Annual Research Review: What is resilience within the social ecology of human development?

Resilience in the Disabling Effect of Gait Speed Among Older Turkish and Moroccan Immigrants and Native Dutch

OBJECTIVE

To investigate the factors that inhibit the disabling effect of impairments among citizens who have migrated from Turkey and Morocco and native Dutch according to a resilience perspective.

METHOD

Using data from the Longitudinal Aging Study Amsterdam with 928 native Dutch, 255 Turks, and 199 Moroccans aged 55 to 65, linear regression analysis assessed whether country of origin, mastery, income, and contact frequency modified the relationship between gait speed and activity limitations.

RESULTS

Turks, but not Moroccans, demonstrated stronger associations between gait speed and activity limitations than the Dutch. Mastery modified the association among the Dutch and the Turks. Income modified the association only among the Dutch. Effect modification by contact frequency was not observed.

DISCUSSION

Moroccans and Dutch appeared to be more resilient against impairments than Turks. As none of the resilience factors buffered in all three populations, we conclude that resilience mechanisms are not universal across populations.

Modelling life satisfaction and adjustment to trauma in children exposed to ongoing military violence: An exploratory study in Palestine

Exposure to war and ongoing political violence increases mental health risks among children, especially in terms of posttraumatic stress disorder (PTSD), and depressive or somatic symptoms. However, an exclusive focus on negative functioning can lead to underestimating the coping abilities and natural potential for adjusting to trauma of war-affected children at different developmental phases. Using structural equation modelling, we tested the extent to which data gathered in a predominantly nonclinical sample of Palestinian children (N=1276) living in refugee camps supported a conceptual model in which the relationship between subjective wellbeing and the effects of trauma is mainly top-down in direction. The cross-sectional design adopted showed that feelings of life satisfaction contributed to better affect balance in children (aged 6-11 years), which in turn, mitigated the impact of traumatic events. These findings point up the importance of dimensions of subjective well-being in children involved in traumatic events and may inspire intervention and treatment focused on the ability to activate positive emotions as a crucial resource for dealing with traumatic reactions.

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

BACKGROUND

Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Many methods to assess ACEs exist but have not been compared. The National Survey of Children's Health (NSCH) now measures ACEs for children, but requires further assessment and validation.

METHODS

We identified and compared methods to assess ACEs among children and families, evaluated the acceptability and validity of the new NSCH-ACEs measure, and identified implications for assessing ACEs in research and practice.

RESULTS

Of 14 ACEs assessment methods identified, 5 have been used in clinical settings (vs public health assessment or research) and all but 1 require self or parent report (3 allow child report). Across methods, 6 to 20 constructs are assessed, 4 of which are common to all: parental incarceration, domestic violence, household mental illness/suicide, household alcohol or substance abuse. Common additional content includes assessing exposure to neighborhood violence, bullying, discrimination, or parental death. All methods use a numeric, cumulative risk scoring methodology. The NSCH-ACEs measure was acceptable to respondents as evidenced by few missing values and no reduction in response rate attributable to asking about children's ACEs. The 9 ACEs assessed in the NSCH co-occur, with most children with 1 ACE having additional ACEs. This measure showed efficiency and confirmatory factor analysis as well as latent class analysis supported a cumulative risk scoring method. Formative as well as reflective measurement models further support cumulative risk scoring and provide evidence of predictive validity of the NSCH-ACEs. Common effects of ACEs across household income groups confirm information distinct from economic status is provided and suggest use of population-wide versus high-risk approaches to assessing ACEs.

CONCLUSIONS

Although important variations exist, available ACEs measurement methods are similar and show consistent associations with poorer health outcomes in absence of protective factors and resilience. All methods reviewed appear to coincide with broader goals to facilitate health education, promote health and, where needed, to mitigate the trauma, chronic stress, and behavioral and emotional sequelae that can arise with exposure to ACEs. Assessing ACEs appears acceptable to individuals and families when conducted in population-based and clinical research contexts. Although research to date and neurobiological findings compel early identification and health education about ACEs in clinical settings, further research to guide use in pediatric practice is required, especially as it relates to distinguishing ACEs assessment from identifying current family psychosocial risks and child abuse. The reflective as well as formative psychometric analyses conducted in this study confirm use of cumulative risk scoring for the NSCH-ACEs measure. Even if children have not been exposed to ACEs, assessing ACEs has value as an educational tool for engaging and educating families and children about the importance of SSNRs and how to recognize and manage stress and learn resilience.

