Showing papers by "George A. Bonanno published in 2014"

Resilience definitions, theory, and challenges: interdisciplinary perspectives

Abstract: In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture). Keywords: Resilience; stress; trauma; post-traumatic stress disorder Responsible Editors: Ananda Amstadter, Virginia Institute for Psychiatric and Behavioral Genetics, VA, USA; Nicole Nugent, Warren Alpert Medical School of Brown University, RI, USA. This paper is part of the Special Issue: Resilience and Trauma . More papers from this issue can be found at http://www.eurojnlofpsychotraumatol.net (Published: 1 October 2014) Citation: European Journal of Psychotraumatology 2014, 5 : 25338 - http://dx.doi.org/10.3402/ejpt.v5.25338

Prospective trajectories of posttraumatic stress in college women following a campus mass shooting.

Abstract: In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the impact of a campus mass shooting on trajectories of PTS in the 31 months following the shooting using latent growth mixture modeling. Female students completed 7 waves of a longitudinal study (sample sizes ranged from 812 to 559). We identified 4 distinct trajectories (n = 660): (a) minimal impact-resilience (60.9%), (b) high impact-recovery (29.1%), (c) moderate impact-moderate symptoms (8.2%), and (d) chronic dysfunction (1.8%). Individuals in each trajectory class remained at or returned to preshooting levels of PTS approximately 6 months postshooting. The minimal impact-resilience class reported less prior trauma exposure (η(2) = .13), less shooting exposure (η(2) = .07), and greater emotion regulation skills than all other classes (η(2) > .30). The chronic dysfunction class endorsed higher rates of experiential avoidance prior to the shooting than the minimal-impact resilient and high impact-recovery classes (η(2) = .15), as well as greater shooting exposure than the high impact-recovery class (η(2) = .07). Findings suggest that preshooting functioning and emotion regulation distinguish between those who experience prolonged distress following mass violence and those who gradually recover.

Optimism and Death: Predicting the Course and Consequences of Depression Trajectories in Response to Heart Attack

Abstract: The course of depression in relation to myocardial infarction (MI), commonly known as heart attack, and the consequences for mortality are not well characterized. Further, optimism may predict both the effects of MI on depression as well as mortality secondary to MI. In the current study, we utilized a large population-based prospective sample of older adults (N = 2,147) to identify heterogeneous trajectories of depression from 6 years prior to their first-reported MI to 4 years after. Findings indicated that individuals were at significantly increased risk for mortality when depression emerged after their first-reported MI, compared with resilient individuals who had no significant post-MI elevation in depression symptomatology. Individuals with chronic depression and those demonstrating pre-event depression followed by recovery after MI were not at increased risk. Further, optimism, measured before MI, prospectively differentiated all depressed individuals from participants who were resilient.

A longitudinal investigation of changes to social resources associated with psychological distress among Kurdish torture survivors living in Northern Iraq.

Abstract: Social resources can buffer against psychological distress following potentially traumatic events. Psychological distress can also lead to social resource deterioration. This longitudinal study evaluated whether baseline psychological distress symptoms and changes in these symptoms were associated with changes in social resources 5 months later among 96 adult male (52.6%) and female treatment-seeking torture survivors residing in Kurdistan, Iraq. Adapted versions of the Hopkins Symptom Checklist-25, Harvard Trauma Questionnaire, and a traumatic grief measure were used. Locally derived scales measured perceived social support, social integration, and frequency of social contact. Multinomial logistic regression models assessed the association between symptoms and loss or gain in social resources. We hypothesized that higher mental health symptoms would relate to decreased social resources. Higher baseline depression (adjusted conditional odds ratio [ACOR] = 1.14), posttraumatic stress disorder (PTSD; ACOR = 1.09), and traumatic grief symptoms (ACOR = 1.14) increased the odds of loss of social integration. For some, higher traumatic grief symptoms were associated with increased social integration (ACOR = 1.17). Increased anxiety (ACOR = 1.23) and PTSD symptoms (ACOR = 1.07) was associated with declines in social contact; decreased depression (ACOR = 1.06) and PTSD symptoms (ACOR = 1.04) were related to gaining social contact. This study highlights the complex relationship between mental health symptoms and losses and gains in social resources among torture survivors.

Heterogeneous depression responses to chronic pain onset among middle-aged adults: A prospective study

Abstract: Studies on depression response to chronic pain are limited by lack of clarification of different forms of response patterns and cross-sectional measures. The current study examined heterogeneous long-term patterns of depression response to chronic pain onset prospectively using the mixture modeling technique. Depression symptoms prior to and following pain onset over a course of six years were charted in a nationally representative middle-aged sample. Four distinct depression symptom trajectories emerged. The resilience (72.0%) trajectory describes a pattern of no/minimal depression symptoms prior to and following pain onset. The post-pain depression trajectory (11.4%) describes a pattern of low depression at baseline and increasing symptoms following pain onset. The chronic depression (6.8%) trajectory is characterized by persistently high depression symptoms irrespective of pain onset. The prior depression improved (9.8%) trajectory describes a pattern of high depression at baseline and gradually declining symptoms following pain onset. Self-rated health at both baseline and following pain onset predicted the resilience trajectory. Baseline self-rated health distinguished the post-pain depression and chronic depression trajectories. Individuals in the prior depression improved trajectory were older and had more chronic illnesses at baseline but fewer illnesses following pain onset, compared to those in the resilience or post-pain depression trajectory.

