Posttraumatic Stress,Posttraumatic Growth,and Satisfaction With Life in Military Veterans

Objective: Military veterans are more likely than civilians to experience trauma and posttraumatic stress disorder (PTSD). Research suggests, however, that some people who experience trauma, including veterans, report posttraumatic growth (PTG), or positive personal changes following adversity. In this study, we tested a comprehensive model of PTG, PTSD, and satisfaction with life in a veteran population, exploring the roles of challenges to core beliefs, types of rumination, sex, and time since event. Method: Data were collected via Amazon’s Mechanical Turk, an online crowdsourcing website, from veterans (N = 197) who had experienced a stressful event within the last 3 years (M = 16.66 months, SD = 12.27 months). Structural equation modeling was used to test an integrated conceptual model of PTG, PTSD, and satisfaction with life. Results: Results showed that challenge to core beliefs was directly associated with both deliberate and intrusive rumination. Deliberate rumination was positively related to PTG; intrusive rumination was positively related to symptoms of PTSD. PTG and PTSD, in turn, mediated the relationship between rumination styles and satisfaction with life; PTG was related to higher satisfaction with life; and PTSD was negatively related to satisfaction with life. Results failed to show differences on any model variables as a function of time since event or sex. Conclusion: Results indicate that the intentional facilitation of PTG may be a complementary and alternative option to the reduction of PTSD symptoms for improving satisfaction with life. Findings suggest that efforts to facilitate PTG should be focused on strategies for promoting deliberate rumination.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

A double‐edged sword: Event centrality,PTSD and posttraumatic growth

Previous research has demonstrated negative mental health consequences (including PTSD symptoms) of construing a potentially traumatic event as central to one's identity. In the current paper, we replicated an association between event centrality and PTSD symptoms. We also found event centrality similarly predicts posttraumatic growth (PTG) even after controlling for PTSD symptoms, depression, DSM‐IV A1 and A2 status of the event, coping styles and cognitive processing of the event. Because predictive relationships between event centrality and PTSD symptoms, as well as event centrality and PTG were positive, construing an event as central to one's identity can indeed become a double‐edged sword, allowing for both debilitation and growth. Copyright © 2010 John Wiley & Sons, Ltd.     

Mediators of Posttraumatic Mental Health in Sexual Assault Survivors

The development of posttraumatic growth (PTG) and the relationship between PTG and distress outcomes in sexual assault is an important area of investigation. Recent research suggests that some forms of cognitive processing might be critical in the development, maintenance, and resolution of posttraumatic mental health among sexual assault survivors. The objective of this study was to examine factors associated with posttraumatic mental health among sexual assault survivors. Seventy-three participants who experienced sexual assault completed measures of trauma symptoms, PTG, changes in outlook, cognitive processing, and support and coping. Results revealed that significant levels of posttraumatic symptomatology and low levels of PTG were reported 3 years following sexual assault. A weak relationship was found between symptoms of distress and growth. Contrary to predictions, only ratings of hope and brooding rumination were mediators of the relationship between posttraumatic symptoms and PTG. Reflective rumination was not related to the development of PTG.     

Loneliness as Moderator Between Trauma and Posttraumatic Growth

This study investigated the association between loneliness, trauma symptomatology, and posttraumatic growth (PTG) in undergraduate students (N = 362). The study also explored whether loneliness moderated the relationship between experiences of trauma and PTG. The results demonstrated that both loneliness and trauma symptoms predicted levels of PTG, and loneliness moderated the relationship between trauma and PTG. Limitations, directions for future research, and implications for counseling are discussed.     

Vivid memories of distant trauma: Examining the characteristics of trauma memories and the relationship with the centrality of event and posttraumatic stress 26 years after trauma

In the present study, we investigated the phenomenological characteristics of distant trauma memories and the relationship between the vividness of trauma memories, the centrality of event and symptoms of posttraumatic stress in two groups with different types of trauma exposure, namely survivors and bereaved, from the fire on the passenger ferry, Scandinavian Star, 26 years earlier. More than two decades after the fire, the traumatic event was represented as a vivid, emotional recollection for many of the victims. For both the survivors and the bereaved, a higher degree of vividness of trauma memories and centrality of the event were associated with higher levels of posttraumatic stress. The present findings show that even very distant trauma memories can be represented as vivid recollections. Furthermore, the findings suggest that both vividness of trauma memories and event centrality may contribute to explain how posttraumatic stress reactions can remain present over a very long time.     

