Resilience: Building immunity in psychiatry

The potential role of religiosity, psychological immunity, gender, and age group in predicting the psychological well-being of diabetic patients in Saudi Arabia within the Bayesian framework

This study aimed to investigate the differences in Religiosity (R), Mental Immunity (MI), and Psychological Well-Being (PWB) in patients with diabetes due to gender and age group variables, and to detect the best predictors of PWB in diabetic patients within the Bayesian framework. The study was conducted from May 2022 to February 2023 on a random sample of 186 Saudis diagnosed with diabetes. After obtaining participants' consent, they completed three R, MI, and PWB scales. Bayesian Independent Samples t-test was performed to identify differences, and Bayesian linear regression analysis was used to reveal the best prediction model of PWB. The results of the Bayesian independent samples t-test indicated strong evidence supporting the alternative hypothesis H1, suggesting differences between male and female diabetic patients in R, MI, and PWB, with Bayesian factor values exceeding 10 (8.338×10+23, 1.762×10+25, and 1.866×10+24), and Cohen's δ of (-1.866, -1.934, -1.884). These results indicated that females with diabetes have higher means of R, MI, and PWB compared to males. However, the results also suggested evidence for the null hypothesis H0 of no differences in R, MI, and PWB among diabetic patients due to age group, with Bayesian factor values (0.176, 0.181, and 0.187) less than 1.00 and small Cohen's δ of (-0.034, -0.050, -0.063). Bayesian linear regression analysis detected strong evidence that the model including MI is the best predictive model (BF10 for mental immunity is 1.00 and for the other two models are 0.07 and 4.249×10-16) for the PWB of diabetic patients, however, there is no evidence that the model including R or the interaction between R and MI is the best predictor of PWB for diabetic patients. These findings highlight the need for direct psychological care services for male diabetic patients and the urgent need to enhance IM in diabetic patients to improve their PWB. Furthermore, results recommended that healthcare providers in Saudi Arabia integrate MI interventions into diabetes care programs.

Exploring Nurses' Emotional Resilience and Coping Strategies in Palliative and End-of-Life Care Settings in Saudi Arabia: A Qualitative Study

BACKGROUND

Nurses working in palliative and end-of-life care settings face significant emotional challenges due to the demanding nature of their profession. This study aimed to explore the emotional resilience of these nurses, understanding the factors that contribute to their resilience, the impact on their professional well-being and performance, and strategies to enhance resilience.

METHODS

A qualitative study was conducted involving 15 registered nurses from various healthcare facilities in Riyadh, Saudi Arabia. Data were collected through semi-structured interviews, document analysis, and observational data. Thematic analysis was employed to identify recurring themes.

RESULTS

The study identified three key themes: Emotional Challenges and Resilience-Building, Support Systems and Resources for Resilience, and Professional Growth and Fulfillment as Resilience Factors. The findings revealed the emotional toll of patient suffering, highlighting resilience-building strategies, such as peer support, mindfulness, and reflective practices. Support systems, including workplace support, organizational resources, and mentorship, were identified as crucial for fostering resilience. Professional growth, a sense of purpose, and recognition emerged as factors contributing to resilience.

CONCLUSIONS

This study underscores the importance of emotional resilience for nurses in palliative and end-of-life care settings. Healthcare organizations can enhance resilience by implementing resilience training, providing counseling services, fostering a supportive culture, and offering professional development opportunities. Addressing the emotional needs of nurses is vital for their well-being and the delivery of compassionate care.

A four-year longitudinal analysis examining the effects of e-cigarette advertisements and disparities among youth with internalizing problems

BACKGROUND

Prior research indicates a direct, short-term effect of e-cigarette advertising on e-cigarette use among youth. This study seeks to investigate the long-term effects of e-cigarette advertisements and disparities in exposure among adolescents with different levels of internalizing problems.

METHODS

Panel data of the Population Assessment of Tobacco and Health (PATH) Study Waves 3-5 (2015-2019) were analyzed. Youth aged 12-17 who were non-e-cigarette users at the time of Wave 3 were included (n = 4,678). A moderated mediation model was employed to examine the mediating role of perceived harm of e-cigarettes and the moderating effect of internalizing problems.

