Resilience in the Context of Chronic Stress and Health in Adults

Gastrodin enhances stress resilience through promoting Wnt/β-Catenin-dependent neurogenesis

BACKGROUND

Enhancing stress resilience constitutes a pivotal strategy in mitigating the risk of depression, making it a critical component of both prevention and treatment. In the current work, we identified a compound, gastrodin (GAS), as capable of enhancing stress resilience, as demonstrated by its ability to protect against depression following chronic stress exposure.

OBJECTIVES

To elucidate the potential of GAS to promote neurogenesis under chronic stress, along with the associated cellular and molecular processes involved.

METHOD

We evaluated the effect of GAS on NSPC proliferation and differentiation using both in vitro and in vivo investigations. Neurogenesis was inhibited using temozolomide to verify GAS's impact on stress resilience. Comprehensive methodologies, including hippocampal transcriptome analysis and western blotting, were utilized to identify the involvement of the Wnt/β-catenin pathway. Immunolocalization was conducted to confirm β-catenin's nuclear translocation in SOX2+ cells within the hippocampal dentate gyrus subgranular zone.

RESULTS

GAS demonstrated robust stimulation of NSPC proliferation and neuronal differentiation, enhancing adult hippocampal neurogenesis under conditions of chronic stress. Inhibition of neurogenesis negated GAS's protective effects on stress resilience. Integrated analysis pointed to the Wnt/β-catenin signaling pathway within NSPCs as a crucial mechanism facilitating GAS-promoted neurogenesis. Inhibiting Wnt expression or blocking β-catenin's nuclear translocation abolished GAS's neurogenic and stress-resilience enhancing effects.

CONCLUSION

These results suggested that GAS directly activates the Wnt/β-catenin signaling pathway, which promotes the proliferation and neuronal differentiation of NSPCs, thereby enhancing adult hippocampal neurogenesis and promoting stress resilience to mitigate the risk of depression.

Exploring the Trajectories of Depressive Symptoms Associated With Bullying Victimization: The Intersection of Gender and Family Support

INTRODUCTION

Children from multicultural families in South Korea are at high risk of bullying victimization, highlighting the need for a deeper understanding of the challenges they face. This study explores the gendered dynamics of depressive symptoms associated with persistent exposure to bullying victimization among these youths, as well as the role of family support.

METHODS

This study utilizes data from nine waves of the Multicultural Adolescents Panel Study (MAPS), spanning from 2011 (Wave 1) to 2019 (Wave 9). MAPS is a nationally representative longitudinal survey of adolescents with multicultural backgrounds and their mothers. Participants include 1375 families (51.1% girls; grade 4-13). Fixed-effects models were estimated to address the possibility of bias due to unobserved time-invariant confounders. Gender-stratified analyses and interaction models were employed to examine the moderating role of gender and family support.

RESULTS

Depressive symptoms among girls were higher with persistent bullying victimization; however, this association was observed up to two consecutive waves of exposure (an immediate and short-term pattern). In contrast, persistent bullying victimization was associated with a cumulative increase in depressive symptoms up to three or more consecutive waves of exposure in boys (an immediate and cumulative pattern). Moreover, while family support was associated with lower levels of depressive symptoms among bullied girls, bullied boys exhibited a similar pattern of a cumulative increase in depressive symptoms regardless of the level of family support.

CONCLUSION

The study's findings suggest potential considerations for gendered interventions related to mental health outcomes of bullying victimization among multicultural family youth in Korea.

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.

Life Stressors, Resilience Resources, and Asthma Among Adults in the Hispanic Community Health Study/Study of Latinos

BACKGROUND

Whether life stressors and resiliency interact on asthma risk in adults is largely unknown.

OBJECTIVE

To examine life stressors, resiliency, and asthma in Hispanic/Latino adults.

METHODS

This is a cross-sectional study of 4747 adults aged 18 to 74 years in the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos. Participants completed questionnaires on life stressors (adverse childhood experiences [ACE], traumatic stress exposure (TSE), and chronic stressors [for ≥6 months]) and resilience resources (family cohesion, perceived social support, and spiritual well-being). Logistic regression was used for the multivariable analyses of current asthma and current asthma symptoms.

RESULTS

Any ACE and any chronic stressor were associated with 54% to 69% increased odds of asthma and asthma symptoms in all individuals, with stronger associations for ACE in men and for chronic stressors in women. In a separate analysis, high family cohesion and high spiritual well-being were each associated with 35% to 36% reduced odds of asthma symptoms. There was suggestive evidence of interactions: any TSE was associated with increased odds of asthma in adults with low family cohesion (adjusted odds ratio [aOR] = 2.40, 95% confidence interval [CI] = 1.01-5.73) but not in others, and any chronic stressor was associated with increased odds of asthma symptoms in adults with low spiritual well-being (aOR = 2.24, 95% CI = 1.20-4.20) but not in others.

CONCLUSIONS

In Hispanic/Latino adults, ACE and chronic stress were associated with higher odds of asthma or asthma symptoms, whereas family cohesion and spiritual well-being were linked to lower odds of asthma or asthma symptoms. Further, resiliency may interact with life stressors on asthma.

"I've Been Forged in Fire": Preliminary Theory of HIV Prevention Resilience Among Sexual Minority Men With HIV Risk Factors

HIV prevention research on sexual minority men focuses predominantly on risk factors, yet there is potential for enhancing HIV risk reduction by also examining resilience factors. We used mixed methods to explore HIV-related resilience pathways among 20 HIV-negative sexual minority men reporting HIV syndemic risks (childhood sexual abuse, partner abuse, mental health problems, substance abuse). Using grounded theory, we found that stress-related growth after mental health problems and/or unwanted sexual experiences can trigger development/use of HIV prevention resilience resources that, in turn, help sexual minority men cope and enhance HIV prevention behavior. We identified 23 HIV resilience resources at individual, interpersonal, community, health system, and structural levels. These findings informed a preliminary Theory of HIV Prevention Resilience for Sexual Minority Men. Our findings identified resilience resources to be nurtured through public health or mental health/substance use-focused interventions at broader levels to better address the HIV epidemic.

The Mind Under Pressure: What Roles Does Education Play in the Relationship Between Chronic Stress and Cognitive Ability?

Chronic stress is an important predictor of mental and physical health, but little is known about its association with cognitive abilities and education during the lifespan. We hypothesized that chronic stress would be negatively correlated with cognitive abilities, particularly crystallized intelligence, and that this association would be stronger among individuals with lower educational attainment due to limited stress-coping resources. We used cross-sectional data from the German National Educational Panel Study (NEPS SC6), comprising 10,416 adults aged 29 to 71 years (50.80% female; 49.20% male). Fluid and crystallized intelligence were assessed with a reasoning test and a vocabulary test, respectively; chronic stress was assessed with a questionnaire on social stress and anxiety. The tests and the questionnaire were conceptualized for a heterogeneous and large-scale sample. Our results show small negative associations between chronic stress and both fluid and crystallized cognitive abilities, which persist after controlling for demographic variables. However, there were no significant differences between educational groups. Although the study does not address longitudinal patterns, it highlights the complex interaction between stress and cognition, and it underscores the need for further research to explore how educational resources may mitigate the impact of chronic stress on cognitive health.

