Resilience as a Psychopathological Construct for Psychiatric Disorders

Caregiver-reported emotional-behavioral symptoms in Spanish youth during the COVID-19 pandemic: a longitudinal study

BACKGROUND

COVID-19 pandemic stressors affected youth's mental health. This longitudinal study aims to explore these effects while considering predictive factors such as age and sex.

METHODS

An initial sample of 1502 caregivers answered a longitudinal survey evaluating their youths' (4-17 years of age) emotional/behavioral symptoms using the Pediatric Symptom Checklist (PSC) screening tool. First assessment in May-July 2020 included the prior year's retrospective (TR) and since-lockdown-start (T0) PSC, followed by monthly evaluations until February 2021.

RESULTS

A positive screening PSC (PSC+) was reported in 13.09% of cases at TR and 35.01% at T0, but the likelihood of PSC+ quickly decreased over time. At T0, a more pronounced impact was found on children (39.7%) compared to adolescents (25.4%); male children exhibited higher risk for a PSC+ at T0 and longitudinally than females. Adolescents presented a weaker effect of time-improvement. PSC+ at TR, experienced stressors, and caregiver's stress/depressive symptoms positively predicted PSC+ at T0 and longitudinally; adolescents' unproductive coping style predicted PSC+ at T0. CONCLUSION: The study shows a caregiver-reported increase in emotional/behavioral symptoms in youths during the COVID-19 pandemic, affecting predominantly younger children in the early stages and showing gradual improvement over time, albeit possibly slower in adolescents.

IMPACT

The results show the anticipated surge in emotional and behavioral symptoms during the COVID-19 lockdown in youth reported by caregivers, followed by subsequent amelioration. Of greater significance, the study reveals a heightened impact on young children initially, yet it suggests a slower improvement trajectory in adolescents. The study also identifies risk factors linked to emotional and behavioral symptoms within each age group. Alongside the longitudinal approach, the authors underscore the remarkable inclusion of a significant representation of young children, an unusual feature in such surveys.

Clinical and psychological factors associated with resilience in patients with schizophrenia: data from the Italian network for research on psychoses using machine learning

BACKGROUND

Resilience is defined as the ability to modify thoughts to cope with stressful events. Patients with schizophrenia (SCZ) having higher resilience (HR) levels show less severe symptoms and better real-life functioning. However, the clinical factors contributing to determine resilience levels in patients remain unclear. Thus, based on psychological, historical, clinical and environmental variables, we built a supervised machine learning algorithm to classify patients with HR or lower resilience (LR).

METHODS

SCZ from the Italian Network for Research on Psychoses (N = 598 in the Discovery sample, N = 298 in the Validation sample) underwent historical, clinical, psychological, environmental and resilience assessments. A Support Vector Machine algorithm (based on 85 variables extracted from the above-mentioned assessments) was built in the Discovery sample, and replicated in the Validation sample, to classify between HR and LR patients, within a nested, Leave-Site-Out Cross-Validation framework. We then investigated whether algorithm decision scores were associated with the cognitive and clinical characteristics of patients.

RESULTS

The algorithm classified patients as HR or LR with a Balanced Accuracy of 74.5% (p < 0.0001) in the Discovery sample, and 80.2% in the Validation sample. Higher self-esteem, larger social network and use of adaptive coping strategies were the variables most frequently chosen by the algorithm to generate decisions. Correlations between algorithm decision scores, socio-cognitive abilities, and symptom severity were significant (pFDR < 0.05).

CONCLUSIONS

We identified an accurate, meaningful and generalizable clinical-psychological signature associated with resilience in SCZ. This study delivers relevant information regarding psychological and clinical factors that non-pharmacological interventions could target in schizophrenia.

Psychoendocrinology: arginine vasopressin and resilience in patients with major depressive disorder

BACKGROUND

There is a burgeoning body of evidence suggesting that arginine vasopressin (AVP) acts as a neuromodulator of the stress response. AVP stimulates the release of adrenocorticotropic hormone, synergistic to corticotropin-releasing hormone, which might explain AVP's role in resilience. Personal hardiness is the bedrock of resilience. Numerous studies have demonstrated elevated plasma levels of AVP in patients with major depressive disorder (MDD), suggesting an etiopathogenetic role as well as a novel therapeutic target.

OBJECTIVE

The aim of this study was to examine the relationship between AVP and resilience in patients with MDD and to determine AVP levels in serum of patients with MDD.

METHODS

Forty patients with MDD and 40 healthy control subjects were studied using the Dispositional Resilience (Hardiness) Scale by Barton, the Quality of Life Scale, the Social Readjustment Rating Scale, and the Beck Depression Inventory. Biochemical analysis of plasma levels of AVP, using the enzyme-linked immunosorbent assay (ELISA), was performed for all participants.

RESULTS

Levels of AVP were statistically significantly elevated in patients with MDD compared with healthy controls. Psychological hardiness was decreased in patients with MDD compared with healthy controls, a finding also statistically significant. There was a negative correlation between plasma AVP level and psychological hardiness.

CONCLUSION

AVP and psychological hardiness are negatively correlated, reflecting lower stress resilience. AVP levels are indeed higher in patients struggling with MDD.

Integrative review of the recent literature on human resilience: From concepts, theories, and discussions towards a complex understanding

Resilience may be viewed as the capacity of an individual, or perhaps of a dynamic system, to adjust and adapt positively to adversities and disruptions that impact one’s functioning and development. Yet a common statement in the literature is that there are still today numerous ways of defining and conceiving resilience. This multiplicity of approaches calls for clarification and generates a need of common theoretical ground. Therefore, this review aims to examine, to clarify and to synthesize how “human” resilience is conceptualized within the recent human sciences literature to help answer the question: ‘What are the key approaches, concepts, and definitions of resilience?”. Following Whittemore and Knafl (2005, https://doi.org/10.1111/j.1365-2648.2005.03621.x) methods, an integrative review of the recent resilience literature (2013–2019) was undertaken. Four databases were used for the search: PsycINFO, PubMed, ERIC, Google Scholar. A reference and citation tracking was then performed on the papers identified. Sixty-nine papers passed all the stages (identification, screening, eligibility, inclusion) and formed the sample. Results show that resilience definitions are nowadays either about “adapting and bouncing back to previous levels of health” or about “thriving and rising above the adversity towards increased levels of health.” Results also show that resilience features—antecedents, mechanisms, consequences—are mainly conceptualized in a vertical sequence where an antecedent influences another or influences a mechanism leading to consequences. This paper concludes that modern conceptions can fit within a transactional and constructivist approach that goes beyond the former approaches by providing a more nuanced and realistic picture of the resilience process and by viewing it as a dynamic and person-situation-defined process.

Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults

INTRODUCTION

The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic.

METHODS

Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393).

RESULTS

Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience.

CONCLUSIONS

Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.