# French validation of the Core Beliefs Inventory and the Event-Related Rumination Inventory

Emma Gendre, Andrea Soubelet, Charlotte Henson, Stacey Callahan

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Emma Gendre, Andrea Soubelet, Charlotte Henson, Stacey Callahan. French validation of the Core Beliefs Inventory and the Event-Related Rumination Inventory. Journal of Affective Disorders Reports, 2025, 22, pp.100990. 10.1016/j.jadr.2025.100990. hal-05352063

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Research Paper

# French validation of the Core Beliefs Inventory and the Event-Related Rumination Inventory

Emma Gendre<sup>a, *, b</sup>, Andrea Soubelet<sup>b, *</sup>, Charlotte Henson<sup>c, *</sup>, Stacey Callahan<sup>a, b</sup>

ARTICLE INFO

Keywords:

Posttraumatic growth

Core beliefs

Rumination

Psychotrauma

ABSTRACT

**Background:** Posttraumatic growth (PTG) is associated with two important cognitive factors: challenge to core beliefs and event-related rumination. The objectives of this study were to 1) validate the French versions of the Core Beliefs Inventory (CBI, Cann et al., 2010) and the Event-Related Rumination Inventory (ERRI, Cann et al., 2011) and 2) explore direct and indirect effects of core beliefs and rumination on PTG in the long-term.

**Methods:** A sample of adults (N = 433 at T1, N = 222 at T2, six months later) who had experienced at least one traumatic event in their lifetime completed online questionnaires measuring core beliefs, rumination, distress, and PTG. Confirmatory factor analyses, correlations, and structural equation modeling were performed.

**Results:** Analyses supported a two-factor structure for the CBI: (1) beliefs about justice, control, and the causality of events and (2) beliefs about relationships, self, and the future; as well as for the ERRI: (1) intrusive rumination and (2) deliberate rumination. Both scales showed good psychometric qualities. Disruption of beliefs about relationships, self, and the future at T1 and deliberate rumination at T2 had a direct positive effect on PTG at T2, while intrusive rumination at T1 had no effect. Deliberate rumination mediated both the relationship between disruption of core beliefs and PTG and the relationship between intrusive rumination and PTG.

**Conclusions:** The results demonstrate the validity of the CBI and ERRI and are consistent with the theoretical model emphasizing the importance of cognitive processing in the development of PTG.

# 1. Introduction

The likelihood of experiencing a traumatic event during one's lifetime is high and is estimated at 70.4% (Kessler et al., 2017). The prevalence of posttraumatic stress disorder (PTSD) after exposure to trauma is estimated at 5.6% worldwide, in populations that have experienced events such as accidents or injuries, the sudden death of a loved one, and witnessing a death or serious injury (Koenen et al., 2017). Positive adaptive responses, such as posttraumatic growth (PTG), may also emerge. This concept, introduced by Tedeschi and Calhoun (2004), is defined as "positive psychological changes experienced as a result of the struggle with traumatic or highly challenging life circumstances" (Tedeschi et al., 2018, p. 3). These changes are comprised of five dimensions: appreciation of life (enjoying life and its simplest aspects), relationships with others (having more intimate, appreciated, invested relationships), personal strength (feeling stronger and able to cope with difficulties), new possibilities (developing new interests, new

opportunities), and spiritual development (on a religious or existential level) (Tedeschi & Calhoun, 2004). According to this model, shattering of core beliefs is essential to initiate cognitive processing, including rumination, which promotes the reconstruction of shattered assumptions and life narratives, leading to PTG. Recognition of PTG is therefore essential to provide a more comprehensive vision of posttraumatic responses, and to offer more holistic care for individuals confronted to distressful events.

However, the perception and onset of PTG can vary according to cultural context. A study conducted in ten countries (Taku et al., 2021) identified different patterns of cognitive predictors. Reexamination of core beliefs and/or rumination were associated with PTG only in some countries (e.g., Australia and Poland for both; Turkey for reexamination of core beliefs; Germany for rumination). Few studies have been carried out on this subject in French-speaking countries, mainly due to the lack of French-validated tools for assessing PTG. In France, growth is still poorly recognized, unlike resilience. This lack of research hinders

<footnote><sup>a</sup> Centre d'Études et de Recherches en Psychopathologie et Psychologie de la Santé (CERPPS, EA 7411), Université Toulouse - Jean Jaurès, Toulouse, France</footnote>

<footnote><sup>b</sup> Cognition Behaviour Technology (CoBTeK Lab, EA 7276), Université Côte d'Azur, Nice, France</footnote>

<footnote><sup>c</sup> Trauma and Recovery Research Unit, McMaster University, Ontario, Canada</footnote>

<footnote>* Corresponding author.</footnote>

<footnote>E-mail address: emma.gendre@univ-tlse2.fr (E. Gendre).</footnote>
researchers and clinicians' ability to identify and promote posttraumatic growth in French-speaking patients. For this reason, our main objective is to test the validity of scales measuring the cognitive processes of PTG in a French-speaking context. Our second objective is to evaluate, using a mediation model, the effect of cognitive factors on PTG, as proposed by Tedeschi and Calhoun's model (2004), in a French-speaking and longitudinal context.

The shattering of core beliefs, which affects one's perception of the world, its meaning (e.g., controllability assumption), and one's self-worth (Janoff-Bulman, 1992), is one of the cognitive factors that facilitate (Barzegari-Soltan-Ahmadi et al., 2022; Cann et al., 2010; de Moura et al., 2020; Juczyński & Ogińska-Bulik, 2018; Ramos et al., 2016), or predict PTG (Beck et al., 2017; Lindstrom et al., 2013). The disruption of these beliefs, which hinders well-being (Cann et al., 2010) and promotes PTSD (de Moura et al., 2020; Juczyński & Ogińska-Bulik, 2018), can catalyze the cognitive processes required for the reconstruction of assumptions about self, the world, and the future, which in turn would lead to PTG (Calhoun & Tedeschi, 2012).

The degree of disruption of core beliefs is measured using the Core Beliefs Inventory (CBI), developed by Cann et al. (2010) and consists of a nine-item factor. The psychometric properties of the CBI are satisfactory. Internal consistency is excellent ($α_{time1} = 0.82$ and $α_{time2} = 0.87$) and test-retest reliability is good ($r = 0.69$). The scale has been translated and validated in Korean (Jo, 2012), Japanese (Taku et al., 2015), Portuguese (Ramos et al., 2016), Brazilian Portuguese (de Moura et al., 2020), Tiv (Chukwuorji et al., 2019), Polish (Juczyński & Ogińska-Bulik, 2018), Italian (Romeo et al., 2022), and Persian (Barzegari-Soltan-Ahmadi et al., 2022). The factor structure of the Polish and Portuguese versions diverges from the original version, respectively consisting of three (items 1-3, items 4-6, items 7-9) and two factors (items 1-2, items 3-9, only after exploratory analysis). Model fit indices are not always presented (Chukwuorji et al., 2019; Romeo et al., 2022; Taku et al., 2015).

A second facilitating factor for PTG is event-related rumination (Tedeschi & Calhoun, 2004). Unlike other types of negative repetitive thinking—such as depressive rumination, which tends to be more abstract and centers on negative emotions, thoughts, or events—event-related rumination is specifically focused on negative memories of the traumatic event (Mertens et al., 2025). This rumination is not necessarily maladaptive. In contrast, rumination in response to depressed mood is viewed in some approaches, such as metacognitive theory (Wells & Papageorgiou, 2003), as dysfunctional regardless of its content. According to this theory, its persistence is linked to both positive (e.g., that it is a helpful coping strategy) and negative (e.g., that it is uncontrollable) metacognitive beliefs.

Event-related rumination can be divided into two distinct processes: intrusive rumination, defined as automatic, repetitive, uncontrollable thoughts, and deliberate, conscious, voluntary rumination focused on the meaning of the event in order to integrate it into one's life narrative (Cann et al., 2011). Intrusive and deliberate rumination are both positively correlated to PTSD (Cann et al., 2011; Ogińska-Bulik & Juczyński, 2015). However, deliberate rumination is more strongly associated with PTG (Ogińska-Bulik & Juczyński, 2015) and positively predicts it (Allen et al., 2022; Ogińska-Bulik & Bąk, 2023; Wang et al., 2023). These types of rumination develop during the core belief accommodation process and mediate the relationship between shattered assumptions about the world and PTG (Freedle & Kashubeck-West, 2021; Hammer et al., 2019; Zhou et al., 2015).

