The relationship between sense of coherence and post-traumatic stress: a meta-analysis

Figures & data

Figure 1. Schematic illustration of the theoretical framework concerning the relationship between sense of coherence and health outcomes, especially post-traumatic stress disorder (PTSD) symptom severity.

Figure 2. Search terms and search engines, as well as hits per included database.

Figure 3. Flowchart of the study selection process, adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group (Moher et al., 2009).

Table 1. Included samples and their characteristics.

	Sample	Country	n	r	Age (years)	Female (%)	Criterion A	Trauma type	Acute vs chronic
1	Arévalo, Prado, and Amaro (2008)	USA	393	−.22	33.70	100	2
2	Cassel and Suedfeld (2006)	Canada	45	−.52		62	2	WT	Chronic
4	Dudek and Szymczak (2011)	Poland	453	−.47	28.50	0	1	PT
5	Dudek and Szymczak (2011)	Poland	821	−.35	33.50	0	1	PT
3	Dudek and Koniarek (2000)	Poland	378	−.27	34.00	0	2	PT
6	Ekblad and Wennström (1997)	Sweden	33	−.53	39.00	61	2	WT	Chronic
7	Engelhard et al. (2003)	Netherlands	117	−.25	31.00	100	3	MT	Acute
8	Ferrajão and Oliveira (2016)*	Portugal	120	−.85	64.00	0	2	WT	Chronic
9	Forstmeier et al. (2009)	Germany	103	−.30	78.78	1	2	WT	Chronic
10	François, Brouette, Etienne, and Fontaine (2000)	France	14	−.59	40.28	50	1
11	Frommberger et al. (1999)	Germany	51	−.56	33.60	33	1	AT	Acute
12	Glück et al. (2016)	Austria	91	−.58	73.60	68	2	WT	Chronic
13	Hepp, Moergeli, Büchi, Wittmann, and Schnyder (2005)	Switzerland	101	−.34	37.90	26	1	AT	Acute
14	Hollifield, Warner, Krakow, Jenkins, and Westermeyer (2009)	USA	252	−.42	44.00	46	2	WT	Chronic
15	Hyun Ju (2017)	Korea	162	−.39		93	2	PT
16	Jonsson, Segesten, and Mattsson (2003)	Sweden	223	−.35	38.36	21	2	PT
17	Kaiser, Sattler, Bellack, and Dersin (1996)	USA	193	−.24	19.54	64	1		Acute
18	Kassen and DiLalla (2008)		51	−.44	33.50	43	2	PT
19	Kazlauskas et al. (2017)	Lithuania	110	−.36	44.65	68	2
20	Kaźmierczak, Strelau, and Zawadzki (2016)	Poland	289	−.39	44.00	34	1	AT	Acute
21	Kindermann et al. (2017)	Germany	64	−.53	37.00	56	2	PT
22	Scheffer Lindgren and Renck (2008)	Sweden	14	−.52	38.00	100	1		Chronic
23	Livneh and Martz (2014)*	USA	95	−.71	47.50	30	2
24	Mehnert et al. (2012)	Germany	71	−.18	48.00	0	1	PT	Acute
25	Nielsen, Matthiesen, and Einarsen (2008)	Norway	221	−.41	50.47	63	3		Chronic
26	Nishi et al. (2010)	Japan	118	−.47	39.70	28.00	1	AT	Acute
27	Noyman-Veksler, Herishanu-Gilutz, Kofman, Holchberg, and Shahar (2015)	Israel	92	−.44	28.70	100	3	MT	Acute
28	Pham, Vinck, Kinkodi, and Weinstein (2010)*	Congo	2466	−.66	37.00	50	2	WT	Chronic
29	Ratzer, Brink, Knudsen, and Elklit (2014)	Denmark	43	−.36	40.40	42	1	MT
30	Römisch, Leban, Habermas, and Döll-Hentschker (2014)	Germany	14	−.15	32.00	100	1
32	Schnyder, Büchi, Mörgeli, Sensky, and Klaghofer (1999)	Switzerland	112	−.35	37.90	26	1	AT	Acute
31	Schnyder, Wittmann, Friedrich-Perez, Hepp, and Moergeli (2008)	Switzerland	241	−.24	41.40	33	2	AT	Acute
33	Sommer and Ehlert (2004)	Switzerland	519	−.18	44.04	2.00	2	AT	Acute
34	Steinlin et al. (2017)	Switzerland	235	−.37	38.60	61	2	PT
35	Stramrood et al. (2011)	Netherlands	428	−.59	32.00	100	3	MT	Acute
36	Streb et al. (2014)	Switzerland/Lichtenstein	625	−.44	36.60	31	2	PT
38	Tagay, Erim, Brähler, and Senf (2006)	Germany	389	−.54	35.50	68.30
37	Tagay, Schlottbohm, Reyes-Rodriguez, Repic, and Senf (2014)	Germany	103	−.24	29.11	100	2
39	Teegen and Handwerk (2006)	Germany	59	−.54	82.00	100	2	WT	Chronic
40	Tham, Christensson, and Lena Ryding (2007)	Sweden	75	−.29	32.70	100	3	MT	Acute
41	van der Hal-van Raalte, van IJzendoorn, and Bakermans–Kranenburg (2008)	Israel	203	−.43	64.60	63	2	WT	Chronic
44	Veronese, Fiore, Castiglioni, el Kawaja, and Said (2012)	Israel	114	−.24	29.85	66	2	PT
43	Veronese and Pepe (2014)*	Israel	216	−.15	30.37	44	2	PT
42	Veronese and Pepe (2017)	Israel	159	−.28	29.13	47	2	PT
45	Wettergren, Langius, Bjorkholm, and Bjorvell (1999)	Sweden	15	−.22	37.00	40.00	1	MT	Chronic
46	Zerach and Levin (2018)	Israel	102	−.21	43.59	0	2	PT
47	Zerach and Levin (2018)		90	−.60	36.28	0	2	PT