RESULTS

Exposure to e-cigarette advertisements in Wave 3 predicted lower harm perception of e-cigarette in Wave 4 (bp = -0.055, p <.01), leading to more e-cigarette use in Wave 5 (bp = -0.042, p <.001). While e-cigarette advertisements exhibited a lasting indirect effect (bp = 0.002, p <.05), there was no long-term direct effect (bp = 0.017, p >.05) on youth e-cigarette use. Furthermore, a moderating effect of internalizing problems was observed (bp = 0.107, p <.05).

CONCLUSIONS

E-cigarette advertisements can exert a lasting influence indirectly by diminishing harm perception, particularly among those with lower internalizing problems. Adolescents with higher internalizing problems exhibit lower susceptibility to advertisement influence, yet their perceived harm of e-cigarettes is notably lower than their peers with fewer internalizing problems. These disparities underscore the need for tailored prevention strategies: implementing anti-e-cigarette education programs for adolescents with low internalizing problems and providing mental health care for those facing internalizing challenges. Regulatory measures targeting e-cigarette advertising are also crucial.

A Literature Review on Holistic Well-Being and Dopamine Fasting: An Integrated Approach

Popularly known as dopaminergic detox or dopamine fasting, it is a concept that aims at reducing dependence on instant satisfaction gratification and overstimulation to attain mental clarity, lessen anxiety, and be able to enjoy everyday events again. Digital detox has been a part of the dopamine fasting concept for several years now. However, some critics argue that this notion has no scientific proof behind it and may fail to deal with the problem of dopamine dysregulation. Some intense types of dopamine fasting which include extreme isolation or strict dieting can result in damage to mental health as well as physical fitness. The objective of the article is to understand what dopamine fasting means and see the literature and evidence available on the topic. Indexes like PubMed, Scopus, OVID, Embase, and Google Scholar were searched using the keywords to understand the existing knowledge about dopamine fasting. The literature review was then written to incorporate the understanding in a way that can be implemented practically. Recent studies have shown that individuals who engage in dopamine-fasting-like ideologies may experience reduced impulsive behaviors, increased focus on tasks, and reduced overwhelm. However, extreme forms of dopamine fasting can lead to feelings of loneliness, anxiety, and malnutrition, which can have detrimental effects on mental and physical health. Hence, the effects of dopamine fasting can vary greatly among individuals, and there is no one-size-fits-all approach. It is essential to consider individual needs and preferences when incorporating dopamine fasting into one's lifestyle and explore alternative practices that align with the principles of dopamine fasting. Understanding and respecting these differences is crucial in determining the most suitable strategies for maintaining a balanced dopamine response and overall psychological health. The benefits of dopamine fasting can be tremendous if done correctly but it depends on every individual to find the correct way and in the modern day, the practices can become tough to implement.

Main Biological Models of Resilience

Objective

Resilience is a complex process of adaptation to new conditions that would permit a positive outcome after adversities, traumas or other sources of stress. However, despite the growing interest in this topic, there is no universally accepted definition and no comprehensive bio-behavioural model. This systematic review aims to provide an overview of the main biological models that have been theorized to date, with a focus on new alternative theories to improve our understanding of the mechanisms underlying the development and strengthening of resilience, with potential implications for the prevention of some psychopathological disorders.

Method

This review was conducted according to PRISMA guidelines and includes 185 studies published in English in PubMed and Embase up to December 2023.

Results

Most studies use the stress-related model, which conceptualizes resilience as the absence of symptoms after the stressful event and mainly deal with the differences between stress-prone and resilient phenotypes in animals exposed to stress. However, the results of this search seem to suggest that resilience might be an independent construct with biological bases rooted in the stress system and the social brain, and widely sculptured by individual and environmental factors, especially early life events and affiliation.

Conclusions

This work contributes to ongoing efforts to understand the intricate mechanisms of resilience, while highlighting the potential of improving social relationships since our birth to promote coping strategies towards stress and traumas, and even a peaceful world.

