Resilience Trajectories Research Articles

Adulthood trajectories of resilience and vulnerability: exploring gender differences in disadvantage after experience of out-of-home care

BackgroundChildhood adversity places individuals in a vulnerable position, resulting in potentially enduring disadvantage across life domains like health and work. Studying the manifestation of this disadvantage is crucial for understanding which resources society can provide to mitigate or prevent it, which makes this subject a fundamental public health concern. This study investigated whether disadvantage patterns after childhood adversity differ by gender and educational level, using out-of-home care as proxy for early adversity.MethodsWe used register data from a 1953 Swedish birth cohort. Distinct profiles of socioeconomic and health disadvantage in individuals with out-of-home care experience were identified using group-based multi-trajectory modelling. Multinomial logistic regression was then used to determine whether gender and education, individually or in interaction with each other, predict group membership.ResultsIn the population without history of out-of-home care, adulthood disadvantage was highly gendered, with women being more likely to experience disadvantage related to unemployment and poor health, while criminality and substance misuse was more common among men. History of out-of-home care was associated with a general increase in adulthood disadvantage, but the gender differences were largely absent. Women in this group were however less likely than men to experience disadvantage across multiple life domains (complex disadvantage OR = 0.56, p = 0.046; unemployment-related disadvantage OR = 0.51, p = 0.005). Higher level of education was associated with reduced likelihood of membership in the group marked by disabling health disadvantage (OR = 0.55, p = 0.002) and complex disadvantage (OR = 0.37, p = 0.001). An interaction term between gender and education was not significant.ConclusionsAdulthood disadvantage was more common in the group with history of out-of-home care. The gender differences in disadvantage present in the full cohort were largely attenuated among individuals with out-of-home care history. We showed that using administrative data on outcomes across multiple life domains can provide rich descriptions of adult experiences after childhood adversity. Future research could examine gender differences in mechanisms translating into resilient or vulnerable trajectories, including the protective potential of education in relation to specific disadvantage patterns.

A longitudinal study of resilience and social function in patients with colorectal cancer and stomas.

To explore the dynamic changes, influencing factors, and relationships between resilience and social function in patients with colorectal cancer (CRC) and stomas at different postoperative stages, and to inform precise psychosocial rehabilitation interventions. A longitudinal study was conducted at a tertiary hospital in eastern China from January 2021 to June 2023. Patients completed a self-designed socio-demographic questionnaire one month post-surgery, and the Connor and Davidson Resilience Scale (CD-RISC) and Social Dysfunction Screening Scale (SDSS) at 1, 3, and 5months post-surgery. Data were analyzed using repeated measures ANOVA, Spearman correlation, group-based trajectory modeling, and binary logistic regression. A total of 131 patients were included in the analysis. Resilience showed an initial increase followed by a decline, while social function consistently improved. A moderate negative correlation between social dysfunction and resilience was observed at all time points. Influencing factors for resilience and social function varied across different postoperative stages. Significant differences in resilience trajectories were observed based on education and family income. Resilience trajectories significantly impacted social function trajectories (OR 19.39, 95% CI 2.46-152.91, P<0.05). This study identifies distinct trajectories of resilience and social function in patients with colorectal cancer and stomas. Low resilience is linked to severe social function deficits. Stage-specific interventions are crucial to enhance social adaptation and improve overall quality of life. Tailored support is needed throughout recovery to address the unique challenges faced by these patients.

