A gift wrapped in barbed wire: Personal growth among individuals with arthritis or inflammatory bowel disease

Despite the growing interest in the development of personal growth following a healthrelated adversity such as the diagnosis of a chronic illness, there has been little research investigating the factors that may give rise to personal growth. The objective of the present study was to explore the experience of posttraumatic growth and to identify the factors associated with posttraumatic growth among individuals with arthritis or inflammatory bowel disease (IBD) at two time points spaced six months apart. Using Schaefer and Moos' (1992) model as a theoretical framework, the association of positive outlook, spirituality, social support, stressors, cognitive appraisal variables, and coping strategies was examined among 214 individuals diagnosed with arthritis and 377 individuals diagnosed with IBD. Two structural equation models were estimated for each illness group. For the IBD group, the results showed that positive outlook, stressors, and social support each had an indirect effect on posttraumatic growth, mediated through symptom control beliefs, benefit-finding, and adaptive coping strategies. For the arthritis group, the results showed that positive outlook and stressors had an indirect effect on posttraumatic growth, mediated though benefit-finding and adaptive coping strategies, whereas social support had an indirect effect on posttraumatic growth, mediated through symptom control beliefs and adaptive coping. Importantly, this study highlights the relative roles of positive outlook, stressors, social support, cognitive appraisal variables and coping strategies that may facilitate the experience of posttraumatic growth among individuals facing a non-life threatening chronic illness. Personal growth and chronic illness v Dedication To my beloved Tarik. As much as you think I helped you this year, I think you helped me more. You taught me to believe in myself and you gave me hope when I thought there was none. And. I'll never look at Macs or blue jays the same way again. Personal growth and chronic illness vi Acknowledgements I would first like to thank my dissertation committee. In particular, I would like to thank my advisor, Dr. Fuschia Sirois, for taking me on as a student and helping me achieve this goal. I would also like to thank Dr. Dennis Jackson, Dr. Kathryn Lafreniere, and Dr. Anne Snowdon for their thoughtful, valuable, and always friendly feedback throughout the course of this study. A sincere thank you to Dr. Susan Cadell for agreeing to be my external reviewer and providing helpful guidance on this study. I would also like to thank Dr. Charlene Senn for the guidance, encouragement and support she provided throughout my graduate career whenever I needed it. I hope to become the esteemed academic and mentor you are. I would also like to thank Dr. Christine Thrasher for continuing to work and collaborate with me for all of these years. I have thoroughly enjoyed working with you and have learned so much from that experience. I would also like to acknowledge the participants who took the time to complete my study. The support and interest for this study was far beyond what I expected, and I have an incredible amount of respect for each of you. I am incredibly grateful for the time and thoughtful responses you provided. And finally, Darren. What would I have done without you this year! Thanks for keeping me sane and motivated throughout the final stages of this project, and always being there during my emotional highs and lows. You are a true friend. Personal growth and chronic illness vii TABLE OF CONTENTS APROVAL PAGE ii AUTHOR'S DECLARATION OF ORIGINALITY iii ABSTRACT iv DEDICATION v ACKNOWLEDGEMENTS vi LIST OF FIGURES AND TABLES xi CHAPTER