The Posttraumatic Growth Inventory: A Revision Integrating Existential and Spiritual Change

Spiritual Change (SC) is one of 5 domains of posttraumatic growth (PTG). The current Posttraumatic Growth Inventory (PTGI) assesses this area of growth with only 2 items, one focusing on religiosity and the other focusing on spiritual understanding. The addition of 4 newly developed spiritual–existential change (SEC) items, creating an expanded PTGI (Posttraumatic Growth Inventory‐X), reflects a diversity of perspectives on spiritual–existential experiences that are represented in different cultures. Samples were obtained from 3 countries: the United States (n = 250), Turkey (n = 502), and Japan (n = 314). Analyses indicated that the newly added items capture additional experiences of growth outside traditional religious concepts, yet still are correlated with the original SC items, especially in the U.S. and Turkish samples. Relationships of the PTGI‐X to established predictors of PTG, event‐related rumination, and core beliefs, were as predicted in all 3 countries. The new 6‐item SEC factor demonstrated high internal reliability, and the 5‐factor structure of the expanded scale was supported by confirmatory factor analysis. The resulting 25‐item PTGI‐X can be used as a validated instrument in a wide range of samples in which traditional religious beliefs are less dominant.     

自我表露在乳腺癌患者反刍性沉思与创伤后成长间的中介效应

目的 探讨乳腺癌患者反刍性沉思、自我表露与创伤后成长之间的关系，为采取针对性措施促进患者的创伤后成长提供参考。方法 采用反刍性沉思量表、自我表露量表、创伤后成长量表对200例乳腺癌患者进行调查。结果 乳腺癌患者创伤后成长总分为（61.17±12.69）分，反刍性沉思总分为（29.29±10.63）分，自我表露总分为（38.05±6.82）分；侵入性反刍性沉思与创伤后成长和自我表露呈负相关，自我表露与创伤后成长呈正相关（均P<0.05）；自我表露在侵入性反刍性沉思与创伤后成长间起中介作用，中介效应占总效应的40.18%。结论 自我表露是乳腺癌患者侵入性反刍性沉思与创伤后成长的中介变量，医护人员应引导患者减少消极沉思，增强其自我表露意愿，提高创伤后成长水平。     

Long‐term perspectives on posttraumatic growth in disaster survivors

Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long‐term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow‐up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.     

Coping and rumination as predictors of posttraumatic growth and depreciation

PurposeThe present study examined the joint impact of coping and rumination after trauma on posttraumatic growth (PTG) and posttraumatic depreciation (PTD) based on the PTG model.MethodsA cross-sectional study was conducted between October 2017 and May 2018. A sample of 253 individuals who had experienced a traumatic event in the last two years, was included. Participants completed an online self-reported survey, including demographic variables, trauma characteristics, the German Posttraumatic Growth and Depreciation Inventory – Expanded, the Brief COPE Inventory, and the Event Related Rumination Inventory. An analysis of correlation, a principal component analysis and hierarchical regression analyses were conducted. Statistical analyses were undertaken on SPSS (version 25.0; IBM, New York, USA).ResultsAfter controlling for the effects of personal and trauma characteristics, self-sufficient coping and socially supported coping were found to favor the emergence of PTG. Event-related and recent deliberate rumination were positively related to PTG. Avoidant-focused coping and recent intrusive rumination were positively associated with PTD. Overall, the final models accounted for 46% and 58% of the variance in PTG and PTD.ConclusionOur findings confirm the PTG model and support the central role of deliberate rumination, self-sufficient coping and socially supported coping in the development of PTG. Our results indicate that a similar model of PTD with comparable influencing factors can be assumed: if the individual is stuck in ongoing intrusive rumination and uses more avoidance-focused coping, it might lead to more reports of PTD.     

The impact of receiving an HIV diagnosis and cognitive processing on psychological distress and posttraumatic growth

This study examined human immunodeficiency virus (HIV) as a traumatic stressor, intrusive and deliberate cognitive processing, psychological distress, and posttraumatic growth. One‐hundred twelve participants completed interviews on posttraumatic stress disorder (PTSD) Criterion A, Rumination Scale‐Revised, Impact of Event Scale, and the Posttraumatic Growth Inventory; relationships were modeled using path analysis. Model 1 attempted to replicate prior empirical research, Model 2 attempted to empirically replicate part of the posttraumatic growth theoretical model, and Model 3 attempted to empirically replicate an integrated model of posttraumatic growth and traumatic stress theories. Model 3 had good fit with study data. Results suggest shared and separate pathways from traumatic stressor to psychological distress and posttraumatic growth, with pathways mediated by cognitive processing. Implications of findings are discussed.     