* Samples excluded as outliers.

See Appendix A, Table A1, for a detailed version of the table including all moderator variables. n, sample size; r, reported bivariate correlation or mean of reported correlations; Criterion A: 1 = criterion A was ensured on an individual basis; 2 = criterion A was not ensured on an individual basis but was probably met (i.e. high-risk samples); 3 = events did not fulfil stringent criterion A; Trauma type: AT, accidental trauma; MT, medical trauma; PT, professional trauma; WT, Holocaust and war trauma.

Table 2. Results of the main analyses and nominally scaled moderator variables.

Analysis	k	M(r)	τ^2	95% CIu	95% CIl	Q	df	p	I^2
All studies	47	−.41	.02	−.36	−.46	695.52	46	< .001	89.35
		−.53	.04	−.40	−.66
Without outliers	43	−.39	.01	−.35	−.43	172.56	42	< .001	72.56
		−.40	.01	−.35	−.45
SOC version
SOC-13	18	−.42	.02	−.35	−.49	81.51	17	< .001	77.18
		−.46	.02	−.36	−.56
SOC-29	16	−.35	.01	−.29	−.41	37.66	15	.001	58.08
		−.33	.01	−.25	−.40
PTSD measure
IES(-R)	11	−.40	.01	−.33	−.47	22.61	10	.012	52.44
		−.44	.01	−.33	−.54
PDS	8	−.32	.01	−.22	−.41	35.94	7	< .001	76.70
		−.33	.01	−.17	−.50
Other measures	19	−.41	.01	−.34	−.47	103.07	18	< .001	80.11
		−.42	.01	−.34	−.51
DSM criterion A
Ensured on individual basis	14	−.39	.00	−.33	−.44	22.06	13	.055	43.49
		−.39	.00	−.31	−.47
High-risk samples	23	−.37	.01	−.32	.43	85.95	22	< .001	73.97
		−.36	.01	−.30	−.43
Stressful life events not fulfilling criterion A	5	−.42	.02	−.29	−.54	22.84	4	< .001	78.76
		−.50	.02	−.22	−.78
Trauma type
Accidental traumas (e.g. traffic accidents)	7	−.35	.01	−.25	−.45	25.11	6	< .001	74.35
		−.32	.01	−.17	−.46
Professional traumas	14	−.38	.01	−.32	−.44	40.40	13	< .001	71.72
		−.39	.01	−.32	−.46
Medical traumas	6	−.40	.02	−.26	−.53	21.91	5	< .001	69.82
		−.52	.02	−.17	−.86
Holocaust and war traumas	7	−.47	.00	−.40	−.54	8.32	6	.215	29.38
		−.46	.00	−.39	−.54
Duration of traumatic stressor
Short	13	−.35	.02	−.27	−.43	86.94	12	< .001	78.77
		−.39	.03	−.25	−.53
Long	9	−.45	.00	−.40	−.51	9.59	8	.295	14.70
		−.45	.00	−.39	−.51

