Posttraumatic growth and posttraumatic stress – a network analysis among Syrian and Iraqi refugees

Traumatic events related to war and displacement may lead to development of posttraumatic stress symptoms (PTSS), but many war trauma survivors also report experiencing posttraumatic growth (PTG). However, the phenomenon of PTG remains poorly understood among refugees. Previous findings are also contradictory on whether more PTSS associate with PTG and what specific symptoms or aspects of growth may account for any possible link. Here, we aimed to better understand posttraumatic growth among refugees, especially its structure and most important constituent elements, as well as how it associates with PTSS. We employed regression and network analysis methods with a large sample (<i>N </i>= 3,159) of Syrian and Iraqi refugees living in Turkey self-reporting on PTG and PTSS. We found PTG and PTSS to be clearly distinct phenomena. Still, they often co-occurred, with a positive, slightly U-shaped relationship found between levels of PTSS and PTG. The main bridge between the constructs was identified from intrusive symptoms to having new priorities in life, although new priorities were more peripheral to the overall network structure of PTG. Meanwhile, discovering new psychological strengths and abilities and a new path in life emerged as elements most central to PTG itself. Many refugees report elements of PTG, even as they suffer from significant PTSS. The two phenomena appear distinct but positively associated, supporting the idea that intense cognitive processing involving distress may be necessary for growth after trauma. Our findings may inform efforts to support refugee trauma survivors in finding meaning and perhaps even growth after highly challenging experiences. Refugees from Syria and Iraq report substantial posttraumatic growth.Posttraumatic stress symptoms and posttraumatic growth positively associated.Intrusive symptoms appear as main link to posttraumatic growth.Discovering new strengths, abilities, and paths appears central to posttraumatic growth among refugees. Refugees from Syria and Iraq report substantial posttraumatic growth. Posttraumatic stress symptoms and posttraumatic growth positively associated. Intrusive symptoms appear as main link to posttraumatic growth. Discovering new strengths, abilities, and paths appears central to posttraumatic growth among refugees.

与战争及流离失所相关的创伤性事件可能引发创伤后应激症状（posttraumatic stress symptoms, PTSS），但诸多战争创伤幸存者亦报告出现了创伤后成长（posttraumatic growth, PTG）。然而，目前学界对难民群体中的创伤后成长现象仍知之甚少。既往研究关于更高水平的创伤后应激症状是否与创伤后成长相关，以及何种具体症状或成长维度可解释二者间的潜在关联，结论亦存在矛盾。
本研究旨在深入了解难民群体的创伤后成长状况，尤其是其结构与核心构成要素，以及该现象与创伤后应激症状的关联模式。本研究采用回归分析与网络分析方法，对居住在土耳其的3159名叙利亚及伊拉克难民开展了创伤后成长与创伤后应激症状的自我报告调研，样本量较大。
研究结果显示，创伤后成长与创伤后应激症状是两种显著不同的现象，但二者常共同出现，且创伤后应激症状水平与创伤后成长水平之间呈正相关且近似U型的关系。二者构念间的主要关联通路为闯入性症状指向生活中新的优先事项，尽管生活中新的优先事项在创伤后成长的整体网络结构中处于较边缘的位置。与此同时，发掘新的心理优势与能力、开辟人生新道路，被证实为创伤后成长最核心的构成要素。
诸多难民即使正遭受严重的创伤后应激症状困扰，也报告了创伤后成长的相关体验。两种现象虽相互独立却呈正相关，这支持了“创伤后成长需要涉及痛苦体验的深度认知加工”这一假说。本研究结果可为后续支持难民创伤幸存者在历经极端困境后找寻生命意义、乃至实现创伤后成长的实践提供参考。
叙利亚与伊拉克难民报告存在显著的创伤后成长。创伤后应激症状与创伤后成长呈正相关。闯入性症状是与创伤后成长相关的核心关联点。发掘新的优势、能力与人生道路是难民群体中创伤后成长的核心要素。
叙利亚与伊拉克难民报告存在显著的创伤后成长。创伤后应激症状与创伤后成长呈正相关。闯入性症状是与创伤后成长相关的核心关联点。发掘新的优势、能力与人生道路是难民群体中创伤后成长的核心要素。