Correlation Between Posttraumatic Growth and Posttraumatic Stress Disorder Symptoms Based on Pearson Correlation Coefficient: A Meta-Analysis

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

INTRODUCTION

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

OBJECTIVE

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

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Constellations of posttraumatic stress symptoms and posttraumatic growth among Israeli female combat veterans: A latent profile analysis approach

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.

A study on post-traumatic stress disorder and post-traumatic growth among patients infected with COVID-19 in Wuhan

Objective

The purpose of this study is to assess the physical and psychological conditions of hospitalized patients who were infected with COVID-19 in Wuhan, China, including post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) scores and predictors.

Methods

The test group consisted of 102 hospitalized patients diagnosed with COVID-19 in Wuhan between March 4, 2020 and April 5, 2020, whereas the control group comprised 168 healthy study participants. Relevant information of the study participants was obtained using online questionnaires, covering five aspects-general information, physical state, emotional state, PTSD, and PTG.

Results

In Wuhan, 37.3% of COVID-19-diagnosed hospitalized patients exhibited hyper-arousal symptoms of PTSD. This percentage is significantly higher than the 13.1% observed in the healthy population. Furthermore, the prevalence of PTG among the same group of hospitalized patients stood at 77.5%, surpassing the 66.1% rate found within the healthy population. It was determined that inconsistent sleep patterns during the hospitalization phase could be indicative of heightened vulnerability to hyperarousal symptoms of PTSD in COVID-19-diagnosed hospitalized patients. The study determined that inconsistent sleep patterns during hospitalization may be a predisposition factor that makes hospitalized patients diagnosed with covid-19 more susceptible to high arousal symptoms of post-traumatic stress disorder. Conversely, COVID-19-diagnosed hospitalized patients who maintained a tranquil demeanor and exhibited positive emotional perceptions during their hospitalization displayed reduced susceptibility to these PTSD symptoms. Factors such as possession of a bachelor's degree, history of severe acute respiratory syndrome (SARS) infection, and poor sleep patterns were identified as predictors elevating the risk of PTG. Whereas, a sentiment of happiness and consistent positive emotional perception during hospitalization were predictors of PTG. Intriguingly, a direct correlation was established between hyper-arousal symptoms of PTSD and PTG.

Conclusion

Although the outbreak of COVID-19 has badly affected the physical and psychological well-being of patients, it has greatly enhanced their PTG.

Interaction between posttraumatic stress symptoms and posttraumatic growth among adolescents who experience an earthquake: A repeated longitudinal study

For adolescents who experience an earthquake, posttraumatic stress symptoms (PTSSs) and posttraumatic growth (PTG) often co-occur. However, no study has yet examined how the interaction between them changes from the short term to the long term after an earthquake. This study conducted six surveys among local adolescents across three waves after the Wenchuan earthquake, and a directed network of PTSS and PTG co-occurrence was constructed for each wave. It was found that the bridge nodes between PTSSs and PTG were different for each wave. The connection between PTSSs and PTG became loose over time. The incubation effect of PTSSs on PTG was sustained until the middle term but was not observed in the long term. The suppression effect of PTSSs on PTG was only observed in the short term. PTG not only alleviated PTSSs but also exacerbated PTSSs. Finally, the effect of PTSSs on PTG was much stronger than that of PTG on PTSSs. This study suggests that efforts should be made to alleviate specific PTSSs or facilitate specific PTG elements among adolescents for different terms after an earthquake, and PTG is more likely to be an outcome of trauma rather than a strategy for coping with trauma.

The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes

Introduction

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes.

Methods

This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level.

Results

Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress.

Discussion

These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

Empirically Derived Patterns of Posttraumatic Stress and Growth: A Systematic Review

The relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) has been extensively studied; however, the nature of the relationship remains unclear. Inconsistencies in the literature could be, in part, due to the use of variable level approaches. Person centered methods may further our understanding of this relationship, as they enable the identification of clinically meaningful subgroups based on PTS/PTG scores. This review aimed to identify commonly found subgroups of PTS and PTG, clinically relevant factors that distinguish the subgroups and to critically appraise the utility of categorizing individuals into subgroups based on PTS/PTG scores. Five databases (Embase, Medline, Web of Science, PILOTS, and PsycINFO) were searched. Seven studies (with a total of eight study samples; n = 6,776) met the eligibility criteria. A narrative synthesis of the findings revealed that the majority of the analyses (n = 6) found three patterns of PTS/PTG. These were categorized as: (1) low PTS/PTG (representing 26.89% of the entire sample), (2) high PTS/PTG (weighted mean percentage = 20.05%), and (3) low PTS/high PTG (weighted mean percentage = 43.1%). The role of social support was examined in five studies and higher social support was consistently found to predict membership in the low PTS/high PTG class. All five studies that examined the role of trauma characteristics found that it was a significant predictor of class membership. These findings could inform the developments of tailored interventions. The utility of person-centered approaches was discussed and recommendations to improve the application and reporting of such methods were made.

Distinct pre-COVID brain structural signatures in COVID-19-related post-traumatic stress symptoms and post-traumatic growth

Post-traumatic stress symptoms and post-traumatic growth are common co-occurring psychological responses following exposure to traumatic events (such as COVID-19 pandemic), their mutual relationship remains unclear. To explore this relationship, structural magnetic resonance imaging data were acquired from 115 general college students before the COVID-19 pandemic, and follow-up post-traumatic stress symptoms and post-traumatic growth measurements were collected during the pandemic. Voxel-based morphometry was conducted and individual structural covariance networks based on gray matter volume were further analyzed using graph theory and partial least squares correlation. Behavioral correlation found no significant relationship between post-traumatic stress symptoms and post-traumatic growth. Voxel-based morphometry analyses showed that post-traumatic stress symptoms were positively correlated with gray matter volume in medial prefrontal cortex/dorsal anterior cingulate cortex, and post-traumatic growth was negatively correlated with gray matter volume in left dorsolateral prefrontal cortex. Structural covariance network analyses found that post-traumatic stress symptoms were negatively correlated with the local efficiency and clustering coefficient of the network. Moreover, partial least squares correlation showed that post-traumatic stress symptoms were correlated with pronounced nodal properties patterns in default mode, sensory and motor regions, and a marginal correlation of post-traumatic growth with a nodal property pattern in emotion regulation-related regions. This study advances our understanding of the neurobiological substrates of post-traumatic stress symptoms and post-traumatic growth, and suggests that they may have different neuroanatomical features.

