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Coping Flexibility, Potentially Traumatic Life Events, and

Resilience: A Prospective Study of College Student Adjustment

Article  in  Journal of Social and Clinical Psychology · June 2012

DOI: 10.1521/jscp.2012.31.6.542

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Journal of Social and Clinical Psychology, Vol. 31, No. 6, 2012, pp. 542-567

College Student Adjustment

Galatzer-Levy et al.

Coping Flexibility, Potentially Traumatic

Life Events, and Resilience: A Prospective
Study of College Student Adjustment
Isaac R. Galatzer-Levy
New York University School of Medicine

Charles L. Burton and George A. Bonanno

Columbia University

College has been shown to be a particularly stressful time both due to unique
emergent stressors and because of increased vulnerability for exposure to po-
tentially traumatic events (PTEs). Both of these conditions are associated with
heightened risk for the development of stress-related pathology. However, while
this period may be particularly challenging, previous work shows most students
adapt in a number of heterogeneous ways that result in little or no stress-related
symptomatology over the four years of college. There is indication from the cop-
ing literature that the ability to flexibly move between multiple coping behaviors
may foster resilient outcomes. In this study, we examined trajectories of distress,
using Latent Growth Mixture Modeling, and whether flexible coping aids in adap-
tion. Results showed that trajectories were not influenced by exposure to a PTE
and that the common outcome was little or no distress over the four years of col-
lege. Flexible coping was strongly associated with a resilient outcome.

What is it like to leave home to attend four years of college? The

literature suggests competing answers to this question. On the one
hand, college life has long been shrouded in a romantic ethos in
which a college career at its best is synonymous with the sense of
serenity that accompanies a respite from real life concerns (Arehart-

Address correspondence to Isaac R. Galatzer-Levy, Ph.D., NYU School of Medicine,

PTSD Research Program, 1 Park Ave., 8th Floor, New York, NY 10016. E-mail: Isaac.
Galatzer-Levy@NYUMC.ORG

© 2012 Guilford Publications, Inc.

542
COLLEGE STUDENT ADJUSTMENT 543

Treichel, 2002; Canfield, 1902). On the other hand, at its worst college
has been characterized by an equally romantic vision of students
quietly consumed with existential turmoil as they find their way in
the world (Benjamin, 1996). These idealized visions may however
have little to do with the current reality of college students’ lives.
A growing body of literature has drawn attention to the stressful
nature of modern college life, both in terms of the prevalence of
daily stressors and in terms of what appears to be an unusually high
occurrence of potentially traumatic life events. In terms of common-
place stressors, college students routinely face such challenges as
changes in their environment, loss or diminishment of previous so-
cial support networks, new and increased academic pressures, need
to create new peer relationships, and increases in personal responsi-
bility in housing and money management (Vaez & LaFlamme, 2008;
Voelker, 2003). There is growing recognition that these common-
place stressors may have deleterious effects on the mental health
of students (Sargent, Crocker, & Luhtanen, 2006). Related to this,
there is mounting evidence that college students are having diffi-
culty coping with the increasing stress of college (Wells, Klerman, &
Deykin, 1987) and that college students are increasingly exhibiting
severe psychopathology (Kadison & DiGeronimo, 2004).
Aside from common stressors which in themselves appear to
have an impact on the mental health of students, there is growing
recognition of the high rates of exposure to potentially traumatic
events (PTEs) among college students (LaLande & Bonanno, 2011;
Vrana & Lauterbach, 1994). There is evidence that college students
are at an increased risk for exposure to PTEs such as sexual assault
(Humphrey & White, 2000) as well as community violence (Scarp et
al., 2002) as they are no longer confined to the external structure as-
sociated with pre-college adolescence. While estimates of exposure
vary greatly based on the nature of the sample and definitions of a
PTE, recent analyses using large representative samples of matricu-
lating college students estimated that 66% of the students met the
A criteria from DSM-IV TR for a traumatic event (Read, Ouimette,
White, Colder, & Farrow, 2011). The most highly reported traumatic
events were life-threatening illness (35%), the sudden death of a
loved one (34%), accident/natural disaster/or fire (26%), and phys-
ical violence (24%). One of the largest contributors to these high
rates of trauma exposure is alcohol use, the high incidence of which
has been well documented in college students (Straus & Bacon,
1953; Johnston, O’Malley, & Bachman, 1997). One national survey
544 GALATZER-LEVY ET AL.

observed that frequent binge drinkers were up to 10 times more

likely than non-frequent binge drinkers to get injured, engage in un-
planned and unprotected sexual intercourse, to get in trouble with
campus police, or to drive under the influence of alcohol (Wechsler,
Davenport, Dowdall, Moeykens, & Castillo, 1994). Further, alcohol
is a leading cause of death in college-aged students (McGinnis &
Foege, 1993).

Individual Variation in Distress

In attempting to assess the ways that college students might adapt

to these stressors, we adopted an individual differences framework
that mapped variations in distress levels across time. Traditional
paradigms on stress and potential trauma have tended to assume
a single homogeneous outcome distribution, characterized by dys-
function and pathology at one end and health and successful cop-
ing at the other. However, more recent statistical and conceptual
advances have suggested a more rich and complex set of patterns
that highlight the natural heterogeneity of longitudinal outcomes
(Bonanno, 2004; Bonanno, Westphal, & Mancini, 2011; Curran &
Hussong, 2003; Muthén, 2004).
The available empirical literature on stressful life events and tran-
sitions suggests that most of this heterogeneity can be captured
by a relatively small set of prototypical trajectories of change over
time (Bonanno, 2004; Bonanno et al., 2011). Some individuals fail to
adapt to the stressful event and exhibit chronically elevated distress
and dysfunction for years afterward. Others experience more acute
stress reactions characterized moderate to severe elevations in dis-
tress followed by a steady, gradual return to baseline functioning
over a period of one to two years. A smaller subset of individuals
evidence moderate stress reactions but fail to improve and in fact
gradually worsen over time (Andrews, Brewin, Philpott, & Stew-
art, 2007; Harvey & Bryant, 2002). Importantly, however, the modal
outcome consistently has been shown to be positive adaptation
characterized by little or no disruption in functioning, or resilience
(Bonanno, 2004; Bonanno et al., 2011).
These patterns have been documented to varying degrees in re-
sponse to crucial life transitions, including job-loss (Galatzer-Levy,
Bonanno, & Mancini, 2010), parenthood (Galatzer-Levy, Mancini,
& Bonanno, 2011), marriage, and divorce (Mancini, Bonanno, &
COLLEGE STUDENT ADJUSTMENT 545

