Positive and Negative Adjustment and Social

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Positive and Negative Adjustment and Social
Support of Sexual Assault SurvivorsSusan E. Borja, Jennifer L. Callahan, and Patricia J. Long
Department of Psychology, Oklahoma State University, Stillwater, OK
The roles of positive (i.e., growth) and negative (i.e., posttraumatic stress symptoms and general symp-
tomatology) adjustment following adult sexual assault experience(s) were examined using a standardized
definition of abuse. These reactions were explored in association with positive and negative support
from formal and informal providers. Finally, using standardized measures, the collective impact of
positive and negative support, formal and informal support were investigated in predicting positive and
negative psychological adjustment. Both forms of informal support were found to be associated with
positive outcomes. Only negative informal support was associated with posttraumatic stress symptoms.
First responders should consider whether support resources are appropriate to victims’ needs.
Exposure to interpersonal violence is associated with
both short-term and long-term psychological and phys-
ical health problems (for reviews see Briere & Jordan,
2004; Plichta, 2004; Resnick, Acierno, & Kilpatrick, 1997;
Woods, 2005), with problems characterizing posttraumatic
stress disorder (PTSD) among the most commonly re-
ported (Kessler, Sonnega, Bromet, Hughes, & Nelson,
1995). More specifically, consistently higher rates of PTSD
are found among interpersonal violence survivors, in com-
parison to survivors of other traumas (Kessler et al., 1995;
Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993), with
the risk of PTSD being as much as 10 times more likely
(Breslau, Chilcoat, Kessler, & Davis, 1999).
Brewin, Andrews, and Valentine (2000) concluded from
their meta-analysis that vulnerability for PTSD was linked
to specific populations (e.g., women, those socially, edu-
cationally, or intellectually disadvantaged, those with psy-
chiatric history, and those with greater life stress) under
certain circumstances (e.g., trauma severity, additional life
Jennifer Callahan is a Visiting Lecturer at Yale School of Medicine, New Haven, CT. Patricia Long is now an Assistant Professor at University of LaVerne, LaVerne, CA.
Correspondence concerning this article should be addressed to Jennifer Callahan, 215 North Murray, Stillwater, OK 74078. E-mail: jennifer.callahan@okstate.edu.
C
2006 International Society for Traumatic Stress Studies. Published online in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/jts.20169
stress), including lack of social support. Recently, Ozer,
Best, Lipsey, and Weiss (2003) found that prior character-
istics (e.g., trauma, psychological adjustment, and family
history of psychopathology) were less predictive of adjust-
ment following trauma than other posttrauma variables,
including social support. Such findings indicate that one
method that could be useful in identifying individuals
likely to experience lasting psychological distress following
interpersonal violence is to assess the victim’s experience of
social support (e.g., Brewin, Andrews, & Valentine, 2000;
Ozer et al., 2003; Ruch & Chandler, 1983).
Although research has largely focused on adverse out-
comes (e.g., Breslau et al., 2002; Norris et al., 2002), it is
clear that some victims experience a mixture of both posi-
tive and negative sequelae following trauma. Research that
includes examination of both positive and negative trauma
outcomes, further indicates that such outcomes can coex-
ist as independent constructs, and are not mutually exclu-
sive, within the same individual (Linley, Joseph, Cooper,
905
906
Borja, Callahan, and Long
Harris, & Meyer, 2003). Among the positive changes re-
ported in the literature are improved relationships, devel-
opment of new possibilities, a greater appreciation for life,
a greater sense of personal strength, and spiritual devel-
opment (Linley et al., 2003; Tedeschi & Calhoun 1995).
Although positive sequelae are not often examined in stud-
ies of trauma, several studies have documented some form
of growth or positive change in 50% or more of trauma
survivors (Tedeschi & Calhoun, 1995), including sexual
assault survivors (Burt & Katz, 1987; Frazier, Conlon, &
Glaser, 2001; Frazier, Tashiro, Berman, Steger & Long,
2004; Thompson, 2000).
Individuals who experience some form of positive
growth after trauma, and are able to maintain such gains
over time, may experience less sustained psychological dis-
tress (Linley & Joseph, 2004). For example, a longitudinal
study by Frazier and colleagues (2001) found that some vic-
tims of sexual assault experienced positive changes (more
empathy, greater appreciation for life, and improvements in
relationships) as early as 2 weeks following victimization.
