Lower Posttraumatic Growth Research Articles

Exploring Post-traumatic Growth in Parkinson's Disease: A Mixed Method Study.

Post-traumatic growth (PTG) may favor the psychological adaptation to chronic illnesses. However, few studies investigated PTG in Parkinson's Disease (PD). This study aims to investigate PTG in patients with PD, by exploring disease-specific features and assessing its impact on distress, well-being, and quality of life. A mixed methodology with a convergent parallel design was used. 54 patients were classified according to their level of PTG (low PTG, medium PTG, and high PTG). PD patients with high PTG showed a more positive psychological adaptation and less distress when compared to patients with less PTG. Forty-nine patients were interviewed and their transcripts were analyzed using Thematic Analysis. The emerged themes confirmed the traditional dimensions of PTG model, but a specific theme connected to a new body awareness was identified. Patients with high PTG were more likely to report positive statements following PD diagnosis, particularly concerning spirituality and maintaining a good physical functioning. PTG presents peculiar characteristics in PD and it may favor a better psychological adjustment following the diagnosis.

Post-traumatic growth and its predictors among Syrian refugees in Istanbul: A mental health population survey

AimsThe negative mental health effects of exposure to trauma are well-documented. However, some individuals are theorized to undergo post-traumatic growth (PTG) after exposure to trauma, potentially experiencing positive psychological change across five domains: appreciation for life, relationships with others, new possibilities in life, personal strength, and spiritual change. PTG is less studied in forcibly displaced populations in low- and middle-income countries. This study aimed to explore levels of PTG and associated factors among Syrian refugee adults living in Istanbul, Turkey. MethodsA cross-sectional survey was conducted with 1678 respondents. This study analyzed PTG data from 768 individuals as measured by the Post-Traumatic Growth Inventory (PTGI). Descriptive analysis and univariate and multivariate least squares linear regression modeling were used. Factor analysis and Cronbach's alpha tests assessed the psychometric properties of the PTGI. ResultsThe sample exhibited a moderate level of PTG at 55.94 (SD=22.91, range 0–105). Factor analysis of PTGI revealed only four factors instead of five, and the PTGI yielded high internal reliability (Cronbach's α=0.90). PTG and post-traumatic stress disorder (PTSD) had a curvilinear relationship, with the highest PTG levels experienced by those with moderate PTSD levels. Five other variables were significantly associated with PTG: older age, less education, somatic distress, and history of an overnight stay at a health facility for mental health care were associated with lower PTG, while more years of education were associated with higher PTG. ConclusionsThis study identified the role of the sociodemographic and psychological determinants that influence post-traumatic growth among Syrian refugees in Istanbul. These findings could be used to inform future research and programs seeking to understand PTG in refugees.

Post-traumatic growth and related factors among 1221 Chinese cancer survivors.

There is an increasing number of studies on the post-traumatic growth (PTG) of cancer survivors worldwide. However, few Chinese studies have reported about PTG in cancer survivors because of the underdevelopment of community health services. This study aimed to evaluate the level of PTG in China and explore related factors among a large sample of survivors of more than 12 cancer types. We recruited 1236 survivors from 14 sites of the Beijing Cancer Rehabilitation Association. Survivors completed standardized questionnaires assessing PTG, social support, coping styles, demographic characteristics, and clinical conditions. Multivariate linear regression was used to evaluate potential predictive factors of PTG. A total of 1221 (98.7%) subjects completed the questionnaires. The average PTG score was 61.15 ± 20.26. Seven variables were included in the final regression model: social support, coping style, time after treatment, exercise, BMI, work status, and economic income (P < .05). Survivors who had low levels of social support, had negative coping strategies, had a time after treatment of less than 5 years, exercised irregularly, had an abnormal BMI, were unemployed, or had low economic income had lower PTG levels. PTG levels among Chinese cancer survivors are associated with social support, coping style, time after treatment, exercise, BMI, work status, and economic income. Strategies tailored to Chinese survivors should be developed to promote their PTG and improve their physical and psychological well-being.