Clark, 2011). Interestingly, these same patterns have also been ob-
served in response to potentially traumatic life events, including
traumatic injury (de Roon-Cassini, Mancini, Rusch, & Bonanno,
2010), life-threatening medical procedures (Lam et al., 2010), di-
saster (Bonanno, Brewin, Kaniasty, & LaGreca, 2010), response to
disease epidemic (Bonanno et al., 2008), terrorist attacks (Bonanno,
Rennicke, & Dekel, 2005), bereavement (Bonanno et al. 2002, Bonan-
no, Moskowitz, Papa, & Folkman, 2005; Bonanno, Papa, Lalande,
Westphal, & Coifman, 2004; Galatzer-Levy & Bonanno, 2011), and
military deployment (Bonanno et al., 2011; Dickstein, Suvak, Litz,
& Adler, 2010).
Given that college is both a significant life transition and tends to
involve increased exposure to potentially traumatic events, similar
trajectories of longitudinal adjustment should also be observed in
college samples. This is in fact what we found in a recent study
in which we measured distress levels each semester for four years
in a representative sample of college students (Galatzer-Levy et al.,
2011). Once again, the modal response was positive adaptation as
signified by consistently low distress or resilience (Stable Resilient;
63.8%). This class was characterized by a distinct intercept well be-
low the clinical cutoff (Est mean = 0.48) and a flat slope indicat-
ing consistently low levels of distress for all four years. The second
largest trajectory was characterized by moderate but stable subsyn-
dromal levels of distress (Stable Moderate Distress; 21.1%). This
class was also characterized by a distinct intercept just below the
clinical (Est mean = 0.87) cutoff, also with a flat slope indicating a
consistent level of distress over all four years. The two remaining
trajectories were associated with pathological degrees of distress.
One group demonstrated consistently high levels of distress over
all four years (High Distress; 9.8%), while the other was character-
ized by initially high levels of distress in year one, that gradually
decreased to the normal range over the subsequent three years (Dis-
tressed -Recovered; 5.3%). The High Distress trajectory was char-
acterized by an initial level of distress approximating the clinical
cutoff on the SCL-90-R (Est mean = 1.04) with significant positive
growth over the four years characterized by a significant positive
slope (Est = 0.12, SE = 0.06 p < .05). The Distressed-Recovered trajec-
tory was characterized by extremely high initial distress (Est mean
= 2.16) followed by a dramatic drop to subclinical levels over the 4
years of college (Est = −0.54, SE = 0.14 p < .001; Figure 1).
546 GALATZER-LEVY ET AL.

FIGURE 1. A) Four Class Unconditional Model of Distress over the

Four Years of College with Semester Growth Factor (N = 155).
B) Four Class Growth Mixture Model with Semester Growth Factor and
PACT Variables (N = 110).

In this previous analysis, we also explored variability by semes-

ter through the use of a separate growth parameter nested in the
LGMM. This analysis revealed significant and consistent variability
in distress by semester in two classes, the Stable Resilient class and
the High Distress class. While the variability in the Stable Resilient
class was significant, it was slight in comparison to the high degree
of variability in the High Distress class. This finding indicates that
while some degree of variability in distress by semester is common,
the High Distress class is characterized by not only a clinically sig-
nificant degree of distress that is increasing throughout college, but
also marked instability in distress from semester to semester.
COLLEGE STUDENT ADJUSTMENT 547

Predicting the Parameters of Distress

Identification of trajectories of adjustment is a key emergent feature

of clinical research. However, a remaining question with clear links
to social psychological concerns pertains to the possible factors that
might predict those trajectories. One potential factor is the way
that people cope with adversity. Ways of coping represent a well-
researched interface of clinical and social inquiry. However, to the
best of our knowledge, no previous research has examined coping
variables in relation to trajectories of adjustment in the context of a
marked stressor. Another key area of potential interface lies in the
ways that people use their social networks. Again, although social
network characteristics have been well researched in both clinical
and social domains, previous studies have not typically examined
these factors in relation to long-term patterns of adjustment.
In the current study we sought to address this deficit by revisit-
ing the same four trajectories in the same college student sample
reported by Galatzer-Levy and Bonanno (in press) but using a dif-
ferent set of covariates related to coping and social net work charac-
teristics as described below. Because the basic analyses will be iden-
tical to that reported in Galatzer-Levy and Bonanno (in press), the
unconditional trajectory analyses (no convariates) we report will
also be identical. Importantly, however, because we used a different
set of covatiates in the current study (variables related to coping
flexibility and social network characteristics), the trajectory model
we observed in the conditional analyses and the predictors of that
model were completely unique.

Coping Flexibility

Although level of exposure to PTEs is an important determinant of

subsequent adjustment in both youth and adults (Bonanno et al.,
2010; Neria et al., 2010), individual differences in response patterns
have also been found to vary in relation to a number of unique per-
sonal and contextual factors. For example, consistent evidence has
demonstrated that resilient individuals differ from the nonresilient
on a number demographic factors, such as male gender, older age,
greater education (Bonanno, Galea, Bucciarelli, & Vlahov, et al.,
2007), personality variables, such as low negative affectivity, per-
548 GALATZER-LEVY ET AL.

ceived coping self-efficacy, trait self-enhancement, optimism, social

and economic resources, past and current stressors, a priori positive
world views, and the capacity for positive emotions (for reviews,
see Bonanno et al., 2010; Bonanno et al., 2011).
Given the confluence of these findings, it would appear that cop-
ing behaviors and strategies should also inform adjustment in the
face of aversive life events. The body of research and theory on
the ways people cope with extreme adversity has emphasized two
seemingly paradoxical sets of strategies. Historically, a healthy re-
sponse to a loss or trauma was assumed to require focused process-
ing of personal thoughts and feelings associated with the event and
a deliberate and effortful kind of trauma focus or working through
(Foa & Rothbaum, 1998; Horowitz, 1986). Indeed, the symptomatic
consequences of avoiding one’s own thoughts and feelings follow-
ing trauma is a line of research to the present (Plumb, Orsillo, &
Luterek, 2004).
More recent research and theory, on the other hand, has empha-
sized optimism, and a focus toward the future, and away from ex-
tremely distressing events lead to better outcomes (Bonanno, Kelt-
ner, Holen, & Horowitz, 1995; Coifman, Bonanno, Ray & Gross,
2007; Scheier & Carver, 1992). Expression of positive emotion, stay-
ing active and socially engaged are some of the components of this
form of coping that, in contrast with the prior strategy, rely upon in-
terpersonal functioning (Bonanno, 2004, 2005; Bonanno, Rennicke,
& Dekel, 2005).
Recently, researchers have moved toward a more integrative per-
spective that emphasizes the importance of both dimensions through
the concept of coping flexibility (Bonanno et al., 2004; Cheng, 2001).
Early work on coping flexibility with college undergraduates dem-
onstrated the benefit of have multiple coping strategies and emo-
tion regulation behaviors (Cheng, 2001, 2003). Experimental studies
investigating emotional flexibility have been capable of distinguish-
ing distress in college students as well as recently bereaved persons
(Bonanno et al., 2004; Gupta & Bonanno, 2011). However, many re-
search settings do not permit for an impractical experimental as-
sessment of coping flexibility. In this vein, the Perceived Ability to
Cope with Trauma (PACT) scale, a self-rated questionnaire, was
developed to measure participants’ ability to use coping behaviors
falling into the two diametric coping strategies: forward-focused
coping and trauma-focused coping. Intrinsic to this questionnaire
are the social and asocial qualities of the respective coping types.
COLLEGE STUDENT ADJUSTMENT 549

In this study, we test the hypothesis that flexible coping as defined

as the ability to both focus attention on distressing material and the
ability to focus attention away from that same material will predict
resilience in individuals adapting to college. We hypothesize that
individuals who are capable of utilizing both of these coping be-
haviors will adapt better and more fully to college both if they were
exposed to a PTE or if they are solely adapting to the multiplicity of
stressors associated with college.

