Validity and reliability of the Spanish version of the 10-item CD-RISC in patients with fibromyalgia

Measurement of Psychological Resilience to Support Therapy Interventions for Clients in the Clinical Mental Healthcare Setting: A Scoping Review

Waves of psychological research over 50 years have resulted in the development of scales to measure psychological resilience. Multiple psychological resilience definitions and factors have emerged during this time, making its measurement complex. The overall aim of the review was to identify and describe developments in the measurement of psychological resilience in the clinical mental healthcare setting. Specific objectives included (1) consideration of the validity and reliability of psychological resilience scales, (2) the effectiveness of the scales in clinical mental healthcare settings and (3) to identify the scope that resilience factors are addressed in the included scales. It provides a timely update regarding psychological resilience measurement tools and considers further developments that may be required. Between 2011 and 2024, databases were searched, and English-language, peer-reviewed papers with full text were extracted. Eligible studies were those reporting validated existing resilience measures or the outcomes of new measures for use in clinical mental healthcare settings. Seventeen studies met the inclusion criteria. The review demonstrated that psychological resilience measures require further development, particularly focusing on the utility of measurement tools in clinical mental healthcare settings. In this review, we highlight an existing gap in resilience measurement and underscore the need for a new measure of psychological resilience that can effectively assess individuals' subjective experience of their psychological resilience in clinical mental healthcare settings. The currently available psychological resilience measures included in this review do not directly reflect all the factors that might impact a client's depression or anxiety and warrant further research.

The role of resilience in the potential benefits of cognitive-behavioural stress management therapy during pregnancy

PURPOSE

Stress during pregnancy has many negative repercussions on maternal and foetal health. It is therefore important to understand which therapies are effective in reducing stress levels and which variables influence the outcomes of these therapies. In this line, psychological resilience could play a key role. Thus, the aim of the study was to check whether pregnant women with different levels of resilience have different benefits in reducing cortisol levels, perceived stress, pregnancy worries, stress vulnerability, anxiety or depression through Cognitive Behavioural Stress Management Therapy.

METHOD

The total sample consisted of 56 pregnant women: one group of pregnant women with high levels of resilience (n = 35); and another group with low levels of resilience (n = 21). Participants' cortisol concentration levels, perceived stress, pregnancy concerns, stress vulnerability, anxiety and depressive symptoms were assessed before and after therapy. Linear mixed models were performed to compare the two groups, which showed a group x time interaction for perceived stress.

RESULTS

The low resilience group showed a reduction in their perceived stress levels with a medium effect after the intervention compared to the high resilience group, but no reduction was found in this group. No differences were found between the two groups on the other variables.

CONCLUSION

Knowing which variables have a differential effect on the results of psychological therapy would allow delimiting the groups that obtain greater benefits from the therapy. This may lead to more efficient implementation of effective intervention programmes.

Mental Health and Other Factors Associated with COVID-19 Vaccination Intention toward Children of Military Parents in Lambayeque, Peru

There is evidence that vaccine acceptability is strongly associated with mental health. However, no studies assessing intention to vaccinate (ITV) intention toward children of military parents have been documented. The current research aimed to establish the prevalence and factors of ITV children against COVID-19 in military parents in Lambayeque-Peru, 2021. Analysis was conducted with the dependent variable ITV children reported by military parents. The independent variables were history of mental health, searching for mental health support, food insecurity, resilience, anxiety, depression, burnout, posttraumatic stress, and suicidal risk. Prevalence ratios and 95% confidence intervals were estimated. Of 201 military personnel evaluated, 92.5% were male, 82.5% were of the Catholic faith, and the median age was 40.9% of respondents reported seeking mental health help during the COVID-19 pandemic. It was reported anxiety (20.3%), depression (6.5%), and posttraumatic stress disorder (6.5%). Most reported ITV in children against COVID-19 (93%). In the multiple models, we found that Catholics had a 23% higher prevalence of ITV in the children where PR = prevalence ratios and CI = confidence intervals (PR = 1.23; 95% CI: 1.01-1.50). Likewise, seeking mental health support increased the prevalence of ITV by 8% (PR = 1.08; 95% CI: 1.00-1.15). Seeking mental health support and belonging to the Catholic faith had a higher ITV of children of Peruvian military personnel. Finding mental health support, experiencing burnout syndrome, having a relative who suffers from mental health problems, and being part of the Catholic religion were associated with a higher willingness to immunize the children of Peruvian military members.

Psychometric Properties of Patient-reported Outcome Measures to Assess Resilience in Individuals with Musculoskeletal Pain or Rheumatic Conditions: A COSMIN-based Systematic Review

OBJECTIVES

The objective of this systematic review was to provide a comprehensive overview of the measurement properties of patient-reported outcome measures (PROMs) used to assess resilience in individuals with musculoskeletal and rheumatic conditions.

METHODS

Four electronic databases (MEDLINE, CINAHL, PsycINFO, and Web of Science) were searched. Studies assessing any measurement property in the target populations were included. Two reviewers independently screened all studies and assessed the risk of bias using the COSMIN checklist. Thereafter, each measurement property of each PROM was classified as sufficient, insufficient, or inconsistent based on the COSMIN criteria for good measurement properties.

RESULTS

Four families of PROMs [Brief Resilient Coping Scale (BRCS); Resilience Scale (RS-18); Connor-Davidson Resilience Scale (CD-RISC-10 and CD-RISC-2); and Pain Resilience Scale (PRS-14 and PRS-12)] were identified from the 9 included studies. Even if no PROM showed sufficient evidence for all measurement properties, the PRS and CD-RISC had the most properties evaluated and showed the best measurement properties, although responsiveness still needs to be assessed for both PROMs. Both PROMs showed good levels of reliability (intraclass coefficient correlation 0.61 to 0.8) and good internal consistency (Cronbach's alpha ≥0.70). Minimal detectable change values were 24.5% for PRS and between 4.7% and 29.8% for CD-RISC.

DISCUSSION

Although BRCS, RS-18, CD-RISC, and PRS have been used to evaluate resilience in individuals with musculoskeletal and rheumatic conditions, the current evidence only supports the use of PRS and CD-RISC in this population. Further methodological studies are therefore needed and should prioritize the assessment of reliability and responsiveness.

Pregnant women's mental health during the COVID-19 pandemic according to the trimester of pregnancy

AIM

This study aimed to analyse the psychological impact of the COVID-19 pandemic on pregnant women according to the pregnancy trimester, comparing their psychopathological symptomatology, pregnancy-specific stress, resilience and perceived stress to those of women pregnant before the pandemic.

