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In: Research on Hispanic Psychology ISBN: 978-1-68507-450-0

Editors: C. H. García Cadena et al. © 2022 Nova Science Publishers, Inc.

Chapter 1

POSTTRAUMATIC GROWTH IN LATIN

AMERICA: WHAT IS IT, WHAT IS KNOWN
AND WHAT IS ITS USEFULNESS?

Felipe E. García1,, Constanza Rivera1

and Sandra Garabito2
1
Universidad de Concepción, Concepción, Chile
2
Universidad Santo Tomás, Concepción, Chile

ABSTRACT

Posttraumatic growth is known as the perception of positive

changes after being exposed to a highly stressful event. Its study allows
obtaining a wider view of the consequences of a stressful event in
people’s life. Particularly, this chapter is focused on the learning that
people obtain from these potentially traumatic experiences. In Chile,
several studies, whose objectives have been to comprehend the
posttraumatic growth phenomenon and recognize strategies and
conditions that make people’s growth possible, have been carried out in
order to enable the design of procedures and stimulate their


Corresponding Author’s E-mail: felipegarciam@yahoo.es.

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2 Felipe E. García, Constanza Rivera and Sandra Garabito

development. This chapter shows findings related to posttraumatic

growth worldwide and in Chile through studies that have been
performed with people exposed to natural disasters, police brutality and
work accidents, among other stressors. After reviewing the variables
related to growth, intervention ideas deduced from findings are
presented.

INTRODUCTION

Either due to geologic, climatic, political or social reasons, there is no

person that has not been ever exposed to a highly stressful or potentially
traumatic event. This occurs in Chile, where we have experienced
earthquakes, floods, volcanic eruptions, political repression, tortures and
common crimes as well as in other countries in the American continent
and in other regions of the world affected by wars, famines, hurricanes
and other threats.
However, and in spite of it, most of the people seem to properly cope
with threats, achieving to continue with their lives without developing
any emotional consequence that interferes with their life plans. This
quality has been called “resilience.” The word “resilience” comes from
physics and it refers to the property of some metals to twist and return to
their original state and it seems that the effort to bend them does not
leave a trace. The word “resilience” applied to mental health does not
have a commonly accepted definition, since for some people it is simply
defined as the absence of relevant symptoms after coping with an adverse
situation (Bonanno, 2004; Vázquez, Castilla, & Hervás, 2009), whereas,
according to other authors it can also include positive changes in people’s
life (Quiceno & Vinaccia, 2011). In this chapter, resilience will refer to
the ability that allows human beings to fall down and get up time after
time, rising from ashes, recovering from chaos, destruction or other
threats.
An example of resilience is seen in Figure 1, a picture taken after the
tsunami that lashed Chilean costs on February 27th, 2010. This is one of
the strongest earthquakes ever recorded in the world and it represented a

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 Posttraumatic Growth in Latin America 3

real challenge for the reconstruction, not only of the physical

infrastructure but also of the own lives and identities of the affected
people.

Source: www.colegioaltamira.cl.

Figure 1. “I have fallen but I will get up again. The ‘uncle’”. Picture taken in the
coast of the Maule region, Chile, after the tsunami of February 27th, 2010.

WHAT POSTTRAUMATIC GROWTH IS?

If we understand now the small semantic distinctions that we use to

refer to the ability to recover from a crisis, it turns out to be that some
people not only fall down or get up with or without efforts, but they are
also able to recognize that they learned something or positively changed
after a painful or traumatic experience. This possibility does not seem to
be so unusual and therefore it has been possible to be studied, making a
difference from the most general idea of resilience used to refer to a
person that does not easily give up in spite of inclemencies. The person
who learns or changes when facing adversity and does not come back to
his/her original state, but to a state that seems to be better, will be able to
face similar events using new tools resulting from these learnings and
changes. This ability to learn from crisis has been called “posttraumatic
growth.”

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4 Felipe E. García, Constanza Rivera and Sandra Garabito

A sentence that summarizes a central aspect of PTG is: “If I faced

this and I was able to keep my integrity, then I can face anything that can
happen to me. I’m stronger than I ever thought I would be.” It is
important to mention that this paradoxical idea “I’m more vulnerable, but
stronger” implies, on one hand the feeling of vulnerability in front of an
event that could not be controlled or prevented, but on the other hand, it
also increases the feeling that the ability to survive and learn from it does
exist.
In view of the above, it is deduced that experiences and learning from
the event do not necessarily void the suffering, but they can coexist with
it. This paradoxical and contradictory element is essential to understand
the deep break point or twisting of stories that traumas can make in a
human being (Pérez-Sales, 2006). It is difficult not to continue feeling
pain when external conditions or internal processes linked to the
traumatic event reappear. However, as proposed by Calhoun and
Tedeschi (1999), in order to continue learning and growing, the
coexistence of this duality of positive and negative emotions is necessary;
otherwise it is possible that the growth is not produced. In short, the
growth experience does not arise from a trivial process of positive
emotions but from a change that frequently involves painful and
ambivalent reconstructions, but incorporating beliefs of having
personally grown.
Tedeschi and Calhoun (1996), promoters of this construct, have
defined posttraumatic growth (hereinafter PTG) in several ways
throughout the time, with small variations among the definitions. By
doing a syntax of the different nuances and perspectives, we dare to
define PTG as the positive changes, noticed by a person, from the
struggle he/she fights to recover from a traumatic or highly stressful
event.
From this definition, it is possible to deduce that one of the
conditions for PTG to be produced is that the person has lived a severe
event and has had a bad time. Therefore, PTG is not something arising
immediately. In fact, it is more likely that in the contiguity of the event,
the person struggles for surviving rather than attenuating his/her suffering

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 Posttraumatic Growth in Latin America 5

and only with the distance given by the time, he/she is finally able to
recognize these new learnings.
According to Tedeschi and Calhoun (1996), these perceived changes
can happen in three areas of life (see Figure 2):

1. Changes in oneself: one of the main aspects of PTG is to

perceive oneself as a stronger and more confident person, with
more experience and ability to cope with difficulties in the future.
At this point, persons can perceive themselves stronger than they
thought they were before the stressful event or that they have the
necessary abilities to survive to an extreme event. An example is
that after the earthquake in Chile in 2010, some persons
perceived they were stronger than they thought, able not only to
survive by themselves but also to assist other people.
2. Changes in interpersonal relationships: the occurrence of a severe
vital crisis can produce positive changes in the relationships.
Many people report that as a result of the traumatic experience
“one can realize who are your real friends and those relationships
become better and deeper.” Individuals also report a higher
comfort and confidence at the time of expressing their feelings
and emotions to others and a higher sensation of compassion to
others, especially for those who experience similar vital
difficulties. These positive changes allow the person to perceive
a higher closeness with other people and higher availability of
social support networks. In 2010 earthquake, a lot of people
mentioned having changed their perception in regards of their
neighbors, from whom they didn’t know much before the event,
but during the crisis they protected and helped each other.
Moreover, relatives and friends with whom they have lost
contact, reappeared worried for them. But crisis cannot only
produce positive changes, they can also result in negative ones.
Some relationships can become less important and even
disappear (for example: separations or divorces after a traumatic
situation like a severe illness of some of the kids), although these

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6 Felipe E. García, Constanza Rivera and Sandra Garabito

events are not usually frequent. Finally, it is worth mentioning

that sometimes person’s PTG processes can create some growth
spirals in other close persons, resulting in a vicarious growth
effect (Ochoa, Castejón, Sumalla & Blanco, 2013).
3. Changes in spirituality or in life’s philosophy: important changes
are perceived in the religious, spiritual and existential
components of their life’s philosophies. These changes are
revealed, for example, by a higher valuation of the own
existence, taking life easier and enjoying each moment;
distinguishing what it is important from the accessory. A higher
sensation of control and search for sense is acquired. Some
people that survived the earthquake and tsunami of 2010 felt they
had another connection with God. Others valued their life
differently, distinguishing important from superfluous things.

