Secondary Posttraumatic Growth Research Articles

From negative to positive effects of secondary exposure to trauma - the mediating role of cognitive coping strategies.

Professionals working with trauma victims can experience both negative and positive effects following exposure to secondary trauma. The aim of the study was to determine the relationship between secondary traumatic stress (STS), secondary posttraumatic growth (SPTG) and cognitive coping strategies and to establish the mediating role of cognitive coping strategies in the relationship between STS and SPTG. A group of 500 professionals working with trauma survivors were surveyed. The Secondary Traumatic Stress Inventory, the Secondary Posttraumatic Growth Inventory and the Cognitive Processing of Trauma Scale was used. The results indicated that 29% of professionals demonstrate a high intensity of STS, and nearly 34% exhibit a high level of SPTG. Denial and regret were positively correlated with STS; positive cognitive restructuring, resolution/acceptance and downward comparison were positively related to SPTG. Two cognitive coping strategies, i.e., positive cognitive restructuring and downward comparison, were found to act as mediators in the relationship between STS and SPTG. Understanding the effects of secondary exposure to trauma and the coping responses of professionals working with trauma survivors will support the development of prevention and intervention actions aimed at protecting them from the deleterious impact of exposure to secondary trauma at work and promoting secondary posttraumatic growth. Med Pr Work Health Saf. 2023;74(6):449-60.

Secondary posttraumatic growth in children of survivors of the 1994 genocide: The role of childhood trauma, posttraumatic stress, and meaning-making.

Secondary posttraumatic growth in children of survivors of the 1994 genocide: The role of childhood trauma, posttraumatic stress, and meaning-making.

A dyadic exploration of the associations between posttraumatic stress symptoms and posttraumatic growth among combat veterans and their parents: The role of distress tolerance.

Indirect exposure to traumatized combat veterans may facilitate positive transformations in the form of posttraumatic growth (PTG) among family members. We aimed to use a dyadic approach to explore the association between veterans' and parents' posttraumatic stress symptoms (PTSS) and their PTG and that of their parents' secondary PTG (SPTG), as well as to examine the moderating role of distress tolerance (DT) in these associations. A volunteer sample of 102 dyads of Israeli combat veterans and their parents responded to online validated self-report questionnaires. Veterans' PTG was positively correlated with parents' SPTG. Moreover, parents' secondary PTSS was associated with higher levels of their own SPTG and their veteran offspring's PTG. Furthermore, veterans' DT contributed to lower levels of their own PTSS and their PTG, but the moderation effects of DT were not found. Parents' experience of secondary PTSS, which refers to their offspring's military service, may be also associated with their offspring higher levels of PTG. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The mediating role of job satisfaction in the relationship between social support and the consequences of secondary exposure to trauma among medical providers working with trauma victims.

Medical providers working with trauma survivors are exposed to the negative and positive effects of secondary trauma, both of which are affected by social support and job satisfaction. The aim of this study was to determine the mediating role of job satisfaction in the relationship between social support and the negative and positive effects of secondary exposure to trauma among medical personnel. The negative indicator of such exposure was secondary traumatic stress (STS), while the positive indicator was secondary posttraumatic growth (SPTG). The analyses included 419 medical providers working with trauma victims (201 paramedics and 218 nurses). Data was collected with the Secondary Traumatic Stress Inventory, Secondary Posttraumatic Growth Inventory, Social Support Scale, Work Satisfaction Scale, and survey. Mediation analyses were applied to assess relationships between variables. The mediation analyses indicated that job satisfaction mediates (mainly partly) the relationship between social support and STS and SPTG. This may indicate that both social support and job satisfaction act as significant predictors of the negative and positive effects of secondary exposure to trauma. As a friendly and mutually-supportive environment can increase job satisfaction, reducing the risk of secondary traumatic stress and promoting positive posttraumatic changes, it is important to increase social support and job satisfaction among medical providers exposed to secondary trauma. Int J Occup Med Environ Health. 2023;36(4):505-16.

