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Fernández-Alonso V, Rodríguez-Fernández S, Secadas-Rincón L, Pérez-Gómez M, Moro-Tejedor MN, Salcedo M. Resilience After COVID-19: A Descriptive, Cross-Sectional Study. Clin Nurs Res 2023; 32:618-628. [PMID: 36760005 PMCID: PMC9922667 DOI: 10.1177/10547738231154326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The main purpose of this study was to examine the relationship between resilience and health-related quality of life in patients following COVID-19 disease among those with and without lingering symptoms. The study design is descriptive and cross-sectional. Participants (n = 97) were adults who had earlier contracted COVID-19 disease and were in post-infection status between July and October 2020. Participants completed the following instruments: Connor-Davidson Resilience Scale, Short-Form 12-item Health Survey, and Hospital Anxiety and Depression Scale. Approximately 35% post-COVID-19 patients had a low level of resilience. The impact on the health status and resilience of those who had reported symptoms after 6 months was also significant. Age and depression had a significant impact on level of resilience. This relationship can affect patient recovery and negatively impact the ability to cope with COVID-19 disease. It is necessary to implement specialized training for clinicians on the effects of long-term COVID-19 to improve patient care. Long COVID symptoms might manifest months after an acute COVID-19 illness; clinicians who can confirm patient reports of these symptoms may help patients recover and become more resilient.
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Affiliation(s)
- Víctor Fernández-Alonso
- Hepatology and Liver Transplantation
Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria
Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, Madrid,
Spain,Víctor Fernández-Alonso, Hepatology and
Liver Transplantation Unit, Instituto de Investigación Sanitaria Gregorio
Marañón, Hospital General Universitario Gregorio Marañón, Calle Dr. Esquerdo 46,
Madrid 28007, Spain.
| | | | - Laura Secadas-Rincón
- Hepatology and Liver Transplantation
Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuela Pérez-Gómez
- Hepatology and Liver Transplantation
Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Nieves Moro-Tejedor
- Instituto de Investigación Sanitaria
Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, Madrid,
Spain,Red Cross University College of
Nursing, Spanish Red Cross, Autonomous University of Madrid, Madrid, Spain
| | - Magdalena Salcedo
- Hepatology and Liver Transplantation
Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Rezaeipandari H, Mohammadpoorasl A, Morowatisharifabad MA, Shaghaghi A. Psychometric properties of the Persian version of abridged Connor-Davidson Resilience Scale 10 (CD-RISC-10) among older adults. BMC Psychiatry 2022; 22:493. [PMID: 35869455 PMCID: PMC9308300 DOI: 10.1186/s12888-022-04138-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/13/2022] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Resilience is an ability of an individual to respond positively to environmental challenges. This ability could help elderly people to better cope with their age-related changes and diseases. The aim of this study was to examine the psychometric properties of Persian version of abridged Connor- Davidson scale of resilience among Iranian elderly people with chronic diseases.
Methods
Standard translation/back-translation procedure was applied to prepare the Persian version of abridged Connor-Davidson scale of resilience (CD-RISC 10-P) and its face and content validity were examined by an expert panel. The internal consistency and reliability of the drafted CD-RISC 10-P were investigated using the Cronbach’s alpha and intra-class correlation coefficients. A sample of 400 Muslim and Zoroastrian Persian older adults residing in the city of Yazd, Iran was recruited to assess factor structure of CD-RISC 10-P using the confirmatory factor analysis.
Results
The calculated values of the Cronbach’s alpha (0.89) and ICC (0.90) coefficients were in the within of acceptable range. The confirmatory factor analysis outputs also confirmed the unidimensionality of the CD-RISC 10-P (RMSEA = 0.073, SRMR = 0.030).
Conclusions
The study findings showed that the CD-RISC 10-P is a valid and reliable scale to measure resilience with age-related challenges of chronic diseases among Persian-speaking elderly people. Cross-cultural adaptability of the CD-RISC 10-P is recommended to be assessed in different subgroups of the Iranian elderly people and possibly in other Persian-speaking populations of different countries.