Figure 2. Areas where growth is seen after a trauma.

In order to value these changes, Tedeschi and Calhoum (1996)

created a PTG measurement scale called Posttraumatic Growth Inventory
[PTGI], developed from a wide review of the available bibliography
about the responses to trauma and interviews with people that have faced
important crisis or stressful events. It includes five factors: a)
interpersonal relationships, b) appreciation of life, c) personal strength, d)
changes in spirituality and e) changes in life’s priorities and goals. On the
other hand, there is a short version of the instrument (Cann, Calhoun,
Tedeschi, Taku, et al., 2010) and a version to be applied to children
(Kilmer et al., 2009), both including 10 items only. These three PTGI
versions (long, short and for children) were translated, validated and used

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 Posttraumatic Growth in Latin America 7

in various studies by our research team (Andrades, García, Reyes,

Martínez-Arias & Calonge, 2016; García, Cova & Melipillán, 2013;
García & Wlodarczyk, 2016).

POSTTRAUMATIC GROWTH AND SYMPTOMATOLOGY

There have been apparently contradictory findings in regards of the

consequences PTG has in adjustment and adaptation (Vázquez, Castilla
& Hervás, 2009), mainly because some studies show a positive
correlation between posttraumatic symptomatology [PTS] or
Posttraumatic Stress Disorder [PTSD] with PTG (García, Jaramillo;
Martínez, Valenzuela & Cova, 2014; Levine, Laufer, Stein, Hamama-Raz
& Solomon, 2009). In the studies we perform to population exposed to
the 2010 earthquake, in a total sample of 726 persons, the correlation that
we found between PTG and PTS was r = 0.42, which is not only
considered significant but also important. In another study with 629
persons exposed to various types of stressful events, we found a
correlation of r = 0.21, also significant, although lower than in persons
who faced the earthquake (García, Vega, Briones & Bulnes, 2018).
This relation has made that some authors support the idea that PTG is
more of an illusion (Hobfoll et al., 2007) rather than a cognitive bias
related to a naïve optimism in the face of adversity (Levine et al., 2009)
and that is not necessarily related to a higher wellbeing or better life
quality. Other authors assign this correlation to a problem with the scale
used (PTGI) and not with the construct, proposing a new instrument for
its measurement, which will correct that bias (Boals & Schuler, 2018).
However, the PTG phenomenon seems relatively robust and
unquestionable (Zoellner & Maercker, 2006; Sumalla, Ochoa & Blanco,
2009). In fact, this association between PTS and PTG does not deny the
real and positive nature of PTG.
The position of our team in regards of the association between
posttraumatic stress and PTG has a plausible explanation. For us, the
learning and growth experience seems to occur just because of and not in

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8 Felipe E. García, Constanza Rivera and Sandra Garabito

spite of the suffering produced by the stressful event. Furthermore, recent

studies have shown a positive relation between PTG and psychological
adjustment. For example, a study carried out with people affected by the
earthquake of 2010 in Chile, found a correlation of r = 0.34 between PTG
and psychological wellbeing (García, Cova & Reyes 2014) and even PTG
was able to predict wellbeing (cross sectional studies) (García, Villagrán,
Wlodarczyk & Cova, 2015). It has also been observed that PTG predicts
a better life quality and vital meaning (Cann, Calhoun, Tedeschi, &
Solomon, 2010).
This coincides with the review made by Tennen and Afleck (2005)
and the meta-analysis carried out by Helgelson, Reynolds and Tomich
(2006) that show us that PTG is related to a reduced depression and
increased psychological wellbeing.
In spite of these results, the performance of studies that allow
distinguishing the paths that lead to one or other outcome or that allow
assessing the trajectory of PTG and posttraumatic stress throughout time,
determining their predictors and their consequences longitudinally, is a
pending challenge.
Research about PTG, although it is about a construct only proposed
in 1996, has been plentiful worldwide. The scale to measure it, the PTGI,
has been studied and/or validated in different contexts and for different
populations around the world. At this point, there are publications that
propose theoretical models explaining the development of PTG in adults
(Calhoun, Cann & Tedeschi, 2011) as well as in children (Kilmer et al.,
2014) and some meta-analysis that show the trend in the cumulative
knowledge about PTG (Helgeson, Reynolds & Tomich, 2006; Prati &
Pietrantoni, 2009; Vishnevsky, Cann, Calhoun, Tedeschi & Demakis,
2010).
Latin America has not been indifferent to the interest of studying
PTG, developing research lines linked to this phenomenon in countries
such as Chile (García, Villagrán et al., 2015), Colombia (Acero, 2011),
Ecuador (Arias, García & Valdivieso, 2017) and Argentina (Esparza,
Martínez, Leibovich, Campos & Lobo, 2015), among others.

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FACTORS PREDICTING PTG

One of the most relevant challenges at the time of studying PTG is

determining its predicting factors. That is, what characteristics of the
person, event or coping used before the stressful experience do allow
predicting a higher PTG. To the extent that the last findings follow the
trend of showing that a higher PTG enables a higher wellbeing and a
lower presence of psychopathology in the long-term, then encouraging or
intervening on these factors could bring important consequences in the
prevention of discomfort after living a traumatic event.
In the researches carried out by our team in Chile (most of them cross
sectional studies), we have seen a series of variables that are positively
related to a higher PTG. Some of them are of socio-demographical
nature. For example, persons of male sex or middle income grew less
than those of female sex or low or high incomes (Garcia, 2017).

Figure 3. Variables related to posttraumatic growth.

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10 Felipe E. García, Constanza Rivera and Sandra Garabito

In regards of variables more related to the psychology, below there is

a review of each of them (see Figure 3).

Subjective Severity of the Event

Perceiving that the event was severe seems to positively impact PTG.
As we have mentioned, this would be explained by the fact that growth
can only exist if the person qualifies his/her experience as severe or
intense (Zoellner & Maercker, 2006; Helgeson et al., 2006), thus it is
possible to learn something from it. Therefore, the severity of the trauma
would be a requirement of PTG because it is more likely that the own
gravity of the event leads to a strong questioning of beliefs, which would
favor growth (Helgeson et al., 2006).
Even objective severity shows a lower relevance compared to
subjective severity in its relation with PTG. For example, Cordova et al.,
(2007) found a positive relation between subjective valuation of the
gravity of cancer diagnosis and PTG, whereas no evident relation was
found between the medical measurements of the gravity of the disease
and PTG. These studies are consistent with the Calhoun and Tedeschi´s
model (2006), highlighting that in case the diagnosis is not initially
valued as severe by the individual, in spite of the objective valuations,
there will be no motivation for him/her to reassess his/her life and create
positive changes.
In studies done in Chile, we have also found positive relations
between subjective severity of the trauma and PTG in population exposed
to the earthquake of 2010, both in adults and children (Andrades, García,
Calonge & Martínez-Arias, 2018: García, Jaramillo et al., 2014; García,
Cova et al., 2014). Should we consider the total of 1536 persons assessed
in our different studies about the earthquake, we found a correlation of
r = 0.45 between subjective severity and PTG. However, considering that
severity also shows a strong relation with PTS, it is necessary to
distinguish the factors that mediate or moderate these relations.

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Optimism

Optimism is the tendency of some people towards having expectation

of a positive and favorable outcome in the future (Carver, Scheier &
Segerstrom, 2010). This optimism seems to reduce the negative impact of
some events on the affected persons. A negative correlation is observed
with PTS (Sumer, Karanci, Berument & Gunes, 2005; Vernberg et al.,
2008) and anxiety on the general population (Pavez, Mena & Vera-
Villarroel, 2012). Likewise, optimism would positively influence the
psychological and subjective wellbeing (Vera-Villarroel, Pavez & Silva,
2012).
In regards of PTG, a positive relation was found with optimism in
patients with different types of cancer (Bozo, Gundogdu & Buyukasik-
Colak, 2009; Ho et al., 2011). In the studies we have carried out with
population affected by the 2010 earthquake (García, Cova et al., 2014),
we also observed a positive significant relation (r = 0.12) and even
moderating the relation with subjective severity. Thus, in high optimism
scores, the positive relation between severity and PTG is strengthen, but
in low levels of optimism, there is no significant relation between the two
variables (García, Villagrán et al., 2015). In other words, the ones who
consider the natural disaster as a traumatic event that changed their lives
are also able to perceive positive changes from that extreme experience
only if they are optimistic.

