Cross-Cultural Challenges to the Construct “Posttraumatic Growth”

Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience

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.

A Meta-Study of Posttraumatic Growth and Coping Strategies

The present study examined the relationship between posttraumatic growth (PTG) and different types of coping strategies to explain the mechanism underlying PTG. It also considered whether the relationship takes on different patterns in different cultures, thereby expanding on the existing literature regarding PTG. Initially, we found 666 articles published and unpublished between 2013 and 2020. All potentially eligible studies were examined based on the inclusion criteria for this study. The inclusion criteria ultimately yielded total of 96 studies. The findings of this meta-analysis indicate that the relationship varies depending on the coping strategy and culture. Moreover, identifying the coping strategies involved in overcoming traumatic events may be the key to differentiating real PTG from illusory PTG. The results show that PTG has different correlations with the four groups of coping strategies: problem-focused coping, positive emotion-focused coping, negative emotion-focused coping, and unclassified coping.

Applicability of the Hebrew Bible to Post-traumatic Stress Disorder and Post-traumatic Growth

Since the new millennium, biblical scholars have begun to reread certain writings in the Hebrew Bible through the concepts of post-traumatic stress disorder and post-traumatic growth. Some scholars believe such a reading is legitimate, whereas others think it problematic, and still, others hold a midway perspective. This article argues for the midway, the position that accepts the applicability of the Hebrew Bible to today's psychological concepts but calls for caution. Because ancient Israelites reacted to traumatic events and distinguished the human mind from the body like modern people, it is reasonable to approach their thoughts and emotions in the Hebrew Bible through today's psychological concepts. However, the cultural differences between today's society and ancient Israelites in understanding and reacting to traumatic events should be considered.

Personal and work-related factors associated with post-traumatic growth in nurses: A mixed studies systematic review

INTRODUCTION

Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses.

DESIGN

Mixed studies systematic review.

METHODS

Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design.

RESULTS

A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation.

CONCLUSION

The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors.

CLINICAL RELEVANCE

Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.

'Now I Have Dreams in Place of the Nightmares': An Updated Systematic Review of Post-Traumatic Growth Among Refugee Populations

Trauma exposure places refugees at serious risk of developing mental health difficulties. However, research also recognizes that refugees can respond to trauma with psychological development and growth, commonly referred to as post-traumatic growth (PTG). An updated systematic review was conducted to investigate PTG across different refugee populations, including the processes that mediate this phenomenon, and the use of therapy in promoting PTG. A systematic search of CINAHL Complete, Proquest 5000, PsychINFO, Scopus, and Web of Science was performed to identify studies exploring PTG in refugee populations, published between June 2013 and November 2021. In all, 26 studies met the inclusion criteria for this review. Quantitative results reveal a positive correlation between PTG and religious commitment and coping, and the effectiveness of narrative and community-based interventions in facilitating PTG. Qualitative results facilitate insight into the complex ways refugees find meaning and strength after trauma through religion, comparison-based thinking, helping others, and storytelling. Findings highlight the need for future research and interventions to recognize the distinct PTG experiences of different refugee populations.

Elements of cultural scripts of trauma sequelae among trauma victims in East Africa

Background

As a new, unifying approach to mapping the cultural expressions of trauma sequelae, cultural scripts of trauma sequelae are empirically investigated here for the first time in a primarily qualitative study. Elements of Cultural Scripts of Trauma (CST) include the typical symptoms and appraisals of changes of those who have experienced traumatic events. These elements refer to the value orientations in the given culture.

Aims

To identify post-traumatic cultural scripts' elements and their groupings, as expressed by trauma survivors from the East African population, and to explore the cultural values that serve as a reference to such scripts' elements.

Methods

Semi-structured, in-depth interviews were conducted in nine focus groups of trauma survivors and trauma experts. Grounded theory was the basis for the content analysis, and MAXQDA was used for coding and grouping. Semi-quantitative analyses of the frequency of groupings followed.

Results

The study extracted 270 elements of the cultural scripts of trauma. Three stages of cultural scripts' elements were identified including unspeakable, heart wounds and painful scars and growth. The reported elements are only those in the three last stages and they are grouped into six categories, such as cognitive appraisals, worldview, interpersonal relationships, body-related, positive changes and changes in family interest and management, while the elements of the first stages are not codable as the survivors do not yet get the words of their expressions. The cultural values that served as a reference consisted of holding the sadness, Christianity, community reputation, solidarity, social connectedness, social cynicism, and reproductiveness, among others.