Accumulation of perceived discrimination over time and likelihood of probable mental health problems in UK adults: A longitudinal cohort study

BACKGROUND

Limited research has examined whether accumulation of discrimination over time is associated with worse mental health and whether such experiences are related to socioeconomic status (SES).

METHODS

A sample of UK adults with self-reported discrimination experiences (n = 3863) was taken from three waves of the UK Household Longitudinal Study (2015-2020). Multinomial logistic regression assessed associations between SES (income, education, occupation) and cumulative discrimination (number of timepoints discrimination was reported). Logistic regression models assessed prospective associations between cumulative discrimination and probable mental health problems (GHQ-12; 4+ threshold).

RESULTS

Those with lower income were more likely to report discrimination at one timepoint (vs. none). No SES measures were associated with experiencing discrimination at multiple timepoints. Participants who reported one timepoint of discrimination (vs. no experiences) were significantly more likely to report probable mental health problems (OR = 1.47, p < .001, 95% CI 1.20-1.80). Moreover, compared to those experiencing one timepoint, participants reporting multiple timepoints of discrimination were significantly more likely to report probable mental health problems (OR = 1.46, p = .002, 95% CI 1.15-1.86), indicating a cumulative association between discrimination and mental health. There was limited evidence that SES moderated this cumulative association.

LIMITATIONS

Mental health measures were based on self-report questionnaires and not a clinical diagnosis.

CONCLUSIONS

Amongst a sample of UK adults, perceiving discrimination at multiple timepoints increased the likelihood of experiencing probable mental health problems. There was limited evidence that this cumulative association differed by SES. National measures designed to reduce discrimination may benefit mental health.

Emerging adults' financial stress and self-rated health: Meaning in life as a moderator

Objective: The primary objective of the study was to examine associations between financial stress and self-rated health (mental and physical), with presence of and search for meaning in life as moderator variables. The secondary objective was to examine the association between presence of meaning and self-rated health, with search for meaning as a moderator. Participants and methods: The sample included 166 emerging adults (ages 18-32, mean age 22.55) recruited from a university setting (n = 87) and online platform (n = 79). To examine the proposed moderating effects, two hierarchical multiple regression models were conducted using secondary data. Results: For the primary objective, presence of meaning did not moderate the association between financial stress and self-rated health (mental or physical). Search for meaning strengthened the negative association between financial stress and physical health, exacerbating the negative health impacts associated with financial stress. However, search for meaning did not moderate the association between financial stress and mental health. For the secondary objective, search for meaning moderated the association between presence of meaning and physical health such that a negative presence-physical health association emerged at high levels of search, and a positive presence-physical health association emerged at low levels of search. Conclusion: Presence of meaning was not a protective factor in the association between financial stress and self-rated health, perhaps because average presence of meaning was lower than average search for meaning in this sample. Search for meaning was a risk factor for adverse physical health when financial stress was high or presence of meaning was low. Future research should examine in which contexts (e.g., different stressors, cultures) meaning in life dimensions emerge as risk versus protective factors.

Reflections on resilience

Resilience research has long sought to understand how factors at the child, family, school, community, and societal levels shape adaptation in the face of adversities such as poverty and war. In this article we reflect on three themes that may prove to be useful for future resilience research. First is the idea that mental and physical health can sometimes diverge, even in response to the same social process. A better understanding of explanations for this divergence will have both theoretical and public health implications when it comes to efforts to promote resilience. Second is that more recent models of stress suggest that stress can accelerate aging. Thus, we suggest that research on resilience may need to also consider how resilience strategies may need to be developed in an accelerated fashion to be effective. Third, we suggest that if psychological resilience interventions can be conducted in conjunction with efforts to enact system-level changes targeted at adversities, this may synergize the impact that any single intervention can have, creating a more coordinated and effective set of approaches for promoting resilience in young people who confront adversity in life.

Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma

Importance

Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD).

Objective

To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward.

Design, Setting, and Participants

As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023.

Exposures

Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC).

Main Outcome and Measures

PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income).

Results

In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory.

Conclusions and Relevance

In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.

How can we build structural resilience? Integration of social-ecological and minority stress models

As the United States contends with racism and a social justice reckoning, the need to advance our understanding of how to build structural resilience continues to be pressing. This article proposes a culturally and structurally informed model of resilience for individuals with minoritized identities that integrates social-ecological and minority stress models. First, common stressors and traumas experienced by minoritized individuals at multiple levels of proximal/distal influence are reviewed: microsystem (e.g., family rejection), mesosystem (e.g., community-based discrimination), exosystem (e.g., barriers to health care), macrosystem (e.g., harmful legal policies), and chronosystem (e.g., historical legacy). Next, how these exposures have cascading effects on minority stress processes (e.g., discriminatory policies in the macrosystem affect how a child is socialized in the microsystem) are considered. Then, modifiable factors (e.g., community cohesion) that promote resiliency in the face of ongoing exposures are discussed. To conclude, guidelines are offered for advancing the psychological science of resilience in minoritized groups including mixed methods to reflect participants' experiences, ecological approaches to assess resilience, and multilevel modeling to understand the interplay between the social-ecological context and individual factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Witnessing their mother's acute and prolonged stress affects executive functioning in children

Stress can detrimentally affect physical and mental health, especially during childhood. During this critical period, parental bonds can foster resilience or amplify stress. This study explored whether mothers' everyday stress can act as a source of childhood stress, affecting children's executive functioning. 76 healthy mother-child dyads participated, with mothers assigned to a stress-inducing or stress-free condition. Children observed their mothers and were subsequently tested for cognitive flexibility and working memory. Subjective stress, heart rate, and cortisol were measured repeatedly in mothers and children, alongside everyday stress perceptions. Linear mixed models showed that children's acute stress response was associated with impaired cognitive flexibility. Maternal stress, both acute and past-month, was a better predictor of children's cognitive performance than children's own stress. Quadratic relationships indicated the highest error rates at very low and high maternal stress. We found no evidence that children's working memory was impaired by their own or their mothers' stress. Although expected covariations of acute or prolonged stress between mothers and children were not observed, an interaction between maternal past-month stress and acute stress condition provided insights into adaptive mechanisms in children. These findings underscore the significant impact of maternal stress on children's executive functioning, illustrating how parental experiences shape children's everyday outcomes.

