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Bibliothèque Et Archives Canada Library and Archives Bibliotheque et Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-91444-1 Our file Notre reference ISBN: 978-0-494-91444-1 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library and permettant a la Bibliotheque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet, distribuer et vendre des theses partout dans le loan, distrbute and sell theses monde, a des fins commerciales ou autres, sur worldwide, for commercial or non­ support microforme, papier, electronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in this et des droits moraux qui protege cette these. Ni thesis. Neither the thesis nor la these ni des extraits substantiels de celle-ci substantial extracts from it may be ne doivent etre imprimes ou autrement printed or otherwise reproduced reproduits sans son autorisation. without the author's permission. In compliance with the Canadian Conformement a la loi canadienne sur la Privacy Act some supporting forms protection de la vie privee, quelques may have been removed from this formulaires secondaires ont ete enleves de thesis. cette these. While these forms may be included Bien que ces formulaires aient inclus dans in the document page count, their la pagination, il n'y aura aucun contenu removal does not represent any loss manquant. of content from the thesis. Canada AN EXAMINATION OF POST TRAUMATIC GROWTH AND POST TRAUMATIC DEPRECIATION IN PARASPORT ATHLETES WITH AN ACQUIRED SPINAL CORD INJURY by Jennifer J. Crawford Bachelor of Arts, Wilfrid Laurier University, 2010 THESIS Submitted to the Faculty of Graduate Studies In partial fulfillment of the requirements for Master of Science in Kinesiology and Physical Education Wilfrid Laurier University © Jennifer J. Crawford 2012 2 Acknowledgements First and foremost, I would like to thank my supervisor Dr. Jill Tracey who has supported me throughout my thesis. I attribute the level of my Masters degree to her patience, knowledge, encouragement and effort. Secondly, I extend my utmost gratitude to my committee members Dr. Amy Gayman and Dr. Margaret Schneider. Without their guidance and valuable assistance, this study would not have been possible. Dr. Pam Bryden, I thank you for your patience and invaluable insight into statistics. To the athletes who have participated in this study you are a true inspiration and I am happy I was given the opportunity to tell your story. Last but not least my family. Mum and Dad I never could have embarked on this journey without your support and guidance. Thank you for always allowing me to spread my wings and fly but always reminding me where the nest was when I needed it. Emily you have been my motivation and have always showed me the true success that comes with hard work. Michael thank you for making sure I never took life too seriously. My grandparents your support has been endless and 1 will never be able to thank you enough for your wisdom. Curtis I appreciate your patience and support throughout this project and for always lifting my spirits. To those not mentioned your friendship and support has provided me with the encouragement to successfully complete this project. 3 Abstract Post-traumatic growth (PTG) can occur in individuals attempting to adapt to a new set of circumstances following a trauma, period of distress or suffering. Individuals may not return to baseline levels, but can be a period of improvement some individuals experience as profound. Alternatively, some individuals may experience post traumatic depreciation (PTD), negative psychological change that results from trauma. The purpose of the study was to examine the possibility of PTG and/or PTD in ParaSport athletes who acquired a spinal cord injury (SCI) and either integrated or reintegrated into competitive sport. Positive (PTG) and negative (PTD) changes were assessed using the PTGI-42 with participants reporting changes after acquiring a SCI. Twelve of these participants completed semi-structured interviews. It was found that participation in ParaSport post injury had a positive impact on identity, appreciation for life, relating to others, health and wellbeing and increased self-confidence about capabilities in sport and life. While both negative and positive psychological changes occurred simultaneously, a higher level of growth in comparison to depreciation was reported. This study supports theoretical and clinical research that the experience of a medical