Resilience in developing systems: the promise of integrated approaches

Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study

Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.

Reflections on resilience

Resilience research has long sought to understand how factors at the child, family, school, community, and societal levels shape adaptation in the face of adversities such as poverty and war. In this article we reflect on three themes that may prove to be useful for future resilience research. First is the idea that mental and physical health can sometimes diverge, even in response to the same social process. A better understanding of explanations for this divergence will have both theoretical and public health implications when it comes to efforts to promote resilience. Second is that more recent models of stress suggest that stress can accelerate aging. Thus, we suggest that research on resilience may need to also consider how resilience strategies may need to be developed in an accelerated fashion to be effective. Third, we suggest that if psychological resilience interventions can be conducted in conjunction with efforts to enact system-level changes targeted at adversities, this may synergize the impact that any single intervention can have, creating a more coordinated and effective set of approaches for promoting resilience in young people who confront adversity in life.

Inpatient Screening of Parental Adversity and Strengths

BACKGROUND AND OBJECTIVES

Social adversities, including health-harming social risks and adverse childhood experiences, contribute to poor outcomes after hospital discharge. Screening for social adversities is increasingly pursued in outpatient settings. Identifying and addressing such adversities has been linked to improved child outcomes. Screening for social adversities and strengths in the inpatient setting may contribute to better transitions from hospital to home. Our goal was twofold: 1. to use qualitative methods to understand parent perspectives around screening tools for potential use in inpatient settings; and 2. to develop a family-friendly inpatient screening tool for social adversity.

METHODS

We used in-depth, cognitive qualitative interviews with parents to elicit their views on existing screening tools covering social adversities and strengths. We partnered with a local nonprofit to recruit parents who recently had a child hospitalized or visited the emergency department. There were 2 phases of the study. In the first phase, we used qualitative methods to develop a screening prototype. In the second phase, we obtained feedback on the prototype.

RESULTS

We interviewed 18 parents who identified 3 major themes around screening: 1. factors that promote parents to respond openly and honestly during screening; 2. feedback about screening tools and the prototype; and 3. screening should include resources.

CONCLUSIONS

Social adversity routinely affects children; hospitalization is an important time to screen families for adversity and potential coexisting strengths. Using qualitative parent feedback, we developed the family friendly Collaborate to Optimize Parent Experience screening tool.

The contribution of a complex systems-based approach to progressive social resilience

The use of resilience in social practice has evolved from a theoretical framework at the intersection between individuals and their social ecology. Critics argue this theory still results in policies and practices that are too individualised, with the potential for negative social consequences. This paper further critiques contemporary understanding of resilience theory and its application. It juxtaposes complex systems theory with a social inequalities oriented resilience practice. This provides a paradoxical approach. It is acknowledged that state and public policy decisions and actions can be anti-resilient, undermining community and social resilience that already exists in the form of social relationships, self-organisation and co-production. Nevertheless, collective social resilience also illustrates the potential of local and service user organisations to contribute to an overall transformational change process.

Mediating Role of Emotional Intelligence in the Relationship Between Resilience and Academic Engagement in Adolescents: Differences Between Men and Women

Introduction

Resilience and academic engagement have become some of the most important elements in the academic context, due to their relationships with school adjustment, the protective role against risky behaviors and the well-being of adolescents.

Purpose

Therefore, the objective of this study was to analyze the relationships established between the variables of resilience and academic engagement, the differences according to sex, as well as to determine the mediating role of emotional intelligence in the relationship between resilience and academic engagement in adolescence.

Participants and Methods

A cross-sectional descriptive study was performed. The sample consisted of 802 secondary school students, with an average age of 13.65 years (SD = 1.24) (where 50.6% were women and 49.4% men) who filled out the Connor-Davidson Resilience Scale (CD-RISC 10), the General Academic Engagement Scale for Spanish Adolescents (CAADE) and the Spanish version of the Wong Law Emotional Intelligence Scale (WLEIS-S).

Results

The results showed the existence of positive relationships between resilience and factors of academic engagement. Furthermore, the mediation models showed the direct effect of emotional intelligence on this relationship. On the other hand, with respect to sex, men showed significantly higher averages in resilience and emotional intelligence, with no significant differences in the variable of academic engagement.

Conclusion

Concluding, design of emotional intelligence intervention programs in secondary is recommended as an effective measure for promoting resilience and a positive academic trajectory.

Exploring the lived experiences of women with children during COVID-19: Maternal stress and coping mechanisms

This paper presents the results of a qualitative study of mothers' lived experiences during the COVID-19 lockdown in the United States. An analysis of open-ended interviews with 44 mothers who had children ages zero-to-five identified two main themes: (1) increased stress among mothers; and (2) resilience through the use of coping mechanisms. The findings indicate that the COVID-19 pandemic has led to higher stress among mothers due to issues of work-family life balance, family and children's needs, decision-making about getting sick, concerns for children's development, and lack of clarity from government officials. Mothers described using a variety of problem-focused and emotion-focused methods to cope with this stress. The lived experiences of mothers during the pandemic highlights the need for innovations in childcare modalities, paid leave policies to relieve stress, and strengthening whole family processes and resilience through the use of coping mechanisms.

Assessing perceptions of resilience: The understanding from network analysis

Introduction

Previous studies have yet to reach a consensus on the construct of resilience perception, and how to enhance the effect of resilience intervention remains an urgent issue. In this consideration, this study examines the fundamental construct of resilience. It provides insight into the critical prevention goal for resilience intervention by utilizing the latest methods of psychological network analysis.

Methods

The sample is the graduate students enrolled in September 2021. Participants completed (1) the Connor-Davidson Resilience Scale, (2) the University of Washington Resilience Scale-8 Item, (3) the Brief Resilience Scale, and (4) the Resilience Scale for Adults, each representing different orientations of resilience.

Results

The network analysis grants greater clarity to the resilience perception as a dynamic system that interacts between an individual's tendency to intrinsic capacity and response to external resources. This study has shown that a positive perception of external social resources is the most important for individuals' resilience cognition; the effect of resilience intervention can be achieved more quickly by changing the individual's sense of hope.

Discussion

Based on the results, a psychometric instrument that integrates different orientations of resilience concepts and is based on time-varying needs to be developed.

Predictors of psychological risk and resilience among Syrian refugee children

OBJECTIVES

War-exposed refugee children are at elevated risk for mental health problems, but a notable proportion appear resilient. We aimed to investigate the proportion of Syrian refugee children who can be considered resilient, and applied a novel approach to identify factors predicting individual differences in mental health outcomes following war exposure.

