Abstract
In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind–body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD.
Highlights
In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources
Another study of individuals with late-life depression (LLD) found that the Met allele predicted poorer response to paroxetine, and that this effect was moderated by the cyclic AMP responsive element binding protein 1 (CREB1)[207]
The results of one study investigating the neurological effects of Electroconvulsive therapy (ECT) suggest that increases in frontal white matter fractional anisotropy (FA) may account for ECT’s antidepressant effect[315]
Summary
Positive emotionality Secure attachment Extroversion, conscientiousness, grit Self-esteem, self-efficacy, mastery, growth mindset, sense of purpose Active coping, accommodative coping, religious/spiritual practice Social support, formal volunteering. Behavioral inhibition Insecure attachment Neuroticism Depression-related stigma, negative attitudes about aging Passive coping Trauma, chronic stress, more social role "absences", loneliness Sedentary lifestyle, nutritional deficiencies, substance abuse
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