Trauma and resilience

Abstract While exposure to traumatic events is highly prevalent, only a small proportion of those exposed to such stressors develop psychiatric illnesses. This raises a number of questions for social psychiatry. What are the mechanisms underlying risk and resilience after trauma? And what can be done to further decrease risk and increase resilience? This chapter reviews the epidemiology, neurobiology, and social determinants of post-traumatic stress disorder (PTSD) and resilience, in order to address these questions and to provide an integrative approach. An integrative approach to trauma and PTSD requires the recognition of a broad range of biological and societal risk and resilience factors that are relevant to trauma exposure, and that are important after such trauma, as well as the need for a range of interventions to target these factors. Such an approach aims to avoid both biological and sociological reductionism, instead emphasizing the need for a public health approach that reduces vulnerability to trauma and to PTSD, and to increase resilience.