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Research confirms that the definition of resilience as compared to posttraumatic growth (PTG), allows posttraumatic growth to be its own phenomenon when studied comparatively. This review is a look at what defines PTG and how it is measured. Personality type and cognitive processing define distinct roles in intervention with posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD), and are closely examined when integrated within the construct of PTG. Posttraumatic growth is important today as it allows for the development of a heightened value of life and its meaning in the aftermath of events that could potentially be seen as trauma or danger, such as that of war, assault, tragic loss, etc. These developments of growth seem to be related to the feelings involved with surviving an event and meaningfulness of that experience while also possessing a support system that reinforces these ideas. Research shows that spirituality, religiosity and rumination can be major footholds in the development of future growth and often act as stepping stones.
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Post-traumatic stress disorder (PTSD) is a disorder that develops after exposure to a traumatic event. Symptoms of PTSD are nightmares, flashbacks, anger, and difficulty staying asleep. In order to be diagnosed with PTSD a person has to experience symptoms that last more than a month, and lead to serious impairments in a person’s ability to function. The psychological inability to fully function after experiencing some form of traumatic event dates back over two hundred years (Paige, 1997).
Post-traumatic growth (PTG) according to Gemmel (2009) is defined as a positive life change that occurs after experiencing a potentially traumatic event. Posttraumatic growth began in the 1990’s due to clinicians’ interest in positive aspects of human behavior. Posttraumatic growth does not come as a result of experiencing a potentially traumatic event, but from the conflict of accepting a new reality following the trauma. According to Baker, Kelly, Calhoun, Cann, and Tedeschi (2008) the most used assessment for measuring PTG is the Posttraumatic Growth Inventory (PTGI).
The PTGI consists of three domains (Changed Interpersonal Relationships, Changed Philosophy of Life, and Changed Perceptions of Self). The PTGI is composed of five factors or sub-categories (New Possibilities, Personal Strength, Spiritual Change, Relating to Others, and Appreciation of Life) (Taku, Cann, Calhoun, & Tedeschi, 2008). Construct validity of the 21 items on the PTGI show strong support that the PTGI is a multidimensional measurement. The PTGI uses a scale measurement from 0 to 5 with 0 meaning did not experience any changes and 5 meaning experienced changed to a high degree. The significance of the PTGI is that the five factors do relate differently to other variables. Limitations to the PTGI are that the responses to the items are based on positive changes, and no negative experiences are examined. Another limitation to the PTGI is that the PTGI does not measure actual growth, but instead measures perceived growth (Frazier et al., 2009).
The first source, “An Examination of Posttraumatic Growth and Posttraumatic Depreciation: Two Exploratory Studies”, conducts two studies to investigate the implications of allowing individuals the opportunity to report posttraumatic growth and depreciation in the same areas describing responses to stressful events. Both types of changes were reported, but growth was reported at much higher levels. There was no connection between growth and depreciation. Small differences were found when the items were grouped into two separate series, but not when equal items were paired. People experience both growth and depreciation on the same dimensions following a stressful event. The findings propose that individuals who experience significant stress may concurrently report depreciation in the same sphere in reporting posttraumatic growth. (Baker, Kelly, Calhoun, Cann, and Tedeschi 2008)
The second source, “Current perspectives on post-traumatic stress disorder: From the clinic and the laboratory”, outlines post-traumatic stress disorder (PTSD), how it develops, what the symptoms are, and how it is diagnosed. The Diagnostic and Statistical manual of the American Psychiatric Association (DSM) in 1952 first defined PTSD as traumatic neuroses. In 1968 the DSM- II defined PTSD as gross stress reactions (Paige, 1997). PTSD is the only anxiety disorder for which the episode of an external event is specified as a diagnostic criterion. Also, due to Vietnam Veterans that were experiencing symptoms of PTSD, the DSM-III used the term PTSD as a clinical syndrome within the category of anxiety disorders. In the examination of the elevation levels in six Vietnam veterans, participating in group trauma therapy for combat related PTSD, heart rate was measured during eleven sessions for approximately two and a half hours. It was found that the precondition for elimination, an increase in elevation by an increase in heart rate is evident in patients actively engaged in imagined re-exposure to their personal traumas (Paige, 1997).
The third source, “Spirituality in psychiatry: A biopsychosocial perspective. Psychiatry: Interpersonal & Biological Processes”. For the past two decades researchers have desired to know the effect of spirituality on the body’s ability to heal. There have been studies that reflected the longevity of resistance to terminal illnesses as well as the mind’s ability to resist mental illness (Galanter, 2010). As psychologists learn more about the resilience of the mind in the face of adversity, new light is shed on the possibilities of growth from potential trauma versus healing. Researchers have delved into the world of PTG as an answer to this theory. The role Spirituality has played through the centuries is being examined, as seen in the article by McGrath (2006). This article takes a sharp look at where the potential trauma of the death of a spiritual leader, Jesus Christ, took the world. The evolution of the Christian culture could be included in science’s definition of PTG.
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McGrath noted a number of elements that link to Tedeschi and Calhoun’s (1996) self-regulatory model of the growth process, which includes the event and a certain response, rumination, initial growth, and a longer-term phase of internalization of what has been integrated into a life narrative (McGrath 2006). All of these modifications of the personal schema are a result of changed behaviors that emerged in the light of Jesus’ resurrection. The noted resilience of Jesus’ followers in the light of persecution of government and society is a key element that led to PTG. This article looks at outcomes instead of cognitive processing, and the recollection of several authors during a 50-year span as recorded in the New Testament of the Holy Bible.
Furthermore, researchers Calhoun, et al. (2000) found a distinct correlation to rumination, religion, and the connection to PTG. The information gathered from this small group of individuals included a variety of potentially traumatic experiences in order to reflect an accurate sample of the overall population. The group reflected college students, but it is concluded that no matter what the age or statistical classification, the intensity of the perceived trauma remains the same. Although the results look at cognitive processing in lieu of outcomes, this article is a gateway to potential research topics in the field of PTG, and its effect on the aforementioned population.
Calhoun’s findings are often referenced in further research done by Shaw, Joseph and Linley (2005). In the article “Religion, spirituality, and posttraumatic growth: A systematic review,” researchers review 11 qualitative and quantitative studies that produced three main findings. “First, these studies show that religion and spirituality are usually, although not always, beneficial to people dealing with the aftermath of trauma. Second, the potentially traumatic experiences can lead to a deepening of religious and spiritual beliefs. Third, that religious openness, readiness to face existential questioning, religious participation, positive religious coping, and intrinsic religiousness are typically associated with posttraumatic growth.” (Shaw, et al. 2005) As the variables of religion and spirituality are examined, the need for further longitudinal research designs is evident.
Post-traumatic growth is a phenomenon that is an outgrowth of post-traumatic stress disorder. As a relatively new phenomenon there is a lot of research that needs to be done on PTG itself. Specifically, research to determine the efficacy of utilizing PTG characteristics as tools for intervention and prevention of stress disorders. Continued research is needed for the dimension of personality, and its impact on stress and growth. Emotionality needs to be studied in reference to the neurological aspects of trauma, differences in neurological sensitivity levels, emotional defense mechanisms, and ways to process and integrate emotions that may enhance growth. Perhaps the most valuable information that future research should look at is how well the techniques proposed in this paper foster recovery and growth among clients with posttraumatic stress symptoms or full-blown posttraumatic stress disorder. Researchers should focus on how the proposed techniques work in combination with each other as well as their effectiveness if used as standalone techniques. This will ultimately give greater insight to the effect size of each individual technique.
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