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Relationships among Proactive

Coping, Posttrauma Gratitude, and
Psychopathology in a Traumatized
College Sample
a
Laura L. Vernon
a
Wilkes Honors College , Florida Atlantic University , Jupiter ,
Florida , USA
Published online: 18 Jan 2012.

To cite this article: Laura L. Vernon (2012) Relationships among Proactive Coping, Posttrauma
Gratitude, and Psychopathology in a Traumatized College Sample, Journal of Aggression,
Maltreatment & Trauma, 21:1, 114-130, DOI: 10.1080/10926771.2012.633298

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 Journal of Aggression, Maltreatment & Trauma, 21:114–130, 2012
Copyright © Taylor & Francis Group, LLC
ISSN: 1092-6771 print/1545-083X online
DOI: 10.1080/10926771.2012.633298

Relationships among Proactive Coping,

Posttrauma Gratitude, and Psychopathology
in a Traumatized College Sample

LAURA L. VERNON
Wilkes Honors College, Florida Atlantic University, Jupiter, Florida, USA
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Scant previous research has examined associations of proactive

coping and psychopathology, although two preliminary findings
suggest that proactive coping might be negatively associated with
posttraumatic stress disorder (PTSD) and general depression symp-
tom level. This study examined associations of proactive coping
with PTSD and anhedonic depression in a sample of 169 trauma-
tized undergraduates. As expected, women tended to report more
severe PTSD symptoms and less life threat than men. No other gen-
der differences were found. Most important, proactive coping and
posttrauma state gratitude were independently negatively associ-
ated with PTSD symptom level, after controlling for trauma history
and female gender. Further, proactive coping was independently
negatively associated with anhedonic depression, beyond the effect
of traumatic life threat. The implications of the findings for models
of posttrauma psychopathology development are discussed.

KEYWORDS anhedonic depression, gratitude, posttraumatic

stress disorder, proactive coping, trauma

Traumatic events are tragically common, even among relatively young

populations such as college students, of whom 80% or more report hav-
ing experienced at least one potentially traumatic lifetime event (e.g.,
Lauterbach & Vrana, 2001). Recovery from trauma can be quite variable,
extending from negative outcomes such as posttraumatic stress disorder
(PTSD) and major depressive disorder (MDD) to positive outcomes including

Submitted 24 September 2010; revised 2 December 2010, 27 January 2011; accepted

1 February 2011.
Address correspondence to Laura L. Vernon, Wilkes Honors College, Florida Atlantic
University, 5353 Parkside Drive, Jupiter, FL 33458. E-mail: lvernon@fau.edu

114
 Proactive Coping, Gratitude, and Psychopathology 115

posttrauma growth (Breslau et al., 1998; Carver, 1998). This study examined
the association of two individual difference variables, proactive coping and
posttrauma state gratitude, in psychopathology in a high-functioning college
sample with trauma history.

TRAUMA-RELATED PSYCHOPATHOLOGY

It is not uncommon for anxiety disorders and mood disorders, collectively

known as emotional disorders, to develop following traumatic events. For
example, depending on the type of traumatic event experienced, approx-
imately 9% to 21% of individuals might go on to develop PTSD (Breslau
et al., 1998) and a subset of individuals also develop MDD and other anxiety
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disorders (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). In general,

and specifically after trauma, the emotional disorders are highly comorbid.
Kessler et al. (1995) found that among those with PTSD, nearly half had
experienced a major depressive episode and comorbidities with the other
anxiety disorders ranging from 7% to 18%. PTSD research has attempted
to pinpoint the source of such comorbidity (Franklin & Zimmerman, 2001;
Grant, Beck, Marques, Palyo, & Clapp, 2008) and the tripartite model of anx-
iety and depression (Clark & Watson, 1991) provides a useful framework for
such discussion.
The tripartite model divides symptoms of anxiety and depression into
three groups: symptoms of general distress that are nonspecific, somatic
arousal symptoms (termed anxious arousal) that are unique to anxiety,
and low levels of positive affect (termed anhedonia) that are specific to
depression (Clark & Watson, 1991). The tripartite model structure has been
supported in research with student, community, and treatment-seeking clin-
ical populations (Brown, Chorpita, & Barlow, 1998; Watson, Clark, et al.,
1995). One compelling theory about the comorbidity of PTSD with MDD
and other anxiety disorders runs parallel to the tripartite model, focusing on
nonspecific general distress, which has been termed the dysphoria symp-
tom cluster comprised of PTSD symptoms of numbing, irritability, sleep
difficulties, and concentration difficulties (Simms, Watson, & Doebbeling,
2002). Grant and colleagues (2008) showed that although PTSD, MDD,
and generalized anxiety disorder following trauma can be reliably distin-
guished, they are all related to the dysphoria symptom cluster. It follows
that posttrauma emotional disorder research might find inflated similarities
between the antecedents and correlates of PTSD, MDD, and other anxiety
disorders due to the disorders’ shared nonspecific factor of high negative
affect or dysphoria symptoms. To understand those factors that are spe-
cific to individual emotional disorders, researchers need to study the distinct
emotional disorder symptom clusters of anhedonic depression and anxious
arousal.
 116 L. L. Vernon

