Higher Posttraumatic Growth Research Articles

The vagaries of valuation: Post-traumatic growth and psychological responses to gains and losses

The experiences of war and trauma have been shown to have many implications for the behavior and attitudes of individuals, including economic and social preferences. It has been argued that this may in part be the result of a process called Post Traumatic Growth (PTG), where individuals exposed to traumatic events experience growth in a number of domains, thereby shifting preferences. However, few studies have actually tested this supposition with field data. I argue that in populations that have experienced trauma such as armed conflict, individuals who experience PTG will display a reduced tendency towards loss-aversion, which individuals in threatening conditions otherwise display. To test my hypotheses, I conduct a survey with over 2000 refugees from the ongoing conflict in Syria, living in the Midyat refugee camp in Mardin, near the Turkish-Syrian border. In addition to reporting individual level trauma, the respondents also complete a hypothetical valuation task. I show that in this conflict-exposed sample, individuals not experiencing PTG displayed stronger responses to losses than to gains. However, individuals with high PTG showed the inverse relationship, with stronger responses to gains than to losses. This has implications for post conflict societies and other contexts where people may have experienced high levels of trauma.

Neural Prediction of Posttraumatic Growth in Healthy Adults With and Without Probable PTSD

Posttraumatic growth (PTG) is the advantageous change some people report following the struggle to overcome traumatic life circumstances. As neural understanding of PTG is limited, debate persists regarding whether PTG represents “real” or “illusory” change. This study presents a novel supervised machine learning examination, predicting high versus low PTG from electroencephalographic (EEG) data collected from 66 trauma-exposed individuals. Alpha and gamma EEG frequency power accurately classified PTG and demonstrated the disruptive neural influence of posttraumatic stress disorder. Results provide objectively measurable neural evidence of the existence of PTG and the first whole-brain, high-density EEG scalp topographies of PTG in known literature.

Characterising Posttraumatic Growth in Individuals With TBI Based on Social Participation, Self-Awareness, and Self-Identity

<h3>Research Objectives</h3> To characterise individuals with higher and lower posttraumatic growth based on their social participation, self-awareness, and self-identity. <h3>Design</h3> A sequential explanatory/exploratory mixed-methods design. <h3>Setting</h3> General community in British Columbia. <h3>Participants</h3> 15 participants with moderate to severe TBI (average age=49.7, male=10, average years post-injury= 15.2). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Qualitative data were collected through semi-structured interviews (approximately 40 minutes). Quantitative data were obtained from self-report questionnaires that assessed social participation (Impact of Participation and Autonomy), self-awareness (Awareness Questionnaire), self-identity (Head Injury Semantic Differential Scale-III), and global functioning (Mayo-Portland Adaptability Inventory-4). For the analysis, qualitative data were used to categorise participants into two groups of higher (n=8) and lower (n=7) posttraumatic growth. The quantitative data were then used to characterise the participants. <h3>Results</h3> Participants with higher posttraumatic growth had more social participation, higher self-awareness, and fewer negative discrepancies in their pre- and post-injury identities. Participants with lower posttraumatic growth had less social participation, lower self-awareness, and more negative discrepancies in pre- and post-injury identities. <h3>Conclusions</h3> This study contributes to the growing literature of posttraumatic growth after TBI by describing the characteristics of participants with higher and lower levels of posttraumatic growth. By integrating qualitative and quantitative data, this study provides a more comprehensive understanding about the subsequent growth that may take place after a TBI. Findings can facilitate future experimental studies to explore the relationships between posttraumatic growth and social participation, self-awareness, and self-identity in individuals with TBI. <h3>Author(s) Disclosures</h3> There are no author disclosures.

Prevalence and factors of posttraumatic growth among Hubei residents during the COVID-19 pandemic: A cross-sectional study

ABSTRACT The adverse impact of the COVID-19 pandemic on mental health has been widely concerned, but the research on positive psychological factors is insufficient, this study aims to investigate the prevalence and factors of posttraumatic growth (PTG) among residents in the worst-hit areas of China (Hubei Province). We were conducted in three disaster areas with different severity in Hubei Province three months after the outbreak, and the data were from 575 respondents. Instruments included the simplified Chinese version of the Posttraumatic Growth Inventory (C-PTGI) and the public health emergency psychological questionnaire. Nonparametric tests, Spearman correlation analyses, and multiple linear regression equations were used to analyze the data. The results showed that three months after the outbreak of COVID-19, the PTG of Hubei residents was at a low level, and their sense of fear was the most prominent, with a positive detection rate of 82.09%. According to the results of this study, high PTG levels were associated with high levels of fear, married and healthcare providers, while low levels of PTG were associated with serious chronic diseases, males, good economic status, and poor prevention and control measures. Government departments should strengthen social support for residents, carry out necessary stress management training to help them correctly deal with negative emotions and promote their personal growth.

