Resilience and mental health

The influence of childhood trauma on social media-induced secondary traumatic stress among college students: the chain mediating effect of self-compassion and resilience

Background: Studies have shown that media exposure to critical public events can lead to secondary traumatic stress (STS). Personal trauma history, self-compassion and resilience are important factors influencing STS in healthy professionals. However, whether these variables are associated with social media-induced STS in college students and the underlying mechanisms remain unclear. The purpose of this study was to explore the complex relationship linking childhood trauma to social media-induced STS in a large sample of college students.Methods: A total of 1151 Chinese college students from Chengdu, Sichuan Province of China completed a web-based cross-sectional survey, which included standard assessments of childhood trauma, self-compassion, resilience and social media-induced STS, as well as sociodemographic questionnaires. The chain mediation model was tested using the PROCESS macro programme in SPSS software.Results: There was a moderate correlation between childhood trauma and social media-induced STS (r = 0.34, p < .001). This association was significantly mediated by self-compassion (indirect effect [95% CI] = 0.14[0.11, 0.17]) and resilience (indirect effect = 0.03[0.01, 0.04]), respectively. Further, a chained mediating effect was observed with self-compassion and resilience consecutively mediated the relationship between childhood trauma and social media-induced STS (indirect effect = 0.02[0.01, 0.03]). These results persisted after sociodemographic characteristics were included as controlling variables.Conclusions: Early life trauma impacts STS induced by exposure to traumatic materials on social media through self-compassion and resilience among Chinese college students. Psychological interventions targeting self-compassion and resilience can be implemented to reduce the risk of STS, especially in vulnerable individuals.

The longitudinal association between problematic Internet use and psychotic-like experiences in adolescents: Mediated by sleep disturbance and moderated by psychological resilience

Problematic Internet use (PIU) has been empirically identified as a risk factor for future psychotic-like experiences (PLEs) among adolescents. This study aimed to examine the short-term predictive role of PIU on PLEs in adolescents and investigate their underlying mechanisms, focusing on the mediating role of sleep disturbance and the moderating role of psychological resilience. A total of 27,260 Chinese adolescents (52.2 % males, Meanage = 14.33 ± 1.49) were included for analyses in this two-wave longitudinal study conducted six months apart. The baseline survey (time 1, T1) was between December 17 and 26, 2021, and the follow-up survey (time 2, T2) was between May 17 and June 5, 2022. Participants reported their socio-demographics, T1 PIU, T1 sleep disturbance, T1 resilience, T1 PLEs, T2 PLEs, and T2 negative life events. After controlling for socio-demographics, T1 PLEs, and T2 negative life events, T1 PIU exacerbated T2 PLEs directly and indirectly through T1 sleep disturbance, with T1 resilience moderating both parts of the mediation pathway. These findings provide novel insights into the mechanisms linking PIU to PLEs among adolescents and offer valuable implications for clinical practice and school policy.

Resilience and its association with mental health among forcibly displaced populations: A systematic review and meta-analyses

BACKGROUND

Forcibly displaced populations are growing exponentially and are at increased risk of experiencing mental health difficulties. However, it remains unclear if, and how, their resilience and mental health are associated. This systematic review and meta-analyses investigated the relationship between resilience and mental health outcomes among forcibly displaced groups.

METHODS

MEDLINE Ultimate, APA PsycInfo and SCOPUS were searched up until January 2024. Peer-reviewed studies measuring a statistical association between resilience and mental health among forced migrants were eligible for inclusion. Random-effects meta-analyses for each identified mental health category were conducted. Study quality was evaluated using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

Thirty-one studies were included in the review (n = 6656). Meta-analyses revealed a significant negative association between resilience and symptoms of post-traumatic stress (k = 13, n = 2446, r = -0.15, 95 % CI [-0.23; -0.06]), depression (k = 14; n = 2952, r = -0.34, 95 % CI [-0.41; -0.26]), anxiety (k = 7, n = 1516, r = -0.19, 95 % CI [-0.27; -0.11]), and psychological distress (k = 10; n = 2712, r = -0.29, 95 % CI [-0.36; -0.23]).

LIMITATIONS

Effect sizes were highly heterogenous, most studies recruited small samples using non-random sampling strategies, and data was collected cross-sectionally.

CONCLUSIONS

Our findings point to an association between resilience and mental health difficulties in forcibly displaced groups. Directions for future research are discussed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (CRD42023395925).

Sixth wave of global public health progress

The "Sixth Wave of Global Public Health Progress" concept introduces a transformative approach to address contemporary health challenges by leveraging historical advancements and innovative strategies. This wave emphasizes the integration of data-driven decision-making, personalized public health, and technological innovations, such as artificial intelligence and digital tools, to enhance global health outcomes. By focusing on the connectedness of human, animal, and environmental health systems through the One Health approach, the framework aims to tackle critical threats like climate change, pandemics, and social inequities. It advocates for global collaboration, community-centric approaches, and sustainable practices to ensure equitable health access. Ultimately, this paper proposes a comprehensive framework that catalyzes social and scientific discourse, paving the way for resilient and adaptive health systems that align with the United Nations' Sustainable Development Goals.

The influence and mechanism of Taichi Chuan on improving mental health in adolescents: The chained mediating effect of meaning in life and psychological resilience

This study explored the main effect of Taichi Chuan on adolescents' mental health, as well as the heterogeneous influencing factors. Two separate studies were conducted on 722 Chinese adolescents from one secondary school in Guangzhou. We used the method of statistical analysis to analyze the scales designed to assess their Taichi Chuan, meaning in life, psychological resilience and mental health. In Study 1, the practice of Taichi Chuan exhibits a substantial positive impact on mental health (β = 1.125, p < 0.001). Additionally, meaning in life and psychological resilience have a mediating effect on the relationship between Taichi Chuan and mental health. Intriguingly, both mediators play a chained mediating role in the impact of Taichi Chuan on adolescents' mental health, with an effect size of 0.035 (95%CI: [0.001, 0.045], p < 0.01). Study 2 re-evaluated the hypotheses, incorporating age and grade as control variables, and confirmed that Taichi Chuan enhances mental health (β = 0.257, p < 0.05). A chain mediation effect was observed with meaning in life and psychological resilience as mediators (effect size = 0.106, 95 % CI: [0.025, 0.226], p < 0.05). The findings of study 2 were consistent with those of study 1.Embodied cognition theory posits that the integration of internal psychological processes with external bodily dynamics leads to a state of harmony and unity. The conclusions of this study integrate the principles of Taichi Chuan with embodied cognition theory, not only can alleviate the individual distress and family burdens associated with adolescents' mental health, but also promote the integrative development of martial arts education in middle schools.

A sport-for-protection program reduces anxiety and depression in youth affected by displacement: A randomized controlled trial of the Game Connect program in Uganda

INTRODUCTION

Youth affected by displacement are at risk for anxiety and depression. Supervised sport programs are a potentially effective strategy, however trials from displacement contexts are lacking.

METHODS

Displaced youth and youth from host communities in five humanitarian settings across Uganda aged 15 to 24 years, and with at least mild anxiety and/or depression, were randomized to a 16-week sport-for-protection program or a wait-list control condition. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9, adolescent version (PHQ-9-A) were assessed pre- and post-intervention. Linear mixed modelling was conducted.

RESULTS

834 young people were randomized (421 in the experimental and 413 in the control condition; median age = 19.0 years; 46.9 % boys; 14.7 % with self-reported or observed disability; 29.5 % from host community and 70.5 % displaced youth). Large effect sizes were found for the anxiolytic (Cohen d = 1.21, 95%CI = 1.06-1.36) and antidepressant (Cohen d = 1.32, 95%CI = 1.17-1.47) effects of sport-for-protection in comparison with a wait-list control condition. In subgroup analyses, large effect sizes were observed in displaced youth (Cohen d GAD-7 = 1.15, 95%CI = 1.0-1.32; Cohen d PHQ-9-A = 1.33, 95%CI = 1.16-1.51) and youth from host communities (Cohen d GAD-7 = 1.34, 95%CI = 1.06-1.61; Cohen d PHQ-9-A = 1.30, 95%CI = 1.03-1.58); in boys (Cohen d GAD-7 = 1.23, 95%CI = 1.03-1.43; Cohen d PHQ-9-A = 1.36, 95%CI = 1.14-1.58) and girls (Cohen d GAD-7 = 1.11, 95%CI = 0.89-1.33; Cohen d PHQ-9-A = 1.26, 95%CI = 1.05-1.47); and in those with (Cohen d GAD-7 = 0.99, 95%CI = 0.61-1.37.; Cohen d PHQ-9-A = 1.53, 95%CI = 1.12-1.94) and without disability (Cohen d GAD-7 = 1.24, 95%CI = 1.08-1.49; Cohen d PHQ-9-A = 1.28, 95%CI = 1.12-1.44).

CONCLUSION

Sport-for-protection is an effective stand-alone or adjunctive intervention to reduce symptoms of anxiety and depression among young people affected by displacement within humanitarian settings.

Psychological resilience, cardiovascular disease, and mortality - Insights from the German Gutenberg Health Study

OBJECTIVE

Psychological distress is associated with a higher risk of cardiovascular disease (CVD) and mortality, whereas psychological resilience may confer a protective effect. However, evidence on these relationships remains limited. This study aimed to examine the associations between psychological resilience, CVD, and all-cause mortality within a large general population cohort.

