Resilient Coping Moderates the Effect of Trauma Exposure on Depression

Psychometric evaluation of the Brief Resilient Coping Scale (BRCS) over the course of the pandemic in a large German general population sample

BACKGROUND

The Brief Resilience Coping Scale (BRCS) is a brief instrument suitable for epidemiological studies. The aims of this paper were to analyze changes in BRCS depending on time, sex, age group, relationship status, as well as risk of poverty, to test the psychometric properties including test-retest reliability and measurement invariance, and to determine associations with psychosocial stress, depressiveness, anxiety, social support, as well as subjective mental and physical health. As the data from this study was collected during the pandemic, an additional sensitivity analysis was performed with pre-pandemic data.

METHODS

A longitudinal study of resilience and distress in a large-sized community sample was performed at one pre-pandemic (T0) and three pandemic time points (T1-3). Resilient coping was assessed by the 4-Item short form of the BRCS, distress by the PHQ-9 and GAD-2.

RESULTS

BRCS decreased between the first and the second and increased at the third pandemic time point. The scale had a good internal consistency. Test-retest correlation coefficients ranged from 0.527 to 0.589. Higher resilient coping was found in younger participants, participants not at-risk-of-poverty and in males. Stability was higher in those with a partner, and at-risk-of-poverty. Significant negative associations with psychosocial stress, loneliness, depressiveness, anxiety, social support, as well as subjective and physical health and SES underscored the construct validity.

CONCLUSION

Overall, findings underscore that resilient coping is a dynamic construct with considerable stability. The scale showed good psychometric properties including test-retest reliability over four months to two years. We found that it is not only important to describe the level of resilient coping, but also its stability.

Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model

Introduction

A doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience.

Method

A web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period.

Results

As hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor.

Discussion

Theoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.

Intergenerational Transmission of Depression: Examining the Roles of Racism and Trauma Among Black Mothers and Youth

OBJECTIVE

Racism is a multifaceted system of oppression that disproportionately harms Black mothers and children across the lifespan. Despite reliable evidence that racism is associated with worse mental health outcomes (eg, increased depressive symptoms), less is known about potential intergenerational effects of Black mothers' experiences of racism on children's mental health, as well as how traumatic experiences influence these pathways. In this cross-sectional quantitative study, we aimed (1) to replicate the finding that maternal experiences of racism are associated with both maternal and child depression; (2) to identify whether maternal experiences of racism are indirectly associated with child depression via the effect of maternal depression; and (3) to test whether the indirect effect of racism on child depression via maternal depression is conditioned on maternal trauma.

METHOD

Black mothers and their children (N = 148 dyads) were recruited from an urban hospital and were interviewed about their experiences of racism, trauma, and mental health symptoms. The mothers' average age was 35.16 years (SD = 8.75) and the children's average age was 10.03 years (SD = 1.51).

RESULTS

First, we found that maternal experiences of racism were associated with more severe maternal depression (r = 0.37, p < .01) as well as more severe child depression (r = 0.19, p = .02). Second, we found that maternal experiences of racism were indirectly associated with child depression through the effect of maternal depression (ab = 0.76, 95% CI = 0.26, 1.37). Third, we found that maternal trauma exposure moderated this indirect effect such that, at relatively lower levels of maternal trauma exposure, the indirect effect of maternal experiences of racism on child depression was nonsignificant (ωlow = -0.05, 95% CI = -0.50, 0.45), whereas at relatively higher levels of maternal trauma exposure, the indirect effect of maternal experiences of racism on child depression was statistically significant (ωhigh= .65, 95% CI = 0.21, 1.15).

CONCLUSION

These findings suggest that the indirect effect of maternal experiences of racism on child depression through the effect of maternal depression depends on the degree of maternal trauma exposure. This study advances the literature by shedding light on key processes that can explain the intergenerational effects of racism as well as contextual factors that can exacerbate racism's downstream consequences across generations.

Psychosocial Stressors and Maternal Mental Health in the U.S. During the First Wave of the COVID-19 Pandemic: A Cross-Sectional Analysis

OBJECTIVES

The COVID pandemic has had widespread impacts on maternal mental health. This research aims to examine the relationship between psychosocial stressors and symptoms of depression and anxiety and the extent to which emotional support or resilient coping moderates the relationship between psychosocial stressors and maternal mental health during the first wave of the COVID pandemic.

