Surviving and Thriving: Evaluations of Three Interventions Fostering Well Being and Growth in the Face of Adversity

It is easy to imagine how positive psychology (the science of human flourishing) applies to people who are already doing well and wish to do better. It is less obvious how to apply positive psychology in negative contexts: Can positive psychology concepts and strategies help people flourish in the face of mental illness, trauma, and loss? The current investigation presents findings from three randomized trials of interventions informed by positive and clinical psychology, which aim to help people survive and thrive in the face of highly challenging circumstances: depression, mixed traumatic and adverse events, and bereavement. Chapter 1 summarizes the findings of a randomized controlled trial evaluating a smartphone-based/web-based application (app) that integrates clinical and positive psychology strategies with game mechanics in order to alleviate depression symptoms. Results indicated that the app reduced symptoms of depression (in comparison to a waiting list control) and that there were no significant differences between two versions of the app. Chapter 2 summarizes the findings of a randomized controlled trial evaluating an online writing-based intervention aimed at fostering posttraumatic growth (PTG) after adverse events. This intervention, called prospective writing, prompts participants to seek new doors opening in their lives in the wake of loss and trauma. Results indicated that prospective writing fostered PTG for people with recent and long-ago trauma/loss, and mediation analyses suggested that attending to new possibilities was indeed the mechanism for this change. Chapter 3 describes the creation and initial testing of a group-format psychosocial intervention aimed at fostering PTG. Acceptability and feasibility analyses of the data (from an ongoing randomized trial) indicated that bereaved adult participants found this intervention helpful, engaging, inoffensive, and not overly upsetting; that they appreciated diverse intervention modules; and that they would recommend the intervention to other bereaved people. Collectively, these findings underscore the usefulness of positive psychology in negative contexts and suggest further research into intervention strategies that can help suffering people to not only survive but also thrive in the wake of adversity

Can people experience post-traumatic growth after committing violent acts?

The concept of post-traumatic growth refers to the positive psychological changes that some people experience as a result of their struggle with highly stressful and often traumatic circumstances. Research into post-traumatic growth has typically focused on survivors of violent victimisation or other uncontrollable and tragic circumstances. However, emerging research into service members in the armed forces has shown that post-traumatic growth can also occur in this population. We synthesise existing research to propose a preliminary model outlining the psychosocial processes that may facilitate post-traumatic growth among people who have perpetrated acts of violence. We end by discussing some of the important questions that future theoretical and empirical work will need to address

Randomized controlled trial of SecondStory, an intervention targeting posttraumatic growth, with bereaved adults

Objective: People often report positive psychological changes after adversity, a phenomenon known as posttraumatic growth (PTG). Few PTG-focused interventions have been rigorously tested, and measurement strategies have had significant limitations. This study evaluated the effects of a new group-format psychosocial intervention, SecondStory, aimed at facilitating PTG by helping participants make meaning of the past and plan a purposeful future. Method: In a randomized controlled trial, adults (N = 112, 64% women) bereaved within five years were randomly assigned to SecondStory or an active control, expressive writing. The primary outcome, PTG, was measured using two contrasting methods: the Posttraumatic Growth Inventory, which asks participants retrospectively how much they believe they have changed due to struggling with adversity, and the Current-Standing Posttraumatic Growth Inventory, which tracks quantifiable change in participants’ standing in PTG domains over time. Secondary outcomes included depression symptoms, posttraumatic stress symptoms, and life satisfaction. Outcomes were measured at two-week intervals: pre-test, post-test, and three follow-up occasions. Hierarchical linear modeling was used to assess whether SecondStory participants experienced greater gains in primary and/or secondary outcomes over the eight-week trial. Results: Results indicated that SecondStory participants did not show significantly greater improvements than control participants on measures of PTG, posttraumatic stress, or life satisfaction, but did show greater decreases in depression symptoms by the first follow-up. Conclusions: These findings suggest that SecondStory may not facilitate PTG more effectively than existing interventions, but may be promising for addressing depression. Positive interventions may productively be refined to support people experiencing trauma and loss

Randomized controlled trial of SecondStory, an intervention targeting posttraumatic growth, with bereaved adults

Objective: People often report positive psychological changes after adversity, a phenomenon known as posttraumatic growth (PTG). Few PTG-focused interventions have been rigorously tested, and measurement strategies have had significant limitations. This study evaluated the effects of a new group-format psychosocial intervention, SecondStory, aimed at facilitating PTG by helping participants make meaning of the past and plan a purposeful future. Method: In a randomized controlled trial, adults (N = 112, 64% women) bereaved within 5 years were randomly assigned to SecondStory or an active control, expressive writing. The primary outcome, PTG, was measured using two contrasting methods: the Posttraumatic Growth Inventory, which asks participants retrospectively how much they believe they have changed due to struggling with adversity, and the Current-Standing Posttraumatic Growth Inventory, which tracks quantifiable change in participants' standing in PTG domains over time. Secondary outcomes included depression symptoms, posttraumatic stress symptoms, and life satisfaction. Outcomes were measured at 2-week intervals: pretest, posttest, and three follow-up occasions. Hierarchical linear modeling was used to assess whether SecondStory participants experienced greater gains in primary and/or secondary outcomes over the 8-week trial. Results: Results indicated that SecondStory participants did not show significantly greater improvements than control participants on measures of PTG, posttraumatic stress, or life satisfaction, but they did show greater decreases in depression symptoms by the first follow-up. Conclusions: These findings suggest that SecondStory may not facilitate PTG more effectively than existing interventions but may be promising for addressing depression. Positive interventions may productively be refined to support people experiencing trauma and loss

