Ego-resiliency reloaded: a three-component model of general resiliency

Modelling the Relationship Between Resilience to Depression and Recent Stressful Life Events in University Students

Resilience, or successful coping with the experience of stressful life events (SLEs), protects against depression, but its operational mechanisms are unclear. Views diverge whether resilience intervenes as a trait or as a process of dynamic interactions of protective factors, such as self-esteem, social support and family cohesion. We evaluated five theoretically-based models of how resilience, defined as either a trait or a process, interacts with recent SLEs, to explain depressive symptomatology in 2434 university students. The moderating effect of problematic, age-inappropriate parenting (i.e., helicopter parenting) was also assessed. SLEs moderated both the effects of trait and process resilience on depression, but models conceptualising resilience as a dynamic process of interacting components showed better explanatory power than models conceptualising resilience solely as a trait. Trait resilience was protective through self-esteem at all levels of SLEs exposure (low, mild, moderate or high), and significantly, but less so through hope or social support. Experiencing helicopter parenting weakened the protective influence of process resilience, through decreasing family cohesion in the presence of SLEs. The overall assessment of the five models supports a process conceptualisation of resilience to depression in the face of adversity. However, the results also suggest that not all protective factors are equally important, with self-esteem appearing a significant and strong mediator of resilience to depression in all models including it as a variable. Building process resilience is proposed as a key intervention target for depressive symptoms. Clinical assessments and interventions following SLEs should routinely consider both trait resilience and self-esteem, as the interaction of these two factors protects against depression even at the highest levels of adversity exposure. Depression prevention approaches should address the individual's experience of overparenting, given the deleterious influence of helicopter parenting on resilience.

The impact of storytelling on building resilience in children: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily. Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children. It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies. The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults. Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience. This holds particular importance for low- and middle-income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting.

ABSTRACT

INTRODUCTION: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences.

AIM

The aim of this review is to synthesize peer-reviewed studies on the impact of storytelling interventions in developing resilience in children.

METHOD

The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children.

RESULTS

The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children.

DISCUSSION

Storytelling-based interventions in school settings with participatory approaches using cultural stories, and positive psychology-based interventions were effective and feasible.

IMPLICATIONS FOR PRACTICE

This review has scope for informing future interventions with children, especially those who live in marginalized communities in low- and middle-income countries (LMICs).

The leading role of personality in concerns about autonomous vehicles

Development of autonomous vehicles (AVs) is growing in a rapid rate, however, the most dominant barriers in their adoption seem to be rather psychological than technical. The present online survey study aimed to investigate which demographical and personality dimensions predict attitudes towards AVs on a Hungarian sample (N = 328). Data was collected by convenience and snowball sampling. Three-level hierarchical regression models were applied: in the first level, demographical variables, then general personality traits and third, attitude-like personality factors were entered. We demonstrated that the predictive effect of age, gender and education disappeared when personality dimensions were included into the models. Importantly, more positive general attitudes towards technology and higher optimism regarding innovations predicted eagerness to adopt AVs. On the other hand, individuals with more negative attitudes and higher dependence on technology as well as those with lower level of Sensory Sensation Seeking and higher level of Conscientiousness were more concerned about AVs. Our results suggest that AV acceptance cannot be regarded as a one-dimensional construct and that certain personality traits might be stronger predictors of AV acceptance than demographical factors.

Slow art plus: developing and piloting a single session art gallery-based intervention for mental health promotion via a mixed method waitlist randomized control trial

Introduction

The current study builds on the expertise of National Gallery Singapore and Nanyang Technological University Singapore (NTU) in developing and piloting an enhanced version of the Slow Art program, namely "Slow Art Plus" for mental health promotion.

Methods

A single-site, open-label, waitlist Randomized Control Trial (RCT) design comprising of a treatment group and waitlist control group was adopted (ClinicalTrials.gov ID: NCT05803226). Participants (N = 196) completed three online questionnaires at three timepoints: baseline [T1], immediately post-intervention/s baseline [T2], post-intervention follow-up/immediately post-intervention [T3]. Qualitative focus groups were conducted to evaluate program acceptability.

Results

A mixed model ANOVA was performed to understand intervention effectiveness between the immediate intervention group and waitlist control group. The analyses revealed a significant interaction effect where intervention group participants reported an improvement in spiritual well-being (p = 0.001), describing their thoughts and experiences (p = 0.02), and nonreacting to inner experiences (p = 0.01) immediately after Slow Art Plus as compared to the control group. Additionally, one-way repeated measure ANOVAs were conducted for the intervention group to evaluate maintenance effects of the intervention. The analyses indicated significant improvements in perceived stress (p < 0.001), mindfulness (p < 0.001) as well as multiple mindfulness subscales, active engagement with the world (p = 0.003), and self-compassion (p = 0.02) 1 day after the completion of Slow Art Plus. Results from framework analysis of focus group data revealed a total of two themes (1: Experiences of Slow Art Plus, 2: Insights to Effective Implementation) and six subthemes (1a: Peaceful relaxation, 1b: Self-Compassion, 1c: Widened Perspective, 2a: Valuable Components, 2b: Execution Requisites, 2c: Suggested Enhancements), providing valuable insights to the overall experience and implementation of the intervention.

Discussion

Slow Art Plus represents a unique approach, offering a standardized, multimodal, single-session program that integrates mindfulness and self-compassion practices, as well as reflective and creative expressions with Southeast Asian art. It demonstrates potential in meeting the mental health needs of a wide range of individuals and could be readily incorporated into social prescribing initiatives for diverse populations.

Network analysis of illness perception, stigma, and resilience with cognition in old people living with HIV

OBJECTIVES

Old people living with HIV (PLWH) are highly susceptible to HIV-related psychological and neurocognitive disorders, which are multidimensional and inseparably intertwined. Despite this, few studies have investigated the interrelationship between these disorders. We aimed to estimate the detailed associations and identify potential intervention points between HIV-related psychological factors and cognitive function in old PLWH.

