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。     

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。     

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.     

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。     

Post-traumatic stress symptoms and post-traumatic growth in children and adolescents 12 months and 24 months after the earthquake and tsunamis in Chile in 2010: A longitudinal study

On 27 February 2010, Chile experienced one of the strongest earthquakes in recorded history. The study aimed to evaluate post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in children and adolescents 12 months (T1) and 24 months (T2) after the earthquake and tsunamis in Chile in 2010. Three hundred twenty-five children and adolescents (47.4% girls; 52.6% boys) between the ages of 10 and 16 years participated in the study. The instruments included the Revised Post-traumatic Growth Inventory for Children by Kilmer et al., the Childhood PTSD Scale by Foa et al. and the Rumination Scale for Children by Cryder et al., as well as a scale to assess the severity of the event and a sociodemographic questionnaire. The PTSS and PTG scores decreased at T2. In addition, the main predictors of PTSS and PTG were disruptive experiences, losses after the event and intrusive and deliberate rumination during the previous year. These results enhance understanding of factors related to PTG, improve the ability to predict PTSS and PTG in children and adolescents following natural disasters, and inform the design of intervention strategies to promote better mental health in those affected.     

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.     

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。     

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。     

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。     

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.     

Intrusive versus deliberate rumination in posttraumatic growth across US and Japanese samples

To examine the role of rumination in the aftermath of traumatic/stressful events, posttraumatic growth (PTG) and the four types of rumination (i.e., intrusive rumination soon after the event, intrusive rumination recently, deliberate rumination soon after the event, and deliberate rumination recently) were assessed retrospectively for participants from the USA (N=224) and Japan (N=431). The results from a hierarchical regression analysis revealed that the hypothesized relationships among the four types of rumination and PTG were largely supported. Intrusive rumination soon after the event was positively related to PTG but recent deliberate rumination most strongly predicted the current levels of PTG for both samples. Some evidence for cultural differences in the role of rumination in PTG was also observed. In the US sample, deliberate rumination recently was more important than the deliberate rumination in the immediate aftermath of the traumatic/stressful event, whereas in the Japanese sample, deliberate rumination both soon after and recently were positively related to PTG. The results illustrate the importance of considering rumination as multidimensional and as varying across time in its impact on PTG. Future directions and clinical implications were discussed.     

The relationship among resilience,rumination and posttraumatic growth in hemodialysis patients in North China

Research has indicated that clinical serious disease may lead to posttraumatic growth (PTG). However, little is known about PTG among hemodialysis (HD) patients. The study examined the relationship among resilience, rumination and PTG among Chinese HD patients. 196 HD patients were recruited from a tertiary hospital in a Northern city of China between 1 June 2015 and 30 May 2016. Patients were surveyed using the Posttraumatic Growth Inventory-Chinese version, Connor-Davidson Resilience Scale, and Chinese Event Related Rumination Inventory. Correlation analyses showed that resilience was most highly positively correlated with PTG (r = .70, p < .001), deliberate rumination moderately correlated to PTG (r = .50, p < .001), and intrusive rumination was lower negatively related to PTG (r = –.26, p < .001). Regression analyses showed that age, gender, duration of dialysis, resilience and deliberate rumination had significant associations with PTG (β = ?.31, p ＜ .0001; β = –.14, p = .002; β = .10, p = .032; β = .44, p < .001; β = .20, p < .001). They together explained 65% of the total variance in PTG (F [8,195] = 46.74, p < .001). However, intrusive rumination was not associated with PTG (p > .05). The results suggested that resilience and deliberate rumination may be instrumental for PTG improvement.     

Predictors of Growth in the Aftermath of Traumatic Events: The Role of Personal Growth Initiative

The current study examined the role of personal growth initiative (PGI) in predicting posttraumatic growth and posttraumatic stress, and the extent to which rumination styles explain these relations among 286 college students. As predicted, results showed that the cognitive component of PGI negatively predicted posttraumatic stress. Also, there was a significant positive indirect effect of behavioral PGI on posttraumatic growth through deliberate rumination. However, contrary to our hypothesis, there were also significant positive indirect effects of behavioral PGI on posttraumatic stress through intrusive and deliberate rumination. The current study creates new insights on the application of PGI in trauma research.     

