Roberto David/

Avoiding the Sickening Effects of Stress

A gritty attitude seems to prevent chronic inflammation from overwhelming the body in the aftermath of trauma.

It’s well known that stress makes people sick, and extreme trauma makes them even sicker. But a new study suggests that not everyone who endures adversity is doomed to chronic illness. There might be a way to prevent the body from attacking itself in the wake of trauma.

For the study, published Monday in the Proceedings of the National Academy of Science, a team of researchers examined the effects of resilience—a measurement of grittiness in the face of strife—on the immune systems of former child soldiers in Nepal. From 1996 to 2006, Maoist rebels fought a civil war against Nepal’s monarchy and the government forces that protected it. One of their strategies was recruiting children, first in various “cultural” activities, such as dancing, but eventually in military roles. By the time the war was over, thousands of children had served as soldiers.

The researchers, from Duke University and the University of California, Los Angeles, found these former child soldiers all over Nepal, interviewed them, and tested their blood. Perhaps expectedly, the soldiers were more likely to have PTSD, and consequently, a marker of chronic inflammation called CTRA gene expression. CTRA stands for “conserved transcriptional response to adversity.” It means that chronic, prolonged trauma can activate genes that pump pro-inflammatory proteins into the blood, gut, brain, and other areas. People who have high CTRA are more susceptible to cancer, diabetes, heart disease, and mental health issues like depression and anxiety. 

To test the former soldiers’ resilience, the researchers measured how much the soldiers agreed with phrases like “I can be on my own if I have to” and “My belief in myself gets me through hard times.” The soldiers who considered themselves very resilient turned out to have low CTRA expression—a level comparable to young people who hadn’t endured the same trauma. This was true even of the soldiers who experienced PTSD. Struggling with the aftermath of war, in other words, didn’t prevent them from reaping the healing benefits of resilience.

“You had kids who reported still having nightmares about the war, still being afraid, still being jumpy when reminded of loud noises,” said Brandon Kohrt, an assistant professor of psychiatry and anthropology at Duke University and the lead author of the study. Nevertheless, he found, they were biologically quite healthy.

Because PTSD often arises from things like natural disasters and terror attacks, it’s hard to prevent and not always curable. But through therapy and community interventions, resilience can be taught, so it’s promising that the trait can override PTSD’s harmful effects.

“By focusing on resilience with these individuals, even if they have PTSD symptoms, we might help them prevent the physical effects on the body,” Kohrt said.

This study replicated past research in rich, Western countries showing that resilience protects against CTRA expression. That offers hope for people in poorer nations or in conflict zones—who, after all, are more likely to be affected by war, poverty, and other types of trauma.