Showing papers by "George A. Bonanno published in 2011"
TL;DR: The question of whether resilience-building interventions can actually make people more resilient is critically evaluated, and a set of prototypical outcome patterns are identified that show multiple independent predictors of resilient outcomes.
Abstract: 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 researc...
856 citations
TL;DR: The Perceived Ability to Cope with Trauma (PACT) scale as discussed by the authors measures the perceived ability to focus on processing the trauma (trauma focus) and to move beyond the traumatic event (forward focus).
Abstract: Theories about coping with potential trauma have emphasized the importance of concerted focus on processing the traumatic event. However, empirical evidence also suggests that it may be salubrious to distract oneself, remain optimistic, and focus on moving past the event. These seemingly contradictory perspectives are integrated in the concept of coping flexibility. This investigation reports the development and validation of a brief questionnaire, the Perceived Ability to Cope With Trauma (PACT) scale, with 2 scales that measure the perceived ability to focus on processing the trauma (trauma focus) and to focus on moving beyond the trauma (forward focus). In addition, we created a single flexibility score that represented the ability to use both types of coping. Participants included an Israeli sample with potential high trauma exposure and a sample of American college students. The factor structure of the PACT was confirmed in both samples. Preliminary evidence was obtained for the PACT’s convergent, discriminant, and incremental validity. Both the Forward Focus and Trauma Focus scales were independently associated with better adjustment, and each scale independently moderated the impact of heightened trauma exposure. Similarly, the combination of these scales into a single parsimonious flexibility score also moderated trauma exposure. Limitations of and future research with the measure are considered.
182 citations
TL;DR: Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social, and financial resources could benefit people exposed to chronic trauma.
176 citations
TL;DR: Bereaved adults who lost their spouse 1.5-3 years earlier and a comparable sample of married adults exhibited deficits in expressive flexibility, and the CG group was less able to enhance and more able to suppress emotional expression relative to asymptomatic bereaved and married adults.
Abstract: There is growing evidence that deficits in emotion regulation may be at the heart of maladaptive reactions after bereavement. Expressive flexibility, or the ability to flexibly enhance or suppress emotional expression, appears to be especially important for adjustment in the aftermath of highly aversive events (Bonanno, Papa, Lalande, Westphal, & Coifman, 2004). In this study, we compared expressive flexibility in a sample of bereaved adults who lost their spouse 1.5–3 years earlier and a comparable sample of married adults. Approximately half of the bereaved adults had Complicated Grief (CG) and half were asymptomatic. Using a within-subjects design, we asked all participants to either enhance or suppress their expressions of emotion or to behave normally while viewing evocative pictures at a computer screen. Observer ratings of expressiveness made blind to condition showed no group differences in overall emotion. However, bereaved adults suffering from CG exhibited deficits in expressive flexibility. Specifically, the CG group was less able to enhance and less able to suppress emotional expression relative to asymptomatic bereaved and married adults.
132 citations
TL;DR: This paper used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage) and found that a four-class trajectory solution provided the best fit for bereavement and marriage.
Abstract: Theorists have long maintained that people react to major life events but then eventually return to a setpoint of subjective well-being. Yet prior research is inconclusive regarding the extent of interindividual variability. Recent theoretical models suggest that there should be heterogeneity in long-term stress responding (Bonanno, 2004; Muthen & Muthen, 2000). To test this idea, we used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage). A four-class trajectory solution provided the best fit for bereavement and marriage, while a three-class solution provided the best fit for divorce. Relevant covariates predicted trajectory class membership. The modal response across events was a relatively flat trajectory (i.e., no change). Nevertheless, some trajectories diverged sharply from the modal response. Despite the ten- dency to maintain preevent levels of SWB, there are multiple and often divergent trajectories in response to bereavement, divorce, and marriage, underscoring the essential role of individual differences.
119 citations
TL;DR: Advances made after 9/11 are reviewed, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders.
