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1
Resilience as a Relational Construct.
Theoretical and Empirical Evidences.
Giovanna Gianesini, PhD
Ϯ
Foreword
There were at least three major issues with the relatively new
construct of resilience. In spite of fast becoming a popular buzzword in the
psychological and clinical literature, it was still an “orphan” construct
without any connection or link to a background theoretical framework. Its
sudden and intense popularity was ahead of theoretical links to a major
theoretical framework and clinical applications. Its uncritical popularity
and speed of acquisition was ahead of theoretical considerations and
clinical applications.
Not to fear, these three issues are amply solved and scholarly
considered in this classical volume that should become a must read source
for researchers, teachers, and clinical psychologists. Such a positive
appraisal could constitute a conflict of interest since my work is cited
frequently.
Consequently, my enthusiastic reaction to this outstanding treatise
should be viewed as certainly suspect. I am not one who should preface this
manuscript. Would it be possible to obtain an unbiased opinion without
such a conflict? An answer to such a dilemma should consider any
psychologist who is not cited in this unique contribution. However, if one
is not cited would it mean that it would be impossible to review work that
is outside of one’s expertise?
Therefore, the only way a reviewee can show complete objectivity
would be to find missing or incomplete sources or evidence that should
have been considered.
AshardandascriticallyItriedtodo, Ifailedtofindsomething
missing, something misinterpreted, something incomplete, or something
overelaborated. Every part of this volume is well elaborated, amply
discussed, and critically supported. Evidence is paramount and resilience is
no longer a convenient construct suddenly produced from thin air or
inventive or utopian fantasies.
ϯ
Resilience is a real important construct that is no longer an “orphan”
theoretically or clinically. We owe this conclusion to the hard work of its
brave author. May she prosper and continue her scholarly and research
contribution to other psychological topics.
Luciano L’Abate, Ph.D , ABEPP
Professor Emeritus Psychology
Georgia State University
ϰ
Summary
ForewordϮ
Introductionϴ
Part 1: Theoretical Evidences ϭϭ
Theoretical EvidencesϭϮ
Chapter 1 - Relational Competence Theory (RCT).ϭϱ
1.1 Relational Competence. Model1 ERAAwC.ϭϲ
1.2 Relational Competence and Resilience.ϭϴ
1.3 RAQ (Relational Answer Questionnaire)ϮϬ
1.3.1 RAQ Psychometric CharacteristicsϮϬ
1 3.2 RAQ Gender differencesϮϮ
1.3.3 Concurrent Validity of RAQ SubscalesϮϮ
1.3.4 Emotionality Scale (E
feeling
and E
expressed
)Ϯϯ
1.3.5 Rationality Scale (R
relationa)l
Ϯϰ
1.3.6 Activity Scale (A
performance)
Ϯϲ
1.3.7 Awareness Scale (Aw
relational
and Aw
feeback,)
Ϯϳ
1.3.8 Context Scale (Csensitiveness)Ϯϵ
1.4 Sharing of hurt feelingsϯϬ
1.4.1 Relational Competence, Pro-social behavior and Altruism ϯϭ
Chapter 2 - The adaptive function of Emotions.ϯϯ
2.1 Emotion dysregulation: Alexithymiaϯϱ
2.2 The role of Emotions in Parenting.ϰϭ
2.3 The Role of Positive Emotions in Resilienceϰϱ
Chapter 3 - A dynamic model of affect (DMA)ϱϬ
3.1DMAandSubstanceAbuseϱϮ
3.2 Uncoupling & Resilienceϱϯ
3.3 Mindfullness & Resilienceϱϱ
3.4 Physiological Processesϱϱ
Chapter 4 - Life eventsϱϳ
4.1 Dynamic equilibrium model of Subjective Well Being (SWB)ϱϴ
4.2 Assessing life events: Life events checklists and LCUϱϵ
Chapter 5 - Coping and Expressing Flexibilityϲϭ
5.1 Grief, Bereavement, and Resilienceϲϯ
5.2 Potentially Traumatic Life Events (PTE)ϲϱ
ϱ
5.3 Post Traumatic Stress Disorder (PTSD)ϲϲ
5.4 Posttraumatic Growth (PTG)ϲϳ
5.5 Multiple Trajectories of Adjustmentϲϵ
Chapter 6 - Defining and Operationalizing ResilienceϳϮ
6.1 The construct of Resilienceϳϯ
6.2 Resilience as a personality trai: self-esteem, hardiness, sense of
control and ego resiliencyϳϰ
6.3 Self-esteem, Self-worth and interpersonal relationshipsϳϲ
6.4 Hardinessϳϳ
6.5 Sense of controlϳϴ
6.6 Ego resiliencyϳϴ
6.7 Resilience as a dynamic processϴϬ
6.10 Is resilience as personality trait, a dynamic process, or an adaptive
outcome?ϴϱ
6.11 Relational Resilienceϴϲ
6.12 Social Networks and Social Supportϴϳ
6.13 Building relationships and resilience in the workplace: mentoring.
ϴϵ
Chapter 7 - The assessment of Resilience.ϵϭ
7.1 Resilience Measures: RSA, RAS, CD-RISC, RS-14, ARS, SERIϵ Ϯ
Chapter 8 - Interventionsϵϳ
8.1 Interventionsϵϵ
Chaptert 9 – Final Discussion ϭϬϯ
9.1 Conclusions ϭϬϱ
Part 2: Empirical Evidences ϭϬϴ
Chapter 10 - Empirical Evidences ϭϬϵ
Chapter 10 - Study 1: The influence of emotional and relational
resources on parenting quality ϭϭϭ
10.1 Emotional competence, Parenting Styles & Alexithymia ϭϭϭ
10.2 Participants and procedure ϭϭϮ
10.3 Measures ϭϭϯ
10.5 Perceived Emotional Parenting Styles and Socio-demographic
Variables ϭϮϬ
10.6 Alexithymia and Perceived Emotional Parenting styles ϭϮϯ
ϲ
10. 7 Resilience and Perceived Emotional Parenting Styles ϭϮϰ
10.8 Structural equation modeling for Relational Competence and
Parenting styles ϭϮϳ
10.9 Discussion ϭϯϬ
10.10 Conclusion ϭϯϬ
10.11 Limits and Future Research ϭϯϮ
Chapter 11 - Study 2. Resilience and its shielding effect on relationship
quality and life satisfaction. ϭϯϯ
11. 1 Introduction ϭϯϯ
11.2 Participants and procedure ϭϯϰ
11.3 Measures ϭϯϰ
11.4 Results ϭϯϱ
11.5 Individual Level of analysis ϭϯϲ
11.6 Couple Level of Analysis ϭϰϬ
11.7 Conclusions ϭϰϯ
Chapter 12 – Study 3. Relational Resilience and Pro-social behavior
ϭϰϰ
12.1 Introductionϭϰϱ
12.2 Relational Resilience ϭϰϲ
12.3 Participants and procedures ϭϰϲ
13.5 Measures ϭϰϴ
13.6 Results ϭϰϵ
13.7 Conclusions ϭϱϲ
13.8 Limits ϭϱϴ
Chapter 14 – Study 4. Resilience and substance abuse ϭϱϵ
14.1 Substance abuse ϭϲϬ
14.2 Participants and procedures ϭϲϭ
14.3 Demographic Characteristics of the sample ϭϲϭ
14.4 Family composition ϭϲϮ
14.5 Measures ϭϲϰ
14.6 Results ϭϲϱ
14.7 Conclusions ϭϳϲ
References ϭϳϴ
APPENDIX Ϯϭϱ
ϳ
Relational Answer Questionnaire, Ed. 2011 (italian version) Ϯϭϱ
Relational Answer Questionnaire, Ed. 2011 Ϯϭϵ
Disorders of Internalization ϮϮϳ
Children and Youth ϮϮϳ
Disruptive Developmental Disorders ϮϮϴ
ϴ
Introduction
Positive psychology is concerned with identifying, measuring, and
enhancing human strengths and is a complementary framework for the
deficit-based medical model. While the pathogenic paradigm focuses on
why and how illness occurs, the salutogenic paradigm investigates the
origins and development of health and wellness, looking at the individuals’
functioning in various life circumstances. Within this paradigm are theories
that focus on individual’s resilience, as the ability to maintain
psychological well-being even when exposed to trauma or adversity. The
literature on resilience, which has been evolving over the past 70-80 years,
only in the last two or three decades has grown into a broad, dynamic and
comprehensive field of study unfortunately still lacking a theory of
reference (L’Abate, 2010). The study of resilience first arose from the
empirical identification of characteristics of survivors of trauma and
adversities, mainly focusing on descriptive issues and protective/recovery
factors, to progress toward a more contemporary perspective on the
underlying self-regulatory processes, stress responses and the ability to
capitalize on support structures such as social interactions and attachment.
Classified as predictor of good outcome in high-risk groups, moderator able
to enhance or reduce the effect of adversity and pattern of recovery from
trauma (Masten, Best & Garmezy, 1990), resilience implies the capacity for
transformation and change (Lifton, 1993) and determines a successful
adaptation following H[SRVXUH WR VWUHVVIXO OLIH HYHQWV 5\II HW DO
Werner, 1989). Determined by complex interactions between genetic
makeups, previous exposure to stress, personality, coping style, and
availability of social support, resilience comprises cognitive, emotional and
behavioral tendencies reflecting dispositional character traits and patterns
of behavior that develop through life experiences (Burns & Anstey, 2010)
showing substantial individual variation in response to potentially
traumatic events. In this volume, resilience is explored as a relational,
dynamic, contextual, and attributional construct, with focus on those
interpersonal characteristics that support efforts to promote harmony and
balance during developmental transitions, changes over time, crisis,
prolonged challenges and traumatic events. The general aims of Part I of
this book, Theoretical Evidences, is a critical evaluation of recent literature
ϵ
on resilience and its assessment, the integration and systematization of
scientific knowledge regarding the relational nature of resilience and the
proposal for a competence-based approach to resilience, Relational and
Emotion Regulatory Resilience (RERR). Model RERR is grounded in a
developmental systemic perspective that emphasizes relational processes,
emotional and cognitive strengths, resources and context, and builds on
Relational Competence Theory (RCT, L’abate, 2012). Theoretically, I
integrated Relational Competence Theory (RCT, L’Abate, 1995), the
Broaden-and Built Theory of Positive Emotion by Tugade & Fredrickson
(2007) and The Dynamic Model of Affect ('DYLV=DXWUD 6PLWK
Zautra, 2004) proposing a conceptualization of resilience as “relational”.
Finally, by introducing the Coping and Emotion Flexibility paradigm
(Bonanno at al. 2011), and the Multiple Trajectories of Outcome Approach
(Bonanno, 2008 %RQDQQR0DQFLQL) I challenged the assumption
that resilience is rare confirming that it represents a distinct, common
trajectory of healthy response to potentially traumatic events with
substantial individual variation leading to multiple pathways (Bonanno et
al., 2011). Resilience defined as a relational competence becomes a
complex information processing not necessarily comprising a higher level
of material, individual and relational resources, but simply a more flexible
way to modulate emotional responses and expressions, and to use a broader
repertoire of behavioral strategies within relationships providing the
individual with maximal flexibility and an optimal response at any given
event.
In Part II of this book, Empirical Evidences, I examined the
interpersonal, emotion regulatory and cognitive components of the
construct “resilience”, the processes that promote and deteriorate resilience,
and the heterogeneity of responses (outcomes) to potential trauma across
seven different studies, samples, measures and methodologies. Specifically,
in the first study I explored the influence of emotional and relational
resources on parenting quality in parents of preschoolers and elementary
schoolchildren (N= 324). In the second study, I investigated the combined,
reciprocal and summative shielding effect of resilience on relationship
quality and life satisfaction in married couples (N= 318). In the third study,
I evidenced how relational resources and resilience can be differently
utilized by working adults (N= 339). In the fourth study, I discovered the
ϭϬ
mediating and moderating effects of Resilience on substance abuse and
treatment in Adolescents (N= 429). In the fifth study, I tested how
personal and relational resources are used to build Resilience in face of
violence crime and abuse in a small sample of sexually exploited
immigrant women (N=21) and finally in the last study I related resilience
with bullying and cyberbullying in a sample of xxx high school students.
This research plan represents a comprehensive, integrated,
theoretically and empirically grounded attempt to understand resilience as a
relational construct, which may be used to develop preventative
intervention models in various contexts and specific intervention strategies
for assisting individual and families in managing the turbulences and
transitions of their life stages as well as unexpected potentially traumatic
events. This innovative and advanced contribution to the field provides a
sound theoretical framework for the construct of resilience. It shows that
resilience is a process that varies across gender lines and changes
throughout particular lifespan stages. Its relational and contextual
dimensions explain both functional and dysfunctional behavior. Resilience
is defined by positive and negative emotions and positive and negative life
events. It implies the ability to flexibly regulate emotional expression and
within the heterogeneity of responses to potentially traumatic events, it
represents a stable trajectory of healthy adjustment over time.
ϭϭ
Part 1: Theoretical Evidences.
ϭϮ
Theoretical Evidences
Resilience has been described in the scientific literature either as an
individual’s capacity for maintenance, recovery or improvement in mental
health following life challenges (Ryff, Singer, Dienberg Love, & Essex,
1998), a successful adaptation following exposure to stressful life events
(Werner, 1989), and as an individual’s capacity for transformation and
change (Lifton, 1988; 1993). The construct has been classified in literature
(Masten, Best and Garmezy, 1990) into three classes: 1) as predictor of
good outcome in high-risk groups, 2) as moderator able to enhance or
reduce the effect of adversity, 3) as pattern of recovery from trauma. The
study of resilience has arisen from the empirical identification of
characteristics of survivors of trauma and adversities and, despite lacking a
theory of reference, has now evolved from the first simplistic attempts to
describe resilient qualities to uncover the process of attaining those
qualities (Connor & Zhang, 2006). Although previous research has mainly
focusedondeterminingwhatprotective and recovery factors are critical to
adjustment and adaptation in the face of specific risks, cluster of risks as
well as family crises, contemporary resilience research has progressed
beyond descriptive issues. Researchers have now concluded that each
person has an innate capacity for resilience, and proved hat resilience is not
a fixed personality trait, but rather the process of doing what is necessary to
survive in different contexts. The interest and focus, thus, has shifted to the
underlying processes by which all risk and protective factors exert their
influence, the self-regulatory (emotion, arousal, behavior) and stress
responses, and the ability to capitalize on social support structures
(relationships. interactions and attachment). Resilience as the ability to
thrive in the face of adversity is determined by complex interactions
between genetic makeup, previous exposure to stress, personality, coping
style, availability of social support, relational competence, and emotion
regulatory processes. By using multivariate designs, it appears evident that
no single variable alone explains more than a small portion of the variance
(Bonanno, Brewin, Kaniasty, & La Greca, 2010). Resilience reflects
dispositional character traits and patterns of behavior that develop through
life experiences (Burns & Anstey, 2010) and determine substantial
individual variation in response to potentially traumatic events (Bonanno,
ϭϯ
2004). A stable trajectory of healthy functioning, or resilience, when
exposed to trauma or adversity, is typically the most common outcome
observed (Bonanno et al., 2010). Considering its dynamic, contextual, and
attributional nature, in this book we proposed that resilience needs a
competence-based approach, grounded in a developmental systemic
perspective that emphasizes relational processes, emotional and cognitive
strengths, resources and context. The general aim of this first, theoretical
part of the book is the integration and systematization of scientific
knowledge regarding the relational nature of resilience by critically
evaluating the more recent literature and proposing a more dynamic model
of resilience.
Starting with an integration and systematization of scientific
knowledge regarding the relational nature of resilience, in this book I
critically evaluated the more recent literature, systematically analyzed, and
integrated the theoretical models at the basis of the different definitions of
the resilience construct. Specifically, I first explored and assessed the
extent to which the five components of Model ERAAwC of Relational
Competence Theory (RCT, L’Abate, 2011), that is Emotionality,
Rationality, Action, Awareness and Context, can explain the strengths and
abilities that produce, enhance and even reduce resilience. Then, I further
investigated their contribution to resilience building on the Broaden and
Built Theory of Positive Emotion by Tugate and Fredrickson (2004) and
Zautra’s Dynamic Model of Affects (2004). Finally, following Bonanno’s
(2004) paradigm I explored evidences that there are substantial individual
variation in response to potentially traumatic events leading to multiple and
sometimes unexpected pathways to resilience. The focus on relational
competence and emotion regulation offers a useful and unique
interpersonal and intrapersonal developmental perspective on resilience
that considers multiple processes and multiple patterns varying over time.
Resilience demonstrated at the relational level and examined trough key
relational processes, empower individual, families and communities on
their own resources and strengths (Cusinato & L’Abate, 2011; Gianesini,
2009). Resilience defined as a relational construct becomes relevant to a
number of fields of study (O’Neal, 1999) and thus applicable to mental
health, clinical and educational settings as well to the workplace
(Gianesini, 2010). Individuals, families and organizational life all are
ϭϰ
socially embedded and relationships are the foundation of human
adaptation and development, forming the basis for both social and
cognitive competence from childhood on (Masten & Coatsworth, 1998).
The Relational and Emotion Regulatory Resilience (RERR) model
proposed in this book entails resources and processes involving relational
competence, the managing of both negative and positive affect (Gianesini,
2009; 2012) and emotion regulation processes. Resilience is, thus, defined
not a singular or a set of skills but as a more comprehensive,
developmental, ecological and multidimensional construct that supports
individuals in all types of relationships (Kinnear, 2002), from fulfilling
parental functions competently, to resolving marriage disputes, to building
relationships in the workplace (Gianesini, 2011).