All results of moderator analyses exclude the outliers and are based on 43 samples. The second line of each analysis reports results corrected for small sample effects according to Henmi and Copas (2010). All results including outlying studies are presented in Appendix C, Table C1.

k, number of samples; M(r), mean correlation; τ², estimated variance in population; CI_l, lower bound of 95% confidence interval; CI_u, upper bound of 95% confidence interval; Q, Q statistic; df, degrees of freedom of Q statistic; p, significance of Q; I², index of heterogeneity; SOC, sense of coherence; PTSD, post-traumatic stress disorder; IES(-R), Impact of Event Scale (Revised); PDS, Post-traumatic Stress Diagnostic Scale; DSM, Diagnostic and Statistical Manual of Mental Disorders.

Table 3. Results for the interval scaled moderator variables.

Analysis	k	τ^2	QM	df	pQM	R^2	Q	df	pQ	I^2
Publication year	43	.01	.84	1	.358	6.28	160.34	41	< .001	71.10
Percentage of females (%)	43	.01	1.22	1	.270	4.76	156.14	41	< .001	70.88
Age	41	.01	2.12	1	.145	5.57	170.34	39	< .001	72.58

All results of moderator analyses exclude the outliers and are based on 33 samples. Results including outlying studies are presented as Appendix C, Table C2.

k, number of samples; τ², estimated variance in population; QM, Q statistic of the moderating variable; df, degrees of freedom of Q statistic; Q, Q statistic of a main analysis relying on the included samples; p_QM/Q, significance of QM and Q; I², index of heterogeneity.

Table 4. Pearson correlations of the moderator variables (outliers excluded).

		1	2	3	4	5	6	7
1	Publication year	43
2	Percentage of females (%)	.08	43
3	Age	.10	−.08	41
4	SOC scale version [SOC-13 (1) vs SOC-29 (2)]	−.21	−.40*	−.13	34
5	PTSD measure [IES (1) vs PDS (2)]	.13	.32	.32	−.14	19
6	Trauma criterion A [stringent criteria (1) vs high-risk samples (2)]	.27	.13	.29	−.31	.22	37
7	Duration of stressor [short (1) vs long (2)]	−.01	.07	.67**	−.27	−.10	.65**	22

The diagonal contains the number of studies (k) included in each moderator analysis.

SOC, sense of coherence; PTSD, post-traumatic stress disorder; IES, Impact of Event Scale; PDS, Post-traumatic Stress Diagnostic Scale

*p < .05, **p < .01.

Figure 4. Forest plot of the meta-analysis including all samples.

Figure 5. Results of the influence statistics as the basis for outlier identification. The outliers identified by the influence analyses are marked by a circle. Study numbers correspond to those in the forest plot.

Figure 6. Trim-and-fill funnel plot of the main analysis with all samples including the amended effect sizes (white points).

Table A1. Included samples and their characteristics.

