ARTICLES + PUBLICATIONS

 

 

Articles about Posttraumatic Growth

Boulder Crest Foundation's Distinguished Chair, Dr. Richard Tedeschi, is the leader in the field of Posttraumatic Growth. Dr. Tedeschi has written and contributed to hundreds of articles on the subject — some of which are below.

 

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Cann, Arnie; Calhoun, Lawrence G.; Tedeschi, Richard G.; Taku, Kanako; Vishnevsky, Tanya; Triplett, Kelli N.; Danhauer, Suzanne C.

A Short Form of the Posttraumatic Growth Inventory

A short form of the Posttraumatic Growth Inventory (PTGI-SF) is described. A sample of 1351 adults who had completed the Posttraumatic Growth Inventory (PTGI) in previous studies provided the basis for item selection. The resulting 10-item form includes two items from each of the five subscales of the original PTGI, selected on the basis of loadings on the original factors and breadth of item content. A separate sample of 186 completed the short form of the scale (PTGI-SF). Confirmatory factor analyses on both data sets demonstrated a five-factor structure for the PTGI-short form (PTGI-SF) equivalent to that of the PTGI. Three studies of homogenous clinical samples (bereaved parents, intimate partner violence victims, and acute leukemia patients) demonstrated that the PTGI-SF yields relationships with other variables of interest that are equivalent to those found using the original form of the PTGI. A final study demonstrated that administering the 10 short-form items in a random order, rather than in the fixed context of the original scale, did not impact the performance of the PTGI-SF. Overall, these results indicate that the PTGI-SF could be substituted for the PTGI with little loss of information.

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Tedeschi, Richard G.

Posttraumatic Growth in Combat Veterans

Combat veterans and their families face significant challenges not only to their abilities to cope, but often to their fundamental belief systems. Traumatic events represent assaults on core beliefs, yet at times, produce cognitive processing that can ultimately result in personal transformations called posttraumatic growth (PTG). Clinicians can utilize a systematic therapeutic approach to facilitate PTG as they carry out a relationship of expert companionship. PTG in service members is described in this article, as well as the approach to facilitation of PTG.

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Danhauer, Suzanne C; Russell, Gregory B.; Tedeschi, Richard G.; Jesse, Michelle T.; Vishnevsky, Tanya; Daley, Kristin; Carroll, Suzanne; Triplett, Kelli N.; Calhoun, Lawrence G; Cann, Arnie; Powell, Bayard L.

A Longitudinal Investigation of Posttraumatic Growth in Adult Patients Undergoing Treatment for Acute Leukemia

An acute leukemia diagnosis can be an extremely stressful experience for most patients. Posttraumatic growth (PTG) is positive psychological change experienced following a struggle with highly challenging life circumstances. The current study is the first longitudinal investigation of predictors of PTG and distress in adult acute leukemia patients undergoing induction chemotherapy. Findings suggest that these patients report PTG, and levels of PTG appear to increase over the weeks following leukemia diagnosis and induction chemotherapy. Variables associated with higher total PTG scores over time included greater number of days from baseline, younger age, and greater challenge to core beliefs. Variables associated with higher distress included greater number of days from baseline, greater perceived cancer threat, higher symptom severity, and lower spiritual well-being. Results underscore the critical role that examination of one’s core beliefs may play in the development of PTG over time.

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Shakespeare-Finch, Jane; Martinek, Emma; Tedeschi, Richard G.; Calhoun, Lawrence G.

A Qualitative Approach to Assessing the Validity of the Posttraumatic Growth Inventory

The Posttraumatic Growth Inventory (PTGI) is the most commonly used measure of positive psychological change that can result from negotiating a traumatic experience. While the PTGI has strong internal reliability, validity studies are still sparse. The present research details trauma survivors’ understanding of items comprising the PTGI in order to qualitatively assess content validity. Participants were 14 trauma survivors who completed the PTGI and participated in a semistructured interview. Thematic analysis was conducted on participants’ transcribed interviews. One latent theme was identified reflecting that questions were consistently understood. A relationship was found between the constituent themes identified and the five factors of the PTGI. Participants answered the PTGI statements in a way that is consistent with the purpose of the instrument, with only a small discrepancy found when some participants used the PTGI scale to indicate when a decrease in an element of the inventory had been experienced. Overall results supported the content validity of the PTGI.

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Cann, Arnie; Calhoun, Lawrence G.; Tedeschi, Richard G.; Triplett, Kelli N.; Vishnevsky, Tanya; Lindstrom, Cassie M.

