Annual Research Review: Resilience and child well-being--public policy implications

Family and community resilience: a Photovoice study

BACKGROUND

Adverse childhood experiences (ACEs), in combination with adverse community environments, can result in traumatic stress reactions, increasing a person's risk for chronic physical and mental health conditions. Family resilience refers to the ability of families to withstand and rebound from adversity; it involves coping with disruptions as well as positive growth in the face of sudden or challenging life events, trauma, or adversities. This study aimed to identify factors contributing to family and community resilience from the perspective of families who self-identified as having a history of adversity and being resilient during the COVID-19 pandemic.

METHODS

This study used Photovoice, a visual participatory research method which asks participants to take photographs to illustrate their responses to a research question. Participants consisted of a maximum variation sample of families who demonstrated family level resilience in the context of the pair of ACEs during the COVID-19 pandemic. Family members were asked to collect approximately five images or videos that illustrated the facilitators and barriers to well-being for their family in their community. Semi-structured in-depth interviews were conducted using the SHOWeD framework to allow participants to share and elucidate the meaning of their photos. Using thematic analysis, two researchers then independently completed line-by-line coding of interview transcripts before collaborating to develop consensus regarding key themes and interpretations.

RESULTS

Nine families were enrolled in the study. We identified five main themes that enhanced family resilience: (1) social support networks; (2) factors fostering children's development; (3) access and connection to nature; (4) having a space of one's own; and (5) access to social services and community resources.

CONCLUSIONS

In the context of additional stresses related to the COVID-19 pandemic, resilient behaviours and strategies for families were identified. The creation or development of networks of intra- and inter-community bonds; the promotion of accessible parenting, housing, and other social services; and the conservation and expansion of natural environments may support resilience and health.

Children's digital play as collective family resilience in the face of the pandemic

In this article we explore how digital play as conducted through various social media and online meeting platforms facilitated resiliency and confidence building in children during the COVID-19 pandemic. Using day-in-the-life methodology and narrative inquiry, we disseminate and examine observations collected on children aged 2-10 during lockdown in a Newfoundland neighbourhood. Children utilized platforms such as TikTok, YouTube, and Zoom to embrace their agentic digital play in ways that repurposed the platforms to fulfil life milestones and social needs otherwise impacted and disrupted by pandemic restrictions. Through a series of vignettes and interviews, our research not only examines how such digital play benefits children and their healthy development, but how parents reacted to and assisted with their children's agentic digital platform manipulation and how this provided positive benefits and enriching experiences to the entire family. We additionally explore the conflicts and tensions both children and parents encountered in securely implementing free play via digital platforms, including fears of excess screen-time, digital dependency, and online threats, all of which risk limiting children's ability to independently explore their creativity and identities through digital play if not handled sensitively. Despite the hurdles to implementing digital play, this study exposes why it is essential for families to navigate this online terrain; this study ultimately poses that digital play and online platforms not only were beneficial to maintaining and building family resilience during the pandemic but will be vital assets in sustaining resiliency and positive mindsets moving forward with pandemic recovery.

SPARK Resilience in the workplace: Effectiveness of a brief online resilience intervention during the COVID-19 lockdown

Science asserts that resilience at work can be developed, with evidence pinpointing to multiple resources that can be built through deliberate coaching, training and interventions. This paper presents a mixed-methods study exploring the effectiveness of group coaching using SPARK Resilience training, a model and a structured coaching protocol that have been administered in educational and workplace settings in face-to-face format and remotely. The study used a non-randomised controlled design with a pre-test and a post-test in a sample of French adults (N = 101 in the intervention group and N = 86 in the waitlist control group). The SPARK Resilience programme was administered online with 8 sessions spanning 4 weeks in April 2020, during the very early stage of the pandemic and lockdown in France. The results indicate beneficial effects of the intervention on meaning, resilience, positive affect, and perceived stress outcomes (d in the .40-.56 range), as well as weaker effects on negative affect (d = .35) and work engagement (d = .21). Moderator analyses suggest that the effects of the intervention on perceived stress and negative affect tended to be stronger for older adults. Participants reported high levels of satisfaction with the intervention and provided 151 responses to three open-ended questions that were coded using thematic analysis, revealing specific benefits of the intervention. The findings are interpreted within the pandemic context, showing the way resilience interventions can help people overcome unprecedented challenges.

