Relationships between self‐consistency, trauma‐centred identity, and post‐traumatic adjustment

Revisiting the Factor Structure of the Centrality of Event Scale

Traumatic experiences that become self-defining impact posttraumatic outcomes, yet exact mechanisms are currently being studied. Recent research has used the Centrality of Event Scale (CES). However, the factor structure of the CES has been in question. We analyzed archival data (N = 318) split into homogenous groups of participants to examine whether the factor structure of the CES differed based on event type (bereavement vs. sexual assault) or by levels of PTSD (meeting clinical cut off score vs. group of lowest scorers). Exploratory factor analyses with subsequent confirmatory analyses revealed a single factor model in the bereavement group, sexual assault group, and the low PTSD group. A three-factor model emerged in the high PTSD group, with the factors' themes matching previous findings. Event centrality appears to be a universal theme when people endure and process a diversity of adverse events. These distinct factors may illuminate pathways in the clinical syndrome.

Validierung der deutschen Übersetzung der Centrality of Event Scale (CES-G)

Zusammenfassung. Theoretischer Hintergrund: Eine wachsende Zahl von Forschungsarbeiten weist auf die Bedeutung der wahrgenommenen Zentralität eines traumatischen Ereignisses in der eigenen Lebensgeschichte für das Verständnis von Symptomen der Posttraumatischen Belastungsstörung (PTBS) hin. Zur Untersuchung dieser Beziehung exisitert bislang noch kein Messinstrument, das die Ereigniszentralität auf Deutsch erfasst. Fragestellung: Um die Forschung auf diesem Gebiet im deutschsprachigen Raum zu ermöglichen, wird die Centrality of Event Scale (CES; Berntsen & Rubin, 2006 ) in einer deutschen Übersetzung (CES-G) vorgestellt und hinsichtlich ihrer psychometrischen Eigenschaften untersucht. Methode: Zur psychometrischen Auswertung wurde die CES-G 322 Student_innen sowie 115 ambulanten Patient_innen mit ausgeprägter PTBS-Symptomatik vorgelegt. Ergebnisse: Die CES-G zeigt eine hervorragende interne Konsistenz, substanzielle Korrelationen mit Maßen von PTBS Symptomen, allgemeiner Psychopathologie, Depressivität und maladaptiven kognitiven Prozessen sowie eine kriterienbezogene Validität bezüglich PTBS Symptomen in einer klinischen Stichprobe. Schlussfolgerungen: Die deutsche Übersetzung der CES ist ein verlässliches und valides Messinstrument für Ereigniszentralität.

"Maybe I imagined it, maybe it really was all just childish play": Complexity and ambiguity in survivors' perceptions of harmful preadolescent sexual behavior

BACKGROUND

Harmful preadolescent sexual behavior (HPSB) is an understudied phenomenon in the field of child sexual abuse (CSA).

OBJECTIVE

The purpose of the present study was to analyze and describe the experiences and perceptions of adult survivors of HPSB.

PARTICIPANTS AND SETTING

16 survivors of HPSB were recruited as part of a purposeful sample. Their ages at the time of the study ranged from 21 to 50; they were Jewish-Israeli, secular, and Hebrew-speaking.

METHODS

Semi-structured interviews and qualitative thematic analysis were conducted based on a descriptive phenomenological-psychological approach.

RESULTS

Participants described elements of complexity in their perceptions of the "truthiness" of their memories and the mutuality of the HPSB experiences, as well as their primacy, seriousness, and life impact. They also described elements of support during disclosure, but mostly exposed the challenges and hardship involved, particularly the lack of legitimacy in exposing harmful sexual behavior perpetrated by other children.

CONCLUSIONS

Both the HPSB experiences themselves and the subsequent disclosure contributed to the development of detached, mistrustful identities among the participants.

The Downside Risk of Failing to Transcend Extraordinarily Negative Experiences: A Narrative Analysis

Introduction

American service members who survived a trauma like a prisoner of war (POW) experience and successfully rebounded afterwards present outcomes of resilience that merit further exploration. Difficulties in defining or measuring human resilience in the clinical setting have been acknowledged for some time, with a call for greater openness to lessons from other disciplines. Transcendence as an identity-enhancing experiential process of meaning-making may offer insights that complement medical and psychological care. If a person fails to make meaning of an extraordinarily negative event, he may experience anti-transcendence, or an anti-process that results in by-products that are antonymous to transcendence, like destabilization of one's sense of self or the fracturing or disintegration of connections within and beyond the self. Such outcomes may trigger a crisis of identity.

Materials and Methods

Eight memoirs of resilient American POW survivors from two time periods and the text were digitized and converted using optical character recognition software (Foxit PhantomPDF) to enable scanning for repetitious word patterns and themed searches. As passages were selected, sorted, and tagged, I designed a database in Microsoft Access to enter and query the fragments. Everyday baselines were established for each memoirist, and instances of transcendence and anti-transcendence were analyzed.

