Posttraumatic growth, depression and posttraumatic stress in relation to quality of life in tsunami survivors: a longitudinal study

Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre-Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden

BACKGROUND

Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors.

METHODS

This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed.

RESULTS

Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods.

CONCLUSIONS

The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.

Depression and life satisfaction after Kahramanmaraş earthquakes: The serial mediation roles of life meaning and coping with earthquake stress

This study aims to examine the meaning of life, and the mediating effect of strategies for coping with earthquake stress in the relationship between depression, and life satisfaction in survivors of the 2023 Kahramanmaraş centered earthquakes. The participants of this study were 472 adults (31.1% male, 68.9% female; Mage = 24.52) who were affected by earthquakes. The data of the study were tested with the bootstrapping-based PROCESS macro program (Model-81). The results showed that depression negatively predicted life satisfaction. Meaning of life mediated the relationship between depression and life satisfaction. However, problem solving and cognitive avoidance coping strategies reduced the effects of depression and the meaning of life on life satisfaction. These results can be a resource for mental health services for earthquake victims. At the same time, the study provides evidence that protecting personal resources in disaster situations positively affects life satisfaction in terms of conservation of resources theory (COR).

Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review

BACKGROUND

The COVID-19 pandemic has imposed unprecedented stress and challenges upon medical staff, potentially resulting in posttraumatic growth (PTG). This scoping review aims to synthesize the existing knowledge on PTG among medical staff during the pandemic by identifying its current status and potential influencing factors. The findings may provide a foundation for future research and interventions to enhance the medical staff's psychological resilience and well-being.

METHODS

Literature was systematically searched on PTG among medical staff during the COVID-19 pandemic from 01 January 2020 to 31 December 2022. The following databases were searched: PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Data. Eligibility criteria included: (1) medical staff as research subjects; (2) a focus on "posttraumatic growth" or "alternative posttraumatic growth" related to the COVID-19 outbreak and pandemic; (3) discussion of the situation and influencing factors of PTG; and (4) study types, such as qualitative, quantitative, and mixed methods. Two researchers independently selected and extracted study characteristics (study design, study population, region, measurement instruments, and primary outcomes) from the included literature. The data were synthesized qualitatively and descriptively.

RESULTS

Thirty-six papers from 12 countries met the inclusion criteria. Moderate PTG levels were observed among healthcare workers during the COVID-19 pandemic, with emphasis on "interpersonal relationships," "changes in life philosophy," and "growth in personal competence." Influencing factors included trauma exposure, sociodemographics, psychological characteristics (resilience and positive qualities), coping, and social support.

CONCLUSIONS

This review discovered moderate PTG levels among medical staff during the COVID-19 pandemic, with critical areas in interpersonal relationships, life philosophy, and personal competence. The identified influencing factors can inform future research and interventions to enhance healthcare workers' psychological resilience and well-being.

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

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

Low Resilience Was a Risk Factor of Mental Health Problems during the COVID-19 Pandemic but Not in Individuals Exposed to COVID-19: A Cohort Study in Spanish Adult General Population

BACKGROUND

The aim is to analyze whether people with low resilience are at higher risk of mental health problems during the COVID-19 pandemic in Spanish adults.

METHODS

a longitudinal cohort study was carried out. Resilience was measured with the CD-RISC. Mental health problems that were assessed included: Major Depressive Episode (MDE), Generalized Anxiety Disorder (GAD), Suicidal Thoughts and Behaviors (STB), and Posttraumatic Stress Disorder (PTSD) symptoms.

RESULTS

we found statistically significant differences between groups and resilience scores in MDE [F (3; 48.40) = 19.55], GAD [F (3; 19.63) = 6.45] and STB [F (3; 111.74) = 31.94]. Multivariable analyses showed individuals with very low resilience were at a 5-fold risk of Incidence of MDE and a 4-fold risk of STB. Persistent group presented a 21-fold risk of MDE and 54-fold risk of STB. No evidence of higher risk was found for GAD. Individuals with low resilience and exposed to COVID-19 were not at higher risk. Individuals with low resilience were at higher risk of PTSD in general population [β(95% CI) = -3.25 (-3.969 to -2.54)], but not for individuals with COVID-19.