Abstract: A wealth of research and experience after 9/11 has led to the development of evidence-based and evidence-informed guidelines and strategies to support the design and implementation of public mental health programs after terrorism and disaster. This article reviews advances that have been made in a variety of areas, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation; clarification of risk and resilience factors as these relate to varying outcome trajectories for survivors and inform interventions; development and implementation of evidence-based and evidence-informed early, midterm, and late interventions for children, adults, and families; adaptation of interventions for cultural, ethnic, and minority groups; improvement in strategies to expand access to postdisaster mental health services; and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders. Continuing improvement of psychologists' national capacity to respond to catastrophic events will require more systematic research to strengthen the evidence base for postdisaster screening and interventions and effective methods and platforms for training. Policy decisions are clearly needed that enhance federal funding to increase availability and access to services, especially for longer term care. Traumatic bereavement represents a critical area for future research, as much needs to be done to clarify issues related to reactions and adaptation to a traumatic death.
100 citations
TL;DR: Although participants underrecalled the frequency of all types of life events, recollection was more accurate for PTEs than for non-PTEs and high distress at recall was associated with a greater recalled-frequency, but only for people low in trait self-enhancement.
Abstract: We conducted a prospective study that tracked the frequency of potentially traumatic events (PTEs) and nontraumatic events among college students over a 4-year period using a weekly web-based survey. At the study’s completion, participants attempted to recall the number of events they had endorsed on the web surveys. Although participants underrecalled the frequency of all types of life events, recollection was more accurate for PTEs than for non-PTEs. Recalled-frequency of PTEs was associated positively with distress at recall and inversely with trait self-enhancement. These effects were qualified by a distress X self-enhancement interaction. High distress at recall was associated with a greater recalled-frequency of PTEs, but only for people low in trait self-enhancement.
64 citations
TL;DR: The current prospective study is among the first to provide evidence for a role for positive emotion as a mechanism by which bereavement influences hypothalamic-pituitary-adrenal axis dysregulation in older adults.
Abstract: Objective: The objective of this study was to examine the role of spousal bereavement and positive emotion in naturally occurring levels of daily cortisol. Methods: Analyses were conducted using data from the Midlife in the United States survey and the National Study of Daily Experiences. Baseline assessments of extraversion, neuroticism, trait positive emotion, and trait negative emotion were obtained, as were reports of demographic and health behavior covariates. Salivary cortisol levels were measured at wakeup, 30 min after awakening, before lunch, and at bedtime on each of 4 successive days. Results: Multilevel growth curve analyses indicated that independent of age, gender, education, extraversion, neuroticism, negative emotion, medication use, and smoking, spousal bereavement was associated with lower levels of cortisol at wakeup and a flattening of the diurnal cortisol rhythm. Mediation analyses revealed that prospective changes in positive emotion accounted for the impact of bereavement on diurnal cortisol slopes. Conclusion: The current prospective study is among the first to provide evidence for a role for positive emotion as a mechanism by which bereavement influences hypothalamic– pituitary–adrenal axis dysregulation in older adults.
45 citations
TL;DR: By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, it is found that the majority of individuals demonstrate no long-term effects on life satisfaction in response to childbirth.
Abstract: A recent article in New York Magazine echoed what psychological studies of parenthood have consistently demonstrated since the 1970s: "Most people assume that having children will make them happier. Yet a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so" (Senior, 2010). There is consistent evidence that, as opposed to other life events that cause transient disruptions in life satisfaction, becoming a parent appears to cause harm to individual subjective well-being (Twenge, Campbell, & Foster, 2003), and that this harm is sustained over time (Clark, Diener, Georgellis, & Lucas, 2008). The current investigation was predicated on the concern that these findings may be the result of the methodology used to examine them. As the experience of parenthood does not represent a unified phenomenon, we employed a methodological approach that allows for the exploration of heterogeneity as well as its predictors. By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, we find that the majority of individuals (84.2%) demonstrate no long-term effects on life satisfaction in response to childbirth. Only a small percentage demonstrate the sustained declines (7.2%), and a significant cohort, previously unobserved in the literature, demonstrate dramatic and sustained improvements in response to parenthood (4.3%), providing compelling evidence for heterogeneity in life satisfaction among parents. Key demographic covariates that distinguish between trajectories of response are also explored.
41 citations
TL;DR: Theories of complicated grief and posttraumatic stress disorder (PTSD) posit a central etiological and maintaining role for global beliefs about the world (Janoff-Bulman, 1992) as mentioned in this paper.