Changes in posttraumatic growth, core belief disruption, and social support over the first year of the COVID-19 pandemic.

Post-traumatic Growth (PTG) is the positive psychological change that may occur after a highly stressful situation that shakes a person's core beliefs about the world. During 2020, the United States experienced the COVID-19 pandemic and a highly contentious political election, both of which have the potential to disrupt core beliefs and evoke perceptions of PTG. Post-traumatic growth, core belief disruption, perceived social support from humans and pets, coping strategies, and stressful events were assessed in 201 participants from the United States (Mage: 35.39, SD: 14.60) at four time points from April 2020 (T1) until April 2021 (T4). While total PTG did not significantly change from Time 1 to Time 4, perceptions of personal strength and new possibilities increased, as did core belief disruption, and the use of coping strategies decreased. Higher PTG was reported by those who owned pets, those who knew someone who had been hospitalized due to COVID-19, and those who knew someone who had died of COVID-19. While rating COVID-19 or politics as the most stressful event at Time 4 did not correspond to differences in PTG, those who perceived the event to be resolved had higher PTG than those who perceived the event to be ongoing. Having COVID-19 personally and vaccination status was not associated with differences in Post-traumatic Growth. PTG at Time 4 was predicted by core belief disruption and social support in the full sample and in the pet owners only sample, and by support from video conferencing for the full sample only. Time 4 PTG was also predicted by core belief disruption, problem-focused coping, and avoidance coping. Results are discussed in terms of the PTG theoretical model. Additionally, implications for interventions aimed at fostering psychological growth, including through non-traditional forms of social support (i.e., remote communication and perceived support from pets) are addressed.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

Resilience, coping, and posttraumatic growth in fathers of children with intellectual disabilities: Stress as moderator

AbstractObjectiveWe sought to examine the correlation between resilience and posttraumatic growth (PTG) in fathers of children with intellectual disabilities (ID), exploring the mediating effect of coping. We also tested whether this mediation effect is moderated by sense of stress.BackgroundRaising a child with ID has been associated with both negative and positive aspects of psychological functioning. Little is known, however, about determinants of positive changes in fathers.MethodThe data for this study come from 106 Polish fathers of children with ID who completed a set of questionnaires measuring PTG, resilience, coping strategies, and sense of stress. The relations between variables using moderated mediation were tested.ResultsPTG correlates positively with resilience. Coping strategies (i.e., seeking emotional support and religion) are mediators of this relationship, and sense of stress is a moderator of this mediation. Higher levels of sense of stress increase the mediating role of these coping strategies, which translates into higher PTG in fathers with higher resilience.ConclusionThe relationship between resilience and PTG is complex, mediated by coping strategies, and differs in fathers with high and low stress.ImplicationsKnowledge on the importance of resilience and coping strategies for experiencing positive changes may be used by professionals working with fathers raising children with ID.

Utilization of an Electronic Patient-Reported Outcome Platform to Evaluate the Psychosocial and Quality-of-Life Experience Among a Community Sample of Ovarian Cancer Survivors.

