Optimism, Social Support, and Coping Strategies As Factors Contributing to Posttraumatic Growth: A Meta-Analysis

Personally important posttraumatic growth in adolescents: The effect on self-esteem beyond commonly defined posttraumatic growth

Research on posttraumatic growth (PTG), positive psychological changes that may occur as a result of highly stressful life events, reveals adolescents are able to experience PTG. The current study tests individual differences among adolescents in relative importance of PTG and examines the relationships among personally important PTG, commonly defined PTG, and self-esteem. Adolescents (N = 145) with the mean age of 15.75 (SD = 1.13) completed the Rosenberg Self-Esteem Scale and PTG Inventory, and then reported which items on the PTG Inventory were personally important to them. Results indicated within-scale differences in item importance on the PTG Inventory. Personally important PTG was a better predictor of adolescent self-esteem than commonly defined PTG, measured as total PTGI score or each of the five factors. These findings suggest future research should look at both short-term and long-term effects of personally important PTG as well as commonly defined PTG.

Looking for the Silver Lining: Benefit Finding after Hurricanes Katrina and Rita in Middle-Aged, Older, and Oldest-Old Adults

Looking for potentially positive outcomes is one way that people cope with stressful events. In two studies, we examined perceived "silver linings" after the 2005 Hurricanes Katrina and Rita among indirectly affected adults. In Study 1, middle-aged (ages 47-64 years), older (ages 65-89 years), and oldest-old (ages 90-95 years) adults in the Louisiana Healthy Aging Study (LHAS) responded to an open-ended question on perceived silver linings in a longitudinal assessment carried out during the immediate impact (1 to 4 months after landfall) and post-disaster recovery phase (6 to 14 months post-storm). Qualitative grounded theory methods were employed to analyze these narrative data. Team-based coding yielded three core themes: (1) learning experience and better preparedness for future disasters, (2) having improved cities (Baton Rouge and New Orleans), and (3) an increase in "Good Samaritan" acts such as strangers helping one another. Responses were similar across age groups, although older adults were the least likely to report positive outcomes. Study 2 was a conceptual replication using a different sample of adults (ages 31 to 82 years) tested at least five years after the storms. A learning experience and preparedness core theme replicated Study 1's findings while improved social cohesion amongst family and friends emerged as a new core theme in Study 2. These data indicate that identifying lessons learned and potentially positive outcomes are psychological reactions that may facilitate post-disaster coping and foster resilience for indirectly affected adults in the years after disaster.

Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: role of resilience and rumination

Posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) are two different outcomes that may occur after experiencing traumatic events. Resilience and rumination are two important factors that determine the development of these outcomes after trauma. We investigated the association between these two factors, PTSD and PTG, among Chinese survivors in an earthquake. With a convenience sample of 318 survivors from earthquake, we measured trauma exposure, PTSD, PTG, resilience, and rumination (Impact of Event Scale-Revised, Posttraumatic Growth Inventory, 10 item Connor-Davidson Resilience Scale, Ruminative Response Scale). Then we used bivariate correlation and structural equation modeling to examine the structure of relations among these factors. Results showed that resilience and reflective rumination have a positive effect on PTG (β = 0.32, p < 0.001; β = 0.17, p = 0.049). Earthquake exposure, brooding rumination and depressed-related rumination are related with higher level of PTSD (β = 0.10, p = 0.021; β = 0.33, p < 0.001; β = 0.36, p < 0.001). The findings suggest distinct determinants of the negative and positive outcomes, and this may provide better understanding about the risk and protective factors for traumatic reactions.

What makes a thriver? Unifying the concepts of posttraumatic and postecstatic growth

The thriver model is a novel framework that unifies the concepts of posttraumatic and postecstatic growth. According to the model, it is not the quality of an event, but the way it is processed, that is critical for the occurrence of post-event growth. The model proposes that meaning making, supportive relationships, and positive emotions facilitate growth processes after positive as well as traumatic experiences. The tenability of these propositions was investigated in two dissimilar cultures. In Study 1, participants from the USA (n = 555) and India (n = 599) answered an extended version of the Social Readjustment Rating Scale to rank the socioemotional impact of events. Results indicate that negative events are perceived as more impactful than positive ones in the USA, whereas the reverse is true in India. In Study 2, participants from the USA (n = 342) and India (n = 341) answered questions about the thriver model's main components. Results showed that posttraumatic and postecstatic growth are highly interrelated. All elements of the thriver model were key variables for the prediction of growth. Supportive relationships and positive emotions had a direct effect on growth, while meaning making mediated the direct effect of major life events.

