The Role of Spirituality and Rumination in the Occurrence of Posttraumatic Stress Symptoms and Posttraumatic Growth Among Ukrainians Exposed to War Trauma Studying in Poland.

Background: Previous studies have found that rumination and challenge to core beliefs may have a predictive effect on Posttraumatic Stress Disorder (PTSD) and Posttraumatic Growth (PTG) among different samples. In addition, there is some evidence that these variables have different effects on PTSD and PTG, although the latter construct has been the target of a larger body of research and theoretical models. The main objective of the current study is to examine the effect of challenge to core beliefs, intrusive rumination, and deliberate rumination on PTSD and PTG, through an item-level analyses.Methods: The sample was composed of 205 Portuguese women who had been given a breast cancer diagnosis (M = 54.32, SD = 10.05), and who completed the following self-administered questionnaires: the Posttraumatic Stress Disorder Checklist (PCL-C); the Posttraumatic Growth Inventory (PTGI); the Core Beliefs Inventory; and the Event Related Rumination Inventory. Two multivariate multiple regression analyses, using each item of the PCL-C and the PTGI as dependent variables, were conducted.Results: The results demonstrated that challenges to core beliefs predict 17 of the 21 PTGI items and 12 of the 17 PCL-C items. All but one item of the PCL-C are predicted by intrusive rumination, while the variance of only 4 items of the PTGI are explained by deliberate rumination.Conclusion: These findings indicate that women with breast cancer who tend to display higher levels of intrusive rumination are more likely to report PTSD symptoms, and that an examination of one’s core beliefs is predictor of both positive and negative outcomes. In spite of the proven effect of challenge to core beliefs on both variables, this study suggests that this effect has only a minor influence on PTSD, in addition to confirming its major impact on PTG.

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

The relationship between rumination, posttraumatic stress disorder, and posttraumatic growth among Chinese adolescents after earthquake: A longitudinal study

Background Rumination can either prolong distress or foster growth following traumatic experiences like childbirth. This study investigates the association between post-traumatic stress symptoms and post-traumatic growth in women who underwent traumatic childbirth, examining the potential mediating role of two types of rumination – intrusive and deliberate. Methods A cross-sectional study in Northern Portugal from January 2020 to December 2021 surveyed 202 women with infants under 12 months, self-reporting traumatic childbirth experiences. Instruments included the City Birth Trauma Scale, Event-Related Rumination Inventory, and Post-traumatic Growth Inventory. Results Women experienced various childbirth-related traumatic events, with most showing post-traumatic stress symptoms for over three months. Approximately 60% met post-traumatic stress disorder criteria. The results indicate that post-traumatic stress symptoms were positively correlated with post-traumatic growth, and both showed positive associations with intrusive rumination and deliberate rumination. Mediation analysis revealed deliberate rumination significantly mediated post-traumatic stress symptoms and post-traumatic growth, highlighting its role in trauma outcomes. Conclusions This study illuminated the pathway through which post-traumatic stress symptoms can lead to posttraumatic growth, highlighting the pivotal role of deliberate rumination in this association. This finding is essential for tailoring therapeutic interventions that effectively foster post-traumatic recovery and resilience, underscoring the importance of promoting deliberate rumination.

Both posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) are associated with spirituality and different kinds of repetitive thinking, such as deliberate rumination (DR) and intrusive rumination (IR) respectively. This study aimed to examine if spirituality modifies the relationship between types of rumination and trauma outcomes. Method: Ninety-six students from the University of Liverpool completed an online survey of four questionnaires: The Posttraumatic stress Diagnostic Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory-Short form and the Expressions of Spirituality Inventory- Revised. Results: Correlations revealed that spirituality was related to DR and PTG, but not to IR or PTSD symptoms. Moderation analysis showed that spirituality significantly moderated the relationship between PTG and DR, but not the relationship between PTSD and IR. Conclusions: The findings suggest that although spirituality has no relationship with negative outcomes of trauma, it may help individuals to ruminate in a constructive manner in order to develop positive outcomes. Keywords: trauma, posttraumatic growth, posttraumatic stress disorder, rumination, cognitive processes, spirituality.

