Natural Resilience and Innate Mental Health.

Comments on George Bonanno's article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see record 2004-10043-003). The author notes that Bonanno's article on loss, trauma, and resilience represents another important step toward pointing psychology in a more positive and fruitful direction. Bonanno was right; psychologists have dramatically underestimated the human capacity to thrive after extremely aversive events. More important, psychologists have also failed to realize that the human capacity for resilience, highlighted by Bonanno, is natural and normal, part and parcel of the innate health built into all human beings. Bonanno concluded from his review of the research on grieving and posttraumatic stress disorder that resilience to interpersonal loss and traumatic events is common and represents healthy adjustment. This conclusion points to the existence of an innate human psychological immune capacity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual Clarifications in the Study of Resilience.

Comments on George Bonanno's article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see record 2004-10043-003). The authors note that Bonanno's article on loss, trauma, and human resilience serves an important function for the field in drawing attention to the pseudoscientific mythologies that have grown up around brief normative (loss-related) and nonnormative (traumatic) stressors. As the author rightly pointed out, traditional assumptions regarding the absolute necessity of "grief work" in the case of loss and clinical debriefing following exposure to traumatic events may indeed be overdrawn (and overprescribed) in light of emerging evidence. Although there is much to like about Bonanno's analysis, several limitations inherent in the author's conceptualization of resilience are troubling in light of the history of developmental research in this area, much of which is cited in the target article. In essence, Bonanno defined adult resilience as an individual's capacity to resist maladaptation in the face of risky experiences (e.g., "stress resistance"). Although this is one plausible way of conceptualizing resilience, it is by no means an exclusive definition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Has Resilience to Severe Trauma Been Underestimated?

Comments on George Bonanno's article entitles Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see record 2004-10043-003). The author notes that Bonanno articulated a model of loss and trauma-related resilience cogently and evocatively. In the trauma field, there is a new focus on risk and resilience factors across the life span (e.g., King, Vogt, & King, 2004), and the article by Bonanno will serve as a herald for this new way of thinking about adjustment to trauma and loss. Because the author believes that the most important function of Bonanno's article should be to stimulate theory development and research in this burgeoning area, he raises three issues in service of that goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On Hardiness and Other Pathways to Resilience.

Comments on George Bonanno's article entitles Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events? (see record 2004-10043-003). The author of this comment notes that Bonanno's article is a compelling analysis of several different reactions to extremely aversive events. With regard to major stressors, such as the death of a loved one or the experience a life-threatening circumstance, there is, notably, not only the psychopathological breakdown (e.g., posttraumatic stress disorder [PTSD] or depressive disorder) that has been emphasized but also the less recognized resilient response, in which there is little or no loss of functioning. Whereas the emphasis in the breakdown response is understandably on treatment that facilitates recovery, the resilient response may require little but the person's own ongoing efforts in life to continue effectively. Indeed, Bonanno suggested that the typical treatment efforts following traumatic events might actually undermine the resilient person's adjustment efforts. Bonanno's conceptualization and supportive research evidence advance our understanding of individuals' reactions to massive stressors. Further, Bonanno (2004) argued that there are multiple pathways to resilience under stress, and he identified personality hardiness as one of them. His presentation of hardiness accurately emphasizes its interrelated attitudes of commitment (rather than alienation), control (rather than powerlessness), and challenge (rather than threat) but does not cover how this concept has evolved over the last 25 years. Coordinating theory, research, and practice over this period of time, the author has concluded (Maddi, 2002) that hardy attitudes amount to the courage and motivation to face stressors accurately (rather than to deny or catastrophize them). This courage and motivation lead to coping by problem solving rather than by avoiding and to interacting with others by giving and getting assistance and encouragement rather than by striking out or overprotecting. Thus, personality hardiness is emerging as a pattern of attitudes and actions that helps in transforming stressors from potential disasters into growth opportunities. The author concludes that Bonanno's exciting position has opened the way for such comparative analytic research through which researchers can further their current knowledge concerning how resilience under stress comes about. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarifying and Extending the Construct of Adult Resilience.

In this article the author responds to comments made in this issue (see records 2005-03019-010; 2005-03019-011; 2005-03019-012; 2005-03019-013; and 2005-03019-014) responding to his original article entitled Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? (see record 2004-10043-003). The author notes that in his original article he focused on three crucial points: Resilience among adults represents a distinct and empirically separable outcome trajectory from that normally associated with recovery from trauma; resilience is more prevalent than generally accepted in either the lay or professional literature; and there are multiple and sometimes unexpected factors that inform adult resilience. Owing to the brevity of the article, the author could only touch briefly on many of the more nuanced and complex issues suggested by the resilience construct; this left plenty of room for critique. Fortunately, the comments are generous and insightful and for the most part compatible with the driving goal of the article. As might be expected, of course, there were statements peppered throughout the comments that the author deemed worthy of rebuttal or correction. He considers four points that seemed to beg most urgently for response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

APA's Resilience Initiative.

Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Focus groups conducted by the APA Practice Directorate after the terrorist attacks of September 11, 2001, found people to be experiencing a chronic sense of stress and uncertainty for which they wanted to be more resilient. In response, APA launched its public education campaign, "The Road to Resilience," in August 2002. A key component of the campaign is community outreach by psychologists, in which psychologists around the country bring information about resilience directly into their communities. This has allowed psychologists to help their communities and to help communities better understand the value of psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ordinary magic: Resilience processes in development.

The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology. The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overgeneral autobiographical memory and traumatic events: An evaluative review.

Does trauma exposure impair retrieval of autobiographical memories? Many theorists have suggested that the reduced ability to access specific memories of life events, termed overgenerality, is a protective mechanism helping attenuate painful emotions associated with trauma. The authors addressed this question by reviewing 24 studies that assessed trauma exposure and overgenerality, examining samples with posttraumatic stress disorder, acute stress disorder, depression, traumatic event exposure, and other clinical disorders. Limitations are discussed, including variations in assessment of events, depression, and overgenerality and the need for additional comparison groups. Across studies, there was no consistent association between trauma exposure and overgenerality, suggesting that trauma exposure is unlikely to be the primary mechanism leading to overgenerality. Instead, psychopathology factors such as depression and posttraumatic stress appear to be more consistently associated with overgenerality. Alternative overgenerality theories may help identify key overgenerality mechanisms, improving current understanding of autobiographical memory processes underlying psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Adjustment to Threatening Events: An Organismic Valuing Theory of Growth Through Adversity.

A positive psychological theory of growth through adversity is proposed. The organismic valuing theory of growth through adversity posits an intrinsic motivation toward growth, showing how this leads to the states of intrusion and avoidance that are characteristic of cognitive-emotional processing after trauma. The theory posits 3 possible outcomes of this cognitive-emotional processing, namely, assimilation, negative accommodation, and positive accommodation. The theory shows how the organismic valuing process will automatically lead to the actualization of positive changes in psychological well-being, through the positive accommodation of the new trauma-related information, provided that the social environment is able to support this positive accommodation process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comprehensive Soldier Fitness: Building resilience in a challenging institutional context.

The Comprehensive Soldier Fitness (CSF) program is designed to increase psychological strength and positive performance and to reduce the incidence of maladaptive responses of the entire U.S. Army. Based on the principles of positive psychology, CSF is a historically unique approach to behavioral health in a large (1.1 million members) organization. There are four program elements: (a) the assessment of emotional, social, family, and spiritual fitness; (b) individualized learning modules to improve fitness in these domains; (c) formal resilience training; and (d) training of Army master resilience trainers (MRTs) to instill better thinking skills and resilience in their subordinates. In contrast to traditional approaches, CSF is proactive; rather than waiting to see who has a negative outcome following stress, it provides ways of improving resilience for all members of the Army. CSF aims to move the full spectrum of responses to trauma and adversity—ranging from stress-related disorders to ordinary resilience—toward personal growth. This program may provide a model for implementing similar interventions in other very large institutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homo invictus: The indomitable species.

Discusses the coping and health enhancing reactions to adversity by reviewing evidence from laboratory experiments on restricted stimulation, field studies in polar stations, archival analyses of decision-making under stress, and interviews with Holocaust survivors, which attest to the fortitude and resilience of human beings in the face of severe environmental demands. Psychologists should address the many remaining questions—theoretical, scientific, and practical—concerning such positive reactions to even extreme stressors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Considering resilience in the rehabilitation of people with traumatic disabilities.

Objectives: To provide discussion on (a) the construct of resilience in relation to people with traumatic injuries, (b) potential research directions, and (c) reliable and valid measures of resilience. Conclusions: Resilience as a construct is part of the "positive psychology" movement that focuses on identifying the strengths of an individual when faced with adversity rather than on his or her weaknesses (e.g., depression, anxiety). Although a universal definition does not exist, resilience is generally considered a multidimensional construct consisting of behaviors, thoughts, and actions, which can be learned overtime. Consequently, there is a growing body of literature examining resilience in different populations (e.g., children, older adults). However, there is a paucity of literature examining the resilience of individuals who have experienced a traumatic injury. Potentially, resilience and rehabilitation is a very fruitful line of research due to the extreme adversity individuals are faced with postinjury when dealing with the trauma of the injury and resultant impairments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse life events and resilience

OBJECTIVE: Adverse life events are well-documented risk factors of psychopathology and psychological dysfunction in children and adolescents. Youth with good adjustment despite high levels of adverse life events are considered resilient. This study identifies factors that characterize resilience. METHOD: Household probability samples of youth aged 9 through 17 years at four sites were used. Main and interaction effects of 11 factors were examined to assess their impact on youth adjustment. RESULTS: Children at risk because of higher levels of adverse life events exhibited a greater degree of resilience when they had a higher IQ, better family functioning, closer parental monitoring, more adults in the household, and higher educational aspiration. The interaction between maternal psychopathology and adversity was significant, and the interaction between IQ and adversity approached significance. CONCLUSION: Resilient youth received more guidance and supervision by their parents and lived in higher-functioning families. Other adults in the family probably complemented the parents in providing guidance and support to the youth and in enhancing youth adjustment. Higher educational aspirations might have provided high-risk youth with a sense of direction and hope. Although IQ had no impact in youth at low risk, youth at high risk who had a higher IQ might have coped better.     

Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?

Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic growth among Norwegian children and adolescents exposed to the 2004 tsunami.

This study examined posttraumatic growth (PTG), positive change experienced as a result of the struggle with trauma, in children and adolescents exposed to a high-impact disaster, after which their experience of secondary adversity was minimal. The study also examined whether reduction in posttraumatic stress symptoms (PTSS) over time related to reports of PTG. There were 105 participants, age 6 to 17 years, who were directly exposed to the 2004 tsunami in Southeast Asia. They were interviewed 10 and 30 months after the disaster—PTSS was assessed at both time points, and PTG was assessed at 30 months. The individual's subjective reactions to the event and concurrent PTSS (30-months post-tsunami) were independently and positively related to PTG, whereas the decrease in PTSS was not related to growth. Children and youth in this study reported lower absolute levels of PTG than those in other studies. Taken in sum, findings suggest that secondary adversities may influence posttraumatic reactions and ongoing distress, which are hypothesized to play a key role in the development of PTG. In the absence of such secondary stressors, continued distress in the form of PTSS may serve to catalyze the growth process. Implications for clinical practice are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Clinician's reactions to depressive behavior and ill health.

Psychotherapists are susceptible to prevailing negative stereotypes that exist in society at large. Inappropriate negative attitudes toward depressed and ill patients can adversely affect interactions with such clients. The authors examined the reactions of 410 psychologists to vignettes that described a client who emitted either depressed or nondepressed behavior and who varied in terms of cancer prognosis. Clinicians had negative mood reactions after reading the vignette of the depressed client; they also believed the depressed client possessed many undesirable personal attributes. Practicing psychologists are urged to reflect on their attitudes and beliefs so they do not negatively affect assessment and therapy services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes of clinical psychologists toward involuntary civil commitment law.

Presents results from a recent national survey of the attitudes of 316 clinical psychologists toward involuntary civil commitment and a comparison of these results with trends in the law. Clinical psychologists generally, although not completely, supported the current trends toward more concern with the rights of individuals undergoing commitment. Survey results and problems concerning standards for commitment, the right to treatment, and the right to refuse treatment are discussed. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inherited hypohedonia leads to learned helplessness: A conjecture updated.

The reformulated learned helplessness theory posits depressogenic explanatory style (DES) as a vulnerability factor in depression. Early-life adversity has been suggested as the source of DES, but this is contradicted by empirically established features of the learned helplessness phenomenon itself and by the evidence for human resilience in the face of adversity. This article extends a conjecture first advanced by P. E. Meehl (1975) and argues that an inherited defect in hedonic capacity would be sufficient to produce DES by causing intermittent schedules of reinforcement to be experienced as extinction schedules, resulting in a pervasive and unremitting sense of helplessness. This proposed hedonic defect also provides a means for integrating the original and reformulated versions of learned helplessness theory and for integrating learned helplessness with emerging research and theory on the biology of vulnerability to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding meaning, perceiving growth, and acceptance of tinnitus.

Objectives: The authors test hypotheses derived from current models of growth following adversity in a sample of people with tinnitus. These models assume a process whereby adversity or trauma threatens major assumptions, which, in turn, promotes a search for meaning in the adversity and subsequently growth. Method: Data from a sample of 315 people with tinnitus who completed an online survey were used to assess the relations of reports of negative changes to asking "Why me?" and answering the Why me? question with reports of growth, acceptance, and well-being. Results: indicate that reports of negative changes in goals and philosophy of life predict a search for meaning and that finding meaning is associated with perceived growth. Those who report never searching for meaning are less likely to report growth but report better adjustment and acceptance of their tinnitus than those who have searched for meaning. Discussion: The data are consistent with models of growth that give a central role to meaning-making processes, but they also suggest that a significant minority of people with tinnitus do not report searching for meaning or perceiving growth--yet appear to be coping well. Acceptance of tinnitus is identified as a key construct for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically Supported Psychotherapies: Comment on Westen, Novotny, and Thompson-Brenner (2004).

D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) suggested that efforts to identify empirically supported treatments are misguided because they are based on assumptions that are not appropriate for some types of treatment and patients. The authors of this comment argue that Westen and colleagues are simply incorrect when they assert that empirically supported treatments require that psychopathology must be highly malleable, that treatments must be brief, or that the samples studied are unrepresentative of the kinds of patients typically encountered in clinical practice--comorbidity is common in many clinical trials. Randomized controlled trials remain the most powerful way to test notions of causal agency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)