2012. Vol.3, No.12A, 1142-1147
Published Online December 2012 in SciRes (
Copyright © 2012 SciRes.
A Proposed Mediated Path between Gender and Posttraumatic
Growth: The Roles of Empathy and Social Support in a
Mixed-Age Sample
Rhonda J. Swickert, James B. Hittner, Aasha Foster
Department of Psychology, College of Charleston, Charleston, USA
Received August 9th, 2012; revised September 10th, 2012; accepted September 27th, 2012
Social support coping has been shown to mediate the relationship between gender and posttraumatic
growth. This study examined whether empathy also serves as a significant mediator in this relationship,
potentially as a precursor to social support coping. Participants (N = 156) were recruited on a college
campus and at a retirement community. They completed questionnaires that assessed the variables of in-
terest and they provided information regarding a stressful life event. Single-mediator path analytic models
indicated that both empathy and social support were significant mediators. The full multiplicative media-
tional path from gender to empathy to support to growth was significant, but this finding was largely
driven by the strong mediational effect of empathy. These findings suggest that although both empathy
and social support coping are significant mediators in the relationship between gender and stress related
growth, of the two constructs, empathy appears to exert a stronger mediational effect.
Keywords: Gender; Posttraumatic Growth; Empathy; Social Support; Coping
Posttraumatic growth can be understood as the occurrence of
positive psychological change that can come about when indi-
viduals respond to highly challenging life events (Tedeschi &
Calhoun, 2004). Previous studies have shown that gender
serves as a significant predictor of growth following trauma
(Linley & Joseph, 2004; Swickert & Hittner, 2009). Although
not all studies have reported a relationship between these vari-
ables (Cryder, Kilmer, Tedeschi, & Calhoun, 2006), many
studies have shown that females, as compared to males, are
more likely to report benefit and growth following a traumatic
event (Bellizzi, 2004; Salo, Qouta, & Punamäki, 2005; Swick-
ert, DeRoma, & Saylor, 2004), and a recent meta-analysis sup-
ports this conclusion (Vishnevsky, Cann, Calhoun, Tedeschi, &
Demakis, 2010). In determining why gender is associated with
posttraumatic growth, Swickert and Hittner (2009) showed that
social support coping plays a mediational role in the relation-
ship between these two variables. The current study aims to
replicate this finding and extend this work by examining
whether empathy might also serve as a mediator in the rela-
tionship between gender and posttraumatic growth.
Regarding the mediating role of social support, females natu-
rally seek out others during times of stress (Eagly & Crowley,
1986; Taylor et al., 2000), and as a result of these supportive
experiences, the traumatized person may over time see others in
more positive ways and may feel more confident in responding
to the stressful event (Tedeschi & Calhoun, 2004). Indeed, in
examining the mediational role of social support in the rela-
tionship between gender and posttraumatic growth, Swickert
and Hittner (2009) found that social support enhanced one’s
feelings of closeness with family members as well as other
social network members. In coping with a traumatic event, the
individual may need a great deal of emotional support, as well
as other forms of assistance. Thus, when the traumatized person
seeks out support and it is provided, this often leads the indi-
vidual to see others in more positive ways and to grow closer to
the people in their support network.
In addition to social support, it is possible that empathy
might also mediate the relationship between gender and post-
traumatic growth. Definitions of empathy vary, but for the pur-
pose of the present study we define empathy as entailing both
an understanding of another’s emotional state coupled with the
tendency to feel emotional responses that are similar to another
person’s emotional responses (Lawrence, Shaw, Baker, Baron-
Cohen, & David, 2004). Although females do not necessarily
show greater empathic accuracy than do males (Ickes, Gesn, &
Graham, 2000), there is a general consensus that females dis-
play greater empathy when responding to others than do males
(Chakrabarti & Baron-Cohen, 2006). Recent studies in social
neuroscience suggest that the estrogen-linked neuropeptide
oxytocin contributes to empathic responding (Carter et al.,
2009). Other research has shown that portions of the “pain ma-
trix” (i.e., the anterior ansula and the anterior cingulate) are less
active in men, compared to women, when participants view an
individual in pain (Singer et al., 2004). Additionally, females
self-report higher levels of empathy than do males (Davis,
1994), and girls seem to develop a theory of mind earlier than
do boys (Putallaz, Hellstern, Sheppard, Grimes, & Glodis, 1995;
Walker, 2005). Finally, research also has shown that females
tend to be more responsive than males when those around them
experience stress (Neff & Karney, 2005). Taken together, this
evidence suggests an important relationship between gender
and empathy.
