Positive Psychological Changes Research Articles

Associations between posttraumatic stress symptoms and posttraumatic growth elements: A network analysis.

The COVID-19 pandemic is a collective trauma causing profound psychological distress and, in some cases, positive psychological changes. The present study ascertained the most influential symptoms and strong connections between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) elements. It also examined the symptoms/elements that acted as a bridge between the two, to elucidate how PTS and PTG co-exist. The PTSD Checklist (PCL-5) and Posttraumatic Growth Inventory (PTGI) were used to assess PTS symptoms and PTG, respectively, in a sample of 509 adults from Kashmir, India. The network analysis revealed negative trauma-related emotions as the most influential symptom in the PTS network, and the ability to do better things with life as the most influential element in the PTG network. Eight bridge symptoms/elements emerged between the PTS and PTG, namely intrusive thoughts, nightmares, more compassion for others, sleep disturbances, trauma-related amnesia, hypervigilance, willingness to express emotions, and counting on others more. The study identified the most influential symptom in the PTS network and the bridge symptoms in the combined network of PTS symptoms and PTG elements in the context of the COVID-19 pandemic in the present sample. The bridge symptoms helped in understanding how PTS and PTG co-existed in adults exposed to disasters such as COVID-19. Identification of these symptoms can be highly significant for developing targeted interventions. These implications have been discussed further in the present study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A prospective observational study examining weight and psychosocial change in adolescent and adult eating disorder inpatients admitted for nutritional rehabilitation using a high-energy re-feeding protocol

BackgroundHigh-energy re-feeding protocols are increasingly utilised for nutritional rehabilitation in adolescents with anorexia nervosa (AN), however, concern persists that adults with AN may be at greater risk of developing complications. In addition, research on psychological outcomes of eating disorder (ED) inpatient treatment programs, and outcomes of high-energy protocols in avoidant restrictive food intake disorder (ARFID) and bulimia nervosa (BN), is limited. This study of an ED inpatient program using a high-energy protocol, compared changes in weight and psychosocial outcomes between adolescents and adults, and identified medical risk factors associated with deviation from the protocol.MethodThis prospective observational study took place in a voluntary ED treatment program in a private hospital. Weight, height, and psychosocial questionnaires (ED Examination-Questionnaire, Depression Anxiety Stress Score, Clinical Impairment Assessment and AN/BN Stage of Change) were collected from consenting adolescents (16–20 years) and adults (> 20 years) on admission and discharge. Medical tolerance to the high-energy protocol was assessed daily. Independent samples t-tests and paired samples t-tests were applied to normally distributed data, and Mann–Whitney U tests and Wilcoxon signed-rank tests to skewed data. P-values < 0.05 were considered significant statistically.ResultsNinety-seven participants were recruited. The majority (n = 91, 94%) were female and most (n = 80, 83%) had AN. Forty-two (43%) were adolescents and 55 (57%) were adults. In participants with AN, weight change (Δ) was significant [median Δ 8.0 (interquartile range (IQR) 4.3) kg]. There was no difference in rate of weight change between adolescents and adults with AN [mean Δ 1.8 (standard deviation (SD) 0.5) kg/week vs. Δ 1.8 (SD 0.6) kg/week; p = 0.841, respectively]. One (1%) participant with AN did not tolerate the high-energy protocol due to oedema. Participants achieved positive change in psychosocial questionnaire scores (p < 0.001) after the the specialist ED program, with no difference between adolescents and adults (p > 0.05).ConclusionsThis voluntary ED treatment program using a high energy re-feeding protocol was effective in achieving positive weight and psychological change for adolescents and adults with minimal adverse events. This indicates that the specialist ED program has both nutritional and psychological benefits.

Relationships between body image, dyadic coping and post-traumatic growth in breast cancer patients: a cross-sectional study.

