A Look at Traumatic Stress Through the Prism of Vulnerability and Resilience

This article details two existing perspectives on traumatic stress: vulnerability and resilience. Traditionally, the issue has been considered in the narrow psychopathological context of risk factors and vulnerability, despite evidence indicating that most people exposed to potentially traumatic events will remain mentally healthy and continue to lead fulfilling lives, following a trajectory of resilience. We will examine both perspectives and try to relate them. The view of post-traumatic stress through a vulnerability lens focuses on the risk factors and mechanisms that lead to the development of the disorder, and the qualities that increase susceptibility to them. Predictors are well researched and a consensus has been reached here, so to add some novelty to the data we already know, we will list risk and vulnerability factors, dividing them into three groups: pre-, peri- and post-traumatic. Looking at post-traumatic stress through the lens of resilience is not as clear-cut — this area is poorly understood, so there are several competing theories, and consensus has yet to be reached. The trajectory of resilience is common among large numbers of people — two-thirds of the trauma survivor population — so isolating individual correlates of resilience has led to a paradox: While there are many variables that correlate reliably with resilience, it is impossible to predict with great accuracy who will be resilient to potential trauma and who will not. One solution to the resilience paradox is the not yet widely accepted, but widely discussed, Flexibility Sequence Theory proposed by George Bonanno. In examining the two perspectives, we conclude that vulnerability does not preclude resilience and that the focus of interventions can be not only on identifying and mitigating risk factors, but above all on maintaining effective use of natural internal protective factors and developing a sequential flexibility that ensures resilience.

Keywords

traumatic stress, post-traumatic stress, PTSD, resilience, vulnerability, risk factors, resilience paradox, Flexibility Sequence Theory, predictors of PTSD

Received

03.09.2023

Publication date

03.09.2023

Number of characters

21705

Cite

GOST	Shmarina T. A Look at Traumatic Stress Through the Prism of Vulnerability and Resilience // Chelovek – 2023. – V. 34. – Issue 4 C. 181-191 [Electronic resource]. URL: https://chelovek-journal.ru/S023620070027360-3-1 (circulation date: 22.07.2024). DOI: 10.31857/S023620070027360-3
MLA	Shmarina, Tatiana A "A Look at Traumatic Stress Through the Prism of Vulnerability and Resilience." Chelovek 34.4 (2023):181-191. DOI: 10.31857/S023620070027360-3
APA	Shmarina T. (2023). A Look at Traumatic Stress Through the Prism of Vulnerability and Resilience. Chelovek 34(4), pp.181-191 DOI: 10.31857/S023620070027360-3

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1. Bykhovets Yu.V. Fenomen posttravmaticheskogo rosta [The phenomenon of post-traumatic growth]. Psihologicheskie issledovaniya lichnosti: istoriya, sovremennoe sostoyanie, perspektivy. Moscow: Institut psihologii RAN Publ., 2016. P. 214–227.

2. Bykhovets Yu.V., Tarabrina N.V. Psikhologicheskaya otsenka perezhivaniya terroristicheskoi ugrozy [Psychological assessment of the experience of the terrorist threat]. Moscow: Institut psihologii RAN Publ., 2010.

3. Kazymova N.N. Faktory riska i resursy ustoichivosti k perezhivaniyu terroristicheskoi ugrozy [Risk factors and resilience resources for surviving the terrorist threat]. Obshchestvo: sotsiologiya, psikhologiya, pedagogika. 2017. Vol. 12. P. 102–109.

4. Karayani A.G. Voennaya psikhologiya: uchebnik i praktikum dlya vuzov [Military Psychology: Textbook and Workbook for Higher Education Institutions], ed. by A. G. Karayani. Moscow: Yurait Publ., 2nd ed., revised. 2023.

5. Kitaev-Smyk L.A. Psikhosotsial'nye bolezni voennogo stressa u zhenshchin Chechni [Psychosocial illnesses of war stress among women in Chechnya]. Psihopedagogika v pravoohranitel'nyh organah. 2009. Vol. 3. P. 22–29.

6. Nartova-Bochaver S.K. Psihologiya lichnosti i individual'nyh razlichij. Uchebnoe posobie dlya vuzov [Psychology of personality and individual differences. A textbook for higher education institutions]. St.-Petersburg: Piter Publ., 2023.

7. Nurkova V.V. Rol' avtobiograficheskoj pamyati v strukture identichnosti lichnosti [The role of autobiographical memory in the structure of personal identity]. Mir psihologii. 2004. N 2. P. 77–87.

