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Erichsen implied that in railway accidents, invisible injuries and nervous shock were produced by shakes or concussions of the spinal cord, something he called "railway spine". The symptoms were described as being pale, feeling shaky, bursting into tears, including a state of "natural perturbation of the mind" after the railway accident, often followed by insomnia, anxiety, feeble pulse, etc. The injury of the nervous system was explained by drawing an analogy between nervous shock and the effects of a magnet struck by a heavy blow with a hammer.

In the following half-century, the notions of trauma injury and nervous shock continued to evolve through the works of scientists such as Jean-Martin Charcot, Pierre Janet, W. Rivers, and Ivan Pavlov. Toward the turn of the 20th century and the years following First World War, Sigmund Freud turned his attention to trauma as the origin of hysterical attacks and to what was later described as "traumatic war neuroses". Moving away from neurological explanations, Freud attributed the symptoms of hysteria as resulting from reminiscences or memories of the traumatic experience, also called "traumatic memory.

This collection of polymorphic symptoms was later labelled as "shell shock" by the Royal Army Medical Corps and was attributed to the exposure to explosives in the frontlines Interestingly, the explanation for "shell shock" was in many ways similar to the "railway spine": the exposure to shock waves produced by the proximity to an explosion caused concussions and vascular disturbances, resulting in microscopic injuries and damage to histological structures in the brain and spinal cord.

During the Second World War, large numbers of US troops exposed to combat developed a wide variety of psychiatric symptoms, often classified under the general rubric of "war neuroses". Many of these cases were described as clinical syndromes and labelled as "anxiety", "conversion states", "somatic regressions" or "psychosomatic disturbances", and treated accordingly with a wide set of therapies: abreactive therapy, drug-induced sleep, convulsive shocks, psychotherapy, and occupational therapy.

As proposed by Kirmayer 36 , trauma can be seen at once as a sociopolitical event, a psycho-physiological process, a physical and emotional experience, usually followed by an explanation and a narrative theme. From this perspective, it can be argued that war trauma cannot only be expressed on a political level but can also be verified at multiple levels of experience: physiological changes e. From a biomedical perspective, the neurobiology of trauma provides evidence that PTSD is biologically different from other traumatic and non-traumatic stress responses.

A recent review of the neurobiology of PTSD 37 points at three important sets of research findings: noradrenergic axis changes, neuroendocrine changes involving the hypothalamic-pituitary-adrenocortical HPA axis, and neuro-anatomic changes involving the hippocampus. In addition to noradrenergic changes, the exposure to extreme violence and acute stress brings out neuroendocrine changes modulated by the HPA axis: the release of corticotropin-releasing hormone stimulates adrenocorticotropic hormone, which in turn stimulates cortisol a primary stress hormone secretion.

Cortisol activates a cascade of physiologic stress-related responses. In chronic non-traumatic stress HPA axis patterns seem to behave differently as shown by lower urinary cortisol levels in veteran PTSD inpatients. In animals exposed to stressors of disrupted attachment, researchers have found damaged cells in the hippocampal region of the brain also measured by hippocampal volume similar to the damage induced by glucocorticoids directly implanted in the hippocampus. This preliminary evidence of changes in the hippocampal volumes as measured by magnetic resonance imaging in combat veterans and healthy controls suggests that changes in size and function of the hippocampus and the amygdala may be an important feature of chronic PTSD Current trauma research is being undertaken not only by neuroscientists, but also by clinicians and psychologists, as well as political scientists, anthropologists, and historians.

However, the majority of published studies focus on one possible main outcome of exposure to violence: Posttraumatic Stress Disorder PTSD. The core set of disturbances and symptoms associated with PTSD are assumed to be caused by stressful experiences "outside the range of usual human experience", and connected with the Vietnam War as experienced by former combatants and patients of the US Veterans Administration. The diagnostic construct of PTSD is characterised by three main aspects: 1 the repeated reliving of memories of the traumatic experience intense sensory and visual memories and intrusive recollections of the event, accompanied by extreme distress ; 2 avoidance of reminders of the trauma, including emotional numbing, detachment and withdrawal, associated with an inability to experience joy and pleasure; and 3 a pattern of increased arousal hypervigilance, irritability, sleep disturbances, and an exaggerated startle response.

