Coping strategies and perceived social support in fibromyalgia syndrome: Relationship with alexithymia

Fibromyalgia (FM ) is a chronic pain syndrome characterized by high levels of psychological distress and alexithymia, a personality disposition affecting emotional self‐awareness. The main aim of the present study was to investigate for the first time the relationship between alexithymia and coping strategies on the one hand, and alexithymia and perceived social support on the other, in a sample of FM patients. To reach this aim, 153 FM patients completed a battery of tests assessing coping strategies, perceived social support, alexithymia, psychological distress and pain intensity. Four regression analyses were performed to assess whether alexithymia was still a significant predictor of coping strategies and perceived social support, after controlling for psychological distress. High levels of both psychological distress and alexithymia were found in our sample of FM patients. Regarding coping strategies, FM patients reported higher scores on problem‐focused coping, with respect to the other two coping strategies. The regression analyses showed that the externally‐oriented thinking factor of alexithymia significantly explained both problem‐ and emotion‐focused coping, while the difficulty‐describing feelings factor of alexithymia proved to be a significant predictor of perceived social support. Only the variance of dysfunctional coping ceased to be uniquely explained by alexithymia (difficulty identifying feelings factor), after controlling for psychological distress, particularly anxiety. These results highlight a negative relationship between alexithymia and both the use of effective coping strategies and the levels of perceived social support in FM patients. An adequate assessment of both alexithymia and psychological distress should therefore be included in clinical practice with these patients.     

Alexithymia and aspects of dreaming: Differential associations of alexithymia facets with dream variables

Research on aspects of dreaming associated with alexithymia has yielded mixed results. The present study recruited a young adult online sample of 577 participants who completed validated indices of alexithymia, emotion suppression, negative moods, and eight aspects of dreaming, with a focus on evaluating a counterintuitive previous finding that alexithymia and two of its core facets were associated with greater self-reported typical emotional intensity of dreams. Total alexithymia and facet scores showed differential relationships to aspects of dreaming including dream recall frequency, emotionality, meaningfulness, nightmare frequency, nightmare distress, usefulness of dreams in problem-solving and creativity, and learning about oneself through dreams. Planned hierarchical regression controlling for demographics, alcohol use, and dream recall frequency indicated that the difficulties identifying feelings (DIF) facet of alexithymia was a significant positive predictor of dream emotionality, whereas the externally oriented thinking (EOT) facet was a significant negative predictor. Stress, but not emotion suppression, mediated the positive relationship between DIF and dream emotionality. The likely role of dream emotionality in higher ratings of nightmare distress, dream meaningfulness, and learning about oneself through dreams among those with higher DIF scores is noted, along with other findings and the strengths and limitations of the study.     

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.     

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.     

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.     

PTSD与PTG的关系：来自教师群体的追踪研究证据

采用追踪研究的方式,在汶川地震后一年和一年半两个时间点,对极重灾区的116名中小学教师进行问卷调查,通过建立交叉滞后模型,探讨其创伤后应激障碍（PTSD）和创伤后成长（PTG）在时间进程中的相互关系。结果显示：（1）震后一年和一年半的教师,其PTSD水平较低,PTG水平中等,两者具有一定稳定性;（2）在同一个时间点上,PTSD和PTG的相关不显著;（3）震后一年的PTG能显著负向预测震后一年半的PTSD,而震后一年的PTSD不能显著预测震后一年半的PTG。成长对于长期的创伤后负性应激降低有积极作用,可采用积极的视角来进行心理重建。     

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.     

Finding words for feelings: The relationship between personality disorders and alexithymia

This study examined whether personality disorders (PDs) are associated with alexithymic features at varying levels of comorbid psychopathology distress. 167 psychiatric outpatients completed the Toronto Alexithymia Scale (TAS) and the General Severity Index (GSI) of the SCL90-revised. Bootstrapping analyses were performed to test whether the PD/alexithymia relationship was moderated by psychopathology distress (GSI). The overall number of PD criteria was associated with cognitive aspects of alexithymia (i.e., Externally Oriented Thinking, EOT) only at low/moderate levels of distress. Borderline criteria predicted EOT only when distress was low, while avoidant and dependent criteria were independently related with EOT. No association was found between other PDs and alexithymia facets. Thus, within clinical samples the alexithymia/PD association is mainly explained by comorbid psychopathology; however, individuals with avoidant, dependent and borderline features might have a specific difficulty with focusing on internal reality, even when their current symptom distress is low.     

Post-traumatic Growth in Breast Cancer Survivors: New Insights into its Relationships with Well-Being and Distress

Research investigating possible relations between Post-traumatic growth (PTG) and clinical indexes—such as psychosocial distress, physical and psychological well-being—is lacking in medical settings. The aim of this study was to look into such relationships in breast cancer survivors (Bcs) and in healthy control subjects who experienced other stressful events. Sixty Bcs and 60 healthy women reporting other stressful events were compared according to the following scales: Post-traumatic Growth Inventory, Psychological Well-being Scales (PWB), Symptom Questionnaire and Psychosocial Index. Bcs reported significantly higher levels of PTG and distress, and lower levels of PWB compared to healthy women. Bcs with high levels of PTG showed increased levels of physical well-being and decreased distress. Healthy women under stressful circumstances reporting high levels of PTG showed increased levels of PWB. PTG levels were higher in Bcs and associated with decreased psychological distress and somatisation. These results carry important implications for clinical assessment, as well as for planning interventions to improve well-being and resilience in oncology.     

