The role of leisure in the experience of posttraumatic growth for people with spinal cord injury.

Ads by GoogleFull-Text Online Library Online library of books, journals, articles. Research online. www.Questia.com/Online_Library Darwin Reader for Android Read DAISY text and audio books on your Android phone or tablet! www.darwinreader.com 2012 Economic forecast Here's how to position yourself for next years bull market. New Rpt WealthDaily.com/Economic_Forecast Cognitive Training Improve Your Cognitive Skills with Scientific Brain Training Games www.lumosity.com Ask a Lawyer Online Now A Lawyer Will Answer You Now! A Question is Answered Every 9 Sec. Law.JustAnswer.com Access China Research Find Access China Market Reports & Industry Analysis www.marketresearch.com Link to this page Considerable evidence has suggested that traumatic spinal cord injury (SCI) can lead to disrupted social relationships (Kleiber, Brock, Lee, Dattilo, & Caldwell, 1995) as well as negative psychological consequences such as depression (e.g., Elliot & Frank, 1996), anxiety (e.g., Kennedy & Rogers, 2000), distress (e.g., Kennedy & Evans, 2001), and disruption of one's sense of well-being (McCann & Pearlman, 1990). However, an emerging body of literature indicates that people who experience trauma can experience personal growth in the midst of such trauma (e.g., O'Leary & Ickovics, 1995; Park, Cohen, & Murch, 1996). For example, the experience of personal growth following traumatic events has been reported in various types of chronic and life-threatening illness, such as cancer (Bellizzi & Blank, 2006), HIV/AIDS (Cadell, Regehr, & Hemsworth, 2003), heart disease (Sheikh, 2004), and pediatric leukemia (Best, Streisand, Catania, & Kazak, 2001). In terms of negative life events, leisure researchers have paid great attention to leisure coping and have provided important insights into the role of leisure in coping with stressful life events and chronic illnesses (e.g., Hutchinson, Loy, Kleiber, & Dattilo, 2003; Iwasaki & Mannell, 2000; Kleiber, Hutchinson, & Williams, 2002). Kleiber, Hutchinson, and Williams introduced a concept of "positive transformation" following negative life events. They conceptualized the potential functions of leisure in transcending negative life events and challenged leisure researchers to explore positive outcomes following traumatic events, which can be conceptualized as posttraumatic growth (PTG). PTG refers to "positive change that the individual experiences as a result of the struggle with a trauma" (Calhoun & Tedeschi, 1999, p. 11). However, few empirical studies have examined the role of leisure in the experience of PTG. Moreover, no empirical study has intentionally selected people experiencing personal growth to explore the characteristics of growth. The purpose of this study was to explore the role of leisure in the

experience of PTG for people with SCI. To capture the characteristics of PTG, this study deliberately selected individuals exhibiting evidence of PTG. Ads by GoogleHyperflation is coming... the Dollar's "Reckoning" is coming. You need this free report. MoneyMorning.com/dollar_inflation Asperger's & ADHD School Residential, affordable, holistic, boys & girls 5-15, year-round www.HunterSchool.org Review Posttraumatic of Relevant Growth Literature

Despite the considerable evidence that traumatic events can lead to negative psychological, physical, and social consequences, there is increasing evidence that personal distress and growth frequently coexist in the midst of trauma. People who experience PTG demonstrate "a significant beneficial change in their cognitive and emotional lives that may have behavioral implications" (Tedeschi, Park, & Calhoun 1998, p. 3). This change facilitates a constructive cognitive processing of trauma that can change perspectives on self, others, and one's way of living (Tedeschi & Calhoun, 1995). PTG has been variously referred to as "benefit finding" (Affleck & Tennen, 1996), "flourishing" (Ryff & Singer, 2000), "perceived benefits" (Calhoun & Tedeschi, 1991), "positive by products" (McMillen, Howard, Nower, & Chung, 2001), "stress-related growth" (Park, Cohen, & Murch, 1996), and "thriving" (O'Leary & Ickovics, 1995). However, Tedeschi and Calhoun (2004) argued that the term, posttraumatic growth, is the most appropriate expression to describe the phenomenon because this term captures transformative positive life changes beyond individuals' previous level of adaptation, psychological functioning, or life awareness following major life crises. PTG tends to "have more impact on people's lives, and involves such fundamental changes or insights about living that it does not appear to be merely another coping mechanism" (Tedeschi, Park, & Calhoun, 1998, p. 3). Previous literature has documented various personal and social factors (e.g., social support, coping, personality characteristics, and positive emotions) contributing to PTG. Social support from significant others not only helps people restore cherished beliefs threatened by victimization (Janoff-Bulman, 1989), but also has a significant influence on the likelihood of PTG (Calhoun & Tedeschi, 1999). Social interaction with supportive others provides the opportunity to express self, improve selfesteem, and experience the sense of acceptance within a social network (Affleck, Tennen, Higgins, & Urrows, 1994; Calhoun & Tedeschi). Calhoun and Tedeschi stated that people tend to find new value and experience greater closeness in their relationships with significant others who have provided great support during the recovery or adaptation process. Social support also aids in PTG by facilitating the rebuilding of personal narratives and finding value in life (Tedeschi & Calhoun, 2004). In addition, an individual's coping responses with stress are an important factor influencing PTG outcomes (Schaefer & Moos, 1998) because through the coping process individuals tend to make sense of their experiences and rebuild personal narratives that were disrupted by the traumatic experience (Janoff-Bulman, 1989). Coping is defined as "the thoughts and behaviors used to manage the internal and

external demands of situations that are appraised as stressful" (Folkman & Moskowitz, 2004, p. 745). Previous studies have suggested that the likelihood of PTG occurring may be influenced by the ways in which an individual responds to stress (e.g., Park, 1998; Schaefer & Moos, 1998). Tedeschi, Park, and Calhoun (1998) stated that "individuals who appraise a life crisis as a challenge that they can master may cope more actively with the problem and thus be more apt to grow from the experience" (p. 115). Furthermore, the employment of effortful coping was identified as an essential coping strategy for personal growth following a traumatic event (Schaefer & Moos, 1992; Tedeschi & Calhoun, 1995). Calhoun and Tedeschi (1999) argued that positive rumination and thinking about the traumatic event were significantly related to the amount of psychological growth reported. Typically, when individuals experienced a traumatic event, they were likely to make an effort to make sense of what happened (Grubaugh, 2003). Calhoun and Tedeschi reported that participants, who engaged in effortful cognitive processing such as intentionally trying to make sense of the event by thinking about it, demonstrated a greater degree of PTG. However, ruminating about the event in a self-punitive or circular manner was not likely to promote PTG, but rather would increase adverse psychological symptoms. In addition, Park, Cohen, and Murch (1996) reported that positive reinterpretation and acceptance coping were the most significant predictors of stress related growth. Similarly, Collins, Taylor, and Skokan (1990) found that coping efforts involving cognitive reinterpretation of the event and personal growth were related to a greater positive change in beliefs. These findings explained that people experienced PTG in the process of actively integrating a traumatic event into one's cognitive framework. As the previous studies implied, coping research warrants increased attention because it may provide a better understanding of growth outcomes. Lastly, recent literature has also reported that positive emotions not only play an essential role in coping with stressful life events (Stanton & Low, 2004), but also may facilitate experiencing PTG (Calhoun & Tedeschi, 2006). Salovey, Rothman, Detweiler, and Steward (2000) explained that positive emotions, such as joy, interest, curiosity, and love protect individuals from illness and in fact promote health. Moreover, if individuals experience positive feelings, they can expand their momentary thought-action repertoires, push the limits, and be more creative and hopeful (Fredrickson, 2003; Gillham, Shatte, Reivich, & Seligman, 2001). Leisure and Coping

Leisure has been conceptualized in various ways. Among the definitions, this study adopted a free-time perspective, referencing any activities that occur during freetime (Kleiber, 2004). If leisure is used to refer to purely enjoyable and intrinsically motivated activity, it may limit the value of leisure as a component of PTG. Kleiber suggested that it is relevant to define leisure more broadly from a free-time perspective to generate true growth option; therefore, good acts (e.g., volunteering) or good habits (e.g., regular exercise) can be considered leisure activities regardless of enjoyment status and levels of intrinsic motivation. Kleiber further noted that "the higher purposes emerging with PTG are more readily addressed within leisure and the freedom of leisure may offer the most fertile conditions for such" (p. 21).

