Background
Adverse experiences (e.g., natural disasters, war, terrorism, and sexual/physical abuse) during childhood or adolescence can result in long-term impairment of one’s psychosocial functioning [
1‐
4]. Although most people encounter various adverse or traumatic events in the course of their lives, their reactions to such events are not universal [
5]. Some people may exhibit psychological difficulties, while others actively respond to disasters, and may even attain post-traumatic growth. Resilience is defined as the ability to bounce back from social disadvantages or highly adverse conditions. Elucidating the role of resilience in children and adolescents in the aftermath of traumatic events can help improve their well-being and suppress the risk of developing psychopathologies, including posttraumatic stress disorder (PTSD), depression, and anxiety [
6‐
8].
Despite the fact that there is no universally accepted definition of resilience, two core concepts have been previously mentioned: adversity and positive adaptation. Bonanno defined resilience as the ability to maintain a relatively stable psychological and physical functioning during adversity [
5]. Based on increasing interest in this concept, many scales have been developed to assess resilience in development psychology, including the Resilience Scale (RS) [
9], Connor-Davidson Resilience Scale (CD-RISC) [
10], Resilience Scale for Adults (RSA) [
11], and Brief Resilience Coping Scale (BRCS) [
12]. Among them, one scale widely used in prior studies is the Resilience Scale [
13].
The Resilience Scale (RS) was initially developed from a qualitative study [
9]. In this study, 24 elderly women who had demonstrated a successful adaptation to traumatic events were interviewed. Five components (equanimity, perseverance, meaningfulness, self-reliance, and existential aloneness) were found to be correlated with resilience. In an empirical study [
9], two factors (personal competence and acceptance of self and life) were extracted from 25 RS items through exploratory factor analysis. Personal competence consists of 17 items including self-reliance, perseverance, mastery, and resourcefulness, while acceptance of self and life includes 8 items involving acceptance of life and a sense of peace in spite of adversities. The 25-item RS has been translated into many languages, including Chinese, Dutch, Swedish, and Japanese, all of which have shown good psychometric characteristics [
7,
14‐
16]. Studies have documented that the mental structure of resilience may vary depending on cultural contexts. For example, 5 factors were identified in the Swedish version [
15], whereas 3 factors were extracted from the Brazilian version [
17]. Furthermore, inconsistent results from different samples of the same country have been documented. For instance, after the 2010 Haitian earthquake, a 5-factor model was found to be supported by child and adolescent survivors [
18], whereas a 3-factor model was confirmed by adult survivors [
19]. Therefore, it is important to examine the psychometric properties of the 25-item RS under different socio-cultural backgrounds.
Risk and protective factors associated with resilience are of particular importance. According to the current resilience models, the factors affecting resilience can be grouped into internal and external factors. Internal factors, such as demographic (gender and age) and psychological (optimism and gratitude) factors, are generated from within an individual. External factors, such as family functions and school climate, are generated from outside of a person. Among the external factors, parenting styles are of particular importance. Parenting styles can affect an adolescent’s mental health [
20,
21]. Positive parenting styles, such as warm, supportive, and acceptance, have been associated with increasing resilience, for example, in protecting adolescents from depression and anxiety. In a study involving elementary school children, it was found that an authoritative parenting style was negatively associated with parent- and teacher-rated maladaptive behavior, and positively correlated with indicators of healthy adjustment [
22]. In the Chinese culture, mothers spend more time taking care of their children compared to fathers, and children tend to feel closer to their mothers than their fathers. Mothers are more involved in educating their children, and thus, maternal parenting styles may exert a greater impact on children’s adjustment. The above studies are limited by the fact that they mainly involved normal children and adolescents. These associations have not been elucidated in traumatized adolescents. Based on this limitation, we systematically examined the contribution of maternal parenting styles to resilience among adolescent survivors after a natural disaster, which may inform the development of interventions aimed at improving resilience.
At 14:28 on the 12th of May, 2008, a destructive earthquake occurred in Sichuan province of southwest China. It resulted in 69,227 deaths, 374,176 injuries and 18,222 missing people. A great number of the children and adolescents suffered the direct effects of the earthquake. Six months after the earthquake, a cohort study was conducted in Dujiangyan city, one of the most severely damaged areas [
23]. With the data on resilience and parenting styles among adolescent survivors from this cohort, the objectives of the current study were: i. To examine the underlying structure and the psychometric properties of the 25-item RS in the Chinese context; and ii. To assess the resilience levels and determine whether maternal parenting styles are important predictors of resilience among adolescent survivors.
Discussion
The first objective of this study was to evaluate the psychometric properties of the Chinese version of the RS in 1266 adolescent survivors of the Wenchuan earthquake. Factor analysis showed that a 3-factor model (factor 1: personal competence; factor 2: meaningfulness; factor 3: acceptance of self and life) was acceptable. Personal competence refers to the willingness or belief that individuals should rely on their own strengths to reconstruct their lives when they encounter setbacks. Meaningfulness refers to the realization that life has a purpose and the sense of having something for which to live. Acceptance of self and life means that individuals can always appreciate life and a sense of peace in the face of adversity. Compared to the study by Wagnild and Young [
9], there is a similarity between their factors and our two factors (factor 1 and factor 3). These two factors were also validated using a sample of adult survivors following Haiti’s earthquake [
19]. In addition, the second factor (meaningfulness) in our study was also presented within the five characteristics of resilience as defined by the original authors [
9]. This factor measured the extent by which the belief in having a goal in life is established. It is the recognition that there is something for which to live.
