Amy L. Ai

Meaning Making and Growth: New Directions for Research on Survivors of Trauma

The meaning-making framework of trauma and recovery is presented. The following specific topics are discussed: (a) the meaning-making coping framework and the processes of meaning that typically occur following traumatic encounters; (b) empirical support for the meaning-making model; (c) the possibility that growth may result from this making of meaning; (d) methodologies for examining meaning making, including both quantitative and qualitative research; and (e) clinical implications of the meaning-making framework.

Hope, Meaning, and Growth Following the September 11, 2001, Terrorist Attacks

Positive psychologists found the increase of seven character strengths that encompass the so-called theological virtues, including hope and spirituality, in Americans after the September 11, 2001, attacks. Little is known about how they may affect post-September 11, 2001, mental health. Using multivariate analysis, this study investigated the relationship of hope and spiritual meaning with depression and anxiety in a sample of 457 students 3 months after September 11, 2001. Both characters contributed to lower levels of symptoms. In qualitative analysis, of 313 answers to an open-ended question regarding personal change, four categories emerged. The first three were consonant with other studies on posttraumatic growth (PTG), including changes in the self or behavior, relationships, and worldviews. The fourth category unique to September 11, 2001, was changes in political views. These findings offer further credence to the study of positive aspects resulting from violence-related trauma and highlight the needs for addressing the nature of traumatic events and PTG.

Psychosocial Mediation of Religious Coping Styles: A Study of Short-Term Psychological Distress Following Cardiac Surgery

Although religiousness and religious coping styles are well-documented predictors of well-being, research on the mechanisms through which religious coping styles operate is sparse. This prospective study examined religious coping styles, hope, and social support as pathways of the influence of general religiousness (religious importance and involvement) on the reduced postoperative psychological distress of 309 cardiac patients. Results of structural equation modeling indicated that controlling for preoperative distress, gender, and education, religiousness contributed to positive religious coping, which in turn was associated with less distress via a path fully mediated by the secular factors of social support and hope. Furthermore, negative religious coping styles, although correlated at the bivariate level with preoperative distress but not with religiousness, were associated both directly and indirectly with greater post-operative distress via the same mediators.

Possibilities of the Positive Following Violence and Trauma Informing the Coming Decade of Research

The effects of trauma and violence may be better understood by taking a broader perspective that includes resilience and recovery as well as damage and symptomatology. Based on this broader view, this article describes three interrelated, cutting-edge trends in mental health research: (a) the positive psychology movement, (b) the recognition of the role of spirituality and religion in health and well-being, and (c) stress-related growth. The integration of these trends into mainstream studies of trauma and violence will provide a counterbalance to the predominant orientation of victimization and pathology currently evidenced in the literature. All three have important implications for survivors of violence and trauma.

War-Related Trauma and Symptoms of Posttraumatic Stress Disorder Among Adult Kosovar Refugees

Since 1999, almost 16,000 Kosovar refugees have entered the United States. Few studies have investigated trauma and symptoms of posttraumatic stress disorder (PTSD) in this population. We conducted a caseworker-assisted survey of 129 Kosovar refugees (aged 18 to 79 years, 55% male). Of these individuals, 78 (60.5%) showed the likely presence of PTSD. The mean number of war-related traumatic events reported was 15 (SD = 4.5). Higher PTSD scores were associated with more traumatic events and female gender.

Faith-based and Secular Pathways to Hope and Optimism Subconstructs in Middle-aged and Older Cardiac Patients

This study was designed to fill gaps in the new field of positive psychology. Using data from two sequential interviews, this study examined the effect of faith-based and secular pathways to hope and optimism among 226 middle-aged and older patients facing a major medical crisis—cardiac surgery. Structural equation modeling demonstrated that religious faith factors contributed to the agency component of hope and dispositional optimism indirectly through the use of prayer as a coping strategy. Other sociodemographically resourcable factors affected both the agency and pathway components of hope as well as dispositional optimism and dispositional pessimism directly or indirectly through their effects on emotional distress.

The Traumatic Impact of the September 11, 2001, Terrorist Attacks and the Potential Protection of Optimism

This study examined the impact of the September 11 terrorist attacks on graduate and undergraduate students and the role of optimism in posttraumatic distress. A sample of 457 students who attended courses at three schools of social work (Nevada, Pennsylvania, and Washington) participated in the study. A quarter of them had a known person as an immediate victim of the attacks. Multivariate analysis showed that posttraumatic stress disorder symptom scores were positively related to personal loss and two types of previous trauma reactivated by the attacks, and levels of initial negative emotional response. Optimism and its interaction with personal loss were inversely associated with posttraumatic stress disorder symptom scores.

Posttraumatic symptoms and growth of Kosovar war refugees: The influence of hope and cognitive coping

Research on war trauma has been dominated by a pathological focus for decades. Researchers have now counterbalanced studies of trauma with a new focus, positive changes following crisis. This prospective study examines how specific psychological factors might influence post-war adaptive outcomes (the coexistence of posttraumatic growth [PTG] and posttraumatic stress disorder [PTSD] symptoms) in a sample of 50 Kosovar war refugees. Individual differences in positive attitude and coping strategies were explored. Hope assessed during resettlement, and cognitive coping strategies, employed between resettlement and follow-up, were associated with PTG, controlling for war-related trauma and baseline symptoms. PTG and symptoms were unrelated. No predictors for present symptoms were identified. Future mental health practice with refugees should address both positive and negative aspects.

The Relationship Between Religious Identity and Preferred Coping Strategies: An Examination of the Relative Importance of Interpersonal and Intrapersonal Coping in Muslim and Christian Faiths

Religious affiliation has consistently been shown to help individuals cope with adversity and stressful events. The present paper argues that this proposition is valid for both Christians and Muslims, but that these religious identities foster different types of coping. In accordance with historical, cultural, and psychological accounts, it is proposed that the Christian core self is relatively individualistic, whereas the Muslim core self is oriented more toward the collective. As a consequence, it is hypothesized that when confronted with a stressful life event, Muslims are more likely to adopt interpersonal (collective) coping strategies (such as seeking social support or turning to family members), while Christians are more likely to engage intrapersonal (individualistic) coping mechanisms, such as cognitive restructuring or reframing the event. Evidence from the literature on coping strategies is reviewed and systematized. Evidence lend support to the analysis by indicating that Muslims indeed tend to use an interpersonally oriented (collective) coping style when dealing with adversity, whereas Christians are more likely to employ intrapersonally oriented (individualistic) strategies when facing comparable scenarios. Implications for theory and practice are discussed.

The Influence of Prayer Coping on Mental Health among Cardiac Surgery Patients The Role of Optimism and Acute Distress

To address the inconsistent findings and based on Hegels dialectic contradictive principle, this study tested a parallel mediation model that may underlie the association of using prayer for coping with cardiac surgery outcomes. Three sequential interviews were conducted with 310 patients who underwent open-heart surgery. A structural equation model demonstrated that optimism mediated the favorable effect of prayer coping. Prayer coping was also related to preoperative stress symptoms, which had a counterbalance effect on outcomes. Age was associated with better preoperative mental health, but age-related chronic conditions were associated with poor outcomes; both of these were mediated through the same mediators.