PROACTIVE COPING AND TRAUMA-RELATED

PSYCHOPATHOLOGY

Proactive coping is understudied in relation to emotional disorders and

trauma. Proactive coping has been conceptualized as future-oriented
thoughts and behaviors performed with the purpose of increasing one’s
resources (Greenglass, Schwarzer, Jakubiec, Fiksenbaum, & Taubert, 1999;
Schwarzer & Taubert, 2002). Rather than a single response to a specific
prior or anticipated future negative event, proactive coping involves a sta-
ble, ongoing set of behaviors and thoughts and a positive perception of
stress (Aspinwall & Taylor, 1997; Greenglass, 2002; Schwarzer & Taubert,
2002). Only one study to date has examined proactive coping in relation to
trauma (Vernon, Dillon, & Steiner, 2009).
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Vernon et al. (2009) found that proactive coping was negatively related
to PTSD symptom severity among traumatized undergraduate women, even
when controlling for trauma history, trauma severity, time since the trauma,
and state gratitude immediately posttrauma. These results are consistent with
previous findings of negative associations between future-oriented thinking,
a cognitive aspect of proactive coping, and general psychological distress
(Holman & Cohen Silver, 2005). Such findings provide additional evidence in
support of Hobfoll’s (1989) theory of conservation of resources, which sug-
gests that trauma’s negative impact might be a result of rapid resource loss,
an outcome from which individuals with strong proactive coping might be
protected. Further, proactive coping’s combination of proactive cognitions
and behaviors is likely related to what Hobfoll et al. (2007) recently termed
action growth, which they posit might be necessary for positive posttrauma
adaptation. Their findings seem to suggest that positive cognitions are not
always sufficient for positive posttrauma adjustment, unless they are accom-
panied by positive behaviors. Although a negative relationship has been
found between proactive coping and PTSD for women (Vernon et al., 2009),
the relationship between PTSD and proactive coping among males has not
been examined.
MDD is also common following traumatic experiences (Franklin &
Zimmerman, 2001). Although not examined in relation to trauma, two pub-
lished studies to date have examined the relationship of proactive coping
and general measures of depression symptoms (which include nonspecific
general distress). Uskul and Greenglass (2005) found that among Turkish
immigrants in Canada, proactive coping was negatively related to general
depressive symptom severity, beyond the effects of optimism, gender, mar-
ital status, and education. Similarly, among senior citizens proactive coping
was negatively associated with general depression symptoms in a struc-
tural equation model (Greenglass, Fiksenbaum, & Eaton, 2006). This is in
line with research suggesting that variables related to proactive coping,
such as proactive behavior and optimism, could be related to decreased
 Proactive Coping, Gratitude, and Psychopathology 117

general depression symptom severity during stressful circumstances (Carver

et al., 1993; Ironson et al., 2005). Associations between proactive coping and
depression symptoms have not been examined in a college sample or in a
traumatized sample.

GRATITUDE AND TRAUMA-RELATED PSYCHOPATHOLOGY

Another potential buffer against the debilitating effects of trauma might be

positive emotion, particularly gratitude. Gratitude can be defined as “the
emotional response stemming from the recognition and/or appreciation of
the receipt of a benefit” (Vernon et al., 2009, p. 118). Gratitude can be
examined as a trait variable, which is a dispositional tendency toward expe-
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riencing gratitude. A person high in trait gratitude might experience gratitude

