"What doesn't kill me makes me stronger": Constructive or illusory posttraumatic growth?

Abstract

The development of the concept of posttraumatic growth (PTG) and its measurement, the Posttraumatic Growth Inventory, has highlighted the possibility of positive psychological changes after psychotrauma. The actual nature of perceived PTG is, however, debated in the literature. This article aims to summarize the conceptual, methodological, and empirical elements questioning the concept of PTG and to present theoretical perspectives integrating two forms of perceived PTG, real and illusory. The authors performed a review using the PubMed, PsycInfo, and Google Scholar databases. The concept of PTG has been criticized for its confusing and limited definition (particularly as regards the nature of change and its dimensions) and for its complex retrospective self-assessment associated with numerous biases (e.g., self-improvement bias, positive attention bias, downward comparison bias, memory bias). There are further reservations about the character of PTG based on empirical data, such as both the absence of a relationship between perceived and actual changes, and the lack of consensus regarding the adaptive value of PTG (variable associations between PTG and distress and coping types). As for theoretical perspectives, the Janus-Face model was the first to describe constructive PTG and illusory PTG, linked differently to distress and coping. More recent models have also examined these two faces in light of other concepts such as dissociation, and identified PTG trajectories on the basis of person-centered longitudinal analyses, suggesting heterogeneity in PTG. This review underlines the importance of developing further research into patterns of PTG, potentially by improving PTG assessment and considering possible heterogeneity of responses.