Does self-reported posttraumatic growth reflect genuine positive change?

Progress Toward Meaning-as-Goal and Its Association with Pain, Functioning, and Global Meaning and Purpose Among Veterans with Co-occurring Chronic Pain and PTSD

BACKGROUND

Co-occurring chronic pain and posttraumatic stress disorder (PTSD) is associated with poorer physical and mental functioning and well-being. Treatments often incorporate goal-setting around personally meaningful behaviors; however, it is unclear whether intentionally focusing on improving meaning and purpose in life (i.e., meaning-as-goal) may also serve as a helpful treatment target. The objective of the current study is to determine whether reported progress toward meaning-as-goal at 6 months is associated with pain severity and interference, physical and mental health functioning, and global meaning and purpose at 6- and 12-months.

METHODS

Data were collected as part of an evaluation effort focused on VA's Whole Health System implementation efforts. VA electronic health records were linked to survey data across three time points (baseline, 6 months, and 12 months) from Veterans with both chronic pain and PTSD across 18 VA sites. A total of 1341 Veterans met inclusion criteria (mean age = 62, SD = 11.7).

RESULTS

Regression analyses showed that progress toward meaning-as-goal was significantly associated with all 6-month variables, with standardized coefficients ranging from - 0.14 (pain severity and interference) to .37 (global meaning and purpose), in addition to all 12-month variables, with standardized coefficients ranging from - .13 (pain severity and interference) to .31 (global meaning and purpose).

CONCLUSIONS

Efforts to intentionally promote meaning and purpose as part of evidence-based treatment for chronic pain and PTSD may lead to decreased pain and improved physical and mental health functioning and global meaning and purpose. With coefficients ranging from small to moderate effect sizes, more work is needed to better understand how best to maximize meaning-related goals.

Perceived posttraumatic growth: positive change occurring because of or despite the trauma?

BACKGROUND

Some researchers have posited that self-reports of PTG are often illusory, designed to help trauma survivors maintain positive views of the self. We examined whether participants might select an alternative, attractive option to reporting PTG that could similarly help maintain positive views of the self - reporting that the respondent experienced positive growth despite exposure to an adverse event, which we call Positive Change-Despite (PC-Despite).

METHOD

In two separate studies, after asking respondents about positive change they experienced following exposure to an adverse event, we then asked about the extent to which they experienced positive change because of the adverse event (PC-Because) or despite the adverse event (PC-Despite).

RESULTS

We found that participants rated 40% (Study 1 - undergraduate sample) and 31% (Study 2 - first responder sample) of their positive change as PC-Despite. Further, in both studies PC-Despite scores were positively related to measures of distress and both adaptive and maladaptive coping, suggesting a link with an illusory form of PTG. In contrast, PC-Because was only related to adaptive coping.

CONCLUSION

Participants chose an attractive alternative response to reporting PTG at substantial rates, supporting the notion that many self-reports of PTG reflect motivated biases and coping processes.

The athlete psychological well-being inventory: Factor equivalence with the sport injury-related growth inventory

Until now, research on growth following sport injury has relied exclusively on retrospective reports and nomothetic measures drawn from other fields of research. Therefore, to more objectively explore growth following sport injury pre- and post-injury, rather than retrospectively, this study adapts and examines the psychometric properties of the Athlete Psychological Well-Being Inventory (APWBI), which can be used throughout the sport injury process (i.e., prior to and following sport injury). A sample of 164 athletes free from injury (71.3 % men; M age = 19.7 years, SD = 2.1) were compared to a sample of 168 athletes with history of previous injury (73.2 % men; M age = 19.7 years, SD = 2.1). Multigroup Confirmatory Factor Analysis demonstrated the measurement and factor equivalence between the APWBI and a retrospective measure, the Sport Injury-Related Growth Inventory (SIRGI). The APWBI also showed satisfactory to excellent internal consistency reliability for all its sub-dimensions ("sense of mastery", "positive relations with others", "responsibility for one's health", "self-awareness", "emotional ability", "purpose in life", "purpose in sport", and "body awareness") and for the total score. Analysis of the relationships with other self-report measures (i.e., the Positive Functioning Inventory, the Rosenberg's Self-Esteem Scale, and the Lie Scale) provided convergent and discriminant evidence to support the construct validity of the instrument. To conclude, the APWBI is a valid and reliable instrument for use within English-speaking athletes of various competitive levels (from local/county to international level).

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.

The relationship between fear of cancer recurrence and posttraumatic growth: a meta-analysis

Background

Theoretically, stress is positively correlated with posttraumatic growth (PTG). However, evidence for a correlation between fear of cancer recurrence (FCR), a cancer-specific stressor, and PTG is mixed. The present study aimed to systematically investigate the overall effect size between the two and to explore moderators that may influence this relationship.

Methods

From the earliest available date to October 2023, a comprehensive search was conducted in seven databases. Correlation coefficients (r) were calculated using Stata software. Publication type, continent, trauma role, gender, FCR measurements, PTG measurements, sample size, age, and time since diagnosis were used to examine moderating effects. The National Heart, Lung, and Blood Institute's (NHLBI) assessment tool was used to evaluate study quality.

Results

A total of 14 studies, involving 17 samples and 3,701 participants, were included. The studies found a small association between FCR and PTG (r = 0.161, 95% CI: 0.070-0.249, p < 0.01) and large heterogeneity (I2  = 85.5%). The strength of the association varied according to the publication type and FCR measurement.

Conclusion

The current review suggests a small but significant positive correlation between FCR and PTG. Future studies would benefit from exploring additional moderators and the use of standardized, validated FCR measurement tools.

Systematic review registration

PROSPERO, identifier CRD42023460407.

