Dysfunctional Attitudes and Long-Term Posttraumatic Growth in Victims of Terrorist Attacks.

Background: The theoretical models of posttraumatic growth (PTG) assume that a change in core beliefs or attitudes about the world and oneself is at the root of PTG. However, there are few studies on the relationship between these attitudes and PTG and their results are contradictory. The contradictions could be clarified using an instrument that assesses attitudes more specifically related to the traumatic event (traumatic dysfunctional attitudes) and analyzing whether said relationship is linear or an inverted U. Methods: A sample of 210 adults directly exposed to terrorist attacks in Spain completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, traumatic and depressive dysfunctional attitudes, and PTG a mean of 29.6 years after the attacks (range: 2-47 years). Results: Multiple regression analyses revealed that some long-term PTG dimensions were significantly associated in a linear or inverted-U fashion with traumatic dysfunctional attitudes, such that the most extreme levels of spiritual change were associated with the highest total levels of traumatic dysfunctional attitudes while the highest levels of appreciation of life were associated with moderate levels of total traumatic dysfunctional attitudes and, especially, attitudes of perpetual suffering. However, long-term PTG was not associated with depressive dysfunctional attitudes. Conclusion: The findings underscore the importance of core attitudes for PTG and offer support for the hypothesis that, over time, the positive basic attitudes of many people who have experienced a traumatic event are reconstructed, but incorporating negative or dysfunctional attitudes, which means that a certain amount of traumatic dysfunctional attitudes may be a necessary condition for long-term PTG. [ABSTRACT FROM AUTHOR]