Available online at www.sciencedirect.com ScienceDirect Procedia - Social and Behavioral Sciences 159 ( 2014 ) 702 706 WCPCG 2014 The Roles of Meaningful Life and Posttraumatic Stress in Posttraumatic Growth in A Sample of Turkish University Students Pınar Dursun a *, Sinan Saracli b, Osman Konuk c a Afyon Kocatepe University, Art-Science Faculty, Department of Psychology, 03200, Afyon, Turkey b Afyon Kocatepe University, Art-Science Faculty, Department of Statistics, 03200, Afyon, Turkey c Izmir Katip Celebi University, Department of Sociology, 35620, Izmir, Turkey Abstract The present study aimed to find out the prevalence of traumatic experiences in students and the relationships among posttraumatic stress, meaningful life, and posttraumatic growth as well as to investigate the possible contributory roles of meaning in life dimensions and posttraumatic stress in posttraumatic growth. The instruments included, a series of questionnaires consisting of demographic information, Turkish versions of Posttraumatic Diagnostic Scale, Posttraumatic Growth Inventory, and the Meaning in Life Questionnaire which were carried out in Afyon Kocatepe University. Statistical analysis of 564 university students (376 female and 188 male) revealed that sudden death was the most distressing event (51.4%). The hierarchical multiple regression results revealed both meaning in life dimensions significantly and positively predicted the total growth scores and posttraumatic stress severity contributed a significant increase in explained variance. In conclusion, following adversities, posttraumatic stress and both meaning in life dimensions are separate routes to posttraumatic growth. 2014 Published The Authors. by Elsevier Published Ltd. by This Elsevier is an Ltd. open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). Keywords: Posttraumatic Growth (PTG), Meaning in life, Posttraumatic Stress (PTS), Psychological Trauma. 1. Introduction A student s college years can often be full of distress and various traumatic experiences that require proper adjustment. Severe events mostly demolish students' physical, and social environments and bring out some psychological health problems including posttraumatic stress disorder (Norris et al., 2002). Although these traumatic events can lead to severe psychological distress in university students, simultaneously some individuals may engender growth experiences. This growth process is defined as posttraumatic growth (PTG). PTG refers to positive * Pınar Dursun.Tel:+4-344-232. E-mail address: dursun.pinar@gmail.com, pinar.dursun@colostate.edu 1877-0428 2014 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). doi:10.1016/j.sbspro.2014.12.454
Pınar Dursun et al. / Procedia - Social and Behavioral Sciences 159 ( 2014 ) 702 706 703 psychological consequences or changes experienced as a result of the struggle in coping with traumatic events (Tedeschi & Calhoun, 1996; 2004). There are numerous empirical studies reporting these growth experiences following various traumatic life events such as terminal diseases (e.g., Schroevers & Teo, 2008), 9/11 terrorist attacks (e.g., Park, Aldwin, Fenster, & Snyder, 2008), and natural disasters (e.g., Karanci & Acarturk, 2005). Because trauma is psychologically a "seismic event" (Calhoun, 1996 cited in Tedeschi, Park, & Calhoun, 2008, p.2), survivors have a need to understand the meaning of these experiences and reconstruct their global meaning systems. In this meaning-making process, people need "a comprehension (achieving a consistent understanding of one's self, world, and fit) and purpose (having an overarching set of goals or missions one strives to accomplish)" (Steger, Bundick, & Yeager, 2012, p. 1672). Since the observations of Frankl's (1963) derived from Nazi concentration camps, searching and finding meaning in suffering has long been recognized in psychological literature. Recent empirical studies have demonstrated that meaning in life is a trait-like and relatively stable concept and is accepted as one of the most consistent well-being measures (Steger & Frazier, 2005; Steger & Kashdan, 2007). Previous studies revealed that meaningful life was found to be correlated with positive changes and significantly predicted PTG scores (Linley & Joseph, 2011; Steger, Frazier, & Zacchanini, 2008). Nevertheless, the literature includes mixed findings about the association between PTG and PTS (e.g., Butler et al., 2005; Dekel, Mandl, & Solomon, 2011). In sum, there has been little empirical research investigating PTG relationship with meaning in life dimensions and posttraumatic stress (PTS) in university students. Thus, the present study aimed to examine the prevalence of traumatic events that students have experienced and the relationships among PTS, the meaning in life dimensions, and PTG and lastly to find out the unique contributions of meaning in life dimensions and PTS in PTG total scores. 