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Looking for resilience: Understanding the longitudinal trajectories of responses to stress
Authors:Fran H Norris  Melissa Tracy  Sandro Galea
Institution:aDartmouth Medical School, Psychiatry/NCPTSD, VA Medical Center, 215 North Main Street, White River Junction, VT 05009, USA;bUniversity of Michigan, MI, USA
Abstract:Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n = 561) and the September 11, 2001 terrorist attacks in New York (n = 1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.
Keywords:Resilience  Disaster  Terrorism  Posttraumatic stress disorder (PTSD)  Mexico  USA
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