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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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Su, Y., & Liang, S. H. (2022) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2022.01.007 · Cited by 13
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“A score >60% of the potential maximum score is regarded as a moderate to high level of domain-specific or total PTG (Wu et al., 2019).”
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“%) of the population who endured any traumatic experience report different degrees of PTG (Wu et al., 2019).”
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“Worldwide, refugees and IDPs appear to experience moderate-high levels of PTG. Previously it has been reported that almost half of all individuals exposed to trauma might experience moderate-high PTG following a trauma (Wu et al., 2019).”
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“36 However, with a dearth of past pan-demic-related PTG studies, it isn ’ t clear if direct comparison of our study on the degree of perceived growth with such other traumatic events is meaningful.”
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“Researchers suggest that people will likely be exposed to a traumatic event at least once in their lifetime (Wu et al. 2019).”
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“Also, it seems that around half of the people experiencing traumatic events might subsequently express moderate-to-high PG (Wu et al., 2019).”
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“According to previous studies (Chen et al., 2021; Wu et al., 2019), scores in the 60th percentile of the scale range were suggested as a cut-off to classify low versus moderate-to-high growth.”
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Ten ignored questions for stress psychology research.
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“Notably, although the precise nature of this influence is yet unknown, various research (Felix et al., 2015; Kilmer & Gil-Rivas, 2010 ; Wu et al., 2019 ) used varying age ranges and suggested that a child’s developmental age level is likely to influence the rumination process leading to growth.”
InfluentialWan, J., Cao, C., Fang, R., Chen, C., & Wang, L. (2024) · Stress and Health · doi:10.1002/smi.3494 · Cited by 6
Childhood trauma and entrepreneurs’ individual entrepreneurial orientation
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“Experiences of posttraumatic growth are relatively common; 52.58% of people who suffered a traumatic life event reported moderate-to-high experiences of posttraumatic growth (Wu et al., 2019).”
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“Other research expanded their contentions (Teixeira and Pereira, 2013; Wu et al., 2019).”
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Harding-White, M. F., Carson, J. F., & Mojtahedi, D. (2025) · Psychiatry International · doi:10.3390/psychiatryint6020055 · Cited by 5
“Some research does support the reduced occurrence of PTG in older samples [88]; however, such research usually references comparisons with elderly groups [25] which were under-represented within this sample, so such evidence is unlikely fully explana-tive.”
Personal Versus Work-Related Trauma: Mental Health Nurse PTG Change from Resilience-Building Program
Miller, O. K., Shakespeare‐Finch, J., Shochet, I. M., Wurfl, A. M., Maybery, D. J., & Foster, K. (2025) · Journal of Loss and Trauma · doi:10.1080/15325024.2025.2461170 · Cited by 4
“Meta-analyses have identified that PTG can be impacted by age, gender and profession with people working in high-risk professions like emergency services and healthcare being likely to experience more PTG than other groups (Melinte et al., 2023; Wu et al., 2019).”
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“Yet, when PTG starts, their coping mechanisms grow stronger, and their psychological resilience increases [19].”
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Gower, T., Fischer, I. C., Tsai, J., Kang, H., Na, P. J., Tedeschi, R. G., & Pietrzak, R. H. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.04.046 · Cited by 5
The Routledge International Handbook of Posttraumatic Growth
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“…gender, personality traits (e.g., optimism, extraversion, bravery, self-efficacy, fortitude, mindfulness, emotion regulation, religiosity/ spirituality, and perseverance), coping and attachment styles, and systemic structural aspects (Gleeson et al., 2021; Schmidt et al., 2019; Wu et al., 2019).”
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“Moreover, PTG can reduce the negative effects caused by distress and depression, allowing them to better cope with traumatic events (Wu et al., 2019).”
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Perceived Positive and Negative Life Changes in Testicular Cancer Survivors
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“The high percentage of survivors reporting positive life changes is consistent with studies using the original posttraumatic growth inventory in cancer patients [22].”
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The COVID-19 pandemic: A source of posttraumatic growth?
