Marianne Skogbrott Birkeland

Posttraumatic growth, posttraumatic stress and psychological adjustment in the aftermath of the 2011 Oslo bombing attack.

BackgroundExperiencing potentially traumatic events is associated with psychological distress. However, some survivors also experience positive personal and psychological changes in the aftermath of trauma.MethodsThe present study investigated perceived posttraumatic growth in 197 ministerial employees who were present at work during the 2011 Oslo bombing attack. The relationships between trauma-exposure, peritraumatic reactions and posttraumatic growth were studied. Moreover, the adaptive significance of posttraumatic growth was addressed.ResultsThe results showed that higher levels of trauma-exposure and immediate reactions were significantly related to perceived posttraumatic growth. No support for an adaptive significance of posttraumatic growth was found. On the contrary, posttraumatic growth was associated with higher symptom levels of posttraumatic stress. After adjusting for posttraumatic stress symptoms no association was found between perceived growth and work and social adjustment. However, perceived growth was associated with higher levels of life satisfaction.ConclusionThe present results are in line with previous findings indicating that perceived growth may be unrelated to psychological adjustment, and suggest that the concept and significance of posttraumatic growth should be interpreted with caution.

Posttraumatic growth and centrality of event: A longitudinal study in the aftermath of the 2011 Oslo bombing.

Previous studies have reported that construing a traumatic event as central to ones life story and identity are associated with posttraumatic growth (PTG). Due to cross-sectional designs, these studies provide only weak evidence of a causal relationship between event centrality and PTG. The main aim in the present study is to examine the longitudinal associations and directionality between centrality of event and PTG in ministerial employees who were present at work during the 2011 Oslo bombing attack (N = 229). By applying a cross-lagged autoregressive model, the present study investigates both stability across time, possible time-lagged effects, and the relationship between centrality of event and PTG at 1 and 2 years after the bombing. The results showed that levels of centrality of event and PTG were stable across time. There was a significant association between centrality of event and PTG both 1 and 2 years after the bombing; however, this relationship attenuated over time. No time-lagged effects in either direction were found. The present findings are in line with previous findings indicating that centrality of a traumatic event is related to PTG. However, the present longitudinal data do not support a hypothesis about a long-term causal effect of event centrality on PTG. Rather, the relationship between centrality of event and PTG are concurrent, and attenuates with time.

Making connections: exploring the centrality of posttraumatic stress symptoms and covariates after a terrorist attack

ABSTRACT Background: Posttraumatic stress symptoms are interconnected. Knowledge about which symptoms of posttraumatic stress are more strongly interconnected or central than others may have implications for the targeting of clinical interventions. Exploring whether symptoms of posttraumatic stress may be differentially related to covariates can contribute to our knowledge on how posttraumatic stress symptoms arise and are maintained. Objective: This study aimed to identify the most central symptoms of posttraumatic stress and their interconnections, and to explore how covariates such as exposure, sex, neuroticism, and social support are related to the network of symptoms of posttraumatic stress. Method: This study used survey data from ministerial employees collected approximately 10 months after the 2011 Oslo bombing that targeted the governmental quarters (n = 190). We conducted network analyses using Gaussian graphical models and the lasso regularization. Results: The network analysis revealed reliably strong connections between intrusive thoughts and nightmares, feeling easily startled and overly alert, and between feeling detached and emotionally numb. The most central symptom in the symptom network was feeling emotionally numb. The covariates were generally not found to have high centrality in the symptom network. An exception was that being female was connected to a high physiological reactivity to reminders of the trauma. Conclusions: Ten months after a workplace terror attack emotional numbness appears to be of high centrality in the symptom network of posttraumatic stress. Fear circuitry and dysphoric symptoms may constitute two functional entities in chronic posttraumatic stress. Clinical interventions targeting numbness may be beneficial in the treatment of posttraumatic stress, at least after workplace terrorism.

