Counseling Psychology Literature (not reviewed)
Non-Counseling Psychology Literature (no summary)
Hanson, J. L., Adluru, N., Chung, M. K., Alexander, A. L., Davidson, R. J., & Pollak, S.D. (in press). Early neglect is associated with alterations in white matter integrity and cognitive functioning. Child Development.
Rosenkranz, M., Davidson, R., MacCoon, D., Sheridan, J., Kalin, N., & Lutz, A. (in press). A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain, behavior, and immunity.
Davidson, R. J. & McEwen, B. S. (2012).Social influences on neuroplasticity: Stress and interventions to promote well-being. Nature Neuroscience, 15(5), 689-95. NIHMSID: 366958
Experiential factors shape the neural circuits underlying social and emotional behavior from the prenatal period to the end of life. These factors include both incidental influences, such as early adversity, and intentional influences that can be produced in humans through specific interventions designed to promote prosocial behavior and well-being. Here we review important extant evidence in animal models and humans. Although the precise mechanisms of plasticity are still not fully understood, moderate to severe stress appears to increase the growth of several sectors of the amygdala, whereas the effects in the hippocampus and prefrontal cortex tend to be opposite. Structural and functional changes in the brain have been observed with cognitive therapy and certain forms of meditation and lead to the suggestion that well-being and other prosocial characteristics might be enhanced through training.
Hanson, J., Chung, M., Avants, B., Rudolph, K., Shirtcliff, E., Gee, J., Davidson, R. J., & Pollak, S. (2012).Structural variations in prefrontal cortex mediate the relationship between early childhood stress and spatial working memory. Journal of Neuroscience, 32(23), 7917-25. PMCID: PMC3375595
A large corpus of research indicates exposure to stress impairs cognitive abilities, specifically executive functioning dependent on the prefrontal cortex (PFC). We collected structural MRI scans (n=61), well-validated assessments of executive functioning, and detailed interviews assessing stress exposure in humans, to examine whether cumulative life stress affected brain morphometry and one type of executive functioning, spatial working memory, during adolescence—a critical time of brain development and reorganization. Analysis of variations in brain structure revealed that cumulative life stress and spatial working memory were related to smaller volumes in the PFC, specifically prefrontal gray and white matter between the anterior cingulate and the frontal poles. Mediation analyses revealed that individual differences in prefrontal volumes accounted for the association between cumulative life stress and spatial working memory. These results suggest that structural changes in the PFC may serve as a mediating mechanism through which greater cumulative life stress engenders decrements in cognitive functioning.
Davidson, R. J. (2010).Empirical explorations of mindfulness: Conceptual and methodological conundrums. Emotion, 10(1), 8-11.
This commentary reflects on the articles in this Special Issue. The appearance of this group of articles underscores the important idea that a major target of mindfulness practice is on emotion. Transformation in trait affect is a key goal of all contemplative traditions. This commentary addresses several key methodological and conceptual issues in the empirical study of mindfulness. The many ways in which the term "mindfulness" is used in the articles in this Special Issue are noted, and they include its reference to states, traits, and independent variables that are manipulated in an experimental context. How the term "mindfulness" is conceptualized and operationalized is crucial, and for progress to be made it is essential that we qualify the use of this term by reference to how it is being operationalized in each context. Other methodological issues are considered, such as the duration of training and how it should be measured, and the nature of control and comparison groups in studies of mindfulness-based interventions. Finally, the commentary ends with a consideration of the targets within emotion processing that are likely to be impacted by mindfulness. This collection of articles underscores the substantial progress that has occurred in the empirical study of mindfulness and it is a harbinger of a very promising future in this area.
Perlman, D. M., Salomons, T. V., Davidson, R. J., & Lutz, A. (2010).Differential effects on pain intensity and unpleasantness of two meditation practices. Emotion, 10(1), 65–71. PMCID: PMC2859822
Pain is an unpleasant sensory and emotional experience that can be regulated by many different cognitive mechanisms. We compared the regulatory qualities of two different meditation practices during noxious thermal stimuli: Focused Attention, directed at a fixation cross away from the stimulation, which could regulate negative affect through a sensory gating mechanism; and Open Monitoring, which could regulate negative affect through a mechanism of nonjudgmental, nonreactive awareness of sensory experience. Here, we report behavioral data from a comparison between novice and long-term meditation practitioners (long-term meditators, LTMs) using these techniques. LTMs, compared to novices, had a significant reduction of self-reported unpleasantness, but not intensity, of painful stimuli while practicing Open Monitoring. No significant effects were found for FA. This finding illuminates the possible regulatory mechanism of meditation-based clinical interventions like Mindfulness-Based Stress Reduction (MBSR). Implications are discussed in the broader context of training-induced changes in trait emotion regulation.
Bauer, P. M., Hanson, J. L., Pierson, R. K., Davidson, R. J., & Pollak, S. D. (2009).Cerebellar volume and cognitive functioning in children who experienced early deprivation. Biological Psychiatry, 66(12), 1100-1106. PMCID: PMC2878609
BACKGROUND: The cerebellum is a brain region recognized primarily in the coordination of movement and related accessory motor functions. In addition, emerging evidence implicates the cerebellum in cognitive processes and suggests that this brain region might be subject to experience-dependent changes in structure. Therefore, the aim of this study was to evaluate the role of early environmental deprivation in the maturation of the cerebellum and aspects of cognitive development.
