Reliability and validity of the Khmer version of the 10-item Connor-Davidson Resilience Scale (Kh-CD-RISC10) in Cambodian adolescents

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN

Background

Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical.

Objective

This review study aimed to evaluate the psychometrics quality of resilience scales.

Methods

International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality.

Results

Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent.

Conclusion

The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis

BACKGROUND

Non-suicidal self-injury (NSSI) by adolescent patients with depression has become a serious public health problem. This cross-sectional study aims to identify subgroups of adolescents based on NSSI and explore the factors related to these subgroups.

METHODS

The study recruited 326 in- and out-patient adolescents (263 girls and 63 boys) aged 12 to 18 years (mean = 14.7, SD = 1.6) who had self-injured in the past year. Latent class indicators included 12 NSSI variables, as well as suicidal ideation. Logistic regression examined associations between identified classes and related factors.

RESULTS

In this study, two distinct subgroups were identified: a "high suicidal ideation NSSI group" (n = 129, 39.6%) and a "low suicidal ideation NSSI group" (n = 197, 60.4%). Depression (OR = 1.10; 95% CI, 1.05-1.16), female (OR = 2.01; 95% CI, 1.09-3.69), left-behind experience (OR = 2.08; 95% CI, 1.17-3.71), single-parent family (OR = 1.84; 95% CI, 1.11-3.04) and peer victimization (OR = 1.04; 95% CI, 1.02-1.05) increases the probability of belonging to the "high suicidal ideation NSSI group". A high level of perceived social support (OR = 0.99; 95% CI, 0.97-0.99) was a protective factor towards NSSI.

CONCLUSIONS

This study identifies two subgroups of NSSI and the factors associated with each subgroup. The early identification of high-risk groups for major NSSI in adolescents diagnosed with depression is possible due to the identification of correlating factors. Different treatment plans can be developed for different subtypes of NSSI to improve the effectiveness of prevention and intervention, promoting the healthy physical and mental development of adolescents with depression.

'I feel hopeless': Exploring the psychosocial impacts of caring for mentally ill relatives in Cambodia

BACKGROUND

There is growing recognition of the psychosocial burden of caregiving on relative caregivers of the mentally ill in low-and middle-income countries. Yet there remains limited formal research examining the challenges and psychosocial support needs of these relative caregivers, particularly with sensitivity to understanding caregiver experiences across diverse cultures and contexts. The purpose of this study was to study caregiver burden to inform potential intervention approaches among relative caregivers of treatment-engaged mentally ill patients in Cambodia.

METHODS

Participants were all relative caregivers identified through their connection to a non-governmental organization providing psychiatric care. Five focus group discussions were held with 37 participants to explore challenges experienced by relative caregivers. A total of 115 caregivers then completed a mental health assessment consisting of the Patient Health Questionnaire - 9 item scale, Generalized Anxiety Disorder - 7-item scale, and 21-item Depression, Anxiety, and Stress Scale. Internal consistencies ranged from α = .81 to .87 across scales.

RESULTS

Five themes emerged from the focus group discussions: financial burden, erratic behavior of patients, social alienation, somatic and emotional symptoms, and barriers to help-seeking. Assessment data indicated the sample was highly symptomatic. Women and those with no employment appeared to be at higher risk of distress, as were those caregivers with a biological relationship to the patient (parents, children, and siblings; relative to spouses or other relationships).

DISCUSSION

Findings suggest a need for regular screening and greater psychosocial support for relative caregivers. It is notable that the needs identified within the current study remain prominent even as this is a treatment-engaged sample.

Adolescent Victimization during COVID-19 Lockdowns and Its Influence on Mental Health Problems in Seven Countries: The Mediation Effect of Resilience

The objective of this study was to test the differences between the mean scores of victimization, an indicator of depression, stress, and anxiety (DASS), across seven countries (Australia, Chile, India, Indonesia, Mexico, Poland, and the Russian Federation) during the COVID-19 lockdowns. In addition, this study sought to analyze the mediator role of resilience in these relationships in the different countries. To this end, a structural equation model (SEM) was tested and differences across countries were considered through a multigroup analysis. Data for adolescent students from seven countries (n = 7241) collected by the Global Research Alliance showed that levels of anxiety, depression, and stress among adolescents were different in the countries assessed; all of them presented values above the mean of the indicator, with Chile and Russia having the highest values. Regarding the prevalence of exposure to violence, the mean across all countries studied was 34%, with the highest prevalence in Russia and India. At the global level, an adequate adjustment was observed in the SEM mediation model considering all countries. However, a mediator effect of resilience was only observed in the relationship between victimization and the indicator of DASS in Chile, Indonesia, and Russia. The results are discussed, analyzing the relevance of resilience as a protective factor for mental health during COVID-19 lockdowns.

Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population

Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examine the psychometric properties of Chinese version of the Fear of COVID-19 Scale. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis were conducted in Sample 1, followed by validity tests in Sample 2. Likely, test-retest reliability was conducted in sample 3. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α = .92), composite reliability (CR = .92), and validity correlation validity. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-020-00441-7.

The upside: coping and psychological resilience in Australian adolescents during the COVID-19 pandemic

BACKGROUND

Since the COVID-19 outbreak, few studies have investigated the positive psychological consequences on young people. This study examined resilience, positive experiences, and coping strategies reported by Australian adolescents during COVID-19.

METHODS

Self-report surveys were administered online to a sample of 760 Australian adolescents aged 12-18 years. Quantitative and qualitative methods were used to assess resilience, positive experiences, and coping strategies. Exploratory regression analyses were conducted to explore the relationship between resilience and demographics and mental illness history, as well as between resilience and positive experiences.

RESULTS

Overall, adolescents were somewhat resilient (M = 20.93, SD = 8.29). They reported positive experiences during COVID-19, including increased empathy, compassion, gratitude, and connection with others, and reported using a range of active coping strategies. Having a mental illness history and identification as female or non-binary gender were associated with lower resilience (Bs > 2.82, ps < 0.001). Further, resilience was associated with decreased psychological distress (OR = 0.89, p < 0.001) and with increased positive experiences (ORs > 1.03, ps < 0.001).

CONCLUSIONS

Our results indicate that Australian adolescents commonly reported positive experiences and used active coping strategies during COVID-19. Some young people demonstrated higher levels of resilience and were able to make the most out of an unpredictable situation that severely disrupted their daily routine. However, further prospective research using longitudinal methods is necessary to examine causal relationships between variables. An implication of our findings is that resilience-building programs for adolescents may be effective in increasing adaptability after adversity (e.g., climate change, bushfires, pandemics).

Validity and Longitudinal Invariance of the 10-Item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese Left-Behind and Non-Left-Behind Children

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a self-report instrument widely used to assess resilience in particular demographics. This study aimed to evaluate the validity and measurement invariance (MI) of the CD-RISC-10 in Chinese left-behind children. A total of 968 children from three middle schools in Guizhou Province participated in this study, with the CD-RISC-10 used twice, at the base line time point and again after six months. The Ego-resilience Scale (ERS), and General Self-efficiency Scale (GSES-10) were also used as criteria-related validity instruments. Confirmatory factor analysis (CFA) was carried out to examine the one-factor model and the MI with regards to gender and left-behind status, as well as the longitudinal measurement invariance (LMI). The study proved satisfactory reliability and validity of the CD-RISC-10, with good criterion validity with the ERS and GSES-10. CFA results showed that the satisfactory model fit for the one-factor structure was supported in all groups (e.g., CFI = .942, TLI = .925, RMSEA = .057). The strict MI was evident across genders, as well as both the left-behind and non-left-behind groups. Additionally, the LMI of the CD-RISC-10 was also adequately supported. Generally speaking, these findings demonstrate that the CD-RISC-10 can effectively measure the resilience level of left-behind children - boys as well as girls - in China.

Psychometric properties of the Spanish version of the 10-item Connor Davidson Resilience Scale (CD-RISC) among adolescent mothers in Peru

The objective of this research is to assess the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in order to contribute to the literature identifying validated resilience measures in low-resource settings where individuals face significant adversity. This cross-sectional study included 789 adolescent mothers who delivered at a maternity hospital in Lima, Peru. The Spanish version of the 10-item CD-RISC was used to measure resilience. Internal consistency and construct validity were assessed by evaluating individual item characteristics as well as the association of CD-RISC score with symptoms of depression, anxiety and sleep disturbance. Exploratory factor analysis (EFA) was performed to test the factorial structure of the CD-RISC. The CD-RISC was found to have good internal consistency (Cronbach's alpha = 0.85). CD-RISC scores were positively associated with school attendance, financial hardship, and history of childhood abuse; scores were negatively associated with household dysfunction, depression, anxiety and poor sleep quality. The results of the EFA showed that the CD-RISC contained a two-factor solution, which accounted for 46% of the variance. Overall, these findings suggest that the Spanish-language version of the CD-RISC-10 is an adequate measure of resilience in this population. Further research is needed to incorporate culturally-specific constructs into resilience measures.

