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What is resilience? A review and concept analysis

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The complexities of defining what appears to be the relatively simple concept of resilience are widely recognized. This paper analyses the concept of resilience from a range of disciplinary perspectives and clarifies a definition in order to inform research, policy and practice. The work takes a life course approach to resilience, examining evidence derived from research across the lifespan. It incorporates the methods of systematic review, concept analysis and consultation through face-to-face meetings. The synthesis of methodological approaches enables a clear identification of the antecedents, defining attributes and consequences of resilience, validated with stakeholder partners. Through this process, resilience is defined as the process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and 'bouncing back' in the face of adversity. Across the life course, the experience of resilience will vary. A large proportion of resilience research is routed within the discipline of developmental psychology, and has mainly been developed with children and adolescents. A major contribution to resilience research could be made through more multi-disciplinary studies that examine the dynamics of resilience across the lifespan, its role in healthy ageing and in managing loss, such as changes in cognitive functioning.
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Reviews in Clinical Gerontology: page 1 of 18
C
Cambridge University Press 2010 doi:10.1017/S0959259810000420
What is resilience? A review and concept analysis
Gill Windle
Dementia Services Development Centre, Institute of Medical Social Care Research, Bangor University, UK
Summary
The complexities of defining what appears to be
the relatively simple concept of resilience are widely
recognized. This paper analyses the concept of resilience
from a range of disciplinary perspectives and clarifies a
definition in order to inform research, policy and practice.
The work takes a life course approach to resilience,
examining evidence derived from research across the
lifespan. It incorporates the methods of systematic review,
concept analysis and consultation through face-to-face
meetings. The synthesis of methodological approaches
enables a clear identification of the antecedents, defining
attributes and consequences of resilience, validated with
stakeholder partners. Through this process, resilience is
defined as the process of effectively negotiating, adapting
to, or managing significant sources of stress or trauma.
Assets and resources within the individual, their life
and environment facilitate this capacity for adaptation
and ‘bouncing back’ in the face of adversity. Across
the life course, the experience of resilience will vary. A
large proportion of resilience research is routed within
the discipline of developmental psychology, and has
mainly been developed with children and adolescents. A
major contribution to resilience research could be made
through more multi-disciplinary studies that examine the
dynamics of resilience across the lifespan, its role in
healthy ageing and in managing loss, such as changes
in cognitive functioning.
Key words: resilience, systematic review, concept
analysis, life course.
Introduction
Research on resilience has increased substantially
over the past two decades1and is now also
receiving increasing interest from those involved
with policy and practice in relation to its potential
impact on health, well-being and quality of life.
This interest is due to a move away from
‘deficit’ models of illness and psychopathology, as
Address for correspondence: Dr Gill Windle, Dementia
Services Development Centre, Institute of Medical
Social Care Research, Bangor University, Ardudwy,
Holyhead Road, Bangor, Gwynedd LL57 2PX, UK.
Email: g.windle@bangor.ac.uk
resilience theory focuses on understanding healthy
development despite risk, and on strengths rather
than weaknesses.2
Unfortunately the complexities of defining what
appears to be the relatively simple concept
of resilience are widely recognized, especially
within the behavioural sciences.1,3–5 This creates
considerable challenges when developing an
operational definition of resilience; definitional
variation leads to inconsistencies relating to the
nature of potential risk and protective processes,
and in the estimates of prevalence.1,3 A review of
resilience research reporting prevalence data noted
that the proportions found to be resilient varied
from 25 to 84%.6
This has strong implications for improving
knowledge about the factors that contribute to
the development, maintenance or reduction of
resilience and how resilience might be promoted
to improve health and well-being. It is noted
that many of the debates around the definition
of resilience could be addressed by better
science, including ‘rigorous attention to sharpening
concepts’.5In order to inform future research more
clarity is required. This should be derived from a
thorough methodological assessment to ensure it is
underpinned by a robust scientific approach.
Limitations of current research on the concept of
resilience
A number of discussion papers have contributed
substantially to the study of resilience and their
value to the advancement of knowledge on the
topic is immense.2,3,5,7–10 However, in most cases
these critiques have been mainly embedded within
the discipline of developmental psychology and
derived from studies of children and adolescents.
Their content is rich and extremely informative,
but it has not been developed from a clear
methodological approach; for example, methods
for obtaining the papers discussed are not
presented.
2Gill Windle
Previous work has examined the concept of
resilience within a recognized analytical frame-
work: concept analysis.11, 12 Concept analysis is a
method of conceptual knowledge representation
and data analysis that is routinely applied
to clarify meanings and develop operational
definitions, through considering evidence from
multiple disciplines.13 The application of this
recognized methodological framework enables a
more objective approach to concept clarification
and addresses differences in application within
diverse scientific disciplines.
Unfortunately there are a number of method-
ological limitations with both of these previous
concept analyses of resilience.11, 12 In the analysis
presented by Dyer and McGuiness11 the aims of
the analysis are not clear, which is a first step
of concept analysis.13 The search strategies for
the literature reviews are not provided, nor is
a rationale for which data should be included
or excluded in the analysis. This presents a key
drawback regarding the extent of the coverage
of the research literature, as without a thorough,
systematic approach it is quite possible that key
omissions were made. This is particularly evident
in both papers. For example, Gillespie et al.12 state
that self efficacy, hope and coping are the defining
attributes of resilience. Dyer and McGuiness11 state
that a sense of self, determination and pro-social
attitude are the defining attributes. Whilst these
constructs may be implicated in resilience, it is not
clear why these specific ones were chosen whilst
other, equally possible constructs (e.g. self esteem,
competence) were excluded. Neither of the papers
synthesize the literature to provide an operational
definition of resilience.
