A Systematic Review of Posttraumatic Growth in Survivors of Interpersonal Violence in Adulthood

Post-Traumatic Growth Promoting and Inhibiting Factors Among Intimate Partner Violence Survivors: A Systematic Review

Intimate partner violence (IPV) is a traumatic experience that is universally present across the globe. Undeniably, there are expected adverse outcomes. However, it is also conceivable that IPV survivors might see, feel, and experience a hopeful, positive future after their IPV experience. Notably experienced by IPV survivors is post-traumatic growth (PTG). PTG is a type of positive psychological change that occurs following the struggle with a traumatic experience. The changes are then reflected across five domains. As more studies on PTG among IPV survivors continue to rise, there must be a better understanding of the process. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, this systematic review consolidated findings from existing literature guided by the research questions: (a) What areas of PTG do IPV survivors most experience positive psychological growth? (b) What factors are associated with PTG among IPV survivors? A total of 22 studies met the criteria and were included. Spiritual growth and new possibilities domains were experienced the most by adult IPV survivors. Contributing and inhibiting factors toward PTG were identified and categorized as interpersonal, contextual, or intrapersonal. Targeted interventions aiding the process toward PTG for IPV survivors were also identified, including commonly maladaptive coping strategies. This systematic review contributes to the literature by increasing knowledge that can be used for more effective support, interventions, and policies that promote PTG for adult IPV survivors.

Psychosocial consequences of growing up as Austrian occupation children in post-World-War II Austria

Background: During the post-World War II occupation of Austria, approximately 20,000-30,000 'children born of war' (CBOW), also called occupation children were born through intimate contacts between Austrian women and occupation soldiers. Research on other CBOW populations indicates that CBOW mostly grow up under difficult conditions, sometimes with strong long-term mental health consequences.Objective: To examine whether comparable psychosocial consequences can be found in Austrian occupation children (AOC), a first quantitative study was carried out.Method: Child maltreatment, post-traumatic stress disorder, depression and somatization, and general life satisfaction were assessed in a sample of 98 AOC using self-report instruments. Results were compared to a sample of German occupation children (GOC; N = 146).Results: High prevalence of above threshold full (10.2%) and partial (14.3%) PTSD, somatic (16.3%) and depressive (11.1%) symptomatology were found in AOC. They were at high risk of child maltreatment (e.g. emotional abuse: 53.6%), which was associated with current symptomatology. Notably, AOC tended to report high levels of general life satisfaction. No differences were found between GOC and AOC.Conclusions: Findings highlight the complex and long-term effects of developmental conditions and childhood maltreatment on mental health of CBOW, even decades later. Findings of high life satisfaction provide evidence of resilience and maturation processes across the lifespan.

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.

Scoping review protocol of post-traumatic growth (PTG) in Korean cancer survivors

INTRODUCTION

Cancer, a life-threatening chronic disease, is the leading cause of death in Korea, accounting for 27% of all deaths in 2020. Due to advancements in medical technology and early detection of cancer in Korea, the 5-year relative survival rate reached 70.7% (2015-2019), highlighting remarkable progress over the past decades. Although cancer has been seen as a traumatic event, cancer survivors also go through a subjective process of self-maturation, which is called post-traumatic growth (PTG). Because research on PTG among Korean cancer survivors has not been systematically synthesised, a scoping review on this topic will provide a better understanding of the positive psychological changes that occur as a patient moves through the illness trajectory of cancer from a Korean cultural perspective. The purpose of this study was to describe the protocol of a scoping review regarding PTG in Korean cancer survivors.

METHODS AND ANALYSIS

The scoping review framework suggested by Arksey and O'Malley and the manual refined by the Joanna Briggs Institute for scoping reviews will be used with the six framework guidelines developed by Levac et al. Searched databases will include Ovid-MEDLINE, PubMed, Embase, CINAHL, Cochrane Library and PsycInfo, as well as Korean databases, examining all articles published between 2012 and 2023 in Korean or English on PTG in Korean cancer survivors. Extracted data will be collated, charted and summarised.

ETHICS AND DISSEMINATION

Because the scoping review methodology undertakes a secondary analysis of collected data from previous research studies, this study does not require ethical approval. The results of this scoping review will be disseminated through presentations at conferences and publication in a scientific journal.

Posttraumatic Growth in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study

Despite increasing recognition that positive psychological changes or posttraumatic growth (PTG) may develop after highly stressful or traumatic events, contemporary population-based data on the epidemiology of PTG in high-risk samples such as U.S. military veterans are lacking. Additionally, in light of emerging evidence suggesting an 8-factor model of posttraumatic stress disorder (PTSD) symptoms, an up-to-date characterization of how these symptom clusters relate to PTG can help inform efforts to help promote PTG. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 3,847 trauma-exposed U.S. veterans. Participants completed assessments of potentially traumatic events, PTSD symptoms, and PTG, as well as a broad range of sociodemographic, military, trauma, health, personality, and psychosocial characteristics. Results revealed that 63.2% of trauma-exposed veterans and 86.4% of veterans who screened positive for PTSD endorsed moderate-or-greater PTG; these prevalences are higher than those reported in an independent U.S. veteran sample in 2011 (50.1% and 72.0%, respectively). An inverted U-shaped association was observed between PTSD symptom severity and PTG levels, with scores of 31 to 51 on the PTSD Checklist for DSM-5 associated with the highest likelihood of PTG. Intrinsic religiosity and internally- and externally-generated intrusive symptoms of PTSD were identified as the strongest correlates of PTG. Results suggest that prevention and treatment efforts to mitigate severe PTSD symptoms, and help promote intrinsic religiosity, and more deliberate and organized rumination about traumatic experiences may help foster PTG in veterans.