Concordance between two intrapersonal psychological resilience scales: how should we be measuring resilience?

BACKGROUND

While resilience has generated a lot of interest in mental health, operationalizing the construct of resilience remains an important challenge. This study aims to evaluate the concordance of two resilience scales that evaluate intrapersonal aspects of resilience in adolescents.

METHODS

Cross-sectional evaluation of internal consistency, concordance, and correlation of the Individual Protective Factors Index Questionnaire (IPFI) and the Adolescent Resilience Scale (ARS) in sixth grade students of three low-income public schools in Colombia.

RESULTS

325 adolescents (41.5% female) participated in the study (72.5% response rate). Mean age was 12.1 years (standard deviation [SD]: 1.04). Of a possible score from 1-4, the mean adjusted IPFI score was 3.3 (SD: 0.3; Cronbach's alpha: 0.87). Of a possible score from 21-105, the total ARS score was 76.4 (SD 13.0; Cronbach's alpha: 0.82); both distributions were non-normal and left-skewed. The Lin's concordance correlation coefficient was 0.34 and the Spearman correlation coefficient was 0.52 (p-value < 0.0001 for both). Notably, 10 adolescents (3.1% of the sample) had a score in the lowest quartile in one of the two instruments, and a score in the highest quartile in the other instrument.

CONCLUSIONS

There was low concordance between the scales, with notable lack of overlap in who was identified as having "low" levels of resilience. To better elucidate and operationalize the construct of resilience, studies using resilience scales should consider greater focus in understanding what aspects of the construct are being measured and how they relate to meaningful variables (well-being, risk of illness, etc.).

Basic epidemiology of wellbeing among children and adolescents: A cross-sectional population level study

Wellbeing and mental health are fundamental rights of children and adolescents essential for sustainable development. Understanding the epidemiology of child and adolescent wellbeing is essential to informing population health approaches to improving wellbeing and preventing mental illness. The present study estimated the prevalence of wellbeing and how wellbeing indicators were distributed across social and economic groups. This study used data from the 2019 Wellbeing and Engagement Collection; an annual census conducted in South Australian schools that measures self-reported wellbeing in students aged 8–18 years (n = 75,966). We estimated the prevalence (n, %) of low, medium and high wellbeing across five outcomes: life satisfaction, optimism, sadness, worries and happiness, overall and stratified by gender, age, language background, socio-economic position and geographical remoteness. The prevalence of low wellbeing on each indicator was: happiness 13%, optimism 16%, life satisfaction 22%, sadness 16% and worries 25%. The prevalence of low wellbeing increased with age, particularly for females. For example, 22.5% of females aged 8–10 years had high levels of worries compared to 43.6% of 15 to 18-year old females. Socioeconomic inequality in wellbeing was evident on all indicators, with 19.5% of children in the most disadvantaged communities having high levels of sadness compared to 12.5% of children in the most advantaged communities. Many children and adolescents experience low wellbeing on one or more indicators (40.7%). The scale of this problem warrants a population-level preventative health response, in addition to a clinical, individual-level responses to acute mental health needs. Universal school-based programs that support social and emotional wellbeing have a role to play in this response but need to be supported by universal and targeted responses from outside of the education system.

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Many children and adolescents experience low wellbeing during their schooling years.

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Wellbeing declines with age and adolescent females are at a particularly high risk of low wellbeing.

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Children living in more disadvantaged communities have poorer wellbeing than their peers living in more affluent communities.