The Predictors of the Consequences of Secondary Exposure to Trauma Among Professionals Working With Trauma Victims

Helping those who have experienced trauma exposes the helpers to secondary traumatization. The mechanisms of its development are most often explained using the cognitive model of trauma processing. The aim of the research is to determine how disturbances of core beliefs and cognitive processing in the form of coping with stress are associated with secondary traumatic stress (STS) and secondary posttraumatic growth (SPTG). The study was conducted among psychologists and social workers (N = 240), working with people after traumatic experiences. Four standardized measurement tools were used. Based on the differential diagnosis, four types of consequences were identified. Discriminant analysis was used to establish the optimal configuration of predictors explaining the differences between the four subgroups. Two significant discriminant functions were significant, each identifies different beliefs and coping strategies. The first is associated with the disruptions of core beliefs about the world and cognitive processing in the form of a non-adaptive strategy; the second—with disturbed beliefs about oneself and adaptation strategies. Our results show a much greater exposure of social workers to the negative consequences of secondary traumatic stress disorder. A system of constant monitoring should be introduced, and the principles of prevention and therapy should be implemented.

Predictors of Secondary Posttraumatic Growth Among Police Officers Exposed to Secondary Trauma

Predictors of Secondary Posttraumatic Growth Among Police Officers Exposed to Secondary Trauma

The role of empathy and cognitive trauma processing in the occurrence of professional posttraumatic growth among women working with victims of violence.

Professionals helping victims of violence trauma, in addition to a number of negative effects, may also experience positive changes in the form of vicarious posttraumatic growth (VPTG). Cognitive trauma processing and empathy seem to be important to VPTG. The aim was to determine the relationship between empathy, cognitive trauma processing and VPTG in female professionals helping violence victims. The study included 154 women representing 3 professional groups (therapists, social workers, probation officers). The subjects' age ranged 26-67 years (M±SD 43.98±10.83). The study used 3 standard measurement tools, i.e. the Secondary Posttraumatic Growth Inventory, the Empathic Sensitiveness Scale, measuring 3 aspects of empathy, i.e. empathic concern, personal distress and perspective taking, the Cognitive Processing of Trauma Scale, allowing assessment of 5 remedial strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret) and a survey developed for the use of the research. Positive correlations were found between empathy, cognitive coping strategies and VPTG. Positive cognitive restructuring and resolution/acceptance strategies were found to mediate the relationship between empathy and VPTG. Professionals helping trauma victims may experience positive effects in the form of VPTG. The occurrence of VPTG in female professionals is enhanced by the use of empathy and positive coping strategies. Int J Occup Med Environ Health. 2022;35(6):679-92.

Assessing Positive Posttraumatic Changes Among Professionals Working With Trauma Victims: The Secondary Posttraumatic Growth Inventory

By providing constant help to trauma victims, the helpers themselves run the risk of secondary traumatization. As a rule, research focuses on the negative consequences of secondary trauma. Meanwhile, there are also positive changes in the form of Secondary Posttraumatic Growth (SPTG). The present study describes the design and testing of a new tool for measuring SPTG. Thirty items were presented to employees from five different professions constantly working with trauma victims (N = 580). A 4-factor solution (PCA) turned out to be clear and unambiguously interpretable. After excluding items based on their component loading and redundancy, the tool was pared down to 12 items. A separate sample used in confirmatory factor analysis (CFA) yielded good fit indexes. The four dimensions were given the following designations: 1. New challenges and an increase in professional competences, 2. Increase in spiritual experiences and a greater sense of responsibility for others, 3. Greater confidence in oneself and appreciating life, 4. Increased acceptance and actions for others. Cronbach’s alpha was .90. The inventory demonstrated high stability, as indicated by the two-month test–retest stability value (.78). The theoretical validity was estimated by comparing SPTGI scores with other measures which should be associated with secondary positive changes. The SPTGI is a new, reliable, and valid instrument for measuring positive posttraumatic changes among professionals exposed to secondary trauma. It can be useful in scientific research and in clinical practice.

The Relationship between Social Support and Secondary Posttraumatic Growth among Health Care Providers Working with Trauma Victims-The Mediating Role of Cognitive Processing.

