How resilience is strengthened by exposure to stressors: the systematic self-reflection model of resilience strengthening

Stepping back or stepping in: A qualitative investigation of self-distanced versus self-immersed stressor reflections with competitive swimmers

High performance sport consists of stressor events which can disrupt an athletes' functioning and negatively influence performance. The way in which one reflects upon stressor events and develops insights regarding how they coped is essential to overcoming similar experiences in the future. We conducted a pilot randomised controlled trial with a qualitative analysis to explore the coping insights among 48 highly trained/national level swimmers in the lead up to major swimming competitions, who reflected on stressor events from self-distanced or self-immersed perspectives over a 3-week period. Using the self-reflection and coping insight framework as a guideline, we captured divers coping insights across both groups. Irrespective of the group to which they were assigned, athletes showed positive signs towards re-interpreting their stressor experience and embracing the stressor event, whereas consideration of individual values and adoption of a future-focus viewpoint were areas lacking. The emotionality described by athletes in their written reflections varied across both groups and influenced the development of coping insights. Our findings indicate a necessity to examine the emotionality associated with unique stressor events and consider integrating reflection strategies, while also enhancing the operational definitions within conceptual models of stress reflection protocols.

A randomized controlled trial comparing the effects of self-reflective writing focused on successful and unsuccessful coping experiences on resilience

Evidence supports the effectiveness of self-reflective training approaches for the development of resilience. Building this work, the objective of this study was to investigate the impact of the focus of coping self-reflective activities on resilience by applying a self-reflection approach to a sample of 254 Australian ministry workers. This randomized controlled trial included three attention-matched conditions: (1) self-reflective writing focused on successful coping, (2) self-reflective writing focused on unsuccessful coping or (3) written descriptions of stressor events alone. Participants were assessed across four time points: prior to, immediately post, 3-months, and 6-months after the intervention. Results demonstrated that self-reflective writing was more effective in enhancing perceived resilience than descriptive writing. Analyses also showed greater maintenance of beneficial effects in the successful self-reflection condition, compared to the unsuccessful condition. These findings support the use of self-reflection training to strengthen individuals' psychological resilience, particularly when focused on successful coping situations for those who initially experience more ruminative thought.

A coping self-insight scale for adults: development and preliminary psychometric properties

BACKGROUND

Self-insights focused on the coping process are implicated in the refinement of capacities for resilience. To advance this research, we must identify key coping self-insights and develop a concise measurement tool.

OBJECTIVE

The purpose of this paper is to develop evidence for the construct dimensionality and validity of a measure of coping self-insight.

METHODS

Items measuring 13 coping self-insight dimensions were generated via consultation with theoretical work, subject matter experts, and pre-testing items for clarity. Thereafter, the dimensionality of items was assessed with undergraduate students (N = 232) and an online sample (N = 800) via exploratory and confirmatory analyses. Finally, a multi-trait, multi-method approach was used to test discriminant validity in a further sample of students (N = 228).

RESULTS

The initial item list was reduced to five key dimensions that balanced data-driven and conceptual considerations. Confirmatory Factor Analysis revealed moderate-to-strong correlations (r = .47-.80) among dimensions. We also demonstrated evidence of internal reliability, convergent, criterion, and discriminant validity. Invariance tests for sub-groups of interest (e.g., sex, sample type) frequently demonstrated metric or scalar invariance, except for age sub-groups.

CONCLUSIONS

Findings offer a starting point regarding the types of coping self-insights important for the emergence of resilience and a validated tool for future research.

When there is no justice, we need an old HERO. The trickle-down effect of psychological capital: the moderating role of organizational justice and leaders' age

The objective of the study was to explore the impact of leaders' ages and followers' perceptions of organizational justice (POJ) on the transfer of psychological capital (PsyCap) from leaders to followers, particularly examining how employees' resilience is influenced by leaders' PsyCap. While some evidence exists regarding PsyCap's trickle-down effect, the specific circumstances triggering this phenomenon remain unclear. This study investigates the relationship between followers' and leaders' PsyCap, employing the Social Cognitive Theory and considering the moderating effects of leaders' age and POJ. The study focused on leader-follower dyads within a randomly selected sample of 406 businesses, encompassing 812 respondents. The survey investigation utilized the CAPI approach. The hypothesized model underwent testing through multilevel dyadic regression analysis, employing an actor-partner interdependence model. The findings support two moderators -employees' POJ and managers' age - and highlight the cross-over effect of PsyCap. Specifically, a stronger trickle-down link is observed when a leader is older and operating within a low POJ environment. Additionally, the study revealed a positive correlation between employees' PsyCap and POJ. The development of POJ enhances employees' PsyCap and resilience, while leaders' PsyCap may compensate for organizational POJ deficiencies. This study is among the first to explore PsyCap's moderators, specifically analyzing leaders' ages and POJ as factors influencing the cross-over effect of PsyCap. By identifying previously unrecognized moderators affecting the cross-over PsyCap effect, this research contributes significantly to the PsyCap literature.

Rumination, Basic Beliefs, and Posttraumatic Growth in Cancer Patients: A Moderated Mediation Model

BACKGROUND

Cancer is a highly distressing and traumatic experience that can significantly impact individuals' psychological well-being. Whereas many cancer patients may experience negative psychological outcomes, such as posttraumatic stress symptoms, a subset of individuals also reports positive psychological changes known as posttraumatic growth.

OBJECTIVE

To contribute to theory-driven development of these treatments by exploring the role of deliberate rumination in posttraumatic growth, along with the basic beliefs that might shape it.

METHODS

A sample of cancer patients (n = 139) completed self-report measures assessing rumination, basic beliefs, and posttraumatic growth. Multiple linear regression analyses and moderated mediation models were conducted to analyze the data.

RESULTS

Findings support the hypothesis that intrusive rumination, deliberate ruminating, and disruption in basic beliefs strongly predict posttraumatic growth in cancer survivors. The results of this simple mediation indicate that deliberate rumination has a full mediating role. The results show that at all levels of basic beliefs, there is a positive and statistically significant indirect effect of intrusive rumination on posttraumatic growth.

