Effects of Emotional Regulation, Resilience, and Distress Disclosure on Post-Traumatic Growth in Nursing Students

ObjectiveThis study aimed to investigate the dyadic relationship between illness perception, emotion regulation strategies, and posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers.MethodsThis study used a cross‐sectional approach to collect data from 332 pairs of lung cancer patients receiving chemotherapy and family caregivers from China. Participants completed the Brief Illness Perception Questionnaire, the Emotion Regulation Questionnaire, and the Posttraumatic Growth Inventory. The actor–partner interdependence effects were used to analyze how illness perception and emotion regulation strategies affect posttraumatic growth in the patients themselves and their family caregivers.ResultsBoth illness perception and emotion regulation strategies had significant actor and partner effects on posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Emotion regulation strategies were categorized as cognitive reappraisal and expressive suppression, and patients had lower scores than caregivers for posttraumatic growth, illness perception, and expressive suppression, except for cognitive reappraisal scores, which were higher than caregivers. In patient–caregiver dyads, cognitive reappraisal was positively associated with posttraumatic growth in themselves and each other, whereas both illness perception and expressive suppression were negatively associated with posttraumatic growth.ConclusionReducing negative illness perceptions and expressive suppression may promote posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Facilitating cognitive reappraisal may be useful in enhancing posttraumatic growth, which provides direction for future intervention research. Healthcare professionals should view lung cancer chemotherapy patients and their family caregivers as a whole and develop dyadic interventions.

Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people navigate recovery from trauma.

Posttraumatic Growth: Positive Changes in the Aftermath of Crisis

The urgency and risk of clinical nursing may cause nurses to experience traumatic stress, but it may also lead to posttraumatic growth. However, no study has comprehensively analyzed the prevalence of posttraumatic growth among nurses using a unified outcome measure and a validated assessment tool. This study aims to systematically assess the prevalence and factors of posttraumatic growth among nurses based on the Posttraumatic Growth Inventory (PTGI). Ten databases, including The Cochrane Library, PubMed, Web of Science, CINAHL, Springerlink, Embase, Chinese Biomedical (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases, were searched as of December 31, 2022. The prevalence of posttraumatic growth was pooled using Stata 17.0 software. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42022365620. A total of 30 studies were included in this systematic review and meta-analysis, consisting of 14,022 nurses worldwide from four countries. In our study, the pooled mean score of posttraumatic growth among nurses was 66.34 (95% CI: 61.25-71.43). From 2015 to 2022, nurses' posttraumatic growth levels gradually increased. In addition, Turkey nurses have the lowest posttraumatic growth levelnurses who experienced workplace violence have a lower posttraumatic growth level compared with other nurses; while nurses aged over 30 and male have higher posttraumatic growth levels. While several studies on the prevalence of posttraumatic growth among nurses have been published, the reported data are quite different. Our systematic review and meta-analysis found that nurses' posttraumatic growth level was "moderate," and nurses' posttraumatic growth may vary based on publication year, country, traumatic event, age, and gender. Our findings may provide a theoretical basis for hospital administrators and policy makers to scientifically manage human resources, comprehensively evaluate nurses' mental health, and promote nurses' posttraumatic growth in different traumatic events, which is conducive to the formulation and implementation of relevant policy guidelines.

Emotions can be generated in response to inherently emotional perceptual properties of a stimulus (‘bottom up’) and in response to cognitive interpretations of an event (‘top down’). Similarly, emotion regulation (ER) strategies may deploy bottom-up or top-down processes, however the specific nature of these processes remains unclear. In this study we sought to replicate and extend previous studies that have investigated the interaction between ER and emotion generation. Specifically, we examined the relationship between both methods of emotion generation and ER in a sample of 75 undergraduate students who completed self-report questionnaires and a behavioral task of ER. We attempted to extend previous research by testing whether the positive effect of cognitive reappraisal on top-down generated emotions was specific to reappraisal or true of multiple ER strategies. Overall there was a main effect of generation such that top-down generated emotion was better regulated by cognitive reappraisal, expressive suppression, and appraisal strategies. We also found a main effect of ER such that cognitive reappraisal was perceived as the most successful ER strategy. We argue that ER is a state-dependent process that includes dynamic cycles between emotion generation and regulation processes. We further discuss expressive suppression as a top-down emotion regulation strategy in the context of our study despite debated literature.

