Resilience - research

Question 1

Fogarty et al. (2019)

Answer 1

intimate partner violence

promoting resilience:

• role modelling
• talking about healthy relationships

reduce exposure to IPV

difficult to respond to child when distressed

Question 2

Forgarty et al. (2019) (2)

Answer 2

4 yo children exposed to IPV

resilience associated with:

• maternal physical wellbeing
• no IPV
• employment
• early intervention

Question 3

Milaniak et al. (2017)

Answer 3

resilience associated with oxytocin gene methylation in conduct disorder domain

those with conduct disorder also resilient in other domains

Question 4

Afifi and MacMillan (2011)

Answer 4

Method:
The databases MEDLINE and PsycINFO were searched for relevant citations up to July 2010 to identify key studies and evidence syntheses.

Results:
Although comparability across studies is limited, family-level factors of stable family environment and supportive relationships appear to be consistently linked with resilience across studies. There was also evidence for some individual-level factors, such as personality traits, although proxies of intellect were not as strongly related to resilience following child maltreatment.

Conclusions:
Findings from resilience research needs to be applied to determine effective strategies and specific interventions to promote resilience and foster well-being among maltreated children.

Question 5

Howell (2011)

Answer 5

Little research exists on how young children cope with traumatic events, including exposure to intimate partner violence (IPV). Available research reveals that many young children who witness IPV suffer greater adjustment problems than non-exposed children, while others appear to fare well despite violence exposure. Taking a developmental psychopathology perspective, this review seeks to consolidate current research on the impact of IPV exposure, focusing on relevant developmental domains of the preschool years. Specifically, it addresses the psychological functioning of preschool children following IPV exposure, including problematic internalizing and externalizing behaviors, as well as posttraumatic stress. This review also explores cognitive and physical functioning following exposure to interpersonal violence, as well as the socio-emotional consequences of witnessing violence. Following an examination of the impact of IPV exposure on preschool children, this review evaluates resilient coping and those children who seem to function well despite witnessing violence in the home. Finally, potential future research directions, as well as clinical implications, are suggested to provide a complete picture of the role IPV exposure plays in young children’s development.

Question 6

Gray et al. (2015)

Answer 6

This study employed a relational post-traumatic stress frame to explore the co-contribution of young children’s exposure to violence and caregiver insightfulness on child behavioral outcomes in a high-risk, non-referred sample of caregivers and preschoolers (n = 64; mean age 3.83 years, SD = .77). Caregiver insightfulness did not have a main effect on child outcomes but did moderate the relation between violence exposure and child behavior across all observed outcomes. Violence-exposed children with non-insightful caregivers demonstrated higher caregiver-rated internalizing and externalizing behaviors and observer-rated negative affect than all other groups. Among children not exposed to violence, insightfulness was not related to children’s behavior problems or negative affect, suggesting violence-specific processes. Though cross-sectional, results suggest that the effects of violence and caregiver insightfulness on child outcomes are contingent on one another and that caregiver insightfulness may play a protective role in contexts of violence.

Question 7

Gomez et al. (2018)

Answer 7

Utilizing a two-dimensional model of parenting emphasizing both (1) proximity seeking and (2) exploration, consistent with a conceptual framework rooted in attachment theory, the relations between parental insightfulness, observed parenting, and child cognitive outcomes were investigated in a low-income sample of 64 of caregivers and their young 3–5-year-old children. Specifically, observed parental sensitivity (proximity seeking) and intrusiveness (exploration) and parental insightfulness assessed dimensionally to capture Positive Insight and Focus on Child were examined in relation to child cognitive outcomes. Parental intrusiveness was negatively correlated with cognitive performance; however, parental sensitivity was not associated with child cognitive outcomes. Parents’ capacity to remain child-focused during the Insightfulness Assessment was negatively correlated with observed intrusiveness and was associated with child cognitive performance. These results suggest unique contributions of dimensions of parental insightfulness and parenting behaviors to child cognitive outcomes – specifically, parents’ capacity to remain focused on children’s experience during the Insightfulness Assessment and nonintrusive parenting behavior, which may reflect strategies to support children’s exploration.

Question 8

Martinez-Torteya et al. (2018)

Answer 8

maternal insightfulness and stressful life events

insightful = more positive parenting despite stress
- may be a protective factor against negative outcomes

without = more likely to become resilient

The current study evaluated whether maternal insightfulness can buffer the negative influence of postpartum stressful life events on maternal parenting behaviors. Participants were 125 mother–infant dyads (55% boys) who present a subsample of a larger longitudinal study on maternal maltreatment during childhood and its impact on peripartum maternal adjustment. Women were primarily white and middle class. At 4 months postpartum, mothers reported on the stressful life events experienced after the child’s birth and current depressive symptoms. At 6 months postpartum, maternal parenting quality was assessed using videotaped mother-infant interactions and maternal insightfulness was evaluated using the Insightfulness Assessment. Insightfulness significantly moderated the effect of postpartum stressful events on maternal parenting behaviors. Mothers who were insightful displayed high levels of positive parenting during interactions with their infant regardless of the amount of stressful life events experienced. In contrast, mothers classified as non-insightful showed less positive parenting as they experienced more stressful life events. Findings highlight the protective role of maternal insightfulness in the face of postpartum stress, and suggest that efforts to enhance insightfulness during the early postpartum period may be particularly relevant for women in high-risk contexts.

Question 9

Masten (2007)

Answer 9

Perspectives based on the first three waves of resilience research are discussed with the goal of informing the fourth wave of work, which is characterized by a focus on multilevel analysis and the dynamics of adaptation and change. Resilience is defined as a broad systems construct, referring to the capacity of dynamic systems to withstand or recover from significant disturbances. As the systems perspective on resilience builds strength and technologies of measuring and analyzing multiple levels of functioning and their interactions improve, it is becoming feasible to study gene–environment interactions, the development of adaptive systems and their role in resilience, and to conduct experiments to foster resilience or reprogram the fundamental adaptive systems that protect development in the context of adversity. Hot spots for future research to study and integrate multiple levels of analysis are delineated on the basis of evidence gleaned from the first waves of resilience research.

Question 10

Masten (2018)

Answer 10

Origins and advances in the history of resilience science with children and families are highlighted in this article, with a focus on interconnections and integration. Individual and family resilience scholarship reflect interwoven roots, and there is a growing impetus to integrate knowledge and strategies to inform practice and policies to mitigate risk and promote resilience in systems that shape human adaptation over the life course. Resilience is defined as the capacity of a system to adapt successfully to significant challenges that threaten its function, viability, or development. Research evidence is summarized to illustrate parallels in concepts and findings from studies of child and family resilience, with special emphasis on parenting processes. Integrating models, findings, methods, and training across multiple systems and levels holds great promise for elucidating resilience processes that will inform efforts to build capacity for healthy adaptation in the face of rising threats to families and societies around the world.

