Evidence for a curvilinear relationship between posttraumatic growth and posttrauma depression and PTSD in assault survivors

Posttraumatic growth, spiritual damage, and psychosocial and mental health problems in survivors of clergy-perpetrated child sexual abuse: A mixed methods approach

INTRODUCTION

Although clergy-perpetrated child sexual abuse (CSA) implies severe traumatic repercussions for the victims, they may also experience posttraumatic growth (PTG) deriving from the need to deal with the trauma suffered. This PTG is associated with the processes of recovery, healing, and empowerment.

OBJECTIVE

Applying a mixed methods approach to analyse PTG outcomes and to explore experiences of PTG in survivors of Spanish clergy-perpetrated CSA and its relation with psychosocial, mental and spiritual suffering.

PARTICIPANTS

Thirty-one survivors (M = 51.6 years; SD = 12.4) in the quantitative stage of the research, and seven (M = 49.3; SD = 8.9) in the qualitative stage.

METHODS

A sequential explanatory mixed methods study design was applied using standardized questionnaires and semi-structured interviews. Descriptive, correlation and thematic analyses were conducted. The quantitative and qualitative data were integrated.

RESULTS

Positive associations were found between PTG and psychosocial and mental health problems (r = 0.53; p < .01), damage to faith in God (r = 0.43; p < .05) and damage to faith in the Church (r = 0.48; p < .01). Three themes emerged from the qualitative data that explained, expanded, and complemented the quantitative results, highlighting the relationship between damage and growth and the specific meanings of PTG from the perspectives of the survivors.

CONCLUSIONS

This study shows that survivors may develop PTG in the course of the processes of psychological suffering, spiritual transformation, and meaning-making of traumatic experiences.

Posttraumatic growth and health-related quality of life in cancer survivors: Does fatigue moderate the link?

Interest in post-traumatic growth (PTG) as a predictor of health-related quality of life (HRQoL) is currently gaining attention. However, current evidence is still inconclusive on the nature of this relationship. The first objective of this study was to investigate the relationship between PTG and global HRQoL among cancer survivors. We further investigated the moderating role of fatigue in the association between PTG and global HRQoL. In the FiX study (Fatigue in Germany - Examination of prevalence, severity, and state of screening and treatment) cancer-related fatigue (EORTC QLQ-FA12), PTG inventory and global HRQoL (EORTC QLQ-C30) were assessed four years after cancer diagnosis in 1316 cancer-free survivors (mean age = 67.28, SD = 11.05, 51.4% female). Multiple linear regression analysis and moderation analysis were performed. The results showed that PTG had a convex quadratic relationship with global HRQoL (p < 0.001). Contrary to our hypothesis, fatigue did not moderate the relationship between PTG (linear and quadratic terms) and global HRQoL, neither when considering the overall PTG score nor for any PTG subdimension. In conclusion, PTG has a convex quadratic relationship with long-term global HRQoL that was not modified by persisting fatigue. Future statistical models investigating PTG and global HRQoL should take this non-linear relationship into account. Aiming to increase PTG might contribute to, but is likely not sufficient for high levels of global HRQoL in cancer survivors in the long run.

Posttraumatic Growth in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study

Despite increasing recognition that positive psychological changes or posttraumatic growth (PTG) may develop after highly stressful or traumatic events, contemporary population-based data on the epidemiology of PTG in high-risk samples such as U.S. military veterans are lacking. Additionally, in light of emerging evidence suggesting an 8-factor model of posttraumatic stress disorder (PTSD) symptoms, an up-to-date characterization of how these symptom clusters relate to PTG can help inform efforts to help promote PTG. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 3,847 trauma-exposed U.S. veterans. Participants completed assessments of potentially traumatic events, PTSD symptoms, and PTG, as well as a broad range of sociodemographic, military, trauma, health, personality, and psychosocial characteristics. Results revealed that 63.2% of trauma-exposed veterans and 86.4% of veterans who screened positive for PTSD endorsed moderate-or-greater PTG; these prevalences are higher than those reported in an independent U.S. veteran sample in 2011 (50.1% and 72.0%, respectively). An inverted U-shaped association was observed between PTSD symptom severity and PTG levels, with scores of 31 to 51 on the PTSD Checklist for DSM-5 associated with the highest likelihood of PTG. Intrinsic religiosity and internally- and externally-generated intrusive symptoms of PTSD were identified as the strongest correlates of PTG. Results suggest that prevention and treatment efforts to mitigate severe PTSD symptoms, and help promote intrinsic religiosity, and more deliberate and organized rumination about traumatic experiences may help foster PTG in veterans.

Pandemic-related posttraumatic psychological growth in U.S. military veterans: A 3-year, nationally representative, longitudinal study

Little is known about the positive psychological changes or posttraumatic growth (PTG) in response to the pandemic as the COVID-19 vaccines has become widely available. This longitudinal study aimed to characterize changes in the prevalence of pandemic-related PTG, and to identify and quantify the relative importance of PTG correlates pre-pandemic, 1- year peri‑pandemic, and 2-years post-pandemic onset. A total of 2,441 U.S. military veterans completed Wave 3 assessment of the National Health and Resilience in Veterans Study. In the full sample, a significant decrease from peri‑pandemic to 2-years post-pandemic onset was observed in overall pandemic-related PTG (41.5% to 32.2%) and four domains of PTG (appreciation of life, relating to others, personal strength, spiritual changes). Among veterans who screened positive for pandemic-related posttraumatic stress symptoms, the prevalence of pandemic-related PTG was markedly higher and did not change from peri‑pandemic to 2-years post-pandemic onset (78.4% to 73.4%). Greater pre-pandemic PTG (personal strength and new possibilities) and greater worries about the effect of pandemic on one's mental health were the strongest correlates of pandemic-related PTG 2-years post-pandemic onset. Results suggest that psychosocial interventions to bolster PTG in relation to early life traumas may help facilitate PTG in response to the pandemic and related crises.

The relationship between psychological flexibility, self-compassion, and posttraumatic growth in cancer patients in the COVID-19 pandemic

PURPOSE

The COVID-19 pandemic may have an important long-term emotional impact on patients with cancer diagnosis, as they are in the high-risk group. We aimed to evaluate the relationship between self-compassion, psychological flexibility, and posttraumatic growth, and to examine whether psychological flexibility may serve as a mediator between self-compassion and posttraumatic growth.

METHODS

Two hundred fifty-three patients with cancer were included in the study. Sociodemographic and Clinical Features Data Form, Self-Compassion Scale (SCS), Freiburg Mindfulness Inventory (FMI), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Posttraumatic Growth Inventory (PTGI) were applied to all patients.

