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Anxiety, Stress, & Coping: An
International Journal
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Event centrality and posttraumatic
outcomes in the context of pervasive
violence: a study of teachers in El
Salvador
Ashli G. Rolanda, Joseph M. Curriera, Lisseth Rojas-Floresa & Sofia
Herreraa
a Department of Clinical Psychology, Graduate School of
Psychology, Fuller Theological Seminary, 180 N Oakland Avenue,
Pasadena, CA 91101, USA
Accepted author version posted online: 16 Aug 2013.Published
online: 16 Sep 2013.
To cite this article: Ashli G. Roland, Joseph M. Currier, Lisseth Rojas-Flores & Sofia Herrera (2014)
Event centrality and posttraumatic outcomes in the context of pervasive violence: a study of
teachers in El Salvador, Anxiety, Stress, & Coping: An International Journal, 27:3, 335-346, DOI:
10.1080/10615806.2013.835402
To link to this article: http://dx.doi.org/10.1080/10615806.2013.835402
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BRIEF REPORT
Event centrality and posttraumatic outcomes in the context of
pervasive violence: a study of teachers in El Salvador
Ashli G. Roland*, Joseph M. Currier, Lisseth Rojas-Flores and Sofia Herrera
Department of Clinical Psychology, Graduate School of Psychology, Fuller Theological Seminary,
180 N Oakland Avenue, Pasadena, CA 91101, USA
(Received 1 March 2013; accepted 2 August 2013)
It is well established that the importance assigned to a trauma can affect one’s
recovery and psychological health in numerous ways. Event centrality is an
increasingly popular construct that captures the tendency among survivors to
reevaluate and possibly accommodate their worldviews posttrauma. The centrality
given to trauma appears to serve as a “double-edged sword”in that this construct
might factor prominently in both posttraumatic stress disorder (PTSD) and posttrau-
matic growth (PTG). Focusing on 257 violence-exposed teachers from educational
departments throughout El Salvador, we examined whether the centrality assigned by
the teachers to stressful life events uniquely predicted both PTSD symptomatology
and PTG. Results revealed that event centrality was positively related to both PTSD
and PTG, even when controlling for demographic factors, violence exposure, and
depression. In addition, PTSD symptomatology and PTG were not associated with one
another in this sample. In summary, these findings support the role of event centrality
as a contributing factor for PTSD and PTG among persons exposed to pervasive
trauma.
Keywords: event centrality; posttraumatic stress disorder; posttraumatic growth;
trauma; community violence
Introduction
It has long been recognized that the importance one attributes to stress and trauma can
have a significant impact on posttraumatic adjustment. However, the topic of event
centrality has gained special empirical attention among behavioral scientists over recent
years (e.g., Berntsen & Rubin, 2006,2007; Berntsen, Rubin, & Siegler, 2011; Boals &
Schuettler, 2011; Brown, Antonius, Kramer, Root, & Hirst, 2010; Groleau, Calhoun,
Cann, & Tedeschi, 2012; Lancaster, Rodriguez, & Weston, 2011; Robinaugh & McNally,
2010,2011; Rubin, Boals, & Berntsen, 2008; Schuettler & Boals, 2011; Webb & Jobson,
2011). Although contemporary theories of posttraumatic stress disorder (PTSD) emphas-
ize the healing role of reconciling the reality of the trauma with one’s preexisting meaning
structures (for review, see Dalgleish, 2004), event centrality recognizes the possibility for
too much integration in this process. This construct attempts to capture the tendency
among many survivors to over-accommodate their personal meaning systems following
exposure to violence or other potentially traumatic events, thereby allowing the stressor to
*Corresponding author. Email: ashliroland@fuller.edu
Joseph M. Currier is now at the University of South Alabama.
Anxiety, Stress, & Coping, 2014
Vol. 27, No. 3, 335–346, http://dx.doi.org/10.1080/10615806.2013.835402
© 2013 Taylor & Francis
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serve as a turning point in one’s life story, key feature of one’s sense of identity, or
reference point for structuring autobiographical memory. Berntsen and Rubin (2006,
2007) have also emphasized the revision of cherished beliefs/values in this integrative
process and described event centrality in terms of an enhanced memory of the stressful
event and source of meaning attribution of future experiences.
