future perspectives

Transcription

future perspectives

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Master Thesis, Psychology
Titel
Adult resilience, empirical and theoretical development.
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No man is an Iland, intire of it selfe;
every man is a peece of the Continent, a part of the
maine
- John Donne, Meditation XVII, 1624
The world breaks everyone and afterward many are
strong at the broken places
- Ernest Hemingway, A Farewell to Arms, 1929
TABLEOFCONTENT
Abstract..................................................................................................................................................1
1.INTRODUCTION..............................................................................................................................2
1.2.WhatIsResilience?......................................................................................................3
PAST-
2.THEHISTORYOFPSYCHOLOGICALRESILIENCE.............................................................6
TheFourWavesofResilienceresearch
2.1TheFirstWave................................................................................................................6
-IndividualResilienceandFactorsthatmakesaDifference
2.2TheSecondWave........................................................................................................10
-DevelopmentalandEcologicalSystems,Processes
2.3TheThirdWave...........................................................................................................12
-InterventionsthatFosterResilience
2.4TheFourthWave.........................................................................................................14
MultipleLevels
-Ametaphor,ProbabilisticEpigenesis,NeurobiologicalProcessesandResearchon
PRESENT-
3.ADULTRESILIENCERESEARCH............................................................................................28
3.1ExamplesofAdultResilienceResearch............................................................29
4.RESILIENCESCALES...................................................................................................................31
4.1TheConnor-DavidsonResilienceScale(CD-RISC).......................................32
4.2TheCD-RISC10............................................................................................................35
4.3TheResilienceScale(RS)........................................................................................37
4.4TheResilienceScaleforAdults(RSA)................................................................40
4.5TheBriefResilienceScale(BRS)..........................................................................43
4.6EgoResiliency(ER)&TheDispositionalResilienceScale(DRS)..........45
4.7TheUseofResilienceScales...................................................................................45
-Traitvs.Process
I
5.PSYCHOBIOLOGICALFACTORS.............................................................................................49
5.1Heritability.....................................................................................................................49
5.2MolecularGeneticTechniques..............................................................................53
5.3Catechol-O-Methyltransferase(COMT).............................................................54
5.4BrainDerivedNeurotrophicFactor(BDNF)...................................................56
6.STRESSRESILIENCE...................................................................................................................59
6.1TheSerotoninTransporterPolymorphism(5-HTTLPR)..........................59
6.2COMTandStressResilience...................................................................................61
6.3BDNFandStressResilience....................................................................................62
6.4NeuropeptideY(NPY)..............................................................................................62
6.5Gene–GeneInteraction...........................................................................................63
6.6NewPerspectivesandResearchonStressResilience................................64
7.SUMMARYPSYCHOBIOLOGICALFACTORS......................................................................66
FUTUREPERSPECTIVES
8.CULTURE..........................................................................................................................................70
-ApossibleFifthWaveofResilienceResearch
8.1TheSocialEcologyofResilience...........................................................................71
8.2ResearchonCulturalAspectsofResilience.....................................................75
8.3DisasterResponse/Preparedness.......................................................................78
9.WHEREDOWEGOFROMHERE?.........................................................................................83
-AdultResilienceResearchintheFuture
9.1TraitorProcess...........................................................................................................83
9.2LongitudinalStudies..................................................................................................84
9.3Interventions................................................................................................................86
9.4Summary.........................................................................................................................89
-Meta-TheoriesinFutureResearchandTheory&ConcludingRemarks
References..........................................................................................................................................92
II
ABSTRACT
Research on the term psychological resilience with regards to the adult
populationhasexplodedinpopularitysincetheearly2000’s.Havinggonefroma
term that earlier was based in developmental psychology with children and
adolescents. This thesis will explore how research and theory on the term
resilience developed through what is known as the four waves of resilience
research.Thetheoreticalandempiricalbasisfoundedinthesefourwavesisthen
contrasted with modern resilience research with adult participants, and
similaritiesanddifferencesareexamined.Thethesisconcludesthattheviewof
adultresilienceisoftentoofocusedonresilienceasanindividualtraitforadults,
comparedtohowtheoryandresearchonthetermingeneralhasdevelopedover
the years. Implications of this are discussed and future perspectives and
recommendations for the further development of adult resilience research are
given.
1 1.INTRODUCTION
Psychological resilience has over the last three-to-four decades become one of
themostinfluentialtermswithindevelopmentalpsychology,andforalongtime
thefieldofdevelopmentalpsychologywastheterm’ssoleproprietor.Therefore
research and theory on the term has involved children and adolescents as
subjects(Luthar,2006).Yetinthelast20yearsorso,thedefinitionoftheterm
hasshiftedtoincludeindividualresilienceacrossexperiencesandregardlessof
age,andalifelongdevelopmentalperspective,thatopenedupthepossibilityfor
theoreticalandempiricalworkonadultresilience.Despitethisadultresilienceis
still underdeveloped compared to resilience and children (Masten & Wright,
2010). This thesis will explore the theoretical and empirical background of
resilience,alookatwhereresearchandtheoryonthetermistodaywithregards
to adults and based on this make propositions for the future in regards to the
theoreticalandempiricaldevelopmentoftheterm.
Itisdividedintothreemainsections,calledpast,presentandfutureperspective.
InthepastsectionofthethesisIwillgobacktotheoriginsofresilience,show
wherethetermstemfrom,andhowtheoryandresearchdevelopedthroughthe
socalled“fourwaves”ofresilienceresearchwhichhighlightsfourdifferentshifts
inthekindofresearchandtheorythatwasappliedtothetermthroughoutthe
years, with the different waves having focused on very different aspects and
methodsofresilience.ThereasonwhyIfocusonthesefourwavesisbecauseI
agree with Masten & Wright’s (2010) notion that they offer “a wealth of ideas,
strategies,models,andfindingstoguidetheburgeoningscienceaboutresilience
acrossthelifespanandindiverseculturalcontexts”(p.231)andthat“theearly
waves of resilience underscore the profound importance of a developmental
perspective on resilience, from the beginning to the end of life” (p. 231). It is
mainlybasedonresearchonchildrenandadolescentsasthetermresilienceina
psychological setting stem from developmental psychological research with
childrenandadolescents.Buttounderstandadultresilienceitisessentialtolook
backtothehistoryofthetermwithinthefieldofpsychology,andseehowithas
developed.Amoredetailedreportisgiventothefourthwave,asitisthecurrent
wave of research we are in, and its models are more complex and essential to
understandpresentdayresearchandtheory.
2
The“present”sectionmainlyfocusesontwoaspectsofadultresilienceresearch
that play a big part in resilience research in the adult population today. It
involves a critique of the widespread use of resilience scales, measuring
resilience on an individual level and a segment concerning research on
psychobiological aspects of resilience for adults. Now as this thesis’ main focus
are with the broader theoretical, some aspects of modern adult resilience
research are not explored as detailed as these two main factors. This is simply
becauseresearchonadultresiliencehasexplodedinthelastdecadeorso,andit
is not conceivable to explore every research article posted on the subject.
Therefore the focus remains on “the bigger picture” and on these aspects that
have gathered the most traction within the field. These two aspects of present
dayalsoillustrateaninterestingdifferenceinhowthefieldshowstwodifferent
ways of viewing resilience on a fundamental level, and the use of resilience
scalesillustrateshowcertainaspectsofadultresilienceresearchhavedeveloped
inafundamentallydifferentwaysfromwhatweareabouttoseefromthepast
perspectivesoftheterm’sfoundationindevelopmentalpsychology.
The future perspective segment introduces a possible new wave of resilience
research, as the aspect of cultural perspectives on resilience has grown
tremendouslyinthelastcoupleofyears,andwillmorethanlikelydosointhe
future. In the end, I draw upon both the past and the present perspectives
presented to point out my view of where I think research and theories on the
termshouldheadinthefuture.
1.2.WhatIsResilience?
The research and theoretical literature on the term psychological resilience is
known for having little consensus with regards to definitions with varying
operationalization and measurement of key constructs (Luthar, Cicchetti &
Becker, 2000). Rutter (1990, 1999) has characterized resilience as positive
developmentaloutcomesforpeoplewhohaveexperiencedsituations“thathave
been shown to carry major risk for the development of psychopathology”
(Rutter, 1999 p. 120). Masten and colleagues (Masten, Best & Garmezy, 1990)
specify that there are three phenomena of resilience: (a) better-than-expected
outcomes of high-risk individuals, (b) maintenance of positive adaptions and
3 competenceduringstressand(c)recoveryfromtrauma.Alsowhenitcomesto
empirical research on the subject, the negative life events that are being
researchedinrelationtoresiliencerangefromsinglestressfullifeexperiences–
likeexposuretowar–toanaggregationofseveralnegativelifeevents(Lutharet
al.,2000).
Tosumup,itisdifficulttogiveaclearandprecisedefinitionthatencompasses
psychological resilience fully. This is because (1) the meaning and view of the
term has changed so much through the years within psychology, and (2) the
moderninternationalviewofresilienceisthatitisadynamicandrelativeterm,
which changes throughout an individual’s lifespan (Sommer, 2011). In other
wordsthetermisdefinedasbeingmulti-facetedandthereforecanbeexplored
on many different levels, and in many different ways. At least that is how it is
with children and adolescents. With adults it is not so clear cut, as we will see
later.
Thereiswideagreementwithinthefieldofmodernresilienceresearchthatthe
term should be conceived as a dynamic developmental process involving the
attainment of positive adaptation despite exposure to significant threat (like
growingupinanenvironmentofdrugsandviolence),severeadversity(having
parentswhoarealcoholicsand/orviolent),ortrauma(survivorsofrape,assault
orwar)thattypicallyisseenasathreattoprocessesthatunderliebiologicaland
psychologicaldevelopment(Cicchetti,2013;Lutharetal.,2000;Masten,Best,&
Garmezy, 1990; Masten & Tellegen, 2012; Masten & Obradović, 2006; Rutter,
2012; Sommer, 2011). To understand how this view on resilience emerged we
have to explore the history of the term, and what is now known as the four
wavesofresilienceresearch.
4
PAST-
5 2.THEHISTORYOFPSYCHOLOGICALRESILIENCE
ThefourwavesofResilienceresearch
Psychological resilience is a term that stems from developmental psychology,
andhashistoricallybeenconnectedtothislineofresearch,especiallywithinthe
discipline that is known as Developmental Psychopathology (Masten &
Obradović, 2008; Sommer, 2011). Before this paradigm shift in the 1960s and
70stheviewonpsychopathologyofchildrenwastoalargeextentinfluencedby
the psychoanalytical/clinical view, which saw the child as being an inherently
vulnerable, passive-reactive organism without active potential. Notions of
individual differences with regard to the child’s genetic, biological and
neuropsychological features, and its dynamic relationship to the environment,
were not even a part of the discourse during the 1950s (Sommer, 2011). The
changeintothenewparadigmofDevelopmentalPsychologyaffordedanewview
on children and their competences, and research within this new paradigm
started what are now commonplace terms within developmental psychology,
like focus on attachment, temperament, family processes, intelligence and selfregulationamongstotherthings(Sommer,2011).Resiliencehasbeenanintegral
partofthisparadigmshiftsincethebeginning.Thetermalsostartedbeingused
inecologicalresearchinthebeginningofthe1970s(Holling,1973)independent
ofitsuseinpsychologicalresearch,whichindicatethatthetimewasrightforthe
ideaofresiliencetobeusedindifferentfieldsofstudy.
2.1TheFirstWave
IndividualResilienceandFactorsthatmakesaDifference
The dawn of resilience research started in the 1970s, with studies of children
withschizophrenicparents(Luthar,2006).NormanGarmezysstudyfrom1974
that intended to identify the aetiology and prognosis of children in high-risk
groupsofdevelopingseriouspsychopathology(Luthar,2006).Theyfoundthata
subsetoftheseatriskkidsshowedpositiveandhealthydevelopmentalpatterns.
Before the paradigm shift, results like these found in other cases, were seen as
atypical(Sommer,2011).Garmezyandcolleagueswereamongthefirsttotryto
identify the factors that are associated with healthy development (Masten,
2007), in other words to try to find out what factors make the subgroup of
resilientchildren,resilient.Anotherresearcherofchildrenofschizophrenics,E.
6
JamesAnthonynamedresilientchildreninvulnerablein1974(Wright,Masten&
Narayan,2013).Thisviewbecamewidespreadandsawtheresilientchildrenas
possessing special individual personality traits and characteristics, which
implicated that these children were more or less immune to stressors and
trauma.Afterlongitudinalstudiesacrosstime,andstudiesacrossdifferenttypes
of trauma surfaced, this stringent term was gradually replaced by resilienceor
stress-resistance (Wright et al., 2013). The term ego-resilience emerged in the
80s,coinedbyBlock&Block(1980)asadynamicindividualtrait,thatrunsona
continuum between the ego-resilient person that is “resourceful before the
strainsetbynewandyetunmasteredsituations”(p.48),andtheego-unresilient
(brittle) person that is “generally fixed in his/her established pattern of
adaption” (p. 49). In other words it’s an individual dynamic capacity (based on
the persons resourcefulness, sturdiness and flexibility) to adapt to different
environmentalcircumstances(Block&Block,1980).
Whatistypicalofthis‘firstwave’ofresilienceresearchisthefocusonindividual
traits(Wrightetal.2013),whichleadtoarichstreamofempiricalresearch.For
example Rutter showed that a subgroup of the resilient children in Anthony’s
study, was characterized by traits of creativity, competence and effectiveness
(Luthar, 2006). Other studies during this time period showed that resilient
childrenashavinghighsocialcharisma,capacitytorelatewelltoothersandan
abilitytoregulatetheiremotions(Luthar,2006).Duringthistimetheresultsof
the groundbreaking longitudinal study of the “Kauai children” from Hawaii
started emerging (Werner & Schmidt, 1977, 1982, 1992, 2001). This study
startedin1954andusedacohortofalltheknownbirthsoftheentireislandof
Kauai the following year (n=698), and under the leadership of Emmy Werner
checked in on the children for follow up assessments several times, at 1, 2, 10,
18, 32 and 40 years of age (Werner, 2005). About 30 % of the children in the
cohort were “born and raised in poverty, had experienced pre- or perinatal
complications;livedinfamiliestroubledbychronicdiscord,divorce,orparental
psychopathology; and were raised by mothers with less than 8 grades of
education” (Werner, 2005 p.11). Werner and her colleagues showed a special
interest in this group and found that even though most of the children who
7 experienced four or more of these risk factors, developed problems regarding
mentalhealth,learningand/oranti-socialbehaviour,asonewouldexpect,buton
the other hand about 1/3 of the “at risk” children developed into competent,
confidentandcaringadults,whodidn’texperienceproblemsregardingschoolor
employment.Theresearchdoneonthisgroupshowedseveralresiliencefactors
and instead of merely focusing on individual characteristics, they also included
family and community characteristics. Individual factors were: temperament
thatelicitedpositiveresponsesfromcaregivers(evenfromearlyinfancy),with
higher motor and language skills, better problem solving and reading abilities
laterinchildhoodandabeliefintheirownefficacyandaconfidenceinthattheir
problems could be overcome by their actions in later years (Werner & Smith,
1982, 1992). The family factors were: having a close bond with at least one
competent and emotionally stable person, who usually was a family member
other than the parents, and they seemed adept in finding such “surrogate”
parents. The same applied for the community factor, where responsible role
models, were found with teachers, neighbours, parents of boy- or girlfriends,
peoplefromchurchgroupsetc.(Werner&Smith,1982,1992).
Thisfocusonvariablesorfactorsleadingtoresiliencewasnotuncommoninthe
first wave of resilience research, where the variable-focused approach focused
on the link between individuals and their environmental factors for the
development of resilience (Wright et al., 2013). Many different studies using
different methodologies, showed consistent findings of broad correlates that
lead to better adaptions of children at risk. Masten (2001, 2007) called these
correlates“theshortlist”(seetable1).
8
Note:Reprintedfrom”ResilienceProcessesinDevelopment:FourWavesofResearchonPositiveAdaption
intheContextofAdversity”byWright,M.O.,Masten,A.S.&Narayan,A.J.,2013,In:Goldstein,S.&Brooks,
R.
B.
(Eds.),
Handbook
of
Resilience
in
Children,
p.
15-37.
9 Howeverasresearchersfoundmoreandmorefactorsassociatedwithresilience,
it became all the more important to understand the processes leading to
resilience.Inotherwords,fromthequestionof“what”to“how”asMastenand
colleagues put it (Masten et al., 1990). This question is a central one, for the
secondwaveofresilienceresearch.
2.2TheSecondWave
DevelopmentalandEcologicalsystems,Processes
The second wave of resilience research, focused on finding out how the social
factors and interactions influenced resilience. This “second wave” of research
also coincided with a shift within developmental psychology in general, where
the importance of Dynamic System Theory (DST) and especially the Ecological
DevelopmentalSystemTheoryofBronfenbrenner(1979).Withtheidentification
of the different promotive and protective factors during the first wave of
research, that keeps development on course and facilitate recovery from
adversity (Masten, 2001) and that several of these factors seems to facilitate
development for both high and low risk groups (Wright et al. 2013), like
attachment relationships with close family, self-regulatory systems, extended
familynetworks,religiousgroupsandothercultural/societalsystems.Therefore
thesecondwavework,focusedlessontheindividualandmoreonthefamilyand
communalnetworks(Cummings,Davies,&Campbell,2000;Masten&Obradović,
2008), where DST concepts like equifinality and multifinality, developmental
pathways and trajectories, started being used, which better captures the
interactional, dynamic, reciprocal, multicausal and multi-level models of DST
(Bronfenbrenner, 1979; Cicchetti & Rogosch, 1996; Ford & Lerner, 1992). The
viewinotherwordsshiftedfromlookingattheindividualandhowfactorsinthe
environment influenced individual resilience, to looking at the complex
interaction between the environment and the child. Therefore researchers also
hadtoradicallychangethequestionsasked:“Ratherthanaskingquestionsabout
why a child is resilient, questions are asked about bidirectional connections
between the child and his or her context” (Wright et al. 2013, p. 23). Research
from “the second wave” has given insights into the roles of attachment
relationships, potential protective stress regulators, psychological stress
reactivity and self-regulation of impulses, attention and behaviour (Sommer,
10
2011). It also became clear that resilience was not best defined as a personal
trait,andthatapersoncouldbediagnosed“resilient”atoneparticulartime,but
notothers,andthatpeoplecanoftenbewelladaptedincertainaspectsoftheir
life but not others. This changes dramatically from the previous view where
terms like ego-resilienceand the research from the first wave saw the term as
being,moreorlessa“fixed”orstablecharacteristicoftheindividual.Alsosecond
wave research lent itself to the idea of having multiple levels of contexts that
interactandproduceresilience.Theimportanceoflongitudinalstudiesalsohad
abigimpactinthechangeinthinkingaboutresilienceduringthisperiod.Alotof
whatisknownaboutdifferentdevelopmentalpathwaystoresiliencestemsfrom
evidence collected from longitudinal studies, studying everything from youth
delinquency, adolescent mothers and youths growing up in impoverished
circumstances (Furstenberg, Brooks-Gunn, & Morgan, 1987; Hawkins et al.,
2003; Masten, Obradović, & Burt, 2006), which allowed for studying withinindividuals changes over time not only between individuals changes.
Longitudinal research showed, amongst other things: that the majority of the
high-risk youth in the aforementioned Kauai study had recovered when they
reachedtheir30s(Werner&Smith,1992)and40s(Werner&Smith,2001);that
the majority of 300 primarily black urban adolescent mothers completed highschool, found steady employment and got off public assistance as adults
(Furstenberg et al., 1987), with pathways to success that were “surprisingly
diverse” (p. 142) and another study found that the majority of juvenile
delinquents stopped their antisocial behaviour as adults (Sampson & Laub,
1993). These studies showed how resilience changes over time, and why it
doesn’t make sense to view it as a stable personality trait, as it is prone to
changesduringanindividual’slifetimeandlifesituation.Thesethreestudiesalso
showedtheimportanceofsocialsupportandstructures,andthatthereismany
trajectoriesorpathwaystoresilience,involvingbothpersonal,interpersonaland
culture factors. In other words, longitudinal studies showed that there are
multiple pathways to resilience, and supported the more complex, holistic
modelsofresilience.
