Exploring curvilinear and reciprocal relationships between posttraumatic stress and growth in adolescents and mothers following a major earthquake.

Although the COVID-19 pandemic has been traumatogenic for some people, posttraumatic growth (PTG) outcomes have also been observed. This study examined the PTG in adolescents and the moderating effect of self-efficacy on post-traumatic stress disorder (PTSD) symptoms and PTG. An online questionnaire was conducted on 2090 adolescent Chinese students to measure COVID-19 related exposure, self-efficacy, PTSD, and PTG. PTG prevalence was found in 20.6% of the sample, with the relationship between PTSD and PTG being found to be a reverse U-shaped curve. Objective exposure factors were found to be closely associated with PTSD symptoms but not with PTG. Similarly, subjective feelings of extreme fear were significantly associated with PTSD symptoms but not with PTG. Self-efficacy was found to be positively correlated with PTG (r = 0.551) and to moderate the relationship between PTSD and PTG. For those with low self-efficacy, the higher the PTSD, the higher the PTG, and for those with high self-efficacy, the higher the PTSD, the lower the PTG. As an improved sense of self-efficacy in adolescents could promote positive psychological transformations, these results could assist in identifying self-efficacy levels and providing guidance for targeted psychological interventions to promote positive growth.

ABSTRACTMany children and adolescents are exposed to different types of trauma, e.g. abuse or various disasters. Trauma can cause severe and long-term impairment and consequences, the most studied of which are post-traumatic stress disorder (PTSD) and PTSD symptoms (PTSS). PTSD is highly prevalent in clinical practice (about 7%) and is a debilitating consequence of trauma. Of those children and adolescents exposed to trauma, about 16% will develop PTSD: almost 10% as a consequence of non-interpersonal traumatic events and 25% following interpersonal traumas. In this paper, we review predictors, assessment and treatment options for youth with PTSD (symptoms) and give directions for future research.In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), PTSD has been included in the new chapter on Trauma- and Stressor-Related Disorders and now also includes a subtype of PTSD for preschool children; this represents a significant step in DSM taxonomy as it is the first developmental subtype of a psychiatric disorder. More emphasis has been placed on behavioural changes, with new wording, and consequently the chances of diagnosing PTSD in this population have been enhanced three- to eight-fold.Predictors of PTSD include acute stress reaction, depression, anxiety, parental effects, and smaller effects of female gender, injury severity, duration of hospitalization, heart rate after admission, pre-existing psychiatric problems, history of significant losses or threat to life, insufficient psychological and social support systems, and presence of functional impairment. Other consequences of trauma include depression, anxiety, addiction and somatic health problems.The thorough and accurate assessment of trauma and its impact using the appropriate instruments is important to implement appropriate early prevention and treatment interventions (Olff, 2015). The study of phenotypes or domains, e.g. cognitive, memory and executive functioning, may be a new approach in studying PTSD and its impact.There are few studies on the long-term effects of mass trauma on victimized communities (Thordardottir et al., 2016). In the aftermath of major natural disasters, acute stress reactions are expected, and overall resilience is the rule rather than the exception. Many studies have shown that 1–6 months post-trauma, PTSD is reduced by approximately 50%; nevertheless, there are doubts as to whether there is further reduction of PTSD after 6 months post-trauma.A large recent meta-analysis showed that psychotherapy for PTSD symptoms has a small or large effect size depending on the control group; cognitive behavioural therapy has the highest effect sizes, especially in individual therapy with parental involvement (Gutermann et al., 2016). Key components of effective treatment are psychoeducation about trauma reactions, exposure to trauma-related cues and memories until they become habituated, coping skills training for children to help them to manage their anxiety, and parental training to help them to facilitate their children’s recovery. Medications such as selective serotonin reuptake inhibitors are used to treat disturbing PTSD symptoms and comorbidity, and to facilitate psychotherapy. However, more research is needed into their efficacy and safety in this vulnerable population.In summary, we are still at the beginning of research on trauma and PTSD in children and adolescents. We need more studies of better quality, longitudinal studies and modified psychotherapies to meet younger patients’ needs. The same is true for a possible role of early pharmacotherapy (e.g. opiates, beta-adrenergic blockers) in reducing or preventing PTSD symptoms. Evaluation of both biological and psychosocial predictors that increase the risk of later development and maintenance of PTSD is important for early prevention and treatment. It has been suggested that we should use a dimensional rather than a categorical clinical entity of PTSD, and/or approach trauma beyond PTSD but also in terms of resilience and post-traumatic growth, beyond single predictors and linear associations, beyond the individual level (family is considered more and more important) and also in terms of a developmentally oriented theory. Without treatment, PTSD can become chronic and have an impact on normal psychosocial development and functioning in adulthood. Therefore, there is a need for action and a public health approach with regard to children’s traumatic exposure. The role of national and international organizations (e.g. the International and European Societies for Traumatic Stress Studies) could be important.

