Associations Between the Cause of Loved One's Death, Mourner's Psychological Distress and Ongoing Relationship With the Deceased, and Mourner's Posttraumatic Growth

The current study focused on the associations between the cause of a loved one's death, mourner's emotional distress, mourner's ongoing relationship with the deceased, and posttraumatic growth (PTG). The sample comprised 91 Israeli mourners following death due to traffic accident, military service, or prolonged illness. Participants completed questionnaires assessing psychological distress, ongoing relationship with the deceased, and PTG. Findings showed that in traffic-accident deaths, mourners reported higher psychological distress and preoccupation with the deceased compared to that reported by the other mourner groups. Moreover, psychological distress mediated the association between the cause of death and PTG. The findings emphasize the differences between the mourner groups.

The underlying mechanisms by which Post-Traumatic Growth is associated with cardiovascular health in male UK military personnel: The ADVANCE cohort study

Post-Traumatic Growth (PTG) is associated with good cardiovascular health, but the mechanisms of this are poorly understood. This cross-sectional analysis assessed whether factors of PTG (Appreciation of Life (AOL), New Possibilities (NP), Personal Strength (PS), Relating to Others (RTO) and Spiritual Change (SC)) are associated with cardiovascular health in a cohort of 1006 male UK military personnel (median age 34). The findings suggest AOL, PS and RTO are associated with better cardiovascular health through cardiometabolic effects (lower levels of triglycerides, and total cholesterol) and haemodynamic functioning (lower diastolic blood pressure), but not inflammation. However, NP and SC were associated with poorer cardiovascular health through cardiometabolic effects (lower levels of high-density lipoproteins and higher levels of total cholesterol) and AOL had a non-linear association with low-density lipoproteins. These findings suggest that the relationship between PTG and cardiovascular functioning is complex and in need of further scrutiny.

Developmental pathways of the family bereavement program to promote growth 15 years after parental death

Although parental death increases the risks of negative developmental outcomes, some individuals report personal growth, an outcome that has received little attention. We tested a developmental cascade model of postloss growth in 244 parentally bereaved youth (ages 8-16 at baseline) from 156 families who participated in a randomized controlled trial of a family-based intervention, the Family Bereavement Program (FBP). Using five waves of data, the present study examined the prospective associations between the quality of parenting immediately following the FBP and postloss growth 6 and 15 years later, and whether these associations were mediated by changes in intra- and interpersonal factors (mediators) during the initial 11 months following the FBP. The mediators were selected based on the theoretical and empirical literature on postloss growth in youth. Results showed that improved quality of parenting immediately following the FBP was associated with increased support-seeking behaviors and higher perceived parental warmth at the 11-month follow-up, both of which were related to postloss growth at the 6-year follow-up and 15-year follow-up. No support was found for the other hypothesized mediators that were tested: internalizing problems, intrusive grief thoughts, and coping efficacy. To promote postloss growth for parentally bereaved youth, bereavement services should target parent-child relationships that help youth feel a sense of parental warmth and acceptance and encourage youth to seek parental support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The levels and related factors of posttraumatic growth among nurses: A systematic review and meta-analysis

WHAT IS KNOWN ON THE SUBJECT?: Nurses often encounter traumatic events in their clinical practice. Trauma can have both negative effects, such as post-traumatic stress disorder and positive effects, such as growth and positive emotions. Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate. We have identified individual, work-related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work-related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth.

ABSTRACT

INTRODUCTION: While the negative effects of trauma on nurses have been well-documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses.

AIM

This study aims to explore the levels and related factors of PTG among nurses.

METHOD

A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta-regression analyses were performed to identify potential moderators of PTG among nurses.

RESULTS

A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67-60.72).

DISCUSSION

Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work-related, and social and organizational factors.

IMPLICATIONS FOR PRACTICE

Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG.

Can mindfulness facilitate posttraumatic growth in breast cancer patients? The mediating role of illness perceptions and positive emotions

The current observational study aimed to examine the relationship between mindfulness and posttraumatic growth (PTG) among patients with breast cancer. Additionally, it explores the mediating role of illness perceptions and positive emotions. A total of 697 women with breast cancer were recruited from four clinical sites as part of the Bounce project in Finland, Portugal, Italy, and Israel. The study measures were mindfulness (MAAS), illness perceptions (IPQ), positive affect (PANAS), and post-traumatic growth (PTGI) at three time points: near the time of diagnosis, 6 months, and 12 months post-diagnosis. A higher level of mindfulness was associated with perceptions of the illness as less chronic. Specifically, the perception of a limited timeline of breast cancer was associated with positive emotions, thus leading to enhanced PTG. Emphasis should be placed on promoting mindfulness, elaborating on illness perceptions, and maintaining positive affect as part of clinical interventions for PTG among breast cancer patients.

Prolonged grief, reconstruction of meaning, and posttraumatic growth in nursing home residents who have lost loved ones

AIM

This study was conducted to determine the relationship between sociodemographic characteristics, prolonged grief, meaning reconstruction, and posttraumatic growth of elderly individuals who have lost loved ones.

METHODS

A total of 122 elderly individuals who had lost loved ones were included in the research conducted in a nursing home.

RESULTS

The levels of Prolonged Grief Inventory (PG-13), Grief and Meaning Reconstruction Inventory (GMRI), and Posttraumatic Growth (PTG) scale were found to be high among the individuals in the study. While the PG-13 scores of single individuals who have lost their spouses are statistically significantly higher compared to married individuals, the scores for GMRI are higher for elderly individuals with chronic illness and expected death compared to those who have experienced sudden loss. A significant negative correlation was also determined between PG-13, GMRI, and PTG scores.

CONCLUSION

Counseling to reconstruct grief and meaning is recommended for at-risk groups. Geriatr Gerontol Int 2024; 24: 364-370.

Examining the trajectory of meaning violation and its bidirectional relationship with perceived posttraumatic growth

Despite extensive theoretical discussions on the dynamic process of meaning violation (MV) and restoration, empirical research on this topic remained lacking. This study aimed to explore the trajectory of MV and the bi-directionality between MV and perceived posttraumatic growth (PPTG). This study employed a 3-wave longitudinal design spanning over 3 months, and a sample of participants from China who experienced any distressing event within the past 3 months was considered eligible. Participants (N = 215; aged 18-38 years old) were instructed to assess MV and PPTG regarding a chosen event. A latent growth model was used to examine changes in MV over time and a random intercept cross-lagged panel model was used to analyze bidirectional associations between MV and PPTG. Results revealed that, at the within-person level, MV at T1 negatively predicted PPTG at T2, while PPTG at T2 negatively predicted MV at T3. These results indicate that the sense of MV may have impeded PPTG in the initial stages, whereas PPTG might serve as a predictor for diminished MV at later stages. At the between-person level, a positive relationship between these two constructs was observed, suggesting that individuals who experienced higher levels of MV, in general, also tended to report greater PPTG. These findings reflect the complex and dynamic nature of meaning reconstruction processes and provide empirical evidence for the meaning-making model.

