Coping strategies as mediators in relation to resilience and posttraumatic stress disorder

Background: Resilience has been shown to protect against the development of posttraumatic stress disorder (PTSD) in the aftermath of trauma. However, it remains unclear how coping strategies influence resilience and PTSD development in the acute aftermath of trauma. The current prospective, longitudinal study investigated the relationship between resilience, coping strategies, and the development of chronic PTSD symptoms. Methods: A sample of patients was recruited from an emergency department following a Criterion A trauma. Follow-up assessments were completed at 1-, 3-, and 6-months post-trauma to assess PTSD symptom development (N = 164). RESULTS: Resilience at 1-month positively correlated with the majority of active coping strategies (all p < .05) and negatively correlated with the majority of avoidant coping strategies (all p < .05), as well as future PTSD symptoms (p < .001). Additionally, all avoidant coping strategies, including social withdrawal, positively correlated with future PTSD symptoms (all p < .01). After controlling for demographic and clinical variables, social withdrawal at 3-months fully mediated the relationship between resilience at 1-month and PTSD symptoms at 6-months. Limitations: Limitations include participant drop out and the conceptual overlap between avoidant coping and PTSD. Conclusions: These data suggest that resilience and social withdrawal may be possible therapeutic targets for mitigating the development of chronic PTSD in the aftermath of trauma.