Resilience in Relation to Post-Traumatic Stress Disorder and Coping Behaviors in Combat-exposed Veterans

Field: Psychology (Social Sciences)

Resilience in Relation to Post-Traumatic Stress Disorder and Coping Behaviors in Combat-exposed Veterans\nAbigale Dagher, Dept. of Psychology, with Dr. Christina Sheerin, Dept. of Psychology and Virginia Institute for Psychiatric and Behavioral Genetics, and Dr. Ananda Amstadter, Dept. of Psychology and Virginia Institute for Psychiatric and Behavioral Genetics\nPost-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur following a traumatic experience. Many veterans who are exposed to combat develop PTSD, yet many also show resilience following these stressors. Resilience can be defined as adaptive functioning in the face of stress or trauma. PTSD is often associated with less resilience while coping skills often increase resilience outcomes. However, it is less known whether the relationship is different across the different clusters of PTSD symptoms and different types of coping behaviors, which can be adaptive (e.g., social support) or maladaptive (e.g., drug use). Thus, this study aimed to investigate in a combat trauma-exposed veteran population 1) whether there was a difference in resilience scores as a function of PTSD status, 2) whether there was a different association with resilience by PTSD symptom cluster total severity score, and 3) which types of coping behaviors were more strongly related to resilience above and beyond PTSD symptoms. It was hypothesized that combat trauma-exposed veterans without PTSD would have greater resilience scores than those with PTSD, that the avoidance symptom cluster would be the strongest predictor of lower resilience in the veterans who have PTSD, and that coping subscales would be associated with higher resilience above and beyond PTSD status, but some coping subscales would be more strongly related to resilience than others. Following informed consent, participants (N=226, Mean age=30.48, 90.3% Male) were interviewed with a structured clinical interview (Clinician-Administered PTSD Scale for DSM-IV; CAPS-IV) and then completed a large battery of self-report assessment measures, including the Connor-Davidson Resilience Scale (CD-RISC) and the Coping Orientation to Problems Experienced (COPE). A t-test analysis was run to determine if there is a difference between trauma-exposed veterans with and without PTSD. Those with PTSD had a significantly lower resilience score (M=30.16, SD=6.96) compared to those without PTSD (M=32.68, SD=4.54), t(174)=2.91, p=.004. Next, a regression analysis was run with each symptom cluster total score predicting resilience total score. Avoidance symptoms significantly predicted lower resilience, β=-.296, t=-2.397, p=.019, but not re-experiencing β=-.056, t=-.426, p=.672 or arousal symptoms β=.022, t=-.173, p=.863. Finally, significant COPE subscales from correlation analyses were included as predictors of resilience, covarying for total PTSD symptoms. Of the 14 coping skills examined, Positive reinterpretation and growth, Active coping, Turning to religion, and Acceptance were associated with greater resilience scores whereas Behavioral disengagement, and Focus on and venting of emotions were negatively associated with resilience scores (all ps < .01). In conclusion, all hypotheses were supported. Combat exposed veterans with PTSD had lower resilience scores than those without PTSD. Likewise, avoidance behaviors predicted higher resilience compared to the other symptom clusters, perhaps given the importance of avoidance for impacting daily functioning and maintaining symptoms. Finally, coping subscales were variably associated with resilience, suggesting that not all coping approaches are necessarily beneficial. Limitations of the study included self-report bias, little variability in resilience measure, and limited generalizability given the restricted sample demographics.