Resilience Following Child Maltreatment: Definitional Considerations and Developmental Variations

A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories

The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.

The protective role of resilience in the reporting of post-concussive symptoms within a non-clinical sample

Objective: Despite being common following a brain injury, post-concussive symptoms (PCS) are highly prevalent in healthy and non-concussed individuals. Psychosocial factors likely subserve the maintenance of symptoms, and numerous studies have identified prominent risk factors associated with post-concussive symptom reporting (e.g. history of depression). However, few studies have investigated protective factors in this context. The aim of the current study was to examine the relationship between resilience and PCS, and to identify the factors subserving resilience within this relationship. Method: Healthy and non-concussed participants (n = 283, Mage = 22.70 years) completed questionnaires examining PCS (Rivermead Post-Concussion Symptom Questionnaire) and resilience (Resilience Scale for Adults), together with a screener of background demographic/clinical factors. Results: Resilience negatively predicted PCS above and beyond the effect of demographic and clinical factors previously implicated in the reporting of PCS. Interestingly, heightened "perception of self" was the resilience factor uniquely associated with PCS symptoms. The final model accounted for 33% of the variance in PCS. Overall, female gender, a history of headaches, and diagnoses of ADHD and depression, and reduced "perception of self" were all predictive of greater PCS (ps < .05). Conclusion: Resilience, particularly perception of self, is a positive protective factor in the reporting of PCS. These findings highlight the importance of early identification of less resilient individuals following trauma-such as an mTBI and provide a potential rationale for the incorporation of resilience-based rehabilitation programs into the recovery process, particularly those that promote greater self-efficacy and self-competency.

Toward a multi-level approach to the study of the intergenerational transmission of trauma: Current findings and future directions

A central goal in the field of developmental psychopathology is to evaluate the complex, dynamic transactions occurring among biological, psychological, and broader social-cultural contexts that predict adaptive and maladaptive outcomes across ontogeny. Here, I briefly review research on the effects of a history of childhood maltreatment on parental, child, and dyadic functioning, along with more recent studies on the intergenerational transmission of trauma. Because the experience and sequelae of child maltreatment and the intergenerational transmission of trauma are embedded in complex biopsychosocial contexts, this research is best conceptualized in a developmental psychopathology framework. Moreover, there is a pressing need for investigators in this area of study to adopt dynamic, multi-level perspectives as well as using developmentally guided, sophisticated research methods. Other directions for research in this field are suggested, including the implementation of collaborative interdisciplinary team science approaches, as well as community-based participatory research, to increase representation, inclusion, and equity of community stakeholders. A greater focus on cultural and global perspectives is also recommended.

Trajectories of resilience among young children involved with child protective services

Although child maltreatment is associated with short- and long-term maladaptive outcomes, some children are still able to display resilience. Currently, there is a limited understanding of how children's resilience changes over time after experiencing maltreatment, especially for young children. Therefore, the current study used a longitudinal, multidimensional approach to examine trajectories of resilience among very young children involved in child protective services and determine whether placement setting and caregiving behaviors are associated with resilience trajectories. This study used data from National Survey of Child and Adolescent Well-Being I and conducted repeated measures latent class analysis, focusing on children under 2 years old at baseline (n = 1,699). Results suggested that there were three trajectories of resilience: increasing resilience, decreasing resilience, and stable, low resilience. Caregiver cognitive stimulation was related to increasing trajectories of resilience compared to both decreasing and stable, low resilience. These findings illustrate the importance of caregiving behaviors for promoting resilience among a particularly vulnerable population.

Can resilience change over time? Patterns and transitions in resilience among young children involved with the child welfare system

This study examined transitions in resilience profiles and the role of caregiver risk and protective factors in resilience transition probabilities over 18 months among children involved with the child welfare system, using latent profile analysis and latent transition analysis. The sample included 486 children (48% female, baseline Mage  = 3.49). There were three resilience profiles at Time 1 (19.9% low emotional behavioral, 26.1% low cognitive, 54.0% multidomain) and two profiles at Time 2 (18.9% low emotional behavioral, 81.1% multidomain). Caregiver mental health problems were negatively associated with membership in the multidomain resilience group at Time 1. Higher levels of cognitive stimulation were associated with initial and continued membership in the multidomain resilience group. Implications for resilient child development are discussed.

Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis

Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains.Objective: To develop a protocol for conducting a systematic review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations.Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle-Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively.Conclusions: This protocol will facilitate a systematic review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM.PROSPERO registration: CRD42023394120.

Adults with a child maltreatment history: Narratives describing individual strengths that promote positive wellbeing

BACKGROUND

Child maltreatment often has negative impacts, but some individuals have strengths that lead to better outcomes.

OBJECTIVE

Describe the narratives of adults who experienced childhood maltreatment, all of whom had positive psychosocial wellbeing at average age 18 years.

PARTICIPANTS AND SETTING

A purposive sample of 21 adults (mean age 27.8 years SD = 1.0) who were part of a longitudinal study on the effects of childhood maltreatment. The sample was self-described as 85.7 % female, 14.3 % male, 42.9 % Black, 33.3 % Latinx, 19.0 % White, and 4.8 % multiracial.

METHODS

This descriptive qualitative study, which is part of a sequential mixed method study, used semi-structured interviews and a narrative analysis approach. Four coders completed: (1) initial reading of sample interviews (2) generating codes independently and discussion, (3) creating a codebook, (4) reviewing 10-11 transcripts each (5) reconvening to discuss/resolve differences in coding, (6) identifying themes.

RESULTS

There were four themes. The first theme was seeing oneself in a good light, highlighting self-worth and helper roles. The second theme, moving forward, included letting go of their past and a future orientation. Coping with life, the third theme, included boundaries for people around them, routines, and self-sufficiency. Meaning making, the fourth theme, included insights on the effect of their maltreatment and foster care, and reflections on appreciating life and adapting to changing circumstances.

CONCLUSIONS

Findings describe varied strengths that promote positive functioning after childhood maltreatment. Study themes highlight how these strengths allow adults to make meaning of their experiences and move forward successfully in life.

Emerging Adults' Adverse Life Events and Psychological Functioning: A Comparison Based on Intergenerational Trajectories of Child Maltreatment

Intergenerational continuity of child maltreatment (CM) is a well-documented phenomenon of concern; however, its effects on the child's level of exposure to CM, as well as subsequent trauma exposure and adult functioning remain undocumented. The present study aimed to further explore the intergenerational effects of CM by comparing emerging adults (EA; ages 18-25) on their exposure to CM, adult victimization, and psychological functioning according to their mother's CM histories. One hundred and eighty-five mothers and their EA completed independently an online survey measuring sociodemographics, material deprivation, CM, adult victimization, and psychological functioning. The participating dyads (primarily White and female-identifying) were recruited online through social media, universities, and advertisements in non-profit organizations throughout Canada. Findings revealed that maternal histories of CM were associated with increased neglectful and physically abusive acts endured in childhood for maltreated EA. Maternal histories of CM, regardless of the EA' victimization status, were associated with a higher EA' number of adulthood interpersonal-but not non-interpersonal-traumas experienced. While a maternal history of CM was a risk factor for intimate partner violence (IPV) in maltreated EA, it was protective for non-maltreated EA. Maltreated EA with maltreated versus non-maltreated mothers presented more psychological difficulties, but only if they also reported material deprivation. Practitioners working with children at-risk or exposed to CM should document parents' histories of CM and take that into account in their assessments and intervention practices. This study also provides further evidence to support social policies targeting the family system as a whole.

A Systematic Review of Resilience Factors for Psychosocial Outcomes During the Transition to Adulthood Following Childhood Victimisation

Exposure to childhood victimisation (i.e. abuse, neglect, domestic violence or bullying) can detrimentally impact later psychosocial adjustment. However, this is not the case for all victimised children; some do well despite their experiences and are considered to be resilient. Understanding the factors associated with such resilience is important to inform interventions to support better psychosocial outcomes among victimised children. This review provides an overview of the extant research examining resilience factors for psychosocial outcomes during the transition to adulthood following exposure to childhood victimisation. Studies were identified through a systematic literature search of Embase, PsychINFO and Ovid MEDLINE databases. The 26 included studies spanned a range of psychosocial outcomes between ages 18-25, including education and work, housing and independent living, criminal behaviour, victimisation, and social and psychological adjustment. For each outcome, a variety of putative resilience factors had been investigated including those related to the individual, their family and the wider community within which they lived. However, because few studies had comparable resilience factors and psychosocial outcomes, it is difficult to draw conclusions about which factors are consistently associated with resilience to a particular psychosocial outcome. Additionally, this review revealed that the included studies were of variable methodological quality - many were limited by cross-sectional designs with retrospective self-reports of childhood victimisation, and convenience or unrepresentative samples. In this review, we also highlight gaps in knowledge about the co-occurring impact of multiple resilience factors in combination and the need for studies conducted in non-Western and low- and middle-income countries.