Child and Adolescent Mental Health and Resilience-Focussed Interventions: A Conceptual Analysis to Inform Future Research

Internationally, the mental health of children and adolescents is undoubtedly an important construct of theoretical, clinical, and policy level concern. Worldwide, five mental disorders (depression, alcohol misuse, bipolar affective disorder, schizophrenia, and obsessive-compulsive disorder) represent half of the 10 leading causes of disability and premature death; with mental disorders accounting for 15–30% of disability adjusted life years in the first three decades of life. This provides a solid rational founded in implications for population health as to why reducing and preventing mental health problems in children and adolescents deserves attention. Past research has indicated interventions focussed on building resilience through strengthening protective factors may offer the potential to address mental health problems in children and adolescents, and in particular aid in reducing such problems during times of increased risk or adversity. With childhood and adolescence being critical periods of development, there is a need to reflect on the strengths and limitations of resilience-focussed interventions and anticipated future needs of the world’s youth. This conceptual analysis identifies a number of future research directions that may meaningfully add to the evidence base and improve implementation, evaluation, and impact of resilience-focussed interventions. These largely relate to refining the understanding of how resilience protective factors relate to mental health problems in children and adolescents. Important issues and potential opportunities to improve the related research field include improved reporting of intervention content; improved measurement of resilience protective factors in intervention trials; continued reporting and review of evidence of association between protective factors and mental health outcomes; and incorporation of mediation analysis within intervention trials. There is a need for further intervention studies in this space to be conducted as rigorous trials of resilience-focussed approaches based on such evidence of association, with clearly posited mechanisms of change, and inclusive of analysis of differential intervention effects. The suggested implications for research made in this conceptual analysis will aid in improving the quality of the evidence base relevant to the fostering of resilience and prevention of mental health problems in children and adolescents.

The Moral Foundations of Child Health and Social Policies: A Critical Interpretive Synthesis

Background: Allusions to the uniqueness and value of childhood abound in academic, lay, and policy discourse. However, little clarity exists on the values that guide child health and social policy-making. We review extant academic literature on the normative dimensions of child health and social policy to provide foundations for the development of child-focused public policies. Methods: We conducted a critical interpretive synthesis of academic literature on the normative dimensions of child health and social policy-making. We employed a social constructivist lens to interpret emergent themes. Political theory on the social construction of target populations served as a bridge between sociologies of childhood and public policy analysis. Results: Our database searches returned 14,658 unique articles; full text review yielded 72 relevant articles. Purposive sampling of relevant literature complemented our electronic searches, adding 51 original articles, for a total of 123 articles. Our analysis of the literature reveals three central themes: potential, rights, and risk. These themes retain relevance in diverse policy domains. A core set of foundational concepts also cuts across disciplines: well-being, participation, and best interests of the child inform debate on the moral and legal dimensions of a gamut of child social policies. Finally, a meta-theme of embedding encompasses the pervasive issue of a child’s place, in the family and in society, which is at the heart of much social theory and applied analysis on children and childhood. Conclusions: Foundational understanding of the moral language and dominant policy frames applied to children can enrich analyses of social policies for children. Most societies paint children as potent, vulnerable, entitled, and embedded. It is the admixture of these elements in particular policy spheres, across distinct places and times, that often determines the form of a given policy and societal reactions to it. Subsequent work in this area will need to detail the degree and impact of variance in the values mix attached to children across sociocultural contexts and investigate tensions between what are and what ought to be the values that guide social policy development for children.

Risk and Resilience Factors During the COVID-19 Pandemic: A Snapshot of the Experiences of Canadian Workers Early on in the Crisis