METHODS

Data from 12,675 participants in the German Gutenberg Health Study were analyzed. Psychological resilience was assessed using the Brief Resilient Coping Scale (BRCS). CVD prevalence and mortality data were obtained from medical records and registry updates. Logistic and Cox regression analyses examined the associations between resilience, CVD, and mortality, with adjustments for socio-demographics, lifestyle, and clinical factors.

RESULTS

Cross-sectionally, lower resilience was linked to higher odds of any CVD (odds ratio (OR) 1.030, 95 % confidence interval [CI] 1.009-1.051). Participants with low resilience had 38 % higher odds of CVD and 61 % higher odds of peripheral artery disease compared to those with high resilience. Longitudinally, low resilience was associated with the highest all-cause mortality risk (log-rank test, p < 0.0001). This association remained significant in Cox models after adjusting for confounders (hazard ratio (HR) 1.362, 95 % CI 1.002-1.852).

CONCLUSIONS

Lower psychological resilience is associated with increased CVD prevalence and all-cause mortality. These findings highlight resilience as a potential target for cardiovascular risk assessment and intervention. Incorporating resilience measures in clinical practice may help identify vulnerable individuals who could benefit from strategies to enhance adaptive coping, improving cardiovascular and overall health outcomes.

Neurocognitive resilience as a predictor of psychosis onset and functional outcomes in individuals at high risk

BACKGROUND

Neurocognitive resilience (NCR) refers to the ability of individuals to maintain cognitive function despite the presence of risk factors for psychosis. Investigating NCR is important as it may help predict the onset of psychosis and functional outcomes in individuals at clinical high risk (CHR) for psychosis.

METHODS

This study employed a multi-group prospective design with a 3-year follow-up as part of the ShangHai At Risk for Psychosis-Extended project. Neurocognitive performance was assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. The study focused on two primary outcomes: conversion/non-conversion to psychosis (CHR-C/CHR-NC) and non-remission/remission (CHR-NR/CHR-R). NCR was defined based on the adjusted cognitive variable relative to the healthy control(HC) group's mean, with three categories: NCR (NCR = 0) for scores within one standard deviation, NCR + (NCR = 1) for scores more than one standard deviation above, and NCR - (NCR = - 1) for scores more than one standard deviation below.

RESULTS

The study included 771 individuals at CHR (346 males, mean age 18.8 years) and 764 HCs (359 males, mean age 22.5 years). Among the CHR participants, 540 (70.0%) completed the 3-year follow-up, with 106 (19.6%) converting to psychosis (CHR-C) and 277 (51.3%) classified as non-remission (CHR-NR). Significant negative correlations were found between the total NCR score and various clinical symptoms. Comparing CHR-C and non-converters (CHR-NC), there were notable differences in NCR distributions across four cognitive measures, with a higher proportion of CHR-C individuals categorized as NCR - . For CHR-NR versus remission (CHR-R), CHR-NR individuals were more likely to be classified as NCR - across nearly all cognitive domains. The receiver operating characteristic (ROC) curve for predicting conversion to psychosis yielded an area under the curve (AUC) of 0.621 (95% CI (0.561-0.681), p = 0.0001), while the ROC for predicting non-remission demonstrated a higher AUC of 0.826 (95% CI (0.790-0.861), p < 0.0001).

CONCLUSIONS

NCR was associated with both conversion to psychosis and non-remission outcomes in CHR individuals, showing notable predictive accuracy, particularly for non-remission.

Work demands and mental health: the mediating effects of resilience and sense of belonging among college students

Objective: This study investigates the relationship between work demands and mental health among college students and the mediating effects of resilience and sense of belonging. Participants: Data was collected from 3,082 undergraduate students at a mid-sized public University in the Northeast on work demands, resilience, sense of belonging, and number of poor mental health days. Methods: Structural equation modeling (SEM) was used to analyze the data for students who reported at least one job (n = 2,083). Results: Higher work demands were positively associated with more poor mental health days. Resilience significantly and negatively mediated this relationship. In multiple-group SEM analyses, students working one job (vs multiple jobs) and those working a higher number of work hours (vs lower) exhibited a stronger negative indirect effect through the resilience mediating factor. Conclusions: Findings highlight the crucial role of resilience in managing work-related stress and suggest areas for further research to enhance student well-being.

The relationship between sports participation and bullying in elementary schools: the mediating role of mental toughness

Purpose

Previous research has shown a correlation between sports participation and bullying in schools. However, less attention has been paid to the factors influencing children's perpetrated bullying and victimized. Therefore, this study constructed a model of the role of influencing factors between sports participation, children's mental toughness, and school bullying to explore the link between sports participation and mental toughness on children's perpetrated bullying and victimized.

Methods

A sample of 861 students was randomly selected from five elementary schools in Shandong Province, China. After excluding invalid questionnaires with missing answers or consistent responses, 712 questionnaires were collected. The Physical Activity Rating Scale (PARS-3) was selected to assess sports participation, the Mental Toughness Scale to evaluate mental resilience, and the Chinese-adapted version of the Oweis Bullying Questionnaire (OBQ), which was revised by Chinese scholar Zhang Xinwen, to measure bullying experiences. All participants completed maturation scales on sports participation, mental toughness, and school bullying. Data were analyzed in SPSS 24.0, SPSSprocess 4.1, and AMOS 27.

Results

The results of this study are as follows: (1) According to the correlation test results, since p < 0.05 or p < 0.01, there is a correlation between sports participation and psychological resilience, bullying and being bullied. There is a correlation between mental resilience and bullying, being bullied. There is a correlation between bullying and being bullied. (2) Mental toughness plays a mediating role in the influence of sports participation on the perpetrated bullying and in the influence of sports participation on victimized. (3) In the pathways of sports participation, mental toughness, and school bullying, it suggested that mental toughness played a partial mediating role in this pathway. For the pathways of sports participation, mental toughness, and children's exposure to bullying. The mental toughness played a full mediating role in this pathway.

Conclusion

It is recommended that early intervention and support be given to promote children's physical mobility and increase their own levels of sports participation and mental toughness, thereby reducing the likelihood of children committing or experiencing bullying in schools and improving their physical and mental health.

Cognitive reserve types and depressive symptoms development in late-life: A population-based cohort study

INTRODUCTION

Cognitive reserve (CR) describes individual differences in susceptibility to brain damage that translates into varying dementia onsets and may also influence the occurrence of depressive symptoms. Within a population-based cohort of older people, we investigated two operationalizations of CR, residual- and activity-based approaches, in their association with the development of depressive symptoms.

METHODS

We analyzed longitudinal data on 402 dementia- and depression-free adults aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) who underwent brain MRI at baseline. Residual-based reserve was derived by regressing episodic memory on a brain-integrity index incorporating six structural MRI markers. Activity-based reserve factored lifelong CR-enhancing experiences, including education, work complexity, social network, and leisure activities. Clinically relevant depressive symptoms were defined as a Montgomery-Åsberg Depression Rating Scale score >6. Cox hazard models were used to explore the association between both residual- and activity-based CR measures (categorized in tertiles) and incidence of depressive symptoms over a 15-year follow-up, while accounting for sociodemographic, clinical, behavioral factors, and brain integrity. Analyses for the activity-based measure were replicated in the full SNAC-K sample (N = 2709), further exploring depression diagnosis as additional outcome.

RESULTS

Compared to low levels, higher levels of residual-based CR were associated with a lower hazard of depressive symptom onset in fully adjusted models (HR: .43, 95%CI .22, .84). While activity-based CR was not significantly associated with developing depressive symptoms in the MRI subsample (HRhigh .47, 95%CI .21, 1.04), it was in the full sample (HRhigh .52, 95%CI .39, .71). Activity-based CR was further associated with depression diagnoses in the full sample (HRhigh: .45, 95%CI .31, .65).

DISCUSSION

Largely independent of its measurement, CR appears to influence depressive symptomatology in late life. Reserve-enhancing initiatives may be beneficial not only for cognitive but also for mental health in older people.

Resilience resources, coping, and health outcomes in college students during the Covid-19 pandemic

Background: Resilience resources are predispositions that promote individuals' abilities to cope with stress. Objective: The current cross-sectional study used path analysis with parallel multiple mediators to test whether coping behaviors mediated associations between resilience resources and somatic, depression, and anxiety symptoms during the Covid-19 pandemic. Method: Undergraduates at a small Northeastern college (n = 193) completed online surveys assessing resilience resources, coping, and symptoms. Results: Results support significant indirect effects from resilience resources to somatic symptoms through positive reinterpretation and growth, mental disengagement, and substance use. Total indirect effects for depressive symptoms were driven by mental disengagement and substance use, with a direct effect of resilience resources. The effect of resilience resources on anxiety symptoms was mediated by mental disengagement, and there was a direct effect of resilience resources. Conclusions: Findings demonstrate that some coping strategies link resilience resources to better outcomes, potentially informing interventions for adaptive coping during public health crises.

Factors affecting resilience among young breast cancer survivors: A cross-sectional study

PURPOSE

Resilience is a crucial factor in allowing young breast cancer survivors (YBCSs) to adapt to life following treatment. However, a comprehensive understanding of the factors that affect resilience in this population is limited. This study aimed to investigate the associations among various factors affecting resilience, including social support, family communication, fear of cancer recurrence (FCR), cancer coping, and hope, in YBCSs.

METHODS

This cross-sectional study included 227 YBCSs aged 20-45 years who completed active cancer treatment. Data were gathered through self-administered surveys utilizing validated instruments to measure FCR, social support, family communication, cancer coping, hope, and resilience. Statistical analyses involved descriptive statistics, Pearson correlation analysis, linear regression, and bootstrapping for assessing indirect effects.

