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Keywords: Posttraumatic growth, Stress-related growth, Resilience
Common acronyms encountered:
Positive psychology has fuelled interest in post-traumatic
growth over the past decade, but scientific interest
in positive changes following adversity was sparked
much earlier when a handful of studies appeared in the
late 1980s and early 1990s, reporting positive changes
in, e.g., rape survivors, male cardiac patients, bereaved
adults, survivors of shipping disaster and combat
veterans (see Joseph & Butler, 2010 for a review). Then,
the topic of post-traumatic stress disorder (PTSD) was
relatively new (following its introduction in 1980 by
the American Psychiatric Association, 1980) and was
attracting research interest. As such, the relatively few
observations of positive change lay scattered throughout
the literature overshadowed by research on the ways
in which trauma could lead to the destruction and
devastation of a person's life.
Interest took hold during the 1990s (see, e.g., O'Leary & Ickovics, 1995). Various terms were used throughout the literature to describe the positive changes that survivors' experienced, from, e.g., positive changes in outlook (Joseph, Williams, & Yule, 1993), stress-related growth (Park, Cohen, & Murch, 1996), thriving (Abraido-Lanza, Guier, & Colon, 1998) and perceived benefits (McMillen & Fisher, 1998). But most notably, it was the term post-traumatic growth (Tedeschi & Calhoun, 1996) that researchers gravitated to and has now become the term most widely used to describe this field of study and clinical practice.
Post-traumatic growth is a wide-ranging concept, still in development; but to date, three broad domains of positive change have been noted throughout the literature (Tedeschi & Calhoun, 1996). First, relationships are enhanced in some way. For example, people describe that they come to value their friends and family more and feel an increased sense of compassion for others and a longing for more intimate relationships. Second, people change their views of themselves in some way, e.g., that they have a greater sense of personal resiliency, wisdom and strength, perhaps coupled with a greater acceptance of their vulnerabilities and limitations. Third, people describe changes in their life philosophy, e.g., finding a fresh appreciation for each new day and re-evaluating their understanding of what really matters in life (Joseph, Murphy, & Regel, 2012, p.317).
Following is the text of two articles summarizing posttraumatic growth, Tedeschi and Calhoun (2004c) and Joseph and Butler (2010). I then present an excerpt from an article by Coyne and Tennen (2010) that raises a number of critical concerns about posttraumatic growth. This critical review includes research questioning the Posttraumatic Growth Inventory.
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There is a long tradition in psychiatry, reaching at least back to World War I, of studying the response of people who are faced with traumatic circumstances and devising ways to restore them to psychological health. The main focus of this work has been on the ways in which traumatic events are precursors to psychological and physical problems. This negative focus is understandable and appropriate to the requirements of these contexts. However, only a minority of people exposed to traumatic events develop long-standing psychiatric disorders.
Although not prevalent in either clinical or research settings, there has been a very long tradition of viewing human suffering as offering the possibility for the origin of significant good. A central theme of much philosophical inquiry—and the work of novelists, dramatists and poets—has included attempts to understand and discover the meaning of human suffering (Tedeschi and Calhoun, 1995). In the 20th century, several clinicians and scientists have addressed the ways in which critical life crises offered possibilities for positive personal change (e.g., Caplan, 1964; Frankl, 1963; Maslow, 1970; Yalom and Lieberman, 1991). However, the widespread assumption that trauma will often result in disorder should not be replaced with expectations that growth is an inevitable result. Instead, continuing personal distress and growth often coexist (Cadell et al., 2003).
In the developing literature on posttraumatic growth, we have found that reports of growth experiences in the aftermath of traumatic events far outnumber reports of psychiatric disorders (Quarantelli, 1985; Tedeschi, 1999). This is despite the fact that we are concerned with truly traumatic circumstances rather than everyday stressors. Reports of posttraumatic growth have been found in people who have experienced bereavement, rheumatoid arthritis, HIV infection, cancer, bone marrow transplantation, heart attacks, coping with the medical problems of children, transportation accidents, house fires, sexual assault and sexual abuse, combat, refugee experiences, and being taken hostage (Tedeschi and Calhoun, in press).
The Domains of Posttraumatic Growth
The kinds of positive changes individuals experience in their struggles with trauma are reflected in models of posttraumatic growth that we have been building (Calhoun and Tedeschi, 1998) and in a measure of posttraumatic growth that we developed based on interviews with many trauma survivors (Tedeschi and Calhoun, 1996). These changes include improved relationships, new possibilities for one's life, a greater appreciation for life, a greater sense of personal strength and spiritual development. There appears to be a basic paradox apprehended by trauma survivors who report these aspects of posttraumatic growth: Their losses have produced valuable gains.
We also find that other paradoxes are involved. For example: "I am more vulnerable, yet stronger." Individuals who experience traumatic life events tend to report—not surprisingly—an increased sense of vulnerability, congruent with the experience of suffering in ways they may not have been able to control or prevent. However, these same people also may report an increased sense of their own capacities to survive and prevail (Calhoun and Tedeschi, 1999). Another experience often reported by trauma survivors is a need to talk about the traumatic events, which sets into motion tests of interpersonal relationships—some pass, others fail. They also may find themselves becoming more comfortable with intimacy and having a greater sense of compassion for others who experience life difficulties.
Individuals who face trauma may be more likely to become cognitively engaged with fundamental existential questions about death and the purpose of life. A commonly reported change is for the individual to value the smaller things in life more and also to consider important changes in the religious, spiritual and existential components of philosophies of life. The specific content varies, of course, contingent on the individual's initial belief system and the cultural contexts within which the struggle with a life crisis occurs. A common theme, however, is that after a spiritual or existential quest, philosophies of life can become more fully developed, satisfying and meaningful. It appears that for many trauma survivors, a period of questioning their beliefs is ushered in because existential or spiritual issues have become more salient and less abstract. Although firm answers to the questions raised by trauma—why do traumatic events happen, what is the point to my life now that this trauma has occurred, why should I continue to struggle—are not necessarily found, grappling with these issues often produces a satisfaction in trauma survivors so that they are experiencing life at a deeper level of awareness. It should be clear by now that the reflections on one's traumas and their aftermath are often unpleasant, although necessary in reconstructing the life narrative and establishing a wiser perspective on living that accommodates these difficult circumstances. Therefore, posttraumatic growth does not necessarily yield less emotional distress.
Cognitive Engagement and Growth
A central theme of the life challenges that are the focus here is their seismic nature (Calhoun and Tedeschi, 1998). Much like earthquakes can impact the physical environment, traumatic circumstances, characterized by their unusual, uncontrollable, potentially irreversible and threatening qualities, can produce an upheaval in trauma survivors' major assumptions about the world, their place in it and how they make sense of their daily lives. In reconsidering these assumptions, there are the seeds for new perspectives on all these matters and a sense that valuable—although painful—lessons have been learned.
As the individual comes to recognize some goals as no longer attainable and that some components of the assumptive world can not assimilate the reality of the aftermath of the trauma, it is possible for the individual to begin to formulate new goals and to revise major components of the assumptive world in ways that acknowledge the and cognitive processing of trauma may be assisted by the disclosure of that internal process to others in socially supportive environments. At some point, trauma survivors may be able to engage in a sort of meta-cognition or reflection on their own processing of their life events, seeing themselves as having spent time making a major alteration of their understanding of themselves and their lives. This becomes part of the life narrative and includes an appreciation for new, more sophisticated ways of grappling with life events (McAdams, 1993).
Facilitating Posttraumatic Growth
The changes that trauma produces are experiential, not merely intellectual, and that is what makes them so powerful for many trauma survivors. This is the same for posttraumatic growth—there is a compelling affective or experiential flavor to it that is important for the clinician to honor. Therefore, the clinician's role is often subtle in this facilitation. The clinician must be well-attuned to the patient when the patient may be in the process of reconstructing schemas, thinking dialectically, recognizing paradox and generating a revised life narrative. What follows are some general guidelines for this process. More extensive discussion and case examples can be found in Calhoun and Tedeschi (1999).
Attention to elements of posttraumatic growth is compatible with a wide variety of approaches that are currently utilized to help people who are dealing with trauma. Initially, clinicians should address high levels of emotional distress, providing the kind of support that can help make this distress manageable (Tedeschi and Calhoun, 1995). Allowing a distressed patient to regain the ability to cognitively engage the aftermath of the trauma in a rather deliberate fashion will promote the possibility for posttraumatic growth.
Clinicians must feel comfortable and be willing to help their patients process their cognitive engagements with existential or spiritual matters and generally respect and work within the existential framework that patients have developed or are trying to rebuild in the aftermath of a trauma. Further-more, although individual patients may need additional specific interventions designed to alleviate crisis-related psychological symptoms, listening—without necessarily trying to solve—tends to allow patients to process trauma into growth (Calhoun and Tedeschi, 1999). In fact, one way of insuring that clinicians practice this sort of approach is to relate to the trauma survivor's story in a personal manner. Being changed oneself as a result of listening to the story of the trauma and its aftermath communicates the highest degree of respect for the patient and encourages them to see the value in their own experience. This acknowledged value is a short step away from posttraumatic growth.
The immediate aftermath of tragedy is a time during which clinicians must be particularly sensitive to the psychological needs of the patient. Never engage in the insensitive introduction of didactic information or trite comments about growth coming from suffering. This is not to say that systematic treatment programs designed for trauma survivors should not include growth-related components, because these may indeed be helpful (Antoni et al., 2001). A posttraumatic growth perspective can be used even in critical incident stress management (Calhoun and Tedeschi, 2000). However, even as part of a systematic intervention program, matters related to growth are best addressed after the individual has had a sufficient amount of time to adapt to the aftermath of the trauma.
Caveats About Posttraumatic Growth
In order to clarify the clinical perspective on posttraumatic growth, we offer these reminders. First, posttraumatic growth occurs in the context of suffering and significant psychological struggle, and a focus on this growth should not come at the expense of empathy for the pain and suffering of trauma survivors. For most trauma survivors, posttraumatic growth and distress will coexist, and the growth emerges from the struggle with coping, not from the trauma itself. Second, trauma is not necessary for growth. Individuals can mature and develop in meaningful ways without experiencing tragedy or trauma. Third, in no way are we suggesting that trauma is "good." We regard life crises, loss and trauma as undesirable, and our wish would be that nobody would have to experience such life events. Fourth, posttraumatic growth is neither universal nor inevitable. Although a majority of individuals experiencing a wide array of highly challenging life circumstances experience posttraumatic growth, there are also a significant number of people who experience little or no growth in their struggle with trauma. This sort of outcome is quite acceptable—we are not raising the bar on trauma survivors, so that they are to be expected to show posttraumatic growth before being considered recovered.
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Throughout human history the theme of positive changes following adversity is found in literature, religions, and philosophies. Most notable is Nietzsche's famous dictum, "What doesn't kill me makes me stronger." It was an idea also common to the existential and humanistic traditions of psychology of the mid-twentieth century. Viktor Frankl wrote about the will to meaning following his experiences in Theresienstadt and Auschwitz, and Abraham Maslow noted that confrontations with tragedy were often precursors to self-actualization. Scientific interest was sparked when a handful of studies appeared in the late 1980s and early 1990s, reporting positive changes in, for example, rape survivors (Burt & Katz, 1987), male cardiac patients (Affleck, Tennen, Croog, & Levine, 1987), bereaved adults (Edmonds & Hooker, 1992), and combat veterans (Elder & Clipp, 1989).
Interest took hold during the 1990s as the construct was elaborated (e.g., O'Leary & Ickovics, 1995; Tedeschi & Calhoun, 1995) and with the emergence of several psychometric self-report tools, the Changes in Outlook Questionnaire (CiOQ: Joseph, Williams, & Yule, 1993), the Posttraumatic Growth Inventory (PTGI: Tedeschi & Calhoun, 1996), the Stress-Related Growth Scale (SRGS: Park, Cohen, & Murch, 1996), the Perceived Benefit Scales (PBS: McMillen & Fisher, 1998), and the Thriving Scale (TS: Abraido-Lanza et al., 1998). But it is only over the past decade, bolstered by the new positive psychology movement, that the topic has become firmly established as a field of scientific research and clinical interest. Recent major texts include Calhoun and Tedeschi's (2006) Handbook of Posttraumatic Growth, and Joseph and Linley's (2008) Trauma, Recovery and Growth.
Positive changes are difficult to study well, and much of the research is open to criticism. The field is still young, and as such, the reader should beware over-generalized interpretations of specific results to new situations and clinical practice. With apologies to all of those whose work was omitted, we have tried to select articles that r eflect the development of the field and the diversity of contexts and populations that have been studied and that illustrate a method, trend, issue, or conclusion that is important.
The term posttraumatic growth has now become the most widely used term to describe the field. Other terms which have been used include stressrelated growth. There is debate over the use of the term growth, which others have used explicitly to invoke the biological metaphor associated with the humanistic psychology tradition and how growth arises through the resolution of an adversarial tension between pre-existing assumptive worlds and the new trauma-related information. To avoid such theoretical connotations, other terms such as benefit-finding, perceived benefits, and positive change have been used. Although within the literature the various terms are often used inter changeably, it needs to be recognized that different epistemological positions are represented by each. Mindful of this, we have chosen to generally use the term positive change in this brief review.
The bulk of research has relied on the use of the aforementioned, or other similar, retrospective self-report measures. Particularly important have been reviews of the literature. A systematic review of 39 studies by Linley and Joseph (2004) suggested that positive change is commonly reported in around 30-70% of survivors of various traumatic events, including transportation accidents (shipping disasters, plane crashes, car accidents), natural disasters (hurricanes, earthquakes), interpersonal experiences (combat, rape, sexual assault, child abuse), medical problems (cancer, heart attack, brain injury, spinal cord injury, HIV/AIDS, leukaemia, rheumatoid arthritis, multiple sclerosis), and other life experiences (relationship breakdown, parental divorce, bereavement, immigration), and that growth is associated with higher socio-economic status, higher education, younger age, personality traits such as optimism and extraversion, positive emotions, social support, and problem focused, acceptance, and positive reinterpretation coping. More recently, Helgeson et al. (2006) conducted a meta-analytic review of 87 studies, concluding that benefit finding was related to lower depression and higher wellbeing, but also greater severity of intrusive and avoidant posttraumatic experiences. This latter finding has caused some confusion, leading some to question the adaptive utility of growth, while others propose that posttraumatic stress symptoms should be viewed as signs of the cognitive processes that give rise to growth. Evidence from the Stanford Internet survey following 9/11 (Butler et al., 2005) indicated that there might be a curvilinear relation between levels of posttraumatic stress and positive change, suggesting that there may be a range of traumatic experience most conducive to growth.
Janoff-Bulman's (1992) shattered assumptions theory was developed prior to the establishment of the field but has provided the fundamental theoretical architecture for the two main theories of positive change, notably the transformational model (Tedeschi & Calhoun, 2004) and the organismic valuing theory (Joseph & Linley, 2005). Organismic valuing theory attempts to provide an account of positive changes rooted in humanistic psychology wherein posttraumatic stress is viewed as indicative of normal, natural cognitive processes that have the potential to generate positive change. Theoretically, the largest challenge facing the field over the coming years is whether it succeeds in providing a useful alternative nonmedical paradigm for the study of traumatic stress.
The empirical literature has been limited by an over-reliance on cross-sectional studies, but increasingly longitudinal studies are available and beginning to paint a clearer picture of which factors lead to positive change. For example, in a study of 206 long-term cancer survivors (Schroevers, Helgeson, Sanderman, & Ranchor, 2010), the more emotional support was received at 3 months after diagnosis, the greater was the experience of positive consequences of the illness at 8 years after diagnosis, even when controlling for concurrent levels of emotional support at that follow-up.
Of interest is whether positive changes lead to better outcomes on other more-traditional indices. Linley, Joseph, and Goodfellow (2008) found that people who report positive change are less likely to experience problems of posttraumatic stress at six months. Frazier et al. (2004) asked 171 rape survivors to complete a specially designed questionnaire to measure positive changes at 2 weeks following the assault, and then again 2, 6, and 12 months later. This well-designed study allowed the investigators to see how positive changes related to well-being over time. Four groups were created: (1) those who reported low levels of positive change at 2 weeks and high levels at 12 months ("gained positive change" group); (2) those who reported high levels of positive change at 2 weeks and low levels at 12 months ("lost positive change" group); (3) those who reported low levels at both time points ("never had positive change" group), and (4) those who reported high levels at both time points ("always had positive change" group). Results indicated that those in the "always had positive change" group did the best, showing the lowest levels of depression and posttraumatic stress.
Affleck, Tennen, Croog, and Levine (1987) reported that heart attack patients who found benefits immediately after their first attack had reduced re-occurrence and morbidity statistics eight years later. Turning to biological markers, Epel, McEwen, and Ickovics (1998) found that high levels of positive change were related to lowered cortisol levels in women exposed to laboratory stress, as did Cruess et al. (2000) who reported lower cortisol levels through the enhancement of benefit finding among women with breast cancer. Dunigan, Carr, and Steel (2007) reported that among patients with hepatoma, those scoring high on positive change survived 186 days longer than their lower-scoring peers, due to higher peripheral blood leukocytes. Furthermore, Bower et al. (1998) reported that lower AIDS-related mortality was associated with self-reported benefit finding among bereaved HIV-positive men. Milam (2004) also reported greater immune system functioning among HIV patients with higher levels of positive change.
Issues, Controversies, and Directions
Research has progressed considerably with the introduction of standardized self-report instruments to assess positive change, allowing comparisons to be made between studies, but there is still no consensus regarding the parameters that define the universe of positive change. The most widely used of the measures is the Posttraumatic Growth Inventory (PTGI), which assesses five domains: (1) perceived changes in self (becoming stronger, more confident); (2) developing closer relationships with family, friends, neighbours, fellow trauma survivors, and even strangers; (3) changing life philosophy/increased existential awareness; (4) changed priorities; and (5) enhanced spiritual beliefs. As research has continued to develop and mix in-depth qualitative analysis into the inquiry, many aspects of positive change appear to be absent from the current scales of measurement, suggesting the need to use multiple measures, to recognize that change can be in both positive and negative schematic directions, and to include study-specific measurement.
One of the main current criticisms is the overreliance on retrospective self-report, with some questioning the validity of the concept itself. However, evidence for positive change arises when beforeand- after measures are used. A fortuitous study by Peterson and Seligman (2003) had 4817 respondents complete the on-line Values in Action Classification of Strengths prior to September 11. When scores for individuals who completed the survey in the 2 months immediately after September 11 were compared with the scores for those who completed the survey before September 11, seven character strengths showed increases: gratitude, hope, kindness, leadership, love, spirituality, and teamwork. So, while the use of retrospective self-report is limited, the notion of positive change when measured through other means seems substantiated.
One of the issues that makes measurement so problematic is that the various measures of positive change ask respondents to rate their perceptions of how much they have changed as a result of the event. Ford, Tennen, and Albert (2008) described the complex cognitive operations required of respondents, all of which can be subject to bias. Data on the validity of these retrospective selfreports was questioned by Patricia Frazier and her colleagues (2009) who asked over 1500 students in an on-line survey to complete a battery of questionnaires, including a measure of psychological well-being. Eight weeks later they were asked to complete the questionnaires again and report whether they had experienced any major life events in the interim. Ten percent of the sample reported the experience of a traumatic event in the preceding eight weeks, and increases in psychological well-being were noted when the measure of psychological well-being after the event was compared with that completed before the event. But ratings of how people thought they had changed did not correspond well to these actual changes. A further complication when considering the validity of self-report is the suggestion that some reports of positive change are illusory, such as those that are fleeting or due to positive reporting biases or wishful, defensive, or even superstitious thinking. While illusory change should not be considered as real positive change, most commentators agree that a certain amount of illusory positive reappraisal coping can be psychologically helpful.
Methodologically, the bulk of the research to date is cross-sectional and high-quality longitudinal studies remain relatively rare, and it cannot yet be concluded what factors are predictive of positive change. It is likely, given the example of the wider trauma literature, that there are complex interactions among demographic, personality, coping, and social support variables, such that the effects of one variable are only found at certain levels of other variables. Of note, one prospective study examining reactions to the SARS epidemic among a sample of Chinese who had recovered from the illness, their family members, and other healthy adults living in Hong Kong (Cheng, Wong, & Tsang, 2006) found those who reported "mixed" accounts (accounts that included both benefits and costs to the experience) fared better over the longer term than those reporting exclusively positive or exclusively negative experiences, suggesting that enduring positive change may involve the development of a complex, balanced, and realistic understanding of the experience.
As well as more sophisticated interactional research, there is a need for longitudinal research in order to test the relation of proposed predictive factors with subsequent reports of positive change. Directionality is an issue that deserves further attention, as positive changes might be as likely to lead to increases in many of the factors that have been posited as predictors.
One common misunderstanding is the expectation that those who report positive changes should be free of distress, but this is neither what the evidence suggests nor how researchers in the field understand positive change. Positive changes refer to the eudaimonic rather than the hedonic side of well-being (Joseph & Linley, 2005). Whereas the hedonic approach focuses on emotions, the eudaimonic approach is derived from Aristotelian philosophy and is concerned with the optimal functioning and development of the person. In current positive psychology terminology, the eudaimonic approach refers to psychological well-being (PWB) as opposed to subjective well-being (SWB). SWB refers to people's affective states, the balance between their positive and negative feelings, and the extent to which they are satisfied with life. In contrast, PWB is concerned with the more existential side of life - autonomy, mastery, personal growth, positive relations with others, self-acceptance and purpose in life. Moreover, growth cannot undo what has happened; neither is it necessarily psychologically pervasive. Experiences of positive change may be domain-specific, and distress and growth may co-exist - a condition often observed clinically in those who have suffered a significant loss. As such, theorists argue that positive changes are of value in themselves and that facilitation of growth is a worthwhile clinical outcome in its own right and not simply to be valued in relation to how well positive changes predict lower distress. Advice for therapists is available (Calhoun & Tedeschi, 1999).
Group interventions have been shown to be effective. Antoni et al. (2001) tested the effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention increased participants' reports that breast cancer had made positive contributions to their lives, and it increased generalized optimism at a 3-month followup. While such results are encouraging, caution is still warranted in terms of whether and how this research can be applied in the real world (Lechner, Stoelb, & Antoni, 2008). The topic opens up debate on the ethics of the therapeutic process. Researchers and clinicians are urged to be wary of the potential for patients to experience a tyranny of positive thinking wherein they feel that they must inhibit expression of their concerns and distress and forgo psychotherapeutic work in an effort to remain "positive." Professionals should also consider carefully the moral issues associated with interventions deliberately aimed at helping patients find benefits, as opposed to non-directive interventions that work only with clients' growth when it spontaneously occurs.
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Even if people were not burdened by the recall problems documented repeatedly in studies of perceived personal change and relationship change, to complete current measures of PTG they would need to accurately determine how much change can be attributed to the traumatic event itself. In other words, people must be able to accurately judge co-variation between the event and subsequent personal changes. A good deal of evidence demonstrates how judgments of co-variation are biased through illusory correlation , whereby the individual who expects a relationship between the two variables tends to overestimate the magnitude of any relation that might exist or even infers a relation when none exists.
Consider a participant in one of the many published studies of PTG among women with breast cancer. The participant is asked to rate the growth she experienced from the cancer experience. To accurately convey the amount of growth that occurred for each scale item, the respondent must first compare herself in the present with how she recalls being on that dimension prior to her cancer diagnosis and then estimate how much of that difference is due to the cancer experience rather than to a secular trend, a developmental change, or a process unrelated to her illness. But, the psychological literature makes clear that people deprecate their past selves to enhance themselves in the present, and they exaggerate in retrospect the stressfulness of life encounters as a way to enhance their current selves. Schacter  provides convincing evidence to support his conclusion that "[e]xaggerating the difficulty of past experiences is another way people enhance [their current status]" (p. 152).
Even among those relatively few people with near-perfect recall and no motivational impetus, the challenge of detecting and recalling trauma-related change, i.e., change that takes into account developmental trajectories unrelated to any particular event, is formidable, and positive psychology's measures of PTG and benefit finding are not exceptions to the rather overwhelming evidence. Psychological science has known for a half century  that people cannot combine the complex information required to judge that personal growth has occurred in response to a threatening encounter, and many investigations over many years have documented the significant limitations in people's capacity to recall personal change. We must conclude that positive psychology researchers are either unaware of the rich and broad psychological science that is at odds with their measurement tools or that they have decided, contrary to their public assertions, to ignore the science.
A recent study  has now tested directly the validity of self-reported post-traumatic growth by assessing prospectively the relation between the measurement of posttraumatic growth as advocated by positive psychology investigators and actual growth from pre- to post-trauma. In this study, more than 1,500 young adults completed measures of the post-traumatic domains measured by the Post-traumatic Growth Inventory (PTGI)  on two occasions separated by 2 months. They also completed the PTGI on the second occasion. One hundred twenty-two of the participants were selected for further study because they reported experiencing a traumatic event during the 2 months. Nearly 75% of these events were rated by the participants as causing intense fear, helplessness, or horror, which is part of the definition of a traumatic event in the DSM-IV .
Frazier and colleagues compared actual change in the PTGI domains to scores on the PTGI among participants who reported a traumatic event during the time between the two assessments. PTGI scores were by and large unrelated to actual growth in PTG-related domains. Moreover, growth measured with the PTGI was associated with increased distress from preto post-trauma, whereas actual growth was related to decreased distress. Finally, PTGI measured growth, but not actual growth was strongly related to positive reinterpretation coping. Based on these findings, the authors conclude "[t]hus, the PTGI and perhaps other retrospective measures [of PTG] do not appear to measure actual pre- to posttrauma change" (p. 912). Most recently, Yanez, Stanton, Hoyt, Tennen, and Lechner  replicated these troubling findings and offered preliminary evidence for their underlying mechanisms.
We are at a loss to explain why positive psychology investigators continue to endorse the flawed conceptualization and measurement of personal growth following adversity. Despite Peterson's  warning that the credibility of positive psychology's claim to science demands close attention to the evidence, post-traumatic growth-a construct that has now generated hundreds of articles-continues to be studied with flawed methods and a disregard for the evidence generated by psychological science. It is this same pattern of disregard that has encouraged extravagant claims regarding the health benefits of positive psychological states among individuals living with cancer.
We want to be clear that we are not asserting that people cannot grow from confronting life's slings and arrows, including serious illness and other health challenges. Of course, positive psychology has no corner on the concept of post-traumatic growth, which has been alluded to by philosophers, playwrights, novelists, theologians, and more recently, icons of the popular culture. What positive psychology potentially has to offer the concept of posttraumatic growth is scientific scrutiny through careful measurement, sensitive study designs, an attitude that propels investigators to seek facts that will disconfirm positive psychology's elegant hypotheses, and careful attention to credible evidence. It is here, in the science- which ostensibly distinguishes the current version of positive psychology from its predecessors-that positive psychology has failed, quite miserably we believe, in its approach to examining growth following adversity.
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Affleck, G., & Tennen, H. (1996). Construing benefits from adversity: Adaptational significance and dispositional underpinnings. Journal of Personality, 64(4), 899-922. doi:10.1111/j.1467-6494.1996.tb00948.x ABSTRACT The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-finding) and the use of such knowledge as a deliberate strategy of coping with the problem (benefit-reminding) is underscored and illustrated by daily process research on coping with chronic pain.
