michaelgalvin.memichaelgalvin.me/wp-content/uploads/2016/06/mgalvin… · Web viewA robust sample of well-recommended and well-cited scholarly literature, harvested from databases

Running head: ENHANCING COLLEGE STUDENT RESILIENCE

Toward Enhancing College Student Resilience:

An Exploration of Resilience Definitions, Factors, Interventions and Measures

Michael Galvin

George Mason University

Summer 2016, Third Portfolio Synthesis Paper

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ENHANCING COLLEGE STUDENT RESILIENCE

I. Part One: Operationalizing the Resilience Construct: Definitions and Factors

A. Introduction

A robust sample of well-recommended and well-cited scholarly literature, harvested from

databases and catalogues such as Psycnet, Elsivere, Sage, Wiley, Proquest, PubMed, and Annual

Reviews, was examined in order to gain an understanding of the evolution of resilience

scholarship from the emergence of the concept as an important object of study, to the most

contemporary approaches to the topic. 72 peer-reviewed journal articles and book chapters were

sorted by publication date and theoretical framework and examined with regard to definitions of

resilience and factors that were indicated as significant indicators of and influences on resilience

outcomes and processes found in the literature.

The resulting narrative describes the trajectory of the emergence of resilience from a focus on

characteristics of school children that achieved academic and personal success despite a history

of adversity, to an eclectic and interdisciplinary systems approach to human resilience that

encompasses the full spectrum of resilient experience, development, processes, and outcomes

that contribute to success and flourishing across the lifespan.

B. The Study of Resilience

In the early years of research into resilience as an important object of scholarship, researchers

wanted to know why some children seemed to attain far better outcomes than others despite

sharing a similar set of experiences of adversity and challenge.

The study of resilience was initially handicapped by the diversity of definitions and

frames of reference from which researchers approached the topic, but has since flourished due to

a trend toward a holistic and inclusive discovery process within which multiple levels of

analysis, dimensions of research, theory and practice that have been woven around this important

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construct. The result has been an expansion of research opportunities and lenses that continue to

create rich new ways to explore the implications of using the word.

The term “resilience” has only relatively recently become a word applied to living beings.

Before the late 1970s it was a key concept in the lexicon of materials science. Materials that were

malleable yet tended to maintain their original (manufactured) shape were highly valued,

representing matter that withstands stresses. These materials are the iron alloys and aluminums

and recently the titanium blends that build the best bridges, skyscrapers, eyeglass frames and

spaceships because they can withstand violent forces, “bend” in the face of adversity, and return

to an often new and better normal. The word gained traction in psychiatry and prevention circles

in the early and mid 20th century, and became a focus of intense interest after the Kauai

longitudinal study of resilience began to show results (E. Werner, 2005; E. E. Werner, 1993) that

surprised people.

Ann Masten is a seminal theorist and empirical researcher in the field of resilience and

remains an important and influential author. In 2006 she wrote that there have been three waves

of resilience research, all behavioral in focus. The initial work was largely descriptive: a short

list of assets/protective factors associated with resilience in kids emerged. The second wave

focused on uncovering the processes and regulatory systems that raise up that short list.

The third wave was characterized by efforts to promote resilience through prevention,

intervention and policy, and rose from a sense of urgency for the welfare of children at risk who

could not wait for the long tail of research. “The emergence of multivariate resilience research,

and the sophisticated application of models and statistics signaled the coming of the fourth

wave” (A. S. Masten & Obradovic, 2006, p. 14). This fourth wave now focuses on integrating

the study of resilience across levels of analysis, species and disciplines, and the plasticity of

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adaptive functioning (Shapiro, Oman, Thoresen, Plante, & Flinders, 2008). Resilience is now

studied as a force in a complex ecosystem.

The first part of this paper looks at definitions of resilience and the factors that are related to

divided and labeled by empirical era and by the contextual framework through which the work

has emerged and viewed.

C. The First Wave

1. Public health and K-12.

From the perspective of Public Health and prevention, Kumpfer explains that research in

this field suffers from difficulties separating cause and effect, locating good measures for

resiliency variables, simultaneously studying large numbers of variables needed to determine

which are most salient or predictive of positive outcomes despite high risk status, and finding

nonlinear, transactional data analytic methods capable of accurately summarizing bi-directional,

transactional data (1999) . She defines resilience as the capacity of a child to meet a challenge

and use it for positive growth, or using a broader definition offered by Masten in an early

publication (Wang & Gordon, 1994); " a process capacity or outcome of successful adaptation

despite challenges or threatening circumstances…good outcomes despite high risk status,

sustained competence under threat and recovery from trauma” (Kumpfer, 1999, p. 181).

Kumpfer offers a resilience framework outlining a broad range of resilience factors that

influenced early education teachers, school psychologist and counselors and a myriad of scholars

throughout the 20th century and beyond. This framework includes both process and outcome

constructs, with six major predictors of resilience: 1) stressors or challenges, incoming stimuli

that activate the resilience process and create disequilibrium, disruption in homeostasis, 2) the

external environmental context, including the balance of salient risk and protective factors and

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processes in the context in critical domains of influence; family, community, culture, school,

peers. 3) The Person-environment interaction process: transactions between a child and their

environment, 4) Internal Resilience factors, such as spirituality, dreams, goals and sense of

purpose, existential meaning in life; determination and perseverance; cognitive competencies

such as academic, planning, creativity, intelligence, mastery experiences, insight and reflective

skills, moral reasoning, self esteem and ability to restore, problem solving skills; socio-

behavioral skills such as life and communication skills; physical good health; physical talents

attractiveness; emotional stability and management; empathy; humor; awareness of

competencies and strengths; independence; internal locus of control; hopefulness; optimism;

multi-cultural and cross-gender competencies; talents; capacity for intimacy; empathy and

interpersonal skills, 5) Resilience processes; unique resilience or coping processes learned by the

individual through gradual exposure to use as reliable tools for resilient reintegration,

homeostatic reintegration, or maladaptive adaptation or dysfunctional reintegration with major

reduction in positive reintegration, 6) Positive outcomes/successful adaptation (life hacks) that

support future positive adaptation. This domain is difficult to define because the judgment is

value-laden and culturally relative (Kumpfer, 1999).

Michael Rutter (1987) refrained from defining resilience. Scholars were struggling to see

resilience as separate from the factors that contributed to it. He does assert at this early date that

resilience cannot be seen as a fixed attribute of an individual. It is not a trait. Vulnerability and

protection, positive and negative poles; the process or mechanism of the interaction between the

risk and the outcome, not the variable, determine the function of resilience. These often come

together at key turning points in people's lives, and influence the direction of the trajectory of

adaptation.

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Rutter and others explore the vulnerability and protection processes that influence

resilient outcomes. interaction processes: sex, temperament; parent-child relationships; marital

support; planning; school experience; early parental loss; life turning points, mediating

mechanisms: the alteration of risk, as in "inoculation"; reducing demands of the task that

produces risk effect; the alteration of exposure, as through parental supervision and support;

temperamental variations and reduction of chain reactions perpetuating maladaptive patterns of

experience; self-esteem and efficacy (affective and cognitive self concepts) as manifested by

well-established feelings of self worth; personal relationships that produce long term sequalae of

secure early attachments; task accomplishment (Bandura's idea of mastery experiences) and

times in the life-course that change the mix of mechanisms and opportunities provided by these

turning points/changes, decisions, and physical relocation.

In this early period of research, theory and practice, we continue to see an expectation

that some students possess trait resiliency. Writing from the schools and early childhood

development theoretical framework, Waxman et al. define educational resilience as student

success in schools despite the presence of adverse conditions (Waxman, Gray, & Padron, 2003).

Synonyms are hardy, invulnerable, and invincible. Resiliency refers to those factors and

processes that limit negative behaviors associated with stress and result in adaptive outcomes

even in the face of adversity, and point to Wang and Gordon’s definition as the short version: the

heightened likelihood of success in school and other life accomplishments despite environmental

adversities brought about by early traits, conditions and experiences (1994).

The authors assert that adversity is a difficult phenomenon to operationalize and define

due to other risk factors that act as confounding variables of influence. So the number and

magnitude of risk factors need to be continually addressed, and suggest that there will continue

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to be difficulty inherent in measuring resiliency. Factors that influence trait resilience are social

competence; problem solving skills; autonomy: a sense of purpose; personal attributes such as

motivation and goal orientation; positive use of time; family life; school and classroom learning;

individual characteristics; school environment; genetic factors; individual dispositional attributes

affectional ties with family; external support systems in the environment; time management

skills; academic aspirations; teacher expectations; mastery opportunities; modeling of positive

professional relationships; and developing an environment and opportunities for the experience

of "flow" (Csikszentmihalyi, 1997; Waxman et al., 2003).

2. Developmental Psychology.

Developmental investigators often defined resilience in terms of a record of meeting

developmental expectations: salient developmental tasks, competence criteria, or cultural age

expectations, while others in Public Health and prevention of substance abuse and

psychopathology focused on the absence of symptoms and impairment (Ann S. Masten et al.,

2004). Scholars are interested in transitions that occur with normative changes in the individual,

the environment and their interaction for three reasons: developmental transitions into YA and

EA provide opportunities for change in adaptive functioning, “as multiple systems that aim to

sustain continuity in the organism and its transactions with the environment enter a period of

flux, where reorganization may become easier” (Ann S. Masten et al., 2004, p. 1071). Also

resilience and psychopathology may emerge in tandem with normative as well as non-normative

transitions, and cultures and adults tend to create structures and rituals that socialize young

people through scaffolding transitions to influence their development.

Masten and colleagues define resilience as a class of phenomena characterized by good

outcomes in spite of serious threats to adaptation or development. Results of their research

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reinforce the expectation that change is the norm. Success in developmental tasks in YA and EA

is related to core resources from childhood (IQ, parenting quality, SES) and to EA adaptive

resources such as planfulness/future motivation, autonomy (a global index of self-reliance, self-

directedness, emotional independence and independent decision-making), adult support and

coping skills, and the turning points that offer opportunities for change. Competence (a global

measure of adaptive capacity, IQ, social adjustment, ego strength, and coping measures), realistic

goal setting, intellectual investment and capacity, dependability, productivity, self confidence,

self control, autonomy (a global index of self-reliance, self-directedness, emotional

independence and independent decision-making), agency with opportunity, having adults one

can count on for help, are additional factors that contribute to positive developmental outcomes

from childhood through YA, EA and into adulthood (Ann S. Masten et al., 2004).

Connor and Davidson designed the robust and often-used Connor-Davidson Resilience scale

as a brief, self-rated assessment to quantify resilience as a clinical measure for establishing

reference values in the general population, and to assess response to treatment (pharmacological

intervention) for anxiety, depression and stress reactions (2003). They defined educational

resilience as a multi-dimensional characteristic varying with context, time, age, gender, cultural

origin and individual differences, that embodies the personal qualities that enable one to thrive in

the face of adversity, and one that may be viewed as a measure of successful stress-coping

ability. The instrument measures what they label as characteristics of resilient people: the

individual’s view change or stress as challenge or opportunity; commitment; recognition of

limits to control; engaging the support of others; close, secure attachment to others; personal or

collective goals; self-efficacy; the strengthening effect of stress; past success; realistic sense of

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control/having choices; sense of humor; an action oriented approach; patience; tolerance of

negative affect; adaptability to change; optimism, and faith (a spiritual component).

Beginning at a state of biopsychospiritual balance (homeostasis) we adapt our mind,

body, and spirit to our life experiences. With some situations, our usual adaptations and

protective factors are not enough, and this homeostasis is disrupted. Over time our response is a

reintegration process leading to one of four outcomes: 1) an opportunity for growth and

increased resilience leads to a new higher level of homeostasis; 2) a return to baseline

homeostasis, as we just hope to get through the disruption; 3) recovery with loss, resulting in a

new lower baseline, or; 4) a dysfunctional state in which we use maladaptive strategies, such as

self destructive behaviors, to cope with what adversity life throws at us (Connor & Davidson,

2003).

3. Positive psychology

As early as 2001, Barbara Frederickson offered a positive psychology perspective in her

Broaden and Build theory of positive emotions. Discrete positive emotions all share the ability to

broaden people's thought-action repertoires, building enduring personal resources. The capacity

to experience positive emotions: joy, interest, contentment, pride, land love, fuels psychological

resilience, and may even build resilience in "upward spirals toward improved emotional well-

being" (Fredrickson, 2001, p. 9).