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

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

An ecological approach to understanding the impact of sexual violence: a systematic meta-review

Aim

A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence.

Methods

Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted.

Results

Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however.

Conclusion

Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.

Path to posttraumatic growth: The role of centrality of event, deliberate and intrusive rumination, and self blame in women victims and survivors of intimate partner violence

Increased interest in positive changes in the aftermath of traumatic events led researchers to examine assumptions about the process of posttraumatic growth (PTG). However, existing studies often use samples from mixed trauma survivors and investigate separate factors and their associations with growth. Therefore, the purpose of the current study was to examine the path from centrality of event to PTG involving intrusive and deliberate rumination and self-blame as a coping strategy in women survivors of intimate partner violence (IPV). The study sample consisted of 200 women with a history of IPV (ages 18–69, M = 44.79, SD = 12.94). Results of the path analysis indicated that higher centrality of event was related to higher levels of intrusive rumination which was positively related to self-blame and deliberate rumination eventually leading to PTG. Indirect effects from centrality of event to PTG through intrusive and deliberate rumination, and from intrusive to deliberate rumination through self-blame were examined. This study gave support to some theoretical assumptions of the process of PTG and pointed out problematic areas of investigation of coping strategies in this process.

Locating event centrality in associations of emotion regulation with posttraumatic stress disorder symptoms and posttraumatic growth in emerging adults

Previous research suggests that cognitive reappraisal (CR) and expressive suppression (ES) strategies of emotion regulation (ER) are associated with posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). How the patterns of these associations may vary in the context of event centrality (EC) however requires investigation to help delineate groups for whom the impact of event centrality may be more salient. We examined whether EC would moderate the associations of CR and ES with PTSD symptoms clusters and PTG domains among 388 emerging adults (18-30 year-olds) of Tiv ethnic group who were survivors of armed attack by Fulani herdsmen and were temporarily sheltered in two internally displaced persons' (IDPs') camps in North-central Nigeria. They completed self-report measures of the variables. Results indicated that EC strengthened the negative associations of CR and the positive associations of ES with avoidance, hyper-arousal and total PTSD symptoms, but not intrusion symptoms. For the PTG domains, EC only strengthened the positive association between CR and personal strength and weakened the association of ES with greater appreciation of life. These findings suggest that primary intervention programs that incorporate training of armed attack survivors in cognitive reappraisal strategy centered on the traumatic event could be effective in controlling PTSD but be less critical in engendering PTG. They also show that the psychological processes that underlie PTSD and PTG are related but involve nuances even within PTSD, and do not seamlessly set into the Janoff-Bulman's "strength through suffering" model of PTG. More research is required to test the model.

Do levels of posttraumatic growth vary by type of traumatic event experienced? An analysis of the Nurses' Health Study II

OBJECTIVE

Posttraumatic growth (PTG) has been documented in the aftermath of a range of traumatic events, including bereavement, physical assault, and rape. However, only a handful of studies have examined whether levels of total PTG, as well as the 5 domains of PTG (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength, and Spiritual Change), vary by the type of potentially traumatic event. The current study examined variation in total PTG and PTG domains, as well as posttraumatic stress (PTS), by event type using data from a large epidemiological study.

METHOD

Participants were from a substudy of the Nurses' Health Study 2, an epidemiologic study of female nurses in the United States (N = 1,574).

RESULTS

Controlling for demographic covariates, we found that rape was consistently associated with lower PTG, both total PTG and all five PTG domains, relative to other event types. Other findings were limited to specific PTG domains; for example, intimate partner violence (IPV) was associated with higher Personal Strength and New Possibilities. In contrast, rape and IPV were associated with higher PTS, and the serious illness or injury of someone close with lower PTS, relative to other event types.

CONCLUSION

These results add to the growing literature exploring variation in PTG by event type and suggest that different events could yield markedly different patterns of PTG domains and PTS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trauma Survivors' Experiences of Kundalini Yoga in Fostering Posttraumatic Growth

The prevalence of traumatic events in South Africa is considerably high due to a history of political violence and the ongoing cycle of interpersonal, community-based, and socioeconomic violence. While conventional therapeutic techniques have been found to support trauma survivors in the local context, alternative approaches that focus on the mind-body connection have become increasingly popular. However, studies reporting on the use of these approaches remain scarce. This study aimed to add to the body of knowledge on yoga as a non-conventional therapy to support trauma survivors and foster posttraumatic growth. Semi-structured interviews were conducted with a sample of seven Kundalini yoga practitioners who had been exposed to trauma. A thematic analysis confirmed that Kundalini yoga was beneficial in fostering posttraumatic growth. Overall, the study findings, evidence a pocket of success in relation to value of such an intervention within a low socio economic black South African context.

The role of repetitive thinking and spirituality in the development of posttraumatic growth and symptoms of posttraumatic stress disorder

Both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) are associated with spirituality and different kinds of repetitive thinking, such as deliberate rumination (DR) and intrusive rumination (IR), respectively. This study aimed to examine if spirituality modifies the relationship between types of rumination and trauma outcomes. Ninety-six students completed an online survey of four questionnaires in a cross-sectional online survey: The Posttraumatic Stress Diagnostic Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory-Short form and the Expressions of Spirituality Inventory- Revised. Findings revealed that spirituality was related to DR and PTG, but not to IR or PTSD symptoms. Moderation analysis showed that spirituality significantly moderated the relationship between PTG and DR, but not the relationship between PTSD and IR. These findings indicate that while spirituality has no relationship with negative outcomes of trauma, it may help individuals to ruminate in a constructive manner in order to develop positive outcomes.

