(WITHDRAWN) Associations between Posttraumatic Stress Disorder, Posttraumatic Growth, and Resilience Among Vietnam Combat Veterans: Opportunity for Trauma-Informed and Strength-Based Care

Background: Traumatic experiences are associated with both pathogenic and salutogenic outcomes. While trauma exposures predispose survivors to compromised mental health outcomes such as posttraumatic stress disorder (PTSD), some individuals may experience salutatory corollaries of trauma, including posttraumatic growth (PTG). Likewise, resilience, an adaptive coping skill, is associated with both PTSD and PTG. The current study aimed to examine dyadic links between total-PTSD, PTSD symptom-clusters, PTG, and resilience across linear and curvilinear models.

Methods: Vietnam combat veterans across five counties of Western New York participated in this cross-sectional study (N=117; M_age=69.53yrs, SD=3.4). Most Veterans (94%) were non-Hispanic White, 28.2% had ≥4-yr college, 76.1% were married/cohabiting. Veterans were enlisted (62.4%) or drafted (37.6%) and the majority were Army (65.8%). Measures included PCL-5 (PTSD), PTGI (PTG), BRS (Resilience), and DRRI-2 (Social support). Hierarchical regressions (linear and quadratic) were run, controlling for social support.

Results. Quadratic models fit best for PTG regressed on total-PTSD, resilience regressed on PTG, and PTG regressed on symptom cluster 4 of PTSD (Alterations in arousal and reactivity).

For instance, PTG regressed on total-PTSD showed that PTG increased by 1.23 units for an additional unit of total-PTSD if the slope remained unchanged. Each additional increase in total-PTSD reduced the slope by 1.5 units, such that the PTG decreased and the relationship reversed after total-PTSD increased further. Some linear models had better fit than quadratic models. Results indicated that PTSD1 (Intrusion symptoms) and PTSD2 (Avoidance) were positively associated with PTG, whereas total-PTSD, PTSD1, PTSD2, PTSD3 (Negative alterations in cognitions and mood), and PTSD4 (Alterations in arousal and reactivity) were negatively associated with resilience.

Implications. Empirical evidence supports salubrious outcomes and/or correlates of trauma, such as PTG and resilience, may coexist or proceed from PTSD/trauma. Clinical research, therefore, should examine efficacy of strength-based approaches along with trauma-informed models.