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The main aim of this study was to investigate the psychometric properties of the Italian version of the newly-developed Posttraumatic Growth and Depreciation Inventory (PTGDI-X) in a heterogeneous sample of Italian adults who had experienced a traumatic event.The instrument was translated following the forward-backward method and completed by 601 participants who met the inclusion criteria. The factorial structure of the PTGDI-X was assessed by means of multiple confirmatory factor analyses (CFA). Convergent and discriminant validity and reliability were also evaluated.The results of the CFA revealed that the original 5-factor model was the best fit for the growth (PTG) dimension of the PTGDI-X, whereas it poorly fit the data with respect to the depreciation (PTD) component. With regard to convergent and divergent validity, positive correlations were found between the PTG scores and the core belief disruption and rumination scores, whereas the PTG factors correlated negatively with depressive and posttraumatic symptom measures. Conversely, positive correlations were identified between the PTD total score and all the other investigated constructs. Finally, the total scales and subscales of the PTG/PTD dimensions revealed good to excellent internal consistency.The current findings indicate that the Italian version of the PTGDI-X appears to be a valid assessment tool for the multidimensional structure of the PTG component. Future research is needed, on the other hand, to confirm the validity of the PTD dimension in the Italian population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

OBJECTIVE Posttraumatic growth (PTG) has been primarily recognized as a result of experiencing a single life crisis. The current study investigated how PTG may be attributed to experiences of a multitude of highly stressful life events, and how PTG is correlated with PTSD symptoms, the severity of the event, and the total number of childhood traumas experienced. METHOD Adolescents (N = 139) participated in a survey that assessed six major life events of childhood trauma and rated the severity of each event, posttraumatic stress symptoms (PTSS), and PTG. RESULTS The majority of adolescents attributed their PTG experiences to one event, despite experiencing multiple traumas. However, experiencing more events was associated with greater PTSS and some forms of PTG such as changed priorities, increased self-reliance, and establishing a new path in life. Results from regression analyses also showed that trauma severity and PTSS were linearly correlated with PTG, and thus, a curvilinear relationship was not identified. CONCLUSIONS Cumulative traumatic events may lead to increases in a sense of personal growth, while also increasing distress, in nonclinical adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The ongoing COVID-19 pandemic has caused significant psychological impact on medical professionals, including medical students, many who have been caring for patients on the frontlines. Understanding how medical students perceive their stressful life experiences is important as the mental health of these future physicians directly impacts their ability to care for patients. We assessed for post-traumatic growth and resilience in the face of traumatic events among a cohort of medical students that attended a medical school located in an early epicenter of the COVID-19 pandemic. Between October 29, 2020 and December 1, 2020, medical students at the Icahn School of Medicine at Mount Sinai in New York City were surveyed on various stressful life events, including COVID-19. We identified specific resilience behaviors, including establishing a supportive social network, relying on a moral compass, and using cognitive flexibility, that medical students commonly used to cope with traumatic experiences. Compared with students who perceived COVID-19 as their most stressful life event, students who perceived other events, such as family issues or serious illness, as most stressful experienced less COVID-related stress (t = -2.2, p = .03), greater posttraumatic growth (t = 4.3, p.001), and demonstrated more resilient behaviors including establishing and nurturing a supportive social network (t = 2.2, p = .03), developing brain fitness (t = 2.2, p = .03), and finding meaning and purpose in things (t = 2.9, p = .006). This suggests that stressful experiences prior to or in parallel with COVID-19 encouraged posttraumatic growth and development of resilience behaviors that were protective to COVID-19-related stress.

Medical mishaps are well-known sources of distress. However, some mishaps may give medical professionals an opportunity to experience personal growth. We examined the associations between medical mishaps, second victim distress, and posttraumatic growth. A total of 157 physicians and 139 nurses completed a survey that included questions about mishaps, Second Victim Experience and Support Tool and the Posttraumatic Growth Inventory. Overall, 82.8% of the physicians and 48.9% of the nurses experienced at least one mishap. Lack of training, rumination, and impact of mishaps were associated with distress among nurses, whereas rumination, impact, and stressfulness were associated with distress among physicians. On the other hand, the impact of mishaps is the only factor that was associated with posttraumatic growth among nurses, whereas none with physicians. This study suggests that the posttraumatic growth from medical mishaps is not associated with the theory-driven event-related factors, and highlights the importance of further investigation.