How might the gender-empathy association shed light on the
finding that females report greater posttraumatic growth than
males? One model to consider is that empathy has a direct me-
diational role in accounting for the association between gender
and stress-related growth. Researchers have suggested that
individuals who are more prosocial in their orientation (e.g.,
more empathic and nurturing) may be better equipped to man-
age traumatic life events (Staub & Vollhardt, 2008; Woike &
Matic, 2004). That is, it is believed that the act of empathizing
and helping others who are coping with stressful experiences
provides a model for the traumatized individual in terms of
self-care during a personally-experienced stressful or traumatic
event. However, an alternate model to consider in regards to the
mediational role of empathy is that empathy may serve as a
precursor to social support coping in the mediational path. Em-
pathy has been shown to strengthen one’s ties with others (Sul-
livan, Pasch, Johnson, & Bradbury, 2010), and enhance rela-
tionship satisfaction (Cramer, 2003; Davis & Oathout, 1987).
Furthermore, those who are higher in empathy tend to turn to
others when coping with stressors in the environment (Mc-
Whirter, Besett-Alesch, Horibata, & Gat, 2002). As such, those
who are more empathic should have a stronger social support
system to rely on when coping with stressful life circumstances.
Given the mediational role of social support in addressing the
relationship between gender and posttraumatic growth, it seems
then reasonable to consider a multi-mediated, or multiplicative,
path that includes both empathy and social support coping as
significant mediators in the relationship between gender and
stress-related growth.
In addressing the associations among gender, the proposed
mediators, and posttraumatic growth, we identified three major
goals. First, we examined whether the mediational role of social
support coping in accounting for the relationship between gen-
der and posttraumatic growth could be replicated. Second, we
addressed whether empathy also serves as a significant media-
tor in the relationship between these two variables. Third, we
tested whether a multi-mediated path (multiplicative effect)
could best account for the relationship between gender and
growth. In this model we predicted that females, as compared to
males, would report greater levels of empathy. Higher levels of
empathy would, in turn, be associated with greater levels of
social support coping and greater levels of social support would
be predictive of higher levels of posttraumatic growth. Finally,
in addressing these goals we had the opportunity to sample
participants who were tested as part of a larger study that ex-
amined age differences in stress-coping processes. In that re-
gard, we collected data from a college-student population (aged
18 to 35) and from a retirement community (aged 55 to 100).
Although age differences in stress-coping were not the focus
of the present inquiry, we chose to utilize the full sample for
two reasons. First, the process of combining the two distinct
subsamples (college students and retirees) creates a more het-
erogeneous sample, and the results derived from this sample
might, in turn, have greater generalizability. Second, because
the combined sample size is, of course, larger than either sub-
sample, the standard errors of the parameter estimates will be
smaller thereby giving us greater statistical power to detect
potentially meaningful effects. The principal caveat associated
with combining the two subsamples concerns the possible con-
founding role of age (i.e., the age disparities between the two
subsamples). However, as discussed below in the Method sec-
tion, we have effectively dealt with the age confound issue by 1)
removing the influence of age on the dependent, or criterion,
variable by creating an age-residualized dependent variable,
and 2) conducting data diagnostics (i.e., between-sample tests
of covariance matrices) in order to justify pooling the two sub-
samples. The details of these procedures are described below.
One hundred and fifty-six participants were recruited from
two different settings: students from a college campus (N = 94)
and older adults in a retirement community (N = 62). Females
constituted 61% of the sample. The participants were primarily
White (90%), although both Asians and Blacks were repre-
sented (10%). The college students ranged from 18 to 35 years
of age (M = 20.5, SD = 2.5) and the retirees ranged in age from
55 to 100 (M = 74.8, SD = 7.2). The two subsamples did not
differ on the basis of gender (χ2(1) = .553, p = .457) or ethnicity
(χ2(4) = 5.337, p = .254).
The Perceived Benefits questionnaire (PB; McMillen & Fish-
er, 1998) was used to measure posttraumatic growth. Partici-
pants are asked to complete a 44-item questionnaire (8 of which
are filler items), using a 5-point Likert scale. Higher scores on
this scale are indicative of greater posttraumatic growth. The
internal reliability of the PB in this study was high (Cronbach’s
alpha = .94). Validity information regarding this scale can be
found in McMillen and Fisher (1998).
