George A Bonanno

George A Bonanno
Teachers College · Department of Counseling and Clinical Psychology

Ph.D.

About

279
Publications
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Introduction
Skills and Expertise

Publications

Publications (279)
Article
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Background: Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are two highly comorbid psychological outcomes commonly studied in the context of stress and potential trauma. In Hubei, China, of which Wuhan is the capital, residents experienced unprecedented stringent lockdowns in the early months of 2020 when COVID-19 was fir...
Preprint
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The COVID-19 pandemic is a significant stressor potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to ad...
Article
Full-text available
Background Adverse childhood experiences (ACEs) serve as a risk factor for developing posttraumatic stress disorder (PTSD) in those who experience additional adult trauma. However, while some individuals with ACEs develop severe PTSD symptoms following exposure to additional adult trauma, others do not. We propose that updating prior knowledge in t...
Article
This study aims to examine the ability to flexibly enhance and suppress emotional expression, known as expressive flexibility, in relation to physical and psychological health, as well as trait emotional intelligence (EI). A sample of 503 Italian (Mage = 28.65 ± 9.26 years, 85.1% females) participants completed the Italian version of Flexible Regul...
Article
Heterogeneity in the course of posttraumatic stress symptoms (PTSS) following a major life trauma such as childhood sexual abuse (CSA) can be attributed to numerous contextual factors, psychosocial risk, and family/peer support. The present study investigates a comprehensive set of baseline psychosocial risk and protective factors including online...
Article
Flexible self-regulation has been shown to be an adaptive ability. This study adapted and validated the adult Flexible Regulation of Emotional Expression (FREE) Scale for use with youth (FREE-Y) in community and maltreatment samples. The FREE-Y measures the ability to flexibly enhance and suppress emotion expression across an array of hypothetical...
Article
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Humans try to make sense of the world using hypotheses that were formed by prior experiences. After trauma, these hypotheses can be exaggerated and resistant to change. This may result in difficulties to update expectations regarding the negative outcomes associated with traumatic stimuli. Critically, it has been proposed that such difficulties may...
Article
Full-text available
In Hubei, China, where the coronavirus disease (COVID-19) epidemic first emerged, the government has enforced strict quarantine and lockdown measures. Longitudinal studies suggest that the impact of adverse events on psychological adjustment is highly heterogenous. To better understand protective and risk factors that predict longitudinal psychopat...
Article
The loss of a loved one is a potentially traumatic event that can result in disparate outcomes and symptom patterns. Machine learning methods offer computational tools to probe this heterogeneity and understand grief psychopathology in its complexity. In this article, we examine the latest contributions to the scientific study of bereavement reacti...
Article
Prolonged grief (PG) is a potentially debilitating consequence of bereavement. Previous studies have associated PG severity with relative deficits in key future-oriented cognitive processes, including the discounting of future rewards. Individual differences in the rate at which one devalues the future have been associated with a range of important...
Preprint
Full-text available
In Hubei, China, where the COVID-19 epidemic first emerged, the government has enforced strict quarantine and lockdown measures. Longitudinal studies suggest that the impact of adverse events on psychological adjustment is highly heterogenous. To better understand protective and risk factors that predict longitudinal psychopathology and resilience...
Article
Full-text available
Child sexual abuse (CSA) is associated with revictimization and sexual risk-taking behaviours. The Internet has increased the opportunities for teens to access sexually explicit imagery and has provided new avenues for victimization and exploitation. Online URL activity and offline psychosocial factors were assessed for 460 females aged 12–16 (CSA...
Preprint
Full-text available
Adverse childhood experiences (ACEs) serve as a risk factor for developing posttraumatic stress disorder (PTSD) for those who experience additional adult trauma. However, while some individuals with ACEs develop severe PTSD symptoms following exposure to additional adult trauma, others do not. We propose that updating prior knowledge in the face of...
Article
Objective The current study examined trajectories of anxiety and depression symptoms at three-time points during the COVID-19 pandemic and examined correlates of those trajectories. Design Data were collected at three time points during the COVID-19 pandemic. Participants The sample in the current study consisted of 804 respondents who had comple...
Preprint
Full-text available
Humans try to make sense of the world using hypotheses that were formed by prior experiences. After trauma, these hypotheses can be exaggerated and resistant to change. This may result in difficulties to update expectations regarding the negative outcomes associated with traumatic stimuli. Critically, it has been proposed that such difficulties may...