2. Method 2.1. Participants and Procedure A sample of 648 students were recruited through convenient sampling procedure from various grades and departments of Afyon Kocatepe University in Turkey however, analyses were carried out with a sample of 564 (376 female and 188 male) students. The age of the participants ranged between 18 and 30 (M =21.07, SD = 1.69). The participants were enrolled in the Art & Science Faculty/College (56.9%), Health School (40.8%) and other faculties/colleges (2.3%). Of these participants 0.7% were English preparatory students, 31.7% freshmen, 25.5% juniors, 25.2% sophomores, and 17.2% seniors. The survey packets were randomly distributed to the students who agreed to participate in the classroom settings in campus. 2.2. Instruments 2.2.1. Demographic Information Form This form was prepared by the researchers and includes information regarding sex, department, faculty, and grade of the participants. 2.2.2. The Posttraumatic Diagnostic Scale (PDS; Foa, Cashman, Jaycox, & Perry, 1997) The PDS is a 49-item self-report measure to assess the history of traumatic experiences, the most distressing event, and the severity of symptoms of posttraumatic stress disorder (PTSD) based on DSM-IV criteria (American Psychiatric Association, 1994). The PDS includes ten series of events that participants might have experienced such as natural disasters, life-threatening illnesses, sudden death, sexual assault by strangers or family members. Participants were also asked to endorse the most distressing experience. In order to assess the severity of PTSD symptoms for a previous month, a 17-item with 4-point scale ranging from never (0) to five times a week (3) was used. The Cronbach alpha coefficient was reported as.92 (Foa et al., 1997). Turkish adaptation was performed by Duru (2006). The Cronbach alpha coefficient was reported as.92. In this study, the Cronbach alpha coefficient was found as.93.
704 Pınar Dursun et al. / Procedia - Social and Behavioral Sciences 159 ( 2014 ) 702 706 2. 2. 3. Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) The PTGI is a 21-item self-report scale developed to what extent a change occurs resulting from a traumatic experience. It is a 6-point scale ranging from I did not experience this change (0) to I experienced this change to a very great degree (5). PTGI has five domains: relationship with others, new possibilities, personal strength, spiritual change, and appreciation of life. The Cronbach alpha was reported as.95 for total score (Tedeschi & Calhoun, 1996). The scale was adapted into Turkish by Duru (2006). The Cronbach alpha coefficient was reported as.93. In this study, Cronbach alpha coefficient was found as.95. 2.2.4. Meaning in Life Questionnaire (MLQ; Steger, Frazier, Oishi, & Kaler, 2006) The MLQ is a 10-item self report scale designed to measure two dimensions of meaning in life using 5 items in each dimension. The Presence of Meaning (MLQ-P) subscale measures how full respondents feel their lives are of meaning. The Search for Meaning (MLQ-S) subscale measures how engaged and motivated respondents are in efforts to find meaning or deepen their understanding of meaning in their lives. Participants are asked to rate each item on a 7-point ranging from Absolutely Untrue (1) to Absolutely True (7). The Cronbach alpha coefficients were reported as.86 for MLQ-P and.87 for MLQ-S. Turkish adaptation was performed by Dursun (2012). Cronbach alpha coefficients were found as.83 for MLQ-P and.87 for MLQ-S. In this study, Cronbach alpha coefficient for each dimension was calculated as.76 for MLQ-P,.88 for MLQ-S. 2.3. Data Analysis After data cleaning and assumption checking procedure, correlation analysis and hierarchical multiple regression were run using SPSS program. 3. Results 3.1. Descriptive Information and Zero-order Correlations Descriptive analysis revealed that 99.8 % of students in our sample have experienced at least one traumatic event during their life-time. Among various types of events, the most distressing events that participants have experienced as follows: serious accidents (8.9%, N = 50), natural disasters (13.8%, N = 78), life-threatening illnesses (3%, N = 17), sexual assault by stranger (1.1%, N = 6), sexual assault by acquaintance (1.4%, N = 8), non-sexual assault by family member (1.6%, N = 9), non-sexual assault by stranger (1.8%, N = 10), Child sexual abuse (1.1%, N = 6), military conflict (0.9%, N = 5), torture (0.4%, N = 2), imprisonment (0.7%, N = 4), sudden/unexpected death (60.8%, N = 343), and other (4.6%, N = 26). As presented in Table 1, descriptive analyses indicated that participants reported moderate levels of growth, meaningful life and search for meaning differently from posttraumatic stress level which was lower than midpoint level (midpoint = 25.5). PTG was positively and significantly correlated with PTS (r =.36, p.<.01) and MLQ-P (r =.11, p.<.05), and MLQ-S (r =.09, p.<.05). Table 1. Means, Standard Deviations and the Correlation Matrix of the Variables Measures M SD 1 2 3 4 1.Meaning in life-presence (MLQ-P) 26.94 5.87-2. Meaning in life-search (MLQ-S) 20.37 8.41 -.15 ** - 3. Posttraumatic stress (PTS) 14.52 11.81 -.26 **.12 ** - 4. Posttraumatic growth total scores (PTG) 48.23 25.68.11 *.090 *.36 ** - ** p.<.01 (2-tailed) *p.<.05 (2-tailed)