METHODS

This cross-sectional study drew on the Older People with HIV Infections Cohort from 65 communities in Sichuan, China. Three HIV-related psychological factors, including illness perception, HIV stigma perception and resilience, were collected using a self-reported questionnaire. Cognitive function was measured using the MoCA-B scale. Network analysis was used to estimate the interrelationships between HIV-related psychological factors and cognitive function dimensions in old PLWH, and to identify factors that act as bridges in connecting these factors in the network.

RESULTS

Of the 1587 old PLWH, 47.0% had mild or severe cognitive function impairment. Network analysis revealed that better visual perception was directly connected with poorer negative self-image (edge weight: 0.13), and poorer illness comprehensibility was connected with poor visual perception (-0.09) and executive functioning (-0.13). The cognitive illness perceptions (bridge strength: 0.41), illness comprehensibility (0.36) and negative self-image (0.39) were identified as bridges connecting HIV-related psychological and cognitive function.

CONCLUSIONS

The interconnection of HIV-related illness perception, stigma perception, and resilience with cognition may be achieved through the links of negative self-image, illness comprehensibility and cognitive illness perceptions. These factors may serve as potential non-pharmaceutical action points to improve psychological and cognitive health among old PLWH.

Non-Cognitive Adaptive Resourcefulness: Scrutiny of Its Multidimensionality and Nomological Validity

Recent research has observed that Mental Toughness, Optimal Regulation, and Self-Efficacy share core features and variance. Investigators have named this commonality Non-Cognitive Adaptive Resourcefulness (NCAR). The NCAR validation study reported that the construct possesses promising psychometric properties, however, further research is required to replicate and extend these findings. Acknowledging this, the present paper using a UK-based sample of 1998 participants (Mage = 40 years, range 18-83), tested the NCAR model against competing alternatives (multidimensional and one-factor solutions), and assessed the nomological validity of NCAR in relation to Perceived Stress and Anxiety Control. Participants completed the self-report study measures online. Exploratory structural equation modelling revealed that a bifactor solution represented data more effectively than one-factor and multi-factor alternatives. Additionally, a structural equation model found that NCAR significantly predicted Perceived Stress (subfactors of Distress and Coping) and Anxiety Control (subfactors of Emotional Control, Threat Control, and Stress Control). Moreover, NCAR predicted PSS Coping and Emotional Control to a greater extent than the specific bifactors (Mental Toughness, Optimal Regulation, and Self-Efficacy). This suggested that NCAR comprises an underpinning, positive psychological energy that facilitates coping. Particularly, an enabling resource that enhances the capacity to thrive under pressure and retain emotional control in demanding and trying circumstances.

Acculturation Among Chinese Married Immigrant Women in South Korea: A Structural Equation Modeling Analysis

INTRODUCTION

The purpose of this study was to determine acculturation and the associated factors among Chinese immigrant married women in South Korea.

METHODOLOGY

Data collected from 220 participants through an online survey at four health family support centers in South Korea were analyzed in an acculturation model, which included family environment, ego-resilience, acculturative stress, stress-coping style, and acculturation.

RESULTS

The fit indices of the modified model satisfied the recommended levels. Among the variables, ego-resilience (β = 0.34, p < .001) and acculturative stress (β = -0.65, p < .001) directly affected acculturation. Family environment (β = 0. 35, p = .001) indirectly influenced acculturation through acculturative stress and stress-coping style. The explanatory power of the variables was 80.7%.

DISCUSSION

The results confirmed the usefulness of the acculturation model that provides a theoretical basis for improving acculturation in married immigrant women.

A systematic review of cross-cultural measures of resilience and its promotive and protective factors

As psychological resilience has been increasingly recognized as contextually constructed, mixed methods studies that map out local ecologies of resilience have become increasingly common. However, the direct adaptation of quantitative tools for cross-cultural use based on qualitative findings has been relatively lacking. The current review aims to provide an overview of existing measures of resilience used cross-culturally and to synthesize the protective and promotive factors and processes (PPFP) of resilience identified within these measures into a single resource. A January 2021 search of PubMed for studies of the development of psychological resilience measures that excluded studies of non-psychological resilience yielded 58 unique measures. These measures contain 54 unique PPFP of resilience, ranging from individual to communal-level characteristics. This review is intended to serve as a complementary tool for adapting standardized measures for stakeholders requiring an assessment tool that is attuned to their context for mental health risk assessment and intervention evaluation.

How Do Women React to the COVID-19 Pandemic Period? Relationship Between Ego-Resiliency, Anxiety, Alcohol Consumption and Aggression Among Polish Women

Purpose

There are many reports in the literature on the impact of the COVID-19 pandemic on mental health, including the condition of women. Most of these studies refer to a single time point, while there is a lack of studies controlling for selected parameters during different periods of the pandemic. This work aimed to determine the role of ego-resiliency in women's adaptation to the COVID-19 pandemic.

Patients and Methods

The survey was conducted in two stages - all via online forms. A total of 762 Polish women took part in the overall project. The scales used in the study were the Ego-resiliency scale (ER89-R12), Generalized Anxiety Disorder 7 Scale (GAD-7), Alcohol Use Disorders Identification Test (AUDIT), and Buss-Perry Aggression Questionnaire (BPAQ). Statistical analysis was performed using Statistica 13.3.

Results

Women participating in the second study had significantly lower scores on ego-resilience and its components compared to the first study. In the first research, ego-resiliency and optimal regulation were statistically significantly correlated with anxiety, alcohol consumption, generalised aggression, verbal aggression and hostility, while openness to life experiences was correlated with alcohol consumption and hostility. The second part of the project highlighted new significant correlations between ego-resiliency and optimal regulation and physical aggression and anger, but a non-significant correlation of these variables with alcohol consumption. The effect of openness to life experiences on alcohol consumption and anxiety, evident in the first study, was no longer present in the second part of the study.

