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

Although resilience is a dynamic process of recovery after trauma, in most studies it is conceptualized as the absence of specific psychopathology following trauma. Here, using the emergency department AURORA study (n = 1,865 with 63% women), we took a longitudinal, dynamic and transdiagnostic approach to define a static resilience (r) factor, which could explain greater than 50% of variance in mental well-being 6 months following trauma and a dynamic resilience factor, which represented recovery from initial symptoms. We then assessed its neurobiological profile across threat, inhibition and reward processes using functional magnetic resonance imaging collected 2 weeks post-trauma (n = 260). Our whole-brain and study-wide Bonferroni-corrected results suggest that resilience is promoted by activation of regions involved in higher-level cognitive functioning, reward valuation and salience detection in response to reward, whereas resilience is hampered by posterior 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. The authors report data from the emergency department AURORA study to characterize resilience in more detail than the absence of psychopathology after trauma.