Association Of Resilience Research Articles

The association of resilience with HbA1c and key psychosocial factors in emerging adults with type 1 diabetes.

Emerging adults (EAs) with type 1 diabetes (T1D) have difficulty meeting glycemic targets and have a high prevalence of mental health comorbidities. Resilience, the ability to harness resources needed to sustain one's emotional and physical well-being, may be a key factor impacting poor mental health and glycemic outcomes. We aimed to (a) evaluate the association between resilience, HbA1c, and key psychosocial factors and (b) explore whether resilience moderates the relationship between psychosocial factors (depression, diabetes-related distress, anxiety) and HbA1c in EAs with T1D. EAs with T1D (N = 233) (mean age = 19.9 years (SD = 1.6), range 16.8-24.7) seen at an EA-specific diabetes clinic completed resilience, diabetes-related distress, depression, and anxiety measures and had their HbA1c level evaluated. We used linear regression models and conducted moderation analyses for the resilience factor. Resilience was strongly associated with HbA1c, depression, diabetes-related distress, and anxiety in EAs with T1D. We did not find evidence that resilience moderates the relationship between depression, anxiety, or diabetes-related distress and HbA1c. This study found that resilience is a highly relevant psychological factor associated with HbA1c and a key mental health factor for EAs with T1D. Novel interventions are needed to ameliorate high diabetes-related distress and HbA1c, and bolstering resilience may be one avenue to explore. Future research on resilience should longitudinally characterize and evaluate whether resilience may be a mechanism underlying the relationship between poor psychosocial outcomes and not meeting glycemic targets in EAs with T1D.

Associations of Resilience, Perceived Control of Health, and Depression with Geriatric Outcomes after Surgery.

To identify if depression, resilience, and perceived control of health are related to 2.5-year mortality and instrumental activities of daily living (IADL) decline among older adults after surgery. The relationships of psychosocial factors with postoperative mortality and IADL decline among older adults are understudied. We identified 3778 community-dwelling older adults in the Health and Retirement Study (HRS) with Medicare claims for surgery (mean [SD] age: 75.4 [7.8] years, 53.9% women, and 86.0% non-Hispanic White). We assessed associations of depression, resilience, and perceived control of health with 2.5-year postoperative mortality and IADL decline using cox and modified Poisson regression analyses, adjusting for sociodemographic and health variables. The incidence of 2.5-year postoperative mortality was 18.5% and IADL decline was 9.4%. Depression was associated with a higher incidence and adjusted hazard [95% CI] of mortality (26% vs. 16%, aHR:1.2[0.9, 1.5]), but high resilience was associated with a lower incidence and adjusted hazard of mortality (9% vs. 21%, aHR:0.6[0.5, 0.8]). Those with depression had higher incidence and adjusted relative risk [95% CI] of IADL decline (17% vs. 7%, aRR:1.6[1.2, 2.2]), but lower incidence and adjusted relative risk of IADL decline was identified for those with high resilience (4% vs. 11%, aRR:0.6[0.4, 1.0]) and high perceived control of health (7% vs. 10%, aRR:0.6[0.4, 1.0]). While depression confers greater risk of mortality and IADL decline, higher resilience and perceived control of health may be protective. Addressing psychosocial factors in the peri-operative period may improve outcomes among older adults.

Family Support, Resilience, and Life Goals of Young People in Residential Care.

Establishing goals for young people in residential care (RC) is a gap in the literature, especially in terms of the relationship between family support and resilience. The literature suggests that RC is associated with the breakdown of family relationships, so the possibility of the family playing a positive role in establishing life goals for young people is reduced. However, family support in the context of organization and stability can be assumed to be a protective factor for the formulation of life goals and contribute to the resilient development of young people. This study aimed to analyze the role of family support in the process of setting goals for young people in RC, as well as to analyze the potential mediating role of resilience in the previous association. The sample included 124 young people aged between 12 and 23 years living in RC. The results point to a positive association between family support (autonomy) and the planning of life goals and verify the total mediating effect of resilience in this association. The results are discussed considering attachment theory and the role of the family in the adaptive development of young people. This study's findings provide important indications for developing future interventions.

Association of resilience and psychological flexibility with surgeons' mental wellbeing.