in a greater range of situations, at a higher intensity, for longer durations,
or more easily than those with low trait gratitude (McCullough, Emmons, &
Tsang, 2002). Gratitude can also be examined as a state variable, which is an
emotional reaction at a specific point in time, such as during or immediately
following a trauma or during the current hour, day, or week (e.g., Vernon
et al., 2009).
To date, two studies of PTSD point to the potential protective effects
of state and trait gratitude following trauma. Vernon et al. (2009) exam-
ined state gratitude in the hours and days after trauma, which they referred
to as posttrauma gratitude. They found that women who retrospectively
reported experiencing greater posttrauma state gratitude endorsed fewer
current PTSD symptoms, even when controlling for proactive coping style,
trauma severity, time since the trauma, and trauma history. Similarly, in a
between-subjects comparison with male Vietnam War veterans, Kashdan,
Uswatte, and Julian (2006) found that those without PTSD reported more
trait gratitude than did those with PTSD.
In addition several studies have found evidence that state and trait
gratitude might be negatively related to general measures of depression
symptoms. For example, trait gratitude might be part of an adaptive response
to stressful life transition; Wood, Maltby, Gillett, Linley, and Joseph (2008)
found that high trait gratitude scores at the beginning of the first semester of
college were predictive of lower levels of general depression symptoms at
the semester’s end. Further, the experience of positive emotions, including
state gratitude, among college students was negatively related to general
depression symptoms following the September 11, 2001 terrorist attacks
(Frederickson, Tugade, Waugh, & Larkin, 2003).
Each of these studies examined gratitude in a different way: as a
posttrauma state response, as a trait, and as part of a broader positive affec-
tive response. The convergence of findings suggests the potential benefits of
various kinds of gratitude in recovery from trauma and other negative events.
 118 L. L. Vernon

EXAMINING THE SPECIFICITY OF ASSOCIATIONS OF PROACTIVE

COPING AND POSTTRAUMA GRATITUDE WITH TRAUMA-RELATED
PSYCHOPATHOLOGY

Given previous findings of relationships between PTSD symptoms and

proactive coping and posttrauma gratitude (Vernon et al., 2009), one might
also expect proactive coping and posttrauma gratitude to be related to other
emotional disorders given their shared nonspecific factor of general distress
symptoms (or what has also been referred to as PTSD’s dysphoria symptom
cluster). It would be especially useful, however, to examine the specificity
of emotional disorder associations with proactive coping and posttrauma
gratitude, separate from the contributions of the shared distress factor. For
this reason, this study examines PTSD and two distinct emotional disor-
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der symptom clusters, anhedonic depression and anxious arousal, and their
associations with proactive coping and posttrauma state gratitude. Neither
anhedonic depression nor anxious arousal has been examined in relation to
proactive coping or posttrauma state gratitude.

GENDER DIFFERENCES IN TRAUMA-RELATED VARIABLES

A better understanding of the influence of gender in trauma recovery seems

important in light of findings suggesting gender differences in key peritrau-
matic and posttraumatic variables (see Olff, Langeland, Draijer, & Gersons,
2007, for a review). For example, although men generally report a larger
number of traumas and more severe, life-threatening traumas, it is women
who typically report more severe PTSD symptoms (e.g., Breslau, Davis,
Andreski, Peterson, & Schultz, 1997; Breslau et al., 1998; Lauterbach &
Vrana, 2001). Speculations about the reason for this gender discrepancy have
included gender differences in coping after trauma (Olff et al., 2007).
Despite the fact that women appear more at risk for some negative
outcomes following trauma, women are also more likely than men to report
benefits from trauma (Tedeschi & Calhoun, 1996). Gender has not been
previously examined in posttrauma state gratitude; however, there is some
evidence that women report stronger trait gratitude (Wood, Maltby, Stewart,
& Joseph, 2008), which might lead one to expect stronger posttrauma state
gratitude reported by women.
Gender differences have not previously been found in the other
psychopathology and coping variables of interest in this study. Although
women tend to report higher scores on general measures of depression
that encompass nonspecific factors related to both anxiety and depression,
no such difference has been found for anhedonic depression or anxious
arousal among college students (Watson, Weber, et al., 1995). Further, no
gender difference has been found in previous studies using the proactive
coping scale (Greenglass, 2002).
 Proactive Coping, Gratitude, and Psychopathology 119