The role of resilience in the relationship between intimate partner violence severity and ICD-11 CPTSD severity

Background: Resilience is a modulating factor in the development of PTSD and CPTSD after exposure to traumatic events. However, the relationship between resilience and ICD-11 CPTSD is not adequately understood in survivors of intimate partner violence (IPV).Objective: The aim of this study is to determine whether resilience has a mediating role in the relationship between severity of violence and severity of CPTSD symptoms.Method: A sample of 202 women IPV survivors completed self-rated questionnaires to assess CPTSD, severity of violence and resilience.Results: Mediation analyses indicated that there was a direct relationship between the severity of violence and the severity of CPTSD symptoms (β = .113, p < .001) and that there was a significantly inverse relationship between levels of resilience and the severity of CPTSD symptoms (β = -.248, p < .001). At the same time, there was no significant relationship between the severity of violence and resilience (β = -.061, p = .254).Conclusions: These findings suggest that resilience does not mediate the relationship between violence severity and CPTSD severity. Directions for future research are discussed.

The association between adverse childhood experiences and oral health: A systematic review

OBJECTIVE

It is well established that adverse childhood experiences (ACEs) negatively affect health and are associated with health-risk behaviors. This study aimed to provide a systematic review of the studies that examine the relationship between ACE exposure and oral health among adults aged 18 years and older.

METHODS

The following electronic databases were searched in January 2022: MEDLINE, Cochrane, Web of Science, CINAHL via EBSCOhost, ProQuest, ScienceDirect, and Google Scholar. Data were extracted independently by two reviewers. The quality of the studies was assessed using the Newcastle-Ottawa Scale.

RESULTS

Among the 292 articles identified, four met the eligibility criteria. All included studies were cross-sectional and of satisfactory quality. The dental outcomes included: last dental visit, last dental cleaning, number of filled teeth, number of extracted teeth, and number of remaining teeth. The studies showed that exposure to ACE was negatively associated with oral health. The relationship between ACE score and oral health outcome measures was found to be directly proportional.

CONCLUSION

There is an association between ACE and poor oral health. Moreover, the association was proven to have a dose-response relationship. Given that the studies in the literature were cross-sectional, causality cannot be determined with certainty, therefore interpretation of the results should be cautious. Longitudinal follow-up studies are needed to understand how ACEs contribute to oral diseases later in life.

Relationship between childhood trauma and resilience in patients with mood disorders

BACKGROUND

Childhood trauma has lasting negative impacts on individuals' psychological functioning. However, there is limited empirical evidence on the association between childhood trauma and resilience and none examining such relationship among diverse clinical populations. This study aimed to investigate the relationship in patients with major depressive disorder, bipolar I disorder, bipolar II disorder, and a comparison group.

METHODS

In total, 787 psychiatric patients and 734 people from the general population participated in the study. The Childhood Trauma Questionnaire-Short Form and Connor-Davidson Resilience Scale were used to assess childhood trauma and resilience, respectively.

RESULTS

Individuals with childhood trauma showed lower levels of resilience in all subjects; among them, those who experienced emotional abuse and emotional neglect exhibited even stronger associations than other types of childhood trauma. There was a significant difference in the negative relationship between childhood trauma and resilience by group, where the association was more prominent in the comparison group than in MDD and BD II patient groups.

LIMITATIONS

The generalizability of our results may be limited due to unproportionate patient sample size. Also, we could not examine the causal relationship between childhood trauma and resilience.

CONCLUSION

Childhood trauma and resilience had a significantly negative association. Our results suggest that people who have experienced emotional abuse and emotional neglect should be closely assisted to develop resilience. Interventions that promote resilience should be provided to individuals predisposed to psychological risks as a result of childhood trauma.

Sociodemographic and Psychological Predictors of Resilience Among Frontline Nurses Fighting the COVID-19 Pandemic

OBJECTIVE

According to a WHO report, the number of patients with coronavirus disease 2019 (COVID-19) has reached 456,797,217 worldwide as of 15 March, 2022. In Wuhan, China, large teams of health-care personnel were dispatched to respond to the COVID-19 emergency. This study aimed to determine the sociodemographic and psychological predictors of resilience among frontline nurses fighting the current pandemic.

METHODS

A total of 143 nurses were recruited from February 15 to February 20, 2020, to participate in this study. The 10-item Connor-Davidson Resilience Scale and the 21-item Depression Anxiety Stress Scale were used to estimate the participants' resilience and mental wellbeing.