The diagnosis and treatment of cancer triggers not only a negative psychological response for the patient, but also a positive psychological outcome. Positive dyadic coping, as a form of coping for mental health outcomes, can maintain or reestablish internal stability between the patient and his or her spouse, resulting in positive physical and psychological changes. However, there is a paucity of research on body image, dyadic coping, and post-traumatic growth in breast cancer patients. The purpose of this study was to explore the relationship and pathways between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A cross-sectional study was conducted from November 2022 to November 2023 at a tertiary care hospital in Wuxi, Jiangsu, China. This study was conducted among 154 breast cancer patients treated at the Affiliated Hospital of Jiangnan University, all of whom completed demographic and clinical information questionnaires, Body image self-rating questionnaire for breast cancer (BISQ-BC), Dyadic Coping Inventory (DCI) and Post Traumatic Growth Inventory (PTGI). A Pearson correlation analysis was used to explore the relationship between body image, dyadic coping, and post-traumatic growth. Structural equation modeling was used to analyze the path relationships among the three and to explore the mediating role of dyadic coping. The level of body image was negatively correlated with post-traumatic growth (r = -0.462, p < 0.01); and the level of body image was negatively correlated with dyadic coping (r = -0.308, p < 0.01). And dyadic coping was positively associated with post-traumatic growth (r = 0.464, p < 0.01). The structural equation modeling results supported the mediation model with the following model fit indices, chi-square to degrees of freedom ratio (χ2/df = 2.05), goodness of fit index (GFI = 0.93), comparative fit index (CFI = 0.99), canonical fit index (NFI = 0.93), incremental fit index (IFI = 0.99), non-canonical fit index (TLI = 0.99) and the root mean square of the difference in approximation error (RMSEA = 0.03). Body image and dyadic coping directly affected post-traumatic growth (β = -0.33, p < 0.05; β = 0.43, p < 0.05). And body image indirectly influenced post-traumatic growth through dyadic coping (β = -0.17, p < 0.05). Interconnections between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A preliminary validation of the mediating role of dyadic coping between body image and post-traumatic growth, body image can have an impact on dyadic coping, which in turn can have an impact on post-traumatic growth. Whereby higher levels of dyadic coping in patients may also be associated with higher levels of post-traumatic growth, whereas body image disturbance may impede levels of post-traumatic growth.

Constructing and Preliminary Testing a Narrative Therapy Programme for Posttraumatic Growth in Chinese Patients With Inflammatory Bowel Disease-A Pilot Study.

The research on posttraumatic growth (PTG) promotion programmes, particularly narrative therapy (NT), for patients with inflammatory bowel disease (IBD) remains limited. This pilot study aims to develop an NT programme to promote PTG and evaluate its feasibility, preliminary effectiveness, participants' experiences and improvement suggestions. The NT programme was initially developed through literature review, interviews with IBD patients and expert panel discussions. A randomized controlled pilot trial was conducted to assess the feasibility and preliminary effectiveness of the programme. Participants in the NT group received five consecutive weekly sessions of the programme, while the control group received standard care. Outcomes including PTG, anxiety, depression and quality of life were measured. Qualitative interviews were conducted to explore participants' experiences and suggestions for programme modifications. The NT programme was developed with scientific rigour. The recruitment rate and retention rate were 62.5% and 96.7%, respectively. A significant reduction in anxiety levels was observed, and manifestations of PTG were reported in the NT group. Suggestions for improvement of the NT programme were received from the participants. The NT programme was constructed to promote PTG in IBD patients in this study, further offering preliminary evidence for its feasibility and potential positive psychological change. However, large-scale research is needed to validate its effectiveness for broader applications.

Relationships, stability, and authenticity: How being yourself is ‘the’ key to community sport coaching and youth work

AbstractThe fields of youth work and community sport development both use participation in sport as a means by which to engage young people and support behavioural change. This is achieved through social intervention programmes (whether part of broader or specific approaches, or individual, group, or community contexts), that specifically address community and psychological wellbeing. While extensive bodies of literature support effective practices in both fields, there are fewer related to the intersubjectivity between them. Given, in the UK context at least, the crossover of funded programmes, objectives, and practice in an applied and policy sense, this study sought to investigate what practitioners in both fields considered best practice relative to how they facilitated appreciable changes in pro‐social behaviour and lifestyle trajectories. This study used semi‐structured interviews with nine participants who all had experience of working in both community sport coaching and youth work. The findings suggest that youth workers and community sport coaches can fashion effective practice through working climates that actively ensure stability and connections, and that authentic projection of self, one that means practitioners must care and have the interest of the young people at heart, are essential to create positive psychological change through meaningful relationships. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Coping in Women With Breast Cancer Awaiting a Surgical Intervention: A Cross-Sectional Study

