A concurrent examination of protective factors associated with resilience and posttraumatic growth following childhood victimization

Measuring Healing and Recovery After Gender-Based Violence: A Scoping Review

Healing after gender-based violence (GBV) is multidimensional, with varying instruments used in the scientific literature to capture this phenomenon quantitively in survivor populations. The purpose of this scoping review was to (a) describe quantitative measures used to evaluate recovery after GBV, (b) compare these findings with domains uncovered in a qualitative metasynthesis about survivors' perspectives about healing after GBV, and (c) summarize recovery relationships found. We searched Pubmed, PsycInfo, and Violence/Criminology/Family Studies Abstracts. Studies were included for review if they (a) used quantitative methods, (b) evaluated healing or recovery in survivors of GBV, (c) were available in English, and (d) were empirical articles in peer-reviewed journals. Two thousand nine hundred thirty-five articles were reviewed by title and abstract, and 92 articles were reviewed by full text. Twenty-six articles were included in this review. Eight studies used an alleviation of adverse symptomology as a proxy for recovery, eight used growth-related outcomes, and ten used a combination of both types of measures. While the quantitative instruments synthesized in this review seemed to map onto some of the recovery domains identified through qualitative metasynthesis, no study synthesized measured all domains simultaneously. Studies synthesized identified that recovery-related outcomes may be influenced by social support, symptom burden, disclosure, and various therapeutic intervention programs tested in the literature to date. Synthesizing research on recovery after GBV is an essential step to understand gaps in measurement and understanding. Streamlining and using holistic recovery outcome measurement can aid in the development of evidence-based interventions to promote healing in survivor populations.

Adverse Childhood events of individuals and its relationship with resilience

OBJECTIVE

The aim of this study is to examine the relationship between childhood trauma and psychological resilience in the Turkish Cypriot community and to identify the predictors of psychological resilience.

METHOD

The research was conducted with 354 individuals in a web-based online environment in Northern Cyprus. Data were collected using a "Personal Information Form", the "Adverse Childhood Events Scale", and the "Resilience Scale for Adults". Percentage, mean, standard deviation, and Pearson's correlation analysis were used in the data analysis.

RESULTS

In the study, 16.67 % of the participants were exposed to war or conflict when they were young and 10.17 % had a mental illness. In addition, it was determined that there were statistically significant and negative correlations between the Adverse Childhood Events Scale scores and the scores they got from the Adult Resilience Scale and the sub-dimensions of the scale. Female gender and education level predicted the scores on the Resilience Scale for Adults positively, and the presence of mental disease and the scores on the Adverse Childhood Events Scale negatively predicted the scores on the Resilience Scale for Adults.

CONCLUSION

İn this study, gender, educational status, presence of mental illness, and the total score on the Adverse Childhood Events Scale were determined to be predictive variables affecting resilience. Considering the research findings, it is recommended that nurses plan studies for the protection of the mental health of children and adolescents and the groups exposed to trauma should be psychologically supported to raise individuals with high resilience.

Turkish version of the resilience scale for young children: Validity and reliability study

PURPOSE

This study was conducted to determine the validity and reliability of the Turkish version of the Resilience Scale for Young Children.

METHOD

This study used a methodological and descriptive design. The study was conducted with 210 parents of children aged 2-6 years at a Family Health Centre in Sakarya from June 2023 to January 2024. Data was collected by face-to-face interviews via a Descriptive Information Form and the Chinese Resilience Scale for Young Children. Translation processes, expert opinions, and content validity were meticulously addressed. Data analysis was utilized by IBM SPSS Statistics and AMOS 24.

RESULT

The mean age of parents was 35.85 ± 6.52 years, and 82.9% of the parents were mothers (n = 174). The item-content validity index (I-CVI) ranged between 0.81 and 0.94, indicating a high level of agreement between the experts. The Cronbach's alpha value for the scale was 0.791. In the exploratory factor analysis, it was determined that the distribution of the items according to the sub-dimensions was consistent with the original scale. Confirmatory factor analysis results are as follows: chi-square/df = 2.395, RMSEA = 0.082, GFI = 0.842, CFI = 0.853, IFI = 0.856, RFI = 0.726, NFI = 0.776 and TLI = 0.820.

CONCLUSION

This study revealed that the Turkish scale with four sub-dimensions and 16 items is a valid and reliable tool.

PRACTICE IMPLICATIONS

It is recommended to use the Turkish version of the Resilience Scale for Young Children to assess resilience in children aged 2-6 years.

Examining childhood experiences and personality functioning as potential predictors for the speed of recovery during psychotherapy of patients with anxiety disorders

Background

Adverse childhood experiences were previously identified as relevant risk factors for the development of anxiety disorders. Furthermore, anxiety disorders were shown to be associated with impairments of personality functioning. The objective of this study was to investigate adverse and protective childhood experiences as well as personality functioning, as defined by the Operationalized Psychodynamic Diagnosis system, as potential predictors for the speed of recovery during psychotherapy for patients with anxiety disorders.

Methods

The sample consisted of n = 312 completed psychotherapies. The speed of recovery, defined as symptom abatement over time, was calculated using a two-stage hierarchical linear model. The effects of adverse and protective childhood experiences as well as personality functioning on the speed of recovery during psychotherapy were then examined using a structural equation model.

Results

The presence of adverse childhood experiences predicted a lower speed of recovery during psychotherapy. In addition, a higher number of adverse childhood experiences was associated with greater impairments in the abilities of perception and regulation as dimensions of personality functioning. A higher number of protective childhood experiences was associated with fewer impairments in the communication and attachment dimensions. Impairments in personality functioning in patients with anxiety disorders did not predict the speed of recovery during psychotherapy.

Conclusions

Among patients with anxiety disorders, adverse childhood experiences lead to a lower speed of recovery during psychotherapy. Therefore, childhood adversity should be routinely assessed before and thoroughly addressed during psychotherapy in patients with anxiety disorders.

"We Try to Fix Things Quietly, and We Do Not Take Revenge": Christian Arab Teachers' Experiences Coping with Child Sexual Abuse Among Their Pupils in Israel

Teachers are at the frontlines of the fight to identify and cope with child sexual abuse (CSA) among their pupils. Their methods of coping with CSA cases, both personally and professionally, are strongly influenced by their socio-cultural contexts and religious beliefs. The purpose of the present study was to investigate the experiences of Christian Arab teachers in Israel coping with the CSA of their pupils. Twelve Christian Arab elementary school teachers in Israel were recruited for the study. Semi-structured interviews were conducted, and a qualitative thematic analysis was employed based on a descriptive phenomenological-psychological approach. Two key themes emerged from the analysis: (a) The teachers' intense emotional reactions regarding the CSA of their students and the empowerment some found in handling such difficult situations, and (b) The teachers' Christian beliefs and identity strongly affected their understanding of CSA and their approach to intervention. The findings indicated the dialectical position of the teachers' religio-cultural context, particularly the duality of the Christian value of forgiveness, a powerful resource for their coping, yet with adverse implications for children's vulnerability. This unique risk should inform training teachers regarding CSA matters. Teachers must also have systems that support them and allow them to reflectively examine their coping styles.

