Posttraumatic growth describes positive changes following challenging events.
Although such changes are well documented there remain a number of important areas
for further research, some of which are addressed in this thesis. In particular, this thesis
aimed to clarify the relationship between growth and adjustment following health
events, explore growth in different cultures (UK and Africa), and examine growth
following childbirth using a prospective design.
First, two systematic reviews were carried out to examine (i) growth following
health events and (ii) maternal wellbeing in African women. The first meta-analytic
review found that growth following cancer and HIV/AIDS was associated with higher
levels of positive mental health, higher subjective physical health, and lower levels of
negative mental health. Moderating variables were time since the event, age, ethnicity,
and type of negative mental health outcome. The second review found that maternal
psychological problems in African women have a similar or slightly higher prevalence
than reported in developed countries. Risk factors were broadly comparable although
some culture-specific factors were also found.
Three research studies were conducted. The first study qualitatively explored 55
Gambian women’s experiences of pregnancy, childbirth, and the postnatal period.
Thematic analysis identified five themes: (1) transition to adulthood, (2) physical
difficulties, (3) value of children in relation to others, (4) children as a strain, and (5)
going through it alone. Prospective studies of growth following childbirth were then
carried out in the UK (N=125) and The Gambia (N=101). Women completed
questionnaires during their third trimester of pregnancy and up to 12 weeks after birth.
A proportion of women in both countries reported growth following childbirth. In the
UK, higher levels of growth were associated with caesarean sections and prenatal
posttraumatic stress symptoms. In The Gambia, higher growth was associated with
lower income, lower education, and higher postnatal social support