Abstract: Theories of complicated grief (CG) and posttraumatic stress disorder (PTSD) posit a central etiological and maintaining role for global beliefs about the world (Janoff-Bulman, 1992). In two studies using separate bereaved samples, we examined these theoretical postulates. Study 1 included prospective data on bereaved spouses and nonbereaved controls at baseline and 6-months post-loss. High pre-loss justice beliefs and acceptance of death prospectively predicted lower depression in bereaved but not control participants, providing evidence for buffering effects. Study 2 used longitudinal data on bereaved spouses and parents (4- and 18-months post-loss), and matched nonbereaved controls. In comparisons to matched controls, bereaved persons showed more benevolent but less meaningful worldviews, and violent or sudden loss was not associated with negative worldviews. In contrast to theoretical proposals, early benevolence, and meaningfulness beliefs showed no longitudinal relation to later PTSD, grief, and depr...
39 citations
TL;DR: This study compared adaptive and maladaptive dependency across three matched groups: prolonged grievers, asymptomatically bereaved adults, and a married comparison group, suggesting a link between adaptive dependency and asymPTomatic bereavement, and between mal Adaptive dependency and prolonged grief.
01 Aug 2011
Abstract: Introduction As much as we might wish it otherwise, bad things happen: war, natural disaster, the death of close friends and relatives, serious accidents, senseless abuse or violence at the hand of others, and so on. Any of these things can and all too often do happen, and at every stage of life. Epidemiological data indicate that most adults experience at least one and usually several potentially traumatic events (PTE) during the course of their lives (Norris, 1992; Kessler et al., 1995; Breslau et al., 2000), and that most children are also exposed to such experiences (Copeland et al., 2007). It is important to note, however, that life event research typically relies on retrospective accounts, which more than likely underestimate the frequency of PTEs. Indeed, a recent study that measured life events among college students over a four-year period using a weekly internet survey reported an average of six PTEs per student (Lalande & Bonanno, 2011). Perhaps because acutely aversive events are so dreaded, both clinicians and the lay public tend to assume that they will almost always result in lasting emotional damage. The available evidence, however, suggests a more complex and far more encouraging picture. To emphasize the pronounced individual differences in the way people react to adversity, we emphasize that such events are only “potentially traumatic” (Norris, 1992; Bonanno, 2004), for the simple reason that not everyone experiences them as traumatic. Most people in fact cope with PTEs remarkably well (Bonanno, 2004, 2005; Bonanno & Mancini, 2008). Although some do, in fact, endure lasting emotional difficulties, the vast majority of people exposed to extreme adversity recover a semblance of their normal level of functioning within several months to several years after the event, and many if not most show little evidence of more than transient disruptions in functioning.
TL;DR: In this article, the authors examined the consequences of expressing anger among sexually abused women in contexts of either voluntarily disclosing or not disclosing a previous abuse episode (n 94) and found that the expression of anger was associated with better long-term adjustment (decreased internalizing and externalizing symptoms), but only among CSA survivors who had expressed anger while not disclosing an abuse experience.
Abstract: Previous research on anger and childhood sexual abuse (CSA) is largely cross-sectional and retrospective. In this study, we prospectively examined the consequences of expressing anger among sexually abused women in contexts of either voluntarily disclosing or not disclosing a previous abuse episode (n 94). All CSA survivors in the study had documented histories of CSA. These participants and a matched, nonabused sample were asked to describe their most distressing experience while being videotaped to allow coding of anger expression. Approximately two thirds of the CSA survivors voluntarily disclosed a previous abuse experience. Participants completed measures of internalizing symptoms and externalizing symptoms at the time of disclosure and again two years later. The expression of anger was associated with better long-term adjustment (decreased internalizing and externalizing symptoms), but only among CSA survivors who had expressed anger while not disclosing an abuse experience. For CSA survivors who disclosed an abuse experience and for nonabused women, anger expression was unrelated to long-term outcome. These findings suggest that the benefits of anger expression for CSA survivors may be context specific.
01 Aug 2011
TL;DR: Bonanno et al. as discussed by the authors found that most bereaved people experience relatively transient disruptions in their ability to function effectively following a loss, and that the most problematic reaction is found among those with a persistent syndrome of a sometimes incapacitating distress that may take years to resolve.