The presence of unsuitable coping and emotion regulation strategies in young populations with gambling disorder (GD) and in those who have experienced cyberbullying victimization has been suggested. However, this association has not been explored in depth. In this study, our aim was to analyze individual differences in emotion regulation, coping strategies, and substance abuse in a clinical sample of adolescents and young adult patients with GD (n = 31) and in a community sample (n = 250). Furthermore, we aimed to examine the association between cyberbullying and GD. Participants were evaluated using the Cyberbullying Questionnaire-Victimization, the Canadian Adolescent Gambling Inventory, the Coping Strategies Inventory, the Difficulties in Emotion Regulation Scale, the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test. Structural Equation Modeling was used to explore associations between these factors in a community sample and in a clinical group. In both groups, exposure to cyberbullying behaviors was positively associated with higher emotion dysregulation and the use of maladaptative coping styles. Our findings uphold that adolescents and young adults who were victims of cyberbullying show difficulties in emotion regulation and maladaptive coping strategies when trying to solve problems. The specific contribution of sex, age, gambling severity, emotion regulation, and coping strategies on cyberbullying severity is also discussed. Populations at vulnerable ages could potentially benefit from public prevention policies that target these risk factors.

This study aimed to examine the roles of personality traits, traumatic event types, coping, rumination, and social support in explaining posttraumatic stress symptoms (PTS) and posttraumatic growth (PTG) in a representative community sample of 498 Turkish adults. The results of 2 multiple regression analyses showed that PTS was associated with neuroticism, experiencing events involving intentional/assaultive violence, intrusive and deliberate rumination, and fatalistic coping. In contrast, PTG was related to conscientiousness, openness to experience, injury/shocking and sudden-death type of events, deliberate rumination, problem-solving coping, and perceived social support. When all variables were entered into the equation, almost two thirds of the variability (R2 = .64) in the severity of PTS and more than one third of the variability (R2 = .40) in PTG was explained. The findings can aid in the development of psychosocial support programs for individuals experiencing traumatic events.

Research related to newly diagnosed lung cancer patients' emotional regulation strategies and how these strategies influence their emotional distress is scarce. The aim of this study was to investigate the relationship between cancer fear, emotion regulation, and emotional distress in patients with newly diagnosed lung cancer. A cross-sectional, correlation research design was conducted, using self-report questionnaires: the Cancer Fear Scale, the Emotion Regulation Questionnaire, and the Hospital Anxiety and Depression Scale. A total of 117 newly diagnosed lung cancer patients were sampled. Nearly 70% of newly diagnosed lung cancer patients had a high level of cancer fear; 56.4%, depression; and 45.3%, anxiety. Depression was positively associated with cancer fear ( r = 0.239, P < .01) and expressive suppression ( r = 0.185, P < .05), but negatively associated with cognitive reappraisal ( r = -0.323, P < .01). Anxiety was positively associated with cancer fear ( r = 0.488, P < .01) but negatively associated with cognitive reappraisal ( r = -0.214, P < .05). Cancer fear and cognitive reappraisal were significant explanatory factors and explained 25.2% of variance in anxiety. Cancer fear, expressive suppression, and cognitive reappraisal were significant explanatory factors and explained 16.7% of variance in depression. Newly diagnosed lung cancer patients with cancer fear and who used fewer cognitive reappraisal strategies or more expressive suppression had more emotional distress. Clinicians should be attentive to patients' cancer fears and emotion regulation strategies as early as possible to prevent their emotional distress.