Assessing Posttraumatic Cognitive Processes: The Event Related Rumination Inventory

Cognitive processes in the aftermath of experiencing a major life stressor play an important role in the impact of the event on the person. Intrusive thoughts about the event are likely to be associated with continued distress, while deliberate rumination, aimed at understanding and problem-solving, should be predictive of posttraumatic growth (PTG). The Event Related Rumination Inventory (ERRI), designed to measure these two styles of rumination, is described and validation information is provided. Using a college student sample screened for having experienced highly stressful life events, data were obtained (N = 323) to conduct an exploratory factor analysis that supported the two factors of the ERRI. Separate confirmatory factor analyses (CFA) on two additional samples (Ns = 186 and 400) supported a two-factor model. The two ERRI factors were validated by comparison with related variables and by assessing their contributions to predicting distress and PTG in two samples (Ns = 198 and 202) that had been combined to conduct the second CFA. Data indicate the ERRI has solid psychometric properties, captures variance not measured by stable differences in cognitive styles, and the separate factors are related to posttraumatic distress and growth as predicted by existing models of PTG.

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Cann, Arnie; Calhoun, Lawrence G.; Tedeschi, Richard G.; Solomon, David T.

Posttraumatic Growth and Depreciation as Independent Experiences and Predictors of Well-being

Positive changes (posttraumatic growth [PTG]) and negative changes (posttraumatic depreciation [PTD]) were assessed using the PTGI-42 with persons reporting changes from a stressful event. PTG and PTD were uncorrelated, and PTG was much greater than PTD. PTG was positively related to disruption of core beliefs and recent deliberate rumination and negatively related to recent intrusive rumination. PTD was positively related to intrusive rumination. Quality of life and meaning in one's life were positively related to PTG, negatively related to PTD, and an interaction indicated that PTG moderated the impact of PTD on both, indicating that PTG and PTD may separately contribute to current well-being.

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Tedeschi, Richard G.; Blevins, Cara L.

From Mindfulness to Meaning: Implications for the Theory of Posttraumatic Growth

In their article, Garland et al (see record 2015-53832-002) compile literature from various fields to present a compelling model detailing the mechanisms by which mindfulness may facilitate meaning-making and eudaimonic well-being. The authors do an excellent job of describing the impact of mindfulness on cognitive, emotional, and interoceptive processes that contribute to one’s phenomenological experience. The interest in the processes by which growth and meaning emerge following trauma, the commentators found their theory in this issue particularly intriguing. This article has been chosen to focus this commentary on the process of positive reappraisal central to Garland et al.’s model, which we feel is of particular relevance to existing theories of growth and meaning-making.

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Kaler, Matthew E.; Erbes, Christopher R.; Tedeschi, Richard G.; Arbisi, Paul A.; Polusny, Melissa A.

Factor Structure and Concurrent Validity of the Posttraumatic Growth Inventory-Short Form among Veterans from the Iraq War

The Posttraumatic Growth Inventory is a frequently used self-report measure of posttraumatic growth. It was adapted recently to a short form with preliminary evidence in support of its psychometric properties. The current survey study replicates evidence for the short form’s factor structure, internal consistency reliability, and concurrent validity among a sample of 327 National Guard soldiers deployed in support of military operations in Iraq, a population distinct from the original scale-development sample of undergraduates. Findings provide evidence for satisfactory reliability, replicable factor structure (i.e., the same 5-factor structure as the original measure), and support for concurrent validity (i.e., relations with theoretically related constructs). Further research should address validity of the scale among more ethnically and racially heterogeneous samples.

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Tedeschi, Richard G.; McNally, Richard J.

Can We Facilitate Posttraumatic Growth in Combat Veterans?

The Comprehensive Soldier Fitness program, currently under development for the U.S. Army, will include a component designed to increase the possibilities for posttraumatic growth in the aftermath of combat. In this article, we briefly review studies that provide evidence for this phenomenon in combat veterans, and we suggest elements that such a program might include to facilitate posttraumatic growth. We urge the Army to conduct randomized controlled trials testing the efficacy of the program prior to its implementation.

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Triplett, Kelli N.; Tedeschi, Richard G.; Cann, Arnie; Calhoun, Lawrence G.; Reeve, Charlie L.