Aldwin, C. M. (2007). Stress, coping, and development: An integrative approach (2nd ed.). New York: Guilford Press. We examined three community samples to determine whether stressful episodes form a context for the development of coping resources in adulthood. The first study found that 81.9% of a sample of 845 older men reported drawing upon prior experiences in coping with a recent problem. Content analysis revealed that only 22.7% drew upon similar stressful episodes; the rest drew upon problems from work, the military, illnesses, deaths, etc. The second study replicated the earlier findings in 102 men and women, ages 24 to 84, who reported on a recent low point in semistructured interviews. In addition, 75% reported long-term effects, equally split between negative, positive, and mixed effects. Those individuals who perceived advantages from the low point were significantly more likely to report positive long-term effects. The third study replicated the findings from the first two studies in a sample of 941 men and women ages 23 to 62. Path analyses showed that coping strategies differentially predicted perceived positive or negative outcomes, which in turn predicted current mastery and depression levels. While the findings are cross-sectional and causality cannot be inferred, they are nonetheless supportive of the effects of stress and coping on personality.
Aldwin, C. M., & Levenson, M. R. (2004). Posttraumatic growth: A developmental perspective. Psychological Inquiry, 15(1), 19-22. Stable URL: http://www.jstor.org/stable/20447195 Abstract: Although investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of the "Psychological Inquiry" are not the first to discuss post-traumatic growth, they have done much to systematize investigation into the topic, by both their theoretical and empirical work. Few would disagree with their identification of the five major domains of post traumatic growth. Nonetheless, the field is still new and there are a great many questions still unresolved. This commentary focuses on developmental issues about the process by which growth occurs after the experience of traumas and other events. The study of adult development has much to contribute to this discussion, given its major focus on how and why change occurs in adulthood.
Aldwin, C. M., Park, C. L., & Spiro, A., III (Eds.). (2007). Handbook of health psychology and aging. New York: Guilford Press.
Aldwin, C. M., Sutton, K., & Lachman, M. (1996). The development of coping resources in adulthood. Journal of Personality, 64, 837-871. doi:10.1111/j.1467-6494.1996.tb00946.x Data collection on the Normative Aging Study was supported by a FIRST Award (R29-AG07465) from the National Institute on Aging and by two services of the Department of Veterans Affairs (Medical Research and Health Services R&D). The Health and Personality Styles Survey was supported by NIA Grant AGO6038 and the John D. and Catherine T. MacArthur Research Network on Successful Midlife Development; the Davis Longitudinal Study was also supported by the MacArthur Research Network, as well as by Hatch Funds from the University of California, Davis (UCD), Cooperative Extension Service and a UCD New Faculty Research Grant. Portions of this research were presented by the first author in an invited address at the 1994 annual meeting of the American Psychological Association. We would like to thank Gina Chiara, Cory Lewkowicz, Rebecca Parker, Cory Fitzpatrick, and Rael Dornfest for their help in data collection and coding, Leanne Friedman for her help in data analysis, and Michael R. Levenson and an anonymous reviewer for their helpful comments on earlier drafts of this article.
Allemand, M., Gomez, V., & Jackson, J. J. (2010). Personality trait development in midlife: exploring the impact of psychological turning points. European Journal of Ageing, 7(3), 147-155. doi:10.1007/s10433-010-0158-0. This study examined long-term personality trait development in midlife and explored the impact of psychological turning points on personality change. Self-defined psychological turning points reflect major changes in the ways people think or feel about an important part of their life, such as work, family, and beliefs about themselves and about the world. This study used longitudinal data from the Midlife in the US survey to examine personality trait development in adults aged 40-60 years. The Big Five traits were assessed in 1995 and 2005 by means of self-descriptive adjectives. Seven types of self-identified psychological turning points were obtained in 1995. Results indicated relatively high stability with respect to rank-orders and mean-levels of personality traits, and at the same time reliable individual differences in change. This implies that despite the relative stability of personality traits in the overall sample, some individuals show systematic deviations from the sample mean-levels. Psychological turning points in general showed very little influence on personality trait change, although some effects were found for specific types of turning points that warrant further research, such as discovering that a close friend or relative was a much better person than one thought they were.
Almedom, A. (2005). Resilience, hardiness, sense of coherence, and posttraumatic growth: All paths leading to "light at the end of the tunnel"? Journal of Loss and Trauma, 10(3), 253-265. doi:10.1080/15325020590928216. Two questions prompted this targeted review: (a) What are the behavioral and social determinants of individual and/or collective resilience-the capacity to rebound from crisis? and (b) Is the evidence base for related concepts, including hardiness, sense of coherence, and posttraumatic growth consistent? The findings suggest that the theory of salutogenesis, operationalized by the sense of coherence construct, is inclusive of the related concepts of resilience and hardiness. Moreover, it is grounded in robust primary research of cross-cultural relevance. More recent concepts of recovery and posttraumatic growth also contribute to our understanding of resilience. Implications for international humanitarian psychosocial programming are discussed.
Anderson, K. M., Danis, F. S., & Havig, K. (2011). Adult daughters of battered women: Recovery and posttraumatic growth following childhood adversity. Families in Society, 92(2). doi:10.1606/1044-3894.4092. This article details the recovery process, including posttraumatic growth, for 15 adult daughters of battered women. Using qualitative inquiry, participants' recovery was found to involve a cognitive restructuring of childhood misconceptions of themselves, their parents, and the trauma itself. Key to this transformation process, and consequently allowing for posttraumatic growth, was an interwoven process of meaning-making including two specific elements of understanding: the cause and effect of domestic violence and the significance of suffering from such exposure in childhood. Distancing from their parents, education on domestic violence, accessing therapeutic/support services, and having a spiritual connection contributed to enhanced insight and wisdom. Implications include providing professionals with conceptual insights regarding how to identify and support adult daughters' lifelong recovery and growth.
Anderson, W.P., Jr., & Lopez-Baez, S. I. (2008). Measuring growth with the posttraumatic growth inventory. Measurement and Evaluation in Counseling and Development, 40, 215-227. The Posttraumatic Growth Inventory (PTGI; R. G. Tedeschi & L. G. Calhoun, 1996) was used to measure the growth of university students (N = 347). Results were compared with those of trauma studies and indicate that the PTGI is a general measure of growth suitable for future nontrauma studies. Results reflect a minimal relationship between growth and stress.
Armeli, S., Gunthert, K. C., & Cohen, L. H. (2001). Stressor appraisals, coping, and post-event outcomes: The dimensionality and antecedents of stress-related growth. Journal of Social and Clinical Psychology, 20(3), 366-395. doi:10.1521/jscp.20.3.366.22304 This study evaluated the dimensionality and the appraisal and coping antecedents of stress-related growth. We surveyed university alumni (N = 447) and college students (N = 472) about their most stressful event in the past two years. Participants reported appraisals of this event and their use of specific coping strategies. To assess growth from this event, we used a revised version of Park, Cohen, and Murch's (1996) Stress-Related Growth Scale (SRGS). Results from confirmatory factor analyses in both samples indicated that the revised SRGS should be regarded as a multidimensional instrument. Next, we used cluster analysis to identify event profiles based on appraisal and coping reports, and then compared these profiles on reports of growth. In both samples, stress-related growth was highest for individuals who reported highly stressful events, for which they had adequate coping and support resources and for which they used adaptive coping strategies.
Biswas-Diener, R. (2006). From the equator to the North Pole: A study of character strengths. Journal of Happiness Studies, 7, 293-310. doi:10.1007/s10902-005-3646-8ABSTRACT. Recently, psychologists have begun to shift their research attention to positive topics historically overlooked by the profession. The study of character strengths is a major research interest of positive psychologists. A classification of 24 character strengths, called the Values in Action (VIA) Classification, has recently been developed, and the current study evaluates these character strengths across cultures. Among 123 members of the Kenyan Maasai, 71 Inughuit in Northern Greenland, and 519 University of Illinois students, we found high rates of agreement about the existence, desirability, and development of these strengths of character. Despite these strong similarities, there were differences between and within cultures in terms of gender, the perceived importance of specific strengths (such as modesty), and the existence of cultural institutions that promote each strength.
Biswas-Diener, R. (2009). Personal coaching as a positive intervention. Journal of Clinical Psychology, 65(5), 544-553. doi:10.1002/jclp.20589 Personal coaching is a relatively new and unlicensed profession aimed at helping functioning individuals set and achieve goals, overcome obstacles, and maintain motivation. Coaching is increasingly merging with psychology as evidenced by new journals, academic programs, and research symposia. Although coaching has traditionally been used with non-clinical populations, it can be highly relevant to psychotherapy. Clinicians who develop a hybrid psychotherapy-coaching practice might be better protected from occupational stress and burnout. In addition, a number of coaching interventions and assessments might translate well to therapy and help clinicians innovate their practice. The synergy between personal coaching and psychotherapy are illustrated with a case example.
Biswas-Diener, R., & Dean, B. (2006). Positive psychology coaching: Putting the science of happiness to work for your clients. Hoboken, NJ: Wiley.
Biswas-Diener, R., Kashdan, T. & King, L. (2009). Two traditions of happiness research, not two distinct types of happiness. Journal of Positive Psychology, 4(3), 208-211. doi:10.1080/17439760902844400 In an earlier paper (Kashdan, Biswas-Diener, & King, 2008), we outlined a critique of the distinction being made between eudaimonic and hedonic forms of happiness. That paper seems to have had the desired effect in stimulating discourse on this important subject as evidenced by a number of responses from our colleagues. In this paper, we address these responses collectively. In particular, we outline common intellectual ground with the responding authors as well as points of difference.
Biswas-Diener, R., Kashdan, T., & Minhas, G. (2011). A dynamic approach to psychological strength development and intervention. The Journal of Positive Psychology, 6(2), 106-118. doi:10.1080/17439760.2010.545429 Many practitioners working with clients from a strengths perspective largely rely on ad hoc interventions and employ a simplistic 'identify and use' approach. In this article, we suggest that clients can extract greater benefits when practitioners adopt more sophisticated approaches to strengths intervention. We introduce an alternative approach that we call 'strengths development'. This approach is distinguished by the view that strengths are not fixed traits across settings and time (the dominant, contemporary approach to personality). Instead, we adopt dynamic, within-person approaches from personality science to research, assessment, and interventions on strengths. Specifically, strengths are highly contextual phenomena that emerge in distinctive patterns alongside particular goals, interests, values, and situational factors. Strengths are potentials for excellence that can be cultivated through enhanced awareness, accessibility, and effort. Finally, we outline potential psychological risks associated with the strengths perspective that are worthy of explicit discussion with clients.
Boals, A., Steward, J., & Schuettler, D. (2010). Advancing our understanding of posttraumatic growth by considering event centrality. Journal of Loss & Trauma, 15(6), 518-533. doi:10.1080/15325024.2010.519271 Research on posttraumatic growth (PTG) has been plagued by inconsistencies and small effect sizes. We hypothesized that relationships between PTG and other psychological variables would become stronger and more consistent with expectations when we limited analyses to only adverse events construed as central to one's identity. The results supported the hypothesis. Comparing our results to those from a recent meta-analysis on PTG, the relationships between PTG, depression, and positive affect were stronger when examining only events central to identity. Additionally, previously nonsignificant correlations with anxiety, global distress, and physical health became significant in the expected directions. Lastly, a formerly puzzling positive correlation between PTG and posttraumatic stress disorder (PTSD) symptoms became nonsignificant. In stark contrast, limiting analyses to only events meeting the DSM-IV A1 criterion did not produce similar results. Future PTG studies should exclude events that fail to cause disruption in respondents' core beliefs to better separate coping behaviors from PTG.
Bonanno, G.A. (2004) Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28 doi:10.1037/0003-066X.59.1.20 Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.
Bonanno, G. A. (2005). Clarifying and extending the construct of adult resilience. American Psychologist, 60, 265-267. doi:10.1037/0003-066X.60.3.265b In this article the author responds to comments made in this issue responding to his original article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The author notes that in his original article he focused on three crucial points: Resilience among adults represents a distinct and empirically separable outcome trajectory from that normally associated with recovery from trauma; resilience is more prevalent than generally accepted in either the lay or professional literature; and there are multiple and sometimes unexpected factors that inform adult resilience. Owing to the brevity of the article, the author could only touch briefly on many of the more nuanced and complex issues suggested by the resilience construct; this left plenty of room for critique. Fortunately, the comments are generous and insightful and for the most part compatible with the driving goal of the article. As might be expected, of course, there were statements peppered throughout the comments that the author deemed worthy of rebuttal or correction. He considers four points that seemed to beg most urgently for response.
Bonanno, G. A. (2005). Resilience in the face of potential trauma. Current Directions in Psychological Science, 14(3), 135-138. Until recently, resilience among adults exposed to potentially traumatic events was thought to occur rarely and in either pathological or exceptionally healthy individuals. Recent research indicates, however, that the most common reaction among adults exposed to such events is a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences. A surprising finding is that there is no single resilient type. Rather, there appear to be multiple and sometimes unexpected ways to be resilient, and sometimes resilience is achieved by means that are not fully adaptive under normal circumstances. For example, people who characteristically use self-enhancing biases often incur social liabilities but show resilient outcomes when confronted with extreme adversity. Directions for further research are considered.
Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007). What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of consulting and clinical psychology, 75(5), 671-82. doi:10.1037/0022-006X.75.5.671. A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.
Bonanno, G.A., & Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125(6), 760-776. doi:10.1037/0033-2909.125.6.760 For nearly a century, bereavement theorists have assumed that recovery from loss requires a period of grief work in which the ultimate goal is the severing of the attachment bond to the deceased. Reviews appearing in the 1980s noted a surprising absence of empirical support for this view, thus leaving the bereavement field without a guiding theoretical base. In this article, the authors consider alternative perspectives on bereavement that are based on cognitive stress theory, attachment theory, the social-functional account of emotion, and trauma theory. They then elaborate on the most promising features of each theory in an attempt to develop an integrative framework to guide future research. The authors elucidate 4 fundamental components of the grieving process—context, meaning, representations of the lost relationship, and coping and emotion-regulation processes—and suggest ways in which these components may interact over the course of bereavement.
Bonanno, G. A., Westphal, M., & Mancini, A. D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511-535. Retrieved from http://www.annualreviews.org/doi/abs/10.1146/annurev-clinpsy-032210-104526. Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience.
Bonanno, G.A., Wortman, C.B., Lehman, D.R., Tweed, R.G., Haring, M., Sonnega, J., Carr, D., & Nesse, R.M. (2002). Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology, 83(5), 1150-1164. doi:10.1037/0022-35220.127.116.110 Abstract The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-mo postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.
Borja, S. E., Callahan, J. L., & Rambo, P. L. (2009). Understanding negative outcomes following traumatic exposure: The roles of neuroticism and social support. Psychological Trauma: Theory, Research, Practice, and Policy, 1(2), 118-129. doi:10.1037/a0016011. The established literature indicates that an overwhelming majority of adults will experience at least 1 traumatic stressor during their lifetime. Such stressors have been consistently linked to a range of adverse subsequent conditions and span the mood, anxiety, and personality diagnostic categories. Yet, understanding why some individuals experience traumatic reactions and adverse outcomes and others facing significant stressors do not succumb to such problems remains a challenge. In this study, trauma-exposed participants (natural disaster, n = 51; sexual assault, n = 35) completed measures of neuroticism and social support as well as measures of adverse mental health outcomes known to be associated with traumatic exposure. Results indicate that the personality characteristic of neuroticism is generally significantly correlated with symptoms of posttraumatic stress disorder, depression, and general distress. Social support was found to have no impact alone but a differential impact on these outcomes (sometimes helpful, sometimes harmful) depending on the survivor's level of neuroticism. In considering social support options following traumatic exposure, providers are therefore encouraged to carefully consider the survivor's neurotic demeanor.
Boyraz, G., & Efstathiou, N. (2011). Self-Focused attention, meaning, and posttraumatic growth: The mediating role of positive and negative affect for bereaved women. Journal of Loss & Trauma, 16(1), 13-32. doi:10.1080/15325024.2010.507658 This study examined the mediating impact of positive and negative affect on the relationship between two distinct self-focusing tendencies (i.e., reflection and rumination) and meaning and posttraumatic growth among bereaved women. Supporting the study hypotheses, positive affect mediated the relationship between self-focusing tendencies and both meaning and posttraumatic growth. Reflection and rumination also had indirect effects on meaning through negative affect. The study model accounted for 25% of the variance in positive affect, 31% of the variance in negative affect, 43% of the variance in PTG, and 58% of the variance in meaning. These findings underlined the importance of intellectual self-reflection and positive affect in fostering personal growth and adjustment of bereaved women. Results and implications of the findings are discussed in the light of existing literature on bereavement and self-focusing tendencies.
Burt, M. R., & Katz, B. L. (1987). Dimensions of recovery from rape: Focus on growth outcomes. Journal of Interpersonal Violence, 2, 57-81. doi:10.1177/088626087002001004 The authors attempted to conceptualize and measure how women grow as a consequence of having to cope with rape and its aftermath. Factor analyses of measures completed by 113 rape victims yielded six dimensions of self-concept, five dimensions of coping techniques, and three dimensions of self-ascribed change.
Butler, L. D. (2007). Growing pains: Commentary on the field of posttraumatic growth and Hobfoll and colleagues? Recent contributions to it. Applied Psychology, 56(3), 367-378. doi:10.1111/j.1464-0597.2007.00293.x The field of research on benefit-finding and growth following traumatic experience lacks consensus with respect to some central conceptual questions, and a number of these issues are apparent in the research reported by Stevan Hobfoll and his colleagues. In this commentary I briefly discuss, and at times dispute, some of the assertions and assumptions in this target article that I believe reflect these broader issues, including that: psychosocial gains (or benefits) and psychological growth are equivalent, reporting gains (or benefits) represents maladaptive efforts at coping, posttraumatic growth (PTG) is necessarily linked with positive psychological adjustment, and trauma symptoms represent poor adjustment following traumatic event exposure. I also discuss the intriguing proposal of this research: that action is essential to true growth.
Butler, L. D., Blasey, C. M., Garlan, R. W., McCaslin, S. E., Azarow, J., Chen, X., et al. (2005). Posttraumatic growth following the terrorist attacks of September 11, 2001. Cognitive, coping and trauma symptom predictors in an internet convenience sample. Traumatology, 11, 247-267. doi:10.1177/153476560501100405 Cognitive, coping, and trauma symptom predictors of posttraumatic growth (PTG; measured with the Post-traumatic Growth Inventory) were examined in a large convenience sample (n =1,505) participating in a longitudinal Internet-based study following the terrorist attacks of 9/11/01. Results indicate that initial PTG levels (mean 9 weeks post-attacks) were generally associated with higher trauma symptoms (measured with the PTSD Checklist-Specific), positive changes in worldview (measured with the Changes in Outlook Questionnaire), more denial, and less behavioral disengagement (measured with the Brief COPE). Additionally, PTG had a curvilinear association with level of trauma symptoms, such that those reporting symptoms at intermediate levels reported the highest levels of growth. Levels of PTG declined somewhat over time with the exception of Spiritual Change. As expected, PTG levels at follow-up (mean 6.5 months post-attacks) were primarily predicted by initial PTG levels; however, decreases from baseline in trauma symptoms and increases from baseline in positive worldview, acceptance, and positive reframing were also associated with higher reported posttraumatic growth at follow-up. These findings suggest that there may be a range of traumatic experience most conducive to growth and they also highlight the important contributions of cognitive and coping variables to psychological thriving in short- and longer-term periods following traumatic experience.
Cadell, S., Regehr, C., & Hemsworth, D. (2003). Factors contributing to posttraumatic growth: A proposed structural equation model. American Journal of Orthopsychiatry, 73(3), 279-287. doi:10.1037/0002-9418.104.22.1689 With the current shift to include positive outcomes of trauma, this research was designed to explore factors that allow growth to occur. Structural equation modeling was used to test a model for understanding posttraumatic growth. A sample (N = 174) of bereaved HIV/AIDS caregivers completed questionnaires. Spirituality, social support, and stressors were found to have a positive relationship with growth. Facilitation of posttraumatic growth is crucial to all helping professions.
Calhoun, L. G., Cann, A., Tedeschi, R. G., & McMillan, J. (2000). A correlational test of the relationship between posttraumatic growth, religion, and cognitive processing. Journal of Traumatic Stress, 13(3), 521-527. doi:10.1023/A:1007745627077 The present study examined the degree to which event related rumination, a quest orientation to religion, and religious involvement is related to posttraumatic growth. Fifty-four young adults, selected based on prescreening for experience of a traumatic event, completed a measure of event related ruminations, the Quest Scale, an index of religious participation, and the Posttraumatic Growth Inventory. The three subscales of the Quest Scale, the two groups of rumination items (soon after event/within past two weeks), and the index of religious participation were entered in a standard multiple regression with the total score of the Posttraumatic Growth Inventory as the dependent variable. The degree of rumination soon after the event and the degree of openness to religious change were significantly related to Posttraumatic Growth. Congruent with theoretical predictions, more rumination soon after the event, and greater openness to religious change were related to more posttraumatic growth. Present findings offer some confirmation of theoretical predictions, and also offer clear direction for further research on the relationships of religion, rumination, and posttraumatic growth.
Calhoun, L. G., & Tedeschi, R. G. (1998). Beyond recovery from trauma: Implications for clinical practice and research. Journal of Social Issues, 54(2), 357-371. doi:10.1111/j.1540-4560.1998.tb01223.x This article draws implications for clinicians working with survivors of major life crises in four general areas: the relation of psychological well-being, distress, and posttraumatic growth; conceptual issues in this type of clinical work; the process of encouraging growth in clients following traumatic events; and suggestions for additional research. Posttraumatic growth can be accompanied by an increase in well-being, but distress and growth may also coexist. Positive changes can occur in several domains, but many are likely to be phenomenological. Degree of change produced by clinical intervention may be limited in scope, but there clearly are some ways in which the clinician may make growth more likely for the client. Suggestions for future research include the call for longitudinal investigations, studies of rumination and responses of the social network, and the examination of potential gender differences in posttraumatic growth.
Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic growth: A clinician's guide. Mahwah, NJ: Erlbaum. The authors provide a framework for clinical efforts to enhance posttraumatic growth. Chapters provide case examples, clinical approaches, and resources for both clinicians and clients.
Calhoun, L. G., & Tedeschi, R. G. (2001). Posttraumatic growth: The positive lessons of loss. In R. A. Neimeyer, (Ed), Meaning reconstruction & the experience of loss, (pp. 157-172). Washington, DC: American Psychological Association. doi:10.1037/10397-008 Presents a wide-ranging review of the substantial empirical literature that provides evidence of personal growth resulting from a struggle with loss, for at least a stable minority of those who suffer it. Processes addressed include factors such as individual differences, the magnitude of the trauma and the growth processes facilitating a changed sense of self, changed relationships, existential and spiritual growth. The authors go on to develop not only a research agenda for future investigations, but also some preliminary guidelines for practicing clinicians engaged with their clients in an effort after meaning.
Calhoun, L. G. & Tedeschi, R. G. (2004) The foundations of posttraumatic growth: New considerations, Psychological Inquiry, 15(1), 93-102 doi:10.1207/s15327965pli1501_03 In response to comments on our model of posttraumatic growth, we consider the validity of reports of posttraumatic growth, appropriate methodology to use to assess posttraumatic growth, and its relation with other variables that appear to bear a resemblance to posttraumatic growth (e.g., well-being and psychological adjustment). The potentially important role of proximate and distal cultural factors is also addressed. Clinicians are encouraged to use interventions that facilitate posttraumatic growth with care, so as not to create expectations for posttraumatic growth in all trauma survivors, and to instead promote a respect for the difficulty of trauma recovery while allowing for the exploration of possibilities for various kinds of growth even in those who have suffered greatly.
Calhoun, L. G. & Tedeschi, R. G. (2008). The paradox of struggling with trauma: Guidelines for practice and directions for research. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 325-337). Hoboken, NJ: Wiley.
Calhoun, L., Tedeschi, R., & Cann, A. (2010). Positive outcomes following bereavement: Paths to posttraumatic growth. Psychologica Belgica, 50(1&2), 125-143. Recent theory and research have drawn attention to the need to better understand the positive changes, termed posttraumatic growth, that often occur in bereaved individuals; even as negative emotions related to grief persist. We describe five dimensions of posttraumatic growth and present a model for understanding how the loss of a close other can eventually lead to a recognition of important positive personal changes. Loss, especially unexpected loss, disrupts an individual's beliefs about the world and initiates a process of rebuilding an understanding. During this process, many people come to realise their own strengths, appreciate the impact of their relationships, and have new spiritual insights. A strategy for facilitating growth during clinical work also is described.
Campbell, W. K., Brunch, A. B. & Foster, J. D.(2004). Sitting here in limbo: Ego shock and posttraumatic growth. Psychological Inquiry, 15(1), 22-26. Abstract: In their target article in the January 2004 issue of "Psychological Inquiry," investigators Richard G. Tedeschi and Lawrence G. Calhoun bring together literature from a variety of fields to highlight the personal growth that can occur after a range of traumatic experiences. The authors do an excellent job of documenting examples of post-traumatic growth and describing some of the cognitive and interpersonal processes that drive this growth. The article offers an optimistic picture of the individual response to trauma. This counters a long tradition in psychology of highlighting the importance of psychologically defending the self against threat. The authors offer a compelling portrait of the narrative self-reconstruction processes that leads to post-traumatic growth.
Cann, A., Calhoun, L., Tedeschi, R., Taku, K., Vishnevsky, T., Triplett, K., & Danhauer, S. (2010). A short form of the Posttraumatic Growth Inventory. Anxiety, Stress & Coping, 23(2), 127-137. doi:10.1080/10615800903094273 A short form of the Posttraumatic Growth Inventory (PTGI-SF) is described. A sample of 1351 adults who had completed the Posttraumatic Growth Inventory (PTGI) in previous studies provided the basis for item selection. The resulting 10-item form includes two items from each of the five subscales of the original PTGI, selected on the basis of loadings on the original factors and breadth of item content. A separate sample of 186 completed the short form of the scale (PTGISF). Confirmatory factor analyses on both data sets demonstrated a five-factor structure for the PTGI-short form (PTGI-SF) equivalent to that of the PTGI. Three studies of homogenous clinical samples (bereaved parents, intimate partner violence victims, and acute leukemia patients) demonstrated that the PTGI-SF yields relationships with other variables of interest that are equivalent to those found using the original form of the PTGI. A final study demonstrated that administering the 10 short-form items in a random order, rather than in the fixed context of the original scale, did not impact the performance of the PTGI-SF. Overall, these results indicate that the PTGI-SF could be substituted for the PTGI with little loss of information.
Cann, A., Calhoun, L., Tedeschi, R., Triplett, K., Vishnevsky, T., & Lindstrom, C. (2011). Assessing posttraumatic cognitive processes: the Event Related Rumination Inventory. Anxiety, Stress & Coping, 24(2), 137-156. doi:10.1080/10615806.2010.529901 Cognitive processes in the aftermath of experiencing a major life stressor play an important role in the impact of the event on the person. Intrusive thoughts about the event are likely to be associated with continued distress, while deliberate rumination, aimed at understanding and problem-solving, should be predictive of posttraumatic growth (PTG). The Event Related Rumination Inventory (ERRI), designed to measure these two styles of rumination, is described and validation information is provided. Using a college student sample screened for having experienced highly stressful life events, data were obtained (N=323) to conduct an exploratory factor analysis that supported the two factors of the ERRI. Separate confirmatory factor analyses (CFA) on two additional samples (Ns=186 and 400) supported a two-factor model. The two ERRI factors were validated by comparison with related variables and by assessing their contributions to predicting distress and PTG in two samples (Ns=198 and 202) that had been combined to conduct the second CFA. Data indicate the ERRI has solid psychometric properties, captures variance not measured by stable differences in cognitive styles, and the separate factors are related to posttraumatic distress and growth as predicted by existing models of PTG.
