ORI GIN AL PA PER

Post-Traumatic Stress and World Assumptions:The Effects of Religious Coping

Gil Zukerman • Liat Korn

� Springer Science+Business Media New York 2013

Abstract Religiosity has been shown to moderate the negative effects of traumatic event

experiences. The current study was deigned to examine the relationship between post-

traumatic stress (PTS) following traumatic event exposure; world assumptions defined as

basic cognitive schemas regarding the world; and self and religious coping conceptualized

as drawing on religious beliefs and practices for understanding and dealing with life

stressors. This study examined 777 Israeli undergraduate students who completed several

questionnaires which sampled individual world assumptions and religious coping in

addition to measuring PTS, as manifested by the PTSD check list. Results indicate that

positive religious coping was significantly associated with more positive world assump-

tions, while negative religious coping was significantly associated with more negative

world assumptions. Additionally, negative world assumptions were significantly associated

with more avoidance symptoms, while reporting higher rates of traumatic event exposure

was significantly associated with more hyper-arousal. These findings suggest that religious-

related cognitive schemas directly affect world assumptions by creating protective shields

that may prevent the negative effects of confronting an extreme negative experience.

Keywords Religious coping �World assumptions � Post-traumatic stress � Israeli students �Undergraduate students � PTSD check list

Introduction

Exposure to a traumatic, life-threatening event may cause considerable psychological

distress followed by several symptoms that are characterized by uncontrollable intrusive

G. Zukerman (&)Department of Communication Disorders, School of Health Sciences, Ariel University, Ariel, Israele-mail: gilzu@ariel.ac.il

L. KornDepartment of Health Management, School of Health Sciences, Ariel University, Ariel, Israele-mail: Kornli@zahav.net.il

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memories, hyper-arousal manifested by sleep difficulties, a lack of concentration, and a

significant tendency to avoid trauma-related stimuli (Connor and Davidson 2001). A

substantial proportion of those who report experiencing a traumatic event may exhibit a

short stress reaction phase, accompanied by symptoms which diminish over several weeks.

Symptom prevalence beyond one month leads to the diagnosis of post-traumatic stress

disorder (PTSD; DSM IV TR) (APA 2000). Although a majority of related studies focuses

on the effects of a direct traumatic experience on the individual’s well-being, recent

research findings suggest that post-traumatic stress-related symptoms can also develop

following vicarious exposure to catastrophic events (e.g., by hearing about an event

through mass media, or by having close friends or relatives injured or assaulted) (Bleich

et al. 2006).

In recent years, PTSD has raised a profound interest and several explanatory models

have been suggested for its occurrence. Some researchers stress the roll of classical con-

ditioning on emotional responses to extreme traumatic stimuli and of operant conditioning

to the avoidance of traumatic stimuli (Ehlers and Clark 2000), while other research findings

link PTSD development to disturbed fear conditioning associated with the prefrontal

cortex, the hippocampus, and abnormal amygdala functioning (Shin et al. 2006). Cognitive

behavioral-related treatment protocols have concentrated on trauma-related cognitive

changes and their contribution to the development of PTSD (Resick et al. 2008).

One prominent theory which received much attention in recent years relates to a set of

beliefs which the individual holds regarding the world and the self. Janoff-Bulamn (1989)

suggested that the individual holds a set of cognitive schemas, termed world assumptions,

that contain assumptions regarding three main categories; benevolence of the world means

the degree to which one views the impersonal world (e.g. events) and the people in either a

positive or a negative manner (i.e., ‘‘There is more good than evil in the world’’);

meaningfulness of the world concerns the way in which outcomes are distributed and the

individual’s ability to control them (i.e., ‘‘People’s misfortunes result from mistakes they

have made’’); and self-worthiness relates to assumptions about the self and the world (i.e.,

‘‘I am very satisfied with the kind of person I am’’). Generally, these assumptions develop

throughout the years and support an illusion of invulnerability, necessary for standard daily

functioning (Janoff-Bulamn 1989). However, when confronted by a traumatic event

experience, these otherwise stable schemas are shattered and called into question. Thus,

most theory and research on stressful/traumatic events conceptualize the assumptive world

as an outcome variable. Janoff-Bulamn’s hypothesis is supported by several research

findings, indicating a more negative world assumption among subjects who reported a

traumatic history (Fasel and Spini 2010; Lilly et al. 2011; Magwaza 1999).