As for intrusive rumination, contradictions exist as some studies show there is a positive (Cann et al., 2011; Ogińska-Bulik & Juczyński, 2015), negative (Lianchao & Tingting, 2020; Liu et al., 2023), or non-significant relationship between intrusive thoughts and PTG (Allen et al., 2022). The nature of the relationship may vary with temporality, i. e. be positive when the event is recent and insignificant when the event goes further back (Romeo et al., 2025). In the latter case, the role of intrusive rumination in the development of PTG could be indirect, by

promoting individual engagement in deliberate rumination processes (García et al., 2016; Wang et al., 2020; Wu et al., 2015; Zhou et al., 2015; Zhou & Wu, 2016). Indeed, multiple indirect effect models showed that intrusive rumination predicted PTG via deliberate rumination (Choi & In, 2020; Eze et al., 2020; Khechuashvili, 2019; Zhou et al., 2015), and that the disruption of core beliefs predicted PTG through both intrusive rumination and deliberate rumination (Choi & In, 2020; Eze et al., 2020).

To measure the level of rumination individuals experience, the Event-Related Rumination Inventory (ERRI; Cann et al., 2011) was developed. The ERRI is a 20-item scale, of which 10 measure intrusive rumination, and 10 measure deliberate rumination. Depending on the instructions, participants report rumination experienced in the weeks immediately following the event, or in the weeks preceding the assessment. Internal consistency is satisfactory ($α_{intrusive} = 0.94$ and $α_{deliberate} = 0.88$). The scale has also been validated in Korean (Ahn et al., 2013), Japanese (Taku et al., 2015), Chilean Spanish (Alzugaray et al., 2015), Portuguese (Ramos et al., 2015), Brazilian Portuguese (da Silva et al., 2016), Tiv (Chukwuorji et al., 2018), Polish (Ogińska-Bulik & Juczyński, 2015), Georgian (Khechuashvili, 2019), Greek (Seliniotaki et al., 2021), and Italian (Romeo et al., 2025). The Spanish version is shorter, consisting of 12 items (7 for intrusive rumination and 5 for deliberate rumination). Some studies used a broader Likert scale (Chukwuorji et al., 2018; Romeo et al., 2025), while others did not indicate or evaluate model fit indices (Chukwuorji et al., 2018; da Silva et al., 2016; Taku et al., 2015). The Italian version showed better fit in the second time frame, "recent" (Romeo et al., 2025).

To date, neither tool (neither the CBI nor the ERRI) has been validated for French-speaking populations. Indirect effect models were therefore tested on non-French-speaking samples, usually exposed to a specific type of traumatic event (e.g., terrorist attacks, earthquake), using cross-sectional data. This longitudinal study aimed to analyze the factor structure and psychometric properties of the CBI and ERRI so as to test their validity in French. Once they were validated, we conducted a study on the direct and indirect long-term effects of these cognitive processes on posttraumatic growth, by testing a multiple indirect effect model (from disruption of core beliefs to PTG via event-related rumination).

## 2. Method

### 2.1. Transparency and openness

All data supporting the article are publicly available at https://osf.io/ae3nu/

### 2.2. Translation

The translation was carried out using the reverse translation method (Vallerand, 1989). The two original scales were translated into French by Henson (2022), who gave us permission to use them. We made slight modifications for the translations to be more faithful to the original versions. The adjustments mainly concern lexical variations through the use of equivalents closer to the English terms (e.g., "j'ai réfléchi" rather than "je me suis demandé", "à faire face" rather than "gérer", "évenement" rather than "expérience"), as well as changes in wording that are closer to the structure and style of the original version (e.g., "mon" rather than "cette", "même lorsque je ne le souhaitais pas" rather than "même lorsque je n'en avais pas envie"). The French versions were then back-translated by a native English speaker. The back-translations were compared with the original versions. The CBI and ERRI in French are presented in Appendices A and B (Supplementary material).
## 2.3. Participants and procedure

A two-stage longitudinal study<fnref n="1" /> was conducted using LimeSurvey online questionnaires, distributed via social networks (Facebook®, Instagram®, LinkedIn®) and through 20 different healthcare facilities (psychotrauma centers, medical-psychological emergency units, victimology or medico-judicial units, hospitals, clinics) as well as 71 organizations (for patients, caregivers, and professionals) in France. All participants had experienced a traumatic event meeting PTSD criterion A of the DSM-5 ("exposure to actual or threatened death, serious injury or sexual violence"), either directly, indirectly, as a witness, or in a professional setting (e.g., police officers repeatedly exposed to the aversive aspects of traumatic events) (American Psychiatric Association, 2022, p. 301). They were over 18 years of age, understood the French language, and had no neurodegenerative diseases, intellectual disabilities, or psychotic disorders. At T1, 433 participants (347 women, 86 men, M<sub>age</sub> = 43.5, SD = 15.6) completed the online survey. They predominantly had university degrees ranging from 2 to 5 years (18.5% Bac +2, 22.6% Bac +3, 24% Bac +5). Participants were primarily executives (24.7%), employees (23.1%), or students (14.1%), and many were either in committed relationships (in a civil partnership or married, 36.3%) or a couple (26.8%). Most lived in France (95.8%), while a smaller portion resided in other French-speaking areas (e.g., Belgium, Francophone provinces of Canada, 3.5%) or as expatriates in non-French-speaking countries (e.g., Sweden, United Kingdom, 0.7%). The most cited Traumatic Events (TEs) included the sudden death of a loved one (32.1%), episodes of assault or violence particularly of a sexual nature (26.3%), and life-threatening health issues or injuries (13.6% experienced directly, 9.2% indirectly). Less commonly reported events included accidents (9%), terrorist attacks (1.6%), war zone exposure (1.2%), natural disasters (0.9%), fires or explosions (0.5%), or were unspecified (various events listed, 4.2%). The median time since trauma was 61 months (approximately 5 years), with an interquartile range of 129 months (approximately 10 years). The mean number of TEs experienced directly during the participants' lives was 3.8 (SD = 2.5), with 83.1% reporting having experienced more than one TE.

Participants then responded to the second questionnaire six months after the initial assessment (T2). We first excluded 41 people who had changed the TE they initially reported during T1 at T2 so that repeated measures would refer to the same traumatic event. These 41 individuals experienced more TEs during their lifetime (t(261) = 2.56, *p* = 0.011) which were predominantly experienced during childhood (χ²(1) = 4.90, *p* = 0.027). The final sample at T2 was comprised of 222 participants (176 women, 46 men, M<sub>age</sub> = 45.4, SD = 14.6). They were older (t(390) = 3.31, *p* < 0.001), less likely to have experienced the traumatic event during childhood (χ²(1) = 11.17, *p* < 0.001) and reported less anxiety (t (390) = -2.87, *p* = 0.004) than those who only participated at T1. Additionally, 11.3% reported experiencing a new traumatic event since T1.

Their free and informed consent was obtained. The study protocol was validated by the Research Ethics Committee of the University of Toulouse (project 2023_683) and was carried out in accordance with the Helsinki Declaration.

## 2.4. Measures

Participants first completed the Life Events Checklist for DSM-5 (LEC-5). The LEC-5 (Weathers, Blake, et al., 2013, translated into French by Henson, 2022) consists of a list of 17 stressful events. It aims to assess lifetime exposure to potentially traumatic events. Participants indicated the form(s) of exposure for each event: direct, indirect, as a witness, and/or during their professional activity.

They then reported on the traumatic event they considered being the most impactful in their lives and were asked to rate their level of perceived distress and threat at the time of the TE via a Likert scale ranging from 0 (*Not at all*) to 4 (*Extremely*). At T2, they had to re-describe the event they mentioned during T1.

At T1 and T2, participants responded to the following questionnaires:

As noted above, the CBI assesses the degree of disruption to core beliefs about the self, others, the world, and the future. It consists of 9 items, rated on a scale ranging from 0 (*Not at all*) to 5 (*To a very great extent*). The higher a person scores on the CBI, the more likely they are to reexamine their core beliefs.

