Office of Primary Care and Area Health Education Centers (AHEC) Program

Larner Professor of Psychiatry William Copeland, Ph.D.

(JANUARY 13, 2025) The Sector reported that new work led by Larner Professor of Psychiatry William Copeland, Ph.D., challenges the narrative that children are inherently resilient beings—that they can recover from tragedy or difficulties with ease and without consequence.

While most children do well in response to adversity, Copeland said that when children experience multiple traumas, the outcome is often different.

As the principal investigator for the Great Smoky Mountains Study, which has tracked the mental and physical outcomes of a cohort of North Carolina residents since 1992, Professor Copeland and fellow researchers analyzed data in the early 2000s, finding that 10 percent of children exposed to multiple traumas seemed to emerge unscathed. 

Running repeat analysis 20 years later, when participants in the study were aged in their 40s, a 2022 study uncovered a different story, with a significant portion of the children who had appeared resilient earlier in their life developing anxiety and depression as adults.

“Even though they looked like super-copers in childhood, there was still a cost,” Professor Copeland said. “I wasn’t unhappy with shattering this notion of the resilient individual.”

Hundreds of papers have come from the Great Smoky Mountains Study as investigators routinely check in with participants with hefty questionnaires that screen for exposure to trauma and sample their blood for biomarkers of stress. Over the years, the focus of the Great Smoky Mountain Study has shifted from examining the psychiatric health of rural youth to health across the participants’ lifespans. The participants were 9 to 13 years of age when first enrolled and many now have children of their own, and many of those children are now part of the study.