CONCLUSIONS

in the general population, having low or very low resilience increases the risk of suffering MDE, STB, and PTSD, but not GAD during the COVID-19 pandemic, and not in the population with COVID-19.

Psychological resilience and posttraumatic growth in adolescent survivors of earthquake: A 10-year cohort study

This 10-year cohort study explored whether individual differences in resilience during early stages post-earthquake could have diverse impacts on future PTG and whether the impacts varied by sex. 1357 Chinese adolescent survivors of the Wenchuan earthquake were assessed on their resilience at 6-, 12-, 18-, and 24-months post-earthquake. 799 participants responded to an online survey 10 years later, and 744 of which provided useable data for subsequent analysis. Resilience trajectories were modeled using the latent class growth analysis. Linear regressions were used to test the predictive effects of different resilience trajectories on subsequent PTG. Of 744 samples (M_age=15.44, SD = 0.66 at baseline), 59.1% were females. Three trajectories of resilience were identified, including low resilience (19.8%), moderate resilience (58.7%), and high resilience (21.5%). Highly resilient participants reported greater PTG 10 years later (β = 0.12, 95%CI 0.60-6.08) after adjusting for demographic variables, earthquake exposure, negative life events, and mental health problems. Moreover, the same findings only existed in males (β = 0.22, 95%CI 1.26-11.01). Our findings highlight the importance of classifying survivors by resilience trajectories in order to better account for different implications on future PTG. Moreover, sex-specific programs are needed to provide tailored intervention.

Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal

Quality of life is defined by the World Health Organization as "Individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It is a comprehensive measure of health outcome after trauma. Childhood maltreatment is a determinant of poor mental health and quality of life. Resilience, however, is supposed to be protective. Our aim is to examine childhood trauma and resilience in patients visiting psychiatry outpatient and investigate their relations with quality of life. A descriptive cross-sectional study was conducted with a hundred patients with trauma and visiting psychiatry outpatient. Standardized tools were applied to explore childhood trauma, resilience, quality of life and clinical diagnoses and trauma categorization. Sociodemographic and relevant clinical information were obtained with a structured proforma. Bivariate followed by multivariate logistic regressions were conducted to explore the relation between childhood trauma, resilience, and quality of life. Poor quality of life was reported in almost one third of the patients. Upper socioeconomic status, emotional neglect during childhood, current depression and low resilience were the determinants of poor quality of life in bivariate analysis. Final models revealed that emotional neglect during childhood and low resilience had independent associations with poor quality of life. Efforts should be made to minimize childhood maltreatment in general; and explore strategies to build resilience suited to the cultural context to improve quality of life.

How to improve the long-term quality of life, insomnia, and depression of survivors 10 years after the Wenchuan earthquake? A network analysis

BACKGROUND

Previous studies have found a negative effect of depression and insomnia on the psychological health domain of quality of life (QOL) among earthquake survivors. However, little is known about the symptom-to-symptom interactions among the above psychological outcomes. This study thus aimed to assess the interplay among the above three variables in survivors 10 years after the Wenchuan earthquake at the symptom level.

METHODS

A total of 744 survivors completed the questionnaire at 10 years post-earthquake, reporting depressive symptoms, insomnia symptoms, and the psychological health domain of QOL. All network structures were estimated and compared using the network analysis approach in R version 4.1.1.

RESULTS

Among the 744 survivors, 593 individuals did not have significant depressive and insomnia symptoms, while 151 individuals reported depressive and/or insomnia symptoms. "Little energy", "Suicidal ideation", and "Spirituality" were the key highest bridge symptoms in the three networks, respectively. Additionally, there were significant differences in network global strength, network structure, and individual edge weights between individuals with and without depression and/or insomnia.

CONCLUSIONS

Intervention programs aimed at treating symptoms, such as exercise therapy, cognitive behavioural therapy, and spirituality education, may improve the QOL of survivors following an earthquake.

The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients

Background

Patients and Methods

Results

Conclusion

Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies

This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. n = 47 studies on heterogeneous research questions were included, with sample sizes ranging from n = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. n = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.

