The Other Side of Suffering: Posttraumatic Growthamong Internally Displaced Persons in Ukraine
Reo Morimitsu
October 2019
This dissertation is submitted in partial fulfilment of the MA degree in Development and Emergency Practice,
Oxford Brookes University.

Abstract
The main purpose of this study was to build a better understanding of potentially positive
aspects of displacement experiences by examining a phenomenon called posttraumatic
growth. The research was conducted with internally displaced persons (IDPs) in Ukraine, inthe context of an armed conflict. The study was particularly interested in uncovering
whether posttraumatic growth was experienced in the target population, as well as
investigating predictors of the growth. In order to fulfil this, the mixed-methods research
design was selected and both a survey and face-to-face interviews were conducted.
Three key findings were produced in the study. First, the results showed that 61.48% of thesample Ukrainian IDPs reported at least a small or moderate degree of posttraumatic
growth. Interviews with the IDPs provided concrete case studies of positive changes in the
IDPs, which generated knowledge about the process of posttraumatic growth. Specifically,
the growth has emerged through the processes of coping and meaning-making efforts.
Importantly, the level of growth was significantly related to positive well-being of the IDPs.
Second, the study retrospectively examined predictors of posttraumatic growth following
displacement. As a result, two extremely important predictors were found: cognitive
processing and social support during displacement. In particular, positive reinterpretation
and rumination were found as best predictors, with the largest regression coefficients.
These results highlighted that IDPs who were capable of reinterpreting their experiences,making sense of the stressful situations and having access to social support were in the best
position to develop positive changes following displacement.
Third, the research explored context-specific factors that may influence posttraumatic
growth. Two factors appeared to be unique in the context of displacement in Ukraine. One
was social disruption due to political separatism, and the other factor was relocation
experience prior to displacement. Both provided insights for further research.
The main achievement of the study was to draw attention to the potentially positive
aspects of displacement experience, whilst previous work predominantly focused on thenegative psychological consequences of forced migration. The importance of social support
gives empirical evidence that humanitarian practitioners need to strengthen socialinetworks among displaced populations. Moreover, the study suggests that it would bemeaningful if future research works on developing how best clinicians can promote
cognitive reinterpretation and rumination capacity among displaced individuals.

Keywords: posttraumatic growth, displacement, forced migration, IDPii

Statement of Originality
This thesis is the result of my own independent work/investigation, except where otherwise stated. Other
sources are acknowledged by explicit references.

Signed: ……………………………………... (candidate) Date: ……… October 2019

I hereby give consent for my thesis, if accepted, to be available for photocopying and for interlibrary loan,
and for the title and summary to be made available to outside organisations.

Signed: ……………………………………... (candidate) Date: ……… October 2019

Statement of Ethics Review Approval

This dissertation involved human participants. The TDE E1 and E2 Forms for each group of participants,
showing ethics review approval, have been attached to this dissertation appendices.

iii

Table of Contents
Abstract …………………………………………………………………………………….……………………………………. i
Statement of Originality ………………………………………………………………………………………..…… iii
List of Figures and Tables ……………………………………………………………………….…………………….… vi
List of Acronyms ……………………………………………………………………………………………………….…… vii
Acknowledgments ….…………………………………………………………………………………………………. viii
Chapter 1: Introduction ………………………………………………………………………………………….…… 1
1.1. Background of the Research …..…………………………………………………………………………...… 1
1.2. Research Context ………………………………………………………………………………………………..…… 2
1.3. Problem Statement …………………………………………………………………………………………………. 2
1.4. Research Objectives ….…………………………………………………………………………………………..… 3
1.5. Research Questions ….……………………………………………………………………………………………… 3
1.6. Structure of Chapters …………………………………………………………………………………………….… 4
Chapter 2: Literature Review …………………………………………………………………………………….… 5
2.1. Introduction ………………………………………………………………………………………………………….… 5
2.2. Definition and Conceptualisation of Posttraumatic Growth ………………………………………. 5
2.3. Measurement of Posttraumatic Growth ………………………………………………………………..… 7
2.4. Factors Associated with Posttraumatic Growth ………………………………………………………… 8- PTG and demographic factors- PTG and environmental / event-related factors- PTG and social process- PTG and psychological process- PTG and well-being outcomes
Chapter 3: Research Context: Internal Displacement after Conflict in Ukraine ….…. 12
3.1. Introduction ………………………………………………………………………………………………………..… 123.2. Armed Conflict in Ukraine ………………………………………………………………………………….…… 12
3.3. Internally Displaced Persons (IDPs) in Ukraine ………………………………………………………... 14
Chapter 4: Methodology …………………………………………………………………………………………… 18
4.1. Introduction ………………………………………………………………………………………………………..... 18
4.2. Research Design …………………………………………………………………………………………………….. 18
4.3. Data Collection …………………………………………………………………………………………………….... 19
4.3.1. Questionnaire ………………………………………………………………………………………………. 19
4.3.1.1. Participants …………………………………………………………………………………..…… 19iv

4.3.1.2. Procedure …………………………………………………………………………………………. 19
4.3.1.3. Measures ………………………………………………………………………………………..… 20
4.3.2. In-depth Semi-structured Interviews ……………………………………………………………… 23
4.3.2.1. Participants ……………………………………………………………………………………….. 23
4.3.2.2. Procedure ……………………………………………………………………………………….… 23
4.4. Data Analysis …………………………………………………………………………………………………………. 24
4.4.1. Quantitative Analysis …………………………………………………………………………………….. 24
4.4.2. Qualitative Analysis ………………………………………………………………………………………. 25
4.5. Ethics …………………………………………………………………………………………………………………….. 26
4.6. Limitations …………………………………………………………………………………………………………….. 26
Chapter 5: Findings and Discussions ……………………………………..…………………………………… 28
5.1. PTG Reported among IDPs in Ukraine …………………………………………………..………………… 28
5.1.1. Prevalence ……………………………………………………………………………………………………. 28
5.1.2. Case Studies of Positive Changes …………………………………………………………………… 29- Appreciation of Life
- Relating to Others- Personal Strength- Spiritual Changes- New Possibilities
5.1.3. Summary of PTG among IDPs in Ukraine ……………………………………………………….. 34
5.2. Factors Associated with PTG …………………………………………………………………………………… 36
5.2.1. PTG and Demographic Factors ………………………………………………………………………. 36
5.2.2. PTG and Well-being ………………………………………………………………………………………. 39
5.2.3. Correlations between PTG and Other Factors ………………………………………………… 39
5.2.4. Predictors of PTG ….………………………………………………………………………………………. 41
5.2.4.1. Positive Reinterpretation as a Predictor of PTG …………………………………… 42
5.2.4.2. Social Support as a Predictor of PTG …………………………………………………… 43
5.3. Context-specific Factors that may Influence PTG ……………………………………………………. 46
5.3.1. Social Disruption due to Political Divides …………………………………………………….. 46
5.3.2. Relocation and Acculturation Experience prior to Displacement ……….………. 47
Chapter 6: Conclusion ………………………………………………………………………….…………………… 49
Bibliography ………………………………………………………………………………………………………………… 52
Appendices ……………………………………………………………………………………………………………….. 59v

List of Figures and Tables
List of Figures
Figure 1. Forms of posttraumatic growth _______________________________________8
Figure 2. Contact line that divides eastern Ukraine into GCA and NGCA ______________13
Figure 3. Annual conflict-related displacement figures in Ukraine ___________________15
Figure 4. Overview of IDPs in Ukraine _________________________________________15
Figure 5. Histogram of PTG mean scores ______________________________________28
Figure 6. A scatter plot showing no relationship between age and PTG ______________38

List of Tables
Table 1. Summary statistics of PTG scores _____________________________________29
Table 2. Mean Scores and SD for PTG per Gender _______________________________36
Table 3. ANOVA: Effect of Current Residence Place on PTG Scores __________________36
Table 4. ANOVA: Effect of Place of Origin on PTG Scores __________________________37
Table 5. Mean Scores and SD for PTG per Marital Status __________________________37
Table 6. ANOVA: Effect of Marital Status on PTG Scores __________________________37
Table 7. Mean Scores and SD for PTG per educational Level _______________________38
Table 8. Means (SD) and Pearson’s correlation r between PTG and well-being _________39
Table 9. Means (SD) and Pearson’s correlation r between PTG and potentially related
factors _________________________________________________________________40
Table 10. Results of Multiple Linear Regression Predicting PTG: Model 1 _____________41
Table 11. Results of Multiple Linear Regression Predicting PTG: Model 2 _____________41viList of Acronyms

GCA

Government-controlled area

IDMC

Internal Displacement Monitoring Centre

IDP

Internally displaced person

IFRC

International Federation of Red Cross and Red Crescent Societies

NGCA

Non-government controlled area

OCHA

United Nations Office for the Coordination of Humanitarian Affairs

OHCHR

Office of the United Nations High Commissioner for Human Rights

OSCE

Organization for Security and Co-operation in Europe

PTG

Posttraumatic growth

PTSD

Posttraumatic stress disorder

UN

United Nations

UNHCR

United Nations High Commissioner for RefugeesviiAcknowledgements
I would first like to express my sincere gratitude to my supervisor Dr Supriya Akerkar, notonly for her insightful guidance on this research but also her practical and emotional
support over many months. Her positivity, reassurance and sense of humour have been
truly a driving force for me, particularly at difficult times.
My earnest appreciation goes to the Ukrainian Red Cross National Committee. Without
their kindness, I would never have been able to reach the participants in this research andfulfil this dissertation.
Special thanks to my translator Mariia. She generously shared her time with this research,helped me communicate with the participants and gave me valuable insights into thecontext of Ukraine.
I would also like to thank my friend Catherine Shkvarska – a wonderful woman who not
only helped me develop a questionnaire in the Ukrainian language but also gave me a space
to feel as if I was still a part of a community in Ukraine with her hospitality.
A big hug to the CENDEP family and my course mates there. I was lucky to be in such a
warm, inclusive and multi-cultural atmosphere, which shaped me to see myself as a global
citizen. I am going to miss our interesting and long-lasting chats.
Finally, I would like to express my deepest gratitude to my family who have gone through allof this resettlement process over the last few years with me. I am proud of my children,
Sota and Riko, who showed incredible capacity to adapt to new environments. Their
resilience always encouraged me to stay tough and move forward. And lastly, a very special
appreciation goes to my beloved wife, Akiko who has been the best supporter for me eversince the first moments when I decided to study abroad. Thanks for believing in me all thetime.
October 2019
Reo Morimitsu

viiiChapter 1: Introduction

Chapter 1
Introduction
1.1. Background of the Research
It is widely assumed that when catastrophic events such as war, disaster, genocide and/or
conflict happen, they cause human suffering on affected populations. The world has seen
tremendous amounts of human suffering; disasters have killed over one million people
during 2004-2013 (IFRC, 2016) and there have been 25.4 million refugees and 3.1 million
asylum seekers reported in the world in 2017 (UNHCR, 2017). This existence of humansuffering has been one of the fundamental motives for humanitarian organisations toprovide help to affected populations (Riddell, 2008). The International Federation of Red
Cross and Red Crescent Societies (IFRC) for example, states that their mission is “to prevent
and alleviate human suffering wherever it may be found” (IFRC, no date). Therefore,
responding to human suffering and preventing subsequent negative consequences on
affected individuals have been placed at the centre of humanitarian practice.
The negative consequences of devastating life events have been well studied in social andbehavioural science, particularly in the field of traumatic stress and trauma psychology.
Numerous studies have found negative mental health consequences of exposure to difficult
life events such as military combat experience, bereavement, disaster and childhood abuse(Zisook, Chentsova-Dutton and Shuchter, 1998; Binder et al., 2008; Kessler et al., 2008;
Pugh et al., 2014). The majority of such studies have relied predominantly on pathology
focusing on mental health symptoms such as anxiety, depression and posttraumatic stressdisorder (PTSD).
However, recent studies have drawn attention to ‘the other side’ of such human suffering.
Namely, there has been a growing recognition that some people grow and develop positive
personal changes despite their highly challenging life situations (Calhoun and Tedeschi,2014). This phenomenon is known as posttraumatic growth (PTG). PTG is not entirely a newthing. The idea that suffering can be a source of personal growth has been widely

１Chapter 1: Introduction

recognised in ancient narrative reports, theatre, philosophy and religion (Prati andPietrantoni, 2009). Later, the term posttraumatic growth (PTG) has been defined as a“positive psychological change experienced as a result of the struggle with highly
challenging life circumstances” (Tedeschi and Calhoun, 2004, p.1). Since this idea has been
contrary to the focus of PTSD studies, the emerged concept of PTG has shifted thediscussion and research trends in traumatic studies.
Despite the wide recognition of positive growth following adversity in human history, it was
not until the past 20 years that have PTG been of interest for scientific studies (Prati andPietrantoni, 2009). After the 1990’s, many studies have found PTG in various populations
who experienced highly stressful events. These include chronic illness, cancer, HIV/AIDS,
rape/sexual assault, military combat, plane crashes, bereavement, severe injury (Linley andJoseph, 2004; (Polatinsky and Esprey, 2000; Linley and Joseph, 2004). Similarly, the wave of
PTG which has given more attention to the potentially positive side of human suffering, hasalso reached the discourse of humanitarian studies such as forced migration studies.
Several studies have reported that PTG has been observed in forced migrant populations;for example, in Holocaust survivors (Baker et al, 1983); in Kosovar war refugees (Ai et al,2007); in Bosnian war refugees (Powell et al, 2003). This indicates that growth can occur in
war/conflict-affected population too, despite their vulnerability to poor mental health(Krupinski, Stoller and Wallace, 1973; Liu, Lamanna and Murata, 1979; Bram, 1983; Hitch,1983). These findings, however, are primarily about refugees and asylum seekers (Baker etal, 1983; Ai et al, 2007), and little is known about internally displaced populations.

