Posttraumatic Growth in Physically Injured Trauma Survivors: Randomized Trial Results and Associations with Clinical Characteristics

OBJECTIVE: Few randomized clinical trials have examined whether interventions that are effective in reducing posttraumatic stress disorder (PTSD) symptoms can simultaneously enhance posttraumatic growth. METHOD: We conducted a secondary analysis of a collaborative care randomized clinical trial that successfully targeted PTSD among 121 physically injured trauma survivors. The trial also included a measure of posttraumatic growth as an outcome. Regression analyses assessed differences between patients randomized to the intervention and control groups on 6-month postinjury posttraumatic growth outcomes. Additional analyses explored which clinical and demographic characteristics were associated with 6-month posttraumatic growth. RESULTS: There were no significant intervention or control group differences in posttraumatic growth at the 6-month time point. When exploring the relationship between baseline characteristics and 6-month posttraumatic growth, regression analyses demonstrated that non-White/Hispanic patients had significantly increased PTGI scores compared to White/non-Hispanic patients, whereas patients who endorsed greater pre-injury bodily pain demonstrated significantly diminished PTGI scores. Cross-sectionally, at the 6-month postinjury time point, PTGI scores demonstrated significant negative associations with suicidal ideation/intent; PTGI spiritual change and appreciation of life subscales demonstrated significant positive associations with PTSD symptoms. CONCLUSIONS: Although posttraumatic growth was not impacted by the collaborative care intervention, non-White/Hispanic race/ethnicity was associated with increased growth, and greater pre-injury bodily pain and suicidal ideation were associated with decreased growth. Future investigations among physically injured trauma survivors could, using these findings, develop stepped care interventions that specifically target posttraumatic growth.