ϭϱ
Chapter 1 - Relational Competence Theory (RCT).
Relational competence Theory (RCT, L’Abate, 2010) offers a
comprehensive theoretical model,
evidence-based, with relevant implications for intervention, both
clinical practice and organizational training. RCT’s sixteen models
(L’Abate, 2009b) have showed how individuals’ functioning in interaction
with others, into full family and social context, can be demonstrated,
recorded, studied, and analyzed looking at the socialization settings, the
ability to control and regulate the self, relationship styles, intimacy and
negotiation abilities. The Relational Competence (RC) construct refers to
the extent to which individuals function through meaningful interactions in
the interpersonal context. Relational competence theory (L’Abate, 1976,
2005, 2008; L’Abate & Cusinato, 2011) is hierarchical and views
paradigms as conceptual constructions overseeing a variety of
psychological theories and models, giving dimensional and relational
meanings to monadic psychiatric classification. It comprises 16 models
derived from meta-theoretical and theoretical assumptions that encompass
relational competence socialization in different settings and in different
relationships (Bakan, 1968; Brehm, Miller, Perlman, & Campbell, 2002;
Clark & Mills, 1979; DeGenova & Rice, 2005). These models, interrelated
at different levels of abstraction and complexity, represent attempts to
capture the process of socialization in intimate and non-intimate
relationships. RCT (Cusinato & L’Abate, 2011; L’Abate, 2009a) proposes
a classification of intimate relationships, defined as close, committed,
interdependent, and lasting, rather than of personalities, although using the
term relational is in some ways redundant and implicit in all human
relationships. The relevance of the theory is its applicability not only to
individuals in relationships but also to dyadic and multi-relational systems,
such as couple, family, parent-child, siblings, in-laws as well as to non-
intimate exchange relationships such as organizations and workplace
(L’abate, 2010, Gianesini, 2009).
ϭϲ
1.1 Relational Competence. Model1 ERAAwC.
According to Model
1
(ERAAwC) of Relational Competence Theory
(L’Abate, 2010), RC varies along a horizontal dimension based on
individual resources available and exchangeable in relationships within self
and others (Figure 1.2) and is defined by five sequential components:
Emotionality, Rationality, Activity, Awareness, and Context.
Figure 1.1. The E-R-A-AW-C Model1of relational competence (L’Abate, 1986)
The ERAAwC model serves as a basis for understanding the
development of personality socialization from Eto C(L'Abate, 1986, 1994,
1997) and describes an almost invariant sequence of steps. This
information processing stars with E
feeling
(expressing and sharing feelings),
progresses to R
relational
, (negotiation and problem-solving about pros and
cons of possible courses of action), find agreement or consensus about
which particular course of action to follow (A
performance
), and verify its
effectiveness (Aw
relational
eAw
feeback
)with acknowledgment, denial, or
ignorance of context. (C
sensitiveness)
ϭϳ
Figure 1.2 Standardized coefficients (Ȝ) for the ERAAWC dimensions (Corsi
2000)
Relational Competence Theory (L’Abate, 2010) states that
socialization in intimate and non-intimate relationships varies along
dimensions ranging from functional to dysfunctional styles and prototypes
connected to real life conditions rather than to abstract, hypothetical,
inferred, or ideally intra-psychic constructs. These connections attribute
dimensional, relational, and contextual meanings to otherwise static,
monadic, and non-relational psychological categories and serves as a
framework to understand psychiatric classification according to relational
dimensions rather than according to categorical lists of symptoms and
syndromes. Socialization, that is the process whereby relational
competence is articulated, nurtured, molded, and produced by lifelong
relationships, by pleasurable and painful events, and by traumatic and
joyful experiences (L’Abate, 2010) has been identified as one of the best
predictor of resilience (Blum, 1998). The perceived presence of a
supportive social network enhances a person’s capacity to deal with life’s
FKDOOHQJHV +HDWKHUWRQ 1LFKROV :DJQLOG <RXQJ .
Consequently, I expected Relational Competence, as defined by L’Abate
,
,QSXW
7
7
KU
RXJ
K
SXW
2
2XWSXW
1.17
.26
- .22
.18
- .53 .16
.15
- .13
Ȥ²= Gl= P= GFI= CFIRMSEA = .000
.21 1.65
1.00=1.00
C
E
Aw
A
ϭϴ
(RCT, 2010), not only to include factors that compose resilience but rather
Resilience to be significantly accounted for by Relational Competence and
involving emotional, cognitive, social and learning processes over a life-
time from continued interactions with intimates and non-intimate. In light
of Relational Competence Theory (L’Abate, 2010) resilience becomes the
natural outcome of a dyadic system operating in balanced, congruent ways.
Although each individual possesses the potential for resilience, an interplay
between the individual and the broader environment is responsible for its
level (L’Abate, 2010). Resilience does not function uniformly and
automatically, but waxes and wanes in response to contextual and relational
variables (Tusaie and Dyer, 2004).
1.2 Relational Competence and Resilience.
Masten and Coatswoth (1998) have defined Competence as “a pattern
of effective adaptation in the environment, either broadly defined in terms
of reasonable success with major developmental tasks expected for a
person of his/her culture, society and time or more narrowly defined in
terms of specific domains of achievements”. Resilience is a “manifested
competence in the context of significant changes to adaptation or
development” (p. 206). In the past 20 years, numerous models of resilience
have been proposed (Masten, Best & Garmezy, 1990) as well as different
operational definitions of the construct that have corresponded to a
proliferation of assessment measures sometimes misused (Bonanno &
Mancini, 2012). Numerous measures has been developed to assess different
factors related to resilience and has been used both with clinical and non-
clinical populations. However, their psychometric properties have revealed
several limitations, mostly referable to the multi-dimensional nature of the
measures (Campbell-Sills & Stein, 2007). Contemporary resilience
research (see Chapter xx) has now progressed beyond descriptive issues,
focusing on relational processes that imply self-regulatory systems for
modulating emotion, arousal and behavior, identification and capitalization
of support structures, and reduction of the likelihood of a stress response
(Gucciardi et al., 2011). However, it is still a major theoretical and
measurement issue whether resilience should be best considered as a single,
underlying psychological quality or a series of related, but distinct
ϭϵ
competences. Current evidences suggest that domain specificity seems
more useful in research and practice applications than an overall and global
definition of resilience, of questionable utility (Neill & Dias, 2000). In this
book, I proposed Relational Competence (RCT, Cusinato & L’Abate,
2011), which is a multidimensional construct (Figure 1.0) consisting of a
hierarchy of specific abilities and skills (emotions, cognitions, actions,
awareness and context sensibility) allowing measurement and validation
(L’Abate, 2010), as the conceptual framework for a dynamic, relational and
emotion regulatory model of resilience (RERR). Relational Competence
(RC) is defined by how effective an individual is in relation with others,
and is composed of skills that involve learning processes over a lifetime
from continued reciprocal, expressive, close, committed, interdependent,
and prolonged interactions (Bakan, 1968; Brehm, Miller, Perlman, &
Campbell, 2002; Clark & Mills, 1979; DeGenova & Rice, 2005). A
relationally competent individual is resilient, and the higher the level of
such competence, the greater the likelihood of withstanding stresses,
threats, and crises (L’Abate, 2010). Resilience, defined as a relational
competence, is thus a complex information processing not necessarily
comprising a higher level of material, individual and relational resources,
but simply a more flexible way to modulate emotional responses and
expressions and a broader repertoire of behavioral strategies within
relationships which provides the individual with maximal flexibility and an
optimal response at any given event. The focus on relational competence,
developmental relationships and psychosocial support, offer a useful and
unique relational and developmental perspective on resilience. The RERR
model considers multiple processes and multiple patterns varying over
time, all demonstrated at the relational level and examined trough key
relational processes, which facilitate strengths and can be used to empower
individual, families and communities on their own resources (Cusinato &
L’Abate, 2011; Gianesini, 2009). From a practical perspective,
emphasizing psychosocial support and the capacity to build relationships is
worth not only in mental health, clinical and educational settings but also in
the workplace (Gianesini, 2010). Model RERR is applicable at the
individual, family, group and organisational level, and thus relevant to a
number of fields of study.
ϮϬ
1.3 RAQ (Relational Answer Questionnaire)
Individual level of functionality in a relational context, that is
Relational Competence, is assessed with the Relational Answer
Questionnaire (RAQ, version 2001, Cusinato & Corsi, 2005; Cusinato &
Colesso, 2008, see Appendix). This 66 item, 7 factor scale measures the
adequacy of the relational answer defined as a balanced level and use of all
five components of Model
1
ERAAwC. If the scores for each components
are too high or too low, or the scores are not distributed among the
components in a balanced way, the relational answer may be inadequate
and dysfunctional. Its reliability and concurrent validity has been well
established, with good reliability, in previous studies (Cusinato & Colesso,
2008; Cusinato, 2009; Gianesini, 2010) and in the one proposed in
empirical section (Part 2- Empirical Evidences) of this book. The first
proposal about Model
1
dates back to Hansen and L'Abate (1982),
summarized and adapted with the acronym ERAAwC, used as a model of
negotiation between and among intimates and non intimates (L'Abate,
1986). At the application level, it is known as the "Lucky Star" model
(Figure 1.3). It was later reinterpreted as an experiencing-expressing
continuum (L'Abate, 1994), then defined as the horizontal dimension of
interpersonal relationships (L'Abate, 1997), approaching a formal
Information-Processing Model (L'Abate, 2005) with the goal of
emphasizing the plurality of dimensions beyond available knowledge.
Indeed this model asserted the priority of emotionality over cognition that
finally resulted in a "meta-theoretical" model (L'Abate, 2011). Yet, the
ingredients of the model remained the same since the beginning:
Emotionality, Rationality, Activity, Awareness, and Context, which are
contained in the afore-mentioned acronym (L’Abate & Cusinato, 2011).
1.3.1 RAQ Psychometric Characteristics
The psychometric characteristics of the scale are presented in Table
1.1 showing a satisfactory reliability (L’Abate & Cusinato, 2011).
Correlations among its subscales are shown in Table 1.2
Ϯϭ
Table 1.1. Psychometric Characteristics of the RAQ scales
Figure 1.3 "Lucky Star" model (reprinted from Cusinato, 2001, p. 595)
Table1.2. Pearson’s correlations among the seven RAQ scales
Eexpressed Rrelational Aperformance Awrelational Awfeeback Csensitiveness
Efeeling .59** .16** .21** -- .13** .27**
Eexpressed 1 .09* .37** .18** .21** -.12**
R 1 .29** .58** .58** .14**
A 1 .24** .36** --
Awmeta 1 .52** -.21**
**Correlation significant per p= .01; Effect size medium to large:r> .30
The RAQ subscales correlate significantly with each other and in a
positive way, except E
feeling
and Aw
relational
, C
sensitiveness
and A
performance
without significant correlation, while C
sensitiveness
correlates negatively with
Efeeling Rrelational Aperformance Eexpressed Awrelational
Awfeeba
ck
Csensitiveness
Cronbach’s
Į
.77 .71 .72 .82 .71 .71 .77
Items: 10 10 10 10 10 6 10
Mean 29.26 33.66 33.86 34.34 36.44 22.49 25.71
SD 6.17 5.91 4.99 5.11 4.87 3.46 4.72
ϮϮ
E
expressed
and Aw
relational
. The most significant correlations are between the
two E, between R
relational
and the two Aw (and between the two Aw),
between E
expressed
and A
performance
. They are not very consistent even if
significant correlations are between R
relational
and the two E showing some
connection between the cognitive and emotional resources.
1 3.2 RAQ Gender differences
Variance analyse showed that females score significantly higher than
menindimensionE
feeling
(t=-12.21 (477), p= .001; Cohen’s D = -1.12)
and E
expressed
, although the difference here is less pronounced (t=-7.59
(477), p=.001; Cohen’s D = -.70). Furthermore, awareness as feedback is
also higher in females than in males (t=-2.27(477), p= .02; Cohen’s D =
.21). Considering the breakdown by subgroups, the level of size increases
with age: E
feeling
:F= 8.60 (2, 475), p = .001; E
expressed
:F= 3.13 (2, 475), p
= .015; R: F= 9.03 (2, 475), p= .001; A
performance
:F=9.41(2, 475), p=
.001; Aw
relational
:F= 4.40 (2, 475) = 4.40, p= .002; C: F= 3.05 (2, 475), p
= .02. E1, E2, R, A, Aw
relational
indicate higher scores of married compared
to unmarried: E
feeling
=F= 12.78 (2, 47), p= .001; E
expressed
:F=8.15(2,
475), p= .001; R: F= 4.45 (2, 475), p= .01; A: F= 9.60 (2, 475), p= .001;
Aw
relational
F= 3.08 (2,475), p= .05. Education and occupation did not show
significant differences between subgroups.
1.3.3 Concurrent Validity of RAQ Subscales
The convergent and divergent validities of each RAQ subscales have
been extensively tested between 2001 and 2011, as well as exploratory
factor analysis to identify the most consistent items related to each
dimension (Corsi, 2002; Zuliani, 2002; Cusinato and Corsi , 2005;
Sandonà,2006; Zanardini , 2006; Arnaldi , 2007; L’Abate and Cusinato,
2011). Numerous studies studies have supported the scale reliability and
the construct validity of the RAQ self-report questionnaire by verifying its
criterion and convergent validity with the Coping Strategies Inventory
(COPE, Carver, Scheier, & Weinstraub, 1989), Post-traumatic Reaction
Scale (PRS), the Family Environment Scale (Moos & Moos, 1976),
Rosemberg Self-esteem Scale (RS, Rosemberg, 1985), Adult Attachment
Ϯϯ
Questionnaire (AAQ, Salvo, 1998), and Differential Emotional Scale
(DES, Tiberi & Pedrabissi, 1988), Emotional Intelligence Scale (EIS ,
Schütte et al., 1998), Impulse Control Scale (ICS), and Emotion Control
Scale (ECS), both sub-scales of Big Five Questionnaire (BFQ, McCrae &
Costa, 1987), State-Trait Anger Expression Inventory (STAXI, Spielberger,
1988), and Chabot Emotional Differentiation Scale (CEDS, Chabot &
Licht, 2006).
Figure 1.4. RAQ empirical model (Edition 2011)
1.3.4 Emotionality Scale (E
feeling
and E
expressed
)
Exploratory factor analysis identified the most consistent items
relating to a dimension of inside feeling so as to form a new scale (named
E
feeling
) with a reliability of Į= .83 for 10 items. E
feeling
correlations with
basic emotions are showed in (Table 1.3). Negative emotions are excluded
probably filtered by awareness.
Table1.3 Correlation between Efeeling and other Emotions
Sadness Anger Fear Empathy Guilt Joy
Efeeling -- -- -- .71** -- .45**
Ϯϰ
The concurrent validity analysis showed significant correlations with
the criterion scales confirming what they state but, however, it appears not
applicable to “negative emotions”. They seem to monitor whatever is
expressed outwardly rather than what is experienced inwardly. E
feeling
scale
measures the first impulse as initial answer to an incoming stimulus, a type
of energy that pushes the individual to respond relationally. It has to be
considered distinct, close but not overlapping, from expressed emotionality
(E
expressed
). An example could be crying: is crying an emotion or an action?
ItcouldbearguedthatcryingisindicativeofE
feeling
although the same
crying represents an Action, a behaviour or reaction to whatever has been
experienced by the individual. Additionally, crying could be provoked by a
painful experience as well as a pleasurable one (Gianesini, 2009). An
analysis of variance concerning age shows significant differences among
the basic emotions expressed. Depending on age, the inner activation
varies, how to think, act, and express its internal states, if painful, express
fear, anger or joy. However, there are no significant differences in E
feeling
indicating how, with age, the resonance of internal to external stimuli does
not change. There is, however, a difference between gender (male vs.
females) and status (single vs. married). This studyhasshownhowthe
content validity of the two emotionality scales need to be handled in
conjunction with the meaning of output-action.
1.3.5 Rationality Scale (R
relationa)l
In a study involving 113 Croatian war refugees and a control group of
as many non-refugees, exactly nine years after the end of the war of former
Yugoslavia (Zuliani, 2004), RAQ, Post-traumatic Reaction Scale (PRS)
and Coping Orientation of Problem Experience revised (COPEr) were
administered. Results did not show any significant correlations between R
and PRS but a negative correlation with the COPE subscale Disengagement
(r=-.36, p< .001) and positive with Support (r= .28, p< .001) and
Problem Solving (r = .44, p< .001) for war refugees. Participants in the
control group did not show positive correlations between R and COPE
subscale Support” (r= .28, p< .001) and R and Problem Solving (r= .55, p
< .001). In a study by Sandonà (2006) on a sample of 175 teenagers (age
12-18, m=61 and f=114), R resulted positively correlated with FES
Ϯϱ
subscale Cultural Orientation (r= .21, p= .02) and more markedly for
males (r= .30, p= .02). RAQ Scale R also correlated positively with the
AAQ subscale Secure (r= .13, p= .02) and negatively with subscale
Avoidant (r=-.19, p= .001) in an empirical inquiry with 302 participants
(age 19-70, m=117, f= 184). Lastly, Miozzi (2007) found that R is higher
in individuals with higher education (F= 12.61 (1, 274), p< .001).
