The Korean version of the Connor-Davidson Resilience Scale: an extended validation

Community-Based Mental Health Challenges and Implications: Examining Factors Influencing Distress and Help-Seeking Behaviors among Korean American Church Leaders and Members in Greater Los Angeles

There is limited research on the factors that impact mental distress among Korean American (KA) church leaders even though their unique social situation can create many barriers to seeking mental health assistance. This study compared factors impacting mental distress and help-seeking behaviors between KA church leaders (CLs) and church members (CMs) in the greater Los Angeles area. The respondents (N = 243) were mostly female, married, educated, first-generation immigrants with a mean age of 47.9 years (SD = 19.7). The Hopkins Symptoms Checklist 10 was used to measure anxiety and depression. Hierarchal linear regressions showed that health status exerted the strongest effect on both anxiety and depression among CLs and CMs. Beyond health status, education (only for depression), informal resource use, and resiliency impacted mental distress scores for CLs. Only resiliency and religious coping predicted depression scores among CMs. To effectively reach this population, community-based organizations and behavioral health specialists should consider collaborating with churches to promote and provide essential mental health support. Our findings also highlight that the needs of church leaders (CLs) and church members (CMs) differ, which should guide the development of culturally tailored interventions that build on the resilience of both groups.

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN

Background

Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical.

Objective

This review study aimed to evaluate the psychometrics quality of resilience scales.

Methods

International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality.

Results

Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent.

Conclusion

The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

The mediating role of resilience between emotional intelligence and academic procrastination in nursing undergraduates: A cross-sectional study

AIM

To investigate the relationship among emotional intelligence (EI), resilience and academic procrastination (AP), and provide suggestions for the development of targeted intervention strategies and lowering of AP level of nursing undergraduates.

DESIGN

A cross-sectional study.

METHODS

Three provincial universities offering nursing courses in China were investigated in this study. A convenience sample of 256 nursing undergraduates from May 2021 to September 2021 were recruited, with a response rate of 91.4%. Data were collected using face-to-face interviews. The survey tools included the General Information Questionnaire, Academic Procrastination Scale, Emotional Intelligence Scale and Resilience Scale. IBM SPSS v19.0 and Amos 22.0 were used for data analysis.

RESULTS

The AP of sampled nursing undergraduates was at the middle level (54.4 ± 21.5). The AP of nursing undergraduates was negatively correlated with EI and resilience. Moreover, the analysis on the mediating role of resilience via structural equation model showed a good fit, with χ2/df = 2.34, RMSEA = 0.07, CFI = 0.99, GFI = 0.95, TLI = 0.98.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Dimensions of Resilience and Their Predictive Utility Among Clients With Anxiety Disorders or Depressive Disorders: A Factor Analytic Study

The Connor-Davidson Resilience Scale is a commonly used measure of resilience. However, while resilience is considered multidimensional, the specific dimensions embedded within this scale remain equivocal. The aim of this article was to contribute to this debate by analyzing responses from a large sample obtained within a mental health setting. Baseline data from 672 consecutive referrals to a publicly funded outpatient service for adults with anxiety and depression were subjected to exploratory factor analysis. Outcome data from 349 of these participants who had completed treatment were analyzed using confirmatory factor analysis. Both analytical strategies suggested that two dimensions were evident (Adaptability and Tenacity), although comparisons of Adaptability and Tenacity across sociodemographic, diagnostic, psychological distress, and functional impairment variables provided little support for their discriminability. The practical utility to mental health nurses of subcomponents of resilience remains clinically persuasive yet empirically elusive with current instrumentation.

Exploring the measurement of psychological resilience in Chinese civil aviation pilots based on generalizability theory and item response theory

Understanding and accurately measuring resilience among Chinese civil aviation pilots is imperative, especially concerning the psychological impact of distressing events on their well-being and aviation safety. Despite the necessity, a validated and tailored measurement tool specific to this demographic is absent. Addressing this gap, this study built on the widely used CD-RISC-25 to analyze and modify its applicability to Chinese civil aviation pilots. Utilizing CD-RISC-25 survey data from 231 Chinese pilots, correlational and differential analyses identified items 3 and 20 as incongruent with this population's resilience profile. Subsequently, factor analysis derived a distinct two-factor resilience psychological framework labeled "Decisiveness" and "Adaptability", which diverged from the structure found in American female pilots and the broader Chinese populace. Additionally, to further accurately identify the measurement characteristics of this 2-factor measurement model, this study introduced Generalized Theory and Item Response Theory, two modern measurement analysis theories, to comprehensively analyze the overall reliability of the measurement and issues with individual items. Results showed that the 2-factor model exhibited high reliability, with generalizability coefficient reaching 0.89503 and dependability coefficient reaching 0.88496, indicating the 2-factor measurement questionnaire can be effectively utilized for relative and absolute comparison of Chinese civil aviation pilot resilience. However, items in Factor 2 provided less information and have larger room for optimization than those in Factor 1, implying item option redesign may be beneficial. Consequently, this study culminates in the creation of a more accurate and reliable two-factor psychological resilience measurement tool tailored for Chinese civil aviation pilots, while exploring directions for optimization. By facilitating early identification of individuals with lower resilience and enabling the evaluation of intervention efficacy, this tool aims to positively impact pilot psychological health and aviation safety in the context of grief and trauma following distressing events.

Internet addiction and depressive and anxious symptoms among Chinese rural left-behind adolescents: Mediating roles of resilience and friendship quality

BACKGROUND

Rural left-behind adolescents are more vulnerable to Internet addiction and depressive and anxious symptoms due to the lack of family support and parental supervision. This study was the first to investigate the longitudinal relationships between Internet addiction and depressive and anxious symptoms and to examine the mediating roles of resilience and friendship quality in rural left-behind adolescents.

METHODS

Included in this study, which was from a longitudinal study conducted five times over 2 years, were 1001 rural left-behind adolescents. The internationally used scales for depressive and anxious symptoms, Internet addiction, resilience and friendship quality were administered. A structural equation model was used for analysis.

RESULTS

The prevalence of Internet addiction, depressive and anxious symptoms among rural left-behind adolescents were 17.7%, 35.8% and 27.6%, respectively. Internet addiction predicted the later depressive and anxious symptoms (β = 0.200, 95% confidence interval [CI]: 0.116-0.274 and β = 0.263, 95% CI: 0.188-0.330). Resilience acted as an independent mediator in the relationships between Internet addiction and depressive and anxious symptoms (β = 0.037 and 0.034, P < 0.01). Resilience and friendship quality played a chain-mediating role on the longitudinal relationships between Internet addiction and depressive and anxious symptoms (β = 0.011 and 0.010, P < 0.001). The mediating effects accounted for 24.0% and 16.7% of the total effects, respectively.

CONCLUSION

Resilience and friendship quality play an independent or chain-mediating role in longitudinal relationships between Internet addiction and depressive and anxious symptoms. The findings inform targeted intervention strategies to improve the mental health of left-behind adolescents.