Several research findings have demonstrated the effects of demographic characteristics

on the development of PTSD symptoms. Females were found to be less subjected to

traumatic events, but tended to exhibit higher rates of PTSD symptoms than males

(Perkonigg et al. 2000). Another finding indicated that people from lower socio-economic

levels may be more prone to PTSD (Kessler et al. 1995; Perkonigg et al. 2000).

The impact of traumatic event exposure on the personal feeling of well-being is also

affected by the individual’s resilience—the maintenance of positive adaptation despite

experiences of significant adversity (Luthar et al. 2000), which was postulated to be

comprised of many possible personal and environmental characteristics, such as the

internal locus of control (Wilson 1995), extroverted personality traits (King et al. 1998),

and the availability of social support (Rutter 1990). Among these, religion, as manifested

by various measures of the person’s level of religiosity, has been shown to moderate the

negative effects of traumatic event exposure and to reduce the intensity of stress-related

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symptoms following such an experience (Fischer et al. 2006; Laufer and Solomon 2011;

Korn and Zukerman 2011). These findings have brought several authors to suggest that

religiosity may have a buffering or moderating effect on the association between affective

and behavioral changes and the real-life stressful events preceding them (Laufer and

Solomon 2011; Korn and Zukerman 2011).

In spite of the growing interest, the mechanism by which religion may influence the

response to a traumatic event is unclear. Religion may enhance emotional regulation by

promoting an inner feeling of self-efficacy (Fischer et al. 2006) or, alternatively, designate

a greater ability to attach a new, less negative meaning to a traumatic experience (Levav

et al. 2008; Schiff 2006). Another possible explanation refers to religion as a set of

cognitive schemas that may buffer the impact of external events on internal beliefs (Park

2005; Mcintosh 1995). Thus, in the presence of an overwhelming stressful event, religion

may provide a powerful cognitive schema that will moderate the shattering of previously

held beliefs (Laufer and Solomon 2011).

Throughout the years, several studies have examined the effects of various aspects of

religiosity on well-being measures. Religiosity was examined by using measures such as

religious orientation (Laufer and Solomon 2011), affiliation (Flannelly and Inouye 2001),

practices such as the frequency of church attendance (Koenig 1995), or the relative

importance attributed to religious beliefs (Korn and Zukerman 2011). However, some

authors claim that these dispositional aspects of religiosity provide little information

regarding the effects of religiosity on the individual’s way of coping with life stressors

(Ano and Vasconcelles 2005). Alternately, it was suggested that instead of measuring

general religious indices, examining situation-specific religious coping strategies would

yield a better understanding of the individual’s use of religion when dealing with stressors

(Harris et al. 2008; Pargament et al. 2000; Tsang and McCullough 2003).

In the current study, we examined the possible effects of religious coping—conceptu-

alized as drawing on religious beliefs and practices to understand and deal with life

stressors (Pargament 1997), on the association between traumatic event exposure and

world assumptions.

In general, research on religious and mental health and Judaism and mental health in

particular has identified two types of religious coping, positive and negative (Rosmarin

et al. 2009). Positive coping, which includes benevolent religious appraisals, seeking

spiritual support, and seeking a spiritual connection with G-d, has previously been asso-

ciated with better adjustment to stressful events (Pargament et al. 2000). Negative coping,

which includes religious discontent and questioning ones’ religious beliefs, faith, and

practices, was linked to higher levels of anxiety, depression, and post-traumatic symptoms

(Harris et al. 2008; McConnell et al. 2006). The mechanism by which religious coping

effects the individual response to negative events is not clear, but recent research findings

suggest several possible mechanisms, particularly regarding the effects of negative reli-

gious coping. One attempt to explain the association between negative religious coping and

emotional distress refers to the spiritual struggle hypothesis (Pargament 2009). Primary

spiritual struggle was defined as conflicts over spiritual matters with G-d/a Higher Power,

within oneself, and with other people, leading to distress that may results in psychological

symptoms such as depression and anxiety (Pirutinsky et al. 2011). Another conceptuali-

zation is suggested by a recently proposed model of worry, postulating that religious

coping may affect symptoms through cognitive variables (Rosmarin et al. 2011).

According to this, negative religious coping may enhance mistrust in G-d, elevate intol-

erance for uncertainty, and increase worry, leading to more distress resulting in anxiety-

and depression-related symptoms.

