Measurement and predictors of resilience among community-dwelling older women

Background

Resilience, the ability to adapt positively to adversity, may be an important factor in successful aging. However, the assessment and correlates of resilience in elderly individuals have not received adequate attention.

Method

A total of 1395 community-dwelling women over age 60 who were participants at the San Diego Clinical Center of the Women’s Health Initiative completed the Connor-Davidson Resilience Scale (CD-RISC), along with other scales pertinent to successful cognitive aging. Internal consistency and predictors of the CD-RISC were examined, as well as the consistency of its factor structure with published reports.

Results

The mean age of the cohort was 73 (7.2) years and 14% were Hispanic, 76% were non-Hispanic white, and nearly all had completed a high school education (98%). The mean total score on the CD-RISC was 75.7 (sd = 13.0). This scale showed high internal consistency (Cronbach’s alpha = 0.92). Exploratory factor analysis yielded four factors (somewhat different from those previously reported among younger adults) that reflected items involving: (1) personal control and goal orientation, (2) adaptation and tolerance for negative affect, (3) leadership and trust in instincts, and (4) spiritual coping. The strongest predictors of CD-RISC scores in this study were higher emotional well-being, optimism, self-rated successful aging, social engagement, and fewer cognitive complaints.

Conclusions

Our study suggests that the CD-RISC is an internally consistent scale for assessing resilience among older women, and that greater resilience as assessed by the CD-RISC related positively to key components of successful aging.     

Resilience and spirituality in patients with depression and their family members: A cross-sectional study

ObjectiveThe degree and quality of resilience in patients with depression have never been investigated in the context of remission status, spirituality/religiosity, and family members' resilience levels, which was addressed in this study.MethodsThis cross-sectional study recruited Japanese outpatients with depressive disorder according to ICD-10 and cohabitant family members who were free from psychiatric diagnoses. Resilience was assessed using the 25-item Resilience Scale (RS). Other assessments included the Montgomery-Asberg Depression Rating Scale (MADRS); the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT) and Kasen et al.'s (2012) scale for spirituality/religiosity; and the Rosenberg Self-Esteem Scale (RSES).ResultsOne hundred outpatients with depression (mean ± SD age, 50.8 ± 14.5 years; 44 men; MADRS total score 9.8 ± 9.0) and 36 healthy family members (mean ± SD age, 56.5 ± 15.0 years; 18 men) were included. Symptom severity, attendance at religious/spiritual services, and self-esteem were significantly associated with RS scores in the patient group. RS total scores were significantly higher in remitted patients compared to non-remitted patients (mean ± SD, 112.3 ± 17.1 vs. 84.8 ± 27.7, p < 0.001). No correlation was found in RS total scores between patients and their family members (p = 0.265), regardless of patients' remission status.ConclusionsResilience may be influenced by individual characteristics rather than familial environment; furthermore, self-esteem or spirituality/religiosity may represent reinforcing elements. While caution is necessary in extrapolating these findings to other patient populations, our results suggest that resilience may be considered a state marker in depression.     

Patients' resilience and distress over time: Is resilience a prognostic indicator of treatment?

BackgroundResilience is a positive adaptation or the ability to maintain mental health despite experiencing difficulty. Many researchers are linking resilience with many aspects of life, most often with better mental health. Resilience can affect health status and symptoms, but conversely, it can also be affected by health status or symptoms. From the literature it appears that resilience can even be a predictor of psychiatric symptoms. Resilience can predict severity of symptoms, but the question is whether symptoms can also affect resilience over time when previous levels of resilience are controlled for. The aim of this study was to explore the relationship of resilience scores and the expression of distress in the context of treatment over time.MethodsNinety-five patients diagnosed with affective and anxiety disorders from a clinical sample treated psychotherapeutically with (N = 81) or without (N = 14) a pharmacological treatment at a psychotherapy day center participated in the study. All the participants were assessed three times: at the beginning of the treatment, after treatment (after 6 weeks), and after a follow-up interval of 6 months after the end of therapy. The Resilience Scale for Adults and the Clinical Outcomes in Routine Evaluation Outcome Measure were used in the study.ResultsAll distress indicators were expressed more before the treatment compared to right after the treatment or half a year after the treatment. Distress indicators were more stable from Time 1 to Time 2, while from Time 2 to Time 3 they were less stable. In this study, resilience increased during the treatment and stayed stable after the treatment. Looking at bidirectional relationships between distress indicators and resilience over time, the results of this study suggest that levels of resilience have a prognostic value for the reduction of symptoms over the course of treatment. However, decrease in distress does not predict increase in resilience.ConclusionsLevels of resilience measured by RSA scores seem to have a certain prognostic value for the reduction of symptoms over the course of treatment. Perception of self was the strongest predictor of lower levels of distress over time when distress and perception of self-stability are controlled for. Results suggest that decreased distress indicators are not directly related to increasing resilience over six weeks or over six months. Considering that resilience is rather stable over time and indicators are less stable, it is possible that resilience could be increased by personal or environmental factors, and a decrease in distress is not a contributing factor. In this study distress decreased over time, while resilience characteristics increased for the whole sample. Patients in this study underwent treatment, and decreases in global distress were a result of treatment. An increase in resilience over time supports the effectiveness of treatment. However, there were no significant differences between treatment types while evaluating models. Results suggest that treatments (psychotherapy or psychopharmacological with psychotherapy) were equally effective for the chosen patients.     