Pathways towards Cognitive resilience in the context of amyloid pathology: a longitudinal matched study design

AbstractBackgroundCognitive resilience can be defined as better‐than‐expected cognitive performance in the context of Alzheimer’s disease (AD) pathologies or increased AD risk. We investigated pathways associated with cognitive resilience trajectories in amyloid positive (A+) and/or APOE4 cognitively unimpaired (CU) older adults including brain resilience, resistance to AD pathologies and vascular pathology.MethodWe included 534 CU ADNI participants with available cognitive data, longitudinal amyloid‐PET ( [18F]florbetaben and [18F]florbetapir) and structural MRI (gray matter volumes) and, as ubset with tau‐PET ( [18F]AV1451) (n = 287) and white matter hyperintensities (n = 467) volume data (n = 534). We performed a one‐to‐one matched design, aligning participants by their baseline amyloid levels, MMSE scores, and age within an average follow‐up time of 6 years (68.18 ±32 months). We identified 44 CU participants ‐ defined as cognitive resilient ‐ who were A+ and/or APOE4 carriers and remained CU and 44 CU A+ matched participants who converted to MCI or AD (non‐resilient). To assess brain resilience, resistance to pathologies and vascular pathways, at baseline, t‐test were performed with gray matter volumes, amyloid (n = 44), tau (n = 12) and WM measurements (n = 27) as outcomes of interest. Longitudinally, linear mixed effect models were used to examine the interaction between cognitive resilient status (resilient vs non) and time on regional amyloid and tau deposition, and gray matter volume.ResultAt baseline, cognitive resilient participants were characterized by lower tau burden in temporal regions (Figure 1). Longitudinally, cognitive resilient participants showed lower tau accumulation in medial temporal and limbic areas, including the insular and anterior cingulate cortices, and lower volume loss in fusiform, inferior temporal and entorhinal cortex (Figure 2). Unexpectedly, cognitive resilience participants showed greater amyloid increases notably in the anterior cingulate, although both groups showed increased amyloid accumulation. Sensitivity analysis adjusting by conversion time, to rule out the impact of varying accumulation rates due to disease progression, rendered similar results.ConclusionOur results suggest that processes downstream amyloid deposition including resistance to tau and brain maintenance might be key to maintain cognitive function in the presence of amyloid pathology.

Resilience throughout and beyond COVID-19: a longitudinal analysis.

Defined as the ability to adapt to adversity with a positive and stable mindset, resilience should be an important factor in coping with long-term evolving setbacks such as the COVID-19 pandemic. Although the negative mental health impacts of the pandemic are well-documented, the course of resilience during the pandemic and recovery periods remains understudied. This study examined resilience trajectories among respondents in the Canadian Personal Impacts of COVID-19 Survey (PICS) who provided data for at least two timepoints (n = 741). Resilience was measured using the Connor-Davidson Resilience Scale (CD-RISC), and linear mixed models assessed for variations in resilience over time. Sociodemographic factors were introduced as fixed-effects variables to ascertain impacts on baseline resilience scores and temporal trends. Overall, resilience levels were low throughout the course of the study. The study sample's median baseline resilience score was 26 (IQR 21-30), which is significantly lower than the 25th percentile CD-RISC score noted in a pre-pandemic American community survey. This remained relatively unchanged until month 20 of follow-up, when point resilience scores showed a subtle (under one point), yet significant uptick from baseline. Sociodemographic analysis showed that low income was consistently associated with lower resilience (1.8-point difference, SE = 0.5, p = 0.002) throughout the observational period. Participants with a psychiatric disorder history had lower baseline resilience compared to those without any psychiatric history (3.4-point difference, SE = .05, p < 0.001). This gap decreased to 2.0 points (SE = 0.6, p < 0.001) by 24 months post baseline, suggesting that this negative effect on resilience diminished over time.

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Resilience in Chinese Spouses of Patients with Advanced Cancer: A Longitudinal Exploration.