Drawing on a “landmark perspective”of trauma, these theorists have also asserted
that highly emotional and distinctive events might increase risk for PTSD and other
mental health problems if they remain too salient and serve as an organizing principle for
other benign events (Berntsen, 2001; Rubin & Kozin, 1984). Others have theorized that
aspects of event centrality might serve as a double-edged sword in many cases, and
similarly promote positive psychological outcomes such as posttraumatic growth (PTG)
via the survivor’s attempt to revise beliefs/values and reframe the stressor in a broader
context of meaning (Boals & Schuettler, 2011; Groleau et al., 2012; Schuettler & Boals,
2011; Tedeschi & Calhoun, 2004). However, research on the psychological consequences
of event centrality has largely relied upon undergraduate samples and focused on isolated
stressors that might not be viewed as being traumatic from a clinical standpoint. As such,
there is a need for additional research on event centrality with samples of persons
exposed to a greater severity of potentially traumatic events. In addition, there are also
questions regarding the applicability of event centrality across cultures as this construct is
yet to be applied in less developed countries where existential threat and trauma can be
pervasive for many individuals. This study attempted to advance the literature in this area
by examining the role of event centrality in PTSD symptomatology and PTG among a
group of teachers from El Salvador –a specific population who frequently must contend
with violence on many levels in their lives and work.
Violence in El Salvador
Despite being the smallest nation in Latin America, El Salvador has been regarded as one
of the most violent locales in the region (Chavez, 2004). The country has experienced
nearly a century of violence, with some sources tracing violence in rural areas as far back
as the colonial period (Kay, 2001). Other violent incidences include the peasant uprising
of 1932, infamously named La Matanza (“The Killing”) that claimed 20,000 to 40,000
lives, waves of conflict in the 1970s that were responsible for over 200,000 deaths, and
military violence and assassinations in the 1980s (Kay, 2001; Lopez-Reyes, 1997; Truth
Commission, 1992). The country also had a devastating civil war that formally ended in
1992, which was responsible for approximately 75,000 deaths. Over the past decade,
much of the community violence in El Salvador has been attributed to inadequate
reintegration of demobilized soldiers from the war and an increase in gang activity and
drug trafficking (Chavez, 2004; Kay, 2001; Lopez-Reyes, 1997; NACLA Report, 2009;
Richani, 2010). Factors contributing to this system of violence for the Salvadorian people
are complex and wide-ranging; poverty and under-employment, social exclusion/
inequality, and rapid urbanization have been key factors. Rates of violence have also
been exacerbated at points by policy changes in the USA that led to the precipitous
deportation of an estimated 43,000 Salvadorian immigrants with a criminal record in the
years after the civil war (Richani, 2010).
Given these concerns, teachers in El Salvador are not only vulnerable for direct
victimization common to all citizens but may also confront added challenges through their
profession. For example, they often focus on reducing the risk of violence and delinquency
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among troubled youth (Croninger & Lee, 2001; Garbarino, Dubrow, Kostelny, & Pardo,
1992; Springer, Parcel, Baumler, & Ross, 2006) and serve as advocates for social change
in violent communities (Watson, 1983). In acting as mentors to students and their families,
they are also likely to have indirect and vicarious exposure via witnessing the
consequences of violent events and hearing stories of their aftermath. In fact, initial
results from this sample revealed that these teachers had on average each experienced three
to four types of potentially traumatic events as adults, including a variety of war-related
stressors (e.g., witnessing fighting, injured people, and dead bodies), witnessing someone
commit suicide, being raped or sexually assaulted, stabbed or attacked with a knife, or
being in a life-threatening accident (Rojas-Flores et al., 2013). There is an established
positive relationship between violence exposure and PTSD symptomatology (i.e., Ozer &
Weinstein, 2004; Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993; Scarpa, Haden, &
Hurley, 2006). As one might anticipate, Rojas-Flores et al. (2013) also found that those
teachers with higher levels of direct violence exposure reported worse PTSD sympto-
matology. This study will expand on these findings by examining the contribution of event
centrality in teachers’posttraumatic adjustment while controlling for this already
established predictor of posttraumatic adjustment in the sample.