METHODS

A total of 797 pregnant women participated in the study, one group of 393 women pregnant before the pandemic and the other of 404 women pregnant during the pandemic. Student-t test was used to analyse continuous data and the Chi-square test was used for categorical data.

RESULTS

Psychopathological symptomatology was significantly higher in six subscales of the SCL-90-R in pregnant women during COVID-19: somatisation, interpersonal sensitivity, depression, anxiety, phobic anxiety, obsessions-compulsions, mainly on the first two trimesters. There is also a higher level of pregnancy-specific stress in pregnant women during the pandemic on the first two trimesters, most likely due to the hypervigilance and fears related to the COVID-19 disease. Nevertheless, perceived stress, usually elevated during pregnancy, was lower in women pregnant during the pandemic in comparison to those pregnant before, as a positive consequence of being on lockdown and diminishing the exposure to daily stressful situations.

CONCLUSIONS

Knowing the struggles these women go through during each trimester of pregnancy can be the key to a better health professional-patient relationship, consequently having a positive impact on their mental and physical health.

Medical students' resilience level and its associated factors: A Tunisian study

INTRODUCTION

Resilience is one's ability to adapt to internal and external stressors and cope with challenges encountered throughout life.

AIM

Our work aimed to determine resilience levels at the Medical University of Ibn El Jazzar-Sousse (Faculty of Medicine of Sousse) Tunisia and to identify the key factors influencing resilience in order to help students improve their college experience, as well as their future career and eventually their quality of life.

METHODS

It's a cross-sectional study conducted during October and November 2021 at the FMS including all undergraduate medical students using a questionnaire elaborated in French language and composed of 02 major parts Socio-demographic and general health data and The Connor-Davidson Resilience Scale (CD-RISC). Data were collected using Google Forms platform via social networks (Facebook students' groups).

RESULTS

A total of 225 participants filled the questionnaire; the mean age was 21±5 years. Among them 75.1% were females (sex ratio=0.33). The total resilience mean score was 56.36±12.43. Comparison of resilience scores according to different covariates showed that resilience was positively associated with male gender, extracurricular activities, relationships with both colleagues and teachers and physical exercise, but negatively associated with imposed course of study and perception of both study difficulties and personal academic results. No correlation was found between resilience score and age.

CONCLUSIONS

This work encourages university administrators to devote more resources to promote resilience, and it emphasizes the importance of implementing new educational and entertaining interventions to improve students' ability to deal with academic challenges.

Protocol for a Parallel Group Randomized Clinical Trial Comparing a Culturally Adapted Cognitive Behavioral Telerehabilitation Intervention to Usual Physical Therapy for Latino Patients With Chronic Spine Pain

OBJECTIVE

Disparities exist in health care access, diagnosis, and treatment of chronic pain in Latino populations and other minority populations. Cognitive behavioral-based physical therapy (CBPT) interventions have been shown to be effective in predominantly non-Hispanic white populations with chronic spine pain. However, there is a need for culturally adapted CBPT interventions that focus on the conservative management of chronic spine pain. The primary purpose of the study described in this protocol is to test the efficacy of an adapted cognitive behavioral-based hybrid telerehabilitation intervention for Latino patients with chronic spine pain.

METHODS

A single-blind, 2-arm parallel group, superiority randomized clinical trial is planned to compare an adapted CBPT intervention to Usual Care physical therapy. Goal Oriented Activity for Latinos with chronic Spine pain (GOALS/Metas) is an 8-week hybrid telerehabilitation intervention that integrates guideline-based physical therapy and pain management interventions using cognitive behavioral approaches and has been adapted for Latino patients with chronic spine pain. Usual Care physical therapy will be administered based on institutional standards at the referring health center. Outcome measures will be evaluated preintervention and at 1-week, 3-months, and 6-months postintervention. The primary outcome is pain-related disability 1-week postintervention using the Brief Pain Inventory Pain Interference subscale. Secondary outcome measures include behavioral measures of functional activity, social participation, physical activity, and sleep. Determinants of treatment effect, including pain-related psychological measures, posture and movement, self-efficacy, treatment expectancy, and therapeutic alliance, will be included in the secondary moderation and mediation analyses.

IMPACT

This clinical trial will provide information on the extent to which an adapted CBPT hybrid telerehabilitation intervention is effective in reducing pain-related disability for Latino patients with chronic spine pain. This information will be useful for clinicians to integrate in their practice, given the growing population of Latino patients who experience disparities in health care management of chronic pain.

Association of anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA): a cross-sectional study

OBJECTIVES

To evaluate the association between anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA).

DESIGN

Cross-sectional evaluation of baseline data from a prospective cohort study, with recruitment from January 2018 to March 2021.

SETTING

Outpatient clinic in a tertiary hospital in Singapore.

PARTICIPANTS

Patients aged 21 years and above who were diagnosed with axSpA.

OUTCOME MEASURES

The Hospital Anxiety and Depression Scale (HADS) was used for assessing anxiety and depression, 10-item Connor Davidson Resilience Scale (CD-RISC-10) for resilience, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity, Bath Ankylosing Spondylitis Functional Index (BASFI) for functional limitation and Assessment of SpondyloArthritis International Society Health Index (ASAS HI) for overall health and functioning. Univariable and multivariable linear regression analyses were performed to assess the association between anxiety, depression and resilience with health and functioning.

RESULTS

We included 296 patients in this study. The median (IQR) score for HADS-Anxiety was 5.0 (2.0-8.0), with 13.5% and 13.9% having borderline abnormal and abnormal anxiety, respectively. The median (IQR) score for HADS-Depression was 3.0 (1.0-7.0), with 12.8% and 8.4% having borderline abnormal and abnormal depression, respectively. The median (IQR) CD-RISC-10 score was 29.0 (23.0-32.0) while the median (IQR) ASAS HI score was 4.0 (2.0-7.0). Apart from BASDAI, BASFI and disease duration, anxiety and depression were associated with overall health and functioning (β: 0.12, 95% CI 0.03, 0.20; β: 0.20, 95% CI 0.09, 0.31) in the multivariable linear regression. Level of resilience was not associated with health and functioning.

CONCLUSION

Anxiety and depression, but not resilience, were associated with poorer health and functioning. Clinicians could consider routinely screening for anxiety and depression in their patients, especially in patients with more severe symptoms.

Psychometric properties of the Persian version of abridged Connor-Davidson Resilience Scale 10 (CD-RISC-10) among older adults

Background

Resilience is an ability of an individual to respond positively to environmental challenges. This ability could help elderly people to better cope with their age-related changes and diseases. The aim of this study was to examine the psychometric properties of Persian version of abridged Connor- Davidson scale of resilience among Iranian elderly people with chronic diseases.