Carver, C. S. (1998). Resilience and thriving: Issues, models and linkages. Journal of Social Issues, 54(2), 245-266. doi:10.1111/j.1540-4560.1998.tb01217.x This article addresses distinctions underlying concepts of resilience and thriving and issues in conceptualizing thriving. Thriving (physical or psychological) may reflect decreased reactivity to subsequent stressors, faster recovery from subsequent stressors, or a consistently higher level of functioning. Psychological thriving may reflect gains in skill, knowledge, confidence, or a sense of security in personal relationships. Psychological thriving resembles other instances of growth. It probably does not depend on the occurrence of a discrete traumatic event or longer term trauma, though such events may elicit it. An important question is why some people thrive, whereas others are impaired, given the same event. A potential answer rests on the idea that differences in confidence and mastery are self-perpetuating and self-intensifying. This idea suggests a number of variables whose role in thriving is worth closer study, including personality variables such as optimism, contextual variables such as social support, and situational variables such as the coping reactions elicited by the adverse event.
Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61, 679-704. doi:10.1146/annurev.psych.093008.100352 Personality psychology addresses views of human nature and individual differences. Biological and goal-based views of human nature provide an especially useful basis for construing coping; the five-factor model of traits adds a useful set of individual differences. Coping-responses to adversity and to the distress that results-is categorized in many ways. Meta-analyses link optimism, extraversion, conscientiousness, and openness to more engagement coping; neuroticism to more disengagement coping; and optimism, conscientiousness, and agreeableness to less disengagement coping. Relations of traits to specific coping responses reveal a more nuanced picture. Several moderators of these associations also emerge: age, stressor severity, and temporal proximity between the coping activity and the coping report. Personality and coping play both independent and interactive roles in influencing physical and mental health. Recommendations are presented for ways future research can expand on the growing understanding of how personality and coping shape adjustment to stress.
Chopko, B. (2010). Posttraumatic distress and growth: An empirical study of police officers. American Journal of Psychotherapy, 64(1), 55-72. Few studies have examined the experience of posttraumatic growth, among police officers following traumatic incidents. Additionally, research examining the relationship between posttraumatic distress (e.g., posttraumatic symptoms) and posttraumatic growth among various populations has been inconsistent. Consistent with the need to gain enhanced understanding in the area of posttraumatic growth, this study investigated the relation between posttraumatic distress (using the Impact of Events Scale-Revised) and posttraumatic growth (using the Posttraumatic Growth Inventory) among 183 police officers. Results of Pearson Correlations showed that posttraumatic distress was significantly and positively related to the Posttraumatic Growth Inventory full-scale and all sub-scale scores. Multiple regression analyses revealed that being involved in a duty-related shooting was the most significant predictor of posttraumatic growth. Implications for mental health providers are discussed.
Christopher, M. (2004). A broader view of trauma: A biopsychosocial-evolutionary view of the role of the traumatic stress response in the emergence of pathology and/or growth. Clinical Psychology Review, 24(1), 75-98. doi:10.1016/j.cpr.2003.12.003 The main goal of this paper is to articulate a biopsychosocial evolutionary approach to understanding the traumatic stress response. The secondary goal of this paper is to draw out the general clinical implications of this approach. I articulate seven interconnected and overlapping empirically grounded theoretical conclusions: (1) Stress is best understood as a prerational form of biopsychological feedback regarding the organism's relationship with its environment; (2) The normal outcome of traumatic stress is growth, rather than pathology; (3) Most psychopathology is a function of the maladaptive modulation of the stress response; (4) Trauma always leaves the individual transformed on a biological, as well as psychological, level; (5) The general biological process underlying stress responses is universal, but the specific dynamics are always a function of the unique sociocultural environment and psychological makeup of the individual; (6) The biology underlying stable psychopathological symptoms may change even as the psychological symptoms remain the same; and (7) Rationality is humanity's evolutionarily newest and most sophisticated stress-reduction behavioral mechanism, and the most important aspect of restoring psychological health to the trauma victim.
Cicchetti, D., & Blender, J. a. (2006). A multiple-levels-of-analysis perspective on resilience: implications for the developing brain, neural plasticity, and preventive interventions. Annals of the New York Academy of Sciences, 1094, 248-58. doi:10.1196/annals.1376.029. Resilient functioning, the attainment of unexpected competence despite significant adversity, is among the most intriguing and adaptive phenomena of human development. Although growing attention has been paid to discovering the processes through which individuals at high risk do not develop maladaptively, the empirical study of resilience has focused predominantly on detecting the psychosocial determinants of the phenomenon. For the field of resilience to grow in ways that are commensurate with the complexity inherent to the construct, efforts to understand underlying processes will be facilitated by the increased implementation of interdisciplinary research designed within a developmental psychopathology framework. Research of this nature would entail a consideration of psychological, biological, and environmental-contextual processes from which pathways to resilience might eventuate (known as equifinality), as well as those that result in diverse outcomes among individuals who have achieved resilient functioning (know as multifinality). The possible relation between the mechanisms of neural plasticity and resilience and specific suggestions concerning research questions needed to examine this association are discussed. Examples from developmental neuroscience and molecular genetics are provided to illustrate the potential of incorporating biology into the study of resilience. The importance of adopting a multiple-levels-of-analysis perspective for designing and evaluating interventions aimed at fostering resilient outcomes in persons facing significant adversity is emphasized.
Cicchetti, D., & Rogosch, F. A. (1997). The role of self-organization in the promotion of resilience in maltreated children. Development and Psychopathology, 9(4), 797-815. Retrieved June 5, 2011, from http://dionysus.psych.wisc.edu/lit/Articles/CicchettiD1997a.pdf. The dynamic nature of resilience necessitates that children from high-risk backgrounds who are functioning adaptively despite experiences of adversity must be examined over time. In the current investigation, the adaptation of school-age maltreated and nonmaltreated socioeconomically disadvantaged children was examined over 3 consecutive years. In accord with predictions, a higher percentage of nonmaltreated children than of maltreated children were found to be resilient. Moreover, a higher percentage of maltreated than of nonmaltreated children were shown to exhibit functioning consistently in the low adaptive range. Differential predictors of resilience were found in maltreated and nonmaltreated children. Specifically, for maltreated children, positive self-esteem, ego resilience, and ego overcontrol predicted resilient functioning, whereas relationship features were more influential for nonmaltreated children. These findings are discussed in relation to the unfolding of resilient self-organizational strivings in maltreated and nonmaltreated children.
Classen, C. C., Pain, C., Field, N. P., & Woods, P. (2006). Posttraumatic personality disorder: a reformulation of complex posttraumatic stress disorder and borderline personality disorder. The Psychiatric Clinics of North America, 29(1), 87-112. doi:10.1016/j.psc.2005.11.001. There is a growing recognition among clinicians who treat individual who are chronically traumatized that the Diagnostic and Statistical Manual, 4th Edition (DSM-IV)  does not provide an adequate diagnostic category to capture the full range of symptomatology with which these individuals frequently present. Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) often are considered the best diagnostic options. Alone or together, however, these categories do not describe the full range of symptomatology for individuals suffering as a result of chronic traumatization. Furthermore, they do not provide an adequate framework for understanding etiology or how to treat these individuals. New diagnostic categories are needed to better account for the range of symptom constellations that can result from chronic traumatization.
Clay, R., Knibbs, J., & Joseph, S. (2009). Measurement of posttraumatic growth in young people: A review. Clinical Child Psychology & Psychiatry, 14(3), 411-422. doi:10.1177/1359104509104049 The potential of the positive psychology perspective to change the focus of clinical research and practice has become increasingly recognized. A variety of new psychometric instruments informed by positive psychology are now available to mental health clinicians, providing them with tools to assess change across the spectrum of human functioning. One area of research and practice in which this is evident is in posttrauma work, where it is becoming more common to assess posttraumatic growth alongside posttraumatic stress. The majority of work on posttraumatic growth has been with adults, but the last few years have also seen a new body of research with children and adolescents. The aim is to review literature relating to the measurement of growth. It is concluded that several measures with acceptable psychometric properties now exist for the assessment of posttraumatic growth in children and adolescents.
Cohn, M. A., Fredrickson, B. L., Brown, S. L., Mikels, J. A., & Conway, A. M. (2009). Happiness unpacked: Positive emotions increase life satisfaction by building resilience. Emotion, 9(3), 361-368. doi:10.1037/a0015952 Happiness-a composite of life satisfaction, coping resources, and positive emotions-predicts desirable life outcomes in many domains. The broaden-and-build theory suggests that this is because positive emotions help people build lasting resources. To test this hypothesis, the authors measured emotions daily for 1 month in a sample of students (N = 86) and assessed life satisfaction and trait resilience at the beginning and end of the month. Positive emotions predicted increases in both resilience and life satisfaction. Negative emotions had weak or null effects and did not interfere with the benefits of positive emotions. Positive emotions also mediated the relation between baseline and final resilience, but life satisfaction did not. This suggests that it is in-the-moment positive emotions, and not more general positive evaluations of one's life, that form the link between happiness and desirable life outcomes. Change in resilience mediated the relation between positive emotions and increased life satisfaction, suggesting that happy people become more satisfied not simply because they feel better but because they develop resources for living well.
Collins, R., Taylor, S. E., & Skokan, L. A. (1990). A better world or a shattered vision? Changes in perspectives following victimization. Social Cognition, 8, 263-285. doi:10.1521/soco.1922.214.171.1243 Previous research has separately documented positive (Taylor, 1983) and negative (Janoff-Bulman, 1989) changes in beliefs following victimization. An integration of these literatures is proposed, considering the coping responses of the victim, the area of belief examined, and attributes of the victimizing event as mediators of change valence. Fifty-five cancer patients were interviewed concerning changes experienced in self-views, views of the world, future plans, relationships, and activities/priorities following diagnosis. Changes in activities/priorities and relationships were primarily positive, whereas changes in views of the self, the world, and the future were affectively mixed. Active coping was associated with positive belief changes, as was use of multiple coping methods. In addition, respondents experiencing ongoing threat reported more negative changes than did those not under threat. Implications of the findings are discussed.
Connor-Smith JK, Flachsbart C. (2007). Relations between personality and coping: a meta-analysis. Journal of Personality and Social Psychology, 93(6), 1080-1107. doi:10.1037/0022-35126.96.36.1990 Personality may directly facilitate or constrain coping, but relations of personality to coping have been inconsistent across studies, suggesting a need for greater attention to methods and samples. This meta-analysis tested moderators of relations between Big Five personality traits and coping using 2,653 effect sizes drawn from 165 samples and 33,094 participants. Personality was weakly related to broad coping (e.g., Engagement or Disengagement), but all 5 traits predicted specific strategies. Extraversion and Conscientiousness predicted more problem-solving and cognitive restructuring, Neuroticism less. Neuroticism predicted problematic strategies like wishful thinking, withdrawal, and emotion-focused coping but, like Extraversion, also predicted support seeking. Personality more strongly predicted coping in young samples, stressed samples, and samples reporting dispositional rather than situation-specific coping. Daily versus retrospective coping reports and self-selected versus researcher-selected stressors also moderated relations between personality and coping. Cross-cultural differences were present, and ethnically diverse samples showed more protective effects of personality. Richer understanding of the role of personality in the coping process requires assessment of personality facets and specific coping strategies, use of laboratory and daily report studies, and multivariate analyses.
Coyne, J. C., & Gottlieb, B. H. (1996). The mismeasure of coping by checklist. Journal of Personality, 64, 959-991. doi:10.1111/j.1467-6494.1996.tb00950.x Hundreds of studies bave now used standardized checklists to assess respondents' self-reports of coping with naturally occurring stress. This article presents a critical review of the conceptual and methodological issues involved in the use of these checklists. As they are currently employed, conventional checklists render an incomplete and distorted portrait of coping. Specifically, these checklists are grounded in too narrow a conception of coping; the application and interpretation of checklists in the typical study are not faithful to a transactional model of stress and coping; statistical controls cannot eliminate the effects of key person and situation variables on coping; and no consistent interpretation can be assigned to coping scale scores. Researchers are encouraged to consider a broader range of methods for assessing coping, including semistructured interviews, customized checklists tailored to their specific hypotheses and objectives, daily diaries, and traditional trait measures.
Coyne, J.C., & Tennen, H. (2010). Positive psychology in cancer care: Bad science, exaggerated claims, and unproven medicine. Annals of Behavioral Medicine, 39, 16-26. doi:10.1007/s12160-009-9154-z Background Claims of positive psychology about people with cancer enjoy great popularity because they seem to offer scientific confirmation of strongly held cultural beliefs and values. Purpose Our goal is to examine critically four widely accepted claims in the positive psychology literature regarding adaptational outcomes among individuals living with cancer. Methods We examine: (1) the role of positive factors, such as a "fighting spirit" in extending the life of persons with cancer; (2) effects of interventions cultivating positive psychological states on immune functioning and cancer progression and mortality; and evidence concerning (3) benefit finding and (4) post-traumatic growth following serious illness such as cancer and other highly threatening experiences. Results Claims about these areas of research routinely made in the positive psychology literature do not fit with available evidence. We note in particular the incoherence of claims about the adaptational value of benefit finding and post-traumatic growth among cancer patients, and the implausibility of claims that interventions that enhance benefit finding improve the prognosis of cancer patients by strengthening the immune system. Conclusion We urge positive psychologists to rededicate themselves to a positive psychology based on scientific evidence rather than wishful thinking.
Coyne, J.C., Tennen, H., & Ranchor, A.V. (2010). Positive psychology in cancer care: A story line resistant to evidence. Annals of Behavioral Medicine, 39, 35-42. doi:10.1007/s12160-010-9157-9 Background Aspinwall and Tedeschi (Ann Behav Med, 2010) summarize evidence they view as supporting links between positive psychological states, including sense of coherence (SOC) and optimism and health outcomes, and they refer to persistent assumptions that interfere with understanding how positive states predict health. Purpose We critically evaluate Aspinwall and Tedeschi's assertions. Methods We examine evidence related to SOC and optimism in relation to physical health, and revisit proposed processes linking positive psychological states to health outcomes, particularly via the immune system in cancer. Results Aspinwall and Tedeschi's assumptions regarding SOC and optimism are at odds with available evidence. Proposed pathways between positive psychological states and cancer outcomes are not supported by existing data. Aspinwall and Tedeschi's portrayal of persistent interfering assumptions echoes a disregard of precedent in the broader positive psychology literature. Conclusion Positive psychology's interpretations of the literature regarding positive psychological states and cancer outcomes represent a self-perpetuating story line without empirical support.
Davidson, R. J. (2000). Affective style, psychopathology, and resilience: Brain mechanisms and plasticity. American Psychologist, 55(11), 1196-1214. doi:10.1037/0003-066X.55.11.1196. The brain circuitry underlying emotion includes several territories of the prefrontal cortex (PFC), the amygdala, hippocampus, anterior cingulate, and related structures. In general, the PFC represents emotion in the absence of immediately present incentives and thus plays a crucial role in the anticipation of the future affective consequences of action, as well as in the persistence of emotion following the offset of an elicitor. The functions of the other structures in this circuit are also considered. Individual differences in this circuitry are reviewed, with an emphasis on asymmetries within the PFC and activation of the amygdala as 2 key components of affective style. These individual differences are related to both behavioral and biological variables associated with affective style and emotion regulation. Plasticity in this circuitry and its implications for transforming emotion and cultivating positive affect and resilience are considered.
Davis, C. G., & Asliturk, E. (2011). Toward a positive psychology of coping with anticipated events. Canadian Psychology/Psychologie canadienne, 52(2), 101-110. doi:10.1037/a0020177. Many people appear to be quite resilient to significant stress suggesting that they may possess an orientation to events and life that is resistant to such threats. We propose that one significant aspect of this orientation is the tendency to view adversities as something that can happen to anyone and is reflected in the tendency of people entering uncertain contexts to prepare by imagining a range of possible outcomes, both desired and undesired. This preparatory work facilitates the immediate implementation of effective problem solving and support seeking strategies should the desired outcome seem in doubt. We refer to this orientation as the realistic orientation and review evidence suggesting that such an orientation is associated with realistic—but not unrealistic—optimism and smooth adaptation to adversity.
Dekel, R., & Nuttman-Shwartz, O. (2009). Posttraumatic stress and growth: The contribution of cognitive appraisal and sense of belonging to the country. Health and Social Work, 34(2), 87-96. National Association of Social Workers. Retrieved May 26, 2011. The study has three aims: (1) to compare the effect of the Qassam attacks in two types of communities: development town and kibbutz; (2) to examine the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG); and (3) to examine the contribution that level of exposure, cognitive appraisal, and sense of belonging to the country make to PTS and PTG. The sample consisted of 134 residents, 67 living on two kibbutzim and 67 living in the development town of Sderot. Results revealed that the development town residents reported more PTS symptoms and more PTG than did the kibbutz residents, and the association between PTS and PTG was positive. In addition, the findings show that most of the predictors contribute to either PTS or PTG, or predicted them differently. The discussion examines the results in light of the current literature on PTS and PTG.
Dekel, S., Ein-Dor, T., & Solomon, Z. (2011). Posttraumatic growth and posttraumatic distress: A longitudinal study. Psychological Trauma: Theory, Research, Practice, and Policy. doi:10.1037/a0021865. This longitudinal study examined the course and bidirectional relation between posttraumatic distress and posttraumatic growth (PTG). A sample of Israeli ex-prisoners of war and matched controls were followed over 17 years. Participants' posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were measured at three time-points. PTG was assessed twice. Applying an autoregressive cross-lagged modeling strategy, initial PTSD predicted subsequent PTG above and beyond PTG stability, but not vice versa. Cross-lagged relations of PTG to depression and anxiety were not significant. Moreover, analysis of PTG trajectory revealed that individuals with PTSD reported higher PTG levels across times than those without PTSD. Thus, growth is facilitated and maintained by endorsement rather than absence of PTSD. The findings are discussed in the context of the illusionary versus adaptive notion of PTG.
Dekel, S., Mandl, C., & Solomon, Z. (2011). Shared and unique predictors of post-traumatic growth and distress. Journal of clinical psychology, 67(3), 241-52. doi:10.1002/jclp.20747. This prospective longitudinal study compared pretraumatic, peritraumatic, and post-traumatic predictors of post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD). A total of 103 Israeli former prisoners of the Yom Kippur War were followed over 30 years. Sociodemographic variables, trauma exposure, reactions in captivity, world assumptions, social support, and personality factors were assessed in 1991, and PTG and PTSD symptoms in 2003. Hierarchical regression modeling showed that although some predictors, namely, loss of control and active coping during captivity, predicted both PTG and PTSD, others predicted one outcome and not the other. Self-controllability predicted PTG while sociodemographic factors predicted PTSD when controlling for PTSD and PTG, respectively. The findings indicate that salutary and pathogenic trauma outcomes share some but not all precursors, underscoring their multifaceted relationship.
Delahanty, D. L. (Ed.). (2008). The psychobiology of trauma and resilience across the lifespan. Lanham, MD: Aronson.
DeRoon-Cassini, T., Mancini, A. D., Rusch, M. D., & Bonanno, G. A. (2010). Psychopathology and resilience following traumatic injury: a latent growth mixture model analysis. Rehabilitation psychology, 55(1), 1-11. doi:10.1037/a0018601. One of the first studies to use LGMM to examine resilient trajectories following traumatic injury; assesses depression and PTSD during and after hospitalization.
Diener, E. (2009). The science of well-being: The collected works of Ed Diener. Social Indicators Research Series, Volume 37. The Netherlands: Springer.
Diener, E. (2009). Culture and well-being: The collected works of Ed Diener. Social Indicators Research Series, Volume 38. The Netherlands: Springer
Diener, E. (2009). Assessing well-being: The collected works of Ed Diener. Social Indicators Research Series, Volume 39. The Netherlands, Springer.
Diener, E., & Biswas-Diener, R. (2009). Happiness: Unlocking the mysteries of psychological wealth. Malden, MA: Wiley-Blackwell.
Diener, E., & Chan, M. Y. (2011). Happy people live longer: Subjective well-being contributes to health and longevity. Applied Psychology: Health and Well-Being, 3(1), 1-43. doi:10.1111/j.1758-0854.2010.01045.x Seven types of evidence are reviewed that indicate that high subjective wellbeing (such as life satisfaction, absence of negative emotions, optimism, and positive emotions) causes better health and longevity. For example, prospective longitudinal studies of normal populations provide evidence that various types of subjective well-being such as positive affect predict health and longevity, controlling for health and socioeconomic status at baseline. Combined with experimental human and animal research, as well as naturalistic studies of changes of subjective well-being and physiological processes over time, the case that subjective well-being influences health and longevity in healthy populations is compelling. However, the claim that subjective well-being lengthens the lives of those with certain diseases such as cancer remains controversial. Positive feelings predict longevity and health beyond negative feelings. However, intensely aroused or manic positive affect may be detrimental to health. Issues such as causality, effect size, types of subjective well-being, and statistical controls are discussed.
Dolbier, C. L., Jaggars, S. S., & Steinhardt, M. a. (2010). Stress-related growth: Pre-intervention correlates and change following a resilience intervention. Stress and Health, 26(2), 135-147. doi:10.1002/smi.1275. Correlates of stress-related growth and the effectiveness of a resilience intervention to enhance stress-related growth were examined. College students were randomly assigned to intervention (n = 31) and waiting list control (n = 33) groups. The intervention group received the psychoeducational intervention, Transforming Lives Through Resilience Education, in four weekly 2-hour sessions. Measures of personal, environmental and stressor characteristics, coping strategies, adjustment and stress-related growth were assessed. Multiple regressions revealed that pre-intervention self-esteem, self-leadership, hopeful coping and depressive symptoms significantly related to pre-intervention growth. A repeated measures analysis of variance yielded a significant group by time interaction for total growth; the intervention group showed greater increases in growth pre- to post-intervention compared with the control group. Our results supported the relationships of self-esteem and adaptive coping strategies to stress-related growth and introduce a new correlate of growth, self-leadership, to the literature. In addition, our results highlighted the complex role depressive symptoms may play in relation to growth, indicating that depressive symptoms might decrease one's inner resources while simultaneously serving as a catalyst for growth. Further, the findings supported the resilience intervention as a promising approach to facilitate growth.
Durkin, J., & Joseph, S. (2009). Growth following adversity and its relation with subjective well-being and psychological well-being. Journal of Loss & Trauma, 14(3), 228-234. doi:10.1080/15325020802540561 Studies have shown that posttraumatic growth is associated with greater well-being. However, it is not clear whether posttraumatic growth is related to subjective well-being (SWB) or psychological well-being (PWB). Whereas SWB is derived from the hedonistic tradition, PWB is derived from the eudaimonic tradition. In a sample of 125 college students who had experienced a distressing event, we found evidence that growth is related to PWB rather than SWB.
Emmons, R. a, & McCullough, M. E. (2003). Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377-89. doi:10.1037/0022-35188.8.131.527. The effect of a grateful outlook on psychological and physical well-being was examined. In Studies 1 and 2, participants were randomly assigned to 1 of 3 experimental conditions (hassles, gratitude listing, and either neutral life events or social comparison); they then kept weekly (Study 1) or daily (Study 2) records of their moods, coping behaviors, health behaviors, physical symptoms, and overall life appraisals. In a 3rd study, persons with neuromuscular disease were randomly assigned to either the gratitude condition or to a control condition. The gratitude-outlook groups exhibited heightened well-being across several, though not all, of the outcome measures across the 3 studies, relative to the comparison groups. The effect on positive affect appeared to be the most robust finding. Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits.
Finzi-Dottan, R., Triwitz, Y. S., & Golubchik, P. (2011). Predictors of stress-related growth in parents of children with ADHD. Research in Developmental Disabilities, 32(2), 510-9. doi:10.1016/j.ridd.2010.12.032. This study was designed to investigate stress-related growth in 71 parents of children with ADHD, compared with 80 parents of non-clinical children. Adopting Tedeschi and Calhoun's (2004) theoretical framework for predicting personal growth, the study investigated the contribution of emotional intelligence (individual characteristics), social support (environmental factors), parental self-efficacy and perceptions of parenting as a challenge vs. a threat (cognitive processing). Results indicated that emotional intelligence was the main predictor of stress-related growth, particularly for parents of ADHD children, emphasizing that this personal trait is especially relevant to coping with on-going parental strain; whereas social support made a greater contribution to growth for the control group than for parents of children with ADHD. Path analysis confirmed our research model, suggesting that parents' sense of competence and of parenthood as a challenge vs. a threat mediates between emotional intelligence and social support on the one hand, and growth on the other.
Floyd, M., Coulon, C., Yanez, A. P., & Lasota, M. T. (2005). The existential effects of traumatic experiences: a survey of young adults. Death studies, 29(1), 55-63. doi:10.1080/07481180490483463. This study examined the relation between exposure to trauma and attitudes toward existential issues. Participants were 504 undergraduate students (average age = 19.67) who answered questions on exposure to trauma, fear of death, overall distress, and meaning in life. Results indicated that those with a history of trauma exposure had higher levels of overall distress, but there were no differences in death anxiety or meaning in life. The results suggest that the positive outcomes (less fear of death and increased meaning in life) associated with exposure to traumatic events may be relatively rare, especially amongst younger adults.
Ford, J. D., Tennen, H., & Albert, D. (2008). A contrarian view of growth following adversity. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery and growth: Positive psychological perspectives on posttraumatic stress (pp. 297-324). Hoboken, NJ: Wiley. The concept of posttraumatic growth is a potentially important paradigm shift in the traumatic stress field. Reports of individuals experiencing personal growth in the face of adversity run contrary to the dominant scientific, clinical, and lay views that psychological trauma primarily causes damage to the body, mind, and relationships. Although posttraumatic growth has become an icon in the positive psychology movement, we review evidence that suggests that growth in the aftermath of psychological trauma is better conceptualized as the resumption or continuation of preexisting psychological development, or as an artifact of cognitive attribution processes that lead persons who experience psychological trauma to believe that they have experienced growth.
Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69(6), 1048-1055. doi:10.1037/0022-006X.69.6.1048 A longitudinal study was conducted to investigate (a) the timing and course of posttraumatic growth and (b) the relations between positive and negative life changes and posttraumatic distress among recent female sexual assault survivors (N=171). Most survivors reported positive change even at 2 weeks postassault. Positive changes generally increased over time and negative changes decreased, although change in different domains followed different courses and there was significant individual variability in change patterns. Both positive and negative changes were associated with distress in expected ways, although the relations with negative changes were stronger. The least distress at 12 months was reported by those who noted positive life changes at both 2 weeks and 12 months postassault. Implications for theory and research on posttraumatic growth are discussed.
Frazier, P., & Kaler, M. E. (2006). Assessing the validity of self-reported stress-related growth. Journal of Consulting and Clinical Psychology, 74(5), 859-69. doi:10.1037/0022-006X.74.5.859. The purpose of these studies was to assess the validity of self-reported stress-related growth (SRG). In Study 1, individuals with breast cancer (n = 70) generally did not report greater well-being than a matched comparison group (n = 70). In Study 2, there were no significant differences in well-being between undergraduate students who said that something positive had come out of their worst stressor (n = 34) and those who reported no positives (n = 34). In Study 3, specific domains of SRG assessed in undergraduate students (n = 96) generally were not uniquely related to corresponding well-being measures. Thus, the authors found fairly little evidence for the validity of self-reported SRG. Future research directions are highlighted.
