Received 11/09/15

Revised 08/25/16
Accepted 10/01/16
DOI: 10.1002/jcad.12158

Loneliness as Moderator
Between Trauma and
Posttraumatic Growth
Melissa Zeligman, Jacquelyn A. Bialo, Jane L. Brack,
and Moriah A. Kearney
This study investigated the association between loneliness, trauma symptomatology, and posttraumatic growth (PTG)
in undergraduate students (N = 362). The study also explored whether loneliness moderated the relationship between
experiences of trauma and PTG. The results demonstrated that both loneliness and trauma symptoms predicted
levels of PTG, and loneliness moderated the relationship between trauma and PTG. Limitations, directions for future
research, and implications for counseling are discussed.

Keywords: posttraumatic growth, loneliness, trauma

The impact of traumatic events on individuals has been well
documented. Although not all survivors of trauma develop
psychological distress, those who do may experience depres-
sion, anxiety, panic and stress disorders, phobias, dissociation,
and posttraumatic stress disorder (PTSD; Briere & Scott,
2015; Calhoun, Tedeschi, Cann, & Hanks, 2010). According
to Janoff-Bulman (2006), when a trauma occurs, it shocks the
individual’s core and creates something of a “psychological
earthquake” (Bayer, Lev-Wiesel, & Amir, 2007, p. 5). The
trauma shatters one’s illusions of safety and security, as well
as one’s basic assumptions about the world (Bayer et al.,
2007). These basic assumptions are founded on the idea that
if individuals do the right thing, are careful, and are overall
good people, they can prevent bad things from happening to
them (Janoff-Bulman, 2006). Although individuals know that
bad things happen in the world, they do not expect those bad
things to happen to them personally until a traumatic event
happens (Janoff-Bulman, 2006).
Posttraumatic Growth
Although somewhat counterintuitive, researchers have found
that in some cases, the emotional healing process in the after-
math of a traumatic event can actually lead to positive psycho-
logical changes and effects (Bayer et al., 2007; Bush, Skopp,
McCann, & Luxton, 2011). This phenomenon is known as
posttraumatic growth (PTG). PTG is a complex process that
begins when individuals start to cope with their trauma and
learn to assimilate or accommodate the trauma into their exist-
ing belief system and cognitive schema (Bayer et al., 2007).
As individuals strive to make meaning from their trauma,
changes to their cognitive and emotional conceptualizations
of themselves and the world they live in lay the foundation
for PTG (Janoff-Bulman, 2006). According to Tedeschi and
Calhoun (2004), it is the struggle with this new reality “that
is crucial in determining the extent to which posttraumatic
growth occurs” (p. 5); trauma and PTG are not mutually
exclusive. Although PTG is sometimes used interchangeably
with the term resilience, Tedeschi and Calhoun (1995, 1996)
saw these as two distinct concepts. Resilient personality traits
may enable someone to better cope with crisis or trauma, but
inevitably resilience refers to an individual maintaining emo-
tional stability (Ogińska-Bulik, 2015). In contrast, individuals
who experience PTG undergo a transformation following
trauma, whereby there is movement past their pretrauma level
of functioning (Tedeschi & Calhoun, 1995, 1996).
The mechanisms underlying PTG, however, remain some-
what unclear. Various researchers have created theoretical
models and hypotheses to try to understand and explain how
PTG occurs. Janoff-Bulman (2006) suggested there are three
pathways to PTG: strength through suffering, existential re-
evaluation, and psychological preparedness, which involves
adjusting one’s schema to accept that there are random, un-
controllable events in the world. PTG happens by survivors

Melissa Zeligman, Jacquelyn A. Bialo, Jane L. Brack, and Moriah A. Kearney, Department of Counseling and Psychological
Services, Georgia State University. Correspondence concerning this article should be addressed to Melissa Zeligman, Department
of Counseling and Psychological Services, Georgia State University, PO Box 3980, Atlanta, GA 30302-3980 (e-mail: mzeligman@
gsu.edu).

© 2017 by the American Counseling Association. All rights reserved.