Relationship between acute glucose variability and cognitive decline in type 2 diabetes: A systematic review and meta-analysis

BACKGROUND

Cognitive decline is one of the most widespread chronic complications of diabetes, which occurs in more than half of the patients with type 2 diabetes (T2DM). Emerging evidences have suggested that glucose variability (GV) is associated with the pathogenesis of diabetic complications. However, the influence of acute GV on cognitive dysfunction in T2DM is still controversial. The aim of the study was to evaluate the association between acute GV and cognitive defect in T2DM, and provide a most recent and comprehensive summary of the evidences in this research field.

METHODS

PubMed, Cochrane library, EMBASE, Web of science, Sinomed, China National Knowledge Infrastructure (CNKI), and Wanfang were searched for articles that reported on the association between acute GV and cognitive impairment in T2DM.

RESULTS

9 eligible studies were included, with a total of 1263 patients with T2DM involved. Results showed that summary Fisher's z value was -0.23 [95%CI (-0.39, -0.06)], suggesting statistical significance (P = 0.006). Summary r value was -0.22 [95%CI (-0.37, -0.06)]. A lower cognitive performance was found in the subjects with greater glucose variation, which has statistical significance. Mean amplitude of glycemic excursions (MAGE) was associated with a higher risk of poor functional outcomes. Fisher's z value was -0.35 [95%CI (-0.43, -0.25)], indicating statistical significance (P = 0.011). Sensitivity analyses by omitting individual studies showed stability of the results.

CONCLUSIONS

Overall, higher acute GV is associated with an increased risk of cognitive impairment in patients with T2DM. Further studies should be required to determine whether targeted intervention of reducing acute GV could prevent cognitive decline.

Post traumatic growth among military enroute care nurses: A secondary analysis

To date, little is known about the experience of military nurses and post traumatic growth (PTG). An analysis focusing on PTG was performed using data from the surveys and qualitative interviews of military enroute care nurses. In a mixed methods study designed to understand behavioral health symptoms experienced by military enroute care nurses, the qualitative data confirmed the experiences of nurses found in the quantitative data regarding the presence of PTG. Although the mean PTG total score was low in the quantitative findings, the qualitative data supported the presence of important factors comprising PTG. More research is needed to determine the experience of PTG among nurses.

Reliability and Validity of the Japanese Version of the Short Form of the Expanded Version of the Posttraumatic Growth Inventory (PTGI-X-SF-J): A Cross-Sectional Study

A Japanese version of the short form of the expanded Posttraumatic Growth Inventory (PTGI-X-SF-J) was developed in this study, as the extended version captures broader, more diverse personal growth perspectives, such as existential spiritual growth. We collected cross-sectional data from 408 (first sample) and 284 (second sample) Japanese university students using the expanded version of the Posttraumatic Growth Inventory (PTGI-X-J). Exploratory factor analysis (EFA) was performed with the first sample and confirmatory factor analysis (CFA) with the second; reliability and validity were examined. The short-form version resulting from the EFA and CFA comprised 10 items and five factors. Cronbach's alpha for the PTGI-X-SF-J total and subscale scores ranged from 0.671 to 0.875. The intraclass correlation coefficient for the total and subscale scores between the PTGI-X-J and PTGI-X-SF-J ranged from 0.699 to 0.821. Regarding external validity, no significant correlation was found between posttraumatic growth and posttraumatic stress disorder checklists. Due to its brevity, the PTGI-X-SF-J can help assess diverse spiritual and existential personal growth experiences among clients, patients, and trauma survivors while reducing physical and psychological burdens.

Validation of the Post-Traumatic Growth Inventory in Adolescents Who Lost a Family Member in the Past 4 years: Effects of Time After the Death Event and Gender

Post-traumatic growth is the psychological capacity to perceive positive changes facing high-stress or potentially traumatic events and may be especially useful in lessening their effects in adolescents' lives. Present study aimed to evaluate the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in 662 Peruvian adolescents who suffered the death of an immediate family member over the last 4 years. Firstly, an exploratory graphical analysis (EGA) was conducted to determine the best parsimonious structure of the instrument and confirmed with its respective factor models. The results report adequate fit indices in the EGA Bifactor model. Furthermore, another structural model is included, which reports significant latent effects of the time elapsed since the relative's death and gender (male) on PTGI general factor. Likewise, gender measure was significantly related to items 3, 7, and 11, which is linked to personal growth.

Can respondents accurately self-report posttraumatic growth when coached through the required cognitive steps?

BACKGROUND

Coyne and Tennen [(2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39(1), 16-26. https://doi.org/10.1007/s12160-009-9154-z] argue that completing self-reports of posttraumatic growth (PTG) requires four complicated cognitive steps.

DESIGN

We conducted two experiments designed to (1) use mental chronometry (i.e., reaction times on cognitive tasks) to test whether respondents engage in multiple cognitive steps when completing self-reports of PTG, and (2) determine whether coaching participants to take these steps results in a more valid assessment.