Genetic and serum biomarker evidence for a relationship between TNFα and PTSD in Vietnam war combat veterans

BackgroundPosttraumatic stress disorder (PTSD) is associated with increased inflammation and comorbid medical conditions. However, study findings for individual inflammatory marker levels have been inconsistent. Some research suggests that resilience may play a role in decreased inflammation. A polymorphism in the promoter region of the tumor necrosis factor α gene (TNFα), TNFA −308 (rs1800629) is associated with psychiatric illness but its role in PTSD is yet to be elucidated.ObjectiveThis study investigates a key inflammatory marker, TNFα, for its role in PTSD severity.MethodIn a cohort of trauma-exposed Vietnam War veterans (n = 299; 159 cases, 140 controls) TNF α serum levels and TNFα polymorphism rs1800629 were correlated with PTSD severity and resilience scores.ResultsThe polymorphism was associated with PTSD severity (p = 0.045). There were significant group differences between cases and controls with regards to serum TNFα levels (p = 0.036). Significant correlations were found between PTSD severity and elevated TNFα levels (r = 0.153; p = 0.009), and between resilience and decreased TNFα levels at a trend level (p = 0.08) across the entire cohort. These relationships were non-significant after controlling for covariates. In the PTSD diagnostic group, a correlation of TNFα and PTSD severity was observed on a trend level (p = 0.06), the relationship between TNFα and resilience remained non-significant.ConclusionsTo our knowledge, this is the first time rs1800629 has been investigated in PTSD contributing to a growing body of literature that identifies the GG as a risk genotype for psychiatric disorders in Caucasian cohorts. However, more research is needed to replicate our results in larger, equally well-characterized cohorts. The relationship between serum TNFα levels and PTSD severity and resilience requires further investigation.     

Family Accommodation Scale for Obsessive–Compulsive Disorder—Interviewer-Rated (FAS-IR), Brazilian Portuguese version: Internal consistency,reliability, and exploratory factor analysis

ObjectiveTo examine the psychometric properties of the Brazilian Portuguese version of the Family Accommodation Scale for Obsessive–Compulsive Disorder—Interviewer-Rated (FAS-IR).MethodA total of 114 family members of patients with obsessive–compulsive disorder (OCD) were assessed. The following analyses of the FAS-IR were carried out: internal consistency, inter-rater and test–retest reliability, and exploratory factor analysis.ResultsThe Brazilian Portuguese version of the FAS-IR showed excellent inter-rater reliability (intraclass correlation coefficient [ICC] = 0.94) and acceptable test–retest reliability (ICC = 0.77), with no significant differences in FAS-IR scores. Factor analysis produced three factors for the scale. However, factor loadings were not well defined within each factor, and the factors did not have distinct constructs. Thus, a global analysis approach was chosen, revealing good internal consistency of the scale as a whole (Cronbach’s α = 0.805).ConclusionsThe Brazilian Portuguese FAS-IR showed sound psychometric properties for the evaluation of family accommodation, and is, therefore, a reliable instrument for use in research and clinical practice.     

