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Resilience: Determinants, Measurement, and Treatment Responsiveness

Published online by Cambridge University Press:  07 November 2014

Kathryn M. Connor
Affiliation:
Dr. Connor is associate professor and Dr. Zhang is director of the Anxiety and Traumatic Stress Program in the Department of Psychiatry and Behavioral Sciences at, Duke University Medical Center in Durham, North Carolina
Wei Zhang*
Affiliation:
Dr. Connor is associate professor and Dr. Zhang is director of the Anxiety and Traumatic Stress Program in the Department of Psychiatry and Behavioral Sciences at, Duke University Medical Center in Durham, North Carolina
*
Wei Zhang, MD, PhD, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3812, Durham, NC 27710; Tel: 919-684-5645; Fax: 919-684-8866; E-mail: zhang032@mc.duke.edu

Abstract

In human terms, resilience is an ability to cope with stress and varies with context, time, age, gender, and cultural origin. Resilience shifts the focus of psychological investigation onto increasing the positive rather than reducing the negative. Inquiry into resilience has evolved from descriptions of resilient qualities, to discovery of the process to attain resilience, to uncovering the motivation to reintegrate in a resilient manner. Much of the research on resilience has focused on children in settings such as family violence, extreme poverty, war, and natural disasters. A coherent pattern of characteristics associated with successful adaptation has emerged. Salient characteristics include commitment, dynamism, humor in the face of adversity, patience, optimism, faith, and altruism. As such, resilience may represent an important target of treatment in anxiety, depression, and stress reactions. Resilience can be quantified, but available measures need to be validated transculturally. There exist many possible determinants of resilience, including neurobiologic, genetic, temperament, and environmental influences. Resilience is modifiable on individual and cultural levels. Posttraumatic stress disorder is an example of a serious disorder associated with impaired stress coping that can improve with treatment.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2006