In China, spouses of patients with advanced cancer have reported experiencing psychological distress. However, little attention has been paid to the positive psychological health trajectories of these caregivers, particularly regarding their resilience and the factors influencing its development over time. To examine the trajectories of resilience in Chinese spousal caregivers over a nine-month post-treatment period and to identify the basic characteristics associated with these trajectory patterns. This was a longitudinal, observational study conducted in mainland Chinese between January 2022 and May 2024. A total of 306 spouses of patients receiving cancer treatment were recruited from five local hospitals. Data was collected in four waves: within one month of initial treatment, and then at three-, six-, and nine-month intervals post-treatment. Socio-demographic questionnaires, the Connor-Davidson Resilience Scale, and the Beliefs in Chinese Familism Scale were used to collect data. Growth mixture modeling was employed to determine the various trajectories of resilience, followed by logistic regression analysis to examine the associated factors to predict types of trajectories. Growth mixture modeling showed two distinct trajectories of resilience were identified: an increased group (N = 78, 25.5%) and a stable group (N = 228, 74.5%). The increased group began with a low baseline level (intercept = 46.713) and showed a slight increase over time (slope = 7.505, p < 0.001), while the stable group had a moderate baseline level (intercept = 56.565) and remained stable over time (slope = 0.068, p > 0.05). Those in the stable group were more likely to be female, and to have achieved a middle school level of education, a lower family income, and greater Chinese familism at baseline than those in the increased group. Our findings underscore the importance of tracking the trajectories of resilience and predictors of trajectory patterns among spouses caring for patients with advanced cancer within a specific cultural context. Healthcare providers should provide tailored interventions to enhance resilience in spousal caregivers, considering the trajectory patterns of mental health change.

Exploring the developmental changes in and the relationship between resilience and anxiety and depression in older gastric cancer survivors: A latent growth mixture model and random intercept cross-lagged panel model analysis.

This study aims to investigate the independent and joint trajectories of resilience, anxiety, and depression symptoms and research the interaction between older gastric cancer survivors' resilience and anxiety-depression during the period of 1 year after surgery. The participants were 381 older gastric cancer survivors, with a mean age of 69 years. Resilience, anxiety, and depression symptoms were assessed immediately after surgery, and at 3, 6, and 12 months post-surgery, respectively. A longitudinal design was employed to capture the dynamic changes in resilience, anxiety, and depression levels among older gastric cancer survivors post-surgery. Latent growth mixture model and random intercept cross-lagged panel model were used to analyse the trajectories of resilience and anxiety-depression and the interaction between them. Two latent trajectories were identified for the resilience, four latent trajectories were identified for the anxiety, and five latent trajectories were identified for the depression, respectively, with three joint trajectories identified: gradual-increasing resilience, gradual-decreasing anxiety, and depression group (10.0%); gradual-decreasing resilience, gradual-increasing anxiety, and depression group (21.2%); and rapid-growth resilience, rapid-decline anxiety, and depression group (68.8%). Resilience among older gastric cancer survivors exhibits significant bidirectional and negative predictive effects on anxiety and depression. Individual differences in resilience, anxiety, and depression trajectories exist among older gastric cancer survivors, with heterogeneous joint progression patterns, and the relationship between resilience and anxiety-depression appears bidirectional. More sophisticated intervention programmes tailored to the unique characteristics of the relevant trajectories are necessary to enhance resilience and mitigate the risk of anxiety and depression.

6.M. Scientific session: Risk And Resilience Factors Of Mental Health During COVID: European Multi-country Data Findings