METHODS: Structural magnetic resonance imaging volumes of 12 cerebellar sub-regions from 31 previously neglected and 30 typically developing children were compared with subjects' corresponding neuropsychological test scores.
RESULTS: Neglected children had smaller volume of the superior-posterior cerebellar lobes. Moreover, superior-posterior lobe volume was found to mediate neuropsychological test performance differences between groups, with larger volumes yielding better outcomes on tests of memory and planning.
CONCLUSIONS: These data support the importance of experience-dependent changes in cerebellar structure and highlight the role of the cerebellum in higher cognitive functions.
Light, S. N., Coan, J. A., Zahn-Waxler, C., Frye, C., Goldsmith, H. H., & Davidson, R. J. (2009).Empathy is associated with dynamic change in prefrontal brain electrical activity during positive emotion in children. Child Development, 80(4), 1210-1231. PMCID: PMC2717040
Empathy is the combined ability to interpret the emotional states of others and experience resultant, related emotions. The relation between prefrontal electroencephalographic asymmetry and emotion in children is well known. The association between positive emotion (assessed via parent report), empathy (measured via observation), and second-by-second brain electrical activity (recorded during a pleasurable task) was investigated using a sample of one hundred twenty-eight 6- to 10-year-old children. Contentment related to increasing left frontopolar activation (p < .05). Empathic concern and positive empathy related to increasing right frontopolar activation (ps < .05). A second form of positive empathy related to increasing left dorsolateral activation (p < .05). This suggests that positive affect and (negative and positive) empathy both relate to changes in prefrontal activity during a pleasurable task.
Shackman, A. J., McMenamin, B. W., Maxwell, J. S., Greischar, L. L., & Davidson, R. J. (2009).Right dorsolateral prefrontal cortical activity and behavioral inhibition. Psychological Science, 20(12), 1500-1506. PMCID: PMC2858783
Individuals show marked variation in their responses to threat. Such individual differences in behavioral inhibition play a profound role in mental and physical well-being. Behavioral inhibition is thought to reflect variation in the sensitivity of a distributed neural system responsible for generating anxiety and organizing defensive responses to threat and punishment. Although progress has been made in identifying the key constituents of this behavioral inhibition system in humans, the involvement of dorsolateral prefrontal cortex (DLPFC) remains unclear. Here, we acquired self-reported Behavioral Inhibition System Sensitivity scores and high-resolution electroencephalography from a large sample (n= 51). Using the enhanced spatial resolution afforded by source modeling techniques, we show that individuals with greater tonic (resting) activity in right-posterior DLPFC rate themselves as more behaviorally inhibited. This observation provides novel support for recent conceptualizations of behavioral inhibition and clues to the mechanisms that might underlie variation in threat-induced negative affect.
Ekman, P., Davidson, R. J., Ricard, M., & Wallace, B. A. (2005).Buddhist and psychological perspectives on emotions and well-being. Current Directions in Psychological Science, 14, 59-63.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M. A., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003).Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.
BACKGROUND: The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees.
METHODS: We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine.
RESULTS: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine.
CONCLUSIONS: These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research.
Skowron, E. A., Kozlowski, J. M., & Pincus, A. L. (2010). Differentiation, self–other representations, and rupture–repair processes: Predicting child maltreatment risk. Journal Of Counseling Psychology, 57(3), 304-316. doi:10.1037/a0020030
This set of studies was designed to examine the relational underpinnings of child abuse potential in a sample of 51 urban families. In Study 1, lower maternal differentiation of self-most notably, greater emotional reactivity and greater emotional cutoff-along with self-attacking introjects, together distinguished mothers at higher risk (vs. lower risk) for child maltreatment (CM). In Study 2, patterns of interactive rupture and repair were examined in a subsample of n = 15 families and found to vary as a function of risk for CM. Specifically, SASB coding (Benjamin, 1996, 2003) of mother-children interactions during two moderately stressful lab tasks revealed higher rates of interactive mismatch and mother-initiated ruptures, and fewer successful repairs in families at higher-risk-for-CM, relative to families at lower-risk. Implications for counseling and directions for further translational research are discussed.
Wang, Y., & Heppner, P. (2011). A qualitative study of childhood sexual abuse survivors in Taiwan: Toward a transactional and ecological model of coping. Journal Of Counseling Psychology, 58(3), 393-409. doi:10.1037/a0023522
In this study, we aimed to explore the experiences of 10 female Taiwanese childhood sexual abuse (CSA) survivors (age range = 20–39 years) to broaden our understanding of the post-abuse coping process in a Chinese sociocultural context. This investigation was grounded on a feminist paradigm, and the consensual qualitative research method (Hill et al., 2005; Hill, Thompson, & Williams, 1997) was utilized as the strategy of inquiry. The transactional and ecological model of coping that emerged from the data describes the dynamic interplay among (a) intrapersonal, interpersonal, and sociocultural factors and (b) the coping process and outcomes of CSA survivors. Implications for research on CSA recovery and culturally appropriate interventions in a collectivistic sociocultural context are discussed.
Hund, A. R., & Espelage, D. L. (2005). Childhood Sexual Abuse, Disordered Eating, Alexithymia, and General Distress: A Mediation Model. Journal Of Counseling Psychology, 52(4), 559-573. doi:10.1037/0022-0188.8.131.529
This study evaluated structural equation models of the associations among family functioning, childhood abuse, depression, anxiety, alexithymia, and eating disorder symptomatology in a sample of 412 European American and 192 African American female undergraduates. Additionally, the specific roles of anxiety, depression, and alexithymia as mediators were assessed. Each of these variables was a significant mediator of the association between childhood abuse and disordered eating. Finally, a test of invariance between the African American and European American subsamples was significant, highlighting the need for additional cross-cultural eating disorder research.