RESULTS

Results showed that the nurses displayed a moderate resilience level. Their median depression, anxiety, and stress scores were 1, 2, and 3, respectively, which were negatively correlated with resilience. Female gender, being dispatched to Wuhan, and depression levels were the significant predictors of resilience.

CONCLUSIONS

The results suggest that particular attention should be given to nurses who were dispatched to Wuhan and who exhibited depression symptoms, and appropriate measures should be taken to boost their resilience.

Associations between Mental Resilience, Mood, Coping, Personality, and Hangover Severity

Extensive research exists on relationships between psychological constructs and alcohol consumption. However, research on relationships with hangover severity remains limited. This study aimed to assess the associations between mental resilience, mood (i.e., depression, anxiety, and stress), coping, personality, and hangover severity. A total of N = 690 participants completed an online survey by answering questions regarding their demographics, alcohol use, hangover prevalence and severity, and several psychological assessments (Brief Resilience Scale, DASS-21, Brief Cope, and Brief Version of the Big Five Personality Inventory). Significant associations were found between hangover severity and mental resilience, mood, and avoidant coping. Higher levels of mental resilience were associated with less severe hangovers, whereas poorer mood was associated with more severe hangovers. No significant associations were found with personality traits. These findings demonstrate that several associations between psychological constructs and hangover severity exist and suggest a role of psychological factors in the pathology of the alcohol hangover. As our findings contrast with the results of previous studies that did not report an association between mental resilience and the presence and severity of hangovers, further research is warranted.

Resilience in Children and Adolescents Survived Psychologically Traumatic Life Events: A Critical Review of Application of Resilience Assessment Tools for Clinical Referral and Intervention

Psychological traumatic life events (TLEs) and resilience, both are multidimensional, complex, and share salient features. Both are products of individual, familial, and environmental (socio-cultural-political contextual) variables, which is very crucial in children and adolescents. This systematic review used Boolean search strategies in electronic databases, namely, PubMED, PsycNET, JStor, and Google scholar. All researches not studying resilience per se but similar or related constructs such as life strengths, hardiness, protective/risk factors, social support, self-efficacy, social-emotional adjustment, and so on were excluded. A total of 12 resilience tools meant for children between 5 and 18 years were reviewed. The scale characteristics were analyzed in terms of targeted age-group of sample; purpose (i.e. screening and profiling for intervention); number of items; purpose/type of scale; year, country, and domain wise distribution; response format, standardization sample profile; psychometric properties; and availability of manual with norms of cutoff score. Although no scale was originally developed for children and adolescent population with history of TLEs particularly various forms of abuse and trauma, Child and Youth Resilience Measure and Connor-Davidson Resilience Scale had small samples of children from welfare homes. Neither did any scale tested the divergent validity against absence of any psychopathology or global functioning or poor quality of life Nor did Majority of scales provide a cutoff value for institutionalized children and adolescents with history of TLEs; therefore, using an existing scale for this purpose should be carefully examined. Trauma-focused multidimensionality in resilience needs to be explored more rigorously through mixed methods.

Resilience mechanisms at work: The psychological immunity-psychological elasticity (PI-PE) model of psychological resilience

Recently, scientists have shifted their focus from studying psychological resilience as a single, isolated construct (e.g. attribute or outcome) to studying it as a dynamic process encompassing a number of temporally related elements. Models depicting this process explain why some people adapt to stressor exposure, whereas others do not. To date, these process models did not sufficiently explain how people adapt differently to a stressor. To address this issue, we developed a new model of psychological resilience, called the Psychological Immunity-Psychological Elasticity (PI-PE) model. The aim of this article is to clarify this model and to discuss its added value. First, we explain how we derived the PI-PE model from the literature regarding both the crucial elements in any resilience process model and the (mal)adaptive outcomes following stressful events. Secondly, we describe the different elements that make up the model. Characteristic of the PI-PE model is that it distinguishes between two pathways of psychological resilience - psychological immunity and psychological elasticity - with four adaptive outcomes, namely sustainability, recovery, transformation and thriving. To explain how people arrive at these different outcomes, we argue that two consecutive mechanisms are critical in these pathways: tolerance and narrative construction. Taken as a whole, the PI-PE model presents a comprehensive framework to inspire both research and practice. It explains how the process of psychological resilience works differently for different people and how to support individuals in their process towards successfully and differently adapting to stressors.