Previous studies indicated that self-compassion can alleviate posttraumatic stress disorder (PTSD) and promote posttraumatic growth (PTG). Rumination is a cognitive process in which individuals repeatedly think about traumatic events and their consequences, which includes invasive rumination (IR) and deliberate rumination (DR). IR is a process of thoughts over traumatic event that invades the cognitive world in an undesired state, whereas DR is an individual’s conscious and repeated thinking on events. IR and DR have also been shown to have effects on PTSD and PTG. Studies have examined the relationship between self-compassion, IR, deliberate rumination DR, PTSD, and PTG, respectively, but only a few studies have examined their combined roles in PTSD and PTG among adolescents who have experienced an earthquake. In addition, recent studies have shown that the positive and negative components of self-compassion have different effects on post-traumatic stress responses, but few studies have explored the mechanisms of positive and negative self-compassion on PTSD and PTG in adolescents who experience earthquakes. This study examines the mediating roles of rumination in the relationship between self-compassion, PTSD and PTG among Chinese adolescents after the Jiuzhaigou earthquake. Ten months after the Jiuzhaigou earthquake, a questionnaire survey was conducted among 621 middle school students in Jiuzhaigou county. The participants were assessed by using the following systems: Trauma Exposure Questionnaire, Self-Compassion Scale, Event-Related Rumination Inventory, PTSD Checklist for DSM-5, and Posttraumatic Growth Inventory. When we controlled for the gender, age, and trauma exposure in the direct effect model, positive self-compassion (PSC) had a negative effect on PTSD and a positive effect on PTG. Moreover, negative self-compassion (NSC) had a positive effect on PTSD, but the effect on PTG was nonsignificant. In the indirect model, PSC had an indirect and positive effect on PTSD and PTG via deliberate rumination (DR). NSC had an indirect and positive effect on PTSD and PTG via invasive rumination (IR), whereas NSC also had an indirect and negative effect on PTSD and PTG, as well as via an indirect path from IR to DR on PTSD and PTG. Findings indicated that increased PSC may reduce PTSD and be beneficial for PTG. NSC may exacerbate PTSD. Rumination plays a significant mediating role between self-compassion, PTSD, and PTG.

Background: Although previous research has demonstrated that fear and guilt have an effect on posttraumatic stress disorder (PTSD), it is still unclear how these two emotions affect posttraumatic growth (PTG). Moreover, few studies have examined the mechanisms by which fear and guilt affect PTSD and PTG. Guided by Lee et al.’s theory of PTSD generation mechanisms and Calhoun and Tedeschi’s PTG theory, the current study proposes that intrusive rumination (IR) and deliberate rumination (DR) may play a mediating role in the effects of guilt and fear on PTSD and PTG. Objective: This study aimed to simultaneously examine the mediating roles of IR and DR in the relationship between fear, guilt, PTSD, and PTG. Method: This study employed a two-wave longitudinal design. A total of 408 adolescent survivors were assessed using self-report questionnaires after the Ya’an earthquake in China. Measures were obtained for trauma exposure, subjective fear, survivor guilt, IR, and DR at three and a half years after the Ya’an earthquake (Time 1), while PTSD and PTG were assessed at time point four and a half years after the Ya’an earthquake (Time 2). Results: The results showed that both fear and guilt had a direct and positive effect on PTSD and PTG. Fear and guilt were positive predictors of PTSD and negative predictors of PTG through the mediating variable of IR. DR mediated the relationship between guilt and PTG but not PTSD, and also mediated the relationship between IR and PTG. Conclusions: Study findings indicate that fear, guilt, and intrusive rumination may contribute to PTSD symptoms in adolescent trauma survivors. Results also suggest that adolescent survivors can grow emotionally and psychologically following traumatic events, and that directed rumination may contribute to such growth. Interventions that reduce fear, guilt, and intrusive rumination while increasing directed rumination may assist adolescent trauma survivors in recovery and growth.