	Sample	Country	n	r	Age (years)	Female (%)	SOC measure	PTSD measure	Criterion A	Trauma type	Acute vs chronic
1	Arévalo, Prado, and Amaro (2008)	USA	393	−.22	33.70	100	SOC-13	PDS	2
2	Cassel and Suedfeld (2006)	Canada	45	−.52		62	SOC-13	Trauma Symptom Checklist	2	WT	Chronic
4	Dudek and Szymczak (2011)	Poland	453	−.47	28.50	0	SOC-27	K-PTSD	1	PT
5	Dudek and Szymczak (2011)	Poland	821	−.35	33.50	0	SOC-27	K-PTSD	1	PT
3	Dudek and Koniarek (2000)	Poland	378	−.27	34.00	0	SOC-29	PTSD-I	2	PT
6	Ekblad and Wennström (1997)	Sweden	33	−.53	39.00	61	SOC-29 (M)	SCID assessment	2	WT	Chronic
7	Engelhard et al. (2003)	Netherlands	117	−.25	31.00	100	SOC-13	PSS-SR	3	MT	Acute
8	Ferrajão and Oliveira (2016)*	Portugal	120	−.85	64.00	0	SOC-29	IES-R	2	WT	Chronic
9	Forstmeier et al. (2009)	Germany	103	−.30	78.78	1	SOC-29	PDS	2	WT	Chronic
10	François, Brouette, Etienne, and Fontaine (2000)	France	14	−.59	40.28	50	SOC-29	IES	1
11	Frommberger et al. (1999)	Germany	51	−.56	33.60	33	SOC-29	IES, PSS	1	AT	Acute
12	Glück et al. (2016)	Austria	91	−.58	73.60	68	SOC-13	ETI	2	WT	Chronic
13	Hepp, Moergeli, Büchi, Wittmann, and Schnyder (2005)	Switzerland	101	−.34	37.90	26	SOC-29	CAPS-2	1	AT	Acute
14	Hollifield, Warner, Krakow, Jenkins, and Westermeyer (2009)	USA	252	−.42	44.00	46	SOC-13	NMRSCL-121 (PTSD)	2	WT	Chronic
15	Hyun Ju (2017)	Korea	162	−.39		93	SOC-29	IES-R	2	PT
16	Jonsson, Segesten, and Mattsson (2003)	Sweden	223	−.35	38.36	21	SOC-13	IES, PTSS-10	2	PT
17	Kaiser, Sattler, Bellack, and Dersin (1996)	USA	193	−.24	19.54	64	SOC-29	Questionnaire based on DSM III criteria	1		Acute
18	Kassen and DiLalla (2008)		51	−.44	33.50	43	SOC-29	IES-R, PSS	2	PT
19	Kazlauskas et al. (2017)	Lithuania	110	−.36	44.65	68	SOC-13	IES-R	2
20	Kaźmierczak, Strelau, and Zawadzki (2016)	Poland	289	−.39	44.00	34	–	PTSD Factorial Version Inventory	1	AT	Acute
21	Kindermann et al. (2017)	Germany	64	−.53	37.00	56	SOC-29	QST	2	PT
22	Scheffer Lindgren and Renck (2008)	Sweden	14	−.52	38.00	100	SOC-13	IES-R	1		Chronic
23	Livneh and Martz (2014)*	USA	95	−.71	47.50	30	SOC-29	PPTSD-R	2
24	Mehnert, Nanninga, Fauth, and Schäfer (2012)	Germany	71	−.18	48.00	0	LAP-R	PDS	1	PT	Acute
