Why don't all trauma survivors develop PTSD? A multi-method exploration of resilience.

Abstract

The role of factors which influenced individual differences in post-trauma outcome were explored using a multi-method design, in response to recommendations in the literature that self-report data should be incorporated into studies of post-traumatic stress disorder (PTSD). In part 1, a psychophysiological study with process interviews was tested for feasibility and acceptability with a small-scale sample (n = 17) and found individual differences between how participants described responding to trauma-related picture stimuli. Five primary response types were identified: avoidance, acceptance, increased attendance, dismissal and confrontation. In part 2, resilient and recovered individuals (n = 11) were interviewed in depth about their experiences of coping with trauma and transcripts were analysed using an interpretative phenomenological approach. Themes identified were attitudes and beliefs, emotion regulation, narrative development, support and safety and recovery. Some resilient participants described initial use of avoidance as a coping strategy but moved from this position towards acceptance of their trauma in their recovery journey. Therefore avoidance may play a more helpful role than has previously been thought. The importance of specific attributes of factors positively associated with recovery from trauma and potential interactions between these factors was discussed.