Discussion

This comprehensive study with participants from several countries in East Africa collected a large number of elements of cultural scripts of trauma for this regional area. Notably, these elements were based mostly on man-made traumas, such as the genocide against the Tutsis in Rwanda. Further steps in the CST investigation are subject to future studies, such as a more systematic investigation of the relationship with cultural values and the temporal relationships within the scripts.

Associations among posttraumatic growth, demographic characteristics, posttraumatic stress symptoms, and trauma type, with a focus on sexual violence

This study assessed posttraumatic growth (PTG) across multiple trauma types and by demographic characteristics (i.e., sex, age, education). Moreover, we examined the association between PTG and posttraumatic stress disorder (PTSD) symptoms as well as the characteristics and predictors of PTG after sexual violence. A phone survey was conducted in a nationally representative sample of 1,766 Icelandic adults. In total, 1,528 individuals reported having experienced some form of trauma and were included in the analysis, and 563 reported experiencing sexual violence. Interpersonal trauma (e.g., sexual violence, emotional abuse, and domestic violence) was associated with the highest levels of PTG. Moderate levels of PTSD symptoms were associated with the highest levels of PTG, whereas high- or low-level PTSD symptoms were related to less PTG. Women reported significantly more PTG than men, d = 0.16 and survivors of sexual violence reported significantly more PTG than individuals who reported other forms of trauma exposure, d = 0.28. Among sexual violence survivors, no demographic factors were associated with PTG, but cumulative trauma and positive social reactions were significantly related to higher levels of PTG. This study highlights that personal growth can result from aversive experiences and suggests a curvilinear association between PTG and PTSD symptoms.

Mental Health Treatment-Seeking Appraisal, Afrocentric Cultural Norms, and Mental Health Functioning: Buffering Factors of Young Black Men's Externalizing Behavior

BACKGROUND

Depression rates are disproportionately high among Black American Men. This disparity--compounded by low mental healthcare seeking rates and high incorrect diagnosis rates in men--could be related to masculine norms, including self-reliance, restrictive emotionality, and stoicism. Furthermore, men are more likely to engage in externalized behavior, such as aggression, to cope with mental health challenges; this pattern is influenced by cultural and environmental factors. Contrary to these detrimental factors, social relationships, belief in social networks, and collectivism have been associated with positive mental health in these populations. Similarly, an Afrocentric worldview (including concepts like Ubuntu and African self-consciousness) has been hypothesized to promote positive mental health outcomes among Black American men. However, little research exists on harnessing these factors as a means of increasing health-seeking behaviors in young Black males.

AIM

To elucidate the effect of region, depression, African humanism, collectivism, and help-seeking values and needs concerning aggression in young Black males.

METHOD

This study included Black or African American participants (n = 428) identifying as male, aged 18-25 years, who responded to a Qualtrics survey with questions on region, aggression, depression, African humanism, collectivism, and help-seeking value and need.

RESULTS

Hierarchical linear regression revealed that collectivism, humanness, value, and the need for seeking treatment were inversely associated with aggression (p < 0.001).

DISCUSSION/CONCLUSION

Highlighting the effect of cultural norms and help-seeking behaviors and the aggravating effect of depression on aggression in young Black males can help to develop aggression-mitigating interventions rooted in Afrocentric Norms.

Reconstructing self from the illness: a constructivist grounded theory study of posttraumatic growth in patients with Crohn's disease

BACKGROUND

Some patients with Crohn's disease report posttraumatic growth, which can promote reductions in anxiety and depression, and improve the patient's quality of life. However, the process of posttraumatic growth remains unclear. The objectives of this study were to explore the social-psychological process of posttraumatic growth in patients with Crohn's disease in the context of Chinese culture and construct an interpretive understanding based on the perspectives of patients.

METHODS

This research adopted Charmaz's constructivist grounded theory. Nineteen participants with Crohn's disease were selected by purposive and theoretical sampling from three hospitals in Hangzhou, Zhejiang Province, as well as from the China Crohn's & Colitis Foundation. In-depth interviews were conducted. Data analysis was based on initial, focused and theoretical coding strategies, and methods such as constant comparison and memo writing were adopted. The Consolidated Criteria for Reporting Qualitative Research, a 32-item checklist for interviews and focus groups, was utilised.

RESULTS

An interpretive understanding of posttraumatic growth in patients with Crohn's disease was constructed. The core category was "reconstructing self from the illness", which included the following four categories: "suffering from the illness", "accepting the illness", "dancing with the illness" and "enriching life beyond the illness". However, not every patient reached the last phase. Before patients enter the next stage, they might begin a new cycle by experiencing new suffering or discovering new unacceptable facts about the illness.