Background: Breast cancer affects a woman’s body and mind in complex ways and is more than just a physical condition that requires medical treatment. Objective: To investigate how women with breast cancer undergoing surgical treatment cope with and adjust to the disease. Methods: A cross-sectional study between April 12 and July 22, 2022. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: A total of 125 women participated (median age 52). Most (64.8%) responded rationally, 25.4% emotionally, and 9.8% nonprevailing. About 76.2% used problem-focused coping. Women living with others had better adaptation than those alone. Emotional appraisal increased the likelihood of poor adaptation compared to rational appraisal. Nonprevailing coping was linked to a 6-fold increase in psychosocial maladjustment (OR, 5.88; 95% CI,1.14-30.30). Conclusions: The study indicates that women with breast cancer tend to adopt problem-focused coping strategies, with rational responses correlating with better psychological adaptation outcomes, while emotional or nonprevailing responses may lead to poorer adjustment. Implications for Practice: Coping strategies should be shared by oncology nurses with targeted women, especially if their potential for postdiagnosis positive psychological change is considered. What is Foundational: Women diagnosed with breast cancer eligible for surgical treatment may undergo a positive psychological transformation, as the majority exhibit a problem-focused, rational approach to the disease.

The Experience of Stress-Related Growth Associated With COVID-19 Among Older Korean Immigrants

While some studies have investigated stress-related growth (SRG) during the COVID-19 pandemic, little research has been conducted to explore the positive psychological changes associated with COVID-19 among older Asian immigrants. Thus, we aimed to identify perceived positive changes resulting from the COVID-19 pandemic based on the SRG framework. Semi-structured in-depth interviews were conducted with 11 participants using a purposeful criterion sampling strategy. Both content mapping and content mining questions were used. Data were analyzed qualitatively using the constant comparative method. Challenges and stressors associated with the pandemic such as fears of physical or verbal attack, COVID-19 infection, strict COVID-19 regulations and mandates, and limited opportunities to interact with others were identified based on the statements of participants. We identified three salient themes that were characterized as SRG components: (a) increasing leisure-time physical activity participation, (b) developing a closer relationship with others, and (c) improving resilience. The findings of this study present qualitative evidence that older Korean immigrants to the United States experienced positive changes associated with the pandemic such as being more physically active, developing closer relationships, and improving resilience. These changes are associated with the main elements of SRG, and it appears that the pandemic may have resulted in older Korean immigrants experiencing SRG.

Perceived stress and posttraumatic growth in caregivers of pediatric burn patients undergoing mHealth-enhanced outpatient burn care: A pilot study

Approximately 120,000 children in the United States are evaluated in the emergency department annually due to burn injuries. Studies have consistently documented that pediatric burns are among the most stressful events for caregivers, resulting in a wide range of emotions, including guilt, anxiety, grief, depression, and posttraumatic stress symptoms, as well as positive psychological changes, a phenomenon known as posttraumatic growth. The present pilot study aimed to explore the prevalence of elevated perceived stress as well as posttraumatic growth among caregivers of pediatric burn patients receiving outpatient burn care and using an mHealth burn platform to administer burn treatment. Our results demonstrated that, on average, caregivers endorsed similar or lower levels of perceived stress over the past 30 days compared to the general population of 30–44-year-old adults and only a third of caregivers reported elevated levels of perceived stress in the past 30 days. However, during the treatment phase, two-thirds of caregivers reported elevated levels of stress. Further, approximately half of the caregiver sample reported moderate to high levels of posttraumatic growth following their child’s burn injury. This pilot study clarifies the level of the perceived stress that caregivers of burn-injured children experience, particularly during the treatment phase when they are responsible for their children’s outpatient burn care (e.g., dressing changes). Additionally, the results shed light on the high prevalence of moderate to high posttraumatic growth in caregivers, with a prevalence rate similar to other trauma survivors.

群像特征、潜存风险与价值引领: 2023 年度热词背后的青年社会心态研究

Annual hot words have a summarizing and predictive role, and are an important dimension for examining the social mentality of young people. The hot words of 2023 reflect that contemporary youth are generally concerned about the national social development trend and cutting-edge technological trends, and their digital and technological literacy has generally improved; Having a love for life and a positive and optimistic attitude; Having a certain level of self-regulation ability. At the same time, the new consumption concepts that have emerged among young people in the post pandemic era convey positive psychological changes. However, some negative hot words also expose the social mentality bias of young people, who express powerlessness and anxiety towards the current situation, face difficulties in social isolation and labeling, are disturbed by blind obedience psychology, and the use of some negative hot words exposes negative venting tendencies. Standardizing the use of hot words, promoting positive examples, and directly addressing real-life issues are of great significance for strengthening the guidance of youth values, correcting deviations in youth social attitudes, and building positive social attitudes among young people.

