Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study.
Although many cross-sectional studies have examined the correlates of psychological resilience in U.S. military veterans, few longitudinal studies have identified long-term predictors of resilience in this population. The current prospective cohort study utilized data from a nationally representative sample of 2157 U.S. military veterans who completed web-based surveys in two waves (2011 and 2013) as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of cumulative lifetime exposure to potentially traumatic events and Wave 2 measures of current symptoms of posttraumatic stress, major depressive, and generalized anxiety disorders was performed to characterize different profiles of current trauma-related psychological symptoms. Different profiles were compared with respect to sociodemographic, clinical, and psychosocial characteristics. A three-group cluster analysis revealed a Control group with low lifetime trauma exposure and low current psychological distress (59.5%), a Resilient group with high lifetime trauma and low current distress (27.4%), and a Distressed group with both high trauma exposure and current distress symptoms (13.1%). These results suggest that the majority of trauma-exposed veterans (67.7%) are psychologically resilient. Compared with the Distressed group, the Resilient group was younger, more likely to be Caucasian, and scored lower on measures of physical health difficulties, past psychiatric history, and substance abuse. Higher levels of emotional stability, extraversion, dispositional gratitude, purpose in life, and altruism, and lower levels of openness to experiences predicted resilient status. Prevention and treatment efforts designed to enhance modifiable factors such as gratitude, sense of purpose, and altruism may help promote resilience in highly trauma-exposed veterans.
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA. Electronic address: kayla.isaacs@yale.edu.
Kayla
K
Isaacs
Department of Clinical Health Psychology, University of Manitoba, College of Medicine, 771 Bannatyne Ave., Winnipeg, Manitoba R3E 3N4, Canada. Electronic address: natalie.mota@umanitoba.ca.
Natalie P
NP
Mota
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, 950 Campbell Ave. 161E, West Haven, CT 06516, USA. Electronic address: jack.tsai@yale.edu.
Jack
J
Tsai
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: ilan.harpaz-rotem@yale.edu.
Ilan
I
Harpaz-Rotem
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Evaluation Division, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: joan.cook@yale.edu.
Joan M
JM
Cook
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: paul.kirwin@yale.edu.
Paul D
PD
Kirwin
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: john.krystal@yale.edu.
John H
JH
Krystal
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: steven.southwick@yale.edu.
Steven M
SM
Southwick
Department of Psychiatry, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, USA; US. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. Electronic address: robert.pietrzak@yale.edu.
Robert H
RH
Pietrzak
D000328:Adult; D000533:Altruism; D016000:Cluster Analysis; D005106:Exploratory Behavior; D005260:Female; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D000067656:Optimism; D011446:Prospective Studies; D055500:Resilience, Psychological; D012649:Self Concept; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*
Depression; Epidemiology; Posttraumatic stress disorder; Resilience; Trauma; Veterans