Background: Individuals, who help trauma victims as part of their professional responsibilities, may experience positive effects of their work, occurring in the form of Secondary Posttraumatic Growth (SPTG). Its determinants include environmental factors such as social support, and individual characteristics, particularly cognitive processing of the trauma. The purpose of this study was to determine the associations between SPTG and social support and cognitive processing of trauma, also considered as a mediator, in a group of medical personnel exposed to secondary trauma. Methods: The results of 408 participants, paramedics and nurses, were analyzed. Three measurement tools were used: the Secondary Posttraumatic Growth Inventory, the Social Support Scale measuring four sources of support and the Cognitive Trauma Processing Scale to assess five cognitive coping strategies. Results: The results indicated that SPTG was positively related to social support and cognitive coping strategies. Cognitive coping strategies act as a mediator in the relationship between social support and SPTG. Conclusions: Despite their exposure to secondary traumatization, paramedics and nursing staff experience positive consequences of their work related to helping injured people. In order to promote growth after trauma, it is advisable to encourage medical representatives to use social support and primarily positive coping strategies.

Empathy and Cognitive Processing as Factors Determining the Consequences of Secondary Exposure to Trauma Among Roman Catholic Clergymen

By helping individuals after traumatic experiences, the helper is also exposed to the consequences of trauma. The aim of this study was to determine the predictors of consequences of secondary exposure to trauma among clergymen and therapists (N = 140) helping victims of trauma in Poland. Symptoms of secondary traumatic stress (STS) were identified in 22.9% of the clergymen and 8.6% of therapists, and secondary posttraumatic growth (SPTG) in 61.4% of the clergymen and 42.9% of therapists. STS and SPTG predictors were identified based on regression models. In the case of clergymen, regret is a determinant of STS, and positive cognitive restructuring of SPTG. Research findings highlight the need to increase awareness of exposure to secondary trauma among the clergy, and for them to acquire greater skills for coping with stress.

Negatywne i pozytywne skutki wtórnej ekspozycji na traumę wśród personelu medycznego - rola wsparcia społecznego

Introduction: Social support is included among the factors determining the occurrence of negative and positive effects of secondary exposure to trauma in professionals working with people after traumatic experiences. The aim of the research was to determine the role of social support from various sources in the occurrence of symptoms of secondary stress and growth after trauma in the group of medical personnel exposed to secondary trauma. Material and methods: The analysis included the results obtained from 185 representatives of medical personnel, including paramedics (64.9%) and the nursing team (35.1%) who worked directly with the injured or suffering. Most of the respondents were women (56.8%). The age of the respondents was in the range of 20–65 years (M = 42.41, SD = 8.92). The research used a questionnaire developed for the purpose of the study and three standard measurement tools, i.e. the Secondary Traumatic Stress Inventory, the Secondary Posttraumatic Growth Inventory and the Social Support Scale — What support can you count on? Results: The obtained research results indicated a high intensity of secondary stress and moderate intensity of secondary growth after trauma in the examined group of medical personnel. Social support is primarily associated with secondary growth after the trauma. Support from the family plays a protective role for secondary stress. In turn, the factor conducive to the occurrence of secondary growth is primarily the support from co-workers. Conclusions: Developing the ability to perceive and use social support can contribute to reducing the negative and promoting the positive effects of secondary exposure to trauma.

Prevalence and determinants of secondary posttraumatic growth following trauma work among medical personnel: a cross sectional study