The Tutor of Resilience Program with Children Who Have Experienced Maltreatment: Mothers' Involvement Matters

Resilience is a dynamic process involving the presence and interaction of personal and environmental factors that modify the impact of adversity. Resilience-building interventions are therefore important for improving trauma-related outcomes in children and caregivers exposed to adversity. This study examines the impact of the Tutor of Resilience (TOR) program on beneficiaries' trauma-related symptoms and on mother-child interactions in a group of children exposed to maltreatment (N = 186; mean age = 11.95; SD = 2.50). Assessments were completed at baseline and post-intervention. RM-ANOVAs indicated significant improvements for most trauma symptoms (anxiety, anger, post-traumatic stress, and disassociation, but not depression) in the intervention group relative to a control group (N = 88; mean age = 10.76; SD = 2.57), and indicated further improvements to anxiety and dissociation for the intervention group when mothers were involved. Mother-child interactions also improved over time, as did their overall trauma symptoms and distress. Findings support the effectiveness of the ToR, especially when involving mothers.

Factors Associated with Post-Traumatic Growth during the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic was an unprecedented event that further stimulated the debate on the concept of trauma. To increase knowledge about the traumatic potential of the pandemic, the main objective of this study was to identify, through a systematic literature review, the main factors associated with the adaptive outcome of post-traumatic growth caused by COVID-19. Studies were selected from the PsychInfo, Embase, and PubMed databases, and 29 articles were included at the end of the screening process. The identified factors are of different natures, including personal variables such as personality traits, coping, and cognitive strategies used to face adversity, and interpersonal variables, one of the most important of which is the level of social support. In addition, several results confirmed a relationship between post-traumatic growth and post-traumatic stress symptoms, as well as indices related to psychological well-being. Finally, the results are discussed by comparing them with those already present in the literature, as well as with some of the main explanatory models of post-traumatic growth. In this regard, some of the factors identified, such as maladaptive coping, avoidance symptoms, optimism, and low-stress tolerance, suggest the possibility that the process of post-traumatic growth may also be characterized by an illusory dimension.

"I have a special prayer 'O Lord, open my lips'": Experiences of ultra-Orthodox educators after their students' disclosures of sexual abuse

BACKGROUND

Child sexual abuse (CSA) is a large-scale, worldwide phenomenon. However, research on educators' experiences with CSA in specific social, cultural or religious contexts is limited.

OBJECTIVE

The current study is part of a larger qualitative research project examining Israeli educators' coping with CSA of their students in diverse cultural contexts. This study focused on Jewish ultra-Orthodox educators' perceptions and experiences of CSA disclosure and its impact on their professional and personal lives. Their perceptions of belonging to the ultra-Orthodox community were also explored.

METHODS

Interviews were conducted with 28 ultra-Orthodox educators and analyzed using a thematic approach.

RESULTS

The ultra-Orthodox educators perceived their roles on a continuum, from not being responsible to being fully responsible. They perceived the abused children as having negative behavior or as victims who deserved protection. Their personal lives were deeply affected, impacted by fear, disassociation or devotion to the mission of caring for these children. Finally, educators perceived the ultra-Orthodox community as fragile regarding CSA disclosure and emphasized the importance of encouraging culturally adaptive ways to conceptualize and address CSA.

CONCLUSIONS

This study highlights the importance of ultra-Orthodox educators in identifying CSA and leading interventions. It also raises the need for training to combine reflective, cultural-based practice and support for the educator to maintain their wellbeing. Despite this community's uniqueness, the current findings may be relevant to professionals and policymakers regarding other closed and religious communities and diverse educational settings confronting CSA.

Individual and Social Risk and Protective Factors as Predictors of Trajectories of Post-traumatic Stress Symptoms in Adolescents

The present study elucidates heterogeneity in post-traumatic stress symptoms (PTSS) across adolescence in a sample of youth who have experienced myriad types and combinations of potentially traumatic events (PTEs), including substantiated physical abuse, sexual abuse, neglect and/or at least one other self-reported PTE. A machine learning technique was used to assess a multivariate set of variables (e.g., PTEs, individual risk and protective factors, social risk and protective factors, and racial and ethnic minority status) as predictors of PTSS trajectory group membership. The sample included 498 maltreated (n = 275) and comparison (n = 223) 14-19-year-old female adolescents (M = 15.27, SD = 1.06 at Time 1) assessed annually until age 19. 45.7% of participants were White, 45.3% Black, 0.4% Native American, 0.8% Hispanic, and 7.7% other. Growth mixture modeling identified three distinct trajectories of PTSS: (1) recovery (56%); (2) moderate, chronic (25%); and (3) high, chronic (19%). An elastic net model was used to test predictors of membership in the recovery versus the high, chronic PTSS trajectory groups. Results demonstrated that the recovery trajectory was characterized by the absence of sexual abuse, physical abuse, and other traumas, higher self-esteem, less affective dysregulation, less risky peers, lower levels of parent depression, and being of racial/ethnic minority status. Findings help to characterize individual variation in trajectories of PTSS following PTEs by underscoring the unique trauma responses of racial and ethnic minority youth and offering possible targets of interventions to promote recovery from PTSS.

Patterns of resilient functioning in early life: Identifying distinct groups and associated factors

Resilience, the capacity to maintain or regain functionality in the face of adversity, is a dynamic process influenced by individual, familial, and community factors. Despite its variability, distinct resilience trajectories can be identified within populations, yet the predictors defining these distinct groups remains largely unclear. Here, using data from the Avon Longitudinal Study of Parents and Children (ages 0-18), we quantify resilience as the remaining variance in psychosocial functioning after taking into account the exposure to adversity. Growth mixture modeling identified seven distinct resilience trajectories, with over half of the study population maintaining resilience throughout early life. Factors increasing the likelihood of resilient trajectory membership included a less emotional temperament, high cognitive abilities, high self-esteem, low levels of autistic social traits, strong sibling relationships, high maternal care, and positive school experiences. Among the socioeconomic factors considered, maternal education - a significant indicator of socioeconomic status - and birth-order were associated with resilient trajectories. Our findings underscore the importance of fostering cognitive abilities, self-esteem, social relationships, positive school experiences, and extracurricular engagement to bolster resilience in adversity-exposed individuals and communities. This research informs resilience-focused interventions in mental health, education, and social policy sectors, and prompts further exploration of socioeconomic influences on resilience trajectories.

Discussion Surrounding Theory, Knowledge, and Practical Applications for Clinical Nurse Specialists to Aid Them in Caring for Parents with Cancer Who Have Young Children

PURPOSE

To identify the theory, knowledge, and practical applications that clinical nurse specialists should consider adding to their "toolkit" to support them in caring for people affected by cancer with young children.

DATA SOURCES

Expert opinion and relevant studies on the topic formed the basis of this article.

CONCLUSION

A conversation with experts identified five key areas of knowledge important to supporting clinical nurse specialists in caring for people affected by cancer with young children: family-centered and systemic practice, nursing responsibilities and competencies, trauma-informed practice, adult life stages, and stages of child development. Key areas identified have relevance to all healthcare professionals working in cancer care.

IMPLICATIONS FOR NURSING PRACTICE

This article provides a useful overview of psychological theories important to supporting healthcare professionals in caring for people affected by cancer. A discussion on the boundaries and competencies of the nursing role led to agreement about practical advice rooted in theory and knowledge that could benefit clinical practice. Concepts of emotional labor and the wounded healer were identified as important to inform reflection and supervision when caring for a parent affected by cancer who has a young family.

