title: Neural correlates and predictive power of trait resilience in an acutely traumatized sample: a pilot investigation.
abstract: OBJECTIVE
  Resilience refers to the ability to thrive despite adversity and is defined as a multidimensional phenomenon, spanning internal locus of control, sense of meaning, social problem-solving skills, and self-esteem. We aimed to investigate the predictive value of resilience for the development of posttraumatic stress disorder (PTSD) and to examine the neural correlates mediating the relationship between resilience and recovery from a traumatic event in acutely traumatized subjects. We hypothesized that resilience would mediate the relationship between childhood trauma and posttraumatic recovery.
  
  
  METHODS
  We conducted a prospective study with 70 acutely traumatized subjects with DSM-IV PTSD recruited at the emergency department, assessing PTSD symptom severity at 3 time points within the first 3 months posttrauma. Scores for childhood trauma as assessed with the Childhood Trauma Questionnaire and trait resilience as assessed with the Connor-Davidson Resilience Scale were used as predictors of symptom severity. A subsample of 12 subjects additionally underwent a functional 4 Tesla magnetic resonance imaging scan 2 to 4 months posttrauma. We employed the traumatic script-driven imagery paradigm to assess the correlations between trait resilience and blood oxygen level-dependent (BOLD) response. The study was conducted from 2003 to 2007.
  
  
  RESULTS
  Resilience predicted PTSD symptom severity at 5 to 6 weeks (β = -0.326, P = .01) as well as at 3 months (β = -0.423, P = .003) posttrauma better than childhood trauma. Resilience essentially mediated the relationship between childhood trauma and posttraumatic adjustment. Resilience scores were positively correlated with BOLD signal strength in the right thalamus as well as the inferior and middle frontal gyri (Brodmann area 47).
  
  
  CONCLUSIONS
  This pilot investigation revealed a significant relationship between resilience and emotion regulation areas during trauma recall in an acutely traumatized sample. Resilience was established as a significant predictor of PTSD symptom severity and mediated the influence of childhood trauma on posttraumatic adjustment.
authors.affiliation: Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Daniels
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Hegadoren
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Coupland
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
authors.forename: Maria
authors.initials: M
authors.lastname: Densmore
authors.forename: Richard W J
authors.initials: RW
authors.lastname: Neufeld
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lanius
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000523:psychology*; D008297:Male; D011939:Mental Recall / Q000502:physiology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D055500:Resilience, Psychological; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000523:psychology*