Profiles of posttraumatic stress disorder and posttraumatic growth among breast cancer patients: role of caregiver burden

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.

Background: Due to the job characteristics, firefighters are repeatedly exposed to trauma incidents. However, not all firefighters exhibit the same level of post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG). Despite this, few studies have looked into firefighters’ PTSD and PTG. Objective: This study identified subgroups of firefighters based on their PTSD and PTG levels, and investigated the influence of demographic factors and PTSD/PTG-related factors on latent class classification. Method: Latent profile analysis was used to examine the patterns of PTSD and PTG among 483 firefighters in South Korea. Using a cross-sectional design, demographic factors and job factors were examined as group covariates through a three-step approach. PTSD-related factors such as depression and suicide ideation, as well as PTG-related factors such as emotion-based response were analysed as differentiating factors. Results: Four classes were identified and named ‘Low PTSD-low PTG (65.2%),’ ‘Mid PTSD-mid PTG (15.5%),’ ‘Low PTSD-high PTG (15.3%),’ and ‘High PTSD-mid PTG (3.9%).’ The likelihood of belonging to the group with high trauma-related risks increased with more rotating shift work and years of service. The differentiating factors revealed differences based on the levels of PTSD and PTG in each group. Conclusions: 34.8% of firefighters experienced changes due to traumatic events while on the job, and some required serious attention. Modifiable job characteristics, such as the shift pattern, indirectly affected PTSD and PTG levels. Individual and job factors should be considered together when developing trauma interventions for firefighters.

Patterns of posttraumatic stress disorder and posttraumatic growth among women after an earthquake: A latent profile analysis

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.

The aim of this study was to identify the patterns of posttraumatic responses among breast cancer (BC) patients, to explore the variables associated with these patterns, and to compare anxiety and depression on various posttraumatic response patterns. A questionnaire survey was conducted with a sample of 612 BC patients who were currently undergoing treatment. The questionnaire package included Posttraumatic Stress Disorder Symptom Scale (PSS), Posttraumatic Growth Inventory (PTGI), Network of Relationships Inventory, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Modeling was performed using a latent profile analysis (LPA) to explore patterns of posttraumatic responses among BC patients. Based on the fitting indicators of LPA, three-class patterns model of posttraumatic responses was optimal. Resisting group (34.6%): patients reported mild posttraumatic stress symptoms (PTSS) and mild posttraumatic growth (PTG). Growth group (47.4%): patients showed mild PTSS and high PTG. Struggling group (18.0%): patients showed high PTSS and high PTG. BC patients with lower income were more likely to belong to Resisting group and Struggling group. BC patients with high levels of social support were more likely to belong to Growth group. Patients in Struggling group had the highest levels of anxiety and depression. This study showed that there was heterogeneity in posttraumatic response patterns of BC patients. The results provided theoretical base guiding the development of health care schemes and psychological interventions for patients, suggesting the necessity of differentiated health care for BC patients with different posttraumatic response patterns.

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.

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.

The primary aim of this study is to explore distinct patterns of post-traumatic growth (PTG) and fear of cancer progression (FOP) among breast cancer patients through latent profile analysis (LPA). Additionally, we assessed the differences in demographic and disease-related factors among breast cancer patients with varying patterns. Finally, we examined the influence of socio-demographic, disease-related, social support, anxiety, depression, and post-traumatic stress disorder (PTSD) factors on the varying patterns, aiming to assist healthcare providers in developing more effective psychological care strategies for breast cancer patients. A questionnaire survey was conducted on 752 breast cancer patients. Latent profile analysis was employed to explore the patterns of post-traumatic growth and fear of cancer progression in these patients, and multiple logistic regression analysis was used to identify the predictive factors for the different patterns. Based on the fit indices of latent class analysis, a three-class model was identified as the optimal solution, which included the Resisting group, Struggling group, and Growth group. In the Resisting group (24.33%), patients reported low levels of post-traumatic growth and high levels of fear of cancer progression; in the Struggling group (46.14%), patients exhibited moderate levels of post-traumatic growth and low levels of fear of cancer progression; in the Growth group (29.52%), patients demonstrated high levels of post-traumatic growth and moderate levels of fear of cancer progression. Additionally, the multiple logistic regression analysis reveals that marital status, place of residence, education level, disease stage, social support, anxiety, and post-traumatic stress disorder levels in breast cancer patients serve as significant factors influencing the distinct patterns of post-traumatic growth and fear of progression. This study suggests that there is heterogeneity in the PTG and FOP patterns in breast cancer patients. It provides a research basis for promoting the psychological recovery of breast cancer patients and highlights the importance of focusing on the positive effects of PTG while mitigating the negative impact of FOP. Healthcare providers can implement targeted nursing interventions based on the different patterns observed in breast cancer patients.