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Waddimba AC, Baker BM, Pogue JR, McAuliffe MP, Bennett MM, Baxter RD, Mohr DC, Warren AM. Psychometric validity and reliability of the 10- and 2-item Connor-Davidson resilience scales among a national sample of Americans responding to the Covid-19 pandemic: an item response theory analysis. Qual Life Res 2022; 31:2819-2836. [PMID: 35366196 PMCID: PMC8976171 DOI: 10.1007/s11136-022-03125-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
Abstract
Purpose Psychometric validity/reliability of 10-item and 2-item abbreviations of the Connor–Davidson Resilience Scale (CD-RISC-10; CD-RISC-2) was investigated via item response theory and classic approaches. Methods We sampled 5023 adult American participants in a June/July 2020 survey on the COVID-19 pandemic’s psychological effects. Our questionnaire incorporated the CD-RISC-10 with other validated measures. CD-RISC-10 items were ranked on item-to-scale correlations, loadings on a one-factor confirmatory factor analysis model, and item slope/threshold parameters plus information curves from a unidimensional graded response model. Concurrent validity of the highest ranked item pair was evaluated vis-à-vis the CD-RISC-10 and CD-RISC−2. Internal consistency, based on average variance extracted (AVE) and multiple reliability coefficients, was also compared. Convergent/divergent validity was tested by correlating anxiety, depression, fear of COVID-19, anxiety sensitivity, coping, and personality measures with both scales and the highest ranked item pair. Binary agreement/classification indexes assessed inter-rater reliability. Results Items 2 and 9 from CD-RISC-10 ranked the highest. Reliability coefficients were > 0.93, > 0.72, and > 0.82 for the CD-RISC-10, CD-RISC-2, vs summation of items 2 and 9. AVEs were 0.66, 0.67, and 0.77. CD-RISC abbreviations and the summation of items 2 and 9 correlated negatively with anxiety (> − 0.43), depression (> − 0.42), and fear of COVID-19 (> − 0.34); positively with emotional stability (> 0.53) and conscientiousness (> 0.40). Compared to the CD-RISC-2, summative scores of items 2 and 9 more efficiently classified/discriminated high resilience on the CD-RISC-10. Conclusion We confirmed construct validity/reliability of copyrighted CD-RISC abbreviations. The CD-RISC-10’s items 2 and 9 were psychometrically more salient than the CD-RISC−2. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03125-y.
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Affiliation(s)
- Anthony C Waddimba
- Baylor Scott and White Research Institute, Dallas, TX, USA.
- Department of Surgery, Health Systems Science, Baylor University Medical Center, Dallas, TX, USA.
| | - Bailey M Baker
- College of Medicine, Texas A&M University Health Science Center, Dallas Campus, Dallas, TX, USA
| | - Jamie R Pogue
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Division of Trauma, Acute Care, & Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Madison P McAuliffe
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Division of Trauma, Acute Care, & Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Monica M Bennett
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Division of Trauma, Acute Care, & Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Ronald D Baxter
- General Medical Education, Department of Surgery, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, TX, 75246, USA
| | - David C Mohr
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Ann Marie Warren
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Division of Trauma, Acute Care, & Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
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Brown T, Chen S, Ou Z, McDonald N, Bennett-Murphy L, Schneider L, Giles L, Molina K, Cox D, Hoskoppal A, Glotzbach K, Stehlik J, May L. Feasibility of Assessing Adolescent and Young Adult Heart Transplant Recipient Mental Health and Resilience Using Patient-Reported Outcome Measures. J Acad Consult Liaison Psychiatry 2022; 63:153-162. [PMID: 34438097 PMCID: PMC8866525 DOI: 10.1016/j.jaclp.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/05/2021] [Accepted: 08/11/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although adolescents and young adults may be particularly prone to mental health symptoms after heart transplant, screening practices are variable. OBJECTIVE To assess the feasibility of using patient-reported outcome (PRO) measures to assess mental health, functional status, and resiliency in posttransplant adolescents and young adult patients. METHODS Patients transplanted between ages 15 and 25 years at 3 centers completed 6 PRO instruments via web-based platforms: PROMIS instruments for anxiety, depression, satisfaction with social roles, and physical functioning; the Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5; and the Connor-Davidson Resilience Scale-10. Feasibility (completion, time to completion, and measure missingness) and PRO results were described and compared between patients with congenital heart disease and cardiomyopathy. RESULTS Nineteen patients (median age at transplant 17.7 y [interquartile range 16.3, 19.2 y], 84% male) were enrolled at an average of 3 ± 1.8 years after transplant. Enrollment was 90% among eligible patients. Measure missingness was zero. The average completion time was 12 ± 15 minutes for all instruments. Timely PRO completion was facilitated by in-clinic application. The PRO results indicated that 9 patients (47%) had at least mild posttraumatic stress disorder symptoms (≥11 points on Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5). Among them, 4 patients had scores >28 suggestive of probable posttraumatic stress disorder. Two (11%) and 6 (32%) patients had anxious and depressive symptoms, respectively. The cardiomyopathy cohort had a higher median Posttraumatic Stress Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, version 5 score than that of the congenital heart disease subgroup (11.0 vs 6.0; P = 0.015). Twelve (63%) had resiliency scores that were lower than the population average. No significant differences were found in PRO results between patients with cardiomyopathy and congenital heart disease apart from the posttraumatic stress disorder assessment. CONCLUSIONS This novel PRO-based approach to psychiatric screening of adolescents and young adult patients after transplant appears feasible for assessing mental health, functional status, and resiliency, with excellent enrollment and completion rates. These instruments characterized the burden of mental health symptoms within this adolescents and young adult heart transplant cohort, with a high prevalence of posttraumatic stress disorder symptoms. Resiliency scores were lower than in a comparison population. Electronically-administered PRO administration could facilitate more consistent mental health screening in this at-risk group.