In chronic forms of PTSD, the pattern of hyperarousal and avoidance may be the dominant clinical features Since the early s, trauma has emerged as a key heuristic concept in much of mental health research, from developmental effects of early trauma to personality disorders to psychosis.

However, some authors have begun to seriously challenge psychological or psychiatric models that posit the existence of biological, psychological, and social mechanisms, which are based on assumptions of universality of PTSD. Trauma exposure and PTSD have been associated with worse physical health but the relative roles of trauma exposure, with PTSD and the overall context are still contested However, these persons most often display a variety of complaints and psychological problems e. Over the last few decades, the language of violence, terror and dislocation has often been conflated with the discourse of trauma and stress.

In Western popular and professional traditions "trauma" has become a dominant category to explain at times the origins or cause of other problems, at times the consequences of exposure to violence brought by conflict and war. It is in the West where "trauma" has become an emblematic category that is ubiquitous and invasive in our everyday life. Its use has reached epidemic proportions: the media, the public, the sports and the arts, the scientific and the profane, all are claiming the universality of "trauma" as an unavoidable outcome of exposure to violence.

This rapidly expanding phenomenon has widely disseminated and not only popularised the notion of trauma in the general population, but also transformed its meaning and lead to what has been called the "metamorphosis of trauma". Psychiatric teams or trauma counsellors are immediately mobilised after train and plane crashes, natural or man-made disasters, or other incidents, like a shooting or a bank robbery. In the Western nations, the growing of counselling services into almost every corner of life has escaped much critical enquiry, which is largely due to the difficulties of discerning when an unpleasant emotional state ends and a clinical syndrome or an abnormal state begins.

The ever expanding and inclusive definition of trauma has made the objective assessment of its existence problematic, and one should exercise caution in trying to measure it. Emerging questions: outlining a regional research agenda. From the cursory review of the literature, a few central questions relevant to the Latin American region begin to emerge: What is the short, medium and long-term health impact of extreme and sustained forms of violence in the local populations? Are PTSD and other trauma-related disorders universal outcomes of violence, which can be applied as such to Latin American and Caribbean populations?

What are the risk factors predicting those who will be most affected by exposure to extreme violence? What is the role of other social ills, such as racism and social exclusion, alongside poverty and wars, in determining the health and disease equation? What is the social production of collective and individual suffering? What is the role of other forces at play such as resilience, coping skills, and the density and quality of social support networks?

What are the most effective interventions for promoting resilience and strengthening social cohesion in a given population affected by conflict and violence? What are, then, the biopsychosocial pathways, if any, between ethnic conflict, political violence, wars and mental health outcomes? How does this web of causes, linkages, and pathways determine the level of suffering, disease and death in a given population? By what mechanisms do social forces ranging from poverty to racism and political violence become embodied as individual experience?

Most of these questions have no definite answer yet. In fact, as we have seen above, scientists have been concerned about these questions since the end of the 19th century, when the meaning of "trauma" was extended from physical injury to include psychogenic ailments. But it is in the last few decades that trauma research has erupted as a major field of enquiry and taken a more ubiquitous and comprehensive character.

When trying to explain disease occurrence, distress, and social suffering in relation to violence, the contextual issues of poverty and social inequalities cannot be ignored. Critical social scientists believe that not being explicit about the context social, political, and economic sources of inequality contributes to an inadequate reading of the realities in which suffering and disease are produced. The neglect of the social origins of pain and suffering often results in immodest claims of causality, increases the bias toward medicalization of social problems, and ultimately leads to the widening of social inequalities.

In assessing and reacting to trauma-related conditions, it is crucially important to not only focus on the narratives of trauma and the meaning of the illness experience, but also to understand and to act on the context; that is, on the social and political determinants of health and human suffering, while staying aware of the particular stakes and interests of a given perspective and of the cultural diversity of individual and collective healing and coping responses. As we have seen in the previous section, the medical model of trauma, however, has important limitations in capturing the complex ways in which individuals, communities, and larger groups experience massive trauma, socialize their grief, and reconstitute a meaningful existence.

It has been suggested that in Latin American populations, the sequelae of trauma are experienced as a cluster of signs and symptoms transcending the narrow boundaries of PTSD and manifested in local idioms of distress and diverse somatoform disorders From an epidemiological perspective, the magnitude and distribution of trauma-related disorders as a collective experience in local populations of the region, exposed to political violence and contemporary wars, is far from being understood. There are few and random findings, undeveloped frames for analysis and an overall lack of hypotheses on basic issues about how people experience and are affected by political violence, ethnic conflict, and wars.

