Annual Research Review: Resilience--clinical implications

A network analysis of adolescent mental well-being during the coronavirus pandemic: Evidence for cross-cultural differences in central features

The COVID-19 pandemic continues to pose unprecedented threat globally. Adolescents and youth may be especially susceptible to the long-term impact of these stressors, thus intervening early is an important priority. However, it is also crucial to understand how young people maintain psychological well-being in the face of adversity, particularly given that many nations are experiencing further waves of the pandemic. The understanding of such resilient outcomes could inform the development of programs to encourage positive mental health.We explored adolescents' resilience to the COVID-19 pandemic stress by examining core aspects of well-being across countries using network analysis. Using the short Warwick-Edinburgh Mental Wellbeing Scale, cross-sectional data was collected online from adolescents from India (N = 310; Males = 159, Females = 151, aged 12-18 years), Israel (N = 306; Males = 154, Females = 152, aged 12-18 years) and the United Kingdom (UK; N = 1666; Males = 598, Females = 1068, aged 12-25 years). Two highly similar network clusters were identified for UK and Israel, with three clusters emerging for India. UK and Israeli networks centred on "dealing with problems well" while the Indian network centred on "feeling useful". As central items highlight aspects of well-being that influence or are influenced by other aspects, these findings may inform interventions to safeguard adolescent mental health during future phases of the pandemic.

Editorial: 'The giant's shoulders': understanding Michael Rutter's impact on science and society

The recent death of our colleague and friend Professor Sir Michael Rutter has quite rightly been greeted by an outpouring of gratitude and respect from distinguished commentators across the globe working in diverse fields of the basic, social and clinical sciences as well as from clinicians and policy makers. These have without exception highlighted his seminal role as a pioneer, perhaps The Pioneer, of the application of the scientific method to the study of child and adolescent mental health and disorder - the father of evidence-based Child Psychiatry and the most influential voice in the new field of Developmental Psychopathology (Stevenson, 2022). In this editorial, we will attempt to build on these commentaries. We will parse Mike's scientific contributions to our field, in order to identify the personal characteristics and intellectual modus operandi that made him such a uniquely important figure, whose influence will resonate through the many fields he influenced for decades to come. We will also attempt something of a reframing of that contribution. Our thesis being that, although he never agitated for it politically or even stated it as a goal explicitly, Mike's work was motivated by a desire for social reform and created the scientific catalyst for such reform to occur.

Psychosocial resilience among left-behind adolescents in rural Thailand: A qualitative exploration

When parents migrate, they often leave children behind with relatives. Despite being at higher risk of socio-emotional problems, many left-behind children have good health and social outcomes, suggesting their resilience. We sought to understand how adolescents with internal and international migrant parents build resilience in Thailand. We conducted qualitative interviews with 24 adolescents aged 10-19, and six caregivers, parents and community leaders. Interviews were transcribed, translated and analysed, drawing on techniques from grounded theory. We found that resilience was built in a context where for many families, migration was a financial necessity and the parent-child relationship was mainly phone-based. Adolescents built resilience using three key 'resources': warmth (love and understanding), financial support and guidance. Adolescents with insecure parent or caregiver relationships, or with caring responsibilities for relatives, were less likely to have access to these resources. These adolescents sought emotional and financial independence, prioritised friendships and identified role models to obtain key resources and build resilience. The findings indicate practical and psychosocial barriers to building resilience among left-behind adolescents in Thailand. Further work could explore pathways to mental illness in this population, interventions that build peer networks and caregiver-child relationships and the use of technology to support remote parenting.

Does Resilience Mediate the Association of Adverse Early Childhood Experiences With Emotional and Behavioural Problems?

Objectives: To explore the role of resilience as a mediator in the association between adverse childhood experiences (ACE) and emotional and behavioural problems (EBP) among adolescents.

Methods: We used data from the Slovak 2018 Health Behaviour in School-aged Children study, comprising 2,839 adolescents aged 13–15 (mean age 13.93; 49.6% boys). We used multivariate linear regression performed on 5000 bootstrap samples adjusted for age, gender, family affluence to explore mediation of the associations between ACE (measured using the adapted Adverse Childhood Experience Questionnaire) and EBP (measured using the Strengths and Difficulties Questionnaire) by resilience (measured with the Child and Youth Resilience Measure).

Results: We found ACE [B = 0.78; 95% confidence interval (CI): 0.67|0.90] and resilience (B = −0.73; 95% CI: −0.79|−0.67) to be significantly associated with EBP. The association of ACE and EBP was mediated by resilience. The mediated indirect effect of resilience was ab = 0.25; 95% CI: 0.18|0.32.

Conclusion: Resilience seems to play a mediator role in the relationship between ACE and EBP. Helping adolescents with ACE to build and use internal and external sources of resilience can decrease the negative impact of ACE on EBP.

Recognizing Resilience: Exploring the Impacts of COVID-19 on Survivors of Intimate Partner Violence

This study explores self-reported impacts of the COVID-19 pandemic on several facets of IPV survivor well-being, such as mental health, economic stability, food security, and resilience. Semi-structured interviews were conducted with survivors of IPV. Qualitative data were collected on variables related to mental health, economic stability, food security, and resilience. The findings of this study suggest that while survivors of intimate partner violence (IPV) face a variety of challenges posed by COVID-19 (e.g., employment, income, etc.), they identify themselves as resilient. Our findings also show that while survivors of have faced setbacks due to COVID-19, variables such as mental health and well-being have improved. Our findings suggest that while the pandemic has certainly impacted survivors, and included setbacks or delays, survivors have seen improvements in several areas. Our data suggest that these improvements, in the face of difficulties, is because of the overwhelming resilience of survivors.

Resilience and young people's brain structure, function and connectivity: A systematic review

Although negative early life experiences are associated with an increased risk of developing psychopathology, some individuals exposed to childhood adversity demonstrate psychological resilience. Little is known about the neural correlates of resilience, especially in young people. To address this gap, we conducted a systematic review of neuroimaging studies of resilience in youth. The PubMed, Web of Science, Scopus, and PsycINFO databases were searched; 5,482 studies were identified. Following title/abstract screening, and full reading of the remaining articles, 22 studies based on 19 unique datasets were included. We found preliminary evidence that resilience is associated with structural, functional, and connectivity differences in young people, as assessed using structural and functional MRI and diffusion tensor imaging methods. Despite heterogeneity in definitions/assessment of resilience and a limited number of studies, the neuroimaging literature suggests some convergence across modalities regarding brain regions linked to resilience (especially the prefrontal cortex). Future studies would benefit from adopting longitudinal designs, broader conceptualisations of resilience that capture the impact of adversity exposure, and a dimensional approach to psychopathology.

