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Black MH, Helander J, Segers J, Ingard C, Bervoets J, de Puget VG, Bölte S. Resilience in the face of neurodivergence: A scoping review of resilience and factors promoting positive outcomes. Clin Psychol Rev 2024; 113:102487. [PMID: 39178757 DOI: 10.1016/j.cpr.2024.102487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/06/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
Neurodivergent individuals, including a range of conditions impacting neurological function, are at an increased likelihood of poor life outcomes, such as in functional adaptation, mental health, and well-being. Yet, many live meaningful and fulfilling lives. Resilience may provide some explanation for the heterogeneity in outcomes observed in neurodivergent populations. We conducted a scoping review embedded in a neurodiversity-affirmative approach to provide an understanding of resilience in neurodivergent populations. A total of 176 articles were included in this review and were synthesized using a two-phased process. First, findings were synthesized narratively to examine how resilience has been conceptualized and explored in neurodivergent populations. Second, to identify the bio-psycho-social factors important for resilience in neurodivergent individuals, we converted concepts identified in articles to the nomenclature of the World Health Organizations' International Classification of Functioning, Disability and Health (ICF) using a standardized linking process. We find considerable variability in how resilience is conceptualized and measured in neurodivergent populations. We identified 83 unique ICF categories representing resilience factors, of which only 20 appeared in more than 5% of the articles. Identified ICF categories highlight the importance of support systems such as families and friends, community participation and acceptance, and individual capabilities for resilience.
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Affiliation(s)
- Melissa H Black
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet & Region Stockholm, Stockholm, Sweden.
| | - Johan Helander
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet & Region Stockholm, Stockholm, Sweden; Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Julie Segers
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Cecilia Ingard
- Faculty of Health and Occupational Studies, Department of Social Work and Criminology, University of Gävle, Gävle, Sweden
| | - Jo Bervoets
- University of Antwerp, Department of Philosophy, Compost Collective, Belgium
| | | | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet & Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
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Margetts JL, Hazelton M, Santangelo P, Yorke J, Wilson RL. Measurement of Psychological Resilience to Support Therapy Interventions for Clients in the Clinical Mental Healthcare Setting: A Scoping Review. Int J Ment Health Nurs 2024. [PMID: 39238108 DOI: 10.1111/inm.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 09/07/2024]
Abstract
Waves of psychological research over 50 years have resulted in the development of scales to measure psychological resilience. Multiple psychological resilience definitions and factors have emerged during this time, making its measurement complex. The overall aim of the review was to identify and describe developments in the measurement of psychological resilience in the clinical mental healthcare setting. Specific objectives included (1) consideration of the validity and reliability of psychological resilience scales, (2) the effectiveness of the scales in clinical mental healthcare settings and (3) to identify the scope that resilience factors are addressed in the included scales. It provides a timely update regarding psychological resilience measurement tools and considers further developments that may be required. Between 2011 and 2024, databases were searched, and English-language, peer-reviewed papers with full text were extracted. Eligible studies were those reporting validated existing resilience measures or the outcomes of new measures for use in clinical mental healthcare settings. Seventeen studies met the inclusion criteria. The review demonstrated that psychological resilience measures require further development, particularly focusing on the utility of measurement tools in clinical mental healthcare settings. In this review, we highlight an existing gap in resilience measurement and underscore the need for a new measure of psychological resilience that can effectively assess individuals' subjective experience of their psychological resilience in clinical mental healthcare settings. The currently available psychological resilience measures included in this review do not directly reflect all the factors that might impact a client's depression or anxiety and warrant further research.
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Affiliation(s)
- Judye L Margetts
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Michael Hazelton
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
- RMIT University, Melbourne, Victoria, Australia
| | - Peter Santangelo
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
- RMIT University, Melbourne, Victoria, Australia
| | - Janelle Yorke
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
- School of Nursing, The Hong Kong Polytechnic University Hunghom, Hong Kong, China SAR
- University of Manchester, Manchester, UK
| | - Rhonda L Wilson
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
- RMIT University, Melbourne, Victoria, Australia
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Agerskov H, Thiesson HC, Schultz H, Pedersen BD. Relationships and dynamics in families with a child with a kidney transplant-A study of parents' everyday life experiences. J Ren Care 2024; 50:151-158. [PMID: 36949556 DOI: 10.1111/jorc.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Paediatric kidney transplantation is often the best choice of treatment for kidney failure with replacement therapy and represents an important change in the child's well-being. There are, however, still a number of challenges in addition to the parental role. The magnitude of intensive parental caregiving and support required by children with a kidney transplant could be disruptive to family relationships and dynamics. OBJECTIVE To explore the experiences of family relationships and dynamics among parents of a child with a kidney transplant. DESIGN An explorative study using a qualitative method. PARTICIPANTS Twelve parents (seven mothers and five fathers) of seven children with a kidney transplant were included. APPROACH A phenomenological-hermeneutic approach was applied. METHOD Semistructured, individual interviews were conducted. The data were analysed using Ricoeur's theory of interpretation on three levels: naïve reading, structural analysis and critical interpretation and discussion. FINDINGS Three themes were generated: Emotions during ups and downs in everyday life; Balancing different needs among children; and Opportunities and having consideration in the family. CONCLUSION Relationships between parents that are based on mutual emotional support are significant and essential during periods of severe illness in a child. Parents who are alone or emotionally marked by their child's disease history feel vulnerable and struggle to overcome challenges. Different health situations among siblings lead to challenges in bringing up the children and emotional dilemmas among parents that impact family dynamics. Resilience in parents is a shifting phenomenon that can influence how they deal with family relationships and dynamics.
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Affiliation(s)
- Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Family Focused Health Care Research Centre, University of Southern Denmark, Odense C, Denmark
| | - Helle C Thiesson
- Department of Nephrology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Helen Schultz
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Surgical Department, Odense University Hospital, Odense C, Denmark
| | - Birthe D Pedersen
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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Bonanno GA, Chen S, Bagrodia R, Galatzer-Levy IR. Resilience and Disaster: Flexible Adaptation in the Face of Uncertain Threat. Annu Rev Psychol 2024; 75:573-599. [PMID: 37566760 DOI: 10.1146/annurev-psych-011123-024224] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Disasters cause sweeping damage, hardship, and loss of life. In this article, we first consider the dominant psychological approach to disasters and its narrow focus on psychopathology (e.g., posttraumatic stress disorder). We then review research on a broader approach that has identified heterogeneous, highly replicable trajectories of outcome, the most common being stable mental health or resilience. We review trajectory research for different types of disasters, including the COVID-19 pandemic. Next, we consider correlates of the resilience trajectory and note their paradoxically limited ability to predict future resilient outcomes. Research using machine learning algorithms improved prediction but has not yet illuminated the mechanism behind resilient adaptation. To that end, we propose a more direct psychological explanation for resilience based on research on the motivational and mechanistic components of regulatory flexibility. Finally, we consider how future research might leverage new computational approaches to better capture regulatory flexibility in real time.
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Affiliation(s)
- George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Shuquan Chen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Rohini Bagrodia
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Isaac R Galatzer-Levy
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, USA;
- Google LLC, Mountain View, California
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Li MK, Patel BP, Chu L, Strom M, Hamilton JK. Investigating resilience and its association with stress, anthropometrics, and metabolic health in adolescents with obesity: a pilot study. PSYCHOL HEALTH MED 2023; 28:1997-2006. [PMID: 35373663 DOI: 10.1080/13548506.2022.2059094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
The increasing prevalence of children with obesity has contributed to a higher risk of developing cardiometabolic comorbidities. Adversity and chronic stress are negatively linked to cardiometabolic outcomes, and resilience is positively associated with improved outcomes. However, whether resilience is protective against metabolic disturbances preceding disease presentation is less understood. This study explored correlations between stress, anthropometrics, and metabolic parameters with resilience (total, individual, family, peers, school, community), and determined which resilience domains predict metabolically unhealthy obesity. Adolescents with obesity (n = 39; 12-18y) completed anthropometrics, an oral glucose tolerance test, the Adolescent Resilience Questionnaire, and Perceived Stress Scale. Lower stress (r = -0.70, p < 0.001), BMI (r = -0.42, p = 0.01), fat mass (ρ = -0.41, p = 0.01), and fat-free mass (ρ = -0.41, p = 0.01) were associated with greater resilience. Greater school resilience was associated with lower risk for having metabolically unhealthy obesity (odds ratio = 0.87, 95% Confidence Intervals, 0.78-0.98, p = 0.02). Our findings suggest that resilience is associated with lower adiposity, and that lower school resilience is an independent predictor of having metabolically unhealthy obesity. Further work exploring correlations between school resilience, perceived stress, and metabolic outcomes, would optimize programs for obesity-related chronic conditions.
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Affiliation(s)
- Ming K Li
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barkha P Patel
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Chu
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michele Strom
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill K Hamilton
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
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van der Laan SEI, Berkelbach van der Sprenkel EE, Lenters VC, Finkenauer C, van der Ent CK, Nijhof SL. Defining and Measuring Resilience in Children with a Chronic Disease: a Scoping Review. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:105-123. [PMID: 37139096 PMCID: PMC10088629 DOI: 10.1007/s42844-023-00092-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 05/05/2023]
Abstract
More than 25% of all children grow up with a chronic disease. They are at higher risk for developmental and psychosocial problems. However, children who function resiliently manage to adapt positively to these challenges. We aim to systematically review how resilience is defined and measured in children with a chronic disease. A search of PubMed, Cochrane, Embase, and PsycINFO was performed on December 9, 2022, using resilience, disease, and child/adolescent as search terms. Two reviewers independently screened articles for inclusion according to predefined criteria. Extraction domains included study characteristics, definition, and instruments assessing resilience outcomes, and resilience factors. Fifty-five out of 8766 articles were identified as relevant. In general, resilience was characterized as positive adaptation to adversity. The included studies assessed resilience by the outcomes of positive adaptation, or by resilience factors, or both. We categorized the assessed resilience outcomes into three groups: personal traits, psychosocial functioning, and disease-related outcomes. Moreover, myriad of resilience factors were measured, which were grouped into internal resilience factors (cognitive, social, and emotional competence factors), disease-related factors, and external factors (caregiver factors, social factors, and contextual factors). Our scoping review provides insight into the definitions and instruments used to measure resilience in children with a chronic disease. More knowledge is needed on which resilience factors are related to positive adaptation in specific illness-related challenges, which underlying mechanisms are responsible for this positive adaptation, and how these underlying mechanisms interact with one another. Supplementary Information The online version contains supplementary material available at 10.1007/s42844-023-00092-2.
