Pasteuning Jasmin M, Gathier Anouk W, Vinkers Christiaan H, Sep Milou S C
Department of Psychiatry, Amsterdam University Medical Centers Location Vrije Universiteit Amsterdam, the Netherlands.
Department of Anatomy & Neurosciences, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, the Netherlands.
Neurosci Appl. 2024 Apr 18;3:104069. doi: 10.1016/j.nsa.2024.104069. eCollection 2024.
Both Childhood Adversity (CA) and resilience are heterogeneous constructs that are differently conceptualized and operationalized across studies. CA in any operationalization is associated with mental and physical health problems across the lifespan, but some individuals fare quite well after CA exposure. The large body of studies investigating CA and its consequences includes a growing number of studies on resilience following CA exposure. However, large heterogeneity in study design and conceptualization of resilience hampers integration of findings and our understanding of positive outcomes after CA. Collaborative efforts to move the field forward have been valuable yet insufficient, as a consensus on the conceptualization and study of resilience in the context of CA is still lacking. Therefore, we postulate the need for the practical implementation of a comprehensive multilevel dynamic framework of resilience after CA, which aims to guide the integration of I) the contextual diversity of CA, II) the heterogeneity of resilience operationalization in the context of CA, and III) time dynamics of resilience after CA. We build upon earlier frameworks and postulate that CA occurs in and is impacted by different contexts, such as the direct family environment and the broader community context. Second, we show that studies on resilience following CA measure outcomes across different functional levels (inflammatory, endocrine, brain structure and function, cognitive/emotional/behavioral/social functioning, and health, well-being, and quality of life), adhere to numerous definitions, and are inconsistent in referring to the integral dynamic nature of resilience. In addition, we present a multilevel dynamic framework reporting checklist to encourage practical implementation of our framework and facilitate an explicit conceptualization and assessment of resilience during or after CA exposure. Our framework and corresponding checklist could promote transparency, facilitating the synthesis of research findings, aiding in the identification of gaps for future research, and enabling multilevel modeling on the dynamic interplay between various domains of our framework.
童年逆境（CA）和心理韧性都是异质性的概念，在不同研究中有着不同的概念化和操作化方式。任何操作化定义下的CA都与一生中的身心健康问题相关，但有些个体在经历CA后表现良好。大量研究CA及其后果的文献中，越来越多的研究关注CA暴露后的心理韧性。然而，研究设计和心理韧性概念化的巨大异质性阻碍了研究结果的整合以及我们对CA后积极结果的理解。推动该领域发展的合作努力虽有价值但还不够，因为在CA背景下心理韧性的概念化和研究仍缺乏共识。因此，我们假定需要切实实施一个CA后心理韧性的综合多层次动态框架，该框架旨在指导整合：一、CA的背景多样性；二、CA背景下心理韧性操作化的异质性；三、CA后心理韧性的时间动态变化。我们以早期框架为基础，假定CA发生在不同背景中并受其影响，如直接的家庭环境和更广泛的社区背景。其次，我们表明，关于CA后心理韧性的研究在不同功能水平（炎症、内分泌、脑结构与功能、认知/情感/行为/社会功能以及健康、幸福感和生活质量）测量结果，遵循众多定义，且在提及心理韧性的整体动态性质时并不一致。此外，我们提出了一个多层次动态框架报告清单，以鼓励实际应用我们的框架，并便于在CA暴露期间或之后对心理韧性进行明确的概念化和评估。我们的框架和相应清单可以提高透明度，促进研究结果的综合，有助于识别未来研究的差距，并能够对我们框架各领域之间的动态相互作用进行多层次建模。