METHODS

This analysis includes data collected in October and November 2020 from a geographically and sociodemographically diverse sample of 776 mothers in the U.S. with children ≤ 18 years of age. Log binomial models were used to estimate the association between moderate or severe symptoms of anxiety and depression and psychosocial stressors.

RESULTS

Symptoms of moderate or severe anxiety and depression were reported by 37.5% and 37.6% of participants, respectively. Moderate (aRR 2.76 [95% CI 1.87, 4.07]) and high (aRR 4.95 [95% CI 3.40, 7.20]) levels of perceived stress were associated with greater risk of moderate or severe anxiety symptoms. Moderate and high levels of parental burnout were also associated with greater prevalence of moderate or severe anxiety symptoms in multivariable models. Results were similar when examining the relationship among stress, parental burnout, and depressive symptoms. Neither resilient coping nor social support modified the relationship between psychosocial stressors and mental health.

CONCLUSIONS FOR PRACTICE

Evidence-based strategies to reduce stress and parental burnout and improve the mental health of mothers are urgently needed. Strategies focused on bolstering coping and social support may be insufficient to improve maternal mental health during acute public health emergencies.

Psychometric properties of the Korean adaptation of the communities advancing resilience toolkit (CART) assessment survey

AIMS

This study aimed to establish a cross-cultural adaptation of the Communities Advancing Resilience Toolkit (CART) assessment survey for Korean communities (K-CART) and evaluated its psychometric properties of K-CART.

DESIGN

A cross-sectional study design was used.

METHODS

A forward and backward translation of the CART was conducted. The psychometric properties of K-CART were evaluated with test-retest reliability, internal consistency, content validity and construct validity. A field study was conducted involving 315 older adults in Pohang city, South Korea from January to March, 2019. Two versions of K-CART were analysed, based on the four-factor and the expanded five-factor K-CART.

RESULTS

The test-retest reliability and internal consistency were acceptable (intraclass consistency coefficient = .90). The consistency reliability was satisfactory (Cronbach's α = 0.91). The content validity index (CVI) was found to be acceptable; wherein the item-CVI and scale-CVI were both 0.95. Confirmatory factor analysis confirmed that the construct validity of the expanded K-CART with five factors reached a more acceptable model fit (χ² /df = 2.27, CFI = 0.89, TLI = 0.86, RMESA = 0.05).

Resiliency and mental health of school teachers in Okinawa

Purpose

The purpose of this paper is to describe the mental health issues among teachers globally and to investigate the significant factors that specifically impact the mental health of school teachers in Okinawa, Japan.

Design/methodology/approach

This cross-sectional study examined depression, anxiety, stress, self-esteem and resiliency among 174 teachers from seven schools in Okinawa, Japan. The study questionnaire consisted of four parts, including demographic data, Depression, Anxiety, and Stress scale (DASS-42), Rosenberg Self-Esteem Scale (RSE), and Connor-Davidson Resiliency Scale (CD-RISC). Multiple regression analyses were performed to identify predictors of mental health variables.

Findings

Of the 174 teachers, 111 were females (64%) and 60 were males (35%). Average age of participants was 41.65 (SD = 10.07). Average number of years being a teacher was 15.50 (SD = 9.88). There was a significant gender difference in the level of self-esteem. Significant differences in anxiety were found among varying grade levels taught. Regression analyses indicated that resiliency and self-esteem significantly predicted depression, anxiety and stress among school teachers in Okinawa.

Originality/value

This is the first study among school teachers in Okinawa that examined the impact of resiliency and self-esteem on their mental health. To reduce psychological distress common within the teaching profession, social and environmental support should be provided within the school to better foster the successful promotion of teacher resiliency and self-esteem.

