Longitudinal cross-lagged association between posttraumatic stress disorder, post-traumatic growth, and deliberate rumination among healthcare staff 2 years after the COVID-19 pandemic in Hubei Province, China

Background Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are inspiratory areas of psychological research in which deliberate rumination has important implications. However, these relationships have not yet been assessed in the COVID-19 pandemic using longitudinal designs. Methods In this study, measures of PTSD, PTG, and deliberate rumination were collected from 2,292 healthcare staff members at two-time points six months apart in 2022-2023 from two general hospitals in Hubei Province, China. A cross-lagged analysis was used to simultaneously determine the directional relationships between these three variables. Results The results suggest that the relationship between PTG and deliberate behavior is bidirectional and mutually reinforcing (beta = 0.133, P < 0.001; beta = 0.129, P < 0.001). Significant prospective relations were observed between PTG and PTSD (beta = 0.054, P < 0.01), and PTSD prospectively predicted changes in deliberate rumination (beta = 0.204, P < 0.001). In addition, significant sex differences were observed in the cross-lagged models. Conclusion These findings highlighted the noteworthy cross-lagged relationship between PTSD, PTG, and deliberate rumination two years after the COVID-19 pandemic in Hubei Province, China. Therefore, interventions to reduce PTSD, promote PTG, and improve well-being among healthcare staff are important.