Article
Full-text available
Decades of research have consistently shown that the most common outcome following potential trauma is a stable trajectory of healthy functioning, or resilience. However, attempts to predict resilience reveal a paradox: the correlates of resilient outcomes are generally so modest that it is not possible accurately identify who will be resilient to...
Article
Importance Major life stressors, such as loss and trauma, increase the risk of depression. It is known that individuals show heterogeneous trajectories of depressive symptoms following major life stressors, including chronic depression, recovery, and resilience. Although common genetic variation has been associated with depression risk, genomic fac...
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A vignette approach was adopted to investigate flexibility of sustaining daily routines and whether and how this ability was related to mental health at different levels of financial strain. Three separate studies were conducted with community-dwelling adults (N = 1685) in the USA. In Study 1, we drafted, tested, and modified vignettes with referen...
Article
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There has been a marked increase of network studies of Major Depressive Disorder (MDD). Despite rapidly growing contributions, their findings have yet to be systematically aggregated and examined. We therefore conducted a systematic review of depression network studies using PRISMA guidelines. A total of 254 clinical and population studies were col...
Preprint
There has been a marked increase of network studies of Major Depressive Disorder (MDD). Despite rapidly growing contributions, their findings have yet to be systematically aggregated and examined. We therefore conducted a systematic review of depression network studies using PRISMA guidelines. A total of 254 clinical and population studies were col...
Article
Emotion regulation flexibility has been conceptualized as a multi-componential construct that consists of context sensitivity, repertoire, and feedback responsiveness. Although individuals with greater abilities in each component show better psychological adjustment, the patterns of these components remain unknown. In two cross-sectional Mturk stud...
Article
Autonomic arousal may facilitate beneficial decision-making when the link between choices and outcomes is uncertain. However, it is unknown whether greater risk-specific autonomic arousal is linearly associated with faster learning to avoid risky decisions. Furthermore, although the influence of stress on decision-making is well documented, it is u...
Article
Background The ability to flexibly enhance and suppress emotional expressions plays an important role in emotion regulation and the fostering of social connections. Deficits in expressive flexibility have been linked with posttraumatic stress disorder and prolonged grief reactions. Previous studies have suggested that the ability to respond flexibl...
Article
Introduction: In the current study, we assessed self-reported and behavioral measures of support provided to others and examined their longitudinal relationship to grief and depression symptoms. Methods: Hierarchical regressions that controlled for initial grief symptoms and support received from others indicated that providing support to others du...
Article
In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in respo...
Article
Background Visual and auditory signs of patient functioning have long been used for clinical diagnosis, treatment selection, and prognosis. Direct measurement and quantification of these signals can aim to improve the consistency, sensitivity, and scalability of clinical assessment. Currently, we investigate if machine learning-based computer visio...
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Servicemen are exposed to high levels of stress as part of their daily routine, however, studies which tested the relationship between stress and clinical symptoms reached inconsistent results. The present study examines the role of expressive flexibility, which was determined according to the ability to enhance or suppress either negative or posit...
Article
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Annually, approximately 30 million patients are discharged from the emergency department (ED) after a traumatic event1. These patients are at substantial psychiatric risk, with approximately 10–20% developing one or more disorders, including anxiety, depression or post-traumatic stress disorder (PTSD)2–4. At present, no accurate method exists to pr...
Article
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Amid the global outbreak of COVID-19, resilience is likely to be one of the many possible outcomes.Studies pertaining to resilience following potentially traumatic events including disease outbreak haveshown that the vast majority of individuals are resilient, and that outcomes depend on a combination ofresilience factors including exposure severit...
Article
The habitual use of expressive suppression (suppression frequency) is consistently associated with a number of negative outcomes, but paradoxically, the ability to suppress when there is a situational need (suppression ability) is usually linked to positive outcomes. The two sides of the paradox, suppression frequency and suppression ability, have...
Article
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Monitoring and deciding how to adjust an active regulatory strategy in order to maximize adaptive outcomes is an integral element of emotion regulation, yet existing evidence remains scarce. Filling this gap, the present study examined core factors that determine behavioral regulatory monitoring decisions and the neuro-affective consequences of the...
Article
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Background: There are a growing number of forced migrants worldwide. Early detection of poor adjustment and interventions to facilitate positive adaptation within these communities is a critical global public health priority. A growing literature points to challenges within the post-migration context as key determents of poor mental health. Aims: T...
