The relationship between sense of coherence, self-efficacy and post-traumatic stress disorder

M.A.The current social and political situation in South Africa has resulted in an extremely violent climate in which the incidence of highly stressful events experienced by people on the whole is extremely high. The severe and pathological negative symptoms that often follow the experience of highly stressful events are defined as Post-traumatic Stress Disorder (PTSD) in the Diagnostic and Statistical Manual for Mental Disorders - IV (DSM-IV)(APA, 1994). An improved understanding of the factors involved in the development, treatment and prevention of PTSD is important considering the potentially debilitating effects of this disorder. With the increasing emphasis being placed on 'positive' psychology, the salutogenic orientation was given focus in this study. Antonovsky (1979, 1987) defines salutogenesis as 'the origins of health', and the emphasis is on identifying those factors in which health originates and is promoted. This study aimed to investigate two specific variables, sense of coherence (Antonovsky, 1979, 1987) and self-efficacy (Bandura, 1977, 1986) as two potential psychological resilience factors that may positively contribute to effective functioning after the experience of a highly traumatic event. The research tested a postulated model which suggested that the two resilience variables influence the presentation of PTSD symptoms after exposure to a traumatic event. The research was conducted in a police and banking environment with 50 participants, all of whom had experienced a traumatic event as defined by the criteria in the DSM-IV. Three measuring instruments were used to measure the constructs of interest. PTSD symptomatology was measured by means of Horowitz's "Impact of Events Scale - Revised" (Weiss & Marmar, 1997), self-efficacy in the face of a traumatic event was measured by means of a specific questionnaire constructed by the researcher for this study (SEFTE), and sense of coherence was measured by means of Antonovsky's "Orientation to Life" questionnaire, or Sense of Coherence Scale (1983). The results of the study indicated that a relationship does exist between the three constructs of interest. A higher sense of coherence. contributes to higher selfefficacy expectations in the face of a traumatic event, and both these variables reduce the level of PTSD symptomatology after exposure to a traumatic event. In conclusion, the importance of understanding some of the psychological resilience factors which may help to prevent PTSD after exposure to a traumatic event, or at least reduce the severity of the symptoms, was highlighted. By doing so, emphasis can be moved from the treatment of PTSD after the event, to the prevention of the disorder, by strengthening the resilience of those people at risk of exposure to a highly traumatic event, before the event occurs