The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis
Abstract
Background Posttraumatic growth (PTG) is positive psychological changes after encountering challenging events. The main purpose of this meta-analysis was to summarize the prevalence of moderate-to-high PTG in people who experienced traumatic events and to understand what social-demographic and trauma characteristics distinguish those who show a high rate of PTG from those of low level. Methods Six electronic databases were searched. Loney's appraisal criteria were used to evaluate the quality of studies. Freeman-Turkey double arcsine transformation method was used to calculate the combined prevalence. Age, time since event, type of trauma and trauma form were analyzed as subgroup factors. According to the source of the trauma, the type of trauma was divided into three different categories: disease, accident and specific profession. Specific profession refers to firefighters, veterans, intensive care staff, etc. The complex working environment, irregular lifestyle, various unpredictable factors, as well as the frequently adverse stimuli from others contribute to great physical and mental pressure. Results Twenty-six articles were deemed as qualified for this systematic review and meta-analysis. The level of PTG across studies ranged from 10% to 77.3%, and heterogeneity tests showed high heterogeneity (I 2 = 92.3%, 95%CI = 90.1%-94.0%, p Limitations Because the included studies haven't provided adequate PTG-related information, these factors could not be used to performed subgr…
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“A composite measure of “any PTG” was operationalized as endorsement of PTG in 1 or more of the 5 domains (Wu et al., 2019).”
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“Furthermore, clinical trials have confirmed that promoting PTG could promote cancer patients to seek positive significance (Wu et al., 2019).”
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“A meta-analysis [14] showed that survivors of different trauma younger than 60 years were more likely than older survivors to report moderate-to-high PTG.”
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Frazier, P. A., Liu, Y., Asplund, A., Meredith, L. N., & Nguyen‐Feng, V. N. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1987247 · Cited by 54 · see citing works
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“9% of traumatized populations in this systematic review reported at least a moderate degree of PTG [8].”
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“Still, the reported PTG of cancer survivors is lower than that of people working in a specific profession such as firefighters, veterans, and intensive care staff and people experiencing a series of adverse life events in general [11,13].”
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“The meta-analysis conducted by Wu and colleagues [16] represents the levels of PTG in the general population and the variation in experiences of PTG is likely due to the wide range of trauma experienced by those who participated in the included studies.”
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“The popularity of PTG has soared in the past decade, resulting in a plethora of research studies and its incorporation into clinical practices (Roepke, 2015; Shakespeare-Finch, and Lurie-Beck, 2014; Wu et al., 2019, [2–4]).”
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“Moreover, PTG has been associated with socio-demographic characteristics in such that female sex and lower age are linked to higher levels of PTG (Boyle et al., 2017; Wu et al., 2019).”
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“Such positive changes have been observed after a range of traumatic events (Wu et al., 2019), such as hurricanes (Lowe et al., 2013), major earthquakes (Kesnold Mesidor, 2019), or man-made disasters (Kleim and Ehlers, 2009).”
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“Regarding the sociodemographic profile with greater PTG, it was that of the women and younger age groups, similar to that reported in previous studies (Helgeson et al., 2006; Vishnevsky et al., 2010; Wu et al., 2019; Kalaitzaki, 2021).”
ResultWhat Factors are Associated with Posttraumatic Growth in Older Adults? A Systematic Review
Kadri, A., Gracey, F., & Leddy, A. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2022.2034200 · Cited by 38 · see citing works
“Within demographic factors, age was negatively associated with PTG in several later life studies, supporting previous findings that PTG decreases with age (Wu et al., 2019).”
Post-traumatic Growth: The Roles of the Sense of Entitlement, Gratitude and hope
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“First, while PTG is usually measured following a traumatic event (Wu et al., 2019), we employed a retrospective measurement asking the participants to recall an event that caused them significant emotional stress.”
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“Similarly, the prevalence was low compared to findings from studies in adult populations, which have reported prevalence rates of approximately 50% after experiencing a serious disease or accident or being employed in a profession that carries a high risk of trauma exposure (Wu et al., 2019).”
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“A recent meta-analysis of 26 studies reported that around 53% of individuals who have experienced traumatic events reported experiencing at least moderate PTG afterward (Wu et al., 2019).”
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“Post-traumatic growth and mental health Around one in two individuals experiencing trauma report moderate-to-high degrees of post-traumatic growth (see Wu et al., 2019 meta-analysis), with women displaying higher levels of such growth than men (Vishnevsky et al., 2010).”
