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Yang Q, Huo J, Jiang Y. How to Reduce the Influence of COVID-19 Epidemic on Employees' Anxiety of Continuous Work in China? Empirical Analysis Based on Industrial Enterprises. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:837-853. [PMID: 39189892 DOI: 10.1080/19371918.2024.2395263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
The COVID-19 epidemic not only impacted China's economy but also induced periodic anxiety among employees, especially during its peak. Even as governmental controls relaxed, enterprises seemed unaffected externally. However, beneath the surface, the lingering effects on employee mental health persisted. Many faced dual stressors concerning their job and personal well-being due to the epidemic, heightening work-related anxieties. This research, a year after China resumed work, delves into the psychological stress influencing this sustained anxiety. A survey of 516 employees helped test the hypothesis using a multiple regression model. Findings indicated heightened continuous work anxiety due to the epidemic, particularly in hard-hit areas. However, individual resilience, organizational, and social support were found to mitigate these effects. The study underscores the sustained psychological aftermath of the epidemic on employees, urging health authorities to address it.
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Affiliation(s)
- Qiang Yang
- School of Business, Nanjing Audit University, Nanjing, China
| | - Jiale Huo
- School of Economics and Management, Nanjing Agricultural University, Nanjing, China
| | - Yushi Jiang
- School of Economics and Management, Southwest Jiaotong University, Chengdu, China
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2
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Marciano H, Kimhi S, Eshel Y, Adini B. Resilience and coping during protracted conflict: a comparative analysis of general and evacuees populations. Isr J Health Policy Res 2024; 13:56. [PMID: 39358809 PMCID: PMC11448295 DOI: 10.1186/s13584-024-00642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 09/20/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND On October 7th, 2023, Hamas launched a surprise attack on Israel, triggering a conflict with Israel in the Gaza Strip. This ongoing war, now six months old, has also seen threats from Hezbollah in Lebanon, as well as from Yemen and Iran. The precarious security situation along Israel's southern and northern borders led to extensive evacuations, with residents relocating within Israel under uncertain conditions concerning their return and property safety. This study compares resilience (societal, SR; community, CR; and individual, IR), hope, morale, distress symptoms (anxiety and depression symptoms), and perceived danger between general Hebrew-speaking adults and evacuee adults a few months post-conflict initiation. METHODS Data was collected using structured self-reported questionnaires focusing on resilience and coping strategies, administered through two online panel companies. The general population data was collected from January 14-21, 2024 (N = 1,360), and the evacuees' data from March 1-9, 2024 (N = 372; 133 from the north, 239 from the south). RESULTS Evacuees reported lower SR and CR, hope, and morale, and higher distress symptoms and perceived danger compared to the general population. No differences in IR were found. Regression analyses identified different primary predictors of SR for each group: hope for the general population and governmental support for evacuees. Additionally, IR significantly predicted outcomes only among evacuees, whereas age, religiosity, and education were significant predictors solely in the general population. One notable similarity emerged: CR served as the second most influential predictor in both samples. CONCLUSIONS The entire population of Israel is affected by the ongoing war, yet evacuees endure a disproportionately severe impact, with potential for increased harm as the conflict persists. The adjustment to a new wartime emergency routine is more complex for evacuees than for the general population. It is crucial for policy and decision-makers to address the distinct differences between evacuees and the general populace to effectively meet their specific needs. Yet, it should be acknowledged that the evacuees represent a heterogenic group, necessitating a detailed subdivision into subgroups to accurately assess and address their unique challenges.
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Affiliation(s)
- Hadas Marciano
- Stress and Resilience Research Center, Tel-Hai Academic College, Kiryat Shmona, Israel.
- The Institute of Information Processing and Decision Making, University of Haifa, Haifa, Israel.
| | - Shaul Kimhi
- ResWell Research Collaboration, Tel Aviv University, Tel Aviv, Israel
- Tel-Hai College, Kiryat Shmona, Israel
| | - Yohanan Eshel
- Stress and Resilience Research Center, Tel-Hai Academic College, Kiryat Shmona, Israel
- University of Haifa, Haifa, Israel
| | - Bruria Adini
- Head of the Department of Emergency Management and Disaster Management, and ResWell Research Collaboration, School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
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3
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Mecha P, Rodriguez-Morales M, Sanchez-Lopez A. Components of hot and cold executive functions and their relations to different forms of stress resilience: A systematic review. Stress Health 2024; 40:e3439. [PMID: 38943558 DOI: 10.1002/smi.3439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 05/28/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
Increasing evidence points out that Executive Functions (i.e., EFs) may be core mechanisms for the generation of resilient responses to adversity. A systematic review testing the relations between either affective (hot) and/or non-affective (cold) EFs (i.e., inhibition, flexibility and working memory updating) and resilience was conducted. A total of 449 articles were initially identified. After two steps of title-and-abstract (k = 449), and full-text reading filtering (k = 67), 11 studies were reviewed. Three studies included cold measures of working memory and supported significant positive relations between higher working memory functioning and higher trait resilience levels. One study included cold measures of inhibition and another one both hot and cold measures, with only the first one supporting a positive relation between more efficient inhibition and higher trait resilience levels. Finally, 7 studies measured flexibility in its cold and/or hot dimensions and overall supported significant relations between higher flexibility and higher levels of trait, process and outcome resilience measures. These results support the role of EFs performance to promote different forms of resilience. This review allows to identify different issues that need to be addressed in future research and highlight the need to integrate the analysis of all hot and cold EFs components to understand their role in the generation of resilience.
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Affiliation(s)
- Patricia Mecha
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Maria Rodriguez-Morales
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Alvaro Sanchez-Lopez
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
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Bonanno GA, Westphal M. The three axioms of resilience. J Trauma Stress 2024; 37:717-723. [PMID: 38840482 DOI: 10.1002/jts.23071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 06/07/2024]
Abstract
This article summarizes the growing literature on resilience in the face of aversive and potentially traumatic events (PTEs) in three basic axioms: (a) resilience is a common outcome, 2) there are no "key" traits to resilience (resilience is not a type), and (c) resilient outcomes occur through flexible self-regulation. The first axiom highlights the limitation of a traditional, binary view of trauma in terms of the presence-absence of posttraumatic stress disorder, emphasizing instead the heterogeneity of trauma outcomes. Four prototypical trajectories are reviewed: chronic symptoms; delayed symptoms; recovery; and the most common trajectory, resilience. The second axiom reviews the paradoxical inability of known correlates of resilience to adequately predict resilient outcomes. Resilience is instead described as a multifaceted phenomenon with no singular set of key traits, as various factors contribute to resilient outcomes in complex ways. The third axiom provides an explanation of how resilience can emerge from this complex array by introducing the concept of flexible self-regulation. The flexibility mindset is described as providing the motivation for flexible responding. The flexibility sequence is described as explaining the mechanisms underlying flexibility in terms of three serial stages: context sensitivity, strategy repertoire, and feedback adjustment. The final section briefly considers clinical implications.
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Affiliation(s)
- George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Maren Westphal
- Department of Psychology, Pace University, Pleasantville, New York, USA
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Ahmed S, Hossain MA, Bristy SA, Ali MS, Rahman MH. Adopting Integrated Bioinformatics and Systems Biology Approaches to Pinpoint the COVID-19 Patients' Risk Factors That Uplift the Onset of Posttraumatic Stress Disorder. Bioinform Biol Insights 2024; 18:11779322241274958. [PMID: 39281421 PMCID: PMC11402063 DOI: 10.1177/11779322241274958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/23/2024] [Indexed: 09/18/2024] Open
Abstract
Owing to the recent emergence of COVID-19, there is a lack of published research and clinical recommendations for posttraumatic stress disorder (PTSD) risk factors in patients who contracted or received treatment for the virus. This research aims to identify potential molecular targets to inform therapeutic strategies for this patient population. RNA sequence data for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and PTSD (from the National Center for Biotechnology Information [NCBI]) were processed using the GREIN database. Protein-protein interaction (PPI) networks, pathway enrichment analyses, miRNA interactions, gene regulatory network (GRN) studies, and identification of linked drugs, chemicals, and diseases were conducted using STRING, DAVID, Enrichr, Metascape, ShinyGO, and NetworkAnalyst v3.0. Our analysis identified 15 potentially unique hub proteins within significantly enriched pathways, including PSMB9, MX1, HLA-DOB, HLA-DRA, IFIT3, OASL, RSAD2, and so on, filtered from a pool of 201 common differentially expressed genes (DEGs). Gene ontology (GO) terms and metabolic pathway analyses revealed the significance of the extracellular region, extracellular space, extracellular exosome, adaptive immune system, and interleukin (IL)-18 signaling pathways. In addition, we discovered several miRNAs (hsa-mir-124-3p, hsa-mir-146a-5p, hsa-mir-148b-3p, and hsa-mir-21-3p), transcription factors (TF) (WRNIP1, FOXC1, GATA2, CREB1, and RELA), a potentially repurposable drug carfilzomib and chemicals (tetrachlorodibenzodioxin, estradiol, arsenic trioxide, and valproic acid) that could regulate the expression levels of hub proteins at both the transcription and posttranscription stages. Our investigations have identified several potential therapeutic targets that elucidate the probability that victims of COVID-19 experience PTSD. However, they require further exploration through clinical and pharmacological studies to explain their efficacy in preventing PTSD in COVID-19 patients.
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Affiliation(s)
- Sabbir Ahmed
- Department of Electrical and Computer Engineering, The University of Texas at El Paso, El Paso, TX, USA
| | - Md Arju Hossain
- Department of Microbiology, Primeasia University, Dhaka, Bangladesh
| | - Sadia Afrin Bristy
- Bioinformatics and Biomedical Research Network of Bangladesh, Dhaka, Bangladesh
| | - Md Shahjahan Ali
- Department of Electrical and Computer Engineering, The University of Texas at El Paso, El Paso, TX, USA
| | - Md Habibur Rahman
- Department of Computer Science and Engineering, Islamic University, Kushtia, Bangladesh
- Center for Advanced Bioinformatics and Artificial Intelligence Research, Islamic University, Kushtia, Bangladesh
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Saltzman LY, Hunter LD. What's Time Got to Do With It?: A Time-Informed Approach to Longitudinal Research With Trauma Affected and Bereaved Populations. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:1551-1559. [PMID: 35476536 PMCID: PMC9606143 DOI: 10.1177/00302228221096245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper outlines a new approach to using participants' self-identified temporal triggers to center data collection around meaningful time periods as it pertains to coping with loss and trauma. We describe the utility of ecological momentary assessment and wearable technology as tools for time-informed data collection; and provide a study protocol for a recent study in which we paired these approaches to gather data from adult respondents who had lost a loved one. Data collection included two phases: a baseline phase and a target date phase. The target date phase was centered around the participant's self-identified temporal trigger. Several lmitations to this mode of data collection are disucsed. The overall approach is client centered and more accurately captures the lived experiences of individuals coping with loss and trauma. Data of this kind will begin to highlight the psychological and physiological impacts of anniversary dates among survivors of trauma and loss.
