Model of Post-traumatic Growth in Newly Traumatized vs. Retraumatized Adolescents

Hannah Pazderka; Matthew Rg Brown; Caroline Beth McDonald-Harker; Andrew James Greenshaw; Vincent Io Agyapong; Shannon Noble; Monica Mankowski; Bonnie Lee; Joy Omeje; Pamela Brett-MacLean; Deborah Terry Kitching; Leslie A Hayduk; Peter H Silverstone

doi:10.3389/fpsyt.2021.682055

Model of Post-traumatic Growth in Newly Traumatized vs. Retraumatized Adolescents

Front Psychiatry. 2021 Sep 30:12:682055. doi: 10.3389/fpsyt.2021.682055. eCollection 2021.

Authors

Affiliations

¹ Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
² Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, AB, Canada.
³ Department of Computing Science, University of Alberta, Edmonton, AB, Canada.
⁴ Department of Sociology and Anthropology, Mount Royal University, Calgary, AB, Canada.
⁵ Fort McMurray Public School District, Fort McMurray, AB, Canada.
⁶ Fort McMurray Catholic School District, Fort McMurray, AB, Canada.
⁷ Addictions Counselling Program, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
⁸ Department of Sociology, University of Alberta, Edmonton, AB, Canada.

Abstract

Background: In our analysis of adolescents affected by the 2016 Fort McMurray wildfire, we observed many negative mental health effects in individuals with a prior history of psychological trauma. Elevated rates of depression and markers of post-traumatic stress disorder (PTSD) were observed, consistent with the hypothesis that prior trauma may reduce sensitivity thresholds for later psychopathology (stress sensitization). Surprisingly, levels of anxiety did not differ based on prior trauma history, nor were retraumatized individuals at increased risk for recent (past month) suicidal ideation. These results are more suggestive of inoculation by prior trauma than stress sensitization. This led us to consider whether individuals with a prior trauma history showed evidence of Post-Traumatic Growth (PTG), a condition in which the experience of a previous trauma leads to areas of sparing or even improvement. Method: To investigate this issue, we generated a structural equation model (SEM) exploring the role of anxiety in previously traumatized (n = 295) and wildfire trauma alone (n = 740) groups. Specifically, models were estimated to explore the relationship between hopelessness, anxiety, PTSD symptoms, self-efficacy and potential protective factors such as friend and family support in both groups. The model was tested using a cross-sectional sample of affected youth, comparing effects between the two groups. Results: While both models produced relatively good fit, differences in the effects and chi-squared values led us to conclude that the groups are subject to different causal specifications in a number of areas, although details warrant caution pending additional investigation. Discussion: We found that adolescents with a prior trauma history appear to have a more realistic appraisal of potential difficulties associated with traumatic events, and seem less reactive to potentially unsettling PTSD symptoms. They also seemed less prone to overconfidence as they got older, an effect seen in the adolescents without a history of trauma. Our findings provide preliminary evidence that the construct of anxiety may work differently in newly traumatized and retraumatized individuals, particularly in the context of mass trauma events.

Keywords: adolescent; collective trauma; inoculation theory; post-traumatic growth; resilience; retraumatization; stress sensitization; trauma informed practice.