Event centrality and posttraumatic outcomes
Several studies have documented links between event centrality and PTSD symptoms
(Berntsen & Rubin, 2006,2007; Berntsen et al., 2011; Boals, Hayslip, Knowles, &
Banks, 2012; Boals & Schuettler, 2011; Brown et al., 2010; Groleau et al., 2012;
Lancaster et al., 2011; Robinaugh & McNally, 2010,2011; Rubin et al., 2008; Schuettler
& Boals, 2011; Webb & Jobson, 2011). For example, Robinaugh and McNally (2011)
investigated the relation between event centrality and PTSD in a sample of 102 female
survivors of childhood sexual abuse. When controlling for depression and several other
relevant factors, these researchers found that event centrality was uniquely linked with
greater PTSD symptoms in their sample. In another study with 46 combat veterans of the
Iraq and Afghanistan wars, Brown et al. (2010) similarly found that event centrality
predicted PTSD symptoms when controlling for depression. In general, the results of
these two studies align with research with college students on this topic and support the
relevance of the event centrality construct for trauma populations.
Other research also suggests that event centrality can figure prominently in survivors’
perceptions of PTG in the context of struggling with stress and trauma (Boals &
Schuettler, 2011; Groleau et al., 2012; Schuettler & Boals, 2011). In accordance with the
complex relationship between PTSD and PTG in general (for reviews, see Tedeschi &
Calhoun, 2004; Zoellner & Maercker, 2006), these studies assessed for both PTSD and
PTG and found that event centrality was a salient predictor of each outcome. For
example, in an undergraduate sample, Boals and Schuettler (2011) found that event
centrality was one of the strongest predictors of PTG when in the presence of several
relevant control variables. Groleau et al. (2012) also examined event centrality and PTG
in a sample of 187 undergraduate students. They found that event centrality was
positively related to PTG, after controlling for several well-established predictors of
growth as well. Findings such as these bring up complex questions about the nature of
PTG in coping with stress and trauma (Frazier et al., 2009; Zoellner & Maercker, 2006),
and how event centrality might factor into both distress and constructive life changes
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following exposure to stressful life events. To our knowledge, this is the first study to
address these questions using persons residing in Latin America with histories of
pervasive violence and potentially traumatic events.
Study aims and hypotheses
The present study attempted replication of the double-edged sword effect by examining
the link between event centrality and PTSD and PTG in a sample of Salvadorian teachers
from a range of educational contexts in the country. Based on available theory and
empirical evidence, we had these two main study hypotheses:
(1) When controlling for demographic factors, severity of violence exposure, and
depressive symptoms, event centrality will uniquely predict greater PTSD
symptomatology.
(2) When controlling for demographic factors, severity of violence exposure, and
depressive symptoms, event centrality will uniquely predict greater perceptions
of PTG.
Method
Participants and procedures
Following institutional approval, 257 teachers were recruited in March 2012 through
advertisements across the country from the Ministry of Education in El Salvador.
Participants completed a 45-minute survey prior to attending a free, psycho-educational
workshop on coping with trauma and stress led by the second author (J.M.C.). Teachers
were informed from the outset that they could attend the workshop even if they declined
to participate in the research study. Persons who attended the workshop were offered a
light meal and $7.00 to defer travel costs, regardless of their involvement in the study. Of
those teachers who attended the workshop, less than 5% declined to participate in this
study. This sample was largely composed of women (68.6%) and the average age was
42.02 years (SD = 13.12). Nearly half of the participants were married (45.2%), 32.4%
were single, 11.9% were separated or divorced, 8.5% were in committed relationships and
living with a partner, and 1.9% were widowed. The majority resided in urban areas in the
country, such as San Salvador (86.9%), and the majority worked in urban schools
(79.3%). Refer to Rojas-Flores et al. (2013) for additional details of the study.