Making meaning in a burn peer support group: qualitative analysis of attendee interviews

There is a paucity of literature on the personal experiences of burn support group members, the members' perceived benefits of group participation, and the meaning the survivors make of the support they receive. In order to provide effective psychosocial rehabilitation services and to meet the needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the experiences of burn survivors in a burn survivor support group. Six self-identified burn survivors were interviewed by using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the findings from the individual interviews. The experiences of the group members coalesced around four main themes: acceptance of self, perspective change, value of community, and reciprocity. The findings demonstrated the overall perceived positive impact the support group had on psychosocial recovery. For these members, the group aided the process of adjustment through the encouragement of adaptive coping strategies and the facilitation of community and relationships. Their experiences mirrored much of the literature on psychological growth from adversity. Burn survivors reported unique opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Using these accounts, the authors generated clinical suggestions that may encourage similar growth in other support group settings.

Profiles of Connectedness: Processes of Resilience and Growth in Children With Cancer

OBJECTIVE

Identified patterns of connectedness in youth with cancer and demographically similar healthy peers.

METHOD

Participants included 153 youth with a history of cancer and 101 youth without a history of serious illness (8-19 years). Children completed measures of connectedness, posttraumatic stress symptoms (PTSS), and benefit-finding. Parents also reported on children's PTSS.

RESULTS

Latent profile analysis revealed four profiles: high connectedness (45%), low connectedness (6%), connectedness primarily to parents (40%), and connectedness primarily to peers (9%). These profiles did not differ by history of cancer. However, profiles differed on PTSS and benefit-finding. Children highly connected across domains displayed the lowest PTSS and highest benefit-finding, while those with the lowest connectedness had the highest PTSS, with moderate PTSS and benefit-finding for the parent and peer profiles.

CONCLUSION

Children with cancer demonstrate patterns of connectedness similar to their healthy peers. Findings support connectedness as a possible mechanism facilitating resilience and growth.

Relationships among Trait Resilience, Virtues, Post-traumatic Stress Disorder, and Post-traumatic Growth

The present study aims to examine the relationship between trait resilience and virtues in the context of trauma. A total of 537 participants who attended the preliminary investigation and completed the Life Events Checklist were screened. Of these participants, 142 suffered from personal traumatic experiences in the past year; these individuals were qualified and invited to respond to online questionnaires to assess trait resilience, virtues (i.e., Conscientiousness, Vitality, and Relationship), post-traumatic stress disorder (PTSD) symptoms, and post-traumatic growth (PTG). The following questionnaires were used: Connor-Davidson Resilience Scale-Revised, Chinese Virtues Questionnaire, PTSD Checklist-Specific, and Post-traumatic Growth Inventory-Chinese. Only 95 participants who manifested self-reported PTSD symptoms and PTG were involved in the current analyses. Trauma was positively and significantly correlated with PTSD in the current sample. Results indicated that trait resilience was positively associated with virtues and PTG; by contrast, PTSD scores were negatively but not significantly related to most of these factors. The three virtues contributed to PTG to a greater extent than trait resilience in non-PTSD and PTSD groups. However, trait resilience remained a significant predictor in the PTSD group even when the three virtues were controlled. The relationship between trait resilience and PTG was moderated by PTSD type (non-PTSD group vs. PTSD group). Our results further suggested that trait resilience and virtues were conceptually related but functionally different constructs. Trait resilience and virtues are positively related; thus, these factors contributed variances to PTG in the context of trauma; however, trait resilience is only manifested when virtues are controlled and when individuals are diagnosed as PTSD. Furthermore, implications and limitations of this study are discussed.

