Coping with my own way: Mediating roles of emotional expression and social support seeking in the associations between individual differences and posttraumatic growth

[A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19]

PURPOSE

This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review.

METHODS

The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.

RESULTS

The modified model showed appropriate goodness of fit (χ² = 369.90, χ²/degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.

CONCLUSION

This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

A latent profile analysis of emotional expression among patients with unintentional injuries

BACKGROUND

Emotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder.

METHODS

A cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version.  RESULTS: Three unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership.

CONCLUSIONS

Most patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.

Post accidental injury: Mediating roles of emotional expressivity, rumination, and posttraumatic growth

This study explored the relationship between rumination (deliberate or intrusive), emotional expressivity (positive or negative), and posttraumatic growth among patients within 1 month after an accidental injury. Using a cross-sectional design, 313 patients were investigated in two comprehensive hospitals. The results revealed that intrusive rumination had a significant positive effect on posttraumatic growth, partly through four different pathways: (i) the mediating role of deliberate rumination; (ii) the chain mediating role of deliberate rumination and negative emotional expressivity; (iii) the chain mediating role of negative emotional expressivity and positive emotional expressivity; and (iv) the chain mediating role of negative emotional expressivity, positive emotional expressivity, and deliberate rumination. Interventions to encourage emotional expressivity and facilitate the transition from intrusive rumination to deliberate rumination may promote posttraumatic growth soon after an accidental injury.

Finding the silver linings: Psychosocial correlates of posttraumatic growth among husbands of Chinese breast cancer survivors

OBJECTIVES

Caregiving does not have to be a totally negative experience for the husband caregivers of breast cancer survivors (BCS). There are growing interests in exploring the positive psychological changes (aka posttraumatic growth; PTG) among husbands of BCS. Western studies have shown that coping resources, cognitive appraisal, and coping strategies are associated with PTG among caregivers of BCS. Studies in the Chinese context are limited. This study examined the psychosocial correlates of PTG among husbands of Chinese BCS.

METHODS

Husbands of Chinese BCS (N = 176) were recruited from two hospitals in Weifang, China to complete a cross-sectional survey. Their levels of caregiving burden, marital satisfaction, cognitive appraisals, coping strategies, and PTG were measured.

RESULTS

After controlling for covariates, hierarchical regression results indicated that higher caregiving burden (β = .29), marital satisfaction (β = .27), challenge appraisal (β = 016), and social support seeking (β = .23) were associated with higher PTG (Ps < .05). Additionally, a significant interaction between caregiving burden and positive reframing emerged in explaining PTG (β = .17, P < .05). Positive reframing was only associated with higher PTG among those with higher caregiving burden (β = .25, P = .03), but not those with lower caregiving burden (β = -.09, P > .05).

CONCLUSIONS

Stress and coping variables significantly contributed to PTG among husbands of Chinese BCS. Our findings implied that addressing those husband caregivers' marital satisfaction, challenge appraisal toward the impact of breast cancer, and social support seeking could be intervention strategies to facilitate their PTG. Among husbands having higher caregiving burden, positive reframing may also facilitate their PTG.

Feasibility and effect of a guided self-disclosure intervention designed to facilitate benefit finding in breast cancer patients: A pilot study

PURPOSE

This pilot study aimed to evaluate the feasibility and effect of a guided self-disclosure intervention (GSDI) promoting benefit finding (BF) for breast cancer patients.

METHODS

A total of 40 women with breast cancer were randomized either to a GSDI group, which included a 6-session face-to-face self-disclosure intervention, or to a control group. The Benefit Finding Scale (BFS) was used to measure BF, the Distress Disclosure Index (DDI) was used to measure self-disclosure, and the Impact of Event Scale-Revised (IES-R) was used to measure cognitive reappraisal. The outcomes were evaluated at baseline and the 3rd and 6th months.

RESULTS

The GSDI group had more satisfaction (t = 2.35, P = .02) than the control group and had significant group effects of higher BF (t = 2.214, P = .03) and a lower avoidance of the IES-R (t = -2.353, P = .024) at the 3rd month. There was a significant difference of BF (t = 2.036, P = .049) between the two groups at the 6th month, and other outcomes were not significant (P > .05). Intention-to treat (ITT) analysis showed significant time effects for all outcomes (P < .05); there were slightly significant time × group effects for BF (F = 4.15, P = .052) and disclosure (F = 2.719, P = .090). There were no time × group effects for the other outcomes (all P > .05).

CONCLUSION

This study suggests that the GSDI intervention may be feasible in the clinic and might improve BF for breast cancer patients. However, future research needs to further refine the intervention and expand the sample to carry out a full-scale randomized controlled trial.