The effect of a couple-based posttraumatic growth intervention in supporting couples coping with colorectal cancer: A randomized controlled study

OBJECTIVES

To promote posttraumatic growth (PTG) in colorectal cancer (CRC) couples, a couple-based PTG intervention was conducted, and the intervention had previously proved be feasible in CRC couples. The current study was conducted to validate the effects of intervention in CRC couples.

METHOD

This is a randomized controlled study that included 174 CRC couples. All participants were randomized to either the intervention (usual care plus 5-week PTG intervention, n = 87) or the control group (usual care, n = 87). Data were collected from CRC couple dyads at baseline and immediately post-intervention periods. Primary outcome refers to positive changes, and secondary outcomes include marital satisfaction, quality of life (QOL), and anxiety and depression. Multilevel modeling was applied to analyze the intervention effects.

RESULTS

Participants in the program showed increased PTG, marital satisfaction, and QOL both physically and mentally, and decreased levels of anxiety and depression over time. And spousal caregivers showed greater improvement in marital satisfaction and physical QOL compared with patients. In addition, significant intervention effects were shown in the participants' benefit finding, physical health and depressive symptoms.

CONCLUSION

The study confirmed the effect of the PTG intervention on CRC couples' benefit finding, physical health and depressive symptoms. However, this study only measured outcome variables at two time-points. Future studies should add follow-up assessments to evaluate long-term effects of the intervention in CRC couples.

REGISTRATION NUMBER

ChiCTR2300067809.

Meaning-making while staying connected matters in psychological adaptation during pandemic: a longitudinal moderated mediation study

Adversity may bring about both negative and positive changes in psychological adaptation. Although there is mounting evidence regarding the psychological distress during the pandemic, the other side of posttraumatic change, posttraumatic growth (PTG) and its predictors are relatively underexamined. Moreover, there is a paucity of longitudinal investigations that examined intra- and interpersonal predictors responsible for both sides of psychological adaptation. Therefore, this study comprehensively examined the longitudinal relationship among cognitive processing, social support, and adaptation during the pandemic using a moderated mediation model. Specifically, it was tested whether two types of event-related rumination mediated the link between perceived stress and ambilateral adaptational outcomes, and whether social support moderated the mediating pathways of ruminations on adaptation. After informed consent, a representative sample of adults was followed up for over a year, and answered a package of online questionnaires. The results showed that intrusive rumination prospectively predicted greater psychological distress and less PTG in response to stress, whereas deliberate rumination led to less psychological distress and more PTG over time. As predicted, the indirect protective effect of deliberate rumination was stronger when perceived social support was higher. This longitudinal study highlighted the core factors responsible for continued suffering and personal growth during the pandemic. These results have both practical and clinical implications for mental healthcare in the post-COVID era, when the heterogeneity of psychological adaptation increases and preparation for the next pandemic is warranted.

"A crossroads generation." Great-grandchildren of Holocaust survivors' perspectives on the impact of the genocide on family functioning

As a cultural trauma, the Holocaust exerted negative psychological effects on many survivors, with such effects often extending to their families. Research has explored these effects with respect to the survivors' children and grandchildren, but the experiences of the next generation have yet to be canvassed. Knowledge about resilience in Holocaust survivor families is also comparatively sparse. In this exploratory study, 10 semi-structured interviews were conducted with Australian great-grandchildren of Holocaust survivors, garnering perspectives concerning the genocide's impact on family functioning. Six superordinate themes were identified through Interpretive Phenomenological Analysis: The experience of being raised by the third generation, honoring traumatic family histories, the need to move on, proudly identifying with the Holocaust, valuing achievement and ambition, and the importance of not taking things for granted. The findings suggest that multiple generations within survivor families grapple with the lingering negative effects of the Holocaust. Concurrently, attempting to redress these effects has the potential to benefit family dynamics and processes.

"I loved before, but now I love even more." Qualitative study of posttraumatic growth as a consequence of severe COVID-19 experience in Slovak adults

Introduction

The results indicate that post-traumatic growth does indeed occur after overcoming the severe form of COVID-19. It suggests that this posttraumatic growth most often occurred through a reassessment of priorities and an appreciation of life itself and loved ones. COVID-19 disease has been one of the most discussed and researched topics for several years, as it dramatically affects everyone's daily life.

Methods

The qualitative study presented here focuses on health psychology, especially post-traumatic growth after overcoming a severe form of the COVID-19 disease. We worked with adult people who had either been treated in the intensive care unit or had been hospitalized with severe pneumonia.

Results

Thematic analysis was used to determine categories and subcategories. The study presented here contributes to knowledge about the COVID-19 experience by mapping a Slovakian sample of adult participants.

Discussion

The results obtained by Thematic analysis help us better understand how people experience the disease, especially those who have overcome a severe form of the disease and thus had a borderline experience when their lives were directly threatened, as well as their overall health.

The Silver Lining of Posttraumatic Growth around the Dark Side of the COVID-19 Pandemic: A School-Based Intervention with Mindfulness and Character Strengths Practices among Children

The theory of posttraumatic growth (PTG) proposes that from life difficulties positive changes can happen, such as deepened personal relationships and an awareness of new possibilities in life. PTG can occur naturally or can be facilitated. This study aimed to promote PTG through a school-based intervention of eight sessions of 45 min each with mindfulness and character strengths practices (the so-called "The exploration of happiness during the COVID-19 pandemic"). The study conducted assessments at baseline, post-intervention, and follow-up (i.e., one month after the intervention). The post-intervention results showed that the participants in the intervention group experienced an improvement in PTG, well-being, mindfulness, strengths use, and PTS symptoms compared to the children in the control group. Furthermore, these positive changes were sustained at follow-up. The findings of this study highlight that mindfulness-based strengths practices can increase positive outcomes (i.e., well-being, posttraumatic growth) and reduce negative psychological symptoms (PTS) among children. The implications for theory and practice are discussed, and detailed appendices for practitioners are provided.

Factors Involved in Posttraumatic Growth in Mothers Experiencing Fetal and Infant Death

Factors associated with posttraumatic growth (PTG) are investigated in mothers who have suffered fetal or infant death. Mothers (N = 66) completed the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), the Core Beliefs Inventory (CBI; Cann et al., 2010), and answered questions about the severity of their loss, age of fetus or infant, time since loss, social support, finding meaning, and involvement in loss-related behavior. Results indicate a greatly traumatic loss (M = 4.41), a great degree of core belief disruption (M = 3.57), and a moderate level of PTG (M = 2.80). CBI scores are positively correlated with severity of the loss and age of the fetus or infant. PTGI scores are positively related to CBI scores and to social support from family and friends who have suffered similar losses and support groups. PTG and finding meaning are positively correlated with involvement in loss-related activities and supporting others.

veterans: evaluation of post-intervention and long-term follow-up outcomes

Introduction

Exposure to trauma among U.S. military veterans occurs at a high rate, often resulting in continued difficulty with emotional adjustment and a diagnosis of posttraumatic stress disorder (PTSD). The present study provides data from 184 U.S. military veterans who completed a manualized posttraumatic-growth oriented training program during an integrative seven-day retreat.

