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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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K. NVSL, Rajkumar E, Gopi A, Hareesh PV, Romate J, Lakshmi R, Abraham J. Correlates of post-traumatic growth among persons bereaved from cancer: A systematic review and meta-analysis. PLoS One 2024; 19:e0300291. [PMID: 38489290 PMCID: PMC10942051 DOI: 10.1371/journal.pone.0300291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Recent research identified that cancer bereavement can lead to post-traumatic growth (PTG). Although PTG and its correlates are well explored in cancer patients and survivors, persons bereaved from cancer have received scant attention. Therefore, the present review attempts to identify the correlates of PTG among persons bereaved from cancer. METHODS A systematic search in PubMed, Web of Science, APA PsycNet, Science Direct, Scopus, and Wiley was conducted to identify quantitative studies published in English, resulting in 12 eligible reports being included in the final analysis. JBI critical checklists were employed to appraise the risk of bias. RESULTS The review identified 17 correlates, which were classified into four categories: demographic factors (age, gender, religious status, level of education), loss-related factors (time since death, quality of death, prolonged grief symptoms), interpersonal factors (relationship to the deceased, social support, attachment style, bereavement behaviours) and intrapersonal factors (resilience, coping, rumination, benevolence, meaningfulness, self-worth). Random effects meta-analyses on six correlates revealed correlation coefficients of age = -0.02 (95% CI: -0.35-0.31), gender = 0.27 (95% CI: 0.08-0.45), time since death = 0.09 (95% CI: -0.02-0.20), quality of death = 0.29 (95% CI: -0.01-0.54), prolonged grief symptoms = 0.22 (95% CI: 0.08-0.35) and relationship to the deceased = 0.13 (95% CI: -0.03-0.29). Fixed effects meta-analysis was performed for social support (r = 0.13, 95% CI: 0.04-0.21). However, PTG was found to be significantly associated with gender, prolonged grief symptoms, and social support. CONCLUSIONS Very few studies examined PTG among persons bereaved from cancer, highlighting the need for increased attention, understanding, and conceptualisation of PTG in the population.
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Affiliation(s)
- N. V. Sri Lakshmi K.
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Eslavath Rajkumar
- Department of Liberal Arts, Indian Institute of Technology Bhilai, Durg, Chhattisgarh, India
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - P. V. Hareesh
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - R. Lakshmi
- Department of Applied Psychology, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - John Abraham
- St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore, India
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Başcıllar M, Güre MDP, Sakarya H. Examination of the relationship between post-traumatic growth and social support and life satisfaction in wounded veterans in Turkey. Arch Psychiatr Nurs 2023; 47:10-15. [PMID: 38070988 DOI: 10.1016/j.apnu.2023.10.006] [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: 08/18/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023]
Abstract
AIM This study aims to examine the effects of social support and life satisfaction on post-traumatic growth in wounded veterans in Turkey. METHODS 1175 wounded veterans participated in the cross-sectional study. The sociodemographic questionnaire, the Post-Traumatic Growth Inventory, the Multidimensional Scale of Perceived Social Support, and the Satisfaction with Life Scale were used to collect data. Data were analyzed via SPSS. RESULTS The results of the study show that the mean age is 43.04 ± 7.36. The participants are low in education and socioeconomic level. The mean of the Post-Traumatic Growth Inventory score is 43.44 ± 21.18, the mean of the Multidimensional Scale of Perceived Social Support score is 50.01 ± 15.23, and the mean of the Satisfaction With Life Scale score is 9.86 ± 4.04. The results of the study show that there is a positive relationship between social support and life satisfaction and post-traumatic growth. CONCLUSION It can be suggested to develop psychosocial intervention strategies and service delivery systems to promote the life satisfaction, social support mechanisms of wounded veterans.
