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Coronavirus (COVID-19)

Association of Symptoms of Posttraumatic Stress Disorder With Posttraumatic Psychological Growth Among US Veterans During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: April 8, 2021

Research Letter

Article Information and Disclosures

Robert H. Pietrzak, PhD, MPH^1,2;

Jack Tsai, PhD^3,4;

Steven M. Southwick, MD²

Author Affiliations

¹US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven
²Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
³US Department of Veterans Affairs National Center on Homelessness Among Veterans, James A. Haley Veterans’ Hospital, Tampa, Florida
⁴School of Public Health, University of Texas Health Science Center at Houston, San Antonio Campus, San Antonio

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Although extensive research has documented the negative psychiatric consequences of the COVID-19 pandemic,¹^,2 no study, to our knowledge, has examined whether the pandemic may be associated with positive psychological changes or posttraumatic growth (PTG). In addition to increasing risk for psychiatric illness, traumatic events may also stimulate PTG in the form of increased personal strength and appreciation of life, improved social relationships, spiritual changes, and new possibilities for one’s life.³^,4 Posttraumatic growth is associated with better functioning⁵ and greater resilience to subsequent traumatic events⁶ in trauma survivors.

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Article Information

Accepted for Publication: February 16, 2021.

Published: April 8, 2021. doi:10.1001/jamanetworkopen.2021.4972

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Pietrzak RH et al. JAMA Network Open.

Corresponding Author: Robert H. Pietrzak, PhD, MPH, US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, 151E, West Haven, CT 06516 (robert.pietrzak@yale.edu).

Author Contributions: Dr Pietrzak had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Pietrzak.

Drafting of the manuscript: Pietrzak.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Pietrzak.

Administrative, technical, or material support: Pietrzak, Tsai.

Supervision: Pietrzak, Southwick.

Conflict of Interest Disclosures: Dr Southwick reported receiving royalties from Cambridge University Press for the book Resilience: The Science of Mastering Life’s Greatest Challenges outside the submitted work. No other disclosures were reported.

Funding/Support: The National Health and Resilience in Veterans Study is supported by the US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder.

Role of the Funder/Sponsor: The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank all of the veterans who participated in the National Health and Resilience in Veterans Study, and Ipsos staff members who facilitated data collection, particularly Robert Torongo, MA, and Alyssa Marciniak, MA, who were not compensated for their contributions.

References

Krishnamoorthy Y , Nagarajan R , Saya GK , Menon V . Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 2020;293:113382. doi:10.1016/j.psychres.2020.113382 PubMed Google Scholar

O’Connor RC , Wetherall K , Cleare S , et al. Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. Br J Psychiatry. 2020;1-8. doi:10.1192/bjp.2020.212 PubMed Google Scholar

Cann A , Calhoun LG , Tedeschi RG , et al. A short form of the Posttraumatic Growth Inventory. Anxiety Stress Coping. 2010;23(2):127-137. doi:10.1080/10615800903094273 Google Scholar Crossref

Wu X , Kaminga AC , Dai W , et al. The prevalence of moderate-to-high posttraumatic growth: a systematic review and meta-analysis. J Affect Disord. 2019;243:408-415. doi:10.1016/j.jad.2018.09.023 PubMed Google Scholar Crossref

Tsai J , El-Gabalawy R , Sledge WH , Southwick SM , Pietrzak RH . Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study. Psychol Med. 2015;45(1):165-179. doi:10.1017/S0033291714001202 PubMed Google Scholar Crossref

Tsai J , Mota NP , Southwick SM , Pietrzak RH . What doesn’t kill you makes you stronger: a national study of U.S. military veterans. J Affect Disord. 2016;189:269-271. doi:10.1016/j.jad.2015.08.076 PubMed Google Scholar Crossref

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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
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1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.