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Affiliation(s)
- Sabine E. I. van der Laan
- Department of Pediatric Pulmonology,Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Virissa C. Lenters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Cornelis K. van der Ent
- Department of Pediatric Pulmonology,Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sanne L. Nijhof
- Department of Pediatrics, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Elledge DK, Lee SC, Stewart SM, Pop R, Trivedi MH, Hughes JL. Examining a Resilience Mental Health App in Adolescents: Acceptability and Feasibility Study. JMIR Form Res 2023; 7:e38042. [PMID: 36947113 PMCID: PMC10132019 DOI: 10.2196/38042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/12/2023] [Accepted: 01/29/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Resilience is defined as the ability to rely on internal characteristics and external strengths to adapt to adverse events. Although universal resilience-enhancing programs are effective for adolescents, there is a need for interventions that are more easily accessible and can be customized for individual teens. Phone apps are easy to use, can be tailored to individuals, and have demonstrated positive effects for mental health outcomes. OBJECTIVE This study aimed to examine the feasibility and acceptability of a resilience app for adolescents. This app aimed to enhance resilience through modules focused on depression prevention, stress management, and healthy lifestyle approaches containing videos, measures, and practice suggestions. Furthermore, the study aimed to evaluate the effect of short-term app use on changes in resilience. METHODS In study 1, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to discuss possible incentives for using a mental health app, the benefits of app use, and concerns associated with app use. Feedback from study 1 led to ideas for the prototype. In study 2, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to gather feedback about the resilience app prototype. Feedback from study 2 led to changes in the prototype, although not all suggestions could be implemented. In study 3, 40 adolescents used the app for 30 days to determine feasibility and acceptability. Additionally, resilience and secondary mental health outcomes were measured before and after app use. Dependent samples 2-tailed t tests were conducted to determine whether there were changes in resilience and secondary mental health outcomes among the adolescents before and after app use. RESULTS Multiple themes were identified through study 1 individual interviews and focus groups, including app content, features, engagement, benefits, concerns, and improvement. Specifically, the adolescents provided helpful suggestions for making the prototype more appealing and functional for teen users. Study 2 adolescents and adults reported that the prototype was feasible and acceptable through the Computer System Usability Questionnaire (mean 6.30, SD 1.03) and Mobile App Rating Scale (mean 4.08, SD 0.61). In study 2, there were no significant differences in resilience and mental health outcomes after using the app for 30 days. There was variation between the participants in the extent to which they used the app, which may have led to variation in the results. The users appeared to prefer the depression module and survey sections, which provided mental health feedback. CONCLUSIONS Qualitative and quantitative data provide evidence that youth are interested in a resilience mental health app and that the current prototype is feasible. Although there were no significant mental health changes in study 3 users, practical implications and future directions are discussed for mental health app research.
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Affiliation(s)
| | - Simon Craddock Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children's Medical Center, Dallas, TX, United States
| | - Radu Pop
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Peter O'Donnell Jr Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jennifer L Hughes
- Nationwide Children's Hospital, Columbus, OH, United States
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
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Emotion Regulation in the Classroom: A Network Approach to Model Relations among Emotion Regulation Difficulties, Engagement to Learn, and Relationships with Peers and Teachers. J Youth Adolesc 2023; 52:273-286. [PMID: 36180661 PMCID: PMC9524346 DOI: 10.1007/s10964-022-01678-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/31/2022] [Indexed: 01/19/2023]
Abstract
Emotion regulation is theorized to shape students' engagement in learning activities, but the specific pathways via which this occurs remain unclear. This study examined how emotion regulation mechanisms are related to behavioral and emotional engagement as well as relations with peers and teachers. The sample included 136 secondary school students (59,7% girls; Mage = 14.93, SDage = 1.02, range: 13-18 years). Psychometric network models revealed that difficulties in emotional awareness, emotional clarity, and access to emotion regulation strategies were differentially related to behavioral and emotional engagement, establishing an indirect link with teacher and/or peer relations. Nonacceptance of emotional responses, emotional awareness, and impulse control difficulties were uniquely related to teacher and/or peer relations, establishing an indirect link with student engagement. Causal discovery analysis suggested that student emotional engagement is an empirically-plausible direct cause of increased access to emotion regulation strategies. These findings uncover potential pathways through which emotion regulation hampers or facilitates learning at school, providing information useful for the design of school curricula and teacher training programs.
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Taylor HA, Finkel T, Gao Y, Ballinger SW, Campo R, Chen R, Chen SH, Davidson K, Iruela-Arispe ML, Jaquish C, LeBrasseur NK, Odden MC, Papanicolaou GJ, Picard M, Srinivas P, Tjurmina O, Wolz M, Galis ZS. Scientific opportunities in resilience research for cardiovascular health and wellness. Report from a National Heart, Lung, and Blood Institute workshop. FASEB J 2022; 36:e22639. [PMID: 36322029 PMCID: PMC9703084 DOI: 10.1096/fj.202201407r] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
Exposure of biological systems to acute or chronic insults triggers a host of molecular and physiological responses to either tolerate, adapt, or fully restore homeostasis; these responses constitute the hallmarks of resilience. Given the many facets, dimensions, and discipline-specific focus, gaining a shared understanding of "resilience" has been identified as a priority for supporting advances in cardiovascular health. This report is based on the working definition: "Resilience is the ability of living systems to successfully maintain or return to homeostasis in response to physical, molecular, individual, social, societal, or environmental stressors or challenges," developed after considering many factors contributing to cardiovascular resilience through deliberations of multidisciplinary experts convened by the National Heart, Lung, and Blood Institute during a workshop entitled: "Enhancing Resilience for Cardiovascular Health and Wellness." Some of the main emerging themes that support the possibility of enhancing resilience for cardiovascular health include optimal energy management and substrate diversity, a robust immune system that safeguards tissue homeostasis, and social and community support. The report also highlights existing research challenges, along with immediate and long-term opportunities for resilience research. Certain immediate opportunities identified are based on leveraging existing high-dimensional data from longitudinal clinical studies to identify vascular resilience measures, create a 'resilience index,' and adopt a life-course approach. Long-term opportunities include developing quantitative cell/organ/system/community models to identify resilience factors and mechanisms at these various levels, designing experimental and clinical interventions that specifically assess resilience, adopting global sharing of resilience-related data, and cross-domain training of next-generation researchers in this field.
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Affiliation(s)
- Herman A. Taylor
- Cardiovascular Research Institute Morehouse School of Medicine, Atlanta, Georgia, USA
- Morehouse-Emory Cardiovascular Center for Health Equity, Atlanta, Georgia, USA
- Harvard Chan School of Public Health, Atlanta, Georgia, USA
- Emory School of Medicine, Atlanta, Georgia, USA
| | - Toren Finkel
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yunling Gao
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Scott W. Ballinger
- University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Rebecca Campo
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rong Chen
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Sema4, Stamford, Connecticut, USA
| | - Shu Hui Chen
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Karina Davidson
- Feinstein Institutes for Medical Research, Northwell Health, New York, New York, USA
| | | | - Cashell Jaquish
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - George J. Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Martin Picard
- Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Pothur Srinivas
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Olga Tjurmina
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Michael Wolz
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Zorina S. Galis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Glaser M, Green G, Zigdon A, Barak S, Joseph G, Marques A, Ng K, Erez-Shidlov I, Ofri L, Tesler R. The Effects of a Physical Activity Online Intervention Program on Resilience, Perceived Social Support, Psychological Distress and Concerns among At-Risk Youth during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1704. [PMID: 36360432 PMCID: PMC9688810 DOI: 10.3390/children9111704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 07/29/2023]
Abstract
BACKGROUND COVID-19 restrictions have led to social isolation affecting youth's health, particularly at-risk youth. OBJECTIVES We examined whether an online mentoring health intervention (OMHI) would strengthen characteristics that can prevent risky behaviors: resilience, perceived social support, psychological distress, and crisis concerns. METHODS Fifty-six secondary-school students participated, 27 in the intervention group and 29 in the control group (mean age 16.18, SD 0.83 vs. 16.62, SD 0.82, respectively). The study took place between March and August 2020. RESULTS The intervention group was less resilient pre-test, with similar resilience levels as the control group post-test. Intervention group participants presented a significantly higher crisis level pre- and post-test than the control group, as well as an increase in resilience (effect size = 1.88) and social support (effect size = 1.22), while psychological distress significantly decreased (effect size = -1.03). Both groups (intervention vs. control) predicted changes from pre-to-post test for resilience and crisis (adjusted R2 = 0.33, p = 0.001 and R2 = 0.49, p = 0.0001 respectively). CONCLUSIONS OMHI participation was associated with improved resilience and social support, and decreased psychological distress, making it an effective strategy in health promotion for at-risk youth. An online intervention program combining mentoring in physical activity and interpersonal connections may constitute an effective health promotion strategy for at-risk youth, especially in times of crisis.
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Affiliation(s)
- Michal Glaser
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel
- Health Promotion & Wellbeing Research Center, Ariel University, Ariel 4077625, Israel
| | - Gizell Green
- Department of Nursing, School of Health Sciences, Ariel University, Ariel 4077625, Israel
| | - Avi Zigdon
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel
- Health Promotion & Wellbeing Research Center, Ariel University, Ariel 4077625, Israel
- Disaster Research Center, Ariel University, Ariel 4077625, Israel
| | - Sharon Barak
- Department of Nursing, School of Health Sciences, Ariel University, Ariel 4077625, Israel
- Department of Pediatric Rehabilitation, The Chaim Sheba Medical Center at Tel Hashomer, Ramat-Gan 5262000, Israel
| | - Gili Joseph
- Department of Physical Education, Faculty of Science, Seminar Kibbutzim College, Tel Aviv 6250769, Israel
| | - Adilson Marques
- Faculdade de Motricidade Humana, Centro Interdisciplinar para o Estudo da Performance Humana, Universidade de Lisboa, 1649-004 Lisboa, Portugal
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, 70211 Kuopio, Finland
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, V94 T9PX Limerick, Ireland
| | | | - Lani Ofri
- Department of Nursing, School of Health Sciences, Ariel University, Ariel 4077625, Israel
| | - Riki Tesler
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel
- Health Promotion & Wellbeing Research Center, Ariel University, Ariel 4077625, Israel
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Suárez Soto E, Pereda N, Guilera G. Suicidal ideation and behaviour in Spanish adolescents during the COVID-19 pandemic: an exploratory study. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:256-265. [PMID: 36622713 PMCID: PMC10803869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic and its related containment measures, mainly physical distancing and isolation, are having detrimental consequences on the mental health of the juvenile infant population worldwide.