METHOD

In Experiment 1, 310 undergraduates were randomly assigned to complete either the Posttraumatic Growth Inventory (PTGI) or Stress-Related Growth Scale (SRGS), and its corresponding current version that requires only one cognitive step. In Experiment 2, 306 undergraduates were randomly assigned to complete either a guided-steps version of the SRGS or the original SRGS.

RESULTS

Experiment 1 indicated a very small difference in completion time for the PTGI, but not the SRGS, in comparison to the current versions, suggesting respondents do not engage in the four required cognitive steps. In Experiment 2, participants reported less PTG when coached to go through the four cognitive steps, but the resulting scores were generally unrelated to measures of convergent and predictive validity.

CONCLUSION

We conclude that individuals cannot accurately report PTG, even when explicitly coached.

Post-traumatic growth in PhD students during the COVID-19 pandemic

Throughout the COVID-19 pandemic, graduate students have faced increased risk of mental health challenges. Research suggests that experiencing adversity may induce positive psychological changes, called post-traumatic growth (PTG). These changes can include improved relationships with others, perceptions of oneself, and enjoyment of life. Few existing studies have explored this phenomenon among graduate students. This secondary data analysis of a survey conducted in November 2020 among graduate students at a private R1 University in the northeast United States examined graduate students' levels and correlates of PTG during the COVID-19 pandemic. Students had a low level of PTG, with a mean score of 10.31 out of 50. Linear regression models showed significant positive relationships between anxiety and PTG and between a measure of self-reported impact of the pandemic and PTG. Non-White minorities also had significantly greater PTG than White participants. Experiencing more negative impact due to the pandemic and ruminating about the pandemic were correlated with greater PTG. These findings advance research on the patterns of PTG during the COVID-19 pandemic and can inform future studies of graduate students' coping mechanisms and support efforts to promote pandemic recovery and resilience.

Posttraumatic Growth, Dissociation and Identification With The Aggressor Among Childhood Abuse Survivors

Childhood abuse puts individuals at risk for psychopathology and psychiatric symptoms such as posttraumatic stress disorder (PTSD) and anxiety symptoms. At the same time, research has indicated that some survivors report positive transformations in the aftermath of their trauma, known as posttraumatic growth (PTG). Yet the essence of PTG reports is questionable, and some scholars claim that it may reflect maladaptive illusory qualities. Furthermore, according to a recent theoretical model, PTG might be dissociation-based and related to survivors' bonds with their perpetrators. This study aimed to explore these claims by assessing PTG, dissociation, and identification with the aggressor (IWA), as well as PTSD and anxiety symptoms. An online survey was conducted among 597 adult childhood abuse survivors. Study variables were assessed via self-report measures. Analyses indicated positive associations between PTG, dissociation, and IWA. Three distinct profiles were found, reflecting high, medium, and low scores on PTG, dissociation, and IWA. Profile type explained PTSD and anxiety symptoms above and beyond gender, age, and abuse severity. These findings suggest that whereas some childhood abuse survivors might experience a positive transformation subsequent to their trauma, others' PTG reports might reflect dissociative mechanisms and pathological attachments to their perpetrators, and thus might be maladaptive.

Posttraumatic Growth and Subjective Well-Being in Men and Women after Divorce: The Mediating and Moderating Roles of Self-Esteem

Prior research has mainly examined non-adaptive responses to divorce, with less attention being paid to positive changes following the adversity of marital dissolution, especially posttraumatic growth and its consequences. The aim of this paper was to analyse the relationship between posttraumatic growth and subjective well-being, as well as the mediating and moderating role of self-esteem in this relationship among divorced men and women. The sample consisted of 209 divorcees (143 females, 66 males) aged 23-80 (M = 41.97, SD = 10.72). The Posttraumatic Growth Inventory (PTGI), the Oxford Happiness Questionnaire (OHQ) and the Rosenberg Self-Esteem Scale (SES) were used in the study. Positive associations between overall posttraumatic growth, specific growth dimensions, subjective well-being and self-esteem were found. Self-esteem was confirmed as a mediator in the relationships between changes in perception of self and subjective well-being (SWB), between changes in relating to others and SWB and between appreciation for life and SWB. Self-esteem moderated the association between spiritual changes and subjective well-being; namely, changes in spirituality were positively related to happiness in individuals with lower and average self-esteem but not with high self-esteem. We found no differences between women and men in the obtained results. Self-esteem might be considered a possible psychological (mediating rather than moderating) mechanism in the transmission of PTG onto SWB in divorcees, regardless of their gender.

Posttraumatic growth in people affected by an occupational accident: A longitudinal multilevel model of change

This study analyzed a predictive model of posttraumatic growth (PTG) in a cohort of 244 workers affected by an occupational accident. A longitudinal design with three points in time (i.e., 1, 6, and 12 months after the accident) was used. PTG, posttraumatic stress symptoms (PTSS), subjective severity of the event, deliberate rumination, and seeking social support were evaluated. In addition, time since the accident, age, and gender were included as predictors in our model. Deliberate rumination and seeking social support significantly predicted PTG trajectory in a multilevel model. Practical conclusions from the results suggest that work accident victims should be encouraged to seek social support and to positively reframe their experience.

50 Years After Political Protest Violence, Posttraumatic Growth is Associated with PTSD and Anxiety but not Depression or Sleep Difficulties

Rates of, and relationships between, posttraumatic stress disorder (PTSD), depression, anxiety, and posttraumatic growth (PTG) decades after a single-incident trauma remain unclear. During a two-month period surrounding the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 132 individuals completed measures of PTG, PTSD, depression, anxiety, and sleep difficulties. Participants were, on average, 19 years old (SD = 3.01) on May 4, 1970, and 44% were present at the protests. 17% met cutoff scores consistent with PTG, 6% for PTSD, 8% for anxiety, 11% for depression and 20% for sleep difficulties. PTG was significantly and positively correlated with PTSD (r = .32, 95% CI: 0.17-0.44) and anxiety (r = .23, 95% CI: 0.08-0.38) but not depression or sleep difficulties after controlling for additional trauma exposure since May 4, 1970. All relationships were best explained by linear rather than curvilinear relationships and were not moderated by proximity to the events of May 4, 1970. Results indicate that clinicians working with survivors of trauma decades later may be able to capitalize on the adaptive functions of PTG to foster positive treatment outcomes.