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Affiliation(s)
- Tyler Brown
- Department of Pediatrics, University of Utah, Salt Lake City, UT.
| | | | - Zhining Ou
- Division of Epidemiology, Internal Medicine, University of Utah, Salt Lake City, UT
| | | | | | | | - Lisa Giles
- Pediatrics, University of Utah, Salt Lake City, UT
| | - Kimberly Molina
- Pediatric Cardiology, University of Utah, Salt Lake City, UT
| | - Daniel Cox
- Pediatric Cardiology, University of Utah, Salt Lake City, UT
| | | | | | - Josef Stehlik
- Cardiovascular Medicine, University of Utah, Salt Lake City, UT
| | - Lindsay May
- Pediatric Cardiology, University of Utah, Salt Lake City, UT
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Warren AM, McMinn K, Testa G, Wall AE, Saracino G, Waddimba AC, Johannesson L. Psychological Characteristics of Recipients Pretransplantation in the Dallas UtErus Transplant Study (DUETS). Prog Transplant 2021; 31:330-336. [PMID: 34704857 DOI: 10.1177/15269248211046002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Uterus transplantation is now a viable option for fertility treatment for women with absolute uterine factor infertility. Psychological assessment is recommended as a part of the perioperative evaluation process. RESEARCH OBJECTIVE The purpose of this study was to examine the psychological characteristics and mental health history of the 20 women who participated in the Dallas UtErus Transplant Study (DUETS) trial. DESIGN This retrospective observational descriptive study was part of a prospective clinical trial. Prior to transplant, 20 women completed a clinical psychological interview, 19 of whom also completed psychological assessment measures including the Hospital Anxiety and Depression Scale, Patient Health Questionnaire 9 item, Generalized Anxiety Disorder 7 item, PTSD Checklist for DSM-5, 36-Item Short Form, Connor-Davidson Resilience Scale 10 item, and Dyadic Adjustment Scale. RESULTS Women who participated in the trial had high health-related quality of life and minimal psychological history, with most reporting psychological distress associated with their initial infertility diagnosis (N = 13). None of the participants endorsed psychological distress to meet clinical concerns on the psychological measures used. Satisfaction with relationship adjustment with their partners was also high. CONCLUSIONS Women with absolute uterine factor infertility who underwent uterus transplant demonstrated low psychological distress on assessment measures, were resilient, had high health related quality of life, and strong satisfaction with the quality of relationships with their partners. Although some women reported either current or past psychological diagnosis, most reported psychological distress that occurred at the time of the infertility diagnosis and appeared to resolve over time.
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Affiliation(s)
- Ann Marie Warren
- 466551Baylor Scott & White Research Institute, Dallas, TX, USA.,Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Kenleigh McMinn
- Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Giuliano Testa
- Annette C. and Harold Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA
| | - Anji E Wall
- Annette C. and Harold Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA
| | - Giovanna Saracino
- Annette C. and Harold Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA
| | - Anthony C Waddimba
- 466551Baylor Scott & White Research Institute, Dallas, TX, USA.,Health Systems Science, Department of Surgery, Baylor University Medical Center, Dallas, TX, USA
| | - Liza Johannesson
- Annette C. and Harold Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA
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Waddimba AC, Bennett MM, Fresnedo M, Ledbetter TG, Warren AM. Resilience, Well-being, and Empathy Among Private Practice Physicians and Advanced Practice Providers in Texas: A Structural Equation Model Study. Mayo Clin Proc Innov Qual Outcomes 2021; 5:928-945. [PMID: 34585086 PMCID: PMC8456060 DOI: 10.1016/j.mayocpiqo.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective To investigate structural relationships of latent constructs such as occupational wellbeing, resilience, work meaningfulness, and psychological empowerment with affective and cognitive clinical empathy among a community of physicians and advanced practice providers. Methods We conducted a cross-sectional observational study. We gathered data by an anonymous self-administered multidimensional questionnaire disseminated electronically between March and May 2016. Participants were physicians and advanced practice providers belonging to the Health Texas Provider Network, a group private practice affiliated with the Baylor Scott and White Health system. We excluded allied health care staff (eg, nurses) and trainees (eg, residents, medical students). We pursued a 3-step strategy: (1) confirmatory factor analysis of a theory-driven measurement model, (2) a modified structural equation model from which pathways with nonsignificant path coefficients were deleted, and (3) multigroup analyses of the modified model. Results Cognitive empathy was the strongest predictor of affective empathy. We observed modest positive associations of resilience with cognitive and affective empathy and of well-being and meaning with affective but not with cognitive empathy. Resilience, meaning, and psychological empowerment were surprisingly negatively associated with well-being, suggesting diminished self-care among practitioners. Effects of psychological empowerment on empathy and well-being were mediated by resilience and meaning. Conclusion Cognitive empathy directly influenced affective empathy; well-being and meaningfulness exerted direct positive effects on affective but not on cognitive empathy, whereas resilience had direct positive associations with both empathy dimensions. Resilience and meaning manifested direct, negative associations with well-being, revealing clinicians’ disproportionate focus on patient care at the expense of self-care.
