title: Resilience to trauma in the two largest cities of Brazil: a cross-sectional study.
abstract: BACKGROUND
  Resilience is a dynamic process involving the interaction between intrapsychic and social factors of risk and protection. For resilience to be recognized there must be a significant threat to the individual, such as a traumatic event, and a good quality of adjustment. The aim of this study was to identify predisposing factors and possible mechanisms associated with resilience to traumatic events in the general population.
  
  
  METHODS
  We conducted a cross-sectional study with a random sample, aged 15-75 years, living in the two largest cities in Brazil, who were exposed to trauma (N = 3,231). Positive adaptation to trauma was defined as the lifetime absence of anxiety (including posttraumatic stress disorder), depression and alcohol related disorders in the presence of at least one traumatic event. Logistic regression models predicting resilience were used to estimate the incidence density ratio. This measure expresses the extent to which the rate of resilience differs from the exposed group to the non-exposed group. Moreover, we explored the relationship between positive/negative affect and resilience, using linear regression models.
  
  
  RESULTS
  Male gender was a predisposing factor to positive adaptation (incidence density ratio [IDR] = 1.34; p < 0.001). There was an inverse linear relationship between childhood violence and resilience (IDR = 0.67; 0.53; 0.19; p < 0.001). Our findings suggest that the absence of parental mental disease (IDR = 1.35; p = 0.07) also predisposes individuals to positive adaptation.
  
  
  CONCLUSIONS
  This study provides results that help to identify vulnerable groups and protective factors that may lead to a positive adaptation following traumatic experiences.
authors.affiliation: Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Av: Venceslau=Brás 71 - fundos - Botafogo CEP, Rio de Janeiro 22290-140, Brazil. lilianevilete@hotmail.com.
authors.forename: Liliane
authors.initials: L
authors.lastname: Vilete
authors.forename: Ivan
authors.initials: I
authors.lastname: Figueira
authors.forename: Sérgio Baxter
authors.initials: SB
authors.lastname: Andreoli
authors.forename: Wagner
authors.initials: W
authors.lastname: Ribeiro
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Quintana
authors.forename: Jair
authors.initials: J
authors.lastname: de Jesus Mari
authors.forename: Evandro Silva Freire
authors.initials: ES
authors.lastname: Coutinho
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D014754:Violence / Q000523:psychology*; D055815:Young Adult