Personality and Individual Differences 169 (2021) 110222

Contents lists available at ScienceDirect

Personality and Individual Differences

journal homepage: www.elsevier.com/locate/paid

Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across T

ten countries: Global validation of the PTG-PTD theoretical model☆
Kanako Takua, , Richard G. Tedeschib, Jane Shakespeare-Finchc, Daniel Kroschc,
⁎

Georgina Davidc, Doris Kehld, Selina Grunwaldd, Annunziata Romeoe, Marialaura Di Tellae,
Kiyoko Kamibeppuf, Takafumi Soejimaf, Kohichi Hirakig, Rebekah Volginc, Sandesh Dhakalh,
Mariusz Ziębai, Catarina Ramosj,l, Romina Nunesk, Isabel Leall, Patrícia Gouveiaj,
Carolina C. Silval,m, Pamela Núñez Del Prado Chavesn, Claudia Zavalan, Andrea Pazo,
Emre Senol-Durakp, Atsushi Oshioq, Amy Canevellob, Arnie Cannb, Lawrence G. Calhounb
a
Department of Psychology, Oakland University, Rochester, MI, USA
b
Department of Psychological Science, UNC Charlotte, Charlotte, NC, USA
c
School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Australia
d
Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
e
Department of Psychology, University of Turin, Italy
f
Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
g
Nagasaki Wesleyan University, Nagasaki, Japan
h
Central Department of Psychology, Tribhuvan University, Kathmandu, Nepal
i
SWPS University of Social Sciences and Humanities, Centre for Trauma, Crisis and Growth, Poznań, Poland
j
LabPSI – Laboratório de Psicologia, CiiEM - Centro de Investigação Interdisciplinar Egas Moniz, IUEM – Instituto Universitário Egas Moniz, Caparica, Portugal
k
ISPA – Instituto Universitário, Lisbon, Portugal
l
WJCR - William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
m
ADAPT Centre, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
n
Pontificia Universidad Catolica del, Peru
o
Universidad Peruana Cayetano Heredia, Peru
p
Department of Psychology, Bolu Abant Izzet Baysal University, Bolu, Turkey
q
Faculty of Letters, Arts and Sciences, Waseda University, Tokyo, Japan

ARTICLE INFO ABSTRACT

Keywords: This study examined the relationships between posttraumatic growth (PTG) and posttraumatic depreciation
Posttraumatic growth (PTD) across 10 countries and assessed the factorial invariance of the standardized inventory assessing PTG and
Posttraumatic depreciation PTD, the PTGDI-X, the expansion of the PTGI-X (Tedeschi et al., 2017). We also investigated the roles of social
Culture and cognitive factors in PTG and PTD. Data were collected from participants who identified that their most
Core beliefs
stressful life experience met the definition of trauma in Australia, Germany, Italy, Japan, Nepal, Peru, Poland,
Event centrality
Rumination
Portugal, Turkey, and the US. The participants completed the PTGDI-X and inventories measuring posttraumatic
Disclosure stress disorder symptoms, and predictor variables such as reexamination of core beliefs, centrality of the event,
rumination, and disclosures. Results identified universal aspects such as equivalence of factor loadings of the
PTGDI-X and the impact of positive/negative disclosure on PTG and PTD. Results also revealed culture-specific
aspects, including the relationships between PTG and PTD, and different patterns of cognitive predictors for PTG
and PTD. The current study offered the insight that, for the first time using international data, positive and
negative post-trauma changes are not likely to be on opposing ends of one dimension, and it is essential to use
the PTGDI-X to better understand both positive and negative aspects of post-traumatic experiences.

