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Posttraumatic Growth Following the Terrorist Attacks of September 11, 2001: Cognitive, Coping, and Trauma Symptom Predictors in an Internet Convenience Sample

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

Christine M. Blasey

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

Robert W. Garlan

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

Shannon E. McCaslin

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, University of California, San Francisco, CA

Jay Azarow

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, Kaiser Permanente Medical Center, Santa Clara, CA

Xin-Hua Chen

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

Juliette C. Desjardins

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, San Mateo County Health Services Agency, San Mateo, CA

Sue DiMiceli

SoluGenics, LLC, Palo Alto, CA

David A. Seagraves

WebFeet Creations, Boulder Creek, CA

T. Andrew Hastings

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, Gonzaga University School of Law, Spokane, WA

Helena C. Kraemer

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

David Spiegel

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA

Cognitive, coping, and trauma symptom predictors of posttraumatic growth (PTG; measured with the Posttraumatic Growth Inventory) were examined in a large convenience sample (n =1505) participating in a longitudinal Internet-based study following the terrorist attacks of 9/11/01. Results indicate that initial PTG levels (mean 9 weeks post-attacks) were generally associated with higher trauma symptoms (measured with the PTSD Checklist - Specific), positive changes in worldview (measured with the Changes in Outlook Questionnaire), more denial, and less behavioral disengagement (measured with the Brief COPE). Additionally, PTG had a curvilinear association with level of trauma symptoms, such that those reporting symptoms at intermediate levels reported the highest levels of growth. Levels of PTG declined somewhat over time with the exception of Spiritual Change. As expected, PTG levels at follow-up (mean 6.5 months post-attacks) were primarily predicted by initial PTG levels; however, decreases from baseline in trauma symptoms and increases from baseline in positive worldview, acceptance, and positive reframing were also associated with higher reported posttraumatic growth at follow-up. These findings suggest that there may be a range of traumatic experience most conducive to growth and they also highlight the important contributions of cognitive and coping variables to psychological thriving in short- and longer-term periods following traumatic experience.

Key Words: posttraumatic growth • coping • changes in outlook • worldview • traumatic stress symptoms • curvilinear • terrorism • 9/11/01

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