Frazier, P., Tashiro, T., Berman, M., Steger, M., & Long, J. (2004). Correlates of levels and patterns of positive life changes following sexual assault. Journal of Consulting and Clinical Psychology, 72, 19-30. doi:10.1037/0022-006X.72.1.19 This study builds on previous work suggesting that many survivors report positive life changes soon after a sexual assault and that those who retain those changes over time report the least distress 1 year post-assault (P. Frazier, A. Conlon, & T. Glaser, 2001). The purposes of this study were to assess correlates of early reports of positive life changes and individual trajectories of self-reported positive changes over time among female sexual assault survivors (n = 171) using hierarchical linear modeling. The factors most related to reporting positive life change soon after the assault were social support, approach and religious coping, and perceived control over the recovery process. Increases in these factors also were associated with increases in self-reported positive life changes over time. The relations between social support and positive change also were mediated by coping strategies and control appraisals, particularly perceived control over the recovery process.
Frazier, P., Tennen H., Gavian M., Park C., Tomich P., & Tashiro T. (2009). Does self-reported posttraumatic growth reflect genuine positive change? Psychological Science, 20(7), 912-919. doi:10.1111/j.1467-9280.2009.02381.x ABSTRACT In this study, we evaluated the validity of self-reported posttraumatic growth (PTG) by assessing the relation between perceived growth and actual growth from pre- to posttrauma. Undergraduate students completed measures tapping typical PTG domains at Time 1 and Time 2 (2 months later). We compared change in those measures with scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) for those participants who reported a traumatic event between Time 1 and Time 2 (n= 122). PTGI scores generally were unrelated to actual growth in PTG-related domains. Moreover, perceived growth was associated with increased distress from pre- to posttrauma, whereas actual growth was related to decreased distress, a pattern suggesting that perceived and actual growth reflect different processes. Finally, perceived (but not actual) growth was related to positive reinterpretation coping. Thus, the PTGI, and perhaps other retrospective measures, does not appear to measure actual pre- to posttrauma change.
Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2(3), 300-319. doi:10.1037//1089-26184.108.40.2060. This article opens by noting that positive emotions do not fit existing models of emotions. Consequently, a new model is advanced to describe the form and function of a subset of positive emotions, including joy, interest, contentment, and love. This new model posits that these positive emotions serve to broaden an individual's momentary thought-action repertoire, which in turn has the effect of building that individual's physical, intellectual, and social resources. Empirical evidence to support this broaden-and-build model of positive emotions is reviewed, and implications for emotion regulation and health promotion are discussed.
Fredrickson, B. L., & Losada, M. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist, 60, 678-686. doi:10.1037/0003-066X.60.7.678 Extending B. L. Fredrickson's (1998) broaden-and-build theory of positive emotions and M. Losada's (1999) nonlinear dynamics model of team performance, the authors predict that a ratio of positive to negative affect at or above 2.9 will characterize individuals in flourishing mental health. Participants (N=188) completed an initial survey to identify flourishing mental health and then provided daily reports of experienced positive and negative emotions over 28 days. Results showed that the mean ratio of positive to negative affect was above 2.9 for individuals classified as flourishing and below that threshold for those not flourishing. Together with other evidence, these findings suggest that a set of general mathematical principles may describe the relations between positive affect and human flourishing.
Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84(2), 365-376. Retrieved from http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-35220.127.116.115 Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, the authors hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks-gratitude, interest, love, and so forth-fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory. Discussion touches on implications for coping.
Froh, J. J. (2004). The history of positive psychology: Truth be told. NYS Psychologist, 18-20. Martin E. P. Seligman, in his 1998 APA Presidential Address, is said to have introduced positive psychology to the American Psychological Association. However, overwhelming evidence suggests that the principal components of positive psychology date back at least to William James. More recently, Abraham Maslow spoke of a psychology in which attention should be given not only to what is, but also to what could be. Maslow even used the words "positive psychology" for a chapter title in the 1950s. Contemporary positive psychologists seem to have distanced themselves from Maslow's humanistic approach largely because they believe that its experiential methodology lacks scientific rigor. It is argued here that positive psychology will only self-actualize when it embraces its history.
Gallagher, M. W., Lopez, S. J., & Preacher, K. J. (2009). The hierarchical structure of well-being. Journal of Personality, 77(4), 1025-1050. doi:10.1111/j.1467-6494.2009.00573.x ABSTRACT Theories of hedonic, eudaimonic, and social well-being provide 3 extensively studied models for explaining flourishing mental health. Few studies have examined whether these models can be integrated into a comprehensive structure of well-being. The present study builds upon previous theoretical and empirical work to determine the complex relationships among these 3 models of well-being. Confirmatory factor analysis techniques were used to test a series of models in order to (a) confirm the proposed latent structures of hedonic, eudaimonic, and social well-being and (b) examine whether these models could be successfully integrated into a hierarchical structure of well-being. In 2 large samples, results supported the proposed latent structures of hedonic, eudaimonic, and social well-being and indicated that the various components of well-being could be represented most parsimoniously with 3 oblique second-order constructs of hedonic, eudaimonic, and social well-being.
Garbarino, J. (2011). The positive psychology of personal transformation: Leveraging resilience for life change. New York: Springer.
Greenberg, M. A. (1995). Cognitive processing of traumas: The role of intrusive thoughts and reappraisals. Journal of Applied Social Psychology, 25, 1262-1295. doi:10.1111/j.1559-1816.1995.tb02618.x Cognitive processing theories of post-traumatic adaptation (Horowitz, 1986a; Janoff-Bulman, 1992) propose that repeated comparisons of trauma content with preexisting cognitive schemas result in trauma reappraisal or schematic revision. Thus, intrusive ruminations should facilitate cognitive integration and resolution of past traumas. However, research has shown that some survivors become stuck in endless, repetitive rumination cycles. This raises the issue of how to differentiate ruminations that promote cognitive integration from those that merely prolong or exacerbate psychological distress. Identifying substantive dimensions for categorizing cognitions about past traumas could enhance prediction of their effects on adjustment and inform clinical treatment interventions. This paper seeks to: (a) Assess the current state of theoretical knowledge concerning cognitive adaptation to trauma, (b) integrate theoretical postulates with empirical research findings, (c) define gaps or inconsistencies in our understanding of the cognitive adaptation process, and (d) identify foci for future theory and research.
Gunty, A. L., Frazier, P., Tennen, H., Tomich, P., Tashiro, T., & Park, C. (2011). Moderators of the relation between perceived and actual posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy, 3(1), 61-66. doi:10.1037/a0020485. Although numerous studies suggest that most people report posttraumatic growth (PTG) following traumatic events, the relations between measures of self-reported PTG and actual pre- to posttrauma growth are small (Frazier et al., 2009). The purpose of the current study was to investigate moderators of the relation between perceived and actual growth. Participants were undergraduates who had experienced a traumatic event between Time 1 and Time 2 (2 months later; n = 122) and a matched no-trauma comparison group (n = 122). Participants completed self-report measures of perceived growth (Posttraumatic Growth Inventory; Tedeschi & Calhoun, 1996) at Time 2, actual growth from Time 1 to Time 2 (Frazier et al., 2009), and 4 potential moderators (i.e., distress and life satisfaction at Time 2 and neuroticism and self-esteem at Time 1 pre-event). The moderator analyses suggested that, in the trauma group, perceived growth was more strongly related to actual growth for individuals who reported less distress and more life satisfaction posttrauma. None of the 4 variables were significant moderators for the no-trauma group. Clinical and research implications are discussed.
Hagenaars, M. A., & Minnen, A. van. (2010). Posttraumatic growth in exposure therapy for PTSD. Journal of Traumatic Stress, 23(4), 504-8. doi:10.1002/jts.20551. This study aims to increase our understanding of trauma positive outcomes by (a) exploring associations between posttraumatic growth and posttraumatic stress disorder (PTSD), and (b) investigating posttraumatic growth course and its impact on exposure treatment. In 80 mixed trauma PTSD patients, growth was negatively related to PTSD symptoms, especially emotional numbing. Sixty-five PTSD patients also completed Prolonged Exposure therapy with pretreatment and posttreatment assessments. Posttraumatic growth-New Possibilities and Personal Strength-increased during exposure therapy, and these increases were associated to decreases of PTSD symptoms. Pretreatment posttraumatic growth, more specifically the Appreciation of Life subscale, predicted better treatment outcome after controlling for pretreatment PTSD. The results indicate that posttraumatic growth may be a valuable new concept in trauma therapy.
Hartman, D. (2007). Posttraumatic growth and thriving with heart-centered therapies. Journal of Heart-Centered Therapies, 10(1), 65-85. Abstract: The predominant themes in the paper by Stiles (2007) are: whether the dissociative states experienced during childhood sexual abuse influence the adult woman survivor's spiritual development (defined as the process by which one actively engages in the search for purpose and meaning in one's life), and whether the experiences were ultimately of value. Stiles also refers to "the human psyche's capacity to expand through dissociative experience." In particular, she suggests early dissociative patterns may contribute to: a tendency to experience boundarylessness; merging with something beyond the self; awareness of the existence of states of nonordinary reality; and acceptance of a state of out-of-control overwhelm as near-death, i.e., "being near death is akin to being near God." A proclivity to experience dissociative states, resulting from childhood sexual abuse, does contribute to the adult woman survivor's spiritual development; however, it also adds the challenge to integrate dissociated parts that have grown into autonomous sub-personalities in order to avoid either unconscious emotionality or disconnection from emotion and the body. Thus, what begins as seeking psychic refuge through dissociation ideally evolves into allowing the dissolving of one's psychic self. This article will discuss these themes utilizing several theoretical perspectives: (1) the Coactivation Model of healthy coping (Larsen et al., 2003); (2) "posttraumatic growth" or "resilience"; (3) current research into purpose in life, and wisdom; and (4) the neuropsychology of mystical experience.
Harvey, J. H., Barnett, K., & Overstreet, A. (2004). Trauma growth and other outcomes attendant to loss. Psychological Inquiry, 15, 26-29.
Hefferon, K., Grealy, M., & Mutrie, N. (2009). Transforming from cocoon to butterfly: The potential role of the body in the process of posttraumatic growth. Journal of Humanistic Psychology, 50(2), 224-247. doi:10.1177/0022167809341996. The diagnosis of cancer has the potential to elicit positive change (posttraumatic growth PTG) through the experience of trauma and adversity. However, psychology and clinical practices and most recently positive psychology have been criticized for their indifference toward the influence of the body on positive psychological functioning. The aim of this study was to broaden the understanding of PTG, including its process and outcomes, using interpretive phenomenological analysis. Ten female breast cancer survivors, from an already existing study, participated in an individual, open-ended interview. These were transcribed verbatim and analyzed for themes that reflected the womens experience of growing from adversity. The role of the body was found to be a vital component to the process and outcomes of PTG and was deconstructed into three smaller themes: fear of new body, negative effects of chemotherapy on the body (fatigue, loss of desire), and reconnection with body (cocoon to butterfly, listening to body, body as a barometer/monitoring). In addition, the analysis revealed how these 10 women perceived the body as an integral component to their self-identity and how this affected their achievement of PTG. Future research should begin to acknowledge and conduct further study into the neglected role of the body as a contributor or determinant of the PTG process.
Held, B. (2004). The negative side of positive psychology. Journal of Humanistic Psychology, 44(1), 9-46. doi:10.1177/0022167803259645 This article explores three ways in which the positive psychology movement's construction and presentation of itself are negative. First, the negative side is construed as the negative side effects of positive psychology's dominant, separatist message. Second, the negative side is construed as the negativity that can be found within the positive psychology movement. Here the author elaborates on the negative or dismissive reactions of some spokespersons for the movement to ideas or views that run counter to the movement's dominant message: (a) negativity about negativity itself, which is explored by way of research in health psychology and coping styles; and (b) negativity about the wrong kind of positivity, namely, allegedly unscientific positivity, especially that which Seligman purports to find within humanistic psychology. This constitutes an epistemological position that contributes to "reality problems" for positive psychologists. The author concludes with the implications of positive psychology's "Declaration of Independence" for psychology's much discussed fragmentation woes. She appeals to the wisdom of William James for guidance in finding a third, more positive meaning of positive psychology's negative side. This third meaning can be gleaned from a not-yet-dominant but more integrative message emerging within the movement, one compatible with the reactions of some humanistic psychologists to positive psychology.
Helgeson, V. S., Reynolds., K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74, 797-816. doi:10.1037/0022-006X.74.5.797 The authors conducted a meta-analysis to examine the relations of benefit finding to psychological and physical health as well as to a specific set of demographic, stressor, personality, and coping correlates. Results from 87 cross-sectional studies reported in 77 articles showed that benefit finding was related to less depression and more positive well-being but also to more intrusive and avoidant thoughts about the stressor. Benefit finding was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health. Moderator analyses showed that relations of benefit finding to outcomes were affected by the amount of time that had passed since stressor onset, the benefit finding measure used, and the racial composition of the sample.
Hobfoll, S. E., Hall, B. J., Canetti-Nisim, D., Galea, S., Johnson, R. J., & Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology, 56(3), 345-366. doi:10.1111/j.1464-0597.2007.00292.x Recent studies related to global terrorism have suggested the potential of posttraumatic growth (PTG) following experiences of terror exposure. However, investigations of whether psychological distress is reduced or increased by PTG in other trauma contexts have been inconsistent. Results from our studies conducted in New York following the attacks of 11 September 2001 and in Israel during recent tumultuous periods of violence and terrorism, the Al Aqsa Intifada, have found posttraumatic growth to be related to greater psychological distress, more right-wing political attitudes, and support for retaliatory violence. Only when individuals were deeply involved in translating growth cognitions to growth actions in our research on the forced disengagement of settlers from Gaza did we find positive benefit in posttraumatic growth. Findings are considered within the framework of a new formulation of action-focused growth.
Hobfoll, S. E., Watson, P., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., et al. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70(4), 283 -315. doi:10.1521/psyc.2007.70.4.283 Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid-term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self- and community efficacy, 4) connectedness, and 5) hope.
Hofer, M. a. (2006). Evolutionary basis of adaptation in resilience and vulnerability: Response to Cicchetti and Blender. Annals of the New York Academy of Sciences, 1094, 259-62. doi: 10.1196/annals.1376.030. This masterful and wide-ranging paper gives us a clear picture of the need for interdisciplinary studies of resilience and vulnerability. We need to go beyond the interacting events at the different levels to see clearly that multiple levels of analysis and concept do not themselves interact, but instead give us different aspects of a biological, psychological, or behavioral event. Thus, no levels are reducible to any of the others. In the rest of my discussion, I raise the likelihood that the multiple level responses of "resilience" are no more adaptive in their evolutionary history than the very different responses we call "vulnerability." Keeping in mind the evolved functions of these responses, and the circumstances of their selection during evolution, will provide us with new ideas and approaches for understanding and intervention.
Hooper L. M., (2009). Individual and family resilience: Definitions, research, and frameworks relevant for all counselors. The Alabama Counseling Association Journal, 35(1), l9-26. The author provides a brief review of the clinical and research literature on individual and family resilience. The review includes resilience-focused frameworks that may have relevance to counselors working in varied contexts who provide strength-based counseling. School, family, and mental health counselors are encouraged to consider the potential utility of infusing the construct of resilience in future research and helping intervention and treatment efforts.
Hooper, L. M., Marotta, S. A., & DePuy, V. (2009). A confirmatory factor analytic study of the Posttraumatic Growth Inventory among a sample of racially diverse college students. Journal of Mental Health, 18, 335-343. doi:10.1080/09638230802522502
Abstract Aims: The primary aim of the study was to confirm the five-factor structure of Tedeschi and Calhoun's (1996) Posttraumatic Growth Inventory (PTGI). A secondary aim of this study was to explore the potential usefulness of the PTGI among populations that experience parentification-common form of childhood neglect and adversity. Method: The PTGI was administered to a sample of 143 college students with a history of various levels of parentification. Results: The resulting data were subjected to confirmatory factor analysis. The goodness-of-fit indices for the five-factor model indicated a moderate fit with the current sample. However, a five-factor, 18- item model produced a more optimal fit than Tedeschi and Calhoun's five-factor, 21-item PTGI. Conclusions: The study's findings suggest that the PTGI appears to be a useful assessment inventory for mental health practitioners in measuring globally the resources an individual might have following the adversity of parentification.
Jaffe, D. T. (1985). Self-renewal: Personal transformation following extreme trauma. Journal of Humanistic Psychology, 25(4), 99-124. doi:10.1177/0022167885254012 This article presents a model of the process of self-renewal, the creative restructuring of the self that may follow the painful and disconfirming personal crisis of illness or other extreme personal trauma. Self-renewal is a possible response to pain and struggle, and one that can be facilitated and encouraged. The article presents several examples of the complex processes that make up self-renewal, including the self-definition as a person taking an active role, the presence of a deep relationship to others, and the role of being a public witness concerning issues raised by the struggle. The article concludes by suggesting that self-renewal as a process has important social implications, beyond the personal level.
Janoff-Bulman, R. (1992). Shattered assumptions: Toward a new psychology of trauma. New York: Free Press.
Janoff-Bulman, R. (2004). Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15(1), 30-34. Abstract: Cognitive processing and schema reconstruction play central roles in investigators Richard G. Tedeschi and Lawrence G. Calhoun's model of post-traumatic growth, shown in the January 2004 issue of the "Psychological Inquiry." They further define and flesh out these crucial cognitive processes and present a thorough, empirically rich analysis of post-traumatic coping. Their presumed focus on understanding post-traumatic growth, however, raises a question about the relation between this coping process and post-traumatic growth, that is about how specifically does the process inform the phenomenon referred to as post-traumatic growth.
Johnson, R. J., Hobfoll, S. E., Hall, B. J., Canetti-Nisim, D., Galea, S., & Palmieri, P. A. (2007). Posttraumatic growth: Action and reaction. Applied Psychology, 56(3), 428-436. doi:10.1111/j.1464-0597.2007.00296.x We respond to the commentators who raise several key issues. Points of agreement include the need to incorporate several new concepts within the broader umbrella of posttraumatic growth (PTG), a need to understand more of the context under which PTG might have positive, negative, or limited influence, and a need to understand aspects of persons and populations who might use PTG in different ways. A major point of disagreement remains with the original formulation of PTG which poses PTG as a universally positive contribution to well-being, or even that it is beneficial in its own right. Illusion may have positive aspects, but we remain interested in the idea that it is most beneficial when translated into action. Some of these actions may be cognitive, but they should in such instances have lasting meaning for individuals' lives. Too often, PTG represents the belief that one has grown in some deep way, without validation of that depth of experience.
Joseph, S. (2009). Growth following adversity: Positive psychological perspectives on posttraumatic stress. Psihologijske teme / Psychological Topics, 18(2), 335-343. doi:10.1016/j.cpr.2005.12.006 Retrieved from EBSCOhost. The impact of traumatic events is well documented within the clinical psychology literature where it is recognized that people who experience traumatic events may go on to develop posttraumatic stress disorder (PTSD). At first glance one might ask what the relevance of positive psychology is to the study of trauma. But a number of literatures and philosophies throughout human history have conveyed the idea that there is personal gain to be found in suffering. The observation that stressful and traumatic events can provoke positive psychological changes is also contained in the major religions of Buddhism, Christianity, Hinduism, Islam, and Judaism. Within existential philosophy and humanistic psychology it has also been recognized that positive changes can come about as a result of suffering. But it is only within the last decade that the topic of growth following adversity has become a focus for empirical work. In this paper I will provide an overview of the subject and the research we have conducted at the Centre for Trauma, Resilience, and Growth (CTRG).
Joseph, S. (2011). What doesn't kill us: The new psychology of posttraumatic growth. New York, NY: Basic Books.
Joseph, S., & Butler, L. D. (2010). Positive changes following adversity. PTSD Research Quarterly, 21(3), 1-3.
Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9(3), 262-280. doi:10.1037/1089-2618.104.22.1682 A positive psychological theory of growth through adversity is proposed. The organismic valuing theory of growth through adversity posits an intrinsic motivation toward growth, showing how this leads to the states of intrusion and avoidance that are characteristic of cognitive-emotional processing after trauma. The theory posits 3 possible outcomes of this cognitive-emotional processing, namely, assimilation, negative accommodation, and positive accommodation. The theory shows how the organismic valuing process will automatically lead to the actualization of positive changes in psychological well-being, through the positive accommodation of the new trauma related information, provided that the social environment is able to support this positive accommodation process.
Joseph, S., & Linley, P. A. (2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical Psychology Review, 26(8), 1041-1053. doi:10.1016/j.cpr.2005.12.006 Abstract A number of literatures and philosophies throughout human history have conveyed the idea that there is personal gain to be found in suffering, and it is an idea central to the existential-humanistic tradition of psychology. However, it is only relatively recently that the topic of growth following adversity has become the focus for empirical and theoretical work. In this paper, we review theoretical models of growth, and discuss the implications of growth for clinical practice. Three main theoretical perspectives are reviewed, the functional-descriptive model, the meta-theoretical person-centered perspective, and the biopsychosocial-evolutionary view. It is proposed that these three approaches to theory offer different but complementary levels of analysis, and that theoretical integration between them is possible. We then go on to explore the implications of this theoretical integration for clinical practice, and conclude with a consideration of the role of therapy in facilitating growth following adversity.
Joseph, S., & Linley, P. A. (2008a). Positive psychological perspectives on posttraumatic stress: An integrative psychosocial framework. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 3-20). Hoboken, NJ: Wiley.
Joseph, S., & Linley, P. A. (2008b). Psychological assessment of growth following adversity: A review. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 21-36). Hoboken, NJ: Wiley.
Joseph, S., & Linley, P. A. (2008c. Reflections on theory and practice in trauma, recovery, and growth: A paradigm shift for the field of traumatic stress. In S. Joseph & P. A. Linley (Eds.), Trauma, recovery, and growth: Positive psychological perspectives on posttraumatic stress (pp. 339-356). Hoboken, NJ: Wiley.
Joseph, S., & Linley, P. A. (Eds.). (2008d). Trauma, recovery and growth: Positive psychological perspectives on posttraumatic stress. Hoboken, NJ: John Wiley.
Joseph, S., Linley, P. A., Andrews, L., Harris, G., Howle, B., Woodward, C., Shevlin, M. (2005). Assessing positive and negative changes in the aftermath of adversity: Psychometric evaluation of the Changes in Outlook Questionnaire. Psychological Assessment, 17(1), 70-80. doi:10.1037/1040-3522.214.171.124 The Changes in Outlook Questionnaire (CiOQ; S. Joseph, R. Williams, & W. Yule, 1993) is a 26-item self-report measure that was designed to assess positive and negative changes in the aftermath of adversity. This article had 3 aims: 1st, to investigate the factor structure of the CiOQ; 2nd, to test for internal consistency reliability and convergent and discriminant validity; and, 3rd, to investigate the association between positive and negative changes in outlook, posttraumatic stress, and psychological distress. Three studies are reported. Study 1 provides evidence that positive and negative changes are statistically separable and that the 2-factor model is a better fit than the 1-factor model. Studies 2 and 3 provide evidence for internal consistency reliability, convergent and discriminant validity of the CiOQ, and its associations with posttraumatic stress and psychological distress. In conclusion, the CiOQ has much promise for research on responses to stressful and traumatic events.
Joseph, S., Linley, P. A., & Harris, G. (2005). Understanding positive change following trauma and adversity: Structural clarification. Journal of Loss and Trauma, 10(1), 83-96. doi:10.1080/15325020490890741 Growing interest in positive change following trauma and adversity has prompted the development of a number of different labels and measurement instruments. This proliferation has led to some conceptual confusion, due to the different labels being used, and structural confusion, due to the different numbers of underlying factors proposed. The present study addressed both these questions through exploratory principal components analysis of three different growth measures. One hundred seventy six adults (113 women, 63 men), who had experienced a range of distressing life events, completed the Perceived Benefit Scales, the Thriving Scale, and the Posttraumatic Growth Inventory. Results revealed that all subscales loaded highly on a single component, although the possibility of three second-order components of interpersonal relationships, self-perception, and spirituality, was also noted. Discussion focuses on the implications for understanding the concept and structure of positive change following adversity.
Joseph, S., Linley, P. A., Shevlin, M., Goodfellow, B., & Butler, L. (2006). Assessing positive and negative changes in the aftermath of adversity: A short form of the Changes in Outlook Questionnaire. Journal of Loss and Trauma, 11(1), 85-89. doi:10.1080/15325020500358241 The aim of this study was the preliminary development of a short 10-item version of the CiOQ. First, 10 items were selected on the basis of their high factor loadings in previously published work. Two studies are then reported. In Study 1, the 10 items were subjected to confirmatory factor analysis using data from a sample of college students (n ¼ 336) who had experienced adverse events. Study 2 involved a clinical sample (n ¼ 40) of people with posttraumatic stress disorder and examined associations of reported changes with posttraumatic stress symptoms and posttraumatic growth. Evidence is provided for a two-factor structure of the CiOQ Short Form, consisting of positive changes and negatives changes, and for the subscales' internal consistency reliability, convergent validity, and differential associations with clinically meaningful outcomes.
Joseph, S., Murphy, D., & Regel, S. (2012). An affective-cognitive processing model of post-traumatic growth. Clinical Psychology & Psychotherapy, 19, 316-25. doi:10.1002/cpp.1798
A topic that has begun to attract interest from clinical psychologists and psychotherapists is post-traumatic growth. First, we provide a general overview of the field, setting out the historical development, main concepts, measurement issues and research findings. Second, we review evidence showing that the relationship between post-traumatic stress and post-traumatic growth is likely curvilinear. Third, a new affective-cognitive processing model of post-traumatic growth will be introduced in which post-traumatic stress is understood to be the engine of post-traumatic growth. Fourth, points of clinical intervention are described showing the ways in which therapists can facilitate post-traumatic growth. KEY PRACTITIONER MESSAGE: No one approach to the treatment of trauma is able to help all people all of the time. Post-traumatic growth emerges out of satisfactory affective-cognitive processing. A common-factor approach that recognizes that there are many points of therapeutic intervention is described.
Joseph, S., & Williams, R. (2005). Understanding posttraumatic stress: Theory, reflections, context, and future. Behavioral and Cognitive Psychotherapy, 33(4), 423-441. doi:10.1017/S1352465805002328 Abstract. Exposure to a traumatic event may lead a person to experience posttraumatic stress. But there are wide individual differences in the severity and chronicity of reactions. Some people remain affected for considerable periods of time, but others are able to adjust relatively quickly, and some even go on to report experiencing positive personal changes as a result of experience of trauma. The psychosocial framework proposes that individual variation in response to trauma is attributable to the interaction between various personality and social psychological factors. This is a practical framework for formulation and for developing interventions with people who have problems adjusting to traumatic life experiences. In this paper we provide a retrospective account of the building of the psychosocial framework, and using case examples illustrate its use in formulation and developing intervention with individuals with varying difficulties. We also aim to look beyond this work in the past to subsequent developments and to future directions, in particular the new and emerging field of growth through adversity.
