title: Posttraumatic growth, depression and posttraumatic stress in relation to quality of life in tsunami survivors: a longitudinal study.
abstract: BACKGROUND
  Quality of life (QoL) may often be reduced in survivors of a natural disaster. This paper investigated how posttraumatic growth (PTG), depression and posttraumatic stress interact and independently predict QoL in a longitudinal study of disaster survivors.
  
  
  METHODS
  A total of 58 Norwegian adults who were present in Khao Lak, Thailand at the time of the 2004 Southeast Asia Tsunami completed self-report questionnaires 2 and 6 years after the disaster. The participants reported symptoms of depression and posttraumatic stress as well as PTG and QoL. Multiple mixed effects regression analyses were used to determine the independent effects of PTG, depression and posttraumatic stress on QoL measured 2 and 6 years after the disaster.
  
  
  RESULTS
  Posttraumatic stress and depression were negatively related to QoL. PTG was not significantly related to QoL in a bivariate analysis. However, considerable interaction effects were found. Six years after the tsunami, high levels of posttraumatic stress were related to lower QoL in those participants with low levels of PTG, whereas lower levels of depression were related to higher QoL in those participants with high levels of PTG.
  
  
  CONCLUSIONS
  Posttraumatic stress and depression are negatively associated with QoL after a natural disaster. PTG may serve as a moderating factor in this relationship.
authors.affiliation: Department of Mental Health Services, Akershus University Hospital, R & D Mental Health Services, 1478, Lørenskog, Norway. josi@ahus.no.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway. josi@ahus.no.
authors.forename: Johan
authors.initials: J
authors.lastname: Siqveland
authors.affiliation: Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. egilny@psykologi.uio.no.|Department of Psychology, University of Oslo, Oslo, Norway. egilny@psykologi.uio.no.
authors.forename: Egil
authors.initials: E
authors.lastname: Nygaard
authors.affiliation: Department of Mental Health Services, Akershus University Hospital, R & D Mental Health Services, 1478, Lørenskog, Norway. Ajmal.Hussain@ahus.no.
authors.forename: Ajmal
authors.initials: A
authors.lastname: Hussain
authors.affiliation: Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA. rtedesch@uncc.edu.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Tedeschi
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway. trond.heir@nkvts.unirand.no.|Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. trond.heir@nkvts.unirand.no.
authors.forename: Trond
authors.initials: T
authors.lastname: Heir
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D004190:Disasters; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013785:Thailand / Q000453:epidemiology; D057192:Tsunamis