Erin M. Tooley

The Brief Resilience Scale: Assessing the ability to bounce back

Background: While resilience has been defined as resistance to illness, adaptation, and thriving, the ability to bounce back or recover from stress is closest to its original meaning. Previous resilience measures assess resources that may promote resilience rather than recovery, resistance, adaptation, or thriving. Purpose: To test a new brief resilience scale. Method: The brief resilience scale (BRS) was created to assess the ability to bounce back or recover from stress. Its psychometric characteristics were examined in four samples, including two student samples and samples with cardiac and chronic pain patients. Results: The BRS was reliable and measured as a unitary construct. It was predictably related to personal characteristics, social relations, coping, and health in all samples. It was negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality (high negative affect and high social inhibition) were controlled. There were large differences in BRS scores between cardiac patients with and without Type D and women with and without fibromyalgia. Conclusion: The BRS is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.

A Pilot Study Comparing the Effects of Mindfulness-Based and Cognitive-Behavioral Stress Reduction

OBJECTIVES The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). SUBJECTS Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. INTERVENTION MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. DESIGN Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. SETTINGS/LOCATIONS: Weekly meetings for both courses were held in a large room on a university medical center campus. RESULTS MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. CONCLUSIONS While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters.

OBJECTIVE This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. METHOD Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience resources including mindfulness, optimism, personal mastery, and social support. The Mindful Awareness and Attention Scale (MAAS; Brown & Ryan, 2003) was used to assess mindfulness. Participants also completed measures of firefighter stress, number of calls, and years as a firefighter as control variables. Hierarchical multiple regressions were conducted with the health measures as the dependent variables with 3 levels of independent variables: (a) demographic characteristics, (b) firefighter variables, and (c) resilience resources. RESULTS The results showed that mindfulness was associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems when controlling for the other study variables. Personal mastery and social support were also related to fewer depressive symptoms, firefighter stress was related to more PTSD symptoms and alcohol problems, and years as a firefighter were related to fewer alcohol problems. CONCLUSIONS Mindfulness may be important to consider and include in models of stress, coping, and resilience in firefighters. Future studies should examine the prospective relationship between mindfulness and health in firefighters and others in high-stress occupations.

Habituation and sensitization to heat and cold pain in women with fibromyalgia and healthy controls

Abstract The purpose of this study was to examine differences in habituation to heat and cold pain in women with fibromyalgia (FM; n = 33) and in women who were healthy controls (HC; n = 44). Quantitative sensory testing (QST) was used to assess pain thresholds during five consecutive trials of ascending heat and descending cold stimulation. Anxiety, depression, fatigue, and pain during the previous week were assessed using self‐report measures. The overall hypotheses were that there would be differences between groups in pain thresholds and in the rate of habituation to heat and cold pain stimuli. Multilevel modeling was used to test the hypotheses. There were large overall differences in pain thresholds, with the FM group showing greater sensitivity to heat and cold pain stimuli compared with the HC group. While habituation occurred in both of the groups for heat pain, the HC group had stronger habituation across trials than the FM group. Conversely, while the HC group habituated to cold pain stimuli, the FM group showed sensitization and had decreased cold pain thresholds across trials (they felt cold pain at higher temperatures). In addition, anxiety, depression, fatigue, and pain were related to decreased heat and cold pain thresholds in the overall sample. However, when group was controlled, none of these variables were related to thresholds or rates of habituation or sensitization. The differences between women with FM and healthy women in habituation and sensitization may have important implications for the etiology, diagnosis, and treatment of FM and other chronic pain conditions.

Resilience as the ability to bounce back from stress: A neglected personal resource?

The purpose of this study was to examine resilience, as the ability to bounce back from stress, in predicting health-related measures when controlling for other positive characteristics and resources. We assessed resilience, optimism, social support, mood clarity, spirituality, purpose in life, and health-related measures in two large undergraduate samples. In Study 1, resilience was related to both health-related measures (less negative affect and more positive affect) when controlling for demographics and other positive characteristics. In Study 2, resilience was related to all four health-related measures (less negative affect, more positive affect, less physical symptoms, and less perceived stress) when controlling for the other variables. None of the other positive characteristics were related to more than three of the six possible health-related measures when controlling for the other variables. Resilience, as the ability to bounce back, may be an important personal resource to examine in future studies and target in interventions.

The Role of Resilience and Purpose in Life in Habituation to Heat and Cold Pain

UNLABELLED This study examined the role of resilience in habituation to heat and cold pain in healthy women (n = 47). Heat and cold pain thresholds were each assessed across 5 equally spaced trials. Resilience, purpose in life, optimism, social support, and neuroticism were assessed using self-report measures. The hypothesis was that the resilience and the associated resilience factors would be positively related to habituation to heat and cold pain while controlling for neuroticism. Multilevel modeling was used to test the hypothesis. When considering each characteristic separately, resilience and purpose in life predicted greater habituation to heat pain while resilience, purpose in life, optimism, and social support predicted greater habituation to cold pain. When controlling for the other characteristics, both resilience and purpose in life predicted greater habituation to heat and cold pain. Resilience and associated characteristics such as a sense of purpose in life may be related to enhanced habituation to painful stimuli. Future research should further examine the relationship between resilience, purpose in life, and habituation to pain and determine whether psychosocial interventions that target resilience and purpose in life improve habituation and reduce vulnerability to chronic pain. PERSPECTIVE This article showed that resilience and a sense of purpose in life were both related to the ability to habituate to heat and cold pain in healthy women. These personal characteristics may enhance habituation to pain by providing the confidence and motivation to persist in the face of painful stimuli.

The Foundations of Resilience: What Are the Critical Resources for Bouncing Back from Stress?

The purpose of this chapter was to examine the relationship between potential resources for resilience and resilience itself. The Brief Resilience Scale [Smith et al. (International Journal of Behavioral Medicine 15:194–200, 2008)] was used to assess resilience as the ability to bounce back or recover from stress. Several potential resilience resources were assessed based on a model of resilience that involves the three stages of confronting a stressor, orienting to a positive outcome, and actively coping with the stressor. The personal and social resources assessed included active coping, mindfulness, mood clarity, optimism, purpose in life, spirituality, positive relations with others, and social support. The demographic characteristics assessed included age, gender, education, and income. The participants were 844 adults who were part of six samples: (1) general college students (n =259), (2) healthy adult women (n = 51), (3) women with fibromyalgia (n = 32), (4) cardiac patients (n = 228), (5) first-generation college students (n = 150), and (6) urban firefighters (n = 123). The results were consistent with the temporal stage model in that the personal resources targeted at each stage were related to resilience. With all samples combined, mindfulness, mood clarity, purpose in life, optimism, and active coping were related to greater resilience in both correlation and multiple regression analyses. Even when the samples were analyzed separately, these variables were consistently related to greater resilience with optimism and mood clarity having the strongest relationships with resilience. Optimism and purpose in life had very strong relationships with resilience in cardiac patients and women with fibromyalgia purpose, respectively. Age and male gender were also related to greater resilience in the multiple regression analyses of the combined samples. A revised theoretical model for understanding the foundations of resilience based on the findings is presented and implications for future research and clinical work are discussed.