Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review

Resilience in children of parents with mental illness, alcohol or substance misuse-An integrative review

AIM

The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse.

DESIGN

An integrative review.

METHOD

The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors.

RESULTS

Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family.

PATIENT OR PUBLIC CONTRIBUTION

Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations.

Psychological resilience and cortisol levels in adults: A systematic review

Resilience or the capacity to "bend but not break" refers to the ability to maintain or regain psychobiological equilibrium during or after exposure to stressful life events. Specifically, resilience has been proposed as a potential resource for staving off pathological states that often emerge after exposure to repeated stress and that are related to alterations in circulating cortisol. The aim of this systematic review of the literature was to gather evidence related to the relationship between psychological resilience and cortisol levels in adult humans. An extensive systematic search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method in the PubMed and Web of Science databases. In total, 1256 articles were identified and, of these, 35 peer-reviewed articles were included in the systematic review. We categorized findings according to (1) the short and long-term secretion period covered by the cortisol matrices selected by studies and also according to (2) the differentiated diurnal, phasic (acute), and tonic (basal) components of the HPA output to which they refer and their relationships with resilience. Reported relationships between psychological resilience and distinct cortisol output parameters varied widely across studies, finding positive, negative, and null associations between the two variables. Notably, several of the studies that found no relationship between resilience and cortisol used a single morning saliva or plasma sample as their assessment of HPA axis activity. Despite limitations such as the great variability of the instruments and methods used by the studies to measure both resilience and cortisol, together with their high heterogeneity and small sample sizes, the evidence found in this systematic review points to the potential of resilience as a modifiable key factor to modulate the physiological response to stress. Therefore, further exploration of the interaction between the two variables is necessary for the eventual development of future interventions aimed at promoting resilience as an essential component of health prevention.

Effectiveness of resilience interventions among cancer patients - A systematic review, meta-analysis, and meta-regression of randomised controlled trials

PURPOSE

This systematic review, meta-analysis and meta-regression aimed to (1) evaluate the effects of resilience interventions on cancer patients' resilience and posttraumatic growth and (2) identify essential contents and features of resilience interventions.

METHODS

A systematic review, meta-analysis, and meta-regression analyses were conducted. Published and unpublished randomised controlled trials evaluating the effects of resilience interventions among cancer patients were retrieved from nine databases, trial registries, and grey literature. The mean and standard deviation scores were used to compute the effect sizes.

RESULTS

23 randomised controlled trials comprising 3287 cancer patients were included. The random effects model found that resilience interventions had beneficial impacts on patients' resilience, posttraumatic growth, quality of life, anxiety, and depressive symptoms with moderate to large effects. The subgroup analyses concluded that theoretically guided interventions that adopted synchronous communication delivered physically had greater effect sizes. Interventions comprising skills that promote patients' cognitive flexibility, self-efficacy, self-esteem, self-regulation, and coping had greater effect in comparison with interventions lacking these components. The meta-regression analyses revealed that sample size has a significant effect on posttraumatic growth scores. More well-designed trials are needed to confirm the effects of resilience interventions.

CONCLUSIONS

There is merit in utilizing resilience interventions to improve cancer patients' resilience and psychological well-being. Resilience interventions should be incorporated into the routine care for cancer patients and survivors.

Feasibility and efficacy of a digital resilience training: A pilot study of the strengths-based training RESIST

Background

Work-related stress is a risk factor for a number of adverse health and work outcomes. Resilience trainings are a promising approach for adequately dealing with work stress and keeping employees mentally healthy. However, results of previous resilience trainings have been heterogeneous, ranging from null findings to large effects. Existing digital resilience interventions show a lack of consistency in terms of an underlying theoretical framework and methods used to foster resilience. Positive Appraisal Style Theory of Resilience offers an innovative conceptualization of resilience. Strengths-based cognitive behavioral therapy is a corresponding therapeutically method reflecting resilience as a resource-oriented process of dealing with stress. Based on this background, a new hybrid web-and app-based digital resilience intervention for employees named RESIST was developed.

Objective

The first aim of the study was to investigate the feasibility of the newly developed training RESIST regarding its usability, user behavior, user experience and motivation to use. Second, the study sought to explore preliminary effects of the intervention on reducing stress and enhancing resilience by conducting a pilot randomized controlled trial.

Methods

The feasibility study was conducted in three phases. First, the usability of the app was investigated in a pre-test with five participants using a thinking-aloud method. Second, the preliminary efficacy of the training was examined in a pilot randomized controlled trial. A sample of 30 employees were randomized either to receive the resilience training (n = 15) or to be member of a control group (n = 15). The primary outcome was measuring perceived stress. Secondary outcomes included measures of resilience and depressive symptoms. Third, semi-structured interviews were undertaken with six participants of the resilience training group on training content, motivation for use, and user experience.

Results

Overall, results indicate that RESIST can be a feasible training for resilience promotion and stress reduction with high user satisfaction. Analysis of covariance showed that, relative to controls, participants who received RESIST reported significantly lower stress scores at post-intervention (F1,27 = 16.91, p < 0.001; Cohen's d = 1.57; 95 % CI 0.71-2.43) than controls. Significant differences, with moderate-to-large effect sizes, were also detected for general resilience and various resilience factors.

Conclusions

Results are promising and provide hope that a hybrid web- and app-based resilience intervention based on strengths-based cognitive behavioral therapy can have a positive impact on dealing adequately with stress and improve resilience of employees.

Relation between resilience and personality traits: The role of hopelessness and age

Resilience refers to the process by which individuals use the ability to cope with challenges to successfully adapt to adverse situations, inclining towards the future and hope. The main aim of this study was to analyze the relation between resilience, personality traits, and hopelessness. Furthermore, we conducted comparisons between two age groups: young and older adults. The sample comprised 439 Spanish participants (66.7% women; M = 43.73, SD = 26.41; age range = 18-98 years). The Connor-Davidson Resilience Scale, NEO-Five Factor Inventory, and Beck Hopelessness Scale were used to measure the main study variables. The results revealed a negative relation between resilience and neuroticism, and a positive association with the other personality traits. Additionally, levels of resilience were found to be negatively related to hopelessness. The group of older adults showed significantly lower resilience levels than the young adults, although age was not a significant predictor of resilience. Neuroticism, extraversion, openness, and hopelessness were the only predictors of resilience for the current study. This work contributes to the study of resilience and related factors, by attempting to understand the role of resilience and resistance to risk and how individuals tackle challenges over time, with important implications for mental health.