Mental health of unaccompanied children: effects of U.S. immigration policies

BACKGROUND

There is an unprecedented surge of forcibly displaced people globally, with a crisis of unaccompanied minors seeking haven across the US border.

AIMS

This paper aims to provide an understanding of the intersection between mental health and immigration policies.

METHOD

Examples of contemporary policies that focus on the deterrence, detention and deportation of unaccompanied minors in the USA, will be discussed, as well as the mental health effects of such 'iron triangle' immigration policies.

RESULTS

In the ideal circumstances, systems and policies for migrant children would uphold international humanitarian law, hasten the shift from enforcement to protection, adhere to a 'do no (further) harm' model that uses a trauma-informed, culturally responsive approach to engaging with migrant children, engage the community as stakeholders to end detention and advocate to share the burden of responsibility.

CONCLUSIONS

Building a humanitarian response that protects both country and migrant interest is possible through commitment and policy change that addresses mental, physical and legal protection needs.

Psychiatric Resilience and Alcohol Resistance: A Twin Study of Genetic Correlation and Sex Differences

Variability in psychiatric response following stressful/traumatic life events is frequently observed. There is also variability in propensity for alcohol use disorder (AUD) such that some can consume substantial amounts and not develop AUD symptoms whereas others develop an AUD. Our group has applied discrepancy-based approaches to capture psychiatric resilience (PR) and alcohol resistance (AR), both moderately heritable. This study sought to (1) examine the genetic and environmental correlation of these constructs and (2) model qualitative and quantitative sex effects. Data came from a large twin sample (N = 4501 twin pairs) with self-report measures and interviews assessing distress symptoms, stressful life events, alcohol use, and AUD. Correlated liability model results suggested a moderate degree of genetic correlation between PR and AR (0.54) due to the same genetic factors in males and females. Findings highlight the shared genetic predisposition of these resilience/resistance constructs while emphasizing the impact of unique environmental experiences.

Professional quality of life and resilience in emergency department healthcare professionals during COVID-19 in Hong Kong: A cross-sectional study

Background:

The professional quality of life of healthcare professionals in emergency departments may be compromised during the COVID-19 pandemic.

Objectives:

This study aims to examine professional quality of life and resilience as well as their relationships among emergency department healthcare professionals in Hong Kong during the COVID-19 outbreak.

Methods:

This study employed a cross-sectional design. Healthcare professionals (doctors and nurses) working in emergency departments in Hong Kong were recruited via snowball sampling. The Professional Quality of Life Scale, version 5, and the 10-item Connor-Davidson Resilience Scale were used to assess their positive (compassion satisfaction) and negative (secondary traumatic stress and burnout) aspects of professional quality of life and self-reported resilience. Socio-demographics and work-related characteristics were also analysed.

Results:

A total of 106 participants provided valid responses. The results showed an overall moderate level of compassion satisfaction, secondary traumatic stress and burnout among emergency department healthcare professionals. The mean score of the 10-item Connor-Davidson Resilience Scale was 23.8. Backward linear regression analyses revealed self-reported resilience was the only significant predictor of compassion satisfaction (regression coefficient B = 0.875; p < 0.001), secondary traumatic stress (B = −0.294, p < 0.001) and burnout (B = −0.670; p < 0.001), explaining 70.6%, 18.5% and 59.8% of total variance, respectively.

Conclusion:

Emergency department healthcare professionals in Hong Kong experienced an overall moderate level of professional quality of life during the COVID-19 outbreak. Those with a higher level of self-reported resilience had better compassion satisfaction and lower levels of secondary traumatic stress and burnout. The results support the importance of developing interventions that foster resilience among this group of emergency department healthcare professionals to combat COVID-19.

Psychological distress in refugees: The role of traumatic events, resilience, social support, and support by religious faith

Many refugees have been exposed to potentially traumatic events and report elevated levels of psychological distress. However, refugees vary greatly in the severity of mental health problems. Intra- and interpersonal factors help some refugees to cope effectively. To shed light on these factors, we scrutinized how potentially traumatic events, resilience, social support, and support by religious faith are associated with psychological distress in refugees in Germany and German residents. We assessed data from 205 German residents and 205 refugees (total N = 410). Questionnaires assessing psychological distress, potentially traumatic events, resilience, social support, and perceived support by religious faith were disseminated online in Arabic and German. Refugees reported higher levels of psychological distress, more exposure to potentially traumatic events, less social support, less resilience, and more perceived support from their faith than German residents. Using a pathway model, lower social support and resilience partially accounted for group differences of higher psychological distress in refugees. This study points to the importance of social support and individual resilience in explaining mental health discrepancies between refugees and residents. This, in turn, may inform future intervention studies to reduce elevated levels of psychological distress experienced by refugees.

Sibling Bullying: A Prospective Longitudinal Study of Associations with Positive and Negative Mental Health during Adolescence

Sibling bullying is associated with poor mental health outcomes, but the relevance of specific bullying roles remains unclear. Data from a population-based study (n = 17,157, 48% female) focusing on early (11 years), middle (14 years), and late (17 years) adolescence were analyzed. Associations between sibling bullying roles in early adolescence and positive and negative mental health outcomes in late adolescence were investigated. Generally, bullying, irrespective of role, was associated with poorer mental health outcomes in late adolescence. As the frequency of bullying victimization increased between early and middle adolescence so did the severity of mental health outcomes in late adolescence. The developmental trajectories of externalizing problems were influenced by bullying in early adolescence. Sibling bullying, irrespective of role, is associated with poor mental health outcomes.

Psychological Distress Symptoms and Resilience Assets in Adolescents in Residential Care

Most studies with institutionalised children and adolescents focus on evaluating the impact of negative life events on emotional development. However, few have investigated the relationship between resilience assets and the teenagers’ psychopathological problems. The purpose of the present study was to investigate differences in psychological distress symptoms and in resilience assets in institutionalised and non-institutionalised adolescents. A total of 266 adolescents aged between 12 and 19 years old took part in the study (60.5% female): 125 lived in residential care and 144 resided with their families. Results found a significant and inverse relation between psychopathology and the perception of individual resilience assets, specifically with self-efficacy and self-awareness in the community sample, and with empathy in the institutionalised sample. Overall, and regardless of the age group, adolescents in residential care tend to perceive themselves as significantly less resilient in perceived self-efficacy and empathy, and they report fewer goals and aspirations for the future. The importance of promoting mental health and resilience assets in adolescents, particularly in those in residential care, is discussed. This can be achieved through early interventions that may prevent emotional suffering and deviant life paths, with transgenerational repercussions.

Factors Associated with Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data

Background

The COVID-19 pandemic has resulted in a high degree of psychological distress among health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological effects from the pandemic. Given the differences in the response of individuals to stress, an analysis of both the perceived and physiological consequences of stressors can provide a comprehensive evaluation of its impact.