A quantitative analysis of the relationship between posttraumatic growth,depression and coping styles after burn

IntroductionPosttraumatic growth (PTG) is “the subjective experience of positive psychological change reported by an individual as a result of the struggle with trauma” (Zoellner and Maercker, 2006 [1]). PTG after burn is similar to PTG after other types of trauma (Martin et al., 2016 [2]). The aim was to assess the relationship between coping styles, via the BriefCOPE (Carver et al., 1989 [9]), and posttraumatic growth via the Posttraumatic Growth Inventory (Cann et al., 2010 [4]), in an adult burn population.Method36 burn patients who required surgery for wound closure were recruited within 2 years of their burn. They completed the PTGI, DASS-D, and BriefCOPE, and again one month later. Regression analysis with backwards elimination assessed the relationships between coping styles, depression and posttraumatic growth.ResultsOf the 14 coping types identified in the BriefCOPE, three were associated with PTG after burn: positive reframing, religion and acceptance. Three coping strategies were associated with greater levels of depression: behavioural disengagement, venting and self-blame.ConclusionBehavioural disengagement, venting and self-blame behaviours can be used as ‘red flags’ to trigger early screening for depression and to enable timely treatment of depression. To maximise posttraumatic growth interventions that promote positive reframing, use of religion, and acceptance are necessary.     

重大车祸伤存活患者创伤后成长状况调查分析

目的 了解重大车祸创伤存活后患者创伤后成长(PTG)状况及其相关影响因素.方法 对58例重大车祸创伤后存活患者进行一般情况和创伤后成长评定量表(PTGI)调查,并进行统计分析.结果 58例患者PTGI总分为(84.63±15.46)分；不同性别、职业、学历、月收入、损伤程度、创伤处理方式、可预计的康复时间、可预计的康复结局及可预计的康复后工作情况患者PTGI得分比较,差异有统计学意义(P＜0.05,P＜0.01).结论 重大车祸受伤存活患者PTG水平较高,不同类别患者间心理成长水平存在差异.     

Are reports of posttraumatic growth positively biased?

This study examines positivity bias in reports of growth following exposure to traumatic events. Participants (N = 276) from an urban university and a superior court jury pool were randomly assigned to one of two methodological groups. In one, participants responded to the Posttraumatic Growth Inventory (PTGI) in relation to a specific stressful event. In the other, PTGI questions were not linked to specific events. Findings indicate that current methods for assessing posttraumatic growth (PTG) may actually underestimate growth. That is, linking questions about growth to specific stressors may have led participants to be cautious about attributing their growth experiences to a traumatic event. These findings contradict notions that current methods of measuring PTG create a positivity bias. Suggestions for future research include the use of prospective designs and corroborating reports of growth.     

Cognitive processing in the aftermath of relationship dissolution: Associations with concurrent and prospective distress and posttraumatic growth

Non‐marital romantic relationship dissolution is amongst the most stressful life events experienced by young adults. Yet, some individuals experience posttraumatic growth following relationship dissolution. Little is known about the specific and differential contribution of trait‐like and event‐specific cognitive processing styles to each of these outcomes. A longitudinal design was employed in which trait‐like (brooding and reflection) and dissolution‐specific (intrusive and deliberate) cognitive processing was examined as predictors of growth (Posttraumatic Growth Inventory) and distress (Breakup Distress Scale) following a recent relationship dissolution. Initially, 148 participants completed measures of trait‐like and dissolution‐specific cognitive processing, growth, and distress (T1). A subsample completed a seven‐month follow‐up (T2). Higher frequency of relationship‐dissolution intrusive thoughts predicted concurrent distress after accounting for brooding and relationship characteristics. Further, higher brooding and lower reflection predicted higher distress prospectively. Concurrent growth was predicted by both higher brooding and more deliberate relationship‐dissolution thoughts. Prospectively, T1 dissolution intrusive thoughts predicted higher T2 deliberate thoughts, and the interaction between these two constructs predicted higher T2 growth. Therefore, deliberately thinking of the dissolution was related to positive psychological outcomes. In contrast, intrusive dissolution cognitions and a tendency for brooding had a mixed (paradoxical) association with psychological adjustment.     