Aim: A subtype of depression called Modern-type depression (MTD) is typically viewed as less severe compared to the Traditional-type depression (TTD). The purpose of this study was to explore the reasons behind the differences of perceptions when assessing the severity of MTD and TTD. Methods: After reading two vignettes describing an individual who is experiencing symptoms of MTD or TTD, participants (N = 300, Mage= 20.36) were asked to rate the severity of the depression for each and rank, in order of importance, a set of sentences in each vignette that served as reasons why they chose that rating. Results: Overall, TTD was more likely to be rated as severe than MTD. Those who perceived high severity in TTD relied on the information of the individual experiencing mental and physical consequences a high workload. Those who perceived high severity in MTD also relied on the same information of X suffering a high workload; however, those who perceived low severity in MTD relied more on the information of the individual complaining about the workload. Conclusion: These results indicate that perceptions of each disorder may in part come from which information people pay attention to. Future studies should explore the possibility of other factors, such as familiarity with mental health disorders or certain trauma experiences that could lead some individuals to process circumstances and situations within each depression to reduce stigma of mental disorders.

After experiencing trauma, people often report both negative and positive changes, which can be operationally defined as posttraumatic growth (PTG) and posttraumatic depreciation (PTD). However, there is no brief measure for assessing both posttraumatic changes simultaneously.This study describes the short form of the expanded version of the Posttraumatic Growth and Depreciation Inventory (PTGDI-X-SF) among German Adults.Using a sample of 253 German adults, the dimensionality of the PTGDI-X-SF was examined by confirmatory factor analyses. Internal consistencies were determined. The relation of PTG and PTD was investigated. Regression analyses explored the relationships to established predictors as previously found for the full-scale version of the PTGDI-X.Findings indicate a 5-factor structure for the PTGDI-X-SF equivalent to the PTGDI-X as well as high reliability for PTG (α = .88) and PTD (α = .88). Participants reported more PTG (Overall, results support the applicability of the PTGDI-X-SF as a valid and efficient measure to assess PTG and PTD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Many patients with cancer report positive changes often referred to as posttraumatic growth (PTG). Some of these self-reported PTG may represent maladaptive illusions created by individuals to cope with the illness. A recently established Posttraumatic Growth and Depreciation Inventory - Expanded version (PTGDI-X) includes both PTG and posttraumatic depreciation (PTD) items. This inventory may provide a more balanced picture of the phenomenological world of cancer survivors. We examined the Chinese version of the PTGDI-X's applicability to cancer patients, and how PTG and PTD were related to posttraumatic stress symptoms. Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure posttraumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis showed that the factor structure of the PTGDI-X established in a multi-national study fit our data from cancer patients modestly well. The PTD score had a significant and positive correlation with PTSD symptoms, whereas the PTG and PTSD showed a significant curvilinear relationship in the form of an inverted U-shape. This study's results indicate that PTG and PTD are separated constructs with differential relationships with cancer outcomes. The Chinese version of the PTGDI-X is a viable instrument for psycho-oncological research. The PTD scores can provide useful information to guide cognitive interventions to reduce distorted cognitions. In contrast, the PTG scores can provide further information on the phenomenological world of cancer survivors. In this study, clinical implications and future studies were considered.

The 2019 Novel Coronavirus pandemic disrupts typical human support networks through forced isolation. This study examined perceived support from pets and humans, the use of social media for coping,...

A Japanese version of the short form of the expanded Posttraumatic Growth Inventory (PTGI-X-SF-J) was developed in this study, as the extended version captures broader, more diverse personal growth perspectives, such as existential spiritual growth. We collected cross-sectional data from 408 (first sample) and 284 (second sample) Japanese university students using the expanded version of the Posttraumatic Growth Inventory (PTGI-X-J). Exploratory factor analysis (EFA) was performed with the first sample and confirmatory factor analysis (CFA) with the second; reliability and validity were examined. The short-form version resulting from the EFA and CFA comprised 10 items and five factors. Cronbach’s alpha for the PTGI-X-SF-J total and subscale scores ranged from 0.671 to 0.875. The intraclass correlation coefficient for the total and subscale scores between the PTGI-X-J and PTGI-X-SF-J ranged from 0.699 to 0.821. Regarding external validity, no significant correlation was found between posttraumatic growth and posttraumatic stress disorder checklists. Due to its brevity, the PTGI-X-SF-J can help assess diverse spiritual and existential personal growth experiences among clients, patients, and trauma survivors while reducing physical and psychological burdens.

