Post-traumatic growth as positive personality change: Developing a measure to assess within-person variability

Earlier work has defined post-traumatic growth (PTG) as positive personality change, but measurement of this construct has relied almost exclusively on cross-sectional and retrospective assessments. The aim of this study was to use an experience-sampling procedure to measure the extent to which PTG manifested in individuals’ everyday lives after a recent highly stressful or traumatic adverse event (compared to a control group). In doing so, we developed a state measure of PTG. The factor structure of state PTG was comparable to trait PTG, there was significant variability in individuals’ PTG from moment-to-moment, but individuals’ trait PTG was unrelated to their state PTG. Moreover, individuals who had experienced a recent adversity did not differ from control participants on state PTG.     

社会支持、主动反刍与创伤后成长的关系:基于汶川地震后青少年的追踪研究

本文以追踪研究的方式,在汶川地震后3.5年、4.5年和5.5年三个时间点,采用社会支持问卷、反刍问卷和创伤后成长问卷对汶川地震后245名中学生进行调查。通过建立交叉滞后模型,考察社会支持、主动反刍与创伤后成长的相互作用关系。结果发现,震后3.5年至5.5年间,社会支持对主动反刍和PTG的跨时间点预测作用不显著;主动反刍对PTG具有显著的跨时间点正向预测作用,但对社会支持的跨时间点预测作用不显著;震后3.5年的PTG对震后4.5年的主动反刍具有显著的跨时间点正向预测作用,但震后4.5年的PTG对震后5.5年的主动反刍的跨时间点预测作用不显著;震后3.5年和4.5年的PTG分别对震后4.5年和5.5年的社会支持的跨时间预测作用均不显著。     

汶川地震四年半后青少年的感恩对PTG的影响：社会支持与主动反刍的中介作用

采用问卷法,对汶川地震四年半后的354名中学生进行测试,探究社会支持和主动反刍在感恩与创伤后成长（PTG）关系中的作用。结果发现,感恩不仅对PTG具有直接的正向预测作用,而且可以通过社会支持和主动反刍正向预测PTG,也可以通过社会支持经主动反刍的多重中介来正向预测PTG。说明社会支持与主动反刍在感恩与PTG之间起着部分中介作用,其中主动反刍在社会支持与PTG之间也有部分中介效应。     

Posttraumatic Growth and Sexual Violence: A Literature Review

Posttraumatic growth (PTG) is the positive psychological growth that a person might experience after enduring a traumatic event. PTG is a relatively new area of research identified by researchers because it represents a shift in thinking. Rather than focusing on the negative consequences of trauma, it explores the potential for positive outcomes associated with trauma. Although PTG is well documented across different types of traumas, it is unclear how this kind of growth stems from sexual violence, specifically. This review provides an overview of the literature concerning PTG that is associated with sexual violence. Results across the literature indicate that sexual violence is consistently associated with PTG. However, given the inconsistency in research designs, assessment, and operational definitions used to study PTG, many researchers suggest that it might be difficult to determine how and when PTG occurs. This study provides a literature review of the research on PTG in the aftermath of sexual violence. Important implications for future directions and trauma-based therapy are discussed and include the identification of relevant predictors, the importance of context, and how service providers might benefit from a better understanding of PTG.     

Ceiling Effects and Floor Effects of the Posttraumatic Growth Inventory

The current study investigated the effects of a brief psycho-educational presentation about posttraumatic growth (PTG: positive changes that may occur as a result of psychological struggle with a highly stressful life event) on the self-reported PTG by using the PTG Inventory (PTGI). Few empirical studies have investigated the possible ceiling or floor effects of the PTGI, despite researchers indicating the necessity of longitudinal studies to reveal the PTG processes. This study used a pre-test, brief presentation, and post-test longitudinal design to examine the effects of intervention among adolescents by considering the floor and ceiling effects of the PTGI. Participants, 54 high school students (37 females, 17 males, Mean age?=?15.92 years), completed the PTGI at three weeks interval. Results using the Latent Rank Theory approach demonstrated ceiling effects in students who reported a high degree of PTG at Time 1, and floor effects in students with low PTG at Time 1. Presentation effects were not evident even in those who reported a moderate degree of PTG at Time 1. These findings suggest that it is important to be aware of the ceiling/floor effects while measuring changes in PTG perception over time and that explaining the phenomenon of PTG is not likely to be enough to affect the PTG perceptions.     

