Posttraumatic growth, depression and posttraumatic stress in relation to quality of life in tsunami survivors: a longitudinal study

Johan Siqveland, Egil Nygaard, Ajmal Hussain, Richard G Tedeschi, Trond Heir, Johan Siqveland, Egil Nygaard, Ajmal Hussain, Richard G Tedeschi, Trond Heir

Abstract

Background: Quality of life (QoL) may often be reduced in survivors of a natural disaster. This paper investigated how posttraumatic growth (PTG), depression and posttraumatic stress interact and independently predict QoL in a longitudinal study of disaster survivors.

Methods: A total of 58 Norwegian adults who were present in Khao Lak, Thailand at the time of the 2004 Southeast Asia Tsunami completed self-report questionnaires 2 and 6 years after the disaster. The participants reported symptoms of depression and posttraumatic stress as well as PTG and QoL. Multiple mixed effects regression analyses were used to determine the independent effects of PTG, depression and posttraumatic stress on QoL measured 2 and 6 years after the disaster.

Results: Posttraumatic stress and depression were negatively related to QoL. PTG was not significantly related to QoL in a bivariate analysis. However, considerable interaction effects were found. Six years after the tsunami, high levels of posttraumatic stress were related to lower QoL in those participants with low levels of PTG, whereas lower levels of depression were related to higher QoL in those participants with high levels of PTG.

Conclusions: Posttraumatic stress and depression are negatively associated with QoL after a natural disaster. PTG may serve as a moderating factor in this relationship.

Figures

Figure 1
Figure 1
Flowchart of the study population consisting of Norwegian tourists (≥18 years) in Khao Lak (Thailand) at the time of the disaster.
Figure 2
Figure 2
Moderator effects of posttraumatic growth on the relationship between posttraumatic stress reactions and G-QoL. The figure displays the moderator effects of posttraumatic growth on the relationship between posttraumatic stress reactions and general QoL at T2. Posttraumatic stress is standardized (Z-value).
Figure 3
Figure 3
Moderator effects of posttraumatic growth on the relationship between depression and G-QoL. The figure displays the moderator effects of posttraumatic growth on the relationship between depression and general QoL at T2. Depression is standardized (Z-value).

References

    1. Nygaard E, Heir T. World assumptions, posttraumatic stress and quality of life after a natural disaster: A longitudinal study. Health Qual Life Outcomes. 2012;10:76. doi: 10.1186/1477-7525-10-76.
    1. Choul FH-C, Chou P, Lin C, Su TT-P, Ou-Yang W-C, Chien IC, et al. The relationship between quality of life and psychiatric impairment for a Taiwanese community post-earthquake. Qual Life Res. 2004;13:1089–97. doi: 10.1023/B:QURE.0000031337.73269.64.
    1. Kraemer B, Wittmann L. Tsunami: long-term psychological consequences for Swiss tourists in the area at the time of the disaster. Aust N Z J Psychiatry. 2004;2009(43):420–5.
    1. Rapaport M, Clary C. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005;162:1171–8. doi: 10.1176/appi.ajp.162.6.1171.
    1. Calhoun L, Cann A, Tedeschi R. Posttraumatic growth cult competent pract lessons learn from around globe. 2010. The posttraumatic growth model: sociocultural considerations, posttraumatic growth and culturally competent practice: lessons learned from around the globe.
    1. Siqveland J, Hafstad GS, Tedeschi RG. Posttraumatic growth in parents after a natural disaster. J Loss Trauma. 2012;17:536–44. doi: 10.1080/15325024.2012.678778.
    1. Martins da Silva SI, Moreira H, Canavarro MC. Growing after breast cancer: a controlled comparison study with healthy women. J Loss Trauma. 2011;16:323–40. doi: 10.1080/15325024.2011.572039.
    1. Ying L-H, Lin C-D, Wu X-C, Chen C, Greenberger E, An Y-Y. Trauma severity and control beliefs as predictors of posttraumatic growth among adolescent survivors of the Wenchuan earthquake. Psychological Trauma: Theory, Research, Practice, and Policy. 2014;6(2):192. doi: 10.1037/a0031964.
    1. Jin, Yuchang, Jiuping Xu, and Dongyue Liu. The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups. Soc Psychiatry Psychiatr Epidemiol. 2014;1-8.
    1. Neblett R, Cohen H, Choi Y, Hartzell MM, Williams M, Mayer TG, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain. 2013;14:438–45. doi: 10.1016/j.jpain.2012.11.012.
    1. Lowe SR, Manove EE, Rhodes JE. Posttraumatic stress and posttraumatic growth among low-income mothers who survived Hurricane Katrina. J Consult Clin Psychol. 2013;81:877–89. doi: 10.1037/a0033252.
    1. Kilmer RP, Gil‐Rivas V. Exploring posttraumatic growth in children impacted by Hurricane Katrina: Correlates of the phenomenon and developmental considerations. Child Dev. 2010;81(4):1211–27. doi: 10.1111/j.1467-8624.2010.01463.x.
    1. Morrill EF, Brewer NT, Neill SCO, Lillie SE, Dees EC, Carey LA, et al. The interaction of post-traumatic growth and post- traumatic stress symptoms in predicting depressive symptoms and quality of life. Psychooncology. 2008;17:948–53. doi: 10.1002/pon.1313.
    1. Helgeson VS, Reynolds KA, Tomich PL. A meta-analytic review of benefit finding and growth. J Consult Clin Psychol. 2006;74:797–816. doi: 10.1037/0022-006X.74.5.797.
    1. Hussain A, Weisaeth L, Heir T. Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: a population based study. J Affect Disord. 2011;128:135–41. doi: 10.1016/j.jad.2010.06.018.
    1. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress. 1996;9:455–71. doi: 10.1002/jts.2490090305.
    1. Weathers FW, Ford J. Meas stress trauma, adapt. 1996. Psychometric properties of the PTSD checklist (PCL-C, PCL-C, PCL-M, PCL-PR) pp. 250–1.
    1. Hem C, Hussain A, Wentzel-Larsen T, Heir T. The Norwegian version of the PTSD Checklist (PCL): construct validity in a community sample of 2004 tsunami survivors. Nord J Psychiatry. 2012;66:355–9. doi: 10.3109/08039488.2012.655308.
    1. Goldberg DP, Hillier VF. A scaled version of the general health questionnaire. Psychol Med. 1979;9:139–45. doi: 10.1017/S0033291700021644.
    1. Group THEW Development of the world health organization WHOQOL-BREF quality of life assessment. the WHOQOL group. Psychol Med. 1998;28:551–8. doi: 10.1017/S0033291798006667.
    1. Hanestad BR, Rustøen T, Knudsen Ø, Lerdal A, Wahl AK. Psychometric properties of the WHOQOL-BREF questionnaire for the Norwegian general population. J Nurs Meas. 2004;12:147–59. doi: 10.1891/jnum.2004.12.2.147.
    1. Arnberg FK, Bergh Johannesson K, Michel P-O. Prevalence and duration of PTSD in survivors 6 years after a natural disaster. J Anxiety Disord. 2013;27:347–52. doi: 10.1016/j.janxdis.2013.03.011.
    1. Zoellner T, Maercker A. Posttraumatic growth in clinical psychology - a critical review and introduction of a two component model. Clin Psychol Rev. 2006;26:626–53. doi: 10.1016/j.cpr.2006.01.008.
    1. Heir T, Sandvik L, Weisæth L. Hallmarks of posttraumatic stress: Symptom Z-scores in a tsunami-affected tourist population. Psychopathology. 2009;42(3):157–64. doi: 10.1159/000207457.

Source: PubMed

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