As highlighted previously, the method of
concept analysis can be poorly applied. Beckwith
et al.14 note that various concept analysis
frameworks have been applied uncritically, and
may not contain sufficient scientific rigour to add
to theoretical development. Paley15 also notes that,
within concept analysis, there is often a lack
of clarity regarding the specification of how the
defining attributes of the concept under question
are identified. This has implications for identifying
what might be viewed as a model case of resilience,
or identifying other concepts that may be related
to resilience, or indeed have been used in research
to demonstrate resilience, but on closer inspection
may not actually share all of the defining attributes.
Research objective
To address the need for concept clarification
and improve the methodological approach in
achieving this outcome, the aim of this paper
is to present a review of the literature within a
concept analysis framework. This will enable a
more robust, theoretically informed measurement
framework for future research on resilience. This
paper synthesizes methodological approaches and
draws on a range of disciplinary perspectives to
address the question: ‘how can resilience be best
defined in order to inform research, policy and
practice?’
Specifically, the analysis will:
(i) clarify the meaning of the concept of resilience
from a multi-disciplinary perspective;
(ii) develop an operational definition that is
meaningful across different disciplines and
stakeholders, and can be universally under-
stood and applied across research, policy and
practice;
(iii) highlight implications for future research.
To determine the definition of resilience, this
paper draws on three approaches: concept analysis,
literature review using systematic principles, and
stakeholder consultation. Full details of the
methods can be downloaded from: http://
resilience.bangor . ac.uk/ Work %20Programme%
20Methodology.pdf
Resilience – identifying uses of the concept
Dictionary definitions
Resilience originates from the Latin ‘resilire’ (to
leap back). General dictionary definitions note that
the noun ‘resilience’ is a derivative of the adjective
‘resilient,’ which has two uses:
(i) 1. able to recoil or spring back into shape
after bending, stretching, or being compressed;
2. (of a person) able to withstand or recover
quickly from difficult conditions.16
(ii) 1. (of a person) recovering easily and quickly
from misfortune or illness; 2. (of an object)
capable of regaining its original shape or
position after bending or stretching.17
Resilience is also defined in discipline-specific
dictionaries as:
What is resilience? 3
Figure 1. Flow diagram of review process
(i) the rate at which a system regains
structure and function following a stress or
perturbation;18
(ii) the personal quality of a person exposed to
high risk factors that often lead to delinquent
behaviour, but they do not do so;19
(iii) a measure of a body’s resistance to
deformation. Resilience is usually defined as
the work required to deform an elastic body
to its elastic limit divided by the volume of the
body.20
The academic search yielded a large amount
of potential papers, which were primarily routed
in the disciplines of psychology and the social
sciences. The disciplines of education, health and
medicine feature to a lesser extent. Figure 1
summarizes the process of the review.
Common within many of the papers was the
recognition of the difficulties in defining resilience.
Many authors went to commendable lengths to
justify their description of the concept, drawing
on theory and other research to inform their
choice. In many instances authors did not present
their own definition of resilience, but discussed
the definitions and applications of other key
researchers in the field of resilience research. Due
to the volume of papers identified and to avoid
repetition, a representative overview is presented.
This was ascertained through examining the
authors’ definition, and the supporting citations.
These reflect the uses of the concept within different
disciplines.
Developmental psychology
Underpinning the rationale for many researchers
is the early work from developmental psychology
on stress-resistant children by Garmezey,21 who
set the scene for subsequent research to explore
how protective factors might function. Masten
et al.22 defined resilience as the process of,
capacity for, or outcome of successful adaptation
despite challenging or threatening circumstances.
Observations from longitudinal research span-
ning four decades describe resilience as an
innate self-righting mechanism.23 More recently
resilience has been defined as good outcomes
in spite of serious threats to adaptation or
development.24
4Gill Windle
Context – the life course
In many instances the risk or adversity is not
an isolated event that the person is able to
actively change. For example, a common adversity
in studies of resilient children and adolescents
is poverty and deprivation. From a life course
perspective poverty and deprivation can persist.
However, as adults develop there are a number of
other adverse occurrences that create irreversible
losses, such as bereavement of friends and relatives,
unemployment, divorce and ill-health.
In relation to the study of older age, Staudinger
et al.25 propose that the management of loss
should also be considered. Adaptation to situations
such as chronic illness may be at a lower level
of functioning, but should still be considered
resilience, given the context of the adversity.26 In
his research of adult trauma and bereavement,
Bonnano7,27 recognizes this distinction in the
experience of adversity and notes that adult
adversities are more likely to be isolated, but
are potentially highly disruptive. He defines adult
resilience as an individual’s capacity to resist
maladaptation in the face of risky experiences
and to maintain a stable equilibrium. From
a longitudinal perspective, resilience has been
defined as the ability to ‘bounce back’ from
adversityandgoonwithlife.
28 Within a lifespan
development framework, the examination of the
ability to bounce back from earlier dysfunction
can highlight adaptation and turning points at all
stages of the life course.32 This reflects the notion
of ‘steeling effects’, an important aspect of Rutter’s
work30 in relation to the life course, where effective
negation of risk exposure earlier in life facilitates a
resilient response later.