Certain emotion regulation (ER) strategies are often considered to be more or less demanding of cognitive resources. However, age-related differences in the perceptions of these demands are not yet understood. Older adults might perceive greater demands for certain strategies due to differences in cognitive ability and motivation to maintain emotional well-being. In the present study, we examined age and cognitive ability as predictors of perceived effort required to use ER strategies that span all families of the process model. A diverse sample of community participants (age 22-83) completed assessments of cognitive ability and perceived demands associated with ten ER strategies. Overall, response-focused strategies were rated as highest in demands whereas situation selection and savoring were perceived as least demanding. Older adults reported higher demands associated with situation selection, distraction, and detached reappraisal (but not positive reappraisal) compared with younger adults. Cognitive ability was not associated with perceived demands for ER strategies traditionally viewed as cognitively demanding (e.g., suppression). Rather, higher cognitive ability only predicted lower perceived demands for strategies often considered low in demand: situation selection and savoring. Perceived ER success was not consistently associated with age or cognitive demands. Results suggest that older adults view some, but not all, ER strategies as more demanding than younger adults do. The role of cognitive ability in age-related changes in ER may be more complex than previously expected. Notably, the lack of findings with perceived ER success suggest effort requirements associated with ER may not impede ability to successfully regulate across adulthood.

Child maltreatment has been linked to numerous psychopathology outcomes throughout life, with emotion regulation proposed as a transdiagnostic mechanism. However, it remains relatively unknown how childhood abuse and neglect may differentially predict the development of emotion regulation during later years vulnerable to psychopathology. We examined the impact of early abuse and neglect experiences on the developmental trajectories of emotion regulation throughout adolescence and into young adulthood. The sample consisted of 167 adolescents who completed questionnaires assessing emotion regulation difficulties and emotion regulation strategies (cognitive reappraisal and expressive suppression) approximately annually across six time points, from ages 14 to 20 (2014-2021). Information on maltreatment experienced from ages 1 to 13 was collected at 18-19 years. Conditional growth curve models examining the effects of both abuse and neglect from ages 1 to 13 on the initial levels and growth rates of emotion regulation difficulties and strategies from ages 14 to 20. Abuse predicted developmental changes in emotion regulation difficulties, such that greater childhood abuse was associated with larger increases in emotion regulation difficulties from ages 14 to 20. Neglect predicted the initial levels of emotion regulation difficulties such that greater childhood neglect was associated with greater difficulties in emotion regulation at age 14. The findings suggest developmental consequences of childhood abuse and neglect evidenced by impaired development of emotion regulation abilities throughout adolescence and into young adulthood, whereas emotion regulation strategy is relatively unaffected by childhood abuse and neglect. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

ABSTRACTExperiences during the COVID‐19 pandemic may be traumatic to healthcare workers (HCWs). This study investigated the associations of resilience and mindfulness with posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG), and the mediation role of adaptive coping and stigmatisation related to HCWs' role in these associations from the perspective of trauma and positive psychology research. An anonymous online survey was conducted among 1449 doctors and nurses (85.4% females; mean age 34.1 years) from five hospitals in different regions of China between October and November 2020, which was about six months after the COVID‐19 outbreak was almost ‘put under control’ in China. PTSS and PTG were assessed using the 17‐item PTSS Scale‐Self‐Report and Posttraumatic Growth Inventory, respectively. The prevalence of PTSS and PTG was 42% and 65%, respectively. Results of structural equation modelling suggested that the association between resilience and PTSS was partially mediated by adaptive coping, self‐stigma, and the serial path via adaptive coping and self‐stigma, which accounted for 66% of the total association. The association between mindfulness and PTSS was partially mediated by adaptive coping and serially mediated by adaptive coping and self‐stigma. In contrast, only adaptive coping was a significant mediator in the associations between resilience/mindfulness and PTG. The findings first unravelled the mechanisms between resilience, mindfulness, and posttraumatic outcomes of COVID‐19 among a large sample of HCWs. Health promotion may consider alleviating PTSS and promoting PTG for HCWs experiencing traumatic stressful events via strengthening resilience and mindfulness, fostering adaptive coping, and reducing stigmatisation.