Objective

This study aimed to determine characteristics associated with longitudinal perceived stress in HCWs and to assess whether changes in heart rate variability (HRV), a marker of autonomic nervous system function, are associated with features protective against longitudinal stress.

Methods

HCWs across 7 hospitals in New York City, NY, were prospectively followed in an ongoing observational digital study using the custom Warrior Watch Study app. Participants wore an Apple Watch for the duration of the study to measure HRV throughout the follow-up period. Surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism were collected at baseline and longitudinally.

Results

A total of 361 participants (mean age 36.8, SD 10.1 years; female: n=246, 69.3%) were enrolled. Multivariate analysis found New York City’s COVID-19 case count to be associated with increased longitudinal stress (P=.008). Baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<.001). A significant reduction in stress during the 4-week period after COVID-19 diagnosis was observed in the highest tertial of emotional support (P=.03) and resilience (P=.006). Participants in the highest tertial of baseline emotional support and resilience had a significantly different circadian pattern of longitudinally collected HRV compared to subjects in the low or medium tertial.

Conclusions

High resilience, emotional support, and quality of life place HCWs at reduced risk of longitudinal perceived stress and have a distinct physiological stress profile. Our findings support the use of these characteristics to identify HCWs at risk of the psychological and physiological stress effects of the pandemic.

Rocks, Dandelions or Steel Springs: Understanding Resilience from a Public Health Perspective

The multifaceted concept of resilience is widely used to describe individual or societal abilities to withstand and adjust to external pressures. In relation to health, resilience can help us to understand a positive health development despite adverse circumstances. The authors of this article aimed to disentangle this complex concept by elaborating on three metaphors commonly used to describe resilience. Similarities and differences between resilience as a rock, a dandelion, and a steel spring are discussed. The metaphors partly overlap but still provide slightly different perspectives on the development and manifestation of resilience. With reference to longitudinal studies of long-term health development, the article also elaborates on how resilience relates to temporal dimensions commonly used in epidemiological studies: age, cohort, and period. Moreover, the interaction between resilience at individual, organizational, and societal levels is discussed. In conclusion, it is argued that public health sciences have great potential to further a theoretical discussion that improves our understanding of resilience and promotes the integration of individual- and community-level perspectives on resilience.

Brief postpartum separation from offspring promotes resilience to lipopolysaccharide challenge-induced anxiety and depressive-like behaviors and inhibits neuroinflammation in C57BL/6J dams

Emerging evidence indicates an important role for neuroinflammation in depression. Brief maternal separation promotes resilience to depression in offspring, but relatively little is known about the effects of different durations of postpartum separation (PS) from offspring on anxiety and depressive-like behaviors in dams following immune challenge. Lactating C57BL/6J mice were subjected to no separation (NPS), brief PS (15 min/day, PS15) or prolonged PS (180 min/day, PS180) from postpartum day (PPD) 1 to PPD21 and then injected with lipopolysaccharide (LPS). Behavioral tests, including the open field test (OFT) and forced swimming test (FST), were carried out at 24 h after the injection. LPSresulted in anxiety and depressive-like behaviors in NPS dams and activated ionized calcium-binding adaptor molecule (Iba1), an important biomarker of microglia, in the hippocampus. However, compared with NPS + LPS dams, PS15 + LPS dams spent significantly more time in the center of the OFT (anxiety-like behavior) and exhibited lower immobility time in the FST (depressive-like behavior), which indicated a phenomenon of resilience. Furthermore, the activation of neuroinflammation was inhibited in PS15 dams. Specifically, levels of the Iba1 mRNA and protein were decreased, while the mRNA expression of NLR family pyrin domain containing 3 (NLRP3) inflammasome/interleukin-18 (IL-18)/nuclear factor kappa-B (NF-κB) was decreased in the hippocampus. Furthermore, positive linear correlations were observed between microglial activation and LPS-induced depressive-like behaviors in dams. Collectively, the findings of this study confirm that brief PS from offspring promotes resilience to LPS immune challenge-induced behavioral deficits and inhibits neuroinflammation in dams separated from their offspring during lactation.

Remote and adjacent psychological predictors of early-adulthood resilience: Role of early-life trauma, extraversion, life-events, depression, and social-support

Resilience is important for people to maintain mental health after negative life-events. However, its longitudinal psychological and social predictors are poorly revealed. Based on the ecological system theory model, the current study aimed to determine the longitudinal temporal mechanism underlying the development of early-adulthood resilience using long-term (early-life trauma and personality), medium-term and short-term (life-events, social support, and depression) psychosocial predictors. A total of 505 university students were recruited at baseline (T1), 433 of whom took part in a three-year longitudinal investigation (T2). The results showed that at T1 and T2, the resilience scores of individuals were identically high (72.98 and 73.21, respectively). Pearson correlation analysis showed that early-adulthood resilience was negatively correlated with early-life trauma, psychoticism and neuroticism, depression, ad life-events, and positively correlated with extraversion, social-support, and resilience. Regression and structural equation models showed that extraversion had a direct positive effect on T1 resilience through the mediation of T1 life-events, depression, and social-support, while childhood emotional neglect (EN) had indirect negative effect and extraversion had direct positive effect on T2 resilience through the mediation of T1 resilience, and T2 depression and social-support. In conclusion, this study is among the first to reveal the longitudinal temporal process of the development of early-adulthood resilience using remote and adjacent psychosocial predictors. The findings confirm that childhood EN and extraversion have a remote impact on early-adulthood resilience through recent and current depression and social-support. Our results imply that early-life trauma does not hinder the development of early-adulthood resilience in a linear trend.

A qualitative study on the multi-level process of resilience development for adults recovering from eating disorders

BACKGROUND

Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery.

METHOD

Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis.

RESULTS

The overarching theme which described the process of developing resilience was 'Bouncing back to being me', which involved three stages: 'Who am I without my ED?', 'My eating disorder does not define me', and 'I no longer need my eating disorder'. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement.

CONCLUSION

This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes.

A bioecocultural approach to supporting adolescent mothers and their young children in conflict-affected contexts

An estimated 12 million girls aged 15-19 years, and 777,000 girls younger than 15 give birth globally each year. Contexts of war and displacement increase the likelihood of early marriage and childbearing. Given the developmentally sensitive periods of early childhood and adolescence, adolescent motherhood in conflict-affected contexts may put a family at risk intergenerationally. We propose that the specifics of normative neuroendocrine development during adolescence, including increased sensitivity to stress, pose additional risks to adolescent girls and their young children in the face of war and displacement, with potential lifelong consequences for health and development. This paper proposes a developmental, dual-generational framework for research and policies to better understand and address the needs of adolescent mothers and their small children. We draw from the literature on developmental stress physiology, adolescent parenthood in contexts of war and displacement internationally, and developmental cultural neurobiology. We also identify culturally meaningful sources of resilience and provide a review of the existing literature on interventions supporting adolescent mothers and their offspring. We aim to honor Edward Zigler's groundbreaking life and career by integrating basic developmental science with applied intervention and policy.