A new look at social support: a theoretical perspective on thriving through relationships

Close and caring relationships are undeniably linked to health and well-being at all stages in the life span. Yet the specific pathways through which close relationships promote optimal well-being are not well understood. In this article, we present a model of thriving through relationships to provide a theoretical foundation for identifying the specific interpersonal processes that underlie the effects of close relationships on thriving. This model highlights two life contexts through which people may potentially thrive (coping successfully with life's adversities and actively pursuing life opportunities for growth and development), it proposes two relational support functions that are fundamental to the experience of thriving in each life context, and it identifies mediators through which relational support is likely to have long-term effects on thriving. This perspective highlights the need for researchers to take a new look at social support by conceptualizing it as an interpersonal process with a focus on thriving.

Resilience among patients across the cancer continuum: diverse perspectives

Each phase of the cancer experience profoundly affects patients' lives. Much of the literature has focused on negative consequences of cancer; however, the study of resilience may enable providers to promote more positive psychosocial outcomes before, during, and after the cancer experience. The current review describes the ways in which elements of resilience have been defined and studied at each phase of the cancer continuum. Extensive literature searches were conducted to find studies assessing resilience during one or more stages of the adult cancer continuum. For all phases of the cancer continuum, resilience descriptions included preexisting or baseline characteristics, such as demographics and personal attributes (e.g., optimism, social support), mechanisms of adaptation, such as coping and medical experiences (e.g., positive provider communication), as well as psychosocial outcomes, such as growth and quality of life. Promoting resilience is a critical element of patient psychosocial care. Nurses may enable resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation.

Association between virtues and posttraumatic growth: preliminary evidence from a Chinese community sample after earthquakes

Objective. Relationship, vitality, and conscientiousness are three fundamental virtues that have been recently identified as important individual differences to health, well being, and positive development. This cross-sectional study attempted to explore the relationship between the three constructs and post-traumatic growth (PTG) in three directions, including indirect trauma samples without post-traumatic stress disorder (PTSD), direct trauma samples without PTSD, and direct trauma samples with PTSD.

Methods. A total of 340 community participants from Sichuan Province, Mainland China involved in the study, most of which experienced Wenchuan and Lushan Earthquake. Participants were required to complete the self-reported questionnaire packages at one time point for obtaining their scores on virtues (Chinese Virtues Questionnaire), PTSD (PTSD Checklist-Specific), and PTG (Post-traumatic Growth Inventory-Chinese).

Results. Significant and positive correlations between the three virtues and PTG were identified (r = .39–.56; p < .01). Further regression analysis by stepwise method reveled that: in the indirect trauma samples, vitality explained 32% variance of PTG. In reference to the direct trauma sample without PTSD, both relationship and conscientiousness explained 32% variance of PTG, whereas in the direct trauma sample with PTSD, only conscientiousness accounted for 31% the variance in PTG.

Conclusion.This cross-sectional investigation partly revealed the roles of different virtues in trauma context. Findings suggest important implications for strengths-based treatment.

Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study

BACKGROUND

There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking.

METHOD

Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form.

RESULTS

We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least 'moderate' PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG.

CONCLUSIONS

PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a 'positive legacy' of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.

Finding benefit in stressful uncertain circumstances: relations to social support and stigma among women with unexplained illnesses

Living with a chronic illness can be challenging, but the ability to derive benefits and grow from this experience may enhance well-being. However, the possibility of obtaining such benefits may be dependent on the levels of stigmatization and lack of social support experienced by an individual as a result of the illness. Chronic fatigue syndrome (CFS) and fibromyalgia are chronic conditions that remain largely unexplained and those with these conditions must often contend with stigma and skepticism from others. Individuals with CFS/fibromyalgia often display stress-related biological alterations and the experience of stressful life events has been associated with illness development. The present study demonstrated that women with CFS/fibromyalgia (n = 40) as well as community participants who were depressed/anxious (n = 37), reported higher stigma levels than healthy women (n = 33). Moreover, women with CFS/fibromyalgia and those with depression/anxiety also reported greater levels of stigma than women with a chronic yet more widely accepted condition (n = 35; rheumatoid arthritis, osteoarthritis and multiple sclerosis). Secrecy related to stigma among those with CFS/fibromyalgia declined with increased social support, but this was not apparent among those with other chronic conditions. In addition, posttraumatic growth was lower among women with CFS/fibromyalgia compared to those with other chronic conditions. Qualitative analysis examining both negative impacts and positive changes stemming from illness experience revealed many similarities between women with CFS/fibromyalgia and those with other chronic conditions, including elevated appreciation for life, personal growth and compassion for others. However, women with CFS/fibromyalgia tended to report less positive change regarding interpersonal relationships compared to women with other chronic conditions. In general, unexplained illnesses were also accompanied by stigmatization which might ultimately contribute to women's lower ability to derive positive growth from their illness experience.