青少年核心信念挑战对创伤后成长的影响：反刍与社会支持的作用

采用核心信念问卷、反刍问卷、社会支持问卷和创伤后成长问卷, 以汶川地震4年半后的354名中学生为被试, 考察其核心信念挑战、侵入性反刍、主动反刍、社会支持与创伤后成长之间的关系。结果发现, 地震4年半后青少年创伤后成长的整体水平较高, 其中女生高于男生, 初二学生相对低于高年级学生。结构方程模型的结果显示, 侵入性反刍和主动反刍在核心信念挑战与创伤后成长之间起部分中介作用, 核心信念挑战可以直接正向预测创伤后成长, 也可以通过侵入性反刍对创伤后成长起负向预测作用、通过主动反刍对创伤后成长起正向预测作用、通过侵入性反刍经主动反刍正向预测创伤后成长; 社会支持在侵入性反刍影响创伤后成长的直接路径上不起调节作用, 但在侵入性反刍经主动反刍对创伤后成长的间接路径上起调节作用, 具体表现为侵入性反刍对主动反刍的正向预测作用随着社会支持的增加而降低。     

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.     

The Impact of Stigma and Social Support on Development of Post-traumatic Growth Among Persons Living with HIV

Given high rates of trauma in people living with HIV (PLH) and the health benefits of posttraumatic growth (PTG), understanding how to foster PTG in PLH exposed to trauma could be of interest to clinical psychologists working with this population. The current study examined factors theoretically related to development of PTG in PLH, namely HIV-related stigma, disclosure of HIV status, and emotional support. A sample of 334 HIV-positive adults answered a battery of self-report questionnaires. HIV-related stigma, disclosure to sexual partners, and emotional support were significant predictors of PTG: stigma was associated with lower PTG, whereas disclosure and emotional support were associated with higher PTG. Disclosure and emotional support remained significantly associated with PTG in the model including demographic factors and stigma. These findings highlight the need for development of interventions that can aid PLH in disclosing their HIV status to sexual partners and increasing available social support.     

Patient-targeted googling by psychological therapists: A narrative review of the literature and ethical implications

Background

“Patient-Targeted Googling” (PTG) refers to a healthcare professional using the Internet to discover information about a patient. The present review explores PTG by psychological therapists. The review focused on the prevalence of PTG, how often consent is sought from the patient, and the motivations for and consequences of PTG.

Method

A narrative literature review of published PTG studies was undertaken. Potentially eligible studies were identified by searching PsycINFO, PsycARTICLES, Psychology and Behavioural Sciences Collection, and MEDLINE. Results were screened for suitability for inclusion in the sample (n = 9). All studies were appraised for quality using a structured tool developed for this review.

Results

PTG prevalence rates ranged from 20% to 98%, with rates of non-consent ranging from 60% to 84%. Motivations for PTG included curiosity, to gather new information and to verify existing information. Consequences of PTG included enhancing the therapist's sense of safety and causing harm to the therapeutic relationship.

Discussion

Current literature on PTG is limited and focussed largely in the United States. This review revealed no published PTG studies including UK-based psychological therapists, as well as issues in defining and operationalising PTG. Further research is needed to understand the prevalence of PTG by UK-based psychological therapists, as well as the motivations behind, and consequences of, PTG. This evidence base will inform the development of PTG professional guidelines and training, neither of which currently exist for therapists practising in the UK. Both would be timely given the increasing move of the therapeutic frame to the online environment due to the COVID-19 pandemic.     

