TPC Journal V7, Issue 4 - FULL ISSUE

330 Hannah E. Acquaye PTSD, Optimism, Religious Commitment, and Growth as Post-Trauma Trajectories: A Structural Equation Modeling of Former Refugees Refugees report several mental health challenges associated with pre-, peri-, and post-flight conditions. Some of these challenges include fear, anxiety, hypervigilance, hyperarousal, and nightmares—symptoms that could meet the diagnostic criteria for post-traumatic stress disorder (PTSD). Despite these challenges, some refugees also report psychological growth with nomenclature like post-traumatic growth, resilience, and benefit-finding. This study examined the directional relationship among war-related events, optimism, PTSD, religious commitment, and growth. Prior studies in traumatized samples have demonstrated that PTSD and growth can occur concurrently, while optimism and religiousness may enhance growth. The hypotheses undergirding this study posited that participants in this non-Western population could demonstrate concurrent PTSD and growth, while those with higher levels of optimism and religiousness would exhibit increased levels of growth compared to those with lower levels. For a sample of 444 former refugees, hypotheses were theoretically modeled to identify whether the data fit the model. Inspection of fit indices provided support for the hypothesized model. Implications for professional counselors are included and recommendations for future research are provided. Keywords : refugees, post-traumatic growth, PTSD, optimism, religious commitment Professional counselors who work with refugees, specifically refugees resettled as a result of war or conflict, hear their clients share the harrowing experiences encountered on their journeys toward safety (Clay, 2017; International Counseling and Community Services [ICCS], 2015). War-related internally displaced persons (IDPs) and refugees, more than immigrants or other displaced people, report suffering inhumane acts like ethnic cleansing (United Nations, 2017). Others describe running through forests to avoid warring tribal factions, defending themselves against wild animals and forces of nature, and going without food for days (Betancourt et al., 2015). These experiences can be traced through the precipitating events leading to their flight, the flight progression, and finally the pathways to resettlement. Each of these processes incurs a traumatic adjustment. Clients among this population have reported diverse somatic symptoms and physical challenges (Cline, 2013; Edge, Newbold, & McKeary, 2014), as well as difficulties associated with basic physiological needs (e.g., food, water, shelter; ICCS, 2015; Maslow, 1970). They have described symptoms that meet the criteria for diagnosing post-traumatic stress disorder (PTSD; American Psychiatric Association [APA], 2013; Zerach, Solomon, Cohen, & Ein-Dor, 2013), depression (APA, 2013; Praetorius, Mitschke, Avila, Kelly, & Henderson, 2016), anxiety (APA, 2013; ICCS, 2015; Praetorius et al., 2016), and bereavement (APA, 2013; ICCS, 2015). Dated research has examined these conditions in refugees through the lens of psychopathology; however, studies spanning the past three decades have emphasized the salutogenic components of post-trauma experience (Antonovsky, 1987). Salutogenesis originates from the Latin salus , meaning “health,” and was developed by Antonovsky (1987), who suggested that when people encounter stress, not all will have negative health outcomes. He therefore entreated researchers to use a strength- based lens instead of a deficit-based one in understanding human reactions to stress (Antonovsky, 1993). Although a strength-based perspective of post-trauma paths was not a new concept (Splevins, The Professional Counselor Volume 7, Issue 4, Pages 330–348 http://tpcjournal.nbcc.org © 2017 NBCC, Inc. and Affiliates doi:10.15241/hea.7.4.330 Hannah E. Acquaye, NCC, is an assistant professor at Western Seminary. Correspondence can be addressed to Hannah Acquaye, 5511 SE Hawthorne Blvd., Portland, OR 97215, hacquaye@westernseminary.edu .