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Author Notes:

Corresponding Author: Vasiliki Michopoulos, PhD, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, 30329, USA. vmichop@emory.edu

Authors Thompson Fiorillo, Ressler, Rothbuam and Michopoulos all implemented the overall study design and recruitment of participants.

Authors Thompson, Fiorillo, and Michopoulos collected data for the current study and undertook the data analysis.

Authors Thompson and Fiorillo wrote first draft of the manuscript, to which all other authors provided feedback on interpretation and presentation.

We would like to thank Alex Rothbaum, Thomas Crow, and Becky Roffman for their support and assistance.

All of this work would not have been possible without the support of all the nurses, physicians, associate providers, and staff of the Emergency Care Center at Grady Memorial Hospital.

Additionally, we would like to acknowledge the patients and families that agreed to participate in both studies.

All authors declare that they have no conflicts of interest.


Research Funding:

The National Institutes of Health supported this work via MH094757 (KJR) and HD085850 (VM).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Psychiatry
  • Neurosciences & Neurology
  • Resilience
  • PTSD
  • Coping strategies
  • Social withdrawal

Coping strategies as mediators in relation to resilience and posttraumatic stress disorder


Journal Title:

Journal of Affective Disorders


Volume 225


, Pages 153-159

Type of Work:

Article | Post-print: After Peer Review


Background Resilience has been shown to protect against the development of posttraumatic stress disorder (PTSD) in the aftermath of trauma. However, it remains unclear how coping strategies influence resilience and PTSD development in the acute aftermath of trauma. The current prospective, longitudinal study investigated the relationship between resilience, coping strategies, and the development of chronic PTSD symptoms. Methods A sample of patients was recruited from an emergency department following a Criterion A trauma. Follow-up assessments were completed at 1-, 3-, and 6-months post-trauma to assess PTSD symptom development (N = 164). RESULTS: Resilience at 1-month positively correlated with the majority of active coping strategies (all p <.05) and negatively correlated with the majority of avoidant coping strategies (all p <.05), as well as future PTSD symptoms (p <.001). Additionally, all avoidant coping strategies, including social withdrawal, positively correlated with future PTSD symptoms (all p <.01). After controlling for demographic and clinical variables, social withdrawal at 3-months fully mediated the relationship between resilience at 1-month and PTSD symptoms at 6-months. Limitations Limitations include participant drop out and the conceptual overlap between avoidant coping and PTSD. Conclusions These data suggest that resilience and social withdrawal may be possible therapeutic targets for mitigating the development of chronic PTSD in the aftermath of trauma.

Copyright information:

© 2017 Elsevier B.V.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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