Resilience to stress during pregnancy: Biopsychosocial mechanisms and implications for offspring emotional and behavioral outcomes in toddlerhood

Exposure to high levels of stress during pregnancy is a known risk factor for a wide range of offspring outcomes, but little is known about the biopsychosocial factors underlying resilience and recovery from stress during pregnancy. The current study investigated associations between emotional and instrumental support during pregnancy and resilience to stress during pregnancy, including perceived resilience (belief in ability to "bounce back" from adversity) and physiological resilience (ability to physiologically recover quickly after an acute stressor). We further tested whether support and resilience during pregnancy predicted offspring internalizing and externalizing behaviors. Participants included 130 pregnant women (ages 26-28 years; 58% Black, 27% White, 15% Multiracial; 28% receiving public assistance) from a population-based longitudinal study. During pregnancy, participants reported on emotional and instrumental support, current life stressors, and perceived resilience to stress. In addition, heart rate variability was recorded continuously before, during, and after a controlled stress test to measure physiological recovery from stressors. When offspring were 2-3 years of age, mothers reported on children's internalizing and externalizing problems. Results from moderated mediation analyses indicated that emotional, but not instrumental, support was associated with perceived resilience during pregnancy, which predicted lower internalizing and externalizing problems in offspring. Emotional support also predicted greater physiological recovery during pregnancy, but only for individuals reporting multiple life stressors. Findings suggest that emotional support may influence psychological and physiological responses to stress during pregnancy, with implications for offspring emotional and behavioral health. Clinical implications of these results and directions for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Compounding effects of stress on diet, physical activity, and wellbeing among African American parents: a qualitative study to inform the LEADS health promotion trial

The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; Mage = 49.73, SD = 10.88; MBMI = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families.

How to build resiliency in autistic individuals: an implication to advance mental health

INTRODUCTION

Individuals on the autism spectrum (ASD) often experience poor mental health and coping strategies compared to their peers due to social exclusion and co-occurring conditions. Resiliency has been identified as a key factor in preventing adverse outcomes and promoting mental health. Therefore, it is important to determine what strategies can be used to build resiliency among autistic individuals. The current paper is one of the first studies that aims to collect information from autistic individuals and their caregivers on potential strategies to enhance resiliency.

METHODS

We interviewed 18 participants from various provinces in Canada, comprising of 13 autistic individuals and 5 parents. We used thematic analysis to identify patterns in the data.

RESULTS

Thematic analysis revealed three themes to indicate strategies that could be used to enhance resiliency, including: (a) self-reliant strategies, (b) using community-based facilities, and (c) contextual and individual characteristics.

CONCLUSION

Although the body of literature on resiliency is evolving, this paper provides a unique perspective as it is one of the few studies that considers the experiences of individuals on the spectrum. In addition, this study focuses on identifying and describing specific strategies that can be used to enhance resiliency and mental health, which consequently can help address the existing gaps in knowledge and practice.

The Toxic Stress of Racism and Its Relationship to Frailty

Significant morbidity and mortality from COVID-19-related illnesses have been observed among people of color within the United States. While theories involving healthcare inequity and political division have emerged to explain this observation, the role of chronic stress and inflammation is also being explored. Toxic stress is experienced disproportionately by race, ethnicity, and socioeconomic status and increases frailty and vulnerability to diseases such as COVID-19. C-reactive protein (CRP) is a biomarker associated with the inflammatory response that is typically elevated due to exposure to acute or chronic traumatic stress, as well as COVID-19. This study explored the relationship between CRP and Hispanic/non-Hispanic ethnicity among adults hospitalized with COVID-19 via a secondary analysis of retrospective electronic health record (EHR) data collected from a community healthcare system in Southern California. A total of 1,744 cases representing hospitalized adults with COVID-19 were reviewed. Data were extracted from the EHR to reflect demographics, medical diagnoses, medications, CRP, and comorbidity burden. Frequencies, percentages, and measures of central tendency were assessed to understand the distribution of data. Associations were conducted using Pearson's r and the chi-square test of independence. Differences between groups were examined via independent samples t-tests. The sample was 52% Hispanic, 56% male, and the mean age was 62 years (SD = 16.1). The mean age of Hispanic cases was younger than non-Hispanic cases (p < .001, η = 0.289). Serum CRP was significantly higher in the Hispanic cases, with a high degree of association (p < .001, η = 0.472). In addition, higher CRP levels were significantly associated with the need for mechanical ventilation (p < .001, φc = 0.216). No significant relationships were found between CRP and age, body mass index (BMI), or comorbidity burden. Findings challenge the assumption that the disproportionate morbidity and mortality suffered by the Hispanic population due to COVID-19 was due to age, BMI, or comorbidities such as metabolic syndrome or heart disease. CRP in the Hispanic population should be further investigated to understand its relationship to chronic stress, frailty, and risk for COVID-19 in this population.

Resting-state activity and functional connectivity of insula and postcentral gyrus related to psychological resilience in female depressed patients: A preliminary study

BACKGROUND

Psychological resilience is a protective factor of depression. However, the neuroimaging characteristics of the relationship between psychological resilience and brain imaging in depression are not very clear. Our objectives were to explore the brain functional imaging characteristics of different levels of resilience in female patients with depression.

METHODS

Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on 58 female depressed patients. According to the resilience score, participants were divided into three groups: Low resilience (Low-res), Medium resilience (Med-res) and High resilience (High-res). We compared the differences in the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) among the three groups and correlated psychological resilience with ALFF and FC.

RESULTS

According to ALFF, there was a higher activation in RI and RPG in the High-res compared with Med-res and Low-res, but no significant differences between Med-res and Low-res. The FC between the RPG and supramarginal gyrus (SG) in the High-res was significantly stronger than that in the Med-res and the Low-res, and the FC of the Med-res is stronger than that of the Low-res. Both ALFF and FC were positively correlated with the score of resilience.

LIMITATIONS

The sample size of this study was relatively small and it lacked healthy controls. The results of this study could be considered preliminary.

CONCLUSIONS

Among female patients with depression, patients with higher psychological resilience had higher resting state activation in the RI and RPG and had a stronger interaction between the RPG and the SG.

Multilevel Resilience and HIV Virologic Suppression Among African American/Black Adults in the Southeastern United States

OBJECTIVE

To assess overall and by neighborhood risk environments whether multilevel resilience resources were associated with HIV virologic suppression among African American/Black adults in the Southeastern United States.

SETTING AND METHODS

This clinical cohort sub-study included 436 African American/Black participants enrolled in two parent HIV clinical cohorts. Resilience was assessed using the Multilevel Resilience Resource Measure (MRM) for African American/Black adults living with HIV, where endorsement of a MRM statement indicated agreement that a resilience resource helped a participant continue HIV care despite challenges or was present in a participant's neighborhood. Modified Poisson regression models estimated adjusted prevalence ratios (aPRs) for virologic suppression as a function of categorical MRM scores, controlling for demographic, clinical, and behavioral characteristics at or prior to sub-study enrollment. We assessed for effect measure modification (EMM) by neighborhood risk environments.

RESULTS

Compared to participants with lesser endorsement of multilevel resilience resources, aPRs for virologic suppression among those with greater or moderate endorsement were 1.03 (95% confidence interval: 0.96-1.11) and 1.03 (0.96-1.11), respectively. Regarding multilevel resilience resource endorsement, there was no strong evidence for EMM by levels of neighborhood risk environments.

CONCLUSIONS

Modest positive associations between higher multilevel resilience resource endorsement and virologic suppression were at times most compatible with the data. However, null findings were also compatible. There was no strong evidence for EMM concerning multilevel resilience resource endorsement, which could have been due to random error. Prospective studies assessing EMM by levels of the neighborhood risk environment with larger sample sizes are needed.

Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model

Introduction

A doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience.

Method

A web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period.

Results

As hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor.

Discussion

Theoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.

The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study

PURPOSE

This study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants.

DESIGN AND METHODS

A cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively.

