Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA.
Department of Psychology, Pace University, Pleasantville, New York, USA.
J Trauma Stress. 2024 Oct;37(5):717-723. doi: 10.1002/jts.23071. Epub 2024 Jun 5.
This article summarizes the growing literature on resilience in the face of aversive and potentially traumatic events (PTEs) in three basic axioms: (a) resilience is a common outcome, 2) there are no "key" traits to resilience (resilience is not a type), and (c) resilient outcomes occur through flexible self-regulation. The first axiom highlights the limitation of a traditional, binary view of trauma in terms of the presence-absence of posttraumatic stress disorder, emphasizing instead the heterogeneity of trauma outcomes. Four prototypical trajectories are reviewed: chronic symptoms; delayed symptoms; recovery; and the most common trajectory, resilience. The second axiom reviews the paradoxical inability of known correlates of resilience to adequately predict resilient outcomes. Resilience is instead described as a multifaceted phenomenon with no singular set of key traits, as various factors contribute to resilient outcomes in complex ways. The third axiom provides an explanation of how resilience can emerge from this complex array by introducing the concept of flexible self-regulation. The flexibility mindset is described as providing the motivation for flexible responding. The flexibility sequence is described as explaining the mechanisms underlying flexibility in terms of three serial stages: context sensitivity, strategy repertoire, and feedback adjustment. The final section briefly considers clinical implications.
本文总结了在面对厌恶和潜在创伤事件 (PTE) 时韧性的日益增多的文献,主要有三个基本公理:(a) 韧性是常见的结果,(b) 韧性没有“关键”特征(韧性不是一种类型),(c) 韧性结果是通过灵活的自我调节产生的。第一个公理强调了传统的、二元的创伤观点的局限性,即根据创伤后应激障碍的存在与否来判断,而是强调了创伤结果的异质性。本文回顾了四种典型的轨迹:慢性症状;延迟症状;恢复;以及最常见的轨迹,韧性。第二个公理回顾了已知韧性相关因素无法充分预测韧性结果的悖论。韧性被描述为一个多方面的现象,没有单一的关键特征集,因为各种因素以复杂的方式促成了韧性结果。第三个公理通过引入灵活的自我调节概念,解释了如何从这种复杂的组合中产生韧性。灵活的心态被描述为提供了灵活反应的动机。灵活序列被描述为解释了三个连续阶段的机制:语境敏感性、策略库和反馈调整。最后一节简要考虑了临床意义。