CONCLUSIONS

These findings highlight the importance of addressing rumination and core beliefs in interventions aimed at promoting posttraumatic growth among cancer patients. Further research is needed to explore additional factors that may influence the relationship between rumination, basic beliefs, and posttraumatic growth.

IMPLICATIONS FOR PRACTICE

Oncology nurses can assist individuals in recognizing and managing intrusive rumination, as well as advocating deliberate rumination as a constructive cognitive process for making sense of a traumatic event and fostering growth.

Are we really studying resilience in sport? A critical review of adopted methodologies

Psychological resilience has gained considerable attention in sport. Nevertheless, the construct often remains poorly understood and multiple conceptual and methodological issues pervade the literature. The purpose of the present article is to provide a critical review of the commonly adopted methodologies to study resilience in sport. This review is divided into four sections. The first section will briefly discuss opposing conceptualizations of resilience as a static trait or a dynamic process. The second section will then discuss key methodological implications relating to the conceptualization of resilience as a dynamic process. In the third section, common methodologies to study resilience in sport are presented and critically reviewed. These methodologies are broadly divided into: (i) self-report resilience measures, (ii) qualitative research, and (iii) direct assessment of functioning in relation to observed adversity. In the final section, some avenues for future research are offered.

Perceived stress of mental demands at work, objective stress and resilience - an analysis of the LIFE-Adult-study

BACKGROUND

So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level.

OBJECTIVE

The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience.

METHOD

A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work.

RESULTS

According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload.

CONCLUSION

Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.

A Mixed Methods Investigation on the Relationship Between Perceived Self-Regard, Self-Efficacy, and Commitment to Serve Among Military Medical Students

INTRODUCTION

Routinely faced with potentially traumatizing situations, resilience is critical for military physicians. However, related studies are limited in scope. The current study distinctively combines hyper-realistic immersion training for military medical students with emotional intelligence and hardiness measures. With self-reflection shown to improve performance, qualitative inquiry was concurrently conducted in a mixed methodology approach to provide a uniquely comprehensive perspective on the resilience training needs of this population.

MATERIALS AND METHODS

Thirty-four osteopathic military medical students participated in a week-long training simulating real-life combat and mass casualty events. The Emotional Quotient-Inventory 2.0 (EQ-i 2.0) and Hardiness Resilience Gauge were administered as pre- and post-test measures. Paired t-tests were used to determine statistically significant gains, and a multiple case study analysis of a six-student focus group allowed for the synchronization of quantitative and qualitative data. Institutional Review Board approval for the study was obtained through Rocky Vista University with a reciprocal agreement with Touro University California's Institutional Review Board. All students participating in the study received written informed consent.

RESULTS

Qualitative findings for this study aligned with this current year's findings of statistically significant results in the improvement of the Overall EQ-i and Overall Hardiness. Qualitative responses thematically analyzed demonstrated environmental realism, adaptation, increased awareness, and positive interpersonal and clinical outlook. Notable increases occurred in all EQ-i domains except Decision-Making and Stress Tolerance. The Self-Perception domain saw significant increases in Self-Regard and Emotional Self-Awareness while Well-Being and Optimism simultaneously improved.

CONCLUSION

This unique pilot study showed that quantitative and qualitative results aligned, supporting the finding that a safe trauma-related training environment can improve the confidence and resilience in military medical students. The goal of this training was to promote resilience and mitigate trauma. Results demonstrate improved self-efficacy and enhanced commitment. Increases in self-awareness and confidence made participants more inclined to see their worth and strengthened their sense of duty as described in their qualitative responses. Pervasive gains suggest that the training aligned well with its purpose, and the methods employed enhanced participant experience. Long-term follow-up studies are needed to assess outcome sustainability.

The impact of global health outreach experiences on medical student burnout

BACKGROUND

Student burnout during medical education is a prevalent and critical problem. Burnout has reaching consequences, including negative health outcomes for students, financial loss for schools, and worsened patient care as students transition to practice. Global Health Outreach Experiences (GHOEs), known to enhance cultural awareness and clinical knowledge among medical students, are offered in most programs. Prior studies document that GHOEs benefit physicians suffering from burnout, with effects demonstrating improvement over 6 months. No study, to our knowledge, has assessed the influence GHOEs may have on medical student burnout with a comparable control group. This study examines whether participation in a GHOE, compared to a standard break from school, has a positive effect on burnout.

METHODS

A case control study utilizing the Copenhagen Burnout Inventory was conducted on medical students. 41 students participated in a one-week, spring break GHOE and 252 were randomly selected as non-participating students in a control group. Assessments were gathered 1 week prior, 1 week after, and 10 weeks after spring break. Response across the surveys in chronological order included 22, 20, 19 GHOE and 70, 66, 50 control participants.

RESULTS

A significant reduction in personal burnout (PB) (P = 0.0161), studies related burnout (SRB) (P = 0.0056), and colleagues related burnout (CRB) (P = 0.0357) was found among GHOE attendees compared to control participants at 10-weeks after spring break. When modeled with potential confounders, CRB and SRB reductions remained significant.

CONCLUSION

GHOEs may be a potential tool for institutions to combat burnout rates in their students. The benefits of GHOEs appear to enhance over time.

The Impact of a Psychoeducational Group Program on the Mental Well-Being of Unit-Based Nurse Leaders: A Randomized Controlled Trial

This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout and enhance purposeful adaptive coping to reduce distress and improve mental wellbeing. The sample included 77 unit-based nurse leaders. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout, and job satisfaction. Paired samples t-tests and repeated measures ANOVA tests were conducted to compare outcomes at baseline to the follow-up timepoints of endpoint, one-month follow-up, three-month follow-up, and six-month follow-up. The intervention group participants showed significant improvement in post-traumatic growth between baseline and all follow-up timepoints compared to the waitlist control group. Among intervention group participants, there were also significant improvements in self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction, as well as significant reductions in perceived stress, burnout, and secondary traumatic stress. This study extends existing evidence that this psychoeducational group program can be an effective intervention for improving and protecting mental wellbeing. Among nurse leaders, it can reduce stress and burnout and improve post-traumatic growth, self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction.

