Adolescents' PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.

Neuroimaging research has identified systems that facilitate minimizing negative emotion, but how the brain is able to transform the valence of an emotional response from negative to positive is unclear. Behavioral and psychophysiological studies suggest a distinction between minimizing reappraisal, which entails diminishing the arousal elicited by negative stimuli, and positive reappraisal, which instead changes the emotional valence of arousal from negative to positive. Here we show that successful minimizing reappraisal tracked with decreased activity in the amygdala, but successful positive reappraisal tracked with increased activity in regions involved in computing reward value, including the ventral striatum and ventromedial pFC (vmPFC). Moreover, positive reappraisal enhanced positive connectivity between vmPFC and amygdala, and individual differences in positive connectivity between vmPFC and amygdala, ventral striatum, dorsomedial pFC, and dorsolateral pFC predicted greater positive reappraisal success. These data broaden models of emotion regulation as quantitative dampening of negative emotion and identify activity in a network of brain valuation, arousal, and control regions as a neural basis for the ability to create positive meaning from negative experiences.

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Potential trauma is common across the life span. Responses to these highly aversive events vary significantly, yet many individuals will demonstrate psychological resilience and a clear pattern of psychological health and adaptive functioning in the wake of extreme adversity. Amid expanding conceptual diversity and a proliferation of research, we present a novel, unified framework for resilience that consists of four constituent, temporally related elements: baseline or preadversity functioning, the actual aversive circumstances, postadversity resilient outcomes, and predictors of resilient outcomes. The temporal framework integrates and extends several existing lines of research by conceptualizing resilience as a process that unfolds over time with each temporal element playing an essential role.