Conclusion

The lack of a significant effect of openness to life experience on alcohol consumption, lower ego-resiliency and optimal regulation scores are observed in the second part of the research, which might be an expression of adaptation to the COVID-19 pandemic. Ego-resiliency is a protective factor against aggression, while optimal regulation against anxiety among Polish women.

Psychological first aid intervention: rescue from psychological distress and improving the pre-licensure nursing students' resilience amidst COVID-19 crisis and beyond

Background

The public health emergencies such as the COVID-19 pandemic resulted in mental and psychological ramifications on the healthcare professionals. The pre-licensure nursing students found themselves not only fighting against the baneful virus but also weak ego resilience. At this point, enriching the pre-licensure nursing students with psychological first aid (PFA) could help them to recover from the feeling of psychological distress and improve their resilience capacity to encounter any upcoming outbreaks.

Methods

A quasi-experimental two groups, a pre-post-test study was used in which sixty-four pre-licensure nursing students completed a baseline survey which revealed high levels of psychological distress and low resilience capacity due to the COVID-19 crisis. The study group engaged in the Psychological First- aid Intervention (PFA) at the end of the clinical practicum course period, while the comparison group received routine psychological support.

Results

A significant reduction in the psychological distress levels among students in the PFA group (F^ET=7.83, P = 0. 001). Likewise, significant improvements in the students' resilience capacity level immediately after the intervention (F^ET=3.34, P = 0.019) and during the two-month follow-up (F^ET=12.94, P = 0. 001). The implementation of PFA enhanced the pre-licensure nursing students' psychological health status and resilience capacity levels after their clinical training amid the ambiance of the COVID-19 crisis.

Conclusion

The PFA effectively fostered the pre-licensure nursing students' recovery from the COVID-19 related- psychological distress and improve their resilience capacity. The application of RAPID model is recommended to reduce stress and prevent burnout among novice and future nurses who show signs of psychological exhaustion.

Stability of resilience in times of the COVID-19 pandemic

There is disagreement among researchers regarding the conceptualization of resilience as a dynamic state or stable trait. Aiming to shed light on the state-versus-trait debate, we explored the stability and construct validity of four of the most frequently utilized state or trait resilience scales in a longitudinal assessment. Additionally, we examined the predictive validity of these scales. Our study was conducted before and during the COVID-19 pandemic, which served as collectively experienced adversity. Correlations among the resilience scales and among resilience scales and Big Five personality traits were strong. All except one scale showed high test-retest correlations. Experience of an additional critical life event during the pandemic led to an increase in resilience. Other than in cross-sectional studies, associations between resilience and psychological distress were weak, because personality and baseline psychological distress were controlled for. Nevertheless, next to personality, resilience explained additional variance in distress change. Our results show relatively high stability of resilience overall. Yet, they also confirm dynamic resilience features, suggesting that resilience change occurs with significant adversity, leading to improved adaptation. To gauge the true association between resilience and mental health, baseline levels of these variables as well as personality traits should be considered.

Ways of preventing surgeon burnout

In surgical practice, numerous sources of stress (stressors) are unpredictable, two examples being daily workload and postoperative complications. They may help to explain surgeon burnout, of which the prevalence (34 to 53%) has been the subject of many studies. That said, even though assessments are legion, recommended solutions have been few and far between, especially insofar as by nature and training, surgeons are disinclined to interest themselves in burnout, which they are prone to consider as something experienced by "others". The objective of this attempt at clarification is to identify in the literature the strategies put forward in view of avoiding surgeon burnout, and to assess the impact of this phenomenon not only on the surgeon's professional and personal entourage, but also on patient safety. Prevention-based strategies, many of them focused on modifiable stressors, will be detailed.

"Faith Is Not Enough?" Ego-Resiliency and Religiosity as Coping Resources with Pandemic Stress-Mediation Study

Based on the concepts of Pargament's adaptational functions of religiosity, Huber's centrality of religiosity, and Block's conceptualisation of ego-resiliency as psychosocial resources, a nonexperimental, moderated mediation project was designed for a group of 175 women and 57 men who voluntarily participated in an online study to determine whether and to what extent religiosity mediated or moderated the relationship between ego-resiliency and the severity of PTSD and depression during the COVID-19 epidemic. The analyses carried out showed that the studied variables, ego-resiliency and centrality of religiosity, were predictors of the intensity of some psychopathological reactions caused by the COVID-19 pandemic but were not connected via a mediation relationship. Therefore, one question remains open: what is the role of ego-resiliency and the nature of the stated immunogenic effect of the centrality of religiosity in dealing with the critical threat to mental health that is the COVID-19 pandemic?

How to measure ego-resiliency in the face of various life-changing crises: Measurement invariance, convergent and discriminant validity and reliability of the Polish version of the Revised Ego-Resiliency Scale (ER89-R12)

This study examines the generalizability of the latent structure of the Polish version of the Ego-Resiliency Scale (ER89-R12), a brief self-report scale that measures ego-resiliency. We investigated the measurement invariance, validity, and reliability of ER89-R12 among three groups of individuals who were facing various major, long-term, life-changing crises (N = 512): parents of children with Down's syndrome, women with breast cancer, and individuals after divorce. The analysis of the measurement invariance confirmed the two-factor structure of the questionnaire and the high reliability of this measure in those studied groups. A multigroup confirmatory factor analysis provided evidence of configural, metric, scalar, and residual invariance across the three groups. Moreover, the correlation patterns were similar across the groups. Ego-resiliency was strongly and consistently positively correlated with mental health: psychological well-being, perceived social support, self-esteem, and post-traumatic growth, and negatively correlated with perceived stress. The presented results indicate the potential usefulness of the ER89-R12 tool in studies on people experiencing various crises in their lives.