A part of this study was funded by the grant 2013/10/E/HS6/00502 from the National Science Center, Poland, awarded to Mariusz Zięba.
☆

All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of
interest.
⁎
Corresponding author at: Department of Psychology, Oakland University, 654 Pioneer Drive, 123 Pryale Hall, Rochester, MI 48309, USA.
E-mail address: [email protected] (K. Taku).

https://doi.org/10.1016/j.paid.2020.110222
Received 14 February 2020; Received in revised form 13 May 2020; Accepted 26 June 2020
Available online 06 July 2020
0191-8869/ © 2020 Elsevier Ltd. All rights reserved.
K. Taku, et al. Personality and Individual Differences 169 (2021) 110222

1. Introduction beliefs about self, others, and the world (Cann, Calhoun, Tedeschi,
Kilmer, et al., 2010). When the event challenges one's core beliefs, in-
Posttraumatic growth (PTG) or positive psychological changes have dividuals are forced to rebuild their cognitive system. The degree of
been reported by people around the world who struggled with the challenged core beliefs has been shown to be one strong predictor for
aftermath of a highly stressful and potentially traumatic life event PTG (Wilson et al., 2014), however, its relationship with PTD is un-
(Weiss & Berger, 2010). The phenomenon of PTG are generally ob- known. Similar to this concept, event centrality, the extent to which the
served in the five domains (Shakespeare-Finch et al., 2013). The first memory of adversity becomes central to one's identity (Berntsen &
domain is an increased sense of self-reliance or strength. The second lies Rubin, 2006), has been suggested to predict both PTG and PTD
in the changed quality of relationship that includes more compassion (Allbaugh et al., 2016). We therefore hypothesized that across the
and feeling of connectedness. The third domain reflects the experience cultures, challenged core beliefs would be positively associated with
of finding a new or different path in life that would not have been a part PTG, whereas event centrality would be positively associated with both
of one's life if there had been no adversity. The fourth domain includes PTG and PTD because the event may become central to one's identity
a greater appreciation for life. And the fifth domain contains spiritual whether it leads to either positive or negative change after a trauma
and existential changes that may include a deeper understanding of (Groleau et al., 2013).
philosophical questions. These five domains have been validated in Second, cognitive processing followed by challenged core beliefs
quantitative studies (Taku et al., 2008) and identified by thematic also plays a major role in PTG (Cann et al., 2011). Two distinct types
analyses (Mosher et al., 2017). have been identified. “Intrusive rumination” often occurs as an auto-
While studies have examined the nature of these five domains of matic uncontrollable negative thought while “deliberate rumination” is
PTG, researchers have pointed out that people experience both positive more effortful, constructive, and intentional in nature. Positive impact
and negative changes in the aftermath of a trauma (Cann, Calhoun, of deliberate rumination on PTG has been consistently reported (e.g.,
Tedeschi, & Solomon, 2010). For example, people who became more Tedeshci & Blevins, 2015), whereas the impact of intrusive rumination
self-reliant might also recognize how much they need others' support on PTG is equivocal, but mostly weak or none (Gul & Karanci, 2017).
and felt more vulnerable than they thought they were. People who On the other hand, intrusive rumination showed a positive association
learned how wonderful and helpful other people are might also have with PTD (Cann, Calhoun, Tedeschi, Kilmer, et al., 2010) and deliberate
learned how cruel and inconsiderate some people could be. These rumination showed a smaller, although still positive, relationship with
seemingly opposite changes were referred to as posttraumatic depre- PTD (Allbaugh et al., 2016). We hypothesized that intrusive rumination
ciation (PTD) and have been recognized in the same five domains would be associated with PTD, whereas deliberate rumination would be
(Baker et al., 2008; Cann et al., 2010). A concept of PTD reflects the associated with PTG.
opposite side of PTG to more comprehensively understand both positive The third component that explains PTG and PTD are the impact of