Existing research highlights the link between certain personality traits and mental health in surgeons. However, little research has explored the important role of psychological skills and qualities in potentially explaining this link. A cross-sectional survey of UK-based surgeons was used to examine whether two such skills (psychological flexibility and resilience) helped to explain why certain personality traits might be linked to mental health in surgeons. An online survey comprising measures of personality (neuroticism, extraversion and conscientiousness), psychological skills/qualities (psychological flexibility and resilience) and mental health (depression, anxiety, stress and burnout) was sent to surgeons practising in the UK. Mediation analyses were used to examine the potential mediating role of psychological flexibility and resilience in explaining the relationship between personality factors and mental health. A total of 348 surgeons completed the survey. In all 12 mediation models, psychological flexibility and/or resilience played a significant role in explaining the relationship between personality traits (neuroticism, extraversion and conscientiousness) and mental health (depression, anxiety and burnout). Findings suggest that it is not only a surgeon's personality that is associated with their mental health, but the extent to which a surgeon demonstrates specific psychological qualities and skills (psychological flexibility and resilience). This has important implications for improving surgeons' mental wellbeing, because psychological flexibility and resilience are malleable, and can be successfully targeted with interventions in a way that personality traits cannot.

Correction to: The association of resilience and physical activity in older adults: cross-sectional analyses from the NICOLA study

Correction to: The association of resilience and physical activity in older adults: cross-sectional analyses from the NICOLA study

The association of resilience and physical activity in older adults: cross-sectional analyses from the NICOLA study

Abstract Aim As more of the world’s population are living longer, supporting the mental and physical health of older adults is becoming increasingly important in public health. Resilience is a dynamic process encompassing positive adaptation in the face of adverse experiences that would otherwise lead to poor outcomes. The aim of the study is to explore the association between physical activity and resilience in older adults. Subject and methods The data used in this study was taken from the results of the Self Completed Questionnaires and Computer Assisted Personal Interviews from the Northern Ireland Cohort for the Longitudinal Study of Ageing. A secondary analysis was conducted on a sample of 4040 participants to examine the association between resilience (Brief Resilience Scale) and on moderate/vigorous physical activity (International Physical Activity Questionnaire – Short Form) through chi-square and Mann–Whitney U tests and an ordinal regression being conducted. Results Data was included for 4040 participants, of whom 90% did not meet the recommended moderate physical activity guidelines. The findings of this study indicated that higher resilience levels are associated with higher levels of moderate and vigorous physical activity levels. Conclusion Worryingly, a large percentage of the older adult population are not sufficiently active and this is something that needs to be addressed. The findings suggest that with these low levels of physical activity, interventions should be created to target this population.

The association of resilience and positive mental health in systemic sclerosis: A Scleroderma Patient-centered Intervention Network (SPIN) cohort cross-sectional study

ObjectiveA previous study using Scleroderma Patient-centered Intervention Network (SPIN) Cohort data identified five classes of people with systemic sclerosis (also known as scleroderma) based on patient-reported somatic (fatigue, pain, sleep) and mental health (anxiety, depression) symptoms and compared indicators of disease severity between classes. Across four classes (“low”, “normal”, “high”, “very high”), there were progressively worse somatic and mental health outcomes and greater disease severity. The fifth (“high/low”) class, however, was characterized by high disease severity, fatigue, pain, and sleep but low mental health symptoms. We evaluated resilience across classes and compared resilience between classes. MethodsCross-sectional study. SPIN Cohort participants completed the 10-item Connor-Davidson-Resilience Scale (CD-RISC) and PROMIS v2.0 domains between August 2022 and January 2023. We used latent profile modeling to identify five classes as in the previous study and multiple linear regression to compare resilience levels across classes, controlling for sociodemographic and disease variables. ResultsMean CD-RISC score (N = 1054 participants) was 27.7 (standard deviation = 7.3). Resilience decreased progressively across “low” to “normal” to “high” to “very high” classes (mean 4.7 points per step). Based on multiple regression, the “high/low” class exhibited higher resilience scores than the “high” class (6.0 points, 95% confidence interval [CI] 4.9 to 7.1 points; standardized mean difference = 0.83, 95% CI 0.67 to 0.98). ConclusionsPeople with worse disease severity and patient-reported outcomes reported substantially lower resilience, except a class of people with high disease severity, fatigue, pain, and sleep disturbance but positive mental health and high resilience.