What predicts personal growth following a deployment? An examination of National Guard soldiers through the lens of posttraumatic growth

National Guard soldiers experience unique reintegration challenges. In addition to managing the consequences of combat-related trauma, they also navigate multiple transitions between military and civilian life. Despite these obstacles, many soldiers report positive outcomes and personal growth due to deployment, a phenomenon most commonly referred to in the literature as posttraumatic growth (PTG). The current study explored PTG in National Guard soldiers using a multidimensional longitudinal approach, with the goal of validating reports of PTG in soldiers. Data were collected from National Guard soldiers at pre-deployment, reintegration, one year post-deployment and two years post-deployment. Informed by PTG theory, three PTG constructs were measured (perceived ability to handle stress, social support seeking, and purpose in life) at each of the four time points, with increases in these constructs indicating growth. Potential predictors of growth in these PTG constructs were also explored. Results from a repeated measure latent profile analysis indicated that PTG did occur in certain soldiers, and that higher optimism and less severe PTSD symptoms predict this growth. These findings emphasize the importance of making efforts to facilitate PTG in soldiers.

Daily emotional dynamics and changes in posttraumatic growth and posttraumatic depreciation among people living with HIV

OBJECTIVE

Posttraumatic growth (PTG), and its negative reflection, posttraumatic depreciation (PTD), are two aspects of response to trauma. This study explores whether daily emotional dynamics (inertia and innovation) can translate into positive versus negative changes among people living with HIV (PLWH) in the form of long-term changes in PTG or PTD.

METHODS

The study combined a classical longitudinal approach with two assessments of PTG and PTD within one year and a measurement burst diary design with three weekly electronic diaries. In total, 249 PLWH participated in this study, filling out an expanded version of the Posttraumatic Growth and Depreciation Inventory (PTGDI-X) and a survey of sociodemographic and clinical data. In addition, they assessed their positive affect (PA) and negative affect (NA) at the end of each day in online diaries using a shortened version of the PANAS-X.

RESULTS

Although we observed stable significant inertia and innovation of PA and NA across all bursts, these parameters of daily emotional dynamics were unrelated to the longitudinal changes in PTG and PTD. The same null results were also noted for the average levels of NA and PA.

CONCLUSIONS

The results indicated the relative stability of emotion regulation in PLWH over the course of one year and contributed to understanding its dynamic mechanisms in terms of trait-like characteristics. The null result of the relationship between the PTG and PTD change might suggest a weak role of emotion regulation in shaping these trajectories as well as a lack of validity of the PTG/PTD measures.

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.

Encouraging inflated reports of posttraumatic growth: the presence of a wording effect on self-reports of posttraumatic growth

BACKGROUND AND OBJECTIVES

Posttraumatic growth (PTG) refers to positive psychological changes that result from a traumatic experience. The Posttraumatic Growth Inventory (PTGI) and the Stress-Related Growth Scale (SRGS) are the two most commonly used measures of PTG. One criticism of these measures is that all their items are positively worded (for example, "I have a greater feeling of self-reliance").

DESIGN AND METHODS

In the current paper, we conducted two studies that examined a possible wording effect in these two measures.

RESULTS

In Study 1, we found that positively worded items on the PTGI are positively correlated with the negatively worded version of the same items. Additionally, the positively and negatively worded versions of these items formed two separate factors, further suggesting a wording effect. In Study 2, we conducted an experimental design by comparing self-reports of PTG when randomly assigned to complete either positively- or neutrally worded versions of the items. We found that participants reported 27% less PTG when given neutrally worded items.

CONCLUSIONS

The combined results strongly suggest a wording effect that encourages overreporting of self-reports of PTG.

Does perceived post-traumatic growth during the COVID-19 pandemic reflect actual positive changes?

BACKGROUND AND OBJECTIVES

People commonly report positive changes following stressful experiences (perceived posttraumatic growth; PPTG), yet whether PPTG validly reflects positive changes remains unestablished.

DESIGN AND METHODS

We tested the extent to which COVID-19 pandemic-related PPTG relates to positive changes in corresponding psychosocial resources in a national US sample participating in a five wave study (T1-T5), focusing here on T2-T5: ns = 712-860. We examined correlations between resource change (both latent and observed difference scores) and PPTG at each occasion and conducted structural equation models to separate occasion-specific and stable (traitlike) PPTG variance. We related changes in resources to occasion-specific and stable PPTG components.

RESULTS

Associations between change scores and occasion-specific PPTG were sparse, providing limited evidence of PPTG validity. Associations between change scores and stable PPTG tended to be positive and stronger than associations for occasion-specific PPTG.

DISCUSSION

Perceptions of growth were largely unrelated to experienced positive changes and thus appear to be largely illusory. However, a personality-like tendency to believe one grows from stressful experiences relates more strongly to actual resource growth. These results suggest that people are not accurate reporters of positive changes they experience and that interventions aimed at promoting post-traumatic growth may be premature.

Illusory posttraumatic growth is common, but genuine posttraumatic growth is rare: A critical review and suggestions for a path forward

Over the last 2.5 decades, trauma researchers have increasingly become interested in posttraumatic growth (PTG) - the concept that some people experience growth as a result of trauma exposure. I begin by reviewing extant research on PTG, with a focus on measurement and conceptual issues. Expanding on arguments made by others, I distinguish between three forms of PTG, 1) perceived PTG, which is an individual's beliefs about their own PTG, 2) genuine PTG, which is veridical growth following adversity, and 3) illusory PTG, which is motivated fabrications of PTG. Perceived PTG is extremely common, as over half of individuals exposed to a potentially traumatic event (PTE) report moderate or greater levels of PTG. I review evidence that most self-reports of PTG are greatly exaggerated and argue that perceived PTG is mostly illusory PTG. I propose five reasons for the disconnect between perceived PTG and genuine PTG, including design flaws in the current measurements, emotional biases that favor perceived PTG, the inherent appeal of PTG, cultural expectations, and problems of definition. I then review the empirical evidence concerning the prevalence rate of genuine PTG, coming to the bold conclusion that the occurrence of genuine PTG is very rare, contradicting current fundamental beliefs about PTG. I recommend researchers focus on the key areas of measurement and etiology of genuine PTG, which are necessary to create interventions that foster genuine PTG. I conclude by outlining a path to steer the scientific progression of PTG back in the right direction.