Methods

Data was collected at baseline, after program completion, and at 18-month follow-up.

Results

Results on primary outcomes indicated significant increases, with medium to large effect sizes, in growth related outcomes. Specifically, there was a significant increase in scores by 54% on the posttraumatic growth outcome measure (PTGI-X) from baseline (M = 50.2, SD = 31.1) to endpoint (M = 77.4, SD = 29.6), t(183) = -8.78, p < 0.001. Also, results indicate that immediately following training (Day 7), participants reported a significant decrease of 49% on the PCL-5 from baseline (M = 39.7, SD = 17.6) to endpoint (M = 20.1, SD = 13.2), t(183) = 11.75, p < 0.001. Depression subscale scores decreased by 60% from baseline (M = 8.0, SD = 5.2) to endpoint (M = 3.2, SD = 3.0), t(183) = 10.68, p < 0.001; Anxiety scores decreased by 28% from baseline (M = 5.8, SD = 4.3) to endpoint (M = 4.2, SD = 3.5), t(183) = 4.08, p < 0.001; and Stress scores decreased by 50% from baseline (M = 10.0, SD = 4.4) to endpoint (M = 5.0, SD = 3.3), t(183) = 12.21, p < 0.001. Eighteen-month follow-up data was available for 74 participants and indicated that all significant changes in growth-related outcomes were maintained. Further, all significant changes in symptomatology-related outcomes were also maintained at follow-up.

Discussion

These findings demonstrate both the immediate and the long-lasting impact of an integrative posttraumatic growth-oriented training program on psychological growth and PTSD symptom reduction among U.S. military veterans.

Associations between Psychological Resilience and Social Support with Posttraumatic Growth in Breast Cancer Patients: A Cross-Sectional Study

This cross-sectional study examined the associations of psychological resilience, perceived social support, and posttraumatic growth (PTG) in breast cancer (BC) patients (N = 203). The participants' mean age was 43.14 ± 9.06, 80.3% were married, 40.9% had a university degree, 61.6% were unemployed, and 72.4% reported a moderate economic status. No significant correlation was found between PTG and psychological resilience, while a moderate and positive correlation was observed between PTG and perceived social support. A weak and positive correlation was also detected between perceived social support and psychological resilience.    Professionals working in the field of psycho-oncology and social work can make attempts to increase psychological resilience, perceived social support, and PTG in BC patients.

Cumulative trauma and perceived community resilience: A serial mediation model

Communities affected by cumulative trauma can experience negative psychological reactions but also posttraumatic growth and community resilience, which promote adaptation and preparation for future traumatic events. This study aims to investigate the mechanisms that mediate the relationship between traumatic events and perceived community resilience. Participants were 118 Italian adults who experienced cumulative trauma and were recruited to complete an online survey. A serial multiple mediation model was estimated to assess whether the impact of the Morandi bridge collapse and posttraumatic growth mediated the relationship between the psychological impact of the Covid-19 pandemic and perceived community resilience. The impact of the collapsed bridge and posttraumatic growth in serial partially mediated the relationship between the impact of the Covid-19 pandemic and perceived community resilience. The impact of cumulative trauma can be considered through an ecological perspective that considers the consequences of these events in relation to community resilience.

Exploring the Meanings of Posttraumatic Growth in Spanish Survivors of Clergy-Perpetrated Child Sexual Abuse: A Phenomenological Approach

A healing and recovery perspective related to child sexual abuse (CSA) has gained attention in the past two decades, a concept that accurately refers to the process is posttraumatic growth (PTG). Scarce empirical research on PTG in clergy-perpetrated CSA survivors shows evidence of the presence of growth after the abusive experience and a tendency to create accounts of trauma as a way to heal. The general aim of the study is to explore the experiences and meanings of PTG as lived by survivors of clergy-perpetrated CSA. Seven clergy-perpetrated CSA survivors were interviewed with semi-structured in-depth interviews conducted in person. Using reflexive thematic analysis, we identified three dominant themes in the participants' stories: (a) the hindering of PTG; (b) the meanings of PTG, and (c) the internal and contextual and facilitators of PTG. The present study brings new insights into the meanings of PTG, the close relationship between damage and growth, and the mechanisms (both internal and contextual) that are involved in healing from clergy-perpetrated CSA in Spanish culture.

Risk perception predicts post-traumatic growth during the COVID-19 pandemic in China: the mediation effect of engaging in health-protective behaviors

The COVID-19 pandemic exposed the public to enormous health risks and induced wide-ranging impacts on people's mental health. Post-traumatic growth is a possible psychological benefits that may occur during struggling with the COVID-19 pandemic. This research explored 1) demographics differences on risk perception of COVID-19 pandemic, engagement in health-protective behavior and post-traumatic growth during the COVID-19 pandemic; and 2) the mediation effect of engaging in health-protective behaviors between risk perception and post-traumatic growth during the COVID-19 pandemic. Females showed a significant higher level of engagement in health-protective behaviors. People who were married reported a significantly higher level of risk perception, engagement in health-protective behavior and post-traumatic growth than those who were in other marital status (i.e. single, divorced, widowed). People who had acquaintances being infected with COVID-19 reported significant higher level of risk perception and engagement in health-protective behaviors. Engagement in health-protective behaviors mediated the relationship between risk perception and post-traumatic growth. Implications of the results for public health interventions are discussed.

Prevalence and factors of posttraumatic growth among Hubei residents during the COVID-19 pandemic: A cross-sectional study

The adverse impact of the COVID-19 pandemic on mental health has been widely concerned, but the research on positive psychological factors is insufficient, this study aims to investigate the prevalence and factors of posttraumatic growth (PTG) among residents in the worst-hit areas of China (Hubei Province). We were conducted in three disaster areas with different severity in Hubei Province three months after the outbreak, and the data were from 575 respondents. Instruments included the simplified Chinese version of the Posttraumatic Growth Inventory (C-PTGI) and the public health emergency psychological questionnaire. Nonparametric tests, Spearman correlation analyses, and multiple linear regression equations were used to analyze the data. The results showed that three months after the outbreak of COVID-19, the PTG of Hubei residents was at a low level, and their sense of fear was the most prominent, with a positive detection rate of 82.09%. According to the results of this study, high PTG levels were associated with high levels of fear, married and healthcare providers, while low levels of PTG were associated with serious chronic diseases, males, good economic status, and poor prevention and control measures. Government departments should strengthen social support for residents, carry out necessary stress management training to help them correctly deal with negative emotions and promote their personal growth.