Positive Metacognitions and Meta-Emotions as Predictors of Posttraumatic Stress Disorder and Posttraumatic Growth in Survivors of a Natural Disaster

ABSTRACT

Exposure to natural disasters can lead to both negative and positive mental health consequences (i.e., posttraumatic stress disorder [PTSD] and posttraumatic growth [PTG]). While there is evidence linking metacognition to these outcomes, the focus is mostly on maladaptive metacognitions. The present study investigated the role of positive metacognitions and meta-emotions (i.e., confidence in extinguishing perseveration [Extinguishing], confidence in interpreting emotions as cues [Interpreting], and confidence in setting flexible and attainable hierarchies of goals [Setting]) on PTSD and PTG among Filipino typhoon survivors. Findings supported a model wherein Extinguishing and Setting, but not Interpreting, predicted PTSD and PTG through posttraumatic cognitions.     

Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

Obsessive Compulsive Symptoms Predict Posttraumatic Growth: A Longitudinal Study

Although posttraumatic growth (PTG) has received growing attention, the relationship between PTG and distress remains unclear. This longitudinal study examines the relationship between posttraumatic obsessive-compulsive (OC) symptoms and PTG. Israeli veterans were followed over 17 years using self-report questionnaires of OC symptoms, posttraumatic stress disorder (PTSD), and PTG. Hierarchical regression analyses demonstrated that OC symptoms predicted PTG, even when initial PTG levels and PTSD symptoms were controlled for in the combatants group. These preliminary findings suggest that OC symptoms may play an important role in facilitating psychological growth. Future research is warranted to explore the mechanisms responsible for this relationship.     

Posttraumatic Reactions among Firefighters after Critical Incidents: Cross-National Data

The presence of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) following a critical incident were examined among firefighters from eight predominantly European countries. A sample of 1916 firefighters completed the Impact of Event Scale–Revised (IES–R) and the Posttraumatic Growth Inventory–Short Form (PTGI–SF) with reference to a critical incident they had experienced. Analyses indicated both negative and positive posttraumatic outcomes could derive from experiencing critical incidents in the line of duty. The analyses also showed country differences exist regarding firefighters’ PTSD symptoms and PTG. It is recommended that future researchers examine factors that could evoke such national differences.     

Posttraumatic Growth in Trauma Recollections of 9/11 Survivors: A Narrative Approach

The relationship between posttraumatic growth (PTG) and adaptation is unclear. This study is the first to examine PTG in trauma narratives of survivors of the World Trade Center (WTC) attacks. Participants recalled their experiences 7 and 18 months post 9/11, and content analysis was conducted to detect PTG. Posttraumatic stress was also measured. PTG was commonly reported. Relating to others and positivity were frequent in the PTSD and non-PTSD group, although less frequent over time in the PTSD. Greater appreciation for life was reported by the non-PTSD group but relatively absent in the PTSD group. Women but not men reported relating to others across time. It appears that there are distinct profiles of growth implicated in distress and adaptation.     

震后儿童创伤后应激障碍的症状网络演化

本研究借助网络分析方法,探讨儿童创伤后应激障碍(PTSD)症状的演化规律。以经历汶川地震的197名儿童为研究对象,在灾后4、29、40和52个月对其PTSD症状进行了历时4年的追踪测量。网络分析结果显示,闪回的中心性一直较高,而其他高中心性的症状随时间的推移发生了变化：侵入性想法和创伤线索引发生理性反应的中心性随时间推移呈上升趋势,线索引发情感反应和未来无望的中心性随时间推移呈下降趋势。本研究拓宽了学界对儿童PTSD症状学的认识, 并为建立灾后阶段性干预模式提供启示。     

Associations Between Time Since Event and Posttraumatic Growth Among Military Veterans

Despite efforts to understand the antecedents, correlates, and consequences of posttraumatic growth (PTG), the role of time since a traumatic event (time since event) vis-à-vis PTG is not well understood. Part of a larger project exploring experiences following emotionally distressing events among military veterans (N = 197) using Amazon’s Mechanical Turk (Mturk), in the current study, we sought to clarify associations between the time since event and PTG. We used cluster-analytic techniques and analyses of variance to (a) determine the number of clusters, and (b) assess differences in core constructs of PTG and participant characteristics across clusters. Results revealed 4 significantly different groups (i.e., clusters) characterized by differential associations between PTG and time since event. These groups also differed significantly in challenge to core beliefs, level of PTSD symptoms, intrusive and deliberate rumination, and age. The immediate moderate-growth group (Cluster 1) experienced moderate levels of PTG over shorter periods of time, severe PTSD symptoms, and was significantly younger. The low-growth group (Cluster 2) was characterized by minimal PTG, regardless of time, the least challenge to core beliefs, and low amounts of intrusive and deliberate rumination. The long-term small-growth group (Cluster 3) was primarily characterized by small amounts of PTG over longer periods of time. The high-growth group (Cluster 4) was characterized by high PTG, regardless of time, greater challenge to core beliefs, the highest amount of deliberate rumination, and the highest number of PTSD symptoms. Findings underscore heterogeneity within military veterans’ experiences of PTG over time.     

