The role of ruminations in the relation between personality and positive posttraumatic changes resulting from struggling with cancer
Keywords:
posttraumatic growth, personality, ruminations, cancerAbstract
Background
Cognitive activity, including event-related ruminations, and personality features play an essential role in the occurrence of positive outcomes of experienced trauma. The study investigated the role of ruminations, treated both in terms of stable disposition (trait-like rumination), and about the event, in the relationship between personality dimensions and posttraumatic growth (PTG).
Participants and procedure
Sixty people, aged 18-78 years (M = 50.40, SD = 17.74), who had experienced malignant tumours in the craniofacial area were examined. The majority of respondents (68.30%) were women. The Posttraumatic Growth Inventory (PTGI), the NEO-Five Factor Inventory (NEO-FFI), the Rumination-Reflection Questionnaire (RRQ), and the Event Related Rumination Inventory (ERRI) were used in the study.
Results
Conscientiousness is positively and neuroticism is negatively related to PTG. Reflection and both types of ruminations about the experienced event, i.e. intrusive and deliberate, are positively associated with positive posttraumatic changes. The multiple mediation analysis (double mediation model) indicated that intrusive ruminations about the experienced event and reflection (reflective rumination), treated in terms of disposition, play the role of suppressors in the relation between neuroticism and PTG. Neuroticism lowers the ability to perceive the positive effects of experienced trauma, but promotes intrusive ruminating, which, in combination with reflection, increases the level of PTG.
Conclusions
Ruminations seem to play a more important role in occurrence of PTG than personality. Ruminations about the experienced situation are more significant than trait-like rumination for the occurrence of positive posttraumatic changes.
Downloads
References
An, Y., Ding, X., & Fu, F. (2017). Personality and posttraumatic growth of adolescents 42 months after the Wenchuan earthquake: a mediated model. Frontiers in Psychology, 8, 2152. https://doi.org/10.3389/fpsyg.2017.02152.
Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health Psychology, 25, 47–56.
Brooks, M., Graham-Kevan, N., Robinson, S. J., & Lowe, M. (2018). Trauma characteristics and posttraumatic growth: The mediating role of avoidance, coping, intrusive thoughts and social support. Psychological Trauma. Theory Research Practice and Policy. https://doi.org/10.1037/tra0000372.
Calhoun, L. G., & Tedeschi, R. G. (1998). Posttraumatic growth: Future directions. In R. G. Tedeschi, C. L. Park, & L. G. Calhoun (eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 1–23). New Jersey: Lawrence Erlbaum Associates.
Calhoun, L. G., & Tedeschi, R. G. (2006). The foundations of posttraumatic growth: An expanded framework. In L. G. Calhoun & R. G. Tedeschi (eds.), Handbook of posttraumatic growth: Research and practice (pp. 3–23). New Jersey: Lawrence Erlbaum Associates.
Calhoun, L. G., Cann, A., & Tedeschi, R. G. (2010). The posttraumatic growth model: Sociocultural considerations. In T. Weiss & R. Berger (eds.), Posttraumatic growth and culturally competent practice: Lessons learned from around the globe (pp. 1–14). New Jersey: John Wiley & Sons.
Cann, A., Calhoun, L. G., Tedeschi, R. G., Triplett, K. N., Vishnevsky, T., & Lindstrom, C. M. (2011). Assessing posttraumatic cognitive processes: the Event Related Rumination Inventory. Anxiety, Stress and Coping, 24, 137–156.
Carboon, I., Anderson, V., Pollard, A., Szer, J., & Seymour, J. (2005). Posttraumatic growth following a cancer diagnosis: do world assumptions contribute? Traumatology, 11, 269–283.
Carter, J. A. (2010). Worry and rumination: Measurement invariance across gender. Doctoral thesis, Utah State University. digitalcommons.usu.edu/ cgi/viewcontent.cgi?article=1801&context=etd.
Casellas-Grau, A., Ochoa, C., & Ruini, C. (2017). Psychological and clinical correlates of posttraumatic growth in cancer: a systematic and critical review. Psycho-Oncology, 26, 2007–2018. https://doi.org/10.1002/pon.4426.
Chan, M. W., Ho, S. M., Tedeschi, R. G., & Leung, C. W. (2011). The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer. Psycho-Oncology, 20, 544–552.
