Page 245 - Biobehavioral Resilence to Stress

222 Biobehavioral Resilience to Stress

a trauma-exposed population to report few or no psychological symptoms,
to continue fulfilling their personal and social responsibilities, and to be able

to embrace new tasks and experiences.
It is worth noting that this type of resilient response is probably not limited
to acute and isolated stressor events (PTEs). Some individuals may demon-
strate a similar level of resilience to more chronic or enduring stressors (e.g.,
diagnosis of a catastrophic illness). Some studies do address resilience to acute
as well as chronic stress. However, it is not clear whether personality factors
that promote resilience to acute stressors are as adaptive or as helpful in the
context of chronic stress. Given the current scarcity of studies that off er

clear definitions of resilient outcomes in adults and the diffi culty inherent

in defining resilience and resilient outcomes, we prefer, for now, to focus on

acute stressor events because they offer more precise and operationally defi n-
able outcome trajectories.

Resilience versus Recovery
Within the trauma literature, there have been few attempts to distinguish
subgroups within the broad category of trauma-exposed individuals who
do not develop PTSD. When resilience to trauma has been addressed in the

trauma literature, it is often conceived in terms of factors that “favor a path
to recovery” (McFarlane & Yehuda, 1996, p. 156). Trauma theorists typically
use the terms “resilience” and “recovery” interchangeably, sometimes pooling
the two outcomes into a single category (King, King, Foy, Keane & Fairbank,
1999). Moreover, without an adequate database from which to consider a full
range or incidence of reactions to trauma, it has been widely assumed that
a positive outcome, that is, few or no symptoms of PTSD is rare and occurs
only in individuals who possess exceptional physical or emotional strength.
Most early studies of adults exposed to PTEs were anecdotal and relied
upon retrospective data, small sample sizes, and variable levels of trauma
exposure. For example, published accounts of British civilians exposed to
repeated aerial bombardment during World War II have been cited as evi-
dence for widespread resilience (Janis, 1951; Rachman, 1978). However, these
accounts were typically based on retrospective and relatively unsystematic
assessments. Recent trauma studies have provided more systematic, although
indirect evidence, for resilience in adults exposed to trauma. For example,
Bryant, Moulds, and Guthrie (2000) studied hospitalized survivors of motor
vehicle accidents and observed that the vast majority did not develop PTSD
and demonstrated very few PTSD symptoms within the first week aft er hos-

pitalization. Although these findings suggest that many accident survivors

suffer few or no symptoms of posttraumatic stress, this study, as most simi-

lar studies in this area, was not specifically designed to address the issue of

resilience. Therefore, more precise estimates of resilience were not possible.

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