Post-traumatic Growth

POST-TRAUMATIC GROWTH AFTER PICU

Background

The literature on psychological trauma has traditionally focused on pathological reactions after crisis. Recently however there has been an increasing acknowledgement that, as well as distress, traumatic experiences can bring about perceived benefit as well as distress in the affected individual, with some writers proposing that through struggling with adversity, a traumatised person may ultimately attain a higher level of functioning than they had previously possessed A recent review of 39 studies addressing this phenomenon - referred to as post-traumatic growth - has demonstrated its applicability in the aftermath a wide variety of natural, man-made and medical disasters and in a number of different cultures1.

Research to date on parents

  • Analysis of qualitative information from a study of 50 mothers and fathers, interviewed 8 months after their child’s discharge from PICU, showed that many parents reported positive as well as negative changes as a result of their experience. Specifically they described feeling closer to their child and being clearer about their priorities in life2
  • In a subsequent study following 133 parents up at 4 months, a formal measure of posttraumatic growth (Post Traumatic Growth Inventory3) was used to examine this phenomenon more systematically over 80% of parents endorsed at least one item as having changed markedly for the better, as a result of their crisis4
  • However, those with high post-traumatic growth scores tended also to report higher post-traumatic stress, anxiety and depression, ie being able to appreciate positive aspects of their experience did not in itself protect parents from negative psychological consequences 4

Research to date on children

  •  Preliminary evidence in a case series of 15 children, showed that children were significantly less fearful than age/sex matched peers following their traumatic experiences 5 .This could be evidence of posttraumatic growth in children, which has been reported in adolescents after cancer6 and in children after road accidents7
  • In a subsequent larger study of 102 children, when asked if they felt they had changed as a result of their experience of being critically ill, a significant proportion of children described positive changes8

Ideas for future research

It may be that if patients and /or parents are encouraged to look for ways to reframe their experience with more of a focus on the positive, that they would be less likely to suffer long term negative psychological consequences.  Intervention research could examine this.

References

  1. Linley & Joseph 2004
  2. Colville et al (2009)
  3. Tedeschi and Calhoun (1996)
  4. Colville and Cream (2009) See also 'Post-traumatic growth in mothers after Intensive Care' (European Society of Traumatic Stress Studies, Stockholm 2005) ppt/handout 
  5. Colville G (2008)
  6. Barakat et al (2006)  
  7. Salter & Stallard (2004)
  8. See 'Think Positive!: reflections on the application of the concept of post-traumatic growth' presented at Paediatric Psychology Network Annual Meeting, Oxford 2005 ppt/handout

 

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