Joseph, S., Williams, R., & Yule, W. (1993). Changes in outlook following disaster: The preliminary development of a measure to assess positive and negative responses. Journal of Traumatic Stress, 6(2), 271-279. doi:10.1002/jts.2490060209 Although the introduction of PTSD (APA, 1980, 1987) has fueled much interest into the psychological sequelae of disaster, little attention has been paid to the more existential changes in outlook many survivors report. Preliminary work on the development of a measure to assess both positive and negative responses to disaster is presented.
Joseph, S., Williams, R., & Yule, W. (1995). Psychosocial perspectives on post-traumatic stress. Clinical Psychology Review, 15(6), 515-544. doi:10.1016/0272-7358(95)00029-O ABSTRACT. Although exposure to a traumatic event is a necessary etiological factor in the development of posttraumatic stress disorder, it is not thought to be sufficient and there remains much debate over what other factors may be associated with more severe and chronic distress. The present paper summarizes empirical work with survivors of various traumatic events. Evidence is reviewed for an integrative model of psychosocial factors relating to adjustment following traumatic stressors. The components of this model are stimulus factors, appraisal factors, personality factors, state factors, and activity factors. It is also argued that some forms of intrusion and avoidance constitute normal processes of appraisal and activity that mediate between the traumatic event and symptoms of increased arousal and negative affect. The social context of the traumatic event is also considered to be an important determinant of appraisal and activity. Methodological issues and implications for therapeutic intervention are addressed.
Joseph, S., Williams, R., & Yule, W. (1997). Post-traumatic stress: Psychosocial perspectives on PTSD and treatment. Chichester, West Sussex, England: Wiley.
Kashdan, T., Biswas-Diener, R., & King, L. (2008). Reconsidering happiness: The costs of distinguishing between hedonics and eudaimonia. Journal of Positive Psychology, 3(4), 219-233. doi:10.1080/17439760802303044 In recent years, well-being researchers have distinguished between eudaimonic happiness (e.g., meaning and purpose; taking part in activities that allow for the actualization of one's skills, talents, and potential) and hedonic happiness (e.g., high frequencies of positive affect, low frequencies of negative affect, and evaluating life as satisfying). Unfortunately, this distinction (rooted in philosophy) does not necessarily translate well to science. Among the problems of drawing too sharp a line between 'types of happiness' is the fact that eudaimonia is not well-defined and lacks consistent measurement. Moreover, empirical evidence currently suggests that hedonic and eudaimonic well-being overlap conceptually, and may represent psychological mechanisms that operate together. In this article, we outline the problems and costs of distinguishing between two types of happiness, and provide detailed recommendations for a research program on well-being with greater scientific precision.
Kashdan, T., & Kane, J. Q. (2011). Post-traumatic distress and the presence of post-traumatic growth and meaning in life: Experiential avoidance as a moderator. Personality and Individual Differences, 50(1), 84-89. Elsevier Ltd. doi:10.1016/j.paid.2010.08.028. Existing models of trauma suggest that for recovery to occur, trauma related cues and emotions require awareness and openness while survivors continue committing action toward valued life aims (other than regulating emotions). Based on this theoretical framework, an unwillingness to be in contact with distressing thoughts and feelings (experiential avoidance) might operate together with post-traumatic distress to predict when people find benefits and meaning in the aftermath of trauma. We hypothesized that people reporting post-traumatic distress and less reliance on experiential avoidance would report greater post-traumatic growth and meaning in life compared with other trauma survivors. We administered questionnaires to 176 college students reporting at least one traumatic event. Results supported these moderation models. This is the fourth study (with different samples, measures, and methodologies) to provide evidence that a combination of excessive anxiety and a heavy reliance on experiential avoidance leads to attenuated well-being. We discuss the implications for understanding heterogeneous trauma reactions.
Kelley, T. M. (2005). Natural resilience and innate mental health. The American psychologist, 60(3), 265; discussion 265-7. doi: 10.1037/0003-066X.60.3.265a.
Kesimci, A., Göral, S., & Gençöz, T. (2005). Determinants of stress-related growth: Gender, stressfulness of the event, and coping strategies. Current Psychology, 24(1), 68-75. doi:10.1007/s12144-005-1005-x Retrieved from EBSCOhost. The present study aimed to investigate the determinants of stress-related growth. For this aim the associations of gender, stressfulness of the event, and three coping strategies (problem-oriented, fatalistic, and helplessness) with stress-related growth were tested by multiple regression analysis. Participants were 132 undergraduate students. Results revealed that females reported higher levels of stress-related growth than males, and as expected, higher levels of the stressfulness of the event associated with more stress-related growth. Furthermore, frequent utilization of problem-oriented and fatalistic coping strategies was associated with higher stress-related growth. These findings were discussed in the light of relevant literature and culture-specific features.
King, L. (2000). Stories of life transition: Subjective well-being and ego development in parents of children with Down syndrome. Journal of Research in Personality, 34(4), 509-536. doi:10.1006/jrpe.2000.2285. Eighty-seven parents of children with Down Syndrome (DS; 63 women, 24 men) wrote narratives about finding out that their child had DS and completed questionnaire measures of subjective well-being (SWB) and stress-related growth and completed the Sentence Completion Test as a measure of ego development. Forty-two of these individuals participated in a follow-up 2 years later. Foreshadowing and happy endings in the stories were related to heightened SWB at both time periods. Evidence of accommodative change-actively experiencing a paradigmatic shift- was related to stress-related growth and ego development at both time periods. A high sense of closure and accommodation in the stories was associated with the highest levels of stress-related growth. Implications for research on well-being and personal growth are discussed.
King, L. A., Hicks, J. A., Krull, J. L., & Del Gaiso, A. K. (2006). Positive affect and the experience of meaning in life. Journal of Personality and Social Psychology, 90, 179-196. doi:10.1037/0022-35126.96.36.199 Six studies examined the role of positive affect (PA) in the experience of meaning in life (MIL). Study 1 showed strong relations between measures of mood, goal appraisals, and MIL. In multivariate analyses, PA was a stronger predictor of MIL than goal appraisals. In Study 2, the most consistent predictor of the experience of meaning in a day was the PA experienced that day. Later, global MIL was predicted by average daily PA, rather than average daily MIL. Study 3 demonstrated no prospective relations between measures of MIL and PA over 2 years. In Study 4, priming positive mood concepts enhanced MIL. In Study 5, manipulated positive mood enhanced ratings of MIL for those who were not given an attributional cue for their moods. In Study 6, PA was associated with a high level of distinction between meaningful and meaningless activities. Results indicate that positive moods may predispose individuals to feel that life is meaningful. In addition, positive moods may increase sensitivity to the meaning-relevance of a situation.
Klebanov, P., & Brooks-Gunn, J. (2006). Cumulative, human capital, and psychological risk in the context of early intervention: links with IQ at ages 3, 5, and 8. Annals of the New York Academy of Sciences, 1094, 63-82. doi:10.1196/annals.1376.007. This article examines the effects of risks for a sample of low birth weight children (2,001 to 2,500 g and family income-to-needs at 250% of the poverty threshold or less; n = 228) using data from the Infant Health and Development Program (IHDP, an experiment testing the efficacy of early intervention). Cognitive test scores (IQ) are assessed at 3, 5, and 8 years of age. Links with risks at each age point are examined using three different models-cumulative, human capital, and psychological risks. Similar decrements in IQ scores are found at all ages for the cumulative and human capital models but not for the psychological risk model. Treatment effects are found at 3 years of age (when the intervention ended) for all levels of risk and for all models. Sustained effects of the treatment were found at 5 and 8 years of age for children with moderate levels of human capital risk but were not found for any levels of psychological risk. Implications for early childhood intervention programs are discussed.
Knaevelsrud, C., Liedl, A., & Maercker, A. (2010). Posttraumatic growth, optimism and openness as outcomes of a cognitive-behavioural intervention for posttraumatic stress reactions. Journal of health psychology, 15(7), 1030-8. doi:10.1177/1359105309360073.The aim of this study was to examine the effect of an Internet-based CBT intervention on posttraumatic growth, openness and optimism. Ninety-six participants suffering from posttraumatic stress reactions were randomly assigned to either the treatment or a waiting-list control condition. We assessed posttraumatic stress reactions, depression and anxiety, posttraumatic growth, optimism and openness to new experiences. We found significant changes in posttraumatic growth in the treatment group. In addition regression analysis revealed that symptom improvements in posttraumatic stress reactions significantly predicted posttraumatic growth post-treatment. Our findings indicate the potential of psychotherapy to stimulate posttraumatic growth.
Kobasa, S. C. (1979). Stressful life events, personality and health: An inquiry into hardiness. Journal of Personality and Social Psychology, 37, 1-11. doi:10.1037/0022-35188.8.131.52 Studied personality as a conditioner of the effects of stressful life events on illness onset. Two groups of middle-and upper-level 40-49 yr old executives had comparably high degrees of stressful life events in the previous 3 yrs, as measured by the Schedule of Recent Events. One group of 86 Ss suffered high stress without falling ill, whereas the other group of 75 Ss reported becoming sick after their encounter with stressful life events. Illness was measured by the Seriousness of Illness Survey (A. R. Wyler et al 1970). Discriminant function analysis, run on half of the Ss in each group and cross-validated on the remaining cases, supported the prediction that high stress/low illness executives show, by comparison with high stress/high illness executives, more hardiness, that is, have a stronger commitment to self, an attitude of vigorousness toward the environment, a sense of meaningfulness, and an internal locus of control.
Kunst, M. J. J. (2011). Affective personality type, post-traumatic stress disorder symptom severity and post-traumatic growth in victims of violence. Stress and Health, 27(1), 42-51. doi: 10.1002/smi.1318. The current study explored the differential association between affective personality type, post-traumatic stress disorder (PTSD) symptom severity, and post-traumatic growth (PTG) in victims of violence (N = 113). Relying on previous research, median cut off-scores on the Positive and Negative Affect Schedule Short Form were used to classify participants as high affective [i.e. high positive affectivity (PA) and high negative affectivity (NA)], self-actualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA) and low affective (i.e. low PA and low NA). Results indicated that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptoms severity. High affective personality type was found to be the only significant predictor of PTG. Results, study limitations and directions for future research were discussed.
Lechner, S. C., & Antoni, M. H. (2004). Posttraumatic growth and group-based interventions for persons dealing with cancer: What have we learned so far? Psychological Inquiry, 15(1), 35-41. Abstract: Investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of the "Psychological Inquiry" present a complex theoretical model of the development of post-traumatic growth. This model is of special interest here given the emphasis on developing and testing clinical interventions to promote psychological health and thriving. This article is concerned with the clinical applications of Tedeschi and Calhoun's theory, and has tested various pathways of the theory in individuals with cancer. This article focuses on those facets of this theory that are particularly relevant to facilitating post-traumatic growth within a group setting.
Lerner, R. M. (2006). Resilience as an attribute of the developmental system: Comments on the papers of Professors Masten & Wachs. Annals of the New York Academy of Sciences, 1094, 40-51. doi:10.1196/annals.1376.005. When conceptualized within a developmental systems theoretical framework, resilience involves mutually beneficial, reciprocally influential relations between a person and his or her context. The key features of developmental systems theory, which stress the plasticity of these relations, lead to an optimistic view of the possibility of promoting positive human development (PHD) across the life span. The results of recent longitudinal research about adolescent development allow this period to serve as a sample case of how positive development is associated with the alignment of the strengths of individuals with ecological resources for healthy growth.
Levine, S. Z., Laufer, A., Hamama-Raz, Y., Stein, E., & Solomon, Z. (2008). Posttraumatic growth in adolescence: Examining its components and relationship with PTSD. Journal of traumatic stress, 21(5), 492-6. doi:10.1002/jts.20361. To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.
Lev-Wiesel, R., Amir, M. & Besser, A. (2004). Posttraumatic growth among female survivors of childhood sexual abuse in relation to the perpetrator identity, Journal of Loss and Trauma, 10(1), 7-17. doi:10.1080/15325020490890606 The objective of this study was to examine the extent of posttraumatic stress disorder (PTSD) symptomatology and posttraumatic growth in young adult female survivors of childhood sexual abuse in relation to the identity of the perpetrator. Two hundred and forty-six non-clinical female university students were administered self-report questionnaires with regard to negative life events, PTSD symptoms, and posttraumatic growth. A sample of 93 participants who reported having been sexually abused during childhood either by a family member or a stranger were drawn for the study purpose. Comparison between the survivors in relation to the identity of the perpetrator, family member versus a stranger, revealed that the levels of PTSD and posttraumatic growth were both higher among survivors who were sexually abused by a family member compared to those who were sexually abused by a stranger. Mediational analysis revealed that levels of PTSD mediated the identity of the perpetrator effect on posttraumatic growth.
Linley, P. A. (2003). Positive adaptation to trauma: Wisdom as both process and outcome. Journal of Traumatic Stress, 16(6), 601-610. doi:10.1023/B:JOTS.0000004086.64509.09 Positive adaptation to psychological trauma and wisdom both have a rich history in European literature and philosophy. Although the literature on posttraumatic growth has recognized the possibility of wisdom as an outcome of adaptation, its role in the process of adaptation has been neglected. A theoretical framework is presented that conceptualizes three dimensions of wisdom as crucial to an understanding of the role it can play in posttraumatic positive adaptation. These dimensions are the recognition and management of uncertainty; the integration of affect and cognition; and the recognition and acceptance of human limitation. The role of these dimensions in the process and outcome of traumatic adaptation is considered, together with limitations of the framework and directions for future research.
Linley, P. A., Andrews, L., & Joseph, S. (2007). Confirmatory factor analysis of the Posttraumatic Growth Inventory. Journal of Loss and Trauma, 12(4), 321-332. doi:10.1080/15325020601162823 With a sample of 372 participants who had experienced a range of adverse life events, we conducted a confirmatory factor analysis (CFA) of the Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996). CFA results support the original five-factor structure, as well as indicating that a single higher-order construct with five first-order latent variables provides an acceptable fit.
Linley, P., & Joseph, S. (2003). Trauma and personal growth. Psychologist, 16(3), 135.
Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11-21. doi:10.1023/B:JOTS.0000014671.27856.7e Empirical studies (n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress-related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. The review indicated that cognitive appraisal variables (threat, harm, and controllability), problem-focused, acceptance and positive reinterpretation coping, optimism, religion, cognitive processing, and positive affect were consistently associated with adversarial growth. The review revealed inconsistent associations between adversarial growth, sociodemographic variables (gender, age, education, and income), and psychological distress variables (e.g., depression, anxiety, posttraumatic stress disorder). However, the evidence showed that people who reported and maintained adversarial growth over time were less distressed subsequently. Methodological limitations and recommended future directions in adversarial growth research are discussed, and the implications of adversarial growth for clinical practice are briefly considered. "It is through this process of struggling with adversity that changes may arise that propel the individual to a higher level of functioning than that which existed prior to the event. These positive changes have been labelled posttraumatic growth, stress-related growth, perceived benefits, thriving, blessings, positive by-products, positive adjustment, and positive adaptation." (p. 11) -Post traumatic growth has validity -Associated more with perception of threat than severity of trauma -Coexists with negative feelings eg PTS -Relatively stable over time -Some evidence that higher PTG predicts better adjustment
Linley, P. A., & Joseph, S. (Eds.). (2004). Positive psychology in practice. Hoboken, NJ: Wiley.
Linley, P. A., & Joseph, S. (2005). The human capacity for growth through adversity. The American psychologist, 60(3), 262-4; discussion 265-7. doi: 10.1037/0003-066X.60.3.262b. Comments on George Bonanno's article entitles Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see 10.1037/0003-066X.59.1.20). The author notes that Bonanno articulated a model of loss and trauma-related resilience cogently and evocatively. In the trauma field, there is a new focus on risk and resilience factors across the life span (e.g., King, Vogt, & King, 2004), and the article by Bonanno will serve as a herald for this new way of thinking about adjustment to trauma and loss. Because the author believes that the most important function of Bonanno's article should be to stimulate theory development and research in this burgeoning area, he raises three issues in service of that goal.
Linley, P. A., & Joseph, S. (2011). Meaning in life and posttraumatic growth. Journal of Loss & Trauma, 16(2), 150-159. doi:10.1080/15325024.2010.519287 It has often been assumed that the search for meaning following adversity is adaptive, but scant evidence exists to support this. Rather, it seems that while the presence of meaning is adaptive, the search for meaning is actually related to greater distress. Across three samples (158 churchgoers, 128 members of the general population, 84 funeral directors), we assessed schematic changes following adversity using the Changes in Outlook Questionnaire and both the presence of meaning and the search for meaning using the Meaning in Life Questionnaire. It was found that the presence of meaning was associated with greater positive change and less negative change, but the search for meaning was associated with greater negative change across all three samples.
Linley, P. A., Joseph, S., & Goodfellow, B. (2008). Positive changes in outlook following trauma and their relationship to subsequent posttraumatic stress, depression, and anxiety. Journal of Social and Clinical Psychology, 27, 877-891. doi:10.1521/jscp.2008.27.8.877 In a study of 40 traumatized people who were interviewed twice over a six-month interval, the experience of positive changes predicted lower levels of PTSD symptoms, depression, and anxiety. The authors discussed implica-tions of the findings for clinical work with traumatized people.
Linley, P. A., Joseph, S., Harrington, S., & Wood, A. M. (2006). Positive psychology: Past, present, and (possible) future. Journal of Positive Psychology, 1(1), 3-16. doi:10.1080/17439760500372796. Abstract What is positive psychology? Where has it come from? Where is it going? These are the questions we address in this article. In defining positive psychology, we distinguish between the meta-psychological level, where the aim of positive psychology is to redress the imbalance in psychology research and practice, and the pragmatic level, which is concerned with what positive psychologists do, in terms of their research, practice, and areas of interest. These distinctions in how we understand positive psychology are then used to shape conceptions of possible futures for positive psychology. In conclusion, we identify several pertinent issues for the consideration of positive psychology as it moves forward. These include the need to synthesize the positive and negative, build on its historical antecedents, integrate across levels of analysis, build constituency with powerful stakeholders, and be aware of the implications of description versus prescription.
Litz, B. T. (2005). Has resilience to severe trauma been underestimated? American psychologist, 60(3), 262; discussion 265-7. doi:10.1037/0003-066X.60.3.262a. Comments on George Bonanno's article entitles Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see 10.1037/0003-066X.59.1.20). The author notes that Bonanno articulated a model of loss and trauma-related resilience cogently and evocatively. In the trauma field, there is a new focus on risk and resilience factors across the life span (e.g., King, Vogt, & King, 2004), and the article by Bonanno will serve as a herald for this new way of thinking about adjustment to trauma and loss. Because the author believes that the most important function of Bonanno's article should be to stimulate theory development and research in this burgeoning area, he raises three issues in service of that goal.
Luthar, S. S. (2006). Resilience in development: A synthesis of research across five decades. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Risk, disorder, and adaptation (2nd edition), pp. 739-795. New York: Wiley.
Luthar, S. S., & Cicchetti, D. (2000). The construct of resilience: Implications for interventions and social policies. Development and psychopathology, 12(4), 857-85. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1903337&tool=pmcentrez&rendertype=abstract. The focus of this article is on the interface between research on resilience-a construct representing positive adaptation despite adversity—and the applications of this work to the development of interventions and social policies. Salient defining features of research on resilience are delineated, as are various advantages, limitations, and precautions linked with the application of the resilience framework to developing interventions. For future applied efforts within this tradition, a series of guiding principles are presented along with exemplars of existing programs based on the resilience paradigm. The article concludes with discussions of directions for future work in this area, with emphases on an enhanced interface between science and practice, and a broadened scope of resilience-based interventions in terms of the types of populations, and the types of adjustment domains, that are encompassed.
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543-562. doi:10.1111/1467-8624.00164. This paper presents a critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity. As empirical research on resilience has burgeoned in recent years, criticisms have been levied at work in this area. These critiques have generally focused on ambiguities in definitions and central terminology; heterogeneity in risks experienced and competence achieved by individuals viewed as resilient; instability of the phenomenon of resilience; and concerns regarding the usefulness of resilience as a theoretical construct. We address each identified criticism in turn, proposing solutions for those we view as legitimate and clarifying misunderstandings surrounding those we believe to be less valid. We conclude that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals. Realization of the potential embodied by this construct, however, will remain constrained without continued scientific attention to some of the serious conceptual and methodological pitfalls that have been noted by skeptics and proponents alike.
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). Research on resilience: Response to commentaries. Child Development, 71(3), 573-575. doi:10.1111/1467-8624.00168. Clarifications are provided with respect to two sets of issues raised in preceding commentaries. First, interaction effects are undoubtedly salient in resilience research; yet main effect findings can be equally critical from an intervention perspective. Second, although resilience research and prevention science reflect similar broad objectives, the former (but not usually the latter) involves explicit attention to positive adjustment outcomes in addition to the avoidance of psychopathology.
Luthar, S. S., Sawyer, J., & Brown, P. J. (2006). Conceptual issues in studies of resilience: Past, present, and future research. Annals of the New York Academy of Sciences, 1094, 105-15. doi:10.1196/annals.1376.009. We begin this article by considering the following critical conceptual issues in research on resilience: (1) distinctions between protective, promotive, and vulnerability factors; (2) the need to unpack underlying processes; (3) the benefits of within-group experimental designs; and (4) the advantages and potential pitfalls of an overwhelming scientific focus on biological and genetic factors (to the relative exclusion of familial and contextual ones). The next section of the article is focused on guidelines for the selection of vulnerability and protective processes in future research. From a basic science standpoint, it is useful and appropriate to investigate all types of processes that might significantly affect adjustment among at-risk individuals. If the research is fundamentally applied in nature, however, it would be most expedient to focus on risk modifiers that have high potential to alter individuals' overall life circumstances. The final section of this article considers conceptual differences between contemporary resilience research on children versus adults. Issues include differences in the types and breadth of outcomes (e.g., the tendencies to focus on others' ratings of competence among children and on self-reports of well-being among adults respectively).
Lyons, J. A. (1991). Strategies for assessing the potential for positive adjustment following trauma. Journal of Traumatic Stress, 4(1), 93-111. doi:10.1002/jts.2490040108 The subset of survivors who evidence resilience rather than pathology following trauma is frequently overlooked in empirical studies and theoretical discussions of PTSD. Susceptibility to dysfunction is clearly not a simple function of individual fortitude. The present paper discusses the complex interplay of variables which may influence post-trauma adjustment and suggests assessment instruments which may be useful in future research on this topic.
Maddi, S. R. (2005). On hardiness and other pathways to resilience. The American psychologist, 60(3), 261-2; discussion 265-7. doi:10.1037/0003-066X.60.3.261. Comments on George Bonanno's article entitles Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events? (see 10.1037/0003-066X.59.1.20). The author of this comment notes that Bonanno's article is a compelling analysis of several different reactions to extremely aversive events. With regard to major stressors, such as the death of a loved one or the experience a life-threatening circumstance, there is, notably, not only the psychopathological breakdown (e.g., posttraumatic stress disorder [PTSD] or depressive disorder) that has been emphasized but also the less recognized resilient response, in which there is little or no loss of functioning. Whereas the emphasis in the breakdown response is understandably on treatment that facilitates recovery, the resilient response may require little but the person's own ongoing efforts in life to continue effectively. Indeed, Bonanno suggested that the typical treatment efforts following traumatic events might actually undermine the resilient person's adjustment efforts. Bonanno's conceptualization and supportive research evidence advance our understanding of individuals' reactions to massive stressors. Further, Bonanno (2004) argued that there are multiple pathways to resilience under stress, and he identified personality hardiness as one of them. His presentation of hardiness accurately emphasizes its interrelated attitudes of commitment (rather than alienation), control (rather than powerlessness), and challenge (rather than threat) but does not cover how this concept has evolved over the last 25 years. Coordinating theory, research, and practice over this period of time, the author has concluded (Maddi, 2002) that hardy attitudes amount to the courage and motivation to face stressors accurately (rather than to deny or catastrophize them). This courage and motivation lead to coping by problem solving rather than by avoiding and to interacting with others by giving and getting assistance and encouragement rather than by striking out or overprotecting. Thus, personality hardiness is emerging as a pattern of attitudes and actions that helps in transforming stressors from potential disasters into growth opportunities. The author concludes that Bonanno's exciting position has opened the way for such comparative analytic research through which researchers can further their current knowledge concerning how resilience under stress comes about.
Maddux, J. E., Snyder, C. R., & Lopez, S. J. (2004). Toward a positive clinical psychology: Deconstructing the illness ideology and constructing an ideology of human strengths and potential. In P. A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 320-334). Hoboken, NJ: Wiley.
Maercker, A., & Zoellner, T. (2004). The Janus face of self-perceived growth: Toward a two-component model of posttraumatic growth. Psychological Inquiry, 15(1), 41-48 Abstract: Researchers studying groups of traumatized patients whose trauma fulfils the "Diagnostic and Statistical Manual of Mental Disorders" criteria are continually surprised by spontaneous reports of growth or maturity among these shattered individuals. This applies to people who have suffered sexual violence, torture, persecution, or wartime experiences, at least the majority of them. This article begins with a critical discussion of the possibilities and limitations of the model proposed by investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of "Psychological Inquiry" then explores what implications can be drawn from the failure, as yet, to find a connection between post-traumatic growth and psychological adjustment.
Masten, A. S. (2001). Ordinary magic. Resilience processes in development. American Psychologist, 56(3), 227-38. doi:10.1037/0003-066X.56.3.227. The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology.
Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Frameworks for research, practice, and translational synergy. Development and Psychopathology, 23(02), 493-506. doi:10.1017/S0954579411000198. This article delineates parallel frameworks that grew out of the research on risk and resilience over the past four decades, a framework for research and a framework for practice, and then discusses the promise of an emerging synthesis. The research framework defined the meaning, models, and methods that successfully guided four waves of research to date on the nature and processes involved in human resilience. The applied framework emerged in response to urgent needs of children and families faced by adversity and those charged with helping them, resulting in guidelines for translating the unfolding but incomplete research evidence into action. The application of a resilience approach transformed practice in many fields concerned with promoting resilience in people at risk for problems, revolutionizing the mission, models, measures, and methods of practice to align with the emphasis on positive adaptation and strengths defining a resilience-based approach. Yet these interventions rarely translated back to inform and refine resilience theory in ways that would accelerate progress to promote resilience more effectively. The concluding section on translational synergy discusses the potential for a synthesis of basic and applied resilience frameworks as the next steps toward realizing the original objective and promise of resilience science.
Masten, A. S., & Obradovic, J. (2006). Competence and resilience in development. Annals of the New York Academy of Sciences, 1094, 13-27. doi:10.1196/annals.1376.003. The first three waves of research on resilience in development, largely behavioral in focus, contributed a compelling set of concepts and methods, a surprisingly consistent body of findings, provocative issues and controversies, and clues to promising areas for the next wave of resilience research linking biology and neuroscience to behavioral adaptation in development. Behavioral investigators honed the definitions and assessments of risk, adversity, competence, developmental tasks, protective factors, and other key aspects of resilience, as they sought to understand how some children overcome adversity to do well in life. Their findings implicate fundamental adaptive systems, which in turn suggest hot spots for the rising fourth wave of integrative research on resilience in children, focused on processes studied at multiple levels of analysis and across species.
