B - 39 Resilience in Active Duty US Military Service Members: Factor Analysis and Prediction of Psychological Symptoms in a Mild Traumatic Brain Injury Sample

Abstract Objective The factor structure of the Connor-Davidson Resilience Scale (CD-RISC) varies between cultures, settings, and samples, yet has not been assessed in an active-duty United States (US) military sample. We used factor analysis to characterize resilience in a generalizable sample of active-duty service members (ADSMs) and explored its associations with self-reported psychological outcomes in ADSMs with a history of mild traumatic brain injury (mTBI). Method Exploratory factor analysis (EFA) of the 25-item CD-RISC was performed on a non-clinical convenience sample of 212 active duty SMs followed by a confirmatory factor analysis (CFA) for model validation. Hierarchical regressions compared the relationships among the resulting factors and total scores on the Post Traumatic Stress Disorder Checklist (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) between subgroups with self-reported history of mTBI (n = 60) and TBI-negative controls (n = 54). Results EFA returned a 4-factor, 19-item solution. After modifications to improve model fit, CFA validated a 4-factor, 17-item solution: Fortitude, Resoluteness, Decisiveness, and Dedication. The interaction of TBI history with the Decisiveness and Dedication factors significantly predicted BDI and PCL-5 total scores (p < 0.05), but not BAI total scores. Fortitude and Resoluteness did not differentially predict any psychological outcomes between groups. Conclusion Four latent factors of resilience that are unique to ADSMs were identified and validated from the 25-item CD-RISC. Decisiveness and Dedication more strongly predicted depressive and PTSD symptoms in ADSMs with a history of mTBI than in controls, suggesting these factors of resilience are especially critical for better psychological outcomes following mTBI in military populations.