The role of emotional approach coping in facilitating post-traumatic growth after medical trauma
Individuals who suffer a traumatic medical event, such as diagnosis of life-threatening illness or invasive treatment, are now recognised as at significant risk of posttraumatic stress disorder (PTSD) and PTSD symptomology (DSM-IV, (American Psychiatric Association, 1994)). Yet, these individuals also have the opportunity to transform their negative experience into a positive, life-changing experience; a process known as posttraumatic growth (PTG) (Tedeschi & Calhoun, 1996). Given this apparent dichotomy, this review attempts to integrate the literature on these phenomena, to identify the common variables involved in producing these outcomes. Published studies were included if they focused on adult medical populations (of 18 years and above) and assessed predictor variables of either PTSD or PTG. Exclusion criteria applied to studies were; articles where samples included family and carers, studies that implemented interventions, qualitative studies and studies without objective, standardised psychometric measures. A total of 27 studies were included in this review (18 PTSD; 9 PTG). Similarities and dichotomies in the literature were found, indicating that both phenomena may be inextricably linked. In general, sociodemographic and medical variables showed inconclusive patterns of prediction. Instead psychological and interpersonal factors, namely personality and coping styles, were found to have a consistent influence on outcomes. Methodological limitations and recommended future directions in the research are discussed, as are the implications for clinical practice.