
many types of experiences that are not traditionally viewed as being ―
traumatic.‖
Examples from this sample would be parents’ divorce and the incarceration of a parent,
both of which are no longer low base rate incidents in our society. The motivation should
not be to pathologize more in our society, but rather, to understand these struggles as
being a common part of the human experience.
A second clinical implication is that growth should be viewed as more complex
than perhaps previously thought. Often it appears that trauma reactions are viewed in a
dichotomous manner, as being either pathological or ―
positive.‖ Specifically, participants
in this sample often reported both positive and negative growth across a range of items.
In other words, there are nuances to even the ―
positive‖ aspects of trauma experience that
need to be considered when working with this population.
Finally, the wide range of reported trauma events and corresponding reactions in
this sample highlights the possibility of viewing trauma in a dimensional way. Currently,
PTSD is the primary DSM-IV diagnosis for trauma-related experience. While PTSD
certainly has a role to play in our conceptualization, its dichotomous nature is
problematic. Currently, you either have PTSD or you don’t. In other words, there is no
range of trauma reaction currently diagnosable. The present sample suggests that there is
a wide variation in the events themselves, and in the manner in which people respond to
very stressful events. From a clinical standpoint, more people may be able to receive help
if a dimensional approach was utilized and better treatments could be developed for a
wider range of trauma situations.
75
Research Implications
The present study also has important research implications. First, most growth
research has taken place with specific trauma populations. While this is definitely
important to do, it is also necessary to assess how growth is related to a broader range of
experience. By examining growth in a college population, for example, it is possible to
gain valuable information about normative experiences for young adults in our society. In
addition, investigating growth in a broader population allows for a better understanding
of the construct of PTG.
Second, the present findings contradict results from a similar study (Zoelner, et
al., 2008) that also examined the Janus Model. Specifically, that study reported low levels
of posttraumatic growth in their sample. Among the possible reasons for differences in
the outcomes are cultural issues. The Zoelner et al. study was conducted in Germany,
where the authors suggest there is less of a tendency to display overtly positive attitudes
and beliefs. They go further and argue that America displays a ―
tyranny of positive
thinking.‖ Given that much of the research on growth is originating in Europe, perhaps
cultural issues should be given a higher profile in the discourse on posttraumatic growth.
Anecdotally, in the course of the present study several international students, representing
a variety of foreign cultures, voiced a lack of understanding with the concept of trauma.
One international student pointed out that in the country where he grew up in Africa
events of the nature mentioned in the TEI simply do not occur, suggesting that he viewed
the concept of trauma as a completely American construction. The positive response
style of participants in the present study has already been noted and this may, in part,
reflect these cultural differences.
76
Future Directions
This study highlights the need for continued refinement of methods for
posttraumatic growth research. Particularly promising are the methods employed by
Shakespeare-Finch and Enders (2008), in which they utilized a significant other to
corroborate growth scores. Also, more longitudinal growth studies are needed in order to
better understand the long term course of posttraumatic growth. Studies such as those by
Kleim and Ehlers (2009), hint at the insights that may be gained from such innovative
research designs. Employing a longitudinal design in their study of assault survivors,
Kleim and Ehlers identified a curvilinear relationship between PTG and both depressive
and PTSD symptoms.
Though it is unlikely to be resolved to anyone’s satisfaction in the near future, the
field of posttraumatic growth theory, research, and practice must come to terms with a
number of major issues. First, what role does a person’s behavior play in growth? In
general, we have only studied the individual’s self-report of cognitive constructs. The
issue of whether behavioral action is important, or perhaps even required, to define
growth is still debated (Hobfoll, et al. (2007). One possible approach would be to
introduce more research designs that combine quantitative and qualitative methods. It
may be easier to examine some of these research questions with less rigid approaches
than are presently employed.
A second important issue related to the adaptive role of growth is avoidance.
Avoidance is viewed as a major component in clinical manifestations of trauma and plays
a central role in the current conceptualization of PTSD. The issue is whether PTG
77
facilitates avoidance and short term anxiety reduction, therefore, ultimately inhibits long
term adaptive functioning.
Differing theoretical perspectives on the issue of the adaptive significance of PTG
have led to the development of entrenched camps (Zoellner & Maercker, 2006). Hobfoll,
et al. (2007) argues that PTG without being accompanied by observable, related
behaviors (such as becoming more active in your church or returning to college to earn a
degree) may largely serve as a positive illusion that may facilitate avoidance. In sharp
contrast, Tedeschi and Calhoun (2007) argue that, though it is not the only important
facet of PTG, cognitions are vital to an individual’s post-trauma experience and that they
should not be discounted because they are not quantifiable by the naked eye. It is argued
in the present study, however, that raising the issue of adaptive functioning is not only
valid, but is imperative before posttraumatic growth can be accepted more widely and
utilized in treatment of trauma.
The adversities people face vary greatly among individuals, but they generally
have certain shared qualities. They tend to be sudden, uncontrollable, and severely strain
the individual’s resources to handle them. As Tedeschi and Calhoun (2004) point out in
their conceptualization of posttraumatic growth, it is the struggle through which the
growth is developed, not the event itself.
Though the present study found a wide range of events and situations that people
reported as being very stressful, it is not the intent to further pathologize everyday human
struggles and dub them as ―tr
aumatic.‖ Rather, it is the very commonness of these events
that underscore the need for a better understanding of how people face and, in some
cases, grow as a result of adversity.
78
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Appendix A
University of Toledo
Psychology Department
2801 West Bancroft Street
Toledo, Ohio 43606-3390
ADULT RESEARCH SUBJECT - INFORMED CONSENT FORM
The Two Sides of Posttraumatic Growth: A Study of the Janus Face Model
In a College Population
Principal Investigator:
2853
Mojisola F. Tiamiyu, Ph.D., Associate Professor, 419-530Darren R. Jones, M.A, Student Investigator, 419-530-2721
Purpose: You are invited to participate in the research project entitled, The Two Sides
of
Posttraumatic Growth: A Study of the Janus Face Model In a College Population.