Abstract: Introduction It is an unfortunate but inevitable fact of life that virtually all of us must face: people we are close to die. Despite this universality, researchers and theorists have long assumed that bereavement almost always results in significant, and sometimes incapacitating, distress. Curiously, the absence of distress after loss has itself been considered pathological and a likely harbinger of future difficulties (Middleton et al., 1993). When bereaved persons fail to display the expected distress reaction, some have maintained that they are suppressing their grief (Middleton et al., 1993) or lack an attachment to their spouse (Fraley & Shaver, 1999). Indeed, emotional expression following loss – particularly negative emotions – has long been considered cathartic, a necessary ingredient of healthy adjustment (Freud, 1957). Perhaps for this reason, bereaved people who appear outwardly resilient and who resume their lives with minimal disruptions have often been thought to possess extraordinary coping abilities. However, this idea has increasingly come under fire (Bonanno, 2004). In fact, most bereaved people experience relatively transient disruptions in their ability to function effectively. Furthermore, research increasingly shows that there is a marked diversity in how people respond to loss. Indeed, it appears that three primary patterns or trajectories adequately describe most people’s response to interpersonal loss. The largest category, usually from 50% to 60%, is characterized by stable, healthy levels of psychological and physical functioning relatively soon after a loss, or “resilience” (Bonanno, 2004; Mancini & Bonanno, 2006). A second category of bereaved persons (20–25%) displays more acute and persistent levels of distress but gradually they too recover their bearings and return to their former level of functioning. The most problematic reaction is found among those with a persistent syndrome of a sometimes incapacitating distress that may take years to resolve. This pattern, often described as “complicated grief” (Bonanno et al., 2007), is relatively rare, typically occurring in 10–15% of grievers (Bonanno & Kaltman, 2001). Two other types of bereavement response have also emerged recently, although they typically characterize only a small proportion of grievers. These include a chronic form of distress that predated the loss and is exacerbated in its aftermath (Bonanno et al., 2002; Mancini et al., 2011) and dramatic improvement following loss (A.D. Mancini, I. Galatzer-Levy, & G.A. Bonanno, unpublished data). Although each is quite uncommon (5–10%), these patterns have been confirmed using different methods and samples, suggesting that they are veridical.
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TL;DR: This article used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage) and found that a four-class trajectory solution provided the best fit for bereavement and marriage.
Abstract: Theorists have long maintained that people react to major life events but then eventually return to a setpoint of subjective well-being. Yet prior research is inconclusive regarding the extent of interindividual variability. Recent theoretical models suggest that there should be heterogeneity in long-term stress responding (Bonanno, 2004; Muthen & Muthen, 2000). To test this idea, we used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage). A four-class trajectory solution provided the best fit for bereavement and marriage, while a three-class solution provided the best fit for divorce. Relevant covariates predicted trajectory class membership. The modal response across events was a relatively flat trajectory (i.e., no change). Nevertheless, some trajectories diverged sharply from the modal response. Despite the tendency to maintain preevent levels of SWB, there are multiple and often divergent trajectories in response to bereavement, divorce, and marriage, underscoring the essential role of individual differences.
TL;DR: This paper examined whether trait self-enhancement would correlate with immune markers and sexual risk taking in a sample of 54 asymptomatic HIV-positive gay men, most of whom were ethnic minorities.
Abstract: Over the past few decades, a relationship has emerged between intrapsychic factors and health outcomes in HIV-positive and other populations. We examined whether trait self-enhancement would correlate with immune markers and sexual risk taking in a sample of 54 asymptomatic HIV-positive gay men, most of whom were ethnic minorities. Participants completed a one-time assessment with regard to self-enhancement, psychological distress, and sexual risk taking, and provided consent to access information regarding immune status and other health-related variables. Both self-enhancement and minority status were significantly associated with CD4 counts, but the latter effect disappeared when looking at only white and African American participants. Neither factor was related to viral load, sexual risk taking, or psychological distress. More research with larger and more diverse samples is needed to further elucidate the possible salutary relationship between self-enhancement and critical medical and behavioral outco...