A strange fact of human nature is that two people can experience exactly the same seemingly traumatic event and respond completely differently. One might face years of struggles as a result of suffering from the effects of post-traumatic stress disorder and other psychological fallout, while the other, after an initial period of being shaken up, bounces back completely.
Researchers have an obvious interest in figuring out why these distinctions exist; if they want to best treat the psychological ravages of trauma, it would help to know who is most susceptible and why. That’s the thinking behind a new study (http://onlinelibrary.wiley.com/doi/10.1002/brb3.322/abstract) in Brain and Behavior led by Heather Rusch of the National Institutes of Health’s National Institute of Nursing Research.
Rusch and her team noted a surprising dearth “of research examining psychological resilience in women exposed to assault,” so they decided to focus in on this population. They found 159 women who had endured what the previous edition of the DSM considered to be the most psychologically severe form of “assaultive trauma” and gave them a series of established questionnaires designed to gauge their current and past levels of PTSD and other psychiatric conditions, as well as various measures of resilience, social support, personality, and quality of life.
At the most basic level, the participants were divided into three groups: one whose members were “never diagnosed with a psychiatric disorder”; another whose members had been diagnosed with one in the past, but whose symptoms had dissipated; and a third who still showed signs of a disorder.
From there, it was a matter of seeing which statistical attributes correlated with which outcomes. There was a lot to unpack, but two of the researchers’ biggest findings had to do with a psychological concept called “mastery” and with social support, both of which were correlated with never developing a psychiatric condition after being assaulted (a high degree of social support was also correlated with developing one, and then recovering from it).
Mastery is, at its core, about “perceived control over one's life,” as the researchers write. The higher your sense of mastery, the more you think your efforts can lead to a payoff. “I think a sense of personal control over one's life is central to psychological adjustment, especially in the aftermath of an assault, which can consume the survivor with feelings of uncertainty and powerlessness,” said Rusch in an email. It’s no wonder, then, that this characteristic has been linked to recovery from trauma in past studies as well.
As for the importance of social support, this also makes sense: It’s not hard to imagine that when victims have people around them who they can open up to, that makes the recovery process at least marginally easier. But there’s also some potential for this to backfire. “Unlike the social support benefits afforded to military personnel or cancer survivors, women exposed to assault are more often blamed upon disclosure,” explained Rusch. “This can confirm maladaptive perceptions of self-blame, encourage social withdrawal, and promote cognitive avoidance of trauma-related memories.” So simply having people around isn’t enough — they need to react in a properly supportive way.
A study like this one that seeks out correlations but doesn’t test a particular intervention can help lay the groundwork for better treatment of victims in the future, but can’t tell us a huge amount about the specifics of what these treatments will look like. According to Rusch, though, the study offers some pretty clear hints. When a woman is first given a psychological examination after an assault, she said, “I'd recommend assessing perceived social support and sense of mastery given the known link to stress-related disorders.”
On the social-support front, “It is critical to make efforts to reduce stigmatization in the community and help assault-exposed women to identify supportive social networks,” she said — a problem advocates for sexual-assault victims — and victims themselves — know all too well.
Rusch also thinks there might be some potential ways to increase people’s senses of mastery, therefore also boosting the odds of benefiting from its apparent protective powers. Rusch cited (admittedly anecdotal) “personal experience with martial arts and Vipassana meditation,” and also said that “Mindfulness meditation, which inherently promotes mastery, as well as acceptance and equanimity, has shown promising effects in trauma-exposed populations.” Further research could lead to other methods for increased mastery, as well.
Whenever discussing this subject, it’s worth keeping in mind, Rusch and her team note in their paper, that most women never develop post-traumatic symptoms, or do so only briefly. In other words, people are naturally quite resilient. The tricky part is figuring out what factors can complicate the healing process.