In a follow up study (Frazier et al., 2004), hierarchical
linear analysis revealed self-reported experience of social
support to be a significant predictor of positive sequelae
following sexual assault. Although consistent with other
studies (Cadell, Regehr, & Hemsworth, 2003; Tedeschi &
Calhoun, 1995), this finding is inconsistently reported in
the literature. For example, in another recent meta-analysis
(Linley & Joseph, 2004), social satisfaction was related to
growth, but social support, more generally, was not signif-
icantly related.
In exploring social reactions more specifically, re-
searchers have noted that such reactions may be inter-
preted variably (Linley & Joseph, 2004; Ullman, 1999).
That is, some may interpret a particular reaction as posi-
tive, whereas others consider it negative. Support typically
considered positive consists of the reactions one would
hope to receive in the wake of a trauma (e.g., being be-
lieved, being absolved of blame, receiving information or
tangible aid; Ullman, 1996c). On the other hand, reac-
tions from support sources that are usually characterized
as negative include reactions that, although perhaps well
intentioned, are unresponsive to the victim’s needs or may
even be overtly harmful (e.g., telling the victim to move
on, forget about it, blaming the victim, or taking con-
trol; Ullman, 1996c). Such negative reactions following
sexual assault have been associated with greater psycholog-
ical distress and are predictive of poor adjustment (Davis,
Brickman, & Baker, 1991; Frank et al., 1988; Ullman,
1996a, 1996b, 1996c). In contrast, positive social reactions
have not been found to be predictive of negative adjust-
ment (Campbell, Aherns, Self, Wasco, & Barnes, 2001;
Ullman, 1996b).
Research suggests that that the impact of responses
may be a function of the source’s importance to the sur-
vivor (Ullman, 1996b) or the frequency of disclosure and
the opportunity for support (Golding, Siegal, Sorenson,
Burnam, & Stein, 1989). For example, informal providers
of support, including family members, friends, and/or ro-
mantic partners, may be more readily available, or in more
frequent contact with victims. Formal providers of sup-
port (e.g., first responders, including police, firefighters,
medical or mental health providers, and other emergency
personnel) may differ in characteristic behavior and differ-
entially impact adjustment compared to informal sources.
Although formal support sources are meant to be experi-
enced as helpful to victims of interpersonal violence, their
efforts are not uniformly helpful (Golding et al., 1989;
Popiel & Susskind, 1985; Ullman, 1996b, 1996c).
In summary, reactions from sources of formal and in-
formal support are associated with a range of sequelae,
including both growth and distress. The present study
sought specifically to explore both positive (i.e., growth)
and negative (i.e., posttraumatic stress symptoms and gen-
eral emotional distress) adjustment following an adult
sexual victimization, particularly in regard to how such
adjustments are related to positive and negative reac-
tions provided by formal and informal support sources.
Based on the literature, we hypothesized that negative
reactions would increase general emotional distress and,
more specifically, symptoms associated with posttraumatic
stress (PTSD). We further hypothesized that growth would
be predicted by positive reactions. Positive and nega-
tive reactions were not expected to be mutually exclusive
constructs.
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
Adjustment and Social Support of Sexual Assault Survivors
907
M E T H O D
Participants
Participants were drawn from 517 female college students
recruited from a large Midwestern university research par-
ticipant pool for an online survey of life experiences. Reg-
istration in the subject pool was required to gain access
to the survey to prevent duplicate submissions by partici-
pants and limit participation to the university sample. All
participants were awarded class credit in their coursework
and were treated in accordance with the Ethical Princi-
ples of Psychologists and Code of Conduct (American Psy-
chiatric Association, 2002). Eleven women chose not to
complete any portion of the survey. Of the remaining
506 participants, 115 participants (22.7%) met criteria to
be considered adult sexual assault victims as identified on
the Modified Sexual Experiences Survey (Messman-Moore
& Long, 2000; acknowledging forced or coerced vaginal or
anal intercourse, forced or coerced penetration by objects,
or forced oral–genital contact). The assault victim sample
reported an average of 2.45 (SD
= 2.66, range = 1–10) ac-
quaintance assaults, with the most recent assault occurring
an average of 17 months ago (Mode
= 1, 25%; Mdn = 12,
SD
= 17, range = 1–66). No participants in this sample
reported an assault by either spouse or stranger.