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Key Words
- APP, advanced practice provider
- AVE, average variance extracted
- BIC, Bayesian information criterion
- CD-RISC, Connor-Davidson Resilience Scale
- CD-RISC-10, 10-item short form of the Connor-Davidson Resilience Scale
- CFA, confirmatory factor analysis
- CFI, comparative fit index
- GFI, goodness of fit index
- HTPN, Health Texas Provider Network
- IRI, Interpersonal Reactivity Index
- LPA, latent profile analysis
- MCPWBI, Mayo Clinic Physician Well-being Index
- PEI, Psychological Empowerment Instrument
- RMSEA, root mean square error of approximation
- SE, standard error
- SRMR, standardized root mean square residual
- TIPI, 10-Item Personality Inventory
- TLI, Tucker-Lewis Index
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Affiliation(s)
- Anthony C Waddimba
- Baylor Scott and White Research Institute, Dallas, TX.,Health Systems Science, Department of Surgery, Baylor University Medical Center, Dallas, TX
| | | | - Michelle Fresnedo
- Baylor Scott and White Research Institute, Dallas, TX.,Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX
| | - Thomas G Ledbetter
- Chief Medical Office, Baylor Scott and White Medical Center, Waxahachie, TX
| | - Ann Marie Warren
- Baylor Scott and White Research Institute, Dallas, TX.,Division of Trauma, Acute Care, and Critical Care Surgery, Baylor University Medical Center, Dallas, TX
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Ng R, Chow TYJ. Aging Narratives over 210 years (1810-2019). J Gerontol B Psychol Sci Soc Sci 2020; 76:1799-1807. [PMID: 33300996 PMCID: PMC7798532 DOI: 10.1093/geronb/gbaa222] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The World Health Organization launched a recent global campaign to combat ageism, citing its ubiquity and insidious threat to health. The historical context that promoted this pernicious threat is understudied, and such studies lay the critical foundation for designing societal-level campaigns to combat it. We analyzed the trend and content of aging narratives over 210 years across multiple genres—newspaper, magazines, fiction, nonfiction books—and modeled the predictors of the observed trend. Method A 600-million-word dataset was created from the Corpus of Historical American English and the Corpus of Contemporary American English to form the largest structured historical corpus with over 150,000 texts from multiple genres. Computational linguistics and statistical techniques were applied to study the trend, content, and predictors of aging narratives. Results Aging narratives have become more negative, in a linear fashion (p = .003), over 210 years. There are distinct shifts: From uplifting narratives of heroism and kinship in the 1800s to darker tones of illness, death, and burden in the 1900s across newspapers, magazines, and nonfiction books. Fiction defied this trend by portraying older adults positively through romantic courtship and war heroism. Significant predictors of ageism over 210 years are the medicalization of aging, loss of status, warmth, competence, and social ostracism. Discussion Though it is unrealistic to reverse the course of ageism, its declining trajectory can be ameliorated. Our unprecedented study lay the groundwork for a societal-level campaign to tackle ageism. The need to act is more pressing given the Covid-19 pandemic where older adults are constantly portrayed as vulnerable.
