A social‐ecological framework for resilience underscores the importance of conceptualizing individuals embedded within their context when evaluating a person's vulnerability and adaptation to stress. Despite a high level of trauma exposure, most veterans exhibit psychological resilience following a traumatic event. Interpersonal trauma is associated with poorer psychological outcomes than noninterpersonal trauma and is experienced more frequently across the lifespan by women as compared to men. In the present study, we examined gender differences in trauma exposure, resilience, and protective factors among veterans. Participants included 665 veterans who completed a baseline survey assessing traumatic events; 544 veterans (81.8%) completed a 1‐year follow‐up survey assessing resilience, combat exposure, deployment social support, deployment preparedness, and military sexual trauma (MST). Principal component analyses revealed the Traumatic Life Events Questionnaire categorized into four meaningful components: sexual abuse, interpersonal violence, stranger violence, and accidents/unexpected trauma. Women reported greater exposure to sexual abuse, d = 0.76; interpersonal violence, d = 0.31; and MST, Cramer's V = 0.54; men reported greater exposure to stranger violence, accidents/unexpected trauma, and combat exposure, ds = 0.24–0.55. Compared to women, men also reported greater social support during deployment, d = 0.46. Hierarchical linear regression indicated that men's resilience scores were higher than women's, β = .10, p = .032, yet this association was no longer significant once we accounted for trauma type, β = .07, p = .197. Results indicate that trauma type is central to resilience and suggest one must consider the social‐ecological context that can promote or inhibit resilient processes.

Summary Background Psychological trauma can have a significant impact on mental and physical health, and interpersonal relationships. Many physicians report discomfort addressing psychological trauma in the context of health care visits, and few training opportunities exist for health care trainees to learn about the relationship between trauma and health. The aim of this project was to develop and implement an educational curriculum to teach medical and nursing trainees about trauma‐informed primary care. Methods We expanded upon pilot data from a brief interdisciplinary intervention to train medical residents in trauma‐informed primary care at a Veterans Affairs hospital. We generated a trauma‐informed care curriculum involving five 1‐hour didactic sessions, 10‐minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback. The curriculum aligned with internal medicine (n = 16) and nurse practitioner (n = 5) interprofessional primary care education sessions during the 2017/18 academic year. Results The curriculum was feasible and associated with increased self‐reported knowledge, attitudes and practice around trauma‐informed care. Free text feedback indicated that residents found the topic important, appreciated a skills‐based approach and valued experiential educational activities. Conclusions Training residents in trauma‐informed care results in improved knowledge, attitudes and practices in caring for patients with psychological trauma. Residents appreciated both experiential and skills‐based exercises. Next steps include continued exploration of using direct observation and feedback, and examining effects of training on patient outcomes (e.g. satisfaction with care).

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Resilience contributes to better chronic disease adjustment but is understudied in Parkinson's disease. Although nonmotor symptoms affect quality of life, their effect on other aspects of Parkinson's disease adjustment is less understood. Hierarchical regression analyses from a cross-sectional survey of 138 community-dwelling adults with Parkinson's disease (mean (standard deviation) age = 64.15(10.09) years) investigated relationships between nonmotor symptoms and resilience on depression, apathy, life satisfaction, and quality of life. After controlling for demographic variables, functional status, and nonmotor symptoms, resilience was associated with all adjustment variables. Nonmotor symptoms were associated with depression and worse quality of life. Nonmotor symptoms and resilience appear to play critical roles in Parkinson's disease adjustment.