Post-traumatic Growth in Women With Histories of Addiction and Victimization Residing in a Sober Living Home

Research consistently documents the deleterious sequelae of interpersonal trauma, including domestic and sexual violence (DSV). More recently, however, researchers and practitioners have focused on positive outcomes, such as post-traumatic growth (PTG), in survivors of DSV. Although research has begun to document the prevalence and correlates of PTG, no study to our knowledge has explored PTG in a sample of women with histories of addiction and victimization residing in a trauma-informed sober living home (SLH). The purpose of the current study was to examine this gap in the literature. Participants were 59 women (89.8% White; 86.4% heterosexual; mean age = 41.6) who completed a survey while residing in a SLH. Most women reported moderate to high levels of PTG. At the bivariate level PTG was related to less depression, post-traumatic stress disorder, and financial worries, and greater active coping, and sense of community. PTG was also related to the absence of past 6-month physical intimate partner violence. In regression analyses, PTG was related to less depression and greater sense of community. These data offer insights into modifiable factors such as fostering a sense of community while also promoting mental health treatment that could be the focus of interventions to increase PTG in women with histories of addiction and victimization residing in SLHs.

Posttraumatic growth experiences of refugees: A metasynthesis of qualitative studies

Although forced displacement may lead to many adverse psychological problems, this experience may also result in positive psychological consequences. Given the increasing disturbance in countries, many people are forcibly displaced, a comprehensive understanding of the posttraumatic growth (PTG) experiences of refugees is warranted. In this study, we examined 12 primary studies exploring PTG among refugees using the qualitative metasynthesis method. Our analysis of the primary studies consisting of 319 adults revealed four themes: (a) improved psychologic functioning; (b) enhanced interpersonal relationships; (c) reconstruction of the meaning of life; and (d) positive future direction. These findings indicate that no matter how traumatic experiences are painful, people can hold on to life, build a new life, and grow from adversity.

Burden and Growth during COVID-19: Comparing Parents of Children with and without Disabilities

The COVID-19 pandemic and the measures taken to contain it have had a disproportionate impact on families with young children, especially with disabilities. This study examined factors associated with burden and growth among parents of young children in Israel, while comparing parents of children with and without disabilities. We hypothesized that the association between family functioning, informal social support, and perceived adequacy of educational services and burden and growth would be moderated by disabilities. An online questionnaire was completed by 675 parents of young children, 95 of them with disability. The moderating effect of disability on burden and growth was examined using PROCESS. Compared to parents of children without disabilities, greater burden was found among parents of children with disabilities, but levels of growth were similar. External support was lacking for both parent groups. Educational services were perceived as severely inadequate. Lower perceived adequate educational services were associated with greater burden. On the other hand, higher levels of family functioning (i.e., family cohesion and adaptability) and greater adequacy of educational services were associated with growth. The results show that while burden was greater for parents of children with disabilities, growth during the COVID-19 period was possible for parents of both groups. The findings also pointed to the importance of the family system for sustaining the wellbeing of its members in lockdown situations. Put together, the findings highlight the importance of planning for such national and global emergencies.

Responding to Disclosure of Sexual Assault: The Potential Impact of Victimization History and Rape Myth Acceptance

Victims of sexual assault often disclose their victimization experiences to friends and family members in the hope of gaining support. However, a number of factors may influence the manner in which these confidants respond to the disclosure (e.g., severity of the victim's assault). The purpose of this study was to examine the role of two unique factors-the disclosure recipient's sexual victimization history and endorsement of rape myths-in predicting responses to disclosure. Participants were 114 undergraduate students who indicated that a close friend or family member had previously disclosed a sexual victimization experience to them. The participants' responses to that disclosure, personal sexual victimization history, and rape myth attitudes were assessed via a self-report. Results indicated that a history of victimization predicted increased emotionally supportive responses to disclosure. Lower rape myth acceptance predicted increased supportive responses (i.e., emotionally supporting the victim and aiding the victim) and decreased unsupportive responses (i.e., treating the victim differently after the abuse, distracting the victim from the abuse, and blaming the victim). These results have implications for prevention efforts and those working with sexual assault survivors.

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.

Systematic Review: Effectiveness of psychosocial interventions on wellbeing outcomes for adolescent or adult victim/survivors of recent rape or sexual assault

Sexual assault and rape are common forms of sexual violence/abuse. The psychological/health consequences represent significant and ongoing harm. It seems imperative that victim/survivors receive evidence-based support within first response settings. To assess what psychosocial interventions work for victim/survivors of a recent sexual assault. Twenty-seven electronic databases were systematically searched. Narrative data synthesis was used to read across studies. Reporting format follows PRISMA checklist. Ten studies were identifed including range of interventions. The evidence is sparse and scientifically weak, common flaws are reviewed. There is some weak evidence for the impact of video and cognitive behavioural therapy (CBT) based interventions, especially trauma processing. There is a gap in the evidence base on psychosocial interventions for victim/survivors of sexual assault and higher quality research is required.