RESULTS

The multivariate analysis with independent variable SCS, FMI, AAQ-II, and CFQ scores explains 49% of the variance in PTGI (F(4,248) = 60,585, p < 0.001). SC and FMI scores were found to have a positive and AAQ-II and CFQ scores a negative predictive effect on PTGI scores. The partial mediational effect of psychological flexibility on the relationship between self-compassion and posttraumatic growth was found to be statistically significant.

CONCLUSION

In traumatic life events such as pandemics, the importance of self-compassion for posttraumatic growth and the mediator role of psychological flexibility in this relationship should be considered in order to manage the treatment process in cancer patients. These patients are more affected by the pandemic due to the nature of their malignancy and the strict protective measures they must follow as members of a high-risk group. The significance of therapies focused on psychological flexibility should be emphasized in comprehensive biopsychosocial approaches for the management of cancer patients.

Racial Identity and Mindfulness as Predictors of Posttraumatic Growth in Black Adults Experiencing Race-Based Trauma

Racial discrimination and race-based trauma (RBT) have led to the development of various negative psychological and physiological effects among Black adults in the USA. There is a lack of understanding in relation to how various psychosocial factors influence posttraumatic growth (PTG) in the context of RBT among Black adults. The authors examined associations of RBT, racial identity, and mindfulness with PTG among Black adults while controlling for gender, household income, and duration of trauma. The sample consisted of 134 self-identified Black adults who met the criteria for RBT from the USA. The hierarchical regression analysis showed the final model with all the predictors accounted for 35% of the total variance of PTG, with racial identity and mindfulness facets accounting for 26% of the variance. The study provides a foundation for future research addressing RBT and promoting PTG in Black adults.

Posttraumatic growth after perinatal loss: A systematic review

Perinatal loss is a potentially painful event for parents and a grief that is often not recognised socially. Research has widely shown that grief responses can coexist with posttraumatic growth responses. The aim of this systematic review was to assess the available evidence of studies investigating posttraumatic growth in people who have suffered a perinatal loss. A search was conducted in PROQUEST and Web of Science for articles published from 2011 to 2021. After reviewing 10 selected articles, it was found that the participants showed moderate levels of posttraumatic growth, mostly in the domains of personal strength, relationships with others, appreciation of life, and to a lesser extent in the perception of new possibilities and spiritual growth. Factors that facilitated the growth experience were finding meaning in the loss, changes in core beliefs, adaptive coping strategies, deliberate rumination, continued bonds with the deceased baby, and social support. It is expected that this systematic review will provide a basis for the design of future interventions aimed at promoting growth when facing perinatal loss.

Race-based trauma and post-traumatic growth through identity transformation

Race-based trauma has been linked to multiple adverse health and mental health outcomes, including hypertension, post-traumatic stress, anxiety, and depression. While the possibility of post-traumatic growth (PTG) has been investigated following other types of trauma, relatively less work has been done on PTG following race-based trauma. In this article, we present a theoretical framework integrating three areas of research: race-based trauma, PTG, and racial identity narratives. Based on the work on Black and Asian American identity and integrating theory and research on historical trauma and PTG, this framework posits that the transformation of externally imposed narratives into more authentic, internally generated ones can serve as an important influence that sparks PTG after racial trauma. Based on this framework, strategies and tools that enact the cognitive processes of PTG, including writing and storytelling, are suggested as ways to promote post-trauma growth in response to racial trauma.

PTSD as a Moderator of the Relationship Between the Distribution of Personal Resources and Spiritual Change Among Participants of Hostilities in Ukraine

The theory of conservation of resources (COR) can be used to search for mechanisms that explain spiritual changes caused by trauma. The present study aimed to verify whether PTSD could be a potential moderator between the distribution of personal resources and spiritual changes. The study included a total of 324 adults (75 women and 243 men) aged 18-74. The mean age was 34.3 (SD = 9.9). The Polish adaptation of Hobfoll's Conservation of Resources-Evaluation (COR-E), the posttraumatic stress disorder (PTSD) Checklist-Civilian Version and the Posttraumatic Growth Inventory were employed in the research. This study analyzed the spiritual change, which is one of the five domains of posttraumatic growth. The outcomes indicated the significant role of PTSD as a moderator of the relationships between 1) personal resources gain and spiritual change and 2) personal resources loss and spiritual change. PTSD is not a moderator in the relationship between assigning value to personal resources and spiritual change.

Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study

Background

Contracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual's previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization.

Method

A cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19.

Results

The median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p < 0.001), retirees (B = -12.060, 95% CI = -21.310 to -2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046).

Conclusion

Experiencing stigma contributed to patients' PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement.

Personal growth in early pregnancy: the role of perceived stress and emotion regulation

OBJECTIVE

Coping with the stress aroused by early pregnancy can not only result in distress, but may constitute an opportunity to experience personal growth. Relying on the model of posttraumatic growth, this study examined the contribution of perceived stress and emotion regulation to women's personal growth during the first trimester of pregnancy.

METHOD

A convenience sample of Israeli women (n=170), who were during their first trimester of pregnancy (up to 13 weeks), over 18 years old, and capable to completing the instruments in Hebrew, were recruited through a women's health clinic and through social media during the years 2017-2019.

RESULTS

The findings indicate that primiparous mothers report higher personal growth than multiparous. In addition, younger age, being primiparous, and higher cognitive-reappraisal contributed to greater personal growth. Moreover, a curvilinear association was found between perceived stress and personal growth, so that a medium level of stress was associated with the highest level of growth. Finally, cognitive-reappraisal fully mediated the relationship between perceived stress and personal growth.

CONCLUSIONS

The findings add to the growing body of knowledge concerning the implications of early pregnancy in general, and personal growth as a result of dealing with the stress typical of this period in particular and highlight the role of the perceived stress as well as the woman's personal characteristics and resources that contribute to this result.

The Hormesis Model for Building Resilience Through Adversity: Attention to Mechanism in Developmental Context

In developmental science, resilience refers to children and youths’ ability to recover and pursue positive development in the face of stress related to adversity. Extant research has documented protective factors and ecological contexts that mitigate the impact of adversity and thereby promote resilience. One intriguing aspect of resilience is that individuals also develop strength in response to early adversity. However, very little theoretical guidance exists on the developmental mechanisms and contexts through which early adversity may lead to strengthening effects that confer the process of resilience. The strengthening mechanism in the context of specific circumscribed environmental stress is a process known in the field of toxicology as hormesis. It is proposed here that the study of resilience in developmental and psychological sciences can benefit from shifting more attention to the hormesis model. The hormesis model is reviewed and discussed as a promising perspective on mechanisms, developmental timing, and context through which adversity strengthens or impedes resilience.