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Affiliation(s)
- Elizabeth Suárez Soto
- Research Group on Child and Adolescent Victimisation (GReVIA), University of Barcelona, Spain. International University of Valencia, Spain
- International University of Valencia, Spain
| | - Noemí Pereda
- Research Group on Child and Adolescent Victimisation (GReVIA), University of Barcelona, Spain. International University of Valencia, Spain
- Institute of Neurosciences (UBNeuro), University of Barcelona, Spain
| | - Georgina Guilera
- Research Group on Child and Adolescent Victimisation (GReVIA), University of Barcelona, Spain. International University of Valencia, Spain
- Institute of Neurosciences (UBNeuro), University of Barcelona, Spain
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12
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Guo R, He Y. Narrative resilience in the cross-regional support of healthcare workers during the COVID-19 outbreak: The Chinese experiences of cultural input. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103376. [PMID: 36267110 PMCID: PMC9562614 DOI: 10.1016/j.ijdrr.2022.103376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
The healthcare staff who supported Wuhan's rescue work were the first batch of cross-regional supporters during the outbreak of the COVID-19 pandemic. To determine the cultural factors that affected their mental health and resilience, as well as the processes that organizations and individuals underwent to transform cultural resources into benefits. This study collected narrative materials in the form of national and individual statements and used Social Ecology of Resilience theory to analyse them. It identified and analysed the cultural factors of resilience in macrosystems, mesosystems, and microsystems according to four themes, namely: cognition, emotion, will, and behaviour. Altogether, it was found that the national voice adopted an optimistic narrative tone reminiscent of that used during the context of war and that the personal or public voice approved of it. The study revealed that the party and government's use of moral narration derived from its heritage culture and its belief in its continuity in new China's culture served as a mechanism of cultural resilience and mobilisation. The above is the experience of the operation of living culture (LC) and cultural heritage (CH) mentioned in Culture Based Development (CBD). In light of this, it was concluded that the predominant form of cultural input during China's national public health crisis has been storytelling with narrative resilience.
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Affiliation(s)
- Ruitong Guo
- School of Education, Yunnan Minzu University, Kunming, China
| | - Yiqing He
- School of Education, Guangzhou University, Guangzhou, China
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13
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Anderson JR, Mayes TL, Fuller A, Hughes JL, Minhajuddin A, Trivedi MH. Experiencing bullying's impact on adolescent depression and anxiety: Mediating role of adolescent resilience. J Affect Disord 2022; 310:477-483. [PMID: 35390356 DOI: 10.1016/j.jad.2022.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 11/17/2022]
Abstract
Youth who experience bullying are at risk for psychopathology, indicating the necessity of identifying factors that may protect against the deleterious effects of being bullied. The present study expands upon prior research by examining resilience as a mediator of the effects of experiencing bullying on depression and anxiety within a sample of 2155 adolescents. Results indicated that youth who experienced bullying were more likely to have higher symptoms of depression and anxiety and lower resilience, while higher levels of resilience were associated with fewer symptoms of depression and anxiety. Resilience partially mediated the associations of experiencing bullying with depression and anxiety symptoms, suggesting that resilience may serve as a protective factor for adolescents who experience bullying. These findings have implications for programming that seeks to address bullying, peer victimization, and promotion of adolescent mental health.
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Affiliation(s)
- Jacqueline R Anderson
- Department of School Psychology, University of Northern Colorado, Greely, CO, United States; Center for Depression Research and Clinical Care, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Anne Fuller
- School of Psychology, Xavier University, Cincinnati, OH, United States
| | - Jennifer L Hughes
- Psychiatry and Behavioral Health, Nationwide Children's Hospital, Columbus, Ohio, United States; The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States.
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14
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Psychometric properties of the Adolescent Resilience Questionnaire (ARQ) in a sample of Swedish adolescents. BMC Psychiatry 2022; 22:468. [PMID: 35836194 PMCID: PMC9284718 DOI: 10.1186/s12888-022-04099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/28/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The importance of resilience, and interest in it, has increased markedly in recent years, based on the need to understand why some children and young people have a resilience to stress that others lack. At the same time, there has been a lack of instruments to measure resilience. The aim of this study was to translate the Adolescent Resilience Questionnaire (ARQ) into Swedish and investigate the psychometrics of this Swedish version. METHODS A normative sample of 616 students aged 15-17 was recruited through the school system in five different communities. Students filled out a digitalised composite form consisting of ARQ and three other standardised questionnaires, the Sense of Coherence Scale-13 (Soc-13), the Rosenberg Self-Esteem Scale (RSES) and the Relationship Questionnaire (RQ). RESULTS The ARQ, with five domains and twelve subscales, showed good alpha coefficients α = .95 for the total scale and subscales ranging between α = .70 to .91, except for the subscales Emotional insight (α = 0.69) and Empathy/Tolerance (α = .61). The convergent validity, which was tested for the first time in this study, was good, especially with the Internal Domain for both SOC-13 and RSES. The confirmatory factor analysis showed a satisfactory construct validity. Finally, some gender differences were seen, with boys scoring higher on the total ARQ scale. CONCLUSION The study shows that the Swedish translation of ARQ has satisfactory psychometric properties. The ARQ could therefore be used as a tool for adolescents when evaluating the importance of resilience.
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15
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Sociodemographic and Psychological Predictors of Resilience Among Frontline Nurses Fighting the COVID-19 Pandemic. Disaster Med Public Health Prep 2022; 17:e171. [PMID: 35673807 PMCID: PMC9273726 DOI: 10.1017/dmp.2022.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE According to a WHO report, the number of patients with coronavirus disease 2019 (COVID-19) has reached 456,797,217 worldwide as of 15 March, 2022. In Wuhan, China, large teams of health-care personnel were dispatched to respond to the COVID-19 emergency. This study aimed to determine the sociodemographic and psychological predictors of resilience among frontline nurses fighting the current pandemic. METHODS A total of 143 nurses were recruited from February 15 to February 20, 2020, to participate in this study. The 10-item Connor-Davidson Resilience Scale and the 21-item Depression Anxiety Stress Scale were used to estimate the participants' resilience and mental wellbeing. RESULTS Results showed that the nurses displayed a moderate resilience level. Their median depression, anxiety, and stress scores were 1, 2, and 3, respectively, which were negatively correlated with resilience. Female gender, being dispatched to Wuhan, and depression levels were the significant predictors of resilience. CONCLUSIONS The results suggest that particular attention should be given to nurses who were dispatched to Wuhan and who exhibited depression symptoms, and appropriate measures should be taken to boost their resilience.
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16
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Anderson JR, Killian M, Fuller A, Hughes JL, Byerly M, Lindow J, John Rush A, Trivedi MH. Psychometric Evaluation of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire in a General Youth Population. Child Psychiatry Hum Dev 2022; 53:546-553. [PMID: 33713250 DOI: 10.1007/s10578-021-01148-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire is a brief 15-item self-report measure of quality of life and life satisfaction originally developed for clinical populations (6 to 17 years old). The current paper examines the initial factor structure proposed by the developers and underlying psychometric properties of the measure in a non-clinical population of teens. A cross-sectional adolescent sample (N = 3222) completed self-report measures as part of mental health promotion program. A confirmatory factor analysis was conducted with construct validity analyses. The original factor structure was replicated with strong internal consistency (Cronbach α = .912). Strong construct validity (e.g. resilience, well-being, depression, and anxiety) was found. Minimal differences were found based on gender, race, and ethnicity. PQ-LES-Q has strong, replicable psychometric properties, which makes it a generally reliable and valid assessment tool to evaluate the quality of life and life satisfaction in adolescents.
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Affiliation(s)
- Jacqueline R Anderson
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA
| | - Michael Killian
- College of Social Work, Florida State University, 296 Champions Way, Tallahassee, FL, 32304, USA
| | - Anne Fuller
- School of Psychology, Xavier University, 1 Drexel Drive, New Orleans, LA, 70125, USA
| | - Jennifer L Hughes
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA
| | - Matthew Byerly
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, 85724, USA.,Southern Arizona VA Healthcare System, Tucson, AZ, 85723, USA
| | - Janet Lindow
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, 85724, USA.,Biomedical Research and Education Foundation of Southern Arizona, Tucson, AZ, 85723, USA
| | - A John Rush
- Duke National University of Singapore, 8 College Rd, Singapore, 169857, Singapore.,Duke Medical School, Durham, NC, 27710, USA.,Texas Tech Health Science Center, 3600 N Garfield St., Midland, TX, 79705, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA.
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17
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Lieslehto J, Rantanen N, Oksanen LMAH, Oksanen SA, Kivimäki A, Paju S, Pietiäinen M, Lahdentausta L, Pussinen P, Anttila VJ, Lehtonen L, Lallukka T, Geneid A, Sanmark E. A machine learning approach to predict resilience and sickness absence in the healthcare workforce during the COVID-19 pandemic. Sci Rep 2022; 12:8055. [PMID: 35577884 PMCID: PMC9109448 DOI: 10.1038/s41598-022-12107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractDuring the COVID-19 pandemic, healthcare workers (HCWs) have faced unprecedented workloads and personal health risks leading to mental disorders and surges in sickness absence. Previous work has shown that interindividual differences in psychological resilience might explain why only some individuals are vulnerable to these consequences. However, no prognostic tools to predict individual HCW resilience during the pandemic have been developed. We deployed machine learning (ML) to predict psychological resilience during the pandemic. The models were trained in HCWs of the largest Finnish hospital, Helsinki University Hospital (HUS, N = 487), with a six-month follow-up, and prognostic generalizability was evaluated in two independent HCW validation samples (Social and Health Services in Kymenlaakso: Kymsote, N = 77 and the City of Helsinki, N = 322) with similar follow-ups never used for training the models. Using the most predictive items to predict future psychological resilience resulted in a balanced accuracy (BAC) of 72.7–74.3% in the HUS sample. Similar performances (BAC = 67–77%) were observed in the two independent validation samples. The models' predictions translated to a high probability of sickness absence during the pandemic. Our results provide the first evidence that ML techniques could be harnessed for the early detection of COVID-19-related distress among HCWs, thereby providing an avenue for potential targeted interventions.
