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Huang H, Liu T, Peng Y, Du X, Huang Q, Zhao Q, Xiao M, Luo Y, Zheng S. "Learn from Errors": Post-traumatic growth among second victims. BMC Public Health 2024; 24:2330. [PMID: 39198793 PMCID: PMC11350947 DOI: 10.1186/s12889-024-19738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 08/08/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Second victims, defined as healthcare providers enduring emotional and psychological distress after patient safety incidents (PSIs). The potential for positive transformation through these experiences is underexplored but is essential for fostering a culture of error learning and enhancing patient care. OBJECTIVE To explore the level and determinants of post-traumatic growth (PTG), applying the stress process model. METHODS The study was conducted at a tertiary general hospital in Chongqing, China. A descriptive, cross-sectional study design was used. A total of 474 s victims were included. An online survey was conducted in November 2021 to assess various factors related to the second victim experience. These factors included PSIs (considered as stressors), coping styles, perceived threats, and social support (acting as mediators), as well as the outcomes of second victim syndrome (SVS) and PTG. Statistical description, correlation analysis, and structural equation modeling were utilized for the data analysis. A p-value ≤ 0.05 was considered to indicate statistical significance. RESULTS The participants reported moderate distress (SVS = 2.84 ± 0.85) and PTG (2.72 ± 0.85). The total effects on SVS of perceived threat, negative coping, social support, positive coping, and PSIs were 0.387, 0.359, -0.355, -0.220, and 0.115, respectively, accounting for 47% of the variation in SVS. The total effects of social support, positive coping, and PSIs on PTG were 0.355, 0.203, and - 0.053, respectively, accounting for 19% of the variation in PTG. CONCLUSIONS The study provides novel insights into the complex interplay between perceived threats, coping styles, and social support in facilitating PTG among second victims. By bolstering social support and promoting adaptive coping strategies, the adverse effects of PSIs can be mitigated, transforming them into opportunities for resilience and growth, and offering a fresh perspective on managing PSIs in healthcare settings.
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Affiliation(s)
- Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Tong Liu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Ying Peng
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xingyao Du
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Qi Huang
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China.
| | - Shuangjiang Zheng
- Department of Medical Affairs, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Anisman H, Doubad D, Asokumar A, Matheson K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. Neurosci Biobehav Rev 2024; 165:105859. [PMID: 39159733 DOI: 10.1016/j.neubiorev.2024.105859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 08/06/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024]
Abstract
Anisman, H., Doubad, D., Asokumar, A. & Matheson, K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. NEUROSCI BIOBEHAV REV, XXXX. Immigration occurs between countries either to obtain employment, for family reunification or to escape violence and other life-threatening conditions. Refugees and asylum seekers are often obligated to overcome a uniquely challenging set of circumstances prior to and during migration. Settlement following immigration may pose yet another set of stressors related to acculturation to the host country, as well as financial insecurity, discrimination, language barriers, and social isolation. Here we discuss the multiple consequences of immigration experiences, focusing on the health disturbances that frequently develop in adults and children. Aside from the psychosocial influences, immigration-related challenges may cause hormonal, inflammatory immune, and microbiota changes that favor psychological and physical illnesses. Some biological alterations are subject to modification by epigenetic changes, which have implications for intergenerational trauma transmission, as might disruptions in parenting behaviors and family dysfunction. Despite the hardships experienced, many immigrants and their families exhibit positive psychological adjustment after resettlement. We provide information to diminish the impacts associated with immigration and offer strength-based approaches that may foster resilience.
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Affiliation(s)
- H Anisman
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada.
| | - D Doubad
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - A Asokumar
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - K Matheson
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
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Weiss-Dagan S, Taubman-Ben-Ari O. Perceived stress and personal growth following the transition to military service: The role of sense of coherence and perceived social support. Stress Health 2024; 40:e3406. [PMID: 38646939 DOI: 10.1002/smi.3406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/04/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
Relying on personal growth and structuration theories, we aimed to examine the internal (sense of coherence/SOC and help-seeking/HS) and external (perceived social support) resources that contribute to soldiers' personal growth following the transition to military service. We also investigated the role that perceived social support plays in moderating the relationship between SOC and personal growth, and between HS and personal growth. Two-hundred-and-seventy-one compulsory service soldiers (of whom 135 were men and 136 were women) completed self-report questionnaires between 6 and 12 months post-recruitment. The results showed both linear and curvilinear associations between soldiers' perceived stress and personal growth; SOC, HS, and perceived social support were positively correlated with personal growth; and perceived social support moderated both SOC and HS correlations with personal growth. Empirical evidence of personal growth in the transition to military service has been scant. Transitioning from civilian life to military service can be stressful and even traumatic but it can also provide opportunities for personal development. Our findings shed light on contributors to personal growth in the transition to military service, with both internal and external resources found to help one gain personal growth. It is evident that in order for soldiers to thrive, both perceived social support and active help-seeking are key factors.
