Most people will experience a traumatic event within their lifetime. One commonly recognized response to trauma exposure is posttraumatic stress disorder (PTSD). The biological underpinnings of PTSD, including epigenetic mechanisms of DNA methylation and gene expression, have been studied intensively. However, psychological posttrauma responses vary widely and can include positive outcomes, such as posttraumatic growth (PTG) and, more commonly, resilience. The aim of this systematic review was to summarize the current DNA methylation and gene expression data with respect to three potential posttrauma responses: PTSD, PTG, and resilience. A literature search identified 486 studies, 51 of which were deemed eligible for inclusion (total N = 10,633). All included studies examined PTSD and consistently implicated DNA methylation and gene expression changes in hypothalamic-pituitary-adrenal axis and inflammatory genes. Ten studies acknowledged resilience as a posttrauma response, but only two studies examined epigenetics and gene expression using a scale to measure resilience. Low resilience was associated with gene expression patterns in immune and dopamine genes, and high resilience was associated with a blunted inflammatory response. No studies examined epigenetic or gene expression changes associated with PTG. These findings highlight a focus on pathogenic research, which has failed to adequately acknowledge and measure positive posttrauma outcomes of PTG and resilience. Future research should examine DNA methylation and gene expression changes associated with PTG and resilience in addition to PTSD in order to gain a more comprehensive picture of an individual's well-being following exposure to trauma.

Objective: Understandings of the biological mechanisms underpinning posttrauma responses are limited. This pilot study aimed to expand research in this area by examining the relationship between DNA methylation of stress genes nuclear receptor subfamily 3 group C member 1 (NR3C1) and FK06 binding protein 5 (FKBP5) with an array of posttrauma responses of posttraumatic stress disorder (PTSD) symptom severity, posttraumatic growth (PTG), and resilience. Method: First-year paramedicine students (N ϭ 47) completed self-report measures of PTSD symptom severity, PTG, and resilience and provided a saliva sample for methylation analysis. Surrogate variable analyses identified covariates after which generalized regression models were performed to identify genomic sites significantly associated with PTSD symptom severity, PTG, or resilience. Results: Methylation of different FKBP5 and NR3C1 sites was significantly associated with PTSD symptom severity, PTG, and resilience. Methylation in FKBP5 site cg07485685 was a predictor of both PTSD symptom severity and resilience in opposite directions. Conclusions: This is the first study investigating methylation changes in PTG, and overall the results suggest that NR3C1 and FKBP5 methylation is associated with both positive and negative posttrauma responses. Clinical Impact StatementThis study advances understanding of how experiences of trauma can influence the epigenome. With further research, NR3C1 and FKBP5 genes may act as specific and individualized targets for research, prevention, identification, and treatment of various posttrauma responses as well as health promotion.

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Correctional officers (COs) work in high-stress environments, frequently experience critical incidents and have shown high levels of burnout. The current review synthesizes and evaluates literature on determinants of CO well-being. The review followed the Joanna Briggs Institute approach for mixed-method systematic reviews. Eligible studies measured subjective or psychological well-being in frontline COs. Studies of disorder absence or nonfrontline COs or associated professions were excluded. Searches of psychology and criminal justice databases including PsycINFO (EBSCOhost) and Criminal Justice (ProQuest) were completed in June 2021, and data were synthesized using a convergent segregated approach. A total of 29 studies were included and explored individual, interpersonal, and organizational determinants of well-being. Key themes identified by thematic synthesis of qualitative research included job satisfaction, personal growth, and coping. COs can experience well-being, however, further research into determinants of CO well-being is required.

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