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The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis

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The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis

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Abstract

Background: Posttraumatic growth (PTG) is positive psychological changes after encountering challenging events. The main purpose of this meta-analysis was to summarize the prevalence of moderate-to-high PTG in people who experienced traumatic events and to understand what social-demographic and trauma characteristics distinguish those who show a high rate of PTG from those of low level. Methods: Six electronic databases were searched. Loney's appraisal criteria were used to evaluate the quality of studies. Freeman-Turkey double arcsine transformation method was used to calculate the combined prevalence. Age, time since event, type of trauma and trauma form were analyzed as subgroup factors. According to the source of the trauma, the type of trauma was divided into three different categories: disease, accident and specific profession. Specific profession refers to firefighters, veterans, intensive care staff, etc. The complex working environment, irregular lifestyle, various unpredictable factors, as well as the frequently adverse stimuli from others contribute to great physical and mental pressure. Results: Twenty-six articles were deemed as qualified for this systematic review and meta-analysis. The level of PTG across studies ranged from 10% to 77.3%, and heterogeneity tests showed high heterogeneity (I2 = 92.3%, 95%CI = 90.1%-94.0%, p < 0.01). Random effect model was chosen to calculate the combined prevalence and the prevalence was 52.58% (95%CI = 48.66%-56.48%). People whose age was younger than 60,had shorter time since trauma,worked in a specific profession and suffered from direct trauma reported high rate of moderate-to-high PTG. Limitations: Because the included studies haven't provided adequate PTG-related information, these factors could not be used to performed subgroup analyses. In addition, some studies were excluded due to the different standard may lead to deviation of the combined prevalence. Conclusions: Nearly half of the investigated individuals reported moderate-to-high PTG after experiencing a traumatic event. Future research needs to further study the determinants of PTG to provide relevant interventions for the victims of trauma.

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... Indeed, research has consistently found that age can inversely impact the likelihood of PTG. One review found a higher combined prevalence of moderate-to-high PTG in those under 60 years to those older (Wu et al., 2019), whilst an inverse relationship between age and PTG was found in adults aged 20-70 years (Manne et al., 2004). ...
... (López, Camilli, & Noriega, 2015;Oksuzler & Dirik, 2019) and illnesses of cancer (Brix et al., 2013;Heidarzadeh, Dadkhah, & Gholchin, 2016;Hoogland, Jim, Schoenberg, Watkins, & Rowles, 2019), diabetes (Senol-Durak & Durak, 2018) and living with stoma (Blaszczynski & Turek, 2013). Whilst no standardized cut-off for PTGI scores exists, as with Wu et al. (2019), >60% of the highest PTGI score (i.e. 63; SF 3) was used to indicate moderate-to-high levels. ...
... Some psychological processes previously associated with PTG were found to be supported with older adults, including spirituality (Shaw, Joseph, & Linley, 2005) and meaning (Aflakseir, Soltani, & Mollazadeh, 2018;Mostarac & Brajković, 2021). Within demographic factors, age was negatively associated with PTG in several later life studies, supporting previous findings that PTG decreases with age (Wu et al., 2019). In addition, highest reported PTG scores were in later life studies. ...
Article
Objectives: Posttraumatic growth (PTG) is of increased theoretical and clinical interest. However, less is known about PTG in older adults specifically. This systematic review aimed to identify domains where PTG is studied for older adults; investigate factors associated with PTG in older adults; consider how these might differ between historical and later life traumas. Methods: Online databases were searched for quantitative studies examining PTG outcomes in adults aged ≥ 60 years. Results: 15 studies were subject to a narrative synthesis. Conclusions: Older adults can experience substantial levels of PTG, from traumas during later life or across the lifespan, and historical wartime traumas. Traumas can be diverse, some studies found equivalent levels of PTG from different traumas across the lifespan. Social processes may be a key variable for older adults. Additional psychosocial factors are found; however, diverse findings reflect no overall model, and this may be consistent with variations found in other PTG literature. Clinical implications: Clinical considerations are discussed. As diverse studies, findings may not be widely generalizable and directions for further research are highlighted. PROSPERO: CRD42020169318.
... Studies using the PTGI indicate that growth is an important process for people with serious illness. For instance, between 10% and 73% of cancer patients experience moderate to high growth, as do 47% of heart disease survivors (Bluvstein et al., 2013;Wu et al., 2019). ...
... The PTGI is not a diagnostic instrument and lacks established cutoffs and reporting standards (Wu et al., 2019). To examine and describe the levels of PTG experienced by our participants, we drew inspiration from a study on PTG in cancer survivors (Jansen et al., 2011) and differentiated between no growth or low growth, moderate growth, and high to very high growth, as outlined in Table 1. ...
... We found that 44% of our participants experienced no growth or low growth, 47% moderate growth, and 9% high to very high growth. With 56% of palliative patients reporting moderate to very high PTG levels, our study reveals a prevalence level similar to that of cancer patients (46% to 73%), and higher than heart disease survivors (47%) (Bluvstein et al., 2013;Wu et al., 2019). Our results are particularly close to those of women with breast cancer (57-59%), adolescents and young adults with cancer (59%), and open heart surgery patients (57%) (Wu et al., 2019). ...
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Objectives Posttraumatic growth (PTG) refers to positive psychological changes resulting from individuals’ inner struggles with traumatic events such as life-threatening illness. Although palliative care patients are confronted with their own mortality, little is known about their PTG experience. This study investigates whether PTG is an empirically relevant concept for palliative patients by assessing the prevalence and areas of growth, and examining associations with psychological distress and quality of life. Methods Participants were recruited in Switzerland. Using validated questionnaires, we assessed PTG (Posttraumatic Growth Inventory, PTGI), psychological distress (Hospital Anxiety and Depression Scale), and quality of life (McGill-Quality of Life Questionnaire – Revised). We performed descriptive analyses, Spearman correlations, and linear regressions. Results Fifty-five patients completed the PTGI, 44% of whom experienced no/low growth, 47% moderate growth, and 9% high/very high growth. Participants experienced the greatest positive changes in terms of appreciating life and relating to others. We found significant negative bivariate correlations between PTG and psychological distress ( r = −0.33) and between PTG and depression ( r = −0.47). Linear regressions showed that PTG is associated with depression ( β = −0.468; p = 0.000), but not with anxiety or quality of life (adjusted R ² = 0.219). Significance of results Over half of our patients experienced moderate to very high growth, indicating that PTG is an empirically relevant psychological process in palliative care. PTG is associated with lower levels of depression, possibly as those experiencing growth are more able to process past traumas and build a more positive outlook on one's life and self. By contrast, the relative independence of anxiety and PTG points to the likely coexistence of positive and negative psychological responses to trauma. The lack of association between PTG and quality of life points to the uniqueness of the PTG concept in capturing how people access deeper meaning and greater appreciation of life along the path toward posttraumatic self-reconstruction.
... One criticism of the Posttraumatic Growth Inventory is that it does not facilitate the diagnosis of PTG (Wu et al., 2019). By offering only items that identify possible positive changes with a response scale that permits only the reporting of positive outcomes, the Posttraumatic Growth Inventory may skew reports in favor of growth (Boals & Schuler, 2018b). ...
... And because all scores besides 0 reflect reports of at least some growth, it is difficult to know when a satisfactory threshold has been reached for researchers to confirm that PTG has occurred (Wu et al., 2019). Wu et al. (2019) suggested that a score of 60% of the total possible score on the Posttraumatic Growth Inventory (a score of 63 or above on the full scale with a maximum of 105) or any of its subscales should be considered moderate-to-high PTG. ...
... And because all scores besides 0 reflect reports of at least some growth, it is difficult to know when a satisfactory threshold has been reached for researchers to confirm that PTG has occurred (Wu et al., 2019). Wu et al. (2019) suggested that a score of 60% of the total possible score on the Posttraumatic Growth Inventory (a score of 63 or above on the full scale with a maximum of 105) or any of its subscales should be considered moderate-to-high PTG. Their meta-analysis of 26 studies reporting Posttraumatic Growth Inventory scores for 10,181 individuals found that a little over half of participants in the included studies experienced moderate-to-high PTG under this definition (Wu et al., 2019). ...
Article
Background. Posttraumatic growth (PTG)—positive changes that people may experience in the aftermath of highly distressing experiences—has been observed in survivors of a variety of events but has not been previously studied among people who have caused accidental death or injury (PCADIs). In addition, questions remain about the role, in PTG, of changes in the assumptive world and the relationships between PTG and distress, personality, and social support. Methods. Participants (N = 528), included PCADIs (n = 44) and a non-trauma comparison group (n = 484), who completed the Primals Inventory and measures of personality, anxiety, and depression. PCADIs (n = 43) also completed measures of PTG, PTG behavioral changes, social support and life satisfaction. Results. Modest levels of PTG commensurate with survivors of other relevant forms of distress were observed. Results demonstrated significant differences between primal world beliefs Good, Safe, Enticing, Just, Regenerative, Funny, and Improvable in PCADIs and non-trauma survivors as well as significant positive relationships between PTG and the primals Good, Safe, Alive, Just, Regenerative, Funny, and Improvable and between PTG and reported behavior changes related to PTG, but no significant relationships were found between PTG and distress, PTG and social support, or PTG and personality traits Extraversion, Openness to Experience, Conscientiousness, or Agreeableness (though a significant negative relationship was observed between PTG and Neuroticism). Conclusions. PCADIs may experience PTG that both influences and is influenced by primal world beliefs, but the hypothesized relationships between PTG and distress, personality, and social support were not observed. Additional studies with larger PCADI populations may find these relationships exist at a statistically significant level. And future research should aim to develop interventions addressing the distress and growth potential of this population.
... In fact, both the full version and the short form of the PTGI, the PTGI-SF , are the most used assessment tools for PTG. These assessment tools are used in studies included in various meta-analyses, such as the ones published by Vishnevsky et al. (2010), Liu et al. (2017), and Wu et al. (2019). ...
... However, hardly any of these studies address that PTG can develop after suffering a terrorist attack. To be precise, none of the 63 studies in the meta-analysis conducted by Liu et al. (2017), or the 26 studies in the meta-analysis conducted by Wu et al. (2019), examined the appearance of PTG after a terrorist attack. Out of the 70 studies included in the Vishnevsky et al. (2010) meta-analysis, only five cover this topic. ...
... Previous studies have also found a relationship between the level of PTG and the elapsed time since the traumatic event (Linley and Joseph, 2004;Wu et al., 2019). For instance, the metaanalysis conducted by Wu et al. (2019) found that the presence of moderate levels of PTG was associated with the elapsed time since the traumatic event. ...
Article
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Background Scientific literature on posttraumatic growth (PTG) after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.Methods We examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks (range: 2–47 years). The participants had been injured by a terrorist attack (38.6%) or were first-degree relatives of people who had been killed or injured by a terrorist attack (41.4% and 20%, respectively). They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.ResultsMultiple regression analyses revealed gender differences (women reported higher levels of PTG than did men) and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.Conclusion The findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research.
... Having been infected with COVID-19 infection and being exposed to risk in work settings, frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19 (Wu et al., 2019;Kalaitzaki et al., 2020) involving a threat to life and mental health in daily basis, a major upheaval of their life habits linked to confinement and the difficulty of projecting themselves into the future (Constant, 2020). Work-related trauma can act as a catalyst for positive post-trauma changes (Wu et al., 2019) involving "life-changing" psychological shifts in thinking and relating to the world that is deeply meaningful (Tedeschi and Moore, 2021). ...
... Having been infected with COVID-19 infection and being exposed to risk in work settings, frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19 (Wu et al., 2019;Kalaitzaki et al., 2020) involving a threat to life and mental health in daily basis, a major upheaval of their life habits linked to confinement and the difficulty of projecting themselves into the future (Constant, 2020). Work-related trauma can act as a catalyst for positive post-trauma changes (Wu et al., 2019) involving "life-changing" psychological shifts in thinking and relating to the world that is deeply meaningful (Tedeschi and Moore, 2021). Although the negative psychological impact of COVID-19 on mental health have been examined in recent studies, little is known about the potential positive outcomes that may occur from the pandemic . ...
... Despite the adversities of trauma, some individuals report positive life changes, known as post-traumatic growth (PTG), including an increased appreciation for life, meaningful interpersonal relationships, sense of personal strength, changed priorities, and a richer existential/spiritual life (Tedeschi and Calhoun, 1995, 1996Rogan et al., 2013), as a result of their cognitive efforts to deal with challenging life events Calhoun, 2004, 1995). A systematic review found that 53% of individuals who endure trauma have experienced PTG from having to cope with life stressors (Wu et al., 2019), enjoying greater psychological and even physical wellbeing (Manning-Jones et al., 2015). ...