Also noted earlier, the ERRI measures the level of intrusive and deliberate rumination experienced by individuals following a TE. Each of these subscales consists of 10 items, rated on a scale ranging from 0 (*Not at all*) to 3 (*Often*). At T1, participants were asked to consider the "weeks immediately following the event" to answer the questions (referring to "past rumination" in this study), whereas at T2, they were asked to consider "the past 6 months" (referring to "recent rumination"). The higher a person scores on the ERRI, the more they engage with intrusive and/or deliberate thoughts.

The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5, Weathers, Litz, et al., 2013, translated into French by Ashbaugh et al., 2016) consists of 20 items scored on a scale ranging from 0 (*Not at all*) to 4 (*Extremely*). It measures the severity of posttraumatic symptoms over the past month, as per the DSM-5. Four symptom clusters are measured: intrusion (DSM-5 criterion B), avoidance (criterion C), negative alterations in cognition and mood (criterion D), and alterations in arousal and reactivity (criterion E). Cronbach's alpha is excellent in the current sample ($α_{T1}$ = 0.95; $α_{T2}$ = 0.94).

The Hospital Anxiety and Depression Scale (HADS, Zigmond & Snaith, 1983, translated into French by Lépine et al., 1985) is a self-administered questionnaire consisting of 14 items. Each item is scored between 0 (no impairment) and 3 (severe impairment), with 7 items measuring anxiety (e.g., "I get sudden feelings of panic") and 7 items evaluating depression (e.g., "I still enjoy the things I used to enjoy"). Cronbach's alphas are excellent ($α_{T1}$ = 0.82, $α_{T2}$ = 0.83 for anxiety and $α_{T1/T2}$ = 0.86 for depression).

The Posttraumatic Growth Inventory (PTGI, Tedeschi & Calhoun, 1996, translated into French by Cadell et al., 2015) consists of 21 items rated on a scale ranging from 0 (*I did not experience this change*) to 5 (*I experienced this change to a very great degree*). The five PTG domains measured are personal strength, appreciation of life, new possibilities, relationships, and spiritual change. Cronbach's alphas are very satisfactory ($α_{T1}$ = 0.92, $α_{T2}$ = 0.94 for total score; $α_{T1}$ = 0.80, $α_{T2}$ = 0.83 for factor 1; $α_{T1}$ = 0.72, $α_{T2}$ = 0.79 for factor 2; $α_{T1}$ = 0.85, $α_{T2}$ = 0.86 for factor 3; $α_{T1}$ = 0.85, $α_{T2}$ = 0.87 for factor 4; $α_{T1}$ = 0.79, $α_{T2}$ = 0.84 for factor 5).

## 2.5. Statistical analysis

To test the psychometric validity of the CBI and ERRI, confirmatory factor analyses (CFA) were carried out, expecting to obtain the same factorial structures that have been identified by most previous studies. CFAs were conducted separately at T1 (N = 433) and T2 (N = 222) to assess the stability of factor structures over time. Since the CFA tests a predefined model (Brown, 2015), using the same sample to validate two separate scales should not introduce significant bias. Dividing the sample would also have reduced statistical power and compromised the reliability of the estimates (N ≈ 216 at T1 and N = 111 at T2). The fit indices used to assess factor structures were: χ²/df < 3; Comparative Fit Index (CFI) > 0.90; Tucker-Lewis Index (TLI) > 0.90; Standardized Root Mean Square Residual (SRMR) < 0.08 (Hu & Bentler, 1999); and Root Mean Square Error of Approximation (RMSEA) ≤ 0.08 (MacCallum et al., 1996). Longitudinal invariance was then tested to confirm that the scales consistently measured the same construct at T1 and T2. The

<footnote n="1">¹ The longitudinal study comprises a third, ongoing phase, and includes additional variables not analyzed here.</footnote>
internal consistency of the scales was assessed using Cronbach's alpha, and convergent/divergent validity and test-retest reliability using Pearson's or Spearman's correlations (when distributions were non-normal). All analyses were performed using JASP 0.18.3.0 software, except for the longitudinal invariance tests, which were conducted using R software (version 4.4.1).

To explore the direct and indirect effects of disrupted core beliefs and rumination on PTG, the hypothesized structural equation model was tested via AMOS 29. The measured fit indices were identical to those used in previous confirmatory analyses. Bias-corrected bootstrap tests were conducted with a 95% confidence interval to assess the significance of indirect effects (MacKinnon et al., 2004).

# 3. Results

## 3.1. Confirmatory factor analysis (CFA) and longitudinal invariance

The data do not follow a normal distribution (MardiaKurtosis = 13.61, *p* < 0.001 for CBI; MardiaKurtosis = 142.58, *p* < 0.001 for ERRI) and the items are ordinal. We therefore chose to use the maximum likelihood estimation method with robust standard errors (MLR). For the CBI, we first analyzed the one-factor model of the original version. As its fit indices were not satisfactory, two models from exploratory analyses in previous validations were tested: (1) a two-factor model (Portuguese version, Ramos et al., 2016) distinguishing beliefs about predictability and control of events (items 1-2) and beliefs about self, relationships and the future (items 3-9), and (2) a three-factor model (Polish version, Juczyński & Ogińska-Bulik, 2018) separating beliefs about justice, control, and causality of events (items 1-3), beliefs about relationships with other people, one's abilities, and the future (items 4-6), and beliefs about the meaning of one's life, spiritual beliefs, and one's value as a person (items 7-9). This structure can be linked to the model developed by Janoff-Bulman (1992), which distinguishes between three assumptions: "the world makes sense," "the world is benevolent," and "I am a worthy person". Another two-factor model (items 1 to 3 and 4 to 9) was also evaluated, given the strong association of item 3 with factor 1. At T1, this latter model fit the data best (see Table 1). At T2, the fit indices were still satisfactory (χ²(26) = 4.18, *p* < 0.001; CFI = 0.92; TLI = 0.89; RMSEA = 0.12; SRMR = 0.071), except for the RMSEA. It should be noted that the two two-factor models were close-fitting.

For the ERRI, a two-factor CFA model of the original version was conducted. The fit indices confirmed the adequacy of the model at T1 (see Table 1) and T2 (χ²(169) = 2.40, *p* < 0.001; CFI = 0.93; TLI = 0.92;

<table><caption>**Table 1**

Fit Index Value for the different tested models of the CBI and ERRI (N = 433).</caption><thead><tr><th>Model</th><th>df</th><th>χ<sup>2</sup></th><th>χ<sup>2</sup>(df)</th><th>CFI</th><th>TLI</th><th>RMSEA</th><th>SRMR</th></tr></thead><tbody><tr><td>CBI</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>1 factor<br>(original)</td><td>27</td><td>276.06***</td><td>10.22</td><td>0.84</td><td>0.78</td><td>0.146</td><td>0.089</td></tr><tr><td>2 factors<br>(items 1 to<br>2 and 3 to<br>9)</td><td>26</td><td>172.94***</td><td>6.65</td><td>0.90</td><td>0.87</td><td>0.114</td><td>0.071</td></tr><tr><td>2 factors (1<br>to 3 and 4<br>to 9)</td><td>26</td><td>135.07***</td><td>5.20</td><td>0.93</td><td>0.90</td><td>0.098</td><td>0.065</td></tr><tr><td>3 factors (1<br>to 3, 4 to 6,<br>7 to 9)</td><td>24</td><td>132.63***</td><td>5.53</td><td>0.93</td><td>0.89</td><td>0.102</td><td>0.057</td></tr><tr><td>ERRI</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2 factors</td><td>169</td><td>606.08***</td><td>3.59</td><td>0.93</td><td>0.92</td><td>0.077</td><td>0.055</td></tr></tbody></table>

Note. Values from the best-fitting models are in bold. *df* = degrees of freedom; χ² = Chi-Square; CFI = Comparative Fit Index; TLI = Tucker Lewis Index; RMSEA = Root-Mean-Square Error of Approximation; SRMR = Standardized Root Mean Square Residual; CBI = Core Beliefs Inventory; ERRI = Event-Related Rumination Inventory.

*** *p* < 0.001.

RMSEA = 0.08; SRMR = 0.057). However, for both scales, the chi-square test, known for its sensitivity to sample size, was significant, and the adjusted chi-square exceeded 3 (except for ERRI at T2).

