Cognitive, coping, and trauma symptom predictors of posttraumatic growth (PTG; measured with the Posttraumatic Growth Inventory) were examined in a large convenience sample (n =1505) participating in a longitudinal Internet-based study following the terrorist attacks of 9/11/01. Results indicate that initial PTG levels (mean 9 weeks post-attacks) were generally associated with higher trauma symptoms (measured with the PTSD Checklist - Specific), positive changes in worldview (measured with the Changes in Outlook Questionnaire), more denial, and less behavioral disengagement (measured with the Brief COPE). Additionally, PTG had a curvilinear association with level of trauma symptoms, such that those reporting symptoms at intermediate levels reported the highest levels of growth. Levels of PTG declined somewhat over time with the exception of Spiritual Change. As expected, PTG levels at follow-up (mean 6.5 months post-attacks) were primarily predicted by initial PTG levels; however, decreases from baseline in trauma symptoms and increases from baseline in positive worldview, acceptance, and positive reframing were also associated with higher reported posttraumatic growth at follow-up. These findings suggest that there may be a range of traumatic experience most conducive to growth and they also highlight the important contributions of cognitive and coping variables to psychological thriving in short- and longer-term periods following traumatic experience.
Results suggest that specialized end-stage clinical interventions are particularly needed for cancer patients as they approach death. Moreover, intervention studies for patients with deteriorating illnesses may need to take this "spike" in psychological distress and pain proximal to death into account to avoid Type II errors in evaluations of psychological outcomes.
This study assessed a range of benefits from participation in a brief existential intervention consisting of a semi-structured videotaped interview with cancer patients and their families designed to illuminate a life legacy for the family (the Life Tape Project [LTP]). Results indicated the majority reported intervention-specific benefits, especially in the areas of symbolic immortality (passing on personal values and philosophy), self-reflection and growth, and improved family cohesion and communication. Participants, particularly those who had perceived their cancer as a threat of death, serious injury, or threat to their physical integrity, and responded with intense fear or helplessness, also reported more general reductions in mood disturbance, improvements in aspects of well-being (including overall quality of life), satisfaction with the understanding they received, and enhanced cancer-related posttraumatic growth. In short, the LTP is a brief, inexpensive, existential intervention that can yield broad positive psychosocial changes for a majority of participants.
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