Traditionally, leisure studies had emphasized buffering and moderating effects of leisure in coping with stressors (e.g., Coleman & Iso-Ahola, 1993; Iso-Ahola & Park, 1996). Another trend of early coping research was that it identified specific leisure activities that contributed to coping with various stressors (e.g., Calbabiano, 1994; Coleman & Patterson, 1994; Patterson & Coleman, 1996). Through analyzing 83 leisure activities using discriminant analysis, Caltabiano provided lists of leisure activities that helped to cope with stress. Among the activities listed, cultural hobbies were more likely to reduce stresses for females while outdoor active sports contributed reduced stress for males. More recently, leisure coping research has focused on the various types of leisure coping strategies with daily challenges and normative life stressors coping (e.g., Iwasaki, Bartlett, & O'Neil, 2005; Trenberth & Dewe, 2005). One of the most recognized studies is Iwasaki and Mannell's hierarchical dimensions of leisure coping (2000). Iwasaki and Mannell conceptualized the dimensions of leisure stress coping based on a comprehensive review of interdisciplinary research on stress and coping. The model is divided into two primary levels: leisure coping beliefs and strategies. Leisure coping beliefs are considered dispositional leisure coping styles, which is based on individuals' internal factors such as personality and personal belief in coping. On the other hand, leisure coping strategies are situation specific and intentional coping strategies. This model emphasizes that both personal beliefs in leisure and engaging in an actual leisure plays a significant role on coping with everyday stress. Focusing on people with chronic illness or disabilities, a number of recent studies have provided empirical support for the hierarchical dimensions of leisure coping and provided an approach to the role of leisure in PTG via stress-coping (e.g., Iwasaki, 2003; Iwasaki, Mactavish, & Mackay, 200S). Mactavish and Iwasaki (2005) conducted stress-coping research using a sample of people with physical disabilities to explore the strategies in coping with various life stresses. Adapting empowerment as a conceptual framework, Mactavish and Iwasaki identified five key themes of the coping strategy: (a) socializing/social support, (b) cultivating and using positive affirmations, (c) reconnecting spiritually, (d) diverting one's focus, and (e) rejuvenating through leisure/exercise. Mactavish and Iwasaki urged needs for leisure coping studies focusing on individuals with various backgrounds, especially people with disabilities. In the context of leisure coping and positive psychology, Iwasaki, Mactavish, and Mackay explored a leisure coping strategy on individual strengths and resilience among five target groups including professional managers, aboriginal people with diabetes, individuals with disabilities, lesbians, and gays. The study found that a palliative coping strategy through leisure was essential in coping with stress, and that leisure was "a survival strategy with the use of human strengths and resilience" (p. 98). In addition to leisure coping for people with disability, Kleiber, Hutchinson, and Williams (2002) attempted to understand leisure from the context of the "positive transformation" perspective following negative life events. Based on literature analysis of leisure coping, general coping, and stress, Kleiber et al. proposed four important functions of leisure that relate to self protection, self-restoration, and personal transformation. The self-protection and self-restoration perspectives emphasized buffering functions of leisure related to coping with negative life events. These two key functions explain that involvement in leisure activity, as one of the coping mechanisms or coping resources, help people to deal with immediate

life stress and generate optimism and hope for the future. Moreover, it facilitates the reconstruction of one's life story through providing a context of experiencing a sense of continuity following negative life events. In the context of PTG, Kleiber et al explained that leisure has potential to be a vehicle for personal transformation through helping people experience strengthened relationships and discover new options for leisure. Kleiber et al. stated that leisure coping studies were limited to examining the role of leisure in the context of the coping process, and urged researchers to explore various mechanisms in the coping and adjustment process and transformative experience. As a follow-up empirical study using the interview data from two different studies, Hutchinson, Loy, Kleiber, and Dattilo (2003) examined how individuals use leisure in coping with a traumatic injury or the onset of a chronic illness. They reported that engaging in personally meaningful and enjoyable leisure activities can be a significant coping source, both right after the onset of a traumatic injury and over time. Hutchinson et al.'s findings tend to emphasize the importance of emotionfocused leisure coping, which attempts to regulate one's feelings or emotions through avoidance or distancing from stressors and involves "cognitive efforts that change the meanings of a situation, without changing the environment" (Lazarus, 1999, p. 114). In the later conceptual work, Kleiber (2004) challenged researchers to broaden viewpoints through exploring the relationships between leisure and PTG rather than examining the traditional conceptual context of coping, adaptations, and recovery. Kleiber argued that strengthening positive aspects of life can facilitate PTG, and especially experience of "touching moments" through leisure can facilitate to experience personal growth. Hutchinson and Kleiber (2005) also suggested that casual leisure contributes to experiencing growth-oriented changes following a negative life event through providing a context to discover new potentials and interests (e.g., expanded sense of self and strengthened relationships). Hutchison and Kleiber argued that both causal and serious leisure have a potential to contribute to growth-oriented change and that future research is needed to expanding understanding of both casual and serious leisure in terms of health, welling outcomes as well as PTG. Method In order to explore the role of leisure in the experience of PTG for people with SCI, this study employed a grounded theory methodology, which "offers insight, enhance understanding, and provide a meaningful guide to action" (Strauss & Corbin, 1998, p. 5). Although a great number of studies using the PTG inventory have contributed to the body of knowledge related to PTG, several recent studies have criticized the inventory. For example, Smith and Cook (2004) stated that "current methods of measurement may actually underestimate PTG to a small but significant degree" (p. 356) and the overlapping types of PTG may cause difficulty in defining and measuring people's actual PTG experience. Moreover, Pals and McAdams (2004) argued that the PTG inventory explains culturally acceptable outsiders' views rather than effectively describing the insider voice of the people who are experiencing the phenomena. Pals and McAdams also suggested that the employment of qualitative methods is needed for better understanding of PTG. Therefore, it is appropriate to employ a qualitative methodology to better understand the insiders' voices on the role of leisure in the experience of growth.

Participants In this study, participants were recruited among former and current clients of two rehabilitation centers in a Midwestern city. After the interviewer explained the purpose of study and the criteria for selecting participants, two recreation therapists working at the rehabilitation centers released contact information of 64 potential participants who met the study inclusion criteria. In addition, the therapists identified 7 potential participants who did not demonstrate evidence of PTG. A letter describing the purpose of the study and data collection procedures was mailed to potential participants requesting their participation in the research. A total of 20 potential participants voluntarily called to the researcher or returned study invitation cards indicating their interest in the study. This study used purposeful and criterion-based sampling strategies (Strauss & Corbin, 1998) to identify individuals with SCI experiencing PTG. The criteria for selecting participants demonstrating PTG was that people (a) had SCI, (b) possessed clear external evidence of various achievements (e.g., holding a full-time job, demonstrating athletic achievement, providing consistent voluntary public service), (c) reported satisfaction in their lives, (d) had a cognitive ability to recall and chronologically explain their life stories, and (e) were at least 18 years of age. The researchers considered behaviors such as holding a full-time job, demonstrating athletic achievement, or providing consistent voluntary public services to be positive external evidence of PTG. The negative cases who did not meet the study's criteria were intentionally selected, and their life stories were compared to others' stories in an attempt to identify why they did not fit into the emerging framework (Lincoln & Guba, 1985). Upon the completion of each interview, participants were thanked for their time and contribution, and given a coupon incentive valued at $20. A total of 15 participants, including two negative cases, were selected. Table 1 describes some demographic characteristics of participants (pseudonyms were used). Ten participants (67%) were male and five (33%) were female, all between the ages of 27 and 58 (M = 39, SD = 10.96). The average onset of injury was 30 years old (range = 14 to 57 years, SD = 13.4), and the average length of time since injury was 10.7 years (range = 1 to 34 years, SD = 9.12). The participants, including the negative cases, completed an average of 15.53 years of education (SD = 2.47), indicating some college education as an average academic background. Interview Procedures

The interview protocol consisted of several broad, open-ended questions and follow-up prompts, allowing the interviewers to probe within the subject area, while also wording some questions spontaneously to facilitate conversation (Crabtree & Miller, 1991). The interviews, ranging from one to four hours, were conducted at participants' homes. With permission, each interview was audio-taped and transcribed by professional transcribers. Using the descriptive interview techniques, each interview began with "grand-tour questions", which encouraged interviewees to verbally describe significant features of their everyday life experiences related to space, time, events, people, activities, or objects (Spradley, 1979). For example, the interviewer asked: "Could you describe a typical day before experiencing your injury?" and "Could you tell me your experience after the injury?" After collecting a lengthy description of participants' everyday life stories followed by the "grand-tour questions," the interviewer asked "mini-tour experience

questions" to explain a small unite of personal experiences related to significant and positive life changes (Spradley). Each participant explained what his/her personal experiences had been like and provided examples of specific moments and/or events related to the process and outcomes of their recovery from the traumatic injuries. The participants were asked to complete a demographic information questionnaire (e.g., age, education, gender, etc) at the end of the interview. The final question asked the participants to identify others with experience relevant to the study. After each interview, the interviewer immediately recorded field notes (Strauss & Corbin, 1998), describing both impressions and the conditions of the interview. Additionally, memos were written describing observations, progress, experiences, thoughts, and feelings. After reviewing the summary and emerged patterns of each interview, the interviewer used follow-up phone calls or e-mails to five participants, who agreed to participate in member checking process, to clarify interviewees' comments, to correct errors in summaries and emerged patterns. Data Analysis

