by Leslie Matuszewich, Ph.D., and Holly Orcutt, Ph.D., guest contributors
With events of mass violence such as the shootings in Newtown, Conn., occurring with increasing frequency, many of us have probably wondered how people cope with the long-term impact of such trauma. It seems natural to believe that one could be scarred for life or forever damaged. Fortunately, recent research seems to suggest that many individuals rebound after a trauma, and researchers believe the rebound or recovery is due to resilience.
Resilience is defined as the ability to adapt well and maintain normal functioning despite exposure to adversity (Yehunda and Flory, 2007). Resilience to trauma has been studied a number of ways.
One useful approach has been to evaluate the same victims of trauma at multiple points of time following an incident. Based on these recent studies, we have learned that symptoms related to trauma, such as anxiety and depression, generally improve over time (Bryant, O’Donnell, Creamer, McFarlane, & Silove, 2013).
With information from the same individuals over at least three time points, we are able to determine a trajectory. This provides a more accurate picture of functioning. Having multiple time points is critical because if we measure someone at one point in time, we can’t be sure whether we are catching them in their path, or trajectory.
Scientists study trajectories after exposure to traumatic events that might include mass violence, disease epidemics, natural disasters and traumatic injuries. We typically see four patterns of response.
Most people demonstrate minimal-impact resilience, defined as “little or no lasting impact on functioning and a relatively stable trajectory of continuous healthy adjustment from before to after” (Bonanno & Diminish, 2013, p. 380).
The remaining people usually fall into one of the following categories:
(1) chronic distress – they have long-lasting impact from the exposure;
(2) recovery – they experience moderate to severe symptoms soon after the exposure, enduring for at least several months, until gradually returning to pre-exposure functioning;
(3) delayed elevations – they do not show symptoms after the exposure but develop symptoms later.
So what psychological factors are associated with an individual having a greater chance of a low-impact, healthy adjustment to trauma?
Because most individuals show minimal-impact resilience, there are many predictors in this large and heterogeneous group. In a recent review of the newer studies that include trajectories, Bonanno and Diminich (2013) highlight promising predictors of resilience, and we’ll mention a few here.
Not surprisingly, the level of exposure to the traumatic event relates to pattern of functioning. Exposures of lesser intensity are associated with an increased likelihood of being in the minimal-impact resilience trajectory. For example, those who were a mile away from the twin towers on 9/11 would have been more likely to display minimal-impact resilience than those who were near or escaped from the buildings.
Turning to aspects of the individual, greater social support and education also are associated with greater likelihood of minimal-impact resilience. If a person interprets or appraises a stressful event as a potential for growth or gain as opposed to a threat, he or she is more likely to be in a minimal-impact resilience trajectory. Finally, new evidence is suggesting that the ability to be flexible about which coping strategies you use is associated with resilience.
Biological factors can also play a role in the likelihood of resiliency. One factor found consistently in the minimal-impact resilience trajectory is being male (Bonanno and Diminich, 2013). Researchers have begun to investigate the association between the hormone estrogen, which is present in higher levels in females than males, and genetic markers for stress-related systems (Ressler et al., 2011).
The neurotransmitter serotonin (5-HT) has also been studied for its role in resiliency. Studies of the human genome look for variations in genes called polymorphisms, and one variation in particular has been found to predict sensitivity to stress and trauma (for review see Wu et al., 2013).
Another potential biological system associated with resiliency is the hypothalamus-pituitary-adrenal (HPA) axis. This axis regulates the secretion of the stress hormone cortisol during times of stress. It is thought that individuals who show resiliency to traumatic events have an adaptive HPA axis, responding to the stressor by releasing cortisol, but then turning off the stress response fairly quickly (McEwen et al., 1987). Recent studies have also found that polymorphisms of genes regulating the receptors that respond to cortisol are associated with risk for the severity of response to a trauma (Bradley et al., 2008; Binder et al., 2008).
The good news is that, by and large, most people do show amazing resilience when responding to trauma. As more biological and psychological factors are measured and studied, researchers will continue to better understand who is at risk for developing trauma-related disorders and who is likely to be resilient. When bad things happen, reach out for social support and be flexible with your coping strategies (what works today may not be your best strategy next week). And take heart in the fact that the odds are in your favor.
Leslie Matuszewich is an associate professor of psychology at Northern Illinois University. She is in the neuroscience and behavior program and teaches courses in biopsychology, research methods and psychopharmacology. Her research interests include the effects of chronic stress on brain function and behaviors, sex differences in motivated behaviors, and long-term effects of early stimulant exposure.
Holly Orcutt is a professor of psychology at Northern Illinois University. She is in the clinical psychology program and teaches courses in theories of psychotherapy and cognitive/behavioral techniques in psychotherapy. Her research interests include posttraumatic stress disorder, and risk/resilience factors following trauma exposure.
Binder, E.B., Bradley, R.G., Liu, W., Epstein, M.P., Deveau, T., Mercer K.B. et al. (2008) Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults, JAMA 299, 1291-1305.
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