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Research papers, University of Canterbury Library

Canterbury, New Zealand, was struck by two major earthquakes in 2010 and 2011. Using a dyadic and developmental perspective, the current thesis first aimed to determine how the experience of earthquake-related stressors (including loss of material resources, trauma exposure, and ongoing earthquake-related stressors) and stress (posttraumatic stress symptoms) impacted individuals’ intimate relationship quality (Part 1). Data were collected from a sample of 99 couples at four time points over a period of approximately 15 months, with Time 1 completed 14 months after the 2010 earthquake (eight months post the 2011 earthquake). Data were analysed using moderated growth curve modelling in an Actor-Partner Interdependence Model framework. In line with expectations, posttraumatic stress symptoms were the strongest predictors of relationship quality. More specifically, individuals’ (actor) posttraumatic stress symptoms and their partner’s posttraumatic stress symptoms had an adverse effect on their relationship quality at Time 1. Demonstrating the importance of taking a developmental perspective, the effect of partner posttraumatic stress symptoms changed over time. Although higher partner posttraumatic stress symptoms were associated with worse relationship quality in individuals (actors) at Time 1, this was no longer the case at Time 4. Differences were also found between men and women’s actor posttraumatic stress symptom slopes across time. Using the same data and analyses, Part 2 built on these findings by investigating the role of a possible posttrauma resource available within the relationship – support exchanges. Overall, results showed that individuals were protected from any adverse effects that posttraumatic stress symptoms had on relationship quality if they had more frequent support exchanges in the relationship, however, differences between men and women and slopes across time were found. Although not the case initially, individuals’ relationship quality was worse in the longer-term if their partner reported receiving lower support from them when they were experiencing high posttraumatic stress symptoms. Results also suggested that although women coped better (as evidenced through slightly better relationship quality) with higher symptoms and lower support than men initially, these efforts diminished over time. Furthermore, men appeared to be less able to cope (i.e., had worse relationship quality) with their partner’s stress when they were not receiving frequent support. Contrary to expectations, negative exchanges in the relationship did not exacerbate any adverse effects that posttraumatic stress symptoms (experienced by either individuals or their partner) had on an individuals’ relationship quality. The theoretical and practical implications and applications of these findings are discussed.

Research papers, University of Canterbury Library

Following exposure to trauma, stress reactions are initially adaptive. However, some individuals’ psychological response can become maladaptive with long-lasting impairment to functioning. Most people with initial symptoms of stress recover, and thus it is important to distinguish individuals who are at risk of continuing difficulties so that resources are allocated appropriately. Investigations of predictors of PTSD development have largely focused on relational and combat-related trauma, with very limited research looking at natural disasters. This study assessed the nature and severity of psychological difficulties experienced in 101 people seeking treatment following exposure to a significant earthquake that killed 185 people. Peritraumatic dissociation, posttraumatic stress symptoms, symptoms of anxiety, symptoms of depression, and social isolation were assessed. Descriptive analyses revealed the sample to be a highly impaired group, with particularly high levels of posttraumatic stress symptoms. Path analysis was used to determine whether the experience of some psychological difficulties predicted experience of others. As hypothesised, peritraumatic dissociation was found to predict posttraumatic stress symptoms and symptoms of anxiety. Posttraumatic stress symptoms then predicted symptoms of anxiety and symptoms of depression. Depression and anxiety were highly correlated. Contrary to expectations, social isolation was not significantly related to any other psychological variables. These findings justify the provision of psychological support following a natural disaster and suggest the benefit of assessing peritraumatic dissociation and posttraumatic stress symptoms soon after the event to identify people in need of monitoring and intervention.

Research papers, University of Canterbury Library

While it is well known that challenging and distressing events can negatively impact people’s psychological and physical state, increasingly researchers have investigated how challenging or stressful life circumstances can lead to the phenomenon of posttraumatic growth: positive psychological or life changes that can emerge from potentially traumatic events. Posttraumatic growth has been investigated primarily with people displaying varying levels of posttraumatic stress symptoms and other psychopathology due to theories suggesting that resilience would prohibit posttraumatic growth. Few studies have examined growth amongst resilient people. The current study examined posttraumatic growth in a sample of sixty psychologically healthy people who experienced the Canterbury earthquake sequence of 2010-2011. The current study is a follow-up study that used thematic analysis to explore: (1) Whether posttraumatic growth is evident nine years after the Canterbury earthquake sequence and approximately six years after baseline assessment; and (2) What themes may facilitate the posttraumatic growth process in psychologically healthy people. Data were collected using semi-structured interviews. Thematic analysis revealed four themes describing participants’ experiences of growth: New possibilities, reappraisal of life and priorities, positive changes in self-perception and closer more meaningful relationships. Themes describing posttraumatic growth provide evidence for research question one. Thematic analysis revealed three main themes and multiple subthemes that may facilitate the process of growth in psychologically healthy people: Hardship, optimistic positive appraisal and people helping people. Themes describing processes that may lead to growth provide evidence for research question two. Results of the current study provide insights about the experience of growth in psychologically healthy people and cognitive and psychosocial factors that may facilitate growth in resilient individuals.