trauma can act as a catalyst for positive PTG. 4 Table of Contents Acknowledgements 2 Abstract 3 List of Table and Figures 6 Chapter 1: Introduction 7 Chapter 2: Literature Review 10 2.1 Post Traumatic Growth 10 2.1.1 Sex Differences in Post Traumatic Growth 19 2.1.2 Age of Trauma 22 2.2 Post Traumatic Depreciation 23 2.3 Spinal Cord Injury 25 2.3.1 Comorbidities Associated with a Spinal Cord Injury 26 2.3.2 Stress and Quality of Life in Individuals with Spinal Cord Injury 27 2.4 Physical Activity and Organized Sport 30 2.4.1 ParaSport 30 2.4.2 Psychological Effects of Physical Activity and Organized Sport for Individuals with Spinal Cord Injuries 31 2.5 Purpose 32 Chapter 3: Methodology 33 3.1 Research Questions 33 3.2 Research Design 33 3.3 Sampling Strategy 34 3.4 Participants 34 3.5 Procedures and Data Analysis 35 3.6 Triangulation 38 3.7 Qualitative Instruments 39 3.7.1 Demographic Questionnaire and Open Ended Questions 39 3.7.2 Semi Structured Interviews 39 3.7.2.1 Field notes 40 3.7.2.2 Member Checks 40 3.7.2.3 Bracketing 41 3.8 Researcher as a Tool 42 3.9 Quantitative Instruments 43 3.9.1 Post Traumatic Growth Inventory-42 Item 43 3.10 Ethical Considerations 43 3.10.1 Anonymity and Confidentiality 43 3.10.2 Potential Risks From the Study 44 3.10. 3 Potential Benefits from the Study 45 3.10.4 Feedback to participants 45 Chapter 4: Qualitative Results 46 4.1 Introduction to themes 46 4.1.2 Summary of Participants 48 4.2 Injury Relevant Information Processing 49 4.2.1 Loss of Identity 49 4.2.2 Re-establishment of Identity 50 5 4.3 Appreciation for Life 52 4.3.1 Being in the Present 52 4.3.2 Taking Things for Granted 53 4.3.3 Clarity and Perspective 55 4.4 Reactive Behaviour Following Spinal Cord Injury As A Result of Attempted Integration Into ParaSport 57 4.4.1 Problem Solving 57 4.4.2 Confidence 61 4.4.3 Less Judgmental 63 4.5 Relating to Others 64 4.5.1 Family and Friends 65 4.5.2 Meeting People 67 4.5.3 Learning from People 69 4.6 Health and Wellbeing 70 4.6.1 Increased Health and Fitness 70 4.6.2 Independence 72 4.8 Wisdom 74 Chapter 5: Quantitative Results 76 5.0 Post Traumatic Growth Inventory- 42 Item 76 Chapter 6: Discussion and Conclusion 80 6.1 Discussion 80 6.1.1 Injury Relevant Information Processing 81 6.1.2 Greater Appreciation for Life 83 6.1.3 Reactive Behaviour Following SCI As A Result of Attempted Integration Into Sport 85 6.1.4 Relating to Others 87 6.1.5 Health and Wellbeing 88 6.1.6 Personal Strength 88 6.1.7 Religious and Spiritual Growth 89 6.1.8 Sex and Age of Trauma 89 6.2 Study Limitations 90 6.3 Implications 91 6.4 Future Directions 92 Appendices 96 Appendix A: Letter of Recruitment to Key Informants 96 Appendix B: Letter of Recruitment to Participants 97 Appendix C: Informed Consent 98 Appendix D: Demographic Questionnaire 100 Appendix E: Post Traumatic Growth Inventory-42 Item 102 Appendix F: Interview Guide 105 Appendix G: Member Check Response 107 References 108 6 List of Table and Figures Table 1: American Spinal Cord Injury Classification System (Troncoso, Rubio, & Fowler, 2010) 26 Table 2 Medical Complications and Co-Morbidities of SCI (Tate, 2010) 27 Figure 1. General dimensions and second order themes that emerged from the data 47 Table 3: Summary of participant descriptions 48 Table 4: Means, standard deviations and ranges for five factors of the PTGI examining PTG and PTD 77 Figure 2: Percent of total range by growth factors of the PTGI 78 Figure 3: Percent of the total range by depreciation factors from the PTGI 79 7 Chapter 1: Introduction There is a growing body of literature indicating that people who are subjected to traumatic events may experience some form of growth emerging from their struggle in dealing with such events. Populations where such growth has been experienced and researched include individuals coping with season ending ski injuries (Gould, Udry, Bridges, & Beck, 1997); cancer survivors (Barakat, Alderfer, & Kazak, 2010; Burke & Sabiston, 2010; McDonough, Sabiston, & Crocker, 2008); first responders (Shakespeare- Finch, Smith, Gow, Embelton, & Baird, 2003); and victims of road traffic accidents (Salter & Stallard, 2004). Post-traumatic growth (PTG) can occur in individuals attempting to adapt to a new set of circumstances following a period of distress or suffering. PTG is defined as "the experience of positive change that occurs as a result of the struggle with highly challenging life crises" (Tedeschi & Calhoun, 2004, p.
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