The challenging journey from trauma to post-traumatic growth: Lived experiences of facilitating and hindering factors

Being Human Under Inhuman Conditions: Meanings of Living with Severe Dissociative States Involving the Experience of Being in Parts

Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.

Posttraumatic growth in eating disorder recovery

OBJECTIVE

To investigate posttraumatic growth in individuals recovering from an eating disorder.

DESIGN

A convergent parallel mixed methods design was used.

PARTICIPANTS

The sample consisted of 28 participants who completed the entire study and an additional 10 who completed only the quantitative portion of this mixed methods study.

METHODS

The National Eating Disorders Association (NEDA) provided a link to the electronic survey via their website. Participants were asked to complete the Posttraumatic Growth Inventory (PTGI) and the Core Beliefs Inventory (CBI) in the quantitative strand. For the qualitative strand, participants were asked to describe any positive changes in their beliefs or life as the result of their eating disorder (ED).

RESULTS

Participants reported a high amount of posttraumatic growth as indicated by their mean score on the CBI (30.39, SD 7.89) and (71.26, SD 16.58) on the PTGI. Qualitative categories included relating to others, personal strength, new possibilities, appreciation of life, and spiritual change.

CONCLUSION

Participants described the transformation they experienced in the recovery process, with recovery from an eating disorder facilitating an opportunity for growth. Providing posttraumatic growth interventions may have the potential to help individuals with eating disorders find meaning in their pathway through recovery.

Why emotional neglect brings suicidal ideation? The mediating effect of meaning in life and the moderating effect of post-stress growth

BACKGROUND

Emotional neglect during childhood has long-lasting negative effects on individuals, and it is often hidden and unrecognized. Previous research has not fully understood its unique effects on mental health outcomes, especially when considering the co-occurrence with other forms of maltreatment. The meaning-making coping and growth model suggests that individuals achieve positive psychological outcomes by constructively integrating negative experiences into their self-concept, which may be a protective mechanism against the detrimental effects of emotional neglect.

OBJECTIVE

This study aimed to examine the relationship between emotional neglect and suicidal ideation among undergraduates, accounting for the presence of emotional abuse and physical neglect, and to investigate the mediating role of meaning in life and the moderating role of post-stress growth in this relationship.

METHODS

A self-reported survey was conducted with 3132 undergraduate students from a university in South China. The survey assessed emotional neglect, emotional abuse, physical neglect, suicidal ideation, post-stress growth, and meaning in life.

RESULTS

Meaning in life partially mediated the relationship between emotional neglect and suicidal ideation. Post-stress growth moderated the association between emotional neglect and the sense of meaning in life, in particular the moderation effect was stronger when emotional abuse was weaker.

CONCLUSIONS

Meaning in life mediated the relationship between emotional neglect and suicide ideation. Post-stress growth moderated the mediation effect such that it was weakened among individual with a higher level of post-stress growth. This study contributes to the understanding of the psychopathological processes following emotional neglect and the development of positive personal changes thereafter.

Providing Gender Sensitive and Responsive Trauma-Informed Psychiatric Nursing Care. How Hard Can It Be?

This paper addresses the challenge of providing gender sensitive and responsive trauma-informed care (TIC) in psychiatric nursing practice. Gender identity, gender subordination, and gender-related trauma history are examined as three key individual-level factors that affect nurses' capacity to engage therapeutically to provide gender sensitive and responsive TIC. Using Peplau's Interpersonal Theory and building on a shared trauma and resilience model, gender-sensitive and responsive TIC is situated within interpersonal science and the ability of the psychiatric nurse to attune to her own and her patient's gender ideologies. Strategies for transforming practice including self-reflection, self-compassion, and peer and supervisor support are reviewed. Noting the import of the practice environment, several observations of changes needed at the level of the unit, organization, and society to effect gender equitable policies that enable the implementation of gender-sensitive and responsive TIC are made.

Encouraging inflated reports of posttraumatic growth: the presence of a wording effect on self-reports of posttraumatic growth

BACKGROUND AND OBJECTIVES

Posttraumatic growth (PTG) refers to positive psychological changes that result from a traumatic experience. The Posttraumatic Growth Inventory (PTGI) and the Stress-Related Growth Scale (SRGS) are the two most commonly used measures of PTG. One criticism of these measures is that all their items are positively worded (for example, "I have a greater feeling of self-reliance").

DESIGN AND METHODS

In the current paper, we conducted two studies that examined a possible wording effect in these two measures.

RESULTS

In Study 1, we found that positively worded items on the PTGI are positively correlated with the negatively worded version of the same items. Additionally, the positively and negatively worded versions of these items formed two separate factors, further suggesting a wording effect. In Study 2, we conducted an experimental design by comparing self-reports of PTG when randomly assigned to complete either positively- or neutrally worded versions of the items. We found that participants reported 27% less PTG when given neutrally worded items.

CONCLUSIONS

The combined results strongly suggest a wording effect that encourages overreporting of self-reports of PTG.