GOALS AND HYPOTHESES

The primary goal of this study was to examine associations of proactive

coping and posttrauma state gratitude with emotional disorder symptoms in
a high-functioning sample including both genders and a range of trauma
types. Although anhedonic depression and anxious arousal have not been
examined in relation to proactive coping or posttrauma state gratitude,
following preliminary findings suggesting negative relationships between
emotional disorder symptoms and proactive coping (Greenglass et al., 2006;
Uskul & Greenglass, 2005; Vernon et al., 2009), it was hypothesized that
proactive coping would be related to lower PTSD and anhedonic depres-
sion symptoms. Further, consistent with previous findings about the benefits
of posttrauma state gratitude and trait gratitude (Frederickson et al., 2003;
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Kashdan, Uswatte, & Julian, 2006; Vernon et al., 2009), posttrauma state grat-
itude was expected to be negatively related to PTSD and anhedonic depres-
sion. Further, proactive coping and posttrauma state gratitude were each
expected to be uniquely associated with variance in PTSD and anhedonic
depression scores, following Vernon et al.’s (2009) findings solely with PTSD.
In contrast, as an index of physiological arousal symptoms, anxious arousal
was not expected to be related to proactive coping or posttrauma state grat-
itude. Both PTSD and anxious arousal symptom severity were predicted to
be positively related to trauma history, severity, and recency, in line with
similar previous findings (e.g., Lauterbach & Vrana, 2001).
A second goal was to examine gender differences among the variables.
Because women are more likely to report benefits from trauma (Tedeschi &
Calhoun, 1996) and to report stronger trait gratitude (Wood, Maltby, Stewart,
et al., 2008), more self-reported posttrauma state gratitude was expected
among women than men. Further, given past findings (e.g., Breslau et al.,
1997; Breslau et al., 1998; Lauterbach & Vrana, 2001), it was expected that
women would report more severe PTSD symptoms whereas men would
report a larger number and more severe, life-threatening traumas. No gen-
der difference was expected for anhedonic depression or anxious arousal
given past findings (Watson, Weber, et al., 1995). Further, based on scores
previously obtained with the proactive coping scale (Greenglass, 2002), no
gender difference was hypothesized for proactive coping scores.

METHOD
Participants
Participants were 187 undergraduate students at universities in Alabama and
Florida who received extra credit in psychology courses for participation, all
of whom provided informed consent. The advertised purpose of the study
was an examination of life experiences and emotions. Those who reported
no trauma history (8 men, 10 women) were dropped from further analyses,
 120 L. L. Vernon

leaving a final sample of 86 (50.9%) men and 83 (49.1%) women between

the ages of 17 and 35 (M = 20.70, SD = 2.54). The majority of participants
(80.5%) indicated their primary race or ethnicity as White or Caucasian, 9.5%
indicated Black or African American, 3.0% indicated Asian American, 3.0%
indicated Hispanic, and 4.2% indicated a multiracial ethnicity. On average,
participants had completed 2.5 years of college.

Procedure
Participants were tested in small groups. Packets contained one of four semi-
randomized questionnaire sequences, with the trauma history questionnaire
administered at a point prior to the PTSD and posttrauma gratitude mea-
sures because these were rated in relation to each participant’s worst event
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as identified on the trauma history questionnaire. All other questionnaires

were presented in a randomly generated order.

Measures
TRAUMA AND PTSD MEASURES

The Life Events Checklist (LEC; Blake et al., 1990) lists 17 potentially
traumatic events (e.g., physical assault, natural disaster) and participants
indicated whether they have experienced, witnessed, or learned about each.
Lifetime trauma history was computed as the total number of traumas par-
ticipants reported directly experiencing. For their self-identified worst event,
participants noted whether their own or someone else’s life was threatened,
which was used as an index of trauma severity, as well as the number
of months elapsed since the trauma. Current PTSD symptom severity was
assessed via the PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, &
Keane, 1993). Participants indicated on the PCL how bothered they had
been by each of 17 PTSD symptoms during the past month using a 5-point
scale ranging from 1 (not at all) to 5 (extremely). Previous examinations
have found the PCL to have strong internal consistency (α = .97), and high
test–retest reliability (.96; Weathers et al., 1993). The PCL also demonstrates
convergent validity with diagnoses established via interview (Blanchard,
Jones-Alexander, Buckley, & Forneris, 1996) and other PTSD questionnaires
(Ruggiero, Del Ben, Scotti, & Rabalais, 2003). Internal consistency in the
present sample was strong (α = .89).

ANHEDONIC DEPRESSION AND ANXIOUS AROUSAL MEASURE

We measured two distinct, independent aspects of emotional disorders,

anxious arousal and anhedonic depression (Clark, Watson, & Mineka,
1994; Nitschke, Heller, Imig, McDonald, & Miller, 2001) using the Mood
 Proactive Coping, Gratitude, and Psychopathology 121