Development of a screening instrument to assess premenstrual dysphoric disorder as conceptualized in DSM-5

ObjectiveThis study aimed at developing and validating a screening instrument to assess premenstrual dysphoric disorder (PMDD) based on DSM-5 criteria, which is not yet available.MethodsThe Premenstrual Dysphoric Disorder Questionnaire for DSM-5 (Cuestionario del Trastorno Disfórico Premenstrual – DSM-5), a 25-item questionnaire to assess PMDD was developed and completed in Spanish by 2820 women (Age M = 23.43; SD = 7.87). Exploratory factor analysis (N = 1410) and confirmatory factor analysis (N = 1410) were performed in randomly selected subsamples. Empirical evidence of construct validity was obtained via a multitrait-multimethod approach (N = 118). Additional validity evidence was provided by associating PMDD with Neuroticism. Internal consistency and test–retest reliability were checked.ResultsExploratory and confirmatory factor analyses yielded a bi-dimensional structure. The first dimension, called Dysphoria, included dysphoric symptoms and weight gain; the second dimension, Apathy, referred to apathetic and physical symptoms. Both dimensions displayed good internal consistency coefficients (Dysphoria's ordinal alpha = 0.88; Apathy's ordinal alpha = 0.84), and moderate temporal stability. The multitrait-multimethod analysis showed that convergent coefficients were higher than discriminant coefficients. Furthermore, a positive relationship between Neuroticism and PMDD was observed.ConclusionThese findings suggest that the instrument is valid and reliable to assess PMDD.     

Measuring attitudes towards suicide: Preliminary evaluation of an attitude towards suicide scale

ObjectivesOur study aimed to validate a previously published scale assessing attitudes towards suicide. Factor structure, convergent and discriminant validity, and predictive validity were investigated.MethodAdult German participants (N = 503; mean age = 24.74 years; age range = 18–67 years) anonymously completed a set of questionnaires. An exploratory factor analysis was conducted, and incongruous items were deleted. Subsequently, scale properties of the reduced scale and its construct validity were analyzed. A confirmatory factor analysis was then conducted in an independent sample (N = 266; mean age = 28.77 years; age range = 18–88 years) to further confirm the factor structure of the questionnaire.ResultsParallel analysis indicated a three-factor solution, which was also supported by confirmatory factor analysis: right to commit suicide, interpersonal gesture and resilience. The subscales demonstrated acceptable construct and discriminant validity. Cronbach's α for the subscales ranged from 0.67 to 0.83, explaining 49.70% of the total variance.ConclusionsPositive attitudes towards suicide proved to be predictive of suicide risk status, providing preliminary evidence for the utility of the scale. Future studies aiming to reproduce the factor structure in a more heterogeneous sample are warranted.     

The history of sleep apnea is associated with shorter leukocyte telomere length: the Helsinki Birth Cohort Study

ObjectivesSleep apnea poses an elevated risk for chronic age-related diseases. Leukocyte telomere length (LTL), a biomarker and factor associated with accelerated cellular aging processes, may serve as a novel mechanism underlying these disease risks. We investigated if a history of clinician-diagnosed sleep apnea or primary snoring was associated with LTL in later adulthood.MethodsData on sleep apnea, primary snoring and LTL, were available for 1948 participants from the Helsinki Birth Cohort Study. Patients with sleep apnea (n = 44) and primary snoring (n = 29) severe enough to be recorded as an inpatient diagnosis for hospitalization were identified by their case records through the Finnish Hospital Discharge Register. The LTL was measured by using the realtime quantitative polymerase chain reaction (PCR) method at a mean age of 61.5 years (standard deviation [SD], 2.9).ResultsA history of sleep apnea was associated with shorter LTL (P = .010). Adjustment for a number of covariates did not alter the association.ConclusionsAccelerated cellular aging reflected in shorter LTL in patients with a history of sleep apnea may partly explain their higher risk for age-related diseases. Future studies elucidating the impacts of long-term or successful treatment history of sleep apnea on the maintenance of LTL are warranted.     

Clinical predictors for favorable outcomes from endovascular recanalization in wake-up stroke

