Abstract
Many patients with cancer report positive changes often referred to as posttraumatic growth (PTG). Some of these self-reported PTG may represent maladaptive illusions created by individuals to cope with the illness. A recently established Posttraumatic Growth and Depreciation Inventory - Expanded version (PTGDI-X) includes both PTG and posttraumatic depreciation (PTD) items. This inventory may provide a more balanced picture of the phenomenological world of cancer survivors. We examined the Chinese version of the PTGDI-X's applicability to cancer patients, and how PTG and PTD were related to posttraumatic stress symptoms. Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure posttraumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis showed that the factor structure of the PTGDI-X established in a multi-national study fit our data from cancer patients modestly well. The PTD score had a significant and positive correlation with PTSD symptoms, whereas the PTG and PTSD showed a significant curvilinear relationship in the form of an inverted U-shape. This study's results indicate that PTG and PTD are separated constructs with differential relationships with cancer outcomes. The Chinese version of the PTGDI-X is a viable instrument for psycho-oncological research. The PTD scores can provide useful information to guide cognitive interventions to reduce distorted cognitions. In contrast, the PTG scores can provide further information on the phenomenological world of cancer survivors. In this study, clinical implications and future studies were considered.
Highlights
Many cancer patients and survivors report positive psychological changes after their diagnosis and treatment (Cordova, Cunningham, Carlson, & Andrykowski, 2001; Stanton, Bower, & Low, 2006)
We examined the Chinese version of the PTGDI-X’s applicability to cancer patients, and examine how posttraumatic growth (PTG) and post-traumatic depreciation (PTD) were related to posttraumatic stress symptoms
Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure post-traumatic stress disorder (PTSD) symptoms
Summary
Many cancer patients and survivors report positive psychological changes after their diagnosis and treatment (Cordova, Cunningham, Carlson, & Andrykowski, 2001; Stanton, Bower, & Low, 2006) This phenomenon is known as post-traumatic growth (PTG) (Tedeschi & Calhoun, 1995, 2004) or stress-related growth (Park, 1998; Park & Fenster, 2004) in psychological literature. Many researchers have proposed that self-reported PTG may be defensive self-enhancing cognitive biases to temporarily cope with distress rather than an indicator of genuine positive changes (Wortman, 2004). To support this hypothesis, Maercker and Zoellner (2004) suggested a two-component Janus face model of PTG, comprising a constructive and an illusory component. Supporting the above findings, a most recent study reported a two-class model of long-term anxiety trajectory among breast cancer survivors, with a resistant group (85.2%) and a distress group (14.8%) (C.-T. Cheng, Ho, Lai, Zhang, & Wang, 2021)
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