Article
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Background: Frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19. Post-traumatic growth (PTG) happens when a person can transform trauma and use adversity in one’s advantage. In response to limited studies on positive outcomes that may occur from the pandemic; this study aimed to elucidate the positive impact of coping with COVID-19 outbreak on mental health, such as PTG. Methodology: The study comprised a sample of 691 healthcare providers 59% female, including physicians ( n = 138) and nurses ( n = 550), working in public health facilities in Kosovo, with an average age of 41.6 years ( SD = 10.79). They were asked to complete a questionnaire with four parts: Socio-demographic, GHQ-28, COPE and PTGI. A deterioration of mental health with somatic symptoms leading to the escalation due to COVID-19 outbreak was found. Results: Female healthcare providers reported more clinical symptoms as well as higher coping skills scores than men. The domains in which positive changes were most frequently observed were Relating to Others, New Possibilities and Personal Strength. There was no significant direct effect of mental health on PTG in the mediation model, though a significant indirect effect was observed for coping skills. Conclusion: The results suggest that levels of mental health exacerbation do not play a conclusive role in determining levels of PTG, as long coping mechanisms are in place. The development and implementation of interventions to minimize COVID-19-related mental health consequences, by fostering PTG among healthcare providers could be highly beneficial in pandemic response work.
... Tedeschi and Calhoun (2004) defined PTG as the experience of positive changes that can occur as a consequence of struggling with highly challenging life crises or stressful events. PTG is a phenomenon that has been observed in different types of stressful events (Hegelson et al., 2007;Xiaoli et al., 2019). However, although the experience of PTG following an occupational accident is plausible (Maitlis, 2019), empirical evidence is scarcer than for other stressful events (e.g., García & Miranda, 2019). ...
... According to Tedeschi and Calhoun (1996), these perceived positive changes can happen in three areas of life: a) changes in one's self: for example, perceiving oneself as stronger and more confident, with more experience and ability to cope with difficulties in the future; b) changes in interpersonal relationships: for example, realizing who are the true friends or the strongest and most genuine relationships; c) changes in spirituality or in life's philosophy: for example, a higher appreciation of one's own existence or taking a better distinction between important and accessory goals. A metaanalysis based on 26 articles on three types of trauma (i.e., diseases, accidents, and workrelated trauma experienced in professions relating to security, military, health), found that 52.58% of individuals report moderate to high PTG (Xiaoli et al, 2019). However, this meta-analysis only included five studies analyzing the effects of accidents and did not specifically report whether they were occupational. ...
... Second, the nature of one's exposure and the severity of the experience appear relevant to the PTG process. A meta-analysis revealed that the prevalence of PTG in direct trauma victims was higher (54.05 %) than in indirect trauma victims (50.4%) (Xiaoli et al, 2019). This finding supports the idea that growth can only occur if the person rates their experience as severe or intense (Zoellner & Maercker, 2006;Helgeson et al., 2006). ...
Article
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This study analyzed a predictive model of posttraumatic growth (PTG) in a cohort of 244 workers affected by an occupational accident. A longitudinal design with three points in time (i.e., 1, 6, and 12 months after the accident) was used. PTG, posttraumatic stress symptoms (PTSS), subjective severity of the event, deliberate rumi-nation, and seeking social support were evaluated. In addition, time since the accident, age, and gender were included as predictors in our model. Deliberate rumina-tion and seeking social support significantly predicted PTG trajectory in a multilevel model. Practical conclusions from the results suggest that work accident victims should be encouraged to seek social support and to positively reframe their experience.
... Tedeschi and Calhoun (2004) defined PTG as the experience of positive changes that can occur as a consequence of struggling with highly challenging life crises or stressful events. PTG is a phenomenon that has been observed in different types of stressful events (Hegelson et al., 2007;Xiaoli et al., 2019). However, although the experience of PTG following an occupational accident is plausible (Maitlis, 2019), empirical evidence is scarcer than for other stressful events (e.g., García & Miranda, 2019). ...
... According to Tedeschi and Calhoun (1996), these perceived positive changes can happen in three areas of life: a) changes in one's self: for example, perceiving oneself as stronger and more confident, with more experience and ability to cope with difficulties in the future; b) changes in interpersonal relationships: for example, realizing who are the true friends or the strongest and most genuine relationships; c) changes in spirituality or in life's philosophy: for example, a higher appreciation of one's own existence or taking a better distinction between important and accessory goals. A metaanalysis based on 26 articles on three types of trauma (i.e., diseases, accidents, and workrelated trauma experienced in professions relating to security, military, health), found that 52.58% of individuals report moderate to high PTG (Xiaoli et al, 2019). However, this meta-analysis only included five studies analyzing the effects of accidents and did not specifically report whether they were occupational. ...
... Second, the nature of one's exposure and the severity of the experience appear relevant to the PTG process. A meta-analysis revealed that the prevalence of PTG in direct trauma victims was higher (54.05 %) than in indirect trauma victims (50.4%) (Xiaoli et al, 2019). This finding supports the idea that growth can only occur if the person rates their experience as severe or intense (Zoellner & Maercker, 2006;Helgeson et al., 2006). ...
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This study analyzed a predictive model of posttraumatic growth (PTG) in a cohort of 244 workers affected by an occupational accident. A longitudinal design with three points in time (i.e., one month, six months and twelve months after the accident) was used. PTG, posttraumatic stress symptoms (PTSS), subjective severity of the event, deliberate rumination, and social support seeking were evaluated. In addition, time since the accident, age and gender were included as predictors in our model. Deliberate rumination and social support seeking significantly predicted PTG trajectory in a multilevel model. Results suggest, as practical conclusions, that victims of work-related accidents should be encouraged to seek social support and positive reframe their experience.
... This evolutionary process, partly resulting from stress and strong emotion following an aversive event, is not systematic. According to Wu's meta-analyses [9], around half the individuals may develop such process following a traumatic event, without erasing its negative impact [10]. PTG is commonly measured by the Post-Traumatic Growth Inventory (PTGI), a multidimensional scale developed by Tedeschi and Calhoun [10], that includes five fields of development: appreciation of life, richer relationships with others, strength in the face of difficulties, new possibilities, and spirituality. ...
... The second questionnaire (VICAN 5) was administered in 2015 and 2016 to 4,174 participants; among them, 2,009 individuals had already participated in the VICAN 2 survey. A detailed description of the methodology and data collection is available elsewhere [9]. ...
... PTGI score, obtained by summing up all 21 items, varies between 0 and 105 with higher scores denoting higher PTG. We identified a moderate to high PTG (60% of the higher score) in individuals presenting a PTGI score greater or equal to 63 [9]. Individuals with scores lower than 62 were characterized as having a low PTG. ...
Article
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Background: The number of cancer survivors is growing increasingly worldwide. The long-term negative consequences of the disease are now better known. Cancer may also foster positive outcomes. Some survivors consider life after cancer as the start of a new life and experience positive changes called post-traumatic growth (PTG) measured by a scale developed by Tedeschi and Calhoun. Objective: The purpose of this article was to explore actionable factors affecting PTG, particularly those in relation with health care management and those that reflected health behavior changes. Methods: This study included the 1,982 participants in the VICAN cohort who responded to the questionnaire on living conditions 2 and 5 years after diagnosis. Factors associated with a moderate or high PTG (score ≥ 63) were identified using logistic regressions. Results: Factors positively associated with moderate or high PTG were being satisfied with the time spent by health care team on information (OR:1.35 [1.08;1.70]), increased physical activity (OR:1.42 [1.04;1.95]) and healthier diet (OR:1.85 [1.44;2.36]) since diagnosis, and having benefited from psychological support at diagnosis (OR:1.53 [1.16;2.01]). Conclusion: High PTG is positively associated with health behavior and time spent on information. Our findings suggest that appropriate clinical and educational interventions can help foster growth after the experience of cancer. Even if we do not know what causes what, it is admitted that the interventions leading to an increase of physical activity, for example, are good from all points of view.
... The existence of posttraumatic growth has been documented following a wide range of traumatic events, such as war (e.g., Hall et al., 2010;Powell et al., 2003), life-threatening illness (e.g., Bellizzi and Blank, 2006;Leong Abdullah et al., 2015), a terrorist attack (e.g., Butler et al., 2005;Hobfoll et al., 2006), or the loss of a loved one (e.g., Caserta et al., 2009;Drapeau et al., 2019;Moore et al., 2015). While not all people may experience positive personal and psychological changes in the aftermath of trauma, posttraumatic growth is estimated to affect one in two who experienced a traumatic event (Wu et al., 2019). Individual differences in the development of PTG or the overall likelihood of PTG to develop following a traumatic event have been (cautiously) associated with a wide range of psychological factors. ...
... The COVID-19 pandemic has triggered an array of emotional, physical, and economic issues and, as such, can be understood as a traumatic stressor event capable of eliciting PTSD-like responses, potentially exacerbating other mental health issues in the process (Bridgland et al., 2021). Posttraumatic growth, that is positive change following trauma and adversity, is estimated to affect one in two trauma survivors (Wu et al., 2019). Aspects related to the experienced trauma, such as the intensity of PTSD symptomatology, as well as one's coping style, perceived level of social support, resiliency factors and overall affect, have been associated with individual differences in PTG (Baños et al., 2021;Ogińska-Bulik and Kobylarczyk, 2016;Rzeszutek, 2018;Tedeschi and Calhoun, 2004;Zoellner and Maercker, 2006). ...
Article
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The COVID-19 pandemic has affected all areas of life, with severe potential consequences for people's mental health. Posttraumatic growth (PTG), a positive psychological change that may develop following a traumatic event, in light of the COVID-19 pandemic has only received little attention. The current study aimed to investigate (1) the prevalence of PTG within the context of the COVID-19 pandemic and (2) which psychological aspects predict COVID-19 pandemic-related PTG using a 1-year longitudinal design. A sample of 70 participants completed a survey on COVID-19, posttraumatic stress, emotional well-being, coping styles, determinates of resilience, and PTG at both T1, May 2020, and T2, May 2021. Results reveal moderate levels of PTG for about one in five participants at both T1 and T2 (21% and 23% respectively). Moreover, PTG at T1 and T2 were moderate to strongly, positively correlated, r = .62. Posttraumatic stress and social support were found to positively predict PTG at T1, while positive affect and social skills were found to positively predict PTG at both T1 and T2, βs = .22–.52. Implications of the current findings and suggestions for future research are discussed.
... 13 These positive psychological changes, which have produced an unused perception of life after stressful life events, is called posttraumatic growth (PTG) 14 and is suggested as a common and representative result after natural disasters. 15,16 Unlike psychological resilience, which refers to the ability to maintain the levels of psychological well-being after continuing a traumatic event, PTG refers to positive psychological changes and growth further than previous levels of performance due to the challenging crises of life, which through cognitive reconstruction, lead to adaptation to the new reality. 17 When confronting life-threatening events, through struggling with traumatic experiences, traumatized survivors re-assess their goals and priorities; therefore, positive changes following the trauma focus on the five aspects: "Recognizing Personal Strength" occurs when a greater sense of self-reliance is recognized; "Finding Unknown Possibilities and Opportunities" is experienced when people improve a new path that would have not been available if they did not experience the life emergency in the first place; The "Experiencing Positive Changes in Relationships" domain involves developing a greater sense of kindness or closeness to others; "Appreciation of Life" simultaneously appears to possess a greater appreciation for each new day of life; and finally the "Spiritual and Existential Change" domain indicates personal growth associated with a far better understanding of spiritual issues and, then, developing a greater sense of harmony with the planet. ...
... 26 Paying attention to this issue is effective in the detailed examination and long-term explanation of the subject of the present research. The previous study 15 showed that most adolescents, 1 y after the Wenchuan earthquake, were categorized in the high PTG group (76.9%), which was characterized by initially higher and, subsequently, increasing PTG. ...
Article
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Posttraumatic stress disorder (PTSD) is one of the most important issues after earthquakes. Following the Bam earthquake, much of the literature has documented the prevalence and correlates of PTSD, but no study has evaluated predominant typologies of PTSD in this population. The present study aims to investigate PTSD typologies among adults exposed to the Bam earthquake after 17 years. The data were collected 17 years after the 2003 Bam earthquake using multistage cluster sampling, in a historical cohort study. In total, 917 people participated in the study. Latent class analyses (LCA) were conducted to identify predominant typologies of PTSD symptoms and associated correlates. The LCA identified four meaningfully different classes that were characterized based on the PTSD items. The common profile was class 1 with 36.1% of the study population, which reported medium on “Re-experiencing” and “avoidance” items and high for “dysphoria” item. Also, the results showed significant differences for marital status, death relative, and age across the four classes of PTSD. The results indicated after 17 years of the Bam earthquake, people who were exposed to this earthquake were divided into subgroups based on the severity and prevalence of PTSD symptoms. These findings highlighted the existence of experimental subgroups of PTSD symptoms following an earthquake, which can help us find those who are most in need of mental health services and also which can find specific interventions for any subgroups.
... respectively, for the Relating to Others, Personal Strength, and Appreciation of Life subscales. For some analyses, the composite score was dichotomized into low (i.e., less than 2.0) and moderate to high (i.e., 2.0 or higher; Wu et al., 2019). ...