and Anxiety Symptom Questionnaire (MASQ; Watson & Clark, 1991). The
17 items of the anxious arousal subscale describe symptoms of hyperarousal
specific to anxiety, whereas the 22-item anhedonic depression subscale
describes symptoms of low positive affect specific to depression. Participants
rated each item on a 5-point scale ranging from 1 (not at all) to 5 (extremely).
The MASQ anhedonic depression subscale was used rather than other gen-
eral measures of depression, which have been demonstrated to include
nonspecific factors related to both depression and anxiety (Watson, Clark,
et al., 1995). The MASQ subscales have demonstrated validity, with moder-
ate correlations of the anhedonic depression subscale reported with more
general measures of depression such as the Beck Depression Inventory and
correlations of the anxious arousal subscale with the Beck Anxiety Inventory
(Watson, Clark, et al., 1995). Both subscales have been found to have high
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internal consistency and good test–retest reliability (Watson & Clark, 1991;
Watson, Clark, et al., 1995). In this sample, internal consistency was high for
the anhedonic depression subscale (α = .93) and for the anxious arousal
subscale (α = .86).

POSTTRAUMA STATE GRATITUDE AND PROACTIVE COPING MEASURES

Participants rated the four-item posttrauma state gratitude scale (Vernon

et al., 2009) using a 5-point scale ranging from 1 (very slightly or not at
all) to 5 (extremely). Ratings were made based on general feelings of state
gratitude (“fortunate,” “grateful,” “appreciate life,” and “relieved”) during the
hours and days immediately following the trauma. The posttrauma state
gratitude scale had moderately strong internal consistency in this sample
(α = .83). On a 4-point scale ranging from 1 (not at all true) to 4 (exactly
true), participants rated items from the 14-item proactive coping subscale
of the Proactive Coping Inventory (Greenglass, 2002; Greenglass et al.,
1999). The validity of the proactive coping subscale is suggested by its
positive associations with scores on measures of active coping, optimism,
life satisfaction, control, and achievement (Greenglass, 2002; Schwarzer &
Taubert, 2002; Uskul & Greenglass, 2005). Previously reported internal con-
sistency for the proactive coping subscale has been fairly strong, ranging
from α = .79 to .85 (Greenglass et al., 1999). Internal consistency for the
proactive coping subscale in this sample was α = .81.

RESULTS
Descriptive Statistics
Consistent with previous college samples (Lauterbach & Vrana, 2001;
Ruggiero et al., 2003; Vernon et al., 2009), 90.4% (n = 169) of the sample
here reported directly experiencing one to ten lifetime events of a potentially
 122 L. L. Vernon

TABLE 1 Descriptive Statistics for Primary Variables

Mena Womenb Both gendersc

Range of
Measures M SD M SD F(1, 168) M SD responses

Total PTSD symptoms 29.29 11.64 31.26 10.21 3.10† 29.75 11.03 17–64
Anhedonic 53.92 13.82 52.60 15.26 0.25 53.25 14.52 25–94
depression
symptoms
Anxious arousal 24.90 7.93 25.11 7.83 0.02 25.01 7.85 17–64
symptoms
Proactive coping 43.65 5.61 43.89 5.74 0.08 43.77 5.66 26–54
Posttrauma gratitude 11.28 4.68 11.10 5.42 0.06 11.19 5.05 4–20
Number of lifetime 3.56 1.96 3.26 1.67 1.15 3.41 1.83 1–10
traumatic events
Trauma severity 1.73 .72 1.94 .79 3.08† 1.84 .76 1–3
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Time elapsed since 25.67 44.91 35.74 51.69 1.71 30.51 48.40 0–276
trauma
Note. PTSD = posttraumatic stress disorder. Trauma severity was scored as 1 = personal life threat,
2 = life threat to others, 3 = no life threat. Time elapsed is in months.
a
n = 86. b n = 83. c N = 169.
†
p < .08.

traumatic nature on the LEC (M = 3.4, SD = 1.8). The most frequently

reported event was motor vehicle accidents, reported by approximately
70.4% of the sample, followed by natural disasters, such as hurricanes,
reported by 68.6%. On average, the events occurred 2.5 years previously
(SD = 4.0, range = 0–23). For their worst trauma, a minority of participants
reported no life threat (21.8%), 38.2% reported threat to their own life, and
40.0% reported threat to someone else’s life.
Descriptive statistics for all measures are shown in Table 1. As would
be expected in a high-functioning sample, average PTSD symptom level was
rather low and only 12.4% of the sample scored above the suggested college
student PTSD cutoff score of 44 (Blanchard et al., 1996; Ruggiero et al., 2003)
and 6.5% scored above the stricter cutoff score of 50 (Weathers et al., 1993).
Both anhedonic depression and anxious arousal symptom severity were rel-
atively low, consistent with previous college samples (Watson, Weber, et al.,
1995). Proactive coping was fairly high and posttrauma gratitude intensity
was moderate, consistent with the sample of women described by Vernon
et al. (2009).

