Back-to-Back Climate shocks and the mental health crisis: A Texas-sized surge in depression and anxiety ER visits

Climate change is intensifying the frequency and severity of climate-related disasters, posing significant challenges to public mental health. This study explores the relationship between successive climate events and emergency department (ED) visits for depression and anxiety in the Greater Houston area from 2019 to 2023. Combining monthly data from the Texas Syndromic Surveillance System, the National Weather Service, and the Agency for Healthcare Research and Quality, we conducted a time-series analysis to assess the impact of successive weather events on ED visits for anxiety and depression. Our random forest models reveal significant associations between weather variables and mental health-related ED visits. Specifically, time series decomposition uncovered distinct seasonal patterns, with specific periods consistently showing higher demand for mental health services. Additionally, the analysis indicates that severe weather events that restrict mobility, such as hurricanes and tropical storms, initially lead to a decrease in ED visits, followed by a surge in the following months, whereas events that do not impede travel, such as heatwaves and droughts, correlate with immediate increases in visits. Feature importance analysis indicated social factors, such as the number of households and children ≤17, along with weather variables like average temperature and total precipitation, were significant predictors of ED visits for both anxiety and depression. Access to healthcare services, including proximity to healthcare clinics and treatment centers, also played a crucial role. These observed patterns underscore the significant influence of seasonal and weather-related factors on mental health and underscore the need for targeted public health interventions that consider the timing and nature of climate events, as well as strategies to enhance community resilience and strengthen mental health support systems.

The impact of social welfare support on mental health in Vietnam

This study examines the impact of government support on mental health in Vietnam using Vietnam's Households Living Standard Surveys in 2018 and 2020 and a probit estimator. Characteristics of the households and the households' heads are also examined. We find that government support tends to worsen mental health in Vietnam, implying the current Government support is insufficient to improve mental health in households, particularly during stressful times during the COVID-19 pandemic. Female-headed households appear to experience a more significant mental health deterioration compared to their counterparts, whereas households living in urban areas are mentally struggling compared to those living in rural areas. Our results also indicate that mental health deterioration exhibits an inverted U-shaped relationship with age, implying mental health appears to be a significant issue for young individuals in Vietnam. Household incomes and assets act as a buffer against mental health deterioration. These findings support the view that mental health deterioration appears to emerge from financial distress. Households suffer mental health deterioration if their financial circumstances are not improved and support from the government is insufficient.

Posttraumatic Growth among Children and Adolescent Survivors of Trauma: Systematic Scoping Review

This review explores the existing literature on posttraumatic growth in children and adolescent survivors of trauma. The review follows 5 stages of Arksey and O'Malley's framework of a scoping review. Databases like PsychINFO, PubMed, ProQuest, Web of Science, and Google Scholar were searched for the articles. Of those retrieved, 35 met the criteria. The review findings suggest that the mean prevalence of growth in children and adolescent survivors ranges from 2.10 to 81.84 in the PTGI total scores, ranging from 0 to 105. The highest level of growth was consistently experienced in relation to other domains. Posttraumatic stress, social support, religious and cultural practices, coping strategies, rumination, and social support were suggested to be associated with posttraumatic growth.

Anxiety, post-traumatic symptoms, media-induced secondary trauma, post-traumatic growth, and resilience among mental health workers during the Israel-Hamas war

The ongoing Israel-Hamas war is posing additional challenges for mental health workers in an already stressful workplace. This study centres on the psychological effects of the shared traumatic reality on mental health workers, arising from the Israel-Hamas war. One month after exposure to the terrorist attack of 7 October 2023 and the outbreak of war following this event, 147 mental health workers completed questionnaires regarding a variety of variables such as demographics, anxiety symptoms, acute stress symptoms, media-induced secondary trauma, personal resilience, National resilience (NR), and post-traumatic growth (PTG). The study found that mental health workers with previous trauma displayed higher anxiety symptoms, acute stress symptoms, and media-induced secondary trauma. Additionally, acute stress and anxiety were positively correlated with media-induced secondary trauma. Religiosity, personal resilience, and NR were found associated with lower anxiety and acute stress symptoms. Religiosity was also positively correlated with personal resilience, NR, and PTG. The PTG of mental health workers working with trauma survivors and evacuees was higher compared to that of other mental health workers. Both adverse and adaptive reactions were evident among mental health workers. While traumatic stress is expected, individual, professional, and NR factors may mitigate its effects. Providing training, social support, regulated media exposure, stress management, and meaning-focused coping strategies can help safeguard workers' well-being.

Factor structure of academic resilience among Polish and Ukrainian students involved in remote education caused by Covid-19 and military aggression

Academic resilience explains how students overcome various challenges or negative experiences that can hinder the learning process. The COVID pandemic as well as war conflicts might be significant factors affecting the structure of the academic resilience of students. This study attempted to assess the extent to which the Cassidy's construct of resilience can be used to interpret the behavior of other-Polish and Ukrainian samples, under remote education caused by the COVID-19 pandemic and Russian military aggression against the Ukrainian civils. Second, the relationships between resilience and students' self-efficacy were estimated. To test the factor structure of the resilience exploratory and confirmatory factor analyses were conducted. Assumed structure reproduced to a greater extent among Polish (83.4% similarity) than in Ukrainian respondents (from 27 to 40%) and it was three or two factors for Polish and Ukrainian students, respectively. General self-efficacy positively correlated with resilience both among Polish and Ukrainian respondents confirming the concurrent validity of the scale. The discovered differences were explained by differences in the historical and sociocultural experiences of the two nations. If among Ukrainian students historical and social experiences actually lead to the formation of a pattern of Perseverance in Overcoming Problems, then in the factor analysis, this pattern should be reproduced in the form of a single factor. At the same time, experiences with negative emotions should give a second-factor Negative affect and emotional response. The results obtained confirmed this assumption.