Clearly, women, mainly widows and the elderly, were the most affected, not only by the long-term effects of exposure to traumatic events, but also indirectly by the disruption of their social networks, low social cohesion and relative isolation from their peers, lack of food and shelter, and other conditions generally related to the overall collapse of the local economy and extremely adverse conditions, imposed by Shining Path guerrillas and military repressive forces operating in the region We know that most contemporary conflicts and modern warfare affect civilian populations many times more than the armed forces directly involved in the conflict in modern warfare, death rates among the military have dropped considerably.

We also know, at least in the Latin American region, that most of these armed conflicts involve politically marginal, ethnically distinct peoples, so-called "fourth-world" peoples Mass terror becomes a deliberate strategy followed by both insurgent and repressive armies: the destruction of houses, schools, religious buildings, roads and bridges, animals and crops, as well as torture, rape and incarceration are commonplace.

Modern warfare is concerned not only to annihilate life, but also to destroy "ways of life", trying to eliminate entire ethnic groups and eradicate entire cultures and social systems, thus undermining the critical means whereby people endure and recover from suffering and loss Finally, we know from previous epidemiological research conducted among survivors of the Nazi holocaust that only a fraction of persons exposed to traumatic events develop long-term symptomatology compatible with PTSD Today, there is no humanitarian intervention or rehabilitation program that can neglect the reconstruction of the social tissue as a primary concern.

Still, in every village or small scale community, there are endogenous, protective or ameliorative influences which are largely derived from resilient structures, as well as survival and conflict resolution strategies followed by communities in post-conflict. Some of these include: community-based strategies for reconciliation, ideological shifts for instance, conversion into other religions or political conversions , spontaneous forms of enhancing social support e.


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Preserving and strengthening such cultural forms of support for healing and coping must be a priority in psychosocial interventions While in the near future psychotropic drugs, counselling and psychotherapeutic techniques may become an important part of the armamentarium for targeted clinical interventions, we should not ignore the importance of indigenous resources for coping and healing, neither that a significant proportion of persons spontaneously recover from the exposure to extreme violence. In spite of the various forms of individual therapy available whether proven effective or not , we should acknowledge that the medicalization of rehabilitation programs, limited to the uncritical application of check-lists and provision of "trauma counselling", reflects a narrow understanding of the relationships among critically important social determinants of distress and the range of possible health outcomes after exposure to traumatic events.

Moreover, we still know little of who should receive individual therapy, and even less about how and why does it work in some cases and not in others 8. Furthermore, we must admit to have limited knowledge concerning how to build up, repair and reinforce social bonds and support networks, foster resilience, and increase social cohesion or social capital in societies that have been devastated by distress, massive trauma and dislocation.

Finally, most trauma intervention initiatives are expensive ventures being imported into war scenarios across the world: the West Bank, Bosnia, Rwanda, South Africa, Central America, Peru, Nepal, Bangladesh, etc. We must acknowledge that these world scenarios have differing norms, values and traditions, a range of attributions and understandings, different ways of expressing emotions, distress and suffering, and different ways of help-seeking, healing and coping with traumatic events.

Implications for humanitarian assistance and psychosocial rehabilitation programs. As a corollary of the preceding discussion, it seems timely to review some basic principles or steps to be followed, which may prove useful when designing psychosocial interventions in post-conflict situations for Latin America and the Caribbean region. These are mostly based on similar observations made by Ager 44 in war-affected populations, which were field tested and confirmed by our own experience developing a post-conflict stabilization and psychosocial rehabilitation program in the Peruvian highlands First, all intervention initiatives in any given setting should be planned in a manner that involves minimal disruption of intact endogenous protective influences.

That is, where community resilient structures and social networks have survived through conflict, assistance programs must explicitly seek to preserve those endogenous resources for coping and healing, instead of trying to replace them with outside help. Second, where protective influences have been deactivated or are perceived clearly insufficient to ameliorate distress and experienced trauma, the intervention should aim at reestablishing protective mechanisms and provision of compensatory support from the outside , such as community development initiatives, income-generating activities provision of small credit or financial assistance or peace education programs.