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“001), we dichotomized responses based on moderate or greater endorsement of any item; this approach to operationalizing endorsement of PTG has been used in a meta-analysis on the prevalence of PTG (Wu et al., 2019), as well as our recent study on the prevalence of COVID-19 pandemic-related PTG in the current sample (P…”
Posttraumatic growth and posttraumatic stress – a network analysis among Syrian and Iraqi refugees
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“Moreover, even among those who suffer from trauma related distress, it is not uncommon for the traumatic experience to also instigate a trajectory of positive psychological development, often referred to as posttraumatic growth (PTG) [14].”
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“People who have experienced various types of trauma identify positive changes in their lives and improved mental health and wellbeing (e.g., Helgeson et al., 2006; Wu et al., 2019).”
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“[15] Additionally, studies in the literature highlighted that earthquakes can lead to positive outcomes such as PTG. [16,17] PTG manifests uniquely for each individual, influenced by their internal resources, support systems, and the nature of the trauma.”
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“in two who experienced a traumatic event (Wu et al., 2019).”
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Advancing a Three-Tier Personality Framework for Posttraumatic Growth
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“Coping with and adaption to trauma brought about the post-traumatic growth (Wu et al., 2019).”
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The transformative power of pain and posttraumatic growth in nurses with Covid‐19 PCR positive
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“Wu et al. (2019) found that the posttraumatic growth level of female was higher.”
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“The PTGI is not a diagnostic instrument and lacks established cutoffs and reporting standards (Wu et al., 2019).”
InfluentialPosttraumatic growth of medical staff during COVID-19 pandemic: A scoping review
Li, Q., Zhu, Y., Qi, X., Lu, H., Han, N., Yan, X., Guo, J., & Wang, L. (2024) · BMC Public Health · doi:10.1186/s12889-023-17591-7 · Cited by 19 · see citing works
“It might result from young people’s greater willingness to change their cognitive patterns and derive positive meaning from trauma, consistent with previous research on age differences in PTG [69].”
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“Research dealing with positive change after trauma states that 30% to 70% of traumatised people experience positive changes following a negative experience (Joseph & Hefferon, 2013; Wu et al., 2019).”
BackgroundPost-traumatic growth promotes resilience development: A Longitudinal Mediation Model
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“In several studies, death awareness seems to draw us in the opposite direction than being a conformist follower of das Man, as shown in studies of posttraumatic growth and studies of reactions of persons narrowly avoiding death (Joseph and Linley, 2005; Wu et al., 2019): Confrontation with death also often lead people…”
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“A burgeoning literature points to the ability of humans to grow in the face of disasters and other major stressful life events (Shing et al., 2016; Wu et al., 2019).”
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“Wu et al. (46) conducted a systematic review and meta-analysis of 26 studies in the general population and discovered that between 10 and 77.3% of participants experienced PTG.”
MethodInfluentialChina's marine economic efficiency: A meta-analysis
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Post-Traumatic Growth among Older People after the Forced Lockdown for the COVID–19 Pandemic
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“Variables have been studied that seem to influence the experience of PTG. Features of the event, such as time since it occurred and the type of event, as well as sociodemographic variables and social resources, have been stressed to be the most relevant (Wu et al., 2019).”
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“…of the highest PTGI score (maximum total score is 105, therefore 60% equals to 63) or 60% of the highest score of each item (maximum item score is 5, therefore 60% equals to 3) as medium and above levels, stating that it is more appropriate to use the term ‘ moderate to high PTG ’ (Wu et al. 2019).”
Dyball, D. M., Bennett, A. N., Schofield, S. J., Cullinan, P., Boos, C. J., Bull, A. M. J., Stevelink, S. A. M., & Fear, N. T. (2022) · Psychological Medicine · doi:10.1017/s0033291722002410 · Cited by 22 · see citing works
“It is well recognised that PTG can occur after both physical or psychological trauma (Wu et al., 2019), and it has been shown to be associated with better mental health outcomes such as lower rates of depressive disorders in longitudinal studies of those with serious medical conditions, (Barskova & Oesterreich, 2009).”
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Lin, Q., Dong, F.-H., Xue, Y.-W., Yu, Q.-Y., Ren, J.-H., & Zeng, L. (2021) · Intensive & Critical Care Nursing · doi:10.1016/j.iccn.2021.103134 · Cited by 15 · see citing works
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“More recently, a meta-analysis by Wu et al. (2019) found that nearly half of individuals who experienced a traumatic event reported moderate to high posttraumatic growth.”