25	Nielsen, Matthiesen, and Einarsen (2008)	Norway	221	−.41	50.47	63	SOC-29	IES-R	3		Chronic
26	Nishi et al. (2010)	Japan	118	−.47	39.70	28.00	SOC-29	IES-R	1	AT	Acute
27	Noyman-Veksler, Herishanu-Gilutz, Kofman, Holchberg, and Shahar (2015)	Israel	92	−.44	28.70	100	SOC-13	PDS	3	MT	Acute
28	Pham, Vinck, Kinkodi, and Weinstein (2010)*	Congo	2466	−.66	37.00	50	SOC-13	PCL-C	2	WT	Chronic
29	Ratzer, Brink, Knudsen, and Elklit (2014)	Denmark	43	−.36	40.40	42	SOC-29	HTQ	1	MT
30	Römisch, Leban, Habermas, and Döll-Hentschker (2014)	Germany	14	−.15	32.00	100	SOC-L9 (?)	PDS	1
32	Schnyder, Büchi, Mörgeli, Sensky, and Klaghofer (1999)	Switzerland	112	−.35	37.90	26	SOC-29	CAPS-2, IES-R	1	AT	Acute
31	Schnyder, Wittmann, Friedrich-Perez, Hepp, and Moergeli (2008)	Switzerland	241	−.24	41.40	33		CAPS-2	2	AT	Acute
33	Sommer and Ehlert (2004)	Switzerland	519	−.18	44.04	2.00	SOC-29	PDS	2	AT	Acute
34	Steinlin et al. (2017)	Switzerland	235	−.37	38.60	61	SOC-L9 (?)	IES-R, STS	2	PT
35	Stramrood et al. (2011)	Netherlands	428	−.59	32.00	100	SOC-13	TES-B	3	MT	Acute
36	Streb et al. (2014)	Switzerland and Lichtenstein	625	−.44	36.60	31	SOC-L9	PDS	2	PT
38	Tagay, Erim, Brähler, and Senf (2006)	Germany	389	−.54	35.50	68.30	SOC-13	IES-R, (PDS)
37	Tagay, Schlottbohm, Reyes-Rodriguez, Repic, and Senf (2014)	Germany	103	−.24	29.11	100	SOC-13	ETI	2
39	Teegen and Handwerk (2006)	Germany	59	−.54	82.00	100	SOC-13	PCL-C	2	WT	Chronic
40	Tham, Christensson, and Lena Ryding (2007)	Sweden	75	−.29	32.70	100	SOC-13	IES-R	3	MT	Acute
41	van der Hal-van Raalte, van IJzendoorn, Bakermans-Kranenburg, and others (2008)	Israel	203	−.43	64.60	63	SOC-13	PDS	2	WT	Chronic
44	Veronese, Fiore, Castiglioni, el Kawaja, and Said (2012)	Israel	114	−.24	29.85	66	SOC-29	IES-R	2	PT
43	Veronese and Pepe (2014)*	Israel	216	−.15	30.37	44	SOC-29	IES-R	2	PT
42	Veronese and Pepe (2017)	Israel	159	−.28	29.13	47	SOC-29	IES-R-13	2	PT
45	Wettergren, Langius, Bjorkholm, and Bjorvell (1999)	Sweden	15	−.22	37.00	40.00	SOC-13	IES-R	1	MT	Chronic
46	Zerach and Levin (2018)	Israel	102	−.21	43.59	0	SOC-13	PTSS	2	PT
47	Zerach and Levin (2018)		90	−.60	36.28	0	SOC-13	PTSS	2	PT