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Affiliation(s)
- Leia Y Saltzman
- Tulane University School of Social Work, New Orleans, LA, USA
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Oppo A, Forresi B, Barbieri A, Koenen KC. Trajectories of posttraumatic stress symptoms following collective violence: A systematic review and meta-analyses. J Trauma Stress 2024. [PMID: 39176467 DOI: 10.1002/jts.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 08/24/2024]
Abstract
Although collective violence represents a significant public health concern, a limited number of longitudinal studies have addressed this topic, with no systematic reviews focusing on posttraumatic stress symptom (PTSS) trajectories. The present systematic review and meta-analyses examined PTSS prevalence and trajectories after exposure to collective violence. A systematic literature search across six databases (APA PsycInfo, APA PsycArticles, PSYINDEX, MEDLINE, ERIC, and PubMed) identified 771 studies that were screened for the following eligibility criteria: exposure to collective violence, adult sample, longitudinal design, PTSS assessment using validated measures, PTSS trajectories estimated using latent growth modeling, and report sample prevalence rate for each trajectory. Ten studies met the criteria, and five meta-analyses were performed to assess the overall prevalence of each trajectory. Most included studies (63.6%) identified four trajectories, characterized as low-stable, high-stable, decreasing, and delayed-worsening. The low-stable trajectory was the modal response, with a pooled prevalence of 58.0%, 95% CI [51.0, 65.0]. The high-stable prevalence was 7.0%, 95% CI [4.0, 19.0]; the decreasing trajectory was 13%, 95% CI [9.0, 17.0]; and the delayed-worsening trajectory was 8.0%, 95% CI [5.0, 10.0]. A fifth trajectory, moderately stable, had a prevalence of 19.0%, 95% CI [9.0, 29.0]. The trajectory models robustly identified clinically relevant patterns of response to collective violence, offering a contribution to the literature and a starting point for future research. Further studies are needed, as a better comprehension of symptom trajectories after collective violence events has important clinical and public health implications.
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Affiliation(s)
- Annalisa Oppo
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Barbara Forresi
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Alice Barbieri
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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8
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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Liu H, Hou WK, Lau EYY, Birk JL, Bonanno GA. Identifying multilevel predictors of trajectories of psychopathology and resilience among juvenile offenders: A machine learning approach. Dev Psychopathol 2024; 36:1503-1519. [PMID: 37605996 DOI: 10.1017/s0954579423000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Mental ill health is more common among juvenile offenders relative to adolescents in general. Little is known about individual differences in their long-term psychological adaptation and its predictors from multiple aspects of their life. This study aims to identify heterogeneous trajectories of probable psychiatric conditions and their predictors. Participants included 574 juvenile offenders who were first convicted for serious crimes and without detention history. The participants were assessed at 11 timepoints over seven years (2000-2010). Growth mixture modeling revealed the same three trajectories for both probable anxiety and probable depression: stable low trajectory (75.96%; 75.78%), stable high trajectory (15.16%; 10.98%), and recovery (8.89%, 13.24%). Least absolute shrinkage and selection operator (LASSO) logistic regression identified three multilevel predictors for memberships of different trajectories. Risk factors against stable low trajectory lay within personal (e.g., neuroticism), relationship (e.g., parental hostility), and contextual levels (e.g., chaotic neighborhood). Resilience factors for stable low trajectory included strong work orientation and low education level of father. Recovery was predicted by Black race, self-identity, high education level of father, and nonincarcerated sentencing. Our findings suggest that both psychopathology and psychological resilience could be predicted by multiple personal, relationship, and contextual factors in the social ecology of juvenile offenders.
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Affiliation(s)
- Huinan Liu
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
| | - Esther Yuet Ying Lau
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
| | - Jeffrey L Birk
- Center for Behavioral Cardiovascular Health (CBCH), Columbia University Irving Medical Center, New York, NY, USA
| | - George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
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10
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Ozdemir C, Kaplan A. Factors affecting psychological resilience, self-efficacy and job satisfaction of nurse academics: A cross-sectional study. Int Nurs Rev 2024. [PMID: 38953465 DOI: 10.1111/inr.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/05/2024] [Indexed: 07/04/2024]
Abstract
AIM The study aimed to determine the factors affecting psychological resilience, self-efficacy and job satisfaction in nurse academics. BACKGROUND Nurse academics follow an emotionally and mentally intense career path, along which they are required to balance many different roles and responsibilities, including teaching, research and guidance. However, in some cases, this equilibrium is disrupted and may cause functional disruptions; in achieving this balance, resilience, self-efficacy and job satisfaction play important roles. METHODS The data of this cross-sectional study were collected between January and April 2023, and 446 nurse academics were included in the study. The Descriptive Characteristics Information Form, Brief Psychological Resilience Scale (BPRS), General Self-Efficacy Scale (GSES) and Job Satisfaction Scale (JSS) were used to collect the research data.We adhered to the STROBE checklist for reporting. RESULTS A significant positive relationship was found between general self-efficacy levels and psychological resilience and job satisfaction levels. There is a significant positive relationship between job satisfaction levels and age, total years of service, psychological resilience and general self-efficacy levels. In addition, it has been noted that family relationships, friend relationships and academic title factors were effective on the nurse academics' psychological resilience, self-efficacy and job satisfaction levels. CONCLUSION Managers can play an important role in increasing the psychological resilience, self-efficacy and job satisfaction levels of nurse academics by developing strategies for these effective factors. IMPLICATIONS FOR NURSING AND NURSING POLICY Governments need to ensure that nurse academics have an appropriate career framework that enables them to balance the competing demands on their time and that they have adequate mentoring and support in the early stages of their careers to enable them to adapt to working life as a nurse academic.
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Affiliation(s)
- Cevriye Ozdemir
- Incesu Ayse and Saffet Arslan Health Services Vocational School, Department of Medical Services and Techniques, University of Kayseri, Kayseri, Turkey
| | - Ali Kaplan
- Incesu Ayse and Saffet Arslan Health Services Vocational School, Department of Medical Services and Techniques, University of Kayseri, Kayseri, Turkey
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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 PMCID: PMC11381009 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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12
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McGiffin JN, Ehde DM, Williams RM, Bonanno GA. Heterogeneous trajectories of depression and resilience following limb amputation. PM R 2024; 16:594-604. [PMID: 37916584 DOI: 10.1002/pmrj.13095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To identify longitudinal trajectories of depression in the first 6 months following limb loss and to explore baseline predictors of trajectories, including pain and demographic factors. A secondary aim was to evaluate whether trajectories of depression were associated with elevated symptoms of posttraumatic stress (PTS) at 6 months. DESIGN Secondary longitudinal data analysis of an inception cohort study of persons with new-onset limb loss. Participants completed assessments at three intervals (initial, 3 months, and 6 months). SETTING Hospitalized care, acute rehabilitation, ambulatory care, and community. PARTICIPANTS Participants were recruited from consecutive cases of amputation surgery in a metropolitan hospital system over a period of 4 years (2002-2007). The final sample (n = 203) was predominantly White (79.3%) and male (78.8%) with an average age of 49.4 years (standard deviation [SD] = 14.6). MAIN OUTCOME MEASURE(S) Depression was assessed via the Patient Health Questionnaire-9 (PHQ-9); posttraumatic stress symptoms were measured via the PTSD checklist- Civilian Version (PCL-C). RESULTS Four trajectories of depression were identified via Latent Growth Mixture Modeling: Resilience (73.2%), Chronic Depression (11.2%), Emerging Depression (8.9%), and Recovery (6.7%). Average pain intensity significantly predicted trajectory membership. Membership in the Chronic Depression class predicted elevated 6-month PTS compared to all other classes; membership in the Resilience class predicted lower PTS than in the Chronic and Emerging Depression classes but did not differentiate from the Recovery trajectory. CONCLUSIONS Findings reveal that the course of depression post-amputation is heterogenous, with varying profiles of symptom development, maintenance, and remission. A majority of individuals were classified as Resilient, whereas a substantial minority of individuals developed clinically significant depression between 3 and 6 months (Emerging Depression), suggesting that early screening during acute care may be insufficient. We detected a significant prospective relation between depression trajectories and distal PTS, advancing the potential clinical utility of trajectory modeling as a risk surveillance tool.
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Affiliation(s)
- Jed N McGiffin
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Rhonda M Williams
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
- VA Puget Sound Health Care System, Seattle Division, Rehabilitation Care Services, Seattle, Washington, USA
| | - George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York City, New York, USA
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13
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Opsomer S, De Clercq L, De Lepeleire J, Joossens S, Luyten P, Pype P, Lauwerier E. Do all roads lead to Rome? An ideal-type study on trajectories of resilience in advanced cancer caregiving. PLoS One 2024; 19:e0303966. [PMID: 38820251 PMCID: PMC11142429 DOI: 10.1371/journal.pone.0303966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/03/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE Studies on resilience in advanced cancer caregiving typically focus on the interplay between resilience-promoting resources and coping strategies that may be associated with resilience. However, no studies have investigated the emergence of trajectories of resilience and distress in individuals confronted with a cancer diagnosis of a loved one. METHODS Ideal-type analysis, a method for constructing typologies from qualitative data, was used to identify trajectories involving resilience or the lack thereof based on fifty-four interviews conducted with seventeen partners of patients recently diagnosed with advanced cancer over a period of three years. FINDINGS Six trajectories could be distinguished, three of which involved resilience (rapidly adapting resilience, gradually adapting resilience, and slowly adapting resilience), while the other three trajectories (continuing distress, delayed distress, and frozen disconnection) reflected a less optimal adjustment. These different trajectories seemed to be rooted in the individual characteristics of partners, the behavior of a support network, and interactions between the two. CONCLUSION The differentiation between these trajectories in partners of patients diagnosed with cancer not only furthers research on resilience in the face of adversity, but also promises to assist healthcare professionals in optimizing support for this often-neglected group of partners of patients diagnosed with cancer.
