Prospective risk factors for subsequent exposure to potentially traumatic events.

In a sample of 1528 college students, we examined (1) whether several risk factors prospectively predicted exposure to potentially traumatic events (PTEs) over a 2-month period and (2) whether dependent events (i.e., those more likely to depend upon one's behavior or characteristics) and independent events were predicted by different risk factors. Logistic regression analyses indicated that overall subsequent PTE exposure was higher for women, those with more previous PTEs, and those who engaged in more binge drinking. Female gender and previous PTE exposure also predicted exposure to independent events. Subsequent dependent PTE exposure was predicted by more previous PTEs and binge drinking, and was somewhat higher in ethnic minority students. Implications for prevention efforts are discussed.

Posttraumatic growth following cancer: links to quality of life.

This study examined the linkage of posttraumatic growth (PTG) to quality of life (QOL) among individuals newly diagnosed with cancer. Individuals (26 men, 36 women) reported PTG 3 months postdiagnosis (T1) and 3 months later (T2). Cross-sectional analyses revealed a linear association between PTG and QOL-more PTG was related to worse mental health at T1 (ß = -.28). PTG, however, revealed a quadratic relationship with depressive symptoms at T1 and physical health at T2: Individuals with high or low levels of PTG had fewer depressive symptoms and better QOL than those with moderate levels. Longitudinal analyses revealed a linear association between PTG and QOL; more PTG at T1 predicted better physical health at T2. There were no longitudinal curvilinear associations. Although the linear links of PTG to QOL were contradictory within this study, both of the curvilinear relations, although not robust, confirm previous research. Further analyses differentiated low, medium, and high PTG groups in terms of perceiving cancer as stressful, intrusive thoughts, and coping strategies. Overall, relations of PTG to adjustment may be more complex and dynamic than previously assumed. Clinicians should consider the notion that more growth may sometimes, but not always, be better.

Does self-reported posttraumatic growth reflect genuine positive change?

In this study, we evaluated the validity of self-reported posttraumatic growth (PTG) by assessing the relation between perceived growth and actual growth from pre- to posttrauma. Undergraduate students completed measures tapping typical PTG domains at Time 1 and Time 2 (2 months later). We compared change in those measures with scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) for those participants who reported a traumatic event between Time 1 and Time 2 (n= 122). PTGI scores generally were unrelated to actual growth in PTG-related domains. Moreover, perceived growth was associated with increased distress from pre- to posttrauma, whereas actual growth was related to decreased distress, a pattern suggesting that perceived and actual growth reflect different processes. Finally, perceived (but not actual) growth was related to positive reinterpretation coping. Thus, the PTGI, and perhaps other retrospective measures, does not appear to measure actual pre- to posttrauma change.

Assessing the psychometric properties of the World Assumptions Scale.

The notion that traumatic events shatter survivors' fundamental assumptions about the world has been accepted as a truism in the trauma literature, although tests of this hypothesis provide a somewhat mixed picture. Because this research has relied heavily on the World Assumptions Scale (WAS), it is unclear whether these inconsistent results are due to problems with assumptive world theory, improper tests of the theory, or problems with the WAS. Data were gathered from 742 undergraduate students at four universities to assess the psychometric properties of the WAS. Findings suggest several shortcomings of the WAS, including temporal instability, and mixed evidence regarding construct validity. Implications for trauma research are discussed.

A meta-analytic review of benefit finding and growth.

The authors conducted a meta-analysis to examine the relations of benefit finding to psychological and physical health as well as to a specific set of demographic, stressor, personality, and coping correlates. Results from 87 cross-sectional studies reported in 77 articles showed that benefit finding was related to less depression and more positive well-being but also more intrusive and avoidant thoughts about the stressor. Benefit finding was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health. Moderator analyses showed that relations of benefit finding to outcomes were affected by the amount of time that had passed since stressor onset, the benefit finding measured used, and the racial composition of the sample.

Cognitive adaptation theory and breast cancer recurrence: Are there limits?