How Reflective Automated e-Coaching Can Help Employees Improve Their Capacity for Resilience: Mixed Methods Study

BACKGROUND

An eHealth tool that coaches employees through the process of reflection has the potential to support employees with moderate levels of stress to increase their capacity for resilience. Most eHealth tools that include self-tracking summarize the collected data for the users. However, users need to gain a deeper understanding of the data and decide upon the next step to take through self-reflection.

OBJECTIVE

In this study, we aimed to examine the perceived effectiveness of the guidance offered by an automated e-Coach during employees' self-reflection process in gaining insights into their situation and on their perceived stress and resilience capacities and the usefulness of the design elements of the e-Coach during this process.

METHODS

Of the 28 participants, 14 (50%) completed the 6-week BringBalance program that allowed participants to perform reflection via four phases: identification, strategy generation, experimentation, and evaluation. Data collection consisted of log data, ecological momentary assessment (EMA) questionnaires for reflection provided by the e-Coach, in-depth interviews, and a pre- and posttest survey (including the Brief Resilience Scale and the Perceived Stress Scale). The posttest survey also asked about the utility of the elements of the e-Coach for reflection. A mixed methods approach was followed.

RESULTS

Pre- and posttest scores on perceived stress and resilience were not much different among completers (no statistical test performed). The automated e-Coach did enable users to gain an understanding of factors that influenced their stress levels and capacity for resilience (identification phase) and to learn the principles of useful strategies to improve their capacity for resilience (strategy generation phase). Design elements of the e-Coach reduced the reflection process into smaller steps to re-evaluate situations and helped them to observe a trend (identification phase). However, users experienced difficulties integrating the chosen strategies into their daily life (experimentation phase). Moreover, the identified events related to stress and resilience were too specific through the guidance offered by the e-Coach (identification phase), and the events did not recur, which consequently left users unable to sufficiently practice (strategy generation phase), experiment (experimentation phase), and evaluate (evaluation phase) the techniques during meaningful events.

CONCLUSIONS

Participants were able to perform self-reflection under the guidance of the automated e-Coach, which often led toward gaining new insights. To improve the reflection process, more guidance should be offered by the e-Coach that would aid employees to identify events that recur in daily life. Future research could study the effects of the suggested improvements on the quality of reflection via an automated e-Coach.

Effect of a Four-Week Soccer Training Program Using Stressful Constraints on Team Resilience and Precompetitive Anxiety

The present study examined the effects of stressful constraints during soccer trainings on psychological skill development and internal load when compared with control (nonstressful) trainings. A total of 51 elite male youth soccer players (27 in the experimental group, M = 16.54 years; 24 in the control group, M = 15.44 years) participated in the study. In a 12-week longitudinal survey, team resilience, using the Spanish version of the Characteristics of Resilience in Sports Teams Inventory, and anxiety, using the Sport Anxiety Scale, were measured at baseline (after 4 weeks of regular trainings), postprotocol (after 4 weeks of control or experimental trainings), and follow-up (after 4 weeks of regular trainings). Results show that, when compared with the control group, a program with stressful constraints helped young soccer players to develop better psychological skills: specifically, increased ability to cope with impairments in resilience (both resilience characteristics and team vulnerability under pressure; p < 0.001). Increases in anxiety (p = 0.06) and decreases in preoccupation (p < 0.001) and lack of concentration (p < 0.001) were also observed. The adaptation of human behavior to specific trainings may explain these results. In conclusion, the regular exposure of young soccer players to stressful situations during trainings shows benefits for their psychological skill development in soccer. Then, benefits on internal load were also observed.

Factors Associated With Resilience During Long-Term Hemodialysis

BACKGROUND

Resilience has been associated with greater adherence to treatment, better outcomes, and improved quality of life (QOL) in people with chronic health conditions. This study aimed to identify sociodemographic, treatment accessibility-related, clinical, and psychological variables associated with resilience in patients with advanced chronic kidney disease (CKD) undergoing long-term hemodialysis (>6 months).

METHODS

This was a multicenter, cross-sectional, and correlational study. The instruments used were the Spanish versions of the Connor-Davidson Resilience Scale, the Perceived Stress Scale-10, and the Kidney Disease Quality of Life-36. The participants were categorized as resilient (with a score of ≥49.37 on the Connor-Davidson Resilience Scale) or nonresilient. Binary logistic regression analysis was performed to identify variables with predictive power for the group with the resilient profile.

RESULTS

Perceived stress, general QOL, and subcomponents of QOL, such as the physical component and burden of kidney disease, were identified as factors related to the resilient profile.

DISCUSSION

Identifying the factors related to resilient adjustment in patients with advanced CKD may assist health caregivers in improving adherence to treatment, treatment outcomes, and QOL.

The sporting resilience model: A systematic review of resilience in sport performers

We systematically reviewed resilience research in sport and exercise psychology. Sample included 92 studies comprising empirical qualitative and quantitative studies, mixed-method studies, review studies and conceptual/theoretical studies on psychological resilience in sports context. From the findings, we synthesized an evidence-based sport-specific definition and meta-model of "Sporting Resilience." The review incorporates evidence from global culture contexts and evidence synthesized into the new definition and meta-model to achieve its aim. Conceptual detail and testability of the operational definition is provided. Sporting resilience provides a guiding framework for research and applied practice in a testable, objective manner. The new theoretical meta-model of resilience is derived from systematic evidence from sport psychology with theoretical considerations from positive and clinical psychology allowing generalizability. This original theory posits that there is a resilience filter comprised of biopsychosocial protective factors. The strength of this filter determines the impact of adversity and establishes the trajectory of positive adaptation. The findings of the review are used to discuss potential avenues of future research for psychological resilience in sports psychology.

Systematic review registration

https://doi.org/10.17605/OSF.IO/AFWRU.