Abstract The COVID-19 pandemic significantly affected mental health. It worsened the mental health and well-being of those already vulnerable or exposed to excess pandemic-related stress. In addition, lockdowns and other measures created additional obstacles to mental health support access. In response, the European Commission funded the RESPOND project in 2020, aimed at enhancing the preparedness of mental health systems for pandemics and global crises. As part of the RESPOND project, (meta-)analyses were conducted on prospective cohort datasets, national health register data, and multi-country individual participant data (IPD). The aim was to examine whether there was a change in prevalence rates of mental health conditions (e.g., anxiety and depression) in the general adult population of the EU during, compared to before and in between, the COVID-19 pandemic waves. Analyses on risk factors (e.g. sociodemographic- and economic factors, severity of COVID-19 infection, (lack of) social activity and support, and loneliness) associated with psychological distress and mental disorders as well as resilience and well-being (coping strategies and core value orientations) in the general population or specific vulnerable groups were conducted as well. This workshop will feature five talks covering various aspects of the RESPOND epidemiological analyses. First, an introduction and rationale of the RESPOND study on short- and long-term impacts of the COVID-19 pandemic and outbreak response, will be provided. Subsequently, findings from the multi-country longitudinal COvid MEntal healTh Survey (COMET) on forecasting psychological distress throughout the pandemic will be presented. Second, findings from the French TEMPO (Trajectoires EpideMiologiques en POpulation) cohort and merged datasets will be presented indicating associations and interactions between socioeconomic factors, mental health, and public health behaviours during the pandemic. Third, using data of a large Belgian prospective cohort, fluctuations in risk of psychological distress across study waves and the factors associated with individual trajectories of psychological distress during the COVID-19 pandemic will be presented. Fourth, the risk of SARS-CoV-2 infection, severe COVID-19 outcomes, and death among individuals with various mental disorders, based on Spanish health records, will be presented with specific attention to sex differences. Finally, based on the IPD meta-analyses of 9 European cohorts, findings on stressor reactivity, resilience trajectories, and factors associated with resilient outcomes and vulnerability are presented. By presenting a selection of findings from large datasets together, we aim to facilitate discussions on critical topics such as vulnerability and resilience to mitigate mental health impacts in future public health crises. Key messages • Targeting specific individual vulnerabilities appears to be more effective in reducing the pandemics’ mental health impact than solely responding to pandemic-related fluctuations. • Research and harmonised data on vulnerability and resilience factors are essential for guiding the development of targeted interventions and support systems for vulnerable populations during crises.

Stress Resilience And Resilience Factors Across 9 European Samples During The COVID-19 Pandemic

Abstract While many describe changes in mental health over the pandemic, we investigate change in resilience over time during the pandemic. Stress resilience can be operationalised as stressor reactivity, that is, how much a person’s mental health is affected by the stressors that they experience. Utilising the individual participant data (IPD) meta-analyses megadataset available we first define and quantify how many stressors individuals. We then regress this stressor exposure on mental health within each sample to compute each sample’s normative stressor reactivity. Each person’s individual stressor reactivity is then calculated as the residual to this line at each time points. Resilient outcomes can be understood as lower reactivity as this indicates lower susceptibility to stressors. Stressor reactivity (SR) scores control for individual stressor exposure, therefore allowing us to investigate resilience factors during a time in which exposure to macro and micro stressors varied greatly between individuals. Further, SR scores are a harmonised outcome that can easily compared across different samples in the IPD dataset. Using this outcome, we present findings on resilience trajectories and identify factors that are associated with resilient outcomes. We also disentangle the role of current stressor exposure and prior stressors, showing that prior exposure to stressors increases vulnerability in subsequent exposures. Our findings show that stressor reactivity over time was more stable than mental health symptoms during the pandemic, therefore indicating that SR as an outcome offers new insights into the impact of the pandemic.

Bouncing back from life's perturbations: Formalizing psychological resilience from a complex systems perspective.

Experiencing stressful or traumatic events can lead to a range of responses, from mild disruptions to severe and persistent mental health issues. Understanding the various trajectories of response to adversity is crucial for developing effective interventions and support systems. Researchers have identified four commonly observed response trajectories to adversity, from which the resilient is the most common one. Resilience refers to the maintenance of healthy psychological functioning despite facing adversity. However, it remains an open question how to understand and anticipate resilience, due to its dynamic and multifactorial nature. This article presents a novel formalized framework to conceptualize resilience from a complex systems perspective. We use the network theory of psychopathology, which states that mental disorders are self-sustaining endpoints of direct symptom-symptom interactions organized in a network system. The internal structure of the network determines the most likely trajectory of symptom development. We introduce the resilience quadrant, which organizes the state of symptom networks on two domains: (1) healthy versus dysfunctional and (2) stable versus unstable. The quadrant captures the four commonly observed response trajectories to adversity along those dimensions: resilient trajectories in the face of adversity, as well as persistent symptoms despite treatment interventions. Subsequently, an empirical illustration, by means of a proof-of-principle, shows how simulated observations from four different network architectures lead to the four commonly observed responses to adversity. As such, we present a novel outlook on resilience by combining existing statistical symptom network models with simulation techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The spatial-temporal evolution patterns of landslide-oriented resilience in mountainous city: A case study of Chongqing, China