Finding Strength in Times of Crisis? Post-Traumatic Growth During the Covid-19 Pandemic: A Saudi Arabian Perspective

This paper contributes to the Covid-19 literature by exploring the concept of post-traumatic growth (PTG) utilizing a mixed methods approach. The study examines to what extent the participants experienced positive growth and renewal arising from the prolonged period of lockdowns and emergency online learning. Exploring the experiences of 552 female undergraduate students in a private Saudi Arabian university, an online survey was utilized to gather the data. All the students had experienced online education as a result of the pandemic. The findings indicate the participants underwent a diversity of personal growth experiences. In addition, they also developed different coping mechanisms. The study provides insights into the responses of the students to the issues they were facing during the pandemic. It identifies ways in which participants experienced personal growth as well as a shift in perspective about their lives. There are implications for educators, counselors and policymakers emerging from this study.

Caring for a Relative With Dementia in Long-Term Care During the COVID-19 Pandemic: A Prospective Longitudinal Study

Background and Objectives

The coronavirus disease 2019 (COVID-19) pandemic introduced unprecedented threats and disruptions for caregivers of people with dementia living in residential long-term care (LTC) facilities. Qualitative and cross-sectional studies have reported substantial negative effects of the pandemic on dementia caregivers' well-being, but little to no prospective research has examined the impact of COVID-19 on caregiver well-being using pre-pandemic assessments. The present study used longitudinal data from an ongoing randomized controlled trial of a psychosocial intervention to support family caregivers whose relatives had entered LTC.

Research Design and Methods

Data collection began in 2016 and continued through 2021. Caregivers (N = 132) completed up to 7 assessments measuring their depressive symptoms, self-efficacy, and burden.

Results

Latent growth curve models testing preregistered hypotheses revealed no significant effects of the pandemic on caregiver outcomes on average, though caregivers varied in terms of individual intercepts and slopes. Furthermore, factors such as caregiver-care recipient relationship closeness, care recipient's COVID-19 infection status, and caregivers' ratings of LTC facilities' COVID-19 policies did not significantly moderate trajectories of well-being.

Discussion and Implications

Findings highlight the heterogeneity of caregivers' experiences during the pandemic, and suggest caution when interpreting cross-sectional findings on the impacts of the COVID-19 pandemic on caregiver well-being and distress.

"Psychometric properties of the Arabic version of the post-traumatic growth inventory with university students in Jordan

Post-traumatic Growth plays a key role to cope with traumatic incidents. The scale for Post-Traumatic Growth Inventory (PTGI) has been used by several researchers in different languages. This study aims to evaluate the Arabic-translated version of the PTGI scale by focusing on its validity in different languages and contexts. This study introduces an Arabic version of the PTGI-M normed with 417 undergraduate students at a large university in Jordan. The internal consistency (Cronbach's alpha) and test-retest reliability of the instrument were 0.97 and 0.82, respectively. Bivariate correlation was used to approximate the concurrent validity (CV). Significant correlations were found between the PTGI-M and the beck depression inventory (BDI), perceived stress scale (PSS), Taylor's manifest anxiety (TMAS), satisfaction with life (SWL), and the Rosenberg self-esteem scale (RSES). Confirmatory factor analysis (CFA) to assess the convergent and discriminant validity of the translated scale. Convergent and discriminant validity was established for the Arabic version of the PTGI-M by conducting a confirmatory factor analysis (CFA). In conclusion, this study proposes that future investigations should consider analysing the total PTGI-M subtotal scores to comprehend the complexity of the post-traumatic growth experience.

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.

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.

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.

Associations of suffering with facets of health and well-being among working adults: longitudinal evidence from two samples

Suffering is an experiential state that every person encounters at one time or another, yet little is known about suffering and its consequences for the health and well-being of nonclinical adult populations. In a pair of longitudinal studies, we used two waves of data from garment factory workers (Study 1 [T1: 2017, T2: 2019]: n = 344) and flight attendants (Study 2 [T1: 2017/2018, T2: 2020]: n = 1402) to examine the prospective associations of suffering with 16 outcomes across different domains of health and well-being: physical health, health behavior, mental health, psychological well-being, character strengths, and social well-being. The primary analysis involved a series of regression analyses in which each T2 outcome was regressed on overall suffering assessed at T1, adjusting for relevant sociodemographic characteristics and the baseline value (or close proxy) of the outcome assessed at T1. In Study 1, associations of overall suffering with worse subsequent health and well-being were limited to a single outcome on each of the domains of physical health and mental health. Overall suffering was more consistently related to worse subsequent health and well-being in Study 2, with associations emerging for all but two outcomes. The pattern of findings for each study was largely similar when aspects of suffering were modeled individually, although associations for some aspects of suffering differed from those that emerged for overall suffering. Our findings suggest that suffering may have important implications for the health and well-being of worker populations.

Character Strengths' Change During COVID-19

The COVID-19 had negative effects on individuals and nations worldwide. However, based on literature suggesting that crises can trigger growth, we propose that it may have also triggered individuals' character strengths development, especially among those having experienced moderate levels of difficulty during the pandemic and having received social support. The participants' (N = 1700) 24 character strengths were assessed twice: before and during COVID-19. At the second assessment, participants also reported the level of impact COVID-19 had on their lives, and their perceived social support. MANOVA analysis revealed a general increase in character strengths, with significant - but mainly negligible or small - increases in 17 strengths: appreciation of beauty and excellence, bravery, prudence, creativity, curiosity, fairness, gratitude, honesty, hope, judgment, kindness, leadership, perspective, self-regulation, social intelligence, spirituality, and zest. Across the 24 strengths, the reported level of COVID-19's impact (i.e., low, moderate, or high) was not associated with different changes during the pandemic. Univariate analyses showed that such changes were significant only in curiosity, forgiveness and kindness. The multivariate effect of social support on changes in character strengths was significant. Specifically, it enhanced the increase in love, prudence, curiosity, forgiveness, gratitude, honesty, hope, judgment, leadership, humility and zest during COVID-19, although the interactions effect sizes were small. The results suggest that, in the time frame examined in this study, character development processes triggered by COVID-19 were evident, yet specific changes in strengths were relatively mild. Some of these processes may have been enhanced by social support.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10902-022-00575-6.

