Exploring self-perceived growth in a clinical sample of severely traumatized youth

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Abstract

Objective

The aims of this study were threefold: (1) examine the prevalence of Posttraumatic Growth (PTG) among severely traumatized youth, (2) systematically describe the PTG reported, and (3) study the course of PTG from pre- to post-treatment.

Method

The sample consisted of 148 severely traumatized Norwegian youth (M ageĀ =Ā 15, SDĀ =Ā 2.2, 79.1% girls) receiving treatment in child mental health clinics. The Clinician Administered PTSD Scale for Children (CAPS) was used to assess level of posttraumatic stress symptoms (PTSS) pre- and post-treatment. One of the questions in CAPS: ā€œHow do you think (traumatic event) has affected your life?ā€ formed the basis for our analysis of PTG. Words and phrases indicative of PTG were identified using the Consensual Qualitative Research method.

Results

Pre-treatment, the prevalence rate of PTG was low compared to previous findings, and reports of PTG were not related to levels of PTSS. The main PTG themes identified were: personal growth, relational growth, and changed philosophy of life. A sub-theme of personal growth; greater maturity/wisdom, was the most salient theme identified both pre- and post-treatment. Age was significantly related to reports of PTG; older participants reported more growth. Reports of PTG increased significantly from pre- to post-treatment, but were not related to decrease in PTSS.

Conclusions

The findings suggest that PTG is not only possible for youth, but quite similar to that observed among adults. However, we need to carefully consider whether reports of self-perceived positive change among traumatized youth actually are indicative of growth, or simply indicative of increased vulnerability.

Section snippets

Posttraumatic growth and childhood trauma

To date, relatively few studies have investigated the prevalence of PTG among children and adolescents. Given that a perception of growth appears to involve sophisticated cognitive appraisals, both in terms of recognizing both losses and gains and comparing oneself ā€œbeforeā€ and ā€œafterā€, it has been questioned whether PTG is possible for children (Cryder et al., 2006, Taku et al., 2011). Existing literature does, however, suggest that youth can experience and report PTG. Positive changes have

Limitations of existing research

Even though the potential for positive change following trauma has received increased attention over the past years, the existing literature in this area has some important limitations. First, most studies on PTG have used quantitative measures, such as the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Though fruitful in terms of identifying correlates of PTG, and documenting the prevalence of change in specific growth domains in large and diverse populations, this type of

The present study

This study aimed to enhance our understanding of the phenomenon of PTG in youth. Research examining PTG among children and adolescents can broaden our understanding of growth from a developmental perspective. We wanted to explore the extent to which severely traumatized children and adolescents experience PTG, and systematically describe the types of growth reported. This particular sample might help elucidate the relationship between PTG and PTSS. We were also interested in studying the course

Participants

The data in the present study was collected as part of a longitudinal treatment study designed to determine the effect of trauma therapy among severely traumatized children and adolescents (Jensen et al., 2013). A total of 148 children and adolescents were included within this study, aged between 10 and 18 years (MĀ =Ā 15, SDĀ =Ā 2.2), 79.1% girls. The majority of the sample had at least one Norwegian parent (nĀ =Ā 122, 82.4%), while 15 (10.1%) had Asian born parents, and 11 (7.4%) reported other countries

Attrition and baseline comparisons

Eighteen participants dropped out of treatment before the sixth session, and were thus not assessed at T2. There were no significant differences between the retention group and the attrition group when it came to gender (Ļ‡2(1)Ā =Ā .056, pĀ =Ā .813), initial PTSS (t (146)Ā =Ā 1.04, pĀ =Ā .330), parental education (pĀ =Ā .338, FET), or number of traumas experienced prior to treatment (t (146)Ā =Ā āˆ’1.60, pĀ =Ā .112). The attrition group was, however, significantly older than the retention group (t (146)Ā =Ā āˆ’2.89, pĀ =Ā .004).

Descriptive statistics

Level

Discussion

The primary aim of this study was to improve our understanding of how traumatic events affect children and adolescents, with a particular focus on aspects that may reflect PTG. More specifically, we wanted to explore the prevalence and characteristics of self-perceived positive changes reported by a clinical sample of severely traumatized youth.

Contrary to expectations, only 17% of the participants reported aspects of growth pre-treatment. Compared to previous findings of PTG among youth (e.g.,

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    Norwegian Centre of Studies on Violence and Traumatic Stress (NKVTS), Kirkeveien 166, Building 48, 0407 Oslo, Norway.

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