RESULTS

Social support (β = .15, p = .008), family communication (β = .25, p < .001), cancer coping (β = .23, p < .001), and hope (β = .33, p < .001) were positively associated with resilience, whereas FCR exhibited a significant negative effect (β = -.08, p = .028). Indirect effects indicated that social support and family communication affected resilience through hope, whereas family communication demonstrated an indirect effect on cancer coping. FCR negatively affected resilience primarily through hope.

CONCLUSION

Targeted interventions focusing on reducing FCR, improving social support, and enhancing family communication are crucial for fostering resilience in YBCSs. Coping and hope-based strategies in clinical nursing care need to be integrated for long-term survivor support. Nurses and healthcare providers need to develop and implement sustained, culturally sensitive interventions that address the evolving psychosocial requirements of YBCSs.

Neurophysiology of adaptative and maladaptive stress: Relations with psychology of stress

OBJECTIVES

The stress reaction is an integrated response to a change in the environment that enables each individual to adapt to demand. While this response is physiologically coordinated by the brain, its phenomenology is expressed in the field of psychology and psychopathology. This interrelation between neurophysiological mechanisms and psychological processes is complex as dynamic interpersonal, biological, and psychocognitive systems interact with contextual and environmental factors to shape adaptation over the life constraints.

METHOD

This article aims to present the actors of the adjusted stress response, such as coping and coping flexibility, mindfulness and resilience, and their respective neurophysiology.

RESULTS

A model of the relationship between resilience, mindfulness and coping was proposed for optimizing adaptation to stress response.

DISCUSSION

These focuses are prerequisites for understanding and supporting human adaptation in the everyday environment and promoting efficient management of stress for mental and physical health.

Physical exercise and children's resilience: mediating roles of self-efficacy and emotional intelligence

Purpose

This study aims to examine the inner relationship between children's physical exercise, self-efficacy, emotional intelligence, and resilience, and explore effective ways to promote the improvement of children's resilience.

Methods

Using measurement tools such as the Physical Activity Rating Scale (PARS-3), the General Self-Efficacy Scale (GSES), the Chinese version of the Emotional Intelligence Scale (EIS), and the Adolescents Resilience Scale, we conducted a questionnaire survey was conducted among 700 primary school students in 4 primary schools. The SPSS 22.0 software was used to process and analyze the data, including correlation analysis, regression analysis, and Bootstrap analysis, and AMOS 21.0 software was used to establish a structural equation model.

Results

(1) Physical exercise has a significant positive correlation with self-efficacy (r = 0.29, p < 0.001), emotional intelligence (r = 0.32, p < 0.001), and resilience (r = 0.37, p < 0.001), and there is also a significant positive correlation between emotional intelligence and resilience (r = 0.30, p < 0.001). (2) Physical exercise can directly and positively predict children's resilience (β1 = 0.38) and its five sub-dimensions, that is, physical exercise can positively predict goal concentration (β = 0.35, p < 0.001), emotional control (β = 0.29, p < 0.001), positive cognition (β = 0.20, p < 0.01), family support (β = 0.33, p < 0.001), interpersonal assistance (β = 0.31, p < 0.001), respectively. (3) Self-efficacy (SE = 0.10) and emotional intelligence (SE = 0.08) have partial mediating effects, respectively, on the relationship between physical exercise and resilience, and the chain mediation effect of self-efficacy and emotional intelligence also reaches a significant level (SE = 0.02).

Conclusion

Physical exercise can have a positive impact on children's resilience through self-efficacy and emotional intelligence, so schools or parents should attach importance to children's physical activities, which is an effective way to improve their resilience.

Mirrors for Pacific Islander Children: Teaching Resilience Through Culturally Adapted Bibliotherapy

Pacific Islander youth face disproportionately high rates of suicide and mental health challenges, yet culturally appropriate interventions remain scarce. This study investigated whether culturally adapted bibliotherapy could effectively promote resilience in American Samoan children by incorporating culturally relevant stories and coping strategies. Through collaboration with on-island Samoan cultural brokers, we developed and implemented culturally adapted stories and lessons designed to resonate with the experiences of children in American Samoa. The study employed a mixed-methods approach with 34 American Samoan children aged 5-13 years, using observations, adapted card sorts, and forced-choice procedures to measure responses to the intervention. The results demonstrated that participants showed strong identification with the culturally adapted stories and characters, actively engaged with the embedded coping strategies, and reported increased confidence in applying resilience techniques. These findings suggest that culturally adapted bibliotherapy holds promise as an effective method for promoting resilience in Pacific Islander children while highlighting the importance of cultural authenticity in mental health interventions.

Posttraumatic stress disorder in the aftermath of the Turkey earthquake: exploring the role of demographics, level of exposure, and personality traits

BACKGROUND AND OBJECTIVES

Post-Traumatic Stress Disorder (PTSD) is an important mental disorder that can develop after mass traumas such as earthquakes. In our study, we aimed to investigate the development of PTSD after the Turkey earthquake (6 February 2023) and its association with some demographic variables, personality traits, and psychological vulnerability.

METHOD

547 participants completed assessments of personality, disaster exposure, and PTSD symptoms. Multiple regression analyses were used to identify predictors of PTSD symptoms.

RESULTS

PTSD scores were higher in women, single people, those with low educational level, those who witnessed someone else's injury or death, those who were injured, and those whose homes were destroyed. Physical injury, conscientiousness, marital status, income, and agreeableness predicted PTSD. Among these variables, physical injury was the strongest predictor of PTSD.

CONCLUSIONS

Psychological vulnerability, conscientiousness, physical injury, employment, witnessing someone else's injury, gender, and emotional stability predicted PTSD score in a significant way. Physical injury, conscientiousness, marital status, income, agreeableness predicted PTSD in a significant way.

Psychological Resilience and Future Anxiety Among University Students: The Mediating Role of Subjective Well-Being

Future anxiety is the worry and concern individuals experience regarding uncertainties and potential negative outcomes in their future. This emotional state can manifest at different stages of students' academic lives and can impact their academic performance and social relationships. In the process of coping with negative experiences and overcoming challenges, psychological resilience plays a crucial role. Students who struggle to manage stress and have high levels of anxiety tend to experience future anxiety more intensely. The aim of this study is to determine the mediating role of subjective well-being in the relationship between psychological resilience and future anxiety among university students. The study was conducted with a total of 483 university students, including 280 females and 203 males. Data were collected using the Connor-Davidson Resilience Scale (CD-RISC-10), Subjective Well-Being Scale (SWB-7), and Future Anxiety (Dark Future) Scale (Short Form). Analyses were performed using AMOS 22.0 and SPSS 27.0 software. The findings indicate that psychological resilience has a significant negative effect on future anxiety, a significant positive effect on subjective well-being, and that subjective well-being has a significant negative effect on future anxiety. Additionally, the study found that subjective well-being mediates the relationship between psychological resilience and future anxiety.

Effectiveness of Adaptation of a Resilience-Building Intervention Among Individuals With Adverse Childhood Experience: Protocol for a Randomized Controlled Trial

BACKGROUND

The impact of adverse childhood experiences (ACEs) has been the focus of most studies for the past decade. There is an indication that developing resilience can help youth overcome these ACEs.

OBJECTIVE

This article presents a study protocol for a randomized controlled trial (RCT) to investigate the effects of a resilience-building intervention on psychological well-being, coping strategies, stress, quality of life, resilience, resource finding, and resilience among individuals affected with ACEs in Malaysia.

METHODS

The is a 2-armed, single-blind, RCT, whereby 50 participants (25 in each group) with ACEs will be randomly assigned to intervention and control groups. The former will be exposed to a resilience-building program (R2), which entails a multisystemic approach to resilience and recognizes the importance of rugged qualities and access to resources among individuals affected with ACEs. The intervention will be delivered via internet-based by a facilitator and broadly divided into 5 sessions, focusing on self-exploration and social support, coping techniques and coping skills, resource finding, spirituality, and resilience building. Meanwhile, the control group participants will not receive any form of intervention. Saliva samples will also be collected from both groups and assessed for salivary cortisol levels. Outcome measures will be assessed during baseline and postintervention using validated instruments. Another follow-up measurement will be conducted 4 weeks later.

RESULTS

The clinical trial has been registered with the Australia New Zealand Clinical Trials Registry. Ethical approval was obtained from the Research Ethics Board at the National University of Malaysia (UKM PPI/111/8/JEP-2021-894). A total of 28 participants have been recruited to the RCT Participant recruitment will be completed by January 2025. The final analysis will be conducted by March 2025.

CONCLUSIONS

This is among the first studies to provide evidence in the context of RCTs for resilience-building intervention that combines self-report and physiological measures (ie, saliva and heart blood pressure) among individuals with ACEs. The findings will assist relevant authorities in the health and policy sectors to develop effective strategies for addressing the negative impacts of ACEs on the vulnerable population in Malaysia.

TRIAL REGISTRATION

ACTRN12622000604707; https://www.anzctr.org.au/Trial/Result/DataSharingStatement.aspx?id=383614.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56826.

The correlation between resilience and mental health of adolescents and young adults: a systematic review and meta-analysis

Background

Adolescents and young adults (AYAs) aged 10-25 exhibit an increased prevalence of mental health disorders. Resilience has been well established as a positive factor in promoting and protecting mental health. This systematic review and meta-analysis aimed to quantify the correlation between resilience and mental health in AYAs by including relevant observational studies. Additionally, it explored potential moderators such as percentage of female participants, sample regions, and resilience measurements.