Depression Following COVID-19 Lockdown in Severely, Moderately, and Mildly Impacted Areas in China

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has led to overwhelming levels of distress as it spread rapidly from Wuhan, Hubei province to other regions in China. To contain the transmission of COVID-19, China has executed strict lockdown and quarantine policies, particularly in provinces with the highest severity (i.e., Hubei). Although the challenges faced by individuals across provinces may share some similarities, it remains unknown as to whether and how the severity of COVID-19 is related to elevation in depression. Methods: The present study compared depression among individuals who lived in mildly, moderately, and severely impacted provinces in China following the lockdown (N = 1,200) to norm data obtained from a representative sample within the same provinces in 2016 (N = 950), and examined demographic correlates of depression in 2020. Results: Residents in 2020, particularly those living in more heavily impacted provinces, reported increased levels of depression than the 2016 sample. Subsequent analyses of sub-dimensions of depression replicated the findings for depressed mood but not for positive affect, as the latter only declined among residents in the most severely impacted area. Increased depressed mood was associated with female, younger age, fewer years of education, and being furloughed from work, whereas reduced positive affect was associated with younger age and fewer years of education only. Conclusions: This study underscored the impact of COVID-19 on depression and suggested individual characteristics that may warrant attention.

Cardiovascular risk as a moderator of associations among anxiety sensitivity, distress tolerance, PTSD and depression symptoms among trauma-exposed firefighters

BACKGROUND

Firefighters experience frequent and severe trauma exposure, which places them at elevated risk for posttraumatic stress disorder (PTSD) and major depression. Cardiovascular issues may exacerbate the effects of mental health risk factors, such as anxiety sensitivity (AS) and distress tolerance (DT), on PTSD and depression. The current study investigated cardiovascular risk as a moderator of associations between risk factors (AS and DT) and psychiatric symptoms (PTSD and depression) among firefighters.

METHODS

Participants were 836 trauma-exposed active duty firefighters (93.90% men; with mean age 38 years, [SD = 9]). Participants endorsing at least one of three cardiovascular risk items-experiencing current high blood pressure, history of heart problems, and experiencing chest pains in the past 2 years-were considered high in cardiovascular risk.

RESULTS

A structural equation model indicated that higher AS was associated with greater PTSD (β = 0.38, p < .01) and depression symptoms (β = 0.32, p < .01); lower DT was associated with greater PTSD (β = -0.18, p < .01) and depression symptoms (β = -0.31, p < .01). Multigroup analyses showed that cardiovascular risk moderated the association between 1) AS and PTSD symptoms, but not 2) AS and depression symptoms, 3) DT and PTSD symptoms, or 4) DT and depression symptoms. For those high in cardiovascular risk, higher AS was associated more strongly with greater PTSD symptoms (high cardiovascular risk group: β = 0.46, p < .01]; low cardiovascular risk group: β = 0.33, p < .01).

CONCLUSIONS

High cardiovascular risk may contribute to PTSD symptoms among trauma-exposed firefighters with high AS. These results highlight the importance of considering physical and mental health vulnerabilities in first responder populations.

Personality, Resilience, and Psychopathology: A Model for the Interaction between Slow and Fast Network Processes in the Context of Mental Health

Network theories have been put forward for psychopathology (in which mental disorders originate from causal relations between symptoms) and for personality (in which personality factors originate from coupled equilibria of cognitions, affect states, behaviours, and environments). Here, we connect these theoretical strands in an overarching personality–resilience–psychopathology model. In this model, factors in personality networks control the shape of the dynamical landscape in which symptom networks evolve; for example, the neuroticism item ‘I often feel blue’ measures a general tendency to experience negative affect, which is hypothesized to influence the threshold parameter of the symptom ‘depressed mood’ in the psychopathology network. Conversely, events at the level of the fast–evolving psychopathology network (e.g. a depressive episode) can influence the slow–evolving personality variables (e.g. by increasing feelings of worthlessness). We apply the theory to neuroticism and major depressive disorder. Through simulations, we show that the model can accommodate important phenomena, such as the strong relation between neuroticism and depression and individual differences in the change of neuroticism levels and development of depression over time. The results of the simulation are implemented in an online, interactive simulation tool. Implications for research into the relationship between personality and psychopathology are discussed. © 2020 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology

A cross-sectional study of psychological wellbeing of Indian adults during the Covid-19 lockdown: Different strokes for different folks

