Date of Award

8-2022

Document Type

Open Access Thesis

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Jean Rhodes

Second Advisor

Alice Carter

Third Advisor

Sarah Lowe

Abstract

As the study of posttraumatic growth (PTG) has progressed in recent years, questions remain about the durability of such growth over time as well as factors that may be associated with that maintenance of PTG. Researchers have begun to investigate this question more rigorously and have identified multiple pathways for the development of PTG, providing empirical support to the theoretical assertion that it is not a fixed construct but rather a process that unfolds over time. However, the narrative of PTG remains largely centered on the individual with less consideration of the potential role of other factors. Greater insight is needed in determining the extent to which both internal and contextual v factors unrelated to the traumatic experience itself are associated with the maintenance or changes in such growth. Further, no studies have been able to account for pre-event characteristics in their analyses, complicating our ability to isolate the association of specific, post-event factors with such growth in the years following survivors’ traumatic experiences. The purpose of this dissertation, therefore, was to reconsider PTG as a dynamic process that occurs over time, shifting the focus from the traumatic event and its immediate aftermath to locate PTG (and the survivor) within the longer-term recovery that survivors experience once the waters have receded and the dust has settled. To achieve this aim, courses of PTG over two time points were identified in a large sample of low-income, primarily Black young mothers exposed to Hurricane Katrina using a multi-wave dataset that included pre-disaster data. Internal characteristics found to be associated with PTG in previous research, as well as contextual factors, such as neighborhood satisfaction and financial instability, derived from theory and research on psychological well-being and recovery, were then evaluated to determine what associations, if any, such factors have with the courses of PTG over time. Participants in the current study were low-income mothers (81.6% identified as non- Hispanic Black) who survived Hurricane Katrina in New Orleans, which made landfall in August 2005. Data for the present study was drawn from surveys completed one year prior to Hurricane Katrina, one year following Hurricane Katrina, four years following Hurricane Katrina (Wave 4; W4), and 12 years following Hurricane Katrina (Wave 5; W5). Survivor PTG was measured using the Posttraumatic Growth Inventory (PTGI) at W4 and W5. Only full scale scores on the PTGI were used in this dissertation. Psychosocial resources, including vi survivor sense of purpose in life, perceived social support, religious coping style, and perceptions of neighborhood satisfaction, were completed at W4. Survivor self-reported experience of potential stressor events that occurred between W4 and W5 were collected at W5. Such stressors covered a variety of domains, including physical health, child-related stressors, weather-related disaster exposure, and financial instability. Possible associations between courses of PTG and the stressor domains were assessed both cumulatively and individually. Data analysis in this dissertation consisted of a series of analyses, including a two-step cluster analysis, ANOVAs, and multinomial logistic regressions, to investigate courses of PTG over time. Results from these analyses identified three distinct courses of PTG in survivors participating in this study: (1) Consistently High PTG (31.6% of overall sample); (2) Low and Decreasing PTG (38.3%); and (3) Increasing PTG (30.1%). Psychosocial resources, including survivors’ reported sense of purpose in life, neighborhood satisfaction, positive religious coping, and sense of social support, were significantly associated with increased odds in membership in the Consistently High PTG course relative to the Low and Decreasing PTG course. Higher scores on positive religious coping were also associated with increased odds in membership in the Increasing PTG course relative to the Low and Decreasing PTG course. Contrary to expectations, negative religious coping was not associated with any course of PTG. Higher overall stressor levels were associated with greater odds of membership in the Low and Decreasing PTG course relative to the other two courses of PTG. Of the specific stressor domains, only financial instability was significantly associated with group membership, with those experiencing higher levels of financial instability vii experiencing increased odds of membership in the Low and Decreasing PTG course relative to the Consistently High PTG course. Participant health stressors and financial instability trended toward significance (p=.08), indicating increased odds in membership in the Low and Decreasing PTG course relative to the Increasing PTG course. In a final analytic step, both psychosocial resources and stressor domains were combined into a single model to determine whether the combination of these factors could create a model that identified significant predictors of PTG course membership. Sense of purpose in life, perceived social support, and positive religious coping remained significant predictors of increased odds of membership in the Consistently High PTG course. Positive religious coping also significantly predicted increased odds of membership in the Increasing PTG course relative to the Low and Decreasing PTG course. Financial instability significantly predicted increased odds of membership in the Low and Decreasing PTG course relative to the Consistently High PTG course. Higher levels of participant health stressors trended toward, but did not reach, significance in predicting increased odds of membership in the Low and Decreasing PTG course relative to the Consistently High PTG (p=.054) and Increasing PTG (p=.09) courses. Implications for theory, research, practice, and policy are discussed.

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