Higher Posttraumatic Growth Research Articles

Posttraumatic Growth Characteristics and Distress in Mothers of Children with Cancer

Purpose: The aim of this study was to understand distress and posttraumatic growth (PTG) in mothers of children with cancer. Methods: The data were collected through self-reported questionnaires completed by 222 mothers of children with cancer who had visited the hospital between 9th August and 17th September 2013. Results: The results showed high distress both currently and at diagnosis in the majority of respondents. Analysis of the effects of general characteristics on PTG revealed that religious respondents, or those with considerable religious influence, had higher PTG. PTG was also higher in participants with 2 or more children, and for whom the patient was the second-born or later. There were no significant differences in PTG according to either the mother’s characteristics (age, level of education, employment status, and burden of medical care costs) or the patient’s characteristics (age, gender, birth order, diagnosis, duration of disease, and recurrence). Conclusion: The results of this study allowed a balanced observation of both positive and negative psychological states, such as distress and PTG, in mothers of children with cancer. These study findings may be useful foundation data for development of interventions to promote PTG.

Predictors of physical activity in colorectal cancer survivors after participation in a telephone-delivered multiple health behavior change intervention.

Physical activity improves the health outcomes of colorectal cancer (CRC) survivors, yet few are exercising at levels known to yield health benefits. Baseline demographic, clinical, behavioral, and psychosocial predictors of physical activity at 12 months were investigated in CRC survivors. Participants were CRC survivors (n = 410) who completed a 12-month multiple health behavior change intervention trial (CanChange). The outcome variable was 12 month sufficient physical activity (≥150 min of moderate-vigorous physical activity/week). Baseline predictors included demographics and clinical variables, health behaviors, and psychosocial variables. Multivariate linear regression revealed that baseline sufficient physical activity (p < 0.001), unemployment (p = 0.004), private health insurance (p = 0.040), higher cancer-specific quality of life (p = 0.031) and higher post-traumatic growth (p = 0.008) were independent predictors of sufficient physical activity at 12 months. The model explained 28.6% of the variance. Assessment of demographics, health behaviors, and psychosocial functioning following a diagnosis of CRC may help to develop effective physical activity programs. Understanding the demographic, behavioral and psychosocial determinants of physical activity may facilitate the development and delivery of effective public health interventions designed to promote long term behavior change. ACTRN12608000399392.

Posttraumatic growth in the aftermath of a disaster: looking for the role of gender.

In the past 10 years, the literature on disasters and mental health has shifted from a focus on psychopathology, to an interest in documenting manifestations of resilience in the face of mass trauma. The Jin et al. study, published in this issue of the Journal, examines gender differences in the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of the Wenchuan Earthquake in China. The study suggests that the coping response to PTSD may differ between males and females, and raises interesting questions about the types of factors that contribute to the manifestation of high versus low PTG given high levels of PTSD. At the same time, this type of study highlights the need to investigate the long-term impact and meaning of PTG, and to examine whether it reflects an adaptive process with long-term benefits in the face of traumatic exposures, or an illusory type of posttraumatic response.

"I know it when I see it." The complexities of measuring resilience among parents of children with cancer.

Promoting parent resilience may provide an opportunity to improve family-level survivorship after pediatric cancer; however, measuring resilience is challenging. The "Understanding Resilience in Parents of Children with Cancer" was a cross-sectional, mixed-methods study of bereaved and non-bereaved parents. Surveys included the Connor-Davidson Resilience scale, the Kessler-6 psychological distress scale, the Post-Traumatic Growth Inventory, and an open-ended question regarding the ongoing impact of cancer. We conducted content analyses of open-ended responses and categorized our impressions as "resilient," "not resilient," or "unable to determine." "Resilience" was determined based on evidence of psychological growth, lack of distress, and parent-reported meaning/purpose. We compared consensus impressions with instrument scores to examine alignment. Analyses were stratified by bereavement status. Eighty-four (88 %) non-bereaved and 21 (88 %) bereaved parents provided written responses. Among non-bereaved, 53 (63 %) were considered resilient and 15 (18 %) were not. Among bereaved, 11 (52 %) were deemed resilient and 5 (24 %) were not. All others suggested a mixed or incomplete picture. Rater-determined "resilient" parents tended to have higher personal resources and lower psychological distress (p = <0.001-0.01). Non-bereaved "resilient" parents also had higher post-traumatic growth (p = 0.02). Person-level analyses demonstrated that only 50-62 % of parents had all three instrument scores aligned with our impressions of resilience. Despite multiple theories, measuring resilience is challenging. Our clinical impressions of resilience were aligned in 100 % of cases; however, instruments measuring potential markers of resilience were aligned in approximately half. Promoting resilience therefore requires understanding of multiple factors, including person-level perspectives, individual resources, processes of adaptation, and emotional well-being.

