Measuring protective factors: the development of two resilience scales in Norway

Measuring Resilience in Long-term Sick-listed Individuals: Validation of the Resilience Scale for Adults

Return to work from long-term sick leave is influenced by personal and social factors, which can be measured by resilience, a construct that describe healthy adaptation against adversity. This study aimed to validate the validity and psychometric properties of the resilience scale for adults in a sample of long-term sick-listed individuals, and to investigate measurement invariance when compared with a university student sample. Confirmatory factor analysis was used on a sick-listed sample (n = 687) to identify the scale?s factor structure, and comparison with a university student sample (n = 241) was utilized to determine measurement invariance. Results show that a slightly modified factor structure, in accordance with previous research, achieved acceptable fit in the sick-listed sample, while comparisons with the student sample supported measurement invariance. This means that the study to a large degree support the factor structure of the resilience scale for adults in long-term sick-listed. Furthermore, the results indicate that the scale is similarly understood among long-term sick-listed as in a previously validated student sample. Thus, the resilience scale for adults can be a valid and reliable measure of protective factors in the long-term sickness absence and return to work context, and the subscale and total score can be interpreted similarly in long-term sick-listed as in other populations.

Validation of the Arabic version of the resilience scale for adolescents (READ)

INTRODUCTION

Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic-speaking adolescents aged 13-18 years.

METHODS

A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13).

RESULTS

Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ.

CONCLUSION

Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events.

Psychometric Properties of the Resilience Scale for Adolescents (READ) and Measurement Invariance Across Two Different German-Speaking Samples

The Resilience Scale for Adolescents (READ) is a highly rated scale for measuring protective factors of resilience. Even though the READ has been validated in several different cultural samples, no studies have validated the READ across samples in German from Switzerland and Germany. The purpose of this study was to explore the construct validity of the German READ version in two samples from two different countries and to test the measurement invariance between those two samples. A German sample (n = 321, M = 12.74, SD = 0.77) and a German-speaking Swiss sample (n = 349, M = 12.67, SD = 0.69) of seventh graders completed the READ, Hopkins Symptom Checklist (HSCL-25), Rosenberg Self-Esteem Scale (RSE), General Self-Efficacy Scale, and Satisfaction with Life Scale (SWL). The expected negative correlations between READ and HSCL-25 and the positive correlations between RSE, self-efficacy, and SWL were supported. Furthermore, the results of the measurement invariance demonstrated that the originally proposed five-dimensional structure is equal in the German and Swiss samples, and it can be assumed that the same construct was assessed by excluding one item. The five-factor, 27-item solution is a valid and reliable self-report measure of protective factors between two German-speaking samples.

Do Childhood Boarding School Experiences Predict Health, Well-Being and Disability Pension in Adults? A SAMINOR Study

Indigenous Sámi and Kven minority children in Norway were during the 20th century placed at boarding schools to hasten their adoption of the Norwegian majority language and culture. This is the first population-based study examining health, well-being and disability pension rates among these children. Data stem from two epidemiological studies conducted in 2003/04 (SAMINOR 1) and 2012 (SAMINOR 2) by the Centre for Sami Health Research. The SAMINOR 1 study included N = 13,974 residents (50.1% women, Mage = 52.9 years) and n = 2,125 boarding participants (49.6% women, Mage = 56.2 years). The SAMINOR 2 part included N = 10,512 residents (55.5% women, Mage = 47.6 years) and n = 1246 boarding participants (48.7% women, Mage = 54.1 years). Main outcome measures are mental and general health, well-being and disability pension linearly regressed upon the predictors. We observed minor differences between boarding and non-boarding participants that generally disfavored the former, of which many disappeared after covariate adjustment. Boarding school participants reported more discrimination, violence, unhealthier lifestyle behavior (smoking), less education and household income compared to non-boarding participants. The exceptionally long timeframe between boarding school and the current outcome measures (40–50 years) is a likely reason for the weak associations. The study supports the international literature on health inequalities and highlights the risk of ill health following boarding school placement of indigenous or minority children. On a positive note, participants reporting stronger ethnic belonging (strong Sámi identity) were well protected, and even functioned better in terms of lower disability rates than majority Norwegians.