Consequently, Secure individuals seem to use R better with respect to
avoidant individuals and those who experienced stress or disengagement
have a weaker R, which summarizes the ability to constructively manage
relationships, a certain degree of integration between rationality and
emotionality, the ability to control emotional reactions (anger in particular)
and problem solving skills. Consistently, individuals well differentiated
and with higher level of education showed higher cognitive abilities. A
variance analysis between R
relational
(10 items, reliability index Į= .87) and
concurrent scales (Table 1.4) showed consistently positive correlations.
R
relational
appears to monitor cognitive abilities within intimate relationships
in the direction of emotion regulation and emotional intelligence and tends
to facilitate a congruent performance in a relational context. In fact, early in
the ERAAwC information processing, R intercepted the first emotional
experiences, while remaining an available resource in each subsequent
steps. R
relational
positively correlated with positive relations with partners (r
= .24**), children (r= .19**), and family relationships (r= .23**). No
significant gender differences emerged (t(582) = .37, p= .07), but older
individuals have higher R
relational
than younger (F15.26 (3, 580) p< .01) as
well as people with responsibility at work (F14.40 (4, 578) = 14.40, p<
.01) and married/living couples (F25.55 (2, 581), p< .01). Last, education
level shows a significant but small and unexpected tendency from the lower
to the higher level (F14.40 (2, 581), p< .01).
Ϯϲ
1.3.6 Activity Scale (A
performance)
The conceptual consideration about the dimension of Emotionality
could also apply here to the dimension of Activity which in RCT
emphasizes the meaning of performance in the relational process as an
answer to a received emotional input. The A
performance
scale comprises 10
items (Į= .87) expressing performance ability and is adequately correlated
with E
expressed
(r= .67**) and the Dynamic Subscale of the Big Five
Questionnaire (SD, Caprara, Barbaranelli, & Borgogni, 2000) (SD, r=
.41**). In a study with adolescents, this scale showed a negative correlation
(r= -. 19*) with the Family Environment Scale-Performance Orientation
(Sandonà, 2006), while in a group of prisoners (Zanardini, 2006) showed a
positive correlation with Rosenberg self-esteem scale (RSE, r= .28*). At
the same time, in a qualitative study with detained people, A resulted
positively correlated with the psychoticism scale of Minnesota Multiphasic
Personality Inventory.
Table 1.4 Correlations between Rrelational and Concurrent Scales
Scale Rrelational
CEDS Chabot Emotional Differentiation Scale (Chabot &
Licht, 2006).
.49**
RAS (Relational Awareness Scale, Snell, 1998) .17**
BFQ (Big Five Questionnaire, McCrae & Costa, 1987)
Impulse Control Scale (ICS) .36**
Emotion Control Scale (ECS)
.28**
STAXI (State-Trait Anger Expression Inventory, Spielberger,
1988)
Anger Control .47**
EIS (Emotional Intelligence, Schütte et al., 1998) .39**
Self Awareness .40**
Self Management .37**
Self Direction .49**
**Correlation significant per p= .01; Effect size medium to large:r> .30
Ϯϳ
1.3.7 Awareness Scale (Aw
relational
and Aw
feeback,)
Within the area of intimate relationships, Acitelli (1993) defined
awareness as: “a person thinking about interaction patterns, comparisons,
or contrasts between him/herself and the partner. Although relationship
awareness is a process and is not defined here as a personality disposition,
there is evidence that thinking about relationships may be a personality
trait” (p.151). L’Abate (2005) conceived awareness as “the ability to reflect
on one’s own emotionality, rationality, activity, or context” (p. 97) but Aw
also included a relational ability developed from past relational experiences
to conduct and possibly correct and change current relationships. Block
(1995, 2007) revealed another experiential aspect defined as “accessible
consciousness”. It represents the ability to report and act upon experiences
equivalent to the existence of same representation of the experience in the
brain, the content of which is available for verbal report and for high level
process such as conscious judgments, reasoning, and the planning of
guidance of action” (Braud, & Anderson, 1998; Zelaso, Moscovich, &
Thompson, 2007) emphasized Aw both as a tool and as a goal for
understanding more adequately inner thoughts and feelings. At the
operational level, Fenigstein, Scheier and Buss (1975) proposed a
consciousness model starting from the humans’ ability to shift the focus of
attention from environment to inner self and vice versa. This self-focus
included a public and a private dimension: the first characterized by
attentiveness to features of self presentation to others (e.g., physical
features and mannerisms), the second involving any attentiveness to
internal, personal aspects, such memories and feelings of physical pleasure
or pain (Buss, 1980). Both dimensions can be dispositional – often referred
as “self-consciousness” – or situational, usually labelled “self-awareness”.
In this way, public and private self-consciousnesses may assume a
configuration of relatively stable traits or elements (Buss & Scheier, 1976;
Carver & Glass, 1976) while public and private self-awareness are viewed
as transient states susceptible to manipulation (Carver & Glass, 1976). This
discrimination was made by L’Abate (2005), distinguishing about
awareness directed toward the self and awareness directed toward the
context. Consciousness traits were investigated specifically by Snell
(1998) moving from the theory of self-consciousness (Buss, 1980;
Ϯϴ
Fenigstein, Scheier, & Buss, 1975) that created the Relational Awareness
Scale (RAS). This scale operationalized three intimate relationship
tendencies: (a) Relational Consciousness defined as “a person’s tendency to
be aware of the private nature and dynamics of his/her intimate
relationships”, (b) Relational-monitoring defined as “the tendency to be
concerned with the public image of one’s intimate relationship”, and (c)
Relational-anxiety defined as “the tendency to feel anxious, tense, and
inhibited in intimate relationships”. Higher scores on the RAS correspond
respectively to greater relational-consciousness, relational-monitoring, and
relational-anxiety. Snell (1998) provided evidence for the reliability of
RAS with internal consistency and stability justifying the subscales’ use.
On the other hand, Govern and Marsh’s (2001) work focused on the
transient states of consciousness and created the Situational Self-
Awareness Scale (SSAS) distinguishing public from private self-
awareness. Their results showed the existence of three factors labelled (a)
“Public Self-awareness”, (b) “Private Self-awareness”, and (c) ”Awareness
of immediate surrounding”. The SSAS had a reliable factor structure
consistent with the theoretical underpinning of public and private self-
awareness, but no explanation was given about their “immediate
surrounding”, a construct that seemed foreign to their theoretical
framework. Relational consciousness account for a multidimensional
model with four traits of awareness. Awareness as feedback (Aw
feedback
)is
the ability to think about present and past relationships and
building/managing relationships (L’Abate, 1986, 2005). Awareness of self
(Aw
self
), is the ability to reflect on own emotionality, rationality, activity,
and relationship context expectations (Fenigstein, Scheier, &Buss, 1975;
L’Abate, 1986, 2005; Snell, 1998). Awareness of other (A
others
), is the
ability to realize other’s emotionality, rationality, activity, and context
expectations (Govern & Marsh, 2001; L’Abate, 1986, 2005). Awareness of
self-regulation (Aw
regulation
), is the ability to represent relational
experiences in the brain, for high level process such as reasoning, and the
planning of guidance of relational actions (Block, 1995, 2007). The formal
model supposes that Aw
feedback
influences Aw
self
and A
others
, in turn
influencing Aw
regulation
. Correlations (Table 2.4) between the four awareness
scales of the model are that are consistently and significantly positive. The
correspondence between the formal and the empirical models was
Ϯϵ
strengthened by confirmatory factor analysis (LISREL).
Table 1.5 Correlations among Four Awareness Scales.
Awfeeback Awself Awothers
Awself .50** 1
Awothers .42** .57** 1
Awregulation .44** .70** .57**
** Correlation significant at the .01 level
On one hand, past relational experiences increase progressively the
realization of cultural and contextual norms that regulate intimate
relationships while on the other hand, personality trait characterized by
attention to one’s internal dynamics scaffolds the process in various steps
moderated by the awareness of specific situational inputs. The attention to
public impression management or self-presentation must always be
considered in the background to avoid generalizations. In conclusion, it
appear that Aw
relational
and Aw
feeback,,
which are sensitive to age and gender,
in that women seem to possess greater capacity to understand the relational
competences of others (F = 5.65 (2), p < .02) are essential component of
what constitutes relational awareness in intimate relationships.
1.3-8 Context Scale (Csensitiveness)
The context scale distinguish between the influence of the relationship
context on the person and the adaptation to the context by the individual.
The psychometric characteristics of its 10 items and the concurrent validity
of the scale were tested with Multidimensional Scale of Perceived Social
Support (MSPSS, Zimet, Dahlem, Zimet, & Farley, 1988), the scale of
Cooperativity, taken from the Big Five Questionnaire (BF-C, Barbaranelli,
Caprara, & Borgogni, 1993). Context sensitivity does not directly influence
the individual’s relational answer, but moderates the expression of emotion
in relations and thus play an important role in supporting the relational
process. In addition, context sensitivity is made possible by the awareness
of all the resources that come into play in the process of information
processing and management. The attenuated or inappropriately modulated
expression of positive and negative emotions can be reflected in a lack of
ϯϬ
behavioral responsiveness to change in the emotional environment, called
emotion context-insensibility (Rottember& Gotlib, 2004). In many
contexts, this emotional impoverishment , or lack of emotional
competence, may violate other’s expectations about the interaction as a
lack of emotional-expressive reciprocity may frustrate, disrupt and erode
interpersonal coordination and relationship quality (Rottember & Vaughan,
2008). Similarly, rigid and unchanging emotional behavior in social
interactions could frustrate the other persons desire for dynamic feedback
on their on performance and the state of their relationship.
1.4 Sharing of hurt feelings
Relational Competence Theory (RCT, L’Abate & Cusinato, 2011)
includes a model of intimacy that
involves all five components of the previously presented Model
1
(ERAAwC) and strongly builds on previous research on affect regulation
(Bradley,2000; Firestone and Catlett, 1999), affect avoidance (Hsyes,
Strosahl & Wilson, 1999), traumas and espressive emotions (Pennebaker,
2001) and mood regulation (Watson, 2000). Being emotionally attuned and
available means sharing concern, care, and compassion when hurts
(L’Abate, 2011) that is, showing empathy in the "here and now" (Feeney,
2004; Young, 2004). As it takes a certain degree of functionality to share
hurt feelings reciprocally thus this ability and process is found in functional
relationships and is absent in dysfunctional ones. In fact, it takes
functionality to admit feeling vulnerable to hurts and to share this
vulnerability with others (L’Abate, 2010). In literature, hurt feelings are
often defined by using indirect constructs such as “distress”, “negative
feelings”, “social pain”, or “emotional disturbances”. In Relational
Competence Theory, instead, intimacy is defined behaviorally as the
sharing of joys, hurts, and the fear of being hurt (Feeney, 2007; L’Abate,
2013; Vangelisti, 2013; Vangelisti & Beck, 2007). This definition also
implies that sharing of hurts and of fears of being hurt are the conditio sine
qua non necessary for forgiveness of errors and of transgressions (Fincham,
2000; Fincham & Beach, 2002; Friesen, Fletcher, & Overall, 2005;
L’Abate, 2011). According to the Sharing of Hurt Feeling (Model14),
subjectively experienced feelings emerge as separate from observably
ϯϭ
expressed emotions thus feeling should not be equated with emotions, but
rather considered as a subjective appraisal with no positive or negative
hedonic valence (L’abate, 2011). The importance of separating clearly
between emotional stimuli on the receptive side, as feelings, affect or
moods versus the output of such stimuli o the expressive side, as emotions,
is crucial to personality socialitazion (L’Abate, 2005, p. 338) and
fundamental to a Relational and Emotion Regulatory Model of Resilience
(RERR).
Between experiencing of hurt feelings and their expression lies the
importance of relational and emotion regulatory processes. It has been
argued that displaying emotions, either positive or negative, elicits positive
responses in other people thus encouraging social affiliation and making
social resources available for coping with adversities (Gianesini, 2011b), as
long as they somehow alternate each other in a wavelike manner (Bonanno,
2009). Other researchers have proposed that when hurts offset joys
inevitably psychopathology emerges (L’Abate, 2011, 2011; Tugade &
Fredrickson, 2007) and only when feelings emerge and are shared they
transform themselves into emotions, facilitating close relationships,
connections and bonds which are inner resources, culturally different and
contextually adaptive (Bonanno, 2009; L’Abate, 2009). Social engagement
derives from needs that arise from both affective systems, as individuals
seek contact for both enjoyment and alleviation of suffering (Davis, Zautra,
& Smith, 2004). Especially during stress and adversity, “reflecting and
recalibrating to reality, moving in and out of sadness, by switching to more
positive states of mind, by finding joy and laughter within pain, and
making sense out of it” (Bonanno, 2009, p. 195) in relationships with
others allow individuals to gradually return to a state of equilibrium and
resources restoration.
1.4.1 Relational Competence, Pro-social behavior and Altruism.
The tendency to engage in prosocial behaviors is correlated with
interpersonal and relational skills as it provide an opportunity to practice
and develop social skills, make more friends and contacts, increase self-
confidence and life satisfaction, provide with a natural sense of
accomplishment, pride and identity, and help gain a more positive view of
ϯϮ
life and future. Pro-social behavior increases competence, flexibility,
problem solving, self-worth, positive relationships and hope behavior. A
source of community strength, resilience, solidarity, and social cohesion it
can bring positive social change by fostering respect for diversity, equality
and the participation of all. As competence refers to the ability to meet the
demands of a situation, like the related constructs of adaptation, ego
mechanisms, self-efficacy, and intelligent behavior, it refers simultaneously
to the environment and to individual abilities (Masten et al., 1995). Pro-
social behaviors are actions that benefit others without any expectation for
later reward (Bryan & London, 1970; Leahy, 1979) and are among
society’s most vital assets. The mediating, intervening process that allows
people to help others altruistically, that is without expecting rewards or
avoiding punishment is empathy (Batson, 1991; Hoffman, 1981). Empathy
comprises not only emotional aspects but also cognitive elements, such as
perspective taking and causal attribution. Social learning theory holds that
pro-social behavior in children is built on the basis of the moral standards
available in their environment and the more children observe someone
engaging in pro-social behaviors, the more they tend to share their
belongings and help others (Zahn-Waxler, Radke-Yarrow, Wagner, &
Chapman (1992). However the ways in which individuals manage to
exhibit positive adaptation under adverse conditions, with the mediation
and, possibly, moderation of pro-social behaviors, need to be further
explored. There is no question that altruism has health-engendering
outcomes (Post, 2007) and the relationship between pro-social behavior
and health remains clear and valid.
ϯϯ
Chapter 2 - The adaptive function of Emotions.
Once Resilience is defined in light of Relational Competence Theory
(RCT, L’Abate, 2010) as a process of continual development of personal
competence while negotiating with others available resources, how these
individual resources are capitalized and the quality and strengths of the
relationships where they are exchanged need to be investigated. In social
contexts, the use of adaptive emotion regulation strategies facilitate
interpersonal interactions and is associated with healthier pattern of
physical and psychologically functioning (John & Gross, 2004). The
majority of emotion expression occurs during social interactions (Ekman,
1992), with complex informative and evocative functions. Emotions
(Lazarus, 2006) can impair or facilitate not only psychological adaptation,
but also the accuracy of judgment and task performance. The central role of
emotion expression in adaptation has been investigated by many
SV\FKRORJLVWV (NPDQ )ULGOXQG LQWHUHVWHG LQ FRQQHFWLQJ
impaired social functioning to clinical disoUGHUV .HOWQHU.ULQJ
Rottember & Johnson, 2007) mostly depression. Depressed individuals, in
facts, express emotions inflexibility and in ways that are inappropriate to
dynamically changing environmental contexts. Emotional reactions are
triggered when an individual encounter a meaningful inside or outside
stimuli and are indexed by several indicators of multiple responses
(Rottember & Vaughan, 2000), as previously discussed for Model
ERAAwR. In fact, the adaptive function of emotions deals with attention to
both environmental stimuli and internal clues about the interaction with the
environment (Schultz et al., 2005). Emotions are a complex and
multidimensional phenomena: every emotion involves multidimensional
appraisal processes, which are affected by a vast number of factors, such as
other emotions, moods, characteristics, environmental circumstances,
experience, and physical factors (Solomon & Stone, 2002). Tomodify the
emotional impact of a situation (John & Gross, 2004) an individual needs
to change cognitively how a potentially emotion-eliciting event (cognitive
reappraisal) is perceived. In addiction to cognitive reappraisal, inhibiting
ongoing expression of emotion-related behavior (emotion suppression)is
another form of emotion regulation that allows changing the way we
respond behaviorally once we are already in an emotional state, without
ϯϰ
modifying the subjective experience (Gross & Levenson, 1993). Emotions
manifest themselves in specific cognitive, behavioral and physiologic
reactions and they are crucial for adaptation of environmental stimuli.