Adaptive coping strategies towards seasonal change impacts: Indonesian small-scale fisherman household

Small-scale fishers are always expected to adapt to fishing activities that cannot be conducted all year round due to weather and fishing season. This condition, especially when it is not the fish season, makes fishers face a problem. Notwithstanding, fishermen households need to develop an adequate adaptation strategy to solve the problem of fulfilling their needs, known as coping strategies. This study aims to analyze fishermen households' coping strategies in facing the fishing season and non-fish season by using fishermen's family resources and two types of internal and external family coping strategies. The data were gathered from approximately 150 small-scale fishing households using simple random sampling. The results indicate the fishers do fishing activities in three batch: peak season (68%), mild season (20%), and off-season (12%). The use of resources for fishermen households' coping strategy is carried out by diversifying the sources of household income. Some economic activities include cultivating forest land belonging to the forest department, marine tour guides, livestock, and his wife. This study also confirm that all households use internal family coping strategies with humor indicator as the highest percentage. Accordingly, the households also adopt the external family coping strategy to deal with the existing situation. This strategy follows the local community's characteristics and culture who are friendly and open and based on religion. The household coping strategy strengthening model is generated through the synergy of formal institutional roles in society and government institutions as policymakers.

The Polish Version of the Resilience Scale 25: Adaptation and Preliminary Psychometric Evaluation

Background: The aim of the presented series of studies was to test the factor structure and assess the psychometric properties of the Resilience Scale 25 in the Polish population. It was developed and tested during the course of four independent studies analysing various aspects of the validation of the RS 25 questionnaire’s Polish version.

Method: Study 1 concerned the procedure for developing the Polish language version. Study 2 (N = 2716) consisted of reliability tests and a confirmatory factor analysis. In Studies 3 (N = 733) and 4 (N = 431), the validity was assessed by examining the relationship between resilience and the assessment of ego-resiliency, the risk of depression, styles of coping with stress, perceived stress, and satisfaction with life.

Results: The presented research results obtained using the measure indicate that it can be considered to be a reliable and valid research tool. A five-factor solution showed a good fit to the data: χ²/df = 12.85; RMSEA = 0.066 (low = 0.064; high = 0.068; 90% CI); GFI = 0.90; AGFI = 0.90. An assessment of the internal consistency was carried out on the basis of Cronbach’s alpha. The values achieved were satisfactory and indicate acceptable internal reliability of the questionnaire (0.89) and of the five dimensions: (1) purpose (0.65); (2) equanimity (0.65); (3) self-reliance (0.75); (4) perseverance (0.72); and (5) existential aloneness (0.66). In accordance with the predictions and earlier studies, resilience was correlated positively with ego-resiliency, a task-oriented style of coping with stress, and life satisfaction and negatively with perceived stress, the risk of depression, and an emotion-oriented coping style.

Conclusion: The Polish version of the RS 25 allows the assessment of the intensity of resilience as a general indicator and its five constituting dimensions. Such a measurement seems to be important from the perspective of assessing the role of an individual’s resources in clinical psychology, health psychology, and psychotherapy.

Early childhood caries and oral health-related quality of life of Brazilian children: Does parents' resilience act as moderator?

BACKGROUND

Early childhood caries (ECC) is the most common chronic disease in childhood. Measures to reduce the prevalence of ECC cannot be taken without recognizing that oral health is influenced by biopsychosocial factors on individual and community levels.

AIM

To evaluate the impact of ECC on OHRQoL and moderation effect of parents' resilience.

DESIGN

Population-based, cross-sectional study with 497 children (4-6 years old) at preschools in Ribeirão das Neves, MG, Brazil. Parents self-completed the Brazilian version of the early childhood oral health impact scale (B-ECOHIS), the Resilience Scale and questionnaires about socioeconomic and oral health behaviour factors. Calibrated dentists conducted examinations for ECC (ICDASepi) and pulp consequences (pufa). Data analysis used multivariate Poisson regression for complex sample (P < .05).

RESULTS

Model#1, adjusted for parents' resilience and socioeconomic factors, revealed that preschoolers with pulp involvement had 2.36 (95% CI: 1.60-3.49) and fistula/abscess had 3.57 (95% CI: 2.23-5.72) more prevalence of negative impact on OHRQoL than preschoolers with ECC without pulp consequences. In Model#2, resilience was removed from the analysis and the strength of associations almost did not change (OHRQoL vs pulp involvement RP = 2.33;95% CI: 1.58-3.43; OHRQoL vs fistula/abscess RP = 3.65;95% CI: 2.22-5.99).

CONCLUSION

Early childhood caries with pulp consequences had negative impact on OHRQoL of preschoolers and families, and it is not moderated by parents' resilience.

The impact of resilience on anxiety and depression among grass-roots civil servants in China

Background

The grass-roots civil servants are the final implementers and executors of a series of government policies and the fundamental force for social stability and harmonious development. However, the mental health problems of grass-roots civil servants have not got full attention. This study aimed to assess the impact of resilience on anxiety and depression among grass-roots civil servants in China.

Method

From Oct to Dec 2019, 302 civil servants completed a series of questionnaires. The Civil Servants Stress Scale (CSSS) was used to assess the stress of civil servants. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) were used to evaluate the depression and anxiety of participants, respectively. The resilience of civil servants evaluates by the Connor-Davidson Resilience Scale (CD-RSCI). We conducted the moderating and mediating analysis on the impact of resilience on depression and anxiety in grass-roots civil servants.

Results

There were significant differences in gender, education, position, relationship with coworkers, physical exercise, and monthly income for stress in grass-roots civil servants (P < 0.05). Resilience can negatively regulate the stress of grass-roots civil servants, and an effective mediator and moderator in the relationship between stress and anxiety and depression and the mediating effect ratios of 7.77 and 22.79%.

Conclusion

Resilience has moderating and mediating effects on the relationship between stress and depression, and anxiety. The negative effects of stress on depression and anxiety of grass-roots civil servants can be buffered by resilience as a dynamic moderator directly and indirectly. These findings contribute to society and government better understand the mental health status of grass-roots civil servants and provide references and guidance for the formulation of corresponding management and prevention measures.

Significance of Self-Care Management as Persons Prepare to Reintegrate Into the Community

INTRODUCTION

Persons reentering the community after incarceration often confront a range of challenges that influence their ability to engage in self-care. This study sought to gain insight and understanding of how persons recently released from an incarceration experience perceive their preparedness for reentry and how this affects their ability to engage in self-care management.