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Only when the above steps have been established and after a careful assessment of existing needs that have remained unmet, a third step can be implemented in form of a package of targeted therapeutic interventions directed to individuals, families and specific groups demanding specific attention or care. Depending on the resources available, screening and passive search of trauma cases could be performed by trained nurses among the clientele demanding medical services. Alternatively, case finding could be delegated to the community structures in place i. The therapeutic interventions should also take into account the indigenous resources available and the community experience in what may or may not work as an effective solution.

In other words, this phase should be clearly participatory; and the services to be provided derived as a negotiated product with the community at large and vulnerable groups i. In designing humanitarian responses and strategies for healing and coping with violence and adversity, we need to replace the current narrow focus on the intrapsychic and psychological mechanisms, with a wider approach aimed at the social context and community life in which people recover from traumatic experiences.

It involves a concern to help rebuilt, or invent anew, the social structures through which lives are lived and found to have a meaning. Normalization and recovery, from this perspective, touches all aspects of social and economic survival, involving the context in which development and learning takes place and, for all people, it involves the notions of social justice, solidarity, reconciliation and the break of the cycles of violence and impunity Ongoing experiences in post-conflict stabilization and psychosocial rehabilitation in the Latin American region suggest that the goals for peace, reconciliation and economic recovery cannot be secured by unilateral ad hoc interventions aimed exclusively at trauma victims and their families.

The underlying problems require the participation across the range of sectors agriculture, finance, credit, health, education and justice , which may in turn involve establishing an open dialogue with the international agencies, donors and financial institutions as well as with national, regional, and local authorities. Pedersen D. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being. Soc Sci Med ; 55 2 The post-war public health effects of civil conflict.

Soc Sci Med ; 59 4 Tuberculosis mortality during a civil war in Guinea-Bissau. JAMA ; 5 Mortality in Eastern Democratic Republic of Congo. New York: International Rescue Committee; Parker R. Am J Publ Health ; 92 3 Elbe S. The Adelphi Papers ; 1. United Nations Children's Fund. The state of the world's children. Oxford: Oxford University Press; Yehuda R, Hyman SE. The impact of terrorism on brain, and behavior: what we know and what we need to know. Neuropsychopharmacology ; Young A. The harmony of illusions: inventing post-traumatic stress disorder. Bracken PJ, Petty C, editors.

Rethinking the trauma of war. Summerfield D. War and mental health: a brief overview. BMJ ; Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev ; Kobasa SC. Stressful life events, personality, and health: an enquiry into hardiness. J Pers Soc Psychol ; 37 1 Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies.

J Child Psychol Psychiatry ; 44 8 Bourdieu P. The forms of capital. In: Richardson JG, editor. Handbook of theory and research for the sociology of education. New York: Greenwood; Antonovsky A. Unraveling the mystery of health: how people manage stress and stay well. Resilience is generally thought of as a "positive adaptation" after a stressful or adverse situation.

It is still unknown what the correct level of stress is for each individual. Some people can handle greater amounts of stress than others. According to Germain and Gitterman , stress is experienced in an individual's life course at times of difficult life transitions, involving developmental and social change; traumatic life events, including grief and loss; and environmental pressures, encompassing poverty and community violence. Resiliency allows a person to rebound from adversity as a strengthened and more resourceful person.

The first research on resilience was published in The study used epidemiology , which is the study of disease prevalence, to uncover the risks and the protective factors that now help define resilience. Emmy Werner was one of the early scientists to use the term resilience in the s.

She studied a cohort of children from Kauai , Hawaii. Kauai was quite poor and many of the children in the study grew up with alcoholic or mentally ill parents. Many of the parents were also out of work. However, one-third of these youngsters did not exhibit destructive behaviours. Werner called the latter group 'resilient'. Resilience also emerged as a major theoretical and research topic from the studies of children with mothers diagnosed with schizophrenia in the s.

On the other hand, some children of ill parents thrived well and were competent in academic achievement, and therefore led researchers to make efforts to understand such responses to adversity. Since the onset of the research on resilience, researchers have been devoted to discovering the protective factors that explain people's adaptation to adverse conditions, such as maltreatment, [15] catastrophic life events, [16] or urban poverty.

Researchers endeavor to uncover how some factors e. In all these instances, resilience is best understood as a process. However, it is often mistakenly assumed to be a trait of the individual, an idea more typically referred to as "resiliency". When people are faced with an adverse condition, there are three ways in which they may approach the situation.

