Abate Biruk Beletew, Sendekie Ashenafi Kibret, Tadesse Abay Woday, Engdaw Tesfaye, Mengesha Ayelign, Zemariam Alemu Birara, Alamaw Addis Wondmagegn, Abebe Gebremeskel, Azmeraw Molla
College of Medicine and Health Science, Woldia University, Woldia, Ethiopia.
Department of Clinical Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Front Psychiatry. 2024 Oct 4;15:1391312. doi: 10.3389/fpsyt.2024.1391312. eCollection 2024.
Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions.
To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context.
The study included English language articles sourced from PubMed, Embase, Scopus, Web of Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed.
A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 ( < 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversity were 0.31 ( < 0.001) and 0.42 ( < 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively.
The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness-based interventions, and mixed interventions, to enhance resilience promotion programs.
心理韧性是从创伤、具有挑战性的生活境遇、关键转变或身体疾病等应激源中维持或恢复心理健康的动态适应过程。逆境后的心理韧性可通过保护因素以及实施促进心理韧性的干预措施来培养。因此，研究保护因素和脆弱因素对于减少不利生活事件的负面影响以及通过积极的风险应对干预措施增强心理韧性至关重要。
在全球范围内评估既往逆境、保护因素以及促进心理韧性的干预措施对逆境后具备心理韧性的影响。
该研究纳入了2024年4月15日前发表于PubMed、Embase、Scopus、科学网、Cochrane系统评价数据库、Scopus和谷歌学术的英文文章。这些文章报告了在全球范围内、无人群年龄限制的情况下，逆境、保护因素和/或促进心理韧性的干预措施对逆境后具备心理韧性的影响。采用多项系统评价评估法对纳入研究的质量进行评估。应用加权逆方差随机效应模型来计算合并估计值。还进行了亚组分析、异质性分析、发表偏倚分析和敏感性分析。
本综述共纳入44篇文章（n = 556,920名参与者）。从随机效应模型分析来看，逆境对心理韧性发展的合并效应为0.25（P < 0.001）。逆境 - 保护因素和逆境后促进心理韧性的干预措施的合并效应分别为0.31（P < 0.001）和0.42（P < 0.001）。具体逆境保护因素的合并效应分别为：支持的可获得性（家庭、朋友和学校）为0.26、认知能力为0.09、社区凝聚力为0.05、积极的自我认知为0.34、宗教参与为0.23、自我调节为0.43。具体促进心理韧性干预措施的合并效应分别为：认知行为疗法（CBT）干预为0.30、基于正念的干预为0.21、混合干预为0.51、促进心理韧性的干预为0.52。
本综述的研究结果表明，经历过早先逆境的人在晚年能够培养出心理韧性。该研究强调，需要考虑逆境保护因素，如支持的可获得性（家庭、朋友和学校）、认知能力、社区凝聚力、积极的自我认知、宗教参与和自我调节，以及促进心理韧性的干预措施，包括CBT干预、基于正念的干预和混合干预，以加强心理韧性提升项目。