Perceptions of interpreters working for refugee clients of the psychological effects of their work

This study aims at presenting a picture of the perceptions of the interpreters working for refugees in legal and public healthcare settings in Türkiye with a focus on the psychological effects of their work. Taking this objective as a departure point, questionnaires and semi-structured interviews were conducted to investigate the causes of psychological challenges, reactions to these challenges, coping strategies, and negative and positive psychological changes that interpreters went through in the course of their work. Interviews were analyzed following a thematic analysis procedure, complemented with the analysis of the questionnaire results. The findings revealed that the interpreters came under a degree of psychological strain, including psychological stress, in the course of their work. The reasons included trauma-related stories of refugees, service providers’ lack of awareness of the interpreters’ work specifications, unfavorable working conditions, and racism against refugees in the workplace. The interpreters were also found to show certain reactions to psychological challenges, including feeling sad, crying, and sleep problems among others. Findings also revealed that the interpreters employed a few strategies to cope with these challenges such as socializing with friends, and that the interpreting work with refugees led to mostly positive psychological changes on the interpreters. The changes involved gaining self-confidence and feeling stronger than before. The findings, pinpointing the needs for support structures for interpreters working for refugees in Türkiye, will feed into the overall discussions on the psychological dimensions of interpreting for refugee clients.

Scoping review protocol of post-traumatic growth (PTG) in Korean cancer survivors

IntroductionCancer, a life-threatening chronic disease, is the leading cause of death in Korea, accounting for 27% of all deaths in 2020. Due to advancements in medical technology and early detection...

Effectiveness of a narrative nursing intervention on reproductive concerns in women of childbearing age undergoing cervical cancer surgery: A randomized controlled trial

ObjectiveThis study aims to explore the intervention effects of narrative nursing on the reproductive concerns of cervical cancer patients of childbearing age undergoing surgical treatment. MethodsPatients undergoing cervical cancer surgery with moderate to severe levels of reproductive concerns, treated between January and December 2023 at a tertiary Grade-A oncology hospital in China, were selected as the research subjects. Patients were randomized into an intervention group and a control group, each consisting of 33 patients. The control group received standard nursing care, while the intervention group received a narrative nursing intervention in addition to standard care. The changes in the levels of reproductive concerns, post-traumatic growth, and quality of life scores before and after the intervention were compared between the two groups. ResultsAfter the intervention, the reproductive concerns scores of the cervical cancer patients in the intervention group (32.53 ± 4.77) were significantly lower than those in the control group (59.29 ± 3.24), with a statistically significant difference (t = 26.143, p < 0.001). The post-traumatic growth scores in the intervention group (86.78 ± 3.52) were significantly higher than those in the control group (68.06 ± 6.24), with a statistically significant difference (t = −14.595, p < 0.001). The quality of life scores in the intervention group (149.00 [IQR = 8.75]) were significantly higher than those in the control group (129.00 [IQR = 13.00]), with a statistically significant difference (z = −5.799, p < 0.001). ConclusionNarrative nursing can effectively alleviate reproductive concerns in cervical cancer patients undergoing surgical treatment, promote positive psychological changes post-trauma, and improve patients' quality of life.

Post-Traumatic Growth, Resilience and Social-Ecological Synergies: Some Reflections from a Study on Conflict-Related Sexual Violence

The concept of post-traumatic growth (PTG) continues to generate significant interest, as reflected in the increasing number of studies. This article makes two novel contributions to existing scholarship on PTG. First, it seeks to demonstrate that the common framing of PTG as positive psychological change is too narrow. To do so, it looks to research on resilience and highlights the shift from person-centred understandings of resilience to more relational approaches that situate the concept in the interactions and dynamics between individuals and their social ecologies (environments). The article’s core argument is that there are social-ecological synergies between resilience and PTG, which, in turn, are highly relevant to how we think about and study growth. Second, the article empirically develops this argument by drawing on a larger study involving victims-/survivors of conflict-related sexual violence (CRSV) in Bosnia-Herzegovina, Colombia and Uganda. It is important to note in this regard that there are no major studies of PTG focused on CRSV, just as scholarship on CRSV has given little attention to PTG (or indeed resilience).

Interpersonal and intrapersonal factors contributing to women's posttraumatic growth following perinatal loss.

