Background. Posttraumatic growth (PTG)—positive changes that people may experience in the aftermath of highly distressing experiences—has been observed in survivors of a variety of events but has not been previously studied among people who have caused accidental death or injury (PCADIs). In addition, questions remain about the role, in PTG, of changes in the assumptive world and the relationships between PTG and distress, personality, and social support. Methods. Participants (N = 528), included PCADIs (n = 44) and a non-trauma comparison group (n = 484), who completed the Primals Inventory and measures of personality, anxiety, and depression. PCADIs (n = 43) also completed measures of PTG, PTG behavioral changes, social support and life satisfaction. Results. Modest levels of PTG commensurate with survivors of other relevant forms of distress were observed. Results demonstrated significant differences between primal world beliefs Good, Safe, Enticing, Just, Regenerative, Funny, and Improvable in PCADIs and non-trauma survivors as well as significant positive relationships between PTG and the primals Good, Safe, Alive, Just, Regenerative, Funny, and Improvable and between PTG and reported behavior changes related to PTG, but no significant relationships were found between PTG and distress, PTG and social support, or PTG and personality traits Extraversion, Openness to Experience, Conscientiousness, or Agreeableness (though a significant negative relationship was observed between PTG and Neuroticism). Conclusions. PCADIs may experience PTG that both influences and is influenced by primal world beliefs, but the hypothesized relationships between PTG and distress, personality, and social support were not observed. Additional studies with larger PCADI populations may find these relationships exist at a statistically significant level. And future research should aim to develop interventions addressing the distress and growth potential of this population.