Post-traumatic growth

Traumatic experiences are defined as events in which a real death or threat of death is experienced, serious injury or a threat to bodily integrity occurs, and that the person himself or herself has experienced or witnessed (APA, 1994). Öztürk (2017) states that traumatic experiences can be caused by natural disasters such as earthquakes, floods, wars, sexual or physical assault, torture, sexual abuse, childhood abuse, traffic accidents, work accidents, diagnosis of a life-threatening disease, states that it includes traumatic events such as witnessing the event that are compelling and negatively affect the person’s ability to cope. Similarly, Yüksel (2000) states that traumatic experiences are those that occur during the normal course of life and negatively affect the adaptation of individuals to life by deactivating their coping mechanisms.

It is seen that traumatic events, unlike ordinary misfortunes, usually involve threats to the life or integrity of the victims and cause significant and effective physical and mental injury symptoms on individuals (Mum, 2011; Sargın & Akdan, 2016). It is noteworthy that individuals are rendered helpless by a destructive force during trauma. Parallel to these, Önder and Tural (2004) state that psychological trauma is a situation where a person faces his powerlessness, weakness and helplessness.

According to Herman (1992), traumatic experiences overturn the normal behavioral system that gives people a sense of control, bonding and meaning. In this context, it is argued that psychological trauma requires individuals to make changes in their lives and requires re-adjustment in terms of individuals (Coddington, 1972). In addition to these, it is noteworthy that people’s reactions to traumatic events differ. Kılıç (2003) argues that traumatic experiences have various negative effects and besides the physical consequences of traumatic events, there are also various psychological consequences such as anxiety, depression symptoms, alcohol and substance abuse or abuse, suicide and post-traumatic stress disorder.

In the studies conducted, it has been observed that although traumatic experiences often cause serious psychological stress, it can also cause positive psychological changes as a result of the struggle of those who are exposed to trauma (Slyke, 2014). In addition to these, İnci and Boztepe (2013) emphasize that there are beliefs in different belief systems that suffering changes and matures people. Similarly, Tedeschi, Park and Calhoun (1998), based on the ideas of thinkers such as Kierkegaard and Nietzsche in existential philosophy, characterize the traumatic experience as an experience in which people question the meaning of life. In a study conducted by Sawyer and Ayers (2009), it was seen that between 30% and 90% of individuals reported some positive changes after trauma. Concepts such as ‘post-traumatic growth (PTD)’, ’empowerment’, ‘post-traumatic growth’ and ‘stress-related development’ are expressed as positive situations that occur as a result of trauma (Calhoun & Tedeschi, 1999; Özlü, Yıldız & Aker, 2010) .

In addition to these, Shakespeare-Finch et al. (2003) argue that the trauma experience is effective in the formation of important positive changes such as priorities, meaning of life, improving relationships and the perception of personal empowerment. These positive changes, also known as PSD, described as positive psychological changes reported by an individual as a result of coping with trauma, include the development of new perspectives and personal growth (Zoellner & Maercker, 2006; Kleim & Ehlers, 2009).

TSB concept; Positive mental changes that develop as a result of struggling with challenging life events, a traumatic event and positive cognitive, emotional and behavioral transformation that occurs after efforts to fight against the event (Özlü, Yıldız, & Aker, 2010) or a life closely related to the death of the individual or a loved one. It is defined as the psychological positive change that occurs as a result of struggling against the crisis (Calhoun & Tedeschi, 1999; Tedeschi & Calhoun, 2004). Zoellner and Maercker (2006), on the other hand, evaluate PSD as a coping mechanism that develops as a result of coping with traumatic stress. In this respect, it is seen that PSD does not mean not being harmed by stressful life events, but rather the positive change that occurs as a result of these events (Tedeschi & Calhoun, 2004).