Question 11

Windle et al, (2011)

Answer 11

Methods
Eight electronic abstract databases and the internet were searched and reference lists of all identified papers were hand searched. The focus was to identify peer reviewed journal articles where resilience was a key focus and/or is assessed. Two authors independently extracted data and performed a quality assessment of the scale psychometric properties.

Results
Nineteen resilience measures were reviewed; four of these were refinements of the original measure. All the measures had some missing information regarding the psychometric properties. Overall, the Connor-Davidson Resilience Scale, the Resilience Scale for Adults and the Brief Resilience Scale received the best psychometric ratings. The conceptual and theoretical adequacy of a number of the scales was questionable.

Conclusion
We found no current ‘gold standard’ amongst 15 measures of resilience. A number of the scales are in the early stages of development, and all require further validation work. Given increasing interest in resilience from major international funders, key policy makers and practice, researchers are urged to report relevant validation statistics when using the measures.

Question 12

Davydov et al. (2010)

Answer 12

The relationship between disease and good health has received relatively little attention in mental health. Resilience can be viewed as a defence mechanism, which enables people to thrive in the face of adversity and improving resilience may be an important target for treatment and prophylaxis. Though resilience is a widely-used concept, studies vary substantially in their definition, and measurement. Above all, there is no common underlying theoretical construct to this very heterogeneous research which makes the evaluation and comparison of findings extremely difficult. Furthermore, the varying multi-disciplinary approaches preclude meta-analysis, so that clarification of research in this area must proceed firstly by conceptual unification. We attempt to collate and classify the available research around a multi-level biopsychosocial model, theoretically and semiotically comparable to that used in describing the complex chain of events related to host resistance in infectious disease. Using this underlying construct we attempt to reorganize current knowledge around a unitary concept in order to clarify and indicate potential intervention points for increasing resilience and positive mental health.

Question 13

Windle (2011)

Answer 13

The complexities of defining what appears to be the relatively simple concept of resilience are widely recognized. This paper analyses the concept of resilience from a range of disciplinary perspectives and clarifies a definition in order to inform research, policy and practice. The work takes a life course approach to resilience, examining evidence derived from research across the lifespan. It incorporates the methods of systematic review, concept analysis and consultation through face-to-face meetings. The synthesis of methodological approaches enables a clear identification of the antecedents, defining attributes and consequences of resilience, validated with stakeholder partners. Through this process, resilience is defined as the process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and ‘bouncing back’ in the face of adversity. Across the life course, the experience of resilience will vary. A large proportion of resilience research is routed within the discipline of developmental psychology, and has mainly been developed with children and adolescents. A major contribution to resilience research could be made through more multi-disciplinary studies that examine the dynamics of resilience across the lifespan, its role in healthy ageing and in managing loss, such as changes in cognitive functioning.

Question 14

Luthar and Cicchetti (2000)

Answer 14

The focus of this article is on the interface between research on resilience—a construct representing positive adaptation despite adversity —and the applications of this work to the development of interventions and social policies. Salient defining features of research on resilience are delineated, as are various advantages, limitations, and precautions linked with the application of the resilience framework to developing interventions. For future applied efforts within this tradition, a series of guiding principles are presented along with exemplars of existing programs based on the resilience paradigm. The article concludes with discussions of directions for future work in this area, with emphases on an enhanced interface between science and practice, and a broadened scope of resilience-based interventions in terms of the types of populations, and the types of adjustment domains, that are encompassed.

Question 15

Ungar (2019)

Answer 15

Method
By identifying common aspects of resilience research from a purposeful selection of studies (ones with weak and strong methodologies), this paper identifies three dimensions of well-designed studies of childhood resilience.

Results
Attention to all three dimensions enhances both the empirical validity (in the quantitative research paradigm) and phenomenological trustworthiness (in qualitative research) of resilience research with children and families. Challenges researching resilience can also be resolved by designing studies that account for all three dimensions. These challenges include the lack of systemic thinking to account for contextual factors and other external threats to child wellbeing, and the excessive generalization of findings.

Conclusion
This three-part model for resilience research reflects the very best practices among resilience researchers and has the potential to address the definitional and methodological ambiguity that plague studies of resilience.

Question 16

Yoon et al. (2019)

Answer 16

Resilience following childhood maltreatment has received substantial empirical attention, with the number of studies on this construct growing exponentially in the past decade. While there is ample interest, inconsistencies remain about how to conceptualize and assess resilience. Further, there is a lack of consensus on how developmental stage influences resilience and how protective factors affect its expression. The current systematic review uses a developmental lens to synthesize findings on resilience following child maltreatment. Specifically, this article consolidates the body of empirical literature in a developmentally oriented review, with the intention of inclusively assessing three key areas—the conceptualization of resilience, assessment of resilience, and factors associated with resilience in maltreatment research. A total of 67 peer-reviewed, quantitative empirical articles that examined child maltreatment and resilience were included in this review. Results indicate that some inconsistencies in the literature may be addressed by utilizing a developmental lens and considering the individual’s life stage when selecting a definition of resilience and associated measurement tool. The findings also support developmental variations in factors associated with resilience, with different individual, relational, and community protective factors emerging based on life stage. Implications for practice, policy, and research are incorporated throughout this review.

Question 17

Aburn et al. (2016)

Answer 17

Review methods
The methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis.

Results
One hundred articles were included in the final data analysis. The most significant finding of the review was that there is no universal definition of resilience. There were, however, some common themes identified: rising above, adaptation and adjustment, dynamic process, ‘ordinary magic’ and mental illness as a marker of resilience.

Conclusion
Despite the increasing use of the term ‘resilience’, this review has identified that there is no universal definition of resilience adopted in the research literature. Further research is required to explore this construct in the context of nursing.

