Studies of posttraumatic growth are fundamentally flawed, researchers say.
German philosopher Friedrich Nietzsche is credited with the famous quote, “What does not kill me, makes me stronger.” There are many variations of this adage in literary, spiritual, and more lately, psychiatric sources.
According to psychological studies, at least half of survivors go on to grow more appreciative of life, forge greater bonds with others, and become emotionally stronger after surviving horrific events—a process known as “posttraumatic growth.”
Especially at this present and challenging time, the notion that bad things can frequently result in positive outcomes is tempting. Globally, COVID-19 has caused the deaths of more than 6.3 million individuals, and the number of fatalities is still rising.
However, many researchers referred to findings of posttraumatic growth as “mostly fictitious” in a series of presentations made in May in Chicago at the Association for Psychological Science meeting. These scholars claim that there are significant methodological problems with growth studies. That includes relying on surveys that ask respondents to evaluate their personal development over time, a task that the majority of people find challenging.
The issue might not be solved by using better research tools. The researchers claim that this is because these studies are fundamentally defective. They contend that a Western mentality that tends to prioritise good emotions and discount or even avoid negative emotions is the driving force behind the want to study trauma in terms of growth. This may put survivors under pressure to hide or repress their negative emotions, which could have negative effects.
Psychologists used to generally view a person’s inability to recover from stressful circumstances as a personal failure fifty years ago. However, studies on returning Vietnam War soldiers and other trauma survivors started to challenge that perspective. In its manual of mental diseases, the American Psychiatric Association classified posttraumatic stress disorder, or PTSD, in 1980. People who struggle with the disorder may have flashbacks, nightmares, and very high levels of anxiety.
The worst effects were everyone’s main concern thirty years ago, according to Columbia University‘s George Bonanno.
However, only around one-fifth of victims of trauma go on to acquire PTSD. Richard Tedeschi and Lawrence Calhoun, psychologists, said in the 1996 Journal of Traumatic Stress that an emphasis on suffering concealed the positive that might result from trauma in the mid-1990s.
The two created a “growth inventory,” which is now extensively used to evaluate good results that people reported after going through a stressful incident. The items fall under five main categories: interpersonal relationships, inner power, fresh opportunities, life appreciation, and spiritual change.
According to Tedeschi, who is currently chair of the Boulder Crest Institute for Posttraumatic Growth, an organisation in Bluemont, Virginia that uses posttraumatic growth research to assist combat veterans, first responders, and their families, posttraumatic growth is when you descend to the depths before eventually rising above that baseline into some other realm. However, several researchers soon started to doubt people’s capacity for providing truthful answers to the growth survey.
About 1,500 college students were enrolled in a now-classic 2009 study published in Psychological Science, and the researchers followed them for eight weeks. Students replied to surveys for each of the five growth categories covered by the growth inventory as well as a modified version of the inventory twice: once at the beginning of the study and once at the conclusion.
The five surveys and modified inventory, in contrast to Tedeschi and Calhoun’s inventory, requested respondents to consider the current rather than compare it to the past.
In those eight weeks, 122 students said they had gone through a terrible experience that left them in a lot of anguish. The standard growth inventory was also performed by those pupils at the conclusion of the eight-week period. High perceived growth ratings on the standard inventory did not correlate with real growth scores on the modified inventory or five well-being surveys, according to the researchers.
According to research co-author and clinical health psychologist Crystal Park of the University of Connecticut in Storrs, people are poor at recalling how they felt in the past, which is why there is this discrepancy.
According to Tedeschi, trauma separates a person’s life into a before and after, making it easier for many individuals to see changes over time. Additionally, he adds that progress requires time. People’s spiritual beliefs cannot be expected to change in just eight weeks, according to him. How long, though? How can one know that, once enough time has passed, the growth is due to the trauma and not some other significant life event, such as moving across the nation or having children?
According to Jayawickreme, research demonstrates that people struggle with introspection.
Jayawickreme and others claim that the original inventory’s design caused additional issues. The worst or lowest consequence a respondent might indicate is that they experienced no change as a result of their crises, for instance, given the inquiries only take into account positive developments. According to Jayawickreme, this framing puts pressure on survivors to indicate progress even when they could be feeling worse. The things are urging expansion.
A brand-new growth survey that takes adverse changes brought on by stress into consideration has just been created by Tedeschi and colleagues. However, compared to the original, it is not yet as frequently used in posttraumatic growth studies.
Adriel Boals, a trauma researcher at the University of North Texas in Denton, aimed to circumvent the growth bias of the initial survey in unpublished work. He questioned respondents about whether they changed as a result of a traumatic occurrence, as a result of their own growth, or otherwise.
Half of the respondents claim, “I changed despite this event,” according to Boals. This shows that individuals who may have shown growth on the initial assessment really credit such growth to other life experiences rather than the trauma.
In addition, the original growth inventory, according to Jayawickreme and others, requires respondents to complete four cognitive tasks as opposed to the typical psychological survey’s single cognitive task of “how are you doing now” or “reflect on the present.” Respondents need to think about how they are currently doing and how they were doing before the incident. They must then calculate the difference in well-being and establish if the trauma or another life event, such becoming older or having a kid, was the reason of the change.
However, people don’t actually follow those instructions. Boals, Park, and Elizabeth Griffith presented that discovery in March in Anxiety, Stress, and Coping and at the conference in May.
When the team examined reaction times between college students taking the regular growth inventory and students taking a streamlined version containing just one cognitive task, they discovered that the students conducting the standard inventory only took 8% longer than the other students. According to Boals, that only results in a half-second delay in response time for each item.
Beyond methodological details, some researchers who study trauma in other cultures are sceptical of some Western psychologists’ emphasis on personal development and, to a lesser extent, resilience, which is characterised by stability in the face of adversity rather than a sharp rise in wellbeing following a decline, as is the case with posttraumatic growth.
According to psychologists Iara Meili and Andreas Maercker from the University of Zurich, “resilience” and “posttraumatic growth” are metaphors that are frequently employed in Euro-American countries to describe good reactions to tremendous hardship. They blame individualistic countries’ emphasis on self-determination and agency, even in the face of disease or death, for the prevalence of these Western “metaphors.” Other cultures have these ideas, according to Maercker. But they rarely assume such enormous significance, which he refers to as taking a “almost religious approach.”
According to Jayawickreme, there might be great pressure on survivors to conceal their suffering due to societal expectations of growth.
“Self-reports of posttraumatic growth should be highly correlated with doing well on other measurements, like less depression, more satisfaction with life, those types of things,” says Boals, who was not involved with this research. “But if anything, [growth] is positively correlated with PTSD symptoms.”
Consider a study where results were compared among 380 or more Norwegian soldiers who were deployed to Iraq in 2004. Five months after returning home, soldiers who claimed the greatest personal improvement also had the most posttraumatic stress symptoms ten months later, according to research published in Clinical Psychological Science in 2015.
According to Jayawickreme, acknowledging survivors’ sentiments is ultimately the most humane reaction to suffering. Adversity affects people differently. Positive changes in people are possible. People are capable of negative change. Nobody can change at all. It’s okay that way.