Department of Psychology, University of Bath, Bath, United Kingdom.
St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
PLoS One. 2022 Aug 8;17(8):e0271314. doi: 10.1371/journal.pone.0271314. eCollection 2022.
The possibility of posttraumatic growth in the aftermath of pregnancy loss has received limited attention to date. This study investigated posttraumatic growth in mothers following stillbirth compared to early miscarriage. It was hypothesised that mothers following stillbirth will demonstrate more posttraumatic growth, challenge to assumptive beliefs, and disclosure than mothers following early miscarriage. The study also sought to understand how theoretically-derived variables of the Model of Growth in Grief (challenge to assumptive beliefs and disclosure) explained unique variance in posttraumatic growth when key factors were controlled for. One-hundred and twenty women who had experienced a stillbirth (N = 57) or early miscarriage (N = 63) within the last two to six years completed validated questionnaires in an online survey relating to posttraumatic growth and key variables relevant to emotional adjustment post-bereavement. Participants who had experienced a stillbirth demonstrated significantly higher levels of posttraumatic growth, posttraumatic stress symptoms, perinatal grief, disclosure, challenge to assumptive beliefs and rumination than participants who had experienced an early miscarriage (Cohen's d ranged .38-.94). In a hierarchical stepwise regression analysis, challenge to assumptive beliefs alone predicted 17.5% of the variance in posttraumatic growth. Intrusive and deliberate rumination predicted an additional 5.5% of variance, with urge to talk, reluctance to talk, and actual self-disclosure predicting a further 15.3%. A final model including these variables explained 47.9% of the variance in posttraumatic growth. Interventions targeting challenge to assumptive beliefs, disclosure, and rumination are likely to be clinically useful to promote psychological adjustment in mothers who have experienced stillbirth and early miscarriage.
创伤后成长在妊娠丢失后的可能性在目前为止受到了有限的关注。本研究调查了与早期流产相比，胎死宫内后母亲的创伤后成长。研究假设胎死宫内的母亲会表现出更多的创伤后成长、对假设信念的挑战和披露，而早期流产的母亲则不会。该研究还试图了解在控制关键因素的情况下，理论上衍生的悲伤模型（对假设信念和披露的挑战）变量如何解释创伤后成长的独特差异。在过去两年至六年内经历过胎死宫内（n=57）或早期流产（n=63）的 120 名女性在一项在线调查中完成了与创伤后成长和与悲伤后情绪调整相关的关键变量相关的有效问卷。与经历早期流产的参与者相比，经历过胎死宫内的参与者表现出更高水平的创伤后成长、创伤后应激症状、围产期悲伤、披露、对假设信念的挑战和沉思（Cohen's d 范围为.38-.94）。在逐步回归分析中，仅对假设信念的挑战就能预测创伤后成长的 17.5%。侵入性和深思熟虑的沉思预测了另外 5.5%的方差，而谈话的冲动、不愿意谈话和实际的自我披露预测了进一步的 15.3%。包括这些变量的最终模型解释了 47.9%的创伤后成长的方差。针对假设信念挑战、披露和沉思的干预措施可能对促进经历过胎死宫内和早期流产的母亲的心理调整具有临床意义。