Measures
Modified Sexual Experiences Survey. The original Sex-
ual Experiences Survey (SES; Koss & Gidycz, 1985) con-
tains four questions regarding unwanted intercourse (due
to continual arguments or pressure, authority, alcohol or
drugs, and physical force), and two questions regarding at-
tempted intercourse (due to alcohol or drugs and physical
force). The Modified Sexual Experiences Survey (MSES;
Messman-Moore & Long, 2000) extends the SES and as-
sesses additional victimization exposure to specific types
of attempted or completed sexual activities since the age
of 17. Additional forms of sexual contact were categorized
into the following three areas: (a) kissing and fondling, (b)
oral–genital contact, and (c) penetration by objects. Each
method of force (alcohol or drugs and physical force) and
two methods of coercion (continual arguments or pressure
and misuse of authority) were assessed for each attempted
activity, resulting in 24 questions. The set of 24 questions
was administered three times to assess unwanted sexual
contact perpetrated by (1) girlfriend/boyfriend, dates, or
acquaintances; (2) spouses; and (3) strangers. Reliability of
.74 (for women) has been reported for the original SES
with a 1-week test-retest reliability of .93 (Koss & Gidycz,
1995) and internal consistency in female college samples
ranges from .84 to .87 (Messman-Moore & Long, 2000).
Internal consistency of the MSES in the present study was
good (
α = .81).
Life Experiences Questionnaire. The Life Experiences
Questionnaire (LEQ; Long, 2005) is a 57-item self-report
measure to assess for a range of child sexual victimiza-
tion (CSA) prior to age 17, excluding voluntary activities.
Questions may be answered up to three times to reflect
different perpetrators. Items assess coercion/force of sexual
victimization, the nature of the relationship with the per-
petrator, as well as the nature of the sexual activity. Both
internal consistency (
α = .89) and test-retest reliability
(r
= 1.00) in female college samples have been acceptable
(Messman-Moore, Long, & Siegfried, 2000).
Perceived Benefits Scale. The Perceived Benefits Scale
(PBS) is a 38-item, self-report measure that uses a Lik-
ert scale ranging from 0 (not at all like my experience) to 4
(very much like my experience) to measure subjective posi-
tive life changes after negative traumatic events (McMillen
& Fisher, 1998). Items intended to measure gains include
areas of increased caring and self-efficacy. A composite per-
ceived benefits score (ranging from 0 to 152) was obtained
by summing the individual item responses, with higher
scores indicating more benefits following trauma. Total
scores (range
= 0–90) obtained by current participants
(M
= 26.23, SD = 21.00) fell within the range (14.35–
47.85) obtained from other samples reported in the litera-
ture (Joseph, Linley, & Harris, 2005; McMillen & Cook,
2003). Comparable elevations were found across subscales
with highest gains in domains measuring compassion,
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
908
Borja, Callahan, and Long
self-esteem, and family closeness. Two-week test-retest reli-
ability has been reported as reasonably strong (.66–.97) and
construct validity has been demonstrated with the Post-
traumatic Growth Inventory (McMillen & Fisher, 1998).
Composite internal reliability in the current study was ex-
cellent (
α = .94).
Posttraumatic Stress Diagnostic Scale. The Posttrau-
matic Stress Diagnostic Scale (PDS) is a 49-item, self-
report measure of posttraumatic stress disorder (Foa, Cash-
man, Jaycox, & Perry, 1997). For the purposes of this
study, only the 17 items assessing PTSD symptomatology
were included. A symptom severity score (ranging from 0
to 68) was obtained by summing the individual item re-
sponses. According to the measure’s authors, scores greater
than 10 indicate moderate or greater symptom severity.
In the current sample, on average, women reported mod-
erate symptom severity (M
= 12.21, SD = 8.93, range
= 2–39). The PDS has demonstrated good psychometric
properties including test-retest reliability (.87; Foa et al.,
1997) and construct validity with the Structured Clinical
Interview for DSM-III Disorders (.82; Foa et al., 1997).
For the sample included in the current investigation, in-
ternal consistency was excellent (
α = .91).
The Symptom Checklist 90-Revised. The Symptom
Checklist 90-Revised (SCL-90-R; Derogatis, 1997) is a
well-established 90-item self-report instrument used to
assess psychological symptoms. The Global Severity In-
dex (GSI), measuring general symptomatology, was used
with very good resultant internal consistency (
α = .97)
in our sample. The participants’ mean score fell in the
nonclinical range (M
= 0.86, SD = 0.50, range = 0.22–
0.86), although somewhat higher than the normative
comparison group (M
= 0.36, SD = 0.35; Derogatis,
1994).