To sum up the second wave of research and theory focused on giving a better
understanding of the mediating and moderating processes that “might explain
11 thelinksbetweenadversityanddevelopmentalcompetence,asanintermediate
steptowardtheultimategoalofinterveningtopromoteresilienceandpositive
development.” (Wright et al., 2013 p. 27) and researching processes like these
arestillimportanttoday.However,withknowledgeobtainedfromthefirsttwo
wavesofresearchresearcherswantedtorenderthebasicscienceofresilienceto
interventionsandactionstopromoteresilience.Thisledtowhatisknownasthe
thirdwave.
2.3TheThirdWave
InterventionsthatFosterResilience
The idea of transforming the knowledge gained from studying naturally
occurring resilience, into practice, prevention and policy changes to “create”
resiliencewhereitisnotlikelytooccurnaturally,hasbeenimportantsincethe
beginning of research on the term. Intervention methods are seen as being
essentialfortestingresiliencetheory(Masten,2011).Thethirdwavehaveused
methods, goals and models from what is know as preventionscience, coined by
Coie and colleagues (1993), which is a conceptual framework for “studyingthe
preventionofhumandysfunction”(p.1013).Itisprimarilythestudyofpotential
precursors of health dysfunction, called risk and protection factors, where
knowledge of these factors leads to preventive interventions, to counteract the
riskfactors,andreinforcetheprotectivefactors.Interventionsarenotjustmade
attheleveloftheindividual,butalsothroughchangesinfamilyandenvironment
(Coieetal.,1993)andevenwithregardstosocialpolicy(Cowen&Durlak,2000).
As mentioned earlier, third wave research of resilience is based on knowledge
obtained from the first two waves, which are summed up in the mentioned
“short list” (Masten, 2001). The increased influence of resilience research and
theoryalsoplayedanimportantpartinchanginginterventionmodels,especially
prevention methods, where the models are being explained in terms of
protective processes to promote resilient development (McLain et al., 2010;
Patterson, Forgatch, & DeGarmo, 2010; Toth, Pianta, & Erickson, 2011;
Weissberg, Kumpfer, & Seligman, 2003; Wyman, 2003), where intervening by
reducingriskoradversityexposure,nurturingrelationships,boostingresources
or mobilizing protective systems around the child is important. Another
12
important factor of the third wave of resilience research was not only on
interventioninitself,butalsothestrategictimingoftheinterventions.Research
hasshownthatthereare“windowsofopportunities”whenitcomestochanging
the course of development, with periods where systems are more mouldable
and/orthereisahigherlikelihoodofpositivedevelopmentalcascades(Cicchetti,
2010;Masten&Cicchetti,2010;Masten,Obradović&Burt,2006,Masten,Long,
Kuo,McCormick,&Desjardins,2009)andbeingableto usethesewindowshas
beenshowntoincreasethespanandlongevityoftheeffectsoftheinterventions
(Masten, Long, Kuo, McCormick & Desjardins 2009; Masten & Cicchetti, 2010;
Shonkoff, Boyce, & McEwen, 2009) and has even been shown to give a better
return on the economic investment (Heckman, 2006; Galinsky, 2006). An
exampleofthiswindowofopportunitycanbeseeninRutterandhiscolleagues’
longitudinal study of Romanian adoptees (1998, 2007). The study focused on
Romanianchildren(n=165)wherethemajority(n=144)grewupinhorriblyand
impoverished and deprived institutions under Ceaușescu’s regime, who were
adopted by British families. The results of the study showed that the children
whowereadoptedbeforetheageofsixmonthsshowedthemselvestobemuch
moreresilientthanthosewhowereadoptedatalaterage.Inotherwords,there
wasawindowofopportunityfortheages<sixmonthsfortheadoptionofthese
children.However,thetimingofinterventionsisnotnecessarilyage-related,but
can also be connected to life events, or turning points, by using targeted
interventions to cascade such turning points (Masten & Cicchetti, 2010). An
example of this is the Parent-Management Training- Oregon (PMTO) model
which functions as a turning point for children with antisocial behaviour and
their parents, through the promotion of positive involvement of parents and
demotion of negative developmental patterns for both parents and children
(Patterson et al. 2010). It was shown that there was a clear cascading effect of
theintervention9yearsaftertheinterventionstookplace,withhigherstandards
of living and better social interactions, than families who did not participate in
thetrainingprogram(Pattersonetal.2010).AlsoSandler,Wolchik,Davis,Haine,
andAyers(2003),designedapreventiveinterventionforfamiliesgoingthrough
a divorce (a turning point), with the goal of moderating a key mediator in the
child’slife,theparent’sbehaviour,yieldedpositiveresults.
13 Despiteresilienceresearchoninterventionshavinggainedmomentum,andnow
have an eclectic evidence base, there is still much work needed to be done to
understandresilienceprocesseswellenoughtomanipulatethemasefficientlyas
possibletopromote/createresilience(Wrightetal.,2013).
2.4TheFourthWave
A metaphor, Probabilistic Epigenesis, Neurobiological Processes and
ResearchonMultipleLevels
Theriseofnewmethodsofresearchinneurosciencethatcanmakeassessments
of: genes, gene expressions, brain structure and function changed research
within the field of psychology in general, and also naturally, within resilience
research. However this does not mean that the view has changed into a
deterministicbiologicalview,asfourthwaveresearchandtheorystillislargely
basedonadynamicmultidimensionalunderstanding,withtheaddeddimension
of a biological perspective, and interdisciplinary models (Christiansen &
Sommer,2015).Theseideasandtheoriesinthefourthwaveviewsresilienceasa
complex multidimensional phenomenon, with an integrated reciprocal
relationship between biological and environmental factors (Masten, 2007). To
understandresiliencewiththislineofthinking,oneneedstousemultiplelevels
of analysis. Therefore an important shift within the fourth wave of resilience
research is the influence of meta-theories like Dynamic System Theory (DST),
Transaction Theory and Probabilistic Epigenesis, which allowed for multi-level
analysestobemade(Christiansen&Sommer,2015).
IwanttostartbyquotingEstherThelen’s(2005)beautifullyprecisemetaphorof
developmentwithinaDSTview.Shewrote:
Alltheoriesaremetaphoric;metaphorshelpusmakethebridgefromthe
theorytothephenomenon.Adominantmetaphorincognitivescienceis
thatthemindislikeacomputer,acharacterizationthatevokesimagesof
machines,programs,andinterchangeableparts.
Isuggestanothermetaphorforhumanbehavior:amountainstream.This
isanaptcomparisontokeepinmind,becauseastreamismovingallthe
time in continuous flow and continuous change. Development is
14
continuous—whateverhashappenedinthepastinfluenceswhathappens
in the future. But the stream also has patterns. We can see whirlpools,
eddies, and waterfalls, places where the water is moving rapidly and
placeswhereitisstill.Likethestream,developmentalsohasrecognizable
patterns:milestonesandplateausandagesandstagesatwhichbehavior
is quite predictable. In the mountain stream, there are no programs or
instructions constructing those patterns. There is just water and the
streambedunderit.Thepatternsarisefromthewaterandnaturalparts
ofthestreamandtheenvironment,suchasthestreambed,therocks,the
flowofthewater,thecurrenttemperatureandwind.Thepatternsreflect
not just the immediate conditions of the stream, however; they also
reflect the history of the whole system, including the snowfall on the
mountain last winter, the conditions on the mountain last summer, and
indeed the entire geological history of the region, which determined the
inclineofthestreamanditspaththroughthemountain.Inaddition,the
stream also carves the rocks and the soil and creates its own
environment, which then constrains and directs the water. It is not
possibletosaywhatdirectlycauseswhat,becausethewholesystemisso
mutuallyembeddedandinterdependent.
[...]
There is another way in which development is like a mountain stream.
Dependingontheconditionsofthestream,similaractionsmayhavevery
differentresults.Thus,ifIthrowarockintoadeeppool,thepoolmaybe
disturbedbyripplesforashorttime,butitwillremainlargelyunchanged.
The same rock tossed into a shallow part may divert the stream
completely,withconsequencesdownstream.
Developmentalpatternsalsoshowthiskindofnonlinearity.Itisdifficult,
maybeimpossible,topredicttheoutcomeoftheprocessforanychildin
any particular situation. Sometimes chance events have large
consequences; at other times, they have little impact. The same event in
thefamilyortheschoolmayhavevastlydifferenteffects.Somechildren
are resilient in what seem to be very damaging environments, whereas
othersgrowupwithproblemsdespiteprivilegedbackgrounds.Atheory
15 mustbeabletohandleboththepredictableaspectsofdevelopmentand
thosethatsurpriseus.
(p.259-260)
As this metaphor explains, development is seen as something that should be
viewed as continuous throughout the lifespan, is dependent on factors of the
environmentandtheindividual,ismulti-causalandcomplexinnature.Thefirst
principleofDSTthereforeiscomplexity.DevelopmentintheDSTapproachisto
understand development as an interaction between all the levels of the
developmental system; “from the molecular to the cultural” (Thelen & Smith,
2006 p. 258) this interaction is to be understood as multiple, mutual and
continuous. Therefore any single-cause explanations, like that there are certain
individual resilience traits that certain resilient individuals have, should be
reconsidered. To use Thelen’s metaphor the mountain stream undeniably has
certain characteristics that other mountain streams don’t have, but these
characteristics are shaped by and integrated with the characteristics of the
mountain, and the characteristics of the stream undeniably changes/influences
the mountain itself. The other important factor is time, and the different
timescales development (of for example resilience) occurs in. The processes of
development can unfold from milliseconds to years, and much like the second
wave’s focus on longitudinal studies, there is an emphasis on studying
developmentalphenomenainatimeframethatmakessenseforthephenomena
in question. The relative stability of the developmental systems over time
(known as Dynamic stability) is another important factor of DST. There are
differentdegreesofstabilityforhumanbehaviour.Someformsofbehaviourare
so stable and reliable that we call them programmed, like speaking a language
andwalking,whicheveryhumanbeingthatisn’tdamagedlearnstodo(Thelen,
2005). However within DST the issue isn’t whether these universal behaviour
traits are hardwired or learned but rather to understand their stability. The
dynamicaspectsofstabilityarethecentralfactorinunderstandingdevelopment,
becauseeventhoughthesystemsarestable,theyofnaturallyaren’timmutable.
Dynamic systems must lose stability to shift from one stable mode to another.
These stable modes are called attractor states (Thelen, 2005; Thelen & Smith,
16
2006) and adaptability and the change between attractor states is what drive
development of for example resilience. Resilience with a DST point of view is
thereforeseenasacertainpatternbetweenattractorstatesthathasdeveloped
over time (Christiansen & Sommer, 2015). These patterns emerge from a
complexinteractionbetweenthecomponents,asmentionedwiththecomplexity
principle. Theories like DST has led to new integrated models and research on
resilienceinecosystems,socialsystemsandindividualbiologyorneuralsystems
(Longstaff,2009),thathashadabiginfluenceonamongstotherthingsresearch
ofresilienceanddisasterpreparationandrecovery(Masten&Obradović,2008;
Norris, Stevens, Pfefferbaum, Wyche & Pfefferbaum 2008), that I will explain
laterinthesegmentoffutureperspectives.
Another influential theory for fourth wave research has been Probabilistic
Epigenesis (PE). It is a metatheoretical model developed by Gilbert Gottlieb
(2007),whichconsistsoffourlevelsofanalysis.AsyoucanseeinFigure1,the
four levels of analysis are environmental (including the physical, social and
cultural environment), behavioural and neural and genetic activity levels, with
the arrows indicating a bidirectional influence between all of the levels
throughoutindividualdevelopment.
Figure1:Metatheoreticalmodelofprobabilisticepigenesis
Note:Reprintedfrom“Probabilisticepigenesis”byGottliebG.,2007,DevelopmentalScience,10(1),pp.1-11
Gottlieb (2007) saw PE as being opposite of predetermined epigenesis, where
geneticactivitygiveriseto“neural(andother)structuresthatbegintofunction
17 when they become mature in the unidirectional sense of genetic activity →
structure → function.” (p. 1) where new evidence showed bidirectional
influences within and between the different levels of analysis and that “neural
(and other) structures begin to function before they are fully mature and this
activity,whetherintrinsicallyderived(‘spontaneous’)orextrinsicallystimulated
(evoked), plays a significant role in the developmental process.” (p.2). In other
words, he saw that neural structures doesn’t begin to function when they are
fullydevelopedbutcanspontaneouslybecomeactive,orbeevokedbyexternal
(for example environmental) factors. The probabilistic element is introduced
because “the coordination of formative functional and structural influences
within and between all levels of analysis is not perfect.” (p.2). With regard to
resilience,PEhasbeenaninfluenceonthemodernmulti-levelleddynamicview
ofresilience(Masten,2007).PEgoesagainstlinearexplanationmodels,aseven
themostbasiclevelofthetransformationofDNA→RNA→Protein,nolongeris
understood as a unidirectional transformation of DNA → RNA (known as
transcription) and RNA → Protein (known as translation) because it has been
shown that Proteins act on RNA and on DNA, and in extreme cases RNA can
transform DNA through a process that is known as reverse transcription
(Gottlieb, 2007). So even on this basic genetic level, you see that a
straightforwardlinearexplanationmodelsimplywon’tdo.Thisisalsothecase
for the three other levels of analysis, as there are considerable amounts of
evidence that genetic activity is influenced by neural, behavioural and
environmental factors, as can be seen in the selection of studies presented in
Table2.
18
mRNA = messenger RNA; PER and TIM are proteins arising from per (period) and tim (timeless) gene
activity; activity of c-fos genes leads to production of c-FOS protein. References documenting the findings
listedcanbefoundinGottlieb,(1998,Table2).
Note:Reprintedfrom“Probabilisticepigenesis”byGottliebG.,2007,DevelopmentalScience,10(1),pp.1-11
A PE view on resilience offer a understanding of the term as a multi-level
dynamicsystem,wheredevelopmentofresilienceisseenasbeingaffordedwith
different developmental pathways with different end goals which are more or
less probabilistic for different individuals, depending on how the different
factorsonthedifferentlevelsofanalysisinteract(Sommer,2011).PEdoesn’tsee
development as being determined by an evolutionary or ontogenetic
“masterplan”butratherbythiscomplexinteractionbetweenthedifferentlevels
of analysis. Therefore it would be considered nonsensical with a PE view to
considerresilienceasasettraitthatcertain“resilientpeople”have,asthetheory
showsamorecomplicatedpictureofhumandevelopmentthanthat.PEhasalso
played an important part in avoiding dichotomy between biological and
psychosocial factors, as Gottlieb (2007) recognizes the influences of biological
and psychosocial factors as bidirectional and interrelated. PE opens up the
19 possibility for trans-generational transmission of resilience (Christiansen &
Sommer, 2015), as the environment a person lives in can influence the
individual’sgenes,whichthencanbepassedontofuturegenerations(Sommer,
2011).Epigeneticanimalresearchsupportsthis,whereinattentiveratmothers
(who displayed low licking/grooming behaviour with their pups) are shown to
have had an effect on the pups’ methylation of the genes for the oestrogenreceptors in the brain, which made them smaller (Champagne & Curly, 2011,
Meaney,2010).Whenthesepupsgrewuptobecomeparentsthemselves,their
smaller oestrogen-receptors lead too that they themselves became inattentive
mother(Champagne&Curly,2011,Meaney,2010),whichleadtoaninattentive
parentingstyleacrossgenerations.Atransmissioneffectfromepigeneticstudies
from a population in Norbotten, Sweden, with three cohorts of born in 1890,
1905and1920,whereboyswhogrewupduringararewinterwheretheycould
overeat, compared to other cohorts of boys who grew up during times where
foodwasscarce,laterhadgrandsonswhodiedearlier,andsufferedmorefrom
diabetes and cardiovascular disease (Bygren, Kaati & Edvinsson, 2001; Kaati,
Bygren&Edvinsson,2002),whichindicatethatriskfactorsarenotonlyrelated
totheindividualslife,butsomethingthatmightgobackforgenerationswiththe
environmentseffectonthegene-material.
Theimportanceofconsideringbiologicalfactorsofresiliencewashighlightedby,
amongst others, Cicchetti & Curtis (2006), who in their article calls for greater
attention to biological processes that might yield resilience processes. Up until
the point the article was written most resilience researchers had not taken
advantage of the new evolving technology, quite simply because “most
investigators who examine pathways to resilient functioning have not been
trainedinthevariousneuroscienceapproaches”(Cicchetti&Curtis,2006p.47)
and vice versa, one could say that most researchers trained in neuroscientific
approaches, did not have the necessary knowledge (or perhaps interest) in the
termresilienceatthetime.Itisimportanttonotehowever,thattheyunderline
theimportanceofbiologicalresearchofresiliencealwaysbeingapartofmultiple
levelsofanalysis,likewefindinPE.
20
In later years, progress has been made in biological research of resilience, for
example within the field of Gene × Environment (G × E) research, which KimCohen&Gold(2009)describedas:
Inbrief,G×Edemonstratethatvariationinspecificgenesmoderatesthe
impact of environmental risks on psychopathology (or vice versa), such
that risk-exposed individuals who carry the ‘‘protective’’ version (or
allele) of the gene have significantly reduced levels of psychopathology
compared to comparably risk-exposed individuals with the ‘‘vulnerable’’
allele.
(p.138)
Thismeansthatcertaingenescanbe“protective”or“vulnerable”,but(andthisis
important)onlyiftheyare“turnedon”bycertainenvironmentalfactors.G×E
was first described and defined by Caspi & Moffitt (2006) who, in the figure
below,showstheconceptuallogicofG×Eresearch(seeFigure2).
Note: Reprinted from “Gene–environment interactions in psychiatry: joining forces with neuroscience” by
Caspi,A.&Moffitt,T.E.,2006,NatureReviewsNeuroscience,7,pp.583-590..
Caspi and colleagues (2002) first demonstrated the association between
childhood maltreatment and later antisocial behaviour was moderated by a
21 functional polymorphism in the promoter (or regulatory) region of the gene
encoding the monoamine oxidase A (MAOA) enzyme, and that maltreated
children with “a genotype conferring high levels of MAOA expression were less
likelytodevelopantisocialproblems.”(p.851)inbothchildhoodandadulthood.
AyearlaterCaspiandcolleagues(2003)showedthatstressfulexperienceslead
to more depressive symptoms, diagnosed depression and suicidality for people
withacertaintypeofafunctionalpolymorphisminthepromoterregionofthe
serotonintransporter(5-HTT)gene.Peoplewithoneortwocopiesoftheshort
allele of 5-HTT-promoter polymorphism showed significantly more of the
aforementionedsymptomscomparedtopeoplewhohadtwolongalleles(Caspi
etal.,2003).Whatisimportanttonoteisthatthesegeneticfactorsonlyleadto
mental health outcomes (respectively anti-social problems and depression)
when exposed to environmental risks, as these genetic factors showed no
significant differences anti-social behaviour with people who didn’t experience
maltreatment, and depression for people who experienced fewer stressful life
experiences (Caspi et al., 2002, 2003). These results have been replicated in
independentstudies,andameta-analysis(Kim-Cohnetal.2006;Taylor&KimCohen, 2007; Uher & McGuffin, 2008) and Cicchetti, Rogosch and Sturge-Apple
(2007), did a large sample study which further specified what subtypes of
environmentalriskswhichleadtopsychopathologyandthatlevelsofdepressive
symptomswerehigheramongcarriersofthelow-activityMAOAallelewhohad
experienced three or four maltreatment subtypes. Additionally, among
adolescents carrying two copies of the 5-HTT short allele, sexual abuse had a
greater effect than physical abuse (with no sexual abuse) or neglect on
increasing internalizing symptoms. These results together indicate that
experiencingseveraltypesofmaltreatmentisariskfactorthatmorelikelygoes
“under the skin” and triggers genetic mediated biological process that leads to
psychopathology(Kim-Cohen&Gold,2009).
Whatisimportanttonoteisthatthesestudies(andG×Eingeneral)werenot
specifically thought of as a way of studying resilience, but is a model to study
psychopathology and therefore has been based on an absence-ofpsychopathologycriteriononly.Tobeanevenbettermeasuringtoolinregards
to measuring resilience, G × E also needs to test whether particular genotypes
22
canenhancedevelopmentofcompetenceswherethereismaltreatmentorother
adversities(Kim-Cohen&Gold,2009).