(Vingerhoets et al., 2008) They result from the outcome of the evaluation
of environmental stimuli and as such “they provide the necessary
physiologic support for emotion-specific action tendencies, thereby
facilitating overt action” (p. 3) Emotions are no longer considered the
opposite of rationality and are essential for adequate cognition. Cognitive
appraisal, that is changing the way we perceived a potentially emotion-
eliciting event, allows modifying the emotional impact of a situation (John
& Gross, 2004). In addiction to cognitive reappraisal, emotion suppression,
that is inhibiting ongoing expression of emotion-related behavior, is
another form of emotion regulation that allows changing the way we
respond behaviorally once we are already in an emotional state without
modifying the subjective experience. (Gross & Levenson, 1993). Intense
and unresolved negative emotions have an acute effect on body functioning
and trigger and increase the risk of health problems. In social contexts , the
use of adaptive emotion regulation strategies facilitate interpersonal
interactions and is associated with healthier pattern of physical and
psychologically functioning (John & Gross, 2004). Thus, if emotions are
action tendencies that serve an adaptive function (Lang, Bradley &
Cuthbert, 1998), adaptive emotion regulation is the norm while emotion
dysregulation is dysfunctional (Rodebaugh & Heimber, 2008). Emotional
Intelligence, as the ability to perceive, assimilate, comprehend and manage
emotions (van Heck & Oudsten, 2008), is not another form or type of
intelligence but simply intelligence applied to a particular life domain,
emotions (Locke, 2005), and therefore can be considered as a skill or
competence. Emotional interactions between parents and child have a great
impact on a child’s long-term well-being and emotional interactions among
family members become the foundation for emotional, thus relational,
competence, for instilling values and raising moral people. Emotionally
intelligent people (Goleman, 1995), in fact, are able to regulate their own
emotional states, to sooth themselves when they are upset, to calm down
faster thus relating better to others, even in difficult social situations, while
performing more efficiently (Gottman, 1997).
ϯϱ
2.1 Emotion dysregulation: Alexithymia and relational
competence
Alexithymia describes problems in affect regulations, such as
difficulties with recognizing, processing and regulating emotions (De Rick
and Vanheule, 2006) and attachment theorists (Fonagy,Gergely, Jurist &
Target, 2002) have underlined the importance of significant others,
especially caregivers, in its offset. They have claimed that problems in
regulating affects, such as alexithymia, cohere dynamically with a
problematic relationship with others. Specifically, an internal working
model of cold and overprotective parenting has been found strongly
associated with alexithymia (Kooiman et al., 2004) and perceived parenting
style have been predictive of differences between a high and a low scoring
group on trait alexithymia in samples of alcoholic inpatients (De Rick &
Vanheule, 2006). Parker at al. (2001) have studies the association between
emotional intelligence (EI) and alexithymia and found the two construct to
be independent but overlapping while other studies (Schutte et al., 1998)
have found them strongly but inversely correlated.
The alexithymia construct has been investigated in relations with
various aspect of emotional processing (Taylor & Bagby, 2004) and found
comprised of four components: a) difficulty in identifying feeling and
distinguishing between feelings and the bodily sensations of emotional
arousal, b) difficulty describing feeling to others, c) externally oriented
cognitive style and d) constricted imaginal processes. (Nemiah, Freyberg &
Aifneos, 1976). On the basis of differences in neurobiology connected with
emotional experience, Bermond (1997), proposes an incapacity or reduced
ability to experience emotional feelings as a distinct fifth components of
the alexithymia construct and proposed in alternative two types of
alexithymia: Type I characterized by a low degree of conscious awareness
of emotional arousal and a low degree of emotion accompanying
cognitions), while Type I is characterized by a normal or high degree of
conscious awareness of emotional arousal and a low degree of emotion
accompanying cognitions (R). However, these findings were not confirmed
by Babgy et al.’s (2009) factor and cluster analyses on a large international
sample which supported the prevailing view of alexithymia as a multi-
faceted dimensional construct and not a taxon that can be decomposed into
ϯϲ
meaningful subtypes (Taylor et al., 1997). Although Alexithymia is
defined as a disorder of affect regulation, in the normal range for both the
Affective and Cognitive component (Lexithymia and Type III) it
represents normal manifestation of affect regulation while only Type I and
Type II should be considered as psychological illness and as a disorder
(Moormann et al., 2008). Individuals who experience problems with the
cognitive components of Alexithymia, in fact, display a more pathologic
personality profile (Type I and Type II), whereas more healthy personality
profiles can be seen in individuals where the cognitions accompanying the
emotions are highly articulated (Lexithymia and Type III). Individuals with
low scores on the emotion component are stress resistant but lack empathy
in interpersonal relationship, while highly emotional person may either
outperform themselves, if the cognition accompanying the emotions are
well-matched, or may perform far below their standards in stress situation
if cognitions accompanying the emotions are nearly absent. (Moormann et
al., 2008). Type I persons are emotionally cold, socially and emotionally
incompetent but they possess a rational inclination to life, which can be an
advantage in many profession where rational thinking devoid of emotional
interference is an advance. However, in personal and intimate relations,
the emotionally cold and distant behavior may cause them interpersonal
problems. Type I alexithymics do not suffer from emotional exhaustion
(with feature of schizoid personality style) while Type II alexithymics
suffer from lack of emotional stability (neuroticism) and consider
themselves incompetent and socially inadequate. They report a high level
of somatic complains and sleeping problems, are suspicious, somehow
paranoid toward others and react in a depressive manner to problems. They
are not capable of feeling related to others and predominantly manifest a
psychoneurotic personality structure, a borderline style as often found
among women with childhood sexual abuse. Lexithymics score high on
facilitating anxiety which means they can excel in challenging situations,
are inclined to work actively on problems, as they alleviate themselves by
searching for distractions or by seeking support in comforting toughs. Both
the emotional and cognitive component of affect regulation are well tuned,
they are “emotional intelligent” and possess an healthy personality
structure. They have the capacity to rise above their own standards in
demanding situations and show adequate coping mechanisms (well-adapted
ϯϳ
histrionic personality). Type III individuals also show an healthy profile,
possess good social skills and no signs of neuroticism. However, they may
be repressors and negative, as threatening experiences are not allowed to
enter their conscious awareness (narcissistic personality) (Moormann et al.,
2008). The consequences of failing to learn the basics of emotional
intelligence are scientifically grounded (Goleman, 1995). Girls unable to
distinguish between anxiety and hunger are at risk for eating disorders,
while those having troubles controlling impulses are more likely to get
pregnant by the end of their teen years. Boys impulsivity heighten the risk
of delinquency and violence and for both genders the inability to handle
anxiety and depression increases the likelihood of abusing drugs or alcohol.
The ability to regulate emotions and inhibit inappropriate behavior allows
for a more focused attention, strong and lasting attachments, conflict
resolution and the mastering of new challenges.
2.1.1 Somatoform dissociation
Somatoform dissociation, which appears to be independent of age and
gender (Nijenhuis, 1999; Irwin, 2000), refers to the partial or complete loss
of the normal integration of somatoform components of experience,
reactions and functions (Nijenhuis, 1999), and involves negative
(anesthesia) and positive (pain) symptoms. Although apparently “physical,”
no organic cause is found (Engel, 2000), as many of these symptoms
affecting sensations, perception and behavior are “mental” in nature.
Somatoform and psychological dissociation are thus “highly intertwined
phenomena” (Nijenhuis & van der Hart, 1999) positing psychological
trauma to be the linking etiological factor (Buhler & Heim, 2001;
Vanderlinden, Vandereycken, van Dyck, & Vertommen, 1993). Clayton
(2004) suggested that dissociation, a blocking of connections between
affects, cognitions, and voluntary behavior control, influences the
development of alexithymia, resulting in the “dissociation” of the
physiological, cognitive, and affective components of emotions and that
alexithymia could be better conceptualized from a dissociative theoretical
stance. She found after controlling for age, gender and psychopathology,
that only somatoform dissociation remained significantly related to any
facet of alexithymia and was the most influential of the dissociative facets
ϯϴ
in predicting alexithymia facets, suggesting, albeit tentatively, a previously
unrecognized link between somatoform dissociation and alexithymia.
Young males with high levels of somatoform dissociation were more likely
to have difficulties with all facets of alexithymia except fantasizing.
Regardless of age, males with somatoform dissociation appeared to have
greater difficulty emotionalizing their emotions, and to a lesser degree
identifying emotions; however, their ability to fantasize emotionally
remained. The difficulties males exhibited may in part be due to
socialization, as males in general are often not encouraged to focus on
emotions. In particular though, males who score high on somatoform
dissociation may have specific difficulty realizing their emotions at a level
of self-awareness which according to Wheeler, Stuss, and Tulving (1997)
“allows healthy human adults to both mentally represent and become aware
of their subjective experiences in the past, present, and future” (p. 331).
When this mental process of realization remains undeveloped or
incomplete, the emotion may perhaps become “stuck” at the bodily level of
information processing. This bodily level could be seen as the first level of
emotionality, as the “somatic marker” of emotion and feelings (Damasio,
1994): individuals become aware of emotions at a basic level of
consciousness through bodily signals that then need further processing to
go from very basic forms of consciousness to higher levels of
consciousness, that if, their realization. In young females, higher levels of
psychopathology, combined with pathological psychoform and somatoform
dissociation, are related to greater difficulties identifying emotions while
their ability to fantasize emotions remained high. In referring to Bermond’s
posited types of alexithymia, this suggests that younger females may be
more aligned with alexithymia II. If pathological psychoform dissociation,
somatoform dissociation and alexithymia II are trauma-related, as research
suggests, then females may be initially dissociating as an avoidance
reaction to trauma or as coping with aversive or stressful environments,
thereby resulting in a disconnection of emotions and a general incapacity to
identify emotions. That females maintained a high capacity to fantasize
suggests some involvement of dissociation – possibly a paradoxical
combination of dissociation, psychopathology, and a socialization process
that encourages emotionality for females. While women may be socialized
to experience and express emotions, they may, when traumatized, have too
ϯϵ
little integrative capacity to realize the trauma, and thus develop
dissociative symptoms and other types of psychopathology that are trauma-
related like fear, phobia, and depression. While younger age in females
remained extremely important in relationship to greater alexithymia
difficulties, no direct links remained between psychopathology or any of
the dissociation factors and alexithymia. Alternatively, lower levels of
maturity or perhaps high levels of confusing emotionality may have
contributed to the alexithymic difficulties identifying emotions (Clayton,
2004). The interesting finding of Clayton’ research is that females and
males retained the capacity to fantasize emotions. This is unexpected in the
light of traditional alexithymia theory (Sifneos, 1973) but not surprising in
view of dissociation theory, which suggests a strong relationship between
fantasy and dissociation (IJzendoorn, & Schuengel, 1996). Notably
however, the results of this study suggest that pathological dissociation
(not nonpathological dissociation as may be expected, may influence one’s
ability to fantasize emotionally (Putnam, et al., 1996). The influence of
trauma and/or abuse in infancy (Ogawa, Sroufe, Weinfield, Carlson &
Egeland, 1997), childhood (Berenbaum & James, 1994; Chu & Dill, 1990;
Irwin, 1999) and adolescence (Brunner, Parzer, Schuld, & Resch, 2000;
Carrion & Steiner, 2000), is strongly indicated in both dissociation and
alexithymia. Chu, Mathews, Frey andGanzel(1996)notedthatfollowing
trauma, children who develop dissociative tendencies (or a dissociative
coping style) tend to present with “failure” to define or acknowledge
feelings and often have significant impairment in social and emotional
functioning.
Researchers from a wide range of fields (i.e., neurophysiological,
psychoanalytic, social learning, developmental and genetics) have
postulated that many different pathways are involved in the etiology of
alexithymia (Jula, Salminen, & Saarijarvi, 1999; Valera & Berenbaum,
2001). Some theorists advocate a reaction to abuse, especially in childhood,
trauma (Berenbaum, 1996) or family factors (King, 2000; Lumley, Mader,
Grzmsown, & Papneau, 1996), a maladaptive defenses and coping styles,
which result in a “suspension” of the boundaries between bodily sensations
and emotions (Taylor, Bagby, & Parker, 1997; Wise, Mann, & Sheridan,
2000). Individuals with this “suspension” often report joint stiffness or
general body soreness, and have no awareness of or ability to identify the
ϰϬ
connection between these somatic symptoms and the associated emotion.
These losses of connections, which often makes therapeutic interventions
all the more difficult (Grabe, Spitzer, & Freyberger, 2001), have also been
observed in those who suffer dissociative disorders. Appearing emotionally
constricted, expressionless, machine-like, frozen, and exhibiting an
inability to establish close ties with others (Krystal, 1998; Wise, Mann, &
Shay, 1992) are to described aspects of dissociation as well as alexithymic
characteristics. The similarities are particularly evident more for the
negative dissociative symptoms like losses of knowledge, sensations,
affects, perceptions and will-power, rather than the positive symptoms such
as hearing voices and re-experiences of trauma. The impaired capacity for
the cognitive integration of experiences, the inability of individuals to
locate, identify, or experience feelings, or capture emotional experiences in
words (van der Kolk, 1994), and diminished differentiation of relevant
from irrelevant information (van der Kolk et al., 1996, Waller, Quinton, &
Watson, 1995) are apparent in both alexithymia and dissociation. In both
phenomena, individuals often relate to their environment and themselves in
an “as if” or “object like” manner (Taylor, 1984; Morton, 1996) and both
evidence complex characterological adaptations, as well as disturbed
regulation of affective arousal. Research suggests that 30-40% of general
psychiatric outpatients (Nyklicek, & Vingerhoets, 2000) and approximately
13-19% of the normal adult population exhibit some alexithymia
characteristics (Salminen, Saarijarvi, Aarela, Toikka, & Kauhanen, 1999).
Vorst and Bermond (2001) noted that older people were less able to
fantasize, males less able to emotionalize, and anxious people more likely
to fantasize and emotionalize, irrespective of the cognitive components.
Increasing age and male gender have exhibited strong associations with
alexithymia (Carpenter & Addis, 2000; Posse & Hallstrom, 1998). These
results suggest that the affective dimension (emotional arousability and
fantasy) and the cognitive dimension should be viewed as distinct factor
groupings (Bermond, 1997) and recent neuropsychological investigations
of individuals’ emotional experiences and conscious awareness offer
support for this view (Stone & Nielson, 2001). Until recently, dissociation
was conceptualized as a continuous trait ranging from normal to
pathological levels, and as such relatively common, with 80-90% of
individuals reporting the experience of some type of dissociative symptom
ϰϭ
(Atchison & McFarlane, 1994). Waller, Putnam, and Carlson (1996),
however, identified two distinct types of psychological dissociation: the
first, which encompassed non-pathological experiences, like absorption in
movies and books, is inherently genetic and on a continuum (Finkel &
McGue, 1997). The second type, pathological dissociation, such as
depersonalization and amnesia, is as a typological construct and thus not
continuous as previously thought (Bernstein & Putnam, 1986; Cardeña,
1994).
2.1.2 Positive emotional granularity.
Recent research demonstrates that positive emotions can be
differentiated from one another (Shiota & Keltner, 2002) and that distinct
positive emotions serve to broaden and build personal resources in different
ways (Fredrickson, 1998; 2001). Whether individuals actually make these
distinctions in their everyday experiences of emotion and coping predict
emotion regulation and resilience. Positive emotions experienced by
people are protective factors serving important short-term health-promoting
functions as well as long-term advantages for coping in the future.
Moreover, individuals with a fine-tuned understanding of emotions,
especially during times of stress (Tugade & Fredrickson, 2002), have a
better insight into discrete emotion concepts. Such information could be
beneficial to dirct coping and it is associated with healthier outcomes.
Positive emotional granularity indicates the tendency to discriminate
between positive emotions (e.g., joy, interest, contentment), rather than
representing feelings in terms of more global states (i.e., pleasantness).
2. 2 The role of Emotions in Parenting.
The importance of parenting quality on childhood positive
development has been widely investigated in literature, however many
factors may account for differences in developmental outcomes in children
as well as different parenting styles in adults. Parenting style captures two
important elements of parenting: responsiveness and demandingness
(Maccoby & Martin, 1983). Parental responsiveness represents the extent
to which parents intentionally foster individuality, self-regulation, and self-
ϰϮ
assertion by being attuned, supportive, and acquiescent to children’s special
needs and demands (Baumrind, 1991) while parental demandingness
involves the claims parents make on children to become integrated into the
family whole, by their maturity demands, supervision, disciplinary efforts
and willingness to confront the child who disobeys (Baumrind, 1991).
Categorizing parents according to whether they are high or low on this two
parental dimensions creates a typology or parenting styles (Maccoby &
Martin, 1983) which reflects different naturally occurring patterns of
parental values, practices, and behaviors (Baumrind, 1991) and a distinct
balance of responsiveness and demandingness. The dimension of
demandeness, relies on a combination of behavioral control and nurturing
behaviors and defined two styles of parenting: authoritative and
authoritarian. The authoritative parents are flexible and responsive to their
children’s needs, while making reasonable demands on their children’s
behavior, encouraging verbal give and take, and frequently explaining the
reasoning behind their demands (Baumrind, 1971). Authoritarian parents,
on the other hand, rely on power assertion, rather than reason, to enforce
their demands. They value obedience as a virtue, and favor punitive,
forceful measures to enforce demands as their disciplinary decisions are
considered final (Baumrind,1971). The dimension of responsiveness is
about meeting the physical, psychological and emotional needs of children
(Gottman ,1997) and deals with the dynamics of families emotional
relationships (Gottman, 1997). Parenting styles also differ in the extent to
which they are characterized by psychological control which refers to
“control attempts that intrude into the psychological and emotional
development of the child" (Barber, 1996, p. 3296) through use of parenting
practices such as guilt induction, withdrawal of love, or shaming. Focusing
on the locus of parental control, Barber (2010) proposed a distinction
between Psychological Control (PC) and Behavioral Control (BC) as they
seem to elicit opposite outcomes in children. PC has a robust, negative,
linear effect on self-worth and internalized problems in children (i.e.
enmeshment, indifferentiation, social withdrawn) while a lack of non
coercive BC, in term of limit setting and awareness, is associated with
externalized problems. In this taxonomy, the emotional dimension of
parenting, such as the validation of feelings, it’s defined as respect and
ϰϯ
accounts for the parental responsiveness to the child’s emotional and
psychological needs.
