Resiliencia: una aproximación al concepto

Effects of interventions to promote resilience in nurses: A systematic review

BACKGROUND

Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects.

OBJECTIVE

The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience.

DESIGN

This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.

METHODS

Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected.

RESULTS

A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups.

CONCLUSIONS

The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement.

TWEETABLE ABSTRACT

It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.

Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system

Introduction

Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect.

Objectives

To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system.

Methods and analysis

This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed.

Discussion

This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role.

Trial registration

ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

An Exploration of Resilience and Positive Affect among Undergraduate Nursing Students: A Longitudinal Observational Study

BACKGROUND

The purpose of this study is to analyze the variation in resilience and emotional state scores in nursing students throughout the four years of training for the nursing degree.

METHODS

This is a longitudinal observational study of a paired and prospective cohort of 176 nursing students who enrolled in the first year of a bachelor's degree in 2019. The study followed up with the students in 2022 and examined several sociodemographic factors, including sex, marital status, date of birth, living arrangements and occupation. Additionally, the study investigated changes in negative affect, positive affect, and resilience.

RESULTS

A total of 176 students participated in the study. The study found that resilience increased from 68.24 ± 10.59 to 70.87 ± 9.06 (p < 0.001), positive affect increased from 28.16 ± 4.59 to 33.08 ± 8.00 (p < 0.001), and the negative affect score decreased from 25.27 ± 5.12 to 21.81 ± 7.85 (p < 0.001). The study also found that married individuals experienced an increase in negative affect (p = 0.03) compared to singles or those in open relationships. Furthermore, the change in resilience was greater in men than in women (p = 0.01).

CONCLUSIONS

Throughout their four-year training, nursing students experience an increase in resilience and positive affect, as well as a decrease in negative affect.

Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study

BACKGROUND

Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk.

AIM

The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD.

METHODS

Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson's 10-item Resilience Scale.

RESULTS

Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide (T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores (r = -.28; p < .01).

CONCLUSIONS

Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.

Coping with the Stress through Individual and Contextual Resilient Factors in Primary School Settings

Children face school stress as students through all educational stages. A negative association between resilience and stress has been demonstrated by many authors, but most of these studies have been carried out in higher educational stages. So, the aim of the present study is, on the one hand, to find out the level of stress of primary school children and also the types of stressful situations in school settings, and on the other hand, to analyze the effect of individual and contextually resilient factors on their level of school stress. The study involved 427 children between 6 and 12 years of age, who were administered the IECI school stress scale and the RES-PRIM Resilience questionnaire for children. Descriptive analyses, correlations, and regression analyses were performed on the data. Results showed an average level of school stress, with the most stressful situations being: participating in too many activities, concentration problems, and nervousness when being asked by the teacher in class. Predictive analysis showed that part of the school stress could be explained by both individual factors (self-esteem, introspection, future purpose, and social skills) and resilient contextual factors (teacher support, parental support, and peer support). It is concluded that it is necessary to pay more attention to the transitions between different educational stages with programs that reinforce academic information and encourage the development of individual resilient skills, stressing the importance of the role of teachers, peers, and parents as support groups.

Post-COVID-19 syndrome in a sample of climacteric women living in Latin America

OBJECTIVE

The aim of this study was to assess resilience, fear of COVID-19, sleep disorders, and menopause-related symptoms after the acute phase of COVID-19 in middle-aged women with positive reverse transcription-polymerase chain reaction and noninfected women.

METHODS

This is a cross-sectional, analytical study of climacteric women from 9 Latin American countries, aged 40-64 years, attending a routine health checkup. We evaluated clinical characteristics and used the Connor-Davidson Resilience Scale, the Fear of COVID-19 Scale, the Jenkins Sleep Scale, and the Menopause Rating Scale to evaluate their health.