METHODS

The sample included 1,528 war-exposed Syrian refugee children and their primary caregiver living in refugee settlements in Lebanon. Children were classed as having low symptoms (LS) if they scored below clinically validated cut-offs for post-traumatic stress disorder (PTSD), depression and externalising behaviour problems. Children scoring above any cut-off were classified as having high symptoms (HS). Each LS child was matched with one HS who reported similar war exposure, to test what differentiates children with similar exposures but different outcomes.

RESULTS

19.3% of the children met our resilience criteria and were considered LS. At the individual level, protective traits (e.g. self-esteem; OR = 1.51, 95% CI [1.25, 1.81]) predicted LS classification, while environmental sensitivity (OR = 0.69, 95% CI [0.59, 0.82]), poorer general health (OR = 0.71, 95% CI [0.58, 0.87]) and specific coping strategies (e.g. avoidance; OR = 0.90, 95% CI [0.85, 0.96]) predicted HS classification. Social/environmental predictors included perceived social support (OR = 1.23, 95% CI [1.02, 1.49]), loneliness and social isolation (OR = 0.85, 95% CI [0.80, 0.90]), child maltreatment (OR = 0.96, 95% CI [0.94, 0.97]), and caregiver mental and general health (e.g. caregiver depression; OR = 0.94, 95% CI [0.92, 0.97]).

CONCLUSIONS

Future research should take multiple dimensions of functioning into account when defining risk for mental health problems and consider the identified predictors as potential targets for interventions.

Resilience, and positive parenting in parents of children with syndromic autism and intellectual disability. Evidence from the impact of the COVID-19 pandemic on family's quality of life and parent-child relationships

Family quality of life (FQoL) outcomes collected during the first year of COVID-19 has been combined with 2018 data to estimate the outbreak's impact on parental outcomes on a sample of 230 families with syndromic autistic children and those with intellectual disabilities (IDs). Despite challenges imposed by the COVID-19 outbreak, our study found that FQoL outcomes reported by participating parents during the first year of COVID-19 appears to be similar to ratings from a prepandemic study of families with the same conditions. Parents of children in our sample generally displayed a stable functioning trajectory as measured by the validated FQoL instrument. Across syndromic autistic groups considered, families reported that their relationships with their children were positive. Our findings provide evidence of families' resilience which might explain the presence of positive parent-child interactions during COVID-19. Exploring mechanisms which would explain how families with autistic and ID children confront, manage disruptive experiences, and buffer COVID-19 induced stress is a fruitful direction for future research.

A factor analytic approach to understanding health risk behaviors and resilience among multi-racial/ethnic adolescents in New Mexico

OBJECTIVE

This study examined the factor validity of health risk behaviors and resilience indicators and their covariation across a large racially/ethnically diverse adolescent population.

DESIGN

The study subsample (47% Hispanic, 31% White Non-Hispanic, 17% American Indian) was derived from the 2013 New Mexico Youth Risk Resilience Survey (YRRS; N-19,033). We conducted a confirmatory factor analysis on the 6 health risk domains identified by the CDC as contributing most to adolescent morbidity/mortality: (1) cigarette use, (2) alcohol and other illicit drug use, (3) marijuana use, (4) sexual activity, (5) nutrition habits, and (6) physical activity.

RESULTS

A 4-factor CFA model of adolescent health risk behaviors was replicated, and a hypothesized 6-factor structure based on behaviors that contribute most to adolescent morbidity/mortality was confirmed. The pattern of covarying risk behaviors differed by Hispanic, Native American, and Non-Hispanic White groups. We also confirmed a single external resilience-interference factor (decreased parental support, low school/community engagement, negative peer associations) that positively correlated with all six risk behaviors.

CONCLUSION

This study described the structure of adolescent health risk behaviors within a context of psychosocial resilience for American Indian and Hispanic adolescents in contrast to Non-Hispanic White adolescents. Our findings provided evidence for the construct validity of six health-risk behavior dimensions within a large racially/ethnically diverse adolescent sample, which reveal different patterns of loadings, degrees of model fit, and factor inter-correlations across the three racial/ethnic groups. Patterns of covarying risk behaviors differed in strength and direction by racial/ethnic group. Results suggest that interventions should target multiple behaviors and be tailored for different racial/ethnic groups. Targeting health risk and resilience indicators supports the use of multi-level health interventions at the individual, school, family, and community level by identifying individuals based on external resilience scores.

Exploring resilience processes of Filipino migrant domestic workers: A multisystemic approach

This study identified resilience processes at the individual, family, and community levels among Filipino migrant domestic workers (MDWs). Resilience processes highlight strengths and resources that can enhance positive adaptation to problems that affect this vulnerable migrant group. Data came from focus groups and key informant interviews involving 27 MDWs and 7 key informants. Data was analyzed using thematic analysis and organized according to the socioecological model. Results revealed 7 resilience processes. Financial coping, health management, and spirituality were found across levels. Companionship and emotional support are transacted within family and community levels, whereas expanding knowledge and support occurs at individual and community levels. MDWs and their families prioritize each family member, whereas the community provides legal support. Resilience processes exist across ecological levels. However, individual resilience processes are insufficient, thus necessitating collective agency through familial and community resilience processes and building social structures that facilitate resilience.

Factors associated with resilience among children and youths with disability during the COVID-19 pandemic

There is evidence of negative impact of social distancing and confinement measures to manage the COVID-19 pandemic on children, including increased anxiety and depression and behaviour difficulties. Paradoxically, positive impacts like increased support and more self-care activities have also been documented. Little is known about the impact of the COVID-19 pandemic on the children with disability and the potential role of familial, environmental, and biological factors on mitigating this impact. The aims of the study were 1) identifying profiles of functioning across multiple domains during the COVID-19 pandemic and 2) examining the extent to which parenting self-efficacy, support in accessing schooling, and type of diagnosis predict the likelihood of resilience among children with disability, after controlling for household income and single-parent status. An online survey developed from COVID-19 guidance recommendations, was available from June 11- July 21, 2020, and resulted in a convenience sample of caregivers across Canada (n = 883) of children with disability (mean age of 9.4 years old, SD_age = 5.7, 58% male). We conducted latent class analysis to examine the number of latent profiles on caregiver-reported changes of 12 functioning domains, as either ‘worsening’, ‘no change’, or ‘improving’. Most participants belonged to ‘stable’ or ‘worsening’ profiles. However, we identified a small subgroup with improvements in child functioning, a pattern indicative of a ‘resilient’ profile. Using a multinomial logistic regression, we found that diagnosis type, parenting self-efficacy and support in accessing schooling were associated with membership in the Resilient or Stable profiles compared to the Worsening profile, after controlling for single-parent status and income. Taken together, our findings identified variability in responses to adversity that is dependent on the child’s diagnosis type, parenting self-efficacy, and support in accessing schooling. By identifying potentially modifiable predictors of resilience, namely parenting self-efficacy and support in accessing schooling, we signal the potential for tailored supports for different diagnoses, through interventions that enhance caregiver empowerment, access to schooling, access to health and social services, and/or mitigate disparities resulting from social disadvantage.

