Personal transformation in chronic physical disease: Conceptual limitations of the posttraumatic growth construct

This quantitative-qualitative case study focuses on processes of personal transformation in chronic physical disease in order to further our understanding of the posttraumatic growth construct. Semistructured interviews were conducted with women suffering from Systemic Lupus Erythematosus. The validity of the posttraumatic growth construct is assessed comparing results obtained by a standardized measure (Posttraumatic Growth Inventory) to individual pictorial and verbal depictions of personal transformation processes. Detailed examinations of three cases evidenced the validity of subjective appraisals of posttraumatic growth. Also, the Posttraumatic Growth Inventory covered all facets of positive growth processes as portrayed by individual depictions. However, the concept of posttraumatic growth neglects negatively evaluated processes of personal transformation. The consequences of this conceptual bias are discussed with respect to clinical care as well as contradictory results seen in empirical research. Posttraumatic loss and destruction is suggested as a second dimension for the representation of personal transformation in chronic physical disease.