Recent studies related to global terrorism have suggested the potential of posttraumatic growth (PTG) following experiences of terror exposure. However, investigations of whether psychological distress is reduced or increased by PTG in other trauma contexts have been inconsistent. Results from our studies conducted in New York following the attacks of 11 September 2001 and in Israel during recent tumultuous periods of violence and terrorism, the Al Aqsa Intifada, have found posttraumatic growth to be related to greater psychological distress, more right-wing political attitudes, and support for retaliatory violence. Only when individuals were deeply involved in translating growth cognitions to growth actions in our research on the forced disengagement of settlers from Gaza did we find positive benefit in posttraumatic growth. Findings are considered within the framework of a new formulation of actionfocused growth.De récentes recherches en rapport avec le terrorisme international ont souligné le potentiel du développement post-traumatique (PTG) découlant de la confrontation à la terreur. Toutefois, les travaux cherchant à savoir si la détresse psychologique était atténuée ou accentuée par le PTG dans d'autres contextes traumatiques se sont révélés contradictoires. Nos investigations à New York après l'attentat du 11 septembre 2001 et en Israël durant des périodes récentes de violence et de terrorisme, la seconde Intifada, ont montré que le développement post-traumatique était plutôt lié à une grande détresse psychologique, à des opinions politiques de droite et à une attente de représailles. On a observé lors du déménagement obligatoire des colons de Gaza que ce n'est que lorsque les individus étaient profondément impliqués dans la transformation des cognitions de développement en actions de développement que le développement post-traumatique avait des retombées positives. Ces résultats sont appréhendés dans le cadre d'une nouvelle approche du développement centré sur l'action.

Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed.

Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.

Purpose/Objectives To develop and test the efficacy of a web-based intervention for alleviating depression in male stroke survivors (SSs) and their spousal caregivers (CGs) that blends both peer and professional support. Design and Methods The research consisted of an intervention protocol evaluated by a focus group of rehabilitation professionals, a “think aloud” session conducted with female stroke CGs, and a usability test of the intervention’s online features with 7 female stroke CGs. Efficacy of the final protocol was tested in a two-group randomized clinical trial with a sample of 32 CG-SS dyads. The CGs in the intervention condition received an online group intervention. Intervention components were based on the Stress Process Model. Those CGs in a control condition received minimal support with individualized access to relevant online information. Measures of depression, as well as the secondary outcomes of mastery, self-esteem, and social support, were obtained from SSs and CGs at pretest, post-test, and one-month later. Results At posttest and one month later, CGs in the intervention condition reported significantly lower depression than CGs in the control condition with baseline depression controlled. There was no significant effect on depression among SSs. Although no significant treatment effects for either SSs or CGs were found on the secondary outcomes, post-treatment changes on some constructs were significantly correlated with change in depression. Conclusions/Implications CGs benefit from web-based programs that help them better understand both their emotional needs and those of the SS.

This study places the reporting of sexual harassment within an integrated model of the sexual harassment process. Two structural models were developed and tested in a sample (N = 6,417) of male and female military personnel. The 1st model identifies determinants and effects of reporting; reporting did not improve--and at times worsened--job, psychological, and health outcomes. The authors argue that organizational responses to reports (i.e., organizational remedies, organizational minimization, and retaliation) as well as procedural satisfaction can account for these negative effects. The 2nd model examines these mediating mechanisms; results suggest that these mediators, and not reporting itself, are the source of the negative effects of reporting. Organizational and legal implications of these findings are discussed.