McGrath, J. C. (2006). Post-traumatic growth and the origins of early Christianity [Special issue]. Mental Health, Religion & Culture, 9(3), 291-306. doi:10.1080/13694670600615532. This paper applies the concept of post-traumatic growth, and some contemporary psychological models of wisdom, to the phenomenon of the emergence and development of Christianity in the aftermath of the traumatic death of its leader. It is argued that a process of 'sense-making' is evident in the New Testament texts, particularly the Passion narratives. There is evidence that this process involved a modification of existing cultural schemas to accommodate both the challenges posed by the death of Jesus and his followers' affective experience of his continuing presence. The texts also contain evidence of a developing wisdom tradition based on the transformation of suffering into victory, the finding of strength in weakness, and the emergence of wisdom where human thinking reaches its limits. It is suggested that the meaning and social cohesion that this provided for the primitive Church go some way towards explaining its dramatic growth and resilience in the face of persecution.
McMillen, J. C. (2004). Posttraumatic growth: What's it all about? Psychological Inquiry, 15(1), 48-52. Abstract: Research on the positive changes that people report following adversity could be described as at the Alfie stage of development. Researchers have discovered an interesting finding-people commonly report positive changes from their tragedies, but the key question remains as to what it is all about. In their target article, investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of the "Psychological Inquiry," propose to answer this question through the introduction of a complex explanatory model of the phenomenon they call post-traumatic growth.
McMillen, J. C., & Fisher, R. H. (1998). The Perceived Benefits Scales: Measuring perceived positive life changes after negative events. Social Work Research, 22(3), 173-187. If social work researchers are to accurately describe the psychosocial functioning of clients who experience negative events, they need to consider positive as well as negative outcomes. In this article, new measures of self-reported positive life changes after traumatic stressors are introduced. Factor analyses suggest that the Perceived Benefit Scales consist of eight subscales: lifestyle changes; material gain; and increases in self-efficacy, family closeness, community closeness, faith in people, compassion, and spirituality. Internal consistency and test-retest coefficients range from adequate to excellent. The scales correlate with indicators of severity and differ by type of negative event experienced.
McMillen, J. C., Smith, E. M., & Fisher, R. H. (1997). Perceived benefit and mental health after three types of disaster. Journal of Consulting and Clinical Psychology, 65(5), 733-739. doi:10.1037/0022-006X.65.5.733 The study of growth and perceived benefit after traumatic events has been hailed as one of the most promising directions for stress research. This research, however, has been limited by several methodological limitations. These limitations are addressed in this prospective study, which examines perceived benefit and mental health adjustment after 3 different types of disaster. Survivors of a tornado in Madison, Florida, had the highest rates of perceived benefit, followed by survivors of a mass killing in Killeen, Texas, and survivors of a plane crash in Indianapolis, Indiana. Perceived benefit 4-6 weeks postdisaster predicted posttraumatic stress disorder 3 years later. Perceived benefit moderated the effect of severity of disaster exposure on mental health diagnosis change over time. Without perceived benefit, as exposure severity increased, the amount of recovery decreased. If benefit was perceived, as exposure severity increased, the amount of recovery increased. Implications for clinical interventions and future research are discussed.
McNally, R. J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 54, 229-52. doi:10.1146/annurev.psych.54.101601.145112. Research on posttraumatic stress disorder (PTSD) has been notable for controversy as well as progress. This article concerns the evidence bearing on the most contentious issues in the field of traumatic stress: broadening of the definition of trauma, problems with the dose-response model of PTSD, distortion in the recollection of trauma, concerns about "phony combat vets," psychologically toxic guilt as a traumatic stressor, risk factors for PTSD, possible brain-damaging effects of stress hormones, recovered memories of childhood sexual abuse, and the politics of trauma.
McNally, R. J., Bryant, R. A., & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest, 4(2), 45-79. doi:10.1111/1529-1006.01421 Summary-In the wake of the terrorist attacks at the World Trade Center, more than 9,000 counselors went to New York City to offer aid to rescue workers, families, and direct victims of the violence of September 11, 2001. These mental health professionals assumed that many New Yorkers were at high risk for developing posttraumatic stress disorder (PTSD), and they hoped that their interventions would mitigate psychological distress and prevent the emergence of this syndrome. Typically developing in response to horrific, life-threatening events, such as combat, rape, and earthquakes, PTSD is characterized by reexperiencing symptoms (e.g., intrusive recollections of the trauma, nightmares), emotional numbing and avoidance of reminders of the trauma, and hyperarousal (e.g., exaggerated startle, difficulty sleeping). People vary widely in their vulnerability for developing PTSD in the wake of trauma. For example, higher cognitive ability and strong social support buffer people against PTSD, whereas a family or personal history of emotional disorder heightens risk, as does negative appraisal of one's stress reactions (e.g., as a sign of personal weakness) and dissociation during the trauma (e.g., feeling unreal or experiencing time slowing down). However, the vast majority of trauma survivors recover from initial posttrauma reactions without professional help. Accordingly, the efficacy of interventions designed to mitigate acute distress and prevent longterm psychopathology, such as PTSD, needs to be evaluated against the effects of natural recovery. The need for controlled evaluations of early interventions has only recently been widely acknowledged. Psychological debriefing-the most widely used method-has undergone increasing empirical scrutiny, and the results have been disappointing. Although the majority of debriefed survivors describe the experience as helpful, there is no convincing evidence that debriefing reduces the incidence of PTSD, and some controlled studies suggest that it may impede natural recovery from trauma. Most studies show that individuals who receive debriefing fare no better than those who do not receive debriefing. Methodological limitations have complicated interpretation of the data, and an intense controversy has developed regarding how best to help people in the immediate wake of trauma. Recent published recommendations suggest that individuals providing crisis intervention in the immediate aftermath of the event should carefully assess trauma survivors' needs and offer support as necessary, without forcing survivors to disclose their personal thoughts and feelings about the event. Providing information about the trauma and its consequences is also important. However, research evaluating the efficacy of such "psychological first aid" is needed. Some researchers have developed early interventions to treat individuals who are already showing marked stress symptoms, and have tested methods of identifying those at risk for chronic PTSD. The single most important indicator of subsequent risk for chronic PTSD appears to be the severity or number of posttrauma symptoms from about 1 to 2 weeks after the event onward (provided that the event is over and that there is no ongoing threat). Cognitive-behavioral treatments differ from crisis intervention (e.g., debriefing) in that they are delivered weeks or months after the trauma, and therefore constitute a form of psychotherapy, not immediate emotional first aid. Several controlled trials suggest that certain cognitive-behavioral therapy methods may reduce the incidence of PTSD among people exposed to traumatic events. These methods are more effective than either supportive counseling or no intervention. In this monograph, we review risk factors for PTSD, research on psychological debriefing, recent recommendations for crisis intervention and the identification of individuals at risk of chronic PTSD, and research on early interventions based on cognitive-behavioral therapy. We close by placing the controversy regarding early aid for trauma survivors in its social, political, and economic context.
Milam, J. E., Ritt-Olson, A., & Unger, J. B. (2004). Posttraumatic growth among adolescents. The Annals of the American Academy of Political and Social Science, 19(2), 192-204. doi:10.1177/0743558403258273 This study examined posttraumatic growth (PTG), the construing of benefits from a traumatic event, in a sample of 435 mostly Hispanic adolescents who experienced a major life event within the previous 3 years. Levels of PTG did not differ between experienced negative life events. The relationship between PTG and sociodemographics, substance use, religiosity, and depression was explored. Age and religiosity were positively associated with PTG, whereas substance use was inversely associated with PTG. Only age and substance use remained associated with PTG after adjusting for all other variables in a multiple regression analysis. These results demonstrate the existence of PTG among an adolescent population and suggest that PTG can be related to important health behaviors such as substance use.
Moore, S. , Varra, A., Michael, S. T., & Simpson, T. L. (2010). Stress-related growth, positive reframing, and emotional processing in the prediction of post-trauma functioning among veterans in mental health treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 2(2), 93-96. doi:10.1037/a0018975. The role of stress related growth (SRG) in posttrauma functioning is currently uncertain and may be obscured by the overlap between SRG and key coping strategies. Utilizing a veteran sample in mental health treatment, the current study examined whether SRG accounts for unique variance in the severity of posttraumatic stress disorder (PTSD), depression, and Disorders of Extreme Stress Not Otherwise Specified (DESNOS) beyond the effects of two general coping strategies, emotional processing and positive reframing. Curvilinear relationships were evident between SRG and outcome measures, such that individuals with moderate SRG reported the greatest distress, and individuals with the lowest and highest SRG scores reported lower distress. In regression analyses, SRG accounted for significant variance in lower PTSD, depression, and DESNOS while accounting for demographics, trauma type, emotional processing, and positive reframing. The results suggest that SRG captures variance in posttrauma functioning that may be distinct from general emotional processing and positive reframing coping and provides further evidence for a curvilinear relationship between SRG and measures of psychological distress.
Morris, B. A., Shakespeare-Finch, J., Rieck, M., & Newbury, J. (2005). Multidimensional nature of posttraumatic growth in an Australian population. Journal of Traumatic Stress, 18(5), 575-585. doi:10.1002/jts.20067 Recent trauma literature has supported a philosophical shift from a pathogenic to a salutogenic paradigm in which the focus is on positive, as well as negative, posttrauma changes; however, empirical knowledge exploring the different domains of positive change or posttraumatic growth (PTG) is scarce. The present study investigated the multidimensionality of PTG in Australian undergraduate students (N=219). Results indicated five factors for the Posttraumatic Growth Inventory, and moderate levels of PTG. Trauma severity was found to significantly predict PTG in addition to a positive correlation between PTG and negative posttrauma effects. While not negating negative effects of traumatic experiences, this area of traumatology research has important implications for redefining the victims of trauma as individuals capable of positive change rather than merely surviving.
Nelson, S. D. (2011). The posttraumatic growth path: An emerging model for prevention and treatment of trauma-related behavioral health conditions. Journal of Psychotherapy Integration, 21(1), 1-42. doi:10.1037/a0022908. The aim of this study is threefold. First, the current evidence-based treatments for posttraumatic stress disorder (PTSD) are reviewed. Treatments reviewed for efficacy include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing. Next, concepts identified as protective measures against chronic PTSD are explored, with particular emphasis on resiliency and posttraumatic growth (PTG). Third, based on the abovementioned systematic review, a new treatment model for trauma-related behavioral health conditions, the posttraumatic growth path (PTGP), is proposed. This research will demonstrate how this new model integrates a variety of therapeutic approaches and protective measures to treat and mitigate the development of chronic PTSD and other concomitant mental health concerns. Implications for practice are discussed
Neimeyer, R. A. (2004). Fostering posttraumatic growth: A narrative elaboration. Psychological Inquiry, 15(1), 53-59. Abstract: In their target article, investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of the "Psychological Inquiry" summarize the fecund field of research on post-traumatic growth, a burgeoning literature that amply demonstrates the association between traumatic disruptions of people's worlds of meaning and their frequent reports of positive personal transformation. As they document, whether the profound challenges to the fundamental schemas of survivors lives result from encounters with tragic bereavement, catastrophic illness, interpersonal violence, or political oppression, a majority experience growth as well as grief, being prompted by highly distressing circumstances to higher levels of post-trauma adaptation.
Nelson, S. D. (2011). The posttraumatic growth path: An emerging model for prevention and treatment of trauma-related behavioral health conditions. Journal of Psychotherapy Integration, 21(1), 1-42. doi:10.1037/a0022908. The aim of this study is threefold. First, the current evidence-based treatments for posttraumatic stress disorder (PTSD) are reviewed. Treatments reviewed for efficacy include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing. Next, concepts identified as protective measures against chronic PTSD are explored, with particular emphasis on resiliency and posttraumatic growth (PTG). Third, based on the abovementioned systematic review, a new treatment model for trauma-related behavioral health conditions, the posttraumatic growth path (PTGP), is proposed. This research will demonstrate how this new model integrates a variety of therapeutic approaches and protective measures to treat and mitigate the development of chronic PTSD and other concomitant mental health concerns. Implications for practice are discussed
Nolen-Hoeksema, S., & Davis, C. C. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15(1), 60-64. Abstract: Although the idea of growth following adversity is not new to humanistically oriented counseling psychologists. Few researchers gave much attention to such a notion until the late 1980s. Since then, investigators Richard G. Tedeschi and Lawrence G. Calhoun have been at the forefront of efforts to document the evidence of post-traumatic growth, and to suggest the processes by which distressing negative events may become catalysis for personal development, values reorganization. With the recent focus on optimal human functioning, resilience, and well-being, research on post-traumatic growth has become popular.
O'Brien, T. B., & DeLongis, A. (1996). The interactional context of problem-, emotion-, and relationship-focused coping: The role of the Big Five personality types. Journal of Personality, 64, 775-813. doi:10.1111/j.1467-6494.1996.tb00944.x This study examined the role that personality and situational factors play in three forms of coping responses: problem-, emotion- and relationship-focused. Coping responses were strongly associated with whether the situation involved a primarily agentic (work) or communal (interpersonal) stressor. Among communal stressors, the involvement of close versus distant others was also associated with coping responses. Situational factors were linked most strongly with the use of problem-focused (planful problem solving) and relationship-focused (empathic responding) modes of coping. Dimensions of personality derived from the five-factor model (Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness) had important associations with coping responses. Coping responses were best predicted by models that included both the additive and multiplicative effects of person and situation factors. Taken together, the findings suggest that a model of coping that considers both agentic and communal dimensions of stressful situations, includes interpersonal dimensions of coping, and considers personality and situation factors in tandem is needed to increase the predictive utility of current models.
O'Leary, V. E. (2010). Strength in the face of adversity: Individual and social thriving. Journal of Social Issues, 54(2), 425-446. doi:10.1111/j.1540-4560.1998.tb01228.x Inherent in any profound challenge is the potential for crisis or opportunity. This article focuses on the opportunities that challenge presents at the level of individuals, organizations, and nations: opportunities to move beyond recovery and to display thriving by using the challenge as an impetus for change leading to growth. A variety of individual and social resources hypothesized to promote thriving are explored with an eye toward identifying a set of conceptually meaningful categories for use in future theoretical development and empirical investigation.
O'Leary, V. E., & Ickovics, J. R. (1995). Resilience and thriving in response to challenge: An opportunity for a paradigm shift in women's health. Women's Health: Research on Gender, Behavior, and Policy, 1, 121-142. The purpose of this article is to move beyond the vulnerability/deficit model of women and to focus on women's strengths and their ability to thrive in the face of adversity. Thriving is a dynamic process of adaptation, influenced by numerous individual and social factors; it emerges and changes over the life course and may be identified in behavioral, cognitive, or affective domains. The foundation of this concept comes from the literature on resilience, but it goes beyond the common view of resilience as homeostasis. It suggests, instead, a value-added construct whereby challenge provides an opportunity for change and growth. Understanding the concept and process of thriving can provide an important basis for theoretical development, empirical research, and clinical intervention. Thriving can provide a framework within which to examine the antecedents and consequences of differential reactions to health-related challenges. Knowledge of the factors that promote thriving can provide an important foundation for a paradigm shift away from a focus on illness and pathology toward one that understands, explains, and nurtures health.
Ong, A. D., Fuller-Rowell, T. E., & Bonanno, G. (2010). Prospective predictors of positive emotions following spousal loss. Psychology and Aging, 25(3), 653-60. doi:10.1037/a0018870. Whereas theoreticians are interested in modeling how bereavement contributes to health, the bulk of research on spousal bereavement is conducted after a loss has occurred. Using prospective longitudinal data, this study examined the extent to which positive emotion following spousal loss varies on the basis of preloss characteristics of the bereaved spouse and the marital relationship prior to loss. Analyses are based on the National Survey of Midlife Development (MIDUS), a 2-wave panel survey of adults in the contiguous United States. Results indicate that compared with continuously married controls, widowed participants experienced a significant decline in positive emotion within 3 years following loss. Conversely, no significant declines in positive emotion were evident among widowed persons with greater preloss trait resilience or greater marital strain. Results provide support for the notion that adjustment to loss may be linked to factors that precede actual loss.
Ong, A. D., Zautra, A. J., & Reid, M. C. (2010). Psychological resilience predicts decreases in pain catastrophizing through positive emotions. Psychology and Aging, 25(3), 516-23. doi:10.1037/a0019384. The study used a daily process design to examine the role of psychological resilience and positive emotions in the day-to-day experience of pain catastrophizing. A sample of 95 men and women with chronic pain completed initial assessments of neuroticism, psychological resilience, and demographic data, and then completed short diaries regarding pain intensity, pain catastrophizing, and positive and negative emotions every day for 14 consecutive days. Multilevel modeling analyses indicated that independent of level of neuroticism, negative emotions, pain intensity, income, and age, high-resilient individuals reported greater positive emotions and exhibited lower day-to-day pain catastrophizing compared with low-resilient individuals. Mediation analyses revealed that psychologically resilient individuals rebound from daily pain catastrophizing through experiences of positive emotion. Implications for research on psychological resilience, pain catastrophizing, and positive emotions are discussed.
Owens, G. P., Steger, M. F., Whitesell, A. a, & Herrera, C. J. (2009). Posttraumatic stress disorder, guilt, depression, and meaning in life among military veterans. Journal of Traumatic Stress, 22(6), 654-7. doi:10.1002/jts.20460. Veterans of various service eras (N = 174) completed an Internet survey about combat exposure, posttraumatic stress disorder (PTSD) symptoms, depression, guilt, and meaning in life. Results of a hierarchical regression indicated that younger age; higher levels of combat exposure, depression, and guilt; and lower meaning in life predicted greater PTSD severity. The interaction between meaning in life and depression also was significant, with a stronger inverse relation between meaning and PTSD at lower levels of depression. Meaning in life may be an important treatment concern for veterans with PTSD symptoms, particularly at higher levels of functioning.
Pals, J. L., & McAdams, D. P. (2004). The transformed self: A narrative understanding of posttraumatic growth. Psychological Inquiry, 15(1), 65-69. Abstract: To assess post-traumatic growth, investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of "Psychological Inquiry" rely mainly on a simple self-report questionnaire that asks people to rate their growth in live domains. Although the Post-traumatic Growth Inventory has yielded some promising results, it is believed that the questionnaire approach would be well complemented by one that focuses on the presence of growth themes within narrative accounts of traumatic events themselves. Indeed, the analysis of narrative accounts may constitute the most valid way of assessing post-traumatic growth.
Parappully, J., Rosenbaum, R., van den Daele, L., & Nzewi, E. (2002). Thriving after trauma: The experience of parents of murdered children. Journal of Humanistic Psychology, 42(1), 33-70. doi:10.1177/0022167802421003 Psychological literature on trauma usually focuses on pathology that results from trauma and pays little attention to positive out-comes. This article presents a phenomenological inquiry into the experiences of a profoundly traumatized group of people-parents whose son or daughter has been murdered-to assess if they were able to experience a positive outcome resulting from their trauma and to identify associated processes and resources. Of 65 parents who volunteered, 16 were selected to complete a questionnaire and were given in-depth, semistructured interviews. The interview data, analyzed qualitatively, affirm positive outcomes for these parents. Four processes-acceptance, finding meaning, personal decision making, and reaching out to others in compassion-and six resources-personal qualities, spirituality, continuing bond with the victim, social support, previous coping experience, and self-care-facilitate a positive outcome.
Park, C. L. (1998). Stress-related growth and thriving through coping: The roles of personality and cognitive processes. Journal of Social Issues, 54(2), 267-277. doi:10.1111/j.1540-4560.1998.tb01218.x Retrieved from EBSCOhost. This article describes the theoretical perspectives and the empirical research relating personal dispositions, resources, appraisals, and coping processes to stress-related growth and thriving within a transactional stress and coping framework. Following a description of this framework, the personal characteristics relevant to thriving and growth are reviewed. It is noted that personal characteristics may exert effects directly on positive outcomes such as thriving and growth, and that the effects of these personal characteristics may also be mediated by various appraisal and coping processes. Theoretical and empirical work on appraisal and coping processes as predictors of growth and thriving are then reviewed. Work on comprehensive models of stress-related growth and thriving that include personal resources and coping processes is discussed: such models consider appraisal and coping processes as potential mechanisms through which personal characteristics may operate indirectly to affect stress-related growth and thriving. Finally, some implications of these relationships for individuals and for communities are suggested.
Park, C. L. (2004). The notion of stress-related growth: Problems and prospects. Psychological Inquiry, 15, 69-76.
Park, C. L. (2010a). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136, 257-301. Interest in meaning and meaning making in the context of stressful life events continues to grow, but research is hampered by conceptual and methodological limitations. Drawing on current theories, the author first presents an integrated model of meaning making. This model distinguishes between the constructs of global and situational meaning and between "meaning-making efforts" and "meaning made," and it elaborates subconstructs within these constructs. Using this model, the author reviews the empirical research regarding meaning in the context of adjustment to stressful events, outlining what has been established to date and evaluating the strengths and weaknesses of current empirical work. Results suggest that theory on meaning and meaning making has developed apace, but empirical research has failed to keep up with these developments, creating a significant gap between the rich but abstract theories and empirical tests of them. Given current empirical findings, some aspects of the meaning-making model appear to be well supported but others are not, and the quality of meaning-making efforts and meanings made may be at least as important as their quantity. This article concludes with specific suggestions for future research.
Park, C. L., Chmielewski, J., & Blank, T. O. (2010). Post-traumatic growth: Finding positive meaning in cancer survivorship moderates the impact of intrusive thoughts on adjustment in younger adults. Psycho-Oncology, 19, 1139-1147. Abstract Objective: We examined whether post-traumatic growth would moderate the impact of intrusive thoughts on a range of dimensions of well-being in a sample of younger adult survivors of various types of cancer. Methods: 167 participants completed questionnaires regarding intrusive thoughts, posttraumatic growth, mental and physical health-related quality of life, positive and negative affect, life satisfaction, and spiritual well-being. Multiple regression analyses controlling for relevant background and cancer-related variables tested the interaction effects of post-traumatic growth and intrusive thoughts. Results: Intrusive thoughts were related to poorer adjustment on all indices except physical health-related quality of life. However, post-traumatic growth moderated the effects of intrusive thoughts on positive and negative affect, life satisfaction, and spiritual well-being in a protective fashion. That is, for those higher in post-traumatic growth, higher levels of intrusive thoughts were related to better adjustment. Conclusions: The positive meaning that individuals assign to their cancer experience as reflected in their reports of post-traumatic growth appears to be important in determining the impact of intrusive thoughts on post-cancer adjustment.
Park, C. L., Cohen, L. H., & Murch, R. L. (1996). Assessment and prediction of stress-related growth. Journal of Personality, 64(1), 71-105. doi:10.1111/j.1467-6494.1996.tb00815.x This article reports the development of the Stress-Related Growth Scale (SRGS) and its use in a study examining determinants of stress-related positive outcomes for college students. Study 1 analyses showed that the SRGS has acceptable internal and test-retest reliability and that scores are not influenced by social desirability. Study 2 analyses showed that college students' SRGS responses were significantly related to those provided by friends and relatives on their behalf. Study 3 analyses tested the determinants of stress-related growth longitudinally. Significant predictors of the SRGS were (a) intrinsic religiousness; (b) social support satisfaction; (c) stressfulness of the negative event; (d) positive reinterpretation and acceptance coping; and (e) number of recent positive life events. The SRGS was also positively related to residual change in optimism, positive affectivity, number of socially supportive others, and social support satisfaction, lending further support to the validity of this new scale. Results have implications for current theory on stress-related positive outcomes.
Park, C. L., & Fenster, J. R. (2004). Stress-related growth: Predictors of occurrence and correlates with psychological adjustment. Journal of Social & Clinical Psychology, 23(2), 195-215. Retrieved from EBSCOhost. Although stressful experiences can lead to many negative consequences, the processes involved in confronting them may also promote broadened perspectives, new coping skills, deepened relationships, and the development of personal resources. The present study examined the processes through which such growth may occur and the relationship of this growth to adjustment as reflected in changes in personal resources and psychological adjustment over time. Ninety-four college students completed measures of personal resources and adjustment. Six months later, they completed a second set of measures that also included questions about their most stressful experience in the past six months as well as cognitive processing, coping, and growth related to the stressor. Results suggested that specific coping processes (resources, appraisals, and coping activities) and, to a lesser extent, cognitive processing, were related to growth. Stress-related growth predicted increases in personal resources and positive states of mind, but was unrelated to depressive symptoms. Implications for future research and potential clinical applications are discussed.
Park, C. L., & Helgeson, V. S. (2006). Introduction to the special section: growth following highly stressful life events—current status and future directions. Journal of consulting and clinical psychology, 74(5), 791-6. doi:10.1037/0022-006X.74.5.791. Interest in the phenomenon of perceived growth following highly stressful experiences continues to proliferate. Already there is abundant evidence that perceptions of growth are commonly reported, often by the majority of people experiencing even the most traumatic of events. However, much remains to be learned about perceptions of growth. In this article, the authors pose 7 major theoretical and empirical questions regarding perceived growth, including issues of measurement, validity, mechanisms, links with well-being, and clinical implications. The authors summarize the current status of psychologists' knowledge, including articles in the present special section, and conclude that there is much to learn about perceived growth. The authors end with suggestions for future research.
Park, C. L., Lechner, S., Antoni, M. H., & Stanton, A. (Eds.) (2008). Positive life change in the context of medical illness: Can the experience of serious illness lead to transformation? Washington, DC: American Psychological Association.
Park, C. L., Riley, K. E., & Snyder, L. B. (2012). Meaning making coping, making sense, and post-traumatic growth following the 9/11 terrorist attacks. The Journal of Positive Psychology, 7, 198-207. doi:10.1080/17439760.2012.671347 According to the meaning making model, traumatic events disrupt global meaning systems, and meaning making coping helps restore congruency between global meaning and appraisals of traumatic events. We examined the contextual and coping predictors of two specific meanings made: having made sense and perceiving post-traumatic growth in a nationally representative sample of 1004 adults approximately six weeks after the September 11th terrorist attacks in the United States. Although the two meanings made were positively correlated, they had very different predictors: having made sense was primarily predicted by some aspects of meaning focused coping as well as other typically adaptive coping (e. g., active coping), but perceived growth was predicted by nearly all types of coping. Further, having made sense was related to less distress, but perceived growth was related to more distress. These results suggest that having made sense is a product of meaning focused and active coping and appears adaptive, while post-traumatic growth reflects a mix of positive functioning and continued distress and coping efforts.
Park, N., & Peterson, C. (2009). Achieving and sustaining a good life. Perspectives on Psychological Science, 4(4), 422-428. doi:10.1111/j.1745-6924.2009.01149.x ABSTRACT How can we live well? To answer this question, psychology must acknowledge and integrate its descriptive and prescriptive components. One of psychology's strengths has been its willingness to embrace different purposes, perspectives, and approaches, and this recommendation is in the spirit of the field's history. At present, psychology knows more about people's problems and how to solve them than it does about what it means to live well and how to encourage and maintain such a life. Moreover, what is known is often fragmented because of psychology's specialization. Our article calls for further discussion in psychological terms of what it means to live well; the study of actual people and how they behave; multivariate, multimethod, and longitudinal research; more sophisticated interventions; interdisciplinary collaboration; and translational research.