How does parent–child communication affects posttraumatic stress disorder and growth in adolescents during the COVID-19 pandemic? The mediating roles of self-compassion and disclosure

ABSTRACTBackground and objective: Although posttraumatic stress disorders (PTSD) and posttraumatic growth (PTG) can co-exist, and several theories suggest that social support, self-esteem, and hope can predict both PTSD and PTG, no study to date has examined the combined role of social support, self-esteem, and hope in PTSD and PTG. The present study aimed to simultaneously examine the mediating roles of self-esteem and hope in the relations between social support and PTSD, and between social support and PTG.Design: This study included 397 adolescents living in Lushan County, China, who were affected by the Ya’an earthquake.Method: The participants completed the self-report questionnaires at two and a half years after the earthquake. Structural equation models were built to examine the roles of social support, self-esteem, and hope in PTSD and PTG.Results: Social support directly and negatively predicted PTSD and positively predicted PTG. Moreover, social support negatively predicted PTSD via self-esteem, and positively predicted PTG via hope. In addition, social support positively predicted PTG through multiple mediating paths from self-esteem to hope.Conclusions: PTSD and PTG had different predictive paths. Specifically, social support reduced PTSD through enhanced self-esteem and promoted PTG through hope, or through the path from self-esteem to hope.

The traumatic experience of contracting and living with HIV/AIDS may produce a myriad of mental health problems, especially posttraumatic stress disorder (PTSD) symptoms, and conversely, bring posttraumatic growth (PTG), that is, positive changes resulting from a struggle with trauma. The growing body of research into the relationship between PTSD symptoms and PTG has produced mixed results. In addition, some research has suggested that psychosocial and cognitive factors may mediate the development of PTG after trauma exposure. Specifically, individuals experience fewer psychological symptoms and better mental health when adaptive coping strategies align with stressors; however, little research is available on the relationship and the mediating effect of coping strategies on the link of PTSD symptoms and PTG among HIV-infected men who have sex with men (MSM) in China. The aims of the current study were to investigate the relationship between PTSD symptoms and PTG as well as the potential mediating effects of coping strategies through which PTSD symptoms contributes to PTG among this vulnerable population. One hundred and forty HIV-positive MSM were recruited from the Beijing Center for Disease Prevention and Control and were asked to complete a battery of self-administered questionnaires, covering sociodemographic and HIV-related characteristics, coping strategies (i.e., problem-solving, seeking social support, self-blame, and wishful thinking), PTSD symptoms, and PTG. Results showed that, after controlling for sociodemographic and HIV-related variables, a negative linear relationship was found between PTSD symptoms and PTG. In addition, problem-solving and self-blame played significant mediating roles in the association between PTSD symptoms and PTG. The mediating effects of seeking social support and engaging in wishful thinking on the PTSD symptoms and PTD link were, however, non-significant. The present study contributes to an understanding of the association between PTSD symptoms and PTG and underscores the mediators through which individuals gain growth from traumatic experience in the context of HIV infection in Beijing, China. Given these findings, the future efforts at psychological intervention should differentiate and target various types of coping strategies, especially focusing on enhancing problem-solving skills and decreasing self-blame, in response to the promotion of positive growth among HIV-infected MSM.