The coping insights evident through self-reflection on stressful military training events: Qualitative evidence from self-reflection journals

Research has demonstrated that adaptive forms of self-reflection on stressor events and insight may strengthen resilient capacities. However, the coping insights that emerge during self-reflection are notoriously under-researched. In this research, we sought to explore the evidence for the self-reflective activities and coping insights drawn from the Self-Reflection and Coping Insight Framework and find evidence of new reflections or insights not captured within the framework. Qualitative analysis was used to examine weekly, written self-reflective journals completed by Officer Cadets involved in a randomised-controlled trial of Self-Reflection Resilience Training. Sixty-eight Officer Cadets who submitted their journals for analysis were included. Journals were analysed using a deductive thematic approach. Findings revealed that self-reflective activities occurred frequently over the course of the intervention. Coping insights were comparatively less frequent, but conveyed complex ideas about the self in the context of stressor exposure, broad principles about stress and coping, and nuanced interpretations regarding the interaction between the efficacy of coping approaches and broader contextual and intrapersonal factors. These findings demonstrate the critical role of coping insight during Self-Reflection Resilience Training, with implications for developing a validated self-report measure of self-reflective activity and coping insight.

Exploring the Association Between Resilience and Quality of Life Among Glaucoma Patients: Sleep Disturbance as a Mediating Factor

BACKGROUND

Patients with glaucoma may experience many symptoms such as blindness, which seriously affect their quality of life (QoL). Resilience is playing a vital role in enhancing the QoL and well-being of patients with chronic diseases. In addition, sleep disturbance is common in patients with glaucoma, leading to a decline in their QoL. However, there is a dearth of research on whether sleep disturbance plays a mediating role between resilience and QoL among glaucoma patients.

OBJECTIVE

The aim of this study is to explore the role of sleep disturbance in the relationship between resilience and QoL among glaucoma patients.

METHODS

From July to December 2019, a cross-sectional survey was conducted on 215 glaucoma patients in an ophthalmic hospital in Liaoning Province. Hierarchical multiple regression (HMR) analyses and structural equation modeling (SEM) were conducted to examine the factors related to QoL and to test the hypothesis that sleep disturbance mediates the relationship between resilience and QoL among glaucoma patients.

RESULTS

The average QoL score among glaucoma patients was 43.85 ± 14.97 as reported by the Glaucoma Quality of Life-15 (GQL-15) scale, where a higher scores indicating a poorer QoL. Resilience was found to be linked with a lower QoL score (P < 0.01), while sleep disturbance was associated with a higher QoL score (P < 0.01). When sleep disturbance was included in the model as partial mediator, the path coefficients for the association between resilience and QoL score was significantly decreased (a*b = -0.1, BCa95% CI: -0.154∼-0.045).

CONCLUSION

Findings of this study reflected that QoL among glaucoma patients in China was poor. Resilience was found to be an important positive factor, which could result in the improvement of QoL. Furthermore, sleep disturbance mediated the relationship between resilience and QoL among patients with glaucoma, thereby reducing the positive impact of resilience on QoL in glaucoma patients. Efforts to improve QoL among glaucoma patients may benefit from interventions that enhance the levels of resilience and promote healthy sleep.

Professionalism, Resilience and Reflective Thinking: How Do These Influence Occupational Therapy Student Fieldwork Outcomes?

The relationship between entry-level, undergraduate occupational therapy students' fieldwork performance and measures of professionalism, reflective thinking and resilience was examined. A group of 135 undergraduates (86% female) completed a self-report questionnaire containing the standardized instruments measuring professionalism, resilience and reflective thinking. The Australian Student Practice Evaluation Form-Revised (SPEF-R) measured fieldwork performance. Linear regression analyses identified Staying Healthy and Relationships with Others as significant predictors of students' fieldwork performance in Professional Behaviors, Self-Management and Information Gathering. The findings highlight the importance of interpersonal skills and engagement in healthy lifestyles in key fieldwork performance areas.

The effectiveness of self-distanced versus self-immersed reflections among adults: Systematic review and meta-analysis of experimental studies

Stressor events can be highly emotional and disruptive to our functioning, yet they also present opportunities for learning and growth via self-reflections. Self-distanced reflections in which one reasons about target events in ways that maximise their removal of the current self from the experiential reality are said to facilitate this reflective process. We tested the expectation that self-distanced reflections offer an advantage over self-immersed vistas via a pre-registered systematic review of seven electronic databases (Scopus, Medline, Web of Science, PsycInfo, CINAHL Plus, Embase, and ProQuest Dissertations and Theses Global) to identify experimental tests with adults aged 18-65 years where the focus of the reflection was a stressor or adverse event that participants had already experienced. A three-level, random effects meta-analysis of 25 experiments (N = 2,397, 68 effects) revealed a small-to-moderate advantage of self-distanced reflections (g = 0.19, SE = 0.07, 95% CI [0.05, 0.33]) and were most effective when they targeted a stressor experience that emphasised one's emotional state or lifetime. Nevertheless, our assessment of the overall quality of evidence including risk of bias suggested uncertainty regarding the benefit of this pragmatic self-regulatory tactic and therefore the need for future high-powered, high-quality experiments.

Association of Self-reflection With Cognition and Brain Health in Cognitively Unimpaired Older Adults

BACKGROUND AND OBJECTIVES

Self-reflection (the active evaluation of ones thoughts, feelings, and behaviors) can confer protection against adverse health outcomes. Its effect on markers sensitive to Alzheimer disease (AD), however, is unknown. The primary objective of this cross-sectional study was to examine the association between self-reflection and AD-sensitive markers.

METHODS

This study used baseline data from cognitively unimpaired older adults enrolled in the Age-Well clinical trial and older adults with subjective cognitive decline from the SCD-Well clinical trial. In both cohorts, self-reflection was measured via the reflective pondering subscale of the Rumination Response Scale, global cognition assessed via the Preclinical Alzheimer's Cognitive Composite 5, and a modified late-life Lifestyle-for-Brain-Health (LIBRA) index computed to assess health and lifestyle factors. In Age-Well, glucose metabolism and amyloid deposition were quantified in AD-sensitive gray matter regions via fluorodeoxyglucose- and AV45-PET scans, respectively. Associations between self-reflection and AD-sensitive markers (global cognition, glucose metabolism, and amyloid deposition) were assessed via unadjusted and adjusted regressions. Furthermore, we explored whether associations were independent of health and lifestyle factors. To control for multiple comparisons in Age-Well, false discovery rate-corrected p values (p _FDR) are reported.