Methods

A comprehensive search of the PubMed, Embase, Cochrane Library, Web of Science and Scopus databases was conducted until September 2024. CMA 3.0 software was used to perform meta-analysis, publication bias and sensitivity analysis of the included studies, and the moderating effect was verified by meta-analysis of variance (ANOVA).

Result

Nineteen studies involving a total of 17,746 participants were included, and the summary effect sizes from the random effect model showed that resilience among AYAs had a correlation coefficient of -0.391 with negative indicators of mental health (95% CI: - 0.469, - 0.308, p < 0.001), and a correlation coefficient of 0.499 with positive indicators of mental health (95% CI: 0.400, 0.586, p < 0.001). Additionally, sample regions and resilience measurements significantly moderated the correlation between resilience and positive indicators of mental health.

Conclusion

Resilience in AYAs showed a moderately negative correlation with negative indicators of mental health and a moderately strong positive correlation with positive indicators of mental health. The findings strengthened the basis for future resilience research in AYAs aged 10-25, highlighting the potential of resilience to help mitigate the increasing mental health challenges faced by this population.

Relationship between physical literacy and mental health in adolescents: a moderated mediation model with resilience and physical activity as variables

Introduction

Physical literacy is defined as the motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engaging in physical activities for life, and may be associated with higher mental health; however, few studies have explored the processes underlying these positive associations.

Objectives

The present study aimed to explore the role of resilience in the relationship between physical literacy and mental health, and further examines the mediating role of physical activity.

Methods

This cross-sectional study recruited a sample of 1,022 (aged 10-18 years, Mage = 14.84, SD = 1.79, 44.9% male) Chinese students, grades five to twelve, via physical education courses. The hypothesized moderated mediation model was employed using Model 4 and Model 8 of the PROCESS macro for SPSS to examine the relationships between physical literacy, mental health, resilience, and physical activity.

Results

Physical literacy was positively and significantly correlated with mental health (r = 0.364, p < 0.001), and resilience (r = 0.486, p < 0.001). After controlling for sex and grade variables, resilience mediated the relationship between adolescent physical literacy and mental health, physical activity moderated the relationship between physical literacy and resilience in the mediator model but not between physical literacy and mental health.

Discussion

The present study suggests that could physical literacy predict increased levels of resilience, which could then lead to higher mental health. However, this mediation effect may fluctuate across individuals with different levels of physical activity. Overall, this study may reveal that physical literacy promotes resilience and mental health processes in individuals with different levels of physical activity.

A meta-analysis of genome-wide studies of resilience in the German population

Resilience is the capacity to adapt to stressful life events. As such, this trait is associated with physical and mental functions and conditions. Here, we aimed to identify the genetic factors contributing to shape resilience. We performed variant- and gene-based meta-analyses of genome-wide association studies from six German cohorts (N = 15822) using the 11-item version of the Resilience Scale (RS-11) as outcome measure. Variant- and gene-level results were combined to explore the biological context using network analysis. In addition, we conducted tests of correlation between RS-11 and the polygenic scores (PGSs) for 12 personality and mental health traits in one of these cohorts (PROCAM-2, N = 3879). The variant-based analysis found no signals associated with resilience at the genome-wide level (p < 5 × 10-8), but suggested five genomic loci (p < 1 × 10-5). The gene-based analysis identified three genes (ROBO1, CIB3 and LYPD4) associated with resilience at genome-wide level (p < 2.48 × 10-6) and 32 potential candidates (p < 1 × 10-4). Network analysis revealed enrichment of biological pathways related to neuronal proliferation and differentiation, synaptic organization, immune responses and vascular homeostasis. We also found significant correlations (FDR < 0.05) between RS-11 and the PGSs for neuroticism and general happiness. Overall, our observations suggest low heritability of resilience. Large, international efforts will be required to uncover the genetic factors that contribute to shape trait resilience. Nevertheless, as the largest investigation of the genetics of resilience in general population to date, our study already offers valuable insights into the biology potentially underlying resilience and resilience's relationship with other personality traits and mental health.

The resilience mediation effect on the relationship of suicide risk and psychological pain in nursing students: Structural equation modelling

WHAT IS KNOWN ON THE SUBJECT?: Suicide is an important health problem that has been common all over the world in recent years. Nursing students are a high-risk group for suicide. Factors affecting suicide risk should be investigated and included in psychiatric nursing interventions. Psychological pain is a predisposing condition for suicide risk. Studies focus on the relationship between suicide risk and psychological pain. Studies examining the moderator factors affecting this relationship are limited. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: By means of the structural equation model, the effect of resilience mediation on the relationship of suicide risk and psychological pain has been shown. In the process of going from psychological pain to suicide, resilience takes on a buffer function with its mediating effect, and this process can be prevented by the development of resilience. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Resilience can be added as a protective factor for suicide to the practices of psychiatric nursing. Initiatives to strengthen resilience can be added to psychiatric nursing practices. In this way, psychological pain and the risk of suicide can be reduced by strengthening resilience. Psychological pain can be added as a risk factor for suicide to the practices of psychiatric nursing. Within the scope of psychiatric nursing practices, nursing interventions can be structured to assess and reduce psychological pain. Interventions on strategies to manage and cope with psychological pain and initiatives to strengthen resilience can be added to suicide prevention programs created for nursing students.

ABSTRACT

INTRODUCTION: Nursing students are a high-risk group for suicide. Psychiatric nurses should investigate risk factors for suicide.

AIM

The aim of this study was to examine the resilience mediation effect in the relationship of suicide risk and psychological pain in nursing students.

MATERIALS AND METHODS

This cross-sectional study was conducted between March and May 2021 with 619 students in the Akdeniz University Faculty of Nursing. A Descriptive Information Form, the Suicide Probability Scale, the Psychache Scale and the Brief Resilience Scale were used to collect data. The structural equation model approach was used to examine the resilience mediating effect on the relation between suicide risk and psychological pain, and Path Analysis was performed. The reporting of the study was conducted according to STROBE.

RESULTS

A semi-mediatory effect of resilience was found between psychological pain and the risk of suicide, and the effect size was determined to be broad (0.57).

DISCUSSION

Resilience can be considered as a protective factor for suicide prevention in psychiatric nursing practices.

CONCLUSION

Resilience has an effect on the relationship between psychological pain and suicide risk.

IMPLICATIONS FOR PRACTICES

The results of this study may guide psychiatric nursing practices in reducing and preventing suicide risk.

Comparison of Resilience Measures in Chinese Adolescents: Based on Item Response Theory

Resilience is an important ability that helps adolescents resist stress from everyday life. While resilience has been measured in many ways, no measures have been developed specifically for the adolescent population. This study analyzed three popular resilience questionnaires, evaluated their psychometric properties using item response theory and explored their applicability. Graded response model (GRM) was used to compare the psychometric properties of the three questionnaires. The results of the item response theory analysis showed that the CD-RISC-10 provided more average item information (AII) than the CD-RISC and the ER89 in the interval -4 < θ < +2.9 SD. At more than +2.9 SD, CD-RISC has higher AII. We also tested the external validity of the three questionnaires by calculating the correlation of the three questionnaires with the total and dimension scores of the Adolescent Psychological Adaptability Scale (APAS). The correlation coefficient ranged between 0.30 and 0.58. The results also suggest that the CD-RISC-10 can more accurately screen participants across a wide range of resilience levels. The CD-RISC is also suitable for measuring very high levels of resilience.

How belief in a just world shapes academic engagement among Chinese college art majors: A cross-level moderated mediation model

The belief in a just world (BJW) is perceived as an individual trait that aids in coping with challenges. This study employed Mplus8.0 and HLM6.08 to analyze 346 questionnaire responses, leading to the following conclusions: (1) BJW shows a positive correlation with academic engagement among college art majors; (2) Academic resilience mediates the relationship between BJW and academic engagement for college art majors; (3) The teacher-student relationship (TSR) exhibits a positive correlation with academic engagement among college art majors; (4) TSR functions as a moderator in the relationship between BJW and academic engagement among college art majors. These findings provide valuable insights for enhancing learning efficiency and talent development in art schools, thereby contributing to the overall quality of education for art students.

Resilience in maternal, newborn, and child health in low- and middle-income countries: findings from a scoping review

OBJECTIVES

The research objectives were to identify and synthesise prevailing definitions and indices of resilience in maternal, newborn, and child health (MNCH) and propose a harmonised definition of resilience in MNCH research and health programmes in low- and middle-income countries (LMICs).

DESIGN

Scoping review using Arksey and O'Malley's framework and a Delphi survey for consensus building.

PARTICIPANTS

Mothers, new-borns, and children living in low- and middle-income countries were selected as participants.

OUTCOMES

Resilience as defined by the authors was deduced from the studies.

RESULTS

Twenty-two out of 76,566 cited studies published between 2006 and 2010 were included in the review. Thirteen (59.1%) examined maternal resilience, and nine (40.9%) examined newborn and child health resilience; most of the included studies were quantitative (n = 17; 81%). Seven studies defined 'resilience' in the context of maternal health, most of which described the term at the individual level. 'Maternal resilience' was measured using validated scales in five studies; another five defined newborn and child resilience. Only one reviewed study used maternal characteristics to identify newborn and child resilience. The synthesised consensus definition of 'maternal, newborn, and child resilience' is 'A woman's ability to prevent or adapt to significant and challenging circumstances including threats, tragedy, and trauma to herself during pregnancy, childbirth, and puerperium and to her neonates or children five years or younger'.