RESULTS

A total of 1,238 women were studied, including 304 who were positive for COVID-19 reverse transcription-polymerase chain reaction. The median (interquartile range) age was 53 (12) years; years of studies, 16 (6); body mass index, 25.6 (5.1) kg/m 2 ; and time since first COVID-19 symptom, 8 (6) months. COVID-19 patients reported fatigability (18.8%), joint and muscular discomfort (14.1%), and anosmia (9.5%). They had a significantly lower resilience score (26.87 ± 8.94 vs 29.94 ± 6.65), higher Fear of COVID-19 score (17.55 ± 7.44 vs 15.61 ± 6.34), and a higher Jenkins Scale score (6.10 ± 5.70 vs 5.09 ± 5.32) compared with control women. A logistic regression model confirmed these results. There was not a significant difference in the total Menopause Rating Scale score, although the odds ratios for both severe menopausal symptoms (1.34; 95% confidence interval, 1.02-1.76) and the use of hypnotics were higher in women with COVID-19 (1.80; 95% confidence interval, 1.29-2.50) compared with those without infection. We found no decrease in studied outcomes between the initial 7 months versus those reported after 8 to 18 months since first COVID-19 symptoms.

CONCLUSIONS

COVID-19 climacteric women have sleep disorders, lower resilience and higher fear of COVID-19.

Student Perceptions of the Resilience in a Confinement Due to COVID-19 in University of A Coruña: A Qualitative Research

The home confinement caused by COVID-19 has caused university students to express feelings, negative experiences, and concerns about the confinement situation they were experiencing. This prompted the development of research on resilience, which shows that it is closely related to well-being. The general objective is to determine if resilience acts as a guarantor of personal growth and, therefore, of the self-perception of well-being. The research is developed with qualitative methodology and is framed in the interpretative phenomenological analysis approach and is framed in the hermeneutic-dialectical method. The selection of participants was carried out through an intentional sampling, by non-random methods, among university students. Fifty-two students participated, 41 are women (78.84%) and 11 men (21.15%), with an average age of 20.7 years. The information was collected through a diary card in which they had to collect their experiences and prepare a short speech identifying three temporal moments of confinement: beginning, during, and end. The information was collected between 16 April and 15 May 2020. An inductive analysis was carried out, and the emerging categories were defined: personal growth, resilience, and well-being. Personal growth materializes through three subcategories: personal changes, interpersonal changes, and changes in the philosophy of life. The university students showed that the vital transformation related with resilience acts as a guarantor of personal growth and self-perception of well-being. A voluntary, conscious, and intelligent evolution of people is detected, and personal changes, interpersonal changes, and changes in the philosophy of life are identified as factors of personal growth.

Resilience in the Perinatal Period and Early Motherhood: A Principle-Based Concept Analysis

A context-specific delineation of research approaches to resilience in the perinatal and early motherhood literature is currently lacking. A principle-based concept analysis was used to establish a description of how women's resilience is currently conceptualised and operationalised within empirical research in the perinatal period and early motherhood (defined as up to five-years postpartum). CINAHL, Medline, PsychInfo, EMBASE, ASSIA, Web of Science, Scielo, Maternity and Infant Care, the Cochrane Library, and the World Health Organization were systematically searched (January/February 2020 and March 2022). Fifty-six studies met the inclusion criteria. Analysis demonstrated interchangeable use of associated concepts such as 'coping', 'coping strategies', and 'adaptation'. Resilience was frequently operationalised as the absence of illness symptomatology, rather than the presence of mental well-being. Investigations of positive areas of functioning were predominately related to the mother's family role. There was limited qualitative exploration of women's perspectives. Recommendations for the pragmatic application of resilience research were not well developed. The narrow operationalisation of resilience by mental ill-health and parental role, and the distinct absence of women's perspectives, restricts the logical maturity and pragmatic application of the concept. Future research may benefit from exploration of women's insights on indicators that might best reflect positive functioning and resilience in this period.