Depressive and Anxiety Symptoms and Their Relationships with Ego-Resiliency and Life Satisfaction among Well-Educated, Young Polish Citizens during the COVID-19 Pandemic

Ego-resiliency is a set of traits that promotes positive adaptation to life's vicissitudes. High ego-resiliency helps in upholding one's personality system when facing adversity and in adjusting it to new environmental demands. Our study aimed at evaluating the connections between ego-resiliency, the severity of anxiety and depressive symptoms as well as life satisfaction during the COVID-19 pandemic in Poland. A total of 604 Polish citizens aged 16 to 69 years participated in the online survey. Ego-resiliency was measured with the Ego Resiliency Scale (ER89-R12), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and life satisfaction with the Satisfaction with Life Scale (SWLS). Statistical analyses were performed using the Spearman rank correlation coefficient. The results revealed correlations between the intensity of depressive and anxiety symptoms, life satisfaction, and the intensity of ego-resiliency. Individuals with a high level of ego-resiliency tended to experience a lower intensity of anxiety and depressive symptoms during the COVID-19 pandemic. Moreover, individuals with a high level of ego-resiliency exhibited a higher level of life satisfaction. Our conclusions might assist in better understanding the close link between levels of ego-resiliency, the occurrence of depressive and anxiety symptoms, and satisfaction with life among Polish individuals experiencing crises.

The Ego Resiliency Scale-Revised: Confirmatory Factor Analysis and Rasch Models

This study examined the psychometric properties of the Ego Resiliency Scale-Revised (ER89-R). Though support exists for a multidimensional conceptualisation using classical test theory approaches (i.e., a higher-order model comprising Openness to Life Experiences and Optimal Regulation factors), this measure has not been subjected to Rasch analysis. Accordingly, this paper evaluated the higher-order model via confirmatory factor analysis (CFA) before assessing Openness to Life Experiences and Optimal Regulation components using Rasch analysis. CFA, using a general population sample ( N = 2009), supported the higher-order factor structure. Openness to Life Experiences and Optimal Regulation scales met Rasch model assumptions. Specifically, good item/person fit and item/person reliability, and evidence of unidimensionality. Moreover, most items displayed gender invariance. Overall, findings supported the higher-order conceptualisation of the ER89-R, and indicated that the Openness to Life Experiences and Optimal Regulation scales are relatively useful measures of ego resiliency components in a general population sample.

Stress, and coping strategy of university students during COVID-19 in Korea: The mediating role of ego-resiliency

We aimed to identify the level of stress, ego-resiliency (ER), and coping strategies of university students during the onset of coronavirus disease 2019 (COVID-19) and examine the mediating role of ER in the relationship between stress and coping strategies (e.g., problem-solving, social support seeking, and avoidance). We analyzed responses from 160 university students and found that problem-solving was the most common coping strategy (26.02 ± 4.65), followed by social support-seeking (25.08 ± 5.23), and avoidance (19.21 ± 3.78). ER was negatively associated with stress and showed a mediating effect on the relationship between stress and social support, and stress and problem-solving coping strategies. These findings indicate that ER helps decrease stress caused by the pandemic among university students and should be considered a significant factor for developing adaptive stress coping strategies.

Emotional Functioning in the Context of Health Behaviors During the COVID-19 Pandemic in Health Sciences Students: The Polish Case

Purpose

The fear for health, uncertainty, loss of freedom, boredom, and frustration accompanying the COVID-19 pandemic caused mental health burdens. Young people are particularly at a risk of emotional functioning problems. The aim of this manuscript was to verify the relationships between health behaviors and emotional functioning in health sciences students during the third wave of the COVID-19 pandemic in Poland.

Patients and Methods

The study group comprised 493 Polish health sciences students (314 women, 179 men) aged 21.5 ± 2.25 years. The intensity of health behaviors was examined using the Health Behavior Inventory (HBI). The Hospital Anxiety and Depression Scale (HADS) was carried out to assess symptoms of anxiety and depression. Stress levels were examined with the Perceived Stress Scale (PSS-10). The online versions of psychological scales were created using Google Forms software.

Results

Mild anxiety symptoms were observed in 21% of examined students and moderate-to-severe in 28%. Mild depressive symptoms were observed in 14% of the study group, and 8% of the examined students suffered from moderate-to-severe depression. The mean perceived stress result was high (22.2 ± 4.1 pts.). The overall intensity of health behavior was, at the mean level, significantly higher in females compared to males. The odds of developing severe symptoms in terms of anxiety, depression, and stress in students with high levels of health-related behaviors were respectively: four times, more than seven times, and nine times lower compared to students with lower levels of these behaviors.

Conclusion

Undertaking regular pro-health behavior decreased the odds of developing severe symptoms of anxiety, depression, and stress in health sciences students during the COVID-19 pandemic.

Personality metatraits predict resilience among family caregivers responsible for a dependent youth's chronic respiratory management

Background

Family caregivers of children and youth with severe neurodisabilities that require chronic respiratory management often report a compromised quality of life. In this cross-sectional study, we used DeYoung’s (Psychol Inq 21(1): 26–33, 2010. 10.1080/10478401003648674) conceptualization of two personality metatraits, Alpha and Beta, to test their theorized role in facilitating resilience among these family caregivers. We expected higher Alpha and Beta would exhibit direct, beneficial effects on caregiver mental and physical health quality of life (QoL), and they would operate through self-reported resilience and coping to exert positive, indirect effects on caregiver QoL.