A bright side of adversity? A systematic review on posttraumatic growth among refugees

Until the third trimester of 2022, 103 million people worldwide had been forced to leave their homes and become refugees. The traumatic experiences of refugees can lead not only to mental disorders but also to Posttraumatic Growth (PTG). (1) To find the variables positively and negatively associated with PTG in refugees. (2) To investigate the relationship between PTG and Posttraumatic Stress Disorder (PTSD) among refugees. We systematically searched Medline, Web of Knowledge, PsycInfo, Scopus, and PTSD Pubs for studies about PTG in refugees. Epidemiological studies using the Posttraumatic Growth Inventory. Grey literature, reviews, and meta-analysis. Risk of bias was assessed by the 'The Joanna Briggs Institute Prevalence Critical Appraisal Tool'. We included 24 studies investigating PTG and associated factors. The factors positively associated with PTG were social support, regular migration status, religiosity, satisfaction with life, time, and problem-focussed and emotion-focussed coping. The factors negatively associated with PTG were: irregular migration status, emotional suppression, and avoidance coping. Studies on PTG in refugees are essential to finding new ways to address mental health in this field. Few studies offered risk of bias, particularly regarding the sample selection. We conclude that PTG may be influenced by many factors and it would be of importance that the centres for support, as well as public policies, took that into account to foster the outcome and not only to focus on disease. This study was partially supported by CAPES and registered on PROSPERO (CRD42020215607).

Posttraumatic growth among participating and non-participating organ donor families in grief support groups

This article aimed to assess posttraumatic growth among participating and nonparticipating families of organ donors in grief support groups. The program, in the form of both face-to-face and WhatsApp groups, is unique in that it extends over many years without limitation for a predefined period, is open to both immediate and extended family members, and is conducted according to predetermined topics. A questionnaire was completed by 84 participants and 115 non-participant family members. Most participants had attended for between 1 and 5 years (57.2%), although 33.3% had participated for >5 years, including 16.7% who participated for >10 years. All measures of posttraumatic growth were significantly higher in group participants (3.40 [0.75] vs. 3.15 [0.75], p = .010) than non-participants. The often-prolonged participation in the groups suggests there may be an important need for ongoing contact with and support for these families even many years after the loss.

Dynamic structure of posttraumatic growth among victims of the 2021 Henan floods: A 6-month, three-wave longitudinal study

Posttraumatic growth (PTG) following traumatic events is a dynamic and transformational process. However, its dynamic structure is currently unknown. The study aimed to estimate the dynamic structure of PTG at the nuance level based on PTG measurement items using network analysis. A three-wave longitudinal study was conducted from July 20, 2021, to January 30, 2022, among the victims experiencing the 2021 Henan floods. The final sample (n = 297) completed reports of PTG after 0, 3, and 6 months of the disaster. We employed the graphical vector autoregressive model approach to estimate extended network models. Contemporaneous network results revealed strong positive associations between domains of PTG in the same measurement window, especially between new possibilities and personal strength. Moreover, temporal network results-the internal interplays among PTG items across measurement windows-revealed that the domain of relating to others plays a central role in the dynamics of PTG. Although other domains predicted an increase in relating to others, relating to others inhibited the development of other domains, especially new possibilities and personal strength. Our study identifies the culture-specific process of PTG and provides empirical evidence on the explanatory models of PTG and the Janus-Face model of PTG.

Factors Associated with Growth in Sexual Violence Survivors: A Systematic Scoping Review

Sexual violence has been defined as any sexual act perpetrated against someone's will. Sexual violence has many negative consequences for the victims. The most prevalent mental health issue in victims is posttraumatic stress disorder. However, a new trend in positive psychology suggests that many survivors of traumatic events, in addition to negative repercussions, adapt and develop positive personal changes, i.e., Posttraumatic growth (PTG), to mitigate their impact. This review explores the literature on posttraumatic growth among survivors of sexual violence. The review follows 5 stages of Arksey and O'Malley's framework of scoping review. 6 databases were searched using indexed terms. Approximately 65 articles were initially identified and evaluated in the preliminary search using the specified keywords. Of those retrieved, 16 met the criteria and were included in this study. Posttraumatic stress, Control over Recovery, Social Support, and Spirituality/Religiosity were the significant factors for PTG. The results suggest that fostering social support, spirituality, and a sense of control over recovery can facilitate PTG, highlighting the importance of holistic approaches in promoting resilience after trauma. Implications for practice, policy, and future directions are discussed.

Posttraumatic growth after perinatal loss: A systematic review

Perinatal loss is a potentially painful event for parents and a grief that is often not recognised socially. Research has widely shown that grief responses can coexist with posttraumatic growth responses. The aim of this systematic review was to assess the available evidence of studies investigating posttraumatic growth in people who have suffered a perinatal loss. A search was conducted in PROQUEST and Web of Science for articles published from 2011 to 2021. After reviewing 10 selected articles, it was found that the participants showed moderate levels of posttraumatic growth, mostly in the domains of personal strength, relationships with others, appreciation of life, and to a lesser extent in the perception of new possibilities and spiritual growth. Factors that facilitated the growth experience were finding meaning in the loss, changes in core beliefs, adaptive coping strategies, deliberate rumination, continued bonds with the deceased baby, and social support. It is expected that this systematic review will provide a basis for the design of future interventions aimed at promoting growth when facing perinatal loss.

The Role of Personality Risk and Protective Factors in Living with Covid-19: A Longitudinal Study

Earlier research has shown the significant role of personality in serving as risk or protective factors in psychological wellbeing. However, it is less clear the extent to which personality plays in coping with the Covid-19 pandemic. The aim of the current study was to examine the role of a personality risk factors such as self-criticism, and personality strengths such as efficacy and intrinsic motivation representing resilience in predicting psychological outcomes in response to the Covid-19 pandemic. As part of a broader longitudinal study, personality measures were assessed at ages 23 and 29, and Covid-19-related outcomes were measured at age 41 on a subsample of 83 Israeli participants, who were approached after the first lockdown that was implemented (April 2020). Findings showed that self-criticism measured at age 23 anticipated greater Covid-19-related distress and lower satisfaction at age 41. Decrease in self-criticism from age 23 to 29, which indicates developmental progress toward maturity, explained lower non-adaptive emotional reactions at age 41- lower distress and lower anxiety. In addition, a higher level of intrinsic motivation at age 29 explained a greater likelihood to expect post pandemic growth. Findings highlight the role of personality in addressing unexpected stressful events such as the current Covid-19 pandemic.

