Thorburn, Joanne Marie (2021) Psychological Recovery After Aneurysmal Subarachnoid Haemorrhage: The Role of Post-traumatic Growth and Self-Compassion. PhD thesis, Victoria University.

Abstract

Aneurysmal subarachnoid haemorrhage (aSAH), a subset of haemorrhagic stroke, is a potentially fatal condition with a mortality rate of 50%. Of those that survive, some 60% will experience ongoing disability and impairment. Forty percent of remaining survivors will experience what is deemed as a good neurological recovery. Despite this seemingly good recovery, people have still been found to experience negative psychosocial outcomes such as elevated levels of post- traumatic stress symptoms (PTSS), depression and reduced levels of overall well- being. As a result, an aSAH can be viewed as a traumatic life experience with the potential for ongoing psychological sequelae. More recently the literature has identified that traumatic experiences can also elicit an opportunity for growth. Post-traumatic growth (PTG) has previously been investigated as an outcome after a range of natural disasters and medical conditions; however, no known studies have specifically investigated PTG after an aSAH. Recently PTG has been identified as playing a psychologically protective role after a diagnosis of breast cancer. The Transformational theory of PTG posits that there is an interrelationship between cognitive and social aspects of an individual’s functioning after trauma that may support the recovery process. This model will be used for this study. This research comprised two separate studies incorporating established measures and semi-structured interviews. The quantitative study comprised N = 251 adults who had experienced an aSAH, and were recruited from Australia, New Zealand, U.K., U.S.A. and Canada. This study examined whether people who have survived an aSAH experience PTG; if predictors including self-compassion and social support influence the development of PTG after an aSAH; if PTG moderates the relationship between PTSS, and depression and subjective well-being (SWB); and if self-compassion moderates the relationship between PTSS and depression and SWB. Regression analyses were used to analyse the data. Results showed that people experience PTG after an aSAH; Self-compassion predicted PTG, but social support did not; PTG and self- compassion were not found to moderate the relationship between PTSS and either depression or SWB domains. Supplementary analyses revealed that self- compassion was found to mediate the relationship between PTSS and depression and PTSS and SWB domains. The qualitative study comprised N = 6 Australian adults exploring experiences of recovery. Qualitative data was analysed using a comparative exploratory descriptive case studies approach with four categories (physical, psychological, social, and treatment) and four main cross-case themes identified: psychological impacts, physical impacts, impact on family, friends and work, interaction with medical professionals and the implications of surgical treatment. Exploration of PTG and self-compassion after an aSAH was also explored with seven themes being identified: feeling grateful, new directions in life, prioritising living life to the fullest, strengthening of relationships, spiritual and existential growth and change, self-criticism and frustration, and putting the aSAH experience in context.

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