Resilience Moderates Negative Outcome from Stress during the COVID-19 Pandemic: A Moderated-Mediation Approach

Resilience refers to an individual’s healthy coping abilities when encountering adverse life events. The COVID-19 pandemic represents a situation with a high amount of stress exposure, which in turn may be associated with negative emotional outcome like depressive symptoms. The current study investigated if resilience moderated the effect of stress on symptoms of depression and if anxiety symptoms mediated this association. An adult sample of community controls completed the Perceived stress scale 14 (PSS-14), the Resilience scale for adults (RSA), the Patient health questionnaire 9 (PHQ-9) and the Generalized anxiety disorder 7 (GAD-7). Independent samples t-test, correlation analyses and moderated mediation analyses were conducted. The results showed that resilience moderated the relations between stress and anxiety symptoms (β = −0.131, p < 0.001) as well as between stress and depressive symptoms (β = −0.068, p < 0.05). In support of a moderated mediation model, resilience moderated the indirect effect of stress on depressive symptom, as confirmed by the index of moderated mediation (IMM = −0.036, p < 0.001; [95% BCa: −0.055, −0.020]). The high resilience subgroup was less affected than the low resilience subgroup by the effect of stress exposure symptoms of depression, mediated by anxiety. The study shows that stress exposure is associated with symptoms of depression, and anxiety mediates this association. Level of resilience differentiates the direct and indirect effect of stress on depression. Knowledge about the effect of stress in response to a pandemic is important for developing treatment and prevention strategies for stress, depression and health-related anxiety.

Protective and Vulnerability Factors in Self-Esteem: The Role of Metacognitions, Brooding, and Resilience

The aim of the current study was to explore protective (resilience) and vulnerability factors (dysfunctional metacognitions and brooding) for self-esteem. A total of 725 participants were included in a cross-sectional study. A path analysis revealed five paths to self-esteem. The three main paths were as follows: (1) symptoms −> metacognitions −> brooding −> self-esteem, (2) symptoms −> resilience −> self-esteem, and (3) a direct path from symptoms. The first path corresponds with the metacognitive model of psychopathology and suggests that triggers in the form of anxiety and depression symptoms lead to the activation of metacognitive beliefs, which in turn activates brooding in response to these triggers. When a person engages in brooding, this makes the person vulnerable to experiencing low self-esteem. The second path suggests a protective role of resilience factors. The overall model explained 55% of the variance in self-esteem. Regression analysis found that unique predictors of self-esteem were female sex, symptoms of anxiety and depression, brooding, and resilience. These findings have possible clinical implications, as treatment may benefit from addressing both protective and vulnerability factors in individuals suffering from low self-esteem.

Validierung einer deutschen Version der Resilience Scale for Adults (RSA)

Zusammenfassung. Bislang war im deutschen Sprachraum kein Fragebogen vorhanden, der den multifaktoriellen Konstrukteigenschaften der Resilienz gerecht wird. Ziel der vorliegenden Untersuchung war es daher, eine deutsche Version eines multifaktoriellen, personelle, familiäre und soziale Schutzfaktoren abbildenden Selbstauskunftsfragebogens, der Resilience Scale for Adults (RSA) zu validieren. Hierzu wurde eine internetbasierte Querschnittsuntersuchung an einer nicht-klinischen Stichprobe ( N = 524) durchgeführt. Ergänzend wurde explorativ eine klinische Stichprobe von Patientinnen und Patienten mit einer ersten depressiven Episode ( N = 69) mit der RSA untersucht. Eine konfirmatorische Faktorenanalyse bestätigte eine akzeptable Passung des postulierten Sechs-Faktoren-Modells. Die internen Konsistenzen der Subskalen und der Gesamtskala RSA waren moderat bis hoch einzuschätzen, eine Ausnahme bildete hierbei die Subskala Strukturiertheit. Signifikant positive sowie negative Korrelationen mit Fragebögen zur wahrgenommenen Resilienz, sozialen Unterstützung und Beeinträchtigung durch Symptombelastungen belegten die Konstruktvalidität. Die Probanden der nicht-klinischen Stichprobe erreichten im Vergleich zur klinischen Stichprobe in allen RSA Subskalen sowie dem Gesamtskalenwert signifikant bessere Summenwerte. Mit der untersuchten Version der RSA steht dem deutschsprachigen Raum erstmals ein reliables und valides Instrument zur Verfügung, das auf ökonomische Weise eine multifaktorielle Erfassung des individuellen Schutzfaktorenrepertoires und damit der potentiellen psychischen Resilienz gegenüber widrigen Lebensumständen ermöglicht.

