Posttraumatic Depreciation Research Articles

Religious beliefs and well-being and distress in congestive heart failure patients.

Religiousness (typically assessed as service attendance) is often associated with well-being and psychological distress in persons with life-threatening illnesses, but little of this work has focused explicitly on religious beliefs. We examined the longitudinal relationships of religious beliefs (i.e., in God and in the afterlife) with well-being and distress (assessed 6months later) in a sample of patients with congestive heart failure, a chronic and progressive disease. After controlling for religious service attendance, belief in God was associated with negative affect and spiritual well-being, while belief in the afterlife was associated with physical health, post-traumatic depreciation, and spiritual well-being. However, after controlling for baseline values of well-being or distress, religious beliefs were not associated with nearly all well-being or distress outcomes at follow-up. Over the 6-month duration of the study, participants increased in belief in afterlife but decreased in their belief in God. Increases in religious beliefs across time were associated with higher levels of distress. These results suggest that religious beliefs are neither positively nor negatively associated with well-being and distress independent of religious attendance among seriously ill patients with CHF. Based on these findings, healthcare providers are encouraged to assess religious belief change at the individual level to better understand and inform spiritual care for patients with late-stage CHF.

Measuring posttraumatic growth and depreciation after spinal cord injury: A Rasch analysis.

Individuals with spinal cord injury (SCI) may experience both positive (posttraumatic growth, PTG) and negative (posttraumatic depreciation, PTD) psychological changes following the injury. PTG and PTD were assessed using the 10-item short form of the Posttraumatic Growth Inventory (PTGI-SF) and 10 matched negatively worded items for PTD (selected from the PTGI-42) within the Swiss Spinal Cord Injury Cohort Study (SwiSCI). This item selection is henceforth called PTG/D-SF. The objective of this study was to test the metric properties of the PTG/D-SF to determine the best strategy to derive reliable sum scores and to test the validity of several different structural conceptualizations. Using cross-sectional data (N = 278), a series of unidimensional and multidimensional Rasch analyses of the PTG/D-SF (N = 20) were performed. Rasch analyses were conducted separately for the items or by domains to investigate dimensionality, monotonicity, item and model fit, and local item dependency of the instrument. The separate PTG and PTD items or their domains can be summated to form a unidimensional scale. Aggregation into domains improved the score distribution and increased the scope of the instruments. The reliability of the sum score for PTG was good (Person Separation: 0.81); the one for PTD was admissible (Person Separation: 0.77). PTG and PTD should be understood as distinct constructs rather than two ends of a continuum. Findings support the use of a PTG total score and to some degree the PTD total score. Future work could adapt the PTD items to improve the performance of the scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Recipients of Suicide-Related Disclosure: The Link between Disclosure and Posttraumatic Growth for Suicide Attempt Survivors.

It is important to explore factors that could help or hinder one’s wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors (n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables—time since attempt and quality of support—were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one’s personal story to family regardless of whether one receives supportive responses and that social support can impact one’s PTG.

Coexistence of Post-traumatic Growth and Post-traumatic Depreciation in the Aftermath of Trauma: Qualitative and Quantitative Narrative Analysis.

Objectives: Post-traumatic growth (PTG) and post-traumatic depreciation (PTD) can be defined, respectively, as positive and negative changes in the aftermath of trauma. These changes can be assigned to the following domains: personal strength, relating to others, new possibilities, appreciation of life, spiritual and existential change. The aim of this study was to explore the possibility that positive and negative effects of trauma can coexist and explore the categories of effect.Methods: 72 participants were asked to recount their experience of trauma and answer questions about how it had affected their thinking about themselves and the world. Participants’ narratives were analyzed by competent judges and using Linguistic Inquiry and Word Count.Results: The domains in which positive changes were most frequently observed were Personal Strength (26.09%), Relating to Others (24.22%), and Appreciation of Life (21.12%). Negative changes mainly affected Relating to Others (33.33%) and Personal Strength (23.33%). The results were confirmed by quantitative analysis of narratives: participants’ narratives of trauma and its consequences contained more words which expressing positive emotions (1.67%) than negative emotions (0.90%), paired-sample t(60) = 9.70, p < 0.001. There were correlations between the frequency of words referring to positive emotions and PTG, r(62) = 0.39, p < 0.01, and between the frequency of words referring to negative emotions and PTG, r(62) = 0.23, p < 0.05.Conclusion: PTG and PTD can coexist and they can be regarded as outcomes of two separate processes. The study results also suggest that although PTG and PTD can coexist, they may be considered different domains of psychological functioning.

Supplemental Material for Perceived Posttraumatic Growth and Depreciation After Spinal Cord Injury: Actual or Illusory?