Journal of Counseling & Development  ■  October 2017  ■  Volume 95 435

acknowledging these elements, utilizing coping skills and
resources, and relying on their reestablished psychological
sense of coherence (Janoff-Bulman, 2006). Similarly, Taylor’s
(1983) model of cognitive adaptation includes three themes
that arise during the posttrauma readjustment process: (a)
searching for meaning, (b) trying to gain mastery and a
sense of control over the event and over one’s life, and (c)
working toward self-enhancement and improved self-esteem.
The individual reconciles these themes by using constructive
thoughts and actions to adapt and to grow from the trauma.
Another mechanism by which PTG could occur is through
cognitive processing, which involves processing the trauma in
such a way as to enable the rebuilding of core beliefs (Tedes-
chi, 2011). More specifically, central to cognitive processing is
the idea of rumination. Tedeschi (2011) described rumination
as initially involving intrusive, repetitive, automatic thoughts
that eventually subside into a more deliberate reflection of the
event. Through the rumination process, survivors assimilate
their new, changed reality into their cognitions (Tedeschi,
2011; Triplett, Tedeschi, Cann, Calhoun, & Reeve, 2012).
Women are more likely to engage in thoughtful, deliberate
rumination compared with men (Treynor, Gonzalez, & Nolen-
Hoeksema, 2003), which Segerstrom, Stanton, Alden, and
Shortridge (2003) hypothesized is why women more regularly
report experiences of PTG. For this reason, we controlled for
gender in the present study. Elements such as rumination and
cognitive processing could have either a mediating or a moder-
ating effect on the relationship between a stressful experience
and psychosocial outcomes (Ben-Zur, 2012). For example,
in their study of individuals after a myocardial infarction,
Garnefski, Kraaij, Schroevers, and Somsen (2008) found
that 24% of the variance of PTG was explained by cognitive
processing and coping strategies. Additionally, Barskova and
Oesterreich (2009) suggested that PTG may occur as family
and friends help survivors to identify what is truly meaningful
in their lives and to process the trauma experience.
Several factors (e.g., self-esteem, optimism, self-efficacy)
may contribute to an individual healing from trauma and
experiencing PTG (Epel, McEwen, & Ickovics, 1998; Linley
& Joseph, 2004; Updegraff, Taylor, Kemeny, & Wyatt, 2002).
Two of the most salient variables appear to be personality traits
and social supports/networks (Clapp & Beck, 2009; Evans,
Steel, & DiLillo, 2013; Linley & Joseph, 2004). Linley and
Joseph (2004) reviewed the literature on positive changes
following trauma and found that of the Big Five personality
traits, extraversion, openness, agreeableness, and consci-
entiousness were positively associated with PTG, whereas
neuroticism was negatively correlated with PTG. In looking
at the role of social support, Evans et al. (2013) asserted that
individuals might evaluate a situation as being less stressful
if they perceive that others can offer support and resources
needed to help them cope with the event. Clapp and Beck’s
436 Journal of Counseling & Development  ■  October 2017  ■  Volume 95
Zeligman, Bialo, Brack, & Kearney
(2009) erosion model described the relationship between so-
cial support and PTSD as one in which the severity of PTSD
symptoms (e.g., social withdrawal) adversely influences uti-
lization of supports and resources. In their study of survivors
of traumatic motor vehicle accidents, Clapp and Beck were
specifically interested in looking at the moderating effect
of negative network orientation (i.e., when the traumatized
individual views social support as ineffective, inappropriate,
or dangerous) on the indirect association between PTSD and
social support. They found that after controlling for childhood
victimization and its interaction with PTSD symptoms, there
was a relationship between severity of PTSD and increased
negative network orientation, which subsequently was associ-
ated with decreased perceptions of social support.
Although the findings have been somewhat inconsistent,
researchers have found that PTG has both psychological and
physical benefits for survivors. When individuals experience
PTG, they may find an increase in their positive feelings, such
as having more compassion and empathy, stronger ties to loved
ones, and a greater appreciation for life (Bush et al., 2011).
