Trauma and growth in parents of children with chronic illness and brain injury

Background: Parents of children with chronic physical illness (CPI) may experience poor mental health. There has also been a growing focus on posttraumatic growth (PTG): positive psychological adaptation following the struggle with trauma. Method: A systematic review was conducted to develop understanding of variables associated with PTG in parents of children with CPI. Quantitative studies across various CPIs were eligible. A cross-sectional study explored the relationship between post-traumatic stress (PTS) and PTG in parents of children with acquired brain injuries (ABI), considering the influential role of coping. Results: Twenty-nine papers were reviewed. Most had fair methodological rigour and were in oncology samples. Time and social support were positively associated with PTG. Additionally, cognitive factors (illness perception, core belief re-examination, deliberate rumination) may be associated. Anxiety and moderate PTS were also associated with PTG, although several papers failed to find a relationship between PTS and PTG. Interventions may facilitate PTG. In parents of children with ABI (N = 49), PTS and PTG were unrelated. Significant relationships were found between avoidance-coping and PTS, and acceptance-coping and PTG. Conclusions: PTG experiences in parents of children with CPI and ABI largely align with existing research and models of PTG (Tedeschi & Calhoun, 2004). The PTS and PTG relationship in this population is complex: results from this thesis suggest they may be curvilinearly related, or independent, though sharing common variables. This may result from paediatric CPI characteristics, namely, beyond initial CPI onset, re-traumatisation from medical procedures and acknowledgement of loss. Interventions which encourage social support, approach-oriented coping and reduce avoidance may be beneficial. Empirical study results are limited by sample size. Future research should explore the dimensional relationship between PTS, PTG and associated variables. PTG in this population may evolve across time; longitudinal research could strengthen causal inferences and understanding