Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction. In recent years, the population of Ukraine has been exposed to powerful psychosocial stress associated with the war. The stress of the current war is one of the most powerful and dangerous distress factors, which is closely related to the risk of psychopathological disorders, psychosocial maladjustment and significant deterioration in the quality of life and psychosocial functioning, especially in the most vulnerable populations, including internally displaced persons [1–3]. The stress of war is characterised by the totality of the damage, the massive nature of the impact and profound mental disorders, which gives grounds to consider it as one of the greatest threats to the health of both individuals and society as a whole [4–6]. In these circumstances, the search for ways to counteract the destructive effects of war stress on the human psyche and prevent the development of post-traumatic stress-associated disorders is of particular relevance. One of the most promising psychological phenomena aimed at offsetting the negative effects of severe psychosocial distress is post-traumatic growth (PTG). Purpose – to study the peculiarities of interaction of inter- and intrapsychological resources of the individual in the process of posttraumatic growth in people with stress-related disorders that arose under the influence of the stress of war and forced displacement. Materials and methods. In compliance with the principles of biomedical ethics, we examined 67 internally displaced persons who were forced to leave their place of residence as a result of full-scale Russian aggression on the basis of informed consent. These individuals were first examined by us in March–September 2022 when they sought medical, psychological and psychiatric care after forced displacement, and all of them were diagnosed with adaptation disorders according to ICD-10 criteria (code F43.2). The same individuals were re-examined in October–December 2024 using a specially designed questionnaire and psychodiagnostic tools designed for a) determination of clinical and psycho(patho)logical features of post-traumatic distress (The Mississippi Scale for Civilian PTSD [21]), b) establishing the presence and severity of PTG (The Posttraumatic Growth Inventory (PTGI) [20]) c) identification of the state of intrapsychic parameters of personality functioning (2-item modification of Hardiness test (Maddi S.R., 2006) [22], The Connor-Davidson Resilience Scale (Connor K.M., Davidson, J.R.T., 2003) [23], Ways of Coping Questionnaire S. Folkman and R. Lazarus (1988) [24]), d) studying the state of interpersonal personal resources (The Multidimensional Scale of Perceived Social Support (D. Zimet et al., 1988) [25]). The statistical analysis consisted of the formation of descriptive statistics, as well as the analysis of differences in quantitative indicators using the non-parametric Mann–Whitney test, and correlation analysis of relationships using the Spearmanʼs rank correlation method. The acceptable level of statistical significance of differences and correlations was 95% (p<0.05) Results. Subjects with low levels of PTSD showed high values both for the overall PTSD score and for its individual components: intrusion, avoidance, excitability, and guilt symptoms. Differences in the values of the indicators between this group and the group with a high level of PTG were significant for all indicators, and with the group with a moderate level of PTG – for all indicators, except for the symptoms of excitability. Persons with moderate PTG had higher PTSD severity scores compared to subjects with high PTG, however, the differences between these groups were not statistically significant (p>0.05). Among the subjects with a high level of PTG, 14.3% had no signs of PTSD, 81.0% had some symptoms of PTSD, and 1 subject (4.7%) had signs of clinically manifested PTSD. The PTGI score revealed significant inverse correlations of moderate strength with both the overall PTSD score and the severity of individual PTSD symptoms. The PTG score was directly correlated with the severity of the coping strategies of distancing, self-control, seeking social support, accepting responsibility, planning for problem solving, and positive reassessment, and inversely with the severity of confrontational coping and escape-avoidance strategies. Significant direct correlations were also found with the indicators of hardiness (both with the overall indicator and its individual components), resilience, and social support. The differences in the severity of posttraumatic symptoms in subjects with different levels of PTG are natural, given that PTG is the psychological antithesis of PTSD. Traditionally, traumatic stress is viewed primarily as a source of mental disorders, which hinders the focus on its possible positive effects, even though positive experiences are always closely intertwined with traumatic and pathological ones [16]. The shift in researchersʼ attention to the positive effects of stress, primarily to mindfulness, which has occurred in recent years, has allowed us to confirm that mindfulness (including psychotherapeutically stimulated mindfulness) effectively reduces post-traumatic, depressive, and anxiety symptoms [26]. Our results (including the results of the correlation analysis, which revealed a significant inverse relationship between the PTG and PTSD and its individual symptoms) confirm the evidence that PTG can be considered an effective means of preventing the formation of PTSD, as well as eliminating its manifestations if PTSD has already developed. Conclusions. PTG is a psychological phenomenon, the ability to form which is conditioned by the state of intrapsychic and interpersonal sources of the personality resource base, and variants of their interaction, authentic for each patient. The level of resilience is associated with a higher expression of constructive coping strategies. The core coping strategy for internally displaced persons with adjustment disorders is self-control, which in individuals with low PTG is combined with confrontational coping, and in individuals with high PTG – with strategies for seeking social support, accepting responsibility, planning problem solving, and positive reassessment. The ability to resist stress and recover from distress (resilience and resistance) are basic parameters of intrapsychic functioning, the state of which directly correlates with the level of resilience. A high level of social support is a significant interpersonal resource of PTG. The identified patterns should be taken into account when formulating treatment and rehabilitation tactics for the management of patients with stress-related mental disorders.
Authors: O.O. Belov, M.V. Markova, A.R. Markov
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W4410106124