Perceived posttraumatic growth after interpersonal trauma and subsequent well-being among young Colombian adults: A longitudinal analysis

Research has shown that people sometimes report self-perceived growth as a result of dealing with a potentially traumatic event, but relatively few methodologically rigorous studies have examined whether perceived posttraumatic growth is associated with improved subsequent well-being across a wide range of outcomes. In this three-wave longitudinal study of Colombian emerging adults (n = 636), we examined the associations of perceived posttraumatic growth with 17 well-being outcomes across domains of psychological well-being (i.e., self-rated mental health, meaning in life, sense of purpose, happiness, life satisfaction), psychological distress (i.e., anxiety symptoms, depression symptoms, subjective suffering), social well-being (i.e., content with relationships, satisfying relationships, loneliness), physical well-being (i.e., self-rated physical health, sleep quality), and character strengths (i.e., state hope, trait forgivingness, orientation to promote good, delayed gratification). Using an outcome-wide analytic design that adjusted for a range of covariates assessed in Wave 1, we found that overall perceived posttraumatic growth assessed in Wave 2 was robustly associated with improvements in one or more facet of each well-being domain (15/17 outcomes in total) assessed approximately six months later in Wave 3. Our findings suggest that perceived posttraumatic growth may contribute to individual well-being over the longer-term.

The Personification of Chronic Pain: an Examination Using the Ben-Gurion University Illness Personification Scale (BGU-IPS)

Objective: Relying on anthropomorphism research, Illness Personification Theory (ILL-PERF) posits that individuals living with a chronic illness ascribe human-like characteristics to their illness. Herein we examine the personification of chronic pain using a new measure: the Ben-Gurion University Illness Personification Scale (BGU-IPS). Method: Three samples of chronic pain patients (Sample 1 and 2 are distinct samples sharing similar characteristics, collected in the context of a cross-sectional design, Ns = 259, 263; Sample 3: a 2-waves longitudinal, N =163) completed the 12-item BGU-IPS, and measures of pain and related factors. Results: An orthogonal, two-factor structure was revealed for the BGU-IPS pertaining to negative vs. positive personifications. Negative personification was associated with pain intensity and illness-related distress (e.g., depression and low adjustment to pain). Positive personification was correlated with hope, pain-related sense of control, and low depression. However, positive personification also augmented the associations between negative personification and several risk factors. Conclusions: Pain personification, particularly as assessed via the BGU-IPS, plays a major role in (mal)adaptation to chronic pain.

Examining the protective influence of posttraumatic growth on interpersonal suicide risk factors in a 6-week longitudinal study

Research has found an inverse relationship between posttraumatic growth (PTG) and suicidal ideation in military and community samples that holds when controlling for other suicide risk factors. However, further research is needed into the underlying mechanisms to clarify how PTG protects against the formation of suicidal ideation. The current two-wave longitudinal study examined whether perceiving PTG from recent adverse circumstances while in a national lockdown during the COVID-19 pandemic attenuated the positive relationship of two interpersonal suicide risk factors – perceived burdensomeness (PB) and thwarted belonginess (TB)–over 6 weeks. Participants (n = 170) were recruited online from Prolific from income-deprived areas in the United Kingdom (mean age = 37.65; SD = 12.50; 53.5% female). Post-hoc power analyses indicated we had insufficient power to examine the hypothesised mediation for TB. We examined whether PTG mediated the relationship between PB at wave 1 and wave 2 while controlling for depression and anxiety in a sample of individuals at-risk for suicidal ideation. PTG did significantly and partially mediate the positive relationship between PB at wave 1 and 2. We discuss the theoretical and clinical implications that could result if future research successfully replicates these initial exploratory findings.

Do stressful life events impact long-term well-being? Annual change in well-being following different life events compared to matched controls

Available longitudinal evidence suggests that personal growth following adversity may not be as prevalent as suggested in cross-sectional research. Firm conclusions regarding resiliency versus post-traumatic growth following adverse events are further tempered by the restricted range of outcomes assessed when examining resilience, the focus on specific adverse events or cumulative adversity scores that hinder comparisons between event types, and the relative scarcity of analyses including matched control groups. The current study addresses these gaps by leveraging longitudinal panel data comparing annual change in well-being from 2018 to 2019 for people who experienced a major life stressor relative to propensity score matched controls who did not experience such stressors over the same period. Moreover, independent comparisons are conducted across three distinct event categories: traumatic interpersonal events (N matched pairs = 1,030), job loss (N matched pairs = 1,361), and birth (N matched pairs = 1,225), and five self-reported well-being indicators: life satisfaction, felt belongingness, self-esteem, meaning in life, and gratitude. Results indicate that people's well-being (across all five indicators) remained consistent over the year in independent analyses of samples experiencing each of the three types of events, and did not differ from matched controls. These findings indicate high population levels of psychological resilience, in the sense that people did not decrease in annual well-being following various life events. These findings also fail to detect significant evidence for possible post-traumatic growth, insofar as such growth might relate to a broad range of different aspects of well-being.

Understanding the Pathways from Mindfulness to COVID-19 Vaccination Intention via Positive Psychology Attributes among Health Care Workers in China

OBJECTIVE

The present study aims to examine the association between mindfulness and COVID-19 vaccination intention, and the mediating role of presence of meaning in life and moral elevation in such association.

METHOD

In a cross-sectional study design, a total of 1733 health care workers (81.1% females, M_age = 34.16 ± 9.03) from four cities in China were recruited and completed an online survey that measured mindfulness, moral elevation, presence of meaning in life and COVID-19 vaccination intention.