and negative changes that may happen after a trauma in a parallel way. disclosure (Tedeschi et al., 2018). Self-disclosure has been shown to
Studies indicate that some people experience both PTG and PTD con- foster PTG regardless of different methods of disclosure (Slavin-Spenny
currently. A longitudinal study with tsunami survivors, for example, et al., 2011). However, disclosure may lead to PTD when the person
revealed that people who experienced multiple trauma showed a perceives his/her disclosure was not well-received by others, because it
greater level of both PTG and PTD than those who experienced a single would lead to a sense of regret and lack of emotional bonds. If, how-
exposure (Michélsen et al., 2017). In addition, PTG is more reported ever, the person recognized that his/her disclosure was well-received
than PTD (Cann, Calhoun, Tedeschi, Kilmer, et al., 2010; Michélsen by others, it would lead to PTG. Little research was done about the
et al., 2017). However, little research has been conducted to examine impact of positive and negative experiences of self-disclosure on PTG
the domain level of PTD. and PTD.
Several studies have also attempted to capture PTG and the corre- In summary, we investigated the potentially different patterns of
sponding negative changes by applying a single dimension ranging these theory-driven predictors, that is, core belief disruption (Cann,
from “much worse or less than before” to “much better or more than Calhoun, Tedeschi, Kilmer, et al., 2010) and event centrality (Berntsen
before”, while placing no change or “same as before” in the middle, & Rubin, 2006), cognitive processing (Cann et al., 2011), and positive
assuming that people should experience either positive or negative and negative perceptions about self-disclosure (Müller et al., 2000) on
changes as a result of a trauma (e.g., Nordstrand et al., 2017). However, PTG and PTD.
it is important to allow study participants to report positive and nega-
tive changes that may happen concurrently, because studies that ex- 2. Method
amined PTG and PTD generally support the independent nature of these
two constructs (Barrington & Shakespeare-Finch, 2013). One study 2.1. Participants and procedure
demonstrated an inverted-U shape relationship between PTG and PTD,
suggesting that PTG is greatest when the level of PTD is not too low or The participants responded to demographic measures, reported one
high (Michélsen et al., 2017). However, this finding has not been re- major traumatic life experience, and indicated whether their event met
plicated. The first aim of the present study was to investigate the re- the definition of a trauma according to DSM-IV (American Psychiatric
lationship of PTG and PTD, as well as posttraumatic stress disorder Association, 2000). Those who met the criteria then rated the severity
(PTSD) symptoms across countries, as a meta-analytical study has of the event, stressfulness when the event happened, the stressfulness
suggested that PTG is also correlated with PTSD symptoms in a positive when they took the survey, and the level of resolution. They then re-
or curvilinear manner (Shakespeare-Finch & Lurie-Beck, 2014). We also sponded to a series of inventories that measure PTG, PTD, and the re-
assess the factorial invariance of the standardized inventeory assessing levant social cognitive factors based on their traumatic experiences.
PTG and PTD, the Posttraumatic Growth and Posttraumatic Deprecia- Sample information is presented in Supplemental Table S1.
tion Inventory - Expanded version (PTGDI-X) and provide the psycho-
metric properties. 2.1.1. Australian sample
The second aim was to identify the psycho-social factors that would Of 231 adults who participated (189 university students and 42
explain PTG and PTD. A theoretical model depicting the PTG process members of community sample), 226 identified that their experience
has been refined across diverse samples and cultural contexts (Tedeschi met the definition of a trauma (18.58% women; 18 to 69 years old;
et al., 2018, for review). According to the model, three components Mage = 26.28; SD = 12.14). Data were collected online. University
primarily explain PTG and possibly PTD. First, a potentially traumatic students were offered course credit, and the members from the com-
life event may challenge one's core beliefs, a broad set of fundamental munity participated with no incentives. The research was approved by