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Affiliation(s)
- Sophie Opsomer
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luca De Clercq
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Jan De Lepeleire
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Sofie Joossens
- Program of Health, University Colleges Leuven ‐ Limburg, Leuven, Belgium
| | - Patrick Luyten
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- End-of-Life Care Research Group, Ghent University campus, Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Health Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands
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14
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van der Heide A, Dommershuijsen LJ, Puhlmann LMC, Kalisch R, Bloem BR, Speckens AEM, Helmich RC. Predictors of stress resilience in Parkinson's disease and associations with symptom progression. NPJ Parkinsons Dis 2024; 10:81. [PMID: 38605033 PMCID: PMC11009258 DOI: 10.1038/s41531-024-00692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
People with Parkinson's disease (PD) are sensitive to effects of long-term stress, but might differ in stress resilience, i.e. the ability to maintain mental health despite adversity. It is unclear whether stress resilience in PD is predominantly determined by dopamine deficiency, psychosocial factors, or both. In PD animal models, chronic stressors accelerate disease progression, but evidence in humans is lacking. Our objectives were to (1) distinguish stressor-reactive from resilient PD patients, (2) identify resilience factors, and (3) compare symptom progression between stressor-reactive and resilient patients. We conducted a longitudinal survey in Personalized Parkinson Project participants (N = 350 PD). We used the COVID-19 pandemic as a model of a stressor, aligned in time for the entire cohort. COVID-19-related stressors, perceived stress, and PD symptoms were assessed at 11 timepoints (April-October 2020). Both pre-COVID and in-COVID clinical assessments were available. We quantified stressor-reactivity as the residual between actual and predicted perceived stress relative to COVID-19-related stressors, and modeled trajectories of stressor-reactivity across timepoints. We explored pre-COVID predictors of 6-month average stressor-reactivity, and tested whether stressor-reactivity was prospectively associated with one-year clinical progression rates. Latent class trajectory models distinguished patients with high (N = 123) or low (N = 227) stressor-reactivity. Pre-existing anxiety, rumination and non-motor symptom severity predicted high stressor-reactivity (risk factors), whereas quality of life, social support, positive appraisal style and cognitive abilities predicted low stressor-reactivity (resilience factors). PD-specific factors, e.g. disease duration, motor severity, and levodopa use, did not predict stressor-reactivity. The COVID-19 pandemic did not accelerate disease progression, but worsened depressive symptoms in stressor-reactive PD patients.
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Affiliation(s)
- Anouk van der Heide
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands.
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| | - Lisanne J Dommershuijsen
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Lara M C Puhlmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Bastiaan R Bloem
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Anne E M Speckens
- Radboud University Medical Centre, Department of Psychiatry, Nijmegen, the Netherlands
| | - Rick C Helmich
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
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15
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Sun J, Zhang J, Chen Q, Yang W, Wei D, Qiu J. Psychological resilience-related functional connectomes predict creative personality. Psychophysiology 2024; 61:e14463. [PMID: 37855121 DOI: 10.1111/psyp.14463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/25/2023] [Accepted: 07/27/2023] [Indexed: 10/20/2023]
Abstract
Both psychological resilience and creativity are complex concepts that have positive effects on individual adaptation. Previous studies have shown overlaps between the key brain regions or brain functional networks related to psychological resilience and creativity. However, no direct experimental evidence has been provided to support the assumption that psychological resilience and creativity share a common brain basis. Therefore, the present study investigated the relationship between psychological resilience and creativity using neural imaging method with a machine learning approach. At the behavioral level, we found that psychological resilience was positively related to creative personality. Predictive analysis based on static functional connectivity (FC) and dynamic FC demonstrated that FCs related to psychological resilience could effectively predict an individual's creative personality score. Both the static FC and dynamic FC were mainly located in the default mode network. These results prove that psychological resilience and creativity share a common brain functional basis. These findings also provide insights into the possibility of promoting individual positive adaptation from negative events or situations in a creative way.
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Affiliation(s)
- Jiangzhou Sun
- College of International Studies, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingyi Zhang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Qunlin Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Wenjing Yang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
- Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Beijing, China
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16
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Han W. Job Demands and Mental Health Deterioration: Investigating the Mediating Role of Resiliency. Psychol Res Behav Manag 2024; 17:1151-1161. [PMID: 38505353 PMCID: PMC10949271 DOI: 10.2147/prbm.s448258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction In the past decade, China has witnessed a significant surge in the popularity of food delivery apps, with its industry now thrice the size of the U.S, employing approximately 7 million drivers navigating urban landscapes on electric bikes and scooters. Predominantly, the market is governed by two main players: Meituan Dianping (backed by Tencent) and Ele.me (supported by Alibaba). Notably, stress and absenteeism stand out as significant challenges in this service sector, with implications for occupational health that translate into considerable costs for both healthcare systems and companies. Existing research has largely overlooked how job demands affect the mental health of food delivery workers in China, and how resilience plays a role in this process. The present study addresses this gap by examining the direct impact of Workload Volume and Pace on the mental health of these workers, and by exploring how personal resilience can mediate this relationship. Furthermore, it delves into the mediating role of Resilience, a personal strength, in this relationship. Methods Using a correlational design with 206 participants, multiple regression analysis suggested a notable variance in Mental Health Decline. Results Subsequent bootstrapping-mediated analysis confirmed resilience's mediating role, highlighting its importance in managing stress from workload. Discussion The results underscore the critical role of personal strengths in managing work-related stress, which can significantly impact both job performance and mental well-being.
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Affiliation(s)
- Wei Han
- School of Marxism, Nanchang University, Nanchang, 330030, People’s Republic of China
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17
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Kampa M, Stark R, Klucken T. The impact of past childhood adversity and recent life events on neural responses during fear conditioning. J Neuroimaging 2024; 34:217-223. [PMID: 38009652 DOI: 10.1111/jon.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND AND PURPOSE Many studies have shown that exposure to life events can have a negative impact on mental health. Life events like the death of a spouse or the birth of a child pose a challenge and require temporal or permanent adjustments. Meta-analyses on brain stress responses found bilateral anterior insula activation in response to acute stress. Fear conditioning is assumed a crucial mechanism for the development of anxiety disorders associated with increased activation in the bilateral amygdala. Empirical evidence is lacking regarding the relationship of exposure to recent life events and past childhood adversity with neural processing during fear conditioning. METHODS In the present study, we analyzed data from 103 young, healthy participants. Multiple linear regressions were performed on functional magnetic resonance imaging activation during fear conditioning with the Life Events Scale for Students and the Childhood Trauma questionnaire included as covariates in two separate models. RESULTS We found a positive relationship between the number of life events in the last year and left amygdala activation to the conditioned stimulus. A second finding was a positive relationship between childhood adversity and right anterior insula response to the unconditioned stimulus. CONCLUSIONS Many studies have shown increased amygdala activity after stressful life events. In addition, the anterior insula is activated during acute stress. The present study points to stressor-induced increased salience processing during fear conditioning. We suggest that this could be a potential mechanism for resilience versus mental illness.
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Affiliation(s)
- Miriam Kampa
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University, Giessen, Germany
| | - Rudolf Stark
- Bender Institute of Neuroimaging, Justus Liebig University, Giessen, Germany
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
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18
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Champagne ER. Caregiver Resilience and Dance/Movement Therapy: A Theoretical Review and Conceptual Model. J Appl Gerontol 2024; 43:319-327. [PMID: 37991282 PMCID: PMC10809734 DOI: 10.1177/07334648231210679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 11/23/2023] Open
Abstract
With the population aging, more people are living with neurodegenerative conditions, leading to an influx of informal family caregivers, who often experience negative health outcomes. Few caregiver interventions have successfully adopted a holistic, strengths-based approach to fostering resilience. This article examines existing literature on caregiver resilience factors, which include self-efficacy, flexibility, cultivating positive emotions, and drawing on spiritual and social supports. Despite how dance/movement therapy (DMT) has been shown to foster psychological and physiological benefits, it remains underexplored for caregivers. Therapeutic mechanisms of DMT are expounded for their innate correspondence to resilience factors, and a new comprehensive model of DMT for caregiver resilience is presented, with implications for future intervention design and measurement.
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Affiliation(s)
- Eden R. Champagne
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, USA
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19
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Kalvesmaki AF, Trevino AY, Charron E, Kroll-Desrosiers A, Peterson K, Pugh MJ. The Impact of Resilience on Employment Among Post-9/11 Veterans With and Without Military Sexual Trauma Exposure. Mil Med 2024; 189:e493-e501. [PMID: 37464907 DOI: 10.1093/milmed/usad267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/10/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Successful employment is a functional outcome of high importance for veterans after military discharge. There is a significant rising concern regarding exposure to military sexual trauma (MST) and related mental health outcomes that can impair functional outcomes, such as employment. Although resilience training is a key component of preparing for military service, to date the impact of resilience on employment outcomes for veterans with exposure to MST has yet to be examined. We sought to examine the relationship between resilience and employment in a national sample of post-9/11 veterans with and without MST exposure. MATERIALS AND METHODS A national survey was conducted between October 2021 and January 2022 to respond to the 2021 National Defense Authorization Act mandate to identify factors affecting post-9/11 women veteran's unemployment. Of veterans, 1,185 completed the survey. Of these, 565 (47.6%) were post-9/11 veterans. The survey collected data on demographics and employment; MST, adult sexual trauma (AST, outside of military), and childhood sexual trauma (CST) exposure; resilience (Response to Stressful Experiences Scale); Post Traumatic Stress Disorder (PTSD) Checklist (PCL-5); and depression (Patient Health Questionnaire-2). Multivariable logistic regression models identified gender-specific associations of resilience with employment among those exposed and not exposed to MST, adjusting for AST, CST, PTSD, and depression. Significance was set at P < .05. RESULTS Of 322 women and 243 men post-9/11 veterans, 86.5% were employed. MST exposure (MST[+]) was reported by 31.4% (n = 101) of women and 16.9% (n = 41) of men. MST(+) women veterans were more likely to report CST (35.6% vs. 14.5%; P < .001), AST (68.3% vs. 17.2%; P < .001), and both CST and AST (19.8% vs. 7.2%; P < .001) than MST(-) women. MST(+) men were more likely to report AST (65.9% vs. 7.9%; P < .001), and both CST and AST (14.6% vs. 1.0%; P < .001) than MST(-) men. Levels of self-reported resilience were similar for MST(+) women and men and their MST(-) counterparts (women: 11.1 vs. 11.0; men: 11.5 vs. 12.0). For MST(+) women, each unit increase in resilience was associated with a 36% increase in odds of employment (OR: 1.36, 95% CI, 1.08-1.71); resilience was not associated with increased odds of employment among MST(-) women. Among MST(+) men veterans, each unit increase in resilience was associated with an 83% increase in odds of employment (aOR: 1.83, 95% CI, 1.13-2.98), and like women veterans, resilience was not associated with employment among MST(-) men. CONCLUSIONS Among MST(+) women and men post-9/11 veterans, higher resilience was associated with increased odds of employment, whereas resilience was not associated with employment in MST(-) veterans. These findings suggest that resiliency during and after military service is a key component for potentially improving long-term outcomes. Improving resilience using evidence-based approaches among post-9/11 veterans exposed to MST may be an important avenue for increasing successful functional outcomes such as employment. Moreover, MST(+) women and men veterans may benefit from trauma-informed care as a substantial proportion of these individuals also report exposure to CST, AST, PTSD, and depression.