Posttraumatic Growth, Meaning in Life, and Life Satisfaction in Response to Trauma

A model of the processes leading to posttraumatic growth and to life satisfaction following exposure to trauma was tested. Two types of repeated thought, deliberate and intrusive, posttraumatic symptoms, posttraumatic growth, and meaning in life, were assessed as predictors of general life satisfaction. Challenges to core beliefs were shown to be related to both intrusive and deliberate rumination. The two forms of rumination were in turn differentially related to posttraumatic growth and posttraumatic distress. Distress and posttraumatic growth were independently and oppositely related to meaning in life and to life satisfaction. Overall, the best fitting model was supportive of proposed posttraumatic growth models. Additional exploratory analyses examined participant groupings, based of self-reported category of resolution of the traumatic experience, and differences supportive of proposed underlying processes were found.

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Taku, Kanako; Tedeschi, Richard G.; Cann, Arnie

Relationships of Posttraumatic Growth and Stress Responses in Bereaved Young Adults

The present study examined posttraumatic growth (PTG) and its associations with stress responses in bereaved young adults. It was hypothesized that the PTG domains that are more strongly endorsed among the bereaved would show an inverted-U-shaped relationship with stress responses. Japanese undergraduate students who reported their loss of loved ones as the most traumatic experience within the past 5 years completed the Posttraumatic Growth Inventory (PTGI) and the revised Impact of Event Scale. Results revealed that the hypothesized curvilinear relationships were observed in the PTG domain of relating to others and the combined domain of spiritual change and appreciation of life, whereas linear relationships were found in the personal strength and new possibilities domains. These results suggest that although a certain level of stress response may be crucial for experiencing PTG, the relationship varies across the PTG domains in these bereaved young adults.

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Groleau, Jessica M.; Calhoun, Lawrence G.; Cann, Arnie; Tedeschi, Richard G.

The Role of Centrality of Events in Posttraumatic Distress and Posttraumatic Growth

Disruptions to core beliefs, rumination, and finding meaning have been associated with the development of posttraumatic distress (Janoff–Bulman, 1992, 2006). These variables have also contributed to the development of posttraumatic growth, which is the experience of a positive life change as the result of a traumatic experience (Tedeschi & Calhoun, 1996). A new variable, centrality of event, has recently been implicated in both processes (Boals & Schuettler, 2011), although it remains unclear if centrality of event is a unique contributor to posttraumatic outcomes beyond the influence of other variables known to do so. The present study examined the unique contribution of centrality of event to the development of both posttraumatic distress and posttraumatic growth. Centrality of event was a unique predictor of both variables. This seemingly paradoxical finding underscores the need for further research in this area, particularly concerning the perceived valence of a major event that may be interpreted as central. Clinicians may usefully attend to centrality when working with individuals who have experienced a potentially traumatic event.

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Lindstrom, Cassie M.; Cann, Arnie; Calhoun, Lawrence G.; Tedeschi, Richard G.

The Relationship of Core Belief Challenge, Rumination, Disclosure, and Sociocultural Elements to Posttraumatic Growth

The relationship of challenge to core beliefs, rumination, disclosure, and some sociocultural elements to posttraumatic growth (PTG) were explored. Participants were college students enrolled in psychology classes who reported having experienced a stressful event within the past 2 years and who completed measures in groups. Findings suggested that challenge to core beliefs was the main predictor of PTG, and that a very large proportion of the sample had encountered themes of PTG in their sociocultural contexts. 

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Tedeschi, Richard; Calhoun, Lawrence

Beyond the Concept of Recovery: Growth and the Experience of Loss

Responding to D. E. Balk (2004) about use of the term recovery to describe bereavement outcome, the authors take the view that this term is inadequate. Among the points raised are (a) the term recovery may imply a response to psychological disorder, whereas bereavement responses are generally normative; (b) recovery does not easily allow for transformative outcomes in bereavement, e.g., posttraumatic growth; and (c) terminology guides the thinking of bereaved persons, clinicians, and researchers in this area, and the term recovery may produce bias toward viewing bereavement as a disordered state. More neutral terms such as change or resolution avoid some of these pitfalls.

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Tedeschi, Richard; Calhoun, Lawrence; Cann, Arnie

Evaluating Resource Gain: Understanding and Misunderstanding Posttraumatic Growth

Comments on an article by Hobfoll and colleagues (see record 2007-10032-001), regarding the concept of posttraumatic growth. It is noted that posttraumatic growth should be assessed as such, with measures developed specifically to address this construct; that it follows a challenge to and re-examination of core beliefs, not every bad experience; it can be influenced by many factors; it can coexist with distress during stages of the process without indicating that growth is unimportant or negative; and it can follow various trajectories, including ones where it may at first serve one function, but later involve personally transformative changes.