Psychological Adjustment,Coping, and Emotion Regulation as Predictors of Posttraumatic Growth

Abstract

The present study examined factors contributing to reported benefits of traumatic experiences or posttraumatic growth (PTG) in a college sample. Specifically, we examined dimensions typically associated with trauma recovery (i.e., psychological functioning, coping, emotion regulation) and features of the trauma (i.e., number and recency of traumatic events, average, and maximal distress). Participants (N= 193) completed standardized questionnaires measuring these constructs. Results indicated that active coping and subjective well-being independently contributed to PTG, but social desirability and symptom distress were independent of growth. These results were consistent with study expectations. Although not specifically predicted, maximal trauma distress also uniquely predicted PTG. Contrary to expectations, effective emotion regulation did not contribute to PTG.     

Posttraumatic Growth and HIV: A Study on Associations of Stigma and Social Support

The present study investigated the influence of HIV‐related stigma and social support on posttraumatic growth (PTG) in adults with HIV (N = 126). The study examined if social support moderated the relationship between stigma and PTG. Results from the study revealed that the predictor variables contributed significantly to PTG following an HIV diagnosis; however, no significant interaction effect between the 2 variables was found. Implications for counselors and directions for future research are provided.     

Religious coping,general coping strategies,perceived social support,PTSD symptoms,resilience, and posttraumatic growth among survivors of the 2010 earthquake in Haiti

This study examines the relationships between coping strategies, perceived social support, resilience, PTSD symptoms, and posttraumatic growth (PTG) in a sample of 256 survivors of the 2010 Haiti earthquake. The results of the bivariate analysis suggested a significant positive correlation between PTG and resilience, PTSD symptoms, perceived social support, positive religious coping, and active coping. There was a significant positive relationship between perceived social support and resilience and between resilience and active coping. PTSD symptoms were positively correlated with both positive and negative religious coping. Results of the multiple regression analysis indicated that positive religious coping, active coping, perceived social support, resilience, and PTSD symptoms accounted for 34% of the variance in the participants’ PTG. The strongest predictor of PTG was positive religious coping, followed by active coping, perceived social support, resilience, PTSD symptoms, and negative religious coping. Implications and recommendations for future research were discussed.     

Exploring posttraumatic growth in Tamil children affected by the Indian Ocean Tsunami in 2004

Few studies explore posttraumatic growth (PTG) in children from Eastern cultures. To help address this gap, the present study examined PTG among 177 South Indian children aged 8–17 years who were affected by the 2004 Tsunami. The study identifies the underlying factor structure of the Tamil version of the Revised Posttraumatic Growth Inventory for Children (PTGI‐C‐R), and aims to explore the prevalence of PTG, the relationship between distress and growth, and gender and age differences in PTG. The results of the principal component analysis indicated a two‐factor structure with an interpersonal and a person‐centred dimension of growth. The total scores of the Tamil PTGI‐C‐R were positively associated with posttraumatic stress symptoms (PTSS) and age. Moreover, there was a significant relationship between age and the person‐centred growth subscale. Non‐parametric tests found no gender differences in perceived growth. The role of socio‐cultural factors on the nature of PTG is discussed.     

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.     

Alexithymia--state or trait?

Alexithymia refers to a specific disturbance in emotional processing that is manifested by difficulties in identifying and verbalizing feelings and a tendency to focus on and amplify the somatic sensations that accompany emotional arousal. Alexithymia is conceptualized both as an affect-deficit disorder and a continuous personality variable. The main purpose of the present study was to investigate the stability levels of alexithymia with regard to changes in emotional distress levels caused by university exams. We tested 20 university students at four different times, before and after the exams. Alexithymic features and self-reported emotional distress (trait anxiety and physical symptoms) were measured. Whereas emotional distress measures changed significantly during the diverse phases, the level of alexithymia remained unchanged. We therefore conclude that alexithymia represents a constant trait.     

Stability in alexithymia levels: A longitudinal analysis on various emotional answers

Alexithymia refers to a specific disturbance in emotional processing that is manifested through difficulties in identifying and verbalizing feelings, and a tendency to focus and amplify the somatic sensations accompanying emotional arousal. The main purpose of the present study was to investigate the stability levels of alexithymia related to changes in emotional distress levels caused by university exams at two different times: after and during the exams. We carried out a 17-week follow-up on 36 university students, alexithymic features and self-reported emotional distress (anxiety, depression and somatic illness) were measured. Whereas emotional distress measures changed significantly during the follow-up period, the degree of alexithymia remained unchanged. We conclude therefore that alexithymia presents a constant trait in non-clinical samples, in contrast to anxiety and depression, which are state phenomena, influenced by stress levels.     

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.     

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.     

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.     

Variables Related to Posttraumatic Growth in Turkish Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is a chronic, deteriorative disease, which can cause great psychological distress. Although RA has negative psychological consequences, it may also lead to positive changes, which has been given relatively little attention in the research literature. The Posttraumatic Growth Inventory (PTGI) has been used to evaluate growth in survivor’s thinking, feeling and/or behavior following the experiencing of traumatic or severely adverse life events. The purpose of the current study was to examine the domains of the PTGI and to identify variables related to Posttraumatic Growth (PTG) in 117 RA patients from Turkey, a secular, Islamic, non-western developing country. Results showed that the PTGI has three domains: relationship with others; philosophy of life; and self-perception. Regression analyses showed that problem-focused coping had significant contributions to the total PTG levels and PTGI domains of relationship with others and self-perception. Perceived social support appeared as a significant associate for the total PTG levels and for all three domains. In addition, age and perceived disease severity were found to be significantly related to some domains of PTG. Clinicians, aiming to increase positive experience of RA patients, may need to focus on and facilitate perceived social support and problem-focused coping to facilitate growth experiences.