Coping Strategy in Differentianting Levels of Post-Traumatic Growth on Housewives Living with Breast Cancer

The psychological state of a person will be affected when they are diagnosed with cancer and this condition will actually worsen the physical condition of the patient. However, many breast cancer sufferers are able to face this stressful situation positively, and they experience post-traumatic growth. They did a series of coping strategy when they had cancer and some of these strategies were able to influence their post-traumatic growth. The current study aims to investigate and to understand how different coping strategy can affect the level of post-traumatic growth of housewives with cancer. This study used a descriptive-explorative qualitative approach with eight women with breast cancer completed surveys using the Posttraumatic Growth Inventory (Tedeschi&amp; Calhoun). The coping strategy was obtained using an interview. The results of the present study indicate that sufferers performed different coping strategies and this affects their level of post-traumatic growth. Respondents with high post-traumatic growth exercise a problem-focused coping i.e. positive reappraisal and emotion-focused coping strategy, i.e. seeking social support when they first learned about the condition of their disease. Respondents who had low post-traumatic growth, on the other hand, did emotional-focused coping strategies, which isavoidance and distancing when they first learned about the condition of their illness. This study also found several factors that influence patients’ strategy. There are differences in the Coping pattern Strategy used by housewives with breast cancer in terms of differences in levels of post-traumatic growth it has. The pattern of coping strategy that is carried out for the first time by housewives with breast cancer could lead themto be in a variety of post-traumatic growth conditions.

Family Caregivers of Liver Transplant Recipients: Coping Strategies Associated With Different Levels of Post-traumatic Growth

ObjectiveAnalyze the influence of 2 variables (post-traumatic growth and time since liver transplantation) on coping strategies used by the transplant recipient's family members. MethodsIn all, 218 family members who were their main caregivers of liver transplant recipients were selected. They were evaluated using the Posttraumatic Growth Inventory and the Brief COPE. A 3 × 3 factorial analysis of variance was used to analyze the influence that post-traumatic growth level (low, medium, and high) and time since transplantation (≤3.5 years, >3.5 to ≤9 years, and >9 years) exerted on caregiver coping strategies. ResultsNo interactive effects between the two factors in the study were found. The only significant main effect was the influence of the post-traumatic growth factor on the following variables: instrumental support (P = .007), emotional support (P = .005), self-distraction (P = .006), positive reframing (P = .000), acceptance (P = .013), and religion (P = <.001). According to the most relevant effect sizes, low post-traumatic growth compared with medium growth was associated with less use of self-distraction (P = .006, d = −0.52, medium effect size), positive reframing (P = .001, d = −0.62, medium effect size), and religion (P = .000, d = −0.66, medium effect size), and in comparison with high growth, it was associated with less use of positive reframing (P = .002, d = −0.56, medium effect size) and religion (P = .000, d = 0.87, large effect size). ConclusionRegardless of the time elapsed since the stressful life event (liver transplantation), family members with low post-traumatic growth usually use fewer coping strategies involving a positive, transcendent vision to deal with transplantation.

The relationships between growth and meaning in life following adversities: Considering multidimensional aspects of meaning in life

The purpose of this study was to explore the relationships between posttraumatic growth(PTG) and meaning in life considering multidimensional aspects of meaning in life, which are importance, consistency, and specific sources of meaning in life. Data were collected from the 283 undergraduate students, who answered at 15 minutes-required questionnaires. Descriptive statistics for all the measurements were obtained and correlational analyses were conducted to explore the relationships between PTG and meaning in life by SPSS ver.18.0. And t-test was conducted to compare the characteristics of meaning in life according to the degree of PTG. The results showed that there was a significant difference between two groups (high PTG vs. low PTG) in the scores of importance and consistency of meaning in life. Second, the high PTG group considered ‘physical and psychological health’, ‘self-acceptance and growth’, and ‘relationships with family and friends’ more important than low PTG group, while there was no group-difference in importance for ‘satisfaction at work’, ‘social achievement’, ‘spirituality and religiosity’ and ‘contribution to society’. Third, the high PTG group tend to make their lives more meaningful in the aspects of self-related and interpersonal relational values than the lower. These findings suggest that the relationship between PTG and meaning in life could become different according to which aspects of meaning in life identified and measured.