Only the third approach promotes well-being. It is employed by resilient people, who become upset about the disruptive state and thus change their current pattern to cope with the issue. The first and second approaches lead people to adopt the victim role by blaming others and rejecting any coping methods even after the crisis is over. These people prefer to instinctively react, rather than respond to the situation. Those who respond to the adverse conditions by adapting themselves tend to cope, spring back, and halt the crisis. Negative emotions involve fear, anger, anxiety, distress, helplessness, and hopelessness which decrease a person's ability to solve the problems they face and weaken a person's resiliency.

Constant fears and worries weaken people's immune system and increase their vulnerability to illnesses. These processes include individual continuous coping strategies, or may be helped by a protective environment like good families , schools, communities, and social policies that make resilience more likely to occur. These factors are likely to play a more important role, the greater the individual's exposure to cumulative risk factors.

Three notable bases for resilience—self-confidence, self-esteem and self-concept —all have roots in three different nervous systems—respectively, the somatic nervous system , the autonomic nervous system and the central nervous system. An emerging field in the study of resilience is the neurobiological basis of resilience to stress. There is some limited research that, like trauma, resilience is epigenetic —that is, it may be inherited—but the science behind this finding is preliminary. Studies show that there are several factors which develop and sustain a person's resilience: [28].

Resilience is negatively correlated with personality traits of neuroticism and negative emotionality, which represents tendencies to see and react to the world as threatening, problematic, and distressing, and to view oneself as vulnerable. Positive correlations stands with personality traits of openness and positive emotionality, that represents tendencies to engage and confront the world with confidence in success and a fair value to self-directedness. There is significant research found in scientific literature on the relationship between positive emotions and resilience. Studies show that maintaining positive emotions whilst facing adversity promote flexibility in thinking and problem solving.

Positive emotions serve an important function in their ability to help an individual recover from stressful experiences and encounters. That being said, maintaining a positive emotionality aids in counteracting the physiological effects of negative emotions. It also facilitates adaptive coping, builds enduring social resources, and increases personal well-being. Formation of conscious perception and monitoring one's own socioemotional factors is considered as a stability aspect of positive emotions.

Individuals who tend to approach problems with these methods of coping may strengthen their resistance to stress by allocating more access to these positive emotional resources. Positive emotions not only have physical outcomes but also physiological ones. Some physiological outcomes caused by humor include improvements in immune system functioning and increases in levels of salivary immunoglobulin A , a vital system antibody, which serves as the body's first line of defense in respiratory illnesses.

A study was done on positive emotions in trait-resilient individuals and the cardiovascular recovery rate following negative emotions felt by those individuals. The results of the study showed that trait-resilient individuals experiencing positive emotions had an acceleration in the speed in rebounding from cardiovascular activation initially generated by negative emotional arousal, i.

Grit refers to the perseverance and passion for long-term goals. High grit individuals display a sustained and focused application of self in problematic situations than less gritty individuals. Grit affects the effort a person contributes by acting on the importance pathway. When people value a goal as more valuable, meaningful, or relevant to their self-concept they are willing to expend more effort on it when necessary.

The influence of individual differences in grit results in different levels of effort-related activity when gritty and less gritty individuals performed the same task. Grit is associated with differences in potential motivation, one pathway in motivational intensity theory. Grit may also influence an individual's perception of task difficulty. Grit was highly correlated with the Big Five conscientiousness trait. Grit emphasizes long-term stamina, whereas conscientiousness focuses on short-term intensity.

Grit varies with level of education and age. More educated adults tend to be higher in grit than less educated individuals of the same age. In life achievements, grit may be as important as talent. College students at an elite university who scored high in grit also earned higher GPAs than their classmates, despite having lower SAT scores. Grit may also serve as a protective factor against suicide.

A study at Stanford University found that grit was predictive of psychological health and well-being in medical residents. Individuals high in grit also focus on future goals, which may stop them from attempting suicide. It is believed that because grit encourages individuals to create and sustain life goals, these goals provide meaning and purpose in life. Grit alone does not seem to be sufficient, however.

Only individuals with high gratitude and grit have decreased suicidal ideation over long periods of time. Gratitude and grit work together to enhance meaning in life, offering protection against death and suicidal thoughts or plans. A study was conducted among high achieving professionals who seek challenging situations that require resilience. Research has examined 13 high achievers from various professions, all of whom had experienced challenges in the workplace and negative life events over the course of their careers but who had also been recognized for their great achievements in their respective fields.