Another interesting line of biological research has been research of
programming, biological sensitivity to context, differential susceptibility,
bidirectional influences, and calibration of adaptive systems for adaptive
response to adversity. Boyce & Ellis (2005) theorized that stress reactivity
doesn’tonlyreflectexaggeratedarousalbut“anincreasedbiologicalsensitivityto
context (BSC), with potential for negative health effects under conditions of
adversity and positive effects under conditions of support and protection” (p.
271) and that there is (from an evolutionary perspective) developmental
plasticity of the stress response system with structured context-dependent
effectsthatmayconstituteconditionaladaptionsforthestressresponsesystem
ofeachindividual.Thisledtothemdevelopinganewhypothesis:“thatthereisa
curvilinear, U-shaped relation between early exposures to adversity and the
development of stress-reactive profiles, with high reactivity phenotypes
disproportionately emerging within both highly stressful and highly protected
earlysocialenvironments.”(p.271,seefigure3)
Note: Reprinted from “Biological sensitivity to context: I. An evolutionary–developmental theory of the
origins and functions of stress reactivity” by Boyce, W. T. & Ellis, B. J., 2005, Development and
Psychopathology,17,pp.271-301.
23 A companion article supported the theory of BSC and showed that heightened
stress reactivity, a neuroendocrine predisposition toward exaggerated
responsiveness to environmental stressors that includes a susceptibility to
environmentalinfluencewithbidirectionaleffectsonhealthanddisorder(Ellis,
Essex & Boyce, 2005). This susceptibility may influence what we call stress
resilience.LaterDelGiudice,Ellis&Shirtcliff(2011)furtherdevelopedamodel
based on BSC, called the Adaptive Calibration Model (ACM) to explore what
factorsinfluenceanindividual’sstressresponsesystem(seefigure4).
This model shows a more complex image of the influences (from hormonal to
environmentalinfluences)ofstressmanagement.Thismodelfitsbetterintothe
generalviewofmulti-dimensionalfactorsrelatedtostressresilience,than“just”
lookingataneuroendocrinepredisposition.
Figure 4: Conceptual structure of the Adaptive Calibration Model. SRS: stress response system; LH: life
history;OT:oxytocin;5-HT:serotonin;andDA:dopamine.
Note:Reprintedfrom“TheAdaptiveCalibrationModelofstressresponsivity”byDelGiudice,M.,Ellis,B.J.,&
Shirtcliff,E.A.2011,NeuroscienceandBiobehavioralReviews,35,pp.1562-1592.
Morefascinatingprogresswithinbiologicalresilienceresearchisthewayithas
integrated what the third wave research theme of interventions with new
innovative biological research methods. This includes an attachment-based
interventionmethod(AttachmentandBiobehavioralCatch-up[ABC])foryoung
infants in foster care to normalize the function of the Hypothalamus-pituitaryadrenal (HPA) axis (Dozier, Peloso, Lewis, Laurenceau, & Levine, 2008). It
24
showed that the infants who had the ABC intervention showed significantly
lowerlevelsofcortisol(Dozieretal.2008).Similarresultswhereshownonthe
rise and fall of cortisol levels during the day for young foster children moving
betweenfosterhomes,orfromafosterhometoapermanentresidence,where
children from an intervention group (specifically designed to prepare foster
children for placement changes) showed more stable cortisol levels than
children from a non-intervention group (Fisher, Van Ryzin & Gunnar, 2011).
Similarresearchandtheoryhasbeendevelopedforabiologicalunderstandingof
interventions related to executive function skills and emotion regulation
(Yehuda, Flory, Southwick, & Charney, 2006). In general having assessments of
biomarkers, gene expressions or neural functioning in relation to intervention
studies has been hailed as being a new important factor in resilience research
(Cicchetti, 2010). For example it has been shown that stress influence on
glucocorticoidandcatecholaminelevelsandexecutivefunctioning(Blair,2010)
andthepositiveeffectsofapreventionprogramcalledStrongAfricanAmerican
Families (SAAF) on children with 5-HTTLPR genotype, with regards to risk
behaviour(Brody,Beach,Philibert,Chen&Murry,2009).
So,tosumup,themaintraitsofthisfourthwaveofresilienceresearchareaview
that resilience is not a singular individual trait that a person has, but a
phenomena that develops over multiple levels, and can not be
compartmentalisedintosinglefactorexplanations.Norisresilienceunderstood
as being developed in a specific context any longer, where the earlier waves
(especiallywaveoneandtwo)putalotoffocusontheimportanceoffamily,and
the bond between caregivers and children and how this effected the
development of resilience in children. The idea is that the fourth wave will
integrateandfurtherdeveloptheearliertheoriesandempiricalresultsfromthe
precedingwaves(Masten,2007).Thereforethefourthwavedoesnotmeanthe
deathofpastresearchandtheory,butareconceptualizationofitandadifferent
way of applying it, for example how successful resilience-promoting
interventions has been reconceptualised as being examples of experiencedependentneuralplasticity(Cicchetti,2013;Cicchetti&Curtis,2006).
25 The fact that new theories of development such as DST and PE frame human
developmentasalifelong,continuousprocessaffordsfantasticopportunitiesto
continuethisresearchtraditionforanadultpopulation.
26
PRESENT-
27 3.ADULTRESILIENCERESEARCH
As mentioned earlier for many years resilience was a term confined to
developmentofresilienceinchildrenandadolescents,yetinlateryearstheterm
has been further developed to be applicable for adults as well. As mentioned
WernerandcolleaguesKauailongitudinalstudiesfromKauaishowedsomething
remarkable in their follow up of the “children” at 30 and 40 years of age
(Werner,2005).Theyfound“thatmostoftheyouthwhohaddevelopedserious
copingproblemsinadolescencehadstagedarecoverybythetimetheyreached
midlife.” (p. 12). This means that something (more likely a series of factors)
happened to the cohort between the ages of 18 and 30/40 that facilitated
positiveresilientdevelopment,thatledtothembecominghappy,well-adjusted
andcaringadults,despitebeingtroubledteenagers.Nowthisshouldnotbethat
surprising as most modern developmental theories (like DST) no longer
considersdevelopmentassomethingthatcomestoascreechinghaltattheageof
18,butsomethingthatcontinuesthroughoutthelifespan.
Whatiscleartomehoweveristhatresultslikethisillustratetheimportanceof
researching and understanding resilience as just that, a developmental pattern
thatfluxes,changesanddevelopsthroughthelifespanofanindividual.Entailed
intheseresultsfromtheKauaistudiesisaclusterofexcitingresearchquestions:
why didn’t the participants show resilience at age 18, but at age 30? What
happened in these 12 years to foster resilience, and afford them opportunities
forpositivedevelopment?Whatisthedifferencebetweendevelopingresilience
atage30or40,thanatage2,10or18ingeneral?Anditshowstheimportance
ofhavingresilienceresearchwithadultparticipants.Thissegmentofthethesis
willexplorepresentdayadultresilienceresearch,bygoingintodetailofhowthis
researchisdoneandhowitfitsinwiththedevelopmentoftheresiliencefieldin
general,throughthefourwaves.Thereisnodoubtthatadultsliveverydifferent
livesthanwhatchildrenandadolescentsdo,withdifferentchallenges,levelsof
autonomy and social situations with a different biological system having gone
through puberty. So we will see research on a biological level and with new
social environments. Especially the workplace context and its connection to
stressresilienceisafieldofadultresilienceresearchthesedaysthatgathersalot
of interest (Luthans, 2002; Luthans, Avolio, Avey & Norman, 2007). There are
28
also examples of resilience research that do not follow the development of the
fourwaves,andthatdefinesandmeasuresresilienceinawaythatisinconsistent
withhowthetermisviewedwithinthefieldofdevelopmentalpsychology.
3.1Examplesofadultresilienceresearch
Since the early 2000s there has been an explosion of resilience research with
adult participants. Having high resilience has been connected to: growth for
women experiencing domestic abuse (Anderson, Renner & Danis, 2012), lower
depressive symptoms and higher health related quality of life for HIV-positive
and negative women (Dale et al., 2015), better treatment response for people
sufferingfromPTSD(Davidsonetal.,2012),lowerchronicpsychologicalstress
(De Robert, Barontini, Forcada, Carrizo and Almada, 2010), better GPA (grade
pointaverage)scoresandmentalhealthforuniversitystudents(Hartley,2011)
lower alcohol consumption for university students (Johnson, Dinsmore & Hof,
2011),fewersuicideattempts(Roy,Sarchiapone&Carli,2007)andalowerrisk
ofdepressionamongstRussianimmigrantstoIsrael(Aroian&Norris,2000).
This looks very promising, but there is one problematic factor that all these
studiesshare:theyalldependonwhatisknownasresiliencescalestomeasure
and define resilience. Unlike what we have seen with the development of the
four waves of resilience research, resilience scales sees resilience as an
individual trait, that can be measured by simple questionnaires. This view of
resilience as a trait has been widely criticized within the field (Luthar, 2006;
Luthar et al., 2000; Masten 2014a, Rutter, 2012) and the debate of whether
resilienceshouldbeseenasatraitorprocessisacentraloneinadultresilience
(Reich,Zatura&Hall,2010).
Michael Rutter (2006) even went so far as to calling the efforts of developing
resiliencescales:
afallaciousapproach[...]becauseresilienceisnotasinglequality.People
mayberesilientinrelationtosomesortofenvironmentalhazardsbutnot
others. Equally they may be resilient in relation to some kinds of
outcomes but not others. In addition, because context may be crucial,
peoplemayberesilientatonetimeperiodintheirlifebutnotatothers.
(p.4)
29 With this backdrop I want to show how resilience scales claim to measure
resilience,andwhattheoreticalandempiricalbackgrounditbuildson.
30
4.RESILIENCESCALES
Thereasonwhyitisimportanttocriticallyevaluateresiliencescalesisbecause
of the increased role it plays in adult resilience research, is to assure that
research on the term doesn’t become narrow, and isn’t able to capture the
multitude of aspects embedded with resilience. This segment therefore takes a
criticallookofthetheoreticalandempiricalclaimsthesescalesmake.
Becauseoneofthedefiningfactorsofpresentdayresilienceresearchwithadults
is the development and use of resilience scales, self-report questionnaires
developed to measure resilience. A search on PsycINFO of “Resilience scale*”
gives 3553 peer reviewed results, and when specified for an adult age group
thereis2672resultsremaining,1964ofwhichhasbeenpublishedsince2010.
There have been dozens of resilience scales developed for adults, children and
theelderlyfromtheearly‘90supuntiltoday,andasyoucanseeithasbecome
commonplace to use it in resilience research, especially within the adult
population.Inmyviewthereisadangertothis,asthefieldshouldnotbereliant
on simple resilience scales to define what resilience is, as they, at best, can be
usedtomeasurecertaintraitsrelatedtoresilience.Itismyconcernthatafterthe
term has been through 40 years of the research and theory development with
youthandchildren,goingfromtryingtoidentify“brittleandresilient”children
basedontheirtraits,toviewingitasadynamicdevelopmentalprocess,weare
going backwards, to a narrower definition regarding adults. The debate about
theuseofresiliencescalesInowtrytoinstigateisthereforeultimatelyapartof
the bigger debate on whether or not resilience shall be seen as a process or a
trait.Butbeforewedelveintothisdiscussion,let’slookatsomeresiliencescales,
andhowtheydefineandmeasureresilience.
IntheirreviewWindle,BennettandNoyes(2011)identified15resilience
scales,wheresixweredevelopedtomeasureadultresilience1.Thesixscalesin
questionare:TheDispositionalResilienceScale(DRS)(Bartone,Ursano,Wright
&Ingraham1989;Bartone1991,1995,2007),TheConnor-DavidsonResilience
Scale (CD-RISC) (Connor & Davidson, 2003; Cambell-Sills & Stein, 2007), The
1I’veexcludedadditionalfivetargeting“youths”and“youngadults”,andonetargetingolder
adultsasthisthesisconcentratesonresilienceinanadult,notadolescentorgerontological
perspective.
31 Resilience Scale for Adults (RSA) (Friborg Hjemdal, Rosenvinge & Martinussen,
2003, Friborg, Barlaug, Martinussen, Rosenvinge & Hjemdal, 2005), The Brief
ResilienceScale(BRS)(Smithetal.,2008),TheResilienceScale(RS)(Wagnild&
Young, 1993), and Ego Resiliency (ER) (Klohnen, 1996). The CD-RISC, RSA and
BRSweregiventhehighestpsychometricratingsinthereview(7/18pointsin
their quality assessment score), but the authors were not able to find a ‘gold
standard’ofresiliencemeasurement(Windleetal.,2011).
4.1TheConnor-DavidsonResilienceScale(CD-RISC)
The CD-RISC is now one of the most widely used resilience scales in adult
resilience research, and has been cited 593 times according to the Web of
Science2and 1858 times according to Google Scholar34. It’s based on two main
factors of previous resilience, stress-coping abilities, hardiness, Rutters (1985)
summary of personal resilience characteristics with the addition of faith and
optimism(Connor&Davidson,2003).Theyviewresilienceasapersonalquality
thatmainlyreflectstheabilitytocopewithstress.Anexampleofthisistheiruse
ofthearticexplorerSirErnestShackleton’s1912expeditioninthearcticwhere
“SirEdward”(astheyerroneouslynamehim)showedthathe“possessedmany
personal characteristics compatible with resilience” (Connor & Davidson, 2003
p. 77) This historical example of resilience, was the reason they including a
spiritualcomponenttoresilience,asheexhibitedfaithandabeliefinbenevolent
interventionsduringtheroughexpedition.Seetheirsummaryof“characteristics
of resilient people” that they based their scale on in Table 3. The scale itself
consistsof25itemswhichcarrya5-pointrangeofresponse,nottrueatall(0),
rarelytrue(1),sometimestrue(2),oftentrue(3),andtruenearlyallofthetime
(4).AdescriptionoftheitemsisincludedinTable4.
2http://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&
qid=25&SID=W2UC99Dz4YuigTi5ccB&page=1&doc=3Retrieved20-01-2016
3https://scholar.google.no/scholar?cites=17627499399597950985&as_sdt=2005&sciodt=0,5&h
l=noRetrieved20-01-2016
4Seehttp://www.cd-risc.com/bibliography.phpforalistofresearchcompiledbytheauthors.
32
Note:Reprintedfrom”DevelopmentofanewResilienceScale:TheConnor-DavidsonResilienceScale(CDRISC)”byConnor,K.M.&Davidson,J.R.T.,2003DepressionandAnxiety(18)p.76–82
Note:Reprintedfrom”DevelopmentofanewResilienceScale:TheConnor-DavidsonResilienceScale(CDRISC)”byConnor,K.M.&Davidson,J.R.T.,2003DepressionandAnxiety(18)p.76–82
ThereareseveralfactorsIfindhighlyproblematicwiththeCD-RISC.The
theoretical,empiricalandhistoricalbasetheauthorsuseisonthetopofthelist.
Hardinessisatermthatisdescribedasmoreorlessstableinternalpersonality
traitswhichmakessomeindividualsbetterathandlingstressfullife-eventsthan
33 othersandconsistofthreefactors:(1)Commitment:theabilitytoeasilycommit
to what one is doing, (2) Control: a general belief that events are within one’s
controland(3)Challenge:perceivingchangeasachallengeratherthanathreat
(Kobasa,1979).Kobasabasedherhardinessmodelonanarrowgroupofwhite
male, middle to upper class business executives, and later research on the
subject in different social groups have failed to replicate her results, and
triggered faulty generalization as it was imposed on other groups (Hartling,
2008). The problem of the generalization of these concepts by Connor &
Davidsons (2003) should therefore be self-evident. An even greater example of
overgeneralizationintheCD-RISCistheirbasisofincludingfaithandoptimism
intheirscale.Theyuseananecdotalexampleofonearcticexplorer’sexperience
onthevoyageoftheshipEndurance.Naturallyonecannotseriouslyconsidered
ananecdotalevidenceofthiskind,assoundevidencethatfaithandoptimismis
important for resilience. Especially because he was such an extraordinary man
who lived such an extraordinary life, far removed from any normal modern
human conditions. It is fine if Connor & Davidsons want to use his example to
show a man who showed tremendous resilience under extremely difficult
circumstances (which he no doubt did show), but it should be obvious to
everyonethatyouhavetobackthisclaimupbystatisticallygroundedevidence
andtheoryaswell,tohaveasolidtheoreticalbase.Basingsuchaclaimsolelyon
one individual whom they admire and have studied the life story of (though
apparentlynotthoroughlyenoughtogethisnameright)isludicrous.
One may also question why a scale developed in the early 2000s base
theirconceptsanddefinitionsofresilienceonresearchandtheoryfromthelate
70sandmid80s.Knowingthehistoryofthefourwavesofresilienceresearch,its
clearthattodeveloparesiliencescalearoundtheassumptionthatresilienceis
built on individual personality traits, they would have to go back to the first
wave,wherefindingindividualfactorsofresiliencewasattheforefront,tofind
definitionsandempiricalevidencetosupportthisassumption.Byusingtheearly
research presented by Rutter (1985) as a base they found individual factors
related to resilience, however had they looked further at Rutter’s newer work
(e.g.Rutter,1999;2000)theywouldfindthathisviewon,andhisdefinition(s)of
theterm,hasdevelopedalongwiththefieldingeneral.Thefactthattheevidence
34
and theory that was presented by Rutter in 1985 was based on children and
adolescents, and used on an adult population to develop a resilience scale, for
adults, is not discussed or problematized by Connor & Davidson (2003), and
leadstofurtherpossibleissuesofgeneralization.
To account for individual factors related to stress resilience they quote Lyons
(1991), in her article about positive adjustment following serious traumatic
events. She mentions a variety of complex factors on interpersonal and
individuallevels,butthetwofactorsusedintheCD-RISCistheroleofpatience
and ability to endure stress or pain. Again they show an over-simplification of
the authors view, and cherry pick which factors they want to include, without
givingareasonforwhytheychosethem.
Overallthesectiononthedevelopmentoftheirscalelacksdepth,asitisnotclear
whytheworksofonlythreeauthors(Kobasa,Rutter&Lyons)havebeenchosen
to identify the “characteristics of resilient people”. In addition the anecdotal
exampleofShackletonisonlybrieflymentionedaswell.
Resultsfromtheexplanatoryfactoranalysisshoweda5-factorsolutionwiththe
different factors representing “personal competence, high standards, and
tenacity,”“trustinone’sinstincts,toleranceofnegativeaffect,andstrengthening
effects of stress,” “positive acceptance of change and secure relationships,”
“control,”and“spiritualinfluences”(Connor&Davidson,2003,p.80).Thisfivefactor model now serves as the basis for understanding resilience in the most
widelyusedresiliencescaleforadults.
4.2TheCD-RISC10
Toavoidsomeoftheissuesregardingthesefivefactors,likespiritualinfluence
being defined by just two items (item no. 3 and 9, see Table 4) despite
methodologists specifying that factors should be measured by at least three to
five measurable variables (MacCallum, Browne, & Sugawara, 1996), CampbellSills and Stein (2007) set out to construe and validate a 10-item measure of
resilience, named CD-RISC 10. They ended up choosing items from what they
labelledthe“hardiness”and“persistence”factors(item1,4,6,7,8,11,14,16,17
and 19, see Table 4). These items basically refer to the ability to adapt and
withstand stressful events, and the self-belief that goals and challenges are
35 achievable. These are features that most commonly are talked about with
regards to stress resilience, personal traits that contribute to being able to
handle stressful life events. The CD-RISC 10 was developed on two groups of
individuals,onethathadexperiencedhighlevelsofchildhoodmaltreatmentand
peoplewhodidnotreportsuchexperiences(Campbell-Sills&Stein,2007).They
found that people who experienced high levels of childhood mistreatment, but
characterised themselves as having high resilience on the CD-RISC 10, showed
equallylowpsychiatricsymptomsaspeoplewhoexperiencedlowmaltreatment
andcharacterisedthemselvesasbeinghighlyresilient.However,astheauthors
pointout,theseanalysesarecross-sectionalandassuchitcannotaccountfora
causalrelationshipthatexplainsthispattern.Forexampleparticipants’symptom
levelsmightbethecausalfactorthatleadstothemexperiencingandreporting
low resilience, participants who, for example, are depressed might view
themselvesandtheirabilitytohandlestressful(i.e.theirresilienceasmeasured
by CD-RISC 10) in a more negative light. So to put it simply, psychiatric
symptoms might be the causal factor that leads to people reporting lower
(stress) resilience and not the other way around. The old phrase “correlation
doesnotimplycausation”springstomind.