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References

1.Richardson, GE. The metatheory of resilience and resiliency. J Clin Psychol. 2002;58:307321.CrossRefGoogle ScholarPubMed
2.Seligman, ME, Csikszentmihalyi, M. Positive psychology. An introduction. Am Psychol. 2000;55:514.CrossRefGoogle ScholarPubMed
3.Rutter, M. Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder. Br J Psychiatry. 1985;147:598611.CrossRefGoogle ScholarPubMed
4.Garmezy, N. Stress Resistant Children: The Search for Protective Factors. Recent Research in Developmental Psychopathology. Book supplement no. 4 to J Child Psychol Psych. Oxford: Pergamon Press; 1985.Google Scholar
5.Garmezy, N, Rutter, M. Acute stress reactions. In: Rutter, M, Hersob, L, eds. Child and Adolescent Psychology: Modern Approaches. Oxford: Blackwell; 1985.Google Scholar
6.Kobasa, SC. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol. 1979;37:111.CrossRefGoogle ScholarPubMed
7.Lyons, J. Strategies for assessing the potential for positive adjustment following trauma. J Trauma Stress. 1991;4:93111.CrossRefGoogle Scholar
8.Werner, EE. The children of Kauai: resiliency and recovery in adolescence and adulthood. J Adolesc Health. 1992;13:262268.CrossRefGoogle ScholarPubMed
9.Richardson, GE, Neiger, B, Jensen, S, Kumpfer, K. The resiliency model. Health Educ. 1990;21:3339.CrossRefGoogle Scholar
10.McEwen, BS, Stellar, E. Stress and the individual. Mechanisms leading to disease. Arch Intern Med. 1993;153:20932101.CrossRefGoogle ScholarPubMed
11.Sterling, P, Eyer, J. Allostasis: a new paradigm to explain arousal pathology. In: Fisher, S, Reason, J, eds. Handbook of Life Stress, Cognition, and Health. New York, NY: John Wiley & Sons; 1988:629649.Google Scholar
12.Seeman, TE, McEwen, BS, Rowe, JW, Singer, BH. Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci U S A. 2001;98:47704775.CrossRefGoogle ScholarPubMed
13.Karlamangla, AS, Singer, BH, McEwen, BS, Rowe, JW, Seeman, TE. Allostatic load as a predictor of functional decline. MacArthur studies of successful aging. J Clin Epidemiol. 2002;55:696710.CrossRefGoogle ScholarPubMed
14.Charney, DS. Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry. 2004;161:195216.CrossRefGoogle ScholarPubMed
15.Bale, TL, Picetti, R, Contarino, A, Koob, GF, Vale, WW, Lee, KF. Mice deficient for both corticotropin-releasing factor receptor 1 (CRFR1) and CRFR2 have an impaired stress response and display sexually dichotomous anxiety-like behavior. J Neurosci. 2002;22:193199.CrossRefGoogle ScholarPubMed
16.Baker, DG, West, SA, Nicholson, WE, et al.Serial CSF corticotropin-releasing hormone levels and adrenocortical activity in combat veterans with posttraumatic stress disorder. Am J Psychiatry. 1999;156:585588.CrossRefGoogle ScholarPubMed
17.Nemeroff, CB. Recent advances in the neurobiology of depression. Psychopharmacol Bull. 2002;36(suppl 2):623.Google ScholarPubMed
18.Bremner, JD, Licinio, J, Darnell, A, et al.Elevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder. Am J Psychiatry. 1997;154:624629.Google ScholarPubMed
19.Lesch, KP, Mossner, R. Genetically driven variation in serotonin uptake: is there a link to affective spectrum, neurodevelopmental, and neurodegenerative disorders? Biol Psychiatry. 1998;44:179192.CrossRefGoogle Scholar
20.Lesch, KP, Bengel, D, Heils, A, et al.Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science. 1996;274:15271531.CrossRefGoogle ScholarPubMed
21.Murphy, DL, Li, Q, Engel, S, et al.Genetic perspectives on the serotonin transporter. Brain Res Bull. 2001;56:487494.CrossRefGoogle ScholarPubMed
22.Hariri, AR, Mattay, VS, Tessitore, Aet al.Serotonin transporter genetic variation and the response of the human amygdala. Science. 2002;297:400403.CrossRefGoogle ScholarPubMed
23.Hamer, D. Genetics. Rethinking behavior genetics. Science. 2002;298:7172.CrossRefGoogle ScholarPubMed
24.Lesch, KP. Neuroticism and serotonin: a developmental genentic perspective. In: Plomin, R, DeFries, JC, Craig, IW, McGuffin, P, eds. Behavioral Genetics in the Postgenomics Era. Washington, DC: American Psychiatric Association; 2003:389424.CrossRefGoogle Scholar
25.Caspi, A, Sugden, K, TE, Moffittet al.Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science. 2003;301:386389.CrossRefGoogle ScholarPubMed
26.Costello, EJ, Pine, DS, Hammen, Cet al.Development and natural history of mood disorders. Biol Psychiatry. 2002;52:529542.CrossRefGoogle ScholarPubMed
27.Kendler, KS, Karkowski, LM, Prescott, CA. Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry. 1999;156:837841.CrossRefGoogle ScholarPubMed
28.Tsuang, MT, Faraone, SV. The future of psychiatric genetics. Curr Psychiatry Rep. 2000;2:133136.CrossRefGoogle ScholarPubMed
29.Kendler, KS, Roy, MA. Validity of a diagnosis of lifetime major depression obtained by personal interview versus family history. Am J Psychiatry. 1995;152:16081614.Google ScholarPubMed
30.Tsuang, MT. Genes, environment, and mental health wellness. Am J Psychiatry.. 2000;157:489491.CrossRefGoogle ScholarPubMed
31.Kim-Cohen, J, Moffitt, TE, Caspi, A, Taylor, A. Genetic and environmental processes in young children's resilience and vulnerability to socioeconomic deprivation. Child Dev. 2004;75:651668.CrossRefGoogle ScholarPubMed
32.Tschann, JM, Kaiser, P, Chesney, MA, Alkon, A, Boyce, WT. Resilience and vulnerability among preschool children: family functioning, temperament, and behavior problems. J Am Acad Child Adolesc Psychiatry. 1996;35:184192.CrossRefGoogle ScholarPubMed
33.Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:10481060.CrossRefGoogle ScholarPubMed
34.Shalev, AY. Stress versus traumatic stress: from acute homeostatic reactions to chronic psychopathology. In: van der Kolk, BA, McFarlane, AC, Weisaeth, L, eds. Traumatic Stress. New York, NY: Guilford Press; 1996:77101.Google Scholar
35.Brewin, CR, Andrews, B, Valentine, JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68:748766.CrossRefGoogle ScholarPubMed
36.Wagnild, GM, Young, HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993;1:165178.Google ScholarPubMed
37.Connor, KM, Davidson, JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18:7682.CrossRefGoogle ScholarPubMed
38.Alexander, C. The Endurance: Shackleton's Legendary Antarctic Expedition. London: A. Knopf; 1998.Google Scholar
39.Ravindran, AV, Griffiths, J, Waddell, C, Anisman, H. Stressful life events and coping styles in relation to dysthymia and major depressive disorder: variations associated with the alleviation of symptoms following pharmacotherapy. Prog Neuro Psychopharmacol Biol Psychiatry. 1995;19:637653.CrossRefGoogle ScholarPubMed
40.Healy, D, Healy, H. The clinical pharmacologic profile of reboxetine: does it involve the putative neurobiological substrates of wellbeing? J Affect Disord. 1998;51:313322.CrossRefGoogle ScholarPubMed
41.Connor, KM, Sutherland, SM, Tupler, LA, Malik, ML, Davidson, JR. Fluoxetine in post-traumatic stress disorder. Randomised, double-blind study. Br J Psychiatry. 1999;175:1722.CrossRefGoogle ScholarPubMed
42.Sheehan, DV, Raj, AB, Sheehan, KH, Soto, S. Is buspirone effective for panic disorder? J Clin Psychopharmacol. 1990;10:311.CrossRefGoogle ScholarPubMed
43.Sheehan, DV. The Anxiety Disease. New York, NY: Charles Scribners Sons; 1983.Google Scholar
44.Davidson, JR, Payne, VM, KM, Connoret al.Trauma, resilience and saliostasis: effects of treatment in post-traumatic stress disorder. Int Clin Psychopharmacol. 2005;20:4348.CrossRefGoogle ScholarPubMed
45.Davidson, J, Stein, DJ, Rothbaum, BO, Pedersen, R, Tain, XW, Musgnung, J. Resilience as a predictor of remission in PTSD patients treated with venlafaxine XR or placebo. Poster presented at: Annual Meeting of the Anxiety Disorders Association of America; March 23-26, 2006; Miami, Florida.Google ScholarPubMed