Biological Correlates of Post-Traumatic Growth (PTG): A Literature Review

Since the beginning of medical science, much research have focused on the psychopathological effects of traumatic experiences. Despite in past centuries the scientific literature on mental health has been mainly focused on the harmful effects of traumatic occurrences, more recently the idea of "post-traumatic growth" emerged, on the basis of a growing interest in the characteristics of resilience and possible positive consequences of trauma. In this framework, increasing attention is now being paid to the psychological meaning of PTG, with a consistent number of psychopathological and epidemiological studies on this subject, but limited literature focused on neurobiological correlates or eventual biomarkers of this condition. The present work aimed to summarize and review the available evidence on neurobiological correlates of PTG and their psychological and clinical meaning. Results highlighted a variety of biochemical and neurobiological differences between PTG and non-PTG individuals, partially corroborating findings from earlier research on post-traumatic stress disorder (PTSD). However, although promising, findings in this field are still too limited and additional studies on the neurobiological correlates of traumatic experiences are needed in order to gain a better understanding of the subject.

Comparing posttraumatic growth in mothers after stillbirth or early miscarriage

The possibility of posttraumatic growth in the aftermath of pregnancy loss has received limited attention to date. This study investigated posttraumatic growth in mothers following stillbirth compared to early miscarriage. It was hypothesised that mothers following stillbirth will demonstrate more posttraumatic growth, challenge to assumptive beliefs, and disclosure than mothers following early miscarriage. The study also sought to understand how theoretically-derived variables of the Model of Growth in Grief (challenge to assumptive beliefs and disclosure) explained unique variance in posttraumatic growth when key factors were controlled for. One-hundred and twenty women who had experienced a stillbirth (N = 57) or early miscarriage (N = 63) within the last two to six years completed validated questionnaires in an online survey relating to posttraumatic growth and key variables relevant to emotional adjustment post-bereavement. Participants who had experienced a stillbirth demonstrated significantly higher levels of posttraumatic growth, posttraumatic stress symptoms, perinatal grief, disclosure, challenge to assumptive beliefs and rumination than participants who had experienced an early miscarriage (Cohen’s d ranged .38-.94). In a hierarchical stepwise regression analysis, challenge to assumptive beliefs alone predicted 17.5% of the variance in posttraumatic growth. Intrusive and deliberate rumination predicted an additional 5.5% of variance, with urge to talk, reluctance to talk, and actual self-disclosure predicting a further 15.3%. A final model including these variables explained 47.9% of the variance in posttraumatic growth. Interventions targeting challenge to assumptive beliefs, disclosure, and rumination are likely to be clinically useful to promote psychological adjustment in mothers who have experienced stillbirth and early miscarriage.

Differences in post-traumatic growth: Individual quarantine, COVID-19 duration and gender

Objective

This study focuses on positive effects of the COVID-19 pandemic and aims to identify associations between gender, individual quarantine and duration of the COVID-19 (short- medium- and long-term pandemic), and posttraumatic growth (PTG).

Method

The data was collected via an online survey in Israel, and included 1,301 participants, 543 participants experienced short-term pandemics, 428 participants experienced medium-term pandemics and 330 participants experienced long-term pandemics. Most of the participants were female (73.6%), ranging from 18 to 89 years-old. The participants answered questions about their demographic background, individual quarantine experiences and ranked their PTG level.

Results

The results indicate a significant main effect of gender and pandemic duration (short-, medium- and long-term pandemic). Women reported higher PTG levels than men, and participants experiencing short-term pandemic reported significantly lower PTG levels than participants experiencing medium- or long-term pandemic. There was also a significant interaction between gender and pandemic duration regarding PTG and a significant interaction in PTG by gender, pandemic duration and individual quarantine.

Conclusion

The discussion addresses the findings in the context of traditional gender roles and gender differences in finding meaning and worth in home confinement situations.

Shared trauma during the COVID-19 pandemic: Psychological effects on Israeli mental health nurses

Mental health nurses, tasked with the constant care of clients undergoing mental health treatment, have faced unique challenges arising from the uncertain outcomes of the COVID-19 pandemic. The shared exposure of both nurses and their patients to a traumatic event such this pandemic leads to additional challenges and ways of coping. The psychological effects of this shared trauma on mental health nurses arising from the pandemic are the subject of this study. An online survey was used to examine personal levels of anxiety and concern, personal and national resilience (NR), and posttraumatic growth (PTG) among 183 mental health nurses working in mental health services in Israel. Overall, the study revealed moderate levels of concern and relatively low levels of anxiety, with significant negative correlations between personal and NR and levels of concern and anxiety. Higher levels of personal and NR were related to lower levels of concern and anxiety, and there was a significant positive correlation between assessments of personal resilience and NR. A significant positive correlation was found between personal and NR and PTG. Higher religiosity was associated with higher resilience, and higher professional seniority was related to higher PTG. Finally, results for particular demographic subgroups indicate that in Israel, special attention should be given to those mental health nurses who have immigrated to Israel, are non-Jews or have less professional experience.

Posttraumatic growth during the COVID-19 lockdown: A large-scale population-based study among Norwegian adolescents

The negative consequences of the COVID-19 lockdown during the spring of 2020 have been documented. However, adolescents may also have experienced positive personal and interrelational changes. This was the first study to examine the prevalence of posttraumatic growth (PTG) during the lockdown. We additionally explored how potential risk and protective factors, as well as experiences with the pandemic, were related to PTG and whether these associations were moderated by mental health resources and social support. We used data from a representative survey of 12,686 junior and senior high school students from Oslo, Norway, conducted during the lockdown (37% response rate, 56.4% girls). A short version of the Posttraumatic Growth Inventory was used to assess growth relative to personal strength, relationships with others, and appreciation of life. Several potential predictors in the domains of mental health, social relationships, experiences during the pandemic, and sociodemographic background factors were examined. Results from multiple regression analyses showed that satisfaction with life, parental care, worries about the pandemic, and immigrant status were the most prominent predictors of PTG, βs = .14-.22, p < .001. Moderation analyses indicated a complex interplay between predictors of PTG by showing that good mental health was associated with higher degrees of PTG only in groups typically considered to be at higher risk of adverse outcomes. The findings provide information regarding who would profit from additional help to reinterpret the dramatic events during the lockdown to facilitate growth.