Polish Version of the Resilience Scale (RS-14): A Validity and Reliability Study in Three Samples

There has been a need for an instrument which not only can adequately evaluate trait-like resilience, but also can be applied to Polish adolescents and young adults. The purpose of this study was to validate the Resilience Scale RS-14 (Wagnild, 2009a,b). We aimed to examine and assess the psychometric properties of the Polish version in three different samples. The first sample was made up of adolescents aged 13–17 (N = 400).The second sample was made up of a problem group aged 13–18 (N = 656) who had special needs and attended either Probation Centers, Youth Sociotherapy Centers, or Youth Educational Centers. The third sample was made up of students in early adulthood aged 19–27 (N = 1,659). Exploratory and confirmatory factor-analytic methods were employed. CFA demonstrated a good fit of the factor structure in all three samples. The original one-dimensional structure of the RS short form was confirmed. All items loaded (>0.40) onto 1 factor, indicating cohesive structure for a 1-factor model explaining 35.02% of the variance in the whole sample, 34.62% in the young adolescent sample, 31.11% in the problem sample, and 38.51% in the early adulthood sample. Descriptive statistics, reliability (young adolescence α = 0.85, problem sampleα = 0.82 early adulthood α = 0.87) and validity data were calculated; test-retest showed good stability [r₍₄₀₎ = 0.88; p < 0.001]. The validity of the scale RS-14 was applied in two groups (the N = 382 early adulthood aged 19–27, and the N = 120 problem group aged 13–18) and was subsequently evaluated. The RS-14 correlated significantly, as expected, with measures of positive concepts (satisfaction with life). Results showed that resilience was negatively related with indexes of perceived stress and the dimension-of-depression. Findings support the RS-14 to be a valid and useful instrument for assessing resilience in diverse Polish adolescent groups, including those with special needs and those in early adulthood.

Promotion of Wellbeing for Children of Parents With Mental Illness: A Model Protocol for Research and Intervention

Background: The main objective of this project is to create a research and intervention model to promote large-scale implementation and evaluations of generic very brief interventions for children of parents with mental disorders (COPMI). Feasible interventions for COPMI aged 0-18 years are highly needed, as this is a large high-risk group in society. Reducing behavioral problems and enhancing wellbeing for families with parents affected by any mental disorder are important preventive initiatives. One key prevention strategy is to reduce the risk and expression of psychopathology in children and to promote wellbeing. The present model protocol offers an intervention for children of parents with mental disorders internationally based on a model already implemented in the Netherlands and Norway. Methods: Participants will be parents receiving treatment in mental health services in participating countries and their minor children aged 6-18 years. Participants should be randomized into an intervention group or control group. Data should be retrieved from electronic patient journals (demographics, DSM 5/ICD-10, SCID, MINI) as well as from assessment measures administered at baseline and follow-up, including the KIDSCREEN-27, Strengths and Difficulties Questionnaire (SDQ), Parents' Evaluations of Developmental Status (PEDS), Parenting Sense of Competence (PSOC), Resilience Scale for Adolescence (READ), Guilt and Shame Questionnaire for Adolescents of Parents with Mental Illness (GSQ-APMI), Mental Health Literacy Scale, and Parent-Child Communication Scale. Results: The hypothesis is that there will be improvements of child behavioral and emotional problems, and outcomes in the project will be reported in terms of parent´s diagnosis, child behavioral and emotional problems, child wellbeing, family communication and functioning, as well as participants' satisfaction. Discussion: This multi-site international protocol will focus the attention of European scientific and policy makers toward COPMI. This young segment of the population is presently almost completely neglected in most European health policies, despite having a large burden of disability and being at risk of transgenerational transmission of psychopathology. We will further discuss the feasibility of a very brief intervention aiming at preventing mental disorders in young people.

Factors promoting resilience among breast cancer patients: a qualitative study

OBJECTIVE

The purpose of this study was to investigate resilience factors that helped Chinese breast cancer patients adapt to the trauma in the traditional Chinese cultural context.

