Roots and routes to resilience and its role in psychotherapy: a selective,attachment-informed review

Developmental research on resilience is summarised and illustrated with a case example. Self-reflection, positive relationships, and agency foster resilience in the face of adversity. Attachment and resilience are related categories. The different patterns of attachment – secure, insecure-organised and insecure-disorganised – are manifest in different patterns of resilience, depending on prevailing environmental conditions. However, the greater the environmental adversity, the less will the resilience factors emerge. Clients tend to present for psychotherapy when resilience strategies have failed. The therapeutic relationship has neurochemical and relational characteristic mirroring the secure mother–infant bond. These foster mentalising, stress innoculation, affect co-regulation, self-esteem, and agency, forming the basis for enduring and more flexible resilience strategies.     

From liability to challenge: Complex environments are associated with favorable psychosocial outcomes in adolescent sport participants

This study aimed to identify different groups of adolescents who have distinct profiles based upon their perceptions of interpersonal and activity-based dimensions of the sport environment. A sample of 310 adolescents from Eastern Canada (M_age = 14.69 ± 1.60 years; 54.8% girls) completed questionnaires assessing selected interpersonal, activity-based, demographic and sport-specific variables. Using TwoStep Cluster Analysis, we identified three groupings of adolescent sport participants. Consistent with the literature, we labeled these groups ‘negative context,’ ‘positive context,’ and ‘complex context,’ respectively. As expected, participants in the last two groups reported greater enjoyment, perceived competence, and commitment to sport. Further, participants in the ‘complex context’ group showed the highest levels of sport commitment. We draw on insights from Csikszentmihalyi's theory of complexity and relational conceptions of compensation and resilience to interpret the findings, and offer an alternative account of contextual conditions suitable for adolescents involved in competitive sport.     

腹腔镜下子宫次全切除术后患者心理弹性水平及其影响因素分析

目的 探讨腹腔镜下子宫次全切除术后患者心理弹性水平及其影响因素。方法 选择2016年6月至2018年6月在达州市中西医结合医院接受治疗的86例腹腔镜下子宫次全切除术后患者进行问卷调查，调查工具包括：自制一般资料调查表、《大五人格量表简化版》、《社会支持评定量表》、《心理弹性量表简表》。采用Logistic回归方法分析腹腔镜下子宫次全切除术后患者心理弹性独立性影响因素。结果 共发放问卷86份，回收有效问卷83份，回收率为96.51%。患者《心理弹性量表简表》平均得分（63.18±13.52）分。单因素分析结果显示：年龄、学历、家庭月收入、医疗费用支付方式、婚姻状况、社会支持的不同腹腔镜下子宫次全切除术后患者心理弹性水平差异具有统计学意义（P<0.05）。多因素分析结果显示：年龄≥60岁（OR:1.513,95%CI:1.409~1.648）;受教育程度初/高中及中专（OR:1.498,95%CI:1.379~1.641）,大专及以上（OR:1.711,95%CI:1.590~1.829）；家庭月收入(OR:1.383,95%CI:1.129~1.692)；婚姻状况未婚(OR:1.322,95%CI:1.218~1.499)，离异或丧偶(OR:1.548,95%CI:1.321~1.659)；高水平社会支持(OR:1.513,95%CI:1.385~1.626)均为腹腔镜下子宫次全切除术后患者心理弹性独立性影响因素（P<0.05）。结论 腹腔镜下子宫次全切除患者心理弹性处于中等水平，其主要受年龄、教育程度、婚姻状况及社会支持的影响。     

Beyond normality in the study of bereavement: heterogeneity in depression outcomes following loss in older adults