Resilience to COVID-19 challenges: Lessons for school psychologists serving school-attending youth with experiences of marginalization

This special issue is focused on the lessons learned from the COVID-19 health crisis, showcasing new cross-cultural research from different countries, such as rural/urban US, South Africa, and Australia. The aim οf the special issue is to highlight new knowledge related to pandemic-related impacts, as well as underscore variables that will promote children's resilience and especially vulnerable and marginalized children. We argue that all adults associated with schools (e.g., teachers, school psychologists, administrators, aides, parents, and social workers) need to synergize in creating a caring school community that is purposefully committed to supporting student resilience, especially among students with experiences of marginalization. A multisystemic resilience approach has been adopted and the focus has been on caring adults in the school communities and how they can support the most vulnerable students if the adults (school psychologists parents, caregivers, teachers, and other role-players) take co-ownership of championing student resilience in times of crisis. The studies included in this special issue highlight important issues especially for school psychologists, such as girls' school engagement as a buffering factor to school disruptions, the value of multigenerational supports, the value of spirituality in dealing with crises, the sense of supportive connectedness with schools and finally teacher empowerment to support student wellbeing.

School- and community-level protective factors for resilience among chronically maltreated children in Japan

PURPOSE

Few studies have investigated how school- and community-level modifiable factors might enhance resilience, defined as an ability to recover from and cope with adversity, among chronically maltreated pre-adolescent children. This study aims to investigate school and community factors that can increase children's resilience following maltreatment.

METHODS

We used data from the Adachi child health impact of living difficulty (A-CHILD) Study, a population-based prospective longitudinal study starting with first-grade children in all public elementary schools in Adachi City, Tokyo, Japan in 2015. Children who experienced chronic maltreatment while in 1st and 4th grades and whose resilience scores were available at those grades were included in the analysis (N = 789). Crude and multiple regressions were used to examine associations of child-reported school factors (i.e., school social capital, number of friends to consult with) and community factors (i.e., having a non-parental role model and supportive adult, having a third place, which is defined as a place other than home to spend time after school) with parent-reported resilience at 4th grade. These regressions were also performed stratified by sex.

RESULTS

School social capital and having a non-parental role model at 4th grade were positively associated with resilience after adjusting covariates, including resilience at 1st grade [coefficient = 3.63, 95% confidence intervals (CI) 2.26-4.99; coefficient = 2.52, 95% CI 0.57-4.38, respectively]. Analysis by sex revealed that having a supportive adult, but not a role model, was associated with resilience among girls (coefficient = 5.50, 95% CI 0.20-10.8).

CONCLUSIONS

The findings suggest that school and community factors can promote resilience following child maltreatment, and these factors are different between boys and girls.

Family-, School-, and Neighborhood-Level Predictors of Resilience for Adolescents with a History of Maltreatment

Child maltreatment is a well-known risk factor that threatens the well-being and positive development of adolescents, yet protective factors can help promote resilience amid adversity. The current study sought to identify factors at the family, school, and neighborhood levels associated with resilience outcomes including positive functioning and social skills, among adolescents who have experienced maltreatment. Using longitudinal data from the Fragile Families and Child Wellbeing Study, the analytic sample was limited to 1729 adolescents who experienced maltreatment before age 9. Family-, school-, and neighborhood-level predictors were assessed at age 9, and youth resilience was measured at age 15. We conducted a series of multiple regression analyses to examine multi-level protective factors at age 9 as predictors of positive adolescent functioning and social skills at age 15. The study found that mothers' involvement was significantly and positively associated with positive adolescent functioning and social skills. Additionally, school connectedness and neighborhood social cohesion were significantly associated with higher levels of adolescent social skills. Our findings suggest that positive environmental contexts such as maternal involvement in parenting, school connectedness, and socially cohesive neighborhoods can serve as important protective factors that promote resilient development among adolescents who have experienced maltreatment as children.