Environmental perspectives on resilience
As with the dictionary definitions, there are
definitions used within specific academic discip-
lines. From the ecological perspective comes the
idea of social resilience, the ability of groups
or communities to cope with external stresses
and disturbances as a result of social, political
and environmental change.31 Inthefaceofan
environmental disaster, social–ecological resilience
is defined as how far a particular relationship
between social processes (e.g. informal networks
within civil society and the private sector) and
ecological dynamics can be disturbed without
dramatic loss of complexity of both, rather than
the speed at which the status quo can be restored
after disturbance.32 In the context of school
and education, resilience is the ability to thrive
academically despite adverse circumstances.33, 34
Biology and psychiatry
From the field of psychiatry, overcoming stress
or adversity is how Rutter33 views resilience,
with a focus on relative resistance to psychosocial
risk experiences. He notes that the identification
of resilience requires examining a range of
possible psychological outcomes, not just a focus
on an unusually positive one or on super-
normal functioning. The limited number of
papers that looked at the neuroscience/biological
contributors to resilience define it as competent
functioning despite adversity, but emphasize it is
a ‘dynamic process that is influenced by neural
and psychological self-organisation, as well as
transactions between the ecological context and
the developing organism’.8Nigg et al.35 also
highlight that the avoidance of psychopathology
is critical to resilience. From a genetics perspective,
resilience can be viewed as the degree to which
the person at genetic risk for maladaptation and
psychopathology are not affected.3
Personal characteristics
Others suggest that resilience represents personal
qualities that enable the individual to thrive in
thefaceofadversity,
36 or that resilience is a
relatively stable personality trait37 characterized
by the ability to overcome, steer through and
bounce back from adversity.38 Alternatively it
may be viewed as a personality factor that
protects against life adversities and negative
emotions by resourceful adaptation, flexibility and
inventiveness.39 From the policy perspective, in
‘Equally Well’, a report from the Ministerial Task
Force in Health Inequalities,40 resilience is also
viewed as an individual attribute and is defined as
a personal strength/vulnerability that can influence
socio-economic inequalities in health. The focus of
resilience as a personal attribute has generally been
addressed more within the adult literature than
with children.9Also, the examination of resilience
by assessment of personality characteristics is a
point of debate in the literature and warrants
What is resilience? 5
discussion. The main point of contention is that
psychological resilience is viewed by some as
a fixed, stable personality trait37, 41 and that
resilience is not, and cannot be, an observed trait.42
Others exercise caution against referring to any
representations of resilience as a stable personality
trait/characteristic, as this implies that a person
who does not have this attribute is somehow a
failure.3
Resilience as a process
As resilience research has developed, so has the
focus of study, away from identifying some of
the key factors associated with resilience, to
understanding the mechanisms by which they
might operate. In this context, resilience refers
to a dynamic process encompassing positive
adaptation within the context of significant
adversity.3Resilience has been described as
processes and patterns of positive adaptation
in development, during or following threats to
adaptation.43 Hjemdal et al.44 define resilience as
the protective factors, processes and mechanisms
that contribute to a good outcome despite
experiences with stressors that carry significant
risks for mental ill health. Policy from the World
Health Organisation views resilience as something
that embraces positive adaptation, with protective
factors and assets that moderate risk factors and
therefore reduce the impact of risk on outcomes.45
The American Psychological Association46 defines
resilience as the process of adapting well in the
face of adversity, trauma, tragedy, threats, or even
significant sources of stress – such as family and
relationship problems, serious health problems,
or workplace and financial stressors. It means
‘bouncing back’ from difficult experiences.
Diversity in the operation of resilience
In a review of the literature, Masten7suggests that
the concept of resilience has been described as
(1) developing well in the context of high cumu-
lative risk for developmental problems (beating
the odds, better than predicted development);
(2) functioning well under currently adverse con-
ditions (stress-resistance/coping); (3) recovery to
normal functioning after catastrophic adversity or
severe deprivation (bouncing back, normalization).
As well as examining resilience, research in the UK
by Bartley and colleagues also includes capability,
referring to the ability to react and adapt positively
when things go wrong.47 They use a multi-
dimensional definition of resilience, which refers to
the process of withstanding negative effects of risk
exposure, demonstrating positive adjustment in the
face of trauma or adversity and beating the odds
associated with risks, focusing on socio-economic
disadvantage and poverty.
Stakeholder perspectives
In order to extend scientific definitions and
reflect a wider perspective from service users and
providers, stakeholders were asked in consultation
workshops to consider how they would define
resilience. Their responses reflected experiences
from their own lives, which they felt might enhance
or be detrimental to resilience. Considering that
the stakeholder group was not familiar with
the academic research on resilience, their ‘reality
driven’ perspectives generally reflect those posed
by science and dictionaries (see Figure 2). The
stakeholders felt that the term ‘bouncing back’ was
meaningful and gave an implicit understanding of
the concept and what it represents.
Determining the defining attributes of resilience
The overview of uses of resilience so far highlights
some diversity but many similarities in how it has
been defined across a range of areas, confirming
the complexity that underlies the concept. All
the identified uses of the concept are considered
beneficial for the further stages of the analysis.
How resilience is defined reflects how it might be
measured and so assessment is intricately tied up
with issues of definition. Through the next steps
of the analysis, an in-depth exploration of the
antecedents, defining attributes and consequences
will assist with concept clarification; whether
resilience is best viewed within a dynamic, multi-
dimensional model or as a unitary construct.
This step requires identification of the attributes
most frequently associated with the concept. This
phase has important implications for measurement
as, alongside the identification of the antecedents
and consequences, it can provide a useful basis
for developing measures and evaluating existing
ones.15 The definitions highlight a number of
factors that could be considered defining attributes
6Gill Windle
Figure 2. Examples of stakeholder comments
of resilience (e.g. adversity, resistance, adaptation).
However, to understand resilience it is also
important to understand what underlies these
attributes and the subsequent outcomes.