Changes in posttraumatic growth, core belief disruption, and social support over the first year of the COVID-19 pandemic

Post-traumatic Growth (PTG) is the positive psychological change that may occur after a highly stressful situation that shakes a person's core beliefs about the world. During 2020, the United States experienced the COVID-19 pandemic and a highly contentious political election, both of which have the potential to disrupt core beliefs and evoke perceptions of PTG. Post-traumatic growth, core belief disruption, perceived social support from humans and pets, coping strategies, and stressful events were assessed in 201 participants from the United States (Mage: 35.39, SD: 14.60) at four time points from April 2020 (T1) until April 2021 (T4). While total PTG did not significantly change from Time 1 to Time 4, perceptions of personal strength and new possibilities increased, as did core belief disruption, and the use of coping strategies decreased. Higher PTG was reported by those who owned pets, those who knew someone who had been hospitalized due to COVID-19, and those who knew someone who had died of COVID-19. While rating COVID-19 or politics as the most stressful event at Time 4 did not correspond to differences in PTG, those who perceived the event to be resolved had higher PTG than those who perceived the event to be ongoing. Having COVID-19 personally and vaccination status was not associated with differences in Post-traumatic Growth. PTG at Time 4 was predicted by core belief disruption and social support in the full sample and in the pet owners only sample, and by support from video conferencing for the full sample only. Time 4 PTG was also predicted by core belief disruption, problem-focused coping, and avoidance coping. Results are discussed in terms of the PTG theoretical model. Additionally, implications for interventions aimed at fostering psychological growth, including through non-traditional forms of social support (i.e., remote communication and perceived support from pets) are addressed.

Post-Traumatic Growth and Resilience among Hospitalized COVID-19 Survivors: A Gendered Analysis

The literature on behavioral outcomes associated with the COVID-19 pandemic is inundated with mental health burdens such as depression and stress disorders. The current study investigated gender invariance on resilience and post-traumatic growth (PTG) as positive psychological changes associated with the COVID-19 pandemic. A total of 381 survivors of the COVID-19 infection completed measurements of resilience, PTG, violence and stigma experience, and mental health problems like post-traumatic stress disorder (PTSD). The data were analyzed using descriptive statistics, correlation, multivariate regression, and a latent profile analysis. The results revealed that more than half of the participants had high scores on resilience (53.6%) and PTG (60.9%). The positive psychological changes, although independent of each other, were moderated by gender, and influenced by the negative experiences of participants such as stigma, violence, and PTSD. Latent profile analyses revealed three classes of participants, two of which were characterized by high scores on mental health problems and PTG. The clusters were invariant across gender. Surviving COVID-19 contributed to resilience and PTG. These can be targeted for intervention programs to mitigate the mental health burden occasioned by the pandemic.

Cancer-related posttraumatic growth and posttraumatic stress: how are they connected and what are their correlates?

PURPOSE

Cancer is a stressful life event that can lead to specific posttraumatic reactions. Posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) are two main posttraumatic reactions that are related to each other, and both have different correlates.

METHODS

The linearity of the relationship between PTG and PTSS and the different socio-demographic, cancer-related, emotional, and psychological correlates were analyzed in patients with cancer (N = 126).

RESULTS

The relationship between PTG and PTSS was found to be more curvilinear than linear. PTSS was more strongly related to psychological factors (e.g., anxious preoccupation, hope-helplessness, and resilience) while PTG was strongly related to existential factors (e.g., self-transcendence and religiosity).

CONCLUSION

The results show that cancer-related PTSS and PTG are specifically related constructs which are related differently to particular correlates. Specifically, the greatest differences were observed in the psychological variables. In the early phases, therapeutic interventions focused on variables related to PTSS can lead to the reduction of PTSS. In follow-up phases, the therapeutic intervention focused on the increase of the level of variables related to PTG can help the development of PTG.

The effects of trait resilience and rumination on psychological adaptation to breast cancer

This cross-sectional study examined the effect of trait resilience and specific types of rumination on positive psychological adaptation post-diagnosis among 201 breast cancer patients. They completed self-reported measures describing trait resilience, rumination, posttraumatic growth, and health-related quality of life. Hierarchical analysis showed that trait resilience significantly predicted higher quality of life and posttraumatic growth after controlling for demographic and clinical variables. Additionally, “intrusion” and “brooding” subtypes of rumination negatively predicted quality of life, with “instrumentality” positively predicting quality of life and posttraumatic growth, suggesting the importance of trait resilience and multidimensional rumination for positive psychological changes among breast cancer survivors.

Post-traumatic Growth in Women With Histories of Addiction and Victimization Residing in a Sober Living Home

Research consistently documents the deleterious sequelae of interpersonal trauma, including domestic and sexual violence (DSV). More recently, however, researchers and practitioners have focused on positive outcomes, such as post-traumatic growth (PTG), in survivors of DSV. Although research has begun to document the prevalence and correlates of PTG, no study to our knowledge has explored PTG in a sample of women with histories of addiction and victimization residing in a trauma-informed sober living home (SLH). The purpose of the current study was to examine this gap in the literature. Participants were 59 women (89.8% White; 86.4% heterosexual; mean age = 41.6) who completed a survey while residing in a SLH. Most women reported moderate to high levels of PTG. At the bivariate level PTG was related to less depression, post-traumatic stress disorder, and financial worries, and greater active coping, and sense of community. PTG was also related to the absence of past 6-month physical intimate partner violence. In regression analyses, PTG was related to less depression and greater sense of community. These data offer insights into modifiable factors such as fostering a sense of community while also promoting mental health treatment that could be the focus of interventions to increase PTG in women with histories of addiction and victimization residing in SLHs.