The role of resilience in the relationship between intimate partner violence severity and ICD-11 CPTSD severity

Background: Resilience is a modulating factor in the development of PTSD and CPTSD after exposure to traumatic events. However, the relationship between resilience and ICD-11 CPTSD is not adequately understood in survivors of intimate partner violence (IPV).Objective: The aim of this study is to determine whether resilience has a mediating role in the relationship between severity of violence and severity of CPTSD symptoms.Method: A sample of 202 women IPV survivors completed self-rated questionnaires to assess CPTSD, severity of violence and resilience.Results: Mediation analyses indicated that there was a direct relationship between the severity of violence and the severity of CPTSD symptoms (β = .113, p < .001) and that there was a significantly inverse relationship between levels of resilience and the severity of CPTSD symptoms (β = -.248, p < .001). At the same time, there was no significant relationship between the severity of violence and resilience (β = -.061, p = .254).Conclusions: These findings suggest that resilience does not mediate the relationship between violence severity and CPTSD severity. Directions for future research are discussed.

Relationship Between Resilience, Community Participation, and Successful Aging Among Older Adults in South Korea: Mediating Role of Community Participation

A high level of resilience is positively related to successful aging. However, interventions to increase resilience in older adults are not yet available. This study aimed to examine the mediating role of community participation in the relationship between resilience and successful aging. Data from 284 individuals aged 60 years and above were analyzed in this cross-sectional study. The pathways among resilience, community participation, and successful aging were statistically significant after controlling for sociodemographic characteristics, depression, disability, and chronic disease. The analysis revealed a partial mediating effect of community participation (unstandardized estimate = .01, p < .01), explaining 16.4% of the total effect of resilience on successful aging. Promoting community participation may be beneficial for enhancing successful aging in community-dwelling older adults. Further studies to examine the causal relationship between community participation and successful aging and to develop community services are recommended to use community resources as means to support successful aging.

Resilience, Stress, Well-Being, and Sleep Quality in Multiple Sclerosis

(1) Background: Multiple Sclerosis (MS) is a chronic, progressive, immune-mediated disorder that affects the Central Nervous System and is the most common cause of non-traumatic neurological disability in young adults. The study aimed to assess the levels of stress, resilience, well-being, sleep quality, and fatigue in Israeli people with MS (PwMS), and to examine the associations between these factors and the sociodemographic and clinical characteristics. These factors had never before been studied in conjunction in PwMS, nor had they been systematically addressed in Israel, the unique geopolitical situation of which may pose unique challenges. (2) Methods: This was a survey-based, cross-sectional study conducted through an Internet platform. (3) Results: Israeli PwMS who participated in the study were experiencing relatively high levels of stress and low resilience, poor sleep quality, and severe fatigue. The analysis revealed significant associations between resilience and stress, well-being, and anxiety, as well as stress and well-being, resilience, sleep quality, fatigue, and Clinically Isolated Syndrome (CIS). (4) Conclusions: the Israeli PwMS who participated in the study were experiencing higher levels of stress, lower resilience and worse sleep quality than PwMS in other countries, as compared to results previously reported in literature. The findings of this study ought to serve as a call to action for the MS care providers in Israel and warrant further research into the possible causes of the phenomenon and strategies to address it.

The moderating effect of resilience on the relationship between academic stress and school adjustment in Korean students

Introduction

This study investigated the moderating effects of resilience on the relationship between academic stress and school adjustment among Korean adolescents. We examined the moderating effect for the total scores of school adjustment and the two subscales of school adjustment (academic adjustment and general school adjustment).

Methods

Data were obtained in Pusan, Korea, using the convenience sampling method, and a total of 674 participants' responses were used for the final analysis. Hierarchical regression analysis and multiple regression analysis were performed to examine our research questions.

Results

The results of the study showed that academic stress was a significant predictor of school adjustment among Korean adolescents. More specifically, academic stress was related to poor school adjustment. The study also found that resilience has a significant mediating effect on the relationship between academic stress and school adjustment.

Discussion

Our findings suggest that resilience is likely to alleviate the harmful effect of academic stress on school adjustment. Finally, implications for school-based intervention were discussed for providing practical academic assistance.

The relationship between abuse and neglect and adolescent suicidality: A moderated mediation model

Abuse and neglect can lead to suicide in adolescents; however, the internal mechanisms between abuse and neglect and suicidality remain unclear. We hypothesized that abuse and neglect could affect adolescent suicidality, and that mediating and moderating mechanisms exist between these two variables. We tested the mediating effects of stressful life events (misunderstanding and discrimination by others, poor academic performance, failed exams, interpersonal problems, and school punishment) on suicidal tendencies and moderating effects of resilience among 5,852 adolescents from 37 middle schools in five provinces of North, south, East, west, and central China. We used a questionnaire to collect data and adopted structural equation modeling to verify the correlation, mediating, and moderating effects among the variables. The results showed that stressful life events mediated the relationship between abuse, neglect, and suicide. Furthermore, resilience moderated the direct effect and second half of the mediating effect.

COVID-19-Related Functional Impairment in a Community Sample of Korean Adults: Associations With Depression, COVID-19 Infection Fear, and Resilience

OBJECTIVE

We aimed to determine the effects of depression, COVID-19 infection fear, and resilience on COVID-19-related functional impairment.

METHODS

We obtained data from 476 community-dwelling adults aged 20-69 years living in Jeju, South Korea, and evaluated the relationships between COVID-19-related functional impairment (work/school, social, and home life) and sociodemographic and healthrelated characteristics, COVID-19-related life changes (financial difficulties since the pandemic, employment change, interpersonal conflict), and clinical characteristics, including depression, COVID-19 infection fear, and resilience.

RESULTS

Functional impairment in the home life domain was associated with marital status and monthly income. Greater work/school, social, and home life functional impairment was significantly associated with all COVID-19-related life changes. Regression analysis indicated that resilience modulated the positive associations of COVID-19-related functional impairment with symptoms of depression and COVID-19 infection fear when relevant factors were controlled for.

CONCLUSION

Our results suggest the importance of clinical characteristics, including depression, COVID-19 infection fear, and resilience for understanding functional impairment related to COVID-19. These results have important implications for interventions aimed at reducing depression and COVID-19 infection fear, and enhancing resilience.

Demographic characteristics, family environment and psychosocial factors affecting internet addiction in Chinese adolescents

BACKGROUND

Internet addiction of adolescents has aroused social concern recently. The present study aims to identify predicting factors of internet addiction on adolescents.

METHODS

The demographic characteristics and psychological characteristics of 50, 855 middle school students were investigated through Internet Gaming Disorder Scale- Short Form(IGDS9-SF), Smartphone Application-Based Addiction Scale (SABAS), Bergen Social Media Addiction Scale (BSMAS), Strengths and Difficulties Questionnaire-students (SDQS), 16-Item Version of the Prodromal Questionnaire (PQ-16), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Multidimensional Peer Victimization Scale (MPVS), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Connor-Davidson Resilience Scale (CD-RISC10) were used to analyze factors associated with internet addiction by Pearson correlation coefficient and multiple hierarchical regression.