RESULTS

It has been found that 73.1% of the participants reported an intention to receive COVID-19 vaccination. Mindfulness was positively associated with COVID-19 vaccination intention; Mediation analyses using structural equation modeling showed a significant indirect effect of mindfulness on COVID-19 vaccination intention, accounting for 42.4% of the total effect. Mindfulness was positively associated with COVID-19 vaccination intention directly via presence of meaning in life, and indirectly via moral elevation and presence of meaning in life.

CONCLUSIONS

The findings add knowledge of how mindfulness may increase COVID-19 vaccination intention, and underscore the potential need for mindfulness training, positive emotion promotion, presence of meaning in life interventions to improve acceptance of COVID-19 vaccination among health care workers.

Comparing posttraumatic growth in mothers after stillbirth or early miscarriage

The possibility of posttraumatic growth in the aftermath of pregnancy loss has received limited attention to date. This study investigated posttraumatic growth in mothers following stillbirth compared to early miscarriage. It was hypothesised that mothers following stillbirth will demonstrate more posttraumatic growth, challenge to assumptive beliefs, and disclosure than mothers following early miscarriage. The study also sought to understand how theoretically-derived variables of the Model of Growth in Grief (challenge to assumptive beliefs and disclosure) explained unique variance in posttraumatic growth when key factors were controlled for. One-hundred and twenty women who had experienced a stillbirth (N = 57) or early miscarriage (N = 63) within the last two to six years completed validated questionnaires in an online survey relating to posttraumatic growth and key variables relevant to emotional adjustment post-bereavement. Participants who had experienced a stillbirth demonstrated significantly higher levels of posttraumatic growth, posttraumatic stress symptoms, perinatal grief, disclosure, challenge to assumptive beliefs and rumination than participants who had experienced an early miscarriage (Cohen’s d ranged .38-.94). In a hierarchical stepwise regression analysis, challenge to assumptive beliefs alone predicted 17.5% of the variance in posttraumatic growth. Intrusive and deliberate rumination predicted an additional 5.5% of variance, with urge to talk, reluctance to talk, and actual self-disclosure predicting a further 15.3%. A final model including these variables explained 47.9% of the variance in posttraumatic growth. Interventions targeting challenge to assumptive beliefs, disclosure, and rumination are likely to be clinically useful to promote psychological adjustment in mothers who have experienced stillbirth and early miscarriage.

Post-Traumatic Growth and Quality of Life among World Trade Center Health Registry Enrollees 16 Years after 9/11

A recent study of World Trade Center Health Registry enrollees found that about one-third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees' overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental functioning quality of life scales in a sample of 4760 enrollees from the Registry's Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry's baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sociodemographic and other variables. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: b = 0.15 (-0.45, 0.75), mental: b = 3.61 (2.85, 4.37)). Those who were physically injured during 9/11 showed larger improvements in mental functioning than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.

COVID-19 pandemic-related posttraumatic growth in a small cohort of university students: A 1-year longitudinal study

The COVID-19 pandemic has affected all areas of life, with severe potential consequences for people's mental health. Posttraumatic growth (PTG), a positive psychological change that may develop following a traumatic event, in light of the COVID-19 pandemic has only received little attention. The current study aimed to investigate (1) the prevalence of PTG within the context of the COVID-19 pandemic and (2) which psychological aspects predict COVID-19 pandemic-related PTG using a 1-year longitudinal design. A sample of 70 participants completed a survey on COVID-19, posttraumatic stress, emotional well-being, coping styles, determinates of resilience, and PTG at both T1, May 2020, and T2, May 2021. Results reveal moderate levels of PTG for about one in five participants at both T1 and T2 (21% and 23%, respectively). Moreover, PTG at T1 and T2 were moderate to strongly, positively correlated, r = 0.62. Posttraumatic stress and social support were found to positively predict PTG at T1, while positive affect and social skills were found to positively predict PTG at both T1 and T2, βs = 0.22-.52. Implications of the current findings and suggestions for future research are discussed.

A longitudinal study of dispositional compassion in Syrian origin young adults resettling in the Netherlands

Background

Dispositional compassion is regarded as a facet of Agreeableness, an emotional driver of prosociality, and a primary marker of adjustment. We examined changes in dispositional compassion in Syrian young adults resettling in the Netherlands, as well as the role of migration-related and demographic variables in this change.

Methods

We analyzed data from a 4-wave (T1-T4), 13-month longitudinal study ( N = 168; T1 Mage = 28.1 years, 70% male) using Latent Growth Curve Modelling (LGCM) in Mplus.

Results

Bivariate correlations indicated moderate test-retest correlations across the four waves of dispositional compassion and several correlations with the migration-related and demographic variables. A LGCM indicated a high initial level and small linear decrease in compassion over the four waves. Except for a link between pre-migration adversity and the intercept, the migration-related and demographic variables were not related to either the intercept of the slope of dispositional compassion.

Conclusion

Results suggest that high levels of dispositional compassion may be common for Syrian young adults with refugee backgrounds, but on average, slowly decreases over time. The cross-sectional associations between migration-related and demographic variables and dispositional compassion in the absence of a prospective one emphasize the importance of longitudinal research for understanding trajectories of adjustment.

Growing together: interpersonal predictors of posttraumatic growth trajectory among suicide-loss survivors

BACKGROUND

Recent studies have indicated that grieving after suicide loss can be particularly complex and traumatic. However, studies have recognized the opportunity for personal growth among suicide-loss survivors. This study signifies an effort to develop a comprehensive understanding of the underlying interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors in a longitudinal design.

METHOD

Participants included 189 suicide-loss survivors (155 females), aged 21-73, who completed questionnaires of thwarted belongingness (TB), perceived burdensomeness (PB), and self-disclosure at T1. Moreover, participants were assessed on PTG levels at T1, 18 months (T2), and 42 months (T3).