Public health emergencies can trigger posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents. However, few studies have explored the distinct and common processes of these outcomes in adolescents from the perspective of social support during public health emergencies, and whether the mechanisms underlying these phenomena are unique or shared remains unclear. This study examined how social support relates to PTSD and PTG, with empathy, positive coping, and negative coping as mediators. A cross-sectional study using self-report questionnaires collected data from 921 Chinese junior middle school students. The results showed that social support was directly negatively associated with PTSD and positively associated with PTG. Social support was negatively associated with PTSD via positive coping styles (PCSs), negative coping styles (NCSs), and through a two-step path from empathy to PCSs. Social support was negatively associated with PTG via NCSs, and positively associated with PTG via empathy, PCSs, and through a two-step path from empathy to PCSs. Findings suggest partly distinct pathways linking social support to PTSD and PTG: empathy was related to PTG but not PTSD, PCSs functioned as a shared pathway, and NCSs showed a double-edged pattern. Parents and teachers should foster adolescents' empathy and PCSs to promote healthy psychological development after public health emergencies.

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.

Theories of posttraumatic growth suggest that some degree of distress is necessary to stimulate growth; yet, investigations of the relationship between stress and growth following trauma are mixed. This study aims to understand the relationship between posttraumatic stress symptoms and posttraumatic growth in adolescent and young adult (AYA) cancer patients. 165 AYA patients aged 14-39 years at diagnosis completed standardized measures of posttraumatic stress and posttraumatic growth at 12 months following diagnosis. Locally weighted scatterplot smoothing and regression were used to examine linear and curvilinear relationships between posttraumatic stress and posttraumatic growth. No significant relationships between overall posttraumatic stress severity and posttraumatic growth were observed at 12-month follow-up. However, curvilinear relationships between re-experiencing (a posttraumatic stress symptom) and two of five posttraumatic growth indicators (New Possibilities, Personal Strengths) were observed. Findings suggest that re-experiencing is associated with some aspects of posttraumatic growth but not others. Although re-experiencing is considered a symptom of posttraumatic stress disorder, it also may represent a cognitive process necessary to achieve personal growth for AYAs. Findings call into question the supposed psychopathological nature of re-experiencing and suggest that re-experiencing, as a cognitive process, may be psychologically adaptive. Opportunities to engage family, friends, cancer survivors, or health care professionals in frank discussions about fears, worries, or concerns may help AYAs re-experience cancer in a way that enhances their understanding of what happened to them and contributes to positive adaptation to life after cancer.