CONCLUSION

The information identified was limited but included a few definitions of resilience in MNCH and an index of child resilience in LMICs. The proposed definition is useful for MNCH programme implementation and interventions in LMICs. Scoping review registration: The protocol for this review was registered in the open science framework at the registered address ( https://osf.io/jt6nr ).

Mindfulness and resilience as serial mediators of links between childhood psychological maltreatment and substance misuse

Substance misuse is a seriously risky behavior in young adulthood. To protect and support the psychological health of university students, the risk factors and protective factors related to substance misuse should be examined. This study aims to examine the serial mediating role of mindfulness and resilience in the relationship between childhood psychological maltreatment and substance misuse. The sample of the study consists of a total of 383 university students, 269 female (70.2%) and 114 male (29.8%), aged between 18 and 28 years (M = 20.849, SD = 1.773). Research findings have proven that childhood psychological maltreatment is an important predictor of mindfulness, resilience, and substance misuse. The following results revealed that mindfulness and resilience played a partially serial mediating role in the relationship between childhood psychological maltreatment and substance misuse. The findings indicated that childhood psychological maltreatment is an important risk factor for substance misuse, and mindfulness and resilience may be protective factors in this relationship. All these results suggest that psychoeducational interventions that increase the mindfulness and resilience levels of young adults may contribute to alleviating substance misuse in individuals exposed to childhood psychological maltreatment.

Prevalence and Independent Predictors of Anxiety and Depression Among Elementary and High School Educators: Cross-Sectional Study

BACKGROUND

Globally, anxiety and depression are primary contributors to work disability and impact the mental and physical well-being of educators.

OBJECTIVE

This study aims to determine the prevalence and independent predictors of likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) among teachers in the Canadian provinces of Newfoundland and Labrador, Alberta, and Nova Scotia.

METHODS

The study used a cross-sectional design. Educators from the 3 Canadian provinces participated by completing a web-based survey after enrolling in the Wellness4Teachers program, a free, self-subscription, daily, supportive SMS text messaging initiative. The program was launched at the beginning of the 2022-2023 academic year, and all teachers in the 3 provinces were eligible to enroll. Likely GAD and likely MDD among subscribers were assessed using the Generalized Anxiety Disorder-7 scale and the Patient Health Questionnaire-9, respectively. Data analysis was conducted using SPSS (version 28.0).

RESULTS

Of the 1912 Wellness4Teachers subscribers, 763 (39.9%) completed the survey. The prevalence of likely MDD was 55.7% (425/763) and that of likely GAD was 46% (349/759). After controlling for all other variables in the regression model, participants who reported high stress were 7.24 times more likely to experience MDD (odds ratio [OR] 7.24, 95% CI 4.22-12.42) and 7.40 times more likely to experience GAD (OR 7.40, 95% CI 4.63-11.80) than those with mild to moderate stress. Participants with emotional exhaustion were 4.92 times more likely to experience MDD (OR 4.92, 95% CI 3.01-8.05) and 4.34 times more likely to experience GAD (OR 4.34, 95% CI 2.47-7.62) than those without. Moreover, respondents with a lack of professional accomplishment were 2.13 times as likely to have MDD symptoms (OR 2.13, 95% CI 1.41-3.23) and 1.52 times more likely to experience GAD symptoms (OR 1.524, 95% CI 1.013-2.293) than those without. Similarly, respondents with low resilience were 1.82 times more likely to have likely MDD than those with normal to high resilience (OR 1.82, 95% CI 1.24-2.66). In addition, respondents with low resilience were 3.01 times more likely to experience likely GAD than those with normal to high resilience (OR 3.01, 95% CI 2.03-7.62). Participants with >20 years of teaching experience were 0.28 times less likely to experience GAD symptoms than those with ≤5 years of teaching experience (OR 0.28, 95% CI 0.12-0.64). Sociodemographic and work-related variables did not independently predict likely GAD and likely MDD.

CONCLUSIONS

This study underscores the need for governments and policy makers in the education sector to implement comprehensive mental health support programs. Addressing the unique stressors faced by educators, reducing emotional exhaustion, and enhancing resilience are crucial steps toward mitigating anxiety and depression, promoting educators' well-being, and improving the quality of educational delivery.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/37934.

Resilience: A panacea for burnout in medical students during clinical training?: A narrative review

Clinical rotations or clerkships are a necessary part of medical education but are associated with significant psychiatric morbidity, including burnout and psychological distress. This review aims to explore the role of resilience as a protective factor and assess the effectiveness of resilience-building interventions. We conducted a narrative review using the Medline database via PubMed. The search strategy included the terms "resilience," "burnout," and "medical students." A total of 52 articles were included and synthesized narratively. Burnout affects 40% to 80% of medical students, with higher rates during their clinical years. Resilience was consistently found to be a stable, protective factor that buffers against stress and burnout. Most research focused on medical students, regardless of whether they are in clinical training. However, the effectiveness of resilience interventions varied. Interventions such as psychological workshops and curriculum changes showed mixed results, with competence-based approaches showing the most promise for long-term benefits. Resilience is a critical target for improving medical students' psychological health and reducing burnout during clinical training. Future interventions should focus on combining psychological support with competence-based training to equip students for the challenges ahead.

The Relationship Between Self-Compassion and Resilience in the General Population: Protocol for a Systematic Review and Meta-Analysis

BACKGROUND

Resilience can protect individuals from the negative impact of adversity, facilitating a swift recovery. The exploration of protective factors contributing to resilience has been a central focus of research. Self-compassion, a positive psychological construct that involves treating oneself with kindness, holds the potential to bolster resilience. Although several studies have indicated an association between self-compassion and resilience, there is a lack of systematic reviews and meta-analyses examining this relationship and the potential moderators and mechanisms.

OBJECTIVE

This study aimed to systematically review the literature on the relationship between self-compassion and resilience in the general population, perform a meta-analysis to quantify the effect size of their association, and explore potential moderators (eg, age, gender, culture, and health status) and mediators.

METHODS

We will search the Web of Science, PsycINFO, MEDLINE, Scopus, CINAHL, and CNKI databases for peer-reviewed studies (including observational and experimental studies) that examined the relationship between self-compassion and resilience, with no language restrictions. There are no restrictions regarding participants' age, gender, culture, or health status. Qualitative studies, conference abstracts, review articles, case reports, and editorials will be excluded. Two reviewers (XL and JH) will independently screen the literature, extract data, and assess the quality of the eligible studies. If possible, the pooled effect size between self-compassion and resilience will be meta-analyzed using a random-effect model. Meta-regression and subgroup analysis will be conducted to examine the moderating roles of age, gender, culture, health status, and other potential moderators. The characteristics and main findings of eligible studies will be summarized in tables and narrative descriptions. Results from the meta-analysis, meta-regression, and subgroup analysis will be presented quantitatively.

RESULTS

We registered our protocol with PROSPERO, conducted the search, and initiated the screening in April 2024. We expect to start data analysis in October 2024 and finalize the review by March 2025.

CONCLUSIONS

The systematic review and meta-analysis will provide evidence on the protective role of self-compassion in resilience under adversity. Our investigation into potential moderators will highlight the contexts and groups where the benefits of self-compassion can be maximized. The findings are expected to provide valuable insights for health care professionals and stakeholders, informing the development of interventions aimed at enhancing resilience by fostering self-compassion.

TRIAL REGISTRATION

PROSPERO CRD42024534390; https://tinyurl.com/3j3rmcja.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/60154.

The association between family resilience and mental health: A three-level meta-analysis

Family resilience refers to a family's ability to successfully cope with adversity from a system dynamics perspective, and is considered an effective resource for promoting individual mental health. However, there is a lack of meta-analyses examining the relationship between family resilience and mental health outcomes, nor the impact of different cultural context factors. The current study conducted a three-level meta-analysis of 48 studies published before January 25, 2022, from 5 scientific databases. The main effect test revealed a significant medium positive correlation between family resilience and positive mental health (r = 0.446, p < 0.001) and a significant medium negative correlation between family resilience and negative mental health (r = -0.543, p < 0.001). In addition, the moderator analyses for positive outcomes revealed significant effects for the average age (p = 0.048) and the type of adversity affected (p = 0.007). Meanwhile, the moderator analyses for negative outcomes found significant effects for individualism scores (p = 0.020). The findings suggest that family can be a valuable resource for individual psychological adaptation and growth. It is important to pay attention to the role of family members and cultural context factors in addressing the effect of family resilience on mental health.

Understanding Resilience in Parents: Longitudinal Examination of Trait Resilience, Stressful Life Events, and Psychological Distress Symptoms-Insights From the FinnBrain Study

The study aimed to investigate the persistence or changes in trait resilience of parents over a 6-year period and its association with stressful life events (SLEs). Furthermore, we explored the potential protective effect of trait resilience against exposure to stressful life events and their negative mental health consequences. The study population was drawn from the ongoing FinnBrain Birth Cohort Study and included 1388 mothers and 657 fathers who completed the CD-RISC-10 questionnaire during pregnancy and again 6 years later. Data collection involved self-report questionnaires, including CD-RISC-10, EPDS, SCL-90, and a questionnaire on SLEs. Data analysis utilised linear regression and statistical assessments. Parents in the highest or lowest quartile of resilience showed greater stability in resilience scores over time compared to those in the middle quartiles. Trait resilience during pregnancy was significantly associated with resilience 6 years later. SLEs did not moderate this association. Additionally, higher trait resilience consistently associated with lower levels of distress symptoms. The investigation of SLEs may require more nuance due to their event-specific variability of impact. Furthermore, the study's sample size of individuals who experienced a high frequency of stressful life events was limited. Trait resilience appears to be rather stable, but also susceptible to some change. Because of its persistency and the positive impact on mental health it is worthwhile to be assessed as a part of comprehensive evaluation of parents' mental health.