METHOD

Using focus group methodology, four male, two female, and one mixed focus groups (N = 31) were held at a syringe access program, a medication-assisted recovery clinic, and a postincarceration support service. The Rediscovery of Self-Care (RSC) model served as the framework. The a priori RSC constructs guided data analysis.

FINDINGS

Participants defined self-care as basic hygiene, eating well, engaging with family, and managing mental health and their substance use issues. Depending on the interview location, self-care also included using clean injection materials, taking prescribed medications, or adhering to treatment programs. Reported challenges to self-care included transportation, substance addiction, job and housing instability, and mental illness. Our results indicate that there is value in applying the RSC model to guide nursing interventions in promoting self-care for persons with an incarceration experience.

CONCLUSION

There is a need for reskilling, especially pertaining to sober environments, mental health services, syringe access programs, and continuity of care. Self-care ability, self-efficacy, motivation, sense of internal control, and social support were identified as critical to the successful transition to full reentry after incarceration.

A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team personnel

The stressors associated with emergency medical teams responding to critical incidents are well documented; however, the impact of such duties on the UK military personnel had never been investigated. This study explored the psychosocial effects of Medical Emergency Response Teams (MERT) operating in Afghanistan to inform the development of a Resilience Model. A structured and contextually relevant process could then be applied for a team's preparation for, delivery of and recovery from, their duties. A qualitative cross-sectional design used semi-structured interviews and 15 multidisciplinary team members participated. Interviews were transcribed verbatim and data were systematically analysed using grounded theory. Emergent theory poses that developing resilience against the demands of this role is dependent upon personnel having a realistic understanding of the deployed environment by phased immersion within it. This preparatory training generates situational awareness, trust and strong team cohesion, which together with peer and organizational support are necessary factors to effectively cope with the role. To limit the costs of caring, there is a need for MERT personnel to segregate the physiological and emotional aspects of delivering care to the injured; those unable to do so may be at greater risk of poor mental health outcomes. The preparatory training of MERT personnel must be further developed to provide an immersive environment that more closely matches the reality of the role. A period of stability is required post deployment with the support of peers to enable personnel to more efficiently transition back to their home life.

Chronic early trauma impairs emotion recognition and executive functions in youth; specifying biobehavioral precursors of risk and resilience

Exposure to chronic early trauma carries lasting effects on children's well-being and adaptation. Guided by models on resilience, we assessed the interplay of biological, emotional, cognitive, and relational factors in shaping two regulatory outcomes in trauma-exposed youth: emotion recognition (ER) and executive functions (EF). A unique war-exposed cohort was followed from early childhood to early adolescence. At preadolescence (11-13 years), ER and EF were assessed and respiratory sinus arrhythmia (RSA), biomarker of parasympathetic regulation, was quantified. Mother-child dyadic reciprocity, child's avoidance symptoms, and cortisol (CT) were measured in early childhood. Trauma-exposed youth displayed impaired ER and EF abilities. Conditional process analysis described two differential indirect paths leading from early trauma to regulatory outcomes. ER was mediated by avoidance symptoms in early childhood and modulated by cortisol, such that this path was evident only for preadolescents with high, but not low, CT. In comparison, EF was mediated by the degree of dyadic reciprocity experienced in early childhood and modulated by RSA, observed only among youth with lower RSA. Findings pinpoint trauma-related disruptions to key regulatory support systems in preadolescence as mediated by early-childhood relational, clinical, and physiological factors and highlight the need to specify biobehavioral precursors of resilience toward targeted early interventions.

Neurobiological mechanisms of early life adversity, blunted stress reactivity and risk for addiction

Blunted stress reactivity resulting from early exposure to stress during childhood and adolescence may increase vulnerability to addiction. Early life adversity (ELA) affects brain structure and function and results in blunted stress axis reactivity. In this review, we focus on the underlying neurobiological mechanisms associated with a blunted response to stress, ELA, and risk for addictive disorders. ELA and blunted reactivity are accompanied by unstable mood regulation, impulsive behaviors, and reduced cognitive function. Neuroimaging studies reveal cortical and subcortical changes in persons exposed to ELA and those who have a genetic disposition for addiction. We propose a model in which blunted stress reactivity may be a marker of risk for addiction through an altered motivational and behavioral reactivity to stress that contribute to disinhibited behavioral reactivity and impulsivity leading in turn to increased vulnerability for substance use. Evidence supporting this hypothesis in the context of substance use initiation, maintenance, and risk for relapse is presented. The effects of ELA on persons at risk for addiction may lead to early experimentation with drugs of abuse. Early adoption of drug intake may alter neuroregulation in such vulnerable persons leading to a permanent dysregulation of motivational responses consistent with dependence. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.

The interplay between adolescent friendship quality and resilient functioning following childhood and adolescent adversity

Background

Child and adolescent adversity ('CA') is a major predictor of mental health problems in adolescence and early adulthood. However, not all young people who have experienced CA develop psychopathology; their mental health functioning can be described as resilient. We previously found that resilient functioning in adolescence following CA is facilitated by adolescent friendships.However, during adolescence, friendships undergo significant change. It is unknown whether resilient functioning after CA fluctuates with these normative changes in friendship quality.

Methods

We used Latent Change Score Modelling in a large sample of adolescents (i.e. the ROOTS cohort; N=1238) to examine whether and how emergent friendship quality and resilient functioning at ages 14 and 17 inter-relate and change together.

Results

We found that friendships quality and resilient functioning had strong associations at age 14, although friendships at 14 did not predict higher resilient functioning at 17. Higher resilient functioning in 14-year-olds with a history of CA was associated with a positive change in friendships from age 14 to 17. Finally, improvements in friendship quality and resilient functioning went hand in hand, even when taking into account baseline levels of both, the change within friendship quality or resilient functioning over time, and the association between resilient functioning and change in friendship quality over time.

Conclusions

We show that friendship quality and resilient functioning after CA inter-relate and change together between ages 14 and 17. Our results suggest that improving friendship quality or resilient functioning within this timeframe may benefit this vulnerable adolescent group, and this should be tested in future research.

Can the migration process influence the clinical expression of heroin use disorder in migrants to Italy?

BACKGROUND

For some time now, there has been a strong consensus that the migration process can influence the onset, course, development, outcome, and clinical aspects of psychiatric pathologies.

METHODS

In this study, we have analyzed the influence of the migration process on the clinical expression of heroin use disorder (HUD). In a naturalistic case-control study, we compared, both at univariate and multivariate level, 30 migrant HUD (M-HUD) patients with 30 age/gender-matched Italian HUD (IT-HUD) patients. We also analyzed demographic data, drug addiction history, psychopathological symptoms, addictive behavior, and emotional reactivity to life events.