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Affiliation(s)
- Andrea F Kalvesmaki
- Informatics Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Amira Y Trevino
- Department of Educational Psychology, University of Utah College of Education, Salt Lake City, UT 84112, USA
| | - Elizabeth Charron
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Schusterman Center, Tulsa, OK 74135, USA
| | - Aimee Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, 421 North Main Street, Leeds, MA 01053, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, USA
| | - Kelly Peterson
- Informatics Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Mary Jo Pugh
- Informatics Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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20
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Qiao T, Sun Y, Ye P, Yan J, Wang X, Song Z. The association between family functioning and problem behaviors among Chinese preschool left-behind children: the chain mediating effect of emotion regulation and psychological resilience. Front Psychol 2024; 15:1343908. [PMID: 38476393 PMCID: PMC10927802 DOI: 10.3389/fpsyg.2024.1343908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Objective The family environment has a significant impact on the psychological and behavioral development of children, especially those who are left behind in preschool and experience parent-child separation at a young age. These children face a greater risk of family dysfunction, which can lead to internalizing and externalizing problem behaviors. While numerous studies have established a connection between family functioning and problem behaviors, few have explored the underlying mechanisms driving this relationship. Our study seeks to address this gap by examining how emotion regulation and psychological resilience mediate the link between family functioning and problem behavior. Methods The sample consisted of 940 preschool children (51.5% male, 48.5% female) with a mean age of 5.07 ± 0.80. The main guardians of the children were given the Family Assessment Device, Preschool Children's Emotion Regulation Scale, the Devereux Early Childhood Assessment for Preschoolers (2nd edition), and the Social Skills Improvement System-Rating Scales to assess their family functioning, emotion regulation, psychological resilience, and problem behavior respectively. Results Lower family functioning was associated with more severe problem behaviors in preschool left-behind children, and emotion regulation and psychological resilience partially mediated the relationship between family functioning and problem behaviors, respectively. In addition, emotion regulation and psychological resilience were also chain mediators between family functioning and problem behaviors. Conclusion The study's findings highlighted the crucial role of emotional regulation and psychological resilience in the correlation between family functioning and problem behaviors. It is recommended that policymakers and educators place a high priority on the cultivation of internal psychological resources, such as emotional regulation and resilience, in preschool-aged children when designing interventions to address problem behaviors.
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Affiliation(s)
- Tianqi Qiao
- College of Education, Guangzhou University, Guangzhou, China
| | - Yan Sun
- College of Teacher Education, Shaoxing University, Shaoxing, China
| | - Pingzhi Ye
- College of Education, Guangzhou University, Guangzhou, China
| | - Jingfeng Yan
- College of Education, Wenzhou University, Wenzhou, China
| | - Xinxin Wang
- College of Education, Guangzhou University, Guangzhou, China
| | - Zhanmei Song
- College of International Education, Wenzhou University, Wenzhou, China
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21
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Yao ZF, Yang MH, Yang CT, Chang YH, Hsieh S. The role of attitudes towards contradiction in psychological resilience: the cortical mechanism of conflicting resolution networks. Sci Rep 2024; 14:1669. [PMID: 38238421 PMCID: PMC10796669 DOI: 10.1038/s41598-024-51722-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
Managing contradictions and building resilience help us overcome life's challenges. Here, we explored the link between attitudes towards contradictions and psychological resilience, examining the role of cortical conflict resolution networks. We enlisted 173 healthy young adults and used questionnaires to evaluate their cognitive thinking styles and resilience. They underwent structural and functional magnetic resonance imaging scans. Our results revealed that contrasting attitudes toward contradictions, formal logic, and naïve dialecticism thinking styles corresponded with varying degrees of resilience. We noted structural and functional differences in brain networks related to conflict resolution, including the inferior frontal and parietal cortices. The volumetric variations within cortical networks indicated right-hemispheric lateralization in different thinking styles. These findings highlight the potential links between conflict resolution and resilience in the frontoparietal network. We underscore the importance of frontoparietal brain networks for executive control in resolving conflicting information and regulating the impact of contradictions on psychological resilience.
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Affiliation(s)
- Zai-Fu Yao
- College of Education, National Tsing Hua University, Hsinchu City, 30013, Taiwan
- Research Center for Education and Mind Sciences, National Tsing Hua University, Hsinchu City, 30013, Taiwan
- Basic Psychology Group, Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu City, 30013, Taiwan
- Department of Kinesiology, National Tsing Hua University, Hsinchu City, 30013, Taiwan
| | - Meng-Heng Yang
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion (CASE), Department of Psychology, National Cheng Kung University, Tainan City, 70101, Taiwan
| | - Cheng-Ta Yang
- Graduate Institute of Mind, Brain, and Consciousness, Taipei Medical University, Taipei, Taiwan
- Department of Psychology, National Cheng Kung University, 1 University Road, Tainan City, 70101, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychology, National Cheng Kung University, 1 University Road, Tainan City, 70101, Taiwan
- Institute of Gerontology, National Cheng Kung University, Tainan City, 70101, Taiwan
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, 402, Taiwan
| | - Shulan Hsieh
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion (CASE), Department of Psychology, National Cheng Kung University, Tainan City, 70101, Taiwan.
- Department of Psychology, National Cheng Kung University, 1 University Road, Tainan City, 70101, Taiwan.
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan City, 70101, Taiwan.
- Department of Public Health, National Cheng Kung University, Tainan City, 70101, Taiwan.
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22
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Bonanno GA, Chen S, Bagrodia R, Galatzer-Levy IR. Resilience and Disaster: Flexible Adaptation in the Face of Uncertain Threat. Annu Rev Psychol 2024; 75:573-599. [PMID: 37566760 DOI: 10.1146/annurev-psych-011123-024224] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Disasters cause sweeping damage, hardship, and loss of life. In this article, we first consider the dominant psychological approach to disasters and its narrow focus on psychopathology (e.g., posttraumatic stress disorder). We then review research on a broader approach that has identified heterogeneous, highly replicable trajectories of outcome, the most common being stable mental health or resilience. We review trajectory research for different types of disasters, including the COVID-19 pandemic. Next, we consider correlates of the resilience trajectory and note their paradoxically limited ability to predict future resilient outcomes. Research using machine learning algorithms improved prediction but has not yet illuminated the mechanism behind resilient adaptation. To that end, we propose a more direct psychological explanation for resilience based on research on the motivational and mechanistic components of regulatory flexibility. Finally, we consider how future research might leverage new computational approaches to better capture regulatory flexibility in real time.
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Affiliation(s)
- George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Shuquan Chen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Rohini Bagrodia
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Isaac R Galatzer-Levy
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, USA;
- Google LLC, Mountain View, California
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23
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Zerban M, Puhlmann LMC, Lassri D, Fonagy P, Montague PR, Kiselnikova N, Lorenzini N, Desatnik A, Kalisch R, Nolte T. What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic. Front Psychol 2023; 14:1272199. [PMID: 38164261 PMCID: PMC10757941 DOI: 10.3389/fpsyg.2023.1272199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic. Method We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners. Results Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute βs = 0.16-0.40; SRS: 15/18 RFs, absolute βs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression. Discussion Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.
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Affiliation(s)
- Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Marie Christine Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Dana Lassri
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - P. Read Montague
- Virginia Tech Carilion Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA, United States
| | - Natalia Kiselnikova
- Department of Psychosocial Studies, Birkbeck College, University of London, London, United Kingdom
| | - Nicolas Lorenzini
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Alex Desatnik
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Open Door Young People’s Service, London, United Kingdom
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Tobias Nolte
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
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Su P, He M. Relationship between sleep quality and subjective well-being: resilience as a mediator and belief in a just world as a moderator. Front Psychiatry 2023; 14:1297256. [PMID: 38130291 PMCID: PMC10733969 DOI: 10.3389/fpsyt.2023.1297256] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Background/Purpose Sleep quality significantly impacts subjective well-being, yet its underlying mechanisms remain largely unknown from a scholarly perspective. Existing research has inadequately addressed the relationship between sleep quality and the subjective well-being of College students. This study primarily investigates the influence of sleep quality on the subjective well-being of College students and explores the mediating role of resilience and the moderating role of belief in a just world. Methods The study sample comprises 3349 enrolled College students. Measures include the Pittsburgh Sleep Quality Index, the Subjective Well-being Scale, resilience scale, and belief in a just world scale. A moderated mediation model is employed to verify the mediating role of resilience and the moderating role of belief in a just world. Results (1) Sleep quality among College students is significantly positively correlated with resilience, belief in a just world, and subjective well-being. (2) Sleep quality positively predicts subjective well-being among College students. Resilience among College students serves as a mediator between sleep quality and subjective well-being, while belief in a just world moderates the influence of resilience on subjective well-being. Conclusion The results suggest that sleep quality can directly enhance the subjective well-being of College students and can also indirectly affect it through resilience. Additionally, belief in a just world can enhance the promoting effect of resilience on the subjective well-being of College students. These findings may contribute to understanding the impact of sleep quality on the subjective well-being of College students and its pathways. These research findings can serve as a reference for improving the subjective well-being of College students.
