Beyond Resilience and PTSD: Mapping the Heterogeneity of Responses to Potential Trauma

The formal acceptance of posttraumatic stress disorder (PTSD) as a legitimate diagnostic category in the1980 Diagnostic and Statistical Manual of Mental Disorders stimulated a torrent of research onpsychological trauma. Not surprisingly, PTSD and its treatment had dominated that research. Anothercommon approach has been to measure the average impact of different potentially traumatic events, aswell as the factors that inform that impact. In this article, we consider the limitations of these perspectivesand argue for a broader theoretical approach that takes into account the natural heterogeneity of traumareactions over time. To that end, we review recent attempts to identify prototypical patterns or trajectoriesof trauma reaction that include chronic dysfunction, but also delayed reactions, recovery, and psycho-logical resilience. We consider the advantages but also the limitations and ongoing controversiesassociated with this approach. Finally, we introduce promising new research that uses relative sophis-ticated advances in latent growth mixture modeling as a means of empirically mapping the heterogeneityof trauma responses and consider some of the implications of this approach for existing trauma theories.Keywords: resilience, PTSD, trauma trajections, grief