Social Network Characteristics

As a final goal of the present study, we examined the role of social

network characteristics. Aspects of social network have received
increasing attention in studies of psychological functioning among
college students (Morosanu, Handly, & O’Donovan, 2010; Papa &
Bonanno, 2008). The loss or diminishment of previous social net-
works and the need to establish new ones has long been considered a
major stressor with potential deleterious effects (Vaez & LaFlamme,
2008; Voelker, 2003). Universities have attempted to mitigate the ef-
fects of this inevitable stressor through from above approaches that
manifest as institutional initiatives to foster or create community
through community building activities. However, these from above
initiatives seem to have little impact compared to the ways in which
students informally organize themselves during their first year of
college from below (Morosanu, Handly, & O’Donovan, 2010). Infor-
mal social networks appear to be of great value to students as they
offer a number of psychologically stabilizing characteristics includ-
ing guidance and feedback, nondirective support, positive social
interactions, and occasionally tangible assets such as shelter and
money (Barrera, Sandier, & Ramsay, 1981). In fact, there is signifi-
cant evidence that students rely heavily on informal social support
networks and that student’s utilization of these networks strongly
predicts psychological adjustment (Wilcox, Winn, & Fyvie-Gauld,
2005).
Social networks may play a complex role in adjustment to stress,
especially in negative or stressful contexts (Cohen, Gottlieb, & Un-
derwood, 2000). Furthermore, social network quality may have a
stronger impact on adjustment then the gross quantity of people
in ones social network (Morosanu, Handly, & O’Donovan, 2010).
As a high level of variability in distress is observed in our sample,
550 GALATZER-LEVY ET AL.

we hypothesize that social network characteristics will impact vari-

ability in distress by semester. Furthermore, as social networks have
been shown to have the strongest effect on adjustment among those
in negative contexts, we hypothesize that the classes showing the
most distress will be most impacted by social network character-
istics. Finally, consistent with evidence that the quality rather than
quantity of students’ social network may have a greater positive ef-
fect on distress, we predict that the number of social networks that
students are embedded within rather than simply the total number
of people they are regularly in contact with will better predict ad-
justment throughout college.

Methods
Participants and Procedure

Letters describing the study were mailed to all first-year undergrad-

uates at a large campus in New York City. A cohort of 157 under-
graduates was recruited to participate in an intensive 4-year longi-
tudinal study sponsored by the college. The study was approved by
the Teachers College, Columbia University IRB and all participants
received written informed consent upon entering the study. Partici-
pants completed several self-report measures in their first and fourth
year of college and completed self report measures of distress each
semester for four years. The measures were administered in group
testing sessions in large classrooms. The group testing took place
as close to the beginning of the fall and spring semester as possible.
For a full description of the methods, see Bonanno et al., (2004). The
mean age at the beginning of the study was 18.08 years (SD = .55).
Among the participants, 50% identified themselves as Caucasian,
26.39% as Asian or Asian-American, 6.94% as African-American,
4.17% as Hispanic or Hispanic-American, 1.39% as Native-Ameri-
can, and 11.11% identified themselves as being of other racial/eth-
nic background. The majority of participants were female (62.6%).
Data from 155 students were used in the current investigation.

Self-Report Measures

Symptom Checklist-90-Revised (SCL-90-R). Distress was measured

each semester using the SCL-90-R, Brief version (Derogatis & Me-
COLLEGE STUDENT ADJUSTMENT 551

lisaratos, 1983), which is a multidimensional self-report inventory

designed to screen for a broad range of psychological problems and
symptoms of psychopathology. In this study, a 32-item brief ver-
sion (General Symptom Index, GSI) was used to measure levels of
overall psychological distress. The GSI has shown adequate internal
consistency (.77 to .86) and good 1-week test-retest reliability (.78 to
.90). Typically, a cut-off score of 1 indicates distress in the pathologi-
cal range (Derogatis & Melisaratos, 1983).
Coping Flexibility. Participants completed the 20-item Perceived
Ability to Cope with Trauma (PACT) scale (Bonanno et al., 2011).
This scale asked participants to endorse their ability to use different
coping strategies on a 7-point Likert scale, where 1 = not true and 7
= extremely true. The PACT provides the following instructions:

Sometimes we must contend with difficult and upsetting events. Un-

fortunately, sometimes we are confronted with events that might be
traumatic and disruptive to the course of our lives. Examples of such
events include the death or injury of someone close to us, a natural
disaster, a serious accident or illness, sexual and physical assault, and
terrorist attack. Below you will find a list of different kinds of behav-
iors and strategies people sometimes use in the weeks following po-
tentially traumatic events. This questionnaire asks which of these be-
haviors and strategies you might be able to use. Please rate the extent
you would be able to do each of these behaviors and strategies follow-
ing a potentially traumatic event if you needed to.

Confirmatory factory analysis and application of the PACT in

trauma-exposed samples (Bonanno, Pat-Horenczyk, & Noll, 2011)
provided preliminary validation of two independent scales: The
forward-focus scale (12 items, α = .83) is comprised of coping abili-
ties related to thinking optimistically, attending to the needs of oth-
ers, maintaining plans and goals, remaining calm, reducing painful
emotion, and being able to laugh or be entertained. The trauma-fo-
cus scale (8 items, α = .73) gauges the participant’s ability to remain
focused on a traumatic event, fully experience the emotional and
cognitive significance of the event, withdraw from social interac-
tions, revise goals and plans, and think realistically. The forward-fo-
cus and trauma-focus scores were found by calculating the mean re-
sponse for each scale and then converting those scores to z-scores.
Social Integration and Social Network Size. The social network scale
was adapted from the Social Network Index (SNI; Cohen, Doyle,
552 GALATZER-LEVY ET AL.

Skoner, Rabin, & Gwaltney, 1997) to assess college specific domains

of significant others, family, friends, college personnel (e.g., profes-
sors), roommates, and other activities. The resulting scales assess
both gross social network size, or the number of people in ones so-
cial network (social network size) as well as 15 support domains and
was 37 items in length. Social integration was calculated as number
of individuals’ high-contact social roles (social domains that include
2+ people with whom individuals has contact with at least once ev-
ery two weeks).
Exposure to a PTE. Participants completed an online questionnaire
consisting of 53 positive and negative life events, including 9 poten-
tially traumatic events (PTE). Of the 9 events, we chose a stringent
criterion involving only events that were of direct impact including
death of a loved one, hospitalization, suicide attempt, mugging or
assault, or a serious injury. This scale, based on and adapted from
Holmes & Rahe (1967), was completed on a weekly basis during
the participants’ first year of college. For the current analyses, we
used only the potentially traumatic events (PTE) category that in-
cludes events such as serious physical injury/illness, and assault,
robbery/muggings. Participants indicated whether they had ex-
perienced any of these events in the last week, and then rated the
degree of distress they felt at the time of the event using a 0 (Not at
all distressing) to 4 (Extremely distressing) scale. Participants were
categorized as having trauma exposure if they endorsed at least one
PTE at the highest level of subjective distress at point of their fresh-
man year. Fifty-one students (32.9%) reported exposure to at least
on PTE in their first year. Reported rates of PTEs for year 2 (54 stu-
dents; 34.2%) and 3 (48 students; 30.4%), indicate that exposure to
potentially traumatic events occurs among students at a highly pre-
dictable rate. Because of inconsistent reporting rates in the fourth
year on the weekly online questionnaire, we are not including rates
of exposure for that year.