Participants were interviewed about everyday life in the workplace as well as their experiences with resilience and thriving. The study found six main predictors of resilience: positive and proactive personality, experience and learning, sense of control, flexibility and adaptability, balance and perspective, and perceived social support.

High achievers were also found to engage in many activities unrelated to their work such as engaging in hobbies, exercising, and organizing meetups with friends and loved ones. Several factors are found to modify the negative effects of adverse life situations. Many studies show that the primary factor for the development of resilience is social support.

Temperamental and constitutional disposition is considered as a major factor in resilience. It is one of the necessary precursors of resilience along with warmth in family cohesion and accessibility of prosocial support systems. Another protective factor is related to moderating the negative effects of environmental hazards or a stressful situation in order to direct vulnerable individuals to optimistic paths, such as external social support.

More specifically a study distinguished three contexts for protective factors: [51]. Furthermore, a study of the elderly in Zurich, Switzerland, illuminated the role humor plays as a coping mechanism to maintain a state of happiness in the face of age-related adversity. Besides the above distinction on resilience, research has also been devoted to discovering the individual differences in resilience.

Self-esteem , ego-control, and ego-resiliency are related to behavioral adaptation. Ego-control is "the threshold or operating characteristics of an individual with regard to the expression or containment" [54] of their impulses, feelings, and desires. Ego-resilience refers to "dynamic capacity, to modify his or her model level of ego-control, in either direction, as a function of the demand characteristics of the environmental context" [55].

Maltreated children who experienced some risk factors e. Furthermore, maltreated children are more likely than nonmaltreated children to demonstrate disruptive-aggressive, withdraw, and internalized behavior problems. Finally, ego-resiliency, and positive self-esteem were predictors of competent adaptation in the maltreated children. Demographic information e. Examining people's adaptation after disaster showed women were associated with less likelihood of resilience than men. Also, individuals who were less involved in affinity groups and organisations showed less resilience.

Certain aspects of religions, spirituality, or mindfulness may, hypothetically, promote or hinder certain psychological virtues that increase resilience. Research has not established connection between spirituality and resilience. According to the 4th edition of Psychology of Religion by Hood, et al.

In military studies it has been found that resilience is also dependent on group support: unit cohesion and morale is the best predictor of combat resiliency within a unit or organization.

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Resilience is highly correlated to peer support and group cohesion. Units with high cohesion tend to experience a lower rate of psychological breakdowns than units with low cohesion and morale. High cohesion and morale enhance adaptive stress reactions. In cognitive behavioral therapy , building resilience is a matter of mindfully changing basic behaviors and thought patterns. Self-talk is the internal monologue people have that reinforce beliefs about the person's self-efficacy and self-value. To build resilience, the person needs to eliminate negative self-talk, such as "I can't do this" and "I can't handle this", and to replace it with positive self-talk, such as "I can do this" and "I can handle this".

This small change in thought patterns helps to reduce psychological stress when a person is faced with a difficult challenge. The second step a person can take to build resilience is to be prepared for challenges, crises, and emergencies. Resilience is also enhanced by developing effective coping skills for stress. Coping skills include using meditation, exercise, socialization, and self-care practices to maintain a healthy level of stress, but there are many other lists associated with psychological resilience.

The Besht model of natural resilience building in an ideal family with positive access and support from family and friends, through parenting illustrates four key markers. They are:. In this model, self-efficacy is the belief in one's ability to organize and execute the courses of action required to achieve necessary and desired goals and hardiness is a composite of interrelated attitudes of commitment, control, and challenge. A number of self-help approaches to resilience-building have been developed, drawing mainly on the theory and practice of cognitive behavioral therapy CBT and rational emotive behavior therapy REBT.

Psychological resilience - Wikipedia

A meta-analysis of 17 PRP studies showed that the intervention significantly reduces depressive symptoms over time. The idea of 'resilience building' is debatably at odds with the concept of resilience as a process, [65] since it is used to imply that it is a developable characteristic of oneself. Bibliotherapy , positive tracking of events, and enhancing psychosocial protective factors with positive psychological resources are other methods for resilience building. Contrasting research finds that strategies to regulate and control emotions, in order to enhance resilience, allows for better outcomes in the event of mental illness.