Stout, M., & Mintz, L. B. (1996). Differences among nonclinical college women with alcoholic mothers, alcoholic fathers, and nonalcoholic parents. Journal Of Counseling Psychology, 43(4), 466-472. doi:10.1037/0022-0184.108.40.2066
To further examine the uniformity myth as it pertains to adult children of alcoholics (ACAs) and to elucidate potential within-ACA difference variables, differences among 90 nonclinical 17–24-yr-old college females with alcoholic fathers (F-ACAs), alcoholic mothers (M-ACAs), and no alcoholic parents (non-ACAs) were explored. These groups were compared in terms of eating disorder symptomatology, interpersonal difficulties, and reports of abuse. F-ACAs reported significantly more distress arising from interpersonal problems than did non-ACAs. Non-ACAs reported significantly fewer threats of parent-perpetrated abuse than either ACA group, whereas F-ACAs reported significantly more father-perpetrated threats of abuse than either non-ACAs or M-ACAs. F-ACAs also reported a significantly higher prevalence of father-perpetrated physical abuse than did M-ACAs. Suggestions for future research are made, and counseling implications are discussed.
Goff, D. C. (2011). Antipsychotics and the shrinking brain. Psychiatric Times. http://www.psychiatrictimes.com/display/article/10168/1854683
Post-traumatic growth by Ashley Hutchison (Ball State University)
Counseling Psychology Literature
Counseling psychologists have suggested that post-traumatic growth is an important construct to consider when working with clients affected by traumatic life experiences. Within the counseling and counseling psychology literature, multiple authors have written both theoretical and empirical articles that focus on post-traumatic growth. For example, several authors have conducted studies that focused on the validation and development of The Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1999). In addition, other researchers have investigated post-traumatic growth in client-centered group treatment, in the context of religious or spiritual self-growth, and among survivors of childhood sexual assault, cancer patients, and college students. Interestingly, investigators have also researched the applicability of post-traumatic growth with individuals who work with trauma. This type of post-traumatic growth has been called vicarious post-traumatic growth, which is conversely related to the concept of vicarious traumatization of service providers.
Other authors have published theoretical or conceptual writings on post-traumatic growth. These authors have focused on how clinicians can incorporate positive psychology into trauma-treatment, recommendations of pathways to client post-traumatic growth, theoretical and methodological issues in studying post-traumatic growth, and incorporating post-traumatic growth at a systems level.
Although counseling psychologists have incorporated posttraumatic growth in trauma-informed work to some extent, additional research is needed to fully understand the relationship between posttraumatic growth, trauma, and its place in counseling psychology. Given counseling psychology’s commitment to strengths and prevention, increasing the field’s focus on this important construct is highly relevant and a critical future direction of prevention-oriented work.
Counseling Today article.http://ct.counseling.org/2012/02/the-transformative-power-of-trauma/
Anderson, W.P., Jr., & Lopez-Baez, S. I. (2008). Measuring growth with the posttraumatic growth inventory. Measurement and Evaluation in Counseling and Development, 40, 215-227.
The Posttraumatic Growth Inventory (PTGI; R. G. Tedeschi & L. G. Calhoun, 1996) was used to measure the growth of university students (N = 347). Results were compared with those of trauma studies and indicate that the PTGI is a general measure of growth suitable for future nontrauma studies. Results reflect a minimal relationship between growth and stress.
Anderson, W.P., & Lopez-Baez, S.I. (2011). Measuring personal growth attributed to a semester of college life using the posttraumatic growth inventory. Counseling and Values, 56, 73-82.
In this descriptive exploratory study, the Posttraumatic Growth inventory (PTGI; Tedeschi & Calhoun, 1996) was used to measure levels of personal growth attributed by college students (N = 117) to a semester of university life In retrospective self-reports. Results reflect attributions of substantial total growth in the range reported in the posttraumatic studies and attributions of substantial growth to a variety of specific experiences. The results suggest that personal growth as defined by the PTGI is not necessarily adversarial and that personal growth can be intentionally facilitated by educational activities.
Hoffman, M.A., & Kruzcek, T. (2011). A bioecological model of mass trauma: Individual, community, and societal effects. The Counseling Psychologist, 39, 1087-1127.
Biopsychosocial consequences of catastrophic events create an ongoing need for research that examines the effects of mass traumas, developing psychosocial interventions, and advocacy to address the needs of affected individuals, systems, and communities. Because it is neither possible nor necessarily desirable to intervene with all touched by disasters at an individual level, a systems approach that allows conceptualization and response at the individual, family, community, and societal levels seems optimal. Many of the models commonly used in counseling psychology to explain coping with difficult events focus on individual effects and do not adequately capture the complex, multisystemic effects of large-scale catastrophic events and disasters. A bioecological model of mass trauma, which provides a conceptual framework for understanding the effects, intervening in the aftermath, addressing prevention, and researching aspects of large-scale disasters, catastrophes, and mass traumas, is presented. Relevant literature and illustrative examples from three categories of mass traumas or catastrophic events (disasters, war, and terrorism or violence) that currently contribute to a persistent atmosphere of stress for many are reviewed using the bioecological model. Recommendations for future research are provided.