In order for resilience to be achieved, a consensus
within research is for the role of protective
factors, also referred to as ‘assets’, ‘resources’
or ‘strengths’.12,23,33,51–56 These are recognized as
crucial in achieving resilience and, through their
dynamic interplay, enable the ability to respond
positively to risks and alter or reduce the effects
of adversity. In other words, they facilitate the
competence/capability that enables resistance to
adversity and underlies the process of adaptation.54
Competence is the capacity or motivation for,
or process of effective adaptation43 and enables
adaptive use of resources within and outside the
person. It is based on the beliefs of perceived
effectiveness in adaptation and arises from
interactions with the environment. Experiences
that enable successful adaptation can inspire
further confidence to overcome future challenges
and set-backs. Competence has been identified
as an essential component of the resilience
experience.2The protective factors have commonly
been identified across three levels of functioning:
(1) individual (e.g. psychological, neurobiological),
(2) social (e.g. family cohesion, parental support)
and (3) community/society (e.g. support systems
generated through social and political capital,
institutional and economic factors).55, 56 Some
researchers2,57 distinguish the individual level
protective factors as assets, whereas resources
are viewed as external to the individual. Assets
might include factors such as competence and
efficacy; resources encompass the contextual or
environmental influences, such as family support
and community services. Figure 3 presents an
example of the multiple layers at which health
promoting factors might occur. A full discussion
of protective factors is beyond the scope of this
paper (for more detailed reviews see Charney,58
What is resilience? 7
Welfare
Temperament
Aptitudes Biology
Behaviour
Motivation
Services
Stability
Finances
Housing
Support
Cohesion
Social
Networks
Work
Schools
Transport
Environment
Health
Housing
Education
Fiscal
Employment
Figure 3. Example of the layers of resources and assets that facilitate resilience (from A. Sacker, personal
communication, September 2009; adapted from Dahlgren & Whitehead, 1991, with permission)
Curtis & Cicchetti,8Luthar,29 Mowbray et al.,52
Masten5and Vanderbilt-Adriance & Shaw6).
Antecedents
Antecedents are the events that must happen
prior to the occurrence of the concept.13 Within
resilience research, a necessary requirement is the
experience of a risk or adversity that carries
a significant threat for the development of a
negative outcome. The context of the adversity
could be biological, psychological, economic or
social, and cover areas such as stress,59 diagnosis
of Alzheimer’s disease,48 the impact of poverty
and economic disadvantage,60 refugee children,61
childrenincare,
62 caring,63 ill-health in older
age,64 and bereavement.65 Within neurobiological
approaches, from a developmental perspective,
resilience has been identified from studying why
childhood adversity leads to maladjustment in
some children but not others.66 Others have
explored why some individuals exposed to trauma
develop post-traumatic stress disorder (PTSD)
while others do not.67 Neighbourhood deprivation
has been found to contribute to depression is some
individuals, but not others.41
A key point is that it is misleading to use
the term resilience if a stressor, under normal
circumstances with a majority of people, would not
ordinarily pressure adaptation and lead to negative
outcomes.68 Vanderbilt-Adriance & Shaw6also
caution that not all risks are equivalent in severity;
some may be acute and others chronic and
persistent. Thus any findings for the occurrence of
resilience can only be considered within the context
of that specific adversity.
Consequences
Consequences are the end-points that occur
as a result of the antecedents and attributes
of resilience. Having considered the previously
outlined definitions within resilience research, the
required outcomes of resilience should reflect
the maintenance of normal development or
functioning (mental or physical health), or better
than expected development or functioning, given
exposure to the adversity under question. This
might not necessarily be an exceptionally positive
outcome. Within a life span developmental
perspective, the resilience process is often referred
to as positive adaptation or adjustment.2,3,30
It is worth noting that some of the conceptual
difficulties around resilience are determined by the
criteria researchers use to assess how the outcome
is a ‘good’ one and reflects adaptation. Within
child and adolescent research, the achievement of
salient developmental tasks in the face of adversity,
such as learning to read and write, attending and
behaving properly at school, are viewed as positive
outcomes.24
8Gill Windle
The nature of the risk/adversity could be used
to guide the strength of resilience, for example
for severe to catastrophic events, the maintenance
of near-average functioning is adequate.69 Also
within the context of severe adversity, a return
to normal functioning or ‘recovery’ may be
sufficient.24 It is also important to consider the
meaning of the adversity to the individual, as
it may amplify or attenuate subjective distress,70
which suggests that in an ideal research design,
both subjective and objective outcome measures
be incorporated.
Other research with older adults defines a
resilient outcome as flourishing despite adversity.71
However, within a resilience framework, superior
functioning is not the expected outcome. The term
‘flourishing’ tends to be placed more in the realms
of positive psychology, where the focus is on good
outcomes for all individuals, not just those who
experience significant difficulties.29 Rutter30 also
cautions that the study of resilience should examine
a range of possible [psychological] outcomes,
rather than focus on an unusually positive one, or
on super-normal functioning. If too narrow a range
of outcomes are considered, or reliance is placed on
one data source, or if there is measurement at only
one point in time, resilience may be artefactual.
Similarly, within the disciplines of prevention of
substance abuse and psychopathology, the absence
or avoidance of psychopathology, or low levels of
symptoms, are viewed as a good outcome.29, 72 This
approach has been criticised by Olsson et al.,54
who note that considerable adolescent research
has demonstrated that young people functioning
well under high stress often show higher levels of
emotional distress compared with their low-stress
peers, and so resilience may not be the absence
of distress and measuring such outcomes may be
misleading. Indeed, the presence of distress AND
the maintenance of competence may be one of the
strongest forms of resilience. The key point is that
there is no necessary expectation that protection
from stress and adversity should lead to positive
experiences.30
Defining empirical referents
According to Walker & Avant13 empirical referents
are ‘classes or categories of actual phenomena that
by their existence or presence demonstrate the
occurrence of the concept itself’. This aspect of
concept analysis is concerned with how resilience
would be measured. There are three key features
emerging from the analysis that demonstrate
the experience of resilience: the encounter with
adversity, the ability to resist and adapt to the
adversity, and the avoidance of a negative outcome.
A simple assessment of resilience then needs
to consider: (a) what is the risk or adversity?,
(b) which assets/resources might offset the effect of
the risk?, and (c) is the outcome better than could
be expected (comparing with a group of individuals
not at risk, or comparing on the presence or
absence of the assets/resources)? Researchers have
utilized two main approaches to the study of
resilience that address these three key features,
described by Masten24 as variable focused and
person focused approaches.
Variable focused approaches
These use multi-variate statistics to examine
the relationships between adversity, outcome
and the protective factors/assets. Within the
variable focused approach are three models –
compensatory, protective and challenge – which
explain how the protective factors can alter the
effects of adversity on outcome.