Data Analysis Plan

Using Latent Growth Mixture Modeling (LGMM), we previously

identified and reported on four distinct trajectories of distress using
the SCL-90-R at eight equidistant time points (once per semester for
four years).
COLLEGE STUDENT ADJUSTMENT 553

TABLE 1. Means, Standard Deviations, and Multinomial Logistic Regression for

Predictors of Class Membership (Resilient Class as Reference Class; n = 110)
Forward Trauma Exposure
Focus Focus to a PTE
Class M(SD) EST. SE M(SD) EST. SE EST. SE
Resilient 0.17(0.98) — — -0.10(0.96) — — — —
High Distress -0.68 (0.74) -1.36 0.52** -0.08(0.95) 0.61 0.42 0.53 0.68
Moderate Distress 0.01(1.06) -0.32 0.33 0.28(1.11) 0.53 0.32+ -0.12 0.58
Distressed Recovered -0.64(0.67) -1.67 0.75* 0.29(1.19) 1.14 0.59* 0.55 0.90
Notes. M = mean; SD = standard deviation; Est = Estimate; SE = standard error. **p < = .01;
*p < = .05; + p < = .10

A number of data analytic advances have been made which allow

for the study of patterns with high levels of variability. For exam-
ple, both Hierarchical Linear Modeling (Bryk & Raudenbush, 1987)
and Growth Curve Modeling (McArdle & Epstein, 1987) represent
advances over traditional linear models because they allow for the
exploration and prediction of individual level variability in patterns
over time. However, these modeling techniques assume a com-
mon pattern that individuals fit better or worse. In situations such
as stress responses—for which we find true heterogeneity—such
models may be inadequate (Nagin, 1999). Latent Growth Mixture
Modeling (LGMM) techniques test whether the population under
study is composed of a mixture of discrete distributions character-
ized as classes of individuals with differing profiles of growth, with
class membership determined by these different growth parameters
(Curran & Hussong, 2003). LGMM allows for the modeling of lon-
gitudinal data with consideration for empirical observation as well
as parsimony and interpretability (Jung & Wickrama, 2008), while
also allowing for the modeling of predictors of these emergent lon-
gitudinal patterns (Muthén, 2000). Within the LGMM framework,
covariates can be utilized as predictors of latent growth parame-
ters such as class membership, slope, and intercept. This approach
has been applied to a wide variety of phenomena in which it is not
parsimonious to assume one continuous distribution, including
drinking behavior among college students (Greenbaum, Del Boca,
Darkes, Wang, & Goldman, 2005), childhood aggression (Schaeffer,
Petras, Ialongo, Poduska, & Kellam, 2003), developmental learn-
ing trajectories (Boscardin, 2008), disease epidemic (Bonanno et al.,
2008), traumatic injury (de Roon-Cassini, Mancini, Rusch, & Bo-
nanno, 2010), life satisfaction in response to bereavement (Mancini
554 GALATZER-LEVY ET AL.

et al., 2011), unemployment (Galatzer-Levy et al., 2010), childbirth

(Galatzer-Levy et al., 2011), and posttraumatic stress following ex-
posure to life threatening events (Galatzer-Levy et al., 2011).
LGMM is uniquely suited to identifying multiple unobserved tra-
jectories in the data because it extends conventional approaches to
longitudinal data (Curran & Hussong, 2003) by estimating growth
parameters within latent mixtures of individuals that represent dis-
tinct multivariate distributions. More specifically, LGMM allows for
the exploration of unobserved mixture class differences in growth
through the examination of posterior probabilities of class mem-
bership. LGMM allows both for the modeling of discrete patterns
of response and allows for the flexible exploration of the effects
of covariates. LGMM may be a particularly fruitful data analytic
methodology in this instance because it integrates variable-centered
analytic techniques (e.g. regression analysis, factor analysis) and
person-centered techniques that allow for the exploration of popu-
lation heterogeneity (e.g., cluster analysis, Latent Class Analysis;
Muthén, 2000). In the current investigation, we utilize a multinomi-
al logistic regression nested in the trajectory model (unconditional
model), to regress covariates (coping flexibility and social network)
on class (trajectory) membership and seasonal (semester) variation.
Using this strategy, we can determine whether and to what extent
the covariates may influence and predict specific trajectory patterns.
LGMM allows for the flexible exploration of the effects of covariates
on any number of characteristics of the classes simultaneously, al-
lowing for a much richer understanding of what is driving change
in stress responses. Although covariates may be thoughtfully treat-
ed as predictors of various parameters within the model, none are
treated as independent as they all influence the overall model. As
such, we can explore the roll of covariates on different parameters
simultaneously to explore much richer hypotheses about prediction
of the course of stress responses.

Results

We assessed the best fitting model both in terms of the number of

latent classes and linear vs. linear and quadratic trends by assessing
relative fit with the information criteria and fit indices, including
the Bayesian (BIC), sample-size adjusted Bayesian (SSBIC), Aikaike
(AIC; Akaike, 1987; Schwartz, 1978; Sclove, 1987), entropy values,
COLLEGE STUDENT ADJUSTMENT 555

the Lo-Mendell-Rubin likelihood test (LRT; Lo, Mendell, & Rubin,

2001), and the Bootstrap Likihood Ratio Test (BLRT). We also at-
tended to entropy values which range from 0 to 1 and indicate the
the degree of separation among the classes where scores closer to
one indicating better fit of the data into the prescribed class struc-
ture (Duncan, Duncan, & Strycker, 2006).
Based on recommendations from the literature, we primarily fo-
cused on the BLRT and the BIC method for assessing relative model
fit (Nylund, Asparouhov, & Muthén, 2007) while being accountable
to both parsimony and interpretability (Curran & Hussong, 2003;
Nylund, Asparouhov, & Muthén, 2007) (Unconditional Model).
Based on these criteria, we chose a 4-class solution with linear and
quadratic trends (Table 1). Next, we added a separate growth pa-
rameter to test for this variability within class by semester, with fall
semester’s distress loadings set at 1 and spring semesters distress
loadings set at 0. The semester growth factor demonstrated a strong
effect in two classes, a marginal effect in one, and no effect in the
fourth, indicating that there is a high degree of within-subject vari-
ability (Table 2). The unconditional model was previously identified.
For a full description see (Galatzer-Levy & Bonanno, this issue).