Gender Comparisons
It was hypothesized that women would report more severe PTSD symp-
toms and stronger posttrauma state gratitude, whereas men would report a
larger number and more severe, life-threatening traumas. No gender differ-
ence was expected for anhedonic depression, anxious arousal, or proactive
 Proactive Coping, Gratitude, and Psychopathology 123

coping scores. To compare scores on the primary variables by gender, a

2 (men, women) × 8 (PTSD symptom score, anxious arousal, anhedonic
depression, life threat, trauma recency, trauma history, proactive coping,
posttrauma gratitude) analysis of variance (ANOVA) was conducted. The
ANOVA results are shown in Table 1. As hypothesized, women tended
to report more overall PTSD symptom severity (p < .08) and there was
a trend for men to report more life threat (p < .08). Although men had been
expected to report a larger number of lifetime traumatic events, no gen-
der difference was found. Consistent with previous findings (Watson, Clark,
et al., 1995), men and women in this sample did not differ on anhedonic
depression or anxious arousal.
As expected given the results of Greenglass (2002), there was no gen-
der difference in proactive coping score. Contrary to predictions, men and
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women also did not differ in level of reported posttrauma state gratitude,
despite previous findings of women’s higher trait gratitude scores (Wood,
Maltby, Stewart, et al., 2008).

Comparing Proactive Coping and Gratitude

Proactive coping was distinct from posttrauma state gratitude in several ways.
First, the two were not correlated (r = .05, ns). Second, whereas proactive
coping was not related to any of the trauma variables, posttrauma gratitude
was negatively correlated with extent of life threat (r = –.41, p < .001), and
time since the trauma (r = –.21, p < .05). Neither proactive coping nor
posttrauma state gratitude was associated with lifetime trauma history.

Posttraumatic Stress Disorder, Anhedonic Depression, and Anxious

Arousal Symptom Analyses
In line with previous findings suggesting that PTSD and MDD were dis-
tinct but highly correlated (Grant et al., 2008) and that anxious arousal and
anhedonic depression are distinguishable (Watson, Weber, et al., 1995), the
three emotional disorder symptom measures were significantly positively
related, although not strongly so: PTSD and anhedonic depression (r = .38,
p < .001), PTSD and anxious arousal (r = .29, p < .01), and anhedonic
depression and anxious arousal (r = .26, p < .05).
Next, bivariate correlations between psychopathology symptom scores
and the trauma measures and the proactive coping and posttrauma state
gratitude scores were conducted, as shown in Table 2. It was hypothesized
that proactive coping and posttrauma state gratitude would be negatively
related to PTSD and anhedonic depression symptoms. Anxious arousal was
expected to be positively related to trauma history, severity, and recency, but
not significantly associated with proactive coping or posttrauma gratitude.
 124 L. L. Vernon

TABLE 2 Correlations between Emotional Disorder Symptoms and Trauma, Coping, and
Gratitude Variables

PTSD Anhedonic depression Anxious arousal

∗∗∗
Trauma history .30 .03 .19
Traumatic life threat −.004 .18† .17†
Time since trauma .13 .17 .10
Proactive coping −.22∗∗ −.55∗∗∗ −.13
Posttrauma gratitude −.18∗ −.02 .09
Note. PTSD = posttraumatic stress disorder.
†
p < .08. ∗ p < .05. ∗∗ p < .01. ∗∗∗ p < .001.

Each emotional disorder measure showed a distinct pattern of asso-

ciations. PTSD severity was negatively related to proactive coping and
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posttrauma state gratitude, as predicted. Also as expected, anhedonic

depression was negatively associated with proactive coping; however, con-
trary to expectations it was not significantly associated with posttrauma
state gratitude. Also consistent with hypotheses, anxious arousal was
associated with neither proactive coping nor posttrauma state gratitude.
As expected, trauma history was positively related to PTSD symptom sever-
ity, however, surprisingly, trauma recency and life threat were not. Trauma
history was the only variable with a trend for an association with anxious
arousal.
To examine the independence of associations of coping, emotion, and
trauma variables with emotional disorder symptom severity, three hier-
archical multiple regression analyses were conducted. PTSD, anhedonic
depression, and anxious arousal symptom severity were the dependent vari-
ables. The relevant trauma variable (that was correlated with the dependent
variable; trauma history for PTSD and anxious arousal, traumatic life threat
for anhedonic depression) and gender were entered in the first step, fol-
lowed by proactive coping and posttrauma state gratitude in the second
step. The regression results are shown in Table 3. The final regression mod-
els, which included proactive coping and posttrauma gratitude, accounted
for 19% of the variance in PTSD scores and 34% of the variance in anhedonic
depression scores. In contrast, the full model did not account for a significant
portion of the variance in anxious arousal scores.
It was hypothesized that proactive coping and posttrauma state grati-
tude would be independently related to PTSD and anhedonic depression,
but not to anxious arousal. Consistent with predictions, proactive coping
and posttrauma gratitude were independently negatively related to PTSD
symptom level beyond the effects of gender and trauma history, which were
positively related to PTSD. Further, proactive coping was uniquely negatively
associated with anhedonic depression severity, although posttrauma state
gratitude was not. In contrast, none of the variables tested were uniquely
associated with level of anxious arousal.
 Proactive Coping, Gratitude, and Psychopathology 125

