Changes in posttraumatic growth, core belief disruption, and social support over the first year of the COVID-19 pandemic.

The aftermath of traumatic events differs from person to person. Although some people show negative results, many people report positive results such as Post-traumatic Growth(PTG). PTG refers to positive psychological changes resulted from individuals' struggle against their main threatening life adversity, and it contains changed perception of self, changed sense of interpersonal relationship, and changed philosophy of life. Recently, the overwhelming majority of research has put their emphasis on the influencing factors of PTG, particularly the exploration of the developmental mechanism of PTG. According to Calhoun and Tedeschi's model of PTG, traumatic event is assumed to challenge the important components of individuals' assumptive world or core beliefs. When a trauma event happens, individuals are led to reexamine their core beliefs, and what makes it possible for individuals to recognize the positive changes and experience PTG. Therefore, the challenge to individuals' assumptive world or core beliefs is an important element for understanding the developmental process of PTG.Although many theoretical and empirical studies agreed that core belief challenge had effects on PTG, the roles of other relevant factors in the relationship of core belief challenge to PTG have been ignored. Relevant theories indicate that rumination may play an important role in the process which core belief challenge affects PTG, and social support may moderate the path which rumination impacts on PTG. For this reason, rumination and social support were incorporated into the exploration of relationship between core beliefs and PTG in our study, and the internal mechanism how core belief challenge affects PTG was also taken into much account. In the current study, 354 adolescents(165 males, 189 females) from grade 8, 9 in junior schools and grade 11, 12 in senior high schools of the Wenchuan county were investigated by means of questionnaires four and a half years after the Wenchuan earthquake. The main results were as follows:(1) The overall level of PTG among adolescents was high, while the level of female students was higher than that of male students, and the grade 8 students' PTG level was lower than that of students from any other grades.(2) Both intrusive rumination and deliberate rumination mediated partly the relationship between core belief challenge and PTG. On the one hand, core belief challenge could affect the PTG directly. On the other hand, core belief challenge could affect PTG negatively through intrusive rumination while had a positive effect on PTG through deliberate rumination. In addition, core belief challenge could affect PTG positively via the indirect way which intrusive rumination influenced deliberate rumination.(3) Neither the relationship of intrusive rumination to nor deliberate rumination to PTG, the path which social support moderated was the relationship of intrusive rumination to deliberate rumination. To be specific, the effect of intrusive rumination on deliberate rumination decreased with the increase of social support. That is, social support moderated the indirect path from intrusive rumination to PTG via deliberate rumination. The results have indicated that school psychologists should take notice of the changes in adolescents' core beliefs before and after the disaster, and guide them to think the significance of life positively. Moreover, the encouragement of positive cognition should also be given while social support for students be provided.

Social support is theoretically expected to be positively associated with posttraumatic growth (PTG) and subjective well-being, and stress is expected to be positively associated with PTG and negatively associated with subjective well-being among breast cancer (BC) survivors. However, empirical evidence is mixed, predominantly cross-sectional, and few studies have examined the unique effects of these predictors on positive changes in psychological experiences post cancer diagnosis and systemic treatment. This study examined both general and BC-specific social support and stress as predictors of change in PTG and subjective well-being among BC survivors. Women (N = 173, Mage = 55.40, SD = 10.99) who had recently finished treatment completed demographic and treatment measures at baseline (T1); general and cancer-specific social support and stress, PTG and subjective well-being at 3 months (T2); and PTG and subjective well-being again at 6 months (T3). Longitudinal predictors of change in PTG and subjective well-being were examined using hierarchical multiple regression. The BC-specific social support (β = .12) and stress (cancer worry; β = .10) predicted increasing levels of PTG. Improvements in subjective well-being were predicted by higher levels of general social support (β = .21) and lower levels of general stress (β = -.59). There are distinct predictors of change in PTG and subjective well-being among BC survivors, supporting the distinction between the trauma-specific process of PTG and well-being.