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Affiliation(s)
- Mehmet Başcıllar
- Faculty of Health Sciences, Malatya Turgut Özal University, Malatya, Turkey.
| | | | - Hakan Sakarya
- Social Work Department, Hacettepe University, Ankara, Turkey
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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: 0] [Impact Index Per Article: 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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Dyball D, Bennett AN, Schofield S, Cullinan P, Boos CJ, Bull AMJ, Stevelink SAM, Fear NT. Post-traumatic growth amongst UK armed forces personnel who were deployed to Afghanistan and the role of combat injury, mental health and pain: the ADVANCE cohort study. Psychol Med 2023; 53:5322-5331. [PMID: 35993322 PMCID: PMC10476051 DOI: 10.1017/s0033291722002410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Post-traumatic growth (PTG) is a positive psychological consequence of trauma. The aims of this study were to investigate whether combat injury was associated with deployment-related PTG in a cohort of UK military personnel who were deployed to Afghanistan, and whether post-traumatic stress disorder (PTSD), depression and pain mediate this relationship. METHODS 521 physically injured (n = 138 amputation; n = 383 non-amputation injury) and 514 frequency-matched uninjured personnel completed questionnaires including the deployment-related Post-Traumatic Growth Inventory (DPTGI). DPTGI scores were categorised into tertiles of: no/low (score 0-20), moderate (score 21-34) or a large (35-63) degree of deployment-related PTG. Analysis was completed using generalised structural equation modelling. RESULTS A large degree of PTG was reported by 28.0% (n = 140) of the uninjured group, 36.9% (n = 196) of the overall injured group, 45.4% (n = 62) of amputee and 34.1% (n = 134) of the non-amputee injured subgroups. Combat injury had a direct effect on reporting a large degree of PTG [Relative risk ratio (RRR) 1.59 (95% confidence interval (CI) 1.17-2.17)] compared to sustaining no injury. Amputation injuries also had a significant direct effect [RRR 2.18 (95% CI 1.24-3.75)], but non-amputation injuries did not [RRR 1.35 (95% CI 0.92-1.93)]. PTSD, depression and pain partially mediate this relationship, though mediation differed depending on the injury subtype. PTSD had a curvilinear relationship with PTG, whilst depression had a negative association and pain had a positive association. CONCLUSIONS Combat injury, in particular injury resulting in traumatic amputation, is associated with reporting a large degree of PTG.
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Affiliation(s)
- Daniel Dyball
- King's Centre for Military Health Research, King's College London, London, SE5 9RJ, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Alexander N. Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, near Loughborough, Nottinghamshire, LE12 5BL, UK
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK
| | - Susie Schofield
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK
| | - Paul Cullinan
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK
| | - Christopher J. Boos
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, BH1 3LT, UK
| | - Anthony M. J. Bull
- Department of Bioengineering, Centre for Blast Injury Studies, Imperial College London, London, SW7 2AZ, UK
| | - Sharon A. M. Stevelink
- King's Centre for Military Health Research, King's College London, London, SE5 9RJ, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Nicola T. Fear
- King's Centre for Military Health Research, King's College London, London, SE5 9RJ, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Academic Department of Military Mental Health, King's College London, London, SE5 9RJ, UK
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Gori A, Topino E, Musetti A. The Relationship among Anxiety, Worry, Perceived Stress, Defense Mechanisms, and High Levels of Post-Traumatic Stress Symptoms: A Discriminant Analytic Approach. J Pers Med 2023; 13:jpm13020237. [PMID: 36836471 PMCID: PMC9966516 DOI: 10.3390/jpm13020237] [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: 09/29/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a pathological condition that may lead to a significant deterioration in the quality of life over time. Therefore, the study of the elements that can characterize the disorder could be considered of great clinical interest and relevance. The aim of the present research was to empirically discriminate the influence of perceived stress, state anxiety, worry, and defense mechanisms (mature, neurotic, and immature) at different levels of post-traumatic stress symptoms. A sample of 1250 participants (69.5% women, 30.5% men; Mage = 34.52, SD = 11.857) completed an online survey including the Impact of Event Scale-Revised, Ten-Item Perceived Stress Scale, Penn State Worry Questionnaire, Forty Item Defense Style Questionnaire, and State-Trait Anxiety Inventory-Form X3. Data were analysed by implementing MANOVA and discriminant analysis. Results showed significant differences in the levels of perceived stress, state anxiety, and worry, as well as neurotic and immature defenses based on the levels of post-traumatic stress symptoms: F(12,2484) = 85.682, p < 0.001; Wilk's Λ = 0.430. Furthermore, these variables discriminate significant accuracy between participants who reported a mild psychological impact and those with a probable presence of PTSD, with perceived stress, which was found to be the best predictor. Classification results indicated that the original grouped cases were classified with 86.3% overall accuracy. Such findings may provide useful insight for clinical practice.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Firenze, Italy
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
- Correspondence:
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, 00193 Rome, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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Deleuil S, Mussap AJ. Evaluating an online self-distancing intervention to promote emotional regulation and posttraumatic growth during the COVID-19 pandemic. ANXIETY, STRESS, AND COPING 2023; 36:18-37. [PMID: 36469741 DOI: 10.1080/10615806.2022.2150177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Three online studies were conducted to elucidate the role of emotional regulation (ER) in posttraumatic growth (PTG), evaluate the ability of an online self-distancing intervention to achieve ER, and test whether increasing the use of ER strategies promotes PTG. DESIGN Cross-sectional (Study 1) and longitudinal randomized controlled trials (RCT) (Studies 2 and 3). METHOD In Study 1, 626 adults completed measures of ER, PTG, and psychosocial functioning during the COVID-19 pandemic. In Study 2, 149 adults participated in a five-week RCT comparing self-immersed, spatially self-distanced, and temporally self-distanced reflection in their ability to regulate negative affect. In Study 3, 117 adults replicated the RCT of Study 2 and completed the measures from Study 1 a week pre- and post-intervention. RESULTS Path analyses confirmed that ER strategies were relevant to COVID-19-related PTG. MANOVAs revealed that self-distancing was effective in regulating state negative affect. However, ANOVAs suggest that this was not due to increased use of ER strategies and did not improve PTG or psychosocial functioning. CONCLUSIONS These findings support further research into the relevance of ER to PTG, and provide a foundation to understand PTG and develop PTG-promoting interventions within a broader stress-coping framework.
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Romeo A, Castelli L, Zara G, Di Tella M. Posttraumatic Growth and Posttraumatic Depreciation: Associations with Core Beliefs and Rumination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15938. [PMID: 36498012 PMCID: PMC9737883 DOI: 10.3390/ijerph192315938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/20/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The positive transformation (i.e., posttraumatic growth, PTG) that can emerge after the struggles associated with a stressful life event has been widely investigated. However, less attention has been paid to the negative posttraumatic changes (i.e., posttraumatic depreciation, PTD) that might occur after a traumatic experience. This study aimed to investigate the role of a series of psychological factors (e.g., disruption of core beliefs, rumination, and depressive symptoms) in predicting PTG and PTD, separately considered. METHODS To reach this goal, 601 participants who experienced different types of traumatic events were recruited. They were asked to indicate sociodemographic and trauma-related information and to complete self-report measures assessing PTG/PTD, core beliefs, rumination, and depressive symptoms. RESULTS The results of regression analyses showed that gender, age, time since the trauma, core beliefs, deliberate/intrusive rumination, and depressive symptoms were significant predictors of PTG. Conversely, core beliefs, intrusive rumination, and depressive symptoms were found to be positively related to PTD. CONCLUSIONS Taken together, these findings highlight the role that different psychological factors may play in the manifestation of the PTG and/or PTD dimensions. From a clinical perspective, professionals should pay attention to these factors when a person struggles in coping with a highly stressful experience.