Pat-Horenczyk, R., & Brom, D. (2007). The multiple faces of post-traumatic growth. Applied Psychology, 56(3), 379-385. doi:10.1111/j.1464-0597.2007.00297.x The concept of Post-Traumatic Growth (PTG) creates an interesting challenge for researchers and theorists in the trauma field. Hobfoll et al. examine the concept and strengthen the need for refining the understanding of traumatic growth in the face of terrorism. They raise and "zoom in" on central questions regarding this relatively new concept. Moreover, they significantly contribute to the emerging doubts about the positive nature of PTG and its adaptive significance. As a result of this article we can ask the question whether or not PTG should be promoted in the aftermath of disasters and adversities. In this commentary we will discuss the relationship between the current thinking on PTG and the development of the concepts of trauma and resilience. We will then critically discuss the research findings of Hobfoll and end with some comments on the differentiation between the cognitive and the action components of PTG presented by the authors.
Payne, A. J., Joseph, S., & Tudway, J. (2007). Assimilation and accommodation processes following traumatic experiences. Journal of Loss and Trauma, 12(1), 75-91. doi:10.1080/15325020600788206. The organismic valuing theory of growth following adversity (Joseph & Linley, 2005) is an account of recovery following trauma that attempts to integrate an understanding of posttraumatic stress with posttraumatic growth. It stipulates that processes of assimilation and accommodation dictate psychological outcomes following trauma. This article explores the nature of these processes with a view to enhancing clinicians' understanding of recovery from trauma. This was achieved via analytic induction and in-depth exploration of 13 personal accounts of "making sense of traumatic experiences." The findings expanded Joseph and Linley's (2005) theory. Clinical implications for treatment of trauma survivors are discussed, and methodological considerations and directions for future research are presented.
Peterson, C., Park, N., Pole, N., D'Andrea, W., & Seligman, M. E. P. (2008). Strengths of character and posttraumatic growth. Journal of Traumatic Stress, 21(2), 214-217. doi:10.1002/jts.20332 How are strengths of character related to growth following trauma? A retrospective Web-based study of 1,739 adults found small, but positive associations among the number of potentially traumatic events experienced and a number of cognitive and interpersonal character strengths. It was concluded that growth following trauma may entail the strengthening of character.
Peterson, C., & Seligman, M. E. P. (2003). Character strengths before and after September 11. Psychological Science, 14, 381-384. Did Americans change following the September 11 terrorist attacks? We provide a tentative answer with respect to the positive traits included in the Values in Action Classification of Strengths and measured with a self-report questionnaire available on-line and completed by 4,817 respondents. When scores for individuals completing the survey in the 2 months immediately after September 11 were compared with scores for those individuals who completed the survey before September 11, seven character strengths showed increases: gratitude, hope, kindness, leadership, love, spirituality, and teamwork. Ten months after September 11, these character strengths were still elevated, although to a somewhat lesser degree than immediately following the attacks.
Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14(5), 364-388. doi:10.1080/15325020902724271 This meta-analytic review examines the role of optimism, social support, and coping strategies in contributing to posttraumatic growth. Results from 103 studies showed that all three systems of variables yielded significant effect sizes. Religious coping and positive reappraisal coping produced the largest effect sizes. Social support, seeking social support coping, spirituality, and optimism were moderately related to posttraumatic growth. Acceptance coping yielded the smallest effect sizes. Moderator analyses showed that effect sizes did not differ according to time elapsed since trauma, gender, and type of posttraumatic growth measure (posttraumatic growth vs. benefit finding). Age and gender were significant moderators of religious coping, whereas study design (longitudinal vs. cross-sectional) significantly moderated the effect of positive reappraisal coping. Implications for research and interventions on posttraumatic growth are also discussed.
Rajandram, R. K., Jenewein, J., McGrath, C., & Zwahlen, R. A. (2011). Coping processes relevant to posttraumatic growth: An evidence-based review. Supportive Care in Cancer, 19(5), 583-9. doi:10.1007/s00520-011-1105-0. This study aims to perform an evidence-based review on the quantitative data regarding coping processes related to posttraumatic growth in the field of oncology to facilitate understanding of posttraumatic growth in oral cavity cancer (OCC) patients.
Reich, J. W., Zautra, A. J., & Hall, J. S. (Eds.).(2010). Handbook of adult resilience. New York: Guilford Press.
Robinson, J. L. (2000). Are there implications for prevention research from studies of resilience? Child Development, 71(3), 570-572. doi:10.1111/1467-8624.00167. In this commentary, the question is raised whether prevention research can benefit from resilience research in designing interventions. Although many areas in the investigative interests of prevention and resilience researchers overlap, Luthar, Cicchetti, and Becker may have set the bar too high for defining resilience in the context of varying levels of adversity.
Roe, J., Joseph, S., & Middleton, H. (2010). Symbolic interaction: A theoretical approach to understanding stigma and recovery. Mental Health Review Journal, 15(1), 29-36. doi:10.5042/mhrj.2010.0200. Recent years have seen the emergence of the recovery perspective. However, as yet there is no overriding theoretical framework which supports our understanding of recovery and its counterpart, stigma. In large part this is because discourses concerning mental health remain dominated by the medical model and an illness ideology, even though there is growing interest in more socially defined determinants of disability. We propose symbolic interaction as a theoretical framework which might address this shortcoming. Published literature concerning the use of this approach in the mental health field is reviewed and we discuss the implications and ways forward for future research on mental health, stigma and recovery. In particular, we consider how this approach can help identify ways in which contemporary practices and conventions might inadvertently hinder recovery and contribute towards a disabled self.
Roesch, S. C., Rowley, A. A., & Vaughn, A. A. (2004). On the dimensionality of the Stress-Related Growth Scale: One, three, or seven factors? Journal of Personality Assessment, 82(3), 281-290. Routledge. Retrieved June 5, 2011, from http://www.informaworld.com/index/785038684.pdf. We examined the factorial validity and dimensionality of the Stress-Related Growth Scale (SRGS: Park, Cohen, & Murch, 1996) using a large multiethnic sample (n = 1,070). Exploratory and confirmatory factor analyses suggested that a multidimensional representation of the SRGS fit better than a unidimensional representation. Specifically, we cross-validated both a 3-factor model and a 7-factor model using confirmatory factor analysis and were shown to be invariant across gender and ethnic groups. The 3-factor model was represented by global dimensions of growth that included rational/mature thinking, affective/emotional growth, and religious/spiritual growth. We replicated the 7-factor model of Armeli, Gunthert, and Cohen (2001) and it represented more specific components of growth such as Self-Understanding and Treatment of Others. However, some factors of the 7-factor model had questionable internal consistency and were strongly intercorrelated, suggesting redundancy. The findings support the notion that the factor structure of both the original 1-factor and revised 7-factor models are unstable and that the 3-factor model developed in this research has more reliable psychometric properties and structure.
Roisman, G. I. (2005). Conceptual clarifications in the study of resilience. American Psychologist, 60(3), 264-5; discussion 265-7. doi:10.1037/0003-066X.60.3.264. Comments on George Bonanno's article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see 10.1037/0003-066X.59.1.20). The authors note that Bonanno's article on loss, trauma, and human resilience serves an important function for the field in drawing attention to the pseudoscientific mythologies that have grown up around brief normative (loss-related) and nonnormative (traumatic) stressors. As the author rightly pointed out, traditional assumptions regarding the absolute necessity of "grief work" in the case of loss and clinical debriefing following exposure to traumatic events may indeed be overdrawn (and overprescribed) in light of emerging evidence. Although there is much to like about Bonanno's analysis, several limitations inherent in the author's conceptualization of resilience are troubling in light of the history of developmental research in this area, much of which is cited in the target article. In essence, Bonanno defined adult resilience as an individual's capacity to resist maladaptation in the face of risky experiences (e.g., "stress resistance"). Although this is one plausible way of conceptualizing resilience, it is by no means an exclusive definition.
Roosa, M. W. (2000). Some thoughts about resilience versus positive development, main effects versus interactions, and the value of resilience. Child Development, 71(3), 567-569. doi:10.1111/1467-8624.00166. Interaction effects are the defining feature of resilience and resilience research and are responsible for the unique contributions of this field of study to our understanding of human development. The methodological and statistical challenges posed by interaction effects do not, by themselves, undermine the value of resilience as a construct.
Rutter, M. (2006). Implications of resilience concepts for scientific understanding. Annals of the New York Academy of Sciences, 1094, 1-12. doi:10.1196/annals.1376.002. Resilience is an interactive concept that refers to a relative resistance to environmental risk experiences, or the overcoming of stress or adversity. As such, it differs from both social competence positive mental health. Resilience differs from traditional concepts of risk and protection in its focus on individual variations in response to comparable experiences. Accordingly, the research focus needs to be on those individual differences and the causal processes that they reflect, rather than on resilience as a general quality. Because resilience in relation to childhood adversities may stem from positive adult experiences, a life-span trajectory approach is needed. Also, because of the crucial importance of gene-environment interactions in relation to resilience, a wide range of research strategies spanning psychosocial and biological methods is needed. Five main implications stem from the research to date: (1) resistance to hazards may derive from controlled exposure to risk (rather than its avoidance); (2) resistance may derive from traits or circumstances that are without major effects in the absence of the relevant environmental hazards; (3) resistance may derive from physiological or psychological coping processes rather than external risk or protective factors; (4) delayed recovery may derive from "turning point" experiences in adult life; and (5) resilience may be constrained by biological programming or damaging effects of stress/adversity on neural structures.
Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141-166. doi:10.1146/annurev.psych.52.1.141 Abstract Well-being is a complex construct that concerns optimal experience and functioning. Current research on well-being has been derived from two general perspectives: the hedonic approach, which focuses on happiness and defines well-being in terms of pleasure attainment and pain avoidance; and the eudaimonic approach, which focuses on meaning and self-realization and defines well-being in terms of the degree to which a person is fully functioning. These two views have given rise to different research foci and a body of knowledge that is in some areas divergent and in others complementary. New methodological developments concerning multilevel modeling and construct comparisons are also allowing researchers to formulate new questions for the field. This review considers research from both perspectives concerning the nature of well-being, its antecedents, and its stability across time and culture.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069-1081. doi:10.1037/0022-35184.108.40.2069 Reigning measures of psychological well-being have little theoretical grounding, despite an extensive literature on the contours of positive functioning. Aspects of well-being derived from this literature (i.e., self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth) were operationalized. Three hundred and twenty-one men and women, divided among young, middle-aged, and older adults, rated themselves on these measures along with six instruments prominent in earlier studies (i.e., affect balance, life satisfaction, self-esteem, morale, locus of control, depression). Results revealed that positive relations with others, autonomy, purpose in life, and personal growth were not strongly tied to prior assessment indexes, thereby supporting the claim that key aspects of positive functioning have not been represented in the empirical arena. Furthermore, age profiles revealed a more differentiated pattern of well-being than is evident in prior research.
Ryff, C. D., & Singer, B. (1998). The contours of positive human health. Psychological Inquiry, 9(1), 1-28. doi:10.1207/s15327965pli0901_1 Retrieved May 26, 2011, from http://www.informaworld.com/index/785831961.pdf. The primary objectives of this article are (a) to put forth an explicit operational formulation of positive human health that goes beyond prevailing "absence of illness" criteria; (b) to clarify that positive human health does not derive from extant medical considerations, which are not about wellness, but necessarily require a base in philosophical accounts of the "goods" in life; (c) to provoke a change of emphasis from strong tendencies to construe human health as exclusively about the mind or the body toward an integrated and positive spiral of mind-body influences; (d) to delineate possible physiological substrates of human flourishing and offer future directions for understanding the biology of positive health; and (e) to discuss implications of positive health for diverse scientific agendas (e.g., stress, class and health, work and family life) and for practice in health fields (e.g., training, health examinations, psychotherapy, and wellness intervention programs).
Saakvitne, K., & Tennen, H. (1998). Exploring thriving in the context of clinical trauma theory: Constructivist self development theory. Journal of Social Issues, 54(2), 279-299. In this article we critique current conceptualizations and methods of studying posttraumatic growth and offer an alternative framework using clinical trauma theory, specifically, Constructivist Self Development Theory (CSDT). We identify five limitations in the current literature: (1) a strict adherence to nomothetic investigation, (2) reliance on moderator analyses over descriptive inquiry, (3) exclusive use of univariate outcome indicators, (4) failure to distinguish effortful from automatic change, and (5) oversight of abrupt change. We offer CSDT as an integrative clinical theory that identifies five aspects of the self affected by traumatic events and examine how the study of thriving guided by CSDT could overcome these limitations. We conclude with a discussion of change, distinguishing that which occurs within psychotherapy from that which occurs outside the therapeutic context.
Salter, E., & Stallard, P. (2004). Posttraumatic growth in child survivors of a road traffic accident. Journal of Traumatic Stress, 17(4), 335-40. doi:10.1023/B:JOTS.0000038482.53911.01. Although the negative consequences of trauma have been well researched and described, posttraumatic growth has only recently come to the attention of researchers. This paper considers whether children (aged 7-18 years) who have been involved in a road traffic accident can experience posttraumatic growth outcomes. From 158 children who took part in an interview, qualitative analysis of interview notes found that 67 (42%) reported some aspect of posttraumatic growth, most notably in terms of their philosophy of life. Of these, 25 (37%) were also assessed as experiencing posttraumatic stress disorder.
Sameroff, A. J., & Rosenblum, K. L. (2006). Psychosocial constraints on the development of resilience. Annals of the New York Academy of Sciences, 1094, 116-24. doi:10.1196/annals.1376.010. Although resilience is usually thought to reside in individuals, developmental research is increasingly demonstrating that characteristics of the social context may be better predictors of resilience. When the relative contribution of early resilience and environmental challenges to later child mental health and academic achievement were compared in a longitudinal study from birth to adolescence, indicators of child resilience, such as the behavioral and emotional self-regulation characteristic of good mental health, and the cognitive self-regulation characteristic of high intelligence contributed to later competence. However, the effects of such individual resilience did not overcome the effects of high environmental challenge, such as poor parenting, antisocial peers, low-resource communities, and economic hardship. The effects of single environmental challenges become very large when accumulated into multiple risk scores even affecting the development of offspring in the next generation.
Schexnaildre, M. A. (2011). Predicting posttraumatic growth: Coping, social support, and posttraumatic stress in children and adolescents after hurricane Katrina. Faculty of the Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Master of Arts in The Department of Psychology By Mark A. Schexnaildre BS, Louisiana State University. Retrieved May 26, 2011, from http://etd.lsu.edu/docs/available/etd-04022011-221554/.
Schneider, K. (2011). Toward a humanistic positive psychology. Existential Analysis, 22(1), 32-38. Retrieved from EBSCOhost. I propose that despite the nay-saying 1) positive psychology is justifiably a branch of humanistic psychology, and 2) a humanistic positive psychology would be salutary to the profession of psychology. From the standpoint of theory, I show how positive psychology shares humanistic psychology's concern with what it means to be fully, experientially human, and how that understanding illuminates the vital or fulfilled life. However, I also show how the findings of positive psychology, particularly in the area "happiness" research - or what has recently been termed "human flourishing," stop short of the fuller aforementioned aims. Specifically, I show how positive psychology appears to oversimplify both the experience of human flourishing and its social-adaptive value. While the positive psychology findings on flourishing are useful in limited contexts, e.g., in terms of their implications for the attainment of pleasure, physical health, and cultural competency, they are inadequate with respect to the more complicated contexts of creativity, emotional depth, and social consciousness. I will detail the nature of these discrepancies, such as their implications for perception of reality, psychological growth, and capacity for self-reflection, and consider their role in an expanded vision of human resiliency.
Schuettler, D., & Boals, A. (2011). The path to posttraumatic growth versus posttraumatic stress disorder: Contributions of event centrality and coping. Journal of Loss & Trauma, 16(2), 180-194. doi:10.1080/15325024.2010.519273 This study examined positive and negative trauma outcome predictors within the same sample. Measures known to correlate with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) were included to replicate past findings, as well as additional measures minimally or not addressed in PTG research. Stepwise multiple regression analyses revealed PTSD symptoms were best predicted by visceral reactions to the event, event centrality, avoidant coping, and a negative perspective of the event. In contrast, PTG was best predicted by event centrality, problem-focused coping, and a positive perspective of the event. These results are an important step to understanding differential paths to PTSD and PTG.
Seligman, M. P. (2011). Building resilience. Harvard Business Review, 89(4), 100-106. Failure is a familiar trauma in life, but its effects on people differ widely. Some reel, recover, and move on with their lives; others get bogged down by anxiety, depression, and fear of the future. Seligman, who is known as the father of positive psychology, has spent three decades researching failure, helplessness, and optimism. He created a program at the University of Pennsylvania to help young adults and children overcome anxiety and depression, and has worked with colleagues from around the world to develop a program for teaching resilience. That program is being tested by the U.S. Army, an organization of 1.1 million people where trauma is more common and more severe than in any corporate setting. Nevertheless, businesspeople can draw lessons from resilience training, particularly in times of failure and stagnation. The program is called Comprehensive Soldier Fitness, and it has three components: the Global Assessment Tool, a test for psychological fitness (administered to more than 900,000 soldiers to date); self-improvement courses following the test; and "master resilience training" (MRT) for drill sergeants. MRT focuses on enhancing mental toughness, highlighting and honing strengths, and fostering strong relationships-core competencies for any successful manager.
Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5-14. doi:10.1037/0003-066X.55.1.5 A science of positive subjective experience, positive individual traits, and positive institutions promises to improve quality of life and prevent the pathologies that arise when life is barren and meaningless. The exclusive focus on pathology that has dominated so much of our discipline results in a model of the human being lacking the positive features that make life worth living. Hope, wisdom, creativity, future mindedness, courage, spirituality, responsibility, and perseverance are ignored or explained as transformations of more authentic negative impulses. The 15 articles in this millennial issue of the American Psychologist discuss such issues as what enables happiness, the effects of autonomy and self-regulation, how optimism and hope affect health, what constitutes wisdom, and how talent and creativity come to fruition. The authors outline a framework .['or a science of positive psychology, point to gaps in our knowledge, and predict that the next century will see a science and profession that will come to understand and build the factors that allow individuals, communities, and societies to flourish.
Shakespeare-Finch, J., & Enders, T. (2008). Corroborating evidence of posttraumatic growth. Journal of Traumatic Stress, 21(4), 421-424. doi:10.1002/jts.20347 Over the last decade, a healthy shift in the trauma literature has meant that published theory and research in the posttraumatic growth (PTG) domain has burgeoned, but the validity of the self-report questionnaires used to measure PTG has recently been criticized. Corroboration of these subjective reports by an observer would provide convergent validity. Therefore, this study's aim was to validate the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Sixty-one trauma survivors and 61 paired significant others completed the PTGI. A significant correlation was reported between the total PTGI scores of the trauma survivors and the corroborating significant others, supporting the use of the PTGI as an appropriate measure of positive posttrauma changes.
Shmotkin, D., & Shrira, A. (2011). Happiness and Suffering in the Life Story: An Inquiry into Conflicting Expectations Concerning the Association of Perceived Past with Present Subjective Well-Being in Old Age. Journal of Happiness Studies, 13(3), 389-409. doi:10.1007/s10902-011-9270-x The study examined whether positive or negative aspects of the life story were predominantly associated with present subjective well-being (SWB). Two samples (N = 815 and 213; mean ages 75 and 73) rated past emotions (happiness and suffering) in positive and negative anchor periods (e.g., "the happiest period," "the most miserable period") of their life stories. The indices of present SWB were present happiness, present suffering, and life satisfaction. Results indicated that when the past emotions were net of each other, past happiness was related to the positive indices, but not to the negative index, of present SWB whereas past suffering was related to the negative index, and only partially to the positive indices, of present SWB. Congruent emotions (happiness in positive periods, suffering in negative periods) were stronger than incongruent emotions (happiness in negative periods, suffering in positive periods), yet each had unique associations with present SWB. Finally, past happiness weakened the inverse relationship between past suffering and present SWB, yet it strengthened this relationship when past emotions were both incongruent (i.e., when happiness in negative periods was analyzed in conjunction with suffering in positive periods). In conclusion, rather than presenting predominance over each other, positive and negative ingredients in the life story maintain complementary and interactive associations with present SWB. In this context, the study points to the SWB-related implications of the interplay between paramount life experiences in the individual's anchor periods and the emotions that the individual attributes to these periods.
Siegel, K., & Schrimshaw, E. W. (2000). Perceiving benefits in adversity: Stress related growth in women living with HIV/AIDS. Social Science and Medicine, 51(10), 1543-1554. doi:10.1016/S0277-9536(00)00144-1 This study examines perceptions of illness-related positive of change or stress-related growth among a sample of African American, Puerto Rican, and non-Hispanic White women (n = 54) living with HIV/AIDS in New York City, USA. While these women acknowledged the negative stresses of living with HIV/AIDS, 83% reported at least one positive change in their lives that they attributed to their illness experience. A number of different domains of potential growth were identified including: health behaviors, spirituality, interpersonal relationships, view of the self, value of life, and career goals. While growth was reported by nearly all the women, some variation was found in the forms of growth reported in relation to the women's ethnic/racial background, class, and IV drug use history. These data suggest an expanded conceptualization of stress-related growth that includes behavioral aspects of growth in response to stress and illness, and which takes into account the diverse ways in which growth may be experienced.
Skaggs, B. G., & Barron, C. R. (2006). Searching for meaning in negative events: Concept analysis. Journal of Advanced Nursing, 53, 559-570. Aim. The aim of this paper was to synthesize the literature related to meaning and present a conceptual analysis of searching for meaning in unexpected, significant, negative events. Background. Events or situations that are perceived as unexpected and negative (e.g. chronic and/or life-threatening illness) can disrupt life plans and lead to emotional distress. Nurses are in a key position to aid in the coping process by assisting individuals to integrate the meaning of an unexpected, negative event into the life experience. Methods. In May 2004, a comprehensive literature search using the terms meaning, search for meaning, meaning-making, making meaning, life change events, adaptation-psychological, stress, and coping was carried out. Of 339 possible references, 86 were included in the analysis. Findings. Global meaning refers to an individual's beliefs, values, and purpose/goals. Situational meaning refers to the meaning the individual attaches to a situation. When the meaning attached to the situation is not congruent with global meaning, meaning is considered shattered and a search for meaning ensues. In the search for meaning, people may attempt to change the meaning of the event (through reattributions or creating illusions) or change global meaning (through positive reappraisal, problem-solving coping, or revaluing ordinary events). Conclusion. Nurses are in a key position to assist people through negative events. The process of searching for meaning provides a solid foundation for the development of nursing interventions to assist individuals through difficult times. Research is needed to develop nursing interventions based on the process of the search for meaning, as well as measures reflective of the search for meaning.
Smith, S. G., & Cook, S. L. (2004). Are reports of posttraumatic growth positively biased? Journal of Traumatic Stress, 17(4), 353-358. doi:10.1023/B:JOTS.0000038485.38771.c6 This study examines positivity bias in reports of growth following exposure to traumatic events. Participants (N = 276) from an urban university and a superior court jury pool were randomly assigned to one of two methodological groups. In one, participants responded to the Posttraumatic Growth Inventory (PTGI) in relation to a specific stressful event. In the other, PTGI questions were not linked to specific events. Findings indicate that current methods for assessing posttraumatic growth (PTG) may actually underestimate growth. That is, linking questions about growth to specific stressors may have led participants to be cautious about attributing their growth experiences to a traumatic event. These findings contradict notions that current methods of measuring PTG create a positivity bias. Suggestions for future research include the use of prospective designs and corroborating reports of growth.
Splevins, K., Cohen, K., Bowley, J., & Joseph, S. (2010). Theories of posttraumatic growth: Cross-cultural perspectives. Journal of Loss and Trauma, 15(3), 259-277. doi:10.1080/15325020903382111. Posttraumatic growth is a concept that has been established within a Western cultural framework. This review examines whether there is a Western cultural bias in this concept, and related processes and outcomes, and whether any cultural bias has been incorporated into associated psychometric tools. It is concluded that, although at an abstract level the concept of posttraumatic growth appears cross-culturally valid, the operationalization of the concept may serve to impose assumptions of a Western individualistic society. The impact of this for the emerging cross-cultural literature on posttraumatic growth is discussed, alongside recommendations for future research.
Snyder, C. R., & Lopez, S. J. (Eds.). (2002). Handbook of positive psychology. New York: Oxford University Press.
Sodergren, S., & Hyland, M. (2000). What are the positive consequences of illness? Psychology & Health, 15(1), 85-97. doi:10.1080/08870440008400290. Fifty five people, either currently sick or having recovered from their illness, were recruited if they reported positive consequences of illness. They were questioned about their experiences of illness, 41 by semi-structured interview and 14 by open-ended questionnaire and responses were classified into 17 categories. The categories were similar but slightly more extensive than previous accounts of positive consequences reported in the literature. The content of the interviews and questionnaires was used to construct a 66 item questionnaire about positive consequences of illness which was then completed by 97 patients. A principal components analysis indicated a large first factor accounting for 27% of the variance. Endorsement of items varied between 87% and zero for chronic lung disease patients attending pulmonary rehabilitation. However, all patients endorsed at least one item and the median number of items endorsed was 31. Positive consequences of illness are highly varied and more common than often realised, and this has implications for the concept and measurement of quality of life.
Stanton, A. L., & Low, C. A. (2004). Toward understanding posttraumatic growth: Commentary on Tedeschi and Calhoun. Psychological Inquiry, 15(1), p76-80. Abstract: Along with others who catalyzed theoretical and empirical attention to the perception of positive change from extremely challenging experiences, investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 of the "Psychological Inquiry" are among the leaders in illuminating the phenomenon of post-traumatic growth. They and many other researchers have established without question that individuals undergoing trauma often perceive concomitant positive life changes. The presents research and clinical experience with individuals and couples facing such health-related adversities as cancer and infertility are also convincing that abundant gain can arise from struggle and loss.
Stasko, E. C., & Ickovics, J. R. (2007). Traumatic growth in the face of terrorism: Threshold effects and action-based growth. Applied Psychology, 56(3), 386-395. Wiley Online Library. Retrieved from http://doi.wiley.com/10.1111/j.1464-0597.2007.00294.x. Although posttraumatic growth is generally thought of as a protective factor for posttraumatic stress disorder, Hobfoll and colleagues (this issue) suggest that the benefits derived from posttraumatic growth are dependent upon the translation from cognition to action, an occurrence they term action-based growth. In their latest examination of traumatic growth in the face of terrorism, Hobfoll et al. reviewed five studies and found that posttraumatic growth was positively associated with posttraumatic stress disorder. This commentary addresses the strengths and limitations of the studies' methodology and the theoretical and clinical implications of action-based growth. We speculate that the severity and chronicity of terrorism result in psychosocial vulnerability, such that PTG cannot ameliorate risk of adverse consequences. It is expected that psychosocial vulnerability may be related to all traumas falling above a certain threshold of severity. However, when cognition and action are linked- as they are in one of the studies of the Gaza disengagement-posttraumatic growth may be protective, even in the face of persistent terrorism.
Steger, M. F. (2009). Meaning in life. In S. J. Lopez (Ed.), Oxford handbook of positive psychology (2nd Ed.) (pp. 679-687). Oxford, UK: Oxford University Press.
Steger, M. F. (in press). Experiencing meaning in life: Optimal functioning at the nexus of spirituality, psychopathology, and well-being. In P. T. P. Wong & P. S. Fry (Eds.), The human quest for meaning (2nd Ed). New York: Routledge.