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Background Diagnostic criteria for prolonged grief have appeared in the Diagnostic and Statistical Manual of Mental Disorders ( DSM‐5; persistent complex bereavement disorder, PCBD) and in the ICD‐11 (prolonged grief disorder, PGD), and the question of which diagnosis is most clinically useful has been hotly debated. This study provides the first l...
Article
A growing body of research has examined regulatory flexibility as the ability to dynamically modulate emotional expression and experience (Bonanno & Burton, 2013). The late positive potential (LPP), an event-related potential reflecting processing of emotionally-evocative stimuli, is sensitive to emotion regulation (ER) or the psychological process...
Article
Introduction: Previous research has demonstrated that different forms of mental health trajectories can be observed in service members, and that these trajectories are related to combat. However, limited research has examined this phenomenon in relation to physical health. This study aims to determine how combat exposure relates to trajectories of...
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Evidence suggests that mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) experience elevated rates of psychological symptoms. However, previous studies of this population have been mainly cross-sectional and have focused on very preterm infants. Although moderate- to late-preterm infants generally thrive, the possible psych...
Article
The ability to accurately perceive cues to contextual demands across different situations has been identified as a crucial component of successful self-regulation. However, previous attempts to measure context sensitivity have suffered from serious methodological limitations, most notably the possibility that respondents may not possess sufficient...
Article
Objective: Adjustment to chronic disability is a topic of considerable focus in the rehabilitation sciences and constitutes an important public health problem given the adverse outcomes associated with maladjustment. While existing literature has established an association between disability onset and elevated rates of depression, resilience and a...
Article
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An avoidant grief style is marked by repeated and often unsuccessful attempts to prevent thinking about loss. Prior work shows avoidant grief involves monitoring the external environment in order to avoid reminders of the loss. Here we sought to determine whether avoidant grievers also monitor the internal environment in attempts to minimize consci...
Article
Background: The intense loss processing that characterizes grieving may help people to adapt to the loss. However, empirical studies show that more conscious loss-related thinking and greater reactivity to reminders of the deceased correspond to poorer adaptation. These findings raise the possibility that loss processing that is unconscious rather...
Article
Background Complicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria...
Chapter
Human beings are resilient and defined by a capacity for psychological and functional adaptation in the face of potential trauma and adversity. We present an integrative temporal framework that conceptualizes resilience as a dynamic process that unfolds over time and consists of the following four key elements: (a) baseline or pre-adversity functio...
Article
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Objective To determine whether there were incremental mental health impacts, specifically on depression trajectories, as a result of the 2008 economic crisis (the Great Recession) and subsequent Hurricane Sandy. Method Using latent growth mixture modeling and the ORANJ BOWL dataset, we examined prospective trajectories of depression among older ad...
Article
The aim of the present study is to examine whether expressive flexibility (i.e., enhancement and suppression abilities) are associated with reduced psychopathology and increased life satisfaction. A total of 310 Chinese college participants completed the Chinese version of Flexible Regulation of Emotional Expression (FREE) Scale together with a bat...
Article
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Emotion mobilizes and demobilizes a social movement while the movement itself impacts people’s emotions. An evidence base is needed for developing timely emotion-focused counseling services for affected populations worldwide. This experience sampling study investigated the impact of social movement on everyday emotional reactivity, variability, ins...
Article
Although only a relatively small minority of military veterans develop Posttraumatic Stress Disorder (PTSD), mental health theory and research with military veterans has focused primarily on PTSD and its treatment. By contrast, many and by some accounts most veterans experience high levels of stress during the transition to civilian life, however t...
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p>Consistent failure over the past few decades to reduce the high prevalence of stress-related disorders has motivated a search for alternative research strategies. Resilience refers to the phenomenon of many people maintaining mental health despite exposure to psychological or physical adversity. Instead of aiming to understand the pathophysiology...
Article
Post-traumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies across individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and inability to account for com...
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Background Distinguishing temporal patterns of depressive symptoms during pregnancy and after childbirth has important clinical implications for diagnosis, treatment, and maternal and child outcomes. The primary aim of the present study was to distinguish patterns of chronically elevated levels of depressive symptoms v. trajectories that are either...
Article
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Sensitivity to emotional context is an emerging construct for characterizing adaptive or maladaptive emotion regulation, but few measurement approaches exist. The current study combined behavioral and neurocognitive measures to assess context sensitivity in relation to self-report measures of adaptive emotional flexibility and well-being. Sixty-six...