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“Hence, PPTG is commonly reported following exposure to a wide variety of potentially traumatic or adverse events and is associated with a variety of positive outcomes.”
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“It does not provide standardised cut-points to designate PTG although we used thresholds designated by Wu et al. (2019) to report moderate-to-high PTG.”
InfluentialWhittaker, S., Rasmussen, S. A., Cogan, N. A., Tse, D. C. K., Martin, B., Andriessen, K., Shiramizu, V. K. M., Krysinska, K. E., & Levi‐Belz, Y. (2025) · JMIR Research Protocols · doi:10.2196/64615 · Cited by 5
“Literature has begun to show that, on average, PTG occurs more often than the development of pathological disorders following exposure to a traumatic event [10,11].”
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“Second, individuals from diverse socioeconomic backgrounds may interpret distress and traumatic experiences differently (Wu et al., 2019), potentially altering the relationship between distress and PTG.”
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Perceived posttraumatic growth: positive change occurring because of or despite the trauma?
Boals, A., & McKillip, N. (2024) · Anxiety Stress & Coping · doi:10.1080/10615806.2024.2396423 · Cited by 2
“Self-reports of PTG following adverse events exposure are very common (Wu et al., 2019), as over half of individuals who experience an adverse or traumatic event self-report experiencing moderate or greater levels of PTG.”
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“Conversely, there is now a growing body of research demonstrating that people can also experience positive psychological change following traumatic events (Wu et al., 2019).”
InfluentialZhang, Y., Zhang, N., Da, L.-J., Feng, D., & Zhao, C. (2023) · Psychology, Health & Medicine · doi:10.1080/13548506.2023.2274313 · Cited by 3
“…consequences attracted the most attention among researchers and practitioners during COVID-19 pandemics, many studies reported positive changes on mental health worldwide, for example, post-traumatic growth (Schubert et al., 2016; Tedeschi & Calhoun, 2004; Wu et al., 2019; Zhang et al., 2023).”
BackgroundPost-adversarial appreciation: a novel re-conceptualisation of posttraumatic growth
Harding-White, M. F., Mojtahedi, D., & Carson, J. F. (2023) · Mental Health and Social Inclusion · doi:10.1108/mhsi-08-2023-0090 · Cited by 3
Maltais, D., Cadell, S., Simard, C., Grenier, J., Cherblanc, J., Verdon, C., Gauthier, G., Ross, G., Bergeron‐Leclerc, C., & Côté, I. (2023) · Etudes sur la mort/Études sur la mort · doi:10.3917/eslm.159.0073 · Cited by 4
Kawashima, M., Murakami, M., Kobayashi, T., Takebayashi, Y., Tsubokura, M., Yasutaka, T., & Tamaki, T. (2023) · International Journal of Disaster Risk Reduction · doi:10.1016/j.ijdrr.2023.103917 · Cited by 4
Ramos‐Vera, C., O’Diana, A. G., Vallejos-Saldarriaga, J., & Saintila, J. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231166833 · Cited by 4
“Other research reported positive and stable effects of PG 6 months after the stressful event in adults (Hirooka et al., 2017; Wu et al., 2019).”
Ben‐Hayun, S. G., & Zysberg, L. (2023) · Psychology in the schools (Print) · doi:10.1002/pits.22897 · Cited by 3
Rabinowitz, E. P., Sayer, M. A., Richeson, A. L., Samii, M. R., Kutash, L. A., & Delahanty, D. L. (2023) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-023-00085-7 · Cited by 1
“Considered a distinct phenomenon from post-traumatic stress, approximately 53% of individuals who experience a traumatic event develop moderate to high PTG (Wu et al., 2019; Zoellner & Maercker, 2006).”
BackgroundMethodInfluentialLong-term post-traumatic growth after natural disasters: A scoping review of contextual influences
Nguyen, H. T. D., Pope, D., & Harms, L. (2022) · The British Journal of Social Work · doi:10.1093/bjsw/bcac240 · Cited by 4
Sub-groups (profiles) of individuals experiencing post-traumatic growth during the COVID-19 pandemic
Blom, D. M., Sulkers, E., Post, W. J., Schroevers, M. J., & Ranchor, A. V. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.969253 · Cited by 6
“Previous research findings suggest that many individuals experience PTG not only in the long term but also in the short term and even during stressful circumstances (Wu et al., 2019).”
