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Protective responses to trauma

Wells, J 2004 , 'Protective responses to trauma', PhD thesis, University of Tasmania.

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Abstract

Research has indicated multiple factors unique to the individual may be more important in
predicting their response to a traumatic event than objective assessment of the severity of
an event. Such factors have included individual appraisal of threat to life and fear of death,
emotional processing of the experience, perceived severity of the stressor, and perceptions
of blame for the event. The current research aimed to systematically examine the
contribution of such factors in the aetiology of posttraumatic stress responses and to
consider factors that might influence the development of both positive and negative
responses.
The integrative model proposed by Joseph, Williams and Yule (1995) pro\'ided structure to
the investigation. The components included appraisal factors (the explanations formed for
the event); stimulus factors (characteristics that rendered it most traumatic); personality
factors (e.g., dysfunctional beliefs, attributional style, locus of control, anger expression and
hostility); emotional state factors (peritraumatlc emotional states, psychophysiOlogical
responses and dissociation); and activity factors (cogrutive or behavioural actions taken
after the event).
Eight studies based on evaluating each of these factors were conducted. The studies
involved participants with Posttraumatic Stress Disorder (PTSD) (n= 19), Acute Stress
Disorder (ASD) (n=13), Sub-Clinical symptoms (n=17) and No symptoms (n=18).
Comparisons across two event types; Motor Vehicle Accident (1vfV A) and Physical assault
and two blame types; self-blame and other-blame were also made. The methodologies
included clinical interview, questionnaire and a four stage guided imagery methodology to
access psychological and psychophysiological states during imagery of the traumatic event.
\ "
These studies contributed to the current understanding of trauma responses by highlighting
that a more vulnerable response to trauma was associated with more blame towards others,
a perception of malicious intent to harm, less control, greater perceptions of life threat and
peritraumatic fear of death and higher perceptions of the severity of the event, the threat to
life and injury. Vulnerability was associated with greater irrational belief and social
withdrawal. Although posttraumatic growth was observed in the PTSD group, a greater
degree of negative changes were also observed. A more protective response to trauma, as
observed in the ASD group who recovered withm 4 weeks of the traumatic event, was
associated with delay in attnbution of blame unul after the event, self-blame or blame
towards others that was coupled with low perceptions of life threat and fear of death, lower
severity ratings, lower levels of mjury, and an absence of a trauma history. The Sub-Clirucal
group tended to blame their behavtour; to feel gUilty and to criticise themselves more
strongly than other groups but they may have been protected from developmg full PTSD
by the fact that they did not direct blame externally.
The results of the empirical studies contributed to the current understanding of protective
responses to trauma and supported the role of the components of the integrative model
Qoseph, Williams et al., 1995) in the aetiology of posttraumatic stress responses. The
implications of these results for assessment, diagnosis and treatment of posttraumatic stress
symptoms and directions for future research were discussed.

Item Type: Thesis - PhD
Authors/Creators:Wells, J
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