It is stated that PSD includes situations such as a greater willingness to life, the perception of changing priorities, establishing closer relationships with other individuals, greater personal power, awareness of new possibilities in the individual’s life, and spiritual development (Lykins et al., 2007). In some studies conducted in parallel, it is stated that PSD includes dimensions such as a positive change in the individual’s self-perception, a change in relationships with other people and a change in philosophy of life (Garland et al., 2007; Özlü, Yıldız, & Aker, 2010). In addition, it is seen that the PTD process begins after a major crisis that may cause the individual to understand the world and question his place in life, and develops differently depending on various variables (Yılmaz, 2006). When the studies on TSD are examined, it is seen that TSD primarily works with people who have been exposed to traumas such as earthquakes and other natural disasters (Guo et al., 2004; Karancı and Acartürk, 2005). Later, it is noteworthy that the concept of TSD is studied in the field of health. It is observed that PTG studies are given more attention to individuals who have life-threatening diseases such as cancer and coronary artery disease (Nenova et al., 2013; Sarısoy, 2012) and parents whose children have health problems (Elçi, 2004; Boztepe, İnci, & Tanhan, 2015). it crashes. In addition, PSD, which occurs after many traumatic situations such as natural disasters, loss due to death, war, causes a greater appreciation of life and a reevaluation of priorities, developing closer relationships, greater awareness of one’s own strength, and realization of new possibilities. It is seen that it is explained by the changes in five different areas of life, namely development and spiritual development (Tedeschi & Calhoun, 2004; Tedeschi, Park & ​​Calhoun, 1998). Similarly, in the study conducted by King and Hicks (2009), it was found that significant changes occurred in five basic areas as a result of PSD: a better understanding of the value of life, close relationships, awareness of new possibilities, increased personal power, and a positive change in spirituality.

A better understanding of the value of life as a result of the traumatic event is characterized as a change in priorities and enjoying different aspects of life (Slyke, 2014). In this context, İnci and Boztepe (2013) state that when people appreciate their life more and change their priorities, they can begin to enjoy the things that are part of daily life that they did not realize before. argues that they can be satisfied. In addition, it is seen that individuals can start to value their close relationships more after the traumatic experience and they can get closer with their “bad friends”. In addition, Tedeschi and Calhoun (2004) argue that traumatic experience leads to the development of the idea that “if I overcome this, I will overcome everything” in individuals. In another study related to TSD, it was observed that trauma survivors had an increase in compassion and empathy levels, which enable them to establish deeper and more meaningful relationships with others (Slyke, 2014). He argues that situations such as the recognition of new possibilities and an increase in personal power can be seen in victims. For example; the individual may show a higher level of self-efficacy or a stronger belief in his ability to overcome obstacles. The same individual may experience a shift in values ​​post-traumatic and realize that he or she can identify a more fulfilling path towards the future. Finally, it is observed that trauma survivors can experience a positive change in spirituality, perceiving themselves as more capable of connecting with something stronger than themselves, regardless of their religious affiliation (Sheikh, 2008).

In addition, not every person who has had a traumatic experience has TSD; It is noteworthy that having a traumatic experience is not sufficient for TSD. Apart from the traumatic event, it is emphasized that individual characteristics (coping strategies, self-confidence), environmental resources (social support, financial resources) and variables related to the traumatic event are also effective in the formation of TSD (Park, 1998; Abraido-Lanza, Guier, & Colon, 1998). . Tedeschi and Calhoun (2004) argue that for growth to occur as a result of a traumatic experience, the event must first be a shocking event and the person must struggle with this trauma. In addition to these, it has been observed that there are differences related to demographic information and events in studies on TSD (Slyke, 2014). As a result of the findings obtained from the studies, it is noteworthy that women grow more than men and young individuals grow more than older ones (Linley and Joseph, 2004). In addition, Linley and Joseph (2004) state that PSD is associated with high income and education level and argue that the perceived threat of danger is more effective on PSD compared to the type or severity of the trauma. In addition, many personality traits seem to be associated with PSD (Prati & Pietrantoni, 2009). The Five Factor Personality Model developed by Benet-Martinez and John (1998) and adapted into Turkish by Sümer and Sümer (2005) in order to measure personality traits. however, it was found that the high level of neuroticism sub-dimension was associated with low level of TSD (Sheikh, 2008). In parallel, in the study conducted by Prati and Pietrantoni (2009), it was observed that individuals with high levels of extraversion, openness to experience and agreeableness also have effective coping skills and are more likely to seek social support. Tennen and Affleck (1998), on the other hand, argue that personality traits such as self-confidence, locus of control and optimism have effects on the relationship between traumatic experiences and PTD. Tedeschi and Calhoun (2004) state that the variables of resilience, hardiness, optimism and sense of coherence are among the concepts associated with PSD. Psychological resilience is defined as “the ability to achieve positive and unexpected success under difficult conditions and to adapt to extraordinary conditions and situations” (Fraser, Galinsky, & Richman, 1999). Resilience, on the other hand, is defined as the ability of individuals to recover themselves in the face of difficult life experiences (Garmezy, 1991) or the ability to successfully overcome change or disasters (Wagnild & Young, 1993). Tedeschi and Calhoun (2004) state that individuals with high resilience are curious, active and have a sense of control over life. Optimism, another concept associated with PSD, is defined as being hopeful about many situations in life or having an expectation that good things will happen in life in general (Tedeschi & Calhoun, 1996). Bossick (2008) argues that optimistic individuals tend to use active coping skills and focus on the positive aspects of the situation, so that they can use their energies to cope with the problem and find new solutions. In addition to these, another concept that is thought to be related to PSD is the perception of consistency. Tedeschi and Calhoun (2004) state that individuals with a high sense of coherence are in a good position to cope with stress thanks to their ability to analyze, understand, cope and make sense of events.

