Resilience Shown in Youth Protects Against Adult Stress

Building on work done by other investigators, a group of San Diego researchers has found that resilience can temper the relationship between a form of childhood maltreatment—emotional neglect—and current psychiatric symptoms.

Further, they have identified some of the personality traits and one of the coping styles that resilient individuals seem to possess.

Their findings are reported in “Relationship of Resilience to Personality, Coping, and Psychiatric Symptoms in Young Adults,” in press with Behaviour Research and Therapy. The major author was Laura Campbell-Sills, Ph.D., a postdoctoral fellow in the Department of Psychiatry at the University of California at San Diego.

In their report, Campbell-Sills and her coworkers pointed out that developmental psychologists have generally described the construct of resilience as “a dynamic process wherein individuals display positive adaptation despite experiences of significant adversity or trauma.” However, the essence of resilience, in their opinion, is “the capacity to rebound from stress effectively and to attain good functioning despite adversity.”

They selected for their study 132 college students. Subjects were asked to fill out the Connor-Davidson Resilience Scale, a yardstick designed in 2003 to measure resilience in adults since there are few well-validated measures of resilience for use with adult populations. The scale includes questions such as “I tend to bounce back after illness, injury, or other hardships” and “I am able to handle unpleasant or painful feelings like sadness, fear, and anger.”

Subjects were also asked to fill out the NEO Five Factor Inventory, which measures the “big five” dimensions of personality—neuroticism (defined as a trait that includes negative emotions, poor coping, and difficulty controlling impulses), extraversion, openness, agreeableness, and conscientiousness; the Coping Inventory for Stressful Situations, which reveals whether a person reacts to difficult situations with emotions, avoidance, or active problem-solving; the Childhood Trauma Questionnaire-Short Form, designed to assess emotional neglect as well as several other forms of childhood maltreatment; and, finally, the Brief Symptom Inventory, which identifies any anxiety or depression symptoms an individual may have experienced during the previous week.

Personality Traits Crucial

The researchers then examined subjects' results on the resilience scale and on the personality scale to see whether they could find any association between the two. Resilience, they discovered, had a highly significant, positive relationship with both extraversion and conscientiousness, and a highly significant, negative one with neuroticism. Resilience was also found to have a small, but statistically significant, positive relationship with openness and a nonsignificant positive link with agreeableness.

The investigators then examined subjects' results on the resilience scale and on the coping-with-stress scale to see whether they could find any association between resilience and the means by which a person copes with stress. They found that active problem-solving in the face of stress was positively linked with resilience, whereas simply responding emotionally to stress was negatively linked.

Both the personality trait of conscientiousness and a task-oriented coping style when under stress were found to contribute even more to resilience in ethnic minority subjects than in Caucasian ones. Such contributions, the researchers suspected, may give a number of minority individuals an edge over nonminority individuals when faced with hardship. In fact, recent data have revealed that minorities have a lower lifetime prevalence of certain psychiatric disorders than do nonminorities. This lower lifetime prevalence in turn may be due to their heightened psychological hardiness, or resilience, Altha Stewart, M.D., president of the American Psychiatric Foundation and former chair of APA's Council on Social Issues and Public Psychiatry, suggested—in other words, “people who have suffered are somehow better able to manage in spite of their difficulties (Psychiatric News, May 20).

Finally, Campbell-Sills and her group looked to see whether resilience, as measured by the Connor-Davidson Resilience Scale, would moderate the relationship between emotional neglect during childhood, as measured by the Childhood Trauma Questionnaire-Short Form, and current psychiatric symptoms, as measured by the Brief Symptom Inventory. They expected that individuals endorsing relatively high levels of childhood neglect and low levels of resilience would manifest high levels of current psychiatric symptoms, whereas individuals reporting high levels of childhood neglect in combination with high resilience would manifest low levels of current psychiatric symptoms. And this is what they found.

But they found something else interesting as well—individuals who had experienced childhood neglect and who scored high on resilience reported even fewer current psychiatric symptoms than did individuals who had not experienced childhood neglect and who scored high on resilience.

This finding, Campbell-Sills and her team admitted, may appear counterintuitive on the surface. “One would intuitively expect low neglect/high resilience individuals to have the lowest levels of psychiatric symptoms,” they wrote. “However, there are some plausible explanations for our finding that high neglect/high resilience individuals appeared healthier. First, the finding is consistent with [the] contention that resilience constitutes not just recovery but growth and strengthening from adversity. Individuals who suffered from adversity in their home environments yet coped effectively may have experienced additional personal growth beyond that which characterized the young adults who came from more nurturing environments. The result also may be explained in the context of stress-inoculation theory, whereby a psychological and physiological `toughening' occurs through exposure to moderate levels of stress.”

Thus resilience, Campbell-Sills and her team concluded, might be“ viewed as a dynamic concept capturing positive adaptation and even growth in the face of stress and trauma.”

Resilience Can Be Tapped

Although this study focused exclusively on college students who took a series of psychometric tests, it nonetheless contributes to the emerging understanding of resilience, James Sabin, M.D., said in an interview.

Sabin, a professor of clinical psychiatry at Harvard Medical School and director of the Ethics Program at Harvard Pilgrim Health Care, has a special interest in the mental illness recovery movement (Psychiatric News, January 3, 2003).

Such understanding, he continued, can help psychiatrists recognize the potential for resilience and growth in patients. “Recognizing the capacity for resilience and growth is at least as important as recognizing vulnerability and trauma,” he asserted. “Recognizing resilience and growth encourages us clinicians to be optimistic and hopeful even when in the current moment our patient is experiencing significant symptoms and dysfunction.”

Moreover, he pointed out, a comprehensive, biopsychosocial understanding of resilience could aid in the development of treatments that emphasize the building of psychological strengths rather than simply the remediation of symptoms.

“This perspective resonates with the mental illness recovery movement,” he said, “and helps us ally with our patients' wish to enhance their lives, not simply to reduce their symptoms.”

The study was funded by the National Institutes of Health. ▪