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Affiliation(s)
- Shlomit Weiss-Dagan
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Orit Taubman-Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
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4
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Gower T, Fischer IC, Tsai J, Kang H, Na PJ, Tedeschi RG, Pietrzak RH. Functional significance of posttraumatic growth in U.S. military veterans. J Affect Disord 2024; 356:267-273. [PMID: 38614442 DOI: 10.1016/j.jad.2024.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Although many studies indicate that individuals who have experienced a traumatic event can experience posttraumatic growth (PTG), some researchers have questioned the significance of PTG in associations with functioning. The role of PTG in functioning following trauma may be better elucidated by accounting for its joint effects with posttraumatic stress disorder (PTSD) symptoms. METHODS Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3847 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 PTG was independently and moderately associated with higher mental, cognitive, and psychosocial functioning, but not physical functioning. Results showed a similar pattern of findings when examining relations between subdomains of PTG and these aspects of functioning. Additionally, among veterans who screened positive for PTSD, those who endorsed PTG reported higher levels of mental, cognitive, and/or psychosocial functioning than those who did not endorse PTG. LIMITATIONS Findings may be limited by the use of a cross-sectional design, retrospective self-reports of PTG, and a predominantly older white male veteran sample. CONCLUSION Results provide support for the functional significance of PTG and highlight the importance of considering PTSD symptoms to better understand the role of PTG in functioning. Clinical interventions to foster PTG may help promote post-trauma functioning.
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Affiliation(s)
- Tricia Gower
- Veterans Affairs Maryland Healthcare System, Baltimore, MD, United States of America
| | - Ian C Fischer
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jack Tsai
- U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Washington, DC, USA; School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hun Kang
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Richard G Tedeschi
- Boulder Crest Institute for Posttraumatic Growth, Bluemont, VA, United States
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
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Zerach G. Constellations of posttraumatic stress symptoms and posttraumatic growth among Israeli female combat veterans: A latent profile analysis approach. J Clin Psychol 2024; 80:1377-1390. [PMID: 38401144 DOI: 10.1002/jclp.23671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Posttraumatic stress disorder symptoms (PTSS) and posttraumatic growth (PTG) are possible reactions to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about patterns of both PTSS and PTG among female combat veterans is sparse. This study examines constellations of PTSS and PTG among Israeli female combat veterans, as well as military-related exposure and positive psychological correlates of these constellations. METHODS A volunteer sample of Israeli women combat veterans (n = 885) responded to self-report questionnaires in a cross-sectional design study. RESULTS Latent profile analysis (LPA) was used to identify four profiles characterized by unique constellations of PTSS and PTG: moderate PTSS and high PTG (33%), moderate PTSS and moderate PTG (30%), low PTSS and high PTG (30%), and low PTSS and PTG (5.5%). Higher levels of combat experiences were associated with higher odds of inclusion in the moderate PTSS and high PTG and moderate PTSS and moderate PTG profiles. Moreover, compared to the other classes, both low PTSS and high PTG and moderate PTSS and high PTG classes were associated with higher levels of satisfaction with life and happiness psychological outcomes. CONCLUSION The study's findings offer an overview of the complex pattern of associations between PTSS, PTG, and associated predictors and outcomes. Clinicians treating female veterans should be aware of the varying reactions to military service challenges, including the presence of moderate to high levels of PTG reactions in addition to PTSS.
