The experience of being diagnosed with and treated for cancer is an extremely stressful experience for most individuals. Historically, the literature on stress and coping has focused on negative outcomes, such as depression and anxiety, in relation to one‘s experience with cancer. Under-represented in the literature has been a theoretical framework that examines positive and transformative experiences that may occur throughout the cancer experience. The current study assessed interpersonal variables that rarely have been investigated in relation to one‘s experience with cancer (i.e., received social support and unsupportive interactions) and their association with depressive symptoms, positive emotion, and posttraumatic growth in a sample of men and women recently diagnosed with cancer. The main research design was cross-sectional (although longitudinal analyses were conducted on an exploratory basis), and self-report data were collected from 60 participants who had been diagnosed with cancer on average 5.68 months prior to data collection. Contrary to hypotheses, hierarchical regression equations indicated that received social support was not related to any of the outcome variables. However, unsupportive responses from a main support person were found to be significantly and positively related to participants‘ reports of depressive symptoms and posttraumatic growth within the context of their cancer experience. A major contribution of the present study is that it called attention to the importance of studying unsupportive interactions separately from social support. Moreover, this is the first study to investigate the relationship between unsupportive interactions and posttraumatic growth in a sample of recently diagnosed cancer patients. Findings were surprising in that the more unsupportive responses individuals with cancer received from a main support person, the more personal growth they reported. The results from the present study have important research and clinical implications for understanding the relationship between unsupportive interactions and posttraumatic growth among men and women who have been diagnosed with cancer.

Background: Current literature on caregivers of children with chronic illnesses and developmental disabilities primarily focuses on negative aspects of adjustment, with maternal stress and depression as common outcome variables (Duvdevany & Abboud, 2003; Shin and Crittenden, 2003). While these pediatric caregivers have been shown to struggle more than caregivers of typically developing children, the possibility of positive psychological outcomes from such an experience is only beginning to be explored (Kim, Greenberg, Seltzer & Krauss, 2003; Scallan, Senior & Reilly, 2010). One such positive outcome is the idea of Posttraumatic Growth (PTG), a construct for which a widely accepted theoretical model exists (Tedeschi & Calhoun, 2004). This model has yet to be empirically validated and fails to provide an exhaustive picture of PTG. The current study aims to document this phenomenon among caregivers of children with Williams, empirically evaluate a portion of the proposed theoretical model, and explore possible extensions of the model in the form of health behaviors. Methods: Participants included 104 primary caregivers of children with Williams syndrome who were recruited through the Williams Syndrome Association List serve. Caregivers completed an online survey through SurveyMonkey software that included the posttraumatic growth inventory, the deliberate rumination scale, the MOS social support survey, and the taking care of yourself questionnaire. Results: The vast majority of caregivers reported some degree of growth following a diagnosis of Williams syndrome (M =55.91, SD =22.63), consistent with reports of other pediatric caregivers (Polantinsky & Esprey, 2000). Further, perceived social support was found to predict posttraumatic growth, F(2,73) = 2.488, p=.029, consistent with model predictions. However, perceived social support was not predictive of an increase in deliberate rumination, F(2,72) = 0.143, p=.867, failing to support the mediational model. Finally, posttraumatic growth was not found to predict health behaviors, although those caregivers who reported more posttraumatic growth also reported being less bothered by sleep-related caregiving burdens. Conclusion: Posttraumatic growth is prevalent among Williams syndrome caregivers, indicating the need for future research in facilitating this process among pediatric caregivers and patients alike. Further, a better understanding of the cognitive constructs involved in the posttraumatic growth process is essential. This improved understanding will facilitate more accurate measurement tools for evaluating these cognitive processes along with additional clarity with regards to the theoretical model. Finally, the identification of health behaviors and health belief constructs that are impacted by posttraumatic growth would improve the depth of the theoretical model and improve overall understanding of the construct.

