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 specific psychopathology following trauma. Using the emergency department AURORA study (n=1,865, 63% women), we took a longitudinal, dynamic and transdiagnostic approach to define 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 profile across threat, inhibition, and reward processes using fMRI collected 2-weeks post-trauma (n=260). Our whole brain and study-wide Bonferroni-corrected 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 findings serve to generate new hypotheses for brain mechanisms that could promote dynamic and multifaceted components of resilience following trauma.