Hooper, L. M., Marotta, S. A., & DePuy, V. (2009). A confirmatory factor analytic study of the Posttraumatic Growth Inventory among a sample of racially diverse college students. Journal of Mental Health, 18, 335-343.
Aims: The primary aim of the study was to confirm the five-factor structure of Tedeschi and Calhoun's (1996) Posttraumatic Growth Inventory (PTGI). A secondary aim of this study was to explore the potential usefulness of the PTGI among populations that experience parentification-common form of childhood neglect and adversity. Method: The PTGI was administered to a sample of 143 college students with a history of various levels of parentification. Results: The resulting data were subjected to confirmatory factor analysis. The goodness-of-fit indices for the five-factor model indicated a moderate fit with the current sample. However, a five-factor, 18- item model produced a more optimal fit than Tedeschi and Calhoun's five-factor, 21-item PTGI. Conclusions: The study's findings suggest that the PTGI appears to be a useful assessment inventory for mental health practitioners in measuring globally the resources an individual might have following the adversity of parentification.
Hutchinson, J., & Lema, J.C. (2009). Ordinary and extraordinary narratives of heroism and resistance: Uncovering resilience, competence, and growth. Counselling Psychology Review, 24, 9-15.
Current approaches to work with trauma often emphasise diagnosis, symptoms and exposure-based treatments. This paper, based within a narrative framework and drawing on recent research in positive psychology, focuses on how we can collaborate with clients to move from trauma-saturated stories that limit possibility and meaning for the future, to stories that are possibility-rich, meaningful and ordinarily and extra-ordinarily heroic. We identify some principles, assumptions and ideas that guide our interventions: labelling people, for example, as 'abused' or suffering from PTSD can sometimes constrain progress; people find small ways to resist even the most violent of situations; inviting fun, laughter and other positive emotions into therapy can help build resilience; having our ear attuned to noticing strength and small acts of coping and progressing builds success; and the importance of giving good attention to the client's theory of change. We end with some questions about different pathways to resilience, recovery and post-traumatic growth.
Nolen-Hoeksema, S., & Davis, C. C. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15(1), 60-64. Although the idea of growth following adversity is not new to humanistically oriented counseling psychologists. Few researchers gave much attention to such a notion until the late 1980s. Since then, investigators Richard G. Tedeschi and Lawrence G. Calhoun have been at the forefront of efforts to document the evidence of post-traumatic growth, and to suggest the processes by which distressing negative events may become catalysis for personal development, values reorganization. With the recent focus on optimal human functioning, resilience, and well-being, research on post-traumatic growth has become popular.
Payne, A. Liebling-Kalifani, H., & Stephen, J. (2007). Client-centered group therapy for survivors of interpersonal trauma: A pilot investigation. Counselling & Psychotherapy Research, 7, 100-105.
Group therapy for trauma survivors provides an opportunity to share experiences with others in a supportive environment. Client-centred groups have received very little attention as a way of working with traumatised people. Such groups promise to promote psychological growth following trauma. In this paper we present pilot data from a client-centred group of six survivors of interpersonal violence who were experiencing complex posttraumatic stress reactions. Results suggested that those who perceived the presence of empathic listening within the group therapy sessions benefited from the group, showing greater positive changes. Clinical implications for working with trauma survivors, methodological considerations and directions for future research are discussed.
Sheikh, A.I. (2008). Postraumatic growth in trauma survivors: Implications for practice. Counselling Psychology Quarterly, 21, 85-97.
The study of positive sequelae to trauma is increasingly a focus of attention in the trauma research literature. This paper describes the construct of posttraumatic growth, a phenomenon that involves positive changes and benefits gained through coping with traumatic experiences. Variables associated with posttraumatic growth are summarized. Specific interventions for counselling psychology practice are described.
Sheikh, A.I., & Marotta, S.A. (2008). Best practices for counseling in cardiac rehabilitation settings. Journal of Counseling and Development, 86, 111-120.
Heart disease is the leading cause of death in the United States and can affect individuals of all ages, gender, ethnicity, and socioeconomic status. This article reviews the research on psychosocial interventions in cardiac rehabilitation programs and discusses the evolving set of best practices for counselors working in a new setting with people who have experienced the trauma of cardiac disease. Recommendations for best practices for counselors who work in this emerging area are provided, including recommendations for facilitating posttraumatic growth.
Hoffman, A. (2013). Introduction to Special Issue: Positive adaptation: Conceptualizing posttraumatic positive adjustment. Counselling Psychology Quarterly, 26, 1-7.
The contributions to this Special Issue focus on three conceptualizations of positive adjustment following a trauma: posttraumatic growth, meaning making, and spiritual transformation. The authors explore these concepts among varying populations and provide implications for counseling practice and research.
Park, C.L., & Gutierrez, I.A. (2013). Global and situational meanings in the context of trauma: Relations with psychological well-being. Counselling Psychology Quarterly, 26, 8-25.
Using the meaning making model as our framework, we examined relations among global and appraised meaning and well-being in a sample of 189 college students who had experienced a highly stressful event in the past 5 years. Results suggested that elements of both global meaning (especially self-esteem beliefs) and situational meaning (especially appraisals of the event as violating one's goals) were independently related to a range of well-being outcomes, including depression, anxiety, stress, subjective happiness, and life satisfaction. However, relations varied by specific aspect of well-being. Neither control nor religious beliefs were consistently related to well-being. These results demonstrate the importance of both global and situational meanings in adjusting to life stress. Counselors should attend to both global and situational meanings in the context of helping clients deal with stressful experiences; such attention may focus on bolstering adaptive global beliefs such as self-esteem while also reappraising situational meanings, particularly of the event as violating important global beliefs and goals.