A Community Survey of Quality of Life and Psychiatric Disorders among Residents Following the Kaohsiung Gas Explosion: a 5-Year Cross-Sectional Follow-Up Study

To investigate factors associated with quality of life (QoL) and disaster-related psychiatric disorders, including posttraumatic stress disorder (PTSD) and major depressive episode (MDE), in the survivors of a gas explosion in Taiwan 5 years after the event. A community-based cross-sectional study of residents from an area that experienced a gas explosion was conducted 5 years after the event. The Short Form 12v2 (SF-12v2) was used to screen 2511 participants. The Disaster-Related Psychological Screening Test (DRPST) was used to assess probable MDE and PTSD. A total of 2511 participants, including 604 males and 1907 females, completed the QoL survey. The average age was 56.02 ± 16.78 years, and most participants were in the ≧65 age group (39.7%). The males had better QoL in the physical dimensions. Lifestyle was significantly positively associated with QoL. A total of 894 participants completed the DRPST, which showed some individuals with probable MDE (n = 93, 10.4%), probable PTSD (n = 22, 2.5%), or probable MDE and PTSD (n = 49, 5.5%); most people had no MDE or PTSD (n = 730, 81.7%). Those in the probable PTSD or MDE groups were significantly more likely to be female or to be experiencing stressors (p < 0.001). The participants continued to be affected by the disaster based on their QoL, even 5 years later. Females had a higher risk of probable psychiatric disorders and poorer QoL in the physical dimensions. Long-term follow-up, interventions and investigations after a disaster are needed.

The Consequences of COVID-19 Toward Human Growth: The Role of Traumatic Event and Coping Strategies Among Indonesian Sample

COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.

Trajectories of mental health symptoms predict long-term quality of life among Wenchuan adolescent survivors: A 10-year follow-up study

PURPOSE

Previous studies usually examine the associations between psychological distresses and quality of life (QOL) with a variable-centred approach, while little is known about the effect of the individual variance in time-varying changes of psychological distresses on QOL. Therefore, this study aimed to examine whether individual variance in psychological distresses during the early phases post-earthquake would develop different QOL's levels among adolescent survivors 10-year after the Wenchuan earthquake.

METHODS

Data were extracted from the Wenchuan Earthquake Adolescent Health Cohort Study. The current study included 744 adolescent survivors who effectively completed surveys at 6 months, 24 months, and 10 years after the earthquake. Self-report questionnaires were administered to collect information on socio-demographic characteristics, earthquake exposure, life events, anxiety symptoms, depressive symptoms, posttraumatic stress symptoms (PTSS), and QOL. Data were analysed using hierarchical multiple regression.

RESULTS

Trajectories of psychological distresses were classified as follow: resistance (anxiety 40.73%; depression 54.70%; PTSS 74.46%), recovery (anxiety 17.20%; depression 9.27%; PTSS 10.35%), delayed dysfunction (anxiety 10.35%; depression 18.15%; PTSS 6.18%), and chronicity (anxiety 31.72%; depression 17.88%; PTSS 9.01%). After controlling covariates, hierarchical multiple regression only revealed that the anxiety trajectory with delayed dysfunction remained significantly predictive for four domains of QOL (physical health, psychological health, social relationships, and environment).

CONCLUSION

The current study highlights the importance of focusing on the variations in trajectories of anxiety symptoms among disaster survivors and providing individualized mental health services to improve survivors' QOL.

Moderating Effect of Posttraumatic Growth on the Relationship Between Social Support and Quality of Life in Colorectal Cancer Patients With Ostomies

BACKGROUND

Little research has examined the moderating influence of posttraumatic growth (PTG) on the relationship between social support and quality of life.

OBJECTIVES

This study examined the relationship between social support and quality of life by the level of PTG in colorectal cancer patients with ostomies.

METHODS

Using a cross-sectional design, colorectal cancer patients with ostomies (n = 140) were recruited using convenience sampling. The City of Hope Quality of Life-Ostomy, the Multidimensional Scale of Social Support, and the Posttraumatic Growth Inventory measured quality of life, social support, and PTG, respectively.

RESULTS

Social support and PTG were positively related to psychological and social well-being. Higher social support was associated with better psychological and social well-being. Posttraumatic growth moderated the relationship between psychological and social well-being. At a low and moderate level of PTG, social support was more strongly associated with psychological and social well-being, whereas at high levels, this association was not significant.