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18
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Martínez-García A. Contributions of universal school-based mental health promotion to the wellbeing of adolescents and preadolescents: a systematic review of educational interventions. HEALTH EDUCATION 2022. [DOI: 10.1108/he-07-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe study aims to determine the contributions of universal school-based educational programs to the current and future worldwide youth mental health condition.Design/methodology/approachA systematic search was conducted in accordance with the PRISMA 2020 guidelines. Academic education and health databases including ERIC, Education Database, APA PsycInfo, APA PsycArticles, Psychology Database, and PubMed were used. Characteristics and outcomes of educational interventions developed in school settings and education potential for mental health promotion were examined.FindingsUniversal school-based mental health educational programs positively affect preadolescents and adolescents. The study review provided further insight into educational programs' characteristics and identified two primary curricula foci: mental health education and development of resiliency traits and skills.Originality/valueResearch on mental health promotion using a pedagogical approach is rare as most studies focus on mental health symptomatology and psychotherapy techniques training.
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19
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The Brief 35-Item ARQ: Validation of the Adolescent Resilience Questionnaire in India. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00643-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Krebs S, Moak E, Muhammadi S, Forbes D, Yeh MC, Leung MM. Testing the Feasibility and Potential Impact of a Mindfulness-Based Pilot Program in Urban School Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063464. [PMID: 35329150 PMCID: PMC8950248 DOI: 10.3390/ijerph19063464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/05/2022] [Accepted: 03/12/2022] [Indexed: 02/04/2023]
Abstract
Mindfulness-based interventions (MBIs) could be effective in engaging children and reducing childhood obesity risk. The purpose of this study was to test feasibility, fidelity, and potential impact of a pilot MBI in urban school youth. A two-group quasi-experimental study was conducted in a Harlem, New York school. Participants comprised 51 students (ages 9–12, 54% female, 85% African American/Black). The experimental (E) group (n = 26) participated in a nine-session pilot MBI. Sessions were 90 min and offered weekly as part of afterschool programming. Children only attending during the school day comprised the control (C) group (n = 25). Process evaluation (e.g., fidelity, reach) was performed. Interviews with the E group were conducted to determine program acceptability. Mindful eating and resilience measures were collected at baseline and post-intervention. Intervention feasibility was high as the retention rate was 100% and fidelity was good as nine out of ten sessions were implemented. Relative to baseline, significant improvements were observed in the C group compared to the E group in the resilience composite score (p = 0.01) and its confidence domain (p = 0.01). A MBI may provide a unique opportunity to engage youth. However, further research is warranted to determine if a MBI could promote health in urban, school-age children.
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Affiliation(s)
- Sabrina Krebs
- Nutrition Program, Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; (S.K.); (M.-C.Y.)
| | - Emily Moak
- School of Public Health, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; (E.M.); (S.M.)
| | - Shakiba Muhammadi
- School of Public Health, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; (E.M.); (S.M.)
| | - David Forbes
- Urban Education Doctoral Program, Graduate Center, City University of New York, 365 Fifth Avenue, New York, NY 10016, USA;
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; (S.K.); (M.-C.Y.)
| | - May May Leung
- Nutrition Program, Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, USA; (S.K.); (M.-C.Y.)
- Correspondence:
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21
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Russell BS, Tomkunas AJ, Hutchison M, Tambling RR, Horton AL. The Protective Role of Parent Resilience on Mental Health and the Parent-Child Relationship During COVID-19. Child Psychiatry Hum Dev 2022; 53:183-196. [PMID: 34533667 PMCID: PMC8447807 DOI: 10.1007/s10578-021-01243-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic is linked to particularly potent psychological effects for children and their caregivers while families adjust to new daily routines for work, education, and self-care. Longitudinal associations are presented from a national sample of 271 parents (mean age = 35.29 years, 48.5% female) on resilience, mental health and stress indicators, and parenting outcomes. Multigroup path model results indicate significant associations between resilience and parent stress or parent perceived child stress initiates a sequence of significant linkages to parent depression, followed by caregiver burden and parent-child relationship quality. This final set of linkages between depression and both parenting outcomes were significantly stronger for men, who also reported higher rates of perceived child stress. Results suggest that fathers' depression symptoms and associated spill-over to perceived child stress is producing stronger effects on their parenting experiences than effects reported by mothers.
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Affiliation(s)
- Beth S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA.
| | - Alexandria J Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Morica Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Rachel R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Abagail L Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
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22
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Less is more. Discovering the latent factors of trait resilience. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Satapathy S, Dang S, Sagar R, Dwivedi SN. Resilience in Children and Adolescents Survived Psychologically Traumatic Life Events: A Critical Review of Application of Resilience Assessment Tools for Clinical Referral and Intervention. TRAUMA, VIOLENCE & ABUSE 2022; 23:288-300. [PMID: 32700641 DOI: 10.1177/1524838020939126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Sujata Satapathy
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Saloni Dang
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
| | - S N Dwivedi
- Department of Biostatistics, All India Institute of Medical Science, New Delhi, India
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Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, Alstergren P, Conti PCR, Durham J, Goulet JP, Hirsch C, Kalaykova SI, Kapos FP, King CD, Komiyama O, Koutris M, List T, Lobbezoo F, Ohrbach R, Palermo TM, Peck CC, Penlington C, Restrepo C, Rodrigues MJ, Sharma S, Svensson P, Visscher CM, Wahlund K, Michelotti A. Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II. J Oral Rehabil 2021; 49:541-552. [PMID: 34951729 DOI: 10.1111/joor.13301] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/27/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established. OBJECTIVES To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. METHODS A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended. RESULTS The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience. CONCLUSION Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.
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Affiliation(s)
- Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ing-Marie Nilsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Center for Oral Rehabilitation, FTV Östergötland, Norrköping, Sweden
| | - Amal Al-Khotani
- Scandinavian Center for Orofacial Neurosciences, Sweden.,East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Paulo Cesar Rodrigues Conti
- 7Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Stanimira I Kalaykova
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, United States
| | - Christopher D King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Center for Understanding Pediatric Pain (CUPP), Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Osamu Komiyama
- Division of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo, Japan
| | - Michail Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden
| | - Frank Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, United States.,Seattle Children's Research Institute, Seattle, United States
| | - Christopher C Peck
- Faculty of Medicine and Health, University of Sydney, Westmead, Australia
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Maria Joao Rodrigues
- Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sonia Sharma
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Peter Svensson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark
| | - Corine M Visscher
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Wahlund
- Department of Stomatognathic Physiology, Kalmar County Hospital, Kalmar, Sweden
| | - Ambrosina Michelotti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
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Mattelin E, Khanolkar AR, Fröberg F, Jonsson L, Korhonen L. 'Long journey to shelter': a study protocol: a prospective longitudinal analysis of mental health and its determinants, exposure to violence and subjective experiences of the migration process among adolescent and young adult migrants in Sweden. BMJ Open 2021; 11:e043822. [PMID: 34593481 PMCID: PMC8487179 DOI: 10.1136/bmjopen-2020-043822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION According to the UN Refugee Agency (UNHCR), around 40% of the 79.5 million forcibly displaced persons in the end of the year 2019 were children. Exposure to violence and mental health problems such as posttraumatic stress disorder are frequently reported among migrant children, but there is a knowledge gap in our understanding of the complex longitudinal interplay between individual, social and societal risk and resilience factors that impact mental health and well-being, quality of life and ability to function and adapt. There is also an urgent societal need to facilitate interdisciplinary and intersectoral collaborative efforts to develop effective methods to prevent, detect and respond to the needs of the migrants. This project will study adolescent and young adult migrants in Sweden using multiple methods such as quantitative analysis of data from a prospective cohort study and qualitative analysis of data gathered from teller-focused interviews. The aim is to understand how different factors impact mental health and integration into the Swedish society. Furthermore, individual experiences related to the migration process and exposure to violence will be studied in detail. METHODS AND ANALYSIS Study participants will include 490 migrants aged 12-25 years recruited through social services, healthcare, social media and the civil society. A subsample of adolescents (n=160) will be re-interviewed after 1 year. Data are collected using structured and semi-structured interviews along with saliva and hair sampling. Measures include sociodemographic data, longitudinal data on mental health and its determinants, including genotypes and stress-hormone levels, access to healthcare and the process of migration, including settlement in Sweden. ETHICS AND DISSEMINATION The Regional Ethics Board of Linköping (2018/292-31 and 2018/504-32) and the National Ethics Board (2019-05473,2020-00949 and 2021-03001) have approved the study. Results will be made available to participants, their caregivers, professionals working with migrants, researchers and the funders.
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Affiliation(s)
- Erica Mattelin
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Amal R Khanolkar
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Frida Fröberg
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Linda Jonsson
- Department of Social Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Brown SJ, Gartland D, Woolhouse H, Giallo R, McDonald E, Seymour M, Conway L, FitzPatrick KM, Cook F, Papadopoullos S, MacArthur C, Hegarty K, Herrman H, Nicholson JM, Hiscock H, Mensah F. The maternal health study: Study design update for a prospective cohort of first-time mothers and their firstborn children from birth to age ten. Paediatr Perinat Epidemiol 2021; 35:612-625. [PMID: 33956353 DOI: 10.1111/ppe.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal health is critical to the health and well-being of children and families, but is rarely the primary focus of pregnancy and birth cohort studies. Globally, poor maternal health and the exposure of women and children to family violence contribute to the perpetuation and persistence of intergenerational health inequalities. OBJECTIVES The Maternal Health Study was designed to investigate the contribution of social and obstetric risk factors to common maternal physical and psychological morbidities. Over time, our focus has expanded to include mother-child pairs and investigation of intergenerational trauma and family violence. POPULATION A total of 1507 first-time mothers were recruited in early pregnancy from six public hospitals in Melbourne, Australia, in 2003-2005. METHODS Women completed questionnaires or telephone interviews in early pregnancy (≤24 weeks); at 32 weeks' gestation; at three, six, nine, 12 and 18 months postpartum; and at four and ten years. At ten years, women and children were invited to participate in face-to-face interviews, which included direct assessment of children's cognitive and language development. A wide range of obstetric, social and contextual factors have been measured, including exposure to intimate partner violence (IPV) (1-year, 4-year and 10-year follow-up). RESULTS 1507 eligible women were recruited at a mean gestation of 15 weeks. At one year, four years and ten years postpartum, 90.0%, 73.1% and 63.2% of the original cohort took part in follow-up. One in three women in the study (34.5%) reported exposure to IPV in the first ten years of motherhood: 19% in the first 12 months postpartum, 20% in the year prior to four-year follow-up and 18.3% in the year prior to ten-year follow-up. CONCLUSION The study affords a unique opportunity to examine patterns of maternal and child health and health service use associated with exposure to IPV.
