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Coping Flexibility and Trauma:
The Perceived Ability to Cope With Trauma (PACT) Scale
George A. Bonanno
Columbia University Ruth Pat-Horenczyk
Hebrew University of Jerusalem
Jennie Noll
Cincinnati Children’s Hospital Medical Center, University of Cincinnati
Theories about coping with potential trauma have emphasized the importance of concerted focus on
processing the traumatic event. However, empirical evidence also suggests that it may be salubrious to
distract oneself, remain optimistic, and focus on moving past the event. These seemingly contradictory
perspectives are integrated in the concept of coping flexibility. This investigation reports the development
and validation of a brief questionnaire, the Perceived Ability to Cope With Trauma (PACT) scale, with
2 scales that measure the perceived ability to focus on processing the trauma (trauma focus) and to focus
on moving beyond the trauma (forward focus). In addition, we created a single flexibility score that
represented the ability to use both types of coping. Participants included an Israeli sample with potential
high trauma exposure and a sample of American college students. The factor structure of the PACT was
confirmed in both samples. Preliminary evidence was obtained for the PACT’s convergent, discriminant,
and incremental validity. Both the Forward Focus and Trauma Focus scales were independently
associated with better adjustment, and each scale independently moderated the impact of heightened
trauma exposure. Similarly, the combination of these scales into a single parsimonious flexibility score
also moderated trauma exposure. Limitations of and future research with the measure are considered.
Keywords: flexibility, coping, trauma, grief, resilience
During the normal course of their lives, most adults are con-
fronted with at least one and sometimes several highly aversive or
potentially traumatic events (PTEs; e.g., a violent or life-
threatening accident, assault, or natural disaster; Kessler, Sonnega,
Bromet, Hughes, & Nelson, 1995). The psychological reactions
that often accompany such extreme events can present a formida-
ble coping challenge. Historically, trauma theorists have empha-
sized the importance of coping with PTEs by effortful trauma
focus of the thoughts, images, and memories associated with the
event (e.g., Horowitz, 1986). Yet, a growing body of research has
also highlighted the salutary importance of behaviors that appear
to minimize trauma focus, such as optimism (Scheier, Carver, &
Bridges, 1994) or emotional avoidance (Bonanno, Keltner, Holen,
& Horowitz, 1995). These seemingly disparate literatures are
potentially integrated by a third perspective, adapted from the
general stress and coping literature (e.g., Lazarus & Folkman,
1984), that takes into account the variability in coping and adjust-
ment demands across different stressor events. According to this
perspective, resilience to trauma is fostered not by one particular
type of coping response but rather by the ability to flexibly engage
in different types of coping responses as needed across different
types of PTEs (Bonanno, 2004, 2005; Bonanno & Mancini, 2008).
Despite its potentially integrative usefulness, however, there has
been surprisingly little research on this broader conception of
coping flexibility in the context of PTEs. In this article, we report
on the development of a questionnaire measure designed to capture
competing coping abilities in the specific context of potential
trauma. Specifically, we report data from a sample of students
from Hebrew University in Jerusalem that had been recruited for
their likely high exposure to terrorist violence and a sample of
American college students. In both samples, we tested the scale’s
factor structure and its convergent and discriminant validity. In
addition, we used the high-exposure Israeli sample to test the
incremental validity of the individual scales and the single flexi-
bility score, as well as their ability to moderate the corrosive
effects of high trauma exposure.
Coping With Potential Trauma
One of the striking characteristics of PTEs is that they tend to
defy meaning (McFarlane & De Girolamo, 1996) and, in extreme
cases, can “shatter” normal assumptions about the self, the world,
and other people (Janoff-Bulman, 1992). Such emotionally jarring
events are not easily assimilated and integrated with other more
normative experiences (Janet, 1889; van der Kolk, 1996). It is not
surprising that a common thread running through theories of
psychological trauma is that recovery of normal functioning after
This article was published Online First February 14, 2011.
George A. Bonanno, Department of Pediatrics, Columbia University;
Ruth Pat-Horenczyk, Department of Pediatrics, Hebrew University of
Jerusalem; Jennie Noll, Cincinnati Children’s Hospital Medical Center,
University of Cincinnati.
Correspondence concerning this article should be addressed to George
A. Bonanno, Department of Counseling and Clinical Psychology, Teachers
College, Columbia University, 525 West 120th Street, Box 218, New York,
NY 10027. E-mail: gab38@columbia.edu
Psychological Trauma: Theory, Research, Practice, and Policy © 2011 American Psychological Association
2011, Vol. 3, No. 2, 117–129 1942-9681/11/$12.00 DOI: 10.1037/a0020921
117
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