CONCLUSIONS

Findings highlight the significance of social support to improve the quality of life for colorectal cancer patients with an ostomy, particularly those with low levels of PTG.

IMPLICATIONS FOR PRACTICE

Screening for patients' positive cognitive adaptations while living with an ostomy could identify those who might need further social support to improve their quality of life. Further, intensive social support programs might promote the quality of life for colorectal patients with an ostomy, which was found to be effective for those with low levels of PTG.

Factors Associated With Post-traumatic Growth Among Healthcare Workers Who Experienced the Outbreak of MERS Virus in South Korea: A Mixed-Method Study

Background: Infectious disease outbreaks such as COVID-19 and MERS pose a major threat to healthcare workers' (HCWs) physical and mental health. Studies exploring the positive changes gained from adapting to traumatic events, known as post-traumatic growth (PTG), have attracted much attention. However, it is unclear which factors or experiences lead to PTG among HCWs. The purpose of this mixed-method study was to investigate factors associated with PTG among HCWs who experienced the MERS outbreak in South Korea, and fully describe their experience of developing PTG.

Methods: Quantitative data from 78 participants were collected using psychometric tools for Psychological distress, Resilience, and Support for coping, and Post-traumatic growth. Qualitative interviews were conducted with seven nurses. Data were analyzed using the qualitative content analysis method according to the sub-themes of resilience, which was the main factor associated with PTG.

Results: We found resilience to have a significant impact on PTG (ß =0.486, p = 0.001). Thus the qualitative interviews were analyzed using the core concepts of resilience. Qualitative interviews with nurses illustrated how participants experienced the development of resilience in terms of its sub-factors: hardiness, persistence, optimism, and support.

Conclusion: HCWs who endured the MERS outbreak showed high levels of PTG, and the analysis of the interview data provided a fuller understanding on the experience of remaining resilient and developing PTG. These results provide practical and pragmatic information helpful for developing intervention strategies and protocols that can help HCWs transform adversity into growth and development.

Post-traumatic Growth Level and Its Influencing Factors Among Frontline Nurses During the COVID-19 Pandemic

Objective: To assess post-traumatic growth (PTG) level and explore its influence factors among frontline nurses during the COVID-19 pandemic. Methods: From April 11th to 12th, 2020, a cross sectional study was conducted on 116 frontline nurses who had participated in fight against the COVID-19 in Wuhan city, China. General information and psychological discomfort were collected. Chinese version post-traumatic growth inventory with 20 items was applied to assess PTG level. Univariable analyses and multiple linear regression were performed to explore potential influencing factors of PTGI score. Results: The average score of PTGI in frontline nurses was 65.65 ± 11.50. In univariable analyses, gender, age, education level, marital status, living with parents, professional title, working years and professional psychological support was not statistically associated with the PTGI score. In both univariable and multivariable analyses, having support from family members and friends, being psychological comfort and having children and increased the PTGI score significantly. The three factors only explained 3.8% variance. Conclusion: Moderate PGT was observed in the frontline nurses who had battled against COVID-19. Social support and professional psychological intervention should be applied to further improve PTG level. Further studies with large sample size are required to explore more potential influencing factors.

Facilitating Posttraumatic Growth After Critical Illness

The theory of posttraumatic growth arose from accounts of various trauma survivors experiencing not only distress but also growth and change. An intensive care unit admission is an unplanned, sudden, and traumatic experience, and many survivors have posttraumatic stress that can lead to posttraumatic stress disorder. Survivors leave the intensive care unit with new functional impairments that drive depression, and they frequently experience anxiety. Amidst the stress of understanding the trauma of an intensive care unit admission, survivors can grow in their world views, relationships, and sense of self. Understanding posttraumatic growth in intensive care unit survivors will inform health care providers on how to help survivors understand their new difficulties after an intensive care unit stay and facilitate growth. This article is a conceptual review of posttraumatic growth, identifiers of posttraumatic growth, and how the tenets of the posttraumatic growth theory apply to intensive care unit survivors. Health care professionals, specifically nurses, can incorporate practices into their care during and after the intensive care unit stay that encourage understanding and positive accommodation of new difficulties brought on by the intensive care unit hospitalization to support survivor growth. Opportunities for research include incorporating posttraumatic growth assessments into post-intensive care unit clinics, self-help materials, and various programs or therapies. Outcomes associated with posttraumatic growth are listed to suggest directions for research questions concerning posttraumatic growth in intensive care unit survivors.