Stress and burnout among health-care workers in the coronavirus disease 2019 intensive care unit

Since late December 2019, the city of Wuhan in China has reported a novel pneumonia caused by coronavirus disease 2019 (COVID-19), which has now spread domestically and internationally. The COVID-19 pandemic has caused unthinkable consequences and has challenged and, in numerous cases, beaten the capacity of hospitals and intensive care units (ICUs) worldwide to handle it. Apart from the obvious burden of patient care, extended work timings, and fear of personal safety, health-care workers (HCWs) also suffer from occupational stress as a result of lack of skills, organizational factors, and low social support at work leading to distress, burnout, and psychosomatic problems. This leads to stress, direct deterioration in quality of life as well as the quality of service provided. In this article, the authors navigate on the root cause of stress that is peculiar to the HCWs deployed in the ICU and suggest recommendations to alleviate it. To aid in the research, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, CINAHL, NIOSHTIC-2, and Web of Science up to May 2021.

Desenvolvimento e Investigação de Evidências de Validade para o Instrumento Marcadores de Resiliência Infantil

Resumo Embora a resiliência seja considerada um construto importante para o enfrentamento de situações adversas, nenhum instrumento brasileiro encontra-se disponível para sua avaliação na infância. Assim, os objetivos deste trabalho relacionam-se à elaboração de um instrumento para avaliação da resiliência em crianças de oito a 12 anos, investigação das evidências de validade baseadas no conteúdo e realização de estudo piloto. Participaram do processo de construção 20 crianças, de escolas públicas e particulares. Do estudo de validade de conteúdo, participaram 16 juízes. E, do estudo piloto, participaram 43 crianças de uma escola pública. Os resultados possibilitaram a seleção das alternativas dos itens, bem como indicaram a pertinência de 27 dos 30 itens desenvolvidos, segundo avaliação dos juízes, bem como sua adequação à faixa etária almejada. A partir dos resultados, pode-se notar que as escolhas metodológicas tomadas no processo de construção colaboraram para que o instrumento apresentasse bom potencial. Sugere-se que novos estudos sejam realizados, a fim de aprofundar a compreensão sobre suas qualidades psicométricas.

Building the Concept of Nurturing Resilience

THEORETICAL PRINCIPLES

Children and adolescents are faced with ubiquitous daily stressors. When faced with various stressors, they will either recover or stay distressed. For those unable to recover, acute daily stressors have potential to turn chronic with long term negative mental health outcomes. Nurturing resilience is one way to prevent distress from turning to mental health disorders. With the ability of adolescents and children to access nurses with various specialties, it is imperative nurses understand the nuances of resilience and the core elements to nurture resilience in youth.

PHENOMENA ADDRESSED

The purpose of building the concept of nurturing resilience is to clarify the meaning of this concept in children and adolescents, develop a conceptual definition of nurturing resilience, and provide a conceptual model of nurturing resilience based on the building process. The concept was formulated utilizing Liehr and Smith's practice-based approach to concept building.

RESEARCH LINKAGES

Concept building defines nurturing resilience as developing secure connections with another to support self-acceptance that aids in tempering reactivity when faced with environmental hardships. Resilience is a protective mechanism which keeps youth balanced while promoting positive mental health when faced with adversities by allowing one to bounce back after adversity to an original, fundamental state. Understanding patterns and processes of resilience enables nurses to nurture resilience. Nurturing resilience provides adolescents and children the ability to change in response to difficult circumstances; in turn, mental distress is reduced, and mental health of youth are optimized.

Resilience in inpatient palliative care nursing: a qualitative systematic review

Background

Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.

Objective

The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.

Design

A thematic synthesis of qualitative studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

Academic Search Ultimate, Cumulative Index to Nursing and Allied Health Literature, Medline Complete, PsycINFO and Scopus.

Review methods

The review stages were searching for relevant literature, selecting relevant papers, data extraction, critical appraisal and thematic synthesis.

Results

Eight studies revealed 10 subthemes, 3 descriptive themes and 1 analytical theme: resilience occurs when nurses incorporate stressful aspects of their personal or professional lives into a coherent narrative that enhances their ability to cope with the demands of their role.