In addition, individuals may experience changes in personal
strength, spirituality, self-concept, and life priorities, and they
begin to recognize new life opportunities and possibilities (Cal-
houn et al., 2010; Solomon & Dekel, 2007; Tedeschi, 2011). For
example, Bush et al. (2011) used hierarchical linear regression
to analyze data related to PTG among 5,302 participants, 97.5%
of whom had served in the United States Army. They found not
only that PTG served as a protective factor against suicide risk
in the military but also that participants experienced positive
change following the stress and trauma of deployment. Linley
and Joseph (2004) reviewed 39 studies and found that growth
after trauma led to a reduction in depressive symptoms, anxiety,
and distress. Frazier, Conlon, and Glaser (2001) showed that
12 months after a sexual assault, women who reported positive
life changes exhibited the least amount of distress and depres-
sive symptoms. Similarly, Milam (2004) found that among
HIV-positive individuals, those who indicated they had expe-
rienced PTG exhibited less depression and pessimism as well
as increased optimism. Physically, survivors who experienced
PTG exhibited decreased levels of the stress hormone cortisol
(Epel et al., 1998). Milam also found that participants who
had PTG ate healthier and drank less alcohol. Thus, it appears
that PTG is a complex phenomenon that captures the human
capacity for healing and, for some, can lead to significant and
positive life changes.
Loneliness as a Barrier
to Trauma Recovery
Some survivors experience PTG, whereas others struggle
to recover and regain a sense of normalcy in their lives. A
particularly salient element that may inhibit and hinder PTG
Loneliness as Moderator Between Trauma and Posttraumatic Growth
is loneliness. Loneliness is somewhat of a subjective concept
in that it relies on an individual’s perceptions (Fees, Martin,
& Poon, 1999). Eshbaugh (2010) suggested that loneliness
exists when “there is a discrepancy between the relationships
one actually has and the relationship one wishes one has” (p.
8). Similarly, Ben-Zur (2012) proposed that loneliness has
two components: emotional loneliness and social loneliness.
Emotional loneliness occurs when there is a “loss or absence
of confiding in and forming an attachment to a special and
beloved person” (p. 24). Social loneliness occurs when in-
dividuals experience a lack of meaningful friendships and
relationships in their life. Furthermore, although similar in
concept, there is a subtle, but important distinction between
loneliness and perceptions of social support. Social isolation
is considered an objective measure of social interactions and
relationships, whereas loneliness is based on perceptions of
social isolation that cause distress and pain (J. T. Cacioppo et
al., 2015; Hawkley & Cacioppo, 2010; Masi, Chen, Hawkley,
& Cacioppo, 2011).
Loneliness is not limited to people who have been through
a trauma. Rather, it appears to be a common human condition
reported by up to 80% of youth age 18 and under, and more
than 40% of adults age 65 and older (Hawkley & Cacioppo,
2010). Loneliness is associated with myriad negative physical,
cognitive, psychological, social, and mental health outcomes.
These include being at increased risk for depression, drug and
alcohol use, suicidal ideation and self-harm, and personality
disorder and psychoses (Hawkley & Cacioppo, 2010; Masi
et al., 2011). In their meta-analysis, Holt-Lunstad, Smith, and
Layton (2010) found that lonely people have a 45% increased
risk for mortality, which is roughly comparable with the mor-
tality risks associated with smoking and alcohol consumptions
and which exceeds other factors such as obesity. Loneliness
also contributes to decreases in executive functioning and is
a risk factor for cognitive decline and dementia (S. Cacioppo,
Capitanio, & Cacioppo, 2014). Among older adults, loneli-
ness can lead to increased systolic blood pressure, depression,
and poorer physical health (Chen & Feeley, 2014; Fees et al.,
1999). Loneliness has been shown to affect quality of sleep,
reduce immune system effectiveness, and increase stress
responses (Masi et al., 2011). Thus, studying loneliness and
PTG becomes necessary for increasing wellness of clients
who have experienced trauma.
Furthermore, similar to the ways in which certain personal-
ity traits facilitate PTG, researchers have demonstrated how
other characteristics, such as social anxiety and low self-
concept, contribute to feelings of loneliness (Fees et al., 1999;
Gallagher, Prinstein, Simon, & Spirito, 2014). Additional
relationships exist between loneliness, blaming oneself for
social shortcomings and failures, being more self-conscious
in social settings, and experiencing increased likeliness of
social rejection (Masi et al., 2011). Gallagher et al. (2014)
Journal of Counseling & Development  ■  October 2017  ■  Volume 95
suggested that social anxiety, a symptom that survivors of
trauma may experience (Briere & Scott, 2015), contributes to
loneliness in that individuals with anxiety are more sensitive
to perceived negative evaluation from others, which in turn
affects how they perceive social support.