Longitudinal Investigation of Posttraumatic Growth in Female Survivors of Intimate Partner Violence: The Role of Event Centrality and Identity Exploration

The purpose of this study was to investigate the change in posttraumatic growth (PTG) of women survivors of intimate partner violence (IPV) in Lithuania, in relation to the centrality of traumatic experience, identity exploration, and time after exposure to violence. The longitudinal study sample consisted of 217 women who experienced IPV, recruited from women shelters, social support centers, and through counseling psychologists. In this sample the assessment instruments were administered three times during an 18-month period (at 6-month intervals). The results of the study revealed that PTG significantly increased over time for the women who experienced IPV more recently. Those women who experienced IPV more anciently reported higher PTG levels at the beginning of the study, but significant changes in PTG did not emerge. In addition, higher levels of PTG at the beginning of the study were positively associated with event centrality and identity exploration, meaning that those women who perceived their IPV experience as central to their identity and who explored possible identity choices were more likely to have higher levels of PTG at the beginning of the study. However, neither the centrality of the event nor the identity exploration was important for the change in PTG over the study period. Findings of this study highlighted the importance of the first 2-year period after the violence when the potential for PTG and its increase occurs. Limitations of the study and implications for future research are discussed.

Process of forgiveness in the recovery of Chinese women survivors of intimate partner violence: Empowerment, transformation, and integration

Forgiveness has been found one substantial element in the recovery for women survivors from intimate partner violence following the termination of the abusive relationship. To further investigate the details of forgiveness in this specific context, the present study explored the process of forgiveness using grounded theory. In-depth and semi-structured interviews were conducted with 25 Chinese women survivors of IPV. The findings suggest that forgiveness is a strength-based process including empowerment, transformation, and integration phases. In the empowerment phase, survivors obtain strength at the intrapersonal, behavioural, and interpersonal levels. In the transformation phase, survivors complete cognitive transformation for their IPV experiences and emotional transformation towards former partners. In the integration phase, survivors-now freed from the past-reflect upon and apply the changes they have undergone. Two trajectories in the process were found. One trajectory is going through stages sequentially and the other trajectory is experiencing back and forth between empowerment and transformation stages before moving into the integration stage. The study's findings broaden our knowledge of the strength-based forgiveness process that women survivors of IPV undergo during recovery. Practitioners and policymakers could develop programmes and policies that support forgiveness by holistically facilitating their recovery and empowerment like assistance in dealing with life difficulties and promoting their reconnection with social networks. To improve the transferability and validity of the findings, the forgiveness of survivors of IPV could be explored in a diverse sample (e.g., survivors with low educational background or live in the rural area).

The Mediating Role of Cognitive Processing in the Relationship Between Negative and Positive Effects of Trauma Among Female Victims of Domestic Violence

Exposure to domestic violence may lead not only to negative but also positive consequences of trauma. Negative effects are indicated by posttraumatic stress symptoms (PTSSs), and positive effects by posttraumatic growth (PTG) changes. PTG has been conceptualized to follow experiences of PTSSs. Therefore, the positive and negative effects of trauma appear to be related to one another. The cognitive processing may play a special role in determining whether the positive and negative consequences of trauma exposure are experienced. The aim of the study was to establish the mediating role of multiple patterns of cognitive processing, reflected by the cognitive strategies used to cope with trauma, in the relationship between negative and positive posttraumatic changes in women following domestic violence. Data were obtained from 63 Polish women who had experienced domestic violence. The age of the respondents ranged from 19 to 71 years (M = 42.25, SD = 14.81). The Polish versions of the following standardized tools were used: the Posttraumatic Stress Disorder Checklist (PCL-5), the Posttraumatic Growth Inventory (PTGI), and the Cognitive Processing of Trauma Scale (CPOTS). PTSS severity appeared to be negatively related to that of PTG. Negative coping strategies were positively related to the PTSS severity but negatively to PTG, while positive strategies were negatively related to the PTSS severity but positively to PTG. Cognitive strategies for coping with trauma, such as resolution/acceptance, downward comparison, and regret, appeared to play a mediating role in the relationship between PTSS severity and PTG. Positive coping strategies strengthen the occurrence of positive posttraumatic changes while strategy of regret weakens the PTG changes occurrence. The process of adaptation and human development among people who have experienced traumatic events is favored by the use of more frequent positive and less frequent negative strategies of dealing with trauma.

Posttraumatic growth in women who have experienced the loss of their spouse or partner

BACKGROUND

The loss of a spouse or long-term partner has a significant impact on a woman's well-being; psychological, physical, social, spiritual, and economic. Women dealing with loss are faced with numerous stressors which place them at risk for a variety of health challenges.

PURPOSE

The aim of this study was to describe the experiences of women who have lost their spouse or partner to death using the theoretical framework of posttraumatic growth (PTG) developed by Tedeschi and Calhoun.

METHODS

A qualitative descriptive study was conducted with semi-structured interviews of 15 widows. Purposive sampling was employed using the researchers' nursing network of colleagues through their academic institutions, hospital affiliations, and professional organizations.

FINDINGS

Six themes emerged from the data analysis: (1) Listen to my story of loss, (2) Pushing through the sadness, (3) Anticipated versus unanticipated loss, (4) A new depth of compassion and empathy, (5) My strength grew over time, and (6) My view of myself changed. Participants experienced varying degrees of PTG evidenced by a greater appreciation of life, personal strength, improved relationships, new possibilities, and spiritual growth.