Article
Theory and research on emotion regulation have shifted from emphasizing the adaptiveness of specific strategies to flexible regulation. Studies on the modulation of emotional expression, or expressive flexibility (EF), have demonstrated a close link between flexibility and psychological adjustment. The present study extended this line of research t...
Article
Background Grieving individuals demonstrate attentional bias toward reminders of the deceased versus neutral stimuli. We sought to assess bias toward reminders of the deceased versus a living attachment figure and to evaluate similarities and differences in the neural correlates of deceased- and living-related attention. We also sought to identify...
Article
An emerging body of research on individuals exposed to trauma shows that the ability to flexibly employ different coping styles is associated with better adjustment. Specifically, individuals who use both “trauma-focused” (focusing on the experience and significance of a potentially traumatic event) and “forward-focused” (optimism, helping others,...
Article
Divorce is a common stressful event associated with both increased rates of depression and mortality. Given evidence of significant individual differences in depression following major life stressors, we examined if heterogeneous depression responses confer differential risk for mortality. Data from a population-based longitudinal study was utilize...
Article
The death of a loved one can trigger a range of emotional, behavioral, motivational and cognitive reactions collectively labeled as “grief.” There has been a recent resurgence of empirical interest in grief reactions, and there is now a general consensus that 7%-10% of bereaved individuals experience intense and chronic reactions termed Prolonged G...
Article
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Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD) following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone. Methods: Here we examined salivary cortisol responses...
Article
Job loss has been associated with the emergence of depression and subsequent long-term diminished labor market participation. In a sample of 500 adults who lost their jobs, trajectories of depression severity from four years before to four years after job loss were identified using Latent Growth Mixture Modeling. Rates of unemployment by trajectory...
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Objective: The impact of multiple major life stressors is hypothesized to reduce the probability of resilience and increase rates of mortality. However, this hypothesis lacks strong empirical support because of the lack of prospective evidence. This study investigated whether experiencing multiple major health events diminishes rates of resilience...
Article
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Background: Deceased-related thinking is central to grieving and potentially critical to processing of the loss. Self-report measurements might fail to capture important elements of deceased-related thinking and processing. Here, we used a machine learning approach applied to fMRI - known as neural decoding - to develop a measure of ongoing deceas...
Article
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Post-traumatic stress disorder (PTSD) is a serious mental illness that affects current and former military service members at a disproportionately higher rate than the civilian population. Prior studies have shown that PTSD symptoms follow multiple trajectories in civilians and military personnel. The current study examines whether the trajectories...
Article
The present study examines the factor structure of the Perceived Ability to Cope with Trauma (PACT) scale (Bonanno, Pat-Horenczyk, & Noll, 2011) in an Italian sample. The authors investigated whether the structure which emerged in the original scale is confirmed in a culturally different sample. Using data from a non-random sample of 450 Italian yo...
Article
This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy rangin...
Article
Background: A growing body of evidence suggests that the ability to flexibly express and suppress emotions ("expressive flexibility") supports successful adaptation to trauma and loss. However, studies have yet to examine whether individuals that meet criteria for posttraumatic stress disorder (PTSD) or depression exhibit alterations in expressive...
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The relation between resilience and mild traumatic brain injury (TBI) outcome has been theorized but empirical studies have been scarce. This systematic review aimed to describe the research in this area. Electronic databases (Medline, CINAHL, PsychINFO, SPORTdiscus, and PILOTS) were searched from inception to August 2015 for studies in which resil...
Article
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The intensive care unit (ICU) has been portrayed as psychologically stressful, with a growing body of research substantiating elevated rates of depression, posttraumatic stress disorder (PTSD), and other psychological disruptions in populations of critical care survivors. To explain these psychopathology elevations, some have proposed a direct effe...
Article
A large number of studies have identified trajectories of adjustment following acute and aversive life events. In these studies, a stable trajectory of positive health or resilience is almost always the modal outcome (Bonanno, 2004; Bonanno et al., 2011). Infurna and Luthar (2016, this issue) reported that they replicated findings from two early st...
Article
Particular emotion regulation (ER) strategies are beneficial in certain contexts, but little is known about the adaptiveness of switching strategies after implementing an initial strategy. Research and theory on regulatory flexibility suggest that people switch strategies dynamically and that internal states provide feedback indicating when switche...