Editorial Commentary: Resilience in child development--interconnected pathways to wellbeing

Childhood maltreatment and mental health problems in a 10-year follow-up study of adolescents in youth residential care: A latent transition analysis

Childhood maltreatment and mental health problems are common among young people placed out-of-home. However, evidence on the impact of maltreatment on the course of mental health problems in at-risk populations is sparse. The aim of this longitudinal study is twofold: (a) describe the course of mental health problems and the shift in symptom patterns among adolescents in youth residential care into young adulthood and (b) assess how childhood maltreatment is related to the course of mental health problems. One hundred and sixty-six adolescents in Swiss youth residential care were followed up into young adulthood (36.1% women; MAge-Baseline = 16.1 years; MAge-Follow-Up = 26.4 years). Latent transition analysis was employed to analyze transitions of symptom patterns and their association with maltreatment exposure. We found three latent classes of mental health problems: a "multiproblem"-class (51.8% baseline; 33.7% follow-up), a "low symptom"-class (39.2% baseline; 60.2% follow-up), and an "externalizing"-class (9.0% baseline; 6.0% follow-up). Individuals in the "multiproblem"-class were likely to transition towards less-complex symptom patterns. Higher severity of self-reported childhood maltreatment was associated with more complex and persistent mental health problems. Our study underlines the need for collaboration between residential and psychiatric care systems within and after care placements, with a specialized focus on trauma-informed interventions and care.

A qualitative study of coping strategies and resilience in the aftermath of childhood adversity in first-episode psychosis

AIM

Exposure to adversity during childhood is associated with elevated risk for commonly occurring forms of psychopathology, especially psychotic disorders. Despite the noteworthy consequences associated with adverse childhood experiences, an inconsistent and unpredictable number of at-risk populations present with remarkably good physical and mental health outcomes that can be attributed to resilience. This study aimed to qualitatively explore the experience of childhood adverse events and coping strategies employed by individuals that promote resilience and better mental health outcomes.

METHODS

Fourteen individuals with a history of childhood adversity were recruited to participate using a case-study approach. A semi-structured interview guide was developed based on empirical evidence and theoretical background, and the interviews were analysed using a reflexive thematic approach.

RESULTS

Our findings showed that the type of adversity impacted the experience of trauma, for example, the death of a caregiver versus emotional abuse or witnessing violence at home. Five coping strategies were identified (social support, religious coping, problem or emotion-focused coping, and meaning-making), with healthy controls found to identify and use these resources more than the psychosis group to promote individual well-being and better mental health outcomes.

CONCLUSIONS

Our findings provide insights into experiences in the aftermath of childhood adversity, emphasising the need to assess the history of trauma systematically. They further underscore the importance of mental health prevention programmes bolstering individual-level coping strategies and the resources available within our environments to help them manage adversity, improve overall outcomes, and promote resilience.

Examining heterogeneity: A systematic review of quantitative person-centered studies on adversity, mental health, and resilience in children and young adults with refugee backgrounds

BACKGROUND

Child and young adult refugees are a heterogeneous group comprising both vulnerable and resilient individuals. Person-centered statistical methods could help disentangle this heterogeneity, enabling tailored interventions. This systematic review examined person-centered studies on adversity, mental health, and resilience in children and young adults with refugee backgrounds to identify subgroups and assess their theoretical and practical relevance.

METHODS

The strategy included three search blocks: 1) refugee, 2) child and/or youth, and 3) person-centered method. Studies were identified through searches of PubMed, Academic Search Complete, Scopus, PsycINFO, CINAHL, ERIC, and Cochrane. The search included all published studies until December 2023. Studies were eligible for review if they used adversity, mental health or resilience variables as indicators in a person-centered analysis. The study population needed to have a refugee background with a mean age of ≤25. The reporting quality of the studies was assessed using the adapted version of the Guidelines for Reporting on Latent Trajectory Studies (GRoLTS) checklist. The results were analyzed in a narrative format and using summary tables.

RESULTS

A total of 6706 studies were initially identified, of which seven were eligible for review. The studies included 2409 individuals and were conducted in refugee camps, communities, and institutional and clinical settings across Africa, the Middle East, Europe, Asia, and North America. Five of the seven studies included adversity as an indicator, and three articles mental ill-health. Only one article specifically investigated resilience. All studies identified subgroups, but the findings regarding predictors of group membership were inconclusive. Risks for adverse outcomes, such as mental health problems, also varied across subgroups. The studies generally displayed inadequate reporting of important methodological aspects of the data analysis, a lack of theoretical consideration, and an absence of reliability testing.

CONCLUSIONS

The use of person-centered approaches in research on children and young adults with refugee backgrounds, focusing on adversity, mental health, and resilience, is currently limited. Nevertheless, the reviewed studies provided valuable insights into subgroups within this population, indicating that person-centered approaches can be employed when studying this group. Future research should consider theory and prior knowledge in the selection of the final number of groups, thoroughly report quality criteria, and rigorously test the reliability of classes.

"No one will come and help me make my life": Ecological-transactional model approach to resilience among people with a history of childhood adversity

Resilience refers to the ability to employ a collection of protective factors to return to or maintain positive mental health following an experience of disadvantage or adversity. Understanding why some children do well despite early adverse experiences is crucial because it can inform more effective policies and programs that help more children reach their full potential. This study aimed to explore and explain the development of resilience within an ecological-transactional framework. A qualitative case study approach was used recruiting participants with history of childhood adversity: six patients with a diagnosis of first-episode psychosis from the main referral psychiatric hospital in Kenya and eight healthy controls from a neighbouring community in Nairobi. The findings indicate that children and their contexts mutually influenced each other. Using the systemic perspective of the ecological-transactional model, our participants identified the home environment (microsystem) as an important enabler of trauma to children. Available social support at both the micro-and exosystem levels, including good caregiver-child relationships, acted as buffers to alleviate the negative influence of adversity, leading to successful adaptation. Our study highlights the significant impact of adversities during childhood and adolescence. In addition, it emphasizes the influence of multiple contexts, supporting the need for appropriate interventions at each level to mitigate the negative consequences.

Fostering resilience in adolescence and young adulthood: Considerations for evidence-based, patient-centered oncology care

Adolescence and young adulthood are times of growth and change. For adolescents and young adults (AYAs) who are diagnosed with cancer, the demands of illness may compound normal developmental challenges and adversely affect physical, emotional, and social health. Nevertheless, AYAs have a tremendous capacity for psychosocial adaptation and resilience. Informed by the Transactional Model of Stress and Coping, observational studies in AYA oncology suggest consistent individual, social, and existential resources that may promote resilience. To date, few interventions have been designed to examine whether resilience can be taught and whether doing so affects patient-centered outcomes. Findings point to the potential value of multicomponent programs that include various skills-building strategies, such as stress management, mindfulness, gratitude, and positive reappraisal coping, among others. New research directions include the need to evaluate delivery strategies to enhance participant adherence and retention (e.g., eHealth modalities, optimization studies) and to examine program effectiveness in community-based oncology practices (e.g., less resource-rich settings in which most AYAs receive care). Ultimately, this scholarship may inform, refine, and strengthen intervention science in resilience more broadly.