Attachment and Mental Health in the COVID-19 Pandemic: Posttraumatic Growth and Religion as Moderators

Consistent with the teachings in various religious traditions of finding meaning amidst suffering, we suspected that Posttraumatic Growth (PTG) would have a buffering effect on attachment insecurity and psychosocial outcomes. We examined the effects of anxious and avoidant attachment, PTG, and religion on psychosocial outcomes (i.e., anxiety, depression, and loneliness). Data from 466 participants recruited from Amazon Mechanical Turk (MTurk) and a college student sample revealed that PTG served as a moderator between anxious attachment and (a) depression and (b) loneliness, and (c) PTG buffered the relationship between anxious attachment and anxiety to a greater extent among Christians, compared to non-Christians. On the other hand, (a) PTG did not moderate the link between attachment avoidance and depression, (b) PTG exacerbated the relationship between attachment avoidance and anxiety, and (c) PTG buffered the association between attachment avoidance and loneliness for non-Christians, but this link was amplified for Christians. We discuss the findings that PTG interacted with religion and offered protective effects for anxious (but not avoidant) attachment. Factors that may have contributed to the difference between the two attachment styles are discussed, along with implications from cultural-religious and adult attachment frameworks.

Posttraumatic Growth Among Older Adults With Age-Related Macular Degeneration

Introduction: The term “post-traumatic growth” describes positive outcomes that accrue from the struggle with highly challenging life circumstances. The purpose of this study is to describe post-traumatic growth accruing from experience with vision loss caused by age-related macular degeneration (AMD) and to identify the relationships between depression, cognitive processing, social support, and post-traumatic growth. Methods: Individuals with vision loss caused by AMD completed an interviewer-administered composite questionnaire to identify elements of Tedeschi and Calhoun’s theoretical model of the process of posttraumatic growth, including measures of distress (depression), intrusive and deliberate rumination (cognitive processing), and social support (quality and quantity of social ties). Relationships were examined using path analysis. Results: Eighty-nine participants completed the questionnaire (mean age = 85.3 years, range = 74–98 years). All paths, including from depression to social support (β = –.363, p < .001), from social support to deliberate rumination (β = .233; p ≤ .01), and from intrusive rumination to deliberate rumination (β = .514, p < .01), were significant and consistent with the posttraumatic growth theoretical model. Deliberate rumination had a significant direct path to post-traumatic growth (β = .38, p = .001). Discussion: The findings may illuminate elements of the process of post-traumatic growth among those with AMD. We found that as social support increased, depression decreased. Increased social support seemed to encourage positive deliberate rumination, which led directly to post-traumatic growth. Although intrusive rumination is often associated with negative outcomes, the model demonstrates that it also stimulates engagement in deliberate attempts to process one’s experience. Deliberate cognitive processing is a direct precursor to post-traumatic growth. Implications for Practitioners: A focus on the process of growth and thriving can offer a broader view of the experience of living with vision loss. Interventions that foster post-traumatic growth among those with AMD should focus on enhancing social support and facilitating deliberate cognitive processing.

Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors

BACKGROUND

Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors.

AIMS

In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors.

METHOD

Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2.

RESULTS

The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model.

LIMITATIONS

Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.

Relationship between post-traumatic disorder and posttraumatic growth in COVID-19 home-confined adolescents: The moderating role of self-efficacy

Although the COVID-19 pandemic has been traumatogenic for some people, posttraumatic growth (PTG) outcomes have also been observed. This study examined the PTG in adolescents and the moderating effect of self-efficacy on post-traumatic stress disorder (PTSD) symptoms and PTG. An online questionnaire was conducted on 2090 adolescent Chinese students to measure COVID-19 related exposure, self-efficacy, PTSD, and PTG. PTG prevalence was found in 20.6% of the sample, with the relationship between PTSD and PTG being found to be a reverse U-shaped curve. Objective exposure factors were found to be closely associated with PTSD symptoms but not with PTG. Similarly, subjective feelings of extreme fear were significantly associated with PTSD symptoms but not with PTG. Self-efficacy was found to be positively correlated with PTG (r = 0.551) and to moderate the relationship between PTSD and PTG. For those with low self-efficacy, the higher the PTSD, the higher the PTG, and for those with high self-efficacy, the higher the PTSD, the lower the PTG. As an improved sense of self-efficacy in adolescents could promote positive psychological transformations, these results could assist in identifying self-efficacy levels and providing guidance for targeted psychological interventions to promote positive growth.

Psychometric Evaluation of the Healing After Gender-Based Violence Scale: An Instrument for Cross-Sectional and Longitudinal Assessment of Recovery Progress for Women-Identifying Survivors

PURPOSE

The Healing after Gender-based Violence Scale (GBV-Heal) was developed to measure the holistic recovery processes of woman-identifying survivors of gender-based violence (GBV). The GBV-Heal asks survivors to evaluate a series of statements based on perceptions of one's lowest point and how they currently feel. These scale response options create lowest point, current feelings, and difference scores to evaluate the healing outcome cross-sectionally. This manuscript aims to evaluate the psychometric properties of the GBV-Heal to understand its usefulness for research and practice.

METHOD

Instrument evaluation consisted of two phases analyzing online survey data from two GBV survivor samples recruited from online health research portals in the United States. In Phase One (N = 236), we conducted factor analyses and evaluated convergent/discriminant validity using depression, anxiety, posttraumatic stress, posttraumatic growth, and wellbeing measures. In Phase Two (N = 47), we evaluated GBV-Heal response consistency via test-retest within two weeks.

RESULTS

Results showed that the scale's final model included 4 components with 18 items, explaining 61.2% and 65% of the overall scale variances for "at my lowest point" and "my current feelings," respectively. The GBV-Heal difference score showed a weak positive correlation with wellbeing and posttraumatic growth scores and a weak negative correlation with depression, anxiety, and PTSD scores. Test-retest revealed Pearson r correlations of 0.82, 0.82, and 0.69 for the lowest point, current feelings, and difference scores respectively.

CONCLUSION

These findings substantiate the reliability and validity of our instrument as an outcome measure that can be used both cross-sectionally and longitudinally with survivors of GBV.

Factors associated with post-traumatic growth in response to the COVID-19 pandemic: Results from a national sample of U.S. military veterans

RATIONALE

The COVID-19 pandemic has had numerous negative effects globally, contributing to mortality, social restriction, and psychological distress. To date, however, the majority of research on the psychological impact of the COVID-19 pandemic has focused on negative psychological outcomes, such as depression, anxiety, and posttraumatic stress disorder (PTSD).

OBJECTIVE

Although there is debate about the constructive vs. illusory nature of post-traumatic growth (PTG), it has been found to be prevalent in a broad range of trauma survivors, including individuals affected by the COVID-19 pandemic. The objective of this study was to identify pre- and peri-pandemic factors associated with pandemic-related PTG in a national sample of U.S. veterans.

METHODS

Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative cohort of 3078 U.S. veterans. A broad range of pre-pandemic and 1-year peri-pandemic factors associated with pandemic-related PTG were evaluated. Curve estimation and receiver operating characteristic curve analyses were conducted to characterize the association between pandemic-related PTSD symptoms and PTG.