The study is being conducted at the University of Toledo under the direction of Dr.
Mojisola F. Tiamiyu and Darren R. Jones, M.A . The purpose of this study is to
investigate the impact of traumatic events on an individual’s life experience. You need
not have experienced a traumatic event to take part in the study.
Description of Procedures: This research will take place in the psychology
department, which is
located on the first floor of UHALL and will take approximately one hour. You will be
asked to
complete various questionnaires in which you will be asked to report any past traumatic
events that
you may have experienced in your life. Traumatic events include, but are not limited to,
violent
crimes, abuse, serious accidents, and disasters. You will also be asked about how these
past events
have impacted your life and how you view them currently.
After you have completed your participation, the research team will debrief you about the
data, theory and research area under study and answer any questions you may have
about the research.
Potential Risks: There are minimal risks to participation in this study, including loss of
confidentiality. Answering the surveys (or participating in this study) might cause you to
feel upset or anxious. If so, you may stop at any time.
Potential Benefits: The only direct benefit to you if you participate in this research may
be that you will learn about how psychology studies are run and may contribute to our
understanding of the impact of traumatic life experiences.
85
Confidentiality: The researchers will make every effort to prevent anyone who is not on
the research team from knowing that you provided this information, or what that
information is. The consent forms with signatures will be kept separate from responses,
which will not include names and which will be presented to others only when combined
with other responses. Although we will make every effort to protect your confidentiality,
there is a low risk that this might be breached.
Voluntary Participation: Your refusal to participate in this study will involve no penalty
or loss of benefits to which you are otherwise entitled and will not affect your relationship
with The University of Toledo or any of your classes. In addition, you may discontinue
participation at any time without any penalty or loss of benefits. If you decide not to
participate or wish to discontinue your participation at any point you will still receive one
unit of research credit.
Contact Information: Before you decide to accept this invitation to take part in this
study, you may ask any questions that you might have. If you have any questions at any
time before, during or after your participation or experience any physical or psychological
distress as a result of this research you should contact a member of the research team
(Mojisola F. Tiamiyu, Ph.D., at 419-530-2853 or
Darren R. Jones, M.A, at 419-530-2721) If you have questions beyond those answered
by the research team or your rights as a research subject or research-related injuries,
please feel free to contact the Chairperson of the SBE Institutional Review Board, Dr.
Barbara Chesney, in the Office of Research on the main campus at (419) 530-2844.
Before you sign this form, please ask any questions on any aspect of this study that is
unclear to you. You may take as much time as necessary to think it over.
SIGNATURE SECTION – Please read carefully
You are making a decision whether or not to participate in this research study. Your
signature indicates that you are at least 18 years of age, have read the information
provided above, you have had all your questions answered, and you have decided to
take part in this research.
The date you sign this document to enroll in this study, that is, today's date must fall
between the dates indicated at the bottom of the page.
Name of Subject (please print)
Signature
Date
Name of Person Obtaining Consent
Signature
Date
86
Appendix B
What Is Traumatic Stress?
Traumatic stress
Traumatic events are shocking and emotionally overwhelming situations. It is natural for
people who experience or witness them to have many reactions. Some of these are
intense fear, horror, numbness, or helplessness. These events might involve actual or
threatened death, serious injury, or sexual or other physical assault. They can be one-time
occurrences, such as a natural disaster, house fire, violent crime, or airplane accident, or
they can be ongoing, repeated, and relentless, as is often the case in combat or war. Child
abuse and neglect, and other forms of domestic violence are additional examples of this.
Most often trauma is accompanied by many losses. Unfortunately, traumatic events are
quite common.
Reactions to traumatic events vary considerably, ranging from relatively mild, creating
minor disruptions in the person's life, to severe and debilitating. It is very common for
people to experience anxiety, terror, shock, and upset, as well as emotional numbness and
personal or social disconnection. People often cannot remember significant parts of what
happened, yet may be plagued by parts of memories that return in physical and
psychological flashbacks. Nightmares of the traumatic event are common, as are
depression, irritability, sleep disturbance, dissociation, and feeling jumpy.
Some of the problems people encounter after traumatic events are part of the diagnosis of
acute stress disorder (ASD). ASD describes experiences of dissociation (e.g., feelings of
unreality or disconnection), intrusive thoughts and images, efforts to avoid reminders of
the traumatic experiences, and anxiety that may occur in the month following the end of
the events. When these experiences last more than a month after traumatic experiences
have stopped, they are described by the diagnosis of post-traumatic stress disorder
(PTSD).
Other equally uncomfortable problems or symptoms may exist with or instead of PTSD.
For example, a traumatic event often challenges the person's sense of personal safety and
control, leaving him or her feeling less secure and more vulnerable. Physical health may
suffer as well, and individuals may notice increased feelings of fatigue, headaches, and
other physical symptoms. Many people traumatized in childhood also experience
revictimization (being harmed again) or aggression, identity disturbance (a feeling that
you don't know who you are), bodily problems such as illnesses or aches and pains
without detectable physical cause (somatization), difficulty staying on an even keel
emotionally, and relationship problems.
What can be helpful after trauma?
It can be helpful to stay connected to natural support systems, whether they are friends,
coworkers, family, neighbors, other familiar groups, personal beliefs, or community.
Taking care of basic needs is important after trauma. This includes trying to get enough
sleep, eating well, exercising, drinking enough water and juice, and avoiding alcohol and
87
caffeine. Keeping to routines and activities if possible, and finding ways to assist
someone else, can be helpful for many. And it is particularly important to know you can
ask for help.
