The Struggle to Grow

Abstract

Over the past several decades trauma research has expanded to recognize the heterogeneity in post-exposure reactions. Posttraumatic stress disorder, the most commonly researched mental health outcome associated with trauma, does not develop in all trauma survivors. Rather, more common trajectories of adaptation following a trauma include normative health adaptation, resilience, and posttraumatic growth. The aims of the current study were to: (1) describe and characterize post-combat adaptation profiles in a sample of Israeli male military veterans (N = 448) based on the combination of posttraumatic distress symptoms, types of coping strategies, and level of posttraumatic growth; (2) test the utility of latent class membership on predicting the quality of posttraumatic growth (i.e. constructive growth); and (3) explore the protective factors (i.e. social support and adaptive coping) that promote constructive posttraumatic growth for each profile of post-combat adaptation. The current study used latent profile mixture modeling to identify profiles of post-combat adaptation, Heckman-probit regression models, and logistic regression analysis. Demographic controls, combat related variables, type of coping strategies utilized, and baseline reports of social support were not significant predictors of constructive growth in either the resilient or struggling latent classes. However, for those in the struggling subset of the sample, reported improvement in perceived social support during the intervention increased the odds of reaching constructive growth. This relationship did not hold for the resilient subset of the sample. The study extends existing literature and theory by proposing a more complex and nuanced examination of posttrauma adaption, and specifies conditions under which protective factors may influence positive adaptation outcomes such as constructive growth. These findings highlight the importance of tailored clinical interventions that account for more complex profiles of post-combat adaptation and provide additional support for the unique effects of group intervention modalities. Further, these findings provide evidence that adaptation takes place over time and as such services should continue to be available for veterans long after combat exposure. Finally, these findings call for future research to build on existing longitudinal investigation by examining the complex temporal components of adaptation in trauma survivors.