title: Trauma history as a resilience factor for patients recovering from total knee replacement surgery.
abstract: Research concerning the impact of trauma history on individuals' ability to cope with subsequent events is mixed. While many studies find that trauma history increases vulnerability for conditions such as post-traumatic stress disorder and chronic pain, others reveal that there are benefits associated with moderate levels of stress (e.g. development of coping skills).
  
  
  OBJECTIVE
  The present study investigated whether the experience of prior traumatic stressors would serve as a risk or resilience factor based on physical and emotional outcomes among patients recovering from total knee replacement surgery (TKR).
  
  
  METHODS
  110 patients undergoing unilateral, TKR completed surveys before surgery, as well as one and three months following the procedure.
  
  
  RESULTS
  Contrary to hypotheses, patients who reported more prior traumas experienced less severe pain and functional limitations at one- (β = -.259, p = .006) and three-month follow-up assessments (β = -.187, p = .04). A similar pattern emerged when specific types of traumas (e.g. interpersonal) were examined in relation to physical recovery. Further, patients' trauma history was negatively related to symptoms of post-traumatic stress three-months following surgery (e.g. Avoidance: β = -.200, p = .037).
  
  
  CONCLUSIONS
  Trauma history represents a source of resilience, rather than vulnerability, within the context of arthroplastic surgery.
authors.affiliation: a Department of Psychology , Kent State University at Stark , N Canton , OH , USA.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Cremeans-Smith
authors.forename: Kenneth
authors.initials: K
authors.lastname: Greene
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Delahanty
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055500:Resilience, Psychological; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*
keywords: arthroplasty; post-operative recovery; post-traumatic stress; resilience; trauma history