... However, the prevalence of posttraumatic growth in the present sample was low compared to findings from studies of child and adolescent populations in which 30%-70% of adolescents reported moderate-to-high levels of posttraumatic growth after experiencing a traumatic or life-changing event (Laufer & Solomon, 2006;Milam et al., 2004). Similarly, the prevalence was low compared to findings from studies in adult populations, which have reported prevalence rates of approximately 50% after experiencing a serious disease or accident or being employed in a profession that carries a high risk of trauma exposure (Wu et al., 2019). The relatively low prevalence of posttraumatic growth may be attributable to the notion that the COVID-19 pandemic may have been perceived as less intrusive or significant than other stressful and traumatic experiences typically examined in posttraumatic growth research. ...
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The negative consequences of the COVID‐19 lockdown during the spring of 2020 have been documented. However, adolescents may also have experienced positive personal and interrelational changes. This was the first study to examine the prevalence of posttraumatic growth (PTG) during the lockdown. We additionally explored how potential risk and protective factors, as well as experiences with the pandemic, were related to PTG and whether these associations were moderated by mental health resources and social support. We used data from a representative survey of 12,686 junior and senior high school students from Oslo, Norway, conducted during the lockdown (37% response rate, 56.4% girls). A short version of the Posttraumatic Growth Inventory was used to assess growth relative to personal strength, relationships with others, and appreciation of life. Several potential predictors in the domains of mental health, social relationships, experiences during the pandemic, and sociodemographic background factors were examined. Results from multiple regression analyses showed that satisfaction with life, parental care, worries about the pandemic, and immigrant status were the most prominent predictors of PTG, βs = .14–.22, p < .001. Moderation analyses indicated a complex interplay between predictors of PTG by showing that good mental health was associated with higher degrees of PTG only in groups typically considered to be at higher risk of adverse outcomes. The findings provide information regarding who would profit from additional help to reinterpret the dramatic events during the lockdown to facilitate growth.
... 7 Posttraumatic growth has also been found in many cultures and religions, 6−9 and has been shown to be related to coping skills and social support, 10,11 as well as sociodemographic variables. 12 −14 In the context of the COVID-19 pandemic, a recent study found that age had a significant effect on posttraumatic growth, such that younger age was related to greater growth. 15 These results are similar to previous studies that have shown that younger people experience more posttraumatic growth compared to older people, 6 although it should be noted that studies on groups with average ages over 70 are rare. ...
... 15 These results are similar to previous studies that have shown that younger people experience more posttraumatic growth compared to older people, 6 although it should be noted that studies on groups with average ages over 70 are rare. 6,12 Given that older individuals have a greater vulnerability to COVID-19, the findings by Celdran and colleagues suggest that older adults may have perceived the event as more fearful than the younger individuals, thereby reducing the appearance of posttraumatic growth during this period. 15 However, more studies in the oldest generation are needed to understand more deeply the mechanisms that might generate posttraumatic growth in older adults. ...
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Background The COVID-19 pandemic has disproportionately impacted the most vulnerable and widened the health disparity gap in both physical and mental well-being. Consequentially, it is vital to understand how to best support elderly individuals, particularly Black Americans and people of low socioeconomic status, in navigating stressful situations during the COVID-19 pandemic and beyond. The aim of this study was to investigate perceived levels of stress, posttraumatic growth, coping strategies, socioeconomic status, and mental health between Black and non-Hispanic, White older adults, the majority over the age of 70. Additionally, we investigated which variables, if any, were associated with posttraumatic growth in these populations. Methods One hundred seventy-six community dwelling older adults (mean age = 76.30 ±8.94), part of two observational studies (The Harvard Aging Brain Study and Instrumental Activities of Daily Living Study) in Massachusetts, US, were included in this cross-sectional study. The survey, conducted from March 23, 2021 to May 13, 2021, measured perceived stress, behavioral coping strategies, posttraumatic growth, and mental health during the COVID-19 pandemic. We investigated associations with post-traumatic growth in a multiple linear regression model and examined their differences by race with t-tests, Wilcoxon rank-sum tests, and Fisher's exact tests. A second multiple linear regression model was used to examine which coping strategies were associated with posttraumatic growth. Findings Our results indicated no significant difference between the groups in terms of mental health or stress. However, Black participants showed significantly greater posttraumatic growth compared to non-Hispanic, White participants. Additionally, the coping strategies of religion and positive reframing were found to be significantly associated with posttraumatic growth. Furthermore, even with the effects of stress and coping strategies controlled for, race remained significantly associated with posttraumatic growth. Interpretation The COVID-19 pandemic has differentially impacted Black and non-Hispanic White older adults. These results may help encourage further analysis on geriatric psychiatry as well as understanding how cultural values and adaptations impact posttraumatic growth and mental health in diverse populations. Funding The Harvard Aging Brain Study (HABS) has been funded by NIH-NIA P01 AG036694 (PI: Reisa Sperling). The IADL study is funded by the National Institute on Aging (R01 AG053184, PI: Gad A. Marshall).
... While a traumatic event can cause post-traumatic symptoms, it can also be a catalyst for positive change, with mounting research showing post-traumatic growth resulting from an adaptive response to, and coping with, trauma [11,12]. Despite the negative sequelae of COVID-19 on mental health, research begun documenting positive psychological effects of the pandemic. ...
... Higher perceived threat of COVID-19 predicted greater post-traumatic growth. This finding was in line with our expectations given that post-traumatic growth has been proposed as a possible positive psychological consequence of encountering a traumatic event [11,12,109]. In fact, when it comes to negative events, perceiving an event as traumatic seems to be a prerequisite for growth [110,111]. ...
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Background Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people’s experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. Methods Adult participants from the general population ( N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. Results Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. Conclusions Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.
... There is evidence that sustained stressors such as natural disasters may have long-lasting consequences on mental health 22,23 . However, other studies showed that most people were resilient in the long-term, or their mental health improved following an initial deterioration 24,25 . These previous findings are consistent with the idea that Scientific Reports | (2022) 12:5632 | https://doi.org/10.1038/s41598-022-09663-2 ...
... In addition, mental health improvement over time may indicate a process of adaptation to long stressful events that promote the emergence of new coping skills 25,49 . ...
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Psychological-distress increased at the onset of the COVID-19 pandemic in Argentina. Longitudinal studies in developing countries are scarce. Particularly, Argentina had one of the longest lockdowns. Differences in preventive measures against the virus spread between countries may differentially affect the mental health of the populations. Here we aimed to characterize distinct psychological-distress and related-symptoms trajectories associated with the pandemic and explore risk/protective factors. In this longitudinal study, data from 832 Argentineans were collected every 3–5 months, between April 2020–August 2021. Mean psychological-distress levels and related-symptoms tended to increase over time. However, latent-class analysis identified four distinct psychological-distress trajectories. Most individuals had consistently good mental health (Resilient). Two classes showed psychological-distress worsening during the initial phase of the pandemic and recovered at different time points (Fast Recovery; Slow Recovery). The remaining class maintained a mild -level of psychological-distress and began to deteriorate in March 2021 (Deteriorating) continuously. Individuals who are younger, female, have pre-existing psychiatric diagnoses, or have high neuroticism or lower resilience were more likely to experiencing fluctuations in psychological-distress. The mental health trajectory during the pandemic had a complex dynamic. Although most participants remained resilient, a vulnerable group was detected, which deteriorated over time and should be considered by health-services.
... Although one may consider posttraumatic growth as an indicator of better mental health, it represents a separate construct on the ground that positive and negative effects of traumatic experiences often coexist (Tedeschi & Calhoun, 1996, 2004. Contrary to what one may expect, moderate to high posttraumatic growth among individuals who experienced trauma is very common with a prevalence rate of 52.58% (Wu et al., 2019). Also, posttraumatic growth is moderately correlated with social support, spirituality, and optimism (Prati & Pietrantoni, 2009) and it has an adaptive significance in both clinical and healthy subjects (Barskova & Oesterreich, 2009;Prati & Pietrantoni, 2014;Tedeschi & Calhoun, 1996). ...
... The last aim of this study was to compare posttraumatic growth between the profiles of reaction to the COVID-19 pandemic. There is evidence that posttraumatic growth represents a relatively common experience of the struggle with trauma that frequently, but not always, coexist with psychological symptoms (Wu et al., 2019). However, more research is still needed to understand its specific role in the aftermath of the pandemic. ...
Article
Objective: This study aimed to examine the profiles of reaction to the COVID-19 pandemic based on the combination of fear and future orientation, as well as their sociodemographic, situational, and relational predictors. We also compared posttraumatic growth between the profiles. Method: A sample of 640 Italian participants completed the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF), the Future Orientation Scale (FOS), the UCLA Loneliness Scale-Version 3, and the Posttraumatic Growth Inventory (PTGI). Results: Latent profile analysis indicated a 4-class solution as the best-fitting model. The first profile ("Detached") comprised 9.9% of the sample and was characterized by both low fear and future orientation. The second profile ("Hopeful") concerned 49.9% of the sample and it featured low fear and high future orientation. The third profile ("Constructively Preoccupied") involved 35.5% of the sample and was distinguished by high fear and high future orientation. The fourth profile ("Fearful") included 4.6% of the sample and was marked by high fear and low future orientation. Multinomial logistic regressions indicated that the female gender was more likely to be associated with the Constructively Preoccupied profile, while older age was more likely to be associated with the Hopeful one. Higher perceived loneliness was associated with all profiles except the Hopeful. Results of comparisons showed substantial differences in posttraumatic growth between the profiles. The Constructively Preoccupied profile showed the greatest posttraumatic growth. Conclusions: Overall, these results point out the various profile of reaction to the pandemic and that adopting a person-oriented approach could enhance their grasp. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... Most people quickly regain normal function after exposure to traumatic stress, a phenomenon commonly labelled resilience [13]. Moreover, even among those who suffer from trauma related distress, it is not uncommon for the traumatic experience to also instigate a trajectory of positive psychological development, often referred to as posttraumatic growth (PTG) [14]. ...
... 11.2)) and 47.2% (n = 226) were female (mean age 34.4 (std.10.4)). The median number of years of work experience in EMS was 12 (IQR [12][13][14][15][16][17][18][19], and reported education level was as follows: student/trainee 8.4% (n = 40), EMT 46.1% (n = 221), nurse 21.1% (n = 101), paramedic 24.4% (n = 117). Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. ...
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Background Posttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel. Methods This study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale. Results The response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences. Conclusions This study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development.
... People differ in how they perceive and make sense of their experience after devastating or stressful life circumstances (Corona et al., 2019;Park, 2010). While some are able to improve their personal perspectives when confronting challenging incidents (Wu et al., 2019), others may have difficulty in finding meaning and perceive those events as aversive or anxiety provoking (Szymanski et al., 2016). Therefore, how people interpret and make meaning of stressors can greatly affect individuals' mental health in a positive or negative way. ...
Article
Young adults with psychological problems are at risk for experiencing personal, social, and economic difficulties, such as educational problems, poverty, social difficulties, and unemployment. Therefore, understanding the risks and protective factors of psychological health problems is a critical step in designing preventative approaches and interventions to foster young adults’ mental health and well-being. This study aims to examine the mediating role of meaning in life, positive emotions, and negative emotions in the relationship between psychological maltreatment and psychological health problems among Turkish young adults. The study included 381 young adults. Participants were 33% male and 67% female and ranged in age from 18 to 41 years (M = 20.73, SD = 3.36). Structural equation modelling indicated that psychological maltreatment had significant predictive effects on positive and negative emotions and meaning in life among young adults. Psychological maltreatment was also predictive of emotions and psychological health problems through meaning in life, and meaning in life mitigate the negative effect of maltreatment on well-being and psychological health. Similarly, both negative and positive emotions mediated the effect of psychological maltreatment on young adults’ psychological health problems. In these results indicate that psychological maltreatment’s effect on psychological health can be mitigated through cultivating meaning in life and positive emotions and striving to manage negative emotions.
... Thus, successful personality change following adversity needs to work against both defensive behaviors and other immediate stress responses (Jayawickreme, Infurna, et al., 2021;Wrzus & Roberts, 2017). Observable personality growth is scarce after traumatic events, except that a significant number of people perceive to have grown after the event (Wu et al., 2019). Perceived personality growth is often reported in life narratives of traumatic events or low points (Jayawickreme, Infurna, et al., 2021), thus, reflecting upon and evaluating the adverse events through narrative processes may be especially relevant for personality growth, at least on the third tier of personality. ...
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Adversity has been assumed to foster positive personality change under certain conditions. In this article, we examine this assumption within the context of the three-tier personality framework integrating traits, characteristic adaptations, and narrative identity to provide a comprehensive understanding of personality growth. We first review findings on how adverse events affect personality on each of these three levels. Second, we summarize knowledge on event-based and person-based predictors of personality change in the face of adversity. Third, we specify affective, behavioral, and cognitive processes that explain personality change across levels of personality. Innovatively, our proposed process model addresses change at all three levels of personality, as well as similarities and differences in processes across the levels. We conclude by discussing unresolved issues, asking critical questions, and posing challenging hypotheses for testing this framework.
