Neuroimaging resilience to trauma: convergent evidence and challenges for future research

Resilience, or the phenomenon of successful adaptation following significant trauma exposure, is a complex, multidimensional, and dynamic process. To date, research on neural mechanisms involved in human resilience has comprised of two major research streams – involving individuals with childhood and adulthood trauma exposure, respectively. Although there are systematic differences in how both trauma and resilience have been defined across these two bodies of research, some striking regions of convergence emerge when considering the literature as a whole. Here, we review functional imaging studies from across these two research streams, alongside discussion of some of the methodological difficulties involved in quantifying both trauma and resilience in human participants. Due to the broad scope of this literature, we restrict the scope of our narrative to several key domains where studies from across these two bodies of work implicate common neural circuitry. These areas of convergence include brain networks implicated in emotion regulation, responses to rewards, and cognitive control. Further, we briefly review functional imaging evidence related to proposed mechanisms underlying resilient outcomes: namely active coping, cognitive reappraisal and successful fear extinction. Finally, we also touch upon several ongoing issues in neuroimaging study design and analysis that will need to be addressed in order to enable us to harness insight from such studies to improve treatments for – or, ideally, guard against the development of – debilitating post-traumatic stress syndromes.