title: Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans.
abstract: OBJECTIVE
  We examined the prospective influence of the resilient, undercontrolled, and overcontrolled personality prototypes on depression and posttraumatic stress disorder (PTSD) symptoms among Iraq/Afghanistan war veterans. After accounting for the possible influence of combat exposure, we expected that the resilient prototype would predict lower depression and PTSD over time and would be associated with adaptive coping strategies, higher social support, lower psychological inflexibility, and higher self-reported resilience relative to overcontrolled and undercontrolled prototypes, independent of traumatic brain injury (TBI) status.
  
  
  METHODS
  One hundred twenty-seven veterans (107 men, 20 women; average age = 37) participated in the study. Personality was assessed at baseline, and PTSD and depression symptoms were assessed 8 months later. Path analysis was used to test the direct and indirect effects of personality on distress.
  
  
  RESULTS
  No direct effects were observed from personality to distress. The resilient prototype did have significant indirect effects on PTSD and depression through its beneficial effects on social support, coping and psychological inflexibility. TBI also had direct effects on PTSD.
  
  
  CONCLUSIONS
  A resilient personality prototype appears to influence veteran adjustment through its positive associations with greater social support and psychological flexibility, and lower use of avoidant coping. Low social support, avoidant coping, and psychological inflexibility are related to overcontrolled and undercontrolled personality prototypes, and these behaviors seem to characterize veterans who experience problems with depression and PTSD over time. A positive TBI status is directly and prospectively associated with PTSD symptomology independent of personality prototype. Implications for clinical interventions and future research are discussed.
authors.affiliation: Department of Educational Psychology.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Elliott
authors.affiliation: Department of Educational Psychology.
authors.forename: Yu-Yu
authors.initials: YY
authors.lastname: Hsiao
authors.affiliation: Durham Veterans Affairs Medical Center.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Kimbrel
authors.affiliation: VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans HealthCare System.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Meyer
authors.affiliation: VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans HealthCare System.
authors.forename: Bryann B
authors.initials: BB
authors.lastname: DeBeer
authors.affiliation: Warriors Research Institute at Baylor Scott and White Health.
authors.forename: Suzy Bird
authors.initials: SB
authors.lastname: Gulliver
authors.affiliation: Department of Educational Psychology.
authors.forename: Oi-Man
authors.initials: OM
authors.lastname: Kwok
authors.affiliation: VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans HealthCare System.
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Morissette
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D011446:Prospective Studies; D055500:Resilience, Psychological; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data