The current study investigated differences between resilience and posttraumatic growth (PTG) by examining their distinctive roles in perceptions of and attitudes toward depression. A series of mixed ANOVAs analyzed the differences in individuals' perceptions of and attitudes towards depression. College students (

Posttraumatic growth (PTG) may foster skills that allow one to understand traumatic experiences in others. The primary aim of this study was to determine the relationship between an individual’s PTG reports and their ability to relate to two growth types, PTG and illusory growth. The purpose of this study was to elucidate perceptions of illusory growth and PTG so clinicians may more readily identify catalysts for growth and customize treatments. Participants were read two vignettes that detailed the experience of PTG and illusory growth as a result of a specific traumatic event (i.e., car accident). They completed a questionnaire regarding their perceptions of the vignettes. Results revealed that participants with higher PTG were more likely to relate to the PTG vignette than the illusory growth vignette, and when participants had experienced the same event in the vignette (i.e., car accident), this relationship was stronger. Last, participants mostly perceived the PTG vignette as female, and the illusory growth vignette as male. Our results suggest that interventions following traumatic experiences could be best facilitated/supplemented by reflective interactions with others who have experienced similar events. Considering one’s gender may be important in order to ensure that gender stereotypes regarding emotional expression are mitigated.

Posttraumatic Growth (PTG) is the positive changes a person may experience due to the struggle with a highly stressful life event. One of the predictors of PTG is social support, and support from v...

On 24 March 2020, an announcement was made that the Tokyo 2020 Olympic and Paralympic games would be postponed until 2021 due to the coronavirus pandemic. Athletes and their coaches have experience...

Purpose Adolescents and young adults (AYA) who undergo cancer treatment sometimes report posttraumatic growth (PTG) and experience posttraumatic stress symptoms (PTSS). Although the importance of peer support has been demonstrated, its association with PTG, especially in the five, distinct domains of PTG, needs to be investigated further in AYA cancer survivors. The present study examined the role of demographics, peer support, and PTSS in PTG among AYA cancer patients and survivors. MethodsThe present, multicenter, cross-sectional, prospective, web-based study enrolled AYA cancer patients and survivors (median age 28 years). Of 549 AYA patients recruited, 212 patients from 11 cancer centers and 12 cancer patient communities agreed to participate by completing a self-reported measure of PTG (PTGIX-J) and providing information about their diagnosis, treatment, peer support (affiliation with an AYA patient community or friendship with other AYA cancer patients), social status, and PTSS. Multiple regression analysis was used to identify significant correlates in the total score and five PTG domains. ResultsIn general, PTG was positively associated with male sex, years since diagnosis, having a confidant, and friendship with other AYA cancer patients. PTG was not significantly related to age, age at diagnosis, affiliation to an AYA patient community or PTSS. Friendship with other AYA cancer patients was positively associated with all five PTG subscales. PTSS was not associated with PTG but was associated with a subscale of “appreciation of life”. For the five subscale scores, “belonging to a religion” was positively associated with “spiritual change,” and “having a confidant” and “a good relationship with siblings” were positively associated with “appreciation of life.” Conclusion “Having a confidant” and “friendship with other AYA cancer patients” was positively associated with PTG. Psychosocial interventions mobilizing peer support can potentially contribute to promoting PTG in AYA cancer patients.

This study examined whether perceiving an event as a trauma influenced a cognitive processing model explaining posttraumatic growth (PTG). A cross-sectional questionnaire survey was conducted with 311 university students from eight universities in Japan. The participants provided information about the most stressful event they had experienced and completed the expanded version of the PTG Inventory, Core Belief Inventory, Event Related Rumination Inventory, and Cognitive and Emotional Processing from Disclosure Inventory. A multi-group structural equation modeling was conducted by dividing the participants into two groups depending on whether they identified the most stressful event as a trauma. The model with no constraint showed a good fit. The model with partial constraint showed a better fit than the models with no constraint or full constraint. The difference of the model was seen as a covariance between the Event Related Rumination Inventory and the Cognitive and Emotional Processing from Disclosure Inventory. The results demonstrated configural invariance and partial metric invariance. This indicated that PTG would be recognized irrespective of whether the event was perceived as a trauma. This study also indicated that different factors out of the model could be associated with the ruminative process and disclosure process. The importance of focusing on the process of PTG, regardless of an individual's perception of the event, was emphasized, especially for factors related to rumination and disclosure.