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

Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are associated with functional impairments, yet little is known about their influence on HIV pre-exposure prophylaxis (PrEP) motivation among women survivors of intimate partner violence (IPV). Understanding how PTSD and MDD symptoms influence PrEP motivation is particularly important given survivors of IPV have an increased risk for HIV acquisition. The present study assessed the association between PrEP motivation with latent profiles of PTSD and MDD symptoms among women survivors of IPV. Data were collected from a sample of 285 women from Baltimore, MD, and New Haven, CT. Latent profile analysis (LPA) was performed to identify distinct patterns of depressive and PTSD symptoms among women survivors of IPV. Binary logistic regression was performed to examine the association of profile membership on PrEP motivation. A six-profile solution was determined to best fit the data. Profiles were characterized by: Profile 1, very low depressive and very low PTSD symptoms (28.07%); Profile 2, average depressive symptoms and low (below the mean) PTSD symptoms (21.05%); Profile 3, high depressive symptoms and low (below the mean) PTSD symptoms (9.8%); Profile 4, moderate depressive symptoms and high PTSD symptoms (15.78%); Profile 5, high PTSD avoidance and average depressive symptoms (17.1%); Profile 6, high depressive and high PTSD symptoms (8%). We found that, the odds of being in Stage 3 of the PrEP Motivational Cascade (PrEParation; defined by having access to a medical provider to prescribe PrEP, be willing to take PrEP, and self-identifying as an appropriate candidate for PrEP) compared to Stage 1 of the PrEP Motivational Cascade (Precontemplation; defined by being eligible for PrEP, but not willing to take PrEP and/or not self-identifying as an appropriate candidate for PrEP) were lower for women assigned to the low depressive symptoms and low PTSD symptoms profile (Profile 1 of the LPA) compared to women in the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.22, 95% CI = 0.06-0.76, p = 0.02). Women assigned to the low PTSD symptoms and average depressive symptoms profile (Profile 2 of the LPA) had lower odds of being in Stage 3 (PrEParation) compared to Stage 1 (Precontemplation) compared to women assigned to the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.25, 95% CI = 0.07-0.92, p = 0.037). Women survivors of IPV with higher PTSD and MDD symptoms expressed greater motivation to engage in PrEP compared to women survivors with low PTSD and low MDD symptoms. Findings support the CDC's clinical PrEP recommendations to integrate depression screening into PrEP services, but there is a critical need to also include PTSD screening. Further, MDD and PTSD symptoms may present differential barriers to PrEP motivation among women survivors of IPV. Precision care could synchronize trauma-informed practices and mental health treatment to engage survivors in PrEP services.

On February 6, 2023, earthquakes with magnitudes of 7.7 and 7.6 on the Richter scale struck Turkey, impacting eleven cities within Turkey and adjacent parts of Syria. This study investigates the immediate aftermath (50 days after the disaster) effects of these earthquakes on survivors. The primary focus is on posttraumatic stress disorder (PTSD) and post-traumatic growth (PTG), coupled with an exploration of the explanatory roles played by resilience, intolerance to uncertainty, and anxiety. For data collection, the study employs instruments such as the PTSD Checklist for DSM-5, Beck Anxiety Inventory, Brief Resilience Scale, PTG Inventory, and Intolerance to Uncertainty Scale. For the analysis, PTSD groups were formed (categorized using cutoff scores based on PTSD severity [69% high PTSD, 31% low PTSD]) and subjected to t-tests. In addition, multiple regression analysis is utilized to assess whether anxiety, resilience, and intolerance to uncertainty account for variations in PTSD and PTG. The findings revealed that the high PTSD group exhibited higher levels of anxiety, PTG, and intolerance to uncertainty, while displaying lower age and resilience in comparison to the low PTSD group. Moreover, the study found that intolerance to uncertainty (specifically in the inhibitory anxiety subscale), anxiety, and age significantly contributed to explaining PTSD. For PTG, the predictors were intolerance to uncertainty (inhibitory anxiety subscale), resilience, and age. This study underscores the significance of anxiety, resilience, and intolerance to uncertainty in comprehending PTG and PTSD. While PTSD was perceived as a negative aftermath of trauma, PTG was seen as a positive facet.