Despite the high prevalence of perinatal loss and its potential for negative impact on mental health, specific risk and resilience factors contributing to adjustment following perinatal loss have not been fully explored. This study investigated the relationship between attachment security, dyadic coping, and posttraumatic growth (PTG). Women who had experienced miscarriage or stillbirth (n = 244) were recruited via social media and completed an online survey that assessed their attachment security, dyadic coping, and PTG. Loss context factors and demographics were also collected. Hypotheses were tested via hierarchical multiple regression and PROCESS macro. Attachment security was related to couples' relational functioning. Dyadic coping mediated the relationship between attachment anxiety, attachment avoidance and PTG. This study contributes to the literature by providing evidence that relational security and ability to utilize a partner to reduce distress following perinatal loss is an important factor contributing to positive psychological change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between the strength of religious faith and spirituality in relation to post-traumatic growth among nurses caring for COVID-19 patients in eastern Poland: a cross-sectional study.

The COVID-19 pandemic had forced intensive care unit (ICU) nurses to adapt to extreme conditions in a short period of time. This resulted in them experiencing extremely stressful situations. The aim of this study was to assess the relationship between post-traumatic growth (PTG) and religiosity and spirituality (R/S) among nurses caring for COVID-19 patients in intensive care during the pandemic. 120 nurses working in Lublin, eastern Poland, participated in the cross-sectional study. The questionnaire was made up of three standardised tools: The Post-Traumatic Growth Inventory, The Santa Clara Strength of Religious Faith Questionnaire, The Spiritual Attitude and Involvement List. In terms of spirituality, the study group of nurses achieved the highest score in the Connectedness with Nature subscale (4.37 ± 1.07), while the strength of religious beliefs had a positive correlation with post-traumatic growth only in the Spiritual changes subscale (r = 0.422, p < 0.001). The following dimensions of spirituality were significantly correlated with post-traumatic growth in the multi-factor model that included religiosity and spirituality: Transcendent experiences, Spiritual activities, Meaningfulness, Acceptance, and Trust. We saw that increase in the assessment of the Transcendent experiences, Meaningfulness and Trust subscales significantly mirrors increase in post-traumatic growth, while increase in the assessment of the Spiritual activities and Acceptance subscales significantly mirrors decrease in post-traumatic growth. The above variables explained up to 44% of the dependent variable. Both religiosity and spirituality were significantly associated with post-traumatic growth in the group of ICU nurses, but spirituality appears to have played a larger role. Our findings support the value and significance of the development of spiritual and religious identity as a means of enhancing positive psychological changes in the face of traumatic events.

To Evaluate the effect of Yoga on specific quality life among menopausal women at initiation of study, after 3 and 6 months with non-intervention group

The present study was planned to evaluate the effect of yoga on specific quality life among menopausal women at initiation of study, after 3 and 6 months with non-intervention group. The present prospective randomized study was conducted among 60 females with menopausal symptoms aged between 45-55 years. The data was analysed by applying standard statistical method. The present study found that study subjects that practiced yoga reported improvement in symptoms of irritability, anxiety, depressive mood, joint and muscular discomfort as well as sleeping problems. As per response to depressive mood at various time intervals, results revealed that 66.7% subjects had score 3 and 33.3% subjects had score 4 at 0 days, 70% subjects had score 2 and 26.7% subjects had score 3 after 90 days and 60% subjects had score 1 and 36.7% subjects had score 2 after 180 days. These results suggest that yoga promotes positive psychological changes in women with menopausal symptoms and may be applied as a complementary therapy.

Rumination, Basic Beliefs, and Posttraumatic Growth in Cancer Patients

Background Cancer is a highly distressing and traumatic experience that can significantly impact individuals’ psychological well-being. Whereas many cancer patients may experience negative psychological outcomes, such as posttraumatic stress symptoms, a subset of individuals also reports positive psychological changes known as posttraumatic growth. Objective To contribute to theory-driven development of these treatments by exploring the role of deliberate rumination in posttraumatic growth, along with the basic beliefs that might shape it. Methods A sample of cancer patients (n = 139) completed self-report measures assessing rumination, basic beliefs, and posttraumatic growth. Multiple linear regression analyses and moderated mediation models were conducted to analyze the data. Results Findings support the hypothesis that intrusive rumination, deliberate ruminating, and disruption in basic beliefs strongly predict posttraumatic growth in cancer survivors. The results of this simple mediation indicate that deliberate rumination has a full mediating role. The results show that at all levels of basic beliefs, there is a positive and statistically significant indirect effect of intrusive rumination on posttraumatic growth. Conclusions These findings highlight the importance of addressing rumination and core beliefs in interventions aimed at promoting posttraumatic growth among cancer patients. Further research is needed to explore additional factors that may influence the relationship between rumination, basic beliefs, and posttraumatic growth. Implications for Practice Oncology nurses can assist individuals in recognizing and managing intrusive rumination, as well as advocating deliberate rumination as a constructive cognitive process for making sense of a traumatic event and fostering growth.