The compensatory model reflects the inde-
pendent contribution of risks or resources to
the outcome and involves examining their direct
(main) effects. Resources with direct effects can be
beneficial at both high- and low-risk conditions
(see Figure 4A). This main effects approach is
commonly examined through multiple regression
procedures or structural equation modelling.
The protective model describes how the presence
of resources will influence the direction and/or
strength of the risk, usually depicted as moderating
or reducing the effects of the risk under question
on a negative outcome. Conversely, it could
moderate the effects in a positive direction. This
type of model is commonly tested through the
inclusion of an interaction term between the
risk and protective factor in multiple regression.
The effects of the interactions in protection
models can also demonstrate the operation of
different processes. Luthar73 proposes a more
detailed range of operational criteria to describe
these interactive processes. ‘Protective-stabilizing’
describes stability despite increasing risk when
the protective factor is present (see Figure 4B).
‘Protective reactive’ describes how the protective
factor might present an advantage, but this is less
What is resilience? 9
Model A - Compensatory
0
10
20
30
40
50
60
70
80
hgiHwoL
Adversity
Low Resources
High Resources
Model B Protective-Stabilising
0
10
20
30
40
50
60
70
80
Low High
Adversity
Low Resources
High Resources
Model C Protective-Reactive
0
10
20
30
40
50
60
70
80
Low High
Adversity
Low Resources
High Resources
Outcome +Outcome + Outcome +
Figure 4. Models of resilience
10 Gill Windle
so when the risks are higher (see Figure 4C). This
is an important approach for explaining resilience
in later life in the face of chronic illness. Windle
et al.64 found evidence for both of these two
models across different age cohorts. In those aged
60–69 years, higher levels of psychological
resilience gave stability in well-being despite
increases in ill health (protective stabilizing). For
those aged 70–79 and 80–90 years, psychological
resilience provided an advantage, but slightly less
so when ill health was higher (protective reactive).
The challenge model describes a curvilinear
relationship between a risk factor and outcome.
Here exposure to low levels and high levels
of risk are associated with negative outcomes,
but moderate levels are associated with better
outcomes. In these models, the risk and protective
factors examined are the same variable, the
distinguishing feature being the level of exposure.
This model assumes that moderate levels of
risk can be important for learning how to
overcome challenges. This approach is commonly
examined with polynomial terms in multiple
regression.2When examined longitudinally, it
enables an examination of whether the experience
of overcoming adversity strengthens people’s
resistance to later risks and challenges. To
illustrate, Schoon75 found that at age 5, children
with good reading ability but who experienced
family economic disadvantage were similar to
others with good reading ability but whose family
had no economic problems. However, by the age of
16, the economically disadvantaged children had
declined dramatically and were doing worse in
exams than economically privileged children who
had poor reading skills at age 5. This suggests
that despite the advantage of educational resilience
earlier in life, it was not able protect against the
persistent effects of economic disadvantage.
Person focused approach
This aims to identify comparative groups of
individuals from within similar high levels of
adversity who show patterns of good or poor
adaptation, simultaneously assessed by multiple
criteria, so as to identify the factors that might
lead to risk or be assets.24 This approach is
often used to classify the proportion who may be
determined resilient. For example, in examining the
characteristics of youths living in poverty, Buckner
et al.60 operationalize resilience as the presence
of competences, adaptive functioning and lack of
significant mental health problems. Through this
categorization, 29% were classed as resilient and
the authors were able to distinguish differences
between groups. The non-resilient experienced
more negative life events, chronic strains and
abuse, whereas the resilient has greater self-
regulatory skills and self esteem and received more
active parental monitoring.
In the context of ‘bouncing back’, using data
from the British Household Panel Survey, resilience
was suggested for those people who had increasing
scores on a mental status measure (GHQ-12)
after exposure to adversity (functional limitation,
bereavement or marital separation, poverty), but
returned to its pre-exposure level after 1 year.28
Resilience measurement scales
Other researchers have developed resilience
measurement scales, some of which have been
examined in a review of instruments appropriate
for the study of resilience in adolescents76
and all age groups.77 Notably, the majority
of self report scales are based primarily on
individual, psychological resilience and require
more validation work.
Identifying model case
This is an example of the use of the concept that
demonstrates all the defining characteristics. The
following illustrate examples of resilience research
that encompass the necessary antecedents, the
defining attributes and the consequences.
Lin and colleagues78 investigated variables at
multiple levels (the environment, the family and
the individual child) that differentiate children
who manifest clinically significant levels of mental
health problems from those children who do not,
after experiencing the death of a primary care
giver. Bereaved children were classified into one
of two subgroups (resilient or affected) based
on their scores on measures of mental health
problems. Those who scored below the clinical
cut-off level on every measure of mental health
were considered resilient. Children who scored
above the clinical cut-off level on any measure
were considered affected. The analyses found that
differences between the bereaved resilient versus
bereaved affected status was related to family and
What is resilience? 11
child variables. Higher levels of caregiver warmth
and discipline and lower levels of caregiver mental
health problems were family-level variables that
significantly differentiated resilient children from
affected children. Bereaved children’s perceptions
of less threat in response to negative events and
greater personal efficacy in coping with stress were
child-level variables that differentiated resilient
from affected status.
Schoon et al.79 examined the influence of
socioeconomic adversity on school adjustment
during adolescence (age 16) and long-term con-
sequences of school adjustment for the transition
from school to work (age 33), whilst considering
factors (parental and individual resources, teacher
expectations) that might buffer such adversity.
They found that overall, socioeconomic adversity
was a significant risk factor for educational failure
and that it influences consequent adjustment in
work and health related outcomes at the age of 33,
as assessed by qualifications, socio-economic status
(SES) and self reports of general health and mental
status. In examining the protective factors at age
16, the negative effects of economic adversity on
exam score was halved through including parental
involvement and aspirations, own educational
motivation and aspirations, teacher expectations
and behaviour. Interactions amongst the protective
factors and socioeconomic adversity were negative
and demonstrated that any protective effects
were found more amongst those at lower
risk. For this group the important predictors
of exam performance were own educational
motivation and teacher expectations and also
behaviour adjustment, own job aspirations and
parental involvement with the school. For those
experiencing socioeconomic adversity, the most
important factor predicting exam performance was
teacher expectations, followed by own educational
motivation and own job aspirations, parental
aspirations and parental involvement with the
school, respectively.