The psychological impacts of the lockdown due to the Covid-19 pandemic are widely documented. In India, a family-centric society with a high population density and extreme social stratification, the impact of the lockdown might vary across diverse social groups. However, the patterning in the psychological impact of the lockdown among LGBT adults and persons known to be at higher risk of the complications of Covid-19 (such as persons with comorbidities or a history of mental illness) is not known in the Indian context. We used mixed methods (online survey, n = 282 and in-depth interviews, n = 14) to investigate whether the psychological influence of the lockdown was different across these groups of Indian adults. We fitted linear and logistic regression models adjusted for sociodemographic covariates. Thematic analysis helped us identify emergent themes in our qualitative narratives. Anxiety was found to be higher among LGBT adults (β = 2.44, CI: 0.58, 4.31), the high-risk group (persons with comorbidities) (β = 2.20, CI:0.36, 4.05), and those with a history of depression/loneliness (β = 3.89, CI:2.34, 5.44). Persons belonging to the LGBT group reported a greater usage of pornography than the heterosexuals (β = 2.72, CI: 0.09, 5.36) during the lockdown. Qualitative findings suggested that LGBT adults likely used pornography and masturbation to cope with the lockdown, given the limited physical access to sexual partners in a society that stigmatizes homosexuality. Moreover, both qualitative and quantitative study findings suggested that greater frequency of calling family members during lockdown could strengthen social relationships and increase social empathy. The study thereby urgently calls for the attention of policymakers to take sensitive and inclusive health-related decisions for the marginalized and the vulnerable, both during and after the crisis.

Central and Peripheral Symptoms in Network Analysis are Differentially Heritable A Twin Study of Anxious Misery

BACKGROUND

Evidence suggests that depression and anxiety disorders are genetically based. Although symptoms of these internalizing disorders tend to correlate, the degree to which the related symptoms are heritable is unclear. This overlap has been conceptualized as Anxious Misery and existing research examining similar constructs of negative affect has revealed moderate heritability. However, it is unclear if some symptoms that characterize these constructs are more heritable than others. Modeling the symptom structure of Anxious Misery and examining which symptoms are most heritable may have implications for etiological models of internalizing disorders. Accordingly, the present study employed network analysis to explore the relationships across symptoms of Anxious Misery and to test if central symptoms in the network, compared to more peripheral symptoms, differ in their heritabilities.

METHODS

Twin pairs (N = 1,344 pairs) with a mean age of 39 years (SD = 16 years) completed measures of anxiety and neuroticism to represent the Anxious Misery network.

RESULTS

Panic-related symptoms were the most central in the network and were the most heritable, with genetic factors accounting for up to 59% of phenotypic variance. Peripheral symptoms were less heritable, accounting for as little as 21% of phenotypic variance. The degree of symptom heritability was strongly correlated with the degree of centrality of a symptom in the network (r = .53).

LIMITATIONS

Reliance on two self-report measures to represent Anxious Misery limits the generalizability of the findings.

CONCLUSIONS

Central and peripheral symptoms of an Anxious Misery network may differ in degree of heritability.

The Moderating Effect of Resilience on the Relationship between Adverse Childhood Experiences (ACEs) and Quality of Physical and Mental Health among Adult Sexual and Gender Minorities

Sexual and gender minority (SGM) individuals experience a greater burden of poor mental health compared to heterosexual individuals. One factor that helps to explain this disparity is trauma experienced during childhood. SGM are more likely to report traumatic experiences during childhood contributing to this disparity. Previous research has shown that resilience moderates the relationship between childhood trauma and adults mental health outcomes. As part of the Strengthening Colors of Pride project, data on 463 SGM adults living in San Antonio were collected using surveys. A diverse recruitment strategy was used in conjunction with a community advisory board. The brief resilience scale (BRS) was used to assess intrapersonal level resilience to determine if there was an effect on the relationship between ACEs and quality of mental and physical health. Differences were noted for some items across low, normal, and high levels of resilience. Both ACEs and BRS significantly predicted quality of mental and physical health. We also noted a significant interaction between ACEs and BRS with regard to quality of mental health. Findings suggest there is a relationship between intrapersonal level resilience, ACEs, and quality of mental health.