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K. Taku, et al. Personality and Individual Differences 169 (2021) 110222

the Queensland University of Technology Human Research Ethics and via the dissemination of an online survey link through email and
Committee. social networks. The participants did not receive any compensation or
course credits for their participation. The research was approved by the
2.1.2. German sample ISPA-Instituto Universitário and by the Instituto Universitário Egas
A total of 202 adults who met the criteria participated in an online Moniz, Portugal.
survey. The participants, an adult community sample, included emer-
gency personnel working in the field of civil protection and trauma 2.1.9. Turkish sample
survivors from the general population (67.82% women; 18 to 78 years A total of 169 adults were recruited from introductory psychology
old; Mage = 34.71; SD = 12.01). Participants could win one of twenty classes at one university as well as the community (78.11% women; 18
15 euros Amazon vouchers in a voluntary raffle. The research was ap- to 83 years old; Mage = 24.45; SD = 8.39). The online survey link was
proved by the Ethics Committee of the University Medicine Greifswald, shared with students at classes and website of a Turkish researcher to
Germany. recruit potential participants who had a traumatic experience. All
participants voluntarily completed the scales online. The research was
2.1.3. Italian sample approved by the Institutional Research Board of Bolu Abant Izzet Baysal
Initially, students of the Department of Psychology at the [removed University, Turkey.
for blind review] were involved in the recruitment of potential parti-
cipants. The volunteers were contacted by e-mail and informed about 2.1.10. American sample
the current research study. A total of 321 participants who met the A total of 214 adults who met the criteria completed an online study
inclusion criteria, agreed to take part in the study, and completed the (46.73% women; 21 to 68 years old; Mage = 35.51; SD = 10.06) via
online survey (76.01% women; 18 to 72 years old; Mage = 29.98; Amazon's Mechanical Turk (MTurk). The participants received $1.60
SD = 11.34). The study was approved by the bioethics committee of the upon completion. The research was approved by the Institutional
University of Turin, Italy. Research Board of University of North Carolina at Charlotte, USA.