There remains a paucity of literature on the relationship
between loneliness and PTG. Given that survivors of trauma
can experience feelings of loneliness, it is essential that we
continue to study its moderating effects on factors such as
PTG. Therefore, studying the association between loneli-
ness and PTG is important in further understanding how
trauma survivors experience PTG and what factors may be
inhibiting this process of growth. To advance the knowledge
of PTG, and to further define the constructs that enable or
prevent individuals from experiencing such growth, we aim
to identify the presence of trauma, loneliness, and PTG in
adults while further assessing the predictive nature of loneli-
ness and trauma on PTG. We examined two primary research
questions: (a) Are perceived loneliness and experiences of
trauma predictive of PTG in adults? and (b) Does loneliness
serve as a moderator between experiences of trauma and PTG
in adults, even when gender is controlled for?
Method
Participants and Procedure
Participants consisted of 362 undergraduate students re-
cruited from a large urban university in the southeastern
United States. A post hoc power analysis was conducted using
G*Power (Version 3.1). With an alpha level of .05, a sample
size of 362, and the small observed effect size of .126 (Co-
hen, 1992), achieved power for the study was .99. Inclusion
criteria for the study required that participants be 18 years
of age or older and able to consent to the sensitive nature
of the research. Potential participants were informed that
the research focused on experiences of trauma and personal
reactions to traumatic experiences. Following approval from
the university institutional review board, data were collected
as part of a larger research project exploring the relationships
of trauma and trauma symptomatology on PTG.
Participants were excluded from the larger data set if they
had not reported experiencing a form of trauma as measured
by the Trauma History Screen (Carlson et al., 2011). Partici-
pants in the final sample ranged in age from 18 to 57 years
(M = 23.73 years, SD = 5.37), were primarily women (n =
215, 59.4%), and identified as heterosexual (n = 334, 92.3%).
The sample was diverse in terms of race, immigration history,
and generational college experiences. The largest percentage
of students, 39.8% (n = 144), identified as Black or African
American, 39.5% (n = 143) were first-generation college
students, and 25.1% (n = 91) identified as first-generation
U.S. citizens. The research was completed at a university with
437

a uniquely diverse student body; therefore, the sample was
representative of the larger university population.
Measures
Posttraumatic Growth Inventory (PTGI). Developed by
Tedeschi and Calhoun (1996), the PTGI measures personal
growth in individuals following a highly stressful or traumatic
event. The subscales measure growth in five areas: Relating to
Others (seven items), New Possibilities (five items), Personal
Strength (four items), Spiritual Change (two items), and Ap-
preciation of Life (three items). A Likert-type scale ranging
from 0 (I did not experience this change as a result of my
crisis) to 5 (I experienced this change to a very great degree
as a result of my crisis) was used. Sample items include “I can
better appreciate each day” and “I discovered that I’m stronger
than I thought I was.” The scale results in a total score created
by taking the sum of each of the 21 items on the assessment.
Items on the PTGI were previously shown to be reliable when
used with trauma survivors (e.g., α = .85 in Sattler, Boyd, &
Kirsch, 2014; α = .94 in Taku, Cann, Tedeschi, & Calhoun,
2015). The present sample had a Cronbach’s alpha of .97,
suggesting this scale has strong internal consistency.
UCLA Loneliness Scale (Version 3). The third version of
the original UCLA Loneliness Scale (Russell, 1996) is a sim-
plified 20-item version designed to measure how individuals
describe their experience of loneliness. Respondents are asked
to indicate how often they experience the feelings listed on a
4-point Likert-type scale ranging from 1 (never) to 4 (always),
with higher scores indicating higher degrees of loneliness.
Sample items include “How often do you feel that you are
no longer close to anyone?” and “How often do you feel
isolated from others?” The scale indicates strong convergent
validity in its correlations with other measures of loneliness
(e.g., NYU Loneliness Scale, Differential Loneliness Scale)
and discriminant validity in its negative association with
scores of social support. In addition, previous researchers
have reported strong internal consistency of the scale when
used with college samples (.96; Demirli & Demir, 2014). The
scores presented strong reliability in the current sample, with
a Cronbach’s alpha of .92.