Identifying additional cases
It is recommended that other concepts be
examined in order to address possible overlap,
and more importantly to clarify the true nature
of the concept in question.13 A number of
concepts (addressed below) are often substituted
for describing resilience; they may contain some
aspects of resilience, or a component of resilience,
but are not true examples.
Borderline case
A borderline case very closely resembles the
concept in question, and could often be mistaken
for it. Further distinguishing features are that a
borderline case should also differ substantially
in one of the defining characteristics.13 A closely
related concept is the Sense of Coherence (SOC).
This is a core component of the theory of the
origins of health – salutogenesis.80 Both resilience
and salutogenesis are developed from observations
of how people manage difficult situations and
display positive adaptation and stay well. Both
theories incorporate protective factors, known as
generalized resistance resources in salutogenesis.
However, where these two approaches may differ
relates to the operation of the constructs. In
salutogenesis, the generalized resistance resources
lead to life experiences that promote a strong SOC
and this sense of coherence is the key focus. In
contrast, resilience would subsume SOC as one
of the defining attributes, but not the only one.
Thus SOC could be considered part of the process
leading to a resilient outcome, but not the only
aspect. Resilience research would ideally focus on
measuring and analysing multiple levels of function
and their interactions. SOC may be one of these
levels, but a resilience framework would place
an emphasis on an actual examination of SOC
across other levels or resilience, in relation to
adversity.
Although both theories have focused on health
outcomes, resilience can also be applied to wider
outcomes. For example, Sacker and Schoon57
looked at educational resilience, examining the
role of educational and personal assets and family
resources in supporting young people from socially
disadvantaged family backgrounds to stay on in
school beyond the mandatory school leaving age.
Another distinction is that Antonovsky postulated
that SOC was mainly formed in the first three
decades of life. Resilience theory acknowledges
the dynamic nature of assets and resources, thus
nothing is fixed.
Nevertheless, salutogenesis is intricately tied in
with resilience, and it has been suggested that
a historical lack of multi-disciplinary integra-
tion has meant that theoretical perspectives on
12 Gill Windle
salutogenesis (from the discipline of medical
sociology) and resilience (largely from the
disciplines of psychiatry and developmental
psychology) have perhaps not been synthesized to
the extent that they should have.81
Related case
These are related to the concept being studied,
but do not contain all of the defining attributes.13
Kobasa82 introduced the concept of hardiness,
which has been defined as a stable personality
resource that consists of three psychological
attributes: commitment, challenge, and control.
Commitment refers to an ability to turn events
into something meaningful and important; control
refers to the belief that, with effort, individuals
can influence the course of events around them,
and challenge refers to a belief that fulfilment in
life results from the growth and wisdom gained
from difficult or challenging experiences.83 Like
resilience, hardiness has been used in the study of its
associations with lower levels of psychopathology
in the face of stress. However, the defining point
which distinguishes hardiness from resilience is
that it is a stable personality trait whereas resilience
is viewed as something dynamic that will change
across the lifespan. Moreover, hardiness measures
are designed to detect stability.
Ego-resiliency84 has been used on occasion
by researchers to measure resilience. It is
proposed as an enduring psychological construct
that characterizes human adaptability. It is a
developmental process of impulse control, where
the individual learns to regulate behaviour so as
to turn events into pleasant experiences and not
into adverse consequences. It is assumed that ego-
resilience renders a pre-disposition to resist anxiety
and to engage positively with the world.
Whilst it shares a number of similarities with
the attributes and consequences of the resilience
concept under question in this paper, in contrast to
resilience, ego-resiliency does not depend on risk
or adversity. Rather it is part of the process of
dealing with general, day-to-day change. Also ego-
resiliency is a personality trait, whereas resilience
is a far broader phenomenon. As with the sense
of coherence, ego-resiliency may be one of the
protective factors implicated in a resilient outcome,
but it would be incorrect to use this as an indicator
of resilience per se.
Contrary case
A contrary case is a clear example of something
that is not resilience. The high functioning of
individuals under conditions of no/low risk or
adversity is not considered resilience. The model
of successful ageing85 is an example of a contrary
case. In order to meet the criteria for successful
ageing, there must be a low probability of
disease and disease-related disability, including the
absence of risk factors for disease, high cognitive
and physical functional capacity and active
engagement with life.85 A resilience framework
would acknowledge the possibility that ill-health
and functional incapacity might be present, but
that their potentially negative influence would not
necessarily lead to a poor outcome. Importantly,
people are not invulnerable, but resilient.
Discussion
The analysis identifies three necessary requirements
for resilience: the need for a significant
adversity/risk, the presence of assets or resources
to offset the effects of the adversity, and positive
adaptation or the avoidance of a negative outcome.
Based on this analysis, the following definition
encompasses all of the key characteristics:
Resilience is the process of effectively negotiat-
ing, adapting to, or managing significant sources
of stress or trauma. Assets and resources within
the individual, their life and environment facilitate
this capacity for adaptation and ‘bouncing back’
in the face of adversity. Across the life course, the
experience of resilience will vary.
This analysis has taken a novel approach
to clarifying the nature of resilience, drawing
on three approaches that cover both academic
and stakeholder perspectives – systematic review,
concept analysis and consultation workshops.
This process has enabled the identification of
important areas that might have otherwise
been overlooked if just using one approach,
enabling a deeper understanding of what is meant
by resilience. Consultation with stakeholders
provided a valuable contribution to the academic
work. Their perspectives on resilience as a multi-
level construct, encompassing the individual and
the wider environment has helped to ensure that
the final definition is one that has the potential for
What is resilience? 13
wider application, and could be universally applied
and understood in ‘real world’ settings.