2.1.4. Japanese sample 2.2. Measures

Of 514 adults, including undergraduate students and firefighters,
who participated in the survey, 130 met the criteria for traumatic event 2.2.1. Expanded version of the PTG and PTD Inventory (PTGDI-X)
(54.62% women; 19 to 64 years old; Mage = 25.75; SD = 10.76). PTG and PTD were assessed using the Posttraumatic Growth and
Participants were recruited in a fire station and from psychology classes Posttraumatic Depreciation Inventory - Expanded version (PTGDI-X) and
at seven universities. Participants did not receive any compensation or the translated version for each country. The PTGDI-X is a 50-item in-
course credit for participation. The survey was conducted using a paper ventory that measures the aforementioned five domains of PTG (PTGI-X:
and pencil survey in a group setting. The study was approved by the Tedeschi et al., 2017) and PTD. Participants indicated the degree to
Institutional Review Board of Tokyo University, Japan. which they did or did not experience a particular change from 0 to 5,
with separate scores calculated for PTG and PTD. Higher scores indicate
2.1.5. Nepali sample greater growth or depreciation. The α for the total PTG was 0.93 (Italy)
Of 247 adults, 196 met inclusion criteria and were instructed to or higher, and also 0.93 (Turkey and Portugal) or higher for PTD.
respond to the survey on the basis of the most traumatic event they
have experienced, including the earthquake that happened in 2015 2.2.2. PTSD symptoms
(65.82% women; 18 to 83 years old; Mage = 24.45; SD = 8.39). It was PTSD symptoms were assessed by the PTSD Checklist for DSM-5
a paper pencil survey and the participants did not receive any com- (PCL-5; Blevins et al., 2015; Weathers et al., 2013) and its translated
pensation for participating in the survey.The study was approved by versions. The PCL-5 consists of 20 items. Participants indicated how
Government of Nepal, Nepal Health Research Council. much they have been bothered by each symptom using a 5-point scale
from 0 to 4. Cronbach's α was 0.93 (Nepal) or above.
2.1.6. Peruvian sample
A total of 201 adults who met the inclusion criteria participated in 2.2.3. Event centrality
an online survey (75.62% women; 18 to 61 years old; Mage = 25.29; Event centrality was assessed by using the Centrality of Event Scale
SD = 9.63). They were recruited in different institutions such as the (CES: Berntsen & Rubin, 2006) and its translated versions. The CES
national oncological hospital and the children's hospital. They were consists of 7 items. Participants indicated the degree to which the focal
instructed to identify one traumatic event that happened within the event was central to their identity using a 5-point scale from 1 to 5.
past two years. The data was part of a bigger research project that has Cronbach's α ranged from 0.85 (Nepal) to 0.92 (Peru).
IRB approval from Instituto Nacional de Enfermedades Neoplasicas
(INEN, the National Oncological Hospital in Peru) and Pontificia 2.2.4. Core beliefs examination
Universidad Catolica del Peru. Examination of core beliefs was assessed using the Core Beliefs
Inventory (CBI: Cann, Calhoun, Tedeschi, Kilmer, et al., 2010) and its
2.1.7. Polish sample translated versions. The CBI consists of 9 items. Participants indicated
A total of 287 undergraduate and graduate students who met the the degree to which the focal event led them to seriously examine their
criteria participated in the study (85.02% women; 18 to 67 years old; core beliefs using a 6-point scale from 0 to 5. Cronbach's α ranged from
Mage = 28.24; SD = 8.99). They were recruited from psychology 0.74 (Nepal) to 0.89 (Peru).
classes at three campuses of a university. Participants received credits
for their participation. The study was approved by the SWPS University 2.2.5. Intrusive and deliberate rumination
of Social Sciences and Humanities Institutional Research Ethics Body. Intrusive and deliberate rumination in the aftermath of the trauma
were assessed using the Event-Related Rumination Inventory (ERRI:
2.1.8. Portuguese sample Cann et al., 2011) and its translated versions. Participants responded to
A total of 181 adults met the criteria and participated in the study 10 items measuring intrusive rumination and 10 items measuring de-
(73.48% women; 18 to 73 years old; Mage = 32.34; SD = 12.91). They liberate rumination using a 4-point scale from 0 to 3. Cronbach's α for
were recruited from two universities as well as from the community. In the intrusive rumination was 0.94 or above, and for the deliberate ru-
both samples the survey was conducted by personal face-to-face contact mination ranged from 0.88 (Italy and Portugal) to 0.92 (Japan).