Background The 10-item short form of the Posttraumatic Growth Inventory (PTGI-SF) has been utilized worldwide. However, there is no Japanese version. Furthermore, the PTGI-SF does not capture a broader category of existential spiritual growth that has been incorporated in the more recent Expanded version of the PTG Inventory (PTGI-X). Thus, we developed a Japanese version of the Short Form (PTGI-X-SF-J), which reflects more diverse perspectives on existential and spiritual growth. Methods A cross-sectional study using questionnaires was conducted in Japan. The first sample consisted of 408 university students, and the second sample comprised 284 university students. Exploratory factor analysis was performed using data from the first sample. Confirmatory factor analysis was conducted, and reliability and validity were confirmed using the second sample. Results The PTGI-X-SF-J is composed of 10 items including two items from each of the five subscales of the PTGI-X, similar to the original version of the PTGI-SF, and this model fits the data well. Items concerning existential/spiritual change in the PTGI-X-SF-J were “I feel more connected with all of existence” and “I have a greater sense of harmony with the world,” which were not included in the original PTGI-SF. The score of the PTGI-X-SF-J was significantly correlated with the scores of the Core Beliefs Inventory and the Event Related Rumination Inventory-Deliberate; however, no correlation was observed with the scores of the PTSD Checklist for DSM-5. Conclusions We developed the PTGI-X-SF-J using 10 items to measure PTG among people whose first language is Japanese and confirmed its factor structure, reliability, and validity. The PTGI-X-SF-J is useful for assessing PTG more efficiently and accurately as it considers more diverse spiritual/existential experiences of personal growth and reduces physical and psychological burdens due to its brevity.

Researchers believe that the impact of repeated trauma on mental health is incrementally more significant than the simple additive effect of one event. This study questioned whether this repetition only further worsens people's mental health. We found that they may report more positive changes than those who haven’t. Thus, we hypothesized that repeatedly experiencing difficult situations and suffering might increase post-traumatic growth (PTG). PTG can be defined as "positive psychological changes experienced due to coping with very difficult life situations," leading to positive outcomes and feelings of well-being. We found that those who experienced a disaster in the past were more depressed, anxious, and stressed than those who had never experienced a disaster and now experienced the COVID-19 pandemic. Additionally, past disaster experience led to a more psychological response to the COVID-19 pandemic, which, in turn, led to an increase PTG. Globally, we found that supportive social interactions, including those with family members, could develop PTG during the COVID-19 pandemic and achieve better well-being during the continuation of the pandemic in the future.

Research on psychological growth after suffering has focused on survivors and victims of trauma and has largely ignored those who are not on the receiving end. The current study aimed to un...

In March of 2011, an earthquake, tsunami, and nuclear accident struck northern Japan causing profound damage to the surrounding area and lasting effects to all those who lived there. Fukushima Medical University (FMU), the closest hospital that remained open during the disaster, was greatly impacted and its students rallied to help the cause. Many of them were directly affected as their neighborhoods were ruined and family and friends were injured or killed. Our study sought to better understand how this disaster impacted their posttraumatic growth and resilience in the wake of the disaster and today, 8 years later. There were three goals of this study. First, we aimed to replicate previous research that showed positive effects of disaster volunteerism on medical students' posttraumatic growth. Second, we sought to better understand the role of resilience in the wellbeing of these students. Finally, we wanted to explore the advantages to our newly created 10-Factor Resilience Behavioral Scale, which we used alongside the Davidson Trauma Scale (DTS), Posttraumatic Growth Inventory (PTGI-X), and Connor-Davidson Resilience Scale (CD-RISC). Overall, 579 responses were collected (response rate of 71.9%). Volunteers continued to show greater PTG as well as greater overall resilience. Furthermore, there were positive correlations between students' feelings of confusion, anger, sadness, guilt or anxiety and their sense of resilience, both at the time of the disaster and in the most recent month, suggesting that within Japanese culture difficult emotions may promote resilient behaviors and actions.

Posttraumatic Growth (PTG), positive psychological change that may arise through the struggle with a highly stressful life event, is theorized to require certain key cognitive processes depicted in a PTG theoretical model. Authenticity of PTG, however, has been debated in literature, raising the awareness of Illusory Growth. We hypothesized that the differences between PTG and Illusory Growth may be explained by characteristics of narcissists' experience with stressors, primarily through positive reevaluation of the stressors for personal gain. The current study investigated perceptions and attitudes toward these different types of growth in a sample of undergraduate students (N = 282). Participants were read vignettes that detailed the experience of PTG and Illusory Growth, and they disclosed their attitudes toward the respective growth types. The participants also completed the Pathological Narcissism Inventory. Results revealed that PTG and Illusory Growth were perceived differently and that the order in which growth types were introduced affected attitudes toward each growth type. Certain narcissistic personality characteristics minimally correlated with perceptions of authenticity of the growth types. Findings have implications for the growing distinction between PTG and Illusory Growth in the literature and for practical attempts to educate about both types of growth.