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Tedeschi, Richard; Calhoun, Lawrence

Time of change? The spiritual challenges of bereavement and loss.

Coping with grief can include, in part, trying either to assimilate the loss into the existing worldview and its spiritual and religious components, or changing those components in congruence with the new reality. This spiritual or religious challenge can lead to loss of faith and a loss of spiritual meaning, but it can also provide a struggle that eventually leads to growth in the religious and spiritual domains. In a similar way, the bereaved person's experiences with their proximate culture and social world, particularly if their social systems include a religious community or shared spiritual beliefs with others, can lead to negative changes, but there is the possibility for growth in the social domain as well. Clinicians who work with bereaved persons need to be aware of the possibility that such themes may be important to their clients, and some suggestions are made to assist clinicians in this kind of work.

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Tedeschi, Richard; Calhoun, Lawrence

Target Article: 'Posttraumatic Growth: Conceptual Foundations and Empirical Evidence'.

This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Although the term is new, the idea that great good can come from great suffering is ancient. We propose a model for understanding the process of posttraumatic growth in which individual characteristics, support and disclosure, and more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an ongoing process, not a static outcome.

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Taku, Kanako; Cann, Arnie; Calhoun, Lawrence; Tedeschi, Richard

The factor structure of the Posttraumatic Growth Inventory: A comparison of five models using confirmatory factor analysis

There are different views about the dimensions of the positive changes resulting from the struggle with traumatic events. Using Posttraumatic Growth Inventory (PTGI) data reported by participants (N = 926) experiencing a variety of traumatic events, five models of the underlying structure of the PTGI were tested via confirmatory factor analyses to examine whether the PTGI comprises three domains (Changed Perception of Self, Changed Interpersonal Relationships, and Changed Philosophy of Life), five factors (Relating to Others, New Possibilities, Personal Strength, Spiritual Change, and Appreciation of Life), or a unitary dimension. Results indicated an oblique 5-factor model best fit the data, thus revealing the PTGI was multidimensional. Present findings offer implications for understanding the nature of posttraumatic growth.

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Powell, Steve; Rosner, Rita; Butollo, Willi; Tedeschi, Richard; Calhoun, Lawrence

Posttraumatic growth after war: A study with former refugees and displaced people in Sarajevo

Research carried out with survivors of a variety of different traumata indicates that a large proportion of them perceive positive changes in themselves after the trauma. This study investigated whether posttraumatic growth also could be found among people who had been exposed to particularly severe traumata over a period of several years (1991 to 1995) during the war in the area of the former Yugoslavia. Included in the study were two representative samples of adult former refugees and displaced people who lived anywhere in former Yugoslavia before the war and were currently living in Sarajevo, Bosnia and Herzegovina, three and a half years after the war. The main instrument was a new Bosnian translation of the Posttraumatic Growth Inventory. Results indicated some differences in the factor structure as compared with the original instrument. The overall means for the scale were considerably lower than reported in most studies on other kinds of trauma. Younger people reported considerably more growth than older people.

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Proffitt, Deborah; Cann, Arnie; Calhoun, Lawrence; Tedeschi, Richard

Judeo-Christian clergy and personal crisis: Religion, posttraumatic growth and well being

This study investigated the psychological impact of personal traumatic events in a sample of 30 Judeo-Christian clergy. Use of religion-based coping strategies following a difficult life event was expected to facilitate posttraumatic growth, and posttraumatic growth was, in turn, expected to result in greater current well being. Both predictions were supported. In addition, higher levels of rumination soon after the event were associated with greater posttraumatic growth. The results indicated that clergy benefited from both positive and negative styles of religious coping, and that posttraumatic growth was not associated with greater well being for this sample.

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Tedeschi, Richard; Kilmer, Ryan

Assessing Strengths, Resilience, and Growth to Guide Clinical Interventions

Recently, the field of mental health has incorporated a growing interest in strengths, resilience, and growth, psychological phenomena that may be associated with healthy adjustment trajectories and profitably integrated into strategies for clinical assessment and practice. This movement constitutes a significant shift from traditional deficit-oriented approaches. Addressing clinical practitioners, this article (a) provides a broad overview of these constructs and phenomena, (b) discusses their relevance for clinical assessment and intervention, and (c) describes selected strategies and approaches for conducting assessments that can guide intervention.

