Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0–4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement.
posttraumatic stress disorder;
Friborg, O., Hjemdal, O., Rosenvinge, J. H., Martinussen, M. (2003). A new rating scale for adult resilience: What are the central protective resources behind healthy adjustment? International Journal of Methods in Psychiatric Research, 12, 65-76.
Resources that protect against the development of psychiatric disturbances are reported to be a significant force behind healthy adjustment to life stresses, rather than the absence of risk factors. In this paper a new scale for measuring the presence of protective resources that promote adult resilience is validated. The preliminary version of the scale consisted of 45 items covering five dimensions: personal competence, social competence, family coherence, social support and personal structure.
The Resilience Scale for Adults (RSA), the Sense of Coherence scale (SOC) and the Hopkins Symptom Checklist (HSCL) were given to 59 patients once, and to 276 normal controls twice, separated by four months.
The factor structure was replicated. The respective dimensions had Cronbach’s alphas of 0.90, 0.83, 0.87, 0.83 and 0.67, and four-month test-retest correlations of 0.79, 0.84, 0.77, 0.69 and 0.74. Construct validity was supported by positive correlations with SOC and negative correlations with HSCL. The RSA differentiated between patients and healthy control subjects. Discriminant validity was indicated by differential positive correlations between RSA subscales and SOC.
The RSA-scale might be used as a valid and reliable measurement in health and clinical psychology to assess the presence of protective factors important to regain and maintain mental health.
sense of coherence;
Luthar, S.S., Cicchetti, D., & Becker, B. (2000). The Construct of Resilience: A Critical Evaluation and Guidelines for Future Work. Child Development, 71, (3), 543-562.
This paper presents a critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity. As empirical research on resilience has burgeoned in recent years, criticisms have been levied at work in this area. These critiques have generally focused on ambiguities in definitions and central terminology; heterogeneity in risks experienced and competence achieved by individuals viewed as resilient; instability of the phenomenon of resilience; and concerns regarding the usefulness of resilience as a theoretical construct. We address each identified criticism in turn, proposing solutions for those we view as legitimate and clarifying misunderstandings surrounding those we believe to be less valid. We conclude that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals. Realization of the potential embodied by this construct, however, will remain constrained without continued scientific attention to some of the serious conceptual and methodological pitfalls that have been noted by skeptics and proponents alike.
Masten, A. S. (2001). Ordinary Magic: Resilience Process in Development. American Psychologist, 56, (3), 227-238
The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology. The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity.
Rutter. M., & The English and Romanian Adoptees (ERA) study team. (1997). Developmental catch-up, and deficit, following adoption after severe global early privation. Journal of Child Psychology and Psychiatry, 39(4), 465-476. doi: 10.1017/S0021963098002236
The extent of developmental deficit and catch-up following adoption after severe global early privation was examined at 4 years in a sample of 111 Romanian children who came to the U.K. before the age of 2 years, and compared with respect to their functioning at the same age to a sample of 52 U.K. adopted children placed before the age of 6 months. The measures at 4 years included height, head circumference, and general cognitive level (assessed on both the McCarthy and Denver Scales). The children from Romania were severely developmentally impaired at the time of U.K. entry, with about half below the third percentile on height, on weight, on head circumference, and on developmental quotient. Many were also in a poor physical state with recurrent intestinal and respiratory infections. The catch-up in both physical growth and cognitive level appeared nearly complete at 4 years for those children who came to the U.K. before the age of 6 months, despite the fact that their background prior to U.K. entry was similar to the children who came to the U.K. when older. The developmental catch-up was also impressive, but not complete, in those placed after 6 months of age. The mean McCarthy General Cognitive Index was 92 compared with 109 for the within-U.K. adoptees. The strongest predictor of level of cognitive functioning at 4 years was the children’s age at entry to the U.K. It was concluded that the remaining cognitive deficit was likely to be a consequence of gross early privation, with psychological privation probably more important than nutritional privation. A further follow-up at age 6 years will determine whether there is continuing recovery after 4 years.
· Preschool children
· cognitive development
· psychological privation
· institution rearing
Smith, B. W., Dalen, J., Wiggins, J., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15(3), 194-200. doi: 10.1080/10705500802222972.
While resilience has been defined as resistance to illness, adaptation, and thriving, the ability to bounce back or recover from stress is closest to its original meaning. Previous resilience measures assess resources that may promote resilience rather than recovery, resistance, adaptation, or thriving. To test a new brief resilience scale. The brief resilience scale (BRS) was created to assess the ability to bounce back or recover from stress. Its psychometric characteristics were examined in four samples, including two student samples and samples with cardiac and chronic pain patients. The BRS was reliable and measured as a unitary construct. It was predictably related to personal characteristics, social relations, coping, and health in all samples. It was negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality (high negative affect and high social inhibition) were controlled. There were large differences in BRS scores between cardiac patients with and without Type D and women with and without fibromyalgia. The BRS is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.
· brief resilience scale
Werner, E. E. (1993). Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study. Development and Psychopathology, 5, 503-515.
This article summarizes the major findings of a longitudinal study that traced the developmental paths of a multiracial cohort of children who had been exposed to perinatal stress, chronic poverty, and a family environment troubled by chronic discord and parental psychopathology. Individuals are members of the Kauai Longitudinal Study, which followed all children born in 1955 on a Hawaiian island from the perinatal period to ages 1, 2, 10, 18, and 32 years. Several clusters of protective factors and processes were identified that enabled most of these high-risk individuals to become competent and caring adults. Implications of the findings for developmental theory and social action programs are discussed, and issues for future research are identified.
Windle, G., Bennet, K. M., & Noyes, J. (2011). A methodological review of resilience measurement scales. Health and Quality of Life Outcomes, 9(8), 1-18. doi: 10.1186/1477-7525-9-8
The evaluation of interventions and policies designed to promote resilience, and research to understand the determinants and associations, require reliable and valid measures to ensure data quality. This paper systematically reviews the psychometric rigour of resilience measurement scales developed for use in general and clinical populations.
Eight electronic abstract databases and the internet were searched and reference lists of all identified papers were hand searched. The focus was to identify peer reviewed journal articles where resilience was a key focus and/or is assessed. Two authors independently extracted data and performed a quality assessment of the scale psychometric properties.
Nineteen resilience measures were reviewed; four of these were refinements of the original measure. All the measures had some missing information regarding the psychometric properties. Overall, the Connor-Davidson Resilience Scale, the Resilience Scale for Adults and the Brief Resilience Scale received the best psychometric ratings. The conceptual and theoretical adequacy of a number of the scales was questionable.
We found no current ‘gold standard’ amongst 15 measures of resilience. A number of the scales are in the early stages of development, and all require further validation work. Given increasing interest in resilience from major international funders, key policy makers and practice, researchers are urged to report relevant validation statistics when using the measures.
Wright, M. O. D., Masten, A. S., & Narayan, A. J. (2013). Resilience processes in development: Four waves of research on positive adaptation in the context of adversity. In S. Goldstein & R. B. Brooks (Eds.). Handbook of resilience in children (pp. 15-37). Us: Springer.
How do children and adolescents “make it” when their development is threatened by poverty, neglect, maltreatment, war, violence, or exposure to oppression, racism, and discrimination? What protects them when their parents are disabled by substance abuse, mental illness, or serious physical illness? How do we explain the phenomenon of resilience—children succeeding in spite of serious challenges to their development—and put this knowledge to work for the benefit of children and society? The scientific study of resilience emerged around 1970 when a group of pioneering researchers began to notice the phenomenon of positive adaptation among subgroups of children who were considered “at risk” for developing later psychopathology (Masten, 2001, 2012).