Examining adversarial growth in illness: the factor structure of the Silver Lining Questionnaire (SLQ-38)

Emotional and Behavioral Responses to COVID-19

Abstract. This review appraises evidence for the role of personality in COVID-19 related emotions and behaviors. Three key models of personality are considered: the Five-factor Model, HEXACO model, and Reinforcement Sensitivity Theory (RST). In line with personality research, more generally, most studies focus on the Five-Factor model. Key findings are that neuroticism is most associated with poor mental health, and extraversion is associated with a reluctance to socially isolate. Conscientiousness predicts compliance with safety guidelines but also with fewer prosocial behaviors, particularly stockpiling. Research within the HEXACO framework largely confirms these findings, especially for emotionality and mental health. The additional HEXACO Honesty-Humility factor is found to be associated with prosocial views and abstention from panic buying. Studies based on the Reinforcement Sensitivity Theory of personality indicate emotional conflict as people wish to stay safe while maintaining a sense of normality. Behavioral compliance is driven by activation in the Fight-Flight-Freeze System (FFFS; fear-related) and the Behavioral Inhibition System (BIS; anxiety-related). The Behavioral Approach System (BAS) is implicated in approach-driven behaviors such as avoiding infection. These findings have implications for health communications and post-pandemic support.

Adolescent Posttraumatic Growth: A Review

Existing literature on posttraumatic growth following adverse experiences has questioned adolescent capacity to experience such growth given immature cognitive and affective development. The aim of this review was to conduct the first review of the literature regarding post-traumatic growth among adolescents (ages 12-18) to determine whether there is empirical evidence of adolescent post-traumatic growth. Results of the review, conducted according to PRISMA guidelines, are reported to (1) summarize existing support for adolescent post-traumatic growth within available empirical literature, (2) discuss potential moderators of adolescent post-traumatic growth occurrence, and (3) review existing measures of post-traumatic growth. Evidence of adolescent post-traumatic growth was found within three studies with correlational designs and two studies with longitudinal designs. The majority of the literature regarding adolescent post-traumatic growth provides initial support in the form of correlational evidence; however, such support is difficult to empirically establish given the lack of longitudinal studies in this area. Critiques of the extant research and areas for future research are discussed.

Associations Between Experienced and Internalized HIV Stigma, Adversarial Growth, and Health Outcomes in a Nationwide Sample of People Aging with HIV in Germany

HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses.

Fibromyalgia impact and depressive symptoms: Can perceiving a silver lining make a difference?

Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day-to-day functioning. However, individual-level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a "silver lining" in one's illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self-report measures including the Fibromyalgia Impact Questionnaire-Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia.

Stories of Growth and Wisdom: A Mixed-Methods Study of People Living Well With Pain

Chronic pain remains a daunting clinical challenge, affecting 30% of people in the United States and 20% of the global population. People meeting this challenge by achieving wellbeing while living with pain are a virtually untapped source of wisdom about this persistent problem. Employing a concurrent mixed-methods design, we studied 80 people living with chronic pain with "positive stories to tell" using semi-structured interviews and standardized questionnaires. In-depth interviews focused on what helped, what hindered, how they changed, and advice for others in similar circumstances. Major qualitative themes included acceptance, openness, self-efficacy, hope, perseverance, self-regulation, kinesthetic awareness, holistic approaches and integrative therapies, self-care, spirituality, social support, and therapeutic lifestyle behaviors such as music, writing, art, gardening, and spending time in nature. Themes of growth and wisdom included enhanced relationships, perspective, clarity, strength, gratitude, compassion, new directions, and spiritual change. Based on narrative analysis of the interviews and Ardelt's Three-Dimensional Wisdom Model, participants were divided into 2 groups: 59 wisdom exemplars and 21 nonexemplars. Non-exemplar themes were largely negative and in direct contrast to the exemplar themes. Quantitatively, wisdom exemplars scored significantly higher in Openness and Agreeableness and lower in Neuroticism compared to non-exemplars. Wisdom exemplars also scored higher in Wisdom, Gratitude, Forgiveness, and Posttraumatic Growth than nonexemplars, and more exemplars used integrative therapies compared to the non-exemplars. As a whole, the exemplar narratives illustrate a Positive Approach Model (PAM) for living well with pain, which allows for a more expansive pain narrative, provides positive role models for patients and clinicians, and contributes to a broader theoretical perspective on persistent pain.