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Affiliation(s)
- Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia.,Department of General Practice, The University of Melbourne, Melbourne, Vic., Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Hannah Woolhouse
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Monique Seymour
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Laura Conway
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Kelly M FitzPatrick
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Fallon Cook
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Sandra Papadopoullos
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Vic., Australia.,Royal Women's Hospital, Melbourne, Vic., Australia
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Vic., Australia
| | - Harriet Hiscock
- Health Services, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Vic, Australia
| | - Fiona Mensah
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
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Role of resilience for the association between trait hostility and depressive symptoms in Japanese company workers. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-0166-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Decades of research have consistently shown that the most common outcome following potential trauma is a stable trajectory of healthy functioning, or resilience. However, attempts to predict resilience reveal a paradox: the correlates of resilient outcomes are generally so modest that it is not possible accurately identify who will be resilient to potential trauma and who not. Commonly used resilience questionnaires essentially ignore this paradox by including only a few presumably key predictors. However, these questionnaires show virtually no predictive utility. The opposite approach, capturing as many predictors as possible using multivariate modelling or machine learning, also fails to fully address the paradox. A closer examination of small effects reveals two primary reasons for these predictive failures: situational variability and the cost-benefit tradeoffs inherent in all behavioural responses. Together, these considerations indicate that behavioural adjustment to traumatic stress is an ongoing process that necessitates flexible self-regulation. To that end, recent research and theory on flexible self-regulation in the context of resilience are discussed and next steps are considered.
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Affiliation(s)
- George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
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Anderson JR, Killian M, Hughes JL, Rush AJ, Trivedi MH. The Adolescent Resilience Questionnaire: Validation of a Shortened Version in U.S. Youths. Front Psychol 2020; 11:606373. [PMID: 33329281 PMCID: PMC7728789 DOI: 10.3389/fpsyg.2020.606373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/03/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Resilience is a factor in how youth respond to adversity. The 88-item Adolescent Resilience Questionnaire is a comprehensive, multi-dimensional self-report measure of resilience developed with Australian youth. Methods Using a cross-sectional adolescent population (n = 3,222), confirmatory factor analysis was conducted to replicate the original factor structure. Over half of the adolescents were non-white and 9th graders with a mean age of 15.5. Results Our exploratory factor analysis shortened the measure for which we conducted the psychometric analyses. The original factor structure was not replicated. The exploratory factor analysis provided a 49-item measure. Internal consistency reliability for all 12 factors ranged from acceptable (α> 0.70–0.80). The revised factor total scores were highly and significantly correlated with item–total correlation coefficients (r > 0.63, p < 0.001). Conclusion This revised shorter 49-item version of the Adolescent Resilience Questionnaire could be deployed and has acceptable psychometric properties.
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Affiliation(s)
- Jacqueline R Anderson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
| | - Jennifer L Hughes
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - A John Rush
- Duke National University of Singapore, Singapore, Singapore.,Department of Psychiatry, Duke Medical School, Durham, NC, United States.,Department of Psychiatry, Texas Tech Health Science Center, Midland, TX, United States
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Aburn G, Hoare K, Adams P, Gott M. Connecting theory with practice: Time to explore social reality and rethink resilience among health professionals. Int J Nurs Pract 2020; 26:e12893. [DOI: 10.1111/ijn.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Gemma Aburn
- Paediatric Palliative Care, Starship Child Health Auckland District Health Board Auckland New Zealand
- School of Nursing University of Auckland Auckland New Zealand
| | - Karen Hoare
- College of Health Massey University Auckland New Zealand
- Greenstone Family Clinic Auckland New Zealand
| | - Peter Adams
- Centre for Addiction Research, School of Population Health University of Auckland Auckland New Zealand
| | - Merryn Gott
- School of Nursing University of Auckland Auckland New Zealand
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Fonagy P, Butler S, Cottrell D, Scott S, Pilling S, Eisler I, Fuggle P, Kraam A, Byford S, Wason J, Smith JA, Anokhina A, Ellison R, Simes E, Ganguli P, Allison E, Goodyer IM. Multisystemic therapy compared with management as usual for adolescents at risk of offending: the START II RCT. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background
The Systemic Therapy for At Risk Teens (START) trial is a randomised controlled trial of multisystemic therapy (MST) compared with management as usual (MAU). The present study reports on long-term follow-up of the trial (to 60 months).
Objectives
The primary objective was to compare MST and MAU for the proportion of young people in each group with criminal convictions up to 60 months post baseline. Secondary outcomes included group comparisons of psychological and behavioural factors. An economic analysis was carried out to determine the cost-effectiveness of MST compared with MAU. Two qualitative studies were conducted to better understand the subjective experiences of the participants.
Design
Primary outcomes (collected up to 60 months) were collected using a centralised police database. Secondary outcomes were evaluated using self-report questionnaires completed by both young people and parents or carers at the 24-, 36- and 48-month follow-ups. Research assistants were blind to treatment allocation.
Setting
Participants were recruited from participating MST sites in nine areas of England. Secondary outcomes were typically collected within the family home.
Participants
A total of 684 families were recruited into the START trial and allocated randomly to a treatment group. Of these, 487 remained in the second phase of the trial. Young people were aged, on average, 13.8 years at baseline, with 63% male and 37% female.
Interventions
MST is a manualised programme for young people exhibiting antisocial behaviour and their families that uses principles from cognitive–behavioural and family therapy to provide an individualised approach. MAU content was not prespecified, but consisted of the standard care offered to young people who met eligibility for the trial.
Main outcome measures
Young people’s offending was evaluated using the Police National Computer. Secondary measures included validated self-report measures completed by both the young person and their parent or carer. The economic evaluation took a broad perspective and outcomes were assessed in terms of quality-adjusted life-years and offending.
Results
No significant differences were found in the proportion of offending between the groups (hazard ratio 1.03, 95% confidence interval 0.84 to 1.26; p = 0.78). No differences were found between the groups on secondary outcome measures, with a few exceptions that did not hold up consistently across the follow-up period. The economic analysis did not find evidence to support the cost-effectiveness of MST compared with MAU. Outcomes from the qualitative studies suggest that families mostly felt positive about MST, and that MST was associated with greater maturity in young men.
Limitations
Some intended evaluations were not possible to deliver. Selective attrition may have influenced the nature of the sample size. It is also unclear how representative the MAU services were of reality.
Future research
Recommendations are made for the evaluation of MST in populations with more severe behavioural problems, as well as for identifying and testing new moderators.
Conclusions
The results of the second phase of the START trial do not support the long-term superiority of MST to MAU, but elements of the intervention may be adapted successfully.
Trial registration
Current Controlled Trials ISRCTN77132214 and London South-East REC registration number 09/H1102/55.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 23. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Stephen Scott
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Ivan Eisler
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Peter Fuggle
- Anna Freud National Centre for Children and Families, London, UK
| | - Abdullah Kraam
- Univesity of Leeds and South West Yorkshire Partnership NHS Foundation Trust, Leeds, UK
| | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - James Wason
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Jonathan A Smith
- Department of Psychological Sciences, School of Science, Birkbeck, University of London, London, UK
| | - Alisa Anokhina
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Rachel Ellison
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Poushali Ganguli
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Ian M Goodyer
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Fonagy P, Butler S, Cottrell D, Scott S, Pilling S, Eisler I, Fuggle P, Kraam A, Byford S, Wason J, Smith JA, Anokhina A, Ellison R, Simes E, Ganguli P, Allison E, Goodyer IM. Multisystemic therapy versus management as usual in the treatment of adolescent antisocial behaviour (START): 5-year follow-up of a pragmatic, randomised, controlled, superiority trial. Lancet Psychiatry 2020; 7:420-430. [PMID: 32353277 DOI: 10.1016/s2215-0366(20)30131-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/17/2020] [Accepted: 03/13/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Multisystemic therapy is a manualised treatment programme for young people aged 11-17 years who exhibit antisocial behaviour. To our knowledge, the Systemic Therapy for At Risk Teens (START) trial is the first large-scale randomised controlled trial of multisystemic therapy in the UK. Previous findings reported to 18 months after baseline (START-I study) did not indicate superiority of multisystemic therapy compared with management as usual. Here, we report outcomes of the trial to 60 months (START-II study). METHODS In this pragmatic, randomised, controlled, superiority trial, young people (aged 11-17 years) with moderate-to-severe antisocial behaviour were recruited from social services, youth offending teams, schools, child and adolescent mental health services, and voluntary services across England, UK. Participants were eligible if they had at least three severity criteria indicating past difficulties across several settings and one of five general inclusion criteria for antisocial behaviour. Eligible families were randomly assigned (1:1), using stochastic minimisation and stratifying for treatment centre, sex, age at enrolment, and age at onset of antisocial behaviour, to management as usual or 3-5 months of multisystemic therapy followed by management as usual. Research assistants and investigators were masked to treatment allocation; the participants could not be masked. For this extension study, the primary outcome was the proportion of participants with offences with convictions in each group at 60 months after randomisation. This study is registered with ISRCTN, ISRCTN77132214, and is closed to accrual. FINDINGS Between Feb 4, 2010, and Sept 1, 2012, 1076 young people and families were assessed for eligibility and 684 were randomly assigned to management as usual (n=342) or multisystemic therapy (n=342). By 60 months' of follow-up, 188 (55%) of 342 people in the multisystemic therapy group had at least one offence with a criminal conviction, compared with 180 (53%) of 341 in the management-as-usual group (odds ratio 1·13, 95% CI 0·82-1·56; p=0·44). INTERPRETATION The results of the 5-year follow-up show no evidence of longer-term superiority for multisystemic therapy compared with management as usual. FUNDING National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Stephen Scott
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ivan Eisler
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter Fuggle
- Anna Freud National Centre for Children and Families, London, UK
| | - Abdullah Kraam
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Rotherham Doncaster and South Humber NHS Foundation Trust, Doncaster, UK
| | - Sarah Byford
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Jonathan A Smith
- Department of Psychological Sciences, Birkbeck College, University of London, London, UK
| | - Alisa Anokhina
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rachel Ellison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Poushali Ganguli
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Prabhu SG, Shekhar R, Philips M. Development and Standardization of a Scale to Measure Adolescent Resilience- A Study in the Indian Context. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:253-265. [PMID: 33300469 DOI: 10.1080/26408066.2020.1724843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study aimed to develop and standardize a scale to measure adolescent resilience in India. The objectives were to (i) construct a comprehensive scale for assessing adolescent resilience (ii) select and test the measurability of items in the resilience scale (iii) test the reliability and validity of the scale and (iv) establish the group differences in resilience among different groups. A total of 1214 adolescents from grades 8 to 10 (aged 10-17 years) were selected through cluster random sampling. The items were developed after an extensive literature review. Face, content, concurrent and convergent validities were established. Nine meaningful factors emerged from factor analysis. Different types of reliability tests showed the scale to be a reliable one (with the values ranging from 0.812 to 0.902). Differences in resilience were noted in adolescent girls and boys and based on the background to which they belonged. Higher resilience scores meant better resilience.