Each participant completed a questionnaire assessing his/her demographic and
professional background, history of violence exposure, depressive symptoms, event
centrality, PTSD, and PTG. Spanish language versions of measures with established
psychometric properties were implemented to assess violence exposure, depression, and
PTSD symptom severity. Graduate research assistants in clinical psychology translated
measures of event centrality and PTG into Spanish for the current study. These measures
were then checked and revised by a Salvadorian psychologist and researcher (S.H.) to
examine whether the items were appropriate and if the language actually reflected the
regionalisms of El Salvador. As a final step, these two measures were then back-
translated into English to ensure that the original meaning and intent of the questions
remained intact. Contact the corresponding author (A.G.R.) for copies of the Spanish
versions of the measures used in this study.
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Measures
Violence exposure
Drawing on items implemented by Putman et al. (2009) in another study in Central
America, a variation of the Survey of Exposure to Community Violence (SECV; Richters
& Saltzman, 1990) was used to measure exposure to 22 common violence events in El
Salvador (e.g., being mugged/beaten up, sexually assaulted, shot at with a gun, physical
abuse, war-related stressors, earthquakes). Refer to Rojas-Flores et al. (2013) for more
details regarding the specific rates of violence exposure in the sample. Items were scored
dichotomously (0 = No, 1 = Yes; range = 0–22), and they were summed to represent
teachers’direct exposure to violence over adulthood (since age 18) as a control variable
for the statistical analyses.
Depressive symptoms
A four-item depression subscale of the Los Angeles Symptoms Checklist (LASC; King,
King, Leskin, & Foy, 1995) was used to measure depressive symptoms (e.g., easily
fatigued, suicidal ideation). Putman et al. (2009) had also successfully implemented these
items in Central America with indigenous individuals. Teachers reported how much of a
problem each symptom had been during the previous month with responses ranging from
0 = not a problem to 4 = an extreme problem (possible range = 0–16). Cronbach’s alpha
for the four depression items was 0.92 in the present study.
Event centrality
We translated the 7-item Centrality of Event Scale (CES; Berntsen & Rubin, 2006) into
Spanish for assessing the degree to which a specified stressor had become a central
organizing feature in the teachers’lives. Example items include “This event colored the
way I think and feel about other experiences”and “This event was a turning point in my
life.”Participants were asked to rate the extent to which they agreed or disagreed with
each statement, with responses ranging from 0 = strongly disagree to 4 = strongly agree
(possible range = 0–28). Participants completed the CES with respect to the most stressful
life event over the entirety of their life, which was used as the focal stressor for assessing
PTG as well. Among the teachers in this study, the top reported index stressors on the
CES included the death of a close family member (21.2%), surviving a natural disaster
(8.0%), domestic violence or sexual abuse (5.7%), being a victim of a crime (5.2%),
witnessing/surviving another type of violent event (4.7%), and major illness/injury of a
close family member (4.7%). Stressful events that would likely not be considered
traumatic in a diagnostic sense include separation/divorce (8.0%) and a variety of life
transitions (6.6%; e.g., beginning or ending formal education). Cronbach’s alpha for the
CES in the present study was 0.91.
Posttraumatic stress symptomatology
We utilized a 17-item subscale assessing PTSD symptomatology from the LASC (King
et al., 1995). This measure had also been implemented previously in Guatemala by
Putman et al. (2009). The measure assesses the three symptom domains of PTSD:
reexperiencing (three items; e.g., nightmares, intrusive memories), avoidance (six items;
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e.g., emotional numbness, avoidance of reminders of the event), and hyperarousal (eight
items; e.g., irritability, excessive jumpiness). Similar to the depression items from the
LASC, participants reported how much of a problem each symptom had been during the
past month. Responses ranged from 0 = not a problem to 4 = an extreme problem
(possible range = 0–68). So as to obtain as full a picture as possible of PTSD, we focused
on the overall score for study analyses. Cronbach’s alpha for this PTSD scale was 0.92 in
the present study.
