Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Robert Pietrzak


Psychological resilience is the most common response following exposure to traumatic life events. To date, most research has focused on factors associated with adverse post-trauma mental health outcomes rather than understanding those associated with psychological resilience. In particular, little is known about factors associated with resilience in veterans, despite their high rates of trauma exposure, such as combat and military sexual trauma. To address this gap, we used a discrepancy-based psychiatric resilience (DBPR) analytic approach to operationalize resilience and to identify modifiable health and psychosocial factors associated with resilience in a nationally representative sample of U.S. veterans (N = 4,069). DBPR scores were computed by regressing a composite measure of distress (posttraumatic stress, major depressive, andgeneralized anxiety disorder symptoms) onto measures of adverse childhood experiences, combat exposure, military sexual trauma, and cumulative potentially traumatic events (e.g., natural disaster, life-threatening illness/injury). Resilience was operationalized as lower actual, relative to predicted, composite distress scores. Results revealed that greater emotional stability (22.9% relative variance explained [RVE]) and mindfulness (13.4% RVE), lower likelihood of lifetime MDD or PTSD (12.8% RVE), greater purpose in life (11.9% RVE), and lower severity of somatic symptoms (10.8% RVE) explained the majority of the variance in resilience scores (total R2=0.40). These results illustrate the utility of a DBPR score approach to operationalizing resilience to traumatic stress in U.S. veterans and identify several modifiable health and psychosocial factors that can be targeted in prevention and treatment efforts designed to bolster resilience in this population.

Open Access

This Article is Open Access

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