Psychometric properties of the Adolescent Resilience Questionnaire (ARQ) in a sample of Swedish adolescents

BACKGROUND

The importance of resilience, and interest in it, has increased markedly in recent years, based on the need to understand why some children and young people have a resilience to stress that others lack. At the same time, there has been a lack of instruments to measure resilience. The aim of this study was to translate the Adolescent Resilience Questionnaire (ARQ) into Swedish and investigate the psychometrics of this Swedish version.

METHODS

A normative sample of 616 students aged 15-17 was recruited through the school system in five different communities. Students filled out a digitalised composite form consisting of ARQ and three other standardised questionnaires, the Sense of Coherence Scale-13 (Soc-13), the Rosenberg Self-Esteem Scale (RSES) and the Relationship Questionnaire (RQ).

RESULTS

The ARQ, with five domains and twelve subscales, showed good alpha coefficients α = .95 for the total scale and subscales ranging between α = .70 to .91, except for the subscales Emotional insight (α = 0.69) and Empathy/Tolerance (α = .61). The convergent validity, which was tested for the first time in this study, was good, especially with the Internal Domain for both SOC-13 and RSES. The confirmatory factor analysis showed a satisfactory construct validity. Finally, some gender differences were seen, with boys scoring higher on the total ARQ scale.

CONCLUSION

The study shows that the Swedish translation of ARQ has satisfactory psychometric properties. The ARQ could therefore be used as a tool for adolescents when evaluating the importance of resilience.

Effects of Socioeconomic Status, Parental Stress, and Family Support on Children's Physical and Emotional Health During the COVID-19 Pandemic

In the current study, we conduct an exploratory study on children's emotional and physical health in response to the COVID-19 pandemic. The direct and interactive effects of parental stress, family socioeconomic status (SES), and family support on child adjustment were investigated. A total of 116 children of varied socioeconomic and their parents were interviewed. Parents with low household income perceived greater distress related to uncertainty and health worries compared to those with higher household income. However, it was among high-SES families that parental distress was associated with child difficulties. At a multivariate level, children's health was associated with SES, family support, and parental COVID-19 stress. Among families with low household income, when parents perceived low/average COVID-19 stress, family support worked as a protective factor for children's adjustment. Understanding how COVID-19 relates with children's emotional and physical health within families with low and high household income may help to inform recommendations for best practices, for example through family support interventions.

Modeling the association between and predictors of two constructs of resilience

PURPOSE

Resilience serves as a protective factor against adverse outcomes following exposure to traumatic events. The extant literature focuses on psychiatric resilience in the context of internalizing symptoms, though resilience is also important in relation to externalizing symptoms. Research is needed to clarify the predictors of resilience across contexts. The aims of the current study are twofold: 1. Determine the association between psychiatric resilience (PR) and alcohol resistance (AR) and 2. Test for differential prediction of each form of resilience by exogenous predictors.

METHODS

The sample (n = 7585) was drawn from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (VATSPSUD). Participants completed measures of internalizing symptoms, exposure to stressful life events, DSM alcohol abuse and dependence symptoms, maximum alcohol consumption, personality variables, and social support. All cross-sectional, structural equation modeling (SEM) analyses were conducted using Mplus software version 8.2.

RESULTS

A single common factor model provided adequate fits for both PR and AR. In the full measurement model the correlation between the two resilience factors was estimated (r = 0.28, SE = 0.018, p < 0.001). Neuroticism and mastery predicted AR and PR, but differentially, with a stronger effect size for PR (neuroticism: B = 0.35, p < 0.001; mastery: B = - 0.36, p < 0.001). The positive social support factor did not predict either resilience variable, while interpersonal conflict was associated with both (AR = 0.09, p < 0.001; PR = 0.07, p < 0.001).

CONCLUSIONS

Findings extend the current literature on resilience in two ways. First, rigorous measurement model based definitions of two resilience variables are specified. Second, external validation of the AR and PR constructs is carried out using latent variable modeling techniques. The modest correlation suggests resilience may not be well-characterized by a single general attribute. Findings provide further evidence for predictors of resilience by way of displaying differential patterns of prediction effect sizes of PR and AR.

Exposome and Trans-syndromal Developmental Trajectories Toward Psychosis

The prenatal period, early childhood, and adolescence are considered sensitive periods for brain and behavior development, when environmental exposures may have long-lasting effects on mental health. Psychosis spectrum disorder (PSD) is a developmental disorder that often manifests with nonspecific clinical presentations long before full-blown PSD is diagnosed. Genetic factors only partly explain PSD. Multiple early-life environmental exposures are associated with PSD. In this review, we describe the conceptual framework of the exposome and its relevance to PSD research in developmental cohorts and beyond and discuss key challenges for the field as it attempts to move beyond studying environment (in the sense of "searching under the lamppost because this is where the light is") to a more comprehensive assessment of environment and its contribution to PSD. We then suggest that the field should aspire to studying environmental origins of PSD through a developmental lens focusing on young cohorts and using multilevel phenotyping of environment, adopting an exposome framework that embraces the dynamic complex nature of environment and acknowledges the effect of additive and interactive environmental exposures alongside the genome. Furthermore, we highlight the need for a developmental perspective when studying exposome effects on psychopathology, accepting the nonspecificity of child/adolescent psychopathology and encouraging the study of trans-syndromal manifestations, shifting the research paradigm from categorical outcomes (e.g., schizophrenia) and going beyond clinical settings to investigate trajectories of risk and resilience.

The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon

AIMS

Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time.

METHODS

In total, 982 Syrian child-caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms.

RESULTS

The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance (β = -0.07) predicted child mental health symptoms over time. Self-esteem (β = -0.08), maternal psychological control (β = 0.10), child maltreatment (β = 0.09) and caregiver depression (β = 0.08) predicted child symptoms and vice versa (β_se = -0.11, β_b = 0.07, β_mpc = 0.08, β_cm = 0.1, β_cd = 0.11). Finally, child symptoms predicted loneliness (β = 0.12), bullying (β = 0.07), perceived social support (β = -0.12), parent-child conflict (β = 0.13), caregiver PTSD (β = 0.07), caregiver anxiety (β = 0.08) and the perceived refugee environment (β = -0.09).

CONCLUSIONS

Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms.

