Pathways to posttraumatic growth versus posttraumatic stress: coping and emotional reactions following the September 11, 2001, terrorist attacks.

Exposure to trauma can lead to both posttraumatic growth and posttraumatic stress, but little is known about the commonalities and differences in the pathways through which they occur. The authors examined coping and emotional reactions as mediators of the effect of television exposure on both posttraumatic growth and posttraumatic stress in a nationally representative sample of 1,004 U.S. adults approximately 6 weeks after the September 11, 2001, terrorist attacks. Although posttraumatic growth and posttraumatic stress symptoms were moderately positively related, the pathways from coping and emotions to the outcomes differed: Positive coping and anger were more strongly related to posttraumatic growth than to posttraumatic stress, and pathways of negative coping and feeling depressed regarding the attacks were more strongly related to stress than to growth. Comparison of models suggested that emotions are both outcomes of and motivators for coping and that patterns of coping and emotions relate differentially to posttraumatic stress and posttraumatic growth.