Children of the Garden Island.

University of California, Davis.
Scientific American (Impact Factor: 1.48). 05/1989; 260(4):106-11. DOI: 10.1038/scientificamerican0489-106
Source: PubMed
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    ABSTRACT: Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES with poor health, and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self to it) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model, and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.
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    ABSTRACT: : To examine what contributes to resiliency in children living with Duchenne muscular dystrophy (DMD), a chronic, progressive neuromuscular disorder that also influences cognitive ability. The authors hypothesized that family and social support will moderate the effects of individual symptoms of illness severity and influence positive adjustment in boys with DMD. : One hundred forty-six boys with DMD were included. Child adjustment, as determined by parent ratings of their son's behavior using the Total Behavior score from the Child Behavior Checklist (CBCL), was examined as an outcome measure. The contributions of individual variables (including age [which serves also as a proxy for degree of physical disability], wheelchair use, and estimated verbal IQ), family variables (the Parental Distress score from the Parent Stress Index), and social environment variables (the Social Competence score from the CBCL) on child adjustment were examined in a linear regression analysis. : Both family and social environment variables significantly contributed to the variance in the CBCL Total Behavior score. In contrast, individual factors that are related to illness severity (age, degree of physical involvement, and estimated verbal IQ) were not associated with child adjustment. : Increased children's social networks and decreased parents' stress levels positively contributed to good child adjustment, whereas degree of individual clinical severity did not. Thus, emphasis on providing opportunities for friendships and social support and on parents' adjustment will aid in children's resilience, ensuring they can live well, even while living with the significant burdens associated with DMD.
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