In May 2020, during the first wave of the COVID-19 pandemic, Dr. Melissa Thomas graduated Yale School of Medicine and immediately started work in the Emergency Department of Yale New Haven Hospital. She quickly noticed similarities between her new job and her two deployments to Iraq as a U.S. Army Medical Service Corps officer.

“Relying on teamwork, having strong bonds with people going through these experiences with you at the same time — that’s very similar,” Thomas said. “It’s why I was drawn to emergency medicine.”

But high stress can also have negative consequences for mental health, even among highly trained and experienced health care providers. To explore how to promote psychological resilience and prevent negative health outcomes among such individuals, Dr. Thomas investigated the long-term physical and mental health risks and resilience of her fellow graduates from the U.S. Military Academy at West Point. It was the first study to focus on graduates and consider gender differences in these topic areas since the elite institution’s integration of women in 1980. It earned Dr. Thomas the William U. Gardner Prize for the most outstanding thesis in her graduating class.

Now published in the peer-reviewed journal Chronic Stress, the study surveyed 1,342 graduates from the classes of 1980-2011 to collect sociodemographic information and data on self-reported physical and mental health behaviors and conditions as well as details of their military service. Women’s Health Research at Yale Director Carolyn M. Mazure, PhD, and Dr. Robert Pietrzak, director of the Translational Psychiatric Epidemiology Laboratory in the Clinical Neurosciences Division of the U.S. Department of Veterans Affairs National Center for Post-traumatic Stress Disorder, served as Dr. Thomas’ mentors on her medical school thesis and published the Chronic Stress paper with her. Other authors include Dr. Steven Southwick at Yale, Dr. Dana Nguyen of the Uniformed Services University, and Dr. Diane Ryan of Tufts University.

After applying statistical models developed by Dr. Pietrzak, Dr. Thomas found that increased psychological resilience in the graduates was associated with a higher sense of purpose in life, social connectedness, and grit, which is defined as “perseverance and passion for pursuing long-term goals.”

“A lot of research on stress and trauma focuses on negative outcomes,” Thomas said. “But by focusing on successful resilience we can learn a lot about how to build prevention strategies.”

Notably, greater time in military service correlated with higher resilience for women but had little correlation for men. The authors suggest this apparent difference in resilience for women remaining in the service might be due to the relative reduction in resilience for those goal-oriented women trained at West Point who leave the service. This latter group may leave paid work in the process of raising a family or pursue a non-military career, and in so doing feel a reduction in their purpose in life or find difficulty adapting to male-dominated fields without the structure and stability of military formalities.

“There are many ways that people can build their mental health and prevent negative health outcomes,” Thomas said. “With this new research, can see the importance of enhancing purpose in life, social connectedness, and even grit to improve the capacity for resilience in the face of stress or trauma.”

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