Studies have shown that social support is positively associated with posttraumatic growth (PTG) among white cancer survivors. Whether the same relationship holds among Asian American cancer survivors and through what mechanism social support may influence PTG is unclear. This study examined the association between social support and PTG among Chinese American breast cancer survivors and proposed perceived stress as a mediator. Chinese American breast cancer survivors (n = 118) were recruited from Southern California. Participants' social support, perceived stress, and PTG were measured in a questionnaire package. Social support was associated with lower perceived stress (r= -0.34, P<.001) and higher PTG (r=0.44, P<.001). Perceived stress was negatively associated with PTG (r=-0.36, P< .001). Results from structural equation modeling supported the mediation model, with satisfactory model fit indices (χ37= 65.55, comparative fit index= 0.98, Tucker-Lewis Index = 0.97, root-mean-square error of approximation = 0.08). Both the indirect effect from social support to PTG via perceived stress (β = .07, P< .05) and the direct effect from social support and PTG (β= .40, P< .001) were statistically significant, suggesting a partial mediation effect of perceived stress between social support and PTG. The positive association between social support and Chinese American breast cancer survivors' PTG was supported. Our findings also suggested that social support may facilitate PTG through reduction of perceived stress. Interventions that help to enhance Chinese American breast cancer survivors' social support may also facilitate their PTG.

Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The current study examined change in PTG over 2 years following breast cancer diagnosis and variables associated with PTG over time. Women recently diagnosed with breast cancer completed surveys within 8 months of diagnosis and 6, 12, and 18 months later. Linear mixed effects models were used to assess the longitudinal effects of demographic, medical, and psychosocial variables on PTG as measured by the Posttraumatic Growth Inventory (PTGI). A total of 653 women were accrued (mean age = 54.9, SD = 12.6). Total PTGI score increased over time mostly within the first few months following diagnosis. In the longitudinal model, greater PTGI scores were associated with education level, longer time since diagnosis, greater baseline level of illness intrusiveness, and increases in social support, spirituality, use of active-adaptive coping strategies, and mental health. Findings for the PTGI domains were similar to those for the total score except for the Spiritual Change domain. PTG develops relatively soon after a breast cancer diagnosis and is associated with baseline illness intrusiveness and increases in social support, spirituality, use of active-adaptive coping strategies, and mental health.

Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a controlled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder versus waitlist (CBCT for PTSD; Monson & Fredman, 2012). We also examined whether pretreatment relationship satisfaction and PTSD symptomatology moderated change in PTG. There were 40 couples (75% with a female partner with PTSD) who were randomized to either immediate CBCT for PTSD or a 3-month waitlist (WL).Compared to WL, individuals who received treatment immediately demonstrated a significant increase in PTG. There was a moderate effect size between-group difference (Hedge's g = 0.45). There was a nonsignificant relationship with a moderate effect size (Hedge's g = 0.65) for the positive effect of pretreatment relationship satisfaction on the trajectory of PTG, but no effect of pretreatment PTSD symptoms. Results suggested that CBCT for PTSD facilitated PTG, even with a limited focus on PTG in this conjoint intervention. Future research should target PTG as a treatment goal and further examine the role of close others in facilitating development of PTG.

ABSTRACTThe study examined psychosocial factors (quality of life, depression, anxiety, optimism, coping, and social support) in relation to symptoms of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in 108 women diagnosed with ovarian cancer. Canonical correlational analysis showed that both PTSD and PTG were related to poorer quality of life, lack of social supports, and avoidant coping styles. However, higher PTG was also associated with the use of meaning and social support to cope with their experience. The findings highlight both negative and positive posttraumatic outcomes but longitudinal studies are now needed to more fully evaluate these relationships.