汶川地震8.5年后青少年的社会支持与创伤后成长的关系:自我效能感和自尊的中介作用

为考察汶川地震8.5年后青少年的社会支持、自我效能感、自尊与创伤后成长（PTG）之间的关系，利用社会支持问卷、自我效能感问卷、自尊量表和创伤后成长问卷对地震灾区的1185名中学生进行了调查。结果发现，创伤暴露程度对社会支持、自我效能感和自尊均不具有显著影响，但对PTG具有显著的预测作用；而在控制创伤暴露后，社会支持不仅可以直接促进PTG，也可以分别通过自我效能感和自尊促进PTG，还可以通过自我效能感经自尊的多重中介作用来促进PTG，表明自我效能感和自尊在社会支持与PTG的关系中发挥着显著的中介效应。这些结果说明社会支持对PTG影响的一个重要机制是通过提升个体的自我效能感、增加其自尊来实现的。     

青少年的乐观与创伤后成长的关系:希望与反刍的中介作用

采用创伤暴露程度问卷、乐观问卷、希望问卷、反刍问卷和创伤后成长问卷,以雅安地震2.5年后的416名中学生为被试,考察其乐观、希望、反刍与创伤后成长（PTG）之间的关系。结果发现,在控制创伤暴露程度后,雅安地震2.5年后青少年的乐观可以直接正向预测PTG,也可以经过希望来间接地正向预测PTG,还可以通过希望经主动反刍的多重中介来正向预测PTG;甚至乐观还可以通过侵入性反刍经主动反刍间接地负向预测PTG,但预测作用远小于乐观对PTG的促进作用;乐观通过希望不能经侵入性反刍对PTG发挥显著的直接和间接预测作用,且乐观还不能直接通过主动反刍促进PTG。     

社会支持、创伤后应激障碍与创伤后成长之间的关系:来自雅安地震后小学生的追踪研究

本文采用追踪研究的设计,在雅安地震后的6、12和18个月三个时间点,采用社会支持问卷、儿童创伤后应激障碍症状量表、DSM-5的PTSD核查表和创伤后成长问卷对303名小学生进行调查。通过建立交叉滞后模型,考察社会支持、创伤后应激障碍(PTSD)与创伤后成长(PTG)三者之间的关系,结果发现在震后6至18个月之间,PTG对PTSD没有显著的预测作用,震后6个月的PTSD对震后12个月的PTG具有显著的跨时间点的正向预测作用,但是该作用在震后12至18个月之间不再显著;震后6至12个月之间,社会支持对PTSD发挥单向的缓解作用,但与PTG之间不存在显著的预测作用;在12至18个月之间,PTSD可以单向地降低社会支持,且社会支持与PTG之间也存在显著的正向相互预测作用。     

Attentional bias toward emotional stimuli in accidentally injured Chinese patients with different posttraumatic growth levels

Extensive evidence has been obtained that supports an association between an attentional bias (AB) toward negative stimuli and vulnerability to stress-related psychopathology, little is known regarding the characteristics of individual AB in different posttraumatic growth (PTG) levels. The current study used a modified dot-probe task to investigate if individual differences in AB towards either positive or negative emotional stimuli, are related to self-reported PTG. A sample of 202 patients completed the experiment. Patients with low levels of PTG did not exhibit AB toward negative or positive stimuli, patients with medium levels of PTG had difficulty disengaging attention from negative stimuli, patients with high levels of PTG had difficulty disengaging attention from positive stimuli. And the AB towards positive stimuli was only predictive for PTG. An implication of this finding is that there are different characteristics of implicit cognitive processing in patients with different levels of PTG, suggesting the necessity of psychological intervention on the accidentally injured patients.     