Supplemental Material for Perceived Posttraumatic Growth and Depreciation After Spinal Cord Injury: Actual or Illusory?

Perceptions of positive and negative changes for posttraumatic growth and depreciation: Judgments from Japanese undergraduates

The present study examined whether psychological changes after trauma, operationally defined as posttraumatic growth (PTG) and posttraumatic depreciation (PTD), were judged as positive or negative within a sample of Japanese adults. Furthermore, potential gender differences in perceptions for changes in PTG and PTD were also assessed. Undergraduate students (n = 257, Mage = 19.91) completed a questionnaire that included 50 items from the expanded versions of the Posttraumatic Growth and Depreciation Inventories. Items operationally defined as PTG were generally agreed upon as positive changes. Conversely, items operationally defined as PTD varied considerably in terms of agreement regarding negative changes. Some items (e.g., appreciate each day less than I did before) showed high agreement for perceptions of negative changes, whereas others (e.g., find it difficult to clarify priorities about what is important in life) were more often perceived as positive changes. Gender differences were also observed with only slight fluctuations in agreement for most PTG items but with wider discrepancies among PTD items. These results suggest that operationally defined PTD may reflect a linguistic opposite to PTG rather than a conceptual or sematic contrast. Furthermore, cultural and gender values may need to be considered when defining psychological changes resulting from trauma.

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 adjustment to spinal cord injury: Moderated by posttraumatic depreciation?

Findings on the relationship of posttraumatic growth (PTG) with adjustment to potentially traumatic events are inconsistent, whereupon posttraumatic depreciation (PTD) has been suggested as a possible moderator. The objective of this study is to investigate the associations between PTG and PTD on one side and life satisfaction and indicators of mental and physical health on the other side in individuals with spinal cord injury (SCI). The primary study aim is to test whether PTD moderates the relationships of PTG and different adjustment indicators. A total of 141 patients administered to one of the four Swiss SCI rehabilitation centers completed questionnaires assessing PTG and PTD and different indicators of mental and physical health as well as life satisfaction at discharge from first rehabilitation. Correlational and regression methods were used to examine the research question. PTG and PTD were significantly positively correlated (rs = .47). PTD was significantly associated with lower mental and physical health and lower life satisfaction, with small to large effect sizes. PTD moderated the associations of PTG with symptoms of depression and life satisfaction (β of interaction term = -.18 and .24, respectively). PTG was significantly related to lower levels of symptoms of depression and higher life satisfaction in individuals experiencing moderate to high levels of PTD. In contrast, PTG was not significantly related to these outcomes in individuals with low PTD levels. The neglect of PTD in research partially explains mixed findings on the relationship of PTG and adjustment to potentially traumatic events. (PsycINFO Database Record

Posttraumatic growth and depreciation six years after the 2004 tsunami

ABSTRACTBackground: Posttraumatic growth (PTG) has been reported after various types of potentially traumatic events, as a part of the personal recovery process among survivors. Even negative changes in survivors’ life view, known as posttraumatic depreciation (PTD), have been identified as an additional aspect in the personal recovery processes.Objective: To examine how the type of exposure experienced by survivors of a natural disaster, the 2004 Southeast Asia tsunami, influenced self-reported PTG and PTD six years later (T2). Additionally, the study examined the relations between psychological distress and posttraumatic stress symptoms (PTSS) 14 months after the disaster (T1), to PTG and PTD, respectively at T2. Finally, the study examined whether psychological distress and PTSS (T1) could have a mediating effect on PTG and PTD at T2.Method: The participants were 848 tsunami survivors living in Stockholm, Sweden who responded to a questionnaire at 14 months (T1) and six years (T2) after the tsunami. The material was analysed using linear regression and pathway analysis. PTG and PTD were measured on separate scales.Results: The type of exposure was significant related to both PTG and PTD six years later (T2). Those experiencing a combination of various types of exposure (including threat to life and bereavement) reported higher scores for both PTG and PTD. There were significant positive correlations between PTSS at T1 and PTG /PTD at T2, and somewhat lower correlations between psychological distress at T1 and PTG/PTD at T2. Both PTSS and psychological distress at T1 were significant mediating variables for both PTG and PTD at T2.Conclusions: Studying survivors’ various types of exposure and subsequent changed view of life – both PTG and PTD – resulted in a broadened understanding of the complexity of reactions and the recovery process among survivors.

Meaning reconstruction in the face of terror: An examination of recovery and posttraumatic growth among victims of the 9/11 World Trade Center attacks.