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Affiliation(s)
- Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
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Li Q, Zhu Y, Qi X, Lu H, Han N, Xiang Y, Guo J, Wang L. Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review. BMC Public Health 2024; 24:460. [PMID: 38355487 PMCID: PMC10865690 DOI: 10.1186/s12889-023-17591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/26/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has imposed unprecedented stress and challenges upon medical staff, potentially resulting in posttraumatic growth (PTG). This scoping review aims to synthesize the existing knowledge on PTG among medical staff during the pandemic by identifying its current status and potential influencing factors. The findings may provide a foundation for future research and interventions to enhance the medical staff's psychological resilience and well-being. METHODS Literature was systematically searched on PTG among medical staff during the COVID-19 pandemic from 01 January 2020 to 31 December 2022. The following databases were searched: PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Data. Eligibility criteria included: (1) medical staff as research subjects; (2) a focus on "posttraumatic growth" or "alternative posttraumatic growth" related to the COVID-19 outbreak and pandemic; (3) discussion of the situation and influencing factors of PTG; and (4) study types, such as qualitative, quantitative, and mixed methods. Two researchers independently selected and extracted study characteristics (study design, study population, region, measurement instruments, and primary outcomes) from the included literature. The data were synthesized qualitatively and descriptively. RESULTS Thirty-six papers from 12 countries met the inclusion criteria. Moderate PTG levels were observed among healthcare workers during the COVID-19 pandemic, with emphasis on "interpersonal relationships," "changes in life philosophy," and "growth in personal competence." Influencing factors included trauma exposure, sociodemographics, psychological characteristics (resilience and positive qualities), coping, and social support. CONCLUSIONS This review discovered moderate PTG levels among medical staff during the COVID-19 pandemic, with critical areas in interpersonal relationships, life philosophy, and personal competence. The identified influencing factors can inform future research and interventions to enhance healthcare workers' psychological resilience and well-being.
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Affiliation(s)
- Qian Li
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Yirong Zhu
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Xuefeng Qi
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Haifei Lu
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Nafei Han
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Yan Xiang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Jingjing Guo
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China
| | - Lizhu Wang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China.
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Eyni S, Hashemi Z, Mousavi SE, Taghavi R. Spirituality, Trait Gratitude, and Post-Traumatic Growth in Iranian Veterans with PTSD: The Mediating Role of Ego Resilience. JOURNAL OF RELIGION AND HEALTH 2023; 62:4072-4087. [PMID: 36670213 DOI: 10.1007/s10943-023-01741-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
In Iran, spirituality is one of the most critical factors affecting veterans' health. The present study aimed to determine the mediating role of ego resilience in the relationship between spirituality and trait gratitude with post-traumatic growth in Iranian veterans with PTSD. In the present descriptive and correlational study, 300 veterans with PTSD were hospitalized and treated at Isar Psychiatric Hospital in Ardabil in 2021 and were selected as the sample. Data were collected using Tedeschi and Calhoun's Traumatic Developmental Questionnaire, Parsian and Dunning, Mc Cullough et al.'s Trait Gratitude Questionnaire, and Block et al.'s Ego Resilience Questionnaire. Based on the obtained results and various fit indices, the direct and indirect relationships between spirituality, trait gratitude, ego resilience, and post-traumatic growth in veterans with post-traumatic stress disorder were confirmed (p < 0.01). Also, spirituality and trait gratitude through ego resilience indirectly affected the post-traumatic growth of veterans with PTSD (P < 0.05). Thus, targeting these three components through psychological therapies may effectively increase post-traumatic growth in veterans experiencing trauma.
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Affiliation(s)
- Sanaz Eyni
- Department of Psychology, University of Kurdistan, Sanandaj, Iran.
| | - Zohreh Hashemi
- Department of Psychology, University of Maragheh, Maragheh, Iran
| | - Seyede Elham Mousavi
- Department of Educational Science, Psychological Counseling and Guidance Branch, Ataturk University, Erzurum, Turkey
| | - Ramin Taghavi
- Psychiatric Ward, Isar Psychiatric Hospital, Ardabil, Iran
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Russell B, Mussap AJ. Rumination and threat-biased interpretation mediate posttraumatic stress and growth responses to military stressors. MILITARY PSYCHOLOGY 2023; 35:451-466. [PMID: 37615560 PMCID: PMC10453989 DOI: 10.1080/08995605.2022.2127618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
We examined the role of rumination and threat-biased interpretation in stress and growth responses to military stressors. Two online surveys were completed by 183 (survey 1) and 393 (survey 2) currently serving or retired military personnel. The surveys measured exposure to potential military stressors (exposure to combat, witnessing the consequences of war, and perceived moral injury), posttraumatic stress symptomatology (PTSS), posttraumatic growth (PTG), and personal wellbeing, with survey 1 including measures of rumination, and survey 2 including a measure of threat-biased interpretation. Path analyses revealed that indirect paths from both witnessing the consequences of war and experiencing betrayal to PTSS were mediated by intrusive rumination and threat-biased interpretation, and that indirect paths from both betrayal and transgressions by others to PTG were mediated by deliberate rumination and threat-biased interpretation. The results reveal the idiosyncratic nature of military stressors, their differential involvement with cognitions that underpin rumination about past events and interpretation of current events, and their relevance to posttraumatic stress and growth in military personnel.