A Unified Model of Resilience and Aging: Applications to COVID-19

Drawing on multidisciplinary research focusing on a spectrum ranging from individual experience to structural system-level risk response and resilience, this article develops a rationale for a Unified Model of Resilience and Aging (UMRA). In response to a broad range of adversities associated with aging, it details the ways in which some individuals are able to bounce back better than others, or adapt better than expected, termed resilience. However, resilience and aging theoretical models have developed out of different disciplinary developments, ranging from individual levels to structural level complex systems, including several gerontological theoretical models addressing adaptation to life course and aging processes. The article reviews and synthesizes prior conceptual and theoretical work, and their empirical groundings, in order to develop an integrated resilience model with wide applications to aging-related problems including chronic illness, mental health, widowhood, poverty, caregiving burden, etc. The article focuses specifically on COVID-19 pandemic risk, response and resilience in order to specify applications of the UMRA, and to suggest avenues for future research and testing of theoretical axioms.

The Multidimensional Taxonomy of Individual Resilience

Theoretical work in resilience has continuously evolved to inform and respond to advances in empirical work. In order to further scientific inquiry, it must continue to do so. This narrative overview of the field of resilience science focuses on contemporary challenges confronted by theoretical models of individual resilience and proposes a taxonomic structure for resilience-the multidimensional taxonomy of individual resilience (MTIR). The goal of the MTIR is to articulate a systematic framework within which extant theoretical and empirical work can be nested. Consistent with existing work, the MTIR organizes resilience into two primary branches-manifested resilience and generative resilience. These two components are then organized into subdomains that demonstrate evidence of conceptual distinctiveness. The specification of the subdomains in the MTIR draws support from a diverse body of work on resilience across disciplines and in multiple global contexts. The MTIR makes several critical advances, including expanding and refining the definitions and components of resilience in psychology, providing a clearer framework for conceptualizing mixed profiles of resilience, and tempering assumptions regarding the relational dependencies across domains of resilience. Finally, the utility of the MTIR in organizing research in resilience and advancing theory-testing and development is discussed.

ARCCH Model of Resilience: A Flexible Multisystemic Resilience Framework

The increasing prevalence and impact of trauma, such as adverse childhood experiences, race-based trauma, and a global pandemic, highlight the critical need for a flexible multisystemic framework of resilience. This manuscript outlines the universality of trauma and resilience and also provides a description of the gaps in existing resilience frameworks that led to the development of a flexible multisystemic resilience framework entitled the ARCCH Model of Resilience. Attachment, Regulation, Competence, Culture, and Health are elements of personal and cultural identities, families, communities, and systems that can be used to evaluate strengths, identify areas that need support, and provide steps for culturally responsive and ecologically valid interventions. A multisystemic application of ARCCH is provided.

Multimorbidity resilience and COVID-19 pandemic self-reported impact and worry among older adults: a study based on the Canadian Longitudinal Study on Aging (CLSA)

Background

The Coronavirus Disease-2019 (COVID-19) pandemic has created a spectrum of adversities that have affected older adults disproportionately. This paper examines older adults with multimorbidity using longitudinal data to ascertain why some of these vulnerable individuals coped with pandemic-induced risk and stressors better than others – termed multimorbidity resilience. We investigate pre-pandemic levels of functional, social and psychological forms of resilience among this sub-population of at-risk individuals on two outcomes – self-reported comprehensive pandemic impact and personal worry.

Methods

This study was conducted using Follow-up 1 data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit COVID-19 study, conducted between April and December in 2020. A final sub-group of 9211 older adults with two or more chronic health conditions were selected for analyses. Logistic regression and Generalized Linear Mixed Models were employed to test hypotheses between a multimorbidity resilience index and its three sub-indices measured using pre-pandemic Follow-up 1 data and the outcomes, including covariates.

Results

The multimorbidity resilience index was inversely associated with pandemic comprehensive impact at both COVID-19 Baseline wave (OR = 0.83, p < 0.001, 95% CI: [0.80,0.86]), and Exit wave (OR = 0.84, p < 0.001, 95% CI: [0.81,0.87]); and for personal worry at Exit (OR = 0.89, p < 0.001, 95% CI: [0.86,0.93]), in the final models with all covariates. The full index was also associated with comprehensive impact between the COVID waves (estimate = − 0.19, p < 0.001, 95% CI: [− 0.22, − 0.16]). Only the psychological resilience sub-index was inversely associated with comprehensive impact at both Baseline (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]) and Exit waves (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]), in the final model; and between these COVID waves (estimate = − 0.11, p < 0.001, 95% CI: [− 0.13, − 0.10]). The social resilience sub-index exhibited a weak positive association (OR = 1.04, p < 0.05, 95% CI: [1.01,1.07]) with personal worry, and the functional resilience measure was not associated with either outcome.

Conclusions

The findings show that psychological resilience is most pronounced in protecting against pandemic comprehensive impact and personal worry. In addition, several covariates were also associated with the outcomes. The findings are discussed in terms of developing or retrofitting innovative approaches to proactive coping among multimorbid older adults during both pre-pandemic and peri-pandemic periods.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-02769-2.

The effect of the 2019 coronavirus disease outbreak on social relationships: A cross-sectional study in Jordan

BACKGROUND

Social relationships refer to the existing associations between family members, friends, neighbours, co-workers, and other associates. Due to the COVID-19 pandemic, social distancing has been imposed by the curfew program in Jordan.

AIM

To evaluate the effects of social distancing on the social relationships of the Jordanian population.

METHODS

A cross-sectional study using an online survey was conducted in Jordan between the 6th and the 30th of May, 2020. Our questionnaire was constructed to explore the population's perception of the quarantine period, how it is affecting their relationship with others, and the characteristics of their social relationships and communication with various population categories, including family members and work colleagues. Multiple linear regression was used to identify predictors of better social relationships and communication.

RESULTS

A total of 4,301 participants were involved in this study. The average score of the influence of the COVID-19 pandemic on social relationships among the whole study population was 5.68 (SD: 2.33) out of 10 (equal to 56.8%), which indicates the marginal strength of the social relationships. Around 31.6% of the participants reported that their social relationships were affected to a high degree by the COVID-19 pandemic. Participants who were aged 36-45 were positively affected in terms of their social relationships during the COVID-19 pandemic.

CONCLUSION

The COVID-19 pandemic is negatively affecting social relationships, which could ultimately lead to negative health implications. Decision-makers are advised to provide educational campaigns that improve the sociological health of the general population.