Background and purposePatients who have acute stroke symptoms present on awakening are ineligible for standard intravenous thrombolysis due to the unclear onset time of symptoms. Some of these wake-up stroke (WUS) patients may benefit from endovascular recanalization. This study aimed to evaluate clinical predictors of outcomes from endovascular recanalization in WUS patients.MethodsForty-one WUS patients with internal carotid (ICA) or middle cerebral artery (MCA) occlusion treated with endovascular recanalization were reviewed. Regression analysis was performed to measure clinical predictors of outcomes from endovascular recanalization in WUS patients.ResultsThe mean initial NIHSS score was 16.41 ± 4.96 (5–24). The mean symptom recognition-to-door time (SRDT) was 108.85 ± 65.80 (19–230) min. Successful recanalization (TICI 2b-3) was achieved in 29 patients (70.7%). Thirty-four patients improved on NIHSS (amount 7.59 ± 4.84, range; 1–17) at 7 days after recanalization. At 90 days after recanalization, a mRS of ≤2 was achieved in 19 patients (46.3%) and a mRS of ≤3 was achieved in 24 patients (58.5%). No symptomatic intracerebral hemorrhage occurred. Multivariate regression analysis identified SRDT (P = 0.019), successful recanalization (P = 0.005), and hypertension (P = 0.013) were factors associated with an improvement of the NIHSS score. For a good functional outcome at 90 days, SRDT (P = 0.036) and initial NIHSS score (P = 0.016) were found to be significant predictors.ConclusionsThe results of this study suggest that the SRDT is an independent predictor of both an improvement of NIHSS score and a good functional outcome in endovascular recanalization for WUS patients.     

Employment program for patients with severe mental illness in Malaysia: A 3-month outcome

ObjectiveThis study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI).MethodsA cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment.ResultsThe rate of successful employment at 3 months was 68.3% (n = 81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p < 0.021; OR 6.12; [95% CI 2.1–11.9]) and getting a preferred job (p < 0.032; [OR 4.021; 95% CI 1.83-12.1]).ConclusionResults showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.     

Validation of Chinese version of the Morisky Medication Adherence Scale in patients with epilepsy

PurposeThis study aimed to validate a Chinese version of the Morisky Medication Adherence Scale (MMAS-8) in patients with epilepsy. The relationships between adherence, seizure frequency, and adverse effects were assessed using this method.MethodsData from patients diagnosed with epilepsy at the Department of Neurology of Huashan Hospital were collected between January and June 2013. To validate the MMAS-8, internal consistency, test–retest reliability, and factor analysis were calculated. Relationships between adherence, seizure frequency, and adverse effects were assessed using Pearson's correlation.ResultsOne hundred and eleven patients were recruited. The MMAS-8 had moderate internal consistency (Cronbach's α = 0.556) and good test–retest reliability (intraclass correlation coefficient = 0.729). The MMAS-8 adherence rate was 79.2%. MMAS-8 adherence was negatively correlated with seizure frequency and adverse effects (r = –0.708, p < 0.001; r = –0.484, p < 0.001).ConclusionThe MMAS-8 scale can be used as a tool to assess medication adherence in Chinese patients with epilepsy. Better seizure control and lower rates of adverse effects were significantly correlated with higher adherence scores.     

Facing Your Fear of COVID-19: Resilience as a Protective Factor Against Burnout in South African Teachers

ObjectiveFrontline workers have been distinctively impacted by the rapid spread of the COVID-19 pandemic. Teachers, as frontline employees in the educational system, had to contend with unprecedented changes to their work role, as well as new job demands coupled with insufficient resources and the effects of the pandemic on their personal lives. While some teachers struggled to cope and reported intense levels of fear of COVID-19 and burnout, others were able to adapt and experienced a sense of growth and accomplishment. Therefore, the current study aimed to examine the role of resilience in the relationship between fear of COVID-19 and burnout among South African schoolteachers using a survey design.Materials and methodsSchoolteachers in South Africa (n = 355) were administered the Maslach Burnout Inventory, the Fear of COVID-19 Scale, and the Connor–Davidson Resilience Scale-10.ResultsThe results showed a positive relationship between fear of COVID-19 and emotional exhaustion and depersonalization. Moreover, structural equation modeling confirmed a health-sustaining role for resilience as it had a significant direct effect on burnout. Resilience also partially mediated the impact of fear of COVID-19 on depersonalization as well as emotional exhaustion, and fully mediated the impact of fear of COVID-19 on personal accomplishment.ConclusionsOur findings underscore that promoting individual- and institutional-level strategies to support teachers is necessary to build resilience, especially in the context of the COVID-19 pandemic.     