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The present study was designed to examine the relationships between traumatic event

exposure, world assumptions, and religious coping among young Israeli students. The main

objective of the study was to gain a better understanding of the mechanism by which

religiosity affects individual responses to a traumatic life event that include a threat to the

individual’s well-being or to that of significant others. Based on previous research findings,

we hypnotized that positive religious coping would affect the individual’s response to a

traumatic life event via the cognitive channel, by moderating the relationships between

traumatic event exposure and world assumptions.

Methods

Participants

The study sample refers to 777 undergraduate students, from all four university faculties

who completed all of the study’s questionnaires. 47.7 % of our sample was male and

54.3 % female. Regarding marital status: 55.2 % of the participants reported being single,

43.0 % were married or in a committed relationship, and 1.7 % reported being separated,

divorced, or widowed. Our subjects mean age was 27.7 (SD = 7.11).

Regarding ethnic origin: 42.3 % of our sample defined themselves as Jews from

European origin (‘‘Ashkenazim’’), 40.9 % defined themselves as Jews from eastern origin

(‘‘Sephardic’’), 1.8 % defined themselves as Jews from Ethiopian origin, and 2.2 % defined

themselves as either Arab–Israelis or Druze. Additionally, 12.5 % of our sample reported

being of combined ethnic origin such as having parents from western as well as eastern

origins. These measures of ethnic origin correspond to the ethnic distribution within the

general Israeli population (Israel Central Bureau of Statistics 2010). Additionally, our

subjects were asked to define their religious orientation by choosing one of four specified

religious categories (secular, traditional, religious, and ultra-orthodox) or an additional

category ‘‘other,’’ as described by the Israel Democracy Institute 2008 (Israel Democracy

Institute, The Guttman Center for Surveys 2008).1 In Israel, although religious orientation

is a self-determined definition, it mainly refers to the degree to which the individual

adheres to religious commandments and practices in daily activities (Israel Central Bureau

of Statistics 2012). Our subjects ascribed themselves to one of the four categories men-

tioned above—37.5 % defined themselves as secular, who do not practice any religious

commandments; 24.1 % defined themselves as traditionalists, who do not strictly adhere to

religious commandments and are highly involved in the general society; 35 % defined

themselves as religious, observant of the religious Jewish commandments but play an

active role in the general society; and 0.08 % defined themselves as ultra-orthodox

(‘‘Haredim’’), who are strictly observant of the religious commandments and are mostly

confined to their own communities. A fifth category (others) consisting of 0.02 % of our

sample refers to the small number of non-Jews that participated in study. In comparison

with a survey conducted by the Israel Democracy Institute, The Guttmann Center for

Surveys (2008), our sample is characterized by lower rates of secular subjects (37.5 vs.

50 %, respectively), lower rates of traditionalist subjects (24.1 vs. 30 %, respectively),

1 The Israeli government has recently expanded these religious categories into five categories by splittingthe traditional category into non-religious traditional and religious traditional Jews (Israel Central Bureau ofStatistics 2012). Thus, conducting a comparison between the current sample and recent data regarding thegeneral population is difficult.

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higher rates of religious subjects (35 vs. 10 %, respectively), and lower rates of ultra-

orthodox subjects (0.08 vs. 10 %, respectively).

Procedure

Approval from the University Ethics Committee was obtained prior to the pilot phase. The

sample was a convenience sample—questionnaires were distributed in classes where the

lecturer gave permission. All of the studied measures were gathered in one questionnaire.

The primary investigator gave detailed guidance to the surveying team as to the technique

of presenting the questionnaire within the classrooms. All students present in participating

classes received the questionnaires inside the classrooms, 5–10 min before the end of the

lesson, during May–December 2012. The survey team read an introduction before handing

out the questionnaire and allowed students the opportunity to refuse participation. All

students participating in the study gave their active informed consent by signing a short

declaration prior to completing the questionnaire.

Measures

Demographic Measures

Four relevant demographic measures were measured in the questionnaire—Age (subjects

were asked to specify their birth year); Ethnic origin (1 = Ashkenazi\West Europe,

2 = Sephardic\Eastern origin, 3 = Eastern Europe\Former USSR, 4 = Ethiopian origin,

5 = Arab Israeli, 6 = Druze, 7 = Other); Family status (1 = Single, 2 = In committed

relationship, 3 = Married, 4 = Separated/divorced/widowed); and Sex (1 = male,

2 = female). Additionally, the subjects were asked to specify their religious orientation

(‘‘Define your religious orientation—1 = Secular, 2 = Traditional, 3 = Religious,

4 = Ultra-Orthodox, 5 = Other, please specify’’).