8. Posttravmaticheskoe stressovoe rasstrojstvo [posttraumatic stress disorder], ed. by V.A. Soldatkin. Rostov-on-Don: RostGMU Publ., 2015.

9. Psihologiya ekstremal'nyh situacij. Uchebnik dlya vuzov [Psychology of Extreme Situations. Textbook for Higher Education Institutions], ed. by Yu.S. Shojgu. St.-Petersburg: Piter Publ., 2019.

10. Tarabrina N.V. Psihologicheskie posledstviya vozdejstviya stressorov vysokoj intensivnosti: posttravmaticheskij stress [Psychological consequences of exposure to high-intensity stressors: post-traumatic stress]. Psihologicheskij zhurnal. 2012. Vol. 33, N 6. P. 20–33.

11. Agaibi C.E., Wilson J.P. Trauma, PTSD, and resilience: A review of the literature. Trauma Violence Abuse. 2005. Vol. 6, N 3. P. 195–216.

12. Almedom A.M., Glandon D. Resilience is not the absence of PTSD any more than health is the absence of disease. Journal of Loss and Trauma. 2007. Vol. 12, N 2. P. 127–143.

13. Andrews B., Brewin C.R., Philpott R., Stewart L. Delayed-onset posttraumatic stress disorder: A systematic review of the evidence. American Journal of Psychiatry. 2007. Vol. 164, N 9. P. 1319–1326.

14. APA dictionary of psychology (2nd ed.). Washington, DC: American Psychological Association, 2015.

15. Bardeen J.R., Kumpula M.J., Orcutt H.K. Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting. Journal of Anxiety Disorders. 2013. Vol. 27, N 2. P. 188–196.

16. Bar-Haim Y., Holoshitz Y., Eldar S., Frenkel T.I. et al. Life-threatening danger and suppression of attention bias to threat. American Journal of Psychiatry. American Psychiatric Association. 2010. Vol. 167, N 6. P. 694–698.

17. Beierl E.T., Böllinghaus I., Clark D.M., Glucksman E., Ehlers A. Psychological Medicine Cognitive paths from trauma to posttraumatic stress disorder: a prospective study of Ehlers and Clark’s model in survivors of assaults or road traffic collisions. Psychological Medicine. 2020. Vol. 50. P. 2172–2181.

18. Bonanno G.A. Resilience in the face of potential trauma. Current Directions in Psychological Science. 2005. Vol. 14, N 3. P. 135–138.

19. Bonanno G.A. The end of trauma: How the new science of resilience is changing how we think about PTSD. New York: Basic Books, 1st ed., 2021a.

20. Bonanno G.A. The resilience paradox. European Journal of Psychotraumatology. 2021b. Vol. 12, N 1. P. 1942642.

21. Bonanno G.A., Burton C.L. Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science. 2013. Vol. 8, N 6. P. 591–612.

22. Bonanno G.A., Romero S.A., Klein S.I. The temporal elements of psychological resilience: An integrative framework for the study of individuals, families, and communities. Psychological Inquiry. 2015. Vol. 26, N 2. P. 139–169.

23. Bonanno G.A., Westphal M., Mancini A.D. Resilience to loss and potential trauma. Annual Review of Clinical Psychology. 2011. Vol. 7. P. 511–535.

24. Bryant R.A. A critical review of mechanisms of adaptation to trauma: Implications for early interventions for posttraumatic stress disorder. Clinical Psychology Review. 2021. Vol. 85. P. 101981.

25. Bryant R.A. Acute stress disorder as a predictor of posttraumatic stress disorder: A systematic review. The Journal of Clinical Psychiatry. 2010. Vol. 71, N 2. P. 381.

26. Bryant R.A., Panasetis P. Panic symptoms during trauma and acute stress disorder. Behaviour Research and Therapy. 2001. Vol. 39, N 8. P. 961–966.

27. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC: American Psychiatric Association, 2022.

28. Fikretoglu D., Brunet A., Best S.R., Metzler T.J. et al. Peritraumatic fear, helplessness and horror and peritraumatic dissociation: Do physical and cognitive symptoms of panic mediate the relationship between the two? Behaviour Research and Therapy. 2007. Vol. 45, N 1. P. 39–47.