Coping with the aftermath of COVID: Industrial resurgence, mental health, and resilience

COVID-19 pandemic has affected billions of people worldwide. Economies world over have suffered slowdown with a direct impact on industry. The vulnerable industrial worker has suffered both financially and mentally. As the pandemic has begun to slow down, the industry has started showing signs of growth and economy appears to be coming back on track. Financial losses may be recovered in time, but the mental health impact of pandemic is likely to be long-lasting. In the aftermath of COVID-19, mental health needs of vulnerable sections of societies need to be addressed. An attempt has been made to understand the mental health impact of COVID-19 pandemic on industrial workers. Preventive and promotive measures for positive mental health of industrial workers are discussed with a focus on resilience-building.

The mediating role of resilience on psychopathology following childhood adversities among UK armed forces veterans residing in Northern Ireland

BACKGROUND

Childhood adversities can have a deleterious impact on mental health. Elevated levels of such adversities have been reported in veteran populations. Levels of resilience may be protective but early adverse experiences may impact on the development of resilience in the first instance.

OBJECTIVE

This study aims to identify classes of childhood adversities among UK military veterans residing in Northern Ireland (NI) and explore levels of resilience and the mediating role resilience may play following such experiences in relation to mental health.

METHOD

The study utilizes data from the Northern Ireland Veterans' Health and Wellbeing Study (n = 656). All participants were UK Armed Forces veterans who were residents of NI with an average age of 56 (586 males, 70 females).

RESULTS

Four childhood adversity classes were revealed, with almost a half of the sample experiencing early adverse experiences. Individuals who experienced a range of adversities, particularly those related to maltreatment were more likely to have PSTD, depression and anxiety disorders and lower levels of resilience. However, those who experienced adversity related to family dysfunction had similar levels of resilience as the low risk class, suggesting tentatively that some adversity may be protective. Mediation analyses revealed that veterans with elevated levels of resilience were less likely to have psychological problems following negative childhood experiences.

CONCLUSIONS

The study highlights the importance of promoting resilience building programmes among military veterans, especially among those who experienced maltreatment as a child.

Resilience to fear: The role of individual factors in amygdala response to stressors

Resilience to stress is an adaptive process that varies individually. Resilience refers to the adaptation, or the ability to maintain or regain mental health, despite being subject to adverse situation. Resilience is a dynamic concept that reflects a combination of internal individual factors, including age and gender interacting with external factors such as social, cultural and environmental factors. In the last decade, we have witnessed an increase in the prevalence of anxiety disorders, including post-traumatic stress disorder. Given that stress in unavoidable, it is of great interest to understand the neurophysiological mechanisms of resilience, the individual factors that may contribute to susceptibility and promote efficacious approaches to improve resilience. Here, we address this complex question, attempting at defining clear and operational definitions that may allow us to improve our analysis of behavior incorporating individuality. We examine how individual perception of the stressor can alter the outcome of an adverse situation using as an example, the fear-conditioning paradigm and discuss how individual differences in the reward system can contribute to resilience. Given the central role of the endocannabinoid system in regulating fear responses and anxiety, we discuss the evidence that polymorphisms in several molecules of this signaling system contribute to different anxiety phenotypes. The endocannabinoid system is highly interconnected with the serotoninergic and dopaminergic modulatory systems, contributing to individual differences in stress perception and coping mechanisms. We review how the individual variability in these modulatory systems can be used towards a multivariable assessment of stress risk. Incorporating individuality in our research will allow us to define biomarkers of anxiety disorders as well as assess prognosis, towards a personalized clinical approach to mental health.

Development and Standardization of a Scale to Measure Adolescent Resilience- A Study in the Indian Context

The current study aimed to develop and standardize a scale to measure adolescent resilience in India. The objectives were to (i) construct a comprehensive scale for assessing adolescent resilience (ii) select and test the measurability of items in the resilience scale (iii) test the reliability and validity of the scale and (iv) establish the group differences in resilience among different groups. A total of 1214 adolescents from grades 8 to 10 (aged 10-17 years) were selected through cluster random sampling. The items were developed after an extensive literature review. Face, content, concurrent and convergent validities were established. Nine meaningful factors emerged from factor analysis. Different types of reliability tests showed the scale to be a reliable one (with the values ranging from 0.812 to 0.902). Differences in resilience were noted in adolescent girls and boys and based on the background to which they belonged. Higher resilience scores meant better resilience.

