UNDERSTANDING TRAUMA AND GROWTH IN AN INTEGRATIVE PSYCHOSOCIAL FRAMEWORK AMONG FLOOD AFFECTED INDIVIDUALS

Abstract

Numerous studies have detailed the maladies imposed by 2010 floods in Pakistan. However, little work has examined potential benefits gathered in the wake of the flood. After experiencing an advers e event, positive personal change (posttraumatic growth [PTG]), a construct getting expanded consideration in the literature for last couple of years. The aim of this longitudinal study was to understand the trauma and growth in an integrative psychosocial framework. More specifically, the study had undertaken to examine the relationship and psychosocial correlates of posttraumatic stress (PTS) and posttraumatic growth and the trajectory of PTS, distress responses, rumination patterns and PTG across time.For the data, individuals 16 to 64-year-olds (M = 28.25 years, SD = 9.59), men (n=1402) and women (n=598) were taken approximately 2 years after flood by utilizing purposive convenient sampling. Data was collected at three time points (T1 [Time 1]), T2 and T3) that were six months apart. At T1 data of 2000 of individuals was taken from different flood affected areas of Pakistan, to be specific: Neelum Valley, Azad Kashmir; Dera Ghazi Khan, Mianwali, and Muzafargarh from Punjab; and Nowshera and Peshawar from Khyber Pukhtunkhwa. For the longitudinal study, one flood affected area, Mianwali (Punjab) was selected for the data of T2 and T3 of the study (N= 239; Mean age = 27.50, SD = 9.85) men (n=115) and women (n=124) and (N= 153; Mean age =26.75, SD = 9.56) men (n=63) and women (n=90) , respectively. T1 data was collected dUling January 2013 ; T2 data was collected in July 2013 and the T3 data was collected in February, 2014. Almost 73 per cent of the original sample responded in T2, and 47 percent of the original sample responded at T3. For the first point of the study, results demonstrated that PTS, intrusive rumination, deliberate rumination, social support, life satisfaction were positively associated with PTG while psychological distress was negatively associated with PTG. Coping strategies such as positive reframing, planning, active coping, and religious coping were positively associated with PTG while; substance use coping and self-blame coping were negatively associated with PTG. Psychological distress, PTS, intrusive rumination, deliberate rumination, and PTG were higher among women as compared to men. Hierarchal regression analysis demonstrated that flood appraisal, social support, psychological wellbeing, intrusive rumination and deliberate xii rumination were the significant predictors of PTG. Moreover, active coping, denial coping, positive reframing, planning, humor, religion, and use emotional support were the significant predictors of PTG, while utilization of self-blame coping negatively predicted PTG and overall explained 35 % variance in PTG. SEM results showed that the predictors (i .e., flood appraisal, PTS, intrusive rumination, deliberate rumination, social support and coping strategies) explained 46 % variance to PTG. Model unconstrained results showed that this model can be applicable for both the genders. Second time point study [T2] was conducted to see the patterns of change across time (i.e., Tl and T2), paired sample t-test and ANOV A was computed to see the difference of distress responses, PTS, rumination patterns and PTG crosswise over Tl and T2. Results showed a significant decline in T2 scores on these variables. The same pattern of decline was seen among both the gender at T2. These results were in accordance with the past studies. Regression analysis showed that psychological distress T2 negatively predicted the PTG T2 and deliberate rumination T2 positively predicted the PTG. PTG Tl significantly predicted PTG T2. To see the longitudinal path across time, P S I was the significant' predictor of P S 2 and explained 23 % of variance in PTS T2. Moreover, PTG Tl was the significant predictor of PTG T2 and overall the model explained 24 % of variance in PTG T2. In the third time point [T3], before taking the data from the flood affected area, that area was again stricken by the flood in August 2013. Repeated Measure ANOV A was used. Results demonstrated a significant increment in the scores on deliberate rumination, PTG and its subscales relating to others, spiritual change, and life appreciation,in T3 as compared to T2. However, there was nonsignificant difference in T1 and T3 on these variables. To see the trajectory of PTS and PTG, both the cross sectional path and longitudinal paths were analysed. Cross sectional paths showed that PTS T1 predicted PTG T 1. PTS T2 predicted PTG T2 and PTS T3 predicted PTG T3. Moreover, predictors of PTG T1 explained 13 % variance. Predictors of PTG T2 explained 29 % of variance and the predictors of PTG T3 explained 34 % of variance. To see the longitudinal path across time, PTS Tl significantly predicted PTS T2 and PTS T2 significantly predicted PTS T3 . Similarly, PTG Tl significantly predicted PTG T2 and PTG T2 significantly predicted PTG T3 xiii Findings of this study would advance our knowledge in understanding that trauma and growth could be understood in an integrative psychosocial framework. Moreover, it would enhance our insight to the trajectory of trauma and growth among flood affected individuals. Study limitations included the utilization of self-report measures, convenient sampling, and reliance on the retrospective self-reports of survivors, which were often subject to recall and social desirability biases. At the end conceptual issues, theoretical considerations, methodological recommendations for future research, and the implications of these findings for policy, research, and clinical practice are discussed.