Cross-Cultural Challenges to the Construct “Posttraumatic Growth”

Responses of individuals to traumatic events are varied. Traumatic events can lead to positive transformations that are known as posttraumatic growth (PTG). Most of the empirical studies of PTG have been addressed from a Western perspective. Theoretically, the concept appears to be cross-culturally valid, but there has been a fundamental deficiency in operationalizing the concept in regard to cultures that are non-Western. Cultural elements play an important role in influencing the behavior of individuals in the aftermath of trauma. Hence, it is important to conceptualize and measure PTG in the framework of the culture to which the individual belongs. The effects of culture come from both the immediate culture (proximal) and the broader (distal) sources that impact the nature of rumination, cognitive strategies, and the process of growth. This paper addresses various cross-cultural challenges to the construct PTG such as emic versus etic perspectives on PTG, proximate and distal influences of culture on PTG, specific cultural influences on rumination, cognitive strategies, and growth, cultural bias inherent in theories of PTG, and measurement issues of PTG across cultures.     

Coping Functions of Prayer and Posttraumatic Growth

Research on prayer and posttraumatic growth (PTG) indicates that those who pray report more PTG. Research is beginning to identify which types of prayer may be operating in this relationship. We sought to identify specific prayer functions related to PTG while considering differences due to the types of trauma experienced. Participants were trauma survivors from diverse, Midwestern Christian churches (N = 327). Participants completed questionnaires assessing trauma history, prayer coping functions, and PTG. Multiple linear regression analyses found that praying for calm and focus was independently related to higher levels of PTG. When considering all variables in the model, the relationship between prayer for calm and focus and PTG was not significant for those whose most significant trauma was interpersonal in nature, but significant for those with noninterpersonal trauma.     

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress

Background/Objective

There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months’ follow-up. Participants’ PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.     

创伤后成长的促进因素、模型及干预

创伤后成长(Post-traumatic Growth, PTG)是指人们在经历了严重的压力性生活事件或创伤性事件后, 由于对抗压力所引起心理的积极变化。本研究对国外创伤后成长进行归纳概括, 论述了促进创伤后成长的影响因素, 如人格特质、社会支持、益处寻求和意义建构。此外, 归纳了基于不同视角的PTG模型, 提出了促进PTG的干预策略, 针对PTG实证研究中某些相关变量的测量问题提出改进意见。未来应着重于开展具备多个评估点的纵向研究, 建构适用于不同人群的PTG理论模型。     

Are Specific Emotion Regulation Strategies Differentially Associated with Posttraumatic Growth Versus Stress?

Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people navigate recovery from trauma.     

Longitudinal relationships between gratitude,deliberate rumination,and posttraumatic growth in adolescents following the Wenchuan earthquake in China

To examine the longitudinal relationship between gratitude, deliberate rumination and posttraumatic growth (PTG) in the adolescent survivors after the Wenchuan earthquake, 217 adolescent survivors were randomly selected from several primary and secondary schools in the county of Wenchuan, and were assessed by questionnaires at three and a half years (T1), four and a half years (T2), five and a half years (T3) after the Wenchuan earthquake, respectively. The results found that there was a one‐way predictive relationship of gratitude onto PTG from T1 to T3, and gratitude predicted deliberate rumination from T1 to T2 but not T2 to T3. Deliberate rumination only had a significant positive effect on PTG from T2 to T3, and PTG only predicted deliberate rumination from T1 to T2. These results indicated that gratitude could be a stable predictive factor for the development of PTG, and gratitude could also affect PTG by deliberate rumination. In addition, the predictive effect between deliberate rumination and PTG is unstable with time change.     

A Longitudinal Investigation of Posttraumatic Growth in Adult Patients Undergoing Treatment for Acute Leukemia

An acute leukemia diagnosis can be an extremely stressful experience for most patients. Posttraumatic growth (PTG) is positive psychological change experienced following a struggle with highly challenging life circumstances. The current study is the first longitudinal investigation of predictors of PTG and distress in adult acute leukemia patients undergoing induction chemotherapy. Findings suggest that these patients report PTG, and levels of PTG appear to increase over the weeks following leukemia diagnosis and induction chemotherapy. Variables associated with higher total PTG scores over time included greater number of days from baseline, younger age, and greater challenge to core beliefs. Variables associated with higher distress included greater number of days from baseline, greater perceived cancer threat, higher symptom severity, and lower spiritual well-being. Results underscore the critical role that examination of one’s core beliefs may play in the development of PTG over time.