Resilience Flashcards

1
Q

Resilience to Adversity:
Other ways individuals may differ from each other in an applied health context rather than via personality.

A
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2
Q

What is the distinction and separation of categories of Clinical Trauma vs. Severe Stressors / Adversity?

A
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3
Q

Resilience Prevalence in Bereavement 1 Methods:

Most bereavement studies survey participants after the bereavement has happened.
(Bereavement is the experience of losing someone important to us and is characterized by grief)

What is wrong with this method?

A

These studies exclude the pre-trauma/pre-adversity levels due to only focusing on outcomes after the event had happened

Problem:
Cannot note if there was an increase in the symptoms before event
We can make assumptions but it is still Retrospective data

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3
Q

Adversity:

What is this the definition of?

A type of aversive event particularly severe ‘exposure to actual or threatened death, serious injury or sexual violence’.

-has to be diagnosed by a clinical psychiatrist
-has a definition in (DSM-5 criteria)

A

Traumatic events

Does not include:
Negative and severely stressful major life events that disrupt and impact quality of life (e.g., divorce, job loss). But do have an impact regardless of diagnosis.

Resilience research = diversity of stressful events.

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3
Q

Prevalence of resilience:
How frequently do individuals experience resilience

Historically?
Bonanno (2004) - bereavement theorists
(experience of losing someone important to us, characterized by grief)

Now?

A

Historically, R viewed as RARE occurrence.
People were expected to have a reaction (not a stable course of symptoms over time)
When they did not show criteria, Bereavement theorists viewed this as absent grief as a rare and pathological reaction. Suppressing emotional response (delayed response) or not being closed to the person they lost.

BUT Now: Research contradicts this assumption arguing people have become more resilient to adversity due to methods when studying R previously.

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3
Q

Which type of event is defined by an individual’s reaction to them (eg. have to experience some PTSD symptoms toward event)?

A

Traumatic events

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3
Q

What are these definitions describing?

-the ability to ‘bounce back’ and flexibly adapt to changing
demands of negative life situations
-involve a positive response/adaption to negative circumstances of aversive events

Most important definition:
-an outcome pattern characterized by a stable trajectory of
healthy functioning after adversity

A

Resilience (R)

  • an outcome over time characterised by stable functioning
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3
Q

Resilience Prevalence in Bereavement 2:

How did Bonanno, Wortman, et al., (2002) categorise who and who was not resilient in their study of their Prospective study of Resilience Prevalence?

A

Participants were categorized based on patterns of change of their baseline pre-event scores:

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3
Q

People vary in their ability to be resilient in the face of adversity, loss and trauma.

Name the 2 ways Resilience is measured:

A

Resilience questionnaires

Resilience trajectory

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4
Q

Which method is this describing to measure resilience?

Measured like a trait
Questions about how you generally react to stressors.

A

Resilience (self-report) questionnaires

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4
Q

Which method is this describing to measure resilience?

Measured after the event (for several months or years)
A Longitudinal design
Identifies people that show a resilient outcome pattern over time.

A

Resilience trajectory

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4
Q

Resilience Prevalence in Bereavement 1 Methods:

How can Prospective studies of Resilience Prevalence be carried out?

A

Can derive many participants from existing longitudinal data sets in a period of time where you have pre-event data

Bonanno, Wortman, et al., (2002):
Prospective study on spousal loss.
205 participants from existing longitudinal data set.
Depression measured: pre-loss, 6 & 18-months after spousal loss.

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4
Q

What does this graph show in relation to Adversity?

A

Y axis explains how much disruption individuals have had in their functioning
(Clinical diagnosis levels are severe, not mild)
Mild level- patient still experiences symptoms of depression towards event but not enough to affect daily functioning or for a diagnosis

Outcome patterns over time:
Looking at how Resilience/ different outcomes unfold overtime from the event

The stable functioning definition of R:
bottom line. Individuals never get out of the mild symptom range

Recovery line:
Over time mild/moderate symptoms decrease showing recovery

Delayed reaction:
Distressed (moderate) Symptoms start to decrease but then increase after 1 year, becoming severe

Chronic reaction:
Starts with severe symptoms, staying in the chronic stress reaction

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4
Q

Resilience Prevalence in Bereavement 3:

What did Bonanno, Wortman, et al., (2002) find in their study of their Prospective study of Resilience Prevalence?