Assessing school community needs during the initial outbreak of the COVID-19 pandemic: Teacher, parent and student perceptions

The COVID-19 pandemic has had an unprecedented impact on the lives of adults and children worldwide. Schools were among the first settings to be influenced by this crisis. Home confinement and school closure were implemented as necessary preventive measures creating a new way of living based on web-based communication. The aim of the study is to explore school community needs during the COVID-19 outbreak in Greece. The study followed a mixed methods design, consisting of a teacher, a parent and an adolescent survey. The sample entailed 1,157 participants (414 teachers, 487 parents and 256 adolescents). Quantitative data were collected using questionnaires. Qualitative data were collected using open-ended questions to explore participants’ adjustment and needs during the pandemic. Parents and teachers showed high propensity for anxiety and high levels of resilient coping. Health and adaptation concerns were evident in all samples. Teachers, parents and adolescents described helpful coping practices, primarily related to social support. The findings highlight the importance of supporting all school community members to cope with feelings of stress and anxiety during the pandemic and to identify and make use of helpful personal and social resources.

Emotional intelligence, resilience and personality traits neuroticism and extraversion: predictive capacity in perceived academic efficacy

BACKGROUND

Recent studies have shown the importance of promoting emotional intelligence and resilience, as well as knowing the personality (extraversion versus emotional instability or neuroticism) in both nursing students and nursing professionals, for better academic adherence, due to stressful situations derived from high academic and attendance requirements for healthcare practices in clinical settings. However, there is little research that analyzes the importance of the perceived academic effectiveness of university students and its relationship with the psychological variables of resilience, emotional intelligence and personality.

OBJECTIVE

To analyse the relationships between perceived academic efficacy, emotional intelligence (EI), resilience and the personality factors of emotional instability and extraversion, as well as to observe the variables that predict perceived academic efficacy.

MATERIALS AND METHODS

Cross-sectional study on a sample of 434 nursing students in Valencia (Spain) aged 17-54 (M = 21; SD = 0.320). They filled in standard tests on perceived academic efficacy, EI, resilience, emotional instability and extraversion.

RESULTS

Perceived academic efficacy is closely and positively related to EI and resilience; and to a lesser extent to emotional instability, but negatively. The academic efficacy predictor variables were EI (global trait, well-being and sociability), resilience (social support and emotional regulation) and emotional instability (R² of 0.201).

CONCLUSIONS

Perceived academic efficacy is fundamentally related to EI and resilience positively, and to a lesser extent to emotional instability negatively, fundamentally via these factors: global trait, social support, well-being, problem-solving capacity. Nursing students' perception of academic efficacy is relevant for building professional skills and carrying out the nurse's role in organisations. So, it is necessary to promote training programs to increase the emotional intelligence and resilience of nursing students, aimed at promoting competence in professional practice.

Childhood Resilient Personality Trajectories and Associations with Developmental Trajectories of Behavioral, Social-emotional, and Academic Outcomes across Childhood and Adolescence: A Longitudinal Study Across 12 Years

This study examined the continuity and change of childhood resilient personality (first three years in grade school), and how differential trajectories in resilient personality were dynamically associated with behavioral problems, social-emotional functioning and academic performance across the primary and secondary school years (Grade 1-12). Participants were 784 academically at-risk students predominantly from low SES families (47% girls, 37.4% Latino or Hispanic, 34.1% European American, and 23.2% African American) who were recruited in grade 1 (Mean age = 6.57) and followed annually through the final year of high school (Grade 12). Results revealed three distinct trajectories of childhood resilient personality, including an ego-resilient or flexible group (26.8%), an ego-brittle or inflexible group (21.9%), and an ordinary or common group (49.9%). Children in the ego-brittle group were at a greater risk for sustaining high levels of behavioral problems, low socio-emotional functioning (based on parent and teacher report), and poor academic performance across formal schooling. In contrast, the resilient children exhibited persistently low behavioral problems, high social-emotional functioning, and better academic performance across formal schooling. Findings also indicated that the protective effect of childhood resiliency was sustained even after the transition from childhood to adolescence.

Resilience in Development and Psychopathology: Multisystem Perspectives

Resilience science in psychology and related fields emerged from clinical research on risk for psychopathology in the 1970s and matured over the ensuing decades with advances in theory, methods, and knowledge. Definitions and models of resilience shifted to reflect the expanding influence of developmental systems theory and the growing need to integrate knowledge about resilience across levels and disciplines to address multisystem threats. Resilience is defined for scalability and integrative purposes as the capacity of a dynamic system to adapt successfully through multisystem processes to challenges that threaten system function, survival, or development. Striking alignment of resilience factors observed in human systems, ranging from individuals to communities, suggests the possibility of networked, multisystem protective factors that work in concert. Evidence suggests that there may be resilience factors that provide transdiagnostic protection against the effects of adverse childhood experiences on risk for psychopathology. Multisystem studies of resilience offer promising directions for future research and its applications to promote mental health and positive development in children and youth at risk for psychopathology.

Resilience in Older Adults during the COVID-19 Pandemic: A Socioecological Approach

Objectives

We examined sources of vulnerability and resilience among older adults early in the COVID-19 pandemic.

Methods

We surveyed 235 respondents, 51–95 years old (M = 71.35; SD = 7.39; 74% female), including two open-ended questions concerning COVID-19-related difficulties and positive experiences during the past week. Using inductive coding, we found nine final codes for difficulties and 12 for positives and grouped them into socioecological levels: personal, interpersonal, and societal.

Results

Difficulties were reported by 94% of the sample, while 63% described positives. Difficulties and positive responses were made at all socioecological levels and illustrated a dialectic between personal level constraints and opportunities, interpersonal level social isolation and integration, and societal level outrage, sorrow, and social optimism.

Discussion

Respondents described sources of vulnerabilities and resilience that supported a socioecological approach to understanding resilience during this pandemic. A notable example was resilience derived from witnessing and contributing to community and social solidarity, highlighting the potential of older adults as resources to their communities during the global pandemic.

A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team personnel

The stressors associated with emergency medical teams responding to critical incidents are well documented; however, the impact of such duties on the UK military personnel had never been investigated. This study explored the psychosocial effects of Medical Emergency Response Teams (MERT) operating in Afghanistan to inform the development of a Resilience Model. A structured and contextually relevant process could then be applied for a team's preparation for, delivery of and recovery from, their duties. A qualitative cross-sectional design used semi-structured interviews and 15 multidisciplinary team members participated. Interviews were transcribed verbatim and data were systematically analysed using grounded theory. Emergent theory poses that developing resilience against the demands of this role is dependent upon personnel having a realistic understanding of the deployed environment by phased immersion within it. This preparatory training generates situational awareness, trust and strong team cohesion, which together with peer and organizational support are necessary factors to effectively cope with the role. To limit the costs of caring, there is a need for MERT personnel to segregate the physiological and emotional aspects of delivering care to the injured; those unable to do so may be at greater risk of poor mental health outcomes. The preparatory training of MERT personnel must be further developed to provide an immersive environment that more closely matches the reality of the role. A period of stability is required post deployment with the support of peers to enable personnel to more efficiently transition back to their home life.