Associations between changes in resilient coping and posttraumatic stress disorder symptoms

The pervasive, damaging nature of posttraumatic stress disorder (PTSD) presents enormous clinical challenges. Understanding the relationship between patients' perceptions of PTSD symptoms and resilient coping strategies may prompt investigation of clinical interventions that improve adaptive, resilient coping skills. In this study, we examined whether changes in resilient coping were related to changes over time in the PTSD symptoms of intrusion and avoidance. A secondary analysis was conducted using longitudinal data from the community-based Washington State Twin Registry. Participants completed the four-item Brief Resilient Coping Scale (BRCS) and the Avoidance and Intrusion subscales of the Impact of Events Scale (IES) at two points in time that were at least 2 years apart. To limit analyses to participants reporting PTSD symptoms at baseline, an initial value of at least 1.0 on either Avoidance (n = 1,337) or Intrusion (n = 1,206) was required for inclusion in the sample. Using linear regression, we assessed associations of change in BRCS with a change in IES scores, controlling for the respective initial scores on each measure. Controlling for initial BRCS and IES-Intrusion values, we observed a small, statistically significant association between change in BRCS and change in IES-Intrusion scores (b* = -0.07; p = .003). There was no statistically significant association between change in BRCS and change in IES-Avoidance (b* < 0.01; p = .869). In this large, longitudinal sample, increases in resilient coping were related to decreases in intrusive thoughts over time. Because coping patterns can be taught, these results warrant further investigations into adaptive coping patterns associated with diminishing PTSD symptoms.

Impact of maltreatment on depressive symptoms in young male adults: The mediating and moderating role of cortisol stress response and coping strategies

BACKGROUND

Converging evidence suggests that maltreated children suffer from depression at an early age and experience recurrent episodes of depression that persist over longer periods of time. However, the stress-related mechanisms hypothesized to be implicated in these associations remain to be specified. The present study tested the mediating and moderating roles of acute cortisol response to stress and coping strategies in the association between child maltreatment and depressive symptoms in early adulthood.

METHODS

Data from 156 men aged 18 to 35 years (n = 56 maltreated) were collected using self-reported questionnaires assessing child maltreatment, depressive symptomatology and coping strategies. Cortisol was measured in response to the "Trier Social Stress Test" (TSST).

RESULTS

Although acute cortisol response to stress did not mediate the maltreatment-depressive symptoms association, a moderation effect was found. Child maltreatment was associated with higher risk of depressive symptoms among participants with a higher cortisol response to stress, but not for those with moderate-to-lower cortisol responses. Additionally, maltreated participants reported more depressive symptoms, an association that was partly explained by their higher use of emotion-oriented coping (mediation). Finally, maltreated individuals who reported using less task-oriented coping had greater depressive symptomatology than those who adopted this coping strategy more frequently (moderation).

CONCLUSION

These findings extend prior work examining the role of the hypothalamic-pituitary-adrenal (HPA) axis in the etiology of depression. The results draw attention to coping strategies, in addition to acute cortisol response to stress, as potential targets for mitigating the onset of depressive symptoms in adults maltreated as children.

Depressive Symptoms Among Police Officers: Associations with Personality and Psychosocial Factors

Protective psychosocial factors may reduce the risk of stress-related illnesses in policing. We assessed the association between protective factors and depressive symptoms among 242 police officers. Participants were from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2014). Coping, hardiness, personality traits, and social support were assessed at baseline. Depressive symptoms were measured at baseline and follow-up using the Center for Epidemiologic Studies-Depression (CES-D) scale. The relationship between protective factors and the rate of change in depressive symptoms was assessed using linear regression. Logistic regression evaluated associations between protective factors and new-onset depression. Of participants free of depression at baseline, 23 (10.7%) developed probable depression during the follow-up. Odds of new-onset depression increased with increasing neuroticism (adjusted odds ratio [ORADJ] = 1.22, 95% confidence interval [CI], 1.11-1.35) and passive coping (ORADJ = 2.07, 95% CI, 1.06-4.03). Increasing agreeableness (ORADJ = 0.87, 95% CI, 0.78-0.96) and conscientiousness (ORADJ = 0.90, 95% CI, 0.84-0.98) were associated with decreased odds of new-onset depression. New-onset depression was not significantly associated with other coping subscales, hardiness, or social support. There were no significant associations between protective factors and change in depressive symptom scores. This study suggests certain personality characteristics and passive coping may be associated with increased odds of new-onset depression in police officers.

