When measuring resilience, the type of trauma suffered matters

Woman veteran in wheelchair returned from the Army. She’s in a military uniform and looks far away or in pain.
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In previous studies of resilience in people, researchers have rarely differentiated in their analysis between the types of traumatic events experienced by individuals. However, the type of trauma undergone seems to be a significant predictor of how someone will fare long-term, according to a new study by researchers at the Yale School of Medicine and the VA Connecticut Healthcare System. Additionally, the team found that reactions to various types of trauma differs greatly by gender.  

This paper was published online in the Journal of Traumatic Stress.

Researchers assessed data examining trauma exposure, deployment experiences, and resilience in a subsample of veterans who participated in a large, three-phase longitudinal study examining gender differences in health outcomes and healthcare utilization among veterans who served in support of the recent conflicts in Iraq and Afghanistan.

When we first analyzed the data without accounting for the type of trauma experienced, it looked as though veteran men were overall more resilient than women following military discharge,” said Galina Portnoy, associate research scientist at Yale, psychologist at the VA Connecticut Healthcare System, and lead author of the study. “But I work with women veterans every day, and I suspected this wasn't the whole story.”

For further analysis, the team separated potentially traumatic events into multiple interpersonal (i.e., sexual abuse, rape, and intimate partner violence) and non-interpersonal (i.e. accidents, combat trauma, stranger violence) events. Once the researchers had statistically accounted for the type of trauma, suddenly men were no longer scoring as more resilient than women.

It turns out that interpersonal trauma has significant consequences for those who experience it, and given that those who experience interpersonal trauma are disproportionately women, this was initially skewing the data,” said Portnoy. “Additionally, social support during stressful periods in one's life, such as military deployment, makes a huge difference in one’s ability to cope, survive, and thrive.” Related to this, they also found that, compared to men, women reported experiencing less social support during deployment.

Portnoy and her co-authors have concluded that “the way our field currently studies ‘resilience’ may need re-thinking.” They say that men and individuals with more resources (i.e., socioeconomic status, education, income, and employment) — or “social privilege”— often score higher on measures of resilience. In other words, the researchers said, these privileges may be contributing more to those high scores rather than any innate capacity those individuals have for resilience.

Therefore, they advocate shifting the way trauma and resilience are studied, away from only “identifying characteristics within the individual (e.g., a person’s ability to cope with triggers)” and towards accounting for “factors within a person’s social-ecological context that serve to promote or inhibit resilient processes and outcomes, such as social support or the types of traumas they have experienced in the past.”

Other authors on the paper include Mark Relyea, Suzanne Decker, Andrea Shamaskin-Garroway, Mary Driscoll, Cynthia Brandt, and Sally Haskell.

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Kendall Teare: kendall.teare@yale.edu, 203-836-4226