To Attribute or Not to Attribute, That is the Post-Traumatic Question

摘要

A significant number of persons worldwide will experience a traumatic event during their lifetime, be it natural (e.g., tornado, hurricane, earthquake) or man-made (e.g., terrorist attacks, sexual assault). The most common difficulty experienced after a traumatic event is some type of anxiety, with the group of symptoms typically labeled post-traumatic stress symptoms (PTSS) being the most common type. Although there are numerous evidence-based programs and therapies designed to alleviate PTSS, they are primarily delivered months, sometimes years, after the traumatic event, as only a small percentage of those persons exposed to a trauma will go on to develop clinically significant difficulties. Attempts to identify those mostly likely to develop significant difficulties has uncovered several variables that are predictive of distress, including coping skills, depression, and trauma characteristics. The present paper discusses the results of several studies designed to examine the role of disaster-specific attributions in predicting current and future post-traumatic stress symptoms in both school-age children and young adults. Primary findings include very strong predictive power for attributions (between 36-74% of variance in PTSS symptoms depending on amount of time post-disaster), particularly those involving searching for the meaning behind the disaster, and this predictive ability was far above and beyond the types of coping skills employed, subjective exposure, or objective exposure to the disaster. The significance of these findings to potential identification of and intervention with persons after exposure to trauma will also be addressed.