While research on the psychological experiences of infertility has focused almost exclusively on the negative aspects, clinical experience with individuals and couples facing infertility has demonstrated that personal gain can also arise from the struggle involved. This study examined whether individuals who struggle with infertility report posttraumatic growth (PTG), and if perceived availability of and satisfaction with social support are associated with such growth. Other correlates of PTG are reported as well. Using a cross-sectional design, a convenience sample of 121 individuals with infertility completed a background questionnaire, the Posttraumatic Growth Inventory and the Social Support Questionnaire. While individuals reported moderate PTG, moderate availability of, and high satisfaction with social support, there was no significant association between the variables. Infertility-related variables emerged as central to explaining PTG with those with non-female related diagnoses and unexplained diagnoses demonstrating lower PTG than others (t = 2.96, t = 3.6, respectively, P < or = 0.05). Additionally, live birth deliveries was positively associated with PTG (r(2) = 0.22, P < or = 0.02), and those who engaged in clergy counseling had higher PTG than those who did not (t = 2.34, P < or = 0.02). Determinants were unexplained infertility (lower PTG) and number of live birth deliveries (higher PTG). In spite of limitations related to the convenience sampling, correlational design and subjective self-report nature of the data, findings suggest that individuals who suffer from infertility can experience personal growth. Further research will help identify correlates and provide guidance for mental health practitioners on counseling infertility patients to promote growth.

This study examined variables associated with post-traumatic growth (PTG) in stroke carers and compared predictions of two models of PTG within this population: the model of Schaefer and Moos was compared to that of Tedeschi and Calhoun (1992, Personal coping: Theory, research, and application. Westport, CT: Praeger, 149; 1998, Posttraumatic growth: Positive changes in the aftermath of crisis. Mahwah, NJ: Lawrence Erlbaum, 99; 2004, Psychol. Inq., 15, 1, respectively). A cross-sectional survey design was employed. Carers of stroke survivors (N = 71) completed questionnaires measuring PTG, coping style, social support, survivor functioning, age, and carer quality of life. Correlation, multiple regression, and mediation analyses were used to test hypotheses. All carers completing the PTG measure (N = 70) reported growth, but average scores differed from cancer carers (Chambers et al., 2012, Eur. J. Cancer Care, 21, 213; Thombre et al., 2010, J. Psychosocial Oncol., 28, 173). PTG was positively correlated with deliberate and intrusive rumination, avoidance coping, social support, and quality of life. Regression analysis showed that factors identified by Tedeschi and Calhoun (deliberate rumination, intrusive rumination, social support, acceptance coping, survivor functioning) accounted for 49% of variance in PTG, whereas those identified by Schaefer and Moos (active coping, avoidance coping, social support, survivor functioning, and age) accounted for only 21%. Rumination, especially deliberate rumination, explained most variance in PTG and mediated the effect of social support on PTG. The findings add to the limited body of evidence suggesting that stroke carers experience growth. Deliberate rumination and social support are important in explaining growth, and the findings support the model proposed by Tedeschi and Calhoun over that of Schaefer and Moos. What is already known on this subject? Literature on caring for stroke survivors focuses on negative outcomes (Ilse, Feys, de Wit, Putman, & de Weerdt, 2008) to the exclusion of positive outcomes such as post-traumatic growth (PTG; Calhoun & Tedeschi, 1999). Studies of a variety of health conditions have demonstrated that PTG occurs in patients and carers after illness events and is associated with well-being (Gangstad, Norman, & Barton, 2006; Helgeson, Reynolds, & Tomich, 2006; Kim, Schulz, & Carver, 2007). Exploratory studies and studies of benefit finding have shown that PTG occurs in stroke carers (Bacon, Milne, Sheikh, & Freeston, 2009; Buschenfeld, Morris, & Lockwood, 2009; Haley et al., 2009; Thompson, 1991), but there are no studies using standard instruments to assess PTG in this population. Moreover, current theories posit different explanations for PTG (Schaefer & Moos, 1992, 1998; Tedeschi & Calhoun, 2004), and there is a need for empirical tests (Park, 2010). What does this study add? This study extends knowledge by measuring PTG with a standard instrument in a sample of UK stroke carers and investigating associated variables. The study also compared the predictive power of the models of PTG proposed by Tedeschi and Calhoun (2004) and Schaefer and Moos (1992, 1998). PTG was found in UK stroke carers, but levels differed from cancer carers in other countries. Factors associated with PTG were identified; Tedeschi and Calhoun's model best predicted PTG. Deliberate rumination had a direct effect on PTG and also mediated the effect of social support. Deliberate rumination is a possible target for therapeutic interventions to enhance PTG.

