Differences in symptom experiences and coping strategies based on post-traumatic growth and depreciation in cancer patients undergoing chemotherapy: a cross-sectional study.

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.

This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a "no growth or depreciation" class and smaller proportions were grouped into either a "posttraumatic depreciation" or "posttraumatic growth" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the "posttraumatic growth" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the "posttraumatic depreciation" class. Sex was the only predictor of the relationship classes: No men were assigned to the "high posttraumatic growth" class. Implications and future directions are discussed.

ABSTRACTBackground: Posttraumatic growth (PTG) has been reported after various types of potentially traumatic events, as a part of the personal recovery process among survivors. Even negative changes in survivors’ life view, known as posttraumatic depreciation (PTD), have been identified as an additional aspect in the personal recovery processes.Objective: To examine how the type of exposure experienced by survivors of a natural disaster, the 2004 Southeast Asia tsunami, influenced self-reported PTG and PTD six years later (T2). Additionally, the study examined the relations between psychological distress and posttraumatic stress symptoms (PTSS) 14 months after the disaster (T1), to PTG and PTD, respectively at T2. Finally, the study examined whether psychological distress and PTSS (T1) could have a mediating effect on PTG and PTD at T2.Method: The participants were 848 tsunami survivors living in Stockholm, Sweden who responded to a questionnaire at 14 months (T1) and six years (T2) after the tsunami. The material was analysed using linear regression and pathway analysis. PTG and PTD were measured on separate scales.Results: The type of exposure was significant related to both PTG and PTD six years later (T2). Those experiencing a combination of various types of exposure (including threat to life and bereavement) reported higher scores for both PTG and PTD. There were significant positive correlations between PTSS at T1 and PTG /PTD at T2, and somewhat lower correlations between psychological distress at T1 and PTG/PTD at T2. Both PTSS and psychological distress at T1 were significant mediating variables for both PTG and PTD at T2.Conclusions: Studying survivors’ various types of exposure and subsequent changed view of life – both PTG and PTD – resulted in a broadened understanding of the complexity of reactions and the recovery process among survivors.

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.

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.

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.

Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across ten countries: Global validation of the PTG-PTD theoretical model

After experiencing trauma, people often report both negative and positive changes, which can be operationally defined as posttraumatic growth (PTG) and posttraumatic depreciation (PTD). However, there is no brief measure for assessing both posttraumatic changes simultaneously. This study describes the short form of the expanded version of the Posttraumatic Growth and Depreciation Inventory (PTGDI-X-SF) among German Adults. Using a sample of 253 German adults, the dimensionality of the PTGDI-X-SF was examined by confirmatory factor analyses. Internal consistencies were determined. The relation of PTG and PTD was investigated. Regression analyses explored the relationships to established predictors as previously found for the full-scale version of the PTGDI-X. Findings indicate a 5-factor structure for the PTGDI-X-SF equivalent to the PTGDI-X as well as high reliability for PTG (α = .88) and PTD (α = .88). Participants reported more PTG (M = 2.53, SD = 1.20) than PTD (M = 1.41, SD = 1.16). PTG and PTD were weakly associated (r = -.148, p = .018). PTG was positively related to disruption of core beliefs (β = .25, p < .001) and deliberate rumination directly after the trauma (β = .38, p < .001). PTD was positively associated with recent rumination irrespective of whether it was intrusive (β = .21, p < .05) or deliberate (β = .33, p < .01). Overall, results support the applicability of the PTGDI-X-SF as a valid and efficient measure to assess PTG and PTD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Findings on the relationship of posttraumatic growth (PTG) with adjustment to potentially traumatic events are inconsistent, whereupon posttraumatic depreciation (PTD) has been suggested as a possible moderator. The objective of this study is to investigate the associations between PTG and PTD on one side and life satisfaction and indicators of mental and physical health on the other side in individuals with spinal cord injury (SCI). The primary study aim is to test whether PTD moderates the relationships of PTG and different adjustment indicators. A total of 141 patients administered to one of the four Swiss SCI rehabilitation centers completed questionnaires assessing PTG and PTD and different indicators of mental and physical health as well as life satisfaction at discharge from first rehabilitation. Correlational and regression methods were used to examine the research question. PTG and PTD were significantly positively correlated (rs = .47). PTD was significantly associated with lower mental and physical health and lower life satisfaction, with small to large effect sizes. PTD moderated the associations of PTG with symptoms of depression and life satisfaction (β of interaction term = -.18 and .24, respectively). PTG was significantly related to lower levels of symptoms of depression and higher life satisfaction in individuals experiencing moderate to high levels of PTD. In contrast, PTG was not significantly related to these outcomes in individuals with low PTD levels. The neglect of PTD in research partially explains mixed findings on the relationship of PTG and adjustment to potentially traumatic events. (PsycINFO Database Record

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.