... Researchers suggest that people will likely be exposed to a traumatic event at least once in their lifetime (Wu et al. 2019). Approximately 5-30% of those who experience a traumatic event may develop post-traumatic stress disorder (PTSD) in addition to any physical injury sustained as a result of the traumatic event (Bonanno, 2004;Bonanno and Mancini, 2008;Shigemoto et al. 2017). ...
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The present study sheds light on the phenomenon whereby groups experience adversity, following which they show signs of growth. We propose the conceptualization of post-traumatic growth as a phenomenon that also exists at the group level, “community post-traumatic growth” (CPTG). The concept of CPTG is explained using a case study on the ultra-Orthodox Jewish community in Israel following the first wave of the coronavirus disease 2019 (COVID-19) pandemic. The study describes shared characteristics of Israeli ultra-Orthodox society and the crisis it experienced during the first wave of the COVID-19 pandemic, both in terms of physiological features such as the relatively high proportion of affected people and in terms of psychological characteristics such as the shut-down of synagogues and yeshivas, and the perceived discrimination they experienced from the general population in Israel. The present study views the sense of discrimination as a traumatic factor at the group level. In total, 256 participants completed online questionnaires examining three hypotheses: (1) sense of discrimination (trauma) will be correlated with level of CPTG; (2) the level of identification with the ultra-Orthodox culture will be positively related to CPTG, while the level of identification with Israeli culture will be negatively correlated with CPTG; (3) the level of life satisfaction of the individual will be predicted by CPTG. The results supported the hypotheses and are discussed at length in the discussion section.
... Higher values indicate higher posttraumatic growth. A recent metanalysis suggested that is more appropriate to use the term "moderate to high PTG" when either the total or each PTGI item score is >60% [27]. Based on this, we considered moderate growth levels at a total score of 63 and at an item level of 3. Scale reliability was high in our study (Cronbach's a = 0.95). ...
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Background: Individuals with physical or mental health conditions represent a vulnerable population, especially during the COVID-19 pandemic. However, limited information is available concerning posttraumatic growth and common mental health symptoms of this vulnerable health group during COVID-19. Methods: An online cross-sectional study (STRONG study; psychological changes and effects after COVID-19 quarantine in Greece) was conducted from 28 September 2020 (no lockdown restrictions) to 2 November 2020, just before the second lockdown in Greece. Main outcomes were depressive and anxiety symptoms as well as posttraumatic growth. Results: A total of 860 adults participated in the study. A high proportion of participants did not report any pre-existing health condition (61%), while 334 individuals reported one or more physical or mental health conditions. Overall, 20.2% of the participants reported significant depressive symptoms, and 27.9% reported moderate to high posttraumatic growth. The presence of physical and mental health conditions, either as single diagnosis or as a multimorbidity, was significantly associated with the development of depressive symptomatology (either physical or mental health conditions: OR = 1.12; 95% CI, 1.07–1.17, p < 0.001; both physical and mental health conditions: OR = 1.23; 95% CI, 1.14–1.33, p < 0.001). Posttraumatic growth did not differ between those with or without any pre-existing health issue. Conclusions: Although having a physical or/and a mental health condition predicted the development of depressive symptomatology in a post-lockdown period, the presence of pre-existing conditions was not associated with posttraumatic growth development. Clinicians should be aware of depressive symptoms among their multimorbid patients, even after exiting lockdown.
... But in recent years, according to the theoretical framework of positive psychology, which considers health as a continuum from positive to (lack of) negative results, researchers have also drawn attention to positive consequences 8 ; since human beings are active, growth-oriented organisms and tend to mix their psychological experiences into a fused sense of self 9 . These positive psychological changes, which have produced an unused perception of life after stressful life events, is called post-traumatic growth (PTG) 10 and is suggested as a common and representative result after natural disasters 11 . Unlike psychological resilience, which refers to the ability to maintain the levels of psychological well-being after continuing a traumatic event, PTG refers to positive psychological changes and growth further than previous levels of performance due to the challenging crises of life, which through cognitive reconstruction, lead to adaptation to the new reality 12 . ...
Article
Objective Posttraumatic growth (PTG) is a positive psychological change after challenging life events. The purpose of this study was to investigate the effects of positive and long-term psychological changes in people who experienced the Bam earthquake. Methods A total of 916 adolescents were surveyed 17 years after the earthquake. Self-report questionnaires were administered to participants. A latent profile analysis (LPA) was conducted to extract the subgroups of adults. Results The LPA identified 5 meaningfully profiles that were characterized based on the pattern of PTG dimensions. The common profile was profile, which perceived very low “relating to others” dimension and medium for other PTG dimensions. Also, the results showed significant differences among gender and age and nonsignificant differences in marital status and education level among the profiles of PTG. Conclusions For stressful situations, the different dimensions of PTG change indirectly in every person. In Bam, some patterns are seen according to PTG after 17 y. Among these dimensions, the part of “relating to others”, has the greatest change. Another conclusion is that according to a relatively high profile for 5 clusters, it seems the impact of 17 y should be less on PTG as the number of extractive patterns is approximately high for the case.
... Another possible explanation may be that the pandemic changed subjective stress appraisals by putting stressful experiences into perspective (Fernández Cruz et al., 2020). A burgeoning literature points to the ability of humans to grow in the face of disasters and other major stressful life events (Shing et al., 2016;Wu et al., 2019). Specifically, being faced with an uncontrollable and potentially life-threatening disease, the appraised harm of daily hassles and consequently their impact on one's well-being might fade (Shing et al., 2016). ...
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Individuals all across the world experienced significant disruptions in their personal and family life with the outbreak of the new coronavirus disease 2019 (COVID-19). The current study investigated dynamic associations between stress and relationship functioning over time in the face of the COVID-19 pandemic. Perceived stress, relationship satisfaction, and relationship quality (appreciation, intimacy, conflict) were reported by 1483 young to middle-aged participants who were in a romantic relationship and lived with their partner in 2018/2019 and in May-July 2020 (a few months after the onset of COVID-19). Data were analyzed using bivariate latent change score models. Relationship functioning (satisfaction, appreciation, intimacy) showed small decreases from before to during the pandemic. Contrary to expectations, levels of perceived stress also decreased on average from before to during the pandemic. Changes in relationship functioning were correlated with changes in stress over time, so that participants with greater decreases in relationship satisfaction, appreciation, and intimacy and greater increases in conflict from before to during the pandemic showed lesser decreases/greater increases in stress. Higher pre-pandemic relationship satisfaction was associated with greater decreases/ lesser increases in stress from before to during the pandemic. Pre-pandemic levels of other measures of relationship functioning or stress were not associated with changes in outcomes over time. Results add to the literature demonstrating that stress is closely intertwined with the functioning of intimate relationships. Furthermore, they suggest that greater relationship satisfaction may serve as a protective factor for stressful life events.
... It is well recognised that PTG can occur after both physical or psychological trauma (Wu et al., 2019), and it has been shown to be associated with better mental health outcomes such as lower rates of depressive disorders in longitudinal studies of those with serious medical conditions, (Barskova & Oesterreich, 2009). One significant exception to this is PTSD, which has an inverted 'u'-shaped (curvilinear) relationship with PTG (Shakespeare-Finch & Lurie-Beck, 2014), whereby as PTSD symptoms increase, so does PTG, until a threshold is met, at which point as PTSD symptoms increase, PTG decreases. ...
Article
Background: The long-term psychosocial outcomes of UK armed forces personnel who sustained serious combat injuries during deployment to Afghanistan are largely unknown. We aimed to assess rates of probable post-traumatic stress disorder (PTSD), depression, anxiety, and mental health-associated multimorbidity in a representative sample of serving and ex-serving UK military personnel with combat injuries, compared with rates in a matched sample of uninjured personnel. Methods: This analysis used baseline data from the ADVANCE cohort study, in which injured individuals were recruited from a sample of UK armed forces personnel who were deployed to Afghanistan and had physical combat injuries, according to records provided by the UK Ministry of Defence. Participants from the uninjured group were frequency-matched by age, rank, regiment, deployment, and role on deployment. Participants were recruited through postal, email, and telephone invitations. Participants completed a comprehensive health assessment, including physical health assessment and self-reported mental health measures (PTSD Checklist, Patient Health Questionnaire-9, and Generalised Anxiety Disorder-7). The mental health outcomes were rates of PTSD, depression, anxiety, and mental health-associated multimorbidity in the injured and uninjured groups. The ADVANCE study is ongoing and is registered with the ISRCTN registry, ISRCTN57285353. Findings: 579 combat-injured participants (161 with amputation injuries and 418 with non-amputation injuries) and 565 uninjured participants were included in the analysis. Participants had a median age of 33 years (IQR 30-37 years) at the time of assessment. 90·3% identified as White and 9·7% were from all other ethnic groups. The rates of PTSD (16·9% [n=89] vs 10·5% [n=53]; adjusted odds ratio [AOR] 1·67 [95% CI 1·16-2·41], depression (23·6% [n=129] vs 16·8% [n=87]; AOR 1·46 [1·08-2·03]), anxiety (20·8% [n=111] vs 13·5% [n=71]; AOR 1·56 [1·13-2·24]) and mental health-associated multimorbidity (15·3% [n=81] vs 9·8% [n=49]; AOR 1·62 [1·12-2·49]) were greater in the injured group than the uninjured group. Minimal differences in odds of reporting any poor mental health outcome were noted between the amputation injury subgroup and the uninjured group (AOR range 0·77-0·97), whereas up to double the odds were noted for the non-amputation injury subgroup compared with the uninjured group (AOR range 1·74-2·02). Interpretation: Serious physical combat injuries were associated with poor mental health outcomes. However, the type of injury sustained influenced this relationship. Regardless of injury, this cohort represents a group who present with greater rates of PTSD than the general population, as well as increased psychological burden from multimorbidity. Funding: The ADVANCE Charity.
... There is a consensus that most people are quite resilient in face of negative changes or potentially traumatic events (82)(83)(84). Onset of societal or economic instability (for example, a recession) may have unstructured effects on suicide rates (85,86). Nevertheless, vulnerability factors (such as previous mental health issues, suicide attempts, a history of self-harm, male sex, age, unemployment and belonging to disadvantaged social groups) may influence the life-long mental health risks, and indeed play an important role in the suicidality dynamics (77,(87)(88)(89). ...
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Background Suicidality is a serious public health concern at a global scale. Suicide itself is considered to be preventable death; worldwide, suicide rates and their trends are under constant scrutiny. As part of the international COMET-G cross-sectional study, we conducted a national level investigation to examine the individual disturbances (such as anxiety, depression, or history of life-threatening attempts) and contextual factors (such as adherence to conspiracy theories or Internet use) associated with suicidality related to the COVID-19 lockdown in a lot of Romanian adults. Participants and Methods One thousand four hundred and forty-six adults responded to an anonymous on-line questionnaire, with mean age ± standard deviation of 47.03 ± 14.21 years (1,142 females, 292 males, 12 identified themselves as non-binary). Data were analyzed using descriptive statistics and structural equation modeling (SEM). Results Univariate analysis showed strong significant correlation between anxiety and depression scorings among the respondents (Spearman R = 0.776, p < 0.001). Both the suicidality scorings and the Internet use correlated fairly with anxiety and depression, with two-by-two Spearman coefficients between R = 0.334 and R = 0.370 ( p < 0.001 for each). SEM analysis substantiated the emotional disturbances, previous life-threatening attempts, and younger age as significant predictors for suicidality. The patterns of reality reading (including religious inquiries, Internet use, and beliefs in conspiracy theories) did not reach the statistical significance as influential factors in the suicidality of these respondents. There was no covariance between the Internet use and belief in conspiracy theories. Conclusion The study confirmed the suicidality risk initially hypothesized as being associated with the history of life-threatening attempts, increased depression within the younger population, and higher anxiety during the first year of the COVID-19 pandemic and its related lockdown. National strategies for effective interventions at various levels of the healthcare system should be developed.
... It should be emphasised that in both analysed situations, the correlations are positive, although the higher strength of the correlation of traumatic stress associated with COVID-19 was associated with a negative perception of the consequences of this pandemic. This discovery was partially in line with our expectations, because the PTG theory was proposed as a possible positive psychological consequence of the encountered traumatic events [46,47], and the individual's perception of a traumatic event becomes a necessary condition for development [48,49]. On the basis of the obtained research results, it can be hypothesized that too high an intensity of traumatic stress causes a negative perception of the consequences of a pandemic. ...
Article
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It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of this study is to determine the relationship between selected sociodemographic variables and selected subjective cognitive resources, and the positive and negative perception of the consequences of the COVID-19 pandemic in a group of nurses working in Poland. The computer-assisted web interviewing method was conducted between 1 and 15 May 2020. Participants were requested to complete the following questionnaires: The Changes in Outlook Questionnaire (CIOQ), The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Safety Experience Questionnaire (SEQ), and The Meaning in Life Questionnaire (MLQ). Three-hundred and twenty fivenurses working all over Poland participated in the study. Their mean age was 39.18 ± 11.16 years. A higher average level was noted among the surveyed nurses in the Positive Change subscale (18.56 ± 4.04). In a multivariate model, taking into account both sociodemographic and cognitive variables, the level of perceived traumatic stress, the level of social support, a sense of security, reflection on safety and a sense of meaning and meaning in life were independent predictors of a positive perception of the consequences of the COVID-19 pandemic. Those variables explained as much as 37% of the dependent variable, and the nature of the relationship was positive. While we are still a long way from understanding the full range of the long-term impact of the COVID-19 pandemic on mental health and psychosocial well-being, it is possible that in this challenging context there are many individual resources available to perceive the effects of the current pandemic positively. Therefore, they should be strengthened through the development and implementation of intervention programs to improve the mental state of nurses.