D. The Second Wave

In the early 21st century we begin to see a second wave of resilience scholarship centered on

the resilience experience in later life, with frequent references to well-being and flourishing.

From this perspective Ong and Bergeman define resilience as characterized by maintaining

developmental capacities in the face of cumulating threat and challenge. They explain that

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heterogeneity of stress response is most pronounced in later life (2004). To the date of this

publication, although reliable and valid measures of well-being had been designed to access

inter-individual differences in traits, few have emerged that address process measures of well-

being appropriate for use with older adults.

Protective resources for this population fall in two broad areas: 1) Individual resources:

personality, optimism; personal control; coping; religiosity; spirituality; perceived or self-rated

health; humor; Duchene laughter; cognitive complexity; trait mindfulness; and positive self-

regard. 2) Familial and Community Resources: quantity and quality of family and friend support

(instrumental and emotional); community resources; religious affiliation; cultural influences;

good quality relationships; life purpose; self-authorship and positive environment management;

self-efficacy; capacity to follow inner convictions; a sense of continuous growth; and general

sense of life satisfaction (Ong & Bergeman, 2004).

A. Public health

Using the public health lens with a focus on adolescents, Fergus and Zimmerman define

resilience as process of overcoming the negative effects of risk exposure, coping successfully

with traumatic experiences, and avoiding the negative trajectories associate with risks (Fergus &

Zimmerman, 2005), with a focus on promoting factors. Resilience theory, though focused in this

middle period and in this discipline on risk exposure among adolescents, is more likely to

consider strengths rather than deficits as key factors, on understanding healthy development in

spite of risk exposure. The authors declare that resilience is either a process or an outcome, not a

static trait. Resilience is defined by the context, the population, the risk, the promotive factor,

and the outcome, so it is suggested that researchers use the term resilience instead of resiliency.

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Resilience does not describe a person, but profiles or trajectories (Fergus & Zimmerman, 2005).

Here we see our first reference to resilience trajectory.

Promoting factors are either assets (w/in person): competence; coping skills; self-efficacy; or

resources (external): parental support; adult mentoring; and positive community organizations.

The term resources encourages one to place resilience theory in an ecological context. Any factor

can be a risk exposure, an asset or a resource, depending on its nature and level of exposure to it.

Think of the potential polarity that inheres in self-esteem; internal locus of control; positive

affect, religiosity; family connectedness; parental involvement with school; psychological well-

being; social competence; academic achievement; decision-making skills; and affective control

(Fergus & Zimmerman, 2005). Here we see the first reference of possible “dark sides” of those

factors we might have assumed to have one or the other valence, positive or negative (T.

Kashdan & Biswas-Diener, 2014).

Three models explain how promotive factors operate to alter the trajectory from risk

exposure to negative outcome: a compensatory-direct effect of promoting factor on an outcome,

independent of the effect of the risk factor; a protective factor model- in which assets or

resources moderate or reduce the effects of risk and influence the relationship between risk and

outcome. Luthar defines a process-stabilizing-protective factor model that neutralizes risk effect,

and protective-reactive model in which the protective factor only diminishes the expected

correlation between risk and outcome. In Luthar’s protective-protective model, a protective

factor enhances the effect of another. In the challenge model, a relationship between risk factor

and outcome is curvilinear (like inoculation); the same variable is risk and protective over time

(Fergus & Zimmerman, 2005; Luthar, Sawyer, & Brown, 2006).

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Hegney et al. define resilience as "a highly complex and dynamic phenomenon composed

of multiple interrelated dimensions which fluctuate over time…conceptualized by the two

pivotal constructs of adversity and adaptation" (2007, p. 3). Resilience following a disaster can

take the form of stress resistance, recovery, and positive transformation. It is not a steady state in

a person, but varies with each individual’s relationship with life experience over their lifespan. In

resonance with the authors’ focus on resilience in indigenous populations in Australia, they add a

new factor to the mix; a connection with the land among rural, indigenous and others who have

cultivated a relationship with the it (Hegney et al., 2007).

From the public health/health education community, Knight (2007) suggests that in the

literature of this time, resilience is discussed as a state, a condition, and a practice, asserting that

it is not a quality that some possess and others do not, and that emotional competence, social

competence, and futures orientation are influential factors that facilitate resilience.

B. Developmental Psychology

Almeida examined the value of tracking stress longitudinally. He found that minor

stressors during the day affect well-being by having separate, immediate and direct effects on

functioning, and will tend to pile up over time to create persistent irritations and allostatic

loading that may result in more serious stress reactions like anxiety and depression. The National

Study of Daily Experiences (NSDE) reveals that about half of the daily stressors in 1483 adults

over eight consecutive days were interpersonal arguments and tensions. Research on these

stressors has benefited from qualitative diary methods of data collection delivered over the phone

or through digital devices or web pages.

Alemeids’s resilience and vulnerability factors include sociodemographic factors: age;

gender; education; income; marital status; and parental status; psychological factors: personality

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traits; mastery; chronic stress; life goals; and health factors: chronic health problems; acute

disease; and mental health. All of these factors interact with stressor exposure and reactivity.

Stress characteristics are frequency; content; focus of involvement; objective severity, and

subjective appraisal of the stressor: goal relevance and commitment; severity of loss; and threat

or challenge, stress reactivity. These factors mediate the experience of stress; daily well being;

psychological distress; and physical symptoms (Almeida, 2005).

Suniya Luthar is one of the most cited resilience theorists, representing the developmental

psychology domain with a focus on adolescents. She asserts that resilience and vulnerability/risk

factors that appear along a continuum from positive to negative (bipolar) need to be examined to

determine whether or not effects lie at one end or another as opposed to equally; these processes

need to be unpacked to reveal correlations, interactions, mediating and modifying effects of

factors in relationship to each other within global risk factors, and what it means to be "high" and

"low" risk. She and her colleagues encourage more within-group analysis as opposed group

comparisons, to see what makes a difference for this population, and to add a layer of focus on

biological and genetic factors. Luthar et al. suggest a set of guidelines for choosing protective

and vulnerability factors for meaningful research; choose factors that are salient in particular life

context, those that are malleable, tend to be enduring across a life span, and may be generative of

other assets-those that may catalyze cascades of other processes (Luthar et al., 2006).

C. Positive Psychology

Using the Broaden and Build theory as a research framework, a study by Tugade and

Frederick showed that resilient individuals use positive emotions to bounce back from negative

emotional experiences. Resilient people have optimistic, zestful and energetic approaches to life,

are curious and open to new experiences, are characterized by positive emotionality, and

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proactively cultivate their positive emotionality through the use of humor, relaxation techniques

and optimistic thinking. The authors define psychological resilience as the ability to bounce back

from negative emotional experiences and flexible adaptation to the changing demands of

stressful experiences (Tugade & Fredrickson, 2004).

Positive emotions may be the underlying mechanism through which high-resilient

individuals achieve their adaptive outcomes. Ong and colleagues, representing the later life

developmental psychology framework (with a dose of well-being theory) define resilience

simply as successful adaptation to stress in later life. Their Dynamic Model of Affect (DMA)

(Ong, Bergeman, Bisconti, & Wallace, 2006) predicts that under ordinary circumstances,

positive and negative emotions are relatively independent, while during stressful encounters, an

inverse relationship between positive and negative emotions increases dramatically. Positive

emotions have both protective and restorative functions. Later life individuals gain in resilience

from benefit finding and positive reappraisal; humor and infusing ordinary events with positive

meaning; goal-directed problem-focused coping; a habitual outlook on life; a capacity to

maintain partial separation and/or simultaneous activation of positive and negative emotions

under stress; preserving emotional complexity; and the ability to selectively mobilize positive

emotions to bounce back.

Some scholars and other uninformed continue to construe resilience as a personal trait, a

disposition, while others see it as an ongoing developmental process. Given the diversity of

perspectives, populations of interest and academic heritage, this is not difficult to imagine, and

for some reduces to a simple issue of preconceived notions that just won’t budge or have not

been challenged. Lightsey defines resilience as "A general sense of self-efficacy... an awareness

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of one's strengths and capacities that allows one to better cope with future stressors and to use

available resources" (2006, p. 101).

By 2007 Tugade and Frederickson have enriched their definition of resilience that reads;

“a resourceful adaptation to changing circumstances and environmental contingencies, analysis

of the ‘goodness of fit’ between situational demands and behavioral possibility, and flexible

invocation of the available repertoire of problem-solving strategies, with problem-solving being

defined to include the social and personal domains as well as the cognitive” (Block & Block

1980, Tugade & Fredrickson, 2007, p. 318)

For these authors emotional regulation has risen to a primacy as the prime factors

influencing psychological resilience: our attempts to influence the types of emotions we

experience, when they are experienced, and how they are experienced or expressed. By

maintaining or savoring emotional experiences, we deliberately attend to pleasant experiences,

we interpret them positively to ourselves and in narratives to others. We celebrate or capitalize

on them, and contentment is the echo, the after-effect of savoring. And we are encouraged to find

meaning in negative events through reappraisal, problem-focused coping, and through infusing

ordinary events with positive meaning. Those who are naturally more resilient people experience

more humor, relaxation, exploration, hopeful optimistic thinking, faster cardio vascular recovery

than those who are not.

Chronically accessible emotions demand minimal cognitive resources, freeing up

conscious and neural space for a more voluntary allocation of resources. Emotion regulation

strategies promote resilience. Some people are more “dispositionally” inclined to savor

experiences; it is a practice that can be cultivated through gratitude exercises (Cohn &

Fredrickson, 2010; Sin & Lyubomirsky, 2009; Tugade & Fredrickson, 2007).

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D. Neuroscience/ Biology

Charney suggests that neural mechanisms of reward and motivation, fear responsiveness and

adaptive social behavior are relevant to the character traits associated with resilience. Many

neurological responses are related to resilience to psychological stress. Neurotransmitters,

neuropeptides and hormones have been linked to acute psychobiological response and long-term

psychopathology, as the roles of these systems are significantly altered by psychological stress.

Levels of these neurochemical mediators of reward and motivation can provide markers of

resilience, and offer some promise for pharmacological intervention of acute stress reactions,

such as anxiety, depression and PTSD (Almeida, 2005; Charney, 2004). One process that speaks

to contemporary resilience literature is the neurobiological process of memory reconsolidation

and extinction, which is a core concept in Graham's imagination-based therapies (Graham,

2013).

Cicchetti and Blender also apply a neurobiological lens to resilience (Cicchetti & Blender,

2006). From this perspective they define resilience as "a dynamic developmental process that is

often operationalized as an person's attainment of positive adaptation and competent functioning

despite having experienced chronic stress or detrimental circumstances, or following exposure to

prolonged and even severe trauma" (Cicchetti & Blender, 2006, p. 249). Their research strongly

suggests that Neuroplasticity, genetics and the environment interact with an individual's

dispositions and cognition to influence resilient processes. "Neural plasticity can be seen as a

dynamic nervous system process that orchestrates nearly constant neurochemical, structural, and

functional central nervous system alterations in response to experience" (p. 251). Biology is just

one piece of the holistic systems approach to understanding resilience, one that is mindful of all

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levels of analysis from cellular to cultural. This framework demands a multiple-levels-of-

analysis perspective on resilience.

Advances in genetics, psychopharmacology, and brain imaging allow for closer study of

biological underpinnings of resilience. A promising avenue of research involves the interaction

between early experience and genetically determined neurobiology. Positive psychology has

turned the study of stress and trauma away from pathology and toward strengths and virtues: the

phenomena of post-traumatic growth, a resilience process through which suffering can prompt

the development of compassion, wisdom and well-being. From this hopeful perspective, stress

and trauma may be as likely to stimulate as impede adaption and positive growth (Cicchetti &

Blender, 2006).

From a theoretical framework of developmental psychology infused with neurobiology,

Haglund et al. (2007) offer a review of research, presenting important neurological and

psychological factors that influence resilience, such as nueuro-hormonal response factors to

acute stress: CRH, Corizol, DHEA, Testosterone, LC-NE system, NPY, Galanin, Seratonin/5-

HT, Dopamine, as well as psychobiological resilience factors: positive affect facilitated by

humor and optimism; an active coping style; facing fears; cognitive flexibility (explanatory style,

cognitive reappraisal) and acceptance; a moral compass; physical exercise; and social support

role models and mentors. Resilience to the effects of severe stress is about avoiding

overgeneralization triggers being embraced by our “monkey mind” that produce fear, and the

capacity to make extinct fearful memories. There are neural processes for reward,

reconsolidation (re-remembering) and extinction that are associated both with psychopathology

and resilience (Graham, 2013; Haglund et al., 2007).