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K. Taku, et al. Personality and Individual Differences 169 (2021) 110222

2.2.6. Positive and negative disclosure countries. Similarly, the negative impact of negative disclosure on PTD
An adapted version of the Cognitive and Emotional Processing from was consistent across the countries, however, the impact of the other
Disclosure Inventory (Müller et al., 2000) was used to assess positive predictors varied across the countries.
aspects of disclosure with 11 items and negative aspects of disclosure
with 9 items. Participants responded using a 6-point scale from 0 to 5. 4. Discussion
Cronbach's α for both positive and negative aspects of disclosure were
0.91 or above for all countries. This was the first study that analyzed international data to examine
the nature of the relationships between PTG and PTD. The respondents
2.3. Data analysis overall reported more PTG than PTD, being consistent with previous
studies (Cann, Calhoun, Tedeschi, Kilmer, et al., 2010; Michélsen et al.,
After obtaining the descriptive statistics, multigroup confirmatory 2017). Results supported the weak invariance of factor loadings of the
factor analyses (MGCFAs) were conducted to test for measurement in- PTGDI-X across the countries, however, invariance in the relationships
variance of the PTGDI-X. Missing data were handled by using person- between the five PTG and PTD factors and their respective higher order
level mean imputation. Correlations were then obtained between PTG factors as well as the covariance between PTG and PTD could not be
and PTD. Two regression models were examined to assess the degree to assumed. In fact, of 10 countries, 5 (Australia, Japan, Turkey, Portugal,
which core beliefs examination, event centrality, intrusive and delib- and Peru) showed no systematic relationships between PTG and PTD,
erate rumination, and positive/negative disclosure, in addition to de- whereas the other 5 countries (i.e., Italy, Nepal, the US, Germany, and
mographics of gender and age, predicted PTG and PTD. Analyses were Poland) indicated a curvilinear relationship, that is, PTG was more
performed using IBM SPSS and AMOS software version 26. likely to be reported when a moderate level of PTD was also present.
These results demonstrate that PTG and PTD are not on opposite ends of
3. Results a single dimension across the board but rather co-exist, being consistent
with findings from other studies (Kunz et al., 2019; Zięba et al., 2019).
3.1. MGCFAs of PTGDI-X Given that PTD and PTSD symptoms were positively correlated with
each other, in line with previous research (Barrington & Shakespeare-
Results of the MGCFAs are presented in Supplemental Table S2. Finch, 2013), PTD was an appropriate indicator measuring the “nega-
Four models were tested and compared. Model 1 was baseline with no tive” aspects of changes after a trauma. It should be noted, however,
restrictions. Model 2 constrained the path coefficients from the PTG and that some of the model fit indices such as TLI and CFI were poor,
PTD five factors to the observed variables (scale items), that is, factor suggesting that there may be an alternative model that would fit better
loadings, to be equal across the ten countries. Model 3 constrained the for each country. One study indicated that PTG and PTD may not reflect
path coefficients from PTG and PTD five factors to each higher order perceptions of positive and negative psychological changes at least in a
factor, PTG and PTD, to be equal, in addition to Model 2. Finally, Model Japanese sample (Oshiro et al., 2019). Future study should examine the
4 constrained the covariance between PTG and PTD to be equal, in paradoxical nature of trauma, instead of relying on the dichotomized
addition to Model 3. Although the fit indices such as NFI and CFI were way, such as either positive or negative outcomes alone.
all poor, RMSEA showed the excellent fit. The difference of CFI between The current study also revealed different patterns of the predictors
the models is less than 0.01, indicating the factorial invariance model for PTG and PTD in each country. Unlike our hypotheses, two main
was satisfactory (Cheung & Rensvold, 2002). Based on the fit indices predictors, reexamination of core beliefs and deliberate rumination,
such as AIC, factorial invariance with the higher order constructs (five showed a positive relationship with PTG only in some countries. Future
factors to their PTG/PTD), that is Model 3, and the covariance between studies should identify the reasons why reexamination of core beliefs
PTG and PTD, that is Model 4, were not supported. Therefore, Model 2 was not a strong predictor for PTG in some samples (e.g., Nepal, US) as
is considered as best fit to the data, meaning each of the PTG/PTD five well as deliberate rumination (e.g., Nepal, Turkey). Similarly, the im-
factors was assessing the same constructs in the same way across the pact of intrusive rumination on PTG also varied. Intrusive rumination
countries, however, the relationships between PTG and PTD as well as could be an indicator of psychological struggle, and thus it could be
what constitutes PTG and PTD varied across the cultures. In the Model positively related to PTG (Cann, Calhoun, Tedeschi, Kilmer, et al.,
2, Standardized regression weights were all greater than 0.77 for PTG 2010). It could, however, also overlap the PTSD symptoms. Our hy-
and PTD. The item level factor loadings were all greater than 0.45 for potheses for PTD were only suppored in some countries. Intrusive ru-
both PTG and PTD. The correlation between PTG and PTD ranged from mination and centrality of the event did not consistently show the po-
−0.37 to 0.23. sitive relationships with PTD. Similar to a previous study (Allbaugh
et al., 2016), we expected event centrality to play a positive role in both
3.2. Descriptive statistics for PTGDI-X PTG and PTD, however, it was only supported with a German sample.
One robust finding in the current study is the role of positive dis-
Descriptive statistics and the correlations among PTG, PTD, and closure on PTG and negative disclosure on PTD. A contrasting re-
PTSD symptoms for each country are presented in Supplemental Tables lationship between positive disclosure and PTG and the relationship
S3 and S4. Participants reported PTG more than PTD across all coun- between the negative disclosure and PTD is consistent with the previous
tries, ranging from t(116) = 4.27, p < .001 for Italy to t(195) = 22.97, findings (Kroemeke et al., 2017). Regardless of the sampling char-
p < .001 for Nepal. Correlations between PTG and PTD varied. Data acteristics, the experience of positive disclosure led to PTG in all
from five countries showed no correlation, whereas the rest five countries studied. These findings suggest that the individual experience
countries indicated a curvilinear relationship. of PTG may be inseparable from social connections and is likely to be
fostered when the person felt relieved and helped after they talked
3.3. Different patterns of the predictors for PTG and PTD about the event. This type of positive disclosure did not, however,
impede the PTD experience. On the other hand, negative experience of
Two regression models were tested to examine the hypothesized self-disclosure predicted PTD, except for Nepal, which may be due to
relationships with a total sample (Supplemental Table S5). However, the extremely low level of PTD reported in Nepal. When people re-
based on the results from MGCFAs, the same models were tested in each flected on their disclosure and felt worse or more confused, it led to
country, separately (Supplemental Tables S6 and S7). The positive PTD experience. Interestingly, negative disclosure did not preclude PTG
impact of positive disclosure on PTG was consistent across the coun- experience across cultures. These findings indicate that the PTG and
tries, however, the impact of the other predictors varied across the PTD processes are again not the opposite, and explained by a uniquet

