User:Freebeast24/Post-traumatic growth

Introduction == In psychology, post-traumatic growth (PTG) is positive psychological change experienced as a result of struggling with highly challenging, highly stressful life circumstances.[1] These circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to the individual's way of understanding the world and their place in it.[1] Post-traumatic growth involves "life-changing" psychological shifts in thinking and relating to the world and the self, that contribute to a personal process of change, that is deeply meaningful.[1]

Characteristics of Post-Traumatic Growth
People who have experienced post-traumatic growth report changes in the following 5 factors: Appreciation of life; Relating to others; Personal strength; New possibilities; and Spiritual, existential or philosophical change.

The Relationship Between Trauma, PTG, and Other Outcomes
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. While the idea that positive change may occur following trauma may seem paradoxical, it common and well documented. However, not everyone who experiences a traumatic event will necessarily develop post-traumatic growth. This is because growth does not occur as a direct result of trauma; rather, it is the individual's struggle with the new reality in the aftermath of trauma that is crucial in determining the extent to which post-traumatic growth occurs.

While PTG often leads individuals to live in ways that are fulfilling and meaningful, the presence of PTG and distress are not mutually exclusive. Experiencing trauma is typically associated with distress and loss, and PTG does not change this. PTG and negative trauma related outcomes (e.g. PTSD) often coexist. Encouragingly, reports of growth experiences in the aftermath of traumatic events far outnumber reports of psychiatric disorders.

A Model of PTG
Calhoun and Tedeschi (2006) outline their updated model of posttraumatic growth in Handbook of Post-traumatic Growth: Research and Practice. Most importantly, this model includes:


 * Characteristics of the Person and of the Challenging Circumstances
 * Management of Emotional Distress
 * Rumination
 * Self-Disclosure
 * Sociocultural Influences
 * Narrative Development
 * Life Wisdom

Promotive Factors
As far as predictors of post-traumatic growth, a number of factors have been associated with adaptive growth following exposure to a trauma.


 * Stressor Related Factors: Characteristics of the traumatic event may contribute to the development or inhibition of PTG. For example, For PTG to come about, the severity of the traumatic experience must be enough to threaten one's preexisting understanding the world or their personal narrative. However, extremely severe trauma exposure may overwhelm one's ability to comprehend and grow from the experience. Experiencing Multiple Sources of Trauma is also considered promoted of PTG.


 * Response Related Factors: The way in which one responds, behaviorally or psychologically, contributes to wether PTG comes about. The presence of rumination, sharing negative emotions, positive coping strategies (e.g. spirituality), event centrality, resilience, and growth actions are associated with increased PTG. Rumination is considered promotive. In this context, rumination is not necessarily negative and can mean the same thing as cognitive engagement. When this occurs, the individual is investing mental resources into understanding and making sense of their experience. People typically participate in this way to comprehend and explain their experience (Why? How?) and to discover how their experience factors into their perceptions and plans (What does this mean? What now?). While neither is entirely bad, deliberate rather than intrusive rumination can be the most effective at producing growth.  (Tedeschi and Calhoun 2014) (O'Rourke 2008),


 * Person Related Factors: Some personality traits have been found to be associated with increased PTG. These traits include openness, agreeableness, altruistic behaviors, extraversion, conscientiousness, sense of coherence (SOC), sense of purpose, hopefulness, and low neuroticism are associated with PTG. Despite being otherwise undesirable, narcissism is also associated with PTG. These traits may increase an individual's capacity to adapt to traumas, leading to growth.


 * Mediators: Social Support
 * Age: Posttraumatic growth has been studied in children to a lesser extent. A review by Meyerson and colleagues found various relations between social and psychological factors and posttraumatic growth in children and adolescents, but concluded that fundamental questions about its value and function remain.

Psycho-Oncology
The study of those who have experienced cancer has contributed significantly to the understanding of PTG.

Trauma Exposure in Psycho-Oncology

Individuals who are diagnosed with cancer may encounter a traumatic stressor at various points throughout their experience such as financial problems, physical consequences of treatment, fear of death, or fear of recurrence. PTSD is more common among individuals who are diagnosed with cancer than those who have not, and rates of PTSD are higher in those who experience some cancer types (e.g. brain cancer) and treatment types (e.g. chemotherapy) than in others. Cancer type also matters for PTG, as more advanced forms are more strongly associated with growth. The loved ones and care givers of patients may also experience severe stressors which pay lead to PTG. Studying patients of cancer has contributed to the understanding of the relationship between PTSD and PTG, including their understanding as independent constructs rather than opposites.

Promotive Factors in Psycho-Oncology

There are many variables which are associated with development of PTG for oncology patients such as social support, subjective appraisal of the threat, and positive coping strategies. In cancer patients, hope, optimism, spirituality, and positive coping styles are associated with PTG outcomes.

Some psychosocial interventions have been able to support the development of PTG. A recent meta-analysis of randomized controlled trials found that psychosocial interventions for cancer patients, especially mindfulness-based interventions, can facilitate PTG.

Characterizing PTG Outcomes in Psycho-Oncology

Post-traumatic growth takes on many forms in the lives of cancer patients and survivors. More often than not, longer-term survivors experience changes in their perspective on life, interpersonal relationships, or self-perception.