Social Support

One of the psycho-social factors that has a stronger positive relation

with PTG is social support. This is defined as the set of perceived or
actual instrumental and expressive disposals provided by different
sources such as family, partner and friends (Zimet, Dahlem, Zimet &
Farkley, 1988). A high level of perceived social support after a highly
stressful event decreases its cognitive impact, allows to better regulate
negative emotions, to control dysfunctional behavior, to reinforce

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entertainment and gratifying activities, and to better solve practical

problems (Prati & Pietrantoni, 2009).
Prati and Pietrantoni (2009) carried out a meta-analysis that
confirmed a positive relation between PTG and social support (r = 0.26).
In Chile, a study made by Avilés, Cova, Bustos and García (2014) with
university students that had declared experiencing a highly stressful event
in the last five years, showed that social support was a significant PTG
predictor in this group. In another study, this time with people living in
2010 earthquake victim camps, we also observed a significant influence
on PTG (García, Páez, Cartes, Neira & Reyes, 2014).
We developed one of the most complete studies about PTG in Aysén
(García, Capponi et al., 2016), an austral and isolated city located in the
Chilean Patagonia, months after a citizen movement that was looking for
a better life quality for the population was severely repressed by the
police (see Figure 4). In a sample of 319 inhabitants, we found that the
search for social support had a positive relation with PTG (r = 0.48) and,
as well, it was its most important predictor controlling other ways of
social connection such as social sharing and social participation (see
Table 1).

Source: Francisco Águila, EMOL.

Figure 4. “Although the wind blows with police repression, the Patagonian will be
the oak that will not bend.” Mobilizations in Aysén, Chile, against repression.

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 Posttraumatic Growth in Latin America 13

It is also worth mentioning that in a qualitative study carried out by

Larizgoitia et al., (2011) with 36 direct victims of collective violence in
the Basque Country, Spain, positive growth experiences linked to the
development of increased strengths and personal security, and of new
relationships and interest, which in many cases are related to activities to
support other victims, were identified. This could mean that not only
receiving, but also giving social support would be a predictor of PTG.
Lately, we have carried out longitudinal studies with people that have
been affected by a work accident. We measured coping strategies used
and PTG before the month and, six months and a year after the accident
in 242 workers. Non-published preliminary analyses show us that social
support received before the first month from the accident has no
influence on PTG one year later, whereas social support received six
months after the accident was an important predictor of PTG one year
later, especially in the perception of changes in the relationship with
others. We believe that initial social support does not contribute to
growth because this latter is expectable. In other words, as in mourning, it
is (to some extent) socially expected that people get close to provide
support or know how you are, but in case that concern and interest is
maintained six months after the accident, this does modify the valuation
people have over their interpersonal relationships.

Social Sharing of the Emotion

Social sharing of the emotion consists of translating an emotion into

a socially shared language and, at least at a symbolic level, direct it to
some recipient (Rime, Finkenauer, Luminet, Zech & Philippot, 1998).
Through self-disclosure and sharing their experiences with others, people
can discover positive aspects of trauma, which they had not noticed
(Tedeschi & Calhoun, 2004). Likewise, people can create new narratives
and modify their schemes (Schexnaildre, 2011). Páez et al., (2012)
emphasize that narration of a trauma and the related personal experience

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force the affected people to face the meaning of the trauma and rebuild a
view with sense of self and of the world.
The relation between social sharing and PTG has been suggested by
Calhoun, Cann and Tedeschi (2011), stating that social sharing would
indirectly influence PTG, mediated by deliberate rumination and social
support, among others.
In the study performed by García, Jaramillo et al., (2014) with
students exposed to the earthquake in Chile, it was observed that social
sharing would indirectly influence PTG through the cognitive processes
of rumination. In the study made by García, Cova, Rincón, Vázquez and
Páez (2016) with people that lost their houses in the 2010 earthquake,
social sharing influences PTG mediated by problem-centered coping and
deliberate rumination. In the study we carried out with inhabitants
exposed to social violence in Aysén (García, Capponi et al., 2016), we
found that social sharing influences PTG, even controlling social support
and social participation (see Table 1).
This influence has also been found in longitudinal studies. For
example, Rimé, Páez, Basabe and Martínez (2010) found positive
bivariate relationship between social sharing and PTG for the three times
and observed that social sharing in time 2 is a significant predictor of
PTG in time 3.
This relation was also found in a study carried out with 644 Spanish
university students one week after the terrorist attack. It was observed
that the fact of early sharing with others the emotions related to the
terrorist incident predicted a posttraumatic growth three and eight weeks
after in this population (Rimé, Páez, Basabe & Martínez, 2010).
In our recent longitudinal study with people who have had accidents
at their works, we observed (in our preliminary analysis) that social
sharing has no relation with PTG in none of the times. We also observed
that casualties had shared little and with few people. It is likely that social
sharing is stronger and has a greater influence on PTG when the threat is
a collective one (for example, in cases of natural disaster, police brutality,
war or terrorism) and, less frequent and with less relation to PTG in

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events that are lived more individually such as work accidents and others
like sexual abuse.

Social Participation

Another way of social bonding of great relevance when we talk about

citizen mobilizations is participation in public demonstrations or
resistance actions. Velásquez and González (2003) understand
participation as a social process resulting from the intentioned action of
individuals and groups in the search for specific relevant goals for the
community. Beristain (1999) confirms that resistance experiences before
repression can be considered as positive coping experiences.
A study carried out in Croatia observed that frequent participation in
social activities such as protests and demonstrations was related to less
symptoms of PTSD linked to a recent civil war (Kunovich and Hodson,
1999). Another study performed by Gasparre, Bosco and Bellelli, (2010),
showed that participation in collective ritual by the victims of genocide in
Guatemala was positively related to PTG. Likewise, rites were associated
with higher social support and increased social sharing of the traumatic
event.
In Chilean population exposed to social violence (García, Capponi et
al., 2016) we observed that social participation, measured by their
participation in protests and assemblies as well as in resistance actions
such as barricades or confrontations with the police force, exerted the
second strongest influence on PTG following social support (see Table
1). It is likely that participation in mobilizations and collective resistance
actions before threats increases the sense of control and social wellbeing,
including confidence in justice and in peers, easing PTG. Therefore,
people that were affected by police brutality, but did not participate in
mobilizations or actions, did not create the chance to grow from that
experience.

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Table 1. Multiple linear regression for PTG predictors in population

affected by police brutality (n = 319; R2 = .33)

Beta t-value
Social sharing 0.20 2.772**
Social participation 0.24 3.259***
Search for social support 0.34 5.129***
Religiosity 0.14 2.152*
*p < 0.05; **p < 0.01; p < 0.001.