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K. Taku, et al. Personality and Individual Differences 169 (2021) 110222

set of cognitive and social factors. Lack of positive predictors does not Conceptualization, Methodology, Data curation, Writing - original
automatically cause negative changes. Similarly, lack of negative pre- draft, Writing - review & editing.Kohichi Hiraki:Conceptualization,
dictors does not seem to be enough to lead to PTG. Methodology, Data curation, Writing - original draft, Writing - re-
There are several limitations to be taken into account. For any view & editing.Rebekah Volgin:Conceptualization, Methodology,
findings derived from the cross-cultural data to be valid, it is important Data curation, Writing - original draft, Writing - review &
to establish methodological and sampling equivalence among the cul- editing.Sandesh Dhakal:Conceptualization, Methodology, Data
tures. It is, however, highly challenging because the impact of culture curation, Writing - original draft, Writing - review & editing.Mariusz
often confounds with demographics. For example, Supplemental Table Zięba:Conceptualization, Methodology, Data curation, Writing -
S4 presented cross-national differences in the PTG and PTD domains. original draft, Writing - review & editing.Catarina Ramos:
However, we cannot know if the national background caused these Conceptualization, Methodology, Data curation, Writing - original
differences. Studies have suggested that PTG and PTD may be affected draft, Writing - review & editing.Romina Nunes:Conceptualization,
by the types and combinations of trauma exposure (Michélsen et al., Methodology, Data curation, Writing - original draft, Writing - re-
2017). It would be ideal if we could test our hypotheses by looking at view & editing.Isabel Leal:Conceptualization, Methodology, Data
each event separately. However, the nature of the trauma people ex- curation, Writing - original draft, Writing - review & editing.Patrícia
perienced is also confounded with their national background, geo- Gouveia:Conceptualization, Methodology, Data curation, Writing -
graphic location, and social stigma when reporting the events. Due to original draft, Writing - review & editing.Carolina C. Silva:
this intricate relationship between trauma, demographics, and social- Conceptualization, Methodology, Data curation, Writing - original
psychological factors, the data would become unrepresentative if re- draft, Writing - review & editing.Pamela Núñez Del Prado
searchers selected a part of the data so these factors (e.g., type of the Chaves:Conceptualization, Methodology, Data curation, Writing -
trauma) will be equivalent across cultures. We therefore used the data original draft, Writing - review & editing.Claudia Zavala:
that were obtained from each country by setting a single criterion, that Conceptualization, Methodology, Data curation, Writing - original
is, the data were included only when a respondent confirmed that their draft, Writing - review & editing.Andrea Paz:Conceptualization,
experience met the definition of trauma provided. Findings that were Methodology, Data curation, Writing - original draft, Writing - re-
reported in this study were thus all based on this self-reported trauma. view & editing.Emre Senol-Durak:Conceptualization, Methodology,
In addition, research procedures such as pencil-and-paper surveys Data curation, Writing - original draft, Writing - review &
versus online surveys, open-ended questions versus using a list to editing.Atsushi Oshio:Formal analysis.Amy Canevello:Concept-
identify the focal event, as well as college students versus community ualization, Methodology, Data curation, Writing - original draft,
sample, might have affected the current results. Future studies should Writing - review & editing.Arnie Cann:Conceptualization,
investigate how cross-cultural dimensions such as individualistic-col- Methodology, Data curation, Writing - original draft, Writing - re-
lectivistic and independent-interdependent characteristics might affect view & editing.Lawrence G. Calhoun:Conceptualization, Methodo-
the pathways of PTG and PTD, to develop a culturally sensitive inter- logy, Data curation, Writing - original draft, Writing - review &
vention for trauma survivors. This is particulary important for cultures, editing.
such as Nepal (Kohrt & Hruschka, 2010), where the meanings of trauma
and distress differ from that of Western societies. Appendix A. Supplementary data
In summary, the current study identified universal aspects, such as
equivalence of factor loadings of the PTGDI-X and the impact of posi- Supplementary data to this article can be found online at https://
tive/negative disclosure on PTG and PTD, as well as culture-specific doi.org/10.1016/j.paid.2020.110222.
aspects, including the relationships between PTG and PTD, and dif-
ferent patterns of cognitive predictors for PTG and PTD. These findings References
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