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- Posttraumatic growth in adult cancer patients: an updated systematic reviewPublication . Patrao, Ivone; Leal, Isabel Maria Pereira; Rudnicki, Tânia; Santos, Ana Isabel; Costa, Margarida; Pimenta, Filipa; Ramos, CatarinaThe current systematic review is an updated analysis of studies with adult cancer patients, regarding factors associated with posttraumatic growth (PTG), which is defined as perceived positive changes after traumatic event, such as cancer. A systematic review was conducted according to the PRISMA Statement guidelines. Seven electronic databases were searched. Quantitative studies with or without psychosocial group intervention that assessed PTG or similar construct (benefit finding [BF], positive life changes, stress-related growth, growth) as main outcome were included. The initial systematic search yielded 659 papers, published between 2006 and 2015. From those, 81 studies fulfilled the inclusion criteria: 73 studies without intervention and 8 entailing an intervention program. The results suggested that socio-demographic (e.g. age, educational level, household income), clinical (e.g. stage of cancer), cognitive (e.g. intrusiveness, challenge to core beliefs), coping-related (e.g. positive reframing, religious coping) and other psychosocial variables (e.g. social support, optimism, spirituality) are positively associated with PTG. BF is associated with gender, marital status, cancer stage, both cancer and treatment type, positive active coping, positive reappraisal, social support and optimism. Psychosocial group interventions with cancer patients show significant effect on the increase of growth reported (PTG or BF). As conclusion, Growth following a cancer experience is an effect of several variables which might be targeted and promoted in the context of multidisciplinary teams, in hospital and clinical settings. Group interventions are a favorable context to the development of PTG after cancer, but interventions that assess PTG as primary outcome are still needed to evaluate the effect of group on PTG’ facilitation.
- An item-level analysis of the Posttraumatic Stress Disorder Checklist and the Posttraumatic Growth Inventory and Its associations with challenge to core beliefs and ruminationPublication . Ramos, Catarina; Leal, Isabel Maria Pereira; Costa, Pedro Alexandre; Tapadinhas, Ana Rosa; Tedeschi, Richard G.Background: Previous studies have found that rumination and challenge to core beliefs may have a predictive effect on Posttraumatic Stress Disorder (PTSD) and Posttraumatic Growth (PTG) among different samples. In addition, there is some evidence that these variables have different effects on PTSD and PTG, although the latter construct has been the target of a larger body of research and theoretical models. The main objective of the current study is to examine the effect of challenge to core beliefs, intrusive rumination, and deliberate rumination on PTSD and PTG, through an item-level analyses. Methods: The sample was composed of 205 Portuguese women who had been given a breast cancer diagnosis (M = 54.32, SD = 10.05), and who completed the following self-administered questionnaires: the Posttraumatic Stress Disorder Checklist (PCL-C); the Posttraumatic Growth Inventory (PTGI); the Core Beliefs Inventory; and the Event Related Rumination Inventory. Two multivariate multiple regression analyses, using each item of the PCL-C and the PTGI as dependent variables, were conducted. Results: The results demonstrated that challenges to core beliefs predict 17 of the 21 PTGI items and 12 of the 17 PCL-C items. All but one item of the PCL-C are predicted by intrusive rumination, while the variance of only 4 items of the PTGI are explained by deliberate rumination. Conclusion: These findings indicate that women with breast cancer who tend to display higher levels of intrusive rumination are more likely to report PTSD symptoms, and that an examination of one's core beliefs is predictor of both positive and negative outcomes. In spite of the proven effect of challenge to core beliefs on both variables, this study suggests that this effect has only a minor influence on PTSD, in addition to confirming its major impact on PTG.