Measuring resilience for Chinese-speaking populations: a systematic review of Chinese resilience scales

Introduction

Despite the rapid growth of interdisciplinary resilience research in Chinese contexts, no study has systematically reviewed individual-level measurement scales for Chinese-speaking populations. We report a systematic review of scales developed for or translated/adapted to Chinese-speaking contexts, where we assessed how widely used scales fare in terms of their psychometric qualities.

Methods

Studies included in this review must have been published in peer-reviewed English or Chinese journals between 2015-2020 and included self-reported resilience scales in Chinese-speaking populations. Searches were conducted in PsycINFO, CNKI (completed in May 2021), and PubMed (completed in January 2024). We developed coding schemes for extracting relevant data and adapted and applied an existing evaluation framework to assess the most frequently used resilience scales by seven methodological criteria.

Results

Analyses of 963 qualified studies suggested that Chinese resilience scales were used in a diverse range of study contexts. Among 85 unique kinds of resilience measures, we highlighted and evaluated the three most frequently used translated scales and three locally developed scales (nine scales in total including variations such as short forms). In short, resilience studies in Chinese contexts relied heavily on the translated 25-item Connor-Davidson Resilience Scale, which scored moderately on the overall quality. The locally developed Resilience Scale for Chinese Adolescents and Essential Resilience Scale received the best ratings but could use further development.

Discussion

We discussed how future work may advance widely used scales, and specified seven methodological recommendations for future resilience scale development with existing and new scales in and beyond the Chinese study contexts. We further addressed issues and challenges in measuring resilience as a process and called on researchers to further develop/evaluate process measures for Chinese-speaking populations.

The Mediating Effect of Psychological Resilience between Individual Social Capital and Mental Health in the Post-Pandemic Era: A Cross-Sectional Survey over 300 Family Caregivers of Kindergarten Children in Mainland China

In the context of the impact of the post-COVID-19 pandemic on families, this study explores the impact of individual social capital and psychological resilience on the mental health of family caregivers of kindergarten children in mainland China. This study included a sample of 331 family caregivers from Zhaoqing City, Guangdong Province, and the researchers applied the Personal Social Capital Scale (PSCS-16), Connor–Davidson Resilience Scale (CD-RISC-10), and Depression Anxiety Stress Scale (DASS) to assess social capital, psychological resilience, and mental health. Findings indicate a positive relationship between bridging social capital and mental health, while psychological resilience is negatively associated with depression, anxiety, and stress. Psychological resilience is identified as a mediator between social capital and mental health outcomes in this study. These insights highlight the importance of enhancing social capital and psychological resilience to improve family caregivers’ mental health and the need for targeted interventions.

Resilience and health in American Indians and Alaska Natives: A scoping review of the literature

American Indians and Alaska Natives suffer from disproportionately high rates of chronic mental and physical health conditions. These health inequities are linked to colonization and its downstream consequences. Most of the American Indian and Alaska Native health inequities research uses a deficit framework, failing to acknowledge the resilience of American Indian and Alaska Native people despite challenging historical and current contexts. This scoping review is based on a conceptual model which acknowledges the context of colonization and its consequences (psychological and health risk factors). However, rather than focusing on health risk, we focus on protective factors across three identified domains (social, psychological, and cultural/spiritual), and summarize documented relationships between these resilience factors and health outcomes. Based on the scoping review of the literature, we note gaps in extant knowledge and recommend future directions. The findings summarized here can be used to inform and shape future interventions which aim to optimize health and well-being in American Indian and Alaska Native peoples.

Resilience under protracted conflict and siege: a new paradigm shift

This study sought to explore the relationship between resilience as perceived within the Palestinian context, and individual, contextual, and psychosocial factors among adults living in the Gaza Strip. Secondly, this study applies the Connor-Davidson Resilience Scale to the Palestinian population within the context of the challenges they are facing while living under extended sieges, in order to examine the generalizability of the resilience scale. Gender-specific bivariate analyses and multivariate linear regression were conducted to examine links between resilience, and diverse psychosocial and contextual factors. Males scored higher in resilience than females. Consistent predictors of higher resilience included, being male, employed, income, not living in a peaceful area, higher life satisfaction, and the Palestinian idea of resilience (Sumud). For the overall sample and males, hardiness was a positive predictor of higher resilience. For the overall sample and females, post-secondary education was a positive predictor of resilience. Psychosocial factors may act synergistically to foster resilience in the face of adversity, low socioeconomic status, and fear of living in a non-peaceful area. Our findings add to a limited body of literature calling for attention to contextual and psychosocial influences on gender differences in measuring and defining the dynamic nature of resilience.

Father contribution to human resilience

Fathers have been an important source of child endurance and prosperity since the dawn of civilization, promoting adaptation to social rules, defining cultural meaning systems, teaching daily living skills, and providing the material background against which children developed; still, the recent reformulation in the role of the father requires theory-building. Paternal caregiving is rare in mammals, occurring in 3-5% of species, expresses in multiple formats, and involves flexible neurobiological accommodations to ecological conditions and active caregiving. Here, we discuss father contribution to resilience across development. Our model proposes three tenets of resilience - plasticity, sociality, and meaning - and discussion focuses on father-specific contributions to each tenet at different developmental stages; newborn, infant, preschooler, child, and adolescent. Father's style of high arousal, energetic physicality, guided participation in daily skills, joint adventure, and conflict resolution promotes children's flexible approach and social competence within intimate bonds and social groups. By expanding children's interests, sharpening cognitions, tuning affect regulation, encouraging exploration, and accompanying the search for identity, fathers support the sense of meaning, enhancing the human-specific dimension of resilience. We end by highlighting pitfalls to paternal contribution, including absence, abuse, rigidity, expectations, and gender typing, and the need to formulate novel theories to accommodate the "involved dad."

Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany

BACKGROUND

Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity.

OBJECTIVES

Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations.

METHOD

A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators.

RESULTS

Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses.

CONCLUSIONS

This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.

Beyond a deficit-based approach: Characterizing typologies of assets for cisgender and transgender female sex workers and their relationship with syndemic health outcomes

Female sex workers (FSWs) live and work at the intersection of multiple marginalized identities that place them at greater risk for various negative health outcomes. Resilience theory asserts that an individual or community needs assets from which they can draw in response to stressors, such as chronic discrimination and abuse. This study characterizes and compares patterns of assets among cisgender and transgender FSWs living with HIV in the Dominican Republic and their relations with syndemic health outcomes. With Latent Class Analysis, we used companion cross-sectional datasets comprised of cisgender and transgender FSWs (N = 211 and 100, respectively) to estimate typologies of interpersonal, community, and institutional assets. We used multivariate logistic regression to model the relationship between class membership and HIV care and treatment, mental health, violence exposure, and substance use outcomes, respectively. Among cisgender FSWs, we identified three classes: Internal and External Multilevel Assets (Class 1); External Institutional Assets (Class 2); and Low Reported Assets (Class 3). Compared to Class 3, Class 1 membership among cisgender FSWs was significantly associated with ART adherence and marginally associated with viral suppression, and Class 2 membership was marginally associated with currently taking ART. We identified two classes in the transgender sample: Internal and External Multilevel Assets (Class 1) and External Institutional Assets (Class 2). Class 1 membership among transgender FSWs was significantly associated with ART adherence and marginally associated with current ART use and physical or sexual violence, compared to Class 2. Having a variety of assets may explain the ability of some FSWs to more effectively engage with healthcare and maintain their HIV medication regimen. Future interventions should seek to expand FSWs' interpersonal and community assets, both from within and outside of the sex worker community, to bolster their ability to care for themselves and their community.