Psychometric evaluation of the characteristics of resilience in sports team inventory in China

This study examines the reliability and validity of the Characteristics of Resilience in Sports Teams Inventory (CREST) in Chinese team athletes. A sample of 659 athletes (male = 355, female = 304) aged from 16-34 (M = 20.08, SD = 2.98) participated in this study. The scale was translated into Chinese using forward and back translation procedures by two independent translators. Questionnaires were administered online. Data was analysed using SPSS 19.0 and Mplus 6.0. Results showed that the items were understood by Chinese team sport athletes. Exploratory factor analysis showed that the Chinese version of CREST had two sub-dimensions as it was in the original scale. Confirmatory factor analysis further demonstrated that the two-structure model was confirmed in the Chinese team sports context. The Cronbach's alpha values of the scale was 0.842, and the test-retest reliability coefficient of one-month interval was 0.836. It is concluded that the Chinese version of CREST can be used as a valid and reliable tool to assess team resilience in China and can be helpful and applicable in helping sports psychologists understand team resilience. Future studies should further examine the psychometric properties of the scale among world-class athletes and develop a team resilience measurement tool based on Chinese traditional culture.

Quality of life and its social determinants for patients with schizophrenia and family caregivers in Cambodia

Due to inadequate human and financial resource support, the development of mental health services in Cambodia has been undertaken by various non-governmental organizations (NGOs). Schizophrenia is the most common functional psychotic disorder, causing severe and chronic symptoms, and the programs provided by the NGOs should have enhanced the quality of life (QoL) of patients and their caregivers; however, epidemiological research, which is a driving force behind the recognition of mental health as a global public health concern, is lacking for schizophrenia in Cambodia. This study therefore aimed to create QoL evaluation questionnaires available in Khmer (the Cambodian language) for patients with schizophrenia and family caregivers, and to identify the social determinants and predictors of their QoL. This cross-sectional study recruited 59 patients and 59 caregivers attending three clinics operated by two NGOs: the Transcultural Psychosocial Organization (TPO) Cambodia and the Supporters for Mental Health (SUMH) Cambodia. We conducted linguistic validation of the Schizophrenia Quality of Life Questionnaire 18-item version (S-QoL 18) and the Schizophrenia Caregiver Questionnaire (SCQ), then analyzed correlations between the QoL dimensions and socio-demographic factors. The main findings of this study were as follows: 1) the newly created Khmer versions of S-QoL 18 and SCQ are relatively good psychometric tools that are suitable for research to identify patients’ and caregivers’ needs to improve their QoL; and 2) engaging in paid work or being of the post-Khmer Rouge generation results in higher QoL for patients, but having low household economic status or being affected by chronic disease leads to lower QoL for family caregivers. These findings are useful for enabling community mental health professionals and aid organizations to create programs to lessen the patient and caregiver burden in Cambodia. Further research is necessary to develop practical projects that will improve patients’ and caregivers’ QoL in various clinical settings in Cambodia.

The Role of Patient and Parental Resilience in Adolescents with Chronic Musculoskeletal Pain

OBJECTIVES

To assess the level of resilience among patients with chronic musculoskeletal pain and their parents and to determine factors associated with patient and parental resilience.

STUDY DESIGN

Cross-sectional cohort study of children aged 13-17 years diagnosed with chronic musculoskeletal pain and their parents. Patient-parent pairs were seen for initial consultation in the pediatric rheumatology pain clinic at Children's Hospital of Philadelphia between March and May 2018 and were administered a series of questionnaires including measures of resilience (Connor-Davidson Resilience Scale 10 item, The 14-item Resilience Scale, and the 7Cs of Resilience Tool). We calculated Pearson correlation coefficients to examine the relationship between the variables of interest and resilience.

RESULTS

According to all resilience measures, patients and parents had low to moderate levels of resilience. These levels were lower than those previously reported among healthy populations, as well as those with chronic medical conditions. According to the Connor-Davidson Resilience Scale 10 item, patient-level resilience was negatively correlated with pain level (r = -0.48), physical disability (r = -0.54), and symptom severity (r = -0.53). The level of resilience among patients was positively correlated with energy level (r = 0.57) and health-related quality of life (r = 0.64). Parental resilience was positively correlated with parental mental health (r = 0.61).

CONCLUSIONS

Higher patient resilience was correlated with reduced disease severity among adolescents with chronic musculoskeletal pain. Future research should explore whether fostering resilience in adolescents with chronic musculoskeletal pain via the application of resilience-training interventions mitigates disease burden in this vulnerable patient population.