PTG
The 10-item Posttraumatic Growth Inventory –Short Form (PTGI-SF; Tedeschi &
Calhoun, 1996) was translated to examine the occurrence of perceived positive changes
that resulted from teachers’efforts to cope with the same events identified for the CES.
Cann et al. (2010) found this condensed version of the PTGI to be equivalent to the
original instrument and reported alphas ranging from 0.86 to 0.89. The PTGI-SF included
items such as “I am able to do better things with my life”and “I discovered that I’m
stronger than I thought I was.”Participants were asked to rate the degree to which they
had experienced each positive change with responses ranging from 0 = I did not
experience this change at all to 5 = I experienced this change to a very great degree
(possible range = 0–50). Cronbach’s alpha was 0.93 in this study.
Results
Table 1 presents descriptive statistics and bivariate correlations between the study
variables. As expected, greater event centrality was associated with higher violence
exposure, depression, PTSD symptomatology, and PTG. Violence exposure was also
positively associated with PTSD symptomatology and depression, but was not linked
with PTG in these analyses.
We next conducted two hierarchical regressions to examine the effects of event
centrality on PTSD and PTG. For the first step in each analysis, age, gender, marital
status (married or unmarried), residence (rural or urban), violence exposure, and
depression were entered into the statistical model. For the second step, we entered
participants’scores on the CES. This analytic procedure allowed us to assess the degree
to which event centrality explained unique variance in the two posttraumatic outcomes
assessed in the study.
Table 1. Descriptive statistics and bivariate correlations between study variables.
Variables MSDRange 1 2 3 4 5
(1) Violence 3.39 2.67 0–12 –
(2) Depression 2.88 2.41 0–13 0.20** –
(3) Event centrality 14.53 7.53 0–28 0.16** 0.19** –
(4) PTSD 14.85 10.64 0–56 0.22*** 0.80*** 0.24*** –
(5) PTG 34.61 11.85 0–50 0.01 0.02 0.39*** 0.01 –
PTSD, posttraumatic stress disorder; PTG, posttraumatic growth.
*p< 0.05; **p< 0.01; ***p< 0.001.
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The first analysis focused on PTSD as the outcome. In Model 1, the entry of the
control variables yielded a statistically significant model, F(6, 247) = 73.37, p< 0.001,
which explained 64% of the variance (see Table 2). On the next step, the addition of event
centrality increased the explained variance in PTSD symptomatology in this sample,
ΔR
2
= 0.01, F
change
(1, 246) = 4.88, p= 0.028. Both depression, p< 0.001, and teachers
with higher event centrality scores, p= 0.028, were significantly related to PTSD in the
final model.
To assess the effects of event centrality on PTG, we followed the same two-step
hierarchical regression procedure (see Table 2). In Model 1, the six control variables did
not yield a statistically significant model, F(6, 247) = 1.37, p= 0.23. However, on the
next step, event centrality again increased the explained variance, ΔR
2
= 0.14, F
change
(1, 246) = 43.17, p< 0.001, and was the only significant predictor of PTG in the overall
regression equation.
Discussion
Event centrality has been gaining recognition as an important factor in psychological
adjustment to stress and trauma. There is an emerging consensus that survivors’attempts
to redefine their lives in terms of stressful life events can figure prominently in shaping
both mental health problems and constructive changes that can also emerge from
struggling with these events. However, much of this research focused on undergraduate
samples and the construct of event centrality is yet to be applied in Latin America (to our
knowledge). This study attempted to advance the literature by examining the contribution
of event centrality in PTSD symptoms and perceptions of PTG among teachers in El
Table 2. Results of multivariate regression analyses with event centrality predicting outcomes.