Looking on the bright side: The relationships between flourishing and pain-related outcomes among adolescents living with chronic pain

A deficits-based approach to adolescent chronic pain currently dominates the literature, to the exclusion of positive approaches, such as flourishing. Addressing this knowledge gap, this study examined the relationships between flourishing and pain-related outcomes in adolescent chronic pain. Seventy-nine adolescents aged 11-24 years were asked to complete self-report measures of three domains of flourishing and four pain-related outcomes. Correlation coefficients and four hierarchical linear regression analyses were conducted, controlling for age and gender. Flourishing mental health was associated with, and significantly contributed to explaining, anxiety and depressive symptoms, and social and family functioning impairment. Benefit finding and posttraumatic growth were each associated with social and family functioning impairment, while posttraumatic growth was also associated with anxiety and depressive symptoms. Additionally, benefit finding significantly contributed to explaining pain intensity. Study findings underscore the importance of assessing the relationships between flourishing and pain-related outcomes in adolescents with chronic pain.

The bereavement experiences of families of potential organ donors: a qualitative longitudinal case study illuminating opportunities for family care

OBJECTIVES

To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature.

METHOD

Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death.

FINDINGS

Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient's death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement.

RECOMMENDATIONS

Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs.

CONCLUSION

The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.

Factors Contributing to Posttraumatic Growth Following Bereavement

Multiple factors have been studied to determine their relationship to posttraumatic growth, with findings suggesting the importance of resiliency (Bensimon, 2012), social support (Tedeschi & Calhoun, 2004), event centrality (Taku et al., 2014), religious coping (Pargament et al., 2006), relationship to the deceased (Oginska-Bulik, 2015), and the circumstance of passing (Feigelman et al., 2009). This study investigated the relationship of these identified factors with posttraumatic growth in a sample of 165 bereaved individuals. Regression results indicated that the overall model predicted scores on posttraumatic growth (R2 = .473, R2 adj = .456, F (5, 159) = 28.51, p < .001), with most robust effects found in social support (β = .281), religious commitment (β = .289), and event centrality (β = .410). This indicates bereavement experiences can result in significant growth in individuals, particularly those who seek social support, identify the event as an essential part of their experience, and identify religion as an important aspect of their routine.

Resilience, optimism and posttraumatic growth in first-time mothers

This study examines the association between posttraumatic growth (PTG) and two psychological attributes, resilience and optimism, in first-time mothers, after controlling for demographic and motherhood-related characteristics. PTG, the self-examination triggered by life-changing events, contains five factors: (1) relating to others, (2) new possibilities, (3) personal strength, (4) spiritual change, and (5) appreciation of life. Outcomes from studies conflict on whether PTG is associated with the two psychological attributes of resilience (the ability to resume one's life after adversity) and optimism (viewing life in a positive light). This study used a cross-sectional design. A convenience sample of first-time mothers whose infants were between 3 months and 1 year (N = 415) completed questionnaires containing several standardized and reliable instruments including those measuring the independent variables of resilience and optimism, and the dependent variable of PTG. A STROBE checklist guided the reporting of this study. Resilience was associated with overall PTG and four of its five factors. Optimism also was associated with overall PTG but only associated with two of its five factors. PTG profiles and squared semipartial correlations indicated that resilience had the stronger association, compared to optimism, with PTG and most of its factors. Our study's findings on the strong link between resilience and PTG suggest the need for research examining the impact of specific psychosocial nursing activities (e.g., providing emotional support; assisting others to identify their own strengths; encouraging the mobilization of one's internal resources; furnishing needed resources and referrals; and supplying health education and information), as these activities may not only promote resilience but also may contribute to PTG.

Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials

BACKGROUND

It has been increasingly recognized that some people experience post-traumatic growth (PTG) as a result of struggling with cancer.

OBJECTIVE

This systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer.

METHODS

A search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward.

RESULTS

A total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39-0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05-2.44), Mindfulness-based (d = 0.54, 95% CI = 0.14-0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1-0.46). Expression-based and Positive Psychology-based approaches also showed promising results. Notably, the majority of studies had a high risk of bias.

CONCLUSIONS

PTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre-cancer state, enhancing resilience, health, and well-being.

A bright side of adversity? A systematic review on posttraumatic growth among refugees

Until the third trimester of 2022, 103 million people worldwide had been forced to leave their homes and become refugees. The traumatic experiences of refugees can lead not only to mental disorders but also to Posttraumatic Growth (PTG). (1) To find the variables positively and negatively associated with PTG in refugees. (2) To investigate the relationship between PTG and Posttraumatic Stress Disorder (PTSD) among refugees. We systematically searched Medline, Web of Knowledge, PsycInfo, Scopus, and PTSD Pubs for studies about PTG in refugees. Epidemiological studies using the Posttraumatic Growth Inventory. Grey literature, reviews, and meta-analysis. Risk of bias was assessed by the 'The Joanna Briggs Institute Prevalence Critical Appraisal Tool'. We included 24 studies investigating PTG and associated factors. The factors positively associated with PTG were social support, regular migration status, religiosity, satisfaction with life, time, and problem-focussed and emotion-focussed coping. The factors negatively associated with PTG were: irregular migration status, emotional suppression, and avoidance coping. Studies on PTG in refugees are essential to finding new ways to address mental health in this field. Few studies offered risk of bias, particularly regarding the sample selection. We conclude that PTG may be influenced by many factors and it would be of importance that the centres for support, as well as public policies, took that into account to foster the outcome and not only to focus on disease. This study was partially supported by CAPES and registered on PROSPERO (CRD42020215607).

Healing After Violence: The Effect of Perception of Social Support on Posttraumatic Growth in Female University Students

This study investigated the Turkish validity and reliability of the Healing After Gender-based Violence Scale (GBV-Heal) and the relationship between social support perception, posttraumatic growth in university students who are victims of gender-based violence. The study sample consisted of 167 female students who experienced gender-based violence. The Turkish version of GBV-Heal of Kaiser-Meyer-Olkin value was 0.892; the Bartlett Sphericity Test result was determined as χ2  =  195,053, and the obtained variables were found suitable for factor analysis. Perception of social support related to post-violence healing in female university students is effective on posttraumatic growth.

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study

AIMS

This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses.

BACKGROUND

Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear.

METHODS

A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research.

RESULTS

Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth.