Trauma Symptom Checklist–40 (TSC-40). The TSC-40
(Briere & Runtz, 1989) consists of 40 items that were created
to determine how many symptoms associated with trauma
experiences participants are reporting and how often such
experiences have occurred. The TSC-40 is intended specifi-
cally for research purposes and is not encouraged for clinical
use. Items include symptoms such as restless sleep, flash-
backs, and feelings of guilt. Together these items constitute
six subscales: Dissociation (six items), Anxiety (nine items),
Depression (nine items), Sexual Abuse Trauma Index (seven
items), Sleep Disturbance (six items), and Sexual Problems
(eight items), with some items used in multiple subscales.
438 Journal of Counseling & Development  ■  October 2017  ■  Volume 95
Zeligman, Bialo, Brack, & Kearney
A reliability analysis on the current sample showed strong
internal consistency (α = .94). This is consistent with alpha
coefficients gathered in other research on trauma (.92; Neal
& Nagle, 2013).
Trauma History Screen. The Trauma History Screen
(Carlson et al., 2011) is used to ensure that participants have
reported experiencing some sort of trauma prior to their
participation. The measure screens for trauma in terms of the
following: car, boat, train, or airplane accidents; accidents at
home or work; hurricanes, floods, earthquakes, tornados, or
fires; being hit or kicked hard enough to incur injury (either
as a child or an adult); being forced to make sexual contact
(either as a child or an adult); being attacked with a gun,
knife, or weapon; seeing something horrible or being badly
scared during military service; sudden death of close family
or friend; seeing someone die suddenly or get badly hurt or
killed; sudden move or loss of home or possessions; suddenly
abandoned by spouse, partner, parent, or family; or some
other sudden event that made participants feel very scared,
helpless, or horrified. Although this measure also contains a
narrative component, only the trauma event portion was used
to determine whether a participant should be included in the
sample (i.e., did the participant report experiencing one of
these traumatic events?).
Demographics. Participants were given a demographic
questionnaire we created to capture a more detailed look at
the sample. This questionnaire included items pertaining to
age, gender, racial/ethnic identity, spiritual/religious affilia-
tion, immigration history (e.g., first-generation immigrant),
sexual orientation, year in school, grade point average, marital
status, disability status, and socioeconomic status. Not all
demographic information was included in the research ques-
tions of this study but rather was used to highlight the diversity
of the sample, particularly in terms of race and immigration
history. In this sense, the inclusion of this assessment helps
to differentiate the present sample from previous samples
exploring the construct of PTG.
Data Analysis
We first conducted descriptive statistics to determine the
presence and level of PTG within the sample. We also ran
descriptive statistics on the scales for loneliness and trauma
symptomatology to assess the presence of both constructs
within the data. We then specified and tested a series of
regression models to determine whether loneliness and
trauma symptomatology were predictive of experiences of
PTG within the sample. Multiple regression analyses were
used to determine the predictive nature of loneliness and
trauma on the total experience of PTG, as well as on the five
PTGI subscales (i.e., Relating to Others, New Possibilities,
Personal Strength, Spiritual Change, and Appreciation of
Life). In addition, the predictor variables (i.e., loneliness and
Loneliness as Moderator Between Trauma and Posttraumatic Growth
trauma symptoms) were tested to determine if an interaction
effect was present and to uncover if loneliness moderated
the relationship between trauma symptoms and PTG in the
sample. We also controlled for gender during this process to
account for significant variance in reported PTG scores, and
the moderating effect of loneliness, over and above that ac-
counted for by gender. Women typically report greater levels
of PTSD symptomatology and PTG than men (Vishnevsky,
Cann, Calhoun, Tedeschi, & Demakis, 2010), leading gender
to regularly be regarded as a control variable in PTG research,
including in the present study. A two-step hierarchical regres-
sion technique (Step 1 including the predictor variable and
Step 2 including the interaction between the predictor and
moderator) guided the testing of a moderation effect (Baron
& Kenny, 1986). Prior to conducting regression analyses,
we ran correlations to assess for potential issues of multicol-
linearity; in addition, centering of the predictor variables was
completed to standardize the variables, as recommended by
Aiken and West (1991).
Results
Descriptive Statistics
Correlations between constructs, and means and standards
deviations for the measures used in this study, are presented
in Table 1. As shown in the table, trauma symptomatology
was significantly and positively correlated with each of the
other predictor variables (loneliness, r = .53; PTG, r = .26).
