Contents & Abstracts
Editorial : Posttraumatic
Growth: Is there evidence for changing our practice?
by Colleen A Jackson
This paper examines recovery from first-episode psychosis in terms of models of trauma and posttraumatic growth. Two first-episode psychosis patients (male and female aged 22 and 25 years respectively) who had a diagnosis of Bipolar I Disorder and had been hospitalised at a public mental health inpatient unit and their family members participated. Qualitative data from in-depth interviews suggests that recovery from first-episode psychosis can be conceptualised within a trauma framework. The two first-episode psychosis participants identified their experiences as traumatic and acknowledged elements of posttraumatic growth. The case studies also point to individual differences and needs and demonstrate important areas for research and early intervention practices. Research is also needed to understand the broader complexities of growth and how it relates to the experience of first-episode psychosis and recovery from this event.
Positive psychological changes and growth beyond previous levels of functioning are characteristics of a phenomenon described as Posttraumatic Growth (PTG). Tedeschi, Park & Calhoun (1998) identified 5 outcomes of PTG: increased appreciation of life; sense of new possibilities in life; increased personal strength; improvement in close personal relationships; and positive spiritual change. More recently, PTG has been proposed as a coping style, as well as a coping outcome. Whilst numerous questions arise concerning theoretical, and reliability and validity issues, and conflicting evidence exists regarding PTG’s relationship to posttrauma pathology, the adaptive significance of PTG is gaining the attention of researchers and practitioners. This paper will present an overview of PTG as a posttrauma phenomenon, from a research perspective and in the practice of treatment of trauma survivors. It will outline research findings related to posttrauma responses and PTG and propose current challenges for research and practice.
The emergence of Posttraumatic Growth (PTG) research in an oncology setting is highlighting the different individual and situational characteristics that promote the perception of benefits, in particular the role of coping processes used post-diagnosis. These coping processes were assessed in a sample of 335 men and women, with heterogeneous cancer diagnoses, treated in a regional Australian hospital in a two year time period. Positive change and coping were measured with the Posttraumatic Growth Inventory (PTGI) and the COPE Inventory. Results show that positive reframing is positively correlated with all PTGI factors and focussing on/venting emotions, social support engagement, and active coping are associated with two dimensions of PTG (New Possibilities and Relating to Others). Furthermore, a comparable pattern of correlations between PTG and coping was found in a sample of emergency service workers perceptions of benefits following workplace trauma. The current study highlights the multidimensional nature of PTG and the coping processes associated with different areas of growth. Further research can be conducted longitudinally in order to identify the differential processes of adaptation that lead to each area of growth.
Police officers are in the front line for exposure to critical incidents. This paper argues that while critical incidents can challenge psychological equilibrium, this circumstance should be conceptualized as a catalyst for change rather than as an automatic precursor of posttraumatic pathology. Following a discussion of the relationship between posttraumatic growth and future adaptive capacity, evidence supporting two approaches to examining the relationship between critical incident experience and salutary outcomes is reviewed. One considers how police officers mental models can be developed prior to exposure to increase their adaptive capacity and reduce the likelihood of an experience becoming a critical incident in the first place. The second accommodates the fact that officers will continue to experience novel, unexpected, challenging incidents, and discusses how personal, team and organizational factors interact to render challenging experiences coherent and meanings. The notion of conceptualizing the relationship between traumatic experience and growth and adaptive capacity as a form of punctuated equilibrium is discussed, as is the need to include non-traumatic challenging events in the assessment of posttrauma outcomes in police populations.
Posttraumatic growth (PTG) of 138 adult Thai survivors with physical injuries was assessed at six months following the 2004 Southeast Asian earthquake-tsunami. The prevalence rates for interpersonal and intrapersonal PTG were 32% and 37%, respectively. Hierarchical regression analyses showed that common predictors of inter- and intrapersonal PTG were intrusive, hyper-aroused, and avoidant states, perceived family emotional support, and being married. Younger age, pre-disaster employment, and disaster-related traumatic experiences were specific predictors of interpersonal PTG, while adaptive coping was a specific predictor of intrapersonal PTG. Implications and limitations of this study were discussed.
June 11, 2007