BackgroundNowicki, G., Ślusarska, B. J., Zboina, B., Jędrzejewska, A., & Kotus, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127073 · Cited by 4
“This discovery was partially in line with our expectations, because the PTG theory was proposed as a possible positive psychological consequence of the encountered traumatic events [46,47], and the individual’s perception of a traumatic event becomes a necessary condition for development [48,49].”
ResultLatent Profiles of Posttraumatic Growth: 17 years After the Bam Earthquake in Iran
Amiri, H., Rezapour, M., Nakhaee, N., Nekoei‐Moghadam, M., Nasab, S. M. H. M., Nezhad, M. S., & Jahani, Y. (2022) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2022.36 · Cited by 4
Seek Balance: Deviation from Balance Mediates Trauma Exposure and Quality of Life
Tomich, P. L., DeMalio, I. S., & Tolich, A. (2021) · Journal of Loss and Trauma · doi:10.1080/15325024.2021.2005329 · Cited by 4
Okoli, C. T. C., & Seng, S. (2021) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12817 · Cited by 4
Marqueses, J. M. S., Fausor, R., Sanz‐García, A., García‐Vera, M. P., & Sanz, J. (2022) · Ansiedad y Estrés · doi:10.5093/anyes2022a23 · Cited by 5
“…experience, it should be noted that the amount of time since the events in this study ranged from two to 83 years, while in the meta-analysis by Wu et al. (2019), which did find a significant negative relationship between time elapsed and PTG, the periods examined ranged from only a few days…”
ResultSurvivor Coping: Theories and Research About Reactions to All Types of Victimization
Frieze, I. H., Newhill, C. E., & Fusco, R. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-42608-8_3 · Cited by 1
Boals, A., King, R. L., Griffith, E. L., & Hord, C. N. (2024) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2024.43.6.556 · Cited by 2
Posttraumatic Growth Following Suicide Bereavement: An Updated Systematic Review and Meta-Analysis
Whittaker, S., Rasmussen, S. A., Cogan, N. A., Tse, D. C. K., Martin, B., Andriessen, K., Shiramizu, V. K. M., Krysinska, K. E., & Levi‐Belz, Y. (2025) · Journal of Loss and Trauma · doi:10.1080/15325024.2025.2586763 · Cited by 3
She, R., Li, L., Yang, Q., Lin, J., Ye, X., Wu, S., Yang, Z., Guan, S., Zhang, J., & Lau, J. T. F. (2025) · Stress and Health · doi:10.1002/smi.70037 · Cited by 7
“PTG is common as a systematic review of 26 studies found that 53% of people who endured traumas experienced PTG (Wu et al. 2019).”
InfluentialFayaz, I., & Khanna, P. (2025) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2025.2510277 · Cited by 1
Sato, K., Ishii, K., Nagai, S., & Ogata, Y. (2025) · Journal of Occupational Health · doi:10.1093/joccuh/uiaf030 · Cited by 2
“Inclusion criteria for the articles were as follows: (1) original and written in English, (2) focused on nurses’ PTG, and (3) reported studies conducted after January 2020.”
InfluentialPsychometric Evaluation of the Greek Version of the PTGI During COVID-19 Pandemic
Tamiolaki, A., Kalaitzaki, A. E., & Benioudakis, E. S. (2025) · Research on Social Work Practice · doi:10.1177/10497315251330869 · Cited by 2
“…contrast to other studies that have found an inverse correlation between PTG and age, with younger people scoring higher on PTG (Bachem et al. 2018; Wu et al., 2019), in this study, correlations were very low, though signi fi cant, possibly because of the large sample size (Kaplan et al., 2014) or…”
Family functioning and post-traumatic growth among disaster survivors: The mediation role of hope
Setiawan, I. M., & Setiyawati, D. (2025) · Humanitas Indonesian Psychological Journal · doi:10.26555/humanitas.v22i1.835 · Cited by 2
“A meta-analysis study of 26 studies conducted by Xiaoli et al. (2019) found that approximately 52.58% of individuals have moderate to high levels of post-traumatic growth after traumatic experiences.”