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E. The Third Wave

Between 2005 and 2008, scholars from a wide variety of theoretical frameworks were

reading, appreciating and writing about each others’ work and taking higher level world-views of

the implications of resilience theory and practice on the study of human success. Scholars

increasingly make references to well-being, healing and success-orientated interventions,

interdisciplinary and multidisciplinary approaches, positive psychology, the impact of our

cognitive appraisal of experience, self-construal, and growth trajectories that originate not in dis-

ease but in moving beyond satisfaction toward excellent life experience.

Mancini and Bonanno (2009) propose a model in which Indirect effects of individual

differences are channeled through at least two resilience mechanisms: the process and the use of

social resources. Person-centered factors interact with one another and with environmental

factors. There are at least two styles of coping that predict resilience outcomes: flexible

adaptation and pragmatic coping. In this model resilience factors include self-enhancing bias,

repressive coping or dissociation, a-priori beliefs, trait self-enhancing biases (which may get a

person "over the hump" but as a disposition is often associated with negative consequences),

identity continuity and complexity, attachment dynamic, positive emotions and comfort from

positive memories. The authors define resilience as “a variegated phenomenon that defies

simple characterization...it cannot be defined in the abstract or applied to individuals in the

absence of an extremely aversive experience, such as loss", so resilience is operationalized as an

outcome following a highly stressful event (Mancini & Bonanno, 2009, pp. 1807, 1803).

1. Positive psychology and well-being

In a review of articles in the December 2009 Journal of personality, Zautra (2009)

suggest that there is a two part definition of the resilience domain: recovery- how quickly people

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and the groups they gather into bounce back and fully recover from challenging events; regaining

homeostasis (a relatively autonomic set of processes); and sustainability-the capacity to endure

and continue forward in the face of adversity, characterized by awareness, Identity is

operationalized as choice of values and purposes. People who are resilient quickly regain

physiological and psychological equilibrium, and in their social lives, following stressful events.

Factors that contribute to resilience outcomes are identified as Well-Being Therapy, "possible

selves" exercises, positive parenting, mindfulness meditation, shared sense of community

purpose-citizen engagement and empowerment (Zautra, 2009).

Seery (2011) reviews the research that reveals U-shaped relationships between exposure

to adversity across the life-span and mental health and well-being. The author administered the

Cumulative Life Time Adversity Measure to a diverse population of 2000 individuals, and

assessed them several times over the next two years. The stats revealed "significant quadratic

relationships between adversity and longitudinal mental health and well-being, such that a

history of some prior adversity was associated with better outcomes over time than a history of

high adversity and of no prior adversity" (Seery, 2011, p. 191), indicating that many factors

contributing to resilient outcomes are adversities that act as inoculants that provide individuals

with a tolerance or “immunity’ to stressful experience at low levels of exposure.

Giovani Fava is a well-cited leading Italian scholar of well-being therapy. He and

colleague Tomba inject an explicit dose of well-being into developmental psychology. They

define well-being as " a longitudinal and dynamic process...a set of attributes and resources that

prevent illness following adverse environmental circumstances in the general population and

prevent relapse after symptomatic remission in a clinical population" (2009, p. 1905). In Well-

being Therapy, a somewhat distal form of Cognitive Behavioral Therapy (CBT), flourishing and

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resilience can be promoted by interventions that lead to a positive self-evaluation, a sense of

ongoing growth and development, meaning and purpose in life, quality relationships, the

capacity to manage life effectively, and a sense of determination. The model assumes that risks

to well-being are generated by inattention to positive experiences and lack of capacity to sustain

states of well-being due to automatic thoughts.

In validation studies, certain forms of Well-Being Therapy have been found effective in

the treatment of generalized anxiety disorder (GAD), recurrent depression prevention, after the

loss of clinical effect of drug treatment for depression, in school interventions, and may work at

the molecular level to alter stress-related genetic expression and protein synthesis,

neurobiological reconsolidation of memories, and contribute to clinical changes (in combination

with mindfulness-based cognitive therapy) to modifications of three character traits: self

directedness, cooperation and self-transcendence (Fava & Tomba, 2009).

Smith et al., (2010) studied resilience as a predictor of health related measures both alone

and when controlling for other positive characteristics and resources, examining the roles of

optimism, social support, spirituality, social support, purpose in life, and mood clarity in relation

to a measure of resilience as the ability to bounce back. They hypothesized that resilience would

be related to better scores on health-related measures. They found that resilience is related to all

of the health-related measures controlling for the other positive characteristics and demographic

variables, and offer an interestingly inclusive definition: the ability to bounce back lies on a

continuum between the "Big Five" personality characteristics: openness to experience;

conscientiousness, extraversion, agreeableness and neuroticism (the positive and negative sides),

and specific coping skills like positive stable personality characteristics, positive and supportive

relationships, and adaptive coping strategies. Also key is a learning history that includes having

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successful experiences bouncing back, having models of bouncing back, and verbal

encouragement that one can do so (Bandura, 1997). Resilience is a malleable resource,

modifiable through interventions. Factors highlighted include optimism, social support,

spirituality, social support, purpose in life, and mood clarity (Smith et al., 2010).

Winnie Mak and her colleagues (2011) tested whether the relationships between

resilience, life satisfaction and depression could be explained in terms of the positive cognitive

triad. Self-esteem, view of the world, and hope were positively correlated with trait resilience;

self-esteem, view of the world and hope were positively correlated with life satisfaction, and

negatively so with depression; trait resilience was positively correlated with life satisfaction and

negatively so with depression. The positive cognitive triad encompasses: positive views toward

the self, the world and the future. Mak takes a unique approach to the trait versus dynamic

models argument by putting it out there in her definition, and conceptualizing resilience as the

mediation power of positive emotion, supported by the positive cognitive triad, promoting an

individual’s positive emotionality and life satisfaction, which therefore protects them from

depression.

The authors define resilience as "a dispositional capacity that is conducive to adaptive

functioning through the way individuals construe themselves, their social surroundings, and their

future" (Mak et al., 2011, p. 610), and highlight positive views about selves, the world, the

future, self efficacy, confidence, determination, positive self-agentic talk, positive frame of mind,

high self-regard/self esteem, curiosity, openness to new experiences and interpersonal insight,

and high levels of hope as factors that facilitate resilient processes and outcomes.

“Mindfulness is an awareness that emerges through paying attention on purpose, in the

present moment, nonjudgmentally to the unfolding of experience moment by moment" (Zinn,

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1990, pg. 154). Recently added characteristics include being aware of aspects of the mind itself,

curious, and open to novelty (Goodman, Kashdan, Mallard, & Schumann, 2014; T. Kashdan,

2010; T. B. Kashdan, Barrett, & McKnight, 2015; Todd B. Kashdan & Rottenberg, 2010; Todd

B. Kashdan, Rottenberg, Goodman, Disabato, & Begovic, 2015). While evidence mounts of the

effectiveness of mindfulness training in improving psychological functioning and decreasing

psychological distress, there remain questions as to the mechanism. As an emotion regulation

strategy, mindfulness promotes an open and flexible approach to experience of life, observing

emotion and experience in general without attempts to change; increases the ability to move

toward value laden outcomes in spite of affective adversity, and reduces avoidance and over-

engagement with emotion. It may interrupt automatic responses to emotions and thoughts to

reduce the chances of a maladaptive pattern of behavior that may follow. Mindfulness then

improves psychological functioning by cultivating acceptance and awareness of experience in

the moment, and may reduce human suffering by facilitating successful emotional regulation:

resilience (Watford & Stafford, 2015).

2. Strengths

Many practitioners and educators work with individuals from a strengths perspective on

an ad hoc basis, using a simple "identify and use" approach. Diener et al. introduce an alternative

to this shallow dive: strength development, distinguished from the former approach by the belief

that strengths are not fixed traits across settings and lifespan, and "adopt dynamic, within-person

approaches from personality science to research, assessment, and interventions on strengths,

They are a highly contextualized phenomenon that emerge in distinctive patters alongside

particular goals, interests, values, and situational factors; strengths are potentials for excellence

that can be cultivated through enhanced awareness, accessibility and effort" (Biswas-Diener,

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Kashdan, & Minhas, 2011, p. 106) through seeking data about interactions between people and

their environment. Merely labeling strengths without a growth mindset (Dweck, 2008) may lead

to iatrogenic (brought forth by the healer) effects. The authors highlight attention to strengths,

longitudinal stability, cross-situational consistency, the role of positive emotions, zest, strengths

in action, and experiences of high control and mastery as factors that contribute to resilient

processes and outcomes.

3. Interdisciplinary and systems framework

In a contemporary "go-to" article with a modern, eclectic multi-disciplinary conceptual

framework, Davydov et al. attempt to collate and classify available resilience research around a

multi-level biopsychosocial model, "theoretically and semiotically comparable to that used in

describing the complex chain of events related to host resistance in infectious disease."

(Davydov, Stewart, Ritchie, & Chaudieu, 2010, p. 497). They explain that the resilience concept

of mental health research is handicapped by poor definitions and lack of a unified methodology.

"A lifespan trajectory approach is necessary to understand the constellation of interacting

biological, psychological, social factors that determine, develop or modify resilience (p. 497).

Factors highlighted as contributing to resilience trajectories include a high level of

positive experiences and use of positive emotions; genetic, epigenetic and gene environments

and behavioral and associated nueronal mechanisms such as cognitive flexibility, social

attachment behaviors, positive self-concept and effective regulations of emotions; the capacity to

change traumatic helplessness to learned helpfulness; meaning in life including spirituality and

religion; social support including role models, an active coping style; capacity to recover from

negative events; stress inoculation; and the capacity to spin new trauma related information in a

positive direction, all mediated in part by neurobiological factors which may include regulation

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of reward, social emotions, motivation, reconsolidation and extinction (Davydov et al., 2010;

Graham, 2013).

Davydov et al. speak of resilience as a broad systems approach, in which dynamic

systems have the capacity to withstand and recover from significant disturbance. There are three

main approaches to resilience in mental health research: 1) the harm-reduction approach, in

which resilience is described as quack and effective recovery after stress. 2) In the protection

approach, it is described in terms of protective mechanisms analogous to immune barriers. 3) In

the promotion approach, the focus is on the development of additional resources that allow a

person to go beyond recovery and return to homeostasis toward growth and flourishing, in which

mental resilience requires an individualized homeostatic balance between negative and positive

experiences, like the interaction between the immune activation and suppression systems

(Davydov et al., 2010).

Windle uses an interdisciplinary lens on resilience as well, defining it simply as the

process of effectively negotiating, adapting to, or managing significant sources of stress or

trauma. It is a lifespan approach. " Resilience is not, and cannot be, an observed trait" (Windle,

2011, p. 5; Windle, Bennett, & Noyes, 2011).

Bonnano and Diminich (2013) observe that the evolution of developmental research on

resilience has spanned three broad phases: 1) a focus on measures and definitions of resilience;

2) teasing out the individual processes that led to resilience; 3) an integrated perspective that may

attend to genetics, neurobehavioral development and statistical analysis, moderators of risk, and

neuroplasticity as factors that impact resilience. They distinguish between emergent resilience

and minimal-impact resilience as trajectories of positive adaptation, using latent growth mixture

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modeling (LGMM). The range of possible outcomes to "traumatic" events are more

appropriately considered "potentially traumatic events".

Emergent resilience occurs across a broad sweep of time in response to chronic

adversities that one endures beginning often in childhood; this perspective on resilience naturally

tends to focus on distal outcomes, while a more recent focus on adversity experienced by adults

interrogates acute life events like loss and trauma categorized as minimal-impact resilience.

Acute stressors lend themselves to a more focused approach to proscribed coping efforts, as they

unpack a broad spectrum of possible resilient outcomes. Research and theory on these

contrasting sorts of outcomes has developed in relative isolation. The literature has commonly

observed six prototypical trajectories in response to Potentially Traumatic Events/Experiences

(PTE): chronic dysfunction, minimal impact resilience (a stable trajectory of healthy

functioning), resistance, recovery, and delayed symptom elevation. Factors indicated as

important for resilience trajectories are demographic variables such as age, gender,

race/ethnicity; proximal or distal exposure; personality, social and economic resources; past and

current stress. positive emotions; appraisal and coping strategies; psychological flexibility,

coping flexibility; and expressive flexibility, from up-regulating to down-regulating of emotions

(Bonanno & Diminich, 2013).