Strength‐based parenting and stress‐related growth in adolescents: Exploring the role of positive reappraisal, school belonging, and emotional processing during the pandemic

Introduction

Methods

Results

Conclusions

Relationship between post-traumatic disorder and posttraumatic growth in COVID-19 home-confined adolescents: The moderating role of self-efficacy

Although the COVID-19 pandemic has been traumatogenic for some people, posttraumatic growth (PTG) outcomes have also been observed. This study examined the PTG in adolescents and the moderating effect of self-efficacy on post-traumatic stress disorder (PTSD) symptoms and PTG. An online questionnaire was conducted on 2090 adolescent Chinese students to measure COVID-19 related exposure, self-efficacy, PTSD, and PTG. PTG prevalence was found in 20.6% of the sample, with the relationship between PTSD and PTG being found to be a reverse U-shaped curve. Objective exposure factors were found to be closely associated with PTSD symptoms but not with PTG. Similarly, subjective feelings of extreme fear were significantly associated with PTSD symptoms but not with PTG. Self-efficacy was found to be positively correlated with PTG (r = 0.551) and to moderate the relationship between PTSD and PTG. For those with low self-efficacy, the higher the PTSD, the higher the PTG, and for those with high self-efficacy, the higher the PTSD, the lower the PTG. As an improved sense of self-efficacy in adolescents could promote positive psychological transformations, these results could assist in identifying self-efficacy levels and providing guidance for targeted psychological interventions to promote positive growth.

Post-traumatic growth in psychosis: a systematic review and narrative synthesis

BACKGROUND AND OBJECTIVE

People with psychosis report experiences of highly traumatic events. Positive change or post-traumatic growth (PTG) can occur as a result of traumatic experiences. Yet there is limited attention on PTG in psychosis, possibly due to the negative impact of psychotic symptoms on functioning and quality of life. The aim of this review was to identify significant correlates and mediators of PTG in psychosis, and to develop a conceptual framework synthesising facilitators of PTG in psychosis.

METHOD

Ten electronic databases were searched in seven languages, and five journals and grey literature were searched in English. Quantitative studies were eligible if examining correlates, mediators, or the temporal relationship between PTG and one or more variables. Qualitative studies were eligible if describing PTG arising from experiences of psychosis. Findings from quantitative papers were grouped by analysis method, with significant correlates, mediators, and temporal relationships descriptively reported upon. Narrative synthesis was conducted on findings in qualitative papers.

RESULTS

Thirty-seven papers were included. Significant correlates and mediators of PTG were identified. Mediators of PTG in psychosis included meaning in life, coping self-efficacy, core beliefs, and self-reported recovery. No studies describing the temporal relationship between PTG and psychosis were identified. The narrative synthesis identified seven facilitators of PTG in psychosis: Personal identity and strength, Receiving support, Opportunities and possibilities, Strategies for coping, Perspective shift, Emotional experience, and Relationships, giving the acronym PROSPER.

CONCLUSIONS

Individuals with psychosis can be supported to grow from traumatic experiences. Clinicians can support PTG through the provision of trauma-informed care that supports positively valued identity changes. For researchers, the findings provide an evidence-based theoretical framework for conceptualising PTG, which can be validated through longitudinal cohort studies and underpin the development of new clinical interventions.

Factors associated with post-traumatic growth in response to the COVID-19 pandemic: Results from a national sample of U.S. military veterans

RATIONALE

The COVID-19 pandemic has had numerous negative effects globally, contributing to mortality, social restriction, and psychological distress. To date, however, the majority of research on the psychological impact of the COVID-19 pandemic has focused on negative psychological outcomes, such as depression, anxiety, and posttraumatic stress disorder (PTSD).

OBJECTIVE

Although there is debate about the constructive vs. illusory nature of post-traumatic growth (PTG), it has been found to be prevalent in a broad range of trauma survivors, including individuals affected by the COVID-19 pandemic. The objective of this study was to identify pre- and peri-pandemic factors associated with pandemic-related PTG in a national sample of U.S. veterans.

METHODS

Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative cohort of 3078 U.S. veterans. A broad range of pre-pandemic and 1-year peri-pandemic factors associated with pandemic-related PTG were evaluated. Curve estimation and receiver operating characteristic curve analyses were conducted to characterize the association between pandemic-related PTSD symptoms and PTG.

RESULTS

Worries about the effect of the pandemic on one's physical and mental health, PTG in response to previous traumas (i.e., new possibilities and improved interpersonal relationships), and pandemic-related avoidance symptoms were the strongest correlates of pandemic-related PTG. An inverted-U shaped relationship provided the best fit to the association between pandemic-related PTSD symptoms and endorsement of PTG, with moderate severity of PTSD symptoms optimally efficient in identifying veterans who endorsed PTG.

CONCLUSIONS

Results of this study suggest that psychosocial interventions that promote more deliberate and organized rumination about the pandemic and enhance PTG in response to prior traumatic events may help facilitate positive psychological changes related to the COVID-19 pandemic in U.S. military veterans. Longitudinal studies on functional correlates of PTG may help inform whether these changes are constructive vs. illusory in nature.

Stress-Related Growth in Adolescents Returning to School After COVID-19 School Closure

The move to remote learning during COVID-19 has impacted billions of students. While research shows that school closure, and the pandemic more generally, has led to student distress, the possibility that these disruptions can also prompt growth in is a worthwhile question to investigate. The current study examined stress-related growth (SRG) in a sample of students returning to campus after a period of COVID-19 remote learning (n = 404, age = 13-18). The degree to which well-being skills were taught at school (i.e., positive education) before the COVID-19 outbreak and student levels of SRG upon returning to campus was tested via structural equation modeling. Positive reappraisal, emotional processing, and strengths use in students were examined as mediators. The model provided a good fit [χ 2 = 5.37, df = 3, p = 0.146, RMSEA = 0.044 (90% CI = 0.00-0.10), SRMR = 0.012, CFI = 99, TLI = 0.99] with 56% of the variance in SRG explained. Positive education explained 15% of the variance in cognitive reappraisal, 7% in emotional processing, and 16% in student strengths use during remote learning. The results are discussed using a positive education paradigm with implications for teaching well-being skills at school to foster growth through adversity and assist in times of crisis.

Psychometric Properties of the Farsi Version of Posttraumatic Growth Inventory for Children-Revised in Iranian Children with Cancer

Objective:

Coping with childhood cancer, as a stressful incident, can lead to a growth in various aspects of the child's life. Therefore, this study aims to validate Posttraumatic Growth Inventory for Children-Revised (PTGI-C-R) in children with cancer.

