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A Double-edged Sword: Event Centrality, PTSD and Posttraumatic Growth

Article  in  Applied Cognitive Psychology · September 2011

DOI: 10.1002/acp.1753

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Applied Cognitive Psychology, Appl. Cognit. Psychol. 25: 817–822 (2011)
Published online 22 October 2010 in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/acp.1753

A Double-edged Sword: Event Centrality, PTSD and Posttraumatic Growth

ADRIEL BOALS* and DARNELL SCHUETTLER

Department of Psychology, University of North Texas, USA

Summary: Previous research has demonstrated negative mental health consequences (including PTSD symptoms) of construing a
potentially traumatic event as central to one’s identity. In the current paper, we replicated an association between event centrality
and PTSD symptoms. We also found event centrality similarly predicts posttraumatic growth (PTG) even after controlling for
PTSD symptoms, depression, DSM-IV A1 and A2 status of the event, coping styles and cognitive processing of the event. Because
predictive relationships between event centrality and PTSD symptoms, as well as event centrality and PTG were positive,
construing an event as central to one’s identity can indeed become a double-edged sword, allowing for both debilitation and
growth. Copyright # 2010 John Wiley & Sons, Ltd.

INTRODUCTION
Recently, there has been growing interest on the impact of
events central to one’s identity. These events are repeatedly
reflected upon and can alter our interpretations of past and
current experiences. These event memories often mark the
beginning and end of lifetime periods (Conway & Pleydell-
Pearce, 2000) and have been referred to as ‘self-defining
memories’ (Singer, 1995). Self-defining events give meaning
and continuity to one’s sense of self and life story
(McAdams, Josselson, & Lieblich, 2006) and influence
behaviour and goals (Sutin & Robins, 2008). Individuals
vary greatly in terms of events used to construct a sense of
self (McLean & Fournier, 2008; Sutherland & Bryant, 2005).
In fact, an inability of the autobiographical memory system
to allow important events to alter the self can be pathological
(Crane, Goddard, & Pring, 2010). A problem occurs when an
individual experiences a stressful or traumatic event, and this
negative event becomes a detrimental organizing principle
for the individual’s sense of self and view of the world.
Construing a traumatic event as central to one’s identity
keeps the memory highly available, leading to further
rehearsal. The rehearsal in turn maintains and strengthens the
memory and the memory’s emotional impact over long
periods of time. For example, McNally, Lasko, Macklin, and
Pitman (1995) noted that Vietnam veterans who came to the
laboratory wearing regalia (medals, fatigues, etc.) had
disproportionately higher rates of PTSD and were more
likely to recall memories from the war, in comparison to
Vietnam veterans not wearing regalia.
The Centrality of Events Scale (CES; Berntsen & Rubin,
2006) assesses the extent to which an individual construes a
stressful or traumatic event as a primary reference to identity.
The questionnaire includes items such as, ‘I feel that this
event has become part of my identity’, ‘This event has
become a reference point for the way I understand myself
and the world’ and ‘I feel that this event has become a central
part of my life story’. The CES measures three functions of
memories: the extent to which a memory becomes (1) a
reference point for everyday inferences, (2) a turning point in
*Correspondence to: Adriel Boals, Department of Psychology, University of
North Texas, Denton, TX 76203, USA. E-mail: adriel@unt.edu
the life story and (3) a core component of personal identity.
Not surprisingly, CES scores are highly correlated with
PTSD symptoms and depression (Berntsen & Rubin). These
correlations have been replicated in samples using older
adults (Berntsen & Thomsen, 2005), college students (Boals,
2010; Rubin, Boals, & Berntsen, 2008) and Iraq War veterans
(Brown, Antonius, Kramer, Root, & Hirst, 2010). In addition,
higher CES scores correlate with greater emotional intensity,
greater visceral reactions, worse overall physical health
(Boals, 2010) and higher levels of complicated grief in
bereaved participants (Boelen, 2009). Importantly, CES
scores remain a significant predictor of PTSD symptoms,
even when controlling for anxiety, depression and dis-
sociation (Berntsen & Rubin, 2007; Rubin et al.). Thus
construing a trauma as central to one’s identity is associated
with multiple poor psychological outcomes.
Although negative effects of trauma exposure have been
well-documented, positive effects are also being explored.
Much of this research centers on benefit finding and
posttraumatic growth (PTG). PTG occurs when individuals
formulate adaptive interpretations or worldviews as a result
of experiencing a traumatic event. PTG is measured by
perceived changes in self, relationships with others,
philosophy of life, spirituality and new possibilities
(Tedeschi & Calhoun, 1996). A meta-analysis found PTG
is related to less depression and greater well-being, yet
positively related to intrusive thoughts about the event
(Helgeson, Reynolds, & Tomich, 2006). The relationship
between PTG and intrusive thoughts may occur because PTG
only comes from events that result in a struggle significant
enough to force re-evaluation of worldviews. Thus, the term
‘adversarial growth’ has also been used in lieu of the term
PTG.
The purpose of the current study is to explore the
relationship between the centrality of an event and PTG.
Although one may assume negative and positive con-
sequences of trauma exposure are two opposite ends of a
singular ‘consequences of trauma’ construct, empirical
evidence supports the possibility of independent negative
and positive trauma consequences (Linley, Joseph, Cooper,
Harris, & Meyer, 2003). In other words, even when an
individual’s struggle with a traumatic event leads to PTG,
this does not necessarily mean a concurrent decrease in