This diploma thesis is focusing on the posttraumatic growth in professional fire fighters. The theoretical part deals with models of the posttraumatic growth and factors which affect this process. Another constituent of the work is a treatise about psychological aspects of the fire fighter job execution. One section of the work, the empirical section, is based on the Czech version of a questionnaire method called "Posttraumatic Growth Inventory ". It is a questionnaire that discovers the level of achieved posttraumatic growth in 5 areas; personal strength, new possibilities, relating to others, appreciation of life and spiritual change. The research sample that consisted of 100 professional firemen verified the relationship between the posttraumatic growth and other aspects of respondents' lives. The research showed following discovery. The marital status, the fact if the respondent has a family, the time which passed since experiencing a difficult incident, the subjectively perceived intensity of an event, the level of distress, psychological well-being, behaviour of type A, cognitive resilience of an individual, strategy of bearing the burden of "negative view", "the concentration on a problem" and "the mineralization of threats" is not connected with the grade of obtained posttraumatic growth....

Societal discourses and rigid gender norms, tenaciously reinforced by media representations, prevent men from being recognized as survivors of sexual violence (Gulas, McKeage, & Weinberger, 2010; Heber, 2017). Consequently, research on the ability of male survivors of sexual violence to acquire positive characteristics as a result of their victimization, termed posttraumatic growth (PTG), is limited (Tedeschi & Calhoun, 2004a). This thesis assesses the experience of PTG for male survivors of sexual violence, specifically analyzing the role of gender norms, coping styles, and service access in the production, or lack thereof, of PTG. Through the concepts of gender norms and coping, the experience of PTG for male survivors is contextualized, providing insight into how these forces individually and collectively facilitate or hinder the experience of PTG. A qualitative comparative analysis is conducted in order to establish a configuration of causal factors that are associated with the presence and absence of PTG for male survivors (N=9). Only one of the five hypotheses this thesis tests are supported; high stability (no interruption) of service access is associated with PTG. This thesis argues that the use of coping styles and service access is intertwined with conflicts between their gender and victimization, where male survivors utilize certain forms of coping or services depending on the degree to which they need to regain feelings of control.

The objective of this study is to undertake research regarding Posttraumatic Growth and its relationship with Sense of Coherence, within the South African context. In addition, the associations between the three domains of SOC, in particular Meaningfulness, and the five domains of PTG, will be investigated. A further aim of this study is to explore whether the relationship between posttraumatic stress symptoms and Posttraumatic Growth is moderated by Meaningfulness. Sample: The sample consisted of tertiary education students, 18 years and older, and who have experienced a traumatic event as defined by the Traumatic Stress Schedule (N=79). Measures: In addition to a demographic questionnaire, the following measures were administered: the Sense of Coherence Scale (SOC), the Posttraumatic Growth Inventory (PTGI), the Impact of Event Scale - Revised (IES-R), and the Traumatic Stress Schedule (TSS). Results: Participants reported moderate scores on overall PTG with lower SOC scores relative to similar samples in the literature. Age was found to be associated with PTG, and PTG was associated with subjective distress as measured by the IES-R. In addition, those reporting PTG, particularly in the areas of Relating to Others, New Possibilities and Appreciation of Life, evidenced lower levels of Comprehensibility, and those low on Comprehensibility tended to report higher levels of subjective distress. High levels of subjective distress also appeared to be associated with lower levels of Manageability. Findings further suggested that participants who had been exposed to multiple traumas, as well as those who reported higher subjective distress, generally evidenced lower SOC. Multiple trauma exposures were strongly associated with increased subjective distress. Implications of the findings and recommendations for future research are discussed.