Question 18

Masten and Cicchetti (2016)

Answer 18

This chapter reviews origins and progress in resilience science, with an emphasis on progress over the past decade in theory, findings, and translational applications for strategic intervention. In alignment with prevailing concepts in developmental systems theory, human resilience is defined as the potential or manifested capacity of an individual to adapt successfully through multiple processes to experiences that threaten his or her function, survival, or development. Resilience pathways, developmental cascades, gene‐environment interactions, and other models salient in current resilience theory are delineated, including new approaches to testing resilience‐related processes in such models. Findings on promotive and protective effects are discussed, focusing on widely replicated adaptive processes that develop in children, their families, other relationships, and key contexts as children develop. Resilience processes involving families, schools, peers, culture, and other socioecological systems are highlighted. Genetic and neurobiological processes are reviewed as a growingedge of resilience science. Intervention research based on resilience theory is discussed, together with translational implications for practice and policy based on the expanding body of knowledge about resilience processes. The chapter concludes with a review of enduring controversies, a summary of progress, and directions for the future.

Question 19

Eggerman et al. (2010)

Answer 19

A critical health-related issue in war-affected areas is how people make sense of adversity and why they show resilience in a high-risk environment. In Afghanistan, the burden of poor mental health arises in contexts of pervasive poverty, social inequality, and persistent violence. In 2006, we conducted face-to-face interviews with 1011 children (age 11–16) and 1011 adult caregivers, randomly selected in a school-based survey in three northern and central areas. Participants narrated their experiences as part of a systematic health survey, including an open-ended questionnaire on major life stressors and solutions to mitigate them. Responses were analysed using an inductive thematic approach and categorised for quantitative presentation, producing a conceptual model. For adults, the primary concern is repairing their “broken economy,” the root of all miseries in social, educational, governance, and health domains. For students, frustrations focus on learning environments as well as poverty, as education is perceived as the gateway to upward social and economic mobility. Hope arises from a sense of moral and social order embodied in the expression of key cultural values: faith, family unity, service, effort, morals, and honour. These values form the bedrock of resilience, drive social aspirations, and underpin self-respect and dignity. However, economic impediments, social expectations, and cultural dictates also combine to create entrapment, as the ability to realise personal and social aspirations is frustrated by structural inequalities injurious to health and wellbeing. This study contributes to a small but growing body of work on resilience in public health and conflict settings. It demonstrates that culture functions both as an anchor for resilience and an anvil of pain, and highlights the relevance of ethnographic work in identifying what matters most in formulating social and public health policies to promote a hopeful future.

Question 20

Yablon and Itzhaky (2019)

Answer 20

looked for factors inhibiting post-traumatic stress and enhancing post-traumatic growth after homicide attacks in school

sheltering - inhibited PTS

supporting - enhanced PTG

Schools have a significant effect on students’ development, and serve as important social agencies for interventions for students facing disasters. However, little is known about the effect of students’ school experience itself on their resilience when facing extreme negative events. The present study focused on students who were exposed to terror-related homicide with the aim of investigating the contribution of school climate resources to their resilience. Since resilience is associated not only with fewer negative outcomes, but also with positive change, the contribution of schools was studied as both inhibiting post-traumatic stress symptoms (PTS) and enhancing post-traumatic growth (PTG). A mixed-methods research design was used. The participants included 117 (52% girls) high school students (mean age = 14.54; SD = 1.49). Twenty-five of them were interviewed in addition to responding to the research questionnaires. Different aspects of the school climate were found to be associated with students’ PTS and PTG, yielding two overarched factors explaining the school’s role as a protective resource: sheltering and supporting. The former is associated with fewer PTS and the latter with higher PTG. The use of different resources for different forms of resilience is discussed.

Question 21

Corbin and Hall (2019)

Answer 21

Approximately 1.8 million people were displaced in northern Uganda as a result of the LRA conflict. This paper explores risk and protective factors as well as examples of resilience among women in northern Uganda resettling after armed conflict and internal displacement. The risk and resilience ecological framework is used to identify and understand these factors along the multiple levels of the ecological social system. Risk factors included poor health, loss of instrumental and emotional support networks, and land vulnerability. Protective factors included engagement in livelihood and sociocultural activities with others. Resilience was located in the women’s coping and maintenance of family and social relationships.

Question 22

Balaban (2016)

Answer 22

Research findings indicate that river floods usually turn into destructive disasters in Turkish cities mainly due to improper land-use planning and management. Ad hoc and discrete land use development within and through the river basins results in serious and chronic flood losses. At the same time, the loose relationship between urban planning and flood risk management is another factor observed. Currently, urban development plans are not equipped with necessary measures to mitigate flood risks. More to the point, the illusory feeling of safety that originates from independent and discrete efforts of mitigation adds to flood vulnerabilities of city residents.

Question 23

Vanderbilt-Adriance and Shaw (2008)

Answer 23

This article examines potential theoretical constraints on resilience across levels of risk, time, and domain of outcome. Studies of resilience are reviewed as they relate to the prevalence of resilience across levels of risk (e.g., single life events vs. cumulative risk), time, and domains of adjustment. Based on a thorough review of pertinent literature, we conclude that resilience, as a global construct, appears to be rare at the highest levels of risk, and that resilience may benefit from a narrower conceptualization focusing on specific outcomes at specific timepoints in development. The implication of this conclusion for future research and intervention efforts is then discussed.

Question 24

Chapin (2015)

Answer 24

Qualitative interviews with 12 Mexican-American adolescent boys and two adult professionals contributed to understanding positive outcomes and resilience using a grounded theory approach. This study provides a cultural and contextual understanding of what it means to grow up well and the processes involved for the current population of Mexican males growing up in the US, who are at greater risk for poor outcomes compared to girls and other ethnic groups. First, the boys provided a definition of positive outcomes, which broadly involved becoming a good family provider. They saw themselves being able to provide by graduating from high school, going to college, and getting a good job. Next, the participants identified several aspects of the resilience processes that helped them to achieve. Support from family and friends were important to the boys because they provided direct help in reaching goals, they were indirect role models, and they could talk about problems. Finally, the boys also displayed individual attributes that were important to resilience and were related to being successful in school and getting a good job. Three individual attribute emerged: emotion regulation, confidence, and adaptability.

Question 25

Shatte et al. (2017)

Answer 25

To examine whether resilience has a protective effect in difficult work environments.Methods:A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics.Results:High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high.Conclusions:Workers with high resilience have better outcomes in difficult work environments.

Question 26

Eakman et al. (2016)

Answer 26

OBJECTIVE. To examine differences in psychosocial protective factors (social support, meaningful occupation, and academic self-efficacy) and health-related vulnerability factors (posttraumatic stress, depression, and somatic symptoms) contributing to resilience in post-9/11 veterans with service-related injuries and nonveterans in postsecondary education.

METHOD. A cross-sectional, matched-participants design using propensity score matching was used to test differences in mean levels of protective and vulnerability factors between injured veterans (n = 26) and nonveterans (n = 19); zero-order correlations explored relationships among study variables.

