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韧性:在精神病学中建立免疫力。

Resilience: Building immunity in psychiatry.

机构信息

Department of Psychiatry, B. Y. L. Nair Hospital and Topiwala National Medical College (Rtd.), Mumbai, Maharashtra, India.

出版信息

Indian J Psychiatry. 2013 Jul;55(3):224-34. doi: 10.4103/0019-5545.117134.

Abstract

The challenges in our personal, professional, financial, and emotional world are on rise, more so in developing countries and people will be longing for mental wellness for achieving complete health in their life. Resilience stands for one's capacity to recover from extremes of trauma and stress. Resilience in a person reflects a dynamic union of factors that encourages positive adaptation despite exposure to adverse life experiences. One needs to have a three-dimensional construct for understanding resilience as a state (what is it and how does one identify it?), a condition (what can be done about it?), and a practice (how does one get there?). Evaluating the level of resilience requires the measurement of internal (personal) and external (environmental) factors, taking into account that family and social environment variables of resilience play very important roles in an individual's resilience. Protection factors seem to be more important in the development of resilience than risk factors. Resilience is a process that lasts a lifetime, with periods of acquisition and maintenance, and reduction and loss for assessment. Overall, currently available data on resilience suggest the presence of a neurobiological substrate, based largely on genetics, which correlates with personality traits, some of which are configured via social learning. The major questions about resilience revolve around properly defining the concept, identifying the factors involved in its development and recognizing whether it is actually possible to immunize mental health against adversities. In the clinical field, it may be possible to identify predisposing factors or risk factors for psychopathologies and to develop new intervention strategies, both preventive and therapeutic, based on the concept of resilience. The preferred environments for application of resilience are health, education, and social policy and the right approach in integrating; it can be developed only with more research and analysis with focus on resilience. Be it patient or family member or caregiver, advocating resilience will empower psychiatrists in India.

摘要

我们在个人、职业、财务和情感方面面临的挑战日益增多,在发展中国家更是如此,人们将渴望心理健康,以实现生活的全面健康。韧性代表一个人从极端创伤和压力中恢复的能力。一个人的韧性反映了一种鼓励积极适应的因素的动态结合,尽管面临不利的生活经历。人们需要有一个三维结构来理解韧性作为一种状态(它是什么,如何识别它?)、一种状态(可以做些什么?)和一种实践(如何到达那里?)。评估韧性水平需要测量内部(个人)和外部(环境)因素,同时考虑到家庭和社会环境变量在个体的韧性中起着非常重要的作用。保护因素在韧性的发展中似乎比风险因素更重要。韧性是一个持续一生的过程,有获取和维持的时期,以及评估的减少和丧失时期。总的来说,目前关于韧性的可用数据表明存在一个神经生物学基础,主要基于遗传学,与人格特质相关,其中一些通过社会学习来构建。关于韧性的主要问题是正确定义概念,确定其发展涉及的因素,并认识到是否有可能使心理健康免受逆境的影响。在临床领域,可能识别出精神病学的易患因素或风险因素,并根据韧性的概念开发新的预防和治疗干预策略。应用韧性的首选环境是健康、教育和社会政策,正确的方法是整合;只有通过更多的研究和分析,关注韧性,才能实现这一目标。无论是患者、家庭成员还是照顾者,倡导韧性都将赋予印度精神病医生权力。

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