RESULTS

The mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively. Mental resilience was a significant mediator explaining the effect of stress on active coping (β = -0.294; 95% bias-corrected bootstrap CI: -0.358 to -0.164).

CONCLUSIONS

Attention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style.

PRACTICE IMPLICATIONS

This study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.

Resilience in children with chronic illness: Tests of the shift-and-persist and skin-deep resilience theories

This study investigated, and discusses the integration of, the shift-and-persist (SAP) and skin-deep resilience (SDR) theories. The SAP theory states that the combination of shifting (adjusting oneself to stressful situations through strategies like emotion regulation) and persisting (enduring adversity with strength by finding meaning and maintaining optimism) will be beneficial to physical health in children experiencing adversity. The SDR theory states that high striving/self-control will be beneficial to mental health but detrimental to physical health among those confronting adversity. This study investigated 308 children ages 8-17 experiencing the adversity of a chronic illness (asthma). SAP and SDR (striving/self-control) were assessed via questionnaires, and physical health (asthma symptoms, inflammatory profiles), mental health (anxiety/depression, emotional functioning), and behavioral (medication adherence, activity limitations, collaborative relationships with providers) outcomes were measured cross-sectionally. SAP was associated with better physical health, whereas SDR was associated with worse physical health. Both were associated with better mental health. Only SDR was associated with better behavioral outcomes. Implications of findings and discussion of how to integrate these theories are provided. We suggest that future interventions might seek to cultivate both SAP and SDR to promote overall better health and well-being across multiple domains in children experiencing adversity.

Association between individual resilience and depression or anxiety among general adult population during COVID-19: a systematic review

BACKGROUND

The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population.

METHODS

We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design.

RESULTS

A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety.

CONCLUSIONS

Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases.

Impact of social support and mindfulness in the associations between perceived risk of COVID-19 acquisition and pregnancy outcomes in Iranian population: a longitudinal cohort study

BACKGROUND AND AIMS

Various devastating infection outbreaks including COVID-19, threat both mother and fetus health. These life-threating outbreaks as potential harms are highly associated with relevant perceived risk. Social support and mindfulness are two factors that may moderate the associations between the perceived risk of COVID-19 and pregnancy outcomes. In this study we investigated the potential moderating impact of social support and mindfulness in the aforementioned association.

METHODS

This study is a longitudinal cohort study in which 483 Iranian pregnant women in Tehran have been studied. Perceived risk of COVID-19 questions, Mindful Attention Awareness Scale (MAAS), and Multidimensional Scale of Perceived Social Support (MSPSS) were used through an online platform to assess the independent variables during pregnancy. Neonatal and maternal outcomes including gestational diabetes, gestational hypertension, preeclampsia, abortion, birth weight, and gestational age at birth, was extracted from Electronic Health Record (EHR) after childbirth as the dependent variables. The aim of the study is to investigate whether social support and mindfulness can affect the associations between perceived risk of Covid-19 acquisition and pregnancy outcomes.

RESULTS

Perceived risk of COVID-19 was negatively associated with pregnancy outcomes including birth weight (-28, 95% CI [-53, -3.4], p < .05) and gestational age at birth (-0.9, 95% CI [-2,0.11], p < .05). However, social support could not moderate these associations. Mindfulness, on the other hand, moderated the association between perceived risk and stillbirth meaning that by increasing mindfulness, the association between the perceived risk and stillbirth may also be increased (OR = 0.03; p < .05).

CONCLUSION

The findings of this study showed that social support lacks the moderating impact on the association between perceived risk of COVID-19 and pregnancy outcomes. Mindfulness, on the other hand, indicate a positive moderating impact for the association between perceived risk of Covid-19 and stillbirth. More studies in different populations are suggested to investigate the impact of mindfulness and social support on the association between perceived risk and pregnancy outcomes.

The needle and the damage done: Deaths of despair, economic precarity, and the white working-class

Economic insecurity has grown in the United States since the 1970s impacting all segments of the working-class, including previously insulated sub-groups such as non-Hispanic whites. Moreover, the white working-class has experienced a surge in socio-cultural isolation, and disengagement with societal institutions. This analysis focuses on the health consequences of these developments, with a particular emphasis on the rising "deaths of despair" (suicide, drug poisoning, alcohol related). These deaths have been increasing since the mid-1990s and, at least until recently, tended to be clustered amongst whites without a four-year college degree. Various competing explanations have been put forth, emphasizing distinct factors such as material conditions, socio-cultural dynamics, and accessibility to opioids. Using a series of linear models this analysis examines the county-level association between economic precarity, white working-class population size, opioid accessibility, and deaths of despair. Results affirm the net effect of each predictor and illuminate an interactive relationship between opioid accessibility and precarity, as well as an interactive relationship between all three predictors. By undertaking an interdisciplinary synthesis of existing research, this study contributes to the understanding of the social determinants of mortality while providing crucial insights into an ongoing crisis in contemporary America.

The effect of childhood trauma and resilience on psychopathology in adulthood: Does bullying moderate the associations?

BACKGROUND

Exposure to traumatic events in childhood, including bullying, can negatively affect physical and mental health in adulthood. The aim of the present study was to determine the prevalence of bullying in different sociodemographic groups of the Slovak Republic and to assess the moderating effect of bullying on the associations between childhood trauma, resilience, and the later occurrence of psychopathology.

METHODS

For the analyses, a representative sample of the population of the Slovak Republic was used (N = 1018, mean age 46.24 years, 48.7% of men). Multivariate linear regression models were used to investigate the predictive ability of childhood trauma (The Childhood Trauma Questionnaire, CTQ) and resilience (The Brief Resilience Scale, BRS) to explain psychopathology (The Brief Symptom Inventory, BSI-53). Bullying (The Adverse Childhood Experiences - International Questionnaire, ACE-IQ) was used as a moderator.

RESULTS

In total, 13.5% of respondents have experienced bullying. The most common form of bullying was making fun of someone because of how their body or face looked (46.7%) and excluding someone from activities or ignoring them (36.5%). Higher scores in all types of psychopathology and the Global Severity Index (GSI) were significantly associated with higher scores of emotional and sexual abuse, and some of them with physical neglect. The protective effect of resilience was moderated by bullying in several types of psychopathology, specifically in somatization, obsessive-compulsive, interpersonal sensitivity, depression, psychoticism, and the GSI.

CONCLUSION

Understanding the links between childhood trauma, bullying, and later psychopathology can help professionals target policies, resources, and interventions to support children and families at risk. Every child should feel accepted and safe at home and school.

The Effect of Reality Therapy on Resilience and Self-Efficacy of Prisoners: A Randomized Controlled Trial Study

This study aimed to determine the effect of reality therapy training on self-efficacy and resilience in male prisoners. To this end, a randomized controlled trial was conducted with a pre-test, post-test, and a control group. The research questionnaires including the Scherer self-efficacy questionnaire and the Connor-Davidson resilience questionnaire were administered to 300 prisoners. Of them, 78 prisoners who met the inclusion criteria were selected and randomly assigned to the intervention and control groups. The intervention group attended ten 90-min sessions on reality therapy training per week. At the end of the training period, the study groups were required to attend the post-test. The data were analyzed with the SPSS software version 23 and through an independent t-test and a paired t-test. The results at the post-test phase showed a significant increase of self-efficacy and resilience in the experimental group, as compared to the control group (p < .01). Therefore, it is recommended for authorities to improve the self-efficacy and resilience of prisoners through reality therapy trainings.