The reliability coefficient of the RS in our study was 0.89, which was comparable to other reliability studies [
7,
14]. As noted in a previous review, Wagnild [
33] also found that the internal consistency of the RS was consistently high in 11 of 12 reviewed studies (Cronbach’s alpha coefficient ranged from 0.85 to 0.94). In addition, the test-retest coefficient of our study was 0.72, which was lower than the results of previous studies. For example, the test-retest correlation (1-month interval) was 0.78 in the study by Nygren, et al. [
34], and 0.82 (6-month interval) in the study by Lei, et al. [
7] . Since a limited number of studies have evaluated the test-retest reliability of the RS, more studies should be performed to test the stability of RS. Regarding the predictive validity of RS, we found that resilience predicted PTSD, depression, and anxiety after adjusting for some confounders. Compared to individuals with low resilience, individuals with a high resilience exhibited fewer PTSD, depression, and anxiety symptoms. These results are consistent with those of previous studies [
35,
36]. For example, three months after the Jiuzhaigou earthquake, a total of 607 participants were recruited from the heavy damaged areas and assessed. It was found that resilience was significantly correlated to the severity of PTSD, depression, and anxiety symptoms [
37]. These correlations were attributed to several factors. First, highly resilient adolescents often adopt effective cognitive emotion regulation strategies [
38] that serve to attenuate the impact of mental illness. Second, resilient adolescents have positive emotions [
39] and optimistic attitudes [
40], all of which would contribute to reducing the impact of mental illness.
After the earthquake, male adolescents showed higher levels of resilience than females, inconsistent with previous studies that did not find gender-related differences [
18,
33]. However, our finding was in agreement with that of Lei, et al. [
7] who reported that male college students had higher resilience scores than females. Moreover, previous studies that used the Connor-Davidson Resilience Scale also found that male participants had significantly higher resilience scores than females [
41,
42]. This could be attributed to the fact that, compared to males, females have abnormal HPA responses to stress, which may makes them more sensitive to stress [
43]. The participants who had no siblings reported greater resilience than those with siblings. Inferably, compared to children with siblings, the only child might receive extensive attention and support from family members or other closed ones.
The second objective of this study was to determine whether maternal parenting styles had unique contributions to resilience. Teenagers whose mothers preferred caring and autonomy-relevant parenting had higher levels of resilience. This kind of mother considers the children’s wish and opinions when appropriate, gives them a positive feedback and corrects their negative behaviors. These results are consistent with those of previous studies [
44,
45]. For example, one South African study involving a sample of 360 teenagers found that authoritative parenting, characterized by warmth and democracy, was one of the most important predictors of resilience [
44]. Similar results were also reported in elderly adults [
45]. Moreover, overprotected teenagers were found to have a lower resilience. This result was consistent with previous studies [
46,
47]. For instance, in a sample of 200 college students and their parents, the researchers found that perceptions of maternal control were a powerful predictor for students’ anxiety [
48]. Overprotective mothers always try to protect their children against experiencing life or enduring struggles that make them anxious, which might hamper their independence and self-confidence, thus reducing their self-efficacy and resilience.
Several limitations should be noted when interpreting the findings. First, the measurements of resilience in this study were self-reported by adolescents, which may be biased by social desirability. Multiple assessments (e.g. parents’ reports or teachers’ reports) should be considered in future studies. Second, participants in this study were only recruited from among adolescents who had suffered a devastating earthquake, which limits generalization of the conclusions to adult populations and other types of acute or chronic traumatic events. It is also possible that the sampling range may bias the validity of the factors. These findings should be verified using larger and representative samples. Third, resilience is a multidimensional concept that may be affected by a variety of factors, such as biological, psychosocial, or contextual. Future studies should use multiple markers that can increase or decrease resilience.
Notwithstanding these limitations, this study shows that the RS is a reliable and valid tool for assessing resilience among adolescent survivors after disasters. Resilience scores may be useful for identifying vulnerable individuals at a high risk of developing mental disorders following natural disasters, so that they might be referred for mental health services. The scale can be administered to a large number of individuals at a low cost, and can maximize the utilization of limited resources in the occurrence of natural disasters. Large scale screening methods may not only be more cost-effective, but can also reduce stigma and discrimination, which might be induced by using scales of psychiatric symptoms as criteria for referral to services. This study also contributes to the identification of factors associated with resilience, which may provide some insights for the development of resilience-oriented interventions. Interventions aimed at enhancing resilience can be carried out in school settings. These interventions have been shown to be effective in reducing the symptoms of depression and anxiety [
49]. Therefore, from a public health perspective, resilience-oriented prevention and early intervention programs are a relatively low-cost investment with the potential for excellent returns.
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