Hurricane Sandy continues to affect the mental health of New York residents. This study examined associations between Posttraumatic Growth (PTG) and mental health difficulties (MHD) including symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). Participants (N = 1,356) recruited from the New York metropolitan area completed questionnaires regarding their PTG, demographics, MHD, and hurricane experiences. A weighted least squares regression assessed the association between MHD and PTG. A post hoc analysis determined whether anxiety or depression moderated the effect of PTSD on PTG. All MHD were crudely associated with greater PTG. After adjustment, an increased PTSD score was significantly associated with a 0.20 unit increase in PTG (t = 6.05, p < .001); this did not hold for depression or anxiety symptoms. Higher PTG was associated with being non-White (B = 5.90, t = 6.49, p < .001), Hispanic (B = 3.38, t = 2.89, p = .004), a smoker (B = 3.18, t = 3.28, p = .001), and greater Hurricane Sandy exposure (t = 7.11, p < .001). The positive association between PTSD symptoms and PTG was weaker among participants with probable depression. Results suggest that participants with higher PTSD symptoms were more likely to grow from the impact of the storm, indicating resilience. Highly exposed participants were more likely to experience PTG. A decrease in PTG was found among those with both PTSD and depression symptoms. The development and implementation of interventions fostering PTG could be beneficial in clinical disaster response work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objectives This study aimed to identify predictors of positive and negative post-traumatic psychological outcomes within a sample of Iranian cancer survivors. Methods In this cross-sectional research, 300 (167 females; age M=53.00, SD=27.57) cancer survivors (breast cancer, leukaemia, colorectal cancer) were recruited from oncology outpatient clinics in Iran. Participants completed measures of post-traumatic stress disorder (PTSD), post-traumatic growth (PTG), cognitive processing, attentional biases, and autobiographical memory specificity. Results Using partial least square structural equation modelling, it was found that the proposed model was capable of predicting PTSD and PTG. Negative attentional biases were significantly associated with PTSD symptoms, but were not significantly associated with PTG. In contrast, memory specificity and positive attentional biases tended to be associated with PTG, but were not significantly associated with PTSD symptoms. Second, negative cognitive processing was significantly associated with PTSD symptoms, while positive cognitive processing was significantly associated with PTG. Finally, there was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing. Conclusions Our findings support growing evidence for differential trajectories to PTG and PTSD symptoms in cancer. Such cognitive factors may be important therapeutic targets in psycho-oncology interventions. Statement of contribution What is already known on this subject? The diagnosis of cancer and its subsequent treatment can result in symptoms of post-traumatic stress disorder (PTSD). Positive changes and psychosocial growth (post-traumatic growth; PTG) are also common as a result of patients' experience of cancer. What does this study add? This study identified predictors of positive (PTG) and negative trauma (PTSD) outcomes within a sample of Iranian cancer survivors (N=300). General habitual cognitive tendencies (memory specificity, attentional biases) were associated with cognitive processing, which in turn contributed to psycho-traumatic adaption. There was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing.

The ability to derive growth from a traumatic event, such as a cancer diagnosis, can facilitate effective adaptation to the challenges associated with cancer survivorship. In two studies, we investigated the possible cognitive mechanisms explaining the relationship between post-traumatic stress and post-traumatic growth in female survivors of breast cancer. Specifically, Study 1 examined the role of interpretation bias, and Study 2 examined the role of cognitive restructuring of trauma. In Study 1, 113 participants completed questionnaires assessing stress- and anxiety-related symptomatology, post-traumatic stress and growth, perceived cognitive functioning, and positive interpretation bias. In Study 2, 117 participants completed questionnaires assessing stress and anxiety-related symptoms, rumination, perceived cognitive functioning, cognitive restructuring of trauma, and post-traumatic stress and growth. In both studies, post-traumatic stress was negatively related to post-traumatic growth. In Study 1, positive interpretation bias explained a significant amount of variance in the relationship between post-traumatic stress and post-traumatic growth, with perceived cognitive functioning moderating the relationship between interpretation bias and post-traumatic growth. In Study 2, cognitive restructuring explained a significant amount of variance in the relationship between post-traumatic stress and post-traumatic growth, with deliberate rumination moderating the effects of cognitive restructuring on post-traumatic growth. Cognitive mechanisms are key to understanding the relationship between post-traumatic stress and growth and should be targeted in interventions to improve cognitive flexibility and resilience among breast cancer survivors.

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.

