A dual-factor model of posttraumatic responses: Which is better, high posttraumatic growth or low symptoms?

Abstract

Objective: Experiencing traumatic events may invoke posttraumatic symptoms (PTS) or growth (PTG). Using a dual-factor approach inspired by the dual-factor model of mental health, we explore the intersections of posttraumatic symptoms and growth with 21 strengths and indicators of psychological, physical, and spiritual well-being. Method: A survey completed by 1,966 participants who had experienced at least one prior victimization (average age 29.8 [SD = 1.64]; 63.6% female) assessed strengths, outcomes, and victimization. Participants were classified into four posttraumatic groups: Resilient (low symptoms, high growth, 23.9%), Prevailed (high symptoms, high growth, 26.1% of sample), Detached (low symptoms, low growth, 20.3%), and Distressed (high symptoms, low growth, 29.8%). Results: Analyses of covariance (ANCOVAs) controlling for age, gender, and victimization found that posttraumatic group classification was associated with each regulatory, meaning-making, and interpersonal strength, and every well-being measure. The Distressed group scored the lowest and the Resilient group scored the highest on almost all measures. Notably, the Prevailed group scored above the Detached group on most measures, except for health-related quality of life and optimism, suggesting that high growth may be more beneficial than low symptoms when coping with trauma. Conclusions: Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. Clinical Impact StatementPromoting posttraumatic growth may be more important for supporting well-being after trauma than reducing posttraumatic symptoms.

The curvilinear relationships between posttraumatic growth and posttraumatic stress, depression, and anxiety.

“…However, Kleim and Ehlers did not examine the health and well-being of those survivors low in symptoms but high in PTG. In contrast, a study of interpersonal violence survivors found high PTG without symptoms was linked to increased psychological and physical well-being (Hamby et al, 2022). Therefore, although self-reported growth may be illusory at times, the illusory growth literature does not definitively explain why PTG occurs in the presence or absence of symptoms, or why patterns differ for the PTS–PTG relationship compared with PTG–depression/anxiety.…”

“…The meaning-making model and engine theories of PTG suggest that PTG typically occurs alongside symptoms early on, but once meaning-making occurs, survivors experience greater PTG and fewer symptoms (Joseph et al, 2012;Park & Blake, 2020;Tedeschi et al, 2018). This theory is further supported by research showing survivors high in both PTG and PTS have greater physical and psychological well-being than those low in both (Hamby et al, 2022). Although our findings do not contradict this explanation, our cross-sectional design was insufficient to examine whether individuals high in PTG but low in symptoms (a) never had clinically significant PTS/depression/anxiety symptoms or (b) recovered from these.…”

Race-based trauma and post-traumatic growth through identity transformation

“…Some manifestations of growth include more meaningful relationships, a greater appreciation for life, an increased sense of personal strength, deeper spirituality, and a recognition of new directions and goals for one’s life ( Calhoun and Tedeschi, 2004 , p. 95; Smith et al, 2019 , p. 4). Studies have shown that promoting PTG may be more important for supporting wellbeing after trauma than reducing post-traumatic symptoms ( Hamby et al, 2022 ).…”

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

“…According to PTG theory, experiencing an adverse event as traumatic, as occurs in PTS, is crucial for triggering positive personal changes, since PTG is initiated by the same cognitive-affective processing that leads to PTS following a traumatic event ( Tedeschi & Calhoun, 2004 ). Nevertheless, there are mixed results on the relationship between PTS and PTG ( Hamby, Taylor, Segura, & Weber, 2021 ), with some meta-analyses reporting a positive linear relationship between them ( Liu, Wang, Li, Gong, & Liu, 2017 ; Schubert, Schmidt, & Rosner, 2016 ), but also a stronger a curvilinear link ( Shakespeare-Finch & Lurie-Beck, 2014 ).…”