An item-level analysis of the Posttraumatic Growth Inventory: Relationships with an examination of core beliefs and deliberate rumination

Posttraumatic growth (PTG), positive change that may occur as a result of psychological struggle with a traumatic event, has been widely reported across cultures. However, there is some disagreement on how the self-reported PTG, measured by the PTG Inventory (PTGI), reflects the construct that is described in PTG theory. The current study was designed to conduct an item-level analysis of the PTGI to identify the type of growth that is explained by an examination of one's core beliefs and deliberate rumination — two major precursors for PTG, according to a PTG theoretical model. A multivariate multiple regression analysis predicting each of the PTGI items was conducted with young adults who experienced the Great East Japan Earthquake (N = 316). Results indicated that five out of 21 items were explained by both core beliefs' examination and deliberate rumination and 13 were explained by only core beliefs' examination. Three items were not accounted for by either core beliefs' examination or deliberate rumination. These findings indicate that most types of PTG assessed by the PTGI are likely to occur when core beliefs are challenged; however, some types of PTG may occur without cognitive effort. Future research should consider the variation within the PTGI.     

Relationship between religious beliefs and post-traumatic growth in patients with cancer in southeast of Iran

Information about religious beliefs and post-traumatic growth is limited in Iranian cancer patients. This study was conducted to determine the relationship between religious beliefs and post-traumatic growth among cancer patients in Iran. This correlational study included a convenience sample of 200 eligible cancer patients who were hospitalized in the oncology wards and outpatient clinics. Using Post-traumatic Growth Inventory (PTGI) and Religious Beliefs Scale, data were collected. Findings showed that, the total mean score of PTG was 93.81 (SD?=?15.25). Among the categories, the lowest score belonged to “appreciation of life” component (7.67±1.99), and the highest score belonged to “spiritual change” component (67.49 ± 17.78). The mean score of Religious Beliefs Scale was 67.20 (12.35). Post-traumatic growth positively correlated with religious beliefs (r?=?.345; p?=?.001). The results suggest that, information about religious beliefs and post-traumatic growth should be included in the continuous and in-service education of cancer patients and nurses who work with them.     

自我隐瞒对消防员创伤后应激反应的影响：经验回避和反刍的链式多重中介作用

人格特质和情绪调节策略是创伤后应激反应的重要影响因素。作为一种在个人感到痛苦时有意地向他人隐藏自身状况的人格特质,自我隐瞒会通过适应不良的情绪调节策略影响心理健康。然而,鲜有研究考察自我隐瞒、适应不良的情绪调节策略与创伤后应激反应的关系。对创伤后应激反应的情绪调节策略的研究发现,经验回避和反刍是两种有重要影响的适应不良的情绪调节策略。在创伤后应激反应的研究对象上,前人主要关注在创伤事件中幸存的直接受害者身上,而对频繁处理各类突发事件而成为创伤后应激反应高危人群的消防员一直缺乏研究。因此,本研究意在考察自我隐瞒对经历职业创伤的消防员创伤后应激反应的影响以及经验回避和反刍这两种适应不良的情绪调节策略的中介作用。 研究被试为215名将个人经历的职业创伤作为首要创伤事件的一线消防员。他们来自我国3个城市,均为男性,平均年龄22.90±3.38岁。使用中文修订版的埃森创伤问卷、自我隐瞒量表、反刍反应量表、接受与承诺问卷第二版和事件影响量表进行现场调查。被试均匿名填写调查问卷。使用SPSS20.0进行描述性统计和相关性分析。使用Mplus7.4进行结构方程模型的分析。采用Harman单因子检验的方法进行共同方法偏差检验。采用偏差矫正的百分位Bootstrap方法进行中介效应的显著性检验。 结果表明,自我隐瞒、经验回避、反刍和创伤后应激反应之间存在两两显著正相关;自我隐瞒对创伤后应激反应具有直接效应;自我隐瞒通过反刍对创伤后应激反应产生间接效应;自我隐瞒通过经验回避-反刍的中介链对创伤后应激反应产生间接效应;自我隐瞒影响创伤后应激反应的总效应值为0.427,其中总间接效应值为0.217,占总效应值的50.82%。本研究还发现,64名(29.77%)将个人经历的职业创伤作为首要创伤事件的一线消防员达到了严重创伤后应激反应的水平。 总之,自我隐瞒可以通过三条路径影响创伤后应激反应：直接影响、反刍的中介作用和经验回避-反刍的系列中介作用。在理论层面,这拓展了对影响创伤后应激反应的人格特质的理解和对自我隐瞒影响的心理健康状况的理解。在实践层面,这提示我们重视自我隐瞒、经验回避和反刍在预防和治疗创伤后应激反应中的潜在贡献。此外,本研究还发现,消防员确实是创伤后应激反应的高危人群。作为突发事件的第一响应人,消防员的心理健康应该得到更多关注与研究。     

