Positive and negative changes after trauma | Psychology Today

Trauma can shatter peoples’ world assumptions. In the process of rebuilding an assumptive world people often report ways in which they change positively. It is becoming increasingly important to integrate this idea into trauma work.
To help do this my colleagues and I have developed a new self-report psychometric tool – the Psychological Well-Being Post-Traumatic Changes Questionnaire (PWB-PTCQ) with which to assess positive changes following trauma.

To illustrate, a sample six items are shown below.

Read each statement below and rate how you have changed as a result of the trauma.

5 = much more so now

4 = A bit more so now

3 = I feel the same about this as before

2 – A bit less so now

1 = Much less so now

1. I like myself____

2. I have confidence in my opinions____

3. I have a sense of purpose in life____

4. I have strong and close relationships in my life____

5. I feel I am in control of my life____

6. I am open to new experiences that challenge me____

Responses to these statements provide an opportunity for people to reflect on how they have changed. 

Did you score over 3 on any of the items? 

Can you think of think of one or two examples in your life that illustrate these changes?

Are there things you can do in the coming weeks that will help you build on and strengthen these changes?

Clinicians will also find the new tool useful as it allows them to bridge their traditional concerns of psychological suffering with the new psychology of posttraumatic growth. The full scale is 18 items so it is not too time consuming and can be used alongside traditional measures of PTSD.

This is not the first such measure of positive changes to have been developed. But there is a difference.

Those of us who study positive changes following adversity are sometimes criticised for offering an unrealistically optimistic view of the world. I don’t think this is true as the literature makes it clear that change can also be in a negative direction. But the critics may be right that this needed to be more fairly recognised in our measurement tools. 

At any single point in time people will have changed in either negative or positive ways.

But existing measures do not offer the opportunity for people to say how they have changed in a negative direction as well as in a positive direction.

Thus, an important and novel aspect of this new instrument is that it recognises that people may also experience themselves as having changed in negative ways.

Did you score under 3 on any of the items?

If you scored under 3 on one or more of the items, is this causing you considerable problems at home or at work?  Is it leading to significant difficulties with family, friends or colleagues?  Have you tried dealing with the problems already, maybe through reading self-help or talking to others? If so, it may be appropriate to seek professional advice.

So as well as giving indications of how people may grow following trauma the PWB-PTCQ can also help people understand the ways in which they need to look after themselves better or flag up areas in which they might need professional help.

The full questionnaire is described in my new book, What Doesn’t Kill Us: The New Psychology of Posttraumatic Growth http://www.whatdoesntkillus.com.

But the book does not go into full technical detail on its psychometric development. For those who do want to learn more the research paper describing the development of the new tool is now available online in the journal Psychological Trauma http://psycnet.apa.org/psycinfo/2011-17454-001/

In the paper we describe the logic behind the questionnaire, its advantages and the research showing its reliability and validity.

I hope this work will interest people. I am always eager to meet new research collaborators – there is so much more yet to be done in this field – so if this new tool does spark some interest in you to use in your own research or clinic please do get in touch.

Ron Huxley’s Reaction: It is good to see a “strength-based” approach to trauma. Trauma has many negative impacts in someones life but it is not destiny. Many people do become stronger and more resilient following a traumatic event. How would score yourself on the measures listed above?