Copyright # 2010 John Wiley & Sons, Ltd.

818 A. Boals and D. Schuettler

negative symptoms will also occur. Thus, one cannot assume Table 1. Means and standard deviations
the direction of the PTG and CES relationship would be the
Variable Mean (SD) Range
opposite direction of the PTSD and CES relationship.
Because PTG is believed to result from a challenge to and re- Centrality of Events Scale 17.9 (8.8) 7–35
examination of core beliefs (Tedeschi, Calhoun, & Cann, Posttraumatic Growth Inventory 53.2 (28.7) 0–105
PTSD Checklist 28.3 (12.9) 17–85
2007), we hypothesize PTG will be positively correlated with
A1 0.42 (0.5) 0–1
CES scores. Such results would suggest that construing a A2 0.47 (0.5) 0–1
traumatic event is like a double-edged sword. On one hand, Problem Coping 20.7 (4.7) 8–32
this construal is associated with higher levels of PTSD Emotion Coping 24.7 (5.4) 10–40
symptoms and depression. On the other hand, this construal Avoidance Coping 18.0 (4.9) 10–40
QIDS (depression) 15.5 (4.2) 0–27
is also associated with higher levels of PTG.
Positive Cognitive Resolution 11.7 (5.3) 3–21
To adequately examine the relationship between PTG and Downward Comparisons 16.9 (4.5) 3–21
event centrality, a number of methodological issues were Resolution 20.0 (6.3) 4–28
considered. First, in the current study, we used a college Denial 9.6 (5.5) 4–28
student sample to examine the relationship between CES and Regrets 9.3 (5.5) 3–21
PTG. This issue is not a concern since rates of trauma Note: A1 and A2 were coded 0 (no) and 1 (yes). Positive Cognitive
exposure and associated symptoms in college student Resolution, Downward Comparisons, Resolution, Denial and Regrets are
subscales of the CPOTS.
samples are comparable to that of the general population
(Bernat, Ronfeldt, Calhoun, & Arias, 1998; Frazier, Anders,
et al., 2009; Smyth, Hockemeyer, Heron, Wonderlich, &
Pennebaker, 2008). In addition, such a sample will yield a categories of potentially traumatic events, such as being a
wide variety of stressful/traumatic events and large levels of victim of physical or sexual abuse (all nine events are listed
variance in PTSD symptoms, CES scores and PTG scores. in Table 1). Participants respond either ‘yes’ or ‘no’ to
The second issue concerns types of stressful events whether they experienced each event during their lifetime.
nominated by a non-clinical sample. Since not all The TEQ also allows for unspecified traumatic events to be
participants will have experienced a DSM-IV-defined listed. If the respondent indicates ‘no’ to all listed traumatic
traumatic event, it is possible the relationship between events (i.e. the respondent had not experienced any of the
PTG and CES may vary as a function of whether the eliciting listed traumatic events), they are asked to ‘describe briefly
event meets the DSM criteria as a traumatic event. Thus, we the most traumatic thing to happen to you’. At the end of the
included measures of the DSM-IV-TR A1 and A2 criteria questionnaire, the respondent indicates which aforemen-
[American Psychiatric Association (APA), 2000] for all tioned event was ‘the most traumatic thing to have happened
events nominated by participants. The inclusion of these to you’. The TEQ evidences good test–retest reliability over
criteria will allow for comparisons between events that do a 2-week period for the number of traumatic events
meet the stated criteria and those that do not meet the criteria. experienced (r ¼ 0.91). Test–retests for specific events
The third issue concerns the measurement of PTG. Some ranged from r ¼ 0.72 to 1.00 (Vrana & Lauterbach, 1994).
evidence suggests current measurements of PTG may reflect
coping as opposed to actual growth (Frazier, Tennan, Gavian, A1 criterion
Park, Tomich, & Tashiro, 2009; McFarland & Alvaro, 2000). Participants responded to questions phrased in exact DSM-
Thus, we included a widely used coping measure to IV-TR wording; ‘Did you experience, witness or confront an
statistically partial out coping variance and increase the event that involved actual or threatened death or serious
chance of measuring actual growth. Lastly, because one injury, or threat to [your] physical integrity or that of others?’
could argue the CES does not measure event centrality but Participants indicated ‘yes’ or ‘no’ in reference to the most
rather simply reflects general cognitive bias, a measure of traumatic event they nominated on the TEQ.
cognitive processing of trauma was included.
A2 criterion
METHODS Participants again responded to questions phrased in exact
DSM-IV-TR wording, ‘Did your response include fear,
Participants helplessness or horror?’ Participants indicated ‘yes’ or ‘no’
in reference to the most traumatic event they nominated on
A sample of 929 (603 female) undergraduates from the
the TEQ.
University of North Texas volunteered for partial course
credit. The average age was m ¼ 20.1 (SD ¼ 3.6) with a range
Brief COPE (BCOPE)
of 18–60. The sample was 59% Caucasian, 16% African–
The BCOPE (Carver, 1997) measures different coping
American, 15% Hispanic, 5% Asian and 5% ‘other’.
strategies. It consists of 28 questions that measure three
primary coping styles: problem focused coping, emotion
focused coping and avoidant coping. Item examples include:
Materials
‘I’ve been thinking hard about what steps to take’ (problem
Traumatic Events Questionnaire (TEQ) focused coping); ‘I’ve been getting emotional support from
The TEQ (Vrana & Lauterbach, 1994) assesses lifetime others’ (emotion focused coping) and ‘I’ve been refusing to
exposure to traumatic events. The TEQ includes nine believe that it has happened’ (avoidant coping). Responses

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 25: 817–822 (2011)