Perera, S., & Frazier, P.A. (2013). Changes in religiosity and spirituality following potentially traumatic events. Counselling Psychology Quarterly, 26, 26-38.
The purpose of our study was to investigate spiritual and religious changes in the context of life adversities. Specifically, we compared university students (n = 122) who had recently experienced a potentially traumatic event (PTE) and a matched comparison group (n = 122) who had not experienced a recent PTE, in terms of: (1) the amount of actual and self-perceived positive and negative change in religiosity and spirituality; (2) the relations between perceived and actual positive and negative spiritual change; and (3) the relation between change in religiosity and spirituality and change in distress. Although there were small actual and perceived changes in religiosity and spirituality within each group, there were no between-group differences in terms of religious and spiritual change. Thus, changes over time in these life domains are not unique to PTE exposure. As expected, the relations between actual and perceived changes were small, highlighting that perceived and actual change are different constructs. Finally, differences between the two groups in the relations between religious and spiritual change and distress suggested that changes in these life domains may reflect coping efforts in the PTE group. We discuss the counseling and research implications of these results.
Vilenica, S., Shakespeare-Finch, J., & Obst, P. (2013). Exploring the process of meaning making in healing and growth after childhood sexual assault: A case study approach. Counselling Psychology Quarterly, 26, 39-54.
Childhood sexual assault (CSA) is one of the most devastating of all traumatic experiences, with population studies documenting survivors experiencing higher levels of pathology than survivors of other traumatic experiences. Yet, recent research has demonstrated that far from being permanently crippled by their experiences, many adult survivors of CSA manage to heal and move forward in their lives to experience a rich and fulfilling existence. In this article, two case studies are presented to provide a detailed account of how people who have experienced CSA may find a pathway to healing. Our data demonstrate that meaning making, spiritual or otherwise, is a pivotal part of acceptance of CSA and ensuing growth. The case studies amplify the unique journeys of two women along with underlying similarities in their pathways to healing. Clinical implications of the research are discussed and specific strategies for encouraging healing and growth are outlined.
Tallman, B.A. (2013). Anticipated posttraumatic growth from cancer: The roles of adaptive and maladaptive coping strategies. Counselling Psychology Quarterly, 26, 72-88.
Research suggests that individuals with chronic health conditions experience posttraumatic growth (PTG), such as in the diagnosis and treatment of cancer. How PTG is perceived at early time points following stressful events and whether PTG reflects a coping process remains uncertain. The current longitudinal study examined cancer patients’ perceptions of anticipated posttraumatic growth (APTG), dispositional and situational coping, and perceived PTG at three time points spanning pre-treatment to nine months later. Participants were 49 mixed-cancer patients. At pre-treatment, participants completed a modified PTG Inventory to assess APTG. Results revealed that patients reported higher levels of APTG compared to reports of PTG in the literature, with patients “over-anticipating” PTG for all scales. Coping via dispositional planning moderated the relation between PTG and APTG. These results provide evidence for APTG as a coping process and as an important precursor for later PTG. I discuss these findings in terms of relevant theory and practice implications.
Barrington, A.J., & Sharkespeare-Finch, J. (2013). Working with refugee survivors of torture and trauma: An opportunity for vicarious post-traumatic growth. Counselling Psychology Quarterly, 26, 89-105.
Clinical work with people who have survived trauma carries a risk of vicarious traumatisation for the service provider, as well as the potential for vicarious post-traumatic growth (VPTG). Despite a growing interest in this area, the effects of working with survivors of refugee-related trauma have remained relatively unexplored. In this study, we examined the lived experiences of people working on a daily basis with survivors of torture and trauma who had sought refuge in Australia. Seventeen clinical, administrative and managerial staff from a not-for-profit organisation participated in a semi-structured interview that was later analysed using interpretive phenomenological analysis. Analysis of the data demonstrated that the entire sample reported symptoms of vicarious trauma (e.g. strong emotional reactions, intrusive images and shattering of existing beliefs) as well as VPTG (e.g. forming new relationships, increased self-understanding and gaining a greater appreciation of life). Moreover, effortful meaning-making processes appeared to facilitate positive changes. Reduction in the risks associated with this work, the enhancement of clinician well-being, and improvement of therapeutic outcomes for clientele are responsibilities shared by the organisation and clinicians. Without negating the distress of trauma work, clinicians are encouraged to more deeply consider the unique positive outcomes that supporting survivors can provide.
Non-Counseling Psychology Literature
Empirical investigations and theoretical discussions of post-traumatic growth are more extensive and more fully developed in fields outside of counseling psychology. Clinical psychologists, in particular, have extensively researched and incorporated post-traumatic growth into clinical work. Many of their studies have demonstrated that posttraumatic growth is often a more commonly outcome of trauma than clinicians previously believed. In particular, clinical psychologists have outlined the five major domains of posttraumatic growth and discussed this construct in relation to adult development. Authors have discussed the following issues in relation to posttraumatic growth: specific processes involved in posttraumatic growth, clinical implications, cultural factors, and assessment methods and tools.