Association of resilience with female sexual dysfunction

ObjectivesFemale sexual dysfunction (FSD), a common concern affecting women of all ages, is often mediated by important psychological factors. Resilience has been shown to correlate with psychological well-being across different groups of people. The aim of this study was to assess if there is an association between resilience and FSD. Study designThis cross-sectional study included 4,366 women (mean [SD] age, 51.7 [11]) seen in women's health clinics at 1 of 3 geographic Mayo Clinic locations. Participants completed the Brief Resilience Scale, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale–Revised (FSDS-R). Main outcome measuresWe used univariate and multivariable logistic regression analyses to assess associations between resilience, sexual function, and sexual distress, adjusting for potential confounding variables. ResultsFSD criteria (FSFI ≤26.55 and FSDS-R ≥ 11) were met by 55.8 % of women. Low, normal, and high levels of resilience were reported by 17.3 %, 57.1 %, and 25.6 % of participants, respectively. The univariate analysis showed that higher resilience was associated with lower sexual distress, lower odds of FSD, and better sexual function. Multivariable analysis adjusted for potential confounders showed that the association persisted and that higher resilience correlated with better sexual function and lower odds of FSD. ConclusionsIn this large cross-sectional study, women with higher resilience scores had better sexual function and lower odds of FSD. Additional studies with diverse women are needed to confirm this association and to determine whether women with FSD could benefit from enhancing resilience as a therapeutic strategy.

Association of resilience with caregiver burden in caring for the elderly with stroke; a systematic review

Objective: To review the construct of resilience and related variables in caregivers caring for older adults with stroke and factors influencing caregiver burden. Methodology: The review included studies published between February 2009 and February 2024, using the Preferred Reporting Items for Systematic Reviews. The PubMed, Web of Science, Scopus, China Academic Journals, Wan Fang Data Knowledge Service Platform, China Science and Technology Journal Database databases were employed. Results: In all 18 investigations, 14 quantitative and 2 qualitative were found. Resilience was linked to positive impacts on life satisfaction and emotional pain in these studies. Building robust coping skills can be facilitated by social support and communication. The majority of the chosen papers employed convenience sampling. Semi-structured interviews were utilized to gather qualitative and quantitative data utilizing resilience-related elements and evaluation tools. Conclusion: Encouraging caregivers to adopt a resilient coping style helps them feel less distressed about changes in their biopsychosocial and spiritual aspects that come with sickness. A resilient coping strategy can help the caregiver adjust while lowering their risk of stress and strain.

Association of resilience with successful ageing and the mediating role of community participation

AbstractBackgroundHigher level of resilience plays a positive role in successful ageing. Participation was reported as a factor related to resilience and successful ageing. As resilience is developed based on interaction between personal characteristics and environment over time, enhancing resilience level of individuals in later life span is difficult. Finding out modifiable factors which mediate the relationship between resilience and successful ageing can be alternative way to promote successful ageing. The aim of this study was to examine the mediating role of community participation.MethodConvenience sampling was applied to recruit community‐dwelling older adults aged 60 or older who could self‐rate the questionnaire independently. Online and on‐site surveys were conducted using the same questionnaire. Total scores of Korean version of the Connor‐Davidson Resilience Scale (CD‐RISC) and Community Integration Measure (CIM) were used respectively to measure resilience and community participation. Sum score of the satisfaction across four areas‐ subjective health; subjective memory; social relationships; socioeconomic status was used to measure successful ageing. Mediation analysis using SAS 9.4 was conducted to examine the mediating role of community participation in relationship between resilience and successful ageing.ResultData from 284 individuals was analyzed (Mean age: 67.99 ± 7.28; Female: 50.70%). Mean scores of CD‐RISC, CIM, and successful ageing were 60.70, 36.65, 13.05 respectively. A total effect of resilience on successful ageing was statistically significant (β = 0.038, 95% CI = 0.027 to 0.049) after controlling for gender, age, education, living status, employment status, disabilities, depression and chronic disease. Community participation mediated the relationship between resilience and successful ageing (β = 0.006, 95% CI = 0.002 to 0.010). Mediating role of community participation explained 16.44% of total effect of resilience on successful ageing.ConclusionAssisting older adults to increase community participation can be considered as a community‐based health care service to promote successful ageing. Further studies to examine causality among resilience, community participation, and successful ageing is necessary to strengthen the evidence of effect of active community participation on successful ageing.