Interactions with community members and institutions: Preventive pathways for child maltreatment

Parents interact with their environment in important ways that may impact their ability to parent their children positively. The current study uses data from the age 3 wave of the Fragile Families and Child Wellbeing study to investigate whether neighborhood processes and community participation relate to internal control, and whether these three variables are associated with child maltreatment behaviors. Using structural equation modeling, the direct and indirect effects of the environment (neighborhood disorder, social control, and social cohesion) and community participation on child maltreatment are tested. The mediating variable tested is internal control. The results show that neighborhood processes and community participation are associated with child neglect, physical child abuse, and psychological aggression but that these associations are driven through their effect on internal control.

Cognitive reappraisal and expressive suppression: Links to racial-ethnic discrimination and adjustment among Latino/a and Asian-heritage college students

OBJECTIVE

We examined whether two key emotion regulation strategies, cognitive reappraisal and expressive suppression, moderated the relations between discrimination (i.e., foreigner objectification and general denigration) and adjustment.

METHODS

Participants were U.S. Latino/a and Asian-heritage college students (N = 1,279, 67% female, 72% U.S. born) from the Multi-Site University Study of Identity and Culture (MUSIC). Students completed online self-report surveys in 2009.

RESULTS

Multi-group path analysis demonstrated that a fully constrained model fit well for both Latino/a and Asian-heritage student data. The results showed that with increasing levels of denigration (but not foreigner objectification), the combination of lower cognitive reappraisal and higher expressive suppression was related to greater depressive symptoms, anxiety, and aggression.

CONCLUSIONS

Our findings highlight the importance of examining multiple emotion regulation strategies simultaneously-considering what strategies are available to individuals and in what combination they are used-to understand how best to deal with negative emotions resulting from experiencing discrimination.

Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study

This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10–17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

Children's Physical Resilience Outcomes: Meta-Analysis of Vulnerability and Protective Factors

Resilience has generally been understood as positive coping and adaptation despite stress and adversity and as a buffer against stress. Researchers examining resilience have typically focused on children's psychological resilience because of the well-established impact of stress on children's mental health. However, although it has also been well-established that high levels of stress can impact children's physical health, their physical health has received little attention in resilience research.

ELIGIBILITY CRITERIA

Articles were selected for review if they (1) had a variable that was in some way a measure of physical health in response to a psychosocial stressor; (2) had participants who were children or adolescents within the age range of 4-18years; and (3) were a peer-reviewed, empirical study.

SAMPLE

Two random-effect meta-analyses were conducted with a sample of 12,772 participants across 14 studies to determine the influence of protective and vulnerability factors on children's physical health in adverse experiences.

RESULTS

Protective factors had a moderate effect and vulnerability factors had a small-moderate effect on health measures across domains of physiological, sleep behavior, and overall health. The type of health measure moderated the effect size for vulnerability factors, but not for protective factors.

CONCLUSIONS

These findings suggest that protective factors may be associated with an environment that encourages children to thrive, as apparent by their physical health.

IMPLICATIONS

The results of this review and meta-analysis can be used to guide the methodological design of future studies on childhood resilience and to inform clinical practice with children and adolescents.

Measuring resilience in competitive tennis players: psychometric properties of the Resilience Scale for Adults

The Resilience Scale for Adults is considered a valid and reliable measure of resilience resources and has received validation support across several populations. This study attempted to validate and examine the psychometric properties of the instrument in a sample of competitive tennis players to prospectively appropriate the inventory for use among athletes. The tennis athletes ( n = 365) completed the Resilience Scale for Adults, the Sports Mental Toughness Questionnaire, and the stress items included on the Recovery-Stress Questionnaire for Athletes. Confirmatory factor analysis model fit indices revealed an acceptable level of fit for the original six-factor structure. The Resilience Scale for Adults scale and subscales were negatively associated with stress and correlated positively with mental toughness, providing evidence of the convergent validity of the Resilience Scale for Adults. Collectively, the findings offer initial support for using the Resilience Scale for Adults to assess a broad range of protective factors among competitive tennis players. Further research is required to explore the adaptation or refinement of the Resilience Scale for Adults for use in multiple sporting contexts.