RESULTS

IGDS9-SF, SABAS and BSMAS are positively correlated with SDQS, PQ-16, PHQ-9, GAD-7 and MPVS (r-values ranging from 0.180 to 0.488, p < 0.01). IGDS9-SF, SABAS and BSMAS are negatively correlated with WEMWB and CD-RISC (r-values ranging from -0.242 ~ -0.338, p < 0.01). Multiple hierarchical regression shown gender, one-child, twins, left-behind, rural, education (father), drink (father), smoke (father), CD-RISC-10, SDQS, PQ-16, PHQ-9, GAD-7 and MPVS predicted 32.7 % of the variance in internet gaming disorder (IGD) (F = 1174.949, p < 0.001). Group (junior and senior), Gender, Age, One-Child, Twins, Village, Education (father), Drink (father), Drink (mother), Smoke (father), WEMWBS, CD-RISC-10, SDQS, PQ-16, PHQ-9, GAD-7 and MPVS predicted 28.9 % of the total variance in social media addiction (SMA) (F = 982.932, p < 0.001). Fifteen variables [Gender, Age, Twins, Left-behind, Residence, Residence, Education (mother), Drink(father), Drink (mother), Smoke (father), WEMWBS, CD-RISC-10, PHQ-9, GAD-7 and MPVS] predicted 30.7 % of the variance in smartphone addiction (SA) (F = 1076.02, p < 0.001).

CONCLUSION

The present study found that demographic characteristics, family environment and psychosocial factors were associated with internet gaming addiction, social media addiction and smartphone addiction. Negative psychological factors (such as anxiety and depression) play an important role in different behavioral addictions.

The mediating effect of resilience on pregnancy stress and prenatal anxiety in pregnant women

Objective

To investigate the relationship between pregnancy stress and prenatal anxiety in pregnant women in Urumqi, Xinjiang, and the mediating effect of mental resilience level on the relationship between pregnancy stress and prenatal anxiety.

Method

The investigation involved 750 pregnant women at a tertiary hospital in Urumqi, and included a questionnaire eliciting general demographic information, a pregnancy stress scale (Pregnancy Pressure Scale, PPS), generalized anxiety disorder scale (Generalized Anxiety Disorder-7, GAD-7), and a mental resilience scale (Connor-Davidson resilience scale, CD-RISC). The Bootstrap mediation effect test was used to test the effect relationship between variables, and Amos was used to establish the structural equation model.

Results

Among the 750 participants, 122 (16.2%) had moderate or greater pregnancy stress (PPS > 1), 372 (49.6%) had mild or greater anxiety symptoms (GAD-7 > 5), and 241 (32.1%) had good or higher mental resilience score. Pregnancy stress negatively affected resilience (β = -0.37, p < 0.01), and resilience also negatively affected prenatal anxiety (β = -0.12, p < 0.01). The mediating effect value of resilience was 8.3%.

Conclusion

Pregnancy stress, mental resilience, and prenatal anxiety were significantly correlated, and mental resilience played a partial mediating role in the influence of pregnancy stress on prenatal anxiety. It is recommended that pregnant women exercise their mental resilience to reduce the incidence of prenatal anxiety and promote physical and mental health.

Psychometric properties of Farsi version of the resilience scale (CD-RISC) and its role in predicting aggression among Iranian athletic adolescent girls

The sport presents an opportunity for young people to experience the joys of success and cope with setbacks to develop resilient behaviors. However, there is a lack of clarity about how sport can cultivate resilience, particularly among adolescent girls. This study investigated the psychometric properties of Farsi version of the Resilience Scale (CD-RISC) and its role in predicting aggression in Iranian athletic adolescent girls. The method of the present study was cross-sectional. The population of this study was Iranian athletic adolescent girls, and 475 Iranian athletic adolescent girls were selected through the convenience sampling method. The participants completed the Resilience Scale (CD-RISC), Quality of Mindfulness, General Self-efficacy (GSE), Alexithymia, and Aggression Scale. The CD-RISC’s psychometric properties were analyzed using confirmatory factor analysis, while reliability was tested using Cronbach’s alpha. Discriminant validity was measured by examining the relationship with alexithymia, and convergent validity was assessed with the quality of mindfulness and GSE. In addition, multiple regression analysis was conducted on the prediction of aggression by the CD-RISC subscales. The five-factor structure provided a good fit for the data. CD-RISC had significant negative associations with alexithymia, and there was a significant positive correlation between CD-RISC and Quality of Mindfulness, GSE. The results indicate that CD-RISC significantly predicts aggression in athletic adolescent girls. The CD-RISC has good validity for athletic adolescent girls in Iran and can be used in psychological evaluations in the Iranian context. CD-RISC significantly predicts aggression among athletic adolescent girls.

Current status and associated factors of psychological resilience among the Chinese residents during the coronavirus disease 2019 pandemic

BACKGROUND

Since December 2019, over 4,600 deaths and 84,000 confirmed cases were reported in China because of the coronavirus disease 2019 (COVID-19) pandemic. However, there is a dearth of studies on the psychological resilience in residents.

AIMS

This study aims to measure the psychological resilience of Chinese residents to reflect their psychological status as well as influencing factors during the pandemic.

METHOD

We conducted a combination of stratified sampling and snowball sampling to select survey subjects. We employed the psychological resilience and influencing factor questionnaire based on the 10-item Connor and Davidson Resilience Scale (CD-RISC10) for survey. We collected data from 3,398 residents in China between 31 January and 29 February 2020. Multivariable linear stepwise regression analysis was used to determine factors associated with psychological resilience in residents.

RESULTS

The mean score of psychological resilience among Chinese residents was 27.11 ± 8.45 (SD = 7.98). There were some factors significantly associated with psychological status among the Chinese residents during the COVID-19 outbreak. Residents with lower financial status, living in rural areas, unmarried, lacking fixed employment or retirement guarantees, and lacking knowledge of policies were more likely to report a lower level of psychological resilience.

CONCLUSION

Health service policy makers in many countries should adopt relevant measures to improve the psychological resilience of residents during the pandemic. This includes short-term aggressive treatment, strengthening health education, and improving the awareness of residents with respect to emergency health policies. In addition, the financial status, health levels, and risk management capabilities of residents should be increased over the long term.

Psychiatric symptoms mediate the effect of resilience on health-related quality of life in patients with breast cancer: Longitudinal examination

OBJECTIVE

Patients with breast cancer receiving neoadjuvant chemotherapy are at increased risk of poor health-related quality of life (HRQOL). This study examined clinical caseness on depression and anxiety mediate the relationship between resilience and HRQOL in patients with breast cancer.

METHODS

A total of 193 patients with breast cancer undergoing neoadjuvant chemotherapy completed questionnaires including the Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-Breast before the first session (T0), before the start of the last session (T1), and 6 months after the end (T2) of chemotherapy. Mediation analyses using a bootstrapping method was performed.

RESULTS

The indirect effect (IE) through T1 depression was significant (IE through depression = 0.043, 95% confidence interval [CI] [0.002-0.090]), while IE through T1 anxiety was not significant (IE through anxiety = 0.037, 95% CI [-0.010-0.097]) in the association between T0 resilience and T2 HRQOL.

