Trajectories of posttraumatic growth among US military veterans: a 4-year nationally representative, prospective cohort study.

Abstract

This study examined the nature and determinants of predominant trajectories of posttraumatic growth (PTG) over time. Using data from a prospective, nationally representative survey of 2718 US veterans assessed in 2011, 2013, and 2015, we used latent growth mixture modeling to identify PTG trajectories, and to examine key determinants of PTG trajectories from a comprehensive set of sociodemographic, military, health, and psychosocial variables. Three PTG trajectories were identified, labeled as Low and Decreasing PTG (74.0%), Consistently Moderate PTG (12.0%), and High and Increasing PTG (14.0%). Greater severity of posttraumatic stress disorder symptoms, specifically re-experiencing and avoidance symptoms, at baseline predicted Consistently Moderate and High and Increasing PTG trajectories. Compared to the Low and Decreasing PTG trajectory, the High and Increasing PTG trajectory scored higher on baseline measures of gratitude, purpose in life, Spirituality, and social support. Posttraumatic growth is a dynamic process with divergent trajectories. Developing interventions that target certain psychosocial factors may help trauma survivors maintain PTG over time.