1.2. Research Context
Following on from the author’s previous work experience in Ukraine with the conflictaffected population, this research attempts to better understand PTG among internallydisplaced persons (IDPs) in Ukraine. Ukraine has seen civil unrest followed by prolonged
armed conflict since late 2013, which has resulted in around 1.4 million IDPs (OCHA, 2015).
Detailed information about the context of the conflict in Ukraine is presented in Chapter 3.

1.3. Problem Statement
Since the field of PTG is still young and open to criticism (Joseph and Butler, 2010), several
２

Chapter 1: Introduction

gaps have been identified in the previous research in relation to PTG among forced
migrants populations. First, many studies focused on pathological symptoms wheninvestigating psychosocial consequences of the forced migration experience (for example,
Krupinski and Docent, 1967; Liu, Lamanna and Murata, 1979; Hitch and Rack, 1980). Second,even in the existing literature regarding PTG, inconsistent findings are found (Linley andJoseph, 2004). This is primarily because previous research in this area has been conductedin various contexts with survivors of different types of traumatic events. Therefore, thefocus of PTG research should be specific, taking into consideration the specific traumatic
context and local culture (Weiss and Berger, 2010). Third, few studies have been foundamong conflict-affected IDPs in terms of PTG. This is particularly true of the target
population of this study. Although hardships that Ukrainian IDPs have gone through are
well-documented (e.g. see Council of Europe, 2014), little is known about what positivechanges they have gained over the course of their experiences.

1.4. Research Objectives
Based on the gaps identified, the general objective of this research is to gain a better
understanding of potentially positive effects of forced migration and resettlement
experience on internally displaced persons (IDPs) in Ukraine by looking into a phenomenon
called posttraumatic growth (PTG).
The specific objectives are to:1) Uncover positive changes occurred among Ukrainian IDPs after 5 years ofdisplacement
2) Examine relationships between PTG and other related factors
3) Generate knowledge about context-specific factor(s) that may influence PTG
4) Provide insights for the humanitarian community supporting IDPs in Ukraine5) Draw attention to the potentially positive legacy of forced migration experiencein the light of human strengths

1.5. Research Questions
In order to better understand the nature of PTG in the study context, two main research

３Chapter 1: Introduction

questions with sub-questions were selected as follows:
1) To what degree is PTG observed among IDPs in Ukraine after 5 years ofdisplacement?
a) What is the prevalence of PTG among IDPs in Ukraine?
b) What positive changes are being reported by IDPs in Ukraine as a result of
displacement?
2) What are the factors influencing PTG among IDPs in Ukraine?
a) Does the level of PTG differ by demographic factors?
b) What environmental factors are associated with PTG?
c) Is social support associated with PTG?
d) Is PTG associated with IDPs’ positive well-being?
e) What are the best predictors of PTG among IDPs in Ukraine?
f) What are the context-specific factors that may influence PTG?

1.6. Structure of Chapters
This research paper is organised into six chapters as follows.
• Chapter 1 begins with an introduction to the research topic. It then states theidentified research gap, leading to the research objectives and questions of thepresent study.
• Chapter 2 provides the theoretical backgrounds of the research topic by reviewing theexisting literature and research related to posttraumatic growth.
• Chapter 3 presents an overview of the research contexts. It outlines the background of
the armed conflict in Ukraine and then describes common experiences of IDPs in
Ukraine.
• Chapter 4 describes the research design and methodology used to address theresearch objectives.
• Chapter 5 reports the empirical research findings related to the research questions set
in Chapter 1.
• Chapter 6 concludes the paper by summarising what the research has achieved andproviding recommendations for further study.

４

Chapter 2: Literature Review

Chapter 2
Literature Review
2.1. Introduction
The purpose of this chapter is to set out the theoretical backgrounds of the research topic in
the present study - a phenomenon called posttraumatic growth (PTG). It attempts toprovide an overview of positive changes that occur as a result of struggling with major life
crises by reviewing the relevant literature related to PTG. The chapter starts with thedefinition and conceptualisation of PTG. It also describes common domains of positivechanges that can be emerged out of suffering. The chapter then introduces the existing
tools for measuring PTG and overviews empirical research findings on factors associatedwith PTG.

2.2. Definition and Conceptualisation of Posttraumatic Growth
Definition of PTG
The term posttraumatic growth (PTG) has been defined as a “positive psychological change
experienced as a result of the struggle with highly challenging life circumstances” (Tedeschi
and Calhoun, 2004, p.1). The phenomenon of psychological growth after human sufferinghas been consistently reported throughout human history in the forms of narrative reports,
arts and religion (Splevins et al., 2010). In addition, scientific research has found empiricalevidence of PTG in various populations who experienced different types of critical life
events/crises. These include chronic illness, cancer, HIV/AIDS, rape/sexual assault, military
combat, plane crashes, bereavement, injury and in the parents of children with disabilities(Calhoun and Tedeschi, 1999; Linley and Joseph, 2004).
Conceptualisation of PTG
The research in this area is characterised by a lack of consistency in terminology.

５Chapter 2: Literature Review“Posttraumatic growth,” “benefit finding,” and “stress-related growth” are the mostfrequently used terminologies to conceptualise positive changes following major life crises
or traumatic events (Joseph and Butler, 2010). Although the growth and benefits thatpeople gain may depend on different contexts. The most commonly reported positivechanges following major life crises include the following 3 areas:
1. Changes in sense of self
2. Changes in sense of relationship with others
3. Changes in philosophy of life (meaning-making, reprioritising, revising life,changed spirituality) (Calhoun and Tedeschi, 1999)
This illustrates that growth after a harsh experience can occur at multiple dimensions within
individuals. It can be occurred at self, interpersonal, cognitive and spiritual levels.
It is worth noting the conceptual differences between PTG and other related concepts.
Perhaps resilience is the concept that most researchers find similarity with PTG. Mitchelland Harris (2012) suggest that resilience is the ability to recover from the effect of adversity
and bounce back to previous functioning levels. In contrast, PTG emphasises changes; itemphasises the transformative process of self that occurs as a result of suffering (Cryder etal., 2006). Although PTG is used to describe positive changes that go beyond the previous
levels, resilience however, refers to bouncing back to the previous status (Clay, Knibbs andJoseph, 2009, p.413). Another related construct is posttraumatic symptoms. Interestingly,
PTG does not prevent from developing such posttraumatic symptoms as PTSD. PTG instead
tends to co-exist with PTSD or other posttraumatic symptoms in survivors of major life
crises (Sleijpen et al, 2016). This implies that PTG and PTSD symptoms are conceptually
distinct, independent to each other and that perceived PTG does not necessarily mean theabsence of posttraumatic symptoms. An individual perhaps needs psychologicaldisturbance prior to their growth. The second generation of Holocaust survivors reports alower level of PTG with less appreciation of life than their parents’ generation who actuallyexperienced the tragic genocide (Baker et al, 1983).

６

Chapter 2: Literature Review

Process of PTG
There has been a range of discussions regarding conceptualising the process of PTG. The
original model of PTG (Calhoun and Tedeschi, 1998; Tedeschi and Calhoun, 2004) suggeststhat the following steps are required for PTG to emerge:
1. Seismic disruptions to one’s world and sense of self
2. Cognitive task of rebuilding views of themselves in a meaningful and coherentway (reconstruction of schema)
3. Recognition of such changes in themselves
4. Attributes such changes to events
This model emphasises a cognitive process that involves the reconstruction of worldview or
self-image after major life crises. Other theories such as Cognitive Adaptation Theory (CAT;
Taylor, 1983) or Terror Management Theory (TMT; Solomon, Greenberg and Pyszczynski,1991) see growth following crises as a part of the defence mechanism to maintain selfesteem over the difficult life event. Consensus therefore is yet to be fully achieved regarding
conceptual issues in this field.

2.3. Measurement of Posttraumatic Growth
Several psychometric instruments to date have been published to measure positive change
after major life crises. Most of them are retrospective self-report measures and developed
during the 1990s with the elaboration of the construct. These measures include theChanges in Outlook Questionnaire (CiOQ: Joseph, Williams and Yule, 1993), thePosttraumatic Growth Inventory (PTGI: Tedeschi and Calhoun, 1996; Short form of PTGI:
Cann et al., 2010) and the Stress-Related Growth Scale (SRGS: Park, Cohen and Murch,
1996), the Perceived Benefit Scales (PBS: McMillen & Fisher, 1998). The two most widelyused measures in the literature are the PTGI and the SRGS. The SRGS however only gives asingle-factor interpretation whereas the PTGI allows the researcher to examine fivedomains of PTG.
Domains of PTG
It is important to mention that the literature review found that PTG has been most７

Chapter 2: Literature Review

commonly measured by the PTGI scale and its shorter form (Short Form of Posttraumatic
Growth Inventory; PTGI-SF; Cann et al., 2010) with a few exceptional studies using SRGS
scale. The original PTGI scale was developed based on the frequently observed positivechanges in the literature and has a five-domain structure as follows:• Relating to Others (RO)• Personal Strength (PS)• New Possibilities (NP)• Spiritual Changes (SC)• Appreciation of Life (AL) (Tedeschi and Calhoun, 1996, p.460; see Figure 1)

Figure1. Forms of posttraumatic growth
Data source: Whole House Counseling & Consultation (no date)

2.4. Factors Associated with Posttraumatic Growth
A number of studies have examined predictors of PTG. They mostly employ a correlational
analysis, looking at the relations between various factors and the self-reported level of PTG.
There seem to be inconsistent findings in terms of predictors of PTG in the literature. This isprobably because the field is still young (Joseph and Butler, 2010) and because previous

８Chapter 2: Literature Review

studies were conducted in a wide range of contexts (e.g. types of events) and samples (e.g.
ethnicity and geographic locations). Mindful to this inconsistency, this literature review
section primarily focuses on meta-analytic studies and systematic reviews to gain a better
understanding of the contributing factors of PTG.
PTG and demographic factors
A meta-analysis of 87 studies found that women and racial and ethnic minorities tend toreport more PTG than men and white-individuals whilst marital status and socioeconomic
status were not correlated with PTG (Helgeson, Reynolds and Tomich, 2006). Younger age isanother demographic factor associated with higher levels of PTG. Little is yet known
however regarding whether children can develop PTG or not (Clay, Knibbs and Joseph,2009). Considerate cognitive development seems to be required as PTG is considered to
involve the reconstruction process of disrupted views of the world (Tedeschi and Calhoun,
1996, 2004). The present research therefore solely focuses on PTG in adults.
PTG and environmental / event-related factors
Severity of event and perceived stress/distressFindings regarding the severity of event have been mixed. One meta-analysis (Meyerson etal., 2011) found positive correlation between PTG and event severity in 10 out of 18 studies
whilst the latter 8 studies did not. Another study, in contrast, discovered a negative
correlation between growth and degree of war-exposure in post-war context (Kimhi et al.,2010). This inconsistency can be explained by Laufer and Solomon (2006) who foundevidence of an inverted “U” curvilinear relation between these two constructs. Namely
persons who report moderate severity of the event are likely to show the highest level ofgrowth, compared to those who report low or high severity. The same inverted “U” patternsimilarly, was found in the relation between growth and distress level (e.g. posttraumaticstress symptoms) among Israeli adolescents who were exposed to terror incidents (Levine
et al., 2008). The severity of event in summary, seems to be a prerequisite for growth, andthe degree of growth may be optimal when the level of stress from the event is moderate.

９Chapter 2: Literature Review

Time elapsed since event
Another important environmental factor is time elapsed since event. No studies have foundstrong evidence for a positive relationship between PTG and time elapsed since event(Meyerson et al., 2011). The time since the event, however, is considered as a significant
moderator variable of the relation between growth and well-being outcomes. For example,
the meta-analysis of Helgeson, Reynolds and Tomich (2006) found that growth was morestrongly correlated with less depression and positive mental health when growth wasmeasured more than 2 years after the traumatic event. Growth, on the other hand, wasrelated to poorer mental health such as distress when accessed less than 2 years. Thissuggests that what PTG reflects can vary over time. Self-reported growth measured soonafter the event may reflect that the individuals are still coping with the stress caused by theevent, whilst the growth reported after 2 years since the event may reflect actual changes
or growth emerged through the adaptation process.
PTG and social process
Social support is one of the most consistently reported factors to be related to greater
growth following major life crises. For example, a meta-analysis of 103 studies (Prati andPietrantoni, 2009) found that social support, social support seeking coping and religious
involvement (e.g. religious coping and spirituality) were positively associated with growth.
Given the fact that social support is also known as the most consistently supported
protective factors of mental health after traumatic events (Brewin, Andrews and Valentine,
2000; Vogt, King and King, 2007), it is not difficult to imagine that social support contributes
to developing positive changes after a difficult life event.
PTG and psychological process
Up to now a number of review studies found consistent positive relations between PTG andinternal psychological processes such as positive reinterpretation (also called as positivereframing and positive reappraisal), rumination, acceptance coping and intrusive-avoidance
thought (Linley and Joseph, 2004; Vaughn, Roesch and Aldridge, 2009; Meyerson et al.,2011). A meta-analysis investigated what types of coping strategies were beneficial for PTG,
１０

Chapter 2: Literature Review

concluding that positive reinterpretation (also known as positive reappraisal) had thestrongest influence on PTG with the largest effect size (Helgeson, Reynolds and Tomich,2006). Most importantly these findings give empirical evidence for the critical roles ofcognitive processing on PTG. This view is in line with the conceptual framework of PTG
originally developed by Tedeschi and Calhoun (2004).

PTG and well-being outcomes
Findings of the relation between PTG and well-being, in general, are not consistent.
Helgeson, Reynolds and Tomich (2006), however, discovered evidence that PTG was related
to less depression and better well-being. As described earlier, such a relation between PTG
and well-being outcomes is known to be moderated by the elapsed time since thetraumatic event. In the same study, growth was more strongly associated with lessdepression and positive mental health when it was measured more than 2 years after thetraumatic event whilst growth was more strongly associated with distress when measured
less than 2 years.