Jimmie Holland, a founder in the field of psycho-oncology, has contributed to the understanding of PTG for cancer patients by sharing her clients' stories. In The Human Side of Cancer Holland told the story of one patient, Jim, whose experience with PTG altered both his perspective on life and his interpersonal relationships. After undergoing radiation for cancer of the vocal cord, Jim found a new appreciation for health and used his experience to motivate his sons to never start smoking. Further, survivors of cancer often discover a new sense of compassion and find new purpose in giving back to others. After surviving osteogenic sarcoma which resulted in the amputation of her leg, Sheila Kussner began giving back by visiting other amputees in hospitals to share support. She later whent on to raise millions of dollars for cancer research and establishing the Hope and Cope program at the Montreal Jewish General hospital which provides psychological support to thousands of patients.

Cultural Differences
Preliminary studies show that there are few differences in post-traumatic growth between cultures. It is now apparent that many survivors of traumatic events come out with positive changes directly attributable to the traumatic event.

What promotes post traumatic growth?
Other studies have shown that there are other factors that have been shown to promote traumatic growth. In a meta-analysis, it was again shown that traumatic experiences can be catalysts for positive change. These changes can include improved relationships, new opportunities, a better outlook and appreciation for life, a greater sense of personal strength, and in some cases, new or renewed spiritual beliefs.

Factors that promote post-traumatic growth includes


 * Sharing negative emotions
 * Cognitive processing
 * Positive coping strategies, like positive reappraisal
 * Personality traits like agreeableness
 * Experiencing multiple sources of trauma
 * Event centrality

A few studies have drawn positive correlations between post-traumatic growth and support for aggressive behaviour.

Another four-factor model describes the overarching dimensions of post-traumatic growth, each with separate facets. They are


 * 1) Personal Strength - the sense of survival after the negative consequences of the event, and the notion that the event was used as a trigger of new self-efficacy. The three facets of personal strength are 1. self as survivor, 2. independence, 3. and self-efficacy/coping. The trauma is perceived as a turning point where the individual gains a sense of independence through their ability to cope with the event.
 * 2) Effortful reinvention of the self - the most frequently found dimension of the four. This dimension has four facets: 1. the decision to change, 2. eliminating the negatives, 3. fostering the positives, and 4. Respect for the self
 * 3) Focus on life's positives - relates to the process of being appreciative of what life presents, regardless of what negative things happen to you. The three facets for this dimension are 1. appreciation of the little things, 2. value for life, and 3. positive appraisals.
 * 4) Compassion - the focus is on being supportive of the people who have/ are experiencing similar events. This dimension has three facets, 1. desire to help others, 2. empathy, 2. understanding.

Cultural Differences[edit]
Preliminary studies show that there are few differences in post-traumatic growth between cultures. It is now apparent that many survivors of traumatic events come out with positive changes directly attributable to the traumatic event.

What promotes post traumatic growth?[edit]
Other studies have shown that there are other factors that have been shown to promote traumatic growth. In a meta-analysis, it was again shown that traumatic experiences can be catalysts for positive change. These changes can include improved relationships, new opportunities, a better outlook and appreciation for life, a greater sense of personal strength, and in some cases, new or renewed spiritual beliefs.

Factors that promote post-traumatic growth includes


 * Sharing negative emotions
 * Cognitive processing
 * Positive coping strategies, like positive reappraisal
 * Personality traits like agreeableness
 * Experiencing multiple sources of trauma
 * Event centrality

A few studies have drawn positive correlations between post-traumatic growth and support for aggressive behaviour.

Another four-factor model describes the overarching dimensions of post-traumatic growth, each with separate facets. They are


 * 1) Personal Strength - the sense of survival after the negative consequences of the event, and the notion that the event was used as a trigger of new self-efficacy. The three facets of personal strength are 1. self as survivor, 2. independence, 3. and self-efficacy/coping. The trauma is perceived as a turning point where the individual gains a sense of independence through their ability to cope with the event.
 * 2) Effortful reinvention of the self - the most frequently found dimension of the four. This dimension has four facets: 1. the decision to change, 2. eliminating the negatives, 3. fostering the positives, and 4. Respect for the self
 * 3) Focus on life's positives - relates to the process of being appreciative of what life presents, regardless of what negative things happen to you. The three facets for this dimension are 1. appreciation of the little things, 2. value for life, and 3. positive appraisals.
 * 4) Compassion - the focus is on being supportive of the people who have/ are experiencing similar events. This dimension has three facets, 1. desire to help others, 2. empathy, 2. understanding.

Gender Differences in Post-Traumatic Growth
Results from 70 studies show that there is a small to moderate gender difference (effect size was 0.27), with women reporting more posttraumatic growth than men. The only other significant predictor was age, as older women report incrementally more posttraumatic growth than younger women. Women also have a higher tendency to experience post-traumatic growth than men.

Cultural Differences in Post-Traumatic Growth
Studies that looked at PTG in other countries that had lower mean PTGI scores. A possible explanation for this is that PTG in other countries may not be completely or properly captured by the PTGI. For example, another study done in China found that a two-factor structure of PTG best fit the Chinese samples of cancer patients. This suggests that the original structure of PTGI and the Chinese structure aren’t fully aligned.

Other evidence that suggests this includes the fact that European samples are less likely to answer spirituality items and do not view religiousness as a strength. So, if the items in a questionnaire don’t fit with a culture’s idea of PTG, it is possible that we aren’t able to fully capture the scale of PTG in those countries. Culture/ country specific items and dimensions would need to be developed in order to fully capture PTG everywhere.

[SN1]Cite the Psychological Trauma wiki page

[SN2]I ADDED THIS (from other wiki article)