RESULTS

Worries about the effect of the pandemic on one's physical and mental health, PTG in response to previous traumas (i.e., new possibilities and improved interpersonal relationships), and pandemic-related avoidance symptoms were the strongest correlates of pandemic-related PTG. An inverted-U shaped relationship provided the best fit to the association between pandemic-related PTSD symptoms and endorsement of PTG, with moderate severity of PTSD symptoms optimally efficient in identifying veterans who endorsed PTG.

CONCLUSIONS

Results of this study suggest that psychosocial interventions that promote more deliberate and organized rumination about the pandemic and enhance PTG in response to prior traumatic events may help facilitate positive psychological changes related to the COVID-19 pandemic in U.S. military veterans. Longitudinal studies on functional correlates of PTG may help inform whether these changes are constructive vs. illusory in nature.

Caught by Connections: The Mediating Roles of Social and Community Support after Interpersonal Violence

The purpose of the present study was to examine the potential mediating roles of different sources of social support and sense of community on the relationship between interpersonal violence and mental health outcomes, negative posttraumatic cognitions, and posttraumatic growth. Participants (n = 459) completed an online survey. Interpersonal violence had a significant, direct effect on all posttraumatic outcomes. Support from significant others mediated the relationship between interpersonal violence and posttraumatic stress. Both support from family and a negative sense of community mediated the relationship between interpersonal violence and posttraumatic cognitions, while social support from friends and family and a positive sense of community mediated the relationship between interpersonal violence and posttraumatic growth. The results suggest that posttraumatic distress and growth may be impacted by different connection sources.

The Role of Social Support in Identity Processes and Posttraumatic Growth: A Study of Victims of Intimate Partner Violence

The purpose of this study was to explore the role of social support for posttraumatic growth (PTG) and identity processes in a sample of 217 women victims of intimate partner violence (IPV), recruited from women shelters, social support centers, and through counseling psychologists. The results of the study highlight the important role of social support in seeking positive personal resolutions after experiencing traumatic events of IPV. It indicates that social support, but not social nonsupport, predicts higher levels of PTG and the development of new positive identities. In particular, social support was positively associated with the manifestation of all five identity processes, that is, with identification with commitment, commitment making, exploration in breadth, exploration in depth, and ruminative exploration. Furthermore, contextual and socioeconomic factors, such as time after last violence, relationships with the perpetrator, place of residence, education, and age of the victims of IPV were also related to identity processes. Severity of the violence, time after the last violence, education, and personal income were related to PTG. Thus, this study indicated that there are significant contextual and socioeconomic differences in the PTG and reconsideration of one's identity. Recommendations for practitioners and future research have been suggested.

Psychosocial correlates of posttraumatic growth among U.S. young adults during the COVID-19 pandemic

Given the prolonged nature of the COVID-19 pandemic, the purpose of this study was to examine the association between posttraumatic growth (PTG) among young adults during the COVID-19 pandemic and their psychosocial characteristics, specifically: distress tolerance; resilience; family connectedness; depression, anxiety, and PTSD symptoms; and COVID-19-related worry. The study utilized data from 805 U.S. young adults (18-30 years) who completed online surveys during the COVID-19 pandemic across two waves (April-August 2020 and September 2020-March 2021). Overall, young adults reported low PTG scores. PTSD symptoms and COVID-19-related worry significantly predicted higher levels of PTG, while their depression symptoms predicted lower levels of PTG. Resilience and family connectedness significantly predicted higher levels of PTG, and distress tolerance significantly predicted lower levels of PTG after accounting for sociodemographic characteristics and negative influential factors. Compared to Whites, Asians were less likely to report PTG. In general, young adults have not perceived personal growth from the pandemic; however, young adults with certain psychosocial factors appear to be predisposed to such PTG. This study highlights the importance of exploring and elucidating the potential positive trajectories following the adversity of the COVID-19 pandemic.

Patterns of traumatic events and its relations with posttraumatic growth and religiosity in Iranian college students

BACKGROUND

Traumatic events and psychological damage are common. Identifying different types of traumatic events contributes to the development of psychopathology and can be very helpful in macroeducational and treatment planners. The current study extracted the patterns (overlap) of different traumatic events that Iranian college students commonly experience, with the aim of understanding their association with posttraumatic growth (PTG) and religiosity.

MATERIALS AND METHODS

Four hundred and sixty-six students from Kerman universities completed a cross-sectional survey about religion, and questions about PTG and traumatic events have experienced in the past 5 years. The latent class analysis (LCA) was used for extracting patterns of traumatic events, and the one-way ANOVA test was used to compare PTG and religiosity across these classes in Iranian college students.

RESULTS

The LCA revealed that a three-class solution had an adequate relative and absolute fit. The three classes were labeled and characterized as multiple-traumatic events (2.9%), intermediate-traumatic events (31.1%), and low-traumatic events (66.0%). In ANOVA results for PTG and Duke University Religion Index (DUREL) domains across classes, individuals in the multiple-traumatic classes had the lowest score of PTG and DUREL domains.

CONCLUSION

Although the current study showed the relative frequency of multiple-traumatic events in Iranian students is low, individuals categorized in this class had the lowest PTG, and these findings reveal the necessitation of planning and interventions for PTG.

The Chinese version of Posttraumatic Growth and Depreciation Inventory-Expanded version (PTGDI-X) for cancer survivors

Many patients with cancer report positive changes often referred to as posttraumatic growth (PTG). Some of these self-reported PTG may represent maladaptive illusions created by individuals to cope with the illness. A recently established Posttraumatic Growth and Depreciation Inventory - Expanded version (PTGDI-X) includes both PTG and posttraumatic depreciation (PTD) items. This inventory may provide a more balanced picture of the phenomenological world of cancer survivors. We examined the Chinese version of the PTGDI-X's applicability to cancer patients, and how PTG and PTD were related to posttraumatic stress symptoms. Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure posttraumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis showed that the factor structure of the PTGDI-X established in a multi-national study fit our data from cancer patients modestly well. The PTD score had a significant and positive correlation with PTSD symptoms, whereas the PTG and PTSD showed a significant curvilinear relationship in the form of an inverted U-shape. This study's results indicate that PTG and PTD are separated constructs with differential relationships with cancer outcomes. The Chinese version of the PTGDI-X is a viable instrument for psycho-oncological research. The PTD scores can provide useful information to guide cognitive interventions to reduce distorted cognitions. In contrast, the PTG scores can provide further information on the phenomenological world of cancer survivors. In this study, clinical implications and future studies were considered.