The biggest question I have regarding the development of this scale is the
authors’insistenceofthisbeinga“be-allandend-all”measureofresilienceasa
whole, when it, in my view, would much better serve as a possible “stress
resilience scale”, measuring some individual factors (the ability to handle
stressfulevents)thatisconnectedtoaspecificsub-partofresilience,mainlythe
ability to handle stress. I’m not denying that being able to handle stressful life
events, and having a positive view on one’s ability to do so, might be an
importantaspectofresilience.Buttheproblemariseswhenresilienceisreduced
to being just this one thing. To borrow Thelen’s (2005) metaphor, it would be
like measuring the depth of the mountain stream at one particular place, and
then reduce the defining features of a mountain stream into a measurement of
depth.Youendupignoringsomanyotherfacetsandaspects,thatitmightend
up hurting the entire field of research if this one 10-item scale becomes what
defines “resilience”. As Michael Rutter (1999) once wrote, “the concept of
36
resilienceisnecessarilyandappropriatelybroad”(p.120)andtoscaleitdown
by making claims like “We believe that the 10-item CD-RISC captures the core
featuresofresilience”(Campbell-Sills&Stein,2007,p.1027)clearlygoesagainst
this thinking of resilience as a broad concept. So the claim it makes (on a thin
empiricalandtheoreticalfoundation)tobeafunctionalmeasurethatseparates
theresilientfromthenon-resilientisworthcriticising.
4.3TheResilienceScale(RS)
The RS was developed from a qualitative study of 24 older women that had
adapted successfully following major life events, by the psychiatric nurses
Wagnild & Young (1993). From the narratives of these women they developed
five components of resilience: equanimity, perseverance, self-reliance,
meaningfulness and existential aloneness. Equanimity is defined by Wagnild &
Young(1993)asbeing“abalancedperspectiveofone’slifeandexperiences”(p.
167), perseverance is described as “the act of persistence despite adversity or
discouragement”(p.167),selfreliance,as“abeliefinoneselfandone’sabilities”
(p.167),meaningfulnessas“therealizationthatlifehasapurpose[...]thesense
ofhavingsomethingforwhichtolive”(p.168)andexistentialalonenessas“the
realizationthateachperson’slifepathisunique[...]existentialalonenessconfers
a feeling of freedom and sense of uniqueness” (p. 168). On this theoretical
background the authors developed a 25-item questionnaire that was tested for
psychometric properties on a sample of 810 community-dwelling older adults
(53-95yearsold,meanage71.1years)(seeTable9).
To separate the “resilient” from the “non-resilient”, the group answered
questionnaires regarding life satisfaction, morale (and subjective well-being)
anddepressionasmeasuredbytheLifeSatisfactionIndexA(LSI-A),Philadelphia
Geriatric Center Morale Scale (PGCMS) and the Beck Depression Index (BDI)
(Wagnild&Young,1993).Astheauthorspredictedlowerscoresonthe25-item
resilience scale was correlated with lower scores on these three scales. A later
review (Wagnild, 2009) showed that different studies that have used the scale
overtheyear,haveconfirmeditsinternalconsistencyandreliabilityonavariety
ofpeopleofall(adult)ages,socioeconomicandeducationalbackground.
37 Note:Reprintedfrom”DevelopmentandPsychometricEvaluationoftheResilienceScale”byWagnild,G.M.
&Young,H.M,1993,JournalofNursingMeasurement(1)p.163–178..
AsyoucanseetheRShasthesamefundamentalviewonresilienceasapersonal,
individualquality,whichmostoftheotherscaleshave.Itisclearlyinfluencedby
the leading view of resilience at the time it was developed (started during the
late1980s).Whatisproblematicaboutitisthatthescaleisstillusedtoawide
degreetoday,withwhatisanarchaicunderstandingofresilience.Thescalewas
further developed into a 14-item version, with the same focus on these
individualtraits(Damásio,Borsa&Silva,2011)andaslightlydifferentlyworded
versionofthe25-itemscalecalledtheTrueResilienceScaleTM(TRS),namedfor
38
beingdifferentfromthefalseresiliencescalesonemustpresume,whichcouldbe
takenforfreeathttps://www.resiliencescale.com/5.
The RS is one of the most popular and most widely used resilience scales,
possiblybecauseitcamefirstandpeopleviewlongevityasasignofquality,or
the fact that the scale has been validated and tested many times with different
group,andthereforehaveawideage-span.
Now as was the case for the CD-RISC, the development of this scale is also
questionable. The authors’ state that the five themes found in the qualitative
studywasfurthervalidatedbytheavailableresilienceresearchatthetime,but
other than stating this as a fact, they offer little explanation of how these five
themes are connected to the resilience literature at large (Wagnild & Young,
1993).Theitemsofthescaleareverbatimstatementsthatwerechosenonthe
basis that they “reflected the generally accepted definitions of resilience”
(Wagnild & Young, 1993 p. 168), yet no examples of these generally accepted
definitions are presented, and it is not clear how the 25-items reflect these
definitions. The items presented in the scale basically boils down to having a
beliefinoneself(andonesabilities)andseeingmeaninginonesdaytodaylifeis
the same as being resilient. In other words having perceived self-efficacy
(Bandura,1994)andcompetenceishereseenasbeingequivalenttoresilience,
which has been warned about by researchers supporting the developmental
view of resilience (e.g. Masten, 2014a; Rutter, 2012), where these factors are
seen as an important part of resilience, but that individual factors like these
shouldneverbeseenasequivalenttooradefinitionofresilienceasawhole.The
fact that the authors of the RS view resilience more or less as an ability that
individualscanbetrained,goesagainstthewaythatresilienceisusuallydefined
andexplainedbyacademicsinthefield.
5AfterhavingmeasuredmyresilienceusingtheTRS,itisapparentlyproventhat
Ihavemoderatelylowresilience(71/100).Theywereniceenoughtooffertosell
me a book and enlist a resilience coach to boost my resilience. It has recently
beencloseddown,andisnowonlyavailablethroughlicensing.
39 4.4TheResilienceScaleforAdults(RSA)
The RSA is another scale created specifically, as the name suggests, for
measuring adult resilience. Developed in Tromsø Norway with a Norwegian
sample(Friborgetal.2003)UnliketheCD-RISCtheyviewresilienceasamultidimensionalconstructwhichdoesn’tonlyreferto“importantpsychologicalskills
or abilities but also to the individual’s ability to use family, social and external
support systems to cope better with stress” (p.66). Therefore the authors
developed a 45 items scale, that first had five dimensions covering personal
competence, social competence, social support, family coherence and personal
structure in a preliminary scale (Hjemdal, Friborg, Martinussen & Rosenvinge,
2001).
ThefirstversionoftheRSAendedupwith11personalcompetenceitems(after
oneitemomission),eightsocialcompetenceitems(twoomissions),sevenfamily
coherence items, eight social support items (one omission) and five personal
structure items. Comparing patients from an adult outpatient clinic with
different psychiatric diagnoses, with a normal control group selected by
statisticsNorwayatrandom,wasthebasisofcomparison.Itwasexpectedthat
theoutpatientgroupwouldreportlessprotectiveresourcesandlessindividual
“resiliencetraits”,whichwasconfirmedbytheanalysis(Friborgetal.2003).The
answers on this original version scale was done one a 7-point Likert scale
rangingfrom“Nottrueatall”to“Verytrue”,butwaslaterrevisedtoasemantic
differentialformattoreducepossibleacquiescencebias,asallthequestionson
the Likert scale were positively worded (see Table 6 for examples) (Friborg,
Martinussen&Rosenvinge,2006).
40
Note: Reprinted from ”Likert-based vs. semantic differential-based scorings of positive psychological
constructs: A psychometric comparison of two versions of a scale measuring resilience” by Friborg. O.,
Martinussen,M.&Rosenvinge,J.H.,2006,PersonalityandIndividualDifferences40p.873–884.
A further revision of the scale, lead to it ultimately consisting of 33 items
(Friborgetal.,2005),nowwithsixdimensions,(1)Personalstrengthwithtwo
sub-factors; (1a) Perception of self, and (1b) Perception of future, (2) Social
competence,(3)Structuredstyle,(4)Familycohesion,(5)Socialresources.The
final33-itemRSAcanbeseeninTable7.
Whatisclearfromthetheoreticalbackgroundanddefinitionstheyuseasabasis
fortheirscale,showsamoremodernunderstandingofresilienceassomething
thatisnotjustbasedonfirst-waveresearch.Theauthors’ambitionistoidentify
both protective factors in the environment (positive relationships with friends
and family) and individual traits connected with resilience. Understanding
resilience as a term that encompasses a multitude of different factors, having
differentbutimportantinfluenceonseverallevelsofanalysis,iscertainlyastep
in the right direction when it comes to developing resilience scales. Analysing
andidentifyingprotectivefactorshavebeenanimportantpartoftheresilience
field since the 80s, and this should be included in any scale aiming to measure
resiliencefactors.Thefactthatthepsychometricfactorsalsohavebeenrevised
andrefinedtoavoidcertainbiasesandassureastrongerstatisticalfitofallthe
items, shows an impressive dedication to make the scale as strong as possible.
This includes cross-cultural validations in Belgian and Brazilian samples
(Hjemdaletal.,2011;Hjemdal,Roazzi,Dias&Friborg,2015).
Howeverthefactthatthisscaleonlyencompassesfamilyandfriendsaspossible
protective environmental factors is questionable. Work and school/university
are other places where adults experience stress, and having good relationships
andsupportwithintheseenvironmentsisimportantforthewell-beingofmany
adults. Is the school/work place a stressful environment that strains the
individual?Dopeoplehaveadequatesupportintheirdailywork/schoollife?The
RSA doesn’t account for questions like these, and it limits social resources to
encompassingonlyfamilyandfriends,andnottheseotherimportantfactorsof
adults’dailylife.
41 Note: Reprinted from ”Resilience in relation to personality and intelligence” by Friborg. O., Barlaug, B.,
Martinussen, M., Rosenvinge, J. H. & Hjemdal, O., 2005, International Journal of Methods in Psychiatric
Research(14)p.29–42.
Like Werner & Smith (2001) pointed out with their Kauai study, what
characterised people who developed resilience in adulthood wasn’t necessarily
their personal qualities or even just the protective factors with family and
friends,butrathertheopeningofopportunitiesandturningpointsinlaterlife,
42
like getting an education and finding jobs, proved to be essential for the
developmentofresilience.ThesefactorsarenotaccountedforintheRSA.
Despite the positive aspects of this resilience scale, I do take issue with the
authors’ insistence on finding “resilient individuals” as they call people who
report resilience (Friborg et al. 2003). When individuals report resilience at a
specific time and place, it is a measurement of how they feel at that specific
moment in time and not necessarily a measure adequate to label an individual
‘resilient’or‘not-resilient’.Howeverthisdoesn’tmeanthattheyareasstringent
as the early first wave researchers that developed terms like “hardiness” and
“egoresilience”were,astheyclearlycomefromamoremoderntheoreticaland
empirical background, but they seem to take the view that individual
characteristics (as measured by the RSA) + social protective factors (as
measured by the RSA) = resilient or non-resilient individuals. It is still a
simplistic definition and understanding of resilience, and does not guarantee
resilienceforanyindividual.Grantedthissimplificationmightbeabi-productof
usingscalestomeasureresilienceingeneral.Atsomepointreductionismwillbe
necessarytomakethescalescomprehensive,asresilienceneedstobedefinable
byquestionsonaquestionnaire.
4.5TheBriefResilienceScale(BRS)
Theauthorshaveafairlystraightforwardexplanationforwhatkindofresilience
scale they have developed: “The brief resilience scale (BRS) was created to
assess the ability to bounce back or recover from stress” (Smith et al., 2008 p.
194).Theygoontosaythat“itmaybepreferabletouseawordlike‘resistance’
(asin‘stressresistance’or‘resistancetoillness’)torefertonotbecomingillor
showingadecreaseinfunctioningduringstress”(Smithetal.,2008p.194-195).
So this is a scale that isn’t really developed to measure resilience, but rather a
sub-partofresiliencecallednamedstress-resistanceorstress-resilience.Asthe
namesuggest,thescaleisbriefandconsistof6items,allbaseduponindividual
factors,thatallowpeopleto“bounceback”afterstressfulevents(seeTable8).
43 Reprintedfrom”TheBriefResilienceScale:AssessingtheAbilitytoBounceBack”bySmith,B.W.,Dalen,J.,
Wiggins,K.Tooley,E.,Christopher,P.&Bernard,J.2008,InternationalJournalofBehavioralMedicine(15)p.
194–200.
Theymaketheclaimthatthe“BRSistheonlymeasurethatspecificallyassesses
resilienceinitsoriginalandmostbasicmeaning:tobouncebackorrecoverfrom
stress” (Smith et al., 2008 p. 199) which in my view is an odd thing to boast
about,sincedevelopingascaleontheoriginalunderstanding,andignoringevery
developmentofresilienceresearchsincethetermsinceptionisnotafeat.They
basetheirunderstandingofthe“mostbasic”and“original”meaningofresilience,
onadefinitionfromWebster’snewcollegedictionaryandnotonpsychological
resilienceresearchandtheory.Inalaterarticletheauthors(Smithetal.2013)
repeat this claim, and, despite acknowledging that other understandings of the
word resilience exists, and that many people would refer to this scale as
measuringstressresilienceorstressresistance,theystillclaimtheirdefinitionis
the truest way to define resilience. It’s an etymological argument rather than
theoretical,andontopofthatitisn’taverygoodone.Astheypointoutresilience
isbasedonthewordresile,whichmeanstobounceorspringback,andtherefore
they claim “the ability to bounce back or recover from stress is closest to the
originalmeaningoftheword‘resilience’anditsrootintheword‘resile’.”(Smith
et al. 2013, p. 167). However the word resile only means “to bounce or spring
back”, and the adage of ”from stress” could just as easily be replaced with a
different word. For example I could claim that the ability to “bounce or spring
backfromtrauma”istheclosesttothe“originaldefinition”ofresilience,orthe
ability to bounce or spring back from a period of mental illness is the “truest
definition”ofresilienceandIwouldbejustaswrong.
44
So to sum up, as a scale the BRS would be much more useful as an outcome
measureinthecontextofstressresilience,and,despitetheauthors’insistence,
notinthecontextofresilienceinthebroadersenseoftheword.
4.6 Ego Resiliency (ER) & The Dispositional Resilience Scale
(DRS)
Iwon’tgointomuchdetailonthesetwoscales.FirstofallERmakesnoclaimof
measuring resilience, but the different construct (which is often confused with
resilience)basedonBlock&Block’s(1980)understandingofego-resiliency,and
becauseithasnotbeenutilisedinsubsequentresearch(Windleetal.2011)and
thereforecannotbesaidtohavehadabiginfluenceonadultresilienceresearch.
ThesamegoesfortheDRS,asithasmainlybeenusedinamilitarycontext,and
is (as the author readily admits) actually a hardiness scale (Bartone, Ursano,
Wright&Ingraham1989;Bartone1991,1995,2007).
4.7TheuseofResilienceScales
Traitvs.Process
Asmentionedintheintroductiontothissegmentofthethesis,thedebateonthe
useofresiliencescaleswithadultresilienceresearchisultimatelyalsoadebate
ofwhetherweshouldviewresilienceasatraitoraprocess,ortheoutcomeofa
process.Asshowninthesummaryofthefourwavesofresilienceresearch,the
view that resilience was a special individual quality that certain resilient
individualshavewasthedominatingviewinregardstoresilienceinchildrenand
adolescents. This view is now being perpetuated again with adults. A big
problemovertheyearsisthatthetermsego-resiliencyandresiliencehavebeen
interchangeably used over the years, and have possibly muddied the water.
Luthar, Cicchetti & Becker (2000) wrote: “Ego resiliency encompasses a set of
traits reflecting general resourcefulness and sturdiness of character, and
flexibilityoffunctioninginresponsetovaryingenvironmentalcircumstances”(p.
546).Aquickglanceatthesescalesshowsexactlythat,withtheexceptionofthe
RSA,thatfocusonprotectivefactors,bothinternalandexternaltotheindividual.
Further confusion may also stem from how scholars who conceptualize
resilienceasadynamicprocess,also occasionallyhaveusedtheterm“resilient
45 children” (e.g., Masten et al., 1990; Rutter, 1993; Werner, 1984). Many of these
authors are referenced in the development of these adult resilience scales, as
evidence of resilience being an individual trait. However, in this context
“resilient children” does “not imply reference to a discrete personal attribute,
akintointelligenceorempathy”(Lutharetal.,2000p.546)butratherchildren
who have shown resilient development despite adversity. In other words
resilience was seen as an outcome of positive development, and not a fixed
individual trait. The second factor that puts resilience scales in the trait rather
than process category is that “ego-resiliency does not presuppose exposure to
substantialadversity,whereasresilience,bydefinition,does.”(Lutharetal.,2000
p. 546) a point affirmed by researchers in the adult field (Mancini & Bonanno,
2010). My own experience taking the True Resilience ScaleTM online is a good
exampleofthis.Byanswering25personalquestions,onanindividuallevel,Igot
aresultthatclaimedtoshowwhatmyresiliencewas.Withnoreferencestomy
reallifeandwithoutregardstoanysortofexposuretoadversitiesIwasgivena
moderately low resilience score (71/100). Now of course my point is that this
testinfactdidnotmeasuremyresilienceinanymeaningfulway,shapeorform,
but might have shown that my ego-resiliency (or individual resilience traits) is
not that high compared to people with higher opinions about themselves. This
scale (and the others) therefore do not show resilience, but rather factors that
canmakepeoplemorepredisposedtoresilientdevelopment.Whichbringsmeto
mysecondpoint:
Even though it might seem like I think that resilience scales are completely
uselessaltogether,whichIdonot,asameasureofindividualfactorsconnected
to resilience, the resilience scales can be useful and say something about a
person’sprotectivefactors.Iamhoweververycriticaloftheroleitclaimsandto
a large degree has, in modern adult resilience research. It is seen as being a
measurement and defining quality of resilience itself and not of resilience
factors. It should be used within the context of a developmental view on
resilience,allowingformultiplelevelsofanalysis.Iftheonlylevelofanalysiswe
havetounderstandadultresilienceisontheindividualtraitbasisthepossibility
forresearchwillbeanarrowandtheunderstandingofresilienceevennarrower.
The tendency to define adult resilience as an individual trait is as I mentioned
46
wellknownwithinthefieldandthewayresiliencescalesareusedtodayisbotha
symptomandacauseofthislineofthinkingwithinadultresilienceresearch.
However there are researchers that are aware of the limitations of resilience
scales, and what they actually do and do not measure. For example Ong and
colleagues(Ong,Bergeman&Boker,2009;Ong,Bergeman&Chow,2010)makes
clear distinctions between the individual traits they measure with resilience
scales, and resilience as a term. In other words, these personal resilience traits
(personalityresilience,astheycallit)isseenasanimportantprotectiveassetin
resilience,andtheirresearchprogramemphasise“thedynamicandcoordinated
interplay between both trait and process conceptualizations of resilience” (Ong
et al., 2010 p. 84, original emphasis). This is perfectly in line with Luthar and
colleagues(2000)viewthat“thetraitofego-resiliencymayoftenbeimplicated
in the process of resilience, serving substantial protective functions among
individuals facing adversity” (p. 546). In other words, there is nothing wrong
with using resilience scales or even the old terminology ego-resiliency within
resilienceresearchandtheory,asitcanexplainsomeprotectivefactorsthatlead
to resilient development, however it is problematic if it becomes the defining
qualityofresilience.