However, PTG scores were not correlated with feelings of
loneliness. Furthermore, the means shown in Table 1 give a
clearer picture of where the sample stood in terms of each of
the constructs. Results indicated a PTG mean score of 45.73
(SD = 28.95, range = 0–105), which is considerably lower than
similar samples (e.g., Hooper, Marotta, & Depuy, 2009; M =
67.03). A clinical cutoff score for the TSC-40 is not available;
however, the sample mean of 23.01 for trauma (SD = 21.55,
range = 0–120) is consistent with other means found in other
samples of individuals who have experienced trauma (e.g.,
TABLE 1
Correlations, Means, and Standard Deviations
Among the Variables
Variable 1 2 3 trauma negatively predicted PTG, whereas loneliness was a
1. Trauma (.94)
2. Loneliness .53* (.92)
3. Posttraumatic growth .26* .01 (.94)
M 23.01 44.39 45.73
SD 21.55 11.28 28.95
Note. N = 362. Alpha values are listed in parentheses on the diagonal.
*p < .01.
Journal of Counseling & Development  ■  October 2017  ■  Volume 95
Ghee, Johnson, & Burlew, 2010; Victorson, Farmer, Burnett,
Ouellette, & Barocas, 2005). Finally, the UCLA Loneliness
Scale resulted in a mean loneliness score of 44.39 (SD =
11.28, range = 20–77), which is similar to the mean found
by the authors of the scale when looking at a similar sample
(Russell, 1996; M = 40.08, SD = 9.5).
Consistent with other research (e.g., Vanhalst, Luyckx,
Raes, & Goossens, 2012; Vishnevsky et al., 2010), gender-
based differences existed within the sample in terms of
loneliness, trauma symptoms, and PTG. In exploring the
relationships among gender and the identified constructs, we
found that gender had weak positive correlations (p < .05) with
loneliness (r = .07), trauma symptoms (r = .16), and PTG (r
= .05). Using a t test, we determined that although mean PTG
scores differed for men (M = 44.27) and women (M = 47.10),
these differences were not significant (p > .05). In contrast,
mean differences in loneliness scores (men, M = 43.52;
women, M = 45.14) and reports of trauma symptoms (men,
M = 19.16; women, M = 26.38) were significantly different
between men and women (p < .01), with women reporting
greater trauma symptoms and greater feelings of loneliness.
Predictors of PTG
To examine the first research question, we performed regres-
sion analyses to determine if loneliness and trauma symptoms
were predictive of experiences of PTG within the sample.
Before conducting the analyses, we checked issues of multi-
collinearity by running correlations and collinearity statistics.
These tests indicated that multicollinearity was not a concern
within the present sample (for loneliness, tolerance = .70,
variance inflation factor [VIF] = 1.42; for trauma symptoms,
tolerance = .70, VIF = 1.42). We used R2 to determine the ef-
fect size, because it is an appropriate measure often utilized
in studies of regressions (McMillan & Foley, 2011). Results
indicated that both predictor variables contributed to a model
of PTG in a significant way, accounting for 11% of the vari-
ance in PTGI scores (R2 = .11), F(2, 359) = 23.85, p < .001.
In addition, the analysis resulted in the following equation:
PTG = 59.1 – .57 (loneliness) + .53 (trauma symptoms).
Furthermore, PTG was significantly connected to loneliness
(β = .23, p < .01) and trauma symptoms (β = –.41, p < .01)
within the model. The higher beta score associated with
trauma means this variable contributed to the outcome of PTG
slightly more than loneliness. It is also important to note that
positive predictor.
To explore the predictive role of these variables within
the data, we next assessed whether loneliness served as a
moderator between trauma symptoms and PTG. Prior to
testing a moderation effect, we took appropriate steps (i.e.,
data were centered and predictor variables were included
with the interaction variable; Frazier, Tix, & Barron, 2004).
439

Because gender was significantly associated with experi-
ences of PTG, this demographic variable was controlled for
in the regression analysis. In addition, gender was controlled
for in the analysis due to the noted differences in PTG scores
between men and women in the sample.