Breast Cancer as Trauma: Posttraumatic Stress and Posttraumatic Growth

Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another. Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes.     

中小学教师PTSD和PTG的影响因素研究：灾难前-中-后的视角

采用事件影响量表、创伤后成长问卷、社会支持问卷、应对方式问卷等对汶川地震1年后极重灾区的106名中小学教师进行调查,考察前灾难因子、灾难当下因子和后灾难因子等对教师创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响。结果发现：（1）灾后中小学教师的PTSD处于中低水平、PTG处于中上水平,其中女教师的PTSD和PTG水平高于男教师,班主任教师PTSD水平高于非班主任教师,有过被困经历的教师PTSD水平高于没有被困经历的教师,有亲朋或学生受伤的教师其PTSD和PTG水平均高于无亲朋或学生受伤的教师;（2）社会支持对PTSD没有显著的预测作用,社会支持中的信息支持可以促进PTG,而情感支持和实质性支持对PTG没有显著的影响;（3）逃避的应对方式能显著地正向预测PTSD,问题解决的应对方式能显著正向地预测PTG,而寻求帮助的应对方式对PTSD和PTG都不具有显著的影响。     

Path analytic examination of a cognitive model of PTSD

Ehlers and Clark (2000) developed a cognitive model of posttraumatic stress disorder (PTSD) symptom maintenance which implicated the role of posttraumatic cognitions and aspects of the trauma memory in maintaining symptoms via an increased sense of current threat. The aim of the current study was to empirically test a variant of this model using path analysis. Participants in the current study were 514 undergraduates at a midwestern university who reported experiencing at least one traumatic event. Path analyses examined various models of the possible relationships between one’s posttraumatic cognitions and the centrality of the traumatic event to the sense of self (considered an aspect of memory integration) in predicting current level of PTSD symptoms. Results indicate that both event centrality and posttraumatic cognitions are unique and independent predictors of current symptom level. Overall, the results of this study support aspects of Ehlers and Clark’s cognitive model of PTSD; cognitive appraisals of the self and centrality of the event were highly related to levels of distress. However, the current study suggests that overly integrated trauma memories may lead to greater distress and not poorly integrated ones as suggested by Ehlers and Clark.     

术后乳腺癌患者体象对创伤后应激障碍和创伤后成长的影响：反刍的中介作用

为探讨乳腺癌患者反刍这一认知情绪调节方式在体象和创伤后应激障碍（PTSD）、创伤后成长（PTG）之间的中介作用，采用体象量表（BIS）、认知情绪调节问卷中文版（CERQ-C）、创伤后应激障碍量表（PSS）和创伤后成长问卷（PTGI）对150名乳腺癌术后患者进行研究。结果发现：（1）乳腺癌患者的体象可以正向预测PTSD和PTG；（2）乳腺癌患者的反刍在体象和PTSD的闯入性症状、回避性症状中起中介作用，在体象与PTG中的中介作用不显著。结果表明，体象既可以正向预测乳腺癌患者的PTSD和PTG，也可以通过反刍的中介作用影响PTSD。     

Posttraumatic Growth in Trauma Survivors: Associations With Attachment to God and God Representation

Individuals often turn to religion or spirituality to cope with or make sense of trauma. In this study of 222 university students who reported a history of trauma, we examined whether God representation and attachment to God were associated with posttraumatic outcomes. Trauma outcomes include both the negative impacts of trauma and the perceived posttraumatic growth (PTG) that can occur in trauma survivors. Results revealed that both an authoritarian representation of God and an avoidant attachment to God were predictive of experiences of PTG.     

Relationship of posttraumatic growth to symptoms of posttraumatic stress disorder and depression: A pilot study of Iraqi students

Posttraumatic growth (PTG) and psychopathology are common outcomes following exposure to adversity and trauma. We examined the relationship of PTG to posttraumatic stress disorder (PTSD) and depression in a group of young Iraqi students with war trauma exposure. These young Iraqis had experienced an average of 13 different war‐related adversities. The prevalence of probable PTSD was 17.2% and probable depression 23.1%. PTSD was associated with higher and depression with lower PTG. In addition, the relationship between PTG and PTSD was stronger among males than females. Although PTSD and depression were relatively common, they were related to PTG in opposite directions.