IMPLICATIONS FOR NURSING

Knowledge development in this sphere enhances nursing practice in caring for women as they navigate life without their significant other. Nurses are in pivotal positions to educate others about the grieving process and the possibility of PTG. They help women find their way through trauma and teach others about healing, coping, empathy, compassion and the power of being connected to other human beings.

Posttraumatic Growth in Women who have Experienced Loss of a Child

PURPOSE

The purpose of this study was to describe and explore the experiences of women who have lost a child and the degree of posttraumatic growth revealed by the experiences.

STUDY DESIGN AND METHOD

A qualitative descriptive study was conducted with interviews of mothers and grandmothers of children who died using the posttraumatic growth framework.

FINDINGS

Participants included 11 mothers and 2 grandmothers. The posttraumatic growth framework was useful in examining their experiences. Seven themes were identified through data analysis: When my child died, I lost part of myself; Anticipated loss versus unanticipated loss; Picking up the pieces of my life; Support, kindness, and compassion helped; Moving on while still broken; Never forgotten, always in my heart; and Holding my loved ones close.

CLINICAL IMPLICATIONS

Nurses are in strategic positions to help women who have experienced the loss of a child by building rapport, establishing trust, and demonstrating empathy.

Caught by Connections: The Mediating Roles of Social and Community Support after Interpersonal Violence

The purpose of the present study was to examine the potential mediating roles of different sources of social support and sense of community on the relationship between interpersonal violence and mental health outcomes, negative posttraumatic cognitions, and posttraumatic growth. Participants (n = 459) completed an online survey. Interpersonal violence had a significant, direct effect on all posttraumatic outcomes. Support from significant others mediated the relationship between interpersonal violence and posttraumatic stress. Both support from family and a negative sense of community mediated the relationship between interpersonal violence and posttraumatic cognitions, while social support from friends and family and a positive sense of community mediated the relationship between interpersonal violence and posttraumatic growth. The results suggest that posttraumatic distress and growth may be impacted by different connection sources.

The Role of Social Support in Identity Processes and Posttraumatic Growth: A Study of Victims of Intimate Partner Violence

The purpose of this study was to explore the role of social support for posttraumatic growth (PTG) and identity processes in a sample of 217 women victims of intimate partner violence (IPV), recruited from women shelters, social support centers, and through counseling psychologists. The results of the study highlight the important role of social support in seeking positive personal resolutions after experiencing traumatic events of IPV. It indicates that social support, but not social nonsupport, predicts higher levels of PTG and the development of new positive identities. In particular, social support was positively associated with the manifestation of all five identity processes, that is, with identification with commitment, commitment making, exploration in breadth, exploration in depth, and ruminative exploration. Furthermore, contextual and socioeconomic factors, such as time after last violence, relationships with the perpetrator, place of residence, education, and age of the victims of IPV were also related to identity processes. Severity of the violence, time after the last violence, education, and personal income were related to PTG. Thus, this study indicated that there are significant contextual and socioeconomic differences in the PTG and reconsideration of one's identity. Recommendations for practitioners and future research have been suggested.

The Efficacy of a Health Promotion Intervention for Indigenous Women: Reclaiming Our Spirits

Indigenous women globally are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), yet there is often a mismatch between available services and Indigenous women's needs and there are few evidence-based interventions specifically designed for this group. Building on an IPV-specific intervention (Intervention for Health Enhancement After Leaving [iHEAL]), "Reclaiming Our Spirits" (ROS) is a health promotion intervention developed to address this gap. Offered over 6 to 8 months in a partnership between nurses and Indigenous Elders, nurses worked individually with women focusing on six areas for health promotion and integrated health-related workshops within weekly Circles led by an Indigenous Elder. The efficacy of ROS in improving women's quality of life and health was examined in a community sample of 152 Indigenous women living in highly marginalizing conditions in two Canadian cities. Participants completed standard self-report measures of primary (quality of life, trauma symptoms) and secondary outcomes (depressive symptoms, social support, mastery, personal agency, interpersonal agency, chronic pain disability) at three points: preintervention (T1), postintervention (T2), and 6 months later (T3). In an intention-to-treat (ITT) analysis, Generalized Estimating Equations (GEE) were used to examine hypothesized changes in outcomes over time. As hypothesized, women's quality of life and trauma symptoms improved significantly pre- to postintervention and these changes were maintained 6 months later. Similar patterns of improvement were noted for five of six secondary outcomes, although improvements in interpersonal agency were not maintained at T3. Chronic pain disability did not change over time. Within a context of extreme poverty, structural violence, and high levels of trauma and substance use, some women enrolled but were unable to participate. Despite the challenging circumstances in the women's lives, these findings suggest that this intervention has promise and can be effectively tailored to the specific needs of Indigenous women.

Yoga as a complementary approach to healing for adult victims and survivors of interpersonal violence

PURPOSE

Yoga is increasingly accepted to improve overall health and wellness and is considered a meaningful adjunct treatment for mental and physical health ailments associated with interpersonal violence (IV). This review provides background information about the use of yoga among individuals with IV histories and aims to inform researchers and practitioners about the available evidence on yoga's application and effectiveness.

METHODS

Using six databases, we systematically reviewed empirical literature examining yoga among IV survivors. Criteria for study inclusion: yoga included a physical component and was the primary intervention; participants had an IV history; peer-reviewed; and participants were 17 years and older. After review, 10 articles reporting findings from seven independent samples were included.