* Samples excluded as outliers.

n, sample size; r, reported bivariate correlation or mean of reported correlations; SOC, sense of coherence; PTSD, post-traumatic stress disorder; Criterion A: 1 = criterion A was ensured on an individual basis; 2 = criterion A was not ensured on an individual basis but was probably met (i.e. high-risk samples); 3 = events did not fulfil stringent criterion A; Trauma type: AT, accidental trauma; MT, medical trauma; PT, professional trauma; WT, Holocaust and war trauma.

Inventories: Sense of coherence: SOC-29, Sense of Coherence Scale – 29-item version; SOC-29 (M), Sense of Coherence Scale – 29-item version, meaningfulness scale; SOC-13, Sense of Coherence Scale – 13-item version; SOC-L9, Sense of Coherence Scale – 9-item version; LAP-R, Life Attitude Profile – Revised; PTSD: CAPS-2, Clinician-Administered PTSD Scales; ETI, Essener Trauma Inventar; HTQ, Harvard Trauma Questionnaire; IES(-R), Impact of Event Scale (Revised); K-PTSD, PTSD self-rating measure based on DSM-TR criteria; NMRSCL-121 (PTSD), New Mexico Refugee Symptom Checklist-121; PCL-C, PTSD Checklist – Civilian version; PDS, Posttraumatic Stress Diagnostic Scale; PPTSD-R, Purdue Posttraumatic Stress Disorder – Revised; PSS-SR, PTSD Symptom Scale – Self Report; PTSD-I, PTSD Interview; PTSS-10, Post-Traumatic Symptom Scale; QST, Questionnaire for Secondary Traumatization; SCID, Structured Clinical Interview for DSM-III-R; TES-B, Traumatic Event Scale-B.

Table C1. Results of the main analyses and nominally scaled moderator variables (outliers included).

Analysis	k	M(r)	τ^2	95% CIu	95% CIl	Q	df	p	I^2
All studies	47	−.41	.02	−.36	−.46	695.52	46	< .001	89.35
		−.53	.04	−.40	−.66
Without outliers	43	−.39	.01	−.35	−.43	172.56	42	< .001	72.56
		−.40	.01	−.35	−.45
SOC version
SOC-13	19	−.44	.02	−.37	−.51	195.24	18	< .001	87.57
		−.59	.02	−.41	−.76
SOC-29	19	−.40	.03	−.31	−.49	365.25	18	< .001	89.05
		−.51	.08	−.30	−.71
PTSD measure
IES(-R)	13	−.42	.03	−.30	−.53	221.73	12	< .001	89.59
		−.59	.07	−.31	−.86
PDS	8	−.32	.01	−.22	−.41	35.94	7	< .001	76.70
		−.33	.01	−.17	−.50
Other measures	21	−.44	.02	−.37	−.51	287.86	20	< .001	90.74
		−.56	.03	−.39	−.73
Trauma criterion A
Ensured on individual basis	14	−.39	.00	−.33	−.44	22.06	13	.055	43.49
		−.39	.00	−.31	−.47
High-risk samples	27	−.41	.03	−.34	−.48	569.15	26	< .001	92.99
		−.56	.05	−.37	−.76
Stressful life events not fulfilling criterion A	5	−.42	.02	−.29	−.54	22.84	4	< .001	78.76
		−.51	.02	−.23	−.78
Type of trauma
Accidental traumas (e.g. traffic accidents)	7	−.35	.01	−.25	−.45	25.11	6	< .001	74.35
		−.31	.06	−.17	−.45
Professional traumas	15	−.36	.01	−.30	−.42	52.57	14	< .001	77.59
		−.38	.01	−.30	−.46
Medical traumas	6	−.40	.02	−.26	−.53	21.91	5	< .001	69.82
		−.52	.02	−.17	−.86
Holocaust and war traumas	9	−.55	.02	−.44	−.66	114.01	8	< .001	93.35
		−.66	.02	−.34	−.99
Duration of traumatic stressor
Short	13	−.35	.02	−.27	−.43	86.94	12	< .001	78.77
		−.39	.03	−.25	−.53
Long	11	−.53	.02	−.42	−.63	136.11	10	< .001	92.33
		−.66	.02	−.37	−.94

All results of moderator analyses exclude the outliers and are based on 47 samples. The second line of each analysis reports results corrected for small sample effects according to Henmi and Copas (2010). k, number of samples; M(r), mean correlation; τ², estimated variance in population; CI_l, lower bound of 95% confidence interval; CI_u, upper bound of 95% confidence interval; Q, Q statistic; df, degrees of freedom of Q statistic; p, significance of Q; I², index of heterogeneity; SOC, sense of coherence; PTSD, post-traumatic stress disorder; IES(-R), Impact of Event Scale (Revised); PDS, Post-traumatic Stress Diagnostic Scale.