Sexual Assault, Mental Health, and Alcohol Use in College Women: The Role of Resilience and Campus Belonging

Understanding the mental health outcomes of sexual assault among college women is a public health priority. Although research has identified risk factors for the development of mental health problems following an assault, few studies have utilized a strengths-based approach to identify personal and social resources that may mediate the sexual assault-mental health link. Prior studies allude to the role of resilience and perceived campus belonging in explaining the relationship between sexual assault and mental health. This study represents the first application of the stress process model using a large sample of college women to examine (a) the association between sexual assault and mental health (i.e., psychological distress, suicidality, self-harm) and alcohol use problems and (b) the role of resilience and perceived campus belonging as partial mediators of these associations. Data were collected as part of the Spring 2021 American College Health Association National College Health Assessment (ACHA-NCHA; n = 31,328, Mean age = 20.26, SD = 1.64, 58.8% White), a cross-sectional, online survey that samples college students from 143 self-selected United States colleges. To test our primary hypothesis, a structural regression model was conducted, which included a latent sexual assault predictor, manifest resilience and campus belonging mediators, a latent mental health outcome, and a manifest alcohol use problems outcome. Mental health and alcohol use problems were positively associated with sexual assault and negatively associated with resilience and campus belonging. Resilience partially mediated the association between sexual assault and mental health. Campus belonging partially mediated the association between sexual assault, mental health, and alcohol use problems. This model explained 23.2% of the variance in mental health and 5.9% of the variance in alcohol use. Resilience and campus belonging may represent modifiable factors that can be targeted in trauma-focused interventions in efforts to improve victimized college women's mental health.

Social Determinants of Health: Implications for Voice Disorders and Their Treatment

PURPOSE

Adverse childhood experiences (ACEs) and related conditions, such as discrimination, are social determinants of health (SDOHs). Critical race theory (CRT) is a lens through which to understand SDOHs in a way that may impact our clinical care. When prolonged or chronic, SDOHs might cause toxic stress and trauma, which, in turn, adversely affect health and are shown to be relevant for some voice disorders. The goals of this tutorial are to (a) review the literature on SDOHs that potentially contribute to disparities; (b) discuss explanatory models and theories that describe how psychosocial factors influence health; (c) relate the foregoing information to voice disorders, highlighting functional voice disorders (FVDs) as a particular case in point; and (d) describe how trauma-informed care can improve patient outcomes and advance health equity for vulnerable populations.

CONCLUSIONS

This tutorial concludes with a call for heightened awareness of the role that SDOHs such as structural and individual discrimination may play in voice disorders, and a call for research into SDOHs, traumatic stress, and health disparities in this patient population. A call is also made for more universal practice of trauma-informed care in the clinical voice domain.

A Systematic Review of Resilience Factors for Psychosocial Outcomes During the Transition to Adulthood Following Childhood Victimisation

Exposure to childhood victimisation (i.e. abuse, neglect, domestic violence or bullying) can detrimentally impact later psychosocial adjustment. However, this is not the case for all victimised children; some do well despite their experiences and are considered to be resilient. Understanding the factors associated with such resilience is important to inform interventions to support better psychosocial outcomes among victimised children. This review provides an overview of the extant research examining resilience factors for psychosocial outcomes during the transition to adulthood following exposure to childhood victimisation. Studies were identified through a systematic literature search of Embase, PsychINFO and Ovid MEDLINE databases. The 26 included studies spanned a range of psychosocial outcomes between ages 18-25, including education and work, housing and independent living, criminal behaviour, victimisation, and social and psychological adjustment. For each outcome, a variety of putative resilience factors had been investigated including those related to the individual, their family and the wider community within which they lived. However, because few studies had comparable resilience factors and psychosocial outcomes, it is difficult to draw conclusions about which factors are consistently associated with resilience to a particular psychosocial outcome. Additionally, this review revealed that the included studies were of variable methodological quality - many were limited by cross-sectional designs with retrospective self-reports of childhood victimisation, and convenience or unrepresentative samples. In this review, we also highlight gaps in knowledge about the co-occurring impact of multiple resilience factors in combination and the need for studies conducted in non-Western and low- and middle-income countries.

Research hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords

Objectives

To analyze and summarize the research hotspots and advancement of post-traumatic growth (PTG) over the past 15 years based on co-word analysis of keywords, and provide references for PTG-related research and clinical intervention.

Methods

All studies related to PTG were retrieved from PubMed and Web of Science (WOS) from January 2013 to July 2022. A total of 11 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies. Bibliographic Item Co-occurrence Matrix Builder (BICOMB; version 2.0) was used to conduct high-frequency keywords extraction and matrix setup, Graphical Clustering Toolkit (gCLUTO; version 1.0) was employed to perform clustering analysis, and SPSS (version 25.0) was used to carry out strategic diagram analysis.

Results

A total of 2,370 publications were selected, from which 38 high-frequency keywords were extracted. The results revealed six research hotspots on PTG during the period from 2013 to 2022, including research on i) emotional reactions after negative life events, ii) PTG among cancer survivors, iii) rumination and resilience after trauma, iv) PTG among children and adolescents, v) role of social support and coping strategy in PTG, and vi) association between PTG and quality of life.

Conclusions

This co-word analysis effectively reveals an overview of PTG over the past 15 years. The six research categories deduced from this study can reflect that the research content in the field of PTG is abundant, but some research topics have not yet been mature. The findings of this study are of great value to future investigations associated with PTG.

Maternal, Paternal, and Peer Relationships Differentially Predict Adolescent Behavioral Problems

The current study investigated how maternal, paternal, and peer social relationships predict adolescent behavioral problems using secondary data analyses of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). We aimed to examine differences between maternal and paternal relationships in predicting adolescent behavioral problems, and we hypothesized that parental relationships would more strongly predict adolescent behavioral problems than peer relationship in mid-adolescence. Participants were 929 adolescents at their 14-year-old visit. Hierarchical multiple regressions and multiple regression models revealed the following: Maternal relationship quality predicted fewer adolescent externalizing and total behavioral problems; paternal relationship quality predicted fewer internalizing problems; and peer popularity predicted fewer externalizing and total behavioral problems. In conclusion, mother-adolescent relationship may be more important for externalizing behavioral problems and father-adolescent relationship may be more important for internalizing behavioral problems. In middle adolescence, parental relationships are still more important than peer relationship in predicting adolescent behavioral problems. Study limitations and implications for research, policy, and practice were discussed.

Posttraumatic Growth, Dissociation and Identification With The Aggressor Among Childhood Abuse Survivors

Childhood abuse puts individuals at risk for psychopathology and psychiatric symptoms such as posttraumatic stress disorder (PTSD) and anxiety symptoms. At the same time, research has indicated that some survivors report positive transformations in the aftermath of their trauma, known as posttraumatic growth (PTG). Yet the essence of PTG reports is questionable, and some scholars claim that it may reflect maladaptive illusory qualities. Furthermore, according to a recent theoretical model, PTG might be dissociation-based and related to survivors' bonds with their perpetrators. This study aimed to explore these claims by assessing PTG, dissociation, and identification with the aggressor (IWA), as well as PTSD and anxiety symptoms. An online survey was conducted among 597 adult childhood abuse survivors. Study variables were assessed via self-report measures. Analyses indicated positive associations between PTG, dissociation, and IWA. Three distinct profiles were found, reflecting high, medium, and low scores on PTG, dissociation, and IWA. Profile type explained PTSD and anxiety symptoms above and beyond gender, age, and abuse severity. These findings suggest that whereas some childhood abuse survivors might experience a positive transformation subsequent to their trauma, others' PTG reports might reflect dissociative mechanisms and pathological attachments to their perpetrators, and thus might be maladaptive.

