Wake Forest University, P.O. Box 7778, Winston Salem, NC 27109, USA.
Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
Clin Psychol Rev. 2015 Nov;41:49-60. doi: 10.1016/j.cpr.2014.05.004. Epub 2014 May 29.
A significant proportion of people in remission from depression will experience a recurrence of depression. One theoretical mechanism for this recurrence is that with each additional episode of depression, people become more sensitive to the deleterious effects of less powerful stressors. We propose that research on resilience - the ability to adapt to and recover from stress - can inform interventions to prevent recurrence in people in remission. We conceptualize resilience as a dynamic process that may be deficient in people in remission from depression, rather than as a static personal quality that is unattainable to people who have experienced psychopathology. The three aspects of resilience that we suggest are the most important to target to prevent recurrence are (1) improving stress recovery from minor daily stressors that may aid remitted people in coping with major stressors, (2) increasing positivity, like promoting positive emotions during stress, and (3) and training flexibility-the ability to identify different demands in the environment and employ the appropriate coping strategy to meet those demands. We offer suggestions for the appropriate assessment of changes in resilience in remitted people and provide some examples of effective resilience interventions.
相当一部分抑郁症缓解期的患者会经历抑郁复发。这种复发的一个理论机制是,随着每次抑郁发作的增加,人们对较弱应激源的有害影响变得更加敏感。我们提出,关于适应和从压力中恢复的韧性(resilience)研究可以为预防缓解期患者复发的干预措施提供信息。我们将韧性概念化为一个动态过程,在抑郁症缓解期的患者中可能存在缺陷,而不是作为一种静态的个人素质,对于经历过精神病理学的人来说是无法达到的。我们建议,为了预防复发,最需要针对的韧性的三个方面是:(1)改善从日常较小压力源中恢复的能力,这可能有助于缓解期患者应对较大的压力源;(2)增加积极性,例如在压力期间促进积极情绪;(3)训练灵活性,即识别环境中不同需求并采用适当的应对策略来满足这些需求的能力。我们为评估缓解期患者韧性的变化提供了一些建议,并提供了一些有效的韧性干预措施的示例。