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n = 63, 31.3%, women, n = 138, 68.7%, mean age = 40.1, SD = 10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

The relationship between the positive aspects of caring and the personal growth of caregivers of patients with advanced oncological illness : Postraumattic growth and caregiver

OBJECTIVE

Examine the relationship between the positive aspects of care and the personal growth of caregivers of patients with advanced oncological illness.

METHODS

This research was a quantitative study with a transversal design. One hundred (100) informal caregivers filled out self-applied questionnaire on resilience, aspects of care, emotional distress, spirituality, and posttraumatic growth. Descriptive statistics were applied to the data, later correlation, and regression, and comparative analyses were conducted.

RESULTS

The participants were mainly women (86%) with an average care period of 12 months. The average age was 46.52 years. The highest scores were evidenced in positive aspects of caretaking, spirituality, personal growth, and distress, while the lowest score was seen in questions related to resilience. There was a negative inverse correlation among emotional distress, resilience, spirituality, and posttraumatic growth (p < .05) and a positive correlation among resilience, spirituality, posttraumatic growth, and the positive aspects of caretaking (p < .01). There were significant differences among the items related to emotional distress, resilience, and posttraumatic growth. The linear regression analysis showed that as resilience, spirituality, and the positive aspects of care increased, so did posttraumatic growth.

SIGNIFICANT RESULTS

To promote the perception of benefits among caregivers, resilience and the identification of meaning in the caregiving experience of patients with advanced oncological illness can be considered protective factors favoring adaptation and reducing negative moods.

Post-Traumatic Growth Following Exposure to Memorial Reports of the 5.12 Wenchuan Earthquake: The Moderating Roles of Self-Esteem and Long-Term PTSD Symptoms

Media exposure during a traumatic event has been found to be associated with negative psychological consequences. However, the post-disaster role of the mass media and the possible positive psychological consequences of media exposure has received less attention. In the present study, we hypothesized that exposure to memorial media reports would lead to improved post-traumatic growth (PTG). Further, we evaluated the moderating role of self-esteem and long-term post-traumatic stress disorder (PTSD) symptoms in the relationship between media exposure and PTG. Using a cross-sectional design, we surveyed individuals (N = 1000, mean age = 45.62, 43.5% male) who were recruited from disaster-affected communities ten years after the 5.12 Wenchuan earthquake which was the largest country-level trauma in the past three decades. Results revealed that individuals with lower self-esteem or lower PTSD symptoms would have higher psychological growth with greater exposure to memorial news reports. For individuals who reported having both high levels of self-esteem and PTSD symptoms, the relationship between media exposure and PTG was negative. These findings help present trauma in a new light, particularly regarding the rapid and instantaneous new coverage of the digital age. This study also has multi-disciplinary, cross-cultural, and clinical implications for the fields of psychology, public health, and communications.

Post-traumatic growth in mental health recovery: qualitative study of narratives

OBJECTIVES

Post-traumatic growth, defined as positive psychological change experienced as a result of the struggle with challenging life circumstances, is under-researched in people with mental health problems. The aim of this study was to develop a conceptual framework for post-traumatic growth in the context of recovery for people with psychosis and other severe mental health problems.

DESIGN

Qualitative thematic analysis of cross-sectional semi-structured interviews about personal experiences of mental health recovery.

SETTING

England.

PARTICIPANTS

Participants were adults aged over 18 and: (1) living with psychosis and not using mental health services (n=21); (2) using mental health services and from black and minority ethnic communities (n=21); (3) underserved, operationalised as lesbian, gay, bisexual and transgender community or complex needs or rural community (n=19); or (4) employed in peer roles using their lived experience with others (n=16). The 77 participants comprised 42 (55%) female and 44 (57%) white British.

RESULTS

Components of post-traumatic growth were present in 64 (83%) of recovery narratives. Six superordinate categories were identified, consistent with a view that post-traumatic growth involves learning about oneself (self-discovery) leading to a new sense of who one is (sense of self) and appreciation of life (life perspective). Observable positively valued changes comprise a greater focus on self-management (well-being) and more importance being attached to relationships (relationships) and spiritual or religious engagement (spirituality). Categories are non-ordered and individuals may start from any point in this process.