RESULTS

Compared with IT-HUD pairs, at HUD Agonist Opioid Treatment, M-HUD patients were characterized by inadequate income and the presence of legal problems. They were more frequently at stage 3 of heroin addiction, with a concomitantly less frequent use of stimulants. Their age at the onset of heroin use was greater than that of subjects in the IT-HUD group. HUD post-traumatic stress disorder spectrum was present and was more severe in all M-HUD patients, but grief reactions and maladaptive behavior were the most discriminant traits. No differences were found in terms of addictive behaviors related to heroin craving or with respect to the severity/typology of psychopathology specific to HUD.

CONCLUSIONS

The migratory process does not seem to be correlated with addictive behaviors or with psychopathology specific to HUD. It partly affects HUD history, and specifically correlates with emotional reactivity to loss and traumatic life events, so suggesting that in M-HUD individuals, the link between the migratory syndrome and HUD is very close.

Co-developing a Mental Health and Wellbeing Chatbot With and for Young People

There are many young people who experience mental health and wellbeing challenges. A potential negative mental health trigger for some youth is a struggle to cope with stress at school, feelings of depression and anxiety and availability of adequate help for these stressors. In response to youth needs a mental health and wellbeing Chatbot has been co-developed with youth, technology partners and expert stakeholders. An element of the Chatbot is powered by artificial intelligence and rules based AI using natural language processing. It is created to communicate evidence based resources, wellbeing support, educational mental health information and adaptive coping strategies. This paper will discuss how the Chatbot has been developed, highlighting its participatory, co-design process with youth who are the key stakeholders to benefit from this digital tool. Research from interviews and surveys informed the creation of the Chabots personality and its character design. Examples of the conversation design and content development are provided. The paper finishes with how, if at all, digital tools such as Chatbot applications could support the mental health of young people in secondary schools or health care settings in conjunction with the wellbeing or health care team, concluding with lessons learned and cautions.

Identifying Suicide and Self-Harm Research Priorities in North West England

Background: Understanding and effectively managing self-harm and suicide require collaborative research between stakeholders focused on shared priorities. Aims: We aimed to develop a consensus about suicide and self-harm research priorities in the North West of England using the Delphi method. Method: Items for the Delphi survey were generated through group discussions at a workshop with 88 stakeholders and subsequent thematic analysis of key themes. A total of 44 participants who were experts-by-experience, researchers, and clinicians based within health services including third-sector organizations completed the Delphi survey. Results: A three-round survey reached consensus on 55 research priority items identifying key priorities in each of the following groups: offenders, children and young people, self-harm in community settings, and crisis care in the community. Limitations: The pool of delegates at the workshop and subsequent self-selection into the Delphi may have introduced bias into the study. Conclusion: The current paper highlights specific actionable priorities were identified in four areas that can be used to inform research efforts and future policy and practice, based on shared areas of perceived importance and concern. Future work is needed to confirm the significance of these priority areas, including the use of evidence synthesis approaches to ascertain the extent to which these priorities have already been investigated and where gaps in understanding remain.

Social Behavior as a Transdiagnostic Marker of Resilience

The recent shift from psychopathology to resilience and from diagnosis to functioning requires the construction of transdiagnostic markers of adaptation. This review describes a model of resilience that is based on the neurobiology of affiliation and the initial condition of mammals that mature in the context of the mother's body and social behavior. The model proposes three tenets of resilience-plasticity, sociality, and meaning-and argues that coordinated social behavior stands at the core sustaining resilience. Two lines in the maturation of coordinated social behavior are charted, across animal evolution and throughout human development, culminating in the mature human reciprocity of empathy, mutuality, and perspective-taking. Cumulative evidence across ages and clinical conditions and based on our behavioral coding system demonstrates that social reciprocity, defined by plasticity at the individual, dyadic, and group levels, denotes resilience, whereas the two poles of disengagement/avoidance and intrusion/rigidity characterize specific psychopathologies, each with a distinct behavioral signature. Attention to developmentally sensitive markers and to the dimension of meaning in human sociality may open new, behavior-based pathways to resilience.

Researching Multisystemic Resilience: A Sample Methodology

In contexts of exposure to atypical stress or adversity, individual and collective resilience refers to the process of sustaining wellbeing by leveraging biological, psychological, social and environmental protective and promotive factors and processes (PPFPs). This multisystemic understanding of resilience is generating significant interest but has been difficult to operationalize in psychological research where studies tend to address only one or two systems at a time, often with a primary focus on individual coping strategies. We show how multiple systems implicated in human resilience can be researched in the same study using a longitudinal, six-phase transformative sequential mixed methods study of 14- to 24-year-olds and their elders in two communities dependent on oil and gas industries (Drayton Valley, Canada, and Secunda/eMbalenhle, South Africa). Data collection occurred over a 5-year period, and included: (1) community engagement and the identification of youth health and well-being priorities; (2) participatory youth-centric qualitative research using one-on-one semi-structured interviews and arts-based methods; (3) survey of 500 youth at three time points to assess psychosocial health indicators and outcomes; (4) collection of hair samples to assess stress biomarkers (cortisol and dehydroepiandrosterone-DHEA) over time; (5) youth-led ecological data collection and assessment of historical socio-economic development data; and (6) community resource mapping with community elders. Analyzing data from these multiple systems will allow us to understand the interrelationship and impact of PPFPs within and across systems. To date, we have undertaken thematic and narrative qualitative analyses, and descriptive analyses of the preliminary ecological and survey data. As we proceed, we will combine these and grounded theory approaches with innovative techniques such as latent transition analysis and network analysis, as well as modeling of economic conditions and spatial analysis of human geographies to understand patterns of PPFPs and their inter-relationships. By analyzing the complexity of data collected across systems (including cultural contexts) we are demonstrating the possibility of conducting multisystemic resilience research which expands the way psychological research accounts for positive development under stress in different contexts. This comprehensive examination of resilience may offer an example of how the study of resilience can inform socially and contextually relevant interventions and policies.

Physiological and social synchrony as markers of PTSD and resilience following chronic early trauma

OBJECTIVE

Although resilience is a key topic in clinical theory and research, few studies focused on biobehavioral mechanisms that underpin resilience. Guided by the biobehavioral synchrony frame, we examined the dynamic interplay of physiological and behavioral synchrony as marker of risk and resilience in trauma-exposed youth.

METHODS

A unique cohort of war-exposed versus control children was followed at four time-points from early childhood to preadolescence and child posttraumatic stress disorder (PTSD) repeatedly assessed. At preadolescence (11-13 years), mother and child were observed in several social and nonsocial tasks while cardiac data collected and measures of respiratory sinus arrhythmia (RSA) and RSA synchrony computed. The social interactive task was microcoded for behavioral synchrony and the second-by-second balance of behavioral and physiological synchrony was calculated. War-exposed preadolescents were divided into those diagnosed with PTSD at any time-point across childhood versus resilient children.