Burnout, coping and resilience of the cancer care workforce during the SARS-CoV-2: A multinational cross-sectional study

PURPOSE

Over the past year, the SARS-CoV-2 pandemic has significantly increased the demand placed on health care professionals around the world. The already complex cancer care has been complicated further by the restructuring of services (e.g., working processes, treatment allocation). This study was designed to explore the level of burnout, coping and resilience of the cancer care workforce during SARS-CoV-2.

METHODS

Cross-sectional, multinational study undertaken between March-May 2021. In total 271 healthcare professionals were recruited in the study. These were specialized and/or working in the oncology sector from around the globe. Data were collected with an online survey with the Connor-Davidson Resilience Scale, Brief-COPE (Coping Orientation to Problems Experienced) Scale and The Maslach 's Burnout Inventory.

RESULTS

The majority of the participants were cancer nurses followed by oncologists. The mean overall Burnout score was 64.86 (SD 17.15), the overall COPE score was 31.72 (SD 12.39) and the overall Resilience score was 69.48 (SD 12.4). Positive correlations were found between the COPE dimensions and the burnout overall score (0.316, 0.388, 0.398). The burnout overall score was negatively correlated with the resilience score (p -0.126).

CONCLUSION

The findings showed significand levels of burnout, diminished coping abilities and reduced resilience among cancer care professionals. This study emphasizes the need for a timely and appropriate preparation of the healthcare systems to better support cancer care professionals in the event of a new SARS-CoV-2 healthcare emergency.

The interrelations between psychological outcome trajectories and resource changes amid large-scale disasters: A growth mixture modeling analysis

Currently little is known about the interrelations between changes in psychiatric symptoms and changes in resources (personal, social, financial) amid large-scale disasters. This study investigated trajectories of psychiatric symptoms and their relationships with different patterns of changes in personal, social, and financial resources between 2020 and 2022 amid the COVID-19 pandemic. A population-representative sample (N = 1333) was recruited to complete self-report instruments at the pandemic's acute phase (February-July 2020, T1), and again at 1-year (March-August 2021, T2) and 1.5-year (September 2021-February 2022, T3) follow-ups. Respondents reported depressive and anxiety symptoms, self-efficacy, perceived social support, and financial capacity. Growth mixture modeling (GMM) identified four trajectories of depressive and anxiety symptoms: resilience (72.39-74.19%), recovery (8.40-11.93%), delayed distress (7.20-7.35%), and chronic distress (8.33-10.20%). Four patterns were demonstrated in resource changes: persistent high resources (40.89-47.64%), resource gain (12.08-15.60%), resource loss (6.30-10.43%), and persistent low resources (28.73-36.61%). Loss and gain in financial resources characterized chronic distress and resilience, respectively. Loss in personal resources characterized delayed distress, whereas loss or no gain in social resources was related to chronic/delayed distress. Respondents in resilience were also more likely to have persistent high resources while those with delayed/chronic distress were more likely to have persistent low resources. These results provide an initial evidence base for advancing current understanding on trajectories of resilience and psychopathology in the context of resource changes during and after large-scale disasters.

Operationalizing a Structural Vulnerability Profile for forensic anthropology: Skeletal and dental biomarkers of embodied inequity

Human societies create and maintain structures in which individuals and groups experience varying degrees of inequity and suffering that may be skeletally and dentally embodied. It is necessary to foreground these social and structural impacts for forensic anthropologists to eschew biologically deterministic interpretations of human variation and overly individualistic interpretations of health and disease. We thus propose a 'Structural Vulnerability Profile' (SVP), akin to the Structural Vulnerability Assessment Tool of medical anthropology [1], to be considered along with the traditional 'biological' profile estimated by forensic anthropologists. Assembling an SVP would involve examining and assessing skeletal/dental biomarkers indicative of embodied social inequity-the lived experiences of social marginalization that can get 'under the skin' to leave hard-tissue traces. Shifting our emphasis from presumably hereditary variation to focus on embodied social marginalization, the SVP will allow forensic anthropologists to sensitively reconstruct the lived experiences of the people we examine.

Addressing the mental health needs and burdens of children fleeing war: a field update from ongoing mental health and psychosocial support efforts at the Ukrainian border

Background: The ongoing horrors of the war in Ukraine have led to enormous consequences: loss of life, severe injuries, and mass movements of civilians. Exposure to war, living in conflict zones, and forced displacement increase the risk of experiencing a broad spectrum of direct and indirect burdens towards physical and mental health, in particular among children. Objective: This letter to the editor aims to provide multiple clinical and 'mental health and psychosocial support' (MHPSS) systems' perspectives by experts working in ongoing aid efforts to bridge and disseminate their current observations towards child and adolescent mental health services involved in the mental health response to the current war in Ukraine. Results and Discussion: The diverse perspectives from three mental health professionals involved in the MHPSS response highlight the different burdens and needs of children being confronted with situations of an existential nature. Children live through transformed social situations, deteriorated life conditions, general uncertainty, and encounter numerous losses. As such, war is the ultimate non-normative and existential stressor. The four perspectives highlight the need to: (1) adjust help toward the needs of the beneficiary, (2) understand help efforts as intersubjective human encounters and enable parents and caregivers in these encounters, (3) recognise losses and embrace finding ways to facilitate grief, and (4) continue to address these needs in a coordinated way that follows inter-agency guidelines. Conclusion: Better understanding the needs of refugee children underlines the importance of investing in their future by providing resources for humanitarian aid and psychosocial interventions during sustained emergencies. The perspectives presented in this letter emphasise that psychosocial care is deeply rooted in intersubjective help-encounters and, therefore, a professionalisation of interventions should co-occur with their humanisation and be adapted to subjective needs, varying sociocultural backgrounds, and the individuals themselves with the goal of reducing suffering and fostering well-being.

HIGHLIGHTS

The three expert humanitarian aid perspectives highlight the need to: adjust help toward the needs of the beneficiary,understand help efforts as intersubjective human encounters and enable parents and caregivers in these encounters,recognise losses and embrace finding ways to facilitate grief, andcontinue to address these needs in a coordinated way that follows inter-agency guidelines.