CONCLUSIONS

Post-traumatic growth is often part of mental health recovery. Changes are compatible with research about growth following trauma, but with more emphasis on self-discovery, integration of illness-related experiences and active self-management of well-being. Trauma-related growth may be a preferable term for participants who identify as having experienced trauma. Trauma-informed mental healthcare could use the six identified categories as a basis for new approaches to supporting recovery.

TRIAL REGISTRATION NUMBER

ISRCTN11152837.

Toward a very brief quality of life enjoyment and Satisfaction Questionnaire

OBJECTIVE

To develop and evaluate a new brief self-report measure of satisfaction/quality of life in depressed outpatients.

METHODS

Using the Quality of Life Enjoyment and Satisfaction Questionnaire Short-Form (Q-LES-Q-SF) self-report from Step-1 (n = 2181) of the STAR*D trial, items were selected based on their magnitude of change with treatment and correlation with 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR₁₆). Psychometric analyses were conducted. Replication of scale performance was assessed with STAR*D Step-2 data (n = 250).

RESULTS

The 7 items selected ("Mini-Q-LES-Q") rated satisfaction with work, household activities, social and family relations, leisure time activities, daily function and sense of well-being in the past week. This uni-dimensional scale captured 83-94% variance in Q-LES-Q-SF and had acceptable Item Response and Classical Test Theory characteristics. Baseline to exit percent changes in the Mini-Q-LES-Q and the QIDS-SR₁₆ were significantly, modestly related (r = -0.552) (Step-1) and replicated (r = -0.562) (Step-2). The Mini-Q-LES-Q detected the expected improvement in satisfaction/quality of life in acute treatment, yet also identified residual deficits expected in many at acute-phase exit.

LIMITATIONS

Population norms are yet undefined. Concurrent validity with detailed, well-validated scales that assess the seven Quality of Life domains incorporated in the Mini-Q-LES-Q remains unestablished. Sensitivity to symptom changes induced by psychotherapy or somatic therapies or sensitive to the effects of therapies aimed at enhancing quality of life enjoyment and function is unknown.

CONCLUSION

The 7-item Mini-Q-LES-Q self-report measure satisfaction/quality of life has acceptable psychometric properties, reflects change with depressive symptom reduction, and detects residual deficits in this key clinical outcome.

Examining posttraumatic growth and mental health difficulties in the aftermath of Hurricane Sandy

OBJECTIVE

Hurricane Sandy continues to affect the mental health of New York residents. This study examined associations between Posttraumatic Growth (PTG) and mental health difficulties (MHD) including symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD).

METHOD

Participants (N = 1,356) recruited from the New York metropolitan area completed questionnaires regarding their PTG, demographics, MHD, and hurricane experiences. A weighted least squares regression assessed the association between MHD and PTG. A post hoc analysis determined whether anxiety or depression moderated the effect of PTSD on PTG.

RESULTS

All MHD were crudely associated with greater PTG. After adjustment, an increased PTSD score was significantly associated with a 0.20 unit increase in PTG (t = 6.05, p < .001); this did not hold for depression or anxiety symptoms. Higher PTG was associated with being non-White (B = 5.90, t = 6.49, p < .001), Hispanic (B = 3.38, t = 2.89, p = .004), a smoker (B = 3.18, t = 3.28, p = .001), and greater Hurricane Sandy exposure (t = 7.11, p < .001). The positive association between PTSD symptoms and PTG was weaker among participants with probable depression.

CONCLUSION

Results suggest that participants with higher PTSD symptoms were more likely to grow from the impact of the storm, indicating resilience. Highly exposed participants were more likely to experience PTG. A decrease in PTG was found among those with both PTSD and depression symptoms. The development and implementation of interventions fostering PTG could be beneficial in clinical disaster response work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Moderate Depression Promotes Posttraumatic Growth (Ptg): A Young Population Survey 2 Years after the 2009 L'Aquila Earthquake

Background:

Earthquakes can result in a range of psychopathology and in negative and positive consequences for survivors.

Objective:

To examine the association between clinical aftereffects (anxiety and depressive symptoms) and post-traumatic growth (PTG) among young survivors of the 2009 L’Aquila earthquake, Italy.