Resilience as a potential modifier of racial inequities in preterm birth

PURPOSE

In the US, preterm birth (PTB) is 55% more common among Black compared to White individuals and psychosocial stressors may contribute. Resilience is associated with improved health outcomes; whether it modifies PTB inequity is unknown. We hypothesized high resilience would reduce inequities in PTB risk.

METHODS

This study analyzes data from 535 pregnancies among Black (n = 101, 19%) and White (n = 434, 81%) participants from a prospective cohort. Participants completed the Connor-Davidson Resilience Scale. We calculated risk ratios (RR) stratified by resilience tertiles to test for effect measure modification.

RESULTS

Among those in the lowest resilience tertile, there were six (20.7%) PTBs among Black and seven (4.9%) among White participants (RR: 4.26; 95% confidence interval (CI): 1.53, 11.81). Among those in the highest resilience tertile, there were 8 (18.2%) PTBs among Black and 14 (9.5%) among White participants (RR: 1.92; 95% CI: 0.87, 4.24. The adjusted Black:White RR was 2.00 (95% CI 0.47, 8.64) in the lowest and 3.49 (95% CI 1.52, 8.01) in the highest tertile.

CONCLUSIONS

Black-White PTB inequity did not differ among resilience strata and remained significant in the highest tertile. Our findings suggest that high resilience is inadequate to overcome Black:White racial inequity in PTB.

Prediction of Chronic Stress and Protective Factors in Adults: Development of an Interpretable Prediction Model Based on XGBoost and SHAP Using National Cross-sectional DEGS1 Data

BACKGROUND

Chronic stress is highly prevalent in the German population. It has known adverse effects on mental health, such as burnout and depression. Known long-term effects of chronic stress are cardiovascular disease, diabetes, and cancer.

OBJECTIVE

This study aims to derive an interpretable multiclass machine learning model for predicting chronic stress levels and factors protecting against chronic stress based on representative nationwide data from the German Health Interview and Examination Survey for Adults, which is part of the national health monitoring program.

METHODS

A data set from the German Health Interview and Examination Survey for Adults study including demographic, clinical, and laboratory data from 5801 participants was analyzed. A multiclass eXtreme Gradient Boosting (XGBoost) model was constructed to classify participants into 3 categories including low, middle, and high chronic stress levels. The model's performance was evaluated using the area under the receiver operating characteristic curve, precision, recall, specificity, and the F1-score. Additionally, SHapley Additive exPlanations was used to interpret the prediction XGBoost model and to identify factors protecting against chronic stress.

RESULTS

The multiclass XGBoost model exhibited the macroaverage scores, with an area under the receiver operating characteristic curve of 81%, precision of 63%, recall of 52%, specificity of 78%, and F1-score of 54%. The most important features for low-level chronic stress were male gender, very good general health, high satisfaction with living space, and strong social support.

CONCLUSIONS

This study presents a multiclass interpretable prediction model for chronic stress in adults in Germany. The explainable artificial intelligence technique SHapley Additive exPlanations identified relevant protective factors for chronic stress, which need to be considered when developing interventions to reduce chronic stress.

Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS

Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all patients who were discharged from the ICU. Patients were administered the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire, the Short-Form Health Survey 36Version 2 (SF-36v2), a socioeconomic question set and the Impact of Event Scale-Revised (IES-R) to assess PTSD. Results: The multivariate logistic regression model found that an International Standard Classification of Education Score (ISCED) higher than 2 (OR 3.42 (95% CI 1.28-9.85)), monthly income less than EUR 1500 (OR 0.36 (95% CI 0.13-0.97)), and more than two comorbidities (OR 4.62 (95% CI 1.33-16.88)) are risk factors for developing PTSD symptoms. Patients with PTSD symptoms are more likely to present a worsening in their quality of life as assessed by EQ-5D-5L and SF-36 scales. Conclusion: The main factors associated with the development of PTSD-related symptoms were a higher education level, a lower monthly income, and more than two comorbidities. Patients who developed symptoms of PTSD reported a significantly lower Health-Related Quality of life as compared to patients without PTSD. Future research areas should be oriented toward recognizing potential psychosocial and psychopathological variables capable of influencing the quality of life of patients discharged from the intensive care unit to better recognize the prognosis and longtime effects of diseases.

The relation between childhood maltreatment and hedonic and eudaimonic well-being in emerging adults: A daily diary study

BACKGROUND

Prior research has reported that childhood maltreatment is associated with poor well-being, but few studies have examined the association between childhood maltreatment and well-being including hedonic and eudaimonic well-being using a daily diary method.

OBJECTIVE

The present study investigated the association between childhood maltreatment and hedonic and eudaimonic well-being, and explored the mediating effects of social support and self-esteem.

PARTICIPANTS AND SETTING

Data were collected applying a 14-day daily diary method in two samples. A total of 120 Chinese emerging adults (100 female; M_age = 20.48 years, age range = 18-24 years) and 229 Chinese emerging adults (187 female; M_age = 20.43 years, age range = 18-27 years) comprised the discovery sample and the replication sample, respectively.

METHODS

Multilevel regression analysis and multilevel mediation analysis were conducted, while controlling for sex, age, and socioeconomic status.

RESULTS

In the discovery sample, the multilevel regression analysis showed that childhood maltreatment had an equal effect on predicting the two types of well-being. Additionally, the multilevel mediation analysis demonstrated that social support and self-esteem acted as independent and equally important mediators of the associations between childhood maltreatment and the two types of well-being. Moreover, the total indirect effect on the childhood maltreatment-hedonic well-being link had no significant difference from that on the childhood maltreatment-eudaimonic well-being link. The replication sample reconfirmed the results of the discovery sample, which provides greater credibility to our findings.

CONCLUSIONS

Social support and self-esteem might help to improve the well-being of emerging adults who have suffered childhood maltreatment, and might therefore be important intervention targets.

Combined effects of high temperature and pesticide mixture exposure on free-swimming behaviors and hepatic cytochrome P450 1A expression in goldfish, Carassius auratus

The synergy between multiple compounds and other stressors, including heat, creates volatility and greater unpredictability than standard single-chemical toxicity testing, especially in the case of pesticides and metabolites which might contain several noxious ingredients resulting in adverse ecological effects. To address this, the aim of this study was to examine the dose- and time-dependent effects of low- and high-dose pesticide mixture (metalachlor, linuron, isoproturon, tebucanazole, aclonifen, atrazine, pendimethalin, azinphos-methyl) and heat stress co-exposure (22°C control/32°C treatment for 4-week) on free-swimming behaviors and cumulative actionless time (CAT) of goldfish. Behavioral analysis showed a dose- and time-dependent decrease in distance swam, as well as a subsequent increase in CAT. Vertical and horizontal spatial behavioral use were affected under heat and pesticides co-exposure conditions. In 3- and 4-week(s) exposure groups, horizontal spatial behavioral use demonstrated elevated time spent in the lower third of the aquarium. Similarly, during 3- and 4-week(s) exposure (32°C control and 32°C high doses) vertical spatial behavioral use was found to increase time spent in the outermost edges of the aquarium. In all treatment groups, the final condition factor (KM) showed significant attenuation when compared to the initial KM. However, there was an unclear relationship between heat/pesticide co-exposure and growth most notably in 32°C high-dose groups. In addition, the expression of hepatic cytochrome P450 1A mRNA was significantly higher in pesticide-exposed groups. Taken together, data demonstrated that co-exposure with low- or high-dose pesticide mixture and heat stress significantly impacted natural swimming patterns, which over time might result in the broader population and ecological effects.