Associations of resilience, white matter topological organization, and cognitive functions in first-episode, drug-naïve schizophrenia patients: A moderated mediation analysis

BackgroundCognitive deficits are core symptoms of schizophrenia (SZ) and are associated with impaired resilience to stress. Different cognitive functions appeared to be interrelated, and the mechanism may involve neural alterations. The disrupted topological organization indicated abnormalities in the segregation and integration of brain networks that support various cognitive processes in SZ patients. Therefore, this study aimed to assess the direct and indirect effects of resilience on cognitive functions. We hypothesized that topological properties would moderate these associations. MethodsForty-nine SZ patients and fifty-two healthy controls (HCs) were recruited in this study. The Connor-Davidson Resilience Scale and the MATRICS Consensus Cognitive Battery were used to examine resilience and cognitive functions, respectively, and a graph theory approach was used to assess white matter topological organization. ResultsCompared to HCs, SZ patients showed lower levels of resilience and cognitive functions in multiple domains as well as abnormal global properties and nodal metrics. In addition, shorter characteristic path length was associated with a stronger indirect effect of resilience on working memory through processing speed in SZ patients. ConclusionCharacteristic path length might moderate the mediating effects of processing speed in the relationship between resilience and working memory in schizophrenia patients.

Resilience in Mild Cognitive Impairment (MCI): Examining the Level and the Associations of Resilience with Subjective Wellbeing and Negative Affect in Early and Late-Stage MCI.

The current study examines the relationship between the cognitive state of participants [healthy-early mild cognitive impairment (MCI)-late MCI], some subjective wellbeing factors (positive emotions, engagement, positive relationships, meaning in life, accomplishment, and negative emotions), and negative psychological outcomes (depression, anxiety, stress), as well as psychological resilience. We expected that people with advanced MCI would perceive increased negative psychological outcomes, poorer psychological resilience, and lower levels of subjective wellbeing in contrast to early MCI and healthy participants. The study involved 30 healthy, 31 early, and 28 late MCI individuals. A series of questionnaires have been applied to assess the aforementioned constructs. To examine the hypotheses of the study, path analysis (EQS program) was applied. Results showed that early MCI persons maintain the same levels of positive emotions and feelings of accomplishment with healthy peers. Late-stage patients present those feelings in a diminished form, which adversely impacts psychological resilience. Individuals with early and late MCI exhibit negative emotions and stress that impact their resilience; however, those with early MCI experience greater stress, negative emotions, depression, and anxiety. These findings may be utilized to design psychological interventions for resilience enhancement and support brain health in elderly adults who are at risk of neurodegeneration.

A-70 Association of Resilience With Academic and Social Concerns in School Aged Children With Codncussion

Abstract Purpose Investigate the association between perceived resilience and academic and social concerns expressed by children and adolescents following concussion. Methods This prospective cohort study at North Texas Concussion Registry (CONTEX) clinics included 330 participants aged 5 to 17 diagnosed with concussion. At an initial clinical visit, patients completed the Brief Resilience Scale (BRS) to measure self-perceived pre-injury resilience. Patients were categorized into Low (BRS=1.00-2.99), Average (BRS=3.00 to 4.30), and High (BRS=4.31- 5.00) resilience groups. Participants completed the Concussion Learning Assessment and School Survey (CLASS) 3 months after enrollment. Specific academic/social concerns measured by the CLASS were categorized as either "no concern/stress" or "some level of concern/stress.” Chi-square analysis was used to investigate the association between initial pre-injury resilience and concern/stress. Results Higher resilience was associated with less concern about the injury affecting school learning and performance (χ2(2,329)= 11.65, p=.003), less stress regarding support at home from parents/siblings (χ2(2,330)= 8.60, p=.014), less stress from being overwhelmed by schoolwork piling up (χ2=9.46, p=.009) and grades dropping (χ2(2,330)= 13.29, p=.001). Lower resilience was associated with greater stress from missing time with friends and/or social activities (χ2(2,330)=8.37 p=.015) and not having enough support from teachers (χ2(2,330)=8.49, p=.014). Conclusions Resilience may be associated with academic and social concerns in children and adolescents with concussion. Children with a higher perceived resilience may have better outcomes in terms of their academic and social concerns following concussion. Further studies are necessary to confirm these findings and determine the potential clinical implications.

Associations of resilience and hope with mental and physical health among firefighters.

Firefighters represent an understudied population with high rates of chronic exposure to stress and potentially traumatic events. Thus, there is a need to identify modifiable resilience factors to address posttraumatic stress disorder (PTSD) symptoms (PTSD) and chronic pain in firefighters to inform prevention and intervention efforts. The current sample included 155 firefighters (93.5% male; Mage = 42.2, SD = 9.8) recruited online from career, volunteer, and combination (i.e., volunteer and career) departments in a large metropolitan area in the southern United States. Structural equation modeling (SEM) was used to investigate the associations between/among resilience and hope on PTSD symptoms, chronic pain, well-being, and posttraumatic growth (PTG). Resilience had a stronger, negative relationship with PTSD and chronic pain compared to hope, while hope had a stronger, positive relationship with PTG and well-being compared to resilience. Hope and resilience combined predicted 10%-33% of the variance in the outcomes. The current findings may provide evidence to promote interventions that increase resilience and hope in firefighters.

