Does Psychological Resilience Moderate the Relationship between Chronological Age, Threat Appraisal, Number of Traumatic Events and Trauma Type and Posttraumatic Stress Symptoms?

Abstract

Posttraumatic stress disorder (PTSD) is a common and severe psychiatric disorder. Despite high prevalence of trauma exposure, only a small portion of individuals, subsequently develop PTSD. Research has shown that chronological age, threat appraisal, number of traumatic events experienced, and type of trauma robustly predict PTSD severity. Conversely, there are also known protective factors, such as resilience, that can bolster victims of trauma for subsequent PTSD. Resilience refers to the ability to maintain or regain normal psychological and physical functioning after experiencing adversity. In the current study, we examined the moderating effect of resilience on identified risk factors for PTSD (i.e., chronological age, threat appraisal, the number of traumatic events, and type of trauma) and PTSD severity in a large epidemiological sample of 29,666 Icelandic women (22% of the population; Mage = 44.5). Via an online questionnaire, participating women provided detailed socio-demographic information and were assessed for lifetime exposure to traumatic events, including the number of traumatic events experienced, perceived threat to life or humiliation/rejection during the worst traumatic event and trauma type (e.g., exposure to natural disaster, physical or sexual assault), and current levels of resilience and PTSD symptoms. Consistent with previous findings, our analyses revealed greater perceived threat to life and rejection/humiliation during the traumatic event and exposure to a higher number of traumatic events and experiencing a physical or sexual assault (compared to a natural disaster exposure) was associated with higher PTSD symptoms, whereas higher chronological age was associated with lower PTSD symptoms. Higher levels of resilience were also significantly associated with lower PTSD symptoms. Resilience did not moderate the relationship between chronological age and PTSD symptoms. However, resilience moderated the relationship between threat appraisal, number of traumatic events, type of worst event and PTSD symptoms. Although, the effect size of the interaction term was very small (Cohen’s f2 < 0.002 – 0.005). These findings may have important clinical implications for the treatment and prevention of PTSD in that promoting resilience among traumatized women - in particular those with high threat appraisal of the traumatic event, exposed to a higher number of traumatic events or experienced a physical or sexual assault - may help to protect them against subsequently developing PTSD.Keywords: Posttraumatic stress disorder (PTSD), trauma, protective factors, resilience.