... Tedeschi and Calhoun [9] defined PTG as a positive psychological change experienced as a result of adversity or other challenges to reach a higher level of life functioning. Growth refers to the personal development that goes beyond coping, meaning a qualitative change in people's ability to function and adapt to adverse circumstances [10,11]. It would include a greater appreciation of life; a changed sense of priorities; deeper relationships; a greater emotional states [43]. ...
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Psycho-oncology research suggests that positive personal changes can occur after experiencing breast cancer. These changes can be understood as post-traumatic growth (PTG) and seem to be determined by emotional self-efficacy perception. This study aims to investigate the existence of different profiles of PTG and perceived emotional intelligence (PEI) among breast cancer survivors (BCSs) and healthy controls. Moreover, it aims to study the mechanisms through which PEI may mediate the relationship between disease survival and PTG. The total sample was 636 women divided into two groups: 56 BCS and 580 healthy controls who completed TMMS-24 and PTGI. The results displayed that BCSs apparently show a different profile of PTG and PEI compared to healthy women. The mediation analyses showed that survivorship explained 1.9% of PTG, increasing to 26.5% by the effect of PEI. An indirect effect showed that cancer survival predicts reduced levels of emotional attention, decreasing PTG. However, the most statistical indirect effect evidenced that BCSs regulate their emotions appropriately, having a powerful effect on PTG and counteracting the negative effects of poor emotional attention. Knowing the implications of PEI on PTG could improve follow-up from the time of diagnosis and supporting the patient to cope with the sequelae of the disease.
... Tedeschi and colleagues have identified five primary domains of growth from coping with adversity: (a) increased appreciation of life, (b) stronger or more meaningful relationships with others, (c) spiritual or existential changes, (d) an increased sense of personal strength, and (e) openness to new possibilities (Tedeschi & Calhoun, 1996;Tedeschi et al., 2017Tedeschi et al., , 2018Tsai et al., 2016). A meta-analysis of the prevalence of moderate-to-high PTG among trauma survivors was 10% to 77% across studies (M prevalence = 52%; Wu et al., 2019). Thus, similar to resilience, PTG is both remarkable and common. ...
Article
The literature suggests that the relationship between posttraumatic growth (PTG) and posttraumatic stress (PTS) is curvilinear, and that type or severity of trauma may affect this relationship. The relationship between depression, anxiety, and PTG is understudied. Participants (N = 541) were emerging adult students at a southeastern United States university who had been exposed to one or more posttraumatic stress disorder diagnostic Criterion A events. Participants completed a cross-sectional survey with self-report scales on traumatic event exposure, event severity, PTG, PTS, depression, anxiety, and meaning in life. Controlling for meaning in life, gender, and trauma severity, regression analyses revealed curvilinear PTS predicted linear PTG. A different curvilinear relationship was found for depression/anxiety and PTG, in which curvilinear PTG predicted linear depression/anxiety. The curvilinear model of PTS and PTG supported Park’s meaning-making model, that recovery from PTS, through meaning-making, results in PTG. The curvilinear relationship between depression/anxiety and PTG replicated the minimal literature on depression and PTG, that many survivors experience PTG in the absence of clinically significant depression or anxiety.
... Whilst the risk of traumatisation and re-traumatisation is evident within the population, some studies have begun to highlight the role of post-traumatic growth (PTG) as a potential outcome of the pandemic. A meta-analysis by Wu et al. (2019) has previously suggested that individuals who have experienced a traumatic event could later report moderate-to-high PTG in the future. This was evident within a wide range of trauma types, including military-related. ...
Article
Background: The 2019 coronavirus pandemic has posed a challenge to society to cope with an unprecedented threat. Veterans with pre-existing mental health conditions, such as PTSD, may be susceptible to further re-traumatisation due to COVID-19 restrictions and increased anxiety and depression. Bonding and a sense of connectedness with others are seen as basic psychological needs for maintaining wellbeing. Decreased social connectedness can play a significant role in creating barriers to coping and worsening psychological problems. As the pandemic progresses, the current UK restrictions may challenge veterans’ ability to function, and their abilities to cope, stay connected and adapt. Aims: This thesis had three primary aims: (1) to investigate the relationship between coping, depression, anxiety, traumatic stress, coronavirus anxiety, and social connectedness following COVID restrictions using a cross-sectional survey, (2) to use the results from the survey to inform qualitative data collection and recruitment to interviews, and (3) to gain an experiential understanding of the impact that COVID restrictions may have had from the veteran perspective. Method: A two-phase sequential explanatory design was used and involved two phases: (1) a cross-sectional survey exploring social connectedness, anxiety, depression, traumatic stress, coronavirus anxiety, and coping amongst UK veterans from all branches of the military (n=130). Participants were selected for interview from phase one using a ‘participant selection model’, and overall sample data informed the development of the interview schedule (2) a qualitative exploration of the impact of the pandemic on a sub-sample of the population (n=11) using semi-structured interviews, with transcripts being analysed using reflective thematic analysis. Participants were primarily recruited through social media and veteran charities. Maximum variation sampling was used to select participants for interviews. Results: Phase 1: Spearman’s rank correlations demonstrated a negative association between traumatic stress and social connectedness (
... Over the past 2 decades, several empirical studies have shown that survivors of potentially traumatic events may report positive psychological outcomes after being exposed to highly stressful events (Wu et al., 2019) such as sexual abuse (Hartley et al., 2016); bereavement (Albuquerque et al., 2018), cancer (Aydin & Kabukçuo glu, 2020), natural disasters (Bernstein & Pfefferbaum, 2018), or combat exposure (Zerach, 2020). These positive psychological outcomes might include a strengthened sense of self, a profound and empathic connection with others, new priorities in life, a deepened meaning of life, or a new philosophy of life (Tedeschi & Calhoun, 1996). ...
Article
The relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) has been extensively debated, with evidence supporting that negative and positive outcomes may coexist simultaneously. However, literature consensus has yet to be reached regarding whether the nature of the relationship between these variables is better explained through a linear or curvilinear relationship. In the present study, we examined the psychometric properties of the Posttraumatic Growth Inventory and tested the linear and curvilinear relationship between PTG and PTSD. Participants were 315 adults, with a mean age of 34.66 years (SD = 10.90), and ranged in age between 18 and 68 years; 144 (45.7%) par- ticipants were male and 171 (54.3%) were female who had experienced a potentially trauma or adverse event and had a level of education lower than the university education level. The original 5-factor struc- ture of the PTGI was maintained, with satisfactory internal consistency. Exploratory data analysis showed a violation of the normality assumption because the sample reported low levels of PTSD. We used the bootstrap method, which gives an estimate of the sampling distribution (Field, 2018). Results showed a linear positive relationship between PTSD symptoms and PTG, after adjusting for sociodemo- graphic variables. A curvilinear relationship between these variables was not found in the present sam- ple. An overall small positive relationship was found between each PTSD subscale (Intrusion, Avoidance, and Arousal) and the 5 PTGI factors. This study found that PTSD and PTG can coexist. Implications for practice and recommendation for future research are discussed. Keywords:
... Regarding the sociodemographic profile with greater PTG, it was that of the women and younger age groups, similar to that reported in previous studies (Helgeson et al., 2006;Vishnevsky et al., 2010;Wu et al., 2019;Kalaitzaki, 2021). Furthermore, the variables significantly related to PTG were mostly consistent with previous studies. ...
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The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).
... It is well recognised that PTG can occur after both physical or psychological trauma (Wu et al., 2019), and it has been shown to be associated with better mental health outcomes such as lower rates of depressive disorders in longitudinal studies of those with serious medical conditions, (Barskova & Oesterreich, 2009). One significant exception to this is PTSD, which has an inverted 'u'-shaped (curvilinear) relationship with PTG (Shakespeare-Finch & Lurie-Beck, 2014), whereby as PTSD symptoms increase, so does PTG, until a threshold is met, at which point as PTSD symptoms increase, PTG decreases. ...
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Background Post-traumatic growth (PTG) is a positive psychological consequence of trauma. The aims of this study were to investigate whether combat injury was associated with deployment-related PTG in a cohort of UK military personnel who were deployed to Afghanistan, and whether post-traumatic stress disorder (PTSD), depression and pain mediate this relationship. Methods 521 physically injured ( n = 138 amputation; n = 383 non-amputation injury) and 514 frequency-matched uninjured personnel completed questionnaires including the deployment-related Post-Traumatic Growth Inventory (DPTGI). DPTGI scores were categorised into tertiles of: no/low (score 0–20), moderate (score 21–34) or a large (35–63) degree of deployment-related PTG. Analysis was completed using generalised structural equation modelling. Results A large degree of PTG was reported by 28.0% ( n = 140) of the uninjured group, 36.9% ( n = 196) of the overall injured group, 45.4% ( n = 62) of amputee and 34.1% ( n = 134) of the non-amputee injured subgroups. Combat injury had a direct effect on reporting a large degree of PTG [Relative risk ratio (RRR) 1.59 (95% confidence interval (CI) 1.17–2.17)] compared to sustaining no injury. Amputation injuries also had a significant direct effect [RRR 2.18 (95% CI 1.24–3.75)], but non-amputation injuries did not [RRR 1.35 (95% CI 0.92–1.93)]. PTSD, depression and pain partially mediate this relationship, though mediation differed depending on the injury subtype. PTSD had a curvilinear relationship with PTG, whilst depression had a negative association and pain had a positive association. Conclusions Combat injury, in particular injury resulting in traumatic amputation, is associated with reporting a large degree of PTG.
... On the other hand, according to some authors (e.g., Ulloa et al., 2016), traumatic events that are related to some kind of sexual violence may lead to growth because of their major effect on the survivors' self-perception and their potential awareness of social themes related to their experience. According to a metaanalysis by Wu et al. (2019), about 53% of people exposed to some form of a traumatic event (chronically ill people, war veterans, firefighters, rescuers, etc.) consequently experience at least medium posttraumatic growth, with women reporting higher scores of PTG than men (e.g., Vishnevsky et al., 2010;Hamama-Raz et al., 2020). However, gender differences in PTG scores seem to depend on the measure used to examine PTG (Barskova and Oesterreich, 2009). ...
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Despite negative connotations, surviving trauma can result in improvements in some domains of a person's life. This phenomenon is known as posttraumatic growth (PTG), and it is typically measured using the Posttraumatic Growth Inventory (PTGI). Given the ambiguous results of the existing validation studies, the present study aimed to verify the psychometric properties of the Slovak version of the PTGI in a representative sample of Slovak citizens. Although the results suggest that a modified one-factor structure fit the data best, other issues, such as extremely high correlations between the latent factors related to the PTGI's factor structure, were observed. It is likely that the application of the latent variable model does not represent the essence of PTG adequately and the network approach thus appears to be a far more suitable conceptualization of PTG. More detailed information on between-person differences and within-person changes in PTG could help to tailor more effective interventions or preventive programs.
... Ultimately, this leads to revised world views and positive changes that manifest in five domains: (a) greater appreciation of life; (b) strengthening of relationships; (c) bolstering of personal strengths; (d) openness to new possibilities or enhancement of life purpose; (e) spiritual development (Tedeschi & Calhoun, 1996). A recent meta-analysis indicates that around one in two people who experienced traumatic events report moderate-to-high degrees of post-traumatic growth, even though the level of PTG across studies showed high heterogeneity ranging from 10 to 77.3% (Wu et al., 2019). ...
Article
The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.
... Indeed, exposure to more than one traumatic event is not uncommon (Kilpatrick et al., 2013). Although some individuals adapt well over time and report positive change following adversity (Tedeschi & Calhoun, 1996;Xiaoli et al., 2019), research has established that the experience of traumatic events may have negative implications in both the short-and long-term for individuals' quality of life (see Straussner & Calnan, 2014). In a recent review of the trauma literature, Lopez-Martinez et al. (2018) reported links between trauma exposure and physical health issues, such as coronary heart disease, diabetes, and obesity. ...
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This research assessed direct and mediated relations between lifetime trauma exposure and physical and mental health, with deviation from a balanced time perspective (individuals’ perception of the past, present, and future time frames) as a potential mediator. Participants were 238 undergraduates who completed online assessments of trauma exposure, quality of life, and time perspectives. Mediation analyses revealed that a greater number of traumas indirectly influenced quality of life by way of deviation from a balanced time perspective. Discussion underscores the importance of balance in time perspectives, particularly when adjusting to adverse life events.