Methods

Standard translation/back-translation procedure was applied to prepare the Persian version of abridged Connor-Davidson scale of resilience (CD-RISC 10-P) and its face and content validity were examined by an expert panel. The internal consistency and reliability of the drafted CD-RISC 10-P were investigated using the Cronbach’s alpha and intra-class correlation coefficients. A sample of 400 Muslim and Zoroastrian Persian older adults residing in the city of Yazd, Iran was recruited to assess factor structure of CD-RISC 10-P using the confirmatory factor analysis.

Results

The calculated values of the Cronbach’s alpha (0.89) and ICC (0.90) coefficients were in the within of acceptable range. The confirmatory factor analysis outputs also confirmed the unidimensionality of the CD-RISC 10-P (RMSEA = 0.073, SRMR = 0.030).

Conclusions

The study findings showed that the CD-RISC 10-P is a valid and reliable scale to measure resilience with age-related challenges of chronic diseases among Persian-speaking elderly people. Cross-cultural adaptability of the CD-RISC 10-P is recommended to be assessed in different subgroups of the Iranian elderly people and possibly in other Persian-speaking populations of different countries.

Stressors and difficulties perceived during the pandemic in the teaching activity of nursing professors

Background

The coronavirus 2019 (COVID-19) pandemic has prompted several changes in teaching methods in addition to the ways of learning by students.

Objective

To check whether a relationship between factors, such as resilience, self-esteem, depression, anxiety, academic stressors, and a change in teaching methods and learning since the first epidemic outbreak exists.

Materials and methods

This study was a cross-sectional descriptive one with a non-random sample of nursing degree teachers who did or did not participate in clinical activities but had been teaching online since the start of the pandemic. Data were collected with online questionnaires validated for self-completion with Google Forms.

Results

Regarding the analysis of the descriptive data of each scale, we can verify that data indicate very high levels of resilience and self-esteem in the normal range with minimal levels of depression, moderate anxiety, and finally not worrying about sources of stress in teachers. Also, negative correlations were found between the 10 Connor–Davidson Resilience Scale, Beck Depression Inventory (BDI 2), Beck Anxiety Inventory (BAI), and Scale of Sources of Stress in Teachers with a statistical significance of p < 0.001. The Rosenberg Self-Esteem Scale also showed negative correlations with the three previously mentioned scales with a statistical significance of p < 0.001. Finally, positive correlations between the Beck (BDI 2), Beck (BAI), and Sources of Stress in Teachers scales and between the Rosenberg Self-Esteem scale and the 10 CD RISC scale were found (p < 0.001).

Discussion

Our study shows that nursing degree teachers combine teaching with activities and presented moderate levels of anxiety, depression, and tolerance to academic stressors and were able to maintain optimal levels of self-esteem and resilience, indicating that these two factors act as protectors against these stressors.

Tweetable abstract

Nursing teachers presented moderate levels of anxiety, depression, and academic stressors due to optimal levels of self-esteem and resilience.

Time in Service and Resilience in Active Military Personnel during the COVID-19 Pandemic: A Cross-Sectional Study in Northern Peru

Greater occupational exposure may have a positive effect on the development of resilience. We aimed to determine the association between working time and resilience in Peruvian military personnel during the COVID-19 pandemic. A secondary data analysis was performed including 586 records of military personnel who supported the health emergency during the second epidemic wave in Lambayeque, Peru. Resilience was measured with the short form of the Connor-Davidson Resilience Scale (CD-RISC). Working time and other relevant covariates were collected by self-report. Generalized linear models were used. The mean resilience score was 22.18 and 43.2% scored high for resilience. Participants reported that they are strong individuals when facing difficulties (42.3%), are able to handle unpleasant feelings (40.3%), and achieve their goals despite obstacles (40.4%). Working more than 18 months was associated with a 35% higher prevalence of high resilience (PR: 1.35; 95% CI: 1.05-1.75). In conclusion, a notable number of military personnel experienced high levels of resilience during the pandemic. Working time may have played an important role in the development of this ability. Our findings could help guide the deployment and organization of the military in health emergency support missions.

Resilience Among Direct Care Staff in Nursing Homes: Validation of the CD-RISC2

OBJECTIVES

Caring for older adults is a demanding task. Some professionals may find themselves in complex situations for which they may not be prepared. However, the repercussions of these difficult experiences will depend on personal factors. Resilience acts as a buffer against difficulties and experiences. However, its study with first-line caregivers in nursing homes is limited. This study aimed to validate the Connor-Davidson Resilience Scale-2 (CD-RISC2), examine its psychometric properties, and analyze the variables associated with resilience (sociodemographic and professionals´ variables).

METHODS

312 nursing home professionals participated in the study. Besides the Connor-Davidson Resilience Scale-2, they answered questionnaires about good care, burnout, quality of life, person-centered care, and well-being.

RESULTS

The CD-RISC2 showed adequate reliability and test-retest reliability. Good support was found for convergent validity with perceived health, person-directed care, personal growth, life purpose, quality of life and good care, and for discriminant validity with burnout. Conclusions: To our knowledge, this is the first study that validates the CD-RISC2 Spanish version with front-line workers in nursing homes showing adequate psychometric properties.

CLINICAL IMPLICATIONS

An abbreviated, simpler, self-assessed version may be more useful than longer versions, especially with professionals with a heavy workload, such as direct care staff in nursing homes.

Online cognitive behavioural therapy as a psychological vaccine against stress during the COVID-19 pandemic in pregnant women: A randomised controlled trial

The COVID-19 pandemic has affected the population's levels of stress and anxiety due to its contagious nature and the uncertainties generated by its novelty. One population that is especially vulnerable to these psychological consequences are pregnant women. This is why the objective of this study was to test the efficacy of an online stress management programme of a cognitive behavioural nature on pregnant women during the COVID-19 pandemic, in Spain. The trial was controlled and randomised, with a total of 207 pregnant women divided into three groups: the Online Cognitive Behavioural Therapy group (o-CBT) (N = 70); the Online Psychological Support group (o-PS) (N = 69); and the Usual Care group (UC) (N = 68). To test the therapy's efficacy, the women's resilience, perceived stress, pregnancy-specific stress and psychopathological symptoms were assessed before and after the intervention. The o-CBT and o-PS consisted of a programme of 8 group sessions (one per week). The results showed that pregnant women who participated in the o-CBT group presented lower rates of pregnancy-specific stress and perceived stress, as well as greater resilience and lower anxiety, depression and obsessions-compulsions symptoms. These data show the efficacy of the treatment programme and thus confirm the importance of implementing these types of interventions during a woman's pregnancy, especially over periods of major stress, such as during a pandemic.