Refugee populations worldwide face significant mental health challenges, and Palestinian refugees, who have experienced prolonged displacement and continuous conflict, may be vulnerable to a range of mental health issues. Systematic reviews indicate that refugees are prone to mental health disorders and that they are over 10 times more likely to develop post-traumatic stress disorder (PTSD) compared to the general population. This study aimed to assess the prevalence of PTSD and levels of post-traumatic growth (PTG) among Palestinian refugees in the West Bank camps, as well as to explore the interrelationships between social support and these post-traumatic reactions. A cross-sectional study was conducted among 404 Palestinian refugees aged 18-76 in seven West Bank refugee camps. Participants completed standardized instruments to assess PTSD symptoms (PCL-5), post-traumatic growth (PTGI), and social support (MSPSS). Statistical analyses included descriptive statistics, correlation analyses, and regression models to examine the relationships between study variables. The study revealed a high PTSD prevalence of 63.6%, with a median symptom score of 39. Notably, no significant correlation was found between PTSD and PTG. Social support showed a weak negative correlation with PTSD (rs = -0.14) and a moderate positive correlation with PTG (rs = 0.361). Gender differences were prominent, with females reporting higher levels of both PTSD symptoms and PTG levels. In addition, variations across camps and education levels were observed. Palestinian refugees exhibit a complex psychological landscape marked by high PTSD prevalence and moderate PTG and social support levels. Our results suggest that PTSD and PTG may develop independently in the refugee context. Social support appears more influential in facilitating post-traumatic growth than in alleviating PTSD symptoms. Our findings, thus, contribute to existing literature by providing an understanding of the traumatic experiences and social support role in the refugee context.

Objective To explore the status and influencing factors of posttraumatic growth (PTG) in breast cancer patients and identify the influence of cognitive appraisal on PTG and the relationship between PTG and cognitive appraisal. Methods A cross-sectional study was conducted. Totally 356 breast cancer patients were investigated with the revised Posttraumatic Growth Inventory (PTGI), the Cognitive Appraisal Scale. Results The average score of PTG in breast cancer patients was (55.06±14.36) points. There were significant differences between different education level and health-care payment patients in the total score of PTG (t=5.886, 5.154, P <0.01). The level of PTG was correlated with the patients' cognitive appraisal way. It was negatively correlated with uncertain appraisal about disease and threat appraisal,and positively correlated with positive appraisal and responsible appraisal. The main prediction factors for PTG were positive appraisal, uncertain appraisal about disease, responsible appraisal, health-care payment and education level. All the variables could explain 42.7% variance of PTG. Conclusions Breast cancer patients in this study report moderate level of posttraumatic growth. The level of PTG in breast cancers is influenced by variables of patients' education level, health-care payment and cognitive appraisal. Cognitive appraisal could predict the development of PTG significantly. Key words: Breast neoplasm; Posttraumatic growth; Cognitive appraisal

Objective To identify the posttraumatic growth (PTG) level of cancer patients and to examine the effects of rumination on posttraumatic growth of cancer patients. Methods A total of 312 cancer patients were recruited by convenience sampling. A cross-sectional study was conducted in cancer patient by means of questionnaires that included demographic scale, Event Related Rumination Inventory and the Posttraumatic Growth Inventory (PTGI). Results A total score of event-related rumination in cancer patients was 25.13±11.11, and the total score of posttraumatic growth was 67.21±14.66. The PTG was positively correlated to event-related rumination in cancer patients (r=0.384, P < 0.01). Multiple stepwise regressions indicated that the variables of deliberate of rumination, gender, age, degree of psychological distress, intrusive rumination and education level were main predictors of PTG. Among those deliberate of rumination positively predicts PTG, while intrusive rumination negatively predicts PTG. The level of PTG in female gender cancer patients were higher than male patients, younger age and high education level, less psychological distress patients related to higher PTG. Conclusions Cancer patients reported a lower level of rumination and PTG. Clinical healthcare providers should inspire and promote cancer patients' deliberate rumination, decrease their intrusive rumination, pay attention to male, more psychological distress, older age and lower education level patients, in order to facilitate patients' PTG and then improve their quality of life. Key words: Neoplasms; Rumination; Posttraumatic 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).