The role of rumination in posttraumatic stress disorder and posttraumatic growth among adolescents after the wenchuan earthquake

Abstract

Three hundred and seventy-six middle school students in Wenchuan County were assessed three and one-half years after the Wenchuan earthquake to examine the effects of rumination on posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). The results revealed that recent intrusive ruminations partly mediated the relationship between intrusive rumination soon after the earthquake with PTSD but not with PTG. Recent deliberate rumination partly mediated the relationship between intrusive rumination soon after the earthquake and PTG but not PTSD. Moreover, recent deliberate rumination also partly mediated the relationship between recent intrusive rumination with PTG but not with PTSD. Overall, intrusive rumination soon after the earthquake had an effect on PTSD but not on PTG through recent intrusive rumination and affected PTG but not PTSD through deliberate recent rumination. Furthermore, intrusive rumination soon after the earthquake affected PTG but not PTSD by recent deliberate rumination following recent intrusive rumination. More importantly, the present study also found that PTSD exhibited no relation to PTG. These results suggest that PTSD and PTG are influenced by different mechanisms, which further indicates that PTSD and PTG represent two separate dimensions of experience after adversity.

The relationship between rumination, posttraumatic stress disorder, and posttraumatic growth among Chinese adolescents after earthquake: A longitudinal study

“…Another interesting finding of this study was that intrusive rumination at T1 affect PTSD via intrusive rumination at T2 through deliberate rumination at T2, which are inconsistent with previous studies (Wu et al, 2015;Zhou et al, 2015b). A potential explanation may be difference on study design.…”

“…More importantly, the results also showed that intrusive rumination at T1 had a significantly positive effect on PTSD at T3 by intrusive rumination at T2, which parallels the supposition from Michl et al (2013). It also indicated that if an adolescent's cognitive discrepancy in basic perceptions of personal worth, trust in others, and justice or predictability in the world, between pre-trauma and post-trauma cannot be resolved, the individual might continue to ruminate about it (Wu et al, 2015). As a result, traumatic survivors could focus on the negative aspect of traumatic clues, reduce the capacity to disengage attention from negative emotional information (Joormann, 2006), and encounter difficulties in generating good solutions to problems (Ward et al, 2003;Watkins and Moulds, 2005), which may also result in maintaining or worsening some symptoms of PTSD.…”

“…Wu et al (2015) also found that intrusive rumination soon after Wenchuan earthquake have a positive effect on continued intrusive rumination, and it also results in deliberate rumination. It is likely that baseline intrusive rumination can predict latter intrusive and deliberate rumination, and in turn results in posttraumatic psychological reactions.…”

“…However, because of the limitations of cross-sectional design, previous studies do not indicate causality or a temporal sequence. Furthermore, previous studies found that the predictors for PTSD and PTG are different, then it can be concluded that the pathways to PTSD and PTG are different (Wu et al, 2015;Zhou et al, 2015b). Although this conclusion may be helpful for us to understand the difference on predictors for PTSD and PTG, it is difficultly to find the difference on the developmental process of PTSD and PTG because there lack of longitudinal and developmental perspective.…”

“…More importantly, PTG and PTSD can coexist in individuals following traumatic experiences (Tedeschi and Calhoun, 1996;Zhou et al, 2015a), and thus, an important issue is to examine whether PTSD and PTG share influencing factors. Previous studies suggested that rumination may play an important role in the developmental process of PTSD and PTG (Calhoun and Tedeschi, 2006;JanoffBulman, 2006), and found different ruminations may have different effects on PTSD and PTG (Wu et al, 2015;Zhou et al, 2015b), but these studies are cross-sectional design and have a critical limitations on making the conclusion about casual relation. Therefore, the aim of this study was to extend previous study from a longitudinal perspective, and further examine the effects of different ruminations on PTSD and PTG in a long-time frame after Ya'an earthquake which occurred in Sichuan province of China on April 20th 2013.…”