METHOD

Checklist-guided in-depth interviews were conducted on 15 Chinese breast cancer patients recruited from two affiliated teaching hospitals. All had adapted to the illness successfully. All interviews were guided by checklist-guided interview guidelines based on the social ecosystem theory. They were recorded digitally and transcribed verbatim. Data analysis was performed using published content analysis approach.

FINDINGS

The main themes found to be relevant included hope for rehabilitation, hardiness, confidence in situation, optimistic attitude to the disease, gratitude to supporters, mastery of life. Each level of these individual resource interacted with each other, which was consistent with the micro system of social ecosystem theory.

CONCLUSION

This study showed that individual resource played a significant role in helping the Chinese breast cancer patients deal with the illness. There is a clear need to develop a comprehensive evaluation system to help clinical nurses assess patients' individual resource and promote better adaption to breast cancer.

Psychometric properties of the Resilience Scale for Adults (RSA) and its relationship with life-stress, anxiety and depression in a Hispanic Latin-American community sample

Resilience is a multi-dimensional construct associated with health and well-being. At present, we do not yet have a valid, scientific instrument that is designed to evaluate adult resilience in Spanish-speaking countries and that accounts for family, social and individual components. This study aimed at investigating the construct and cross-cultural validity of the Resilience Scale for Adults (RSA) by combining Confirmatory Factor Analysis (CFA), Multidimensional Scaling (MDS) and Hierarchical Regression models in a Hispanic Latin-American group. A community sample of 805 adults answered the RSA, Spanish Language Stressful Life-Events checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). First-order CFA verified the six factors structure for the RSA (RMSEA = .037, SRMR = .047, CFI = .91, TLI = .90). Five RSA scales and total score have good internal consistency (scales α > .70; total score α = .90). Two second-order CFA verified the intrapersonal and interpersonal dimensions of the protector factors of resilience, as well as their commonality and uniqueness with affective symptoms (anxiety and depression). An exploratory MDS reproduced the relations of RSA items and factors at first and second-order levels against random simulated data, thereby providing initial evidence of its cross-cultural validity in a Spanish-speaking group. The Four-steps hierarchical model showed that the RSA scales are the strongest predictors of anxiety and depression–greater than gender, age, education and stressful life-events. Three RSA scales are significant unique predictors of affective symptoms. In addition, similar to findings in diverse cultural settings, resilience is positively associated with age but not with education. Women report higher scores of Social Resources and Social Competence and lower scores of Perception of the Self. In conclusion, this study demonstrates the construct and criterion-related validity of the RSA in broad, diverse and Spanish speaking sample.

Resilience or hope? Incremental and convergent validity of the resilience scale for adults (RSA) and the Herth hope scale (HHS) in the prediction of anxiety and depression

BACKGROUND

Hope and resilience protect against inner vulnerabilities or harsh life circumstances; they explain individual differences in physical or mental health outcomes under high stress. They have been studied in complementary or competing theoretical frameworks; therefore, the study of measures of hope and resilience should be undertaken prior to explore if they are truly value-added for research. This study investigates the convergent and incremental validity of the Resilience Scale for Adults (RSA) and the Herth Hope Scale (HHS), in the prediction of anxiety and depression (HSCL-25).

METHODS

Participants in this community-based sample are 762 adults from 18 to 74 years old. They answered the RSA, HHS, Spanish Language Stressful Life-Events Checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). Incremental validity analyses combined hierarchical regression and structural equation models (SEM). First, hierarchical regression models were compared based on three criteria (R 2Diff., ΔF, and semi-partial r), then the direct effect of resilience on affective symptoms was compared with the mediated effect of resilience on affective symptoms through hope.

RESULTS

The hierarchical models showed that (1) hope and resilience account significantly for the variance of affective symptoms above age, sex, and life-stress; (2) Resilience Total score has greater incremental validity than positive scales of HHS Hope; and (3) RSA Total score, HHS Optimism/Spiritual support, Stressful life-events and sex are unique predictors of affective symptoms. The SEM analyses verified a stronger direct effect of resilience in the prediction of affective symptoms above the significant partial mediated effect of resilience through hope. Additionally, results show that age and better educational opportunities were associated with protection (i.e. resilience and hope) and emotional well-being (i.e. affective symptoms and hopelessness). Women showed higher scores in social competences and resources (RSA), interconnectedness and initiative to take action (HHS). However, they have poorer evaluations of own abilities and efficacy (RSA), and higher scores in all the affective symptoms assessed.

