Study Suggests High Rates of Post-Traumatic Growth among Veterans with PTSD
Post-traumatic growth (PTG) is defined as positive, meaningful psychological changes that an individual can experience as a result of struggling with traumatic and stressful life events. Veterans are an ideal group in which to study PTG given their relatively high rate of exposure to potentially traumatic events; public concern for their health and well-being, including prevalence of PTSD; and ongoing efforts to prepare soldiers for trauma in the military and to facilitate pathways for PTG after discharge. Therefore, this study sought to: 1) Evaluate the prevalence of PTG in a large, nationally representative sample of U.S. veterans; 2) Examine the relation between PTSD symptoms and PTG; 3) Assess the functional significance of PTG; 4) Explore types of traumas that are independently related to PTG; and 5) Characterize how a comprehensive set of sociodemographic, military (e.g., years served, combat exposure), medical, and psychosocial factors relate to PTG in this population. Investigators used data from the National Health and Resilience in Veterans Study (NHRVS), conducted from October to December 2011. Although data from the full NHRVS sample was used (n=3,157), analyses related to PTG were limited to the 2,719 Veterans who reported at least one potentially traumatic event and completed the PTGI-SF (short form of the Post-traumatic Growth Inventory).
- Post-traumatic growth is prevalent among Veterans, particularly for those with PTSD: 50% of all Veterans and 72% of Veterans who screened positive for PTSD reported at least moderate PTG in relation to their worst traumatic event. The "worst" traumatic event found to be most strongly associated with PTG was a life-threatening illness or injury.
- Among Veterans with PTSD, those with PTG reported better mental functioning and general health than those without PTG. Veterans who reported a moderate level of PTSD symptoms reported the greatest levels of PTG, compared to those with minimal or severe symptoms.
- Greater social support, purpose in life, and intrinsic religiosity were all independently associated with PTG, suggesting clinical interventions designed to promote these factors may help foster psychological growth from trauma among symptomatic Veterans.
- The cross-sectional design of this study precludes any conclusions regarding temporal associations between individual characteristics associated with PTG.
- Study measures relied on retrospective report, which may be susceptible to various biases, and all assessments were self-report.
This study highlights the potential positive side of trauma and possible intervention targets for veterans with PTSD.
Dr. Tsai is an HSR&D Career Development Awardee and is part of the VA Connecticut Health Care System (West Haven).
Tsai J, El-Gabalawy R, Sledge W, et al. Post-traumatic Growth among Veterans in the United States: Results from the National Health and Resilience in Veterans Study. Psychological Medicine. January 2015;45(1):165-79.