CONCLUSIONS

Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

Posttraumatic Growth, Maladaptive Cognitive Schemas and Psychological Distress in Individuals Involved in Road Traffic Accidents-A Conservation of Resources Theory Perspective

Road traffic accidents can have profound psychological impacts on the individuals involved, encompassing both negative distress and positive growth. This study, guided by the conservation of resources (COR) theory, investigates the intricate relationship between posttraumatic growth (PTG), maladaptive cognitive schemas, and psychological distress in individuals involved in road traffic accidents. PTG reflects an individual's ability to derive positive changes from adversity, while maladaptive schemas represent negative cognitive patterns. Using a 122 sample of individuals involved in road traffic accidents, we examined direct and indirect effects within this complex network. Our findings reveal significant direct effects of PTG on psychological distress (β = 0.101, p = 0.02). Particularly noteworthy are the indirect effects mediated by cognitive schemas, emphasizing the role of impaired autonomy and perceived performance deficiencies (β = 0.102, p = 0.05). This suggests that individuals involved in road traffic accidents experiencing higher PTG levels may indirectly experience greater psychological distress through these maladaptive cognitive schemas. This study not only advances our understanding of the psychological consequences of road traffic accidents but also aligns with self-determination theory, emphasizing autonomy and competence as fundamental needs. Individuals involved in road traffic accidents may undergo profound shifts in perspective following the trauma, which our results support. Recognizing the nuanced relationship between PTG, maladaptive cognitive schemas, and psychological distress is crucial for tailoring interventions and support systems for individuals involved in traffic accidents. As PTG can coexist with distress, interventions should foster adaptive growth while addressing maladaptive schemas to promote resilience in the face of traumatic events.

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

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

Feasibility and preliminary effect of a couple-based posttraumatic growth intervention for colorectal cancer couples: A randomized controlled pilot study

BACKGROUND

Colorectal cancer (CRC) causes severe physical and psychological impacts on the patients as well as their spousal caregivers. To facilitate the psychological adaptation of the CRC suffered couples, a couple-based posttraumatic growth (PTG) intervention was developed based on the PTG affective-cognitive processing model. The feasibility, acceptability and preliminary effect of this intervention were tested.

METHODS

A pre-post randomized controlled pilot trail was conducted for Chinese couples coping with CRC. Participants in the intervention group were provided five weekly sessions consecutively, while those in the control group were treated with usual care during the testing period. Outcomes were described as positive changes (PTG, benefit finding [BF]), marital satisfaction, quality of life and anxiety and depression. Qualitative method was also used to evaluate the programme participating sense of the couples.

RESULTS

The rate of programme recruitment and programme retention amounts to 78.6% and 87.5%, respectively. The participants have reported overall satisfaction for the programme attendance and have suggested detailed diet guidance. Significant effects were revealed in the outcomes for the CRC couples, including PTG, marital satisfaction, BF, physical and mental health and anxiety and depression.

CONCLUSION

The study confirmed the feasibility and preliminary positive effect of the couple-based PTG intervention for the CRC couples. However, in order to extend it in more general applications, large-scale researches are warranted.

PRACTICAL IMPLICATION

The couple-based intervention is effective for couples coping with CRC. Clinicians should take the components of the intervention into consideration in their practice work for the CRC couples.

A Trauma-Informed, Geospatially Aware, Just-in-Time Adaptive mHealth Intervention to Support Effective Coping Skills Among People Living With HIV in New Orleans: Development and Protocol for a Pilot Randomized Controlled Trial

BACKGROUND

In 2020, Greater New Orleans, Louisiana, was home to 7048 people living with HIV-1083 per 100,000 residents, 2.85 times the US national rate. With Louisiana routinely ranked last in indexes of health equity, violent crime rates in Orleans Parish quintupling national averages, and in-care New Orleans people living with HIV surviving twice the US average of adverse childhood experiences, accessible, trauma-focused, evidence-based interventions (EBIs) for violence-affected people living with HIV are urgently needed.

OBJECTIVE

To meet this need, we adapted Living in the Face of Trauma, a well-established EBI tailored for people living with HIV, into NOLA GEM, a just-in-time adaptive mobile health (mHealth) intervention. This study aimed to culturally tailor and refine the NOLA GEM app and assess its acceptability; feasibility; and preliminary efficacy on care engagement, medication adherence, viral suppression, and mental well-being among in-care people living with HIV in Greater New Orleans.

METHODS

The development of NOLA GEM entailed identifying real-time tailoring variables via a geographic ecological momentary assessment (GEMA) study (n=49; aim 1) and place-based and user-centered tailoring, responsive to the unique cultural contexts of HIV survivorship in New Orleans, via formative interviews (n=12; aim 2). The iOS- and Android-enabled NOLA GEM app leverages twice-daily GEMA prompts to offer just-in-time, in-app recommendations for effective coping skills practice and app-delivered Living in the Face of Trauma session content. For aim 3, the pilot trial will enroll an analytic sample of 60 New Orleans people living with HIV individually randomized to parallel NOLA GEM (intervention) or GEMA-alone (control) arms at a 1:1 allocation for a 21-day period. Acceptability and feasibility will be assessed via enrollment, attrition, active daily use through paradata metrics, and prevalidated usability measures. At the postassessment time point, primary end points will be assessed via a range of well-validated, domain-specific scales. Care engagement and viral suppression will be assessed via past missed appointments and self-reported viral load at 30 and 90 days, respectively, and through well-demonstrated adherence self-efficacy measures.

RESULTS

Aims 1 and 2 have been achieved, NOLA GEM is in Beta, and all aim-3 methods have been reviewed and approved by the institutional review board of Tulane University. Recruitment was launched in July 2023, with a target date for follow-up assessment completion in December 2023.

CONCLUSIONS

By leveraging user-centered development and embracing principles that elevate the lived expertise of New Orleans people living with HIV, mHealth-adapted EBIs can reflect community wisdom on posttraumatic resilience. Sustainable adoption of the NOLA GEM app and a promising early efficacy profile will support the feasibility of a future fully powered clinical trial and potential translation to new underserved settings in service of holistic survivorship and well-being of people living with HIV.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05784714; https://clinicaltrials.gov/ct2/show/NCT05784714.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/47151.

How are experiences and acceptability of child maltreatment related to resilience and posttraumatic growth: a cross cultural study

Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM).Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income.Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form.Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries.Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity.

The effect of logotherapy-based, nurse-guided meaning attribution conversations on women diagnosed with gynecologic cancer: A Turkish pilot study

Although gynecological cancers are among the most common cancers worldwide, these diagnoses are among the most traumatic experiences in women's lives. This study aimed to examine the effects of logotherapy-based, nurse-guided meaning attribution conversations (MACs) on traumatic stress symptoms, post-traumatic growth, spiritual well-being, and life meaning attribution in gynecological cancer patients. This single-blind, randomized controlled trial consisted of face-to-face interviews with 68 women with gynecological cancer who received chemotherapy at Karadeniz Technical University Health Application And Research Center Farabi Hospital in 2019. Women in the intervention group underwent seven MAC sessions, whereas women in the control group only received routine nursing care. Data were collected using the Personal Information Form (PIF), the Traumatic Stress Symptom Scale (TSSS), the Post-Traumatic Growth Inventory (PTGI), the Meaning in Life Questionnaire (MLQ), and the Spiritual Well-Being Scale (SWBS). Descriptive statistics and parametric and nonparametric tests (Mann - Whitney U-test, Friedman test, Chi-squared test, and Fisher's exact test) were used to analyze the data. The study was registered at ClinicalTrials.gov (NCT05246462). We observed statistically significant differences in the post-intervention and follow-up mean TSSS, PTGI, and MLQ scores (p = .000) between groups. However, mean total SWBS scores were not significantly different between groups (p = .145). This study demonstrated that MACs decreased the traumatic stress symptoms of women with gynecological cancer and increased their post-traumatic growth and ability to attribute meaning to life, but did not affect their spiritual well-being.