CONCLUSION

The RSA has incremental validity above the HHS, however, both the RSA and the HHS are effective, differentiated and complementary measures of protection that are of high relevance for research on psychosocial and emotional well-being.

Validation of the Resilience Scale for Adolescents in Norwegian adolescents 13-18 years

AIM

Resilience is seen as a vital resource for coping and mental health in adolescents. However, there is no universally accepted theory or definition of resilience, leading to considerable challenges regarding how to operationalise and measure this construct. The study aimed at providing further knowledge of the psychometric properties (dimensionality, construct validity and internal consistency) of the 28-item version of the Resilience Scale for Adolescents (READ) in N = 1183 Norwegian adolescents, 13-18 years old.

METHODS

Dimensionality of READ was tested using confirmatory factor analysis (CFA). Convergent validity and reliability were tested using Pearson's correlation analysis, Cronbach's alpha and composite reliability.

RESULTS

The CFA supported a modified, 20-item, five-factor structure with high reliability, supporting the dimensionality and internal consistency of the instrument. Convergent validity was confirmed where all factors correlated in expected directions with measures of sense of coherence, self-esteem, stress and depression.

CONCLUSION

The psychometric properties of the READ need to be further evaluated in adolescents; however, the results indicate that a modified 20-item version of READ is adequate for assessing resilience in the present sample of Norwegian adolescents.

Validation of the Resilience Scale for Adolescents (READ) in Ireland: a multi-group analysis

Resilience is a process reflecting positive adaptation in the face of adversity. The Resilience Scale for Adolescence (READ) incorporates intrapersonal and interpersonal protective factors mapping onto the three salient domains of resilience, including individual, family and external environment. This study investigated the validity and reliability of the READ by means of factor analysis, multi-group analysis, inter-correlations and internal consistency measures. Participants were 6085 young people in Ireland aged 12-18 years. Participants completed the My World Survey - Second Level (MWS-SL), assessing risk and protective factors of mental health. Confirmatory factor analysis validated the original five-factor structure of the READ including Personal Competence, Social Competence, Structured Style, Family Cohesion, and Social Resources, χ² (340) = 6146.02, p < 0.001, RMSEA = 0.056 (90% CI = 0.054-0.057), CFI = 0.97; GFI = 0.93. Measurement invariance indicated that the five-factor structure was similar across gender, school cycle and distress levels. Construct validity was evident, by correlating the five factors of the READ with various social, psychological and behavioural variables. The findings suggest that the READ is a valid measure to assess resilience factors among adolescents in Ireland, demonstrating its applicability in a different cultural context and with a wider age range of adolescents. Copyright © 2016 John Wiley & Sons, Ltd.

Economic shocks and health resilience: lessons from the Russian Federation

Background

Despite extensive research on determinants of health, there is much less information on factors protecting health among those exposed to economic shocks. Using longitudinal data from the Russian Federation in the post-Soviet period, we examined individual-level factors that enhance resilience of health to economic shocks.

Methods

Logistic regression analysed factors associated with good self-assessed health (SAH) and health resilience, using pooled samples from the Russia Longitudinal Monitoring Survey-Higher School of Economics (1994–2012).

Results

The general population consistently reported ‘average’ SAH, indicating almost invariant trends over the years. Male gender was the strongest predictor of good SAH and health resilience. Other factors positively associated with good SAH were age, higher education, employment, residing in rural areas, living in a larger and/or non-poor household. Among unemployed and those remaining unemployed, residing in rural areas, living in a larger and/or non-poor household remained the strongest predictors of good SAH and health resilience. These same factors were also important for males with recent job loss.

Conclusions

Several factors predicting good SAH in the general population also influence health resilience factors among those remaining unemployed and experiencing a job loss. Such factors help to identify those most vulnerable and aid targeting assistance during economic crises.