Stress and reward: A multimodal assessment of childhood sexual abuse

Background

Childhood adversity has been found to impact stress and brain reward systems but it is unclear whether interactions between these systems might explain resilient vs. non-resilient trajectories following childhood sexual abuse (CSA). To address this gap, we adopted a multimodal approach in which cortisol reactivity to an acute stressor was assessed in conjunction with behavioral and neural measures of reward responsiveness in females with major depressive disorder (MDD) or no psychiatric disorders (i.e., resilient) who experienced CSA compared to females with and without MDD who did not experience abuse.

Methods

Latent Class Mixed Modelling (LCMM) identified classes of adults (n = 62; MAge = 26.48, SD = 5.68) characterized by distinct cortisol trajectories in response to a combined social evaluative cold pressor task. Classes were examined for their history of CSA and resilience as well as behavioral and neural measures of reward responsiveness using 128-channel electroencephalography (event-related potentials and source localization analysis).

Results

LCMM analysis identified two distinct classes of individuals with increased (Responders) or blunted (Non-Responders) cortisol reactivity to an acute stressor. Unlike Responders, Non-Responders did not modulate reward responses throughout the stress manipulation. No differences emerged between Responders and Non-Responders in terms of CSA or resilience. However, exploratory results showed that blunted cortisol response and non-modulation of reward responses emerged for those who experienced CSA at a younger age.

Conclusions

Co-occurring blunted stress and reward reactivity emerged irrespective of adults' experience of CSA or resilience. However, preliminary findings showed that CSA ending during peripubertal development was associated with blunted cortisol and reward responsiveness. Future research needs to replicate findings in larger samples and could investigate if increasing reward responsiveness during critical times of neurodevelopment could normalize stress reactivity to future stressors and thus promote resilience.

A Scoping Review of Resilience in Survivors of Human Trafficking

Resilience is critical among survivors of trafficking as they are mostly vulnerable populations who face multiple adversities before, during, and after trafficking. However, resilience in survivors of trafficking is understudied. This scoping review aims to clarify the current state of knowledge, focusing on definitions of resilience, how resilience has been studied, and factors associated with resilience among survivors. Five databases were searched using key words related to trafficking and resilience. Studies were included if they were published in English between 2000 and 2019 and focused on resilience with the study design including at least one of these four features: (a) use of standardized measures of resilience, (b) qualitative descriptions of resilience, (c) participants were survivors or professionals serving survivors, and (d) data sources such as case files or program manuals directly pertained to survivors. Eighteen studies were identified. Findings indicated that resilience was primarily described as emergent from interactions between the survivor and the environment. Resilience in trafficking appeared largely similar to resilience in other kinds of victimization. Nonetheless, trafficking survivors also may display resilience in alternative ways such as refusing treatment. Positive interpersonal relationships were the most commonly mentioned resilience factor. In addition, current research lacks studies featuring longitudinal designs, interventions, participatory methods, types of trafficking other than sexual trafficking, and demographic characteristics such as age, gender, and national origin. Future research needs to establish definitions and measures of resilience that are culturally and contextually relevant to survivors and build knowledge necessary for designing and evaluating resilience-enhancing interventions.

Internalizing and Externalizing Symptoms in Adolescents With and Without Experiences of Physical Parental Violence, a Latent Profile Analysis on Violence Resilience

Questionnaire data from a cross-sectional study on social resilience in adolescence, with a sample of N = 1,974 Swiss seventh grade high school students ages 12-14 (M = 11.76; SD = 0.65) was used to identify and compare violence resilience profiles. Person-centered latent profile analysis (LPA) was applied and allowed for the grouping of adolescents into profiles of internalizing (depression/anxiety, dissociation) and externalizing symptoms (peer aggression, peer victimization, classroom disruption) and differentiation of adolescents with (n = 403) and without (n = 1,571) physical parental violence experiences. Subsequently, a multinomial logistic regression analysis was conducted to further investigate the sociodemographic predictors of violence resilience profiles. With LPA, we identified four distinct profiles for both adolescent groups (with and without parental physical violence experiences). The results showed three particularly burdened profiles of adolescents, one with higher externalizing and one with higher internalizing symptoms, which did not occur simultaneously to the same extent. Furthermore, the third profile contained adolescents with both elevated internalizing and externalizing symptoms, the comorbid profile. The fourth profile consisted of the majority of adolescents, who exhibited little or no internalizing and externalizing symptoms, the so-called no/low symptomatic profile. A differentiated view of the symptoms can create added value regarding the understanding of violence resilience. Moreover, in the multinomial logistic regression, significant associations were found between the profiles and adolescents' gender in the group of adolescents with parental physical violence experiences, but none were found in relation to sociocultural status and migration background.