Association between Family Dysfunction and Post-Traumatic Stress Disorder in School Students during the Second COVID-19 Epidemic Wave in Peru

Although the effect of the COVID-19 pandemic on children and adolescents' mental health has been studied, there is still scarce evidence of the influence of nuclear family on the development of post-traumatic stress disorder (PTSD). This study aimed to determine the association between family dysfunction and PTSD in Peruvian high-school students during the COVID-19 pandemic. A cross-sectional study was conducted using a virtual survey administered to 562 high-school students in three schools in Chiclayo, Peru. The dependent variable was PTSD, which was measured with the Child PTSD Symptom Scale. Family dysfunction was the main independent variable, measured with the Family APGAR Questionnaire. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated with generalized linear models. Most of the students were female (88.3%) and the average age was 14.4 years. We found that 21.4% showed severe family dysfunction and 60.3% had PTSD. Students with mild and moderate family dysfunction had 37% (PR: 1.37; 95% CI: 1.14-1.65) and 26% (PR: 1.26; 95% CI: 1.04-1.54) higher PTSD prevalence, respectively. In conclusion, family dysfunction may influence the development of PTSD in adolescents. This study suggests the importance to develop a healthy family environment to help adolescents face critical situations experienced during the pandemic.

Reserve Soldiers’ Psychological Resilience Impact to Sustainable Military Competences: On the Mediating Role of Psychological Skills (Effort, Self-Efficacy, Proactivity)

This research aims to explore an analytical model, gauge the interplay between psychological resilience and achieved military competencies, and examine an intermediary role of effort, proactivity, and self-efficacy. In this study, 337 reserve soldiers from Lithuania were investigated with the Lithuanian Military Training Competences Assessment Scale, Resilience Scale, Self-Efficacy Scale, Short Grit Scale (Grit-S), and Proactivity Scale. Our findings highlighted the importance of the psychological resilience of reserve soldiers due to its positive relationship with the personality traits. Implicit interconnectedness between psychological resilience and psychological skills together with military competences was researched, and it became evident that self-efficacy determined a statistically important mediating role (indirect effect = 0.264 **, p < 0.05) between reservists’ psychological resilience and perceived military training course results. However, the other components included in the study did not have a mediating effect (effort indirect effect = 0.03, p > 0.1; proactivity indirect effect = 0.094, p > 0.1). The research findings are important because of greater prominence of the role of reserve troops in military operations around the world and achievements in the domain of security and defense. This study has great theoretical and empirical value in making decisions concerning the psychological resilience of reserve soldiers’ promotion and sustainable improvement of military preparedness strategies.

Resilience in the Perinatal Period and Early Motherhood: A Principle-Based Concept Analysis

A context-specific delineation of research approaches to resilience in the perinatal and early motherhood literature is currently lacking. A principle-based concept analysis was used to establish a description of how women's resilience is currently conceptualised and operationalised within empirical research in the perinatal period and early motherhood (defined as up to five-years postpartum). CINAHL, Medline, PsychInfo, EMBASE, ASSIA, Web of Science, Scielo, Maternity and Infant Care, the Cochrane Library, and the World Health Organization were systematically searched (January/February 2020 and March 2022). Fifty-six studies met the inclusion criteria. Analysis demonstrated interchangeable use of associated concepts such as 'coping', 'coping strategies', and 'adaptation'. Resilience was frequently operationalised as the absence of illness symptomatology, rather than the presence of mental well-being. Investigations of positive areas of functioning were predominately related to the mother's family role. There was limited qualitative exploration of women's perspectives. Recommendations for the pragmatic application of resilience research were not well developed. The narrow operationalisation of resilience by mental ill-health and parental role, and the distinct absence of women's perspectives, restricts the logical maturity and pragmatic application of the concept. Future research may benefit from exploration of women's insights on indicators that might best reflect positive functioning and resilience in this period.

Resilience and associated characteristics in adults with spina bifida

AIM

To measure resilience and identify associated demographic and clinical factors in individuals with spina bifida.

METHOD

An anonymous survey was distributed via Facebook advertising to individuals with congenital urological conditions. Respondents 18 years or older with spina bifida were included in this study. Resilience was measured with the 10-item Connor-Davidson Resilience Scale. Mean resilience levels in the study population and a US general population sample were compared with Student's t-test. Multiple linear regression assessed demographic and clinical factors associated with resilience.

RESULTS

The mean resilience score for participants (n=195; 49 males, 146 females; mean age 40y 2mo [SD 12y 7mo] range 18-74y) was 27.2 (SD 7.5), which differed from a mean of 31.8 (SD 5.4) for a US general population sample (p<0.01). Multiple linear regression demonstrated significant positive associations between resilience and older age (p=0.04), prior urological surgeries (p=0.03), higher household education (p<0.01), and higher physical function (p<0.01).

INTERPRETATION

Resilience in individuals with spina bifida is moderately poor, relative to the general population, and is associated with certain demographic and clinical factors. As a modifiable construct with positive effects on quality of life, psychological well-being, and health-related behaviors, resilience is a promising target for intervention in individuals with spina bifida. What this paper adds Resilience in individuals with spina bifida is moderately poor. Resilience is lower in individuals with spina bifida than the general population. Resilience is associated with age, household education, physical function, and urological surgery.

Adolescent Life Satisfaction Explained by Social Support, Emotion Regulation, and Resilience

Adolescence is a stage characterized by many biological and psychosocial changes, all of which may result in a decrease in subjective well-being. It is therefore necessary to identify those factors that contribute to increased life satisfaction, in order to promote positive development among young people. The aim of this study is to examine the dynamics of a set of variables that contribute to life satisfaction. A total of 1,188 adolescents (aged between 12 and 16 years) completed the Perceived Social Support from Family and Friends and Perception of the School Environment Questionnaires, the Trait Meta Mood Scale (TMMS), Connor-Davidson Resilience Scale-10 (CD-RISC), and Satisfaction with Life Scale (SWLS) for social support, emotion regulation, resilience, and life satisfaction. By applying structural equation modeling (SEM), the results reveal a direct prediction of family support, emotion regulation, and resilience on life satisfaction. Support from friends and emotion regulation was also found to explain resilience, and support from family and teachers was found to predict emotion regulation. In conclusion, emotion regulation and social support were found to indirectly affect life satisfaction among adolescents through resilience. The theoretical and practical implications of these results are discussed.