Coping Flexibility

In an attempt to better understand how forward-focused and trau-

ma-focused coping abilities affect adaption in college students fol-
lowing either exposure to a PTE or general college-related stress,
we regressed the two coping ability variables and a dichotomous
dummy coded variable indicating whether or not participants were
exposed to a PTE during their freshman year, on the latent classes
in a multinomial logistic regression nested in the four class solution
with linear, quadratic, and semester growth parameters.
With the addition of the PACT variables (forward-focus; trauma-fo-
cus) and our PTE exposure variable (exposure), 45 subjects dropped
out because of missing data reducing the sample size for the final
model to n = 110. We chose not to impute missing values though the
MPlus software allows for multiple imputation (Muthén & Muthén,
1998–2010). While meanful predictions about missing values can be
made for variables such as the PACT based on other availible infor-
mation, exposure to PTEs may be more random, or less predictable.
As such, we chose not to use multiple imputation. Forward-focus,
 TABLE 2. Fit Indices for One- to Five-Class Growth Mixture Models of Distress (Unconditional; n = 155)
Growth Mixture Model
Linear Weights Only Indicates Linear + Quadratic Weights
Fit Indices 1 Class 2 Classes 3 Classes 4 Classes 5 Classes 1 Class 2 Classes 3 Classes 4 Classes 5 Classes
AIC 1608.89 1216.01 1146.45 1111.91 1102.14 1609.77 1216.62 1146.87 1101.98 1093.24
BIC 1618.02 1234.27 1173.84 1148.43 1147.79 1621.94 1241.00 1183.40 1150.68 1154.11
SSBIC 1608.53 1215.27 1145.35 1110.44 1100.34 1609.28 1215.65 1145.41 1100.04 1090.81
Entropy — .93 .84 .85 .87 — .93 .83 .87 .89
LRT — p < .01 p = .41 p < .05 p = .60 — p < .05 p = .12 p < .05 p = .62
BLRT — p < .001 p < .001 p < .001 p < .001 — p < .001 p < .001 p < .001 p = .19
Notes. AIC = Akaike information criterion; BIC = Bayesian information criterion; SSBIC = sample size adjusted Bayesian information criterion; LRT = Lo-Mendell-Rubin test;
BLRT = bootstrap likelihood ratio test.

TABLE 3. Growth Factor Parameter Estimates for Four-Class Unconditional Model (n = 155)
Intercept Slope Quadratic Semester
Class EST SE p EST SE p EST SE p EST SE p
Stable Low Distress 0.48 0.05 <.001 -0.07 0.02 <.001 0.01 0.002 <.05 0.07 0.02 <.05
Stable Moderate Distress 0.87 0.09 <.001 0.02 0.09 .81 -0.01 0.01 .45 0.03 0.07 .67
High Distress 1.04 0.10 <.001 0.12 0.06 <.05 -0.01 0.01 .12 0.45 0.08 <.001
Distressed Recovered 2.16 0.21 <.001 -0.54 0.14 <.001 0.05 0.02 <.01 0.27 0.16 .08
Note. Est = Estimate
556 GALATZER-LEVY ET AL.
COLLEGE STUDENT ADJUSTMENT 557

trauma-focus, and exposure were regressed as predictors of class

within each of the 4 modeled trajectories. The addition of the cova-
riates did not significantly change the trajectory patterns from the
unconditional model, and percentages of class membership from
the unconditional model changed only slightly reflecting the change
in sample size (Figure 1).
As we were most interested in how these variables predicted re-
silience in the two latent classes that displayed nonclinical levels of
distress (Stable Resilient; Stable Moderate Distress), we chose the
Stable Resilient class as the reference class in our multinomial lo-
gistic regress. As such, we compared the odds that members of the
other three classes will display these covariates to a greater or lesser
degree. None of the nonresilient classes showed a greater probabil-
ity for exposure to a PTE in year one when compared to the Stable
Resilient class. This indicates that all four classes represented a mix
of both students who have been exposed to a PTE as well as un-
exposed students (EstHigh Distress = 0.53, SE = 0.68, p = .44 ; EstDistressed-
Recovered
= 0.55, SE = 0.90, p = .54 ; EstStable Moderate Distress = -0.12, SE = 0.58,
p = .84). Moreover, both forward-focus and trauma-focus predicted
the classes in meaningful ways. The two coping abilities did not sig-
nificantly differentiate the Stable Resilient class from the Moderate-
Stable Distress class indicating that these classes did not differ sig-
nificantly in their coping abilities. However, the PACT scale did sig-
nificantly differentiate the Stable Resilient class from both the High
Distress class and the Distressed-Recovered class. This analysis re-
vealed that the High Distress class was significantly less likely to
report forward-focus coping when compared to the Stable Resilient
class. The Distressed-Recovered class was significantly less likely
to report forward-focus coping and significantly more likely to re-
port trauma-focus coping when compared to the Stable Resilient
class (Table 3). No significant differences were observed on either
forward-focus or trauma focus variables when comparing the High
Distress class to the Distressed-Recoved class in the multinomial lo-
gistic regression. These findings suggest that both the High Distress
class and the Distress-Recovered class were less flexible than the
other two classes but in different ways. However, neither of these
two classes appears to be more flexible then the other.
558 GALATZER-LEVY ET AL.

Social Network Size and Integration

To assess the role of social factors, we also regressed the latent vari-
able representing the semester effect (greater distress at the end of
each academic year relative to the beginning of the academic year)
within each class onto the two social network variables, social inte-
gration and social network size. This analysis allowed us to determine
whether the observed variability by season within classes was pre-
dicted by characteristics of individual’s social network. Both of these
variables were significant predictors of the seasonal variability for
the High Distress class, also the class with the strongest observed
semester effect. More specifically, this analysis indicated that social
network size was positively associated with seasonal variability in
the high distress group (Est = 0.03, SE = 0.01, p < = .001) such that
as the number of people in High Distress students’ social network
increased, so did the size of the semester effect. Conversely, social
integration negatively predict variability by season for High Distress
students (Est = −0.16, SE = 0.06, p < = .01) indicating that High Dis-
tress students who were more integrated into their social network
displayed less variability by semester.
We chose to use the PACT as a predictor of class because the PACT
is thought to represent stable psychological qualities akin to person-
ality or coping style variables. Their roll in predicting patterns of
distress over time may have great clinical value as this could lead
to successful identification of those who will be resilient from those
who will evidence stress responses prior to the event. The social
network variables were treated as predictors of the seasonal latent
parameter because it does not represent a pre-event stable charac-
teristic, and other social indices measuring frequency of contact
have shown to have seasonal variation (Kossinets & Watts, 2006).

Discussion

In this study, we sought to examine if resilience in the face of adjust-

ing to college is predicted by exposure to a PTE as compared to ad-
aptation related to the multitude of unique developmental stressors
associated with this period of life. Based on previous research on
discrete response patterns, we find clear similarities between how
individuals respond to a PTE (Bonanno et al., 2002, 2004, 2008, 2010;
Bonanno & Kaltman, 2001; de Roon-Cassini et al., 2010; Galatzer-
COLLEGE STUDENT ADJUSTMENT 559