RESULTS

The integrated mediation model indicated that both TB and PB contributed to the PTG trajectory. PB and self-disclosure contributed to PTG at T3 beyond the PTG trajectory across time. We also found self-disclosure to mediate the association of TB and PTG at T2 and T3.

CONCLUSIONS

These findings suggest that interpersonal factors play critical roles in contributing to PTG over time among suicide-loss survivors. Basic psychoeducational interventions designed to foster interpersonal behaviors may facilitate achieving PTG among survivors in the aftermath of suicide loss.

Lessons learned from conducting a study of emotions and positive personality change in Syrian origin young adults who have recently resettled in the Netherlands

Post-traumatic growth is a compelling idea, yet extant research has often employed retrospective reports of change, rather than examining change over time. Research on samples of people that are traditionally seen as hard-to-reach are rare within personality psychology. In Karakter, we assessed a sample of Syrian origin young adults who recently resettled in the Netherlands (initial  N = 168) four times over a 13-month period to examine experiences of adversity, emotions, and positive personality change. Here, we provide a detailed narrative of the research process, beginning with a description of how we incorporated open science practices in Karakter. We then turn to a discussion of the changes, challenges, and opportunities we encountered in the research. In doing so, we discuss conceptual and methodological considerations when examining personality change. We close with suggestions for researchers who are interested in conducting similar studies with populations that are underrecruited in the future.

Resolving the paradox of posttraumatic growth and event centrality in trauma survivors

When a traumatic experience is central to an individual's identity and worldview, it can result in either severe posttraumatic stress disorder (PTSD) symptoms, perceived posttraumatic growth (PTG), or, paradoxically, both. To resolve this apparent paradox, we used network analytic methods to estimate the relations among components of event centrality (EC), PTSD symptoms, and PTG in 1,136 undergraduates who had experienced trauma. Participants completed surveys on their experiences with traumatic events as well as the degree to which they experienced PTSD symptoms, components of EC, and components of PTG. We performed network analysis to examine EC, PTSD, and PTG and identify which components of EC were most conducive to its associations with PTSD versus those with PTG. We found that the components of EC most associated with PTSD, the extent to which trauma serves as a script for the future, were markedly distinct from the components associated with PTG, the extent to which trauma is seen as a turning point in one's life. The combined findings suggest that EC may be a catalyst for subsequent positive or negative effects contingent upon how an individual interprets the centrality of their traumatic experience.

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.

Differences Between Posttraumatic Growth and Resiliency: Their Distinctive Relationships With Empathy and Emotion Recognition Ability

Posttraumatic growth (PTG) and resiliency have been observed among people who experienced life crises. Given that the direct relationships between PTG and resiliency have been equivocal, it is important to know how they are different in conjunction with cognitive ability. The purpose of this study is to examine how perceived PTG and resiliency would be, respectively, associated with empathy and emotion recognition ability. A total of 420 college students participated in an online survey requiring them to identify emotions based on photographs of facial expressions, report their traumatic experiences, and respond to the PTG Inventory, Brief Resilience Scale, and Questionnaire of Emotional Empathy. The results suggest that perceived PTG was not associated with empathy but significantly predicted increased emotion recognition, whereas resiliency showed a negative relationship with empathy but no significant relationship with emotion recognition. These findings demonstrate that self-perceived PTG may be associated with cognitive ability, which could be due to one's growth within relationships and social interactions. Even though growing after trauma may promote resilient characteristics, the current results indicate that PTG and resiliency may foster different outcomes. Since empathy and emotion recognition are affected by other contextual factors, future studies should assess how empathy and the type of errors in emotion recognition may be associated with situational factors that are beyond personal factors such as post-traumatic life experiences or personality.

Examining the protective function of perceptions of post-traumatic growth against entrapment and suicidal ideation

BACKGROUND

Recent evidence has found that reporting post-traumatic growth (PTG) from a past stressful life event is associated with lower reports of suicidal ideation. Perceptions of PTG measure the extent to which an individual reports positive changes in their identity, relationships, and worldviews after a stressful event. However, little is known about how perceptions of PTG interact with feelings of defeat and entrapment to influence suicidal ideation. The current study examined this question through the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior.

METHODS

521 adult participants (315 females with age range of 18-82, M = 30.4 years, SD = 13.6) completed an online cross-sectional questionnaire with defeat, entrapment, suicidal ideation, PTG, depression and anxiety measures. Hypotheses and data analysis plans were pre-registered prior to data collection.

RESULTS

PTG negatively correlated with defeat, entrapment and suicidal ideation. PTG predicted lower suicidal ideation when controlling for entrapment, depression and anxiety. PTG did not moderate the relationship between defeat on entrapment or the relationship between entrapment on suicidal ideation.

LIMITATIONS

The findings were based on cross-sectional data where participants recalled experiences of defeat, entrapment and suicidal ideation from the past year. The sample was a large community (non-clinical) sample, and most of the participants identified as white (85%).

CONCLUSION

Although PTG did not function as a moderator within the IMV model of suicidality, it predicted lower suicidal ideation while controlling for other known predictors of suicidal ideation. Future research could explore the function of PTG in appraisal-based models of suicidality.

Do We Know Whether We're Happier? Corroborating Perceived Retrospective Assessments of Improvements in Well-Being

To what extent do our beliefs about how our well-being has improved over time correspond to observed changes? Participants (N = 1,247 from Qualtrics Panels) completed questionnaires measuring dispositional well-being and ill-being (depressive symptoms) at three time points over the course of one year, as well as 44 weekly assessments of state well-being and ill-being over 52 weeks. They additionally completed measures of perceived improvements in well-being and ill-being at Weeks 45 and 52 as well as a measure of broad personality traits. We estimated latent change scores and latent growth curves, which allowed us to obtain more accurate estimates of the convergence between retrospective improvements and veridical change compared to past methods utilized. Stability in both global and state well-being and ill-being were observed. People who agreed more strongly that their well-being had improved (or their ill-being had increased) tended to show greater increases in actual well-being (or ill-being) across the past year. Additionally, we observed meaningful relationships between personality traits and perceived improvements. On average, people have some insight in assessing whether they became happier (or unhappier) over one year.