TABLE 3 Hierarchical Multiple Regression Analyses Predicting Emotional Disorder Symptom

Severity

Dependent Variable Model Predictor B β t

PTSD 1 Trauma history 1.84 .31 4.10∗∗∗

Gender 3.63 .17 2.22∗
2 Trauma history 1.86 .31 4.33∗∗∗
Gender 3.66 .17 2.33∗
Proactive coping −.43 −.22 −3.10∗∗
Posttrauma gratitude −.35 −.16 −2.28∗
Anhedonic depression 1 Traumatic life threat −3.14 −.17 −1.54
Gender −.40 −.01 −.12
2 Traumatic life threat −2.85 −.15 −1.50
Gender −.86 −.03 −.32
Proactive coping −1.31 −.55 −6.00∗∗∗
Posttrauma gratitude −.20 −.07 −.67
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Anxious arousal 1 Trauma history .82 .20 1.80

Gender 3.67 .21 1.90
2 Trauma history .86 .21 1.86
Gender 3.65 .21 1.89
Proactive coping −.19 −.14 −1.29
Posttrauma gratitude .13 .07 .69
Note. PTSD = posttraumatic stress disorder. For PTSD, R2 = .11, p < .001 for Model 1 and R2 = .19,
p < .001, R 2 = .08, p < .01 for Model 2. For anhedonic depression, R2 = .03, ns for Model 1 and R 2 =
.34, p < .001, R 2 = .31, p < .001 for Model 2. For anxious arousal, R2 = .06, p < .08 for Model 1 and
R 2 = .09, ns, R 2 = .03, ns for Model 2. Gender variable coding: men = 0, women = 1.
∗
p < .05. ∗∗ p < .01. ∗∗∗ p < .001.

DISCUSSION

The results of this study provide further support for the potential impor-
tance of proactive coping and gratitude in trauma recovery. Following
Vernon et al.’s (2009) findings with women, this is the first study to
find that both men and women who report greater proactive coping and
posttrauma gratitude endorse less severe current PTSD symptoms. Further,
these relationships are independent of trauma history and gender, which
were related to PTSD symptom level in their own right, and have previously
been found to influence PTSD severity (e.g., Breslau et al., 1998). This is
also the first study to find that proactive coping was negatively related to
anhedonic depression in a high-functioning traumatized sample, indepen-
dent of the significant effects of trauma severity. Further, this study provides
evidence for the specificity of these effects. It is not the case that proactive
coping and posttrauma gratitude are negatively related to all emotional disor-
der symptoms. Anxious arousal was used as a discriminant symptom cluster
and was not significantly related to either proactive coping or posttrauma
gratitude.
The negative relationship of proactive coping with PTSD and anhedonic
depression symptom severity is consistent with the earlier findings of a
negative association between PTSD and proactive coping among women
 126 L. L. Vernon

(Vernon et al., 2009) and between a general measure of depression and

proactive coping among Turkish immigrants and elderly persons (Greenglass
et al., 2006; Uskul & Greenglass, 2005). It is also in line with findings of the
negative associations of psychopathology with some kinds of coping and
with related constructs such as optimism and hope (e.g., Ai, Evans-Campbell,
Santangelo, & Cascio, 2006). Perhaps the appraisal processes (situations per-
ceived as challenging vs. overwhelming) and behavioral orientations (active
vs. passive) associated with proactive coping are incompatible with those
related to the etiology and maintenance of PTSD and other emotional
disorders.
The negative association of proactive coping with PTSD and anhedonic
depression might be explained in terms of Hobfoll’s (1989) theory of
conservation of resources, which points to the harmful effects of trauma due
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to rapid loss of important personal, social, energy, and material resources