Thesis advisor: Belle Liang / The study of treatments for complex posttraumatic stress disorder (CPTSD), especially in cases of chronic childhood abuse, has revealed that traditional trauma treatments often lack success due to the complexity of symptom presentation. CPTSD often manifests as a lack of integration between the self and the body. While certain coping strategies used by survivors during the trauma experiences, such as dissociation, may be adaptive in the short-term, prolonged use posttrauma comes at a cost--resulting in a loss of awareness of one's emotional and physical being in the present moment. Mindfulness-based interventions, such as hatha yoga, show promise as alternative or complementary treatments for CPTSD. Furthermore, current trauma treatments have been criticized for their primary focus on psychopathology. More recent conceptualizations of trauma recovery call for a paradigm shift that recognizes not only the need for symptom-reduction, but also the encouragement of positive development and personal growth (i.e., stronger sense of self, relationships with others, and perspective on life). This qualitative study explored the experiences of women with CPTSD in a 10-week, trauma-informed hatha yoga class, specifically examining perceived changes with regard to symptom reduction and personal growth. Six themes were identified through qualitative content analysis. Theme 1 describes the yoga practice and study design characteristics that influenced participants' experiences. Themes 2 through 6 reflect participants' increased feelings of Gratitude and compassion, Relatedness, Acceptance, Centeredness, and Empowerment (referred to as G.R.A.C.E. themes). Findings are discussed in the context of current literature. Limitations of the study are also presented along with recommendations for future research and clinical work. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

Suicide rates are higher in veterans than civilians, perhaps due to increased trauma exposure (e.g., sexual trauma, combat). However, not all veterans who experience trauma are at increased risk for suicidal behavior as some may experience an increased sense of purpose and meaning in life via posttraumatic growth (PTG). PTG, conceptualized as a positive transformation following trauma that results in improved function, may involve changes in cognitive-emotional processing, including increased feelings of connectedness and perceptions of value and contribution contributing to the well-being of others, as well as beneficial shifts in mood. The interpersonal theory of suicide posits that individuals who feel isolated (thwarted belongingness; TB), or like a burden (perceived burdensomeness; PB) are at increased risk for depression and suicidal ideation and attempts. Veterans who experience PTG after trauma may experience a beneficial shift in perceptions related to interpersonal needs (e.g., feel more connected, feel like less of a burden), with consequent benefits to mood and suicide risk. This premise has not been previously examined; therefore, we assessed the serial mediating effects of thwarted interpersonal needs (i.e., TB and PB, in separate models) and depression on the link between PTG and suicidal behavior. Participants (N=545; 70.1% male (n=382); 86.4% Caucasian (n=469), Mean Age=49.86, SD=16.78) were community-dwelling veterans, who completed the Posttraumatic Growth Inventory, Interpersonal Needs Questionnaire, Multidimensional Health Profile, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and serial mediation analyses were conducted covarying age, sex, and ethnicity. Serial mediation analyses supported hypotheses (10,000 bootstrapped samples); the total indirect effect of PTG on suicidal behaviors was significant when thwarted belongingness (IE= -.024, SE= .005, CI= -.036 to -.015) and perceived burdensomeness (IE= -.024, SE= .006, CI= -.036 to -.014), along with depression, were examined as serial mediators. Specific indirect effects of PTG on suicidal behaviors were also significant through thwarted belongingness (IE= -.015, SE= .005, CI= -.026 to -.008) in the first model and perceived burdensomeness (IE= -.016, SE= -.005, CI= -.027 to -.008) in the second model; however, there were no specific indirect effects observed through depressive symptoms in either model. Our results suggest that the relation between PTG and reduced suicidal behavior may be due to serial, adaptive shifts in cognitive-emotional processing related to interpersonal functioning and mood which, in turn, beneficially impact mood and suicide risk. Of note, there were no significant specific indirect effects with depressive symptoms. This pattern elucidates a potential mechanism between PTG and suicidal behavior, highlighting that the process of PTG does not, initially, involve a reduction of depressive symptoms but, rather, an improvement in perceptions regarding social connectedness and social self-value that has a cascading effect on mental health functioning. Our findings may have clinical implications. Cognitive reframing of traumatic events (e.g., via Cognitive Processing Therapy) and bolstering relationships and the perception of one’s value in a social network (e.g., via Interpersonal Therapy) may reduce depression and suicide risk in veterans.