１１Chapter 3: Research Context

Chapter 3
Research Context: Internal Displacement after Conflict in Ukraine
3.1. Introduction
This chapter sets the scene for this research and provides information concerning thecontexts in which participants of the research had been involved. The chapter is divided into
two parts: the first half describes the background of the armed conflict in Ukraine, and thesecond half presents the overview of internally displaced persons (IDPs) in Ukraine emerged
as a result of the conflict.

3.2. Armed Conflict in Ukraine
Ukraine is the largest country in land size in Europe and gained independence from theSoviet Union in 1991. Although the country shares a history with Russia as a former state of
the Soviet Union, it seems to have two different cultural origins: western parts of thecountry historically have closer ties with the neighbouring European countries such as
Poland, whilst in eastern parts of the country a significant amount of people speak Russianas their first language and have closer ties with Russia (BBC, 2019).
Ukraine has seen civil unrest and subsequent armed conflict since the autumn of 2013.
According to Faundes's conflict analysis (2016), it can be classified into 3 phases as follows:
Phase 1: Internal crisis
In late November 2013 massive street protests, later known as the Euromaidan
Revolution, started at the Ukrainian capital, triggered by the decision of then-President
Viktor Yanukovych not to sign an agreement for building closer ties with the EU (OHCHR,2014). The protesters occupied the Kyiv’s Maidan Square (Independence Square) for
three months against this political decision, demanding the resignation of the President.
In February 2014, the situation dramatically escalated into violence when thegovernment’s use of force with its riot police led to large-scale battles with anti-

１２Chapter 3: Research Context

government protesters. This resulted in the deaths of more than 110 people and theremoval of President Yanukovych from power (IFRC, 2014). New elections shortly
appointed a new pro-West President, Petro Poroshenko. Although this had temporarily
brought some calm in the Capital, it sparked political agitation and counter-revolutionary
movements, especially in predominantly Russian-speaking regions, such as Crimea and insouth-eastern regions of Ukraine.
Phase 2: External conflicts arise
Immediately after President Yanukovych’s removal, pro-Russian armed forces seized
Crimea. They took control of the local government’s parliament, and two weeks later, on
16 March 2014, the so-called "referendum" declared integration of Crimea into theRussian Federation (BBC, 2014a). The UN rejected this referendum as invalid andgroundless in the 68th UN General Assembly on 27 March 2014 (UN, 2014), affirming its
commitment to the “Territorial integrity of Ukraine”.
Phase 3: Separatism spreads in eastern Ukraine
The internal conflict continued to
grow with the spread of separatism,
particularly in eastern Ukraine. On 14
April

2014,

the

UkrainianGovernment launched an “antiterrorist operation (ATO)” mobilising
its National Security Forces against
the pro-Russian separatists, andseized the city of Sloviansk inDonetsk Oblast (BBC, 2014b). In
response, however, in May 2014, theself-proclaimed “Donetsk People’s
Republic” and “Luhansk People’s
Republic” militant groups wereformed (OHCHR, 2014). The armed
group

supporting the “People’s

Figure 2. Contact line that divides eastern Ukraine into GCA and NGCA
Data source: OCHA (2019)

１３

Chapter 3: Research Context

Republics” of Donetsk and Luhansk continued to grow in number and had steady accessto contemporary weaponry such as tanks, semi-automatic assault rifles and anti-aircraft
artillery with the help of Russian Federation (Council of Europe, 2014, p.8). In contrast,
the Ukrainian military forces launched a series of counter-offensive operations to reestablish control over eastern Ukraine. Since that time, the nature of the conflict has
dramatically changed, with active military engagement between Ukrainian national
forces and pro-Russian separatists. Battles began in Sloviansk in Donetsk Oblast in June
2014. The clashes between both sides spread into many cities and towns across Donetsk
and Luhansk regions (the so-called Donbass region). As a result of the growing
separatism, the Donbass region was divided into 2 areas by both sides: GovernmentControlled Area (GCA) and Non-Government Controlled Area (NGCA). The dividing line iscalled the “contact line” by the international humanitarian community. Figure 2 shows
the map of the contact line as of August 2018.

3.3. Internally Displaced Persons (IDPs) in Ukraine
Overview of IDPs
As earlier described, the conflict in Ukraine emerged as civil unrest in late 2013 and there
has been active armed conflict since mid-April 2014. This has resulted in high numbers ofcasualties and massive displacement of civilians from Donetsk and Luhansk regions, as wellas the destruction of their homes and other important city infrastructure. As of 13 June
2017, the UN estimates that the conflict-related death toll is at least 10,090 people,
including 2,777 civilians, with at least 23,966 injured since the beginning of the conflict(OHCHR, 2017). There has also been large-scale population displacement. The UNHCR
reported that the number of IDPs had rapidly reached 190,000 by 20 August 2014 (UNHCR,
2014a) and continued to increase up to 1.4 million by July 2015 (OCHA, 2015). The vast
majority of IDPs emerged during 2014 and 2015 (see Figure 3) and are still living withineither Donetsk or Luhansk Oblast or adjacent regions (see Figure 4). The conflict-related
displacement predominantly affected women, children and the elderly; approximately 65%
of IDPs were women and children (UN Women, 2015) and 64% elderly (OCHA, 2016).

１４

Chapter 3: Research Context

2000000
1679000

1653000

1500000
9420001000000

800000800000647000 647000

500000109000

21000

12000

0
2014

2015

IDPs (Stock)

2016

2017

2018

New Displacements (Flow)

Figure 3. Annual conflict-related displacement figures in Ukraine
Data source: IDMC (2018)

Figure 4. Overview of IDPs in Ukraine
Data source: OCHA (2015)

１５

Chapter 3: Research Context

Experience of IDPs
IDPs from Donetsk and Luhansk regions have gone through challenging experiences during
their journeys of displacement. First, they have experienced great difficulties prior to theirflight. Insecurity was a seriously threatening issue for civilians in eastern Ukraine since theconflict turned violent in April 2014. Interviews with IDPs from the eastern regions (UNHCR,
2014b) revealed that not only were there experiences of being caught up in the crossfire
but also of cases of abduction, threats, extortion and harassment commonly reported
among the IDPs. Many witnessed or were directly exposed to violence. Children’s exposure
to traumatic events and fear of losing their lives were other push factors for the IDPs todecide to flee (OSCE, 2014). Some of the IDPs were afraid of being caught by armed groups
at checkpoints and chose to wait for a chance to move safely, although public infrastructure
and the local economy were seriously damaged. People living close to the “contact line”
were particularly vulnerable due to the exposure to insecurity (OCHA, 2015). Many families
experienced family separation, having at least one member of the family living in NGCA andothers in GCA.
Secondly, the IDPs have suffered significant hardships during their displacement process.
Many IDPs from the eastern regions fled with few personal belongings. Most of them ran
out of resources. Many IDPs became financially exhausted due to the loss of livelihood andproperties, closed banks and unpaid pensions. At the beginning, many of them wereaccommodated through their social network such as in their relatives’ or friends’ places, butthey started to feel pressure to leave such temporary housing as over-crowdedness madegenerosity reach its limit over time. As a result, many IDPs relocated themselves multiple
times, without steady sources of income (OHCHR, 2014). Even after settling down in acommunity, things were not necessarily easy for IDPs. Younger children often showed
posttraumatic stress responses such as sleeping problems and fear of loud sounds (OSCE,
2014). Many IDPs reported that they have perceived critical attitudes from their hostcommunities towards them. It is also common for IDPs to have noticed social tensions withpeople still living in their home communities in eastern Ukraine; divided political views
caused disruption to the social fabric in eastern Ukraine, under a situation where one could
flee to a pro-Ukrainian territory at the same time as another could stay in the pro-Russian,

１６

Chapter 3: Research Context

separatist-controlled area (OSCE, 2014).
Another issue was the Government’s limited ability to protect IDPs. The registration of IDPs
from eastern Ukraine was difficult in many cases because of the lack of direction by thestate. Temporary housing was often not provided to IDPs in many regions, whilst it wastheoretically available. Even if it was provided, the government often only covered costs ofcollective housing for IDPs for the initial stay, with resident IDPs soon having to pay acontribution towards costs, such as for utilities (OHCHR, 2014).

１７

Chapter 4: Methodology

Chapter 4
Methodology
4.1. Introduction
This chapter sets out a description of the research strategy and process undertaken toaddress the research questions described in Chapter 1. It describes the mixed-methods
design that was adopted in the research and rationales for the use of these methods. It also
provides information regarding how data was collected and analysed. The chapter ends
with discussing the ethical considerations and limitations that the researcher had to beaware of in this study.

4.2. Research Design
A mixed-methods research design, combining a quantitative and a qualitative research
approach, has been adopted in this research. As constructs, particularly developed in thefield of social science such as posttraumatic growth, can be argued from various
perspectives differently. Using the mixed methods design enables a researcher to discuss
the same subject with different types of data (Denscombe, 2014) so that the research canprovide a more comprehensive picture of the topic being studied.
The quantitative part of the research employed a survey method using a questionnaire andthe qualitative part of the research adopted semi-structured interviews. The quantitative
survey offers a representative picture of the subjected phenomenon (PTG) of a larger group.
Using standardised and already published measures, the survey allows the production of
more reliable data and make it comparable with other research. This comparability makes
the results of data in this research more and more valuable over time. The main aim of theinterviews is to give an in-depth understanding of PTG within the Ukrainian conflict context.
It also allows exploring potentially new aspects of PTG that have not been captured in theliterature.

１８Chapter 4: Methodology

4.3. Data Collection
This research was conducted with adult Internally Displaced Persons (IDPs) in Ukraine. All
the participants were Ukrainian residents who used to be living in eastern Ukraine, before
the armed conflict started in 2014, and then resettled into a different area within Ukraine
after the conflict. Inclusion criteria were people who were originally living in Donetsk,
Luhansk or Crimea Oblast in eastern Ukraine prior to the conflict in 2014 and fled theirhomes due to the conflict. Participants under the age of 16 and those who resettled for
economic reasons were excluded from the research.
Data collection was carried out on two separate occasions in July and August 2019, which
was more than 5 years after the armed conflict escalated in April 2014 in Ukraine. One
occasion employed an online survey using a questionnaire and the other was in-depth faceto-face interviews.
4.3.1. Questionnaire
4.3.1.1. Participants
139 participants completed the online questionnaire. After a preliminary data screening,
outliers and responses by those who did not meet the inclusion criteria were removed.
As a result, data of 135 samples (15 men and 120 women) ranging in age from 18 to 65(M = 39.70 years, SD = 9.23) was used in the main quantitative analysis of this research.
They were all from conflict-affected areas: from Donetsk (n=79), Luhansk (n=53) andCrimea (n=3), and the average number of months since their first displacement was
58.73 months (SD = 4.73).
4.3.1.2. Procedure
The online questionnaire was developed using the Google Forms format anddistributed to the participants. The access to the participants was gained with the helpof the local gatekeeper humanitarian organisation which had already been working
with IDPs in Ukraine. The questionnaire was distributed nationwide to potential
participants who were asked to fill it out through the organisation’s beneficiary network.
Responses were gained from IDPs who were living in Kyiv city (n = 36), Kyiv region (n =17), Odessa (n = 31), Poltava (n = 28), Kharkiv (n = 7), Kherson (n = 6), Dnipropetrovsk (n１９Chapter 4: Methodology= 3), Zaporizhya (n = 2), Government-controlled area in Luhansk (n = 2) and
Government-controlled area in Donetsk (n = 1). Participation was completely voluntary,and the informed consent was obtained at the top page of the questionnaire before
they began to answer it.
4.3.1.3. Measures
The questionnaire consisted of the following existing measures, listed below. Item
selection for inclusion in the questionnaire was made based on the literature review,
specifically some meta-analytic studies focusing on PTG and equivalent constructs suchas benefit-finding or stress-related growth (Tennen and Affleck, 2002; Park and Fenster,2004). Once developed in English, the questionnaire was translated into the Ukrainian
language following a standard procedure (e.g., translation, back translation, expert
panel and cultural adaptation). Two Ukrainian-English bilinguals and two experts in thehumanitarian sector were involved in the development of the Ukrainian version of thequestionnaire in total. The English version of the questionnaire is attached as Appendix
1.
Demographics. In the questionnaire, the following demographic information wascollected:• Age• Gender• Place of current residence• Place of origin• Marital status• Educational level• Time since displacement (months)
Posttraumatic Growth. The 10-item Short Form of the Posttraumatic Growth Inventory(PTGI-SF; Cann et al., 2010) was used to measure Posttraumatic Growth (PTG). The
original Posttraumatic Growth Inventory (PTGI) has 21 items and was developed by
Tedeschi and Calhoun (1996) to measure positive changes after highly difficult life

２０

Chapter 4: Methodology

events. Like the original PTGI, the PTGI-SF has a five-factor structure which represents
five different types of PTG: (a) New Possibilities, (b) Relating to Others, (c) PersonalStrength, (d) Appreciation of Life, and (e) Spiritual Change. Participants completed the10-item STGI-SF with 6-point Likert scale, ranging from “Strongly disagree”, “Mostly
disagree”, “Disagree a little”, “Agree a little”, “Mostly agree”, to “Strongly agree”. Since
this study aims to capture participants’ perceived personal changes after theirdisplacement experience, additional wording “as a result of displacement” was addedon the top of each item to fit the contexts of IDPs.
Environmental factors. Two environmental factors that may influence the participant’s
displacement experience were assessed: 1) time since the first displacement (numberof months) and 2) number of relocations since the first displacement.
Well-being status. To assess the current well-being status of the participants in theirresettled environment, three categories of their subjective well-being were measured:adjustment level [current], life satisfaction [current], and overall mood [past one month
to present]. Each of the three categories consisted of one-item question with a 9-point
scale. For example, in the question about adjustment, participants were asked “On ascale of 1 to 9, how would you rate your adjustment level to your new life since you
resettled in the current place? Indicate your current adjustment level” by choosing fromthe number 1 (I am not adjusted to the current environment at all) to 9 (I am perfectly
adjusted to the current environment). The rating scale was from 1 (the worst possible
life I could imagine) to 9 (the best possible life I could imagine) in the life satisfaction
question, and from 1 (very stressful) to 9 (very happy) in the overall mood question
respectively. The higher number represents higher well-being status that the sample
IDPs reported.
Perceived social support. To measure social support that the sample IDPs perceived
since their displacement, the Multidimensional Scale of Perceived Social Support(MSPSS; Zimet et al., 1988) was employed. The MSPSS has 12 items and measures selfaccessed availability of social support. It has three subscales, each of which addresses a