The Importance of Parents' Community Connections for Adolescent Well-being: An Examination of Military Families

Drawing from the Social Organization Theory of Action and Change (SOAC), this analysis of 223 military families, including active duty (AD) military and civilian partners, examines how parents' sense of community and community engagement (two elements of community connections) are associated with their own resilient coping, and ultimately with important outcomes capturing their adolescent offspring's individual well-being (depression, anxiety, and self-efficacy) and family well-being (family functioning and parenting quality). The roles of child gender and military context were also examined. Parents with stronger community connections, including greater sense of community and community engagement, reported more resilient coping when faced with adversity. The resilient coping of mothers, in turn, was particularly significant for more positive youth outcomes, when compared to that of fathers. While gender and military context were associated with individual and family well-being, analyses of model invariance indicated that the model fit similarly for male and female adolescents and those experiencing high and low levels of military transitions. Indirect effects were also examined. These findings illuminate malleable dimensions of both community life and family life, primarily showing that community contexts matter for multiple family members.

The effect of social support, gratitude, resilience and satisfaction with life on depressive symptoms among police officers following Hurricane Katrina

BACKGROUND

Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina.

AIM

This cross-sectional study examined the effect of social support, gratitude, resilience and satisfaction with life on symptoms of depression.

METHOD

A total of 86 male and 30 female police officers from Louisiana participated in this study. Ordinary least-square (OLS) regression mediation analysis was used to estimate direct and indirect effects between social support, gratitude, resilience, satisfaction with life and symptoms of depression. All models were adjusted for age, alcohol intake, military experience and an increase in the number of sick days since Hurricane Katrina.

RESULTS

Mean depressive symptom scores were 9.6 ± 9.1 for females and 10.9 ± 9.6 for males. Mediation analyses indicates that social support and gratitude are directly associated with fewer symptoms of depression. Social support also mediated the relationships between gratitude and depression, gratitude and satisfaction with life, and satisfaction with life and depression. Similarly, resilience mediated the relationship between social support and fewer symptoms of depression.

CONCLUSION

Social support, gratitude and resilience are associated with higher satisfaction with life and fewer symptoms of depression. Targeting and building these factors may improve an officer's ability to address symptoms of depression.

Changes in Resilience Predict Function in Adults With Physical Disabilities: A Longitudinal Study

OBJECTIVES

(1) To determine if resilience exhibits similar stability across time as depression, fatigue, and sleep quality; and (2) to determine if changes in resilience over a period of 1 year are associated with changes in depression, fatigue, sleep quality, and physical function over the same time period.

DESIGN

Observational longitudinal survey study with measures administered 2 times, 1 year apart.

SETTING

Community-based population sample.

PARTICIPANTS

Adults with physical disabilities (N=893).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Primary outcomes were measures of resilience (Connor-Davidson Resilience Scale), depression (Patient Health Questionnaire-9), fatigue (Patient-Reported Outcomes Measurement Information System [PROMIS] Fatigue Short Form), sleep quality (PROMIS Sleep Disturbance), and physical function (8-item PROMIS Physical Functioning).

RESULTS

Resilience (r=.71, P<.001) exhibited similar stability over 1 year to depression (r=.71, P<.001), fatigue (r=.79, P<.001), and sleep quality (r=.68, P<.001). A decrease in resilience was associated with an increase in depression (F1,885=70.23; P<.001; R2=.54) and fatigue (F1,885=25.66; P<.001; R2=.64), and an increase in resilience was associated with improved sleep quality (F1,885=30.76; P<.001; R2=.48) and physical function (F1,885=16.90; P<.001; R2=.86) over a period of 1 year, while controlling for age, sex, and diagnosis.

CONCLUSIONS

Resilience exhibits similar test-retest stability as other important domains that are often treatment targets. Changes in resilience were associated with changes in depression, fatigue, sleep quality, and physical functioning over the course of 1 year. Further longitudinal and experimental research is warranted to investigate the potential causal effect of changes in resilience on quality of life in individuals with physical disabilities.