Copyright 2011, The Johns Hopkins University and Judith Bass. All rights reserved. Use of these materials permitted only in accordance with license rights granted. Materials provided “AS IS”; no representations or warranties provided. User assumes all responsibility for use, and all liability related thereto, and must independently review all materials for accuracy and efficacy. May contain materials owned by others. User is responsible for obtaining permissions for use from third parties as needed.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this site.

Judy Bass, MPH, PhD Johns Hopkins University

Processes of Risk and Resilience: Youth and Adults, Part 1

Class Objectives

  Be able to … -  Define and differentiate between the terms risk and resiliency -  Identify mechanisms that underlie different risk and resiliency

factors -  Describe how the impact of risk and resiliency factors may

differ depending on context (i.e., low vs. high resource) -  Describe variations across subgroups (i.e., adults/youth)

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Definitions and Theory

Section A

A Few Definitions of Risk

  Risk is the probability that an event will occur

  Risk factor is a factor that increases the probability that an outcome will occur -  Immutable risk factors -  Modifiable risk factors

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A Few Definitions of Resilience

  A construct representing positive adaptation despite adversity (Luthar, Cicchetti, and Becker, 2001)

  Resilience refers to a pattern over time, characterized by good eventual adaptation despite developmental risk, acute stressors, or chronic adversities (Masten, 1994)

  Different ways of conceptualizing -  Resilience traits -  Resiliency as a process

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How Risk and Resiliency Factors Affect Outcomes

  We’ll be looking at three models for understanding how risk and resiliency factors might produce positive or negative outcomes

  It’s important to know not only what the risk factors are, but also to understand the mechanisms by which risk factors make someone more susceptible to a negative outcome (or how resiliency factors promote positive outcomes)

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Stress-Diathesis Model

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Stress-Adjustment Paradigm

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Developmental Ecological View

10 Sources: Bronfenbrenner. (1979); Elbedour. (1993).

Macrosystem: political and historical context, culture

Exosystem: community situation and support, social services, opportunities

Microsystem: family situation and support, cohesion, resources

Ontogenetic development: individual characteristics, e.g,

IQ

Three Models

1.  Stress-diathesis model

2.  Stress-adjustment paradigm

3.  Developmental ecological view

11 Source: Photo by Internews. Creative Commons BY-NC-SA. Retrieved from flickr.com

Copyright 2011, The Johns Hopkins University and Judith Bass. All rights reserved. Use of these materials permitted only in accordance with license rights granted. Materials provided “AS IS”; no representations or warranties provided. User assumes all responsibility for use, and all liability related thereto, and must independently review all materials for accuracy and efficacy. May contain materials owned by others. User is responsible for obtaining permissions for use from third parties as needed.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this site.

Group Activity in Preparation for LiveTalk

Section B

Exercise

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1.  Identify a risk factor and a resiliency factor that moderates this relationship

2.  Write 2–3 sentences that describe the mechanism for each one

Poverty Mental distress

Resiliency factor

Risk factor

Risk Factors from the Literature

Section C

Risk Factors in Low-Resource Environments

  Poverty

  Gender

  Trauma and violence

  Illness—HIV/AIDS

  Urbanization

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Poverty

  State of having insufficient means

  Impacts incidence and course of disease

  Lack of education and opportunities

  Indebtedness as a source of stress and worry

  Malnutrition

  Defined in epidemiology as … -  Low SES, unemployment, and low

education 6

Photo by simaje via flickr.com. Creative Commons BY.

Poverty and Common Mental Disorders

  Review of 11 studies -  Two African countries, two Asian countries, two Latin American

  10/11 found statistical relationship between disorders and measures of poverty

  Poverty factors -  Poor living conditions, insecurity of income flow, hopelessness

and humiliation, poor education, more general health problems

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Female Gender

  Multiple roles -  Child bearing and rearing,

running the home, caring for the sick, earning income

  Reproduction -  Expectation of childbearing

  Gender selection of child   Issues of infertility

8 Photo by Ben Piven via flickr.com. Creative Commons BY-NC.

Female Gender

  Multiple roles -  Child bearing and rearing,

running the home, caring for the sick, earning income

  Reproduction -  Expectation of childbearing

  Gender selection of child   Issues of infertility

  Gender inequality in power and status

  Domestic violence

9 Photo by Ben Piven via flickr.com. Creative Commons BY-NC.

Trauma and Violence

  Refugees and internally displaced persons -  50 million estimated by

International Federation of Red Cross and Red Crescent Societies (IFRC)

  War and famine often chronic

  Natural disasters with few resources

10 Photo by isafmedia via flickr.com. Creative Commons BY.

HIV/AIDS

  In parts of Africa, more than 20% of the population between the ages of 15 and 49 are infected

  Problem of orphans and mental health

  Social rejection and stigma

  Lack of treatment access

11 Photo by Zoriah via flickr.com. Creative Commons BY-NC.

Urbanization

  Migration

  Overcrowding

  Pollution

  Dependence on cash vs. crops

  Reduced social support/family breakdown

12 Photo by Leigh Rowan via flickr.com. Creative Commons BY-NC-SA.

Summary

  Are risk and resiliency different sides of same coin or are they different factors altogether?

  There are different theoretical models for understanding risk and resiliency

  The impact of risk and resiliency factors is often exacerbated in low-resource settings

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