What does community resilience mean in the context of trauma-informed communities? A scoping review

Several communities are implementing trauma-informed, community-level approaches focused on addressing/preventing adverse childhood experiences (ACEs), yet most community resilience definitions from published articles are based on acute traumas. This scoping review aims to determine how community resilience is defined and operationalized within the context of chronic/complex traumas.

METHODS

We performed a rigorous, comprehensive literature search using multiple databases.

RESULTS

The 38 included articles addressed multiple types of chronic traumas, including historical trauma, poverty, minority stress, mass incarceration, and ACEs. A variety of definitions of community resilience were cited, several of which stressed the ability to thrive despite risk factors and the safety and wellbeing of residents. Few articles operationalized community resilience within the context of ACEs, suggesting significant gaps in the literature.

CONCLUSION

This review can serve as an important building block to develop expanded definitions of community resilience for chronic traumas and assist communities in promoting community-wide responses to ACEs.

Defining and analyzing health system resilience in rural jurisdictions

Rural areas face well known and distinctive health care challenges that can limit their resilience in the face of health emergencies such as the COVID-19 pandemic. These include problems of sparsity and consequent limited health care provisioning; poverty, inequalities, and distinctive economic structures that limit access to health care; and underlying population health risks and inequalities that can increase vulnerability. Nonetheless, not all rural areas face the same problems, and non-rural areas can have challenges. To be useful in influencing policy, a tool to identify more and less resilient areas is necessary. This Commentary reviews key forms of risk and constructs a county-level index of resilience for the United States which helps to identify countries with limited resilience. Further, it argues that health care resilience should be conceptualized in terms of broader regions than counties since health care facilities' referral regions are larger than individual counties; resilience needs to be understood at that level. The index, read at the level of counties and referral regions, can contribute to identification of immediate problems as well as targets for longer term investment and policy response.

The Wither or Thrive Model of Resilience: an Integrative Framework of Dynamic Vulnerability and Resilience in the Face of Repeated Stressors During the COVID-19 Pandemic

During the first 2 years of the COVID-19 pandemic, empirical efforts in the psychological sciences have been unequivocally focused on understanding the psychosocial impact on resilience and vulnerability. While current empirical work is guided by different existing theoretical models of resilience and vulnerability, the emerging datasets have also pointed to a necessity for an update of these models. Due to the unique features and developments specific to the current pandemic such as the occurrence of repeated collective stressors of varying durations, in the current position paper, we introduce the Wither or Thrive model of Resilience (With:Resilience). It integrates key aspects of prevailing psychological resilience frameworks within the context of the COVID-19 pandemic, and extends them by (1) moving away from single scale approaches towards a higher-order latent expression of resilience and vulnerability incorporating also non-clinical mental health markers, (2) proposing different trajectories of resilience-vulnerability emerging across repeated stressors over long periods of time, and (3) by incorporating multiple influencing factors including aspects of the socio-economic concept of social cohesion as well as separate mediating processing mechanisms. We propose that With:Resilience will enable a more nuanced approach and appropriate analytical investigation of the vast incoming data on mental health and resilience during the COVID-19 pandemic, and we suggest some concrete methodological approaches. This framework will assist in the development of actionable public health guidelines for society in the present and future pandemic contexts as well as aid policy making and the interventional sciences aimed at protecting the most vulnerable amongst us.

Development and validation of a multidimensional, culturally and socially inclusive Child Resilience Questionnaire (parent/caregiver report) to measure factors that support resilience: a community-based participatory research and psychometric testing study in Australia

OBJECTIVE

Develop a comprehensive socially inclusive measure to assess child resilience factors.

DESIGN

A socioecological model of resilience, community-based participatory research methods and two rounds of psychometric testing created the Child Resilience Questionnaire (parent/caregiver report, child report, school report). The parent/caregiver report (CRQ-P/C) is the focus of this paper.

SETTING

Australia.

PARTICIPANTS

Culturally and socially diverse parents/caregivers of children aged 5-12 years completed the CRQ-P/C in the pilot (n=489) and validation study (n=1114). Recruitment via a large tertiary hospital's outpatient clinics, Aboriginal and refugee background communities (Aboriginal and bicultural researchers networks) and nested follow-up of mothers in a pregnancy cohort and a cohort of Aboriginal families.

ANALYSIS

Exploratory and confirmatory factor analyses conducted to assess the structure and construct validity of CRQ-P/C subscales. Cronbach's alpha used to assess internal consistency of subscales. Criterion validity assessed with the Strengths and Difficulties Questionnaire (SDQ) parent report.

RESULTS

Conceptually developed CRQ comprised 169 items in 19 subscales across five socioecological domains (self, family, friends, school and community). Two rounds of psychometric revision and community consultations created a CRQ-P/C with 43 items in 11 scales: self (positive self, positive future, managing emotions), family (connectedness, guidance, basic needs), school (teacher support, engagement, friends) and culture (connectedness, language). Excellent scale reliability (α=0.7-0.9), except basic needs scale (α=0.61) (where a highly endorsed item was retained for conceptual integrity). Criterion validity was supported: scales had low to moderate negative correlations with SDQ total difficulty score (R_s= -0.2/-0.5. p<0.001); children with emotion/behavioural difficulties had lower CRQ-P/C scores (β=-14.5, 95% CI -17.5 to -11.6, adjusted for gender).

CONCLUSION

The CRQ-P/C is a new multidomain measure of factors supporting resilience in children. It has good psychometric properties and will have broad applications in clinical, educational and research settings. The tool also adds to the few culturally competent measures relevant to Aboriginal and refugee background communities.

Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches

The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.

The Importance of Spiritual Consumption, Religious Expression and Subjective Well-Being among Christians in the US during COVID-19

Uncertainty, fear, and distress have become prevalent in the lives of U.S. residents since the beginning of the COVID-19 pandemic. The unpredictable reality of social distancing, shutdowns, and isolation have affected daily routines and influenced well-being and health. Drawing on consumer culture theory, we conducted an exploratory study to examine the mediating role of consumer spirituality in the subjective well-being of religious Christians during COVID-19 and to discover links between well-being and health outcomes. Participants from the United States (n = 104) were recruited via a Qualtrics' online panel. Findings show that religiosity among Christians enhanced subjective well-being, demonstrating the positive effect of religious beliefs, especially during the COVID-19 pandemic. However, spiritual consumption mediated this relationship, suggesting the importance of possessions to religious expression and subjective well-being. Implications for messaging about health and well-being are discussed.