Academic Resilience and Engagement in High School Students: The Mediating Role of Perceived Teacher Emotional Support

Academic resilience is the ability to overcome setbacks and chronic difficulties in the academic context. Previous studies have found that resilient students tend to be more engaged in school than their counterparts. Nevertheless, it seems worth deepening the role of contextual factors, such as teacher emotional support and how students perceive it, as it could contribute to foster the abovementioned relationship. The present study aimed to examine the links between academic resilience, perceived teacher emotional support, and school engagement. Moreover, the mediating role of perceived teacher emotional support was investigated. A sample of 205 Italian high school students (58.5% female), aged 14–19 years (M = 16.15, SD = 1.59), completed self-report questionnaires on academic resilience, perceived teacher emotional support, and school engagement. A structural equation model (SEM) was used to test the mediation hypothesis. The results showed that academic resilience was associated with perceived teacher emotional support, and both of them were related to school engagement. Furthermore, perceived teacher emotional support partially mediated the relationship between academic resilience and school engagement. Findings were discussed by underlining the importance of fostering personal and contextual resources in the school context to promote students’ well-being.

Understanding the pathology of psychiatric disorders in refugees

Displacement of people from their homes, families and countries is a current global crisis, with over 70 million people forcibly on the move. A substantial proportion of these people will end up in regions with a different language and culture, where they are registered as refugees or asylum seekers. Due to the underlying reasons for displacement (including conflicts, persecution or violation of human rights), displaced people are severely stress-exposed, which continues into their post-migration life and increases risk for developing psychiatric disorders such as post-traumatic stress disorder and other anxiety disorders and mood disorders. While landmark studies have illustrated the increased prevalence of psychopathology in asylum seeker and refugee populations following pre-/post-displacement stress, few studies add to our understanding of the basic biological mechanisms underpinning risk to psychiatric disorders in these populations. Additionally, the mechanisms underlying resilience despite significant adversity remain unclear. Understanding the molecular mechanisms underpinning the development of psychiatric disorders in refugees can propel treatments (both drug and non-drug) that are capable of influencing biology at the molecular level, and the design of interventions. In the following review, we summarise the status quo of research investigating the pathophysiology of psychiatric disorders in refugees, and propose new ways to address gaps in knowledge with multidisciplinary research.

Effect of Parental Adverse Childhood Experiences and Resilience on a Child's Healthcare Reutilization

BACKGROUND

Adverse childhood experiences (ACEs) are associated with poor health outcomes in adults. Resilience may mitigate this effect. There is limited evidence regarding how parents' ACEs and resilience may be associated with their children's health outcomes.

OBJECTIVE

To determine the association of parental ACEs and resilience with their child's risk of unanticipated healthcare reutilization.

DESIGN, SETTING, AND PARTICIPANTS

We conducted a prospective cohort study (August 2015 to October 2016) at a tertiary, freestanding pediatric medical center in Cincinnati, Ohio. Eligible participants were English-speaking parents of children hospitalized on a Hospital Medicine or Complex Services team. A total of 1,320 parents of hospitalized children completed both the ACE questionnaire and the Brief Resilience Scale Survey.

EXPOSURE

Number of ACEs and Brief Resilience Scale Score among parents.

MAIN OUTCOMES

Unanticipated reutilization by children, defined as returning to the emergency room, urgent care, or being readmitted to the hospital within 30 days of hospital discharge.

RESULTS

In adjusted analyses, children of parents with 4 or more ACEs had 1.69-times higher odds (95% CI, 1.11-2.60) of unanticipated reutilization after an index hospitalization, compared with children of parents with no ACEs. Resilience was not significantly associated with reutilization.

CONCLUSION

Parental history of ACEs is strongly associated with higher odds of their child having unanticipated healthcare reutilization after a hospital discharge, highlighting an intergenerational effect. Screening may be an important tool for outcome prediction and intervention guidance following pediatric hospitalization.

Advancements to the Multi-System Model of Resilience: updates from empirical evidence

In this paper, we discuss further advancements to the Multi-System Model of Resilience through examining empirical factor structures of the Multi-System Model of Resilience Inventory along with other measures of resilience. Evidence from multiple sampled populations provided support for the three-systems organization of the model and highlight its similarities and differences in relation to other measures of resilience. The MSMR conceptualizes resilience as a capacity that enables functioning across a continuum from vulnerability to resilience, whereby internal and external resources interface with dynamic coping processes in response to varying needs and goals. Meaningful applications of this model and future steps in model and measurement developments are discussed.

Validating a Child Youth Resilience Measurement (CYRM-28) for Adolescents Living With HIV (ALHIV) in Urban Malawi

Resilience as a strength-based notion, measured across cultures, age groups, and sub-populations, contributes to understanding health and well-being. Yet, there is limited evidence of how the construct performs in resource-limited countries. We explored the psychometric properties of the CYRM-28 and validated the scale with adolescents living with HIV (ALHIV), a key sub-population. The participants included members of an advisory panel and 406 ALHIV, aged 15–19 years, attending an antiretroviral therapy and teen-club clinic in Blantyre, Malawi. This study employed a mixed-method study using an exploratory sequential design. The advisory panel discussed the CYRM-28, and select ALHIV then translated it into Chichewa, pilot-tested it using cognitive interviews, and back-translated it for clarity and appropriateness. The resultant CYRM-28 was tested using a survey with purposefully selected ALHIV. The overall median score was 123, with an interquartile range of 110–130. Minimum and maximum scores were 53 and 140. Cronbach’s alpha of 0.863 and Kaiser–Meyer–Olkin measure (0.866) confirmed internal consistency and the sample size adequacy, respectively. Bartlett’s tests of sphericity (p < 0.001) informed factor analysis. Exploratory factor analysis determined possible dimensions of resilience and the sub-scales. The confirmatory factor analysis (CFA) confirmed the construct validity and supported a three-factor model consistent with the conceptualization of resilience as a multi-dimensional construct. Structural equation modeling was applied to perform CFA to measure model of resilience. Multiple fit indices showed a good fit for the model. The CYRM-28 has good internal consistency, test and re-test reliability, and moderate convergent validity which render it useful as a self-report resilience measure to inform and evaluate interventions for the health and well-being of adolescents in Malawi.

An exploration of resilience in adolescents facing maternal cancer

BACKGROUND

Research findings on the impact of parental cancer on adolescents are inconsistent, some studies identifying negative psychosocial impact but others identifying positive impact; however, there is not enough understanding on the underlying factors that may lead to differences in outcomes. Research has found that resilience has a role in adolescents' adaptation to maternal cancer; however, the nature of this requires further exploration.