Posttraumatic stress Posttraumatic growth
BSEBβΔR
2
BSEBβΔR
2
Model 1 0.64*** 0.03
Age −0.00 0.00 −0.05 −0.02 0.01 −0.02
Gender −0.04 0.05 −0.03 −0.31 0.16 −0.12
Marital 0.00 0.05 0.00 −0.28 0.15 −0.12
Residence −0.04 0.07 0.02 −0.03 0.22 −0.01
Violence 0.26 0.17 0.06 0.12 0.53 0.01
Depression 0.81*** 0.04 0.78 −0.01 0.13 −0.00
Model 2 0.01*0.14***
Age −0.00 0.00 −0.04 0.00 0.01 0.02
Gender −0.03 0.05 −0.03 −0.29 0.15 −0.11
Marital 0.02 0.05 0.01 −0.16 0.14 −0.07
Residence −0.06 0.07 −0.03 −0.14 0.21 −0.04
Violence 0.22 0.17 0.05 −0.29 0.50 −0.04
Depression 0.79*** 0.04 0.77 −0.13 0.12 −0.07
Event Cent. 0.05*0.02 0.09 0.44*** 0.07 0.40
Note: Gender was coded such that 0 = female and 1 = male. Marital status was coded such that 0 = unmarried
and 1 = married. Violence = lifetime direct exposure to violence. Event Cent. = Event centrality as measured by
the CES.
*p< 0.05; **p< 0.01; ***p< 0.001.
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Salvador who had reported exposure to multiple potentially traumatic events during
adulthood (Rojas-Flores et al., 2013).
Our first hypothesis was supported; event centrality was uniquely related to PTSD
symptoms in the presence of control variables. This finding aligns with other research
(Berntsen & Rubin, 2006,2007; Berntsen et al., 2011; Boals et al., 2012; Boals &
Schuettler, 2011; Brown et al., 2010; Groleau et al., 2012; Lancaster et al., 2011;
Robinaugh & McNally, 2011; Rubin et al., 2008; Schuettler & Boals, 2011; Webb &
Jobson, 2011). In keeping with results for other trauma populations in particular (Brown
et al., 2010; Robinaugh & McNally, 2011), teachers in this study who had accommodated
their beliefs and identity in greater accordance with their identified stressors (as assessed
by the CES) indicated worse PTSD symptoms. Although the cross-sectional nature of this
study restricts causal inferences, this finding could suggest that allowing one’s identity to
become more influenced by a focal stressor could place survivors at risk for PTSD.
However, it might also suggest that those teachers who struggled with higher distress-
related sequelae might have been more preoccupied with the impact of the event, which
could contribute to more extensive accommodative processes related to coping with
stressors as well. Whatever the case, it certainly appears that those teachers who placed
stressful life events at the center of their identity were most susceptible to PTSD
symptomatology at the time of the study.
Our second hypothesis was also supported; event centrality was related to greater
PTG among the teachers in the presence of demographic factors, history of violence
exposure, and depressive symptoms. These results also accord with prior research (Boals
& Schuettler, 2011; Groleau et al., 2012; Schuettler & Boals, 2011). In particular, it
appears that those teachers in the sample who reframed their lives in light of the stressors
also reported higher perceived growth. Although we are again unable to make causal
statements due to methodological limitations, this finding could suggest that reevaluating
one’s belief/value system after a life stressor may lead to greater engagement with
growth-inducing processes and activities. In keeping with contemporary models of PTSD
(Dalgleish, 2004), Tedeschi and Calhoun (2004) suggest that PTG emerges from a crisis
in global meaning and subsequent attempts to reexamine/revise one’s assumptive
worldviews in light of the posttrauma reality. This pattern of results further supports
Boal and Schuettler’s(2011) notion of event centrality as a double-edged sword in again
highlighting the possibility that construing stress and trauma in these terms can contribute
to both debilitation and perceived personal growth in the adjustment process. However,
the strength of the association between event centrality and PTG was considerably greater
than for PTSD in this particular sample, which may indicate that this construct was a
better predictor of personal growth than possible trauma-related distress. As more
empirical knowledge is garnered on the double-edged sword effect, other researchers may
also do well to compare/contrast the effect sizes between event centrality and these
outcomes.
Although event centrality was significantly linked with both PTSD and PTG, it was
notable that these outcomes were again not related with one another. In addition, we
found positive associations between PTSD symptoms and both violence exposure and
depression, whereas PTG only correlated with event centrality among the variables
assessed in this study. Several explanations might be offered for this pattern of results.