This study examines the relationship between meaning reconstruction with posttraumatic growth and depreciation in the aftermath of terrorist trauma and loss. A group of individuals (n=118) who were personally affected by the September 11, 2001 terrorist attacks were surveyed about their experiences and administered the Posttraumatic Growth Inventory and Impact of Event scales. Subjects were volunteer docents at the Tribute World Trade Center Visitor Center. Results revealed that ability to make sense of one's 9/11 experience was related to recovery but not to posttraumatic growth, whereas ability to find some benefit in the experience was related to growth. In addition, location in downtown Manhattan on September 11, 2001 was related to higher levels of posttraumatic depreciation. Findings suggest that two aspects of meaning reconstruction are differentially related to recovery and posttraumatic growth.

The role of repetitive thought in determining posttraumatic growth and distress following interpersonal trauma

Background and Objectives: Repetitive thought (RT) strategies have been linked to a range of negative outcomes following traumatic interpersonal events but are proposed to serve an adaptive function under particular circumstances. This study examined outcomes following RT within a transdiagnostic framework, and explored the potentially adaptive nature of trait-like and event-related RT. Design: The centrality of a traumatic event to one's identity was explored as a context under which the adaptive nature of RT might change. Young adults with interpersonal violence experiences (N = 163) reported use of trait-like and event-related RT, centrality of the event, depressive, anxious, and posttraumatic stress symptoms (PTSS), posttraumatic depreciation and posttraumatic growth. Methods: Hierarchical multiple regression analyses were used to examine main and moderating effects of four types of RT and event centrality on outcome variables. Results: Centrality positively predicted depressive symptoms and PTSS, depreciation, and growth. Brooding RT positively predicted all negative outcomes. Reflecting RT positively predicted anxious symptoms and PTSS and depreciation. Only deliberate RT positively predicted growth. Centrality did not moderate any examined relationships. Conclusions: Findings highlight the importance of addressing specific types of RT in interventions with survivors and of considering centrality as a robust contributor to outcomes following interpersonal violence.

Trajectories of posttraumatic growth and depreciation after two major earthquakes.

This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a "no growth or depreciation" class and smaller proportions were grouped into either a "posttraumatic depreciation" or "posttraumatic growth" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the "posttraumatic growth" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the "posttraumatic depreciation" class. Sex was the only predictor of the relationship classes: No men were assigned to the "high posttraumatic growth" class. Implications and future directions are discussed.

Are meaning and purpose distinct? An examination of correlates and predictors

Existing empirical literature has typically treated meaning and purpose as identical. Based on previous theoretical propositions of these two constructs as distinct, we hypothesized that meaning (defined as a sense of comprehension and significance in life) and purpose (defined as a sense of goals, aims, and direction in life) would have different predictors and correlates. We utilized a longitudinal design and collected data from 167 cancer survivors at two time points one year apart. Although meaning and purpose were strongly correlated, they had different predictors and correlates. Regression analyses showed Time 2 meaning was predicted by Time 1 spirituality, whereas Time 2 purpose was predicted by Time 1 social support. At Time 2, meaning was positively correlated with posttraumatic growth and negatively with posttraumatic depreciation, whereas purpose was negatively correlated with intrusive thoughts pertaining to cancer. Implications of an understanding of meaning and purpose as distinct constructs are discussed.

Posttraumatic Growth and Posttraumatic Depreciation as Predictors of Psychological Adjustment

Informed by current trauma literature, this study explored the relationships between posttraumatic growth (PTG), posttraumatic depreciation (PTD), and other posttrauma outcomes including well-being, psychological flourishing, and psychological distress. The predictive utility of PTG and PTD was also examined. The sample comprised 104 trauma survivors (28 community members and 76 university students) who completed the Posttraumatic Growth Inventory–42 and several outcome measures. As expected, PTD showed strong linear correlations with well-being, flourishing and distress, and emerged as a significant predictor of scores on such measures. However, PTG showed negligible correlations with well-being, flourishing, and distress. This reaffirms that PTG and PTD measure conceptually distinct and independent dimensions of experience, which has implications for therapeutic practice.

Posttraumatic Growth and Depreciation as Independent Experiences and Predictors of Well-Being

Positive changes (posttraumatic growth [PTG]) and negative changes (posttraumatic depreciation [PTD]) were assessed using the PTGI-42 with persons reporting changes from a stressful event. PTG and PTD were uncorrelated, and PTG was much greater than PTD. PTG was positively related to disruption of core beliefs and recent deliberate rumination and negatively related to recent intrusive rumination. PTD was positively related to intrusive rumination. Quality of life and meaning in one's life were positively related to PTG, negatively related to PTD, and an interaction indicated that PTG moderated the impact of PTD on both, indicating that PTG and PTD may separately contribute to current well-being.