Development and Validation of a Chinese Resilience Scale for Young Children

(1) Background: Resilience research began in the child population as a validity scale to describe children's psychological wellbeing and ability to cope with negative events, and to some extent, to predict recovery and adaptation when they experience adversity again. In view of the important developmental implications of resilience in young children and the lack of a Chinese children's resilience scale, this study developed a resilience scale for young Chinese children based on a systematic review of existing international resilience scales and the characteristics of the Chinese cultural background. (2) Methods: The scale was developed by referring to existing scales, expert interviews, item collation and item finalization, developing original items, then deleting and determining items through item analysis, and finally, comparing with existing scales to obtain the internal and external validity of this scale. (3) Results: The results showed that the scale has good measurement properties, internal consistency reliability, and internal and external validity. (4) Conclusions: Through the development and validation of the Resilience Scale for young children in China, the scale can be used to measure the resilience of young children in China.

Gender Differences in Social Support and Posttraumatic Growth for Survivors of Intimate Partner Violence

The current study investigated gender differences in perceived social support and posttraumatic growth for survivors of intimate partner violence. Participants for this study included 86 undergraduate students who indicated at least one instance of partner abuse (consisting of physical abuse, sexual abuse, emotional abuse, and harassment). Participants were predominantly female (68%), White/Caucasian (62%), and between 18 and 21 years of age (84%). Participants responded to the Multidimensional Scale of Perceived Social Support, the Composite Abuse Scale, and the Posttraumatic Growth Inventory. Mean differences and correlational analyses were utilized to investigate potential gender differences in the study variables as well as the relationships among them. The prevalence of intimate partner violence was comparable to those found in other studies, with 59% of men and 57% of women indicating experiencing abuse from a partner. Although the prevalence rates were similar, women indicated higher overall partner abuse victimization than did men. Moreover, women indicated statistically significantly higher scores than men in three of the four Composite Abuse Scale subscales, reflecting higher levels of victimization for all forms of abuse except for partner harassment. Further, perceived social support scores were similar for men and women, with the only significant gender difference to emerge being that men indicated higher levels of familial support than did women. No statistically significant gender differences emerged for overall posttraumatic growth or for any of its domains. Finally, social support was correlated with posttraumatic growth for women but not for men. The current study, therefore, suggests that men and women may experience similar levels of personal growth in the aftermath of partner abuse. Moreover, these results imply that the relationship between social support and posttraumatic growth may vary according to the gender of the survivor.

Differential Associations between Guilt and Shame Proneness and Religious Coping Styles in a Diverse Sample of Young Adults

Positive religious coping is linked with better mental health outcomes following physical and sexual abuse while negative religious coping is associated with poorer outcomes. Religious coping styles may be linked with dispositional tendencies to experience guilt or shame. This study compared the associations between guilt and shame proneness and religious coping styles and tested whether abuse history moderated these relationships. We conducted a cross-sectional study with 425 college students (n = 145 with physical and/or sexual abuse history, n = 280 with no abuse history). Participants completed questionnaires assessing positive and negative religious coping style, as well as two dimensions of guilt proneness and shame proneness. Structural equation models were fitted to examine associations between guilt proneness and shame proneness, and positive and negative religious coping, respectively, accounting for abuse history as a binary moderator. Across the full sample, positive religious coping was positively associated with guilt repair (i.e., the tendency to engage in reparative behaviors following one's wrongdoing), guilt negative behavior evaluation (i.e., the tendency to feel bad about how one acted in a given scenario), and shame withdrawal (i.e., the tendency to try and avoid unpleasant situations in which one has done something wrong), and negatively associated with shame negative self-evaluation (i.e., the tendency to make internal, negative self-attributions about one's wrongdoing). Negative religious coping was positively associated with shame withdrawal and, for participants with no abuse history, shame negative self-evaluation. Results suggest that positive religious coping is more closely related to guilt proneness, and negative religious coping to shame proneness. Additional research with longitudinal designs and more defined abuse history subgroups is needed.

Social support and posttraumatic growth: A meta-analysis

BACKGROUND

The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association.

METHODS

Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis.

RESULTS

The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size.

LIMITATIONS

Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size.

CONCLUSIONS

Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.

A phenomenological exploration of work-related post-traumatic growth among high-functioning adults maltreated as children

Introduction

Childhood maltreatment is a highly prevalent traumatic experience, and its adverse psychological and behavioral consequences are well-documented. Notwithstanding these adverse outcomes, many individuals who suffered from traumatic experiences report post-traumatic growth, i.e., transformative positive changes resulting from their struggle to cope. Post-traumatic growth has been extensively explored among adult survivors of childhood maltreatment, with findings indicating both the previously recognized domains (personal strength, relating to others, appreciation of life, openness to new possibilities, and spiritual change) as well as abuse-specific domains of growth (e.g., increased ability to protect themselves from abuse). However, little attention has been given to vocational aspects of post-traumatic growth among survivors, despite the central role and importance of work in adulthood. Exploration of post-traumatic growth at work has focused on certain vocational traumatic experiences, such as those which occur in the military, or through secondary trauma. This exploratory qualitative study focuses on the question: What is the lived experience of work-related post-traumatic growth among high-functioning adult survivors of CM?

Method

Twenty in-depth interviews were held with high-functioning working adults who were maltreated as children. Phenomenological analysis was applied to the retrospective data reported in these interviews.

Result

Rich descriptions of work-related positive psychological changes were provided by all participants. Analysis revealed that survivors' post-traumatic growth corresponded with all five previously recognized domains of growth: changes in self, relating to others, openness to new possibilities, finding meaning to the abuse, and appreciation of life. It also revealed that work is perceived as a form of resistance (a subtheme of changes in self), and that finding meaning entails three emerging subthemes: being a survivor and a role model, giving others what was needed and never received, and making a better world.

Discussion

While the vocational lives of survivors of childhood maltreatment have rarely been examined through the lens of post-traumatic growth, our results show this lens to be highly valuable. Work-related post-traumatic growth has relevance not only regarding vocational traumas occurring in adulthood as has been previously studied, but also in the context of childhood traumas. Moreover, our research broadens the understanding of the possible domains of work-related growth.

(Un)holy Smokes? Religion and Traditional and E-Cigarette Use in the United States

This study employed national cross-sectional survey data from the 2021 Crime, Health, and Politics Survey (n = 1578 to 1735) to model traditional cigarette and e-cigarette use as a function of religious affiliation, general religiosity, biblical literalism, religious struggles, and the sense of divine control. Although the odds of abstaining from cigarettes and e-cigarettes were comparable for conservative Protestants and non-affiliates, conservative Protestants were more likely to cut down on cigarettes and e-cigarettes during the pandemic. Religiosity increased the odds of abstaining from cigarettes (not e-cigarettes) and reduced pandemic consumption of cigarettes and e-cigarettes. Biblical literalism was unrelated to abstaining from cigarettes and pandemic changes in cigarette use; however, biblical literalists were more likely to cut e-cigarette use during the pandemic. While the sense of divine control was unrelated to abstaining from cigarettes and e-cigarettes, these beliefs increased the odds of cessation from traditional and e-cigarette use. Finally, our religious struggles index was unrelated to smoking behavior. Our study is among the first to report any association between religion and lower e-cigarette use.

Effect of a Virtual Home-Based Behavioral Intervention on Family Health and Resilience During the COVID-19 Pandemic: A Randomized Clinical Trial

IMPORTANCE

Virtual home-based interventions may bolster protective factors, such as family health and resilience, during stressors such as the COVID-19 pandemic; however, their effectiveness is unknown.

OBJECTIVE

To examine the effectiveness of a virtual health coaching intervention on family health and resilience during the pandemic.

