Attachment and coping as facilitators of posttraumatic growth in Turkish university students experiencing traumatic events

Resilience Mediates the Relationship Between Parental Attachment and Posttraumatic Growth in Adolescents: A Longitudinal Study

OBJECTIVE

Previous studies have shown that parental attachment was associated with higher levels of posttraumatic growth (PTG) in individuals who have experienced traumatic events. The aim of the current longitudinal study is to investigate resilience as one pathway through which parental attachment is related to PTG among Chinese adolescents following the Yancheng tornado.

METHODS

A total of 351 adolescent survivors participated in this longitudinal study. Participants completed the revised version of Inventory of Parent and Peer Attachment (IPPA-R) at 12 months (T1), and the revised Chinese version of the Post-Traumatic Growth Inventory (PTGI-R) and the Connor and Davidson's Resilience Scale (CD-RISC) at 18 months (T2) after the tornado, respectively.

RESULTS

It indicated that parental attachment at T1 has direct and positive effect on PTG at T2, and resilience at T2 fully mediated the relationship between parental attachment at T1 and PTG at T2.

CONCLUSION

The findings revealed that parental attachment and resilience are two key resources that promote adolescent's PTG, and parental attachment acts through resilience to promote PTG in adolescents.

Leisure Types, Coping, Happiness, and Life Satisfaction among Veterans

Objectives: Our purpose was to investigate the relationships between leisure types and coping, happiness, and life satisfaction among veterans. Methods: Our sample was 106 veterans. We used hierarchical multiple regression analysis to examine the relationships of the previously identified variables. Demographic variables were entered into the first block of the regression model, and all the demographic variables and types of leisure activities were then entered into the second block. Results: Age, disability status, sports, and volunteer activities were positively associated with the problem-solving coping strategy. Only outdoor activities were positively related to the social support coping strategy. Home-based activities were positively associated with the avoidance coping strategy. Disability status, outdoor activities, and social activities were positively associated with life satisfaction. Age and social activities were positively associated with happiness. Conclusions: Overall, participation in social and outdoor activities was positively associated with active coping, social-seeking coping, life satisfaction, and happiness. This finding supports the literature on leisure and health, suggesting the value of leisure activities as an effective coping strategy and a positive influence on the mental health of veterans.

Insecure attachment styles as predictors of posttraumatic growth in a South African student sample

South Africa, as a developing country, is characterized by high levels of crime, partner violence, and other traumatic experiences. Exposure to these traumas may lead to the development of post-traumatic stress disorder or, conversely, post-traumatic growth. Citizens in developing African countries appear to be at risk for the development of insecure attachment styles due to the cumulative effects of socio-economic risk factors. The prevalence of many possible traumatic experiences along with the risk of more insecure attachments set the stage for investigating the impact of insecure attachment on post-traumatic growth. The aim of this study was thus to determine whether two insecure attachment styles, namely anxious and avoidant attachment, were significant predictors of post-traumatic growth. The sample consisted of 233 undergraduate students from a South African university who had experienced a traumatic event. Participants’ ages ranged from 18 to 33 years ( M = 21 years) and were from various ethnic backgrounds (81.5% Black African, 7.7% White, 9% Coloured, and 3.9% Asian/Indian). Two self-report measures were administered via an online survey to assess attachment styles and post-traumatic growth. Results showed that an anxious attachment style was a significant negative predictor of post-traumatic growth. Furthermore, individuals with an avoidant attachment style were significantly less likely to experience post-traumatic growth through relating to others, than along the other domains of post-traumatic growth. The findings contribute by highlighting the importance of considering how insecure attachment styles may impact post-traumatic growth, as this could inform the treatment of trauma victims.

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

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

Leisure-time physical activity, coping and life satisfaction among Korean individuals with physical disabilities

A few studies explored the relationships among leisure-time physical activity (LTPA), coping, and life satisfaction among individuals with physical disabilities. This study aims to investigate how LPTA contributes to coping and life satisfaction among Korean individuals with physical disabilities. Using a purposive sampling strategy, a total of 351 people with physical disabilities participated in this study. The results of this study find that participation in LTPA leads to the development of active coping strategies that contribute to increased life satisfaction. This study suggests that encouraging LTPA participation can be a critical task to healthcare providers working with individuals with physical disabilities.