The Coping Strategy Indicator (CSI; Amirkhan, 1990) was
used to assess social support seeking as a coping response. The
overall scale is comprised of 33 items, and 11 of these items
make up the support seeking subscale. In completing the CSI,
participants are asked to think about a stressful event and to
respond to statements about their coping responses using a 3-
point Likert-type scale. Higher scores on the support seeking
subscale are indicative of greater social support seeking. In the
current study the internal consistency of the subscale was .90.
Information regarding the validity of this questionnaire can be
found in Amirkahn (1990).
The short version of the Empathy Quotient Scale (EQS;
Muncer & Ling, 2006) was used to assess empathy. This scale
assesses the degree to which the individual understands how
another feels, whether they feel a similar emotional state as
another person, and whether they can interact with others in an
empathic manner. The internal consistency of this scale was
adequate (alpha = .67). A discussion of the psychometric prop-
erties of the EQS can be found in Muncer and Ling (2006).
Participants were solicited from a college campus and from a
retirement community, both of which are located in the south-
eastern region of the United States. Both groups were given a
packet of materials that included an informed consent form, a
demographic form and the survey materials. For the campus
sample, participants received research credit for participating in
the study and they completed the survey in group testing ses-
sions. For the retirement community sample, participants were
instructed to complete the materials in the privacy of their
homes/rooms. After granting informed consent but before com-
pleting the survey instruments, participants were instructed to
recall a distressing experience that they had encountered within
Copyright © 2012 SciRes. 1143
the past year and to respond to the PB and CSI questionnaires
with this event in mind. Examples of distressing events in-
cluded death of a loved one, financial concerns, health prob-
lems, and relationship conflict. Participants also were asked to
rate the perceived stressfulness of the event using a 4-point
Likert scale, which ranged from “not at all stressful” to “ex-
tremely stressful”. For the retiree subsample, the mean stress-
fulness rating was 3.42, and 89% of the older adults indicated
that the event was “moderately stressful” or “extremely stress-
ful”. Regarding the college students, the mean stressfulness
rating was 3.62, and 95% of the younger adults indicated that
the event was “moderately stressful” or “extremely stressful”.
After completing the packet, residents from the retirement
community were instructed to return the materials in a sealed
envelope to the social worker at the facility.
Data Analyses
Before examining the mediational hypotheses, we statistic-
cally removed the potential confounding influence of age from
the Perceived Benefits dependent variable. This procedure was
done for each subsample separately. Removing the influence of
age (i.e., the statistical covariation with age) is important given
previous research showing that participant age can affect self-
reports of posttraumatic growth (Bellizzi, 2004; Linley & Jo-
seph, 2004; Widows, Jacobsen, Booth-Jones, & Fields, 2005).
In addition to age, we also removed from perceived benefits the
potential confounding influence of perceived stressfulness of
the reported event. This is important because level of perceived
stress also can affect self-reports of posttraumatic growth
(Linley & Joseph, 2004). The statistical influence of these two
variables was removed from the dependent variable by creating
a residualized version of perceived benefits. This was accom-
plished through multiple regression by regressing perceived
benefits on both age and perceived stressfulness, saving the
unstandardized residuals from the analysis, and then treating
the doubly-residualized (i.e., residualized for both age and per-
ceived stressfulness) perceived benefits scale as the new de-
pendent variable. The residualized perceived benefits scale can
be thought of as the perceived benefits variable that remains
after controlling for, or removing the variance associated with,
age and perceived stressfulness.
After residualizing the perceived benefits scale for each sub-
sample separately, we then examined the comparability of the
two subsamples by assessing whether the pattern of covariances
among the four variables in the full multi-mediated model (i.e.,
gender, empathy, social support, residualized perceived benefits)
was non-significantly different across the two groups (college
students versus older adults). If the covariances among the tar-
get variables are similar, then the two groups can be combined.
The result of Box’s M Test, which tests the equality of covari-
ance matrices across groups, was non-significant (Box’s M =
16.94, F(10, 73493.3) = 1.64, p = 0.088), indicating that it is
statistically justifiable to pool the two subsamples.
To test for statistical mediation, we used the product of coef-
ficients approach, which calculates indirect effects by multi-
plying the path coefficients that link X to Y through the speci-
fied mediator, or mediators, M. For each indirect effect, a point
estimate is generated along with a corresponding 95th percentile
bias-corrected and accelerated bootstrap confidence interval.
Because the expected sampling distribution of indirect effects is
skewed (Preacher and Hayes, 2008), normal theory tests of
significance, such as Sobel’s test, are not recommended. In-
stead, bootstrap resampling approaches are preferred (see
Hayes, Preacher, & Myers, 2011). An indirect effect is consid-
ered statistically significant at p < .05 when the lower and up-
per limits of the 95th percentile bootstrap interval exclude zero.