Social Reactions Questionnaire. The Social Reactions
Questionnaire (SRQ) is a 48-item self-report instrument
developed to measure specific types of positive and neg-
ative reactions received following disclosure of a sexual
assault experience (Ullman, 2000). This measure has also
demonstrated good convergent validity for positive and
negative social reactions with a number of domains theo-
retically associated (Ullman, 2000). Participants who had
not disclosed their assault experience prior to the study
would not complete this measure. Sample constructs from
the measure include the divulging of information without
consent (negative reaction) and nonblame of the victim
(positive reaction). Mean scores were calculated across all
positive support items and across all negative support items
for each administration reflecting informal and formal
providers’ reactions. This measure was administered twice
to each participant endorsing a sexual assault experience;
once to inquire about formal support providers and again
to assess support provided by informal providers. Lower
frequency of both formal and informal reactions were
reported in the current study (positive formal M
= 1.05,
SD
= 1.09, range = 0–3.52; negative formal M = 0.36,
SD
= 0.50, range = 0–1.89; positive informal M = 1.63,
SD
= 1.02, range = 0–3.57; negative informal M = 0.60,
SD
= 0.55, range = 0–1.93) than those in the nor-
mative female sample (positive M
= 2.02, SD = 0.83;
negative M
= 1.04, SD = 0.93; S. E. Ullman, personal
communication, July 27, 2004). Further, in the current
study internal consistency was very good for both the for-
mal (
α = .96) and the informal (α = .95; Ullman, 2000)
sources of reactions.
There were no significant differences between women
with an assault history and those with no history of adult
sexual assault for marital status, sexual orientation, or
ethnicity/racial status. Socioeconomic status (SES) was
assessed using the Two-Factor Index of Social Position
(Myers & Bean, 1968) with the average participant falling
in the middle class; significant differences were not found
with respect to SES between assault status groups. Sig-
nificant differences between victimized and nonvictim-
ized women were found for age. Specifically, sexually
assaulted women were older (M
= 21.68, SD = 6.71)
than women without an assault history (M
= 20.04,
SD
= 2.89), t (490) = −3.79, p < .01. However, age
differences were not found on any of the dependent
measures.
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
Adjustment and Social Support of Sexual Assault Survivors
909
R E S U L T S
All analyses were conducted using an alpha level of .05 (un-
less otherwise stated) in statistical tests using SPSS (Ver-
sion 12.0). After completing demographic, sexual assault
status, and general distress (SCL-90-R) measures, partic-
ipants who met criteria for assault status were instructed
to continue the survey and respond to further adjustment
and support measures based on the adult sexual experience
they had just described. If more than one assault was re-
ported, the participant was asked to reference the assault
they subjectively considered their worst of the experiences
in the completion of the remainder of the questionnaires.
Many women may not have disclosed their experience
of assault. In these situations, they were instructed not
to complete the SRQ, but to complete further measures
of adjustment (PBS and PDS). If women disclosed to
only formal or informal providers, they were instructed
to complete only the corresponding portion of the SRQ.
Four women disclosed only to informal providers, but all
Table 1. Demographic Frequencies of Categorical Data
Sexual Assault
Survivors Included
Overall Sample
Sample
in Analyses
n
%
n
%
n
%
Marital Status
Never Married
432
85.0
097
84.3
55
83.3
Married
27
5.3
6
5.2
3
4.5
Cohabitating
19
3.7
7
6.1
3
4.5
Divorced/Separated
8
1.6
1
0.9
1
1.5
Other
17
3.3
2
1.7
2
3.0
Race
Caucasian
411
80.9
93
80.9
53
80.3
African American
22
4.3
6
5.2
3
4.5
Hispanic
9
1.8
6
5.2
4
6.1
Native American
32
6.3
6
5.2
4
6.1
Asian
21
4.1
2
1.7
1
1.5
Other
10
2.0
2
1.7
1
1.5
Socioeconomic Status by class
Upper
4
0.8
0
0
0
0
Upper-Middle
62
12.8
16
13.9
10
15.2
Middle
140
28.8
35
30.4
21
31.8
Lower-Middle
208
42.8
45
39.1
22
33.3
Lower
61
12.6
17
14.8
11
16.7
other participants reported disclosing to both formal and
informal providers. However, nearly half of the women
who met criteria for experiencing an adult sexual assault
discontinued the survey and did not complete further mea-
sures of support or adjustment. Class credit was awarded
regardless of level of participation and may have acted as
an incentive to discontinue the survey.