Pınar Dursun et al. / Procedia - Social and Behavioral Sciences 159 ( 2014 ) 702 706 705 3.2. Regression Analysis In order to evaluate how well demographic questions, meaning in life dimensions, and PTS predict PTG total scores, we conducted one hierarchical multiple regression analysis. As seen in Table 2, the predictor variables were entered in three steps. All of the variables explained 18% of the variance in PTG. The results revealed that the first model was not significant for sex and age on PTG (F (2, 557) =.347, p >.05). The second model and multiple regression coefficient were significant (F (4, 555) = 3.43, p <.01; R =.15, p <.001). After statistically controlling the effects of age and sex, presence of meaning and search for meaning added significantly to the model (F change = 6.51, p <.01) and this variable resulted in significant increase in explained variance (R 2 change =.02). Lastly, PTS was entered as third step explained a moderate proportion of the variance (F (5, 554) = 23.74, p <.001; R =.42, p <.001; R 2 change =.15, β =.41, t = 10.12, p <.001, F change = 102.45, p <.001). Table 2. Summary of Hierarchical Multiple Regression for the prediction of PTG total scores Steps B Std.Error Beta (β) T Part Step 1 Sex.97 2.32.01.41.01 Age.41.65.02.63.03 Step 2 MLQ-presence.56.18.13 3.01**.13 MLQ-search.31.13.10 2.41*.10 Step 3 Posttraumatic Stress.88.08.41 10.12***.39 *** p.<.001, ** p.<.01, * p.<.05 4. Discussion The goals of this study were firstly to find out the prevalence of most distressing traumatic events that students have experienced, secondly to investigate the associations among meaning in life dimensions, PTS severity, and PTG and lastly to examine the unique contributions of meaning in life dimensions and PTS severity in PTG. Regarding first purpose of the study, the findings revealed that 99.8% of the students were exposed to at least one traumatic event during their lives. This high prevalence rate is similar to the findings of Vrana and Lauterbach (1994) who demonstrated that 84% of college students reported at least one traumatic event in their life-time. In a study of Bernat, Ronfelldt, Calhoun, and Arias (1998) college students reported experiencing the most commonly natural disasters, and serious accidents. In our sample, students endorsed the sudden/unexpected death of loved ones as the most common event (60.8%, N = 343), natural disasters (13.8%, N = 78) subsequently. Regarding the second and third aims, the results supported that both the presence of meaning in life and searching for meaning dimensions as well as PTS positively predicted posttraumatic growth. As Tedeschi and Calhoun (2004) proposed, PTS should be severe enough to challenge the assumptions and beliefs regarding life priorities, relationships and global meaning system to have an impact. In linking PTG and PTS, previous studies include inconsistent findings displaying curvilinear, positive or negative relationship (e.g., Butler et al., 2005; Dekel et al., 2011). Our finding supports that PTS is the main contributor to growth by positively predicting 15% of the variance in PTG on its own. Regarding meaning in life dimensions, separately from the role of PTS, our study demonstrated that the meaning making process of both having a meaningful life and searching for a new meaning are significant additional pathways to growth, even though the unique contribution (R 2 Change =.02) is quite weaker than PTS (R 2 Change =.15). Inconsistent with our study, limited previous results (e.g., Linley & Joseph, 2011; Steger et al., 2008) showed that the search for meaning was not correlated with PTG unlike presence of meaning. Future studies should highlight especially the role of search for meaning in growth process. To conclude, the present study can illustrate important insights indicating that PTS and meaning in life dimensions have certain roles in explaining posttraumatic growth among university students. Nonetheless, the cross-sectional design with a convenient sample of university students may deter the generalizability of the findings. Further studies should endeavor to obtain larger and more varied samples with longitudinal designs for comparing theories and assumptions about posttraumatic growth. Acknowledgements This research has been funded by Afyon Kocatepe University Scientific Research Projects Coordination (BAP) in
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