range from 1 (I haven’t been doing this a lot) to 4 (I’ve been
doing this a lot). Each of the scales have internal reliabilities
ranging from a ¼ .50 to .90. In the current study, the
reliability for the problem focused coping subscale was
a ¼ .76, the emotion focused coping subscale was a ¼ .76
and the avoidance coping subscale was a ¼ .76.
Centrality of Events Scale (CES)
The short version of the CES (Berntsen & Rubin, 2006) is a
7-item questionnaire designed to measure the extent to which
an event is viewed as central to one’s identity. Participants
are asked to rate the extent to which they agree with the
statements from 1 (totally disagree) to 5 (totally agree).
Example items include, ‘This event permanently changed
my life’ and ‘I feel that this event has become part of my
identity’. The scale’s reported reliability range is a ¼ .88. In
the current sample, reliability was a ¼ .94.
Cognitive Processing of Trauma Scale (CPOTS)
The CPOTS (Williams, Davis, & Millsap, 2002) is a 17-item
measure of cognitive processing of traumatic experiences.
Each item is rated on a scale from 1 (strongly disagree) to 7
(strongly agree). The CPOTS is composed of five subscales:
positive cognitive restructuring, downward comparison,
resolution, denial and regrets. In the current sample,
reliabilities for each subscale were .85, .82, .84, .77 and
.82, respectively.
Posttraumatic Growth Inventory (PTGI)
The PTGI (Tedeschi & Calhoun, 1996) is a 21-item
questionnaire used to measure growth following a traumatic
event. Items were scaled from 0 (I did not experience this
change as a result of my crisis) to 5 (I experienced this
change to a very great degree as a result of my crisis) and the
sum score is reported. The reported coefficient reliability is
.90 and test–retest reliability is .71. In the current sample
reliability was a ¼ .97.
PTSD Checklist (PCL-S)
The PCL-S (Blanchard, Jones-Alexander, Buckley, &
Forneris, 1996) measures intrusive and avoidant thoughts.
The PCL-S is a 17-item measure of PTSD symptoms in
reference to a specific event. Participants are asked to rate
items on a scale of 1 (not at all) to 5 (extremely) regarding the
extent to which the event produced each of the official B, C
and D PTSD symptoms during the past month. A score of
44 or higher is indicative of probable PTSD. Internal
consistency as are acceptable, a ¼ .58–.92, and convergent
correlations for the subscales between the PCL-S and CAPS
(Clinician Administered PTSD Scale; Blake et al., 1995)
were substantial, ranging from r ¼ .58 to .92 (Blanchard
et al.; Palmieri, Weathers, Difede, & King, 2007). Test–retest
reliability was r ¼ .96 (Blanchard et al.). In the current
sample, reliability was a ¼ .94.
The Quick Inventory of Depressive Symptomatology—Self
Report (QIDS-SR)
The QIDS-SR (Rush et al., 2003) was used as a measure of
depression. The 16-item questionnaire asks the participant to
rate how much each depression symptom has been applicable
Copyright # 2010 John Wiley & Sons, Ltd.
Double-edged sword 819
within the last 7 days. Symptoms include sleep patterns,