Methods

Family caregivers of children and youth at an outpatient chronic respiratory management clinic were informed of the study. Of the 68 who consented, 61 provided complete data on measures of personality traits, coping styles, and physical and mental health-related QoL. Factor analytic techniques verified the two personality metatraits, consistent with the DeYoung model. The metatraits were then used as predictor variables in a path model to predict physical and mental health-related QoL. Self-reported resilience and a coping variable were examined as possible mediators of the personality-QoL relationship.

Results

Correlational analyses isolated a coping variable that met criteria as a possible mediator. The path model exhibited good fit to the data. The Alpha metatrait—characterized by emotional stability, self-regulation, perseverance, and intrinsic motivation—was directly predictive of caregiver mental health. The Beta metatrait, reflecting a disposition for adaptive flexibility, responsiveness, and interpersonal initiative, demonstrated significant indirect effects to physical and mental health through its positive association with coping efforts to maintain social support and a sense of self.

Conclusions

Consistent with DeYoung’s conceptualization, higher Alpha and Beta predicted caregiver resilience, albeit through different pathways. The emotional stability, perseverance and emotional regulation associated with Alpha likely accounted for its positive association with caregiver mental health. Beta, in contrast, may operate through their adaptive flexibility, personal resourcefulness and social engagement to augment coping efforts that involve others and support family activities, which, in turn, promote their own physical and mental health. Limitations of the cross-sectional design, and potential theoretical and clinical implications of the personality metatraits and their relation to resilience are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00791-y.

A Novel Mindful-Compassion Art-Based Therapy for Reducing Burnout and Promoting Resilience Among Healthcare Workers: Findings From a Waitlist Randomized Control Trial

Protecting the mental health of healthcare workers is an urgent global public health priority. Healthcare workers, especially those immersed in palliative care, are prone to burnout due to the intense emotions associated with end-of-life caregiving. This study examines the efficacy of a novel, multimodal, and group-based Mindful-Compassion Art-based Therapy (MCAT) that integrates reflective self-awareness with creative emotional expression for protecting healthcare workers' mental health. A dual-arm open-label waitlist randomized controlled trial was conducted. A total of 56 healthcare workers were recruited from the largest homecare hospice in Singapore and randomized to the immediate-treatment condition of a standardized 6-week, 18-hours MCAT intervention (n=29), or the waitlist-control condition (n=27). Self-administered outcome measures on burnout, resilience, emotional regulation, self-compassion, death attitudes, and quality of life were collected at baseline, post-intervention/second-baseline at 6weeks, and follow-up/post-intervention at 12weeks. Results from mixed model ANOVAs reveal that treatment group participants experienced significant reduction in mental exhaustion, as well as significant improvements in overall emotional regulation, nonreactivity to intrusive thoughts, approach acceptance of death, and afterlife belief as compared to waitlist-control immediately after MCAT completion. Effect sizes of these impacts ranged from medium to large (η 2=0.65 to 0.170). Results from one-way ANOVAs further reveal that the treatment gains of reduced mental exhaustion and increased emotional regulation were maintained among treatment group participants at 12-weeks follow-up compared to baseline, with new benefits identified. These include increased ability to observe and describe one's experiences, elevated overall self-compassion, greater mindful awareness, enhanced common humanity, and better quality of life. Effect sizes of these impacts were large (η 2=0.128 to 0.298). These findings reflect the robust effectiveness and positive residual effects of MCAT for reducing burnout, building resilience, nurturing compassion, fostering collegial support, and promoting mental wellness among healthcare workers. The clinical model and applicability of MCAT in larger and more diverse caregiving contexts, such as family dementia care, are discussed. Clinical Trial Registration: ClinicalTrials.gov # NCT03440606, #NCT04548089.

Resilience, coping, and distress among healthcare service personnel during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has a detrimental effect on the health and well-being of health care workers (HCWs). The extent to which HCWs may differ in their experience of depression and anxiety is unclear, and longitudinal studies are lacking. The present study examined theorized differences in distress between resilient and non-resilient HCWs over time, as reported in a national online survey. We also examined possible differences in distress as a function of sex and doctoral-level status.

METHODS

A national sample responded to an online survey data that included the study measures. Of the HCWs who responded, 666 had useable data at the two time points. A longitudinal structural equation model tested an a priori model that specified the relationship of a resilient personality prototype to self-reported resilience, coping, depression and anxiety at both measurement occasions. Additional invariance models examined possible differences by sex and doctoral-level status.

RESULTS

The final model explained 46.4% of the variance in psychological distress at Time 1 and 69.1% at Time 2. A non-resilient personality prototype predicted greater depression and anxiety. A resilient personality prototype was predictive of and operated through self-reported resilience and less disengaged coping to effect lower distress. No effects were found for active coping, however. The final model was generally invariant by sex and HCWs status. Additional analyses revealed that non-doctoral level HCWs had significantly higher depression and anxiety than doctoral-level HCWs on both occasions.

CONCLUSIONS

HCWs differ in their susceptibility to distress imposed by COVID-19. Those who are particularly vulnerable may have characteristics that contribute to a lower sense of confidence and efficacy in stressful situations, and more likely to rely on ineffective, disengaged coping behaviors that can exacerbate stress levels. Individual interventions and institutional policies may be implemented to support HCWs at risk.