CONCLUSIONS

Clinical caseness on HADS depression subscale during chemotherapy was a mediating factor of the relationship between resilience before chemotherapy and HRQOL after chemotherapy in patients with breast cancer receiving neoadjuvant chemotherapy. Depression during chemotherapy in patients with breast cancer may be a target symptom of screening and intervention to maintain the HRQOL after chemotherapy. Also, patients with low resilience are more likely to develop depression during chemotherapy, and clinicians should carefully monitor whether depression occurs in these patients with low resilience.

Effects of a group mindfulness-based cognitive programme on smartphone addictive symptoms and resilience among adolescents: study protocol of a cluster-randomized controlled trial

Background

Smartphone addiction in adolescent is a significant global health issue since the last decade. Evidence has shown that the uncontrolled use of smartphone would lead to undesirable impact on their growth and development. However, evidence-based interventions to manage adolescents’ smartphone addictive behaviors is lacking. The proposed study aims to examine the effect of a group mindfulness-based cognitive programme(MBCP) on resilience, smartphone behavior and addictive symptoms in young adolescents.

Methods

It is an open-label, parallel-group, cluster-randomized controlled trial with repeated measurement analysis. Four primary schools in Hong Kong will be recruited and randomly allocated in a ratio of 1:1 to the intervention/control group. A convenience sample of 240 class level 5 primary school students, 60 from each school, will be recruited. Participants in the intervention group will receive a 12-week MBCP which comprises 90-minute supervised practice at school and daily home practice. Resilience will be measured by Connor-Davidson Resilience Scale – 25 (Chinese version); smartphone behavior will be represented by time spent/day using the smartphone and types of functions used; addictive symptoms will be measured by Smartphone Addiction Scale-Short Version (Chinese Version). Baseline assessment(T0) will be conducted before the intervention starts. Post-tests will be conducted in weeks 4, 8, 12 of the intervention, and 3 months follow-up. Intention-to-Treat analysis will be applied to the variables. Generalized Estimating Equation model will be used to compare differences in resilience scores, smartphone behavior and addiction scores between and within groups, adjusted for socio-demographic factors. P < 0.05 with two-tailed test will be regarded as significance.

Discussion

It is expected that adolescents will demonstrate better resilience and lesser smartphone addictive symptoms after joining the MBCP. The study will be the first provided empirical evidence to support the promising application of MBCP to manage smartphone use among adolescents. It introduces community stakeholders including community nurses a non-invasive and simple-to-administer intervention to tackle problematic smartphone use among adolescent clients.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2000033273, Registered on 26 May 2020.

Validity and Longitudinal Invariance of the 10-Item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese Left-Behind and Non-Left-Behind Children

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a self-report instrument widely used to assess resilience in particular demographics. This study aimed to evaluate the validity and measurement invariance (MI) of the CD-RISC-10 in Chinese left-behind children. A total of 968 children from three middle schools in Guizhou Province participated in this study, with the CD-RISC-10 used twice, at the base line time point and again after six months. The Ego-resilience Scale (ERS), and General Self-efficiency Scale (GSES-10) were also used as criteria-related validity instruments. Confirmatory factor analysis (CFA) was carried out to examine the one-factor model and the MI with regards to gender and left-behind status, as well as the longitudinal measurement invariance (LMI). The study proved satisfactory reliability and validity of the CD-RISC-10, with good criterion validity with the ERS and GSES-10. CFA results showed that the satisfactory model fit for the one-factor structure was supported in all groups (e.g., CFI = .942, TLI = .925, RMSEA = .057). The strict MI was evident across genders, as well as both the left-behind and non-left-behind groups. Additionally, the LMI of the CD-RISC-10 was also adequately supported. Generally speaking, these findings demonstrate that the CD-RISC-10 can effectively measure the resilience level of left-behind children - boys as well as girls - in China.

Correlates of psychological resilience and risk: Prospective associations of self-reported and relative resilience with Connor-Davidson resilience scale, heart rate variability, and mental health indices

BACKGROUND

There are several ways to determine psychological resilience. However, the correlation between each measurement is not clear. We explored associations of baseline relative "resilience" and risk with later self-reported trait resilience and other biological/mental health indices.

METHODS

We utilized baseline and follow-up survey data from 500 participants aged 30-64 in the community cohort. Baseline "relative" resilience was defined by: (a) negative life events (NLEs) in the six months before baseline and (b) depressive symptoms at baseline, yielding four groups of individuals: i) "Unexposed and well," "Vulnerable (depression)," "Reactive (depression)," and "Resilient." "Trait" resilience at follow-up was self-reported using the Connor-Davidson Resilience Scale (CD-RISC). Associations between relative resilience at baseline, CD-RISC, and heart rate variability (HRV) indices at follow-up were assessed with generalized linear regression models after adjustments. Associations between baseline resilience and subsequent loneliness/depression indices were also evaluated.

RESULTS

Overall trait resilience and its subfactors at follow-up showed strong negative associations with "Reactive" at baseline (adj-β for total CD-RISC score: -11.204 (men), -9.472 (women)). However, resilience at baseline was not associated with later HRV, which was compared with the significant positive association observed between CD-RISC and HRV at the same follow-up time point. The "Reactive" exhibited significantly increased depressive symptoms at follow-up. The overall distribution pattern of CD-RISC subfactors differed by baseline resilience status by sex.

CONCLUSIONS

The "relative" resilience based on the absence of depression despite prior adversity seems to be highly related with trait resilience at follow-up but not with HRV. The sub-factor pattern of CD-RISC was different by sex.

Association of Nursing Work Environment, Relationship with the Head Nurse, and Resilience with Post-Traumatic Growth in Emergency Department Nurses

Emergency department nurses are confronted with unpredictable diseases and disasters and work-related traumatic stress events. This study aimed to examine the relationship between nursing work environment, relationship with the head nurse, resilience, and posttraumatic growth among emergency department nurses. Data were collected from December 2018 to February 2019 through a self-administered survey questionnaire. Participants comprised 127 nurses working in the emergency department. The collected data were analyzed using t-test, analysis of variance with Scheffé’s test, Pearson’s correlations, and hierarchical multiple regression. The mean posttraumatic growth score of emergency department nurses was 2.59 ± 0.64 out of a possible 5.00. The posttraumatic growth showed a statistically significant difference according to age in the emergency department nurse. Resilience was the most significant variable controlling other variables, accounting for 29% of the variability. The findings support that intervention programs should be developed to encourage a positive relationship with the head nurse and enhance resilience in emergency department nurses.

Psychometric properties of the Spanish version of the 10-item Connor Davidson Resilience Scale (CD-RISC) among adolescent mothers in Peru

The objective of this research is to assess the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in order to contribute to the literature identifying validated resilience measures in low-resource settings where individuals face significant adversity. This cross-sectional study included 789 adolescent mothers who delivered at a maternity hospital in Lima, Peru. The Spanish version of the 10-item CD-RISC was used to measure resilience. Internal consistency and construct validity were assessed by evaluating individual item characteristics as well as the association of CD-RISC score with symptoms of depression, anxiety and sleep disturbance. Exploratory factor analysis (EFA) was performed to test the factorial structure of the CD-RISC. The CD-RISC was found to have good internal consistency (Cronbach's alpha = 0.85). CD-RISC scores were positively associated with school attendance, financial hardship, and history of childhood abuse; scores were negatively associated with household dysfunction, depression, anxiety and poor sleep quality. The results of the EFA showed that the CD-RISC contained a two-factor solution, which accounted for 46% of the variance. Overall, these findings suggest that the Spanish-language version of the CD-RISC-10 is an adequate measure of resilience in this population. Further research is needed to incorporate culturally-specific constructs into resilience measures.