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Affiliation(s)
- Peng Su
- School of Marxism, University of Chinese Academy of Social Sciences, Beijing, China
| | - Mu He
- College of Marxism, Chongqing Medical and Pharmaceutical College, Chongqing, China
- Institute of Marxism, Central South University, Changsha, China
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Nguyet Trang TT, Thang PC. Development and validation of Vietnam teachers' resilience scale instrument: A four-factor model. Heliyon 2023; 9:e22730. [PMID: 38107296 PMCID: PMC10724667 DOI: 10.1016/j.heliyon.2023.e22730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
Existing studies on resilience measures tailored explicitly to teachers are relatively scarce, and the development of teacher resilience scales in developing Asian nations is lacking. To address this gap, we developed the Vietnam Teachers' Resilience Scale (VITRS), drawing on the Teachers' Resilience Scale (Daniilidou & Platsidou, 2018) and the Multidimensional Teachers' Resilience Scale (Mansfield & Wosnitza, 2015; Peixoto et al., 2020). The VITRS comprises 20 items across four dimensions (Social, Professional, Emotional, and Motivational resilience), demonstrating psychometric properties. The VITRS exhibits high reliability and validity and can serve as a significant assessment tool for high school and university teachers. This enables them to measure their resilience and prepare effectively to face and adapt to adversity. Despite these limitations, this study opens new avenues for future research.
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Affiliation(s)
| | - Pham Chien Thang
- Faculty of Journalism and Communication, TNU-University of Sciences, Viet Nam
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Panter-Brick C. Pathways to resilience and pathways to flourishing: Examining the added-value of multisystem research and intervention in contexts of war and forced displacement. Dev Psychopathol 2023; 35:2214-2225. [PMID: 37766475 DOI: 10.1017/s095457942300113x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
This paper examines the added-value that multisystem approaches bring to research and intervention in contexts of war and forced displacement. I highlight what is useful and truly innovative about systems-level work, aware that providing data-related evidence is only part of the story when connecting research to policy and practice. I discuss four types of added-value: these are conceptual, instrumental, capacity-building, and connectivity impacts that, respectively, aim to change current knowledge, improve implementation, build research skills, and strengthen network connectivity. Specifically, systems-based research can help transform the key frames of humanitarian work, fostering the more integrated and distributive models of professional assistance known as resilience and network humanitarianism. I argue that systems-level approaches on resilience and flourishing in war-affected and refugee populations help to articulate new mindsets, methodologies, partnerships, and ways of working relevant for humanitarian research, policy and practice. I focus attention on interdisciplinary, interventionist, prospective, transgenerational, and network-building initiatives. My specific examples cover the family context of mental health and trauma memory in Afghanistan, as well as program evaluation with Syrian refugees in Jordan, connecting stress biology to human experience, and social networks to psychological empowerment. The paper suggests future directions to support more effective and impactful systems-level work in protracted humanitarian crises.
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Affiliation(s)
- Catherine Panter-Brick
- Department of Anthropology, Yale University, New Haven, CT, USA
- Jackson School of Global Affairs, Yale University, New Haven, CT, USA
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Wang X, Huang J, Yang X, Liu Z, Zhou X. Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety. J Adolesc 2023; 95:1590-1602. [PMID: 37530099 DOI: 10.1002/jad.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/07/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety. METHODS The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed. RESULTS Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3. CONCLUSIONS These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.
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Affiliation(s)
- Xuan Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Jiali Huang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Zhengyi Liu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
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28
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Burrows B, Daniels J, Starks UC, Amso D, Downey G. The Ecological Resilience Framework: The Justice Ambassadors Youth Council as a model for community-based resilience. Dev Psychopathol 2023; 35:2560-2568. [PMID: 37650247 DOI: 10.1017/s0954579423001001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
We present an 'Ecological Resilience Framework' (ERF) to demonstrate how resilience is created through the Justice Ambassadors Youth Council (JAYC) program. JAYC is a platform in which New York government representatives collaboratively learn and develop policy solutions alongside emerging adults who are criminal legal system impacted and reside in predominantly Black and Hispanic communities characterized by chronically high levels of poverty, violence, and incarceration. We focus our work on the process of developing resilience in the context of structural social inequity and injustice. We argue that resilience can best be understood in the context of the adversity to which it is a response, not as an isolated individual quality. Therefore, resilience science is at its best when it incorporates a multi-disciplinary scientific perspective, one that addresses a continuum from individual- to community- to society-level physical, cognitive, relationship, and mental health variables. To demonstrate how our ERF incorporates this approach, we outline how JAYC not only supports young adult participants in understanding their individual life trajectories and narrative identity, but also actively connects them within a diverse social network of mentors and to various opportunities that support a healthy transition to adult resilience.
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Affiliation(s)
| | | | | | - Dima Amso
- Columbia University, New York, NY, USA
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29
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Fares-Otero NE, O J, Spies G, Womersley JS, Gonzalez C, Ayas G, Mossie TB, Carranza-Neira J, Estrada-Lorenzo JM, Vieta E, Schalinski I, Schnyder U, Seedat S. Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2282826. [PMID: 38010898 PMCID: PMC10993816 DOI: 10.1080/20008066.2023.2282826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains.Objective: To develop a protocol for conducting a systematic review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations.Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle-Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively.Conclusions: This protocol will facilitate a systematic review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM.PROSPERO registration: CRD42023394120.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Jiaqing O
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Georgina Spies
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Jacqueline S. Womersley
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Carolina Gonzalez
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Görkem Ayas
- Graduate School of Health Sciences, Koç Üniversitesi, Istanbul, Turkey
| | - Tilahun Belete Mossie
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Julia Carranza-Neira
- Faculty of Health Sciences, School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Inga Schalinski
- Universität der Bundeswehr München, Department of Human Sciences, Munich, Germany
| | | | - Soraya Seedat
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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Kegelaers J. Are we really studying resilience in sport? A critical review of adopted methodologies. Front Psychol 2023; 14:1270887. [PMID: 37954183 PMCID: PMC10637379 DOI: 10.3389/fpsyg.2023.1270887] [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] [Received: 08/01/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Psychological resilience has gained considerable attention in sport. Nevertheless, the construct often remains poorly understood and multiple conceptual and methodological issues pervade the literature. The purpose of the present article is to provide a critical review of the commonly adopted methodologies to study resilience in sport. This review is divided into four sections. The first section will briefly discuss opposing conceptualizations of resilience as a static trait or a dynamic process. The second section will then discuss key methodological implications relating to the conceptualization of resilience as a dynamic process. In the third section, common methodologies to study resilience in sport are presented and critically reviewed. These methodologies are broadly divided into: (i) self-report resilience measures, (ii) qualitative research, and (iii) direct assessment of functioning in relation to observed adversity. In the final section, some avenues for future research are offered.
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Affiliation(s)
- Jolan Kegelaers
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Sport Psychology and Mental Support, Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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31
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Comacchio C, Cesco M, Martinelli R, Garzitto M, Bianchi R, Innocente N, Sozio E, Tascini C, Balestrieri M, Colizzi M. Psychological factors associated with vaccination hesitancy: an observational study of patients hospitalized for COVID-19 in a later phase of the pandemic in Italy. Front Psychiatry 2023; 14:1272959. [PMID: 37928916 PMCID: PMC10622775 DOI: 10.3389/fpsyt.2023.1272959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Vaccination against SARS-CoV-2 has been used to reduce the severity of COVID-19 disease and the incidence of new cases. However, a significant proportion of people have shown vaccination hesitancy. Methods This study explored psychological factors related to vaccination hesitancy in a sample of Italian COVID-19 patients (N = 54), hospitalized during 2021, after vaccines had been made available and while the vaccination campaign was on-going. Consecutive patients, aged 18 or older, admitted to the hospital with a diagnosis of COVID-19 were assessed with a set of standardized measures. Results In our sample, 48.1% was not vaccinated and 7.4% died within 6months after hospitalization, with a preponderance of deaths among non-vaccinated patients. Non-vaccinated participants had higher resilience scores at the CD-RISC-10 scale than vaccinated ones (33.6 ± 5.50 vs 28.6 ± 6.61; t40.2=+ 2.94, p = 0.005). No statistically significant differences were found between the two groups for any other measures. Discussion Higher levels of resilience among non-vaccinated patients may reflect greater identity worth and self-esteem, in turn resulting in a decrease in vaccination likelihood. This finding may have important public health implications, as it indicates that specific psychological aspects, such as resilience, may result in vaccination hesitancy, with implications for hospitalization rates, and thus healthcare costs, as well as loss of lives.
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Affiliation(s)
- Carla Comacchio
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maddalena Cesco
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Rosita Martinelli
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Marco Garzitto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Rita Bianchi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Nicola Innocente
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Emanuela Sozio
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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32
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Cahill S, Hager R, Shryane N. Patterns of resilient functioning in early life: Identifying distinct groups and associated factors. Dev Psychopathol 2023:1-21. [PMID: 37848396 DOI: 10.1017/s0954579423001165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Resilience, the capacity to maintain or regain functionality in the face of adversity, is a dynamic process influenced by individual, familial, and community factors. Despite its variability, distinct resilience trajectories can be identified within populations, yet the predictors defining these distinct groups remains largely unclear. Here, using data from the Avon Longitudinal Study of Parents and Children (ages 0-18), we quantify resilience as the remaining variance in psychosocial functioning after taking into account the exposure to adversity. Growth mixture modeling identified seven distinct resilience trajectories, with over half of the study population maintaining resilience throughout early life. Factors increasing the likelihood of resilient trajectory membership included a less emotional temperament, high cognitive abilities, high self-esteem, low levels of autistic social traits, strong sibling relationships, high maternal care, and positive school experiences. Among the socioeconomic factors considered, maternal education - a significant indicator of socioeconomic status - and birth-order were associated with resilient trajectories. Our findings underscore the importance of fostering cognitive abilities, self-esteem, social relationships, positive school experiences, and extracurricular engagement to bolster resilience in adversity-exposed individuals and communities. This research informs resilience-focused interventions in mental health, education, and social policy sectors, and prompts further exploration of socioeconomic influences on resilience trajectories.
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Affiliation(s)
- Stephanie Cahill
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, MA, UK
- Faculty of Humanities, Cathie Marsh Institute for Social Research, University of Manchester, Manchester, MA, UK
| | - Reinmar Hager
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, MA, UK
| | - Nick Shryane
- Faculty of Humanities, Cathie Marsh Institute for Social Research, University of Manchester, Manchester, MA, UK
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Bögemann SA, Puhlmann LMC, Wackerhagen C, Zerban M, Riepenhausen A, Köber G, Yuen KSL, Pooseh S, Marciniak MA, Reppmann Z, Uściƚko A, Weermeijer J, Lenferink DB, Mituniewicz J, Robak N, Donner NC, Mestdagh M, Verdonck S, van Dick R, Kleim B, Lieb K, van Leeuwen JMC, Kobylińska D, Myin-Germeys I, Walter H, Tüscher O, Hermans EJ, Veer IM, Kalisch R. Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study. JMIR Ment Health 2023; 10:e46518. [PMID: 37847551 PMCID: PMC10618882 DOI: 10.2196/46518] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020. OBJECTIVE Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries. METHODS Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses. RESULTS RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06). CONCLUSIONS We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.