Novel distress screening approaches using electronic patient-reported outcome (ePRO) measurements are critical for the provision of comprehensive quality community cancer care. Using an ePRO platform, the prevalence of psychosocial factors (distress, post-traumatic growth, resilience, and financial stress) affecting quality of life in ovarian cancer survivors (OCSs) was examined. A cross-sectional OCS sample from the National Ovarian Cancer Coalition-Illinois Chapter completed web-based clinical, sociodemographic, and psychosocial assessment using well-validated measures: Hospital Anxiety/Depression Scale-anxiety/depression, Post-traumatic Growth Inventory, Brief Resilience Scale, comprehensive score for financial toxicity, and Functional Assessment of Cancer Therapy-Ovarian (FACT-O/health-related quality of life [HRQOL]). Correlational analyses between variables were conducted. Fifty-eight percent (174 of 300) of OCS completed virtual assessment: median age 59 (range 32-83) years, 94.2% White, 60.3% married/in domestic partnership, 59.6% stage III-IV, 48.8% employed full-time/part-time, 55.2% had college/postgraduate education, 71.9% completed primary treatment, and median disease duration 6 (range < 1-34) years. On average, OCS endorsed normal levels of anxiety (mean ± standard deviation = 6.9 ± 3.8), depression (4.1 ± 3.6), mild total distress (10.9 ± 8.9), high post-traumatic growth (72.6 ± 21.5), normal resilience (3.7 ± 0.72), good FACT-O-HRQOL (112.6 ± 22.8), and mild financial stress (26 ± 10). Poor FACT-O emotional well-being was associated with greater participant distress (P < .001). Partial correlational analyses revealed negative correlations between FACT-O-HRQOL and anxiety (r = -0.65, P < .001), depression (r = -0.76, P < .001), and total distress (r = -0.92, P < .001). Yet, high FACT-O-HRQOL was positively correlated with post-traumatic coping (r = 0.27; P = .006) and resilience (r = 0.63; P < .001). ePRO assessment is feasible for identification of unique psychosocial factors, for example, financial toxicity and resilience, affecting HRQOL for OCS. Future investigation should explore large-scale, longitudinal ePRO assessment of the OCS psychosocial experience using innovative measures and community-based advocacy populations.

Post-traumatic growth 5years after cancer: identification of associated actionable factors.

The number of cancer survivors is growing increasingly worldwide. The long-term negative consequences of the disease are now better known. Cancer may also foster positive outcomes. Some survivors consider life after cancer as the start of a new life and experience positive changes called post-traumatic growth (PTG) measured by a scale developed by Tedeschi and Calhoun. The purpose of this article was to explore actionable factors affecting PTG, particularly those in relation with health care management and those that reflected health behavior changes. This study included the 1,982 participants in the VICAN cohort who responded to the questionnaire on living conditions 2 and 5years after diagnosis. Factors associated with a moderate or high PTG (score ≥ 63) were identified using logistic regressions. Factors positively associated with moderate or high PTG were being satisfied with the time spent by health care team on information (OR:1.35 [1.08;1.70]), increased physical activity (OR:1.42 [1.04;1.95]) and healthier diet (OR:1.85 [1.44;2.36]) since diagnosis, and having benefited from psychological support at diagnosis (OR:1.53 [1.16;2.01]). High PTG is positively associated with health behavior and time spent on information. Our findings suggest that appropriate clinical and educational interventions can help foster growth after the experience of cancer. Even if we do not know what causes what, it is admitted that the interventions leading to an increase of physical activity, for example, are good from all points of view.

Risk and protective factors for posttraumatic stress and posttraumatic growth in parents of children with intellectual and developmental disorders

ABSTRACT Background: Parents of children with intellectual and developmental disorders often experience potentially traumatic events while caring for their children. Heightened posttraumatic stress (PTS) and posttraumatic growth (PTG) have been found in this population. Objective: We aimed to explore risk and protective factors for their PTS and PTG. Method: A cross-sectional study was conducted with 385 parents (average age M = 43.14 years, SD = 7.40; 95.3% mothers). Results: Parenting trauma showed an adverse effect on developing PTS (beta = 0.25, p < .01) and a positive role in promoting PTG (beta = 0.16, p < .01). Social support was protective in its correlation with lower levels of PTS (beta = −0.12, p < .01) and higher levels of PTG (beta = 0.22, p < .01). Barriers to care were associated with increased PTS (beta = 0.23, p < .01), but unrelated to PTG (beta = .01, p = .855). Negative parenting showed a significant, but small, correlation with more severe PTS (beta = 0.11, p < .05), and was unrelated to PTG (beta = −0.09, p = .065). Conclusions: Our study increases the understanding of posttraumatic reactions in parents, predominantly mothers, of children with IDD and identified parenting-related trauma, social support, and barriers to mental health care as predictive factors of the reactions. More research is needed to confirm and validate the effects of the discussed factors. Although causation can not be inferred, prompt and adequate screening and therapeutic resources should be provided to those mothers who were exposed to multiple stressful caregiving events and had limited healthcare access and less support from their spouses, peers, and caregiving partners. HIGHLIGHTS Parents of a child with Intellectual and Developmental Disorders with parenting trauma had higher posttraumatic stress (PTS) and posttraumatic growth (PTG). Social support was related to lower PTS and higher PTG. Barriers to care were related to higher PTS but unrelated to PTG.