29. Folkman S., Moskowitz J.T. Coping: Pitfalls and promise. Annual Review of Psychology. 2004. Vol. 55. P. 745–774.

30. Galatzer-Levy I.R., Huang S.H., Bonanno G.A. Trajectories of resilience and dysfunction following potential trauma: A review and statistical evaluation. Clinical Psychology Review. 2018. Vol. 63. P. 41–55.

31. Hancock L., Bryant R.A. Posttraumatic stress, uncontrollability, and emotional distress tolerance. Depression and Anxiety. 2018. Vol. 35, N 11. P. 1040–1047.

32. Horesh D., Solomon Z., Zerach G., Ein-Dor T. Delayed-onset PTSD among war veterans: The role of life events throughout the life cycle. Social Psychiatry and Psychiatric Epidemiology. 2011. Vol. 46, N 9. P. 863–870.

33. Jones C., Harvey A.G., Brewin C.R. The organisation and content of trauma memories in survivors of road traffic accidents. Behaviour Research and Therapy. 2007. Vol. 45, N 1. P. 151–162.

34. Kangas M., Henry J.L., Bryant R.A. A prospective study of autobiographical memory and posttraumatic stress disorder following cancer. Journal of Consulting and Clinical Psychology. 2005. Vol. 73, N 2. P. 293.

35. Kaniasty K., Norris F.H. Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection. Journal of Traumatic Stress. 2008. Vol. 21, N 3. P. 274–281.

36. Kessler R.C., Aguilar-Gaxiola S., Alonso J., Benjet C. et al. Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology. 2017. Vol. 8, N 5. P. 1353383.

37. Kleim B., Ehlers A., Glucksman E. Early predictors of chronic post-traumatic stress disorder in assault survivors. Psychological Medicine. 2007. Vol. 37, N 10. P. 1457–1467.

38. Layne C.M., Warren J.S., Watson P.J., Shalev A.Y. Risk, vulnerability, resistance, and resilience: Toward an integrative conceptualization of posttraumatic adaptation. Handbook of PTSD: Science and practice. New York: Guilford Press, 2007.

39. Luthar S.S., Cicchetti D., Becker B. The construct of resilience: A critical evaluation and guidelines for future work. Child Development. 2000. Vol. 71, N 3. P. 543–562.

40. Marshall G.N., Miles J.N.V., Stewart S.H. Anxiety sensitivity and PTSD symptom severity are reciprocally related: Evidence from a longitudinal study of physical trauma survivors. Journal of Abnormal Psychology. 2010. Vol. 119, N 1. P. 143–150.

41. O’Kearney R., Perrott K. Trauma narratives in posttraumatic stress disorder: A review. Journal of Traumatic Stress. 2006. Vol. 19, N 1. P. 81–93.

42. Resnick H., Galea S., Kilpatrick D., Vlahov D. Research on trauma and PTSD in the aftermath of 9/11. PTSD Research Quarterly. 2004. Vol. 15, N 1.

43. Robinson M., Mcglinchey E., Bonanno G.A., Spikol E., Armour C. A path to post-trauma resilience: a mediation model of the flexibility sequence. European Journal of Psychotraumatology. 2022. Vol. 13. P. 2112823.

44. Smid G.E., Mooren T.T.M., Van Der Mast R.C., Gersons B.P.R., Kleber R.J. Delayed posttraumatic stress disorder: Systematic review, meta-analysis, and meta-regression analysis of prospective studies. The Journal of Clinical Psychiatry. 2009. Vol. 70, N 11. P. 4091.

45. Smid G.E., Van Der Velden P.G., Lensvelt-Mulders G.J.L. M., Knipscheer J.W. et al. Stress sensitization following a disaster: a prospective study. Psychological Medicine. 2012. Vol. 42, N 8. P. 1675–1686.

46. Southwick S.M., Bonanno G.A., Masten A.S., Panter-Brick C., Yehuda R. Resilience definitions, theory, and challenges: Interdisciplinary perspectives. European Journal of Psychotraumatology. 2014. Vol. 5. P. 25338.

47. Stowman S., Kearney C.A., Daphtary K. Mediators of initial acute and later posttraumatic stress in youth in a PICU. Pediatric Critical Care Medicine. 2015. Vol. 16, N 4. P. e113–e118.

48. Zatzick D.F., Jurkovich G.J., Fan M.Y., Grossman D. et al. Association between posttraumatic stress and depressive symptoms and functional outcomes in adolescents followed up longitudinally after injury hospitalization. Archives of Pediatrics and Adolescent Medicine. 2008. Vol. 162, N 7. P. 642–648.