DESIGN, SETTING, AND PARTICIPANTS

In this parallel-group, single-site randomized clinical trial, 123 parents and their 2- to 8-year-old children were enrolled at a pediatric clinic or community partner site in Tennessee from March 10 to August 11, 2021. Follow-up surveys were completed between June 29 and November 11, 2021.

INTERVENTIONS

All participants received 11 weekly cooking videos and associated home-delivered groceries. The intervention group also received 12 weekly, 30-minute virtual health coach sessions.

MAIN OUTCOMES AND MEASURES

The primary outcome was the validated 6-item (range, 6-30) Family Healthy Lifestyle Subscale (FHLS) scores. The secondary outcome was the validated 6-item (range, 0-6) Family Resilience and Connection Index (FRCI) scores. Outcomes were determined a priori and evaluated at baseline and 12-week follow-up. A priori independent t tests and multivariable tobit regression models assessed intervention effects, and post hoc, secondary interaction models assessed whether effects differed over baseline outcomes.

RESULTS

Among the 123 enrolled families, 110 (89%) were included in the primary analyses (parent mean [SD] age, 35.1 [8.2] years; 104 [95%] female; 55 [50%] non-Hispanic Black; child mean [SD] age, 5.2 [1.7] years; 62 [56%] male). Intervention-control group mean differences were nonsignificant for follow-up FHLS scores (0.7; 95% CI, -0.6 to 2.0; P = .17) and FRCI scores (0.1; 95% CI, -0.5 to 0.6; P = .74). Tobit regression model intervention effects were nonsignificant for FHLS scores (0.9; 95% CI, -0.3 to 2.2; P = .15) and FRCI scores (0.4; 95% CI, -0.2 to 1.1; P = .17). Post hoc, secondary models found no significant interaction for FHLS scores (1.3 increase per 5-point decrease; 95% CI, -0.2 to 2.7; P = .09), with significant intervention associations for baseline scores of 6 to 23. The interaction was significant for FRCI scores (0.4 increase per 1-point decrease; 95% CI, 0.01 to 0.8; P = .047), with significant intervention associations for baseline scores of 0 to 3.

CONCLUSIONS AND RELEVANCE

In this randomized clinical trial of families with young children, weekly virtual health coaching did not detectably improve family health and resilience. Post hoc, secondary results provided preliminary evidence of potential effectiveness among families with low baseline scores.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05328193.

Development of the Individual and Environmental Resilience Model among children, adolescents and young adults using the empirical evidence: An integrative systematic review

To create a new conceptual model of resilience based on evidence, this integrative systematic review aims to identify the evidence-based protective factors related to resilience among children, adolescents and young adults at-risk of several exposures. An Integrative Systematic review was conducted by using systematic principles according to PRISMA statement. Searching strategy was conducted through MEDLINE, CINAHL, Web of Science (ISI) and PsycINFO during July 2021(1991-2021). Keywords were related to resilience, self-esteem, hardiness, ego-resilience, risk factors, vulnerability, protective factors, ecological model and theoretical model. Those statiscally significant protective factors found in individual studies conducted with young populations (from 7 to 24 years old) exposed to violence, trauma or socio-economic instability were included in the qualitative synthesis. Of 15,235 peer-reviewed articles initially identified, 93 articles were screened and met the inclusion criteria; finally, 31 articles were included for the quality synthesis. More than 60 protective factors were found. They were classified in 10 different domains and two dimensions of resilience (Individual skills and Environmental), developing a new model of resilience: The Individual and Environmental Resilience Model (IERM). The Environmental dimension includes the domains: Family, School, Peers, Cultural and Community and The Individual skills dimension: Biological, Behaviour, Communications, Cognitive and Emotional domains. These domains and their specific protective factors have been set up as protective factors that significantly buffer negative outcomes in the face of adverse events. Compared with other models currently available, the new IERM model is potentially a more comprehensive approach that may facilitate the development of effective interventions to promote resilience in children, adolescents and young adults.

Healing After Gender-Based Violence: A Qualitative Metasynthesis Using Meta-Ethnography

Gender-based violence (GBV) is a significant violation of human rights, requiring specific understanding of how individuals heal and recover after these experiences. This article reports on findings of a qualitative metasynthesis that examined the nature of healing after GBV through the perspectives of female-identifying survivors. Empirical studies were identified by a search of peer-reviewed articles via electronic databases. Studies were included for review if they were available in the English language, reported on qualitative studies that directly engaged female-identifying survivors of GBV, and were aiming to understand the GBV healing journey, process, or goals. After our initial search, 1,107 articles were reviewed by title and abstract and 47 articles were reviewed for full text. Twenty-six peer-reviewed articles were included for the review and were analyzed using meta-ethnography. Key findings included the recovery journey as a nonlinear, iterative experience that requires active engagement and patience. Healing was composed of (1) trauma processing and reexamination, (2) managing negative states, (3) rebuilding the self, (4) connecting with others, and (5) regaining hope and power. "Shifts" or "turning points" are also mentioned which catalyzed healing prioritization. This article aggregates and examines the scientific literature to date on GBV healing and provides articulation of the limitations, gaps in evidence, and areas for intervention. The article considers implications for future research, policy, and practice and, in particular, focuses our attention on the need to expand our knowledge of alternative recovery pathways and mechanisms for healing.

Religion and Spirituality: Why and How to Address It in Clinical Practice

Religion and spirituality (R/S) have been influential in societies' history, daily life, and identity in the past and in today's society. From a sociological perspective, R/S contributes to family development and organization, influences culture, and often contributes to forming opinions, beliefs, and concepts about oneself, family, society, and the world. In addition, R/S help shape individuals, families, and communities' ethical and moral understanding, thus influencing their behavior. This review article aims to provide the clinician with tools to understand, assess, and provide interventions that consider the patients' and their families' R/S. A recent review of the topic focused on general aspects of the R/S but we are unaware of reviews that integrate attachment, moral foundation theory, and forgiveness. This review will integrate these additional features into our understanding of the role of R/S in the delivery of mental health.

Child maltreatment and post-traumatic growth: Implications for the well-being of young adults

BACKGROUND

Little is known about the relationship between childhood maltreatment and well-being in young adults, including the role of post-traumatic growth (PTG) in promoting better outcomes for young adults who have a history of childhood maltreatment (HCM).

OBJECTIVE

To examine the relationship between child maltreatment and well-being among young adults, by considering the perpetrator and the extent of the maltreatment, as well as PTG among young adults with a HCM.

PARTICIPANTS AND SETTING

The sample comprised 537 young adults (aged 18-25; M = 21.09 years, SD = 2.36) from across Australia, with 182 young adults in the sample forming the cohort with a HCM.

METHOD

Participants' current well-being, the extent of maltreatment by their mother, father and other adults experienced as a child (<18 years), and PTG was collected using an online survey. Tests of group differences and multiple regression were conducted to analyse the relationships between child maltreatment, PTG, and current well-being.

RESULTS

Maltreatment by one's mother or father predicted poorer current well-being, but not maltreatment by another adult. Young adults who identified as having a HCM had poorer well-being than those who did not. Within the cohort of those with a HCM, greater PTG predicted greater well-being, and also mitigated the negative relationship between child maltreatment by one's father and well-being.

CONCLUSION

Findings indicate that both the extent of child maltreatment and the relationship to the perpetrator have implications for well-being among young adults. PTG appeared to play a protective role, highlighting the potential therapeutic benefit of fostering PTG to improve well-being among young adults with a HCM.

Sexual violence experiences among adolescent and young adult males: a review to empower healthcare providers

PURPOSE OF REVIEW

Despite 3-17% of adolescent and young adult males (AYAMs) experiencing sexual violence, there is a paucity of information regarding their sexual violence experiences leaving them vulnerable to dangerous and detrimental sequelae.