Conclusion

Palliative care nursing is more stressful if patients or situations remind nurses of personal experiences. Nurses cope better with adequate support; however, coping does not necessarily imply increased resilience. Resilience occurs when nurses cognitively process their experiences, articulate their thoughts and feelings into a coherent narrative, and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.

Does resiliency mediate the association of psychological adaptability with disability and pain in patients with an upper extremity injury or illness?

OBJECTIVE

Symptom intensity and magnitude of limitations are highly variable for a given nociception and pathophysiology. As psychological determinants are of great influence to physical wellbeing, we assessed the influence of the protective factor measured and labelled as resilience in upper extremity illness.

METHODS

One hundred and six patients completed a survey of demographics, the Brief Resilience Scale (BRS), the Psychological Adaptation Scale (PAS), an 11-point ordinal measure of pain intensity, and the PROMIS Physical Function (PROMIS PF) Computer Adaptive Test (CAT). Measures of pain intensity and PROMIS PF were repeated 3 months later. We created mediation models using structural equation modeling (SEM) to assess the mediation effect of BRS on the association of PAS and other confounding variables with disability and pain at initial assessment and 3 months later.

RESULTS

Resiliency does not mediate the association of psychological adaptability with physical limitations and pain intensity at baseline (P = .89 and .82 respectively) or 3 months after enrollment (P = .65 and .72 respectively).

CONCLUSIONS

Positive and protective factors promote beneficial resilience mechanisms that strengthen coping responses to pain and disability. In future studies we should either include more patients to improve power and provide more information about the health benefits of resilience or focus more on mood and self-efficacy on symptoms and limitations in patients with musculoskeletal illness.

LEVEL OF EVIDENCE

Prospective, longitudinal cohort study; Level II.

Validez de una escala de resiliencia (RESI-M) en mujeres indígenas de México

Resumen: La resiliencia engloba una serie de capacidades y habilidades, las cuales son adquiridas como resultado de la interacción del individuo con su contexto, logrando superar sus propios límites de resistencia, a través de la generación de mecanismos, procesos de defensa y protección más eficientes que antes, ante la exposición a eventos adversos. La medición de la resiliencia se hace a través de la medición de la adversidad, adaptación exitosa y el proceso, lo que ha generado en la actualidad una variedad de herramientas. En la literatura no existe un instrumento que contemple la resiliencia desde una perspectiva cultural indígena y en mujeres, por lo tanto, el objetivo de este estudio fue evaluar la validez y confiabilidad de las puntuaciones obtenidas con esta escala, al ser aplicada en mujeres indígenas. La muestra la integraron 180 participantes, pertenecientes a diversas localidades indígenas de México, a las cuales se les aplicó la Escala de Resiliencia Mexicana (RESI-M) de Palomar Lever & Gómez Valdez 2010. Se evaluó la consistencia interna mediante el coeficiente de fiabilidad alfa de Cronbach y se determinó la estructura interna de cada una de las dimensiones por medio de un análisis factorial de componentes principales con rotación Varimax. La edad media de las participantes fue de 33±9,4 años de edad. Tras los análisis de confiabilidad y validez estadística, se obtuvo una versión final del instrumento de 34 preguntas, de las 43 originales; con una confiabilidad aceptable de 0,942 (alfa de Cronbach) y con 6 factores que explican el 56,34% de la varianza total. La versión es válida y confiable, con una estructura que permite evaluar la resiliencia como un proceso en mujeres indígenas.

Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates

BACKGROUND

The high level of psychological resilience, self-confidence and problem solving skills of midwife candidates play an important role in increasing the quality of health care and in fulfilling their responsibilities towards patients.

OBJECTIVES

This study was conducted to investigate the psychological resilience, self-confidence and problem-solving skills of midwife candidates.

DESIGN

It is a convenience descriptive quantitative study.

SETTINGS

Students who study at Health Sciences Faculty in Turkey's Central Anatolia Region.

PARTICIPANTS

Midwife candidates (N = 270).

