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 from an initial cohort of 78 participants over a 36-month interval. Data were collected through semi-structured interviews at two time points (T1: within 12 months of a stressful life event; T2: 36 months later). Reflexive thematic analysis (RTA) was employed to identify perceived shifts in beliefs and to map individual trajectories of change. Results The findings demonstrate that posttraumatic adaptation is characterised by a significant shift toward narrative complexity, with the coexistence of PTG and PTD increasing from 42.3% at T1 to 61.5% at T2. A central contribution of this research is the identification of emergent domains—specifically heightened self-awareness and increased assertiveness—which were present in over 70% of narratives but remained inadequately captured by the traditional five-domain framework. We identified four distinct longitudinal trajectories: Persistence, Transience, Latent Impact, and Emergence of Complexity. Notably, the pattern of "Increased Strength at a Relational Cost" emerged as a dominant theme, 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.