Rethinking resilience using the r-factor: Neurobiological mechanisms of static and dynamic components of resilience following trauma

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 large 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. Our neuroimaging 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 redefine the concept of resilience as both dynamic and multifaceted, and identify mechanisms that promote resilience after trauma for early interventions.