Posttraumatic Outcomes Following a Campus Shooting

The frequency of mass shootings has increased, with the FBI reporting a more than ten-fold rise from 2000 to 2015. Given the broad impact of community shootings, it is important to understand how such events affect the psychological well-being of survivors.

While extensive research links trauma exposure with negative mental health outcomes, or posttraumatic stress (PTS), recent research also suggests that some trauma-exposed individuals experience positive mental health outcomes, or posttraumatic growth (PTG).

In an article in Psychological Trauma: Theory, Research, Practice, and Policy (2020), Wozniak, Caudle, Harding, Vieselmeyer, and Mezulis examined pre- and post-trauma factors that predicted posttraumatic stress and growth following a college campus shooting.

Posttraumatic stress refers to negative and distressing changes in thoughts, emotions, and behaviors following a traumatic event, and may include symptoms like anxiety, hypervigilance, intrusive thoughts and memories, and avoidance of trauma reminders. In contrast, posttraumatic growth broadly denotes positive changes in attitudes and beliefs following trauma, possibly including greater sense of life meaning and purpose.

Contextual features of the traumatic event and individual difference characteristics of trauma-exposed individuals may help researchers understand these divergent outcomes.

One important contextual feature is the nature of trauma exposure. Specifically, research suggests it is important to consider how both physical proximity (i.e. geographical closeness to the traumatic event) and emotional proximity (i.e. the strength of the relationship to the perpetrator or victims) may exert unique effects on trauma outcomes.

An important individual difference characteristic may be the way in which individuals cognitively process a traumatic event. Specifically, ruminating about the traumatic event can greatly impact outcomes. Intrusive rumination entails unwanted, repetitive, and negative thoughts about fear and anxiety experienced during a traumatic event. By contrast, deliberate rumination describes an individual's intentional reflections on the event in order to identify purpose or understanding.

While intrusive rumination has been consistently linked with PTS, little research has examined whether deliberate rumination may adaptively foster PTG.

The authors studied more than 350 students, faculty, and staff following a college campus shooting.

They found that greater physical proximity to the shooting predicted more PTS, while greater emotional proximity predicted both PTS and PTG. They also found that intrusive rumination mediated the effect of physical proximity on PTS, suggesting that closeness to a traumatic event may increase the likelihood that a survivor will have intrusive negative and repetitive thoughts, which will in turn increase the likelihood of negative mental health outcomes.

By contrast, deliberate rumination mediated the effect of emotional proximity on PTG, suggesting that personal familiarity to a victim may increase the likelihood that a survivor will engage in deliberate and intentional attempts to understand and make meaning of the traumatic event, which may in turn increase the likelihood of positive outcomes.

It is important to acknowledge that survivors with greater emotional proximity also developed more posttraumatic stress symptoms. However, this study suggests that engaging in intentional reflection on the event can also lead to posttraumatic growth.

These results highlight the unique effects of physical and emotional proximity on trauma outcomes, as well as underscore the importance of using interventions that address intrusive rumination and/or promote a deliberate ruminative style to help trauma survivors channel their experience into growth.

Citation

• Wozniak, J. D., Caudle, H. E., Harding, K., Vieselmeyer, J., & Mezulis, A. H. (2020). The effect of trauma proximity and ruminative response styles on posttraumatic stress and posttraumatic growth following a university shooting. Psychological Trauma: Theory, Research, Practice, and Policy, 12(3), 227–234. https://dx.doi.org/10.1037/tra0000505

Note: This article is in the Health Psychology and Medicine topic area. View more articles in the Health Psychology and Medicine topic area.

Amy H. Mezulis, PhD, is a professor of clinical psychology and chair of the Department of Clinical Psychology at Seattle Pacific University. Her research interests include biological and psychological pathways to adolescent-onset disorders of emotion regulation such as depression and self-injury. Dr. Mezulis is particularly interested in how individuals respond affectively, physiologically, and cognitively to stressful and traumatic events, and how individual differences in stress responses predict mental health outcomes.

Jana DeSimone Wosniak, MS, is a doctoral student at Seattle Pacific University studying trauma exposure, depressive symptoms, and responding to positive events and affect in young adults.

Hailey E. Caudle, MS, is a doctoral student at Seattle Pacific University. Her research and clinical interests include child and adolescent psychopathology, positive affectivity, and disruptive behavior interventions.

Kaitlin Harding, PhD, graduated from Seattle Pacific University in 2017. She is a psychologist in the Comprehensive Pain Clinic at VA Puget Sound Healthcare System in Seattle, Washington.

Julie Vieselmeyer, PhD, graduated from Seattle Pacific University in 2018. She is a psychologist in the Bariatric, Metabolic, and Endocrine Clinic at Swedish Medical Center in Seattle, Washington.