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Affiliation(s)
- Sophie A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lara M C Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carolin Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Antje Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Shakoor Pooseh
- Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany
| | - Marta A Marciniak
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Zala Reppmann
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jeroen Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Dionne B Lenferink
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Natalia Robak
- College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Nina C Donner
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Merijn Mestdagh
- Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Stijn Verdonck
- Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Rolf van Dick
- Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Birgit Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Judith M C van Leeuwen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Erno J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ilya M Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
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Shilton T, Mancini AD, Perlstein S, DiDomenico GE, Visoki E, Greenberg DM, Brown LA, Gur RC, Gur RE, Waller RE, Barzilay R. Contribution of risk and resilience factors to anxiety trajectories during the early stages of the COVID-19 pandemic: A longitudinal study. Stress Health 2023; 39:927-939. [PMID: 36751725 PMCID: PMC10404639 DOI: 10.1002/smi.3233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 12/17/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023]
Abstract
The COVID-19 pandemic, and the response of governments to mitigate the pandemic's spread, resulted in exceptional circumstances that comprised a major global stressor, with broad implications for mental health. We aimed to delineate anxiety trajectories over three time-points in the first 6 months of the pandemic and identify baseline risk and resilience factors that predicted anxiety trajectories. Within weeks of the pandemic onset, we established a website (covid19resilience.org), and enrolled 1362 participants (n = 1064 from US; n = 222 from Israel) who provided longitudinal data between April-September 2020. We used latent growth mixture modelling to identify anxiety trajectories and ran multivariate regression models to compare characteristics between trajectory classes. A four-class model best fit the data, including a resilient trajectory (stable low anxiety) the most common (n = 961, 75.08%), and chronic anxiety (n = 149, 11.64%), recovery (n = 96, 7.50%) and delayed anxiety (n = 74, 5.78%) trajectories. Resilient participants were older, not living alone, with higher income, more education, and reported fewer COVID-19 worries and better sleep quality. Higher resilience factors' scores, specifically greater emotion regulation and lower conflict relationships, also uniquely distinguished the resilient trajectory. Results are consistent with the pre-pandemic resilience literature suggesting that most individuals show stable mental health in the face of stressful events. Findings can inform preventative interventions for improved mental health.
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Affiliation(s)
- Tal Shilton
- Sheba Medical Centre, Child Adolescent Psychiatry Division, Tel Aviv University Sackler School of Medicine, Israel
| | | | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Grace E DiDomenico
- Lifespan Brain Institute, Children’s Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
| | - Elina Visoki
- Lifespan Brain Institute, Children’s Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
| | | | - Lily A Brown
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Lifespan Brain Institute, Children’s Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E Gur
- Lifespan Brain Institute, Children’s Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca E Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ran Barzilay
- Lifespan Brain Institute, Children’s Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Georgescu MF, Fischer IC, Lowe S, Pietrzak RH. Psychological Resilience in U.S. Military Veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study. Psychiatr Q 2023; 94:449-466. [PMID: 37438571 DOI: 10.1007/s11126-023-10041-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
Following exposure to traumatic life events, most individuals are psychologically resilient, and experience minimal-to-no symptoms of posttraumatic stress, major depressive, or generalized anxiety disorders. To date, however, most research has focused on factors associated with adverse post-trauma mental health outcomes rather than understanding those associated with psychological resilience. In particular, little is known about factors associated with psychological resilience in veterans, despite their high rates of trauma exposure, such as combat and military sexual trauma. To address this gap, we used a discrepancy-based psychiatric resilience (DBPR) analytic approach to operationalize psychological resilience, and to identify modifiable health and psychosocial factors associated with resilience in a nationally representative sample of U.S. veterans (N = 4,069). DBPR scores were computed by regressing a composite measure of distress (posttraumatic stress, major depressive, and generalized anxiety disorder symptoms) onto measures of adverse childhood experiences, combat exposure, military sexual trauma, and cumulative potentially traumatic events (e.g., natural disaster, life-threatening illness/injury). Psychological resilience was operationalized as lower actual, relative to predicted, composite distress scores. Results revealed that greater emotional stability (22.9% relative variance explained [RVE]) and mindfulness (13.4% RVE), lower likelihood of lifetime histories of MDD or PTSD (12.8% RVE), greater purpose in life (11.9% RVE), and lower severity of somatic symptoms (10.8% RVE) explained the majority of the variance in resilience scores (total R2 = 0.40). Taken together, results of this study illustrate the utility of a DBPR score approach to operationalizing psychological resilience to traumatic stress in U.S. veterans, and identify several modifiable health and psychosocial factors that can be targeted in prevention and treatment efforts designed to bolster resilience in this population.
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Affiliation(s)
- Michael F Georgescu
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
| | - Ian C Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Sarah Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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Polusny MA, Erbes CR. A dynamic, multilevel approach to conceptualising and designing resilience research in the context of military stress. Stress Health 2023; 39:40-47. [PMID: 37248806 PMCID: PMC10528202 DOI: 10.1002/smi.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Challenges in conceptualising resilience have impeded advancements in resilience science. In response, the National Institutes of Health (NIH) developed a general framework for harmonising the conceptualisation of resilience as a dynamic process determined by multiple systems and levels of analysis. Consistent with the NIH Resilience Framework, this paper presents a conceptual model of resilience applied to military service members. This model encompasses four core components necessary for resilience research: (1) the presence of significant challenge, (2) successful adaptation in response to the challenge, (3) the capacity for resilience (i.e., protective factors), and (4) the processes (i.e., mechanisms) by which protective factors exert positive effects on an individual's response. Guided by this conceptual model, we outline key methodological recommendations to advance resilience research and illustrate each using the Advancing Research on Mechanisms of Resilience study as an exemplar. We emphasise the need for future research to examine resilience as a dynamic process and apply a multilevel approach. We hope to provide a basic road map to those interested in improving the rigour of future research on resilience in a military context, the results of which can inform the development of interventions.
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Affiliation(s)
- Melissa A. Polusny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
| | - Christopher R. Erbes
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
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Bögemann SA, Riepenhausen A, Puhlmann LMC, Bar S, Hermsen EJC, Mituniewicz J, Reppmann ZC, Uściƚko A, van Leeuwen JMC, Wackerhagen C, Yuen KSL, Zerban M, Weermeijer J, Marciniak MA, Mor N, van Kraaij A, Köber G, Pooseh S, Koval P, Arias-Vásquez A, Binder H, De Raedt W, Kleim B, Myin-Germeys I, Roelofs K, Timmer J, Tüscher O, Hendler T, Kobylińska D, Veer IM, Kalisch R, Hermans EJ, Walter H. Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study. BMC Psychol 2023; 11:245. [PMID: 37626397 PMCID: PMC10464364 DOI: 10.1186/s40359-023-01249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience - interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience. METHODS DynaM-INT aims to recruit N = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18-27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement. DISCUSSION The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.
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Grants
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- 01KX2021 German Federal Ministry for Education and Research (BMBF) as part of the Network for University Medicine
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- European Union’s Horizon 2020 research and innovation program
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Affiliation(s)
- S A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - A Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - L M C Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - S Bar
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E J C Hermsen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - J Mituniewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Z C Reppmann
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Uściƚko
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - J M C van Leeuwen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - C Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - M Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - J Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - M A Marciniak
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - N Mor
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A van Kraaij
- OnePlanet Research Center, Wageningen, The Netherlands
| | - G Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - S Pooseh
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - P Koval
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic, 3010, Australia
| | - A Arias-Vásquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - W De Raedt
- Life Sciences Department, Imec, Louvain, Belgium
| | - B Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - I Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - K Roelofs
- Center for Cognitive Neuroimaging, Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - J Timmer
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
- Institute of Physics, University of Freiburg, Freiburg, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - O Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - T Hendler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - D Kobylińska
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - I M Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - E J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Walter
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
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Kasinger C, Schulz AC, Ulke C, Maercker A, Beutel M, Brähler E. Historical and regional particularities in the prevalence of traumatic events and posttraumatic stress disorder in East and West Germany. BMC Public Health 2023; 23:1601. [PMID: 37608365 PMCID: PMC10463859 DOI: 10.1186/s12889-023-16534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/16/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Epidemiological research on the prevalence of traumatic events and PTSD has shown that there are significant differences between countries, due to their different history and socialization processes. In the case of Germany, this is particularly relevant. Germany was divided into two states from 1949 to 1990. This study examines the prevalence of traumatic events and PTSD in the formerly divided East and West Germany. METHODS For the prevalence of traumatic events, we used data from four representative surveys (years 2005, 2007, 2008, and 2016) with a total of N = 9,200 respondents. For the analyses of PTSD prevalence, we used data from three representative surveys (years 2005, 2007, 2008) with a total of N = 6676 respondents. We compared different birth cohorts, persons living in the former West vs. East Germany, and the application of different diagnostic criteria using a chi-square test. RESULTS The overall one-month prevalence rate for PTSD was 3.4% (3.0% for men and 3.8% for women). We found significant differences in the occurrence of traumatic events between genders, different age cohorts as well as between people who live in East and West Germany. Significant differences in the prevalence of PTSD can only be observed for different age cohorts. Most of the age effects are due to traumatic events related to World War II (WWII). Prevalence rates for PTSD were higher when the diagnostic criterions of the DSM-V were applied compared to the criterions of the DSM-IV. CONCLUSIONS Our data suggests that socio-political factors may need to be considered when accounting for differences in occurrence rates of traumatic events, but not for prevalence rates of PTSD, between East and West Germany. People who have experienced WW II have a higher risk of suffering from PTSD. Future epidemiological trauma research should take historical and regional peculiarities of countries into account.