Preferences for life-sustaining treatment in Korean adults: a cross-sectional study

OBJECTIVES

Life-sustaining treatment is any treatment that serves to prolong life without reversing the underlying medical conditions, and includes cardiopulmonary resuscitation, mechanical ventilation, haemodialysis and left ventricular assist devices. This study aimed to investigate the thoughts on life-sustaining treatment of Koreans and to assess the factors associated with deciding to not receive life-sustaining treatment if they develop a terminal disease.

DESIGN

Cross-sectional study.

SETTING

Guro-gu centre for dementia from 1 May 2018 to 31 December 2019.

PARTICIPANTS

In total, 150 individuals participated in this study.

OUTCOME MEASURES

The questionnaire consisted of self-report items with some instructions, demographic characteristics, thoughts on life-sustaining treatment and psychosocial scales. The preferences of the participants were investigated on the assumption that they develop terminal cancer. The psychosocial scales included the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Connor-Davidson Resilience Scale and Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS

We classified our participants into two groups: individuals who wanted to receive life-sustaining treatment (IRLT) and individuals who wanted to not receive life-sustaining treatment (INLT). There were twice as many participants in the INLT group than there were in the IRLT. In making this decision, the INLT group focused more on physical and mental distress. Additionally, 32.7% of participants responded that terminal status was an optimal time for this decision, but more participants want to decide it earlier. The GAD-7 and PHQ-9 scores were significantly higher in the INLT group than in the IRLT group. However, the INLT group had significantly lower MSPSS family scores.

CONCLUSION

Our findings can help assess issues regarding advance directives and life-sustaining treatment, and will be a reference for designing future studies on this issue.

Factors Associated with the Quality of Life of Patients with Cancer Undergoing Radiotherapy

OBJECTIVE

Approximately half of patients with cancer have comorbidities, such as adjustment disorder, major depressive disorder, and delirium. Radiotherapy can cause psychological problems, e.g., the fear of treatment and its side effects, anxiety, depression, and social isolation. Health-related quality of life (QoL) must be determined to evaluate the effectiveness of cancer treatment. We analyzed the clinical, psychological, and sociodemographic factors influencing the QoL of patients with cancer who were undergoing radiotherapy.

METHODS

Twenty-six patients undergoing radiotherapy (10 male, 16 female) were included. Sociodemographic and clinical data were collected prior to radiotherapy. Psychosocial factors were assessed by self-reported questionnaires before, immediately after, and 3 months after radiotherapy. A multivariate regression analysis identified factors affecting QoL at each time point.

RESULTS

Patients' diagnoses were breast, cervical, prostate, endometrial, rectal, hypopharyngeal, laryngeal, liver, gallbladder, esophageal, ovarian, lung, and skin cancers. Before radiotherapy, better resilience was significantly associated with a higher QoL score (R2=0.199, p=0.033). Immediately after radiotherapy, financial difficulty was significantly associated with a lower QoL score (R2=0.274, p=0.010). Three months after radiotherapy, the presence of chronic disease (R2=0.398, p=0.002) and the severity of nausea and vomiting were significantly associated with a lower QoL score (R2=0.278, p=0.014).

CONCLUSION

Resilience, financial difficulty, the presence of chronic diseases, and the severity of nausea and vomiting significantly influenced the QoL of patients with cancer who were undergoing radiotherapy. Factors affecting QoL varied at each time point. Thus, patients with cancer should undergo regular mental health assessments, including assessments of QoL. Multidimensional (physical, psychological, and social) approaches and individualized time-based interventions are needed to improve the QoL of cancer patients undergoing radiotherapy.

Predictors of Resilience Among Parents of Children with Cancer: Cross-Sectional Study

Purpose

Resilience is an ability to overcome adversities in response to a potentially traumatic event. It relieves parents’ discomfort and builds personal capacity when facing a stressful situation like childhood cancer. Therefore, the study’s objective is to assess the magnitude of resilience and its predictors among the parents of children with cancer at Jimma medical center, Ethiopia, 2020.

Methods

The institutional-based cross-sectional design was employed on 126 parents of children with cancer at Jimma Medical Center. All study populations who attend the hospital from February 25 to April 25, 2020, and fulfill the inclusion criteria were included. Data were entered into Epi data version 4.6.0.2 and analyzed by SPSS version 25. Descriptive analysis was used to describe the study variables. Furthermore, linear regression analysis was calculated to assess predictors of resilience.

Results

The level of resilience among parents’ children with cancer were a mean scored 51.41±12.02. In this study, factors associated with resilience were receiving support from friends (β=5.67, 95% CI=1.58, 9.77; P=0.007), attend recreational activities (β=13.8, 95% CI=5.32, 22.37; P=0.03) and receiving health information from health care professionals (β=6.37; 95% CI= (1.75, 11.00), P=0.007), parents depression (β= −0.827, 95% CI= (−1.619,-0.034), P=0.041) and parents stress (β =−0.88,95% CI (−1.54,-0.23), P=0.031).

Conclusion

The magnitude of resilience among parents of children with cancer was low relative to other studies. Support from friends, attending recreational activities, and receiving health information from health care professionals were positively associated with resilience. In contrast, parents’ depression and stress were negatively associated with resilience.

Factors Influencing Formal and Informal Resource Utilization for Mental Distress Among Korean Americans in Southern California

Despite the high prevalence of mental distress in the Korean American (KA) community, KAs continue to have significantly lower rates of professional mental health utilization than the general U.S. population, making it increasingly critical to study factors related to such utilization. A total of 243 surveys were collected at Korean churches of various denominations in the greater Los Angeles area. This cross sectional study examined KAs' resource utilization using Andersen's Behavioral Model of Health Services Use as a multi-level theoretical framework. Level of education and employment status significantly predicted professional health service utilization. Informal resource utilization was significantly influenced by gender, attitudes toward professional mental health services, acculturation, and views of God and religion. Future studies should further explore which types of interventions or resources would be most effective for KAs to decrease their high levels of mental distress based on their unique intersections and cultural realities.

Comparison of subjective quality of life after endoscopic submucosal resection or surgery for early gastric cancer

Quality of life (QoL) has become an important issue after early gastric cancer (EGC) treatment. We aimed to compare the QoL of EGC survivors after ESD (n = 241) or laparoscopic subtotal gastrectomy (n = 241) without recurrence and to evaluate the QoL over the 5-year period after adjusting for various confounding factors related to QoL. QoL related to the gastric cancer subscale (GCS) was significantly higher in the ESD group than surgery group (p < 0.001). After adjusting for all possible confounding factors, survivors who underwent ESD still had higher QoL related to CSG than those who underwent surgery. On the analysis of interaction effects for all QoL subscales, higher QoL related to GCS of ESD group than those of surgery group has been kept over time (p = 0.983). Therefore, we concluded that EGC survivors who undergo ESD have significantly better QoL related to GCS over a 5-year period after treatment than those who undergo surgery. This may be a useful consideration when selecting treatment modalities for patients with EGC.