Methods:

This methodological research was carried out in referral children hospitals in Tehran. PTGI-C-R was translated and back-translated. Content and face validity were assessed. Confirmatory factor analysis (CFA) was performed on 200 children with inclusion criteria, using LISREL V8.5. Due to the rejection of the model, an exploratory factor analysis (EFA) was done, using SPSS V21. The correlation of posttraumatic growth (PTG) with the variables, i.e., age and gender, was investigated.

Results:

Some writing changes were made in phrases in the sections concerning face and content validity. CFA rejected the five-factor model due to the undesirable fit indices. Therefore, an EFA was used and the three-factor model was not approved, either despite the statistical appropriateness or due to the lack of similarity between the items loaded on factors. The results also indicated a significant relationship between PTG and age (r = 0.13, P = 0.05). There is no significant relationship between PTG and gender (z = −1.35, P = 0.83).

Conclusions:

PTGI-C-R does not have desirable psychometric properties in Iranian children with cancer and may not be able to reflect all the aspects of PTG experienced by them. Therefore, it cannot be used as an appropriate scale, and it is necessary to develop and validate a specific tool through a qualitative study.

Discrimination and Posttraumatic Growth Among Muslim American Youth: Mediation via Posttraumatic Stress Disorder Symptoms

Muslim Americans increasingly have been targets of discrimination. Previous research has provided preliminary evidence that higher perceived discrimination is associated with higher symptoms of discrimination-related posttraumatic stress disorder (PTSD) symptoms and higher discrimination-related posttraumatic growth (PTG). Further research in other contexts has shown that PTSD symptoms mediate the relationship between event severity and PTG. However, no existing studies have explored discrimination-related PTG and whether PTSD symptoms mediate the relationship between perceived discrimination and discrimination-related PTG among Muslim Americans. The current study included 110 Muslim American college students who completed an online survey assessing perceived discrimination, discrimination-related PTSD symptoms, and discrimination-related PTG. Higher perceived discrimination was significantly associated with higher discrimination-related PTG at the bivariate level. In a multivariable mediation model, the indirect effect of perceived discrimination on discrimination-related PTG via discrimination-related PTSD was statistically significant. The results suggest that clinicians working with Muslim American college students should attend to the ways in which their discriminatory experiences could foster PTG, in addition to helping them cope with PTSD symptoms.

Rape Crisis Counseling: Trauma Contagion and Supervision

This study of rape crisis counselors considers whether increased exposure to victims' trauma is associated with increased supervision-believed necessary to combat trauma contagion-and whether such supervision will reduce the negative impact of such exposure. One hundred six women counselors in seven of nine rape crisis centers in Israel completed anonymous questionnaires documenting their work and trauma exposure. Trauma exposure was defined by counselors' number of victim-contact hours per week and their assessment of the trauma severity they experienced. Supervision was measured by the number of hours received. Counselors trauma outcome indicators included sexual intimacy, secondary traumatization (evidenced in posttraumatic stress disorder [PTSD]-type symptomology), and vicarious traumatization (expressed as a disturbance in cognitive schemes that undermine the self and others). Hypotheses were evaluated in fully recursive path analyses via ordinary least squares (OLS) regression. Participants' mean age was 43.4 years; 58% were married, 26% single, 13% divorced, and 3% widowed; 81% had a college degree or more; 18.9% reported being exposed to victims-trauma at a minimal level, 54.7% moderate and 26.4% extreme; and 43.4% were abused at some time in their lives. Job exposure to victims' trauma was significantly associated with increases in supervision time (β = .33, p = .002). Supervision time fully mediated the relationship between duration of exposure to victims' trauma and counselors' secondary traumatization reports such that increased supervision was associated with degrading sexual intimacy (β = .22; p = .032) and increased Secondary Trauma Scale scores (β = .44; p = .004) after taking into account counselors' education level, history of abuse, anger management in intimate relationship, and posttraumatic growth scores. The study results raise concern about counselors' mental health in that the supervision effect exacerbated the trauma contagion impacts. The study suggests a need for documenting the nature of the supervision and considering different types of supervision methods.

Post-traumatic stress symptoms and post-traumatic growth in children and adolescents 12 months and 24 months after the earthquake and tsunamis in Chile in 2010: A longitudinal study

On 27 February 2010, Chile experienced one of the strongest earthquakes in recorded history. The study aimed to evaluate post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in children and adolescents 12 months (T1) and 24 months (T2) after the earthquake and tsunamis in Chile in 2010. Three hundred twenty-five children and adolescents (47.4% girls; 52.6% boys) between the ages of 10 and 16 years participated in the study. The instruments included the Revised Post-traumatic Growth Inventory for Children by Kilmer et al., the Childhood PTSD Scale by Foa et al. and the Rumination Scale for Children by Cryder et al., as well as a scale to assess the severity of the event and a sociodemographic questionnaire. The PTSS and PTG scores decreased at T2. In addition, the main predictors of PTSS and PTG were disruptive experiences, losses after the event and intrusive and deliberate rumination during the previous year. These results enhance understanding of factors related to PTG, improve the ability to predict PTSS and PTG in children and adolescents following natural disasters, and inform the design of intervention strategies to promote better mental health in those affected.

The interaction effect between gender and profession in posttraumatic growth among hospital personnel

Aim:

To explore if there is an interaction effect between gender (men and women) and profession (nurses and physicians) in posttraumatic growth (PTG).

Background:

PTG is defined as a positive psychological change experienced as a result of struggling with highly challenging life circumstances. It may take the form of improved self-image, a deeper understanding of self, increased spirituality, and/or enhanced interpersonal relationships. Gender and profession were found separately to be associated with PTG, but to date were not examined under interaction effect.

Methods:

We employed a cross-sectional study conducted in the tertiary medical center in Israel using a convenience sample. One hundred and twenty-eight nurses and seventy-eight physicians gave their consent and agreed to fill out self-report questionnaires regarding personal and professional data and PTG Inventory.