(e.g., Kaniasty & Norris, 1993). Individuals high in proactive coping might
be particularly resilient to such attacks on their resources, as they engage
in consistent strategic resource building. Further, the partnership of positive
cognitions and behaviors represented by proactive coping is likely similar
to action growth described by Hobfoll et al. (2007) following trauma. Future
research should explore the links between action growth and proactive
coping.
Posttrauma state gratitude also appears to be beneficial for recovery, as
it is associated with fewer and less severe PTSD symptoms in this mixed-
gender sample and the women examined by Vernon et al. (2009). As with
proactive coping, one possible explanation for the negative relationship
between posttrauma gratitude and PTSD severity might be incompatible
appraisal processes. It could be the case that those individuals who are grate-
ful are focused on the benefits of the trauma and are relatively less focused
on its negative aspects. For example, Wood, Joseph, and Linley (2007) found
that trait gratitude is negatively related to self-blame. Taken together with
Kashdan, Uswatte, and Julian’s (2006) findings suggesting potential benefi-
cial effects of trait gratitude for male veterans, it appears that under certain
conditions both state and trait gratitude can characterize resilience.
The actual relationship between state and trait gratitude and PTSD
severity is likely far from simple. For example, state posttrauma grati-
tude might be part of a relieved response to a trauma with relatively
less life threat. Life threat and posttrauma state gratitude were significantly
negatively related in this study. Further, recollections of state posttrauma
gratitude might be inflated as trauma recovery progresses, as might be
inferred from the negative association between trauma recency and retro-
spectively reported posttrauma gratitude in this sample. Kashdan, Uswatte,
Steger, and Julian (2006) examined current state gratitude longitudinally and
found that the efficacy of state gratitude as a potential protective factor can
be compromised by fluctuations in its experience, which appear to occur
 Proactive Coping, Gratitude, and Psychopathology 127

disproportionately among male veterans with PTSD relative to those without

the disorder. Future longitudinal research will need to establish the course
and correlates of posttrauma gratitude and those conditions under which it
is important, both in terms of its benefits and its limits, for various trauma
populations.
The results of this study also provide some evidence for the specificity
of the effects of proactive coping and state gratitude following trauma. Not
surprisingly, those individuals with more extensive trauma histories gen-
erally reported more severe anxious arousal symptoms. However, anxious
arousal severity was not related to trauma recency or severity and, most
relevant to the primary hypotheses of this study, it was not associated with
either proactive coping or posttrauma gratitude. Furthermore, posttrauma
gratitude was not independently related to anhedonic depression. Thus, it
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is not the case that all emotional disorder symptoms are broadly negatively
associated with proactive coping and posttrauma state gratitude, but instead
that proactive coping and posttrauma gratitude appear to be beneficial for
specific emotional disorder symptoms.
It is interesting to note that in this investigation, men and women both
appear to benefit from proactive coping and posttrauma gratitude, and that
they engage in each to a similar degree. Gender did not greatly compli-
cate the picture in this study, as men and women reported similar levels
of posttrauma gratitude and proactive coping, and relatively few gender
differences were reported on trauma and psychopathology variables. Men
generally reported greater trauma life threat, but trauma recency and num-
ber of lifetime traumas were similar for the genders. The women in this
sample reported somewhat greater PTSD symptom severity, in line with past
research (e.g., Breslau et al., 1998), but there were no gender differences in
anhedonic depression and anxious arousal, as has been reported elsewhere
(Watson, Weber, et al., 1995).
Interpretation of these results should be made with appropriate cau-
tion given the study’s limitations, including potential biases introduced by
retrospective reports and the correlational nature of the findings. Future lon-
gitudinal examinations will be especially important for establishing whether
proactive coping and posttrauma state gratitude play a causal role in positive
recovery from trauma or are merely by-products of the recovery process.
This investigation utilized a brief self-report measure of state posttrauma
gratitude. Future research should perform more in-depth assessments of
posttrauma gratitude, perhaps including an examination of those cognitions
and behaviors characteristic of posttrauma gratitude. Future directions might
also include an investigation of whether specific types of trauma or trauma
characteristics are associated with posttrauma gratitude. It would also be
interesting to explore relationships among various measures of state and
trait gratitude. For example, to what extent is posttrauma gratitude associated
with trait gratitude?
 128 L. L. Vernon

This study provides support for the potential value of proactive coping
and posttrauma gratitude for men and women recovering from trauma. It is
a question for future research whether proactive coping can be taught and
posttrauma gratitude can be encouraged to improve posttrauma outcomes.

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