The robust methodological approach in this
paper improves on that of the previous concept
analyses of resilience.11, 12 In contrast to the
previous two papers, the systematic framework
in this paper provides a replicable search strategy
and transparent inclusion and exclusion criteria,
thereby minimizing the possibility of selection
bias. The process of systematically identifying
resilience literature over the past 20 years enabled
earlier theoretical formulations of the concept to
be synthesized with more recent developments.
This also ensured that early landmark papers
on resilience were incorporated. Diverse uses of
the concept were identified through exploring
resilience within different disciplines.
This paper utilized actual examples from
the research literature to illustrate examples of
actual cases and related cases of resilience. This
contrasts with the methods of other researchers
using concept analysis,11, 86, 87 who restricted their
illustrations of the defining attributes of the
concepts under question by using hypothetical
scenarios. Whilst this may have served as a useful
method of clarification, the lack of engagement
with actual, theoretically derived examples does
not assist with clarifying any scientific overlap.
Analysing and synthesizing this large volume
of research has enabled the key characteristics
of resilience to be thoroughly examined. This
methodical approach demonstrates that resilience
is the product of a dynamic process that
first requires exposure to a significant threat
or adversity. Protective resources or assets are
the defining attributes of resilience. Examining
the interplay between resources and risk is an
important aspect of resilience research and can
highlight mechanisms underlying vulnerability or
adaptation.5,29,88 It is important to understand
how such factors interact with or mediate adversity
and risk to increase or decrease the opportunity for
resilience.
Within a lifespan developmental framework,
the dynamic nature of resilience indicates it
is not fixed, but will fluctuate over time, as
new vulnerabilities and strengths arise from
changing life circumstances29 (p. 741). Research
from children and adolescents suggests that the
protection from risk is also influenced by earlier
experiences, and that across the lifespan different
factors may play a distinct role from earlier.30, 89
It is suggested that the mental health impact of
adversity in later life is mediated by psychological
resources and social factors inherited from earlier
years.90 Certain factors might predispose to
other experiences that actually mediate the risk.
Poverty is a risk for psychopathology in children,
but this may be more due to the effects of
poverty on impaired family functioning and
family relationships.30 Understanding the process
of resilience, through the consideration of its
defining attributes, can enable examination of how
a resilient response at one point in life may help
facilitate further resilience in later life, identifying
both its stability and changes.
The life course approach considers the
developmental pathways of the concept. It is then
clear that a requirement for understanding the
process of resilience is the acknowledgement of
its complexity; resilience operates across multiple
levels, which interact with each other. These
levels reflect the human ecology framework,
also described as Ecological Systems Theory.91
Although mainly used for understanding child
development, this theory has been receiving
considerable attention in the gerontology literature
and is cited in the resilience literature. This
framework aims to understand people in the
environments in which they live, and to evaluate
their interactions with these environments. People
do not exist in isolation but interact with, and
are influenced by, their physical, social and
environmental contexts. Thus the functioning of
the defining attributes of resilience can be further
explained within this theoretical framework.
Implications for further research
It is also noteworthy that a large proportion of
resilience research is routed within the discipline
of developmental psychology, and has mainly been
developed with children and adolescents. There is
a consensus from child and adolescent research
as to what the most important factors may be,5
especially for the role of relationships.29 However,
the salience of these factors may vary across the
life span. Far less is known about the process
of resilience in adulthood7,92 and even less has
followed individuals over their life time to ascertain
the value of protective factors as people age. Most
research with adults into trauma and loss has only
included treatment-seeking populations7.Akey
14 Gill Windle
question is whether the factors that lead to adult
resilience follow a similar profile to those found
for children and adolescents, and whether they
function in a cumulative and interactive manner7.
Neuroscience/biological approaches to resilience
are notably missing from resilience research.9
To date, most of the biological contribution to
the area is derived from the effects of early
care-giving environment. A major contribution
to resilience research could be made through
more multi-disciplinary studies that examine the
dynamics of resilience across the lifespan, its role
in healthy ageing and managing loss, such as
changes in cognitive functioning. As the methods
for measuring and analysing multiple levels of
functioning and their interactions improves,5the
dynamics underlying resilience should be a key
focus for future research.
The theoretical basis for resilience clearly
acknowledges that protective factors operate
across a number of levels. In order for interventions
to be most effective, theory would imply that
interventions need to consider the dynamic
interplay across these different levels, and not just
focus on developing individual strengths. Little
research has looked at the mechanisms by which
adversities, protective resources, or interventions
work.93 Research on children has examined diverse
sources of resilience, whereas research on adults
has focused more on personal attributes, such as
personality characteristics. Less attention has been
paid to the extent to which these attributes are
influenced by other factors.9This has important
implications for what might be considered the
target for the development of interventions. Will
strengthening individual, psychological resilience
achieve better results than if the focus was on
improving the resources available in the immediate
environment (e.g. social support), or within the
wider environmental context (e.g. support through
health and social services?), and how might one
level interact with another?
Another point is that positive adaptation may
not occur across all spheres of life. A review
notes that although some high-risk children show
positive outcomes in one domain, in 10 out of
13 studies examined this did not generalize to
other domains.6Luthar et al.3suggest that at-
risk children who are resilient in specific domains
(e.g. high academic grades), should show positive
performance on conceptually related measures,
such as classroom behaviour. Thus resilience may
be best measured in its related context. It has been
suggested that more precision could be gained by
using terms to describe the nature of the resilience
experience being studied,3e.g. psychological
resilience,74 educational resilience57, 94 or cognitive
resilience.95 From their review of the literature,
Vanderbilt-Adriance & Shaw6conclude that the
lack of consistency in positive outcomes over the
life course and across domains suggest that ‘global
resilience’ is rare and recommend researchers
are more specific about relating the concept of
resilience to the relevant domain outcome.
