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Updated: Aug 15, 2026

Developing Neuroimaging Phenotypes of the Default Mode Network in PTSD: Integrating the Resting State, Working Memory, and Structural Connectivity
Published on: July 1, 2014
A prospective study of coping after exposure to a mass murder episode
C S North1, E L Spitznagel, E M Smith
1Department of Psychiatry, School of Medicine, Washington University, St. Louis, Missouri 63110, USA. northc@psychiatry.wustl.edu
Abstract:
In a study of 136 survivors of a mass murder spree, multidimensional scaling identified clusters of responses mapping from 75 coping behaviors described by victims. This powerful method identified three coping dimensions: (a) Active Outreach versus Passive Isolation, (b) Informed Pragmatism versus Abandonment of Control, and (c) Reconciliation/Acceptance versus Evading the Status Quo. These coping dimensions were used to predict change in psychiatric status prospectively assessed with structured diagnostic interviews at index 3-4 months after the event and follow-up assessments 1 and 3 years later. Statistically significant changes in the positive direction on each of the three dimensions in this study were associated with reductions of 47-79% of the odds for acute postdisaster major depression, posttraumatic stress disorder (PTSD), and any non-PTSD disorder. These findings suggest mechanisms for development of therapeutic techniques capitalizing on encouraging active outreach, informed focus and pragmatism, and reconciliation and acceptance, and reduction of passive and isolative behaviors, resignation of control, and avoidance of realities of the postdisaster situation.
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