２１

Chapter 4: Methodology

different source of social support: (a) Family, (b) Friends, and (c) Significant Other.
Participants were asked to complete the 12 items in random order. To fit the study
contexts, an instruction was given to the participants to rate social support available tothem during their displacement experience. In addition, although the original MSPSS
has a 7-point scale, a 5-point scale was employed in this study, ranging from 1 (Strongly
Disagree) to 5 (Strongly Agree) to reduce confusion among the participants.
Coping. It is interesting to know how participants have dealt with their stressful
situation during the relocation experience. The coping section of the questionnairemeasured the cognitive processes of the participants, focusing on the following three
types of coping:• Rumination (3 items)• Positive Reinterpretation (4 items)• Acceptance Coping (4 items)
Participants were asked to indicate how often they used each category of coping since
they were displaced with a 4-point Likert scale (ranging from “I didn’t do this at all” to “Ioften did this”). Items of both Positive Reinterpretation and Acceptance Coping werefrom Carver and colleagues’ COPE scales (Carver, Scheier and Weintraub, 1989). The
COPE scales originally have 15 subscales including the Positive Reinterpretation and the
Acceptance Coping. Positive Reinterpretation refers to “the attempt to look on thebright side of things and to put a positive spin on stressful situations” (Helgeson,
Reynolds and Tomich, 2006, p.798), while Acceptance Coping subscale measures thedegree to which the participants accept the reality of the stressful situation since theirdisplacement. In addition, the 3 items of Deliberate Rumination subscale were selectedfrom the Rumination Scale (Calhoun et al., 2000), which is originally developed tomeasure both intrusive rumination and deliberate rumination. The set of items
presented in the Rumination subscale reflects the deliberate rumination. Deliberate
Rumination in this context refers to “deliberately thinking about the event to try to
make sense out of it, to make something good come out of the struggle with the event,and to see benefits in the event” (Calhoun et al., 2000, p.524). In this research, I simply

２２

Chapter 4: Methodology

call it rumination.
4.3.2. In-depth Semi-structured Interviews
4.3.2.1. Participants
11 individual, face-to-face interviews were conducted with IDPs. The interviewees (3men and 8 women) were living in Kyiv Oblast, Ukraine at the time of data collection
but were originally from either Donetsk or Luhansk Oblast prior to the conflict. Age ofthe interviewees ranged from 22 to 74 (M = 43.64 years, SD = 15.88).
4.3.2.2. Procedure
The author of the study visited Ukraine and conducted in-depth, face-to-faceinterviews in July 2019. Due to the limited timeframe and budget of the research, theinterviews took place geographically in 3 places within Kyiv Oblast, Ukraine: Kyiv city,
Bila Tserkva (2 hours’ driving from Kyiv city centre) and Tetiive (3 hours’ driving from
Kyiv city centre). Like the data collection of the questionnaire, the access to theinterviewees was obtained through the local humanitarian organisation. Theinterviews were conducted in meeting rooms of the organisation or local restaurants
where interviewees found it convenient. An English-speaking translator was neededfor 9 of the 11 interviews as the dominant language in Ukraine is either Ukrainian or
Russian. However, no translator was needed with 2 interviewees as both were fluent
in English.
Each interview took about 60 minutes and started with an introduction by theinterviewer, the research topic, expectations about the interview and the informed
consent. To ensure production of accurate transcriptions, the interviews were audiorecorded with the permission of participants.
It is also important to note that the interview structure was designed to create awarm and co-operative atmosphere as well as to reduce defensiveness on behalf ofthe participants. The focus of the interviews was to learn about interviewees’
perceived benefits and positive personal changes after experiencing displacement

２３Chapter 4: Methodology

and the questions were semi-structured. However, answering such questions
requires a high level of self-reflection and disclosure. Hence, for the purpose ofbuilding rapport and reducing emotional reluctance, the interviews began with somecasual opening conversation and followed the sequence that the first half of theinterview focused on facts and then the second half asked about personal
perceptions about themselves (e.g. changes that happened to themselves). Most
IDPs interviewed were happy to talk about their displaced experience and to answer
fact-based questions such as “Can you tell me what happened after you weredisplaced?” “When and how did you come to this place?” or “What difficulties did
you experience since you were displaced?”. Therefore, by the time the interview
came to the second half, there had been a lot of interaction between the interviewee
and the interviewer and this helped the interviewees to be ready for more personalquestions.

4.4. Data Analysis
4.4.1. Quantitative Analysis
Quantitative data, collected online by using Google Forms, was exported into an Excel
sheet. Then the preliminary data screening identified and removed outliers andresponses out of the research inclusion criteria.
• Firstly, descriptive statistics were computed to summarise each variable.
Summary statistics, tables of distribution and histograms helped the researcher
gain a better understanding of the characteristics of each variable.
• Secondly, based on the descriptive statistics, the research looked at theprevalence of PTG reported in the study sample.
• Thirdly, a series of statistical significance tests were conducted to examine therelationship between variables. Specifically, the research was interested ininvestigating the relationship between PTG and factors that are expected to be
associated with PTG. For example, for categorical data (e.g. gender and marital
status), statistically significant tests such as t-test and analysis of variance(ANOVA) were conducted to see the difference between groups in the degree of
２４Chapter 4: Methodology

growth. For numerical data, correlational strengths were computed to see therelationship between PTG and independent variables (e.g. social support andtypes of coping).
• Lastly, multiple regression analysis was employed to find the best predictor(s) of
PTG.
For these statistical data analyses, statistical software called HAD1 was chosen as it
was a functional open-source software.
4.4.2. Qualitative Analysis
The interviews were fully transcribed in order to produce accurate findings andinterpretations for the thematic analysis. For transcribing the interviews, conductedin the local language, there have been frequent contacts with the translator toensure that the transcribed data correctly reflected what the interviewees had said.
The thematic analysis of the narrative transcripts was conducted in both descriptive
and exploratory manners:• The qualitative analysis examined two categories of information in the
narratives, which was about positive changes and influencing factors of PTG.
• Under the category of positive changes, five codes were given to thetranscription based on the conceptual domains of PTG argued by Tedeschi andCalhoun (1996). That is, Relating to Others (RO), Personal Strength (PS), New
Possibilities (NP), Spiritual Changes (SC) and Appreciation of Life (AL). Besides,
additional code was given to the texts that seemed to represent new aspectsof changes that have not been captured in the Tedeschi and Calhoun’s model• Under the category of PTG-related factors, three code of Positive
Reinterpretation, Acceptance, Rumination, Social Support were given to therelevant texts and additional code was given to represent potentiallyinfluencing factors of PTG that may not have been discussed in the literature.
• Data collected with new codes were reviewed and categorised to generate

1

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Chapter 4: Methodology

new themes. Once new themes were generated, names and definitions were
given for each theme.

4.5. Ethics
Important ethical issues were considered in order to conduct the research without causing
any harm. Firstly, this research adheres to the Research Ethics for Research involving
Human Participants - Code of Practice (Oxford Brookes University, 2016) and was approvedby Oxford Brookes University’s Faculty Research Ethics Committee (see Appendix 2-4: E1,
E2 and E3 forms). This ethics reviewing process helped the researcher to comprise core
ethical requirements of research with people such as ensuring consent, confidentiality andanonymity at all stages of the research. Secondly, the researcher was mindful not to create
an unnecessary extra burden on the gatekeeper organisation for the data collection.
Humanitarian organisations, often with limited human resources, are busy with their aid
work on the ground. The initial contacts began far before the time of data collection inorder to obtain consent from the gatekeeper, and the data collection period was agreed
based on the organisation’s availability. Most importantly, at the end, the face-to-faceinterview process was designed to minimise potential distress for the interviewees. Theinterviews did not aim to ask particularly about traumatic experiences. Nevertheless, theinterview questions had the potential to trigger some uneasiness. To deal with this issue,
the interviewer explained the purpose of the interview and informed the participants thatthey had the right not to answer any questions that made them feel uncomfortable andthat they could withdraw from the interview at any point. In addition, when someinterviewees started to show signs of distress, the interviewer asked if they wanted to takea rest or reassured them of their rights.

4.6. Limitations
Regarding limitations, it must be noted that although a mixed-methods design enriches thevalidity of research by triangulating different sources of data on the same topic (Creswell
and Clark, 2017), the findings of this research may not represent the whole IDP populationin Ukraine. The question of representativeness rises because of the following two issues: 1)
gender imbalance in data obtained and 2) participants’ status as recipients of humanitarian
２６

Chapter 4: Methodology

aid. Firstly, throughout the data collection in Ukraine, it was hard to reach male IDPs. Given
the humanitarian contexts in Ukraine, this is true in general; 66% of officially registered IDPs
are women according to the UNHCR (2015). The proportion of the male sample in thepresent research, however, is 11% (15 out of 135) in a survey and 27% (3 out of 11) in theinterviews, which is far below the officially reported proportions of male IDPs, respectively.
Perhaps the gender imbalance in the sample was caused by a combination of gender norms
and the sampling strategy of the research. For the researcher, the access to Ukrainian IDPs
was only possible in coordination with the local humanitarian agency which had been
already working with IDPs in Ukraine. This naturally made the researcher accessible to more
women than men as women, in general, are more likely to seek support than men, as wellas two-thirds of IDPs being women. The second issue related to the representativeness ofparticipants’ status as recipients of humanitarian aid. As the access to the sample of thepresent study was gained through the gatekeeper humanitarian organisation, the majorityof the participants were considered to have had good access to humanitarian support, in
addition to legal support, from the state. As social support is one of the most consistently
reported protective factors for psychological well-being after experiencing a traumatic
event (Brewin, Andrews and Valentine, 2000; Vogt, King and King, 2007), the level ofgrowth and well-being in the present sample may over-report that of the whole IDP
population in Ukraine. Therefore, this should be taken into consideration when interpretingthe findings.

２７

Chapter 5: Findings and Discussion

Chapter 5
Findings and Discussion

5.1. PTG Reported among IDPs in Ukraine
5.1.1. Prevalence
IDPs who completed the questionnaire reported the grand mean score of 4.12 (men =3.86, women = 4.15; range 1 to 6) on the whole PTG scale (PTG-all). A frequency
distribution table (Figure 5) indicated that 61.48% of the sample reported at least asmall or moderate degree of PTG on average and 20% of the sample reported a highdegree of PTG. Besides, 100% of the interview participants (11 out of 11 IDPs)
suggested that they have changed before and after the displacement.

Figure 5. Histogram of PTG mean scores

61.48% appears to be of high prevalence. However, interpretation of this number
should be considered with caution because the prevalence rates of PTG in the literature
are widely ranged depending on the study contexts, target populations and measuresused (for example, a review of Linley and Joseph (2004) found from 30% to 70% of
people reported after various types of traumatic events). The main value of the present

２８Chapter 5: Findings and Discussion

study lies in the fact that it gives empirical data regarding PTG using a publishedinstrument, which will enable any future research to compare the prevalence of PTG in
the contexts of forced migration either cross-culturally or within Ukraine.
Table 1 shows summary statistics of PTG scores including 5 subscales. It indicates that
Appreciation of Life (AL) was the most commonly reported domain among five domainsof PTG with the mean score of 4.83, indicating 85.93% of the sample reported at least asmall or moderate degree of PTG-AL, followed by Personal Strength (PS) (M = 4.56),
indicating 77.04% the sample reported at least a small or moderate degree of PTG.
Table 1. Summary statistics of PTG scores
Cumulative % withat least small ormoderate PTG
PTG-AL
135
4.83
5.00
0.97
1.00
6.00
85.93
PTG-NP
135
3.94
4.00
1.36
1.00
6.00
60.00
PTG-RO
135
4.09
4.00
1.21
1.00
6.00
64.44
PTG-PS
135
4.56
5.00
1.17
1.00
6.00
77.04
PTG-SC
135
3.19
3.00
1.40
1.00
6.00
34.81
PTG-all
135
4.12
4.20
0.93
1.50
6.00
61.48
Note: PTG-all: a whole PTG scale including 5 subscales. AL: Appreciation of Life, NP: New Possibilities, RO:
Relating to Others, PS: Personal Strength, SC: Spiritual Change.
VariableN

MeanMedian

SD

Min

Max

5.1.2. Case Studies of Positive Changes
61.48% of the sample reported at least a small or moderate degree of PTG on
average. Around 34.81% to 85.93% of the sample showed at least a small ormoderate degree of PTG depending on the domains of the growth. What does it
mean? What does each domain of growth look like? This section attempts to gain an
in-depth understanding of positive changes experienced by Ukrainian IDPs by
quoting the participants’ words from the interviews.

２９Chapter 5: Findings and Discussion

Appreciation of Life (AL)
A widowed father of 5 children fled his home due to the conflict. He mentioned thatthe family has become the top priority for his life:“The most significant change was I have become a father of 5 children and then I havebecome a father of 13 children [now he is in his second marriage after displacement]. It’s ahuge responsibility... My attitude toward children changed a lot after my wife’s death andthen I faced with many people’ deaths [due to the conflict]. A lot of my social links wereruined. When I was living in comfortable circumstances [in Donetsk prior to the conflict], I did
not pay much attention to my children. But they became more valuable and I began to pay
more attention to my children… Family is the biggest value. Children, brotherhood,sisterhood, and parents are the first things rather than any other thing”.

A 45-year-old male IDP from Donetsk
Another woman from the Luhansk region shared:“My perception of the world has changed. Now I have learned that everything in our life is so
fragile… I was surprised that why people cannot negotiate with each other to build peace. I
am concerned about who decides these things [about the conflict] to go on. There is nothing
we can change about the fact that life is short and fragile for all of us. There is nothing todivide among us in such a way as we are all humans and that is life”.