Latent classes of posttraumatic stress and growth

Background and Objectives: Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment. Design: This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N = 1970). Methods: We applied latent class analyses with covariates to extract subgroups of individuals. Results: Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: “High stress/high growth” (27% and 11%, respectively), “Low stress/high growth” (74% and 42%, respectively), and “Low stress/low growth” (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning. Conclusions: Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.

For Whom Does Time Heal Wounds? Individual Differences in Stability and Change in Posttraumatic Stress After the 2011 Oslo Bombing†

Prospective studies describing and predicting individual differences in the course of posttraumatic stress symptoms (PTSS) after disasters are scarce. The present study aimed to describe and predict individual differences in both the level and the rate of change in PTSS after the 2011 Oslo bombing, a terrorist attack directed at the Norwegian government. Survey data from ministerial employees (N = 256) were collected 10, 22, and 34 months after the bombing. We used latent growth modeling to examine the development of PTSS, and to identify the strength of predictor variables. High exposure, female sex, and high levels of neuroticism were associated with higher levels of PTSS 10 months after the traumatic event (β ranged from .25 to .30, p < .001), whereas social support was associated with lower levels of PTSS (β = -.30, p < .001). The combination of being female and high in neuroticism was associated with a faster decline in PTSS (β range: -.20 to -.39, p = .010 < .05). High exposure seemed to have a lasting influence by maintaining high levels of PTSS. Our findings suggested that being female, being highly exposed, and having low levels of social support were risk markers for enduring PTSS.

Long-term relationships between perceived social support and posttraumatic stress after the 2011 Oslo bombing: A three-year longitudinal study

BACKGROUND After traumatic events, social support and posttraumatic stress are interrelated, but little is known about the underlying dynamics behind this association. Levels of social support and posttraumatic stress may change and affect each other over time, but there are also stable time-invariant individual differences in both constructs. The present study aimed to determine the amount of variance explained by stable individual differences in levels of social support and posttraumatic stress across three years, and to determine whether and to what extent social support and posttraumatic stress may affect one another when these stable individual differences are controlled for. METHODS We used data from ministerial employees present in the Governmental district during the 2011 Oslo bombing attack (N=255). Data was collected ten months, two years, and three years after the terror attack. Using a random intercept cross lagged panel model (RI-CLPM), we tested the possible directional effects between social support and posttraumatic stress within persons when variance between persons was taken into account. RESULTS The intraclass correlations of the three measures of posttraumatic stress and social support were.83 and.74, respectively. The remaining variation within persons could not be explained by change in either of these constructs. LIMITATION We have no information on the processes that might have occurred before 10 months after the incident. CONCLUSIONS Our findings indicate that the long-term longitudinal linkage between social support and posttraumatic stress may be best explained by stable individual differences rather than causal processes operating within persons.

Associations between Work Environment and Psychological Distress after a Workplace Terror Attack: The Importance of Role Expectations, Predictability and Leader Support

Experiencing terrorism is associated with high levels of psychological distress among survivors. The aim of the present study was to examine whether work environmental factors such as role clarity and predictability, role conflicts, and leader support may protect against elevated levels of psychological distress after a workplace terrorist attack. Data from approximately 1800 ministerial employees were collected ten months after the 2011 Oslo bombing attack which targeted the Norwegian ministries. The results show that after a traumatic event, lower role conflicts, higher role clarity, higher predictability, and higher leader support were independently associated with lower psychological distress. These findings suggest that the workplace environment may be a facilitator of employees’ mental health after stressful events.