METHODS

In collection of data, the Personal Information Form, Psychological Resilience Scale for Adults (PRSA), Self-Confidence Scale (SCS), and Problem Solving Inventory (PSI) were used.

RESULTS

There was a negatively moderate-level significant relationship between the Problem Solving Inventory scores and the Psychological Resilience Scale for Adults scores (r = -0.619; p = 0.000), and between Self-Confidence Scale scores (r = -0.524; p = 0.000). There was a positively moderate-level significant relationship between the Psychological Resilience Scale for Adults scores and the Self-Confidence Scale scores (r = 0.583; p = 0.000). There was a statistically significant difference (p < 0.05) between the Problem Solving Inventory and the Psychological Resilience Scale for Adults scores according to getting support in a difficult situation.

CONCLUSIONS

As psychological resilience and self-confidence levels increase, problem-solving skills increase; additionally, as self-confidence increases, psychological resilience increases too. Psychological resilience, self-confidence, and problem-solving skills of midwife candidates in their first-year of studies are higher than those who are in their fourth year. Self-confidence and psychological resilience of midwife candidates aged between 17 and 21, self-confidence and problem solving skills of residents of city centers, psychological resilience of those who perceive their monthly income as sufficient are high. Psychological resilience and problem-solving skills for midwife candidates who receive social support are also high. The fact that levels of self-confidence, problem-solving skills and psychological resilience of fourth-year students are found to be low presents a situation that should be taken into consideration.

Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: a cross-sectional case-control study

Introduction

This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not.

Methods

This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire. The statistical tests used were the McNemar test for categorical variables, the Wilcoxon signed-rank test for continuous asymmetric variables, and the paired Student t-test for continuous symmetric variables.

Results

The PTSD group showed lower total Resilience Scale scores compared with controls (128.4±20.7 vs. 145.8±13.1, respectively; p = 0.01), along with a lower ability to solve situations and lower personal values that give meaning to life (p = 0.019). They also had lower rates of mature defense mechanisms (p < 0.001) and higher rates of emotional (p = 0.001) and physical (p = 0.003) abuse during childhood.

Conclusion

Lower levels of resilience, especially the ability to solve situations and having personal values that give meaning to life, immature defense mechanisms, and emotional and physical abuse in childhood are associated with PTSD in adult Brazilian victims of urban violence.

What makes leaders resilient? An exploratory interview study

Can the boss take the heat? Is he or she tough enough for the job? Can they take it, endure the pressure, tolerate or stand up to it? Although we know that resilient leaders are essential for a healthy and efficient workforce, the resilience of leaders itself is still largely unexplored. Our study aims to identify distinctive resilience factors in leadership and help close this research gap. We interviewed 27 leaders from various industrial sectors, German regions and leadership positions. In a qualitative content analysis, we identified 77 individual, situational and behavioural factors that seem to impact on the resilience of leaders. We divided these factors into meaningful categories and integrated them into a framework appropriate for leadership. This framework shows that in addition to individual traits and abilities, situational factors (private and work environment) and behavioural factors (personal and interpersonal behaviour) are highly important and that leaders’ resilience results from an interaction of these factors. As most of the identified factors can be directly influenced by the leader or the organization, our study provides important insights into the effective development and nurturing of leaders’ resilience. Furthermore, the findings can be a helpful starting point for future empirical studies.

Experiences of severe childhood maltreatment, depression, anxiety and alcohol abuse among adults in Finland