Social support among releasing men prisoners with lifetime trauma experiences

High rates of lifetime trauma experiences exist among men incarcerated in US state and federal prisons. Because lifetime trauma experiences have been linked to problematic behavioral and psychiatric outcomes for incarcerated populations, trauma-informed interventions could improve post-release well-being of releasing men prisoners with trauma histories. Social support has consistently been found to have a positive impact on trauma-related outcomes in non-incarcerated populations. Therefore, it is reasonable to hypothesize that social support may be an important intervention component for releasing men prisoners with trauma experiences; yet, the relationship between trauma experiences, psychiatric and behavioral factors, and social support has received almost no attention in research with men prisoners. Using a probability sample of 165 soon-to-be-released men, the present study examined differences in certain demographic, criminal justice history, mental health, substance abuse, and social support (type, quality, amount, and source) variables between releasing men prisoners with and without lifetime trauma experiences. Results indicate that men with trauma histories had more negative social support experiences and fewer positive social support resources before prison than their counterparts. Men with trauma histories also had more lifetime experiences with mental health and substance use problems. On further investigation of the subsample of men with trauma histories, those who were older, had substance use disorders, and histories of mental health problems anticipated fewer post-release social support resources. Study findings underscore the nuances of social support for men prisoners with trauma experiences and point to implications for future directions in targeted trauma-informed intervention development for releasing men prisoners.

Psychological Responses of Division I Female Athletes Throughout Injury Recovery: A Case Study Approach

Using the Integrated Model of Response to Sport Injury as a theoretical framework, athletes’ psychological strengths and emotional responses were explored throughout the injury process using a case study approach. Four Division I athletes completed measures of mental toughness, hardiness, and optimism before their season (time 1), once they became injured (time 2), midway through rehabilitation (time 3), and when they were cleared to participate (time 4). Coping behavior, psychological response, and rehabilitation adherence were recorded at time 2–time 4, while recovering. In addition, interviews were conducted after time 4. Mental toughness, hardiness, and optimism varied over time and across cases, with broad individual differences in response to injury. Athletes experienced a loss of athletic identity combined with feelings of guilt and helplessness over the initial stages of injury, but positive experiences were also found. All cases also reported playing through injury. Understanding the psychological strengths and responses of athletes can help professionals work with injured athletes.

Coping Strategies Used by School Staff After a Crisis: A Research Note

There is much literature on crisis support in schools but little on how school staff are affected. This research had two aims: to begin to explore the coping strategies used by school staff after a crisis event, and to investigate measures that might prove valuable for future research. Seven cases are presented using three measures: the WHO (Five) Wellbeing Index, the Impact of Event Scale–Revised, and the Ways of Coping–Revised. Results from this initial study show great variation in the range of responses reported by teachers.

Depth and Breadth Tactics in Support Seeking

Past support-seeking research has examined how much support people seek (strategic level) or the way they seek it (tactical level). However, there are questions that can only be answered by looking at both levels simultaneously. In this article, we investigated how the overall amount of support sought can be decomposed into two component tactics: the number of supporters one seeks (breadth) and the amount one seeks from each supporter (depth). In a 2-week diary study of support seeking, it was found that gender and attachment differences in overall support seeking were driven by the breadth rather than the depth of seeking. It was also found that breadth was associated with increases in perceived support availability, whereas both breadth and depth were associated with increases in self-esteem.