Flourishing Beyond Borders: Facilitating the Well-Being of Accompanying Expatriate Partners

One of the leading causes for failing at expatriate assignments is the accompanying expatriate partners’ (AEPs) unhappiness with life abroad or inability to adjust to the challenges of the host country. Strength-based therapeutic interventions have the potential to increase individuals’ mental health and well-being. The current study formed part of a multimethod study consisting of three related but independent sub-studies. The first sub-study identified the strengths of Gratitude, Curiosity and Hope to be positively associated with AEPs’ resilience and well-being. These results were used to construct a quantitative model that illustrates the interplay between these constructs. In the second sub-study, the proposed model was qualitatively reviewed by a smaller group of AEPs to inform and enrich our understanding of AEPs’ personal experiences of these constructs. In the current study, a panel of practicing psychologists who provide counselling services for South African expatriates and AEPs were asked to qualitatively review a proposed quantitative model. A cross-sectional, interpretive descriptive research design, applying purposive sampling was used to identify and recruit participants. The objective for the current study was firstly to ascertain why participants thought strengths of Gratitude, Curiosity and Hope featured so prominently in the model. Secondly, the study aimed to determine how these participants would, from their experience in working with AEPs, enhance these strengths and AEPs’ resilience in therapy, and ultimately facilitate greater well-being and successful adjustment abroad. Participants completed an online questionnaire consisting of two semi-structured, open-ended questions. The data were analyzed using primary and secondary cycle coding to ultimately develop themes. Results indicated that strengths of Curiosity, Gratitude and Hope featured prominently because these strengths include elements that form part of the process of expatriation. Participants were able to suggest practical strength-based therapeutic techniques which would assist in enhancement of strengths, resilience and ultimately well-being. It is proposed that the therapeutic techniques and approaches suggested in this study could contribute to the success rate of expatriate assignments.

Interparental conflict and depressive symptoms among Chinese adolescents: A longitudinal moderated mediation model

While the detrimental effect of interparental conflict on adolescent depression is well-established, the underlying mechanisms linking the two continue to be inadequately understood. This study investigated the mediating role of family functioning and the moderating role of cultural beliefs about adversity in the association between interparental conflict and adolescent depression. The samples included 651 Chinese adolescents (mean age at Time 1 = 13.27 years; 56.5% girls) from a two-wave longitudinal study with data spanning 1 year. The findings from path modeling analyses provided evidence for the mediating role of family functioning; these findings indicated that interparental conflict can damage family functioning, which in turn exacerbates the risk of adolescent depression. The moderating role of cultural beliefs about adversity was also demonstrated by interactions between interparental conflict and cultural beliefs about adversity, as well as, family functioning and cultural beliefs about adversity. The results indicated a buffering role of cultural beliefs about adversity on the deleterious effect of interparental conflict on adolescent depression. They also suggested that lower levels of family functioning was associated with increased depression among adolescents were lower in cultural beliefs about adversity.

Positioning resilience science more centrally in affirming LGBTIQA+ persons and communities

Historically, in psychology, there was a tendency towards focusing on the individual and intrapsychic pathologisation of LGBTIQA+ persons. Despite a recent shift to affirmative, systemic, interpersonal, and contextual stances, too much emphasis in South African LGBTIQA+ scholarly work remains on adversity. Adversity derived from historical tensions may have accelerated adaptive problem-solving capabilities and solution-focused behaviours in some LGBTIQA+ populations. Certain solutions have generated creative resilience responses inexorably situated in race, ethnicity, culture, religion, gender, history, political oppression, and social class. Resilience science that has similarly evolved from the individual trait conceptualisation may have an important complementary contribution to make in affirming LGBTIQA+ persons and communities and enhancing the understanding of their resilience. Exploring resilience for wellbeing and survival addresses the infinite streams of human experiences of vulnerability and sustainable adaptive solutions. The multisystemic resilience perspective in this article endeavours to summarise current thinking in resilience science and position its applicability to future South African LGBTIQA+ scholarly work, building on existing systematic and critical reviews relating to the resilience of LGBTIQA+ persons. The aim of this position piece, suggesting the expansion of a ‘resilience’ frame, is to offer an important intervention in the overarching ways in which South African scholars and psychology professionals theorise and conduct research; to inform therapeutic and other psychological services to LGBTIQA+ persons and provide an important counterweight to the more general focus in South African LGBTIQA+ scholarship and psychological practice on adversity.

Reliability and Confirmatory Factor Analysis (CFA) of a Paper- Versus App-Administered Resilience Scale in Scottish Youths: Comparative Study

Background

Adequately measuring resilience is important to support young people and children who may need to access resources through social work or educational settings. A widely accepted measure of youth resilience has been developed previously and has been shown to be suitable for vulnerable youth. While the measure is completed by the young person on paper, it has been designed to be worked through with a teacher or social worker in case further clarification is required. However, this method is time consuming and, when faced with large groups of pupils who need assessment, can be overwhelming for schools and practitioners. This study assesses app software with a built-in avatar that can guide young persons through the assessment and its interpretation.

Objective

Our primary objective is to compare the reliability and psychometric properties of a mobile software app to a paper version of the Child and Youth Resilience measure (CYRM-28). Second, this study assesses the use of the CYRM-28 in a Scottish youth population (aged 11-18 years).

Methods

Following focus groups and discussion with teachers, social workers, and young people, an avatar was developed by a software company and integrated into an android smartphone app designed to ask questions via the device’s inbuilt text-to-voice engine. In total, 714 students from 2 schools in North East Scotland completed either a paper version or app version of the CYRM-28. A cross-sectional design was used, and students completed their allocated version twice, with a 2-week period in between each testing. All participants could request clarification either from a guidance teacher (paper version) or from the in-built software glossary (app version).

Results

Test and retest correlations showed that the app version performed better than the paper version of the questionnaire (paper version: r₃₀₃=0.81; P<.001; 95% CI 0.77-0.85; app version: r₄₁₃=0.84; P<.001; 95% CI 0.79-0.89). Fisher r to z transformation revealed a significant difference in the correlations (Z=–2.97, P<.01). Similarly, Cronbach α in both conditions was very high (app version: α=.92; paper version: α=.87), suggesting item redundancy. Ordinarily, this would lead to a possible removal of highly correlated items; however, our primary objective was to compare app delivery methods over a pen-and-paper mode and was hence beyond the scope of the study. Fisher r to z transformation revealed a significant difference in the correlations (Z=–3.69, P<.01). A confirmatory factor analysis supported the 3-factor solution (individual, relational, and contextual) and reported a good model fit (χ²₁₅=27.6 [n=541], P=.24).

Conclusions

ALEX, an avatar with an integrated voice guide, had higher reliability when measuring resilience than a paper version with teacher assistance. The CFA reports similar structure using the avatar when compared against the original validation.

Love and peace across generations: Biobehavioral systems and global partnerships

Children's environments - especially relationships with caregivers - sculpt not only developing brains but also multiple bio-behavioral systems that influence long-term cognitive and socioemotional outcomes, including the ability to empathize with others and interact in prosocial and peaceful ways. This speaks to the importance of investing resources in effective and timely programs that work to enhance early childhood development (ECD) and, by extension, reach communities at-scale. Given the limited resources currently devoted to ECD services, and the devastating impact of COVID-19 on children and communities, there is a clear need to spur government leaders and policymakers to further invest in ECD and related issues including gender and racial equity. This essay offers concrete examples of scholarly paradigms and leadership efforts that focus on child development to build a peaceful, equitable, just, and sustainable world. As scholars and practitioners, we need to continue to design, implement, assess, and revise high-quality child development programs that generate much-needed evidence for policy and programmatic changes. We must also invest in global partnerships to foster the next generation of scholars, practitioners, and advocates dedicated to advance our understanding of the bio-behavioral systems that underlie love, sociality, and peace across generations. Especially where supported by structural interventions, ECD programs can help create more peaceful, just, and socially equitable societies.