The Mediating Effect of Impulsivity on Resilience and Depressive Symptoms In Korean Conscripts

OBJECTIVE

Resilience and impulsivity have opposite effects on depression in stressful situations. This study aimed to investigate the association among resilience, impulsivity, and depression in young males.

METHODS

The participants consisted of 429 conscripts who underwent military training over 5 weeks. The surveys included the Connors- Davidson Resilience Scale-Korean version, the Barratt Impulsiveness Scale-11-Revised, and the Center for Epidemiological Studies- Depression Scale. The surveys were administered both before and after training.

RESULTS

When simultaneously considering impulsivity and resilience, resilience was not associated with depression. Impulsivity had a complete negative mediating effect on resilience and depressive symptoms. Impulsivity is a significant negative mediating factor for the protective effect of resilience on depression.

CONCLUSION

This study recommends considering impulsivity when evaluating the protective role of resilience against depression.

A Comparative Study of Burnout, Stress, and Resilience among Emotional Workers

OBJECTIVE

To investigate associations between stress, resilience, and burnout in three emotional job sectors.

METHODS

We conducted a multi-group comparative study using structural equation modeling and latent mean analysis. In total, 806 participants (403 call center consultants, 270 mental health workers, and 133 school counselors) completed self-administered questionnaires including the Perceived Stress Scale, Korean version of the Connor-Davidson Resilience Scale, and Maslach Burnout InventoryGeneral Survey.

RESULTS

Stress had significant direct effects on resilience and burnout, and resilience had significant direct effects on burnout in all groups. Resilience partially mediated these relationships among call center consultants and school counselors. Stress and burnout were highest in call center consultants, followed, in order, by mental health workers and school counselors. Resilience was highest in school counselors, followed, in order, by mental health workers and call center consultants. The effect size of the latent mean difference was highest for burnout, followed, in order, by resilience and stress. Psychiatry Investig.

CONCLUSION

Our findings suggest that stress caused by emotional labor can contribute to burnout. Interventions targeted at different sectors are needed to reduce burnout.

Temperament profile and its association with the vulnerability to smartphone addiction of medical students in Indonesia

Two dimensions of temperament, namely, (high levels of) novelty seeking and (low levels of) harm avoidance are related to substance addictions. However, their implications for smartphone addiction remain unexplored. Medical students are heavy smartphone users. Accordingly, screening for the risk of smartphone addiction based on individual differences in temperament can facilitate the identification of the best possible prevention strategy. Therefore, the present study aimed to examine the relationship between temperament and the vulnerability to smartphone addiction among medical students in Jakarta, Indonesia. The research study adopted a cross-sectional research design and used a simple random sampling technique. The Indonesian versions of the Temperament and Character Inventory and the Smartphone Addiction Scale were used to measure the study variables. Logistic regression analysis was conducted to examine the relationships between demographic factors, patterns of smartphone use, temperament, and vulnerability to smartphone addiction. A majority of the 185 participants were found to have the following temperament profile: low levels of novelty seeking and high levels of reward dependence and harm avoidance. The average duration of daily smartphone use was 7.83 hours (SD = 4.03) and the age at first smartphone use was 7.62 years (SD = 2.60). The respondents used smartphone to communicate with other people and access social media. A high level of harm avoidance was significantly associated with the risk of smartphone addiction (Odds Ratio [OR] = 2.04, 95% Confidence Interval [CI] = 1.12, 3.70). The findings suggest that smartphone addiction is comparable to other addictive behaviors. Further, harm avoidance increases the risk of smartphone addiction. Therefore, the risk of smartphone addiction among medical students must be ascertained based on their temperament profiles.

Connor-Davidson Resilience Scale: validation study in a Portuguese sample

OBJECTIVE

The objective of this paper was to evaluate the structural validity and convergent validity of the first Portuguese version of the Connor-Davidson Resilience Scale (CD-RISC).

SETTINGS

The data sets come from two studies conducted in Portugal, respectively, from the Resilience Effect in Coping with Trauma (RECT) project and from the Health Impact Assessment of Employment Strategies (HIAES) project.

PARTICIPANTS

The sample is composed of 476 participants from the RECT project and 405 participants from the HIAES project. In both projects, convenience samples were used.

MEASURES

The original CD-RISC items were translated to Portuguese and were used in a survey along with additional psychosocial and biomedical measures.

RESULTS

Independent exploratory factorial analysis (EFA) with each of the two samples revealed that the best solution in both samples had three factors consistent with the self-efficacy, spirituality and social support factors from the original scale. A Confirmatory factor analysis using the two samples together and specifying the three factors from the EFA revealed a good overall fit and, comparatively, better fit than a model specified with the five factors from the original scale. The study of the convergent validity revealed that bivariate correlations between the three factors and validated measures of stress, life satisfaction, mental health and physical health are globally consistent with previous research.

CONCLUSIONS

This study makes available to the broad Community of Portuguese Language Countries a validated measure of resilience extensively used for research and intervention. The results encourage future studies using this translated version of CD-RISC to explore further the three-factor structure found here and to test the convergent validity with new samples.

Less direct patient care delivered by medical trainees by the end of a hematology-oncology ward rotation: Association with empathy and related factors

OBJECTIVE

The education of trainee physicians in hematology-oncology is challenged by inherent stressors of hematology-oncology. Clinical work load, death and dying, and the known phenomenon of empathy decline during clinical education affect trainees. Time spent with patients or direct patient care time (DPCT) is influenced by many factors, which ultimately affect medical education. Therefore, DPCT may decrease by the end training on a busy hematology-oncology ward rotation.

METHODS

Internal medicine interns and residents (n = 64) rotating on a hematology-oncology ward rotation were consecutively selected to participate. Questionnaires containing Likert scale questions assessing time spent with patients before and after the rotation, empathy/resilience/distress measurements (Interpersonal Reactivity Index [IRI], Connors-Davidson Resilience Scale [CD-RISC], and Impact of Events Scale-Revised [IES-R], respectively), and demographic and situational information were collected at the beginning and end of the rotation RESULTS: DPCT decreased from over 10 to 15 minutes per patient to slightly over 1 to 5 minutes with over half of the trainees spending less than 1 minute per patient per day (P < .001, Cohen's d = 1.05). Empathy scores decreased 2.01 points from 58.9 to 56.8 (P = .018, Cohen's d = 0.33) during the rotation. DPCT decrease was associated mistreatment (P < .001) and lack of support (P = .001) while endorsing external issues (P = .002) and longer rotation time predicted for greater DPCT accounting for 67% of DPCT variance on multivariate analysis.

CONCLUSION

Medical trainees in oncology who feel a lack of social/familial support and feel mistreated by mentors/superiors spend significantly less time with patients. Educational initiatives should replicate and utilize these associations to enhance patient-centric care in oncology.