Becauseforthemostpart,adultresiliencescalesobfuscatesthetermresilience
and most uses of resilience scales forwards a highly uncritical view that the
results of these scales are “pure” resilience measured, as shown in these two
examples: Shin and colleagues (2012) found that resilience can be a possible
predictor of lower psychological distress in chronic spinal cord injury patients
andTian&Hong(2014)foundthatresilienceisnotapredictorofqualityoflife
forpatientswithdigestivecancer.Itshouldbeclearthatwhattheseresearcher
have measured with their use of respectively, CD-RISC and TR-14 scales is not
resilience, but rather a measure of some resilience factors, that play a part in
resiliencedevelopmentsomeofthetimeforsomepeople.Soiftheauthorsrather
had concluded that “the individual resilience factors measured by the CD-RISC
canbeapossiblepredictoroflowerpsychologicaldistressinchronicspinalcord
injurypatients”and“theindividualresiliencefactorsasmeasuredbytheRS-14
47 wasn’tconnectedwithqualityoflifeforpatientswithdigestivecancer”itwould
give a much clearer description of what these scales actually measure. This is
also clearly shows the difference in a trait vs. outcome view of resilience. The
outcome view would see resilience as being the development of life quality for
cancerpatientsandlowerpsychologicaldistressforspinalcordinjurypatients,
and the factors that lead to the development of these outcomes (higher life
qualityandlowerpsychologicaldistress)wouldbetheresiliencefactors.Sothe
point is, when you read studies claiming “resilience is connected to...” or
“resilient individuals/people show...” etc., because they have measured it using
these resilience scales, you should be critical of these claims, and remember
what these scales actually measure and are able to say about resilience. It is
problematic for the field of adult resilience research if you don’t. As Walter
Mischel (1969) pointed out a long time ago, it is rare that personality explains
anything more than a small part of the actual variance in people’s behaviour
across situations. Having a term like resilience defined by these small
measurablevariancesisthereforeverydisconcerting.
Now we’re going to a completely different part of adult resilience research,
whichismuchbetteratinterpretingtheresultsintoawiderresiliencecontext.It
comes surprisingly from a branch that often is seen as being deterministic and
narrow in the view of human personality and behaviour, namely the field of
psychobiologicalresearchonadultresilience.
48
5.PSYCHOBIOLOGICALFACTORS
Tohaveabroadpictureofpresentdayadultresilienceresearch,wealsohaveto
lookattheresearchthathasbeendoneonapsychobiologicallevel.Likewesaw
with the promise of the fourth wave of resilience research, the biological
research of adult resilience also encompasses models that function of multiple
levels of analysis. This means that “the answers” aren’t expected to be found
solely in the genes. Rather there is talk about indications and predispositions to
resilience, and the focus is on finding sub-factors that influence resilience on a
biologicallevel,andresilienceisusuallydefinedhereashavingwithstoodsome
form of adversity, like stressful life situations. This field of adult resilience
researchisreallybooming,because(asI’vementionedbefore)wearestanding
in the fourth wave of resilience research, which has made a huge impact on
researchwithadults.
5.1Heritability
So with this development of the fourth wave of resilience research there has
beenarenewedfocusonthegeneticinfluencesofresilience.Inthisfieldoneof
the most important concepts is heritability (Lemery-Chalfant, 2010), which can
bedefinedas“theproportionofthephenotypicvarianceduetogeneticvariance
among individuals in a population.” (p. 59). Since it is only a proportion it is a
descriptive statistic of a specific group that describes said group currently. So
changes in trait relevant environments may lead to changes in heritability
statistics (Lemery-Chalfant, 2010). This means that heritability estimates are
specificallydevelopedforthepopulationsstudiedandcanonlybegeneralizedto
groups that share a distribution of relevant genes and environments (LemeryChalfant,2010).Thisisapointthatisoftenundercommunicatedandsometimes
even overlooked. Heritability studies are mainly based on twin or adoption
studies, and does not specify resilience genes, but focus on phenotypic or
behavioural expression of the entire genotype. The estimation of genetic and
environmental influences is therefore based on resemblance of relatives. It is
alsoimportanttostressthatgeneticinfluencesdonotfunctioninisolationfrom
environmentalinfluencesanddoesnotimplyimmutability,soatraitbeinghigh
heritably does not in any way indicate that it is less modifiable through
49 environmental interventions (Lemery-Chalfant, 2010). It has also been shown
that heritability changes during a person’s life span, for example it has been
shownthatheritabilityofintelligenceincreaseswithage(Boomsma&vanBall,
1998; Pedersen, Plomin, Nesselroade, & McClearn, 1992) and a decrease of
geneticfactorsinfluenceonanti-socialbehaviourfromchildhoodtoadolescence
(Moffitt, 1993). However these studies have been made between
children/youthsandadults/olderchildren,andifyoucontrastgroupsofadults
at different ages, you’ll find a remarking stability of biological factors influence
on personality especially, but also of depression symptoms and life events
(Johnson, McGue, & Krueger, 2005; Kendler, Neale, Kessler, Heath, & Eaves,
1993; McGue & Christensen, 2003; Pedersen & Reynolds, 1998; Plomin,
Pedersen, Lichtenstein, & McClearn, 1994), though, as mentioned before, this
doesnotmeanimmutability.
When it comes to research connecting resilience with heritability, one seldom
finds research that claims to measure it directly, as resilience is a term that
consistsofmanydifferentcomponents,andnosinglecomponentcanbesaidto
bethe“be-allandend-all”ofresilience(unlikewhatwehaveseenwithresilience
scales). Therefore research on the heritability of psychological resilience, is
actuallyresearchonheritabilityofresiliencecharacteristics.Theclassicstudies
ofpsychosocialresiliencebyGarmezy,Masten,andTellegen(1984),Lutharand
Cicchetti(2000),MastenandCoatsworth(1998),andWernerandSmith(1992)
clustered and showed characteristics that facilitate and enhance the dynamic
developmentalprocessofresilienceacrossthelifespan.Southwick,Vythilingam,
andCharney(2005)latercondensedthesefindingsintofivemain(interrelated)
characteristics: (1) positive emotions (including optimism and humour), (2)
cognitive flexibility (including positive explanatory style, positive reappraisal,
and acceptance), (3) social support (including role models), (4) meaning
(including religion, spirituality, and altruism) and (5) active coping style
(including exercise and training). These five factors were used as the basis by
Lemery-Chalfant(2010)inherreviewofheritableresiliencefactors.
ForexampleBoardman,Blalock&Button(2008)investigatedtheheritabilityof
positive affects which has been noted as being one of the individual qualities
connectedtoresilienceasnotedby,amongstothers,Masten(2001,2007)inher
50
aforementioned “short list” (See Table 1). They showed that the heritability of
positiveaffectswas.60formenand.59forwomen,inastudyusingmonozygotic
andsamesexdizygotictwinsages25-75,fromtheenormousNationalSurveyof
Mid-Life Development in the United States (MIDUS), collected in the mid-90’s
(Boardman et al. 2008). After controlling for an exhaustive list of social and
interpersonal stressors, and they later operationalized the residual for positive
effect as resilience. After accounting for these stressors there was a significant
sexdifferenceintheheritabilityoftheiroperationalizationofresilience,with.52
for men and .38, indicating that men seem to draw additional benefits from
environmentalmasterywhenitcomestoheritabilityofresilience,comparedto
women(Boardmanetal.2008).Iwouldliketotakeamomenttocommendthe
authors of this article for their creative way of investigating and defining
resilience.ByusingRutter’s(2006)understandingofresilienceasageneral,not
domain-specific orientation, “implying a relative resistance to environmental
risk experiences, or the overcoming of stress or adversity” (Rutter, 2006, p. 1).
Withthisbasicunderstandingofresilience,whichinmyviewisnottoopenor
too narrow, the researchers manages to operationalize a useful measure of
resilience,fromalargedata-settheresearcherthemselvesdidnothaveanypart
in collecting or developing, as it tells us (or at least indicates) somethingabout
the development of resilience in adulthood. By showing an adult population
maintaining positive affects, despite having gone through environmental
stressors,definitelyindicatesresiliencein the way Rutter (1999, 2006) defines
it. However it is necessary to point out that the data is based on self-report
measurements,whichalwaysentailsvalidityquestionsandthatthewiderange
ofagesofthepopulationinthisparticularstudy,makesitdifficulttogeneralizeit
topeopleoutsideofthisparticulargroup.Sothestudyisnotperfect,butagood
example of how to investigate biological factors of resilience, from a “fourth
wave perspective” showing the relationship between resilience, and
biological/environmentalfactors.
When it comes to the heritability of humour there has been shown differences
between an American and a British sample using the same questionnaire.
Humour was distilled into four main humour styles (affiliative, self-enhancing,
aggressive and self-defeating), and variations were shown to be dependent on
51 genetic and non-shared environmental factors for all four humour styles in the
British study, but not for the American sample, where aggressive and selfdefeating humour styles were contributed to experience and affiliative and self
enhancing humour was heritable (Cherkas, Hochberg, MacGregor, Snieder, &
Spector, 2000; Vernon, Martin, Schermer, Cherkas, & Spector, 2008). This
indicatescertainculturaldifferencesintheappraisalofhumourbutitisdifficult
tosaywhichstyleofhumourismostlyconnectedtoresilience.
Mental toughness being operationalized as having control over ones life,
commitment to what one is doing and to be able to face new challenges, a
important individual quality with regards to resilience as a part of cognitive
flexibility, is estimated to be between .36-.56 (Horsburgh, Schermer, Veselka &
Vernon,2009).Furthermoretherehavebeenreportedheritabilityrangingfrom
.11 to .43 for six aspects of psychological well-being, purpose in life, selfacceptance, autonomy, mastery, personal growth, and positive social
relationships (Kessler, Gilman, Thornton & Kendler 2004), with other studies
having shown high heritability in explaining the differences of psychological
well-being between individuals with .50-.80 in heritability (Lemery-Chalfant,
2010). However this was only the case when well-being was measured with
MultidimensionalPersonalityInventoryandnotbytheCenterforEpidemiologic
Studies Depression Scale, which showed minimal heritability (Lemery-Chalfant,
2010). A Norwegian study that investigated the stability in subjective which
showed largely stability with Cross-time correlations for genetic effects were
0.85 and 0.78 for males and females respectively and that individual
environmental influences on subjective well-being were mostly time-specific
(Nes, Røysamb, Tambs, Harris & Reichborn-Kjennerud, 2006). Additive genetic
effects explained approximately 80% of the phenotypic cross-time correlation
(Nesetal.2006).
With regards to social support and religiosity, research has shown moderate
heritability of social support and marital satisfaction, and modest to moderate
heritability for religiosity, with higher heritability for African Americans, than
AmericansofEuropeandescent(Lemery-Chalfant,2010).
52
5.2MolecularGeneticTechniques
Movingbeyondheritabilitytomoleculargenetictechniquesthatisnotbasedon
familyresemblancemethodsinestimatinggeneticinfluenceisabigpartofthe
new“fourthwave”researchofresilience,andalsoanimportantpartofresearch
on adult resilience. These techniques make it possible to further explore
phenotypes shown to be heritable and identify actual genes, where we can
investigate how variations of the identified gene affect protein expression and
the resulting phenotype (Lemery-Chalfant, 2010). Using association studies,
examining statistical associations between specific genetic variants and
phenotypes, is the most common study design. When there is a significant
association,thiscanmeanthatthegenecanhaveriskorprotectionforthetrait
in question. However such an association does not necessarily mean that the
geneinquestionhasacausalroletoplayinrelationtothetrait,asitmightbe
located near another gene on the same chromosome that plays the important
part in affecting the trait. Another factor that can skew the results is whether
there are mixed ethnicities in the population studied, as frequencies of alleles
canvarysubstantiallyamongdifferentpopulations(Lemery-Chalfant,2010).The
development of these new techniques has led to the discovery of hundreds of
thousands genetic variants called single-nucleotide polymorphisms (SNPs,
pronounced“snips”),whichmeansthatif99%ofthepopulationdonotcarrythe
same nucleotide at a specific position in the DNA sequence, this variation
betweenindividualsiscalledaSNP,theyarecommonastheyoccurinevery300
nucleotide on average, meaning there is roughly 10 million SNPs in the human
genome(Binder&Cubells,2009).SomeSNPssegregateintoclustersofSNPsthat
formgroups,keepingtrackoftheseisknownasHaplotypemapping,whichcan
tell us something about interactions of genetic variances which likely has an
influenceonresilienceprocesses.Testingsuchlargenumbersofgeneticvariants
has been shown to be difficult and complex to achieve within
psychological/psychiatric research (Gottesman & Gould, 2003) and it has been
shown that “Simultaneous testing of association with large numbers of genetic
variantsinevitablyleadstofalse-positiveassociations.”(Lemery-Chalfant,2010,
p. 67). To conquer these issues Gottesman & Gould (2003) focused on
endophenotypes,“measurablecomponentsunseenbytheunaidedeyealongthe
53 pathway between disease and distal genotype” (p. 636), in other words they
bridge the gap between genotypes and phenotypes, and “may be
neurophysiological, biochemical, endocrinological, neuroanatomical, cognitive,
orneuropsychological”(p.636).Tofindusefulendophenotypestheyneedtobe
genetically influenced and associated with one or more of the candidate genes
andthephenotype(Gottesman&Gould,2003).
5.3Catechol-O-Methyltransferase(COMT)
Catechol-O-methyltransferase (COMT), is an enzyme that is central to the
metabolism of dopamine in the prefrontal cortex (Käenmäki et al., 2010).
Dopamine has been shown to have a U-shaped negative effect on human
cognition,meaningthattoolittleortoomuchhasdeleteriouseffectsoncognitive
performance (Mattay et al., 2003; Papaleo et al., 2008; Vijayraghavan et al.,
2007).TherehasbeendiscoveredaSNPofthegeneforCOMTwhichleadstoan
valine (Val) to methionine (Met) mutation at position 158 (Val158Met) rs4680
(Lottaetal.1995),withcodominantalleleswhichmeansthateverybodyinherit
one allele from each parent, forming either an Val/Val, Met/Met or a
heterozygous(Val/Met)paring,whereindividualswiththeVal/Valgenotypehas
the highest activity of COMT, Met/Met the lowest and the heterozygous show
moderateactivity.Whatmakesthisinterestingforusexploringresilienceisthe
effect these different forms of genotypes has on dopamine levels. Low activity
(Met)COMTisrelatedtoelevateddopamineintheprefrontalcortexanddenser
nerve connections, which acts as endophenotypes to, on the one hand, better
concentration and executive functioning in general, and, on the other, reduced
ability to shift attention, higher personality disorganization and more
behavioural rigidity (Sheldrick et al., 2008). This might lead to people with the
COMT-Met allele having enhanced cognitive functioning, but might be more
prone to rumination, which in turn might lead to anxiety. This is supported by
researchassociatingtheCOMT-Metwithincreasedlevelsofanxietyandanxiety
disorderslikepanicdisorder,especiallyamongstwomen(Domschke,Deckertet
al.,2007;Domschke,Freitagetal.,2004;Drabantetal.,2006;Enoch,Xu,Ferro,
Harris,&Goldman,2003;McGrathetal.,2004;Montagetal.,2008;Olssonetal.,
2005; Woo et al., 2004). In addition to this the COMT-Met allele has been
54
associated with obsessive–compulsive disorder in men (Pooley, Fineberg, &
Harrison, 2007), alcoholism and gambling (Gulliot, Fanning, Liang & Berman,
2015),highneuroticism(Hothetal.,2006),lowextroversion(Reuter&Hennig,
2005), low reward dependence (Lang, Bajbouj, Sander, & Gallinat, 2007) and
higher pain sensitivity (Diatchenko et al., 2005; Nackley et al., 2007; Zubieta et
al.,2003).
The opposite is true for high activity COMT alleles (Val), which leads to
decreased dopamine levels in the prefrontal cortex, and is associated with
poorer cognitive functioning (Sheldrick et al., 2008), more specifically, poorer
performance on prefrontal mediated tasks (Barnett, Jones, Robbins, & Muller,
2007; Goldberg et al., 2003; Joober et al., 2002; Malhotra et al., 2002) and
prefrontal inefficiency during cognitive control and working memory tasks
measured by electroencephalography (Winterer, Musso, et al., 2006) and
neuroimaging(Blasietal.,2005;Eganetal.,2001;Winterer,Egan,etal.,2006)
These associations of low and high activity COMT alleles are supported by
Papeolo and colleagues’ (2008) in their study of mice. After studying three
different kinds of mice, (1) with generated transgenic mice overexpressing a
human COMT-Val polymorphism, (2) genetically engineered mice lacking
functional COMT and (3) normal wild mice. They found that “Increased COMT
enzyme activity in Val-tg mice resulted in disrupted attentional set-shifting
abilities, and impaired working and recognition memory, but blunted stress
responses and pain sensitivity” (Papeolo et al., 2008 p. 8709) and that “COMT
disruptionimprovedworkingmemory,butincreasedstressresponsesandpain
sensitivity” (p. 8709). So, as with humans, increased COMT activity was
associatedwithpoorercognitiveabilitiesandbetterstressresponseandlower
pain sensitivities and lower COMT activity with better working memory, but
worsestressresponsesandpainsensitivity.
WhatmakestheCOMTallelesinterestingfromaresiliencepointofview
is how they show the importance of the meta-theories in the fourth wave of
research, highlighting gene and environment interactions. Having high-activity
COMTmightbeaprotectivefactorinstressfulsituations/environment,butcan
be more of a risk in situation/environments that are more cognitively
challenging,becauseofitsassociationwithcognitivedysfunction.Andofcourse
55 theoppositeistrueforlow-activityCOMTasitleadstobetterexecutive,butis
associated with worse stress resistance and higher levels of anxiety, which, as
you probably already have imagined, can be advantageous in certain
situation/environmentsandnotinothers.Thisshowsthatcategorisingcertain
orallelesasbeing“riskalleles”or“protectivealleles”isnonsensicalifwedon’t
also specify the context, as each allele has environmental specific selective
advantage. In general it’s never wise as psychologists to talk about an “allele
for...” anything, as research on this level is always probabilistic rather than
deterministic.Thismeansthatifanindividualhaslow-activityCOMTalleles,itis
not a “psychosomatic death sentence” that guarantees that he or she will
develop into an anxious nervous wreck, with alcohol and addictive gambling
problems. This is what Gottlieb (2007) talked about within the PE framework,
which shows that the genes are dependent on the environment and how we
behave in it, to be “switched” on or off and have an effect on the phenotype.
However, having said all this, it is clear that the variations in the COMT genes
clearlycantellussomethingaboutthedifferencesweseeinresilienceamongst
adults. As shown they can have detrimental effects, as they both are clearly
associated with certain predispositions to factors connected to negative,
unresilientdevelopment,withanxietyandstressvulnerabilityontheonehand,
andcognitivedisadvantagesasavulnerabilityfactorontheother.
5.4BrainDerivedNeurotrophicFactor(BDNF)
Brain derived neurotrophic factor (BDNF) is a protein that functions as “a key
regulatorofthemesolimbicdopaminepathway,whichidentifiesandrespondsto
emotionally salient stimuli” (Lemery-Chalfant, 2010, p.69). Like we saw with
COMT, the focus on BDNF has also been on a SNP called the Val66Met SNP
(rs6265), where the Met-allele attenuates the activity-dependent secretion of
BDNF, meaning it reduces BDNF functioning (Egan et al., 2003; Krishnan et al.
2007).TheMet-allelepolymorphismisconnectedwithpoorermemory(Eganet
al., 2003) enhanced fear generalization (Mühlberger et al., 2014) and harm
avoidance(Jiangetal.,2005).Val-allelecarriershavebeenshowntohavelarger
hippocampal,amygdalarandprefrontalcorticalvolumescomparedtomet-allele
carriers(Frodl,Möller,&Meisenzahl,2008;Pezawasetal.,2004;Subletteetal.,
56
2008.).Onasocialandbehaviourallevel,theVal-allelehasbeenconnectedwith
increasedsocialinteractionsandsocialsupportinacohortofindividualsover60
(Tayloretal.2008)andastudyhaveclaimedconnecttohighertraitresilienceas
measuredbyaSenseofcoherence(SOC)scale(Surteesetal.,2007).
IdowanttopointoutthatIfindusingthisSOCscaleasatoolformeasuringtrait
resilience problematic. Participants answered the following three questions to
measure their comprehensibility, manageability and sense of meaningfulness:
(1)Doyouusuallyfeelthatthethingsthathappentoyouinyourdailylifeare
hard to understand? (Comprehensibility) (2) Do you usually see a solution to
problemsanddifficultiesthatotherpeoplefindhopeless?(Manageability)(3)Do
you usually feel that your daily life is a source of personal satisfaction?