In another study, in which variables related to TSD were examined in parallel with the studies conducted, it was found that hopelessness and post-traumatic stress variables were also significant predictors of PSD (Kardaş & Tanhan, 2013). The findings of the study show that there is a low and positive relationship between PTG and post-traumatic stress. Similarly, in a long-term study conducted by Chan and Rhodes (2013) after Hurricane Katrina in the USA, it was determined that there is a positive and significant relationship between post-traumatic stress and PTD. In this context, it can be said that individuals experiencing TSD also experience stress symptoms. When the studies in the literature are examined, there are findings that there is a positive relationship between PTD and post-traumatic stress (Solomon & Dekel, 2007); however, it is noteworthy that there are also findings showing that there is a negative relationship between these two variables (Frazier, Conlon, & Glaser, 2001) or that there is no significant relationship (Salsman et al., 2009). Researchers argue that these two situations can be seen at the same time and should be evaluated as separate outcomes (Ano & Vasconcelles, 2005; Gerber et al., 2011; Harris et al., 2008).

In the study conducted by Kira et al. (2013), low or high level stress did not predict high growth; however, moderate stress was found to be a predictor of TSD. In this respect, it can be thought that individuals who experience moderate stress after any traumatic experience have a higher rate of experiencing PSD. In addition, the variable of time elapsed after the traumatic event is thought to have an important role in the relationship between PTD and the level of post-traumatic stress (Kardaş & Tanhan, 2013). In a study conducted by Teodorescu et al. (2012) on refugees exposed to traumatic experiences in various countries, it was found that the number of traumatic events and the length of time after the traumatic event were the variables that predicted TSD. In the study conducted, it was observed that there was a moderate and negative significant relationship between PTD and post-traumatic stress disorder (PTSD). Researchers argue that this is due to the fact that the length of time is positively related to growth and negatively related to behavioral problems (Teodorescu et al., 2012). Another variable thought to be associated with PSD is hopelessness. In the study conducted by Kardaş and Tanhan (2013), it was seen that the variable of hopelessness had a dominant effect on PPS. According to the findings, as the level of hopelessness increases, the level of TSD decreases; however, as the level of hopelessness decreases, the level of TSD increases. This shows that PTD is negatively associated with hopelessness. In the study conducted by Dürü (2006), it was determined that hopelessness predicted PSD negatively.

According to the hope theory, individuals’ predisposition to hope occurs in early childhood (Slyke, 2014). In a study conducted by Creamer et al. (2009) to examine the importance of hope on trauma victims, it was found that childhood trauma was associated with a low level of hope in adulthood and a lower PTD after the traumatic experience. In this context, it can be said that individuals who do not experience childhood trauma are more likely to experience TSD after trauma in adulthood.

In summary, the concept of PSD characterizes the positive psychological change that occurs after a highly stressful situation. Both our body and mind give many unusual reactions as a result of the event encountered; At the same time, it is trying to renew itself. It is seen that while some individuals make more of these efforts, others are less able to achieve this renewal. In determining the effect of trauma on the individual, whether the environment in which the individual lives is supportive or not, and the ease or difficulty of the individual’s social support resources and benefiting from these support resources are very effective. If we consider the trauma as an earthquake, we can describe the growth as the removal of the debris from the city after the earthquake. It is possible to build a new life after earthquakes, replace our despair with new hopes, and replace our losses with new ones.

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