How to decide whether you need help
People who have had traumatic life experiences cope the best way they can with their
memories and painful effects. For many people, reactions gradually diminish. Some find
it helpful to talk about what happened and their feelings, to get support from people who
can be trusted, or to be involved in other activities that help them to reconnect with
people and find meaning in their lives. But for some people, the symptoms and disturbing
reactions persist or even worsen. This can lead people to find ways to cope that are not so
helpful, such as withdrawing from friends and family, using drugs or alcohol, or avoiding
activities that are empowering. It is important to consider seeking help if important areas
of life, such as relationships, work, or school, are being affected by traumatic stress.
Likewise, people who become more and more depressed or anxious or for whom the use
of alcohol or other drugs increases significantly may need treatment. Some traumatized
people speak over and over about traumatic events without relief of symptoms. These
people may benefit from treatment.
Treatment options
There are many types of treatment for traumatic stress, from individual therapy to support
groups. Interpersonal, relational, and psychodynamic psychotherapies, which focus on
the meaning of trauma and how it has affected relationships, may help people understand
the source of their current problems and how these relate to their traumatic experiences.
For some, medication can be effective. Also, anxiety management, cognitive therapy
(focusing on thoughts and beliefs), and exposure therapy (helping the person confront
painful memories and situations that are realistically safe although still frightening,
through talking about or imagining them) are helpful for reducing PTSD and related
reactions. A combination of psychotherapy and medication is often helpful for depression
and anxiety following traumatic experiences.
No single treatment is effective for everyone, and it may take time to find the right
treatment. There also may be difficult periods in any treatment. Therefore, it is important
to find a trained psychotherapist or physician, preferably one with experience treating
people with traumatic stress, who can work together with the survivor to find a treatment
approach that makes sense for the individual. A comfort with language, cultural
considerations, and style of expression may enhance rapport in treatment.
Where to go for help
For people who wish to consider psychotherapy, a family doctor, clergy person, local
mental health association, state psychiatric, psychological, or social work association, or
health insurer may be helpful in providing a referral to a counselor or therapist with
experience in treating people affected by traumatic stress.
88
For more information about traumatic stress or the International Society for Traumatic
Stress Studies, call 847-480-9028.
© 2005 International Society For Traumatic Stress Studies. All rights reserved.
89
Traumatic Events Interview (TEI)
Appendix C
Instructions: The next series of questions is related to other traumatic or stressful events
that you might have experienced, witnessed, or had to deal. Please indicate whether you
have experienced the event directly, witnessed it, or in some other way were confronted
with the event.
0 = No; 1 = Witnessed; 2 = Experienced; 3 = Confronted with; 4 = Some combination of
responses 1,2,or 3
1) Have you ever witnessed, experienced, or been confronted with a natural disaster, such
as tornado, hurricane, or flood?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
2) Have you ever witnessed, experienced, or been confronted with a serious accident or
serious injury?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
3) Have you ever had a sudden life-threatening illness?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
90
During the worst incident, were you in physical danger of injury or death?
4) Have you ever been in military combat or in military service in a war zone?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
5) Have you ever witnessed or been confronted with the accidental death or murder of a
close friend or family member of yours?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
6) Have you ever witnessed or been confronted with the suicide of a close friend or
family member?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
7) Has anyone, including your family members, friends, acquaintances, or strangers ever
attacked you with a gun, knife, or other weapon, or have you witnessed or been
confronted with such an attack?
a) How many times?
91
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
8) Has anyone, including your family members, friends, acquaintances, or strangers ever
attacked you without a weapon, but with the intent to kill or seriously injure you, or
have you witnessed or been confronted with such an attack?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
9) As a child, were you severely beaten (example: beatings that left marks), or have you
witnessed or been confronted with violence between your family members (example:
seeing your brothers or sisters severely beaten, or seeing physical violence between
your parents)?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
10) Before you were 13, did anyone five years or more older than you have sexual
contact with you, or have you witnessed or been confronted with such contact?
When we say sexual contact, we mean any contact between someone else and your
sexual organs or between you and someone else’s sexual organs?
a) How many times?
92
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
11) Has anyone ever used pressure, coercion, or nonphysical threats to make you have
unwanted sexual contact with them, or have you witnessed or been confronted with
such an event?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
12) Has anyone ever physical force or the threat of physical force to make you have
some type of unwanted sexual contact with them, or have you witnessed or been
confronted with such an event?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
During the worst incident, were you in physical danger of injury or death?
13) Have you ever witnessed or experienced some other traumatic event that hasn’t been
covered?
a) How many times?
b) How old were you at the time of the worst incident?
c) Please respond to this question with one of these options;
0 = No; 1 = Somewhat; 2 = Very much ; 3 = I was slightly injured during the incident;
4 = I was seriously injured during the incident
93
During the worst incident, were you in physical danger of injury or death?
d) Would you please briefly describe the type of incident you experienced?
94
Appendix D
The Purdue Post-Traumatic Stress Disorder Scale-Revised
These questions ask about your reaction to the most upsetting traumatic event in your
life. The event in your life to use as a basis for your answers is
_________________________________________________________.
How old were you when this event occurred?
_________________________________________________________ .
Please answer each question for how often each reaction occurred during the previous
month.
Circle one number for each question.
Not at All
A
Sometimes
B
C
Often
D
E
In the last month, how often……
1) Were you been bothered by memories or thoughts of the
event when you didn’t want to think about it?
2) Have you dreamed about the event?
3) Have you suddenly felt as if you were experiencing the
event again?
4) Did you feel very upset when something happened to remind you of the event?
5) Did you avoid activities or situations that might remind you of the event?
6) Did you avoid thoughts or feelings about the event?
7) Did you have difficulty remembering important aspects of the event?
8) Did you react physically (heart racing, breaking out in a sweat) to things that
reminded you of the event?
95
Since the event……….
9 Have you lost interest in one or more of your usual activities (examples: work,
hobbies, entertainment)?
10) Have you felt unusually distant or cut off from people?
11) Have you felt emotionally ―
numb‖ or unable to respond to things emotionally
the way you used to?
12) Have you been less optimistic about the future?