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events. Test-retest reliability was studied in four samples, and temporal stability was good to excellent for items and trauma types and excellent for overall HMS and PPD scores. Comprehensibility of items was supported by expert ratings of how well items appeared to be understood by participants with relatively low reading levels. In five samples, construct validity was supported by findings of strong convergent validity with a longer measure of trauma exposure and by correlations of HMS and PPD scores with PTSD symptoms. The psychometric properties Correspondence concerning this article should be addressed to Eve Carlson, Ph.D., National Center for PTSD (334-PTSD), 795 Willow Rd., Menlo Park, CA 94025. eve.carlson@va.gov. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/pas NIH Public Access Exposure to sudden, highly stressful events is fairly common among the general population in the U.S. (Breslau, 2002) and is even more frequent among those seeking mental health treatment (Jacobson, 1989). Information about exposure to sudden, severe stressors is clinically important because such exposure has been found to be associated with increases in later psychological disorder (Brown, Fulton, Wilkeson, & Petty, 2000;Bryant et al., 2010) and decreases in physical health (Schnurr & Green, 2004), occupational functioning (Zatzick et al., 2008), and socioeconomic well-being (Zielinski, 2009). In prospective studies and meta-analyses of trauma research, psychological disorders found to increase most following highly stressful events include depression, generalized anxiety disorder, posttraumatic stress disorder (PTSD), agoraphobia, phobia, and substance abuse (Brown et al., 2000;Bryant et al., 2010;Reed, Anthony, & Breslau, 2007). In addition, repeated, severe sudden stressors that occur during early childhood are thought to play a role in the development of borderline personality disorder (Herman & van der Kolk, 1987); some dissociative disorders (De...

This is the 1st longitudinal examination of trajectories of resilience and resistance (rather than illbeing) among a national sample under ongoing threat of mass casualty. The authors interviewed a nationally representative sample of Jews and Arabs in Israel (N = 709) at 2 times during a period of terrorist and rocket attacks (2004)(2005). The resistance trajectory, exhibiting few or no symptoms of traumatic stress and depression at both time points, was substantially less common (22.1%) than has previously been documented in studies following single mass casualty events. The resilience trajectory, exhibiting initial symptoms and becoming relatively nonsymptomatic, was evidenced by 13.5% of interviewees. The chronic distress trajectory was documented among a majority of participants (54.0%), and a small proportion of persons were initially relatively symptom-free but became distressed (termed delayed distress trajectory; 10.3%). Less psychosocial resource loss and majority status (Jewish) were the most consistent predictors of resistance and resilience trajectories, followed by greater socioeconomic status, greater support from friends, and less report of posttraumatic growth. Research on terrorism and war and other mass casualty events has overwhelmingly focused on pathological responding, most typically symptoms related to traumatic stress (Bleich, Gelkopf, & Solomon, 2003;Galea et al., 2002;Hobfoll, Canetti-Nisim, & Johnson, 2006;Punamäki, Komproe, Qouta, Elmasri, & de Jong, 2005) and, to a lesser extent, depression (Hobfoll, Tracy, & Galea, 2006). However, emerging research has suggested that in the aftermath of mass casualty, the majority of persons do not report psychological distress and may be termed resistant (Bonanno, Galea, Bucciarelli, & Vlahov, 2006. Because we have only begun to study resistance, and in limited contexts, we know little about its prevalence or predictors (Bonanno, 2005;Bonanno, Rennicke, & Dekel, 2005).We longitudinally studied symptoms related to traumatic stress and depression among a national sample of Israeli Jews and Arabs during the latter period of the Second Intifada, when there was ongoing terrorism and likelihood of war because mass casualty exposure weighs heavily on such populations (Shalev, Tuval, Frenkiel-Fishman, Hadar, & Eth, 2006;Somer, Ruvio, Soref, & Sever, 2005). Our aim was to estimate the prevalence of resistance, resilience, chronic distress, and a failure to remain resistant (i.e., delayed symptom onset) and to predict these outcomes. We believe this is the first longitudinal study of resilience and related trajectories in the face of terrorism and war during a period of ongoing conflict.Building on the work of Bonanno et al. (2007);Layne, Warren, Shalev, and Watson (2007); and Norris, Stevens, Pfefferbaum, Wyche, and Pfefferbaum (2007), we outline four key symptom trajectories, over time, after traumatic event exposure. In the first trajectory, termed the resistance trajectory (Layne et al., 2007), individuals never develop symptoms of disorder. A se...

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