Levy et al., 2011; Lam et al., 2010) and how individuals adapt to
other significant life stressors (Galatzer-Levy et al., 2010; Galatzer-
Levy, Mazursky, Mancini, & Bonanno, 2011; Mancini et al., 2011).
Determining the overlap in adapatational patterns among college
students may be of particular value because they are both vulner-
able to high rates of exposure to PTEs (Humphrey & White, 2000;
Read et al., 2011; Scarp et al., 2002), and they are exposed to a mul-
tiplicity of new stressors in a relatively short amount of time (Vaez
& LaFlamme, 2008; Voelker, 2003). Both have been shown to have
potential for a deleterious impact on student’s mental health (Read
et al., 2011; Sargent et al., 2006).
We first found that roughly half (50.6%) of students in this sample
were exposed to a PTE in the first year alone, confirming previous
findings that college students may be particularly vulnerable and
that exposure among this population is common. Interestingly,
whether or not students were exposed did not differentially predict
patterns of adaptation throughout college. This indicates that the
observed patterns of response are consistent whether students are
adapting solely to new stressors related to college or to those same
stressors as well as exposure to a PTE.
We were particularly interested in the role of coping flexibility
both in terms of positive adaptation to exposure to a PTE and in
relation to adaptation to common stressors associated with college.
Our results indicate that the ability to focus attention on distressing
material and the ability to focus attention away from that same ma-
terial aided adaptation in meaningful ways. Our analysis revealed
that both of the trajectories that consistently displayed nonclinical
degrees of distress throughout the four years of college (Stable Re-
silient; Stable Moderate Distress) displayed statistically equivalent
levels on our measure of forward and trauma focus indicating that
both of these trajectories are comprised of individuals who are ca-
pable of flexible coping.
Interestingly, the two classes that did display pathological degrees
of distress both were significantly less likely to display forward fo-
cused coping behaviors when compared to the Low-Distress class.
Furthermore, while the High-Distress class demonstrated equiva-
lent degrees of trauma focus compared to their Stable Resilient and
Stable Moderate Distress counterparts, the Distressed-Recovered
class displayed greater trauma focus. As the Distressed-Recovered
class was able to improve to nonclinical levels of distress over a four
year period, these findings may indicate that while coping flexibil-
560 GALATZER-LEVY ET AL.

ity greatly outweighs specific coping types in adaptation to both

PTEs and general life stressors, greater ability to use one facet such
as focusing on potentially traumatic material may aid in adaptation
in the long run.
Finally, by regressing a latent semester effect variable on the two
social network variables (social integration and social network size),
we observed that social network characteristics play an important
role in adaptation across semesters among the most continuously
distressed students, but have little impact on adjustment by semes-
ter among those who are adapting well over time. This is consistent
with findings that suggest that social networks are of most utility in
adaptation among those under the most stress (Cohen, Gottlieb, &
Underwood, 2000). Interestingly, we find that social integration and
social network size have very different effects on adaptation. Spe-
cifically, among the High Distress class, greater social network size
predicts greater variability in distress by semester while a greater
number of embedded networks predicts less variability, or more
stability. This is consistent with more nuanced explanations of the
effects of social networks on adaptation that argue that sheer quan-
tity does not predict adaptation, but that the quality of those rela-
tionships does (Morosanu et al., 2010).

Limitations

Though our investigation represents a step forward in the study of

resilience by examining both coping abilities and the role of expo-
sure to PTEs during college, it has several important limitations.
First, we distinguished a number of variables as predictors of dis-
tress trajectories. Clearly, however, there are other factors that will
predict adaptation to college, such as social resources variables, as
well as other personality variables.
Second, our analysis of longitudinal trajectories was based solely
on self-reported distress levels. We were unable to access more ex-
treme forms of dysfunction or, by the same token, positive aspects
of adjustment. Future studies should explore a wider range of men-
tal health outcomes.
Third, this analysis could benefit from a functional outcome mea-
sure such as GPA. Such an outcome could better inform the impact
of these trajectories on functioning. Unfortunately, most likely due
COLLEGE STUDENT ADJUSTMENT 561

to grade inflation, our sample demonstrated nearly no variability in

GPA with nearly the entire sample hovering around 4.0.
Next, we examined adaptation in a sample of college students
from a single demographically diverse university. While these re-
sults may be informative, they may be limited as each university
as well as its student body comes with specific characteristics that
may inform and influence adaptation during college. Though our
sample is representative of this college’s student body, they may
not be representative of all college students nationally or interna-
tionally. This may be especially true for higher education settings
where the majority of students are within driving distance of their
hometown, which can have a dramatic impact on the maintenance
of older social networks.
Finally, although we mapped trajectories of adjustment from the
first semester of college to the last, we had no data on students’
pre-college adjustment. Had these data been available, we may
have been able to identify even more complex patterns of adjust-
ment or explored how pre-college adjustment may have informed
the divergent trajectories we did identify. As there is evidence that
large numbers of students are exposed to PTEs prior to matricu-
lation (Read et al., 2011), data on exposure prior to college would
strengthen these findings.

Conclusion

Despite such limitations, these findings provide an important con-

tribution to our understanding of adaption during college to both
stressful life events and PTEs by demonstrating that observed dis-
crete patterns of response among college students are equivalent in
exposure to a PTE and/or normal emergent significant life stressors
associated with this unique developmental period.
Furthermore, our findings indicate that the ability to utilize flex-
ible coping strategies by having the ability to both focus on distress-
ing material and shift one’s focus towards the future predicts greater
degrees of resilience within the context of exposure to a PTE, as well
as managing the stressors associated with college. Interestingly, we
find that in the absence of the ability to flexibly cope, heightened
levels of focus on distressing material may aid long-term adapta-
tion. This may indicate that the ability to augment one domain in
the absence of the ability to utilize multiple domains equally has
562 GALATZER-LEVY ET AL.

potentially positive adaptive value. However, such recovery takes

place over an extended period of time, suggesting that reliance on
trauma-focused coping makes this a sub-optimal adaptive strategy.
Finally, we find that for the most distressed students, increases
in social network size predict high levels of functional instability
throughout college while increases in social network embedded-
ness appears to have a stabilizing effect on these students. This may
indicate that interventions targeting the most distressed students
would benefit from strategies that encourage high quality, high
contact relationships that consist of participation in complex social
groups, as these appear to have a strong stabilizing effect on this
high distress population.

References
Akaike, H. (1987). Factor analysis and the AIC. Psychometrika, 52, 317–332.
Andrews, B., Brewin, C., Philpott, R., & Stewart, L. (2007). Delayed-onset posttrau-
matic stress disorder: A systematic review of the evidence. The American Jour-
nal of Psychiatry, 164(9), 1319-1326.
Arehart-Treichel, J. (2002). Mental illness on rise on college campuses. Psychiatric
News, 37.
Barrera, M. Jr., Sandier, I. N., & Ramsay, T. B. (1981). Preliminary development of a
scale of social support: Studies on college students. American Journal of Com-
munity Psychology, 9, 435–447.
Bauer, J. J., & Bonanno, G. A. (2001). I can, I do, I am: The narrative differentiation of
self-efficacy and other self-evaluations while adapting to bereavement. Jour-
nal of Research in Personality, 35, 424–448.
Benjamin, W. (1996). The life of students. Walter Benjamin: Selected Writings 1913–1926.
Boston: Harvard University Press.
Block, J. H., & Block, J. (1980). The role of ego-control and ego-resiliency in the or-
ganization of behavior. In W. A. Collins (Ed.), Minnesota symposia on child psy-
chology (Vol. 13). Hillsdale, NJ: Erlbaum.
Bonanno, G.A. (2004). Loss, trauma, and human resilience: Have we underestimat-
ed the human capacity to thrive after extremely aversive events? American
Psychologist, 59, 20–28.
Bonanno, G. A. (2005). Clarifying and extending the construct of adult resilience.
American Psychologist, 60(3), 265-267.
Bonanno, G. A., Brewin, C. R., Kaniasty, K., & LaGreca, A. M. (2010). Weighing the
costs of disaster: Consequences, risks, and resilience in individuals, families,
and communities. Psychological Science in the Public Interest, 11, 1–49.
Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007). What predicts psycho-
logical resilience after disaster? The role of demographics, resources, and life
stress. Journal of Consulting and Clinical Psychology, 75(5), 671-682.
Bonanno, G. A., Ho, S.M.Y., Chan, J.C.K., Kwong, R.S.Y., Cheung, C.K.Y. Wong,
C.P.Y., & Wong, V.C.W. (2008). Psychological resilience and dysfunction
COLLEGE STUDENT ADJUSTMENT 563