Studies of individual differences in bereavement have revealed prototypical patterns of outcome. However, many of these studies were conducted prior to the advent of sophisticated contemporary data analytic techniques. For example, Bonanno et al. (2002) used rudimentary categorization procedures to identify unique trajectories of depression symptomatology from approximately 3 years prior to 4 years following conjugal loss in a representative sample of older American adults. In the current study, we revisited these same data using Latent Class Growth Analysis (LCGA) to derive trajectories and test predictors. LCGA is a technique well-suited for modeling empirically- and conceptually-derived heterogeneous longitudinal patterns while simultaneously modeling predictors of those longitudinal patterns. We uncovered four discrete trajectories similar in shape and proportion to the previous analyses: Resilience (characterized by little or no depression; 66.3%), Chronic Grief (characterized by depression following loss, alleviated by 4 years post-loss; 9.1%), _Pre-existing Chronic Depression (ongoing high pre- through post-loss depression; 14.5%), and Depressed-Improved (characterized by high pre-loss depression that decreases following loss; 10.1%). Using this analytic strategy, we were able to examine multiple hypotheses about bereavement simultaneously. Health, financial stress, and emotional stability emerged as strong predictors of variability in depression only for some trajectories, indicating that depression levels do not have a common etiology across all the bereaved. As such, we find that identifying distinct patterns informs both the course and etiology of depression in response to bereavement.     

Cognitive styles and psychological functioning in rural South African school students: Understanding influences for risk and resilience in the face of chronic adversity

Adverse childhood experiences can show lasting effects on physical and mental health. Major questions surround how children overcome adverse circumstances to prevent negative outcomes. A key factor determining resilience is likely to be cognitive interpretation (how children interpret the world around them). The cognitive interpretations of 1025 school children aged 10–12 years in a rural, socioeconomically disadvantaged area of South Africa were examined using the Cognitive Triad Inventory for Children (CTI-C). These were examined in relation to psychological functioning and perceptions of the school environment. Those with more positive cognitive interpretations had better psychological functioning on scales of depression, anxiety, somatization and sequelae of potentially traumatic events. Children with more negative cognitions viewed the school-environment more negatively. Children living in poverty in rural South Africa experience considerable adversity and those with negative cognitions are at risk for psychological problems. Targeting children's cognitive interpretations may be a possible area for intervention.     

Precariously placed: Home,housing and wellbeing for older renters

Older renters may encounter a wide range of challenges and constraints in their experiences of ageing, housing and community life that influence their wellbeing. We employ a two-part conceptualisation of precarity and resilience to investigate how housing-related precarities may impact upon experiences of ageing and home during later life. We draw on narratives collected through in-depth interviews with 13 older renters living in a particularly high-pressure housing market within the greater Auckland area. We ground our analysis in ideas of precarity and resilience evident in participants' experiences of being ‘at home’ at the scale of both the dwelling and wider community. Results show that experiences of renting and ageing can be complicated and compromised in diverse ways by interrelated aspects of precarity and resilience related to housing, community, health, financial and personal circumstances. Distance or isolation from services and healthcare, tourism-related infrastructural pressures, and community changes can intensify precarious experiences of home, and can have implications for older people's wellbeing, as well as their ongoing opportunities to age well in place. In addition to these potential precarities, older renters appear to draw strength from their familiarity with, attachment to, and enjoyment of, place and community. These responses demonstrate older renters' capacity for resilience to challenge and adversity when ageing in rented places.     

伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响的路径分析

目的探讨伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响,并分析其影响路径。方法采用便利抽样法,选取2016年6—2018年8月在广西医科大学附属肿瘤医院住院部及门诊部就诊的喉癌永久性气管造瘘患者264例为研究对象。采用社会影响量表(SIS)、伤残接受度量表(AODS)、心理弹性量表(CD-RISC10)对其进行调查,对三者进行相关性分析并建立结构方程模型进行路径分析。发放264份调查问卷,有效回收256份。结果256例永久性气管造瘘患者病耻感、伤残接受度、心理弹性总分分别为(61.50±9.27)、(76.88±9.34)、(26.49±4.05)分。相关性分析显示,伤残接受度、心理弹性得分与病耻感呈负相关(P<0.01)。结构方程模型分析表明,喉癌气管造瘘患者伤残接受度和心理弹性对病耻感具有直接效应(β值分别为-0.43、-0.28),伤残接受度通过心理弹性间对病耻感的间接效应为-0.06。结论喉癌永久性气管造瘘患者病耻感水平较高,伤残接受度与心理弹性对病耻感有显著预测作用。