Religiosity

Religiosity seems to be an important personal, social and community

resource when the time comes to face critical situations. For this reason,
it has been measured as a coping strategy. However, it is clearly more
than that since it is related to spiritual development, reinforces the sense
of identity, provides a frame of meaning for life’s facts, constitutes a
social support source, allows developing a sense of belonging and
encourages participation in collective social rituals.
In our country, it is particularly important maybe due to the pre-
eminence of Catholicism during centuries and the growing increase of
population following the evangelic religion, which creates strong
commitments in the community. Thus, studies show a strong relation
between religiosity and wellbeing in our country, which has been well
documented by Vargas et al., (2015). Its relation with PTG has been less
studied, but outcomes are also consistent, being religiosity one of the
most important predictors of PTG in this population.
In the case of potentially traumatic events, religiosity serves as a
mechanism to buffer and adapt to catastrophes when sense is given to
these unpredictable and uncontrollable facts (Páez, Basabe, Bosco,
Campos, & Ubillos, 2011). After the 2001 earthquake in El Salvador,
87% of the surveyed population expressed having used their religious
beliefs to face the situation (Vázquez Cervellón, Pérez-Sales, Vidales &

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Gaborit., 2005). After the 2010 earthquake in Chile, a survivor buried by

debris told that relying on God allowed her to keep going during the
hardest times of that experience, to face the uncertainty of what was
going to happen, to provide relief and to give a sense to what she was
living (García, 2013).
In regards of PTG, Helgeson et al., (2007) and, Prati and Pietrantoni
(2009)’s meta-analyses identify religiosity and spirituality as one of the
factors influencing their development. Campos et al., (2004) confirmed
that people praying the most one week after the terrorist attack in Madrid
(11-M), searched for more social support and re-assessed or rebuilt what
has happened more positively. A positive relation has also been found
between religious coping and PTG in patients with cancer (Urcuyo,
Boyers, Carver & Antoni, 2005) and in survivors of a natural disaster
(Bosson, Kelley, & Jones, 2011). In our studies, we have found a
significant association between religious coping and PTG in people
exposed to social violence (r = .24), being as well a significant predictor,
controlling support, participation and social sharing of the emotion (see
Table 1) (García, Capponi et al., 2016). We have also found that in
population exposed to earthquakes in Chile, participation in spiritual
rituals is an important predictor of PTG, although mediated by positive
re-evaluation as communal coping strategy (Wlodarczyk et al., 2015). In
the study carried out by Avilés et al. (2014) with Chilean university
students, religiosity was even a higher PTG predictor than social support.
However, Pargament, Feuille and Burdzy (2011) advise that religious
coping is multivalent since it can also result in detrimental outcomes.
Thus, they distinguish between positive and negative religious coping.
The first one is related to spiritual support and religious purification,
whereas the second refers to a punitive religious appraisal and spiritual
dissatisfaction.
In a study we carried out with people that lived in post-earthquake
camps (García, Páez et al., 2014), we found that positive religiosity is a
PTG predictor even controlling social support and it totally mediated the
relation between subjective severity of the event and PTG. However,
negative religiosity did not have any relation with PTG. In a second study

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performed with 210 people exposed to all kinds of stressful events, we

observed that positive religiosity showed a significant correlation with
PTG (r = 0.50), whereas negative religiosity did not show any relation
with PTG (García, Páez, Reyes & Álvarez, 2017). This longitudinal study
also showed that positive religiosity measured in the first time was a
significant predictor of the increase in PTG measured 6 months after,
controlling also the influence of the search for social support. For its part,
negative religiosity showed to be a negative influence in the increase of
PTG.

Problem-Focused Coping

By using the word coping we refer to the cognitive and behavioral

efforts to control, reduce or tolerate internal and external demands from a
stressful event (Lazarus & Folkman, 1986). Coping has two main
functions: deal with the problem causing distress (problem-focused
coping) and the regulation of the emotions (emotion-focused coping).
Recent researches have suggested that coping strategies are key
components of the path to get to PTG (Bussel & Naus, 2010).
Rajandram, Jenewein, McGrath and Zwahlen (2011) reviewed
studies that related coping strategies and PTG in patients with cancer.
They established that problem-focused coping was related to PTG. For
Stanton, Bower and Low (2006), when the person does not actively cope
with his/her situation in the future, PTSD and discomfort will be
maintained in time, since as a last resort is problem resolution-focused
coping the one that promotes positive results.
In researches carried out after the social conflict in Aysén (García et
al., 2016), we observed that active coping was one of the strategies that
had an important influence on PTG. In population affected by the
earthquake in Chile, we have found significant influence of problem-
focused coping on PTG (García, Cova et al., 2016). In the study made by
Avilés et al., (2014) with university studies, we observed that focusing in
the resolution of the problem constituted an important predictor of PTG.

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It seems that it is exactly the use of different coping strategies what

finally allows distinguishing the processes that lead to PTG and PTS
(Park, Aldwin, Fenster & Snyder, 2008). For example, in the study where
we assessed the different ways that lead to PTG and PTSD, through a
modeling with structural equations, we observed that active coping leads
to PTG, but not to PTS (García, Cova et al., 2016).
On the other hand, in the longitudinal study with persons that
suffered a work accident, our preliminary analyses show us that active
coping after the accident did not have any relation in PTG six months or
one year later, in spite of the prior evidence. Our explanation is that in
case the person actively copes with a highly stressful event from its
beginning, it means he/she already has resources available to deal with
this situation and therefore, that event would be far from being traumatic.
And, as we have mentioned before, it is necessary that the event is
perceive as severe so the mechanisms leading to the growth are activated.
Studies carried out to date generally assess active coping time after the
traumatic event has occurred.

Rumination

Rumination is a type of repetitive thought that can be constructive

and unconstructive (Watkins, 2008). In the depression-focused
rumination there is a distinction between one focused in negative
emotions and experiences, called “brooding” and another focused in the
resolution of problems and the analysis of the lived difficulties, called
“reflexive rumination” (Treynor, González & Nolen-Hoeksema, 2003).
The first one is more highly related to depression than the second one,
even when both have a strong correlation between them (Cova, Rincón &
Melipillán, 2009).
In regards of the relation between rumination and traumatic events,
Weiss and Berger (2010) confirm that this is triggered due to the need of
reviewing or reestablishing the beliefs that constitute individual
assumptions about the world and that have been broken or altered by

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20 Felipe E. García, Constanza Rivera and Sandra Garabito

these events, mainly to establish comprehensibility. For this reason,

Tedeschi (1999) has suggested that rumination over a trauma can
promote PTG.
Studies show that brooding has a positive association with PTS
(Michael, Halligan, Clark & Ehlers, 2007) and with anxious
symptomatology (Pimentel & Cova, 2011). On the other hand, studies
that assess the relation between brooding and PTG are scarce, observing
rather a lack of relation or a negative relation in persons that have
suffered the traumatic death of a loved one (Davis, Nolen-Hoeksema &
Larson, 1998).
In order to assess the relation between brooding, reflection and PTG,
Stockton, Hunt and Joseph (2011) carried out a study with persons that
had expressed that they have lived a traumatic experience. Results
showed a negative correlation between brooding and PTG, and positive
correlation between reflective rumination and PTG, but these relations
were weak. Likewise, in the study carried out by Avilés et al., (2014), we
observed a significant direct relation between reflection and PTG
(r = 0.14) and a non-significant one between brooding and PTG. In the
study performed by García, Vega et al., (2018), this time using structural
equations, we observed an indirect effect of reflection and brooding over
PTG, totally mediated by other ruminative processes to which we will
refer below: intrusive and deliberate rumination.
Calhoun, Cann, Tedeschi and McMillan (2000) developed a new way
to characterize ruminative processes, more related to the exposure to
potentially traumatic events and that is only partially overlapped with the
notion of brooding and reflection, distinguishing between intrusive and
deliberate rumination. Intrusive rumination is defined as the non-
requested invasion of thoughts about an experience, which are not chosen
to be called to mind (Cann et al., 2011). Whereas, deliberate rumination
entails a more premeditated effort focused on the control of the situation
(Taku, Cann, Tedeschi & Calhoun, 2009).
Until now, evidence about the relation between intrusive rumination
and PTG has been inconsistent, appearing in various studies with a direct
(García & Wlodarczyk, 2018) or indirect (García, Cova et al., 2016)

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influence in PTG, although a more clear relation has been observed with
psychological discomfort and PTSD (Kane, 2009; Alzugaray, García,
Reyes & Álvarez, 2015). Whereas deliberate rumination shows a strong
positive relation with PTG (Alzugaray et al., 2015; Morris &
Shakespeare-Finch, 2011). Stockton et al., (2011) designed a study to
assess what type of rumination has a higher relation with PTG,
concluding that the only significant PTG predictor was deliberate
rumination.
In our own studies, we have observed that intrusive rumination,
although it has a positive correlation with PTG, only leads to it if then it
is transformed into a more deliberate rumination. In case of persisting
with an intrusive rumination, this leads to PTS (García, Vega et al.,
2018). Furthermore, we have observed that deliberate rumination is a
total or partial mediator of other strategies such as subjective severity,
social sharing of the emotion, intrusive rumination and active coping,
with PTG (García et al., 2016). This reflects its relevance when the time
comes to transform a traumatic experience into learning. We have
observed these results not only in adults, but also in children affected by
the 2010 earthquake (Andrades et al., 2018).
One of the interesting perspectives in the study of PTG and its
relation with rumination is that we are currently developing it through
longitudinal studies. In the study with 750 adult persons exposed to
stressful events, we assessed the influence of the four types of rumination
(brooding, reflective, intrusive and deliberate) on the increase in PTG
measured 6 months after (García, Duque & Cova, 2017). The analysis of
the regression shows that the only significant predictor of the increase in
PTG is deliberate rumination, confirming what is stated in the already
mentioned prior cross-sectional studies.