Research highlights several risk and resilience factors at multiple ecological levels that influence individuals’ mental health and wellbeing in their everyday lives and, more specifically, in disaster or outbreak situations. However, there is limited research on the role of these factors in the early days of the COVID-19 crisis. The present study examined if and how potential risk factors (i.e., reduction in income, job insecurity, feelings of vulnerability to contracting the virus, lack of confidence in avoiding COVID-19, compliance with preventative policies) and resilience factors (i.e., trait resilience, family functioning, social support, social participation, and trust in healthcare institutions) are associated with mental health and well-being outcomes, and whether these resilience factors buffer (i.e., moderate) the associations between risk factors and said outcomes. One to two weeks after the government recommended preventative measures, 1,122 Canadian workers completed an online questionnaire, including multiple wellbeing outcome scales in addition to measures of potential risk and resilience factors. Structural equation models were tested, highlighting that overall, the considered risk factors were associated with poorer wellbeing outcomes, except social distancing which was associated with lower levels of stress. Each of the potential resilience factors was found to have a main effect on one or more of the wellbeing outcomes. Moderation analysis indicated that in general these resilience factors did not, however, buffer the risk factors. The findings confirm that the COVID-19 crisis encompasses several stressors related to the virus as well as to its impact on one’s social, occupational, and financial situation, which put people at risk for lower wellbeing as early as one to two weeks after the crisis began. While several resilience factors emerged as positively related to wellbeing, such factors may not be enough, or sufficiently activated at that time, to buffer the effects of the numerous life changes required by COVID-19. From an ecological perspective, while mental health professionals and public health decision-makers should offer/design services directly focused on mental health and wellbeing, it is important they go beyond celebrating individuals’ inner potential for resilience, and also support individuals in activating their environmental resources during a pandemic.

Evaluation of a Longitudinal Family Stress Model in a Population-Based Cohort

The Family Stress Model (FSM) is an influential family process model that posits that socioeconomic disadvantage impacts child outcomes via its effects on parents. Existing evaluations of the FSM are constrained by limited measures of socioeconomic disadvantage, cross-sectional research designs, and reliance on non-population-based samples. The current study tested the FSM in a subsample of the Fragile Families and Child Wellbeing Study (N = 2,918), a large population-based study of children followed from birth through age 9. We employed a longitudinal framework and used measures of socioeconomic disadvantage beyond economic resources. Although the hypothesized FSM pathways were identified in the longitudinal model (e.g., economic pressure at age 1 was associated with maternal distress at age 3, maternal distress at age 3 was associated with parenting behaviors at age 5), the effects of socioeconomic disadvantage at childbirth on youth socioemotional outcomes at age 9 did not operate through all of the hypothesized mediators. In longitudinal change models that accounted for the stability in constructs, multiple indicators of socioeconomic disadvantage at childbirth were indirectly associated with youth externalizing behaviors at age 9 via either economic pressure at age 1 or changes in maternal warmth from ages 3 to 5. Greater economic pressure at age 1, increases in maternal distress from ages 1 to 3, and decreases/increases in maternal warmth/harshness from ages 3 to 5 were also directly associated with increases in externalizing behaviors from ages 5 to 9. Results provide partial support for the FSM across the first decade of life.

Randomized trial of a resilience intervention on resilience, behavioral strengths and difficulties of mainstreamed adolescent students with hearing loss

OBJECTIVES

Adolescents with hearing loss have shown emotional and behavioral difficulties. This study evaluated the effectiveness of a resilience-focused intervention on resilience, behavioral strengths, and difficulties of mainstreamed adolescent students with hearing loss.

METHODS

In this experimental study with a pre-test, post-test, follow up, and control group design, a total number of 122 students with hearing loss, were randomly assigned to two equal groups. The intervention group received training in small groups of 3-5 self-contained classes for six weeks (two times per week for 75 min). The "Connor-Davidson Resilience Scale" and the "self-report version of Strengths and Difficulties Questionnaire (SDQ)" were used to measure the resilience and the positive and negative behavioral attributes of participants prior to intervention, then repeat of 6 and 14 weeks later. The scores were compared between intervention and control groups using the Mann-Whitney Test.

RESULTS

After the intervention, the resilience scores in the intervention group was significantly higher than the control group (U = 831, p < .001). Also, the SDQ score in the intervention group was significantly higher than the control group (U = 634, (p < .001). Negative behavioral attributes (total SDQ scores, and sub-scales scores of hyperactivity, emotional, conduct, and peer problems) were decreased, and prosocial behavior was increased significantly in the intervention group (p < .001). All of the differences remained through follow-up measurement except for the subscale of conduct problems.

CONCLUSION

The twelve sessions of resilience-focused intervention led to a marked increase in resilience. It also is effective in decreasing the behavioral difficulties of adolescents with hearing loss and is suggested to apply for students with hearing impairment integrated into middle schools.

