Resilience to adversity

Question 1

what is a traumatic event?

Answer 1

• DSM 5 criteria: exposure to actual or threatened death, serious injury, or sexual violence

Question 2

what is resilience?

Answer 2

• There are multiple definitions… all involve a positive response/adaption to negative circumstances.
• An outcome pattern characterized by a stable trajectory of healthy functioning after adversity (Bonanno, 2004).
• The ability to ‘bounce back’ and flexibly adapt to changing demands of negative life situations (Tugade & Fredrickson, 2004).

Question 3

what is adversity?

Answer 3

Negative and severely stressful major life events that disrupt and impact quality of life (e.g., divorce, job loss).

Question 4

What 2 ways is resilience measured?

Answer 4

Resilience questionnaires:
- measured like a trait
- questions about how you generally react to stressors

Resilience trajectory:
- measured after the event (for several months or years)
- identifies people that show a resilient outcome pattern over time

Question 5

How was resilience viewed historically?

Answer 5

• viewed as a rare occurrence
• Bonanno (2004) - bereavement theorists viewed absent grief as a rare and pathological reaction

Question 6

Resilience prevalence in Bereavement, Bonanno et al. (2002)

Answer 6

• prospective study on spousal loss (prospective study means you have data before the event)
• 205 participants from existing longitudinal data set
• depression measured: pre-loss, 6 & 18-months after spousal loss
• participants were categorised based on patterns of change
• found resilient people had low pre-loss depression and no significant change at 6 and 18 months
• common grief was classed as low pre-loss depression, high at 6 months, no difference at 18-months (from pre-loss).
• chronic grief was classed as low pre-loss depression & high at both 6 & 18 months
• 46% of sample were resilient
• 11% common grief
• 15% chronic grief
• No evidence in pre-loss differences in attachment to spouse or marriage difficulties (to explain resilient pattern)
• Resilient people still affected by bereavement: yearning, emotional upset and intrusive thoughts.

Question 7

latent growth mixture modelling to measure resilience, Mancini et al.,(2011)

Answer 7

• investigated how resilient people are after spousal loss or divorce
• 16,795 participants from German Socioeconomic Panel Study (GSEOP) from 1984-2003.
• Used a new statistical technique – Latent Growth Mixture Modeling (LGMM): Identifies sub-populations in the data.
• Allows examination of different outcome trajectories for each sub-group.

Question 8

resilience prevalence in spousal loss, Mancini et al., (2011)

Answer 8

• Prospective study using GSEOP data.
• 464 people experienced spousal loss within 20 waves of data collection.
• Subjective well-being was used as the outcome measure.
• LGMM revealed a 4-class solution was best fit to data

Question 9

resilience prevalence in divorce, Mancini et al.,(2011)

Answer 9

• Prospective study using GSEOP data.
• 629 people experienced divorce within 20 waves of data collection.
• Subjective well-being was used as the outcome measure.
  LGMM revealed a 3-class solution was best fit to data.

Question 10

summary of Bonanno’s research

Answer 10

• Resilience is not a rare occurrence.
• Most people show a resilient outcome trajectory.
• We examined spousal loss and divorce – but similar results in other samples (e.g., traumatic injury & military service).

Question 11

Is resilience a common trajectory? Norris et al., (2009)

Answer 11

• examined outcome trajectories using longitudinal data in response to two disasters
• Two communities (n = 561) severely affected by 1999 floods in Mexico.
• Residents of NYC (n = 1267) after 9/11 terrorist attacks in USA.
• PTSD symptoms were measured post-disaster: 6, 12, 18 & 24 months post-disaster (Mexico), 6-9 months after 9/11 then 6, 18, 30 months after wave 1 (USA)
• limitation = this study has no pre event data

Norris et al. (2009) findings focusing only on prevalence of resistance (Stability in mild symptoms of PTSD (≤ 3 symptoms)) and resilience (Gradual decreasing in severe/moderate symptoms) outcome trajectories:
Mexico:
- resistance = 34.5%
- resilience = 32%

USA
- Resistance = 40.1%
- resilience = 10.1%

Question 12

How prevalent is resilience?

Answer 12

• The answer to this question depends on the definition of resilience used
• Resilience is not the common outcome when using the definition from Norris et al. (2009).
• Resilience is a common outcome when using the definition from Bonanno et al. (2004), but only in the US sample.

Question 13

How common is resilience? Infurna and Luthar (2016)

Answer 13

• Replication of research indicating most people are resilient.
• Reexamined outcome trajectories with LGMM after spousal loss, divorce and unemployment using GSEOP data set.
• Do the model specifications of LGMM method affect research findings?
• life satisfaction was used as the outcome measure
• for each life event they rab 3 separate models
  A. The same model specifications as in prior studies
  B. The variance of outcome trajectories were allowed to differ within subgroups
  C. The mean and variances of outcome trajectories allowed to differ between subgroups and within each subgroup
• for spousal loss recovery seems to be the most prevalent trait
• Results for divorce and unemployment similar: resilience rates dropped when model specifications changed (B & C)
• for divorce only 2 subgroups, recovery becomes more frequent. Resilience rates dropped when model specifications changed (B & C)

Question 14

Defining resilience, Cosco et al., (2017)

Answer 14

• systematic review of the measurement of resilience in longitudinal studies
• 36 papers in the review with inclusion of criteria
  1. longitudinal data (at least 3 waves)
  2. Operationalised and measure resilience
  3. published peer-reviewed research
• found that resilience was measured in 3 ways in longitudinal studies:
  1. Psychometric questionnaires (n=4)
  2. Definition-driven methods where researchers a priori specified the adaptive response (n=9)
  3. Data-driven methods to identify resilient sub-groups in the sample (n=23).
• Most studies defined resilience as the absence of distress or impairment, not maintenance of well-being
• Although statistics (fit indices) inform how trajectories are identified, researchers still have to interpret and label the trajectories.
• Data driven methods for trajectory identification are based on the characteristics of the sample, and may not generalize to other samples.

Question 15

Is resilience multidimensional? Infurna and Luthar (2017)

Answer 15

• Most research has examined resilience as single outcome trajectories.
• analysis of 13 waves (2001-2013) of existing longitudinal data: Household Income and Labour Dynamics of Australia Study.
• 421 individuals all of whom were widowed during the study.
  Selected multiple domains of adjustment:
  1. Life satisfaction
  2. Positive emotions
  3. Negative emotions
  4. General health
  5. Physical functioning in multiple daily activities (e.g., walking)
• conducted a series of GMM analyses to identify different outcome trajectories for each outcome.
• Analyzed 5 years before and 5 years after bereavement.
• Resilience outcome trajectories were defined as stable good functioning over time.
• found resilience only the most common outcome for life satisfaction

Question 16

Prevalence of Multidimensional Resilience, Infurna and Luthar (2017)

Answer 16

• examined outcome trajectories for individuals after spousal loss across all 5 domains simultaneously.
• Only 8% of the sample (n = 32%) were classified as showing a resilient trajectory across all five domains of functioning.