The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups

This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4%. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. One year following the earthquake, 40.1 and 51.1% of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected.

The Roles of Support Seeking and Race/Ethnicity in Posttraumatic Growth Among Breast Cancer Survivors

Posttraumatic growth (PTG) after cancer can minimize the emotional impact of disease and treatment; however, the facilitators of PTG, including support seeking, are unclear. The authors examined the role of support seeking on PTG among 604 breast cancer survivors ages 40 to 64 from the Health Eating, Activity, and Lifestyle (HEAL) Study. Multivariable linear regression was used to examine predictors of support seeking (participation in support groups and confiding in health care providers) as well as the relationship between support seeking and PTG. Support program participation was moderate (61.1%) compared to the high rates of confiding in health professionals (88.6%), and African Americans were less likely to report participating than non-Hispanic Whites (odds ratio = .14, confidence intervals [0.08, 0.23]). The mean (SD) PTG score was 48.8 (27.4) (range 0–105). Support program participation (β = 10.4) and confiding in health care providers (β = 12.9) were associated (p < .001) with higher PTG. In analyses stratified by race/ethnicity, PTG was significantly higher in non-Hispanic Whites and African American support program participants (p < .01), but not significantly higher in Hispanics/Latinas. Confiding in a health care provider was only associated with PTG for non-Hispanic Whites (p = .02). Support program experiences and patient–provider encounters should be examined to determine which attributes facilitate PTG in diverse populations.

Posttraumatic growth and recovery in people with first episode psychosis: an investigation into the role of self-disclosure

The study investigated the relationship of self-disclosure about a psychotic episode to posttraumatic stress symptoms, posttraumatic growth (PTG) and recovery following psychosis. Thirty-four participants who had experienced a first episode of psychosis completed the Impact of Events Scale-Revised, Disclosure of Trauma Questionnaire (a measure of need for, and resistance to, disclosure), a measure of actual self-disclosure, Posttraumatic Growth Inventory and Process of Recovery Questionnaire. The results highlighted that degree of self-disclosure about a psychotic episode was associated with lower levels of posttraumatic stress disorder (PTSD) and higher levels of PTG and recovery. Low PTSD symptoms, high recovery, high actual self-disclosure and low reluctance to talk were significantly related to high PTG. However, only low levels of PTSD symptoms significantly predicted recovery. Finally, recovery was found to mediate the relationship between self-disclosure and PTG. The findings are discussed in terms of the PTG model. Clinically, the findings suggest that people with early psychosis may benefit from disclosing their experiences of psychosis, including those aspects that were traumatic, as this may support the processes of recovery and PTG.

Posttraumatic Growth Following Cancer: Links to Quality of Life

This study examined the linkage of posttraumatic growth (PTG) to quality of life (QOL) among individuals newly diagnosed with cancer. Individuals (26 men, 36 women) reported PTG 3 months postdiagnosis (T1) and 3 months later (T2). Cross-sectional analyses revealed a linear association between PTG and QOL-more PTG was related to worse mental health at T1 (β = -.28). PTG, however, revealed a quadratic relationship with depressive symptoms at T1 and physical health at T2: Individuals with high or low levels of PTG had fewer depressive symptoms and better QOL than those with moderate levels. Longitudinal analyses revealed a linear association between PTG and QOL; more PTG at T1 predicted better physical health at T2. There were no longitudinal curvilinear associations. Although the linear links of PTG to QOL were contradictory within this study, both of the curvilinear relations, although not robust, confirm previous research. Further analyses differentiated low, medium, and high PTG groups in terms of perceiving cancer as stressful, intrusive thoughts, and coping strategies. Overall, relations of PTG to adjustment may be more complex and dynamic than previously assumed. Clinicians should consider the notion that more growth may sometimes, but not always, be better.