A 65-year-old female IDP from Luhansk
Both IDPs above experienced changes in their worldview and priority in life following
significant losses (e.g. deaths and loss of peaceful life). Theoretically, AL refers tochanged life priority, life philosophy and increased appreciation of the value of life
(Tedeschi, Park and Calhoun, 1998). The results of the questionnaire showed that AL
was the domain of change that most participants agreed to report on (85.93%).
Given the intensive crossfire and sudden escalation of violence in eastern Ukraine, itwould make sense that most IDPs in Ukraine developed the perception of fragility
about life and society, leading to revising values of their own lives.

３０Chapter 5: Findings and Discussion

Relating to Others (RO)The man from Donetsk, a father of 13 children and young adults continued:“Five years ago [when displacement started], my children were very small, so 2 or 3 of them
could sleep together on one bed. But now they’ve grown up. Some of our children are
already 15 and teenagers. So, as they grew, tension grew as well. We [the interviewee andhis wife] tried to create an atmosphere of love and caring for our children. We tried to get
together all the family at least once a week so that everybody can see their faces and maketransparent conversations with each other… We tried to pay attention to our children’s
psychological balance… It was a great help because it helped to understand each other welland such a warm atmosphere helped us to cope with the situation”.

A 45-year-old male IDP from Donetsk
While changes in AL occurred in a cognitive level, this narrative illustrates thechanges can occur in a behavioural level. It also suggests that more than one domainof growth are interconnected and can occur simultaneously. His life priority haschanged due to the experience of the conflict and displacement (an increase of AL).
As a result, his patterns of behaviour changed for example he started to put more
effort into family relationships (an increase of RO). More importantly, his story
suggests that these positive changes may occur as a result of a coping process. The
attempt to establish stronger family bonding is considered to be one of the coping
strategies to help reduce impacts of stressful situations caused by displacement.

Personal to Strength (PS)A woman originally living near the Donetsk airport had to immediately flee from her
hometown with her young children. She started her interview with how hard it was
to re-establish their lives in the early stage of displacement but highlighted theachievements of her family:“Now my husband and I do everything by ourselves. We believe that we have changed so
much… Previously, I spent my life on some spontaneous shopping and entertainment, but

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Chapter 5: Findings and Discussion

now I am down-to-earth. I have notes about some plans and am using money in a planned
manner. So, I became a more practical person. We achieved this in 5 years - everything
including housing and livelihood, which a lot of IDPs here in *** [name of the current
residence] still cannot achieve yet. We asked help and we tried to communicate with local
people and explained that we were normal and suffering... I am proud that we are
maintaining a normal life despite the extremely difficult circumstances without ending up
suicide or being alcoholic that other people would do in such circumstances”.

A 31-year-old female IDP from Donetsk
Another woman who is a single mother from eastern Ukraine and the only source ofincome for the family reflected:“I think I became more experienced and stronger after going through the displacement… I
did everything to restore my life from zero to now by myself without relying on any
assistance from anybody. I rented an apartment and completed school application
procedures for children. If I stayed in *** [name of her hometown], I couldn’t develop suchnew skills and wisdom to do it this quickly in a timely manner”.

A 45-year-old female IDP from the conflict zone in Luhansk
The common element in these two women’s narratives is that they bothexperienced a positive transformation of their self-view through their individual
coping process. They both engaged in problem-solving behaviours trying to handle
challenging situations. The success of such coping behaviours led to their increased
sense of self-reliance, sense of being experienced and sense of accomplishment.

Spiritual Change (SC)Some people reported the increase of their religious beliefs after displacement. For
instance, a woman from Donetsk reported:“We [the interviewee and her husband] went to church and pray more often. It was moredifficult to survive without any religious beliefs… I learned that praying and reading the Bible
was helpful. When praying and reading the Bible did not help, I went to church and asked

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Chapter 5: Findings and Discussion

help for our church leader… I got to know many IDPs here in this community who have trust
in God. With religious belief, I could manage”.

A 33-year-old female IDP from Donetsk
Importantly, they found the religious belief and practice more helpful to manage thestressful situation. Moreover, religious practices helped them re-establish social
networks in the new community after arrival.

New Possibilities (NP)The domain of NP refers to a sense of encountering or establishing new roles, paths,
opportunities, resources, skills, interests and so on as a result of highly difficult life
situations (Tedeschi and Calhoun, 1996).
A woman mentioned that her children had access to more choices and resources
after they moved to the capital:“I had a lot of fear and concerns about the resettlement. How would it look like? How toadapt children to the new environment? But 75% of my concerns did not come true… I’ve
noticed right now there are more new opportunities for my children... For example, my elder
daughter will soon be going to the 9th grade. There in *** [name of her hometown] we had
few institutions that could give some professions. But she did not have interest in any ofthem... If she could go, she could get education that she wanted somewhere else, that would
be Donetsk and that is too far… In a big city, children have public transportation such as a bus.
They can stay a little bit more distance from their parents by using such public transportation,for example. They learn to do it by themselves. And that makes children develop selfresponsibility more”.

A 34-year-old female IDP from Donetsk region

A young IDP who has just graduated from University explained that she has decided
to work on building a better society after she moved to the capital:

３３Chapter 5: Findings and Discussion“I think I started to express my opinion and my source more openly and I understood thatpublic position matters because we did not express it in Donetsk. So yeah probably, I became
somewhat more active. And this is actually a point because I know a lot of people who
moved from Donetsk and they're trying to join some initiatives… I joined a lot of initiatives as
a volunteer. I joined uh NGO. And now I'm looking for a job in this civic sector because I think
it's very important for me now to make something which is socially valuable for the society
and then change it because we need to make a lot of things here in Ukraine. And uh I had
this feeling when I came here [the capital] I realised it's not dangerous to do such things. So, I
can express myself and I really would like to work on this society and this capacity building in
Ukraine”.

A 21-year-old female IDP from Donetsk

The former interviewee found more resources for her children after being displaced.
The latter established a new path for her life after the displacement. These narratives
indicate that NP are more likely to involve meaning-making rather than coping
process within individuals. It seems that the experience of NP is like opening a newdoor to find new values and meanings after a significant life event. The stories above
explain how the transformation of an individual’s worldview and self-image areachieved through meaning-making and value-finding processes. This finding
underpins the view that posttraumatic growth conceptually requires meaningmaking cognitive process (Tedeschi and Calhoun, 2004).

5.1.3. Summary of PTG among IDPs in Ukraine
Reported posttraumatic growth was described both quantitatively and qualitatively.
All the interview participants suggested that they had changed before and after the
displacement, and 61.48% of the questionnaire participants reported at least a small
or moderate degree of PTG. Concrete examples of changes were drawn frominterviews with IDPs, highlighting the transformative aspects of PTG. Individual
stories from IDPs illustrated that after experiencing difficult life events,

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Chapter 5: Findings and Discussion

transformation could occur in many different areas: their worldview, priority in life,
childcaring behaviour, perception of oneself, perception of interpersonal
relationships, religious belief and practice, perception of resources and life
possibilities and so on. In other words, changes could occur in both cognitive andbehavioural levels. Moreover, two possible processes were suggested for PTG toemerge: coping and meaning-making. The interviews suggested some IDPs
experienced their growth as a result of their coping to handle stressful situations andothers experienced transformation of their self-image through the meaning-making
or meaning-finding process.

３５Chapter 5: Findings and Discussion

5.2. Factors Associated with PTG
5.2.1.PTG and Demographic Factors
To examine the research question 2-a): “Does the level of PTG differ by demographic
factors?”, a series of statistical significance tests and correlation analyses were conducted.
●Gender and PTG
A Welch’s two independent sample t-test was conducted to see if there is a significant
gender difference in grand mean scores of PTG (range 1 to 6). As a result, no statisticallysignificant gender difference was found for the PTG scores (t (17.03) = -0.87, p = .40).
Mean scores and SD of PTG per gender are shown as in Table 2.
Table 2. Mean Scores and SD for PTG per Gender
Level

Mean

SD

S.E.

Male
Female

2.87
3.23

1.52
1.38

0.39
0.13

95%Lower 95%Upper
2.09
2.98

3.64
3.47

Samplesize
15
120●Place of current residence and PTG
A one-way ANOVA was conducted to compare the effect of place of current residence on
the grand mean score of PTG. The analysis of variance (Table 3) showed that the effect ofplace of current residence on PTG scores was not statistically significant (F(9, 125) = 0.99,
p = .45).
Table
Table 3. ANOVA: Effect of Current
Residence Place on PTG Scores
ANOVA

Mean PTG scores
BetweengroupsWithin groups
Total

SS

df

MS

F

p-value

7.76

9

0.86

0.99

0.45

108.96116.72

125
134

0.87

３６

Chapter 5: Findings and Discussion●Place of origin and PTG
A one-way ANOVA was conducted to compare the effect of place of origin on the
grand mean score of PTG in groups of Donetsk (N = 79, M = 4.17, SD = 0.98), Luhansk(N = 53, M = 4.08, SD = 0.87) and Crimea (N = 3, M = 3.40, SD = 0.70). The results(Table 4) showed that the effect of place of origin on PTG scores was not statisticallysignificant (F(2, 132) = 1.08, p = .34).
Table 4. ANOVA: Effect of Place ANOVA
of Origin on PTG Scores
Mean PTG scores
Between groups
Within groups
Total

SS
1.87
114.85116.72

df
2
132
134

MS
0.94
0.87

F
1.08

p-value
0.34●Marital status and PTG

Mean scores and SD of PTG by marital status are shown as in Table 5. A one-way
ANOVA was conducted to compare the effect of marital status on the grand meanscore of PTG among Single group (N = 19, M= 4.13, SD = 0.84), Married group including
civil marriage (N = 88, M = 4.11, SD = 0.93) and Widowed, Divorced and Separated (N =28, M = 4.15, SD = 1.03) groups. The results (Table 6) showed that the effect of marital
status on PTG scores was not statistically significant (F(2, 132) = 0.02, p = .98).
Table 5. Mean Scores and SD for PTG per Marital Status

0.19
0.10

95%
accuracy
0.40
0.20

Sample
size
19
88

0.19

0.40

28

Mean

SD

S.E.

Single group
4.13
Married
4.11
Widowed, Divorced
4.15
and Separated

0.84
0.93
1.03

Table 6. ANOVA: Effect of Marital Status on PTG Scores
ANOVA

Mean PTG scores
BetweengroupsWithin groups
Total

SS

df

MS

F

p-value

1.87

2

0.94

1.08

0.34

114.85116.72

132
134

0.87

３７

Chapter 5: Findings and Discussion●Age and PTG
Pearson’s correlation coefficient wascomputed to see the relationship between
age and the grand mean score of PTG. As
shown in the scatter plot Figure 6, theresult indicated that age and PTG scores
were not significantly correlated to eachother (r(133) = -.10, p = .25).
Figure 6. A scatter plot showing no relationship between
age and PTG●Education and PTG
Participants were divided into 2 groups: those who have less than a bachelor’s degree
and those who have a bachelor’s degree or higher educational backgrounds. Meanscores and SD of PTG by educational level are shown as in Table 7. Results of a Welch’s
two independent sample t-test indicated that PTG scores were not significantly different
depending on participants’ educational levels (t (30.07) = 1.59, p = .12).
Table 7. Mean Scores and SD for PTG per Educational Level
Education level

Mean

SD

S.E.

95%Lower

95%UpperLess than Bachelor's
Bachelor's degree orhigher

4.46

1.28

0.25

3.96

4.95

Sample
size
26

4.04

0.82

0.08

3.89

4.20

109

In summary, no statistical differences in PTG scores were found for any of thedemographic factors in this research. Based on the literature review, it was expectedthat women and younger people may report more PTG than men and older people. The
results found the same tendency as in the literature since women reported the greatermean score of PTG (M = 4.15) than men (M = 3.86) and the correlation between PTG and
age was negative (r = -.10). However, gender and age differences in PTG were notstatistically significant in the present sample. This may be due to the gender-biased,

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Chapter 5: Findings and Discussion

small-scale data set in the study. To better examine this issue, I would collect more data
to include equal numbers of both genders for the future study.

5.2.2. PTG and Well-being
To examine the research question 2-d): Is PTG associated with IDPs’ positive well-being?”,
the study investigated correlational relationships between PTG and well-being variables. It
was expected that the degree of PTG was correlated with positive well-being status among
IDPs in the present study. The growth was reported to have had a reassuring relationshipwith positive well-being when it is measured more than 2 years after the traumatic event.
The results confirmed this hypothesis (see Table 8), indicating all the well-being subscales(adjustment, life satisfaction and overall mood during the past 4 weeks) had moderate
positive relations (from .34 to .45) to PTG.
Table 8. Means (SD) and Pearson’s correlation r between PTG and well-being

Variable
PTG
WB-Adjustment
WB-Life Satisfaction
WB-Overall Mood
WB-allMean (SD)
4.12 (0.93)
5.81 (1.75)
5.05 (1.83)
4.44 (2.10)
5.10 (1.66)

r
.34
.45
.43
.47

**
**
**
**

Note: ** p < .01, * p < .05, + p < .10
WB: Well-being

5.2.3. Correlations between PTG and Other Factors
Pearson’s correlation coefficients were computed to examine if potentially related variables(e.g. environmental, social, coping factors) are related to PTG. Such variables were selectedbased on the literature review in chapter 2. The results of the correlation analyses (seeTable 9) illustrate that all the potentially related variables were significantly associated withthe grand mean score of PTG except Time variable. It makes sense that the factor of timesince displacement was not much related to the degree of growth because almost of all
３９Chapter 5: Findings and Discussion

participant IDPs (about 95%) answered that they fled home more than 48 months ago at
the time data was collected. The sample population in this study is thought to behomogeneous in terms of time elapsed since displacement.
Table 9. Means (SD) and Pearson’s correlation r between PTG and potentially related factors
Variable
PTG
Time
Relocation
SS-Family
SS-Friend
SS-OtherSS-allPositive Reinterpretation
Acceptance Coping
Rumination

Mean (SD)
4.12 (0.93)
58.73 (4.73)
3.14 (1.63)
3.80 (1.22)
3.49 (1.18)
3.61 (1.46)
3.63 (0.94)
3.10 (0.71)
3.27 (0.63)
3.08 (0.71)

r
-.07
-.24
.19
.24
.24
.28
.48
.31
.47

**
*
**
**
**
**
**
**

Note: ** p < .01, * p < .05, + p < .10
Time: Number of months since displacement
Relocation: Number of relocations since displacement

Another important finding was the negative correlation between the number of relocations
and PTG. Perceived stress and event severity are often reported to have a positive
relationship with PTG from the findings of previous research (Helgeson, Reynolds andTomich, 2006). A greater number of relocations would lead to a greater level of stress.
Therefore, it was expected that there would be a positive correlation between PTG and thenumber of relocations. The result of this study, however, was the opposite. This may be
explained by the characteristics of displacement experience. Relocations involve multiple
resettlement experiences and adjustment processes. Every time an individual experiences arelocation, he or she goes through not only physical resettlement but also changes in theirsocial environment and community resources. In this sense displacement, particularly if it
involves multiple times of relocations, is different from other types of traumatic events suchas being diagnosed with cancer or a bereavement. The displacement experience is not asingle impact event but involves multiple adjustment processes for a longer period. Perhaps,

４０Chapter 5: Findings and Discussion

those who experienced a greater number of relocations are still in an ongoing process of
coping to adjust themselves to the current environment, thus displacement-related growthis less likely to emerge at this stage.