Table C2. Results for the interval scaled moderator variables (outliers included).

Analysis	k	τ^2	QM	df	pQM	R^2	Q	df	pQ	I^2
Publication year	47	.02	1.37	1	.242	5.68	612.85	45	< .001	88.72
Percentage of females (%)	47	.02	.00	1	.93	.07	695.38	45	< .001	89.06
Age	45	.02	5.73	1	.017	14.21	611.84	43	< .001	88.09

All results of moderator analyses including the outliers are based on 47 samples.

k, number of samples; τ², estimated variance in population; QM, Q statistic of the moderating variable; df, degrees of freedom of Q statistic; Q, Q statistic of a main analysis relying on the included samples; p_QM/Q, significance of QM and Q; I², index of heterogeneity.

Figure C1. Moderating effect of age on the relationship between sense of coherence and post-traumatic stress disorder (PTSD) symptoms. Smaller dots indicate larger standard errors, i.e. more precise findings are shown as larger dots.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G.; PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLOS Medicine, 6(7), e1000097.

 PubMed Web of Science ®Google Scholar

Engelhard, I. M., van den Hout, M. A., & Vlaeyen, J. W. (2003). The sense of coherence in early pregnancy and crisis support and posttraumatic stress after pregnancy loss: A prospective study. Behavioral Medicine, 29(2), 80–84.

 PubMed Web of Science ®Google Scholar

Ferrajão, P. C., & Oliveira, R. A. (2016). The effects of combat exposure, abusive violence, and sense of coherence on PTSD and depression in Portuguese colonial war veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 1.

 PubMed Web of Science ®Google Scholar

Forstmeier, S., Kuwert, P., Spitzer, C., Freyberger, H. J., & Maercker, A. (2009). Posttraumatic growth, social acknowledgment as survivors, and sense of coherence in former German child soldiers of World War II. The American Journal of Geriatric Psychiatry, 17(12), 1030–1039.

 PubMed Web of Science ®Google Scholar

Glück, T. M., Tran, U. S., Raninger, S., & Lueger-Schuster, B. (2016). The influence of sense of coherence and mindfulness on PTSD symptoms and posttraumatic cognitions in a sample of elderly Austrian survivors of World War II. International Psychogeriatrics, 28(3), 435–441.

 PubMed Web of Science ®Google Scholar

Kazlauskas, E., Gailiene, D., Vaskeliene, I., & Skeryte-Kazlauskiene, M. (2017). Intergenerational transmission of resilience? Sense of coherence is associated between Lithuanian survivors of political violence and their adult offspring. Frontiers in Psychology, 8. doi:10.3389/fpsyg.2017.01677

 Web of Science ®Google Scholar

Mehnert, A., Nanninga, I., Fauth, M., & Schäfer, I. (2012). Course and predictors of posttraumatic stress among male train drivers after the experience of ‘person under the train’ incidents. Journal of Psychosomatic Research, 73(3), 191–196.

 PubMed Web of Science ®Google Scholar

Nishi, D., Matsuoka, Y., & Kim, Y. (2010). Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors. BioPsychoSocial Medicine, 4(1), 1.

 PubMedGoogle Scholar

Streb, M., Häller, P., & Michael, T. (2014). PTSD in paramedics: Resilience and sense of coherence. Behavioural and Cognitive Psychotherapy, 42(04), 452–463.

 Web of Science ®Google Scholar

Veronese, G., & Pepe, A. (2014). Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers. American Journal of Orthopsychiatry, 84(5), 597.

 PubMed Web of Science ®Google Scholar

Henmi, M., & Copas, J. B. (2010). Confidence intervals for random effects meta-analysis and robustness to publication bias. Statistics in Medicine, 29(29), 2969–2983.

 PubMed Web of Science ®Google Scholar