In Step 1of the regression analysis, we placed gender into
the first block due to theoretical rationale supporting gender
differences in those who experience PTG (Vishnevsky et al.,
2010). In the second block, the remaining predictor variables
(i.e., trauma symptoms and loneliness) were added to the
model, identifying their impact on PTG while partialing out
the anticipated effects of gender from the first block. Lastly,
consistent with Frazier et al.’s (2004) steps for testing mod-
erating effects, the interaction between trauma symptoms
and loneliness was added into the third block to test the
moderating role of loneliness between trauma symptoms
and PTG. Table 2 shows the order in which variables were
entered to achieve the final model. Step 1 revealed that
gender explained 0.3% of the variance in PTG within the
sample (R2 = .003). In Step 2, the centered variables trauma
symptoms (β = –.40) and loneliness (β = .23) were entered,
with both significantly predicting experiences of PTG (p <
.01) and accounting for 11% of the variance in PTG (R2 =
.11). The two-way interaction between trauma and loneli-
ness (as seen in Step 3 of Table 2) produced a significant
interaction effect (β = –.06, p < .01). Therefore, the pres-
ence of loneliness within the sample moderated the effect
of trauma symptoms on PTG (R2 = .12), F(4, 357) = 12.18,
p < .01, and explained 12% of the variance in PTG scores.
Discussion
The relationship between loneliness and PTG has been re-
viewed in the literature (e.g., Andrykowski et al., 2005; Bishop
et al., 2007), but as with most PTG research, these findings
have centered on cancer survivors. In addition, although the
relationship between social support and PTG is regularly cited
in the literature, current thought tends to suggest that social
TABLE 2
Hierarchical Moderated Regression of
Loneliness and Trauma Symptoms
on Posttraumatic Growth
Predictor β t R2 F
Step 1 .003 0.94
Gender .00 1.22
Step 2 .11 15.85
Trauma symptoms –.40 –6.81*
Loneliness .23 3.91*
Step 3 .12 12.18
Trauma × Loneliness –.06 –1.04*
*p < .01.
440 Journal of Counseling & Development  ■  October 2017  ■  Volume 95
Zeligman, Bialo, Brack, & Kearney
support and loneliness are distinctly different constructs,
warranting separate research to uncover their respective con-
nections with PTG. At the time of this study, we did not find
any other research exploring our research questions, includ-
ing examining the role of loneliness as a moderator between
trauma and PTG. More specifically, our research further
measured the predictive relationship of trauma symptomatol-
ogy and loneliness on PTG, and also controlled for gender
when considering the moderating role of loneliness within
the sample of undergraduate students who had experienced
trauma. Results indicated that both trauma symptoms and
loneliness were significantly predictive of experiencing PTG,
and that loneliness moderated the relationship between trauma
symptoms and PTG in the sample. Furthermore, loneliness
and PTG were both experienced in greater amounts among
the women in our sample.
In addition to confirming the predictive nature of each
of the variables, correlations helped to determine the direc-
tion of these relationships. A correlation matrix identified
that trauma symptoms had a significant, positive relation-
ship with PTG. This finding echoes the very definition of
PTG, which asserts that a marked amount of felt trauma
is necessary in order to experience personal gains after an
event (Calhoun & Tedeschi, 1998). Furthermore, the beta
scores produced in the regression equation suggest that
loneliness contributed slightly less to the experience of
PTG than trauma symptoms, in a significant and positive
manner. This finding helps to further define the experience
of PTG and confirms the unique contribution of loneliness
in the sample.
The second research question, which explored whether
loneliness moderated the presence of trauma symptoms on
PTG, was found to be significant. In other words, the effect
of trauma symptoms on PTG was tied to, or dependent on,
scores of loneliness on the UCLA Loneliness Scale. This find-
ing suggests that the presence of loneliness plays a significant
role in whether those who have experienced trauma are able to
experience PTG or not. Therefore, feelings of loneliness may
exacerbate trauma symptoms or likewise hinder individuals
from being able to grow following their trauma. This finding is
perhaps even more meaningful because gender was controlled
for, suggesting loneliness is capable of affecting one’s ability
to experience PTG regardless of gender.