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Affiliation(s)
- Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.,Lloyd's Register Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Innovation 4.0, 3 Research Link, Singapore
| | - Ting Yu Joanne Chow
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
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Bui YT, Hathcock MA, Benzo RP, Budev MM, Chandrashekaran S, Erasmus DB, Lease ED, Levine DJ, Thompson KL, Johnson BK, Jowsey-Gregoire SG, Kennedy CC. Evaluating resilience as a predictor of outcomes in lung transplant candidates. Clin Transplant 2020; 34:e14056. [PMID: 32748982 DOI: 10.1111/ctr.14056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Resilience represents the capacity to adapt to adversity. Resilience can improve following behavioral interventions. We examined lung transplant candidates' resilience as a novel predictor using the Connor-Davidson Resilience Scale (RISC-10). METHODS Waitlisted candidates at six centers were mailed questionnaires from 9/16/2015 to 10/1/2019. Follow-up surveys were collected annually and post-transplant. Outcomes were recorded through February 17, 2020. Primary outcome was pre-transplant death/delisting. Analyses included t test or chi-square for group comparisons, Pearson's correlation coefficients for strength of relationships, and Cox proportional-hazard models to evaluate associations with outcomes, adjusting for age, sex, and mood. RESULTS Participation was 55.3% (N = 199). Baseline RISC-10 averaged 32.0 ± 5.6 and did not differ by demographics, primary transplant diagnosis, or disease severity markers. RISC-10 did not correlate to the commonly utilized Psychosocial Assessment of Candidates for Transplant [PACT] or Stanford Integrated Psychosocial Assessment for Transplantation [SIPAT] tools. Scores < 26.3 (representing > 1 standard deviation below population average) occurred in 16% and were associated with pre-transplant death or delisting, adjusted Hazard Ratio of 2.60 (95% Confidence Interval 1.23-5.77; P = .01). CONCLUSION One in six lung candidates had low resilience, predicting increased pre-transplant death/delisting. RISC-10 did not correlate with PACT or SIPAT; resilience may represent a novel risk factor.
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Affiliation(s)
- Yvonne Tran Bui
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
| | - Matthew A Hathcock
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Roberto P Benzo
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Marie M Budev
- Division of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Satish Chandrashekaran
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Florida, Gainesville, Florida, USA
| | - David B Erasmus
- Transplant Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Erika D Lease
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Deborah J Levine
- Division of Pulmonary and Critical Care Medicine, University of Texas Health, San Antonio, Texas, USA
| | - Karin L Thompson
- Pulmonary Clinical Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley K Johnson
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.,William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA
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Velickovic K, Rahm Hallberg I, Axelsson U, Borrebaeck CAK, Rydén L, Johnsson P, Månsson J. Psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in a non-clinical population in Sweden. Health Qual Life Outcomes 2020; 18:132. [PMID: 32398074 PMCID: PMC7216522 DOI: 10.1186/s12955-020-01383-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/28/2020] [Indexed: 12/17/2022] Open
Abstract
Background The Connor-Davidson Resilience Scale (CD-RISC) is the most widely used scale which assesses psychological resilience. Although it is recommended to be applied as a unidimensional scale, its factor structure, reliability, as well as discriminant and predictive validity need to be assessed when used in a new context. Moreover, the original five-factor structure has not been replicated in previous investigations. This study aimed to explore psychometric properties of the scale in a Swedish context. Methods Construct validity of the five-factor model of CD-RISC was assessed using Exploratory and Confirmatory Factor Analyses. Its discriminant validity was assessed in relation to a measure of emotion regulation (Brief Version of the Difficulties in Emotion Regulation Scale) using a Confirmatory Factor Analysis. Predictive validity of CD-RISC was assessed in relation to measures of physical and mental health-related quality of life (The 12-Item Short Form Survey) using hierarchical multiple regression analyses. A population based sample cohort was employed (N = 2599). Results Exploratory and Confirmatory Factor Analyses suggested a 22-item unidimensional model of CD-RISC. Psychological resilience was found to be independent from the measure of emotion regulation. It was shown to predict both physical and mental health-related quality of life, being especially strongly associated with mental health aspects. Conclusions The study showed that the Swedish version of CD-RISC is an instrument with high discriminant and predictive validity, although the original factor structure does not apply in this context. CD-RISC can thus be used to identify individuals with a higher need of psychosocial support, especially relating to mental health needs.