Childhood maltreatment increases the risk of subsequent depression, anxiety and alcohol abuse, but the rate of resilient victims is unknown. Here, we investigated the rate of victims that do not suffer from clinical levels of these problems after severe maltreatment in a population-based sample of 10980 adult participants. Compared to men, women reported more severe emotional and sexual abuse, as well as more severe emotional neglect. For both genders, severe emotional abuse (OR = 3.80 [2.22, 6.52]); severe physical abuse (OR = 3.97 [1.72, 9.16]); severe emotional neglect (OR = 3.36 [1.73, 6.54]); and severe physical neglect (OR = 11.90 [2.66, 53.22]) were associated with depression and anxiety while only severe physical abuse (OR = 3.40 [1.28, 9.03]) was associated with alcohol abuse. Looking at men and women separately, severe emotional abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.74 [2.06, 6.81] in women) and severe physical abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.03 [0.99, 9.33] in women) were associated with clinical levels of depression and anxiety. In addition, in women, severe sexual abuse (OR = 2.40 [1.10, 5.21]), emotional neglect (OR = 4.78 [2.40, 9.56]), and severe physical neglect (OR = 9.86 [1.99, 48.93]) were associated with clinical levels of depression and anxiety. Severe emotional abuse in men (OR = 3.86 [0.96, 15.48]) and severe physical abuse in women (OR = 5.18 [1.48, 18.12]) were associated with alcohol abuse. Concerning resilience, the majority of severely maltreated participants did not report clinically significant levels of depression or anxiety (72%), or alcohol abuse (93%) in adulthood. Although the majority of severely abused or neglected individuals did not show clinical levels of depression, anxiety or alcohol use, severe childhood maltreatment increased the risk for showing clinical levels of psychopathology in adulthood.

Measuring psychological resilience to disasters: are evidence-based indicators an achievable goal?

Despite rising interest on the concept of societal resilience and its measurement, little has been done to provide operational indicators. Importantly, an evidence-based approach to assess the suitability of indicators remains unexplored. Furthermore few approaches that exist do not investigate indicators of psychological resilience, which is emerging as an important component of societal resilience to disasters. Disasters are events which overwhelm local capacities, often producing human losses, injury and damage to the affected communities. As climate hazards and disasters are likely to increase in the coming decades, strengthening the capacity of societies to withstand these shocks and recover quickly is vital. In this review, we search the Web of Knowledge to summarize the evidence on indicators of psychological resilience to disasters and provided a qualitative assessment of six selected studies. We find that an evidence-based approach using features from systematic reviews is useful to compile, select and assess the evidence and elucidate robust indicators. We conclude that strong social support received after a disaster is associated with an increased psychological resilience whereas a female gender is connected with a decrease in the likelihood of a resilient outcome. These results are consistent across disaster settings and cultures and are representative of approximately 13 million disaster-exposed civilians of adult age. An approach such as this that collects and evaluates evidence will allow indicators of resilience to be much more revealing and useful in the future. They will provide a robust basis to prioritize indicators to act upon through intersectoral policies and post-disaster public health interventions.

Resilience: Building immunity in psychiatry

The challenges in our personal, professional, financial, and emotional world are on rise, more so in developing countries and people will be longing for mental wellness for achieving complete health in their life. Resilience stands for one's capacity to recover from extremes of trauma and stress. Resilience in a person reflects a dynamic union of factors that encourages positive adaptation despite exposure to adverse life experiences. One needs to have a three-dimensional construct for understanding resilience as a state (what is it and how does one identify it?), a condition (what can be done about it?), and a practice (how does one get there?). Evaluating the level of resilience requires the measurement of internal (personal) and external (environmental) factors, taking into account that family and social environment variables of resilience play very important roles in an individual's resilience. Protection factors seem to be more important in the development of resilience than risk factors. Resilience is a process that lasts a lifetime, with periods of acquisition and maintenance, and reduction and loss for assessment. Overall, currently available data on resilience suggest the presence of a neurobiological substrate, based largely on genetics, which correlates with personality traits, some of which are configured via social learning. The major questions about resilience revolve around properly defining the concept, identifying the factors involved in its development and recognizing whether it is actually possible to immunize mental health against adversities. In the clinical field, it may be possible to identify predisposing factors or risk factors for psychopathologies and to develop new intervention strategies, both preventive and therapeutic, based on the concept of resilience. The preferred environments for application of resilience are health, education, and social policy and the right approach in integrating; it can be developed only with more research and analysis with focus on resilience. Be it patient or family member or caregiver, advocating resilience will empower psychiatrists in India.