... However, similar to the construct of PTSD, it can be argued that PTG also avoids context (Zur, 1996). A meta-analysis by Wu et al. (2019) reported that approximately 50 percent of individuals who experienced trauma experience some PTG. Regarding the impact of SARS on HCWs, 86 percent reported a new appreciation for the meaning and importance of their profession (Tam et al., 2004 Frank (1995), writing in the United States, notes cultural expectations for certain forms of story. ...
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The COVID-19 pandemic is thought to be the greatest challenge the United Kingdom (UK)’s intensive care units (ICUs) have faced. The literature on experiences of nurses working during the COVID-19 pandemic is rapidly evolving. However, there appears to be a scarcity of research on how nurses who worked in ICUs during the pandemic construct their experiences and identities, within social, cultural and political contexts. A qualitative approach, specifically narrative inquiry, was employed to explore the accounts of six nurses, all of whom worked in an ICU during the COVID19 pandemic. The nurses were both ICU-trained nurses and redeployed nurses from other departments, recruited from a specialist cardiothoracic hospital. Nurses were interviewed individually using a semi-structured format. The content and structure of their narratives were analysed, with attention to performative and contextual aspects and the construction of narrative identity. Nurses constructed rich, multi-layered narratives, enhancing the existing literature. Three broad stories were observed across the accounts: 1. “It came with like a bang”, 2. Working in the red zone, and 3. Looking back, looking forward. Nurses faced a multitude of morally challenging situations, including an inability to provide the usual standard of care, lack of adequate personal protective equipment (PPE), and faced the danger of contracting the virus and fears of infecting others. The analysis highlighted that the nurses worked to construct credible narratives that conveyed the difficulties they encountered. This particularly can be seen within the broader contention relating to the existence of the pandemic, despite being depicted as ‘heroes’ by society, the Government and the media. Clinical implications and future research suggestions are proposed.
... The perspectives of our study participants also suggest possibilities for post-traumatic growth, described as positive change experienced due to a traumatic experience [36]. In practice, the continuing perceived threat of COVID-19 and strong social connections have both been shown to increase the possibility of post-traumatic growth [37]. ...
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The COVID-19 pandemic has profoundly affected the lives of almost every individual in every nation, with numbers of infections continuing to grow. Across these nations, first responders are essential in their roles addressing emergencies, despite their risk of exposure to COVID-19 in the course of their work. We sought to understand the impacts of the COVID-19 pandemic on the lives of volunteer firefighters in the United States, an understudied group of these first responders. Interviews were conducted with volunteer firefighters between September and November 2021. Interviews were analyzed using deductive dominant thematic analysis. Thirty-three firefighters were interviewed who had an average of 22 years of service and a mean age of 52 years. Interviewees described pandemic-related challenges including the fear of COVID exposure and frustrations with work and personal relationships. They also identified unexpected work-related benefits including a deepened commitment to serve and improvements to training and safety. Further, some volunteers noted personal benefits such as developing stronger connections with others, having a new outlook on life, and observing goodwill. Our findings provide insight into the multifaceted and complex impact of the COVID-19 pandemic on volunteer firefighters.
... Indeed, research suggests that exposure to traumatic events can promote resilience (Bensimon, 2012;Cénat et al., 2018). Studies showing the beneficial effects of exposure to (and potentially overcoming) trauma have led to a blossoming area of research on posttraumatic growth (Orejuela-Dávila et al., 2019;Tsai et al., 2015;Wu et al., 2019). However, not everyone has equivalent exposure to and benefit from traumatic experiences. ...
... However, stressinduced immune enhancement can also be negative/harmful if it exacerbates pathological immune responses that mediate proinflammatory, allergic, or autoimmune responses (DiSabato et al., 2020). Considering coping outcomes, it is possible to distinguish whether the presence of stress promotes problemsolving, brings about growth (Ord et al., 2020), or brings about negative effects and stress-related disorders (Wu et al., 2019). ...
Article
Stress psychology is an interesting and important interdisciplinary research field. In this perspective article, we briefly discuss 10 challenges related to the conceptual definition, research methodology, and translation in the field of stress that do not receive sufficient attention or are ignored entirely. Future research should attempt to integrate a comprehensive stress conceptual framework into a multidimensional comprehensive stress model, incorporating subjective and objective indicators as comprehensive measures. The popularity of machine learning, cognitive neuroscience, and gene epigenetics is a promising approach that brings innovation to the field of stress psychology. The development of wearable devices that precisely record physiological signals to assess stress responses in naturalistic situations, standardize real‐life stressors, and measure baselines presents challenges to address in the future. Conducting large individualized and digital intervention studies could be crucial steps in enhancing the translation of research.
Article
Background: Post-traumatic growth (PTG) refers to beneficial psychological change following trauma. Aims: This study explores the sociodemographic, health and deployment-related factors associated with PTG in serving/ex-serving UK armed forces personnel deployed to military operations in Iraq or Afghanistan. Method: Multinomial logistic regression analyses were applied to retrospective questionnaire data collected 2014-2016, stratified by gender. PTG scores were split into tertiles of no/very low PTG, low PTG and moderate/large PTG. Results: A total of 1447/4610 male personnel (30.8%) and 198/570 female personnel (34.8%) reported moderate/large PTG. Male personnel were more likely to report moderate/large PTG compared with no/very low PTG if they reported a greater belief of being in serious danger (relative risk ratio (RRR) 2.47, 95% CI 1.68-3.64), were a reservist (RRR 2.37, 95% CI 1.80-3.11), reported good/excellent general health (fair/poor general health: RRR 0.33, 95% CI 0.24-0.46), a greater number of combat experiences, less alcohol use, better mental health, were of lower rank or were younger. Female personnel were more likely to report moderate/large PTG if they were single (in a relationship: RRR 0.40, 95% CI 0.22-0.74), had left military service (RRR 2.34, 95% CI 1.31-4.17), reported better mental health (common mental disorder: RRR 0.37, 95% CI 0.17-0.84), were a reservist, reported a greater number of combat experiences or were younger. Post-traumatic stress disorder had a curvilinear relationship with PTG. Conclusions: A moderate/large degree of PTG among the UK armed forces is associated with mostly positive health experiences, except for post-traumatic stress disorder.
Article
Objective Severe burn injuries have profound mental health impacts on individuals, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Many burn survivors also report positive psychosocial changes, termed posttraumatic growth (PTG). This study investigated long-term mental health of severe burn injury (i.e., PTSD, MDD, and PTG) and the longitudinal influences of coping strategies and social support. Methods Ninety-nine adult burn survivors of the 2015 Formosa Fun Coast Water Park fire disaster participated in the 5-year follow-up (Wave 3, W3), with 93% completing the earlier 2- (Wave 1, W1) and 3-year follow-up (Wave 2, W2). Participants averaged 22.1 years of age at burn, and 62.6% were females. The mean total body surface area burned (TBSA) was 50.3%, with a mean length of hospital stay of 87.6 days. Results Five years after the 2015 fire disaster, 13.1%, and 14.1% of the survivors met probable DSM-5 PTSD and MDD, while 51.5% reported significant PTG. After controlling for demographic, burn-specific, and baseline outcome variables, avoidance coping at W2 prospectively predicted PTSD and depressive symptoms at W3 (p = .003 and 0.04), with medium-to-large and medium effect sizes (sr² = 0.10 and 0.05). Approach coping at W2 prospectively predicted PTG at W3 (p = .014), with a medium-to-large effect size (sr² = 0.07). Conclusion Rates of probable PTSD and MDD were still relatively high in long-term burn survivors. However, PTG continued to be highly prevalent. Our findings highlight the importance of coping in affecting the long-term mental health of severe burn injury.
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Introduction It has been reported that adversarial growth during traumatic events potentially enhances coping with sequelae. The purpose of this work was to assess post-traumatic growth (PTG) amongst radiation medicine staff members at the individual level as well as changes in perceptions of departmental culture following the COVID-19 pandemic. Materials/Methods An anonymous post-traumatic growth inventory (PTGI) survey comprising 21 indicators was disseminated to all 213 members of our multi-center radiation department to measure perceptions of change in personal, interpersonal-relationship and philosophy of life factors using principal-factor analysis. Additionally eight department safety-culture indicators from the National Hospital Patient Safety Culture Survey developed by the Agency for Healthcare Research and Quality (AHRQ) were included to assess changes in department safety-culture perceptions verses a pre-pandemic survey. The survey was repeated fifteen months later to assess longitudinal trends. Results With a 56.3% survey-response rate, PTGI factor analysis yielded Cronbach's alpha values exceeding 0.90 for the 3 aforementioned PTG factors. The average growth per indicator was 2.3 (out of 5.0) which fell between small and moderate. The values were 2.4 (personal), 2.1 (inter-personal) and 1.6 (philosophy) for the 3 factors. The total PTGI score (47.7±28.3 out of 105 points) was lower for masked, patient-facing, frontline workers members (41.8±28.4) compared with others (53.1±27.3, p-value 0.001). For the AHRQ survey there was an improvement of 15% in perceptions of department safety culture and 7 of the 8 indicators showed improvements compared with baseline. The follow-up survey demonstrated overall sustained findings albeit with a trend towards declining PTG scores for non-frontline workers notably in inter-personal relationships (47.4±27.0, p-value 0.05). Conclusions A fair-to-moderate degree of post-traumatic growth was observed in personal and inter-personal relationship factors while least growth was noted in spiritual and religious beliefs. Perceptions of department patient-safety culture improved substantially. Sustained improvements were thus perceived at the individual and department levels.
Article
Purpose: This study aims to examine the relationship between the transformative power of pain and posttraumatic growth in nurses with positive Covid-19 polymerase chain reaction (PCR) test. Design and method: "Sociodemographics Form," "Transformative Power of Pain Scale," and "Post-Traumatic Growth Scale" were used to collect the data of the study. Findings: In the study, posttraumatic growth increased as the level of the transformative power of pain increased for nurses. Furthermore, some variables were found to have an effect on the transformative power of pain and the posttraumatic growth mean score in nurses who had positive Covid-19 PCR test. Practice implications: Nurses should be provided with social and professional psychological support to improve their transformative power of pain and posttraumatic growth levels.
Studies show that experiencing traumatic events can lead to positive psychological change, or posttraumatic growth (PTG). In the hope of promoting PTG, authors have been focusing on identifying the factors that may foster PTG. Despite these attempts, the literature shows inconsistencies, making it difficult to know which variables may be involved in the process of growth. Indeed, authors seem to disagree on the nature of the relationship between PTSD and PTG, time since the event, social support, intrusive rumination, and sociodemographics. Thus, this study aims to clarify these discrepancies, and verify whether the processes involved are the same across two different cultural groups, both of which are confronted with traumatic events regularly: 409 American firefighters, and 407 French firefighters. Results indicate that, in both samples, PTG is positively related to PTSD, subjective perceptions of the event, stress during the event, disruption of core-beliefs, and deliberate rumination; and unrelated to social support, core-self evaluations, and socio-demographic variables (age, gender, relationship status, etc.). However, time since the event and the number of years on the job only predicted PTG in the American sample, while colleague and emotional support only predicted PTG in the French sample. Additionally, American firefighters reported more growth, more social support, more positive self-perceptions, more intrusive rumination, and more neuroticism than French firefighters. These results suggest that the process of growth, as defined by Tedeschi and Calhoun, is relatively stable among firefighters, but that some differences do exist between cultural groups.
Article
We sought to examine the correlation between resilience and posttraumatic growth (PTG) in fathers of children with intellectual disabilities (ID), exploring the mediating effect of coping. We also tested whether this mediation effect is moderated by sense of stress. Raising a child with ID has been associated with both negative and positive aspects of psychological functioning. Little is known, however, about determinants of positive changes in fathers. The data for this study come from 106 Polish fathers of children with ID who completed a set of questionnaires measuring PTG, resilience, coping strategies, and sense of stress. The relations between variables using moderated mediation were tested. PTG correlates positively with resilience. Coping strategies (i.e., seeking emotional support and religion) are mediators of this relationship, and sense of stress is a moderator of this mediation. Higher levels of sense of stress increase the mediating role of these coping strategies, which translates into higher PTG in fathers with higher resilience. The relationship between resilience and PTG is complex, mediated by coping strategies, and differs in fathers with high and low stress. Knowledge on the importance of resilience and coping strategies for experiencing positive changes may be used by professionals working with fathers raising children with ID.
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Objective This study focuses on positive effects of the COVID-19 pandemic and aims to identify associations between gender, individual quarantine and duration of the COVID-19 (short- medium- and long-term pandemic), and posttraumatic growth (PTG). Method The data was collected via an online survey in Israel, and included 1,301 participants, 543 participants experienced short-term pandemics, 428 participants experienced medium-term pandemics and 330 participants experienced long-term pandemics. Most of the participants were female (73.6%), ranging from 18 to 89 years-old. The participants answered questions about their demographic background, individual quarantine experiences and ranked their PTG level. Results The results indicate a significant main effect of gender and pandemic duration (short-, medium- and long-term pandemic). Women reported higher PTG levels than men, and participants experiencing short-term pandemic reported significantly lower PTG levels than participants experiencing medium- or long-term pandemic. There was also a significant interaction between gender and pandemic duration regarding PTG and a significant interaction in PTG by gender, pandemic duration and individual quarantine. Conclusion The discussion addresses the findings in the context of traditional gender roles and gender differences in finding meaning and worth in home confinement situations.