Results

While evidence was found across all memoirists for transcendence of personally relevant, extraordinarily positive and negative events, instances of failure to transcend extraordinarily negative events were found in only three of the narratives. Given that the sample consisted of resilient service members who appeared not only to rebound but also to thrive after their experience, this scarcity of failure to transcend personally relevant, extraordinarily negative events is not surprising. Types of personally relevant, extraordinarily negative events discussed included multiple instances of forced desecration of local graves to make way for construction projects by captors and breaking points after torture.

Conclusion

Transcendence as an experiential meaning-making process may utilize existential resources that enable one to make sense of personally relevant, extraordinarily positive, and negative events. If identity-relevant experiences are more powerful predictors of distress and well-being than those not relevant to one's sense of identity, then there should be greater focus on those kinds of experiences when working with service members struggling to bounce back from trauma. There are many contexts in which this can be done. Military chaplains, for example, are potentially very well suited to help service members reconnect with existential resources to help them make meaning of a traumatic event. Military psychologists can make space in their conversations discuss identity-relevant experiences. Examining written narrative can also help narrow the focus on identity-relevant experiences, both positive and negative. Written narrative about traumatic experiences as a form of self-narration carries with it an interpretive aspect that may help the person make meaning of it in way that he or she could not in a clinical setting. Although assessment of the potential therapeutic effect of written narrative was beyond the scope of the study, this might be one area to investigate.

Psychological and clinical correlates of the Centrality of Event Scale: A systematic review

The Centrality of Event Scale (CES) was introduced to examine the extent to which a traumatic or stressful event is perceived as central to an individual's identity and life story, and how this relates to Posttraumatic Stress Disorder (PTSD) symptoms. In addition, the CES has been examined in relation to a range of other conditions and dispositions. We present a systematic review of the correlates of the CES. Results from 92 publications resulted in 25 measurement categories in the six theoretical domains of trauma, negative affect and distress, autobiographical memory, personality, positive affect, and gender. The mean weighted correlations of the 25 measurement categories ranged from -.17 to .55, with standard errors from .01 to .02, allowing us to distinguish empirically among effects. Consistent with the theoretical motivation for the CES and predictions predating the review, the CES correlated positively with a range of measures, correlating most highly with measures related to trauma, PTSD, grief, and autobiographical memory. The findings show that the CES probes aspects of autobiographical memory of broad relevance to clinical disorders, and with specific implications for theories of PTSD.

Prolonged grief reactions after old age spousal loss and centrality of the loss in post loss identity

BACKGROUND

The loss of a spouse is a major life event. Previous research found that centrality of the loss to one's identity using Centrality of Event Scale (CES) is related to complicated bereavement reactions, such as depression, posttraumatic stress symptoms (PTS), and prolonged grief symptoms (PGS). This study aims to examine loss-centrality in elderly bereaved people up to 4 years post loss, to determine the relation of loss-centrality to complicated bereavement reactions, such as PGS, depression, and PTS, and to identify early predictors of loss-centrality.

METHOD

Self-reported data were collected from 208 elderly bereaved people (mean age 72 years, 63.9% women), who completed measures of psychological distress (PTS, depression, PGS) as well as intra- and interpersonal factors (coping-style, crisis support, satisfaction with life, and NEO-PI-R) at 2, 6, and 48 months post spousal loss. CES was measured 48 months post spousal loss.

RESULTS

In line with previous findings (Boelen, 2012a), loss-centrality 4 years following the loss was significantly related to depression, PTS, and PGS. Additionally, early PGS and gender predicted later loss-centrality.

LIMITATIONS

Self-repport data was used rather than clinical interviews. CES was only measured 48 months post loss. PGS was first measured 6 months post.

CONCLUSIONS

The results support the link between loss-centrality and post loss psychopathology in a population particularly vulnerable to complicated bereavement reactions. The close link between prolonged grief and CES may be relevant in developing treatments for PGS, especially considering the potential relationship between high CES, high PGS, and possibly lack of acceptance of the loss.

Event centrality and posttraumatic outcomes in the context of pervasive violence: a study of teachers in El Salvador

It is well established that the importance assigned to a trauma can affect one's recovery and psychological health in numerous ways. Event centrality is an increasingly popular construct that captures the tendency among survivors to reevaluate and possibly accommodate their worldviews posttrauma. The centrality given to trauma appears to serve as a "double-edged sword" in that this construct might factor prominently in both posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). Focusing on 257 violence-exposed teachers from educational departments throughout El Salvador, we examined whether the centrality assigned by the teachers to stressful life events uniquely predicted both PTSD symptomatology and PTG. Results revealed that event centrality was positively related to both PTSD and PTG, even when controlling for demographic factors, violence exposure, and depression. In addition, PTSD symptomatology and PTG were not associated with one another in this sample. In summary, these findings support the role of event centrality as a contributing factor for PTSD and PTG among persons exposed to pervasive trauma.