Posttraumatic Growth in Children and Adolescents Exposed to the 2010 Earthquake in Chile and Its Relationship with Rumination and Posttraumatic Stress Symptoms

The aim of this study was to assess a predictive model of posttraumatic growth and posttraumatic stress symptoms in children and adolescents exposed to the earthquake in Chile in 2010. 325 children (47.4% male), aged between 10 and 15 years, were surveyed 12 months after the earthquake. The following tests were administered: the posttraumatic growth inventory for children in its brief version of Kilmer et al., the child PTSD symptom scale of Foa et al., the rumination scale for children of Crider et al., along with a scale to assess the trauma severity and a socio-demographic questionnaire. The model was assessed through a path analysis, which showed that deliberate rumination mediated the relationship between trauma severity and intrusive rumination with posttraumatic growth, that intrusive rumination mediated the relationship between the severity of the event and posttraumatic stress symptoms and that the latter mediated the relationship between intrusive rumination and posttraumatic growth. The sex was included as control variable in the path model. The final model achieved adequate fit indexes. The relevance of rumination processes for the development of the psychological consequences in children and adolescents following a natural disaster and their implications for clinical is discussed.     

Stress-Related Growth in Japanese Adolescents Experiencing High School Entrance Examinations

High school entrance examinations and preparation for them have become a highly stressful experience for many Japanese adolescents. This study examined the relationship between stress-related growth (SRG) and distress resulting from these exams from the perspective of positive meaning-making. Ninth graders (N = 183, 87 females, aged 14–15 years) of a public school in Tokyo participated in the study by responding to a questionnaire survey. Results indicated that meaning-making was positively correlated with SRG (r = .58, p < .001), whereas it was negatively correlated with distress (r = ?.20, p = .006). Moreover, SRG was negatively correlated with distress (r = ?.34, p < .001). Mediation analysis demonstrated that SRG positively mediates the relationship between meaning-making and distress, while distress negatively mediates the relationship between meaning-making and SRG. These results have implications for understanding the causal relationships between SRG and distress, from the perspective of positive meaning-making regarding high school entrance examinations in Japan.     

Psychoeducational Intervention Program about Posttraumatic Growth for Japanese High School Students

This study evaluates the effect of a psychoeducational intervention about posttraumatic growth (PTG) among Japanese adolescents. Study 1 examined whether those who learned about changes related to stress would report higher growth than those who did not. Study 2 examined whether those who learned about PTG perceived more growth than those who learned about negative changes or those who did not learn about potential changes. Findings from both studies indicated that PTG was higher in those who received the intervention program than those who did not. These studies demonstrate the potential effectiveness of a psychoeducational intervention program in fostering adolescents’ perceptions and understanding of their personal growth following stressful experiences. Implications are that the knowledge about not only stress reactions or coping but the possibility of PTG can be integrated into the health education.     

主动反刍、创伤后应激障碍与创伤后成长的关系:一项来自汶川地震后青少年的长程追踪研究

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, 采用反刍问卷、创伤后应激障碍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, 考察主动反刍、创伤后应激障碍与创伤后成长的相互作用关系。结果发现, 震后3.5~5.5年间, 创伤后应激障碍对主动反刍具有跨时间点的正向预测作用, 主动反刍对创伤后应激障碍跨时间点的预测作用不显著;主动反刍与创伤后成长之间存在跨时间点的相互正向预测关系;创伤后应激障碍与创伤后成长之间跨时间点的直接预测作用不显著, 但震后3.5年的创伤后应激障碍可以通过震后4.5年的主动反刍间接地正向预测震后5.5年的创伤后成长;创伤后应激障碍与创伤后成长的横断关系随着时间历程的变化而逐渐减弱。     

