Defining the r factor for post-trauma resilience and its neural predictors

Abstract

Resilience is a dynamic process of recovery after trauma, but in most studies it is conceptualized as the absence of speci c psychopathology following trauma. Using the large emergency department AURORA study (n=1,865, 63% women), we took a longitudinal, dynamic and transdiagnostic approach to de ne a static resilience (r) factor, that could explain >50% of variance in mental wellbeing 6-months following trauma, and a dynamic r-factor, which represented recovery from initial symptoms. We assessed its neurobiological pro le across threat, inhibition, and reward processes using fMRI collected 2-weeks post-trauma. Our neuroimaging results suggest that resilience is promoted by activation of higher-level cognitive functioning and salience network regions in response to reward, whereas resilience is hampered by top-down attention and default mode network activation to threat and reward. These ndings serve to rede ne the concept of resilience as both dynamic and multifaceted, and identify mechanisms that promote resilience after trauma for early interventions.