13) Have you had more trouble sleeping?
14) Have you been more irritable or angry?
15) Have you had more trouble concentrating?
16) Have you found yourself watchful or on guard, even when there was no reason to be?
17) Are you jumpy or easily startled by noises?
96
Appendix E
Stress Related Growth Scale-Revised (SRGS-R)
Response scale: Rate how much you have changed as a result of the most stressful event
you have experienced by choosing one of the following responses for each item:
1 = greatly decreased; 2 = moderately decreased; 3 = slightly decreased; 4 = neither
increased or decreased; 5 = slightly increased; 6 = moderately increased; 7 = greatly
increased
1. My belief in how strong I am. (c)
2. Acceptance of others.
3. Respect for others feelings and beliefs. (a)
4. Treating others nicely. (a)
5. My satisfaction with life.
6. Looking at things in a positive way. (g)
7. Faith in God. (b)
8. Taking responsibility for what I do.
9. Not taking things for granted.
10. Trust in God.(b)
11. Ability to make my own decisions. (c)
12. Feeling that I have something of value to teach others about life.
13. Understanding of how God allows things to happen.
14. Appreciation of the strength of others who have had a difficult life.
15. Not ―
freaking out‖ when a bad thing happens. (e)
16. Thinking about the consequences of my actions.
17. Not getting angry about things. (e)
18. Being optimistic. (g)
19. Approaching life calmly.
20. Being myself and not what others want me to be. (f)
21. Accepting myself as less than perfect. (f)
22. Taking life seriously.
23. Working through problems and not just giving up.
24. Confidence in myself. (c)
25. Not taking my physical health for granted.
26. Listening more carefully when others talk to me.
27. Reaching out to help others. (a)
28. Openness to new information and ideas.
29. Communicating more honestly with others.
30. Ability to deal with uncertainty.
31. Feeling that it’s okay to ask others for help.
32. Not letting little things upset me. (e)
33. Standing up for my personal rights.
34. My understanding that there are many people who care about me. (d)
35. My understanding that there is a reason for everything.
36. My sense of belonging. (d)
97
37. Feeling as if I am part of a community. (d)
38. My belief in a supreme being. (b)
39. Ability to deal with hassles.
40. The meaning in my life.
41. The meaningfulness of a prior relationship with another person.
42. Ability to express my feelings.
43. Feeling as if I have a lot to offer other people.
Scales: (a) treatment of others: (b) religiousness; (c) personal strength; (d) belongingness;
(e) affect-regulation; (f) self-understanding; and (g) optimism
98
Appendix F
International Personality Item Pool (IPIP) Measures
Illusory Constructs
Directions: On the following pages, there are phrases describing people's behaviors.
Please use the rating scale below to describe how accurately each statement describes
you. Describe yourself as you generally are now, not as you wish to be in the future.
Describe yourself as you honestly see yourself, in relation to other people you know of
the same sex as you are, and roughly your same age. So that you can describe yourself in
an honest manner, your responses will be kept in absolute confidence. Please read each
statement carefully, and then fill in the bubble that corresponds to the number on the
scale.
Response Options
1: Very Inaccurate
2: Moderately Inaccurate
3: Neither Inaccurate nor Accurate
4: Moderately Accurate
5: Very Accurate
OPTIMISM [Alpha = .86]
+ keyed
Just know that I will be a success.
Feel comfortable with myself.
Seldom feel blue.
Look at the bright side of life.
– keyed
Have a dark outlook on the future.
Feel that my life lacks direction.
Dislike myself.
Often feel blue.
See difficulties everywhere.
Am often in a bad mood.
TOTAL LOCUS OF CONTROL [Alpha = .86]
+ keyed
Feel comfortable with myself.
Believe that my success depends on ability rather than luck.
Just know that I will be a success.
Come up with good solutions.
Love life.
Act comfortably with others.
Feel up to any task.
99
Like to take responsibility for making decisions.
Take the initiative.
Make a decision and move on.
– keyed
Believe that unfortunate events occur because of bad luck.
Believe that the world is controlled by a few powerful people.
Feel that my life lacks direction.
See difficulties everywhere.
Habitually blow my chances.
Believe some people are born lucky.
Dislike taking responsibility for making decisions.
Am less capable than most people.
Dislike myself.
Feel that I'm unable to deal with things.
SELF-DECEPTION [Alpha = .80]
+ keyed
Always know why I do things.
Just know that I will be a success.
Know that my decisions are correct.
Feel comfortable with myself.
Like to take responsibility for making decisions.
– keyed
Am not always honest with myself.
Sometimes have trouble making up my mind.
Dislike myself.
Worry about what people think of me.
Have a low opinion of myself.
Constructive Constructs
Capacity for Love [Cap] (Alpha = .70)
+ keyed
Am willing to take risks to establish a relationship.
Know that there are people in my life who care as much for me as for themselves.
Know that some others accept my shortcomings.
Am the most important person in someone else's life.
Can express love to someone else.
Know someone whom I really care about as a person.
- keyed
Do not easily share my feelings with others.
Feel isolated from other people.
Have difficulty accepting love from anyone.
Omitted
Could never stop loving my family and close friends, no matter what they did.
100
RESOURCEFULNESS (Alpha = .83)
+ keyed
Can handle complex problems.
Face problems directly.
Am good at many things.
Formulate ideas clearly.
Complete tasks successfully.
– keyed
Wait for others to lead the way.
Am easily discouraged.
Am easily intimidated.
Can't make up my mind.
Panic easily.
Perspective/Wisdom [Per] (Alpha = .75)
+ keyed
Have a broad outlook on what is going on.
Have an excellent view of the world.
Have been described as wise beyond my years.
Have a mature view on life.
Consider myself to be a wise person.
Am considered to be a wise person.
- keyed
Lose sight of what is most important in life.
Am not good at figuring out what really matters.
Am rarely consulted for advice by others.