Post–traumatic Growth as Positive Personality Change: Evidence, Controversies and Future Directions

This target article focuses on the construct of post–traumatic growth—positive psychological change experienced as a result of the struggle with highly challenging life circumstances. Prominent theories of post–traumatic growth define it in terms of personality change, and as a result, this area of research should be of great interest to personality psychologists. Despite this fact, most of the research on this topic has not been sufficiently informed by relevant research in personality psychology, and much of the extant research suffers from significant methodological limitations. We review the literature on post–traumatic growth, with a particular focus on how researchers have conceptualized it and the specific methodological issues associated with these conceptualizations. We outline some ways in which personality science can both be enriched by the study of this phenomenon and inform rigorous research on post–traumatic growth and provide a series of guidelines for future research of post–traumatic growth as positive personality change. Copyright © 2014 European Association of Personality Psychology

Vicarious Resilience, Vicarious Trauma, and Awareness of Equity in Trauma Work

This qualitative study examines the coexistence of vicarious resilience and vicarious trauma and explores the inclusion of intersectional identities in trauma work with torture survivors in specialized programs across the United States. A constructionist framework and a method of constant comparison discovered themes that speak about the effects of witnessing how clients cope constructively with adversity, and intersectional identities in social context. The data suggest that trauma therapists can be potentially transformed by their clients’ resilience in positive, but not painless, ways. Choosing to work in the trauma field with survivors of torture and politically motivated violence involves immersion in profound ongoing experiences of intertwined pain, joy, and hope, and expanding the boundaries of self—personally and professionally.

Acute symptoms of posttraumatic stress and dissociative experiences among female israeli civilians exposed to war: the roles of intrapersonal and interpersonal sources of resilience

BACKGROUND

The positive personality characteristics of optimism, hope, self-esteem, and perceived availability of social support are believed to play an important role in psychological adjustment to stressful life events. For example, these characteristics have been shown to be associated with fewer mood disturbances in response to a variety of stressors. However, relatively little is known about the extent to which these characteristics serve as sources of resilience among civilians during real-time exposure to war.

OBJECTIVE

This "natural laboratory" study examined the role that individual differences both in intrapersonal (i.e., positive personality features of hope, optimism, and self-esteem) and in interpersonal (i.e., perceived social support from family, friends, and significant others) sources of resilience may play in the development of acute anxiety symptoms of posttraumatic stress disorder (PTSD) and dissociative experiences during exposure to war.

METHOD

A nonclinical community sample of 140 female adults was assessed during real-time exposure to missile and rocket fire during an eruption of violence in the Middle East in November 2012.

RESULTS

The results demonstrate that both intrapersonal and interpersonal sources of resilience were negatively associated with acute PTSD and dissociative symptoms.

CONCLUSION

The findings of this study provide evidence that both intrapersonal and interpersonal sources of resilience may significantly mitigate the risk for acute anxiety symptoms among civilian communities exposed to traumatic events.

Cross-National and Religious Relationships With Posttraumatic Growth

Posttraumatic growth (PTG)—positive changes experienced as a result of psychological struggle with highly challenging life circumstances—generally correlates with greater religiosity and optimism, and often shows gender and cross-national differences. The current study examined the relationship of national background and religion with PTG, as well as individual differences variables (i.e., optimism, pessimism, and gender) and individuals’ appraisal or perceptions of the event (i.e., whether the event was perceived as having a direct or indirect impact, and whether the event was perceived as deliberate or accidental). American and Japanese college students identified a highly stressful life event and completed the PTG Inventory and the revised Life Orientation Test. Results showed that national background and religiosity (religious affiliation and strengths of religious beliefs) predicted the level of overall PTG. In addition to the national and religious associations, gender and optimism had positive associations with PTG. The role of individual differences variables and perceptions of the triggering event varied cross-nationally across the PTG domains. Limitations and future directions are discussed.

Posttraumatic growth in parents and pediatric patients

BACKGROUND

Pediatric medical experiences are potentially traumatic but may lead to psychological growth.

OBJECTIVE

The study objective was to synthesize the published literature regarding posttraumatic growth (PTG) in parents and patients with serious pediatric illness (SPI) into a conceptual model.