A

Did not find any evidence for Absent Grief (a stable course of mild negative symptoms over time)

as 46% (almost half of the sample) who experienced spasm loss were resilient= Most common outcome

11% common grief
15% chronic grief

Furthermore found no evidence of pre-loss differences in attachment to a spouse or marriage difficulties (to explain resilient pattern)

Resilient people are still affected by a bereavement: yearning, emotional upset, and intrusive thoughts. But it did not interrupt their daily lives.

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4
Q

What do these graphs show in relation to Adversity?

A

Delayed dysfunction is similar to delayed reaction

The resistance graph would be what other psychologists would call resilience. The resilience graph is presented as a bounce-back graph model.
Thus the way Adversity and resilience is measured differs in terms of how you define it.

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4
Q

Resilience Prevalence in Bereavement 1 Methods:

Which type of study involves pre-event data that allows you to measure Resilience Prevalence more accurately?

A

Prospective studies

-due to knowing the individual level of functioning before the event happens + follow them for a period of time after the event to keep measurement

4
Q

What are some of the new methods for Measuring Resilience?(2011)

A

Larger sample sizes
New statistical technique – Latent Growth Mixture Modeling (LGMM):

Mancini, Bonanno & Clark (2011):
How resilient are people after spousal loss or divorce?
16,795 participants from German Socioeconomic Panel Study (GSEOP) from 1984-2003.
Using LGMM

4
Q

What is Latent Growth Mixture Modeling (LGMM)?

A

A statistical technique that allows you to identify sub-populations in the data.
Allows examination of different outcome trajectories for each sub-group. Looking at how people’s responses fold over time (questionnaire).

It generates lots of different models, runs analysis looking for different subgroups, identifying which sub-group has the number of characteristics in that sample

4
Q

Mancini, Bonanno & Clark (2011):
Prospective study using GSEOP data.
464 people experienced SPOUSAL LOSS within 20 waves of data collection.
(measure of resilience has changed as they used a measure of subjective wellbeing/ life satisfaction).

Subjective well-being was used as the outcome measure.
What did the LGMM reveal?

A

A 4-class solution was best fit to data.

Improved was not common
However, Resilient and Chronic Low group look very similar

Problem: Statistics do not differentiate between people, only specify subgroups

This paper argued that individuals are not classified as R due to having a lower starting point of subjective wellbeing.

4
Q

Mancini, Bonanno & Clark (2011):
Prospective study using GSEOP data.
629 people experienced DIVORCE within 20 waves of data collection.
(measure of resilience has changed as they used a measure of subjective wellbeing/ life satisfaction).

Subjective well-being was used as the outcome measure.
What did the LGMM reveal?

A

A 3-class solution was best fit to data.

According to psychologists, we would expect to see satisfaction levels decrease, but graph shows the opposite or same levels of well-being.

Most individuals were R, showing stability in functioning over time

4
Q

Are there individual adversities to resilience and are people really resilient to adversities?

A

In summary of Bonanno’s research: NOW

Resilience is not a rare occurrence.
Most people show a resilient outcome trajectory.
We examined spousal loss and divorce – but found similar results in other samples (e.g., traumatic injury & military service).

4
Q

Is Resilience the Common Trajectory (route)?

Norris et al. (2009) examined outcome trajectories using longitudinal data in response to two disasters.

Two communities (n = 561) severely affected by 1999 floods in Mexico.
Residents of NYC (n = 1267) after 9/11 terrorist attacks in USA.

PTSD symptoms were measured post-disaster
6, 12, 18 & 24 months post-disaster (Mexico)
6-9 months after 9/11 then 6, 18, 30 months after wave 1 (USA)

They did not have any pre-baseline data.
This is another example of how people define resilience differently
Arguing that stability would be better characterized as resistance and adaptability as resilience.

Results of prevalence rates showed?

A

Not much difference between México flood events
However, at face value, Resilience is not the strongest most common trajectory due to low scores of 10%.

4
Q

What is this definition describing?

The ability not to be affected by something, especially adversely.

A

Resistance

4
Q

1 is the act of pushing back against a challenge or obstacle,
while 2 is the ability to adapt and bounce back from adversity.

A

1- Resistance

2- Resilience

4
Q

Which is the Most Common: Resilience or Resistance?

A

Depending on which definition of Resilience is used!

Resilience is not the common outcome when using the definition from Norris et al. (2009)=
Resilience is defined as a positive trajectory of adaptation after experiencing disturbance, distress, or adversity

Resilience is a common outcome when using the definition from Bonanno et al. (2004), but only in the US sample=
Resilience refers to the human capacity to thrive and maintain positive emotional experiences even after exposure to extremely aversive events such as loss or trauma.