RECENT FINDINGS

There is underreporting and under-discussion of AYAMs' experiences of sexual violence, with disclosure influenced by societal perceptions of male sexuality, shame, and fear of discrimination. AYAMs experience sexual violence from individuals known to them, with many experiencing physical violence, threats, coercion, and electronic harassment. Intersectionality, previous traumas, inappropriate childhood exposures to sexually explicit situations, select online media consumption, and adverse childhood experiences (ACEs) increase the risk of sexual violence. AYAMs who experience sexual violence are at increased risk of re-victimization, perpetrating sexual violence, experiencing bodily harm, contracting sexually transmitted infections (STIs), and experiencing internalizing and externalizing symptoms, which can lead to significant morbidity and mortality. Research on male-specific protective and resilience factors is scarce and represents an ongoing need.

SUMMARY

After reviewing AYAMs' experiences of sexual violence, including risk and protective factors, media influences, detrimental sequelae, and resilience factors, we provide a screening framework to empower the healthcare provider (HCP) to champion tailored prevention, screening, intervention, and advocacy efforts to support AYAMs.

Relationships Between Childhood Interpersonal Trauma, Religious Coping, Post-traumatic Stress Symptoms, and Resilience

Positive and negative religious coping strategies have been linked to symptom trajectories following adult interpersonal trauma. However, the interactions between childhood interpersonal trauma, religious coping, and psychological outcomes are less clear. This study examined whether aspects of religious coping moderated the associations between cumulative childhood interpersonal trauma and mental health outcomes, such as post-traumatic stress symptoms (PTSS) and resilience. Participants included 525 undergraduates from two universities (M_age = 20.04, SD = 1.71; range = 18-24; 57.7% White; 82.1% female). In both the positive and negative religious coping models, cumulative childhood interpersonal trauma was related to PTSS (b = 6.66; b = 6.10, respectively). While positive religious coping was not associated with PTSS (b = .01), it was linked to resilience (b = .69). Negative religious coping was significantly related to PTSS (b = .75) but not resilience (b = -.20). No significant interactions were identified between aspects of religious coping and cumulative childhood interpersonal trauma. While religious coping was directly related to both positive and negative mental health outcomes, it may not be associated with the relationships between childhood interpersonal trauma exposure and clinical outcomes. Such findings offer valuable information on malleable factors that may contribute to adaptive and maladaptive functioning following childhood adversity.

Differential Effects of Optimism and Pessimism on Adolescents' Subjective Well-Being: Mediating Roles of Reappraisal and Acceptance

Prior research has found the differential strength of optimism and pessimism in predicting physical health. However, whether similar findings would be obtained in predicting subjective well-being and the possible underlying mechanisms are still unclear. This study examined the relative strength of optimism and pessimism in predicting adolescent life satisfaction and depression, and further explored the possible mediating mechanisms from the perspective of emotion regulation. A sample of 2672 adolescents (M_age = 13.54 years, SD = 1.04; 55.60% boys) completed a survey assessing optimism and pessimism, the habitual use of reappraisal and acceptance strategies, life satisfaction, and depression. The results from dominance analysis revealed that the presence of optimism was more powerful than the absence of pessimism in predicting adolescent life satisfaction, while the absence of pessimism was more powerful than the presence of optimism in predicting adolescent depression. Moreover, mediation models showed that reappraisal and acceptance mediated both the link between optimism and life satisfaction and the link between pessimism and depression. These findings suggest possible avenues for intervening in different aspects of adolescent subjective well-being.

The relationship between religiosity/spirituality and quality of life among female Eritrean refugees living in Norwegian asylum centres

BACKGROUND

Women are more vulnerable to mental health problems than men after migration, but little is known about the influence of religiosity/spirituality on their quality of life. The purpose of this study was to explore religiosity/spirituality, in relationships with various domains of quality of life, among female Eritrean refugees staying in Norwegian asylum centres.

METHOD

A questionnaire assessing sociodemographic characteristics was used together with the World Health OrganizationQuality of Life - Spirituality, Religiosity and Personal Beliefs (WHOQOL-SRPB) questionnaire, which assesses religiosity/spirituality and domains of quality of life. A total of 63 adult female Eritrean refugees who had been granted asylum but were still living in asylum reception centres located in southern and central Norway participated.

RESULTS

Religiosity/spirituality was independently associated with psychological quality of life (B = 0.367, p < .001), level of independence (B = 0.184, p = .028), social quality of life (B = 0.500, p = .003), environmental quality of life (B = 0.323, p < .001) and overall quality of life (B = 0.213, p < .001), but not with physical quality of life (B = 0.056, p = .679). There were no significant differences between religious affiliations on religiosity/spirituality or quality of life measures.

CONCLUSION

Consistent with previous research, this study highlights the correlation between religiosity/spirituality and overall quality of life. We recommend a longitudinal follow-up study of similar populations, after they are resettled and integrated into their host countries, to understand the associations between quality of life and religiosity/spirituality over time.

The validity of the residuals approach to measuring resilience to adverse childhood experiences

BACKGROUND

Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity. Recent work to harmonise the quantification and definition of resilience quantifies resilience as the residual variance in psychosocial functioning that remains after accounting for adversity exposure. However, there have been no published studies that have formally investigated the validity of this approach. Considering this, we examine the construct and predictive validity of the residuals approach using participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a multigenerational, longitudinal cohort study.

METHODS

We regressed exposures of adolescent adversity on adolescent psychopathology scores using the Strength and Difficulties Questionnaire and obtained the residual variance. We investigated construct validity by analysing whether previously identified demographic and resilience factors significantly predicted resilience. Predictive validity of resilience was investigated by comparing the predictive power of resilience with other determinants of psychosocial functioning on two developmental outcomes: depressive symptoms at 18 years, measured by the Short Moods and Feelings Questionnaire, and NEET (Not in Employment, Education or Training) status at 17 and 23 years. The associations between depressive symptoms at 18, resilience, ACEs and covariates were tested using multiple linear regression. NEET status at 17 and 23 were run as separate binary multiple logistic regression models to test associations with resilience and known demographics previously associated with NEET status.

RESULTS

Seven previously identified protective factors, including self-esteem, positive sibling relationship, temperament, and positive perception of school, significantly predicted resilience to adolescent psychopathology, thus providing strong construct validity. Resilience significantly predicted a reduction in depressive symptoms at 18 years, and significantly decreased the likelihood of having NEET status at both 17 years and 23 years, even after taking into account early childhood adversity and other risk factors. None of the socioeconomic factors were significantly associated with resilience.

CONCLUSIONS

Our study demonstrates that the residuals method of operationalising resilience has good construct and predictive validity yet recommend replication studies. It has the potential to advance research into the mechanisms and modifiability of resilience.

TRIAL REGISTRATION

Not applicable.

Psychometric Evaluation of the Healing After Gender-Based Violence Scale: An Instrument for Cross-Sectional and Longitudinal Assessment of Recovery Progress for Women-Identifying Survivors

PURPOSE

The Healing after Gender-based Violence Scale (GBV-Heal) was developed to measure the holistic recovery processes of woman-identifying survivors of gender-based violence (GBV). The GBV-Heal asks survivors to evaluate a series of statements based on perceptions of one's lowest point and how they currently feel. These scale response options create lowest point, current feelings, and difference scores to evaluate the healing outcome cross-sectionally. This manuscript aims to evaluate the psychometric properties of the GBV-Heal to understand its usefulness for research and practice.