RESULTS

Group differences in behavioral synchrony, RSA synchrony, and their interplay emerged. PTSD dyads exhibited the tightest autonomic synchrony combined with the lowest behavioral synchrony, whereas resilient dyads displayed the highest behavioral and lowest autonomic synchrony. Hierarchical Linear Model analysis pinpointed two resilience-promoting mechanisms. First, for resilient and control dyads, moments of behavioral synchrony were coupled with decreased RSA synchrony. Second, only among resilient dyads, moments of behavioral synchrony increased child RSA levels.

CONCLUSION

Findings specify mechanisms by which biobehavioral synchrony promotes resilience. As children grow, the tightly coupled mother-child physiology must be replaced by loosely coordinated behavioral attunement that buttresses maturation of the child's allostatic self-regulation. Our findings highlight the need for synchrony-based interventions to trauma-exposed mothers.

Online sexual harassment and negative mood in Croatian female adolescents

Online sexual harassment (OSH) appears to be a relatively frequent phenomenon, particularly for older adolescents. It is also a gendered experience. Compared to their male peers, female adolescents are more likely to experience OSH and find it upsetting. This study sought to explore the role of resilience in explaining the association between online sexual harassment (OSH) and negative mood (i.e., depression and anxiety symptoms) among female adolescents. Using data from a panel sample of 477 female Croatian adolescents (age at baseline = 15.8 years; SD = 0.48) and two-wave cross-lagged path analysis, we investigated OSH, changes in depression/anxiety symptoms, association between OSH and negative mood, and the role of resilience. During the 26-month period under observation, OSH and negative mood were associated cross-sectionally, but not longitudinally. This suggests the negative mood effects of OSH exposure may be short-lived or that factors other than OSH explain changes in negative mood over time. Resilience was consistently and negatively associated with negative mood, but not OSH. In adolescent girls with low levels of resilience, OSH was associated with negative mood; no such relationship was observed among their highly resilient peers. Experiences other than OSH appear to be more pertinent in predicting symptoms of negative mood in older adolescent girls over time. Given that resilience attenuated the relationship between OSH and negative mood, efforts to increase resilience to online challenges may be more helpful than efforts to limit or control young people's online exposure.

Mitigating adolescent social anxiety symptoms: the effects of social support and social self-efficacy in findings from the Young-HUNT 3 study

Adolescents' exposure to negative life events (NLEs) and potentially traumatic events is highly prevalent and increases their risk of developing psychological disorders considerably. NLE exposure has also been linked to the development of social anxiety disorder (SAD) among older children and young adolescents. Despite the relatively low treatment efficacy reported for children and adolescents suffering from SAD, few studies have addressed the extent to which resilience factors, such as social support and social self-efficacy, are associated with SAD symptoms. This study examined whether social support and social self-efficacy predict, and buffer against SAD symptoms using a large, population-based sample of adolescents, among whom a large proportion have experienced NLEs. The results reveal that NLEs are significantly associated with SAD symptoms, while social support and social self-efficacy are both negatively associated with SAD symptoms. Only the NLEs × social support interaction significantly predicted SAD symptoms, with social support attenuating the association between NLEs and SAD symptoms. Moreover, increases in both social self-efficacy and social support were associated with reduced SAD symptoms, over and above variance explained by social support alone. Our cumulative results suggest that interventions that can modify both social support and social self-efficacy may help reduce SAD symptoms in at-risk adolescents.

Understanding practitioners' and young people's views of a risk calculator for future psychopathology and poor functioning in young people victimised during childhood

BACKGROUND

Although children who are exposed to victimisation (including abuse, neglect, domestic violence and bullying) have an increased risk of later psychopathology and functional impairment, not all go on to develop these outcomes. Risk calculators that generate individualised probabilities of a victimised child developing future psychopathology and poor functioning have the potential to help practitioners identify the most vulnerable children and efficiently target preventive interventions.

AIM

This study explored the views of young people and practitioners regarding the acceptability and feasibility of potentially using a risk calculator to predict victimised children's individual risk of poor outcomes.

METHODS

Young people (n = 6) with lived experience of childhood victimisation took part in two focus groups. Health and social care practitioners (n = 13) were interviewed individually. Focus groups and interviews were audio-recorded, transcribed and thematically analysed.

RESULTS

Ten themes were identified, organised according to the three main topics of discussion: (i) identifying risk (risk factors, current practice, accuracy, implementation, response); (ii) protective factors and prevention (individual, environment, preventative intervention); and (iii) communication of research (stakeholders, methods).

CONCLUSION

Risk calculators have the potential to enhance health and social care practice in the United Kingdom, but we highlight key factors that require consideration for successful implementation.

Youth Resilience to Drought: Learning from a Group of South African Adolescents

Exposure to drought is on the increase, also in sub-Saharan Africa. Even so, little attention has been paid to what supports youth resilience to the stressors associated with drought. In response, this article reports a secondary analysis of qualitative data generated in a phenomenological study with 25 South African adolescents (average age 15.6; majority Sepedi-speaking) from a drought-impacted and structurally disadvantaged community. The thematic findings show the importance of personal, relational, and structural resources that fit with youths' sociocultural context. Essentially, proactive collaboration between adolescents and their social ecologies is necessary to co-advance socially just responses to the challenges associated with drought.

Behavioral Inhibition in Early Childhood and Adjustment in Late Adolescence in China

This study examined relations between behavioral inhibition in toddlerhood and social, school, and psychological adjustment in late adolescence in China. Data on behavioral inhibition were collected from a sample of 2-year-olds (initial N = 247). Follow-up data were collected at 7 years for peer relationships and 19 years for adjustment across domains. The results showed that early inhibition positively predicted later social competence and school adjustment. Peer relationships in middle childhood served as a protective factor in the development of depression of inhibited children. The results indicate the distinct functional meaning of behavioral inhibition in the Chinese context from a developmental perspective.

Debate: Recognising and responding to the mental health needs of young people in the era of COVID-19

The COVID-19 pandemic is a 'perfect storm' for the mental health of young people, because of exposure to known risk factors for psychopathology and lack of support from the infrastructures that are normally in place to ensure safety and provide support. However, it is yet unclear if this 'perfect storm' will flood the Child & Adolescent Mental Health Services. The early, normative emotional responses observed may not lead to enduring psychopathology in most young people. Nevertheless, a minority of young people may show complex presentations, particularly in relation to bereavement. As epidemiology and clinical practice will reveal the actual needs of young people, the hope is that we will find the focus and determination to build new solutions to promote young people's mental health.

Validation of the Polish version of the Brief Resilience Scale (BRS)

Background

We conducted three studies to validate the Polish version of the BRS. Our objectives are as follows: first, to explore the dimensional structure of the scale and to determine the internal consistency (study 1: n = 1022); second, to determine the congruent and divergent validity of the BRS (study 2: n = 242); and third, to examine sensitivity of the BRS scale to detect high-risk population (study 3: n = 602).