Social support and posttraumatic growth: A meta-analysis

BACKGROUND

The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association.

METHODS

Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis.

RESULTS

The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size.

LIMITATIONS

Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size.

CONCLUSIONS

Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.

Intelligent injury prediction for traumatic airway obstruction

Airway obstruction is one of the crucial causes of death in trauma patients during the first aid. It is extremely challenging to accurately treat a great deal of casualties with airway obstruction in hospitals. The diagnosis of airway obstruction in an emergency mostly relies on the medical experience of physicians. In this paper, we propose the feature selection approach genetic algorithm-mean decrease impurity (GA-MDI) to effectively minimize the number of features as well as ensure the accuracy of prediction. Furthermore, we design a multi-modal neural network, called fully convolutional network with squeeze-and-excitation and multilayer perceptron (FCN-SE + MLP), to help physicians to predict the severity of airway obstruction. We validate the effectiveness of the proposed feature selection approach and multi-modal model on the emergency medical database from the Chinese General Hospital of the PLA. The experimental results show that GA-MDI outperforms the existing feature selection algorithms, while it is also validated that the model FCN-SE + MLP can effectively and accurately achieve the prediction of the severity of airway obstruction, which can assist clinicians in making treatment decisions for airway obstruction casualties.

Factors Associated with Post-Traumatic Growth in Healthcare Professionals: A Systematic Review of the Literature

Post-traumatic growth (PTG) research is flourishing across various disciplines; however, it is only emerging in healthcare. Recently, a flurry of studies assessed PTG among healthcare professionals. However, to date, no systematic review has identified the factors that predict their experiences of PTG among healthcare professionals. The current paper aims to address this gap. Of 126 papers, 27 were selected for this systematic review. The analysis identified a range of demographic, individual (work-related and personal), interpersonal and environmental factors that contributed to healthcare professionals' experiences of PTG. Analysis of findings offers a novel perspective on individual factors by dividing them into personal and work-related factors. Results also highlight a variety of psychological interventions that can be used in healthcare to cultivate PTG. In addition, the gaps in current research, implications for further research, policy and practice that can facilitate the experience of PTG among healthcare professionals are discussed.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

Relationship between World Assumptions and Post-Traumatic Growth among Polish Cancer Patients: Moderating Effect of Rumination

BACKGROUND

Although post-traumatic growth is believed to be the result of complex interplays between various factors, cognitive variables appear to play a special role in these interactions. Yet, research on this topic is scant. Therefore, the first purpose of this study was to verify whether there is a direct relationship between world assumptions and post-traumatic growth among Polish cancer patients. As the effect of psychological change in post-traumatic growth may be affected by basic beliefs about the world and oneself, the second goal was to assess whether this association is moderated by rumination.

METHODS

The study included 215 Polish cancer patients. The Post-traumatic Growth and Depreciation Inventory-Expanded version-(intrusive and deliberate rumination), the World Assumption Scale, and the Event-related Rumination Inventory were applied.

RESULTS

Positive, albeit weak, correlations were found between the dimensions of world assumptions and post-traumatic growth. Post-traumatic growth correlated negatively with intrusive rumination and positively with deliberate rumination. The outcomes show that the level of post-traumatic growth resulting from world assumptions is significantly different at various levels of intrusive and deliberate rumination.

CONCLUSION

Lower/medium intrusive rumination seems to strengthen the relationship between benevolence of the world/worthiness of the self and post-traumatic growth, and higher deliberate rumination tends to reinforce the relationship between meaningfulness and post-traumatic growth.

Exploring psychological resilience of entrepreneurial college students for post-pandemic pedagogy: The mediating role of self-efficacy

The psychological impact of the COVID-19 epidemic on college students is an important topic. With the entry of the post-epidemic era, how universities can better improve students’ psychological resilience in teaching is the research topic of this article. In the form of a questionnaire survey, some entrepreneurial college students investigated the loneliness and psychological resilience of college students after the outbreak of the epidemic and explored the role of self-efficacy in it. The data is collected online through cooperation with an entrepreneurial event, and the participating students are asked for background information such as colleges, grade, and majors. After collecting this information, they answered a series of simplified scale questions about loneliness, self-efficacy, and psychological resilience. In the end, a total of 200 questionnaires from different universities were collected, and the structural equation model was used to explore the role of self-efficacy. The results show that: loneliness has a significant negative effect on Self-efficacy, β = -0.292, p &lt; 0.001; Self-efficacy has a significant positive effect on psychological resilience, β = 0.556, p &lt; 0.0 01; loneliness has a significant negative effect on psychological resilience, β = -0.244, p &lt; 0.01. Self-Efficacy has a significant intermediate effect in loneliness and psychological resilience, with an effective value of -0.111 and p &lt; 0.01. The results show that this exploratory survey finds it important to provide targeted personal self-efficacy improvement activities for college students with a strong sense of loneliness and to combine school and family education organically to help college students form a healthy and upward mentality to better cope with the unknown and troubles caused by the epidemic, which will help improve the psychological resilience of college students in the epidemic.

Adaptive performance in refugees after trauma: how relevant are post-traumatic stress and post-traumatic growth?