METHOD

Instrument evaluation consisted of two phases analyzing online survey data from two GBV survivor samples recruited from online health research portals in the United States. In Phase One (N = 236), we conducted factor analyses and evaluated convergent/discriminant validity using depression, anxiety, posttraumatic stress, posttraumatic growth, and wellbeing measures. In Phase Two (N = 47), we evaluated GBV-Heal response consistency via test-retest within two weeks.

RESULTS

Results showed that the scale's final model included 4 components with 18 items, explaining 61.2% and 65% of the overall scale variances for "at my lowest point" and "my current feelings," respectively. The GBV-Heal difference score showed a weak positive correlation with wellbeing and posttraumatic growth scores and a weak negative correlation with depression, anxiety, and PTSD scores. Test-retest revealed Pearson r correlations of 0.82, 0.82, and 0.69 for the lowest point, current feelings, and difference scores respectively.

CONCLUSION

These findings substantiate the reliability and validity of our instrument as an outcome measure that can be used both cross-sectionally and longitudinally with survivors of GBV.

Protective Factors Associated With Post-traumatic Outcomes in Individuals With Experiences of Psychosis

Trauma and trauma-specific mental health difficulties (e.g., post-traumatic stress disorder) are highly prevalent in people with psychosis. However, not everyone develops post-traumatic symptoms, and some people even experience post-traumatic growth (PTG) following trauma. It is important to identify which protective factors are associated with less severe trauma symptoms and/or positive outcomes to inform the development and implementation of interventions fostering these variables. Eighty-five patients with experiences of psychosis took part in a cross-sectional study. They were administered questionnaires measuring exposure to traumatic events, symptoms of PTSD and complex PTSD and potential protective factors assumed to be associated with lower vulnerability for post-traumatic symptoms and higher post-traumatic growth (trait resilience, secure attachment, social support, adaptive coping, optimism, general self-efficacy). Multiple hierarchical regression showed that some of these protective factors, in particular optimism, were associated with lower post-traumatic symptoms, explaining 21% of the variance in complex PTSD symptoms and 16% of the variance in PTSD symptoms. However, the hypothesized protective factors, in particular resilience and adaptive coping, explained a considerably larger proportion of variance in PTG (44%). Our results suggest that whilst these variables provide only moderate protection from the vulnerability to experience post-traumatic stress, they may play an important role in allowing people to find meaning despite multiple traumas and subsequently lead more fulfilling lives. Therapies targeting the emotional and psychological consequences of trauma in people with psychosis might benefit from the integration of intervention strategies to enhance these additional psychological protective factors, which in turn may lead to positive treatment outcomes beyond the mere reduction of post-traumatic stress symptoms.

Charting a Course towards Resilience Following Adverse Childhood Experiences: Addressing Intergenerational Trauma via Strengths-Based Intervention

Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, the study of childhood adversity has blossomed, with expanded conceptualizations and assessments of ACEs. This review brings together various biological, psychological, and sociological principles that inform our understanding of ACEs and our approach to treatment. Specifically, we document the evolution of ACEs research, focusing on the intergenerational impact of ACEs, the importance of incorporating a resilience framework when examining ACEs, and implementing interventions that address adversity across generations and at multiple levels of the social ecology. Evidence is provided to support the evolving perspective that ACEs have long-lasting effects beyond the ACE(s)-exposed individual, with significant attention to the impact of parental ACEs on child development. An intergenerational and multilevel approach to understanding and addressing ACEs offers specific areas to target in interventions and in public policy.

Profiles of Resilience from Early to Middle Childhood among Children Known to Child Protection Services

OBJECTIVE

The processes facilitating resilience are likely to be influenced by individual, familial and contextual factors that are dynamic across the life-course. These factors have been less studied in relation to resilience profiles evident in the developmental period between early to middle childhood, relative to later periods of adolescence or adulthood.

METHOD

This study examined factors associated with resilience in a cohort of 4,716 children known to child protection services by age 13 years, in the Australian State of New South Wales. Latent profile and transition analyses were used to identify multi-dimensional profiles of resilience as evident in social, emotional and cognitive functioning when assessed in early childhood (time 1 [T1], age 5-6 years) and middle childhood (time 2 [T2], age 10-11 years). Logistic regression models were used to investigate factors associated with two types of resilience identified: a transition profile of stress-resistance (i.e., represented by a typically developing profile at both T1 and T2) delineated in the largest subgroup (54%) of children, and a smaller subgroup (13%) with a profile of emergent resilience (i.e., typically developing at T2 following a vulnerable profile at T1).

RESULTS

Factors associated with resilience profiles included being female, and personality characteristics of openness and extraversion; other factors associated with stress-resistance, specifically, included higher socioeconomic status, non-Indigenous background, higher perceived port at home and at school, and not having a parent with a history of criminal offending.

CONCLUSIONS

Resilience processes appear to involve a complex interplay between individual, family, and community characteristics requiring interagency support.

Patterns of Depression and Resilience in Children and Adolescents Exposed to an Earthquake: A Latent Profile Analysis

OBJECTIVE

Depression and resilience are different psychological outcomes caused by experiencing traumatic events. We aimed to 1) explore heterogeneity patterns of co-occurrence between depression symptoms and resilience among children and adolescents exposed to an earthquake and 2) assess covariates (trauma exposure, sex, age, ethnicity, and sleep quality) in identifying the best fitting solution.

METHODS

Latent profile analysis (LPA) was used to examine patterns of self-reported depression and resilience in an epidemiological sample of 2,887 Chinese youth survivors 1 year after the Lushan earthquake.

RESULTS

A suitable 3-class model were identified, which are mild depression/high resilience (65.0%), severe depression/high resilience (22.1%), and severe depression/low resilience (12.9%). Trauma exposure, demographic characteristics and sleep state can be used to identify the different latent classes.

CONCLUSION

Our results contribute to understanding the heterogeneous coexisting patterns of depression and resilience and provide suggestions for identifying high-risk youth survivors and offering effective interventions.

Dispositional optimism mediates relations between childhood maltreatment and PTSD symptom severity among trauma-exposed adults

BACKGROUND

Experiences of maltreatment in childhood, such as abuse and neglect, have been associated with poorer psychological well-being in adulthood, including elevated risk of revictimization and increased likelihood of developing posttraumatic stress disorder (PTSD) symptoms. Maltreatment has also been associated with reduced resources related to resilience, such as optimism, which may act as a protective factor for mental health.

OBJECTIVES

In this study, we examined the mediating role of dispositional optimism in the relationship between childhood maltreatment and PTSD symptom severity from recent trauma in a sample of adults (n = 108) who presented to their local emergency department following trauma.

METHODS

We analyzed six models to account for cumulative childhood maltreatment as well as five primary subtypes of maltreatment: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect.

RESULTS

Greater dispositional optimism mediated relations between total maltreatment and decreased PTSD severity (Bab = .056, SE = .029, 95 % CI [.009, .121]). Optimism also mediated relations between all maltreatment subtypes and PTSD severity, except sexual abuse.

CONCLUSIONS

These results may suggest optimism and positive psychology interventions as effective techniques in reducing the likelihood of PTSD development and severity in trauma-exposed individuals.