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Zięba M, Wiecheć K, Wójcik NE, Zięba MJ. Prioritizing Positivity, Styles of Rumination, Coping Strategies, and Posttraumatic Growth: Examining Their Patterns and Correlations in a Prospective Study. Front Psychol 2022; 13:842979. [PMID: 35282249 PMCID: PMC8913722 DOI: 10.3389/fpsyg.2022.842979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/10/2022] [Indexed: 01/07/2023] Open
Abstract
ObjectivesA growing number of studies indicate that coping with the experience of a crisis event, which causes a breach in the individual’s fundamental beliefs regarding the world and his/her place in it, can result in posttraumatic growth. Positive emotions can have an undoing effect on negative emotional arousal and broaden an individual’s scope of action, and they can foster posttraumatic growth. This study aimed to examine relations between prioritizing positivity, styles of rumination, coping strategies, and posttraumatic growth.MethodsOne hundred and sixty-four Polish adults took part in the study, filling out questionnaires to measure prioritizing positivity, hope, and self-efficacy. Twelve to fifteen months later, 104 of them accepted the invitation to the second part of the study. The participants reported the intensity of rumination associated with the most critical event in their lives, which took place between the first and second stages of the study and the coping strategies they used. Posttraumatic growth and life satisfaction were also measured.ResultsResults from hierarchical regressions found that higher levels of prioritizing positivity, deliberate ruminations, and religious coping and lower level of intrusive ruminations were associated with posttraumatic growth. The results also indicate that self-esteem was a significant predictor of life satisfaction.ConclusionsThe results of the prospective study confirm that individual differences in prioritizing positivity can relate to a process of posttraumatic growth. Prioritizing positivity was associated with the use of an active coping strategy and deliberate but not intrusive ruminations. Previous studies on the role of prioritizing positivity have focused on the impact on the level of wellbeing of seeking positive emotions in everyday life. Our results show the importance of prioritizing positivity in coping with stress and trauma. These results can be used to design effective psychological intervention techniques to support people experiencing trauma and psychological crises. The results also indicate that life satisfaction has different predictors from posttraumatic growth.
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Affiliation(s)
- Mariusz Zięba
- Center for Trauma, Crisis and Growth, SWPS University of Social Sciences and Humanities, Poznań, Poland
- *Correspondence: Mariusz Zięba,
| | - Katarzyna Wiecheć
- Center for Trauma, Crisis and Growth, SWPS University of Social Sciences and Humanities, Poznań, Poland
- Department of Clinical Psychology, Poznań University of Medical Sciences, Poznań, Poland
| | - Natalia E. Wójcik
- Center for Trauma, Crisis and Growth, SWPS University of Social Sciences and Humanities, Poznań, Poland
| | - Michał J. Zięba
- Center for Trauma, Crisis and Growth, SWPS University of Social Sciences and Humanities, Poznań, Poland
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Lee H, Kang S, Choun S, Lee D, Lee HS, Aldwin CM. Life satisfaction of Korean Vietnam War Veterans in later life: A lifespan approach. MILITARY PSYCHOLOGY 2022. [DOI: 10.1080/08995605.2021.1962193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hyunyup Lee
- Department of Psychology and Management, Korea Military Academy, Seoul, South Korea
| | - Sungrok Kang
- Department of Psychology and Management, Korea Military Academy, Seoul, South Korea
| | - Soyoung Choun
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Dylan Lee
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Hye-Soo Lee
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Carolyn M. Aldwin
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, Oregon, USA
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Tappenden PC, Shiner RL, Mo F. Narrating life in the military: Links between veterans' narrative processing of service experiences and their posttraumatic stress symptoms and well-being. J Trauma Stress 2022; 35:288-301. [PMID: 34655109 DOI: 10.1002/jts.22738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/10/2021] [Accepted: 07/14/2021] [Indexed: 11/10/2022]
Abstract
Military veterans frequently experience traumatic, highly stressful events; thus, it is especially important for them to find positive ways of making meaning from these experiences. The present study used the methods of narrative personality psychology to investigate the associations between veterans' narrative processing of highly stressful and significant events from their military service and postdischarge functioning, including posttraumatic stress symptoms (PTSS). United States military veterans (N = 154; M age = 64.28 years, 86.4% men, 57.8% deployed) completed an online survey in which they wrote narratives about one "highly stressful" and one "key scene" military service memory and completed questionnaires to assess PTSS, symptoms of depression and anxiety, functional impairment, and well-being. Narratives were coded for personal growth from the experience, themes of agency and interpersonal communion, affective tone, and coherence. In the highly stressful narratives, small-to-moderate negative associations emerged between both growth and agency and PTSS, depression and anxiety, and functional impairment; growth was also modestly positively associated with well-being. In contrast, affective tone and communion were each only associated modestly with one outcome, and coherence with none, and narrative processing of the key scene narrative was not linked with any mental health outcomes. These findings suggest that (1) the theory and methods of narrative identity research are relevant for studying trauma narratives, and (2) veterans who narrate themselves as growing from and exerting control over their most stressful service experiences may achieve better mental health and day-to-day functioning.