Validity and Longitudinal Invariance of the 10-Item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese Left-Behind and Non-Left-Behind Children

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a self-report instrument widely used to assess resilience in particular demographics. This study aimed to evaluate the validity and measurement invariance (MI) of the CD-RISC-10 in Chinese left-behind children. A total of 968 children from three middle schools in Guizhou Province participated in this study, with the CD-RISC-10 used twice, at the base line time point and again after six months. The Ego-resilience Scale (ERS), and General Self-efficiency Scale (GSES-10) were also used as criteria-related validity instruments. Confirmatory factor analysis (CFA) was carried out to examine the one-factor model and the MI with regards to gender and left-behind status, as well as the longitudinal measurement invariance (LMI). The study proved satisfactory reliability and validity of the CD-RISC-10, with good criterion validity with the ERS and GSES-10. CFA results showed that the satisfactory model fit for the one-factor structure was supported in all groups (e.g., CFI = .942, TLI = .925, RMSEA = .057). The strict MI was evident across genders, as well as both the left-behind and non-left-behind groups. Additionally, the LMI of the CD-RISC-10 was also adequately supported. Generally speaking, these findings demonstrate that the CD-RISC-10 can effectively measure the resilience level of left-behind children - boys as well as girls - in China.

Identifying Patient Strengths Instruments and Examining Their Relevance for Chronic Disease Management: A Systematic Review

INTRODUCTION

Most health care focuses on patients' deficits to encourage behavior change. A strengths-based approach, which relies on identifying patient strengths, has great potential to facilitate behavior change for chronic disease management. Little is known about instruments used to assess patient strengths. We conducted a systematic review to identify validated instruments that assess personal strengths by using a theory elaboration approach.

METHODS

We searched 8 databases including Web of Science, Cumulative Index of Nursing and Allied Health (CINAHL), and PsycINFO (through July 2019) to identify peer reviewed, English-language studies that described strength-based instruments. Thereafter, we evaluated the validity and reliability of the instruments according to 18 Scientific Advisory Committee of the Medical Outcome Trust (SACMOT) criteria, and used an inductive, iterative editing process to identify constructs measured by the instruments.

RESULTS

We identified 26 instruments that met our inclusion criteria. The instruments were validated in various clinical and nonclinical populations. Only 4 instruments met most of the SACMOT criteria for validation. We extracted 91 unique constructs that fell into 3 domains: inner strengths (49), external strengths (13), and personality constructs (29).

CONCLUSION

A limited number of reliable and valid instruments are available to assess strengths for the adult population, particularly for clinical populations. Internal strengths can be leveraged to improve patient health; however, the development and validation of additional instruments to capture personal strengths is necessary to examine the multilevel influence of external strengths on individual behaviors and well-being.

Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study

Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.

The Role of Gender and Age in the Emotional Well-Being Outcomes of Young Adults

Young adults face different stressors in their transition to college. Negative emotions such as stress can emerge from the demands they face. This study aimed at gaining an improved understanding of the role that gender and age play in the well-being of young adults. Coping strategies, resilience, self-regulation, and positivity were selected as indicators of well-being. Descriptive and inferential analysis have been conducted. Results show that well-being varies significantly with age and gender. Gender was predominantly involved in the acquisition of the well-being outcomes, highly predicting problem-focused coping strategies. No interaction effects were found between gender and age. An improved understanding of the developmental factors involved in well-being outcomes will enlighten future interventions aimed at improving young people’s resources to face adversity.

Can Resilience be Measured and Used to Predict Mental Health Symptomology Among First Responders Exposed to Repeated Trauma?

OBJECTIVES

To examine whether baseline measures of resilience among active first responders predicts future mental health symptomology following trauma exposure.

METHODS

Multivariate linear regression examined the associations between baseline resilience and future mental health symptomatology following repeated trauma exposure. Symptomatology at 6-month follow-up was the dependent variable.

RESULTS

The associations between baseline resilience and future posttraumatic stress disorder (PTSD) (P = 0.02) and depression (P = 0.03) symptoms were statistically significant. Those reporting higher resilience levels had lower symptomology at 6-month follow-up. Eighty percent of first-responders who screened positive for low resilience went on to develop more PTSD symptoms.

CONCLUSIONS

Examining resilience may serve as a more effective means of screening, given resilience is a malleable construct which can be enhanced via targeted interventions. Higher levels of resilience may protect the long-term mental health of first-responders, particularly in regard to future PTSD.

Psychometric properties of Meaningful Activity Participation Assessment (MAPA) in chronic stroke survivors

BACKGROUND

Meaningful Activity Participation Assessment (MAPA) is an appropriate tool for assessing both objective and subjective aspects of participation.

OBJECTIVES

This study aimed to investigate the psychometric properties of MAPA in chronic stroke survivors.

METHODS

Translation of MAPA was done according to the standard protocol of forward-backward translation. One hundred and seven chronic stroke survivors participated in this study. In addition to the MAPA, they were assessed by Satisfaction With Life Scale (SWLS), Center for Epidemiologic Studies of Depression Scale (CES-D), Life Satisfaction Index-Z (LSI-Z), Purpose in Life Test-Short Form (PIL-SF), and 36-Item Short-Form Survey (SF-36). To investigate the test-retest reliability, 37 participants were reassessed by MAPA after two weeks. Reliability, construct and known-groups validity were evaluated for MAPA.

RESULTS

The results showed an acceptable internal consistency (Cronbach's α = 0.79) and good test-retest reliability (ICC = 0.92) of MAPA. A significant moderate to high correlation was found between the MAPA and PIL-SF, CES-D, LSI-Z, SWLS, and different subscales of SF-36 (r = 0.32-0.65). MAPA showed good ability to differentiate between young adults (age≤ 65 years) and older adults (age> 65 years) with chronic stroke (P = .005) as well as between chronic stroke survivors with different levels of disability (P < .001).

CONCLUSIONS

The MAPA has appropriate reliability and validity in chronic stroke survivors and is suggested to be used in research and clinical settings.

Understanding the Fertility Desires and Intentions among HIV-Positive Men Living in Ontario: Survey Instrument Development and Validation

Men with HIV have highlighted the importance of understanding their fertility desires. However, most research has focused on women. We aimed (1) to develop a survey instrument to assess fertility desires and intentions among HIV-positive men and (2) to assess its face, content, and construct validity, as well as test–retest reliability and internal consistency. Principal component analysis was used for construct validity analysis in a sample of 60 men with HIV. The test–retest reliability and internal consistency were assessed using Spearman correlation and Cronbach α, respectively. The initial and the final version of the questionnaire consisted of 10 domains and 14 constructs. We found a one-component model for the 3 constructs analyzed and Cronbach α values were ≥.70. Test–retest statistic was stable with Spearman correlation >0.70. In conclusion, a reliable and valid questionnaire was developed for determining the fertility desires and intentions of men with HIV.

Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese undergraduates and depressive patients

BACKGROUDS

The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely self-report questionnaire to assess resilience in different populations, including adolescents, elderly individuals and psychiatric patients. Considering the application of the CD-RISC-10 in depression patients, the present study aimed to evaluate the psychometric properties, especially the measurement invariance, of the CD-RISC-10 in depressive patient sample.

METHODS

A total of 2230 undergraduates from Hunan Province and 293 patients with major depressive disorder (MDD) from psychological clinics participated in our study. Confirmatory factor analysis (CFA) was conducted to evaluate the single-factor model of the CD-RISC-10 and the measurement equivalence of the CD-RISC-10 across the clinical (MDD) and non-clinical (undergraduate) samples, as well as gender invariance in the non-clinical sample.

RESULTS

The findings implied that the CD-RISC-10 showed good reliability and validity, including favorable internal consistency and criterion-related validity. The CFA results showed that the strong model fit for a unidimensional structure of the CD-RISC-10 was supported in the clinical (eg., CFI >0.910, TLI >0.900, RMSEA < 0.080) and non-clinical (eg., CFI >0.950, TLI >0.940, RMSEA < 0.060) groups, respectively. Moreover, the scalar invariance of the CD-RISC-10 was supported across the clinical and non-clinical samples (eg., △CFI < 0.009, △TLI < 0.005, ΔRMSEA < 0.003). Similarly, the strict gender invariance was also established in the male (n = 1035) and female (n = 1195) undergraduate samples (eg., △CFI < 0.008, △TLI < 0.004, ΔRMSEA < 0.002).

LIMITATIONS

The inclusion of Chinese individuals only and the absence of depressive patients with comorbidities were our major limitations.

CONCLUSIONS

Overall, these psychometric findings not only supported the stability and validity of the CD-RISC-10 for application with different samples in resilience study, but also indicated that the CD-RISC-10 could be an effective instrument for research in depression.

Psychometric properties of the Connor-Davidson Resilience Scale in women with breast cancer

The aim was to analyse the psychometric properties of the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC 10©) in breast cancer patients. Method: A sample of 169 Spanish women who had undergone surgery for breast cancer completed the CD-RISC 10©, along with questionnaires assessing life satisfaction, emotional intelligence, self-esteem, and positive and negative affect. Results: Confirmatory Factor Analysis supported a single-factor structure with adequate fit indices. Reliability was analysed by calculating McDonald’s omega coefficient, which yielded a value of .83. Validity evidence based on relationships with other variables was provided by positive and significant correlations between scores on the CD-RISC 10© and scores on emotional intelligence (clarity and repair), life satisfaction, self-esteem and positive affect, and by a negative and significant correlation with negative affect. The majority of these correlations were above |.50|. Conclusions: The CD-RISC 10© has satisfactory psychometric properties and is a suitable tool for measuring resilience in patients with cancer. The instrument is quick and easy to apply and may be used in both clinical and research contexts.

Resilience as a protective factor in pregnancy and puerperium: Its relationship with the psychological state, and with Hair Cortisol Concentrations

PURPOSE

Stress is considered an important risk factor for the physical and psychological health of pregnant women. Hence, it is very important to study those protective factors that attenuate the negative effects of stress, such as resilience. The objective of this study was to verify the role of resilience as a stress-reducing factor during pregnancy.

METHODS

A total of 151 pregnant women were assessed in this study: high resilience (n = 55) and low resilience (n = 96). Assessment consisted on perceived stress, pregnancy-specific stress, psychopathological symptoms, psychological wellbeing and Hair Cortisol Concentrations (HCC) during the third trimester of pregnancy and the puerperium, as well as postpartum depression.

RESULTS

The results show that there were statistically significant differences between women with high and low resilience in: perceived stress [F (1,150) = 8.40; p = .005)], HCC [F (1,150) = 9.70; p = .002], pregnancy-specific stress [F (1,150) = 9.62; p = .002], and various subscales of psychopathological symptoms. Specifically, women with high resilience had lower levels of perceived stress, pregnancy-specific stress, psychopathological symptoms, psychological wellbeing, and Hair Cortisol Concentrations during the third trimester. During the puerperium, women in the high resilience group showed higher psychological wellbeing, lower psychopathological symptoms, and lower postpartum depression scores.

CONCLUSIONS

These results highlight the protective role of resilience when pregnant women are confronted by the negative effects of stress, and therefore the potential utility of resilience to improve the health of pregnant women and their neonates.

Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders

Background

A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.

Objective

This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.

Methods

We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.

Results

Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).

Conclusions

The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12615000574549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368296 (Archived by WebCite at http://www.webcitation.org/75w4xtrpw).

What contributes to resilience in cancer patients? A principal component analysis of the Connor-Davidson Resilience Scale

PURPOSE

Research suggests resilience is a complex multifactorial construct, which may improve health outcomes in cancer, but significant controversy exists regarding its definition and measurement. This study aimed to determine the components of resilience and their relative weight, as measured by the Connor-Davidson Resilience Scale in cancer patients.

METHODS

As part of a larger study, a questionnaire including the Connor-Davidson Resilience Scale was distributed to 228 cancer patients. Principal component analysis was performed to identify the components of resilience measured by the Connor-Davidson Resilience Scale.

RESULTS

Principal component analysis yielded six factors: (1) personal strength and problem-based coping, (2) spirituality/fate, (3) social support, (4) adaptability and flexibility, (5) giving best efforts and (6) self-determination, explaining 64.27% of the variance.

CONCLUSION

The Connor-Davidson Resilience Scale accounts for approximately two-thirds of variance in resilience in cancer patients, but 36% of the total variance remains unexplained, suggesting there are still unexplored determinants of resilience in cancer. Identification of these determinants may improve measurement of resilience in cancer through refinement of existing resilience measures or development of cancer-specific measures. Given the associations found within this study, interventions targeted towards improving coping strategies in at-risk individuals, and ensuring they have adequate social and spiritual support may improve resilience, although additional research is required to verify this.

Spanish validation of the 10-item Connor-Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers

OBJECTIVES

Despite the importance of resilience in populations under stress, and the fact that the 10-item version Connor-Davidson Resilience Scale (CD-RISC 10) is the shortest instrument for reliable and valid evaluation of resilience, there are no data on their psychometric properties in non-professional caregivers. The aim of this study was to analyze the psychometric properties and factorial structure of the spanish version of the CD-RISC 10 in non-professional caregivers.

METHOD

Independently trained assessors evaluated resilience, self-esteem, social support, emotional distress and depression in a sample of 294 caregivers (89.8% women, mean age 55.3 years).