BackgroundBreast cancer, a potential traumatic stressor, may be accompanied by positive changes, such as post-traumatic growth (PTG), which may allow patients to overcome this stressful event more easily. Our aim was to identify factors associated with PTG in breast cancer survivors (BCSs).MethodsWe conducted a cross-sectional study in Seintinelles volunteers who answered online questionnaires. PTG was measured using the Post-Traumatic Growth Inventory (PTGI). Data on sociodemographic, health-related factors and lifestyle habits, fear of cancer recurrence, health locus of control, coping strategies, and time perspective were collected.ResultsThe study included 821 BCSs aged 26 to 79 years, one to 16 years after cancer diagnosis. Mean of PTG scores were: relating to others 20.27 ± 6.61; new possibilities 14.00 ± 5.44; personal strength 12.24 ± 4.32; spiritual change 2.95 ± 2.54; appreciation of life 10.59 ± 3.00 and total PTG 60.05 ± 18.11. Several factors were associated with PTG: health-related factors (satisfaction with one’s own health, longer time since diagnosis), lifestyle habits (increasing physical activity level and stopping or reducing alcohol consumption after diagnosis), elements of locus of control (powerful others), coping strategies (positive thinking, seeking social support) and time perspective (present hedonistic), which were significantly positively associated with PTG. Chance locus of control and coping avoidance were inversely related to several PTG domains, even several years after diagnosis.ConclusionsPTG may be increased in BCSs by acting on its modifiable factors. This includes adopting healthy behaviours, such as increasing physical activity and stopping/reducing alcohol consumption, and developing locus of control elements, such as powerful others, and coping strategies, such as positive thinking and seeking social support, through targeted interventions. Further studies, especially longitudinal studies, are needed to confirm the observed associations between health behaviours, health locus of control, time perspective, and PTG scores. Other measures, such as post-traumatic stress, should be considered because of possible inferences with PTG.

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.

Chronic pain can disrupt everyday life and shatter beliefs about the world. Shattered beliefs may be rebuilt, either positively or negatively, leading to posttraumatic growth (PTG) or posttraumatic depreciation (PTD). According to a transdiagnostic emotion regulation perspective, these phenomena are associated with coping strategies and emotions related to the body, self, others, and the world. Because PTG and PTD can coexist, this study aims to compare different profiles of rebuilt beliefs based on emotions, emotion regulation, and psychopathology. People with chronic pain (N = 1,577) completed online self-report questionnaires evaluating PTG and PTD, trauma-related emotions, and reactions regarding pain (guilt, shame, mental defeat, injustice, feeling discounted, sensitivity to pain traumatization, sense of body-self unity), difficulties in emotion regulation, coping strategies, and psychopathological symptoms. Profiles illustrate four ways to experience potentially traumatic and life-challenging circumstances: no disruption, ambivalence, growth, and distress. Differences were found regarding trauma-related emotions and reactions, levels of comorbid psychopathologies, and emotion regulation. Considering trauma as a genuine dimension of chronic pain experience could provide an important framework to better address the resources and trajectories of people with chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background and objectivesPeople report of both, posttraumatic growth (PTG) and posttraumatic depreciation (PTD) after experiencing traumatic events. This study's aim in Sierra Leone was to explore the applicability of the expanded Posttraumatic Growth and Depreciation Inventory (PTGDI-X) and to examine the relationship between PTG and PTD, alongside predictive theory-driven variables. We also investigated communal and societal PTG, using the Individual and Collective Posttraumatic Growth Scale (ICPTGS). MethodThe PTGDI-X factorial structure was evaluated by confirmatory factor analyses (CFA) of data of 280 students who met DSM-5 trauma criteria. 219 participants, indicating that the event affected their community, and 113 participants, reporting it to have transformed the Sierra Leonean society, answered to the ICPTGS. ResultsThe PTGDI-X factor structure, proposed as cross-culturally invariant, was not applicable to the Sierra Leonean sample, but the use of the instrument's total scores was. PTG and PTD were found to co-exist, with predictive variables showing significant impacts on both constructs (e.g., disclosure, core beliefs disruption). Collective PTG outcomes in Sierra Leone were confirmed. ConclusionThe findings indicated to measure PTG and PTD together, however top-down approaches to reveal only limited culture-specific insights. A broader conceptualization of growth, beyond the personal level was recommended.

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.