Purpose

Wars can lead to massive migration waves, e.g. the Syrian Civil War that began in 2011 led to the European refugee crisis. Discussions about labour integration often accompany huge spikes in asylum applications. Since many refugees experience traumatic events, such as torture, health problems must be considered in the work context. Unfortunately, the relevance of the post-traumatic experiences of refugees to specific job performance facets has mainly been ignored. To close the research gap, a study with refugees living in Germany was conducted to examine to what extent trauma-related variables are relevant to performance variables.

Design/methodology/approach

The relationship between post-traumatic stress (PTS), post-traumatic growth (PTG) and adaptive performance (social and task-oriented adaptive performance) was examined as, nowadays, many activities require dealing with changes (e.g. new colleagues, new technologies). Sixty-nine people met the inclusion criteria (e.g. refugee status, traumatic experiences) and completed the survey. Data were analysed using the Bayesian approach.

Findings

Bayesian analyses revealed that PTG might promote both social and task-oriented adaptive performance. In contrast, PTS was negatively related to task-oriented adaptive performance. Furthermore, there was no substantial evidence that PTG moderates the relationship between PTS and adaptive performance. Furthermore, there is preliminary evidence that refugees do not differ substantially from the general population with respect to social adaptive performance.

Originality/value

The present study demonstrates for the first time the relevance of post-traumatic experiences to the adaptive performance of refugees.

Long-Term Posttraumatic Growth in Victims of Terrorism in Spain

Background

Scientific literature on posttraumatic growth (PTG) after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.

Methods

We examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks (range: 2–47 years). The participants had been injured by a terrorist attack (38.6%) or were first-degree relatives of people who had been killed or injured by a terrorist attack (41.4% and 20%, respectively). They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.

Results

Multiple regression analyses revealed gender differences (women reported higher levels of PTG than did men) and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.

Conclusion

The findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research.

The relationship between posttraumatic stress disorder, posttraumatic growth, and rumination in adolescents after earthquake: A systematic review

PURPOSE

This systematic review aims to examine, from an interdisciplinary perspective, the relationship between posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), and rumination in adolescents after an earthquake. The aim of the review is to provide high-quality, evidence-based recommendations that contribute to the roles of psychiatric nurses and the development of psychosocial support systems.

DESIGN AND METHODS

This study has been conducted in line with the Centres for Reviews and Dissemination (CRD) guideline which guides preparation for transparent reporting of meta-analysis and systematic reviews.

FINDINGS

Despite the limited evidence, it was concluded that it is important to identify the psychological processes that lead to PTG and reduce the incidence of PTSD in earthquake-affected adolescents.

PRACTICAL IMPLICATIONS

This evidence shows how important it is to raise the awareness of healthcare providers in different disciplines, including psychiatric nurses, around the need for psychosocial support interventions following a natural disaster.

What Factors are Associated with Posttraumatic Growth in Older Adults? A Systematic Review

OBJECTIVES

Posttraumatic growth (PTG) is of increased theoretical and clinical interest. However, less is known about PTG in older adults specifically. This systematic review aimed to identify domains where PTG is studied for older adults; investigate factors associated with PTG in older adults; consider how these might differ between historical and later life traumas.

METHODS

Online databases were searched for quantitative studies examining PTG outcomes in adults aged ≥ 60 years.

RESULTS

15 studies were subject to a narrative synthesis.

CONCLUSIONS

Older adults can experience substantial levels of PTG, from traumas during later life or across the lifespan, and historical wartime traumas. Traumas can be diverse, some studies found equivalent levels of PTG from different traumas across the lifespan. Social processes may be a key variable for older adults. Additional psychosocial factors are found; however, diverse findings reflect no overall model, and this may be consistent with variations found in other PTG literature.

CLINICAL IMPLICATIONS

Clinical considerations are discussed. As diverse studies, findings may not be widely generalizable and directions for further research are highlighted. PROSPERO: CRD42020169318.

Does perceived post-traumatic growth predict better psychological adjustment during the COVID-19 pandemic? Results from a national longitudinal survey in the USA

Perceiving that one has grown in positive ways following highly stressful experiences (perceived posttraumatic growth; PPTG) is common and sometimes--but not always--related to psychological wellbeing. However, PPTG is typically studied cross-sectionally and well after the stressful experience has passed; how PPTG might relate to wellbeing over time in an unprecedented, ongoing worldwide disaster such as the COVID-19 pandemic remains unknown. Thus, the current study sought to answer whether, in the midst of the pandemic, PPTG relates to subsequent wellbeing, broadly defined. Participants were N = 1544 MTurk workers who completed a five-wave (T1-T5) six-month longitudinal study. Current analyses focused on T2-T5 (ns = 860-712). At each time point, participants completed self-report measures of PPTG and wellbeing (depression, anxiety, stress, positive states of mind, alcohol use, posttraumatic stress). In cross-lagged panel models, PPTG was largely unrelated to subsequent wellbeing. Somewhat more evidence was found that increasing distress led to increases in PPTG, suggesting perceptions of growth may serve as a coping mechanism. PPTG does not appear to benefit adjustment to the COVID-19 pandemic and may simply reflect efforts to manage distress.

A Positive Legacy of Trauma? The Role of Perceived Social Support on Mental Health Among Earthquake Survivors During the COVID-19 Outbreak

BACKGROUND

People with prior experience of severe trauma may be particularly vulnerable in the face of the COVID-19 pandemic. However, little is known about mental health problems among prior trauma survivors during the pandemic outbreak.

METHODS

A total of 362 Wenchuan earthquake survivors were assessed using Patient Health Questionnaire, Generalized Anxiety Disorder Scale, as well as Multidimensional Scale of Perceived Social Support, as part of an online survey between February 3 and 10, 2020.

RESULTS

Our results showed that 6.6 and 4.7% of the participants experienced depression and anxiety during the COVID-19 outbreak, respectively. Perceived social support was negatively associated with depressive and anxiety symptoms. Earthquake exposure has no direct effect on current depressive and anxiety symptoms, but it would moderate the direct relationship between perceived social support and psychological symptoms.

