What do we mean when we use the word ‘resilience’?
It’s widely accepted that when we talk about ‘resilience’ or ‘psychological resilience’, we are referring to an ability that some people show to withstand or quickly ‘bounce back’ from stress.
What can research tell us about resilience?
Researchers have been investigating psychological resilience for around 50 years. However, there have been a number of limitations with this research. For example, although we usually talk about psychological resilience as an ability to withstand stress, most researchers have not actually investigated their proposed resilience factors in relation to stress. Instead, they have simply measured their factor directly in relation to an outcome they’re interested in. For example, they have measured perceptions of social support in relation to wellbeing. They have found that high social support is linked with higher wellbeing, like this:
However, if you think about it, the opposite of perceived social support is loneliness. And in fact, a number of researchers have previously shown us that feelings of loneliness are linked with indicators of poorer wellbeing, like this:
As you can see, this kind of ‘resilience’ research is not really telling us anything more than we used to learn from studies of risk factors!
So can resilience research tell us anything new?
Yes. However, we have to research it in the same way that we talk about: we need to study which variables reduce the likelihood that exposure to stressors will lead to negative outcomes. If we draw this out, it would look like this:
To provide researchers with a guide for doing this kind of research, and to clarify the criteria that a variable should meet in order to be considered as conferring resilience, I have gathered these ideas together in a framework called ‘The Bi-Dimensional Framework’ (BDF) for resilience research (Johnson, 2016, Johnson et al., 2010a, Johnson et al., 2010b).
What advantages does the BDF offer resilience researchers?
- It overcomes the confusion caused by the range of terms that have been used to describe ‘resilience’
There have been a lot of words used in the research literature to describe psychological resilience, these include ‘mental toughness’, and ‘hardiness’, amongst others. This can be confusing. However, the BDF defines psychological resilience according to methodological criteria (i.e., what a variables does, or how it behaves), rather than terminology. It suggests that resilience factors are psychological variables which buffer the association between stress exposure (or exposure to risk factors) and the likelihood of negative outcomes. In particular, the BDF states that for low resilience individuals, there should be a clear increase in negative outcomes in relation to the amount of stress they experience. However, for high resilience individuals, there should be minimal increase in negative outcomes, no matter how much stress they experience. If we were to draw this relationship out, it would look like this:
- It means we can use research to develop increasingly accurate concepts of resilience
In the past it has been common practice to propose a concept of psychological resilience, create a questionnaire to measure this, and then test it in relation to negative outcomes. If it is linked with lower levels of negative outcomes, the researchers conclude that the variable confers resilience. If it doesn’t, the researchers conclude that resilience doesn’t confer resilience in this instance. As outlined above, this doesn’t tell us whether the variable does indeed buffer the impact of stress. However, even more confusingly, how can a ‘resilience’ factor not confer resilience?! If this concept doesn’t confer resilience, then by the very definition of psychological resilience we must conclude that it is not in fact resilience at all. Instead, we could surmise that there are other factors which confer psychological resilience, which are not related to this concept.
This points to a need for concepts of psychological resilience which can be developed and adapted in response to research. As a framework for resilience research, the BDF allows for this kind of growth and development. In particular, it enables the systematic review of individual studies which have investigated factors which buffer the relationship between stress exposure and negative outcomes.
What do these reviews tell us?
Together with my collaborators, I have conducted two systematic reviews of resilience factors using the BDF approach, both of which have been published in a leading psychology journal (Johnson et al., 2016, Johnson et al., 2011). The first of these investigated psychological variables which buffer the relationship between exposure to any risk factor and suicidal thoughts. This suggested that hope, flexible thinking, self-confidence and a good way of looking at events conferred psychological resilience (Johnson et al., 2011). The second investigated psychological variables which buffer the relationship between exposure to failure experiences and psychological distress. This found that mental flexibility, higher self-esteem and a positive way of explaining events confer resilience to distress in response to failure (Johnson et al., 2016).
Together, these reviews suggest that even if you look at different kinds of negative outcomes, similar variables seem to confer psychological resilience. These variables relate to mental flexibility, self confidence and self-esteem, and a positive way of explaining events.
Can we train people to be more resilient?
Yes. The factors identified by these reviews (mental flexibility, self-esteem and self confidence and explanatory style) are those which are commonly targeted in cognitive-behaviour therapy, which is an evidence-based form of psychological therapy. CBT was initially developed as an intervention for people with mental health problems, but has since been found to be effective for improving mental wellbeing in a range of populations. With a collaborator in Australia, Dr Reema Harrison, I have been developing an intervention plan for training medical students in resilience which draws on CBT. This intervention is designed to train participants in resilience through three 60-minute workshops based on the principles of cognitive-behaviour therapy. These workshops will involve psychoeducation, experiential exercises and group work. We will be piloting this in Sydney in January 2017, and plan to then test this in subsequent research studies in different populations.
JOHNSON, J. 2016. Resilience: The Bi-dimensional Framework. . In: WOOD, A. M. & JOHNSON, J. (eds.) Positive Clinical Psychology. Chichester: Wiley.
JOHNSON, J., GOODING, P. A., WOOD, A. M. & TARRIER, N. 2010a. Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS). Behaviour Research and Therapy, 48, 179-186.
JOHNSON, J., GOODING, P. A., WOOD, A. M., TAYLOR, P. J., PRATT, D. & TARRIER, N. 2010b. Resilience to suicidal ideation in psychosis: Positive self-appraisals buffer the impact of hopelessness. Behaviour Research and Therapy, 48, 883-889.
JOHNSON, J., PANAGIOTI, M., RAMSEY, L., BASS, J. & HARRISON, R. 2016. Resilience to emotional dysfunction in response to failure or error: A systematic review. Clinical Psychology Review, In press.
JOHNSON, J., WOOD, A. M., GOODING, P., TAYLOR, P. J. & TARRIER, N. 2011. Resilience to suicidality: The buffering hypothesis. Clinical Psychology Review, 31, 563-591.
Originally published 23rd Nov 2016 at https://www.psychreg.org/building-psychological-resilience/