Resilience in Koreans With Cancer: Scoping Review

Cancer is a major cause of mortality and morbidity in Korea. However, there has been no previous nursing literature review on the phenomenon of resilience among cancer patients in Korea. The purpose of this study was to identify information about theories, instruments, correlates, and outcomes of resilience in the cancer experiences of Korean adults. This was a scoping review that searched Ovid MEDLINE, CINAHL, Google Scholar, DBpia, and the Korean Studies Information Service System between 2000 and 2016 in order to identify English and Korean research reports. The review yielded 17 quantitative studies, including 2 resilience theories and 6 resilience-specific instruments. The factors self-efficacy, hope, social supports, self-esteem, anxiety, and depression were associated with resilience, regardless of the type of cancer. Quality of life and coping were commonly investigated outcome variables for resilience. This review suggests that a nursing theory reflecting Korean culture and qualitative research concerning the phenomenon of resilience should be conducted as research priorities as the foundation for developing culturally appropriate tools for resilience. This will lead to enhanced quality of life among Korean cancer patients, which is the core of palliative nursing care.

Resilience and its Predictors among the Parents of Children with Cancer: A Descriptive-Correlational Study

Context:

As a common debilitating illness, cancer is among the leading causes of child mortality in developed and developing countries. Cancer diagnosis for children is considerably stressful for their parents. Resilience is a key factor behind effective coping with cancer-related problems. This study evaluated resilience and its predictors among the parents of children with cancer.

Aim:

This study evaluated resilience and its predictors among the parents of children with cancer.

Settings and Design:

This cross-sectional descriptive-analytical study was conducted in 2017 on 400 parents of children with cancer in Tabriz Children's Hospital, Iran.

Methods:

A demographic questionnaire and the Connor-Davidson Resilience Scale were used to collect the data. Parents were conveniently recruited from Tabriz Children's Hospital.

Statistical Analysis:

Data were analyzed using the SPSS for Windows program (v. 16) via descriptive and inferential statistical methods.

Results:

The mean score of parents’ resilience was 66.83 ± 14.28. Fathers obtained significantly higher resilience scores than mothers (P < 0.001). The predictors of parents’ resilience were financial status, parents’ gender, fathers’ employment status, and children's gender.

Conclusion:

The parents of cancer-afflicted children, particularly their mothers, have low resilience and therefore may be at risk for different physical and mental health problems. Health-care providers need to identify at-risk parents and provide them with greater psychological and educational support.

Greek Version of the Connor-Davidson Resilience Scale: Psychometric Properties in a Sample of 546 Subjects

BACKGROUND/AIM

To evaluate psychometric properties of the Connor and Davidson Resilience Scale (CD-RISC) in a Greek population.

MATERIALS AND METHODS

Internal consistency and test-retest reliability were measured. Global Assessment of Functioning Scale (GAF), World Health Organization Quality of Life (WHOQOL) questionnaire, Perceived Stress Scale (PSS) and General Health Questionnaire (GHQ) were used as measures for convergent reliability. Factors were extracted by using exploratory factor analysis (EFA). A total of 546 subjects (244 healthy individuals and 302 psychiatric patients) were recruited.

RESULTS

The scale showed excellent internal consistency (Cronbach's alpha=0.925), as well as excellent test-retest reliability (intra-class correlation coefficient=0.925). CD-RISC scores were positively correlated to GAF and WHOQOL scores, while being negatively correlated to PSS and GHQ scores, establishing adequate convergent validity. We decided on a model with four factors, in order to form sub-scales that measure different, but related aspects of resilience.

CONCLUSION

CD-RISC is a reliable and valid measure of resilience and can be used for clinical and research aims in the Greek population.

The relationship between morningness-eveningness and resilience in mood disorder patients

BACKGROUND

There is some evidence that resilience is related to mental illness. Patients with a mood disorder have a tendency to show eveningness, and they tend to be less resilient. However, no study has investigated the association between resilience and morningness-eveningness in patients with a mood disorder. The aim of this study was to explore whether morningness-eveningness is related to resilience in patients with a mood disorder.

METHODS

We recruited 224 patients with major depressive disorder (MDD), 77 with bipolar disorder (BD), and 958 control participants. Morningness-eveningness and resilience were evaluated using the Composite Scale of Morningness (CS) and the Connor-Davidson Resilience Scale (CD-RISC), respectively.

RESULTS

The CD-RISC scores were significantly lower in patients with MDD, followed by those with BD, than those of the control group. The CD-RISC score was positively correlated with the CS score in patients with MDD and BD. Multiple linear regression analyses revealed that the CS score was significantly associated with the CD-RISC score after controlling for the possible influence of age, gender, length of education, economic status, onset age, and suicide attempt history in the MDD group. However, the association did not reach statistical significance in patients with BD.

CONCLUSIONS

Higher resilience was positively correlated with morningness in patients with MDD or BD. In multiple regression analysis, a significant linear relationship was observed between resilience and morningness only in patients with MDD. The biological mechanism underlying the relationship between morningness-eveningness and resilience should be explored.

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC. The sample had high pain catastrophizing (≥30 points; 66%), moderate-severe insomnia (≥15 points; 63%), low resilience (68 points), and high suicidal ideation (67%). OrCC patients had greater pain interference (85.18% vs. 58.28%, p = 0.017) and lower satisfaction with the LtOT (56.4% vs. 78.3%, p = 0.002). In multivariable analysis, alcohol abuse (OR = 6.84, p = 0.001), prescription drugs abuse (OR = 19.32, p = 0.016), functional pain (OR = 12.96, p < 0.001), head and neck pain (OR = 2.48, p = 0.039), MEDD (morphine equivalent daily dose) ≥ 200 mg/day (OR = 3.48, p = 0.006), and ongoing litigation (OR = 2.33, p = 0.047) were significant predictors of OrCC. In conclusion, the break-out of OrCC in CNCP in South Korea was comparable to those in countries with high opioid consumption, such as the United States, regardless of the country's opioid consumption rate.

Are alexithymia and empathy predicting factors of the resilience of medical residents in France?

OBJECTIVES

To explore resilience, resilience predicting factors and resilience distribution in French medical residents.

METHODS

A cross-sectional study was conducted in which general practice residents (n = 380) were asked to answer the Jefferson Scale of Physician Empathy, the Connor-Davidson Resilience Scale, and the Toronto Alexithymia Scale. One hundred thirty-seven (137) responses were collected. The scores of the different scales have been calculated. The score differences were examined using the Student's t-test or analysis of variance. The correlations were estimated using the Pearson correlation coefficient. The relationships between scores were analysed by multiple linear regression. The heterogeneity of the sample was examined by non-hierarchical cluster analysis.

RESULTS

Resilience and empathy were positively correlated (r(135) = .36, p< .001). Alexithymia was negatively correlated with resilience, r(135) = -.40,p<.001, and empathy, r(135) = -.38, p<.001. Resilience was influenced by alexithymia, b = -.284, p = .001, empathy, b= .255, p = .002, gender (female < male), b = -.231, p = .002 and year of formation, β= .157, p = .036. Two clusters of residents were characterized. They differed by their empathy and resilience profiles and by alexithymia trait.

CONCLUSIONS

Alexithymia, empathy, gender and year of formation correspond to predicting factors of resilience. This suggests that the resilience of vulnerable residents can be enhanced by increasing their empathy and by reducing their alexithymia. Thus, teaching teams could sustain their students' well-being through educational programs aiming to develop their understanding of their own emotions and those of their patients.