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Affiliation(s)
| | | | - Ulrika Axelsson
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lund University, Medicon Village, 223 81, Lund, Sweden
| | - Carl A K Borrebaeck
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lund University, Medicon Village, 223 81, Lund, Sweden
| | - Lisa Rydén
- Department of Clinical Sciences Lund, Division of Surgery, Lund University, Medicon Village, 223 81, Lund, Sweden.,Department of Surgery, Skåne University Hospital, Lund, Södra Förstadsgatan 1, 214 28, Malmö, Sweden
| | - Per Johnsson
- Department of Psychology, Lund University, Box 213, 22100, Lund, Sweden
| | - Johanna Månsson
- Department of Psychology, Lund University, Box 213, 22100, Lund, Sweden
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10
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Psychosocial dimensions of hand transplantation: lessons learned from solid organ transplantation. Curr Opin Organ Transplant 2019; 24:705-713. [PMID: 31689261 DOI: 10.1097/mot.0000000000000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk. RECENT FINDINGS Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocial factors consistently associate with clinical risk in SOT. However, the mechanisms precipitating these psychosocial risk factors are likely diverse in their cause, with large individual differences across SOT and VCA. Transdiagnostic dimensions may serve as mechanistic factors, increasing the risk of adverse clinical outcomes and suggesting potential treatment strategies for risk mitigation. Psychosocial dimensions including psychological flexibility, self-efficacy, and posttraumatic growth are discussed as potential contributory factors. SUMMARY Psychosocial factors hold importance in predicting posttransplant clinical outcomes. Emerging transdiagnostic factors may provide insight into mechanisms and potential treatments.
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Swanson A, Geller J, DeMartini K, Fernandez A, Fehon D. Active Coping and Perceived Social Support Mediate the Relationship Between Physical Health and Resilience in Liver Transplant Candidates. J Clin Psychol Med Settings 2019; 25:485-496. [PMID: 29546621 DOI: 10.1007/s10880-018-9559-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N = 120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience. Findings revealed that physical functioning, active coping, and perceived social support were positively associated with resilience; maladaptive coping was negatively associated with resilience. Perceived social support and active coping partially mediated the relationship between physical functioning and resilience. Transplant center care providers should promote active coping skills and reinforce the importance of effective social support networks. These interventions could increase psychological resilience among liver transplant candidates.
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Affiliation(s)
- Amelia Swanson
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Jessica Geller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Veterans Affairs, Denver-Seattle Center of Innovation, Aurora, CO, USA
| | - Kelly DeMartini
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Smilow Cancer Hospital at Yale-New Haven, New Haven, CT, USA.,Yale-New Haven Transplantation Center, New Haven, CT, USA
| | - Anne Fernandez
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Dwain Fehon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Smilow Cancer Hospital at Yale-New Haven, New Haven, CT, USA.,Yale-New Haven Transplantation Center, New Haven, CT, USA
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12
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Gras ME, Font-Mayolas S, Baltasar A, Patiño J, Sullman MJM, Planes M. The Connor-Davidson Resilience Scale (CD-RISC) amongst Young Spanish Adults. CLÍNICA Y SALUD 2019. [DOI: 10.5093/clysa2019a11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Abstract
UNLABELLED ABSTRACTBackground:Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults. METHODS Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables. RESULTS The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience. CONCLUSIONS Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.
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14
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Laird KT, Lavretsky H, Wu P, Krause B, Siddarth P. Neurocognitive Correlates of Resilience in Late-Life Depression. Am J Geriatr Psychiatry 2019; 27:12-17. [PMID: 30262406 PMCID: PMC6298796 DOI: 10.1016/j.jagp.2018.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/30/2018] [Accepted: 08/22/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Increasing understanding of the neurocognitive correlates of resilience in late-life depression (LLD) could inform interventions to promote more sustained remission. We investigated cross-sectional relations between baseline resilience and domains of neurocognitive functioning in depressed older adults enrolled in one of four trials. METHODS Participants (N = 288) completed neurocognitive tests of memory, language performance, and executive functioning as well as measures of subjective memory performance and components of resilience (grit, active coping self-efficacy, accommodative coping self-efficacy, and spirituality). RESULTS Medium-sized associations were observed between greater resilience (overall resilience, accommodative coping) and lower frequency of self-reported forgetting. Small positive associations were observed between language performance and total resilience, active coping self-efficacy, and accommodative coping self-efficacy. Small negative associations were observed between spirituality and each objective measure of cognitive performance. CONCLUSION Future longitudinal studies will help elucidate the complex relation between resilience and cognitive functioning in LLD. In addition, randomized controlled trials targeting coping self-efficacy may inform the development of more effective and personalized interventions.
