Resilience and vulnerability in adolescents with primary headaches: A cross-sectional population-based study

Translation, content validity and internal structure of the Brazilian version of the Adolescent Resilience Questionnaire (B-ARQ)

Resilience refers to one's ability to face life's challenges and achieve positive outcomes, and has drawn increasing interest from researchers and policymakers. The Adolescent Resilience Questionnaire (ARQ) is a measure that assesses resilience in adolescents according to a multidimensional perspective, encompassing its several different domains. This cross-sectional study aimed to translate and evaluate the measurement properties of the Brazilian version of the ARQ (B-ARQ) for use with Brazilian adolescents. Two native speakers in Brazilian Portuguese language who were also fluent in English language translated the ARQ from English into Portuguese. A committee of experts in validation studies compared the translated versions. A summarized version was produced and back-translated by a translator native of the English language and fluent in Portuguese. The B-ARQ was pre-tested in a sample of 21 adolescents. An expert committee considered the suggestions and defined the final version of the instrument, which was tested in a sample of 210 adolescent students from public and private schools in the city of Dom Pedrito, Brazil. All students filled out the 88-item instrument as well as a socio-demographic questionnaire. Statistical analysis included descriptive statistics of all variables (frequency distribution, floor, ceiling effects), internal consistency, and confirmatory factor analysis of the version with 88 items and the shortened version with 49 items. The short version with 49 items was validated in a cross-sectional study in an adolescent population of high school students using exploratory factor analysis in the Unites States. The 88-item ARQ had poor structural validity with unsatisfactory model fit indices. Therefore, the investigation focused on the short 49-item version of the ARQ (B-ARQ-SV). The final model presented satisfactory RMSEA = 0.042 (p = 0.994, 90% CI: 0.037-0.047) and SRMR of 0.076, despite the low CFI (0.878). The internal consistency was estimated with McDonald's Omega for each factor: Confidence (ω = 0.480), Negative Cognition (ω = 0.588), Empathy/tolerance (ω = 0.295), Emotional insight (ω = 0.425), Social Skill (ω = 0.235), Family Domain Connectedness (ω = 0.785), Family Domain Availability (ω = 0.847), Peers Domain Connectedness (ω = 0.719), Peers Domain Availability (ω = 0.402), School Domain Supportive environment (ω = 0.677), School Domain Connectedness (ω = 0.013), Community Domain Connectedness (ω = 0.791). One scale showed a ceiling effect (frequency higher than 15.0%), but we identified no critical floor effect. The B-ARQ-SV is a valid (in terms of content and structural validity) and reliable (in terms of internal consistency) measurement instrument to assess resilience in Brazilian adolescents.

Defining and Measuring Resilience in Children with a Chronic Disease: a Scoping Review

More than 25% of all children grow up with a chronic disease. They are at higher risk for developmental and psychosocial problems. However, children who function resiliently manage to adapt positively to these challenges. We aim to systematically review how resilience is defined and measured in children with a chronic disease. A search of PubMed, Cochrane, Embase, and PsycINFO was performed on December 9, 2022, using resilience, disease, and child/adolescent as search terms. Two reviewers independently screened articles for inclusion according to predefined criteria. Extraction domains included study characteristics, definition, and instruments assessing resilience outcomes, and resilience factors. Fifty-five out of 8766 articles were identified as relevant. In general, resilience was characterized as positive adaptation to adversity. The included studies assessed resilience by the outcomes of positive adaptation, or by resilience factors, or both. We categorized the assessed resilience outcomes into three groups: personal traits, psychosocial functioning, and disease-related outcomes. Moreover, myriad of resilience factors were measured, which were grouped into internal resilience factors (cognitive, social, and emotional competence factors), disease-related factors, and external factors (caregiver factors, social factors, and contextual factors). Our scoping review provides insight into the definitions and instruments used to measure resilience in children with a chronic disease. More knowledge is needed on which resilience factors are related to positive adaptation in specific illness-related challenges, which underlying mechanisms are responsible for this positive adaptation, and how these underlying mechanisms interact with one another.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42844-023-00092-2.

The Lighter Side of Pain: Do Positive Affective States Predict Memory of Pain Induced by Running a Marathon?

Background

Memory and in turn, memory of pain is a reconstructive process. This study considers the relationship between time, memory, affective states, and pain induced by running a marathon by investigating the influence of these factors on a participant’s memory of pain experienced after a marathon. The following two hypotheses were formulated: 1) participants’ recalled-pain of marathon experience is underestimated; and 2) the underestimation of recalled pain would be greater for participants experiencing higher positive affect.

Methods

A longitudinal design was employed to check pain intensities of marathon participants a) at the finish line and b) 6 months following its completion. The sample size was based on a power analysis, and 108 marathonists rated their pain intensities and positive and negative affects at the finish line. From this sample, 58 participants recalled their pain experience of running the marathon 6 months later. Linear models, including computer-based data-mining algorithms, were used.

Results

The experienced pain was higher than their recalled pain (t(55) = 3.412, p < 0.01, d = 0.45), supporting the first hypothesis. The memory of pain faded similarly in all participants, which did not directly support the second hypothesis. Further exploratory analysis suggested that negative and positive affective states were related to participants’ pain memory; positive affective states appeared to be inversely related to the recall (β = −0.289, p = 0.039).

Discussion

This study shows that time has a significant effect on memory recall and that emotions may also influence the memory of pain. This is the first study that preliminarily showcased the effect of positive affective states on the memory of pain induced by physical exercise.