Objective Disaster survivors often experience negative impacts on their mental health, but some may also exhibit posttraumatic growth, overcoming adversity, and finding positive outcomes. This study aimed to identify psychological factors influencing posttraumatic growth (PTG) among students who survived the Sewol ferry disaster. Methods The study used a longitudinal design. Data were collected at 6-month intervals between high school graduation and 6 years after the ferry disaster. Data were obtained from 48 adolescents who completed self-report measures of rumination, meaning in life, coping, PTG, family adaptability and cohesion. Generalized estimating equation models were fitted to 11 waves of follow-up data. Results Intrusive rumination (coefficient [coef]=0.165; p<0.001; 95% confidence interval [CI] 0.081–0.250) and deliberate rumination (coef=0.554; p<0.001; 95% CI 0.376–0.732) were significantly associated with PTG. Concerning meaning in life, the presence of meaning (coef=0.312; p<0.001; 95% CI 0.189–0.435) and the search for meaning (coef=0.216; p=0.001; 95% CI 0.093–0.340) were also significantly associated with PTG. Finally, the problem-focused (coef=0.682; p=0.011; 95% CI 0.153–1.210) and emotion-focused (coef=0.736; p=0.009; 95% CI 0.186–1.285) coping strategies both showed significant associations with PTG. Conclusion The results of this study indicate that rumination, meaning in life, and adaptive coping (including cognitive and emotional coping) were protective factors for mental health problems among adolescents who survived the Sewol ferry disaster. These psychological factors may promote PTG over time.
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