Domains and Indicators of Resilient Children in Natural Disasters: A Systematic Literature Review

Resilience has received increased attention among both practitioners and scholars in recent years. Child resilience has received notable attention in disaster risk reduction (DRR) during the creation of the Sendai Framework 2015-2030 to improve child protection in the event of disasters. As resilience is a subjective concept with a variety of definitions, this study evaluates its different factors and determinates in the existing research to clarify the path for the near future and objective research. A systematic literature review was conducted by searching and selecting the peer-reviewed papers published in four main international electronic databases including PubMed, SCOPUS, WEB OF SCIENCE, and PsycINFO to answer the research question: "What are the criteria, factors or indicators for child resilience in the context of a natural disaster?" The process was based on PRISMA guidelines. In total, 28 papers out of 1838 were selected and evaluated using thematic analysis. The results are shown in two separate tables: one descriptive and the other analytical. Two main themes and five subthemes for criteria for child resilience in a disaster have been found. The factors found cover the following areas: mental health, spiritual health, physical, social behavior, and ecological, and as well as environmental. The majority of the included studies mentioned the scattered criteria about children resilience without any organized category. Although this concept is multifactorial, additional research is needed to develop this study and also observe other kinds of disasters such as human-made disasters.

Global Mental Health and Adolescent Anxiety: Kin, Care and Struggle in New Mexico

While recent developments within the field of global mental health have illuminated the reality of serious mental health difficulties worldwide, particularly in low-income settings, research that focuses on children and adolescents remains underdeveloped. This is especially the case with respect to ethnographic studies of lived experience of adolescents diagnosed with serious mental health conditions. Drawing from an interdisciplinary study of adolescents in New Mexico who were afflicted with a broad range of disorders according to contemporary research diagnostic criteria, this article focuses on anxiety-related conditions with respect to subjective experience and social-ecological contexts of living with such conditions. We offer preliminary observations regarding the value of linking ethnographic and research diagnostic data to address questions of resilience, endurance, capacity and struggle. These observations are intended as the basis for the formulation of more precise hypotheses about adolescent anxiety, kin, and care under conditions of structural violence marked by psychological, residential, and intergenerational adversity.

Gender, violence and resilience among Ugandan adolescents

Resilience, commonly understood as the ability to maintain adaptive functioning in the face of adversity, has emerged as a salient entry point in the field of positive youth development. This study makes a unique contribution by exploring dimensions of resilience among adolescents in Uganda, examining associations between violence from different perpetrators and resilience, and testing whether sex moderates these relationships. Analyses are based on data from 3706 primary school students. Exploratory factor analysis (EFA) identified five factors underlying the construct of resilience: Emotional Support; Family Connectedness; School Connectedness; Social Assets; and Psychological Assets. We used regression analysis to investigate associations between these dependent variables, background characteristics, and experiences of violence (including exposure to intimate partner violence against female caregivers). Results reflect a complex relationship between violence and resilience, with patterns varying by perpetrator (e.g., teacher, peers, caregivers) and some evidence that the sex of the student moderates these dynamics. Overall, there is a consistently negative relationship between all violence measures and Psychological Assets. In addition, teacher violence is associated with lower resilience across factors and both caregiver violence and exposure to IPV are consistently associated with decreased Family Connectedness. These findings suggest that adolescents experiencing (and exposed to) violence from adults may be particularly vulnerable to internalizing and/or externalizing behaviors and withdrawal from the family. Findings point to preventing violence from teachers complemented with enhancing family relationships as promising avenues for resilience-strengthening interventions, and also emphasize the need to consider gendered strategies to ensure girls and boys benefit equally.

