Positive change following trauma and adversity: a review.

Empirical studies (n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress-related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. The review indicated that cognitive appraisal variables (threat, harm, and controllability), problem-focused, acceptance and positive reinterpretation coping, optimism, religion, cognitive processing, and positive affect were consistently associated with adversarial growth. The review revealed inconsistent associations between adversarial growth, sociodemographic variables (gender, age, education, and income), and psychological distress variables (e.g., depression, anxiety, posttraumatic stress disorder). However, the evidence showed that people who reported and maintained adversarial growth over time were less distressed subsequently. Methodological limitations and recommended future directions in adversarial growth research are discussed, and the implications of adversarial growth for clinical practice are briefly considered.