(Meaningfulness),wheretheparticipantscouldanswer:(a)Yes,usually;(b)Yes,
sometimes;and(c)No(Surteesetal.,2007).
Ofcoursethemostobviousweaknessisthatthisquestionnaireisveryshort,and
Ifinditpreposteroustoclaimtounderstandwhethersomebodyhasaresilient
orcoherentviewoftheworldandtheirplaceinit,byaskingthreequestions.I
also want to point out the wording of two of these questions, as I find them
problematic. The irony of the question measuring comprehensibility: “Do you
usually feel that the things that happen to you in your daily life are hard to
understand?” is that the question itself is hard to comprehend. What does “the
thingsthathappentoyouinyourdailylife”mean?Allthethingsthathappenin
one’sdailylife?Arewemeanttounderstandeverythingthathappenstousona
dailybasis,andisthedefinitionofcomprehensibilityapersonwhounderstands
everything that happens to her on a day-to-day basis? What kind of
understanding are we talking about? Is it a down to earth practical, or a wider
more“philosophical”understandingwearetalkingabout?Eachinterpretationof
this question might yield very different answers, and the question is asked in
suchawaythatleadsitopentoverydifferentinterpretations.Theproblemwith
question two is that it entails a comparison element. You are not asked just to
rateyourownproblemsolvingskills,butalso“otherpeople’s”whofindsthese
problemsanddifficulties“hopeless”.Theyareinotherwordsnotaskedtorate
their own manageability of problems and difficulties in general, but only the
problems and difficulties that these unspecified “other people” find so difficult
57 that it’s hopeless. Therefore this question actually has two additional ratings
thanasimpleratingoftheindividual’sownsenseofmanageability,astheyare
askedtoratetheirfriend’s,family’soracquaintance’s(orwhoevertheyinterpret
as “other people”) manageability, and then compare themselves to these. This
will surely influence the rating as what social and personal background the
individual has will influence whom she/he is comparing her/himself to. This
issuewouldberesolvedhadthequestionbeensimplerandmorepersonal,like:
“Doyouusuallyseeasolutiontoproblemsanddifficultiesyouencounterinyou
dailylife?”Thisagainshowswhywemustbecautioustousesimpleself-report
scalesofresilience,withoutcriticalthought,astheycanbeimpreciseandatthe
same time lack the breadth to be able to say something meaningful about the
term.
However all this being said there are indications that the BDNF Val-allele
polymorphismsisconnectedtoresilience,eitherasaendophenotypethroughits
connection with larger hippocampal volume and through the associations with
bettersocialinteractionsandsocialsupportordirectlywithitbeingconnected
tomoreflexibilityandbettercopingabilitieswithstress,whichIwillaccentuate
in the next segment. But more research is needed to confirm BDNF as a
resilience-associatedgene.
58
6.STRESSRESILIENCE
Oneofthemostcentralresearchquestionswithregardstoadultresiliencehas
beentheroleofstressandwhathasbecomeknownasstressresilience.Finding
factorsonabiologicalleveltoilluminatethenatureofresiliencetowardsstress
isseenasoneofthemostimportantquestionsinunderstandingadultresilience
todifficultlifeevents(Feder,Nestler,Westphal&Charney,2010).Thefirst(and
moststudied)geneticfactorconnectedtostressresilienceis5-HTTLPR.
6.1TheSerotoninTransporterPolymorphism(5-HTTLPR)
Theserotonergicsystemisconsideredtoplayanimportantpartwithresilience,
as serotonin (5-HT) levels are increased dramatically during stress in different
brain regions including the prefrontal cortex, the amygdala and the nucleus
accumbens (Feder et al., 2010). Research focusing on the relationship with
differentgenotypesoftheSerotoninTransporterPolymorphism(5-HTTLPR,the
gene responsible for coding the serotonin transporter 5-HTT) and
environmental stressors is an important part of the psychobiological stress
resilienceresearch.Traditionallyitwasunderstoodthatthelongalleleversionof
5-HTTLPR lead to higher 5-HTT transcribing and the short allele version to
lower 5-HTT transcribing, ultimately leading to respectively higher and lower
serotonin levels in the brain when subjected to stress (Smolka et al., 2007).
However newer studies have showed another SNP rs25531, with an A to G
substitution,whichisconnectedtothelongalleleversionof5-HTTLPRbutacts
in a low 5-HTT transcribing way, similar to the short allele version of the
genotype, if it shows A substitution (Smolka et al., 2007). In other words, it
breaks away from the traditional 5HTTLPR bi-allelic Short allele/Long allele
(S/L) genotyping, and considers 5HTTLPR tri-allelic (S/LG/LA), with “different
versions” of the long allele showing subsequently high (LG) or low (LA) 5-HTT
transcribing.
Asmentionedearlierinthesectionaboutfourthwaveresearch,the5-HTTLPR
genotype has been investigated as a central piece in the Gene × Environment
interactionofresilienceinrelationtoshortallelecarriershavingincreasedrisk
fordepressionwithexposuretostressfullifeevents(Caspietal.2003;Kendler,
Kuhn, Vittum, Prescott, & Riley, 2005). However these findings have been
59 questionedwithamongstothersGillespieandcolleaguesfailingtoreplicatethe
findings (Gillespie, Whitfield, Williams, Heath, & Martin, 2005), and two metastudies where one (using 14 studies) “yielded no evidence that the serotonin
transporter genotype alone or in interaction with stressful life events is
associatedwithanelevatedriskofdepressioninmenalone,womenalone,orin
both sexes combined.” (Risch et al., 2009 p. 2462) and the other (using 15
studies) showed that results connecting the effects of 5-HTTLPR (gene) and
stressful life events (environment) on the risk of depression (phenotype) as
beingnegligible(Munafò,Durrant,Lewis,&Flint,2009)andthatthefindingsof
thismodel“arecompatiblewithchancefindings”(p.218).Thereasonforthese
inconsistencies in results might be caused by the diversity of methods and
approachesthatareusedtomeasureenvironmentalrisks.Ontheotherhanda
larger meta-study that included 54 studies, found “strong evidence that the
studiespublishedtodatesupportthehypothesisthat5-HTTLPRmoderatesthe
relationshipbetweenstressanddepression”(Karg,Burmeister,Shedden&Sen,
2011 p. 444). They found no association when restricting themselves to using
the same 14 and 15 studies as the previous efforts, which indicates that the
inconsistences between these meta-studies is due to different set of included
studiesratherthanthedifferentmeta-analytictechnique(Kargetal.,2011).In
other words when they included a more comprehensive selection of research
papers on the subject published at that point, they found a clear association
between 5-HTTLPR and stress resilience, compared to the limited metaanalysespublishedearlier.
Short allele carriers have also been linked to increased amygdala reactivity to
threat-relatedfacialexpressionsandincreasedactivityingeneral(Haririetal.,
2005; Munafò, Brown, & Hariri, 2008) and decreased amygdala–perigenual
cingulate connectivity (Pezawas et al., 2005). This connection is important in
regards to anxiety and emotion regulation, and therefore can be seen as an
endophenotypetosusceptibilityofdepression.Thisisconfirmedbyself-report
studyofyoungadultsthatshowedthatshort-allelecarriersreportedlessstress
resilienceasmeasuredbyCD-RISC-10(Stein,Campbell-Sills&Gelernter,2009),
howeverO’haraandcolleagues(2012)failedtoreplicatetheseresultsinolder
individuals and found no significant association between the 5-HTTLPR alleles
60
andself-reportedstressresilience.Thismightbeexplainedbythefactthatthe
participants in the elder study were healthy and came from a relatively high
socio-economical background, which possibly indicate that they lead a less
stressfullifethantheundergraduatestudents,whichmightbeanenvironmental
factor leaving one group more exposed to stress in their day-to-day life. This
alsohighlightswhatImentionedearlierasamoresensibleuseoftheresilience
scaleCD-RISC10.Asascaleformeasuringindividualreportsoftheirownability
tocopewithstress,the10-itemversionoftheCD-RISCcanbeusedasatoolin
the sub-category of stress resilience, for measurement of individuals’ stress
resilienttraits.Anotherstudyusingatri-allelic5-HTTLPRpolymorphismfound
in group of mood disorder subjects that “the lower expressing alleles
independently predicted greater depression severity and predicted greater
severityofmajordepressionwithmoderatetoseverelifeeventscomparedwith
thehigherexpressingLAallele”(Zalsmanetal.,2006p.1588)showingthatboth
directly and indirectly by increasing the severity and impact of stressful life
events,thegeneticdifferencesofthe5-HTTLPRexplained31%ofthevariance
indepressionseverityofthesubjects.
So to sum up, there are studies and meta-studies that confirm the linkage
between5-HTTLPR,thatwithintheG×Eshowshowgenesandenvironment(s)
isintegrated,andhavingacertainversionofthegenecanbeariskorprotective
factorifitinteractswithcertainenvironmentalstressors.
6.2COMTandStressResilience
I won’t to go back into to much detail about this term (or BDNF in the next
segment)asI’vealreadycoveredit,butIdowanttohighlightastudyconnecting
COMTtostressresilience.
For example Heinz & Smolka (2006) shows that low-activity Met158 allele is
associated with higher circulating levels of dopamine and norepinephrine,
higher anxiety levels, and increased limbic reactivity to unpleasant stimuli. I
have shown dopamine role in resilience earlier, but in regards to stress
resilience, norepinephrine (NE, a.k.a. noradrenaline) is more interesting. It is
well known that NE is highly increased during stressful situation, and is
connected to mood and arousal regulation (Breedlove, Watson & Rosenzweig,
61 2010).ThisindicatesthathigherlevelsofNEmightleadtohighersensitivityto
stressfulsituation.Thiscombinedwithincreasedanxietyandlimbicreactivityas
endophenotypes, indicates that having this low activity allele makes people
predisposedtoreactingmoreseverelytostressfulsituations.
6.3BDNFandstressresilience
BDNFstudiesfoundthattheVal66Metalteranxiety-relatedbehavioursinastudy
of humans (Chen et al., 2006) and that Met BDNF allele is associated with
reduced BDNF function, greater anxiety-like behaviour, and impaired
hippocampal-dependentlearning,butincreasedresiliencetochronicstressina
study with mice (Krishnan et al., 2007). Like I said earlier there lacks research
confirming BDNF as an resilience associated gene, which is also the case with
stressresilience.
6.4NeuropeptideY(NPY)
Neuropeptide Y (NPY) is an amino acid that is anxiolytic (meaning it inhibits
anxiety)andisreleasedduetostress(Zhouetal.,2008).Itisthoughttoreduce
anxiety by counteracting the anxiogenic (anxiety causing) effects of the
Corticotropin-releasing hormone (CRH), a neurohormone that initiates the
endocrineresponsetostress,intheamygdala,hypothalamus,hippocampus,and
locuscoeruleus(LC)(Britton,Akwa,Spina,&Koob,2000;Heilig,Koob,Ekman,&
Britton, 1994). In their recent review of NPY and stress resilience studies,
Enman, Sabban, McGonigle & Bockstaele (2015) showed a huge amount of
studiesinvolvingrodentsandanxiety-likebehaviour,stressanddepressionlikebehaviour,butfewerinvolvinghumans.HoweverIwanttopresenttwostudies
showing that individuals possessing a genotype associated with low NPY
expression (A single nucleotide polymorphism [SNP rs16147]) report more
negative emotional experiences during a painful stressor, show greater
amygdalareactivityinresponsetothreat-relatedfacialimages,andexhibitlower
stress resilience compared to high NPY genotype carriers (Mickey et al., 2011;
Zhouetal.,2008).ThisisastrongindicationthatNPYisimportantnotonlyto
regulate anxiety (which of course also is helpful for stress resilience) but also
actuallyseemtoregulatestressresponse,anddifferentversionsofthegenotype
62
SNP rs16147, may act as a protective or risk factor when it comes to stress
resilience. Lower NPY levels is not only connected with stress, but it has also
beenshownthatdepressivepeople,suicideattemptersandpost-mortemtestsof
suicide victims all show significantly lower NPY (Enman et al., 2015). Finding
certaingenotypesthatmightinfluenceNPYlevelswillthereforebeavitalpartin
trying to understand why some people succumb easier to stress and mental
illnessinfutureresearch.
6.5Gene-GeneInteraction
Inadditiontosinglegeneticvariables,therehavebeenstudiesidentifyinggene×
gene interactions that modify the functions of the stress response system. For
example Jabbi and colleagues (2007) found that interaction of the low activity
versions of the MAOA and the COMT gene as it affects the endocrine system’s
responsetoapsychologicalstressfultaskcalledtheGroningenAcuteStressTest
(GAST).ThelowactivityCOMTbyMAOAinteractionshowedahigherreleaseof
oneoftheimportanthormonecalledtheAdrenocorticotrophinhormone(ACTH,
importantforreleaseofthe“stresshormone”cortisol),indicatingthat“itislikely
thatacombinationoftheselow-activityvariantsofCOMTandMAOAgenesmay
becomeavulnerabilitytraitifstressfulexperiencespersist”(Jabbietal.,2007p.
488). However the sample used in this study was small and needs replication
withalargersamplesize.
Ithasalsobeenshownthattheshort-allele5-HTTLPRgenotypecombinedwith
the COMT-Met allele and stressful life events affected risk for depression
(Mandellietal.,2007),inotherwordsweseeanG×G×Einteractionasthey“may
notbedirectlyinvolvedinmooddisorders,buttheycouldactasmoderatorsof
thedepressogenicinfluenceofstressfullifeevents,whicharewellknowntobe
riskfactorsfortheappearanceofthesepsychiatricillnesses.”(p.444).Thestudy
by Smolka and colleagues (2007) showed that individuals carrying the low
activityCOMT(COMTMet158)andoneofthelow5-HTTtranscribingversionsof
5-HTTLPR(SorLA,usingatri-allelicpolymorphism)genotypewasconnectedto
higherlimbicreactivitywhenconfrontedwithunpleasantstimuli.Thesegenetic
factors may contribute to carries of low COMT activity and/or low 5-HTT
transcription genotypes may “induce excessive activation of brain networks
63 associatedwithemotionalandcognitivebehaviorcontrolandcontributetothe
lowered resilience against anxiety and dysphoric mood states” (Smolka et al.,
2007p.315)whenconfrontedwithstressfulstimuli.
Thelastexamplesshowaninteractionbetween5-HTTLPR,BDNFVal66Metand
stressful life events, i.e. another G×G×E example. Two studies have shown a
connectionbetweenindividualscarryingtwoMetallelesofBDNFandtwoshort
alleles of 5-HTTLPR (bi-allelic view) and risk of depression in older adults and
children, but only when the environmental factor of stressful life events was
accountedfor(Kaufmanetal.,2006;Kimetal.,2007).
6.6NewPerspectivesandResearchonStressResilience
Last year the journal Neurobiology of Stress released a special issue named
simply Stress Resilience (Valentino, Sheline & McEwen, 2015) presenting new
and different neurobiological research and perspectives on different aspects of
stressresiliencethanwhathaspreviouslybeenstudied.ForexampleValentino&
VanBockstaele(2015)reviewofstudiesshowinghowendogenous“anti-stress”
neuromodulators that inhibits the stress response system can have a negative
effect on stress resilience if excessive, and shows how the stress system works
best (i.e. shows most resilience to stress) if there is a co-regulation of “antistress”and“pro-stress”neuromodulatorsthatleadstoafine-tunedbalance.Or
thereviewshowinghowthehormonalglucocorticoidmechanismsoffunctional
connectivitychangesinstress-relatedneuropsychiatricdisorders(Hall,Moda&
Liston, 2015), with new perspectives on how life style aspects like sleep and
effectsresilienceonaepigeneticlevel(Reuletal.,2015).Orwhattheunderlying
neurobiologicalmechanismsofsocialstressare,andwhatcopingstrategieslead
toresilienceorvulnerabilitytostressinpeople’ssocialenvironments(Wood&
Bhatnagar, 2015). Or what role the hippocampal neurogenesis plays in adult
stress resilience, in a review that found that “Monoaminergic-targeted
antidepressants, environmental enrichment and adrenalectomy are beneficial
forreversingstress-inducedchangesinbehaviourandhavebeenshowntodoso
in a neurogenesis-dependant manner” (Levone, Cryan & O’Leary, 2015 p. 147).
Orevenhowsocialinequalityincrab-eatingmacaquemonkeysleadtoharmful
64
socialstressors,andwhatnegativeeffectsthishasontheirhealth(Shively&Day,
2015).
Thelistgoeson,andistomanifoldandcomplextogointoindetailhere,dueto
the brevity of this thesis. However I mention these studies in passing now
becauseIwanttoshowhowthestudyofstressresilienceonaneurobiological
level is very much an alive and kicking field of study that is constantly moving
forward and reinvigorating itself to bring a greater understanding of the
biologicalbasisofadultstressresilience.Many of these perspectives are brand
newandnotasdevelopedastheaforementionedaspectsofstressresiliencethat
Idiscussedearlier,andwillmostlikelygiveusnewperspectivesinthefieldin
thefuture.
65 7.SUMMARYPSYCHOBIOLOGICALFACTORS
So to sum this segment of psychobiological factors of resilience, we have seen
that,eventhoughthereareclearfactorsthatpointtosomeaspectsofresilience
as being heritable, and we can even pinpoint some genetic factors down to
variationofasinglegenotype,asapossiblerisk/protectivefactor.However,this
isnotdoneinavacuum,anditisalwaysspecifiedthatyoualsohavetoaccount
for the environmental factors when we talk about the “genetic influence”. In
otherwords,itisclassicfourthwaveresearch,wheretheunderstandingisbased
ongene×environmentinteractions(seeFigure2)whichisseenasbeingcrucial
inbothchildandadultdevelopment,andthatresearchonageneticlevel,isjust
one level of analysis of resilience, highly interconnected with other levels, as
shown on Gottlieb’s Probabilistic Epigenesis (PE) model (see Figure 1). Stress
resilienceonageneticlevelisseenasmakingsomepeoplemorestressreactive
ifcertainenvironmentalfactorsarepresent,verymuchinlinewiththebiological
sensitivity to context (BSC) model (Boyce & Ellis, 2005) as shown in Figure 3,
(p. 22 in this thesis). Like the figure shows how biological sensitivity is
inherently interrelated to the stressors in the environment/context of the
individual, and specifying both aspects is crucial. Granted the authors of this
modelfocusedonearlypsychosocialstressandadversityforchildren,butinmy
viewasimilarcurvecanbefoundforindividualadultsaswell,forexamplewith
biologicalreactivitytoaworkcontext.TheresultsandlineofthinkingthatI’ve
presented from the stress resilience research can also easily be transferred to
theAdaptiveCalibrationModel(ACM)(DelGiudice&Shirtcliff2011),asshown
in Figure 4 (p. 23, in this thesis). Again the psychosocial context that adults
interactwithisdifferentfromwhatchildrenexperience(forexampleonemust
assumethatparentbehaviourandcaregivingisnotasimportantforadults).Yet
the principle that the stress response system is influenced by both
environmental factors (threats/unpredictable events or social feedback) and
(reciprocally) by genetic/hormonal factors (like 5-HTTLPR) and is constantly
adapting and calibrating is just as valid for adults, as for children. So if we
compare this to the research based (both theoretical and empirically) on
resiliencescales,itisclearthatthepsychobiologicalresearchismuchmoreopen
forinterpretationandusewithinthelargermeta-modelsofresilience.Itfollows
66
a developmental view of adult resilience, as the biological factors is ultimately
seenassomethingthatcaneitherhinderorhelpthedevelopmentofresilience,if
certainenvironmentalandbehaviouralfactorsareaccountedfor.Itisnotseenas
a factor that identifies “resilient individuals”. Ultimately the psychobiological
viewseesresilienceas“anactiveprocess—notjusttheabsenceofpathology—
thatcanbepromotedbyenhancingpotentiallyprotectivefactors”(Federetal.,
2010p.47)
Like so many of the studies presented here have shown there is an interaction
between genotype (or sometimes two different genotypes) and environmental
factorsthatinfluencetheresiliencefactorsinquestion.Combinedwithwhatwe
knowoftheheritabilityofcertainresiliencerelatedtraitsitisclearthatthereis
muchtolearnbystudyingadultresilienceonabiologicallevelofanalysis.