Both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) are associated with spirituality and different kinds of repetitive thinking, such as deliberate rumination (DR) and intrusive rumination (IR), respectively. This study aimed to examine if spirituality modifies the relationship between types of rumination and trauma outcomes. Ninety-six students completed an online survey of four questionnaires in a cross-sectional online survey: The Posttraumatic Stress Diagnostic Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory-Short form and the Expressions of Spirituality Inventory- Revised. Findings revealed that spirituality was related to DR and PTG, but not to IR or PTSD symptoms. Moderation analysis showed that spirituality significantly moderated the relationship between PTG and DR, but not the relationship between PTSD and IR. These findings indicate that while spirituality has no relationship with negative outcomes of trauma, it may help individuals to ruminate in a constructive manner in order to develop positive outcomes.

Both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) are associated with spirituality and different kinds of repetitive thinking, such as deliberate rumination (DR) and intrusive rumination (IR), respectively. This study aimed to examine if spirituality modifies the relationship between types of rumination and trauma outcomes. Ninety-six students completed an online survey of four questionnaires in a cross-sectional online survey: The Posttraumatic Stress Diagnostic Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory-Short form and the Expressions of Spirituality Inventory- Revised. Findings revealed that spirituality was related to DR and PTG, but not to IR or PTSD symptoms. Moderation analysis showed that spirituality significantly moderated the relationship between PTG and DR, but not the relationship between PTSD and IR. These findings indicate that while spirituality has no relationship with negative outcomes of trauma, it may help individuals to ruminate in a constructive manner in order to develop positive outcomes.

Posttraumatic growth (PTG) may exist in trauma survivors, especially adolescents, whereas rumination is a typical cognitive characteristic among traumatized individuals. However, there were mixed relationships between rumination (intrusive rumination, deliberate rumination) and PTG. The study aimed to increase understanding of the relationships between them by investigating the role of social support among adolescents after the Yancheng tornado. Four hundred forty-three middle school students in the core area of the tornado were administered a revised social support scale based on Furman and Buhrmester's Network of Relationships Inventory, Event-Related Rumination Inventory, and Posttraumatic Growth Inventory. Results showed a nonsignificant relationship between intrusive rumination and PTG, whereas a positive relationship was found between deliberate rumination and PTG. Moreover, social support did not moderate the relationship between intrusive rumination and PTG, but it significantly mediated the relationship between deliberate rumination and PTG. Clinical implications on trauma intervention and limitations as well as future research directions were discussed.

Middle school students in Wenchuan County (N = 354) were assessed 4.5 years after the Wenchuan earthquake to examine the effects of challenges to core beliefs, intrusive rumination, and deliberate rumination on posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). The results indicated that intrusive rumination partly mediated the relationship between challenges to core beliefs and PTSD, whereas deliberate rumination partly mediated both the relationship between challenges to core beliefs and PTG, as well as the relationship between intrusive rumination and PTG. These findings suggest that challenges to core beliefs had a direct positive impact on both PTSD and PTG. Moreover, such challenges predicted PTSD through intrusive rumination and predicted PTG through deliberate rumination. Furthermore, intrusive rumination might cue individuals to engage in a more purposive deliberate rumination process. These results indicate that PTSD and PTG are influenced by different mechanisms and that PTSD and PTG represent 2 separate dimensions of experience following adversity.