World Assumptions Scale (WAS)

Janoff-Bulamn (1989)—This self-report scale examines the subject’s cognitive schemes.

Eight different assumptions about the world are gathered into three primary categories of

the perception of the world; the first, Benevolence of the world, includes two dimensions—

benevolence of the world and benevolence of people. These assumptions concern the

degree to which one views the impersonal world (e.g., events) and people in a positive

(‘‘the world is a good place’’) or negative (‘‘people are naturally unfair and unkind’’) way.

The second category, Meaningfulness of the world, includes three dimensions—justice (the

belief that the world is a just place and that people get what they deserve), controllabi-

lity (the belief that control can be achieved through minimization of personal vulnerability

by engaging in behaviors such as caution and foresight), and randomness (the assumption

that events and consequences occur at random). Unlike the first two dimensions, the

randomness dimension is more related to loss of control and to greater vulnerability.

People are inclined to hold all three of these dimensions to various degrees.

The third category, Self-Worthiness, also includes three assumptions—self-worth (the

degree to which the individual perceives himself/herself as good, decent, and moral), self-

controllability (the degree to which the individual perceives himself/herself as engaging in

the right precautionary behaviors, thus minimizing personal vulnerability), and luck (the

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degree to which the individual feels he/she is somehow protected from ill fortune, without

attributing this protection to any trait or particular behavior).

The three global indices—benevolence of the world, meaningfulness of the world, and

self-worthiness—are calculated by summing the responses on all items, with higher scores

indicating lower beliefs in this assumption (some items are given in reverse order). Alpha

coefficients for the English version ranged from 0.67 to 0.78 (Janoff-Bulamn 1989). The

subjects were given a Hebrew translation of the WAS.

PCL (PTSD Check List)

The PCL is a 17-item questionnaire designed to assess PTSD symptoms according to the

Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric

Association 1994). Each subject was asked to rate the extent to which he or she has

experienced each of the 17 diagnostic symptoms for PTSD as outlined by the DSM 4th

edition. Out of the 17 items—the first 5 are related to intrusive memories, the next 7 to

avoidance and numbness, and the last 5 to hyper-arousal-related symptoms. Research

findings indicate a high test–retest reliability (0.96) and internal consistency (alpha coef-

ficient = 0.96) for this questionnaire (Weathers et al. 1993).

In the current study, subjects were asked to relate to the period of the three months

following the traumatic event they had reported. Thus, the data represent a retrospective

evaluation of the PTS symptoms that the subjects experienced following the traumatic

event exposure. The subjects were given a Hebrew translation of the PCL.

Jewish Religious Coping Scale (JCOPE)

We used a Hebrew translation of the Religious Coping Scale (JCOPE), designed to

measure religious coping among Jewish adults. The JCOPE has previously demonstrated

high reliability and validity (Rosmarin et al. 2009). Participants rated how frequently they

generally engaged in religious methods of coping with stressful problems on a 5-point

Likert scale. Items relate either to positive religious coping (‘‘I look forward to the Sab-

bath’’; ‘‘I try to remember that my life is part of a larger spiritual force’’) or negative

religious coping (‘‘I question my religious beliefs, faith and practices’’). Final scores were

calculated for the 12 items relating to positive religious coping and the four items relating

to negative religious coping. A cross-cultural adaptation was performed for this ques-

tionnaire and some of the items were changed in order to suit the small number of Christian

and Muslim students which completed the questionnaire. The subjects were given a

Hebrew translation of the JCOPE.

G-d Locus of Health Control (GLHC)

The GLHC was developed as an adjunct to the Multidimensional Health Locus of Control

(MHLC) scale and was designed to assess the belief that G-d is either the locus of control

of one’s health status, in general, or the locus of control of one’s specific disease status.

The GLHC consists of six items with six response options on a Likert scale: 1 = strongly

agree, 2 = moderately agree, 3 = agree, 4 = disagree, 5 = moderately disagree, and

6 = strongly disagree. Perviously reported internal consistency ranged from 0.87 to 0.94

(Wallstone et al. 1999). The subjects were given a Hebrew translation of the GLHC.

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Religious Practicing

All subjects were asked to specify how many times they have attended synagogue/mosque/

church prayers during the pervious month.