Fletcher and Sarkar (2013) offer an excellent review and critique of the definitions, key

concepts and theories of psychological resilience. They illustrate the trend in resilience research

of shifting from identifying protective factors to resilience processes since the 1990s, explaining

that some of the main difficulties in researching resilience stem from the myriad of ways that it is

defined, conceptualized and operationalized. Resilience has been thought of as a trait, a process,

or an outcome, and the tensions between trait versus process, protective versus promotive

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factors, recovery versus resilience, and coping versus resilience. With regard to the latter,

resilience influences how an event is appraised to produce a positive response to stress, while

coping can result in positive or negative outcomes (Fletcher & Sarkar, 2013, p. 16).

II. Part Two: Resilience Interventions and Measures

Suicide is the second-leading cause of death among people aged 25 to 34 and the third-

leading cause of death among people aged 15 to 24 (Parks, Johnson, McDaniel, & Gladden,

2014). Less resilient and needy students have shaped the landscape for faculty in that they are

expected to do more handholding, lower their academic standards, and not challenge students too

much, which is producing a sense of helplessness among the faculty. “Students are afraid to fail;

they do not take risks; they need to be certain about things. For many of them, failure is seen as

catastrophic and unacceptable. External measures of success are more important than learning

and autonomous development” (anonymous director of counseling quoted in Gray, 2015).

Directors of Counseling Services are watching with this shift in how college students

cope with challenges with concern. Mistakes that used to be good learning now have incredible

meaning. The little disappointments in life, like getting a B, feel like huge failures. Students are

very uncomfortable with not being right, and they have not developed self-soothing skills

because their parents tend to solve all of their problems, remove obstacles and reward mediocrity

without recognizing it. Without the grit and the resilience borne of occasional falls and failures,

the average traditional college students are destined to suffer unnecessarily, unless there are

remedies and practices provided to enhance their self-regulation, self-efficacy and sense of being

wrong as common to humanity (Gray, 2015; Scelfo, 2015; Wilson, 2015).

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Little literature exists on college student resilience. Until Arnett made the case that

emerging adults (AE), those between about 17 and 25 years of age, had developmental pathways

distinctly different from children, adolescents and adults. Emerging Adults experience the world

in different ways for a number of years (2000). The intent this second portion of the study is to

explore the literature on resilience with a focus on interventions that facilitate resilient outcomes,

and the measures that have been used to measure and identify resilience. This insight will be

used to examine and propose resilient interventions for college students.

A. Methodology

The academic databases were explored using search terms and combinations of search

terms: resilience, intervention, factors, mediate, moderate, and measures, and as the useful

articles emerged, close attention was paid to the citations in each article; breadcrumbs were

followed. Approximately 75 articles were scanned; 57 were in a were chosen for repeated

reading and annotation and added to a spreadsheet already housing notes from 52 articles

collected during the prior semester for an investigation of resilience definitions and factors. The

focus the second semester’s exploration was on the factors that are reported to influence

resilience, and the ways in which these factors are manipulated in resilience-nurturing

interventions to inform the study of resilience and the search for associations between the

factors and any given operationalization of the term resilience. As the articles were read, notes

were entered into a spreadsheet across columns labelled author; year; framework; definitions;

factors; key concepts/assertions; interventions; measures; note, and results.

B. Resilience Research

1. Correlational Studies and Surveys

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In 2000, Arnett offered solid evidence that emerging adulthood is a distinct

developmental period in terms of demographics, subjectivity and identity development. It is a

time of exploration, risk-taking, triumph, disappointment and uncertainty. The multiple

intersecting identities we know to be slightly stable in our becoming as adults are a noisy

clashing maelstrom of opposing and possible selves. Those who survive early adulthood with a

solid sense of self will be those who get to know and hold their values, and find purpose and

meaning as their guides. The characteristics that are most salient to EAs are qualities of

character: accepting responsibility for one’s self, making independent decisions, and becoming

financially independent, marks of self-sufficiency (Arnett, 2000).

Burt and Paysnick studied sense of identity as a moderator of associations between

stressful life events, behavioral and emotional problems and substance abuse in college

undergraduates, and found that individuals with a stronger sense of identity report fewer

problems even when experiencing high levels of stress (Burt & Paysnick, 2014). Brownlee et al.

reviewed all of the outcome studies between 2003 and 2013 for strengths and resilience-based

intervention programs for children and adolescents, and found eleven studies, of which only

three were judged to be of high quality, but on the whole suggest that these sorts of interventions

show promise of being effective (Brownlee et al., 2013). In a survey of the literature, Hofman

and colleagues (2011) found that Loving-Kindness meditation (LKM) and Compassion

Meditation (CM) are associated with in an increase in positive affect and a decrease in negative

affect. Neuroendocrine studies indicate the CM may reduce stress-induced subjective distress

and immune response. Neuroimaging suggest that LKM and CM may enhance activation of

brain areas involved in emotional processing and empathy.

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In a study of the association between teacher self-reports of well-being, mindfulness, and

self compassion, and observations of classroom quality, and ratings of semi-structured interviews

about the teacher’s “most challenging child”, Jennings found that mindfulness, self compassion,

personal self-efficacy and positive emotions were associated with emotional support, while signs

of burnout (emotional exhaustion and depersonalization) were negatively associated with

emotional support (2015). Depression was negatively associated with emotional support,

classroom organization, and instructional support. Ratings of interviews indicated that

mindfulness and efficacy were positively associated with perspective-taking and sensitivity to

discipline. This correlational study suggests that teacher psychosocial characteristics effect their

ability to provide optimal classroom environments and supportive relationships with students.

In a survey-correlational study of college undergraduates, Johnson et al. (2015) tested a

theoretical model including these factors: ratings of influential people in students' lives as models

and messengers of resilience (representing the oft referenced "social support" factor); students'

perceived resilience; regulatory strategy use; and academic achievement. They predicted that

messengers and models of resilience would predict students' perceived resilience, which would

predict greater regulatory strategy use, which would predict academic achievement. They

hypothesized that regulatory strategy use may be an important mediating variable between

resilience and academic achievement. Through path analysis, they found that perceived

resilience directly influenced regulatory strategy, which influenced academic achievement, and

that both models and messengers of resilience influenced their regulatory strategy, but models of

resilience created a much stronger influence on perceived resilience than messengers.

In an attempt to synthesize work on emotional regulation, mindfulness and acceptance,

social and personality psychology and neuropsychology that suggest promising avenues for

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interventions, Kashdan and Rottenburg define psychological flexibility in terms that resonate

with Acceptance and Commitment Theory (ACT): how a person: 1) adapts to fluctuating

situational demands, 2) reconfigures mental resources, 3) shifts perspective, balances competing

desires, needs, and life domains. It is the ability to modify response to best match a situation

(2010). The absence of psychological flexibility is linked to variants of psychopathology

“spanning cognitive rigidities such as rumination and worry, patterns of behavioral

perseveration, inability to rebound after stressful events, and difficulties planning ands working

for distant goals” (p. 866), and, “ like any so-called negative emotions, anger can be adaptive”

(Todd B. Kashdan & Rottenberg, 2010, p. 867).

The authors mentioned several interventions. In one, a two-hour course given to college

students to reduce their prejudice toward people with mental illness, students were trained in

mindfulness, avoiding prejudicial/judgmental thoughts, watching their own socially undesirable

and feelings without being a slave to them (noticing rather than caught in struggle to purge), and

observing thoughts while acting in ways resonating with their central values…such as

compassion. They conclude that the research shows that the ability to modulate behavior as

required by the situation contributes to real-world adjustment over and above any particular

regulatory strategy (Todd B. Kashdan & Rottenberg, 2010).

Growing literature shows that although typical First-Year Experiences usually fail to

address stress, coping and resilience with students (Padgett, Keup, & Pascarella, 2013), and

points to the powerful role of socio-emotional factors in academic performance and persistence

(Paunesku et al., 2015). In a 2012 article in the journal Psychology, Leary and DeRosier

surveyed 120 first year college students approximately six weeks into first semester to measure

the relative impact of four domains that have been shown to promote resilience in the face of

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stress: Social Connectedness, Self-care, Life Skills, Cognitive Style, in order to determine the

extent to which each factor predicted student stress while controlling for the other three. The

results suggest that there may not be a cumulative effect over and above the independent effects

of any one resilience promoting factor, and that students’ social connectedness and optimistic

thinking style were the most important predictors of their positive adjustment during the

transition to college (Leary & DeRosier, 2012).

Stressful situations are events or conditions that demand adjustments beyond the normal

wear and tear of daily living. Unsuccessful adaptation to the stressors of college life can

contribute to depression, and a student’s coping style can make or break a successful college

experience. Using Amirkhan’s taxonomy of coping styles: problem solving, social support-

seeking and avoidance, Li and Nishikawa (2012) examined stress, trait resilience, self-efficacy

and secure attachment as predictors of active coping, which they suggest is characterized by

solving problems, seeking social support, and directory addressing the stressors. In a

correlational survey study, the authors compared coping styles of Taiwanese and U.S college

students and found that although self-efficacy did not predict an active coping style, it did predict

trait resilience, and that trait resilience influences college students’ (of both nationalities) active

coping with stress. In the Taiwanese sample, secure attachment also predicted active coping,

resonating with theories that suggests that more collectivists societies value interdependence, as

opposed to western values of independence (Li & Nishikawa, 2012).

Risky behaviors that emerging adults (EAs) engage in may be an intentional pathway to a

broad array of experiences before settling into adult roles or a way of coping with transition into

college anxiety. Rivers et al. (2013) point to Fuzzy Trace Theory as a partial explanation of why

EAs seem less able to avoid risky situations than adults: the fully developed brain assesses risk

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by looking at the simplest forms of information related to situations, EAs do not have fully

developed emotion knowledge stores, so evaluate informational components with positive affect

and lean toward approach instead of avoid as a coping style (Galatzer-Levy, Burton, & Bonanno,

2012; Li & Nishikawa, 2012). Emotions are adaptive when the information they provide is

perceived, used, understood and managed effectively. Emotional Intelligence, operationalized as

recognizing, understanding and regulating emotions toward positive outcomes, may act as a

buffer against risk-taking. to examine the relative contributions of emotional intelligence and

self-esteem in explaining risky behaviors that college students report, Galatzer-Levy and

colleagues administered a battery of measures to a relatively homogenous sample of 241

undergrads at a state university in the Northeast United States (Galatzer-Levy et al., 2012). Self

esteem was not related to any of the higher order factors making up the risky behaviors measure,

yes significantly and negatively related to conflict with parents and unhealthy lifestyle. Higher

emotional intelligence scores were significantly associated with a lower likelihood to engage in

risky behaviors.

In a 2011 study, researchers assessed the capacity for attention, self concept, and

psychological well-being in college students with ADHD. After testing a sample of these

individuals, they concluded that college students with this diagnosis demonstrate considerable

resilience in the face of (and perhaps as a result of) significant life-long challenges (Wilmshurst,

Peele, & Wilmshurst, 2011).

Dispositional mindfulness is defined as the general tendency to have awareness that results

from purposefully paying attention to sensations, thoughts and feelings in the present moment

while suspending judgments. Mindfulness practices such as meditation can increase dispositional

mindfulness, alleviate psychological and somatic symptoms such as depression and pain which

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can accompany exposure to traumatic experiences. They can result in favorable changes in brain

structure and in the physiology of the stress response, the opposite of changes that can result

from exposure to repeated or severe stress. (Whitaker et al., 2014). Sixty-five percent of the 3375

Head Start teachers in Pennsylvania were asked to report on sixteen binary health indicators

across three domains: health conditions, health behavior, and health-related quality of life

(HRQOL), then about their personal life experience across eight categories of childhood

adversity. Significant results showed that across a large spectrum of exposure to childhood

adversity, greater dispositional mindfulness is associated with fewer health conditions, better

health behavior and better health-related quality of life (Whitaker et al., 2014).

2. Interventions

A. Children and youth.

FRIENDS, a ten session cognitive behavioral intervention, originating in Australia and

used as a universal preventative program in schools in that country, was evaluated for efficacy in

the United Kingdom with several hundred children aged 9-10 years. The program, designed to

promote resilience in children, uses behavioral, cognitive and psychological strategies to teach

children practical skills to identify their anxious feelings; learn to relate; identify unhelpful

anxiety thoughts and replace them with more helpful thoughts; how to overcome their problems

and challenges. Measures of the children’s anxiety and self esteem showed significant reductions

in total anxiety and increases in self-esteem by end of the program (Stallard et al., 2005).