RESULTS. The veteran sample demonstrated lower levels of psychosocial protective factors and higher levels of health-related vulnerability factors compared with nonveterans (10.491 to 11.561). Psychosocial protective factors were consistently negatively associated with health-related vulnerability factors (-.27 to -.63).

CONCLUSION. Post-9/11 veterans with service-related injuries are at a substantial disadvantage in terms of resilience; lower protective factors and elevated vulnerability factors may increase their risk for poor campus integration and impede academic achievement.

Question 27

Oldfield et al. (2019)

Answer 27

Street connected young people (SCYP) are at risk of encountering negative life experiences, such as abuse, neglect, violence and exploitation. Nonetheless, some demonstrate remarkable resilience. This study therefore aimed to explore protective factors that promote resilience in SCYP in Guatemala City. Using ethnographic interviews and image elicitation eight young people and four adult educational outreach project coordinators participated within this study. Three key protective factors emerged that help develop resilience; Empowerment, as educational projects support SCYP and provide opportunities; Belongingness, encapsulated creating positive relationships, a sense of affinity and positive family environments; and Motivation which highlighted the importance of the young peoples’ willpower, engagement with learning and help-seeking behaviour. Educational projects working with SCYP can help to develop resilience by empowering them for change, providing a sense of belonging, while also acknowledging their individual motivation for change.

Question 28

Haglund et al. (2007)

Answer 28

Resilience refers to the ability to successfully adapt to stressors, maintaining psychological well-being in the face of adversity. Recent years have seen a great deal of research into the neurobiological and psychological factors and mechanisms that characterize resilient individuals. This article draws from that research to outline some of the most important contributors to resilience. The authors hope that by contributing to a growing understanding of the genetic, developmental, neurobiological, and psychological underpinnings of resilience, researchers and clinicians in the field will move closer toward the goal of identifying and treating individuals at risk for developing posttraumatic psychopathology.

Question 29

Yule et al. (2019)

Answer 29

Children who experience violence in their families and communities are at increased risk for a wide range of psychological and behavioral difficulties, but some exhibit resilience, or adaptive functioning following adversity. Understanding what promotes resilience is critical for developing more effective prevention and intervention strategies. Over 100 studies have examined potential protective factors for children exposed to violence in the past 30 years, but there has been no quantitative review of this literature. In order to identify which protective factors have received the strongest empirical support, we conducted a meta-analysis of 118 studies involving 101,592 participants. We separately evaluated cross-sectional (n=71) and longitudinal (n=47) studies testing bivariate, additive, and buffering effects for eleven proposed protective factors. Effect sizes generally were stronger in cross-sectional than longitudinal studies, but four protective factors-self-regulation, family support, school support, and peer support-demonstrated significant additive and/or buffering effects in longitudinal studies. Results were consistent across type of violence experienced (i.e., maltreatment, intimate partner violence, community violence). The review highlights the most robust predictors of resilience, identifies limitations of this work, and offers directions for improving our understanding of the processes and programs that foster resilience in children exposed to violence.

Question 30

Gallagher et al. (2019)

Answer 30

Optimism and mastery are two cognitive traits that involve positive expectations for the future and that have been demonstrated to be important predictors of reduced anxiety as well as superior coping and physical health in many populations, including cancer survivors. There is limited research, however, examining the unique effects of these traits when examined simultaneously. The present cross-sectional study used structural equation modeling to examine the unique effects of optimism and mastery on emotion, coping, and health in 603 adult cancer survivors, and whether results were consistent in men and women. Results indicated that both optimism and mastery were associated with improved emotion, coping, and health and together accounted for a small to moderate amount of variance. Although the effects of optimism were generally greater, mastery also uniquely predicted most dependent variables and there was some evidence that gender influenced these effects, with optimism predicting health control more so in women and mastery predicting health control more so in men. These results demonstrate that it is important to examine both generalized positive expectancies such as optimism and positive expectancies regarding mastery when investigating resilience and emotional well-being in cancer survivors.

Question 31

Cherry et al. (2018)

Answer 31

MethodsParticipants were noncoastal and coastal residents exposed to the 2005 Hurricanes Katrina and Rita and the 2010 Deepwater Horizon oil spill. Psychosocial predictors of central interest were (a) spiritual support and (b) use of coping through humor, and both were hypothesized to be associated with resilience. Covariates included group, gender, education, income, social engagement, charitable work done for others, and lifetime trauma.

FindingsLogistic regression analyses confirmed that spiritual support (odds ratio [OR] = 1.11, p .01) and use of coping through humor (OR = 1.17, p .01) were independently and positively associated with resilience. Disruption in charitable work done for others in a typical year before the hurricanes (OR = 0.49, p .05) and income of less than $2,000 per month were negatively associated with resilience (OR = 0.47, p .05).

ConclusionsThese data show that spirituality, humor, disruptions in charitable work, and low income were all independently associated with resilience in the years after consecutive disasters.

Question 32

Hildebrant et al. (2016)

Answer 32

Emotion regulation in the ongoing presence of a threat is essential for adaptive behavior. Threatening situations change over time and, as a consequence, require a fine-tuned, dynamic regulation of arousal to match the current state of the environment. Constructs such as cognitive flexibility, heart rate variability, and resilience have been proposed as resources for adaptive emotion regulation, especially in a moment-to-moment fashion. Nevertheless, none of these constructs has been empirically related to the dynamic regulation of arousal as it unfolds over the course of a prolonged threatening episode. Here, we do so by placing participants in a threatening and evolving immersive virtual environment called Room 101, while recording their skin conductance. Subsequently, participants rated their subjective arousal continuously over the course of the experience. Participants who had shown greater cognitive flexibility in a separate task (i.e., fewer task-switching costs when switching to evaluating the valence of positive stimuli) showed better regulation of physiological arousal (skin conductance level), during less-threatening phases of Room 101. Individuals with higher trait resilience and individuals with higher resting heart rate variability showed more regulation in terms of their subjective arousal experience. The results indicate that emotional, cognitive, and physiological flexibility support nuanced adaptive regulation of objective and experienced arousal in the ongoing presence of threats. Furthermore, the results indicate that these forms of flexibility differentially affect automatic and objective versus reflective and subjective processes.