The Association of Resilience with Way of Coping, Psychological Well-Being and Quality of Life in Parents of Children with Cancer.

Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (n = 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (p < 0.001), more depressive symptoms (p < 0.001), and poorer quality of life (p < 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (p < 0.001), fewer depressive symptoms (p < 0.001), and better quality of life (p < 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (p < 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.

Perfiles de resiliencia asociados al engagement académico y al apoyo social en estudiantes universitarios

Adjustment of first-year students to university environments, as well as their academic success, is not exclusively related to their academic aptitude; instead, this adjustment is associated with psychological characteristics, personal and even social resources that help students cope with stressors and new circumstances. A comprehensive assessment of the students’ adjustment to university environment must transcend preoccupation on academic performance, and instead explore associations among psychological, academic, and social elements that promote adaptation during the initial years of higher education (Marenco-Escuderos et al., 2021). In this line of research, the objective of this work was to inquire how internal characteristics of students (psychological and academic) interplay with external elements in their support systems to promote adaptation in a higher education environment. Associations were explored among resilience, academic engagement, and social support as determining elements in the adjustment to the demands of the university context. The sample consisted of 371 undergraduate students (60 % female), of low socioeconomic status, enrolled in public universities in the Caribbean region of Colombia. Firstly, the resilience of university students was explored, as the ability to respond to obstacles with a positive view of the world, of others, and of one’s own abilities to cope with stressors (Saavedra-Guajardo et al., 2019). Second, the level of engagement that drives young students to concentrate their energies on academic activities was reviewed; and third, the role of peers, and friends as the close-support system that facilitates the overcoming of personal and academic difficulties was investigated (Fernández-Martínez et al., 2017). Based on a statistical cluster analysis, by the agglomerative hierarchical method, individuals were classified according to their similarities in the expression of 12 dimensions of resilience (SV-RES scale), and subsequently compared in terms of engagement (UWES-S scale), and personal support networks (UNICET software). The results showed four student profiles: (1) the largest group consisting of students with low-resilience, high engagement and strong support networks; (2) a resilient group with low levels of engagement and support networks with little intimacy; (3) a resilient group with high characteristics of autonomy, intermediate levels of engagement, and support networks with weak structure; and (4) a very resilient group, high engagement, and wide and strong social support networks. The results point out the fact that the greatest proportion of students who start college show profiles of low resilience, however, high levels of motivation for studies and social resources such as peer support networks are the conditions that mostly allow for coping with adversity in the first years of college. These results could point to cultural aspects specific to the Caribbean region, where social networks are of great importance for daily functioning (Marenco-Escuderos et al., 2021). Regarding the association among the studied variables, it is important to note that only the last profile gathered all elements of high resilience, high engagement, and strong support networks that allow for confirming the association among these constructs. The other three profiles represent cases in which the resilience traits are independent of the students' levels of engagement and the composition of their personal support networks. This study is valuable as it provides a differentiating picture of the relationship of resilience with other psychological and social constructs, and in that it allows to better understand resilience in association with other elements that mediate its interpretation. Important gender differences among the profiles are additionally discussed. https://doi.org/10.16888/interd.2023.40.2.14

The Association of Resilience with Mental Health in a Large Population-Based Sample (LIFE-Adult-Study)

Resilience describes a good adaptation to adversity. Strengthening resilience is a promising approach in the prevention of mental health problems. Yet, research on the association of resilience with mental health symptoms in the general population is scarce. The aim of our study is to examine comprehensively the association of resilience with depressive symptoms, anxiety, and perceived stress in a large population-based sample. We analyzed data of n = 3762 participants from the follow-up assessment of the LIFE-Adult-Study, a population-based cohort study in Leipzig. Assessments included resilience (RS-11), depressive symptoms (CES-D), anxiety (GAD-7), and perceived stress (PSQ). The association of resilience with mental health symptoms was examined via multiple linear regression analyses. In our analyses, higher resilience predicted less mental health problems and contributed significantly to the explained variance in mental health outcomes. Women, individuals with previous mental disorders, and those without employment had higher mental health symptoms. Resilience is closely associated with mental health problems in the general population. Vulnerable groups should be targeted with public health measures. Strengthening resilience is a promising approach in the large-scale prevention of mental disorders.