Research papers, University of Canterbury Library

Research on responses to trauma has historically focused on the negative repercussions of a struggle with adversity. However, more recently, researchers have begun to examine posttraumatic growth: the positive psychological change that emerges from the struggle with a potentially traumatic event. Associations have been found between posttraumatic growth and greater peritraumatic distress, greater objective severity of trauma exposure, greater perceived stressfulness of events, social support, female gender, cognitive and behavioural responses to trauma, and personality measures. Posttraumatic growth has been measured typically in individuals with varying levels of posttraumatic stress disorder symptoms and other psychological difficulties, such as depression and anxiety. Although some theory and research posits that higher resilience would prohibit posttraumatic growth, no studies have examined posttraumatic growth in a resilient sample. The Canterbury earthquake sequence of 2010 and 2011 involved potentially traumatic events that saw the community struggle with a variety of challenges. However, in the midst of earthquake destruction, some positive initiatives emerged, driven by locals. The Gap Filler project (using city spaces left empty from fallen buildings for art and interactive community projects) and the Student Volunteer Army (groups of volunteers coordinated to help others in need) are examples of this. In this context, it seemed likely that posttraumatic growth was occurring and might be seen in individuals who were coping well with challenges. Culture is theorised to influence the posttraumatic growth process (Calhoun, Cann, & Tedeschi, 2010), and the nature of the trauma undergone is also likely to influence the process of growth. The current thesis measures posttraumatic growth quantitatively and qualitatively in a New Zealand sample. It measures and describes posttraumatic growth in a resilient population after the earthquake sequence of 2010 and 2011 in Canterbury, New Zealand. Findings are used to test current models of posttraumatic growth for individuals coping well after trauma and to elaborate on mechanisms proposed by models such as the comprehensive model of posttraumatic growth (Calhoun et al., 2010) and the organismic valuing theory of growth through adversity (Joseph & Linley, 2005). Correlates of posttraumatic growth are examined and likely supporting factors of posttraumatic growth are identified for this population. Study 1 used quantitative analysis to explore correlates of posttraumatic growth and found that greater posttraumatic growth related to greater peritraumatic distress, greater perceived stressfulness of earthquake events, greater objective stressfulness of earthquake events, greater difficulty with stressful life events, less satisfaction with social support, and female gender. Findings from Study 1 give important detail about the nature of distress included in the comprehensive model of posttraumatic growth (Calhoun et al., 2010) for this population. Levels of posttraumatic growth were lower than those in North American studies but similar to those in a Chinese study. The current sample, however, showed lower endorsement of Relating to Others than the Chinese study, perhaps because of cultural differences. Study 2 used qualitative analysis to examine the experience of posttraumatic growth in the sample. The theme of ‘a greater sense of community’ was found and adds to the comprehensive model of posttraumatic growth, in that an expression of posttraumatic growth (a greater connection with others) can inform ongoing social processing in the posttraumatic growth process. Having a formal or informal role in earthquake recovery appeared to influence self-concept and reflection; this elaborates on the influence of role on reflection in Calhoun et al.’s model. Findings illustrate possible mechanisms of the organismic valuing process theorised by Joseph and Linley (2005). Implications include the importance of providing opportunities for individuals to take on a role after a crisis, encouraging them to act to respond to difficulties, and encouraging them to meet personal needs for relatedness, competence, and autonomy. Finding positive aspects to a difficult situation, as well as acknowledging adversity, can be supported in future to help individuals process their traumas. As a society, we can help individuals cope with adversity by providing ways they can meet their needs for relatedness, competence, and autonomy. Community groups likely provide opportunities for members to act in ways that meet such needs. This will allow them to effectively act to meet their needs in times of crisis.

Research papers, University of Canterbury Library

Understanding posttraumatic stress disorder (PTSD) symptoms in police first-responders is an underdeveloped field. Using a cross-sectional survey, this study investigated demographic and occupational characteristics, coping resources and processes, along with first-responder roles and consequences 18 months following a disaster. Hierarchical linear regression (N = 576) showed that greater symptom levels were significantly positively associated with negative emotional coping (β = .31), a communications role (β = .08) and distress following exposure to resource losses (β = .14), grotesque scenes (β = .21), personal harm (β = .14), and concern for significant others (β = .17). Optimism alone was negatively associated (β=−15), with the overall model being a modest fit (adjusted R2 = .39). The findings highlight variables for further study in police.