among hospitalized survivors of the SARS epidemic in Hong Kong: A latent

class approach. Health Psychology, 27, 659–667.
Bonanno, G. A., & Kaltman, S. (2001). The varieties of grief experience. Clinical Psy-
chology Review, 21, 705–734.
Bonanno, G. A., Keltner, D., Holen, A., & Horowitz, M. J. (1995). When avoiding
unpleasant emotions might not be such a bad thing: Verbal-autonomic re-
sponse dissociatation and midlife conjugal bereavement. Journal of Personality
and Social Psychology, 69, 975–989.
Bonanno, G. A., Papa, A., Lalande, K., Westphal, M., & Coifman, K. (2004). The im-
portance of being flexible: The ability to enhance and suppress emotional ex-
pression predicts long-term adjustment. Psychological Science, 157, 482–487.
Bonanno, G. A., Pat-Horenczyk, R., & Noll, J. (2011). Coping flexibility and trauma:
The perceived ability to cope with trauma (PACT) scale. Psychological Trauma:
Theory, Research, Practice, and Policy, 3(2), 117-129.
Bonanno, G. A., Rennicke, C., & Dekel, S. (2005). Self-enhancement among high-
exposure survivors of the September 11th terrorist attack: Resilience or Social
maladjustment? Journal of Personality and Social Psychology, 88(6), 984-998.
Bonanno, G. A., Westphal, M., & Mancini, A. D. (2011). Resilience to loss and poten-
tial trauma. Annual Review of Clinical Psychology, 7, 511–535.
Bonanno, G. A., Wortman, C. B., Lehman, D. R., Tweed, R. G., Haring, M., Sonnega,
J., et al. (2002). Resilience to loss and chronic grief: A prospective study from
preloss to 18-months postloss. Journal of Personality & Social Psychology, 83,
1150–1164.
Boscardin, C. K. (2008). Early identification of reading difficulties using hetero-
geneous developmental trajectories. Journal of Educational Psychology, 100,
192–208.
Bryk, A., & Raudenbush, S. (1987). Application of hierarchical linear models to as-
sessing change. Psychological Bulliten, 101, 147–158.
Canfield, J. H. (1902). The college student and his problems. New York: The Macmillian
Company.
Cheng, C. (2001). Accessing coping flexibility in real-life and laboratory settings:
A multimethod approach. Journal of Personality and Social Psychology, 80,
814–833.
Cheng, C. (2003). Cognitive and motivational processes underlying coping flexibil-
ity: A dual-process model. Journal of Personality and Social Psychology, 84(2),
425-438.
Cohen, S., Doyle, W. J., Skoner, D. P., Rabi, B. S., & Gwaltney, J. M. (1997). Social ties
and susceptibility to the common cold. Journal or the American Medical Associa-
tion, 277, 1940-1944.
Cohen, S., Gottlieb, B. H., & Underwood, L. G. (2000). Social relationships and
health. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support
measurement and intervention: A guide for health and social scientists (pp. 3–25).
London: Oxford University Press.
Coifman, K. G., Bonanno, G. A., Ray, R., & Gross, J. J. (2007). Does repressive cop-
ing promote resilience? Affective-autonomic response discrepancy during
bereavement. Journal of Personality and Social Psychology, 92, 745–758.
Curran, P. J., & Hussong, A. M. (2003). The use of latent trajectory models in psycho-
pathology research. Journal of Abnormal Psychology, 12, 525–544.
564 GALATZER-LEVY ET AL.

de Roon-Cassini, T. A., Mancini, A. D., Rusch, M. D., & Bonanno, G. A.(2010). Psy-
chopathology and resilience following traumatic injury: A latent growth mix-
ture model analysis. Rehabilitation Psychology, 55, 1–11.
Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An intro-
ductory report. Psychological Medicine, 13(3), 595-605.
Dickstein, B. D., Suvak, M., Litz, B. T., & Adler, A. B. (2010). Heterogeneity in the
course of posttraumatic stress disorder: Trajectories of symptomatology. Jour-
nal of Traumatic Stress, 23(3), 331-339.
Duncan, T. E., Duncan, S. C., & Strycker, L. A. (2006). An introduction to latent variable
growth curve modeling: Concepts, issues, and applications (2nd ed.). Mahwah, NJ:
Lawrence Erlbaum Associates.
Foa, E., & Rothbaum, B. (1998). Treating the trauma of rape: A cognitive-behavioral ther-
apy for PTSD. New York: Guilford.
Folkman, S., Lazarus, R. S., Gruen, R., & DeLongis, A. (1986). Appraisal, coping,
health status, and psychological symptoms. Journal of Personality and Social
Psychology, 50, 571–579.
Galatzer-Levy, I., & Bonanno, G. A. (in press). Evidence for heterogeneous patterns
of adaptation in distress symptomatology over the four years of college. Jour-
nal of Personality.
Galatzer-Levy, I., & Bonanno, G. A. (2012). Beyond normality in the study of be-
reavement: Heterogeneity in depression outcomes following loss in older
adults. Social Science and Medicine, 74(12), 1987-1994.
Galatzer-Levy, I. R., Bonanno, G. A., & Mancini, A. D. (2010). From marianthal to
latent growth mixture modeling: A return to the exploration of individual
differences in response to unemployment. Journal of Neuroscience, Psychology,
and Economics, 3, 116–125.
Galatzer-Levy, I. R., Madan, A., Neylan, T. C., Henn-Haase, C., & Marmar, C. R.
(2011). Peritramatic and trait dissociation differentiate police officers with
resilient versus symtpomatic trajectories of posttruamatic stress symptoms.
Journal of Traumatic Stress, 24, 557–565.
Galatzer-Levy, I. R., Mancini, A. D., & Bonanno, G. A. (2011). What we don’t expect
when we’re expecting: Longitudinal patterns of adjustment to parenthood.
Journal of Family Psychology, 25, 384–392.
Galatzer-Levy, I. R., Mazursky, H., Mancini, A. D., & Bonanno, G. A. (2011). What we
don’t expect when expecting: Evidence for heterogeneity in subjective well-
being in response to parenthood. Journal of Family Psychology, 25(3), 384-392.
Greenbaum, P., Del Boca, F., Darkes, J., Wang, C., & Goldman, M. S. (2005). Variation
in the drinking trajectories of freshman college students. Journal of Consulting
and Clinical Psychology, 73, 229–238.
Gupta, S., & Bonanno, G. A. (2011). Complicated grief and deficits in emotional ex-
pressive flexibility. Journal of Abnormal Psychology, 120, 635–643.
Haan, N. (1977). Coping and defending: Processes of self-environment organization. New
York: Academic Press.
Harvey, A. G., & Bryant, R. A. (2002). Acute stress disorder: A synthesis and critique.
Psychological Bulletin, 128, 886–902.
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of
Psychosomatic Research, 11, 213–218.
Horowitz, M. J. (1986). Stress response syndromes (2nd ed.). Northvale, NJ: Aronson.
COLLEGE STUDENT ADJUSTMENT 565

