The association of resilience with health-related quality of life (HRQoL) in adolescent students

Resilience mediates the effect of peer victimization on quality of life in Chongqing adolescents: from a perspective of positive childhood experiences

Background

Peer victimization is a harmful experience that contributed to one's psychological problems, physical health deterioration, and so on. Quality of life (QoL) is an important indicator of adolescent health assessment. To identify potential pathways of positive experiences in preventing peer victimization's detrimental effects and then provide intervention ideas for adolescent health, this study was conducted to examine the relationship between peer victimization and QoL in Chongqing adolescents and discover whether resilience plays a mediating role and positive childhood experiences (PCEs) act as a moderating role in the relationship.

Methods

Data were the first follow-up of a cohort study conducted in four complete middle schools in two districts of Chongqing, China. Self-designed peer victimization items, the Connor-Davidson Resilience Scale, the Adolescent Quality of Life Scale, and the Benevolent Childhood Experiences Scale were used. We investigated the differences and correlations in peer victimization, QoL, and resilience between the two PCEs groups. Mplus version 8.3 was used to analyze the mediating role of resilience and the moderating role of PCEs in peer victimization and QoL.

Results

Peer victimization, resilience, and QoL differed between the two PCEs groups (P < 0.001). Peer victimization negatively correlated with QoL and resilience, while resilience positively correlated with QoL (P < 0.001). In the models with total QOL as the dependent variable, the indirect effect was -0.431 (8.08% of the total effect) in the low-PCEs group vs. -2.077 (41.97% of the total effect) in the high-PCEs group. In the models with four dimensions of QOL as the dependent variable, the indirect effects ranged from -0.054 to -0.180 (6.07-12.95% of the total effects) in the low-PCEs group and from 0.295 to -0.823 in the high-PCEs group (35.89-68.76% of the total effects). Both total and indirect effects were significant (P < 0.05). In addition, the differences in indirect effects were significant between the two PCEs groups (P < 0.05), while differences in total and direct effects were almost not apparent.

Conclusion

Resilience partially mediated the effect of peer victimization on QoL in Chongqing adolescents, and PCEs moderated this mediation. Schools, families, and society should focus on resilience intervention and prioritize the enhancement of PCEs for improving adolescent QoL.

The relationship between negative life events and quality of life in adolescents: Mediated by resilience and social support

Background

Quality of life has become an important indicator for assessing the health care of adolescents. This study aimed to explore the relationship between negative life events and quality of life in adolescents and the potential mediating roles of resilience and social support.

Methods

A stratified cluster sampling technique was used to select 3,860 adolescents as study participants. The Adolescent Self-Rating Life Events Checklist, the Resilience Scale for Chinese Adolescents, the Social Support Rating Scale, and the Adolescent Quality of Life Scale were used by participants to rate their negative life events, resilience, social support, quality of life, respectively. The correlations between study variables were analyzed by the Pearson correlation analyses. The AMOS 26.0 software was used to explore the mediating roles of resilience and social support in negative life events and quality of life.

Results

There was a negative correlation between negative life events and quality of life (β=-0.745, P < 0.05); resilience and social support played an important mediating role in the relationship between negative life events and quality of life (β_Resilience = -0.287, P < 0.05; β_{Social support} = -0.124, P < 0.05). The emotional adjustment dimension of resilience (β = -0.285, P < 0.05) and the subjective support dimension of social support (β = -0.100, P < 0.05) played the largest mediating roles, respectively.

Conclusion

Negative life events were negatively correlated with adolescents' quality of life. Strengthening resilience and social support is expected to weaken and reduce the adverse effects of negative life events on adolescents and further maintain and improve their quality of life.

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

Multiple internal factors, such as psychological resilience and mental health status, have been shown to contribute to overall quality of life (QoL). However, very few studies to date have examined how these factors contribute to QoL of youth and young adults in a stressful situation. Here, we studied the contribution of these factors, as well as of ecological momentary mood assessment, to QoL of young army recruits during their Basic Training Combat (BCT). To this end, we collected data from 156 male and female soldiers in a mixed-gender unit in the Israel Defense Forces (IDF). Using a mobile app installed on participants' phones, participants provided self-reports regarding their mental health status and psychological resilience at baseline, and QoL 2 weeks later. Momentary mood reporting was further collected during the 2-week interval period using a daily self-report mood scale (IMS-12). Structural equation modeling (SEM) was used to examine the interrelationships among the study variables based on a hypothesized model. We found that a model with all factors (gender, resilience, mental health status and momentary mood) provided a good fit for the data based on its fit indices [χ2(38) = 47.506, p = 0.139, CFI = 0.979, NFI = 0.910, RMSEA = 0.040, TLI = 0.964]. However, the only direct contributors to QoL were gender and momentary mood, accounting together for 61.5% of the variance of QoL. Psychological resilience and mental health status contributed to QoL only indirectly, through their associations with momentary mood. Collectively, these results highlight the importance of ecological momentary assessment of mental-health related factors such as mood to the prediction of QoL in young adults under stress. These findings may have broader implications for monitoring and improvement of well-being in young healthy populations as well as in clinical ones.

Social-Ecological measure of resilience: an adapted measure for Persian-speaking university students

Background: There is no validated instrument for Persian-speaking students to apply the social-ecological resilience theory (SERT), which emphasizes the ecological resources for developing resilience. The study aimed at developing the student social-ecological resilience measure(Student-SERM) in Iran’s context.

Methods: Three separate samples of undergraduates participated in this mixed-methods research from the University of Tehran, Iran. Phase-1 qualitatively explored the resilience features in the university setting, to devise the university-specific subscale (USS). Phase-2piloted the construct validity and reliability of the Student-SERM in 242 undergraduates, who also completed Depression, Anxiety, and Stress Scale (DASS-21). Phase-3, as a cross-validation study, investigated 487 undergraduates, who completed the refined Student-SERM, HospitalAnxiety and Depression Scale (HADS), and three indices screening academic performance, loneliness, and suicide acceptability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Pearson’s correlation, and Cronbach’s alpha were performed.

Results: Phase-1 yielded nine items for USS. In phase-2, EFA indicated the construct validity of the main 20-item measure (RMSEA=0.06 and SRMR=0.04) and the nine-item USS (RMSEA=0.07and SRMR =0.04), and the reliability and convergent/divergent validity were confirmed. In phase-3, EFA (RMSEA=0.07 and SRMR=0.04) and CFA (RMSEA=0.07, CFI=0.89, TLI=0.87,and SRMR=0.07) in two separate subsamples and CFA (RMSEA=0.06, CFI=0.92, TLI=0.90,and SRMR=0.06) in the total sample indicated the construct validity of the refined Student-SERM, including family, peer, culture, growth, and USS subscales. The reliability and convergent/divergent validity were also reconfirmed.

Conclusion: The Student-SERM incorporates ecological resources, accounting for the students’resilience. Since the resilience process involves a return to healthy functioning after adversity, further research can examine the application of Student-SERM in high-risk student populations.