InfluentialXingyanan, W., Yuanhong, L., Yang, L., & Xiao, Z. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07137-7 · Cited by 4
Azizi, M. G., Moslemi, D., Kheirkhah, F., Gholinia, H., Jafari, S., Jalalian, E., & Faramarzi, M. (2025) · Journal of Breast Disease · doi:10.61186/ijbd.17.4.68 · Cited by 1
Mamman, R., Fleming, J., Mortenson, W. B., & Schmidt, J. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2405571 · Cited by 2
“First, studies report that younger individuals reported higher post-traumatic growth than older individuals [34, 35].”
Zhang, K. M., Mukherjee, S. D., Pond, G. R., Roque, M. I., Meyer, R. M., SUSSMAN, J. S., Ellis, P. M., & Bryant‐Lukosius, D. (2024) · Current Oncology · doi:10.3390/curroncol31090395 · Cited by 2
“Approximately 42.7% of our sample experienced high levels of PTG, which is lower compared to pre-pandemic levels [37].”
BackgroundInfluentialA measure of psychological antifragility: development and replication
Tsai, J. (2024) · Journal of Positive Psychology · doi:10.1080/17439760.2024.2394466 · Cited by 2
“There is another phenomenon called posttraumatic growth, which is defined as positive psychological change that occurs from exposure to traumatic events (Tedeschi & Calhoun, 2004) and has been found in various populations (Tsai et al., 2015; Wu et al., 2019).”
Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer
Meral, B., & Bulut, H. K. (2024) · Cancer Nursing · doi:10.1097/ncc.0000000000001374 · Cited by 4
Creating new resources: The impact of new group memberships on posttraumatic growth in China
Peng, W., Yang, K., & Jiang, J. (2024) · Social and Personality Psychology Compass · doi:10.1111/spc3.12955 · Cited by 2
Finding Silver Linings in the Covid-19 Pandemic: A 2-Wave Study in the UK
Bacon, A. M., Charlesford, J. J., Hyland, M. E., Puskas, T., & Hughes, P. (2023) · Psychological Reports · doi:10.1177/00332941231219788 · Cited by 2
“The review by Wu et al., (2019) suggested 53% of participants report growth follwing traumatic life events, and a recent study with nurses working through the pandemic reported 39% (Chen et al., 2020).”
Gesi, C., Cafaro, R., Achilli, F., Boscacci, M., Cerioli, M., Cirnigliaro, G., Loupakis, F., di Maio, M., & Dell'Osso, B. (2023) · CNS Spectrums · doi:10.1017/s1092852923002493 · Cited by 2
Posttraumatic growth in family members of individuals with methamphetamine use disorder
Turan, Ç., Ünal, S., Şenormancı, G., & Şenormancı, Ö. (2023) · The European Research Journal · doi:10.18621/eurj.1276458 · Cited by 4
“The same study showed that a long period since the traumatic event was associated with higher PTG in women and youth [6, 7].”
BackgroundDas, K., Qureshi, S., Haider, A., Tarique, M., & Bhatija, R. R. (2023) · Journal of the Pakistan Medical Association · doi:10.47391/jpma.7813 · Cited by 3
Dewar, M., Paradis, A., & Brillon, P. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1171629 · Cited by 10
Mehraban, E. D., Farhangi, A., & Abolghasemi, S. (2022) · Journal of Shahrekord University of Medical Sciences · doi:10.34172/jsums.2022.30 · Cited by 2
“Continuity of automatic thoughts may serve as the initial stage for a search to determine the impact of a stressful events on a person and aid the individual in understanding the fundamental meaning of stress (8,9).”