RESULTS

A total of 134 (mean age 69.3 ± 3.8 years, 61.9% women) Age-Well and 125 (mean age 72.6 ± 6.9 years, 65.6% women) SCD-Well participants were included. Across unadjusted and adjusted analyses, self-reflection was associated with better global cognition in both cohorts (Age-Well: adjusted-β = 0.22, 95% CI 0.05-0.40, p _FDR = 0.041; SCD-Well: adjusted-β = 0.18, 95% CI 0.03-0.33, p = 0.023) and with higher glucose metabolism in Age-Well after adjustment for all covariates (adjusted-β = 0.29, 95% CI 0.03-0.55, p _FDR = 0.041). Associations remained following additional adjustment for LIBRA but did not survive false discovery rate (FDR) correction. Self-reflection was not associated with amyloid deposition (adjusted-β = 0.13, 95% CI -0.07 to 0.34, p _FDR = 0.189).

DISCUSSION

Self-reflection was associated with better global cognition in 2 independent cohorts and with higher glucose metabolism after adjustment for covariates. There was weak evidence that relationships were independent from health and lifestyle behaviors. Longitudinal and experimental studies are warranted to elucidate whether self-reflection helps preserve cognition and glucose metabolism or whether reduced capacity to self-reflect is a harbinger of cognitive decline and glucose hypometabolism.

TRIAL REGISTRATION INFORMATION

Age-Well: NCT02977819; SCD-Well: NCT03005652.

Stressor reflections, sleep, and psychological well-being: A pre-registered experimental test of self-distanced versus self-immersed reflections

Evidence supports the effectiveness of cuing people to analyse negative autobiographical experiences from self-distanced rather than self-immersed perspectives. However, the evidence on which this expectation resides is limited largely to static snapshots of mean levels of cognitive and emotional factors. Via a pre-registered, randomised controlled trial (N = 257), we examined the differential effectiveness of self-distanced relative to self-immersed reflections on mean levels and within-person variability of sleep duration and quality as well as psychological well-being over a 5-day working week. Except for sleep quality, we found that reflecting from a psychologically distanced perspective, overall, was no more effective for mean levels and within-person variability of sleep duration, well-being, and stress-related factors than when the current self is fully immersed in the experiential reality of the event. We consider several substantive and methodological considerations (e.g., dosage, salience of stressor event) that require interrogation in future research via experimental and longitudinal observational methods.

An Exploration of Resiliency Among Nurse Educators During the COVID-19 Pandemic

AIM

The purpose of this study was to explore resilience among nursing faculty during the COVID-19 pandemic and to examine associations or differences that may exist among variables and between groups.

BACKGROUND

Nurse educators' resilience has been identified as an important characteristic because of the challenges involved in nursing education. It is important to explore resilience among nurse educators to determine which factors promote or inhibit this important characteristic.

METHOD

This correlational research study used an online survey to explore factors related to resilience among nurse faculty during the COVID-19 pandemic. Correlational analyses were used to determine the relationship between various resilience constructs and select demographic variables.

RESULTS

Findings indicated that higher levels of resilience were associated with age (ρ = .21, p < .001), experience teaching online ( r = .22, p < .001), and professional development related to online teaching ( M = 80.7, SD = 11.0), t (276) = 2.41, p = .017.

CONCLUSION

Resilience and related characteristics have the potential to assist nurse educators in adapting successfully to stressful circumstances. It is crucial that schools of nursing develop programs to enhance or develop resilience among nurse educators. Support and training in the area of online education are also of paramount importance.

It's worth the trouble: Stressor exposure is related to increased cognitive reappraisal ability

Recent theories propose moderate (compared to high or no) stressor exposure to promote emotion regulation capacities. More precisely, stressful situations are expected to serve as practice opportunities for cognitive reappraisal (CR), that is, the reinterpretation of a situation to alter its emotional impact. Accordingly, in this study, we expect an inverted U-shaped relationship between exposure to daily hassles and performance in a CR task, that is, best reappraisal ability in individuals with a history of moderate stressor exposure. Participants (N = 165) reported the number of daily hassles during the last week as indicator of stressor exposure and completed the Script-based Reappraisal Test (SRT). In the SRT, participants are presented with fear-eliciting scripts and instructed to either downregulate negative affect via reappraisal (reappraisal-trials) or react naturally (control-trials). Two measures indicate CR ability: (1) reappraisal effectiveness, that is, the difference between affective ratings in reappraisal- and control-trials and (2) reappraisal inventiveness, that is, the number of valid and categorically different reappraisal thoughts. Multiple regression analyses revealed positive linear, but not quadratic, relationships of exposure to daily hassles and both indicators of CR ability. Potential benefits of stressor exposure for emotion regulation processes are discussed.

Identifying the Barriers to Incorporating Reflective Practice into a Veterinary Curriculum

A portfolio with good reflective content can play a large role in learning and setting up the lifelong learning practice required by veterinary surgeons in practice or in research. The aim of this project was to investigate students' experience with their reflective diaries within an electronic portfolio (e-portfolio). Focus groups were conducted with veterinary students at the University of Liverpool in years 1-4 to explore student perceptions of the e-portfolio, with an emphasis on reflection. Three themes emerged from the qualitative analysis: assessment, understanding the assignment (i.e., is it a useful and fair exercise?), and student well-being (i.e., stress, professional accountability, anxiety). Students had clear concerns about the assessment and did not see the relevance of the reflective diaries to their future career and learning. This has led the university's School of Veterinary Science to restructure the reflections on professional skills in the portfolio.

Relationship Between Perceived Parental Academic Expectations and Students' Self-Regulated Learning Ability: A Cross-Sectional Study

In the field of self-regulated learning ability for college students, prior research usually neglected the role of parents when considering the physical distance between college and home. Indeed, an underlying describable driving force of learning remains embedded in the relationship between parents and students, even at the college stage. This study aimed to explore the relationships among perceived parental academic expectations, mastery goal orientation, self-reflection, and self-regulated learning ability of college students. Mediation and moderated mediation analyses were employed to analyze a sample of 691 college students. The results indicate that mastery goal orientation partially mediates the relationship between perceived parental academic expectations and self-regulated learning. In addition, self-reflection moderates the relationship between perceived parental academic expectations and self-regulated learning. The positive correlation between perceived parental academic expectation and self-regulated learning is stronger for students with low self-reflection than those with high self-reflection.