A Randomized Waitlist-Controlled Trial of an Intergenerational Arts and Heritage-Based Intervention in Singapore: Project ARTISAN

Loneliness has become a global major public health concern, with detrimental effects to the young and old. ARTISAN (Aspiration and Resilience Through Intergenerational Storytelling and Art-based Narratives) is a 5-week, 15-h participatory art and group-based intervention that focuses on resilience building and loneliness alleviation among the young and old through a structured multimodal framework held at a museum space. Developed with a Participatory Action Research (PAR) approach, this intervention is evaluated using an open-label waitlist randomized controlled trial design (RCT) comprised of community-dwelling youth and older adults randomized into an intervention group (n = 35) or a waitlist-control group (n = 33). Participants were assessed on standardized self-reported psychometric measures including loneliness, resilience, quality of life, social support, life satisfaction and national identity at three time points. Qualitative data generated during each intervention session as well as acceptability focus groups were recorded and transcribed. Linear mixed modeling analyses revealed that participants in the intervention group experienced improvements in life satisfaction compared to participants in the waitlist-control group (95% CI: 0.22 to 0.77, p < 0.001, Cohen's d = 0.53) immediately after the completion of ARTISAN. Subgroup analyses for youth participants indicated improvements in quality of life (95% CI: 0.16 to 0.52, p < 0.001, d = 1.31) and national identity (95% CI: 0.18 to 0.80, p = 0.002, d = 0.43) in comparison to the waitlist-control group. At 5-weeks follow-up, the intervention group participants continued to experience high levels of life satisfaction (95% CI: 0.04 to 0.42, p = 0.017, d = 0.47), enhancements in resilience (95% CI: 0.07 to 0.55, p = 0.011, d = 0.46), as well as a significant reduction in loneliness (95% CI: −0.34 to −0.08, p = 0.001, d = 0.61) compared to baseline, reflecting the effectiveness and positive residual effects of the ARTISAN intervention. Similarly, the qualitative findings provided support for the intervention and additional insights to the quantitative findings. This holistic intervention framework that integrates stories, arts and heritage for bridging and empowering lives fills a critical gap in knowledge and practice between the arts, health and citizenship, paving the way for further research in creating a more caring and inclusive society with the arts.

Clinical Trials Registration:www.ClinicalTrials.gov, identifier: NCT03048708.

The effect of ego-resiliency and COVID-19-related stress on mental health among the Japanese population

Due to the negative psychological consequences of the COVID-19 pandemic worldwide, it is necessary to study the factors that improve mental health. In this study, we evaluated changing income, self-restraint, fear of COVID-19, depression, anxiety, stress, and ego-resiliency, to investigate the main and moderating effects of ego-resiliency on psychological distress. We analyzed 222 Japanese samples from the dataset of Primary Survey in Japan (PSJ) in the Resilience to COVid-19 in Each Region (RE-COVER) project. The results showed significant main effects of ego-resiliency on depression and stress, and a significant interaction effect of self-restraint and ego-resiliency on depression. We also tested the significance of the moderating effect of ego-resiliency on the relationship between self-restraint and depression. The simple slope of ego-resiliency was only significant for individuals with high self-restraint. Our findings provide empirical evidence on mental health associated with the COVID-19 pandemic among the Japanese population, proving that ego-resiliency functioned to cope with the specific stresses associated with COVID-19.

Adaptación y Validación de la Escala de Control del Yo (UC-EgoUndercontrol Scale) a la población argentina

El objetivo del presente trabajo fue evaluar las propiedades psicométricas de la Adaptación de la Escala de Control del Yo (Ego-Undercontrol Scale) de Block y Block (1980, 2006) en estudiantes de Entre Ríos, Argentina. Así, se desarrollaron dos estudios. En el primero, se estudió la validez de constructo a través de un estudio de discriminación de ítems, un análisis factorial exploratorio y los niveles de confiabilidad de la escala. En el segundo, se confirmó la estructura factorial hallada en el estudio 1 así como se analizó la validez convergente con Resiliencia del Yo y los niveles de fiabilidad. Se ha encontrado que la escala posee dos dimensiones y no una, como se presenta en su versión original. Dichos aspectos han sido denominados “impulsividad comportamental” e “impulsividad cognitiva” y presentan buenos niveles de confiablidad. Cabe destacar que la nueva versión presenta menor cantidad de ítems (14 ítems), en comparación con el instrumento original (37 ítems). De este modo, el resultado final es un instrumento breve, el cual puede beneficiar el trabajo y la toma de datos con adolescentes. Los hallazgos obtenidos permiten dar cuenta de que las características psicométricas de la adaptación y validación de la escala de Control del Yo a la población argentina son satisfactorias.

Ego-resiliency in borderline personality disorder and the mediating role of positive and negative affect on its associations with symptom severity and quality of life in daily life

Borderline personality disorder (BPD) is a serious mental health condition associated with severe symptoms of distress and poor quality of life (QoL). Research outside the field of BPD suggests that ego-resiliency is negatively associated with psychopathology and positively associated with a range of positive life outcomes. Thus, ego-resiliency may be a valuable construct for furthering our understanding and treatment of BPD. However, the mechanisms linking ego-resiliency to psychopathology and QoL in relation to BPD have not been examined and explored by research. This study has addressed this gap in the collective knowledge by evaluating whether within-person associations between daily reports of positive affect (PA) and negative affect (NA) mediated the relationship between ego-resiliency, BPD symptom severity, and QoL. For 21 consecutive days, 72 women diagnosed with BPD completed end-of-day electronic assessments regarding ego-resiliency, PA and NA, symptom severity, and QoL. Multilevel structural equation modelling established that PA and NA were parallel mediators linking ego-resiliency with BPD symptom severity and QoL. As hypothesized, the path to QoL was stronger through PA than through NA. The mediation paths through NA and PA to BPD symptom severity were both significant, but their strength did not differ. Our findings align with the assertions of theories on emotion, thus suggesting a two-factor approach to PA and NA. Future research can build on these findings by developing psychotherapeutic interventions designed not only to reduce symptom severity but also to enhance PA in individuals with BPD and determine whether an increase in PA is associated with improved QoL.