In all of our mediation analyses we generated 5000 bootstrap
resamples for each indirect effect in order to ensure stable con-
fidence intervals. In our presentation of the mediation results,
indirect effects are denoted as IE followed, in parentheses, by
the lower and upper 95th percentile bootstrap confidence inter-
vals. All mediation analyses were conducted using Andrew
Hayes’ indirect and medthree SPSS macro programs (available
Descriptive data (means, standard deviations) for gender,
empathy, social support and residualized perceived benefits
(henceforth just “perceived benefits”), along with Pearson cor-
relations among the four variables, are presented in Table 1.
Although the correlations between perceived benefits and
both empathy and social support are significant, the correlation
between perceived benefits (Y) and gender (X) is not. In the
language of path analytic modeling, the correlation between X
and Y—or the total effect of X on Y—equals the sum of the
direct and indirect effects that link X to Y. In some cases, or in
some research scenarios, the direct effect of X on Y might be
most important. In other cases the indirect effects might best
capture the association between X and Y. In yet other scenarios
the indirect effects might exert countervailing influences, there-
by rendering the total effect, or the Pearson correlation, be-
tween X and Y non-significant (see Hayes, 2009, for a recent
review of total, direct, and indirect effects). The growing con-
sensus among research methodologists is that a statistically
significant bivariate correlation (total effect) between X and Y
is not a necessary precondition to performing mediational mod-
eling in an effort to uncover potentially important indirect ef-
fects (see Hayes, 2009; MacKinnon, Krull, & Lockwood, 2000;
Shrout & Bolger, 2002). In fact, as Hayes (2009: p. 415) wrote:
“A failure to test for indirect effects in the absence of a total
effect can lead you to miss some potentially interesting, impor-
tant, or useful mechanisms by which X exerts some kind of
effect on Y”.
Path Analyses
Social Support Coping and Empathy as Individual Mediators.
Table 1.
Descriptive statistics and Pearson correlations among the study vari-
ables (N = 156).
Mean (SD) Gen 1 –.213** –.123 –.356**
24.20 (5.75) SSC 1 .302** .413**
0.00 (21.17) PBS 1 .313**
31.49 (4.03) EQT 1
Note: **p < .01, two-tailed. Study Variables: Gen = Gender (1 = Female, 2 =
Male), SSC = Social Support Coping, PBS = Perceived Benefits Scale, EQT =
Empathy Quotient Total. The mean of PBS is 0.00 because PBS is a residualized
variable (see text for details). The mean of a normal distribution of residuals is
always zero.
Copyright © 2012 SciRes.
Copyright © 2012 SciRes. 1145
Discussion Social support coping significantly mediated the association
between gender and perceived benefits, IE = –2.67 (–6.24,
–.66). Similarly, empathy significantly mediated the link be-
tween gender and perceived benefits, IE = –4.80 (–8.99, –2.05).
In comparing the magnitudes of the two indirect effects, the
point estimate for empathy (–4.80) is 44.3% larger than is the
point estimate for social support (–2.67).
The purpose of this study was to extend our understanding of
the variables that mediate the association between gender and
posttraumatic growth. Results from the single-mediator models
indicated that both social support coping and empathy signifi-
cantly mediated the association between gender and perceived
benefits, with females reporting greater levels of social support
and empathy, and greater levels of each mediator, in turn, pre-
dicted higher levels of perceived benefits (i.e., greater post-
traumatic growth). The significant finding regarding social
support coping replicates previous research on this topic
(Swickert & Hittner, 2009). However, the strength of this rep-
licated finding is tempered by the results of the multi-mediated
path analysis. In this multiple mediation model, empathy ex-
erted a stronger mediational effect (both individually and in
driving the significant multiplicative indirect effect), than did
social support coping. As such, these findings indicate that
empathy plays a more prominent role than social support in
explaining the association between gender and posttraumatic
Empathy and Social Support Coping as a Multiplicative Me-
diator. The question addressed in this case is whether gender
influences overall perceived benefits by way of both empathy
and social support. In particular, the model posits a predictive
chain whereby gender influences empathy, empathy then influ-
ences social support coping, and social support coping then
influences perceived benefits. Results indicated a significant
multiplicative mediational path, IE = –1.25 (–2.82, –.10). Of
the two constituent single-mediator paths, only empathy statis-
tically mediated the influence of gender on perceived benefits,
IE = –3.52 (–7.07, –.72). This finding suggests that when em-
pathy and social support coping are directly pitted against each
other as putative mediators of the gender—perceived benefits
association, empathy emerges as the more important mediator.