This study tested how the patterns of stressfulness would be associated with perceptions of a stressful event. Undergraduates in the United States and Japan reported their stressful event and retro...

The present study examined whether psychological changes after trauma, operationally defined as posttraumatic growth (PTG) and posttraumatic depreciation (PTD), were judged as positive or negative within a sample of Japanese adults. Furthermore, potential gender differences in perceptions for changes in PTG and PTD were also assessed. Undergraduate students (n = 257, Mage = 19.91) completed a questionnaire that included 50 items from the expanded versions of the Posttraumatic Growth and Depreciation Inventories. Items operationally defined as PTG were generally agreed upon as positive changes. Conversely, items operationally defined as PTD varied considerably in terms of agreement regarding negative changes. Some items (e.g., appreciate each day less than I did before) showed high agreement for perceptions of negative changes, whereas others (e.g., find it difficult to clarify priorities about what is important in life) were more often perceived as positive changes. Gender differences were also observed with only slight fluctuations in agreement for most PTG items but with wider discrepancies among PTD items. These results suggest that operationally defined PTD may reflect a linguistic opposite to PTG rather than a conceptual or sematic contrast. Furthermore, cultural and gender values may need to be considered when defining psychological changes resulting from trauma.

Research shows that some adolescents experience positive psychological changes resulting from highly stressful life events. Because “positive change” is a value-laden concept, there may be cross-cultural differences in this conception of growth. The purpose of this study was to qualitatively and quantitatively assess different perceptions of personal growth across cultures. Adolescents from Japan ( n = 288, Mage = 16.16) and the United States ( n = 155, Mage = 16.21) completed demographic information and wrote three words describing their perception of personal growth. Results showed 443 different words generated, which were condensed into 12 categories. The types of words generated differed between nationalities, with Japanese adolescents generating more words related to social connection, and adolescents in the United States generating words related to change. Gender differences were found in physical change and age differences in the knowledge categories. Results demonstrate cross-cultural differences as well as similarities in the conceptualization of personal growth. Future research may examine how adolescents change the meaning of personal growth after experiencing personal growth resulting from a stressful life event.

Many patients with cancer report positive changes often refer to as posttraumatic growth (PTG). Some of these self-reported PTG may represent maladaptive illusions created by individuals to cope with the illness. A recently established Post-traumatic Growth and Depreciation Inventory – Expanded version (PTGDI-X) includes both PTG and post-traumatic depreciation (PTD) items. This inventory may provide a more balanced picture on the phenomenological world of cancer survivors. We examined the Chinese version of the PTGDI-X’s applicability to cancer patients, and examine how PTG and PTD were related to posttraumatic stress symptoms. Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure post-traumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis showed that the factor structure of the PTGDI-X established in a multi-national study fit our data from cancer patients modestly well. The PTD score had a significant and positive correlation with PTSD symptoms, whereas the PTG and PTSD showed a significant curvilinear relationship in the form of an inverted U-shape. This study’s results indicate that PTG and PTD are separated constructs with differential relationships with cancer outcomes. The Chinese version of the PTGDI-X is a viable instrument for psycho-oncological research. The PTD scores can provide useful information to guide cognitive interventions to reduce distorted cognitions. In contrast, the PTG scores can provide further information on the phenomenological world of cancer survivors. In this study, clinical implications and future studies were considered.

Background/Rationale: Hurricane Maria and the COVID-19 pandemic have greatly impacted the lives of adolescents in Puerto Rico. Understanding how individuals respond to stress can elucidate strategies used to cope and grow from impactful life events (ILE) while minimizing adverse mental health consequences. This expands on work with medical students in Fukushima post-3/11. Hypothesis or Research Question: Adolescents who utilize more resilience behaviors will experience more post-traumatic growth. Adolescents who demonstrate posttraumatic growth from a previous event will experience less COVID-related stress. Study Design/Methods: Students were anonymously surveyed and responded to the Davidson-Trauma Scale (DTS), Post-Traumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale-10 (CDRS-10), Resilient Behavior Scale (RBS), and questions specific to COVID-19 and Hurricane Maria. Data was analyzed by examining correlations between scales and between scales and questions specific to COVID-19 and natural disasters. Results: Most students indicated the COVID-19 pandemic as their most impactful life event (44%) (Figure 1). The RBS and CDRS-10 were positively correlated with each other (r = .679, p = .002). The PTGI was positively correlated with the RBS (r = .878, p Conclusions/Future Plans: Our results indicate adolescents’ resilient behaviors, not resiliency per se, were associated with post-traumatic growth since only RBS was correlated with PTG. Additionally, undergoing prior stressful events appears to mitigate distress from future stressors. Finally, experiencing an ILE alongside others appears to lead to greater PTG suggesting an important role for social connection. The social isolation of COVID-19 may have diffused the potential to find something positive in the event even in those experiencing PTG.