Posttraumatic Growth: An Analysis of the Concept Based on Rodgers' Concept Development

The concept of posttraumatic growth appears frequently in the psychology literature. However, there is no clear definition of it. The purpose of this study was to determine its attributes, antecedents, and consequents. Rodgers' evolutionary concept analysis method was used. Data analysis was implemented using thematic analysis. The results showed that posttraumatic growth is a complex concept with four main attributes including spiritual changes, compassion toward others, appreciation of life, and improved self-understanding. Clarifying the concept of posttraumatic growth and identifying its features can be used to design nursing interventions to develop posttraumatic growth.

A meta-analytic review of the relationship between attachment styles and posttraumatic growth

OBJECTIVE

The present review aimed to examine the relationship between attachment styles and posttraumatic growth in adults exposed to traumatizing events.

METHOD

A systematic literature search resulted in the inclusion of 14 studies in the review. Four correlational meta-analyses of the relationship between the attachment styles of secure, dismissive, preoccupied, and fearful, and posttraumatic growth, were conducted.

RESULTS

These revealed a significant small positive relationship between secure attachment and posttraumatic growth (r =  0.21, p < 0.001); a significant small negative relationship between dismissive attachment and posttraumatic growth (r = -0.12, p < 0.001), and a weak relationship between preoccupied attachment and posttraumatic growth (r = -0.04, p = 0.235), and fearful attachment and posttraumatic growth (r = 0.08, p = 0.248).

CONCLUSIONS

The relationship between attachment styles and posttraumatic growth is modest and may be better explained by other variables. Nonetheless, findings provide useful information for clinicians regarding the potential small impact of attachment style following traumatizing exposure. Implications for future research are highlighted with respect to methodological rigor and the role of other potentially influential variables.

An Integrated Historical Trauma and Posttraumatic Growth Framework: a Cross-Cultural Exploration

Trauma recovery for racial and ethnic groups experiencing ongoing systemic violence and discrimination requires a framework that simultaneously addresses harms and strengths. Historical trauma (HT) is a social determinant of health emanating from targeted mass group-level harm. Posttraumatic growth (PTG) focuses on positive shifts in individuals coping with trauma. This article highlights the unique contributions of these two distinct bodies of literature to inform trauma recovery. We explore areas of overlap, gaps, and tensions between the concepts to present an HT-PTG conceptual framework. The HT-PTG framework combines HT's focus on socio-structural-historical experiences in racial and ethnic groups targeted for oppression with PTG's descriptions of characteristics of growth. Specifically, five mass group-level domains of growth, centering healing, creativity, growth, and transformation are described. The ancestral legacies of the authors, including American Indian, Indigenous Mexican, African American, Puerto Rican, and Indigenous Taiwanese, inform the HT-PTG framework. This paper presents implications for trauma-recovery research and practice.

Investigating relationships among coping, personal growth, and life satisfaction among individuals with physical disabilities

Background: It is well-documented that active coping strategies can lead to better positive adjustment and psycho-social outcomes among individuals with disabilities and illnesses. However, little information exists related to exploring how coping is related to health benefits such as personal growth and life satisfaction in an international context. Thus, this study examined how the use of coping strategies is associated with personal growth and life satisfaction among individuals with physical disabilities in non-Western settings.

Methods: In this cross-sectional study, we employed a nonprobability methodology, purposivesampling, to recruit 351 participants who adults over the age of 18 living with a physicaldisability and currently enrolled in the Korean Disability Association. A hierarchical linearregression analysis was conducted to determine which types of coping strategies predictedpersonal growth and life satisfaction, while controlling for the effects of the demographicvariables (i.e., gender and age).

Results: With regard to personal growth, problem-solving coping strategy (β = 0.663, P < 0.001,95% CI [0.51, 0.70]) was the strongest predictor, followed by avoidance coping strategy(β = -0.263, P < 0.001, 95% CI [-0.37, -0.20]). As for life satisfaction, problem-solving copingstrategy (β = 0.268, P < 0.001, 95% CI [0.18, 0.70]) was the strongest predictor, followed bysocial support seeking coping strategy (β = 0.264, P < 0.001, 95% CI [-0.19, 0.10]).

Conclusion: Our study suggests that problem-focused and social support coping strategies playimportant roles in improving the personal growth and life satisfaction among Korean individualswith physical disabilities. This study provides implications for health professionals seeking waysto facilitate the personal growth and enhance the life satisfaction of individuals with physicaldisabilities.