CONCLUSIONS

Our findings suggested that trauma exposure may lead to salutogenic outcomes. The protective effect of perceived social support on psychological symptoms was greater in people with a higher level of trauma exposure than in a lower one.

Posttraumatic growth and posttraumatic stress - a network analysis among Syrian and Iraqi refugees

BACKGROUND

Traumatic events related to war and displacement may lead to development of posttraumatic stress symptoms (PTSS), but many war trauma survivors also report experiencing posttraumatic growth (PTG). However, the phenomenon of PTG remains poorly understood among refugees. Previous findings are also contradictory on whether more PTSS associate with PTG and what specific symptoms or aspects of growth may account for any possible link.

OBJECTIVE AND METHOD

Here, we aimed to better understand posttraumatic growth among refugees, especially its structure and most important constituent elements, as well as how it associates with PTSS. We employed regression and network analysis methods with a large sample (N = 3,159) of Syrian and Iraqi refugees living in Turkey self-reporting on PTG and PTSS.

RESULTS

We found PTG and PTSS to be clearly distinct phenomena. Still, they often co-occurred, with a positive, slightly U-shaped relationship found between levels of PTSS and PTG. The main bridge between the constructs was identified from intrusive symptoms to having new priorities in life, although new priorities were more peripheral to the overall network structure of PTG. Meanwhile, discovering new psychological strengths and abilities and a new path in life emerged as elements most central to PTG itself.

CONCLUSIONS

Many refugees report elements of PTG, even as they suffer from significant PTSS. The two phenomena appear distinct but positively associated, supporting the idea that intense cognitive processing involving distress may be necessary for growth after trauma. Our findings may inform efforts to support refugee trauma survivors in finding meaning and perhaps even growth after highly challenging experiences.

Growth after Trauma: The Role of Self-Compassion following Hurricane Harvey

The psychological impact of a traumatic event includes potentially both negative (e.g., PTSD, depression, and anxiety) as well as positive (e.g., post-traumatic growth) outcomes. The construct of self-compassion—the capacity to be compassionate towards oneself—has been associated with various psychological benefits following disasters; however, the association between self-compassion and PTG have not yet been examined in natural disaster settings. This study aimed to examine the relationship between these constructs, with self-compassion as a potential mediator in this relationship. Three hundred and nine undergraduate students affected by the impact of Hurricane Harvey were recruited. Statistical analyses revealed a significant mediation effect, with PTSD symptoms being both directly and indirectly (via self-compassion) associated with PTG. The capacity to grow from traumatic experiences is mediated by one’s disposition to be compassionate towards oneself, serving as a resilience factor to provide individuals with the cognitive and emotional resources to grow after trauma. These findings have significant implications in both clinical and research contexts, including the use of self-compassion interventions to protect against PTSD and other comorbid psychopathology and also act as a catalyst for growth following natural disaster events.

The Influence of Post-Traumatic Growth on College Students' Creativity During the COVID-19 Pandemic: The Mediating Role of General Self-Efficacy and the Moderating Role of Deliberate Rumination

Purpose: This study used a moderated mediation model to test the mediating effect of general self-efficacy on the relationship between post-traumatic growth (PTG) and creativity and the moderating effect of deliberate rumination in the second path of the indirect mediation path during the COVID-19 pandemic. Methods: A sample of 881 university students from Guangdong Province, China, was surveyed with the Posttraumatic Growth Inventory, the Runco Ideational Behavior Scale, the General Self-Efficacy Scale, and the Deliberate Rumination Inventory. SPSS (23 version) and PROCESS (3.3 version) were used for correlation analyses, mediation analysis, and moderated mediation analysis. Results: (1) PTG was positively correlated with creativity, self-efficacy, and deliberate rumination. Creativity was positively correlated with self-efficacy and deliberate rumination. Deliberate rumination was positively correlated with self-efficacy. (2) Self-efficacy mediated the relationship between PTG and creativity. (3) Deliberate rumination moderated the second half of the path of "PTG → self-efficacy → creativity." Conclusions: PTG affected creativity directly and also indirectly through self-efficacy. In particular, deliberate rumination moderated the relationship between self-efficacy and creativity, such that the association was stronger when the incidence of deliberate rumination was low. These results provide a more comprehensive understanding of the positive link between PTG and creativity.

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.

The Effect of Traumatic Loss on Posttraumatic Growth Among 2011 Van Earthquake Survivors: The Mediating Role of Posttraumatic Stress

OBJECTIVE

Posttraumatic growth (PTG), defined as a positive change after a traumatic event, has become the subject of various studies, and its relationship with posttraumatic stress symptoms (PTSS) has been extensively investigated. However, studies have indicated differences in the relationship between PTG and PTSS. Therefore, this study aimed to investigate the mediating role of PTSS in the relationship between the number of traumatic losses and PTG among the 2011 Van earthquake survivors.

METHODS

The sample of this study consisted of 917 participants who experienced the 2011 Van earthquake. A personal information form, impact of event scale-revised (IES-R), and posttraumatic growth inventory (PTGI) were used as data collection tools.

RESULTS

Survivors with traumatic loss were found to have higher PTSS and PTG than survivors without traumatic loss. The mean scores of the PTGI subscales were higher among survivors with traumatic loss except for changes in self-perception. A positive correlation was found between IES-R and PTGI total scores. In the regression analysis, it was found that PTSS played a mediating role in the relationship between the number of traumatic losses and PTG.

CONCLUSION

This study revealed that PTG is possible with the presence of PTSS. Mental health professionals assisting survivors with traumatic loss should take the enhancement of PTG into consideration in addition to their efforts to reduce PTSS.