HoweverthereisonepartofthefourthwaveresearchinchildrenandyouthsI
miss from research and development with adults. Namely the use and
integration of psychobiological research of resilience (especially stress
resilience)withinterventionsdesignedtopromoteresiliencewithadults.Feder
and her colleagues (2010) do point to some interventions in their excellent
chapter on psychobiological stress resilience factors. However these are purely
onanindividuallevelwiththecognitivebehaviouralbasedprolongedexposure
therapy to treat PTSD and mindfulness-based approaches to reduce stress in
general.Nowwhatdisappointsmeisthateventhoughweknowthatimportant
aspectsofresiliencedevelopsasaninteractionbetweengenesandenvironment,
the interventions proposed are solely based on the individual experiencing
stress. Take the work context for example: We know that some people carry
certain genotypes that make them more vulnerable to stressful environmental
factors,andtheworkenvironmentispossiblethemostcommonstressfactorin
adult life. Now to counteract stress and foster (stress) resilience in a work
context, it therefore isn’t enough to put the workload and responsibility for
managing stress upon the individual employee, as learning better “coping”
strategies isn’t sufficient when the problem is more complex. At the risk of
caricaturing the problem a little: it’s surely easier to change peoples work
environments than their genotypes. And like I’ve mentioned it makes no sense
talking about the genes influence on resilience without including the
67 environmentalaspectsintheconversation.Ingeneralthefieldofinterventions
for fostering adult resilience is not as well understood, and to a much larger
extent based on individual intervening compared to what we have seen in the
thirdwaveofstudieswithyouthsandchildren.Iwillreturntothissubjectinthe
sectionoffutureperspectivesofadultresilience.
68
FUTUREPERSPECTIVES
69 Whatwehaveseeninthissectionconcerningpresentadultresilienceresearch
and theory, is illustrative of how wide-spanning and diverse research on the
termis,bothempiricallyandtheoretically.Partsofthepresentedresearchwith
adultsdirectlycontradicttheviewofresilienceasitdevelopedthroughthefour
waves.Whileotherpartsfitsrightin,andcaneasilybeviewedasaprolongingof
“fourth wave” research, with adult participants. This discussion of how adult
resilience research and theory is central to the latter part of the future
perspectives segment. But first I want to look at the future potential of a new
fieldofresilienceresearch.
8.CULTURE
APossibleFifthWaveofResilienceResearch
ThefirstperspectiveonthefutureofadultresilienceresearchIwanttolookinto
is the new development of theory and research on the role of culture with
regards to resilience. This is an aspect that has been written about within the
fieldforalongtime,wheretherehasbeenanagreementthatthereneedstobea
renewed theoretical and empirical focus on cultural aspects (Masten, 2014b;
Theron,Liebenberg&Ungar,2015)yettheactualresultsofthisisjustrecently
started to appear. Some have even claimed that: “Culture is perhaps the most
neglectedtopicinthestudyofriskandresilience”(Feldman&Masalha,2007,p.
2).OneofthecentralscholarswithinthisfieldofresilienceresearchisMichael
Ungar,whoisthedirectorandfounderoftheResilienceResearchCentre(RRC)6
in Halifax, Nova Scotia Canada. They held a conference in 2005, which was the
first international conference that focused on cross-cultural understandings of
resilience, which showed that “resilience processes are not culturally neutral”
(Theron et al., 2015 p. v). Yet to illustrate how slow the process of truly
developingthisfieldhasbeen,ittook10yearsbeforethefirstmajorvolumewas
published on the topic presenting research and theory, called Youth Resilience
and Culture Commonalities and Complexities, edited by Theron, Liebenberg &
Ungar(2015),thoughaearliervolumededicatedtothetheoreticalaspectscalled
The Social Ecology of Resilience (2013), was released earlier edited by Michael
Ungar.
6Seehttp://resilienceresearch.org/formoreinfo.
70
Nowsomescholarsseethisdevelopmentasaprolongingofthefourthwaveof
resilienceresearch(Wrightetal,2013),howeverIwouldliketomaketheclaim
that this is a possible brand new wave of resilience research for the following
threereasons:(a)liketheotherwavesithasthepossibilitytomakebrandnew
discoveries of and perspectives on what resilient development is, and how to
promote it (b) like the other waves it builds and expands upon research and
theoryfromthepreviouswavesand(c)liketheotherwavesitisbasedupona
new theoretical grounding, namely Michael Ungar’s (2011) Social Ecology of
Resilience Theory. Now whether or not we call this a fifth wave of resilience
researchoradevelopmentofthefourthwaveisnotthemostpressingissue,and
perhapstheempiricalandtheoreticalbackgroundforitisn’tdevelopedenough.
However in this thesis I will continue to refer to it as a new wave of resilience
research, for the stated reasons, and the first subject at hand is the theoretical
background.
8.1TheSocialEcologyofResilience
As it is a ecological theory, it naturally borrows from Bronfenbrenner’s (1979)
classic work on different ecological systems like the microsystem (for example
family, peers and school), the mesosystem (interactions between different
microsystems), the exosystem (linkage between social systems the
child/individual does not have direct contact with) and the macrosystem (the
wider context the child/individual lives in, such as the culture or town
characteristics). What Ungar (2011) explains in his view of resilience in a
culturalisthatthedevelopmentofresilienceisdifferentwithindifferentphysical
and social ecologies, which is the basis that he developed his theory of social
ecology of resilience (2011) it consists of four principles: (1) Decentrality, (2)
Complexity,(3)Atypicalityand(4)Culturalrelativity.
Bythedecentralityprinciple(1),Ungar(2011)problematizeshowresilience,as
a term, is used “to describe both outcomes and the processes leading to those
outcomes” (p. 4) and that “the bulk of the resilience literature still centers its
inquiry on outcomes at the individual level caused by the environment” (p. 4).
This leads to the environment becoming secondary to the analysis where
resilience“asadiscursivetoolisleftmeasuringchangeatthelevelofindividuals
71 as its sine qua non” (p.4). In some instances this subject-based approach can
even be said to place the responsibility of resilience is “on the victim of toxic
environments”(p.5)i.e.byonlyfocusingontheindividualsubjectorwhetheror
notapersonis“individuallyabletotakeadvantageofenvironmentalresources”
(p.5)wecanendupwithresiliencebecominganormativetermiftheindividual
iscentralizedinthisway.Asthisthesishasdocumented,thisisalineofthinking
about resilience that is clearly a part of adult resilience, possibly to an even
larger extent than youths and children. So the solution is to decentralise the
individual, and think that the locus of change does not reside in the individual
nor in the environment, but in the processes where the environments provide
resourcesfortheindividual(Ungar,2011).Therefore“individualresources(e.g.,
a sense of humor, optimism, above average IQ, or musical talents) are only as
goodasthecapacityofhisorhersocialandphysicalecologiesthatfacilitatetheir
expressionandapplicationtodevelopmentaltasks”(Ungar,2011p.6).Sotosum
up the first principle is to see resilience (on a basic level) as a developmental
processandnotcentreitineithertheenvironmentsortheindividual.
Theprincipleofcomplexity(2),understands,asthenamesuggests,resilienceas
complex interactions, and not to create “too narrow a nosology of protective
processes” (Ungar, 2011 p. 6). Embedded in this complexity is also the
understandingthatweshould“‘notexpectaresilientperson,howeverdefinedat
onepointintime,tobedoingwelleveryminuteoftheday,underallimaginable
circumstances,orinperpetuity’’(Masten&Powell,2003,p.4).Sothisprinciple
is about understanding resilience complex interactions, but also realizing that
resilience changes over time, and has very different meanings for different
individuals in different physical and social ecologies (Ungar, 2011). “Many
differentstartingpointscanleadtomanydifferentbutequallydesirableendsby
manydifferentprocessesrelevanttodifferentecologies”(Ungar,2011p.7).
The atypicality principle (3) is the acknowledgment that positive development
for individuals sometimes develops atypically, in different ecological settings.
For example of urban Black youth that had dropped out of school was actually
adaptive behaviour that promoted resilience, because of an environment that
marginalizedchildrenbasedontheirrace(Dei,Massuca,McIsaac&Zine,1997).
“Withdrawal from school, though an atypical coping strategy (and with
72
potentially negative long-term developmental consequences), is nevertheless
understood by young people themselves as a protective process despite its
apparent negative outcome” (Ungar, 2011 p. 8). Ungar also draws on the
example of young Chinese women who increasingly used violence the
relationships with their boyfriends (Wang & Ho, 2007) which helped them to
“maintainpersonalcoherenceandresistnegativestereotypesimposedonthem
bytheyoungmen”(Ungar, 2011 p. 8) in a society with a cultural bias towards
women. This principle leads us away from viewing resilient development in a
dichotomouswayofjudgingbehavioursas“good”or“bad”forexampleits“bad”
todropoutofschooland“bad”tobeviolentwithonesboyfriend.Howeverwe
shouldunderstandthecontextthebehaviouroccursin,andwhetherornotitis
functionalinthespecificenvironment,likewherewetypicallywouldthinkthata
democratic child rearing, where children are reared to be autonomous and are
apart of democratic decision-making in their own lives. However Sameroff,
Gutman and Peck (2003) found that fewer opportunities for democratic
decision-makingwereassociatedwithbetterschoolgradesforAfricanAmerican
youth facing substantial risk in their environments. This lead them to the
conclusionthat“Parentingpracticesthatemphasizedemocraticdecisionmaking
andfosterasenseofautonomymaybemoresuitableforchildrenfromlow-risk
environments, whereas they may be inappropriate for, or even detrimental to,
youth living in more risky environments” (p. 381). This goes to show that the
atypicality principle is useful in regards to having a more open view of what
positiveadaptionanddevelopmentindifferentsocialandphysicalecologies.
Andatlast,theculturalrelativity(4)principlewhichfirststatesthat:“Processes
of positive growth under stress are both culturally and temporally (and
therefore,historically)embedded”(Ungar,2011p.8).Byculturehemeans,“the
everyday practices through which individuals and groups manifest a set of
shared values, beliefs, language, and customs” (p. 9). Cultural relativism in
relationtoresiliencethereforeshowsthatthedifferentculturesweseearound
theworldinfluencewhatresilienceis,andwhatresilientdevelopmentmeansin
a specific cultural context. To simplify it: what is considered resilient (i.e.
positive)developmentinChinawouldn’tnecessarilybeconsideredresiliencein
theU.S.WhatisconsideredpositivedevelopmentinAfghanistanisnotthesame
73 aswhatisconsideredpositivedevelopmentinSouthAfrica,etc.Thisaspectdoes
notonlyaccountforbetweencountrydifferences,aswithin-countrydifferences
canbejustaslarge.AsanexampleUngar(2011)mentionsthedifferentcultural
valuesandviewsofAfrican-AmericansandwhiteAmericans.Ungarsummarises
the principle better than I could when he writes: “Both the individual and the
individual’s ecology mutually adapt to one another, with the patterns that are
protectivehighlyvariableandsensitivetobothcultureandcontext”(p.9-10).
To construct these principles down to an explanatory model, Kurt Lewin’s
(1943) classic equation of B = f(P, E) where behaviour (B) is shown as the
functionofadynamic,butunspecifiedinteractionofthePerson(P),includingthe
person’s neurophysiological strengths and other personal capacities and the
Environment(E).
Model1:Socialecologicalresiliencemodel. Note:Reprintedfrom“TheSocialEcologyofResilience:AddressingContextualandCulturalAmbiguityofa
NascentConstruct”byUngar,M.2008,AmericanJournalofOrthopsychiatry,81(1),p.1–17.
The model Ungar (2011) proposes (See Model 1) is a process-oriented and
contextualised understanding of resilience, where behaviours showing positive
development under adversity (like university graduation or a job promotion)
(RB)requiresensitivitytotheopportunitystructure(O)oftheenvironment,that
shapestheviabilityofdevelopmentalpathwaysovertime.Thesedevelopmental
pathways depend on the availability (Av) and accessibility (Ac) of healthsustainingresourcesandthemeaning(M)thatisconstructedinthecultureand
contextoftheindividual.Thereisaninteractionbetweentheperson(P)withall
of their individual qualities (genetic make-up, traits etc.) here named strengths
(S), and individual challenges (C), the environment(s) (E) and the mentioned
developmental opportunities (OAv, OAc) and meaning (M) constructed by the
cultureandcontext.Themodelchallengestheviewthatresilienceisembedded
withintheindividual.Resilienceisinsteadseenassuccessfuldevelopmentthat
exploitsenvironmentalcontextsastheychangeovertime(RB1,RB2,RB3...).
74
Thistheoreticalbackdropofthesocialecologyofresiliencehasaffordednewand
exciting research into cultural aspects of resilience with youths and children
across the globe, and has the potential to play a vital part in future adult
resilienceresearchonaculturalbasis.
8.2ResearchonCulturalAspectsofResilience
StartinginAfricawheretwoSouthAfricancasestudies(aboyandagirl)showed
theimportancefortheculturaltermUbuntu(alsoknownasBotho,Vumunhi,or
Uhuthu),aphilosophythatemphasizehumaninterdependence,whichserviceto
humanity and a very different view on family community than what is
traditionally called “western values” was shown as being central for the
development of resilience for the two young people in question (Theron &
Phasha, 2015). However the effect of the cultural philosophy of Ubuntu values
andpracticeswasdidnotshowastraightforward“resilienceeffect”onthegirls,
asitbothunderscoredtheirresilience,butalsocomplicateditinsomesituations,
muchlikeRutter’ssocialecologicalmodelshowed.(Theron,Theron,&Malindi,
2013)alsofoundthatresilientyouthinthecommunityofBasotho(acommunity
emphasisingBothovalues)weredescribedasflexibleanddetermined,whichare
attributes reported in youth viewed as resilient in many cultures, but was also
well connected to community support systems and respectful of community
Botho values so important in their culture. In an example from a survey of 18Zimbabweianorphans,foundaclearconnectionbetweenresilienceinthisgroup
and the collectivistic culture of Zimbabwe, where extended family and
communities care for children who are orphaned (Mpofu, Ruhode, Mutepfa,
January&Mapufon,2015).
InChinaTianandWang(2015)describeshowthecollectivisticcultureafforded
resilient development for 220 at-risk youths through nuclear and extended
families, and also “community” values such as tongxiang, which is a cultural
aspect that makes two people that come from the same place in China (i.e.,
province,city,county,orvillage)moreinclinedtohelpandsupporteachother.
For example people from rural parts of China often draws on tongxiang when
moving to bigger cities, where people from their home-town/region are more
75 then willing to help the newcomers settle in (Tian & Wang, 2015). Take the
exampleofMa:
Ma,a17yearold,quitschoolaftermiddleschool,andhadnothingtodoinher
hometown.Later,shewasabletodrawontongxiangtofindajobinBeijing.She
approachedastoremanagerwhohadsharedgeographicallinkswithherfamily.
Ma recalled, ‘Because she (the store manager) and my mother had a good
relationship, she recommended me to be hired when the store was looking for
people.’
(p.100)
This is something that often is frowned upon in individualistic cultures, where
we have negatively loaded terms such as nepotism, cronyism and in-group
favouritism for these kinds of hiring practices. But in China, this is a cultural
factor that opens up opportunities, (OAv & OAcin the social ecology of resilience
model) and is a culturally accepted (M in the model) way of seeking help and
support from people in the community, which overall fosters resilient
development.
TheroleofcultureforminoritygroupswasalsoassessedinNewZealandwhere
resilience was measured amongst 605 Māori, Pacific and Pākehā (New
Zealanders of European decent) youth (Sanders & Munford, 2015). Using a
resilience scale for youths to measure individual resources (such as personal
skills,availabilityofpeersupportandsocialskills),ameasurerelationshipswith
caregivers (physical and psychological care) and a measure of contextual
resources (including connection to culture, community, education and
spirituality) they found that “Māori youth reported the highest levels of risk,
PacificyouthwerelocatedbetweenMāoriandPākehāintermsofrisk,andtheir
risk levels were similar to both Māori and Pākehā” (p. 87) yet in regards to
resilience (as measured here) Pākehā youths showed the lowest resilience
scores.ThisindicatesthateventhoughMāoriandPacificislanderscandrawon
cultural and communal (contextual) support to a larger extent than New
ZealandersofEuropeandecent.
InNorthAmericaasimilarresultwasfoundwithwhiteCanadianyouths(Russel,
Liebenberg&Ungar,2015).Beingapartoftheculturalmajorityoftenleadstoa
76
sortof“invisibility”ofandadisconnectiontotheirownculturalidentity,which
canhampertheresilienceprocessfortheseyouths.
Thisisjustasmallsampleofresearchthatthisnewwavehasbroughtforward7,
yetitisafairlynewlineofresilienceperspectives,andinmanywaysithasonly
juststarted,andwedon’thaveexhaustiveexplanationsofhowtherelationship
between culture and resilience processes interact to facilitate positive (or
negative) outcomes. For example there are no studies exploring gene × culture
interactions, or studies exploring individuals who are confronted by many
different (sometimes contrasting) cultural paradigms, navigates between these
differentcultures,andhowthisaffectsresilienceprocesses.Whatwedohaveisa
foundation both theoretical and empirical to build and expand upon to better
understand the relationship between culture and resilience. This is why I’ve
placed this section within the future perspectives, as I’m convinced the most
comprehensiveandexplanatorystudiesofresilienceandcultureareaheadofus.
Whenitcomestoculturalresilienceresearchwithadults,history(asthecliché
states) has repeated itself. Like we saw with the other waves of resilience
research, the new theoretical and empirical development has come from
researchonchildrenandyouths.Thisdoesn’tmeanthattheculturalaspectsof
resiliencewithadultsareignoredbyscholarswithinthefield(seeforexample:
Castro & Murray, 2010; Ungar, 2010) but so far the most attention (both
researchandtheorywise)hasbeengiventoyouthsandchildren.Hopefullyitis
clear that research on cultural aspects is a little more complicated than
translating a resilience scale to a different language, and measure the same
individualtodetermineresilienceinadifferentculturalsetting.Atthistimewe
don’t really know if our models and thoughts about resilience makes sense in
othercultures,andweneedmodelsandtheoriesliketheonesstatedabovetobe
abletoinvestigateresilienceempiricallyindifferentpartsoftheworld.
The cultural/communal view of resilience research has also influenced new
modelsofdifferentaspectsofresilience,likedisasterresponse/preparedness.
7Seehttp://resilienceresearch.org/research/resources/publicationsforamore
comprehensivesummaryofresearchinthisfield.
77 8.3DisasterResponse/Preparedness
Lastly I want to mention another subpart of what I have named this potential
new wave of cultural research into resilience is how it relates to disaster
response/readinesstocatastrophessuchasterrorism,war,naturaldisastersand
disease (Masten, 2014ab; Masten & Obradović, 2008; Norris et al. 2008) and
other“surprises”(asLongstaff(2008)callsthem)thatneedstobehandledona
communitybasis,suchaspoliticalandfinancialturmoil.Heretheunderstanding
of resilience as a complex interwoven phenomenon between different systems
and levels of analysis really comes into play, as they are in and of themselves
complex problems that effects communities, societies and the individuals that
live in them. Therefore researchers have started developing models to give a
broaderunderstandingoftheseproblems,andhowtheycanbedealtwithinthe
best possible way, without ignoring any of the factors through reductionist
thinking. For example Norris and her colleagues (2008) developed a model of
crisis resilience that involves resources and strengths from several levels of
analysisfromindividualrobustnesstocommunity/societalresponses.Ascanbe
seeninfigure5thismodelinvolvesadynamicunderstandingofhowresilience
develops,duringacrisis.Notealsothatdysfunctionisconsideredtobetransient
atfirst,asdysfunctionisconsideredtobea“normal”reactiontoacrisisinthe
early aftermath, with post-event functioning being something that develops for
themajorityofpeopleexperiencingacrisis(seeFigure5).Thereforeitwouldbe
essentialtomeasureresiliencesometimeaftertheeventofacrisis,asitwould
benormal,andevenexpectedtoreactdysfunctionallytotraumaduringandfora
time after the event. To see what the authors considered being the important
community factors of resilience during and after a crisis see Figure 6. These
models show another aspect of cultural resilience that relates to properties in
communities, this does not only include the insubstantial cultural norms and
valuesmentionedearlier,butalsothephysicalpropertiesliketheinfrastructure
oreconomicsituationofaspecificcommunity.