BackgroundRussia-Ukraine War: Jeopardizing the mental health gains already been obtained globally
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Post-traumatic growth 5 years after cancer: identification of associated actionable factors
Evans, C., Saliba‐Serre, B., Préau, M., Bendiane, M., Gonçalvès, A., Signoli, M., & Bouhnik, A. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07253-6 · Cited by 10 · see citing works
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“PTG was shown to manifest in various trauma-exposed populations, such as survivors of serious diseases and accidents (Wu et al., 2019).”
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Posttraumatic growth following aphasia: a prospective cohort study of the first year post-stroke
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Growth from adversity in trans and gender diverse people of color
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“, 2019), even experiencing a negative event vicariously through a family member, friend, or client (Bartoskova, 2017; Ragger et al., 2019; Wu et al., 2019).”
BackgroundSystematic Review of Posttraumatic Growth From Sexual Assault in Women
Fayaz, I. (2023) · Journal of Loss and Trauma · doi:10.1080/15325024.2023.2254240 · Cited by 13 · see citing works
“Wu et al. (2019) found that half of the investigated individuals reported growth experiences after exposure to traumatic events.”
BackgroundInfluentialKang, H., Fischer, I. C., Dickinson, S., Na, P. J., Tsai, J., Tedeschi, R. G., & Pietrzak, R. H. (2023) · Psychiatric Quarterly · doi:10.1007/s11126-023-10061-8 · Cited by 19 · see citing works
The Thread of Trauma: A Critical Analysis of the Criminal Legal System
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Kaye‐Tzadok, A., & Icekson, T. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1048295 · Cited by 13 · see citing works
“In fact, a recent review has shown that nearly 50% of individuals who suffered from traumatic experiences report moderate to high levels of posttraumatic growth (Wu et al., 2019).”
BackgroundLiu, S., Curenton, S. M., Sims, J., & Fisher, P. A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1270514 · Cited by 12 · see citing works
“%) among individuals who experienced traumatic events (Wu et al., 2019), highlighted the tenacity and perseverance that parents, as well Simple slope probe on the significant moderating effects of perceived change domains on the associations between material hardship mean levels and parents’…”
BackgroundKu, X., Lee, S., & Choi, I. (2023) · Social and Personality Psychology Compass · doi:10.1111/spc3.12799 · Cited by 10 · see citing works
Barnicot, K., McCabe, R., Bogosian, A., Papadopoulos, R., Crawford, M. J., Aitken, P., Christensen, T., Wilson, J., Teague, B., Rana, R., et al. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043539 · Cited by 11 · see citing works
Long-Term Posttraumatic Growth in Victims of Terrorism in Spain
Fausor, R., Sanz, J., Navarro‐McCarthy, A., Gesteira, C., Morán, N., Cobos-Redondo, B., Altungy, P., Marqueses, J. M. S., Sanz‐García, A., & García‐Vera, M. P. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.847099 · Cited by 19 · see citing works
van Stralen, D. V., McKay, S. D., & Mercer, T. (2020) · Neonatology Today · doi:10.51362/neonatology.today/20208158109117 · Cited by 11 · see citing works
Jernslett, M., Kilmer, R. P., Avraam, D., & Anastassiou‐Hadjicharalambous, X. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102617 · Cited by 13 · see citing works
Work Exposome and Related Disorders of Firefighters: An Overview of Systematized Reviews
Descatha, A., Dousseau, H., Pitet, S., Magnolini, F., McMillan, N., Mangelsdorf, N., Swan, R., Steve, J.-M., Pourret, D., & Fadel, M. (2025) · Safety and Health at Work · doi:10.1016/j.shaw.2025.04.003 · Cited by 10 · see citing works
“Mental health is important with a high proportion of posttraumatic stress disorders and also related to daily occupational stress [21,56,59].”
InfluentialPTSD and PTG in French and American Firefighters: A Comparative Study
Henson, C., Truchot, D., & Canevello, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191911973 · Cited by 12 · see citing works
“Potentially traumatic events were screened using the Life Events Checklist for DSM-5 (LEC-5; [100]).”
MethodTrauma exposure and short‐term volitional personality trait change
Blackie, L. E. R., & Hudson, N. W. (2022) · Journal of Personality · doi:10.1111/jopy.12759 · Cited by 8 · see citing works
“high as 52% of participants self-reported moderate to high levels of PTG after a trauma (Wu et al., 2019).”