Child Maltreatment and Mental Health in Middle Childhood: A Longitudinal Study in Japan

Toxic stress caused by child maltreatment can lead to adverse mental health outcomes in later life, yet unmeasured confounding has been a major issue in many previous studies. To examine the association between child maltreatment and resilience and behavior problems among early elementary school-age children, we used data from a population-based longitudinal survey targeting all first-grade children in 2015 in Adachi City, a ward in Tokyo, Japan. Children whose caregivers provided valid responses during the 2015 (first grade; ages 6-7 years), 2016 (second grade; ages 7-8 years), and 2018 (fourth grade; ages 9-10 years) waves of the study were included in the analysis (n = 2,920). Fixed-effects regression models revealed that child maltreatment was inversely associated with resilience (β = -0.89, 95% confidence interval (CI): -1.05, -0.72) and prosocial behavior (β = -0.03, 95% CI: -0.05, -0.003) and positively associated with behavior problems (β = 0.32, 95% CI: 0.27, 0.37) over 4 years of follow-up (2015-2018), after controlling for all time-invariant confounders and measured time-varying confounders and survey year. These associations were consistent across sex. Child maltreatment may hamper the development of resilience and prosocial behavior and induce behavior problems in early elementary school children over time. Future researchers should identify modifiable protective factors for better mental health among maltreated children.

Differential Adaptation to Adversity: A Latent Profile Analysis of Youth Engagement With Resilience-Enabling Cultural Resources and Mental Health Outcomes in a Stressed Canadian and South African Community

Using person-centered latent profile analyses, this article reports two distinct sub-groups—nominal versus robust cultural allegiance—that characterize how a sample of 14- to 24-year-olds from stressed environments in South Africa ( n = 576, nfemales = 314, nmales = 257) and Canada ( n =V481; nfemales = 270, nmales = 211) engage with four cultural resources (spirituality, religiosity, family tradition, and community tradition). It considers how nominal versus robust cultural allegiance is associated with youths’ self-reported symptoms of depression and conduct disorder, age-group, and gender. In doing so, the article addresses pre-existing resilience studies’ general inattention to patterns of differential adaptation in how specific groups of youth adjust to adversity, and the role of cultural resources in youth mental health. The results draw attention to the importance of understanding resilience in sociocultural context and urge mental health practitioners and other resilience champions to be circumspect in their work with at-risk youth about which cultural resources they leverage for which mental health outcomes.

Emotion Regulation as a Pathway Connecting Early Life Adversity and Inflammation in Adulthood: a Conceptual Framework

Chronic inflammation is implicated in a variety of diseases (e.g., cardiovascular disease and cancer). Much evidence suggests that early life adversity (ELA), such as maltreatment or neglect, can increase risk for inflammation in adulthood. ELA may program proinflammatory activity via its effects on brain areas involved in emotion regulation. Of multiple emotion regulation strategies, some are considered maladaptive (e.g., expressive suppression), while others are generally adaptive (e.g., cognitive reappraisal). We propose a conceptual framework for how emotion regulation tendencies may affect vulnerability or resilience to inflammation in adults who experienced adversity in childhood and/or adolescence. In support of this framework, we summarize evidence for the relationships between emotion dysregulation and higher inflammation (i.e., vulnerability), as well as between cognitive reappraisal and lower inflammation (i.e., resilience), in healthy adults with a history of ELA. Plausible neurobiological, physiological, psychosocial, and ELA-specific factors, as well as interventions, contributing to these associations are discussed. Strengths and limitations of the extant research, in addition to ideas for future directions, are presented.

Investigating adjustment profiles in children exposed to intimate partner violence using a biopsychosocial resilience framework: A Canadian population-based study

BACKGROUND

The variability observed across different profiles of adjustment in children exposed to intimate partner violence (IPV) and the factors associated with resilience in this population are not yet well understood.