The relationship between psychological resilience, coping strategies and fear of cancer recurrence in patients with breast cancer undergoing surgery: A descriptive, cross-sectional study

PURPOSE

This study aims to determine the relationship between psychological resilience, coping strategies and the fear of cancer recurrence in women who have undergone surgical procedures due to breast cancer.

METHODS

The study was conducted using a descriptive, cross-sectional, and correlational research design. The sample of the study consisted of 252 women. Data were collected with The Patient Information Form, The Psychological Resilience Scale for Adults, The Ways of Coping Questionnaire and The Fear of Cancer Recurrence Inventory.

RESULTS

The mean scores of Psychological Resilience Scale for Adults, Fear of Cancer Recurrence Inventory, and the optimistic and self-confident subscales of the Ways of Coping Questionnaire among participants were found to be above average. The mean scores of the seeking social support and submissive subscales were at a moderate level, while the mean scores of the hopelessness approach subscale were below the moderate level. A moderate positive significant relationship was found between the total mean score of the Psychological Resilience Scale for Adults and the mean scores of the optimistic approach, self-confident approach, submissive approach, and seeking social support subscales of the Ways of Coping Questionnaire.

CONCLUSION

A direct relationship was found between psychological resilience and coping strategies. However, this relationship could not be found with fear of cancer recurrence. It was concluded that the level of psychological resilience and coping strategies among breast cancer survivors can be positively influenced through the implementation of professional interventions aimed at fostering growth, addressing the initial cancer diagnosis, and promoting healthy adaptation.

"Transgenders are not dinosaurs!" Stigma faced by transgender women in their daily lives in India: implications for research and policy

Background

Transgender women face stigma that adversely impacts their mental wellbeing. The stigma can be self-directed (internal), discrimination, violence and hatred directed towards them by others, mostly cis-gender persons (interpersonal stigma) and discrimination faced at the level of institutional arrangements (structural stigma).

Methods

This was an exploratory study that used qualitative methods of data collection (focused group discussions and in-depth interviews) to gather data from consenting adult trans women who lived in the city of Kolkata situated in the eastern state of West Bengal in India.

Results

The findings showed that trans women faced the trauma of non-acceptance and even rejection by their families when they began to express their chosen gender. Their gender non-conforming behaviour made them the butt of ridicule and harassment in school, resulting in many of them not finishing school. This made finding employment difficult. The trans women study participants also faced harassment at the hands of the police and from hospital staff, making them reluctant to approach the police for help and seek treatment from health providers for their physical as well as mental health concerns.

Conclusions

It is important for researchers to be cognizant of the challenges faced by trans women/transgender people while designing and conducting research. It is also important for policymakers to make gender affirming policies to mitigate and eliminate the stigma that transgender people are subject to thereby promoting their wellbeing.

Exploring the perspectives of child health strategy stakeholders on resilience and well-being in children and youths in Singapore: A qualitative study

Resilience has been defined as the capacity of a dynamic system to adapt well to potential threats,1 while mitigating the negative impact of behavioural and physiological changes due to chronic stress,2 and the resumption of positive functioning thereafter.3 Resilience enables one to adapt positively to adversities in life and allows the transformation of toxic stress to tolerable stress. The factors associated with resilience are homogeneous across studies, which are individual attributes such as self-regulation and problem-solving skills, relational attributes such as secure attachment relationships, and connections to school and community.4 This is relevant to the Singaporean context, as the Singapore Mental Health Study conducted from 2016 to 2018 revealed that 1 in 5 youths, aged between 18 and 34 years old have a mental disorder.5 Mental disorders were also reported to be the largest contributor to disease burden for Singaporeans aged 10 to 34 years old, peaking for 15 to 19 year-olds, for whom it represented 25.8% of total disability-adjusted life years (DALYs).5 In 2020, suicide is the leading cause of death for those aged 10 to 29 years old. Parent-child relationships are the focus of resilience studies in how they shape a child’s resilience to bounce back after encountering adversities. Parental influence is key to the resilience and well-being of the child and family systems.6

Resilience in the face of neurodivergence: A scoping review of resilience and factors promoting positive outcomes

Neurodivergent individuals, including a range of conditions impacting neurological function, are at an increased likelihood of poor life outcomes, such as in functional adaptation, mental health, and well-being. Yet, many live meaningful and fulfilling lives. Resilience may provide some explanation for the heterogeneity in outcomes observed in neurodivergent populations. We conducted a scoping review embedded in a neurodiversity-affirmative approach to provide an understanding of resilience in neurodivergent populations. A total of 176 articles were included in this review and were synthesized using a two-phased process. First, findings were synthesized narratively to examine how resilience has been conceptualized and explored in neurodivergent populations. Second, to identify the bio-psycho-social factors important for resilience in neurodivergent individuals, we converted concepts identified in articles to the nomenclature of the World Health Organizations' International Classification of Functioning, Disability and Health (ICF) using a standardized linking process. We find considerable variability in how resilience is conceptualized and measured in neurodivergent populations. We identified 83 unique ICF categories representing resilience factors, of which only 20 appeared in more than 5% of the articles. Identified ICF categories highlight the importance of support systems such as families and friends, community participation and acceptance, and individual capabilities for resilience.

Stress resilience is an active and multifactorial process manifested by structural, functional, and molecular changes in synapses

Stress resilience is the ability of neuronal networks to maintain their function despite the stress exposure. Using a mouse model we investigate stress resilience phenomenon. To assess the resilient and anhedonic behavioral phenotypes developed after the induction of chronic unpredictable stress, we quantitatively characterized the structural and functional plasticity of excitatory synapses in the hippocampus using a combination of proteomic, electrophysiological, and imaging methods. Our results indicate that stress resilience is an active and multifactorial process manifested by structural, functional, and molecular changes in synapses. We reveal that chronic stress influences palmitoylation of synaptic proteins, whose profiles differ between resilient and anhedonic animals. The changes in palmitoylation are predominantly related with the glutamate receptor signaling thus affects synaptic transmission and associated structures of dendritic spines. We show that stress resilience is associated with structural compensatory plasticity of the postsynaptic parts of synapses in CA1 subregion of the hippocampus.

Influencing factors of kinesiophobia in knee arthroplasty patients under the social cognitive theory: A structural equation model

OBJECTIVE

To analyze the path relationships among influencing factors for kinesiophobia in knee arthroplasty patients through a structural equation model.

BACKGROUND

The occurrence of kinesiophobia significantly impacts the rehabilitation process of knee arthroplasty patients. However, there is still a need to determine factors that contribute to reducing kinesiophobia.

DESIGN

A cross-sectional study was conducted and reported following the STROBE guideline.

METHODS

Between February 2022 to October 2022, 162 total knee arthroplasty (TKA) patients and 81 unicompartmental knee arthroplasty (UKA) patients completed a survey. A structural equation modeling (SEM) approach was utilized to analyze the relationships between kinesiophobia and influencing factors (social support, pain resilience, and rehabilitation self-efficacy). Furthermore, multi-group SEM analysis was conducted to examine whether the model equally fitted patients in different types of knee arthroplasty.

RESULTS

The direct negative effects of rehabilitation self-efficacy (β = -0.535) and pain resilience (β = -0.293) on kinesiophobia were observed. The mediating effect (β = -0.183) of pain resilience and rehabilitation self-efficacy between social support and kinesiophobia was also significant. The SEM model achieved an acceptable model fit (χ2 = 35.656, RMSEA = 0.031, χ2/df = 1.230, GFI = 0.972, NFI = 0.982, IFI = 0.997, CFI = 0.996). In multicohort analysis, no significant differences were observed among knee arthroplasties (TKA, UKA) (Δχ2 = 4.213, p = 0.648).

CONCLUSIONS

Satisfactory social support enhances pain resilience and rehabilitation self-efficacy, so as to reduce kinesiophobia. Future interventions that directly target the assessment and management of kinesiophobia, available social support may help reduce kinesiophobia, and pain resilience and rehabilitation self-efficacy may be critical factors in managing kinesiophobia.

RELEVANCE TO CLINICAL PRACTICE

Reducing kinesiophobia in knee arthroplasty patients requires satisfactory social support, pain resilience, and rehabilitation self-efficacy. Therefore, healthcare organizations may implement initiatives to reduce kinesiophobia by taking these factors into account.

Validation of an eight-item resilience scale for inpatients with spinal cord injuries in a rehabilitation hospital: exploratory factor analyses and item response theory

PURPOSE

People with spinal cord injury (PwSCI) can experience life changes, including impacts on their physical and mental health. PwSCI often report less life satisfaction and lower subjective well-being than peers without SCI. These challenges and adversities increase the demand on them to be more resilient. Healthcare providers need quick and valid instruments to assess adult patients' resilience in clinical settings. We aimed to validate the factor validity and discrimination ability of a resilience scale, CD-RISC-10, for clinical usage in adults with SCI during hospitalization.

MATERIALS AND METHODS

93 adults with SCI responded to the self-reported survey, including CD-RISC-10, the Patient Health Questionnaire-9 Scale (PHQ-9), the Satisfaction with Life Scale (SWLS), and the Intrinsic Spirituality Scale. We conducted descriptive statistics, exploratory factor analysis (EFA), and item response theory (IRT).