Prevalence of PTSD is higher in veterans compared to the general population, with between 12 and 31% of veterans, across combat eras, developing PTSD during their lifetime, compared to 7-8% of civilians, perhaps as a result of military-related experiences (e.g., combat, sexual trauma). Such experiences contribute to the detrimental cognitive-emotional processes, including shame and guilt, which precipitate and maintain post-traumatic stress disorder. Yet, some persons experiencing trauma also experience post-traumatic growth as a result, exhibiting resiliency and, in some cases, even thriving. The mechanism of action for post-traumatic growth (PTG), which is conceptualized as a positive change following trauma (i.e., finding purpose and meaning in life), is unknown, but may involve adaptive schema restructuring (e.g., temporal shifts). Specifically, PTG may involve changes to time-perspective, or the tendency for a person to consider their life as a function of, or in the context of, the past (e.g., past trauma, nostalgia), present (e.g., positive/negative) or future (e.g., goals). The ability, for instance, to temporally transcend the past or present and focus on a more-adaptive future, may contribute to a reduction in the ruminative processes so often involved in shame and guilt, whereas maladaptive temporal views (e.g., negative past and present) may exacerbate guilt and shame. However, this premise has not been tested. We hypothesized that time perspective would mediate the association between PTG and shame/guilt, such that higher levels of PTG would be associated with higher levels of adaptive temporality/lower levels of maladaptive temporality and, in turn, to lower /higher levels of shame and guilt. Participants (N=545; 70.1% male (n=382); 86.4% Caucasian (n=469), Mean Age=49.86, SD=16.78) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the PTG Inventory, Zimbardo Time Perspective Inventory, and Differential Emotions Scale-IV. Bivariate correlations and simple mediation analyses were conducted covarying age, sex, ethnicity, VHA usage, and service era. Supporting hypotheses, in simple mediation analyses (10000 bootstrapped samples), the direct effect of PTG on shame (DE=-.0134, SE=.0098, p=.1720, IE 95% CI=-.0327 to .0059) and guilt (DE=-.0085, SE=.0100, p=.3919, IE 95% CI=-.0281 to .0110) was reduced, and fell out of significance, when future time perspective was added as a mediator, indicating full mediation. The direct effects of PTG on shame and guilt were reduced, but remained significant, when present hedonistic, present fatalistic, past negative, and past positive were added as mediators, indicating partial mediation. Our results suggest that the relation between posttraumatic growth and shame/guilt may be due, in part, to changes in cognitive-emotional processing related to temporality. The PTG process may involve adaptive shifts in time perspective that, in turn, beneficially impact negative emotions associated with trauma exposure. Our findings may have clinical implications. Promotion of acceptance and meaning (e.g., via Acceptance and Commitment Therapy) to foster posttraumatic growth, and encouraging temporal holism (e.g., Cognitive Processing Therapy, Time Perspective Therapy), may reduce shame and guilt associated with trauma in the veteran population.

Suicide rates are higher in veterans compared to the general population, making up a disproportionate 22% of suicides reported annually in the U.S. One factor related to suicidal behavior among veterans is increased exposure to traumatic events. However, not all traumatized veterans engage in suicidal behavior, perhaps due to the presence of protective factors. One such factor, forgiveness (of self, others, and by God), conceptualized as a positive change in cognition, emotion, and behavior, toward a transgressor or transgression, may buffer against suicide risk by facilitating a “letting go” of experienced offenses, and by allowing individuals to respond to trauma in a meaningful way via posttraumatic growth (PTG). This premise has not been tested, however. We hypothesized that forgiveness and PTG would be positively related with each other, and negatively related to suicidal behaviors. We also hypothesized that PTG would mediate the association between forgiveness and suicidal behaviors, such that higher levels of forgiveness would be associated with greater PTG and, in turn, to less suicidal behavior. Participants (N=545; 70.1% male (n=382); 86.4% Caucasian (n=469), Mean Age=49.86, SD=16.78) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the PTG Inventory, the forgiveness subscale from the Fetzer Multidimensional Measure of Religiousness and Spirituality, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and simple mediation analyses were conducted covarying age, sex, and ethnicity. Supporting bivariate hypotheses (p-values

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