title: World assumptions, posttraumatic stress and quality of life after a natural disaster: a longitudinal study.
abstract: BACKGROUND
  Changes in world assumptions are a fundamental concept within theories that explain posttraumatic stress disorder. The objective of the present study was to gain a greater understanding of how changes in world assumptions are related to quality of life and posttraumatic stress symptoms after a natural disaster.
  
  
  METHODS
  A longitudinal study of 574 Norwegian adults who survived the Southeast Asian tsunami in 2004 was undertaken. Multilevel analyses were used to identify which factors at six months post-tsunami predicted quality of life and posttraumatic stress symptoms two years post-tsunami.
  
  
  RESULTS
  Good quality of life and posttraumatic stress symptoms were negatively related. However, major differences in the predictors of these outcomes were found. Females reported significantly higher quality of life and more posttraumatic stress than men. The association between level of exposure to the tsunami and quality of life seemed to be mediated by posttraumatic stress. Negative perceived changes in the assumption "the world is just" were related to adverse outcome in both quality of life and posttraumatic stress. Positive perceived changes in the assumptions "life is meaningful" and "feeling that I am a valuable human" were associated with higher levels of quality of life but not with posttraumatic stress.
  
  
  CONCLUSIONS
  Quality of life and posttraumatic stress symptoms demonstrate differences in their etiology. World assumptions may be less specifically related to posttraumatic stress than has been postulated in some cognitive theories.
authors: Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. egil.nygaard@nvkts.unirand.no
authors: Egil
authors: E
authors: Nygaard
authors: Trond
authors: T
authors: Heir
mesh_terms: D000328:Adult; D001210:Asia, Southeastern; D015986:Confounding Factors, Epidemiologic; D004190:Disasters; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology*; D012737:Sex Factors; D012938:Social Perception; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D014195:Travel; D057192:Tsunamis