Post-traumatic growth and influencing factors among parents of premature infants: a cross-sectional study

BackgroundPost-traumatic growth is a positive psychological change that may aid recovery in individuals experiencing trauma. Owing to the lack of research in the area of parental care for premature infants, we decided to explore the levels and factors influencing post-traumatic growth among parents of premature infants in neonatal intensive care units. We believe that these findings will help reassess existing care practices so that healthcare providers can promptly identify negative emotions and take necessary measures to help develop the potential to enhance post-traumatic growth.MethodsA cross-sectional survey was conducted using convenience sampling between February and September 2022. Data were analysed using independent sample t-tests and one-way analysis of variance (ANOVA). Bivariate correlations were analysed using the Pearson’s or Spearman’s method, and related factors were analysed using multiple linear regression. We followed the SRQR checklist throughout the study period.ResultsA total of 217 patients were effectively treated, with a recovery rate of 98.64%. Univariate analysis showed that the length of hospital stay, presence of only one child, parents’ age, marital status, education level, working status, and per capita monthly familial income were influencing factors. Bivariate analysis showed that post-traumatic growth was moderately and positively correlated with perceived social support, rumination, and family resilience. Multiple linear regression showed that purposeful contemplation, family resilience, education, family support, age, and marital status entered into the regression equation and together accounted for 47.4% of the total variation.ConclusionsIt is necessary to pay attention to post-traumatic growth and familial stability in these families, provide aid in building a good support system, and encourage parents to mobilise their family and favourable factors to increase post-traumatic growth levels.

Highs, Lows, and Hormones: A Qualitative Metasynthesis of Transgender Individuals’ Experiences Undergoing Gender-Affirming Hormone Therapy

ABSTRACT Gender Affirming Hormone Therapy (GAHT) is a key therapeutic approach which aims to help trans and gender diverse (or simply “trans”) individuals’ transition from their sex-presumed-at-birth to their experienced gender identity. Previous reviews have focused on synthesizing quantitative experiences; however, a qualitative lens is important to understand the personal journey of GAHT. This review provides a qualitative meta-synthesis of the experiences of trans people around the world who have undergone GAHT to elicit contextualized understanding of the changes experienced. Systematic searches of eight databases identified an initial 2670 papers, refined to a final 28 papers. Overall, findings suggested that the GAHT journey is unique and elicited a myriad of changes which, whilst challenging at times, were life-changing and brought about positive psychological, physical, and social changes. Other themes explored GAHT not being treated as a fix-all for associated mental health issues, the rules that govern appraisal of physical changes, how privilege and social identity evolve, and the power of affirmation. This work offers important recommendations to improve the care offered to trans people undergoing GAHT. Namely, person-centered support is essential, and peer-navigation may be a useful future direction to explore.

Operation Growth: The Impact of Heroes on the Water Kayak Fishing on Posttraumatic Growth in U.S. Military Veterans

Heroes on the Water is a nonprofit organization providing kayak fishing programs to veterans and their families. The purpose of this study was to explore the impact kayak fishing programs, provided by Heroes on the Water, had on posttraumatic growth in military veterans in the United States. The concept of posttraumatic growth suggests that individuals may experience positive psychological changes after severe traumatic events. Research suggests posttraumatic growth can occur in the form of recognizing personal strengths, new possibilities, relating to others, an appreciation for life, and spiritual changes. Studies also suggest that recreation can aid in facilitation of growth. Additionally, recreation has been considered a complementary form of treatment for veterans, specifically the use of nature-based and outdoor recreation programs. For this study, participants reflected on their experiences before and after engaging in Heroes on the Water using the Posttraumatic Growth Inventory. Though the results cannot be generalized, participants reported an increase in score after participating in Heroes on the Water kayak fishing programs. This study adds to the knowledge about the use of recreation to facilitate growth in veterans and encourages continued research on this topic.