A dual-factor model of posttraumatic responses: Which is better, high posttraumatic growth or low symptoms?

Experiencing traumatic events may invoke posttraumatic symptoms (PTS) or growth (PTG). Using a dual-factor approach inspired by the dual-factor model of mental health, we explore the intersections of posttraumatic symptoms and growth with 21 strengths and indicators of psychological, physical, and spiritual well-being. A survey completed by 1,966 participants who had experienced at least one prior victimization (average age 29.8 [SD = 1.64]; 63.6% female) assessed strengths, outcomes, and victimization. Participants were classified into four posttraumatic groups: Resilient (low symptoms, high growth, 23.9%), Prevailed (high symptoms, high growth, 26.1% of sample), Detached (low symptoms, low growth, 20.3%), and Distressed (high symptoms, low growth, 29.8%). Analyses of covariance (ANCOVAs) controlling for age, gender, and victimization found that posttraumatic group classification was associated with each regulatory, meaning-making, and interpersonal strength, and every well-being measure. The Distressed group scored the lowest and the Resilient group scored the highest on almost all measures. Notably, the Prevailed group scored above the Detached group on most measures, except for health-related quality of life and optimism, suggesting that high growth may be more beneficial than low symptoms when coping with trauma. Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mental Health Symptomatology and Posttraumatic Growth among Those with Multimorbidity in COVID Pandemic: Cross-Sectional Findings from the STRONG Study in Greece

Background: Individuals with physical or mental health conditions represent a vulnerable population, especially during the COVID-19 pandemic. However, limited information is available concerning posttraumatic growth and common mental health symptoms of this vulnerable health group during COVID-19. Methods: An online cross-sectional study (STRONG study; psychological changes and effects after COVID-19 quarantine in Greece) was conducted from 28 September 2020 (no lockdown restrictions) to 2 November 2020, just before the second lockdown in Greece. Main outcomes were depressive and anxiety symptoms as well as posttraumatic growth. Results: A total of 860 adults participated in the study. A high proportion of participants did not report any pre-existing health condition (61%), while 334 individuals reported one or more physical or mental health conditions. Overall, 20.2% of the participants reported significant depressive symptoms, and 27.9% reported moderate to high posttraumatic growth. The presence of physical and mental health conditions, either as single diagnosis or as a multimorbidity, was significantly associated with the development of depressive symptomatology (either physical or mental health conditions: OR = 1.12; 95% CI, 1.07–1.17, p &lt; 0.001; both physical and mental health conditions: OR = 1.23; 95% CI, 1.14–1.33, p &lt; 0.001). Posttraumatic growth did not differ between those with or without any pre-existing health issue. Conclusions: Although having a physical or/and a mental health condition predicted the development of depressive symptomatology in a post-lockdown period, the presence of pre-existing conditions was not associated with posttraumatic growth development. Clinicians should be aware of depressive symptoms among their multimorbid patients, even after exiting lockdown.

Protective Factors Associated With Post-traumatic Outcomes in Individuals With Experiences of Psychosis.

Trauma and trauma-specific mental health difficulties (e.g., post-traumatic stress disorder) are highly prevalent in people with psychosis. However, not everyone develops post-traumatic symptoms, and some people even experience post-traumatic growth (PTG) following trauma. It is important to identify which protective factors are associated with less severe trauma symptoms and/or positive outcomes to inform the development and implementation of interventions fostering these variables. Eighty-five patients with experiences of psychosis took part in a cross-sectional study. They were administered questionnaires measuring exposure to traumatic events, symptoms of PTSD and complex PTSD and potential protective factors assumed to be associated with lower vulnerability for post-traumatic symptoms and higher post-traumatic growth (trait resilience, secure attachment, social support, adaptive coping, optimism, general self-efficacy). Multiple hierarchical regression showed that some of these protective factors, in particular optimism, were associated with lower post-traumatic symptoms, explaining 21% of the variance in complex PTSD symptoms and 16% of the variance in PTSD symptoms. However, the hypothesized protective factors, in particular resilience and adaptive coping, explained a considerably larger proportion of variance in PTG (44%). Our results suggest that whilst these variables provide only moderate protection from the vulnerability to experience post-traumatic stress, they may play an important role in allowing people to find meaning despite multiple traumas and subsequently lead more fulfilling lives. Therapies targeting the emotional and psychological consequences of trauma in people with psychosis might benefit from the integration of intervention strategies to enhance these additional psychological protective factors, which in turn may lead to positive treatment outcomes beyond the mere reduction of post-traumatic stress symptoms.