The Healing after Gender-Based Violence Scale (GBV-Heal): An Instrument to Measure Recovery Progress in Women-Identifying Survivors

Current literature has primarily equated gender-based violence recovery with an improvement of physical or mental health symptoms, causing a gap in our understanding of the impact of interventions beyond the amelioration of adverse symptomology. The purpose of this research was to create an instrument to holistically measure gender-based violence recovery based on survivor healing goals. Ethnographic interviews were conducted in women-identifying gender-based violence survivors (ages 18-76) to determine healing domains and develop items using survivor language (n = 56). Focus groups with academic and community experts (n = 12) and cognitive interviews with gender-based violence survivors (n = 12) were conducted to ensure content and face validity, as well as to evaluate acceptability. This yielded a 31-item instrument to measure healing progress on a 5-point Likert scale. The Healing after Gender-based Violence Scale has the potential to highlight survivor strength and growth while more accurately measuring their recovery process based on survivor goals and desires.

Resilience Protective Factors Checklist (RPFC): Buffering Childhood Adversity and Promoting Positive Outcomes

While research tends to focus on understanding risk factors associated with adverse childhood and adolescent experiences, there is growing empirical support within the field of human services to also focus on strengths and protective factors that bolster resilience in life. This study investigated the psychometrics of the Resilience Protective Factors Checklist (RPFC), which is a questionnaire that assists in the identification of protective factors empirically linked to resilience and positive outcomes. In addition, associations between protective factors, childhood adversity, and quality of life outcomes were examined. Participants were undergraduate college students (n = 1,256). The results revealed good psychometric properties for the RPFC and the factor analysis supported the resilience structural model of three interrelated areas of protective factors - Individual, Family, and Community influences. All three areas of protection were positively correlated with all four domains of positive life outcomes (physical health, psychological health, social relationships, and a healthy environment) and negatively correlated with adverse childhood experiences. RPFC's individual protective factors positively predicted physical health and psychological health outcomes, while the community protective factors positively predicted environmental health outcomes. In addition, the RPFC's family protective factors moderated the path between adverse childhood experiences and social relationships. That is, for individuals who have experienced more adverse childhood experiences, those with higher levels of RPFC family protective factors had positive social relationship outcomes, while those with lower levels of family protective factors had negative social relationship outcomes. These findings lend support for the utilization of assessment measures for identifying and promoting protective factors that can buffer life adversity and heighten resilient positive outcomes.

Psychological trajectories of Chinese women undergoing pregnancy termination for foetal abnormality: A descriptive qualitative study using expressive writing

AIMS AND OBJECTIVES

To explore the psychological trajectories of women who have had a diagnosis of foetal abnormality from the time of receiving a definite diagnosis to one month after discharge.

BACKGROUND

Foetal abnormalities are not uncommon worldwide. Such situations are devastating, and the termination of a pregnancy due to foetal abnormalities is a traumatic and stressful event for the mother.

DESIGN

A descriptive qualitative approach using expressive writing.

METHODS

The study included 20 women recruited through purposive sampling at a tertiary hospital in China. The participants were asked to write four 15-min essays related to their experiences with foetal abnormalities. Thematic analysis was used to generate themes. The COREQ checklist (see Supporting Information Appendix S1) was used.

RESULTS

Four themes that reflected the women's psychological trajectories were identified: (a) traumatic response, (b) ruminant meditation, (c) positive coping and (d) post-traumatic growth stages. The psychological trajectories were dynamically shaped, and different responses were displayed in each stage.

CONCLUSIONS

Various responses were observed during each of the four psychological trajectories, which indicated that awareness regarding the psychological impacts associated with foetal abnormalities should be increased. The present findings suggest that healthcare services should be made accessible for women who have had a diagnosis of foetal abnormality to allow them to receive targeted nursing care at different stages and improve their psychological well-being.

RELEVANCE TO CLINICAL PRACTICE

Midwives, nurses and other healthcare professionals should pay more attention to the mental health of women pregnant with foetuses diagnosed with abnormalities. Interventions designed based on women's worries and demands during various phases should be offered. In terms of the present research method, expressive writing possesses unique advantages that can be applied for relevant qualitative research.

Survivors' lived experiences of posttraumatic growth after institutional childhood abuse: An interpretative phenomenological analysis

BACKGROUND

Institutional childhood abuse (ICA) represents a chronic and severe form of childhood maltreatment and is associated with a host of adverse outcomes. However, there is some evidence to suggest that survivors can also experience positive psychological change after institutional childhood abuse and neglect.

OBJECTIVE

To examine the lived experiences of posttraumatic growth (PTG) in adult survivors of institutional childhood abuse.

PARTICIPANTS AND SETTING

Nine survivors of historical institutional abuse in Ireland ranging in age from 41 to 75 years (M = 60.5).

METHOD

Semi-structured interviews were conducted to explore survivors' experiences of positive change after institutional upbringing. Data were analysed in the tradition of interpretative phenomenological analysis (IPA).

RESULTS

The analysis yielded two superordinate themes. The first major theme, 'Survivor Identity' described participant's subjective understanding of their survivorship through five subthemes. The second major theme, 'Engendering Growth' comprised seven subthemes which collectively identified key factors and processes related to positive change and posttraumatic growth after significant early-life maltreatment.

CONCLUSIONS

Findings underscore the importance of supporting survivors to construct a comprehensive self-narrative that identifies their personal strengths and growthful experiences, whilst also acknowledging the continued distress associated with their unique survivorship trajectory.

The contribution of school experience to students' resilience following a terror-related homicide

Schools have a significant effect on students' development, and serve as important social agencies for interventions for students facing disasters. However, little is known about the effect of students' school experience itself on their resilience when facing extreme negative events. The present study focused on students who were exposed to terror-related homicide with the aim of investigating the contribution of school climate resources to their resilience. Since resilience is associated not only with fewer negative outcomes, but also with positive change, the contribution of schools was studied as both inhibiting post-traumatic stress symptoms (PTS) and enhancing post-traumatic growth (PTG). A mixed-methods research design was used. The participants included 117 (52% girls) high school students (mean age = 14.54; SD = 1.49). Twenty-five of them were interviewed in addition to responding to the research questionnaires. Different aspects of the school climate were found to be associated with students' PTS and PTG, yielding two overarched factors explaining the school's role as a protective resource: sheltering and supporting. The former is associated with fewer PTS and the latter with higher PTG. The use of different resources for different forms of resilience is discussed.

Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels

IMPORTANCE

Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health.

OBJECTIVE

To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels.

DESIGN, SETTING, AND PARTICIPANTS

Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019.

MAIN OUTCOMES AND MEASURES

The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used.

RESULTS

In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES.

CONCLUSIONS AND RELEVANCE

Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.

Posttraumatic Growth in Complex PTSD

Objective: Although efforts have been made to study mechanisms and mediators of posttraumatic growth (PTG - positive sequelae of coping with trauma), little has been done to investigate PTG as a concept in the context of complex PTSD, a disorder recently delineated in ICD11. This article considers PTG in relation to complex PTSD, primarily as associated with childhood sexual abuse. Method: Using clinical case material and available literature, we explore the emergence of PTG in the treatment of patients with complex PTSD and examine factors contributing to its appearance. Results: Despite extensive early traumas, including those associated with histories of ongoing childhood sexual abuse, patients may be capable of PTG. While factors favoring PTG may include temperamental resilience and other as yet ill-defined personality traits, the presence of safe, supportive and enduring therapeutic and extra-therapeutic relationships, appear to address insecure attachments related to trauma and be of considerable importance in fostering possibilities for PTG. Conclusions: While much remains to be learned, encouraging and helping establish varieties of accepting, trusting and nurturing contacts in real world and psychotherapy and introducing and exploring the concept of PTG within therapy, can help patients suffering from complex PTSD address the underlying developmental deficiencies they have endured, facilitate treatment, and promote PTG.