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Affiliation(s)
- Peter C Tappenden
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, New York, USA.,Traumatic Stress Studies Division, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Rebecca L Shiner
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, New York, USA
| | - Fanyi Mo
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, New York, USA
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Hashemi Dezaki Z, Eyni S, Ebadi Kasbakhi M. Life satisfaction of veterans with post-traumatic stress disorder: The predictive role of cognitive flexibility and alexithymia. ANNALES MEDICO-PSYCHOLOGIQUES 2021. [DOI: 10.1016/j.amp.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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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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15
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Sherman H, Frye-Cox N, Lucier-Greer M. Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale. Mil Med 2021; 188:e1156-e1165. [PMID: 34755866 DOI: 10.1093/milmed/usab456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 11/08/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Researchers and practitioners are invested in understanding how deployment experiences impact the nearly 193,000 U.S. service members who deploy in a given year. Yet, there remains a need to adequately identify salient deployment experiences through survey measurement tools and understand how differential experiences are uniquely related to mental health outcomes. Therefore, this study examined the factor structure of an established combat experiences measure from the Army Study to Assess Risk and Resilience in Service members (Army STARRS) dataset to identify underlying survey constructs that reflect nuanced deployment experiences. Then, we examined the association between diverse combat experiences and current mental health symptoms (i.e., anxiety and depressive symptoms) and the mediating role of coping. MATERIALS AND METHODS Data were drawn from the Army STARRS data (N = 14,860 soldiers), specifically the All Army Study component. A principal component analysis (PCA) was conducted to examine the dimensionality of the combat experiences scale, and then a path model was conducted to examine the relationships between combat experiences, coping with stress following a deployment, and mental health symptoms while controlling for relevant individual and interpersonal factors. RESULTS Results from the principal component analysis suggested that the Army STARRS combat experiences scale encompasses two components, specifically: "Expected combat experiences" and "Responsible for non-enemy deaths." Both "Expected combat experiences" and "Responsible for non-enemy deaths" were associated with higher levels of anxiety and depressive symptoms, respectively, and "Responsible for non-enemy deaths" was also indirectly linked to these mental health outcomes through coping with stress after deployment. CONCLUSIONS These findings provide insight into the dimensionality of combat experiences and offer practitioners a more nuanced understanding of how to process unique combat experiences that differentially relate to mental health symptoms.
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Affiliation(s)
- Haley Sherman
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
| | - Nicky Frye-Cox
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
| | - Mallory Lucier-Greer
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36830, USA
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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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17
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Na PJ, Tsai J, Southwick SM, Pietrzak RH. Factors associated with post-traumatic growth in response to the COVID-19 pandemic: Results from a national sample of U.S. military veterans. Soc Sci Med 2021; 289:114409. [PMID: 34537394 PMCID: PMC8445520 DOI: 10.1016/j.socscimed.2021.114409] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Jack Tsai
- U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, FL, USA; School of Public Health, University of Texas Health Science Center at Houston, TX, USA; U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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18
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Ord AS, Stranahan KR, Hurley RA, Taber KH. Stress-Related Growth: Building a More Resilient Brain. J Neuropsychiatry Clin Neurosci 2021; 32:A4-212. [PMID: 32729793 DOI: 10.1176/appi.neuropsych.20050111] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anna S Ord
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Kathryn R Stranahan
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Robin A Hurley
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Katherine H Taber
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Ord, Hurley, Taber); the Mental Health Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Stranahan); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
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19
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Jacobson IG, Adler AB, Roenfeldt KA, Porter B, LeardMann CA, Rull RP, Hoge CW. Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members. Psychiatry 2021; 84:276-290. [PMID: 34340639 DOI: 10.1080/00332747.2021.1929770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Studies examining posttraumatic growth (PTG) rely on surveys evaluating PTG in relation to prior traumatic experiences, resulting in psychometric problems due to the linkage of the dependent and independent variables. Few studies have assessed PTG following combat deployment while also controlling for mental health problems.Method: Longitudinal data on PTG, combat experience, and mental health were examined among U.S. Millennium Cohort Study deployers (n = 8732). Scores from a short-form (SF) version of the PTG inventory assessing current-state beliefs (C-PTGI-SF) independent of any predictor variables were assessed at time 1 (T1), before deployment, and change in scores were assessed approximately 3 years later after deployment at time 2 (T2). All participants screened negative for posttraumatic stress disorder (PTSD) and depression at T1.Results: Combat deployment severity was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate C-PTGI-SF scores at T1. A positive screen for comorbid PTSD/depression was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate or high C-PTGI-SF scores at T1. At T2, a strong inverse correlation was found between C-PTGI-SF scores and PTSD (r = -0.38) and depression (-0.41). Only 5% of participants who screened positive for a mental health problem at T2 (23/517) also experienced positive growth.Conclusions: These results challenge the clinical utility of the PTG construct. While PTG may be a useful framework for supporting trauma recovery on an individual basis, PTG does not appear to be distinct and independent from the negative psychological impact of traumatic experiences.