AIMS

This analysis will help understand resilience in adolescents that experience maternal cancer by exploring the nature of resilience and the individual, family, and environmental risk and protective factors that determine resilience in adolescent lived experiences of maternal cancer that enable positive outcomes.

METHODS

This study is part of a larger investigation focused on understanding adolescent adjustment to maternal cancer and the psychosocial factors that promote adjustment. Original adolescent interview transcripts (n = 15) were subject to a secondary thematic analysis.

RESULTS

The analysis yielded four themes: the first theme, The Journey of Maternal Cancer, describes adolescent experiences of maternal cancer over time; the second theme is a detailed description of adolescent Protective Factors and how these supported the adolescents; the third theme describes the Risk Factors that adolescents faced; and the fourth theme summarizes the Positive Outcomes that adolescents self-identified.

CONCLUSION

This study found resilience as dynamic, as it changes over time. These changes are a result of the course of maternal illness and its treatment over time. Adolescents can adapt to change, but this capacity is shaped by protective factors and risk factors as well as challenges that are unique to having a mother diagnosed with cancer. Most adolescents managed to navigate successfully and identified positive outcomes from a difficult and life-changing experience. The study suggests the need to provide long-term supports for adolescents and carry out longitudinal research to further understand the trajectories of resilience in adolescents who experience maternal cancer.

A behavioral genetic investigation of conceptualizations of resilience in a female twin sample

BACKGROUND

Great variability exists in response to stressful or traumatic events, leading to an interest in the construct of resilience as a trait and an outcome. The etiologic sources of variability across differing conceptualizations of resilience are poorly understood.

METHODS

Using behavioral genetic methods in a sample of 2,056 female twins, the present study sought to (a) examine the etiologic sources of a trait-based self-report measure of perceived resilience (PR), (b) determine the genetic and environmental overlap with an outcome-based measure of resilience, as defined by the absence of psychiatric symptoms after stressful life events, previously used by our research team (discrepancy-based psychiatric resilience [DBPR]), and (c) determine the etiologic overlap of these two resilience measures with major depressive disorder (MDD).

RESULTS

PR was modestly (11%) heritable. A moderate degree of genetic overlap (39%) and a nominal amount of environmental overlap (3%) were found between the two alternative measures of resilience. Genetic factors that influence PR accounted for 3% of MDD heritability, whereas 31% of MDD heritability was due to DBPR genetic factors.

CONCLUSIONS

Findings of a higher genetic correlation between the outcome-based resilience measure and MDD compared to the trait-based measure and MDD suggest gene-finding efforts may benefit from considering the multifaceted nature of resilience and that resilience is best understood as both a phenotypically and genetically heterogeneous construct.

Analysis of the Coping Process among Visually Impaired Individuals, Using Interpretative Phenomenological Analysis (IPA)

There is a lack of research based on in-depth theoretical and scientific knowledge to understand the visually impaired, and there has been little effort in the application of strategies for early intervention to minimize the risk these people might encounter during development. This study used semi-structured interviews from eight persons with visual impairments who had various experiences of coping process. Three coping processes based on life experiences were identified: (1) self-awareness and adaptation process: "self-awareness of disability" and "adaptation to disability and the environment"; (2) facing the circumstance process: "the exposure to concealment and abuse," "the suppression of potential," "denial and abandonment by family," "poverty and disability," "expansion of thinking," and "opportunities of special participation"; and (3) the positive reinforcement process: "self-disclosure and jump-starting life," "maintain satisfaction and achievement," and "socioeconomic independence." These findings expand the understanding of the factors common to the coping process experienced by individuals with visual impairment and highlight the importance of psychological support, family, education, and social support.

Increased instruction time and stress-related health problems among school children

While several studies suggest that stress-related mental health problems among school children are related to specific elements of schooling, empirical evidence on this causal relationship is scarce. We examine a German schooling reform that increased weekly instruction time and study its effects on stress-related outpatient diagnoses from the universe of health claims data of the German Social Health Insurance. Exploiting the differential timing in the reform implementation across states, we show that the reform slightly increased stress-related health problems among school children. While increasing instruction time might increase student performance, it might have adverse effects in terms of additional stress.

"The Worst Part Was Coming Back Home and Feeling Like Crying": Experiences of Lesbian, Gay, Bisexual and Trans Students in Portuguese Schools

Portugal is one of the most egalitarian countries in Europe in terms of lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals' legal rights. However, regarding education Portugal still lacks specific policies, plans and interventions to protect LGBTI students. To assess the perceptions of self-identified LGBTI youth regarding their school context, a total of 663 participants (aged from 15 to 20 years old) filled in an on-line questionnaire about their school climate. One hundred and forty-six of them answered an open-ended question about their personal experiences. A thematic analysis of these answers was conducted, and four main categories were identified: (i) victimization, (ii) coming out experiences, (iii) support networks, and (iv) demands. Most participants reported experiences of discrimination, and several sources of prejudice were identified. Furthermore, participants also recognized a lack of LGBTI information in school curriculum and made several demands. Besides inclusive laws, we suggest that the safety and the well-being of LGBTI youths in Portuguese schools depend upon others measures, such as teacher and school staff training, curricula inclusive of LGBTI diversity, and local strategies, such as Gay-Straight Alliances.

A Sociodemographic variables questionnaire (Q-SV) for research on family caregivers of children with chronic disease

Background

Chronic diseases in childhood can affect the physical and mental health of patients and their families. The literature on pediatric chronic diseases has found important associations between the sociodemographic variables of children and their caregivers and negative health consequences in families.

Methods

In this study, we aimed to design and validate a questionnaire on sociodemographic variables that would be useful for research on pediatric chronic diseases; and investigate the relationship between sociodemographic variables and psychosocial variables among family caregivers. First, we created a questionnaire that consists of 20 demographic, medical, and family-related items based on a literature review and expert evaluations. This questionnaire was then validated by 335 expert reviewers in the field of Social Work, who work daily with the families of patients with chronic diseases in 10 National Institutes of Health of Mexico. The validation was based on three empirical criteria created specifically for this study, and the reviewers evaluated the usefulness, relevance, and permanence of the items. In a second cross-sectional, correlational and comparative study, a total of 446 family caregivers of children with chronic diseases were interviewed, and they completed the Sociodemographic Variables Questionnaire for research on family caregivers of children with chronic sociodemographic diseases and four psychosocial measurement instruments for evaluating anxiety, depression, caregiver burden and quality of life.

Results

Based on the results of the first study, we created the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic diseases, and it includes 17 items that assess demographic, medical, and family characteristics. The results of the second study showed that the 17 sociodemographic variables obtained in the validation by expert judges are useful for measuring and evaluating the relationship between psychosocial variables in families of children with chronic diseases.