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Affiliation(s)
- Kelsey T. Laird
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior , University of California, Los Angeles, Los Angeles.
| | - Pauline Wu
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Beatrix Krause
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
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15
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Kwan YH, Ng A, Lim KK, Fong W, Phang JK, Chew EH, Lui NL, Tan CS, Thumboo J, Østbye T, Leung YY. Validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore. Rheumatol Int 2018; 39:105-110. [PMID: 30523476 DOI: 10.1007/s00296-018-4217-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/30/2018] [Indexed: 01/10/2023]
Abstract
We aimed to assess the validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) in patients with axial spondyloarthritis (axSpA) in Singapore. We used cross-sectional data from 108 patients with axSpA recruited from a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework. Face validity was assessed through cognitive debriefing interviews (CDIs). Internal consistency was assessed through Cronbach's alpha. Test-retest reliability was assessed through intraclass correlation (ICC). Measurement error was assessed through smallest detectable change (SDC). Construct validity was assessed through six a priori hypotheses through correlation of the CD-RISC10 score with other patient-reported outcome measures. Structural validity was assessed using confirmatory factor analysis (CFA). Fit indices evaluated were root-mean-square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TFI), and standardized root-mean-squared residual (SRMR). Ten patients completed the CDIs and face validity was supported. Among 108 patients (median age: 37(21-77), 81.5% males, 93.5% Chinese), the CD-RISC10 demonstrated good internal consistency (Cronbach's alpha = 0.94), and excellent test-retest reliability [ICC = 0.964 (95% CI 0.937-0.980)]. SDC was calculated as 1.88. Construct validity was established by meeting five out of the six a priori hypotheses. Structural validity was supported as CFA confirmed a one-factor model, with adequate fit statistics after adding three covariances (RMSEA = 0.077; CFI = 0.975; TLI = 0.964; SRMR = 0.036). This study supports the CD-RISC10 as a valid and reliable measure of resilience for use in patients with axSpA.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Amanda Ng
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Ka Keat Lim
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Eng Hui Chew
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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16
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Saracino RM, Jutagir DR, Cunningham A, Foran-Tuller KA, Driscoll MA, Sledge WH, Emre SH, Fehon DC. Psychiatric Comorbidity, Health-Related Quality of Life, and Mental Health Service Utilization Among Patients Awaiting Liver Transplant. J Pain Symptom Manage 2018; 56. [PMID: 29526612 PMCID: PMC6360091 DOI: 10.1016/j.jpainsymman.2018.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT The prevalence of psychiatric disorders and mental health service utilization among patients with end-stage liver disease awaiting transplant remains understudied. OBJECTIVES This study assessed the prevalence of psychological disorders and symptoms with the use of a structured diagnostic interview and self-report measures, and examined patient-reported mental health service utilization and barriers to care. METHODS Waitlisted liver transplant candidates (N = 120) completed assessments during routine clinic appointments at a single time point. RESULTS Participants endorsed moderate-to-severe levels of depression (19.2%), anxiety (26.7%), and Post Traumatic Stress Disorder (PTSD) (23.3%). Forty-three percent had received some form of mental health treatment in the recent past, and a range of barriers to accessing mental health services were endorsed. In a subset of 39 participants who received a structure diagnostic assessment, there was a high prevalence of current (51.3%) and past (82.1%) psychiatric disorders. Elevated scores on depression, anxiety, and PTSD measures were associated with significant decrements in health-related quality of life, but were not differentially associated with mental health service utilization. CONCLUSION There are a significant number of end-stage liver disease patients who could benefit from intervention who are not currently connected to treatment. Many patients do not see the need for accessing services, perhaps because of a lack of insight or knowledge about the benefits of mental health treatment. Future research should determine optimal treatment and service delivery methods for this vulnerable population.
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Affiliation(s)
- Rebecca M Saracino
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Devika R Jutagir
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Amy Cunningham
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Mary A Driscoll
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - William H Sledge
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sukru H Emre
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA; Yale-New Haven Transplantation Center, New Haven, Connecticut, USA
| | - Dwain C Fehon
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA; Yale-New Haven Transplantation Center, New Haven, Connecticut, USA.
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17
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The feasibility of a group stress management Liver SMART intervention for patients with end-stage liver disease: A pilot study. Palliat Support Care 2018; 17:35-41. [PMID: 29860964 DOI: 10.1017/s147895151800024x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Structured, empirically supported psychological interventions are lacking for patients who require organ transplantation. This stage IA psychotherapy development project developed and tested the feasibility, acceptability, tolerability, and preliminary efficacy of an 8-week group cognitive behavioral stress management intervention adapted for patients with end-stage liver disease awaiting liver transplantation. METHOD Twenty-nine English-speaking United Network for Organ Sharing-registered patients with end-stage liver disease from a single transplantation center enrolled in 8-week, group cognitive-behavioral liver stress management and relaxation training intervention adapted for patients with end-stage liver disease. Patients completed pre- and postintervention surveys that included the Beck Depression Inventory II and the Beck Anxiety Inventory. Feasibility, acceptability, tolerability, and preliminary efficacy were assessed.ResultAttendance rate was 69.40%. The intervention was rated as "good" to "excellent" by 100% of participants who completed the postintervention survey in teaching them new skills to relax and to cope with stress, and by 94.12% of participants in helping them feel supported while waiting for a liver transplant. No adverse events were recorded over the course of treatment. Attrition was 13.79%. Anxious and depressive symptoms were not statistically different after the intervention.Significance of resultsThe liver stress management and relaxation training intervention is feasible, acceptable, and tolerable to end-stage liver disease patients within a transplant clinic setting. Anxious and depressive symptoms remained stable postintervention. Randomized controlled trials are needed to study the intervention's effectiveness in this population.