Post-traumatic stress, growth, and depreciation during the COVID-19 pandemic: evidence from Turkey

Background: A worldwide health threat, the COVID-19 pandemic, has highlighted the need to focus on its mental health impact. However, literature on mental health effects including post-traumatic consequences of the pandemic is scarce. Objective: The current study examined post-traumatic stress (PTS), growth (PTG), and depreciation (PTD) during the pandemic, and explored factors associated with these mental health outcomes in an adult community sample from Turkey. Method: A total of 685 participants responded to an online survey that gathered data on sociodemographic characteristics, financial loss during the pandemic, time spent at home and frequency of social media use, perception of COVID-related risks, stress, and event-related rumination. Data analysis included correlation and regression analyses. Results: Results showed that PTS, PTG, and PTD were positively correlated with each other. Younger age and being single were associated with higher PTS and PTD, and lower education levels predicted all three outcomes. Experiencing financial loss during the pandemic, more frequent social media use to follow COVID-related news and posts, and longer time spent at home during the pandemic were associated with higher PTS. Anticipating financial risks during the pandemic were associated with all outcomes while anticipating health-related risks due to COVID-19 and perceived stress levels predicted PTS and PTD but not PTG. Both intrusive and deliberate rumination were associated with higher levels of PTS and PTD, and PTG was predicted solely by deliberate rumination. Moreover, provisional PTSD was indicated in 47.9% of the participants. Membership to the provisional PTSD group was predicted by age, level of education, time spent on social media, anticipating COVID-19-related health risks, perceived stress, and event-related rumination. Conclusions: The current study provides empirical evidence for the short-term post-traumatic effects of the COVID-19 pandemic and related factors, which can help to guide mental health services during the pandemic.

Religious coping, perceived discrimination, and posttraumatic growth in an international sample of forcibly displaced Muslims

Displaced persons are exposed to trauma and experience posttraumatic stress symptoms (PTS). Many displaced Muslims come from communities that rely on religious practices to cope with traumatic experiences, and religious coping has been identified as predictive of posttraumatic growth (PTG). Discrimination may contribute to increased PTS and promote in-group identification. In this study, we hypothesized that perceived discrimination would enhance the relationship between religious coping and PTG. Results indicated that religious coping predicted PTG, but the overall interaction with discrimination was not significant. However, probing moderating effects at discrete levels of discrimination yielded enhanced relationship between religious coping and PTG at its mean and above until reaching the highest values of discrimination. For individuals who experience moderate to high levels of discrimination, religious coping increased PTG. These findings highlight the essential role of religious coping in promoting growth for many Muslims exposed to forced migration and elevated levels of discrimination.

Hope and Resilience During a Pandemic Among Three Cultural Groups in Israel: The Second Wave of Covid-19

The aim of this study was to explore the coping resources of hope and sense of coherence, which are rooted in positive-psychology theory, as potential resilience factors that might reduce the emotional distress experienced by adults from three cultural groups in Israel during the chronic-stress situation of a pandemic. The three cultural groups examined were secular Jews, Ultra-Orthodox Jews, and Arabs. We compared these cultural groups during the second wave of the Covid-19 pandemic, just before the Jewish New Year (mid-September 2020) as a second lockdown was announced. Data were gathered from 248 secular Jews, 243 Ultra-Orthodox Jews, and 203 Arabs, who were 18-70 years old (M = 37.14, SD = 12.62). The participants filled out self-reported questionnaires including the Brief Symptom Inventory as a measure of emotional/psychological distress (i.e., somatization, depression, and anxiety) and questionnaires about sense of coherence and different types of hope (i.e., intrapersonal, interpersonal, and transpersonal) as measures of coping resources and resiliency. Differences were found between the three groups in terms of several variables. The Arab participants reported the highest levels of emotional distress and the lowest levels of interpersonal and transpersonal hope; whereas the Ultra-Orthodox participants revealed the highest levels of sense of coherence and other resilience factors. A structural equation model revealed that, in addition to the sociodemographic factors, only sense of coherence and intrapersonal hope played significant roles in explaining emotional distress, explaining 60% of the reported distress among secular Jews, 41% among Ultra-Orthodox Jews, and 48% among Arabs. We discuss our findings in light of the salutogenic and hope theories. We will also discuss their relevancy to meaning-seeking and self-transcendence theory in the three cultural groups.

Peritraumatic reactions during the COVID-19 pandemic - The contribution of posttraumatic growth attributed to prior trauma

Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.

Post-Traumatic Growth of Nurses Who Faced the COVID-19 Epidemic and Its Correlation With Professional Self-Identity and Social Support

OBJECTIVE

To investigate post-traumatic growth (PTG) and analyze its correlation with professional self-identity and social support in Chinese nurses who faced the coronavirus disease 2019 (COVID-19) epidemic.

METHODS

A cross-sectional descriptive design was used in this study. An online questionnaire was completed by 266 nurses who faced the COVID-19 emergency in Hubei Province, China. The Post-traumatic Growth Inventory (PTGI), Professional Self-identity Scale, and Perceived Social Support Scale were used to assess the level of PTG, professional self-identity, and social support. Descriptive, univariate analysis and multiple regression analyses were used in exploring related influencing factors.

RESULTS

Participants' mean scores were 96.26 (SD = 21.57) for PTG, 115.30 (SD = 20.82) for professional self-identification, and 66.27 (SD = 12.90) for social support. Multiple regression analysis showed that nurses from other provinces moving to support Hubei Province, professional self-identity, and social support were the main factors affecting nurse stress (p = 0.014, < 0.001, and 0.017, respectively). Professional self-identity and social support were positively correlated with PTG (r = 0.720 and 0.620, respectively).

CONCLUSIONS

There was a phenomenon of PTG when the nurses faced COVID-19 in Hubei Province. Providing an active coping style helps to improve the level of PTG.