The Effects of the Solution-Focused Model on Anxiety and Postpartum Depression in Nulliparous Pregnant Women

Background

Solution-focused model (SFM) is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression (PPD) in nulliparous pregnant women compared with routine care services.

Methods

We chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale (EPDS) at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire.

Results

Compared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group (p = 0.0046).

Conclusion

In conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women.

Challenge Demands and Resilience

Abstract. This study investigates the relationship of challenge demands (i. e., time pressure, job complexity) on employee resilience. We provide insights into potential pathways (i. e., learning, cognitive irritation) for how challenge stressors influence employee resilience. We employed a two-wave, time-lagged design to examine the influences of challenge stressors and explanatory pathways on employee resilience 2 months later. The data from 359 participants (52.1 % male) were analyzed using a Bayesian time-lagged path model. Results indicate that time pressure and job complexity are negatively related to employee resilience via cognitive irritation. In contrast, we found a positive, indirect effect of job complexity and resilience via learning. This paper contributes to existing employee resilience and stress research by highlighting the roles of learning and cognitive irritation to explain the relationships of challenge stressors on employee resilience. Moreover, the results provide us with a deeper understanding of which factors foster or drain employee resilience.

Working Harder than Others to Prove Yourself: High-Effort Coping as a Buffer between Teacher-Perpetrated Racial Discrimination and Mental Health among Black American Adolescents

High-effort coping (feeling like one must work harder than others to succeed due to anticipated discrimination) is an understudied concept in adolescence. The current study examined among Black American adolescents surveyed in eighth and 11^th grade (N = 630, 49% female) how high-effort coping moderated the relations between teacher-perpetrated racial discrimination and psychological distress across time, and whether the buffering role of high-effort coping varied by adolescent gender and socioeconomic status. Experiencing racial discrimination from teachers in eighth grade was positively related with depressive symptoms, anger, and suicidal ideation in 11^th grade. High-effort coping buffered against teacher discrimination for suicidal ideation among low socioeconomic status youth, as well as for anger among high socioeconomic status youth. Findings underscore the harmful influence of racial discrimination on Black American adolescents' mental health, as well as suggest that among certain subpopulations, high-effort coping may be one psychologically protective resource through which Black American youth retain positive feelings that are undermined by racial discrimination, and thus promote mental well-being.

Resilience to the effects of social stress on vulnerability to developing drug addiction

We review the still scarce but growing literature on resilience to the effects of social stress on the rewarding properties of drugs of abuse. We define the concept of resilience and how it is applied to the field of drug addiction research. We also describe the internal and external protective factors associated with resilience, such as individual behavioral traits and social support. We then explain the physiological response to stress and how it is modulated by resilience factors. In the subsequent section, we describe the animal models commonly used in the study of resilience to social stress, and we focus on the effects of chronic social defeat (SD), a kind of stress induced by repeated experience of defeat in an agonistic encounter, on different animal behaviors (depression- and anxiety-like behavior, cognitive impairment and addiction-like symptoms). We then summarize the current knowledge on the neurobiological substrates of resilience derived from studies of resilience to the effects of chronic SD stress on depression- and anxiety-related behaviors in rodents. Finally, we focus on the limited studies carried out to explore resilience to the effects of SD stress on the rewarding properties of drugs of abuse, describing the current state of knowledge and suggesting future research directions.

Associations of university student life challenges with mental health and self-rated health: A longitudinal study with 6 months follow-up

BACKGROUND

Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health.

METHODS

In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals).

RESULTS

Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6).

DISCUSSION

Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students.

Athlete Resilience Trajectories Across Competitive Training: The Influence of Physical and Psychological Stress

Competitive sport involves physical and psychological stressors, such as training load and stress perceptions, that athletes must adapt to in order to maintain health and performance. Psychological resilience, one’s capacity to equilibrate or adapt affective and behavioral responses to adverse physical or emotional experiences, is an important topic in athlete training and performance. The study purpose was to investigate associations of training load and perceived sport stress with athlete psychological resilience trajectories. Sixty-one collegiate club athletes (30 females and 31 males) completed self-reported surveys over 6 weeks of training. Athletes significantly differed in resilience at the beginning of competitive training. Baseline resilience differences were associated with resilience trajectories. Perceived stress and training load were negatively associated with resilience. Physical and psychological stressors had a small but statistically significant impact on resilience across weeks of competitive training, indicating that both types of stressors should be monitored to maintain athlete resilience.

Association of Innate and Acquired Aerobic Capacity With Resilience in Healthy Adults: Protocol for a Randomized Controlled Trial of an 8-Week Web-Based Physical Exercise Intervention

BACKGROUND

Physical activity alleviates chronic stress. The latest research suggests a relationship between resilience and physical fitness. Beneficial adaptations of the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, endocannabinoid system, and tryptophan pathway, which are induced by an active lifestyle, are considered to be conducive to resilience. However, detailed knowledge on the molecular link between the effects of acute and chronic physical exercise and improved resilience to stress in humans is missing. Moreover, the relationship between innate and acquired aerobic capacity and resilience is poorly understood.

OBJECTIVE

The aim of this study is to implement a human exercise intervention trial addressing the following main hypotheses: a high innate aerobic capacity is associated with high resilience to stress, and web-based physical exercise training improves aerobic capacity of physically inactive adults, which is accompanied by improved resilience. In this setting, we will analyze the relationship between resilience parameters and innate and acquired aerobic capacity as well as circulating signaling molecules.

METHODS

A total of 70 healthy, physically inactive (<150 minutes/week of physical activity) adults (aged 18-45 years) will be randomly assigned to an intervention or control group. Participants in the intervention group will receive weekly training using progressive endurance and interval running adapted individually to their remotely supervised home training performance via web-based coach support. A standardized incremental treadmill exercise test will be performed before and after the intervention period of 8 weeks to determine the innate and acquired aerobic capacity (peak oxygen uptake). Before and after the intervention, psychological tests and questionnaires that characterize parameters implicated in resilience will be applied. Blood and saliva will be sampled for the analysis of cortisol, lactate, endocannabinoids, catecholamines, kynurenic acid, and further circulating signal transducers. Statistical analysis will provide comprehensive knowledge on the relationship between aerobic capacity and resilience, as well as the capacity of peripheral factors to mediate the promoting effects of exercise on resilience.