Not the Promised Land: African Asylum Seekers and Refugees in Israel

The phenomenon of African asylum seekers in Israel is relatively new. The purpose of the study was twofold: (a) to investigate how the asylum seekers construct their life stories and (b) to discover which aspects of the constructed life stories can be taken into consideration by various mental health professionals when providing help to asylum seekers. In this study, we interviewed 16 asylum seekers residing in Israel using the narrative method. Based on holistic analysis, we collected three groups of stories: "Then see what course life takes in the future," "I'm not yet free," and "Open prison." In the discussion of the findings, we focus on the similarities and differences among the groups of stories, with reference to the role of the sociopolitical context and to the private and social self as part of the participants' well-being. We make implementation suggestions for mental health interventions.

The effect of daily small text message reminders for medicine compliance amongst young people connected with the outpatient department for child and adolescent psychiatry. A controlled and randomized investigation

BACKGROUND

Many patients with psychiatric illnesses have difficulty maintaining medication over time. Many take their medicine irregularly and studies show that it is the most vulnerable patients who have the greatest problems adhering to treatment. Often only 50% are still under medical treatment after 6 months.

AIM

In this study we investigated whether text message reminders could improve medicine compliance amongst vulnerable young people with psychiatric disorders who were being treated in the outpatient department for child and adolescent psychiatry and who either are under or were to commence medicinal treatment.

METHODS

This study was conducted as a randomized controlled trial including all non-acute referrals to an outpatient department for adolescent psychiatry within a group aged 15-20 years starting medical treatment. The patients were followed until the end of their treatment, for a minimum of 3 months. To enhance medicine compliance, text messages were sent daily to one group. No message was sent to the other group.

RESULTS

Compliance was not associated with text message intervention in any of the drug interventions. The effect size was calculated to 0.3013, which is low and therefore indicates a weak association between text message and compliance. The power in this study was calculated to 0.3539, which is also low and therefore the likelihood of finding significant association is low.

CONCLUSION

This study does not show increased medicine compliance from the text message intervention group. The conclusion of this study is that it is essential that significant resources are spent preparing and testing a text message strategy.

Resilience in a reborn nation: Validation of the Lithuanian Resilience Scale for Adults (RSA)

BACKGROUND

Resilience, as an ability to withstand or rebound from crisis or adversity, is becoming an increasingly significant concept in health promotion and well-being. Individuals exhibiting resilience use skills or resources flexibly to solve situational demands. The Resilience Scale for Adults (RSA) may be used to assess protective resources, and the aim of the present study was to validate the Lithuanian translation.

METHODS

The translated RSA was administered to a clinical (n=125) and a non clinical sample (n=499) to examine the discriminant validity of the RSA items with a confirmatory factor analysis, the internal consistency as well as construct validity by correlating it with the Quick Psycho-Affective Symptoms Scan (QPASS).

RESULTS

The internal consistency, the test-retest stability and the factor structure were replicated as adequate, thus indicating good psychometric properties and support of discriminant validity. Females reported more resilience resources for the domains of social competence, family cohesion and social resources compared to men. The RSA subscales correlated negatively with the QPASS scores, and patients reported significantly less resilience resources than non-patients, thus indicating construct validity.

CONCLUSIONS

Valid psychometric tools for research purposes and routine every-day use are urgently needed in Lithuania, a young nation still under numerous challenges due to social, economic and political transitions. The RSA represents a reliable and valid tool for assessing protective factors. Assessing resilience factors may extend the understanding of factors relevant for mental health problems as well as treatment prognosis beyond the capabilities of mere symptom oriented approaches.

The support needs of South African educators affected by HIV and AIDS

In a qualitative study of 77 South African educators, participants were asked to explain how they are affected by HIV and AIDS and how they would best like to be supported in response to this. The term 'affected' refers to educators who have colleagues, learners or loved ones who are HIV-positive or who have died from HIV-related illnesses, or those who teach children orphaned by AIDS or learners who are vulnerable because of a parent's or caregiver's HIV status. Their responses endorse current theory regarding support for educators in the context of the epidemic, but their needs for support also include forms of 'ecosystemic compassion': that is, a longing for the school management, learners' parents, learners, and colleagues to have compassion for their HIV-related predicaments. Because the latter need was pronounced among those educators caring for an ill HIV-positive loved one, this study introduces the importance of researchers' and stakeholders' sensitivity to the possibility of differentiated support, according to how educators are affected by HIV. Many of the participants' calls for support were at odds with policyfacilitated demands on educators to function as pillars of support to vulnerable learners and communities in the age of HIV and AIDS. The findings provide a caveat with regard to educators who require support-notwithstanding the expectation that they function as ecosystemic agents of support. Finally, the educators' calls for support should be tempered by resilience theory, which suggests that while it is important to support HIV-affected educators, the choice of supports should not stymie educators' agency or discourage educators' active participation in the support process.