Influence factor and posttraumatic growth analysis about nurses after 6years of Wenchuan earthquake

Objective To understand the levels of posttraumatic growth in rescue nurses 6 years after the great Wenchuan earthquake, and analyze the reasons and influence factors. Methods The general information of the nurses and the post-traumatic growth inventory (PTGI) were used to carry out the cross-sectional study in 736 nurses who took part in the rescue works of the great Wenchuan earthquake. Results The average score of PTGI in rescue nurses was (45.39±23.47) points.Rescue nurses had different posttraumatic growth who had different educational level (F=7.180, P=0.000), household income monthly per capita, the type of rescue work, financial loss, health status, residential satisfaction, satisfaction with social support, satisfaction with family members, satisfaction with leaders and colleagues, satisfaction with friends and relatives(F=3.000-17.484, P<0.050). There was also a statistically significant difference between the score of nurses who had received psychological support and who had received no psychological support (t=-3.657, P<0.05). Multiple linear regression analysis showed that satisfaction with friends and relatives, psychological support, household income monthly per capita and satisfaction with leaders and colleagues could affect the total score of PTGI. All the variables could explain 7.5% variance of posttraumatic growth. Conclusions Rescue nurses have relatively low posttraumatic growth. Satisfaction with friends and relatives, psychological support, household income monthly per capita and satisfaction with leaders and colleagues are related to the posttraumatic growth of rescue nurses. Key words: Nurses; Earthquake; Posttraumatic growth

Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation.

Objectives: Post-traumatic growth (PTG) and its opposite—post-traumatic depreciation (PTD)—may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership.Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied.Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41).Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.

Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: a longitudinal study

PurposeThis study examines posttraumatic growth (PTG) among adolescents and young adults (AYAs) with cancer, as well as its correlates and trajectories over time. The study also explores the buffering role of PTG on the associations between posttraumatic stress (PTS), health-related quality of life (HRQoL), and psychological distress.MethodsA multicenter, longitudinal, prospective study was conducted among AYA cancer patients aged 14–39 years. One hundred sixty-nine patients completed a self-report measure of PTG (PTGI) and PTS (PDS) 6, 12, and 24 months after baseline (within the first 4 months of diagnosis). At 24-month follow-up, HRQoL (SF-36) and psychological distress (BSI-18) were also assessed.ResultsAmong participants, 14% showed increasing PTG, 45% remained at a stable high PTG level, 14% showed decreasing PTG, and 27% remained at a stable low PTG level. AYAs who remained high on PTG were more often younger, female, and received chemotherapy. PTG level at 6-month follow-up was predictive of mental HRQoL (β = 0.19; p = 0.026) and psychological distress (β = −0.14; p = 0.043) at 24-month follow-up when corrected for PTS and sociodemographic and clinical covariates. No relationship between PTG and physical HRQoL was found. The interactive effects of PTS and PTG on outcomes were not significant, indicating that buffering did not take place.ConclusionThis study indicates that PTG is dynamic and predicts mental well-being outcomes but does not buffer the effects of PTS. Psychosocial interventions should focus on promoting PTG and reducing PTS in order to promote the adjustment of AYAs diagnosed with cancer.

Evolution of post-traumatic growth during the first 12 months of dialysis: A longitudinal study.

Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients. To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress. A prospective, longitudinal, observational study. The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups. Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress. Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.

