How common is Post-traumatic growth? Psychol Med Jan 2015

12.01.2015

Mental health professionals  deal with  negative consequences of various psychologically traumatic events on a daily basis. Though it is well known that some traumatic events can have positive consequences , this is not been subjected to research much often and usually do not form part of clinicians enquiry.Post traumatic growth (PTG) is reported following a broad range of traumas.Studies report that up to 50% of trauma survivors report at least a ‘moderate’ degree of PTG in one or more dimensions. Some studies show that perceived social support, optimism, extraversion, spirituality, and effort/perseverance are positively associated with PTG.

How common is PTG? What is the relationship between PTSD and PTG?  What factors contribute to PTG?

J. Tsai, R. El-Gabalawy, W. H. Sledge, S. M. Southwick and R. H. Pietrzak report the results of a large population based study with varied trauma history addressing the above questions. National Health and Resilience in Veterans Study (NHRVS) is a nationally representative survey of 3157 US veterans. A self report measure (Trauma History Screen) was used to assess traumatic events . PTSD check list was used to identify trauma symptoms. PTGI-SF was used to identify positive psychological changes.

Results

Half of all veterans reported at least ‘moderate’ PTG in relation to their ‘worst’ traumatic event. Among veterans who screened positive for PTSD, 72.0% endorsed ‘moderate’ to ‘very great’ PTG on any of the PTGI-SF subscales , with the highest percentages observed for the ‘relation to others’ and the ‘new possibilities’ subscales.

A curvilinear association ( inverted U)  best described the association between life- time PTSD symptoms and PTG, i.e. the PTG initially  increase as the PTSd check list score increase and then decrease  as scores further increase.Presence of PTG correlated with better mental well being and general health. ‘worst’ traumatic event found to be most strongly associated with PTG was a life-threatening illness or injury. Social connectedness, intrinsic religiosity and purpose in life, were independently related to PTG

Limitations

This is a cross-sectional design and that precludes any conclusions regarding temporal associations. Retrospective reports have limitations. 90% of  sample were men.

Comments

Identifying PTG and bringing that to treatment discussions is likely to have important positive impact on those with PTSD. Exploring and expanding such positive aspects if done sensitively can be used effectively to enhance the well being. Growth & Distress can coexist.

Summary of the article:

Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study.

Tsai J, El-Gabalawy R, Sledge WH, Southwick SM, Pietrzak RH. Psychol Med. 2015 Jan;45(1):165-79.