Findings:

The correlation matrix revealed that being a woman was associated with higher PTG total scale (r = 0.242; P ≤ 0.001) and its subscales except for spiritual change that showed no evidence of statistical effect. Similar pattern was found for being a nurse with PTG total scale (r = 0.223; P ≤0.001) and its subscales except for relating to others that showed no evidence of statistical effect. However, the interaction effect revealed that among men, there was no difference in the level of PTG and its subscales based on profession (Physicians men = 62.54 (20.82) versus Nurses men = 60.26 (22.39); F = 9.618; P = 0.002). Among women, nurses had a significantly higher scores in PTG (Physicians women = 61.81 (18.51) versus Nurses women = 73.87 (12.36); F = 9.618; P = 0.002) and its subscales in comparison to physicians except for subscale relating to other.

Conclusions:

Our findings suggest implications for research and practice namely exploring PTG among nurses and physicians would benefit from applying interaction effect of gender and profession. For practice, advocating PTG within the health care organization is needed to be tailored with gender and professional sensitivity.

The moderating effect of exposure to robbery on the relationship between post-traumatic stress and job satisfaction

Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs. isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study-with a lag of two months between measurements-on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the "isolated exposure" group the job satisfaction score was higher among less symptomatic victims, within the "shared exposure" group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.

Mental Distress, Well-Being, and Stress-Related Growth following an Anti-LGBQ Hate Crime among LGBQ Young Adults in Israel: The Effect of Familiarity with the Victims and the Mediating Role of Emotional Support

Using data from 696 Israeli LGBQ individuals aged 13-30, this study explored the negative (mental distress) and positive changes (well-being and stress-related growth) following the deadliest anti-LGBQ hate crime in Israel to date (the Bar-Noar Massacre), while examining differences in these outcomes between those who did and did not know hate crime victims. Furthermore, the mediating role of emotional support in facilitating better mental health and stress-related growth was tested. Results suggested that compared to those who did not know any victims, those who personally knew the victims sought emotional support from more sources, had higher scores of mental distress, but also of well-being and stress-related growth. Emotional support indeed mediated the relationship between familiarity with hate crime victims and better mental health and higher levels of growth. Increasing access to emotional support may be particularly helpful in addressing the needs of LGBQ young adults following an anti-LGBQ hate crime.

Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem

We evaluated the level of post-traumatic growth in a large sample of Chinese adolescent earthquake survivors (n = 5195) and relationships among self-esteem, post-traumatic stress disorder, and post-traumatic growth. This cross-sectional study indicated that the prevalence of post-traumatic growth among adolescent survivors was 14.8 percent. Post-traumatic growth was independently associated with self-esteem, severity of exposures, and avoidance facets of post-traumatic stress disorder. Post-traumatic stress disorder was found to be partially mediated by self-esteem on post-traumatic growth; and post-traumatic stress disorder was also a mediator between earthquake exposure and post-traumatic growth. This study suggests that future longitudinal research and clinical practice should test whether promoting self-esteem can enhance post-traumatic stress disorder treatment.

Palestinian Women in Terrorism: A Double-Edged Sword?

Drawing on a decade of research on terrorism in the Israeli-Palestinian conflict, we show how subjective "rational choices" motivate some women to engage in terrorist activism. Focusing on the motives of young women who engage in terrorism is consistent with feminist theory's insistence on women's agency-even at the extremes. In addition to the well-established motivations for terrorism reported in the literature, interviews with young women involved in terrorism reveal mixed personal motives for their gender-defying choices, including thrill-seeking and some conscious rebellion. However, we contend that women's subjective rationale for participation in such violent behavior needs to be contextualized. A cost-benefit approach, we maintain, highlights the strategic considerations supporting the deployment of women as combatants by Palestinian terrorist organizations. We argue that the inclusion of women in terrorist activism in the Israeli-Palestinian conflict exposes a major fault line in attitudes to the role and proper place of women in what remains largely a patriarchal culture. This social ambivalence accounts for why, on all measures, women fare worse than their male counterparts. The implications of the findings for feminist research as well as policy are discussed.

The relationship between posttraumatic stress disorder, trauma centrality, posttraumatic growth and psychiatric co-morbidity among Chinese adolescents

This study examined the inter-relationship between posttraumatic stress disorder (PTSD) from past trauma, psychiatric co-morbidity, trauma centrality and posttraumatic growth (PTG) among Chinese adolescents. Nine hundred and forty-eight Chinese adolescents (M = 462, F = 486) were recruited from two secondary schools. They completed the Posttraumatic Stress Disorder Checklist for DSM-5, the Centrality of Events Scale, the Posttraumatic Growth Inventory, the General Health Questionnaire-28, and the Educational Stress Scale for Adolescents. After controlling for demographic variables and levels of academic stress, structural equation modeling showed that PTSD was positively associated with trauma centrality and psychiatric co-morbidity but negatively associated with posttraumatic growth. Trauma centrality mediated the impacts of PTSD on posttraumatic growth and psychiatric co-morbidity. To conclude, PTSD from past trauma could impact adolescents' ways of perceiving positive aspects of their trauma and psychological well-being. Such impact, however, was influenced by the changes in their self-concept.

Posttraumatic Growth in Tibetan Adolescent Survivors 6 Years After the 2010 Yushu Earthquake: Depression and PTSD as Predictors

This cross-sectional study explored the prevalence of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) in Tibetan adolescent survivors (98% Tibetan and 2% Han) 6 years after the 2010 Yushu earthquake to identify the PTG predictors. In 2016, 850 high school students (from 11 to 20 years) in Yushu (N = 850) completed the self-rating depression scale, the PTSD Check List-Civilian version, the exposure degree scale, and the posttraumatic growth inventory. It was found that the PTG and probable PTSD prevalence rates were 49.7% and 8.9% 6 years after the earthquake, and that exposure level, depression level, and PTSD symptoms were all significant negative predictors for PTG in both the junior high school and senior high school students. Specifically, having a lower degree of exposure, a lower PTSD level, and no depression symptoms were associated with higher PTG. There was a significant PTG difference found between males and females; however, this gender difference was not found in the senior high school students. No significant PTG differences were found for the different ethnicities. The implications of the results and the limitations of this study are discussed.