[Leisure activities, resilience and mental stress in adolescents]

Objective

To date, the factors contributing to emergence of resilience in different stages of adolescence have yet to be sufficiently examined. This study looks at the influence of extracurricular activities on resilience.

Method

The sample consists of 413 adolescents (f = 14.8) reporting personal problems (mood, concentration problems, behavior). The effect of extracurricular activities on resilience (gathered by the RS25) was analyzed by linear regression models. Predictor variables in these models were extracurricular activities (sport, hobbies, club memberships, household duties) and the subscales of the SDQ (Strengths and Difficulties Questionnaire). Because of the lack of homoscedasticity, two different regression models (model A: Realschule and Grammar School. Model B: Hauptschule) were specified.

Results

The explained variance of both models (model A: R = .516; model B: R = .643) is satisfactory. In both models “prosocial behavior” (SDQ) turns out to be a significant positive predictor for resilience (model A: b = 2.815; model B; b = 3.577) and emotional symptoms (model A: b = -1.697; model B: b = -2.596) are significant negative predictors for resilience. In addition, model A presents significant positive influences of sport (b = 16,314) and significant negative influences of “hyperactivity” (SDQ). In contrast, in model B “club memberships” (b = 15.775) and” peer relationship problems” (b = 1.508) are additional positive predictors.

Conclusions

The results of the study demonstrate the important role of prosocial behavior and emotional competence in the manifestation of resilience. The effect of extracurricular activities proves to depend on the social environment (type of school). Thus, these results could form the basis for further more specific developmental programs.

Determinants of Children's Mental Health in War-Torn Settings: Translating Research Into Action

Research on the mental health and psychosocial wellbeing of children in conflict-affected settings has undergone a significant paradigm shift in recent years. Earlier studies based on a war exposure model primarily emphasized the effects of direct exposure to armed conflict; this has gradually given way to a broader understanding of the diverse pathways by which organized violence affects children. A robustly supported comprehensive model includes risk factors at multiple points in time (prior war exposure, ongoing daily stressors) and at all levels of the social ecology. In particular, findings suggest that material deprivation and a set of family variables, including harsh parenting, parental distress, and witnessing intimate partner violence, are important mediators of the relationship between armed conflict and children's wellbeing. To date, however, interventions aimed at supporting war-affected children's wellbeing, both preventive and treatment-focused, have focused primarily on direct work with children, while paying only modest attention to ongoing risk factors in their families and broader environments. Possible reasons for the ongoing prioritization of child-focused interventions are considered, and examples are provided of recent evidence-based interventions that have reduced toxic stressors (harsh parenting and the use of violent discipline by teachers) in conflict-affected communities.

Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems

US children with emotional, mental, or behavioral conditions (EMB) have disproportionate exposure to adverse childhood experiences (ACEs). There are theoretic and empirical explanations for early and lifelong physical, mental, emotional, educational, and social impacts of the resultant trauma and chronic stress. Using mindfulness-based, mind-body approaches (MBMB) may strengthen families and promote child resilience and success. This paper examines associations between EMB, ACEs, and protective factors, such as child resilience, parental coping/stress, and parent-child engagement. Findings encourage family-centered and mindfulness-based approaches to address social and emotional trauma and potentially interrupt cycles of ACEs and prevalence of EMB.

Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy?

A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL.

Varied Patterns of Family Resilience in Challenging Contexts

While we know much about patterns of family resilience, most of our research and clinical discussion has focused on microsystemic, intrafamilial protective processes. We have far fewer maps of the bidirectional interactions between families and other systems that contribute to successful family adaptation in challenging contexts. The purpose of this article is to address this gap in knowledge and present a map of family resilience that is both systemic and contextually and culturally responsive. Seven specific patterns of family resilience are reviewed. Combined, they account for the varied adaptational patterns families use to nurture and sustain resilience. The article concludes with reflection on how we can assess family resilience and the application of this map to family therapy.