青少年创伤后应激障碍和创伤后成长对亲社会行为的影响:生命意义的中介作用

采用创伤暴露程度问卷、创伤后应激障碍症状核查表、创伤后成长问卷、生命意义感量表和亲社会行为问卷,在汶川地震8.5年后对地震极重灾区的1182名中学生进行调查,考察创伤后应激障碍（PTSD）和创伤后成长（PTG）对亲社会行为的影响,并检验存在意义感和寻求意义感在其中的中介作用。结果发现：PTSD可以直接负向预测亲社会行为,也可以通过降低存在意义感进而负向预测亲社会行为,还可以通过提高寻求意义感进而正向预测亲社会行为;PTG可以直接正向预测亲社会行为,也可以分别通过提高存在意义感和寻求意义感进而正向预测亲社会行为。     

社会支持对震后青少年创伤后应激障碍和创伤后成长的影响:自我效能感的中介作用

本研究采用创伤暴露问卷、社会支持问卷、自我效能感量表、创伤后应激障碍症状核查表和创伤后成长问卷,在汶川地震8.5年后对地震极重灾区的1185名中学生进行调查,考察社会支持对创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响,并检验自我效能感在其中的中介作用。结果发现：在控制创伤暴露程度、性别和年龄等变量后,社会支持不仅可以直接负向预测PTSD、正向预测PTG,也可以通过自我效能感的中介作用负向预测PTSD、正向预测PTG。这表明,自我效能感在社会支持与PTSD、社会支持与PTG的关系中都具有部分中介效应。     

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。     

Posttraumatic Growth in Combat Veterans

Combat veterans and their families face significant challenges not only to their abilities to cope, but often to their fundamental belief systems. Traumatic events represent assaults on core beliefs, yet at times, produce cognitive processing that can ultimately result in personal transformations called posttraumatic growth (PTG). Clinicians can utilize a systematic therapeutic approach to facilitate PTG as they carry out a relationship of expert companionship. PTG in service members is described in this article, as well as the approach to facilitation of PTG.     

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。     

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.     

Perceived Social Support Mediates the Relations Between Parental Attachment and Posttraumatic Growth and Resilience in Adolescents Following the Yancheng Tornado

Previous studies have shown that parental attachment is associated with higher levels of posttraumatic growth (PTG) and resilience in individuals who have experienced traumatic events. The present study investigated perceived social support as one pathway in which parental attachment is related to PTG and resilience among Chinese adolescents who have experienced trauma by considering the role of perceived social support. Participants were 443 Chinese adolescents who had experienced a severe tornado a year prior to this study. The results showed that our model fitted the data well [χ²/df = 2.847, comparative fit index (CFI) = 0.970, TLI = 0.963, root mean square error of approximation (RMSEA) (90% CI) = 0.065 (0.056–0.073)] and revealed that perceived social support partially mediated the relationship between parental attachment, and PTG and resilience. The clinical implications and limitations of our research, and recommendations for future research are discussed in this paper.     

Posttraumatic Stress Disorder in Children and Adolescents: A Review and Analysis

Only recently has the mental health community recognized the applicability of diagnostic criteria for posttraumatic stress disorder (PTSD) in children and adolescents, including a consideration of specific age-related features. This paper provides a current review of the literature on PTSD pertaining to children and adolescents. Following a discussion of issues on diagnostic criteria and assessment of this affective disorder in this population, there is an overview of the existing literature on prevalence, comorbidity, risk factors, parental and family factors, and issues of gender and age of onset. The remainder of the paper focuses on the range of traumatic stressors in children and adolescents that can result in PTSD, including natural or human disasters, war and violence, chronic or life-threatening medical conditions, community violence and the witnessing of traumatic events, and physical and/or sexual abuse and other forms of interpersonal violence. Throughout the paper, there is an emphasis on the importance of considering developmental factors. Finally, implications of the existing literature for future areas of research are addressed.     

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.     