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Affiliation(s)
- Sphoorthi G Prabhu
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Rameela Shekhar
- Department of Social Work, School of Social Work, Roshni Nilaya, Mangaluru, India
| | - Mariamma Philips
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Singh R, Mahato S, Singh B, Thapa J, Gartland D. Resilience In Nepalese Adolescents: Socio-Demographic Factors Associated With Low Resilience. J Multidiscip Healthc 2019; 12:893-902. [PMID: 31806987 PMCID: PMC6844232 DOI: 10.2147/jmdh.s226011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background Resilience can be viewed as the potential to deal with stress positively. Resilient adolescents are likely to enter adulthood with a greater capacity to cope well in difficult circumstances. The purpose of this study was to measure resilience and the socio-demographic characteristics of Nepalese adolescents with low resilience. Methods A cross-sectional study of 4 randomly selected secondary schools in Lalitpur, Nepal, was conducted with 416 adolescent students (54.8% girls; M=16.1 years, SD=1.5). Resilience was measured using the Adolescent Resilience Questionnaire (ARQ) in Nepali. Socio-demographic factors investigated included personal (e.g. gender, age, ethnicity, religion, birth order, and participation in exercise), family (e.g. type of family, parents' relationship status, employment and literacy) and community factors (e.g. living in an urban area). Results Mean resilience score was 311.7 (95% CI 308.6-314.5; SD=32.1) with 17.5% of adolescents classified as having low resilience. Socio-demographic factors associated with having low resilience included female gender (OR=1.73, 95% CI=1.03-2.95), attending a private school (OR=1.77, 95% CI=1.06-2.98), higher birth order compared to first born (OR=4.79, 95% CI=2.46-9.32), living in an urban area (OR=2.18, 95% CI=1.28-3.71); and being physically inactive (OR=3.0, 95% CI=1.77-5.08). Conclusion This first investigation of resilience in Nepalese adolescents using a standardised measure of resilience identified a number of socio-demographic factors as being associated with low resilience. While most socio-demographic factors are not modifiable, they can be used to guide educators and health professionals working with adolescents to identify those who may need greater support to achieve positive outcomes in the often challenging transition through adolescence and into adulthood.
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Affiliation(s)
- Rakesh Singh
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Sharika Mahato
- The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Babita Singh
- National Medical College and Teaching Hospital, Tribhuvan University, Birgunj, Nepal
| | - Jeevan Thapa
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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Singh R, Mahato S, Singh B, Bhushal S, Fomani FK. Psychometric properties of Adolescent Resilience Questionnaire among Nepalese adolescents in Lalitpur. Asian J Psychiatr 2019; 45:13-17. [PMID: 31430691 DOI: 10.1016/j.ajp.2019.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/29/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Although the need of measuring resilience among adolescents has gained attention in recent decades, there is no availability of an appropriate tool designed yet to assess resilience among Nepalese adolescents. This paper describes the psychometric properties of Adolescent Resilience Questionnaire (ARQ) among Nepalese adolescent students in Lalitpur which could be a possible tool for measuring resilience. METHOD The ARQ was translated into Nepali and back translated in English. The Nepali ARQ was self-administered in 512 adolescent students with 46.7% boys between the age of 13 and 19 years (M = 16.07 years, SD = 1.49) enrolled in six secondary schools in Lalitpur, Nepal. Test-retest reliability was assessed among 52 adolescent students within an interval of two weeks. RESULTS Findings confirmed 12 scales and 5 domain factor structure of adolescents' resilience. Cronbach's alpha coefficient (α) for the scales and domains ranged between 0.64-0.86 and 0.71-0.86. The values of Intraclass correlation coefficient (ICC) showed that test-retest reliability of the scales and domains ranged between good and excellent with an overall ICC 0.95 (95% CI 0.92-0.97). CONCLUSION The Nepali version of the ARQ can be used to measure resilience among adolescents in Lalitpur, Nepal. Further studies are recommended to assess adolescents' resilience using the ARQ in diverse settings including communities of various provinces and regions of Nepal.
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Affiliation(s)
- Rakesh Singh
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal.
| | - Sharika Mahato
- The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Babita Singh
- National Medical College and Teaching Hospital, Tribhuvan University, Birgunj, Nepal
| | - Suraj Bhushal
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
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Mohammadinia L, Ebadi A, Malekafzali H, Allen KA, Sharif Nia H. The design and psychometric evaluation of the Adolescents' Resilience in Disaster Tool (ARDT-Q37): A mixed method study. Heliyon 2019; 5:e02019. [PMID: 31360784 PMCID: PMC6639693 DOI: 10.1016/j.heliyon.2019.e02019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/07/2019] [Accepted: 06/27/2019] [Indexed: 11/28/2022] Open
Abstract
Adolescent resilience after a disaster has been shown to be a protective factor against loss, trauma, and psychological distress. Its importance for successful disaster recovery is widely accepted by disaster risk management professionals, yet very few tools are available to assess adolescent resilience during an emergency or after a natural disaster has occurred. The aim of this study was to develop and evaluate the psychometric properties of a questionnaire designed to measure adolescents' resilience before, during or after a natural disaster. This mixed method study was carried out in three phases involving item generation, systematic review (phase one), qualitative analysis (phase two) and the reduction of items (phase three). The psychometric evaluation of the Adolescents' Resilience in Disaster Tool (ARDT) was conducted using the data from 599 high school students North of Iran (Golestan Province). The initial item pool included 80 items that were reduced to 37 after assessment of validity (face, content and structure) and reliability. Exploratory Factor Analysis found five factors that affect adolescents' resilience which included helping, trusting in God and hopefulness, adaptability, self-confidence and social support. The internal consistency was desirable (α = .86 and ICC = .91; 95% CI: .849 to .948). The psychometric support for the 37-item version of the ARDT in this study indicates strong support for the ARDT-Q37 as a rapid assessment tool to evaluate resilience in adolescents aged 12–18 years old. Identifying the status of adolescents’ resilience and determining their level of need for intervention during and after a natural disaster is critical for long- and short-term outcomes. Implications for policy makers and professionals involved in the preparedness, response and recovery from natural disasters are discussed.
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Affiliation(s)
- Leila Mohammadinia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Human Resource Research Center, Department of Health in Emergencies and Disasters, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Kelly A Allen
- Educational Psychology and Inclusive Education, The Faculty of Education, Monash University, Australia
| | - Hamid Sharif Nia
- Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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Resilience resources among African American women living with HIV in Southern United States. AIDS 2019; 33 Suppl 1:S35-S44. [PMID: 31397721 DOI: 10.1097/qad.0000000000002179] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES African American women living with HIV (WLH) often face various challenges to access to and benefit from healthcare across the HIV treatment cascade. Despite experiencing multiple forms of ongoing adversity, some African American WLH are able to adapt and stand strong. The current study aims to identify resources at various socioecological levels that facilitate resilience and explore how these resources interact with each other. DESIGN Guided by the theories of resilience, we collected qualitative data through in-depth interviews with 14 African American WLH in South Carolina, United States. METHODS Participants were purposely recruited and interviewed in private settings in 2016. With appropriate consent, each interview was recorded and was transcribed verbatim. Data analysis was conducted using NVivo 11.0. RESULTS The participants described six major resilience resources including first, internal strength; second, religion and spirituality; third, hopefulness about life and future; fourth, self-awareness and self-care; fifth, social support from family and community; and sixth, HIV-related health facilities. The themes that occurred in qualitative data also show how resilience resources at the family/community level and institutional level affected individual resources, and how these resources collaborated with each other. CONCLUSION The findings suggest that resilient African American WLH maintain hope in the face of adversity and seek out and obtain social support. Self-care, social support, and health facilities are particularly critical resources for African American WLH. Comprehensive interventions are needed to integrate these resources across multiple socioecological levels to enhance resilience and treatment outcomes in African American WLH.
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Phillips SP, King N, Michaelson V, Pickett W. Sex, drugs, risk and resilience: analysis of data from the Canadian Health Behaviour in School-aged Children (HBSC) study. Eur J Public Health 2019; 29:38-43. [PMID: 30188987 PMCID: PMC6345143 DOI: 10.1093/eurpub/cky169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Risk-taking behaviour among adolescents, particularly those experiencing childhood adversities, can predispose to injury, unwanted pregnancy, long-term morbidity and death. Resilience, i.e. adapting to threats and thriving, has rarely been examined as a protective factor for adolescent risk-taking. We studied whether the malleable traits of empathy, confidence, self-control and optimism, all markers of resilience, align with decreased risk-taking despite adversity, among 11-15 year olds. Methods From responses of 22 643 Canadian youth to the Health Behaviour in School-aged Children (2014) survey we validated a five-item resilience scale. Using regression analyses, this scale and a single measure of self-control were considered as potential protective factors for a composite measure of risk-taking behaviour and of initiation of sexual activity before age 14. Results There was a dose-dependent association between greater resilience and diminished risk-taking for boys and, even more so, among girls. This relationship remained significant after controlling for family and social support, implying that greater resilience may override the detrimental impact of childhood adversity on risk-taking. The least resilient youth were most likely to report early sexual activity, although this relationship was not linear. Generally, the impact of self-control on risk-taking was not statistically significant, perhaps because of shortcomings of the self-control indicator. Conclusion Brief screening protocols can identify assets that protect against risk-taking behaviours among adolescents. The malleable nature of these traits offers primary care providers and public health personnel a novel and effective route to decreasing adolescent risk-taking and fostering future health.
