This thesis explores distress and reactions after crime by a previously unknown perpetrator in a two-year perspective. Distress was investigated at eight months and two years, using quantitative and qualitative methods. The specific aims of the thesis were (I) to explore the level of distress and the role of risk factors for post-traumatic and general symptoms eight months post crime, (II) to examine the natural course of adjustment at a two-year follow-up in female and male victims of interpersonal violence, III) to investigate the relationship between shame, guilt, and distress among 35 victims of a single severe violent crime, and (IV) to use qualitative analysis to describe individual post-crime trajectories. The following questionnaires were used: Symptom Check List 90 (Derogatis & Cleary, 1977), Harvard Trauma Questionnaire (Mollica et al., 1992), the Test for Self-Conscious Affect (Tagney et al., 1989). Data were also obtained via semi-structured interviews, including the use of visual analog scales for subjective mental health measures. The participants in paper I were male and female Swedish adult victims of reported interpersonal violence eight months earlier. Participants were between 18 and 66 years of age (n=41). At follow-up (Paper II) the sample size had decreased (n=35). In paper III, adult victims (aged 18-64) of reported interpersonal violence were assessed within two weeks of reported crime (n=35). In paper IV a subsample of 11 adult crime victims were drawn from among the participants from papers I and II. Paper I showed that women reported more distress than men. Prior trauma, adverse childhood, female sex, previous psychiatric history, and unemployment were all associated with more distress. Peritraumatic reactions (especially secondary emotions following cognitive appraisals after the event) predicted the three core PTSD symptoms and comorbid conditions, together with female sex and psychiatric history. Paper II confirmed most of the risk factors at eight months and that, in general, no further recovery took place between eight months and two years. Paper III showed that shame-proneness and event-related shame were highly intercorrelated and related to higher symptoms levels, while the guilt measures were unrelated to each other as well as to symptoms. Paper IV explored narratives of victimization; the results suggest that individual differences within the same trajectories of recovery should be expected.

This study aimed to examine the predictor variables of psychological distress and perceived growth among the survivors of motor vehicle accidents. Demographic characteristics as pre-accident variables, cognitive appraisals of the accident as accident related factors, coping strategies and social support as post-accident variables were used as predictors of distress and perceived growth. 200 adults (142 males and 58 females, ages between 18 and 65) participated in the study. Data was collected by a questionnaire which consisted of four parts. Three trained interviewers who were undergraduate psychology students, administered the questionaire individually. The first part examined on socio-demographic variables. The second part explored variables related to the accident, such as the status of the survivor as driver or non-driver, existence of injury or death to others in the accident, treatment after the accident, duration of hospitalization. The third part focused on the subject&rsquo / s accident related appraisals such as perceived level of responsibility, fear, helplessness, danger, thinking of death to oneself or others, sense of control, perceived level of injury severity. The fourth part contained five scales. Psychological distress was assessed by Impact of Event Scale (IES). Coping strategies were assessed by Ways of Coping Questionnaire (WCQ). Stress Related Growth Scale (SRGS) was used to examine perceived growth. Social support was assessed via Social Support Scale and Depression scores of the participants were assessed by Beck Depression Inventory. The results revealed that the present sample was moderately distressed. The current distress level was significantly related to perceived growth. The general distress level was predicted by age, perceived threat and helplessness coping. Considering intrusive symptoms, age, not having social security entitlement, depression, perceived threat and helplessness coping were found to be significant predictors. Considering avoidant symptoms, years of education, depression and fatalistic coping were found to be significant predictors. Not having an insurance policy, perceived threat, optimistic/problem solving coping and fatalistic coping were found to be significant predictors of percieved growth following motor vehicle accident. The findings are discussed within psychological distress and perceived growth. Limitations of the study, directions for future research and clinical implications are proposed.

The current study employed an exploratory approach to examine how specific sets of variables map onto a theoretical framework of posttraumatic growth (Schaefer & Moos, 1998). Specifically, the predictive capacity of belief in ultimate justice, optimism, and supportive relationships on outcomes of posttraumatic growth (PTG) and distress were examined, as mediated by supportive spirituality, meaning making, and problem solving. Secondarily, the factor structure and internal consistency of the English translation of the Belief in Immanent and Ultimate Justice Scale (BIUJS; Maes, 1998a, 1998b) was tested, which had yet to be used in the United States or with sexual assault survivors specifically. Archival data of 217 female survivors of sexual assault who completed an online survey as part of the author’s thesis were analyzed through structural equation modeling (SEM). The BIUJS, when applied specifically to sexual assault survivors, is best represented by a three-factor solution. The model hypothesized according to Schaefer and Moos’ (1998) theoretical framework was not supported by SEM results, and an alternate model emerged from analyses is presented to explain how worldview and appraisal/coping are related to posttraumatic growth and distress for sexual assault survivors. Survivors’ worldview (i.e., supportive spirituality, belief in ultimate justice, and belief in an immanently just world) indirectly predicted levels of PTG and distress. The relation between worldview and outcomes was significantly mediated by appraisal and coping (i.e., presence of meaning, optimism, supportive relationships, and problem solving). The current study adds to the literature and provides important directions for researchers and clinicians by demonstrating the important roles of worldview and appraisal/coping in facilitating growth, as well as the essential role of distress in healing.