IMPLICATIONS FOR CLINICAL PSYCHOLOGY

As stated before, knowing the variables that influence PTG could

help us promoting more appropriate responses in the face of highly

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22 Felipe E. García, Constanza Rivera and Sandra Garabito

stressful events, as well as preventing the discomfort generally related to

these experiences such as PTSD, depression, substance and alcohol
consumption, among others (García, 2011).
Based on the results obtained in Chile, I dare to make a series of
recommendations that can be included in the general education provided
to the population in areas more likely to experience disasters or included
in more specific psycho-therapeutic processes. These suggestions are:

1. Encourage optimism. This is not so easy in spite of the large

number of documents that refer to methods for instilling
optimism since childhood (Seligman, 1998a, 1998b). Its
difficulty lies in the fact that education of optimism begins at
home and then at school, and the cultural change of focusing
more on positive aspects rather than in negative ones seems to be
titanic. This is especially true in a society that emphasizes more
the difficulties of children rather than their skills. On the other
hand, studies about attentional bias (Duque, Sánchez & Vázquez,
2014) show that those who focus on more positive aspects of
their experience (happy faces) express less depression than those
who focus on more negative aspects (sad faces). This forces us to
include, within psycho-therapy processes, interventions to
modify the negative bias of patients directing them towards those
parts of their experience where the problem has not been present
(exceptions) or allowing them to discover the skills they have
used or developed to face difficult moments. These ways of
intervention has been strongly developed by the solution-focused
therapy or narrative therapy (García & Schaefer, 2015).
2. Connect to social support networks. When we provide support to
a person, family or community exposed to highly stressful
events, we should encourage the connection with their available
social networks, where family, friends, neighbors and peers
(persons who have lived the same) are probably the closest and
more important sources of support. Should the person be
disconnected, which is typical in more individual traumas such as

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abuse or rape, we have to promote his/her incorporation to other

groups such as religious communities or self-help groups, among
others.
3. Ease social sharing of the emotion. We have to create room
within the same psycho-therapy processes as well as within
his/her networks for the person to be able to tell what he/she
wants to tell about his/her experience and to freely express
his/her emotions in an environment of acceptance and support.
Providing spaces is not the same as encouraging the expression
“at all costs” as suggested by some procedures that have shown
iatrogenic effect like debriefing (Aulagnier, Verger & Rouillon,
2004) and other cathartic therapies.
4. Promote social participation in activities that empower the
person, his/her social group or community, although results from
studies that have been done in regards of it are still incipient.
What we know up to now is that if a person is going to be
directly affected by a governmental policy, an environmental
aggression or an institutional repressive action, sitting back and
do nothing does not seem to contribute to his/her growth. In
simple words, if it’s your turn, you better fight.
5. Encourage religious or spiritual coping. Help the person to
connect to his/her faith, search for explanations to what happened
within his/her beliefs, participate in activities or rituals in his/her
religious community, seek for support from significant figures
within his/her religion or perform usual religious practices like
praying seem to be appropriate ways to allow growth or learning
after an extreme experience.
6. Incite active or problem-focused coping. Just like emotional
expression must be allowed in case the person requires it, directly
coping with the causes or consequences of a stressful event (to
which the person was subject) must also be promoted. Persons,
when they face facts that constitute a threat, they do things to
survive. Recognizing these actions that allowed him/her coping
or getting over adversity, or keeping going in spite of them, from

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24 Felipe E. García, Constanza Rivera and Sandra Garabito

coping questions (Beyebach, 2006), as well as guiding the person

to perform concrete activities in order to achieve taking the
control of his/her situation seem to be useful to grow after a
trauma.
7. Promote deliberate rumination. Rumination or repetitive thoughts
about a stressful event seems to be a common response after
experiencing a trauma. The feeling that there is no control over
the negative thoughts reduces the person’s personal procurement
and can lead to despair. Although this type of thought is expected
due to the circumstances, the person must then focus on how to
explain and face the situation, which forces him/her to stop and
think. In brief systemic therapies (García & Schaefer, 2015) there
is a technique called symptom prescription that, in grosso modo,
consists of asking people to express symptoms over which they
do not recognize to have control, produced by them deliberately.
That is, should people have repetitive and uncontrolled thoughts,
they can be prescribed to have a time during the day where they
can voluntarily call these thoughts to “dialogue with them,”
“listen to what they want to say” or simply “let them be.” The
results of our studies provide a scientific foundation to explain
why these techniques work.

CONCLUSION

In this chapter, we have reviewed the concept of PTG as a possible

response to critical or threatening events, beyond mental disorders that
have been more frequently addressed in the researches about these
events. Although there are studies that show the positive effects of
growth in long-term, associated to an increased wellbeing and decreased
depression or PTSD, they are incipient. Therefore, creating designs for
experimental or longitudinal studies, which confirm these associations, is
a must.

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In our studies carried out in Chile, we have found that there is a

series of variables related to growth that must be emphasized and, to the
extent we know the psychological or societal mechanisms by which they
act, we will also be able to encourage them in the persons exposed to
stressful events. For example, although we detected that subjective
severity of the event predicts PTG, it does it mediated by variables such
as optimism, positive religiosity and deliberate rumination. Other
strategies contributing to it are social support, active coping, social
sharing of the emotion and participation in more secular collective
actions.
The challenge now is to continue delving into these studies, looking
for more complex designs that provide convincing responses to allow us
taking clear measures and effective actions to support people and
communities exposed to difficult situations.

REFERENCES

Acero, P. D. (2011). La otra cara de la tragedia. Resiliencia y crecimiento

postraumático [The other side of the tragedy. Resilience and
posttraumatic growth]. Bogotá: San Pablo.
Alzugaray, C., García, F., Reyes, A., & Álvarez, R. (2015). Propiedades
psicométricas de una versión breve de la Escala de Rumiación
Relacionada a un Evento en población chilena afectada por eventos
altamente estresantes [Psychometric properties of a short form of the
event related rumination inventory in Chilean population affected by
stressful events]. Ajayu, 13(2), 183-198.
Andrades, M., García, F., Calonge. I., & Martínez-Arias, R. (2018).
Posttraumatic growth in children and adolescents exposed to the
2010 earthquake in Chile and its relationship with rumination and
posttraumatic stress symptoms. Journal of Happiness Studies, 19(5),
1505-1517.
Andrades, M., García, F., Reyes, A., Martínez-Arias, R., & Calonge. I.
(2016). Psychometric properties of the Posttraumatic Growth