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18
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Abstract
Exploratory factor analysis (EFA) is an extremely popular method for determining the underlying factor structure for a set of variables. Due to its exploratory nature, EFA is notorious for being conducted with small sample sizes, and recent reviews of psychological research have reported that between 40% and 60% of applied studies have 200 or fewer observations. Recent methodological studies have addressed small size requirements for EFA models; however, these models have only considered complete data, which are the exception rather than the rule in psychology. Furthermore, the extant literature on missing data techniques with small samples is scant, and nearly all existing studies focus on topics that are not of primary interest to EFA models. Therefore, this article presents a simulation to assess the performance of various missing data techniques for EFA models with both small samples and missing data. Results show that deletion methods do not extract the proper number of factors and estimate the factor loadings with severe bias, even when data are missing completely at random. Predictive mean matching is the best method overall when considering extracting the correct number of factors and estimating factor loadings without bias, although 2-stage estimation was a close second.
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Affiliation(s)
- Daniel McNeish
- a Department of Methodology and Statistics , Utrecht University , The Netherlands
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19
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Amoyal N, Fernandez AC, Ng R, Fehon DC. Measuring Coping Behavior in Liver Transplant Candidates: A Psychometric Analysis of the Brief COPE. Prog Transplant 2016; 26:277-85. [PMID: 27358343 DOI: 10.1177/1526924816655253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Liver transplant candidates must cope with significant physiological and psychological challenges. The Brief COPE is a frequently used measure of coping behavior; however, knowledge of the scale's factor structure and construct validity is limited with regard to liver transplant candidates. This study assessed the validity of the Brief COPE in 120 liver transplant candidates using exploratory factor analysis. Results revealed a 6-factor solution, only 2 of which were consistent with the original scale assignments. Construct validity of the 6 Brief COPE scales yielded in this study was demonstrated. The results indicate that the Brief COPE is valid, reliable, and can be meaningfully interpreted in liver transplant patients. Future research should confirm this factor structure and examine its predictive validity prior to widespread use among liver transplant patients. Suggestions are presented for enhancing the care of transplant candidates by promoting the use of adaptive coping mechanisms to manage distress.
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Affiliation(s)
- Nicole Amoyal
- Division of General Internal Medicine, University of Colorado Anschutz Medical Center, Boulder, CO, USA
| | - Anne C Fernandez
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Reuben Ng
- Nanyang Technological University & National University of Singapore, Singapore
| | - Dwain C Fehon
- Yale School of Medicine, Yale-New Haven Hospital, New Haven, CT, USA
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20
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Perera HN, Ganguly R. Construct Validity of Scores From the Connor-Davidson Resilience Scale in a Sample of Postsecondary Students With Disabilities. Assessment 2016; 25:193-205. [PMID: 27141039 DOI: 10.1177/1073191116646444] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although theory posits a multidimensional structure of resilience, studies have supported a unidimensional solution for data obtained from the commonly used Connor-Davidson Resilience Scale (CD-RISC). This study investigated the latent structure of CD-RISC responses in a sample of postsecondary students with disabilities. Furthermore, the validity of CD-RISC scores was examined with respect to career optimism and well-being. The analyses were conducted using confirmatory factor analysis and exploratory structural equation modeling (ESEM). Results supported a bifactor-ESEM representation of the CD-RISC data that accounts for construct-relevant multidimensionality in scores due to the presence of general and specific factors and the fallibility of indicators as pure reflections of the constructs they measure. Although three specific factors showed meaningful residual specificity over and above the general factor, two specific factors were weakly defined with little meaningful residual specificity. However, these factors may retain some utility in the bifactor-ESEM model insofar as they control for limited levels of residual covariance in items. Evidence was also obtained for relations of the general and substantively interpretable specific factors with career optimism and well-being. The results of the study provide validation data for the CD-RISC and clarify recent research converging on seemingly disparate unidimensional and multidimensional solutions.
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Affiliation(s)
- Harsha N Perera
- 1 University of New South Wales, Kensington, New South Wales, Australia
| | - Rahul Ganguly
- 2 University of Southern Queensland, Toowoomba, Queensland, Australia
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