Based on the grounded theory methodology, which is a general framework that guides the research process, this study employed a thematic analysis. The thematic analysis emphasizes the participants' own views of the phenomena under investigation. It allows researchers to "use a wide variety of types of information in a systematic manner that increases their accuracy or sensitivity in understanding and interpreting observations and interviews about people, events, and situations" (Boyatzis, 1998, p. 5). The data analysis of interviews was based on and followed the guidelines suggested by Boyatzis and Strauss and Corbin (1998). The six steps of data analysis were as follows: Step 1: Creating the interview transcription. As soon as feasible after completing each interview, taped interviews were transcribed by a professional transcriber who followed systematic editing. Atkinson (1998) explains that several editing tasks are necessary, including (a) using standard spelling, (b) creating sentence and paragraph structure, (c) adding missing elements, and (d) possibly reorganizing certain sections to keep related subject matter together. After completing the first draft of the transcript, the researcher (the first author) read the transcript while listening to each tape in order to verify accuracy. Step 2: Creating individual open coding schemes. In order to reduce the quantity of data for effective comparison of each transcription, open coding schemes within each participant were developed inductively through analyzing each interview transcription. The open coding schemes illustrated broad emerging themes and patterns of each participant's life and leisure experiences before and after experiencing a traumatic accident. For example, most open coding schemes included the broad themes of life experiences such as the experiences of traumatic events, life issues, relationships with others, leisure experiences, and the experience of positive life changes. Step 3: Comparing patterns across participants. The individual open coding schemes were compared with other coding schemes constantly for identifying similar themes and patterns on leisure-related experiences and positive life changes following traumatic accidents (Glaser & Strauss, 1999). This stage focused on

categorizing any broad patterns and developing preliminary themes across participants, rather than analyzing the precise description of the pattern (Boyatzis, 1998). Step 4: Creating an axial coding scheme. While constantly comparing preliminary themes and patterns across participants, the similar themes on leisure experiences related to positive life changes were clustered into new themes and grouped together in an axial coding scheme. The axial coding scheme included revised broad themes such as leisure-based social support, the recognition of personal strengths and abilities, the experience of sense of normality, and the experience of positive emotions. During this step, the researcher returned to the original transcriptions and read each carefully to determine similar themes and their subthemes including rich quotes from raw data (Boyatzis, 1998). In addition, the axial coding scheme was shared with the second author to ensure its appropriateness. Step 5: Creating a selective coding scheme. The researcher revised emerging themes and created a systematic selective coding scheme after analyzing the axial coding schemes including broad themes and subthemes including quotes from raw data. The final step of the data analysis was integrating and refining themes to a larger theoretical scheme (Strauss & Corbin, 1998). During the analysis, the main research themes on the role of leisure in the experience of PTG emerged as follows: (a) providing opportunities to experience success and achievement, (b) building companionship and meaningful relationships, (c) making sense of traumatic experience and finding meaning in everyday life, and (d) generating positive emotions. Step 6: Determining the degree of agreement. To ensure that codes were applied consistently and to check for coding drift over time, the researcher coded five randomly selected pages from a randomly selected transcript (using between 20% and 25% of each transcript) at three different points of the project. The percentage agreement at these three points in time (at the beginning, halfway through, and at the end of coding) showed above the levels of 80% agreement, which indicates that the emerging themes were consistent over these three periods of time. Boyatzis (1998) stated that agreement scores of 70% or better are considered consistent and reliable in qualitative studies. Trustworthiness Qualitative research designs can demonstrate validity and reliability using a different approach and methodological terms (Creswell, 1998; Mertens, 1998). The researchers used (a) expert review, (b) member checking, and (c) negative case analysis to assess the trustworthiness of the data and findings. In order to enhance the credibility of the study's findings, expert debriefing (Lincoln & Guba, 1985) took place. During each coding process, coding data were reviewed by the second author. In addition, member checking was used to confirm interpretations. Through phone or email contacts, five participants were invited for member checking. All agreed with the research findings, and shared additional thoughts and stories related to each theme. Lastly, negative case analysis was conducted to establish the credibility of the study. The two negative cases, who did not fit into the criteria of study, were intentionally selected, and their life stories were compared to others' stories to search for alternative explanations of traumatic experiences (Kuzel, 1999).

The negative cases provided rich and complex examples associated with their disrupted life stories (Kleiber et al., 1995). The results revealed that the negative cases had suffered from various life issues, while the participants experiencing PTG had found positive life changes in their lives. This result suggested that the negative cases represented the experience of trauma rather than PTG. Results The findings in this study demonstrated that leisure contributed to PTG in the following ways: (a) providing opportunities to discover unique abilities and hidden potential, (b) building companionship and meaningful relationships, (c) making sense of traumatic experience and finding meaning in everyday life, and (d) generating positive emotions. Providing Opportunities to Discover Unique Abilities and Hidden Potential A main theme emerging from the data was that participants were able to find unique abilities and hidden potentials through involvement in leisure activities. Specific sub-themes on the discovery of unique abilities and hidden potentials were (a) finding personal strengths and hidden potential, (b) experiencing a feeling of success and achievement, and (c) gaining reputation/recognition. Finding personal strengths and hidden potential. Most participants emphasized the important role of leisure in finding their strengths and hidden potential. While the negative cases in this study were suffering from dealing with activities of daily living, most participants tended to "take the good out of the bad" and view their struggles as opportunities to explore unique abilities and find hidden potential through engagement in leisure activities in the midst of overwhelming traumatic experiences. For example, Jane, one of the negative cases, complained that she lost her ability to engage in her leisure activities and had not found other enjoyable activities in her life. Jane said: There are times where l think things really stink so I wish I didn't have to, going to the beach for example. I used to spend so much time in the water at the lake and even just walk through the sand and feel that on your feet and all that stuff. I haven't had that for almost four years and that's hard still sometimes. It's easier for me if I don't go to the beach. I still like to go, go watch the sunset or something but every time I leave there's a part of me that's like damn, you know, I want to go jump in the water too. You know, so that's kind of hard.

However, through approaching leisure activities more seriously, some participants demonstrated unique musical, artistic, and athletic abilities, and contributed to helping other people in their communities. Tom, a member of a gang in his teenage years, rejected an invitation from his gang friends to rejoin their group and decided to spend his free time improving his musical and dancing abilities. Tom committed himself to the activities and became an amateur drummer, playing his own music everywhere in his town as a leader of his own band: I love soul music and dancing. I would just dance and l would dance

until I got tired ... I didn't realize that I had that ability. I used to do it just for play ... If I would have been practicing and dancing before I got shot, just like I always tell people, if I had been introduced to drums before I got shot, may be I would have changed my direction.

Similarly to Tom, Jenny described how she found her unique abilities in art. Jenny had enjoyed coloring and drawing since she was a child. After acquiring a SCI, Jenny "really started getting into art more seriously" and demonstrated an exceptional artistic ability at school, winning a number of prizes. The pursuit of athletics was also used as a tool to demonstrate unique abilities and hidden potential. Mary mentioned that she got involved in "so many diverse sports clinics" and found that she excelled in sport after her injury. Mary said: I really never was much of an athlete back in those days, long time ago. I walked everyday, but I never was okay going to do the marathon or anything. I hated running ... [After my injury] I've been doing the swimming, going to these sailing clinics, attending tennis clinics, anything that gets me out ... I was just on Channel 8 TV a couple of weeks ago. I went down there to a tennis clinic during the RCA championships, and they interviewed me. So there a picture of me hitting tennis balls and talking a little bit about my life.

Furthermore, some participants talked about their exceptional athletic abilities as amateur athletes. Boyd regularly participated in national wheelchair basketball tournaments. Boyd reported that playing basketball became a central part of his life after the injury. He said: I love playing basketball more than my work as a teacher. It's important going to battle with your team mates and obviously it's a lot more fun to win ... I got second place for this tournament, but almost every three tournament that we go to we win. So that was a little bit of a disappointment.