Beyond Risk and Protective Factors: An Adaptation-Based Approach to Resilience

How does repeated or chronic childhood adversity shape social and cognitive abilities? According to the prevailing deficit model, children from high-stress backgrounds are at risk for impairments in learning and behavior, and the intervention goal is to prevent, reduce, or repair the damage. Missing from this deficit approach is an attempt to leverage the unique strengths and abilities that develop in response to high-stress environments. Evolutionary-developmental models emphasize the coherent, functional changes that occur in response to stress over the life course. Research in birds, rodents, and humans suggests that developmental exposures to stress can improve forms of attention, perception, learning, memory, and problem solving that are ecologically relevant in harsh-unpredictable environments (as per the specialization hypothesis). Many of these skills and abilities, moreover, are primarily manifest in currently stressful contexts where they would provide the greatest fitness-relevant advantages (as per the sensitization hypothesis). This perspective supports an alternative adaptation-based approach to resilience that converges on a central question: “What are the attention, learning, memory, problem-solving, and decision-making strategies that are enhanced through exposures to childhood adversity?” At an applied level, this approach focuses on how we can work with, rather than against, these strengths to promote success in education, employment, and civic life.

Resilience in Context: A Brief and Culturally Grounded Measure for Syrian Refugee and Jordanian Host-Community Adolescents

Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with male/female, refugee/nonrefugee samples (N = 603, 11–18 years). Confirmatory factor analyses tested three‐factor structures for 28‐ and 12‐item CYRMs and measurement equivalence across groups. CYRM‐12 showed measurement reliability and face, content, construct (comparative fit index = .92–.98), and convergent validity. Gender‐differentiated item loadings reflected resource access and social responsibilities. Resilience scores were inversely associated with mental health symptoms, and for Syrian refugees were unrelated to lifetime trauma exposure. In assessing individual, family, and community‐level dimensions of resilience, the CYRM is a useful measure for research and practice with refugee and host‐community youth.

Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study

This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10–17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

Principals' reports of adults' alcohol use in Australian secondary schools

BACKGROUND

Schools provide opportunities for parents and the wider community to connect and support the physical and emotional wellbeing of their children. Schools therefore have the potential to play a role in the socialisation of alcohol use through school policies and practices regarding consumption of alcohol by adults at school events in the presence of children.

METHODS

This survey was undertaken to a) compare the extent to which alcohol is used at secondary school events, when children are present, in the states of New South Wales (NSW) and Victoria (VIC), Australia; b) describe principals' level of agreement with these practices; c) their awareness of state policies on this issue; and d) the predictors of such events. A random sample of secondary schools, stratified to represent metropolitan and non-metropolitan schools were invited to participate. Bivariate and multivariate analysis were conducted with p values < 0.05 considered significant.

RESULTS

A total of 241 (43%) schools consented to participate in the study. Fifteen percent of participating NSW schools and 57% of VIC schools held at least one event in which alcohol was consumed by adults in the presence of children in the year before the survey. Of the 100 reported events, 78% were Year 12 graduation dinners, and 18% were debutante balls. Compared to NSW principals, VIC principals were significantly more likely to agree with the use of alcohol at these events; significantly less likely to be aware of their state education department policy on this issue; have a policy at their own school or support policy that prohibits alcohol use at such events; and less likely to report having enough information to make decisions about this.

CONCLUSIONS

There is a growing focus on adults' use of alcohol at school events when children are present. Schools can play an important role in educating and socialising children about alcohol via both the curriculum and policies regarding adults' alcohol use at school events. Findings from this study suggest education department and school-based policies that prohibit or restrict the use of alcohol, are significant predictors of adults' alcohol use at school events when children are present.

Towards school mental health programmes in Nigeria: systematic review revealed the need for contextualised and culturally-nuanced research

BACKGROUND

School-based mental health programmes, a potential avenue to reach many children and youth, are not yet developed in Nigeria. In view of the importance of cultural nuances in mental health issues, initial groundwork towards the establishment of these programmes in Nigeria must be cognizant of cultural peculiarities at the outset.

OBJECTIVES

The objective of the study was to critically examine, through the lens of transcultural psychiatry, all the currently available epidemiological studies and needs assessments relevant to school-based mental health programmes in Nigeria.

METHODS

The study was a systematic review of relevant studies available from MEDLINE, Science Direct, PsychInfo, Google Scholar, and AJOL databases.