The contribution of school experience to students' resilience following a terror-related homicide

Schools have a significant effect on students' development, and serve as important social agencies for interventions for students facing disasters. However, little is known about the effect of students' school experience itself on their resilience when facing extreme negative events. The present study focused on students who were exposed to terror-related homicide with the aim of investigating the contribution of school climate resources to their resilience. Since resilience is associated not only with fewer negative outcomes, but also with positive change, the contribution of schools was studied as both inhibiting post-traumatic stress symptoms (PTS) and enhancing post-traumatic growth (PTG). A mixed-methods research design was used. The participants included 117 (52% girls) high school students (mean age = 14.54; SD = 1.49). Twenty-five of them were interviewed in addition to responding to the research questionnaires. Different aspects of the school climate were found to be associated with students' PTS and PTG, yielding two overarched factors explaining the school's role as a protective resource: sheltering and supporting. The former is associated with fewer PTS and the latter with higher PTG. The use of different resources for different forms of resilience is discussed.

Post-Traumatic Growth Following Exposure to Memorial Reports of the 5.12 Wenchuan Earthquake: The Moderating Roles of Self-Esteem and Long-Term PTSD Symptoms

Media exposure during a traumatic event has been found to be associated with negative psychological consequences. However, the post-disaster role of the mass media and the possible positive psychological consequences of media exposure has received less attention. In the present study, we hypothesized that exposure to memorial media reports would lead to improved post-traumatic growth (PTG). Further, we evaluated the moderating role of self-esteem and long-term post-traumatic stress disorder (PTSD) symptoms in the relationship between media exposure and PTG. Using a cross-sectional design, we surveyed individuals (N = 1000, mean age = 45.62, 43.5% male) who were recruited from disaster-affected communities ten years after the 5.12 Wenchuan earthquake which was the largest country-level trauma in the past three decades. Results revealed that individuals with lower self-esteem or lower PTSD symptoms would have higher psychological growth with greater exposure to memorial news reports. For individuals who reported having both high levels of self-esteem and PTSD symptoms, the relationship between media exposure and PTG was negative. These findings help present trauma in a new light, particularly regarding the rapid and instantaneous new coverage of the digital age. This study also has multi-disciplinary, cross-cultural, and clinical implications for the fields of psychology, public health, and communications.

Curvilinear relationship between disaster exposure and psychological growth:10 years after the Wenchuan earthquake

The extent of disaster exposure is a crucial predictor of both negative and constructive changes influenced by natural disasters. Posttraumatic growth (PTG) is the typical psychological growth that is defined by significant changes for the better in self-view, relationships, and life philosophy as a result of exposure to a traumatic incident. However, findings of previous studies examining the effects of disaster exposure on PTG are inconsistent. The primary aim of this study was to re-examine the nature of the association between the extent of disaster exposure and PTG in a sample of 1,000 adult survivors of the 5.12 Wenchuan earthquake (occurred in 2008) over 10 years ago in China. The results indicated that, after controlling for the effects of demographic factors (i.e., gender, age, residential area site, and marital status) and socioeconomic status (i.e., educational background and annual household income), disaster exposure showed weak linear but strong inverted U-shaped relationships with different PTG domains. In other words, participants who had been exposed to low or high levels of disaster showed low levels of PTG, while those exposed to moderate levels of disaster exhibited high levels of PTG. The result of the study not only enhanced current understanding of the consequences of disaster exposure but also outlined a long-term support system for post-disaster construction activities.

Coping resources and stress reactions among Bedouin Arab adolescents during three military operations

This study aimed to examine coping resources (sense of coherence and hope) and stress reactions among Bedouin Arab adolescents in southern Israel during three periods of escalated political violence. Two main questions were examined: 1) Did adolescents report different coping resources and levels of stress reactions during these three different periods? 2) Were there any differences in the pattern of the associations between coping resources and stress reactions across those periods? Data were gathered from 81, 91, and 192 Bedouin Arab adolescents, who were 14-18 years old, during three periods. Participants completed self-report questionnaires including the sense of coherence (SOC) scale, a hope index, a measure or state anxiety and state anger, a measure of psychological distress, and a demographic questionnaire. Across the three periods, differences were observed in both coping resources and levels of stress reactions. Over time, SOC was found to be a significant predictor of those stress reactions; whereas the association between hope components and stress reactions weakened over time. These findings support the hypothesis that SOC is a significant component of coping with stressful political events and emphasize the importance of addressing differences in the roles of personal resources over time and transition processes.

Grief intensity, coping and psychological health among family members and friends following a terrorist attack

This study investigates the association of psychological health with grief intensity and coping style among family members and friends of terror victims. The data was collected from 164 bereaved individuals, on average, 18 months after the bombings occurred. The results demonstrated the significant role of problem-focused social support, and religious coping in dealing with grief intensity and contributing to the psychological health. The findings may be of considerable importance in therapeutic situations by providing direction for coping with both the effects of traumatic event and a traumatic loss, and for maintaining emotional stability through reworking relationships with the deceased.

Posttraumatic Growth, Personality Factors, and Social Support Among War-Experienced Young Georgians

Despite much research on adult posttraumatic growth in recent decades, few studies have focused on posttraumatic growth in the young and especially after experiencing war. This study examined personality factors and different types and sources of social support as key correlates of posttraumatic growth in war-experienced children and adolescents. Participants were 242 individuals from settlements for internally displaced people in Georgia with a mean age of 13.22 years (SD = 2.73). Relations between variables were examined with correlations, standard multiple regressions, and mediation analyses. Results showed that the main predictors of posttraumatic growth were extraversion, conscientiousness, and social support. In addition, informational type of support from peers related significantly to posttraumatic growth. Moreover, general social support mediated the link between personality factors and posttraumatic growth. Conclusions are drawn on the mechanisms underlying posttraumatic growth in young persons.

Longitudinal characteristics of resilience among adolescents: A high school student cohort study to assess the psychological impact of the Great East Japan Earthquake

AIM

Resilience, the ability to cope with disasters and significant life adversity, is an important factor to consider when studying the mental health of populations affected by a disaster. Although high school students in a community affected by a disaster should have specific characteristics of resilience, little has been reported on the issue. This study was designed to provide initial data regarding characteristics of the resilience of high school students affected by a catastrophe.

METHODS

A total of 760 high school students in Natori City, which was devastated by the Great East Japan Earthquake in 2011, were profiled, and a 3-year longitudinal study was conducted with 254 students who had entered the school in 2012. Resilience was evaluated with the 10-item Connor-Davidson Resilience Scale. The Quick Inventory of Depressive Symptomatology-Japanese version, the Zung Self-Rating Anxiety Scale, and the Impact of Event Scale-Revised were also administered to assess the students' mental health.