Resilience Intervention for Young Adults With Adverse Childhood Experiences

BACKGROUND

Adverse childhood experiences (ACEs) are correlated with risk behaviors of smoking, disordered eating, and alcohol and substance abuse. Such behaviors can lead to significant public health problems of chronic obstructive pulmonary disease, obesity, liver disease, and hypertension, yet some individuals do not appear to suffer negative consequences but rather bounce back.

OBJECTIVE

To pilot the feasibility and potential efficacy of the Empower Resilience Intervention to build capacity by increasing resilience and health behaviors and decreasing symptoms and negative health behaviors with young adults in an educational setting who have had ACEs.

DESIGN

A two-group pre-post repeated measures design to compare symptoms, health behaviors, and resilience and written participant responses.

RESULTS

There was a statistically significant cohort by time interaction for physical activity in the intervention group. There was no significant change in risk behaviors or resilience score by cohort. Young adults in the intervention group reported building strengths, reframing resilience, and creating support connections.

CONCLUSIONS

An increase in health behavior is theoretically consistent with this strengths-based intervention. Evaluating this intervention with a larger sample is important. Interrupting the ACE to illness trajectory is complex. This short-term empower resilience intervention, however, holds promise as an opportunity to reconsider the negative effects of the trauma of the past and build on strengths to develop a preferred future.

The Schooling Experience of Lesbian, Gay, and Bisexual Youth in lsrael: Falling Below and Rising Above as a Matter of Social Ecology

Research on the schooling experience of lesbian, gay, and bisexual (LGB) youth in Israel and in other Western countries has been largely risk-focused, whereas extrinsic and intrinsic protective factors, which enable LGB adolescent students to cope with school homophobic bullying, are often overlooked. To address this shortcoming, the researchers conducted a qualitative study based on semistructured interviews with 20 LGB-identified secondary school students. The findings and implications emphasized the key role of adequate ecological protective factors for LGB youth in enhancing effective coping mechanisms in response to school homophobic bullying.

Cross-cultural child and adolescent psychiatry research in developing countries

Mental disorders are currently a major source of morbidity among children and youth globally. The bulk of the epidemiological data about childhood mental health morbidity currently comes from the industrialized countries which paradoxically host a small (about 20%) proportion of global children and youth population. As the world seek to generate more data on the mental health of the teeming children and youth population in low- and middle-income countries (LMICs), cross-cultural issues need be considered. This consideration is imperative for reasons which include the high level of ethno-diversity in LMICs; the contextual issues in the conceptualization of normal (and abnormal) childhood across cultures, the cross-cultural nuances in risk and protective factors, and the plurality of nature and expression of childhood psychopathology. As much as it is imperative to do so, advancing cross-cultural child and adolescent research in LMICs will need to overcome challenges such as inclusive sampling and cultural validation of instruments developed in the industrialized countries of the West. Funding, technical resources, and publication bias are other potential challenges. These issues are appraised in this narrative review and some ways forward are proffered.

Factors associated with resilience of adult survivors five years after the 2008 Sichuan earthquake in China

Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience.

How social context impacts on the development, identification and treatment of mental and substance use disorders among young people - a qualitative study of health care workers

Introduction Social context has a major influence on the detection and treatment of youth mental and substance use disorders in socioeconomically disadvantaged urban areas, particularly where gang culture, community violence, normalisation of drug use and repetitive maladaptive family structures prevail. This paper aims to examine how social context influences the development, identification and treatment of youth mental and substance use disorders in socioeconomically disadvantaged urban areas from the perspectives of health care workers.

METHOD

Semi-structured interviews were conducted with health care workers (n=37) from clinical settings including: primary care, secondary care and community agencies and analysed thematically using Bronfenbrenner's Ecological Theory to guide analysis.

RESULTS

Health care workers' engagement with young people was influenced by the multilevel ecological systems within the individual's social context which included: the young person's immediate environment/'microsystem' (e.g., family relationships), personal relationships in the 'mesosystem' (e.g., peer and school relationships), external factors in the young person's local area context/'exosystem' (e.g., drug culture and criminality) and wider societal aspects in the 'macrosystem' (e.g., mental health policy, health care inequalities and stigma).