Relations of the components of cognitive adaptation theory (self-esteem, optimism, control) to quality of life and benefit finding were examined for 70 women (91% Caucasian) diagnosed with Stage I, II, or III breast cancer over 5 years ago. Half of these women experienced a recurrence within the 5 years; the other half remained disease free. Women were matched on age, race, stage of disease, and intervention condition. Baseline perceptions of personal control over illness, but not general self-esteem or optimism, were associated with women's reports of worse physical functioning, worse mental functioning, and less benefit finding 5 years later for recurrent women but not disease-free women. These findings highlight the notion that there may be boundary conditions on the adaptiveness of perceived control.

Perceived growth and decline following breast cancer: a comparison to age-matched controls 5-years later.

Research indicates that individuals who experience stressful life events, such as a diagnosis of cancer, often experience both positive and negative changes as a result of their experiences, but little research has compared these changes with those of a control group who have experienced other stressful life events. We compared 184 5-year breast cancer survivors (Stages: I, II, and III; 95% Caucasian) with 184 age-matched controls in terms of perceived growth and decline that stem from stressful events. Survivors reported on their experience with cancer, whereas controls identified the most stressful event that happened to them 5 years ago. Survivors reported more growth (e.g. appreciation of life) and more decline (e.g. physical side effects) compared with controls. However, there were no group differences in reports of psychological stress. When survivors were compared with controls whose stressor was a personal health problem, many of the differences in growth between the two groups remained, but the differences in decline disappeared. These findings suggest that some growth is unique to breast cancer, but much of the decline associated with breast cancer is similar to the decline associated with other types of health problems.

Surviving cancer: a comparison of 5-year disease-free breast cancer survivors with healthy women.

Women with breast cancer are one of the largest groups of cancer survivors. This research examined whether breast cancer has a long-term impact on quality of life (QOL) by comparing 5-year disease-free survivors to age-matched controls and by comparing women who sustained a recurrence to disease-free survivors. Controls were recruited using the neighborhood control methodology. QOL (physical, emotional, social, and spiritual) was assessed during in-person interviews. There were no differences between disease-free survivors (n = 267) and controls (n = 187) on many indicators of QOL. However, survivors reported more difficulties with physical functioning, more physical symptoms, and more faith than did controls (all ps < 0.05). Compared to disease-free survivors, survivors with a recurrence (n = 37) had a worse QOL on most indices, less positive affect, more general fatigue, and more intrusive and avoidant thoughts (all ps < 0.05). There were no differences between the two groups of survivors on indices of marriage, work experiences, or spirituality. These findings suggest that the QOL of long-term survivors who remain disease-free is comparable to that of women their age with the exception of physical functioning. Women who sustain a recurrence suffer an impaired QOL in some, but not all, domains.

Is finding something good in the bad always good? Benefit finding among women with breast cancer.

The correlates and consequences of benefit finding on quality of life were examined for 364 women (93% Caucasian, 6% African American, and 1% Hispanic) diagnosed with Stage I, II, and III breast cancer. Benefit finding and quality of life were measured 4 months postdiagnosis (Tl), 3 months after Tl (T2), and 6 months after T2 (T3). Women with lower socioeconomic status, minorities, and those with more severe disease perceived more benefits at baseline. Benefit finding was associated with more negative affect at baseline and also interacted with stage of disease, such that negative relations to quality of life across time were limited to those with more severe disease. Findings suggest there are qualifiers as to whether "finding something good in the bad" is good or bad.

Attachment-based assessments of parent-child relationships in middle childhood.

Although a number of measures have been developed to assess parent-child attachments, validity data on middle-childhood measures are lacking. The present study tested attachment-based measures of parent-child relationships designed for the later middle-childhood years (9-12 years of age). Self-reports from children assessed perceptions of security and avoidant and preoccupied coping. Some children also completed a projective interview assessing attachment state of mind. Mothers and fathers reported their willingness to serve as an attachment figure and were rated for responsiveness. Data were collected from a cross-sectional sample of 3rd and 6th graders and their parents. A 2-year follow-up on the younger sample provided data on the stability of the measures. There were modest associations across the different measures and moderate to high stability. The attachment-based measures were also related to teacher ratings of children's school adaptation.