CONCLUSIONS

This interpretive understanding reveals a growth process centred on "reconstructing self from the illness". These findings provide knowledge on the process of posttraumatic growth in patients with Crohn's disease within the wider sociocultural context.

Posttraumatic Growth After Struggling With the Loss of a Parent in Young Adulthood

This study aims to examine posttraumatic growth and its associations with parental bereavement among adolescents and young adults. Fifty-five young adults who had lost a parent to cancer at least 2 months earlier and were about to attend a support group at a palliative care service were recruited. Data was collected through questionnaires before support group participation, about 5-8 months after the loss and at a 6-month follow-up, about 14-18 months after the loss. The result shows that the young adults experienced posttraumatic growth, mostly in the domains Personal strength and Appreciation of life. Posttraumatic growth was associated with bereavement outcomes, especially life satisfaction, a feeling of meaning in future life and psychological health. The result is of value for health care professionals as it adds information about the importance of supporting constructive rumination to enhance the possibility to positive psychological change after a parent's death.

Posttraumatic growth after perinatal loss: A systematic review

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

Posttraumatic Growth and Its Measurement: A Closer Look at the PTGI’s Psychometric Properties and Structure

Despite negative connotations, surviving trauma can result in improvements in some domains of a person’s life. This phenomenon is known as posttraumatic growth (PTG), and it is typically measured using the Posttraumatic Growth Inventory (PTGI). Given the ambiguous results of the existing validation studies, the present study aimed to verify the psychometric properties of the Slovak version of the PTGI in a representative sample of Slovak citizens. Although the results suggest that a modified one-factor structure fit the data best, other issues, such as extremely high correlations between the latent factors related to the PTGI’s factor structure, were observed. It is likely that the application of the latent variable model does not represent the essence of PTG adequately and the network approach thus appears to be a far more suitable conceptualization of PTG. More detailed information on between-person differences and within-person changes in PTG could help to tailor more effective interventions or preventive programs.

Exploring posttraumatic growth after the COVID-19 pandemic

Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.

Exploring posttraumatic growth after the COVID-19 pandemic

Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.

Openness to experience is stable following adversity: A case-control longitudinal investigation

Although many people retrospectively report feeling more open-minded after experiencing highly stressful events, relevant longitudinal studies are scarce and have yielded contradictory findings. The present study used a 12-month longitudinal case-control design to test whether growth in openness (assessed every 4 months using multiple methods) occurs following major stressors, and whether changes relate to clinical symptoms of depression and/or posttraumatic stress. To do so, we compared participants (a) with a recent major stressor and with low symptoms ( n = 66), (b) without a recent major stressor and with low symptoms ( n = 76), and (c) with a recent major stressor and with significant symptoms ( n = 76). Overall, growth curve models showed that group membership was not associated with changes in openness over 12 months for most outcomes. Other variables (e.g., education) predicted changes in openness. This study provides robust evidence that openness to experience is mostly stable following major stressors.

Post-Traumatic Growth during COVID-19: The Role of Perceived Social Support, Personality, and Coping Strategies

Although many studies on mental health have been conducted among various populations during the COVID-19 pandemic, few studies have focused on post-traumatic growth (PTG) in the general population. The current study aimed to explore whether perceived social support, personality, and coping strategies are associated with PTG in the COVID-19 pandemic period. The study also investigated whether coping strategies mediate the relations between perceived social support, personality, and PTG. A total of 181 participants (M_age = 24) completed the self-report questionnaire online, which was distributed via various online channels, mainly in China and Sweden. The relations between the study variables were examined with correlation analyses and a multiple mediation analysis. Results showed that more than half of the participants (60.8%) reported experiences of PTG during the pandemic. Additionally, perceived social support, personality traits (extraversion, emotional stability, agreeableness, and conscientiousness) and coping strategies (problem-focused coping, emotion-focused coping, and social support coping) were positively correlated with PTG. In addition, coping strategies (problem-focused coping, emotion-focused coping, and avoidance coping) mediated the relations between perceived social support, personality traits and PTG. Theoretical and practical implications of this study are discussed, concluding that the findings of this study have the potential to guide intervention efforts to promote positive change during the pandemic.

Post-traumatic growth of people who have experienced earthquakes: Qualitative research systematic literature review

Introduction

Earthquakes can have a variety of physical, emotional, and social effects on the people who experience them. Post-traumatic Growth (PTG) results from people attempting to reconstruct their lives after experiencing a traumatic event. We intend to inform the local community of the importance of disaster psychology by identifying and analyzing the literature on post-traumatic growth experiences of subjects who experienced earthquakes.