No significant differences (on any demographic vari-
ables) existed between the assaulted women who partici-
pated fully and those who discontinued the study. With
respect to child sexual assault, latency, and number of as-
saults, the only significant difference between those who
completed fully and those who discontinued the survey
was with respect to the number of assaults. Women who
participated fully (n
= 63) reported more assaults (M =
3.25, SD
= 2.85) than women who discontinued the sur-
vey (n
= 51; M = 1.45, SD = 2.03), t (112) = −3.80,
p
< .01. Table 1 provides frequencies for the categori-
cal demographic variables for the overall sample, the full
sexual assault sample, as well as the sample of survivors
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
910
Borja, Callahan, and Long
Table 2. Partial Correlations Between Support, Personal Growth, and Distress
Measures
1
2
3
4
5
6
7
1. Perceived Benefits
1.00
.05
.28
.62*
.64*
.31
.29
2. Posttraumatic Stress
1.00
.47
.31
.15
.19
.34*
3. Global Symptom Severity
1.00
.25
.40
.02
.04
4. Formal Positive Support
1.00
.56*
.56*
.39
5. Informal Positive Support
1.00
.24
.49*
6. Formal Negative Support
1.00
.68*
7. Informal Negative Support
1.00
Note. Correlations controlled for frequency of adult victimization experiences.
* p
< .004 (Bonferroni Correction).
who completed all measures. Initial analyses were con-
ducted to examine the relationships among latency since
victimization, frequency of victimization, history of child
sexual assault, and the dependent measures (PBS, GSI, and
PDS). The PDS scores were found to be significantly asso-
ciated with the number of assaults (r
= .50, p < .01), but
no other significant relationships were revealed.
A partial correlation analysis (controlling for the num-
ber of assaults by acquaintances) was conducted to examine
the hypothesis that positive and negative adjustment would
be related to constructs. Using the composite benefits score
from the PBS, the symptom severity score from the PDS,
and the GSI from the SCL-90-R, negative adjustment and
growth demonstrated no significant relationship, although
the measures of negative adjustment (PDS and SCL-90-R)
were related ( pr
= .47, p < .01), with good retrospective
power (.91).
Partial correlations (controlling for number of assaults
by acquaintances) were calculated using mean scores from
the SRQ (formal positive, formal negative, informal posi-
tive, and informal negative), in conjunction with the ad-
justment measures: the composite PBS score, the PDS
symptom severity score (PTSS), and the SCL-90-R GSI.
As hypothesized, growth was found to be significantly cor-
related with both formal ( pr
= .62, p < .001) and in-
formal positive reactions ( pr
= .64, p < .001). Similarly,
the hypothesis that posttraumatic distress (PTSS) could
be significantly correlated with negative informal reactions
( pr
= .34, p < .001) was supported. However, more gen-
eral distress (GSI) was not significantly correlated with
either formal or informal reactions (see Table 2). No other
statistically significant relationships emerged. Retrospec-
tive power calculated in this analysis was excellent (.97).
Next, three regressions were calculated to examine the
predictors of adjustment that were hypothesized. For each
regression, supplemental analyses revealed no difficulties
associated with multicollinearity. The first linear stepwise
regression was performed using the PBS composite bene-
fits score as the criterion. Frequency of assault (
β
= .21)
was entered first as the control variable, which accounted
for less than 5% of the variance in PBS scores. The fol-
lowing support variables were then permitted to enter into
the equation: informal positive, formal positive, formal
negative, and informal negative. Informal positive sup-
port (
β
= .41, p < .01) and formal positive support
(
β
= .38, p < .01) significantly increased the predictabil-
ity of supportive SRQ composite scores by accounting for
an additional 49% of the variance to form a good model of
predictive factors of growth, F (3, 44)
= 16.65, p < .01.
Tolerance (.67–.99) and power (.98) were again acceptable.