Standardized factor loadings for the CBI two-factor model were mostly above 0.40, and those for the ERRI model were all above 0.40 (see Fig. 1 and 2). They were similar and greater than 0.40 at T2 (see Appendix C, Supplementary material). The longitudinal invariance of the CBI and ERRI was confirmed (see Appendix D, Supplementary material).

## 3.2. Internal consistency

The internal consistencies of the CBI total score, factor 1 (items 1 to 3), and factor 2 (items 4 to 9) were satisfactory (αT1 = 0.84, αT2 = 0.88 for the total score; αT1 = 0.71, αT2 = 0.79 for factor 1; αT1 = 0.84, αT2 = 0.88 for factor 2). Those for the ERRI total score, intrusive rumination, and deliberate rumination were excellent (αT1 = 0.93, αT2 = 0.95 for total score; αT1/T2 = 0.96 for intrusive rumination; αT1 = 0.89, αT2 = 0.92 for deliberate rumination).

## 3.3. Convergent and divergent validity

At T1, the factors of the CBI and ERRI were moderately inter-correlated and strongly correlated with the total score (see Table 2). At T2, the factors of the two scales were strongly inter-correlated.

The CBI total score and factor 2 were positively and moderately correlated with TE-related rumination, posttraumatic and anxiety symptoms, and PTG (especially with the *spirituality* subscale). Regarding the total rumination score, correlations were moderate with the CBI total score, Factor 2, posttraumatic stress, anxiety and depressive symptoms, and weak with PTG. More specifically, only intrusive rumination was moderately associated with posttraumatic stress, anxiety and depressive symptoms, while only deliberate rumination was associated with PTG (especially with the *appreciation of life* subscale) (Table 2).

At T2, correlations were stronger between rumination and PTSD (*r* between 0.50 and 0.71), anxiety (*r* between 0.40 and 0.56), and depression (*r* between 0.29 and 0.47), as well as between the ERRI total score, deliberate rumination, and core beliefs (*r* between 0.21 and 0.50). PTG was more strongly associated with the CBI total score (*r* = 0.38), factors 1 and 2 (*r* = 0.25; *r* = 0.39), the ERRI total score (*r* = 0.31), and intrusive and deliberate rumination (*r* = 0.14; *r* = 0.42). Significant links are also observed between PTG dimensions and CBI factor 1.

## 3.4. Test-retest reliability

Correlations between CBI total scores and factor scores, and between ERRI total scores and factor scores, obtained at T1 and T2, were significantly positive and strong.

## 3.5. Mediations

Based on the previously observed correlations, direct effects between cognitive processes and PTG were examined. We then added the path from intrusive rumination at T1 to deliberate rumination at T2 so as to test the theoretical framework of PTG (Tedeschi & Calhoun, 2004). A multiple indirect effects model was established (see Fig. 3). In this model, PTG total score measured at T2 was entered as the outcome variable, CBI factor 2 score at T1 as a predictor, and intrusive rumination at T1 and deliberate rumination at T2 as the mediators. CBI factor 2 was chosen as a predictor because of its stronger correlation with PTG compared to the CBI total score. Perceived threat at the time of the TE was included as a covariate, being associated with CBI factor 2 (*r* = 0.19, *p* < 0.001). The model showed good fit indices: χ²(3) = 0.08, *p* = 0.972; CFI = 1.00; TLI = 1.07; RMSEA = 0.000; SRMR = 0.01.

Several direct effects were significant. Disruption of core beliefs about relationships, self, and the future at T1 had direct effects on
<figure><img src="image_2.png" /><figcaption>Fig. 1 and 2. CBI (1) and ERRI (2) two-factor models (N = 433).</figcaption></figure>

Note. CBI = Core Beliefs Inventory; IR = Intrusive Rumination; DR = Deliberate Rumination.

<caption>Table 2</caption>

Correlations between core beliefs, rumination, distress, and PTG at Time 1 (N = 433).

<table><thead><tr><th></th><th>M</th><th>SD</th><th>1</th><th>2</th><th>3</th><th>4</th><th>5</th><th>6</th><th>7</th><th>8</th><th>9</th></tr></thead><tbody><tr><td>1. CBItotal</td><td>25.7</td><td>10.2</td><td>-</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2. CBI1</td><td>7.07</td><td>4.18</td><td>0.75***</td><td>-</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>3. CBI2</td><td>18.6</td><td>7.54</td><td>0.93***</td><td>0.43***</td><td>-</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>4. ERRItotal</td><td>42</td><td>14.2</td><td>0.35***</td><td>0.17***</td><td>0.37***</td><td>-</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>5. ERRI-IR</td><td>22.7</td><td>8.65</td><td>0.30***</td><td>0.15**</td><td>0.31***</td><td>0.75***</td><td>-</td><td></td><td></td><td></td><td></td></tr><tr><td>6. ERRI-DR</td><td>19.3</td><td>8.22</td><td>0.27***</td><td>0.12*</td><td>0.31***</td><td>0.83***</td><td>0.32***</td><td>-</td><td></td><td></td><td></td></tr><tr><td>7. PTSD</td><td>36.3</td><td>20.9</td><td>0.29***</td><td>0.13**</td><td>0.32***</td><td>0.33***</td><td>0.35***</td><td>0.17***</td><td>-</td><td></td><td></td></tr><tr><td>8. Anxiety</td><td>10.2</td><td>4.69</td><td>0.29***</td><td>0.14**</td><td>0.30***</td><td>0.29***</td><td>0.31***</td><td>0.17***</td><td>0.57***</td><td>-</td><td></td></tr><tr><td>9. Depression</td><td>7.65</td><td>5.01</td><td>0.13**</td><td>0.02</td><td>0.16**</td><td>0.27***</td><td>0.29***</td><td>0.16***</td><td>0.54***</td><td>0.45***</td><td>-</td></tr><tr><td>10. PTG</td><td>47.4</td><td>23.5</td><td>0.27***</td><td>0.09</td><td>0.31***</td><td>0.23***</td><td>0.02</td><td>0.31***</td><td>-0.09</td><td>-0.08</td><td>-0.24***</td></tr><tr><td>11. PTG1</td><td>11.1</td><td>5.65</td><td>0.18***</td><td>0.04</td><td>0.23***</td><td>0.19***</td><td>0.04</td><td>0.24***</td><td>-0.11*</td><td>-0.10*</td><td>-0.22***</td></tr><tr><td>12. PTG2</td><td>9</td><td>4.20</td><td>0.22***</td><td>0.09</td><td>0.25***</td><td>0.21***</td><td>0.03</td><td>0.30***</td><td>-0.15**</td><td>-0.11*</td><td>-0.26***</td></tr><tr><td>13. PTG3</td><td>10.7</td><td>7.35</td><td>0.24***</td><td>0.10*</td><td>0.28***</td><td>0.21***</td><td>0.02</td><td>0.28***</td><td>-0.03</td><td>-0.07</td><td>-0.20***</td></tr><tr><td>14. PTG4</td><td>14</td><td>8.95</td><td>0.18***</td><td>0.07</td><td>0.20***</td><td>0.14**</td><td>-0.04</td><td>0.21***</td><td>-0.11*</td><td>-0.07</td><td>-0.23***</td></tr><tr><td>15. PTG5</td><td>2.63</td><td>3.18</td><td>0.28***</td><td>0.09</td><td>0.34***</td><td>0.24***</td><td>0.11*</td><td>0.28***</td><td>0.10*</td><td>0.07</td><td>0.05</td></tr></tbody></table>

Note. Only correlations involving CBI1, ERRItotal, ERRI-IR, and PTG5 were performed using Spearman's coefficient; CBI = Core Beliefs Inventory; ERRI = Event-Related Rumination Inventory; ERRI-IR = Intrusive Rumination; ERRI-DR = Deliberate Rumination; PTG = Posttraumatic Growth; PTG1 = Personal strength; PTG2 = Appreciation of life; PTG3 = New possibilities; PTG4 = Relationships; PTG5 = Spiritual change.

* *p* < 0.05, ** *p* < 0.01, *** *p* < 0.001.

intrusive rumination at T1, and on deliberate rumination and PTG at T2. Intrusive rumination promoted deliberate rumination, which in turn positively predicted PTG.