For example, Schuettler and Boals (2011) suggest that there could be distinct pathways to
PTSD and PTG in the aftermath of stress and trauma. In addition, Groleau et al. (2012)
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suggest that although PTSD and PTG often coexist in these contexts, the lack of
consistent concurrent relations between these two outcomes might suggest their
uniqueness among many survivors. Although the same event might engender both
distress and processes that facilitate PTG, these results suggest that different factors are
likely involved for these two types of posttraumatic outcomes. Perhaps for the teachers in
this study, a helpful distinction could pertain to whether their identified stressors were
appraised in more of a negative or positive manner. If the events were viewed strictly
negatively, teachers would be in danger of constructing meanings that can impede
recovery (e.g., world is a completely unsafe, other people cannot be trusted). In contrast,
if the event had a centrally defining impact but was also viewed as an opportunity for
making constructive life changes, teachers might have been more likely to experience
PTG (e.g., greater appreciation of life, higher value on remaining relationships, and
deepened sense of spirituality).
The results of this study should be considered in conjunction with several notable
limitations. We have already noted reliance on a cross-sectional design. Second,
information was based on self-report assessments and it is unclear whether factors such
as social desirability or biases in retrospective recall may have affected results. For
example, diagnostic interviews are the gold standard for assessing PTSD and we might
have missed critical information by relying exclusively on self-report. There was also an
overrepresentation of women and teachers with more years of experience in this sample,
such that findings might not generalize as well to men and/or less experienced teachers.
The lack of random sampling over the full population of Salvadorian teachers also limits
our ability to make strong statements about this population or helping professionals in
Central America as a whole. Given that the current set of participants were self-selected
via a psycho-educational workshop on coping with stress and trauma, we also could have
had an overrepresentation of highly distressed or high functioning teachers. Future
research will do well to incorporate more sophisticated methods of assessing and
sampling from this important population.
In keeping with the notion that one’s subjective appraisal of stress and trauma can
frequently contribute to adjustment more than objective circumstance of the events (e.g.,
Boals & Schuettler, 2011), participants were able to complete the CES with respect to
stressors that they deemed to be the most distressing for them. As such, many of the
teachers who rated high levels of victimization on the violence assessment opted to
complete the CES with respect to other stressors that might not meet diagnostic
definitions of trauma. So as to reduce burden in the study questionnaire, we also did not
assess for time elapsed since these events. On a related note, assessment of PTG was
based on the teachers’perceptions of positive changes related to their identified stressors.
Consistent with suggestions that PTG can entail both constructive and illusory elements
(Zoellner & Maercker, 2006), Frazier et al. (2009) have distinguished between actual and
perceived growth, and demonstrated that retrospective assessments of PTG do not always
align with corresponding changes in individuals’beliefs and behaviors. Thus, it is
possible that the more severely distressed teachers had greater difficulty in discerning the
degree to which they had experienced and engaged in the positive changes assessed by
the PTGI. Future research on this topic might address these measurement concerns by
narrowing the foci to predetermined traumas for assessing event centrality and relying on
better ways to gauge actual growth in the aftermath of these stressors
Anxiety, Stress, & Coping 343
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Notwithstanding these limitations, the present study contributes to the field of stress
and trauma research in several ways. Of note, this study addresses the general research
gap regarding Central American samples and bolsters the limited research on event
centrality with trauma-exposed populations. This study is also the first to examine event
centrality and PTSD/PTG in a Latin American setting and among a population with
pervasive violence exposure. In general, study findings support the double-edged sword
effect and suggest the applicability of the event centrality construct across cultures and
with persons who may contend with greater severity of stress and trauma than often
studied to this point. It appears that event centrality factors prominently in both PTSD and
PTG, though there are likely other factors for these outcomes as well. It is hoped that this
study will prompt further research on this construct among other types of trauma
populations and help to inform mental health professionals to better support other helping
professionals who are living and working in violent communities around the world.
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