The Disaster Adaptation and Resilience Scale: development and validation of an individual-level protection measure

Given the increasing threat of disasters in the United States and elsewhere around the world, well-tested assessment tools that operationalise specific protective factors associated with adaptation and resilience to such events are needed. Consequently, the authors proposed, developed, and validated the Disaster Adaptation and Resilience Scale (DARS) to measure five domains found to support adaptive responses in individuals exposed to disasters: physical resources; social resources; problem-solving; distress regulation; and optimism. The development and validation processes of DARS occurred across two studies: the first comprised construct development, item generation, and expert review, whereas the second involved a full validation evaluation of the psychometric properties of the scale in a sample of adults exposed to a disaster in the US (N=625). The results revealed that DARS had psychometric properties that support its use among adults experiencing a disaster. A discussion is presented on how the scale can be employed in both research and practice.

From Theory to Patient Care: A Model for the Development, Adaptation, and Testing of Psychosocial Interventions for Patients With Serious Illness

Psychosocial and supportive care interventions are a cornerstone of palliative care science, yet there is little published guidance regarding how to develop, test, adapt, and ultimately disseminate evidence-based interventions. Our objective was to describe the application of a single intervention-development model in multiple populations of patients with serious illness. Specifically, we use the "Promoting Resilience in Stress Management" (PRISM) intervention as an exemplar for how the Obesity Related Behavioral Intervention Trials (ORBIT) intervention-development model may be applied to: 1) create an initial palliative care intervention; 2) adapt an existing intervention for a new patient-population; 3) expand an existing intervention to include new content; and, 4) consider dissemination and implementation of a research-proven intervention. We began by identifying key psychological and social science theories and translating them a testable clinical hypothesis. Next, we conducted observational studies and randomized trials to design, refine, and standardize PRISM within unique patient-populations. We moved backwards in the ORBIT model when necessary to adapt or expand PRISM content and delivery-strategies to meet patient-reported needs. Finally, we began to explore PRISM's effectiveness using Dissemination and Implementation research methods. Key lessons include the need to ground intervention-development in evidence-based theory; involve patient, clinician, and other stakeholders at every phase of development; "meet patients where they are at" with flexible delivery strategies; invest in the time to find the right scientific premise and the right intervention content; and, perhaps most importantly, involve an interdisciplinary research team.

Identifying Risk and Resilience Factors Impacting Mental Health among Black and Latinx Adults following Nocturnal Tornadoes in the U.S. Southeast

Prior research has found that Black and Latinx communities in the U.S. face significant disparities that impact both preparedness for severe weather events and the support received after a disaster has occurred. In the current study, we examined key risk and protective factors that impacted mental health among 221 Black and Latinx adult respondents exposed to the 2–3 March 2020 nocturnal tornado outbreak in the U.S. state of Tennessee. Key factors that adversely affected mental health among participants were encountering barriers for receiving tornado warning alerts and tornado-related exposure. Key factors that served a protective mechanism against adverse mental health included having access to physical resources, supportive relationships, and adaptive coping skills. These findings may assist National Weather Service (NWS) personnel, emergency managers, and mental health providers with the development of policies and practices to address barriers and promote protective strategies for future nocturnal tornado events.

Building Resilience Through Sport in Young People With Adverse Childhood Experiences

Interventions focused on young people at risk of anti-social and criminal behaviour frequently involve physical exercise and/or participation in sporting activities as a primary vehicle to bring about behavioural change in both the short to medium term. Anecdotal evidence suggests that sporting activities positively influence individual well-being alongside a sense of purpose and belonging centred around sporting clubs and activities. Empirically, participation in sport has been identified as a key resilience factor for young people with numerous Adverse Childhood Experiences (ACEs) and investment and policy initiatives target investment in these opportunities. However, the psychological mechanisms which underpin these improvements in well-being and building of resilience are less clearly articulated. This article will review current and developing research in this field to synthesise future applications of sport-related interventions with young people, with a particular emphasis on furthering understanding of the pathways to capacity building at individual and community level which sport and exercise can generate.

Resilience in Adult Health Science Revisited-A Narrative Review Synthesis of Process-Oriented Approaches

Purpose: This article aims to identify how the term “resilience” is addressed in adult health science due to ongoing criticism about the lack of consistency in its conceptualization.

Method: Two databases (PubMed and PsycArticles) were searched to retrieve reviews published from 2015 up until 2020 on the general conceptualization of resilience. All reviews had to meet specific inclusion criteria, which resulted in the inclusion of 18 articles. After discussing different conceptualizations regarding the process-oriented approach of resilience in adult health research, we will highlight some mechanisms that are supposed to be involved in the resilience process.

Results: Research on resilience in health sciences confronts three core difficulties: defining positive outcome for a processual construct, describing different trajectories within the process, and identifying mechanisms that mediate resilience.

Conclusion: The definition of resilience in mental health research as a multidimensional adaptation process is widely accepted, and multiple research paradigms have contributed to a better understanding of the concept. However, the definition of a processual construct in a way that allows for high expert consensus and a valid operationalization for empirical studies remains a challenge. Future research should focus on the assessment of multiple cross-domain outcomes and international and interdisciplinary prospective mixed-method longitudinal designs to fill in the missing links.

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.

Intergenerational transmission and prevention of adverse childhood experiences (ACEs)

In recent years, research and practice on adverse childhood experiences (ACEs) have shifted from delineating effects of ACEs on adulthood health problems to preventing ACEs in children. Nonetheless, little attention has focused on how parents' own childhood experiences, adverse or positive, may influence the transmission of ACEs across generations. Children's risk for ACEs and potential for resilience may be linked to the early child-rearing experiences of their parents carried forward into parenting practices. Additionally, parents with multiple ACEs may have PTSD symptoms, an under-recognized mediator of risk in the intergenerational transmission of ACEs. Guided by developmental psychopathology and attachment theory with an emphasis on risk and resilience, we argue that a more comprehensive understanding of parents' childhood experiences is needed to inform prevention of ACEs in their children. Part I of this review applies risk and resilience concepts to pathways of intergenerational ACEs, highlighting parental PTSD symptoms as a key mediator, and promotive or protective processes that buffer children against intergenerational risk. Part II examines empirical findings indicating that parents' positive childhood experiences counteract intergenerational ACEs. Part III recommends clinically-sensitive screening of ACEs and positive childhood experiences in parents and children. Part IV addresses tertiary prevention strategies that mitigate intergenerational ACEs and promote positive parent-child relationships.