RESULTS

The study was registered in October 2019, and enrollment began in September 2019. Of the 161 participants who were initially screened via a telephone survey, 43 (26.7%) fulfilled the inclusion criteria and were included in the study. Among the 55% (17/31) of participants in the intervention group and 45% (14/31) of participants in the control group who completed the study, no serious adverse incidents were reported. Of 43 participants, 4 (9%) withdrew during the program (for individual reasons) and 8 (19%) have not yet participated in the program; moreover, further study recruitment was paused for an indeterminate amount of time because of the COVID-19 pandemic.

CONCLUSIONS

Our study aims to further define the physiological characteristics of human resilience, and it may offer novel approaches for the prevention and therapy of mental disorders via an exercise prescription.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/29712.

How self-reflection and resilience can affect pre-competition anxiety? Evidence from national competitive table tennis in adolescent players

Although previous studies have investigated pre-competition anxiety (PCA), the research examining how to promote the development of self-reflection and resilience in order to regulate PCA is limited. This study has three aims: to examine group differences age, gender, sport level, and exercise duration in (PCA), self-reflection and resilience; to test the relationships between PCA, self-reflection, and resilience; and to determine whether self-reflection and resilience can predict PCA. The included 82 male and 105 female adolescent Chinese table tennis player (ages 12–19). SPSS 25.0 software has used to drive ANOVA, Pearson correlations and regression analysis. The main result was that Pearson correlations demonstrated the strongest relationship between PCA, self-reflection, and resilience. The regression analysis model proved that self-insight predicted cognitive anxiety, somatic anxiety and self-confidence; interpersonal assistance and emotional control predicted self-confidence; and emotional control predicted cognitive anxiety and somatic anxiety. The result of this study were consistent with those of previous studies: there was a significant relationship between PCA, self-reflection and resilience when using the Chinese Adolescent Resilience Scale, and there were some differences in the test of group differences. However, this study uncovered new evidence that interpersonal assistance and emotional control can predict PCA. Further research should focus on cross-cultural differences in the process of cultivating athlete self-reflection and resilience.

The Interplay Between Quality of Life and Resilience Factors in Later Life: A Network Analysis

Age-related challenges and transitions can have considerable social, psychological, and physical consequences that may lead to significant changes in quality of life (QoL). As such, maintaining high levels of QoL in later life may crucially depend on the ability to demonstrate resilience (i.e., successful adaptation to late-life challenges). The current study set out to explore the interplay between several resilience factors, and how these contribute to the realization and maintenance of (different facets of) QoL. Based on the previous work, we identified behavioral coping, positive appraisal, self-management ability, and physical activity as key resilience factors. Their interplay with (various facets of) QoL, as measured with the WHOQOL-OLD, was established through network analysis. In a sample of community-dwelling older adults (55+; N=1,392), we found that QoL was most strongly (and directly) related to positive appraisal style and self-management ability. Among those, taking care of multifunctional resources (i.e., yielding various benefits at the same time) seemed to be crucial. It connected directly to "satisfaction with past, present, and future activities," a key facet of QoL with strong interconnections to other QoL facets. Our analysis also identified resilience factor(s) with the potential to promote QoL when targeted by training, intervention, or other experimental manipulation. The appropriate set of resilience factors to manipulate may depend on the goal and/or facet of QoL that one aims to improve.

Support through Social Media and Online Class Participation to Enhance Psychological Resilience

Social support was an important factor in minimizing the effect of social isolation during the COVID-19 pandemic lockdown. This research aimed to study the role of online class participation and social media usage to link the social support available from family and friends to psychological resilience among pre-service special education teachers against the negative psychological effects of the COVID-19 pandemic lockdown. A survey was conducted with 377 pre-service special needs education (SNE) teachers enrolled at universities in Pakistan. Partial least square structural equation modeling (PLS-SEM) was applied using Smart-PLS 3.2.8. Results revealed that social media and online class participation played a mediating role between social support and psychological resilience in the pre-service special needs education (SNE) teachers studied. Teacher education institutions can devise strategies to develop social media platforms for student socialization during an emergency to help build resilience against the negative psychological effects of social isolation. Future studies could be conducted to adapt instructions and curricula to social media environments for education in an emergency.

Individual and organisational strategies to develop resilience in the nursing workforce

Nurses are likely to encounter a wide range of distressing, challenging and sometimes traumatic situations. However, the coronavirus disease 2019 (COVID-19) pandemic has created unprecedented levels of stress, risk, uncertainty and anxiety for nurses. Nurses have been working in highly challenging conditions, particularly on the front line of patient care, which has had adverse effects on their mental health and well-being. The challenges generated by the COVID-19 pandemic have called into question the notion of nursing being an innately resilient profession. Consequently, the pandemic has reinforced the need for individuals, teams and healthcare organisations to foster resilience in nurses. This article discusses the theoretical underpinnings of resilience, explains what resilience in nurses means, and describes the adverse effects of the pandemic on nurses' mental health and resilience. The article also explores how nurses' resilience can be developed and enhanced from an individual and organisational perspective.

Pathways to Mental Well-Being in Young Carers: The Role of Benefit Finding, Coping, Helplessness, and Caring Tasks

Although prior research has shown that young carers may perceive benefits from their challenging situation, it is unclear how and when benefit finding leads to better mental health. This study examines pathways through which benefit finding may influence mental well-being. Self-reported data were obtained from 601 adolescents aged 15–21 (M_age = 17.87, 71.9% female) who provided care for a close person with physical or mental health problems. Benefit finding was associated with better mental well-being directly as well as indirectly via better coping and lower helplessness. These findings were similar across young carers with different caring task profiles, except for a few differences regarding social/emotional and instrumental care. The study suggests that benefit finding could promote coping skills and mental well-being in adolescent young carers with implications for the design of future research on interventions with young carers.