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Affiliation(s)
- Susan P Phillips
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Valerie Michaelson
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Department of Religious Studies, Queen's University, Kingston, Ontario, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
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Surzykiewicz J, Konaszewski K, Wagnild G. Polish Version of the Resilience Scale (RS-14): A Validity and Reliability Study in Three Samples. Front Psychol 2019; 9:2762. [PMID: 30705657 PMCID: PMC6344465 DOI: 10.3389/fpsyg.2018.02762] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/21/2018] [Indexed: 01/07/2023] Open
Abstract
There has been a need for an instrument which not only can adequately evaluate trait-like resilience, but also can be applied to Polish adolescents and young adults. The purpose of this study was to validate the Resilience Scale RS-14 (Wagnild, 2009a,b). We aimed to examine and assess the psychometric properties of the Polish version in three different samples. The first sample was made up of adolescents aged 13–17 (N = 400).The second sample was made up of a problem group aged 13–18 (N = 656) who had special needs and attended either Probation Centers, Youth Sociotherapy Centers, or Youth Educational Centers. The third sample was made up of students in early adulthood aged 19–27 (N = 1,659). Exploratory and confirmatory factor-analytic methods were employed. CFA demonstrated a good fit of the factor structure in all three samples. The original one-dimensional structure of the RS short form was confirmed. All items loaded (>0.40) onto 1 factor, indicating cohesive structure for a 1-factor model explaining 35.02% of the variance in the whole sample, 34.62% in the young adolescent sample, 31.11% in the problem sample, and 38.51% in the early adulthood sample. Descriptive statistics, reliability (young adolescence α = 0.85, problem sampleα = 0.82 early adulthood α = 0.87) and validity data were calculated; test-retest showed good stability [r(40) = 0.88; p < 0.001]. The validity of the scale RS-14 was applied in two groups (the N = 382 early adulthood aged 19–27, and the N = 120 problem group aged 13–18) and was subsequently evaluated. The RS-14 correlated significantly, as expected, with measures of positive concepts (satisfaction with life). Results showed that resilience was negatively related with indexes of perceived stress and the dimension-of-depression. Findings support the RS-14 to be a valid and useful instrument for assessing resilience in diverse Polish adolescent groups, including those with special needs and those in early adulthood.
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Affiliation(s)
- Janusz Surzykiewicz
- Faculty of Philosophy and Education, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany.,Faculty of Education, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - Karol Konaszewski
- Faculty of Pedagogy and Psychology, University of Białystok, Białystok, Poland
| | - Gail Wagnild
- The Resilience Center, Billings, MT, United States
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Mohammadinia L, Khorasani-Zavareh D, Ebadi A, Malekafzali H, Ardalan A, Fazel M. Characteristics and components of children's and adolescents' resilience in disasters in Iran: a qualitative study. Int J Qual Stud Health Well-being 2019; 13:1479584. [PMID: 29932844 PMCID: PMC6032014 DOI: 10.1080/17482631.2018.1479584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Children and adolescents are vulnerable in times of disaster and they will suffer more severely if neglected. The concept of resilience differs between cultures, and identifying the components of resilience is essential for decision making and interventions in disasters such as risk management. This study aimed to identify the components of children's resilience in disasters in Iran. This qualitative study took a content-analysis approach. Data were collected through semi-structured interviews with 23 people and three group meetings. Conventional content analysis was used for data analysis. MAXQDA 10 software was used for classification. The resilience components derived from the data were categorized into two main categories, internal and external, and eight subcategories covering psychological, emotional, cognitive, mental, spiritual, physical, social, and behavioral factors. The results also showed that the nature of resilience is both intrinsic and extrinsic. Recognizing the dimensions of children's resilience in disasters can lead to a new perspective for authorities and planners in disaster and emergency situations. The results of this study could be used by planners and policymakers to develop interventions to enhance children's and adolescents' resilience at the time of disasters, which is also underlined and highlighted by international documents.
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Affiliation(s)
- Leila Mohammadinia
- a Department of Disaster Public Health, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.,b Health Human Resource Research Center, Department of Health in Disasters and Emergencies, School of Management &Information Sciences , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Davoud Khorasani-Zavareh
- c Safety Promotion and Injury Prevention Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran.,d Department of Health in Disaster and Emergency, School of Health, Safety and Environment , Shahid Beheshti University of Medical Sciences , Tehran , Iran.,e Department of Clinical Science and Education, Södersjukhuset , Karolinska Institutet , Stockholm , Sweden
| | - Abbas Ebadi
- f Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing , Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Hossein Malekafzali
- g Department of Heath Policy , Permanent Member of Iranian Academy of Medical Sciences , Tehran , Iran
| | - Ali Ardalan
- a Department of Disaster Public Health, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.,h Harvard Humanitarian Initiative , Harvard University , Cambridge , MA , USA
| | - Mojtaba Fazel
- i Pediatric Nephrology, Valiasr Hospital, Imam Complex , Tehran University of Medical Science , Tehran , Iran
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Isobe A, Izumi M, Akifusa S. Relationship Between Resilience and Self-Rated Health in Dental Hygiene Students and Registered Dental Hygienists. J Dent Educ 2018; 82:1343-1350. [PMID: 30504473 DOI: 10.21815/jde.018.142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/19/2018] [Indexed: 11/20/2022]
Abstract
The aim of this study was to investigate whether two aspects of resilience-acquired and innate resilience-were related to self-rated health status in registered dental hygienists and students. In May through July 2017, 405 students at three dental hygiene programs and 85 registered dental hygienists, all in Fukuoka prefecture in Japan, were invited to participate in a survey including three scales: the Bidimensional Resilience Scale (BRS) to assess innate and acquired resilience, the Stress Response Scale-18 (SRS-18) to assess daily stress responses, and the Sense of Coherence 13-item scale (SOC-13) to assess the sense of coherence. Information about self-rated health status and number of years of clinical experience was also collected. Respondents were 398 students (98.2% response rate) and all 85 dental hygienists (100% response rate). The cohort with a self-rated "healthy" status scored higher on total scale and each domain of the BRS, SRS-18, and SOC-13 scales than the cohort with other self-rated health statuses. These three scales and self-rated health status were significantly correlated with each other. When innate resilience increased by one point, average self-rated health was 1.14-fold higher. In contrast, when the depression/anxiety domain score of SRS-18 increased by one point, self-rated health was 0.84-fold lower. The number of years of clinical experience was also negatively correlated with self-rated health. For these participants, innate resilience was a significant predictor of better self-rated health. To maintain the health of dental hygienists and students, it is important to understand their innate resilience as well as stress responses related to depression/anxiety factors and length of clinical experience.
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Affiliation(s)
- Ayaka Isobe
- Ayaka Isobe, RDH, MOHSc, is Assistant Professor, Department of Support for Senior Citizens, Kyushu Dental University, Fukuoka, Japan; Maya Izumi, RDH, MSN, PhD, is Lecturer, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan; and Sumio Akifusa, DDS, PhD, is Professor, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan
| | - Maya Izumi
- Ayaka Isobe, RDH, MOHSc, is Assistant Professor, Department of Support for Senior Citizens, Kyushu Dental University, Fukuoka, Japan; Maya Izumi, RDH, MSN, PhD, is Lecturer, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan; and Sumio Akifusa, DDS, PhD, is Professor, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan
| | - Sumio Akifusa
- Ayaka Isobe, RDH, MOHSc, is Assistant Professor, Department of Support for Senior Citizens, Kyushu Dental University, Fukuoka, Japan; Maya Izumi, RDH, MSN, PhD, is Lecturer, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan; and Sumio Akifusa, DDS, PhD, is Professor, School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan.
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Waite-Jones JM, Swallow V. Peer-based Social Support for Young-People with Juvenile Arthritis: Views of Young People, Parents/Carers and Healthcare Professionals within the UK. J Pediatr Nurs 2018; 43:e85-e91. [PMID: 30078727 DOI: 10.1016/j.pedn.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE A deeper understanding was sought of what peer-based social support means to young people with juvenile arthritis within the UK and ways in which it could be best provided. DESIGN AND METHODS A secondary analysis of underused, descriptively rich data relating to peer-based support contributed by young people with juvenile arthritis, their parents/carers and healthcare professionals from a qualitative study (seeking their views on a potential self-management mobile-app) was carried out using methods suggested by Interpretive Phenomenological Analysis. RESULTS Peer-based support can provide a new kind of 'normality' for young people with juvenile arthritis, including greater understanding, relief, reassurance, shared learning and increased self-efficacy. However, the risk of stigma through this shared identity suggests a need to offer various forms of access including using new electronic media. CONCLUSION AND IMPLICATIONS The evidence suggests that although desired, the potential social cost of identifying with peers living with juvenile arthritis is influenced by the way such support is provided, which in turn impacts on how readily it will be accessed. This suggests the need to provide various means of accessing peer-based contact, including electronic media, to ensure that young people with juvenile arthritis benefit. Therefore, when promoting and supporting peer-based social support, as far as possible, professionals need to individualise ways in which such support can be accessed because there is no 'one size fits all' approach.
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Affiliation(s)
| | - Veronica Swallow
- School of Healthcare, University of Leeds, Leeds, UK; Faculty of Science, Charles Sturt University, Bathurst, Australia.