Posttraumatic growth during cognitive behavioural therapy for posttraumatic stress disorder: Relationship to symptom change and introduction of significant other assessment

Posttraumatic growth (PTG) may play a role in the treatment of posttraumatic stress disorder (PTSD) as it is supposed to have either beneficial or dysfunctional effects on treatment‐related PTS symptom (PTSS) changes. This study examined whether cognitive behavioral therapy (CBT) for PTSD patients can foster PTG assessed by self‐reports and reports from significant others. Forty‐eight PTSD patients participating in trauma‐focused CBT were assessed twice: at the beginning of therapy (T1) and after 3 months of therapy (T2, N = 34). We used the Clinician Administered PTSD Scale and the Posttraumatic Growth Inventory (PTGI), and constructed a significant other version of the PTGI (PTGI‐SOA). The PTSS severity declined during the course of treatment, whereas PTG levels remained stable. Both the PTGI and PTGI‐SOA were associated with higher PTSS reduction at T2. The results suggest that PTG is associated with greater improvement in PTSS during trauma‐focused CBT, even though treatment could not directly enhance PTG. Significant other assessments seem to be a promising approach to improve PTG measurement.     

Posttraumatic growth in adolescence: examining its components and relationship with PTSD

To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.     

Resilience as a Moderator of Extreme Stress Adaptation: Living Kidney Donor Analysis

Background

The aim of the study was to check if a situation of extreme and traumatizing stress, such as living kidney donation, would result in changes in the quality of the donor's life: whether a posttraumatic growth should occur, and if the donor would develop a strategy to handle strong and uncommon stress, known as resilience.

Posttraumatic growth in bereaved parents

The Posttraumatic Growth Inventory (PTGI), Revised Grief Experience Inventory, and World Assumptions Scale were administered to 111 bereaved parents. The PTGI scores indicate that many bereaved parents report personal growth in domains outlined by L.G. Calhoun and R. G. Tedeschi (2001). Grief intensity was inversely correlated with growth scores. Self-worth was a strong predictor of growth scores, whereas assumptions about the benevolence and meaningfulness of the world were not correlated with growth.     

Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A survey of traumatic stress professionals

We report findings from a Web-based survey of the International Society for Traumatic Stress Studies' members (n = 227) regarding use of trauma exposure and posttraumatic assessment instruments. Across clinical and research settings, the most widely used tests included the Posttraumatic Stress Diagnostic Scale, Trauma Symptom Inventory, Life Events Checklist, Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale, PTSD Checklist, Impact of Event Scale-Revised, and Trauma Symptom Checklist for Children. Highest professional degree, time since degree award, and student status yielded no differences in extent of reported trauma assessment test use.     

口腔癌患者术后创伤后成长状况及影响因素分析

目的调查口腔癌患者术后创伤后成长状况,分析其影响因素。方法采用一般情况调查表、创伤后成长量表、社会支持评定量表和简易应对方式问卷对96例口腔癌术后患者进行调查。结果口腔癌患者术后创伤后成长总分56.72±8.53、社会支持总分34.82±3.64;术后时间、治疗方式、是否复发、积极应对、客观支持为口腔癌患者术后创伤后成长的影响因素(调整R~2=0.879)。结论口腔癌患者术后创伤后成长处于中等水平,术后时间越长、治疗方式越复杂患者创伤后成长水平越低,复发的患者创伤后成长得分较未复发者低,积极应对与客观支持则促进创伤后成长。护理人员应给予口腔癌术后患者针对性干预与支持,以促进其创伤后成长。     

What Determines Posttraumatic Stress and Growth Following Various Traumatic Events? A Study in a Turkish Community Sample

This study aimed to examine the roles of personality traits, traumatic event types, coping, rumination, and social support in explaining posttraumatic stress symptoms (PTS) and posttraumatic growth (PTG) in a representative community sample of 498 Turkish adults. The results of 2 multiple regression analyses showed that PTS was associated with neuroticism, experiencing events involving intentional/assaultive violence, intrusive and deliberate rumination, and fatalistic coping. In contrast, PTG was related to conscientiousness, openness to experience, injury/shocking and sudden‐death type of events, deliberate rumination, problem‐solving coping, and perceived social support. When all variables were entered into the equation, almost two thirds of the variability (R ² = .64) in the severity of PTS and more than one third of the variability (R ² = .40) in PTG was explained. The findings can aid in the development of psychosocial support programs for individuals experiencing traumatic events.     