These narratives indicate engaging in leisure activities assisted people in finding their strengths and hidden potential. Furthermore, people experienced growth through strengthening their unique abilities, which they never experienced prior to the injuries. Experiencing a feeling of success and achievement. Engaging in leisure activities assisted the participants in experiencing a sense of success and achievement, as several participants experienced a feeling of success through successfully learning new leisure activities. In describing her experience associated with rock climbing, Mary said: "I was up there, no weight and I lifted myself with just my fingertips ... So I felt good about myself because I was out of my chair and you're doing something different." Mary put priority on involvement in activities in her life, and frequently

experienced a feeling of success through participation in new leisure activities. In contrast, Jason, a negative case in this study, put his priority on dealing with activities for daily living and spent most of his free-time watching television or movies, therefore he had no chance to experience a feeling of success or achievement. Jason said: The things that are the most difficult are the little things; being able to cut my own finger nails, being able to cut my own toe nails. I chew my finger nails off now. Christy has to cut my toe nails. She gets me undressed and dressed, and helps me in and out of bed but the little things. Once I'm in my chair I'm pretty much independent. But it's the little things that people take for granted and don't think about ... It is just everything. It is so different, it is everything. Every single thing is difficult and on top of that I'm out of breath and I'm tired.

Moreover, Jane experienced a feeling of failure and frustration because she lost the guardianship of her children and had to fight for her kids in court against her mother. I used to do everything for myself, but I cannot do anything. It [the injury] affected my life even when it came to my kids because my morn went and got guardianship of them because at that time I couldn't do things for myself. That's been really hard and I'm still in court fighting for my kids. That's very frustrating ...

Other participants talked about their experiences of engagement in various leisure activities such as sailing, water skiing, traveling, and wheelchair tennis, and expressed that they "had done something cool," "successfully learned something different," and "did not need other people" to enjoy activities. Dan described his achievements in a mini-marathon: I looked up and see myself in the mirror and I looked at myself and started smiling and thought 'Dude, you just won the mini-marathon'. And that was pretty huge; it was about 30,000 people. Granted, I'm in the hand cycle, but it was a littler faster but my whole goal was to be in the top five and beat the able-bodied runners and I ended up being the first one and it was like that's very cool.

Involvement in activities, especially those using individual unique abilities, provided opportunities to experience a feeling of success and achievement for several participants. Gaining recognition and a reputation. While the two negative cases extensively spent their interview time to talk about their reputation before experiencing SCI and reported that they "couldn't do anything for themselves" following the accident, a number of the participants shared their own stories about how they gained recognition from friends. Boyd and Dan reported that they could easily impress

their friends when the friends viewed their athletic performances. Boyd noted that everyone he took to the [basketball] game said "Oh, my gosh, I had no idea that it was like that." Similarly, Dan described his friends' reactions to his water skiing skills. After Dan did the slalom at 22 feet off the 75 foot rope and jumped up to 26 miles an hour, his friend kept saying "Oh, my God," and told him that she "totally understood what Dan was doing." In addition, several participants reported that they gained a reputation with the public through receiving awards for social services and/or excellent athletic performances. As a result of his services to people with disabilities, youth at risk, and individuals incarcerated for more than 20 years, Tom received numerous community service awards. Dan also received a number of awards for excellent athletic performance. Dan described 2005 as "one of the best years that he'd ever had before or after my accident" because he received several awards from the local rehabilitation center, as well as from regional and national water skiing associations. Dan reported that receiving medals for his advanced performance not only provided public recognition, but also intrinsic reward, including improving his self-confidence and experiencing joy for life. Clearly, the examples demonstrate that participants in this study gained public recognition and positive reputation through involvement in leisure activities. Building Companionship and Meaningful Relationships

In this study, engagement in leisure activities built two different types of social relationships: companionship and meaningful relationships with peers. The former emphasizes a boundary of social network within the context of leisure involvement, while the latter emphasizes the quality of social interactions with others. The following details these two distinctive characteristics of relationships generated by engagement in leisure activities. Companionship. All participants talked about the importance of building social relationships while enjoying leisure activities with their peers. Most participants reported that after experiencing traumatic accidents, their social network became limited to their families and a few close friends. However, through engaging in recreational activities, most participants, except the two negative cases, could build new relationships with peers experiencing a similar disability. Mary mentioned that she could expand her social network through "meeting and re-meeting people who have similar injuries" while participating in various adaptive sports programs offered by a local rehabilitation center. In addition, the participants illustrated how they enjoyed companionship with friends who had no disability. Most participants tended to have a number of friends with whom they met regularly during their free time. Timothy described his diverse companionship with "a big group of friends" at college. Timothy reported that he "had lots of fun hanging out with new friends" at college, and their companionship in leisure pursuits allowed him to "open his eyes to a lot [regarding] different culture." Boyd, who enjoyed companionship with musicians, also noted that he not only enjoyed meeting "a lot of friends" who were interested in music, but also benefited from the companionship by receiving free admission to concerts and free food. in contrast to the participants experiencing PTG, Jane, a negative case, expressed that she "really did not associate with people" because she was too busy dealing with life issues such as unemployment and dependence on a social worker

for activities for daily living. The examples show that engagement in leisure activities had an essential role in expanding their social networks through providing enjoyable experiences and interactions with peers. Meaningful relationships. Several participants reported that they built meaningful relationships, e.g., ongoing interpersonal relationships through shared experience and understanding of phenomena "as a result of reflection or interaction" (Duck, 1994, p. 95). While participating in organized leisure activities offered by a local rehabilitation center, some participants could enjoy interactions with their peers' circle, experience a sense of belonging and acceptance, and develop deeper relationships, allowing them to share life stories or issues related to the experience of illness. Mary could build meaningful relationships with her peers through sharing her concerns while engaging in activities. Mary said: "it was good to see other people who could talk about my personal issues such as a 'bowel program' because nobody else really understood and did not talk about those issues if he/ she was not in a chair." Boyd also described a meaningful relationship with Patty, who had lived in the same town and who "won the gold medal at Paralympics in 2004." Through practicing and participating in competitions together, their shared athletic experiences provided commonality in their lives as wheelchair basketball players. Although Patty moved to Arizona, Boyd "kept in touch with her" because they were connected to basketball. In addition, several participants mentioned that they built meaningful relationships with a few close friends without disability as a result of sharing their experiences and thoughts and finding commonality in their lives while engaging in various leisure activities together. Jenny explained how she built meaningful relationships. Before her injury, Jenny was one of the most popular students and enjoyed a broad social network at her school. However, after the injury, Jenny realized that her friends liked her because of her "popularity" and she then found "who her true friends were." With a smile and excitement, Jenny shared all the fun activities she had participated in with her best friend, Emily, during her teenage years after experiencing SCI. When Jenny started driving herself, she "picked up Emily everyday," "had lunch," and did "various social activities together" such as dining out, shopping, and working on crafts. Through sharing their experiences and thoughts, Jenny and Emily could better understand each other and became one of the most important people in each other's lives. Similar to Jenny and Emily's relationship, Carla became Ellie's best friend following the car accident. Ellie expressed that she "felt lucky to have such a wonderful friend" with whom she could enjoy free time. Ellie loved hanging out and shopping with Carla and her four kids, who called her "Aunt Ellie". While enjoying their free-time activities together, Ellie and Carla built a more strengthened relationship. Engagement in activities naturally provided a social space where people could interact with peers and build relationships. Enjoyable interaction with friends allowed the participants to share experiences and thoughts with their peers and to build both activity-based companionships and meaningful relationships while engaging in various activities. Making Sense of Traumatic Experience and Finding Meaning in Everyday Life Leisure engagement provided an opportunity to make sense of traumatic experience and to find meaning in everyday life. Although the negative cases went

through the rehabilitation periods, they did not identify any positive moments and only described how hard the experiences of traumatic accident were. However, mostly during the early stages in rehabilitation, participants ran into moments in making sense of traumatic events through exposures to certain activities and events. In Jenny's case, a community outing helped her make a significant realization. At the age of 4, Jenny experienced a car accident, and she "really didn't know if she was going to pull through or not." However, after participating in a routine community outing (i.e., eating a cheeseburger and French fries at a local fast food restaurant), Jenny became very confident that she was going to "live well for a long time with SCI." Through this seemingly insignificant activity, Jenny realized that she could enjoy her life again. Similarly, when William was again riding his favorite mule, he realized that his accident occurred just by chance and was "not by punishment from God." He said: My friends had me up on my mule. Though l couldn't walk or take a step, they had me riding. If I couldn't have ridden I would have given up. I knew God was not punishing me because I could still ride. I knew that if I was being punished, everything would have been taken from me. So I never felt that it was just a bad deal. I knew God was not punishing me because I could still ride.

