The coexistence and trajectories of posttraumatic growth and depreciation: a 36-month longitudinal qualitative narrative analysis

BACKGROUND: Research into posttraumatic growth (PTG) and posttraumatic depreciation (PTD) has predominantly relied on cross-sectional quantitative designs, often overlooking the subjective nuances and temporal dynamics of adaptation. This study aimed to explore the long-term evolution of perceived posttraumatic outcomes and identify emergent domains of change that transcend traditional theoretical models. METHODS: We utilised a longitudinal qualitative design, following a purposive sample of 26 psychology graduates (23 women, 3 men; age M = 34.42, SD = 9.10) over a 36-month interval. Data were collected through semi-structured interviews at two time points: T1 (within 12 months of a seismic life event) and T2 (36 months later). Reflexive thematic analysis (RTA) was employed, integrating deductive theory-driven coding based on established models with the inductive discovery of emergent themes to map individual trajectories of change. RESULTS: Posttraumatic adaptation was characterised by a shift toward narrative complexity, with PTG and PTD coexistence increasing from 42.3% at T1 to 61.5% at T2. Core findings include the identification of emergent domains-Self-Alignment and Autonomous Regulation (growth) and Existential Vulnerability and Insecurity (depreciation)-which were present in over 70% of narratives. We identified four distinct longitudinal trajectories: Persistence, Transience, Latent Impact, and Emergence of Complexity. A dominant pattern was 'Increased Strength at a Relational Cost,' where personal empowerment coexisted with an enduring loss of interpersonal trust. CONCLUSIONS: Posttraumatic adaptation is a non-linear, ongoing process of narrative reconstruction that continues long after the initial crisis. The results underscore the limitations of cross-sectional snapshots and traditional inventories, highlighting the need for longitudinal monitoring to distinguish transient coping from permanent personality transformation. Clinically, the findings suggest that fostering authenticity and self-alignment may be vital for long-term recovery.