Knowledge of longitudinal changes in posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) may help survivors recover better. Yet, researchers dispute the population-based typologies of PTSD and PTG as well as the temporal transition between these subpopulations across time, especially among adolescents. Thus, the transition pattern still needs further research. Besides, parent-child factors (parenting styles, parent-child cohesion, and parental attachment styles) may influence the transition, but it keeps unclear. In the study, we aimed to solve these questions. A three-wave investigation was conducted among 620 adolescents, 12 months, 21 months, and 27 months, after the Jiuzhaigou earthquake by using self-report measures on PTSD, PTG, and parent-child factors at the three time points. Finally, 339 of them finished the three-wave investigation. Latent profile analysis models showed that three heterogeneous classes of PTSD and PTG existed across time: low-affected (low-level PTSD and PTG), thriving (low-level PTSD but high-level PTG), and struggling (high-level PTSD and PTG) groups. Random intercept latent transition analysis model suggested that samples mainly stayed in the original classes across time, with three main transitional paths: from struggling group to thriving group, from thriving group to low-affected group, and from low-affected group to struggling group. Besides, the study also found that parental rejection, overprotection, and anxious attachment were the possible factors that kept the stability of the struggling group. Parent-child cohesion increased the stability of the thriving group across time. Anxious attachment may worsen PTSD among adolescents and lower the stability of low-affected groups across time. Coexisting and transitional patterns exist in PTSD and PTG across time. Wrong parenting styles and insecure attachments can exacerbate PTSD symptoms and diminish adolescents' resilience, but parent-child cohesion can facilitate their growth after trauma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Traumatic experiences can trigger negative effects such as post-traumatic stress disorder (PTSD). However, some individuals may also experience positive changes following trauma exposure. These changes are known as post-traumatic growth (PTG). Dispositional and situational factors are likely at play in determining both severity of PTSD symptoms and whether and to what degree an individual experiences PTG. This study examined how coping style and personality traits interact to influence PTSD and PTG. Two hundred and seventy-one Operation Iraqi Freedom/Operation Enduring Freedom veterans not engaged in mental health treatment completed self-report measures of trauma exposure, personality traits, coping styles, PTSD symptoms, and PTG. The study was approved by the Minneapolis VAHCS Institutional Review Board. Adaptive coping and positive personality traits such as openness were positively correlated with PTG. Maladaptive coping and neuroticism were positively correlated with PTSD symptoms. Regression analyses indicated that an inverted-U (quadratic) curve characterized the relationship between PTSD symptoms and PTG; veterans who reported moderate PTSD levels reported the most PTG. Mediation analyses revealed that adaptive coping partially mediated the relationship between openness and PTG. Maladaptive coping partially mediated the relationship between neuroticism and PTSD symptoms. This study demonstrated that coping style mediated relationships between personality traits and post-trauma outcomes. Our findings are subject to the limitations of the self-report and cross-sectional nature of the data. Longitudinal studies, preferably incorporating coping-oriented interventions, could convincingly demonstrate the impact of coping style on PTSD and PTG. As coping styles can be modified, our findings nonetheless suggest that coping-oriented clinical intervention has potential to reduce PTSD symptoms and promote positive growth following trauma exposure.

Law enforcement officers tend to be exposed to a high frequency of potentially traumatic incidents. A dichotomous distinction among these events involves the witnessing of threat or harm to others and the experiencing of threat or harm directly to oneself. Past research suggests that different types of trauma exposure produce varying levels of negative posttraumatic responses including posttraumatic stress disorder (PTSD) symptoms and positive outcomes such as posttraumatic growth (PTG). With the goal of better assisting officers experiencing posttraumatic stress, enhanced knowledge regarding this psychological response to the development of PTG is necessary. The purpose of this study was to test a proposed model involving a pathway from type of trauma exposure to PTG that is mediated by PTSD symptoms among law enforcement officers (N = 193). Differences among cognitive PTG and behavioral PTG as our dependent variables, with age, marital status, and relationship stress as control variables, were assessed. Findings indicate that events involving threat to self are more closely related to PTG, via an indirect pathway through PTSD symptoms. Additionally, personal relationship stress was directly associated with PTSD symptoms and behavioral PTG, but not cognitive PTG. Overall, the results of this study provide initial evidence that trauma exposure type (i.e., direct vs. indirect) plays a significant role in the level of PTG. Lastly, the results allow for the possibility of positive changes in behaviors facilitated by cognitive avoidance, in contrast to the common notion that deliberate cognitive engagement is required for growth to occur. (PsycINFO Database Record