Bias-corrected bootstrap tests were conducted with a 95% confidence interval to evaluate the significance levels of the indirect effects. Specifically, 5000 bootstrap samples were created randomly with
<figure><img src="image_3.png" /><figcaption>**Fig. 3.** Multiple indirect effects model (N = 222). *Note.* <sup>a</sup>Factor 2; \* *p* < 0.05, \*\* *p* < 0.01, \*\*\* *p* < 0.001.</figcaption></figure>

replacement from the original dataset. The model was then run 5000 times with these samples, resulting in 5000 estimates for each indirect path coefficient. The results of the bias-corrected bootstrap tests are presented in Table 3. Belief disruption influenced PTG through recent deliberate rumination. To a lesser extent, multiple mediating effects have also been observed: disruption of core beliefs promoted PTG through recent deliberate rumination following past intrusive rumination.

## 4. Discussion

This study's main objective was to validate the French versions of the Core Beliefs Inventory and the Event-Related Rumination Inventory in a sample of people who had experienced at least one traumatic event in their lifetime.

Following confirmatory factor analysis, we found that the model in the original CBI version did not fit the data correctly. Models with two to three factors were then evaluated, based on the results of Ramos et al. (2016) and Juczynski and Oginska-Bulik (2018). The best-fitting model was the two-factor model, similar to that from the exploratory analysis conducted by Ramos et al. (2016), with only one additional item in factor 1. Factor 1 (items 1-3) refers to beliefs about justice, control, and the causality of events, while factor 2 (items 4-9) refers to beliefs about relationships, self, and the future. The first factor is similar to the fundamental "meaning of the world" belief described by Janoff-Bulman (1992). The RMSEA is slightly above 0.08 at T1 and increases at T2, indicating a weaker model fit at the second wave. This increase does not seem to call into question the factor structure, as the longitudinal invariance of both scales has been confirmed. It may be explained by sample characteristics: reduced sample size ($N_{T1} = 433, N_{T2} = 222$), attrition that altered the composition of the group (age, traumatic childhood experiences, anxiety symptomatology), as well as by contextual factors, such as fatigue or a different interpretation of items at T2.

For the ERRI, the original 20-item model divided into two factors

<table><caption>**Table 3**
Bias-corrected bootstrap text on mediating effects (N = 222).</caption><thead><tr><th rowspan="2">Paths</th><th rowspan="2">B</th><th colspan="2">95% CI</th></tr><tr><th>Low</th><th>High</th></tr></thead><tbody><tr><td>Direct paths</td><td></td><td></td><td></td></tr><tr><td>CBI2-IR</td><td>0.25**</td><td>0.10</td><td>0.39</td></tr><tr><td>CBI2-DR</td><td>0.32***</td><td>0.19</td><td>0.45</td></tr><tr><td>CBI2-PTG</td><td>0.23**</td><td>0.10</td><td>0.36</td></tr><tr><td>IR-DR</td><td>0.27**</td><td>0.14</td><td>0.39</td></tr><tr><td>IR-PTG</td><td>-0.05</td><td>-0.18</td><td>0.09</td></tr><tr><td>DR-PTG</td><td>0.34***</td><td>0.20</td><td>0.48</td></tr><tr><td>Indirect paths</td><td></td><td></td><td></td></tr><tr><td>CBI2-IR-PTG</td><td>-0.04</td><td>-0.19</td><td>0.06</td></tr><tr><td>CBI2-DR-PTG</td><td>0.37***</td><td>0.17</td><td>0.63</td></tr><tr><td>CBI2-IR-DR-PTG</td><td>0.08**</td><td>0.02</td><td>0.18</td></tr></tbody></table>

*Note.* CI = Confidence interval; CBI2 = Core Beliefs Inventory Factor 2; IR = Intrusive Rumination; DR = Deliberate Rumination; PTG = Posttraumatic Growth.

(intrusive & deliberate rumination) was valid, as it was for other translations. Similarly to the Georgian version (Khechuashvili, 2019), the chi-square was significant and the normed chi-square was greater than 3, which may be explained by its sensitivity to sample size.

Mean CBI score was identical or very close (with a difference of approximately one point) to that observed in previous research (e.g., de Moura et al., 2020; Ramos et al., 2016; Romeo et al., 2022). Additionally, participants reported more intrusive rumination than deliberate rumination, supporting data from Khechuashvili (2019) and Ramos et al. (2015). The scores obtained on both scales (CBI & ERRI) were nevertheless higher than those reported in the initial studies (Cann et al., 2010; Cann et al., 2011). This difference could be explained by the time elapsed since the event, which was greater in our study. Indeed, research shows that time elapsed since the event is positively associated with PTG, possibly through attenuation of the negative effects of trauma (Grace et al., 2015), and could therefore promote higher scores on the CBI and ERRI. In addition, the type of event reported by participants could play a role in scores obtained on both scales. Indeed, around 26% of our participants reported experiencing interpersonal violence (< 5% in studies by Cann et al.). Psychological distress is higher after this type of event compared with other TEs (Kessler et al., 2017), which could explain why our sample reported higher disruption of core beliefs and rumination. Regarding posttraumatic growth, the Personal Strength and Appreciation of life dimensions appeared to be the most prominent, similarly to Ramos et al.'s study (2016). A possible explanation for this could be that in individualistic societies, PTG may manifest itself more at the individual level, leading to more feelings of personal strength than in collectivist cultures (Kashyap & Hussain, 2018).

The psychometric properties of the scales were assessed. Their reliability was good. The CBI's Cronbach's alpha was similar to the original version (Cann et al., 2010) and to versions in other languages (Barzegari-Soltan-Ahmadi et al., 2022; de Moura et al., 2020; Ramos et al., 2016). The alphas for intrusive and deliberate rumination were also similar to the original version (Cann et al., 2011). The alphas for deliberate rumination were slightly lower than in the translated versions. Convergent validity was demonstrated by moderate positive correlations between (1) CBI scores, rumination, and perceived distress, (2) intrusive rumination and distress, and (3) CBI scores, deliberate rumination, and PTG. Other researchers (Barzegari-Soltan-Ahmadi et al., 2022; de Moura et al., 2020) have observed moderate relationships between these variables. In contrast, factor 1 of the translated CBI was not associated with PTG in our study. According to Juczynski and Oginska-Bulik (2018), this factor did not predict PTG. As for divergent validity, intrusive rumination and PTG, as well as deliberate rumination and distress were weakly if at all related. This corroborates Allen et al.'s (2022) meta-analysis, concluding that the relationship between intrusive rumination and PTG is not significant, particularly when the time elapsed since the event is greater (Romeo et al., 2025). In fact, intrusive rumination is primarily associated with PTSD, while deliberate rumination focused on the meaning of the event is supportive of PTG (Oginska-Bulik & Juczynski, 2015). The relationships between rumination and distress, as well as rumination and growth were stronger at T2, suggesting that recent rumination ("over the last few months") would be a more reliable indicator of growth (Romeo et al., 2025). Moreover, engagement in cognitive processes could be greater over time, since we found stronger correlations between disruption of core beliefs, rumination, and growth in our T2 sample, which also reported less anxiety than our T1 sample.

A secondary objective was to explore the direct and indirect long-term effects of core beliefs and rumination on PTG. Using multiple mediation analyses, our study replicated the results of existing cross-sectional research (e.g., Zhou et al., 2015). More specifically, core beliefs (about relationships, the self, and the future) at T1 and deliberate rumination at T2 had a direct positive effect on PTG at T2, while intrusive rumination at T1 had no effect. Indirect effects have been observed: disruption of core beliefs promoted PTG through recent

<footnote>\* *p* < 0.05, \*\* *p* < 0.01, \*\*\* *p* < 0.001.</footnote>
deliberate rumination (mediating effect) and through recent deliberate rumination following past intrusive rumination (multiple mediating effects). Only recent deliberate rumination had a moderate indirect effect.

Consistent with the PTG model, our results showed that the disruption of core beliefs following an event triggers "cognitive engagement" characterized by intrusive rumination (Tedeschi et al., 2015), a catalyst for meaning-seeking behaviors that help individuals engage in more controlled rumination (Tedeschi et al., 2018). This deliberate long-term rumination is a major predictor of PTG. Its presence suggests an ongoing process of reconstruction of the individual's representations of the world (Henson et al., 2021). Although some theories model rumination as essentially maladaptive, it can, in the context of PTG, play an adaptive role, with its posttraumatic effects varying depending on its form. Indeed, a recent study (Mertens et al., 2025) incorporating different styles of rumination showed that depressive rumination, intrusive rumination, and deliberate rumination were all associated with increased PTSD severity, but that deliberate rumination was also strongly related to PTG.