Parental attachment, coping, and psychological adjustment among adolescents following an earthquake: a longitudinal study

Background and objective: The study aim was to examine the predictive effect of parental attachment on positive psychological outcomes (posttraumatic growth, PTG) and negative psychological outcomes (posttraumatic stress disorder (PTSD) and depression symptoms), and to test the mediating role of positive and negative coping in the relationship among adolescents following an earthquake in China. Design: The study used a longitudinal design with a 6-month time interval. Method: Data was collected from middle schools in the most severely affected areas at 18 and 24 months following an earthquake. Data were analyzed from 398 adolescents who completed self-report measures of parental attachment, coping, PTSD, depression, and PTG. Path analysis was conducted to examine the relationships among the main study variables. Results: Secure parental attachment predicted lower PTSD and depression symptoms at 24-months follow-up, and negative coping partly mediated the effects of parental attachment on PTSD and depression. No significant association was observed between parental attachment and PTG. Conclusions: The findings indicate that secure parental attachment had a protective effect for adolescents after the disaster. Such attachment may reduce the use of negative coping and in turn decrease psychological distress over time.

The Traumatic Experience of Breast Cancer: Which Factors Can Relate to the Post-traumatic Outcomes?

Background: Post-traumatic growth (PTG) is considered a positive outcome of struggling with a traumatic event, distinct, and opposite from negative outcomes, i.e., psychological distress. The present study aimed to shed light on the relationship between potentially relating factors (i.e., coping strategies, perceived social support, and attachment style) and both positive and negative psychological outcomes. Methods: A total of 123 breast cancer survivors were recruited, who completed a battery of self-report questionnaires, assessing PTG, psychological distress, coping strategies, perceived social support, and attachment style. Three regression analyses were run to evaluate whether relating factors were significant predictors of the positive and negative psychological outcomes. Results: The regression analyses showed that the "Fatalism" coping strategy and perceived social support were two significant predictors of PTG. Instead, the "Helpless-Hopeless" and "Anxious Preoccupation" coping strategies, as well as an insecure attachment style, were significant predictors of depression, while the "Anxious Preoccupation" coping strategy and an insecure attachment style were significant predictors of anxiety. Conclusions: The present findings showed that the factors underlying a positive or negative outcome are different and specific. While perceived social support and a fatalistic attitude seem to play a key role in the positive outcome, dysfunctional coping strategies, together with an insecure attachment style, appear to be related with negative psychological outcome. Considering these factors in clinical practice would help patients to give meaning to their traumatic experience, enhancing psychological growth.

Factors Affecting Posttraumatic Growth Among College Students

Background:

College students experience emotional trauma and post-traumatic growth throughout their lives. However, there are few studies that identified the types of traumatic events, and the factors contributing to their positive growth through events among college students.

Objective:

The purpose of the present study was to investigate factors affecting posttraumatic growth among college students.

Methods:

The study is a cross-sectional descriptive survey, and measured the traumatic events experienced, distress, big five personality factors (neuroticism, extroversion, openness, agreeableness, conscientiousness), deliberate rumination, and posttraumatic growth on 305 college students. To find out the influencing factors on the posttraumatic growth, multiple regression analysis was performed.

Results:

The constructed model for posttraumatic growth showed that statistically significant explanatory variables were religion, deliberate rumination, agreeableness, neuroticism, and extroversion and the model including these variables has 43.1% explanatory power on posttraumatic growth (F=45.33, p<.001).

Conclusion:

It is necessary to carry out the assessment and intervention of psychological state after the traumatic accidents of college students. In addition, it is needed to develop an intervention program that they utilize their spirituality and characteristics and use deliberate rumination.

Use of the Adult Attachment Projective Picture System in the formulation of a case of an adolescent refugee with PTSD