ABSTRACT Background: People helping trauma victims as a part of their work may experience positive results, known as Secondary Posttraumatic Growth (SPTG). Aim: The present study aimed to determine the prevalence and determinants of SPTG among medical personnel, considering occupational load, job satisfaction, social support, and cognitive processing of trauma, understood as cognitive coping strategies. Methods: Subjects comprised 419 representatives of the medical profession, including paramedics and nurses. The age of the subjects varied from 19 to 65 (M = 39.60; SD = 11.03). Four standard measurement tools were utilized: the Secondary Posttraumatic Growth Inventory, the Job Satisfaction Scale, the Social Support Scale, which measured four support sources, and the Cognitive Processing of Trauma Scale to assess five cognitive coping strategies. Pearson’s correlation coefficients were applied to analyse the connections between the variables. A linear stepwise regression analysis was used to identify the determinants of SPTG. Pearson’s correlation coefficients with confidence intervals were applied to analyse the connections between the variables. Results: As many as 40% of participants experienced high levels of growth, with only 27.4% indicating a low level. The obtained results showed positive links between job satisfaction, all social support dimensions (from supervisors, co-workers, family, friends), all cognitive coping strategies (positive cognitive restructuring, downward comparison, resolution/acceptance, denial, regret), and SPTG. No significant connection between workload and SPTG total was discovered. The primary determinant of SPTG in the examined group of medical personnel is the cognitive processing of trauma, chiefly the strategy of positive cognitive restructuring. Conclusions: Paramedics and nurses, despite their exposure to secondary trauma, experience positive posttraumatic consequences of the profession that entails helping the injured parties. It is advisable to encourage the medical personnel to apply positive coping strategies, find satisfaction in their work, and benefit from social support to promote posttraumatic growth.

"He ain't heavy, he's my brother": Distress tolerance moderates the association between secondary posttraumatic symptoms and secondary posttraumatic growth among siblings of combat veterans.

Positive psychological and behavioral transformations in the form of posttraumatic growth (PTG) after indirect exposure to a traumatized family member, have been reported mainly among combat veterans' spouses and offspring (secondary posttraumatic growth; SPTG). To date, no studies have examined SPTG among veterans' siblings, and the conditions in which secondary posttraumatic symptoms (secondary PTSS) may contribute to the development of SPTG remain unexplored. In the present study, we aimed to explore the association between secondary PTSS and SPTG among siblings of combat veterans and to examine the moderating role of distress tolerance in this association. A volunteers' sample of 106 dyads of Israeli combat veterans and their close-in-age siblings responded to online validated self-report questionnaires in a cross-sectional study. Analysis included actor-partner interdependence modeling (APIM) and moderation analyses. Veterans' PTG was positively correlated with siblings' SPTG. Moreover, two actor effects were revealed wherein veterans' PTSS contributed to their own PTG, and siblings' secondary PTSS positively predicted their own SPTG. Importantly, analysis of moderation revealed that under high levels of secondary PTSS, the more siblings reported distress tolerance, the higher their own levels of SPTG. Exposure to a traumatized veteran brother or sister might entail psychological distress but also positive changes among siblings. The ability to withstand the emotional valence of negative or stressful events might hold a promise for the facilitation of higher levels of SPTG in the face of secondary PTSS. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Posttraumatic growth among combat veterans and their siblings: A dyadic approach.

We aimed to use a dyadic approach to assess the effects of veterans' posttraumatic stress disorder symptoms (PTSS) and siblings' secondary PTSS, as well as veterans' and siblings' relationship quality, on primary and secondary posttraumatic growth (PTG). A volunteers' sample of 106 dyads of Israeli combat veterans and their close-in-age siblings responded to self-report questionnaires in a cross-sectional, dyadic design study. Veterans' primary PTG was positively associated with siblings' secondary PTG. Veterans' PTSS and siblings' secondary PTSS were associated with higher levels of primary and secondary PTG, respectively. Furthermore, among veterans, warmth in siblings' relationships was associated with higher levels of primary PTG. However, among siblings, rivalry in sibling relationships was associated with lower levels of secondary PTG. Both veterans' and siblings' PTSS are only related to their own PTG. Moreover, perception of siblings' relationship quality might have a differential effect on PTG among veterans and their siblings.

Longitudinal Development of Primary and Secondary Posttraumatic Growth in Aging Veterans and Their Wives: Domain-Specific Trajectories.