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Affiliation(s)
- Brenton Russell
- School of Psychology, Deakin University, Melbourne, Australia
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Tu AK, Restivo Haney J, O'Neill K, Swaminathan A, Choi KW, Lee H, Smoller JW, Patel V, Barreira PJ, Liu CH, Naslund JA. Post-traumatic growth in PhD students during the COVID-19 pandemic. PSYCHIATRY RESEARCH COMMUNICATIONS 2023; 3:100104. [PMID: 36743383 PMCID: PMC9886426 DOI: 10.1016/j.psycom.2023.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023]
Abstract
Throughout the COVID-19 pandemic, graduate students have faced increased risk of mental health challenges. Research suggests that experiencing adversity may induce positive psychological changes, called post-traumatic growth (PTG). These changes can include improved relationships with others, perceptions of oneself, and enjoyment of life. Few existing studies have explored this phenomenon among graduate students. This secondary data analysis of a survey conducted in November 2020 among graduate students at a private R1 University in the northeast United States examined graduate students' levels and correlates of PTG during the COVID-19 pandemic. Students had a low level of PTG, with a mean score of 10.31 out of 50. Linear regression models showed significant positive relationships between anxiety and PTG and between a measure of self-reported impact of the pandemic and PTG. Non-White minorities also had significantly greater PTG than White participants. Experiencing more negative impact due to the pandemic and ruminating about the pandemic were correlated with greater PTG. These findings advance research on the patterns of PTG during the COVID-19 pandemic and can inform future studies of graduate students' coping mechanisms and support efforts to promote pandemic recovery and resilience.
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Affiliation(s)
- Allison K. Tu
- Harvard College, 86 Brattle Street, Cambridge, MA, 02138, USA,Corresponding author
| | - Juliana Restivo Haney
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA,Department of Psychology, West Virginia University, West Virginia University, Morgantown, WV, 26506, USA
| | - Kathryn O'Neill
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
| | - Akshay Swaminathan
- Stanford University, School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA
| | - Karmel W. Choi
- Harvard T.H. Chan School of Public Health, Massachusetts General Hospital, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Hyunjoon Lee
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Jordan W. Smoller
- Massachusetts General Hospital, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Paul J. Barreira
- Office of the Provost and Harvard Medical School, Harvard University, Massachusetts Hall, Cambridge, MA, 02138, USA
| | - Cindy H. Liu
- Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
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Kalvesmaki AF, Gonzales E, George RT, Nguyen H, Pugh MJ. Post-9/11 veterans perceptions of the pandemic: Areas of greatest impact on health and well-being. PEC INNOVATION 2022; 1:100096. [PMID: 36348640 PMCID: PMC9635259 DOI: 10.1016/j.pecinn.2022.100096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 11/08/2022]
Abstract
Objective Assess potential impacts of the COVID-19 pandemic on a subset of Post-9/11 U.S. Veterans included in a study of post-traumatic epilepsy (PTE). Methods Two measures were added to a structured health interview for Veterans during temporary pandemic research shutdown: a validated health questionnaire [1] previously completed by survey, and a semi-structured instrument developed to assess whether pandemic conditions affected responses to the health questionnaire and identify unique impacts. Interviews were conducted between August 2020 – February 2021. Scaled items were calculated and t-tests used to compare results. Open-ended items were coded using thematic analyses. Results Veterans identified eight major areas of impact with negative and positive impacts: mental health, family, social, work/employment, access to resources, physical health, finances, and education. Innovation The temporary shut-down of a large health study for Post-9/11 Veterans provided an opportunity to devise an instrument to assess COVID-19's impact on health and well-being. The instrument was accepted as of the first Veteran instrument in a pandemic SDOH research repository [2], and is being used in other studies. Conclusion This study highlights the need to assess and understand interrelated relationships of factors impacting health and well-being, especially as COVID-19 moves from pandemic to endemic with reverberating effects across multiple social determinants of health (SDOH).