Forced displacements and their psychosocial consequences in adolescent refugees and their families have received increasing attention in recent years. Although supportive family relations play a key role in buffering the impact of traumatization in adolescents, parental ability to provide such is often subject to extreme pressure. Under conditions of forced dislocation and fear, maladaptive interpersonal strategies in the parent-child relationships may develop, contributing to the onset of psychopathology. We explore new aspects of attachment-related issues for the understanding and treatment of adolescent refugees who have experienced multiple traumas in their childhood. We used a multimethod assessment battery including the Adult Attachment Projective Picture System (AAP), the Structured Clinical Interview, the Youth Self Report and the Wechsler Intelligence Scale in an adolescent boy with post-traumatic stress disorder (PTSD). Our subject was an adolescent refugee from the Middle East who demonstrated an unresolved attachment when confronted with loss and fear. His responses on the AAP evoked aspects of insecure-unresolved attachment, including his belief that it is not safe to trust in attachment figures, his limited access to traumatic attachment experiences, his impaired ability to take concrete actions when dealing with threatening attachment situations and the unintentional role-reversal shed new light on our understanding of his traumatic experiences, family functioning and psychopathological symptoms. Our results demonstrate the utility of the AAP in an adolescent refugee with PTSD by expanding our knowledge of a diverse range of experiences across the interpersonal, cognitive, cultural and developmental contexts that formed the basis for an individualized treatment plan.

Understanding posttrauma reactions within an attachment theory framework

The purpose of this paper is to review recent research on posttrauma reactions (i.e., posttraumatic stress disorder [PTSD] symptoms and self-reported posttraumatic growth [PTG]) using attachment theory as a framework. Attachment orientations are significantly related to PTSD symptoms: insecure attachment orientations (particularly attachment anxiety) are positively associated with PTSD symptoms whereas attachment security is negatively associated with PTSD symptoms. Although associations appear to be reciprocal, research typically focuses on insecure attachment orientations predicting PTSD symptoms and the possible mechanisms of those relations, particularly a lack of social support. Some trauma characteristics (e.g., trauma severity) also appear to moderate the association between attachment and PTSD symptoms. Research on attachment orientations and PTG, however, has yielded mixed results. More rigorous methods are needed to better understand the role of attachment orientations in actual growth from pre to post-trauma.

How do attachment dimensions affect bereavement adjustment? A mediation model of continuing bonds

The current study aims to examine mechanisms underlying the impact of attachment dimensions on bereavement adjustment. Bereaved mainland Chinese participants (N=247) completed anonymous, retrospective, self-report surveys assessing attachment dimensions, continuing bonds (CB), grief symptoms and posttraumatic growth (PTG). Results demonstrated that attachment anxiety predicted grief symptoms via externalized CB and predicted PTG via internalized CB at the same time, whereas attachment avoidance positively predicted grief symptoms via externalized CB but negatively predicted PTG directly. Findings suggested that individuals with a high level of attachment anxiety could both suffer from grief and obtain posttraumatic growth after loss, but it depended on which kind of CB they used. By contrast, attachment avoidance was associated with a heightened risk of maladaptive bereavement adjustment. Future grief therapy may encourage the bereaved to establish CB with the deceased and gradually shift from externalized CB to internalized CB.

Post-traumatic stress disorder, coping strategies and type 2 diabetes: psychometric assessment after L'Aquila earthquake

AIM

After natural and collective catastrophes, many behavioral phenomena can occur through psychobiological responses that involve also the diabetic condition.The aim of this study was to investigate post-traumatic stress disorder (PTSD) and coping strategies in type 2 diabetic patients after L'Aquila earthquake, with a particular attention to the newly diagnosed patients and to the gender differences.

METHODS

Among the local diabetic population, we recruited 100 diabetic patients (46 women and 54 men). Sixty of these had diabetes before the earthquake (pre-quake patients), and other 40 received diabetes diagnosis after the earthquake (post-quake patients). A psychometric protocol composed by Davidson Trauma Scale for PTSD and Brief-COPE for coping strategies was administered.

RESULTS

We found significant differences in the levels of PTSD when comparing both post-quake with pre-quake patients (post-quake = 51.72 ± 26.05 vs. pre-quake = 31.65 ± 22.59; p < 0.05) and the female patients with males (women = 53.50 ± 27.01 vs. men = 31.65 ± 23.06; p < 0.05) and also in the prevalence [post-quake = 27/40 (67.5 %) vs. pre-quake = 20/60 (33.3 %); p < 0.05], [women = 27/46 (58.69 %) vs. men = 16/54 (29.62 %); p < 0.05]. Moreover, maladaptive coping was a predictive factor for PTSD in the post-quake group only (OR 1.682; 95 % CI 1.155-2.450; p = 0.006).

CONCLUSIONS

Our results revealed that PTSD may be considered an important comorbidity factor in newly diagnosed patients and in diabetic women. Hence, a psychological support seems particularly important in these patients after a collective traumatic event to help them react to both PTSD and diabetes and to help them improve their coping skills.