Relationships among non-interpersonal and interpersonal trauma types, posttraumatic stress, and posttraumatic growth

METHODS

Adults seeking behavioral health or medical treatment (N = 158) were recruited from a community healthcare agency and a residential support program in the southeastern United States.

RESULTS

Individuals who reported interpersonal trauma had significantly higher total PTS severity and symptom clusters. No significant difference was found in perceived PTG based on trauma type. No significant curvilinear relationship between PTS and perceived PTG was found. A significant negative linear relationship was observed between PTS and perceived PTG for non-interpersonal trauma, but not interpersonal trauma.

CONCLUSION

Trauma type may influence the PTS and perceived PTG relationship and, while associated with PTS, seems less important to reporting of perceived PTG.

Retrospective Accounts of Bullying Victimization at School: Associations with Post-Traumatic Stress Disorder Symptoms and Post-Traumatic Growth among University Students

This retrospective study investigated the association between bullying victimization experiences at school, current post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth (PTG) among Greek university students. A sample of 400 university students aged 17 to 40 years (M age = 20.33, SD = 3.18) completed self-reported scales measuring school bullying victimization experiences, post-traumatic stress disorder symptoms and post-traumatic growth. Results showed that victims of school bullying reported mild levels of PTSD and moderate feelings of post-traumatic growth. Females presented higher scores of post-traumatic growth. Duration and frequency of victimization of school bullying were found to present a significant effect on PTSD symptoms and PTG, respectively. Post-traumatic growth as a result of school-bullying victimization was related to PTSD symptom severity and this relationship was curvilinear. The findings have implications in terms of informing prospective interventions targeting the enhancement of students' sense of growth for handling peer aggression effectively.

Secondary traumatic stress, vicarious posttraumatic growth and their association in emergency room physicians and nurses

Background: Emergency room personnel are indirectly exposed to many traumas. Few studies have examined secondary traumatic stress in emergency room nurses and only a single study examined emergency room physicians. The extent of vicarious post-traumatic growth, i.e., the growth associated with such trauma, has also hitherto not been examined in emergency room personnel. Objective: Our first goal was to examine secondary traumatization in both emergency room nurses and physicians. Our second goal was to examine vicarious post-traumatic growth in emergency room personnel. Finally, we also address the association (linear and curvilinear) between secondary traumatization and vicarious traumatic growth. Methods: A questionnaire comprising demographic variables, secondary traumatic stress and vicarious post-traumatic growth was administered electronically to a sample of emergency room personnel from the Wolfson Hospital, Holon, Israel. Results: There were no differences between nurses and physicians in overall secondary trauma or vicarious post-traumatic growth levels. For physicians, there was both a linear and a curvilinear association between secondary trauma and vicarious post-traumatic growth; for nurses, there was no overall association. Further sub-group analyses revealed that emergency room nurses with low workload, in conjunction with low work experience, did show a linear association. Conclusion: Results indicate that while vicarious post-traumatic growth is linked to secondary traumatic stress for emergency room physicians, it is not so for nurses. Theoretical implications concerning the role of trauma symptoms in vicarious post-traumatic growth are discussed. Clinical implications are raised regarding the identification of excessive secondary traumatic stress levels and the need for interventions to both decrease stress levels, and to increase vicarious post-traumatic growth levels.

The Potential Unique Impacts of Hope and Resilience on Mental Health and Well-Being in the Wake of Hurricane Harvey

Natural disasters can lead to mental health problems, such as posttraumatic stress disorder (PTSD). Higher levels of loss and/or disruption and prior trauma exposure constitute risk factors for mental illness, whereas protective factors, including hope and resilience, support positive functioning. The present cross-sectional study used structural equation modeling to examine the relative influence of resilience and hope on mental health and well-being 1-3 months after Hurricane Harvey made landfall in August 2017, among a sample of 829 adults in the Greater Houston, Texas area. Resilience was more strongly associated with reduced PTSD symptoms, β = -.31, 95% CI [-.42, -.21], than was hope, β = -.17, 95% CI [-;.30, -.04], whereas hope was more strongly associated with components of well-being, βs = .47-.63. Hope was positively associated with posttraumatic growth, β = .30, 95% CI [.19, .41], whereas resilience was negatively associated with posttraumatic growth, β = -.24, 95% CI [-.35, -.12]. These associations remained consistent after considering risk factors, although more variance in trauma-related outcomes was risk factors were included in the model. The present results suggest that considering the influence of both risk and resilience factors provides an enhanced picture of postdisaster mental health.

Considering the Impact of Early Trauma on Coping and Pathology to Predict Posttraumatic Growth Among 9-1-1 Telecommunicators

Recent research has demonstrated that first responders may report posttraumatic growth (PTG), positive psychological changes that arise in the aftermath of a trauma. Less is known regarding the perception of PTG among 9-1-1 telecommunicators, a group of first responders exposed to a high degree of lifetime trauma, including duty-related trauma as well as early and non-duty-related trauma. Moreover, the impact of childhood trauma on the processes involved in the perception of growth is less clear. While some distress is needed to facilitate processes that lead to the perception of PTG, it has been suggested that positive associations between PTG and pathology reflect avoidant coping or represent an illusory component of PTG. Structural equation models were used to examine early trauma exposure, coping, and pathology in predicting PTG among 9-1-1 telecommunicators (N = 788). In separate models using active and avoidant forms of coping, childhood trauma exposure had an indirect effect on PTG through coping. In a model considering both forms of coping, childhood trauma had an indirect effect on PTG through psychopathology, but not through coping. The results show that early trauma exposure leads to the perception of growth through pathways indicative of both adaptive and maladaptive coping processes.

Local exposure to school shootings and youth antidepressant use

While over 240,000 American students experienced a school shooting in the last two decades, little is known about the impacts of these events on the mental health of surviving youth. Using large-scale prescription data from 2006 to 2015, we examine the effects of 44 school shootings on youth antidepressant use. Our empirical strategy compares the number of antidepressant prescriptions written by providers practicing 0 to 5 miles from a school that experienced a shooting (treatment areas) to the number of prescriptions written by providers practicing 10 to 15 miles away (reference areas), both before and after the shooting. We include month-by-year and school-by-area fixed effects in all specifications, thereby controlling for overall trends in antidepressant use and all time-invariant differences across locations. We find that local exposure to fatal school shootings increases youth antidepressant use by 21.4% in the following 2 y. These effects are smaller in areas with a higher density of mental health providers who focus on behavioral, rather than pharmacological, interventions.