CONCLUSIONS

In socioeconomically disadvantaged urban areas, social context, specifically the micro-, meso-, exo-, and macro-system impact both on the young person's experience of mental health or substance use problems and services, which endeavour to address these problems. Interventions that effectively identify and treat these problems should reflect the additional challenges posed by such settings.

Psychological Resilience among Children Affected by Parental HIV/AIDS: A Conceptual Framework

HIV-related parental illness and death have a profound and lasting impact on a child's psychosocial wellbeing, potentially compromising the child's future. In response to a paucity of theoretical and conceptual discussions regarding the development of resilience among children affected by parental HIV, we proposed a conceptual framework of psychological resilience among children affected by HIV based on critical reviews of the existing theoretical and empirical literature. Three interactive social ecological factors were proposed to promote the resilience processes and attenuate the negative impact of parental HIV on children's psychological development. Internal assets, such as cognitive capacity, motivation to adapt, coping skills, religion/spirituality, and personality, promote resilience processes. Family resources and community resources are two critical contextual factors that facilitate resilience process. Family resources contain smooth transition, functional caregivers, attachment relationship, parenting discipline. Community resources contain teacher support, peer support, adult mentors, and effective school. The implications of the conceptual framework for future research and interventions among children affected by parental HIV were discussed.

Practitioner Review: Diagnosing childhood resilience--a systemic approach to the diagnosis of adaptation in adverse social and physical ecologies

BACKGROUND

With growing interest in resilience among mental health care providers globally, there is a need for a simple way to consider the complex interactions that predict adaptive coping when there is exposure to high levels of adversity such as family violence, mental illness of a child or caregiver, natural disasters, social marginalization, or political conflict.

METHODS

This article presents diagnostic criteria for assessing childhood resilience in a way that is sensitive to the systemic factors that influence a child's wellbeing. The most important characteristics of children who cope well under adversity and avoid problems like depression, PTSD, and delinquency are highlighted.

RESULTS

A multidimensional assessment of resilience is presented that examines, first, the severity, chronicity, ecological level, children's attributions of causality, and cultural and contextual relevance of experiences of adversity. Second, promotive and protective factors related to resilience are assessed with sensitivity to the differential impact these have on outcomes depending on a child's level of exposure to adversity. These factors include individual qualities like temperament, personality, and cognitions, as well as contextual dimensions of positive functioning related to the available and accessibility of resources, their strategic use, positive reinforcement by a child's significant others, and the adaptive capacity of the environment itself. Third, an assessment of resilience includes temporal and cultural factors that increase or decrease the influence of protective factors. A decision tree for the diagnosis of resilience is presented, followed by a case study and diagnosis of a 15-year-old boy who required treatment for a number of mental health challenges.

CONCLUSIONS

The diagnostic criteria for assessing resilience and its application to clinical practice demonstrate the potential usefulness of a systemic approach to understanding resilience among child populations.

Self Realization and Meaning Making in the Face of Adversity: A Eudaimonic Approach to Human Resilience

This article considers a eudaimonic approach to psychological well-being built on the integration of developmental, existential and humanistic formulations as well as distant writings of Aristotle. Eudaimonia emphasizes meaning-making, self realization and growth, quality connections to others, self-knowledge, managing life, and marching to one's own drummer. These qualities may be of particular importance in the confrontation with significant life challenges. Prior formulations of resilience are reviewed to underscore the unique features of a eudaimonic approach. Empirical findings on meaning making and self realization are then reviewed to document the capacity of some to maintain high well-being in the face of socioeconomic inequality, the challenges of aging, and in dealing with specific challenges (child abuse, cancer, loss of spouse). Moreover, those who sustain or deepen their well-being as they deal with adversity, show better health profiles, thereby underscoring broader benefits of eudaimonia. How meaning is made and personal capacities realized in the confrontation with challenge is revealed by narrative accounts. Thus, the latter half of the article illustrates human resilience in action via the personal stories of three individuals (Mark Mathabane, Ben Mattlin, Victor Frankl) who endured unimaginable hardship, but prevailed and grew in the face of it. The essential roles of strong social ties and the capacity to derive meaning and realize personal growth in grappling with adversity are unmistakable in all three cases.