Posttraumatic growth in breast cancer survivors: a comparison of volunteers and non‐volunteers

The need to understand posttraumatic growth (PTG) in relation to actual changes in an individual's life has recently been raised. However, the relationship of volunteering, health, and PTG has not yet been assessed. To assess the relationship of volunteer work, health, and PTG, and to assess whether cognitive and emotional processing, emotional expressing, and social support differ in volunteer and non-volunteer breast cancer survivors. Participants were 84 breast cancer survivors who had volunteered to work with newly diagnosed breast cancer patients and 40 breast cancer survivors who did not participate in any volunteer work. Participants completed the PTG inventory, the emotional expression and processing scale, the cognitive processing scale, and the multidimensional scale of perceived social support. Participants in both groups reported similar and relatively high levels of PTG (M = 70.22, SD = 17.38 in a possible range of 0-105). In the volunteer group, PTG levels were not related to self-reported health (r = 0.07, p>0.05), while in the non-volunteer group a high and significant correlation between self-reported health and PTG (r = 0.46, p<0.001), and a significant effect of group × self-reported health on PTG levels, were found. The study variables accounted for 31% of PTG variance, with cognitive and emotional processing and the interaction of group × health being significant predictors. Although volunteers did not differ from non-volunteers in PTG levels, higher PTG was related to better health in the non-volunteers group only. These findings point to the complexity of PTG structure and its multifaceted relation to behavior.

Posttraumatic growth and social support in individuals with infertility

While research on the psychological experiences of infertility has focused almost exclusively on the negative aspects, clinical experience with individuals and couples facing infertility has demonstrated that personal gain can also arise from the struggle involved. This study examined whether individuals who struggle with infertility report posttraumatic growth (PTG), and if perceived availability of and satisfaction with social support are associated with such growth. Other correlates of PTG are reported as well. Using a cross-sectional design, a convenience sample of 121 individuals with infertility completed a background questionnaire, the Posttraumatic Growth Inventory and the Social Support Questionnaire. While individuals reported moderate PTG, moderate availability of, and high satisfaction with social support, there was no significant association between the variables. Infertility-related variables emerged as central to explaining PTG with those with non-female related diagnoses and unexplained diagnoses demonstrating lower PTG than others (t = 2.96, t = 3.6, respectively, P < or = 0.05). Additionally, live birth deliveries was positively associated with PTG (r(2) = 0.22, P < or = 0.02), and those who engaged in clergy counseling had higher PTG than those who did not (t = 2.34, P < or = 0.02). Determinants were unexplained infertility (lower PTG) and number of live birth deliveries (higher PTG). In spite of limitations related to the convenience sampling, correlational design and subjective self-report nature of the data, findings suggest that individuals who suffer from infertility can experience personal growth. Further research will help identify correlates and provide guidance for mental health practitioners on counseling infertility patients to promote growth.

Growth in the Shadow of War: The Case of Social Workers and Nurses Working in a Shared War Reality

This study aimed to assess post-traumatic stress symptoms and vicarious traumatization (VT) versus post-traumatic growth (PTG) among Israeli practitioners who shared war-related reality with their clients during the Second Lebanon-Israel war (2006). In addition, the contribution of potency (one's personal resource) and the role of peri-traumatic dissociation (the emotional detachment activated during or immediately after a traumatic event) were examined. Two months after the war, a convenience sample of 204 practitioners (seventy-six nurses and 128 social workers), all residents and employees in the Haifa area, were administered a self-report questionnaire. Findings showed that nurses had higher post-traumatic growth (PTG) compared with social workers. Personal resource (potency) was found to contribute to the reduction of vicarious traumatization (VT), whereas peri-traumatic dissociation was found to contribute to both PTG and VT in the group of social workers.

Parents' mental health after the birth of an extremely preterm child: A comparison between bereaved and non-bereaved parents

Objective. To assess the impact of extremely preterm birth (24–26 weeks of gestation) on the mental health of parents two to six years after delivery, and to examine potential differences in post-traumatic growth between parents whose newborn infant died and those whose child survived.Method. A total of 54 parents who had lost their newborn and 38 parents whose preterm child survived were assessed by questionnaires with regard to depression and anxiety (HADS) and post-traumatic growth (PTGI).Results. Neither group of parents had clinically relevant levels of depression and anxiety. Mothers showed higher levels of anxiety than fathers. Bereaved parents with no other, living child reported higher levels of depression than bereaved parents with one or more children. Mothers reported higher post-traumatic growth compared to fathers. In particular, bereaved mothers experienced the value and quality of their close social relationships more positively compared to the non-bereaved parents.Conclusion. In the long term, bereaved and non-bereaved parents cope reasonably well with an extremely preterm birth of a child. Post-traumatic growth appears to be positively related to bereavement, particularly in mothers.