Complimentary Contributor Copy

26 Felipe E. García, Constanza Rivera and Sandra Garabito

Inventory for Children in Chilean population affected by the

earthquake of 2010. American Journal of Orthopsychiatry, 86(6),
686-692.
Arias, P. R., García, F. E., & Valdivieso, I. (2017). Propiedades
psicométricas del Inventario de Crecimiento Postraumático en
población ecuatoriana [Psychometric properties of the Posttraumatic
Growth Inventory in Ecuadorian population]. Revista Evaluar, 17(2),
67-80.
Aulagnier, M., Verger, P., & Rouillon, F. (2004). Efficiency of
psychological debriefing in preventing post-traumatic stress
disorders. Revue d'Epidemiologie et de Sante Publique, 52(1), 67-79.
[Journal of Epidemiology and Public Health]
Avilés, P., Cova, F., Bustos, C., & García, F. (2014). Afrontamiento y
rumiación frente a eventos adversos y crecimiento postraumático en
estudiantes universitarios [Coping and rumination against adverse
events and posttraumatic growth in university students]. Liberabit,
20(2), 281-292.
Beristain, C. (1999). Afirmación y resistencia. La comunidad como
apoyo [Affirmation and resistance. The community as support]. In P.
Pérez-Sales (Ed.), Actuaciones psicosociales en Guerra y violencia
política [Psychosocial actions in war and political violence] (pp. 55-
68). Madrid: Ex-libris.
Beyebach, M. (2006). 24 ideas para una psicoterapia breve [24 ideas for
brief psychotherapy]. Barcelona: Herder.
Boals, A., & Schuler, K. (2018). Shattered cell phones, but not shattered
lives: A comparison of reports of illusory posttraumatic growth on
the Posttraumatic Growth Inventory and the Stress-Related Growth
Scale-Revised. Psychological Trauma: Theory, Research, Practice
and Policy. doi: 10.1037/tra0000390.
Bonanno, G. A. (2004). Loss, trauma and human resilience: Have we
underestimated the human capacity to thrive after extremely aversive
events? American Psychologist, 59(1), 20-28. doi: 10.1037/0003-
066X.59.1.20.

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 27

Bosson, J., Kelley, M. L., & Jones, G. (2011). Deliberate cognitive

processing mediates the relation between positive religious coping
and posttraumatic growth. Journal of Loss and Trauma, 17, 439-451.
Bozo, O., Gundogdu, E., & Buyukasik-Colak, C. (2009). The moderating
role of different sources of perceived social support on the
dispositional optimism—posttraumatic growth relationship in
postoperative breast cancer patients. Journal of Health Psychology,
14, 1009–1020.
Bussell, V., & Naus, M. (2010). A longitudinal investigation of coping
and posttraumatic growth in breast cancer survivors. Journal of
Psychosocial Oncology, 28, 61-78.
Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic
growth. A clinician´s guide. London: Lawrence Erlbaum Associates.
Calhoun, L. G., Cann, A., Tedeschi, R. G., & McMillan, J. (2000) A
correlational test of the relationship between posttraumatic growth,
religion, and cognitive processing. Journal of Traumatic Stress, 13,
521-527.
Calhoun, L. G. & Tedeschi, R. G. (2006). The foundations of
posttraumatic growth: An expanded framework. In L. G. Calhoun &
R. G. Tedeschi (Eds.), Handbook of posttraumatic growth: Research
and practice (pp. 3-23). New Jersey: Lawrence Erlbaum.
Calhoun, L. G., Cann, A., & Tedeschi, R. G. (2011). The posttraumatic
growth model: Sociocultural considerations. In T. Weiss & R. Berger
(Eds.), Posttraumatic growth and culturally competent practice (pp.
1-14). New York: Wiley & Sons.
Campos, M., Páez, D., Fernández- Berrocal, P., Igartúa, J., Mendez, D.,
Moscoso, S., Palomero, C., Perez, J., Rodríguez, M., Salgado-Velo,
J., & Tasado, C. (2004). Las actividades religiosas como formas de
afrontamiento de hechos estresantes y traumáticos con referencia a
las manifestaciones del 11-M [Religion as a form of coping with
stressful and traumatic events: The case of March eleven bombing].
Ansiedad y Estrés, 10, 1-12.
Cann, A., Calhoun, L. G., Tedeschi, R. G., & Solomon, D. T. (2010).
Posttraumatic growth and depreciation as independent experiences

Complimentary Contributor Copy

28 Felipe E. García, Constanza Rivera and Sandra Garabito

and predictors of well-being. Journal of Loss and Trauma, 15(3),

151-166.
Cann, A., Calhoun, L., Tedeschi, R., Taku, K., Vishnevsky, T., Triplett,
K., & Danhauer, S. (2010). A short form of the Posttraumatic Growth
Inventory. Anxiety, Stress, & Coping, 23, 127-137.
Cann, A., Calhoun, L. G., Tedeschi, R. G., Triplett, K., Vishnevsky, T.,
& Lindstrom, C. (2011). Assessing posttraumatic cognitive
processes: the Event Related Rumination Inventory. Anxiety, Stress
& Coping, 24, 137-156.
Carver, C. S., Scheier, M. F., & Segerstrom, S. C. (2010). Optimism.
Clinical Psychology Review, 30, 879-889.
Cordova, M., Giese-Davis, J., Golant, M., Kronenwetter, C., Chang, V.,
& Spiegel, D. (2007). Breast cancer as trauma: posttraumatic stress
and posttraumatic growth. Journal of Clinical Psychology in Medical
Settings, 14, 308–319.
Cova, F., Rincón, P., & Melipillán, R. (2009). Reflexión, rumiación
negativa y desarrollo de sintomatología depresiva en adolescentes de
sexo femenino [Reflection, negative rumination and development of
depressive symptomatology in female adolescents]. Terapia
Psicológica, 27, 155-160.
Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of
loss and benefiting from the experience: Two construals of meaning.
Journal of Personality and Social Psychology, 75, 561-574.
Duque, A., Sánchez, A., & Vázquez, C. (2014). Gaze-fixation and pupil
dilation in the processing of emotional faces: The role of rumination.
Cognition and Emotion, 28(8), 1347-1366.
Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors
of chronic posttraumatic stress disorder after motor vehicle accidents.
Journal of Abnormal Psychology, 107, 508–519.
Ehlers, A., Mayou, R. A., & Bryant, B. (2003). Cognitive predictors of
posttraumatic stress disorder in children: Results of a prospective
longitudinal study. Behavior, Research, and Therapy, 41, 1–10.
Esparza, T., Martínez, T., Leibovich, N., Campos, R., & Lobo, A. (2015).
Estudio longitudinal del crecimiento postraumático y la calidad de

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 29

vida en mujeres supervivientes de cáncer de mama [Longitudinal

study of posttraumatic growth and quality of life in women’s breast
cancer survivors]. Psicooncología, 12(2/3), 303-314.
García, F. (2011). Prevention of psychopathological consequences in
survivors of tsunamis. In M. Mokhtari (Ed.), Tsunami: A growing
disaster (211-232). Rijeka: InTech.
García, F. (2013). Bajo los escombros: estrategias de sobrevivencia en
una mujer afectada por un terremoto [Under the rubble: survival
strategies in a woman affected by an earthquake]. Procesos
Psicológicos y Sociales, 9, 1-22.
García, F. (2017). Factores socio-demográficos, crecimiento y
sintomatología postraumática en sobrevivientes del terremoto de
Chile del 2010 [Socio-demographic factors, posttraumatic growth
and symptoms in survivors of Chile earthquake 2010]. Summa
Psicológica UST, 14(1), 33-42.
García, F., Capponi, C., Hinrichs, F., Lillo, F., Rodríguez, C., & Sánchez,
J. (2016). Violencia policial y afrontamiento: Crecimiento
postraumático en pobladores de una comunidad aislada del sur de
Chile [Police violence and coping: Posttraumatic growth in a
community isolated of southern Chile]. Universitas Psychologica,
15(4), 1-12. [Psychology University]
García, F., Cova, F., & Melipillán, R. (2013). Propiedades psicométricas
del Inventario de Crecimiento Postraumático en población chilena
afectada por un desastre natural [Psychometric properties of the
Posttraumatic Growth Inventory in Chilean population affected by a
natural disaster]. Revista Mexicana de Psicología, 30(2), 145-153.
[Mexican Journal of Psychology]
García, F., Cova, F., & Reyes, A. (2014). Severidad del trauma,
optimismo, crecimiento postraumático y bienestar en sobrevivientes
de un desastre natural [Severity of trauma, optimism, posttraumatic
growth and well-being in survivors of a natural disaster]. Universitas
Psychologica, 13(2), 15-24.