Modelling resilience in adolescence and adversity: a novel framework to inform research and practice

Recent conceptualisations of resilience have advanced the notion that it is a dynamic and multifaceted construct. However, its adaptive components, especially those forged by adversity, have not been fully realised, and its neurobiological and psychosocial underpinnings are yet to be meaningfully integrated. In part, this is because a developmental perspective is often neglected in the formulation of resilience. In this review, we consider the findings of resilience research, with a specific emphasis on the developmental period of adolescence. To bridge the gaps in our current understanding, we propose a model of resilience that is predicated on experiencing adversity. Specifically, our model provides a sophisticated insight into the components of resilience, which, together with intrinsic features, involves facilitation of, and skill acquisition via strengthening processes we term tempering and fortification. The model also points to the potential trajectories of adversity-driven resilience and forms the basis of a framework that allows for individual variance in resilience, and the identification of both neurobiological and psychosocial targets for prevention and therapeutic interventions.

Resilience dynamics after interventions made among school children of rural Ethiopia

Objectives of this study are to evaluate the impact of interventions on school children resilience and well-being; assess sensitivity of resilience evaluation tools; and identify shift in resilience among children in poor rural communities of Ethiopia. Qualitative and quantitative data are collected using semi-structured Pre- and Post- Interview Analysis (PIA), child and youth resilience measure (CYRM) and mental health continuum (MHC) questionnaires among the control and intervention groups. The study identified that PIA questions were not sensitive enough to detect all child resilience indicators. Resilience intervention has brought important positive change on most of the resilience indicators. However, no significant improvement observed on problem solving skills, and avoidance of troubling thoughts and feelings. However, the qualitative finding showed that children improved problem solving skill, such as intervening early marriage, avoiding physical abuse, and supporting needy children. In addition, integrated interventions have brought substantial resilience impacts on children school performance, their interaction and social relations. Besides, integration of parents, teachers and community has brought significant change on the result of child resilience and well-being. Younger children under intervention showed lower resilience and well-being score compared to the older ones. Shift of resilience between male and female was observed when compared between the control and intervention groups. In the control communities, female students are more resilience and psychosocial well-being than male students. On the other side, among intervention groups, males showed better resilience than females. This suggests that context specific resilience intervention by gender could be necessary among school children of East Gojjam and similar communities.

Unpacking the Literature on Stress and Resiliency: A Narrative Review Focused on Learners in the Operating Room

PURPOSE

The operating room is a high pressure environment for surgical trainees as they attempt to reach a high level of performance in the midst of a multitude of stressors. The purpose of this work was to examine the relationships between stress, coping, and psychological resilience and their effects on performance and learning in surgical training.

METHODS

A narrative review was carried out of the existing literature on stress, coping, and resilience in surgeons and surgical trainees. Multiple fields of study were examined including medical education, surgery, surgical safety, anesthesia, workplace ergonomics, and psychology.

RESULTS

Sources of intraoperative stress include fatigue, disruptions, interpersonal conflicts, time pressure, a complex case or high risk patient, surgical errors, and surgeon temperament. These stressors can negatively impact the performance of surgeons and trainees and may inhibit learning. How a learner responds to stress in the operating room is highly variable and influenced by the context of the stress, the coping mechanisms available, and individual psychological resilience. Stress management techniques, such as mental rehearsal, are beneficial for reducing stress. Resilience is protective against stress and burnout, and resilience training is useful for reducing stress and improving mental health in physicians and medical students.

CONCLUSIONS

Surgical trainees experience significant stress in the operating room and their experience of stress is modulated by cognitive and behavioral factors. Further research is required on the development of effective interventions to help trainees manage intraoperative stress, with the potential to improve surgical performance, learning, and patient safety.

Does resiliency mediate the association of psychological adaptability with disability and pain in patients with an upper extremity injury or illness?

OBJECTIVE

Symptom intensity and magnitude of limitations are highly variable for a given nociception and pathophysiology. As psychological determinants are of great influence to physical wellbeing, we assessed the influence of the protective factor measured and labelled as resilience in upper extremity illness.