Conclusion
This theoretical exploration of the concept of
resilience highlights how interlaced with normal,
everyday life resilience is, reflecting its multi-
disciplinary roots. It would suggest that for
many, providing the right resources are available,
exposure to risks and adversity may not result
in a poor outcome. In relation to intervention,
the context in which people live could be altered,
the services and treatment received could be
improved and individual assets could be enhanced
so as to enable a better chance for health and
well-being, even when faced with substantial
risk and adversity. Importantly, the complex
interplay between these layers should be recognized
and the underlying processes explored. For
those experiencing persisting, chronic adversities,
psychopathology could be averted providing that
the individual is able to draw on a range of
resources within themselves and their immediate
environment, and that the wider environment is
also supportive. The suggestion by Richardson51
that resilience may be the driving force that
controls the universe may be a little overstated,
but the capacity for ‘ordinary magic’24 and the
opportunity for positive adaptation should be an
option for everyone.
Conflicts of interest
The author has no conflicts of interest to declare.
Acknowledgements
This paper has been developed as part of the
work of the Resilience and Healthy Ageing
What is resilience? 15
Network, funded through the UK Lifelong Health
and Wellbeing Cross-Council Programme. The
LLHW Funding Partners are: Biotechnology and
Biological Sciences Research Council, Engineering
and Physical Sciences Research Council, Economic
and Social Research Council, Medical Research
Council, Chief Scientist Office of the Scottish Gov-
ernment Health Directorates, National Institute for
Health Research/The Department of Health, The
Health and Social Care Research & Development
of the Public Health Agency (Northern Ireland),
and Wales Office of Research and Development
for Health and Social Care, Welsh Assembly
Government.
The author would like to thank the network
members for their inspiring discussions on the
topic: Dr Cherie McCraken (Liverpool University),
Professors Jane Noyes and Jo-Rycroft Malone
(Bangor University) for their helpful comments on
the paper, and Jenny Perry, Eryl Roberts and Marta
Ceisla (Bangor University) for their assistance with
abstract screening and identification of papers.
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... Resilience is understood as an adaptation to high stress or trauma. Individuals with high resilience develop protective factors and resources to adapt to and emerge from adversity [63,64]. Research has found that resilience has been defined as "the capacity to recover and maintain an adaptive sanity after being abandoned or the initial capacity to start a stressful event" [65]. ...
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... In other words, psychological resilience is the ability to be successful in coping with stress, drastic changes, risk, and distress, varying from person to person (Lee & Cranford, 2008). In addition, psychological resilience is the ability to consistently maintain and manage an individual's psychological and physiological health against negative, severe, threatening, devastating situations and to adapt to these situations (Bonanno, 2004;Windle, 2011). Studies on this subject have indicated that people with strong psychological resilience are more successful in coping with situations that may pressure them, and continue to develop themselves (Bonanno et al., 2005;Luthans et al., 2006). ...
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This study aims to determine how the COVID-19 pandemic affects career anxiety of tourism students, who are the potential future employees of tourism and hospitality industry. Data was collected using an online survey with 1097 undergraduate students in the field of tourism in Turkey. The results of the study revealed that perceived risk of infection and fear of COVID-19 significantly impact students' career anxiety, and fear of COVID-19 mediate the relationship between perceived infection risk and career anxiety. In addition, the results indicated that psychological resilience, which is an individual resource against difficulties, represents a factor that reduces career anxieties of students in the face of pandemic-related negative impacts. The findings contribute to the understanding of how pandemic diseases affect career anxiety in students, who are the future workforce of the tourism sector, and to determine the role of individual resources such as psychological resilience in this process.
... The definition of resilience is surrounded by many controversies and diversities. It is defined as a process (Panter-Brick & Leckman, 2013;Windle, 2011;Zautra, Hall, & Murray, 2010), outcome (Bonanno, 2004;Masten, 2018), and personality trait (Block & Block, 1980). Despite all of these differences, in general terms, most of the definitions of resilience describe it as overcoming risk factors and demonstrating positive emotions and behaviour in a situation of adversity (Noble & McGrath, 2013). ...
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The concept of psychological well-being and resilience shares common psychological features involved in positive human functioning. The theoretical dimensions of psychological well-being are deeply rooted in the philosophical approach to humanistic, existential, developmental, and clinical psychology. The present study was aimed to examine the predictable relationship of psychological well-being and resilience among undergraduate university students of Karachi. Secondly, it differentiates the functioning of male and female university students on the construct of psychological Well-being and resilience. The sample was comprised of 300 undergraduate students, purposively selected; with a mean age of 21.89 years belong to different universities of Karachi. The Scales of Psychological Well-being (Ryff, 1989) and The Connor-Davidson Resilience Scale (Connor & Davidson, 2003) were used as measures of this study. Findings indicated that psychological well-being was positive predictor of resilience. In the Scales of Psychological Well-being, the domain of autonomy and environmental mastery were the significant positive correlates of resilience. In addition, psychological well-being and resilience were found to be greater among female students as compared to male students. The findings of this study provide implications for positive education that enables students to robust their strengths and capabilities to increase their well-being and effective management of university life challenges. Keywords: Psychological well-being, resilience, university
... It is thought that having a resilient personality (that is, having emotional flexibility and good problem-solving skills) can help competitive athletes cope with challenge faced during the COVID-19 pandemic and maintain mental health and wellbeing. The important point is that increased resilience stems from positive psychology (Windle, 2011). Positive psychology believes that people who endure a lot of psychological stress in life are looking for something more than pain relief. ...
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... It is a complex phenomenon, which includes personality, interpersonal relationships, and the temporal characteristics of the stressor (21). Resilience means the process of effectively adapting to various adversities and failures, and managing them efficiently (22). It is also the ability to perceive stress as an opportunity, to know one's limitations when it comes to managing stress, fortifying one's resistance to it, and developing a sense of humor (23). ...
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