Methods

This study applied a systematic review of qualitative research published from January 1, 2012 to January 31, 2021 to understand PTG in people who have experienced earthquakes. The search expressions "Post-traumatic Growth", "Earthquake", "Qualitative" were applied to CINAHL, EMBASE, PubMed, PsycInfo, KISS, RISS, and NDSL databases. Initially, 720 papers were found; after removal of duplicates, 318 remained. After a review of titles and abstracts, 186 papers that did not meet the selection criteria of this study were removed. After a further examination of the remaining 132 papers, the researchers removed 65 papers that did not match the research topic. Lastly, of the remaining 67 papers, detailed review eliminated quantitative papers that did not match this study (25), articles that were not original (19), articles in which results were not PTG (8), articles that were not related to this study (3), articles that were not written in English (2), or articles that had mixed topics (2). Eight papers remained.

Results

The results of this study show that the PTG in people who have experienced earthquakes can be classified into three categories: "Change in self-perception", "Change of interpersonal relationships", and "Spiritual change". They can be further classified into eight subcategories: "Reviewing one's existence", "Acceptance", "Discovering strengths by working through adversity", "Gratitude for life", "Changes in personal relations", "Changes in social relations", "Accepting the existence of God", and "A breakthrough to overcome difficulties".

Discussion

These results can be used as basic data for a positive psychological understanding for those who have experienced earthquake trauma.

Transforming their lives: Post-traumatic growth experience in Chinese women with breast cancer - A grounded theory study

Our research sought to explore post-traumatic growth experience among Chinese women with breast cancer. Constructivist grounded theory methodology was utilised to understand Chinese women's post-traumatic growth experience. 24 women with breast cancer were recruited from China. Data was collected through semi-structured, interviews. Three categories were developed from the data: renewing self-perception, encountering changes in relationships, and altering philosophical values and beliefs. The unique manifestations of post-traumatic growth highlight the need for development and adaption of the post-traumatic growth inventory to reduce cultural biases within the assessment tool and incorporate new culturally appropriate items.

Posttraumatic stress or posttraumatic growth? Using network analysis to explore the relationships between coping styles and trauma outcomes

Trauma can produce posttraumatic stress disorder (PTSD), but may also foster positive outcomes, such as posttraumatic growth. Individual differences in coping styles may contribute to both positive and negative sequelae of trauma. Using network analytic methods, we investigated the structure of PTSD symptoms, elements of growth, and coping styles in bereaved survivors of a major earthquake in China. Hypervigilance and difficulty concentrating were identified as the most central symptoms in the PTSD network, whereas establishing a new path in life, feeling closer to others, and doing better things with life ranked highest on centrality in the posttraumatic growth network. Direct connections between PTSD symptoms and elements of growth were low in magnitude in our sample. Our final network, which included PTSD symptoms, growth elements, and coping styles, suggests that adaptive and active coping styles, such as positive reframing, are positively related to elements of growth, but not appreciably negatively related to PTSD symptoms. Conversely, maladaptive coping styles are positively related to PTSD symptoms, but are not negatively associated with growth. Future longitudinal studies could shed light on the direction of causality in these relationships and their clinical utility.

Grief and Posttraumatic Growth Among Chinese Bereaved Parents Who Lost Their Only Child: The Moderating Role of Interpersonal Loss

Objective: Losing the only child is considered as the most severe kind of bereavement. It can trigger intense grief symptoms along with loss of psychosocial resources, but meanwhile, it can also lead to posttraumatic growth (PTG). The current study aimed to examine (a) whether a curvilinear relationship exists between grief and PTG and (b) the moderating role of resources-loss among Chinese bereaved parents who lost their only child (shidu parents). Methods: One hundred and ninety-nine shidu parents from five provinces completed the assessment packet covering prolonged grief symptoms and PTG, as well as resource loss. Hierarchical regression analyses were computed to examine the curvilinear relationship and the moderating effect of interpersonal loss and socio-economic loss. Results: There was no significant curvilinear relationship between grief and PTG in shidu parents. Under the high levels of interpersonal loss, shidu parents' PTG scores decreased as the severity of grief increased. However, the socio-economic loss did not show a significant moderating effect. Conclusion: The results of the current study did not show a significant curvilinear relationship between grief and PTG in shidu parents. High levels of grief coupled with high levels of interpersonal loss may interfere with their ability to achieve PTG. Therefore, evaluating degrees of interpersonal loss seems to be an important part of the treatment process when working with shidu parents. To facilitate their adaptation from a positive perspective, helping them maintain existing or develop new interpersonal relationships may be helpful.