ATTACHMENT AND ATTENTIONAL BIASES FOR FACIAL ExPRESSIONS OF DISGUST

Abstract: Research on biological and psychological functions of disgust is increasing, yet relatively little is known about how people react to facial displays of disgust. This study used the dot probe task to examine attachment-related biases for emotional faces. Anxiously-attached individuals exhibited a significant tendency both to attend away from closed-mouth disgust faces, which have been associated with social rejection (social-moral disgust), and to attend toward open-mouth disgust faces, which are associated with visceral or core disgust. Consistent with theoretical proposals that there are two distinct sub-types of disgust, we propose that attentional avoidance of closed-mouth disgust faces represents an emotion-regulatory response to perceived social threat among individuals high in attachment anxiety. Future research examining attentional biases to disgust in clinical populations may shed light on interpersonal functions of disgust in psychopathology.

Faces, feelings, words: divergence across channels of emotional responding in complicated grief.

Abstract: Recent evidence suggests that the inability to respond in a context appropriate manner earlier in bereavement is predictive of a protracted grief course with poorer adjustment following the loss (Coifman & Bonanno, 2010). However, little is known about the emotional behavior of adults later in bereavement and whether emotional responding becomes dsyregulated across other channels. An impressive body of evidence in the schizophrenia literature demonstrates a marked disconnection between observable displays of emotion and experienced affect within individuals diagnosed with schizophrenia (e.g., Kring & Moran, 2008). On the basis of this influential work, we examined the emotional responses of a sample of bereaved adults who lost a spouse 1.5-3 years previously. One bereaved group had complicated grief (CG) and the other was relatively asymptomatic. We used an idiographic task where participants discussed their relationships with their spouse and current attachment figure in contexts of conflict and intimacy. We measured emotional responses across 3 channels: self-reported affect, facial expressions, and emotional word use. Individuals within the CG group were less facially expressive across contexts than the asymptomatic group but in some contexts reported experiencing greater affect and used more negative emotion words. These findings suggest that complicated grief in later bereavement is characterized by a disassociation between emotional responding across channels, with context insensitive responding, restricted to facial displays of emotion.

Those were the days: Memory bias for the frequency of positive events, depression, and self-enhancement

Abstract: Past research has associated depression with memory biases pertaining to the frequency, duration, and specificity of past events. Associations have been proposed between both negative and positive memory biases and depression symptoms. However, research has not examined the occurrence of actual events over time in the study of memory bias. To address these limitations and investigate whether a negative or positive memory bias is associated with symptoms of depression, we collected weekly data on specific types of life events over a 4-year period from a sample of college students, and asked students to recall event frequency at the end of that period. Exaggerated recall of frequency for positive events but not other types of events was associated with depression symptoms, using both continuous and categorical measures. Moderator analyses indicated that these effects were evidenced primarily for memories involving the self and among individuals low in trait self-enhancement. The current study indicates that positive memory-frequency bias is an important type of memory bias associated with symptoms of depression. Results support the idea that the link between memory bias for positive event frequency and depressed mood arises out of a current-self vs past-self comparison.

Prerequisiti della convivenza entro i contesti di promozione e tutela della salute. Lo screening mammografico al nord e al sud d'Italia

Abstract: Promotion and Health Care in Various Coexistence Contexts. Breast Screening in the North and South of Italy The effectiveness of early detections of cancer masses has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the cases of breast cancer. A diagnosis of this form of cancer at its early phases, in the 97% of cases allows women to survive at least five years after it. For this reason the Italian healthcare system promotes and finances a breast cancer screening program - that consists in a free mammogram every two years - addressed to all women living in Italy ranging in age between 48 and 69 years. Although this important program, statistics shown by the Osservatorio Nazionale Screening reveal a big numeric gap, comparing the regions of the North and the South of the country, referring to the adherence rate. This study aims at exploring the reasons for this discrepancy, assuming that the trust in health care facilities is a prerequisite for a stable relationship between people and institutions and, therefore, the basis of social coexistence; so the trust, or not, in the local hospitals determines women’s access to the national screening program. In order to answer the research questions of this study we chose to use the focus group technique: 32 Italian women, ranging in age between 48 and 65 years (M= 53, SD= 5.26), 17 living in the North (in or around Milan) and 15 living in the South (in or around Naples) of Italy, took part to a 5 Focus Group concerning breast cancer prevention. The analysis on the groups’ verbatim, done with software allowing a text analysis (ATLAS.ti and T-LAB), highlighted important differences in the way northern and southern subjects emotionally symbolize the context where they live and coexist. The southern hospitals are considered, by the women who live in this geographic area, as places characterized by “incompetence”; this consideration limits the probability that the need of an early detection “coexists” with the possibility that these hospitals would give an appropriate answer to it.