Peer victimisation during adolescence and its impact on wellbeing in adulthood: a prospective cohort study

Background

Peer victimisation is a common occurrence and has well-established links with a range of psychiatric problems in adulthood. Significantly less is known however, about how victimisation influences positive aspects of mental health such as wellbeing. The purpose of this study was therefore to assess for the first time, whether peer victimisation in adolescence is associated with adult wellbeing. We aimed to understand whether individuals who avoid a diagnosis of depression after victimisation, maintain good wellbeing in later life, and therefore display resilience.

Methods

Longitudinal data was taken from the Avon Longitudinal Study of Parents and Children, a prospective cohort study based in the UK. Peer victimisation was assessed at 13 years using a modified version of the bullying and friendship interview schedule, and wellbeing at age 23 using the Warwick-Edinburgh Mental Well-Being Scale. The presence or absence of depression was diagnosed using the Clinical Interview Schedule–Revised at 18 years. A series of logistic and linear regression analyses were used to explore relationships between peer victimisation, depression, and wellbeing, adjusting for potentially confounding individual and family factors.

Results

Just over 15% of victims of frequent bullying had a diagnosis of depression at age 18. Victimisation also had a significant impact on wellbeing, with a one-point increase in frequent victimisation associated with a 2.71-point (SE = 0.46, p < 0.001) decrease in wellbeing scores aged 23. This finding remained after adjustment for the mediating and moderating effects of depression, suggesting that the burden of victimisation extends beyond depression to impact wellbeing. Results therefore show that individuals who remain partially resilient by avoiding a diagnosis of depression after victimisation have significantly poorer wellbeing than their non-victimised counterparts.

Conclusion

Overall, our study demonstrates for the first time that victimisation during adolescence is a significant risk factor for not only the onset of depression, but also poor wellbeing in adulthood. Such findings highlight the importance of investigating both dimensions of mental health to understand the true burden of victimisation and subsequent resilience. In addition to the need for interventions that reduce the likelihood of depression following adolescent victimisation, efforts should also be made to promote good wellbeing.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10198-w.

Developmental Risks in Vulnerable Children from a Low-Income South African Community

OBJECTIVE

To describe the developmental risks, and its influence, in young children from a low-income South African community.

METHOD

An exploratory, cross-sectional research study design was employed. Developmental screening was conducted during home visits with 126 caregivers and children between 0 and 42 months of age from a low-income South African community. Children who failed the rescreen were referred for diagnostic assessment. A binomial logistic regression was used to determine the effect of developmental risks on developmental outcomes.

RESULTS

Seventy-three percent of children screened were identified with a possible developmental delay (n = 59) according to caregiver-report using the PEDS tools. The regression model was statistically significant (χ² (3) = 34.902, p < 0.001) with exposure to multiple languages (p < 0.05; odds ratio 3.810, CI 1.2-12.4) most indicative of potential developmental delay. Older children (19-42 months) were also more at risk of developmental delay (p < 0.001) than younger children (0-18 months).

CONCLUSIONS FOR PRACTICE

Healthcare professionals serving these vulnerable populations should create awareness amongst caregivers about the effect of developmental risks, in particularly multiple language exposure, on development.

Biocultural approaches to transgender and gender diverse experience and health: Integrating biomarkers and advancing gender/sex research

Transgender and gender diverse (TGD) people are increasingly visible in U.S. communities and in national media. With this increased visibility, access to gender affirming healthcare is also on the rise, particularly for urban youth. Political backlash and entrenchment in a gender binary, however, continue to marginalize TGD people, increasing risk for health disparities. The 2016 National Institute of Health recognition of sexual and gender minority people as a health disparities population increases available funding for much-needed research. In this article, we speak to the need for a biocultural human biology of gender/sex diversity by delineating factors that influence physiological functioning, mental health, and physical health of TGD people. We propose that many of these factors can best be investigated with minimally invasively collected biomarker samples (MICBS) and discuss how to integrate MICBS into research inclusive of TGD people. Research use of MICBS among TGD people remains limited, and wider use could enable essential biological and health data to be collected from a population often excluded from research. We provide a broad overview of terminology and current literature, point to key research questions, and address potential challenges researchers might face when aiming to integrate MCIBS in research inclusive of transgender and gender diverse people. We argue that, when used effectively, MICBS can enhance human biologists' ability to empirically measure physiology and health-related outcomes and enable more accurate identification of pathways linking human experience, embodiment, and health.

Predictors of child resilience in a community-based cohort facing flood as natural disaster

BACKGROUND

Natural disasters are unpredictable and uncontrollable events that usually induce significant level of stress and social disruption in afflicted individuals. The consequences are formidable, affecting lifetime health and economic prosperity. Among natural disasters, floods are the most common causes and tend to have the highest economic burden. The aim of this study was to examine factors associated with child resilience in the face of the natural disaster experienced by the city of Calgary, Alberta, Canada during its unprecedented flood of 2013.

METHODS

The current study was conducted in a community-based cohort situated in the city of Calgary. The participants were recruited out of the All Our Families longitudinal cohort within the Cummings School of Medicine at the University of Calgary. Of the total 1711 people contacted, 469 people consented and completed questionnaire. Of those 469 who consented to be part of the study, 467 were eligible to be included for analysis. A flood impact questionnaire was delivered 6 months after the 2013 flood in families whose children were an average of 3 years old. Mother reported questionnaires were used to assess child resilience. The study included maternal data on a range of factors including socio-demographic, history of mental health, relationship with the partner and social support. Child related data were also incorporated into the study, and variables included delivery mode, child sex, and child age at the time of disaster.

RESULTS

Child resilience was best predicted by mother's age and social support, and by child gender, the child's externalizing and internalizing behaviors and the Rothbart temperament scale: effortful control. Furthermore, this study revealed that children who were more exposed to the flood events, showed higher resilience compared to the children who were less or not exposed.

CONCLUSIONS

These findings highlight the risk and protective factors that predict child resilience and suggest that mother reported questionnaire are useful tools to assess child resilience amidst early life adversity.

How to become more grateful? The mediating role of resilience between empathy and gratitude

The current study examined the relationship between empathy, resilience, and gratitude. Specifically, the study investigated the potential mediating role of resilience between empathy and gratitude. The study involved 214 participants who completed the Gratitude Resentment and Appreciation Test-Revised (GRAT-R), the Questionnaire of Cognitive and Affective Empathy (QCAE), and the Resilience Measurement Scale (SPP-25). The results showed significant positive correlations among resilience, empathy, and gratitude. Multiple regression analysis confirmed that resilience, gender, and affective empathy were direct predictors of the level of gratitude. Structural equation modeling (SEM) analysis supported the hypothesis that resilience played a mediating role between empathy and gratitude. Implications for research and the promotion of positive psychology programs for adults are discussed.