Omitted
Have never given bad advice to a friend
101
Appendix F: Complete Study Protocol
Part I: Thank you for taking part in this study. Please respond to the following demographic items:
1) Your current age?
2) Please circle the response that indicates your racial affiliation:
African-American
Asian
Biracial
European-American (White)
Hispanic
Other (please write down your response) ______________
3) I am a
Male
Female (please circle)
4) Please circle your marital status: Single (never married)
Divorced
Married
Part II instructions: The next series of questions is related to other traumatic or stressful events that you
might have experienced, witnessed, or had to deal. Please indicate whether you have experienced the event
directly, witnessed it, or in some other way were confronted with the event. If the answer is no, you need
not respond to the items marked a, b, and c.
1) Have you ever experienced a natural disaster, such as a tornado, hurricane, or flood? Yes
a) How many times?
b) How old were you at the time of the incident?
c) During the worst incident, were you in physical danger of injury or death?
2) Have you ever experienced a serious accident or serious injury?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
3) Have you ever had a sudden life-threatening illness?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
4) Have you ever been in military combat or in military service in a war zone?
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
102
Yes
No
No
5) Have you ever witnessed or been confronted with the accidental death or murder of a close friend
or family member of yours? Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
6) Have you ever witnessed or been confronted with the suicide of a close friend or family member?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
7) Has anyone, including your family members, friends, acquaintances, or strangers ever attacked
you with a gun, knife, or other weapon, or have you witnessed or been confronted with such an
attack?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c)During the incident, were you in physical danger of injury or death?
8) Has anyone, including your family members, friends, acquaintances, or strangers ever attacked
you without a weapon, but with the intent to kill or seriously injure you, or have you witnessed or
been confronted with such an attack?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
9) As a child, were you severely beaten (example: beatings that left marks), or have you witnessed or
been confronted with violence between your family members (example: seeing your brothers or
sisters severely beaten, or seeing physical violence between your parents)? Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
10) Before you were 13, did anyone five years or more older than you have sexual
contact with you, or have you witnessed or been confronted with such contact?
When we say sexual contact, we mean any contact between someone else and your
sexual organs or between you and someone else’s sexual organs?
Yes
a) How many times?
b) How old were you at the time of the incident?
103
No
c) During the incident, were you in physical danger of injury or death?
11) Has anyone ever used pressure, coercion, or nonphysical threats to make you have unwanted
sexual contact with them, or have you witnessed or been confronted with such an event? Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
12) Has anyone ever physical force or the threat of physical force to make you have
some type of unwanted sexual contact with them, or have you witnessed or been
confronted with such an event?
Yes
No
a) How many times?
b) How old were you at the time of the incident?
c) During the incident, were you in physical danger of injury or death?
13) Have you ever witnessed or experienced some other traumatic event that hasn’t been covered?
Yes
No
a) How many times?
b) How old were you at the time of the worst incident?
c) During the incident, were you in physical danger of injury or death?
d) Would you please briefly describe the type of incident you experienced?
End of section: Please take this form to the researcher.
104
Part III: These questions ask about your reaction to the most upsetting traumatic event in your life. The
event in your life to use as a basis for your answers is
_________________________________________________________.
How old were you when this event occurred?
_________________________________________________________ .
Please answer each question for how often each reaction occurred during the previous month.
Circle one number for each question.
In the last month, how often……
1) Were you been bothered by memories or thoughts of the
event when you didn’t want to think about it?
Not at All
A
Sometimes
B
C
Often
D
E
2) Have you dreamed about the event?
Not at All
A
Sometimes
B
C
Often
D
E
3) Have you suddenly felt as if you were experiencing the
event again?
Not at All
A
Sometimes
B
C
Often
D
E
4) Did you feel very upset when something happened to remind you of the event?
Not at All
A
Sometimes
B
C
Often
D
E
5) Did you avoid activities or situations that might remind you of the event?
Not at All
A
Sometimes
B
C
Often
D
E
6) Did you avoid thoughts or feelings about the event?
Not at All
Sometimes
Often
105
A
B
C
D
E
7) Did you have difficulty remembering important aspects of the event?
Not at All
A
Sometimes
B
C
Often
D
E
8) Did you react physically (heart racing, breaking out in a sweat) to things that
reminded you of the event?
Not at All
A
Sometimes
B
C
Often
D
E
Since the event……….
9) Have you lost interest in one or more of your usual activities (examples: work,
hobbies, entertainment)?
Not at All
A
Sometimes
B
C
Often
D
E
10) Have you felt unusually distant or cut off from people?
Not at All
A
Sometimes
B
C
Often
D
E
11) Have you felt emotionally ―
numb‖ or unable to respond to things emotionally
the way you used to?
Not at All
A
Sometimes
B
C
Often
D
E
12) Have you been less optimistic about the future?
Not at All
A
Sometimes
B
C
Often
D
E
13) Have you had more trouble sleeping?
Not at All
A
Sometimes
B
C
Often
D
E
14) Have you been more irritable or angry?
Not at All
A
Sometimes
B
C
Often
D
E
106
15) Have you had more trouble concentrating?
Not at All
A
Sometimes
B
C
Often
D
E
16) Have you found yourself watchful or on guard, even when there was no reason to be?
Not at All
A
Sometimes
B
C
Often
D
E
17) Are you jumpy or easily startled by noises?