Article
Objective: Research into post-traumatic growth (PTG) finds individuals report positive changes in their identity, relationships, and worldviews after trauma. In a pre-registered 16-week longitudinal study, we examined trait change after recent trauma exposure to test an operationalization of PTG as positive personality change. We examined the influence of intrapersonal and social factors including motivation to change traits, perceived social support, and event centrality. Method: Participants (n = 1004) reported on trauma exposure in past 1-month, centrality of each traumatic event, and social support. Participants with trauma exposure (n = 146) and a matched control group reported on their traits in 8 waves at 2-week intervals, and motivation to change traits in 3 waves. Results: Although some trait change was observed, it was not consistent with PTG. We found agreeableness declined in the trauma relative to the control group among participants who did not want to change in this trait. Conscientiousness declined for individuals with highly central traumas. Social support predicted increases in emotional stability, conscientiousness, and openness but only for individuals in the control group. Conclusions: We discuss the value of defining PTG as positive trait change and suggest future directions including assessment of facet-level changes and ideographic methods.
Article
Psychiatric nurses often experience burnout and other mental health symptoms. However, few studies have examined these phenomena and gender‐specific associated factors during the COVID‐19 pandemic. We surveyed a national sample of psychiatric nurses (N = 8971) from 41 tertiary psychiatric hospitals in China as part of a large national survey conducted during the pandemic. The Maslach Burnout Inventory‐Human Service Survey was used to assess burnout and the Depression, Anxiety, and Stress Scale‐21 was used to assess mental health symptoms. Binary logistic regression analyses were used to explore factors associated with burnout in the entire sample and separately by gender. The overall prevalence of burnout was 27.27%, with the rate in male psychiatric nurses (32.24%) being significantly higher than that in female psychiatric nurses (25.97%). Many key demographic factors (such as the male gender and marital status), work‐related variables (such as a mid‐level professional title, having an administrative position, longer working hours, more monthly night shifts, and the perceived negative impact of the COVID‐19 pandemic on medical work) were significantly associated with burnout in the whole sample. Moreover, burnout was associated with depression, anxiety, and stress symptoms in the whole sample. Gender‐specific factors associated with burnout were also identified: burnout was associated with night shifts in male psychiatric nurses, whereas it was associated with single or married marital status, a mid‐level professional title, and having an administrative position among female psychiatric nurses. The high rates of burnout and mental health symptoms in psychiatric nurses need attention from hospital administrators. While mental health symptoms, longer working hours, and the perceived impact of COVID‐19 are associated with burnout in both genders, gender‐specific factors also warrant special attention when developing gender‐specific interventions.
Article
Trauma can disrupt an individual's core beliefs about themselves, others, and the world. Posttraumatic growth (PTG) is thought to be the outcome of a reconstruction process involving ruminative processing. This meta‐analysis examined the strength of the associations between event‐related intrusive and deliberate rumination and PTG. The moderating effects of variables including age, time since trauma exposure, and trauma type were examined. Eight databases were searched for English‐language, peer reviewed studies examining the associations between PTG and types of event‐related rumination in adults. Effect sizes (Pearson's r) were extracted and analyzed, and study quality was assessed using the Study Quality Assessment Tool for Observational and Cohort studies. In total, 46 studies were included based on the inclusion and exclusion criteria. A significant main effect was observed for the association between retrospectively reported deliberate rumination that occurred soon after a traumatic event and PTG, r = .45, 95% CI [.41, .49]. There was significant variability in effect sizes, and the strength of this association differed according to age. The association between intrusive rumination and PTG was not significant and varied in direction. Deliberate rumination that occurred relatively soon following trauma exposure was shown to be positively associated with PTG. The findings highlight the importance of supporting trauma survivors to engage in the deliberate cognitive processing of their experiences to encourage PTG. Longitudinal research is needed to further delineate the temporal role of event‐related rumination in PTG development.
Article
Background Traumatic events related to war and displacement may lead to development of posttraumatic stress symptoms (PTSS), but many war trauma survivors also report experiencing posttraumatic growth (PTG). However, the phenomenon of PTG remains poorly understood among refugees. Previous findings are also contradictory on whether more PTSS associate with PTG and what specific symptoms or aspects of growth may account for any possible link. Objective and Method Here, we aimed to better understand posttraumatic growth among refugees, especially its structure and most important constituent elements, as well as how it associates with PTSS. We employed regression and network analysis methods with a large sample (N = 3,159) of Syrian and Iraqi refugees living in Turkey self-reporting on PTG and PTSS. Results We found PTG and PTSS to be clearly distinct phenomena. Still, they often co-occurred, with a positive, slightly U-shaped relationship found between levels of PTSS and PTG. The main bridge between the constructs was identified from intrusive symptoms to having new priorities in life, although new priorities were more peripheral to the overall network structure of PTG. Meanwhile, discovering new psychological strengths and abilities and a new path in life emerged as elements most central to PTG itself. Conclusions Many refugees report elements of PTG, even as they suffer from significant PTSS. The two phenomena appear distinct but positively associated, supporting the idea that intense cognitive processing involving distress may be necessary for growth after trauma. Our findings may inform efforts to support refugee trauma survivors in finding meaning and perhaps even growth after highly challenging experiences.
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COVID-19 presented a major societal challenge including threat to life, bereavement, self-isolation, loss of income and significant psychological distress. Yet, it is possible that such suffering may also lead to post-traumatic growth (PTG) and subsequent wellbeing. The current study aimed to investigate the contributors to PTG and whether PTG mediated their relationship with wellbeing, measured using the Warwick-Edinburgh Mental Well-being Scale. In a cross-sectional sample of 136 participants (mean age = 30.52; SD = 13.80), a hierarchical regression and mediation analysis was conducted, focusing on physical activity, gratitude, tragic optimism, social support, and nature connection, guided by our recently published ‘GENIAL’ framework (Mead, Fisher, & Kemp, 2021). The regression analysis highlighted that our variables predicted up to 18% of the variance in PTG, whilst controlling for age, gender and subjective social status, with gratitude and nature connection being key predictors – indicating the importance of these factors over and above previously reported contributors to PTG, such as social support. Our findings provide new evidence on the drivers of PTG and raise important questions concerning the relationship between the related constructs of PTG and wellbeing. Limitations and suggestions for future research are discussed.
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Objective Little is known concerning post-traumatic growth (PTG) after liver transplantation. Against this backdrop the current study analysed the relationship between PTG and time since transplantation on quality of life. Furthermore, it compared PTG between liver transplant recipients and their caregivers. Design Cross-sectional case–control study. Setting University Hospital in Spain. Participants 240 adult liver transplant recipients who had undergone only one transplantation, with no severe mental disease, were the participants of the study. Specific additional analyses were conducted on the subset of 216 participants for whom caregiver data were available. Moreover, results were compared with a previously recruited general population sample. Outcome measures All participants completed the Posttraumatic Growth Inventory, and recipients also filled in the 12-Item Short-Form Health Survey. Relevant sociodemographic and clinical parameters were also assessed. Results In the sample of 240 recipients, longer time since transplantation (>9 years) was associated with more pain symptoms (p=0.026). Regardless of duration, recipients showed lower scores on most quality of life dimensions than the general population. However, high PTG was associated with a significantly higher score on the vitality quality of life dimension (p=0.021). In recipients with high PTG, specific quality of life dimensions, such as bodily pain (p=0.307), vitality (p=0.890) and mental health (p=0.353), even equalled scores in the general population, whereas scores on general health surpassed them (p=0.006). Furthermore, liver transplant recipients (n=216) compared with their caregivers showed higher total PTG (p<0.001) and higher scores on the subscales relating to others (p<0.001), new possibilities (p<0.001) and appreciation of life (p<0.001). Conclusions Our findings highlight the protective role of PTG in the long-term outcome of liver transplant recipients. Future studies should analyse and develop psychosocial interventions to strengthen PTG in transplant recipients and their caregivers.
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There is almost no data on the role of social support and in general on posttraumatic growth among people who have missing family member(s) as result of war and who experience ambiguous loss. This study explores relationship between reported posttraumatic growth and perceived social support and social activism in community-based organizations dealing directly with issues of missing persons. Family members who reported higher levels of social support from family, friends, and important others reported significant higher levels of posttraumatic growth. Family members that reported being active in community-based organizations reported significant higher averages in posttraumatic growth scores in total and its subscales. Regression analyses indicates that factors associated posttraumatic growth were as follows: being active in community organization dealing with missing person's issues and higher levels of social support from friends and family. Findings provide insight for clinicians working with this population and psycho social experts working in postconflict contexts.
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Purpose: The development of post-traumatic growth was studied longitudinally within 14 months poststroke. The predictions of two models of post-traumatic growth were examined. Method: Forty-three stroke survivors were investigated at two time points (i.e., time 1 and time 2), six months apart. Each completed the Post-traumatic Growth Inventory, Rumination Scale, Impact of Events Scale, Multidimensional Scale of Social Support, the Barthel Index and the COPE scale. Results: Post-traumatic growth was evident four to five months after stroke, increasing significantly over the next six months at which point levels resembled those reported in cross-sectional stroke studies. Active and denial coping and rumination at time 1 were positively associated, and age was negatively associated, with post-traumatic growth at time 2, but acceptance coping was not associated. Neither active coping nor rumination mediated the effect of social support on post-traumatic growth as predicted. As predicted, rumination mediated the relationship between post-traumatic stress and post-traumatic growth. Exploratory stepwise regression demonstrated rumination and active coping at time 1 accounted for 45% of variance in post-traumatic growth at time 2. Conclusions: Post-traumatic growth can develop soon after stroke. Deliberate rumination is a key factor in post-traumatic growth. Both active coping and denial coping were associated with post-traumatic growth demonstrating the psychological complexity of poststroke adjustment. • Implications for rehabilitation • Therapists can expect stroke survivors to show post-traumatic growth in the first months after stroke. • Therapists should look to promote post-traumatic growth and positive adjustment through working with survivors to increase active coping (attempts to deal effectively with the impact of stroke) and rumination (cognitive processing of the impact of the stroke). • Since denial coping was also associated with posttraumatic growth, stroke survivors who maintain overly optimistic views about the severity and impact of their stroke are likely to benefit from therapists continually facilitating capacity for growth and well-being.
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The present study examined how stress reactions after traumatic events influence subjective well-being (SWB) via the indirect effect of posttraumatic growth (PTG) in two samples of Palestinian professional helpers from the Gaza Strip and West Bank (n ¼ 201). Using the General Health Questionnaire (GHQ-12) as a dependent measure of well-being, and PTGI-10, PANAS-20, WHO-5 BREF, and IES-13 questionnaires as independent variables, structural equation modelling (SEM) was used to examine whether: (a) cumulative trauma was negatively and directly related to subjective well-being; (b) levels of trauma were positively and directly related to posttraumatic growth; and (c) PTG was positively and directly related to subjective well-being. The findings suggest that posttraumatic growth contributes to mitigating and buffering (on the order of approximately 10%) the effect of trauma on subjective well-being. PTG seems to be a resource that can help aid workers deal with the consequences of stressful life events. Clinical implications and directions for supervision and training are discussed.
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Objective: The current study was designed to test the hypothesis that quality of death (QOD) and intrusive and deliberate rumination are associated with posttraumatic growth (PTG) among bereaved family members of cancer patients in home palliative care. Methods: Data were collected from 805 bereaved family members of cancer patients who died at home in Japan. We used a cross-sectional design and participants completed Good Death Inventory, Event-Related Rumination Inventory and PTG Inventory. Structural equation modeling was used to test the hypothesized relationships. Results: A direct pathway from QOD to PTG was significant. We also found significant indirect pathways between QOD and PTG via deliberate rumination soon after the death and recent deliberate rumination. Conclusions: Clinicians should provide high-quality end-of-life care with the goals of achieving a good death for terminally ill cancer patients and supporting the experience of PTG in bereaved family members after their loss.
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Purpose: This study examines posttraumatic growth (PTG) among adolescents and young adults (AYAs) with cancer, as well as its correlates and trajectories over time. The study also explores the buffering role of PTG on the associations between posttraumatic stress (PTS), health-related quality of life (HRQoL), and psychological distress. Methods: A multicenter, longitudinal, prospective study was conducted among AYA cancer patients aged 14-39 years. One hundred sixty-nine patients completed a self-report measure of PTG (PTGI) and PTS (PDS) 6, 12, and 24 months after baseline (within the first 4 months of diagnosis). At 24-month follow-up, HRQoL (SF-36) and psychological distress (BSI-18) were also assessed. Results: Among participants, 14% showed increasing PTG, 45% remained at a stable high PTG level, 14% showed decreasing PTG, and 27% remained at a stable low PTG level. AYAs who remained high on PTG were more often younger, female, and received chemotherapy. PTG level at 6-month follow-up was predictive of mental HRQoL (β = 0.19; p = 0.026) and psychological distress (β = -0.14; p = 0.043) at 24-month follow-up when corrected for PTS and sociodemographic and clinical covariates. No relationship between PTG and physical HRQoL was found. The interactive effects of PTS and PTG on outcomes were not significant, indicating that buffering did not take place. Conclusion: This study indicates that PTG is dynamic and predicts mental well-being outcomes but does not buffer the effects of PTS. Psychosocial interventions should focus on promoting PTG and reducing PTS in order to promote the adjustment of AYAs diagnosed with cancer.