When my four-year-old got cancer: a retrospective on resilience in a paediatric oncology ward

The author presents an interpersonal experience between the author and her son during childhood cancer treatment and care, illustrating the complex relationship between childhood cancer and the term 'resilience'. During treatment and care, nurses used the term 'resilience' in an apparent attempt to reassure her. However, the author found that the concept distanced her from her and her son's experience, creating emotional distress for him. She discovered that the everyday use of resilience, devoid of its research connotations, has the potential to create barriers in understanding these experiences for the patient and the caregiver. For example, this everyday use did not account for the relationship that resilience has with growth. It is not just important in terms of diagnosing a tumour, it is also important for supporting the agency of a child and the cultivation of trustworthiness. A focus on growth supports the notion of an "active resilience," a process informed by research literature to help medical staff and families develop the child patient's capability for growing into resilience throughout the survivorship experience. By neglecting this relationship with growth, resilience was found to silence the agency and voice of the author's child which added to the difficulty that she had in providing care. As more children survive cancer, a meaningful use of the term resilience can support their recovery from the adversities of treatment and a life of adverse outcomes. The ethnographic detail provides the context necessary for contributing to and unpacking the normative use of the term resilience in paediatric oncology.

Examining Multilevel Factors Associated with the Process of Resilience among Women Living with HIV in a Large Canadian Cohort Study: A Structural Equation Modeling Approach

Objectives:

We examined how multiple, nested, and interacting systems impact the protective process of resilience for women living with HIV (WLWH).

Methods:

Using data from a Cohort Study, we conducted univariate analyses, multivariable logistic regression, and a 2-step structural equation modeling for the outcome, high resilience (N = 1422).

Results:

Participants reported high overall resilience scores with a mean of 62.2 (standard deviation = 8.1) and median of 64 (interquartile range = 59-69). The odds of having high resilience were greater for those residing in Quebec compared to Ontario (adjusted odds ratio [aOR] = 2.1 [1.6, 2.9]) and British Columbia (aOR = 1.8 [1.3, 2.5]). Transgender women had increased odds of high resilience than cisgender women (aOR = 1.9 [1.0, 3.6]). There were higher odds of resilience for those without mental health diagnoses (aOR = 2.4 [1.9, 3.0]), non-binge drinkers (aOR=1.5 [1.1, 2.1]), and not currently versus previously injecting drugs (aOR = 3.6 [2.1, 5.9]). Structural equation modeling confirmed that factors influencing resilience lie at multiple levels: micro, meso, exo, and macro systems of influence.

Conclusion:

There is a need to consider resilience as the interaction between the person and their environments, informing the development of multilevel interventions to support resilience among WLWH.

Resilience and return-to-work pain interventions: systematic review

BACKGROUND

Resilience is a developing concept in relation to pain, but has not yet been reviewed in return-to-work (RTW) contexts.

AIMS

To explore the role of resilience enhancement in promoting work participation for chronic pain sufferers, by reviewing the effectiveness of existing interventions.

METHODS

Resilience was operationalized as: self-efficacy, active coping, positive affect, positive growth, positive reinforcement, optimism, purpose in life and acceptance. Five databases were searched for randomized controlled trials (RCTs) whose interventions included an element of resilience designed to help RTW/staying at work for chronic pain sufferers. Study appraisal comprised the Cochrane risk of bias (RoB) tool and additional quality assessment. Findings were synthesized narratively and between-group differences of outcomes were reported. Heterogeneous PICO (population, intervention, comparator, outcome) elements precluded meta-analysis.

RESULTS

Thirty-four papers from 24 RCTs were included. Interventions varied; most were multidisciplinary, combining behavioural, physical and psychological pain management and vocational rehabilitation. Four found RTW/staying at work improved with intensive multidisciplinary interventions compared with less intensive, or no, treatment. Of these, one had low RoB; three scored poorly on allocation concealment and selective outcome reporting. Four trials had mixed results, e.g. interventions enabling reduced sick leave for people on short-term not long-term leave; 16 showed no improvement. Five trials reported resilience outcomes were improved by interventions but these were not always trials in which RTW improved.

CONCLUSIONS

Effectiveness of resilience interventions for chronic pain sufferers on RTW is uncertain and not as helpful as anticipated. Further agreement on its conceptualization and terminology and that of RTW is needed.

Building Wellbeing in People With Chronic Conditions: A Qualitative Evaluation of an 8-Week Positive Psychotherapy Intervention for People Living With an Acquired Brain Injury

Research indicates that Acquired Brain Injury (ABI) is associated with significant and chronic impairment across multiple areas of functioning including physical, cognitive, emotional and behavioral domains. Whilst impairments associated with ABI can be ameliorated, cure is seldom possible. The emergence of positive psychology reflects a paradigm shift in health and wellbeing research, highlighting the role of character strengths, positive emotions, meaning, and resilience. Positive psychology interventions have been demonstrated to improve wellbeing in a variety of populations, although research investigating the impact of positive psychotherapy for people living with ABI are sparse. Here we characterize the experience of an 8-week positive psychotherapy intervention for 13 people living with ABI including four mentors and nine participants using thematic analysis of transcripts collected during mini-groups and one-to-one interviews. Six main themes were identified including empowerment, social opportunity, coping, cultivation of positive emotion, consolidation of skills and barriers. Results indicated that wellbeing can be promoted and improved in individuals with ABI. Recent theoretical developments in wellbeing science highlight scope to improve the intervention by connecting individuals to their communities and spending time in nature.

Teacher Support and Mental Well-Being in Chinese Adolescents: The Mediating Role of Negative Emotions and Resilience

Teacher support has been shown to enhance adolescent mental health. However, the effects of negative emotions and resilience in the relationship between teacher support and mental well-being in adolescents are still unknown. This study investigated (a) the mediating role of negative emotions in the relationship between teacher support and mental well-being, (b) the mediating role of resilience in the association between teacher support and mental well-being, (c) the serial mediating role of negative emotions and then resilience in the relationship between teacher support and mental well-being, and (d) the parallel mediating role of the five dimensions of resilience and the three factors of negative emotions in the relationship between teacher support and mental well-being. Participants were 1228 Chinese adolescents (age, M = 15.43 years; 53.09% male). Participants filled out questionnaires regarding teacher support, negative emotions, resilience, and mental well-being. After controlling for age and gender, we found that teacher support, negative emotions, and resilience were significantly linked with mental well-being. Moreover, negative emotions and resilience were found to mediate the relationship between teacher support and adolescent mental well-being, accounting for 5.45 and 30.00% of the total effect, respectively. We also found that teacher support enhances mental well-being by decreasing negative emotions and then increasing resilience. This serial mediating effect accounted for 8.48% of the total effect. Finally, the mediating effect of resilience between teacher support and mental well-being was significantly greater than the mediating effects of the other two indirect effects (negative emotions in the relationship between teacher support and mental well-being, negative emotions and then resilience in the relationship between teacher support and mental well-being). And the parallel mediation model showed that teacher support can promote adolescent mental well-being by increasing goal planning, affect control, and help-seeking behavior, and decreasing depression. These findings suggest a process through which negative emotions can decrease resilience and identify the mediating effects of negative emotions (including the three dimensions of negative emotions) and resilience (including the five factors of resilience) in the relationship between teacher support and adolescent mental well-being.