Complimentary Contributor Copy

30 Felipe E. García, Constanza Rivera and Sandra Garabito

García, F., Cova, F., Rincón, P., Vázquez, C., & Páez, D. (2016). Coping,
rumination and posttraumatic growth in people affected by an
earthquake. Psicothema, 28(1), 59-65.
García, F., Cova, F., Rincón, P., & Vázquez, C. (2015). Trauma or
growth after a natural disaster? The mediating role of rumination
processes. European Journal of Psychotraumathology, 6, 1-10.
García, F., Jaramillo, C., Martínez, A. M., Valenzuela, I., & Cova, F.
(2014). Respuestas psicológicas ante un desastre natural: Estrés y
crecimiento postraumático [Psychological responses to a natural
disaster: Stress and posttraumatic growth]. Liberabit, 20, 121-130.
García, F., Duque, A., & Cova, F. (2017). The four faces of rumination to
stressful events: A psychometric analysis. Psychological Trauma:
Theory, Research, Practice, and Police, 9(6), 758-765.
García, F., Páez, D., Cartes, G., Neira, H., & Reyes, A. (2014). Religious
coping, social support and subjective severity as predictors of
posttraumatic growth in people affected by the earthquake in Chile
on 27/F 2010. Religions, 5, 1132-1145.
García, F., Páez, D., Reyes, A., & Álvarez, R. (2017). Religious coping
as moderator of psychological responses to stressful events: A
longitudinal study. Religions, 8(62), 1-13.
García, F., & Schaefer, H. (2015). Manual de técnicas de psicoterapia
breve. Aportes desde la terapia sistémica. Santiago de Chile:
Mediterráneo. [Brief Psychotherapy Techniques Manual.
Contributions from systemic therapy.]
García, F., Vega, N., Briones, F., & Bulnes, Y. (2018). Rumiación,
crecimiento y sintomatología postraumática en personas que han
vivido experiencias altamente estresantes [Rumination, posttraumatic
growth and posttraumatic symptoms in people who have lived highly
stressful experiences]. Avances en Psicología Latinoamericana,
36(3), 443-457. [Advances in Latin American Psychology]
García, F., Villagrán, L., Wlodarczyk, A., & Cova, F. (2015).
Perspectivas acerca del crecimiento postraumático [Perspectives on
posttraumatic growth]. In J. C. Oyanedel, M. Bilbao, & D. Páez
(Eds.), La felicidad de los chilenos. Estudios sobre bienestar [The

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 31

happiness of the Chileans. Studies of well-being] (pp. 107-126).

Santiago de Chile: RIL.
García, F. & Wlodarczyk, A. (2016). Psychometric properties of the Post-
traumatic Growth Inventory - Short Form among Chilean adults.
Journal of Loss and Trauma, 21(4), 303-314.
García, F., & Wlodarczyk, A. (2018). Communal coping and rumination
in the aftermath of Chile earthquake: A multiple mediation analysis
of the relationship between subjective severity and posttraumatic
growth. Journal of Community & Applied Social Psychology, 28(4),
191-199.
Gasparre, A., Bosco, S., & Bellelli, G. (2010). Cognitive and social
consequences of participation in social rites: Collective coping, social
support, and post-traumatic growth in the victims of Guatemala
genocide. Revista de Psicología Social, 25, 35-46. [Journal of Social
Psychology]
Helgelson, V., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic
review of benefit finding and growth. Journal of Consulting and
Clinical Psychology, 74, 797-806.
Hobfoll, S. E., Hall, B., Canetti-Nisim, D., Galea, S., Johnson, R., &
Palmieri, P. (2007). Refining our understanding of traumatic growth
in the face of terrorism: Moving from meaning cognitions to doing
what is meaningful. Applied Psychology: An International Review,
56(3), 345–366.
Kane, J. (2009). An examination of a two-factor model of rumination and
its impact on the relationship between posttraumatic growth and
posttraumatic stress disorder (PTSD). (Doctoral thesis). Fairfax:
George Mason University.
Kilmer R. P., Gil-Rivas, V., Tedeschi, R. G., Cann, A., Calhoun, L. G.,
Buchanan, T., & Taku, K. (2009). Use of the Revised Posttraumatic
Growth Inventory for Children. Journal of Traumatic Stress, 22(3),
248-253.
Kilmer, R. P., Gil-Rivas, V., Griese, B., Hardy, S., Hafstad, G., & Alisic,
E. (2014). Posttraumatic growth in children and youth: Clinical

Complimentary Contributor Copy

32 Felipe E. García, Constanza Rivera and Sandra Garabito

implications of an emerging research literature. American Journal of

Orthopsychiatry, 84(5), 506-518.
Kunovich, R., & Hodson, R. (1999). Civil war, social integration and
mental health in Croatia. Journal of Health and Social Behavior, 40,
323-343.
Larizgoitia, I., Fernández, I., Markez, I., Izarzugaza, I., Larizgoitia, A.,
Moreno, F., Páez, D., & Beristain, C. M. (2011). Secuelas de la
violencia colectiva: hablan las víctimas del estudio ISAVIC
[Sequelae of collective violence: Victims’ voices in the ISAVIC
study]. Gaceta Sanitaria, 25(2), 115-121.
Lazarus, R., & Folkman, S. (1986). Estrés y procesos cognitivos [Stress
and cognitive processes]. Barcelona: Martínez Roca.
Levine, S., Laufer, A., Stein, E., Hamama-Raz, Y., & Solomon, Z.
(2009). Examinig the relationship between resilience and
posttraumatic growth. Journal of Traumatic Stress, 22, 282–286.
Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007).
Rumination in posttraumatic stress disorder. Depression and Anxiety,
24, 307-317.
Morris, B., & Shakespeare-Finch, J. (2011). Rumination, post-traumatic
growth, and distress: Structural equation modelling with cancer
survivors. Psycho-Oncology, 20, 1176-1183.
Ochoa, C., Castejón, V., Sumalla, E. C., & Blanco, I. (2013).
Crecimiento post-traumático en supervivientes de cáncer y sus otros
significativos: “Crecimiento vicario o secundario” [Posttraumatic
growth in cancer survivors and their significant others: Vicarious or
secondary growth?]. Terapia Psicológica, 31(1), 81-92.
[Psychological Therapy]
Páez, D, Vázquez, C., Bosco, S., Gasparre, A., Iraurgi, I., & Sezibera, V.
(2011). Crecimiento post estrés y post trauma: Posibles aspectos
positivos y beneficiosos de la respuesta a los hechos traumáticos
[Post-stress and post-trauma growth: Possible positive and beneficial
aspects of the response to traumatic events]. In D. Páez, C. Martín
Beristain, J. L. González, N. Basabe, & J. De Rivera (Eds.),
Superando la violencia colectiva y construyendo cultura de paz

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 33

[Overcoming collective violence and building a culture of peace] (pp.