Traumatic Event Exposure

All subjects were asked to specify whether they were ever exposed to a traumatic event,

‘‘at which you experienced substantial threat to the well-being of yourself or that of a loved

one, such as a motor vehicle accident or any other accident, a terror event, an assaults such

as robbery or rape, sudden death of a family member et cetera…’’ Subjects that replied

positively were asked to specify whether the event they had reported fits one of the

following categories: terror event exposure, motor vehicle accident, loss of a close friend,

home/work accident, a violent assault (such as robbery or rape), loss of a family member,

or to specify any other category (Other). Subjects were able to specify more than one

traumatic event.

In order to avoid translation mistakes and to ensure cultural matching to the study

population, the English versions of all of the study questionnaires (WAS, PCL, JCOPE,

and GLHC) were translated into Hebrew and back-translated into English.

Data Analysis

Data were entered into SPSS-20 for initial descriptive statistics. A two-phase hierarchical

regression analysis was conducted with each of the WAS primary categories (benevolence

of the world, meaningfulness of the world, and self-worthiness) as dependent variables.

The demographic variables (sex, age, family status, and ethnic origin) were entered in

phase one, followed by all of the religion-related variables (positive and negative religious

coping, religious orientation, GLHC, and religious practicing) and the traumatic event

exposure index in phase two. Due to their relatively small number (2.2 %), the data on the

non-Jewish subjects were omitted from the statistical analysis.

An additional data analysis was conducted in order to examine the relationship between

demographic variables, world assumptions, traumatic event exposure, and the three cate-

gories of PTS symptoms as reported by the PCL: intrusiveness, avoidance, and hyper-

arousal. Demographic variables were entered in the first phase, followed the by world

assumption main indices (benevolence of the world, meaningfulness of the world, and self-

worthiness) and by traumatic event exposure variables.

Several moderation analyses were conducted in order to test the effects of traumatic

event exposure and religious coping (negative and positive) on each of the WAS main

categories. These analyses were conducted by using a two-step hierarchical regression

analysis as proposed by Frazier et al. (2004).

Results

Traumatic event exposure rates: approximately 65 % of the students reported experiencing

at least one event that they perceived as a substantial threat to their own or their loved

one’s well-being. Of the entire sample, approximately 12 % reported more than one

traumatic event experience (7.9 twice, 3.6 three or more). Road traffic accidents were the

most common type of traumatic event reported (16.7 %), followed by terror event

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exposure (15.7 %). About 6 % of the sample reported being subjected to a violent assault

and 5.7 % reported the loss of a family member, as a traumatic event. The subject’s

tendency to engage in positive and negative religious coping, as well as the extent to which

they believe that G-d is the locus of control of one’s health status, as measured by the

GHLC are presented in Table 1. Mean values for religious coping (positive and negative)

as well as GHLC data are presented across religious orientation categories (Secular,

Traditional, Religious and Ultra-Orthodox). It was observed that while positive religious

coping was more common among religious subjects (mean 45.8) than among secular

subjects (mean 26.5), negative religious coping was more common among secular subjects

(mean 8.2) than among religious subjects (6.3). Additionally, secular subjects were more

prone to disagree with statements stating that G-d is the locus of control of one’s health

status.

PCL scores were calculated only for the subjects who reported experiencing at least one

traumatic event. The reported mean value of the total PCL value was 34.7 and lies within

the upper recommended cutoff point for the general population, which is 30–35 (National

Center for PTSD 2012).

Several regression analyses were conducted in order to examine the associations

between world assumptions and related variables. A two-phase hierarchical regression

analysis was conducted with each of the WAS primary categories (benevolence of the

world, meaningfulness of the world, and self-worthiness) as the dependent variables. The

results of the regression analysis are presented in Table 2. In the final models, male gender

and being a bachelor were significantly associated with a weaker belief of the benevolence

of the world and of self-worthiness, leading to more negative world assumptions. Female

gender was significantly associated with a more negative perspective of the meaningfulness

of the world, while age was significantly associated with more negative benevolence of the

world. Frequent attendance at community prayers, such as in a synagogue, was associated

with a more positive perspective of the benevolence of the world. For all WAS primary

categories, positive religious coping was significantly associated with more positive world

assumptions, while negative religious coping was significantly associated with more

negative world assumptions.