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Spies JP, Cwik JC, Willmund GD, Knaevelsrud C, Schumacher S, Niemeyer H, Engel S, Küster A, Muschalla B, Köhler K, Weiss D, Rau H. Associations Between Difficulties in Emotion Regulation and Post-Traumatic Stress Disorder in Deployed Service Members of the German Armed Forces. Front Psychiatry 2020; 11:576553. [PMID: 33192712 PMCID: PMC7533544 DOI: 10.3389/fpsyt.2020.576553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Experiencing a traumatic event can lead to post-traumatic stress disorder (PTSD), but not every traumatized person develops PTSD. Several protective and risk factors have been identified in civilians and veterans to explain why some individuals develop PTSD and others do not. However, no research has confirmed the relationship between emotion regulation and PTSD in deployed German Armed Forces service members after a foreign assignment. Previous studies have identified some protective factors, such as social support, social acknowledgment, specific personal values, and posttraumatic growth, as well as risk factors, like moral injury and emotion regulation. Thus, the aim of the present study is to confirm the relationship between emotion regulation and PTSD and to test for factors that are associated with higher severity of PTSD symptoms in such a sample. METHODS A post-hoc secondary analysis was conducted on data collected in a randomized controlled trial. Participants (N = 72) were male active and former military service members that have returned from deployment and were recruited from the German Armed Forces. These participants were separated into two groups according to PTSD diagnosis based on the results of a structured diagnostic interview. Data from evaluation questionnaires administered upon entry into the study were subjected to a cross-sectional analysis. The measures included the severity of PTSD symptoms, clusters of PTSD symptoms, clinical measures, and several measures assessing PTSD-related constructs. Analyses included the Spearman rank correlation coefficient, X2 tests for nominal data, Mann-Whitney U-tests for non-parametric data, and a mediation analysis. RESULTS The results of the mediation analysis revealed that difficulties in emotion regulation were significantly associated with the severity of PTSD symptoms, which was mediated by social acknowledgment and experimental avoidance but not by moral injury. The analyses showed that the severity of PTSD symptoms and all clusters of PTSD symptoms were significantly associated with most of the measured constructs in expectable directions. Participants in the PTSD group showed significantly higher mean scores on questionnaires measuring constructs that have been associated with PTSD, like emotion regulation and moral injury. They also showed lower mean scores in questionnaires for social support and social acknowledgment as a victim or survivor than participants in the non-PTSD group. CONCLUSION The present results show that difficulties in emotion regulation are directly associated with the severity of PTSD symptoms in service members of the German Armed Forces. This association is mediated by social acknowledgment and experimental avoidance, but not by moral injury. Thus, future studies should investigate these potentially crucial factors for better understanding of the development and maintenance of PTSD in service members of the German Armed Forces after deployment to create possible treatment adaptions. CLINICAL TRIAL REGISTRATION Australian Clinical Trials Registry, identifier ACTRN 12616000956404 http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370924.