Cities, as complex systems with multi-interconnected subsystems, face significant challenges from both rapid urbanization and climate change. Ensuring high resilience in urban areas is essential for managing these dynamic risks effectively. This study introduces an innovative, data-driven approach to quantitatively analyze the spatial-temporal evolution patterns of urban resilience, validated through a case study of Chongqing, a representative mountainous city in China. Based on historical landslide data from Chongqing (2010–2020), which includes 4464 events, along with indicator data from the Chongqing Statistical Yearbook, we developed a comprehensive assessment framework. This framework incorporates 33 variables, covering indicators of physical-environmental resilience (PER) and socio-economic resilience (SER). The model integrates the Random Forest (RF) algorithm, Analytic Hierarchy Process (AHP), and Coupling Coordination Degree (CCD) model. Key findings include: (1) Social development in mountainous cities like Chongqing follows a point-to-area pattern. Although there is an overall increase in SER, the CCD in more developed areas (Chongqing urban circle) was generally higher than in less developed areas (northeastern and southeastern Chongqing) (2) The PER model demonstrated exceptional performance (AUC values consistently above 0.95). Spatiotemporal evolution models reveal that Chongqing maintains a high overall PER. Notably, from 2019 to 2020, the proportion of administrative units classified as highly resilient peaked at 24.5%, marking a historical high. (3) Multi-year average rainfall primarily impacts PER (ranked first), while Gross Domestic Product (GDP) significantly affect SER. The development of multi-dimensional recovery indicators provides a robust framework for assessing resilience against landslides in mountainous cities. The CCD model illustrates the importance of regional dynamic coordinated development in resilience trajectories. This study provides a detailed blueprint for the scientific development of resilient mountainous cities, emphasizing the need for a spatial-temporal perspective on resilience and the benefits of coordinated regional development.

Trajectories of Short-Term Post-Traumatic Stress Disorder Symptoms in Patients with Post-Intensive Care Syndrome: A Longitudinal Observational Study.

Post-traumatic stress disorder (PTSD) is a major psychiatric health issue among intensive care unit (ICU) survivors with post-intensive care syndrome (PICS). Although early PTSD intervention has been demonstrated to decrease the risk of progression from acute to chronic PTSD, information on the progression trajectory of short-term PTSD symptoms and modifiable risk factors in PICS patients is limited. This study aimed to explore the clinical progression trajectories of short-term PTSD symptoms and the associated factors in PICS patients by conducting a prospective longitudinal observational study. This study was conducted at a tertiary hospital in China. The impact of event scale-revised was used to collect data on the PTSD symptoms of patients at 1, 2, 3, and 4 months post-discharge from the ICU. The latent growth mixture model was used to construct trajectory models for PTSD symptoms and multivariate logistic regression was used to determine the factors associated with the trajectories. A total of 130 ICU survivors with PICS completed the 4-month short-term follow-up. Our results showed that PTSD symptoms in PICS patients manifested as three trajectories, namely, moderate chronic (n = 17, 13.1%), recovery (n = 25, 19.2%), and resilience (n = 88, 67.7%). Compared with the resilience trajectory, age and female were identified as risk factors for the moderate chronic trajectory, while prolonged ICU stay was a risk factor for the recovery trajectory. Our study showed that short-term PTSD symptoms in PICS patients manifested as moderate chronic, recovery, and resilience trajectories. Additionally, our results showed that PTSD screening should be conducted for critically ill patients, especially younger, female, or long-term ICU patients, immediately after their discharge from the ICU.