## 4.1. Therapeutic implications

Given the importance of cognitive processing in PTG, focusing on these processes in psychotherapy by integrating elements of intervention from Cognitive and Behavioral, Narrative, Interpersonal and Existential Therapies, would support patients' understanding about their core beliefs, the meaning of events and their purpose in life, and help them go beyond a simple decrease of their posttraumatic symptoms (Tedeschi & Moore, 2021). In particular, the shift from intrusive to deliberate rumination could be facilitated by mindfulness-based interventions, which encourage non-judgmental attention to thoughts, emotions, and sensations associated with the event, as well as stepping back and even re-evaluating the experience (Tedeschi & Blevins, 2015). Indeed, a recent meta-analysis (Badaghi et al., 2024) supports the positive effect of mindfulness-based interventions on PTG. It would therefore be interesting to explore the relationship between mindfulness and the cognitive processes that can lead to PTG.

## 4.2. Limitations

Our study has several limitations. The generalizability of the results is limited. Indeed, the sample consisted exclusively of individuals exposed to at least one traumatic event in their lifetime (DSM-5 criterion A), of whom 52.6% at T1 and 33.3% at T2 screened positive for PTSD, although a minority of participants (6.5%) were recruited from health-care centers. The majority of participants therefore belonged to a clinical population at T1. This composition makes it difficult to extend the results to non-clinical populations exposed to highly stressful events. It is necessary to consider that construct validity may differ depending on the clinical severity of the studied population. In addition, several characteristics of the sample may influence how processes are reported. The high proportion of women with a high level of education may affect understanding of the items and response styles. The significant average time lapse since the TE is also likely to alter the nature and intensity of disrupted beliefs and ruminations, which could influence psychometric results. Finally, online recruitment excludes people without Internet access, who often have different sociodemographic profiles. These factors must be taken into account when interpreting the results and constitute limitations regarding the generalization and applicability of the tools in other contexts or populations (e.g., individuals recently exposed to trauma, without symptoms).

The results at T2 are not generalizable to all participants either, with those who completed T2 differing from those who only participated at T1 (older, less likely to have experienced TE during childhood, and less anxious). Victims of childhood trauma were more likely to disengage from the study at T2, possibly due to the type of TE, sexual abuse being

the most frequently mentioned within our sample. Childhood sexual abuse is associated with elevated risks of long-term psychosocial, psychiatric, and physical health outcomes (Hailes et al., 2019).

Additionally, self-assessments may be sensitive to social desirability, particularly the PTGI, which is associated with cognitive biases that may lead participants to overestimate perceived growth or even report an illusory PTG (Gower et al., 2022). The construct validity of PTG remains controversial: its retrospective assessment may not capture authentic and truthful growth. PTG reports may reflect a coping mechanism to reduce distress and maintain a positive self-image (Gendre et al., 2025). These findings should therefore be interpreted with caution. Also, retrospective recall of TEs can be complex, as shown by the fact that 15% of participants changed their TE at T2 despite being explicitly asked to re-describe the event mentioned at T1. These participants were exposed to a greater number of TEs and were more likely to choose a TE that occurred during childhood. They were excluded, but this observation highlights the instability of early event recall over time, paving the way for future research to improve the design of longitudinal studies. In view of certain differences between the T1 and T2 groups, the relationships between the variables may have been over- or underestimated. Studies conducted in heterogeneous samples would be relevant to confirm our results. According to a keyword-based analysis (Yang et al., 2023), the relationship between growth and rumination is a topic for further research.

## Data availability

The dataset are available on Open Science Framework, https://osf.io/ae3nu/ The analysis code is available upon reasonable request of the corresponding author.

## Ethics approval and consent to participate

All procedures performed in this study involving human participants were in accordance with the ethical standards and have been approved by the ethics committee of the University of Toulouse and with the Helsinki Declaration. Informed consent was obtained from all the participants included in this study.

## Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

## CRediT authorship contribution statement

**Emma Gendre:** Writing – original draft, Visualization, Methodology, Investigation, Formal analysis, Data curation, Conceptualization.
**Andrea Soubelet:** Writing – review & editing, Supervision, Methodology, Conceptualization.
**Charlotte Henson:** Writing – review & editing.
**Stacey Callahan:** Writing – review & editing, Supervision, Methodology, Conceptualization.

## Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

## Acknowledgments

We would like to thank the organizations and associations for disseminating the study, and especially the participants in this research.
## Supplementary materials

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.jadr.2025.100990.

## References

Ahn, H.N., Joo, H.S., Sim, K.S., Min, J.W., 2013. Validation of the event related ruminative inventory in a Korean population. Cogn. Behav. Ther. Korea. 13, 149-172.

Allen, N., Hevey, D., Cogley, C., O'Keeffe, F., 2022. A meta-analysis of the association between event-related ruminative and posttraumatic growth: The Event-Related Ruminative Inventory and the Posttraumatic Growth Inventory. J. Trauma Stress. 35 (6), 1575-1585. https://doi.org/10.1002/fts.22875.

Alzugaray, C., García, F.E., Reyes, A., Alvarez, R., 2015. Propiedades psicométricas de una versión breve de la escala de ruminación relacionada a un evento en población Chilena afectada por eventos altamente estresantes [Psychometric properties of a short form of the event related ruminative inventory in Chilean population affected by stressful events]. Ajayu Órgano De Difusión Científica Del Departamento De Psicología UCBSP. 13 (2), 183-198.

American Psychiatric Association., 2022. Trauma- and stressor-related disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev., pp. 295-329). American Psychiatric Publishing. https://doi.org/10.1176/appi.book.9 780890425787.x07_Trauma_and_Stressor_Related_Disorders.

Ashbaugh, A.R., Houle-Johnson, S., Herbert, C., El-Hage, W., Brunet, A., 2016. Psychometric validation of the English and French versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLOS ONE. 11 (10), e0161645. https:// doi.org/10.1371/journal.pone.0161645.

Badaghi, N., Buskbjerg, C., Kwakkenbos, L., Bosman, S., Zachariae, R., Speckens, A., 2024. Positive health outcomes of mindfulness-based interventions for cancer patients and survivors: A systematic review and meta-analysis. Clin. Psychol. Rev. 114, 102505. https://doi.org/10.1016/j.cpr.2024.102505.

Barzegari-Soltan-Ahmadi, M., Yaghubi, H., Gholami-Fesharaki, M., 2022. A validity and reliability study on the Persian version of the Core Beliefs Inventory (CBI). Int. J. Behav. Sci. 15 (4), 256-260. https://doi.org/10.30491/jjbs.2022.293742.1602.

Beck, C.T., Rivera, J., Gable, R.K., 2017. A mixed-methods study of vicarious posttraumatic growth in certified nurse-midwives. J. Midwifery. Women. Health. 62 (1), 80-87. https://doi.org/10.1111/jmwh.12523.

Brown, T.A., 2015. Confirmatory Factor Analysis for Applied Research, 2nd ed. Guilford Press.

Cadell, S., Suarez, E., Hemsworth, D., 2015. Reliability and validity of a French version of the Posttraumatic Growth Inventory. Open. J. Med. Psychol. 4 (2), 53-65. https:// doi.org/10.4236/ojmp.2015.42006.

Calhoun, L.G., Tedeschi, R.G., 2012. Posttraumatic Growth in Clinical Practice. Routledge. https://doi.org/10.4324/9780203629048.

Cann, A., Calhoun, L.G., Tedeschi, R.G., Kilmer, R.P., Gil-Rivas, V., Vishnevsky, T., Danhauer, S.C., 2010. The Core Beliefs Inventory: A brief measure of disruption in the assumptive world. Anxiety Stress Coping. 23 (1), 19-34. https://doi.org/ 10.1080/106158008002573013.

Cann, A., Calhoun, L.G., Tedeschi, R.G., Triplet, K.N., Vishnevsky, T., Lindstrom, C.M., 2011. Assessing posttraumatic cognitive processes: The Event Related Ruminative Inventory. Anxiety Stress Coping. 24 (2), 137-156. https://doi.org/10.1080/ 10615806.2010.529901.