METHODS

One hundred and six patients completed a survey of demographics, the Brief Resilience Scale (BRS), the Psychological Adaptation Scale (PAS), an 11-point ordinal measure of pain intensity, and the PROMIS Physical Function (PROMIS PF) Computer Adaptive Test (CAT). Measures of pain intensity and PROMIS PF were repeated 3 months later. We created mediation models using structural equation modeling (SEM) to assess the mediation effect of BRS on the association of PAS and other confounding variables with disability and pain at initial assessment and 3 months later.

RESULTS

Resiliency does not mediate the association of psychological adaptability with physical limitations and pain intensity at baseline (P = .89 and .82 respectively) or 3 months after enrollment (P = .65 and .72 respectively).

CONCLUSIONS

Positive and protective factors promote beneficial resilience mechanisms that strengthen coping responses to pain and disability. In future studies we should either include more patients to improve power and provide more information about the health benefits of resilience or focus more on mood and self-efficacy on symptoms and limitations in patients with musculoskeletal illness.

LEVEL OF EVIDENCE

Prospective, longitudinal cohort study; Level II.

Greek Version of the Connor-Davidson Resilience Scale: Psychometric Properties in a Sample of 546 Subjects

BACKGROUND/AIM

To evaluate psychometric properties of the Connor and Davidson Resilience Scale (CD-RISC) in a Greek population.

MATERIALS AND METHODS

Internal consistency and test-retest reliability were measured. Global Assessment of Functioning Scale (GAF), World Health Organization Quality of Life (WHOQOL) questionnaire, Perceived Stress Scale (PSS) and General Health Questionnaire (GHQ) were used as measures for convergent reliability. Factors were extracted by using exploratory factor analysis (EFA). A total of 546 subjects (244 healthy individuals and 302 psychiatric patients) were recruited.

RESULTS

The scale showed excellent internal consistency (Cronbach's alpha=0.925), as well as excellent test-retest reliability (intra-class correlation coefficient=0.925). CD-RISC scores were positively correlated to GAF and WHOQOL scores, while being negatively correlated to PSS and GHQ scores, establishing adequate convergent validity. We decided on a model with four factors, in order to form sub-scales that measure different, but related aspects of resilience.

CONCLUSION

CD-RISC is a reliable and valid measure of resilience and can be used for clinical and research aims in the Greek population.

Susceptibility to Alcohol Hangovers: Not Just a Matter of Being Resilient

Introduction

Although most drinkers have experienced a hangover the day following heavy alcohol consumption, a minority claims to be hangover resistant despite consuming the same large quantities of alcohol as those reporting alcohol hangover. The aim of the current study was to examine if susceptibility to experiencing hangovers is related to a drinker's interpretation of wellbeing and psychological assets to bounce back.

Methods

A survey was conducted among 2295 Dutch students assessing their past month alcohol consumption patterns, and measuring mental resilience and wellbeing. Estimated peak blood alcohol concentration (e-pBAC) for their heaviest drinking occasion in the past month was computed for each participant. Data from participants who reported a past month hangover, i.e. hangover sensitive drinkers, were compared with hangover resistant drinkers. The analyses were conducted for (a) all participants reaching an e-pBAC ≥ 0.11% (N = 986, of which 24.6% claimed to be hangover resistant) and (b) participants reaching an e-pBAC ≥ 0.18% (N = 480, of which 16.7% claimed to be hangover resistant).

Results

For both e-pBAC cut-off values, no significant differences between hangover sensitive and hangover resistant drinkers were found for mental resilience and wellbeing.

Conclusion

The current findings suggest that having a hangover is not simply an expression of poor psychological coping with the next-day consequences of heavy alcohol consumption.

Impact of mental resilience and perceived immune functioning on the severity of alcohol hangover

Objective

Recent research comparing hangover sensitive drinkers with hangover resistant drinkers has revealed that experiencing alcohol hangovers is associated with significantly poorer self-reported immune functioning (p < 0.0001). No significant difference between the groups was found on mental resilience. The objective of the current survey was to examine the association between hangover severity, perceived immune status, and mental resilience. N = 341 Dutch students, all hangover sensitive drinkers, completed an online survey. The Brief Resilience Scale was completed, and perceived immune functioning and overall hangover severity for their latest past month hangover were assessed.