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Tedeschi, Richard; Cann, Arnie; Taku, Kanako; Senol-Durak, Emre; Calhoun, Lawrence

The posttraumatic growth inventory: A revision integrating existential and spiritual change

Spiritual Change (SC) is one of 5 domains of posttraumatic growth (PTG). The current Posttraumatic Growth Inventory (PTGI) assesses this area of growth with only 2 items, one focusing on religiosity and the other focusing on spiritual understanding. The addition of 4 newly developed spiritual–existential change (SEC) items, creating an expanded PTGI (Posttraumatic Growth Inventory‐X), reflects a diversity of perspectives on spiritual–existential experiences that are represented in different cultures. Samples were obtained from 3 countries: the United States (n = 250), Turkey (n = 502), and Japan (n = 314). Analyses indicated that the newly added items capture additional experiences of growth outside traditional religious concepts, yet still are correlated with the original SC items, especially in the U.S. and Turkish samples. Relationships of the PTGI‐X to established predictors of PTG, event‐related rumination, and core beliefs, were as predicted in all 3 countries. The new 6‐item SEC factor demonstrated high internal reliability, and the 5‐factor structure of the expanded scale was supported by confirmatory factor analysis. The resulting 25‐item PTGI‐X can be used as a validated instrument in a wide range of samples in which traditional religious beliefs are less dominant.

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Taku, Kanako; Tedeschi, Richard; Cann, Arnie

Relationships of posttraumatic growth and stress responses in bereaved young adults

The present study examined posttraumatic growth (PTG) and its associations with stress responses in bereaved young adults. It was hypothesized that the PTG domains that are more strongly endorsed among the bereaved would show an inverted-U-shaped relationship with stress responses. Japanese undergraduate students who reported their loss of loved ones as the most traumatic experience within the past 5 years completed the Posttraumatic Growth Inventory (PTGI) and the revised Impact of Event Scale. Results revealed that the hypothesized curvilinear relationships were observed in the PTG domain of relating to others and the combined domain of spiritual change and appreciation of life, whereas linear relationships were found in the personal strength and new possibilities domains. These results suggest that although a certain level of stress response may be crucial for experiencing PTG, the relationship varies across the PTG domains in these bereaved young adults.

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Hanley, Adam; Garland, Eric; Tedeschi, Richard

Relating dispositional mindfulness, contemplative practice, and positive reappraisal with posttraumatic cognitive coping, stress, and growth

A growing body of theoretical and empirical work suggests that mindfulness may support more positive posttraumatic outcomes by reducing posttraumatic stress (PTS) and encouraging posttraumatic growth (PTG). Positive reappraisal (PR), a cognitive coping correlate of dispositional mindfulness (DM) has also been linked with greater PTG. However, neither DM nor PR have been modeled in relation to core posttraumatic constructs such as core belief disruption, intrusive rumination, deliberate rumination, PTS and PTG. Method: This study explored associations between these constructs in a sample of college students (N = 505), also investigating the impact of contemplative practice involvement on the relationships between the constructs. Results: Results indicate that including DM and PR into established models of PTG increases the model’s explanatory power, which distinct cognitive coping pathways connect DM and core belief disruption with PTS as well as PTG, and that contemplative practice involvement substantially alters relationships between the core PTG variables. Conclusions: The present study contributes to the growing reconceptualization of trauma as linked with both positive and pathogenic outcomes, emphasizing the need to better understand how posttraumatic cognitive coping strategies contribute to more positive outcomes.

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Taku, Kanako; Cann, Arnie; Tedeschi, Richard; Calhoun, Lawrence

Core beliefs shaken by an earthquake correlate with posttraumatic growth

Posttraumatic growth (PTG), psychological growth as a result of personal struggle with trauma, is hypothesized to occur when a highly stressful life event, such as a natural disaster, forces people to reexamine their core beliefs. To the authors’ knoweldge, the present study is the first investigation in Japanese people examining the role of core beliefs, intrusive rumination, and deliberate rumination in PTG. Hypotheses that the level of reexamination of core beliefs, intrusive rumination, and deliberate rumination correlate with the seismicity of an earthquake and that the challenge to core beliefs is the major determinant of PTG were tested. Japanese undergraduate students who experienced the Great East Japan Earthquake on March 11, 2011 (N = 314) participated in this study and completed the Japanese version of the Core Beliefs Inventory (CBI), the Event-Related Rumination Inventory (ERRI), and the Posttraumatic Growth Inventory (PTGI). Results indicated that core beliefs were less likely to be challenged and that ruminations were less likely to be activated in Japanese people who were in the southern area with an approximate Richter magnitude of 4 or lower. PTG was more likely to occur when core beliefs were reexamined following the earthquake. Also, younger participants and those who recalled having engaged in both deliberate and intrusive rumination reported more PTG. Future studies should investigate which aspects of trauma can trigger or suppress the reexamination of one’s core beliefs, for they are likely to be the major determinants of PTG, and should look at change longitudinally.