Awareness of the link between parents responsiveness and children
emotional intelligence has contributed in the past twenty-five years to a
movement toward less authoritarian, more responsive mode of parenting.
Parents’ emotional responsiveness helps establishing and practicing
patterns for emotion regulation and for raising emotionally intelligence
children. When children feel emotionally connected to their parents and the
parents use this bond to help regulate their feelings and solve problems,
they are well prepared to handle the risks and challenges that lie ahead
(Gottman, 1997).
Children’s emotional intelligence is determined to some degrees by
temperament, but it’s also shaped by the child’s interactions with his
parents which play a fundamental role in the development, establishment
and practice of patterns for dealing and regulating emotions. Gottman
(1997) proposed that parents who internalize versus those who fail to
internalize the emotional knowledge of themselves and their children
exhibit four distinct parenting characteristics, defined as disapproving,
dismissing, laissez-faire and emotion coach typology. Disapproving parents
often reprimand, discipline or punish their children for expressing negative
emotions as they disapprove them. They focus on the behavior surrounding
the emotions, are concerned with the child’s obedience to authority and are
quite judgmental of their children’ emotional experience. (Gottman, 1997).
There is a considerable overlap between the behavior of Disapproving and
Dismissing parents, but in more negative way. Dismissing parenting style
refers to a lack of awareness and therefore a diminished ability to deal with
children’s emotions. Such parents fear being emotionally out-of-control,
are unaware of emotion regulation strategies and believe negative feelings
are inappropriate and not valid under any circumstances (Lagacé-Séguin &
d’Entremont, 2004). Laissez-Faire parents are extremely lax in regards to
disciplining their children and regulating their emotions, they do not set
appropriate limits on their child’s behaviors and emotions (Baumrind,
1966), eager to embrace unconditionally whatever feelings their children
expressed (Gottman, 1997). Emotion coach parenting style is defined as
parents’ awareness of own’s and their children’s emotions and the ability to
differentiate and disclose them, both negative and positive (Gottman &
ϰϰ
Declaire, 1996; Gottman, Katz, & Hooven, 1997; Lagacé-Séguin &
d’Entremont, 2004). This form of parenting is associated with children’s
increased trust of their feelings, better emotion regulation and more
competent problem-solving. According to Gottman (1997), Emotion
Coaching is an art that requires emotional awareness, listening and
problem-solving behaviors as it relies on providing children with positive
forms of discipline, clearly understood consequences for misbehavior, and
parental displays of emotions which teach children adequate ways to
handle feelings. Emotion coached children not only do better in terms of
academic achievement, health and peer relationships but have fewer
behavioral problems, are better able to bounce back from distressing
experiences, and well prepared to handle the risks and challenges of life
(i.e. resilient). Although parenting has been considered one of the most
important sources of influence in shaping children’s development (Pluess
& Belsky, 2010), parenting effects are often moderated by characteristics,
both at the phenotypic and genotypic level, of the child and some children
may be more, adversely or positively, affected than others by parenting
behavior (Sameroff, 1983). The dual-risk model of development (Monroe
& Simons, 1991; Zucherman, 1999) has been proposed as a “biological
sensitivity to context” that moderates environmental effects (Boyce & Ellis,
2005), and more recently as a differential-susceptibility framework by
Belskey 2010).
His idea of a developmental plasticity implies that some individuals
are more susceptible to the adverse and the positive developmental
consequences of parenting (plastic or vulnerable) than others (fixed or
resilient) who are less or not at all influenced by the same environmental
conditions (Pluess & Belsky). When parents can be present for their
children emotionally, helping them to cope with negative feelings and
guiding them trough difficulties, their children are shielded from the
damages of traumatic or negative life events (Gottman, 1997). The same
interpersonal style that Emotion Coach parents practice with their children,
being emotionally aware, empathetic and open to join problem solving, is a
relational style that also improve the relationship with intimate partners.
Emotion Coaching, in fact, has a buffering effects on both children and
parents, and implies being relationally competent and psychologically
resilient.
ϰϱ
2.3 The Role of Positive Emotions in Resilience
Emotion regulation refers to the attempts to influence the types of
emotions an individual experiences, when she/he experiences them and
how they are expressed. While negative emotions prompt narrow,
immediate survival-oriented behaviors (i.e. fight-or-flight response),
positive emotions broaden one's awareness and encourage novel and
exploratory thoughts and actions, which over time (i.e. the behavioral
repertoire) build skills and resources (Figure 1.3). Strategies aimed to
regulate emotions can maintain and prolong, or increase and enhance
positive emotions (Tugade & Fredrickson, 2007). Positive emotions have a
unique ability to down-regulate lingering negative emotions and the
psychological and physiological states they generate (Tugade &
Fredrickson, 2007) and the positivity ratio between positive and negative
emotions is 3 to 1. According to Tugade and Fredrickson (2007), positive
emotionality and cognitive appraisals of threat would mediate the effect of
resilience on regulating physiological arousal associated with stress. Their
findings suggest that positive emotions contribute to the ability for resilient
individuals to recover psychologically from negative emotional arousal and
could reveal the dynamics of psychological resilience as they rather appear
to aid resilient individuals in their ability to build psychological resources
that are essential for coping effectively with stressful encounters, leading to
post-traumatic growth.
Figure 1.3. A schema of the Broaden-and-Build Theory (Tugade and Frerickson, 2007).
ϰϲ
Tugade and Fredrickson (2004) examined resilience focusing on its
subjective, cognitive and physiological qualities across several research
methodologies. Their Broaden-and-Build theory of positive emotions
provided empirical evidence for the construct of psychological Resilience
positing that negative emotions narrow one‘s momentary though-action
repertoire by preparing one to behave in a specific way. In contrast, various
discrete positive emotions broaden one‘s though-action repertoire,
expanding the range of cognitions and behaviors that come to mind.
Greater emotion knowledge is consequently associated with larger
repertoires of emotion regulation strategies and might provide advantages
in the coping process. Thus, while traditional coping is reactive, the
positive emotions approach seem proactive and future oriented: the
individual takes preparatory steps before acting on stress and is able to
strengthen is coping capital broadening his/her options for possible action
by learning the effectiveness of particular strategies. This mechanism
allows resilient people to achieve superior coping abilities, by using their
knowledge and complex understanding of positive emotions to flexibility,
and resourcefully adapt to negative circumstances.
2.3.1 Broaden and Build Theory of Positive Emotions
The broader-and-build theory of positive emotions by Fredrickson
(2001) has been used as framework for understanding psychological
resilience and demonstrate that positive emotions contribute to
psychological and physical well-being via more effective coping. On the
same line, Tugate, Fredrickson and Barrett (2004) have examined
individual differences in psychological resilience and positive emotional
granularity, defined as the tendency to represent experiences of positive
emotion with precision and specificity. Examining differences in these
traits, they demonstrated that positive emotions play a crucial role in
enhancing coping resources in the face of negative events. The authors
used a multi-method approach in three studies to predict that resilient
people use positive emotions to rebound from and find positive meaning in
stressful situations (Tugate and Fredrickson, 2004). They hypothesized
that positive emotions are active ingredients within trait resilience and
showed that positive emotions fully accounted for the relations between
ϰϳ
pre-crisis resilience and later development of depressive symptoms and
pre-crisis resilience and post-crisis growth in psychological resources,
suggesting that positive emotions in the aftermath of trauma buffer resilient
individuals against depression (Fredickson and others, 2003). Positive
emotions, thus, appear to aid resilient individuals in their ability to build
psychological resources that are essential for coping effectively with
stressful events and positive emotional granularity (the tendency to
represent the positive emotion experienced with precision and specificity),
could explain individual differences (Tugate and others, 2004). For resilient
individuals, cultivating positive emotions during coping can become an
automatized behavior, depending on the frequent and consistent pairing of
internal responses with external events. Automatically accessible emotions
require minimal cognitive resources to be activated if triggered in those
same environments without conscious thought or intent. With such
automatic activation of positive emotions and proficiency, coping cognitive
resources can be allocated to other concerns (Tugade & Fredrickson, 2007).
2.3.2 Emotion regulation.
The overarching presupposition that emotions can be categorized as
“positive” and “negative”, mutually exclusive and distinct has been
considered highly disputable. Emotions cannot be divided on a simple
polar scale and are not a set of somatic changes, as specific emotions do not
necessarily evoke specific somatic changes (Hacker, 2004). On the same
line, empirical symptoms are not the criteria for whether an emotion is
present, because emotions are intentional (Smedslund, 1991; 1997). At the
base of the ability to sustain affective differentiation are skills related to
emotion regulation, including the ability to identify, understand, process,
and express emotions (Davis, Zautra and Smith, 2004). Evidence from
decades of cognitive and information-processing research has consistently
shown that affective processes such as mood and emotion are significant
influences on both encoding and retrieval processes. However, the extent to
which the elicitation or presence of one emotion influences, or is
influenced by, the presence of another (inversely) related emotional state is
not clear. The key to developing an integrative perspective may reside in
considering the context in which emotions are felt or judged by an
ϰϴ
individual. The experience of emotion always occurs in an environmental
context where the individual process information from multiple sources,
including emotional inputs, to develop adaptive responses to the current
demands the environment is placing upon him/her. An optimal response at
any given time required maximal flexibility, resources allocation and
complex, time consuming processing. However, during times of stress,
uncertainty or difficulties, the individual needs to process information more
rapidly and focus on the immediate demands of a potentially threats to
well-being to alleviate the discomfort of the situation. Thus, in adverse
circumstances, positive (PA) and negative (NA) emotions fuse to become a
simple bipolar dimensions with a high inverse relationship between the two
(Devis, Zautra and Smith, 2004). An alternative perspective posits that
positive and negative affects exist on distinct dimensions, such that positive
and negative systems can be activated independently (Watson, Wiese,
Vaidya, & Tellegen, 1999; Cacioppo & Bernston, 1994; Cacioppo, Gardner
& Bernston, 1999) based on evidences that negative events relate to change
in NA but not PA, and that positive events related to changes in PA but not
NA (Gable, Reis & Elliot, 200; Goldstein & Strube, 1994). Recent finding
on the neural substrates of emotions, using brain (PET) and functional
magnetic resonance imaging (fMRI), suggested the existence of distinct
neural systems for positive and negative evalutative channels that can be
manipulated independently (Canli, Desmon, Zhao, Glover & Barielei,
1998; Canli, Zhao, Desmon, Kang, Gross & Grabieli, 2001; Davidson,
Jackson & Kanlin, 2000). Although positive and negative affects appear to
be regulated by separated neurocognitive systems (Canli et al, 1998), both
rely extensively on neuronal feedback loops during stress to function
optimally (Sackheim & Weber, 1982). In their experimental and
longitudinal work, Zautra et al. (Zautra, Berkhof, & Nicolson, 2002) found
individual differences in the within-subject correlations between affects
and concluded that there may be personality differences that account for
individual differences in the slopes linking PA and NA. While Barlow et
al. (2004) suggested that PA is a differentiating variable as it plays little
role in anxiety, but is suppressed in depressive states. Similarly, Watson
and Kendall (1989) suggested it is a deficit in PA attendant with increased
NA that characterizes the difference between anxiety and depression.
Employing the behavioral activation/inhibition scale (BAS/BIS) of Carver
ϰϵ
and White (1994), Sutton and Davidson (1997) found that higher levels of
left-sided prefrontal anterior cortex activity (BAS) are related to higher
levels of PA, whereas higher levels of right-sided cortical activity (BIS) are
related to higher levels of NA. Gable et al. (2000) showed that high BAS
activity was related to greater PA levels, whereas greater BIS activation
was related to greater NA, while cross factor relationships were not
significant. Davidson (2000) has summarized studies linking brain
activation with PA and NA and suggested that one context is set by the
individual’s own affective style: people vary in their extent of prefrontal
activation, and consequently experience chronic levels of positive or
negative affective styles. The tripartite model of depression and anxiety
hypothesizes that positive and negative affect are related to depression and
anxiety. However, the specific role of cognitive and psychological well-
being constructs like resilience within this model and throughout adulthood
is unclear. Burn et al. (2011) sought to determine, in a sample (N=3989)
from two longitudinal population-based cohorts, age 20-24 and 40-44 the
interrelatedness of two affective measures of well-being, positive and
negative affect with two cognitive measures of psychological well-being,
resilience and mastery and found four affective and cognitive dimensions
of well-being: positive and negative affect, resilience and mastery. Their
structural equation models identified the psychological variables as
significantly related to subjective well-being, which fully mediated the
effects of resilience and partially of mastery on depression and anxiety in
young and middle adulthood. Consequently, both the bipolar and
bifactorial models are necessary in describing positive and negative affect,
but neither provides a comprehensive framework that accounts for the
complexity of affective phenomena. Social engagement, and thus relational
competence and resilience, derives from needs that arise from both
affective systems, as individuals seek interpersonal contact for both
enjoyment and alleviation of suffering.
ϱϬ
Chapter 3 - A dynamic model of affect (DMA)
One mechanism by which positive emotions may play a role in the
regulation of negative states that accompany pain, has been proposed by
Zautra et al. (2001) in their dynamic model of affect (DMA).
This model proposes that positive and negative affective systems
function relatively independently under conditions that promote maximal
information processing, while the two affects become strongly inversely
related under adverse conditions. Building on research examining the
contextual determinants of information processing (Linville, 1985), the
Dynamic Model of Affect (DMA) Zautra (2003) specifies conditions under
which both bivariate (i.e. positive and negative affects are independent)
and bipolar models (i.e. they operate inversely from each other) of affect
are valid and analyzes both affect systems functioning concurrently (Reich,
Zautra, & Davis, 2003). The model also predicts that the inverse correlation
between PA and NA is greater during high vs. low stress.
The role of emotional understanding and the level required to promote
affective differentiation is not straightforward. The degree of affective
differentiation varies within and between individuals over time and thus the
influence of situational context on this differentiation. However, affects
appear less differentiated with increased pain (Davis, Zautra & Smith,
2004). Moreover, increased skills in understanding emotions are related to
grater differentiation between NA and PA among individuals in chronic
pain. During times of pain and stress when positive and negative affect are
strongly related, the ability to continue to laugh and experience pleasure
may leave less room for the powerful negative emotions that can seem so
overwhelming. During times of low pain and stress when positive and
negative affect represent separate dimensions, the ability to enhance
positive emotions could serve to “broaden and build” the resources for
coping with flare-ups of pain and increase overall life satisfaction
(Fredrickson, 1998). Kabat-Zinn (1982) has suggested another approach to
emotional processes, an active, dynamic acceptance of the stress and the
negative cognitions: mindfulness. Such acceptance lowers the stress
response and uncouple positive feelings, allowing for a less constricted
emotional life (Reich, Zautra, and Davis, 2003) as people undergoing
stressors tend to engage in hypervigilance and other anticipatory fear
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responses and thus NA tends to dominate cognitive processes to the
exclusion of positive emotions. Finally, Zautra and other (Zautra, Berkhof,
& Nicolson, 2002) in their experimental and longitudinal work, probed for
individual differences in the within-subject correlations between affects
and found evidence of different pattern of relationships between PA and
NA, thus concluding that personality differences account for individual
differences in the slopes linking PA and NA. Initially the DMA model
(Zautra, Potter, & Reich, 1997) emphasized the importance of the role of
contextual factors in feelings and emotions as individuals’ report feelings
closely linked to their environment. This information-processing model
regards processing information about the environment and the emotion felts
in that environment as a continuum from simple, unitary, undifferentiated,
and unidimensional to complex, highly differentiated, and
multidimensional. Stressful events place demands on the individual system,
raising uncertainty and threatening current adjustment. Thus, attentional
resources become concentrated on the immediate demand, narrowing
attention and reducing processing capacity; discrimination is simplified,
and generalization is expanded. Consequently, the DMA predicts that,
under high stress, PA and NA tend toward collapse into a simple bipolar
dimension with highly inversely coupled affect. Any given stimulus is
considered as eliciting affective responding in one of two separate affect
systems, positive or negative. Such responding in turn is related to one of
two separate activation systems, a behavioral approach system and its
antecedent PA or a behavioral avoidance system and its antecedent NA.