sadness, appetite, weight levels (gain and loss), general
interest, view of self, suicidal ideation, energy level and
feelings of restlessness. Items are rated on a four-point scale
ranging from non-depressive to extreme levels. High internal
consistencies (a ¼ 0.86) have been found for the QIDS-SR,
with this number increasing from a ¼ 0.73 at baseline to
a ¼ 0.92 at 12 week follow-up. This measure has shown to be
highly correlated with other measures of depression such as
the Inventory of Depressive Symptomatology (Trivedi et al.,
2004). In the current sample, reliability was a ¼ .77.
Procedure
As part of a mass testing session, participants completed an
online battery of questionnaires that took approximately
1 hour to complete. Participants completed questionnaires
through an online survey in exchange for partial course
credit. Although there were other questionnaires included
throughout the survey, the questionnaires reported in this
study were completed by participants in the following order:
BCOPE, TEQ, PCL-S, PTGI, CES, A1, A2, CPOTS, and
QIDS. The PCL-S, PTGI, CES, A1, A2, and CPOTS were all
completed in reference to the most traumatic event each
participant indentified on the TEQ.
RESULTS
Participants identified a wide variety of potentially traumatic
events on the TEQ. The most frequently nominated event
was ‘unexpected death of someone’ (18%), followed by
‘serious danger of losing your life’ (7%), ‘serious car
accident’ (7%), ‘child sexual or physical abuse’ (7%),
‘natural disaster’ (6%), ‘experiences like these you can’t tell
about’ (4%), ‘rape, robbery or assault’ (4%), ‘other traumatic
event like these’ (3%), ‘adult physical abuse’ (2%), ‘witness
a serious injury or death’ (2%), ‘unwanted adult sexual
experience’ (3%). The remaining 37% of participants
indicated they had not experienced any of the traumatic
events listed on the TEQ. These participants were asked to
nominate the most traumatic event they had experienced.
Commonly nominated events included romantic relationship
breakups, parents divorcing and academic failures.
Since the current sample was not limited to a clinical
sample, we examined a number of operationalizations of
traumatic event to determine whether the inclusion of non-
clinical participants affected the results. The first operatio-
nalization we examined was whether the event selected by
the participant was one of the predetermined traumatic
events listed on the TEQ. Excluding participants who
indicated they had not experienced any of the traumatic
events on the TEQ did not affect the pattern of the results
obtained, nor did any significant interactions involving this
variable emerge. We next examined whether the event met
the DSM-IV A1 status affected the results. Excluding
participants whose event did not meet the A1 criterion did
not affect the pattern of the results obtained, nor did any
significant interactions involving this variable emerge.
Lastly, we examined whether participants’ score on the
PCL-S affected the pattern of results. A score of 44 or higher
Appl. Cognit. Psychol. 25: 817–822 (2011)
820 A. Boals and D. Schuettler