FINDINGS

Yoga demonstrated preliminary, positive implications as a complementary treatment for individuals with an IV history. Synthesizing across articles four themes emerged: (1) acceptability and feasibility, (2) enhancement of mental and physical health, (3) promotion of personal growth, and (4) facilitators and barriers to practice.

CONCLUSIONS

The nascent literature indicates potential benefits of integrating yoga into interventions for IV survivors to enhance physical and psychological functioning. The primary barriers to intervention were resources (e.g., access) and incompatibility with spiritual beliefs for select clients. Despite consistent barriers, preliminary findings indicate yoga has many positive implications for individuals with an IV history. Given the small evidence base and insufficient methodology, additional empirical research with diverse samples and sites, and robust designs, could improve the state of knowledge and strengthen the efficacy of this promising practice.

"I Thought It Was Normal": Adolescents' Attempts to Make Sense of Their Experiences of Domestic Violence in Their Families

This article describes the experience and impact of domestic violence on adolescents using qualitative methodology. It explores the meanings that adolescents give to their experiences and how this may relate to the impact of those experiences. Five adolescents who were receiving interventions within child and adolescent mental health services were interviewed about their experiences of domestic violence and the interviews were analyzed using interpretative phenomenological analysis (IPA). The results suggest that adolescents had a range of thoughts and feelings connected to their experiences, and that the impact of the domestic violence may be related to the different meanings that the adolescents gave to their experiences and how they made sense of those experiences. The results are explored using theories such as Grych and Fincham's Cognitive-Contextual Model; Watkin's elaborated Control Theory; and the work on posttraumatic growth. Research and clinical implications are discussed in the light of the results.

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.

Identifying Women's Strengths for Promoting Resilience After Experiencing Intimate Partner Violence

Guided by the Resilience Portfolio Model, this study examined strengths associated with well-being and post-traumatic growth (PTG) among women who had experienced intimate partner violence (IPV). Participants were 109 Spanish women who were receiving specialized psychological services for IPV. They completed a survey on multiple indicators of strengths, subjective well-being, and PTG. The results indicated that PTG was positively correlated with well-being and all strengths. Univariate analysis comparing levels of PTG showed significant differences in all factors, except emotional regulation and optimism. Post hoc analyses revealed two patterns, with some strengths distinguishing across all levels of PTG, and others only discriminating the most resilient women (as indicated by PTG) from the rest. Multivariate analyses accounted for 42% of the variance in posttraumatic growth and 52% in well-being. The results suggest ways to promote well-being and resilience among victimized women.

The Remission of Social Anxiety Disorder After Trauma: A Case Report of Posttraumatic Growth?

Posttraumatic growth (PTG) describes positive psychological change and improvement beyond one's previous functioning. It manifests as a change of self-perception, improvement in the relationship with others, and a better outlook on life. Despite consistent literature on the occurrence of PTG in healthy subjects, there is still a dearth of studies in people with pre-existing mental disorders, especially anxiety disorders. We report the case of a patient previously diagnosed with social anxiety disorder (SAD), whose symptoms remitted, and life view improved after a traumatic event, illustrating a case of PTG. The trauma shattered the patient's previous belief system, allowing the emergence of a new cognitive schema. Although PTG and symptom remission do not necessarily correspond to the same construct, we believe that these phenomena were related to each other in this case, probably because of a notable change in our patient's underlying belief system.

Variables protecting mental health in the Spanish population affected by the COVID-19 pandemic

The pandemic produced by COVID-19 can lead the population to suffer serious psychological disorders. However, there are several psychosocial variables that can enhance resilient outcomes in adverse situations. The aim would be to establish the level of resilience of the general Spanish population exposed to a traumatic situation by the COVID-19 in order to identify which protective factors predict resilient outcomes. 1227 homebound people (863-70.3% women), aged 18-73 years (M = 28.10; SD = 12.88) reported on sociodemographic and psychological variables such as optimism, hope, self-efficacy and post-traumatic growth. Having a higher academic level (β = .47; CI (95%) = .11-.34; p < .01), being autonomous (β = .29; CI (95%) = 0.1-.09; p < .01), along with self-efficacy (β = .42; CI (95%) = .71-92; p < .01) and to a lesser extent optimism (β = .31; CI (95%) = .63-.84; p < .01) would be the predictive variables of a resilient outcome. A high level of statistical power (1-β = 1) and effect size (f2 = 19.2) is observed. The Spanish population exposed to confinement presents high levels of resilience, but no relevant post-traumatic growth has taken place.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-020-01132-1.

A Systematic Review of Reviews of the Outcome of Noninstitutional Child Maltreatment

The aim of the systematic review described in this article was to synthesize available high-quality evidence on the outcomes of noninstitutional child maltreatment across the life span. A systematic review of previous systematic reviews and meta-analyses was conducted. Ten databases were searched. One hundred eleven papers which met stringent inclusion and exclusion criteria were selected for review. Papers were included if they reported systematic reviews and meta-analyses of longitudinal or cross-sectional controlled studies, or single-group cohort primary studies of the outcomes of child maltreatment in the domains of physical and mental health and psychosocial adjustment of individuals who were children lived mainly with their families. Using AMSTAR criteria, selected systematic reviews and meta-analyses were found to be of moderate or high quality. Searches, study selection, data extraction, and study quality assessments were independently conducted by two researchers, with a high degree of interrater reliability. The 111 systematic reviews and meta-analyses reviewed in this article covered 2,534 independent primary studies involving 30,375,962 participants, of whom more than 518,022 had been maltreated. The magnitude and quality of this evidence base allow considerable confidence to be placed in obtained results. Significant associations were found between a history of child maltreatment and adjustment in the domains of physical health, mental health, and psychosocial adjustment in a very wide range of areas. The many adverse outcomes associated with child maltreatment documented in this review highlight the importance of implementing evidence-based child protection policies and practices to prevent maltreatment and treat child abuse survivors.