Ten ignored questions for stress psychology research

Stress psychology is an interesting and important interdisciplinary research field. In this perspective article, we briefly discuss 10 challenges related to the conceptual definition, research methodology, and translation in the field of stress that do not receive sufficient attention or are ignored entirely. Future research should attempt to integrate a comprehensive stress conceptual framework into a multidimensional comprehensive stress model, incorporating subjective and objective indicators as comprehensive measures. The popularity of machine learning, cognitive neuroscience, and gene epigenetics is a promising approach that brings innovation to the field of stress psychology. The development of wearable devices that precisely record physiological signals to assess stress responses in naturalistic situations, standardize real-life stressors, and measure baselines presents challenges to address in the future. Conducting large individualized and digital intervention studies could be crucial steps in enhancing the translation of research.

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.

A Latent Class Analysis on Symptoms of Prolonged Grief, Post-Traumatic Stress, and Depression Following the Loss of a Loved One

BACKGROUND

The loss of a significant other can lead to variety of responses, including prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. The aim of this study was to replicate and extend previous research that indicated that three subgroups of bereaved individuals can be distinguished based one similar post-loss symptom profiles using latent class analysis (LCA). The second aim was to examine whether sociodemographic and loss-related characteristics as well as the extent of meaning making were related to classes with more pervasive psychopathology.

METHODS

Telephone-based interviews with 433 Dutch and German speaking persons who had lost a significant other at last 6 months earlier were conducted. Self-rated PGD, PTSD, and depression symptoms were assessed. LCA was conducted and correlates of class-membership were examined using the 3step approach.

RESULTS

The LCA resulted in three distinct classes: a no symptoms class (47%), a moderate PGD, low depression/PTSD class (32%), and a high PGD, moderate depression/PTSD class (21%). A multivariate analysis indicated that female gender, a shorter time since loss, an unexpected loss and less meaning made to a loss were significantly associated with membership to the moderate PGD, low depression/PTSD and high PGD, moderate depression/PTSD class compared to membership to the no symptom class. Losing a child or spouse, a shorter time since loss, and having made less meaning to the loss further distinguished between the high PGD, moderate depression/PTSD symptom class and the moderate PGD, low depression/PTSD class.

DISCUSSION

We found that the majority of individuals coped well in response to their loss since the no symptom class was the largest class. Post-loss symptoms could be categorized into classes marked by different intensity of symptoms, rather than qualitatively different symptom patterns. The findings indicate that perceiving the loss as more unexpected, finding less meaning in the loss, and loss-related factors, such as the recentness of a loss and the loss of a partner or child, were related to class membership more consistently than sociodemographic factors.

Advancing a Three-Tier Personality Framework for Posttraumatic Growth

Adversity has been assumed to foster positive personality change under certain conditions. In this article, we examine this assumption within the context of the three-tier personality framework integrating traits, characteristic adaptations, and narrative identity to provide a comprehensive understanding of personality growth. We first review findings on how adverse events affect personality on each of these three levels. Second, we summarize knowledge on event-based and person-based predictors of personality change in the face of adversity. Third, we specify affective, behavioral, and cognitive processes that explain personality change across levels of personality. Innovatively, our proposed process model addresses change at all three levels of personality, as well as similarities and differences in processes across the levels. We conclude by discussing unresolved issues, asking critical questions, and posing challenging hypotheses for testing this framework.

Lifetime Adversity in the Context of Monthly Adversity and Psychological Well-Being in Midlife: Evidence of Cumulative Disadvantage, But Not Steeling Effects of Lifetime Adversity

OBJECTIVE

Our objective is to examine whether lifetime adversity has either a 'steeling effect' or 'cumulative disadvantage effect' on the consequences of monthly adversity on psychological well-being in middle-aged adults. An exploratory step was to examine whether such associations differed based on the domain of adversity (personal, family/friend, bereavement, social-environmental, and relationship).

METHOD

Multilevel modeling was applied to data from a sample of participants in midlife (n = 358, ages 50-65, 54% women) who were assessed monthly for two years.

RESULTS

Lifetime adversity did not show steeling effects, but instead appeared to exacerbate the impact of monthly adversity on psychological well-being, indicating cumulative disadvantage. On months where an adversity was experienced, on average, individuals who reported more lifetime adversity showed stronger increases in depressive symptoms, anxiety, and negative affect and decreases in positive affect. There was limited evidence to suggest for steeling effects for life satisfaction. Reporting adversity in the personal, bereavement, social-environmental, and relationship domains showed the strongest associations with psychological well-being.

DISCUSSION

Our discussion focuses on how lifetime adversity showed a cumulative disadvantage effect on the consequences of monthly adversity on psychological well-being. We also elaborate on future directions for research that include other conceptualizations of adversity and research to examine mechanisms underlying this relationship.

Changes in Psychosocial Resources as Predictors of Posttraumatic Growth: A Longitudinal Study of Low-Income, Female Hurricane Katrina Survivors

This study examined how well the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) corresponds with self-reported pre- to posttrauma changes in related constructs, including sense of purpose in life, religiosity, and social support. Participants were 328 low-income mothers (85.2% non-Hispanic Black) who survived Hurricane Katrina and completed surveys approximately 1 year predisaster (Time 1), 4 years postdisaster (Time 2), and 12 years postdisaster (Time 3). PTG was assessed at Time 2 and Time 3, and related constructs were assessed at all waves. Pre- to postdisaster changes in the following related constructs were significantly associated with the corresponding PTGI subscales: purpose in life with Relating to Others, Personal Strength, and New Possibilities; religiosity with Spiritual Change; and perceived social support with Relating to Others. The results demonstrate a link between a number of self-reported pre- to posttrauma psychological changes measured over time and the PTGI. Replication of these results using measures more closely aligned to the PTGI subscales, among more representative samples and in the aftermath of other traumatic events, is warranted.