Steger, M. F., Kashdan, T. B., Sullivan, B. A., & Lorentz, D. (2008). Understanding the search for meaning in life: Personality, cognitive style, and the dynamic between seeking and experiencing meaning. Journal of Personality, 76, 199-228. Although several theories assert that understanding the search for meaning in life is important, empirical research on this construct is sparse. Three studies provide the first extensive effort to understand the correlates of the search for meaning in a multistudy research program. Assessed were relations between search for meaning and wellbeing, cognitive style, and the Big Five, Big Three, Approach/Avoidance, and Interest models of personality, with a particular emphasis on understanding the correlates of search for meaning that are independent of presence of meaning. Conceptual models of the relation between search and presence were tested. Findings suggest that people lacking meaning search for it; the search for meaning did not appear to lead to its presence. Study 3 found that basic motive dispositions moderated relations between search for meaning and its presence. Results highlight the importance of basic personality dispositions in understanding the search for meaning and its correlates.
Steger, M. F., Oishi, S., & Kesibir, S. (in press). Is a life without meaning satisfying? The moderating role of the search for meaning in satisfaction with life judgments. Journal of Positive Psychology. Results from two studies revealed that the relation between meaning in life and life satisfaction was moderated by the extent to which the rater was searching for meaning in his or her life. In Studies 1a and 1b, the presence of meaning was more strongly related to life satisfaction for those who were actively searching for meaning in life than for those who were not. Study 2 extended the finding to judgments concerning a fictitious target's life satisfaction based on experimentally manipulated information regarding meaning in life. Thus, the role of meaning in life satisfaction judgments varies across individuals, depending on the level of search for meaning in life. These results suggest that search for meaning behaves like a schema increasing the salience of meaning-relevant information, and provides new ways of understanding people's efforts to establish meaningful lives.
Stockton, H., Hunt, N., & Joseph, S. (2011). Cognitive processing, rumination, and posttraumatic growth. Journal of traumatic stress, 24(1), 85-92. doi:10.1002/jts.20606. Intrusive thoughts about traumatic events are an important factor in determining the development of posttraumatic growth, although research has focused on the frequency rather than the type of intrusions. Based on cognitive processing models of posttraumatic growth, the authors present two cross-sectional studies exploring different types of intrusive ruminations about trauma and their associations with posttraumatic growth. Study 1 examines brooding and reflection; Study 2 uses measures of both deliberate and intrusive rumination regarding a past trauma. The results indicate that intrusive reexperiencing and ruminative brooding are not significantly associated with posttraumatic growth, whereas deliberate rumination is significantly positively associated with posttraumatic growth (? = .44, p < .001) and reflection (partial r = .20, p = .003) is positively associated with posttraumatic growth in the context of low brooding.
Suls, J., & David, J. P. (1996). Coping and personality: Third time's the charm? Journal of Personality, 64, 993-1005. In this special issue, a third generation of research is represented which recognizes and demonstrates that itidividual differences in personality play an important role in the coping process. Although progress is apparent, there are several unresolved issues, including the best way to measure coping and whether "type of coping" matters in naturalistic settings. Three potentially important parameters of coping-range, patterning, and competence- are described, but only the first has received systematic empirical attention. The study of coping might also be advanced by researchers giving more attention to the differences between problem situations in which traits are more easily expressed ("weak" situations) versus those where normative criteria and constraints are explicit ("strong" situations).
Suls, J., David, J. P., & Harvey, J. H. (1996). Personality and coping: Three generations of research. Journal of Personality, 64, 711-735. This article introduces the Journal of Personality's special issue on coping and personality. It first presents a historical overview of the psychological study of how people cope with stress and identifies three generations of theory and research: (a) the psychoanalysts and the ego development school, which tended to equate personality and coping strategies; (b) the transactional approach, which appeared in the 1960s and emphasized situational and cognitive infiuences on coping while downplaying the role of individual differences; and (c) the most recent, "third generation," whose work is represented in this special issue and focuses on the role of personality in coping while maintaining strong operational distinctions among coping, personality, appraisal, and adaptational outcomes. This introduction concludes with a discussion of unresolved conceptual and methodological issues and a brief orientation to the third-generation articles that follow in this special issue.
Sumalla, E. C., Ochoa, C., & Blanco, I. (2009). Posttraumatic growth in cancer: Reality or illusion? Clinical Psychology Review, 29(1), 24-33. doi:10.1016/j.cpr.2008.09.006. Research in posttraumatic growth (PTG) among cancer patients has been triggered primarily by the inclusion of serious illnesses among the events that can lead to posttraumatic stress disorder (PTSD); increasing survival rates among cancer patients; and, attempts at encouraging a positive psychology that focuses on a patient's ability to fight adversity. The difficulties encountered in clearly defining the processes associated with this subjective feeling of growth following recovery raise doubts concerning the real or illusory nature of the phenomenon and its adaptative value. This paper explains why cancer may be different than other traumas and why PTG may interact with this ecology of circumstances in different ways. Difficulty in identifying a single stressor, the internal source of the event, cancer as a future, ongoing and chronic integration threat, and greater perceived control differences between cancer and others traumas. This review brings together the latest studies of PTG in cancer, and focuses in the debate of the real or illusory nature of the PTG and his adaptative value. The ongoing threat, uncertainty and vulnerability associated with cancer are the variables that have been related most consistently with PTG and tend to confuse the relationship between PTG and emotional well-being, too.
Suomi, S. J. (2006). Risk, resilience, and gene x environment interactions in rhesus monkeys. Annals of the New York Academy of Sciences, 1094, 52-62. doi:10.1196/annals.1376.006. Recent research with both humans and rhesus monkeys has provided compelling evidence of gene-environment (GxE) interactions throughout development. For example, a specific polymorphism ("short" allele) in the promoter region of the serotonin transporter (5-HTT) gene is associated with deficits in neurobehavioral functioning during infancy and in poor control of aggression and low serotonin metabolism throughout juvenile and adolescent development in monkeys who were reared with peers but not in monkeys who were reared with their mothers and peers during infancy. In contrast, monkeys possessing the "long" allele of the 5-HTT gene exhibit normal neurobehavioral functioning, control of aggression, and serotonin metabolism regardless of their early social rearing history. One interpretation of these GxE interaction data is that the "long" 5-HTT allele somehow confers resiliency to adverse early attachment relationships on those individuals who carry it ("good genes"). An alternative interpretation of the same data is that secure attachment relationships somehow confer resiliency to individuals who carry alleles that may otherwise increase their risk for adverse developmental outcomes ("maternal buffering"). These two interpretations are not mutually exclusive, but the difference in their respective implications for developing prevention and even intervention strategies is considerable. Moreover, the allelic variation seen in certain genes in rhesus monkeys and humans but apparently not in other primate species may actually contribute to their remarkable adaptability and resilience at the species level.
Sutin, A. R., Costa, P. T., Wethington, E., & Eaton, W. (2010). Perceptions of stressful life events as turning points are associated with self-rated health and psychological distress. Anxiety, stress, and coping, 23(5), 479-92. doi:10.1080/10615800903552015. We test the hypothesis that changes in physical and psychological health are associated with construals of stressful life events. At two points in time, approximately 10 years apart, participants (n=1038) rated their physical health and psychological distress. At the second assessment, participants also reported their most stressful life event since the first assessment and indicated whether they considered the event a turning point and/or lesson learned. Lower self-ratings of health and higher ratings of psychological distress, controlling for baseline health and distress, and relevant demographic factors, were associated with perceiving the stressful life event as a turning point, particularly a negative turning point. The two health measures were primarily unrelated to lessons learned. How individuals construe the most stressful events in their lives are associated with changes in self-rated health and distress.
Sutin, A. R., Costa, P. T., Wethington, E., & Eaton, W. (2010). Turning points and lessons learned: stressful life events and personality trait development across middle adulthood. Psychology and aging, 25(3), 524-33. doi: 10.1037/a0018751. The present research examined stressful life events and personality development across middle adulthood. Participants (N = 533) related the most stressful event they had experienced within the last 10 years, indicated whether they considered the event to be a turning point and/or lesson learned, and twice completed a comprehensive measure of traits defined by the five-factor model of personality; the stressful event occurred between these two assessments. Descriptions were coded to classify events into broad content domains based on the nature of the event. Prospectively, individuals high in Neuroticism perceived the event as a turning point; extraverts learned a lesson from it. Longitudinally, perceiving the event as a negative turning point was associated with increases in Neuroticism, whereas learning a lesson from the event was associated with increases in Extraversion and Conscientiousness. Characteristics of the events themselves were primarily unrelated to trait change. Across middle adulthood, personality trait change may be more strongly related to how individuals understand the stressful events in their lives rather than simply the occurrence of such events.
Taylor, S. (2011). Transformation through suffering: A study of individuals who have experienced positive psychological transformation following periods of intense turmoil. Journal of Humanistic Psychology. doi:10.1177/0022167811404944 This article summarizes a study of 32 individuals who experienced psychological transformation following periods of intense turmoil and trauma in their lives. Several individuals reported temporary spiritual experiences following turmoil, but the majority underwent a permanent psychological transformation. These experiences are termed suffering-induced transformational experiences (SITEs). The types of trauma that featured included intense stress and upheaval, depression, bereavement, serious illness, becoming disabled, alcoholism, and encounters with death (through medical conditions or accidents). The individuals were interviewed, and the most prevalent characteristics of their new state of being were identified, including increased well-being, intensified perception, a sense of connection, improved relationships, a less materialistic and more altruistic attitude, decreased cognitive activity, and reduced fear of death. Reasons for the transformation are suggested, the most important being the dissolution of psychological attachments, followed by acceptance.
Taylor, S., & Armor, D. (1996). Positive illusions and coping with adversity. Journal of Personality, 64, 873-898. We review the literature showing that positive illusions (i.e., self-aggrandizement, unrealistic optimism, and exaggerated perceptions of control) are common and associated with successful adjustment to stressful events, including conditions of extreme adversity. Using theory and recent data, we offer a basis for integrating positive illusions with the constraints of reality. We explicitly contrast the social psychological model of positive illusions with a personality viewpoint that addresses the question "Do higher levels of positive illusions predict higher levels of adjustment?" These issues are explored in the context of people coping with an array of normal stressful events, as well as those coping with more extreme stressful events, including cancer, heart disease, and HIV infection. Life is seldom as unendurable as, to judge by the facts, it ought to be.
Tedeschi, R. G. (2011). Posttraumatic growth in combat veterans. Journal of Clinical Psychology in Medical Settings, 18(2), 137-44. doi:10.1007/s10880-011-9255-2. Combat veterans and their families face significant challenges not only to their abilities to cope, but often to their fundamental belief systems. Traumatic events represent assaults on core beliefs, yet at times, produce cognitive processing that can ultimately result in personal transformations called posttraumatic growth (PTG). Clinicians can utilize a systematic therapeutic approach to facilitate PTG as they carry out a relationship of expert companionship. PTG in service members is described in this article, as well as the approach to facilitation of PTG.
Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oaks, CA: Sage. This volume addresses a variety of topics related to trauma and posttraumatic growth including the religious and psychological roots of suffering, research findings on the negative and positive consequences of trauma, and various factors that influence coping success.
Tedeschi, R. G., & Calhoun, L. G. (1996). Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471. doi:10.1002/jts.2490090305 The development of the Posttraumatic Growth Inventory, an instrument for assessing positive outcomes reported by persons who have experienced traumatic events, is described. This 21-item scale includes factors of New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life. Women tend to report more benefits than do men, and persons who have experienced traumatic events report more positive change than do persons who have not experienced extraordinary events. The Posttraumatic Growth Inventory is modestly related to optimism and extroversion. The scale appears to have utility in determining how successful individuals, coping with the aftermath of trauma, are in reconstructing or strengthening their perceptions of self, others, and the meaning of events.
Tedeschi, R. G., & Calhoun, L. G. (2004a). A clinical approach to posttraumatic growth. In P. A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 405-419). Hoboken, NJ: Wiley.
Tedeschi, R. G. & Calhoun, L. G. (2004b). Posttraumatic growth: Conceptual foundations and empirical evidence, Psychological Inquiry,15(1), 1-18. doi:10.1207/s15327965pli1501_01 This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Although the term is new, the idea that great good can come from great suffering is ancient. We propose a model for understanding the process of posttraumatic growth in which individual characteristics, support and disclosure, and more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an ongoing process, not a static outcome.
Tedeschi, R. G. & Calhoun, L. G. (2004c). Posttraumatic growth: A new perspective on psychotraumatology. Psychiatric Times, 21(4), 1-4.
Tedeschi, R. G., Calhoun, L. G., & Cann, A. (2007). Evaluating resource gain: Understanding and misunderstanding posttraumatic growth. Applied Psychology, 56(3), 396-406. doi:10.1111/j.1464-0597.2007.00299.x In a response to an article by Hobfoll and colleagues, theoretical and empirical considerations regarding the concept of posttraumatic growth are reviewed. It is noted that posttraumatic growth should be assessed as such, with measures developed specifically to address this construct; that it follows a challenge to and re-examination of core beliefs, not every bad experience; it can be influenced by many factors; it can coexist with distress during stages of the process without indicating that growth is unimportant or negative; and it can follow various trajectories, including ones where it may at first serve one function, but later involve personally transformative changes.
Tedeschi, R. G., & McNally, R. J. (2011). Can we facilitate posttraumatic growth in combat veterans? American psychologist, 66(1), 19-24. doi:10.1037/a0021896 The Comprehensive Soldier Fitness program, currently under development for the U.S. Army, will include a com-ponent designed to increase the possibilities for posttraumatic growth in the aftermath of combat. In this article, we briefly review studies that provide evidence for this phenomenon in combat veterans, and we suggest elements that such a program might include to facilitate posttraumatic growth. We urge the Army to conduct randomized controlled trials testing the efficacy of the program prior to its implementation.
Triplett, K. N., Tedeschi, R. G., Cann, A., Calhoun, L. G., & Reeve, C. L. (2011). Posttraumatic growth, meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research, Practice, and Policy. doi:10.1037/a0024204. A model of the processes leading to posttraumatic growth and to life satisfaction following exposure to trauma was tested. Two types of repeated thought, deliberate and intrusive, posttraumatic symptoms, posttraumatic growth, and meaning in life, were assessed as predictors of general life satisfaction. Challenges to core beliefs were shown to be related to both intrusive and deliberate rumination. The two forms of rumination were in turn differentially related to posttraumatic growth and posttraumatic distress. Distress and posttraumatic growth were independently and oppositely related to meaning in life and to life satisfaction. Overall, the best fitting model was supportive of proposed posttraumatic growth models. Additional exploratory analyses examined participant groupings, based of self-reported category of resolution of the traumatic experience, and differences supportive of proposed underlying processes were found.
Tronick, E. (2006). The inherent stress of normal daily life and social interaction leads to the development of coping and resilience, and variation in resilience in infants and young children: Comments on the papers of Suomi and Klebanov & Brooks-Gunn. Annals of the New York Academy of Sciences, 1094, 83-104. doi:10.1196/annals.1376.008. The hypothesis is advanced that behavioral and physiologic resilience develops in part from infants' and young children's experience coping with the inherent normal stress of daily life and social interaction. Data on the stress of normal social interactions and perturbated interactions from the Face-to-Face Still-Face Paradigm (FFSF) are presented for young infants. These findings, including behavioral, heart rate and vagal tone, and electrodermal reactivity demonstrate the stress inherent in normal interaction and how coping with normal stress develops infants' coping with more intense environmental and social stressors.
Tugade, M. M., & Fredrickson, B. L. (2006). Regulation of positive emotions: Emotion regulation strategies that promote resilience. Journal of Happiness Studies, 8(3), 311-333. Springer. Retrieved from http://www.springerlink.com/index/10.1007/s10902-006-9015-4 The regulation of emotions is essential in everyday life. In this paper, we discuss the regulation of positive emotional experiences. Our discussion focuses on strategies aimed at maintaining and increasing experiences of positive emotions. We discuss the importance of these strategies for well-being, and suggest that cultivating positive emotions may be particularly useful for building resilience to stressful events. Then, we explore possible mechanisms that link positive emotions to coping for resilient people, with a focus on the automatic activation of positive emotions while coping. We conclude by discussing alternative models and proposing future directions in the work on positive emotion regulation and resilience.
Tugade, M. M., Fredrickson, B. L., & Barrett, L. F. (2004). Psychological resilience and positive emotional granularity: Examining the benefits of positive emotions on coping and health. Journal of Personality, 72(6), 1161-90. doi:10.1111/j.1467-6494.2004.00294.x. For centuries, folk theory has promoted the idea that positive emotions are good for your health. Accumulating empirical evidence is providing support for this anecdotal wisdom. We use the broaden-and-build theory of positive emotions (Fredrickson, 1998; 2001) as a framework to demonstrate that positive emotions contribute to psychological and physical well-being via more effective coping. We argue that the health benefits advanced by positive emotions may be instantiated in certain traits that are characterized by the experience of positive emotion. Towards this end, we examine individual differences in psychological resilience (the ability to bounce back from negative events by using positive emotions to cope) and positive emotional granularity (the tendency to represent experiences of positive emotion with precision and specificity). Individual differences in these traits are examined in two studies, one using psychophysiological evidence, the second using evidence from experience sampling, to demonstrate that positive emotions play a crucial role in enhancing coping resources in the face of negative events. Implications for research on coping and health are discussed.
Updegraff, J. A., & Taylor, S. E. (2000). From vulnerability to growth: Positive and negative effects of stressful life events. In J. H. Harvey & E. D. Miller (Eds.), Loss and trauma: General and close relationship perspectives (pp. 3-28). Philadelphia, PA: Brunner-Routledge.
van der Kolk, B. A. (1996). The complexity of adaptation to trauma: Self-regulation, stimulus discrimination, and characterological development. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming stress on mind, body and society (pp. 182-213). New York: Guilford Press.
von Eye, A., & Schuster, C. (2000). The odds of resilience. Child Development, 71(3), 563-566. doi:10.1111/1467-8624.00165. This article presents sample research designs for the investigation of questions concerning resilience. Sample hypothesis from specific research designs are described in the form of odds ratios.
Vishnevsky, T., Cann, A., Calhoun, L. G., Tedeschi, R. G., & Demakis, G. J. (2010). Gender differences in self-reported posttraumatic growth: A meta-analysis. Psychology of Women Quarterly, 34(1), 110-120. doi:10.1111/j.1471-6402.2009.01546.x A meta-analysis was conducted to examine the direction and magnitude of gender differences in self-reported post traumatic growth. Results from 70 studies (N = 16,076) revealed a small to moderate gender difference (g = .27, 95% CI = .21 -.32), with women reporting more posttraumatic growth than men. Moderator analyses were then conducted to identify possible sources of these differences. The following moderators were examined: mean age of sample, measure used, nature of the stressful event, language of the measure, and type of sample (i.e., community samples, college students, or mixed). The only significant moderator was age, with women reporting incrementally more posttraumatic growth as the mean age of the sample increased (B = .004, p < .01, SE = .001, Q = 9.13). To check for publication bias, effect sizes were compared across published and unpublished research. The size of the gender difference was not significantly different between published (g = .30, 95% CI = .23 - .38) and unpublished (g = .22, 95% CI = .12 -.31) studies. The present findings indicate that modest, but reliable gender differences exist in posttraumatic growth even when unpublished data are included in the analyses. Possible explanations for these findings and suggestions for future research are discussed.
Wachs, T. D. (2006). Contributions of temperament to buffering and sensitization processes in children's development. Annals of the New York Academy of Sciences, 1094, 28-39. doi:10.1196/annals.1376.004. Temperament refers to relatively stable, early appearing, biologically rooted individual differences in behavioral traits. Individual differences in temperament are multidetermined encompassing both biological and experiential influences. Evidence indicates that certain temperament traits, such as impulsivity, inhibition, and negative emotionality, can serve as developmental risk factors. Evidence also indicates that other temperament traits, such as flexible self-regulation, sociability, and task orientation, can serve to increase children's resilience. Five potential mechanisms through which individual differences in temperament can increase vulnerability or facilitate resilience are presented: (1) Differential treatment of children with different temperaments by caregivers or teachers (reactive covariance). (2) Children with different temperament styles seeking out environments that may increase risk or promote resilience (active covariance). (3) Goodness or poorness of fit between child temperament characteristics and environmental demands. (4) Children with different temperaments reacting to similar levels or types of stress in different ways. (5) Different coping strategies used by children with different temperaments.
Wagner, B., Forstmeier, S., & Maercker, A. (2007). Posttraumatic growth as a cognitive process with behavioral components: A commentary on Hobfoll et al. (2007). Applied Psychology, 56(3), 407-416. doi:10.1111/j.1464-0597.2007.00295.x The commentary highlights some of the key points to emerge from the paper by Hobfoll, Hall, Canetti-Nisim, Galea, Johnson, and Palmieri (2007, in this issue) about the relationship between posttraumatic growth and action, psychological functioning, and cognitive processing. In our commentary, we question the sequence of steps that Hobfoll et al. took to critique current theoretical cognitive models of posttraumatic growth. On the basis of the Janus-face model (Maercker & Zöllner, 2004) of posttraumatic growth, we argue that, in addition to a cognitive core, posttraumatic growth may, but does not necessarily, involve an action component.
Watson, D., & Hubbard, B. (1996). Adaptational style and dispositional structure: Coping in the context of the Five-Factor model. Journal of Personality, 64, 737-774. We review prior evidence-and present data of our own-linking measures of adaptational style to the traits comprising the five-factor model of personality. Neuroticism has been studied most extensively and is consistently associated with passive and ineffective coping mechanisms. Conscientiousness has emerged as an equally powerful predictor of coping; however, it is related to active, problem-focused response strategies. Extraversion is less broadly related to coping but tends to be correlated with social support seeking, positive reappraisal, and problem-focused coping. Openness is largely unrelated to many traditional coping inventories, but appears to reflect a more flexible, imaginative, and intellectually curious approach to problem solving. Finally, Agreeableness is only modestly related to coping. These results demonstrate the value of using well-articulated taxonomic schemes as a framework for trait-based research.
Weinrib, A. Z., Rothrock, N. E., Johnsen, E. L., & Lutgendorf, S. K. (2006). The assessment and validity of stress-related growth in a community-based sample. Journal of Consulting and Clinical Psychology, 74(5), 851-8. doi:10.1037/0022-006X.74.5.851. In an investigation of the assessment and construct validity of stress-related growth, community-dwelling women (N = 163) wrote essays about the impact of a stressful life event that had occurred in the previous few years and completed the Posttraumatic Growth Inventory (PTGI). Independent ratings of growth in the essays were positively correlated with PTGI scores, suggesting that endorsement of growth on questionnaires can be substantiated by personal accounts. There was no relation between reports of growth on the PTGI and socially desirable responding or negative mood. Higher PTGI scores were associated with greater positive mood and greater depth of processing in the essays. These findings support the validity of stress-related growth as a construct and its assessment via questionnaire.
Westphal, M., & Bonanno, G. A. (2007). Posttraumatic growth and resilience to trauma: Different sides of the same coin or different coins? Applied Psychology, 56(3), 417-427. doi:10.1111/j.1464-0597.2007.00298.x Posttraumatic growth (PTG) is an appealing but poorly understood construct. Hobfoll, Hall, Canetti-Nisim, Galea, Johnson, and Palmieri's (2007) insightful paper highlights important weaknesses in existing theory and data. Although we commend Hobfoll et al. for offering a provocative new way to conceptualise PTG in terms of action-focused growth, we also find a number of limitations in their approach. In this article, we attempt to place PTG within a broader framework of individual differences in response to potential trauma. As in most of the literature on PTG, Hobfoll et al. implicitly equate growth with resilience or view it as superior to resilient outcomes. We argue, however, that many if not most people are resilient in the face of trauma and that resilient outcomes typically provide little need or opportunity for PTG. We close by exploring the literature on resilience for possible mechanisms underlying a link between PTG and adaptation. For example, Hobfoll et al. dismiss some forms of reported growth as illusory. In contrast, we review evidence for the adaptive value of self-enhancing illusions in coping with adversity.
Willis, S. L., Martin, M., & Rocke, C. (2010). Longitudinal perspectives on midlife development: stability and change. European Journal of Ageing, 7(3), 131-134. doi:10.1007/s10433-010-0162-4.
Woike, B., & Matic, D. (2004). Cognitive complexity in response to traumatic experiences. Journal of Personality, 72(3), 633-658. doi:10.1111/j.0022-3506.2004.00275.x Two studies examined how personality motives influence the perception of traumatic events in memory and how such perception may be linked to psychological distress. Participants completed implicit and explicit measures of agentic and communal motives. In Study 1, participants living in New York City at the time of the terrorist attacks wrote their thoughts and feelings about the events of September 11th. In Study 2, participants wrote about a personally traumatic experience. In both studies, they also completed questionnaires on psychological symptoms and stress-related growth. The memories were then scored for differentiation and integration. Agentic motives correlated with differentiated perceptions and differentiation was linked to dissociative symptoms in Study 2. Communal motives related to integrated perceptions, and integration related to stress-related growth in both studies. Findings suggest that motives play a significant role in the perception of traumatic and difficult experiences and that these perceptions may be differentially linked to psychological impact.
Wortman, C. B. (2004). Posttraumatic growth: Progress and problems. Psychological Inquiry, 15(1), 81-90. Abstract: During the past 20 years, there has been a dramatic increase in research on life events. The majority of these studies have focused on documenting the negative sequalae of events. Investigators Richard G. Tedeschi, Lawrence G. Calhoun and others have emphasized that stressful life events can bring about post-traumatic growth, or positive psychological change experienced as a result of the struggle with highly challenging life circumstances. These investigators were among the first to focus attention on such positive changes. By so doing, they have encouraged everyone to take a more comprehensive look at the effects of stress, trauma, and loss.
Wren-Lewis, J. (2004). The Implications of near-death experiences for understanding posttraumatic growth. Psychological Inquiry, 15(1), 90-92. Abstract: The word trauma itself is commonly associated in psychiatric circles with subsequent mental disorder or neurosis, as investigators Richard G. Tedeschi and Lawrence G. Calhoun in the January 2004 issue of "Psychological Inquiry" emphasize. In fact a key element in their presentation is insistence that even in cases where a severe crisis experience has led to very positive life change, this often coexists with continuing personal distress, sometimes even to the point where the experiencer says he or she would prefer it had not happened at all, despite having grown emotionally by living through it.
Zautra, A. J., Hall, J. S. & Murray, K. E. (2010). Resilience: A new definition of health for people and communities. In J. W. Reich, A. J. Zautra & J. S. Hall (Eds.), Handbook of adult resilience (pp. 3-34). New York: Guilford.
Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology: Acritical review and introduction of a two component model. Clinical Psychology Review, 26(5), 626-53. doi:10.1016/j.cpr.2006.01.008. Positive psychological or personal changes in the aftermath of trauma, defined as the result of the struggle with highly stressful events, have recently elicited heightened attention by trauma researchers. This article aims at summarizing the most important theoretical models and conceptualizations of posttraumatic growth (PTG) and addresses the issue of the adaptive significance of this phenomenon. It further renders a thorough empirical review of the relationship between PTG and psychological adjustment. European findings are specifically incorporated. As a conclusion, a two component cognitive model of PTG will be proposed that may explain the contradicting empirical findings in regard to the relationship between mental health and PTG. The Janus-Face model of PTG [Maercker, A. and Zoellner, T. (2004). The Janus face of self-perceived growth: Toward a two-component model of posttraumatic growth. Psychological Inquiry, 15, 41-48.] incorporates a constructive and an illusory aspect. On this basis, findings regarding relevant cognitive factors as predictors of PTG are summarized and evaluated. The article ends with a discussion of fruitful future research directions how PTG can add a new perspective into trauma therapy.