The prevalence and factors associated with posttraumatic growth after 3-years outbreak of COVID-19 among resident physicians in China: a cross-sectional study

Introduction

The Coronavirus disease 2019 (COVID-19) pandemic is a global traumatic event that has profoundly struck individuals' mental health. However, this might potentially promote positive transformation such as posttraumatic growth (PTG). Studies have indicated that the COVID-19 pandemic negatively affected the well-being of resident physicians, but little is known about PTG among this vulnerable population in China. Therefore, this study investigated the prevalence and associated factors of PTG among Chinese resident physicians after 3-years outbreak of COVID-19.

Methods

An online survey was conducted from 9 March to 20 March in 2023. PTG was assessed using the 10-item Posttraumatic Growth Inventory-Short Form (PTGI-SF). Scores ≥30 implied moderate-to-high PTG. We also collected possible associated factors for PTG, including socio-demographic and psychological variables. Data was analyzed by applying descriptive statistics, univariable and multivariable logistic regression models.

Results

In total, 2267 Chinese resident physicians provided validated data. 38.7% of them reported moderate-to-high PTG. In the multivariable logistic regression models, age (odds ratio, OR = 1.039; 95% confidence interval, 95%CI = 1.008-1.070), female (OR = 1.383, 95%CI = 1.151-1.662), satisfied or neutral with annual income (OR = 2.078, 95%CI = 1.524-2.832; OR = 1.416, 95%CI = 1.157-1.732), sufficient support at work (OR = 1.432, 95%CI = 1.171-1.751) and resilience (OR = 1.171, 95%CI = 1.096-1.252) were significantly positively associated with moderate-to-high PTG. On the contrary, burnout (OR = 0.653, 95%CI = 0.525-0.812), depression symptoms (OR = 0.700, 95%CI = 0.552-0.889), and stress (OR = 0.757, 95%CI = 0.604-0.949) were significantly negatively associated with moderate-to-high PTG.

Discussion

Overall, resident physicians in China experienced relatively high prevalence of PTG that could be associated with several psychosocial factors. Findings may provide evidence to develop interventions for resident physicians to systematically and constructively process traumatic events related to the pandemic and foster their PTG.

Unchanging dynamics in posttraumatic growth in cancer patients: ways of coping and illness perception

Introduction

This study aims to address the positive changes due to traumatic experiences, such as being diagnosed with cancer and experiencing this disease for a certain period. Within this purpose, socio-demographic and disease-related variables, coping ways and illness perceptions that affect posttraumatic growth in cancer patients were examined. Secondly, the findings of this study, which is one of the first studies on posttraumatic growth in cancer patients in Turkey, were compared with the findings of current studies on the subject.

Method

Datums were collected by an interview form and three scales (Posttraumatic Growth Scale, Ways of Coping Inventory and Illness Perception Scale-R) to 78 cancer outpatients in Istanbul University Oncology Institute in 2007.

Results

Results showed that cancer patients have higher posttraumatic growth levels than the mean. According to analysis, posttraumatic growth total score between confrontive coping (t = -2.344, p < 0.05), self-controlling (t = -3.704, p < 0.001), accepting responsibility (t = -3.032, p < 0.01), escape-avoidance (t = -2.285, p < 0.05), planful problem solving (t = -2.502, p < 0.05), positive reappraisal (t = -5.241, p < 0.001), and seeking social support (t = -3.527, p < 0.01) has relationship. Also, there is a relation between posttraumatic growth subscales and the Revised form of Illness Perception Questionnaire; Change in relationships with others subscale (t = 2.887, p < 0.01) and Change in self-perception subscale (t = 2.660, p < 0.01) between timeline (acute/chronic), Change in self-perception subscale between timeline (cyclical) (t = -2.788, p < 0.01) and uncontrollable body factors (t = -1.916, p < 0.05) Change in philosophy of life subscale between external attributions (t = -2.057, p < 0.05) and Change in relationships with others subscale (t = -2.920, p < 0.01) between chance factors. It was found that positive reappraisal (F = 78.290, p < 0.001), self-controlling (F = 39.814, p < 0.001), and distancing (F = 46.311, p < 0.001) were significant predictors of posttraumatic growth total score. Results showed that ways of coping and illness perceptions were essential variables in posttraumatic growth.

Discussion

Studies on posttraumatic growth in Turkey and the world have significantly increased in recent years. This study aimed to examine the findings obtained from cancer patients in 2007 in discussion with the findings in the current literature. In this context, it is seen that the relevant variables affecting posttraumatic growth in cancer patients in different cultures do not change.

Rumination and threat-biased interpretation mediate posttraumatic stress and growth responses to military stressors

We examined the role of rumination and threat-biased interpretation in stress and growth responses to military stressors. Two online surveys were completed by 183 (survey 1) and 393 (survey 2) currently serving or retired military personnel. The surveys measured exposure to potential military stressors (exposure to combat, witnessing the consequences of war, and perceived moral injury), posttraumatic stress symptomatology (PTSS), posttraumatic growth (PTG), and personal wellbeing, with survey 1 including measures of rumination, and survey 2 including a measure of threat-biased interpretation. Path analyses revealed that indirect paths from both witnessing the consequences of war and experiencing betrayal to PTSS were mediated by intrusive rumination and threat-biased interpretation, and that indirect paths from both betrayal and transgressions by others to PTG were mediated by deliberate rumination and threat-biased interpretation. The results reveal the idiosyncratic nature of military stressors, their differential involvement with cognitions that underpin rumination about past events and interpretation of current events, and their relevance to posttraumatic stress and growth in military personnel.

Benefit finding, posttraumatic growth and health-related quality of life in long-term cancer survivors: a prospective population-based study

BACKGROUND

We explored the relationship between benefit finding (BF)/posttraumatic growth (PTG) at baseline and health-related quality of life (HRQOL) at baseline and follow-up in long-term cancer survivors (LTCS; ≥5-year post-diagnosis).

MATERIALS AND METHODS

HRQOL was assessed in LTCS in 2009-2011 (5- to 16-year post-diagnosis, baseline) and re-assessed in 2018/2019 (14- to 24-year post-diagnosis, follow-up). BF and PTG were measured at baseline; mean scores were dichotomized into 'none-to-low' (<3) and 'moderate-to-high' (> =3). Linear regression models and linear mixed regression models were employed to assess the association of BF/PTG with HRQOL.