RESULTS

Two items were deleted from CD-RISC-10 after EFA, forming CD-RISC-8. The item discriminations of the remaining eight items from the unconstrained IRT model ranged from a high of 3.071 to a relatively low 1.433. CD-RISC-8 is significantly related to PHQ-9 and SWLS.

CONCLUSIONS

The factor validity of the CD-RISC-8 was improved. Significantly, the CD-RISC-8 has excellent potential for clinical usage due to its discriminant ability between low and intermediate resilience.

The mediating role of loneliness between psychological resilience and health-related quality of life among patients with nasopharyngeal carcinoma: a cross-sectional study using structural equation modeling

BACKGROUND

Cancer patients' health-related quality of life (HRQoL) has always been a hot discussion spot. Loneliness and psychological resilience are considered to be significant psychosocial factors impacting the HRQoL of the cancer population. However, there is a lack of studies on the interrelationship among loneliness, resilience, and HRQoL in patients with nasopharyngeal carcinoma (NPC). This study aims to explore the relationship between resilience and HRQoL among NPC patients and to recognize the potential mediating role of loneliness in this relationship.

METHODS

A cross-sectional study was performed in this study. A convenience sampling method was conducted to recruit participants. A total of 155 patients with nasopharyngeal carcinoma were required to complete the socio-demographic questionnaire, the Cancer Loneliness Scale (CLS), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the European Organization for Research and Treatment of Quality of Life Questionnaire C-30 (EORTC QLQ-C30) from April 2022 to August 2022 in a tertiary grade A hospital in Guangzhou, China. The multiple linear regression analysis was used to identify influencing factors, and structural equation modeling with the bootstrap method was performed to test the mediating role of loneliness. This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

RESULTS

HRQoL was at a median level among NPC patients, with a mean score of 64.19 (24.38) on the Global health status/quality of life (GHS/QoL) scale. Monthly household income (B = 4.973, P < 0.001), cancer stage (B=-4.342, P = 0.004), psychological resilience (B = 0.914, P < 0.001), and loneliness (B =-1.083, P < 0.001) were independent factors related to HRQoL, explaining 36.7% of the variance of HRQoL. Psychological resilience exerted its direct negative impact on loneliness (β = -0.199, BC95%CI = -0.318/-0.089), and it also had a both direct and indirect positive impact on HRQoL (β = 0.653, BC95%CI = 0.423/0.912; β = 0.142, BC95%CI = 0.046/0.296). Loneliness exerted a partially mediating impact on the relationship between psychological resilience and HRQoL.

CONCLUSIONS

NPC patients with higher monthly household, early stages of cancer, higher resilience, and lower loneliness show a better HRQoL. Resilience has an indirect positive impact on HRQoL by influencing loneliness in NPC patients. It is suggested that healthcare staff should strive to enhancing resilience and reducing loneliness as new strategies to promote NPC patients' HRQoL further.

Boosting happiness in left-behind children: Unveiling the power of physical activity through cognitive reappraisal and psychological resilience

This study examines the mediating roles of cognitive reappraisal (CR) and psychological resilience (PR) in the relationship between physical activity (PA) and subjective well-being (SWB) among left-behind children in China. A cross-sectional design was employed to collect data from 606 students in grades 4-9. The International Physical Activity Questionnaire Short Form (IPAQ-SF), Positive and Negative Affect Scale (PANAS), Satisfaction with Life Scale (SWLS), Emotion Regulation Questionnaire (ERQ), and Adolescent Resilience Scale were used to collect data. The findings revealed a significant direct effect of PA on SWB and identified CR and PR as significant mediators in this relationship. In particular, the findings indicated that PA was associated with enhanced CR and PR, which in turn, were positively linked to SWB. The study elucidated the chain mediation pathway "PA → CR → PR → SWB," thereby underscoring the pivotal roles of CR and PR in the positive impact of PA on SWB among left-behind children. The findings indicate that PA plays a significant role in the SWB of left-behind children, with CR and PR identified as key mediators in this relationship. The study highlights the necessity of promoting PA, in conjunction with strategies to enhance CR and PR, as efficacious interventions for the enhancement of the mental health and well-being of left-behind children.

Characteristics and factors associated with psychotic-like experiences in remission: a cross-sectional study of 4208 college students in China

OBJECTIVES

Previous research has extensively explored the factors associated with psychotic-like experiences (PLEs). However, the characteristics and associated factors of remitted PLEs, which refer to the absence of current PLEs following previous PLEs, remain unclear. Therefore, this study aims to describe the characteristics of adolescents who reported remitted PLEs.

DESIGN

Cross-sectional study.

SETTING

The survey was conducted from October to December 2020 in three colleges located in Guangzhou, China.

PARTICIPANTS

A total of 4208 college freshmen aged from 15 to 24 participated in our survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

The 15-item positive subscale of the Community Assessment of the Psychic Experience was used to assess both lifetime and current PLEs. Multivariate logistic regression models were used to examine the associations between remitted PLEs and a range of demographic factors, lifestyle, psychosocial factors, lifetime affective symptoms and sleep problems.

RESULTS

Three groups of PLEs were observed: non-PLEs (47.27% of the sample), remitted PLEs (40.42%) and current PLEs (12.31%). Several factors have been identified as shared correlates of remission and absence of PLEs, including fewer recent adverse life events, greater resilience, fewer symptoms of depression and anxiety, and early waking. Furthermore, higher levels of social support (OR 1.48, 95% CI 1.01 to 2.17; OR 1.53, 95% CI 1.18 to 1.97) was a specific factor associated with the remission of PLEs. Compared with individuals without PLEs, those with remitted PLEs were more likely to be female (OR 1.50, 95% CI 1.28 to 1.75), less likely to be younger (OR 0.88, 95% CI 0.81 to 0.95) and prone to have more chronic physical illness (OR 1.67, 95% CI 1.29 to 2.16), habitual alcohol intake (OR 1.85, 95% CI 1.19 to 2.88), more childhood trauma (OR for low vs high=0.72, 95% CI 0.57 to 0.91) and the sleep problems of waking up easily (OR 1.36, 95% CI 1.12 to 1.65).

CONCLUSION

These findings suggest that remitted PLEs play a vital, unique role among three groups and provide preliminary targets for the intervention for adolescents at risk of mental health problems. Further investigation may shed light on the causality of the relationship between remitted PLEs and associated factors.

Attentional Processing of Unpleasant Stimuli in Alexithymia

Alexithymia is a multi-faceted personality trait defined by difficulties in identifying and describing emotions and is considered a risk factor for multiple psychiatric disorders. Current alexithymia research debates the type of attention bias involved in the processing of negative emotional information, especially in anxiety-evoking situations that are frequently associated with stress states. Relatedly, this study aims to examine the role of emotional influence on the attentional processing of Taiwanese alexithymic individuals. Using the Chinese version of the Toronto Alexithymia Scale-20 (TAS-20), individuals with high alexithymia (HA: TAS > 60, n = 26; Mage = 23.36) and individuals with low alexithymia (LA: TAS < 39, n = 26; Mage = 25.76) were recruited. Participants performed an emotional counting Stroop task preceded by anxiety-evoking (threatening and aversive pictures) or neutral pictures. Reaction times (RTs) of the emotional Stroop task were compared between HA and LA groups. Our results demonstrate that compared to individuals with LA, individuals with HA show early avoidance tendency (i.e., allocate less attentional resources to anxiety-evoking stimuli), and that negative affect therefore does not interfere with subsequent attention processing during the Stroop task, resulting in faster RT for unpleasant stimuli (Mthreatening = 683.87, Maversive = 685.87) than neutral stimuli (Mneutral = 695.64) (ps < .05). In addition, the attentional bias toward specific types of negative emotion was not differentiated in individuals with HA (p < .05), suggesting that alexithymic individuals' emotion schemas may be underdeveloped in terms of ability to specify exact emotions. This study provides evidence regarding early sensitization to negative stimuli during information processing, consistent with the notion that alexithymia is related to avoidant emotion regulation processes.

Early-Pregnancy Resilience Characteristics before versus during the COVID-19 Pandemic

OBJECTIVE

 Resilience is associated with mental and somatic health benefits. Given the social, physical, and mental health toll of the coronavirus disease 2019 (COVID-19) pandemic, we examined whether the COVID-19 pandemic was associated with population-level changes in resilience among pregnant people.

STUDY DESIGN

 Secondary analysis of a prospective cohort of nulliparous pregnant people <20 weeks' gestation from a single hospital. Participants completed baseline assessments of resilience characteristics, including dispositional optimism (DO), mindfulness, and proactive coping. For this analysis, participants recruited before the COVID-19 pandemic were compared with those recruited during the pandemic. The primary outcome was DO, assessed as a continuous score on the validated Revised Life Orientation Test. Secondary outcomes included continuous scores on mindfulness and proactive coping assessments. Bivariable analyses were completed using chi-squared and Mann-Whitney U tests. Multivariable linear regression compared resilience scores by recruitment time frame, controlling for confounders selected a priori: maternal age, education, and marital status.

RESULTS

 Of the 300 participants, 152 (50.7%) were recruited prior to the pandemic. Demographic and pregnancy characteristics differed between groups: the during-pandemic group was older, had higher levels of education, and were more likely to be married/partnered. There were no significant differences in any of the resilience characteristics before versus during the pandemic in bivariable or multivariable analyses.

CONCLUSION

 In this cohort, there were no differences in early pregnancy resilience characteristics before versus during the COVID-19 pandemic. This affirms that on a population level, resilience is a stable metric, even in the setting of a global pandemic.