Challen et al. (2014) assessed the effectiveness of the UK Resilience Program (UKRP) at

reducing symptoms of depression. The intervention was an 18-hour cognitive behavioral

intervention modelled after the Penn Resiliency program (Seligman, 2011), delivered to 1000

eleven and twelve year olds in their schools by lightly trained teachers and staff. Small, short-

33


term effects on depression occurred in the intervention group compared to regular school

controls, but did not endure to 1 or 2 year follow up assessments. There was no effect on anxiety

or behavior problems (Challen et al., 2014).

In an attempt to increase resiliency in Palestinian children exposed to major trauma of

war, Diab and colleagues (2015) tested a manualized intervention based on the Teaching

Recovery Techniques (TRT). The intervention tools included a safe place method, relaxation,

talking and drawing frightening experiences and dreams, problem-solving, story telling, role

play, learning about emotions and bodily and verbal regulation of fear, improving sleep patterns,

breath regulation, and voicing somatic complaints. Intervention was not associated with

significant increase in level of well-being or prosocial behavior, nor moderated by mother's

acceptance and willingness to serve as an attachment figure or by family atmosphere.

Interventions focusing strictly on pushing out information have been suggested to be

ineffective. Hodder et al. (Hodder et al., 2011) examined the potential efficacy of a resilience-

based intervention supported by adoption strategies on modifying adolescent resilience and the

extent of adolescent substance use uptake. In this non-controlled before and after study,

implementation of various curriculum materials and programs occurred across three health

promoting school domains: curriculum, teaching and learning; ethos and environment; and

partnership and services, and over three years. The program was designed to enhance student

resilience and protective characteristics, and included materials designed to enhance

communication, connectedness, empathy, and self awareness. Students were assessed at baseline

and one year after the end of the intervention. The post test showed a significantly greater

combined median resilience factor score for the 1200 students across three schools that

participated, as was the median protective factor score. Also, the proportion of students reporting

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substance abuse across six outcome measures in three domains (tobacco, alcohol and marijuana)

was significantly lower than at baseline.

Coholic and colleagues (Coholic, Eys, & Lougheed, 2011) tested the effects of the

Holistic Arts-Based Group (HAP) Program, teaching mindfulness using arts-based methods, for

developing resilience in children. They found that it was beneficial for children; they reported

lower emotional reactivity (resilience measure) post-intervention, but no changes in perceptions

of self-concept.

Mindfulness-based cognitive therapy (MBCT) is a popular group treatment for adults

suffering from anxiety and depression (Segal, Williams, & Teasdale, 2013). Many children

suffer daily anxiety that can be debilitating. Problems with school and the social context causes

negative self-judgment and rumination, leading to anxiety that disrupts attention, which escalates

academic problems, and each day can feel like Ground Hogs Day: same misery, different day.

Mindfulness-based cognitive therapy for children (MBCT-C), adapted by Semple and colleagues

(Semple, Lee, Rosa, & Miller, 2010) from the adult version, aims to enhance attention and

reduce chronic harsh self-judgments. MBCT (and mindfulness practices in general) propose that

thoughts, emotions and body sensations are simply phenomena to observe rather than judge

(including observing the experience of judging) and as events to be described rather that

changed. A “decentering of the self from the disordered whirlwind of thoughts, sensations and

emotions supports affective equanimity. The twelve-week program, administered by Semple and

friends to nine and ten-year olds, consisted of one 90-minute small group mindfulness training

session per week, including breath meditations, body scan, and yoga postures, supplemented by

at home practice. The authors hypothesized that hypothesized that kids randomized to participate

in MBCT-C would show greater reductions in attention problems, anxiety symptoms, and

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behavior problems than wait-listed and gender-matched controls. Results suggested that the

MBCT-C suggest that mindfulness can be taught to children and shows promise alleviating

attention problems and anxiety symptoms.

3. Adults

The integration of eastern philosophies, the efficacy of body-mind-spirit interventions are

effective in reducing depression and anxiety in divorced women and bereaved family members,

improving mental health and the psycho-immunological status of cancer patients, increasing in-

vitro fertilization rates and enhancing a sense of control among SARS patients (Chan, 2006).

For African Americans, the stress of Type 2 Diabetes compounded by higher levels of

chronic life stressors make this population particularly vulnerable to complications from the

synergistic effects of obesity, type 2 diabetes and CVD. The Transactional Model of Stress and

Coping proposes that not everyone exposed to potentially stressful situations makes poor choices

that higher levels of resilience and coping strategies positively influence perceptions of stress

and stressful life events, and are associated with less symptoms of illness in sick and healthy

individuals (Lazarus & Folkman, 1984, in Steinhardt, Mamerow, Brown, & Jolly, 2009). The

authors tested the feasability of offering the Diabetes Coaching Program (DCP) in a sample of

African Americans with type 2 diabetes. The intervention included 4 weekly 2-hour classes held

on Tuesday evenings, with one hour devoted to the resilience intervention Transforming Lives

Through Resilience Education, and the socod hour to diabetes related nutrition information.

Class sesssions were followed by 8 bi-weekly support group meetings 1.5 hours in length. The

intention of the resilience training was to empower participants to manage stressors in life more

effectively by taking greater responsibility for them, using effective coping strategies, thinking in

more empowering ways, and creating and maintaining meaningful social connections. The

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resilience model was based on O'Leary, Ickovics and Carver's model of 4 typical responses to

stress: give up, put up, bounce up, step up. Although psychosocial variables of resilience and

coping skills did not significantly increase as expected, they may have played a role in enhancing

significant evidence of diabetes empowerment and self-management (M. A. Steinhardt et al.,

2009).

Sood and colleagues adapted the Mayo Clinic’s Attention and Interpretation Therapy

(AIT) program to design the Stress Management and Resiliency Training (SMART) program

hoped to decrease stress, anxiety and burnout and increase well-being and quality of life for

physicians. AIT provides training in attention and interpretive flexibility, combined with paced

breathing meditation, to cultivate skills such as gratitude, compassion, acceptance, forgiveness

and higher meaning. Forty-four physicians/medical faculty at the Mayo Clinic were randomized

and assigned to an intervention and a wait-list group. Participants were assessed prior to the

intervention and then eight weeks after the intervention. The intervention was a single 90-minute

session of one-on-one training in attention and interpretive flexibility, combined with paced

breathing meditation. Results showed a significant improvement in resiliency, perceived stress,

anxiety, and overall quality of life at 8 weeks compared to control, suggesting that a brief

training to enhance resilience among physicians using the SMART program was feasible and

provided statistically significant improvements.

Also at the Mayo Clinic, Chesak et al. (2015) tested the effectiveness of the more evolved

Stress Management and Resiliency Training (SMART) program. The newer version combined

didactic presentations about a model of stress and biology with mindfulness, gratitude,

compassion, acceptance, forgiveness and higher meaning practices, and group discussion, with

the intention of increasing resilience and quality of life and decreasing stress and anxiety for

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nurses at the Mayo Clinic. One 90-minute session for 55 nurses in orientation was followed by

weekly handouts via email and a 1-hour follow-up session after 4 weeks. This pre-post,

intervention-control group comparison pilot study suggested that SMART was feasible for

nurses and worthwhile. Although lacking significance, the change in efficacy outcomes

(perceived stress, mindfulness, anxiety and resilience) occurred in the hypothesized direction.

Much has been written about the effects of previous exposure to adversity on the capacity

to create resilient outcomes (Davydov et al., 2010; Fergus & Zimmerman, 2005; Neill & Dias,

2001; Rutter, 1987). An analogue trial was conducted by Varker and Devilly to establish the

viability of resilience-by-inoculation training for emergency services personnel in Australia.

Eighty people from the general community (hence the analogue description) were randomized

and assigned to intervention and a control groups. The intervention group received forty minutes

of Stress Inoculation Training (SIT), an introduction was followed by education about physical

responses to trauma, applied tension techniques for fainting resistance, stopping techniques for

inappropriate thoughts: noticing; challenging, and replacing them with more adaptive thoughts).

They were then exposed to serial approximation/desensitization using still photos of car crashes,

followed by a discussion of the importance of social support and education on

appropriate/inappropriate drug/alcohol use. Post-test results suggested that their was little

distress caused by the intervention, so the authors report that field studies with police recruits

were underway as of 2011 (Varker & Devilly, 2012).

This author’s son is a full-time faculty member at Northern Illinois University by day,

and a full-time fire and rescue lieutenant (responsible for training) on nights and weekends. This

author sent him a copy of this study (Varker & Devilly, 2012), asking if this sort of

approximation and desensitization is to his knowledge a part of any first responder training. He

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responded in writing; “there is a substantial body of literature examining post-event treatment

(including critical incident stress debriefing). I explored a bit of it for a project a few years ago.

Some of this literature focuses on lay people following critical incidents such as natural disasters,

mass shootings, and terrorist attacks (CISD was used in the hours and days post-9/11 with those

responders). In Illinois and in our county, CISD and CISM are routinely used following

particularly disturbing events in fire/ems/law enforcement. We have had debriefings for

particularly grisly suicides, multiple casualty events, traumatic death and dismemberment in

children, and several incidents involving death of a firefighter or close family or friend of

responders. Interestingly, some of the CISM curriculum that is put into practice during a

debriefing might serve as a small bit of resilience training for those participants for incidents in

the future, but I have not seen anything that I would call a dedicated resilience training for first

responders. Sounds like a great idea to me” (Personal conversation, November 2015).

In a preliminary pre-post randomized and controlled trial of a resilience-oriented PTSD

intervention with the aim of effecting levels of anxiety, depressive symptoms, emotional health

and cognitive performance, Kent and colleagues ((2011) delivered a manualized intervention to

39 veterans with a variety of traumatic exposures. The intervention took place over twelve

weekly 90-minute group sessions. Week one entailed an introduction to the program and

concepts. Weeks two and three focused on attention to bodily sensations as sources of

vitality/engagement. Weeks four through seven drew on childhood experiences and the current

experience to build positive emotional experiences and social bonds. Weeks eight through ten

were spent revisiting stressors and traumas while tapping in to earlier attained resources. Weeks

eleven through twelve were dedicated to planning for sustained change. The post-intervention

measures revealed large results for PTSD, depression and anxiety, well-being, vitality, social

39


functioning, and executive functioning, suggesting that resilience interventions for those

suffering from PTSD can yield great benefits with regard to symptoms, positive emotional health

and cognitive functioning.

In 2015, Kent returns with Rivers and Wrenn to propose a biopsychosocial model of self-

regulation, executive functioning and personal growth that they use as a lens to explore the

effectiveness of an intervention they call Goal-Directed Resilience in training (GRIT), while

introducing the experiential quality of “evocative contexts” to treatments for PTSD, obesity and

chronic pain (Kent, Rivers, & Wrenn, 2015). They operationalize resilience with a new twist, as

a positive adaptation to evocative contexts (bringing strong images, memories or feelings to

mind), that may with intervention lead to ‘cognitive shift’: “a dynamic process of coping in

which a person faces an event that produces chronic, unremitting stress requiring exceptional

adaptation and discovers new goals behaviors or ways of thinking that support positive affect and

personal resources” (p. 275).

The intervention in this study occurs in randomized controlled trials with PTSD veterans,

during which (GRIT) is deployed to replace stimulus-based responding with goal directed action,

"restore goal-directed adaptive functions." It is an eight structured, manualized program taking

participants along four steps. Participants identify earlier experiences of approach/engagement

and social relatedness, describe and and re-experience them by describing in detail the reactions

of their five senses, make a visual representation, take them into contexts of old threat or trauma,

modifying the re-experience of threat to induce interoceptive bodily homeostatic changes. In a

reconstructive approach to memory and sensation, (with the understanding that the function of

episodic memory is not the recall of past episodes, but a gathering of bits and pieces of energy, a

constructing and simulating of possible future scenarios, outcomes, goals and needs), the past is

40


re-arranged into a recombined memory with goal-directed action that is grounded in sensation

and a prospective direction to the future. The result is a re-wiring of the neuroplastic brain

(Goleman, 2013; Graham, 2013; Hanson & Mendius, 2009; Kent et al., 2015; Siegel, 2010). The

study suggests that GRIT enhances cognitive functioning in areas related to inhibitory control

and short term episodic memory, helping people break the cycle of chronic, self-maintaining,

maladaptive conditions (Kent et al., 2015).