Table 1 Religious coping and GLHC data across religious orientation categories

Religious orientation Positive religious copingb Negative religious copingc GHLCd

na Mean SD na Mean SD na Mean SD

Secular 269 26.6 9.1 274 8.2 3.1 281 12.38 6.9

Traditional 177 38.5 9.8 180 7.2 3.0 170 20.07 7.7

Religious 258 45.8 8.1 265 6.3 2.9 252 25.90 7.4

Ultra-orthodox 6 54.0 5.5 6 4.3 0.8 6 29.33 5.5

Other 18

Total 728

a n changes due to missing datab Higher scores indicate a more frequent use of positive religious coping. Possible range 0–72c Higher scores indicate a more frequent use of negative religious coping. Possible range 0–24d G-d Health Locus of Control. Higher scores indicate stronger belief in G-d’s control of the individual’shealth status

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Additional regression analyses were conducted in order to examine the relationship

between demographic variables, world assumptions, traumatic event exposure and PTS

symptoms as reported by the PCL and are displayed in Table 3. Demographic variables

were entered in the first phase, followed by world assumption main indices (benevolence of

the world, meaningfulness of the world, and self-worthiness) and by traumatic event

exposure variables. The final regression analysis conducted indicated that the female

gender was significantly associated with higher levels of symptoms in all three symptom

types (intrusive, avoidance and hyper-arousal); traumatic event exposure was significantly

associated with an elevated level of hyper-arousal symptoms; a marginally significant

association was found between traumatic event exposure and intrusive symptoms

(p = 0.051); and a more negative perspective of the world and others, manifested by less

belief in the benevolence of the world, was significantly associated with a more avoidant

behavior.

A number of moderation analyses were conducted to test the moderating effect of

religious coping on the association between traumatic event exposure and world

assumptions. These analyses were conducted by using a two-step hierarchical regression

analysis as suggested by to Frazier et al. (2004). However, since none of these analyses

yielded any significant results, we do not discuss them any further.

Discussion

In the current study, religious coping significantly predicted all three world assumption

main categories (benevolence of the world, meaningfulness of the world, and self-wor-

thiness) of young healthy Israeli students. Using religion as a positive coping strategy (e.g.,

using benevolent religious appraisals, trying to build a stronger spiritual connection with

G-d, and seeking spiritual support from others) was associated with more positive world

assumptions, while using religion as a negative coping strategy (e.g., identifying the

occurrence of a traumatic event as a punishment from G-d or questioning one’s religious

beliefs, faith, and practices) was associated with more negative world assumptions. World

assumptions were also significantly predicated by religious practicing (the frequency of

synagogue/mosque/church attendance) and by the demographic variables: age, sex, and

family status.

Among those of our subjects who reported experiencing at least one traumatic event, the

reported level of PTS symptoms was significantly predicted by several variables. For

instance, sex was found to significantly predict the level of reported intrusiveness and

arousal-related symptoms, with females reporting more symptoms than males. These

finding are in accordance with previous research findings (Kessler et al. 1995; Perkonigg

et al. 2000). Beyond demographics, the reported level of traumatic event exposure sig-

nificantly predicted arousal-related symptoms. A marginally significant association

between traumatic event exposure and intrusive symptoms was also found. Additionally, a

stronger belief in the benevolence of the world and people was associated with less

avoidance-related symptoms.

Janoff-Bulamn (1989) suggested that PTSD symptoms are the result of the shattering of

previously held beliefs when faced by a traumatic event. According to this model, world

assumptions regarding the self and the world sustain an illusion of invulnerability, nec-

essary for standard every day functioning. Results of several pervious studies have dem-

onstrated that, as a group, religious people are more resilient to traumatic event exposure

than non-religious individuals (Fischer et al. 2006; Laufer and Solomon 2011; Korn and

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123

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Zukerman 2011). Recently, some authors have suggested that religion may moderate the

negative effects of a traumatic experience though a cognitive channel, meaning that in the

presence of an overwhelming, stressful event, religion may provide a powerful cognitive

schema that will moderate the shattering of previously held beliefs (Laufer and Solomon

2011).

While cognitive behavioral research and theory have primarily focused on self and

world perceptions, the effects of spiritual schema-related beliefs was less explored.