The individual mediator models for social support coping and
empathy, and the full multiplicative mediator model, are pre-
sented in Figure 1.
In the field of social psychology, empathy is a concept that is
often discussed in the context of prosocial behavior because
empathy has been shown to increase helping behavior that is
Gender Perceived Benefits
Social Sup por t
Social Sup por t
Perceived Benefits
Perceived Benefits
*p < .05, **p < .01, ***p < .001, two-tailed.
Indirect effec t of Em pathy = - 3.52, Bootstrap 95%CI = -7.07, - .72.
Indirect effect of Social Support = -.68, Bootst rap 95%CI = -2.78, .83.
Multiplicative Indirect ef fect of Empathy and S ocial Support = -1. 25, Bootst r ap 95%CI = -2.82, -.10.
***p < .001, two-tailed.
Indirect effect of Empathy = -4.80, Bootstrap 95%CI = -8.99, -2.05.
**p < .0 1, ***p < .001, t wo- t ai led.
Indirect effec t of Social Su pport = -2.67, Bootstrap 95%CI = -6.24, -.66.
Figure 1.
Individual mediator models for social support coping and empathy, and the full multiplica-
tive mediator model.
directed towards others (Batson, 1991; Toi & Batson, 1982). It
is perhaps ironic, then, that empathy also plays a protective role
when the individual is responding to their own difficult life
circumstances. In fact, some theorists believe that empathy
should be considered a coping technique, as it is a process that
helps the individual to effectively manage stress (O’Brien,
DeLongis, Pomaki, Puterman, & Zwicker, 2009), perhaps by
facilitating social bonding and support seeking (Shirtcliff et al.,
2009). In the present study, seeking of social support served as
the measure of social support coping, and it was a significant
component of the multiplicative mediational model. However,
other measures of social support that may also prove relevant in
explaining the gender-empathy-growth pathway include rela-
tionship satisfaction, as well as measures of functional social
support and received social support (Hittner & Swickert, 2001).
In addition to the empathy-social support multiplicative me-
diational model, the influence of empathy on stress-related
growth also may operate through a different coping process.
That is, it is believed that the act of empathizing and helping
others who are coping with stressful experiences provides a
model for the traumatized individual in terms of self-care dur-
ing a personally-experienced stressful or traumatic event (Staub
& Vollhardt, 2008; Woike & Matic, 2004). Thus, perhaps em-
pathy operates through problem solving coping, as well as
through support seeking. Recent research does suggest that
empathy facilitates more effective problem solving coping, and
this effect has been demonstrated with both adolescent and
adult samples (deWied, Branje, & Meeus, 2007; Sullivan,
Pasch, Johnson, & Bradbury, 2010). As such, future work in
this area may want to examine whether, in the context of chal-
lenging life circumstances, empathy influences greater pos-
traumatic growth through problem solving coping, a factor that
has been associated with trauma-related growth (Bellizzi &
Blank, 2006).
Relative to previous research, the current study provides
more detailed information regarding the factors that influence
the association between gender and posttraumatic growth.
However, there are some limitations to the present work that
should be considered. First, because the study was cross-sec-
tional we are unable to make definitive causal statements re-
garding the temporal linkages among the constructs examined
in this study. Nevertheless, for reasons that were outlined ear-
lier in the paper, we believe that our hypothesized model has
good theoretical and empirical grounding in the literature. That
being said, it should be noted that other viable pathways re-
garding the association between empathy and posttraumatic
growth may exist (e.g., through problem solving coping), and
future longitudinal studies in this area are needed to confirm the
causal relationships among these variables. It also would be
interesting to examine, perhaps by using experience sampling
methodology, how it is that empathic responding increases
one’s level of posttraumatic growth. For instance, when one
listens empathically to others, does that lead individuals to feel
more comfortable talking about their own problems too? Does
this process then allow for more active, problem solving coping?
Clearly, there are many questions that remain regarding the role
of empathy in influencing posttraumatic growth.
In summary, we found that both empathy and social support
coping independently mediate the association between gender
and posttraumatic growth. However, of these two mediators,
empathy seems to play a more prominent role in accounting for
the association between gender and growth. In essence, the
capacity for empathy appears not only to help those around us,
but it benefits ourselves as well. Because females, relative to
males, tend to respond more empathically to others, they appear
to extract greater benefit from the positive connection between
empathy and posttraumatic growth.
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