Promotion factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study

BACKGROUND

Since March 2022, Shanghai, China, has experienced a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The pandemic has severely constrained the local healthcare system. After treating critically ill COVID-19 patients, emergency nurses may experience some positive changes due to new insights or gains in their work, even if they have had traumatic experiences. This study aimed to explore the promoting factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai. We hoped to provide a new perspective and theoretical basis for intervening in and promoting the psychological rehabilitation of medical staff after traumatic circumstances.

METHODS

This study employed a qualitative design based on the phenomenological approach. 18 participants from the emergency department of a third-level class-A hospital in Shanghai who participated in treating COVID-19 patients were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The seven-step Colaizzi process was used for data analysis.

RESULTS

The investigation uncovered two themes and six subthemes. Internal factors contained self-affirmation, deliberate rumination, and cognitive restructuring, which constituted attitudes and behaviours that participants could subjectively determine. External factors included social support, transformational leadership, and role modelling, which constituted factors influenced by others or the environment.

CONCLUSIONS

The promoting factors of PTG of emergency nurses originated from different sources such as individuals, organizations, and society. In addition to good psychological adjustment of the individual, society, hospitals, and nursing managers should focus on establishing supportive PTG strategies. The ultimate purpose is to improve the retention rate and career growth of nurses.

The Post-Traumatic Growth Journey of Women Who Have Survived Intimate Partner Violence: A Synthesized Theory Emphasizing Obstacles and Facilitating Factors

Suffering intimate partner violence (IPV) is a devastating personal experience and post-traumatic growth (PTG) is a positive, psychological change in a person, following trauma such as IPV. There is a gap in the literature when it comes to theories on PTG after surviving IPV. The aim of this theory development was to synthesize an approach to understanding the PTG journey of female IPV survivors. According to our theory, their PTG journey includes eight main components: 1. The women’s early experience of trauma, 2. The consequences of that trauma, 3. Their experiences of IPV, 4. The consequences of IPV, 5. The facilitating factors to PTG, 6. The hindering factors to PTG, 7. Their experience of PTG, and 8. The lingering effects of IPV. According to our findings, PTG is a real possibility for female IPV survivors, and it is likely to improve their mental health, well-being, and quality of life, as well as that of their children, loved ones, and communities, thereby decreasing the damaging effects of IPV. The theory can be useful for professionals when guiding female survivors of IPV to promote their recovery and healing. Due to the lack of research in this field, additional research is needed to further develop this theory.

Fourteen Main Obstacles on the Journey to Post-Traumatic Growth as Experienced by Female Survivors of Intimate Partner Violence: "It Was All So Confusing"

In this study, we identified 14 obstacles experienced by female survivors of intimate partner violence who had, nonetheless, reached post-traumatic growth (PTG), which is a positive psychological change by a person following serious difficulties or traumatic events. Intimate partner violence (IPV) is such a trauma. The purpose of this study was to analyze the obstacles to PTG as experienced by women who have succeeded in reaching PTG following traumatic IPV. Participants were twenty-two women aged 23–56 who self-reported their PTG according to the working definition used. The participants reported feelings of diminished self-worth that had negatively influenced their lives and how these negative feelings delayed their PTG. The overriding theme of the study was “It was all so confusing”, which expressed the essence of the participants’ feelings when describing the obstacles they encountered on their journey to PTG. Most of those obstacles were intrapersonal, i.e., negative personal feelings and negative perspectives towards themselves. Other obstacles reported by participants were physical and psychological health problems, challenging personal circumstances, and the perpetrator, as well as laws, regulations, and institutional social systems. This study reveals the broad range of obstacles encountered by women on their journey to PTG following IPV, emphasizing the necessity of an interdisciplinary approach when holistically considering their situation and supporting them on their journey towards PTG.

“I’m a Winner, Not a Victim”: The Facilitating Factors of Post-Traumatic Growth among Women Who Have Suffered Intimate Partner Violence

Post-traumatic growth (PTG) is a positive psychological change following trauma. Intimate partner violence (IPV) is one such trauma. The aim of this phenomenological study was to explore PTG from the perspective of women who have survived IPV as well as their perceptions of PTG. Twenty-two female IPV survivors aged 23–56 who reached PTG, according to the working definition used, were interviewed. The overriding theme of the study was “I’m a winner, not a victim”, which describes the essence of the women’s experience of PTG. They described their experience as a shift from being suffering victims of IPV to becoming winners who enjoyed PTG. They felt that their positive attitude and personal strengths had helped them to reach PTG as well as to face the fact that they had been in an abusive relationship, thus forgiving and believing in themselves and taking responsibility for their own health and well-being. They sought knowledge about violence, how to process it, and how to respond to triggers. They set boundaries for their perpetrators and were in as little contact with them as possible. They chose the company of positive, supportive, and constructive people and situations where they were not being controlled. It was concluded that, even though suffering IPV is a terrible experience that no one should endure, the participants’ experiences had resulted in PTG that they treasured.