In the context of outdoor activities, Timothy reported that he realized he could "enjoy what he used to do" after hunting without any assistance from others during the first season following his motorcycle accident. Timothy mentioned that "challenges" in hunting were "always fun" because he learned from his experiences that he could "conquer other challenges" in his life. Through poignant moments of success or enjoyment during the early stages of rehabilitation, engagement in activities offered the opportunity to make sense of traumatic experience. In addition, several participants emphasized the importance of finding meaning in everyday life through engagement in leisure activities. Jenny reported that she found "a great personal meaning" and obtained a "sense of satisfaction from enjoying arts," not only because she could enjoy the same activities she had prior to the injury, but because she found a way to express herself and to demonstrate her artistic ability. For the participants of this study, volunteering seemed to be one of the most powerful activities contributing to finding meaning in everyday life. Among various volunteering experiences, working for people with similar physical disabilities seemed to carry greater meaning for the participants than other volunteer experiences. Ellie noted that she "always knew that there's someone out there that was worse" than she, she "wanted to try to help them," and she "really enjoyed helping people with SCI by letting them know that this isn't the end and that they have a life after acquiring SCI." Likewise, Dan became involved in counseling when a close friend asked him to visit his niece who was in a hospital due to SCI. Dan shared his experience as a water skier to illustrate an enjoyable part of his life after SCI and encouraged the patient to join his adaptive sport club. While sharing his experiences with her, Dan realized that he was an effective mentor who cared for people with SCI, and thus became more committed himself to helping people with SCI. Tom, who had volunteered for 20 years as a motivational speaker and counselor, shared his life experience with "a minimum of 100,000 kids" at schools and juvenile prisons, and also via phone conversations. Through helping kids at risk, Tom found great satisfaction and meaning in life: "This is the vocation that I

did not choose but it's one of the best vocations that [sic] I believe that if I wasn't up and about, kids would naturally gravitate towards me." Simply having fun or being physically active during free time did not seem to create significant meaning in everyday life for the participants. Instead, participants sought personally meaningful experience to make sense of their lives and to find meaning in everyday life. This theme indicates that leisure can be used as a source of creating personal meaning in life in the pathway to experience PTG. Generating Positive Emotions

Leisure generated positive emotions, including interest, enjoyment, excitement, fun, and relaxation. After experiencing traumatic injury, most participants struggled with negative emotions such as depression and anxiety, threatening the narratives of their life stories. However, the participants also experienced positive emotions while engaging in various activities. Leisure facilitated a feeling of "curiosity" or "interest" in new activities. The participants reported the feeling when they talked about why they started new activities. Dan expressed that he was interested in water skiing after finding "a real opportunity," which looked like "a cool thing to do." Mainly related to the moments of achievement or mastery, the participants reported a feeling of "excitement" or "cool" moments. Boyd's example was when he succeeded his first reverse lay-up: "I did my very first reverse lay-up and it went in. I thought it was kind of cool, got me excited." Dan used the term "thrill" to express his excitement when participating in his first national competition. The participants reported a feeling of enjoyment, commonly using the terms "enjoy," "like" or "love" to explain their favorite activities. Boyd expressed that he "enjoyed playing basketball" because it was "a source of his enthusiasm" and it "allowed him to meet a bunch of people." Likewise, Tom expressed that he "loved soul music and dancing," which allowed him to express himself and which demonstrated his unique abilities. The participants also often talked about having fun while engaging in leisure activities. William described traveling by himself as a fun experience. He proudly reported that he entertained himself and had a lot of fun through traveling to Key West using his tricycle. Likewise, Timothy identified college life as one of the most fun periods in his life because he could socialize with a lot of people while "partying a lot, drinking a lot, and eating bad food." Although most participants reported that they became more interested in personally meaningful activities, some people continued to value pleasure after experiencing traumatic injury. Involvement in leisure activities facilitated relaxation, referring more to mental relaxation than to physical rest. When Tom explained his life at the hospital, he gave the example of mental relaxation through listening to music while getting shots or taking pain medication. The findings indicate that leisure experience is capable of offering not only upbeat moments but also peaceful ones, allowing mental relaxation. Discussion Findings of this study demonstrated that leisure helped participants experience

growth through: (a) providing opportunities to discover unique abilities and hidden potential, (b) building companionship and meaningful relationships, (c) making sense of traumatic experience and finding meaning in everyday life, and (d) generating positive emotions. The PTG literature has emphasized the importance of positive cognitive ruminations in the process of PTG. Kleiber (2004) argued that leisure following traumatic events can be used as a vehicle of reconstructing self and experiencing personal transformation. The findings in this study expanded the understanding of PTG that meaningful engagement in activities has potential to facilitate PTG through providing a context to explore themselves, their lives, and relationships with others following trauma. Tedeschi, Park, and Calhoun (1999) stated that PTG results from a cognitive reconstruction process initiated to cope with traumatic events. It may imply that effective coping with trauma may be one of the first steps in the process of PTG. The extensive leisure coping literature (e.g., Hutchinson, Loy, Kleiber, & Dattilo, 2003; Klieber, 2004; Klieber, Hutchinson, & Williams, 2002) has indicated that leisure coping resources (e.g., leisure companionships and friendships, sense of continuity in life, and experience of positive emotions) play a significant role on coping with and adaptation to various illnesses and disabilities. The leisure coping literature has also empirically illustrated leisure coping recourses (e.g., mood enhancement, mental distractions, and escaping from stressful situation or illnesses) are used to regulate one's emotions and to change meaning of a situation. Interestingly, the participants reported similar characteristics of leisure when they illustrated important leisure experiences related to PTG. This finding indicates that involvement in activities have great potential not just to help people cope with stresses, but discover self and experience PTG. One of the findings, which extends the body of literature in leisure coping, is that engagement in leisure activities offered participants the opportunity to find their unique abilities and hidden potential. While exploring their unique abilities and talents, the participants not only experienced a sense of achievement and gained recognition, but they also found positive identities through activities. These findings support those of Seligman and Csikszentmihalyi (2000), who noted that people can experience personal growth as they activate their strengths and capacity. While involved in enjoyable leisure activities, people can naturally explore their hidden abilities or advance in leisure skills, which allow them to experience a sense of success and achievement, to overcome challenges (Murray & Nakajima, 1999), and to gain recognition. These positive experiences themselves can be considered growth experience, and can facilitate the experience of more in-depth personal growth in everyday life. Another important finding in this study was that involvement in leisure activities not only offered companionship, but also provided opportunities to build meaningful relationships, which is one of the importance outcomes of PTG (e.g., Tedeschi et al., 1998; Tedeschi & Calhoun, 2004). Using the concept of meaningful relationships (Duck, 1994), Lee, McCormick, and Austin (2001) stated that people can experience meaningful relationships through enjoyable interactions with peers while engaging in leisure activities. This study provided empirical support to Lee et al., confirming that shared experiences and enjoyable interactions with peers assist people in finding the commonality of their experiences and create a basis for meaningful relationships. Engagement in enjoyable leisure activity facilitates positive social interactions and shared experiences in activities, assisting in a sense of belonging and building trust with peers. Thus, people can build meaningful relationships

through engagement in leisure activities and experience PTG in the context of social relationships. This study demonstrated that the participants not only found meaning in activities themselves, but also discovered meaning in everyday life through committing themselves to challenging and personally meaningful activities. Although participants enjoyed the same activities after their injuries, the activities provided different meanings to them. Whereas drawing was an activity for fun before Jenny's injury, afterward the same activity allowed her to express herself and to demonstrate her abilities, which helped her restore her life narratives. This finding supports the existing literature stating that people seek personal meaning through leisure activities (Ragheb, 1996) and experience a sense of focus and purpose in their life through enjoyable and personally meaningful activities (Hutchinson et al., 2003). King (2004) stated that "a sense of meaning in everyday life derives from active engagements or commitments to goals that help people feel connected, mobilize their activities and efforts, and contribute to their understanding of themselves and their world" (p. 78). Although existing literature has shown possible connections between finding meaning in an activity and discovering meaning in life, it has not clearly demonstrated that engagement in activities contributes to experiencing PTG by providing meaning in activities and in life. The finding in this study indicates that leisure can be an important source of creating personal meaning in life and experiencing PTG. Further investigation is needed to explore the contribution of fining meaning in life through leisure engagement in the experience of PTG. Furthermore, the findings in this study showed conceptual similarities between engagement in personally meaningful activities and serious leisure. According to Stebbins (1992), serious leisure refers to committing oneself to free-time activities as an amateur. In this study, committing oneself to personally meaningful activities appeared to be a vital source for experiencing PTG. Through involvement in activities as athletes, musicians, and volunteers, the participants found their own identities and a purpose in life. Moreover, volunteering presented as an excellent source for feeling useful and for experiencing joy in providing practical assistance. Likewise, previous studies (e.g., Arai, 1997; Cassie & Halpenny, 2003; Greenfield & Marks, 2004) have demonstrated the various benefits (e.g., developing skills, experiencing well-being, enhanced positive emotions, and sense of empowerment) of commitment to volunteering and personally meaningful activities. This study illustrated that commitment to meaningful activities could provide pathways to experience PTG that leads to personal meaning. It is necessary to give more attention to the role of commitment to leisure activities in the context of PTG. From a methodological standpoint, purposeful selection of "healthy" individuals with SCI contributed to understanding the distinctive role of leisure in the experience of PTG. In contrast to the "healthy" participants, the negative subjects did not provide rich and complex descriptions of their life experiences, especially in terms of engagement in leisure activities. Thus, if negative cases were not identified at all, or if a greater number of negative cases were included, this study may not have found the distinctive role of leisure in the experience of PTG. This study demonstrated that selection of a "healthy" population to explore the relationships between leisure and the experience of PTG is essential. Further research should expand the understanding of the relationships between