BackgroundCatalyst Twenty-Twenty: Post-Traumatic Growth at Scales of Person, Place and Planet
Logan, A. C., Berman, S. H., Scott, R. B., Berman, B., & Prescott, S. L. (2021) · Challenges · doi:10.3390/challe12010009 · Cited by 13 · see citing works
“Still, a recent meta-analysis indicates that approximately half of individuals who experienced traumatic events report moderate-to-high levels of PTG [42].”
BackgroundCraig, N., Haslam, C., Cruwys, T., & Jetten, J. (2024) · Environment and Behavior · doi:10.1177/00139165241286840 · Cited by 8 · see citing works
Mah, A., D’Agostino, N. M., Santiago, A., Garland, S. N., Petrella, A. R., Sabiston, C. M., Chalifour, K., Eaton, G., & Bender, J. L. (2024) · Psycho-Oncology · doi:10.1002/pon.6325 · Cited by 9 · see citing works
“22 Similar to prior research, 9 we defined moderate - to - high PTG as the upper 60% of the PTGI distribution which corresponded to a score of 51 or greater in this sample.”
BackgroundMethodLewis, C. E., Lewis, K., Edwards, B., Evison, C., John, A., Pearce, H. A., Raisanen, L., Richards, N., Roberts, A., Jones, I., et al. (2022) · Journal of Traumatic Stress · doi:10.1002/jts.22884 · Cited by 9 · see citing works
“Both prepandemic and COVID-19–related research has found evidence of an association between PTG and younger age (Northfield & Johnston, 2021; Wu et al., 2019), which may be attributable to younger people being more flexible in their ability to change their views.”
BackgroundResultInfluentialBozal, R. G., Ruíz-González, P., Morales-Sánchez, L., Gómez‐Molinero, R., & Márquez, P. G.-O. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148592 · Cited by 12 · see citing works
“Growth refers to the personal development that goes beyond coping, meaning a qualitative change in people’s ability to function and adapt to adverse circumstances [10,11].”
BackgroundHealing Through Loss: Exploring Nurses’ Post-Traumatic Growth After Patient Death
Kim, Y., Ahn, J., Park, J., Bang, Y. R., Jun, J. Y., Hong, Y., Chung, S., Ahn, J., & Park, C. H. K. (2025) · Psychiatry Investigation · doi:10.30773/pi.2024.0253 · Cited by 8 · see citing works
McErlean, G., Tapp, C., Brice, L., Gilroy, N. M., Kabir, M., Greenwood, M. J., Larsen, S. R., Moore, J. J., Gottlieb, D. J., Hertzberg, M., et al. (2023) · BMC Psychology · doi:10.1186/s40359-023-01204-4 · Cited by 9 · see citing works
“We found that PTG was almost universally experienced by our survivors; only 1% reported no PTG, and over two thirds reported moderate-high degrees of PTG post-HSCT, higher than that reported in the only meta-analysis of PTG (67% vs. 52.6% [41]).”
ResultInfluentialLanfredi, M., Dagani, J., Geviti, A., Cosimo, F. D., Bussolati, M., Rillosi, L., Albini, D., Pizzi, M., Ghidoni, R., Fazzi, E., et al. (2023) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-023-00615-w · Cited by 8 · see citing works
“In line with previous research that considered this difference to be based on a tendency, for women, to use more positive appraisals as coping strategies to deal with traumatic or negative events [52, 88], in our study female students also reported slightly higher levels of post-traumatic growth than males.”
BackgroundResultResearch hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords
Yang, K., Lu, J., Duan, L., Tang, H., Bao, Z., Liu, Y., & Jiang, X. (2023) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2023.03.001 · Cited by 15 · see citing works
Dyball, D. M., Taylor-Beirne, S., Greenberg, N. L., Stevelink, S. A. M., & Fear, N. T. (2022) · BJPsych Open · doi:10.1192/bjo.2022.570 · Cited by 11 · see citing works
- Authors
- Wu, X., Kaminga, A. C., Dai, W., Deng, J., Wang, Z., Pan, X., & Liu, A.
- Affiliations
- Central South University (CN)
- Corresponding author
- Liu, Aizhong
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 243
- Pages
- 408-415
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2891592894
- Cited by
- 314
- References
- 53
- Citations by year
- 2026: 38 · 2025: 49 · 2024: 55 · 2023: 53 · 2022: 57 · 2021: 40 · 2020: 18 · 2019: 4
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- posttraumatic growth, prevalence, traumatic events, sociodemographic factors, trauma characteristics, occupational injuries, firefighters, veterans, intensive care staff, age, time since trauma, direct trauma, psychological resilience
- MeSH terms
- Posttraumatic Growth, Psychological, Humans, Models, Statistical, Prevalence
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