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Affiliation(s)
- Christoph Kasinger
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany.
| | - Ann-Christin Schulz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Maercker
- Department of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Zuerich, Switzerland
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
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Meijer JEM, Machielse A, Smid GE, Schats W, Jong MC. The resilience of Jewish communities living in the diaspora: a scoping review. Front Psychol 2023; 14:1215404. [PMID: 37655197 PMCID: PMC10466794 DOI: 10.3389/fpsyg.2023.1215404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Throughout history, Jewish communities have been exposed to collectively experienced traumatic events. Little is known about the role that the community plays in the impact of these traumatic events on Jewish diaspora people. This scoping review aims to map the concepts of the resilience of Jewish communities in the diaspora and to identify factors that influence this resilience. Methods We followed the Joanna Briggs Institute (JBI) methodology. Database searches yielded 2,564 articles. Sixteen met all inclusion criteria. The analysis was guided by eight review questions. Results Community resilience of the Jewish diaspora was often described in terms of coping with disaster and struggling with acculturation. A clear definition of community resilience of the Jewish diaspora was lacking. Social and religious factors, strong organizations, education, and communication increased community resilience. Barriers to the resilience of Jewish communities in the diaspora included the interaction with the hosting country and other communities, characteristics of the community itself, and psychological and cultural issues. Discussion Key gaps in the literature included the absence of quantitative measures of community resilience and the lack of descriptions of how community resilience affects individuals' health-related quality of life. Future studies on the interaction between community resilience and health-related individual resilience are warranted.
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Affiliation(s)
- Judith E. M. Meijer
- Department Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Anja Machielse
- Department Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Geert E. Smid
- Department Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
- ARQ National Psychotrauma Center, Diemen, Netherlands
| | - Winnie Schats
- Scientific Information Service, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Miek C. Jong
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine (NAFKAM), Arctic University of Norway (UiT), Tromsø, Norway
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40
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Daches Cohen L, Gross JJ, Rubinsten O. Using Reappraisal to Improve Outcomes for STEM Teachers and Students. J Cogn 2023; 6:45. [PMID: 37577258 PMCID: PMC10418247 DOI: 10.5334/joc.313] [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] [Received: 03/02/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
The many stressors associated with teaching can take a toll, resulting in high levels of burnout among teachers and reduced motivation and academic performance among students. This is especially true in the context of science, technology, engineering, and mathematics (STEM) subjects. Despite the efficacy of emotion regulation interventions in pedagogical settings in general and in STEM teaching in particular, there is a lack of suitable interventions. We applied the process model of emotion regulation to STEM teaching and proposed a framework, STEM-Model of EmotioN regulation: Teachers' Opportunities and Responsibilities (STEM-MENTOR), to elucidate how the high demands of STEM teaching and contextual factors (e.g., culture, reforms, teacher-student interactions) may lead to intensified negative emotions and deficits in executive functioning and emotion regulation implementation. Teacher emotions, in turn, shape students' STEM-related achievements and epistemic emotions. Thus, teachers' emotion regulation skills have pervasive effects on teaching outcomes for both teachers and students. We illustrate how at each level of our framework, steps could be taken to improve teachers' emotional trajectory. Our proposed STEM-MENTOR framework has implications for theoretical understanding and may help to shape future interventions that focus on cognitive-emotional processes in STEM education.
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Affiliation(s)
- Lital Daches Cohen
- Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel
- Department of Learning Disabilities, University of Haifa, Haifa, Israel
| | | | - Orly Rubinsten
- Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel
- Department of Learning Disabilities, University of Haifa, Haifa, Israel
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Ahmadi A, Ponder WN, Carbajal J, Schuman DL, Whitworth J, Yockey RA, Galusha JM. Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of Veterans. J Occup Environ Med 2023; 65:643-654. [PMID: 37264532 DOI: 10.1097/jom.0000000000002898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA. METHODS We used a treatment-seeking sample of veterans ( N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7). RESULTS The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model. LIMITATIONS Follow-up studies should validate these measures on nontreatment-seeking discharged veterans. CONCLUSIONS We interpret these findings within the veteran scholarship and explore clinical implications for providers.
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Affiliation(s)
- Aazi Ahmadi
- From the Pennsylvania State University, State College, PA (A.A.); One Tribe Foundation, Fort Worth, Texas (W.N.P.); Stephen F. Austin State University, Nacogdoches, Texas (J.C.); University of Texas at Arlington, Arlington, Texas (D.L.S.); University of Central Florida, Orlando, Florida (J.W.); University of North Texas Health Science Center, Fort Worth, Texas (R.A.Y.); and Private Practice, Dallas, Texas (J.M.G.)
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Nishimi K, Tan J, Scoglio A, Choi KW, Kelley DP, Neylan TC, O’Donovan A. Psychological Resilience to Trauma and Risk of COVID-19 Infection and Somatic Symptoms Across 2 Years. Psychosom Med 2023; 85:488-497. [PMID: 37199425 PMCID: PMC10524129 DOI: 10.1097/psy.0000000000001215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Exposure to trauma increases the risk of somatic symptoms, as well as acute and chronic physical diseases. However, many individuals display psychological resilience, showing positive psychological adaptation despite trauma exposure. Resilience to prior trauma may be a protective factor for physical health during subsequent stressors, including the COVID-19 pandemic. METHODS Using data from 528 US adults in a longitudinal cohort study, we examined psychological resilience to lifetime potentially traumatic events early in the pandemic and the risk of COVID-19 infection and somatic symptoms across 2 years of follow-up. Resilience was defined as level of psychological functioning relative to lifetime trauma burden, assessed in August 2020. Outcomes included COVID-19 infection and symptom severity, long COVID, and somatic symptoms assessed every 6 months for 24 months. Using regression models, we examined associations between resilience and each outcome adjusting for covariates. RESULTS Higher psychological resilience to trauma was associated with a lower likelihood of COVID-19 infection over time, with one standard deviation higher resilience score associated with a 31% lower likelihood of COVID-19 infection, adjusting for sociodemographics and vaccination status. Furthermore, higher resilience was associated with lower levels of somatic symptoms during the pandemic, adjusting for COVID-19 infection and long COVID status. In contrast, resilience was not associated with COVID-19 disease severity or long COVID. CONCLUSIONS Psychological resilience to prior trauma is associated with lower risk of COVID-19 infection and lower somatic symptoms during the pandemic. Promoting psychological resilience to trauma may benefit not only mental but also physical health.
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Affiliation(s)
- Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Jeri Tan
- Mental Health Service, San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Arielle Scoglio
- Department of Natural and Applied Sciences, Bentley University
- Department of Epidemiology, Harvard TH Chan School of Public Health
| | - Karmel W Choi
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital
- Psychiatric & Neurodevelopment Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital
| | - D. Parker Kelley
- Mental Health Service, San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Thomas C Neylan
- Mental Health Service, San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
| | - Aoife O’Donovan
- Mental Health Service, San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco
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43
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Hosgoren Alıcı Y, Hasanli J, Saygılı G, Koçak OM. The importance of mentalization, coping mechanisms, and perceived stress in the prediction of resilience of healthcare workers. PSYCHOL HEALTH MED 2023; 28:2635-2646. [PMID: 36217606 DOI: 10.1080/13548506.2022.2131855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/20/2022] [Indexed: 10/17/2022]
Abstract
Resilience is the process of overcoming stressors. Being able to examine the effect of the Covid epidemic on healthcare workers (HCWs) has provided us a unique opportunity to understand the impact of trauma on resilience. We aimed to investigate the relationship between stress, mentalization, and an individual's coping capacity against a real risk (Covid-19) and evaluate the predictors of resilience. 302 HCWs have enrolled in the study and completed an online questionnaire assessing demographics, perceived stress, resilience, coping, and mentalization. We utilized statistical analysis together with a Random Forest classifier to analyze the interaction between these factors extensively. We applied ten times ten-fold cross-validation and plotted Receiver Operator Characteristic (ROC) with the calculated Area Under the Curve(AUC) score and identify the most important features. Our experiments showed that the Perceived stress scale has the strongest relationship with resilience. The subject's awareness level of emotional states is an important factor that determines the level of resilience. Coping styles such as the decision of giving up is also a crucial indicator. We conclude that being aware of the risks and the mental states are the dominant factors behind the resilience levels of healthcare workers under pandemic conditions.
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Affiliation(s)
| | - Jamal Hasanli
- Department of Psychiatry, Baskent University, School of Medicine, Turkey
| | - Görkem Saygılı
- Department of Biomedical Engineering, Ankara University, Turkey
- Department of Interdisciplinary Neuroscience, Health Science Institute, Ankara University, Turkey
| | - Orhan Murat Koçak
- Department of Psychiatry, Baskent University, School of Medicine, Turkey
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Leung P, Orrell M, Yates L, Orgeta V. A predictive model of carer resilience in dementia family caregiving: A structural equation modelling approach. Int J Geriatr Psychiatry 2023; 38:e5945. [PMID: 37448132 DOI: 10.1002/gps.5945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/20/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES This study aimed to investigate the mediating effects of quality of the caregiving relationship and other carer and person with dementia variables in predicting carer resilience over time. METHOD Carers of people with mild and moderate dementia in community settings completed baseline (n = 176 dyads) and six-month follow-up assessments (n = 139 dyads). Causal mediation analysis was conducted using Pearson Correlation and Structural Equation Modelling (SEM) to examine longitudinal predictors of carer resilience, and the effect of several mediating person with dementia, and carer factors on carer resilience over time. RESULTS At 6-month follow-up, higher levels of carer resilience were longitudinally correlated with higher ratings of perceived relationship quality by people with dementia (r = 0.53 p ≤ 0.01), and lower levels of emotional distress symptoms by carer's (r = -0.59 p ≤ 0.01). Mediation analyses showed that people with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms (β = -0.32, p ≤ 0.001) and carer resilience (β = 0.53, p ≤ 0.001) over time. The final SEM provided a good fit for the data (X 2 = 0.12, p = 0.72, CFI = 1.00, NFI = 0.99, and Root Mean Square Error of Approximation = 0.001). CONCLUSION Higher ratings of perceived relationship quality by people with dementia, and lower levels of carer emotional distress predicted higher carer resilience at follow-up. People with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms and carer resilience over time. Our findings indicate that interventions aimed at strengthening the caregiving relationship might have a protective long-term effect for carer resilience in dementia caregiving.