The Curvilinear Association Between Posttraumatic Distress and Posttraumatic Growth Among Pellet Gun Victims: The Moderating Roles of Time Since Trauma and Age

Since 2010, the use of pellet guns in Indian-administered Kashmir has led to serious physical and psychological consequences among a growing number of victims. However, no research to date has examined the association between posttraumatic distress and posttraumatic growth (PTG) within this population. Previous research conducted on other types of trauma exposure has yielded inconsistent findings regarding the nature and directionality of this association; namely, whether it is linear or curvilinear. Moreover, this inconsistency may also be due to the effects of other variables, such as time since trauma and age. In the present study, we investigated whether the association between posttraumatic distress and PTG among pellet gun victims is best explained as linear or curvilinear and tested whether this association was moderated by time since trauma and/or age. Using purposive sampling, 120 pellet gun victims were recruited from Indian-administered Kashmir. The results of quadratic hierarchical regression suggested that an inverted U-shaped curvilinear association, sr² = 0.07 (medium effect), was a better fit over and above a linear term, sr² = 0.06 - 0.08 (medium effect). The moderation test further revealed that this effect was present across time but became apparent, as an inverted U-shape, 18 to 24 months posttrauma, sr² = 0.04 (small effect); age, however, was not found to influence this association. These findings held even after controlling for the effects of confounding variables. The present findings suggest that across time, moderate levels of posttraumatic distress are associated with the highest levels of PTG.

A hybrid inductive-abductive analysis of health workers' experiences and wellbeing during the COVID-19 pandemic in the United States

The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers' experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care-Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise and associated cutoff values were used to assess rates of probable major depression, generalized anxiety disorder, post-traumatic stress disorder, and alcohol use disorder, respectively. To provide insight into the factors shaping these and other mental health conditions, we included two open-ended questions asking respondents to recount their most upsetting and hopeful experiences during the COVID-19 pandemic and how it made them feel. Using a hybrid inductive-abductive approach and thematic content analysis, we created a Social Ecological Model to represent themes among health workers' experiences within five ecological levels: individual, interpersonal, organization, community, and public policy. Of the 1,132 participants who completed the survey, 14.0% had probable major depression, 15.8% probable generalized anxiety disorder, 23.1% probable post-traumatic stress disorder, and 42.6% probable alcohol use disorder. Individual level themes included participants' personal health and self-care behaviors. Interpersonal level themes included the health of their social circle, family functioning, and social support. Organization level themes included their hospital's management, resources, patient care, routine, and teams. Themes in the community level included the media, scientific knowledge about COVID-19, morale, behavior, and support of health workers. Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers' wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.

Correlates of post-traumatic growth among nursing professionals: A cross-sectional analysis

AIMS

Among nursing professionals, our aims were to examine (a) self-reported traumatic experiences, (b) differences in post-traumatic growth (i.e. positive psychological growth after experiencing a traumatic event) by nursing professional level and (c) demographic, work-related, behavioural and traumatic experience covariates of post-traumatic growth.

BACKGROUND

Trauma experience among nursing professionals is higher than observed in the general population. Due to the nature of their work environment, workplace trauma rates are particularly alarming. Understanding post-traumatic growth among nursing professionals may guide interventions to enhance well-being.

METHOD

A secondary analysis of cross-sectional survey data from nursing professionals (N = 299). Demographic, work-related, behavioural, trauma experience categories and post-traumatic growth variables were examined.

RESULTS

Advanced practice nurses and clinical nurses reported higher rates of workplace trauma, as compared to nursing assistants. Higher post-traumatic growth scores were associated with having a postgraduate degree, serving the paediatric population and lower frequency of alcohol use. Lower post-traumatic growth scores were associated with being married/widowed, being an advanced practice provider or clinical nurse, working in the intensive care unit and reporting workplace, family/personal stress and undisclosed trauma.

CONCLUSIONS

Nursing professionals have several demographic, work-related, behavioural and traumatic experience-related variables associated with and that explain variances in post-traumatic growth.

IMPLICATION FOR NURSING MANAGEMENT

Targeted screening and individualized treatment based on nursing professional level should be considered to support trauma recovery and post-traumatic growth.

PTSD, depression and posttraumatic growth in young adult burn survivors: Three-year follow-up of the 2015 Formosa fun coast water park explosion in Taiwan

OBJECTIVE

The 2015 Formosa Fun Coast Water Park explosion was a devastating disaster in Taiwan, leaving 15 dead and 484 burn injured. The present study estimated the prevalence of probable PTSD, major depression (MDD), and significant posttraumatic growth (PTG) in burn survivors three years after the explosion. Potential predictors of PTSD and depressive symptoms and PTG (demographic, burn-related, and psychosocial variables) were examined.

METHODS

Participants were 125 young adult burn survivors. The mean age at the incident was 22.4 years (SD = 4.1) and 62.4% were female. The average total body surface area burned was 51.6% (SD = 19.2%).

RESULTS

Three years after the explosion, 16.8% and 8.8% of the burn survivors met DSM-5 criteria of probable PTSD and MDD. Gender differences were observed in the prevalence of MDD but not PTSD. PTG was still highly prevalent, with 47.2%, 78.4%, and 84.0% of participants reporting significant PTG at the total scale, subscale, and item levels, respectively. Using hierarchical regression, psychosocial variables explained large amounts of variance in PTSD and depressive symptoms and PTG post-burn (△R² = 0.411, 0.377, and 0.523) beyond that explained by demographic and burn-related variables. More avoidance and less approach coping predicted greater PTSD and/or depression symptoms post-burn. More approach coping and greater social support strongly predicted higher PTG post-burn.

CONCLUSION

Rates of probable PTSD and MDD were relatively high in burn survivors, however, PTG was also highly prevalent. Coping styles and social support may play distinct roles in psychosocial adjustment after burn injury.