However, it is possible for a given stimulus to elicit both simultaneously
(Reich, Zauta & Davis, 2003). The DMA specifies that, under stress,
information-processing capacity is reduced as the organism is under the
pressure of coping with a stressful event. These basic mechanisms of
positive and negative affective functioning have been located by fMRI
techniques in separable brain regions. Employing the behavioral
activation/inhibition scale (BAS/BIS) of Carver and White (1994), Sutton
and Davidson (1997) found that higher levels of left-sided prefrontal
anterior cortex activity (BAS) are related to higher levels of PA on the
PANAS, whereas higher levels of right-sided cortical activity (BIS) are
related to higher levels of NA. Gable et al. (2000) showed that high BAS
activity was related to greater PA levels, whereas greater BIS activation
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was related to greater NA. However, crossfactor relationships were not
significant. The two affect systems are relatively separate and strongly
associated with left and right prefrontal areas involved in approach and
avoidance. Nevertheless neural activation may both enhance PA and
shorten NA suggesting that major component of affective activity is
emotional regulation, the ability to temper emotional reactivity in the face
of arousing (and perhaps stressful) conditions. Such an approach is,
ultimately, contextual, indicating the need for simultaneous consideration
of multiple sources of input and complex regulation of the interaction of
various neurological and hormonal systems operating simultaneously. The
study of the relationships between PA and NA reveals a complex but rich,
heuristic linkage of emotions, stress, and cortical motivational systems and
an array of variables and processes (Zautra, Potter, & Reich, 1997) fruitful
for an integrative approach to resilience. Ong, Bergeman,
Bisconti and Wallace (2006), concluded that the adaptive benefits of
positive emotions are greatest when individuals are under stress; that
positive emotions are more common among high-resilient individuals while
those low in psychological resilience tend to have difficulty regulating
negative emotions and exhibit heightened reactivity to daily stressful life
events. Positive emotional processes are a key component of what it means
to be resilient (Bonanno, 2004; Fredrickson et al., 2003; Zautra, Johnson, &
Davis, 2005). Finally, the concept of resilience has relevance not only to
those undergoing significant life challenge but also to those experiencing
daily stressors that spontaneously arise and subside in naturally occurring
contexts.
3.1 DMA and Substance Abuse
Substance abuse can be interpreted in light of the DMA. Intoxicating
substances serve the purpose of emotion regulation. Both reduction of
social anxiety or negative affective states, and amplification of positive
states have shown to motivate substance abuse (Swendsen et al., 2000).
Zautra (2003) proposed that incrising simplicity could be an affective
consequence of abuse and dependency. The substance itself, over time,
increasingly function as a stressor, provoking a narrowing of the affective
space depending upon the degree of dependency. (Davis, Zautra and Smith,
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2005) The DMA specifies that, under stress, information-processing
capacity is reduced as the oindividual is under the pressure of coping with
a stressful event. Stress is considered arising from a threat to well-being,
and information processing is narrowed to aid successful coping with the
stressor; this shrinks positive information processing in the service of
enhancing negative reactivity to cope with the stressor. The DMA
postulates that a deficit in information-processing complexity stress
induced is a central mechanism whereby the affects become inversely
related. According to this type of model, because stress has negative
consequences, information processing under stress would play a causal role
in slanting attention away from positive states and toward negative states,
resulting in an inverse correlation between them. (Reich, Zautra & Davis,
2003). Recent research is exploring what is called “uncoupling”the
separating of the affects that, as we have shown, tend to become inversely
coupled under stress. Uncoupling should allow the person freer access to
positive feelings and healthful emotional states such as psychological
resilience, even in the presence of stress (Reich, Zautra & Davis, 2003)
3.2 Uncoupling & Resilience
The ability to maintain the separation between positive and negative
emotions in times of stress has been confirmed as a resilience mechanism
(Chow et al., 2007). Although positivity and negativity may often be
characterized by reciprocal activation, they are also characterized by
uncoupled activation, coactivation, or coinhibition. Uncoupled activation
occurs when changes in one system are not accompanied by changes in the
other, coactivation and coinhibition occur when changes in one system are
associated with parallel or opposite changes in the other system,
respectively (Larsen, McGraw & Cacioppo, 2001). The DMA model
characterizes adaptation to stress as the successful uncoupling of negative
and positive emotions. Uncouplings between PA and NA could correspond
to a sensation of oscillation of positive and negative affects, not always
synchronized. Sometimes an increased feeling of joy and pleasure
associated with increased anxiety and stress. Russell and Carroll's (1999)
circumplex model holds that happiness and sadness are polar opposites and,
thus, mutually exclusive. In contrast, the evaluative space model (Cacioppo
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& Berntson, 1994) proposes that positive and negative affect are separable
and that mixed feelings of happiness and sadness can co-occur. When
people are happy they generally smile, laugh, and seek out others. When
they are sad they frown, cry, and withdraw from others (Shaver et al.,
1987). Theorists disagree over the relationship between happiness and
sadness in experience and, in particular, over whether happiness and
sadness can be experienced simultaneously (Larsen, McGraw, & Cacioppo,
2001). Measures of emotion therefore consist of summed ratings of several
positive (happy, joyful, fun/enjoyment ) and negative emotions (depressed /
blue , unhappy , angry) that varied in activation. Congard et al. (2011)
were able to identify predictable, characteristic patterns of variations in
individual behaviors across different situations as a function of trait
anxiety, whilst integrating the dynamic relationship between positive and
negative affectivity, which was presented in a two-dimensional affective
space. They found nonlinear relationships between changes in PA and
NA, and curved trajectories in affective space and believed that
coupling/uncoupling and the line curvature reflected some kind of internal
regulatory process. A negative event could give some reason to feel
negative emotion but in itself, this kind of event does not necessarily
suppress the sources of positive affect in that person’s environment. An
increase in NA is then expected, and due to the inhibitory coupling effect,
this increase in NA is associated with a decrease in PA. However, if there
are still some reasons to feel positive emotions in the environment, these
positive emotions will reappear. The inhibitory coupling effect can then
occur in the other direction where the increase in PA will curb the increase
in NA originally produced by the negative event and help to recover.
(Congard et al. , 2011)
This emotion regulation skill is particularly important when
cognitive performance tend to decline as in old age. Chow et al. (2007)
examined the dynamic of the linkage between positive and negative
emotions and complex cognitive task finding age difference in emotion
regulatory strategies. Older adults, in fact, manifested a significant
unidirectional coupling from negative emotions to cognitive performance
while younger adults from negative to positive emotions and from
cognitive performance to both positive and negative emotions.
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3.3 Mindfullness & Resilience
Mindfulness is described as being highly aware and focused on the
reality of the present moment, accepting and acknowledging it, without
being caught up in the thoughts about the situation or emotional reactions
to the situation (Kabat-Zinn, 2005). The mindfulness component of the
‘acceptance versus change’ dialectic lies in building acceptance skills.
Mindfulness has been demonstrated to improve tolerance of negative
emotions (Siegel 2007, Linehan 1993) and as negative emotions produce
anxiety, tolerance of negative emotions reduces it and increases acceptance
of adversity. Increased acceptance of adversity promotes resilience by
reducing the psychological impact of adverse circumstances. Mindfulness
practices help people to become more aware of how they are feeling,
emotionally and physically, from moment to moment, seing how their
emotions affect their perceptions of their physical symptoms. Kabat-Zinn
(1990) outlined several foundations of mindfulness practice, ranging from
no judging, to patience, acceptance and letting go, that is releasing
thoughts, feelings, and situations that the mind seems to want to hold on to.
While sharing some similarities with other cognitive interventions,
mindfulness-based approaches focus on attending to and altering cognitive
processes rather than changing their content (Orsillo, Roemer, Block-
Lerner, & Tull, 2004) and thus provide powerful cognitive-behavioral
coping tools (Kabat-Zinn et al., 1992; Astin, 1997) cultivating a proactive
approach to building resilience skills. Some authors (Shapiro, Schwartz,
and Bonner, 1998) have suggested that mindfulness training allows
individuals to develop alternative paradigms and therefore to interpret
experiences in new ways so that a stressful situation may be perceived as
an opportunity rather than a threat, and call it “cognitive flexibility (Roemer
& Orsillo, 2003).
3.4 Physiological Processes
Although evidences appears to support a separable affect model
(Cacioppo et al., 1999), as discussed earlier, there are some studies on
psysiological processes that show a certain degree of relatedness between
them. Testosterone replacement therapy in men was found to relate to
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increased PA and reduced NA (Wang et al., 1996). Recent evidence on the
brain neurohormone oxytocin has shown that it is involved in positive
prosocial behaviors, such as maternal nursing and bonding, in human
females and even in virgin laboratory rats. However, it has also been shown
that individuals who maintain higher levels of oxytocin during an induced
stressful situation exhibit higher oxytocin release, which is, in turn, related
to a coincident suppression of stress-related cortisol (Turner, Altemus,
Enos, Cooper, & McGuiness, 1999; Unvas-Moberg, 1997, 1998). These
results suggest that this particular neurohormone is connected to both more
positive (relaxation) and less negative (stress) response systems. Recent
studies have also demonstrated evidences of a heritable component of
resilience, such as higher biological levels of dopamine, neuropeptide Y,
testosterone, and higher functionality of 5-HT and benzodiazepine
receptors (Charney, 2004; Gervai et al., 2005). Other studies (Das,
Cherbuin, Tan, Anstey, & Easteal, 2011) have found that the Dopamine
receptor D4 (DRD4-exonIII-VNTR) moderates the effect of childhood
adversities on emotional resilience in young adults.
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Chapter 4 - Life events
Researchers have long been interested in life events and how
individuals and environments affect each other describe, and explain a
behaviour and individual differences. A life event is indicative of or
requires a significant change in the ongoing life patterns of the individual.
According to Settersten and Mayer (1997), a life event is a significant
occurrence involving a relatively abrupt change that may produce serious
and long lasting effects. It refers to the happening itself and not to the
transitions that will occur because of the happenings. Life events can occur
in a variety of domains (family, health, and work) and may be age relevant
(school, marriage and retirement), history graded (war and depression), or
non normative (illness and divorce). Most life events are transitions
between major roles, age grades, status gains and losses, turning points or
special life events that produce a lasting shift in the life course trajectory,
not just a temporary detour. Their significance usually become obvious
only as time passes and the individual lives (Wheaton & Gotlib, 1997).
Rutter (1996) identified three types of life events can serve as turning
points (Rutter, 1996): those that either close or open opportunities, those
that make a lasting change on the person's environment and life events that
change a person's self concept, beliefs and expectations. However, life
events are very subjective experience depending upon the individual's
assessment of their importance, as the same type of life events may be a
turning point for one individual but not for another. In addition, less
dramatic transitions may become turning points. Surely, all life events
require adaptation although they can be either pleasant (Eustress) or
unpleasant (Dystress) in nature (Selye, 1974). Some life events simply act
to help maintain the internal steady state or to keep the individual interested
in undertaking appropriate activities (Neustress) (Auto, 1995). Although
literature suggests that life events play an important role in the precipitation
and relapse of psychiatric disorders, the relationship is not straightforward.
The relationship between stress and illness varies with pre-existing
vulnerability factors such as differences in social support system, skills,
attitudes, beliefs, and personality characteristics. In recent times, there have
been a considerable focus on the positive responses to adverse or traumatic
events as implicit within the conceptualization of resilience, which imply
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two central conditions: the exposure to significant risk or adversity and the
attainment of a positive adjustment or competence (Gucciardi et al., 2011).
Typically, “negative life events are circumstances known to be statistically
associated to adjustment difficulties” (Luthar & Cicchetti, 2000, p. 858).
Headey & Wearing (1989) looked at stability and change in life-events
scores in four waves of an Australian Quality of Life Panel Study (N=942,
ages 18-65). They found surprising the extent to which favorable and
adverse events kept happening to the same people, suggesting that although
some events may be wholly exogenous other events perhaps depend on
stable person characteristics and so tend to be repeated.
4.1 Dynamic equilibrium model of Subjective Well Being (SWB)
The dynamic equilibrium model of SWB (Headey & Wearing, 1989)
rested on the idea that, as life-events scores and levels of SWB are stable
over time, it is reasonable to think of each person as having his or her own
normal equilibrium levels of favorable and adverse events and normal
equilibrium level of SWB. Exposure to one or more events does not always
dictate the occurrence of negative outcomes (Gucciardi et al. 2011). Zautra
(2003) reviewed the evidence across a range of studies and found little
support for belief that positive events would lower psychological distress.
Although these events promote greater positive emotion, they are typically
uncorrelated with scales that assess anxiety and depressive symptoms.
Several studies have dispute the role of stressful life events in the
development and course of depression , suggesting that life events are
important with increasing age, but require interaction with predisposing
factors (Ohaeri & Otote, 2002). Negative life events models show how
personality difference within processes of daily life. Life events tend, in
fact, to drop in normal controls as age increases (Salsani & Silvestone,
2003; Silvestone & Salsani, 2003), however depressed patients seem to
start from a lower baseline but reach a higher stress level, which they retain
for the greatest part of their lives. Fountoulakis K. N et al. (2006) found
subgroups of depressive patients, male atypical, to be characterized by the
presence of a high load of stressful life events, in comparison to controls
and other patients. Other authors reported life stress to be associated
principally with cognitive-affective symptoms, but not with somatic
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symptoms. Sense of control and social support acted as mediators in the
linkage between live events and depressive symptoms (Chou and Chi,
2001). However, personal capacities and social ties sustain positive
affective responses to events. Social ties, in particular, can enhance well-
being through sharing positive experiences, a process Langston (1994) has
referred to as ‘‘capitalization’’. Gable, Reis, Impetti, and Asher (2004)
have shown that sharing amplifies the effects of these events on well-being,
particularly when others respond with enthusiasm and happiness to the
good news (Gable et al., 2004).
4.2 Assessing life events: Life events checklists and LCU.
Establishing the psychometric soundness of life events self-report
inventories, in terms of validity, is extremely difficult (Norris & Hamblen,
2004). The selection of a PTE measure should adequately addresses the
type of events likely to be experienced by the population being sampled.
Researchers and clinicians should scrutinize the item content to be sure
there is adequate coverage of experiences for the age group and the gender
selected. There is no existing measure that existence inquires incidents that
a clinician or researcher may want to investigate, therefore different live
events need to be assessed for specific populations or purposes (Gray &
Slager, 2006). Failure to report events that actually happened is
problematic for establishing a measure of PTE exposure (Gray & Slagle,
2006). What is essential to evaluate is the temporal stability of the measure
(Gray & Slagle, 2006). Hepp, Gamma, Milos et. al (2006) have has
investigated the prevalence and consistency of reported exposure to PTEs
over time in a large and representative community-based sample and found
that reports of exposure to potentially traumatic events (PTEs) are highly
unreliable across different types of trauma. Similarly, Bonanno and
Lalange (2011) sought to advance research on the accuracy of memory for
PTEs by assessing multiple PTEs over a 4-year period using a prospective
design. The assessed the accuracy of retrospective recall by asking
participants to estimate how frequently they had reported each of the events
over the previous 4 years to document the actual occurrence of the PTEs
and to compare these data directly with retrospective recall. Measuring life
events at repeated intervals over a multiple-year period, they we were able
ϲϬ
to assess frequency recall for multiple PTEs. Their results provided strong
evidence that PTEs are remembered more accurately than nontraumatic
events. Moreover, recall frequency for nontraumatic events was unrelated
to distress at the time of recall and or selfenhancement. By contrast, the
recalled frequency of PTEs was influenced by the interaction of both
factors. The method of self-report assessment of life events proposed by
Rahe has proved to be the most reliable and stable cross-culturally (Rahe et
al,. 1974, 1999). He registers all events and attributes to them an impact
score, empirically derived. The Social Readjustment Rating Scale (SRRS)
created by Holmes and Rahe (1967) is one of the first self-reports of
positive and negative events experienced over the previous year, and the
perceived stress associated with those events.Their checklist of events (43)
is ranked in order of event’s LCU (Life Change Unit), startingwiththe
most high risk to the lowest. The Life Experiences Survey (Sarason,
Johnson, and Siegel, 1978), for example, included 60 items divided into
two sections, 50 life changes common to adult individuals in a wide variety
of situations and 10 items that are for students only. Most of the items were
based on existing life stress measures, in particular the Social Readjustment
Rating Scale developed by Holmes and Rahe (1967). However, in the LES
respondents are asked to rate each life event experienced on a 7-point scale
rangingfrom-3(extremelynegative)to +3 (extremely positive). The item
is coded as 0 if it didn’t occur. The Life Change Units for each events can
then be summed for a total score of recent life events. Positive and negative
events can be summed separately, or they can be scored on the same scale
using positive and negative numbers. Sarason, Johnson, & Siegel, (1978)
found that positive and negative life change scores exhibit different
patterns of relationships with other measures ( anxiety, depression). By
adding the LCU points foe each event happened in the past 12 months, a
total score is obtained indicating a 80% chance of illness developing which
could become a serious health risk (LCU score over 300), a 51% chance
with an LCu score between 150 and 300, and a 35% chance with an LCu
score less than 150.
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Chapter 5 - Coping and Expressing Flexibility
Beliefs can can influence the outcome of events as they foster
flexibility in coping and the view that stressful life events as challenges.
The capacity for positive emotions helps regulate distress as it fosters
social support from others and a flexible repertoire of coping and emotion
regulation behaviors. The term coping flexibility captures the degree to
which the person will be flexible enough to cope in whichever way the
situation calls for and to embraces stressful events as challenges.
Successful adaptation depends on the flexibility to modify emotional
expression in accord with situational constraints and this coping flexibility
predict better long-term adjustment after exposure to stressful life events
(Bonanno, Wortman, & Nesse, 2004). According to this approach,
successful adaptation depends not so much on any one regulatory process,
but on the ability to flexibly enhance or suppress emotional expression in
accord with situational demands. Both the enhancement and the
suppression of emotion expression serve adaptive ends, but also require
cognitive resources (Bonanno, 2001; Gross, 1998) so that a flexible
application of coping strategies corresponds with the nature of the stressor
(Cheng, 2001). Successfully meeting the demands of traumatic live events
require a pragmatic, goal-oriented approach. Such “pragmatic coping” may
involve behaviors that under normal circumstances would be less effective
or even maladaptive, and thus sometimes be “ugly” but necessary to
adjustment (Bonanno & Mancini, 2010).