Conclusions

Psychosocial and sociodemographic factors are relevant for the development of research processes for families that care for children with chronic diseases.

Variations in Dyadic Adjustment Among Heterosexual HIV-Discordant Couples in Rural China: A Latent Profile Analysis

The systemic framework of resilience and dyadic perspective of couple coping suggests that HIV-discordant couples may show heterogeneous profiles of dyadic adjustment, shaped by contextual risks and resources. This study aimed to identify heterogeneous profiles of dyadic adjustment and thus investigate the expression of resilience among 159 heterosexual HIV-discordant couples in rural China. We hypothesized that the couples could be grouped into distinct profiles: both members showing poor well-being, both members showing good well-being, and discrepant well-being across the two members. A latent profile analysis classified the couples into three subgroups based on well-being, which was measured using the World Health Organization Well-Being Index. As expected, one subgroup, labeled Maladapted Couples (n = 58, 36.5%), reported poor well-being in both people living with HIV/AIDS (PLWHA) and the seronegative spouse. The second subgroup, labeled Resilient Couples (n = 50, 31.4%), was characterized by relatively good well-being in both partners. In the third subgroup, labeled Maladapted PLWHA and Resilient Spouses (n = 51, 32.1%), the PLWHA showed poor well-being, while the seronegative spouses demonstrated good well-being. The identified subgroups were validated against external well-being measures, including depression and self-rated health measures. Exploratory analyses identified distinct patterns of contextual risks (including HIV stigma and financial difficulties) and resource factors (including individual resources and relational resources) across the subgroups. These findings underscore the heterogeneity of adjustment among heterosexual HIV-discordant couples in rural China and suggest the potential usefulness of services tailored to specific subgroups.

Close relationships, individual resilience resources, and well-being among people living with HIV/AIDS in rural China

The systems framework of resilience has suggested that resilient factors external to or within the individual and their interactions can contribute to positive adjustment in at-risk populations. However, the interplays of resilience resources at different levels have seldom been investigated in health psychology, particularly in people living with HIV/AIDS (PLWHA). This study aimed to examine the mediating role of individual resilience resources in the associations between marital and family relationships and well-being in PLWHA. A sample of 160 Chinese PLWHA were interviewed to complete measures on marital relationship, family relationship, individual resilience resources, and general, physical, and mental well-being. Results showed that better marital relationship and family relationship were associated with higher levels of individual resilience resources and well-being indicators. Mediation analysis with path analysis showed significant mediating effects of individual resilience resources between marital and family relationships and general, physical, and mental well-being. By highlighting marital and family relationships as external resources of resilience and their roles in increasing individual resilience factors which thereby contribute to the well-being of PLWHA, our findings support the systems framework of resilience. There are implications for resilience enhancement interventions with the aim of improving PLWHA's well-being by including interpersonal strategies of strengthening the protective role of marital and family relationships, which will in turn facilitate the resilience process.

Championing the resilience of sub-Saharan adolescents: pointers for psychologists

In this article, I argue that an ecological systems approach to resilience – specifically, one that is sensitive to how contextual determinants shape successful adaptation differentially – offers a meaningful way to enable sub-Saharan adolescents to adapt well to the apparently intractable risks to their health and well-being. Accordingly, I draw on studies of child and adolescent resilience from sub-Saharan Africa and the global North to show that the resilience field has largely moved beyond individual-focused theories of resilience that have the (long-term) potential to jeopardize adolescent health and well-being and advance neoliberal agendas. I emphasize that the recent attention to differentially impactful resilience-enablers casts suspicion on incautious application of universally recurring resilience-enablers. Allied to this, I problematize the delay in the identification of resources that impact the resilience of sub-Saharan adolescents differentially. Finally, I distil implications for resilience-directed praxis and research that have the potential to advance the championship of adolescent resilience in sub-Saharan Africa.

A Social Ecological Modeled Explanation of the Resilience Processes of a Sample of Black Sesotho-Speaking Adolescents

The primary aim of the study that this article reports was to model and test a social ecological explanation of resilience as explained by Ungar. Its secondary aim was to investigate resilience-promoting supports in school-going Black South African adolescents. School attendance was specified as a culturally appropriate, functional outcome of resilience. The Pathways to Resilience Research Project gathered data through the Pathways to Resilience Youth Measure. Seven hundred and thirty school-going adolescents (age 12-19 years, 388 female, 341 male, one unspecified) from Thabo Mofutsanyana District, in South Africa's Free State province, participated in this cross-sectional study. Latent variable modeling was used to test measurement models of adolescents' self-reported perceptions of social ecological contributions (resources and risks) to their resilience. A complex model based on a social ecological explanation of resilience fitted the data best. The structural model showed that the resilience process predicted 32% of the variance in school attendance. Social skills, cultural, and spiritual resources were most supportive of adolescents' resilience. The results confirmed that the complex model explained resilience in Black South African adolescents as a person-context relational process and prompt principals, parents, teachers, and governmental departments to encourage school attendance.

Parental Adverse Childhood Experiences and Resilience on Coping After Discharge

BACKGROUND AND OBJECTIVES

Adults with a history of adverse childhood experiences (ACEs) (eg, abuse) have suboptimal health outcomes. Resilience may blunt this effect. The effect of parental ACEs (and resilience) on coping with challenges involving their children (eg, hospitalization) is unclear. We sought to quantify ACE and resilience scores for parents of hospitalized children and evaluate their associations to parental coping after discharge.

METHODS

We conducted a prospective cohort study at a children's hospital (August 2015-May 2016). Eligible participants were English-speaking parents of children hospitalized on the Hospital Medicine or Complex Services team. The ACE questionnaire measured the responding parent's past adversity (ACE range: 0-10; ≥4 ACEs = high adversity). The Brief Resilience Scale (BRS) was used to measure their resilience (range: 1-5; higher is better). The primary outcome was measured by using the Post-Discharge Coping Difficulty Scale via a phone call 14 days post-discharge (range: 0-100; higher is worse). Associations were assessed by using multivariable linear regression, adjusting for parent- and patient-level covariates.

RESULTS

A total of 671 (81% of eligible parents) responded. Respondents were primarily women (90%), employed (66%), and had at least a high school degree (65%); 60% of children were white, 54% were publicly insured. Sixty-four percent of parents reported ≥1 ACE; 19% had ≥4 ACEs. The mean Brief Resilience Scale score for parents was 3.95. In adjusted analyses, higher ACEs and lower resilience were significantly associated with more difficulty coping after discharge.

CONCLUSIONS

More parental adversity and less resilience are associated with parental coping difficulties after discharge, representing potentially important levers for transition-focused interventions.