78
Figure 5: Norris et al. (2008) model of crisis resilience. Shown as a complex multi-level problem that contains different levels of analysis.
Note: Reprinted from “Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness” by Norris, F. H., Stevens,
S.P., Pfefferbaum, B., Wyche, K. F. & Pfefferbaum, R. L., 2008, American Journal of Community Psychology, 41, pp. 127–150. .
79 Figure 6: Community resilience as a set of networked adaptive capacities
Note: Reprinted from “Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness” by Norris, F. H., Stevens, S.P.,
Pfefferbaum, B., Wyche, K. F. & Pfefferbaum, R. L., 2008, American Journal of Community Psychology, 41, pp. 127–150. .
80
Masten & Obradović (2008) also pointed out the importance of an integrated
multi-level when it comes to disaster preparation and recovery. The ideas of
Bronfenbrenner(1979),hasinfluencedtheirmodelwithmultiple-levelsthatthe
individual interacts in, which also includes the individuals basic biological
characteristics(seeFigure7).
Figure7:Multi-levelembeddedsystemsofanindividual.
Note:Reprintedfrom“DisasterPreparationandRecovery:LessonsfromResearchonResilienceinHuman
Development” by Masten, A. S. & Obradović J. 2008, Ecology and Society, 13(1), [online]
http://www.ecologyandsociety.org/vol13/iss1/art9/..
This model shows the authors understanding of how many factors are at play
when it comes to development of resilience in a crisis situation. To develop a
goodsystemofdisasterpreparednesswehavetobemindfulofalltheselevels,
astheyallplayarolewithregardstorecoveryafterdisastrousevents.Thisdoes
notmeanthattheyarelookingforasingleintervention,theoryorstudythatcan
81 encompassalloftheselevels.Thatis,ofcourse,impossible,buttheoverarching
ideaistohaveanunderstandingthatifyoudoresearchonacellularlevelorona
familybasedlevelofattachmentsetcetera,itallplaysintototheideaofabigger
whole, where there is room for research from different fields and disciplines,
from a cellular to a societal level, to strive towards giving an as complete as
possibleunderstandingofresilience.Inasense,thisisthecentralideaofnewer
resilienceresearchandtheory,andtheoriesandresearchonaculturallevelfits
intothatidea,andwillmostlikelyplayanimportantpartinfutureresearch.
82
9.WHEREDOWEGOFROMHERE?
AdultResilienceResearchintheFuture
So to conclude this thesis after having looked at where research and theory on
adultresilienceisatthemomentandwhereithasdevelopedfrom,Iwanttogive
mysuggestionsofwherethefieldshouldbeheadingandwhatitshouldstrivefor
inthefuture.
9.1TraitorProcess
ThefirstpointIwanttoraiseistheon-goingdebateaboutconsideringresilience
asatraitoraprocess.Nowitshouldbeclearthatasignificantfractionofadult
resilience researchers and theorists view adult resilience as a trait. This is
evidentbytheincreasingroleresiliencescalesplaywithinadultresilience.Itis
likely that a person first encountering research of resilience within the adult
contextwilllikelybumpintostudiesusingsomesortofresiliencescale,claiming
tohavemeasuredresiliencedirectly,andareabletosorttheresilientfromthe
non-resilientinacohort.Itisstrikingtoseehowdifferentthelineofthinkingis,
just by comparing adult and children/youth resilience, where the theory and
researchhasdevelopedintonewfieldsthatgiveusseveralperspectivesonwhat
resilience is, and how to best foster it, a significant aspect of adult resilience is
mainlyharkingbacktotheveryfirstwaveofresilienceresearch.Alargeofadult
resilience theories is therefore based on theoretical and empirical regression,
andthisisespeciallyworrisomewhentheindividualqualitiesthataremeasured
byresiliencescales,areusedasdefinitionsofresilience.Itisaveryinteresting
questionwhythisdifferenceissobigbetweenresilienceindifferentagegroups.
Is it because we are (still) not able to accept terms and theories from
developmental psychology for adults, despite the field having expanded to
includethedevelopmentthroughoutthelifespan?Isitaculturalbias,wherewe
inourindividualisticcultureseepeople(especiallyadults)ashavingtodepend
ontheirownindividualqualitiesto“pullthemselvesoutofruts”anddealwith
problems? Or is it because it is easier to develop a simpler model of resilience,
onlydependentonindividualisticqualities,andthendevelopscalestomeasure
theseindividualtraits?Idonotknowwhattheansweris,andcanonlyspeculate.
Thestaplethatyouhearfromthedevelopersofresiliencescalesisusuallysome
83 variation of the following statement by Hjemdal and colleagues (2006):
“Previous studies on resilience have applied indirect or partially related
measures of resilience. Although initially necessary, it is a costly and timeconsuming procedure, which reduces power and complicates comparisons of
researchfindings”(p.195)andthatthereisaneedtodevelopa“directmeasure
of resilience” (p. 195). Now the great irony of the last statement is that the
resiliencescalesarethemselvesindirectmeasureandarethemselvesmeasures
of partially related constructs of resilience, namely measures of individual
personalitytraits(andwiththeRSA,relationshipswithfamilyandfriends).Itis
truethatitiscostlyandtimeconsumingtomeasureresilienceinotherways,and
I’m convinced that the cost and difficulty of doing resilience research has been
themostimportantreasonforthepopularityofthesescales,itdoesnotexcuse
simplifyingthetermresilienceforconveniencesake.
Soinfutureadultresilienceresearch,Iwouldliketoseetherolethatresilience
scalesplaychangedwithinthefield,andaviewofadultresiliencethatrunsmore
conjunctive with child/youth resilience scholars that define it as a (life-long)
process, and not an individual trait. However viewing resilience as a process
doesnotrenderresiliencescalesuseless,butitdoeschangetheimpactofthem
andtherolethattheyplay.ForexampletheRSAwouldbeanexcellentmeasure
of an individual’s personal traits and personal relationships that can make
her/him more (or less) predisposed to resilient development. This is very
different from claiming to have measured someone’s resilience directly, and I
think that trying to develop a single questionnaire to measure such a complex
concept of resilience “directly” is a pipe dream, and resilience scales are best
understoodasatoolthatmeasureaspectsofresilience.
Thisisimportantbecausethroughaprocess-orientedviewofresiliencewecan
getamuchmoreopenviewoftheterm,whichcancatchtheimportantnuances
ofwhatresilienceis,andhowitdevelopsthroughoutlife.
9.2Longitudinalstudies
The second factor in adult resilience research that is needed, are more
longitudinal studies. If we remember all the way back to the first waves of
resilience research the most influential study was the longitudinal Kauai study
84
fromHawaii,whichstillgivesussomeofthegreatestinsightsinregardstowhat
resilient development is, and not at least how people develop resilience. This
workwassimplyaparadigmshiftermainlybecauseitwaslongitudinalandthere
aremanyexamplesoflongitudinalstudiesofchildrenandadolescent,withonly
a handful following up into adulthood (Werner, 2013). In my view, if the
understandingofresilienceasadevelopmentalprocessweneedtounderstand
howresilienceforadultsdevelopsovertime,whichiswherelongitudinalstudies
come in. The best example already out in the ether is by Werner & Schmidt
(1992, 2002) themselves that found that the individuals in their cohort that
recoveredinadulthoodwereopeningofopportunitiesinadulthood:
Among the most potent forces for positive change for these youth in
adulthood were continuing education at community colleges and adult
highschools,educationalandvocationalskillsacquiredduringservicein
the armed forces, marriage to a stable partner, conversion to a religion
that demanded active participation in a “community of faith,” recovery
from a life-threatening illness or accident, and, to a much lesser extent,
psychotherapy
(Werner,2005p.12)
SotheKauaicohortrevealedtheimportanceofturningpointsinadultresilience
development, and how social and community factors play an important part in
theirrecoveryinadultage.Howeverwhenitcomestostudyingadultresilience
longitudinallyyoudon’thavetostartwithchild/adolescentparticipants,andthe
newlevelsofanalysisshowexcitingprospectsforfuturestudies.Forexampleit
ispossiblepeoplewhoaregeneticallyvulnerabletostresslongitudinally,tosee
how (or even if) they develop stress resilience over time, and what
environmental/personal/behaviouralfactorsthatmakeadifference,andfurther
illuminate the interactions of gene × environments. Or the new perspectives of
culturalinfluencesofresilience,showsgreatpromiseasabaseforcross-cultural
longitudinalstudies.ForexamplethemodelofacoildevelopedbyPainter-Brick
(2015)showingthedevelopmentofresilienceovertimecouldbeusedasabasis
for a longitudinal study to identify turning points for resilience in a specific
culturalsetting(seefigure8).
85 Figure8:Coilsasanimageforculturally-specifictrajectoriesofresilience
Note:Reprintedfrom“CultureandResilience:NextStepsforTheoryandPractice”byPanter-Brick,C.2015,
In: Theron, L. C., Liebenberg, L. & Ungar, M. [Eds.] Youth Resilience and Culture Commonalities and
Complexities,p.233-244
Theremightevenbetheexcitingopportunitytohaveseverallevelsofanalysisof
asinglecohort,ifthereisinterdisciplinaryworkdone.
NowofcourseIdorealizethepracticalchallengesofconvincingoverathousand
adultstospend40yearsoftheirlivesinonelongitudinalstudy(aswasthecase
intheKauaistudy)anditwillbenecessarytoscaleitdownconsiderably,bothin
regards to sample size and years. But even with these restrictions there are
much to be learned from longitudinal studies in regards to how resilience
develops in adulthood, for example with regards to the next subject of future
areasofadultresilienceresearch,interventionstudies.
9.3Interventions
Like I mentioned earlier there haven’t been many studies of interventions to
promote resilience with an adult population. Unlike what we saw in the third
wave of resilience research for children and youths, where attention to
intervening was at the forefront for developing a understanding of what
resilienceisandhowtobestfosterit,therehasn’tbeenasimilarattentiontothis
86
with the adult population, and there is an overweight of studies focusing on
individualinterventions.
A meta-study (Macedo et al., 2014) found 13 studies on non-clinical samples,
wheresevenwererandomizedcontroltrials,fivenon-randomizedandoneopenendedtrial.Ofthesevenrandomizedcontroltrialsthreeusedresiliencescales,
one measured hardiness, and three used scales that assess process and factors
relatedtoresilience(likecoping,self-esteem,locusofcontrol,socialsupportand
positiveaffect).Ofthefivenon-randomizedonemeasuredhardiness,oneuseda
resiliencescaleandtheremainingthreeusedscalesmeasuringresiliencefactors,
asdidtheopen-endedstudy.Allthestudiesusedinterventionsonanindividual
level including: “positive psychology techniques, CBT, transformational coping,
acceptance and commitment therapy, mindfulness, interpersonal therapy,
attention and interpretation therapy, relaxation and diaphragmatic breathing”
(Macedo et al., 2014 p.5). Four of the studies in the meta-study used online
interventions,eightusedgroupinterventionsandoneusedface-to-facetherapy.
Theauthors(Macedoetal.,2014)foundthat:
“the methodological quality of the selected studies was hampered by the poor
qualityofreporting.Therewerefaultsinreportinginmoststudiesonalmostall
items (random sequence generation, allocation concealment, blinding of
outcome assessment, incomplete outcome data, description of concurrent
treatmentandintent-to-treatanalysis),exceptfortheitem‘selectivereporting’”
(p.1).Veryfewstudiesreportedfollow-updata,andthereforedidnotreportthe
long-term effects of the interventions. Despite this it there was found evidence
pointing towards some degree of effectiveness of the resilience promotion
programs.
Now even though the lack of quality in reporting found in the studies is
problematic, as the meta-study correctly points out, another issue I want to
highlight is the fact that all the intervention methods relied upon are on an
individuallevel.ForexampleSood,Prasad,SchroederandVarkey(2011)useda
stress management and resilience training program on an individual level to
foster stress management and resilience training program in a group of
physicians, psychotherapy was used with a group of bankers to improve
resilience towards stress (Aniţei, Chraif & Chiriac, 2011) and a brief cognitive87 behavioural was used to help foster resilience in soldiers in recruit training
(Cohn & Pakenham, 2008). In fact all the studies included, had to do with
managing stressful work environments in groups ranging from the
aforementioned to company employees, industrial workers, customer service
workers,managersandstudents(Macedoetal.,2014).Nowwhatweknowfrom
fieldsaspsychobiologicalstressresilience,isthatenvironmentalfactorsplaysa
bigrolewithstressresilience.Nostudiesincludedenvironmental,contextualor
evensocietalchanges,likewesawinthethirdwaveofchildrenandadolescent
resilienceresearch.Thisistheclearconsequenceofresiliencebeingdefinedas
anindividualtrait,whichonlylieswithintheindividualandisbasedonher/his
innatequalities,liketheresiliencescalessay.Inthisviewwhereresiliencesolely
isbasedontheindividualqualitiesofaperson,thesolutionbecomessimplyto
train the person to become a “more resilient” human being. Adult resilience
interventions therefore aren’t interventions in the milieu that foster resilient
development, but rather are seen as interventions to change the person that
works/study in stressful environments. One could even say that it lays the
responsibility of (or even the blame of not being) being resilient onto the
individualsolelyandisbasedonacertainviewofresiliencethathasverylittleto
dowithhowthefieldoriginallydevelopedthroughthefourwavesofresilience
research. It also highlights the problem of relying on resilience scales as a
measureofresilience.Asitisstatedinthemeta-study:
forresiliencetobeidentified,thereneedstobeasignificantthreattothe
individual and, when facing such threat, the quality of adaptation or
development needs to be good. Individuals who have never suffered
significant threat cannot be considered resilient. Therefore, we cannot
conclude that individuals who showed increased scale scores after the
interventionwillbeeffectivelyresilientafteratraumaticevent.
(Macedoetal.,2014p.8)
So my hope for the future is that there is a revision of how adult resilience
interventionsstudiesaredoneandnewmethodsofinterventionsaredeveloped,
withabroaderfocusthatincludeotherlevelsofanalysisthanjusttheindividual,
88
sowecanlearnmoreabouthowwebestcanfosteradultresilientdevelopment.
Thesearestudiesthatneedtobedoneovertime,andincludefollow-updatato
understandwhichinterventionsworkbestoverlongperiodsoftime,andtofind
what the “windows of opportunities” are with an adult population. And from
whatIhaveshowninthisthesis,itseemsunlikelythatindividualinterventions
aretheonlywayresiliencecanbefosteredwithanadultpopulation.
9.4Summary
Meta-TheoriesinFutureResearchandTheory&ConcludingRemarks
So where does one begin with making a summary of research and theory on
resilienceinanadultcontext?Ithinkthemostimportantthingittolooktowards
the meta-theories as have been suggested by amongst other Christiansen and
Sommer (2015). Resilience is famously a term that has a rich but fragmented
empirical and theoretical background and it needs meta-theoretical models to
integratethedifferentaspectstoalargerwhole,oramaintheoreticalfoundation
that the field sorely lacks (Christiansen & Sommer, 2015). And this is just as
much the case for adults as it is with children and adolescents. The major
concernoffutureadultresilienceresearchthereforeisn’twhetherornotwecan
develop a perfect resilience scales that accurately measure resilience through
short questionnaires, but whether or not we have the best models available to
integrateresearchandtheoryonmultiplelevels,intothebiggertapestrythatwe
call resilience. In my view the best model to describe this is Gottlieb’s (2007)
modelthatIdescribedallthewaybackinthefourthwavesegmentofthethesis
(see Figure 1, p. 16), Combined with the understanding coming from Dynamic
Systems Theory, that Esther Thelen (2005) so wonderfully presented with her
mountainstreammetaphorofhumanbehaviour,andhowitdevelopsovertime.
With these ideas as a backdrop we have a general understanding of resilience,
which allows for integration of the diverse sources of empirical research
presented in this thesis. And a dynamic developmental understanding of the
term itself fosters the idea of research on multiple levels, and helps us avoid
reductionistic “one size fits all” explanations of what resilience is for different
people.
89 Doesthismeanthateachindividualresearchpaperhastoincludemultiplelevels
ofanalysistobeabletosaysomethingvaluableforresilience?Ofcoursenot.It
wouldbeimpossibleforanysingleresearchpapertobringallthenuancesand
different levels that influence resilience into a single study. The point is by
havingameta-theoreticalunderstandingofresiliencewecanintegratedifferent
researchpapersonanindividualtraitlevelandageneticlevelandabehavioural
level and an environmental level and a cultural level together to get a
comprehensive understanding of what resilience is and how to foster its
development
for
different
adults,
with
different
individual
traits,
genetic/biological make-ups, cultural/societal backgrounds et cetera. With a
larger focus on meta-theoretical contributions in future research and theories
there is a promise of developing new hypothesis of resilience based on
interdisciplinary research. Therefore the fact that so much of research and
theoryofadultresilienceharksbacktoaformof“firstwave”understandingand
definitionoftheterm,isaworryingtheoreticalandempiricalregression.
What I have found is a field of study that is running full steam ahead in many
different directions (which the length and diversity of the reference list attests
to) with different views on what resilience is, and how it should be defined in
boththeadultandthechild/adolescentfield.Thefactthatresilienceasatermis
very complex, and affords research on widely different levels makes it very
difficulttogiveaconciseexplanationofhowresearchandtheoryinthefieldof
adult resilience has developed. Therefore it has been a big challenge to try to
explainthebreadthofadultresilienceresearch,totrulyshowhow widespread
(bothgeographically,theoreticallyandmethodologically)theempiricalresearch
ofthetermis.Ialsofoundatendencytothinkdifferentlyaboutwhatresilience
meanforadultscomparedtochildren/adolescents,withamuchlargerfocuson
individualqualitiesforpeoplewhoareover18yearsold, in a large part of the
adult resilience field. Researcher promoting usually do so by referring back to
old first wave research with children, that also viewed resilience as mainly an
individualquality,butIrarelyfoundexplanationsofwhytheychoosetoignore
the developmental view and favour an individualistic one. So I have not
encountered a convincing argument (other than it being easier or more
90
practical)thatadultresilienceshouldbeviewedasanindividualtrait.However
therearemanyindicationsintheresearchthatIhavereviewed,whichpointto
resiliencebeingdependentonmultiplefactorsotherthantheindividualtraitsof
aperson.Thistendencyofadultresilienceresearchneedstobepointedoutand
discussed, and this thesis aims to be a part of that discussion. By pointing out
howwidespreadthisviewisincertainpartsofadultresilienceresearch,andthe
theoretical and empirical weaknesses of it, I hopefully have made a valid
contribution.
AllthissaidIwouldliketopointoutthattherearemanypositiveaspectsofadult
resilienceresearchandtheoryaswell,whichhopefullyhascomeacrossinthis
thesis as well. For example the future potential of and tremendous insights
already gained by research of psychobiological factors, and the promise of
researchofculturalaspectsinfluenceonthedevelopmentinthefuture.And(just
sowe’reclearonthis)thereisalsobigpromiseforfutureresearchtounderstand
the role that personality and other individual traits play when it comes to the
differences we see in adult resilience. The idea isn’t that these factors have no
influence on resilience because they clearly do, this has been known since the
first wave of resilience research was published (see for example Mastens “the
shortlist”),thatshowedthatcertainindividualtraitsinfluenceresilience,much
the same way modern psychobiological research has shown that there are
certain genotypes that is influential with resilience. But we should be careful
with defining resilience out of these simple factors. Having looked at resilience
for adults as carefully as I have in this thesis, my wish is that the separation
betweenthetermsego-resiliency(orjustresiliency,assomepeoplecallit)and
resiliencebecomesclear-cut,whereonetermreferstoindividualqualities,and
the other the overarching developmental process, dependent on many
interconnectedfactors.Yes,thismakesitmorecomplex,butsoishumanlifein
thisworld,nomatterwhatageyouare,andtolookforsimpleanswersinjustthe
environment,orjusttheindividualorjustthegeneticlevelisamistake.Because
the world will continue to play its part in straining and challenging human
development, and we need a broad understanding of the term to help people
maintainanddevelopresilienceinit.
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