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Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study

Published online by Cambridge University Press:  02 June 2014

J. Tsai ,
R. El-Gabalawy ,
W. H. Sledge ,
S. M. Southwick  and
R. H. Pietrzak
J. Tsai*
Affiliation:
United States Department of Veterans Affairs, New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
R. El-Gabalawy
Affiliation:
Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
W. H. Sledge
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
S. M. Southwick
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven, CT, USA
R. H. Pietrzak
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven, CT, USA
*
*Address for correspondence: J. Tsai, Ph.D., 950 Campbell Avenue, 151D, West Haven, CT 06516, USA. (Email: Jack.Tsai@yale.edu)
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Abstract

Background

There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking.

Method

Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form.

Results

We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least ‘moderate’ PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG.

Conclusions

PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a ‘positive legacy’ of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.

Keywords

Coping behaviorpost-traumatic stress disorderspiritualityveterans
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 165 - 179
Copyright
Copyright © Cambridge University Press 2014 

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