Quizzing – a hazing ritual in workgroups

Purpose

This paper aims to examine how newcomers’ experience and perception of their exposure to the hazing ritual “quizzing” affects their mode of relating to the workgroup.

Design/methodology/approach

Two illustrative cases are selected from a constructivist grounded theory study based on 15 semi-structured interviews with nursing students in clinical internships at somatic hospital wards.

Findings

As newcomers to the nursing profession, nursing students are exposed to experienced insiders’ hazing ritual “quizzing” during their internship at Danish hospitals. “Quizzing” is a public ceremony performed by an experienced insider, e.g. a daily or clinical supervisor. The ritual continues until a bystander intervenes even though the newcomer admits not knowing the answers. “Quizzing” is being met with repulsion and represents a deviation from expectations of social inclusion, civilized behavior and hope of resonance. It leaves newcomers feeling alienated and makes them adopting a repulsive mode of relating to the workgroup.

Originality/value

This paper applies Hartmut Rosa’s resonance theory and theories of workplace hazing to explore how workgroup hazing affects newcomers’ mode of relating to workgroups.

Generation Z undergraduate students' resilience during the COVID-19 pandemic: a qualitative study

Resilience has been documented as an essential component in managing stress. However, understanding how undergraduate students with different sociodemographic characteristics perceive resilience remains understudied. This study aimed to explore how undergraduate students in one university define and build resilience during the COVID-19 pandemic. Students’ perception and preferences for receiving resilience training were additionally solicited. A descriptive qualitative cross-sectional study was conducted. Twenty-seven students were interviewed using a semi-structured interview guide via Skype instant messaging. The thematic analysis generated five themes: resilience as enduring and withstanding; the building blocks of resilience; resilience: learning or earning; pedagogical considerations for resilience training; and a blended platform for resilience training. Participants described resilience as an enduring and withstanding trait essential for university students. Resilience can be built from intrinsic and extrinsic factors. Intrinsic factors that enhanced resilience included desire to succeed and motivation. Extrinsic factors were relational in nature, and friends, family, teachers, and religion were found to boost resilience. Students had several recommendations in designing resilience training, and they recommended the use of a blended platform. Further, students suggested the use of videos, narratives from resilient individuals, and using reflective practice as a pedagogy in resilience training. Future resilience training should consist of personal and interpersonal factors and should be introduced early during the academic term of students’ university life. As the COVID-19 pandemic compounds an already challenging academic climate, this study lends it findings to expand the resilience literature and develop future resilience training.

Changing nursing practice in response to musculoskeletal l pain and injury in the emergency nursing profession: What are we missing?

BACKGROUND

Musculoskeletal disorders in emergency nurses result in physical, psychological and financial strain. Contributing factors include: environmental, organisational, patient-related, medical emergencies, nurse's knowledge and health status. Stress and moral distress impact on nurses changing manual handling practices.

METHODS

Part of a cross-sectional survey of Australian emergency nurses, this study used content analysis to identify occurrence of change to practice and enablers to reporting injury. Secondary interpretive analysis using moral distress theory informed an alternative understanding of why nurses may not change their practice in response to injury.

RESULTS

Most respondents made practice changes and reported pain/injury; 23% did not change, and 45.7% did not report. Respondents considered change impossible due to high demands and lack of resources; a position where nurses may have felt pressured to carry out unsafe manual handling practices. When conflicted between reporting a perceived insignificant injury, with feelings of guilt, nurses can feel devalued. Moral distress can occur when nurses and managers are conflicted between providing care and caring for self.

CONCLUSIONS

A culture of trust, respect and open communication decreases stress/moral distress, enables safer manual handling and reporting of pain/injury. Moral distress is an invisible workplace challenge that needs to be met for staff wellbeing.

The coping insights involved in strengthening resilience: The Self-Reflection and Coping Insight Framework

BACKGROUND

Recent theoretical work suggests that self-reflection on daily stressors and the efficacy of coping strategies and resources is beneficial for the enhancement of resilient capacities. However, coping insights emerging from self-reflection, and their relationship to resilient capacities, is an existing gap in our understanding.

OBJECTIVES

Given that insights come in many forms, the objective of this paper is to delineate exemplar coping insights that strengthen the capacity for resilience.

METHODS

After providing an overview of self-reflection and insight, we extend the Systematic Self-Reflection model of resilience strengthening by introducing the Self-Reflection and Coping Insight Framework to articulate how the emergence of coping insights may mediate the relationship between five self-reflective practices and the enhancement of resilient capacities.

RESULTS

We explore the potential for coping insights to convey complex ideas about the self in the context of stressor exposure, an awareness of response patterns to stressors, and principles about the nature of stress and coping across time and contexts.

CONCLUSIONS

This framework adds to existing scholarship by providing a characterization of how coping insight may strengthen resilient capacities, allowing for a guided exploration of coping insight during future research.

ICD-11 posttraumatic stress disorder, complex PTSD and adjustment disorder: the importance of stressors and traumatic life events

Background: Although ICD-11 adjustment (AjD), posttraumatic stress (PTSD) and complex posttraumatic stress (CPTSD) are commonly diagnosed disorders following exposure to stressful or traumatic life events, their dimensional structure and co-occurrence has never been tested in a single study. The present study explored the latent structure of AjD, PTSD, and CPTSD symptoms and their relationship to stressful and traumatic life events to determine the degree of distinctiveness between these constructs.Methods: Participants were clinical patients (N = 331) who completed self-report measures of stressful and traumatic life events, AjD (The Adjustment Disorder - New Module 8 (ADNM-8)) and PTSD / CPTSD (The International Trauma Questionnaire - ITQ).Results: Using confirmatory factor analysis, a second-order model comprised of correlated latent variables of AjD, PTSD, and CPTSD provided the best fit of the data. It was also found that stressors and traumatic life events were positively associated with all of these conditions although childhood trauma was only associated with CPTSD.Conclusions: The current findings support the ICD-11 model of related-but-distinct stress-related disorders. We discuss the existence of a stress-response continuum and how the current findings impact the development of clinical interventions that may be shared across, or unique to, each stress-related disorder.