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Alper HE, Feliciano L, Millien L, Pollari C, Locke S. Post-Traumatic Growth and Quality of Life among World Trade Center Health Registry Enrollees 16 Years after 9/11. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9737. [PMID: 35955093 PMCID: PMC9368472 DOI: 10.3390/ijerph19159737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
A recent study of World Trade Center Health Registry enrollees found that about one-third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees' overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental functioning quality of life scales in a sample of 4760 enrollees from the Registry's Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry's baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sociodemographic and other variables. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: b = 0.15 (-0.45, 0.75), mental: b = 3.61 (2.85, 4.37)). Those who were physically injured during 9/11 showed larger improvements in mental functioning than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.
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Affiliation(s)
- Howard E. Alper
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Leen Feliciano
- Graduate School of Public Health and Health Policy, The City University of New York, New York, NY 10027, USA
| | - Lucie Millien
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Cristina Pollari
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
| | - Sean Locke
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Division of Epidemiology, New York, NY 11101, USA
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Harwood-Gross A, Weltman A, Kanat-Maymon Y, Pat-Horenczyk R, Brom D. Peace of mind: Promoting psychological growth and reducing the suffering of combat veterans. MILITARY PSYCHOLOGY 2022. [DOI: 10.1080/08995605.2022.2044119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anna Harwood-Gross
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
- METIV, The Israel Psychotrauma Center, Jerusalem, Israel
| | - Alon Weltman
- METIV, The Israel Psychotrauma Center, Jerusalem, Israel
| | - Yaniv Kanat-Maymon
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Ruth Pat-Horenczyk
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Danny Brom
- METIV, The Israel Psychotrauma Center, Jerusalem, Israel
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Feingold JH, Hurtado A, Feder A, Peccoralo L, Southwick SM, Ripp J, Pietrzak RH. Posttraumatic growth among health care workers on the frontlines of the COVID-19 pandemic. J Affect Disord 2022; 296:35-40. [PMID: 34587547 PMCID: PMC8526329 DOI: 10.1016/j.jad.2021.09.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/31/2021] [Accepted: 09/12/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The COVID-19 pandemic has led to significant mental health consequences for frontline health care workers (FHCWs). However, no known study has examined the prevalence, determinants, or correlates of posttraumatic growth (PTG) in this population. METHODS Data were analyzed from a prospective cohort of FHCWs at an urban tertiary care hospital in New York City (NYC). Assessments were conducted during the spring 2020 pandemic peak (Wave 1) and seven months later (Wave 2). Multivariable logistic regression analyses were conducted to identify Wave 1 sociodemographic, occupational, and psychosocial factors associated with PTG at Wave 2, and the association between aspects of PTG with burnout and pandemic-related PTSD symptoms at Wave 2. RESULTS A total 76.8% of FHCWs endorsed moderate or greater PTG; the most prevalent domains were increased appreciation of life (67.0%), improved relationships (48.7%), and greater personal strength (44.1%). Non-White race/ethnicity, greater levels of positive emotions, pandemic-related PTSD symptoms, dispositional gratitude, and feelings of inspiration were independently associated with PTG. At Wave 2, endorsement of spiritual growth during the pandemic was associated with 52% and 44% lower odds of screening positive for pandemic-related PTSD symptoms and burnout, respectively; greater improvement in relationships was associated with 36% lower odds of screening positive for burnout. LIMITATIONS Single institution study and use of self-report instruments. CONCLUSIONS Nearly 4-of-5 FHCWs report pandemic-related PTG, driven largely by salutogenic factors assessed during the pandemic surge. Interventions to bolster these factors may help promote PTG and mitigate risk for burnout and pandemic-related PTSD symptoms in this population.
