International Society for Traumatic Stress Studies

The Posttraumatic Growth Inventory: A Revision of Integrating Existential and Spiritual Change

04/11/2017
by Richard Tedeschi, PhD et al.
The Posttraumatic Growth Inventory (PTGI: Tedeschi & Calhoun, 1996) was developed to evaluate the positive changes people report in the aftermath of highly stressful and potentially traumatic events (Helgeson, Reynolds, & Tomich, 2006; Linley & Joseph, 2004). Over years, the PTGI has been extensively used in studies conducted with people living in different cultures. The scale has five factors: relating to others, new possibilities, personal strength, appreciation of others and spiritual change. Of the five factors of the PTGI, perhaps the one that has been questioned most often is the Spiritual Change (SC) factor since it includes only two items, and these have a spiritual or religious aspect, but they do not capture growth that may be considered more existential in nature. 
A combination of religious, spiritual, and existential concerns or connectedness is common in the process of the Posttraumatic Growth (PTG). In this regard, qualitative studies have supported those concerns and connectedness (Shakespeare-Finch, Martinek, Tedeschi, & Calhoun, 2013) and those concerns may diverge between cultures varying in their religious, spiritual traditions, and existential understandings. In order to allow for a broader evaluation of spiritual/existential change, a better cross-cultural investigation of growth, and to be sensitive to the ways more secular and atheistic people evaluate existential issues in the aftermath of trauma, new items were to be added to the current PTGI.  In so doing, the SC factor has been expanded to better reflect Spiritual-Existential Change (SEC). The current study is our effort to widen the assessment of spiritual growth in PTG by evaluating these additional items for the PTGI (the new expanded PTGI-X) that characterize a diversity of standpoints on spiritual-existential experiences.  

In the light of literature about spiritual and existential changes, several cross-culturally appropriate items were developed and evaluated by ten independent judges (having different cultural background) being familiar with PTG studies. Items were reduced to four that were most highly endorsed in the US, Turkish and Japanese samples in addition to their aspects of construct relevancy and being easily translated. The result is an expansion of the PTGI we are calling the Posttraumatic Growth Inventory – Expanded (PTGI-X). The original two-item SC factor is now termed Spiritual-Existential Change (SEC) in the expanded scale. The four items were added to the two original SC items to create the SEC factor.  

Previous SC items are:
  • “I have a better understanding of spiritual matters”
  • “I have a stronger religious faith.” 
  • The four new SEC items are: 
  • “I have greater clarity about life’s meaning”,
  • “I feel better able to face questions about life and death”,
  • “I feel more connected with all of existence”,
  • “I have a greater sense of harmony with the world.”
The PTGI-X offers the possibility of capturing self-reported growth in a wider range of cultural settings than was possible with the original two-item factor. Evidence for the usefulness of the added items in the PTGI-X was clear. The PTGI-X has very good reliability, and the newly extended SEC factor has good reliability. Morover, a confirmatory factor analysis demonstrated that the extended scale retains the original five factors. Additionally, the PTGI-X established the expected relationship with theoretically related variables. The inclusion of the four new items resulted in endorsement by more people,  especially in a non-Western context, to give an account of growth they had experienced in the domain. The wider representation of areas of existential growth allowed people who might have nonreligious perspectives to give an account of growth they had experienced. The PTGI-X appears to afford further insight into the experience of PTG in various cultures.

About the Authors

Richard G. Tedeschi received his B.A. in Psychology from Syracuse University, his Ph.D. in Clinical Psychology from Ohio University, and completed his Clinical Psychology Internship at The University of North Carolina School of Medicine. Dr. Tedeschi is Professor of Psychology at the University of North Carolina at Charlotte, where he teaches personality and psychotherapy, and serves as Graduate Coordinator for the MA Psychology program. He is a Licensed Psychologist specializing in bereavement and trauma. With his colleague Lawrence Calhoun, he has published books on posttraumatic growth, an area of research that they have developed that examines personal transformations in the aftermath of traumatic life events. Their most recent book is Posttraumatic Growth in Clinical Practice (2013). Dr. Tedeschi serves as a consultant to the American Psychological Association on trauma and resilience, and as a subject matter expert for the US Army’s Comprehensive Soldier Fitness Program. He is a recipient of the Mary G. Clarke Award for Distinguished Service to Psychology given by the North Carolina Psychological Association, and is past President of NCPA. Additional information can be found at home page:https://ptgi.uncc.edu/ptg-research-group/
 
Arnie Cann  received his doctorate in Social Psychology from Indiana University. His general research interests include social cognition processes, interpersonal relationships, and humor. He brings an important social psychological perspective to the posttraumatic growth research and mentors graduate students involved in the research team on methodology and data analysis. Additional information can be found at his individual home page: https://clas-pages.uncc.edu/arnie-cann/http://www.psych.uncc.edu/acann/.

Kanako Taku is an Associate Professor of Psychology who is a leading scholar on post-traumatic growth (PTG).  As a clinical psychologist certified in Japan, she has conducted a series of cross-cultural research on the subject for 14 years on how people change psychologically, cognitively, socially, and spiritually after traumatic events. Additional information can be found at his individual home page: https://kanakotaku.files.wordpress.com/2012/02/cv_kanako-taku_2015may.pdf

Emre Senol-Durak  received her B.A. in Psychology from Middle East Technical University, her M.S. and Ph.D. in Clinical Psychology from Middle East Technical University. She participated posttraumatic growth research group meeting at the University of North Carolina at Charlotte as a post-graduate research scholar in between 2014-2015. Dr. Senol-Durak has published articles about posttraumatic growth among heart disease patients, spouses of heart disease patients, diabetic patients and bereaved individuals. She has worked with Prof.Tedeschi on cross-cultural issues about posttraumatic growth among individuals having bereavement experiences and motor vehicle accident. Dr. Senol-Durak is Associative Professor of Psychology at the Abant Izzet Baysal University at Bolu, TURKEY. She also gives clinical supervision to M.S and Ph.D programs in Clinical Psychology. Also, she has professional practice with prisoners and dealing with forensic psychology issues. Her additional interest are subjective well-being, problematic internet use, depression and anxiety, stress appraisal, coping. Additional information can be found at her individual home page: www.emresenoldurak.com
 
Lawrence G. Calhoun lived his formative years in Brazil, came to the US to attend college, and has remained here since. He earned degrees from St. Andrews Presbyterian College, Xavier University, and the Ph.D. in clinical psychology from the University of Georgia.  A licensed psychologist, he has maintained a part-time clinical practice for many years. Together with Richard Tedeschi he is one of the pioneers in the research and theory on posttraumatic growth. He is co-author or co-editor of 9 books, including Posttraumatic Growth in Clinical Practice, published by Routledge. He is a recipient of the Bank of America Award for Teaching ExcellenceThe University of North Carolina Board of Governor’s Award for Teaching Excellence, and of the First Citizens Bank Scholar’s Medal (with Richard Tedeschi). Although he is no longer engaged in classroom teaching, he continues his research work and he continues to mentor doctoral students. Additional information can be found at his individual home page: https://ptgi.uncc.edu/ptg-research-group/

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