Validation de la version française du Sexual Addiction Screening Test (SAST-Fr)

IntroductionThe Sexual Addiction Screening Test (SAST) is one of the most frequently used tools on the international level for assessing sexual addiction. This study aimed to translate the English version of the SAST, and adapt and test the psychometric properties of its French version (the SAST-Fr) by establishing its factor structure, internal consistency and convergent validity.MethodsThree hundred ninety eight voluntary participants were recruited online through specialized forums. Participants completed a sociodemographic questionnaire, the SAST-Fr and the diagnostic criteria of sexual addiction proposed by Goodman. We tested the psychometric properties of SAST-Fr through an exploratory factorial analysis, especially its internal consistency, using the Kuder-Richardson alpha (KR-20) given that the items were dichotomous. We also performed correlation analyses of Bravais-Pearson on numerical variables. Finally, we studied the predictive validity of Goodman's score in predicting SAST-Fr criteria using a ROC (Receiver Operating Characteristics) analysis.ResultsMean age of participants was 29.08 years (± 11.30) and included 54% of women (n = 215). Statistical analysis had shown that SAST-Fr had a one-factor structure explaining 31% of the variance, an excellent internal consistency (KR-20 = 0.90). We found significant correlation between SAST-Fr item scores and PEACCE scores (r = 0.87; P < 0.001) and Goodman's criteria (r = 0.79; P < 0.001).ConclusionOur results indicate that the psychometric properties of the French version of the SAST are comparable to its original English version with a one-factor structure. The SAST-Fr is a reliable and valid questionnaire to assess symptoms of sexual addiction.     

Psychometric properties of the Haitian Creole version of the Resilience Scale with a sample of adult survivors of the 2010 earthquake

BackgroundResilience is defined as the ability of people to cope with disasters and significant life adversities. The present paper aims to investigate the underlying structure of the Creole version of the Resilience Scale and its psychometric properties using a sample of adult survivors of the 2010 earthquake.MethodsA parallel analysis was conducted to determine the number of factors to extract and confirmatory factor analysis was performed using a sample of 1355 adult survivors of the 2010 earthquake from people of specific places where earthquake occurred with an average age of 31.57 (SD = 14.42). All participants completed the Creole version of Resilience Scale (RS), the Impact of Event Scale Revised (IES-R), the Beck Depression Inventory (BDI) and the Social Support Questionnaire (SQQ-6). To facilitate exploratory (EFA) and confirmatory factor analysis (CFA), the sample was divided into two subsamples (subsample 1 for EFA and subsample 2 for CFA).ResultsParallel analysis and confirmatory factor analysis results showed a good-fit 3-factor structure. The Cronbach α coefficient was .79, .74 and .72 respectively for the factor 1, 2 and 3 and correlated to each other. Construct validity of the Resilience scale was provided by significant correlation with measures of depression and social support satisfaction, but no correlation was found with posttraumatic stress disorder measure, except for factor 2.ConclusionsThe results reveal a different factorial structure including 25 items of the RS. However, the Haitian Creole version of RS is a valid and reliable measure for assessing resilience for adults in Haiti.     

Psychometric properties of Internet-administered measures of health anxiety: An investigation of the Health Anxiety Inventory,the Illness Attitude Scales,and the Whiteley Index

BackgroundThe Health Anxiety Inventory (HAI), the Illness Attitude Scales (IAS), and the Whiteley Index (WI) are three of the most widely used health anxiety measures, but their psychometric properties have not been investigated when administered via the Internet.MethodsWe investigated the three instruments' test–retest reliability, internal consistency, convergent, and discriminant validity and sensitivity to change using one sample (n = 111) of participants with severe health anxiety and one sample of healthy controls (n = 92).ResultsThe HAI, IAS, and WI showed high test–retest reliability (rs ≥ .80), good convergent, and discriminant validity and were sensitive to detect change. The HAI and IAS (αs ≥ .85), but not the WI (αs ≤ .60) demonstrated high internal consistency.ConclusionsThe HAI, IAS, and WI have good psychometric properties, except for the low internal consistency of WI, when used as Internet-administered measures of health anxiety. Using these measures over the Internet offers highly important advantages such as increased ease of administration, reduced attrition, and cost-efficient treatment evaluation.     

Psychometric properties of a caregiver illness perception measure for caries in children under 6 years old