RESULTS

Of the 6057 baseline participants, 4373 were alive in 2019, of whom 2704 completed the follow-up questionnaire. Cross-sectionally, LTCS with none-to-low BF reported better HRQOL at baseline and at follow-up than LTCS with higher BF. Longitudinally, no difference was found between none-to-low and moderate-to-high BF on the HRQOL change from baseline to follow-up. HRQOL differences between the PTG groups were not statistically significant cross-sectionally and longitudinally, except those participants with moderate-to-high PTG reported higher role functioning and global health status/QOL.

CONCLUSIONS

Cross-sectionally, BF was significantly negatively related to subscales of HRQOL, while PTG was positively correlated to role functioning and global health status/QOL. The results add further evidence that BF and PTG are two different positive psychological concepts.

Narratives of holistic mental health recovery in New Zealand Defence Force personnel

Research on military mental health recovery has tended to focus on therapy outcomes while backgrounding the role of diverse healing influences. The New Zealand Defence Force (NZDF) is a bicultural military integrated with Māori customs and cultural perspectives on holistic health and wellbeing. This study used narrative analysis to examine the semi-structured interviews of 21 active duty NZDF personnel who had accessed mental healthcare to understand what factors contributed to their return to wellness. Narratives described an orientation toward recovery as a process, where many interrelated wellbeing and social factors together supported the return to health. Culturally available Māori wellbeing metaphors were adopted as heuristics by service members in their storying of growth and healing. Findings are considered in terms of how wellbeing and recovery are conceptualized and promoted within militaries with diverse cultures. Discussion focuses on how narratives within military institutions can promote resilience and support service member recovery from mental distress.

The Roles of Personal and Environmental Resources in Predicting Work-Family Facilitation and Mental Health among Employed Parents of Children with Disabilities in Croatia

Quantitative research on the positive aspects of work-life integration and the well-being of families with children with disabilities is scarce, especially in the national context. The family can provide gains that enhance work domain functioning (family-to-work facilitation; FWF), and work can provide gains that enhance family domain functioning (work-to-family facilitation; WFF). The aim of this study is to examine the contributions of some personal and environmental resources in explaining WFF and FWF and the mental health of parents of children with disabilities residing in Croatia. The mediational role of WFF and FWF in the relationship between resources and mental health was tested, while controlling for some general socio-demographic variables. A total of 571 employed parents of a child/children with disabilities completed an online self-assessment questionnaire. The results show that higher WFF (19%) was predicted by higher levels of social support at work, a higher level of education, posttraumatic growth (PTG) of personal strength, and recovery management. Higher FWF (46%) was predicted by higher levels of social support in the family, PTG of personal strength, the emotional regulation strategy of reorienting to planning, optimism, a younger age, the male gender, a greater number of children, and a higher level of education. A higher level of mental health (47%) was predicted directly by higher levels of optimism, recovery management, FWF, emotional regulation strategies of positive refocusing and planning, and a greater number of children, and was indirectly predicted by all the predictors of FWF through a higher level of FWF (but not WFF).

Role of Peer Support in Posttraumatic Growth Among Adolescent and Young Adult Cancer Patients and Survivors

Purpose: Adolescents and young adults (AYA) who undergo cancer treatment sometimes report posttraumatic growth (PTG). Although the importance of peer support has been suggested, its association with PTG, especially its five distinct domains, needs to be investigated further in AYA cancer survivors. The present study examined the role of demographics and peer support in PTG among AYA cancer patients and survivors. Methods: The present, multicenter, cross-sectional, web-based study enrolled AYA cancer patients and survivors (median age: 28 years). Of 549 AYA patients recruited, 212 from 11 cancer centers and 12 cancer patient communities agreed to participate by completing a self-reported measure of PTG (Extended Version of the Posttraumatic Growth Inventory-Japanese) and providing information about their diagnosis, treatment, peer support (affiliation with an AYA patient community or friendship with other AYA patients), and social status. Multiple regression analysis was used to identify significant correlations overall and in the five PTG domains. Results: PTG was positively associated with male sex, having a confidant, and friendship with other AYA patients, and negatively associated with cranial radiation. Friendship with other AYA patients was positively associated with four of the five PTG subscales. For the five subscale scores, "cranial radiation" was negatively associated with "relating to others"; "belonging to a religion" was positively associated with "spiritual change"; and "having a confidant" was positively associated with "relating to others" and "new possibility." Conclusion: "Having a confidant" and "friendship with other AYA patients" were positively associated with PTG. Psychosocial interventions mobilizing peer support may contribute to promoting PTG in AYA patients. UMIN000035439.

The impact of COVID-19 on mental health and posttraumatic growth of Korean college students: a mixed method study examining the moderating role of coping flexibility and sense of community

Introduction

In the context of the COVID-19 pandemic, which has led to complex psychological problems, it is important to examine the effect of coping flexibility and sense of community, because relying solely on specific coping strategies is ineffective, and the pandemic necessitates social cooperation.

Methods

This study was divided into two parts. The first study used a quantitative research method(i.e., structural equation modeling) to test if coping flexibility and sense of community moderated the impact of COVID-19-related concerns on mental health (i.e., depression and anxiety) and posttraumatic growth among Korean college students. The second study used a qualitative research method for an in-depth examination of how Korean college students coped with the COVID-19 pandemic and if they achieved any positive change or growth. Given that the COVID-19 pandemic represents a situation distinct from what people have previously encountered, Study II was designed to examine the experiences of individuals during this exceptional period.

Results

In the first study (Study I), coping flexibility was found to increase the impact of COVID-19-related concerns and difficulties on depression and anxiety. Conversely, a sense of community reduced the consequences of these overwhelming worries on depression and anxiety, while also expanding the impact of COVID-19-related disorders on posttraumatic growth. In the second study (Study II), the findings showed that the participants experienced various psychological consequences, including depression and anxiety, and distress in other aspects of their life, including disruptions in interpersonal relationships and college life. Nonetheless, the participants made efforts to cope with such difficulties and overcome the challenges together with the community. In fact, the pandemic improved their coping skills and expanded their value system and worldview.

Conclusion

The study findings suggest that given the unique situation presented by the COVID-19 pandemic, a sense of community protected the mental well-being of Korean college students and facilitated their growth. This study emphasizes the necessity of promoting SOC to effectively cope with disaster situations.

Posttraumatic Growth as a Process Beginning Before Bereavement: New Perspectives on Theory Development

Calhoun and Tedeschi's growth model focuses on cognitive processing after bereavement but it does not show the change in life narrative from beforehand. Our qualitative study aimed to clarify bereaved family growth and revealed new perspectives on posttraumatic growth (PTG), including that the PTG process involves a pre-bereavement experience and is not limited to positive psychological changes.Based on the two new perspectives, a discussion of PTG theory reveals that bereaved families' PTG can only be accurately captured if the pre-loss experience is included; thus, Calhoun and Tedeschi's growth model, which only captures the post-loss process, is insufficient. Additionally, positive psychological changes are not the only type of growth. When considering growth, one must focus on the process, including the experience of the person realizing that it is "okay to be who they are."