The nature of the relationships a person perceives to have with another
person determines that person’s willingness to express or suppress
emotions (Clark & Finkel, 2005) as clearly emotions convey informations
about needs likely or unlikely to elicit a support response or even an
explitation as vulnerabilities are revealed. In exchange relationships, one
gives beneficts to the partner either in response to a previosuly-received
benefict or with the expectation that the partner will repy. Generally, in
close relationships characterized by mutual, noncontingent responsiveness
to need, the willingness to express emotion freely will be higher. Thus,
relationship type and quality does influence expression of emotion.
Emotions rresearchers have long recognized that emotion, as experiences
internally (thus feelings) communicates information to the self and may
ϲϮ
motivate the individual to attent to his/her own needs (Frijda, 1993; Simon,
1967; Clark & Finkel, 2005) whereas emotions outwardly expressed
convey information about the individual’s need to others (Leventon, 1994;
Miller & Leary, 1992). Consequently, the tendency to belief that others do
care incresases the likelihood of emotion expression. An important part of
emotional intelligence is the ability to flesibly choose to express or to
suppress emotion depending upon context (Bonanno, Papa, O’Neil,
Westphal & Coifman, 2005) as particularly both positive and negative
emotions are sometimes wise to be expressed (for example in intimate and
caringre relationships) and sometime wise to be suppressed (in other
relationships) (Clark & Finkel, 2005).
This expressive flexibility, as the ability to both enhance and suppress
emotional expression, predicts better self-reported adjustment after the
occurrence of stressful and potentially-traumatic events and serves as a
protective factor (Bonanno, Papa, O'Neill, Westphal, and Coifman, 2004).
The construct of expressive flexibility, its measurement, and its role in
adjustment have been recently tested in the context of potential threat
(Bonanno, 2011). Results seem to indicate that it is reasonably stable by
young adulthood, it interacts with stressful life events to predict adjustment
and it is strongly associated with resilience when measured in a threatening
context. While both enhancement and suppression abilities independently
contributed to resilience, enhancement was more relevant in the non-threat
context and suppression was more relevant in the threat context. The ability
to flexibly express or suppress emotions as demanded by the situational
context is important for adjustment as positive emotions are not always
adaptive and negative emotions are not always inappropriate (Bonanno et
al., 2004). This capacity for flexibility, which seems to be trait-like has
been observed very early in development yet can change over time as a
result of the dynamic interplay of personality and social interactions with
key attachment figures (Seivert & Bonanno, 2008). It is is a personality
resource that helps bolster resilience to aversive events, such as childhood
maltreatment, and can be enhanced or reduced by developmental
experiences and eventually become stable (Bonanno & Mancini, 2010).
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5.1 Grief, Bereavement, Resilience and the “other side of sadness”
Grief is not a one-dimensional experience everyone go through
following pre-determined stages but people show different patterns or
trajectories of grief reactions across time, as they may cope effectively
(resilience), experience gradual return to normal daily routines (recovery)
or find impossible to deal with the pain of loss (chronic grief). Despite
sadness being a big part of grief, there is also a positive side to it:
bereavement is a powerful experience, dramatically shifting people’s
perspective of life. Bonanno (2009) has benne long challenging the
predominant view of “grief work” by exploring loss across diverse patterns
of adjustment and contexts. What emerged is the “wavelike nature of grief”
(p. 41), oscillating from “loss-oriented” to “restoration-oriented” processes,
and an amazing and powerful portrait of resilience as the “marvelous
human capacity to squeeze in brief moments of happiness and joy that
allows us to see that we may once again being moving forward”(p.19).
The loss of loved ones is a fact in life, “when we confront death head-on
we have no choice but to embrace its meaning” (p. 121) and “open new
doors” (p. 86) for living out our dreams. It requires adjustment and
recalibration but not a one-size-fit-all approach or intervention that may
interfere with a natural recovery process. Bonanno argues that newer
studies, with changed standards of evidence, have found absolutely no
support for the idea that grief is a time-consuming work that must be done
before full recovery is possible. Psychological problems do not have to be
necessarily traced back to earlier unresolved grief reaction nor healthy
responses to loss are suspect, but simply most bereaved people exhibit a
natural resilience (2009). Mostly, Bonanno’s criticism is grounded on the
lack of empirical data, and sampling errors. He also challenges the idea that
the key component of grief is only an intense, plain, silent, all
encompassing and bottomless sadness, an “inward desolation”(p. 27).
Referring to Ekman’s research showing that emotions are varied, complex
and useful, the author underlines that emotions help us manage challenges
in two main ways, feeling them, coming and going, and showing them to
others. The function of sadness is to turn our attention inward, promote
deeper and more effective reflection, and become more detail-oriented,
accurate in evaluating our abilities and performances, and less biased
ϲϰ
toward others. It is an “essentialtoolthathelpus accept and accommodate
to the loss” (p. 31) that “dampens our biological systems so that we can
pull back” (p. 32) and comes “equipped with a build-in safety mechanism”
(p.21), facial emotion expression, a “compelling signal to others that we
may need help”. Emotion are short-terms reactions, “personal and raw”(p.
36) to immediate demands, and their usefulness depends on its context.
Bereavement is essentially a non uniform or static stress reaction, and grief
is tolerable only because it comes and goes in a kind of oscillation:
individuals temporarily lighten up and reconnect with those around us,
then dive back down to continue the process of mourning. Resilience in
response to potentially traumatic life events is common, abundant,
prevalent, the norm rather than the exception, but is not homogeneous.
Some individuals experience a “wondrous sense of calm, even serenity”(p.
59) , many manage to keep their spirit up through the use of humor, while
only a few remain depressed or exhibit enduring psychiatric symptoms.
Resilience lies in the quality of the relationship that was lost, the presence
of others to turn to for comfort, the ability to use avoidance and distraction
as coping strategies, a broader flexibility to adjust to the shifting demands
of different situation, a broader repertoire of behaviors, and emotion
expression flexibility, Being flexible in expression or suppressing emotions
is, in fact, adaptive. The best approach to unexpected adversities seems to
be a “pragmatic coping” or a “coping ugly”, as humans are wired to
survive, adapt, and change gears (p. 81). When sadness becomes too
strong, overwhelming, “pernicious and dysfunctional” (p. 97) individuals
withdraw from world, loose the focus in life, experience confusion about
their identity and tend to ruminate on the past and repeatedly rebuff, deny
access and locked out other in their lives. The glue that seems to bind them
yearning, emptiness and isolation together is dependency (p. 102),
according to the author, an overly investment and reliance on another
person. Humans are equipped with a set of in-born psychological processes
that help them cope with loss, while turning their attention inward, reflect
and recalibrate to the reality of loss. We move in and out of sadness, to
gradually return to a state of equilibrium. This kind of adaptive oscillation
in and out of sadness is achieved by switching to more positive states of
mind, by finding joy and laughter within pain, and making sense out of it.
Positive emotions “propel us out of sadness”, but also connect us to others.
ϲϱ
In the end, resilient people are more flexible in the way they use emotions,
using sometimes even “behavior strategies that under normal
circumstances are less that perfectly healthy” (p. 199), like self-serving
biases, blaming external factors, or focusing on positive outcomes. Many
aspects of bereavement fade gradually with time, because when people
grieve they deal with the unknown and “live with the dissonance”(p. 201)
powerfully evoked by death.
5.2 Potentially Traumatic Life Events (PTE)
It is crucial to consider that not all aversive events are traumatic.
Rather, such events are best understood as “potentially traumatic events”
(PTE) (Norris, 1992; Norris at al. 2004; Bonanno, 2004) that may become
traumas depending on factors like the intensity and duration of exposure,
demographic, personality variables, individual appraisal and situational
variations (Bonanno, Rennicke, & Dekel, 2005; Brewin, Andrews, &
Valentine, 2000). Stressful life events can range from relatively mild but
pervasive hassles to less common but much more severe and potentially
debilitating traumatic events. An event is considered traumatizing if one
experiences, witnesses, or confronts a situation that involves actual or
threatened death or serious injury to oneself or others and if it elicits a
response of intense fear, helplessness, or horror (American Psychiatric
Association; APA, 1994). A number of large-scale epidemiological studies
have revealed that exposure to potentially traumatic events (PTE) is
unfortunately quite prevalent (Gray & Slagle, 2006). It is, thus,
advantageous to screen for exposure to traumatic events in most contexts
(Gray & Slagle, 2006) because of the the relatively high comorbidity of
trauma with other psychological disorders (Kessler et al., 1995) and
conditions. In positive psychology, psychological processes are often
studied in the absence of stressors, losses or trauma (Jowkar, Friborg &
Hjemdal, 2010) while in resilience research their presence is a premise.
Type, duration, and intensity of exposure to potentially traumatic events
has been shown to influence the prevalence of healthy adjustment, with
resilience varying from 33% to 50% across exposure categories (Bonanno
& Mancini, 2010). It has long been recognized that people exposed to the
same potentially traumatic events (PTEs) are affected differently. The
ϲϲ
majority of persons who experience a single PTE do not develop
Posttraumatic Stress Disorder (PTSD) but may experience other disorders,
such as depression; however, others do not seem to be adversely affected
by such exposure. (Bonanno, 2004). Posttraumatic stress disorder diagnosis
(PTSD) requires first identifying a traumatic event, but very few studies
have evaluated methods of potential traumatic event assessment and their
impact on PTSD diagnosis (Bonanno, 2004). Mapping individual
differences across events shows that the minimal response to a PTE is
neither exceptional nor pathological but is resilience. Resilience is typically
the most common outcome although there are multiple and sometimes
unexpected pathways to resilience (Bonanno 2004, 2005, 2008).
Resilience in children has been explored in response to aversive and
enduring life circumstances, with protective factors fostering positive
outcomes at the end poit of the developmental period. Resilience in adult,
on the other hand, is a response to potentially traumatic events (PTE) that
usually isolated event occurring in otherwise normal circumstances and
with protective factors fostering minimal response or a rapid return to
baseline functioning within 2 years. Adults common reaction to loss and
trauma, for example, represents a transient stress reaction (disequillibrium),
a brief period of fluctuations in levels of distress and well-being, but still a
relatively stable trajectory of healthy functioning (STHF), o resilience,
where the capacity for generative experiences and positive emotions
(Fredrickson et al., 2007) and laughter (Keltner & Bonanno, 1997) is
renewed.
5.3 Post Traumatic Stress Disorder (PTSD)
While the likelihood of developing chronic PTSD depends on the type
of PTE experienced, the overall rate of PTSD given traumatic exposure
across different types of PTEs has been estimated approximately around
9% (Breslau et al., 1998). Although PTSD is a formal of psychopathology
following traumatic exposure, other disorders such as major depressive
disorder and substance dependence disorders may also occur instead of, or
in addition to, PTSD (Chilcoat & Menard, 2003; Kessler et al., 1995).
Evidences suggest that an increased level of emotional involvement and
arousal is connected with better memory recall of important events
ϲϳ
(Conway et al., 1994;Neisser et al., 1996; Pezdek, 2003; Schmolck,
Buffalo, & Squire, 2000; Smith, Bibi, & Sheard, 2003). However,
recollection for details surrounding these significant life events was not
perfect and over time became distorted. PTSD has been linked with
increased life stress before and after the marker traumatic event.
Prospective research suggests that only previous stressors resulting in
PTSD tend to predict PTSD at subsequent exposure, thus an important
qualifier for resilience is the actual, empirically observed outcome of
current and previous life stressors (Bonanno & Mancini, 2010). The social
ecology PSTD conceptual framework understand PSTD as depending on
social phenomena, before and after trauma. Charuvasta and Cloitre (2008)
found social support to be an effective emotion regulator as the behavior of
others could soothe or exacerbate trauma-driven fears. There is a large
literature regarding the role of social support in influencing the outcomes of
stressful life events, finding that support helps buffer against psychological
distress (Cohen &Wills 1985). However, thereisdebateaboutthenatureof
the relationship between social support and PTSD as some studies indicate
that social support exerts its influence as a protective factor against the risk
of PTSD, whereas others suggest that the relative absence of support is
salient as it creates an increased risk for PTSD. The relative impact of
each, sometimes occurring even simultaneously, is context sensitive and
relative to the nature of the trauma, the individual’s needs, and the nature of
the social or interpersonal relationships.
5.4 Posttraumatic Growth (PTG)
Resilience research lies within three interrelated, cutting-edge trends
in psychology: positive psychology, health and well-being, and post-
traumatic growth. Posttraumatic growth (PTG) is defined as a positive
psychological change experienced as a result of struggling with highly
challenging life circumstances (Tedeschi & Calhoun, 2004) and has been
found to be a major personal resource following trauma, especially in
health contexts. Findings support the idea that sustained posttraumatic
growth is required to support resilience processes (Helgeson, Reynolds, &
Tomich, 2006; Tedeschi & Calhoun, 2004). Positive adaptation outcomes
to psychological trauma has been explored by the literature on
ϲϴ
posttraumatic growth and Linsley (2003; 2004) has proposed the role of
three dimensions, the recognition and management of uncertainty, the
integration of accept and cognition; and the recognition and acceptance of
human limitation (wisdom), as both processes and outcomes of traumatic
adaptation. A review of empirical studies (Linley, 2004) have also
documented positive growth following trauma and adversity associated
with cognitive appraisal variables, problem-solving abilities, coping, and
positive affect, independently from socio-demographic and psychological
distress variables. Exposure to potentially traumatic events can lead to both
posttraumatic growth and posttraumatic stress, and recently researchers
started investigating the commonalities and differences in the pathways
through which they occur. Park, Aldwin, Fenster and Snyder (2008)
found that although posttraumatic growth and posttraumatic stress
symptoms were moderately positively related, the pathways from coping
and emotions to the outcomes differed suggesting that emotions are both
outcomes of and motivators for coping and that patterns of coping and
emotions relate differentially to posttraumatic stress and posttraumatic
growth. In fact, positive coping and anger were more strongly related to
posttraumatic growth than to posttraumatic stress, and pathways of
negative coping and feeling depressed were more strongly related to stress
than to growth. Janoff- Bulman (2004) has proposed the model of
psychological preparedness, which coincide with the inoculation model, in
which exposure to moderate stress serves as protection against subsequent
stressors. However, the fact that PTG can positively correlate with both
PTSD and resilience need further exploration. Shuettler and Boals (2011)
found that PTSD symptoms were best predicted by visceral reactions to the
events, event centrality, avoidand coping and a negative perspective of
event, while PTG was best predicted by event centrality, problem-focused
coping, and a positive perspective. Differential path, thus, characterized
PTSD and PTG and moderate levels of PTG did not seem to ameliorate
posttrauma psychopathology. Kleim and Ehlers (2009) found, in two
studies of assault survivors, significant curvilinear associations between
PTG and posttraumatic stress disorder. Survivors with no or high growth
levels reported fewer PTSD symptoms than those who reported moderate
growth. Moreover, non-Caucasian ethnicity, religiousness, peritraumatic
fear, shame, and ruminative thinking style, predicted growth.
ϲϵ
Posttraumatic growth seems thus most relevant in trauma survivors who
attach enduring significance to the trauma and show initial distress.
5.5 Multiple Trajectories of Adjustment
The factors that promote and break resilience are clearly
heterogeneous. They include a variety of individual, demographic, and
sociocontexual variables so that some factors promoting resilience to
potentially traumatic events may be maladaptive in other contexts, whereas
exposure to risk factors could be sometimes more broadly adaptive.
Bonanno’s studies revealed a number of unique and variable patterns or
outcome trajectories (2004) suggesting that there is a substantial individual
variation in response to potentially traumatic events. He empirically
derived four prototypical outcome trajectories from mild to severe
disruption in normal functioning: resilience, recovery, delayed reactions
and chronic dysfunction (Figure 1.4) finding that a stable trajectory of
healthy functioning, that is resilience, is typically the most common
outcome observed (Bonanno, 2010). Although there is considerable
variability in the type, severity, and duration of potentially traumatic
events, post traumatic stress disorder symptoms (PTSD) have been
observed in adults only in 5% to 10% of exposed individuals, with the
exeption of prolonged or severe events. Chronic grief reactions, defined as
prolonged suffering and inability to function, usually lasting several years
or longer, in fact, tend to be more prevalent after more extreme losses, such
as when the death event involves violence or when a child dies. In
longitudinal studied, only a small group of those initially experiencing
elevated depression symptoms during bereavement, usually 10% to 15% of
the entire sample, continued to suffer persistent grief and depression, and
ultimately chronic disturbances in functioning over the long term
(Bonanno, 2004). However, children may fail to show evidence of PTSD or
complicated grief because of an increased of externalizing symptoms,
substance use, academic problems, or peer conflict (Bonanno & Mancini,
2010). Individuals who display the chronic dysfunction trajectory tend to
have the most severe symptoms following exposure to a potentially
traumatic event (PTE) and those symptoms tend to persist across time.
ϳϬ
The delayed distress trajectory (Bonanno et al., 2007; Layne et al.,
2007) is rather characterized by initial resistance that later on becomes too
difficult to be substained and is replaced by distress. Individuals with a
delayed distress trajectory have symptoms that are not very prominent or
severe during the first 6 months following exposure to a PTE but with time,
usually by 18 months, they show an abrupt increase in the number and/or
severity of symptoms. Delayed PTSD resembles subthreshold
psychopathology that gradually worses over time and should not be
intended as a denial or confused with absence of overt signs of PTSD. The
absence of PSTD symptoms after exposure to potentially traumatic events,
in fact, should not be considered psychopatology (Bonanno, 2008).