RESULTS

This review shows that there is an ongoing effort at documenting the burden of mental health problems and risks, resource needs, and the available resource and capacity for school-based mental health programmes in Nigeria. However, generally speaking these epidemiological data and needs assessments are significantly limited in epistemological philosophy and cultural contextualisation. This was evidenced by a preponderance of non-representative data, quantitative assessments, and decontextualised interpretation of results and conclusions.

CONCLUSIONS

Going forward, recommendations are offered for culturally-nuanced epidemiology and the direction is set for context-appropriate needs assessments for school-based mental health programmes in Nigeria.

Leaving school: a comparison of the worries held by adolescents with and without intellectual disabilities

BACKGROUND

Leaving school is an important time for adolescents, with increasing autonomy and developing adult identities. The present study sought to shed light on the content and emotional impact of worries amongst adolescents with and without intellectual disabilities (IDs) at this time of change.

METHODS

Twenty-five adolescents with mild to moderate IDs and 27 adolescents without IDs, aged 15 to 18 years, took part in the study. Participants' worries were elicited using a structured interview. The levels of rumination and distress related to their most salient worries were also examined, along with their self-reported levels of anxiety.

RESULTS

Content analysis of the interviews identified differences between the worries of the two groups of participants, with the adolescents with IDs expressing more general worries about failure and personal threat. Level of distress about worries was positively correlated with anxiety in both groups. The adolescents with IDs were significantly more anxious than their non-disabled peers.

CONCLUSIONS

The differences between the groups' worries may be linked to differences in life experience and expectations. Consideration should be given to the specific worries of adolescents at the stage of leaving school. Doing so may allow solutions for their concerns to be identified, thus easing distress and leading to a less stressful transition.

Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building

Background

Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response and adaptation.

Methods

Structured interviews were conducted with 39 stakeholders from three local government areas selected to represent the diversity of conflict experience across the state: Damaturu, Fune and Nguru, and with four officers of the PRRINN-MNCH program providing technical assistance for primary care development in the state. A group model building session was convened with 11 senior stakeholders, which used participatory scripts to review thematic analysis of interviews and develop a preliminary systems model linking identified variables.

Results

Population migration and transport restrictions have substantially impacted access to health provision. The human resource for health capability of the state has been severely diminished through the outward migration of (especially non-indigenous) health workers and the suspension of programmes providing external technical assistance. The political will of the Yobe State government to strengthen health provision — through lifting a moratorium on recruitment and providing incentives for retention and support of staff — has supported a recovery of health systems functioning. Policies of free-drug provision and decentralized drug supply appear to have been protective of the operation of the health system. Community resources and cohesion have been significant assets in combatting the impacts of the insurgency on service utilization and quality. Staff commitment and motivation — particularly amongst staff indigenous to the state — has protected health care quality and enabled flexibility of human resource deployment.

Conclusions

A systems analysis using participatory group model building provided a mechanism to identify key pathways of threat and adaptation with regard to health service functioning. Generalizable systems characteristics supportive of resilience are suggested, and linked to wider discussion of the role of factors such as diversity, self-regulation and integration.

Assessing resilience in adolescence: the Spanish adaptation of the Adolescent Resilience Questionnaire

Background

The concept and assessment of resilience have attracted considerable attention in recent years, but none of the instruments developed to measure resilience in adolescents have been adapted to the Spanish context. The Adolescent Resilience Questionnaire (ARQ) provides a comprehensive and multidimensional assessment of the resources associated with resilience in adolescents.

Methods

This study analyzes the psychometric properties of the ARQ. Participants included a community sample of 1101 Spanish adolescents (53.5 % boys) aged 12–17 years (M = 14.51; SD = 1.755).

Results

Results confirm the factor structure based on 12 scales. Internal consistency was generally adequate (between .60 and .84), although the unacceptable coefficient for the Empathy/Tolerance scale (α = .38) means that this scale needs to be revised for the Spanish context. Relationships between ARQ scales and psychopathology were in the expected direction and magnitude. Some gender differences were observed, with higher scores for boys on Confidence and Negative cognition.