RESULTS

Among the students who entered the high school in 2012, 28.6% showed high resilience, and the proportion increased to 42.9% in 2013 and 46.6% in 2014. The Quick Inventory of Depressive Symptomatology-Japanese version and Impact of Event Scale-Revised scores decreased significantly over the 3-year study period, but there were no significant differences in the Zung Self-Rating Anxiety Scale scores over time.

CONCLUSION

This initial study profiling the characteristics of resilience among adolescents suggests that resilience is a highly changeable component of mental health among people who have faced adversity. Resilience can be a useful indicator of recovery from adversity and a target of interventions for improving mental health conditions.

Trauma-Informed Care and Posttraumatic Growth Among Bereaved Youth: A Pilot Study

Although a fair amount has been written about posttraumatic stress disorder among bereaved children and adolescents, less has been written about posttraumatic growth (PTG) and its predictors among this population. This study examines predictors of PTG and the impact of trauma-informed care on PTG among bereaved youth. A preexperimental, pretest-posttest design was applied to measure PTG among bereaved children (N = 32) before and after attending a healing camp that provides trauma-informed care. A regression model was applied to examine predictors of PTG. Results showed that children participating in the camp increased their PTG scores to a statistically significant degree. Circumstance of death (sudden or expected) was a predictor in this study. The results are discussed in relation to limitations, implications for future research, and practice.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

OBJECTIVE

The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public.

METHODS

A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted.

RESULTS

The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p&lt;0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p&lt;0.001] than religious growth [F (2, 180.984)=4.811, p&lt;0.01].

CONCLUSION

The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

The prevalence of posttraumatic stress in adolescents eight years after the Wenchuan earthquake

In 2008, an 8.0 Richter scale earthquake devastated Wenchuan in China, which resulted in heavy casualties, and had wide-reaching psychological effects on survivors. To examine its impact on the survivors, this study aims to investigate the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents eight years after the earthquake. The cross-section survey was conducted in two different earthquake-affected areas, and data were collected from 4118 respondents. Instruments included the questionnaire on demographic information, the questionnaire on seismic exposure, PTSD Checklist-Civilian Version (PCL-C) questionnaire, Posttraumatic Growth Inventory (PTGI), Perceived Social Support Scale (PSSS) and Simple Coping Style Questionnaire (SCSQ). During the survey, there were 1998 valid questionnaires from the generally affected area and 2120 questionnaires from the severely affected area. The rate of PTSD is 1.9% in the generally affected area and 2.7% in the severely affected disaster area; there is no significant difference between the two differently affected areas. Occurrences of PTSD and PTG are significantly positively correlated in the generally affected area, nevertheless, there is a significant negative correlation between PTSD and PTG in most systems of the severely affected area. The results of this study help to expand our knowledge regarding posttraumatic stress in adolescents 8 years after the Wenchuan earthquake, and it provides suggestions for specific long-term health interventions in such populations. To prevent earthquake-related psychological issues among adolescent survivors, social support, psychological aid, and improvement of the living environment are necessary to buffer negative posttraumatic stress.

Posttraumatic growth among people with serious mental illness, psychosis and posttraumatic stress symptoms

Recent research has shown high rates of exposure to trauma among people with serious mental illness (SMI). In addition, studies suggest that psychosis and mental illness-related experiences can be extremely traumatic. While some individuals develop posttraumatic symptomatology related to these experiences, some appear to experience posttraumatic growth (PTG). Little is known, however, about PTG as a possible outcome among people who experienced psychosis as well as posttraumatic stress symptoms (PTSS). For further understanding of the relationship between PTSS and PTG among people with SMI who experienced psychosis, 121 participants were recruited from community mental health rehabilitation centers and administered trauma and psychiatric questionnaires. Results revealed that while high levels of traumatic exposure were common, most participants experienced some level of PTG which was contingent upon meaning making and coping self-efficacy. In addition, posttraumatic avoidance symptoms were found to be a major obstacle to PTG. The range of effect sizes for significant results ranged from η²=0.037 to η²=0.144. These findings provide preliminary evidence for the potential role of meaning making and coping self-efficacy as mediators of PTG in clinical, highly traumatized populations of people with SMI and psychosis. Implications of these findings for future research and clinical practice are discussed.

PTSD and PTG among Israeli mothers: Opposite facets of exposure to terrorism

The aim of the this study was to test the association between posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), and coping strategies among Israeli mothers with prolonged exposure to rocket missiles. One hundred fifty-two mothers, from the Western Negev region of Israel, took part in the study. Respondents were affected by prolonged exposure to missile attacks even when they themselves had not been hit or injured. A positive correlation was found between PTSD and PTG. Problem-focused coping was found to mediate the relationship between PTSD and PTG; the higher the PTSD, the greater the use of problem-focused coping and the greater the posttraumatic growth. The results help understand the association between PTSD and PTG. The finding whereby problem-focused coping mediates the PTSD-PTG relationship is important for comprehending the association between the variables and the significance of growth in human life and for constructing intervention programs that promote growth following trauma. In addition, the study contributes to raising awareness both of how mothers cope and that they are a separate risk group with distinct growth possibilities.

Affective emotion increases heart rate variability and activates left dorsolateral prefrontal cortex in post-traumatic growth

The present study evaluated the activities of heart rate variability (HRV) and dorsolateral prefrontal cortex (DLPFC) in response to the presentation of affective pictures correlated with posttraumatic growth (PTG) among adults exposed to the Tianjin explosion incident. The participants who were directly involved in the Tianjin explosions were divided into control, post-traumatic stress disorder (PTSD) and PTG group according to the scores of PTSD Checklist-Civilian Version and PTG Inventory survey. All participants received exposure to affective images. Electrocardiogram recording took place during the process for the purpose of analyzing HRV. Meanwhile, functional near-infrared spectroscopy (fNIRS) was used to measure DLPFC activity through hemodynamic response. Our results indicated that, while performing the negative and positive picture stimulating, PTG increased both in low and high frequency components of HRV compared with the control group, but PTSD was not observed in this phenomenon. Moreover, the fNIRS data revealed that PTG had an increased activation in the left DLPFC compared to the control in the condition of negative pictures stimulating, wheras PTSD showed a higher activation in the right DLPFC while receiving positive pictures stimulating. To our knowledge, this is the first study which provides the differences between PTSD and PTG in emotional regulation.