Predictors of lower-than-expected posttraumatic symptom severity in war veterans: The influence of personality, self-reported trait resilience, and psychological flexibility

Abstract

Resilience following traumatic events has been studied using numerous methodologies. One approach involves quantifying lower-than-expected levels of a negative outcome following trauma exposure. Resilience research has examined personality and coping-related factors. One malleable factor is psychological flexibility, or the context-dependent ability/willingness to contact the present moment, including emotional distress, in order to engage in valued actions. Among 254 war Veterans who participated in a longitudinal study, we operationalized resilience as lower-than-expected PTSD symptoms and PTSD-related functional impairment one-year following an initial post-deployment assessment based on lifetime exposure to childhood trauma, combat trauma, and sexual trauma during military service. We evaluated the contribution of personality factors, self-reported trait resilience, and psychological flexibility, measured using the Acceptance and Action Questionnaire-II, to PTSD-related resilience after accounting for lifetime and current PTSD symptom severity and depression symptom severity. In hierarchical regression analyses, neither specific personality factors nor self-reported resilience predicted PTSD-related resilience at follow-up after accounting for PTSD and depression symptoms. In the final step, psychological flexibility predicted unique variance and was the only significant predictor of PTSD-related resilience aside from baseline PTSD symptom severity. Findings indicate that psychological flexibility is a predictor of resilience that is distinct from psychiatric symptoms, personality, and self-reported resilience. Trauma survivors may benefit from interventions that bolster psychological flexibility.