5.2.4. Predictors of PTG
Correlation analyses concluded that all the potentially related variables were significantly
associated with PTG except the Time variable. To examine the research question 2-e):“What is the best predictors of PTG?”, two models of multiple regression analysis wereconducted to see which variables significantly predicted the degree of PTG after controlling
covariance of each independent variable. Both models used a standard linear multiple
regression (the entry method) and focused on the same factors (i.e., Time, Relocation,
Social Support and Coping). The only difference was that the first model used threesubscale variables of Social Support (SS-Fa, SS-Fr and SS-Other) depending on its sources
whilst the second model used one whole Social Support variable (SS-all) without
considering its sources. As a result, the second model was adopted in this research topredict the degree of PTG because Social Support was not able to significantly explain the
degree of PTG if divided into 3 subscales as in Model 1.
Table 10. Results of Multiple Linear Regression Predicting PTG

Table 11. Results of Multiple Linear Regression Predicting PTG

Model 1a)Model 2b)

Variable
nameIntercept

b

S.E.

2.56

1.01

-

Time

-0.01

0.01

-.07

Relocation

-0.05

0.04

-.10

SS-Fa

0.05

0.08

.07

SS-Fr

0.07

0.06

.09

SS-Other

0.04

0.08

.05

COPE-PR

0.33

0.15

.26 *

COPE-Ac
COPE-Ru

-0.02
0.31

0.14
0.16

-.01
.24 +

R2

.30 ****

βp < .01, * p < .05, + p < .10a) Dependent/outcome variable: PTG-all; Independent
variables: Time, Relocation, SS-Fa, SS-Fr, SS-Other, COPE-PR,
COPE-Ac, COPE-Ru.

Variable
nameIntercept

b

S.E.

2.56

1.01

-

Time
Relocation

-0.01
-0.05

0.01
0.04

-.06
-.10

SS-all
COPE-PR
COPE-Ac
COPE-Ru

0.15
0.34
-0.02
0.30

0.07
0.14
0.14
0.16

.16 *
.26 *
-.01
.24 +

β

R2
**

*

.30 **+

p < .01, p < .05, p < .10b) Dependent/outcome variable: PTG-all; Independent variables:
Time, Relocation, SS-all, COPE-PR, COPE-Ac, COPE-Ru.

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Chapter 5: Findings and Discussion

The results of the multiple regression indicated that three predictors (Positive
Reinterpretation, Rumination and Social Support) significantly explained 30.5% of thevariance of PTG-all (R2 = .30, F(6,126)=9.20, p < .001; COPE-PR: b = 0.34, SE = 0.14, β = .26,
t(126) = 2.39, p = .018; COPE-Ru: b = 0.30, SE = 0.16, β = .24, t(126) = 1.92, p = .056; SS-all: b= 0.15, SE = 0.07, β = .16, t(126) = 2.11, p = .037). Neither Time nor Relocation variables
significantly explained the outcome variable, PTG-all. Based on this finding, it is concluded
that cognitive processing such as Positive Reinterpretation and Rumination had thestrongest influence on prediction of posttraumatic growth followed by Social Support.

5.2.4.1. Positive Reinterpretation as a Predictor of PTG
The multiple regression analysis revealed that psychological coping processes such as
positive reinterpretation and rumination were the most significant predictors of PTG. Thisfinding is consistent with previous findings from Helgeson, Reynolds and Tomich (2006) inwhich positive reinterpretation was found to have the largest effect size to predict growth
after various life crises. Positive reinterpretation is one of the cognitive coping strategies
and refers to “the attempt to look on the bright side of things and to put a positive spin onstressful situations” (Helgeson, Reynolds and Tomich, 2006, p.798). Therefore, the findingsof this study give another empirical evidence that PTG is primarily accounted for individual
cognitive processing. It is not so difficult to imagine that such cognitive coping efforts would
lead to the transformation of mental pictures for interpreting the situation. Probably, in
reality, positive reinterpretation includes some avoidant thoughts. As positive
reinterpretation employs the attempt to look for something good in a challenging situation,
it inherently includes two forms of coping: 1) actively looking for something good andpositive in the given circumstances and 2) passively avoiding thinking of something bad andnegative. The following example illustrates both types of coping:“I cannot help feeling sad when I am talking about Donetsk. I miss my house in Donetsk. I
used to have a comfortable house near a lake in Donetsk, where I didn’t have to think about
issues and difficulties, could engage in gardening and watch some pictures and landscapes

４２Chapter 5: Findings and Discussion

from the house. But now, I realised that I won’t have anything like that anymore here in Kyiv.
I have tried to switch my attention to nature. When other IDPs were waiting in line for somevouchers, I went to a park. Here Kyiv is a very beautiful city with parks, forests and lakes andalso rivers. There is nothing like that in Donetsk. Maybe some lakes and parks in Donetsk too,
but not like in Kyiv. At first, I thought that this war wasn’t going to continue for a long time. I
tried to pay attention to such nature aspects here.”

62-year-old IDP woman from Donetsk who lost both of her parents“I tried to find some positive things as much as possible because focusing on difficulties leads
you to become crazy. I tried to keep good vibes rather than feeling sad or stress, for example,
I went to a theatre and parks to shift positive vibes”.

74-year-old IDP woman from Donetsk
Probably avoidant coping alone does not contribute to developing the perception of growth
but is a signal that an individual is engaging in positively reinterpreting his or her experience.
By actively looking for something positive followed by avoidant thoughts, individuals cantransform their mental pictures of the given situation. In fact, growth was frequently
reported with awareness of ‘bright sides’ of the situation such as resources, opportunities,
values, achievements and/or new life roles. It is also worth noting that rumination is a very
similar psychological process to positive reinterpretation. Rumination reflects the processthat an individual is trying to make sense of and make something good come out of the
struggle. As described in section 5.1.2., meaning-making (or meaning-finding) efforts wereobserved in some IDPs who highlighted positive sides of their displacement experiences.
Therefore, it is suggested that deliberately thinking of ‘bright sides’ of a difficult situationand trying to make sense of it can contribute to developing PTG.

5.2.4.2. Social Support as a Predictor of PTG
Another main finding in this study is that social support was a significant predictor of PTG.
The more social support the participant IDPs received during the displacement, the higher

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Chapter 5: Findings and Discussion

growth they reported. Moreover, social support (SS-all) in particular was strongly associatedwith Relating to Others (RO) among the five domains of PTG (r(133) = .32, p < .001). That is,
IDPs are more likely to report positive shifts in regard to a sense of relationship with others
when they have a greater degree of experience of being supported by others.
This is illustrated by the following case examples:“I met lots of good people around my family. I remember a situation when we were in thehospital with one of our children, I had no money at all. I had to go to the pharmacy for
medicine for my child. I explained the situation and showed my passport and ID at thepharmacy. I wrote down my address and promised that I would pay the money back later.
They trusted me and allowed us to get the medicine without payment. It impressed me verymuch. The kindness at the pharmacy. It was totally unexpected. The situation was so
extreme at that time that I was crying and shouting, asking for help intensively. The owner ofthe pharmacy shop gave me all we needed in advance without paying anything… I definitely
think I have changed a lot before and after displacement experience. I wasn’t a bad person
before. But I didn’t appreciate people’s help, for example, I didn’t appreciate help from myparents. Now I do not wish any bad things for anyone. I became to visit the place more often
where I was born to see my relatives. I hardly visited them before, for example, only once for
5 years”.

31-year-old female IDP from Donetsk“There were kind people who supported us. As I came from Donetsk in Summer, our family
didn’t have warm clothes for the coming winter. But we got some winter clothes and boots
here for free in *** [name of NGO] and other charity organizations. I also find the ***[nameof NGO]’s support to be very helpful because I got to know other IDPs and could
communicate with them. We developed a friendship through the *** [name of NGO]’s
activities…
I feel like I became a different human being. I think I became a more compassionate personthan I was before. I became to care about and feel feelings and situations of other humanbeings like as my own… I learned to evaluate circumstances, which allowed me to forgive
and help people. I learned not to shout when talking to people. I try to talk to others in a４４Chapter 5: Findings and Discussion

respectful and calming way, including to my family”.

74-year-old female IDP from Donetsk
These findings appear to be extremely important, particularly from the humanitarianpractitioners’ point of view as it underpins the mid or long-term psychosocial support with astrong focus on strengthening social networks for forced migrants. Of course, it is vital tosupport forcibly displaced population through essential sectors such as shelter, livelihoodand health and so on. However, the results in this study suggest that the availability of social
support does matter for the long run. This may be particularly true in the contexts ofsupporting displaced populations who have already experienced loss of social networks.
Moreover, the role of the non-governmental humanitarian community seems to be criticalon building of social networks at the community level, particularly when the local
government shows limited ability to support people in need on the ground.

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Chapter 5: Findings and Discussion

5.3. Context-specific Factors that may Influence PTG
This section explored context-specific factors that may influence PTG. The factors may nothave been captured in the previous PTG studies and emerged as a result of the interview
analysis.
5.3.1. Social Disruption due to Political Divides
One of the factors that appeared to be unique in the Ukrainian IDP contexts was social
disruption due to the political divides. As I spoke to Ukrainian IDPs in the interviews, I
realised that even when they expressed appreciation of kindness from others, the IDPs
were commonly saying “there are more good people than bad people”. What do “badpeople” mean? What social processes have they gone through? To explore this point, theinterviews were analysed in the light of the social process that the IDPs experienced. The
findings suggested that the Ukrainian IDPs not only experienced support from others but
also faced significant degrees of social tension and hostilities. These included:• Loss of social links with their friends and relatives in the eastern regions• Aggressive attitudes from people staying in the east (e.g. being treated as a
betrayer for moving to the west)• Discrimination and bullying from the host community (particularly related tohousing and education for children)• Hostility from local people (particularly for men being accused of not staying in theeast and joining the conflict)
This implies that political separatism significantly affects civilians’ social experiences bycausing the disruption of social relationships throughout the country. Displaced populationsuch as IDPs, in general, are already vulnerable due to loss of their social links. In addition,social experiences of the IDPs in Ukraine were characterised by hostile attitudes from boththe host community and individuals from their place of origin. In the previous section, theresearch confirmed that positive social experiences such as receiving social support was oneof the significant predictors for PTG. Then, what about negative social experiences? Little isyet known about the relationship between such negative social process and PTG.

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Chapter 5: Findings and Discussion

5.3.2. Relocation and Acculturation Experience prior to Displacement
Relocation experience prior to displacement has emerged as a promoting factor of PTG. The
following two cases are examples that outline experiences of individuals that have a historyof multiple relocations prior to the conflict.
A male IDP who was originally born in Tajikistan, a former state of the Soviet Union,
completed his education and had been working in Donetsk prior to the conflict. After hefled to a new place within Ukraine, he established an NGO and devoted himself to help IDPs
coming from eastern regions. He also worked together with other international NGOs andcoordinated the allocation of external aids. He was asked why he was so passionate about
helping people:“My father was a serviceman of the Soviet Union. And family of a serviceman has to live in
one place only for a year or a year and half and move to the next. I changed schools 7 times
when I was young. Every time I moved, I had to go to new school, make new friends, get toknow the people and learn the local norms. I just changed my social environment manytimes. I think those experiences made me think I’m like a global citizen, not a local person. Do
you know how the Soviet Union was geographically huge with different nationalities fromone cultural context to another?”Another male IDP who was originally born in St. Petersburg in Russia experienced multiple
relocations in the early period of his life, these included Russia, Georgia and Ukraine. He
started a new coffee shop business after he moved to Kyiv from Donetsk and was excited
because he saw the displacement as “an opportunity” and “another step”. He explained thereason behind this optimistic attitude as follows:“I am an optimistic person and of course, it’s [the displacement] an opportunity. I was neverconnected to some special place like my hometown and like my home where I want to live
for all of my life… I always changed territories and maybe it's some kind of travelling… And I
think that's not even my choice. Maybe it's a choice of the era. I don't know. I mean theSoviet Union was collapsed and people needed to move from one country to another as myparents because my mom is from here [Ukraine] and my dad is from Georgia and they havefriends in Russia. And why they moved? Because they were looking for opportunities where

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Chapter 5: Findings and Discussion

they can grow their family well. In Russia, in Georgia or in Ukraine? And they always tried. Sothat was a mission of my early period of life in this eight years”.