Not at All
A
Sometimes
B
C
Often
D
E
Part IV: Response scale: Rate how much you have changed as a result of the most stressful event you have
experienced by choosing one of the following responses for each item:
1 = greatly decreased; 2 = moderately decreased; 3 = slightly decreased; 4 = neither increased or
decreased; 5 = slightly increased; 6 = moderately increased; 7 = greatly increased
1. My belief in how strong I am.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
2. Acceptance of others.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
3. Respect for others feelings and beliefs.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
4. Treating others nicely.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
5. My satisfaction with life.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
107
6
7
6. Looking at things in a positive way.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
7. Faith in God.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
8. Taking responsibility for what I do.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
9. Not taking things for granted.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
10. Trust in God.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
11. Ability to make my own decisions.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
12. Feeling that I have something of value to teach others about life.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
13. Understanding of how God allows things to happen.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
14. Appreciation of the strength of others who have had a difficult life.
Greatly Decreased
Neither
Greatly Increased
108
1
2
3
4
5
6
7
15. Not ―
freaking out‖ when a bad thing happens.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
16. Thinking about the consequences of my actions.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
17. Not getting angry about things.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
18. Being optimistic.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
19. Approaching life calmly.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
20. Being myself and not what others want me to be.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
21. Accepting myself as less than perfect.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
22. Taking life seriously.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
23. Working through problems and not just giving up.
Greatly Decreased
Neither
Greatly Increased
109
1
2
3
4
5
6
7
24. Confidence in myself.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
25. Not taking my physical health for granted.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
26. Listening more carefully when others talk to me.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
27. Reaching out to help others.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
28. Openness to new information and ideas.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
29. Communicating more honestly with others.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
30. Ability to deal with uncertainty.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
31. Feeling that it’s okay to ask others for help.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
32. Not letting little things upset me.
Greatly Decreased
Neither
Greatly Increased
110
1
2
3
4
5
6
7
33. Standing up for my personal rights.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
34. My understanding that there are many people who care about me.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
35. My understanding that there is a reason for everything.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
36. My sense of belonging.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
37. Feeling as if I am part of a community.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
38. My belief in a supreme being.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
39. Ability to deal with hassles.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
40. The meaning in my life.
Greatly Decreased
1
Neither
2
3
4
Greatly Increased
5
6
7
41. The meaningfulness of a prior relationship with another person.
Greatly Decreased
Neither
Greatly Increased
111
1
2
3
4
5
6
7
42. Ability to express my feelings.
Greatly Decreased
1
Neither
2
3
Greatly Increased
4
5
6
7
5
6
Greatly Increased
7
43. Feeling as if I have a lot to offer other people.
Greatly Decreased
1
2
Neither
4
3
Part V: On the following pages, there are phrases describing people's behaviors. Please use the rating scale
below to describe how accurately each statement describes you. Describe yourself as you generally are
now, not as you wish to be in the future. Describe yourself as you honestly see yourself, in relation to other
people you know of the same sex as you are, and roughly your same age.
Response Options
1: Very Inaccurate
2: Moderately Inaccurate
3: Neither Inaccurate nor Accurate
4: Moderately Accurate
5: Very Accurate
1) I feel comfortable with myself.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
2) I know that my decisions are correct.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
3) I panic easily.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
4) I make a decision and move on.
Very Inaccurate
Neither Inaccurate
Or Accurate
112
Very Accurate
1
2
3
4
5
5) I am less capable than most people.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
6) I am not always honest with myself.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
7) I am good at many things.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
8) I believe that my success depends on ability rather than luck.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
9) I complete tasks successfully.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
10) I worry about what people think of me.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
11) I always know why I do things.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
12) I can express love to someone else.
Very Inaccurate
Neither Inaccurate
113
Very Accurate
Or Accurate
1
2
3
4
5
13) I feel that my life lacks direction.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
14) I act comfortably with others.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
15) I am rarely consulted for advice by others.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
16) I am willing to take risks to establish a relationship.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
17) I formulate ideas clearly.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
18) I like to take responsibility for making decisions.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
19) I know that I will be a success.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
20) I am easily discouraged.
114
5
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
21) I am not good at figuring out what really matters.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
22) I believe some people are born lucky.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
23) I often feel depressed.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
24) I have difficulty accepting love from anyone.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
25) I have an excellent view of the world.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
26) I see difficulties everywhere.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
27) I face problems directly.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
115
5
28) I know that some others accept my shortcomings.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
29) I love life.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
30) I consider myself to be a wise person.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
31) I come up with good solutions.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
32) I am the most important person in someone else’s life.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
33) I have a low opinion of myself.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
34) I sometimes have trouble making up my mind.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
35) I take the initiative.
Very Inaccurate
Neither Inaccurate
116
Very Accurate
Or Accurate
1
2
3
4
5
36) I feel up to any task.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
37) I feel isolated from other people.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
38) I feel that I am unable to handle things.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
39) I believe that unfortunate events occur due to bad luck.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
40) I know that there are people in my life who care as much for me as for themselves.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
41) I can’t make up my mind.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
42) I have a broad outlook on what is going on.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
43) I see difficulties everywhere.
Very Inaccurate
Neither Inaccurate
117
Very Accurate
Or Accurate
1
2
3
4
5
44) I am easily intimidated.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
45) I lose sight of what is important in life.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
46) I believe that the world is controlled by a few powerful people.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
47) I know someone who I really care about as a person.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
48) I am considered to be a wise person.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
49) I constantly blow my chances.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
50) I do not easily share my feelings with others.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
118
5
51) I dislike myself.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
52) I have a dark outlook on the future.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
53) I have been described as wise beyond my years.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
54) I can handle complex problems.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
55) I seldom feel depressed.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
56) I dislike taking responsibility for making decisions.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
57) I have a mature view on life.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
58) I look at the bright side of life.
Very Inaccurate
Neither Inaccurate
Or Accurate
119
Very Accurate
1
2
3
4
5
59) I wait for others to lead the way.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
5
60) I am often in a bad mood.
Very Inaccurate
1
Neither Inaccurate
Or Accurate
2
3
Very Accurate
4
End of Study: Please take this form to the researcher.