OBJECTIVE

Within a biopsychosocial framework, this study aimed to identify and describe profiles of adjustment in a cohort of children who had previously experienced IPV exposure, as well as the specific risk and promotive factors that significantly predicted membership in the identified adjustment profiles. The moderating effect of children's biological sex was also tested.

PARTICIPANTS AND SETTING

Population-based administrative data on all residents of the Province of Manitoba (Canada) over a 12-year period (2006-2017) were used to create a cohort of 3886 children aged 6-11 years who experienced IPV exposure and to extract information on these children and their mothers.

METHOD

Within a retrospective cohort study design, all study variables were extracted by linking multiple administrative health, social and justice datasets that were available in the Manitoba Population Research Data Repository.

RESULTS

Person-centered latent class analysis revealed four distinct adjustment profiles in the cohort of children, which differed for boys and girls. These included a resilient profile in which children showed no adjustment problems, as well as three profiles showing different combinations of children's externalizing problems and physical health problems. Positive maternal mental and physical health were the strongest predictors of resilient profile membership in both boys and girls.

CONCLUSIONS

Study results suggest interconnectedness among biological, psychological and social domains in shaping the adjustment of children exposed to IPV and corroborate existing evidence on the key role that mothers play in promoting the resilience of these children. Thus, future resilience research with this group and resilience-promoting programming for IPV-affected families would benefit from adopting a multisystemic biopsychosocial resilience framework that simultaneously accounts for factors at all levels of human ecologies.

Resilience in Children and Adolescents Survived Psychologically Traumatic Life Events: A Critical Review of Application of Resilience Assessment Tools for Clinical Referral and Intervention

Psychological traumatic life events (TLEs) and resilience, both are multidimensional, complex, and share salient features. Both are products of individual, familial, and environmental (socio-cultural-political contextual) variables, which is very crucial in children and adolescents. This systematic review used Boolean search strategies in electronic databases, namely, PubMED, PsycNET, JStor, and Google scholar. All researches not studying resilience per se but similar or related constructs such as life strengths, hardiness, protective/risk factors, social support, self-efficacy, social-emotional adjustment, and so on were excluded. A total of 12 resilience tools meant for children between 5 and 18 years were reviewed. The scale characteristics were analyzed in terms of targeted age-group of sample; purpose (i.e. screening and profiling for intervention); number of items; purpose/type of scale; year, country, and domain wise distribution; response format, standardization sample profile; psychometric properties; and availability of manual with norms of cutoff score. Although no scale was originally developed for children and adolescent population with history of TLEs particularly various forms of abuse and trauma, Child and Youth Resilience Measure and Connor-Davidson Resilience Scale had small samples of children from welfare homes. Neither did any scale tested the divergent validity against absence of any psychopathology or global functioning or poor quality of life Nor did Majority of scales provide a cutoff value for institutionalized children and adolescents with history of TLEs; therefore, using an existing scale for this purpose should be carefully examined. Trauma-focused multidimensionality in resilience needs to be explored more rigorously through mixed methods.

Resilience of Emerging Adults After Adverse Childhood Experiences: A Qualitative Systematic Review

INTRODUCTION

Even as children experience adversity, they can become resilient adults, in large part due to their social supports as emerging adults.

OBJECTIVE

Authors examine constructs of social support applied to the concept of resilience among emerging adults having experienced adverse childhood experiences (ACE).

METHOD

Authors conducted a meta-ethnography with six databases between January 1998 and October 2019. Inclusion criteria were as follows: (i) original peer-reviewed qualitative or mixed-method studies, (ii) sampling adults aged 18-35 years, (iii) reporting at least one ACE as defined by the World Health Organization, (iv) focused on resilience, and (v) in English. Data were collected from six electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, and Google Scholar). Studies were appraised using the Critical Appraisal Skills Program Qualitative Checklist. Analysis drew on Bourdieu's constructs of capital following Noblit and Hare's methods.

RESULTS

Thirteen studies of 277 emerging adults, aged 18-35 years old (mean 23 years), from six countries, reported resilience as "self-righting" appraisals. These were interdependent of their social supports and within a culturally determined sense of self-reliance. Self-reliance appeared to be a precursor shaping resilience of emerging adults with ACE. Self-reliance may deter self-compassion and, as a self-righting appraisal/capacity, may inhibit accessing social support.

