Peritraumatic reactions (PRs) – namely peritraumatic tonic immobility, dissociation, panic reactions, and distress – are among the most important risk factors for the development and severity of post-traumatic stress disorder (PTSD). Although PTSD and post-traumatic growth (PTG) – the positive psychological changes following adversity – may coexist, the role of PRs in PTG remains unclear. This study systematically reviewed the association between PRs and PTG.

We conducted a systematic review in accordance with PRISMA guidelines. Web of Science, Scopus, PubMed/MEDLINE, Embase, and PsycArticles were systematically searched from inception to January 9, 2026. Reference lists of selected papers and relevant reviews were also screened. Observational studies examining the association between PRs and PTG in trauma-exposed adults were included. Two reviewers independently conducted study selection and data extraction. Risk of bias was assessed using the Newcastle-Ottawa Scale. Due to heterogeneity, results were synthesized narratively.

Of 284 records screened, 13 studies met the inclusion criteria (seven cross-sectional and six cohort studies), comprising approximately 5800 participants. All studies showed moderate or high risk of bias. Most examined peritraumatic distress, while fewer assessed dissociation or panic reactions. Overall, PRs were associated with PTG, although findings varied across reactions and populations.

This review provides insights into how immediate trauma reactions might influence long-term psychological trajectories. Despite important limitations – including risk of bias and heterogeneity across studies – PRs, while associated with greater vulnerability and distress, may also act as catalysts for meaningful personal transformation and PTG.

This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES (Finance Code 001).

The review protocol was not registered.