meaningful engagement and PTG using in-depth interviews and "healthy" samples to explore the distinctive characteristics of the positive phenomenon (Maslow, 1987). Specially, it is necessary to investigate the impact of serious commitment to personally meaningful activities on PTG. In addition, leisure research has not given much attention to the benefits of leisure in the experience of meaningful relationships. Thus, it is essential to explore how leisure contributes to meaningful relationships, and how these relationships influence the experience of PTG. One of the important characteristics of PTG is that is the concept embraces both process and an outcome (Tedeschi, Park, & Calhoun, 1999). Leisure researchers need to conduct PTG research not only from an outcome perspective, but also explore leisure and PTG from a process perspective. The findings suggest that recreation therapists can assist their clients to experience PTG through activities that allow clients to "find their own vehicles of change" (Woodward & Joseph, 2003, p. 281). In other words, recreation therapists can effectively facilitate PTG by helping clients to find their own strengths and unique abilities while participating in therapeutic recreation programs. For example, people can find their unique abilities or hidden potential while enjoying various sports led by recreation therapists. Offering volunteer opportunities may promote a sense of self-worth and joy in providing practical assistance to others. In addition, developing meaning-based therapeutic recreation programs may be helpful. Through providing a personal meaningful environment, therapists can assist clients to find meaning in everyday life as well as experience personal growth. Author's note: This study is based on the first author's doctoral dissertation written under the direction of Dr. Lee. References Affleck, G., & Tennen, H. (1996). Construing benefits from adversity: Adaptational significance and dispositional underpinnings. Journal of Personality, 64(4), 899-922. Affleck, G., Tennen, H., Higgins, P., & Urrows, S. (1994). Person and contextual features of daily stress reactivity: Individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity. Journal of Personality & Social Psychology, 66(2), 329-340. Arai, S. M. (1997). Volunteers within a changing society: The uses of empowerment theory in understanding serious leisure. World Leisure & Recreation, 39(3), 19-22. Atkinson, R. (1998). The life story interview. Thousand Oaks, CA: Sage. Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health Psychology, 25(1), 47-56. Best, M., Streisand, R., Catania, L., & Kazak, A. E. (2001). Parental distress during pediatric leukemia and Posttraumatic Stress Symptoms (PTSS) after treatment ends. Journal of Pediatric Psychology, 26, 299-307. Boyatzis, R. E. (1998). Transforming qualitative information. London: Sage.

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Keywords: affective personality type; post-traumatic stress disorder symptom severity; post-traumatic growth Abstract The current study explored the differential association between affective personality type, post-traumatic stress disorder (PTSD) symptom severity, and post-traumatic growth (PTG) in victims of violence (N = 113). Relying on previous research, median cut off-scores on the Positive and Negative Affect Schedule Short Form were used to classify participants as high affective [i.e. high positive affectivity (PA) and high negative affectivity (NA)], self-actualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA) and low affective (i.e. low PA and low NA). Results indicated that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptoms severity. High affective personality type was found to be the only significant predictor of PTG. Results, study limitations and directions for future research were discussed. Copyright 2010 John Wiley & Sons, Ltd. An extensive body of research exists regarding the psychosocial aftermath of violent victimization. Many studies have shown that victims of interpersonal violence suffer from psychological distress, such as post-traumatic stress disorder (PTSD) (e.g. Kunst, Winkel, & Bogaerts, in press; Orth, Cahill, Foa, & Maercker, 2008). Previous research suggests that the prevalence of violence-related PTSD approximates 1015 per cent (see Winkel, 2007). However, individual studies have recorded much higher prevalence rates, with percentages as high as 25 per cent amongst victims recruited through police stations (Wohlfarth, Winkel, & Van den Brink, 2002) and 32 per cent in emergency department samples (Birmes et al., 2003). Other outcomes observed in victims of violence include: symptoms of depression (e.g. Kilpatrick et al., 2003), somatization, hostility, anxiety and phobic anxiety (e.g. Norris & Kaniasty, 1994; Winkel, 2009), decreases in general well being (Denkers, 1996; Denkers & Winkel, 1997) and eating disorders (Brady, 2008). Along with these negative outcomes, several studies have reported on the positive side of coping with violent victimization (e.g. Borja, Callahan, & Long, 2006; Cobb, Tedeschi, Calhoun, & Cann, 2006), particularly experiences of post-traumatic growth (PTG)a state of functioning superior to that which existed prior to trauma exposure (e.g. Linley & Joseph, 2004; Tedeschi & Calhoun, 2004; Zoellner &

Maercker, 2006). PTG comprises varying domains of personal change, including changes in perception of the self, changes in interpersonal relationships, and changes in philosophy of life (Calhoun & Tedeschi, 1999). The current state-of-theart seems to suggest that PTG and manifestations of distress following traumatic events are only marginally correlated and thus represent rather separate, independent dimensions of psychological functioning (Zoellner & Maercker, 2006). In other words, PTG is not merely an indicator of well-being. Individual differences in trait affectivity have been suggested to underlie both adverse and beneficial outcomes of traumatization (e.g. Affleck & Tennen, 1996; Erbes et al., 2005; Frederickson, Tugade, Waugh, & Larkin, 2003; Tedeschi & Calhoun, 1996). NA seems to play an important role in the onset and maintenance of emotional problems following violent victimization (e.g. Kunst, Bogaerts, & Winkel, 2009; Mikkelsen & Einarsen, 2002; Zoellner, Goodwin, & Foa, 2000). NA involves the stable tendency to experience negative emotions (e.g. Watson & Clark, 1984), negative self-evaluations, and over-sensitivity to adverse stimuli (e.g. Watson & Pennebaker, 1989). When exposed to potentially stressful events, people with high levels of NA may be assumed to respond more intensely than others (e.g. Zeidner, 2006). Furthermore, if levels of heightened distress do not automatically resolve within a reasonable amount of time, they are at an increased risk of developing psychiatric disorder. Previous research, although preliminary in nature, indicates that NA is not associated with PTG (e.g. Tedeschi & Calhoun, 1996, 2004; Sheikh, 2004). By contrast, PA reflects one's ability to maintain a positive out-come both over time and across various situations (Cropanzano et al., 1993; Watson, Pennebaker, & Folger, 1987) and has been suggested to act as a determinant of PTG (Park, Cohen, & Murch, 1996; Tedeschi & Calhoun, 2004). PA and NA broadly correspond with the Big Five traits extraversion and anxiety/neuroticism, respectively (Watson, Clark, & Tellegen, 1988). Generally stated, NA and PA seem to be rather weakly correlated with each other (Thompson, 2007; Watson et al., 1988). Although earlier studies have shown that both NA and PA play an independent role in the process of trauma resolution, research on the explanatory power of configurations of high and low NA and PA values is scarce. Such combinations enable the identification of personality subtypes or cognitive-emotional presymptom profiles (Archer, Adolfsson, & Karlsson, 2008) that are differently related to both positive and negative psychological outcomes (Denollet, 2000; Van Yperen, 2003). Norlander, Bood, and Archer (2002) developed a procedure to create four affective personality styles based on the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988): high affective (i.e. high PA and high NA), selfactualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA), and low affective (i.e. low PA and low NA) personality. In a study of 46 grocery store employees and 44 flying squad policemen (Norlander, Von Schedvin, & Archer, 2005) who had experienced a wide array of negative life events, they investigated, amongst other things, differences in experienced stress, as measured by the Stress and Energy Scale (Kjellberg & Iwanowski, 1989) and PTG between the four personality types. Based on two earlier studies (Bood, Archer, & Norlander, 2004; Norlander, Bood, & Archer, 2002), they hypothesized that self-actualizing individuals would report the lowest levels of distress and the highest levels of PTG. Selfdestructive persons were assumed to experience they highest levels of distress and the lowest levels of PTG. In partial support of their expectations, they found that the highest levels of distress were experienced by self-destructive and high affective persons, whereas self-actualizing and low affective persons reported the lowest stress scores. Contrary to expectations, the high affective group scored highest on