ABSTRACTSome previous studies have revealed a negative impact of enacted stigma on post-traumatic growth (PTG) of children affected by HIV/AIDS, but little is known about protective psychological factors that can mitigate the effect of enacted stigma on children's PTG. This study aims to examine the mediating effects of perceived social support, hopefulness, and emotional regulation on the relationship between enacted stigma and PTG among HIV-affected children. Cross-sectional data were collected from 790 children affected by parental HIV (382 girls, 408 boys) aged 6–17 years in 2012 in rural central China. Multiple regression was conducted to test the mediation model. The study found that the experience of enacted stigma had a negative effect on PTG among children affected by HIV/AIDS. Emotional regulation together with hopefulness and perceived social support mediated the impact of enacted stigma on PTG. Perceived social support, hopefulness, and emotional regulation offer multiple levels of protection that can mitigate the impact of enacted stigma on PTG. Results suggest that future psychological intervention programs should seek strategies to reduce the stigmatizing experience of these children and promote children's level of PTG, and health professionals should also emphasize the development of these protective psychological factors.

مقدمه: مفهوم رشد پس از آسیب در سال‌های اخیر موردتوجه پژوهشگران و متخصصان بالینی قرار گرفته است. هرچند مطالعات قبلی رشد پس از آسیب را در نجات‌یافتگان از بیماری سرطان گزارش داده‌اند، در مورد عوامل تسهیل‌کننده یا تشدیدکننده رشد پس از آسیب در این بیماران پژوهش‌های کمی انجام شده است. پژوهش حاضر با هدف پیش‌بینی رشد پس از آسیب بر اساس ابعاد نیروی اراده در بیماران 65-50 ساله مبتلا به سرطان خون در شهر شیراز انجام شد.روش: جامعه آماری شامل بیمارانی بودند که جهت درمان به بیمارستان نمازی یا درمانگاه مطهری شیراز در طول سال‌های 1397-1396 مراجعه داشتند و توسط پزشک متخصص، تشخیص سرطان خون دریافت کردند. از بین این بیماران با استفاده از روش نمونه‌گیری در دسترس 101 بیمار انتخاب شدند. برای سنجش متغیرها از پرسشنامه رشد پس از آسیب (تدسچی و کالهون،1996) و پرسشنامه نیروی اراده (گودرزی، تقوی و کفه زاده، 1395)، استفاده گردید. برای تحلیل آماری از آزمون همبستگی پیرسون و رگرسیون چندگانه به روش هم‌زمان و گام‌به‌گام استفاده شد.نتایج: بر اساس یافته‌های آزمون همبستگی پیرسون، نیروی اراده با رشد پس از آسیب و همه‌ی ابعاد آن، رابطه‌ی مثبت معناداری در سطح 0.01 داشت. همچنین، رشد پس از آسیب با نیروی اراده و همه‌ی ابعاد آن رابطه‌ای مثبت و معنی‌دار داشت. بر اساس تحلیل‌های رگرسیون گام‌به‌گام، تنها بعد «خودکنترلی» قادر به پیش‌بینی معنادار رشد پس از آسیب بود.بحث و نتیجه‌گیری: ارتقای بعد «خودکنترلی» نیروی اراده می‌تواند در افزایش رشد پس از آسیب، نقش داشته باشد. بنابراین، به کار بردن مداخلاتی برای ارتقای «خودکنترلی» می‌تواند در این زمینه، کمک‌کننده باشد.

In the study, the use of coping and emotion regulation (ER) strategies is compared in 194 adults aged between 20 and 65 years, regarding their age (emerging, young or middle adulthood), gender and level of education. There are almost no significant differences in the use of coping and ER strategies in adults regarding age. Women use certain ER strategies (e.g., attentional deployment) more than men, but there is no difference between the two groups in the use of coping strategies. Adults with a low level of education use more confrontive coping and distracting in comparison with adults with a high level of education, while the escape- -avoiding coping strategy is used more by adults with low and middle levels of education than those with a high level of education. Regarding ER, adults with a low level of education use more cognitive reappraisal of importance than both groups with a higher educational level, whereas they use suppression and substances only more than adults with a high level of education. Correlations between coping and ER strategies are mostly non-significant, suggesting that coping and ER are distinct processes in adulthood.

Relations between caregivers’ emotion regulation strategies, parenting styles, and preschoolers’ emotional competence in Chinese parenting and grandparenting