These strategies focused on planning, positively reappraising events, and reducing rumination helped in maintaining a healthy continuity. The Head Start program was shown to promote resilience. Military organizations test personnel for the ability to function under stressful circumstances by deliberately subjecting them to stress during training. Those students who do not exhibit the necessary resilience can be screened out of the training. Those who remain can be given stress inoculation training.

The process is repeated as personnel apply for increasingly demanding positions, such as special forces. Resilience in children refers to individuals who are doing better than expected, given a history that includes risk or adverse experience. Once again, it is not a trait or something that some children simply possess. There is no such thing as an 'invulnerable child' that can overcome any obstacle or adversity that he or she encounters in life—and in fact, the trait is quite common. Research on 'protective factors', which are characteristics of children or situations that particularly help children in the context of risk has helped developmental scientists to understand what matters most for resilient children.

Two of these that have emerged repeatedly in studies of resilient children are good cognitive functioning like cognitive self-regulation and IQ and positive relationships especially with competent adults, like parents. However, this is not a justification to expose any child to risk. Children do better when not exposed to high levels of risk or adversity. Resilient children within classroom environments have been described as working and playing well and holding high expectations, have often been characterized using constructs such as locus of control , self-esteem , self-efficacy , and autonomy.

Communities play a huge role in fostering resilience. The clearest sign of a cohesive and supportive community is the presence of social organizations that provide healthy human development. Children who are repeatedly relocated do not benefit from these resources, as their opportunities for resilience-building, meaningful community participation are removed with every relocation. Fostering resilience in children requires family environments that are caring and stable, hold high expectations for children's behavior and encourage participation in the life of the family.

The definition of parental resilience, as the capacity of parents to deliver a competent and quality level of parenting to children, despite the presence of risk factors, has proven to be a very important role in children's resilience. Understanding the characteristics of quality parenting is critical to the idea of parental resilience. Numerous studies have shown that some practices that poor parents utilize help promote resilience within families.

These include frequent displays of warmth, affection, emotional support; reasonable expectations for children combined with straightforward, not overly harsh discipline; family routines and celebrations; and the maintenance of common values regarding money and leisure. Doob, "Poor children growing up in resilient families have received significant support for doing well as they enter the social world—starting in daycare programs and then in schooling.

Beyond preventing bullying , it is also important to consider how interventions based on emotional intelligence EI are important in the case that bullying does occur. Increasing EI may be an important step in trying to foster resilience among victims. When a person faces stress and adversity, especially of a repetitive nature, their ability to adapt is an important factor in whether they have a more positive or negative outcome.

A study examined adolescents who illustrated resilience to bullying and found some interesting gendered differences, with higher behavioral resilience found among girls and higher emotional resilience found among boys. Despite these differences, they still implicated internal resources and negative emotionality in either encouraging or being negatively associated with resilience to bullying respectively and urged for the targeting of psychosocial skills as a form of intervention.

Transgender youth experience a wide range of abuse and lack of understanding from the people in their environment and are better off with a high resilience to deal with their lives. A study was done looking at 55 transgender youths studying their sense of personal mastery, perceived social support, emotion-oriented coping and self-esteem. This means that transgender youths with lower resilience were more prone to mental health issues, including depression and trauma symptoms.

Emotion-oriented coping was a strong aspect of resilience in determining how depressed the individuals were. Pregnancies among adolescents are considered as a complication, as they favour education interruption, poor present and future health, higher rates of poverty, problems for present and future children, among other negative outcomes. Sotomayor Obstetric and Gynecology Hospital Guayaquil assessing resilience differences between pregnant adolescents and adults. Despite this, total CESD scores and depressed mood rate did not differ among studied groups.

Logistic regression analysis could not establish any risk factor for depressed mood among studied subjects; however, having an adolescent partner and a preterm delivery related to a higher risk for lower resilience. Oftentimes divorce is viewed as detrimental to one's emotional health, but studies have shown that cultivating resilience may be beneficial to all parties involved. The level of resilience a child will experience after their parents have split is dependent on both internal and external variables.

Some of these variables include their psychological and physical state and the level of support they receive from their schools, friends, and family friends.

Children will experience divorce differently and thus their ability to cope with divorce will differ too. This comes to show that most children have the tools necessary to allow them to exhibit the resilience needed to overcome their parents' divorce. The effects of the divorce extend past the separation of both parents. The remaining conflict between parents, financial problems, and the re-partnering or remarriage of parents can cause lasting stress.

