Barger Jordan, Vitale Patty, Gaughan John P, Feldman-Winter Lori
Cooper Medical School of Rowan University, Camden, NJ.
Departments of Pediatrics and Emergency Medicine, The Cooper University Hospital, Camden, NJ.
J Pediatr. 2017 Oct;189:201-206.e3. doi: 10.1016/j.jpeds.2017.06.030. Epub 2017 Jul 10.
To create a valid tool to measure adolescent resilience, and to determine if this tool correlates with current participation in risk behaviors and prior adverse childhood events.
One hundred adolescents were recruited from primary care clinics in New Jersey for this cross-sectional study. A "7Cs tool" was developed to measure resilience using the 7Cs model of resilience. All participants completed the 7Cs tool, the Adverse Childhood Events Survey, and the Health Survey for Adolescents to identify current risk behaviors. Demographic and background data were also collected. To assess the validity of the 7Cs tool, Cronbach alpha, principal factor analysis, Spearman coefficients, and sensitivity analyses were conducted. The χ test and ORs were used to determine if any relationships exist between resilience and prior adverse childhood events and risk taking behaviors.
Participants ranged from 13 to 21 years old (65% female). Internal consistency was established using Cronbach alpha (0.7). Lower resilience correlated with higher adverse childhood events (P = .008) and Health Survey for Adolescents scores (P < .001). Lower resilience was associated with increased problems in school (OR 2.6; P = .021), drug use (OR 4.0; P = .004), violent behavior (OR 3.7; P = .002), recent depression (OR 5.0; P < .001), and suicidality (OR 4.1; P = .009). Higher resilience was associated with participation in exercise (P = .001) and activities (P = .01).
The 7Cs tool is an internally validated tool that may be used to screen adolescent resilience and guide pediatricians' counseling against risk behaviors. Further studies will evaluate resilience-building interventions based on results from this study.
创建一个有效的工具来测量青少年的复原力，并确定该工具是否与当前参与的风险行为以及既往童年不良事件相关。
从新泽西州的初级保健诊所招募了100名青少年参与这项横断面研究。开发了一种“7C工具”，以使用复原力的7C模型来测量复原力。所有参与者均完成了7C工具、童年不良事件调查以及青少年健康调查，以确定当前的风险行为。还收集了人口统计学和背景数据。为评估7C工具的有效性，进行了克朗巴哈系数分析、主成分分析、斯皮尔曼系数分析和敏感性分析。使用χ检验和比值比来确定复原力与既往童年不良事件和冒险行为之间是否存在任何关系。
参与者年龄在13至21岁之间（65%为女性）。使用克朗巴哈系数（0.7）建立了内部一致性。较低的复原力与较高的童年不良事件（P = 0.008）和青少年健康调查得分（P < 0.001）相关。较低的复原力与学校问题增加（比值比2.6；P = 0.021）、药物使用（比值比4.0；P = 0.004）、暴力行为（比值比3.7；P = 0.002）、近期抑郁（比值比5.0；P < 0.001）和自杀倾向（比值比4.1；P = 0.009）相关。较高的复原力与参与锻炼（P = 0.001）和活动（P = 0.01）相关。
7C工具是一种经过内部验证的工具，可用于筛查青少年的复原力，并指导儿科医生针对风险行为进行咨询。进一步研究将根据本研究结果评估增强复原力的干预措施。