PTG. An intermediate response was found for the self-actualizing group. The lowest scores were observed for the self-destructive and low affective groups. Presumably, and in line with the view held by several PTG scholars that a certain degree of distress is a prerequisite for PTG to occur (e.g. Tedeschi & Calhoun, 1995, 2004), PA is most likely to induce growth if one is vulnerable to experience distress in the first place. More precisely, the stress high affective individuals are likely to experience in response to trauma exposure is necessary to trigger the process of growth. Given the aforementioned, the primary purpose of the current study was to explore associations amongst affective personality type, PTSD symptom severity, and PTG in victims of interpersonal violence. To our knowledge, this has never been done before. Building on the observations made by Norlander, Von Schedvin, et al., (2005), it was expected that the self-destructive and high affective personality styles would be associated with increased PTSD symptom severity, while the latter was also expected to be positively associated with PTG. For the self-actualizing group, an association with PTG was expected as well. Methods Procedure The current study was part of a larger study into the psychosocial aftermath of violent victimization (Kunst, Bogaerts, Wilthagen, & Winkel, 2010; Kunst et al., in press). Participants were recruited through the Dutch Victim Compensation Fund (DVCF). Inclusion criteria were: age 18; filing a claim during the first quarter of 2006; and no missing file data on age, gender, and date of crime (cf. Kunst et al., in press). All victims eligible for participation were invited to fill out a set of internet questionnaires on affective personality type, PTSD symptom severity, and PTG in October 2007. Those who did not have access to the World Wide Web or preferred to complete the measures by pencil could request for a paper version. Background variables (age, gender, time relapse since victimization, compensation level for pain and suffering, and type of violence: sexual violence, severe physical assault, moderate physical assault, theft with violence and other1) were retrieved from victims' electronic files. Compensation level for pain and suffering was mainly used as an indicator of the objective severity of the violence experienced and ranged from 0 to 8. Approval for the study was obtained from the DVCF Committee. Unfortunately, reminders were not allowed to be sent to non-respondents. Participants In total, 641 victims were approached for participation. One hundred and thirty-four (20.1%) of them responded. Twenty-one of them were dropped from statistical analyses due to missing data. Those participating in the study did not differ significantly from non-participants on any of the background variables included in the study. The study sample contained 52 (46%) men and 61 women (54%). Their average age was 40.9 (SD = 14.4) years. Mean time since victimization was 4.9 (SD = 3.6) years. Mean compensation levels for pain and suffering was 2.2 (SD = 1.8). Thirteen (11.5%) participants were victims of sexual violence, 12 (10.6%) of severe physical assault, 32 (28.3%) of moderate physical assault, and 30 (26.5%) of theft with violence. The remainder of the sample had experienced another type of violence. Measures

NA and PA NA and PA were measured by the NA subscale of the 10-item PANAS Short Form (PANAS-SF; Thompson, 2007). The PANAS-SF is derived from the original 20-item PANAS version (Watson et al., 1988). The PANAS has been validated in The Netherlands by Peeters, Ponds, & Vermeeren (1996). The Dutch version of the 20item PANAS was used to select the items that correspond to the English version of the PANAS-SF. Both NA and PA are assessed by five items and need to be rated on a five-point likert scale (1 = never, 5 = always). Each item consists of one word describing a particular emotion or feeling. Nervous and determined are examples of the NA and PA subscales, respectively. In accordance with Thompson (2007), participants were instructed to indicate to what extent they generally feel a particular emotion to measure trait affectivity. The psychometric properties of the PANAS-SF have been found to be acceptable in many different language environments (Thompson, 2007). Internal consistency reliability of the NA subscale of the PANAS-SF was Cronbach's = 0.82 and Cronbach's = 0.63 for the PA subscale. Deletion of one item (alert) would have increased its reliability to 0.70. It was decided to retain the PA subscale in its original format though, for internal reliability levels of <0.7 are acceptable for scales containing only a few items. Furthermore, the value for the mean inter-item correlation of the NA items in this study (0.24) lied within the range of 0.20.4 proposed by Briggs and Cheek (1986). Following on the procedure developed by Norlander et al. (2002), a variable representing the four affective personality styles was created by median split dichotomization. In addition, four categorical variables were created for each personality type: high affective (PA 18 and NA 14), self-actualizing (PA 18 and NA < 14), self-destructive (PA < 18 and NA 14) and low affective (PA < 18 and NA < 14). Those who fulfilled the criteria for a particular personality profile were coded as 1 and those who did not as 0. PTSD symptom severity The Dutch version of the PTSD Symptom Scale, Self-Report version (PSS-SR; Arntz, 1993; Foa, Riggs, Dancu, & Rothbaum, 1993) was used to measure PTSD symptom severity. The PSS-SR has often been used as a screening instrument for PTSD symptomatology amongst victims of crime (e.g. Andrews, Brewin, Rose, & Kirk, 2000; Dunmore, Clark, & Ehlers, 1999; Rose, Brewin, & Kirk, 1999). For each of the 17 items, respondents had to indicate to what extent they had experienced the corresponding symptom during the past week on a four-point Likert scale (0 = never, 1 = once, 2 = 24 times, 3 = 5 times or more). An example of the PSS-SR is Upsetting images or thoughts about the event. The psychometric properties of the PSS-SR have been found to be satisfactory in crime victim samples (Foa et al., 1993; Wohlfarth, Van den Brink, Winkel, & Ter Smitten, 2003). In the current study, internal consistency reliability of the PSS-SR was Cronbach's = 0.95. PTG Perceptions of PTG were measured by the Dutch version of the PTG Inventory (PTGI; Jaarsma, Pool, Sanderman, & Ranchor, 2006). The PTGI was originally developed by Tedeschi and Calhoun (1996) and assesses five domains of PTG: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. Each item needs to be answered on a six-point Likert scale (0 = not at all, 5 = extremely). An example of a PTGI item is I changed my priorities about what is important in life. Both subscale and total scale scores can be calculated for

statistical analysis. For the current study, only the PTG total score was used. Participants were instructed to report PTG levels related to the act of violence leading to the request for compensation. The psychometric properties of the PTGI have been well established in victims of violence (e.g. Cobb et al., 2006; Grubaugh & Resick, 2007; Updegraff & Marshall, 2005). Internal consistency reliability for the PTG in the present study was = 0.96. Data analysis To explore the association between PTSD symptom severity and PTG in the current study, the correlation between the PSS-SR and PTG total scores was computed. Two one-way ANOVAs were performed to determine whether the four affective personality groups differed in their mean PSS-SR and PTGI total scores. Tukey LSD post hoc tests were performed to locate observed differences. Next, two multivariate regression analyses were performed to examine the independent contributions of each personality type to the variance in PTSD symptom severity and PTG when adjusting for background variables. In each model, background variables were entered on the first step. On the second step, three of the four categorical personality variables were added to the model. When estimating their associations with PTSD symptom severity (model 1), low affective personality style served as reference category. Self-destructive personality type was used as reference category in the second model. Selection of reference categories followed on the hypotheses presented in the introduction. Prior to regression analyses, data were checked for underlying assumptions (i.e. multicollinearity, outliers, normality, linearity, homoscedasticity and independence of residuals). The alpha level was set at 0.05 in all statistical tests. Analyses did not adjust for multiple testing, as this is not required for exploratory studies (Bender & Lange, 2001). All statistical analyses were performed using the software package SPSS 16.0 for Windows (SPSS Inc., Chicago, IL, USA). Results PSS-SR and PTG total scores were not significantly correlated with each other (r = 0.12, p = ns). Thirty participants could be classified as high affective individuals, 34 as self-actualizing, 20 as low affective, and 29 as self-destructive. ANOVAs revealed overall effects for affective personality type on PTSD symptom severity, F(3, 109) = 27.97, p < 0.001, and PTG, F(3, 109) = 2.92, p < 0.05. Post hoc analyses indicated that self-destructive individuals (M = 29.1, SD = 12.1) reported higher symptom levels than high affective (M = 23.0, SD = 9.6, p < 0.05), self-actualizing (M = 8.6, SD = 10.9, p < 0.001), and low affective (M = 8.2, SD = 8.3, p < 0.001) participants. Mean PTG scores for the high affective group (M = 50.7, SD = 27.4) were higher than for the low affective (M = 33.5, SD = 27.9, p < 0.05) and self-destructive (M = 33.4, SD = 22.9, p < 0.025) groups. High affective individuals also reported higher PTG scores than those in the self-actualizing group (M = 46.5, SD = 30.2), although they did not differ significantly from each other. Regression analyses yielded significant positive associations between the self-destructive and high affective personality types and PTSD symptom severity. None of the other variables included in the model was significantly related to PTSD symptom severity (Table I). High affective personality type was the only factor independently related to higher PTG levels (Table II), although a marginal positive effect for self-actualizing personality was found as well (p = 0.08). Table I. PredictingPTSDsymptomseverity(N = 113)

Variable * *p < 0.05; ** **p < 0.001.

