Measuring Resilience: Challenges and Future Directions
The South Southwest PTTC is proudly presenting a five-part series on the role of trauma for preventionists. Since the original study by Felitti, Anda, and Nordenberg (1998), there has been extensive research on the physical and psychological consequences of early childhood exposure to toxic stress and other adverse childhood experiences.1 The negative outcomes associated with ACEs across the lifespan have now been well documented. However, there is limited evidence for the effectiveness of most interventions for children and youth who have experienced ACEs.2 The strongest evidence is for cognitive behavioral therapy, with other forms of individual therapy (family therapy brief motivational interventions, psychodynamic psychotherapy) producing mixed or equivocal results. 2
Over the last 30 years there has been increasing interest in identifying factors that contribute to healing and resilience in individuals who experienced childhood trauma and adversity. One of the challenges in measuring resilience has been the lack of an agreed upon definition. Common to most definitions is the experience of adversity or stress and the achievement of positive outcomes during or following the exposure.
Available evidence suggests that positive future expectations and self-confidence are key to children’s resilience, especially in response to maltreatment. A child’s belief that they have the ability to make good things happen for themselves is a major predictor of resilience in highly stressed children.3 Increasingly resilience is being viewed as the result of dynamic interaction between individual characteristics and the resources and support within their physical and social environment. While individual traits such as hope, optimism, self-esteem and self-efficacy are associated with resiliency, the availability of resources and opportunities in the larger social environment is also important.
In a review of research on resilience and mental health, Ungar &Theron (2020) maintain that resilience is a process influenced by the social context in which it is measured. Cultural narratives are particularly strong in studies with Indigenous and ethnic minority populations. Thus, interventions should be tailored based on cultural and contextual norms. The influence of social determinants of health such as disadvantage, community resources, social supports and other transactions within the ecological framework should be considered in the design of interventions. The intersection of individual characteristics such as gender, developmental stage at exposure, ethnicity and systemic disadvantage should also be explored.4
Articles of Interest
Gallagher MW, Long LJ, Phillips CA (2020). Hope, Optimism, Self-Efficacy, and Posttraumatic Stress Disorder: A Meta-Analytic review of the Protective Effects of Positive Expectancies. Journal of Clinical Psychology, 76, pg. 329-355.
Nayeri ND, Goudarzian AH, Herth K, Naghavi N, Nia HS, Yaghoobzadeh A, Sharif SP, Allen KA (2020). Construct Validity of the Herth Hope Index. International Journal of Health Sciences, 14 (3); pg. 50-57.
Seko Y, Lamptey D, Nalder E, King G (2020). Assessing Resiliency in Pediatric Rehabilitation: A Critical Review of Assessment Tools and Applications. Child Care Health Development; 46(3); pg. 249-267.
Stoddard SA & Pierce J. (2015). Promoting Positive Future Expectations During Adolescence: The Role of Assets. American Journal of Community Psychology 56; pg. 332-341.
Ungar M & Theron L (2020). Resilience and Mental Health: How Multisystemic Processes Contribute to Positive Outcomes. Lancet, 7; pg. 441-447
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1Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP (1998). Relationship of
Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. The
Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14, pg. 245-268.
2Lorenc T, Lester S, Sutcliffe K, Stansfield C, Thomas J (2020). Interventions to Support People Exposed to Adverse Childhood Experiences: Systematic Review of Systematic Reviews. BMC Public Health 20; pg.657
3Mullin A (2019) Children’s Hope, Resilience and Autonomy. Ethics and Social Welfare, 13 (3), pg. 230-243
4Ungar M & Theron L (2020). Resilience and Mental Health: How Multisystemic Processes Contribute to Positive Outcomes. Lancet, 7; pg. 441-447