Method:

316 young earthquake survivors enrolled in the University of L’Aquila were evaluated two years after the natural disaster. Participants completed three main questionnaires, including Patient Health Questionnaire-9 items (PHQ-9), Self-Rating Anxiety Scale (SAS), and Posttraumatic Growth Inventory (PTGI).

Results:

59.6% of the student sample showed different levels of depression, whereas 13.3% reported anxiety symptoms. In both clinical dimensions (anxiety and depression), gender differences were found: female gender was confirmed risk factor for a clinical post-traumatic response. Personal PTG, demonstrated by 18% of the L’Aquila youths included in our sample, was predicted by moderate levels of depression (O.R. 2.7). In our model, gender, age, and anxiety did not show any predictive value.

Conclusion:

In a post-traumatic setting, the development of individual cognitive strategies is crucial, whereas after a natural disaster, paradoxically, a moderate depressive condition and the related distress could promote the drive to overcome the psychological consequences of the traumatic event.

Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study

Posttraumatic growth (PTG) is defined as positive psychological change in the wake of highly challenging circumstances. Healthcare workers in particular are more vulnerable to stressors and trauma than the general population. The current study examined the use and effectiveness of a novel positive psychological intervention based on Chinese traditional culture to improve PTG in hospital healthcare workers. The intervention was provided to 579 healthcare workers at hospitals in Guilin, Shenzhen and Xiangtan. Scores on the Posttraumatic Growth Inventory (PTGI) and its subscales were significantly higher after intervention than before (p < 0.001). Of the five aspects of PTG, the aspect of "new possibilities" benefited the most from intervention (Cohen's d = 0.45). PTG in women, nurses and college graduates increased to a greater extent than other participants after intervention. It was concluded that our novel intervention is effective at improving PTG in medical staff.

Extreme Weather-driven Disasters and Children’s Health

Extreme weather events such as heat waves, extreme precipitation, and storm surges are likely to become more frequent and intense with climate change. Extreme weather-driven disasters (EWDDs) cause a substantial burden of childhood mortality and morbidity worldwide. We reviewed the published literature on EWDDs and their health impacts on children, and developed a conceptual model based on complex systems thinking to identify the health risks, vulnerabilities, and capacities of children in the context of EWDDs as a means of informing areas for adaptive intervention. We found that direct and indirect physical and mental impacts of EWDDs on child health are abundant and interrelate in complex ways. The literature review and modeling demonstrated the centrality of resilience at the level of the child and his or her direct environment, suggesting that mental health status may play a key role in a child’s experience of numerous other health outcomes of EWDDs. EWDDs interact with environmental and social systems and with individual children and their contexts in complex ways, the impacts of which are nonlinear and difficult to predict. Traditional perspectives on climate change-driven health impacts often overlook complex bio-psychosocial interactions, suggesting a need to work on preventive strategies to reduce vulnerability and build individual child resilience.

Application of the eight-item modified medical outcomes study social support survey in Japan: a national representative cross-sectional study

PURPOSE

This study aimed to create a Japanese version of the eight-item version of modified medical outcomes study social support survey (mMOS-SS), investigate psychometric property, and determine the standard values for Japanese citizens by using a nationally representative sample from the general population.

METHODS

A stratified two-stage sampling was conducted with 4000 Japanese men and women who were in the age group of 25-74 as of January 01, 2014. From February to March 2014, placement method was conducted using self-administered questionnaire. Consequently, 2067 questionnaires were gathered (a collection rate of 51.7%). Thus, the target of analysis was 952 males and 1100 females.

RESULTS

The results of factor analysis showed that each of the samples exhibited two types of factors, i.e., emotional and instrumental, just as was the case with the original version. The Cronbach's alpha ranged from 0.90 to 0.95 for each of the samples for both total score and the subscales. On comparing the groups by married versus unmarried and living alone versus not living alone, those not living alone and married people had significantly higher scores (p < 0.05) for each group except for married females less than 50 years. There was a significant positive correlation among mental health, life satisfaction, and self-rated health.

CONCLUSION

This study revealed that the eight-item Japanese version of the mMOS-SS had the same psychometric properties as those found in the research results of the English version.