AN EXPERIMENTAL STUDY ON BIASED COGNITIVE PROCESSING IN ACCIDENTALLY INJURED PATIENTS WITH DIFFERENT POSTTRAUMATIC GROWTH LEVELS.

Background:Various studies have assessed the negative and/or positive changes in the aftermath of traumatic events. Accidental injuries (such as accidents, injuries, etc.), for its high incidence and disability rate, is easy to cause serious psychological problems and hinder the physical and psychological rehabilitation of the patients.Material and Methods:To explore the characteristics of attention bias in accidentally injured patients with different levels of Posttraumatic growth (PTG), total score of PTG was adopted to screen out 15 high-PTG group and low-PTG group respectively among accidentally injured patients. Dot probe task was used with positive, negative and neutral facial expression pictures as experimental materials. An experimental design of 2 (facial expression: positive and negative)x2 (consistency of probe point and facial expression: consistent and inconsistent)×2 (PTG level: high and low) was employed.Results:Patients with low PTG level had attention bias toward the negative emotional stimuli, and difficulty in distraction from the negative emotional pictures. The value of D and DI were both significantly greater than 0 (p<0.05). Patients with high PTG level did not demonstrate significant attention bias toward positive or negative emotional stimuli. The responding time of patients with high PTG level was significantly shorter than that in patients with low PTG level in the incongruent task (p<0.05).Conclusion:There are different characteristics of implicit cognitive processing in patients with different level of PTG, suggesting the necessity of psychological intervention on the accidentally injured patients.

Posttraumatic growth in aging individuals who have lost their only child in China

ABSTRACTThis article examined the extent of posttraumatic growth (PTG) and factors related to PTG in aging individuals who have lost their only child in China. The sample included 201 bereaved parents from different families residing in Chongqing, China. They were between 49–80 years old (M = 61) and had lost their only child. Personal interviews were conducted in their homes. PTG was assessed with a revised Posttraumatic Growth Inventory (PTGI–R). Descriptive and multiple linear regression analyses were conducted. Overall, the sample showed a positive tendency toward PTG. The older the child was at death, the less PTG the parent experienced. Time since the child’s death was negatively correlated with PTG, and parents whose children died by accident/suicide had lower PTG than those whose children died of illness. Lower education and poor parental health were significantly associated with lower levels of PTG. Community support was significantly and positively associated with PTG. A majority of aging parents who have lost their only child in China experience PTG. Characteristics related to the loss (child’s age at death, time since the death, and cause of death), personal resources (parent’s education and health), and community support are associated with the degree of growth.

The Impact of Stigma and Social Support on Development of Post-traumatic Growth Among Persons Living with HIV.

Given high rates of trauma in people living with HIV (PLH) and the health benefits of posttraumatic growth (PTG), understanding how to foster PTG in PLH exposed to trauma could be of interest to clinical psychologists working with this population. The current study examined factors theoretically related to development of PTG in PLH, namely HIV-related stigma, disclosure of HIV status, and emotional support. A sample of 334 HIV-positive adults answered a battery of self-report questionnaires. HIV-related stigma, disclosure to sexual partners, and emotional support were significant predictors of PTG: stigma was associated with lower PTG, whereas disclosure and emotional support were associated with higher PTG. Disclosure and emotional support remained significantly associated with PTG in the model including demographic factors and stigma. These findings highlight the need for development of interventions that can aid PLH in disclosing their HIV status to sexual partners and increasing available social support.

Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.

Relationship of posttraumatic growth to symptoms of posttraumatic stress disorder and depression: A pilot study of Iraqi students.

Posttraumatic growth (PTG) and psychopathology are common outcomes following exposure to adversity and trauma. We examined the relationship of PTG to posttraumatic stress disorder (PTSD) and depression in a group of young Iraqi students with war trauma exposure. These young Iraqis had experienced an average of 13 different war-related adversities. The prevalence of probable PTSD was 17.2% and probable depression 23.1%. PTSD was associated with higher and depression with lower PTG. In addition, the relationship between PTG and PTSD was stronger among males than females. Although PTSD and depression were relatively common, they were related to PTG in opposite directions.