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.

Posttraumatic growth (PTG) is a possible positive consequence of a traumatic event, such as cancer. Head and neck cancer (HNC) may be particularly traumatic, given its adverse effects on functional, psychological, and social wellbeing. We investigated the extent of PTG, factors associated with PTG, and associations between PTG and health-related quality-of-life (HRQoL) in HNC survivors. HNC survivors (ICD10 C00-C14, C32), identified from the population-based National Cancer Registry Ireland, completed a postal survey. PTG was assessed using the Posttraumatic Growth Inventory (PTG-I) and HRQoL with FACT-G and FACT-H&N. Associations between socio-economic characteristics, social support, and clinical variables and PTG were examined using multivariable linear regression. Total HRQoL scores were compared in those with none-low PTG vs moderate-high PTG. A total of 583 survivors participated (response rate=59%). The mean PTG score was 55.74 (95%CI 53.15-58.33); 60% had moderate-high PTG. Survivors scored highest in the PTG-I domain appreciation of life. In multivariable analysis, being female, being younger, having more social support, and having cancer-related financial stress were significantly associated with more PTG. HRQoL was significantly higher in those with moderate-high than no-little PTG (P<.01). A notable proportion of HNC survivors report PTG but growth is, on average, lower than reported for other cancers. Nonetheless, higher PTG appears related to better HRQoL. Further research would be valuable to understand the pathways by which HNC may lead to PTG and inform development of strategies to support and encourage PTG in this survivor population.

Background: Parents of children with intellectual and developmental disorders often experience potentially traumatic events while caring for their children. Heightened posttraumatic stress (PTS) and posttraumatic growth (PTG) have been found in this population. Objective: We aimed to explore risk and protective factors for their PTS and PTG. Method: A cross-sectional study was conducted with 385 parents (average age M = 43.14 years, SD = 7.40; 95.3% mothers). Results: Parenting trauma showed an adverse effect on developing PTS (beta = 0.25, p < .01) and a positive role in promoting PTG (beta = 0.16, p < .01). Social support was protective in its correlation with lower levels of PTS (beta = −0.12, p < .01) and higher levels of PTG (beta = 0.22, p < .01). Barriers to care were associated with increased PTS (beta = 0.23, p < .01), but unrelated to PTG (beta = .01, p = .855). Negative parenting showed a significant, but small, correlation with more severe PTS (beta = 0.11, p < .05), and was unrelated to PTG (beta = −0.09, p = .065). Conclusions: Our study increases the understanding of posttraumatic reactions in parents, predominantly mothers, of children with IDD and identified parenting-related trauma, social support, and barriers to mental health care as predictive factors of the reactions. More research is needed to confirm and validate the effects of the discussed factors. Although causation can not be inferred, prompt and adequate screening and therapeutic resources should be provided to those mothers who were exposed to multiple stressful caregiving events and had limited healthcare access and less support from their spouses, peers, and caregiving partners. HIGHLIGHTS Parents of a child with Intellectual and Developmental Disorders with parenting trauma had higher posttraumatic stress (PTS) and posttraumatic growth (PTG). Social support was related to lower PTS and higher PTG. Barriers to care were related to higher PTS but unrelated to PTG.

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.

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.

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.

This study investigated factors associated with post-traumatic growth (PTG) after severe traumatic societal events. Utilizing a quota-representative sample of 931 Israeli Jews, we assessed individual and community PTG following the Hamas attack of 7 October 2023, alongside a range of factors guided by Bronfenbrenner's Process-Person-Context-Time (PPCT) model. Using data-driven techniques, we identified three distinct growth profiles: relatively high individual and collective PTG (n = 354), high PTG on all dimensions (n = 273), and secular growth showing high PTG in general but not in spiritual terms (n = 322). Higher levels of religious identification, involvement, and coping, altruistic behaviour, social support, optimism, and mindfulness, as well as lower levels of pessimism, were found in the group(s) with the highest PTG. This research highlights the potentially high societal resilience reported after a large-scale traumatic event, identifying factors that may be tested for their potential to maximize growth in the aftermath of trauma.