It is important to note here that these relocations were not made by their own choices in asense that such relocations were caused by their parents’ job or the collapse of the Soviet
Union. The IDPs with the most significant change episodes had already had the experienceof forced migration and subsequent acculturation processes. It is not so difficult to imagine
that with similar life experience, individuals can minimise their distress caused by the criticallife event, accept major changes occurred in their lives and develop new learnings by taking
advantage of their previous acculturation experiences. This gives insights for further
research in the field of PTG: relocation experience prior to displacement may be a
promoting factor of PTG in forced migration contexts. To expand this insight more into theresearch field of posttraumatic growth in general, it is recommended that researchers
should consider that there may be context-specific factors to promote PTG depending ontypes of major life crises or traumatic events. Having similar life experiences prior to a major
life crisis, individuals are likely to develop positive changes out of it.

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Chapter 6: Conclusion

Chapter 6
Conclusion

Can people grow and strive from challenging, potentially traumatic life experiences? This
study was interested in uncovering possibly positive effects of displacement experiences.
The target population of the research were conflict-affected IDPs in Ukraine and it focusedon the phenomenon called posttraumatic growth (PTG), referred as “positive psychologicalchange experienced as a result of the struggle with highly challenging life circumstances”(Tedeschi and Calhoun, 2004, p.1).
The overall aim was to gain a better understanding of PTG experienced by IDPs in Ukraine.
More precisely, the research has taken the mixed-methods approach in order to achieve
the following three aims:
1) To understand if PTG occurred among Ukrainian IDPs after 5 years since the conflict2) To explore predictors of PTG
3) To generate knowledge about context-specific factor(s) that may influence PTG
First, the main finding of this research was that 61.48% of the sample Ukrainian IDPs
reported at least a small or moderate degree of PTG. It is known that there are possibly fiveforms of positive changes, which is Relating to Others, Personal Strength, New Possibilities,
Spiritual Changes and Appreciation of Life (see section 2.3). Among these five domains ofPTG, Appreciation of Life was the most commonly reported area of changes, followed by
Personal Strength. Consistent with findings from previous studies, there has been a positive
relationship between PTG and well-being status. Namely, IDPs who perceive a greater
degree of positive changes after displacement are more likely to have better well-being
statuses (e.g. adjustment, life satisfaction and overall mood). This can be a useful guide forhumanitarian practitioners, particularly when developing an aid programme for forced
migration. By focusing on factors associated with PTG, the humanitarian community can

４９Chapter 6: Conclusion

better respond in supporting well-being of a displaced population.
The mixed-methods research design fitted well in this study. The PTG was not only
quantitatively described but also concrete examples of each domain of changes werequalitatively described. The case examples of positive changes made it clear that PTG
involves ‘transformation’ within individuals in many different areas: their worldview,priority in life, childcaring behaviour, perception of oneself, perception of interpersonal
relationships, religious belief and practice, perception of resources and life possibilities andso on. Moreover, the qualitative analysis of the interviews underpinned the theoretical viewthat PTG emerges as a result of a coping and meaning-making process.
Second, the research also focused on predictors of PTG by retrospectively measuring
participants’ experiences concerning PTG-related factors, including environmental, socialand coping factors. It revealed that coping processes such as positive reinterpretation andrumination during displacement are the most significant factors that can predict PTG. Thisfinding was consistent with previous research, highlighting the critical roles of cognitive
processing on developing a perception of positive changes following a major life crisis suchas displacement. Social support was found as another significant predictor of PTG. With thepositive correlation between PTG and well-being, this provides empirical evidence thathumanitarian practitioners should put a strong focus on strengthening social networks forforced migrants such as IDPs.
Third, the research looked at potentially influencing factors that may not have been
covered in the literature. Two factors appeared to be unique in the Ukrainian IDP contexts
regarding PTG. One of them was social disruption due to political separatism. Social
experiences of the IDPs in Ukraine were characterised by receiving hostile attitudes fromboth the host community and individuals from their place of origin. The social disruption
seems to be an inhibiting factor of PTG, yet little is known about the relationship between
such negative social process and PTG. The other factor was relocation experience prior todisplacement, which emerged as a promoting factor of PTG. The IDPs who outline the mostsignificant change episodes had already had the experience of forced migration andsubsequent acculturation processes. This provides implications for further studies; researchin the field of PTG needs to be mindful of its contexts. Depending on types of traumatic

５０Chapter 6: Conclusion

events, earlier similar life experiences may be a factor for predicting PTG.
Finally, it is important to emphasise that posttraumatic growth is the flip side of humansuffering. It is the case that many participants reported positive changes as a result of
displacement experiences. However, as previous research shows, perceived posttraumatic
growth does not necessarily mean the absence of posttraumatic symptoms nor distress.
The findings of this research, therefore, should not be overgeneralised and should not be
used for misleading a humanitarian or clinical practice like “Think positively. It will help you”
or a “Don’t worry. You will grow from this experience” type of approach for survivors ofmajor life crises. With this regard, I recall one of the female interviewees saying to me, “I
think I gained nothing. I just lost a lot” although she recognised that the displacement
experience brought about toughness in her. We must remember that growth comes only
after struggles (or sometimes co-exists with distress).
Mindful of this point, it would be meaningful if further research was carried out looking into
both negative and positive consequences of displacement, taking into consideration thecoexistence of posttraumatic stress symptoms and PTG. Furthermore, it would be helpful
for humanitarian practitioners if future studies can investigate how best humanitarian
programmes can promote positive interpretation and social links among displaced
population.

５１

Bibliography

Bibliography
Baker, R. et al. (1983) The Psychosocial problems of refugees. London : British RefugeeCouncil and European Consultation on Refugees and Exiles.
BBC (2014a) Crimea referendum: Voters ‘back Russia union’, BBC News. Available at:https://www.bbc.com/news/world-europe-26606097 (Accessed: 20 July 2019).
BBC (2014b) Ukraine says Donetsk ‘anti-terror operation’ under way. Available at:https://www.bbc.com/news/world-europe-27035196 (Accessed: 22 August 2019).
BBC (2019) Ukraine country profile. Available at: https://www.bbc.com/news/worldeurope-18018002 (Accessed: 1 August 2019).
Binder, E. B. et al. (2008) ‘Association of FKBP5 polymorphisms and childhood abuse withrisk of posttraumatic stress disorder symptoms in adults’, Jama. American Medical
Association, 299(11), pp. 1291–1305.
Brewin, C. R., Andrews, B. and Valentine, J. D. (2000) ‘Meta-analysis of risk factors for
posttraumatic stress disorder in trauma-exposed adults.’, Journal of consulting andclinical psychology. American Psychological Association, 68(5), p. 748.
Calhoun, L. G. et al. (2000) ‘A correlational test of the relationship between posttraumatic
growth, religion, and cognitive processing’, Journal of Traumatic Stress: Official
Publication of The International Society for Traumatic Stress Studies. Wiley Online
Library, 13(3), pp. 521–527.
Calhoun, L. G. and Tedeschi, R. G. (1998) ‘Posttraumatic growth: Future directions’, inPosttraumatic growth: Positive changes in the aftermath of crisis. Routledge, pp.
217–240.
Calhoun, L. G. and Tedeschi, R. G. (1999) Facilitating posttraumatic growth: A clinician’s
guide. Routledge.
Calhoun, L. G. and Tedeschi, R. G. (2014) Handbook of posttraumatic growth: Research andpractice.
Routledge.
Availableat:https://books.google.co.uk/books?id=BHEABAAAQBAJ&printsec=frontcover&source=gbs_ViewAPI&redir_esc=y#v=onepage&q&f=false.
Cann, A. et al. (2010) ‘A short form of the Posttraumatic Growth Inventory’, Anxiety, Stress,
５２

Bibliography& Coping. Taylor & Francis, 23(2), pp. 127–137.
Carver, C. S., Scheier, M. F. and Weintraub, J. K. (1989) ‘Assessing coping strategies: A
theoretically based approach.’, Journal of Personality and Social Psychology, 56(2), pp.
267–283. doi: 10.1037/0022-3514.56.2.267.
Clay, R., Knibbs, J. and Joseph, S. (2009) ‘Measurement of posttraumatic growth in young
people: A review’, Clinical Child Psychology and Psychiatry. Sage Publications Sage
UK: London, England, 14(3), pp. 411–422.
Council of Europe (2014) The humanitarian situation of Ukrainian refugees and displaced
persons, 28 November 2014, Provisional version. Available at:https://www.refworld.org/cgibin/texis/vtx/rwmain?page=search&docid=548584134&skip=0&query=displacemen
t&coi=UKR (Accessed: 19 August 2019).
Creswell, J. W. and Clark, V. L. P. (2017) Designing and conducting mixed methods research.
Sage publications.
Cryder, C. H. et al. (2006) ‘An exploratory study of posttraumatic growth in children
following a natural disaster’, American Journal of Orthopsychiatry. Wiley Online
Library, 76(1), pp. 65–69.
Denscombe, M. (2014) The good research guide: for small-scale social research projects.
McGraw-Hill Education (UK).
Faundes, C. (2016) ‘An analysis of the crisis in Ukraine, and its three conflicts (21 of
november 2013, through 23 of may 2014)’, Revista de relaciones internacionales,
estrategia y seguridad, 11(2), pp. 137–159. doi: 10.18359/ries.1874.
Helgeson, V. S., Reynolds, K. A. and Tomich, P. L. (2006) ‘A meta-analytic review of benefit
finding and growth’, Journal of consulting and clinical psychology. American
Psychological Association, 74(5), p. 797.
Hitch, P. J. and Rack, P. H. (1980) ‘Mental illness among Polish and Russian refugees in
Bradford’, The British Journal of Psychiatry. Cambridge University Press, 137(3), pp.
206–211.
IDMC (2018) Ukraine: Annual conflict and disaster displacement figures. Available at:
http://www.internal-displacement.org/countries/ukraine (Accessed: 4 August 2019).
５３

Bibliography

IFRC (2014) DREF operation update Ukraine: Civil Unrest (07Mar2014). Available at:https://www.ifrc.org/en/publications-andreports/appeals/?ac=&at=0&c=&co=SP5UAUA&dt=1&f=2014&p=1&re=&t=2017&ti=&zo= (Accessed: 18 August 2019).
IFRC(2016)World
Disaster
Report2016.
Available
https://www.ifrc.org/Global/Documents/Secretariat/201610/WDR
FINAL_web.pdf (Accessed: 15 August 2019).

at:
2016-

IFRC (no date) Humanity. Available at: https://www.ifrc.org/en/who-we-are/vision-andmission/the-seven-fundamental-principles/humanity/ (Accessed: 15 October 2019).
Joseph, S. and Butler, L. D. (2010) Positive Changes Following Adversity, PTSD Research
Quarterly. Available at: www.ptsd.va.gov (Accessed: 16 May 2019).
Joseph, S., Williams, R. and Yule, W. (1993) ‘Changes in outlook following disaster: The
preliminary development of a measure to assess positive and negative responses’,
Journal of traumatic stress. Wiley Online Library, 6(2), pp. 271–279.
Kessler, R. C. et al. (2008) ‘Trends in mental illness and suicidality after Hurricane Katrina’,
Molecular psychiatry. Nature Publishing Group, 13(4), p. 374.
Kimhi, S. et al. (2010) ‘Postwar winners and losers in the long run: Determinants of war
related stress symptoms and posttraumatic growth’, Community Mental Health
Journal.
Springer,46(1),
pp.
10–19.
Availableat:https://www.researchgate.net/profile/Shaul_Kimhi/publication/235323701_post_w
ar_winners_and_losers/links/09e41510be1c4595e9000000/post-war-winners-andlosers.pdf.
Krupinski, J. and Docent, M. D. (1967) ‘Sociological aspects of mental ill-health in migrants’,
Social Science & Medicine (1967). Elsevier, 1(3), pp. 267–281.
Laufer, A. and Solomon, Z. (2006) ‘Posttraumatic symptoms and posttraumatic growthamong Israeli youth exposed to terror incidents’, Journal of Social and ClinicalPsychology. Guilford Press, 25(4), pp. 429–447.
Levine, S. Z. et al. (2008) ‘Posttraumatic growth in adolescence: Examining its components
and relationship with PTSD’, Journal of traumatic stress. Wiley Online Library, 21(5),pp. 492–496.

５４

Bibliography

Linley, P. A. and Joseph, S. (2004) ‘Positive Change Following Trauma and Adversity: A
Review’, Journal of Traumatic Stress, 17(1), pp. 11–21. Available at:https://pdfs.semanticscholar.org/bf3d/0c6f34f2dd266406625b4bc6ddbb483be513.
pdf (Accessed: 22 March 2019).
Liu, W. T., Lamanna, M. and Murata, A. (1979) ‘Transition to nowhere: Vietnamese refugees
in America’.
Meyerson, D. A. et al. (2011) ‘Posttraumatic growth among children and adolescents: A
systematic review’, Clinical psychology review. Elsevier, 31(6), pp. 949–964.
Mitchell, T. and Harris, K. (2012) Resilience: A risk management approach. Background Note.
Available at: www.odi.org.uk (Accessed: 19 November 2018).
OCHA (2015) Ukraine Humanitarian Snapshot - As of July 15, 2015. Available at:https://www.humanitarianresponse.info/en/operations/ukraine/infographic/ukrain
e-humanitarian-snapshot-july-15-2015 (Accessed: 4 September 2019).
OCHA (2016) Housing Land and Property Rights of Displaced and Conflict-Affected
Communities in Eastern Ukraine, January 2016 | HumanitarianResponse. Available
at:https://www.humanitarianresponse.info/en/operations/ukraine/document/housing-land-and-property-rights-displaced-and-conflict-affected (Accessed: 4 September2019).
OCHA(2019) Ukraine Humanitarian Response Plan 2019. Available at:https://www.acaps.org/country/ukraine/crisis/conflict (Accessed: 4 August 2019).