Negative Posttraumatic Cognitions Color the Pathway from Event Centrality to Posttraumatic Stress Disorder Symptoms

Background

The centrality of an event indicates the extent to which it becomes a core part of identity and life story. Event centrality (EC) has been shown to have a strong relationship with PTSD symptoms, which seems to be indirectly influenced by negative posttraumatic cognitions (PTC). However, research on this potential mediation and its causal links particularly with clinical samples is limited and essential to derive treatment implications.

Methods

Pre- and posttreatment data of 103 day-unit patients with PTSD was examined using mediation analyses and structural equation modeling.

Results

Negative PTC mediated the relationship between EC and PTSD symptoms, partially pre- and completely posttreatment. Within extended longitudinal analyses causal directions of the mediation pathways were not adequately interpretable due to unexpected suppression effects.

Conclusions

The results suggest that EC may only have an indirect effect on PTSD symptoms through negative PTC. Thus, decreasing negative PTC which are connected to centralized events might be a key element for PTSD treatment. Thereby, transforming the cognitions’ valence to more positive and constructive forms could be crucial rather than mere decentralization. Although suppression effects limited causal inferences, they do not contradict the mediation and further indicate potential interactional terms and a transformation of EC.

Examining Associations Between Major Negative Life Events, Changes in Weekly Reports of Post-Traumatic Growth and Global Reports of Eudaimonic Well-Being

Research on post-traumatic growth (PTG) has been compromised by methodological limitations. Recent process-oriented accounts of personality suggest, however, that positive changes may occur through short-term (i.e., state-level) changes in PTG. In the current year-long study, 1,247 participants provided weekly reports of significant negative events as well as state manifestations of PTG (up to 44 assessments per individual; 34,205 total). Trait assessments of eudaimonic well-being (EWB) were administered at intake and Weeks 45 and 52. Experiencing negative life events predicted increases in state PTG, which in turn predicted increases in EWB. However, stability was observed when modeling prospective changes in overall state PTG before and after the initial negative life event or across all negative life events occurring during the study time frame. These findings highlight the importance of studying PTG-related processes using appropriate research designs, analytic strategies, and time frames.

Coping strategies mediate the association between family functioning and posttraumatic growth in family caregivers of people with dementia

OBJECTIVES

This study aimed to examine the mediating effect of coping strategies on the relationship between family functioning and posttraumatic growth in family caregivers of people with dementia (PwD).

METHODS

A total of 124 family caregivers of PwD from a memory clinic were investigated from July to October 2017. Family functioning, coping strategies, and posttraumatic growth of family caregivers of PwD were measured. Data were processed using descriptive statistics, correlation analysis, regression analysis, and structural equation modelling.

RESULTS

Posttraumatic growth was observed in family caregivers of PwD. The caregiver's gender, relationship with the patient, and difficulty balancing financial income and expenditures in the past month, as well as disease severity of PwD, are significant predictors of posttraumatic growth. There were significantly positive correlations among posttraumatic growth, family functioning and positive coping strategies (P＜0.01). Positive coping strategies exert a complete mediating effect between family functioning and posttraumatic growth (β = 0.49, P < 0.05).

CONCLUSIONS

A model of the posttraumatic growth of family caregivers of PwD can be established, and the relevant mechanisms can be explored. Healthcare providers should pay attention to the family functioning of caregivers and take effective measures to provide them with positive coping strategies to promote their posttraumatic growth.

Investigating Posttraumatic Growth in Midlife Using an Intensive Longitudinal Research Design: Posttraumatic Growth Is Not as Prevalent as Previously Considered

The notion that adversity leads to enduring improvements in psychological functioning carries promise given the diverse adversities individuals confront over their life course. However, research on posttraumatic growth (PTG) has relied on cross-sectional research designs, which severely limit the ability to discern whether growth transpires following adversity. Our goal was to examine whether PTG is possible across a diverse array of outcomes and identify factors that promote PTG. We analyzed data from a longitudinal, prospective study that assessed midlife participants monthly for a period of 2 years. Over the study period, 276 participants experienced a major life stressor, and multiphase multilevel models were used to examine whether PTG transpired in life satisfaction, gratitude, compassion, generativity, meaning-making, and religiosity/spirituality. On average, life satisfaction, generativity, and meaning-making declined following adversity; substantial between-person differences were observed across all outcomes. Our multidimensional approach revealed that, on average, individuals experienced PTG in less than one outcome. More anticipated support and less interpersonal strain were consistently associated with positive functioning in each outcome. Our discussion focuses on how multidimensional approaches to studying PTG promise to disentangle which outcomes potentially grow following adversity and illuminate best research practices for examining PTG, laying the groundwork for future research.

Character Growth Following Collective Life Events: A Study on Perceived and Measured Changes in Character Strengths During the First Wave of the COVID-19 Pandemic

Did the COVID-19 pandemic promote character growth? Studies using sequential samples suggest that collective life events can result in character growth, but their conclusions have been questioned. This study used three approaches to examine character growth during the first wave of the pandemic: perceived changes in oneself and in a close other, and a longitudinal analysis of changes. In addition, we tested whether character strengths assessed before the pandemic predicted specific instances of growth, that is, engagement in volunteering and compliance with regulations during the pandemic. German-speaking participants ( N = 366, 76.5% female, mean age: 45.33 years) who had completed an assessment of character strengths before the pandemic reported on perceived changes in character strengths, engagement in volunteering, and compliance with regulations. A subsample also completed a second assessment of character strengths. The results showed that (a) participants reported perceived changes for most character strengths in both themselves and close others, while (b) longitudinal increases were only observed for humility and prudence. Pre-pandemic character strengths predicted (c) engagement in volunteering and (d) compliance with regulations. We conclude that actual character growth was smaller than the perceived changes but that the character strengths did predict relevant behaviors related to the COVID-19 pandemic.