Growing through adversity: A meta-analytic and conceptual elucidation of the relationship between posttraumatic stress and posttraumatic growth among youth

Trauma may engender both posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among youth, but what is the nature of the relationship between these variables and what does it imply about youths' recovery trajectories? To explore this, PubMed, PsycINFO, Scopus, ERIC, and ProQuest Dissertations and Theses Global were searched, supplemented by reference trails, journal searches, and expert consultations, to identify quantitative studies on PTSS and PTG in youth (mean age ≤ 19 years). This resulted in 63 eligible articles. Both linear (n = 53) and curvilinear (n = 12) estimates were meta-analysed using random-effects models. Linear dependent estimates were pooled using weighted corrected averages and curvilinear dependent effects were clustered using robust variance estimation. The pooled linear estimate was r = 0.2028 [95 % CI 0.1348; 0.2689], p < .0001, based on 53 independent estimates and a total sample size of 33,774.6. The pooled curvilinear estimate was b = −0.199 (SE = 0.0573, p = .012). Moderator analyses further revealed a significant cultural influence, with Western youth (r = 0.3100 [95 % CI 0.1977; 0.4142], N = 6141) demonstrating a stronger association between PTSS and PTG compared to their Eastern counterparts (r = 0.0727 [95 % CI −0.0130; 0.1574], N = 21,778.42). The findings paint a nuanced and complex picture of posttrauma responses among youth, ultimately underscoring that, while PTSS and PTG can coexist, PTSS that are too excessive may not be conducive to PTG.