Research papers, University of Canterbury Library

Post-traumatic stress symptoms are a common reaction to experiencing a traumatic event such as a natural disaster. Young children may be at an increased risk for such mental health problems as these catastrophic events may coincide with developmentally sensitive periods of development. Treatments currently recommended for children with post-traumatic stress symptoms insufficiently acknowledge the role of neurobiological stress related systems responsible for these symptoms. As such, alternative approaches to the treatment of posttraumatic symptoms have been explored, with nature-based interventions offering a potential alternative based on two different theories that uphold the stress reducing benefits of natural environments. To date, there are a limited number of experimental studies that have explored the use of nature-based interventions with children, and no known research that has used a simulated nature experience with child participants. The purpose of this study was to investigate the effects of a simulated nature experience on the physiological and behavioural responses of children with post-traumatic stress symptoms that experienced the Christchurch earthquakes. A single-case research design with repeated measures of heart rate and teacherreported behaviour was gathered across a 20-day period. Heart rate data was collected before and after participants watched a 10-minute nature video, while data from a teacher rating scale provided information about the participants’ behaviours in the 30-minute period after they watched the nature video. Comparisons made to data collected during two different baseline phases indicated that the nature video intervention had no recognisable effects on the participants’ physiological and behavioural stress responses. Limitations to the current study are discussed as possible reasons for the incompatibility between the current study’s results and the findings from previous research. Suggestions are made for any future replications of the study.

Research papers, University of Canterbury Library

Fatal earthquakes such as that which occurred in Christchurch on February 22nd 2011, can result in survivors having difficulties with cognitively processing the event, which may be the precursor to posttraumatic stress symptoms. Trauma related dissociation has been proposed to be a mechanism related to these cognitive processing difficulties. Most research focusing on information processing and dissociation post-trauma has conducted controlled analogue studies or has not focused solely on information processing and dissociation. There is also scant research on these constructs across therapy. In response to this gap in research, two studies were developed. An association was proposed between dissociation and information processing as demonstrated by an increase in conceptual processing and a reduction in dissociation. It was predicted that an improvement in these constructs would be related to a reduction in PTSD symptoms over therapy. Study1 applied a case-study design to 5 individuals who were attending therapy for post-traumatic stress disorder in response to the trauma they had experienced from the Christchurch earthquakes. Study 2 assessed information processing and dissociation (via self and observer report) in 20 individuals who had direct exposure to the effects of the earthquake. Earthquake information processing and dissociation were assessed as they were happening nearly two year’s post-quake using correlation analyses and hierarchical regressions. The hypotheses were partially confirmed, in that an increase in conceptual processing was not shown to be associated with a reduction in dissociation. However, an increase in conceptual processing was shown to be related to trauma symptom improvement particularly for re-experiencing symptoms. In addition, study 2 demonstrated a possible relationship between trait dissociation and arousal symptoms. These findings partially support the proposed role information processing and dissociation play in the recovery from PTSD. The findings suggest that trauma related difficulties should be assessed as early as possible to resolve issues related to a delay in symptom reporting.

Research papers, University of Canterbury Library

For the people of Christchurch and its wider environs of Canterbury in New Zealand, the 4th of September 2010 earthquake and the subsequent aftershocks were daunting. To then experience a more deadly earthquake five months later on the 22nd of February 2011 was, for the majority, overwhelming. A total of 185 people were killed and the earthquake and continuing aftershocks caused widespread damage to properties, especially in the central city and eastern suburbs. A growing body of literature consistently documents the negative impact of experiencing natural disasters on existing psychological disorders. As well, several studies have identified positive coping strategies which can be used in response to adversities, including reliance on spiritual and cultural beliefs as well as developing resilience and social support. The lifetime prevalence of severe mental health disorders such as posttraumatic stress disorder (PTSD) occurring as a result of experiencing natural disasters in the general population is low. However, members of refugee communities who were among those affected by these earthquakes, as well as having a past history of experiencing traumatic events, were likely to have an increased vulnerability. The current study was undertaken to investigate the relevance to Canterbury refugee communities of the recent Canterbury Earthquake Recovery Authority (CERA) draft recovery strategy for Christchurch post-earthquakes. This was accomplished by interviewing key informants who worked closely with refugee communities. These participants were drawn from different agencies in Christchurch including Refugee Resettlement Services, the Canterbury Refugee Council, CERA, and health promotion and primary healthcare organisations, in order to obtain the views of people who have comprehensive knowledge of refugee communities as well as expertise in local mainstream services. The findings from the semi-structured interviews were analysed using qualitative thematic analysis to identify common themes raised by the participants. The key informants described CERA’s draft recovery strategy as a significant document which highlighted the key aspects of recovery post disaster. Many key informants identified concerns regarding the practicality of the draft recovery strategy. For the refugee communities, some of those concerns included the short consultation period for the implementation phase of the draft recovery strategy, and issues surrounding communication and collaboration between refugee agencies involved in the recovery. This study draws attention to the importance of communication and collaboration during recovery, especially in the social reconstruction phase following a disaster, for all citizens but most especially for refugee communities.

Research papers, University of Canterbury Library

Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake- affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross- sectional nature of the study, and potential sampling bias.

Research papers, University of Canterbury Library

Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake-affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross-sectional nature of the study, and potential sampling bias.

Research papers, University of Canterbury Library

Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake- affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross- sectional nature of the study, and potential sampling bias.