Cichocka, A., & Bilewicz, M. (2010). Co się kryje w nieistotnych efektach statystycznych? Możliwości zastosowania analizy supresji w psychologii społecznej [What is hidden in nonsignificant effects? Application of suppression analysis in social psychology]. Psychologia Społeczna, 5, 191–198.
Cordova, M. J., Studs, J. L., Hann, D. M., Jacobsen, P. B., & Andrykowski, M. A. (2000). Symptom structure of PTSD following breast cancer. Journal of Traumatic Stress, 13, 301–309.
Cormio, C., Muzzatti, B., Romito, F., Mattioli, V., & Annunziata, M. A. (2017). Posttraumatic growth and cancer: a study 5 years after treatment. Support Care Cancer, 25, 1087–1096. https://doi.org/10.1007/s00520-016-3496-4.
Costa, P. J., & McCrae, R. R. (1989). NEO-PI/FFI. Manual supplement. Odessa, FL: Psychological Assessment Resources.
Foa, E. B., Chrestman, K. R., & Gilboa-Schechtman, E. (2014). Przedłużona ekspozycja w terapii PTSD nastolatków. Emocjonalne przetwarzanie traumatycznych doświadczeń [Extended exposure in PTSD therapy for teenagers. Emotional processing of traumatic experiences]. Sopot: Gdańskie Wydawnictwo Psychologiczne.
Helgeson, V., Reynolds, K., & Tomich, P. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74, 797–816.
Janoff-Bulman, R. (2006). Schema-change perspectives on posttraumatic growth. In L. G. Calhoun & R. G. Tedeschi (eds.). Handbook of posttraumatic growth – research and practice (pp. 81–99). New Jersey: Lawrence Erlbaum Associates.
Joormann, J., Dkane, M., & Gotlib, I. (2006). Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases. Behavior Therapy, 37, 269–280.
Karanci, A. N., Işıklı, S., Aker, A. T., Gül, E. I, Erkan, B. B., Özkol, H., & Güzel, H. Y. (2012). Personality, posttraumatic stress and trauma type: Factors contributing to posttraumatic growth and its domains in a Turkish community sample. European Journal of Psychotraumatology, 3. http://dx.doi.org/10.3402/ejpt.v3i0.17303.
Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: a review. Journal of Traumatic Stress, 17, 11–21.
Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Ruminations in posttraumatic stress disorder. Depression and Anxiety, 24, 307–317. https://doi.org/10.1002/da.20228.
Morris, B., & Shakespeare-Finch, J. (2011). Rumination, post-traumatic growth, and distress: structural equation modeling with cancer survivors. Psycho-Oncology, 20, 1176–1183.
Mystakidou, K., Tsilika, E., Parpa, E., Galanos, A., & Vlahos, L. (2008). Post-traumatic growth in advanced cancer patients receiving palliative care. British Journal of Health Psychology, 13, 633–646.
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed depressive/anxiety symptoms. Journal of Abnormal Psychology, 109, 504–511.
Ogińska-Bulik, N. (2010). Potraumatyczny rozwój w chorobie nowotworowej – rola prężności [Posttraumatic growth In cancer disease – the role of resiliency]. Polskie Forum Psychologiczne, 15, 125–139.
Ogińska-Bulik, N. (2015). Dwa oblicza traumy – negatywne i pozytywne skutki zdarzeń traumatycznych u pracowników służb ratowniczych [Two faces of trauma – negative and positive effects of traumatic events in employees of emergency services]. Warsaw: Wyd. Difin.
Ogińska-Bulik, N. (2016). Rola ruminacji w występowaniu pozytywnych zmian potraumatycznych u osób zmagających się z chorobami nowotworowymi [The role of rumination in occurrence of posttraumatic positive changes in people struggling with cancer]. Psychoonkologia, 20, 1–8. https://doi.org/10.5114/pson.2015.55305.
Ogińska-Bulik, N. (2017a). Potraumatyczny wzrost u chorych onkologicznie – rola osobowości i ruminacji [Posttraumatic growth among people with oncological disease – the role of personality and rumination]. Psychiatria, 14, 53–60.
Ogińska-Bulik, N. (2017b). Rumination and coping with stress resulting from HIV infection. Przegląd Psychologiczny, 60, 211–222.
Ogińska-Bulik, N., & Juczyński, Z. (2010). Rozwój potraumatyczny – charakterystyka i pomiar [Posttraumatic growth – characteristic and measurement]. Psychiatria, 7, 129–142.
