Anxiety Disorders: Bonanno GA

Bonanno GA, Mancini AD. · Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 W 120th St, New York, NY 10027, USA. · Pediatrics. · Pubmed #18245429 links to  free full text

Abstract: For decades, researchers have documented remarkable levels of resilience in children who were exposed to corrosive early environments, such as those in which poverty or chronic maltreatment were present; however, relatively little research has examined resilience in children or adults who were exposed to isolated and potentially traumatic events. The historical emphasis on psychological and physiologic dysfunction after potentially traumatic events has suggested that such events almost always produce lasting emotional damage. Recent research, however, has consistently shown that across different types of potentially traumatic events, including bereavement, serious illness, and terrorist attack, upward of 50% of people have been found to display resilience. Research has further identified substantial individual variation in response to potentially traumatic events, including 4 prototypical and empirically derived outcome trajectories: chronic dysfunction, recovery, resilience, and delayed reactions. Factors that promote resilience are heterogeneous and include a variety of person-centered variables (eg, temperament of the child, personality, coping strategies), demographic variables (eg, male gender, older age, greater education), and sociocontextual factors (eg, supportive relations, community resources). It is surprising that some factors that promote resilience to potentially traumatic events may be maladaptive in other contexts, whereas other factors are more broadly adaptive. Given the growing evidence that resilience is common, psychotherapeutic treatment should be reserved for those in genuine need.

Mancini AD, Bonanno GA. · Clinical Psychology Program, Columbia University, New York, NY 10027, USA. · J Clin Psychol. · Pubmed #16700017 No free full text.

Abstract: Many persons exposed to loss or potentially traumatic events manage the stresses of these experiences with minimal to no impact on their daily functioning. The prevalence of this resilient capacity has surprised researchers and clinicians alike and refocused clinical practice. We review three key points about resilience: resilience is different from the process of recovery; resilience in the face of loss or potential trauma is common; and there are multiple and sometimes unexpected pathways to resilience. We then present six clinical practices informed by the study of resilience, illustrating key points with clinical vignettes.

Bonanno GA, Galea S, Bucciarelli A, Vlahov D. · Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA. · J Consult Clin Psychol. · Pubmed #17907849 No free full text.

Abstract: 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 GA, Neria Y, Mancini A, Coifman KG, Litz B, Insel B. · Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA. · J Abnorm Psychol. · Pubmed #17516766 No free full text.

Abstract: There is growing interest in complicated grief reactions as a possible new diagnostic category for inclusion in the Diagnostic and Statistical Manual of Mental Disorders. However, no research has yet shown that complicated grief has incremental validity (i.e., predicts unique variance in functioning). The authors addressed this issue in 2 studies by comparing grief, depression, and posttraumatic stress disorder (PTSD) symptoms with different measures of functioning (interviewer ratings, friend ratings, self-report, and autonomic arousal). The 1st study (N = 73) used longitudinal data collected at 4 and 18 months postloss, and the 2nd study (N = 447) used cross-sectional data collected 2.5-3.5 years postloss. With depression and PTSD controlled, grief emerged as a unique predictor of functioning, both cross-sectionally and prospectively. The findings provide convergent support for the incremental validity of complicated grief as an independent marker of bereavement-related psychopathology.

Fraley RC, Fazzari DA, Bonanno GA, Dekel S. · Department of Psychology, University of Illinois at Urbana-Champaign, 61820, USA. · Pers Soc Psychol Bull. · Pubmed #16513805 No free full text.

Abstract: This study examined the relationship between individual differences in adult attachment and psychological adaptation in a sample of high-exposure survivors of the terrorist attacks on the World Trade Center on September 11, 2001. Symptoms of posttraumatic stress disorder (PTSD) and depression were assessed via self-report 7 and 18 months after the attacks. In addition, friends and relatives were asked to provide evaluations of participants' adjustment before and after the attacks. Findings indicate that securely attached individuals exhibited fewer symptoms of PTSD and depression than insecurely attached individuals and were viewed by friends and relatives as showing an increase in adjustment following the attacks. Highly dismissing adults were viewed by their friends and family as showing neither increments nor decrements in adjustment, despite the fact that highly dismissing people self-reported relatively high levels of PTSD and depression.

Bonanno GA, Galea S, Bucciarelli A, Vlahov D. · Teachers College, Columbia University, New York, NY 10027, USA. · Psychol Sci. · Pubmed #16507055 No free full text.