An Integrative Framework of Appraisal and Adaptation in Serious Medical Illness

Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care's focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients' use of active (vs. passive) and approach-oriented (vs. avoidant) coping strategies. However, without a framework outlining the process that individuals with serious medical illness and their loved ones undergo, it is challenging to discern exactly where, how, and why palliative care may affect the serious medical illness experience. To address this gap, we propose a clinically applicable framework, derived from existing theory and research in the social and behavioral sciences. This framework, called the Integrative Framework of Appraisal and Adaptation in Serious Medical Illness, describes how patients and their loved ones cognitively and emotionally process the various events that may occur as they navigate serious medical illness and the end of life. The framework also describes how individuals and their loved ones use that event processing to determine next steps, while considering the impact of their surrounding external environment, their individual social roles, and their connections on this decision making. The framework presented in this article is intended to improve our ability to understand and care for individuals with serious medical illness and their loved ones, while stimulating further discussion and research to test and refine these ideas.

Applicability of the Ego-Resilience Scale (ER89) in the Chinese Cultural Context: A Validation Study

This study examined the cross-cultural validity of the Ego-Resilience Scale (ER89) in the Chinese cultural context. The ER89 was translated and culturally adapted into Chinese by following the psychometric validation procedures, in an adolescent sample ( N = 943) of 13- to 18-year-olds. A series of psychometric analyses were conducted, including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), analysis for measurement invariance across gender groups, analysis for criterion-related validity evidence, and internal consistency reliability estimates. The results supported the use of ER89 scale in the Chinese cultural context (ER89-C). The empirical findings suggest a two-factor structure of ER89-C (openness to life experiences [OL] and optimal regulation [OR]). The findings also revealed that ER89-C has the expected correlations with external and theoretically related constructs. Overall, ER89-C is shown to possess favorable psychometric characteristics for its use as an assessment tool for ego-resilience level of Chinese adolescents.

The physical health costs of positive adaptation to childhood adversity

Theories of allostatic load suggest that recurrent adaptive adjustments in contexts of adversity may have a negative impact on physical well-being. To test this hypothesis, this study evaluated 6-year-old children's ego-resilience and physical abuse experiences on behavior problems and physical illness at the age of 8 years. A significant interaction between ego-resilience and physical abuse exposure indicated that, although ego-resilience buffered physically abused children from internalizing problems, it also predicted more physical illness in that group. Findings contribute to the growing body of evidence suggesting that efforts to mobilize an adaptive response in contexts of adversity may exact a cost on physical well-being.

Cultural Predictors of Resilience in a Multinational Sample of Trauma Survivors

The present study aims to fill a gap in the study of resilience to trauma by examining resilience in a culturally diverse population. Approximately 70% of adults across the globe experience at least one traumatic event in their lifetime, yet resilience is a common response trajectory. This pilot study explored reactions to trauma and psychological resilience in an international sample of trauma-exposed participants. Participants were recruited online using the Amazon Mechanical Turk software and after completing an informed consent, were determined eligible to participate if they endorsed experiencing at least one traumatic event. Eligible participants then completed The Stressful Life Events Questionnaire, Brief Resiliency Scale, Ego Resiliency Scale, Posttraumatic Stress Disorder Checklist-Civilian Version, Brief Religious Coping Scale, and Multigroup Ethnic Identity Measure. The final sample included 200 trauma exposed adults from nineteen different countries worldwide, with a majority hailing from the United States, India, Sri Lanka and the Philippines. Results revealed that Asian participants scored significantly higher on resilience scales and endorsed higher levels of spiritually focused coping than other subgroups. Multivariate analyses revealed that these differences in resilience remained significant even after controlling for sense of ethnic identity and spiritual coping, suggesting that there may be culturally specific predictors of resilience within the Asian subgroup. Understanding variations in resilience will aid in developing culturally tailored interventions and pursuing a strengths-based approach to recovery from trauma. Limitations and implications are discussed.

A Study of Magnitude and Psychological Correlates of Smartphone Use in Medical Students: A Pilot Study with A Novel Telemetric Approach

CONTEXT

Smartphone use is being investigated as a potential behavioral addiction. Most of the studies opt for a subjective questionnaire-based method. This study evaluates the psychological correlates of excessive smartphone use. It uses a telemetric approach to quantitatively and objectively measure participants' smartphone use.

METHODOLOGY

One hundred forty consenting undergraduate and postgraduate students using an Android smartphone at a tertiary care teaching hospital were recruited by serial sampling. They were pre-tested with the Smartphone Addiction Scale-Short Version, Big five inventory, Levenson's Locus of Control Scale, Ego Resiliency Scale, Perceived Stress Scale, and Materialism Values Scale. Participants' smartphones were installed with tracker apps, which kept track of total smartphone usage and time spent on individual apps, number of lock-unlock cycles, and total screen time. Data from tracker apps were recorded after 7 days.

RESULTS

About 36 % of participants fulfilled smartphone addiction criteria. Smartphone Addiction Scale score significantly predicted time spent on a smartphone in the 7-day period (β = 0.234, t = 2.086, P = 0.039). Predictors for time spent on social networking sites were ego resiliency (β = 0.256, t = 2.278, P = 0.008), conscientiousness (β = -0.220, t = -2.307, P = 0.023), neuroticism (β = -0.196, t = -2.037, P = 0.044), and openness (β = -0.225, t = -2.349, P = 0.020). Time spent gaming was predicted by success domain of materialism (β =0.265, t = 2.723, P = 0.007) and shopping by ego resiliency and happiness domain of materialism.

CONCLUSIONS

Telemetric approach is a sound, objective method for evaluating smartphone use. Psychological factors predict overall smartphone usage as well as usage of individual apps. Smartphone Addiction Scale scores correlate with and predict overall smartphone usage.

