Resilience facilitates adjustment through greater psychological flexibility among Iraq/Afghanistan war veterans with and without mild traumatic brain injury. Academic Article uri icon


  • OBJECTIVES: Although many Iraq/Afghanistan warzone veterans report few problems with adjustment, a substantial proportion report debilitating mental health symptoms and functional impairment, suggesting the influence of personal factors that may promote adjustment. A significant minority also incur warzone-related traumatic brain injury (TBI), the majority of which are of mild severity (mTBI). We tested direct and indirect pathways through which a resilient personality prototype predicts adjustment of warzone veterans with and without mTBI over time. METHOD: A sample of 264 war veterans (181 men) completed measures of lifetime and warzone-related TBIs, personality traits, psychological adjustment, quality of life, and functional impairment. Social support, coping, and psychological flexibility were examined as mediators of the resilience-adjustment relationship. Instruments were administered at baseline, 4-, 8-, and 12-month assessments. Structural equation models accounted for combat exposure and response style. RESULTS: Compared with a nonresilient personality prototype, a resilient prototype was directly associated with lower PTSD, depression, and functional disability, and higher quality of life at all time-points. Warzone mTBIs frequency was associated with higher scores on a measure of functional disability. Indirect effects via psychological flexibility were observed from personality to all outcomes, and from warzone-related mTBIs to PTSD, depression, and functional disability, at each time-point. CONCLUSIONS: Several characteristics differentiate veterans who are resilient from those who are less so. These findings reveal several factors through which a resilient personality prototype and the number of mTBIs may be associated with veteran adjustment. Psychological flexibility appears to be a critical modifiable factor in veteran adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

published proceedings

  • Rehabil Psychol

altmetric score

  • 14.85

author list (cited authors)

  • Elliott, T. R., Hsiao, Y., Kimbrel, N. A., DeBeer, B. B., Gulliver, S. B., Kwok, O., Morissette, S. B., & Meyer, E. C.

citation count

  • 17

complete list of authors

  • Elliott, Timothy R||Hsiao, Yu-Yu||Kimbrel, Nathan A||DeBeer, Bryann B||Gulliver, Suzy Bird||Kwok, Oi-Man||Morissette, Sandra B||Meyer, Eric C

publication date

  • November 2019