RESULTS

The internal consistency of CD-RISC 10 was α = .86. A single factor was found that accounted for 44.7% of the total variance. Confirmatory factor analysis corroborated this unifactorial model. The CD-RISC 10 was significantly correlated with the self-esteem (r = .416, p < .001) and social support (r = .228, p < .001) scales, and the emotional distress scale (r = -.311, p < .001), though this was an inverse relationship. A score ≤ 23 was a suitable cut-off point for discriminating caregivers with depression (sensitivity = 70.0%, specificity = 68.2%).

CONCLUSION

The CD-RISC 10 is a reliable and valid instrument to evaluate resilience in the caregiver population.

Validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore

We aimed to assess the validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) in patients with axial spondyloarthritis (axSpA) in Singapore. We used cross-sectional data from 108 patients with axSpA recruited from a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework. Face validity was assessed through cognitive debriefing interviews (CDIs). Internal consistency was assessed through Cronbach's alpha. Test-retest reliability was assessed through intraclass correlation (ICC). Measurement error was assessed through smallest detectable change (SDC). Construct validity was assessed through six a priori hypotheses through correlation of the CD-RISC10 score with other patient-reported outcome measures. Structural validity was assessed using confirmatory factor analysis (CFA). Fit indices evaluated were root-mean-square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TFI), and standardized root-mean-squared residual (SRMR). Ten patients completed the CDIs and face validity was supported. Among 108 patients (median age: 37(21-77), 81.5% males, 93.5% Chinese), the CD-RISC10 demonstrated good internal consistency (Cronbach's alpha = 0.94), and excellent test-retest reliability [ICC = 0.964 (95% CI 0.937-0.980)]. SDC was calculated as 1.88. Construct validity was established by meeting five out of the six a priori hypotheses. Structural validity was supported as CFA confirmed a one-factor model, with adequate fit statistics after adding three covariances (RMSEA = 0.077; CFI = 0.975; TLI = 0.964; SRMR = 0.036). This study supports the CD-RISC10 as a valid and reliable measure of resilience for use in patients with axSpA.

Evaluating Resilience: Development and Validation of the Situated Subjective Resilience Questionnaire for Adults (SSRQA)

Although resilience varies depending on the specific type of adverse situation faced by the individual, to date resilience questionnaires do not consider its situational character. This study aims to develop and validate the Situated Subjective Resilience Questionnaire for Adults (SSRQA), which assesses resilience in five different adverse contexts. A total of 584 Spanish adults (including general population and clinical samples individuals) completed the SSRQA and other measures of resilience, optimism, and self-efficacy. Confirmatory factor analysis showed that the SSRQA structure fitted the situational model better (χ2/df = 1.90; CFI = .96; TLI = .95; RMSEA = .07) than the non-situational version (χ2/df = 4.99; CFI = .79; TLI = .76; RMSEA = .15). The SSRQA was shown to be reliable (α = .90) and to be significantly and positively correlated with other resilience measures (p < .001) and, to a lower degree, with optimism and self-efficacy (p < .001). Degree of exposure to each adverse situation was negatively correlated with resilience in the face of that situation (p < .05), supporting a vulnerability to stress model. The SSRQA has been demonstrated to be a reliable and valid situated measure for resilience towards different adverse contexts.

Mindfulness-Based Resilience Training in the Workplace: Pilot Study of the Internet-Based Resilience@Work (RAW) Mindfulness Program

Background

The impact of mental illness on society is far reaching and has been identified as the leading cause of sickness absence and work disability in most developed countries. By developing evidence-based solutions that are practical, affordable, and accessible, there is potential to deliver substantial economic benefits while improving the lives of individual workers. Academic and industry groups are now responding to this public health issue. A key focus is on developing practical solutions that enhance the mental health and psychological resilience of workers. A growing body of research suggests resilience training may play a pivotal role in the realm of public health and prevention, particularly with regards to protecting the long-term well-being of workers.

Objective

Our aim is to examine whether a mindfulness-based resilience-training program delivered via the internet is feasible and engaging to a group of high-risk workers. Additionally, we aim to measure the effect of the Resilience@Work Resilience@Work Mindfulness program on measures of resilience and related skills.

Methods

The current pilot study recruited 29 full-time firefighters. Participants were enrolled in the 6-session internet-based resilience-training program and were administered questionnaires prior to training and directly after the program ended. Measurements examined program feasibility, psychological resilience, experiential avoidance, and thought entanglement.

Results

Participants reported greater levels of resilience after Resilience@Work training compared to baseline, with a mean increase in their overall resilience score of 1.5 (95% CI -0.25 to 3.18, t₁₄=1.84, P=.09). Compared to baseline, participants also reported lower levels of psychological inflexibility and experiential avoidance following training, with a mean decrease of -1.8 (95% CI -3.78 to 0.20, t₁₃=-1.94, P=.07). With regards to cognitive fusion (thought entanglement), paired-samples t tests revealed a trend towards reduction in mean scores post training (P=.12).

Conclusions

This pilot study of the Resilience@Work program suggests that a mindfulness-based resilience program delivered via the Internet is feasible in a high-risk workplace setting. In addition, the firefighters using the program showed a trend toward increased resilience and psychological flexibility. Despite a number of limitations, the results of this pilot study provide some valuable insights into what form of resilience training may be viable in occupational settings particularly among those considered high risk, such as emergency workers. To the best of our knowledge, this is the first time a mindfulness-based resilience-training program delivered wholly via the internet has been tested in the workplace.

Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain

BACKGROUND

Resilience is an individual's ability to recover or "bounce back" from stressful events. It is commonly identified as a protective factor against psychological dysfunctions in wide range of clinical conditions including chronic pain. Resilience is commonly assessed using the Connor Davidson Resilience Scale (CD-RISC). Translation and cross-cultural adaptation of the CD-RISC into Nepali will allow for a deeper understanding of resilience as an important domain in health in Nepal, and will allow for cross-cultural comparison with other cultures. Therefore, the aims of the study were to translate and culturally adapt 10- and 2-item versions of the CD-RISC into Nepali and evaluate their psychometric properties.

METHODS

After translating the measures, we performed exploratory and confirmatory factor analyses of the 10-item version in two independent samples (ns = 131 and 134) of individuals with chronic pain. We then evaluated the internal consistency, test-retest stability, and construct validity of the 10- and 2-item measures in these samples. We also evaluated the internal consistency, and the construct and concurrent validity of the 2-item version in an additional sample of 140 individuals.

RESULTS

The results supported a single factor model for the 10-item measure; this measure also evidenced good to excellent internal consistency and excellent test-retest stability. Construct validity was supported via moderate associations with pain catastrophizing. The internal consistency of 2-item version was marginal, although construct validity was supported via weak to moderate associations with measures of pain catastrophizing, depression and anxiety, and concurrent validity was supported by strong association with the 10-item CD-RISC scale.

