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Exploration of the Resilience Construct in Posttraumatic Stress Disorder Severity and Functional Correlates in Military Combat Veterans Who Have Served Since September 11, 2001

J Clin Psychiatry 2010;71(7):823-830
10.4088/JCP.09m05780blu

Objective: This study evaluated the relationship between resilience and psychological functioning in military veterans deployed to a region of military conflict in support of Operation Enduring Freedom or Operation Iraqi Freedom.

Method: 497 military veterans completed a structured psychiatric interview and questionnaires measuring psychological symptoms, resiliency, and trauma exposure. The study had 2 primary aims: (1) to examine whether the association between trauma exposure and PTSD was moderated by resilience and (2) to examine whether resilience was uniquely associated with functional outcomes after accounting for PTSD. Measures included the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (for PTSD diagnosis), the Connor-Davidson Resilience Scale, and the Traumatic Life Events Questionnaire. Data were collected between June 2005 and February 2009.

Results: Evaluating the association of resilience and trauma exposure with PTSD revealed main effects for combat exposure, lifetime trauma exposure, and resilience. Additionally, there was a significant (P < .05) interaction between combat exposure and resilience such that higher levels of resilience were particularly protective among individuals with high combat exposure. After controlling for age, gender, minority status, trauma exposure, and PTSD diagnosis, resilience was uniquely associated with decreased suicidality, reduced alcohol problems, lower depressive symptom severity, and fewer current health complaints and lifetime and past-year medical problems.

Conclusions: These results suggest that resilience is a construct that may play a unique role in the occurrence of PTSD and severity of other functional correlates among deployed veterans. Future studies in this area would benefit from a prospective design, the evaluation of other possible protective processes (eg, social support), and specific examination of particular aspects of resilience and how resilience may be increased.

J Clin Psychiatry 2010;71(7):823–830

Submitted: October 20, 2009; accepted December 18, 2009.

Online ahead of print: June 15, 2010 (doi:10.4088/JCP.09m05780blu).

Corresponding author: Kimberly T. Green, MS, VISN 6 MIRECC, 508 Fulton St, Bldg 5, Durham, NC 27705 (Kimberly.Green2@va.gov).