on the PCL-S is considered indicative of probable clinical
PTSD (Blanchard et al., 1996). Excluding participants with
PCL scores below this clinical cutoff score did not affect
the pattern of the results obtained. The only significant
interaction to emerge was an interaction between CES scores
and PCL-S <44 on PTGI scores, F(1, 940) ¼ 5.45, p < .05.
The correlation between the CES and PTGI was stronger
when participants’ PCL-S scores were below the clinical
cutoff, r(815) ¼ .57, p < .0001, in comparison to when scores
were above the clinical cutoff, r(127) ¼ .25, p < .01. In
summary, excluding participants whose most traumatic event
failed to meet a variety of conventional standards for being
considered a traumatic event or produce symptoms that
exceed clinical levels of PTSD did not affect the pattern of
results reported in this study. This pattern of results is
consistent with the idea that the objective nature of
potentially traumatic events is unrelated to mental health
(Boals & Schuettler, 2009; Hathaway, Boals, & Banks, 2010;
Rubin et al., 2008). Consequently, no participants were
excluded from the analyses based on the nature of their most
traumatic event. Means and standard deviations of variables
are listed in Table 1.
In addition to exploring whether trauma-related variables
affected outcomes of the study, we examined possible
gender interactions. Boals (2010) previously found that
females report higher CES scores than male. This gender
difference was replicated in the current data set. Females
reported significantly higher CES scores (m ¼ 18.8,
SD ¼ 8.9) than did males (m ¼ 16.5, SD ¼ 8.5),
t(939) ¼ 3.77, p < .001, d ¼ .26. Despite this gender differ-
ence, no gender significant interactions emerged from
analyses. Thus gender was excluded from all reported
analyses.
As can be seen in Table 2, we replicated previous findings
between the CES, the PCL-S and depressive symptoms. The
results also supported the hypothesis that CES scores would
be positively correlated with PTGI scores. In fact, the
correlation between the CES and the PTGI was the strongest
correlation obtained in the correlation matrix. Thus, the more
a participant construed a traumatic/stressful event as central
to their identity, the greater their likelihood of both PTSD
symptoms and levels of PTG. The rest of the correlations
presented in Table 2 are considered secondary to the primary
hypotheses.
Because the CES was also related to a number of other
variables included in Table 2, simultaneous multiple
regressions were conducted to examine whether relation-
ships between the CES and the PCL-S and between the CES
and the PTGI would remain significant when other variables
are included in the regression model. A multiple regression
model was conducted to predict PTGI scores. Predictor
variables involved all 13 variables (except the PTGI)
included in Tables 1 and 2. The overall model was
significant, F(13, 846) ¼ 59.12, p < .001, adjusted
R2 ¼ .47. The results of the regression model revealed the
CES continued to significantly predict PTG and even more
importantly, was the strongest predictor, t(1, 846) ¼ 14.77,
p < .001, b ¼ .46. Other significant predictor variables
included the PCL-S, t(1, 846) ¼ 7.35, p < .001, b ¼ .25,
problem-focused coping, t(1, 846) ¼ 6.10, p < .001, b ¼ .19,
cognitive restructuring, t(1, 846) ¼ 5.09, p < .001, b ¼ .14,
downward comparisons, t(1, 846) ¼ 3.97, p < .001,
b ¼
.11, depression (QIDS), t(1, 846) ¼ 3.33, p < .001,
b ¼
.10, and resolution, t(1, 846) ¼ 2.07, p < .05, b ¼ .07.
The remaining variables (A1, A2, emotion-focused coping,
avoidant coping, denial and regret) were non-significant.
We next conducted a similar multiple regression model
predicting PCL-S scores. Predictor variables involved all 13
variables (except the PCL-S) included in Tables 1 and 2. The
overall model was significant, F(13, 846) ¼ 64.43, p < .001,
adjusted R2 ¼ .49. The results of the regression model
replicated past results in that the CES continued to
significantly predict PCL-S scores and even, the same as
in the model predicting PTG, CES scores were the strongest
predictor, t(1, 846) ¼ 7.22, p < .001, b ¼ .24. Other signifi-
cant predictor variables included the PTGI, t(1, 846) ¼ 7.35,
p < .001, b ¼ .24, depression (QIDS), t(1, 846) ¼ 6.29,
p < .001, b ¼ .19, regret, t(1, 846) ¼ 5.57, p < .001,
b ¼ .15, resolution, t(1, 846) ¼ 4.52, p < .05, b ¼
.14, A2,
t(1, 846) ¼ 3.79, p < .05, b ¼ .10, cognitive restructuring, t(1,
846) ¼ 3.75, p < .001, b ¼
.10, downward comparisons,
t(1, 846) ¼ 3.03, p < .01, b ¼ .09, avoidance coping, t(1,
846) ¼ 2.68, p < .01, b ¼ .08, problem-focused coping, t(1,
846) ¼ 2.10, p < .05, b ¼ .07 and denial, t(1, 846) ¼ 1.96,