However, there is inconsistency in the use of terms similar to posttraumatic growth, such as resilience. In reviewing the literature, it was unclear whether researchers consider these two constructs to be similar in nature or distinctly different. Future research that delineates between similar constructs, such as posttraumatic growth and resilience, would be useful in determining whether these terms are the same construct or represent different processes following traumatic experiences.
Bonanno , G.A. (2004) Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28 doi:10.1037/0003-066X.59.1.20
Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.
Bonanno, G. A. (2005). Resilience in the face of potential trauma. Current Directions in Psychological Science, 14(3), 135-138.
Until recently, resilience among adults exposed to potentially traumatic events was thought to occur rarely and in either pathological or exceptionally healthy individuals. Recent research indicates, however, that the most common reaction among adults exposed to such events is a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences. A surprising finding is that there is no single resilient type. Rather, there appear to be multiple and sometimes unexpected ways to be resilient, and sometimes resilience is achieved by means that are not fully adaptive under normal circumstances. For example, people who characteristically use self-enhancing biases often incur social liabilities but show resilient outcomes when confronted with extreme adversity. Directions for further research are considered.
Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007). What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of consulting and clinical psychology, 75(5), 671-82. doi:10.1037/0022-006X.75.5.671.
A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.
Bonanno, G. A. (2005). Clarifying and extending the construct of adult resilience. American Psychologist, 60, 265-267. doi:10.1037/0003-066X.60.3.265b
In this article the author responds to comments made in this issue responding to his original article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The author notes that in his original article he focused on three crucial points: Resilience among adults represents a distinct and empirically separable outcome trajectory from that normally associated with recovery from trauma; resilience is more prevalent than generally accepted in either the lay or professional literature; and there are multiple and sometimes unexpected factors that inform adult resilience. Owing to the brevity of the article, the author could only touch briefly on many of the more nuanced and complex issues suggested by the resilience construct; this left plenty of room for critique. Fortunately, the comments are generous and insightful and for the most part compatible with the driving goal of the article. As might be expected, of course, there were statements peppered throughout the comments that the author deemed worthy of rebuttal or correction. He considers four points that seemed to beg most urgently for response.
Bonanno, G.A., & Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125(6), 760-776. doi:10.1037/0033-2909.125.6.760
For nearly a century, bereavement theorists have assumed that recovery from loss requires a period of grief work in which the ultimate goal is the severing of the attachment bond to the deceased. Reviews appearing in the 1980s noted a surprising absence of empirical support for this view, thus leaving the bereavement field without a guiding theoretical base. In this article, the authors consider alternative perspectives on bereavement that are based on cognitive stress theory, attachment theory, the social-functional account of emotion, and trauma theory. They then elaborate on the most promising features of each theory in an attempt to develop an integrative framework to guide future research. The authors elucidate 4 fundamental components of the grieving process—context, meaning, representations of the lost relationship, and coping and emotion-regulation processes—and suggest ways in which these components may interact over the course of bereavement.
Bonanno, G. A., Westphal, M., & Mancini, A. D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511-535. Retrieved from http://www.annualreviews.org/doi/abs/10.1146/annurev-clinpsy-032210-104526.
Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience.
Bonanno, G.A., Wortman, C.B., Lehman, D.R., Tweed, R.G., Haring, M., Sonnega, J., Carr, D., & Nesse, R.M. (2002). Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology, 83(5), 1150-1164. doi:10.1037/0022-35220.127.116.110
The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-mo postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.
Aldwin[AH3] , C. M., & Levenson, M. R. (2004). Posttraumatic growth: A developmental perspective. Psychological Inquiry, 15(1), 19-22. Stable URL: http://www.jstor.org/stable/20447195
Although investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of the "Psychological Inquiry" are not the first to discuss post-traumatic growth, they have done much to systematize investigation into the topic, by both their theoretical and empirical work. Few would disagree with their identification of the five major domains of post traumatic growth. Nonetheless, the field is still new and there are a great many questions still unresolved. This commentary focuses on developmental issues about the process by which growth occurs after the experience of traumas and other events. The study of adult development has much to contribute to this discussion, given its major focus on how and why change occurs in adulthood.
Almedom, A. (2005). Resilience, hardiness, sense of coherence, and posttraumatic growth: All paths leading to "light at the end of the tunnel"? Journal of Loss and Trauma, 10(3), 253-265. doi:10.1080/15325020590928216.
Two questions prompted this targeted review: (a) What are the behavioral and social determinants of individual and/or collective resilience-the capacity to rebound from crisis? and (b) Is the evidence base for related concepts, including hardiness, sense of coherence, and posttraumatic growth consistent? The findings suggest that the theory of salutogenesis, operationalized by the sense of coherence construct, is inclusive of the related concepts of resilience and hardiness. Moreover, it is grounded in robust primary research of cross-cultural relevance. More recent concepts of recovery and posttraumatic growth also contribute to our understanding of resilience. Implications for international humanitarian psychosocial programming are discussed.
Anderson , K. M., Danis, F. S., & Havig, K. (2011). Adult daughters of battered women: Recovery and posttraumatic growth following childhood adversity. Families in Society, 92(2). doi:10.1606/1044-3894.4092.