4
Q

Do the rates of resilience differ if we change the statistical parameters and specifications of the stat modelling we are using?

A

Infurna & Luthar (2016):

R can be measured indirectly (inferred) via outcome patterns over time.
If people are R across time, we should be able to replicate findings of R when we change the parameters of those models.

5
Q

Adversity is an unfortunate reality. Meaning most people will experience a horrible event in their lives.

Strategic decisions are made about the allocation of healthcare resources.

On the basis of research findings, policymakers could decide to invest in more or fewer trauma interventions and resources

A

Opens up questions on how we define resilience

6
Q

Redefining Resilience
In longitudinal studies:
Resilience = there is a lot of variability when taking a data-driven approach

A

Operationalization of resilience is often data-driven in longitudinal designs.
1-5/6 groups, researchers have to decide what is/isn’t R and what it is conceptually.

Resilience is not measured directly, but inferred from an adaptive response over time.

Absence of depression symptoms (Bonanno et al., 2002)
Reduction in PTSD symptoms bouncing back (Norris et al., 2009)
Stable pattern of subjective well-being high functioning stability (Mancini et al., 2011)

7
Q

Defining Resilience:
Systematic Review

Cosco et al. (2017) undertook a systematic review of the measurement of resilience in longitudinal studies.

36 papers in the review (from 5909 initially identified from literature searches).

What was there Inclusion criteria?

A

Longitudinal data (at least 3 waves)
Operationalized and measured Resilience
Published peer-reviewed research

7
Q

Defining Resilience:
Systematic Review

Cosco et al. (2017) undertook a systematic review of the measurement of resilience in longitudinal studies and found that resilience was measured in which 3 ways?

A

Psychometric questionnaires (n = 4)

Definition-driven methods where researchers a priori specified the adaptive response (n = 9)

Data-driven methods to identify resilient sub-groups in the sample (n = 23)

The most common/ used approach in papers =
Data-driven methods

8
Q

Defining Resilience:

Cosco et al. (2017) undertook a systematic review of the measurement of resilience in longitudinal studies and found that the most common/ used approach in papers is?

A

Data-driven methods

9
Q

Defining Resilience:

Cosco et al. (2017) undertook a systematic review of the measurement of resilience in longitudinal studies and found that
most studies defined resilience as the absence of what?

A

The absence of distress or impairment,

NOT maintenance of well-being.

10
Q

Is Resilience Multidimensional? INFO Slide

Most research has examined resilience as single outcome trajectories. (eg. its depression/ PTSD/ well-being) and then make assumptions on the prevalence based on that outcome

People might show resilient responses in some domains of life but show less in other domains. (eg. may show more variability in response to a physical functioning measure than in a life-satisfaction measure)

Investigation of the multidimensional nature of resilience is important to test the extent to which resilience is a common outcome.

A
11
Q

Multidimensional Study Approach to Resilient Outcomes:

Infurna & Luthar (2017): analysis of 13 waves (2001-2013) of existing longitudinal data: Household Income and Labour Dynamics of Australia Study.

421 individuals all of whom were widowed during the study.

Selected multiple domains of outcomes measuring adjustment:
Life satisfaction
Positive emotions
Negative emotions
General health
Physical functioning in multiple daily activities (e.g., walking)

Then conducted a series of GMM analyses to identify different outcome trajectories for each outcome.
Analyzed 5 years before and 5 years after bereavement.

Resilience outcome trajectories were defined as stable good functioning over time (cf. Bonanno, 2004).

What were the findings?

A

Resilience was the most common outcome for life satisfaction!

12
Q

Prevalence of Multidimensional Resilience: INFO SLIDE

Infurna & Luthar (2017): examined outcome trajectories for individuals after spousal loss across all 5 domains simultaneously.

Only 8% of the sample (n = 32%) were classified as showing a resilient trajectory across all five domains of functioning.

A
13
Q

New Directions for Resilience Research: INFO SLIDE

Resilience is a multi-dimensional construct, and people can show different patterns of R depending on which outcome is examined (in response to different life events).
Conceptually, this opens up questions about how we define resilience.
Methodologically, it suggests discussion around rates or prevalence of resilience should be treated with caution.

A
14
Q

Resilience is often inferred from levels of functioning in which type of design?

A

Longitudinal designs

But the prevalence of resilience is dependent on also methodological and statistical decisions.

15
Q

There is a focus on which 2 variables when researchers are defining resilience?

A

stability vs. adaption

16
Q

Resilience is not necessarily a one-dimensional construct. True or false?

A

True