120
5
Appendix H
Stress-Related Growth Scale-Revised Scale Scores by Trauma Event
________________________________________________________________________
Event Type
(n)
Total
Self
Others
Life
Religiosity
M
M
M
M
M
(SD)
(SD)
(SD)
(SD)
(SD)
________________________________________________________________________
Death of Grandparent
(16)
Death of Friend
(15)
Car Accident
(11)
Sexual Assault/
Molestation
(7)
42.00
12.75
14.37
12.62
2.25
(30.23)
(9.79)
(9.36)
(8.63)
(5.70)
33.66
8.86
13.20
10.86
.73
(29.62)
(8.60)
(10.31)
(9.19)
(4.93)
26.72
9.18
5.90
10.45
1.18
(24.61)
(6.33)
(8.37)
(7.33)
(6.03)
48.57
15.71
15.28
13.00
4.57
(45.86)
(13.62)
(13.17)
(15.07)
(6.82)
Death of Other
Family Member
(5)
25.20
5.00
8.00
10.40
1.80
(30.24)
(3.31)
(17.42)
(11.14)
(6.14)
Parent’s Divorce
44.40
20.20
12.00
12.80
-.60
(19.09)
(7.66)
(3.53)
(8.75)
(3.28)
(5)
121
SRGS-R Scale Scores by Trauma Event
________________________________________________________________________
Event Type
(n)
Total
Self
Others
Life
Religiosity
M
M
M
M
M
(SD)
(SD)
(SD)
(SD)
(SD)
________________________________________________________________________
Serious Illness of
Loved One
(5)
30.60
6.20
11.00
10.40
3.00
(15.27)
(3.89)
(4.18)
(7.86)
(2.54)
35.25
11.75
12.50
11.00
.00
(26.33)
(9.17)
(7.04)
(6.37
(8.64)
42.25
15.25
10.25
14.25
2.50
(17.91)
(9.17)
(4.11)
(6.29)
(2.51)
44.00
7.00
9.00
24.50
3.50
(12.90)
(4.96)
(4.69)
(21.57)
(4.35)
98.00
29.00
27.66
31.33
10.00
(3)
(33.64)
(15.71)
(8.38)
(8.62)
(1.73)
Assault
53.00
15.66
12.00
16.66
8.66
(2)
(32.44)
(10.11)
(9.84)
(13.20)
(2.88)
77.50
19.50
26.00
23.00
9.00
(7.77)
(2.12)
(7.07)
(1.41)
(2.82)
20.00
5.50
9.00
8.50
-3.00
(57.98)
(12.02)
(12.72)
(21.92)
(11.31)
Other Serious Accident
(4)
Physical Abuse
(4)
Serious Illness of Self
(4)
Incarceration of Parent
Flood
(2)
Suicide Attempt of
Loved One
(2)
122
SRGS-R Scale Scores by Trauma Event
________________________________________________________________________
Event Type
(n)
Total
Self
Others
Life
Religiosity
M
M
M
M
M
(SD)
(SD)
(SD)
(SD)
(SD)
________________________________________________________________________
Witnessed Domestic
Violence
(2)
47.00
11.50
12.00
12.00
11.50
(9.89)
(3.53)
(7.07)
(7.07)
(.70)
Witnessed Serious
16.50
Accident (non-relation)
(2)
(6.36)
3.00
3.50
7.50
2.50
(4.24)
(3.53)
(.70)
(2.12)
Witnessed Violence
66.00
22.50
18.00
19.00
6.50
(4.24)
(2.50)
(2.82)
(5.65)
(.70)
117.00
39.00
27.00
39.00
12.00
(1)
na
na
na
na
na
Combat
24.00
21.00
.00
15.00
-12.00
(1)
na
na
na
na
na
100.00
33.00
31.00
24.00
12.00
na
na
na
na
na
39.00
14.00
10.00
14.00
1.00
na
na
na
na
na
(2)
Best Friends Abortion
Death of Sibling
(1)
Eating Disorder
(1)
123
SSRGS-R Scale Scores by Trauma Event
________________________________________________________________________
Event Type
(n)
Total
Self
Others
Life
Religiosity
M
M
M
M
M
(SD)
(SD)
(SD)
(SD)
(SD)
________________________________________________________________________
Hospitalization for
Depression
(1)
58.00
18.00
18.00
24.00
-2.00
na
na
na
na
na
2.00
-1.00
5.00
-2.00
.00
na
na
na
na
na
Lengthy Separation
from Family
(1)
75.00
17.00
30.00
18.00
10.00
na
na
na
na
na
Period of Loneliness
and Fear
(1)
61.00
23.00
16.00
10.00
12.00
na
na
na
na
na
Pet Died
31.00
7.00
8.00
10.00
6.00
na
na
na
na
na
12.00
7.00
.00
5.00
.00
na
na
na
na
na
13.00
.00
3.00
10.00
.00
na
na
na
na
na
House Fire
(1)
(1)
Robbery
(1)
Witnessed Serious
Accident (relation)
(1)
124
Appendix I
International Personality Item Pool Scale Scores by Focal Event Type
________________________________________________________________________
Event Type
OPT
SELF
TLC
CAP
RES
WIS
M
(n)
(SD)
________________________________________________________________________
Death of Grandparent
36.93
33.87
72.50
35.81
35.43
32.31
(6.53)
(6.29)
(10.32)
(6.11)
(7.50)
(3.97)
37.00
33.66
71.46
36.20
34.60
33.73
(11.09)
(6.55)
(11.09)
(5.44)
(6.28)
(4.36)
35.36
34.54
74.81
35.36
36.72
33.81
(8.22)
(7.16)
(11.77)
(6.57)
(7.44)
(4.30)
36.42
33.28
76.14
34.42
38.00
34.71
(8.50)
(7.31)
(11.34)
(7.63)
(6.05)
(6.84)
38.80
36.20
75.40
33.60
39.40
36.40
(14.63)
(3.83)
(14.63)
(10.89)
(2.79)
(1.51)
Parent’s Divorce
39.00
33.40
74.80
33.40
37.00
34.80
(5)
(5.78)
(4.77)
(7.32)
(2.88)
(7.71)
(2.58)
Serious Illness of
Loved One
(5)
40.80
34.20
74.80
35.40
33.80
(5.01)
(2.82)
(12.39)
(3.50)
(8.46) (4.60)
Other Serious Accident
41.25