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.

Threatened with death but growing: changes in and determinants of posttraumatic growth over the dying process for Taiwanese terminally ill cancer patients.

Posttraumatic growth at end of life, a positive psychological consequence of dealing with a life crisis, may be catalyzed by the trauma of facing mortality. Studies on cancer patients' posttraumatic growth have overwhelmingly examined early-stage survivors. Of the few studies on advanced cancer patients, none anchored posttraumatic growth with the patient's death. Therefore, the purposes of this study were to describe longitudinal changes in and to identify determinants of posttraumatic growth over the dying process. A convenience sample of 313 cancer patients was recruited and followed until death. Posttraumatic growth was measured by the Posttraumatic Growth Inventory. Determinants were evaluated from sociodemographics, cancer characteristics, social context variables, and coping strategies using a multiple linear regression model. The dying process may be too threatening and stressful for cancer patients to experience profound posttraumatic growth as manifested by low Posttraumatic Growth Inventory scores (26.13 ± 21.59 to 40.33 ± 27.71 on a 0-105 scale) without significant changes as death approached. However, terminally ill cancer patients who were not defeated by the initial threat of death experienced posttraumatic growth. Patients were at risk for low-level posttraumatic growth if they were male, were non-middle aged, had low educational attainment, had a non-metastatic disease, recently recognized terminally ill status, had severe symptom distress, had high functional dependence and weak social support, and were unaware or had low acceptance of their prognosis. Interventions are needed to appropriately relieve symptom distress, facilitate functional independence, enhance social support, and improve prognostic awareness and acceptance to inspire positive changes for cancer patients at end of life.

Posttraumatic growth and associated socio-demographic and clinical factors in Chinese breast cancer survivors

PurposeThe factors that affect posttraumatic growth (PTG) in breast cancer survivors have been discussed for many years, but it remains unclear which are most influential. The purpose of this study was to determine the level of PTG and identify associated socio-demographic and clinical factors in Chinese breast cancer survivors. Methods and sampleA descriptive research design with a convenience sampling method was employed to collect data using the simplified Chinese version of the Posttraumatic Growth Inventory (PTGI-SC). This questionnaire was administered to 1227 participants recruited from eight tertiary hospitals and cancer survivor groups in Beijing between April 2010 and April 2012. Key resultsPTG is present in Chinese breast cancer survivors, with an average PTGI-SC score of 70.18 ± 15.85. There were five variables in the regression model: exercise, other chronic disease, income, education level, and work status. Exercise showed the strongest positive association with PTG after breast cancer. Household income and educational level also positively influenced PTG. Survivors with other accompanying chronic diseases had lower PTG. Retired survivors had the highest PTG, those working had moderate PTG, and those on sick leave had the lowest PTG. ConclusionsPTG is common among Chinese breast cancer survivors. It is positively associated with exercise, income, education, and retirement, and negatively associated with the presence of other chronic diseases and working. The results may provide information on how to promote the development of PTG while nursing breast cancer survivors.

Combat Exposure, Unit Cohesion, and Demographic Characteristics of Soldiers Reporting Posttraumatic Growth

Posttraumatic growth (PTG) refers to the positive cognitive, spiritual, emotional, and social changes that can occur after a traumatic experience. The current study uses data from 1,663 soldiers who participated in a voluntary survey 6 months after redeployment. The purpose of this study was to predict posttraumatic growth from combat exposure, unit cohesion, and demographic characteristics. We found that greater combat exposure and stronger unit cohesion were associated with more PTG. Being married, a minority, and a junior enlisted soldier were also predictive of greater PTG. Our study defines a group of soldiers with low PTG who are at risk for adverse psychosocial problems. Our results suggest that unit cohesion could be targeted and strengthened to improve 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.