Psychological Resilience to Trauma and Risk of Metabolic Syndrome in Women

Previous research suggests an association between posttraumatic stress disorder (PTSD) and metabolic syndrome (MetS) but has not disentangled effects of trauma exposure, PTSD, and psychological resilience following trauma. This study investigated risk of MetS by psychological resilience following trauma exposure.

Data are from 42,425 women in the Nurses' Health Study II who completed a survey in 2008 evaluating PTSD symptoms, psychological distress, facets of positive psychological well-being (PWB), and a broad range of covariates. Psychological resilience to trauma was characterized as: resilient (no PTSD and high positive PWB), coping without thriving (no PTSD and low positive PWB), and PTSD, with a no trauma control group. Probable MetS was derived using data on weight, height, diagnosed hypertension, hyperlipidemia, and diabetes, and medication use from biennial surveys between 1989-2019. Time to probable MetS was approximated as the return date of the first questionnaire at which 3+ probable MetS criteria were met.

Proportional hazards models adjusted for sociodemographic characteristics indicated that, relative to women with no trauma, women categorized as having PTSD (aHR=1.34 [1.05, 1.71]) or as coping without thriving (aHR=1.29 [1.03, 1.62]) experienced a greater hazard of developing MetS, whereas resilient women experienced a similar hazard of developing MetS (aHR=1.06 [0.84, 1.34]). Results remained similar after adjusting for health behaviors and antidepressant use.

Future research on trauma and MetS should consider varied trauma responses and assess if interventions that not only reduce psychological distress but also promote PWB could mitigate MetS risk.