Rumination,Resilience, and Posttraumatic Stress Disorder Symptom Severity Among Veterans of Iraq and Afghanistan

This study investigated the relationships among combat exposure, intrusive, and deliberate rumination, resilience, and posttraumatic stress disorder (PTSD) among service members who deployed to Iraq or Afghanistan (N = 191). Participants completed an online survey and hierarchical linear regression results indicated that enlisted rank, higher combat exposure, lower resilience, and higher intrusive rumination predicted higher levels of PTSD symptom severity. Resilience moderated the relationship between combat exposure and PTSD symptom severity, such that participants who had higher levels of resilience had lower levels of PTSD symptom severity at all levels of combat exposure. These findings suggest the importance of increasing resilience in combat veterans, specifically those of enlisted rank and veterans exposed to higher levels of combat. Findings also suggest that teaching veterans how to control or minimize intrusive rumination might help lower PTSD severity.     

Depressed mood mediates the relationship between rumination and intrusions

Research suggests that rumination is a causal factor for intrusive memories. These are disturbing autobiographical memories that pop into one's mind involuntarily, spontaneously, and repetitively. A three‐wave longitudinal study was conducted to replicate this finding and to test whether one route via which rumination leads to (an increase in) intrusive memories is via depressed affect. Secondary school students (n = 72) filled out self‐report questionnaires measuring their level of rumination, depressive symptoms (DS), and intrusive memories. These were administered at three different points, with 3 weeks in between each measurement. Two types of rumination were measured, that is, depressive rumination and rumination in response to intrusions. Both bootstrapping analyses and cross‐lagged analyses yielded evidence for DS as a partial mediator of the relationship between rumination and intrusion frequency. Both depressive rumination and rumination about the content of intrusive memories seemed to be maladaptive: They may exacerbate negative emotions, which in turn trigger intrusive memories. Ruminative thinking also directly led to (an increase in) intrusive memories. These findings might suggest that people suffering from intrusive memories may benefit not only from therapies directly aimed at reducing intrusions but also from therapies aimed at reducing rumination and DS.     

Examining the role of positive and negative metacognitive beliefs in depression

Many psychological models have been developed to explain the development and maintenance of depression. The most widely evaluated model is the cognitive model of depression, and it is against this model that emerging models should be compared. Accordingly, this cross‐sectional study examined whether metacognitive beliefs, as specified in the metacognitive model of depression, would explain additional variance in depressive symptoms over dysfunctional attitudes; the core feature of the cognitive model. Moreover, mediational relationships between metacognitive beliefs, rumination, and depressive symptoms, predicted by the metacognitive model were also explored, whilst controlling for dysfunctional attitudes. A sample of 715 students completed self‐report questionnaires measuring depressive symptoms, rumination, dysfunctional attitudes, and metacognitive beliefs. Regression analyses showed that metacognitive beliefs made a significant statistical contribution to depressive symptoms, after controlling for age, gender, rumination and dysfunctional attitudes. Furthermore, as predicted by the metacognitive model, the relationship between positive metacognitive beliefs and depressive symptoms was fully mediated by rumination, whilst the relationship between negative metacognitive beliefs about uncontrollability and danger and depressive symptoms was partially mediated by rumination. The results provide further empirical support for the metacognitive model of depression and indicate that positive and negative metacognitive beliefs play an integral role in the maintenance of depressive symptoms.     

High dose alcohol consumption predicts less reduction in post-traumatic stress symptoms after a campus mass shooting

Background: Recognizing that alcohol might affect subsequent processing of trauma-related information, this study examined whether high dose alcohol consumption (HDAC) following a campus mass shooting affected the relation between shooting exposure and post-traumatic stress symptoms (PTSS).

Methods: Female participants (N?=?691) recorded levels of physical exposure to the shooting event, alcohol use, and PTSS 1 month following the shooting event and 8 months later.

Results: No evidence was found to suggest that pre-shooting HDAC moderated the relationship between trauma exposure and PTSS 1 month following the shooting. HDAC in the month following the shooting predicted less resolution of PTSS 8 months later. Specifically, at higher (but not lower) levels of HDAC, shooting exposure was associated with less reduction in PTSS from 1 to 8 months post-trauma. Several alternate explanations were ruled out.

Conclusions: Less reduction in PTSS seems to occur at high levels of both shooting exposure and HDAC. Theoretical implications and directions for future research are discussed.