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. 2020 Apr 30;289:113044. doi: 10.1016/j.psychres.2020.113044

“That which does not kill us, makes us stronger”: COVID-19 and Posttraumatic Growth

Alexandra Tamiolaki a,, Argyroula E Kalaitzaki b
PMCID: PMC7191294  PMID: 32388177

A life-threatening kind of pneumonia named COVID-19 is now a major public threat globally. It was first detected in Wuhan, in China, in December 2019. On March 2020 COVID-19 was declared a pandemic by WHO and ever since it is considered a health emergency of international concern. The rapid spread of the COVID-19 resulted in a large number of deaths, mostly due to respiratory problems. Restrictions in local and international travel, in-house isolation or quarantine were the most common responses and measures enforced by the governments worldwide. These measures were undertaken in order to restrain the spread of the virus and safeguard the health systems from the overwhelming pressure to cope with the profound effects of the pandemic.

As a major life trauma, COVID-19 might have negative impacts on individuals, such as posttraumatic stress symptoms (PTSS; Liu et al. 2020). According to Bo et al. (2020), clinical stable COVID-19 patients from Wuhan and the surrounding cities suffered from severe PTSS due to social isolation, uncertain danger, physical discomfort, fear of virus transmission to others and negative news in mass media. The strict quarantine measures, the shortage of medical staff and resources, the lack of masks and protection supplies could have negatively affected individuals’ quality of life and social functioning leading to PTSS (Bo et al., 2020). Liu et al. (2020), reported that many residents in the hardest-hit areas in China suffered PTSS, as they were re-experiencing the traumatic event, negative alternation in cognition or mood and hyper-arousal. The majority of them were women with poor sleep quality. More studies are needed to explore PTSS during COVID-19 outbreak.

Although there are still few studies examining the negative psychological impact of COVID-19, there are even fewer focusing on how positive outcomes may occur despite adversities. Posttraumatic Growth (PTG) referring to a positive adaptation process through which people reevaluate their traumatic experience, has been largely overlooked by the scholarly literature. Tedeschi and Calhoun (1996) suggested that PTG describes the positive changes experienced by people as a result of their cognitive efforts to deal with challenging circumstances. Growth occurs when people in the aftermath of trauma engage in a deliberate cognitive restructuring of reality, by changing their life narrative to include a better understanding of the self, the others, and the world (Tedeschi and Calhoun, 1996). The result of this cognitive reconstruction is a greater sense of personal strength (personal growth), deeper relationships with others (social growth) and a greater appreciation of life (spiritual growth).

Relevant research is warranted to investigate the potential positive impacts of coping with COVID-19 outbreak on mental health, such as PTG. Studies on the positive impact of SARS epidemic, which was the first Severe Acute Respiratory Syndrome, have already offered valuable insights underlining that PTG can occur after infectious diseases (Lau et al., 2006). In the research of Lau et al. (2006), although a high percentage of people experienced feelings of worry, helplessness, isolation, irritation, sleeping problems and many other negative mental health effects during the SARS outbreak, for a proportion of people, SARS was also considered a chance for positive outcomes. They experienced ‘social growth’, as they reported greater care about their family members’ feelings, were more likely to be spending time together and considered their friends more supportive. They also achieved ‘personal growth’, as they were spending more time to relaxand they adopted a healthier lifestyle. Also, they learnt to be grateful and appreciate their health, family, friends and everyday life, all of which are aspects of ‘spiritual growth’ (Lau et al., 2006).

According to Friedrich Nietzsche “that which does not kill us, makes us stronger”. PTG entails more than simply returning to a preexisting state of balance following a hardship. PTG has to do with reevaluating life positively. Future studies should examine whether PTG may occur after the COVID-19 pandemic and findings may guide policymakers and practitioners to develop tailored-based practices and interventions in future traumatic events. The identification of the coping strategies that could be predictors of growth is necessary to safeguard people from the negative consequences of the COVID-19 and promote PTG. As a concluding mark, PTG seems to be a promising approach in the battle with the virus. Adopting this alternative approach to the study of the consequences of COVID-19 pandemic could be advantageous and potentially beneficial for all.

Authors'contributions

AT contributed to the conception of the manuscript, drafted the manuscript and approved the final version. AK critically reviewed drafts and approved the final version.

Role of the funding source

There is no funding involvement.

Declaration of Competing Interest

There are no conflicts of interest.

References

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Articles from Psychiatry Research are provided here courtesy of Elsevier

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