Section VII Home

Behavioral Emergencies Update

Volume 3, Issue 2
Spring 2002
Section on Clinical Emergenices and Crises
American Psychological Assn.
Section VII Contact Info

In this issue...

Posttraumatic Growth and Crisis (DeBrule & Range)

Integrated Assessment (Hillbrand)

Suicidal Patient Age and Critical Risk Factors (Bongar)


Section VII 2002 APA Convention Program

Task Force Update

Section VII Considerations

Minutes from the Section VII Business Meeting


Publication Highlights

Special Offer for Section VII Members

Extras

 

Posttraumatic Growth and Crisis:
Positive Change in the Aftermath of Trauma
Daniel DeBrule & Lillian Range
University of Southern Mississippi

The Silver Lining Crisis

Just as the Chinese use the same written character to indicate crisis as well as opportunity, an emerging body of literature suggests that the sequelae of crisis may include self-enhancement that leaves the individual feeling stronger and more developed. Posttraumatic growth (PTG) is the tendency of survivors of crises to later report increased functioning and positive change after enduring a trauma (Tedeschi & Calhoun, 1996), and may include changes in personal strength, spirituality, relationships with others, and/or ability to appreciate life. Though many instances of PTG have been found in survivors of traumas such as cancer, spousal bereavement, natural disaster, and combat (Schaefer & Moos, 1998), there have also been reports of PTG after individuals have suffered crises relevant to Section VII such as rape and violent victimization (Burt & Katz, 1987).

Some background conditions are either necessary or helpful in fostering growth following a traumatic experience. One, time must pass. A minority of individuals may experience some forms of PTG months after a crisis, but most have reported PTG at least a year or two or even decades after a crisis has occurred (Calhoun & Tedeschi, 1998). Two, the person must resolve the emotional and psychological damage of this crisis and derive meaning from the event. Crisis often damages or destroys the person’s cognitive world, so the individual must restore devastated assumptions and rebuild cognitive schemata (Janoff-Bulman, 1992). Three, activities such as focused rumination, writing a life narrative, and developing a new self-identity based on overcoming the trauma, may lead one to positive change after a crisis (Calhoun & Tedeschi, 1998). Thus, passage of time and resolution of the consequences of trauma are required for PTG to occur, and certain activities may facilitate PTG.

Researchers have measured posttraumatic growth with two instruments. The Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996) consists of 21 items on a
6-point Likert scale, grouped into five factors: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. The Stress Related Growth Scale (SRGS; Park, Cohen, & Murch, 1996) consists of 50 items on a 3-point Likert scale, but yields only a total score. A 15-item short form of the SRGS is also available. PTG can also be measured qualitatively, through use of unstructured interviews, documents, and observation (Cohen, Hettler, & Pane, 1998).

Evidence of posttraumatic growth following a crisis has been mixed. For example, some victims of rape report the benefit of valuing themselves more, but show no change in interpersonal skills or useful behaviors (Burt & Katz, 1987). Outcomes in other studies of those raped or victimized indicate that interpersonal relationships may become more difficult after suffering an assault, as they tend to feel hostile, resentful, and vulnerable towards others (Aldwin & Sutton, 1998). Unfortunately, no study has fully evaluated the possibility of PTG occurring in individuals who have survived a suicide attempt. Though research suggests that rape victims tend to experience a limited amount of PTG, especially in personal strength, more research is merited on positive change following a potential suicide.

Though research on posttraumatic growth is in its infancy, posttraumatic growth may occur in those who suffer a crisis. Individuals who claim that life is unbearable or horrible during a crisis may find that their level of life satisfaction increases as they resolve the crisis. Clinicians can help facilitate PTG, as positive growth may become a goal for therapy after a crisis, in addition to stabilization and restoration of healthy functioning. Those who experience the personal and spiritual trauma of crisis may find that they, like the Phoenix, rise from their struggle to become a stronger, more complete creature, able to aspire to psychological heights that were previously unreachable.

 

References

Aldwin, C. M. & Sutton, K. J. (1998). A developmental perspective on posttraumatic growth. In R. Tedeschi & L. Calhoun (Eds.) Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (pp. 43-62). Mahwah, NJ: Lawrence Earlbaum Associates.

Burt, M. R., & Katz, B. L. (1987). Dimensions of recovery from rape: Focus on growth outcomes. Journal of Interpersonal Violence, 2, 57-81.

Calhoun, L. G., & Tedeschi, R. G. (1998). Posttraumatic Growth: Future Directions. In R. Tedeschi & L. Calhoun (Eds.) Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (pp. 215-240). Mahwah, NJ: Lawrence Earlbaum Associates.

Cohen, L. H., Hettler, T. R., & Pane, N. (1998). Assessment of Posttraumatic Growth. In R. Tedeschi & L. Calhoun (Eds.) Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (pp. 23-42). Mahwah, NJ: Lawrence Earlbaum Associates.

Janoff-Bulman, R. (1992). Shattered Assumptions. New York: The Free Press.
Park, C. L., Cohen, L. H., & Murch, R. (1996). Assessment and prediction of stress related growth. Journal of Personality, 64, 71-105.

Tedeschi, R. G. & Calhoun, L. G. (1996). “The Posttraumatic Growth Inventory: Measuring the Positive Legacy of Trauma” Journal of Traumatic Stress, 9, 455-471.

Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (1998) Posttraumatic Growth: Conceptual Issues. In R. Tedeschi & L. Calhoun (Eds.) Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (pp. 1-22). Mahwah, NJ: Lawrence Earlbaum Associates.

Tennen, H. & Affleck, G. (1998). Personality and Transformation in the Face of Adversity. In R. Tedeschi & L. Calhoun (Eds.) Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (pp. 65-98). Mahwah, NJ: Lawrence Earlbaum Associates.