Table 2. Correlation matrix

2 3 4 5 6 7 8 9 10 11 12 13 14
         
1. Centrality of Events .59 .55
.04 .18 .14 .16 .20 .29 .06 .10
.29 .06.23
2. Posttraumatic Growth — .44
.07
.13 .33 .26 .11 .07 .18
.08
.08 .11 .13
3. PTSD Checklist — —
.10
.25 .12 .15 .34 .43
.12
.06
.34 .20 .36
4. A1 — — — .41 .02
.05
.01
.07
.02
.08
.06 .06
.07
5. A2 — — — —
.01
.09
.09
.15 .09
.06 .06 .03
.09
6. Problem Coping — — — — — .58 .13
.06 .16 .05 .13 .01
.02
7. Emotion Coping — — — — — — .35 .07 .10 .11 .12 .02 .08
8. Avoidance Coping — — — — — — — .49
.10
.04 .21 .19 .23
9. QIDS (depression) — — — — — — — —
.15
.01 -.28 .14 .22
10. Pos Cog Resolution — — — — — — — — — .28 .38
.02
.03
11. Downward Comparison — — — — — — — — — — .47
.10
.01
12. Resolution — — — — — — — — — — —
.13
.21
13. Denial — — — — — — — — — — — — .35
14. Regrets — — — — — — — — — — — — —
Note: Positive Cognitive Resolution, Downward Comparisons, Resolution, Denial, and Regrets are subscales of the CPOTS.

p < .05; p < .01; p < .001.

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 25: 817–822 (2011)