The mediating role of shame in the relationship between childhood bullying victimization and adult psychosocial adjustment

ABSTRACT Background: Psychological distress following experiencing bullying victimization in childhood has been well documented. Less is known about the impact of bullying victimization on psychosocial adjustment problems in young adulthood and about potential pathways, such as shame. Moreover, bullying victimization is often studied in isolation from other forms of victimization. Objective: This study investigated (1) whether childhood experiences of bullying victimization and violence were associated with psychosocial adjustment (distress, impaired functioning, social support barriers) in young adulthood; (2) the unique effect of bullying victimization on psychosocial adjustment; and (3) whether shame mediated the relationship between bullying victimization and these outcomes in young adulthood. Method: The sample included 681 respondents (aged 19–37 years) from a follow-up study (2017) conducted via phone interviews derived from a community telephone survey collected in 2013. Results: The regression analyses showed that both bullying victimization and severe violence were significantly and independently associated with psychological distress, impaired functioning, and increased barriers to social support in young adulthood. Moreover, causal mediation analyses indicated that when childhood physical violence, sexual abuse, and sociodemographic factors were controlled, shame mediated 70% of the association between bullying victimization and psychological distress, 55% of the association between bullying victimization and impaired functioning, and 40% of the association between bullying victimization and social support barriers. Conclusions: Our findings support the growing literature acknowledging bullying victimization as a trauma with severe and long-lasting consequences and indicate that shame may be an important pathway to continue to explore. The unique effect of bullying victimization, over and above the effect of violence, supports the call to integrate the two research fields.

Does optimism act as a buffer against posttraumatic stress over time? A longitudinal study of the protective role of optimism after the 2011 Oslo bombing.

Objective: Cross-sectional studies have revealed that high levels of optimism can protect against high levels of posttraumatic stress after exposure to trauma. However, this is the first study to explore (a) the protective role of optimism in a longitudinal perspective and (b) optimism’s protective effects on specific symptom clusters within the posttraumatic stress symptomatology. Method: This study used prospective survey data from ministerial employees (n = 256) collected approximately 1, 2, and 3 years after the 2011 Oslo bombing. To examine relationships between optimism and development of posttraumatic stress, we applied a series of latent growth curve analyses of both overall posttraumatic stress and the 5 clusters within the posttraumatic stress symptomatology (intrusions, avoidance, numbing, dysphoric arousal, and anxious arousal) with predictors and interaction terms. Results: The results showed that levels of exposure and optimism had main effects on starting levels of all clusters of posttraumatic stress. In addition, optimism had a protective-stabilizing effect on starting levels of avoidance, numbing, and dysphoric arousal. No associations between optimism and rate of change in symptoms clusters were found. Conclusion: These results suggest that optimism may help to neutralize the effects of high exposure on levels of symptoms of avoidance, numbing, and dysphoric arousal but not on the symptoms of intrusions and anxious arousal. Thus, individuals high in optimism still experience intrusions and anxious arousal after trauma, but may be better equipped to cope with these so they do not develop into avoidance, numbing and dyshorical arousal.

Like a bridge over troubled water? A longitudinal study of general social support, colleague support, and leader support as recovery factors after a traumatic event

ABSTRACT Background: Whereas the association between social support and psychological distress has been well-established through both cross-sectional and longitudinal studies, less is known about whether social support influences rate of change in psychological distress over time. Nor is it clear whether social support predicts baseline psychological distress, or, more importantly, whether social support may contribute to more rapid recovery following trauma exposure. Objective: This study aimed to determine the extent to which social support contributed to the recovery process among individuals with psychological distress after being exposed to trauma. Methods: Prospective survey data from ministry employees were collected 10, 22, and 34 months after the 2011 Oslo bombing that targeted the governmental quarters. We explored recovery in a clinical subsample (N = 238) of individuals with elevated levels of psychological distress (defined as mean 10-item Hopkins symptom checklist score > 1.85) one year after the event. A linear latent growth curve of psychological distress with general social support from friends and family, colleague support, and leader support as predictors was examined. Results: High levels of general social support and leader support were independently associated with a more rapid decline in psychological distress over time. Conclusions: General social support, as well as support from a leader in one’s working life, may facilitate recovery from psychological distress after exposure to a traumatic event. Enhancing social support from family and friends, as well as in work settings, may benefit those with psychological distress following a traumatic workplace event.