R2 change

Note that gender is coded as man = 1. Compensation level refers to compensation for pain and suffering. Step 1 0.138* Age 0.20* Gender 0.07 Time since victimization 0.19* Sexual violence 0.04 Physical assault (severe) 0.12 Physical assault (minor) 0.17 Robbery 0.08 Compensation level 0.10 Step 2 0.341** Age 0.11 Gender 0.10 Time since victimization 0.03 Sexual violence 0.00 Physical assault (severe) 0.06 Physical assault (minor) 0.12 Robbery 0.00 Compensation level 0.07 Self-destructive 0.63** High affective 0.46** Self-actualizing 0.00 Table II. Predictingpost-traumaticgrowth(N = 113) Variable R2 change * *p < 0.05; b **p < 0.001. Note that gender is coded as man = 1. Compensation level refers to

Variable compensation for pain and suffering. Step 1 Age Gender Time since victimization Sexual violence Physical assault (severe) Physical assault (minor) Robbery Compensation level Step 2 Age Gender Time since victimization Sexual violence Physical assault (severe) Physical assault (minor) Robbery Compensation level High affective Self-actualizing Low affective Discussion

R2 change

0.065 0.06 0.02 0.11 0.16 0.10 0.03 0.13 0.02 0.074* 0.05 0.03 0.07 0.16 0.14 0.01 0.09 0.03 0.27* 0.22 0.01

The present study investigated self-reports of PTSD symptom severity and PTG with regard to affective personality type in a sample of victims of rather heterogeneous categories of interpersonal violence. It intended to build on the work provided by Norlander and colleagues (Bood et al., 2004; Norlander, Johansson, et al., 2002; Norlander, Von Schedvin, et al., 2005), who used PANAS median scores to create four configurations of affective personality: high affective, self-actualizing, low affective, and self-destructive. In line with many previous studies, PTSD symptom severity and PTG were not correlated with each other. In support of our expectations, and in line with Norlander, Von Schedvin, et al. (2005), results showed that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptom severity in multivariate regression analyses. Mean symptom score values for individuals in these groups even suggested that individuals in these groups are likely to develop symptom levels that lie well beyond the cutoffs proposed to qualify for probable diagnosis of PTSD (Wohlfarth et al., 2003). Also in accordance with Norlander, Von Schedvin, et al. (2005), high affective individuals reported the highest levels of PTG. Moreover, high affective personality type was found to be the only significant predictor of PTG when adjusting for background variables, while self-actualizing personality type was, contrary to expectations, only marginally associated with PTG.

The results further underline the importance of considering configurations of personality traits when studying the psychological aftermath of trauma rather than solely focussing on single personality dimensions. Admittedly, on the one hand, they seem to indicate that NA is a correlate of PTSD symptom severity irrespective of concurrent PA. However, on the other hand, they suggest that PTG will particularly occur if PA is accompanied by NA. The latter is in line with the notion that a certain level of distress is required to enable the experience of PTG (e.g. Tedeschi & Calhoun, 1995, 2004) and may prove to be an important starting-point for future research into the relationship between PTG and PTSD. As mentioned in the introduction, currently no consensus exists regarding the relationship between PTG and PTSD. Several explanations have been proposed for this lack of consistency (Helgeson, Reynolds, & Tomich, 2006). Most of them refer to the different designs employed by previous studies, including the operationalization of PTG, the types of trauma under investigation, and the failure to test for moderation by third variables (Helgeson et al., 2006; Hobfoll et al., 2007; Zoellner & Maercker, 2006). Based on the current study's results, one might argue that the dominant affective personality style within a particular sample may also determine whether both outcomes are correlated or not. For example, a significant positive correlation would be expected when most study participants qualify as high affective individuals, because in that case most participants combine high PTSD with high PTG scores. With the exception of a study by Norlander, Von Schedvin, et al. (2005), the finding that self-actualizing individuals reported equally low levels of PTSD symptomatology with participants in the low affective group seems to contrast with several previous studies conducted in non-traumatized samples. Archer, Adrianson, Plancak, and Karlsson (2007), for example, found that the self-actualizing group reported significantly lower levels of anxiety and depression on the Hospital and Anxiety Scale (Zigmund & Snaith, 1983) than each of the other three groups. Similar results were reported by Karlsson and Archer (2007, in press). Slightly different results were reported by Garcia and Siddiqui (2009), who found that self-actualizing individuals reported the highest levels of psychological well-being on a short version of Ryff's Measurement of Psychological Well-Being (Clarke, Marschall, Ryff, & Wheaton, 2001), although they failed to observe a significant difference between self-actualizing and high affective participants. Presumably, under non-stress conditions low affective individuals report higher levels of distress/lower levels of general well-being than those characterized by self-actualizing personality, while equally low symptom levels are reported in response to trauma. Although highly speculative, one explanation for the incongruence of the current study's results with those found in other studies is that both self-actualizing and low affective subjects are characterized by high internal locus of control and low external control, whereas high affective and self-destructive individuals score low on internal and high on external control (Archer et al., 2008). Internal locus of control involves the belief that forces shaping one's life are largely within one's control, whereas external locus of control comprises the degree to which one conceives the outcome of an event as uncontrollable and due to luck or chance (Rotter, 1966, 1975). Particularly in the aftermath of trauma, when the adverse impact of the event needs to be overcome, high internal and low external locus of control may be assumed to protect against unsuccessful coping (e.g. Bisson, 2007; Hoge, Austin, & Pollack, 2007), possibly irrespective of affective personality type. By contrast, in the absence of trauma exposure or when external stimuli are not salient enough to trigger the autonomic stress response, perceptions of controllability are

perhaps not always capable of predicting psychological distress above and beyond dispositional affectivity. Unfortunately, these contentions seem to have gone largely untested in the existing literature. To address this topic in a methodologically proper manner, future studies will need to employ a design that allows exploring the main effects of trauma exposure, affective personality type, and locus of control on PTSD and the interactions between (severity of) trauma exposure and affective personality type/locus of control. Preferably, they also account for religious believes about the controllability of life events (cf. Gral, Kesimci, & Genz, 2006; Karanci & Erkam, 2007). When interpreting the study's results several limitations must be considered though. Firstly, the cross-sectional nature of the collected data does not allow interpretation of the results in terms of cause and effect. Secondly, due to the rather low response rate, findings may not be generalizable to the population of victims applying for compensation. However, at first sight this possibility does not seem to be very likely, since no differences were observed between participants and nonparticipants on a wide array of background variables. Thirdly, the specific focus on victims applying for state compensation prevents generalization to the general population of victims of violence and other populations. Fourthly, results may have been biased by participants' interest in compensation (cf. Frueh et al., 2003). This was not deemed very likely though, as all of them had received a final decision on their claim. Despite these limitations, the study was the first to assess the associations between affective personality type, PTSD symptom severity, and PTG. Its results raised several issues which deserve further clarification. In addition to the propositions made above, a topic that may be addressed in future research is how the four affective personality types relate to other concepts. Given their theoretical similarities, it would be worthwhile to determine whether high affective personality overlaps with borderline personality traits. A recent study by McCormick and colleagues (2007), for example, suggests that average PANAS scores for patients diagnosed with borderline personality disorder are high for both NA and PA. Another issue that may be addressed is the similarities between low affectivity and the concepts of apathy and emotional indifference (Peterson & Janssen, 2007) and type C characteristics. Type C individuals deliberately suppress negative emotions and respond passively in the face of distress (Temoshok, 1987). Consequently, one might argue that Type Cs are likely to report low levels of PA and NA on the PANAS. Finally, in line with previous research (e.g. Klein & Shih, 1998), the association between self-destructive personality type and depressive or dysthymic personality traits deserves to be scrutinized. Acknowledgements The author thanks the Dutch Victim Compensation Fund for their financial and organizational support with the data collection. 1 The DVCF categorizes type of violence according to their legal classification used in the Dutch Penal Code (DPC). To enable statistical testing, the number of different categories was reduced from 30 to 5 (cf. Kunst et al., in press). Severe and moderate physical assault and theft with violence corresponded to the original file categorization. Sexual violence included all individuals that had experienced an offence falling under Book 2, Title XIV of the DPC. The remainder of the sample is a mixture of offences that were too low in number

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