Mediating Effect of Resilience on the Association between Emotional Neglect and Depressive Symptoms

OBJECTIVE

Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms.

METHODS

A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression.

RESULTS

Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps<0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms.

CONCLUSION

Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment.

Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS

PURPOSE

Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health.

METHODS

The sample included 367 youth aged 10-17 in rural Rwanda. An earlier qualitative study of the same population identified the constructs "kwihangana" (patience/perseverance) and "kwigirira ikizere" (self-esteem) as capturing local perceptions of individual-level characteristics that helped reduce risks of mental health problems in youth. Nine items from the locally derived constructs were combined with 25 items from an existing scale that aligned well with local constructs-the Connor-Davidson Resilience Scale (CD-RISC). We assessed the factor structure of the CD-RISC expanded scale using exploratory factor analysis and determined the correlation of the expanded CD-RISC with depression and functional impairment.

RESULTS

The CD-RISC expanded scale displayed high internal consistency (α = 0.93). Six factors emerged, which we labeled: perseverance, adaptability, strength/sociability, active engagement, self-assuredness, and sense of self-worth. Protective factor scale scores were significantly and inversely correlated with depression and functional impairment (r = -0.49 and r = - 0.38, respectively).

CONCLUSIONS

An adapted scale displayed solid psychometric properties for measuring protective factors in Rwandan youth. Identifying culturally appropriate protective factors is a key component of research associated with the prevention of mental health problems and critical to the development of cross-cultural strength-based interventions for children and families.

Adolescent perceptions of resiliencepromoting resources: the South African Pathways to Resilience Study

Resilience, or being well-adjusted despite facing adversity that predicts negative life outcomes, is a process that is scaffolded by resilience-enabling supports. How well resilience-enabling resources support positive adjustment depends, in part, on adolescents’ perceptions of the availability and usefulness of such resources. Currently, there is limited quantitative, generalisable evidence of the aforementioned. Accordingly, the purpose of this study was to document how two groups of Sesotho-speaking adolescents perceived available social-ecological resources and how significantly varied perceptions related to these adolescents’ use of formal supports. The advisory panel to the Pathways to Resilience Study clustered participating adolescents into a resilient group ( n = 221) and vulnerable, or service-using, group ( n = 186). In comparison with the service-using adolescents, resilient adolescents reported significantly higher perceptions of physical and psychological caregiving. Analyses of variance revealed that higher perceptions of caregiving were associated with higher voluntary and lower mandatory service usage. We concluded that relationship-building was a crucial resilience mechanism and would, therefore, encourage psychologists to both prioritise and facilitate caregiving.

Factor structure and psychometric evaluation of the Connor-Davidson resilience scale in a new employee population of China

BACKGROUND

In order to find a suitable instrument to evaluate psychological resilience in Chinese new employee population, we intended to propose a possible factorial structure of Connor-Davidson Resilience Scale (CD-RISC). Furthermore, we administered to explore its reliability and validity in the present population.

METHODS

Participants were derived from the male new employees who had started working in the last 2-3 months from 12 machinery factories across 8 different provinces of China. Chinese version of CD-RISC was used to assess the resilience of the study participants. Exploratory factor analysis (EFA) was conducted to assess the possible factor structure, and confirmatory factor analysis (CFA) was used to determine which factor structure was the most suitable among the present study sample.

RESULTS

The present 4-factor model (tolerance for stress, tenacity, and goal orientation; adaptability and acceptance of change; optimism and sense of security; and trust in one's instinct) of CD-RISC showed good internal consistency, concurrent validity and consistent structure validity, and had presented better data fit than the original 5-factor and the Chinese 3-factor patterns. Each of the present 4-factor structure and the total score of CD-RISC were negatively and significantly associated with Global Severity Index T score and Personality Diagnostic Questionnaire-4+ score.

CONCLUSIONS

The measure of resilience is useful in screening high-risk employees who are vulnerable to stress. Optimal and tailored interventions can be further applied to avoid potential adverse events in this population. Longitudinal research should be required to determine whether aging and long-term health events can change the nature of resilience.

Effects of resilience on quality of life in patients with bipolar disorder

BACKGROUND

Few studies have examined the effects of resilience on quality of life (QOL) in patients with bipolar disorder (BD). Therefore, this study investigated the association between resilience and QOL in patients with BD and compared it to the relationship between resilience and QOL in healthy individuals.

METHODS

Participants were 68 euthymic patients with BD and 68 age-, sex-, and length of education-matched controls. Sociodemographic characteristics and clinical variables of the two groups were obtained using face-to-face interviews, and all participants completed the Connor-Davidson Resilience Scale, the World Health Organization QOL-Brief Form.

RESULTS

The QOL of the BD group was significantly impaired compared with that of the controls. Degree of resilience, number of depressive episodes, Clinical Global Impression scores, degree of impulsivity, and length of education were significantly correlated with QOL in the BD group. Resilience was significantly associated with overall QOL, physical subdomains of QOL, psychological subdomains of QOL, social subdomains of QOL, and environmental subdomains of QOL in the BD group, even after controlling for confounders. In the control group, resilience was significantly associated with overall QOL, the physical subdomains of QOL, psychological subdomains of QOL, and social subdomains of QOL.

LIMITATIONS

The number of participants in each group was 68, which is a relatively small sample size.

CONCLUSIONS

Resilience in patients with BD was independently and positively correlated with various areas of QOL. Various strategies to reinforce resilience in patients with BD are needed to improve the low QOL in this population.

Factor structure and psychometric properties of the Connor-Davidson resilience scale among Brazilian adult patients

CONTEXT AND OBJECTIVE

Personal resilience is associated with several mental health outcomes. The Connor-Davidson resilience scale (CD-RISC) is a widely used self-report measurement of resilience. This study aimed to investigate the reliability and validity of a Brazilian Portuguese version of the CD-RISC.

DESIGN AND SETTING

Cross-sectional validation study carried out in the outpatient clinics of a public university hospital.

METHODS

The cross-cultural adaptation followed established guidelines and involved interviews with 65 adults in psychiatric and non-psychiatric outpatient clinics at a teaching hospital. Validation was assessed through concurrent application of the Lipp Brazilian Stress Symptom Inventory (ISSL), Self-Report Questionnaire (SRQ), Sheehan Disability Scales (SDS) and Chronic Pain Grade (CPG) to 575 patients at the same setting. Temporal stability was verified through a second application to 123 participants.

RESULTS

Factor analysis identified four factors, named tenacity, adaptability-tolerance, reliance on support from outside and intuition. The alpha coefficient of 0.93 and intraclass correlation coefficient of 0.84 indicated good internal consistency and temporal stability. Significant correlations between this version of the CD-RISC and the ISSL, SRQ, SDS and CPG were noted. The patients at the outpatient clinic for borderline personality had resilience scores that were significantly lower than those of the patients at the general anxiety or post-traumatic stress outpatient clinics.

CONCLUSION

This Brazilian Portuguese version of the Connor-Davidson resilience scale exhibited adequate reliability and validity among a sample of Brazilian adult patients.