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.
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Interventions targeting increased psychological flexibility are recommended not only for facilitating recovery after stressors but also for enhancing resilience.
“Interventions targeting increased psychological flexibility—ACT being the foremost in this field—are recommended not only for facilitating recovery after stressors but also for enhancing resilience (14, 16, 29, 30).”
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- Authors
- Meyer, E. C., Kotte, A., Kimbrel, N. A., DeBeer, B. B., Elliott, T. R., Gulliver, S. B., & Morissette, S. B.
- Affiliations
- Texas A&M Health Science Center (US)
- Central Texas Veterans Health Care System (US)
- Duke Medical Center (US)
- Texas A&M University (US)
- The University of Texas at San Antonio (US)
- Corresponding author
- Meyer, Eric C.
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 113
- Pages
- 1-8
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2905297875
- Cited by
- 59
- References
- 90
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 6 · 2023: 9 · 2022: 7 · 2021: 10 · 2020: 6 · 2019: 5
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- VA Merit (#I01RX000304-01A1)
- Rehabilitation Research and Development Service (#I01RX000304-01A4)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- post-traumatic stress disorder, resilience, psychological flexibility, war veterans, war injuries, childhood trauma, sexual trauma, personality, depression, Acceptance and Action Questionnaire-II, trauma exposure
- MeSH terms
- War Exposure, Adaptation, Psychological, Adult, Combat Disorders, Depression, Female, Humans, Longitudinal Studies, Male, Personality, Sex Offenses, Stress Disorders, Post-Traumatic, Veterans, Iraq War, 2003-2011, Resilience, Psychological, Afghan Campaign 2001-, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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