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Analysis of the relationship between post-traumatic growth and students’ personality in the conditions of full-scale war

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Background. The phenomenon of post-traumatic growth (PTG), which consists of significant positive changes in the personality due to the experience of a difficult life crisis, is currently considered an effective countermeasure to the destructive consequences of psycho-emotional stress. Purpose – is to determine the individual psychological predictors of PTG among medical students in the context of a large-scale social crisis. Materials and methods. In compliance with the requirements of biomedical ethics and based on informed consent, an anonymous questionnaire and psychodiagnostic examination of 152 medical students was conducted during October– November 2024. According to the subjective assessment of the severity of the stress experienced by an individual during their life, the students were distributed as follows: 7.2% of the surveyed assessed the most severe stress they experienced in their lives as mild, 23.7% as moderate, 42.8% as severe, and 26.3% as very severe. The psychodiagnostic tools of the study consisted of The Posttraumatic Growth Inventory (PTGI) questionnaire, the Mini-Mult questionnaire, and the J.B. Rotter locus of control measurement questionnaire. Results. It was found that the individual-personal profiles of students with low and high PTG are somewhat similar, with differences in the expressiveness of character traits, which are manifested by significantly higher indicators on the Mini-Mult scales: hypochondria (53.49 ± 10.01 points in students with low PTG vs 48.80 ± 10.18 in students with high PTG, p = 0.002), depression (49.08 ± 11.51 points vs 42.17 ± 9.81, p < 0.0001), hysteria (51.70 ± 10.16 points vs 45.77 ± 9.71, p < 0.0001), psychopathy (51.09 ± 14.69 points vs 44.44 ± 13.83, p = 0.008), rigidity (49.40 ± 11.66 points vs 44.63 ± 10.25, p = 0.018), psychasthenia (52.31 ± 12.01 points vs 45.07 ± 12.36, p < 0.0001) and schizoidism (53.19 ± 10.78 points vs 48.28 ± 10.74, p = 0.014). Students with low PTG were characterized by the dominance of the external locus of control, which is associated with the tendency to consider one’s own successes or failures as the result of mainly external forces, passivity, a sense of one’s own inferiority, low self-esteem and self-respect, a low level of aspirations and a desire for external support and help: 12.61 ± 3.90 points vs 10.99 ± 3.19 (p = 0.004). Students with high PTG were characterized by a greater expressiveness of the internal locus of control, which is associated with the belief in the ability to influence the course of events through their own activity, a high level of aspirations, activity in achieving goals, independence in judgments and actions, the desire to change reality, high self-esteem, and orientation to their own efforts to overcome problems: 12.00 ± 3.20 points vs 10.39 ± 3.90 for students with low PTG (p = 0.005). Correlation analysis revealed significant inverse correlations of the PTGI index with the indicators on the scales of psychasthenia (rS = –0.360), depression (rS = –0.307), hysteria (rS = –0.283), psychopathy (rS = –0.276), schizoidism (rS = –0.235), hypochondria (rS = –0.222) and rigidity (rS = –0.170). External locus of control was negatively correlated with PTG, and internal locus of control was positively correlated with PTG (rS = 0.165 and rS = –0.165, respectively, p = 0.042). Conclusion. The results obtained allow us to conclude that individual and personality characteristics are an important, but not the only factor of PTG, and determine the need for further research into relevant factors that may have an impact on PTG.

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  • Research Article
  • Cite Count Icon 6
  • 10.1007/s00520-024-08577-1
Patterns and predictors of symptom burden and posttraumatic growth among patients with cancer: a latent profile analysis.
  • May 17, 2024
  • Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
  • Dongyu Song + 3 more