Posttraumatic growth in colorectal cancer survivors: A systematic review

OBJECTIVE

The diagnosis of cancer is an adverse event; nevertheless, it can also exert positive changes on survivors, such as posttraumatic growth (PTG). This review aims to integrate researches on PTG in colorectal cancer (CRC) survivors, including manifestations and prevalence of PTG, factors associated with PTG and interventions on PTG.

METHODS

A systematic search was implemented on six databases to identify studies on PTG in CRC survivors published in English or Chinese from October 1995 to May 2022. We also performed a manual search for additional studies from the article reference lists.

RESULTS

Thirty-one studies were included. The results were integrated based on the PTG theoretical framework and PTG affective-cognitive processing model. PTG manifests in CRC survivor-caregiver dyads in five domains, including personal growth, appreciation of life, relating to others, new possibilities and spiritual change. Factors correlated with PTG can be integrated into levels of personality, event cognitions, appraisal mechanisms, emotional states, coping and social environmental context. Elements of interventions can be integrated according to the affective-cognitive processing PTG model. Existing interventions are effective in promoting PTG in CRC survivors.

CONCLUSION

We provide a systematic perspective on studies targeting PTG in CRC survivors. PTG manifested in survivor-caregiver dyads. Factors associated with PTG in CRC survivors are significant, and the interventions are effective. An intervention programme based on the affective-cognitive processing model and focused on CRC survivor-caregiver dyads would be significant for the dyads facing cancer.

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

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

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

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

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

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

The effect of the social support on PTSD and PTG about university student volunteers in the prevention and controlling of coronavirus: with coping style as the intermediary

To investigate the relationship among post-traumatic stress disorder (PTSD), posttraumatic growth (PTG), social support, and coping style of university student volunteers in the prevention and control of the coronavirus in 2020, a total of 2,990 university student volunteers (students who are enrolled in a university and involved in volunteer activities) from 20 universities in Sichuan Province participated in the prevention and control of the epidemic were investigated when March 20-31, 2020 when the coronavirus first occurred using the post-traumatic stress disorder questionnaire, posttraumatic growth questionnaire, university student social support questionnaire and coping style questionnaire. The results showed that (1) 7.06% of university student volunteers had some degree of PTSD symptoms (the total PCL-C score was 38-49), and 2.88% had obvious PTSD symptoms, (2) PTSD level of university student volunteers was significantly positively correlated with negative coping style, and significantly negatively correlated with social support and positive coping style; on the contrary, the PTG level is significantly positively correlated with social support and positive coping styles, and (3) Positive coping style plays a partial mediating role in the influence of social support on PTG; in the influence of social support on PTSD, the mediating effect of positive or negative coping style was not significant. These results show that in the prevention and control of the coronavirus, the positive coping style and social support of university student volunteers can positively predict the PTG level of them, while the negative coping style can positively predict the severity of their PTSD symptoms. Among them, a positive coping style plays a partial mediating role in the influence of social support on the PTG level.

Limitations of benefit finding as a coping mechanism for combat-related PTSD symptoms

Benefit finding has been identified as a buffer of the combat exposure-PTSD symptom link in soldiers. However, benefit finding may have a limited buffering capacity on the combat-PTSD symptom link over the course of a soldier's post-deployment recovery period. In the present study, soldiers returning from Operation Iraqi Freedom (OIF) were surveyed at two different time periods post-deployment: Time 1 was 4 months post-deployment (n = 1,510), and Time 2 was at 9 months post-deployment (n = 783). The surveys assessed benefit finding, PTSD symptoms, and combat exposure. Benefit finding was a successful buffer of the cross-sectional relationship between combat exposure and PTSD reexperiencing symptoms at Time 1, but not at Time 2. In addition, the benefit finding by combat interaction at time 1 revealed that greater benefit finding was associated with higher symptoms under high combat exposure at Time 2 after controlling for PTSD arousal symptoms at Time 1. The results of the present study indicate that benefit finding may have a buffering capacity in the immediate months following a combat deployment, but also indicates that more time than is allotted during the post-deployment adjustment period is needed to enable recovery from PTSD. Theoretical implications are discussed.

The effect of nursing care based on human caring theory on posttraumatic growth in parentally bereaved adolescents: Action research

PROBLEM

The death of a parent is a traumatic experience for adolescents. Studies to ensure post-traumatic growth in adolescents are limited. The aim of this study to evaluate the effect of nursing care based on Watson's Theory of Human Caring on posttraumatic growth in parentally bereaved adolescents.

METHODS

This study was participatory action research. The study was carried out with four participants through online interviews. In the study, pre- and post-action data were obtained through individual interviews and scales. During the action process, nursing care based on the Theory of Human Caring was provided to the participants individually tracked through the Omaha System. Pre and post-action qualitative data were analyzed using the descriptive analysis method. In quantitative data, scale total and sub-scores were documented.

FINDINGS

During the action, it was determined via Omaha System coding that the participants mostly experienced grief and mental health problems. In the pre-action, the participants stated that they experienced various difficulties regarding grief. In the post-action, the participants stated that the meaning of parental loss,its effects on life, and their ability to cope with loss changed and they experienced positive changes. In addition, when the scale scores of the participants' pre- and post-action were compared, it was found that the Mourning Scale scores decreased, and the Post-traumatic Growth Inventory scores increased.

CONCLUSIONS

The result of this study demonstrate that nursing care based on Theory of Human Caring reduces the grief symptoms and contributes to post-traumatic growth in parentally bereaved adolescents.

Resilience Mediates the Relationship Between Parental Attachment and Posttraumatic Growth in Adolescents: A Longitudinal Study

OBJECTIVE

Previous studies have shown that parental attachment was associated with higher levels of posttraumatic growth (PTG) in individuals who have experienced traumatic events. The aim of the current longitudinal study is to investigate resilience as one pathway through which parental attachment is related to PTG among Chinese adolescents following the Yancheng tornado.

METHODS

A total of 351 adolescent survivors participated in this longitudinal study. Participants completed the revised version of Inventory of Parent and Peer Attachment (IPPA-R) at 12 months (T1), and the revised Chinese version of the Post-Traumatic Growth Inventory (PTGI-R) and the Connor and Davidson's Resilience Scale (CD-RISC) at 18 months (T2) after the tornado, respectively.

RESULTS

It indicated that parental attachment at T1 has direct and positive effect on PTG at T2, and resilience at T2 fully mediated the relationship between parental attachment at T1 and PTG at T2.

CONCLUSION

The findings revealed that parental attachment and resilience are two key resources that promote adolescent's PTG, and parental attachment acts through resilience to promote PTG in adolescents.