CONCLUSION

The findings support the reliability and validity of the 10-item Nepali version of the CD-RISC, and use of the 2-item version in survey studies in individuals with chronic pain. The availability of these translated measures will allow for cross-cultural comparisons of resilience in samples of individuals with chronic pain.

Resilience is decreased in irritable bowel syndrome and associated with symptoms and cortisol response

BACKGROUND

Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated with early adverse life events (EALs) and a dysregulated hypothalamic-pituitary-adrenal (HPA) axis. Resilience is the ability to recover and adapt positively to stress but has not been well studied in IBS. The aims of this study are to compare resilience in IBS and healthy controls (HCs) and to assess its relationships with IBS symptom severity, quality of life (QOL), EALs, and HPA axis response.

METHODS

Two hundred fifty-six subjects (154 IBS, 102 HCs) completed questionnaires for resilience (Connor-Davidson Resilience Scale [CD-RISC] and Brief Resilience Scale [BRS]), IBS symptoms, IBS-QOL, and EALs. Ninety-six of these subjects had serial serum adrenocorticotropic hormone (ACTH) and cortisol levels to exogenous corticotrophin-releasing hormone (CRH) and ACTH measured. The relationship between IBS status, resilience, and other variables of interest was assessed by regression analysis after adjusting for demographics and neuroticism, a predictor of resilience.

KEY RESULTS

Resilience was significantly lower in IBS compared to HCs (CD-RISC: 72.16±14.97 vs 77.32±12.73, P=.003; BRS: 3.29±0.87 vs 3.93±0.69, P<.001); however, only BRS was significant after controlling for neuroticism (P=.001). Lower BRS scores were associated with greater IBS symptom severity (P=.002), poorer IBS-QOL (P<.001), and a higher number of EALs (P=.01). There was a significant interaction between BRS resilience and IBS status for ACTH-stimulated cortisol response (P=.031); more resilient IBS subjects had lower cortisol response, and more resilient HCs had higher cortisol response.

CONCLUSIONS AND INFERENCES

Lower resilience is associated with IBS status, worse IBS symptom severity, lower IBS-QOL, greater EALs, and stress hyperresponsiveness.

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions

Background

The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers.

Method

This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach’s alpha coefficient, and mean comparisons were determined using t-tests.

Results

The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men.

Conclusion

The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.

Psychometric properties of the Resilience Scale for Adults (RSA) and its relationship with life-stress, anxiety and depression in a Hispanic Latin-American community sample

Resilience is a multi-dimensional construct associated with health and well-being. At present, we do not yet have a valid, scientific instrument that is designed to evaluate adult resilience in Spanish-speaking countries and that accounts for family, social and individual components. This study aimed at investigating the construct and cross-cultural validity of the Resilience Scale for Adults (RSA) by combining Confirmatory Factor Analysis (CFA), Multidimensional Scaling (MDS) and Hierarchical Regression models in a Hispanic Latin-American group. A community sample of 805 adults answered the RSA, Spanish Language Stressful Life-Events checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL-25). First-order CFA verified the six factors structure for the RSA (RMSEA = .037, SRMR = .047, CFI = .91, TLI = .90). Five RSA scales and total score have good internal consistency (scales α > .70; total score α = .90). Two second-order CFA verified the intrapersonal and interpersonal dimensions of the protector factors of resilience, as well as their commonality and uniqueness with affective symptoms (anxiety and depression). An exploratory MDS reproduced the relations of RSA items and factors at first and second-order levels against random simulated data, thereby providing initial evidence of its cross-cultural validity in a Spanish-speaking group. The Four-steps hierarchical model showed that the RSA scales are the strongest predictors of anxiety and depression–greater than gender, age, education and stressful life-events. Three RSA scales are significant unique predictors of affective symptoms. In addition, similar to findings in diverse cultural settings, resilience is positively associated with age but not with education. Women report higher scores of Social Resources and Social Competence and lower scores of Perception of the Self. In conclusion, this study demonstrates the construct and criterion-related validity of the RSA in broad, diverse and Spanish speaking sample.

Linear Relationship between Resilience, Learning Approaches, and Coping Strategies to Predict Achievement in Undergraduate Students

The aim of the present research was to analyze the linear relationship between resilience (meta-motivational variable), learning approaches (meta-cognitive variables), strategies for coping with academic stress (meta-emotional variable) and academic achievement, necessary in the context of university academic stress. A total of 656 students from a southern university in Spain completed different questionnaires: a resiliency scale, a coping strategies scale, and a study process questionnaire. Correlations and structural modeling were used for data analyses. There was a positive and significant linear association showing a relationship of association and prediction of resilience to the deep learning approach, and problem-centered coping strategies. In a complementary way, these variables positively and significantly predicted the academic achievement of university students. These results enabled a linear relationship of association and consistent and differential prediction to be established among the variables studied. Implications for future research are set out.

Factor structure and psychometric properties of the Connor-Davidson resilience scale among Brazilian adult patients

CONTEXT AND OBJECTIVE

Personal resilience is associated with several mental health outcomes. The Connor-Davidson resilience scale (CD-RISC) is a widely used self-report measurement of resilience. This study aimed to investigate the reliability and validity of a Brazilian Portuguese version of the CD-RISC.

DESIGN AND SETTING

Cross-sectional validation study carried out in the outpatient clinics of a public university hospital.

METHODS

The cross-cultural adaptation followed established guidelines and involved interviews with 65 adults in psychiatric and non-psychiatric outpatient clinics at a teaching hospital. Validation was assessed through concurrent application of the Lipp Brazilian Stress Symptom Inventory (ISSL), Self-Report Questionnaire (SRQ), Sheehan Disability Scales (SDS) and Chronic Pain Grade (CPG) to 575 patients at the same setting. Temporal stability was verified through a second application to 123 participants.

RESULTS

Factor analysis identified four factors, named tenacity, adaptability-tolerance, reliance on support from outside and intuition. The alpha coefficient of 0.93 and intraclass correlation coefficient of 0.84 indicated good internal consistency and temporal stability. Significant correlations between this version of the CD-RISC and the ISSL, SRQ, SDS and CPG were noted. The patients at the outpatient clinic for borderline personality had resilience scores that were significantly lower than those of the patients at the general anxiety or post-traumatic stress outpatient clinics.

CONCLUSION

This Brazilian Portuguese version of the Connor-Davidson resilience scale exhibited adequate reliability and validity among a sample of Brazilian adult patients.