Posttraumatic growth (PTG), the positive psychological transformations that follow traumatic events, affects both direct survivors (primary PTG) and their significant others (secondary PTG). Though primary and secondary PTG have been widely investigated in the literature, their long‐term trajectories decades after a traumatic event, especially as survivors enter older age, remain largely uninvestigated. Furthermore, it remains contested whether PTG adds up to a monolithic construct or rather consists of relatively independent components. Addressing these issues, we assessed a sample of Israeli male veterans from the 1973 Yom Kippur war (N = 349) and their wives (N = 156) at three time points over the course of nearly three decades. Both the veterans (primary survivors) and their wives (secondary survivors) reported PTG relating to the veterans' experiences during the war and/or captivity. Latent growth mixture modeling was conducted to identify trajectories of PTG on the five subscales of the Posttraumatic Growth Inventory. Long‐term trajectories of PTG followed heterogeneous patterns of fluctuation over time and particularly as participants entered older age. On most subscales, decreasing PTG scores were evident, a trend that was more pronounced among the primary survivors than the secondary survivors as primary and secondary PTG fluctuate considerably in the long‐term and seem to decrease as individuals enter older age. Furthermore, it would seem that PTG should not be considered a holistic concept but rather a conglomeration of positive changes. Implications of the findings are discussed within the context of limitations and potential intervening factors.

Secondary traumatic stress and secondary posttraumatic growth in a sample of Dutch police family liaison officers.

This study investigated secondary traumatic stress (STS) and secondary posttraumatic growth (SPG) in a sample of Dutch police family liaison officers (N=224). Our study had two aims: (a) to identify potential risk and protective factors for STS and (b) to investigate the association between STS and SPG. None of the risk (caseload and a personal trauma history) and protective factors (age, work experience, and support by supervisors and coworkers) identified in previous research correlated with STS. However, a small positive association was found between STS and SPG. In the discussion section we warn against the use of interventions that aim to prevent STS until more is known about risk and protective factors for STS and provide directions for future research.

Effects of Internet-Based Self-Efficacy Intervention on Secondary Traumatic Stress and Secondary Posttraumatic Growth among Health and Human Services Professionals Exposed to Indirect Trauma.

Background: Although the evidence for the associations among self-efficacy, secondary traumatic stress (STS) and secondary posttraumatic growth (SPTG) is mounting, there is a lack of the experimental evidence for the influence of self-efficacy on positive and negative mental health outcomes among professionals indirectly exposed to trauma.Purpose: This study investigated the effects of an internet-based self-efficacy intervention (the experimental condition), compared to an education (the active control condition) on STS and SPTG among workers exposed to traumatic events indirectly, through their clients. We hypothesized that the group assignment (experimental vs. control) would affect STS and SPTG indirectly, with a mediating role of self-efficacy beliefs.Methods: Participants were 168 health and human services professionals (78% women), exposed indirectly to a traumatic event at work. They were randomly assigned to either a 4-session internet-based self-efficacy intervention (n = 87) or an education control group (n = 81) which received information about coping resources and consequences of stressors at work or at home. STS, SPTG, and self-efficacy were measured at the baseline (Time 1), 1-month follow-up (Time 2) and 2-month follow-up (Time 3).Results: Analysis of covariance showed that the group assignment had a significant effect on STS (Time 2) and self-efficacy (Time 2), with lower STS and higher self-efficacy reported by the self-efficacy intervention participants. Compared to the experimental group, the active control (education) group participants reported higher SPTG at Time 2. Mediation analyses indicated that the group assignment had indirect effects on STS and SPTG at Time 3. Workers who experienced increases in self-efficacy (Time 2) through the intervention were more likely to report lower STS and higher SPTG at Time 3.Conclusion: Elucidating the mediating processes that explain why an intervention for secondary trauma works is essential in order to develop more effective support systems that promote improved mental health outcomes among health and human services professionals. Prevention programs for workers exposed indirectly to traumatic events may target self-efficacy enhancement and education.

Posttraumatic growth and perceived health: The role of posttraumatic stress symptoms.