CONCLUSION

This review emphasizes the life stage of emerging adulthood regarding the development of self-righting appraisal skills, which, when enabled with reliance, others help to transform ACEs and allow resilience to grow.

Resilience to COVID-19-related stressors: Insights from emerging adults in a South African township

There is widespread recognition that stressors related to Coronavirus Disease 2019 (COVID-19) jeopardize the development of emerging adults, more particularly those living in disadvantaged communities. What is less well understood is what might support emerging adult resilience to COVID-19-related stressors. In response, this article reports a 5-week qualitative study with 24 emerging adults (average age: 20) living in a South African township. Using digital diaries and repeated individual interviews, young people shared their lived experiences of later (i.e., month 4 and 7) lockdown-related challenges (i.e., contagion fears; livelihood threats; lives-on-hold) and how they managed these challenges. An inductive thematic analysis showed that personal and collective compliance, generous ways-of-being, and tolerance-facilitators enabled emerging adult resilience to said challenges. Importantly, these resilience-enablers drew on resources associated with multiple systems and reflected the situational and cultural context of the township in question. In short, supporting emerging adult resilience to COVID-19-related stressors will require contextually aligned, multisystemic responses.

The association between early reports to Child Protective Services and developmental trajectories through middle childhood

BACKGROUND

Longitudinal studies on resilience among children who have experienced maltreatment indicate that resilience is multi-dimensional. However, most research consolidates diverse developmental domains comprising resilience into a single score, which does not allow for detection of potentially heterogeneous associations between risk factors and outcomes of resilience processes.

OBJECTIVE

This study seeks to improve our understanding of the association between early child maltreatment and development through middle childhood (6-12 years) using individual domains considered to be outcomes of resilience processes.

PARTICIPANTS AND SETTING

Participants are 499 children from the Longitudinal Studies of Child Abuse and Neglect.

METHODS

We used latent growth curve models to explore patterns of socialization and daily living skills, and internalizing and externalizing behaviors - outcomes of resilience processes - across three time points in middle childhood, and their association with early maltreatment, defined as referral to Child Protective Services (CPS) before age 6.

RESULTS

In fully adjusted models, children experiencing early maltreatment had poorer baseline scores in activities of daily living (-4.22, 95% CI [-7.38, -1.46]) and externalizing behavior (2.95, 95% CI [1.05, 4.86]), but maltreatment was not associated with change over time in these domains. However, maltreatment was associated with increases in internalizing behavior over time (0.42, 95% CI [0.06, 0.77]).

CONCLUSION

Heterogeneity in patterns of association between maltreatment and outcomes of resilience processes support the utility of examining developmental domains individually, versus as a composite, to identify specific targets for intervention.

Associations Between Psychosocial Functioning and Physical Health in Youth with Maltreatment Experiences

Childhood maltreatment often results in long-term untoward outcomes, although some individuals demonstrate better psychosocial functioning. Maltreatment is linked with poor physical health outcomes but little is known about how psychosocial functioning is related to physical health. The aims of this study were to: 1) Identify heterogeneity of psychosocial functioning using a latent profile analysis. Positive functioning was measured by both fewer problematic symptoms (depressive, PTSD, anxiety, externalizing behavior, and substance abuse disorder) and the presence of the protective factor of social support; and 2) Explore the relationship between emergent classes of psychosocial functioning and physical health (self-reported illnesses, symptoms, and health status as well as measured overweight/obesity). Participants included a sample of youth with child welfare-documented maltreatment (n=219; mean age 18.3 years; range 15-23 years) at Time 4 (T4) of a longitudinal study. Mean differences or odds ratios were assessed across the health variables between classes. The three resulting classes were labeled: 1) higher support/lower symptoms (60.7%); 2) lower support/higher internalizing symptoms (29.2%); and 3) lower support/higher externalizing/substance abuse symptoms (10%). Youth in the lower/support/higher externalizing/substance abuse symptoms class had a similar high level of internalizing symptoms as the lower support/higher internalizing symptoms class. Youth in the lower support/high externalizing/substance abuse symptoms class had more colds and pain symptoms in the past month and gastrointestinal illnesses in the past year than the higher support/lower symptoms class, and more illnesses, respiratory problems, and gastrointestinal illnesses the last year than the lower support/higher internalizing symptoms class. Overall, functioning class was related to certain health problems which often have a stress component and were more prevalent for youth with more externalizing and substance abuse symptoms.