This study examined the relationships between posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across 10 countries and assessed the factorial invariance of the standardized inventory assessing PTG and PTD, the PTGDI-X, the expansion of the PTGI-X (Tedeschi et al., 2017). We also investigated the roles of social and cognitive factors in PTG and PTD. Data were collected from participants who identified that their most stressful life experience met the definition of trauma in Australia, Germany, Italy, Japan, Nepal, Peru, Poland, Portugal, Turkey, and the US. The participants completed the PTGDI-X and inventories measuring posttraumatic stress disorder symptoms, and predictor variables such as reexamination of core beliefs, centrality of the event, rumination, and disclosures. Results identified universal aspects such as equivalence of factor loadings of the PTGDI-X and the impact of positive/negative disclosure on PTG and PTD. Results also revealed culture-specific aspects, including the relationships between PTG and PTD, and different patterns of cognitive predictors for PTG and PTD. The current study offered the insight that, for the first time using international data, positive and negative post-trauma changes are not likely to be on opposing ends of one dimension, and it is essential to use the PTGDI-X to better understand both positive and negative aspects of post-traumatic experiences.

The present study investigated how an individual's state anxiety may change before and after exposure to different types of information about mass shootings. Changes were analyzed as either alpha or beta changes; beta changes indicate a “recalibration” of one's anxiety as opposed to experiencing a direct change. A total of 364 participants from a midwestern university were randomly assigned to one of three conditions, in which they read either emotional information (a news article about mass shootings), unemotional information (statistics about mass shootings), or a filler article. Before and after reading these articles, participants responded to questions from the state portion of the State-Trait Anxiety Inventory. Analyses revealed that participants experienced alpha changes in anxiety after reading either article related to mass shootings, but not after reading the filler article. Furthermore, participants did not experience beta changes after reading any of the articles. These results demonstrate that information about mass shootings is likely to elevate anxiety levels regardless of its emotionality, and that these are direct changes as opposed to cognitive recalibrations. The results may be relevant for news sources reporting on mass shootings or professionals attempting to educate about mass shootings.

People sometimes realize personal growth as a result of experiencing highly challenging stressful life events, a phenomenon referred to as posttraumatic growth (PTG). This study investigated the relationships between personality traits and PTG from a person-centered approach. Specifically, we investigated PTG profiles by looking at distinct levels of the five PTG domains, Personal Strength, Relating to Others, New Possibilities, Appreciation of Life, and Spiritual and Existential Changes, using latent profile analysis. In Study 1, we identified five latent patterns of PTG profiles. In Study 2, we examined the replicability of the PTG profiles by applying the expanded version of the PTG Inventory and tested their relations with the HEXACO personality inventory. The structures of PTG profiles were replicated and the profile showed differential patterns of relationships with personality. Implications of this study, and the applicability of PTG profiles and the use of person-centered approaches for studying PTG are discussed.

The death of a loved one has great impact on family members even when the death was expected. While negative changes are reported, some individuals also report personal growth, known as posttraumatic growth (PTG). Many studies on PTG have been performed using quantitative methods and suggest that PTG may differ according to the traumatic event and cultural background. This study aimed to explore how Japanese bereaved family members of patients with cancer express their experience of PTG after the patient’s death by analyzing open-ended answers provided in a cross-sectional survey. Qualitative data were collected through a survey, and thematic analysis was used to analyze the data. The present study was part of a larger cross-sectional survey of bereaved families of patients with cancer. Data analyzed in the current study were obtained from 162 bereaved family members of patients with cancer. We identified 18 sub-themes within five predefined major domains of PTG. Moreover, we also identified two additional themes: changed view of life and death, and awareness of health management. The experience of PTG of bereaved family members varied considerably. Future research on PTG experiences among groups from diverse cultural backgrounds would be beneficial for understanding the concept and its clinical implications.