METHODS

We systematically searched MEDLINE, CINAHL, PsychInfo, and Sociological Abstracts in December 2012 to identify articles on stress or trauma caused by medical events with PTG as an outcome, reviewing articles pertaining to the pediatric population. We additionally reviewed articles outside pediatric medicine that described a model of PTG.

RESULTS

Of the 605 articles identified, 55 met inclusion criteria, 26 of which examined parents or pediatric patients. Parents and children may experience PTG following medical trauma through a combination of cognitive and affective processing of their subjective experience. Components of SPI-PTG are unclear, but may include greater appreciation of life, improved interpersonal relationships, greater personal strength, recognition of new possibilities in one's life course, spiritual or religious growth, and reconstruction of a positive body image. Individual characteristics, and the level of social support, may affect the likelihood that SPI-PTG will occur. SPI-PTG in siblings and other family members has not been well studied.

CONCLUSIONS

SPI-PTG is an important but understudied and inadequately understood phenomenon affecting children with SPI and their family members. Research should focus on clarifying SPI-PTG domains, creating measurement instruments, assessing SPI-PTG across the pediatric age range and among family members, and improving our understanding of and ability to positively intervene regarding the cognitive processes of rumination, sense making, and benefit finding.

Optimism and pessimism as predictors of initiating and ending an antidepressant medication treatment

BACKGROUND

The personality variables optimism and pessimism are potential risk factors for disorders commonly treated with antidepressants.

AIMS

To evaluate optimism and pessimism as predictors of initiating and ending an antidepressant treatment.

METHODS

Data consisted of 29,930 public sector employees with no record of diagnosed depression. Optimism and pessimism were measured using the Revised Life Orientation Test (LOT-R) at baseline. The data of purchases of antidepressants were from the national Drug Prescription Register.

RESULTS

During the mean follow-up of 4.4 years, 1681 participants initiated and of them 1288 ended an antidepressant treatment lasting at least 100 days. In the adjusted model, high optimism was associated with a lower likelihood of starting antidepressant medication treatment (hazard ratios, HR, 0.67, 95% CI 0.62-0.73) and a higher likelihood of stopping the treatment (HR = 1.18, 95% CI 1.08-1.30). High pessimism was associated with a higher likelihood of starting antidepressant medication treatment (HR = 1.27, 95% CI 1.16-1.38) and a lower likelihood of stopping it (HR = 0.89, 95% CI 0.80-0.98). These associations remained after optimism score was adjusted for pessimism and vice versa or those with symptoms of mental health problems at baseline were removed from the analyses.

CONCLUSIONS

Low optimism and high pessimism are independently associated with an increased likelihood of initiating antidepressant medication treatment, but with a decreased likelihood of ending it during the follow-up.

Coping strategies as a mediator of posttraumatic growth among adult survivors of the Wenchuan earthquake

Objective

By testing the mediating effect of coping strategies on the relationship between social support (SS) and posttraumatic growth (PTG), the aim of this research was to develop a new approach for the study of post-disaster psychological intervention.

Methods

A mediating effect model analysis was conducted on 2080 adult survivors selected from 19 of the counties hardest-hit by the 2008 Wenchuan earthquake. The Social Support Rating Scale and the Coping Scale were used to predict the PTG.

Results

A bivariate correlation analysis showed that there was a correlation between posttraumatic growth, social support and coping strategies. The mediation analysis revealed that coping strategies played a mediating role between social support and posttraumatic growth in survivors after the earthquake.

Conclusion

The results demonstrated that mental health programs for survivors need to focus on the establishment of a good social support network, which was found to be conductive to maintaining and increasing mental health levels. At the same time, adequate social support is able to assist survivors in adopting mature coping strategies, such as problem solving and asking for help. Hence, social support was found to play a vital role in balancing and protecting mental health.

South African mothers' coping with an unplanned Caesarean section

In this study, researchers explored mothers' coping strategies in dealing with birth by unplanned Caesarean section. Mothers' experiences of a traumatic birth could be influenced by perceived strengths when coping with the stress related to the incident. Coping strategies resulted in reassessment of the birth process and were associated with a more positive and memorable experience. In-depth interviews with 10 women explored their lived experiences of childbirth. Data were analyzed thematically. Phenomenological theory served as a framework for the structuring, organizing, and categorizing of data. Mothers described several factors and coping strategies that they perceived to be effective in reducing the impact of their traumatic birth experiences.

