A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder
Open accessAbstract
Traumatic experiences can have a powerful impact on individuals and communities but the relationship between perceptions of beneficial and pathological outcomes are not known. Therefore, this meta-analysis examined both the strength and the linearity of the relationship between symptoms of posttraumatic stress disorder (PTSD) and perceptions of posttraumatic growth (PTG) as well as identifying the potential moderating roles of trauma type and age. Literature searches of all languages were conducted using the ProQuest, Wiley Interscience, ScienceDirect, Informaworld and Web of Science databases. Linear and quadratic (curvilinear) rs as well as βs were analysed. Forty-two studies (N = 11,469) that examined both PTG and symptoms of PTSD were included in meta-analytic calculations. The combined studies yielded a significant linear relationship between PTG and PTSD symptoms (r = 0.315, CI = 0.299, 0.331), but also a significantly stronger (as tested by Fisher's transformation) curvilinear relationship (r =0.372, CI = 0.353, 0.391). The strength and linearity of these relationships differed according to trauma type and age. The results remind those working with traumatised people that positive and negative post-trauma outcomes can co-occur. A focus only on PTSD symptoms may limit or slow recovery and mask the potential for growth.
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Severe distress and functional gains reflect a complex, dialectical adaptation rather than a linear progression toward recovery.
“In this framework, severe distress and functional gains reflect a complex, dialectical adaptation rather than a linear progression toward recovery [5, 21, 48].”
From The coexistence and trajectories of posttraumatic growth and depreciation: a 36-month longitudinal qualitative narrative analysis (2026) · cites this paper as [21]
The Discussion (page unavailable) says PTSD symptoms and perceived posttraumatic growth can coexist, and that their relationship is not straightforward. It does not establish functional gains or a dialectical adaptation over time; its linear and curvilinear findings concern the association between symptoms and reported growth, not a progression toward recovery. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe relationship between PTG and distress/posttraumatic stress symptoms remains non-linear or equivocal.
“While PTD is consistently linked to distress [19] and posttraumatic stress symptoms [13], the relationship between PTG and these measures remains non-linear or equivocal [5, 21].”
From The coexistence and trajectories of posttraumatic growth and depreciation: a 36-month longitudinal qualitative narrative analysis (2026) · cites this paper as [21]
A subset of individuals may achieve posttraumatic growth through coping with adversity.
“a subset of individuals may achieve posttraumatic growth (PTG) – positive personal changes such as strengthened relationships, life appreciation, or spiritual development – through coping with the adversity, although overall PTG levels after earthquakes tend to be modest on average (9, 10).”
From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [9]
Overall PTG levels after earthquakes tend to be modest on average.
“although overall PTG levels after earthquakes tend to be modest on average (9, 10).”
From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [9]
The Results and Discussion describe how strongly posttraumatic growth relates to PTSD symptoms among natural-disaster survivors, not their average level of growth. Searches for earthquake survivors and average or modest PTG levels found no passage in our copy supporting the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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“Alternatively, perhaps perceived PTG is something we should discourage—trauma research finds that perceived PTG is generally related to worse psychological adjustment (Boerner, Joseph, and Murphy, 2017; Helgeson et al., 2006; Shakespeare-Finch and Lurie-Beck, 2014, [3,19,20]).”
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“Three studies reported a curvilinear inverted-U shaped relationship, e.g. as PTSD symptom severity increased levels of PTG also increased, up to a certain threshold, whereby after increases in PTSD severity were associated with decreasing levels of PTG (Kanga-slampi et al., 2022; Nuttman-Shwartz et al., 2011; Wen et a…”
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“While PTD is consistently linked to distress [19] and posttraumatic stress symptoms [13], the relationship between PTG and these measures remains non-linear or equivocal [5, 21].”
- Authors
- Shakespeare-Finch, J., & Lurie-Beck, J.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 28
- Issue
- 2
- Pages
- 223-229
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W1763254284
- Cited by
- 504
- References
- 45
- Citations by year
- 2026: 49 · 2025: 40 · 2024: 49 · 2023: 43 · 2022: 56 · 2021: 41 · 2020: 61 · 2019: 28 · 2018: 36 · 2017: 35 · 2016: 31 · 2015: 28 · 2014: 7
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc-nd)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Faculty of Health; Institute of Health and Biomedical Innovation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- posttraumatic growth, post-traumatic stress disorder, posttraumatic stress symptoms, trauma type, age differences, curvilinear relationship, trauma recovery
- MeSH terms
- Adaptation, Psychological, Humans, Stress Disorders, Post-Traumatic, Stress, Psychological
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