Adaptation to Traumatic Stress: Resilient Traits, Resources, and Trajectories of Outcomes

The term resilience is too often poorly operationalized and loosely conceptualized. Historically, it has been defined as a trait, characteristic, or collection of resources that facilitates healthy adjustment to a potentially traumatic event (PTE) and has typically been measured at one point in time. More recently, it has been defined as an outcome, or a successful course of adaptation following exposure to a severe and overwhelming experience. Inherent in this definition is the expectation that a cross-sectional evaluation will fall short; if resilience is an adaptation to an experience, it must then unfold over time. Unfortunately, the absence of a single unifying paradigm of resilience has hindered progress in the field. In this review, we discuss the handful of characteristics that are most consistently linked to low levels of distress following exposure to a PTE and describe several prototypic trait resilience measures for adults. We also describe and critically evaluate research that has generated distinct typologies or groups with similar trajectories of adjustment following exposure to PTEs. Finally, we provide examples of several studies of interventions to promote resilience. Ultimately, for the field to advance, clinicians, researchers, and policy-makers need to isolate the factors that reliably promote a successful adjustment across a broad range of domains, including emotional, physical, and occupational functioning. Once known, prevention and intervention strategies need to be refined and tested so that suffering and dysfunction can be mitigated before chronic and debilitating distress become entrenched in those who do not recover on their own.