Event Centrality,Posttraumatic Cognitions,and the Experience of Posttraumatic Growth

This study tested the extent to which negative appraisals following traumatic events and the centrality of traumatic events predicted posttraumatic growth (PTG; Tedeschi &; Calhoun, 1996 Tedeschi, R. G. and Calhoun, L. G. 1996. The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9: 76–80. [Crossref] , [Google Scholar]). Participants were 405 undergraduates at a Midwestern university who reported experiencing at least one traumatic event. Regression analyses indicated that the centrality of the event was a significant predictor for all five domains of PTG. Negative appraisals of the world were related to some domains of growth, but neither negative cognitions about the self nor self-blame was a significant predictor of any of the growth domains. Interpretation of these results is considered in light of the consistencies with Janoff-Bulman's (2004) Janoff-Bulman, R. 2004. Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15: 30–34. [Crossref], [Web of Science ®] , [Google Scholar] explanatory models of development of PTG.     

Rorschach Protocols From Children and Adolescents Diagnosed With Posttraumatic Stress Disorder

Rorschach protocols from 35 children and adolescents with posttraumatic stress disorder (PTSD) and 35 with oppositional defiant disorder (ODD) were compared. Both groups revealed significant differences from the normative tables on the same 12 variables: SCZI, DEPI, CDI, X+%, EgoC, Afr, T, EA, P, WSumC, RawSumSS, and WgtSumSS. However, as predicted, 4 of those variables, the Schizophrenic Index (SCZI) and 3 of the criterion tests that comprise it (X+%, RawSumSS, and WgtSumSS) were significantly different between the PTSD and ODD groups, with the PTSD group responding with more extreme scores. These findings contradict Exner's (1993) statement that only people with schizophrenia can be "defined or conceptualized as having both the problems of disordered thinking and inaccurate perception" (p. 356). Children and adolescents with PTSD also display these problems when trauma interrupts the child's naive belief that the world has predictable rules, the people in it are trustworthy and fair, and punishment and pain are consequences of bad behavior. When young victims cannot comprehend or make sense of what has happened to them, life becomes irrational, illogical, and confusing. Exner's SCZI does what it was designed to do: identify individuals with disordered thinking and inaccurate perception. Therefore, SCZI should be renamed the Perception and Thinking Index (PATI) to reflect its function rather than a diagnostic category.     

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.     

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。     

Posttraumatic Growth After Motor Vehicle Crashes

The relationship between sub-dimensions of posttraumatic growth (PTG) and distress was investigated for survivors of motor vehicle crashes (MVC). PTG and symptoms of posttraumatic stress disorder (PTSD) for 1045 MVC survivors who attended the Accident and Emergency Services were examined with the Chinese versions of the Posttraumatic Growth Inventory (PTGI) and the Impact of Event Scale-Revised 1 week after the experience of a MVC. A factor structure, which was different from both the original English version of the PTGI and the Chinese version of PTGI for cancer survivors, was identified. Factors extracted were: (1) Life and Self Appreciation; (2) New Commitments; (3) Enlightenment; and (4) Relating to Others. However, correlation analyses indicated a functional similarity between factors from this study and those from previous studies. Relations between PTG sub-dimensions and PTSD symptoms were identified. Results from hierarchical multiple regression analysis and structural equation modeling show that there were different predictors for different PTG sub-dimensions. Findings suggest that different modes of relationship between PTSD symptoms and PTG sub-dimensions may co-exist.     

Posttraumatic Growth, Posttraumatic Stress Symptoms and Mental Health Among Coronary Heart Disease Survivors

The present study aimed to estimate posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among heart disease survivors and examine whether PTG moderates the association between PTSS and mental health. Data from 82 myocardial infarction and acute coronary artery bypass graft survivors (aged 46–82) was obtained at admission to a cardiac rehabilitation unit. Mental status was assessed by the PTSD Inventory, Posttraumatic Growth Inventory (PTGI), Mental Health Inventory and Health Related Quality of Life (HRQOL). 17.1 % of the participants suffered significantly from PTSS and most of the study sample (71.2 %) reported PTG. PTSS were positively associated with PTG and psychological distress and negatively with well-being and HRQOL. PTG moderated the association between PTSS and most mental health outcomes. We conclude that posttraumatic growth may attenuate the negative effect of posttraumatic stress symptoms on mental health.