A growing body of literature supports the efficacy of technology-based interventions for

anxiety and depression (Rose et al., 2013) as well as raising academic achievement (Paunesku et

al., 2015). Rose and colleagues conducted a randomized control trial of Stress Management and

Resilience Training for Optimal Performance (SMART-OP), a self guided, multimedia stress

management and resilience training program, delivered over six weeks that included animations,

game activities, interactive didactics, homework, feedback and motivational encouragement.

Each session begins with a stress briefing, about stress and diet, sleep, exercise, etc. and also

contains one activity from each of three domains: feelings (biofeedback challenge, guided

muscle relaxation, focused breathing), thought (compartmentalization, attention shifting,

weighing evidence, cognitive restructuring) and action activities (effective communication,

problem solving, resilience through writing). After the intervention the SMART-OP group

reported less stress and more perceived control over stress, rated SMART-OP more useful than

the control group, and showed greater within task z-amylase recovery at post-assessment. The

authors concluded that technology-based programs can be as effective or more than the usual

treatment for anxiety and depression

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4. Mindfulness

Research shows mindfulness meditation practices reduce anxiety, depression, substance

abuse, eating disorders, chronic pain, improving quality of life and well-being, associated with a

perceptual shift in which thoughts and feelings are recognized as events occurring in the broader

field of awareness (Hölzel et al., 2011). In a 2011 review and meta-analysis of the literature,

mindfulness-and acceptance-based interventions (MABIs) were found to be associated with

robust and substantial reductions in symptoms of anxiety and co-morbid depressive symptoms

(Vøllestad, Nielsen, & Nielsen, 2012).

In a randomized control study Mindfulness Based Stress Reduction (MBSR) was trained

to a class of biotech employees that met weekly for 2.5 to 3 hours, and across a seven-hour

retreat held during week 6 of the course. Participants also had homework consisting of formal

and informal meditative practices they were asked to perform for 1 hour per day, six days/week

with the aid of guided audiotapes and got a flu shot at the end of the 8-week program. Results

showed significant anterior activation asymmetry (relative left-sided anterior activation)

associated with reductions in anxiety and increases in positive affect, as well as enhanced

immune functions (Davidson et al., 2003).

A small intervention-control sample set of adults enrolled in MBSR courses at the

University of Massachusetts Medical School were recruited and tested at baseline (two weeks

prior) and after completing the course (Hölzel et al., 2011). MBSR included sitting meditation,

yoga, body scans, eight weekly group meetings of 2.5 hours, one 6-hour retreat in week six, with

45-minute audio recording with guided exercises. The resulting Magnetic Resonance Images

(MRIs) show an increase in gray matter in left hippocampus, posterior cingulate cortex, temporo-

parietal junction and cerebellum, regions associated with learning and memory processes,

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emotional regulation, self-referential processing and perspective taking, and significant increases

in mindfulness scales: acting with awareness, observing, and non-judging.

A small sub-sample of this study (Hölzel et al., 2011) was measured to test the hypothesis

that grey matter changes in the pons/raphe/locus coeruleus region of the brain following

mindfulness practice underlie changes in well-being (Singleton et al., 2014). Results from this

sub-sample’s pre and post measurement using Ryff’s Psychological Well-being scale (PWB)

compared to their brain scans showed that changes in grey matter concentration in these regions

were correlated with to changes in the participants’ PWB score. The authors suggesting that

“these morphological changes” in areas of the brain that include sites of synthesis and release of

neuro-transmitters norepinephrine and serotonin, involved in regulation of arousal and mood…

might be part of the mechanism underlying the changes in psychological well-being” (Singleton

et al., 2014, p. 2).

Viewed through the prosocial classroom model, the Cultivating Awareness and

Resilience in Education (CARE) model of professional development was tested against teacher

well-being, classroom efficacy, burnout, stress and health in a randomized controlled trial

(Jennings, Frank, Snowberg, Coccia, & Greenberg, 2013). The prosocial classroom model

focuses on social and emotional competence, which involves five primary skills: self-awareness,

self-management, social awareness, relationship skills, and responsible decision-making. A

thirty-hour program delivered over 4-6 weeks included emotional skills instruction, mindful

awareness practices, caring and compassion practices, didactic, experiential and active learning

processes, with skills practice, reflective writing and activities for home, with intersession phone

coaching and a two-month booster. The intervention yielded significant effects on reappraisal

scale of Emotional Regulation Questionnaire (ERQ) and significant positive interaction effects

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on teacher efficacy as a whole, and efficacy in student engagement and instruction, as well as

significant intervention effects for general mindfulness, and the observing and nonreactive scales

of the Five Facet Mindfulness Questionnaire (FFMQ), and suggests that the CARE program may

have significant positive effects on teachers general well-being, efficacy, burnout and time

pressure, and mindfulness.

Burnout and attrition among primary care physicians in the United States is effecting the

quality of care for the average patient. Burnout is related to loss of control and lack of meaning.

Research shows that "being present" with patients relates more strongly with meaning in work

than diagnostic or therapeutic triumphs (Krasner, 2009). In a pre-post study of 70 primary care

physicians, Krasner and colleagues tested the effectiveness of an intervention named the

Continuing Medical Education Course (CME), designed to improve well being, help practioners

explore control and meaning in the clinical encounter. Based on three mindfulness techniques:

mindfulness meditation, narrative medicine, and appreciative inquiry, the intervention included

an intensive phase of eight weekly 2.5 hour sessions and one seven-hour session between the 6th

and 7th week, and a maintenance phase consisting of ten monthly 2.5 hour sessions. Each session

had fifteen minutes of didactive presentation; then guided meditation across four methods: body

scan, sitting meditation, walking meditation, mindfulness movement; small group work sharing

meaningful narratives; appreciative interviews in pairs; and larger group discussion to talk about

the practices and effects. Participation in a mindfulness communication program was associated

with short-term and sustained improvement in well-being and attitudes associated with patient

care. Skills cultivated in the mindfulness communication program appeared to lower

participants’ reactivity to stressful events and help them adopt greater resilience in the face of

adversity.

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5. Positive emotion

In 2008, in order to test the “build” component of her “broaden and build” theory of

positive emotions, Barbara Fredrickson and colleagues (2008) used Loving Kindness Meditation

(LKM) as a practice known to elicit positive emotions. The Loving Kindness Meditation

intervention consisted of 60-minute group sessions with about 20 tech company employees per

group, over seven weeks. At the first session, participants were given a CD that included three

guided meditations of increasing scope, led by the workshop instructor. During Week 1,

participants practiced a meditation directing love and compassion toward themselves. During

Week 2, the meditation added loved ones. During subsequent weeks, the meditation built from

self, to loved ones, to acquaintances, to strangers, and finally, to all living beings. The first

meditation lasted 15 min, and the final one lasted 22 min. Each workshop session included 15–

20 min for a group meditation, 20 min to check on participants’ progress and answer questions,

and 20 min for a didactic presentation about features of the meditation and how to integrate

concepts from the workshop into one’s daily life.

Participants were assigned to practice LKM at home, at least 5 days per week, with the

guided recordings. As expected, LKM increased participants’ positive emotions over the course

of the study. “Positive emotions emerged as the mechanism through which people build the

resources that make their lives more fulfilling and help keep their depressive symptoms at bay”

(p. 1057). The broaden and build theory was empirically supported (Fredrickson, 2001).

According to Neff and Germer (2013), mindfulness has two elements; paying attention to

the experience of this moment as it occurs, and relating to the experience with openness,

curiosity and acceptance. A mindfulness related practice that is gaining attention in well-being

and positive psychology circles is self-compassion. Self-compassion encompasses three

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interacting polarities: “self-kindness versus self-judgment, sense of common humanity versus

isolation and mindfulness versus over-identification (being carried away by the story line of

suffering) when confronting painful self-relevant thoughts and emotions” (2013, p. 28).

Two studies (a pilot and then a 2 X 2 experiment vs. waitlist control, baseline vs. post treatment

randomized study) were designed to measure the effectiveness of the Mindful Self-Compassion

(MSC) course on adult participants recruited from the greater Boston area. The MSC is an 8-

week workshop designed to train people to be more self-compassionate.

The program structure is modelled after and is complementary to Zin's MBSR program.

The group meets for 2 or 2.5 hours once a week over the eight weeks and participates in a half-

day meditation retreat. Participants learn formal (sitting) and informal (daily life) self-

compassion practices with experiential exercises and engage in discussion in each session. There

are homework assignments and some teaching of loving-kindness skills for everyday situations

(as opposed experiences of serious personal distress). The goal is to provide participants with

tools they can integrate into their daily lives. "Self-compassion provides kindness and

understanding in the face of life's disappointments, does not require feeling 'above average' or

superior, and provides emotional stability when confronting failure or personal inadequacies" (p.

31). The authors hypothesized that, compared to the control group, those taking the course would

demonstrate increased levels of self-compassion, mindfulness, other-focused compassion, social

connectedness, happiness and life satisfaction, and decreased levels of depression, anxiety,

stress, and avoidance. The experimental intervention group showed significantly greater gains in

self-compassion, mindfulness, compassion for others, life satisfaction, and larger decreases in

depression, anxiety, stress, and avoidance than the control group. There were no significant

differences for social connectedness and happiness. There were no changes in self-compassion at

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1-year post intervention, suggesting that the effects of the course were robust and long lasting

(Neff & Germer, 2013)

In order to explore the predictive value of social support on resilience, Neill and Dias

(2001), pre and post-tested participants in an Outward Bound outdoor adventure education

program designed for troubled young adults and compared them to a control group of

undergraduate psychology students. This 22-day guided outdoor experience in Australia included

expedition and food planning, a ropes challenge course, navigation and bushwalking,

communication skills and goal-setting sessions, caving, rafting, canoeing, rock-climbing, cross

country running and and a three-day solo expedition in the wilderness. overall change in

resilience scores was very large for experimental group from pre to post-test, and high levels of

Social Support were reported, with the four Social Support measure items predicting 24% of the

variance. An interesting and insightful finding was that the higher the level of support from the

least supportive group member, the greater the change in resilience scores reported by

participants. This was the only predictor that was significant on its own (Neill & Dias, 2001).

6. Interventions for College Students

Reports of psychological stress in college students are increasing steadily, stress resulting

from numerous intrapersonal, academic, interpersonal and environmental factors. Exposure to

these as well as increasing developmental gaps make this population increasingly vulnerable to

psychological (anxiety, depression) and physical health problems (symptoms and frequency of

illness). Maladaptive efforts to cope with these situations, like emotion-oriented and avoidant-

coping strategies, typically result in negative psychological and physical outcomes for college

students. Interventions aimed at mental and physical well-being in the face of stress have been

successful, usually incorporating several modalities, such as relaxation techniques, CBT, social

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support and psycho-education, in order to enhance "the ability to recover quickly from

disruptions in functioning that result from stress appraisals and to return to the previous level of

functioning" (M. Steinhardt & Dolbier, 2008b, p. 445).

University students were recruited to participate in a resilience program to learn how to

manage change and difficult situations more effectively (M. Steinhardt & Dolbier, 2008b).

Transforming Lives Through Resilience Education included 4 two-hour classroom sessions.

Session 1: Transforming Stress into Resilience, presented the model of four responses to stress:

give-up, put up, bounce up, step up, and discussed problem focused and emotion focused coping,

encouraging problem-based focusing for problems in their circle of influence: active coping,

planning, positive reframing, acceptance (bounce up and step up), and emotion-focused

strategies (denial, behavioral disengagement, self distraction, venting) when overwhelmed in the

short-term or stressful situation was outside their sphere of influence (give up and put up).

Session 2: Taking Responsibility, offered a model in which a line was drawn between

taking and not taking responsibility, owning the power to choose and create versus perceiving

that circumstances are out of one's control. Session 3: Focusing on Empowering Interpretations,

helped students change their disempowering thinking into empowering thinking using Ellis's

(2001) ABCDE thinking model: Activating, Belief, Consequences, Disputing (the

disempowering beliefs), or Distracting and Distancing and, Energy that one has available to

handle an activating event. Session 4: Creating Meaningful Connections, focused on increasing

student awareness of the link between connecting with or withdrawing from friends and family

and how that impacts thinking, behavior and health, then a session on self-leadership. Results

showed significant post-intervention improvements in resilience, coping strategies, protective

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factors and physical and psychological symptomatology compared to a control group (M.

Steinhardt & Dolbier, 2008b).