Question 33

Clark et al. (2019)

Answer 33

Objective: Our objective was to describe behavioral change trajectories for healthful eating and exercise in a group of community-dwelling older adults. A secondary aim was to determine predictors of maintenance and resilience. Method: Subjects were participants in the Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) I study who had achieved postaction stage of change for at least one behavior by its end. They were recruited for SENIOR II, a 48-month study with annual assessments on demographic, anthropometric, cognitive, psychosocial, and behavioral variables. Results: Maintainers generally had higher levels of healthy behaviors and better cognitive function. Resilient older adults were similar to maintainers but were older and had greater functional limitations. Discussion: Findings suggest that both physical health and psychological capital provide important resources upon which to draw as older adults grow even older. The trajectory model can provide useful information for developing resilience interventions for older adults.

Question 34

Kingston et at. (2018)

Answer 34

Exposure to social stressors can cause profound changes in an individual’s well-being and can be an underlying factor in the etiology of a variety of psychopathologies, such as post-traumatic stress disorder (PTSD). In Syrian hamsters, a single social defeat experience results in behavioral changes collectively known as conditioned defeat (CD), and includes an abolishment of territorial aggression and the emergence of high levels of defensive behaviors. In contrast, voluntary exercise has been shown to promote stress resilience and can also have anxiolytic-like effects. Although several studies have investigated the resilience-inducing effects of voluntary exercise after exposure to physical stressors, such as restraint and electric shock, few studies have examined whether exercise can impart resilience in response to ethologically-based stressors, such as social defeat. In Experiment 1, we tested the hypothesis that voluntary exercise can have anxiolytic-like effects in socially defeated hamsters. In the elevated plus maze, the exercise group exhibited a significant reduction in risk assessment, a commonly used index of anxiety, compared to the no-exercise group. In the open-field test, animals in the exercise group exhibited a significant reduction in locomotor behavior and rearing, also an indication of an anxiolytic-like effect of exercise. In Experiment 2, we examined whether exercise can reverse the defeat-induced potentiation of defensive behaviors using the CD model. Socially defeated hamsters in the exercise group exhibited significantly lower levels of defensive/submissive behaviors compared to the no-exercise group upon exposure to the resident aggressor. Taken together, these results are among the first to suggest that voluntary exercise may promote resilience to social defeat stress in Syrian hamsters.

Question 35

Lowe et al. (2017)

Answer 35

different intensity exercises

cortical resilience

exercise promotes cortical resilience - esp in brain regions that support inhibitory control

useful to understand for those experiencing negative outcomes

Methods: In a within-participants experimental design, 28 female participants aged 18 to 26 years (mean [standard deviation] = 20.32 [1.79] years) completed a session each of moderate-intensity and very light-intensity exercise, in a randomized order. Before each exercise session, participants received active cTBS to the left dorsolateral prefrontal cortex. A Stroop task was used to quantify both the initial perturbation and subsequent recovery effects on inhibitory control.

Results: Results revealed a significant exercise condition (moderate-intensity exercise, very light-intensity exercise) by time (prestimulation, poststimulation, postexercise) interaction (F(2,52) = 5.93, p = .005, d = 0.38). Specifically, the proportion of the cTBS-induced decrement in inhibition restored at 40 minutes postexercise was significantly higher after a bout of moderate-intensity exercise (101.26%) compared with very light-intensity exercise (18.36%; t(27) = -2.17, p = .039, d = -. 57, 95% confidence interval = -161.40 to -4.40).

Conclusion: These findings support the hypothesis that exercise promotes cortical resilience, specifically in relation to the brain regions that support inhibitory control. The resilience-promoting effects of exercise have empirical and theoretical implications for how we conceptualize the neuroprotective effects of exercise.

Question 36

Li et al. (2019)

Answer 36

Early trauma can increase the risk for developing posttraumatic stress disorder (PTSD) in adulthood. Early trauma has also been associated with the dysregulation between the hypothalamic-pituitary-adrenal (HPA) and oxytocin systems and may influence the co-regulation between these two systems. But whether the mutual regulation of the two systems represents a sign of resilience and/or mutual dysregulation could be a sign of vulnerability to PTSD and the dissociative subtype of PTSD (PTSD-D) is unknown. The study aims to synthesize and conduct a preliminary test of a conceptual model of the mutual regulation between these two systems as a marker of resilience. We analyzed a pilot data with 22 pregnant women in 3 groups (PTSD only, PTSD-D, and trauma-exposed resilient controls) and repeated measures of plasma oxytocin and cortisol. Oxytocin and cortisol seemed reciprocal in all three groups, but both levels were relatively high in women with PTSD-D and low in those with PTSD compared with controls. This suggests that both hormones in women with PTSD-D and PTSD only are dysregulated, but not lacking in reciprocity.

Question 37

Uygun et al. (2020)

Answer 37

Objective: Psychological resilience (PR) is a risk factor that is associated with onset of disease, quality of life, and prognosis in bipolar disorder (BD). There are variables that can affect PR positively and negatively; one of them is perceived social support (PSS). The aim of this study was to examine this relationship. Methods: The Multidimensional Scale of PSS, Adult PR Scale, and Data Collection Form were requested from 90 patients with bipolar I disorder in the euthymic stage and 30 controls who were matched for age, gender, marital status, and level of education. Results: PSS and PR scores were significantly lower in the bipolar group than in the control group. In the control group, only the family subscale of PSS was significantly correlated with PR, while both the family and friend subscales were significantly associated with PR in the bipolar group. In a regression analysis which considered PR as an independent variable, the family and friend subscales of PSS and age at onset were significant. Conclusion: Family therapy and peer support groups in addition to medical therapy in BD may contribute positively to prognosis. In addition, training modules to develop PR for BD patients with risk factors such as childhood trauma and early onset would improve prognosis.

Question 38

Prout et al. (2019)

Answer 38

Resilience is associated with the internal capacity for the regulation of unpleasant emotions in the face of adversity. These self-regulatory processes, linked with both explicit and implicit emotion regulation systems, have wide ranging implications for overall psychological health. Child psychotherapy can be conceptualized as helping children adapt more effectively to the external environment and develop a more comfortable sense of self as a result of improved emotion regulation and, thus, greater resilience. Most available treatments for youth promote resilience by addressing the explicit emotion regulation system. These treatments include helping parents improve their parenting skills or helping youth modify dysfunctional thinking patterns. In these treatments there is less consideration of the key role of implicit emotion regulation in the enhancement of resilience. The psychodynamic construct of defense mechanisms offers an observable and measurable manifestation of implicit emotion regulation. Thus, addressing the nature of a child’s maladaptive defense mechanisms in the clinical situation can strengthen the implicit emotion regulation system without explicitly instructing the parent or the child to act in a more pro-social manner. This paper utilizes a Regulation Focused Psychotherapy for Children (RFP-C) model to describe how iterative, systematic interpretation of children’s maladaptive defense mechanisms can target the implicit emotion regulation system. This intervention aims to improve the capacity for self-regulation, increase the flexibility of responses to the environment, promote proactivity towards change, and improve interpersonal relatedness. As a result of increases in these adaptive implicit emotion regulation capacities, there is a resultant increase in resilience, especially for children who respond to stressful events with externalizing behaviors

Question 39

Solcova et al. (2016)

Answer 39

Objectives. The present longitudinal study aims to find the links between (1) toddler temperament and adult resilience, and (2) recollections about parental styles and adult resilience among participants of longitudinal study.