Translating disaster resilience: How values, world views and politics complicate interpretation and implementation

Globalized climate change and ecological collapse discourses have created a universally relatable conceptual arena within which institutional actors’ debate, design and implement interventions to create ‘disaster resilient cities’ in the Global South. The implications of resilience ideologies and practices adopted from the Global North can have detrimental and counterproductive effects when translated into interventions in postcolonial countries like Pakistan. In this research paper, we use interviews and discourse analysis to underscore the techniques, rationalities, and framings mobilized by governmental and non-governmental actors in the name of ‘reducing risks’ and building ‘disaster resilience’. Within this arena, Pakistani institutional actors create, mimic, and adapt normative resilience trajectories influenced by international resilience standards that do not align, or worse, conflict with the spiritual, cultural, and postcolonial contexts and values of communities they engage with. Imposition of international resilience standards may result in disconnected top-down interventions that overlook the vulnerabilities of local communities deemed as ‘beneficiaries’ and misallocate funds in favor of ineffective projects and programmes, ultimately missing opportunities for meaningful change. While building upon existing urban resilience efforts in Pakistan is important, it is critical to recognize that merely pursuing resilience as an outcome is not enough. Fulfilling basic needs should take precedence over resilience efforts, particularly when the goal is not only the survival of local communities in the face of escalating climate and disaster risks but also their overall well-being.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trajectories and influencing factors of psychological resilience among Chinese patients with maintenance hemodialysis

ObjectiveTo identify distinct trajectories of psychological resilience among Chinese patients with maintenance hemodialysis, explore influencing factors and inform the formulation of corresponding interventions. MethodsThis was a multi-center longitudinal study with a 6-month follow-up. With convenience sampling, a total of 231 patients with maintenance hemodialysis were recruited between September 2020 and July 2021. Patients’ characteristics, including sociodemographic information, social support and family resilience was collected through structured questionnaires as potential baseline influencing factors of psychological resilience trajectories. Psychological resilience was evaluated using the 25-item Chinese version of the Conner and Davidson resilience scale. Latent class growth modeling was conducted to identify homogeneous subgroups with distinct trajectories of psychological resilience. Univariable and multinomial logistic regression analysis were used to examine whether baseline influencing factors were associated with trajectories in patients with maintenance hemodialysis. ResultsFive distinct psychological resilience trajectory groups were identified: declining group (n = 20, 8.7 %), rising group (n = 17, 7.4 %), moderate-stable group (n = 128, 55.4 %), high-stable group (n = 7, 3.0 %) and low-stable group (n = 59, 25.5 %). High-stable group and moderate-stable group were combined into the well-psychological resilience group for multinomial logistic regression analysis. The multinomial logistic regression analysis showed that influencing factors associated with trajectories of psychological resilience were age, religion, monthly household income per capita, and baseline family resilience. ConclusionsThe results highlight the heterogeneity in the development of psychological resilience among Chinese patients with maintenance hemodialysis. There is a need for healthcare professionals to screen for trajectories of psychological resilience in Chinese maintenance hemodialysis patients and prepare individual mental healthcare interventions.

The Role of War-Related Marketing Activism Actions in Community Resilience: From the Ground in Ukraine

Extant literature considers marketing activities as instrumental for postwar recovery and peace-building. However, war is an ongoing lived experience for numerous societies across the world. Focusing on the role of marketing during war, this article presents a study examining how and why people living in war adversity deploy, perceive, and respond to war-related marketing activism actions (MAA). War-related MAA are acts through which brands/organizations and consumers create or draw on marketing meanings to convey and to enact stances and experiences related to war. This study adopts a multimodal qualitative methodology integrating photo elicitation and in-depth interviews with consumers and with marketing and management professionals in Ukraine, the country enduring invasion and war by Russia at the time of this article’s publication. Analyses through a community resilience theoretical lens generate a conceptualization that demonstrates how war-related MAA are harnessed and serve as a medium in community dialogues concerning envisaged resilience trajectories (survival, creativity and growth, and recovery). The article advances understanding of marketing activism during war by illuminating its potential and boundary conditions for serving as a community resilience resource. It also offers public policy development directions for marketing practice, organizations, and governments.

Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma

Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD). To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward. As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023. Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC). PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income). In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory. In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.

Longitudinal Trajectories of Identity Formation and Resilience Development in Adolescents Living in Under-Resourced Communities

Identity and resilience are critical during adolescence, especially when facing contextual challenges. This longitudinal study explored the trajectories of identity and resilience in adolescents (n = 546; MAge = 16.22) living in an under-resourced South African community. Associations between identity and resilience were analyzed across three time points using repeated measures ANOVA’s. The dimensions of identity did not vary substantially across time, but resilience scores fluctuated significantly. Participants with high resilience showed a substantial decrease in Exploration in Depth over time, while participants with low resilience showed an increase. The findings provide insights into how to foster resilience in adolescents living in under-resourced communities.

A longitudinal investigation of mental health outcomes after the Henan floods in China: Examining predictors of resilience trajectories.

A heavy rainstorm struck Henan, China, in July 2021. Previous studies have indicated that natural disasters have a wide range of psychological sequelae, but little research has been done on the psychological effects of floods specifically. This study aimed to track the mental health trajectories of flood victims over time and identify associated protective and risk factors. People living in the areas most impacted by the flood (N = 376) were surveyed at four different time points: 3 weeks, 1 month, 2 months, and 3 months post-flood. Latent growth mixture modeling was utilized to delineate longitudinal patterns of depression, anxiety, and posttraumatic stress disorder (PTSD). Least absolute shrinkage and selection operator logistic regression, a supervised machine-learning approach, was employed to discern predictors among 49 assessed variables at both contextual and personal levels. Results revealed three classes of PTSD (resilience, recovery, moderate symptoms) and anxiety (resilience, chronicity, recovery) trajectories, along with two classes of depression trajectories (resilience, chronicity). Key factors predicting resilience in mental health included personality traits, media consumption habits, pre-existing health conditions at the individual level, and asset loss and ongoing adversities at the contextual level. In spite of the widespread impact of the flood, most victims displayed resilience in the face of adversity. Identifying critical factors across various psychological symptoms offers valuable insights for both pre-disaster preparation and post-disaster trans-diagnostic psychological interventions.

“It’s Time to see What I Can Do”: A Mixed-Methods Investigation into Trajectories of Resilience in Adolescents during the COVID-19 Pandemic

There is a concern that adolescent mental well-being and resilience has been adversely affected by the COVID-19 pandemic. Consequently, the aim of the current investigation was to track adolescents’ resilience from the initial months of the pandemic (T1) to approximately two years later (T2) using both qualitative and quantitative methods. Through interviews, thirty-one adolescents narrated their COVID-19 experiences and reflected on their mental well-being across this timespan. Using these accounts, we identified four groups of adolescents exhibiting one of the following trajectories of resilience: (1) Enduring resilience, (2) Reaching resilience, (3) Declining resilience and (4) Enduring non-resilience. Our findings revealed that most adolescents were able to maintain or develop good resilience on prolonged exposure to COVID-19 adversity (trajectories 1 and 2). This finding is contrary to the prevailing notion that the majority of adolescents’ mental well-being and hence resilience was adversely impacted by COVID-19 in the short and long term. Further qualitative analysis identified key factors that contributed to maintaining and developing greater levels of resilience during the pandemic: quality of friendships, quality of family relationships and regaining a sense of control. Lastly, we found a lack of congruence between quantitative and qualitative measures of mental well-being and resilience, suggesting that they might tap into different constructs/experiences. Significantly, our findings highlight that the majority of teens showed adaptive resilience during the pandemic and highlight the need for further longitudinal qualitative and quantitative research to assess both adaptive and maladaptive impacts of adversity on the adolescents’ mental well-being and resilience.