A Dual-Factor Model of Posttraumatic Responses: Which Is Better, High Posttraumatic Growth or Low Symptoms?

Objective: Experiencing traumatic events may invoke posttraumatic symptoms (PTS) or growth (PTG). Using a dual-factor approach inspired by the dual-factor model of mental health, we explore the intersections of posttraumatic symptoms and growth with 21 strengths and indicators of psychological, physical, and spiritual well-being. Method: A survey completed by 1,966 participants who had experienced at least one prior victimization (average age 29.8 [SD = 1.64]; 63.6% female) assessed strengths, outcomes, and victimization. Participants were classified into four posttraumatic groups: Resilient (low symptoms, high growth, 23.9%), Prevailed (high symptoms, high growth, 26.1% of sample), Detached (low symptoms, low growth, 20.3%), and Distressed (high symptoms, low growth, 29.8%). Results: Analyses of covariance (ANCOVAs) controlling for age, gender, and victimization found that posttraumatic group classification was associated with each regulatory, meaning-making, and interpersonal strength, and every well-being measure. The Distressed group scored the lowest and the Resilient group scored the highest on almost all measures. Notably, the Prevailed group scored above the Detached group on most measures, except for health-related quality of life and optimism, suggesting that high growth may be more beneficial than low symptoms when coping with trauma. Conclusions: Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. Clinical Impact Statement Promoting posttraumatic growth may be more important for supporting well-being after trauma than reducing posttraumatic symptoms.