Sample and setting. The data from longitudinal project “Mental development of school children from various social environments” conducted in Brno (since 1961) and in Prague (since 1956) were employed in the study (N=76 and N=86, respectively).

Resilience was indexed here as Sense of Coherence (SOC). The toddler temperament was assessed using Brunet-Lezin test.

Recollected interactions between parents and children (parenting styles) were measured using the Parent-Child Interactions Scale, The Social and Health Assessment (SAHA) questionnaire, with four aspects of parenting determined (parental involvement, parental warmth, parental control, and inconsistency of parenting).

Statistical analysis. The correlational analysis and regression analysis were used in the study.

Results. A positive relation between active/dis-inhibited temperament at 12-30 months of age and adult resilience has been found.

Parenting style perceived as “inconsistent” relates negatively to manageability scale and total score of Sense of Coherence. Parenting style “controlling” relates negatively to manageability of SOC.

Perceived “involved” parenting relates positively to comprehensibility, manageability and total score of SOC. Perceived “warmth” parenting relates positively to comprehensibility, manageability and total score of SOC.

Study limitations. The study is unable to find actual cause-and-effect links between actions of parents and adult resilience, as it worked only with recollection of parenting styles.

Question 40

Shehu and Mokgwarthi (2008)

Answer 40

Studies exploring self and health belief systems are keys to understanding the challenges to wholesome development of adolescents and creating interventions to enhance their mental, emotional and physical health status. Accordingly, this case-control study compared internal resilience factors and health locus of control among 1700 physical education and non- Physical Education students in the central and south-central regions of Botswana. The study variables were assessed using the Multidimensional Health Locus of Control Scale (MHLC) (Wallston et al., 1978:165) and a modified version of the Resilience Scale (Wagnild & Young, 1993:160). Analysis of variance of the loci of control and resilience scores were conducted. Although 78% of the resilience scores were well within the moderate range, females across the comparisons groups had significantly higher resilience scores than the males. On the MHLC subscales Physical Education students were significantly more likely than the referents to believe that their health is controlled by powerful others. Mean scores on the internal and chance loci of control scales were significantly higher among the males. Relationships among resilience and locus of control scores were statistically significant

Question 41

Tal-Margalit and Spanglet (2014)

Answer 41

Life is comprised of positive experiences and stressful situations. Exposure to the latter frequently leaves us overwhelmed and traumatized. In Israel, constant security-related threats increase the need for the development of coping skills and strengthening of innate resilience, particularly for children and the adults in their lives.

We developed ‘Treasures of the Winning Couple: Mr. Body and Ms. Awareness’ for this purpose. It is based on Tal-Margalit’s STREAM model (Somatic Therapies, Resilience Enhancement, Awareness & Movement) which combines the Somatic Experiencing (R) trauma healing approach with Dance/Movement Therapy [1].

Our program presents practical body-mind tools designed to help children acquire the competence and life-skills needed for building resilience. Children, teachers and parents gain self-regulation skills together while developing a common language to cope with life’s pressures.

The ‘Treasures’ in the program trigger the senses through various channels. Each is presented by an original poem, a unique illustration and a movement expression while naming the treasure. Imagination, metaphors with which children can identify, together with movement exercises, connect children to their natural resilience. Furthermore, use of mindfulness, developing self-regulation, improving coping skills and self-management create an integrated presence for them, individually and within their environment. Children use movement and awareness of physical sensations as natural resources; natural ‘treasures’ that help them feel better. A survey accompanies the program allowing evaluation of its efficacy. Results from a pilot sample will be presented.

Question 42

Cording and Christofferson (2017)

Answer 42

how to clarify conceptualisations of PF

identification and validation?

incorporation into methods and models

Although research into the theoretical and practical implications of protective factors within a rehabilitative context is still in its infancy, it is possible that they can provide improvements in a number of key areas related to offender management and treatment. However, there are several important issues that must be considered and resolved for the measurement of protective factors to be regarded as valid and reliable. Some of these relate to core questions regarding the nature of protective factors, including how to best clarify current conceptualisations of protective factors and questions regarding our current approach to the identification and validation of protective factors. We additionally discuss more practical issues related to the incorporation of protective factors into current risk assessment methodologies, including implications that this will have for the scoring of actuarial tools. We hope that raising awareness of these issues results in fruitful directions for further discussions and research in this area.

Question 43

Salignac et al. (2019)

Answer 43

Financial inclusion has become a policy priority. For many countries, this has meant focusing on the delivery and practical aspects of financial products and services. This paper argues that this approach is not sufficient to improve financial wellbeing more broadly. It suggests a more comprehensive approach moving away from asking whether people are excluded or not to asking whether they have access to accessible, acceptable and appropriate resources and supports in adverse financial circumstances. A better understanding of individuals’ financial resilience: how they bounce back from adverse financial events and the resources and supports they draw on; could help determine where resources can and should be invested to assist people to cope with financial adversity, assist the development of effective policy and, ultimately, improve financial wellbeing. This paper puts forward a definition of financial resilience and a methodology for measuring it. Australia is used as a case country from which to draw conclusions using a survey of 1496 representative adults (18+). The findings indicate that over 2 million Australian adults experienced severe or high levels of financial vulnerability raising very real concerns about financial wellbeing. Implications for academics and policy makers are presented.

Question 44

Distelberg et al. (2018)

Answer 44

Few measures parallel the robust depth offered in the existing multidimensional and ecologically informed theories of resilience. This study sought to evaluate the test-retest reliability, construct, and predictive validity of the individual, family, and community resilience resource profile (IFCR-R). The IFCR-R measures a family’s access to resilience resources and protective factors across multiple ecological levels. Confirmatory factor analysis was used with a sample of n = 810 low-income families. And 159 families completed multiple time point measures for test-retest reliability and predictive validity evaluation. Results of this study support the proposed multidimensional ecological structure of the IFCR-R and found that the IFCR-R offers an acceptable test-retest reliability and predictive validity for outcomes of mental and physical health

Question 45

Burton et al. (2009)

Answer 45

Methods/Design
In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol·L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects.