OHCHR (2014) Report of the United Nations High Commissioner for Human Rights on thesituation of human rights in Ukraine (as of 19 September 2014). Available at:https://www.ohchr.org/EN/HRBodies/HRC/RegularSessions/Session27/Documents/
A-HRC-27-75_en.pdf (Accessed: 1 September 2019).
OHCHR (2017) Conflict in Ukraine enters its fourth year with no end in sight – UN report.
Availableat:https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=21730(Accessed: 22 September 2019).
OSCE (2014) Internal displacement in Ukraine 12 August 2014. Available at:５５Bibliography

https://www.refworld.org/docid/598c4c8f4.html (Accessed: 19 August 2019).
Oxford Brookes University (2016) Research Ethics for Research involving Human
Participants - Code of Practice. Available at: www.brookes.ac.uk/research/policiesand-codes-of-practice (Accessed: 18 April 2019).
Park, C. L., Cohen, L. H. and Murch, R. L. (1996) ‘Assessment and Prediction of StressRelated Growth’, Journal of Personality. John Wiley & Sons, Ltd (10.1111), 64(1), pp.
71–105. doi: 10.1111/j.1467-6494.1996.tb00815.x.
Park, C. L. and Fenster, J. R. (2004) ‘Stress-Related Growth: Predictors of Occurrence andCorrelates with Psychological Adjustment’, Journal of Social and Clinical Psychology,
23(2), pp. 195–215. doi: 10.1521/jscp.23.2.195.31019.
Polatinsky, S. and Esprey, Y. (2000) ‘An assessment of gender differences in the perceptionof benefit resulting from the loss of a child’, Journal of Traumatic Stress: Official
Publication of The International Society for Traumatic Stress Studies. Wiley Online
Library, 13(4), pp. 709–718.
Prati, G. and Pietrantoni, L. (2009) ‘Optimism, social support, and coping strategies asfactors contributing to posttraumatic growth: A meta-analysis’, Journal of loss andtrauma. Taylor & Francis, 14(5), pp. 364–388.
Pugh, M. J. V et al. (2014) ‘Complex comorbidity clusters in OEF/OIF veterans: thepolytrauma clinical triad and beyond’, Medical care. LWW, 52(2), pp. 172–181.
Riddell, R. C. (2008) Does foreign aid really work? Oxford University Press. Available at:https://books.google.co.jp/books?hl=ja&lr=lang_ja%7Clang_en&id=n6gVDAAAQBAJ&oi=fnd&pg=PR7&dq=does+aid+work%3F&ots=FNkTIkmNOp&sig=r5UGmjFJ3FBcyX
5VO7D8itk785s&redir_esc=y#v=onepage&q=does aid work%3F&f=false.
Sleijpen, M. et al. (2016) ‘Growing from experience: an exploratory study of posttraumatic
growth in adolescent refugees’, European Journal of Psychotraumatology. Taylor &Francis, 7(1), p. 28698. doi: 10.3402/ejpt.v7.28698.
Solomon, S., Greenberg, J. and Pyszczynski, T. (1991) ‘Terror management theory of selfesteem’, Handbook of social and clinical psychology: The health perspective, 162, pp.
21–40.
Splevins, K. et al. (2010) ‘Theories of Posttraumatic Growth: Cross-Cultural Perspectives’,
５６

Bibliography

Journal of Loss and Trauma. Taylor & Francis Group , 15(3), pp. 259–277. doi:
10.1080/15325020903382111.
Taylor, S. E. (1983) ‘Adjustment to threatening events: A theory of cognitive adaptation’,
American psychologist. American Psychological Association, 38(11), p. 1161.
Tedeschi, R. G. and Calhoun, L. G. (1996) ‘The Posttraumatic Growth Inventory: Measuring
the positive legacy of trauma’, Journal of Traumatic Stress. Kluwer Academic
Publishers, 9(3), pp. 455–471. doi: 10.1007/BF02103658.
Tedeschi, R. G. and Calhoun, L. G. (2004) ‘Posttraumatic Growth: Conceptual Foundations
and Empirical Evidence’, Psychological Inquiry. Lawrence Erlbaum Associates, Inc.,
15(1), pp. 1–18. doi: 10.1207/s15327965pli1501_01.
Tedeschi, R. G., Park, C. L. and Calhoun, L. G. (1998) Posttraumatic growth: Positive changes
intheaftermathofcrisis.
Routledge.
Availableat:https://books.google.co.jp/books?hl=en&lr=&id=Bs6QAgAAQBAJ&oi=fnd&pg=PP1&
dq=posttraumatic+growth+future+directions&ots=CEbwxQb6zB&sig=kAm7wSlXGgz
uKUfOZGzDvNVHsl8#v=onepage&q=posttraumatic growth future directions&f=false.
Tennen, H. and Affleck, G. (2002) ‘Benefit-finding and benefit-reminding’, Handbook of
positive psychology, 1, pp. 584–597.
UN (2014) General Assembly Adopts Resolution Calling upon States Not to Recognize
Changesin
Statusof
CrimeaRegion.
Availableat:https://www.un.org/press/en/2014/ga11493.doc.htm (Accessed: 20 September2019).
UN Women (2015) UN tackles gender and humanitarian impacts of Ukraine’s eastern
conflict. Available at: https://eca.unwomen.org/en/news/stories/2015/10/ukraineun-tackles-gender-and-humanitarian-impacts (Accessed: 4 September 2019).
UNHCR (2014a) Ukraine: Overview of population displacement (as of 20 August 2014).
Availableat:https://www.refworld.org/cgibin/texis/vtx/rwmain?page=search&docid=53fc72fe4&skip=0&query=displacement&coi=UKR (Accessed: 19 September 2019).
UNHCR (2014b) Ukraine: UNHCR External Update on the Situation of Displaced Persons, 10
July 2014. Available at: https://www.refworld.org/docid/53c5154b4.html (Accessed:

５７

Bibliography

19 August 2019).
UNHCR (2015) International Protection Considerations Related to the Developments in
Ukraine – Update II. Available at: https://www.refworld.org/docid/54c639474.html(Accessed: 16 September 2019).
UNHCR (2017) Global Trends Forced Displacement In 2017.
https://www.unhcr.org/5b27be547.pdf (Accessed: 1 April 2019).

Availableat:Vaughn, A. A., Roesch, S. C. and Aldridge, A. A. (2009) ‘Stress-related growth in racial/ethnic
minority adolescents: Measurement structure and validity’, Educational andPsychological Measurement. Sage Publications Sage CA: Los Angeles, CA, 69(1), pp.
131–145.
Availableat:https://www.researchgate.net/profile/Allison_Vaughn/publication/247727978_Stre
ssRelated_Growth_in_RacialEthnic_Minority_Adolescents_Measurement_Structure_and_Validity/links/56f5710c08ae7c1fda2ee707.pdf.
Vogt, D. S., King, D. W. and King, L. A. (2007) ‘Risk pathways for PTSD’, Handbook of PTSD:
Science and practice. Guilford Press New York, pp. 99–115.
Whole House Counseling & Consultation (no date) Forms of Post Traumatic Growth.
Availableat:https://www.wholehouseconsultation.com/coaching-services(Accessed: 5 July 2019).
Zimet, G. D. et al. (1988) ‘The Multidimensional Scale of Perceived Social Support’, Journalof Personality Assessment. Lawrence Erlbaum Associates, Inc., 52(1), pp. 30–41. doi:
10.1207/s15327752jpa5201_2.
Zisook, S., Chentsova-Dutton, Y. and Shuchter, S. R. (1998) ‘PTSD following bereavement’,
Annals of clinical psychiatry. Springer, 10(4), pp. 157–163.

５８Appendices

Appendix 1: Questionnaire (English version)

Questionnaire for Internally Displaced Persons

This questionnaire is intended for the internally displaced persons in Ukraine. The study is being organizedby the Oxford Brookes University in the United Kingdom with the help of the Ukrainian Red Cross
Society, aiming to gain better understanding of the displacement experience and to generate knowledge forbetter practice to support forcibly displaced persons. Approximate time to complete the questionnaire is
15-20 minutes. So, kindly please give a short moment and join the survey. Anyone can answer thequestionnaire as long as one can read and understand. We sincerely appreciate your cooperation.

Please give us consent for using your data by ticking the below ‘Yes’. All the data collected here will bestrictly used anonymously.
I agree to my data in the questionnaire being used.
☐Yes
Were you living in eastern Ukraine or Crimea prior to the conflict escalated in 2014?
☐Yes
☐No

If both are yes, please proceed to the next page.

５９

AppendicesPart 1: Personal information
For each question below, please choose the most appropriate answer about yourself or insert the right one.
1-0. Category:☐ IDP☐ Demobilized serviceman☐ Family of serviceman
1-1. Gender:☐Male☐Female1-2. Age: ______ years old
1-3. Where are you currently living?
☐Kyiv city
☐Kyiv region☐Vinnytsya☐Lyiv☐Zaporizhya☐Kherson☐Dnipropetrovsk☐Poltava☐Kharkiv☐Donetsk☐Luhansk☐Other* (________________________________________) *Please indicate the place of your current
residence if you tick other.
1-4. Which part of eastern Ukraine or Crimea are you from?
☐Donetsk province☐Luhansk province☐Crimea☐Other* () *Please indicate where you are from if you tick “Other”.
1-5. Marital status(possibly multipl anwers)☐Single, never married☐Married☐Civil marriage☐Widowed☐Divorced☐Separated
1-6. Education level☐Not completed school education

６０

Appendices☐School graduated☐Vocational school☐Some college credit, but not completed☐Collage☐Bachelor’s degree☐Specialist degree☐Master’s degree☐Doctorate degree

1-7. When did you first flee your home in eastern Ukraine or Crimea?
(Accurate date is not needed. You can just put month and year and leave random number in the day section.)

1-8. Did you flee your home due to the conflict?
☐Yes☐No* (___________________________________)
home if you tick ‘No’.

*Please indicate other reason that you left

1-9. How many time(s) did you change your settlement since you first left your home? : ______ time(s)1-10. On a scale of 1 to 9, how would you rate your adjustment level to your new life since you resettled in thecurrent place? Indicate your current adjustment level.
1 (I am not adjusted to the current environment at all)9 (I am perfectly adjusted to the current environment).

1-11. On a scale of 1 to 9, how would you rate your satisfaction level with your current life? Indicate yourcurrent overall satisfaction level.
1 (the worst possible life I could imagine)
9 (the best possible life I could imagine).

1-12. On a scale of 1 to 9, how would you rate your overall mood for the past one month?
1 (very stressful)
9 (very happy)

６１AppendicesPart 2: Changes in yourself
Following statements ask about changes occurred in yourself as a result of your displacement experience.
Please read each one and choose the most appropriate answer to indicate how much you agree or disagreewith it AT THE PRESENT TIME:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

As a result of displacement, mypriorities about what is
important in life have changed.
As a result of displacement, I
gained a greater appreciation
for the value of my own life.
As a result of displacement, I
became able to do better things
with my life.
As a result of displacement, I
had a better understanding of
spiritual matters.
As a result of displacement, I
gained a greater sense of
closeness with others.
As a result of displacement, I
established a new path for mylife.
As a result of displacement, I
became to know better that I
can handle difficulties.
As a result of displacement, I
gained a stronger religious
faith.
As a result of displacement, I
discovered that I’m stronger
than I thought I was.
As a result of displacement, I
learned a great deal about how
wonderful people are.

Strongly

MostlyDisagree aAgree aMostlyStrongly

DisagreeDisagreelittlelittle

Agree

Agree

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

６２

AppendicesPart 3: Social network
Following statements ask you about available social networks for you during your displacement experience.
Please read each one and choose the most appropriate answer to indicate how much you agree or disagreewith it. Please keep in mind that each question asks about social networks available for you DURING YOURDISPLACEMENT EXPERIENCE:
Strongly

Disagree to

Neither Agree

Agree to some

Disagreesome extent

nor Disagree

extent

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

9. There were special persons
in my life who cared about
my feelings.

☐

☐

☐

☐

☐

10. There is a special personwith whom I can share myjoys and sorrows.

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

☐

Since my displacement…
1. I had special persons who
were around when I was inneed.
2. My family really tried to helpme.
3. I got the emotional help andsupport I need from myfamily.
4. I had special persons who
were a real source of comfort
to me.
5. My friends really tried tohelp me.
6. I could count on my friends
when things go wrong.
7. I could talk about myproblem with my family.
8. I had friends with whom I
could share my joys andsorrows.

11. My family is willing to help
me make decisions.
12. I can talk about my problems
with my friends.

Strongly Agree

６３

AppendicesPart 4: Coping
You are almost there! This is the last section.

Leaving home and resettling in a new place is often tough. Following statements ask you about how you have
coped with the displacement experience since you left home. Obviously, different events bring out somewhat
different responses but think about how you have coped since you left home.

Since the displacement started…
1. I tried to get used to the idea that it happened.
2. I thought about it and tried to figure out why
things like that happened.
3. I tried to see it in a different light to make itseem more positive.
4. I tried to accept the reality of the fact that it
happened.
5. I looked for something good in what was
happing.
6. I tried to accept that this has happened andthat it can’t be changed.
7. I tried to make something good come out of
my struggle.
8. I tried to grow as a person as a result of theexperience.

I didn’t do

I did this a

I did this to

I often did

this at all.

little bit.

some extent.

this.

☐

☐

☐

☐

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9. I tried to learn something from the experience.
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10. I reminded myself of some of the benefits thatcame from adjusting to the difficult
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11. I tried to live with it.

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This is the end of the questionnaire. Thank you so much for your time!!
If you have any questions and concerns about this questionnaire, please contact Reo Morimitsu at
18023080@brookes.ac.uk

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Appendices

Appendix 2: Ethical Form (TDE Form E1)

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Appendices６６Appendices

Appendix 3: Ethical Form (TDE Form E2)

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Appendices６８

Appendices６９Appendices７０

Appendices

Appendix 4: Ethical Approval Form (Form E3)

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Appendices

Appendix 5: Photo Credit
Cover photo – Source: Bloomberg. Available at: (Accessed: 19 September 2019)７２