Two years later, Dolbier and colleagues (2010) randomly assigned about thirty college

students each to an intervention and wait list control group, then administered the psycho-

education intervention, Transforming Lives Through Resilience over four weekly 2-hour

sessions. Growth interventions have typically been cognitive-behavioral, MBSR, creative arts,

internet-based, and journaling. Transforming Lives Through Resilience Education; drawing from

the Internal Family Systems (IFS) model, CBT, rational emotive therapy, the transactional model

of stress and coping, and resilience and thriving models, was deployed for four weeks across

weekly 2-hour classroom experiences. Discussions and activities in this intervention were around

our four responses to stress: give up, put up, bounce up, step up, and two broad categories of

coping: problem-focused and emotion-focused. The amount of pre-post change was negligible in

the control group, and substantial in the experimental group. From the IFS model, Self-

Leadership was positively related to growth, so a new correlate to resilience was added to the

literature (Dolbier et al., 2010).

There is growing evidence of college students’ exposure to Potentially Traumatic Events

(PTEs); a recent analysis shows that 66% met the criteria from the DSM-IV TR for traumatic

event, yet the modal outcome has consistently shown to be adaptation characterized by little or

no disruption in functioning…resilience (Galatzer-Levy et al., 2012). Individuals who are

capable of Coping Flexibility: using both coping behaviors (avoid-approach) will adapt better

and more fully to college both if they were exposed to a PTE or if they are merely adapting to the

multiplicity of stressors associated with college. 156 undergraduates were recruited to participate

in a longitudinal study lasting four years. Based on ongoing testing and monthly self-reports

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students were distributed into four “trajectories”, or classes, of distress: Resilient, High Distress,

Moderate Distress, and Distress Recovered, across coping style (forward focus versus trauma-

focus) and the level and frequency of exposures to PTEs.

Results showed that the High Distress class was significantly less likely to report

forward-focus coping compared to Stable Resilient class. The Distressed-Recovered class was

significantly less likely to report forward-focus coping and more likely to report trauma-focus

coping when compared to Stable Resilient class. Social Network size was positively associated

with seasonal variability in the high distress group. Social integration negatively predicted

variability by season for High Distress students; the more integrated they were, the less

variability by season/semester. Both Stable Resilient and Stable Moderate distress classes are

capable of flexible coping. Additionally, social network size seems to predict functional

instability, while network embededness appears to have stabilizing effects. Lastly, and

importantly for administrators and student affairs professionals, institutions tend to “create”

community from above, while real impact occurs from the ways students organize themselves

from the ground up (Galatzer-Levy et al., 2012) .

Multiple studies show that mindfulness training is a useful intervention for college

students who often lack the resilience to face day-to-day challenges such as romance trouble,

hurt feelings, and academic struggle (Rogers, 2013). Increasing proportions of college students

are reporting being overwhelmed, with stress being the most commonly identified barrier to

academic performance. Continued stress can lead to unproductive rumination that consumes

energy and compounds the experience of stress, which can undermine resilience factors, and

adversely affect physical and mental health (Oman, Shapiro, Thoresen, Plante, & Flinders, 2008;

Shapiro et al., 2008) In a study of the impact of mindfulness on stress, rumination, forgiveness

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and hope, Oman et al. focused on two Meditation Management of Stress (MMS) interventions:

Jon Cabot-Zin's Mindfulness-Based Stress Reduction program (MBSR) and an adaptation of

Easwaran's Eight-Point Program (EPP). The study used pre-post testing and an eight-week

follow-up experimental intervention with control methodology. Group training took place at

eight weekly meetings of 90 minutes each, involving instruction in a form of sitting meditation,

informal corollary practices, and cultivation of attitudinal and motivational supports; each

meeting had formal sitting meditation practice, informal discussion, and didactics. Participants in

both Meditation Management of Stress (MMS) conditions had significantly larger decreases in

perceived stress, effects that increased up to the 8-week follow-up, and significantly larger

increases in forgiveness. There were marginally larger reductions in rumination and no

significant changes in hope (Oman et al., 2008).

There is growing evidence that self-compassion is an important predictor of well-being and

resilience (Barnard & Curry, 2011; MacBeth & Gumley, 2012; Neff & Germer, 2013; Smeets,

Neff, Alberts, & Peters, 2014). The interacting components of self compassion are: interacting

components are self-kindness versus self-judgment (the tendency to be caring and understanding

with oneself); a sense of common humanity versus isolation (recognizing that humans are

imperfect, connecting one's flawed self to a shared human condition); and mindfulness versus

over-identification (being aware of one's suffering in a balanced way that prevents being "carried

away by a dramatic self-narrative). The intervention may be particularly suited to colleges

students as other literature reveals that self-compassionate students have more of a mastery

orientation, less afraid of failure, and more confident in their abilities than those that are lacking.

Smeets et al. hypothesized that self-compassion interventions would facilitate a greater sense of

self-compassion, mindfulness, life satisfaction, social connectedness, optimism, self-efficacy,

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and a reduction in rumination through holding negative emotions in balanced awareness. The

researchers conducted a study with 52 college women who were randomly assigned to an

intervention group for three meetings over three-weeks: a self-compassion compassion skills

course, and a control group for time management skills development. Post-intervention results

indicate that self compassion interventions led to significantly greater increases in self-

compassion, life-satisfaction, connectedness, mindfulness, optimism and self-efficacy and

decreases in rumination for the intervention group (Smeets et al., 2014). For the latest university

student cohort, who show significant entitlement and narcissism, self compassion is likely a

healthier path to improving self-attitudes than raising self esteem, therefor a brief self-

compassion intervention has potential for improving student resilience and well-being. It appears

to facilitate resilience by moderating peoples' reactions to negative events.

B. Measures

Resilience as a construct has seemed to defy definition out of context, time and the

system in and from which becomes, so until recently most researchers measured resilience by

measuring sets of correlates that act as proxies for the condition, process or outcome that we

choose to tag as such. Working from the definition of resilience synthesized from 270 plus

research articles: “Resilience is the process of negotiating, managing and adapting to significant

sources of stress or trauma. Assets and resources within the individual, their life and environment

facilitate this capacity for adaptation and ‘bouncing back’ in the face of adversity. Across the life

course, the experience of resilience will vary” (Windle, 2011). Windle evaluated nineteen

measures of resilience with regard to content validity, internal consistency, criterion validity,

construct validity, agreement, reliability, responsiveness, floor and ceiling effects, and

interpretability, and found that the three most commonly used measures received the highest

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ratings. These are the 25-item Connor-Davidson Resilience scale (CD-RISC) (Chesak et al.,

2015; Dolbier et al., 2010; Sood, Prasad, Schroeder, & Varkey, 2011; M. A. Steinhardt et al.,

2009; M. Steinhardt & Dolbier, 2008b), the 37-item Resilience Scale for Adults RSA) (Neill &

Dias, 2001), and the Brief Resilience Scale (BRS) (Smith et al., 2010; Smith-Osborne &

Felderhoff, 2014), however when considering all of the evaluative criteria, these scores were

only rated moderate in quality (Windle et al., 2011). Because of this we find most measurements

of resilience in the literature measure multiple correlates of resilience in tandem with a measure

that purports to measure the construct directly. Other direct measures of resilience found in the

literature explored in this paper are the Dispositional Resilience Scale (DRS) (Ong & Bergeman,

2004; M. Steinhardt & Dolbier, 2008a), My Resilience Factos Self-Assessment (MRF) (Leary &

DeRosier, 2012), and the Ego Resilience Scale (Fredrickson et al., 2008; Mak et al., 2011; Ong

& Bergeman, 2004).

A multitude of correlates of resilience were measured in the literature explored here.

Anxiety is negatively correlated to resilience, measured by the Smith Anxiety Scale (SAS) (Sood

et al., 2011), the 24-item Spielberger State Anxiety Inventory in trait form (Davidson et al.,

2003; Neff & Germer, 2013), the 7-item Generalized Anxiety Disorder scale (GAD-7) (Chesak

et al., 2015), and the State-Trait Anxiety Inventory (STAI) (Kent et al., 2011).

Compassion is positively correlated with resilience and other well-being factors used to

measure resilience, measured here by the Compassion Scale (Neff & Germer, 2013). Coping

strategies are measured by the Brief Coping Orientations to Problems Experienced scale (Brief

COPE). Depression is measured with the Beck Depression Inventory II (BDI-II) (Kent et al.,

2011; Mak et al., 2011; Neff & Germer, 2013) and the Center for Epidemiological Studies

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Depression Index (CES-D) (Dolbier et al., 2010; Fredrickson et al., 2008; Jennings et al., 2013;

M. A. Steinhardt et al., 2009).

Emotion, Emotional Health and Emotional Regulation are most commonly measured

with the Positive and Negative Affect Scale (PANAS) (Davidson et al., 2003; Fogarty et al.,

2013; Jennings et al., 2013; Ong & Bergeman, 2004; Smeets et al., 2014; M. Steinhardt &

Dolbier, 2008b), and with the RAND 26-Item Health Survey vitality and social functioning

subscales (RAND) (Kent et al., 2015), The Mental Health Inventory (Ong & Bergeman, 2004),

the Depression, Anxiety and Distress Scale (DASS-21) (Varker & Devilly, 2012), and the

Emotional Regulation Questionnaire (ERQ) (Jennings et al., 2013). A related measure is the

Modified Differential Emotions Scale (mDES), which measures the strength of daily emotional

experience (Fredrickson et al., 2008).

Happiness is measured most commonly with Diener’s Satisfaction with Life Scale

(SWLS) (Fredrickson et al., 2008; Mak et al., 2011; Neff & Germer, 2013; Smeets et al., 2014),

health symptoms with the Patient Health Questionnaire (PHQ-15) (Smith et al., 2010), and hope

with the View of the Future 6-Item State Hope Scale (Mak et al., 2011), the Adult Dispositional

Hope Scale (Oman et al., 2008), and the Trait Hope Scale used in this literature to measure

agency and pathways thinking (Fredrickson, 2001).

Mindfulness is measured via the Mindful Attention and Awareness Scale (MAAS)

(Chesak et al., 2015; Fredrickson et al., 2008; Oman et al., 2008), the Cognitive and Affective

Mindfulness Scale-revised (CAMS-R) (Whitaker et al., 2014), Freiburg’s Mindfulness Inventory

(Neff & Germer, 2013), the 2-Factor Mindfulness Scale (Krasner, 2009), the Cognitive and

Affective Mindfulness Scale-revised (Neff & Germer, 2013), the Extended Kentucky Inventory

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of Mindfulness skills (KIMS-E) (Smeets et al., 2014), and the Five-Facet Mindfulness

Questionnaire (FFMQ) (Fogarty et al., 2013; Hölzel et al., 2011; Jennings et al., 2013).

Mood clarity is measured by the Trait Meta-Mood Scale (Smith et al., 2010),

neuroticism by the Eyseneck Personality Inventory (Ong & Bergeman, 2004), and optimism by

the Revised Life Orientation Test (LOT-R) (Smeets et al., 2014; Smith et al., 2010; M. A.

Steinhardt et al., 2009). Dispositional forgiveness is measured by the Heartland Forgiveness

Scale (Oman et al., 2008).

PTSD is a distinctly non-resilient outcome, measured in this corpus by the Clinician-

Administered PTSD Scale (CAPS) (Kent et al., 2011), the Post Traumatic Stress Diagnostic

Scale (PDS)(Kent et al., 2015), and the PTSD Symptom Scale Self Report (PSS-SR) (Varker &

Devilly, 2012). Perceived somatic health is measured by the Daily Physical Symptoms checklist

(DPS) (Jennings et al., 2013), quality of life with the Linear Analog Self Assessment Scale

(LASA) (Sood et al., 2011), rumination with the Rumination and Reflection Questionnaire

(Oman et al., 2008) and the Rumination Response Scale (RRS-NL-EXT) (Smeets et al., 2014).

Self Leadership is measured via the Self-Leadership Scale (SLS) (M. Steinhardt &

Dolbier, 2008a), self compassion with the Self-Compassion Scale (SCS) (Neff & Germer, 2013;

Smeets et al., 2014), self-esteem and view of self via the Rosenburg Self-Esteem Scale (RSES)

(Dolbier et al., 2010; Mak et al., 2011; M. Steinhardt & Dolbier, 2008a) and general self-efficacy

is measure with the General Self-Efficacy Scale (GSE) (Smeets et al., 2014).