Mental illness is a significant cause of disability worldwide, including here in the United States. Given the shortage of trained mental health professionals, a significant portion of patients needing care are managed in the primary care setting. Accountable Care Organizations (ACOs), for example, are seeking to improve the quality of care for this vulnerable population, but many are facing significant challenges relating to integration of new services. We sought to elucidate barriers faced by primary care practitioners (PCPs)-physicians, physician trainees and nurse practitioners-at a New York primary care clinic, which impede delivery of optimal care to those suffering from mental illness. The study was conducted with 32 PCPs in 2016-2017 at Mount Sinai Internal Medicine Associates in New York City. For the quantitative component of the study, a 54-item questionnaire was devised to assess their attitude, behavior and confidence in managing psychiatric patients. For the qualitative component, data was obtained from 3 open-ended questions. Responses were coded for salient themes. Analysis revealed a range of difficulties faced by PCPs. Overall, participants felt that the need to integrate mental health care into primary care was important, however they reported significant barriers in terms of lack of time, lack of resources, low confidence in treating more complex mental health conditions and difficulties with referring patient to mental health specialists. Despite a growing body of evidence that integration of mental health services in primary care leads to improved outcomes, addressing barriers to care will be key to ensuring feasibility of integration measures.

The current review synthesized studies investigating the relationships between resilience and Big Five personality traits and aimed to investigate how the relationships vary according to the two types of resiliency, psychological resilience and ego-resiliency. Thirty studies with a total sample size of 15,609 met the inclusion criteria to be used for the current meta-analysis. Results indicated that overall, estimated average correlation coefficients for resilience were: r = −0.46 with Neuroticism, r = 0.42 for Extraversion, r = 0.34 for Openness, r = 0.31 for Agreeableness, and r = 0.42 for Conscientiousness. When comparing the differences between the two types of resiliency, a stronger negative relationship with Neuroticism, and stronger positive relationships with Openness and Agreeableness were obtained with ego-resiliency, compared with trait resilience. However, there was a lack of homogeneity in effect sizes across studies especially for ego-resilience. Directions for future research regarding resilience and the limitations of present research are discussed.

The transition to high school is generally considered as a stressful turning point in adolescent development, but some students experience personal growth (i.e., positive developmental changes) through that experience. It is important to examine the mechanism behind such positive changes to understand various developmental patterns of adolescents during the transition. However, the concept of growth in this research area remains unexplored. Some researchers have questioned whether retrospective, self-reported growth reflects actual positive changes in the perception of personal growth. We elaborated on the concept of growth after high school transition by examining whether retrospective appraisal of personal growth after transition to high school is correlated with measured change in growth. Two hundred and sixty-two Japanese adolescents (aged 14-16 years, 50% girls) participated in surveys right before and right after transition. We assessed five domains of growth, including improved relating to others, identification of new possibilities, increased sense of personal strength, spiritual growth, and greater appreciation of life. The results showed that retrospective assessment of growth and measured change during transition were positively associated, provided the adolescents reported the transition as an important turning point in their lives. Adolescents who experienced salient positive changes across the transition were more likely to engage in intrusive and deliberate rumination and social support than adolescents who reported fewer changes. In summary, retrospective growth covaried with measured change only when adolescents perceived the transition as impactful in their lives.

The current study investigated the effects of a brief psycho-educational presentation about posttraumatic growth (PTG: positive changes that may occur as a result of psychological struggle with a highly stressful life event) on the self-reported PTG by using the PTG Inventory (PTGI). Few empirical studies have investigated the possible ceiling or floor effects of the PTGI, despite researchers indicating the necessity of longitudinal studies to reveal the PTG processes. This study used a pre-test, brief presentation, and post-test longitudinal design to examine the effects of intervention among adolescents by considering the floor and ceiling effects of the PTGI. Participants, 54 high school students (37 females, 17 males, Mean age = 15.92 years), completed the PTGI at three weeks interval. Results using the Latent Rank Theory approach demonstrated ceiling effects in students who reported a high degree of PTG at Time 1, and floor effects in students with low PTG at Time 1. Presentation effects were not evident even in those who reported a moderate degree of PTG at Time 1. These findings suggest that it is important to be aware of the ceiling/floor effects while measuring changes in PTG perception over time and that explaining the phenomenon of PTG is not likely to be enough to affect the PTG perceptions.

Objective: The present study examines the factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J) among bereaved family members who lost loved ones to cancer after home-based palliative care in Japan. It evaluates the relationships between total score, each PTGI-J domain, and participants’ having a religious belief, gender, age, relationship to the patient, and time since patient death. Procedure: Bereaved family members (n = 849) completed the PTGI-J and a demographic questionnaire. The factor structure was tested using confirmatory factor analysis (CFA), and univariate analysis was used to test hypotheses. Results: Confirmatory factor analysis showed that the current sample moderately fitted to both 4-factor and 5-factor models. Univariate analysis revealed that having a religious belief and gender were associated with all domains and total PTGI-J score. Age, time since patient death, and relationship to the patient showed significant differences with the domains of PTGI-J. Conclusion: Clinicians may be able to adjust the support they provide based on patients’ personal characteristics. Future research should look at the mechanisms of PTG by examining the role of rumination, social support, and emotional distress among bereaved family members of patients with cancer.