ObjectiveBased on the Common-Sense Model of Self-Regulation (CSM), the Revised Illness Perception Questionnaire (IPQ-R) was developed to measure patients' perceptions of their chronic medical illness. Such a measure does not exist for dental conditions. This study describes psychometric properties of the IPQ-R for Dental (IPQ-RD) for parent/caregivers of children under 6 years of age.MethodsParent/caregivers (n = 160) of children aged < 6 years attending a pediatric dental clinic completed the IPQ-RD and a questionnaire assessing their socio-demographics, dental anxiety, oral health self-efficacy, and child's preventive dental visits. Dental charts were abstracted for child's decayed, missing, filled teeth (dmft) information. The 33-item IPQ-RD was tested for internal (construct, discriminant) and external validity (concurrent, convergent, discriminant) and reliability (internal consistency).ResultsConfirmatory factor analysis demonstrated that the eight-factor model in accordance with the CSM framework (identity, consequences–child, consequences–caregiver, control–child, control–caregiver, timeline, illness coherence, emotional representations) had good construct validity based on significant factor loadings and acceptable to excellent model fit (RMSEA = 0.078, CFI = 0.951). Concurrent validity was demonstrated by significant negative correlations and higher mean factor scores for five constructs for children without dental visits indicating inaccurate caregiver perception of cavities. Discriminant validity was suggested by non-relationship with external measures (dental anxiety, self-efficacy). Internal consistency of six IPQ-RD constructs was excellent (Cronbach's alpha > 0.74).ConclusionThe IPQ-RD is a valid and reliable measure to assess parent/caregivers' representation of young children's cavities with potential to be a valuable risk assessment tool for oral health behavioral research.     

Insight in schizophrenia–course and predictors during the acute treatment phase of patients suffering from a schizophrenia spectrum disorder

BackgroundTo analyse insight of illness during the course of inpatient treatment, and to identify influencing factors and predictors of insight.MethodsInsight into illness was examined in 399 patients using the item G12 of the Positive and Negative Syndrome Scale (“lack of insight and judgement”). Ratings of the PANSS, HAMD, UKU, GAF, SOFAS, SWN-K and Kemp's compliance scale were performed and examined regarding their potential association with insight. The item G12 was kept as an ordinal variable to compare insight between subgroups of patients.ResultsAlmost 70% of patients had deficits in their insight into illness at admission. A significant improvement of impairments of insight during the treatment (p < 0.0001) was observed. At admission more severe positive and negative symptoms, worse functioning and worse adherence were significantly associated with poorer insight. Less depressive symptoms (p = 0.0004), less suicidality (p = 0.0218), suffering from multiple illness-episodes (p < 0.0001) and worse adherence (p = 0.0012) at admission were identified to be significant predictors of poor insight at discharge.ConclusionThe revealed predictors might function as treatment targets in order to improve insight and with it outcome of schizophrenia.     

Psychometric properties of the Family Resilience Assessment Scale: A Singaporean perspective

Families of young people with chronic illnesses are more likely to experience higher levels of stress. In turn, their ability to cope with multiple demands is likely to affect young people's adaptation. The purpose of this study was to examine psychometric properties of the Family Resilience Assessment Scale (FRAS), an assessment tool that measures the construct of family resilience. A total of 152 young people with epilepsy, aged 13 to 16 years old, from KK Women's and Children's Hospital, Singapore, completed the FRAS along with the Rosenberg Self-Esteem Scale. Factor structure of the FRAS was examined. Exploratory factor analysis resulted in a 7-factor solution – meaning-making and positive outlook, transcendence and spirituality, flexibility and connectedness, social and economic resources (community), social and economic resources (neighbors), clarity and open emotional expression, and collaborative problem-solving – accounting for 83.0% of the variance. Internal consistency of the scale was high (α = 0.92). Family resilience was significantly correlated with higher levels of self-esteem. Our study provides preliminary findings that suggest that FRAS is a reliable and valid scale for assessing the construct of family resilience among young people with epilepsy in Singapore.     

Subjective wellbeing and longevity: Findings from a 22-year cohort study

ObjectiveThe health implications of positive affect (PA) are still a matter of debate. The present study examined the longitudinal relationships between subjective wellbeing (SWB) components (i.e., Life satisfaction, PA and negative affect (NA)) and all-cause mortality in older adults.MethodsDiscrete-time survival analysis within the structural equation modeling framework was applied to data from the PAQUID Cohort (n = 3777, baseline age 62–101 years) including ten time periods spanning 22 years. Time-invariant (age, gender, baseline life satisfaction, diabetes mellitus and hypercholesterolemia status) and lagged time-varying (PA, NA, dementia, functional status and self-rated health) predictors were included sequentially in the analyses.ResultsWhen included together in the model, only PA among the SWB components showed a significant association with longevity, which persisted (OR = .962, 95% CI = .938, .986) even after adjustment for the interaction between PA and NA, and after additional adjustment for prior medical conditions, functional status and self-rated health.ConclusionsIn congruence with positive psychology, PA proved to be an independent protective factor regardless of variations in NA, which did not seem to be a mortality risk factor.