Mapping the Relationship Between Post-Traumatic Stress and Post-Traumatic Growth and the Mediating Role of Resilience

Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are recognized psychological outcomes of trauma, yet their relationship and role of resilience remain incompletely understood. Resilience, shaped by social and cultural factors, may reduce distress and facilitate growth, making it critical for public mental health strategies. The objective is to systematically map and synthesize evidence on the mediating and moderating role of resilience in the relationship between PTSD and PTG, with attention to social, cultural and contextual determinants relevant to population mental health. A scoping review followed PRISMA-ScR guidelines. PubMed, Scopus, PsycINFO and Google Scholar were searched for English-language studies from 2015 to May 2025. Eligible studies examined PTSD and PTG outcomes related to resilience in trauma-exposed populations. Data were charted on study design, population, measures used, main findings and social and cultural factors. The review identified 14 relevant studies that demonstrated varying relationships between PTSD and PTG. Some studies found a positive linear relationship, where higher PTSD symptoms were linked to increased PTG, provided cognitive processing and resources were available. Other studies revealed a non-linear relationship, with moderate PTSD levels corresponding to the highest PTG, while very low or high symptoms were associated with lower PTG. Resilience consistently showed a positive association with PTG, acting either as a mediator that transforms distress into growth or as a moderator that mitigates the impact of PTSD. Additionally, social support, self-compassion, cognitive reappraisal and hope were found to enhance PTG. Resilience is a key factor shaping trauma outcomes, but its interaction with social determinants warrants further exploration. Strengthening individual and community resilience through social support, equitable access to care and culturally sensitive interventions may enhance recovery and foster growth at the population level. These findings have direct implications for clinical assessment and trauma-focused psychotherapy, highlighting resilience as a modifiable therapeutic target.