Objective The goal of this self-report study was to examine the relation of work variables, self-rated health and mental health status, and perceived social support to physician wellness, physician burnout, and quality of patient care. Methods We administered a demographics questionnaire, the Physician Wellness Inventory, the Maslach Burnout Inventory, and the Patient Care Scale to a random sample of full physician members of the American Academy of Family Physicians. We performed regression analyses on self-reported health status, work variables, and social support data as predictor variables and the subscales from the Physician Wellness Inventory, Maslach Burnout Inventory, and Patient Care Scale as the outcome variables. Results The response rate was 22%. Self-reported mental health status significantly predicted all of the wellness scales, the burnout scales, and the quality of patient care. The ability to manage the workload was the second strongest predictor of multiple scales. Conclusions More work should be done to explore the factors related to physicians' self-ratings of mental health status and what that means to them. Also, it is important to study whether self-rated mental health status is related to objective patient care quality measures.

This study evaluates the effect of a psychoeducational intervention about posttraumatic growth (PTG) among Japanese adolescents. Study 1 examined whether those who learned about changes related to stress would report higher growth than those who did not. Study 2 examined whether those who learned about PTG perceived more growth than those who learned about negative changes or those who did not learn about potential changes. Findings from both studies indicated that PTG was higher in those who received the intervention program than those who did not. These studies demonstrate the potential effectiveness of a psychoeducational intervention program in fostering adolescents’ perceptions and understanding of their personal growth following stressful experiences. Implications are that the knowledge about not only stress reactions or coping but the possibility of PTG can be integrated into the health education.

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.

Background Studies have indicated that the impact of a traumatic experience can be negative and can provide the opportunity to experience psychological growth, known as posttraumatic growth (PTG). Objective To evaluate the role of cognitive processing in PTG among parents of childhood cancer survivors (CCSs) based on the PTG theoretical model. We compared the model between parents of SCC and parents of children with chronic disease (CCDs) to determine how the role of cognitive processing in PTG is different depending on the children's illness. Methods Final sample consisted of 78 parents of CCSs and 44 parents of CCDs. The survey included standardized measurements assessing reexamination of core beliefs, intrusive and deliberate rumination, posttraumatic stress symptoms, and PTG. The hypothetical relationships among the variables were tested by covariance structure analysis. Results Posttraumatic growth among parents of CCSs had significantly strong association with reexamination of core beliefs, but not with deliberate rumination. Reexamination of core beliefs was significantly more likely to foster PTG among parents of CCSs, whereas deliberate rumination was significantly more likely to be associated with PTG among parents of CCDs. Conclusions For parents of CCSs, reexamination of core beliefs had a greater impact on PTG than deliberate rumination. Our results suggest that support should focus on the process of reexamining core beliefs in facilitating PTG among parents of CCSs. Implications for practice Nurses should provide parents of CCSs with reassurance regarding their experiences of the reexamination of core beliefs, which will likely lead to PTG.

Aim Depression is a heterogeneous disorder that has various subtypes. In Japan, however, a prevailing misunderstanding is that the term utsu-byo (clinical depression) indicates only the melancholic type. Consequently, a subtype called 'modern-type depression' (MTD), which has contrasting features to those of melancholic or traditional-type depression (TTD), is severely stigmatized in Japan these days. The present study conducted a cross-cultural comparison of perceptions of TTD and MTD between Japan and the USA to examine how the Japanese collectivistic culture contributes to negative biases toward MTD. Methods Undergraduate students in Japan (N = 303) and the Midwestern USA (N = 272) completed the survey. They read two vignettes that described the conditions of fictional individuals with either TTD or MTD, and then reported their perceptions of each vignette. Results Mixed analyses of variance revealed significant interactions between nation (Japan or the USA) and vignette (TTD or MTD) on most perception items. These interactions and subsequent analyses with Bonferroni corrections mainly indicate the following: (i) Japanese are more likely to suppose that conditions of MTD are milder compared with TTD; and (ii) Japanese are more likely to hold stronger aversive attitudes and weaker willingness to provide support toward people with MTD than toward those with TTD. Conclusion These results indicate that people with MTD are more likely to be accepted in the US independent culture than in the Japanese collectivistic culture. Discussion highlights that cultural diversity education potentially reduces stigma of MTD in Japan.