Discussion
If successful, this program will provide an innovative means by which to promote psychosocial well-being for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups

Question 46

Clark and Gorton (2019)

Answer 46

nurses and resilience to incivility

intervention = cog rehearsal, HeartMath and simulation

the intervention helped promote resiliency in nurses when dealing with rude and bad behaviour in health situations

Background: The detrimental impact of incivility in health care is well documented. Nursing students and new graduate nurses are particularly vulnerable to its effects. Evidence-based civility education strategies are urgently needed to address incivility, which can protect patient safety. Method: Using a mixed methodology, 188 incoming, upper division, prelicensure nursing students participated in an intervention study that combined cognitive rehearsal, HeartMath, and simulation using TeamSTEPPS (TM) Concerned, Uncomfortable, and Safety model to address acts of incivility that threaten patient safety. Results: Student evaluations immediately following the intervention and 6 months postintervention rendered positive results. Eight themes emerged describing uncivil experiences occurring in the patient care environment. Conclusion: This intervention provided nursing students with evidence-based tools to build resilience to effectively address incivility in the patient care environment. Nurse educators are urged to provide civility education in conjunction with tested techniques to build resilience and address uncivil encounters in health care.

Question 47

Chesak et al. (2019)

Answer 47

Background: Burnout in teachers has been linked to decreased effectiveness as educators, and suboptimal interactions with students. The purpose of this pilot study was to assess the outcomes of a brief Stress Management and Resiliency Training (SMART) program for public school staff.

Materials and methods: This single-arm, prospective trial involved an investigation of the effects of a brief SMART program on participant stress, anxiety, resilience, gratitude, happiness, life satisfaction, and quality of life (QOL).

Results: Significant improvements were noted in participant anxiety (P < 0.001), stress (P = 0.003), gratitude (P = 0.001), happiness (P < 0.001), life satisfaction (P < 0.001), and QOL (P < 0.001). Most participants reported that the skills learned positively affected interactions with students (77.2%) and coworkers (72.2%).

Conclusions: The SMART program showed promising effectiveness for improving anxiety, stress, gratitude, happiness, life satisfaction and QOL. Given the prevalence and impact of teacher burnout, larger, controlled trials and broader dissemination of the intervention are warranted.

Question 48

Bargues-Pedreny (2019)

Answer 48

This article examines the response to the crisis of liberal statebuilding in conflict-affected societies since the end of the 2000s. It shows how both resilience policy approaches and academic critical understandings are dissatisfied with the implementation of policies and programs, which seem to fail time and again. That is, there is a widespread perception that resilience is “always more” than what current approaches are providing. In consequence, it is assumed that international interventions require even more locally-sensitive initiatives that are in tune with local needs; new and better technologies, for instance, digital maps to assist practitioners in obtaining sheer volumes of information and accurate representations of space; and programs that are open-ended and flexible. The article cautions that by assuming that satisfactory outcomes are yet to come (i.e., that resilience, or a desired outcome such as peace and security, is still lacking), policy and critical approaches are reproducing and legitimizing failure, furthering neoliberal governance and cementing a profound skepticism.

Question 49

Ryan et al. (2019)

Answer 49

Methods
We delivered the program in community venues to 20 people with diabetes, with 10 weekly sessions (total 18 hours). Assessment was conducted at pre‐ and post‐intervention using questionnaires and pedometers.

Results
There were significant improvements in resilience, psychological flexibility, positive affect, valued living, physical activity and sedentary behaviour, and significant decreases in depression and stress (p 

Question 50

Enrique et al. (2019)

Answer 50

This pilot investigates an internet-delivered intervention for promoting university students’ resilience and well-being

The positive psychology based intervention seeks to enhance several empirically-supported, modifiable resilience factors.

This study may lend support to preventative efforts in managing high levels of stress in university students

The study will help build on the potential benefits of internet-delivered interventions to promote resilience

Trends observed from this trial will inform the development of a full scale randomized controlled trial

Question 51

Plough (Chandra) et al. (2013)

Answer 51

The nascent field of community resilience builds on a strong research base in the areas of community cohesion, neighborhood effects on individual and community well-being, social equity, trust, and knowledge acquisition and transfer. All large-scale disasters, the most recent example being Hurricane Sandy, clearly demonstrate the critical importance of building community resilience.39,40 Equitable and effective response and recovery strategies can be greatly enhanced by the presence of resilience capabilities in communities. However, translating federal policy directives like the CDC community preparedness guidance or the Federal Emergency Management Agency’s “Whole of Community Planning” imperative into operational public health practice activities requires revising health department internal practices as well as developing a sustainable structure for community-level collaboration linked to clearly defined and measurable programmatic outcomes.14 As with any new and evolving field, promising practices such as the approach developed in Los Angeles County need to be evaluated and the evidence-based strategies disseminated to other health departments. Although the CDC is currently working with partners across the country to develop effective metrics for measuring resilience baseline levels and progress, this project incorporates these measures to determine what actually improves resilience.

In practice, a health department’s primary limitations in implementing community resiliency initiatives arise from challenges in achieving a cultural shift from a bioterrorism-focused and individual-preparedness orientation to an all-hazards, community-partnered, and collaborative approach to building resilience. This shift has to occur both within the health department and with community partners. Reframing preparedness while integrating new approaches into standard public health practice is often difficult given the overall budget challenges for public health departments, but alignment and integration of preparedness can strengthen the impact of community resilience intervention and enhance other community-based activities.

Question 52

Chong et al. (2019)

Answer 52

Ramsey County Department of Emergency Management and Homeland Security (RCEMHS) has a knowledge gap in vital information about preparing for, responding to, and recovering from disasters in vulnerable communities. This study focused on three key vulnerable communities within Ramsey County: older adults (60 years or older), children under five, and the Karen population. Qualitative analysis of interviews was conducted with individuals, organizations, and government departments within Ramsey County. Due to the trans-boundary and trans-jurisdictional nature of natural and human-caused disasters, coordination within agencies and with nonprofit and private organizations is necessary. The study found that many vulnerable populations interact with public benefit programs, providing insight into disaster resilience. These touch-points can be trust and resilience-building exchanges. The communities have a lack of knowledge of RCEMHS and emergency management, and which may reinforce complacency towards emergency preparedness. To counter a lack of knowledge and engagement in emergency preparedness by communities, we recommend RCEMHS adopt a human centered approach in preparation and planning activities, where communities hold valuable expertise about their assets and vulnerabilities in regard to disasters. This study developed five recommendations for more effective outreach and engagement in emergency management. Each of the recommendations can use human centered design strategies and are aligned within a community resilience framework.