Child support is often given to help cover basic needs such as schooling. If the parents' finances are already scarce then their children may not be able to participate in extracurricular activities such as sports and music lessons, which can be detrimental to their social lives. Repartnering or remarrying can bring in additional levels of conflict and anger into their home environment.

One of the reasons that re-partnering causes additional stress is because of the lack of clarity in roles and relationships; the child may not know how to react and behave with this new "parent" figure in their life. In the past, divorce had been viewed as a "single event", but now research shows that divorce encompasses multiple changes and challenges.

Certain programs such as the week Children's Support Group and the Children of Divorce Intervention Program may help a child cope with the changes that occur from a divorce. Resilience after a natural disaster can be gauged in a number of different ways. It can be gauged on an individual level, a community level, and on a physical level. The first level, the individual level, can be defined as each independent person in the community.

The second level, the community level, can be defined as all those inhabiting the locality affected. Lastly, the physical level can be defined as the infrastructure of the locality affected. The World Economic Forum met in to discuss resiliency after natural disasters. They conclude that countries that are more economically sound, and have more individuals with the ability to diversify their livelihoods, will show higher levels of resiliency. Little research has been done on the topic of family resilience in the wake of the death of a family member.

Resiliency is distinguished from recovery as the "ability to maintain a stable equilibrium" [] which is conducive to balance, harmony, and recovery.

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Families must learn to manage familial distortions caused by the death of the family member, which can be done by reorganizing relationships and changing patterns of functioning to adapt to their new situation. One of the healthiest behaviors displayed by resilient families in the wake of a death is honest and open communication. This facilitates an understanding of the crisis. Sharing the experience of the death can promote immediate and long-term adaptation to the recent loss of a loved one.

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Empathy is a crucial component in resilience because it allows mourners to understand other positions, tolerate conflict, and be ready to grapple with differences that may arise. Another crucial component to resilience is the maintenance of a routine that helps to bind the family together through regular contact and order. The continuation of education and a connection with peers and teachers at school is an important support for children struggling with the death of a family member.

Resilience has also been examined in the context of failure and setbacks in workplace settings. Beyond studies on general workplace reslience, attention has been directed to the role of resilience in innovative contexts. Due to high degrees of uncertainty and complexity in the innovation process, [] [] failure and setbacks are naturally happening frequently in this context. As a context-specific conceptualization of resilience, Innovator Resilience Potential IRP serves this purpose and captures the potential for innovative functioning after the experience of failure or setbacks in the innovation process and for handling future setbacks.

On the one hand, in this process, IRP can be seen as an antecedent of how a setback affects an innovator. On the other hand, IRP can be seen as an outcome of the process that, in turn, is influenced by the setback situation. Individualist cultures , such as those of the U. Independence, self-reliance, and individual rights are highly valued by members of individualistic cultures. Economic, political, and social policies reflect the culture's interest in individualism. The ideal person in individualist societies is assertive, strong, and innovative. Comparatively, in places like Japan, Sweden, Turkey, and Guatemala, Collectivist cultures emphasize family and group work goals.

The rules of these societies promote unity, brotherhood, and selflessness. Families and communities practice cohesion and cooperation. The ideal person in collectivist societies is trustworthy, honest, sensitive, and generous- emphasizing intrapersonal skills. Natural disasters threaten to destroy communities, displace families, degrade cultural integrity, and diminish an individual's level of functioning.

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In the aftermath of disaster, resiliency is called into action. Comparing individualist community reactions to collectivist community responses after disasters illustrates their differences and respective strengths as tools of resilience. Some suggest that disasters reduce individual agency and sense of autonomy as it strengthens the need to rely on other people and social structures. However, Withey and Wachtel conducted interviews and experiments on disaster survivors which indicated that disaster-induced anxiety and stress decrease one's focus on social-contextual information — a key component of collectivism.

In this way, disasters may lead to increased individualism. Mauch and Pfister questioned the association between socio-ecological indicators and cultural-level change in individualism. In their research, for each socio-ecological indicator, frequency of disasters was associated with greater rather than less individualism. Supplementary analyses indicated that the frequency of disasters was more strongly correlated with individualism-related shifts than was the magnitude of disasters or the frequency of disasters qualified by the number of deaths.