The study identified different patterns of symptom burden and posttraumatic growth (PTG) among patients with cancer and to explored the effects of sociodemographic, disease-related, and family resilience factors, which could provide reference for the development of personalized nursing measures. A questionnaire survey was conducted with 329 patients with cancer who were undergoing treatment. Latent profile analysis (LPA) was used to explore the patterns of symptom burden and PTG among patients with cancer, and multiple logistic regression analysis was used to explore the influencing factors of different patterns. Based on the fit indicators of LPA, a three-class pattern model of posttraumatic responses was shown to be optimal, including resisting, struggling, and growth groups. In the resisting group (34.34%), patients reported low symptom burden and low PTG; in the struggling group (19.15%), patients showed a high symptom burden and moderate PTG; in the growth group (46.51%), patients showed low symptom burden and high PTG. Moreover, patients with cancer with high levels of family resilience were more likely to fall into the struggling and growth groups. Specifically, those with lower scores in the optimistic attitude and higher scores in the family and social support dimension of family resilience were more likely to fall into the struggling group, whereas those with lower scores in the transcendence and spiritual belief dimensions of family resilience were more likely to fall into the resisting group. Additionally, patients with at least three children were more likely to fall into the struggling group. This study showed heterogeneity in symptom burden and PTG patterns among patients with cancer. Patients' growth must include both psychological growth and the mitigated symptom burden. Family factors may be intervention targets to improve the growth patterns.

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  • Cite Count Icon 38
  • 10.3389/fpsyg.2017.01245
Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation
  • Jul 20, 2017
  • Frontiers in Psychology
  • Aleksandra Kroemeke + 2 more

Objectives: Post-traumatic growth (PTG) and its opposite—post-traumatic depreciation (PTD)—may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership.Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied.Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41).Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.

  • Research Article
  • Cite Count Icon 1
  • 10.1080/09638288.2024.2405571
Characterizing post-traumatic growth in individuals with traumatic brain injury according to social participation, self-awareness, and self-identity
  • Sep 28, 2024
  • Disability and Rehabilitation
  • Rinni Mamman + 3 more

Purpose After traumatic brain injury (TBI), individuals may face challenges in their social participation, self-awareness, and self-identity. However, positive life changes can also be experienced (i.e., post-traumatic growth). This study aimed to characterize the social participation, self-awareness, and self-identity of individuals with TBI displaying post-traumatic growth. Materials and methods Fifteen participants (male = 10, mean age = 49.7 years) with moderate to severe TBI (average years post-injury = 15.2) were included in this mixed-methods study. Self-report questionnaires were used to assess social participation, self-awareness, and self-identity. Qualitative data, collected using semi-structured interviews, were used to categorize participants into two groups: higher (n = 8) and lower (n = 7) post-traumatic growth. Descriptive statistics were used to characterize participants in each group in terms of their social participation, self-awareness, and self-identity. Results Participants with higher post-traumatic growth had increased social participation, higher self-awareness, and fewer negative discrepancies between their pre- and post-injury self-identities, compared to participants with lower post-traumatic growth. Conclusion This study contributes to a more comprehensive understanding of post-traumatic growth through the use of both qualitative and quantitative data. These findings can inform future research and development of programs to promote post-traumatic growth post-TBI.

  • Research Article
  • Cite Count Icon 30
  • 10.1016/j.jmh.2020.100010
Post-traumatic growth and its predictors among Syrian refugees in Istanbul: A mental health population survey
  • Jan 1, 2020
  • Journal of Migration and Health
  • Karen Wen + 8 more

Post-traumatic growth and its predictors among Syrian refugees in Istanbul: A mental health population survey

  • Research Article
  • Cite Count Icon 2
  • 10.1016/j.childyouth.2024.108022
Adolescents’ posttraumatic growth during the COVID-19 pandemic: The links between differentiation of self, parents’ posttraumatic growth, and adolescents’ gender
  • Nov 17, 2024
  • Children and Youth Services Review
  • L Hamama + 2 more

Adolescents’ posttraumatic growth during the COVID-19 pandemic: The links between differentiation of self, parents’ posttraumatic growth, and adolescents’ gender

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  • Cite Count Icon 11
  • 10.1080/20008066.2023.2272477
Posttraumatic growth EEG neuromarkers: translational neural comparisons with resilience and PTSD in trauma-exposed healthy adults
  • Nov 15, 2023
  • European Journal of Psychotraumatology
  • Aj Glazebrook + 3 more