This article details the recovery process, including posttraumatic growth, for 15 adult daughters of battered women. Using qualitative inquiry, participants' recovery was found to involve a cognitive restructuring of childhood misconceptions of themselves, their parents, and the trauma itself. Key to this transformation process, and consequently allowing for posttraumatic growth, was an interwoven process of meaning-making including two specific elements of understanding: the cause and effect of domestic violence and the significance of suffering from such exposure in childhood. Distancing from their parents, education on domestic violence, accessing therapeutic/support services, and having a spiritual connection contributed to enhanced insight and wisdom. Implications include providing professionals with conceptual insights regarding how to identify and support adult daughters' lifelong recovery and growth.
Boals , A., Steward, J., & Schuettler, D. (2010). Advancing our understanding of posttraumatic growth by considering event centrality. Journal of Loss & Trauma, 15(6), 518-533. doi:10.1080/15325024.2010.519271
Research on posttraumatic growth (PTG) has been plagued by inconsistencies and small effect sizes. We hypothesized that relationships between PTG and other psychological variables would become stronger and more consistent with expectations when we limited analyses to only adverse events construed as central to one's identity. The results supported the hypothesis. Comparing our results to those from a recent meta-analysis on PTG, the relationships between PTG, depression, and positive affect were stronger when examining only events central to identity. Additionally, previously nonsignificant correlations with anxiety, global distress, and physical health became significant in the expected directions. Lastly, a formerly puzzling positive correlation between PTG and posttraumatic stress disorder (PTSD) symptoms became nonsignificant. In stark contrast, limiting analyses to only events meeting the DSM-IV A1 criterion did not produce similar results. Future PTG studies should exclude events that fail to cause disruption in respondents' core beliefs to better separate coping behaviors from PTG.
Butler, L. D. (2007). Growing pains: Commentary on the field of posttraumatic growth and Hobfoll and colleagues? Recent contributions to it. Applied Psychology, 56(3), 367-378. doi:10.1111/j.1464-0597.2007.00293.x
The field of research on benefit-finding and growth following traumatic experience lacks consensus with respect to some central conceptual questions, and a number of these issues are apparent in the research reported by Stevan Hobfoll and his colleagues. In this commentary I briefly discuss, and at times dispute, some of the assertions and assumptions in this target article that I believe reflect these broader issues, including that: psychosocial gains (or benefits) and psychological growth are equivalent, reporting gains (or benefits) represents maladaptive efforts at coping, posttraumatic growth (PTG) is necessarily linked with positive psychological adjustment, and trauma symptoms represent poor adjustment following traumatic event exposure. I also discuss the intriguing proposal of this research: that action is essential to true growth.
Butler, L. D., Blasey, C. M., Garlan, R. W., McCaslin, S. E., Azarow, J., Chen, X., et al. (2005). Posttraumatic growth following the terrorist attacks of September 11, 2001. Cognitive, coping and trauma symptom predictors in an internet convenience sample. Traumatology, 11, 247-267. doi:10.1177/153476560501100405
Cognitive, coping, and trauma symptom predictors of posttraumatic growth (PTG; measured with the Post-traumatic Growth Inventory) were examined in a large convenience sample (n =1,505) participating in a longitudinal Internet-based study following the terrorist attacks of 9/11/01. Results indicate that initial PTG levels (mean 9 weeks post-attacks) were generally associated with higher trauma symptoms (measured with the PTSD Checklist-Specific), positive changes in worldview (measured with the Changes in Outlook Questionnaire), more denial, and less behavioral disengagement (measured with the Brief COPE). Additionally, PTG had a curvilinear association with level of trauma symptoms, such that those reporting symptoms at intermediate levels reported the highest levels of growth. Levels of PTG declined somewhat over time with the exception of Spiritual Change. As expected, PTG levels at follow-up (mean 6.5 months post-attacks) were primarily predicted by initial PTG levels; however, decreases from baseline in trauma symptoms and increases from baseline in positive worldview, acceptance, and positive reframing were also associated with higher reported posttraumatic growth at follow-up. These findings suggest that there may be a range of traumatic experience most conducive to growth and they also highlight the important contributions of cognitive and coping variables to psychological thriving in short- and longer-term periods following traumatic experience
Calhoun, L. G., Cann, A., Tedeschi, R. G., & McMillan, J. (2000). A correlational test of the relationship between posttraumatic growth, religion, and cognitive processing. Journal of Traumatic Stress, 13(3), 521-527. doi:10.1023/A:1007745627077
The present study examined the degree to which event related rumination, a quest orientation to religion, and religious involvement is related to posttraumatic growth. Fifty-four young adults, selected based on prescreening for experience of a traumatic event, completed a measure of event related ruminations, the Quest Scale, an index of religious participation, and the Posttraumatic Growth Inventory. The three subscales of the Quest Scale, the two groups of rumination items (soon after event/within past two weeks), and the index of religious participation were entered in a standard multiple regression with the total score of the Posttraumatic Growth Inventory as the dependent variable. The degree of rumination soon after the event and the degree of openness to religious change were significantly related to Posttraumatic Growth. Congruent with theoretical predictions, more rumination soon after the event, and greater openness to religious change were related to more posttraumatic growth. Present findings offer some confirmation of theoretical predictions, and also offer clear direction for further research on the relationships of religion, rumination, and posttraumatic growth.