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Affiliation(s)
- Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Lauren Yates
- Department of Clinical, Educational and Health Psychology at University College London, London, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
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45
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Gonzalez-Mendez R, Marrero H, Romei V. Editorial: Mechanisms underlying psychological resilience and post-traumatic growth. Front Psychol 2023; 14:1230055. [PMID: 37448715 PMCID: PMC10338113 DOI: 10.3389/fpsyg.2023.1230055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Affiliation(s)
- Rosaura Gonzalez-Mendez
- Departamento de Psicología Cognitiva, Social y Organizacional, San Cristóbal de La Laguna, Spain
- Instituto Universitario de Neurociencias (IUNE), San Cristóbal de La Laguna, Spain
| | - Hipólito Marrero
- Departamento de Psicología Cognitiva, Social y Organizacional, San Cristóbal de La Laguna, Spain
- Instituto Universitario de Neurociencias (IUNE), San Cristóbal de La Laguna, Spain
| | - Vincenzo Romei
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia “Renzo Canestrari” Università di Bologna, Cesena, Italy
- Facultad de Lenguas y Educación, Universidad Antonio de Nebrija, Madrid, Spain
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46
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Kimhi S, Eshel Y, Marciano H, Adini B. Impact of the war in Ukraine on resilience, protective, and vulnerability factors. Front Public Health 2023; 11:1053940. [PMID: 37397735 PMCID: PMC10311639 DOI: 10.3389/fpubh.2023.1053940] [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] [Received: 09/26/2022] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
War or armed conflict is one of the most severe human-made adversities. The current study examines the resilience, protective, and vulnerability factors of a sample of Ukrainian civilians, during the current Russian-Ukrainian war. The level of resilience and coping indicators were compared with the responses of an Israeli sample following an armed conflict in May 2021. The data were collected by an internet panel company. A representative sample of Ukrainian residents (N = 1,001) responded to an online questionnaire. A stratified sampling method was employed regarding geographic distribution, gender, and age. The data concerning the Israeli population (N = 647) were also collected by an internet panel company during a recent armed conflict with Gaza (May 2021). Three notable results emerged in this study: (a) The Ukrainian sample reported significantly higher levels of the following: Distress symptoms, sense of danger, and perceived threats, compared with the Israeli sample. However, despite these harsh feelings, the Ukrainian respondents reported substantially higher levels of hope and societal resilience compared, to their Israeli counterparts, and somewhat higher individual and community resilience. (b) The protective factors of the respondents in Ukraine (level of hope, wellbeing, and morale), predicted the three types of resilience (individual, community, and social) better than the vulnerability factors (sense of danger, distress symptoms, and level of threats). (c) The best predictors of the three types of resilience were hope and wellbeing. (d) The demographic characteristics of the Ukrainian respondents hardly added to the prediction of the three types of resilience. It appears that a war that threatens the independence and sovereignty of a country may, under certain conditions, enhance the societal resilience and hope of the population under risk, despite a lower sense of wellbeing and higher levels of distress, sense of danger, and perceived threats.
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Affiliation(s)
- Shaul Kimhi
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Yohanan Eshel
- Department of Psychology, University of Haifa, Haifa, Israel
- Stress and Resilience Research Center, Tel Hai, Israel
| | - Hadas Marciano
- Stress and Resilience Research Center, Tel-Hai College, Tel Hai, Israel
- Institute of Information Processing and Decision Making, University of Haifa, Haifa, Israel
| | - Bruria Adini
- Department of Emergency and Disaster Management, School of Public Health, Sackler Faculty of Medicine and ResWell Research Collaboration, Tel Aviv University, Tel Aviv, Israel
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Letcher P, Greenwood CJ, Macdonald JA, McIntosh J, Spry EA, Hutchinson D, O'Connor M, Biden EJ, Painter F, Olsson CM, Cleary J, Thomson KC, Olsson CA. Life course psychosocial precursors of parent mental health resilience during the COVID-19 pandemic: A three-decade prospective cohort study. J Affect Disord 2023:S0165-0327(23)00675-4. [PMID: 37207948 DOI: 10.1016/j.jad.2023.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND There has been widespread interest in the implications of COVID-19 containment measures on the mental health of parents. Most of this research has focused on risk. Much less is known about resilience; yet such studies are key to protecting populations during major crises. Here we map precursors of resilience using life course data spanning three decades. METHODS The Australian Temperament Project commenced in 1983 and now follows three generations. Parents (N = 574, 59 % mothers) raising young children completed a COVID-19 specific module in the early (May-September 2020) and/or later (October-December, 2021) phases of the pandemic. Decades prior, parents had been assessed across a broad range of individual, relational and contextual risk and promotive factors during childhood (7-8 years to 11-12 years), adolescence (13-14 years to 17-18 years) and young adulthood (19-20 years to 27-28 years). Regressions examined the extent to which these factors predicted mental health resilience, operationalised as lower than expected anxiety and depressive symptoms during the pandemic relative to pre-pandemic symptoms. RESULTS Parent mental health resilience during the COVID-19 pandemic was consistently predicted by several factors assessed decades before the pandemic. These included lower ratings of internalising difficulties, less difficult temperament/personality traits and stressful life events, and higher ratings of relational health. LIMITATIONS The study included 37-39-year-old Australian parents with children age between 1 and 10 years. DISCUSSION Results identified psychosocial indicators across the early life course that, if replicated, could constitute targets for long-term investment to maximise mental health resilience during future pandemics and crises.
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Affiliation(s)
- Primrose Letcher
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia.
| | - Christopher J Greenwood
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Jennifer McIntosh
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; La Trobe University, Department of Psychology, The Bouverie Centre, Melbourne, Victoria, Australia
| | - Elizabeth A Spry
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of New South Wales, National Drug and Alcohol Research Centre, Faculty of Medicine, Sydney, New South Wales, Australia
| | - Meredith O'Connor
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Ebony J Biden
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Felicity Painter
- La Trobe University, Department of Psychology, The Bouverie Centre, Melbourne, Victoria, Australia
| | - Catherine M Olsson
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Joyce Cleary
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Kimberly C Thomson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; University of British Columbia, Human Early Learning Partnership, School of Population and Public Health, Vancouver, British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia; University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
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Sarid M, Kalman-Halevi M, Tutian R, Gilat-Yihyie S, Sarid A. Uncovering Resilience Disparities among Religious Groups in Israel's Mass COVID-19 Vaccination Drive: Lessons Learned to the Post-COVID Era. Behav Sci (Basel) 2023; 13:bs13050398. [PMID: 37232635 DOI: 10.3390/bs13050398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of the current study was to examine the emotional resilience, satisfaction with life, social support, and anxiety during the vaccination process of the Israeli population after the end of the third lockdown, according to religiosity degree. We hypothesized that a higher degree of religiosity (ultra-Orthodox and religious participants) would be associated with higher levels of resilience and with lower levels of anxiety than in secular individuals. In addition, it was hypothesized that satisfaction with life, social support, anxiety, and religiosity will predict resilience and anxiety. Nine hundred and ninety-three native Jewish Hebrew-speaking respondents representing ultra-Orthodox, religious, observant, and secular Jews participated in this study. Ultra-Orthodox participants showed higher resilience and satisfaction with life than other groups, and lower levels of anxiety. Satisfaction with life and social support predicted higher resilience. It is suggested that religious faith as well as satisfaction with life may provide a source of strength and resilience in stressful life events.
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Affiliation(s)
- Miri Sarid
- Department of Education, Western Galilee College, Acre 2412101, Israel
| | | | - Rony Tutian
- Department of Education, Western Galilee College, Acre 2412101, Israel
| | | | - Adi Sarid
- Sarid Institute, Haifa 2626047, Israel
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Aksoy D, Simões C, Favre CA. Exposure to Intimate-Partner Violence and Resilience Trajectories of Adolescents: A Two-Wave Longitudinal Latent Transition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095676. [PMID: 37174193 PMCID: PMC10177968 DOI: 10.3390/ijerph20095676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
Despite the serious emotional and social consequences of adolescents' exposure to intimate-partner violence (IPV) and the high prevalence of this exposure, few analyses have focused on person-centered models or considered psychological IPV. Studies that address exposure to violence tend to focus on physical IPV. Therefore, in this study, we examine (across two waves) the trajectories of resilience among adolescents who have witnessed psychological IPV by conducting a latent transition analysis and predicting class membership through socio-demographic and individual-level protective factors. Using a sample of 879 (T1, fall 2020) and 770 (T2, spring 2022) adolescent Swiss students with mean ages of 11.74 (SD = 0.64) and 13.77 (SD = 0.53), we identified four distinct time-invariant resilience classes: comorbid-frustrated, internalizing-frustrated, comorbid-satisfied, and resilient. The classes characterized by some level of psychopathological symptoms and basic psychological-needs frustration were the most stable over time. Furthermore, we found the four typical resilience trajectories: recovery, chronic, delayed, and improving. Gender, socioeconomic background, and protective factors showed a significant prediction of class membership in wave 1, highlighting the importance of increasing sensitivity to psychological-IPV exposure on the one hand, and reinforcing the relevance of prevention in schools regarding the promotion of protective factors on the other.
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Affiliation(s)
- Dilan Aksoy
- Department of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, 5210 Windisch, Switzerland
| | - Celeste Simões
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Lisbon, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Céline Anne Favre
- Department of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, 5210 Windisch, Switzerland
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50
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Rochira A, De Simone E, Mannarini T. Community resilience and continuous challenges: A qualitative analysis of the functioning of communities in the aftermath of persistent and ordinary stressors. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1106-1123. [PMID: 36580672 DOI: 10.1002/jcop.22987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
The study aimed at investigating the functioning of communities in the aftermath of continuous challenges and identifying standards for describing resilient paths based on the perspective of community members. A qualitative investigation was carried out in 11 territorial communities of Salento, in southern Italy. Fifty-two key informants were interviewed and interview transcripts were submitted to thematic content analysis through Atlas.Ti. Overall, the interviewees reported that their communities suffer from a varied set of complex and interrelated adverse circumstances that have increased their vulnerability. The respondents have a clear idea about the community strengths and weaknesses that either allow or impede adaptive responses, though they did not understand the latter in separation from the slow-onset events that have contributed to causing them. On the basis of findings, resilient paths facing continuous challenges can be described as trajectories of functioning allowing the communities to survive and progress through adaptive and maladaptive responses.
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Affiliation(s)
- Alessia Rochira
- Department of Human and Social Studies, Laboratory of Applied Psychology, University of Salento, Lecce, Italy
| | - Evelyn De Simone
- Department of Human and Social Studies, Laboratory of Applied Psychology, University of Salento, Lecce, Italy
| | - Terri Mannarini
- Department of Human and Social Studies, Laboratory of Applied Psychology, University of Salento, Lecce, Italy
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