However, recent research findings suggest that they may have a significant effect on the

individual’s response to negative life events. While the use of positive religious coping was

associated with better adaptation to stressful life events (Pargament et al. 2000), negative

religious coping was associated with depression, anxiety (Pirutinsky et al. 2011), and PTS

(Harris et al. 2008). Negative religious coping was conceptualized as an expression of

spiritual struggle, reflecting a conflict over spiritual matters with G-d/a higher power that

may facilitate emotional distress (Pargament 2009). Some authors have suggested that

negative religious coping may enhance emotional distress through cognitive factors; fol-

lowing a negative experience, negative religious coping may lead to mistrust in G-d,

increase intolerance toward uncertainty, and raise worry (Rosmarin et al. 2011).

The current study’s results indicate a significant association between positive religious

coping and positive world assumptions and between negative religious coping and negative

world assumptions. These findings are supported by previous research findings linking

between religiosity and avoidant behaviors following traumatic event exposure (Korn and

Zukerman 2011) and suggest that religiosity may affect the response to traumatic event

exposure via the cognitive channel as well. Therefore, the current findings suggest that

instead of influencing the association between traumatic event exposure and beliefs about

the world, religious-related schemas directly affect world assumptions, thus creating a

protecting shield that may prevent the negative effects of confronting an extreme negative

experience.

As opposed to pervious research findings (Solomon and Laufer 2005; Lilly et al. 2011),

this study found no significant associations between traumatic event exposure and world

assumptions. Additionally, in contrast to our hypothesis, positive (as well as negative)

religious coping did not significantly moderate the association between the level of trau-

matic event exposure and world assumptions. Several explanations can account for these

results: A number of research findings have shown that the extent to which world

assumptions are associated with traumatic event exposure is related to the type of the

reported event. Individuals who have experienced interpersonal negative events (such as

physical and/or sexual assault) reported more negative world assumptions compared to

individuals who have endured non-personal traumatic events (Bodvarsdottir and Elklit

2004; Lilly et al. 2011). Only 6 % of our sample reported personal traumatic event

exposure.

The current study has several limitations. The first relates to the composition of the

study sample. A survey conducted in 2008 among the Israeli general population found that

50 % of Israelis defined themselves as secular, while only 10 % defined themselves as

religious (Israel Democracy Institute, The Guttmann Center for Surveys 2008). However,

in our sample, only 37.5 % of the subjects defined themselves as secular and as high as

35 % defined themselves as religious. Therefore, it is possible that the current research

findings are more applicable to a moderately religious population rather than to a secular

population. Additionally, the Israeli government has recently updated its religious orien-

tation categorization, by splitting the traditional category into two: non-religious traditional

and religious traditional, thus creating a five-category system (Israel Central Bureau of

J Relig Health

123

Statistics 2012). Further studies using this new categorization version and subject samples

representing a wider distribution of religious orientation are required in order to gain a

more comprehensive understanding of the mechanisms by which religiously may affect the

individual’s resiliency to traumatic event exposure.

Another limitation concerns the way in which the traumatic event exposure data were

collected. Subjects were asked to report any traumatic event in which they had experienced

a substantial threat to their own well-being or to that of a loved one. Our study did not use a

standardized measure of trauma or traumatic history such as the Traumatic Life Events

Questionnaire (Kubany 2004) or the Trauma History Questionnaire (Green 1996). Thus, it

is possible that our subject’s reports were partial and that cartographic event exposure was

actually higher than that reported. However, these assumptions are undermined by the fact

that as many as 65 % of our subjects reported experiencing at least one traumatic event and

12 % reported the occurrence of more than one traumatic event.

The current study findings may contribute to broadening our understating of the

mechanisms by which religious coping enhances the individual’s resiliency to traumatic

event exposure. While several authors have claimed that an occurrence of overwhelming

negative events enhances the possibility of shattering the previously fundamental cognitive

perception of the world and the self (Ehlers and Clark 2000; Janoff-Bulamn 1989), the

current study findings suggest that the influence of previously held religious-related cog-

nitive schemas on world assumptions are relatively high, thus attenuating the negative

effects of traumatic event exposure.

The implications of our study are twofold; first, they suggest that the tension existing

between the exposure to a traumatic event and the previously held basic cognitions can be

attenuated by active religious coping that includes a constant remainder of the association

between the individual and G-d. Second, the current findings suggest that cognitive

changes following traumatic event exposure are complex and include a robust effect of

pervious personal experiences and consequently held schemas. These assumptions are

important when considering cognitive-based intervention programs, such as cognitive

processing therapy (CPT, Resick et al. 2008), especially in the case of religious individuals

coping with traumatic event exposure.

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