Does event centrality mediate the effect of peritraumatic reactions on post-traumatic growth in survivors of a terrorist attack?

BACKGROUND

While self-reported post-traumatic growth (PTG) has been documented after a wide variety of potentially traumatic experiences, we need more knowledge on the mechanisms behind PTG to gain a better understanding of this phenomenon.

OBJECTIVE

We aimed to investigate the hypothesized mechanism of perceived event centrality as a mediator on the pathway between peritraumatic reactions and later PTG.

METHOD

In total, 204 survivors of the 2011 massacre on Utøya island, participated 4-5 months (T1), 14-15 months (T2), and 30-32 months (T3) post-terror. We applied counterfactually based causal mediation analysis to explore the potential mediating role of survivors' perceived centrality (T2) in linking their peritraumatic reactions (T1) and self-reported PTG (T3).

RESULTS

The vast majority of the survivors reported experiencing some positive changes post-terror, and we found a positive, significant association between survivor's peritraumatic reactions, perceived event centrality and self-reported growth. However, we did not find that centrality significantly mediated the longitudinal association between peritraumatic reactions and later PTG.

CONCLUSION

Reports of PTG are common post-terror, and peritraumatic reactions and perceptions of centrality may help explain individual differences in trauma survivors' level of PTG. Perceived event centrality about one year post-trauma does not appear to explain the relationship between initial reactions to trauma and subsequent PTG.

Combat Experiences Link With Posttraumatic Growth Among Veterans Across Conflicts: The Influence of PTSD and Depression

Research has established posttraumatic growth as a potential outcome of highly stressful experiences such as combat. However, a deeper understanding of this relationship is needed to provide practical implications for clinical work and to influence new research directions. We examined the relation between combat experiences and posttraumatic growth along with its subscales, as well as the influence of posttraumatic stress disorder and depression symptom severity. The study contained a sample of 130 combat veterans representing a variety of deployment locations. Regression analysis revealed combat experiences to be associated with posttraumatic growth beyond the effect of age (β = 0.21; p = 0.014). In addition, the association between combat experiences and posttraumatic growth was most evident among those endorsing low levels of depression symptom severity (partial η squared = 0.07; p = 0.009). These results highlight the need to consider negative cognitions and other depressive symptoms as potential barriers to posttraumatic growth.

Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem

We evaluated the level of post-traumatic growth in a large sample of Chinese adolescent earthquake survivors (n = 5195) and relationships among self-esteem, post-traumatic stress disorder, and post-traumatic growth. This cross-sectional study indicated that the prevalence of post-traumatic growth among adolescent survivors was 14.8 percent. Post-traumatic growth was independently associated with self-esteem, severity of exposures, and avoidance facets of post-traumatic stress disorder. Post-traumatic stress disorder was found to be partially mediated by self-esteem on post-traumatic growth; and post-traumatic stress disorder was also a mediator between earthquake exposure and post-traumatic growth. This study suggests that future longitudinal research and clinical practice should test whether promoting self-esteem can enhance post-traumatic stress disorder treatment.

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

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

The Effect of Cognitive-Emotional Intervention on Growth and Posttraumatic Stress in Mothers of Children With Cancer: A Randomized Clinical Trial

BACKGROUND

To diminish the negative impact and improve the positive outcomes on the parents of children with cancer, it is crucial to attend to their problems. This is especially significant in the case of mothers as the main caregivers. The present study aimed at evaluating the efficiency of cognitive-emotional intervention on growth and posttraumatic stress in mothers of children with cancer hospitalized in the chemotherapy ward.

PROCEDURE

This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of a hospital located in southeastern Iran in 2018. The eligible mothers were chosen and randomly assigned to intervention and control groups. Mothers in the intervention group as a whole received 5 sessions of cognitive-emotional intervention. The sessions were held twice a week, each lasting 60 to 90 minutes. Sixteen weeks after the intervention, posttest data were collected through the Posttraumatic Stress Disorder Checklist and Posttraumatic Growth Inventory. The data were then analyzed using SPSS 21 utilizing statistical tests including independent and paired t tests, χ, and covariance analysis.

RESULTS

The results show that the mean value of posttraumatic stress in mothers of children with cancer after cognitive-emotional training in the intervention group (25.92±5.29) was significantly lower than that in the control group (44.94±11.92; P=0.0001). Moreover, in the posttest, the mean value of posttraumatic growth in the intervention group (92.06±5.50) was significantly more than that in the control group (62.98±15.08; P=0.0001).

CONCLUSIONS

Alleviating posttraumatic stress, the cognitive-emotional intervention proposed in this research had a significant and positive impact on posttraumatic growth in mothers of children diagnosed with cancer. Therefore, implementing this intervention in the chemotherapy department and throughout the course of the children's treatment is highly recommended for their caregivers, especially mothers of children diagnosed with cancer.

Posttraumatic Growth in Tibetan Adolescent Survivors 6 Years After the 2010 Yushu Earthquake: Depression and PTSD as Predictors

This cross-sectional study explored the prevalence of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) in Tibetan adolescent survivors (98% Tibetan and 2% Han) 6 years after the 2010 Yushu earthquake to identify the PTG predictors. In 2016, 850 high school students (from 11 to 20 years) in Yushu (N = 850) completed the self-rating depression scale, the PTSD Check List-Civilian version, the exposure degree scale, and the posttraumatic growth inventory. It was found that the PTG and probable PTSD prevalence rates were 49.7% and 8.9% 6 years after the earthquake, and that exposure level, depression level, and PTSD symptoms were all significant negative predictors for PTG in both the junior high school and senior high school students. Specifically, having a lower degree of exposure, a lower PTSD level, and no depression symptoms were associated with higher PTG. There was a significant PTG difference found between males and females; however, this gender difference was not found in the senior high school students. No significant PTG differences were found for the different ethnicities. The implications of the results and the limitations of this study are discussed.

Post-Traumatic Growth, Dissociation, and Sexual Revictimization in Female Childhood Sexual Abuse Survivors

BACKGROUND

Childhood sexual abuse (CSA) survivors are at high risk of sexual revictimization. At the same time, some survivors report positive transformations resulting from the traumatic experience, a phenomenon known as post-traumatic growth (PTG). Although one might expect PTG to be related to reduced risk of revictimization, the link between PTG and revictimization has not been investigated. Furthermore, mixed findings regarding the associations between PTG and distress imply that the effects of PTG are multifaceted. One potential explanation may be that dissociation shapes the implications of PTG, making it more like denial than adaptive processing of traumatic experience. This longitudinal study explores (a) the associations between PTG and sexual revictimization and (b) the moderating role of dissociation within the associations between PTG and revictimization.