Benefit finding as a moderator of the relationship between spirituality/religiosity and drinking

This study evaluated benefit finding as a moderator of the relationship between spiritual and religious attitudes and drinking. Previous research indicates that undergraduates who drink heavily experience negative alcohol-related consequences. Literature also suggests that spirituality and religiosity (S/R) are protective against heavy drinking (e.g., Yonker, Schnabelrauch, & DeHaan, 2012) and that finding meaning, which is conceptually related to benefit finding, is negatively associated with alcohol use (e.g., Wells, 2010). Seven hundred undergraduate students completed the study materials including measures of drinking, benefit finding, and S/R. Based on previous research, we expected that S/R and benefit finding would be negatively associated with drinking. Furthermore, we expected that benefit finding would moderate the association between S/R and drinking, such that S/R would be more negatively associated with drinking among those higher in benefit finding. Consistent with expectations, a negative association between S/R and drinking was present, and was stronger among those high in benefit finding. These findings extend previous research by demonstrating that the protective effect of S/R on drinking appears to be particularly true among those who find benefit following stressful experiences. This study extends previous research showing that S/R is negatively associated with drinking by evaluating benefit finding (measured via the Post-Traumatic Growth Inventory; Tedeschi & Calhoun, 1996) as a potential moderator of the relationship between S/R and drinking. This study contributes to the alcohol literature seeking to understand and identify individual factors in drinking and determine how S/R and benefit finding relate to drinking.

Posttraumatic growth among men with histories of child sexual abuse

Despite an increased risk of long-term mental health problems, many survivors of child sexual abuse (CSA) experience positive changes in areas such as appreciation for life, personal strength, and interpersonal relationships. Drawing on life course theory, this study examined factors related to posttraumatic growth among a sample of men with CSA histories (N = 487). Using multiple linear regression (i.e., ordinary least squares), we found that men who had a better understanding of the sexual abuse experience, who ascribed to less traditional masculine norms, and who experienced a turning point reported greater growth. To promote growth, practitioners can help survivors understand the meaning and impact of the abuse on their lives and deconstruct rigid gender norms. More research on growth is needed with male survivors, especially on the nature of turning points in the recovery process.

[The influence of meaning making following stressful life experiences on change of self-concept]

As interest in meaning making following stressful life experiences continues to grow, it is important to clarify the features and functions of the meaning- making process. We examined the influence of meaning making following stressful life experiences on change of self-concept. In two studies, university students selected their most stressful life experience and completed the Assimilation and Accommodation of Meaning Making Scale. In Study 1, 235 university students also completed questionnaires regarding post-traumatic growth and positive change of the sense of identity following their stressful life experience. The results of covariance structure analysis indicated that accommodation promoted a positive change of self-concept. In Study 2, 199 university students completed questionnaires regarding change of self-concept and emotion as a positive or negative change following stressful life experiences. The results of covariance structure analysis indicated that accommodation promoted a positive change, similar to the results of Study 1. In addition, accommodation also promoted negative change. However, assimilation did not promote positive change but did restrain negative change.

The experience of acculturative stress-related growth from immigrants' perspectives

Previous literature has mainly focused on the positive effects of stress associated with disability and illness, called stress-related growth. Little research has explored positive changes as a result of acculturative stress among a group of immigrants. In particular, older Asian immigrants may experience a high level of stress related to acculturation because they may face more challenges to adapt to and navigate a new culture. This study was designed to capture the characteristics of stress-related growth associated with acculturative stress. Using in-depth interviews among 13 older Korean immigrants, three main themes associated with the stress-coping strategies were identified: (a) the development of mental toughness, (b) engagement in meaningful activities, and (c) promotion of cultural understanding. These themes indicate that by following the stressful acculturation process, participants developed a better understanding of the new culture, engaged in various leisure activities, and enhanced mental strength. This finding provides information on how immigrants deal with acculturative stress and have positive psychological changes, which results in a sense of happiness and psychological well-being.