Conclusions

The Spanish version of the ARQ can help to identify personal characteristics associated with resilience and signs of positive engagement with family, peers, school, and the community. It can identify those adolescents most likely to show resilience in response to adversity, as well as those who may be vulnerable under situations of stress.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-015-0259-8) contains supplementary material, which is available to authorized users.

Refining Trait Resilience: Identifying Engineering, Ecological, and Adaptive Facets from Extant Measures of Resilience

The current paper presents a new measure of trait resilience derived from three common mechanisms identified in ecological theory: Engineering, Ecological and Adaptive (EEA) resilience. Exploratory and confirmatory factor analyses of five existing resilience scales suggest that the three trait resilience facets emerge, and can be reduced to a 12-item scale. The conceptualization and value of EEA resilience within the wider trait and well-being psychology is illustrated in terms of differing relationships with adaptive expressions of the traits of the five-factor personality model and the contribution to well-being after controlling for personality and coping, or over time. The current findings suggest that EEA resilience is a useful and parsimonious model and measure of trait resilience that can readily be placed within wider trait psychology and that is found to contribute to individual well-being.

Toward a culturally sensitive conceptualization of resilience: Participatory research with war-affected communities in northern Uganda

Resilience research with war-affected populations has long conceptualized resilience as the absence of psychopathology and operationalized it by use of standardized measures. However, literature on resilience increasingly highlights the importance of also including indicators of positively valued functioning as well as contextually sensitive indicators of resilience. This study used a participatory approach to examine the contextual conceptualization of youth resilience in the aftermath of war in northern Uganda, as defined by groups of stakeholders (youths, parents, elders, leaders, teachers) in four communities. The results identify 40 indicators covering a multiplicity of domains of functioning. The rationales behind these indicators were clustered into the broad themes: progress, self-reliance, social connectedness, morality, health, and comfort. The findings suggest that positively and negatively valued aspects of functioning are both key to conceptualizing resilience, and indicate the importance of including contextually distinguished indicators. The findings further point to the role of individual and collective processes in the construction of resilience, and to the need to take into account the contexts wherein resilience is conceptualized and observed. This study generated contextually sensitive indicators of young people's resilience, which can be used, complementary to existing measures of functioning, to provide a more comprehensive and culturally sensitive view of youths' resilience in the wake of war adversity.

Resilience as a universal criterion of health

To promote and maintain health in agricultural and food systems, appropriate criteria are needed for the description and assessment of the health of soils, plants, animals, humans and ecosystems. Here we identify the concept of resilience as a universally applicable and fundamentally important criterion of health in all relevant areas of agriculture. We discuss definitions of resilience for soils, plants, animals, humans and ecosystems, and explore ways in which resilience can be applied as a criterion of health in different agricultural contexts. We show how and why resilience can be seen as a key criterion of health. Based on this, we discuss how resilience can be used as a link between soil, plant, animal, human and ecosystem health. Finally, we highlight four key areas for future research on resilience in agriculture, namely spatial and temporal scaling of resilience; effects of diversity; the role of networks for resilience; and stakeholder involvement.

Beating the odds: an approach to the topic of resilience in children and adolescents

The concept of good mental functioning despite negative influences first arose more than a hundred years ago and has received increasing interest during the last decades. For a long time, lack of unified definition of concept and terms rendered research difficult to compare. Nowadays, consent is reached on a definition of resilience as "an individual's ability to properly adapt to stress and adversity" and a large number of studies have been performed trying to identify factors that render children resilient. Among these, interpersonal factors like gender, intelligence, aspects of character and temperament as well as genes; factors within the family like a stable and positive relation to an adult; and factors of the broader environment like being integrated into the community have been those most articulately pointed out by research. Although, to date, research on resilience has been extensive, there is still a lack of robust, comparative, empirical studies allowing policy formulation for fostering resilience in children at risk.

Annual Research Review: The experience of youth with political conflict--challenging notions of resilience and encouraging research refinement

AIMS AND METHOD

Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.

FINDINGS

The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.

CONCLUSIONS

Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.