Pickleball and mental health in adults: A systematic review

Introduction

Physical activity has been extensively studied and numerous mental health benefits have been found. Pickleball is an emerging racquet sport, which is characterized by its accessibility to all audiences and has become especially popular in the United States among the elderly. It is a novel team game and its inclusive nature is innovative for health improvement. The purpose of this systematic review was to review and evaluate existing studies that have examined the effects of pickleball on the mental and psychological health of individuals.

Methods

A systematic review was conducted on articles found in Scopus, PubMed, Elsevier, Web of Science (WoS), PsyINFO, Dialnet, and Elton B. Stephens Company (EBESCO) from 1975 to the present. The keywords used was a five combination between "Pickleball" joint with different terms by the connector AND, the second part of the combo could be "mental disorder" OR "anxiety" OR "depression" OR "psychological health" OR "mental health." Eligibility criteria included: papers focused on pickleball, in English or Spanish, on mental health variables, without establishing an age range. We excluded duplicate works, without access or that did not address the objective of this study.

Results

The search resulted in 63 papers, of which 13 were selected. A total of 90.74% of the population were people over 50 years of age. The results show significant improvements in the different psychological variables measured in pickleball practitioners: personal wellbeing, life satisfaction, depression, stress, happiness, etc., pickleball shows potential as a new tool to work and improve people's mental health.

Conclusions

The pickleball is displayed as an inclusive sport that does not need adaptations, resulting of great interest to be worked in different populations with mental problems.

Psychological Resilience: An Affect-Regulation Framework

Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.

Resilience resources may buffer some middle-aged and older Black Americans from memory decline despite experiencing discrimination

RATIONALE

Experiences of discrimination have been associated with poorer episodic memory in Black Americans. However, resilience resources at multiple levels (individual, social, and endowed) may act as a buffer to protect future memory decline, especially in the face of discrimination.

OBJECTIVE

Using longitudinal data from the 2006-2016 Health and Retirement Study (N = 1862), we tested whether Black Americans aged 50 and older would show different trajectories of episodic memory depending on their reported experiences of discrimination (everyday and major lifetime) and resilience resources.

METHODS

Analyses were conducted in three steps: (1) joint latent cluster mixed modeling (JLCMM) to estimate the number of classes, (2) barycentric discriminant analyses (BADA) to model the combined influence of discrimination and resilience resources between each memory class, and (3) multinomial regression analyses to explore interactions between discrimination and resilience resources.

RESULTS

JLCMM resulted in three memory classes that differentiated baseline from longitudinal memory performance: "High Decliners," "Low Decliners," and "Low Stable." Two independent patterns described the relationships between the three classes in the context of discrimination and resilience resources. First, compared with High Decliners, the two lower baseline memory classes (Low Decliners and Low Stable) reported more everyday discrimination and lower individual and endowed resilience resources. Second, although the Low Stable class did not report different levels of discrimination, they had more social resilience resources (greater social support and more social contact) than both declining classes.

CONCLUSIONS

Black Americans in later life have heterogeneous patterns of memory trajectories as demonstrated by the three memory classes identified. Those with lower baseline memory experienced more everyday discrimination and had fewer resilience resources compared to those with high baseline performance (High Decliners). Greater social resilience resources were associated with maintained episodic memory over time in Black Americans.

Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research

BACKGROUND

Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods.

METHODS

This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews.

RESULTS

The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden.

CONCLUSIONS

The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.

Reliving a traumatic experience through emotional creativity: the bright side of cancer during the COVID-19 pandemic

Purpose

The COVID-19 outbreak has undoubtedly affected overall mental health. Thus, researching resilience is important, as it has been previously discussed as a means to protect people from mental health problems. This study aims to clarify whether survivors of a traumatic event (i.e. cancer survivors) are more resilient to living through another traumatic experience, such as COVID-19, compared to those who have never had such an experience. The study also examines the role of emotional creativity in this process.

Design/methodology/approach

A quantitative research design was adopted. The data collection was performed through a survey (N = 338), which was conducted among two separate groups of participants. The first group (N = 152) included the survivors of a traumatic event (i.e. cancer survivors), and the second group (N = 186) included those who did not have such an experience.

Findings

The results demonstrate that living through a traumatic experience results in a higher level of resilience during another traumatic experience (i.e. COVID-19), which is the result of higher post-traumatic growth. Moreover, emotional creativity is discussed as an explanatory variable that explains a significantly higher level of post-traumatic growth among survivors of a traumatic event.

Originality/value

This research offers a better understanding of the effect of living through a traumatic event on post-traumatic growth and resilience in living through another traumatic experience. Moreover, post-traumatic growth is explained through emotional creativity improvement, which happens after experiencing a traumatic life event.

Scientific opportunities in resilience research for cardiovascular health and wellness. Report from a National Heart, Lung, and Blood Institute workshop

Exposure of biological systems to acute or chronic insults triggers a host of molecular and physiological responses to either tolerate, adapt, or fully restore homeostasis; these responses constitute the hallmarks of resilience. Given the many facets, dimensions, and discipline-specific focus, gaining a shared understanding of "resilience" has been identified as a priority for supporting advances in cardiovascular health. This report is based on the working definition: "Resilience is the ability of living systems to successfully maintain or return to homeostasis in response to physical, molecular, individual, social, societal, or environmental stressors or challenges," developed after considering many factors contributing to cardiovascular resilience through deliberations of multidisciplinary experts convened by the National Heart, Lung, and Blood Institute during a workshop entitled: "Enhancing Resilience for Cardiovascular Health and Wellness." Some of the main emerging themes that support the possibility of enhancing resilience for cardiovascular health include optimal energy management and substrate diversity, a robust immune system that safeguards tissue homeostasis, and social and community support. The report also highlights existing research challenges, along with immediate and long-term opportunities for resilience research. Certain immediate opportunities identified are based on leveraging existing high-dimensional data from longitudinal clinical studies to identify vascular resilience measures, create a 'resilience index,' and adopt a life-course approach. Long-term opportunities include developing quantitative cell/organ/system/community models to identify resilience factors and mechanisms at these various levels, designing experimental and clinical interventions that specifically assess resilience, adopting global sharing of resilience-related data, and cross-domain training of next-generation researchers in this field.

Coping-resilience profiles and experiences of stress in autistic adults

Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.