The contested discourse regarding the nature of posttraumatic growth (PTG) includes 2 main competitive claims. The first argues that PTG reflects authentic positive transformation while the second posits that PTG reflects illusory defenses that could be maladaptive in the long run. The present study assesses these competing claims by investigating secondary PTG in relation to the somatic domain. Specifically, this study investigates: (a) the association between PTG, and perceived health (PH), as measured by 3 indices of somatic complaints, self-rated health (SRH) and a number of health problems; (b) the association between PTG, posttraumatic stress symptoms (PTSS) and PH over time; and (c) the mediating role of PTSS between PTG and PH, among wives of former prisoners of war (ex-POWs) and wives of control veterans. Assessments were conducted 30 (T1) and 38 (T2) years after the Yom Kippur War. Results showed that wives of ex-POWs endorsed higher PTSS, higher PTG and poorer PH, compared to control wives. Higher PTG was associated with higher PTSS and poorer PH. PTG at T1 predicted an increase in PTSS between T1 and T2, which in turn was correlated with poorer PH. PTSS at T2 as well as changes in PTSS from T1 to T2 mediated the association between T1 PTG and T2 PH measures. The present findings imply that PTG might have negative implications on PH through the amplification of PTSS, among secondary trauma victims. It seems that although spouses of trauma victims describe benefits resulting from vicarious trauma exposures, their body indicates differently. (PsycINFO Database Record

A Longitudinal Study of Secondary Posttraumatic Growth in Wives of Ex-POWs

Objective: The current study aimed to investigate (a) “secondary” posttraumatic growth (PTG) in wives of former prisoners of war (ex-POWs) and its association to husbands’ captivity, husbands’ posttraumatic stress disorder (PTSD), and husbands’ PTSD trajectories; and (b) the bidirectional relationships over time between wives’ posttraumatic stress symptoms (PTSS) and PTG. Method: The study compared 116 wives of Israeli ex-POWs from the 1973 Yom Kippur War with 56 wives of a matched control group of non-POW combat veterans. Wives were divided into groups according to husbands’ captivity status, husbands’ PTSD status, and husbands’ PTSD trajectories; and ANOVAs and MANOVAs were conducted to assess group differences in PTSS and PTG, both cross-sectionally and longitudinally. Autoregressive cross-lag modeling was also used to assess bidirectional relationships between wives’ PTSS and PTG over time. Results: Wives of ex-POWs with PTSD reported significantly higher PTG compared with wives of ex-POWs without PTSD and wives of controls. While PTG and PTSS remained stable over time, importantly, the Time 1 (T1) level of PTG predicted avoidance symptoms at Time 2 (T2); the higher the wives’ PTG at T1, the higher their avoidance symptoms at T2, but not vice versa. Conclusions: These findings support the notion that “secondary PTG” exists. They also strengthen the theory that growth and distress can co-occur. Finally, the finding that PTG predicted subsequent avoidance symptoms suggests that PTG does not prevent the future development of distress.

Secondary growth among former prisoners of war’s adult children: The result of exposure to stress, secondary traumatization, or personality traits?

The long-term toll of war captivity on secondary traumatization (ST) on adult children has recently been exemplified. Several studies have also revealed that indirect exposure to trauma might be accompanied by positive psychological changes. This study examined secondary posttraumatic growth (SG) among adult children of former prisoners of war (ex-POWs' children) who were compared with adult children of comparable veterans (controls' children). Furthermore, we examined the role of five-factor personality traits in the associations between exposure to stress stemming from fathers' behaviors, ST symptoms, and SG. Participants were Israeli ex-POWs' children (N = 98) and controls' children (N = 90), whose fathers fought in the 1973 Yom Kippur War. Results show that ex-POWs' children reported higher levels of SG compared with controls' children. ST symptoms were found to mediate the association between research group and SG, and the direct effect was found to be conditioned at the levels of participants' extroversion. Furthermore, among ex-POWs' children, extroversion and openness to the experience personality traits, as well as exposure to stress, were found to predict SG. Forty years after the war ended, the experience of living with ex-POWs is associated with ex-POWs' children SG that might be more related to their exposure to stress and personality traits than their ST symptoms. Clinical interventions aiming to increase the levels of SG among indirect victims of captivity should consider the influence of pretrauma resources, trauma characteristics, and posttrauma factors. (PsycINFO Database Record