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Affiliation(s)
- Jan Peter Spies
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany.,Department for Military Mental Health, German Armed Forces Military Hospital Berlin, Berlin, Germany.,Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Jan Christopher Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Gert Dieter Willmund
- Department for Military Mental Health, German Armed Forces Military Hospital Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Helen Niemeyer
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Sinha Engel
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Annika Küster
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Beate Muschalla
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Technische Universität Braunschweig, Braunschweig, Germany
| | - Kai Köhler
- Department for Military Mental Health, German Armed Forces Military Hospital Berlin, Berlin, Germany
| | - Deborah Weiss
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Heinrich Rau
- Department for Military Mental Health, German Armed Forces Military Hospital Berlin, Berlin, Germany
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21
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Mark KM, Stevelink SAM, Choi J, Fear NT. Post-traumatic growth in the military: a systematic review. Occup Environ Med 2018; 75:904-915. [DOI: 10.1136/oemed-2018-105166] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/07/2018] [Accepted: 09/24/2018] [Indexed: 11/04/2022]
Abstract
BackgroundPost-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.ObjectivesThis systematic review aimed to identify studies that quantitatively measured post-traumatic growth among (ex-) military personnel, to determine whether there is evidence of growth in this context and whether such growth is associated with any sociodemographic, military, trauma or mental health factors.Data sourcesThe electronic databases PsycInfo, OVIDmedline and Embase were searched for studies published between 2001 and 2017.Study eligibility criteria and participantsPapers were retained if they involved military or ex-military personnel, where some had been deployed to Iraq or Afghanistan.Study appraisalQuality assessment was conducted on all studies.Results21 studies were retained. The Post-Traumatic Growth Inventory was employed by 14 studies: means ranged from 32.60 (standard deviation = 14.88) to 59.07 (23.48). The Post-Traumatic Growth Inventory Short Form was used by five studies: means ranged from 17.11 (14.88) to 20.40 (11.88). These values suggest moderate growth. Higher levels of social support, spirituality and rumination and minority ethnicity were most frequently associated with more post-traumatic growth.LimitationsThe involved studies may lack generalisability and methodological quality.ConclusionsOverall, this paper confirms that negative reactions to trauma, particularly post-traumatic stress disorder, are not the only possible outcomes for service personnel, as moderate post-traumatic growth can also be observed.Implications of key findingsInterventions aimed at helping current and former armed forces personnel to identify and promote post-traumatic growth post-conflict may be beneficial for their well-being.
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22
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Jayawickreme E, Rivers J, Rauthmann JM. Do We Know How Adversity Impacts Human Development? RESEARCH IN HUMAN DEVELOPMENT 2018. [DOI: 10.1080/15427609.2018.1495515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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23
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Stein JY, Levin Y, Bachem R, Solomon Z. Growing Apart: A Longitudinal Assessment of the Relation Between Post-traumatic Growth and Loneliness Among Combat Veterans. Front Psychol 2018; 9:893. [PMID: 29930525 PMCID: PMC5999757 DOI: 10.3389/fpsyg.2018.00893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022] Open
Abstract
The aftermath of war-related trauma may entail psychological devastation and is typically accompanied by various deleterious phenomena. These include, but are not limited to, high rates of loneliness. However, trauma may also result in positive outcomes such as personal, spiritual, and relational prosperity, which are typically considered under the conceptual framework of post-traumatic growth (PTG). PTG may theoretically contribute to either loneliness amelioration (e.g., via increasing one's appreciation of close relationships) or exacerbation (e.g., by increasing one's sense of undergoing experiences that others do not share). Loneliness, on the other hand, may potentially hinder PTG by fostering negative social cognitions and behaviors, or otherwise lead to personal growth. The relations between the two phenomena, however, have yet to be investigated. Filling this gap, the current study examined the aforementioned potentialities by utilizing an autoregressive cross-lagged modeling strategy (ARCL) with a cohort of 260 Israeli combat veterans assessed 30, 35, and 42 years after their participation in the 1973 Yom Kippur War. Results indicated that higher rates of PTG were consistently related to higher rates of loneliness both cross-sectionally and longitudinally. Loneliness, however, did not longitudinally predict PTG rates. It is suggested that these findings may be understood in light of the observation that veterans' loneliness is primarily related to the experience of being experientially out of sync with people who have not endured war experiences. It is suggested that this experiential loneliness may include not only the negative but also the positive ramifications of undergoing such traumas (i.e., PTG). We, therefore, argue that while PTG may include authentic positive transformations it may also lead to more negative ramifications, and these should be identified and addressed by researchers and clinicians alike. Thus, as study limitations are acknowledged, clinical implications, and future research directions are suggested.
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Affiliation(s)
- Jacob Y. Stein
- I-CORE Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Yafit Levin
- I-CORE Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Rahel Bachem
- I-CORE Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Zahava Solomon
- I-CORE Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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