The roles of resilience and belonging in mediating the association between positivity and anxiety among underrepresented college students

Objective: Investigate the association of positivity with generalized anxiety and the mediating roles of resilience and sense of belonging in underrepresented college students. Participants: College students (N = 425; 18.4% White, 17.9% Black, 40.2% Hispanic, 20.2% Asian; 38.1% first-generation; M_age = 19.06; 63.1% female) completed an online survey assessing positivity, anxiety, resilience, and belonging. Methods: Path analysis tested the proposed mediation model, controlling for age, sex, race/ethnicity, first-generation status, living status, and diagnosed disability. Results: Positivity was negatively associated with anxiety directly (ƅ = -.468, p < .001) and indirectly through resilience (ƅ = -.083, p < .001), but not through belonging (ƅ = -.026, p > .05). Positivity was associated with belonging (ƅ = .611, p < .001); belonging was not associated with anxiety (ƅ = -.042, p > .05). Conclusions: Findings highlight the benefit of positivity on anxiety and the mediating role of resilience among underrepresented college students.

Neurobiological mechanisms of mood disorders: Stress vulnerability and resilience

Stress is an important factor in the development of several human pathologies. The response of rodents and humans to stress depends on many factors; some people and rodents develop stress-related mood disorders, such as depression and anxiety in humans, depression-like and anxiety-like behavior in mice and rats, while others report no new psychological symptoms in response to chronic or acute stress, and are considered susceptible and resilient to stress, respectively. Resilience is defined as the ability to thrive in the face of adversity and is a learned process that can help protect against occupational stressors and mental illnesses. There is growing interest in the underlying mechanisms involved in resilience and vulnerability to depression caused by stress, and some studies have demonstrated that individual variability in the way animals and humans respond to stress depends on several mechanisms, such as oxidative stress, neuronal plasticity, immunology and genetic factors, among others not discussed in this review, this review provides a general overview about this mechanism.

The More the Better, Only in the Longer Term: A Cluster Randomized Controlled Trial to Evaluate a Compound Intervention Among Mainland Chinese Immigrants in Hong Kong

Barriers to adaptation faced by mainland Chinese immigrants to Hong Kong can be reduced by improving two targets of adaptation: information about negotiating their new environment and psychological well-being. We developed and evaluated a Compound intervention to address these two domains simultaneously and compared its effects to two separate interventions exclusively targeting either information about Hong Kong or psychological well-being. This cluster randomized controlled trial assigned 251 immigrants to an information provision arm (IP, n = 84) targeting knowledge and adaptation difficulties, a psychological well-being enhancement arm (WBE, n = 80) targeting resilience and mental health, or a Compound arm (i.e., IP + WBE, n = 87). The Compound arm showed stronger effects from baseline to postintervention on knowledge than the WBE arm. From postintervention to 6-month follow-up, the Compound arm showed better sustained effects on knowledge and adaptation difficulties than the IP arm and on resilience and mental health than the WBE arm. Additionally, participants in the Compound arm with more baseline depressive symptoms showed greater improvements in adaptation difficulties and general mental health than those with fewer symptoms. The study demonstrated the longer-term effectiveness of the Compound intervention and its greater benefits for immigrants with more depressive symptoms.

A simultaneous concept analysis of resilience, coping, posttraumatic growth, and thriving

BACKGROUND

Research has shifted in recent decades from a focus on negative effects of adversity, trauma, and stress to protective factors and positive outcomes. Resilience and related concepts (coping, posttraumatic growth, thriving, and preparedness) reflect this shift. However, the current state of literature reflects conceptualization challenges in relation to these terms, which blur their differentiation.

AIM

We aim to examine how resilience and related terms are conceptualized in health-related literature.

DESIGN

We used a simultaneous concept analysis to independently explore and further inform the conceptual development of resilience, coping, PTG, and thriving.

DATA SOURCE

We searched PsycINFO and PubMed for literature between 1999 and 2019 for each of our concepts.

REVIEW METHODS

For each of these concepts, we propose a definition, antecedents, attributes, an example, consequences, and related concepts. Next, we concurrently examined the concepts, compared and contrasted findings across them, and clarified similarities as well as differences between them.

RESULTS

Many concepts' definitions lack specificity, clear boundaries, and consistency across the literature. Resilience literature fails to differentiate between attributes and antecedents of resilience. There was overlap regarding conceptualization between resilience and coping, and resilience and thriving.

CONCLUSIONS

Several concepts' definitional literature diverged between a return to baseline functioning and surpassing baseline.

Psychosocial Resilience to Inflammation-Associated Depression: A Prospective Study of Breast-Cancer Survivors

Stress can lead to depression, in part because of activation of inflammatory mechanisms. It is therefore critical to identify resilience factors that can buffer against these effects, but no research to date has evaluated whether psychosocial resilience mitigates the effects of stress on inflammation-associated depressive symptoms. We therefore examined psychosocial resources known to buffer against stress in a longitudinal study of women with breast cancer (N = 187). Depressive symptoms and inflammation were measured over a 2-year period extending from after diagnosis into survivorship. Cancer-related stress and psychosocial resources-social support, optimism, positive affect, mastery, self-esteem, and mindfulness-were measured after diagnosis. As hypothesized, women who reported having more psychosocial resources showed weaker associations between stress and depressive symptoms and weaker associations between stress and inflammation-related depressive symptoms. Results highlight the importance of psychosocial resilience by demonstrating a relationship between psychosocial resources and sensitivity to inflammation-associated depressive symptoms.

Cumulative exposure to poor housing conditions and psychological well-being: Does the relationship differ for young and middle-aged adults and older adults?

OBJECTIVES

This study examined whether cumulative exposure to poor housing conditions is negatively associated with psychological well-being, and whether this association varies by age.

METHODS

Using fifteen waves of the Korean Welfare Panel Study between 2005 and 2019 (118,500 person-observations), this study employed fixed-effects regression models to account for unobserved individual-level heterogeneity. Exposure to poor housing conditions ranged from 1 to more than 5 annual waves. To formally test for age heterogeneity, interactive models were estimated.

RESULTS

The trajectories of change in psychological well-being associated with cumulative exposure to poor housing conditions were different between young and middle-aged adults and older adults. Among young and middle-aged adults, the levels of depressive symptoms increased in the first year of exposure but remained at a similar level since then. In contrast, with the persistence of poor housing conditions, older adults continued to develop greater depressive symptoms over time. Similar age differences were found for life satisfaction. As exposure to poor housing conditions accumulated, life satisfaction persistently declined among older adults, but not young and middle-aged adults.

CONCLUSION

This study suggests that cumulative exposure to poor housing conditions has more adverse psychological consequences for older adults than young and middle-aged adults.

Resilience Resources Scale: A brief resilience measure validated with undergraduate students

Objective: This paper presents a theory-based brief resilience scale, the Resilience Resources Scale (RRS), and evidence for its factor structure, reliability, and validity in two studies of undergraduate students. Participants: Study 1 sampled 295 students and Study 2 sampled 244 students. Methods: Study 1 participants completed the RRS and other measures online at one of two time points eight weeks apart (n = 193), or at both time points (n = 102). Study 2 participants completed the RRS and other measures online on a single occasion. Results: Factor analyses provided evidence for a one-factor model. Results indicated high internal consistency and strong test-retest reliability. Evidence of concurrent and predictive validity is presented. Conclusions: The RRS measures resilience resources known to be protective of physical and mental health. This brief scale has sound psychometric properties in these initial studies of undergraduate students. We offer possible directions for use of the RRS in this and other populations.