Examining Associations Between Major Negative Life Events, Changes in Weekly Reports of Post-Traumatic Growth and Global Reports of Eudaimonic Well-Being

Research on post-traumatic growth (PTG) has been compromised by methodological limitations. Recent process-oriented accounts of personality suggest, however, that positive changes may occur through short-term (i.e., state-level) changes in PTG. In the current year-long study, 1,247 participants provided weekly reports of significant negative events as well as state manifestations of PTG (up to 44 assessments per individual; 34,205 total). Trait assessments of eudaimonic well-being (EWB) were administered at intake and Weeks 45 and 52. Experiencing negative life events predicted increases in state PTG, which in turn predicted increases in EWB. However, stability was observed when modeling prospective changes in overall state PTG before and after the initial negative life event or across all negative life events occurring during the study time frame. These findings highlight the importance of studying PTG-related processes using appropriate research designs, analytic strategies, and time frames

Finding character strengths through loss: an extension of Peterson and Seligman (2003)

People can experience positive changes even in the midst of adversity and loss. We investigated character strengths following three recent shooting tragedies. Using an Internet database of respondents to the Values in Action Inventory of Strengths (VIA-IS), we compared responses from three groups of participants (N = 31,429) within close proximity of each event: those who completed it eight months prior to the event, and one month and two months after. Results suggested that for one of the events, participants who completed the VIA-IS after the event showed slightly different levels of self-reported character strengths compared to participants who completed the VIA-IS before the event, with some mean levels higher and others lower. The observed differences in character strengths were inconsistent across follow-up periods, and effect sizes were small (d values from –0.13 to 0.15). These findings raise questions about whether and how tragedies might catalyze differences in character strengths

Investigating corroboration of self-perceived posttraumatic growth among Sri Lankan Tamil survivors of ethnopolitical warfare through trait, domain, and profile agreement approaches.

Though research on assessing posttraumatic growth has been severely critiqued, some evidence suggests close others can observe and report changes in individuals following traumatic life events and are sensitive to idiosyncratic ways in which changes manifest. We extended these findings by investigating corroboration of self-perceived posttraumatic growth (PTG) and depreciation (PTD) as measured by the Posttraumatic Growth Inventory–42 (PTGI-42) among Sri Lankan Tamil war survivors (n = 200). Informants slightly corroborated overall levels of PTG and PTD, while a more nuanced profile analysis procedure revealed overall—but not distinctive—profile agreement. This suggests self–other agreement is modest and may partly reflect shared narratives and collective cultural understandings about how people change after trauma. Results demonstrate further that informants were not sensitive to idiosyncratic ways in which target individuals had changed. Together, the lack of validity evidence suggests that the PTGI-42 may be inadequate in some cross-cultural contexts as a measure of nuanced posttraumatic change (i.e., as a measure of specific changes in the five theorized domains of growth and depreciation). Future work should emphasize culture- and context-sensitive measurement of posttraumatic change, particularly focusing on methods other than retrospective self-reports, such as prospective longitudinal designs

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Multidimensional signals and analytic flexibility: Estimating degrees of freedom in human speech analyses

Recent empirical studies have highlighted the large degree of analytic flexibility in data analysis which can lead to substantially different conclusions based on the same data set. Thus, researchers have expressed their concerns that these researcher degrees of freedom might facilitate bias and can lead to claims that do not stand the test of time. Even greater flexibility is to be expected in fields in which the primary data lend themselves to a variety of possible operationalizations. The multidimensional, temporally extended nature of speech constitutes an ideal testing ground for assessing the variability in analytic approaches, which derives not only from aspects of statistical modeling, but also from decisions regarding the quantification of the measured behavior. In the present study, we gave the same speech production data set to 46 teams of researchers and asked them to answer the same research question, resulting insubstantial variability in reported effect sizes and their interpretation. Using Bayesian meta-analytic tools, we further find little to no evidence that the observed variability can be explained by analysts’ prior beliefs, expertise or the perceived quality of their analyses. In light of this idiosyncratic variability, we recommend that researchers more transparently share details of their analysis, strengthen the link between theoretical construct and quantitative system and calibrate their (un)certainty in their conclusions

Using Exemplars to Facilitate Character Growth Following Adversity

Experiencing adversity, failure, illness, and setbacks is an inescapable part of human life. These experiences can lead to great suffering but also, for some, to positive transformation. Recent research has focused on this potential for transformation, referred to as posttraumatic growth (PTG; Tedeschi & Calhoun, 1996). Several interventions have been developed to foster growth following adversity, but few have been systematically evaluated in randomized trials. We have developed and rigorously evaluated SecondStory, a new group-format intervention specifically designed to foster growth in character virtues and well-being in the wake of adversity (Roepke, Tsukayama, Forgeard, Blackie, & Jayawickreme, 2018). In the proposed project, we aim to do some pilot-tests of whether and how we could augment SecondStory by incorporating narratives of moral exemplars who have overcome adversity. We will also incorporate insights from recent work on wise interventions (Walton & Wilson, 2018) to improve the potency of the intervention in promoting character growth following adversity