KEY POINTS

· Resilience is associated with mental and somatic health benefits.. · No difference in early-pregnancy resilience in those recruited before versus during the pandemic.. · Consistent with conceptualization of resilience as an innate characteristic..

The mediating effect of resilience between physical activity and mental health: a meta-analytic structural equation modeling approach

Background

While the correlation between physical activity (PA) and mental health is well known, the mediating mechanism of resilience between the two variables remains unclear.

Objectives

To systematically evaluate the relationship between PA and mental health, and explore the mediating role of resilience between them.

Methods

A systematic search of electronic databases (PubMed, Web of Science, ProQuest, Ebsco, China Knowledge, and China Biomedical Database) was conducted to identify relevant studies, and meta-analytic procedures were used to assess the strength of the relationships between PA and mental health. Furthermore, a meta-analytic structural equation model (MASEM) was used to assess the mediating effects of resilience, ensuring the reliability of our findings.

Results

The findings of 15 studies (17,043 subjects) were subjected to meta-analysis and route analysis. The findings of the meta-analysis revealed a statistically significant positive correlation of 0.288 (95% CI, 0.166-0.402) between PA and positive indicators of mental health, as well as a statistically significant negative correlation (95% CI, -0.342 to -0.171) with negative indicators of mental health. Furthermore, the results of MASEM path analysis indicated that PA may indirectly impact both positive and negative indicators of mental health through the mediating factor of resilience. The indirect effect values were 0.108 (95% CI, 0.080-0.141) and -0.074 (95% CI, -0.100 to -0.051), respectively, accounting for 40.15% of the total effect value and 28.91%.

Conclusion

Physical activity is positively correlated with positive indicators of mental health and negatively correlated with negative indicators of mental health. Moreover, PA can positively influence mental health through the mediating role of resilience.

Life course and mental health: a thematic and systematic review

OBJECTIVE

This study explored the influence of the life course on mental health by identifying key trends, seminal works, and themes in existing research. Additionally, it highlights the major discussions at the intersection of life course and mental health.

METHODS

Documents were extracted from the Web of Science Core Collection (WoSCC), to systematically analyze themes on mental health outcomes across the life course. The analysis was based on key bibliometric tools, including VOSviewer 1.6.11, R Studio software, and GraphPad Prism 9 to analyze the evolution and impact of scholarly contributions in this domain.

RESULTS

The accumulated body of research concerning the life course's impact on mental health, which began to emerge around 1990 displayed a consistently upward trend. Predominant contributions originate from developed nations and frequently look into the psychosocial determinants of mental health over life course. Life course and mental health studies have been extensively infused with biopsychosocial frameworks that consider the role of genetic makeup, neurodevelopment, cognition, affect, sociocultural dynamics, and interpersonal relationships. Life course theory application in mental health highlight the substantive effects of accumulated adversities, notably social determinants of health, adverse childhood experiences (ACEs), and their implications for subsequent mental health outcomes.

CONCLUSION

The nexus of life course and mental health outcomes demands further scholarly interrogation, particularly within underserved regions, to strengthen protective mechanisms for vulnerable populations.

Modifiable protective factors for mental health resilience in the offspring of depressed parents: A high-risk longitudinal cohort spanning adolescence and adulthood

Background

Several protective factors have been identified for mental health (MH) resilience in adolescent offspring of depressed parents. However, it is unclear if these effects persist into adulthood.

Methods

Depressed parents and their offspring (N = 188) from the Early Prediction of Adolescent Depression study were assessed four times (mean offspring ages 12.39, 13.77, 14.82, and 23.41). Mental health resilience was examined using residual scores (better-than-expected mood-, behaviour-, or anxiety-related MH at mean age 23 given risk exposure), and categorically as sustained good MH across adolescence and young adulthood.

Results

Only 9.2% of young adults demonstrated sustained good MH. Parents of resilient individuals showed lower comorbidity (anxiety, antisocial behaviour and harmful drinking) and higher depression remission. Considering adolescent protective factors, weak evidence was observed of associations of mood-resilience with adolescent peer-relationship quality (β = -0.20, 95%CI:-0.36, -0.04); friendship quality (β = -0.14, 95%CI:-0.31, 0.02); risk adjustment (β = -0.16, 95%CI:-0.34, 0.03) and dysfunctional attitudes (β = 0.18, 95%CI:0.01, 0.35). There was weak evidence of behavioural-resilience association with parent positive expressed emotion (β = -0.15, 95%CI:-0.31, 0.02) and offspring exercise (β = -0.37, 95%CI:-0.77, 0.03). No adolescent protective factors showed an association with anxiety-resilience. For sustained good MH, there was weak evidence of an association with inhibitory control (OR = 0.39, 95%CI:0.14, 1.07). Strong evidence was observed for associations between young adult-reported peer relationship quality and mood-resilience (β = -0.35, 95%CI:-0.53, -0.17), behavioural-resilience (β = -0.33, 95%CI:-0.51, -0.14) and anxiety-resilience (β = -0.34, 95%CI:-0.53, -0.14), while weak evidence was observed of an association of social activities with anxiety-resilience (β = -0.51, 95%CI:-0.97, -0.06).

Conclusions

We found limited evidence for the long-lasting effects of adolescent protective factors on adult MH resilience. Social factors remained protective into young adulthood, while family factors did not. Early preventative intervention might not be sufficient to maintain good long-term MH, and young people will likely require more prolonged support.

The relationships between quality of life with health literacy, social support and resilience in older stroke survivors: A structural equation model

AIM

To the determinants and the underlying mechanism of health literacy, social support, and resilience on the health-related quality of life (HRQoL) among older stroke survivors.

DESIGN

A cross-sectional design was applied at four comprehensive hospitals in Chongqing via convenience sampling from January 2020 to June 2021.

METHODS

Health literacy, social support, and resilience were designed as independent variables, and HRQoL was measured as a dependent variable. Structural equation modelling with the bootstrap method was used to test the hypotheses.

RESULTS

The theoretically derived model exhibited a good fit (χ2/df ratio = 2.830, GFI = 0.987, CFI = 0.978, RMSEA = 0.066). Health literacy (β = 0.12, p < 0.05) and social support (β = 0.14, p < 0.05) directly affect HRQoL. Resilience (β = 0.40, p < 0.01) also mediated the relationship between health literacy, social support, and HRQoL. The three variables explaining 29.0% of HRQoL variance.

PATIENT OR PUBLIC CONTRIBUTION

There was no direct patient or public involvement in the design, conduct, or reporting of this study. Participants were recruited through convenience sampling from four comprehensive hospitals in Chongqing, and their perspectives or contributions were not explicitly sought. The study focused on examining the determinants and underlying mechanism of health literacy, social support, and resilience on the health-related quality of life among older stroke survivors. Nonetheless, the findings of this research may inform the development of interventions aimed at improving the health-related quality of life in post-stroke older patients.

Prevalence of harassment, abuse, and mental health among current and retired senior Swedish cheerleaders

This study examined the prevalence of non-accidental violence, focusing on experienced harassment and abuse (HA), and mental health among current and retired Swedish competitive cheerleaders. An online survey was distributed to current and retired athletes in the Swedish cheerleading federation. The survey assessed perceived coach-athlete relationship, sport psychological safety, resilience, mental health, and experienced HA within the cheerleading environment. A total of 284 athletes (men = 5; women = 278; gender not disclosed = 1; current athletes = 211; retired athletes = 73) completed the survey. Psychological abuse was the most frequently reported HA form (current athletes = 21.6%; retired athletes = 53.5%), followed by neglect (current athletes = 5.4%; retired athletes: 26.8%) and physical abuse (current athletes = 3.9%; retired athletes = 12.7%). A high-quality coach-athlete relationship was identified as a protective factor for HA. Additionally, 33.1% and 8.9% of participants displayed scores indicating anxiety and depression caseness, while 63.8% reported a high level of wellbeing. Anxiety/depression scores above clinical cut-off were linked to injury episodes and a high level of wellbeing to a mentally healthy environment. Resilience was found to protect mental health overall. The high occurrence of reported psychological abuse and indications of anxiety/depression related to injury episodes suggest a need of attention towards prevention and athlete protection strategies in cheerleading environments.

The chain mediating effects of resilience and perceived social support in the relationship between perceived stress and depression in patients with COVID-19

Introduction

Perceived stress and depression were indirect effects of the COVID-19 pandemic, especially in square-cabin hospitals. It was paramount to understand their mediating effects, which might detonate factors that led to mental illness.

Materials and methods

We conducted a cross-sectional study to investigate perceived stress and depressive symptoms among patients with COVID-19 in Shanghai square-cabin hospitals from April 18 to May 19, 2022. The questionnaire included the Perceived Stress Scale 10, Patient Health Questionnaire 9, Perceived Social Support Scale, and the Connor-Davidson Resilience Scale 10.

Results

This study investigated the chain-mediating roles of perceived social support and resilience in the relationship between perceived stress and depression. Perceived stress positively predicted depression (r = 0.613, p < 0.01), negatively correlated with perceived social support (r = -0.318, p < 0.01) and resilience (r = -0.398, p < 0.01). In the chain mediating model, perceived stress had significant direct predictive effects on depression, and significant indirect predictive effects on depression through perceived social support and/or resilience.

Conclusion

It showed that higher perceived social support and resilience were associated with lower perceived stress among COVID-19 patients, which might lead to symptoms of mild depression, and highlights the importance of resilience and perceived social support in reducing depressive symptoms.