Background: Supporting wellbeing beyond symptom reduction is necessary in trauma care. Research suggests increased posttraumatic growth (PTG) may promote wellbeing more effectively than posttraumatic stress disorder (PTSD) symptom reduction alone. Understanding neurobiological mechanisms of PTG would support PTG intervention development. However, most PTG research to-date has been cross-sectional data self-reported through surveys or interviews. Objective: Neural evidence of PTG and its coexistence with resilience and PTSD is limited. To advance neural PTG literature and contribute translational neuroscientific knowledge necessary to develop future objectively measurable neural-based PTG interventions. Method: Alpha frequency EEG and validated psychological inventories measuring PTG, resilience, and PTSD symptoms were collected from 30 trauma-exposed healthy adults amidst the COVID-19 pandemic. EEG data were collected using custom MNE-Python software, and a wireless OpenBCI 16-channel dry electrode EEG headset. Psychological inventory scores were analysed in SPSS Statistics and used to categorise the EEG data. Power spectral density analyses, t-tests and ANOVAs were conducted within EEGLab to identify brain activity differentiating high and low PTG, resilience, and PTSD symptoms. Results: Higher PTG was significantly differentiated from low PTG by higher alpha power in the left centro-temporal brain area around EEG electrode C3. A trend differentiating high PTG from PTSD was also indicated in this same location. Whole-scalp spectral topographies revealed alpha power EEG correlates of PTG, resilience and PTSD symptoms shared limited, but potentially meaningful similarities. Conclusion: This research provides the first comparative neural topographies of PTG, resilience and PTSD symptoms in the known literature. Results provide objective neural evidence supporting existing theory depicting PTG, resilience and PTSD as independent, yet co-occurring constructs. PTG neuromarker alpha C3 significantly delineated high from low PTG and warrants further investigation for potential clinical application. Findings provide foundation for future neural-based interventions and research for enhancing PTG in trauma-exposed individuals.

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  • Cite Count Icon 1
  • 10.1192/j.eurpsy.2023.675
Mental health and post-traumatic growth in multiple sclerosis
  • Mar 1, 2023
  • European Psychiatry
  • I Gil-González + 2 more

Introductionpeople suffering from multiple sclerosis (MS) can experience post-traumatic growth (PTG), a sense of personal growth and benefit gain. Patients mental health can play an important role in PTG development.Objectivesto explore possible differences in mental health according to PTG levels.Methodsthe sample was composed of 392 outpatients with MS from Virgen de la Macarena University Hospital (268 women; 124 (31.6 %) men, ages 19-78 years old (mean 45.61 years, SD=11.16 years). Expanded Disability Status Scale (EDSS) mean score was 3.38 (SD=2.06). Relapsing remittent (n=327) and progressive (n=65) MS type were reported. Post-traumatic Growth Inventory (PGI-21) measured patients perception of personal benefit gain after MS experience. General Health Questionnaire-28 (GHQ-28) evaluated Mental Health distress symptoms. Unpaired t-test was used to identify differences in mental health distress between “low PTG ≤49 score” and “high PTG ≥50 score” groups.ResultsSignificant differences were found in social dysfunction (t=2.521, p=0.012) and severe depression (t=2.442, p=0.015), “high PTG group” (n=194) presented lower scores compare to “low PTG group” (n=198). No significant difference was detected in somatic symptoms (t=0.185, p=0.087) and anxiety and insomnia (t=0.859, p=0.391).Conclusionspatients with higher PTG reported a better mental health. This suggests the relevance of mental health status in positive outcomes development after an adverse life event. Particularly, social dysfunction and depressive symptoms should be considered in interventions aimed to promote positive outcomes as personal gain and benefit finding in MS population.Disclosure of InterestNone Declared

  • Research Article
  • Cite Count Icon 1
  • 10.1002/jclp.23671
Constellations of posttraumatic stress symptoms and posttraumatic growth among Israeli female combat veterans: A latent profile analysis approach.
  • Feb 24, 2024
  • Journal of Clinical Psychology
  • Gadi Zerach

Posttraumatic stress disorder symptoms (PTSS) and posttraumatic growth (PTG) are possible reactions to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about patterns of both PTSS and PTG among female combat veterans is sparse. This study examines constellations of PTSS and PTG among Israeli female combat veterans, as well as military-related exposure and positive psychological correlates of these constellations. A volunteer sample of Israeli women combat veterans (n = 885) responded to self-report questionnaires in a cross-sectional design study. Latent profile analysis (LPA) was used to identify four profiles characterized by unique constellations of PTSS and PTG: moderate PTSS and high PTG (33%), moderate PTSS and moderate PTG (30%), low PTSS and high PTG (30%), and low PTSS and PTG (5.5%). Higher levels of combat experiences were associated with higher odds of inclusion in the moderate PTSS and high PTG and moderate PTSS and moderate PTG profiles. Moreover, compared to the other classes, both low PTSS and high PTG and moderate PTSS and high PTG classes were associated with higher levels of satisfaction with life and happiness psychological outcomes. The study's findings offer an overview of the complex pattern of associations between PTSS, PTG, and associated predictors and outcomes. Clinicians treating female veterans should be aware of the varying reactions to military service challenges, including the presence of moderate to high levels of PTG reactions in addition to PTSS.