Abstract: Research on adult reactions to potentially traumatic events has focused almost exclusively on posttraumatic stress disorder (PTSD). Although there has been relatively little research on the absence of trauma symptoms, the available evidence suggests that resilience following such events may be more prevalent than previously believed. This study examined the prevalence of resilience, defined as having either no PTSD symptoms or one symptom, among a large (n= 2,752) probability sample of New York area residents during the 6 months following the September 11th terrorist attack. Although many respondents met criteria for PTSD, particularly when exposure was high, resilience was observed in 65.1% of the sample. Resilience was less prevalent among more highly exposed individuals, but the frequency of resilience never fell below one third even among the exposure groups with the most dramatic elevations in PTSD.

Negrao C, Bonanno GA, Noll JG, Putnam FW, Trickett PK. · Teachers College, Columbia University, USA. · Child Maltreat. · Pubmed #16204737 No free full text.

Abstract: Childhood sexual abuse (CSA) may produce powerful and enduring emotion reactions, including intense shame, anger, and humiliation. Whereas shame and anger have received considerable interest from researchers, less attention has been paid to humiliation or associated coherence among these emotions as it relates to the psychological adjustment in CSA survivors. In the current investigation, the authors coded shame, anger, and humiliation from narrative transcripts of CSA survivors as they either voluntarily disclosed an abuse experience or described a distressing nonabuse experience and from nonabused individuals as they described a distressing experience. Verbal humiliation was found to be significantly associated with nonverbal displays of shame. Coherence between verbal humiliation and facial shame among CSA nondisclosers was associated with increased symptoms of posttraumatic stress disorder.

Bonanno GA, Rennicke C, Dekel S. · Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA. · J Pers Soc Psychol. · Pubmed #15982117 No free full text.

Abstract: The authors examined self-enhancing bias as a predictor of adjustment among individuals in or near the World Trade Center during the September 11, 2001, terrorist attacks. Resilience was defined from categorical and continuous analyses of both participant self-report and friend and relative ratings of adjustment. Self-enhancement was associated with a resilient outcome, ratings of better adjustment prior to September 11th, greater positive affect, and reduced perceptions of social constraints. Additional analyses indicated that self-enhancers' reduced symptom levels were fully mediated by their low perceived social constraints. However, consistent with previous evidence suggesting a social cost to self-enhancement, at 18 months post-September 11th, self-enhancers' friends and relatives also rated them as decreasing in social adjustment and as being less honest.

Noll JG, Horowitz LA, Bonanno GA, Trickett PK, Putnam FW. · University of Southern California, USA. · J Interpers Violence. · Pubmed #14678616 No free full text.

Abstract: Lifetime trauma histories were ascertained for females with confirmed histories of childhood sexual abuse and comparison females participating in a longitudinal, prospective study. Abused participants reported twice as many subsequent rapes or sexual assaults (p = .07), 1.6 times as many physical affronts including domestic violence (p = .01), almost four times as many incidences of self-inflicted harm (p = .002), and more than 20% more subsequent, significant lifetime traumas (p = .04) than did comparison participants. Sexual revictimization was positively correlated with posttraumatic stress disorder symptoms (PTSD), peritraumatic dissociation, and sexual preoccupation. Physical revictimization was positively correlated with PTSD symptoms, pathological dissociation, and sexually permissive attitudes. Self-harm was positively correlated with both peritraumatic and pathological dissociation. Competing theoretical explanations for revictimization and self-harm are discussed and evaluated.

Kaltman S, Bonanno GA. · Department of Psychology, The Catholic University of America, VA Capitol Healthcare Network, MIRECC, 10 N Greene Street, Baltimore, MD 21201, USA. · J Anxiety Disord. · Pubmed #12614658 No free full text.

Abstract: The intersection between trauma and bereavement has only recently been explored. Prior studies of bereavement have often neglected to measure posttraumatic stress disorder (PTSD) symptoms; the few that have offer equivocal findings concerning the role of PTSD symptomatology following loss. Few studies have explored the relationship between PTSD and the other psychological sequelae more commonly associated with loss. The current investigation assessed PTSD symptoms over time following the death of a spouse, using violence and the suddenness of the loss as potential outcome predictors. In addition, the relationship between PTSD and depression symptoms was assessed. Violent death predicted PTSD symptoms and the persistence of depression over time. The suddenness of the loss was not related to PTSD symptoms. This investigation suggests that violent death results in development of PTSD symptoms over and above the normal grief response and thus, may contribute to a more severe grief response.