Vicious circle of perceived stigma, enacted stigma and depressive symptoms among children affected by HIV/AIDS in China

Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children's mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6-12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma → depressive symptom → perceived stigma → enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS.

Invited commentary: Resilience and positive youth development frameworks in developmental science

Positive youth development (PYD) and resilience science differ in emphasis and focus but share many roots, assumptions, concepts, and goals. Both frameworks are grounded in developmental systems theory, both are focused on positive adaptation, and both are translational, sharing a common goal of promoting positive development. Yet there also are differences. This commentary examines the concepts, methods, and goals that define the PYD framework as embodied by the 4-H Study of PYD from the perspective of contemporary resilience science in human development, with an eye toward delineating similarities, differences, and future directions.

Mass trauma: disasters, terrorism, and war

Disasters, war, and terrorism expose millions of children globally to mass trauma with increasing frequency and severity. The clinical impact of such exposure is influenced by a child's social ecology, which is understood in a risk and resilience framework. Research findings informed by developmental systems theory and the related core principles of contemporary developmental psychopathology are reviewed. Their application to the recent recommendations for interventions based on evolving public health models of community resilience are discussed along with practical clinical tools for individual response.

Multiple service use: the impact of consistency in service quality for vulnerable youth

Little is known about the way in which variations in service quality influence outcomes when youth are clients of more than one service system. This article reports on a study of 1,210 adolescents (aged 13-17 years), half were concurrent clients of two or more services and half were not involved in two or more services. Youth completed a self-report questionnaire administered by a trained interviewer. It was hypothesized that youth reporting two positive service experiences would report lower risks, higher resilience, and better outcomes than youth reporting inconsistent or two negative service experiences and that their resilience, risks, and outcomes would be similar to those of youth not involved in two or more services. MANCOVA was used to determine the relationship among service quality and resilience, risk, and outcomes with four covariates that assessed family and neighborhood environments, history of abuse and neglect, and chronic need. Results indicate that service quality had an effect on resilience, risks, and outcomes. These relationships were mediated quite strongly by the influence of the risks youth faced in their neighborhoods and to a lesser extent by the other three covariates. Of the three dependent variables, risk appeared to be the most consistently influenced by all the covariates, and it also differentiated service experience groups. Results point to the importance of services developing strategies to effectively address risks confronted by youth and also to ensure that when more than one service is involved with youth, consistency in service delivery is achieved.

Resilience definitions, theory, and challenges: interdisciplinary perspectives

In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).

Global perspectives on resilience in children and youth

Global concerns about the consequences of disasters, political violence, disease, malnutrition, maltreatment, and other threats to human development and well-being have sparked a surge of international interest in resilience science. This article highlights progress and issues in research that aims to understand variations in human adaptation to adverse experiences. Two key questions are considered: Why is a new wave of global research on resilience important for developmental science? and Why is developmental science important for global resilience? The conclusion calls for developmental scientists to engage in international efforts to promote resilience.

Extracurricular interest as a resilience building block for children affected by parental HIV/AIDS

Parental illness and death due to human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) impose challenges to children's psychological adjustment. Positive psychology emphasizes individual's resilience in the face of adversity, trauma, and tragedy. Limited data are available regarding the factors that can cultivate resilience of children affected by HIV/AIDS. This study aims to examine the role of extracurricular interest in strengthening resilience among children affected by HIV/AIDS. Participants included 755 children orphaned by parental HIV/AIDS, 466 vulnerable children living with HIV-positive parent(s), and 404 comparison children from HIV-free families in the same community in rural China. The measures include extracurricular interest (i.e., reading, sports, music, painting, science, and playing chess) and indicators of psychological adjustment (i.e., depression, loneliness, and self-esteem). Having extracurricular interest was positively associated with self-esteem and negatively associated with depression and loneliness. Having extracurricular interest attenuated the negative effect of parental HIV/AIDS on children's self-esteem and loneliness, after controlling for children's age, gender, and family socioeconomic status. The findings underscore the importance of nurturing extracurricular interest and make available of such activities to promote resilience for children affected by HIV/AIDS in resource-limited settings.

Annual Research Review: The experience of youth with political conflict--challenging notions of resilience and encouraging research refinement

AIMS AND METHOD

Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.

FINDINGS

The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.

CONCLUSIONS

Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.