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Affiliation(s)
- Jordyn H. Feingold
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, United States,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States,Corresponding author at: One Gustave L. Levy Place, Box 1002, New York, NY 10029, United States
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Lauren Peccoralo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Steven M. Southwick
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States
| | - Jonathan Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States,U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, United States,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States
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Kangaslampi S, Peltonen K, Hall J. Posttraumatic growth and posttraumatic stress - a network analysis among Syrian and Iraqi refugees. Eur J Psychotraumatol 2022; 13:2117902. [PMID: 36186157 PMCID: PMC9518504 DOI: 10.1080/20008066.2022.2117902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Traumatic events related to war and displacement may lead to development of posttraumatic stress symptoms (PTSS), but many war trauma survivors also report experiencing posttraumatic growth (PTG). However, the phenomenon of PTG remains poorly understood among refugees. Previous findings are also contradictory on whether more PTSS associate with PTG and what specific symptoms or aspects of growth may account for any possible link. OBJECTIVE AND METHOD Here, we aimed to better understand posttraumatic growth among refugees, especially its structure and most important constituent elements, as well as how it associates with PTSS. We employed regression and network analysis methods with a large sample (N = 3,159) of Syrian and Iraqi refugees living in Turkey self-reporting on PTG and PTSS. RESULTS We found PTG and PTSS to be clearly distinct phenomena. Still, they often co-occurred, with a positive, slightly U-shaped relationship found between levels of PTSS and PTG. The main bridge between the constructs was identified from intrusive symptoms to having new priorities in life, although new priorities were more peripheral to the overall network structure of PTG. Meanwhile, discovering new psychological strengths and abilities and a new path in life emerged as elements most central to PTG itself. CONCLUSIONS Many refugees report elements of PTG, even as they suffer from significant PTSS. The two phenomena appear distinct but positively associated, supporting the idea that intense cognitive processing involving distress may be necessary for growth after trauma. Our findings may inform efforts to support refugee trauma survivors in finding meaning and perhaps even growth after highly challenging experiences.
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Affiliation(s)
- Samuli Kangaslampi
- Faculty of Social Sciences / Psychology, Tampere University, Tampere, Finland
| | - Kirsi Peltonen
- Department of Psychology, University of Turku, Turku, Finland.,INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Jonathan Hall
- Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden
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Zhang N, Xiang X, Zhou S, Liu H, He Y, Chen J. Physical activity intervention and posttraumatic growth: A systematic review and meta-analysis. J Psychosom Res 2021; 152:110675. [PMID: 34823114 DOI: 10.1016/j.jpsychores.2021.110675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 01/09/2023]
Affiliation(s)
- Ni Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, MI, United States.
| | - Shanshan Zhou
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China.
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jieling Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Park J, Lee J, Kim D, Kim J. Posttraumatic growth and psychosocial gains from adversities of korean special forces: a consensual qualitative research. CURRENT PSYCHOLOGY 2021; 42:10186-10199. [PMID: 34566389 PMCID: PMC8455156 DOI: 10.1007/s12144-021-02308-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
Because military special forces carry out dangerous missions, they are much more exposed to adversities and traumatic events compared to other occupational groups. According to Posttraumatic Growth theory, individuals tend to obtain positive growth through adversities. Moreover, a framework of Psychosocial Gains from Adversity argues not only individual changes but also social changes in the group to which the individual belongs are induced. Therefore, the present study aimed to explore the adverse experiences of special forces operatives and delineate the positive shift at an individual and social level via Consensual Qualitative Research (CQR). Eight individuals serving in special forces at the Korean Army, Navy and Air Force were interviewed using a semi-structured protocol. Four domains including 10 categories and 34 subcategories were identified: (a) Adverse experiences; (b) Personal change; (c) Social change; and (d) Attributes related to adverse experience. The findings and clinical implications are discussed in light of growth over facing adversities and interaction between personal and social factors.
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Affiliation(s)
- Junsang Park
- Department of Education, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Jungmin Lee
- Hannam University, Hannam-ro 70, Daedeok-gu, Daejeon, South Korea
| | - Daewon Kim
- Department of Education, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, South Korea
| | - Joonsuk Kim
- The Catholic University of Korea, Eunpyeong St. Mary's Hospital, 1021, Tongil-ro, Eunpyeong-gu, Seoul, South Korea
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Livneh H. Psychosocial Adaptation to Chronic Illness and Disability: An Updated and Expanded Conceptual Framework. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211034819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The article revisits and updates an earlier model (Livneh, 2001) that examined the building blocks that constitute the dynamics of psychosocial adaptation to chronic illness and disability (CID). In the revised tripartite model, the author reconstructs and refines the earlier model based on recent theoretical formulations, clinical reviews and research findings. In the revised model, the author discusses three overarching components, namely, antecedents (causes of medical conditions, background variables), processes (the dynamically unfolding course of post-CID events), and outcomes (anticipated exit indicators that serve, as snapshot end products, to assess the individual’s experienced and reported quality of life following onset of CID). The article concludes with a brief review of the model’s practical and research implications.
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