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Danhauer, Suzanne C.; Case, Douglas; Tedeschi, Richard; Russell, Greg; Vishnevsky, Tanya; Triplett, Kelli; Ip, Edward; Avis, Nancy

Predictors of posttraumatic growth in women with breast cancer

Posttraumatic growth (PTG) is defined as ‘positive psychological change experienced as a result of a struggle with highly challenging life circumstances’. The current study examined change in PTG over 2 years following breast cancer diagnosis and variables associated with PTG over time. Methods: Women recently diagnosed with breast cancer completed surveys within 8 months of diagnosis and 6, 12, and 18 months later. Linear mixed effects models were used to assess the longitudinal effects of demographic, medical, and psychosocial variables on PTG as measured by the Posttraumatic Growth Inventory (PTGI). Results: A total of 653 women were accrued (mean age = 54.9, SD = 12.6). Total PTGI score increased over time mostly within the first few months following diagnosis. In the longitudinal model, greater PTGI scores were associated with education level, longer time since diagnosis, greater baseline level of illness intrusiveness, and increases in social support, spirituality, use of active–adaptive coping strategies, and mental health. Findings for the PTGI domains were similar to those for the total score except for the Spiritual Change domain. Conclusion: PTG develops relatively soon after a breast cancer diagnosis and is associated with baseline illness intrusiveness and increases in social support, spirituality, use of active–adaptive coping strategies, and mental health.

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Kilmer, Ryan P.; Gil-Rivas, Virginia; Tedeschi, Richard; Cann, Arnie; Calhoun, Lawrence; Buchanan, Teresa; Taku, Kanako

Use of the revised Posttraumatic Growth Inventory for Children

Posttraumatic growth (PTG; positive change resulting from the struggle with trauma) was examined among children impacted by Hurricane Katrina. The revised Posttraumatic Growth Inventory for Children (PTGI-C-R) assessed PTG at two time points, 12 (T1) and 22 months (T2) post hurricane. The PTGI-C-R demonstrated good reliability. Analyses focused on trauma-related variables in predicting PTG. Child-reported subjective responses to the hurricane and posttraumatic stress symptoms (PTSS) correlated with PTG at T1; however, in the regression, only PTSS significantly explained variance in PTG. At follow-up, T1 PTG was the only significant predictor of PTG. Findings suggest that the PTGI-C-R may assist efforts to understand children's responses posttrauma.

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Cook, James R; Tedeschi, Richard

Systems of care and the integrative clinician: A look into the future of psychotherapy.

The widespread implementation of systems of care represents an important opportunity to integrate behavioral, cognitive, milieu, client-centered, group, solution-focused, systems, multicultural, and ecological approaches to child and family therapy. This integrated approach is described and illustrated, and systems of care principles are considered to be a useful foundation for effective therapeutic practices for difficult problems of children, families, and adults.

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Taku, Kanako; Cann, Arnie; Tedeschi, Richard; Calhoun, Lawrence

Intrusive versus deliberate rumination in posttraumatic growth across US and Japanese samples

To examine the role of rumination in the aftermath of traumatic/stressful events, posttraumatic growth (PTG) and the four types of rumination (i.e., intrusive rumination soon after the event, intrusive rumination recently, deliberate rumination soon after the event, and deliberate rumination recently) were assessed retrospectively for participants from the USA (N 224) and Japan (N 431). The results from a hierarchical regression analysis revealed that the hypothesized relationships among the four types of rumination and PTG were largely supported. Intrusive rumination soon after the event was positively related to PTG but recent deliberate rumination most strongly predicted the current levels of PTG for both samples. Some evidence for cultural differences in the role of rumination in PTG was also observed. In the US sample, deliberate rumination recently was more important than the deliberate rumination in the immediate aftermath of the traumatic/stressful event, whereas in the Japanese sample, deliberate rumination both soon after and recently were positively related to PTG. The results illustrate the importance of considering rumination as multidimensional and as varying across time in its impact on PTG. Future directions and clinical implications were discussed.

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