METHOD

Participants were 111 female CSA survivors who participated in a 6-month efficacy trial evaluating the effectiveness of group psychotherapy for CSA survivors with HIV risk factors.

RESULTS

Dissociation moderated the associations between PTG and revictimization: Whereas PTG had nonsignificant effects on revictimization in participants with low dissociation, it predicted elevated levels of revictimization in participants with high dissociation.

CONCLUSIONS

Reports of PTG among some CSA survivors might mirror dissociative beliefs that increase their risk of revictimization.

Rumination mediates the relationships of fear and guilt to posttraumatic stress disorder and posttraumatic growth among adolescents after the Ya'an earthquake

Background: Although previous research has demonstrated that fear and guilt have an effect on posttraumatic stress disorder (PTSD), it is still unclear how these two emotions affect posttraumatic growth (PTG). Moreover, few studies have examined the mechanisms by which fear and guilt affect PTSD and PTG. Guided by Lee et al.'s theory of PTSD generation mechanisms and Calhoun and Tedeschi's PTG theory, the current study proposes that intrusive rumination (IR) and deliberate rumination (DR) may play a mediating role in the effects of guilt and fear on PTSD and PTG. Objective: This study aimed to simultaneously examine the mediating roles of IR and DR in the relationship between fear, guilt, PTSD, and PTG. Method: This study employed a two-wave longitudinal design. A total of 408 adolescent survivors were assessed using self-report questionnaires after the Ya'an earthquake in China. Measures were obtained for trauma exposure, subjective fear, survivor guilt, IR, and DR at three and a half years after the Ya'an earthquake (Time 1), while PTSD and PTG were assessed at time point four and a half years after the Ya'an earthquake (Time 2). Results: The results showed that both fear and guilt had a direct and positive effect on PTSD and PTG. Fear and guilt were positive predictors of PTSD and negative predictors of PTG through the mediating variable of IR. DR mediated the relationship between guilt and PTG but not PTSD, and also mediated the relationship between IR and PTG. Conclusions: Study findings indicate that fear, guilt, and intrusive rumination may contribute to PTSD symptoms in adolescent trauma survivors. Results also suggest that adolescent survivors can grow emotionally and psychologically following traumatic events, and that directed rumination may contribute to such growth. Interventions that reduce fear, guilt, and intrusive rumination while increasing directed rumination may assist adolescent trauma survivors in recovery and growth.

Sexual Assault Survivors' Post-Traumatic Growth: Individual and Community-Level Differences

Past research has focused on individual differences in post-traumatic growth (PTG) among survivors, but no studies to date have examined differences at the neighborhood level. This exploratory study uses data from a 3-year longitudinal study of women sexual assault survivors (N = 1,863) living in a segregated city. We tested random intercept models of individuals nested within neighborhoods. Disrupted core beliefs, greater perceived control over recovery, less post-traumatic stress disorder (PTSD), religious coping, and positive social coping predicted more PTG. White survivors had lower PTG scores than the women of color in this study. Neighborhood-level differences in PTG scores persisted even though violent crime rate and neighborhood poverty did not emerge as significant in our model.

Gratitude Moderates the Mediating Effect of Deliberate Rumination on the Relationship Between Intrusive Rumination and Post-traumatic Growth

PURPOSE

This study examines the moderating effect of gratitude on the mediating effect of deliberate rumination on the relationship between intrusive rumination and post-traumatic growth (PTG).

METHODS

We used self-report questionnaires to collect data from 450 18-68-year-old participants (Mage = 39.73, SD = 13.73) residing in major cities and regions across South Korea. Data that were collected from 411 participants were subjected to analysis. Version 25 of SPSS (Statistical Package for Social Science) and PROCESS macro were used to analyze mediation, moderation, and moderated mediation effects.

RESULTS

Deliberate rumination mediated the relationship between intrusive rumination and PTG. Gratitude moderated the effect of deliberate rumination on PTG. Finally, gratitude moderated the mediating effect of deliberate rumination on the relationship between intrusive rumination and PTG.

CONCLUSION

Deliberate rumination and gratitude facilitate PTG for traumatized adults. In particular, gratitude reinforces the effect of deliberate rumination on PTG.

Validation of the Core Beliefs Inventory (CBI) in Brazilian Portuguese

INTRODUCTION

Experiencing trauma may entail psychopathological consequences, but also changes considered to be positive (i.e., posttraumatic growth). For positive change to occur, an impact on the beliefs of individuals is required, which may be measured through the Core Beliefs Inventory (CBI). The objective of this study was to validate the Brazilian Portuguese version of the CBI.

METHODS

A total of 248 university students (65.7% female) answered the following assessment instruments: sociodemographic data sheet, Posttraumatic Growth Inventory (PTGI), Posttraumatic Symptoms Checklist - Clinician Version (PCL-5) and the CBI. Psychometric properties of the CBI were assessed by conducting an exploratory factor analysis through a principal component analysis with varimax rotation. Internal consistency (Cronbach's α) and convergent validity (Pearson correlation between instruments) were also investigated.

RESULTS

The total scale showed adequate internal consistency (α = 0.83). A single factor solution explained 42.63% of the variance of the CBI. Significant correlations were found between CBI and PTGI, and between CBI and PCL-5.

CONCLUSION

The psychometric properties indicated adequate internal consistency and construct validity of the Brazilian Portuguese version of the CBI.

Steeling in Later Life: Exploring Age-Specific Effects of Varying Levels of Stress on Psychological Resilience

The steeling effect suggests that "optimal" stress positively affects well-being by enhancing resilience. However, there is lack of longitudinal investigations in diverse age groups. The aim was to explore steeling in later life and potential predictors. The sample consisted of N = 195 participants. A 1-year longitudinal survey study was conducted. Sociodemographics, experienced stress, resilience resources, and satisfaction with life were assessed. Latent profile analysis was used to identify profiles that differ in the change of resilience resources over time and to examine differences between the profiles across the other study variables. Three profiles emerged: decreased resources (Decrease), stability of resources (Maintenance), and increased resources (Increase). "Decrease" was characterized by low, Maintenance by moderate, and Increase by high stress. Age influenced profile membership. While the results failed to support the classic steeling effect, with high stress associated with increased resilience resources, optimal stress was associated with the maintenance of resilience resources.