BackgroundKavalidou, K., Kotsis, K. T., Laimou, D., Panagidou, D., & Mégalakaki, O. (2021) · Psychiatry International · doi:10.3390/psychiatryint3010004 · Cited by 2
“A recent metanalysis suggested that is more appropriate to use the term “moderate to high PTG” when either the total or each PTGI item score is >60% [27].”
BackgroundPutri, E. P., & Pohan, L. D. (2020) · International Conference on Intervention and Applied Psychology (ICIAP) · doi:10.2991/assehr.k.201125.033 · Cited by 2
Posttraumatic Cognitions, Posttraumatic Growth, and Personality in University Students
Arredondo, A. Y., & Caparrós, B. (2020) · Journal of Loss and Trauma · doi:10.1080/15325024.2020.1831812 · Cited by 5
“A recent systematic review has revealed that nearly half of the subjects reported a moderate-to-high PTG after experiencing a traumatic event (Wu et al., 2018).”
BackgroundJordan, G., MALLA, A. K., & Iyer, S. N. (2020) · International Journal of Mental Health · doi:10.1080/00207411.2020.1776458 · Cited by 3
Ko, Y.-S., Ha, Y., Kim, J., & Cho, H.-A. (2020) · doi:10.14400/jdc.2020.18.4.357 · Cited by 2
“외상 후 성장 발생에 대한 체계적 문헌고찰[6]에 따르 면 암환자, 중증질환자, 군인, 지진피해자, 응급구조요원 과 소방관 등 다양한 대상자들을 상대로 외상 후 성장 연 구가 이루어졌으며 특히 이들 중에서 고위험 특수 직업 군의 외상 후 성장이 높은 것으로 보고되었다.”
Is There Always Value to Adversity?
Jayawickreme, E. (2026) · doi:10.1093/oso/9780197515471.001.0001 · Cited by 1
Treatment of Youth with Trauma and Gender Incongruence: A Call for Clinical Integration
Feldman, H., Jankowski, M. K., Sternberg, K. F., Bausha, C. E., & Barnett, E. R. (2026) · Community mental health journal · doi:10.1007/s10597-026-01611-y · Cited by 1
“Similarly, people can experience meaningful post-traumatic growth following trauma and stress, paving a path beyond resiliency and developing new skills, strengths, and perspectives on life (Wu et al., 2019).”
Poandl, M. M., Gutiérrez, D., & Kitching, E. (2026) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2026.2646521 · Cited by 3
“This result is higher compared with PTG prevalence rates reported across all trauma types, as Wu et al. (2019) found 53% of individuals experienced a moderate to high rate of PTG in their meta-analysis of 26 studies.”
Şahin, D. S., Arslan, G., & Uzun, K. (2026) · Aging & Mental Health · doi:10.1080/13607863.2026.2625852 · Cited by 1
“…and autobiographical reasoning, older adults often attempt to reinterpret past adversities-including early-life psychological maltreatment experiences-within broader frameworks of meaning, a process shown to enhance psychological adaptation and resilience (Corona et al., 2019; Wu et al., 2019).”
Kirana, R. S., Asad, A. U., & Indrijati, H. (2025) · Psympathic: Jurnal Ilmiah Psikologi · doi:10.15575/psy.v12i2.45454 · Cited by 1
“In other words, individuals can also experience positive psychological change when facing traumatic events (Wu et al., 2019).”
ZiWei, X., XiaoYan, W., Yi, R., & Ping, Z. (2025) · Nursing and Health Sciences · doi:10.1111/nhs.70278 · Cited by 1
“In survivorship research, PTG has been recognized as particularly relevant for cancer populations (Wu et al. 2019; Liu et al. 2020).”
Dinç, Ş. N., & Işık, E. (2025) · Current Perspectives in Social Sciences · doi:10.53487/atasobed.1669984 · Cited by 1
Demir, B., Bülbüloğlu, S., & Kayaoğlu, K. (2025) · Transplantology · doi:10.3390/transplantology6040036 · Cited by 1
“An individual with PTG may establish more meaningful relationships with others, appreciate life more, become spiritually stronger, and experience spiritual enrichment [11,12].”
Metadata
- 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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