A Theoretical Model of Health-Related Outcomes of Resilience in Middle Adolescents

There is a dearth of knowledge about the health outcomes of resilience during adolescence, making the study of health-related outcomes of resilience important. The purpose of this study was to develop a theory-based just-identified model and to test the direct and indirect effects of resilience on hope, well-being, and health-promoting lifestyle in middle adolescents. The study used a correlational design. The final sample consisted of 311 middle adolescents, aged 15 to 17, who were recruited from a public high school. Participants responded to instrument packets in classroom settings. The structural equation model was tested with the LISREL 8.80 software program. All seven hypotheses were supported at a statistically significant level ( p < .001). The results supported the theoretical propositions and the previous empirical findings that were used to create the theoretical model of health-related outcomes of resilience. Alternate models of outcomes of resilience need to be tested on adolescents.

Assessing resilience: a review of measures across the life course

Through this systematic review the authors analyze scales used to measure resilience in individuals across the life course. The scales were obtained according to a priori inclusion criteria through searches using electronic databases, cited references, and requests to human services researchers currently engaged in research utilizing a resiliency theory framework. Eleven measurement tools meeting study inclusion criteria were located within the existing literature. Currently validated instruments measure specific populations and vary in length and format. The need for an analytical approach to measuring resilience is long overdue. This assessment is intended to aid social work practitioners working with populations that have faced adversity.

Predicting resilient adolescents and youths: validation of a screening test in Colombia

BACKGROUND

This article presents the validation of the Child and Youth Resilience Measure-58 (CYRM-58) in the Colombian context and in Spanish language.

METHODS

CYRM-58 has 58 questions and was developed by an international team of researchers coordinated by the Resilience Research Centre (Dalhousie University, Canada). Simplified CYRM Colombia is a test that uses 7 questions of CYRM-58; for its validation we tested reproducibility in 22 persons aged 14 to 23 years.

RESULTS

We validated content and internal consistency in 39 resilients, 43 youth with deviant behaviors, and 66 controls matched by age and sex. We estimated internal consistency by non-parametric factorial analysis, and we assessed content validity by means of the Mann-Whitney test, bootstrap regression and logistic regression. The reproducibility was found to be in the range of 75-86%. Correlation between measurements was 75%.

CONCLUSION

The best predictive model or Simplified CYRM Colombia was found to have seven questions (sensitivity = 96%, specificity = 76%, power = 80%).

A systematic review of resilience in the physically ill

BACKGROUND

Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.

OBJECTIVE

We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.

METHODS

An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.

RESULTS

A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.

DISCUSSION

These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.

Empirical Support for Resilience as More than the Counterpart and Absence of Vulnerability and Symptoms of Mental Disorder

The construct of resilience has been viewed as the direct counterpart of factors jeopardizing mental health, i.e., vulnerability and psychopathology. Any operationalization of resilience, thus, risks lying on the same latent continuum as indicators of mental illness, although indicating their absence. A factor analysis combining items from these measurement domains, followed by analyses of second-order factor scores was performed to test this assumption. A random selection of 1,724 participants (34% response rate) from the general population of Norway responded. All items were discriminated well by their primary factors. A second-order factor analysis extracted two components, which was confirmed on a hold-out sample by confirmatory factor methods. The Resilience Scale for Adults (RSA), which measures protective factors, correlated with both second-order factors. Thus, the RSA shared common variance with vulnerability and psychopathology, as well as being unique from illness indices. A hierarchical regression analysis that tested interactions between vulnerability and resilience further supported the unique contributions of the RSA. Thus, the notion of resilience-protective indicators as solely counterparts of vulnerability and psychopathology is not empirically supported.