[Post-traumatic growth: Some conceptual considerations]

OBJECTIVE

Post-traumatic growth (PTG) is a quite new concept of positive psychology proposed in the mid-1990s which is still rather confidential in France. This article aims to propose a full description of this concept from an historical view to epidemiological data through underlying mechanisms and evaluation.

METHODS

A literature search identifying relevant results was performed through the Pubmed database.

RESULTS

PTG refers to positive psychological changes experienced as a result of a traumatic life event in order to rise to a higher level of functioning. That is to say that people experiencing psychological struggle following adversity may often see positive outcomes in the aftermath of trauma. Domains of PTG include appreciation of life, relationships with others, new possibilities in life, personal strength and spiritual change. A self-report scale, the Post-Traumatic Growth Inventory (PTGI), has been developed. PTG has been demonstrated after various traumatic events such as transport accidents, natural disasters, interpersonal violence or medical problems, with a prevalence ranging from 3 to 98 % depending on the type of trauma.

DISCUSSION

The concept of resilience and some evaluation bias may have been deleterious for the development of the PTG concept in the French-speaking world. There is a need to consolidate data to understand the pathway leading to PTG, noticeably to identify factors contributing to PTG that can help to promote the growth as a new therapy for trauma.

Measuring positive psychosocial sequelae in patients with advanced cancer

OBJECTIVE

Posttraumatic growth and benefit finding describe the potential for positive changes resulting from traumatic experiences, including cancer. In oncology, these constructs are increasingly examined concurrently using the Posttraumatic Growth Inventory (PTGI) and the Benefit Finding Scale (BFS). However, distinctions between these constructs and their corresponding scales are not altogether clear, and the burden of administering 2 lengthy questionnaires is evident, particularly for patients at end-of-life.

METHOD

Baseline data from 209 participants enrolled in a randomized controlled trial evaluating the efficacy of a psychosocial intervention were analyzed. We assessed the structure and covariance of all PTGI and BFS items using item response theory to determine the extent to which these measures overlap and the potential value of their concurrent administration in patients with advanced cancer.

RESULTS

Despite conceptual differences in posttraumatic growth and benefit finding, results indicated that these measures address the same underlying construct. We subsequently analyzed 3 abbreviated scales (7, 11, and 16 items) that combine items from both scales to identify an optimal briefer combined scale. Results supported all 3 versions, with the 7- and 16-item measures appearing to have the best balance of content and concurrent validity and the 11-item version optimizing information gained with brevity.

CONCLUSIONS

These findings indicate that concurrent administration of the PTGI and BFS may be unnecessary given the high degree of overlap between these 2 measures and that a brief subset of items may adequately evaluate positive change among patients with advanced cancer while reducing participant burden. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Survivors' lived experiences of posttraumatic growth after institutional childhood abuse: An interpretative phenomenological analysis

BACKGROUND

Institutional childhood abuse (ICA) represents a chronic and severe form of childhood maltreatment and is associated with a host of adverse outcomes. However, there is some evidence to suggest that survivors can also experience positive psychological change after institutional childhood abuse and neglect.

OBJECTIVE

To examine the lived experiences of posttraumatic growth (PTG) in adult survivors of institutional childhood abuse.

PARTICIPANTS AND SETTING

Nine survivors of historical institutional abuse in Ireland ranging in age from 41 to 75 years (M = 60.5).

METHOD

Semi-structured interviews were conducted to explore survivors' experiences of positive change after institutional upbringing. Data were analysed in the tradition of interpretative phenomenological analysis (IPA).

RESULTS

The analysis yielded two superordinate themes. The first major theme, 'Survivor Identity' described participant's subjective understanding of their survivorship through five subthemes. The second major theme, 'Engendering Growth' comprised seven subthemes which collectively identified key factors and processes related to positive change and posttraumatic growth after significant early-life maltreatment.

CONCLUSIONS

Findings underscore the importance of supporting survivors to construct a comprehensive self-narrative that identifies their personal strengths and growthful experiences, whilst also acknowledging the continued distress associated with their unique survivorship trajectory.

Predictors of posttraumatic growth among conflict-related sexual violence survivors from Bosnia and Herzegovina

Background

Conflict-related sexual violence (CRSV) was committed on a large scale against women across Bosnia and Herzegovina (BiH) during the 1990’s war, and research has shown both negative and positive psychosocial outcomes following such acts of interpersonal violence. We aim to determine the capacity for posttraumatic growth (PTG) among a population of women who experienced CRSV, and to what extent it is impacted by factors such as coping and optimism.

Methods

This study sought to examine the relationship between PTG (posttraumatic growth inventory), symptoms of posttraumatic stress disorder (PTSD; Harvard Trauma Questionnaire) and dispositional factors such as coping (COPE) and optimism (Life-Orientation Test-Revised) in a sample of n = 104 women. We first conducted bivariate correlations and then hierarchical linear regression analyses, and hypothesized that approach coping strategies and optimism will act to enhance PTG.