Humphrey, J. A., & White, J. W. (2000). Women’s vulnerability to sexual assault from
adolescence to young adulthood. Journal of Adolescent Health, 27, 589–598.
Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (Eds.). (1997). National survey
results on drug use from the monitoring the future study, 1975–1995.Vol. 2: College
students and young adults (NIH Publication No. 94-3810). Washington, DC:
U.S. Government Printing Office.
Jung, T., & Wickrama, K. A. S. (2008). An introduction to latent class growth analysis
and growth mixture modeling. Social and Personality Psychology Compass, 2(1),
302-317.
Kadison, R., & DiGeronimo, T. (2004). College of the overwhelmed: The campus mental
health crisis and what to do about it. San Francisco: Jossey-Bass.
Kossinets, G., & Watts, D. J. (2006). Empirical analysis of an evolving social network.
Science, 311, 88–90.
Lalande, K. M., & Bonanno, G. A. (2011). Retrospective memory bias for the fre-
quency of potentially traumatic events: A prospective study. Psychological
Trauma: Theory, Research, Practice, and Policy, 3, 165–170.
Lam, W.W.T., Bonanno, G. A., Mancini, A. D., Ho, S., Chan, M., Hung, W. K., et
al. (2010). Trajectories of psychological distress among Chinese women diag-
nosed with breast cancer. Psycho-oncology, 19, 1044–1051.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Spring-
er.
Lo, Y., Mendell, N., & Rubin, D. B. (2001). Testing the number of components in a
normal mixture. Biometrika, 88, 767–778.
Mancini, A. D., Bonanno, G. A., & Clark, A. E. (2011). Stepping off the hedonic tread-
mill: Individual differences in response to major life events. Journal of Indi-
vidual Differences, 32, 144–152.
McArdle, J. J., & Epstein, D. (1987). Latent growth curves within developmental
structural equation medels. Child Development, 58, 107–122.
McGinnis, J. M., & Foege, W. H. (1993). Actual cases of death in the United States.
Journal of the American Medical Association, 270, 2207–2212.
Mischel, W. (1973). Toward a cognitive social learning reconceptualization of per-
sonality. Psychological Review, 80, 252–283.
Morosanu, L., Handley, K., & O’Donovan, B. (2010). Seeking support: Researching
first-year students’ experiences of coping with academic life. Higher Education
Reseach & Development, 29, 665–678.
Muthén, B. (2000). Integrating person-centered and variable-centered analyses:
Growth mixture modeling with latent trajectory classes. Alcoholism, Clinical
and Experimental Research, 24, 882–891.
Muthén, B. (Ed.). (2004). Latent variable analysis: Growth mixture modeling and related
techniques for longitudinal data. Newbury Park, CA: Sage Publications.
Muthén, B. O., & Muthén, L. K. (1998–2010). MPlus user’s guide. (6th ed.). Los Ange-
les: Muthén & Muthén.
Neria, Y., Olfson, M., Gameroff, M. J, DiGrande, L., Wickramaratne, P., Gross, R. et
al. (2010). Long-term course of probable PTSD after the 9/11 attacks: A study
in urban primary care. Journal of Traumatic Stress, 23, 474–482.
Nylund, K., Asparouhov, T., & Muthén, B. (2007). Deciding on the number of classes
in latent class analysis and growth mixture modeling: A Monte Carlo simu-
lation study. Structural Equation Modeling: A Multidisciplinary Journal, 14,
535–569.
566 GALATZER-LEVY ET AL.

Papa, A., & Bonanno, G. A. (2008). Smiling in the face of adversity: The interper-
sonal and intrapersonal functions of smiling. Emotion, 8, 1–12.
Plumb, J. C., Orsillo, S. M., & Luterek, J. A. (2004). A preliminary test of experiential
avoidance in post-event functioning. Journal of Behavior Therapy and Experi-
mental Psychiatry, 35, 245–257.
Read, J. P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM-
IV-TR trauma exposure and posttraumatic stress disorder among newly ma-
triculated college students. Psychological Trauma: Theory, Research, Practice, and
Policy, 3, 148–156.
Sargent, J. T., Crocker, J., & Luhtanen, R. K. (2006). Contingencies of self worth and
depressive symptoms in college students. Journal of Social and Clinical Psychol-
ogy, 25, 628–646.
Scarpa, A., Fikretoglu, D., Bowser, F., Hurley, J. D., Pappert, C. A., Romero, N., & Van
Voorhees, E. (2002). Community violence exposure in university students: A
replication and extension. Journal of Interpersonal Violence, 17, 253–272.
Schaeffer, C. M., Petras, H., Ialongo, N., Poduska, J., & Kellam, S. (2003). Modeling
growth in boys’ aggressive behavior across elementary school: Links to later
criminal involvement, conduct disorder, and antisocial personality disorder.
Developmental Psychology, 39, 1020–1035.
Scheier, M. F., & Carver, C. S. (1992). Effects of optimism on psychological and phys-
ical well-being: Theoretical overview and empirical update. Cognitive Therapy
and Research, 16(2), 201-228.
Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from
neuroticism (and trait anxiety, self mastery, and self-esteem): A reevaluation
of the Life Orientation Test. Journal of Personality and Social Psychology, 67,
1063–1078.
Schwartz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6,
461–464.
Schwartz, J. E., Neale, J., Marco, C., Shiffman, S. S., & Stone, A. A.(1999). Does trait
coping exist?: A momentary assessment approach to the evaluation of traits.
Journal of Personality and Social Psychology, 77, 360–369.
Sclove, S. L. (1987). Application of model-selection criteria to some problems in
multivariate analysis. Psychometrika, 52, 333–343.
Straus, R., & Bacon, S. D. (1953). Drinking in college. New Haven, CT: Yale University
Press.
Vaez, M., & LaFlamme, L. (2008). Experience stress, psychological symptoms, self
rated health and academic achievement: A longitudinal study of Swedish
university students. Social Behavior and Personality, 36, 183–196.
Voelker, R. (2003). Mounting student depression taxing campus mental health ser-
vices. Journal of the American Medical Association, 289, 2055–2056.
Vrana, S., & Lauterbach, D. (1994). Prevalence of traumatic events and post-trau-
matic psychological symptoms in a nonclinical sample of college students.
Journal of Traumatic Stress, 7(2), 289-302.
Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B., & Castillo, S. (1994). Health
and behavioral consequences of binge drinking in college. Journal of the Amer-
ican Medical Association, 272(21), 1672-1677.
Wechsler, H., Dowdall, G. W., Davenport, A., & Rimm, E. B. (1995). A gender-spe-
cific measure of binge drinking among college students. American Journal of
Public Health, 85, 982–985.
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Wells, V. E., Klerman, G. L., & Deykin, E. Y. (1987). The prevalence of depressive
symptoms in college students. Social Psychiatry, 22, 20–28.
Westphal, M., Seivert, N. H., & Bonanno, G. A. (2010). Expressive flexibility. Emo-
tion, 10, 92–100.
Wilcox, P., Winn, S., & Fyvie-Gauld, M. (2005). “It was nothing to do with the uni-
versity, it was just the people”: The role of social support in the first-year
experience of higher education. Studies in Higher Education, 30, 707–722.

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