Healthcare workers are often exposed to traumatic events and as a result, they may experience post-traumatic stress disorder (PTSD) and other mental illnesses. The prevalence of these issues is high among healthcare professionals. Positive transformation (i.e., PTG) can emerge after struggles related to a stressful life event. In this cross-sectional study utilizing structural equation modeling (SEM), a sample of Iranian healthcare workers (nurses and pre-hospital emergency personnel from Ardabil) completed a battery of self-report questionnaires. These measures included a demographic information form, the Life Events Checklist (LEC-5), the Core Beliefs Inventory (CBI), the PTSD Checklist for DSM-5 (PCL-5), the Posttraumatic Growth Inventory (PTGI), scales assessing intrusive and deliberate rumination, and a social support questionnaire. In examining the direct coefficient paths, all paths were statistically significant with the exception of the path of core belief disruption to deliberate rumination, social support to intrusive rumination, and PTSD to PTG. Similarly, in the examination of the coefficient of indirect paths, all paths were not statistically significant except for the paths of intrusive rumination to PTG through deliberate rumination and social support to PTG through deliberate rumination. The study's findings suggest that disruptions in core beliefs can result in both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) and that social support plays a crucial role in promoting PTG. Clinical interventions that address disruptions in core beliefs and promote social support, such as mindfulness practices and purposeful thinking, may be effective in promoting mental health and well-being among healthcare professionals. Based on the results of the study, clinical interventions that address disruptions in core beliefs and promote social support may be effective in promoting mental health and well-being among healthcare professionals who have experienced traumatic events. As such, these findings can inform the development of evidence-based clinical interventions that can improve the mental health outcomes of healthcare professionals and, ultimately, enhance patient care.

Emergency service workers are exposed to experienced traumatic events related to the nature of their work. The study aimed at identifying the role of cognitive processes, namely different forms of ruminations, as predictors of consequences of experienced trauma. The data on 120 medical rescuers (80 men, 40 women) who had experienced in their worksite at least 1 traumatic event in the last 5 years, were analyzed. The age of the participants ranged from 25 to 61 years (mean (M) = 38.07; standard deviation (SD) = 8.92). The following Polish versions of standardized tools were used: the Impact of Event Scale - Revised (IES-R), the Posttraumatic Growth Inventory (PTGI) and the Event Related Rumination Inventory (ERRI). The results of regression analyses indicated 2 significant predictors, intrusive rumination for posttraumatic stress disorder (PTSD) and deliberate rumination for posttraumatic growth (PTG). Ruminations play an essential role in the occurrence of negative and positive outcomes of experienced trauma. The associations between PTSD and PTG, with different forms of ruminations, may be used in therapy, treating the appearance of intrusive rumination as an opportunity to turn towards active engagement in deliberate rumination, that facilitates the occurrence of posttraumatic growth. Med Pr 2016;67(2):201-211.

This study aimed to examine the role of core belief disruption, intrusive rumination, and deliberate rumination in posttraumatic growth (PTG) among suicide-loss survivors and individuals who were exposed to a suicide attempt by a parent, sibling, romantic partner, relative, or friend. Participants were university students studying in Aydın, Türkiye; 138 were suicide-loss survivors (68 women; M = 20.8, SD = 2.1) and 198 were exposed to a suicide attempt (128 women; M = 21.05, SD = 2.2). Data were collected using the Core Beliefs Inventory, the Event-Related Rumination Inventory, and the Posttraumatic Growth Inventory. The findings indicated that core belief disruption and deliberate rumination were positively associated with PTG in both groups. In contrast, intrusive rumination was negatively associated with PTG among suicide-loss survivors but was not significantly associated with PTG among attempt-exposed individuals. Mediation analyses showed that both intrusive and deliberate rumination mediated the relationship between core belief disruption and PTG among suicide-loss survivors. However, among individuals exposed to a suicide attempt, only deliberate rumination functioned as a mediator. These findings suggest that intrusive and deliberate rumination may be differentially associated with PTG and that the pattern of associations may differ between suicide-loss survivors and individuals exposed to a suicide attempt involving a parent, sibling, romantic partner, relative, or friend. Overall, the results indicate the relevance of targeting ruminative processes in clinical interventions aimed at meaning reconstruction and suggest the need for longitudinal research to clarify the temporal dynamics of rumination and core belief disruption.

Association of Rumination and Metacognition with Posttraumatic Growth in Parents of Children with Cancer