Question 53

Saja et al. (2018)

Answer 53

Resilience is a multifaceted phenomenon, and approaches to measure resilience across disciplines have produced wide-ranging methods. This paper presents an inclusive and adaptive ‘5S’ social resilience framework that was developed based on the critical review of existing social resilience frameworks discussed in the literature. The proposed social resilience framework consists of five sub-dimensions of social resilience, namely, social structure, social capital, social mechanisms, social equity, and social belief, a set of 16 characteristics, and corresponding 46 indicators. While the key social resilience characteristics are integrated within a single framework, it is flexible enough for adapting to a specific context as needed. Key challenges in resilience measurement approaches developed in disaster management context are also highlighted in this paper. The direct measures of social resilience are resource intensive. Hence, proxy measures have been widely used using data available in the public domain which often result in inadequate measurement of social resilience. It is imperative to explore use of surrogates in measuring social resilience characteristics that are complex and not easily measurable directly

Question 54

Horn et al. (2016)

Answer 54

All individuals experience stressful life events, and up to 84% of the general population will experience at least one potentially traumatic event. In some cases, acute or chronic stressors lead to the development of posttraumatic stress disorder (PTSD) or other psychopathology; however, the majority of people are resilient to such effects. Resilience is the ability to adapt successfully in the face of stress and adversity. A wealth of research has begun to identify the genetic, epigenetic, neural, and environmental underpinnings of resilience, and has indicated that resilience is mediated by adaptive changes encompassing several environmental factors, neural circuits, numerous neurotransmitters, and molecular pathways. The first part of this review focuses on recent findings regarding the genetic, epigenetic, developmental, psychosocial, and neurochemical factors as well as neural circuits and molecular pathways that underlie the development of resilience. Emerging and exciting areas of research and novel methodological approaches, including genome-wide gene expression studies, immune, endocannabinoid, oxytocin, and glutamatergic systems, are explored to help delineate innovative mechanisms that may contribute to resilience. The second part reviews several interventions and preventative approaches designed to enhance resilience in both developmental and adult populations. Specifically, the review will delineate approaches aimed to bolster resilience in individuals with PTSD. Furthermore, we discuss novel pharmacologic approaches, including the N-methyl-d-aspartate (NMDA) receptor ketamine and neuropeptide Y (NPY), as exciting new prospects for not only the treatment of PTSD but as new targets to enhance resilience. Our growing understanding of resilience and interventions will hopefully lead to the development of new strategies for not just treating PTSD but also screening and early identification of at-risk youth and adults. Taken together, efforts aimed at dissemination and implementation of novel interventions to enhance resilience will have to keep pace with the growth of new preventive and treatment strategies.

Question 55

Cicchetti (2013)

Answer 55

Methods: The literature on the determinants of resilience in maltreated children is selectively reviewed and criteria for the inclusion of the studies are delineated.

Results: The majority of the research on the contributors to resilient functioning has focused on a single level of analysis and on psychosocial processes. Multilevel investigations have begun to appear, resulting in several studies on the processes to resilient functioning that integrate biological/genetic and psychological domains.

Conclusions: Much additional research on the determinants of resilient functioning must be completed before we possess adequate knowledge based on a multiple levels of analysis approach that is commensurate with the complexity inherent in this dynamic developmental process. Suggestions for future research on the development of resilient functioning in maltreated children are proffered and intervention implications are discussed.

Question 56

Perez-Gonzalez et al. (2018)

Answer 56

METHOD: A total of 1,105 children and youth (590 male and 515 female) from northeastern Spain and aged between 12 and 17 years were assessed regarding their experiences of caregiver victimization, symptoms of psychopathology, and protective factors.

RESULTS: Caregiver victimization during lifetime was reported by 26.8% of the overall sample. The results showed that any form of caregiver victimization was related to higher levels of emotional and behavioral problems. Some aspects of the Self domain (e.g., Social Skills or low Negative Cognition) were related to lower levels of internalizing problems. In the case of externalizing problems, several factors from different domains (i.e., Self, Family, and School) were relevant, and a significant interaction between caregiver victimization and Connectedness to School was observed.

CONCLUSIONS: The results show that protective factors play a role in the explanation of emotional and behavioral problems. The findings reveal some of the protective factors that should be regarded as key intervention targets in children and youth with a history of caregiver victimization. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

Question 57

Shaw et al. (2019)

Answer 57

cyberbullying, eating meals together and social support

In conclusion, cyberbullying is a strong, albeit rare, threat to adolescent wellbeing. Social support is important for wellbeing, but its ability to buffer adolescents against the consequences of bullying may be limited.

large sample - BUT

self-report measures

This study investigates if cyberbullying is associated with wellbeing independently of traditional bullying and if social support and eating family meals together promotes resilience by buffering adolescents against the consequences of both types of bullying. Data for 5286 eleven, thirteen and fifteen year olds participating in the cross-sectional 2018 Scottish Health Behaviour in School-aged Children study were analysed. Adolescent self-report measures were used to assess traditional bullying, cyberbullying, classmate and teacher support and frequency of family meals together. Psychological wellbeing was assessed with the 5-item World Health Organization Wellbeing index. Analyses were conducted separately by gender with multilevel models, adjusting for socio-demographic factors. Resilience to bullying and cyberbullying was operationalised using statistical interactions. For both genders, cyberbullying and traditional bullying measures were associated with reduced wellbeing and all social support indicators were associated with increased wellbeing. In models containing both bullying measures, frequent traditional bullying victimisation was associated with a 7.2 (95% CI: 3.4-10.1) reduction in wellbeing score for boys and a 7.2 (95% CI: 4.5-10.0) reduction for girls, while cyberbullying was associated with 10.5 (95% CI: 5.8-15.1) reduction in wellbeing score for boys and 11.1 (95% CI: 6.7-15.5) reduction for girls. For both genders adjusting for classmate support explained away the relationships between traditional bullying and wellbeing, but cyberbullying was associated negatively with wellbeing independent of social support. Only one of 12 interaction tests provided any evidence of resilience. Cyberbullying was associated with a 7.8 (95% CI: 0.2-15.4) reduction in wellbeing score for girls who ate with their family every day, and 17.3 (95% CI: 10.5-24.1) reduction for girls who ate with their families less than weekly. In conclusion, cyberbullying is a strong, albeit rare, threat to adolescent wellbeing. Social support is important for wellbeing, but its ability to buffer adolescents against the consequences of bullying may be limited.