39.75
78.50
36.00
39.75
33.25
(4.99)
(1.70)
(6.19)
(1.41)
(2.75)
(2.62)
(16)
Death of Friend
(15)
Car Accident
(11)
Sexual Assault/
Molestation
(7)
Death of Other Family
Member
(5)
(4)
125
34.20
IPIP Scale Scores by Focal Event Type
________________________________________________________________________
Event Type
OPT
SELF
TLC
CAP
RES
WIS
M
(n)
(SD)
________________________________________________________________________
36.75
33.00
73.00
32.50
36.25
35.00
(12.01)
(7.52)
(12.78)
(6.02)
(7.63)
(4.83)
38.75
38.75
78.50
33.75
32.75
35.50
(1.25)
(3.30)
(3.69)
(7.08)
(2.75)
(5.00)
43.66
35.00
80.66
39.66
34.66
36.66
(3)
(3.51)
(4.00)
(4.04)
(.57)
(8.62)
(3.05)
Assault
38.66
44.33
84.33
36.33
42.66
35.66
(2)
(3.05)
(1.15)
(7.03)
(5.68)
(5.50)
(4.04)
30.00
27.00
65.50
35.00
26.00
33.50
(4.24)
(.00)
(9.19)
(.00)
(1.41)
(2.12)
42.00
35.50
75.50
30.50
38.00
33.00
(5.65)
(7.77)
(6.36)
(6.36)
(8.48)
(4.24)
40.50
29.50
71.00
35.00
31.00
34.50
(7.77)
(.70)
(1.41)
(1.41)
(1.41)
(4.94)
43.00
34.00
77.00
36.00
41.00
34.00
(2.82)
(2.82)
(11.31)
(4.24)
(2.82)
(1.41)
Physical Abuse
(4)
Serious Illness of Self
(4)
Incarceration of Parent
Flood
(2)
Suicide Attempt of
Loved One
(2)
Witnessed Domestic
Violence
(2)
Witnessed Serious
Accident (non-relation)
(2)
126
IPIP Scale Scores by Focal Event Type
________________________________________________________________________
Event Type
OPT
SELF
TLC
CAP
RES
WIS
M
(n)
(SD)
________________________________________________________________________
Witnessed Violence
40.00
35.50
81.50
34.00
38.00
31.50
(4.24)
(3.53)
(12.02)
(2.82)
(7.07)
(3.53)
48.00
35.00
80.00
42.00
41.00
34.00
(1)
na
na
na
na
na
na
Combat
38.00
36.00
83.00
21.00
43.00
38.00
(1)
na
na
na
na
na
na
42.00
34.00
81.00
42.00
40.00
35.00
na
na
na
na
na
na
38.00
31.00
78.00
36.00
34.00
33.00
na
na
na
na
na
na
Hospitalization for
Depression
(1)
24.00
27.00
71.00
32.00
35.00
34.00
na
na
na
na
na
na
House Fire
19.00
21.00
52.00
27.00
28.00
26.00
na
na
na
na
na
na
36.00
25.00
58.00
40.00
21.00
28.00
na
na
na
na
na
na
(2)
Best Friends Abortion
Death of Sibling
(1)
Eating Disorder
(1)
(1)
Lengthy Separation
From Family
(1)
127
IPIP Scale Scores by Focal Event Type
________________________________________________________________________
Event Type
OPT
SELF
TLC
CAP
RES
WIS
M
(n)
(SD)
________________________________________________________________________
Period of Loneliness
and Fear
(1)
41.00
43.00
83.00
39.00
40.00
39.00
na
na
na
na
na
na
Pet Died
42.00
38.00
85.00
39.00
36.00
35.00
na
na
na
na
na
na
45.00
48.00
78.00
25.00
39.00
34.00
na
na
na
na
na
na
37.00
35.00
75.00
29.00
32.00
30.00
na
na
na
na
na
na
(1)
Robbery
(1)
Witnessed Serious
Accident (relation)
(1)
________________________________________________________________________
128
Appendix J
Trauma Distress Scores by Focal Trauma Events
_________________________________________________________________
Event Type
PPTSD-R Total Scores
M
(Number of Participants Reporting)
SD
_________________________________________________________________
8.12
6.85
Death of Friend (15)
10.80
9.15
Car Accident (11)
10.54
6.97
Sexual Assault/Molestation (7)
22.00
22.15
8.40
8.84
Parent’s Divorce (5)
20.20
13.23
Serious Illness of Loved One (5)
13.40
5.02
6.00
4.76
12.25
14.66
Serious Illness of Self (4)
4.25
5.05
Incarceration of Parent (3)
12.66
3.21
3.66
2.51
.50
.70
Suicide Attempt of Loved One (2)
37.50
14.84
Witnessed Domestic Violence (2)
7.50
6.36
Death of Grandparent (16)
Death of Other Family Member (5)
Other Serious Accident (4)
Physical Abuse (4)
Assault (2)
Flood (2)
129
Trauma Distress Scores by Focal Trauma Events
_________________________________________________________________
Event Type
PPTSD-R Total Scores
(Number of Participants)
M
SD
_________________________________________________________________
Witnessed Serious Accident (non-relation) (2)
1.00
.00
20.00
.00
5.00
na
Combat (1)
23.00
na
Death of Sibling (1)
11.00
na
Eating Disorder (1)
5.00
na
Hospitalization for Depression (1)
22.00
na
House Fire (1)
26.00
na
8.00
na
25.00
na
Pet Died (1)
3.00
na
Robbery (1)
2.00
na
Witnessed Serious Accident (relation) (1)
2.00
na
11.55
10.88
Witnessed Violence (2)
Best Friends Abortion (1)
Lengthy Separation from Family (1)
Period of Loneliness and Fear (1)
Overall Sample
_________________________________________________________________
130