Results

Findings showed that the average total score for PTG in this study was 58.94 (SD = 23.01), and current PTSD symptomatology above a threshold of > 2.5 was detected in 92.3% (n = 96) participants (mean score 3.18, SD = .45). Bivariate correlations showed that higher levels of PTG were associated with greater optimism, greater approach coping strategies positive reinterpretation and planning, and lower avoidance strategies behavioural disengagement and substance use. When entered into a regression model, only positive reinterpretation and behavioural disengagement remained, the R-square of the total set of predictors was 0.16, thus explaining 16% of PTG total score.

Conclusion

Two types of coping (namely capacity of both greater positive reinterpretation and lower behavioural disengagement) most strongly predicted growth after trauma in this sample of CRSV survivors from BiH. These dimensions of coping confirm the role of coping strategies in the development of PTG. Further research would be useful in corroborating these findings in other post-conflict settings, and delving further into the possibility of a dual mechanism of growth and distress after CRSV.

Electronic supplementary material

The online version of this article (10.1186/s13031-019-0201-5) contains supplementary material, which is available to authorized users.

"It's Brought Me a Lot Closer to Who I Am": A Mixed Methods Study of Posttraumatic Growth and Positive Change Following a First Episode of Psychosis

Background: A first episode of psychosis is often a traumatic experience that may also lead to positive change, a phenomenon that has received little attention. This knowledge gap may impede service providers' capacity to foster positive change among service users. Objective: To investigate aspects of positive change among persons receiving early intervention services for psychosis. Design: The study objective was addressed using a mixed methods convergent design, which entailed simultaneously employing qualitative and quantitative methods. Setting: This study was conducted at a specialized early intervention service for psychosis based in Montreal, Quebec, Canada. Participants: Participants included service users receiving services at an early intervention service for psychosis. Participants had to be fluent in English or French, be clinically stable enough to take part in the study, and have received at least 6 months of treatment. Participants were conveniently sampled in the quantitative component and purposefully sampled in the qualitative component. The quantitative component was carried out using a cross-sectional survey design. Ninety-four participants completed the Posttraumatic Growth Inventory, a widely used measure of positive change. Data on the extent and domains of posttraumatic growth were summarized using descriptive statistics. The qualitative component was carried out using a qualitative descriptive approach. Semistructured interviews were conducted with 12 participants. Data were analyzed using thematic analysis. Findings from both components were integrated using a weaving method in the discussion section. Results: Quantitative results indicated that most participants reported a moderate amounts of posttraumatic growth. A greater appreciation of life was the most commonly endorsed domain, whereas spiritual growth was the least commonly endorsed domain. The qualitative results revealed that in addition to suffering, participants experienced positive changes, such as improved health and personality, and a stronger sense of self; stronger, more balanced religiosity and spirituality; improved relationships with others; and improved lifestyles, goals, and expectations for the future. Conclusions: Positive change may be a common phenomenon in the aftermath of first episode psychosis. The study findings may provide hope to those who have experienced a first episode of psychosis and can inform efforts by early intervention services to provide recovery-oriented, growth-focused care.

Posttraumatic Growth as a Mediator of Self-Blame and Happiness in the Context of Interpersonal Violence

Sexual assault (SA) and intimate partner violence (IPV) occur at alarming rates in the United States. Prior research indicates that victims of traumatic events frequently experience both positive and negative changes as part of their recovery process. The present study aimed to further existing research by examining the relationship between self-blame, posttraumatic growth (PTG), and happiness when controlling for posttraumatic stress and time since victimization. The current study analyzed 357 women who had experienced at least one incident of SA or IPV. We found that PTG partially mediated the relationship between self-blame and happiness, suggesting that PTG only somewhat explains the impact of self-blame on victim happiness. Implications of these findings and directions for future research are discussed.

Vicarious Posttraumatic Growth in Labor and Delivery Nurses

OBJECTIVE

To investigate vicarious posttraumatic growth in labor and delivery nurses who cared for women during traumatic births.

DESIGN

A convergent parallel mixed-methods design was used.

PARTICIPANTS

The sample consisted of 467 labor and delivery nurses who completed the quantitative portion and 295 (63%) who completed the qualitative portion of this mixed-methods study via the Internet.

METHODS

The Association of Women's Health, Obstetric and Neonatal Nurses sent out e-mails to members who were labor and delivery nurses with a link to the electronic survey. Labor and delivery nurses completed the Posttraumatic Growth Inventory and the Core Beliefs Inventory in the quantitative portion. For the qualitative portion, the nurses were asked to describe their experiences of any positive changes in their beliefs or life as a result of their care for women during traumatic births.

RESULTS

Labor and delivery nurses who cared for women during traumatic births reported a moderate amount of vicarious posttraumatic growth as indicated by their Posttraumatic Growth Inventory scores. Appreciation of Life was the dimension of the Posttraumatic Growth Inventory that reflected the highest growth, followed by Relating to Others, Personal Strength, Spiritual Change, and New Possibilities. In the qualitative findings, Relating to Others was also the dimension of posttraumatic growth most frequently described.

CONCLUSION

We compared our results with those of previous studies in which researchers assessed vicarious posttraumatic growth in clinicians, and we found that labor and delivery nurses who cared for women during traumatic births experienced growth levels that were scored between the lowest and highest reported levels of therapists and social workers. Nurses need to be aware of the potential to experience this growth despite the significant stress and unpredictability of the labor and delivery environment, which could decrease burnout and improve retention rates.