Factorial Invariance of the 10-Item Connor-Davidson Resilience Scale Across Gender Among Chinese Elders

Resilience plays an important role in the health of the elderly. The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is widely used to evaluate resilience, but its factorial invariance has not been evaluated in the Chinese elders. In the current study, 1,238 Chinese elders aged 60 years and above completed the Chinese CD-RISC-10, yielding good reliability (Cronbach's α = 0.936, Omega coefficient = 0.83, and test-retest reliability coefficient of 0.665 after 6 months). Confirmatory factor analysis indicated that a single-factor model fitted our CD-RISC-10 data well, both for the total sample and for each gender group. Furthermore, factorial invariance across genders was supported by multigroup confirmatory factor analysis. Finally, the current study revealed greater resilience levels in Chinese elderly women than in Chinese elderly men.

Distinct neural correlates of trait resilience within core neurocognitive networks in at-risk children and adolescents

Background

Most children who are exposed to threat-related adversity (e.g., violence, abuse, neglect) are resilient - that is, they show stable trajectories of healthy psychological development. Despite this, most research on neurodevelopmental changes following adversity has focused on the neural correlates of negative outcomes, such as psychopathology. The neural correlates of trait resilience in pediatric populations are unknown, and it is unclear whether they are distinct from those related to adversity exposure and the absence of negative outcomes (e.g., depressive symptomology).

Methods

This functional magnetic resonance imaging (fMRI) study reports on a diverse sample of 55 children and adolescents (ages 6-17 years) recruited from a range of stressful environments (e.g., lower income, threat-related adversity exposure). Participants completed a multi-echo multi-band resting-state fMRI scan and self-report measures of trait resilience and emotion-related symptomology (e.g., depressive symptoms). Resting-state data were submitted to an independent component analysis (ICA) to identify core neurocognitive networks (salience and emotion network [SEN], default mode network [DMN], central executive network [CEN]). We tested for links among trait resilience and dynamic (i.e., time-varying) as well as conventional static (i.e., averaged across the entire session) resting-state functional connectivity (rsFC) of core neurocognitive networks.

Results

Youth with higher trait resilience spent a lower fraction of time in a particular dynamic rsFC state, characterized by heightened rsFC between the anterior DMN and right CEN. Within this state, trait resilience was associated with lower rsFC of the SEN with the right CEN and anterior DMN. There were no associations among trait resilience and conventional static rsFC. Importantly, although more resilient youth reported lower depressive symptoms, the effects of resilience on rsFC were independent of depressive symptoms and adversity exposure.

Conclusions

The present study is the first to report on the neural correlates of trait resilience in youth, and offers initial insight into potential adaptive patterns of brain organization in the context of environmental stressors. Understanding the neural dynamics underlying positive adaptation to early adversity will aid in the development of interventions that focus on strengthening resilience rather than mitigating already-present psychological problems.

Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain

BACKGROUND

Resilience is an individual's ability to recover or "bounce back" from stressful events. It is commonly identified as a protective factor against psychological dysfunctions in wide range of clinical conditions including chronic pain. Resilience is commonly assessed using the Connor Davidson Resilience Scale (CD-RISC). Translation and cross-cultural adaptation of the CD-RISC into Nepali will allow for a deeper understanding of resilience as an important domain in health in Nepal, and will allow for cross-cultural comparison with other cultures. Therefore, the aims of the study were to translate and culturally adapt 10- and 2-item versions of the CD-RISC into Nepali and evaluate their psychometric properties.

METHODS

After translating the measures, we performed exploratory and confirmatory factor analyses of the 10-item version in two independent samples (ns = 131 and 134) of individuals with chronic pain. We then evaluated the internal consistency, test-retest stability, and construct validity of the 10- and 2-item measures in these samples. We also evaluated the internal consistency, and the construct and concurrent validity of the 2-item version in an additional sample of 140 individuals.

RESULTS

The results supported a single factor model for the 10-item measure; this measure also evidenced good to excellent internal consistency and excellent test-retest stability. Construct validity was supported via moderate associations with pain catastrophizing. The internal consistency of 2-item version was marginal, although construct validity was supported via weak to moderate associations with measures of pain catastrophizing, depression and anxiety, and concurrent validity was supported by strong association with the 10-item CD-RISC scale.

CONCLUSION

The findings support the reliability and validity of the 10-item Nepali version of the CD-RISC, and use of the 2-item version in survey studies in individuals with chronic pain. The availability of these translated measures will allow for cross-cultural comparisons of resilience in samples of individuals with chronic pain.

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions

Background

The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers.

Method

This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach’s alpha coefficient, and mean comparisons were determined using t-tests.

Results

The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men.

Conclusion

The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.