Supplemental Material for A Dual-Factor Model of Posttraumatic Responses: Which Is Better, High Posttraumatic Growth or Low Symptoms?

Supplemental Material for A Dual-Factor Model of Posttraumatic Responses: Which Is Better, High Posttraumatic Growth or Low Symptoms?

A longitudinal investigation of posttraumatic growth and its associated factors among head and neck cancer survivors.

Posttraumatic growth (PTG) may improve well-being among cancer survivors, but a longitudinal study addressing head and neck cancer (HNC) is lacking. This longitudinal study examined PTG trends and determined the associations of physical symptoms and complications, as well as sociodemographic and tumor characteristics on PTG over time among HNC survivors. Participants completed the European Organization of Research and Treatment of Cancer's "Quality of Life Questionnaire-Head and Neck 35" module (EORTC-QLQ-H&N-35) and "Posttraumatic Growth Inventory-Short Form" (PTGI-SF) during baseline (T1 ) and follow-up (T2 ; 5-7months post-baseline) assessments. In total, 200 HNC participants completed the study and 67.5% of them reported increasing PTG. Physical symptoms and complications that were significantly associated with lower PTG included problems with social contact and the senses. Meanwhile, sociodemographic variables that were significantly associated with PTG were gender (males had lower PTG than females) and religion (Muslims and Buddhists had higher PTG than participants of other religious faith). Our findings revealed the need to focus on the impact of sensory issues and reduced social contact following HNC on PTG which may be addressed by various restorative and supportive rehabilitation therapy.

Trajectories of posttraumatic growth in young and middle-aged stroke patients and their predictive effects on mental health.

The increasingly younger age of stroke onset has posed a serious threat to the physical and mental health of young and middle-aged adults. Young and middle-aged stroke patients often suffer from varying degrees of motor, cognitive, and language disabilities, which can trigger considerable psychological trauma. However, these patients may have certain posttraumatic growth (PTG). As a positive psychological experience, PTG provides a new entry point for clinical psychological interventions. Here, we explored the trajectories of PTG in young and middle-aged stroke patients and their predictive effects on mental health. A total of in 165 patients who were treated at our center from January to December 2019 were enrolled with randomized sampling. The survey was conducted at 5 times follow up through use of the Posttraumatic Growth Inventory (PTGI), Social Support Rating Scale (SSRS), and Symptom Checklist-90 (SCL-90). Data were analyzed by using the latent growth mixture modeling (LGMM). The PTG levels in young and middle-aged stroke patients showed a gradual increase (F=9.927; P<0.01). According to the relevant parameters of the trajectories, the subjects were divided into the high PTG group (n=43, 26.06%), low PTG group (n=25, 15.15%), rapidly increasing PTG group (n=47, 28.48%), and constantly decreasing PTG group (n=50 cases, 30.30%). Both the initial level and developmental rate of PTG had significantly negative predictive effects on SCL-90 score (B=-0.46, P<0.01; B=-0.31, P<0.01); in other words, they had positive predictive effects on mental health. There are different trajectories of PTG in young and middle-aged stroke patients, and the initial level and developmental speed of PTG have positive predictive effects on mental health in these patients.

Sense of Stress and Posttraumatic Growth in Mothers of Children with Cystic Fibrosis-The Moderating Role of Resilience.

The aim of this study was to examine the moderating role of resilience in the relationship between sense of stress and posttraumatic growth (PTG) in mothers of children with cystic fibrosis (CF). This cross-sectional study was conducted in a group of 139 mothers of children with CF. A diagnostic survey with Polish versions of the inventories was used. Over half of the mothers (52.89%) reported average and 26.11% high levels of general sense of stress. Mothers also experienced high (37.68%) and average (34.06%) PTG. Generally, mothers of children with CF manifested low general resilience. Sense of stress and PTG were significantly and positively correlated in this group of mothers. Positive correlations were revealed between resilience (total and individual dimensions), total PTG, and 1 dimension of PTG: changes in self-perception. Moreover, resilience was found to correlate with sense of stress. The obtained results indicate that resilience manifested as an optimistic life attitude and the ability to mobilize in difficult situations, and tolerance of failures and treating life as a challenge is a moderator in the relationship between sense of stress and PTG. The relationship between sense of stress and PTG in mothers of children with CF depends on the level of resilience.