Implications for Counseling
In this study, we examined the relationship between trauma
symptomatology and loneliness on PTG. Based on our find-
ings, it is clear that counselors need to pay attention to their
clients’ feelings of loneliness. They can do this in several
ways. First, counselors need to change their perspective on
trauma and learn about PTG, for example, that experiences
of adversity or trauma do not necessarily equate with
Loneliness as Moderator Between Trauma and Posttraumatic Growth
permanent emotional damage (Joseph & Linley, 2006). This,
of course, comes with the caveat that because a person has
not experienced PTG does not mean he or she has failed
to make progress. By increasing their knowledge about
PTG, counselors can shift from simply trying to alleviate
clients’ distress to facilitating clients’ PTG (Joseph & Linley,
2006). As Joseph and Linley (2006) noted, it is “important
to recognize that growth is not simply the absence of post-
traumatic stress, but is rather an independent dimension of
experience” (p. 1048).
Second, counselors should learn to recognize what con-
tributes to feelings of loneliness and how to attend to them.
During intake, they can assess a client’s loneliness by using
a measure such as the UCLA Loneliness Scale. Counselors
need to use techniques that support the rebuilding of clients’
core beliefs that have been shattered and work on ways to
increase trauma survivors’ social support networks. As a way
to address loneliness, we suggest using strength counseling
(Smith, 2006), the foundation of which is establishing a
trusting and caring therapeutic alliance while simultaneously
not neglecting trauma histories. The utilization of clients’
strengths in strength counseling may have tremendous
potential for developing PTG and diminishing loneliness.
The collaborative nature of strength counseling can assist
clients to identify where to begin, and, more importantly,
where to go.
Third, in a similar vein, counselors can work with their
clients to build resilience. Although an in-depth discussion
of resilience is beyond the scope of this article, Agaibi and
Wilson (2005) suggested, “In the most basic sense, resiliency
has been defined as the ability to adapt and cope successfully
despite threatening or challenging situations” (p. 198). Like
strength counseling, resilience is strengths based, and Con-
nor, Davidson, and Lee (2003) found that higher levels of
personal resilience are associated with better mental health.
Factors that affect resilience include social support, effec-
tive coping, determination, and flexible attitudes (Joseph
& Linley, 2006).
Limitations
The study had a number of limitations. Although our sample
was diverse with regard to factors such as ethnicity and im-
migration history, participation in the study was limited to
college students attending an urban university. Results may
be more generalizable if future studies include students from
universities in more suburban or rural environments as well. In
addition, inclusion criteria were based on whether participants
had experienced one or more potentially traumatic events listed
on the Trauma History Screen. Although these events may have
the potential to cause trauma, they might not have been viewed
as traumatic by the participant. Another trauma measure as-
sessing participants’ perceptions of the traumatic nature of the
Journal of Counseling & Development  ■  October 2017  ■  Volume 95
event may have resulted in a different sample, and therefore
different results. Finally, the research involved a cross-sectional,
correlational research design. This design allows relationships
to be explored but limits us from assessing causality.
Directions for Future Research
In addition to replicating this study on more traditional college
campuses, researchers may determine if loneliness moderates
the relationship between trauma symptomatology and PTG
in other populations, such as high school students or young
adults in the workforce. Future studies may also collect longi-
tudinal data when examining factors related to PTG. Although
PTG generally increases over time in women who experience
sexual assault, the biggest gains seem to occur between 2
weeks and 2 months postassault (Frazier et al., 2001). The
domains in which PTG developed also had different patterns
over time, with participants reporting more immediate change
in some domains (e.g., empathy) and more gradual change in
others (e.g., personal strength). It could be that the relation-
ship between loneliness, trauma symptomatology, and PTG
changes over time as well, especially when examining the
different domains of PTG. In more applied work, researchers
can determine the impact of different therapeutic approaches,
such as strength counseling, on client-reported levels of PTG
and loneliness.
Conclusion
This study examined the predictive nature of loneliness and
trauma symptomatology on PTG. We found that both loneli-
ness and trauma symptoms predict levels of PTG, with lone-
liness contributing slightly more to the experience of PTG.
Additional analyses also confirmed the moderating effect that
loneliness has on the relationship between trauma symptoms
and PTG. Findings from this study underscore the role that
loneliness plays in the experience of PTG, by preventing
or diminishing trauma survivors’ ability to grow after their
trauma. In working with clients who have experienced trauma,
counselors may be able to foster PTG by using therapeutic
approaches that address loneliness.
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