Choi, S., In, H., 2020. Paths from core belief disruption to post-traumatic stress symptoms and post-traumatic growth among Korean undergraduates: The mediating role of ruminative. Int. J. Psychol. 55 (2), 215-223. https://doi.org/10.1002/ijop.12578.

Chukwuorji, J.C., Ifeagwazi, C.M., Eze, J.E., 2019. Event centrality influences posttraumatic stress disorder symptoms via core beliefs in internally displaced older adults. Aging. Ment. Health. 23 (1), 113-121. https://doi.org/10.1080/ 13607863.2017.1396580.

Chukwuorji, J.C., Ifeagwazi, C.M., Eze, J.E., 2018. Prolonged grief disorder symptoms in bereaved internally displaced Tiv persons in Nigeria: Associations with ruminative, rebirth concerns and gender. Ment. Health. Relig. Cult. 21 (6), 549-563. https://doi. org/10.1080/13674676.2018.1505838.

da Silva, T.L.G., Donat, J.C., Gauer, G., Kristensen, C.H., 2016. Posttraumatic growth measures: Translation and adaptation of three self-report instruments to Brazilian Portuguese. Archiv. Clinic. Psychiat. (São Paulo). 43 (3), 47-50. https://doi.org/ 10.1590/0101-60830000000083.

de Moura, T.C., Donat, J.C., da Silva, T.L.G., Arteche, A.X., Lisboa, C.S., de, M., Kristensen, C.H., 2020. Validation of the Core Beliefs Inventory (CBI) in Brazilian Portuguese. Trend. Psychiatr. Psychother. 41 (4), 409-414. https://doi.org/ 10.1590/2237-6089-2018-0038.

Eze, J.E., Ifeagwazi, C.M., Chukwuorji, J.C., 2020. Core beliefs challenge and posttraumatic growth: Mediating role of ruminative among internally displaced survivors of terror attacks. J. Happiness. Stud. 21 (2), 659-676. https://doi.org/ 10.1007/s10902-019-00105-x.

Freedle, A., Kashubeck-West, S., 2021. Core belief challenge, ruminative, and posttraumatic growth in women following pregnancy loss. Psychol. Trauma. 13 (2), 157-164. https://doi.org/10.1037/tra0000952.supp.

García, F.E., Cova, F., Rincón, P., 2016. Coping, ruminative and posttraumatic growth in people affected by an earthquake. Psicothema. 28 (1), 59-65. https://doi.org/ 10.7334/psicothema2015.100.

Gendre, E., Soubelet, A., Callahan, S., 2025. What doesn't kill me makes me stronger": Constructive or illusory posttraumatic growth? Acta. Psychol. 258, 105274. https:// doi.org/10.1016/j.acptsy.2025.105274.

Gower, T., Pham, J., Jouriles, E.N., Rosenfield, D., Bowen, H.J., 2022. Cognitive biases in perceptions of posttraumatic growth: A systematic review and meta-analysis. Clin. Psychol. Rev. 94, 102159. https://doi.org/10.1016/j.cpr.2022.102159.

Grace, J., Kinsella, E., Muldoon, O., Fortune, D., 2015. Post-traumatic growth following acquired brain injury: A systematic review and meta-analysis. Front. Psychol. 6. https://doi.org/10.3389/fpsyg.2015.01162.

Hailes, H.P., Yu, R., Danese, A., Fazel, S., 2019. Long-term outcomes of childhood sexual abuse: An umbrella review. Lancet. Psychiat. 6 (10), 830-839. https://doi.org/ 10.1016/S2215-0366(19)30286-X.

Hammer, C., Podlog, L., Wadey, R., Galli, N., Forber-Pratt, A.J., Newton, M., 2019. From core belief challenge to posttraumatic growth in para sport athletes: Moderated mediation by needs satisfaction and deliberate ruminative. Disabil. Rehabil. 41 (20), 2403-2411. https://doi.org/10.1080/09638288.2018.1466203.

Henson, C., 2022. *The process of posttraumatic growth in firefighters: A French-American comparison.* Doctoral dissertation. Bourgogne Franche-Comté University. HAL. https://theses.hal.science/tel-04051888.

Henson, C., Truchot, D., Canefvello, A., 2021. What promotes post traumatic growth? A systematic review. Eur. J. Trauma Dissociat. 5 (4), 100195. https://doi.org/ 10.1016/j.ejtd.2020.100195.

Hu, L., Bentler, P.M., 1999. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equ. Model. 6 (1), 1-55. https://doi.org/10.1080/10705519909540118.

Janoff-Bulman, R., 1992. Shattered Assumptions: Towards a New Psychology of Trauma. Free Press.

Jo, S.M., 2012. *The causal relationship of cognitive factors, social support and resilience on youth's posttraumatic growth* [Unpublished master's thesis]. Pusan National University.

Juczyński, Z., Oginiśka-Bulik, N., 2018. The importance of core beliefs in the process of posttraumatic adaptation – the Polish adaptation of the Core Beliefs Inventory. Adv. Psychiatry. Neurol./Postepy Psychiatry. Neurol. 27 (2), 102-119. https://doi.org/ 10.5114/ppn.2018.77211.

Kashyap, S., Hussain, D., 2018. Cross-cultural challenges to the construct "posttraumatic growth". J. Loss Trauma. 23 (1), 51-69. https://doi.org/10.1080/ 15325024.2017.1422234.

Kessler, R.C., Aguilar-Gaxiola, S., Alonso, J., Benjet, C., Bromet, E.J., Cardoso, G., Degenhardt, L., de Girolamo, G., Dinolova, R.V., Ferry, F., Florescu, S., Gureje, O., Haro, J.M., Huang, Y., Karam, E.G., Kawakami, N., Lee, S., Lepine, J.-P., Levinson, D., Navarro-Mateu, F., Pennell, B.-E., Piazza, M., Posada-Villa, J., Scott, K. M., Stein, D.J., Ten Have, M., Torres, Y., Viana, M.C., Petukhova, M.V., Sampson, N. A., Zaslavsky, A.M., Koenen, K.C., 2017. Trauma and PTSD in the WHO World Mental Health Surveys. Eur. J. Psychotheriatomat. 8 (sup5), 1353383. https://doi.org/ 10.1080/20008198.2017.1353383.

Khechuashvili, L., 2019. From rumination to generativity: The mediation effect of posttraumatic growth. J. Loss Trauma. 24 (2), 177-195. https://doi.org/10.1080/ 15325024.2018.1560903.

Koenen, K.C., Ratanatharathorn, A., Ng, L., McLaughlin, K.A., Bromet, E.J., Stein, D.J., Karam, E.G., Meron Ruscio, A., Benjet, C., Scott, K., Atwoli, L., Petukhova, M., Lim, C.C.W., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Bunting, B., Ciutan, M., De Girolamo, G., Degenhardt, L., Gureje, O., Haro, J.M., Huang, Y., Kawakami, N., Lee, S., Navarro-Mateu, F., Pennell, B.-E., Piazza, M., Sampson, N., ten Have, M., Torres, Y., Viana, M.C., Williams, D., Xavier, M., Kessler, R.C., 2017. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol. Med. 47 (13), 2260-2274. https://doi.org/10.1017/S0033291717000708.

Lépine, J.-P., Godchaux, M., Brun, P., Lempérière, Th. 1985. Évaluation de l'anxiété et de la dépression chez des patients hospitalisés dans un service de médecine interne. [Anxiety and depression evaluation in patients hospitalized in an internal medicine unit.]. Annales. Médico-Psychologique. 143 (2), 175-189.

Lianchao, A., Tingting, M., 2020. Mindfulness, ruminating and post-traumatic growth in a Chinese cancer sample. Psychol. Health Med. 25 (1), 37-44. https://doi.org/ 10.1080/13548506.2019.1612079.

Lindstrom, C.M., Cann, A., Calhoun, L.G., Tedeschi, R.G., 2013. The relationship of core belief challenge, ruminative, disclosure, and sociocultural elements to posttraumatic growth. Psychol. Trauma. 5 (1), 50-55. https://doi.org/10.1037/a0022030.