Evolution of physical activity and body weight changes in breast cancer survivors five years after diagnosis – VICAN 2 & 5 French national surveys

BackgroundRegular physical activity (PA) and healthy body weight have proven benefits on survival in breast cancer (BC) survivors. We aimed to define predictors of long-term PA and weight gain in a representative sample of BC survivors.MethodsData were analysed from 723 women with BC who participated in both the 2012 and 2015 French National VICAN surveys.ResultsFive years after diagnosis, 26.0, 60.6, and 13.4 % of BC survivors reported regular, occasional and no PA, respectively. Moreover, 27.4 % had a weight gain ≥5 kg. In multinomial logistic regressions, regular and occasional PA were both associated with not having depressive disorders, with higher post-traumatic growth, and with a healthy and stable Body Mass Index. Occasional PA was associated with the use of non-conventional medicine, and regular PA with better mental quality of life and normal arm mobility. Weight gain ≥5 kg was associated with younger age, heavier body weight at diagnosis, and lymphedema 5 years after diagnosis.ConclusionsMental well-being is associated with successful long-term patient investment in PA. Psychological support and early management of disease sequelae are needed to help ensure BC survivors engage in and maintain healthy lifestyles.

Transplant-related trauma, personal growth and alcohol use outcomes in a cohort of patients receiving transplants for alcohol associated liver disease

BackgroundLiver transplantation (LT) is stressful experience which can cause psychological trauma but also positive growth. We examined the prevalence of transplant related post-traumatic stress disorder symptoms (PTSD) and post-traumatic growth (PTG) in a cohort of alcohol-associated liver disease (ALD) LT recipients. We also examined whether PTG or PTSD symptoms were associated with post-LT alcohol use. MethodsCross sectional survey of 51 ALD LT recipients one-year post-LT assessed PTSD symptoms, PTG, stress, self-efficacy, social support, and alcohol use. Results18% endorsed symptoms of PTSD; 59% endorsed high PTG. PTSD symptoms and PTG were not associated. 18% drank alcohol; 10% returned to health harmful use. Neither PTSD symptoms nor PTG were associated with alcohol use. Less self-efficacy to abstain and thoughts of drinking were associated with alcohol use. ConclusionsA substantial percentage of ALD LT patients had transplant-related PTSD symptoms and high PTG. Alcohol use was not associated with PTSD symptoms or PTG. Lower self-efficacy to abstain from alcohol use may provide a valuable clinical measure to assess risk for post-LT use. Clinical screening for PTSD would be beneficial as effective treatments for PTSD exist. Whether PTG can be facilitated in transplant recipients would be a valuable future line of inquiry.

Effects of psychosocial factors on posttraumatic growth among lung cancer patients: A structural equation model analysis.

The purpose of this study was to investigate how locus of control, coping strategies, emotion regulation strategies and social support affect posttraumatic growth. A cross-sectional study design was adopted. A convenience sample of 540 patients with lung cancer was recruited from November 2016 to July 2017 at two tertiary grade A hospitals in China. The participants completed a series of questionnaires. Structural equation modelling was used to explore the effects of psychosocial factors on posttraumatic growth. Social support had a direct positive effect on posttraumatic growth (β=0.318, SE=0.071, BC 95% CI=0.252/0.390), and it also had indirect effects on posttraumatic growth (β=0.112, SE=0.023, BC 95%CI=0.088/0.135) through mediating psychological factors. Coping strategies and the cognitive reappraisal emotion regulation strategy were the main mediating variables, explaining approximately 73.1% of the indirect effect between social support and posttraumatic growth. Our study suggests that Chinese lung cancer survivors can show relatively high posttraumatic growth. There are many mediating paths between social support and posttraumatic growth. These results may help healthcare professionals to identify the psychosocial factors that may benefit lung cancer patients and develop interventions to promote posttraumatic growth.