  • Research Article
  • Cite Count Icon 11
  • 10.1007/s10880-020-09713-9
Exploring Post-traumatic Growth in Parkinson's Disease: A Mixed Method Study.
  • Mar 6, 2020
  • Journal of Clinical Psychology in Medical Settings
  • Francesca Vescovelli + 2 more

Post-traumatic growth (PTG) may favor the psychological adaptation to chronic illnesses. However, few studies investigated PTG in Parkinson's Disease (PD). This study aims to investigate PTG in patients with PD, by exploring disease-specific features and assessing its impact on distress, well-being, and quality of life. A mixed methodology with a convergent parallel design was used. 54 patients were classified according to their level of PTG (low PTG, medium PTG, and high PTG). PD patients with high PTG showed a more positive psychological adaptation and less distress when compared to patients with less PTG. Forty-nine patients were interviewed and their transcripts were analyzed using Thematic Analysis. The emerged themes confirmed the traditional dimensions of PTG model, but a specific theme connected to a new body awareness was identified. Patients with high PTG were more likely to report positive statements following PD diagnosis, particularly concerning spirituality and maintaining a good physical functioning. PTG presents peculiar characteristics in PD and it may favor a better psychological adjustment following the diagnosis.

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  • Cite Count Icon 27
  • 10.3389/fpsyt.2020.00749
Coping Strategies and Considering the Possibility of Death in Those Bereaved by Sudden and Violent Deaths: Grief Severity, Depression, and Posttraumatic Growth.
  • Aug 6, 2020
  • Frontiers in Psychiatry
  • Joscelyn E Fisher + 5 more

BackgroundBereavement by sudden and violent deaths can lead to increased grief severity, depression, and reduced posttraumatic growth compared to those bereaved by natural causes. These outcomes can be affected by coping strategies and whether a survivor had been “prepared” for the death. The present study examined the effect of coping and considering the possibility of death on grief severity, depression, and posttraumatic growth in those bereaved by sudden deaths.MethodsParticipants bereaved by suicide, accident, or combat deaths completed an online survey about demographics (including the cause of death), coping, grief severity, depression, and posttraumatic growth. A factor analysis of the coping measure yielded factors representing three coping strategies: avoidant coping, supportive coping, and active coping. These three strategies, the causes of death and considering the possibility of death were used as predictors of either grief severity, depression, or posttraumatic growth in multivariate linear regression models.ResultsEach coping strategy and cause of death was differentially associated with grief severity, depression, and posttraumatic growth. Specifically, supportive coping and active coping were each only associated with higher posttraumatic growth. In contrast, avoidant coping was associated with all outcomes (higher grief severity and depression and lower posttraumatic growth). In addition, accidents and suicides (compared to combat deaths) had independent effects on grief severity and posttraumatic growth. Considering the possibility of death interacted with avoidant coping and also with supportive coping to predict grief severity in combat-loss survivors.DiscussionFindings highlight the differential contributions of coping strategies and their complex relationships with cause of death in contributing to grief severity, depression, and posttraumatic growth. Avoidant coping contributed to negative outcomes and inhibited posttraumatic growth, suggesting its importance as a target for therapeutic intervention. Although supportive and active coping facilitated posttraumatic growth, they had less of a role in mitigating grief severity or depression in this study. Although considering the possibility of death appeared to mitigate negative outcomes among survivors of combat death, avoidance of that possibility is likely protective for the majority of family members whose loved ones return home safely.

  • Research Article
  • Cite Count Icon 14
  • 10.1111/jorc.12196
Evolution of post-traumatic growth during the first 12 months of dialysis: A longitudinal study.
  • Mar 14, 2017
  • Journal of Renal Care
  • Begoña Ruiz De Alegría + 2 more

Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients. To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress. A prospective, longitudinal, observational study. The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups. Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress. Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.

  • Research Article
  • Cite Count Icon 32
  • 10.1111/papt.12069
Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.
  • Aug 3, 2015
  • Psychology and Psychotherapy: Theory, Research and Practice
  • Maria Böttche + 3 more

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.