p < .05, b ¼ .05. Only the variables A1 and emotion-focused
coping were non-significant.
DISCUSSION
Previous research has demonstrated negative consequences
of construing a potentially traumatic event as central to
one’s identity (Berntsen & Rubin, 2006; Rubin et al., 2008).
Specifically, event centrality predicted PTSD symptoms,
even after controlling for anxiety, depression and dis-
sociation (Berntsen & Rubin, 2007). In the current paper, we
replicated the significant correlation between event centrality
and PTSD symptoms. This relationship remained significant
after controlling for depression, cognitive processing of
the trauma, coping styles, PTG, and A1 and A2 status of
the event. We also found a significant correlation between
event centrality and PTG. As with predicting PTSD
symptoms, the relationship between event centrality and
PTG remained significant, even after controlling for
depression, cognitive processing of the event, coping styles,
PTSD symptoms, and A1 and A2 status of the event. The
direction of the correlations between event centrality and
PTSD symptoms/PTG were both positive. Therefore,
construing a potentially traumatic experience as central to
one’s identity can indeed become a double-edged sword,
allowing for both debilitation and growth.
When a multiple regression approach was used to predict
PTG scores with 13 trauma related variables, event centrality
emerged as the strongest predictor. Similar to other trauma
research, event centrality has also been shown to be one of
the strongest predictors of PTSD symptoms even when a
large number of other trauma-related variables are used in a
multiple regression model (Rubin et al., 2008). Additionally,
the predictive contribution of event centrality to both PTSD
symptoms and PTG, even when controlling for five measures
of cognitive processing (subscales of the CPOTS), suggests
the CES does a good job of assessing a belief-system
construct independent of cognitive biases.
Although not central to the hypotheses, the results allowed
us to revisit findings by Frazier, Tennen, et al. (2009) that the
PTGI may measure a coping process, as opposed to actual
growth. In addition, findings by McFarland and Alvaro
(2000) have demonstrated that perceived growth after a
traumatic event may be the result of motivated self-
enhancement, once again suggesting that the PTGI may
not measure actual growth. In our regression model
predicting PTSD symptoms, PTGI scores continued to be
a significant predictor even when measures of coping styles,
along with several other trauma-related variables were
included in the model. If the PTGI measures nothing beyond
general coping, we would expect the PTGI to be non-
significant when coping styles are included in the model.
Since this is not the pattern of results we observed, our results
suggest the PTGI measures something beyond just general
coping. When the PTGI was predicted with a number of
trauma-related variables, problem-focused coping was a
significant predictor, but emotion-focused and avoidant
coping were not. A number of cognitive processing variables
remained significant with coping styles in the model,
including cognitive restructuring, downward comparisons,
Copyright # 2010 John Wiley & Sons, Ltd.
Double-edged sword 821
and resolution, along with depression and PTSD symptoms.
Thus the construct of PTG appears to encompass a number of
complex mechanisms, including coping, cognitive proces-
sing and emotional reactions. Whether these mechanisms are
the result of actual growth should continue to be explored in
future empirical studies.
Certain limitations should be acknowledged when con-
sidering this research. First, no formal PTSD diagnoses were
made. However, the PCL-S is a well-established measure of
PTSD symptoms in both general (Blanchard et al., 1996) and
clinical populations (Weathers, Litz, Herman, Huska, &
Keane, 1993). Second, because the data were cross-sectional,
no causal conclusions can be made about relationships
between event centrality and outcomes. It is possible that
ensuing PTSD symptoms or perceptions of growth cause an
event to be construed as more central to identity.
Longitudinal studies should be conducted to examine the
time course of trauma aftermath. Lastly, we used self-report
measures when observation or peer/family report may have
yielded different results. However, our findings were
consistent with previous research despite these limitations
and further support the critical effect event centrality appears
to have on trauma aftermath.
There are two primary conclusions to draw from this
research. First, event centrality does not only indicate
negative trauma aftermath, but also the possibility of positive
consequences of trauma. As Tedeschi, Calhoun, and Cann
(2007) stated, ‘growth follows a challenge to and re-
examination of core beliefs, not every bad experience’ p.403.
The CES certainly assesses a challenge and re-examination
of the self based on a specific experience, indicating definite
potential to influence levels of growth following trauma.
Secondly, researchers have long hypothesized why some
individuals demonstrate resilience in the face of potentially
traumatic experiences when others in the same situation
become traumatized. Multiple predisposing factors such as
demographics, trauma history, type of trauma and mental
health status have been examined to clarify PTSD
susceptibility versus resilience to such events, yet there is
a general dissatisfaction among the psychology community
with the current available explanations. Much controversy
exists regarding the type of events that should receive trauma
status and who can truly develop PTSD following certain
types of events. Thus far, event centrality research would
suggest subjective rather than objective aspects of a
potentially traumatic event are more critical to trauma
outcomes.
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