Spirituality, Resilience and Vicarious Posttraumatic Growth Among Orthopedic Nurses in Nigeria

We examined whether the salutogenic nature of resilience is the pathway of association, as well as a moderating factor, between spirituality and vicarious posttraumatic growth (VPTG). Two hundred Nigerian orthopedic nurses completed the Resilience Scale (RS-14), Spiritual Involvement and Belief Scale-Revised (SIBS-R), and Posttraumatic Growth Inventory-Short Form (PTGI-SF). We found that greater spirituality and resilience were directly associated with high VPTG. Resilience helped to explain (mediated) the relationship between spirituality and VPT such that spirituality was linked to VPTG by virtue of high resilience. Moderation analysis indicated that resilience was most robustly associated with increased VPTG for nurses with high spirituality compared to those with moderate and low levels of spirituality. Findings may be relevant in integrative/complementary approaches to trauma work.

Youth-led co-production of mental health promotion in Pakistan: intergenerational influences

Youth with mental health needs face barriers in seeking and accessing help, especially in resource-constrained settings in Majority World Countries. Community engagement is thus important for mental health promotion, particularly in addressing stigma. Engagement can be enhanced by involving peer educators and by relating to intergenerational experiences in the sociocultural context of the community. The aim of this study was to explore how intergenerational experiences and perspectives can inform the co-production of youth-led mental health promotion in a Majority World Country, Pakistan. We recruited 11 families (one grandmother, mother and granddaughter in each family) as advisers from two disadvantaged areas of Karachi, and 14 peer educators. Training for peer educators included seminars, experiential activities, three participatory workshops with family advisers and supervision. A sub-sample of family advisers and peer educators attended four focus groups, and peer educators completed reflective diaries following each activity. Data were integrated and subjected to thematic codebook analysis. The three themes related to enabling and hindering factors towards co-production of mental health promotion, incorporation of intergenerational resilience and cascading knowledge to communities. The findings highlighted potential benefits of youth-led mental health promotion that contextualizes intergenerational experiences for those communities. Peer educator roles should be supported by training, and mental health promotion should be integrated within local service systems.

Resilience of sub-Saharan children and adolescents: A scoping review

The population of sub-Saharan children and adolescents is substantial and growing. Even though most of this population is vulnerable, there is no comprehensive understanding of the social-ecological factors that could be leveraged by mental health practitioners to support their resilience. The present study undertakes a narrative scoping review of empirical research (quantitative, qualitative, and mixed) on the resilience of children and adolescents living in sub-Saharan Africa to determine what enables their resilience and what may be distinctive about African pathways of child and adolescent resilience. Online databases were used to identify full-text, peer-reviewed papers published 2000-2018, from which we selected 59 publications detailing the resilience of children and/or adolescents living in 18 sub-Saharan countries. Studies show that the resilience of sub-Saharan children and adolescents is a complex, social-ecological process supported by relational, personal, structural, cultural, and/or spiritual resilience-enablers, as well as disregard for values or practices that could constrain resilience. The results support two insights that have implications for how mental health practitioners facilitate the resilience of sub-Saharan children and adolescents: (i) relational and personal supports matter more-or-less equally; and (ii) the capacity for positive adjustment is complexly interwoven with African ways-of-being and -doing.

The significance of feeling safe for resilience of adolescents in sub-Saharan Africa

Introduction

Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents.

Methods

Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health).

Results

This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique.

Discussion

The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.

Psychological, social, and physical ecologies for child resilience: a South African perspective

Children live in a complex world surrounded by global concerns such as climate change, economic instability, threats of terrorism and war. However, in South Africa, one may note that children face several additional challenges including high unemployment rates in families, exposure to violence, living in conditions of poverty, exposure to HIV/AIDS, and high levels of orphanhood. Compounding these problems is the economic situation in the country where the government is unable to provide adequate support for children in various domains. Understanding the mechanisms through which children successfully adapt to their environments and transition into adulthood are important to understand. Resilience research seeks to understand these mechanisms and underlying processes that enable some individuals to recover from adversity against all odds. Therefore, there is an increased movement not only toward understanding resilience processes in children, which enable them to develop into fully functional and upstanding citizens of society despite the adversities they face, but also how resilience research can be translated into practice to be used by service professionals such as psychologists, school counselors, social workers, and teachers. Adopting a socioecological understanding of resilience, the author reviews literature on the psychological, social, and physical ecologies for child resilience globally. Special emphasis is placed on the ecologies of child resilience within the African context and South Africa in particular. A socioecological perspective positions child resilience within four important levels, namely individual, relationships, community, and society. The salient features of child resilience within a South African context are discussed within the four levels highlighting the implications for interventions to promote child resilience. The implications have global value because child resilience is a phenomenon that needs global attention.

Resilience of adolescents living with HIV in the Cape Metropole of the Western Cape

Resilience shapes the experiences of adolescents living with HIV (ALWH), enabling them to come to terms with their diagnosis, have hope for the future and maintain meaningful relationships. Yet, little is known about contextual factors associated with resilience resources in South Africa. We aimed to describe individual, relational and community resilience resources, and identify contextual factors associated with resilience. We recruited 385 adolescents, aged 13-18, over a period of 5 months from 11 different public health HIV clinics. The Child and Youth Resilience Measure (CYRM-12) was used to measure resilience resources. Data on demographic variables, psychological attributes, and environmental factors such as HIV-related stigma and stressful life events were collected. ALWH lacked resilience in some aspects of the individual, relational and community domains. For every one-unit increase in the HIV-related stigma and stressful life events scores, resilience decreased by 0.29 (p = 0.01) and 0.37 (p = 0.04) units, respectively. Higher levels of resilience were associated with being virally suppressed (Mann-Whitney U, p = 0.028) although this association was no longer present in the regression model. Efforts to improve resilience amongst ALWH should be focused on fostering individual coping skills, interconnectedness, and positive relationships, to mitigate adverse environmental factors.

Youth Resilience to Drought: Learning from a Group of South African Adolescents

Exposure to drought is on the increase, also in sub-Saharan Africa. Even so, little attention has been paid to what supports youth resilience to the stressors associated with drought. In response, this article reports a secondary analysis of qualitative data generated in a phenomenological study with 25 South African adolescents (average age 15.6; majority Sepedi-speaking) from a drought-impacted and structurally disadvantaged community. The thematic findings show the importance of personal, relational, and structural resources that fit with youths' sociocultural context. Essentially, proactive collaboration between adolescents and their social ecologies is necessary to co-advance socially just responses to the challenges associated with drought.

Resilience and mental health: how multisystemic processes contribute to positive outcomes

More is known about the factors that predict mental disorder than about the factors and processes that promote positive development among individuals exposed to atypically high levels of stress or adversity. In this brief Review of the science of resilience, we show that the concept is best understood as the process of multiple biological, psychological, social, and ecological systems interacting in ways that help individuals to regain, sustain, or improve their mental wellbeing when challenged by one or more risk factors. Studies in fields as diverse as genetics, psychology, political science, architecture, and human ecology are showing that resilience depends just as much on the culturally relevant resources available to stressed individuals in their social, built, and natural environments as it does on individual thoughts, feelings, and behaviours. With growing interest in resilience among mental health-care providers, there is a need to recognise the complex interactions across systems that predict which individuals will do well and to use this insight to advance mental health interventions.