Type and Timing of Negative Life Events Are Associated with Adolescent Depression

Previous studies have demonstrated an association between negative life events (NLEs) in childhood and resilience/posttraumatic growth (PTG) with regard to the pathogenesis of major depressive disorder. We hypothesized that the type and timing of NLEs interact to influence mental health in the general youth population. Therefore, the present study aimed to examine the effects of NLE timing and intensity on current depressive symptoms, and to determine the direct and indirect effects of NLEs/resilience on PTG and depression among non-clinical adolescents. Data were collected from 1,038 high-school students across seven high schools in Fukui, Japan, during their freshman and sophomore years (648 boys and 390 girls, mean age = 15.71, SD = 0.524). Respondents completed a set of questionnaires designed to evaluate the type and timing of NLEs, depressive and traumatic symptoms, and PTG. Cluster analysis was used to divide participants into three groups based on outcomes: "cluster 1" (n = 631), for whom depressive scores were significantly lower than other two subgroups (p < 0.05, for both); "cluster 2" (n = 52), for whom levels of current and past perceived stress associated with NLEs were significantly higher than those of the other two subgroups (p < 0.05, for both); "cluster 3" (n = 374), for whom perceived stress at the time of NLE was significantly higher than that of participants in the cluster 1 (p < 0.05) group, but not the cluster 2 group. Our findings indicated that exposure to NLEs at a younger age resulted in stronger negative outcomes and that NLE timing and intensity were associated with PTG and current symptoms of depression. Furthermore, path analysis demonstrated that associations between perceived stress at the time of NLEs were direct and indirect predictors of current depression via PTG and that posttraumatic stress symptom and PTG mediate the association between NLEs/trait-resiliency and current depression. In conclusion, our findings suggest that event intensity, NLE timing, and gender may play a role in emotional vulnerability during adolescence.

Auditory multistability and neurotransmitter concentrations in the human brain

Multistability in perception is a powerful tool for investigating sensory-perceptual transformations, because it produces dissociations between sensory inputs and subjective experience. Spontaneous switching between different perceptual objects occurs during prolonged listening to a sound sequence of tone triplets or repeated words (termed auditory streaming and verbal transformations, respectively). We used these examples of auditory multistability to examine to what extent neurochemical and cognitive factors influence the observed idiosyncratic patterns of switching between perceptual objects. The concentrations of glutamate-glutamine (Glx) and γ-aminobutyric acid (GABA) in brain regions were measured by magnetic resonance spectroscopy, while personality traits and executive functions were assessed using questionnaires and response inhibition tasks. Idiosyncratic patterns of perceptual switching in the two multistable stimulus configurations were identified using a multidimensional scaling (MDS) analysis. Intriguingly, although switching patterns within each individual differed between auditory streaming and verbal transformations, similar MDS dimensions were extracted separately from the two datasets. Individual switching patterns were significantly correlated with Glx and GABA concentrations in auditory cortex and inferior frontal cortex but not with the personality traits and executive functions. Our results suggest that auditory perceptual organization depends on the balance between neural excitation and inhibition in different brain regions.This article is part of the themed issue 'Auditory and visual scene analysis'.

Auditory Multi-Stability: Idiosyncratic Perceptual Switching Patterns, Executive Functions and Personality Traits

Multi-stability refers to the phenomenon of perception stochastically switching between possible interpretations of an unchanging stimulus. Despite considerable variability, individuals show stable idiosyncratic patterns of switching between alternative perceptions in the auditory streaming paradigm. We explored correlates of the individual switching patterns with executive functions, personality traits, and creativity. The main dimensions on which individual switching patterns differed from each other were identified using multidimensional scaling. Individuals with high scores on the dimension explaining the largest portion of the inter-individual variance switched more often between the alternative perceptions than those with low scores. They also perceived the most unusual interpretation more often, and experienced all perceptual alternatives with a shorter delay from stimulus onset. The ego-resiliency personality trait, which reflects a tendency for adaptive flexibility and experience seeking, was significantly positively related to this dimension. Taking these results together we suggest that this dimension may reflect the individual's tendency for exploring the auditory environment. Executive functions were significantly related to some of the variables describing global properties of the switching patterns, such as the average number of switches. Thus individual patterns of perceptual switching in the auditory streaming paradigm are related to some personality traits and executive functions.

Resilience, Pain Interference, and Upper Limb Loss: Testing the Mediating Effects of Positive Emotion and Activity Restriction on Distress

OBJECTIVE

To test mediating effects of positive emotion and activity restriction on the associations of resilience and pain interference with distress reported by individuals with traumatic upper limb loss evaluated for prosthetics.

DESIGN

Cross-sectional correlational study of several demographic and self-report measures of resilience, pain interference, activity restriction, positive emotions, and symptoms of depression and posttraumatic stress.

SETTING

Six regional centers throughout the United States.

PARTICIPANTS

A total of 263 prospective participants consented to be evaluated for eligibility and need for upper extremity prosthetics; participants (N=202; 57 women [28.2%] and 145 men [71.8%]; mean age, 41.81±14.83y; range, 18.01-72.95y) who sustained traumatic injuries were retained in this study. Most of them were identified as white (70.8%; n=143), followed by black (10.4%; n=21), Hispanic (9.9%; n=20), Asian (3.0%; n=6), other (1.5%; n=3), and missing (4.5%; n=9).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Primary Care Posttraumatic Stress Disorder Screen and depression screen.

RESULTS

Resilience and pain interference were significantly correlated in predicted directions with positive emotions, activity restriction, and the 2 distress variables. A path model revealed that the associations of resilience and pain interference with both distress variables were completely mediated by positive emotions and activity restriction. There were no significant direct effects of resilience or pain interference on either distress variable.

CONCLUSIONS

Resilience may facilitate adjustment via beneficial and predicted associations with positive emotions and active engagement with the environment. These relations are independent of the significant and inverse associations of pain interference with these same variables. Longitudinal research is needed to understand interactions between positive emotions and activity over time in promoting adjustment after traumatic limb loss. Individuals reporting depression and/or posttraumatic stress disorder symptoms may require interventions that reduce avoidance and promote activities that may increase the likelihood of experiencing positive emotions.