311-339). Madrid: Fundamentos.
Páez, D., Basabe, N., Bosco, S., Campos, M., & Ubillos, S. (2011).
Afrontamiento y violencia colectiva [Coping and collective
violence]. In D. Páez, C. Martin Beristain, J. L. González, N. Basabe,
& J. Rivera (Eds.), Superando la violencia colectiva y construyendo
cultura de paz [Overcoming collective violence and building a
culture of peace] (pp. 279- 309). Madrid: Fundamentos.
Pargament, K., Feuille, M., & Burdzy, D. (2011). The Brief RCOPE:
Current psychometric status of a short measure of religious coping.
Religions, 2, 51-76.
Park, C. L., Aldwin, C., Fenster, J., & Snyder, L. (2008). Pathways to
posttraumatic growth versus posttraumatic stress: Coping and
emotional reactions following the September 11, 2001, terrorist
attacks. American Journal of Orthopsychiatry, 78, 300- 312.
Pavez, P., Mena, L., & Vera-Villarroel, P. (2012). El rol de la felicidad y
el optimismo como factor protector de la ansiedad [The role of
happiness and optimism as a protector factor of anxiety]. Universitas
Psychologica, 11, 369-380. [Psychology University]
Pérez-Sales, P. F. L. (2006). Trauma, culpa y duelo: Hacia una
psicoterapia integradora [Trauma, guilt and grief: Towards an
integrative psychotherapy]. Bilbao: Desclée de Brower.
Pimentel, M., & Cova, F. (2011). Efectos de la rumiación y la
preocupación en el desarrollo de sintomatología depresiva y ansiosa
en estudiantes universitarios de la ciudad de Concepción, Chile
[Depressive rumination and worry in the development of depressive
and anxious symptoms in university students]. Terapia Psicológica,
29, 43-52. [Psychological Therapy]
Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping
strategies as factors contributing to posttraumatic growth: A meta-
analysis. Journal of Loss and Trauma, 14, 364-388.
Quiceno, J. M., & Vinaccia, S. (2011). Resiliencia: una perspectiva desde
la enfermedad crónica en población adulta [Resilience: A perspective

Complimentary Contributor Copy

34 Felipe E. García, Constanza Rivera and Sandra Garabito

of chronic illness in adult population]. Pensamiento Psicológico,

9(17), 69-82. [Psychological thinking]
Rajandram, R. K., Jenewein, J., McGrath, C., & Kwahlen, A. (2011).
Coping processes relevant to posttraumatic growth: An evidence-
based review. Support Care Cancer, 19, 583-589.
Rimé, B., Finkenauer, C., Luminet, O., Zech, E., & Philippot, P. (1998).
Social sharing of emotion: New evidence and new questions.
European Review of Social Psychology, 9, 145-189.
Rimé, B., Páez, D., Basabe, N., & Martínez, F. (2010). Social sharing of
emotion, post-traumatic growth, and emotional climate: Follow-up of
Spanish citizen’s response to the collective trauma of March 11th
terrorist attacks in Madrid. European Journal of Social Psychology,
40, 1029–1045.
Schexnaildre, M. (2011). Predicting posttraumatic growth: Coping,
social support, and posttraumatic stress in children and adolescents
after Hurricane Katrina. (Master’s Thesis). Baton Rouge: Louisiana
State University.
Seligman, M. E. (1998a). Aprenda optimismo: Haga de la vida una
experiencia maravillosa [Learned optimism: How to change your
mind and your life]. Barcelona: Grijalbo.
Seligman, M. E. (1998b). Niños optimistas: Cómo prevenir la depresión
en la infancia [The optimistic child: A proven program to safeguard
children against depression and build lifelong resilience]. Barcelona:
Grijalbo.
Stanton A., Bower, J., & Low, C. (2006). Posttraumatic growth after
cancer. In L. Calhoun & R. Tedeschi (Eds), Handbook of
posttraumatic growth: Research and practice (pp. 138–175). New
York: Lawrence Erlbaum Associates.
Stockton, H., Hunt, N., & Joseph, S. (2011). Cognitive processing,
rumination, and posttraumatic growth. Journal of Traumatic Stress,
24, 85–92.
Sumalla, E., Ochoa, C., & Blanco, I. (2009). Posttraumatic growth in
cancer: Reality or illusion? Clinical Psychology Review, 29(1), 24-
33.

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 35

Sumer, N., Karanci, N., Berument, S., & Gunes, H. (2005). Personal
resources, coping self-efficacy, and quake exposure as predictors of
psychological distress following the 1999 earthquake in Turkey.
Journal of Traumatic Stress, 18, 331–342.
Taku, K., Cann, A., Tedeschi, R. G., & Calhoun, L. G. (2009). Intrusive
versus deliberate rumination in posttraumatic growth across U.S. and
Japanese samples. Anxiety, Stress & Coping, 22, 129-136.
Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth
Inventory: Measuring the positive legacy of trauma. Journal of
Traumatic Stress, 9, 455-471.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth:
Conceptual foundations and empirical evidence. Psychological
Inquiry, 15, 1-18.
Tedeschi, R. G. (1999). Violence transformed: Posttraumatic growth in
survivors and their societies. Aggression and Violent Behavior, 4,
319-341.
Tennen, H., & Affleck, G. (2005): Benefit-finding and benefit-reminding.
In C. R. Snyder & S. J. López (Eds.), Handbook of Positive
Psychology (pp. 584-597). Oxford: Oxford University Press.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination
reconsidered: A psychometric analysis. Cognitive Therapy &
Research, 27, 247–259.
Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005).
Finding benefit in breast cancer: Relations with personality, coping,
and concurrent well-being. Psychology and Health, 20, 175–192.
Vargas, S., Vargas, F., Torres, J., Bilbao, M. A., García, F., Oyanedel, J.
C., & Páez, D. (2015). Bienestar y religión en Chile [Well-being and
religion in Chile]. In J. C. Oyanedel, M. Bilbao, & D. Páez (Eds.), La
felicidad de los chilenos. Estudios sobre bienestar [The happiness of
the Chileans. Studies of well-being] (pp. 151-166). Santiago de Chile:
RIL.
Vázquez, C., Castilla, C., & Hervás, G. (2009). Reacciones ante el
trauma: Resistencia y crecimiento [Reactions to trauma: Resistance

Complimentary Contributor Copy

36 Felipe E. García, Constanza Rivera and Sandra Garabito

and growth]. In E. Fernández-Abascal (Ed.), Las emociones positivas

[The positive emotions] (pp. 375-392). Madrid: Pirámide.
Vázquez, C., Cervellón, P., Pérez-Sales, P., Vidales, D., & Gaborit, M.
(2005). Positive emotions in earthquake survivors in El Salvador
(2001). Journal of Anxiety Disorders, 19(3), 313-328.
Velásquez, F., & González, E. (2003). ¿Qué ha pasado con la
participación ciudadana en Colombia? [What has happened to
citizen participation in Colombia?]. Bogotá: Fundación Corona.
Vera-Villarroel, P., Pávez, P., & Silva, J. (2012). El rol predisponente del
optimismo: hacia un modelo etiológico del bienestar [The causal role
of the optimism; Towards an etiological model of well-being].
Terapia Psicológica, 30, 77-84. [Psychological Therapy]
Vernberg, E. M., Steinberg, A. M., Jacobs, A. K., Brymer, M. J., Watson,
P. J., Osofsky, J. D., Layne, C., Pynoos, R., & Ruzek, J. (2008).
Innovations in disaster mental health: Psychological first aid.
Professional Psychology: Research and Practice, 39, 381-388.
Vishnevsky, T., Cann, A., Calhoun, L. G., Tedeschi, R. G., & Demakis,
G. (2010). Gender differences in self-reported posttraumatic growth:
A meta-analysis. Psychology of Women Quarterly, 34, 110-120.
Watkins, E. (2008). Constructive and unconstructive repetitive thought.
Psychological Bulletin, 134, 163-206.
Weiss, T., & Berger, R. (2010). Posttraumatic growth and culturally
competent practice: Lessons learned from around the globe. New
York: Wiley & Sons.
Wlodarczyk, A., Basabe, N., Páez, D., Amutio, A., García, F., Villagrán,
L., & Reyes, C. (2015). Communal coping, participation in collective
gatherings and rituals, posttraumatic growth and social well-being in
the aftermath of a collective trauma: The case of 2010 Chilean
earthquake. European Journal of Education and Psychology, 9(1),
9-19.

Complimentary Contributor Copy

 Posttraumatic Growth in Latin America 37

Zimet, G. D., Dahlem, N. W., Zimet, S. G., &. Farley, G. K. (1988). The
Multidimensional Scale of Perceived Social Support. Journal of
Personality Assessment, 52, 30-41.
Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical
psychology: A critical review and introduction of a two-component
model. Clinical Psychology Review, 26(5), 626-653.

Complimentary Contributor Copy