Results

Students consumed a mean (SD) of 12.3 (5.9) alcoholic drinks the evening before their latest hangover. A significant positive association was found between mental resilience and perceived immune functioning (r = 0.372, p = 0.000). No significant associations of hangover severity were found with mental resilience (r = − 0.010, p = 0.858), or perceived immune functioning (r = − 0.025, p = 0.645). Previous research revealed that hangover resistant and hangover sensitive drinkers report having significantly different levels of immune functioning, and that the immune system is involved in the development of alcohol hangover. These findings suggest that levels of mental resilience and perceived immune functioning are not related to the severity of hangovers in hangover sensitive drinkers.

Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: a cross-sectional case-control study

Introduction

This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not.

Methods

This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire. The statistical tests used were the McNemar test for categorical variables, the Wilcoxon signed-rank test for continuous asymmetric variables, and the paired Student t-test for continuous symmetric variables.

Results

The PTSD group showed lower total Resilience Scale scores compared with controls (128.4±20.7 vs. 145.8±13.1, respectively; p = 0.01), along with a lower ability to solve situations and lower personal values that give meaning to life (p = 0.019). They also had lower rates of mature defense mechanisms (p < 0.001) and higher rates of emotional (p = 0.001) and physical (p = 0.003) abuse during childhood.

Conclusion

Lower levels of resilience, especially the ability to solve situations and having personal values that give meaning to life, immature defense mechanisms, and emotional and physical abuse in childhood are associated with PTSD in adult Brazilian victims of urban violence.

Resilience dimensions and mental health outcomes in bipolar disorder in a follow-up study

The individual process of resilience has been related to positive outcomes in mental disorders. We aimed (a) to identify the resilience domains from the Resilience Questionnaire for Bipolar Disorder that are associated cross sectionally and longitudinally with mental health outcomes in bipolar disorder (BD) and (b) to explore cross-lagged associations among resilience factors. A clinical adult sample of 125 patients diagnosed with BD (62.10% female, mean age = 46.13, SD = 10.89) gave their informed consent and completed a battery of disease-specific tools on resilience, personal recovery, symptomatology, psychosocial functioning, and quality of life, at baseline and at follow-up (n = 63, 58.10% female, mean age = 45.13, SD = 11.06, participation rate = 50.40%). Resilience domains of self-management of BD, turning point, self-care, and self-confidence were significantly associated with mental health indicators at baseline. In addition, self-confidence at baseline directly predicted an increase in personal recovery at follow-up, and self-confidence improvement mediated the relationship between interpersonal support and self-care at baseline and personal recovery at follow-up. These findings highlight that resilience domains are significantly associated with positive mental health outcomes in BD and that some predict personal recovery at follow-up. Moreover, some resilience factors improve other resilience factors over time.

The Resilience Questionnaire for Bipolar Disorder: Development and validation

The goal of this research project was to develop a new questionnaire to assess resilience in Bipolar Disorder (BD), the Resilience Questionnaire for Bipolar Disorder (RBD). To examine its psychometric properties, a sample of 125 patients diagnosed with BD and a comparison sample of 107 people completed the new RBD and established measures of generic resilience and health-related outcomes. Exploratory factor analysis for the RBD yielded a 23-item 5-factor solution, and confirmatory factor analysis indicated adequate fit indices. Internal consistency, stability, concurrent validation and known-groups' validity were also supported. The RBD obtained higher responsiveness (6-month follow-up) than the generic resilience scale (BD sample). The RBD is a robust measure to monitor resilience in BD.

Mental resilience, perceived immune functioning, and health

Background

Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status.

Methods

A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ), and questions regarding their perceived health and immune status.

Results

When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health (r=0.233, p=0.0001), perceived immune functioning (r=0.124, p=0.002), and IFQ score (r=−0.185, p=0.0001).

Conclusion

A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health.

Resilience and psychiatric epidemiology: Implications for a conceptual framework

Kalisch and colleagues present a conceptual framework for the study of resilience, using a neurobiological approach. The present commentary examines issues arising for the study of resilience from epidemiological data, which suggest that resilience is most likely a normative function that may operate as a kind of psychological immune system. The implications of the epidemiological data on the development of a neurobiological theory of resilience are discussed.