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Jefferis TC, Theron LC. Explanations of resilience in women and girls: How applicable to black South African girls. WOMENS STUDIES INTERNATIONAL FORUM 2018. [DOI: 10.1016/j.wsif.2018.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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44
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Gallagher ML, Miller AB. Suicidal Thoughts and Behavior in Children and Adolescents: An Ecological Model of Resilience. ADOLESCENT RESEARCH REVIEW 2018; 3:123-154. [PMID: 29904718 PMCID: PMC5995470 DOI: 10.1007/s40894-017-0066-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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45
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Prevalence of dissociative symptoms in adolescent psychiatric inpatients. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2018. [DOI: 10.1016/j.ejtd.2017.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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46
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Oliveira ACPD, Machado APG, Aranha RN. Identification of factors associated with resilience in medical students through a cross-sectional census. BMJ Open 2017; 7:e017189. [PMID: 29133319 PMCID: PMC5695417 DOI: 10.1136/bmjopen-2017-017189] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Research on resilience has been gaining momentum, and it has already been shown that increased resilience creates positive changes at the individual and collective levels. Understanding of the factors associated with resilience may guide specific actions directed towards different populations. The objective of this study was to investigate these associated factors within a population of medical students. DESIGN Cross-sectional census. SETTING A public medical school in the state of Rio de Janeiro, Brazil. PARTICIPANTS Out of a total of 551 medical students, five students were excluded due to inactive registrations, and four transferred students were also excluded, resulting in a total of 542 remaining participants. MEASURES Adopting an anonymous questionnaire that included the Resilience Scale, in addition to questions related to sociodemographic, behavioural health-related and academic variables, the association between these variables and resilience was investigated. RESULTS The high rate of answers to each item constitutes a indication of students' interest in participating, whereas the lowest percentile was 97.1%. The mean resilience score obtained was considered moderate. Factors such as gender, race, previous schools attended, financial independence, living situation, parents' education level, religion, quota-based admission, smoking, alcohol abuse and use of illegal drugs were not associated with resilience. In a multivariate analysis using ordinal logistic regression, associations were maintained only between the highest resilience score and the non-use of habit-forming prescription drugs (OR: 0.58; 95% CI 0.41 to 0.80), having a better perception of one's own health (OR: 0.57; 95% CI 0.41 to 0.81) and being older (OR: 1.37; 95% CI 1.12 to 1.67). CONCLUSION The census performed with the medical students showed, with the multivariate analysis, that besides age, the variables most closely tied with resilience were health and medicalisation, and the variables connected with income and religion showed no association.
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Affiliation(s)
| | | | - Renata Nunes Aranha
- Public Health, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Barger J, Vitale P, Gaughan JP, Feldman-Winter L. Measuring Resilience in the Adolescent Population: A Succinct Tool for Outpatient Adolescent Health. J Pediatr 2017; 189:201-206.e3. [PMID: 28705652 DOI: 10.1016/j.jpeds.2017.06.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/03/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To create a valid tool to measure adolescent resilience, and to determine if this tool correlates with current participation in risk behaviors and prior adverse childhood events. STUDY DESIGN One hundred adolescents were recruited from primary care clinics in New Jersey for this cross-sectional study. A "7Cs tool" was developed to measure resilience using the 7Cs model of resilience. All participants completed the 7Cs tool, the Adverse Childhood Events Survey, and the Health Survey for Adolescents to identify current risk behaviors. Demographic and background data were also collected. To assess the validity of the 7Cs tool, Cronbach alpha, principal factor analysis, Spearman coefficients, and sensitivity analyses were conducted. The χ2 test and ORs were used to determine if any relationships exist between resilience and prior adverse childhood events and risk taking behaviors. RESULTS Participants ranged from 13 to 21 years old (65% female). Internal consistency was established using Cronbach alpha (0.7). Lower resilience correlated with higher adverse childhood events (P = .008) and Health Survey for Adolescents scores (P < .001). Lower resilience was associated with increased problems in school (OR 2.6; P = .021), drug use (OR 4.0; P = .004), violent behavior (OR 3.7; P = .002), recent depression (OR 5.0; P < .001), and suicidality (OR 4.1; P = .009). Higher resilience was associated with participation in exercise (P = .001) and activities (P = .01). CONCLUSIONS The 7Cs tool is an internally validated tool that may be used to screen adolescent resilience and guide pediatricians' counseling against risk behaviors. Further studies will evaluate resilience-building interventions based on results from this study.
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Affiliation(s)
- Jordan Barger
- Cooper Medical School of Rowan University, Camden, NJ
| | - Patty Vitale
- Departments of Pediatrics and Emergency Medicine, The Cooper University Hospital, Camden, NJ
| | - John P Gaughan
- Research Institute, Cooper University Health Care, Camden, NJ
| | - Lori Feldman-Winter
- Department of Pediatrics, The Children's Regional Hospital at Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ.
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Pérez-González A, Guilera G, Pereda N, Jarne A. Protective factors promoting resilience in the relation between child sexual victimization and internalizing and externalizing symptoms. CHILD ABUSE & NEGLECT 2017; 72:393-403. [PMID: 28917189 DOI: 10.1016/j.chiabu.2017.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
Sexual victimization has been one of the most frequently studied forms of child victimization. Its effects are common and diverse; however, not all children and youth exposed to sexual victimization eventually develop adjustment problems. A total of 1105 children and youth (590 male and 515 female) aged between 12 and 17 from northeastern Spain were assessed regarding their experiences of sexual victimization, symptoms of psychopathology, and protective factors. The results showed that all forms of sexual victimization were associated with higher levels of emotional and behavioral problems. However, the presence of a low Negative Cognition, high Social Skills and high Confidence seem to act buffering internalizing problems. Additionally, a significant interaction between Sexual Victimization and low Negative Cognition was observed (p<0.5), so that, low Negative Cognition was related to a lower risk of being in the clinical range for internalizing problems. Likewise, high scores on Empathy/Tolerance, Connectedness to School, Connectedness to Family and low Negative Cognition acted as promotive factors in relation to externalizing symptoms, in this case without any interaction effect. The strong relationship found with emotional and behavioral problems highlights the importance of continuing the research on the protective factors underlying resilience in the relationship between sexual victimization and psychopathological symptoms. The findings also support the multi-dimensional and specific nature of resilience and identify some of the protective factors that should be regarded as key intervention targets in adolescents with a history of sexual victimization.
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Affiliation(s)
- Alba Pérez-González
- Grup de Recerca en Victimització Infantil i Adolescent (GReVIA), University of Barcelona, Spain; Grup de Tècniques Estadístiques Avançades Aplicades a la Psicología (GTEAAP), University of Barcelona, Spain.
| | - Georgina Guilera
- Grup de Recerca en Victimització Infantil i Adolescent (GReVIA), University of Barcelona, Spain; Institut de Neurociències, University of Barcelona, Spain
| | - Noemí Pereda
- Grup de Recerca en Victimització Infantil i Adolescent (GReVIA), University of Barcelona, Spain; Institut de Neurociències, University of Barcelona, Spain
| | - Adolfo Jarne
- Grup de Tècniques Estadístiques Avançades Aplicades a la Psicología (GTEAAP), University of Barcelona, Spain
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Joling KJ, Windle G, Dröes RM, Huisman M, Hertogh CMPM, Woods RT. What are the essential features of resilience for informal caregivers of people living with dementia? A Delphi consensus examination. Aging Ment Health 2017; 21:509-517. [PMID: 26689489 DOI: 10.1080/13607863.2015.1124836] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Few studies have examined what might enable or prevent resilience in carers of people with dementia. Consequently, there are limited insights as to how it should be understood, defined and measured. This creates challenges for research, and also practice in terms of how it might best be promoted. This study aimed to address these limitations and add new insights, identifying the essential features of resilience in dementia caregiving. METHODS A Delphi consensus study was conducted, consulting a multi-disciplinary panel of informal caregivers and experts with relevant professional expertise. Panellists rated the relevance of various statements addressing essential components of resilience; 'adversity' and 'successful caregiving' on a 5-point Likert scale. Based on the median and Inter Quartile Range, the most relevant statements with moderate consensus were proposed in Round 2 in which panellists selected up to five statements in order of importance. RESULTS Moderate consensus was reached for all statements after two rounds. Patients' behavioural problems and feeling competent as a caregiver were selected by both caregivers and professionals as essential resilience features. Caregivers also emphasized the importance of social support, the quality of the relationship with their relative and enjoying spending time together. Professionals considered coping skills, experiencing positive aspects of caregiving, and a good quality of life of caregivers most relevant. CONCLUSION The essential elements of resilience selected from multiple stakeholder perspectives can be used to select appropriate outcomes for intervention studies and give guidance to policy to support caregivers more effectively and better tailored to their needs.
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Affiliation(s)
- Karlijn J Joling
- a VU University Medical Center , EMGO+ Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine , Amsterdam , The Netherlands
| | - Gill Windle
- b Dementia Services Development Centre Wales , School of Healthcare Sciences, Bangor University , Bangor , United Kingdom
| | - Rose-Marie Dröes
- c VU University Medical Center , EMGO+ Institute for Health and Care Research, Department of Psychiatry , Amsterdam , The Netherlands
| | - Martijn Huisman
- d VU University Medical Center , EMGO+ Institute for Health and Care Research, Department of Psychiatry, Department of Sociology, Department of Epidemiology and Biostatistics , Amsterdam , The Netherlands
| | - Cees M P M Hertogh
- a VU University Medical Center , EMGO+ Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine , Amsterdam , The Netherlands
| | - Robert T Woods
- b Dementia Services Development Centre Wales , School of Healthcare Sciences, Bangor University , Bangor , United Kingdom
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Cheraghi MA, Ebadi A, Gartland D, Ghaedi Y, Fomani FK. Translation and validation of "Adolescent Resilience Questionnaire" for Iranian adolescents. Asian J Psychiatr 2017; 25:240-245. [PMID: 28262160 DOI: 10.1016/j.ajp.2016.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 12/04/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Resilience is the process by which adolescents are able to maintain or regain positive outcomes despite stress and negative emotional experiences. Assessing resilience is important to identify adolescentś strengths and vulnerabilities. There are currently no resilience instruments available for Iranian adolescents. This paper describes the translation and validation of Adolescent Resilience Questionnaire (ARQ) for use with Iranian adolescents. METHOD The ARQ was translated into Persian and back-translated. Proportional stratified sampling was used to recruit a representative sample of 523 adolescents aged 11-19 years from 38 public and private high schools in Tehran. Total scale and subscale reliability were examined using Cronbach alpha. Test-retest reliability was conducted with 38 adolescents who completed the ARQ twice with a two week interval in between and assessed using intra-class correlation coefficients (ICC). FINDINGS Cronbach alpha coefficients were equal to or greater than 0.70 for all scales, after the removal of one item in the Community scale. Test-retest reliability for the overall ARQ score was excellent (ICC=0.83, 95%CI, 0.76-0.93) and very good for individual subscales (ICC=0.70-0.79). CONCLUSION The present study provides evidence of good validity, reliability and test-retest reliability of the Persian ARQ for Iranian adolescents. Further testing, including construct validity, and testing across different contexts will strengthen the evidence. The instrument will have applications in resilience research, educational and clinic settings and could facilitate the development and evaluation of intervention programs to build resilience in Iranian adolescents.
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Affiliation(s)
- Mohammad Ali Cheraghi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Deirdre Gartland
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Yahya Ghaedi
- Department of Educational Philosophy, Kharazmi University, Tehran, Iran.
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