A second linear stepwise regression was then performed
using the PTSS as the criterion. Frequency of assault
(
β
= .57) was again entered as a control variable, ac-
counting for 33% of the variance in PDS severity scores,
F (1, 43)
= 20.98, p < .01. As in the first analysis, the
following support variables were then permitted to enter
into the equation: informal negative, formal negative, for-
mal positive and informal positive. Only informal negative
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
Adjustment and Social Support of Sexual Assault Survivors
911
support (
β
= .34, p < .01) significantly increased the
predictability of the PTSS, by accounting for an additional
9% of the variance, F (2, 42)
= 16.12, p < .01. Again,
tolerance (.918) and power (.92) were excellent.
A final linear stepwise regression was then performed
using the GSI score as the criterion. Frequency of assault
(
β
= .18) was again entered first as the control variable.
This variable accounted for only 3% of the variance in GSI
scores, F (1, 48)
= 1.56, ns. As in the other analyses, the
following support variables were then permitted to enter
into the equation (through stepwise probability criteria):
informal negative, formal negative, formal positive, and
informal positive. No support variables met significance to
enter the equation. No variables formed a good model of
fit to predict general distress as measured by the GSI score
on the SCL-90-R. Furthermore, power was inadequate.
D I S C U S S I O N
Several considerations are relevant to this study. First, a
sizable number of participants failed to complete all mea-
sures. Participants who completed all of the measures did
not differ on any demographic characteristics from those
who withdrew after the sexual assault questionnaires. A sig-
nificant difference was revealed with regard to the number
of assaults experienced, but those who completed all mea-
sures reported more assaults than those who withdrew. As
such, theoretically, it does not appear that those who would
be most distressed withdrew. Another consideration is the
sample used. Among a college sample, formal and informal
supports may vary from women who experience a sexual
assault later in life. Nevertheless, understanding the role
of social support in predicting adjustment of sexual assault
survivors is important in the prevention and treatment of
distress.
Consistent with the proposed hypotheses, this study
demonstrated that some women experience positive change
following sexual victimization. The findings indicate that
growth and distress are not bipolar opposites along a sin-
gle continuum, but independent constructs that are not
mutually exclusive. That is, women report both growth
and distress following sexual victimization. This is con-
sistent with findings by Linley and colleagues (2003) but
contrary to speculation by Thoits (1984, 1986), who be-
lieved growth would be effective at buffering sexual assault
victims from distress.
Positive reactions from family and friends as well as
positive reactions from formal support providers were asso-
ciated with benefits in the aftermath of trauma. Only infor-
mal negative reactions were associated with specific post-
traumatic distress in the current investigation. Reactions
from formal and informal providers, regardless of whether
the reaction was positive or negative, were not associated
with more general psychological distress, in contrast to our
hypothesis and also previous literature that measured so-
cial support more globally (Davis et al., 1991; Frank et al.,
1988; Kramer & Green, 1991; Ullman, 1996c). This is
not to say that formal providers’ negative reactions are
irrelevant; however, informal support providers’ reaction
to victims may have been particularly salient to victims
in our sample. It should be noted that although many
women reported receiving negative reactions, they were
less frequent than positive reactions and power may have
been inadequate in these analyses (Cohen, Cohen, West,
& Aiken, 2003). Further, this study only examined more
severe forms of assault. Findings presented here may not
generalize to less severe forms of assault, other traumas, or
other samples.
A number of explanations for the association between
support and adjustment are possible. For example, those
who are experiencing more distress may recall and be more
sensitive to negative reactions (Gotlib, 1983). Similarly,
those who experience positive adjustment may possess a
broadly optimistic and positive outlook. Such individuals
may interpret the support they receive as more positive and
remember receiving such reactions more vividly (Updegraff
& Marshall, 2005).
As an easily modified variable posttrauma that is predic-
tive of PTSD (Ozer et al., 2003), social support remains
an important area for research. This study took a conser-
vative approach in examining the association of support
reactions and adjustment measures by applying a modi-
fied Bonferroni correction due to alpha inflation concerns.
Future research should consider exploring some of these
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
912
Borja, Callahan, and Long
other possible relationships or replicating the current find-
ing in more diverse samples (e.g., type of trauma, gen-
der, age, ethnicity, sexual orientation, etc.). Researchers
may also consider a longitudinal design to allow for
the inclusion of prospective measurement of distress and
support.
Prior research (for a review, see National Institute of
Mental Health, 2002) has demonstrated that even in the
initial stages of recovery, dissemination of efforts and early
interventions may be of great benefit to those at risk and
the recovery environment is an important factor in pre-
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suggest that first responders should consider whether sup-
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