  • Research Article
  • Cite Count Icon 33
  • 10.1037/tra0000211
Posttraumatic growth in pediatric intensive care personnel: Dependence on resilience and coping strategies.
  • Jul 1, 2017
  • Psychological Trauma: Theory, Research, Practice, and Policy
  • Rocío Rodríguez-Rey + 14 more

Staff in pediatric intensive care units (PICU) are inherently exposed to potentially traumatic events. Posttraumatic growth (PTG) is the occurrence of positive changes after experiencing a traumatic event. This study aims (a) to evaluate the prevalence of PTG in PICU staff, and whether their scores are different from those reported by professionals working in other pediatric units, (b) to explore the role of resilience and coping strategies in predicting PTG, and (c) to explore the relation of demographic and work-related variables with PTG. Participants of this multicentric, cross sectional study were 298 PICU workers and 189 professionals working in noncritical pediatric units. They completed the Brief Resilience Scale, a Coping Strategies Questionnaire, the Posttraumatic Growth Inventory (PTGI), and provided demographic and work-related information. Of PICU staff, 68.8% experienced growth to a "great" or "very great" degree in at least one of the PTGI's dimensions. Higher PTG was reported following the death of a child or after a recent conflict with a work colleague. PICU workers and noncritical pediatric staff showed equivalent PTG levels. Multigroup path analysis with latent variables showed that emotion-focused coping was related to PTG only in PICU staff, whereas problem-focused coping was related to PTG in both groups. The relation between resilience and PTG was not significant. Work-related trauma can act as a catalyst for positive posttrauma changes. Modifying coping strategies may be a way to foster PTG in health care providers. (PsycINFO Database Record

  • Research Article
  • Cite Count Icon 1
  • 10.5958/0976-5506.2018.01060.4
The relationships between growth and meaning in life following adversities: Considering multidimensional aspects of meaning in life
  • Jan 1, 2018
  • Indian Journal of Public Health Research & Development
  • Sun-Young Im

The purpose of this study was to explore the relationships between posttraumatic growth(PTG) and meaning in life considering multidimensional aspects of meaning in life, which are importance, consistency, and specific sources of meaning in life. Data were collected from the 283 undergraduate students, who answered at 15 minutes-required questionnaires. Descriptive statistics for all the measurements were obtained and correlational analyses were conducted to explore the relationships between PTG and meaning in life by SPSS ver.18.0. And t-test was conducted to compare the characteristics of meaning in life according to the degree of PTG. The results showed that there was a significant difference between two groups (high PTG vs. low PTG) in the scores of importance and consistency of meaning in life. Second, the high PTG group considered ‘physical and psychological health’, ‘self-acceptance and growth’, and ‘relationships with family and friends’ more important than low PTG group, while there was no group-difference in importance for ‘satisfaction at work’, ‘social achievement’, ‘spirituality and religiosity’ and ‘contribution to society’. Third, the high PTG group tend to make their lives more meaningful in the aspects of self-related and interpersonal relational values than the lower. These findings suggest that the relationship between PTG and meaning in life could become different according to which aspects of meaning in life identified and measured.

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  • Cite Count Icon 3
  • 10.17583/generos.9609
Post-Traumatic Growth Following the Experience of Interpersonal Violence: The Roles of Perceived Stigma and Social Support
  • Jan 30, 2023
  • Multidisciplinary Journal of Gender Studies
  • Olubukola Wellington + 2 more

Post-Traumatic Growth is a term that refers to an individual's experience of considerable positive transformation following the occurrence of a traumatic event. This growth may be rapid, gradual, or non-existent, depending on the circumstances (such as social support or societal stigma) to which the victims are subjected during the process. However, the high prevalence of trauma among traumatized victims and the benefits of post-traumatic growth (PTG) discovered in increasing empirical research demonstrate the need of fostering PTG in victims of interpersonal violence. As a result, the current study analysed risk variables for PTG development. The study enrolled 200 women and men recruited through an organization that provides services to trauma victims. The data were gathered via an online survey that included the PTG inventory and an information sheet on demographic, social support, and stigma-related characteristics. Social stigma and support were found to be significant predictors of PTG, with stigma being associated with lower PTG and family and religious support being associated with higher PTG. The limitations and policy implications were highlighted, and recommendations for additional research were presented.

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