Trauma and Post-traumatic Growth: Spirituality and Self-compassion as Mediators Among Parents Who Lost Their Young Children in a Protracted Conflict

The purpose of the present study was to expand the knowledge on trauma and post-traumatic growth (PTG) by exploring this relationship in parents who lost their children in Kashmir (India). The main aim of the present study was to examine whether spirituality and self-compassion mediate the relationship between trauma and PTG. Data were collected from 80 parents in the age range of 35-80 years (Mean Age = 52.09). Traumatic Grief scale Prigerson et al. (in Am J Psychiatry 154:616-623, 1997), Daily Spirituality Scale (Underwood and Teresi, Ann Behav Med 24(1):22-33, 2002), Self-Compassion Scale (Raes et al., Clin Psychol Psychoth 18:250-255, 2011), and PTG Inventory (Tedeschi and Calhoun, J Trauma Stress 9(3):455-471, 1996) scales were used to measure trauma, spirituality, self-compassion, and PTG, respectively. Results of the study indicated the presence of average amount of spirituality and high amount of trauma among the participants. High level of self-compassion and post-traumatic growth was also found among the participants. The results showed that there is no significant direct relationship between trauma and PTG; however, both the indirect paths (trauma, spirituality, and PTG as well as trauma, self-compassion, and PTG) were found to be significant. The results of the present study supported serial mediation model of Trauma and PTG through spirituality and self-compassion. It implies that trauma would lead to spirituality which in turn would lead to self-compassion and which would finally result in PTG. The result provided another lens to see the relationship between trauma and PTG.

Psychological predictors of posttraumatic growth among adult survivors of Wenchuan earthquake in China

The current research investigates the applicability of the posttraumatic growth inventory and psychological predictors of posttraumatic growth among adult survivors of the Wenchuan earthquake in China. The results indicated that although the survivors reported a high degree of posttraumatic stress symptoms, they also experienced a moderate to high level of posttraumatic growth two years after the earthquake. The simplified Chinese version of the Posttraumatic Growth Inventory had good reliability in the current study. Confirmatory factor analysis of the simplified Chinese version of the Posttraumatic Growth Inventory verified that the original five-factor model fit the data better than the four-factor model documented by Ho et al. (2004, 2011) among Chinese cancer patients. The current study also demonstrates that positive changes in outlook, positive affect, and perceived social support are significant predictors of posttraumatic growth among adult survivors of the Wenchuan earthquake. Directions for future research on posttraumatic growth among survivors of natural disasters and implications for developing psychological interventions to help people recover from traumatic events are discussed.

Posttraumatic Growth at Work

The phenomenon of posttraumatic growth—the transformative positive change that can occur as a result of a struggle with great adversity—has been a focus of interest for psychologists for more than two decades. Research on work-related posttraumatic growth has concentrated primarily on contexts that are inherently traumatic, either through direct exposure to trauma, such as in the military, or through secondary trauma, such as in professions that provide care for traumatized others. There is also an emerging literature on posttraumatic growth in “ordinary” work. Organized into seven sections, this review draws on the research on posttraumatic growth in response to both personal and work-based adversity to build a model of work-related posttraumatic growth. Later sections raise challenges in the study of posttraumatic growth at work and identify critical future research directions. Practical implications for organizations and their members are considered throughout the review and are summarized at the end.

Posttraumatic growth experiences and its contextual factors in women with breast cancer: An integrative review

In this article, we synthesize current research that examines determinants and manifestations of posttraumatic growth (the phenomenon of posttraumatic growth can be embodied in several domains) in women with breast cancer. The findings of the integrative literature review may contribute to facilitating person-centered oncology care by raising health care professionals' awareness and understanding of posttraumatic growth phenomenon among breast cancer survivors. The identification of factors contributing to posttraumatic growth and manifestations of posttraumatic growth are important in increasing the effectiveness of interventions in supporting women during their breast cancer journey. The methods proposed by Whittemore and Knafl ( 2005 ) were adopted to guide this integrative review. Quality assessment was conducted using recognized critical appraisal tools relating to quantitative and qualitative studies. Four main manifestations were synthesized from the literature: new perception of self; relatedness to others; new life philosophy; and spiritual and religious growth. Personal characteristics, illness factors, cognitive processing, coping strategies, social support, religion and spirituality, the body's role and physical activities were identified as influencing posttraumatic growth in women with breast cancer.