Posttraumatic Growth, Coping, and Distress: A Systematic Review of Longitudinal Studies

Posttraumatic growth (PTG) refers to positive psychological change following trauma, yet its evolution over time remains underexplored. This systematic review aimed to evaluate longitudinal studies of PTG to analyze trends in its development and examine associated changes in distress and coping strategies. A comprehensive literature search of databases EBSCO, Science Direct, PubMed, and ProQuest was conducted in June 2023. The search identified 628 studies, which were screened according to the inclusion criteria of adult participants with multiple measures of PTG, distress and coping. Following a validated quality assessment to reduce risk of bias, 22 studies were deemed of sufficient quality for data extraction and narrative synthesis. Among these, nine studies reported stable PTG over time, six observed significant increases, and three noted decreases. Four studies employed trajectory analyses, revealing that approximately half of respondents experienced stable PTG, while the remainder showed substantial variability. The relationship between distress and PTG over time was inconsistent, whereas active-adaptive coping strategies were consistently associated with greater PTG. Notably, some studies linked early denial to later gains in PTG. These findings underscore both the relative stability of self-perceived PTG and the heterogeneity in its longitudinal development. PTG increases were more commonly reported in the context of chronic medical trauma (e.g., cancer), whereas acute traumas (e.g., combat, burns) were more likely to show declines or variability in growth. These insights offer practical value for clinicians tailoring support based on trauma type and highlight the importance of future research into trauma-specific recovery pathways.