Calhoun, L. G., & Tedeschi, R. G. (1998). Beyond recovery from trauma: Implications for clinical practice and research. Journal of Social Issues, 54(2), 357-371. doi:10.1111/j.1540-4560.1998.tb01223.x
This article draws implications for clinicians working with survivors of major life crises in four general areas: the relation of psychological well-being, distress, and posttraumatic growth; conceptual issues in this type of clinical work; the process of encouraging growth in clients following traumatic events; and suggestions for additional research. Posttraumatic growth can be accompanied by an increase in well-being, but distress and growth may also coexist. Positive changes can occur in several domains, but many are likely to be phenomenological. Degree of change produced by clinical intervention may be limited in scope, but there clearly are some ways in which the clinician may make growth more likely for the client. Suggestions for future research include the call for longitudinal investigations, studies of rumination and responses of the social network, and the examination of potential gender differences in posttraumatic growth.
Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic growth: A clinician's guide. Mahwah, NJ: Erlbaum.
The authors provide a framework for clinical efforts to enhance posttraumatic growth. Chapters provide case examples, clinical approaches, and resources for both clinicians and clients.
Calhoun, L. G., & Tedeschi, R. G. (2001). Posttraumatic growth: The positive lessons of loss. In R. A. Neimeyer, (Ed), Meaning reconstruction & the experience of loss, (pp. 157-172). Washington, DC: American Psychological Association. doi:10.1037/10397-008
Presents a wide-ranging review of the substantial empirical literature that provides evidence of personal growth resulting from a struggle with loss, for at least a stable minority of those who suffer it. Processes addressed include factors such as individual differences, the magnitude of the trauma and the growth processes facilitating a changed sense of self, changed relationships, existential and spiritual growth. The authors go on to develop not only a research agenda for future investigations, but also some preliminary guidelines for practicing clinicians engaged with their clients in an effort after meaning.
Calhoun, L. G. & Tedeschi, R. G. (2004) The foundations of posttraumatic growth: New considerations, Psychological Inquiry, 15(1), 93-102 doi:10.1207/s15327965pli1501_03
In response to comments on our model of posttraumatic growth, we consider the validity of reports of posttraumatic growth, appropriate methodology to use to assess posttraumatic growth, and its relation with other variables that appear to bear a resemblance to posttraumatic growth (e.g., well-being and psychological adjustment). The potentially important role of proximate and distal cultural factors is also addressed. Clinicians are encouraged to use interventions that facilitate posttraumatic growth with care, so as not to create expectations for posttraumatic growth in all trauma survivors, and to instead promote a respect for the difficulty of trauma recovery while allowing for the exploration of possibilities for various kinds of growth even in those who have suffered greatly.
Calhoun, L. G. & Tedeschi, R. G. (2008). The paradox of struggling with trauma: Guidelines for practice and directions for research. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 325-337). Hoboken, NJ: Wiley.
Calhoun, L., Tedeschi, R., & Cann, A. (2010). Positive outcomes following bereavement: Paths to posttraumatic growth. Psychologica Belgica, 50(1&2), 125-143.
Recent theory and research have drawn attention to the need to better understand the positive changes, termed posttraumatic growth, that often occur in bereaved individuals; even as negative emotions related to grief persist. We describe five dimensions of posttraumatic growth and present a model for understanding how the loss of a close other can eventually lead to a recognition of important positive personal changes. Loss, especially unexpected loss, disrupts an individual's beliefs about the world and initiates a process of rebuilding an understanding. During this process, many people come to realise their own strengths, appreciate the impact of their relationships, and have new spiritual insights. A strategy for facilitating growth during clinical work also is described.
Cann , A., Calhoun, L., Tedeschi, R., Taku, K., Vishnevsky, T., Triplett, K., & Danhauer, S. (2010). A short form of the Posttraumatic Growth Inventory. Anxiety, Stress & Coping, 23(2), 127-137. doi:10.1080/10615800903094273
A short form of the Posttraumatic Growth Inventory (PTGI-SF) is described. A sample of 1351 adults who had completed the Posttraumatic Growth Inventory (PTGI) in previous studies provided the basis for item selection. The resulting 10-item form includes two items from each of the five subscales of the original PTGI, selected on the basis of loadings on the original factors and breadth of item content. A separate sample of 186 completed the short form of the scale (PTGISF). Confirmatory factor analyses on both data sets demonstrated a five-factor structure for the PTGI-short form (PTGI-SF) equivalent to that of the PTGI. Three studies of homogenous clinical samples (bereaved parents, intimate partner violence victims, and acute leukemia patients) demonstrated that the PTGI-SF yields relationships with other variables of interest that are equivalent to those found using the original form of the PTGI. A final study demonstrated that administering the 10 short-form items in a random order, rather than in the fixed context of the original scale, did not impact the performance of the PTGI-SF. Overall, these results indicate that the PTGI-SF could be substituted for the PTGI with little loss of information.
Chopko, B. (2010). Posttraumatic distress and growth: An empirical study of police officers. American Journal of Psychotherapy, 64(1), 55-72.
Few studies have examined the experience of posttraumatic growth, among police officers following traumatic incidents. Additionally, research examining the relationship between posttraumatic distress (e.g., posttraumatic symptoms) and posttraumatic growth among various populations has been inconsistent. Consistent with the need to gain enhanced understanding in the area of posttraumatic growth, this study investigated the relation between posttraumatic distress (using the Impact of Events Scale-Revised) and posttraumatic growth (using the Posttraumatic Growth Inventory) among 183 police officers. Results of Pearson Correlations showed that posttraumatic distress was significantly and positively related to the Posttraumatic Growth Inventory full-scale and all sub-scale scores. Multiple regression analyses revealed that being involved in a duty-related shooting was the most significant predictor of posttraumatic growth. Implications for mental health providers are discussed.