Development of Long and Short Forms of the Multilevel Resilience Resource Measure for African American/Black Adults Living with HIV

Understanding resilience in relation to HIV-related outcomes may help address racial/ethnic disparities, however, significant gaps in its measurement preclude in-depth study. Thus, this research aims to develop and evaluate the psychometric properties of long and short forms of the Multilevel Resilience Resource Measure for African American/Black Adults Living with HIV. To develop the items, we conducted a mixed methods study (N = 48) and reviewed published resilience measures. We completed content validity index analyses to ensure the items reflected the resilience construct. Next, we conducted 20 cognitive interviews and a field survey (N = 400). The long and short forms demonstrated acceptable to excellent psychometric properties based on factorial validity, internal consistency and convergent validity and on measurement invariance (conducted for the short form only). These measures provide a comprehensive framework to examine resilience and HIV-related outcomes and can inform resilience-building interventions to reduce racial and ethnic health disparities.

Qualitative modelling of social determinants of health using group model building: the case of debt, poverty, and health

Background

Social determinants of health (SDoH) are known to have a large impact on health outcomes, but their effects are difficult to make visible. They are part of complex systems of variables largely indirect effects on multiple levels, constituting so-called wicked problems. This study describes a participatory approach using group model building (GMB) with stakeholders, in order to develop a qualitative causal model of the health effects of SDoH, taking poverty and debt in the Dutch city of Utrecht as a case study.

Methods

With GMB we utilised the perspective of stakeholders who are directly involved in policy and practice regarding poverty, debt, and/or health. This was done using system dynamic modelling, in three interactive sessions lasting three hours each. In these sessions, they constructed a model, resulting in a system of variables with causal relationships and feedback loops. Subsequently, the results of these GMB sessions were compared to scientific literature and reviewed by a panel of researchers with extensive experience in relevant scientific fields.

Results

The resulting model contains 71 causal relationships between 39 variables, 29 of which are present in feedback loops. The variables of participation in society, stress, shame, social contacts and use of services/provisions appear to hold prominent roles in the model’s mechanisms. Most of the relationships in the model are supported by scientific literature. The researchers reviewing the model in the scientific meeting agreed that the vast majority of relationships would concur with scientific knowledge, but that the model constructed by the stakeholders consists mostly of individual-level factors, while important conditions usually relate to systemic variables.

Conclusions

Building a model with GMB helps grasp the complex situation of a wicked problem, for which it is unlikely that its interrelationships result in a fully intuitive understanding with linear mechanisms. Using this approach, effects of SDoH can be made visible and the body of evidence expanded. Importantly, it elicits stakeholders’ perspectives on a complex reality and offers a non-arbitrary way of formulating the model structure. This qualitative model is also well suited to serve as conceptual input for a quantitative model, which can be used to test and estimate the relationships.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-022-01676-7.

Childhood Maltreatment and Psychosocial Flourishing among Emerging Adults: Roles of Psychological Suzhi and Self-Esteem

Studies have shown that childhood maltreatment can negatively predict psychosocial flourishing among emerging adults. However, few studies have revealed the factors that can protect the psychosocial flourishing of emerging adults who experienced maltreatment during childhood. Based on theoretical and empirical considerations, this study investigated whether and how psychological suzhi (a positive quality that can facilitate individuals’ adaptation to environment) plays a protective role in the relationship between childhood maltreatment and psychosocial flourishing among emerging adults. A total of 2863 Chinese emerging adults (M_age = 19.96 years) completed the self-report measures of the Childhood Trauma Questionnaire, Psychological Suzhi Questionnaire, Rosenberg Self-esteem Scale, and Flourishing Scale. The moderated analyses showed that childhood maltreatment had a less negative impact on psychological flourishing in high psychological suzhi emerging adults than in low psychological suzhi emerging adults. Part of the moderating effect of psychological suzhi is mediated through self-esteem. These results demonstrated that psychological suzhi plays a buffering effect between childhood maltreatment and psychosocial flourishing, and part of the effect is achieved by mediated variable self-esteem. These findings are discussed, and practical implications are presented.

Stress Measurement in Primary Care: Conceptual Issues, Barriers, Resources, and Recommendations for Study

OBJECTIVE

Exposure to stressors in daily life and dysregulated stress responses are associated with increased risk for a variety of chronic mental and physical health problems, including anxiety disorders, depression, asthma, heart disease, certain cancers, and autoimmune and neurodegenerative disorders. Despite this fact, stress exposure and responses are rarely assessed in the primary care setting and infrequently targeted for disease prevention or treatment.

METHOD

In this narrative review, we describe the primary reasons for this striking disjoint between the centrality of stress for promoting disease and how rarely it is assessed by summarizing the main conceptual, measurement, practical, and reimbursement issues that have made stress difficult to routinely measure in primary care. The following issues will be reviewed: a) assessment of stress in primary care, b) biobehavioral pathways linking stress and illness, c) the value of stress measurements for improving outcomes in primary care, d) barriers to measuring and managing stress, and e) key research questions relevant to stress assessment and intervention in primary care.

RESULTS

On the basis of our synthesis, we suggest several approaches that can be pursued to advance this work, including feasibility and acceptability studies, cost-benefit studies, and clinical improvement studies.

CONCLUSIONS

Although stress is recognized as a key contributor to chronic disease risk and mortality, additional research is needed to determine how and when instruments for assessing life stress might be useful in the primary care setting, and how stress-related data could be integrated into disease prevention and treatment strategies to reduce chronic disease burden and improve human health and well-being.

Multilevel resilience resources and cardiovascular disease in the United States: A systematic review and meta-analysis

Objective: This systematic review and meta-analysis aimed to quantify the relationship between resilience resources at the individual (e.g., optimism), interpersonal (e.g., social support), and neighborhood (e.g., social environment) levels, and cardiovascular outcomes among adults in the United States. Method: On 9/25/2020, electronic databases (PubMed, Embase, CINAHL, PsycINFO) were systematically searched for randomized controlled trials, nonrandomized intervention studies, and prospective cohort studies that examined the relationship between resilience resources at the individual, interpersonal, or neighborhood level and cardiovascular outcomes. Studies that met the eligibility criteria were summarized narratively and quantitatively. Because relevant search results yielded only observational studies, risk of bias was assessed using an adapted version of the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Results: From 4,103 unique records, 13 prospective cohort studies with a total of 310,906 participants met the eligibility criteria, and six of these studies were included in the meta-analyses. Most relevant studies found that higher levels of individual-level resilience resources were associated with lower incidence of adverse cardiovascular outcomes, with point estimates ranging from .46 to 1.18. Interpersonal-level resilience resources (i.e., social network) were associated with a lower coronary heart disease risk (risk ratio, .76; 95% CI [.56, 1.02]). Neighborhood-level resilience resources (i.e., perceived social cohesion and residential stability) were associated with a lower odds of stroke (odds ratio, .92; 95% CI [.84, 1.01]). Conclusions: Evidence suggests that higher levels of resilience resources are associated with better cardiovascular outcomes. However, more prospective studies with diverse populations are needed to strengthen the evidence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).