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The aim of this study was to evaluate the association of positive and negative religious coping with posttraumatic symptoms (PTS) and growth (PTG). Their moderating role was also examined among predictors such as social support and the subjective severity of event with PTS and PTG. Two hundred and eleven Chilean adults (58.3% women) of 18 years and older who had been exposed to highly stressful were surveyed. The Brief-RCOPE, the Brief-COPE subscale of social support, the Subjective Severity of Event Scale, and a socio-demographic questionnaire were used as measurements at time one. The Posttraumatic Growth Inventory-short form (PTGI-SF) and Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to collect baseline scores and six months after. The results show that negative religious coping predicts the increase in PTS, positive religious coping predicts the increase in PTG and plays a moderation role: at low levels of positive religious coping it was found a strong association between coping by seeking social support and PTG, while at high level the association is weak. These results are discussed in the framework of the functionality of positive and negative religious coping and its role in adjusting to potentially traumatic events.
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Aims Since the early 1980s, the one-child policy has been implemented nationwide in China. A special group called the “only-child-lost family” (OCL family) has emerged and has become a social phenomenon that cannot be ignored. We report latent profiles of posttraumatic growth and their relation to differences in resilience among OCL people in China. Methods A total of 222 OCL people were investigated using the Posttraumatic Growth Inventory and the Connor-Davidson Resilience Scale. Latent profile analysis was applied to explore PTG latent profiles. Multinomial logistic regression was used to analyze the socio-demographic variables in each latent profile and the association between profile membership and resilience. Results Three latent profiles were identified and labeled the “high appreciation-power group” (30.6%), the “general moderate growth group” (47.7%) and the “low growth and extreme possibility group” (21.7%). Compared to those in the high appreciation-power group, individuals with monthly income >2000 ($312) were less likely to be in the general moderate growth group (OR = 0.13, P<0.01), whereas individuals with a spouse were less likely to be in the low growth and extreme possibility group (OR = 0.43, P<0.01). Individuals in the “general moderate growth group”(OR = 0.92, P<0.01, 95%CI:0.89–0.94) and the “low growth and extreme possibility” groups (OR = 0.83, P<0.01, 95%CI:0.79–0.87) demonstrated significantly lower levels of resilience compared to the high appreciation-power group. Conclusion The PTG patterns in only-child-lost parents were varied. Promoting resilience may be a way to foster these parents’ PTG. Targeted intervention should be developed based on the characteristics of each latent class, and timely attention must be paid to the mental health of OCL parents who are without a spouse and have low income.
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Objectives: The current study examined whether various types of rumination are distinguishable and the effects of personal growth initiative (PGI) on posttraumatic growth, posttraumatic stress, and depression through adaptive and maladaptive rumination. Method: Sample included 292 college students who experienced a potentially traumatic event (PTE). Results: Intrusive and deliberative rumination were found to be distinct factors. However, brooding and reflection, thought to be separate aspects of depression, were a single factor. PGI was positively associated with growth and negatively associated with depression for both genders, and a negative relationship was found between PGI and posttraumatic stress among women. Indirect effects of PGI were found on posttraumatic stress and growth through different forms of rumination. These relations did not change after including the covariates (i.e., time since the trauma, direct exposure, and intentional harm). Conclusion: The study provides new insight integrating rumination from the depression literature in the context of trauma and a potential benefit in applying PGI in alleviating pathology after a PTE and facilitating growth.
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Bullying has been recognized as a major public health concern and may be conceptualized as a potentially traumatic experience. A growing body of literature has documented posttraumatic growth (PTG), or positive psychological changes following traumatic experiences, yet no studies have examined bullying as a potential precursor to PTG. This work examined spontaneous expressions of PTG in response to bullying experiences in a sample of 51 adults with visual impairments (Study 1) as well as quantitative relationships between self-reported bullying severity and PTG in 33 children with visual impairments (Study 2). Adults and children with visual impairments were selected as the test populations because limited available research suggests that individuals with disabilities are disproportionally affected by bullying. Indeed, the current results revealed prevalent bullying experiences reported by adults (84 %) and children (48 %) in these samples. Further, approximately 35 % of the adults who had been bullied spontaneously reported experiencing PTG (Study 1), and self-reported severity of bullying experiences exhibited a large, positive relationship with PTG in children (Study 2). Implications and future directions are discussed.
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Background: Posttraumatic growth (PTG) refers to positive psychological change experienced as a result of the struggle with highly challenging life circumstances. PTG in cancer survivors is related to several psychosocial factors such as psychological hardiness and marital satisfaction. Objectives: The purpose of this study was to examine the prediction of posttraumatic growth based on psychological hardiness and marital satisfaction. Patients and Methods: A total of 120 women with breast cancer were recruited from several hospitals in Isfahan using convenience sampling. Participants completed the research questionnaires including the posttraumatic growth inventory (PTGI), the Ahvaz psychological hardiness scale and the Enrich’s marital satisfaction scale (EMS). Statistical analysis including means, standard deviation, Pearson’s correlation and multiple regression analysis were carried out using SPSS software (version 16). Results: Results indicated that the majority of patients with cancer experienced posttraumatic growth. Findings also showed that psychological hardiness, marital satisfaction and longer time since diagnosis of cancer significantly predicted posttraumatic growth. Conclusions: This study highlights the significant role of psychological hardiness and marital support in personal growth of breast cancer survivors.
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Background: Post-traumatic stress disorder (PTSD) is a common psychological disorder caused by unusual threats or catastrophic events. Little is known about the combined incidence of PTSD after earthquakes. This study aimed at evaluating the combined incidence of PTSD among survivors after earthquakes using systematic review and meta-analysis. Methods: The electronic databases of PubMed, Embase, Web of Science and PsycARTICLES were searched for relevant articles in this study. Loney criteria were used to assess the quality of eligible articles. The combined incidence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted using the following variables: the time of PTSD assessment, gender, educational level, marital status, damage to one's house, bereavement, injury of body and witnessing death. Results: Forty-six eligible articles containing 76,101 earthquake survivors met the inclusion criteria, of which 17,706 were diagnosed as having PTSD. Using a random effects model, the combined incidence of PTSD after earthquakes was 23.66 %. Moreover, the combined incidence of PTSD among survivors who were diagnosed at not more than 9 months after earthquake was 28.76 %, while for survivors who were diagnosed at over nine months after earthquake the combined incidence was 19.48 %. A high degree of heterogeneity (I(2) = 99.5 %, p<0.001) was observed in the results, with incidence ranging from 1.20 to 82.64 %. The subgroup analyses showed that the incidence of PTSD after earthquake varied significantly across studies in relation to the time of PTSD assessment, gender, educational level, damage to one's house, bereavement, injury of body and witnessing death. However, stratified analyses could not entirely explain the heterogeneity in the results. Conclusions: Given the high heterogeneity observed in this study, future studies should aim at exploring more possible risk factors for PTSD after earthquakes, especially genetic factors. In spite of that, the results of this study suggest that nearly 1 in 4 earthquake survivors are diagnosed as having PTSD. Therefore, the local government should plan effective psychological interventions for earthquake survivors.
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The purpose of this study was to establish the relation between resiliency and the level of positive changes, comprising posttraumatic growth in a group of firefighters experiencing job-related traumatic events and the mediating role of stress appraisal in this relation. The study was performed on a group of 100 firefighters from firefighting and rescue brigades, out of which 75 admitted to experiencing a traumatic event. Firefighters covered by the study were on average 31.51 years old (SD = 6.34). A Polish version of Posttraumatic Growth Inventory, the Resiliency Assessment Scale - SPP and Stress Appraisal Questionnaire were used in the study. The results have shown that 22.7% of firefighters displayed low, 58.6% average and 18.7% high intensity of positive changes resulting from a traumatic event. Resiliency poorly correlates with posttraumatic growth, expressed in changes in self-perception, and stronger with stress appraisal, negatively with threat and harm/loss and positively with challenge. Appraisal of stress as a threat and challenge appeared to be mediators of the relationship between resiliency and posttraumatic growth.
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Background The aim of the study was to answer the following research questions: What percentage of women after breast cancer surgery experienced posttraumatic growth (PTG)? Which aspect of PTG was experienced to the greatest extent by the participants? Do age at the day of survey, age at diagnosis, time since diagnosis, type of surgery, non-surgical methods of treatment, participation in rehabilitation or physical activity significantly differentiate participants in PTG? Participants and procedure Forty-seven women after breast cancer surgery participated in the study. Posttraumatic growth was measured with the Polish version of the Posttraumatic Growth Inventory (PTGI) consisting of 4 scales: Self-Perception (SP), Relating to Others (RO), Appreciation of Life (AL) and Spiritual Change (SC). The demographic, disease and treatment related variables were controlled. Results Forty-three percent of participants experienced high, 23% moderate, and 34% little or no PTG. Posttraumatic growth manifested itself mainly positive changes in relationships with others. Age at the day of the survey did not correlate significantly with scores of PTGI. Age at diagnosis correlated significantly with total PTG (ρ = –0.37, p = .012), SP (ρ = –0.33, p = .029), RO (ρ = –0.40, p = .008) and AL (ρ = –0.39, p = .010). Women aged ≤ 50 at the day of the survey had significantly higher scores of AL than women > 50 (U = 117.50, p = .042). Women who were physically active at the day of the survey had significantly higher scores in total PTG (U = 118.50, p = .008), SP (U = 7.28, p = .007) and RO (U = 108.00, p = .003). Time since diagnosis, type of treatment and participation in rehabilitation after the surgery did not differentiate respondents significantly in PTG. Conclusions Posttraumatic growth was experienced by a considerable percentage of participants. The average level of PTG was moderate. Women physically active at the time of the survey showed higher levels of PTG. We recommend that women after breast cancer surgery should be encouraged by medical staff, family and friends to undertake physical activity as soon as possible.
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The purpose of the current study was to test the curvilinear associations between experiences of stress and posttraumatic growth among female breast cancer survivors. Participants (n = 193; 86% Caucasian; 80% diagnosed with Stage I or II cancer) completed self-report questionnaires assessing sociodemographic and medical information, perceived general stress, cancer- specific stress, and posttraumatic growth. Two hierarchical regression models tested the associations between general and cancer-specific stress and posttraumatic growth. After controlling for the effects of age, education, and time since diagnosis, there was a significant curvilinear effect of general stress on posttraumatic growth. Moderate levels of general stress were associated with the greatest posttraumatic growth. Cancer-specific stress was not associated with posttraumatic growth. These findings suggest that stress can be adaptive in the aftermath of cancer treatments, and different manifestations of stress may require individualized intervention. Future research studies are needed to better understand and contextualize these findings among other cancer populations.
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Objective: The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables. Background: Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth. Methods: UK (N = 193) and Croatian (N = 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies. Results: Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth. Conclusion: This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth.
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Aim of the work: To test the level of posttraumatic growth in case of women treated with radiotherapy. Material and methods: 40 women treated with radiotherapy were tested. 30 of them were patients of the II Radiotherapy Ward of Centrum Onkologii Ziemi Lubelskiej [Lublin Province Oncology Centre], 10 women were in outpatient treatment. The patients filled in the post traumatic growth inventory (PTGI). Results: 40% of women showed low level of positive change due to the experienced trauma in form fighting cancer. Average level was of positive changes was shown in case of 35% of respondents and 25% have shown high levels of positive changes. In analysis of the fields of the posttraumatic growth we may say that most numerous changes occurred in larger valuing of life (M=3.38) and in relations with others (M=2.96). Changes of lesser intensity occurred in fields of: spiritual life (M=2.57) and changes of perception of oneself (M=2.03). Conclusions: Women treated for cancer experience posttraumatic growth. Although a crisis situation like the diagnosis of cancer and the fight with it are marked with great suffering, it can also be connected with positive changes that can be observed in many aspects of life.
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Background There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking. Method Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form. Results We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least ‘moderate’ PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG. Conclusions PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a ‘positive legacy’ of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.
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Abstract Diabetic patients feel stress regarding the nature of the illness. This study aims to explore factors related to stress related growth (SRG) among diabetic outpatients. A newly proposed model, based on the Schaefer and Moos’ Life Crises and Personal Growth Model was tested in a sample of diabetic outpatients. The sample was 455 diabetic out- patients who were not hospitalized previously. Results revealed that cognitive processing (CP) mediated the relationship between self-esteem and SRG. Moreover, the effect of social support on SRG was significant. As the results of the multi-group comparisons indicated, the proposed model was valid for diabetic patients with or without additional diseases. Regarding clinical implications, clinicians should evaluate CP and family support that are highly correlated with SRG.