Spirituality is measured via the Fetzer Test of Spirituality and Religiousness (Smith et

al., 2010). Stress is most commonly measured using the Perceived Stress Scale (PSS) (Chesak et

al., 2015; Leary & DeRosier, 2012; Oman et al., 2008; Rose et al., 2013; Smith et al., 2010; Sood

et al., 2011; M. A. Steinhardt et al., 2009). Social support is measured with the Interpersonal

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Support Evaluation List (ISEL) (Smith et al., 2010; Varker & Devilly, 2012), social

connectedness via the Social Connectedness Scale (Smeets et al., 2014), speech, memory and

counting ability under stress with the Trier Social Stress Test (TSST) (Rose et al., 2013), and

subjective distress with the Impact of Event-Revised measure (Neff & Germer, 2013).

Savoring is measured by the Savoring Beliefs Inventory (Fredrickson et al., 2008). One’s

view of the world is measured here by the Cognitive Triad Inventory View of the World

Subscale (Mak et al., 2011), well-being by Ryff’s Psychological Well-being Scale (PWB)

(Fredrickson et al., 2008; Kent et al., 2015; Smith et al., 2010), and last but perhaps most

concerning, worry, is measured in this body of literature with the Penn State Worry

Questionnaire (PSWQ) (Smeets et al., 2014).

III. Toward an Intervention for College Student Resilience

From this extended exploration of the resilience literature, there is a list of factors that

appear natural selections for work with and for college students. As faculty of any sort, these

students are increasingly needing of our care. Stress, however ill-defined, misunderstood and

underutilized (McGonigal, 2015), remains an ever present opponent. And her evil twin-sister,

anxiety, the more fearful of the two, although possessing eons-old and forward-thinking adaptive

capabilities (T. Kashdan & Biswas-Diener, 2014), feels pretty terrible when you’re swimming in

it. The literature abounds with commentary about the self-destructive sorts of coping behavior

emerging adults engage in. The experience and outcomes stress, anxiety and poor coping

flexibility are worthy opponents in support of college students. Emotional intelligence, mindset

awareness and ability, coping flexibility, mindfulness, positive emotion and self-compassion are

tools that show promise for providing some sense of relief and control to college students as they

find their pathway and sense of self in the world.

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One might imagine an intervention focusing on all of these may take up far too much

time for students. In the digital age, Amazon can deliver nearly anything…now! So an

understanding of how these factors are interrelated, interconnected and interdependent is helpful

when choosing intervention threads that support and reinforce people in more modalities than

one. Mindfulness practice: meditation, loving-kindness practice, self-compassion practice; these

practices have healing effects on stress and anxiety, enhance emotional intelligence,

psychological flexibility, and enable the experience of positive emotion. The tools of mindset

intervention allow for a healthy revisit of values and sense of purpose that can “change” one’s

mind in a moment.

A. Resilience Intervention for College Students

1. Methodology

Fifty undergraduate college students will be recruited and assigned to an intervention and

a wait list group. It is assumed that there will be some drop off in both groups, but ten students

may be an ideal number for this pilot study, and incentivizing is an option, and may be implicit

in the experience. Students may already be identified via one of two standardized annual

assessments as scoring low on resilience, so would be natural candidates for the intervention

group, as in addition to a set of validated measures of resilience and correlates, the additional

score pre and post will add credence to the usefulness of the pilot.

2. The intervention and control group

The manualized intervention consists of a four-week course that meets once a week for

50 minutes. The threads of mindfulness: mindfulness meditation, loving kindness meditation

(guided), self compassion practice (guided), and emotional intelligence: coping flexibility, values

and purpose, mindset, and rewiring the brain, will be woven through and present in each session,

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with skills and understanding building on previous meetings. Central to the space will be a

slotted box next to scraps of small paper formatted for gratitude notes (to each other). They will

be encouraged each week to take a moment to express gratitude to a different course-mate.

3. Week one

Participants will be introduced to the plan for the course, to each other, to the concept and

practice of mindfulness and the idea of well-being. The group will discuss any prior experience

or perceptions of mindfulness, engage in fifteen minutes of sitting (breath noting and counting)

meditation, then break into small groups or pairs for ten minutes to discuss their experiences and

how mindfulness may benefit them personally. The group will reconvene to report out, and be

guided in step one of Loving Kindness Meditation (LKM), and close with a private note to

themselves as a reminder of the values they hold dear. Participants will be asked to schedule

themselves to engage in sitting meditation for at least 15 minutes each day.

4. Week two

Participants will discuss the plan for the session, their experience with meditation over

the week, engage in fifteen minutes of sitting meditation, a five-minute body scan, and debrief as

a group. In pairs or threes, participants will meet for 10 minutes to share the note to themselves

about values and discuss how the experience of declaring/reminding feels and if their values

have changed since the first note. A “partner” participant will write the new, revised or

unchanged list of values on an index card to be laminated by the facilitator. The group will take

10 minutes to write a note to themselves about a belief they hold that may be hurtful to them,

wrong, or hurtful of others, and engage in “level 2” of loving kindness meditation, spend 2

minutes in self-compassion practice CM (guided), debrief and remind each other to meditate:

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“just breathe”. Participants will be given a journal article or short book chapter to read at home

about the effect of mindfulness on brain physiology.

5. Week three

Week three begins with a discussion of the plans for the session, their experience with

meditation over the week, engage in fifteen minutes of sitting meditation, a five-minute body

scan (guided) and debrief as a group. In pairs or threes, participants will meet for 10 minutes to

share the note to themselves about problem beliefs, discuss how the experience of disclosing

flaws feels, share how the values on their cards might drive future behavior and report out. They

will be guided in 10 minutes of LKM and CM, encourage each other to “just breathe” and take

home a journal article or short book chapter on mindset.

6. Week four

Begins with a discussion of the plans for the session, their experience with meditation

over the week, engage in fifteen minutes of sitting meditation, a five-minute body scan and

debrief as a group. There will be a didactic period on “decentering” In pairs or in threes,

participants will meet for 10 minutes to discuss their experience of communicating in writing to

themselves and exploring values, and report out. The group will be guided in 10 minutes of LKM

and CM, and close the course with a group discussion on purpose in life informed by self-

awareness and gratitude, and asked to articulate a plan for taking charge of their future well-

being and that of others. On their way out the facilitator will hand each student envelopes with

the gratitude notes addressed to them throughout the course.

7. Measures

Both the invention and the wait list groups will be pre-tested using all measures prior to the

first meeting. The Intervention Group will be post-tested after the 4th session. The Wait list

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control will start their course two weeks after the end of the intervention group, and be post-

tested after their 4th session. Participants will be incentivized after completing the post-

intervention assessments. All of the measures used had good psychometric properties across the

studies in which they were used.

Resilience.

The 25-item Connor-Davidson Resilience scale (CD-RISC) is “a 25-item scale designed

to quantify resilience in a variety of populations. Each item is rated on a 0-4 scale with higher

scores reflecting more resilience. Examples of items included in the scale are ‘I am able to adapt

when changes occur,’ ‘I can deal with whatever comes my way,’ and ‘Past successes give me

confidence in dealing with new challenges and difficulties.’” (Chesak et al., 2015, p. 40)

The Brief Resilience Scale (BRS) is used to assess resilience as the

ability to bounce back from stress. There are three positively worded items (e.g., ‘I tend to

bounce back quickly after hard times’) and three negatively worded items (e.g., ‘It is hard for me

to snap back when something bad happens’). The items were scored on a five-point scale from 1

‘strongly disagree’ to 5 ‘strongly agree.’ ” (Chesak et al., 2015, p. 40).

Anxiety.

The Spielberger State Anxiety Inventory "is a commonly used 20-item anxiety

questionnaire that has been found to have good psychometric properties. Responses were given

on a 5-point scale ranging from 1 (almost never) to 5 (almost always)” (Neff & Germer, 2013, p.

32).

Compassion.

The Compassion Scale assesses compassion for others along similar dimensions as self-

compassion. The scale includes six subscales: Kindness (e.g., ‘If I see someone going through a

60


difficult time, I try to be caring toward that person.’); Indifference (reverse-coded; e.g., ‘I don’t

concern myself with other people’s problems.’); Common Humanity (e.g., ‘Suffering is just a

part of the common human experience’); Separation (reverse-coded; e.g., ‘When I see someone

feeling down, I feel like I can’t relate to them’); Mindfulness (e.g., ‘I notice when people are

upset, even if they don’t say anything’); and Disengagement (reverse-coded; e.g., ‘I often tune

out when people tell me about their troubles.’)” (Neff & Germer, 2013, p. 35).

Coping flexibility.

The Brief Coping Orientations to Problems Experienced (COPE) “measures a broad

range of cognitive and behavioral coping strategies that individuals typically use in stressful

situations. It includes 14 two-item subscales: active coping, planning, positive reframing,

acceptance, humor, religion, emotional support, instrumental support, self-distraction, denial,

venting, substance use, behavioral disengagement, and self-blame” (M. A. Steinhardt et al.,

2009, p. 448).

Emotional Intelligence.

Positive and Negative Affect Scale (PANAS) “is a measure of two dimensions of affect.

Multiple time frame stems have been used with the PANAS. Our participants were asked to rate

how they ‘felt during the past few weeks’ on 20 emotions (such as ‘hostile’ and ‘enthusiastic’)

using a five-point Likert-type scale (1=“very little or not at all”, 5=’extremely’)” (Jennings,

2015, p. 732).

Happiness.

Satisfaction with Life (Diener) “assesses cognitive evaluations of life satisfaction with

this five-item scale. It assesses participants’ global satisfaction with their lives and

circumstances. Participants indicate agreement with each item on a 7-point scale, including ‘So

61


far I have gotten the important things I want in life’ “ (Fredrickson et al., 2008, p. 1050).

Hope.

Trait Hope Scale is used to assess these two cognitive components of Snyder’s hope

theory. Participants use a 4-point scale to indicate agreement or disagreement (1 - definitely false,

4 - definitely true) with 10 items divided between two subscales: agency thinking (belief that one

has been/will be personally able to achieve one’s goals), including ‘I meet the goals I set for

myself’ and pathways thinking (belief that there are multiple ways to achieve one’s goals),

including ‘There are lots of ways around any problem’” (Fredrickson et al., 2008, p. 1050)

Mindfulness.

Five Facet Mindfulness Questionnaire “is a 39-item scale to measure five factors of

mindfulness: Observing (attending to or noticing internal and external stimuli, such as

sensations, emotions, cognitions, sights, sounds, and smells), describing (noting or mentally

labeling these stimuli with words), acting with awareness (attending to one's current actions, as

opposed to behaving automatically or absent-mindedly), non-judging of inner experience

(refraining from evaluation of one's sensations, cognitions, and emotions) and non-reactivity to

inner experience (allowing thoughts and feeling to come and go, without attention getting caught

up in them” (Hölzel et al., 2011, p. 538)

Self-compassion.

Self Compassion Scale “assesses the positive and negative aspects of the three main

components of self-compassion: Self-Kindness (e.g., “When I’m going through a very hard time,

I give myself the caring and tenderness I need”) versus Self-Judgment (e.g., “I’m disapproving

and judgmental about my own flaws and inadequacies”); Common Humanity (e.g., “When I feel

inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most

62


people”) versus Isolation (e.g., “When I fail at something that’s important to me, I tend to feel

alone in my failure”); and Mindfulness (“When something upsets me I try to keep my emotions

in balance”) versus Over-Identification.” (“When I’m feeling down I tend to obsess and fixate on

everything that’s wrong”; Neff, 2003a). A single higher order factor has been found to explain

the intercorrelation between the six subscales” (Smeets et al., 2014, p. 798).

Stress.

Perceived Stress Scale (PSS) “aims to tap experiences of distress related to ‘how

unpredictable, uncontrollable, and overloaded respondents find their lives.’ Example items

include ‘In the last month, how often have you felt that you were unable to control the important

things in your life?’ and ‘...felt difficulties were piling up so high that you could not overcome

them?’” (Chesak et al., 2015, p. 572).

The between group differences will be analyized using MANOVA and Multople

Regression Analysis to interrogate the hypothesize that the effect of a multi-modal intervention

will result in significantly higher scores on a variety of well-being measures known to be

associated with resilience, and on measures of well being, than the wait-list control group. I

might hope that this pilot might suggest that a relatively brief intervention may assist students

who exhibit poor resilience to come out of the torrent of thoughts, emotions and sensations that

tend to drown us in ourselves, in order to improve their student experience and academic

success.

63


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