Reward prospect improves inhibitory control in female university students with a history of childhood sexual and physical abuse

BACKGROUND AND OBJECTIVES

Childhood abuse and neglect increase the risk for psychiatric disorders (e.g., depression and anxiety) during adulthood and have been associated with deficits in cognitive control. The specific mechanisms underlying these cognitive control deficits are still unknown.

METHODS

This study examined the expectation for reward to improve inhibitory control in young women (ages 18-35 years) with a history of childhood sexual and/or physical abuse (AG, N = 28), childhood emotional and/or physical neglect (NG, N = 30), or unaffected comparison women (HC, N = 40). They completed a previously validated rewarded (color-word) Stroop task and filled out questionnaires on depression, anxiety, and resilience.

RESULTS

Surprisingly, a significant group by reward interaction revealed larger performance benefits under reward prospect (relative to no-reward) for the AG group relative to both the NG and HC groups.

LIMITATIONS

A small sample size limiting generalizability.

CONCLUSIONS

These results demonstrate sensitivity of abused subjects to reward in modulating cognitive control and might aid in discussing whether using reward schedules during therapeutic interventions could be effective.

Investigating the Interrelations Between Systems of Support in 13- to 18-Year-Old Adolescents: A Network Analysis of Resilience Promoting Systems in a High and Middle-Income Country

Adolescents' ability to function well under adversity relies on a network of interrelated support systems. This study investigated how consecutive age groups differ in the interactions between their support systems. A secondary data analysis of cross-sectional studies that assessed individual, caregiver, and contextual resources using the Child and Youth Resilience Measure (Ungar & Liebenberg, 2005) in 13- to 18-year-olds in Canada (N = 2,311) and South Africa (N = 3,039) was conducted applying network analysis. Individual and contextual systems generally showed the highest interconnectivity. While the interconnectivity between the individual and caregiver system declined in the Canadian sample, a u-shaped pattern was found for South Africa. The findings give first insights into cross-cultural and context-dependent patterns of interconnectivity between fundamental resource systems during adolescence.

Factors associated with resilience in spousal caregivers of patients with cancer: An integrative review

Aim

To explore resilience and associated factors in spousal caregivers of patients with cancer.

Design

An integrative review.

Methods

This review used the standardized critical appraisal instruments developed by the Joanna Briggs Institute and was conducted by researching the electronic databases of Cochrane, CINAHL, ProQuest, Science Direct, PubMed, Scopus, EBSCO and Google Scholar. The articles were published in English with full text from January 2010 to January 2020.

Results

According to data retrieval, 26 articles were finally selected. From this review, resilience was typically measured by using exact resilience scales (i.e. Connor‐Davidson or Wagnild Resilience Scales) or using other variables to indicate either more positive psychological outcomes or less negative psychological outcomes. For factors associated with resilience, these were classified as individual internal and external factors. Internal factors included caregiver burden, psychological distress, coping strategies and other factors, whereas social support, couple interaction, patient health status and other parameters were considered external factors.

Conclusions

Resilience plays an important role in promoting positive adaptation in spite of adversity among the spousal caregivers of patients with cancer. Due to the uniqueness of resilience among spousal caregivers, ways to assess resilience and identify its associated factors deserve more attention and careful consideration.

Risk and protective factors for child maltreatment: A review

PURPOSE OF REVIEW

The purpose of this review was to synthesize the empirical literature regarding key risk and protective factors for child maltreatment at each level of the socioecological model and to identify directions for future research and practice.

RECENT FINDINGS

Prior research has largely focused on risk and protective factors at the individual and interpersonal levels of the socioecological model. More recently, research has begun to examine risk and protective factors at the community and societal levels, with results suggesting that programmatic and policy interventions that reduce risk and enhance protection at these levels are promising primary prevention strategies for child maltreatment.

SUMMARY

Future research should continue to focus on risk and protective factors at the community and societal levels with the aim of building the evidence base for population-wide prevention strategies. Such strategies have the potential to create contexts in which families and children thrive.