Liu, J., Wei, S., Qiu, G., Li, N., Wang, D., Wu, X., Gan, X., Yi, H., 2023. Relationship between ruminative and post-traumatic growth in mobile cabin hospital nurses: The mediating role of psychological resilience. Prev. Med. Rep. 34, 102266. https://doi. org/10.1016/j.pmed.2023.102266.

MacCallum, R.C., Browne, M.W., Sugawara, H.M., 1996. Power analysis and determination of sample size for covariance structure modeling. Psychol. Meth. 1 (2), 130-149. https://doi.org/10.1037/1082-989X.1.2.130.

MacKinnon, D.P., Lockwood, C.M., Williams, J., 2004. Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivar. Behav. Res. 39 (1), 99-128. https://doi.org/10.1207/s15327906mr3901_4.

Mertens, L., Tamm, G., Hoorelbeke, K., 2025. Ruminative thinking styles differentially relate to posttraumatic stress versus trauma following trauma exposure. Psychol. Trauma. https://doi.org/10.1037/tra0001969.

Ogińska-Bulik, N., Bąk, G., 2023. Predictors of secondary posttraumatic growth among police officers exposed to secondary trauma. J. Police. Crim. Psychol. 38, 996-1004. https://doi.org/10.1007/s11896-023-09586-2.

Ogińska-Bulik, N., Juczyński, Z., 2015. Inwentarz Ruminacji o Negatywnym Zdarzeniu-Polska adaptacja the Event Related Ruminative Inventory [The Polish adaptation of the Event Related Ruminative Inventory]. Przeglad Psychol. 58 (3), 383-400.
Ramos, C., Figueiras, L., Lopes, M., Leal, I., Tedeschi, R.G., 2015. Inventário de ruminação relacionada com o acontecimento: Qualidades psicométricas na população portuguesa [Event Related Rumination Inventory: Psymetric properties on a Portuguese sample]. Psicologia, Saúde. E. Doenças. 16 (3), 299-310. https://doi.org/10.15309/15psd160303.

Ramos, C., Figueiras, L., Lopes, M., Leal, I., Tedeschi, R.G., 2016. Core Beliefs Inventory: Factor structure and psychometric properties on a Portuguese sample. Psicologia, Saúde & Doença 17 (2), 120-131. https://doi.org/10.15309/16psd170202.

Romeo, A., Castelli, L., Zara, G., Di Tella, M., 2022. Posttraumatic growth and posttraumatic depreciation: Associations with core beliefs and rumination. Int J. Environ. Res. Public Health. 19 (23), 15938. https://doi.org/10.3390/ijerph192315938.

Romeo, A., Molinengo, G., Di Tella, M., Loera, B.L., 2025. The Event-Related Rumination Inventory: How does scale validity change with time instructions? J Loss. Trauma. 30 (3), 330-350. https://doi.org/10.1080/15325024.2024.2374729.

Seliniotaki, T., Koumarianou, A., Bacopoulou, F., Vlachakis, D., Chrousos, G.P., Darviri, C., 2021. Event-Related Rumination Inventory: A validation process in the Greek language. In: Vlamos, P. (Ed.), GeNeDis 2020. Springer International Publishing, pp. 149-158. https://doi.org/10.1007/978-3-030-78771-4_17.

Taku, K., Cann, A., Tedeschi, R.G., Calhoun, L.G., 2015. Core beliefs shaken by an earthquake correlate with posttraumatic growth. Psychol. Trauma. 7 (6), 563-569. https://doi.org/10.1037/tra0000054.

Taku, K., Tedeschi, R.G., Shakespeare-Finch, J., Krosch, D., David, G., Kehl, D., Grunwald, S., Romeo, A., Tella, M.D., Kamibeppu, K., Soejima, T., Hiraki, K., Volgin, R., Dhakal, S., Zięba, M., Ramos, C., Nunes, R., Leal, I., Gouveia, P., Silva, C. C., Núñez Del Prado Chaves, P., Zavala, C., Pazo, A., Senol-Durak, E., Oshio, A., Canevello, A., Cann, A., Calhoun, L.G., 2021. Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across ten countries: Global validation of the PTG-PTD theoretical model. Personal. Individ. Differ. 169, 110222. https://doi.org/10.1016/j.paid.2020.110222.

Tedeschi, R.G., Blevins, C.L., 2015. From mindfulness to meaning: Implications for the theory of posttraumatic growth. Psychol. Inq. 26 (4), 373-376. https://doi.org/10.1080/1047840X.2015.1075354.

Tedeschi, R.G., Calhoun, L.G., 1996. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. J. Trauma. Stress. 9 (3), 455-471. https://doi.org/10.1007/BF02103658.

Tedeschi, R.G., Calhoun, L.G., 2004. Posttraumatic growth: Conceptual foundations and empirical evidence. Psychol. Inq. 15 (1), 1-18. https://doi.org/10.1207/s15327965pli1501_01.

Tedeschi, R.G., Calhoun, L., Groleau, J., 2015. Clinical applications of posttraumatic growth. In: Joseph, S. (Ed.), Positive Psychology in Practice: Promoting Human Flourishing in Work, Health, Education, and Everyday Life, 2nd ed., Wiley, pp. 503-518. https://doi.org/10.1002/9781118996874.

Tedeschi, R.G., Moore, B.A., 2021. Posttraumatic growth as an integrative therapeutic philosophy. J. Psychother. Integr. 31 (2), 180-194. https://doi.org/10.1037/int0000250.

Tedeschi, R.G., Shakespeare-Finch, J., Taku, K., Calhoun, L.G., 2018. Posttraumatic Growth: Theory, Research, and Applications. Routledge. https://doi.org/10.4324/9781315527451.

Vallerand, R.J., 1989. Vers une méthodologie de validation trans-culturelle de questionnaires psychologiques: Implications pour la recherche en langue française [Toward a methodology for the transcultural validation of psychological questionnaires: Implications for research in the French language]. Can. Psychol. /Psychol. Can. 30 (4), 662-680. https://doi.org/10.1037/h0079856.

Wang, F., Zhang, S., Liu, C., Ni, Z., 2023. Post-traumatic growth and influencing factors among parents of premature infants: A cross-sectional study. BMC Psychol. 11 (1), 388. https://doi.org/10.1186/s40359-023-01360-7.

Wang, W., Wu, X., Lan, X., 2020. Rumination mediates the relationships of fear and guilt to posttraumatic stress disorder and posttraumatic growth among adolescents after the Ya'an earthquake. Eur. J. Psychotheriatol. 11 (1), 1704993. https://doi.org/10.1080/20008198.2019.1704993.

Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). *The Life Events Checklist for DSM-5 (LEC-5)*. Instrument available from the National Center for PTSD at www.ptsd.va.gov.

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). *The PTSD Checklist for DSM-5 (PCL-5)*. Scale available from the National Center for PTSD at www.ptsd.va.gov.

Wells, A., Papageorgiou, C., 2003. Metacognitive therapy for depressive rumination. In: Papageorgiou, C., Wells, A. (Eds.), Depressive Rumination. Wiley, pp. 259-273. https://doi.org/10.1002/9780470713853.ch13.

Wu, X., Zhou, X., Wu, Y., An, Y., 2015. The role of rumination in posttraumatic stress disorder and posttraumatic growth among adolescents after the Wenchuan earthquake. Front. Psychol. 6. https://doi.org/10.3389/fpsyg.2015.01335.

Yang, K., Lu, J., Duan, L., Tang, H., Bao, Z., Liu, Y., Jiang, X., 2023. Research hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords. Int. J. Nurs. Sci. 10 (2), 268-275. https://doi.org/10.1016/j.ijnss.2023.03.001.

Zhou, X., Wu, X., 2016. The relationship between rumination, posttraumatic stress disorder, and posttraumatic growth among Chinese adolescents after earthquake: A longitudinal study. J. Affect. Disord. 193, 242-248. https://doi.org/10.1016/j.jad.2015.12.076.

Zhou, X., Wu, X., Fu, F., An, Y., 2015. Core belief challenge and rumination as predictors of PTSD and PTG among adolescent survivors of the Wenchuan earthquake. Psychol. Trauma. 7 (4), 391-397. https://doi.org/10.1037/tra0000031.

Zigmond, A.S., Snaith, R.P., 1983. The Hospital Anxiety and Depression Scale. Acta. Psychiatr. Scand. 67 (6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.