Resilience as a mediator in the relationship between posttraumatic stress and posttraumatic growth among adult accident or crime victims: the moderated mediating effect of childhood trauma

Abstract

Background: Results on the association between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) are inconsistent, and there may be unknown factors mediating or moderating this relationship. Identifying these factors could help in developing an intervention strategy for promoting PTG. However, few studies have examined relationships among PTSS, resilience, and PTG concurrently, and no study has investigated the effect of childhood trauma on these relationships in adulthood. Objective: The aim of this study was to examine the moderated mediating effect of childhood trauma on resilience and its associations with PTSS and PTG in adult victims of traumatic accidents or crimes. We hypothesized that resilience would mediate relationships between PTSS and PTG and that its mediating effects would differ depending on childhood trauma. Methods: We included adult victims of accidents or crimes referred to a university hospital or specialized support centre (n = 143). PTSS, resilience, childhood trauma, and PTG were measured with the following questionnaires: PTSD Checklist for DSM-5, Connor-Davidson Resilience Scale, Adverse Childhood Experiences Questionnaire, and the Short Form of the Posttraumatic Growth Inventory, respectively. Results: The effect of PTSS on PTG was found to be fully mediated by resilience, and this mediating effect was moderated according to childhood trauma: the more childhood traumatic experiences, the greater the mediating effect of resilience was between PTSS and PTG. The effect of resilience on PTG was highest in the high childhood trauma group. Conclusion: Therapists treating individuals with psychological trauma should attempt to identify a history of childhood trauma and to evaluate resilience. Therapeutic approaches tailored according thereto may improve PTG among individuals with PTSS symptoms, especially those with high levels of childhood trauma.

Thinking about My Existence during COVID-19, I Feel Anxiety and Awe—The Mediating Role of Existential Anxiety and Life Satisfaction on the Relationship between PTSD Symptoms and Post-Traumatic Growth

“…Additionally, the relationship between life satisfaction and post-traumatic growth is moderated by the severity of traumatic symptoms. Our also study confirmed previous findings which indicated that the association between PTSD and PTG may be a curvilinear relationship (a U association) [ 26 , 36 , 37 ]. However, in our study the U association was not inverse.…”

“…The authors explained this relationship in two ways (1) PTG occurs when the trauma has been upsetting enough for person to promote engagement in a positive outlook about the event, but not too overwhelming for survivors to handle; (2) PTG and PTSD have a shared psychological ‘engine’ that sets them in motion, and PTG reflect a cognitive adaptation process among those who experience post-traumatic stress disorders in response to their disaster (a positive reinterpretation). Our findings may be also the results of factors that were not controlled in our study; however, they may modify the relationship between PTSD and PTG—e.g., personality characteristics and maladaptive coping strategies [ 49 ], resilience [ 26 ], and unsupportive social network [ 50 ], time passing after traumatic event [ 51 ].…”

“…The four core post-traumatic stress symptoms disorder (PTSD) are defined by the American Psychological Association (APA) (2013) as intrusion, negative alterations in mood and cognition, avoidance of trauma-related stimuli, and hyperarousal. PTSD results in extreme distress and functional impairment, and as a long-term consequence it causes poor quality of life and lower level of life satisfaction, serious health problems, e.g., depression, chronic physical conditions (such as back and neck pain, headaches, heart disease, or stroke) [ 24 , 25 , 26 ]. However, trauma may also be connected with positive consequences and change for the better.…”

“…Recently, it was found that the relationship between PTSD symptoms and PTGI may differ in order of the severity of the traumatic experience or the category of traumatic event (bereavement, physical assault, and rape) [ 38 ] or time after trauma experience with increased PTG during the first 18 months and stable level after this time [ 39 ]. Additionally, some authors suggest that the above-mentioned relationship may be mediated or moderated by other psychological constructs—e.g., the effect of PTSD symptoms on PTG was fully mediated by resilience—and this mediating effect was also moderated by childhood trauma (the more childhood traumatic experiences, the greater the mediating effect of resilience) [ 26 ] or socio-demographic characteristics—e.g., women reporting more posttraumatic growth than men as the mean age increases [ 40 ].…”

Peer victimisation during adolescence and its impact on wellbeing in adulthood: a prospective cohort study

“…This adjustment is not necessarily a direct result of the adverse event, nor does it revolve around a significant transformation of the individual [27]. Posttraumatic growth and resilience can thus be viewed as related, but distinct concepts, with evidence to suggest that resilience may moderate the likelihood of posttraumatic growth following trauma [28]. Identifying factors that bolster resilience could thus prove key to cultivating further positive outcomes.…”