Methods

To explore the dimensional structure of the scale, we tested a two-factor model with one factor for positively worded items and one factor for negatively worded items. To determine the congruent and divergent validity of the BRS, we analysed correlations among BRS and resilience, positive mental health, and with positive and negative religious coping. We used Student’s t-test to examine sensitivity of the BRS scale to detect a high-risk population.

Results

Based on the CFA, a bivariate model was confirmed for items positively and negatively formulated with a higher order factor, which indicates the homogeneity of the scale, similar to the analyses carried out for their language versions confirming this type of homogeneity of the scale. The internal compatibility assessment based on Cronbach’s Alpha and McDonald’s Omega is good (0.88). Our analyses intended to test convergent and divergent validity, and showed that the BRS results are significantly related to a questionnaire measuring similar constructions. Our validation studies also provided important diagnoses regarding BRS "sensitivity", indicating that groups with higher stress levels achieved lower BRS resilience results.

Conclusion

The results of our research indicate that the Polish version of the BRS should be considered to be a reliable and valid research tool. The Polish version of BRS is a reliable and accurate way of measuring resilience as the ability to bounce back from adversity and overcome various challenges or stressors. This scale may be used for both research and intervention purposes.

Early Childhood Development Risks and Protective Factors in Vulnerable Preschool Children from Low-Income Communities in South Africa

Age-appropriate early childhood development is greatly influenced by exposure to various mediating and moderating factors. Developmental outcomes cannot be viewed in isolation, but by considering the interaction of the various risks and protective factors that influence early child development. A non-experimental, cross-sectional research design was employed. Data was collected in a low-income community in Gauteng, South Africa. Caregivers with children (n = 276) between the ages of 3 years and 6 years 11 months (mean 51.57 months; SD ± 12.4) whose children were in a preschool were invited to participate in the research study. Participants were divided into two groups, children with developmental delays and children without a developmental delay. The study sample included high risk, vulnerable preschool children, with a developmental delay prevalence of 80.1% (221/276). Families included were exposed to an average of five (SD ± 1.86) environmental and/or biological risks. According to a logistic regression model, three factors were significantly associated with increasing resilience amongst children with no developmental delay: living with both parents (p < 0.031, OR 4.5, 95% CI 1.2-17.2), caregivers having at least completed Grade 8 to 12 (p < 0.027, OR 11.9, 95% CI 1.4-10.5) and parents being married (p < 0.023, OR 5.1, 95% CI 1.3-20.9). Important protective factors in low-income communities like caregiver education, living with both parents and parental marriage can inform public health messaging and other population-based interventions to support early childhood development.

Examining Multilevel Factors Associated with the Process of Resilience among Women Living with HIV in a Large Canadian Cohort Study: A Structural Equation Modeling Approach

Objectives:

We examined how multiple, nested, and interacting systems impact the protective process of resilience for women living with HIV (WLWH).

Methods:

Using data from a Cohort Study, we conducted univariate analyses, multivariable logistic regression, and a 2-step structural equation modeling for the outcome, high resilience (N = 1422).

Results:

Participants reported high overall resilience scores with a mean of 62.2 (standard deviation = 8.1) and median of 64 (interquartile range = 59-69). The odds of having high resilience were greater for those residing in Quebec compared to Ontario (adjusted odds ratio [aOR] = 2.1 [1.6, 2.9]) and British Columbia (aOR = 1.8 [1.3, 2.5]). Transgender women had increased odds of high resilience than cisgender women (aOR = 1.9 [1.0, 3.6]). There were higher odds of resilience for those without mental health diagnoses (aOR = 2.4 [1.9, 3.0]), non-binge drinkers (aOR=1.5 [1.1, 2.1]), and not currently versus previously injecting drugs (aOR = 3.6 [2.1, 5.9]). Structural equation modeling confirmed that factors influencing resilience lie at multiple levels: micro, meso, exo, and macro systems of influence.

Conclusion:

There is a need to consider resilience as the interaction between the person and their environments, informing the development of multilevel interventions to support resilience among WLWH.

Neuroimaging Markers of Risk and Pathways to Resilience in Autism Spectrum Disorder

Autism spectrum disorder is a complex, heterogeneous neurodevelopmental condition of largely unknown etiology. This heterogeneity of symptom presentation, combined with high rates of comorbidity with other developmental disorders and a lack of reliable biomarkers, makes diagnosing and evaluating life outcomes for individuals with autism spectrum disorder a challenge. We review the growing literature on neuroimaging-based biomarkers of risk for the development of autism and explore evidence for resilience in some autistic individuals. The current literature suggests that neuroimaging during early infancy, in combination with prebirth and early genetic studies, is a promising tool for identifying biomarkers of risk, while studies of gene expression and DNA methylation have provided some key insights into mechanisms of resilience. With genetics and the environment contributing to both risk for the development of autism spectrum disorder and conditions for resilience, additional studies are needed to understand how risk and resilience interact mechanistically, whereby factors of risk may engender conditions for adaptation. Future studies should prioritize longitudinal designs in global cohorts, with the involvement of the autism community as partners in research to help identify domains of functioning that hold value and importance to the community.

Stresses, Strengths and Resilience in Adolescents: A Qualitative Study

Resilience, or positive adaptation in the face of adversity, mitigates the negative effects of stress and promotes lifelong physical and mental wellbeing. Identifying adolescents who are struggling with stress could provide opportunities for individual clinical preventive interventions. However, resilience assessments are rarely performed in clinical settings and no clear, evidence-based protocols or language for such exploration exist. The aim of this qualitative study was to identify both clinically feasible methods for assessment, and actual findings, regarding stress, supports, attributes, and strategies youth consider most useful for building resilience. We recruited 59 urban and rural dwelling 13-16 year olds from two Canadian primary care practices. Interviewers asked five open-ended questions about sources of stress and resilience and wrote summaries of answers provided. These were then coded. Researchers independently identified conceptual themes, then reached consensus on these. Stress arose from schoolwork and conflicts with friends or family, rather than from socioeconomic adversities. A majority of participants felt able to manage stresses well, finding strength through (1) social connection with family or friends; (2) self-reliant activities including exercise, music or drawing; and (3) personal attributes such as optimism, calmness and competence. They used a variety of approaches to work through stress, many of which align with key domains of resilience, as well as the novel technique of distraction. Ruminating on stress-provoking events made youth feel they were coping poorly. Most participants experienced stress and drew strength from psychosocial and emotional assets, as well as external resources that fostered resilience. Direct, open conversation was particularly effective for building rapport, augmenting strengths by discussing them, and identifying those who were struggling. Similar questions asked in clinical practice may open doors to deep and, perhaps, transformative conversations and evidence-based preventive interventions.