Ogińska-Bulik, N., & Juczyński, Z. (2015). Inwentarz Ruminacji o Negatywnym Zdarzeniu – polska adaptacja the Event Related Rumination Inventory [The Polish adaptation of the event related rumination inventory]. Przegląd Psychologiczny, 58, 383–400.
Park, C. L., & Folkman, S. (1997). Stability and change in psychosocial resources during caregiving and bereavement in partners of men with aids. Journal of Personality, 65, 421–447.
Park, C. L., Chmielewski, J., & Blank, T. O. (2010). Posttraumatic growth: Finding positive meaning in cancer survivorship moderates the impact of intrusive thoughts on adjustment in younger adults. Psycho-Oncology, 19, 1139–1147.
Preacher, K., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891. https://doi.org/10.3758/BRM.40.3.879.
Radoń, S. (2014). Kwestionariusz Ruminacji-Refleksyjności – polska adaptacja the RuminationReflection Questionnaire [Construction and validation of the Polish version of the Rumination-Reflection Questionnaire]. Psychoterapia, 169, 61–72.
Salsman, J. M., Segerstrom, S. C., Brechting, E. H., Carlson, C. R., & Andrykowski, M. A. (2009). Posttraumatic growth and posttraumatic stress disorder symptomatology among colorectal cancer survivors: a 3 month longitudinal examination of cognitive processing. Psycho-Oncology, 18, 30–41.
Shakespeare-Finch, J., Gow, K., & Smith, S. (2005). Personality, coping and posttraumatic growth in emergency ambulance personnel. Traumatology, 11, 325–334.
Shelby, R., & Golden-Kreutz, D. (2008). PTSD diagnoses, subsyndromal symptoms and commorbidity contribute to impairments for breast cancer survivors. Journal of Traumatic Stress, 21, 165–172.
Słowińska, A., Zbieg, A., & Oleszkowicz, A. (2014). Kwestionariusz Ruminacji-Refleksyjności (RRQ) Paula D. Trapnella i Jennifer D. Campbell – polska adaptacja metody [Paul D. Trapnell and Jennifer D. Campbell’s Rumination-Reflection Questionnaire (RRQ) – Polish adaptation of the measure]. Polskie Forum Psychologiczne, 19, 457–478.
Stockton, H., Hunt, N., & Joseph, S. (2011). Cognitive processing, rumination and posttraumatic growth. Journal of Traumatic Stress, 24, 85–92.
Taku, K., Kilmer, R. P., Cann, A., Tedeschi, R. G., & Calhoun, G. (2012). Exploring posttraumatic growth in Japanese youth. Psychological trauma: Theory, Research, Practice and Policy, 4, 411–419.
Tashiro, T., & Frazier, P. (2003). “I’ll never be in a relationship like that again”. Personal growth following romantic relationship breakups. Personal Relationship, 10, 113–128.
Tedeschi, R. G., & Calhoun, L. G. (1996). The PostTraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–8.
Trapnell, P. D., & Campbell, J. D. (1999). Private consciousness and the Five-Factor Model of Personality: Distinguishing rumination from reflections. Journal of Personality and Social Psychology, 76, 284–304.
Vishnevsky, T., Cann, A., Calhoun, A., Tedeschi, R., & Demakis, G. (2010). Gender differences in selfreported posttraumatic growth: a meta-analyses. Psychology of Women Quarterly, 34. journals. sagepub.com/doi/10.1111/j.1471-6402.2009.01546.
Wu, X., Zhou, X., Wu, Y., & An, Y. (2015). The role of rumination in posttraumatic stress disorder and posttraumatic growth among adolescents after the Wenchuan earthquake. Fronties in Psychology, 4, 1335. https://doi.org/10.3389/fpsyg.2015.01335.
Zawadzki, B., Strelau, J., Szczepaniak, P., & Śliwińska, M. (1998). Inwentarz Osobowości NEO-FFI Costy i McCrae [Personality Inventory NEO-FFI of Costa and McCrae]. Warsaw: Pracownia Testów Psychologicznych PTP.
Zwahlen, R., Krsna Rajandram, R., & Jenewein, J. (2016). Post-traumatic growth in oral cavity cancer in relation to positive coping strategies, hope and optimism. In C. Martin, V. Preedy, & V. Patel (eds.), Comprehensive guide to posttraumatic stress disorders (pp. 1783–1796). Cham: Springer.