Magazine article Clinical Psychiatry News

Personal Resilience Staves off PTSD

Magazine article Clinical Psychiatry News

Personal Resilience Staves off PTSD

Article excerpt

NEW YORK -- Severe stress can have lasting effects, most dramatically in posttraumatic stress disorder. But many people undergo equally traumatic experiences--combat, natural disasters, imprisonment, torture--and emerge relatively intact.

What's their secret?

Dr. Steven Southwick, a psychiatrist at Yale University, New Haven, has studied groups of combat veterans, former prisoners of war, and others who have done well after highly stressful experiences, using in-depth interviews and brain imaging to identify factors that may explain such resilience.

"Metaphorically, they resemble a twig with a green, growing core. When twisted out of shape, [the twig] springs back and continues to grow," he said, citing Dr. George Vaillant, a professor of psychiatry at Harvard Medical School, Boston.

One biologic factor that distinguished this group involved neuropeptide Y, which is released along with norepinephrine under stressful conditions and has the effect of dampening arousal. "Neuropeptide Y turns the nervous system down," Dr. Southwick said at a meeting on psychopharmacology sponsored by New York University. He noted that people with PTSD tend to have low levels of the chemical.

A group of U.S. Army Special Forces veterans who had done well under highly stressful combat conditions was found to have unusually high serum concentrations of neuropeptide Y. "This could enable them to remain cool under pressure," he said.

A wider spectrum of personal and relationship traits emerged as being characteristic of resilient people.

For example, a supportive social network--"having others around you"--may bolster the ability to contain one's own neurobiologic responses, Dr. Southwick said.

Mentors and powerful role models seemed to make a particular difference: "Everyone talked about them," he said. The influence of a mentor appears to be a complex issue that can be understood from social, psychological, and biologic perspectives, and may involve the capacity for self-soothing under duress.

"Moral compass and integrity," a factor mentioned by many interviewees, may offer protection against the guilt that appears to play a "huge" role in PTSD. One interviewee described his sense of right and wrong as "something to keep me afloat when drowning."

The ability to find meaning and purpose even in very harsh circumstances--to "stand for an idea"--was a similar source of strength. …

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