Dimensions of Growth? Examining the Distinctiveness of the Five Factors of the Posttraumatic Growth Inventory

Posttraumatic growth, defined as positive transformation following trauma, is commonly measured using the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) and is postulated to comprise five distinct domains: Changes in Relationships, Life Possibilities, Personal Strength, Spirituality, and Appreciation of Life. However, research has indicated that the model fit is not good and the factors are highly intercorrelated. Further, no studies have formally examined the heterogeneity of correlations of the five factors with external constructs. In an effort to examine the construct validity of the five‐factor model of the PTGI, the present study aimed to examine the degree to which the theorized five factors demonstrate meaningful differential associations with relevant external correlates. Participants were 400 undergraduate students who reported having experienced a stressful event and completed the Life Events Checklist for DSM‐5, PTGI, Posttraumatic Stress Disorder Checklist for DSM‐5, Grit Scale‐12, Connor‐Davidson Resilience Scale‐10, and Work and Social Adjustment Scale. We found few instances of significant differentiation, and effect sizes for pairwise comparisons were generally small, Cohen's qs = 0.01–0.35. Although factor analytic evidence suggests there are five distinct underlying constructs, our results indicated that these factors do not significantly differ in their associations with external correlates. Implications for use of the PTGI and future research directions are discussed.     

Personal growth and psychological distress in advanced breast cancer

AIMS: The experience of posttraumatic growth following breast cancer, its association with psychological distress and the predictive value of psychological distress, sociodemographic and clinical characteristics of cancer patients in their personal growth. METHODS: The Posttraumatic Growth Inventory and the Greek version of the Hospital Depression and Anxiety Scale (G-HADS) were administered to 100 breast cancer patients. Sociodemographic and clinical characteristics were recorded. RESULTS: The analysis showed that significant associations were found between PTGI-Total patients' age (p=0.001), and being married (p=0.007). Moreover, significant negative association was observed between PTGI-II ("New Possibilities") and HADS-Depression (r=-0.314, p<0.05). Multiple regression analyses showed that age is a significant predictor of PTGI-II ("New Possibilities") (p=0.005), PTGI-V ("Appreciation of Life") (p=0.0005) and PTGI-Total (p=0.037), while marital status is a significant predictor of PTGI-Total (p=0.009). CONCLUSION: Specific patients' characteristics, such as young age and being with a partner, influence the experience of posttraumatic growth in breast cancer patients.     

Use of the revised Posttraumatic Growth Inventory for Children

Posttraumatic growth (PTG; positive change resulting from the struggle with trauma) was examined among children impacted by Hurricane Katrina. The revised Posttraumatic Growth Inventory for Children (PTGI-C-R) assessed PTG at two time points, 12 (T1) and 22 months (T2) posthurricane. The PTGI-C-R demonstrated good reliability. Analyses focused on trauma-related variables in predicting PTG. Child-reported subjective responses to the hurricane and posttraumatic stress symptoms (PTSS) correlated with PTG at T1; however, in the regression, only PTSS significantly explained variance in PTG. At follow-up, T1 PTG was the only significant predictor of PTG. Findings suggest that the PTGI-C-R may assist efforts to understand children's responses posttrauma.     

Postcancer Experiences of Childhood Cancer Survivors: How Is Posttraumatic Stress Related to Posttraumatic Growth?

Understanding posttraumatic growth (PTG) and the factors associated with PTG among cancer survivors is important to improve their quality of life. This study examined PTG among 225 Korean adolescents and young adults between 15 years and 39 years of age who survived childhood cancer (58.5% males and 41.5% females). We explored the relationships between PTG and several sociodemographic and medical variables, and whether the relationships between PTG and posttraumatic stress disorder (PTSD) symptoms were linear or curvilinear. The Posttraumatic Stress Diagnostic Scale (PDS) and the Posttraumatic Growth Inventory (PTGI) were used to assess PTSD symptoms and PTG, respectively. In addition to the effects of sociodemographic and medical variables, there were linear effects of PDS on PTGI (R² change = .03, p = .008). No evidence of a curvilinear relationship between PDS and PTGI was found. Higher PDS scores were associated with lower PTGI scores (β = ?.18). Older age (β = .41) and shorter time since diagnosis (β = ?.42) were associated with greater PTGI. Understanding the factors that were associated with PTG among Korean adolescent and young adult survivors of cancer adds to the knowledge on PTG and may help develop services to promote PTG in this group.