Resilience in cancer patients and how it correlates with demographics, psychological factors, and lifestyle

BackgroundBeing diagnosed with cancer is challenging. Many patients wish to be actively involved in treatment and contribute to therapy, but the patients’ coping abilities and desire for involvement differ. The individual level of resilience seems to play a major role. Our study aims to learn more about the associations of resilience and factors as demographics and psychological factors.MethodsThis multicentric cross-sectional study was conducted in ten oncological centers in Germany in summer 2021. The questionnaire collected information on demographics, resilience, self-efficacy, general satisfaction with life, and sense of coherence. Considered lifestyle-aspects were diet and physical activity. 416 patients were included in the analyses.ResultsA moderate mean resilience score was achieved (M = 69). Significant correlations in demographics were found for resilience and education (r = 0.146, p = 0.003), income (r = 0.205, p = 0.001), and time since receiving diagnosis (r = − 0.115, p = 0.021). Resilience and self-efficacy correlated on a high level (r = 0.595, p < 0.001), resilience and sense of coherence, and resilience and general satisfaction with life in a moderate way (r = 0.339, p < 0.001; r = 0.461, p = 0.001).ConclusionsResilience portrays an important aspect in cancer treatment. Detecting patients at risk, stabilizing, or improving resilience are important to focus on and strengthen them accordingly. Possible negatively influencing factors (e.g., low self-efficacy) need to be considered. Factors affecting resilience but difficult to influence, as educational background, should be screened for. Also, the combination of low resilience and low income seems to describe a vulnerable patient group.

Associations of resilience and respiratory sinus arrhythmia with alienation among college students

BackgroundAlthough the sense of alienation is harmful and causes many developmental problems, very few studies have focused on its antecedent variables and when these variables are related to alienation. The purpose of this study was to examine the relationship between resilience and sense of alienation among college students, and the moderating role of baseline respiratory sinus arrhythmia (RSA) in this association. MethodPhysiological data were collected during a resting condition in the laboratory from 109 college students aged from 17 to 21 years (M = 18.94, SD = 0.92). Questionnaires that captured demographic information, resilience, and sense of alienation, were also completed. ResultsResults indicated that resilience was negatively related to the sense of alienation. Moreover, this negative relationship was moderated by baseline RSA such that it was significant only among students with low levels of baseline RSA. ConclusionOur findings revealed that individuals with low resilience tend to have a higher level of alienation if their baseline RSA is relatively low. DiscussionThe current study sheds light on the psychological and biological characteristics of these individuals who tend to have higher levels of alienation, which may be useful for intervention program developers and practitioners.

Resilience, self-efficacy and diabetes distress on self-management behaviours in patients newly diagnosed with type 2 diabetes: A moderated mediation analysis.

To examine (1) the mediating role of self-efficacy between resilience and self-management behaviours and (2) the moderating role of diabetes distress on the relationship between self-efficacy and self-management behaviours in patients newly diagnosed with type 2 diabetes. Cross-sectional design. Totally, 195 patients newly diagnosed with type 2 diabetes for more than 5 months but less than 18months were recruited from three endocrine clinics in Taiwan through convenience sampling. Self-reported questionnaires including demographic and disease characteristics, resilience, self-efficacy and self-management behaviours were used to collect data from October 2020 to May 2021. Moderated mediation analysis was performed by Hayes's PROCESS macro. According to bootstrapping results, the indirect effect of resilience on self-management was significant, although the direct effect of resilience on self-management was not. Participants were categorized into with and without diabetes distress groups. The results of moderated mediation analysis indicated self-efficacy significantly correlated with self-management behaviours in participants without diabetes distress, although self-efficacy did not significantly correlate with self-management in participants with diabetes distress. The association of resilience with self-management behaviours was fully mediated through self-efficacy with diabetes distress moderating the relationship between self-efficacy and self-management behaviours in patients newly diagnosed with type 2 diabetes. Improving resilience could enhance self-efficacy leading to possible improvement in self-management behaviour, although improving self-efficacy might not benefit self-management behaviours for those with high levels of diabetes distress. Healthcare providers need to first assess and address the diabetes distress before intervening to improve self-efficacy to enhance self-management behaviours in patients newly diagnosed with type 2 diabetes. When designing this study, two patients newly diagnosed with diabetes were consulted about the importance of self-management behaviours for them personally.