Individual showing a recovery trajectory have an abrupt onset of
symptoms following exposure to a PTE with the symptoms showing
gradual improvement with time. The recovery trajectory is characterized
by an initial high level of symptoms followed by a gradual return to
baseline levels of functioning within 1 to 2 years, indicative of recovery.
When normal functioning is temporarily substituted by threshold or sub-
threshold psychopathology like symptoms of depression or Posttraumatic
Stress Disorder (PTSD), usually it will gradually returns to pre-event levels
after a period of at least several months. Recovering individuals may
constitute the majority of those initially symptomatic; however they
ultimately adjust over time. (Bonanno, Rennicke & Dekel, 2005).
The consistent, stable low-symptom trajectory showed by individuals
who have no problems with their functioning following exposure to PTEs
is resilience. This is the ability of adults exposed to an isolated and
potentially highly disruptive event, to maintain relatively stable, healthy
levels of psychological and physical functioning and a renewed capacity
for generative experiences and positive emotions. While for children, the
definition of healthy adaptation is a complex issue hinging on the temporal
and sociocontextual characteristics of stress and adaptation at different
points in the lifespan, in adults it is more straightforward as responses to
PTEs can usually be assessed in terms of deviation from or return to
normative (baseline) functioning. Resilient individuals experience some
form of transient stress reaction, however, these reactions are usually mild
to moderate in degree, are relatively short-term, and do not significantly
interfere with their ability to continue functioning. A relatively stable
ϳϭ
trajectory of healthy functioning does not result from any specific
dominant factor. Rather, it is the result of multiple independent risk and
protective factors, each contributing to or subtracting from the overall
likelihood of a resilient outcome.
Figure 1.4. Prototypical empirically derived patterns of disruption in normal
functioning across time after potentially traumatic events (PTE) (Bonanno, 2004)
.
ϳϮ
Chapter 6 - Defining and Operationalizing Resilience
The evolution of the construct of resilience from physiological and
psychological research extends from the 1800’s to the present. Tusai and
Dyer (2004) have reviewed it proposing the importance of a dynamic,
interactive and holistic perspective because of the complexity of the
construct. The domains of resilience are developmentally appropriate and
change with different life stages, thus resilience appears to be a process that
can be developed at any time during lifespan, rather than an inherent
characteristic of personality. The development of resilience is, in fact, the
result on an interplay and the synergy shared between the individual and
the broader environments and experiences (Gillspie , Chaboyer & Wallis,
2004), which determine its level (L’Abate, 2010) and varies by life cycle
and by ethnicity (McCubbin et al., 1996). Consequently, integral to the
definition of resilience in research is the interaction among risk and
protective factors at an intrapersonal, interpersonal and environmental
level. The controversy on the prevalence of resilience in general and
clinical population, which ranges from 15% to 50%, depends primarily
upon different definition of resilience and a lack of a background theory
capable of explaining both its components and the underlying processes.
These rates, while confirming that resilience does not function uniformly
and automatically and vary across different populations, in response to
contextual variables (Tusaie & Dyer, 2004) also evidence a need for a
theoretically and empirically grounded definition, operationalization and
normalization of the construct, too different and vague and criticized for
being too amorphous (Neill,& Dias, 2001). Resilience has been described
in literature as an individual’s capacity for maintenance, recovery or
improvement in mental health following life challenges (Ryff, Singer,
Dienberg Love, & Essex, 1998) or a successful adaptation following
exposure to stressful life events (Werner, 1989), an individual’s capacity
for transformation and change (Lifton, 1993). Richardson (2002)
considered it as a self-righting force within everyone that drives him/her to
pursue self-actualization, altruism, wisdom, and harmonium with a spiritual
source of strengths. All these definitions focus on aggregating various
domains and characteristics weakly correlated with outcomes, so that a
global definition of resilience becomes useless in research and practice
ϳϯ
applications. Relational Competence Theory (RCT, L’Abate, 1994) a
theoretical model that emphasizes collaborative exchanges, emotions and
developmental contexts and can explain its components, specificities and
processes during developmental transitions, changes over time, crisis and
prolonged challenges, and across different contexts and populations. A
global, overall definition of resilience as relational, competence-based and
emotion regulatory will overcome any issue of construct definition and
operationalization, offering innovative perspectives and inquiries about its
outcomes.
6.1 The construct of Resilience
Research on resilience has developed along three waves of inquiry
(Richardson, 2002). The initial identification of resilient qualities
characterized by the phenomenological identification of developmental
assets and protective factors, the description of resilience as a disruptive
and re-integrative process for accessing resilient qualities, and a
postmodern and multidisciplinary view of resilience as the force that drives
a person to grow though adversity. Block and Block (1980) originally
defined psychological resilience as “resourceful adaptation to changing
circumstances and environmental contingencies, analysis of the goodness
of fit between situational demands and behavioral possibility, and flexible
invocation of the available repertoire of problem-solving strategies”.
Evolved from its first simplistic attempts to describe resilient qualities to
uncover the process of attaining those qualities (Connor & Zhang, 2006),
contemporary resilience research now concentrates on understanding its
components and developmental dynamics. Recently, the mechanism by
which resilient people achieve superior coping abilities and flexibility and
resourcefully adapt to negative circumstances as been identified in a
complex knowledge and understanding of positive emotions that involve
the interaction of automatic and controlled processes (Tugade and
Fredrickson, 2007). Automatically accessible emotions require minimal
cognitive resources to be activated as they eventually become triggered in
those same environments without conscious thought or intent depending on
the frequent and consistent pairing of internal responses with external
events. Thus, while traditional coping is reactive, resilience seems to be
ϳϰ
proactive and future oriented. Moreover, Storm and Storm (1987) found
that the representation of emotional experiences, discretely or globally,
varies individually by degrees and can be differentiated based on social
relevance (interpersonal or non-interpersonal) and distinctly categorized
based on appraisal theme, behaviors and subjective experiences. This
suggestes that resilience is dynamic across developmental stages,
relational, contextual, and also attributional in nature, as it depends
ultimately on the meaning a person gives to his/her experience and his/her
reaction to that experience. Some researchers have also demonstrated a
heritable and physiological component of resilience, such as higher
biological levels of dopamine, neuropeptide Y, testosterone, and higher
functionality of 5-HT and benzodiazepine receptors (Charney, 2004;
Gervai et al., 2005) and Dopamine receptor D4 in young adults (Das,
Cherbuin, Tan, Anstey, & Easteal, 2011).More recent evidences are
moving toward an individual-differences model of resilience that accounts
for substantial individual variation in response to potentially traumatic
events, which can be defined by prototypical and empirically derived
outcome trajectories (Bonanno, 2011). Hence, resilience today is still not
adequately theorized and needs further empirical validations. There is an
imperative need to replicate and extend evidence for resilience in a wider
range of populations using broader methods and measures (Moskowitz,
Papa, and Folkman,(2005).
6.2 Resilience as a personality trai: self-esteem, hardiness, sense of
control and ego resiliency
Research on resilience has found several global factors within the
individual that seem to promote positive development generally and
different ways in which individuals adapt to all challenges of their
environment (Waaktaar, T. & Torgersen S., 2010). Masten (2001) has
examined converging findings from variable-focused to person-focused
investigation on children growing up in disadvantaged or adverse
conditions and suggests that resilience is common and it arises from the
normative functions of human adaptation systems, and made of ordinary
rather than extraordinary processes. Similarly, Bonanno (2004) has
challenged the assumption that resilience is rare by reviewing evidence that
ϳϱ
resilience represents a distinct trajectory from the process of recovery, is
common, and that there are multiple and sometimes unexpected pathways
to resilience. Weather resilience has to be considered an adaptive ability in
face of actual stressing experience or rather a personal characteristic
describable within a personality profile is still unclear and greatly
influences the operationalization of the construct and the choice of a
specific assessment scale to measure it. Robins et al. (1996) have
investigated the relationship between the Five Factor model (FFM, Costa &
Mc Care, 1992) and the resilient typology and found the resilient type to
score above average on all five dimensions. Similarly, Waaktaar &
Torgersen (2010) confirmed that the resilience scale RS (Wagnild &
Young, 1993) and Ego-Resilience (ER89, Block & Kremer, 1996) were as
good as the FFM at explaining variance in caring relationships, high
expectations and meaningful relationships in the family and social
environment. This seems to indicate that resilience implies the mobilization
of positive resources in such circumstances as stated in process-oriented
resilience models (Wyman et al., 2000). One critical aspect of resilience
that has been emphasized in literature at the individual level is its
improvisational nature, the “willingness to pursue action experimentally”
(Barrett, 2004, p. 95). Resilient people are said to “improvise solutions
from thin air” (Coutu, 2002, p. 55), regain balance and keep going despite
adversity and misfortune and find meaning amidst confusion and tumult.
They are self-confident and understand their own strengths and abilities, do
not feel a pressure to conform but take pleasure in being unique and will
‘go it alone’ if necessary. Resilient individuals have confidence in their
ability to persevere because they have done so before and anticipate rather
than fear change and challenges. They experience the same difficulties and
stressors as everyone else; they are not immune or hardened to stress, but
they have learned how to deal with life’s inevitable difficulties and re-
establish the equilibrium and this ability sets them apart. Segerstrom (1998)
explored the effects of dispositional and situational optimism on mood and
immune changes in response to stress finding only partial accountability for
the relationships. Similarly, a community survey by Connor and Davidson
(2003) evaluated the relationships between spirituality, resilience, anger,
health status, and post-traumatic symptoms in survivors of violent trauma.
Using multivariate regression models, resilience was associated with health
ϳϲ
status and post-traumatic symptom severity only. Theroleoftraitlevelsof
emotional understanding in promoting affective differentiation is not
straightforward but there are evidences of individual differences in the
complexity of information processing, as potential moderators of the
dynamic interplay between positive nad negative emotions. (Davis, Zautra
and Smith, 2005).
6.3 Self-esteem, Self-worth and interpersonal relationships
High self-esteem predicts personal resilience but also predicts
antisocial reactions to various threats, such as failure and uncertainty.
Despite evidences that high self-esteem is associated with personal and
relational resilience (Murray, Holmes, MacDonald, & Ellsworth, 1998;
Stinson et al., 2008; Trzesniewski et al., 2006), research also persistently
reveals an antisocial side. People with high self-esteem, in fact, after
experiencing threat, tend to become antagonistic and self-righteously
dismissive of others holding different perspectives (Heatherton & Vohs,
2000; McGregor, Nail, Marigold, & Kang, 2005; Park & Crocker, 2005;
Vohs & Heatherton, 2001). McGregor, Nash and Inzlicht (2009) found
that people with high self-esteem tend to react to threat with neural activity
characteristic of approach-motivation. Their results should that individuals
with high self-esteem react similarly to various threats with diverse
outcomes (hostility, idealism, self-enhancement, meaning-seeking) with a
common denominator of approach motivation. Such state is associated with
attenuated startle-reflex, less negative reactions to aversive stimuli, more
happiness and meaning, and less depression and negative affect in general
(Drake & Myers, 2006; Elliot, 2008; Gianotti et al., 2009; Jackson et al.,
2003; Urry et al., 2004). However, approach motivated states also constrict
attention and intention to personal goals (Gable & Harmon-Jones, 2008;
McGregor et al.,2007) and could decrease sensitivity to others’
perspectives. The approach-motivation-related phenomenon, indeed, is
associated with impaired perspective taking and objectification of others in
service of personal goals (Keltner, Gruenfeld, & Anderson, 2003). Self-
concept is at least partly derived from standpoints of others around the self,
that is, perceptions about the self-gathered from others’ opinions. It is thus
imperative to examine how self-concept is affected by relationships with
ϳϳ
others. Hinde, Finkenauer and Auhagen (2001) argued that relationship
processes occur in the individual’s mind with the individual having his/her
own view of the relationship as well as a shared one. This view is affected
by one’s selfconcept and therefore it is a critical factor for understanding
the dynamics of relationships. The balance of personal perceptions of self
and others’ perceptions, congruency, is constantly sought and can affect
one’s behaviour in an attempt to confirm one’s self-image.
6.4 Hardiness
The construct of hardiness refers to a set of attitudes toward life
characterized by an orientation toward deriving meaning, growth, and value
from stressful life events (Bartone, 1995; Bonanno, 2004; Maddi et al.,
2006, Bartone, 1999; Kobasa, 1979). Hardiness has been shown to predict
lower levels of illness and to moderate the association between stressful life
events and illness (Kobasa, Maddi, & Kahn, 1982). Specifically, hardiness
consists of three dimensions: commitment to persevering through stressful
events, a sense of control over the outcomes of such events, and openness
to learning and growing from challenges (Maddi et al., 2006).
Psychological hardiness is a personality style first introduced by Kobasa
(1979; Kobasa & Puccetti, 1983) and described as a pattern of personality
characteristics. Recent literature suggests that hardiness is a key “pathway
to resilience” (Maddi & Khoshaba, 2005). The way hardiness fosters
resilience appears to be a combination of cognitive, behavioural
mechanisms, and biophysical processes as the “personality style” of
hardiness encourage effective mental and behavioural coping, building and
utilizing social support, and engagement in effective self-care and health
practices. By contrast, “learned helplessness,” (Seligman ,1975) is the
result when individuals believe or expect their responses will not influence
the future probability of environmental outcomes, and rend people more
vulnerable to stress and depression (McCann & Pearlman, 1990).
Personality, thus, undoubtedly does play a role in resilience to trauma.
However, personality rarely explains 10% of the actual variance in people’s
behavior across situations: it is more accurate, therefore, to conceive of
personality as one of many potential contributors to resilient outcomes
(Bonanno & Mancini, 2010).
ϳϴ
6.5 Sense of control
In addition to the importance of self-esteem and hardiness, some
researchers have noted that stress is most clearly buffered by the sense of
control, a personality attribute (Cohen & Edwards, 1986). A model of
development by Jordan (1987) suggested that power/control modes are
gender-related and imply different coping strategies and complex context-
person interactions. More recently, researchers have noted that emotion-
focused coping is adaptive in situations where one actually has little
control, and problem focused coping is useful where one can effect change.
In general, where, due to a lack of power, the possibility of changing things
is unrealistic the emotion-based coping strategies may be more successful
(Lazarus & Folkman, 1984). The value of a broad sense of control coupled
with the capacity to recognize one's limits are the foundation for
competence and empowermen and is related with the construct of
resilience. (Beardslee, 1989). The sense of power and control at the
personal
level has important implications especially for actionsand interventions
toward resilience (Prilleltensky, Nelson & Peirson, 2001). The acquisition
and development of material and psychological resources, participation and
self-determination, competence and self-efficacy, power and control are
opportunities defined and afforded by social, community, and family
environments.
Antonovsky (1987) postulated that individuals mobilize their
‘‘generalized resistance resources’’, among which individual identity,
intelligence, sense of control and social ties, in order to manage stress and
overcome the pathogenic effects of everyday environmental hassles and
inordinate demands. Waysman et al. (2001) concluded that individuals who
view themselves as in charge of their fate (sense of control), view their
stress as a surmountable challenge and are more likely in the long run to
enjoy a satisfactory level of adjustment (Almedom, A. M., 2005)
6.6 Ego resiliency
Ego-control (EC) refers to the inhibition/expression of impulse and
ego-resiliency (ER) to the dynamic capacity to modify individual’s level of
ϳϵ
ego-control in response to situational aơordances, thus contextually (Block,
J., 1950, 2002; Block, J.H., 1951; Block & Block, 1980). EC refers,
consequently, to a meta-dimension of impulse inhibition/expression while
ER refers to a meta-dimension of the dynamic capacity to contextually
modify one’s level of control in response to situational demands and
aơordance (Letzring, Block, & Funder, 2004). Highly ego-resilient
individuals are characteristically able to modify their level of control, either
up or down, according to the situational context. Individuals with a low
level of ego-resiliency are restricted to the same level of impulse
containment or expression regardless of situational demands. However,
higher levels of control are not monotonically advantageous and adaptive
under all conditions: ego-resiliency is the ability to adapt one’s level of
control temporarily up or down as circumstances dictate (Block, 2002;
Block & Block, 1980). Because of this adaptive flexibility, individuals with
a high level of ego resilience are more likely to experience positive aơect,
and have higher levels of selfconfidence and better psychological
adjustment than individuals with a low level of ego resilience (Block &
Kremen, 1996; Klohnen, 1996). When confronted by stressful
circumstances, individuals with a low level of resiliency may act in a stiơ
and perseverative manner or chaotically and diơusely, and in either case,
the resulting behavior is likely to be maladaptive (Block & Kremen, 1996).
ER has been found also to positively correlate to several other favorable
characteristics, such as having a wide range of interests and a high
aspiration level, being interesting, cheerful, expressive, and assertive, and
valuing intellectual and cognitive matters. ER has been found negatively
related to characteristics such as being self-defeating, emotionally bland,
andgivingupwhenfrustrated. Amongfemales, ERscalescoresare
positively related to the ‘‘big five’’ personality traits of extraversion,
agreeableness, conscientiousness, and openness, and negatively related to
neuroticism. Among males, ER was positively related to extraversion and
openness, only. ER was also found positively related to several measures of
well-being and negatively related to several indicators of psychopathology
from the MMPI-2 (Letzring, Block, &d Funder, 2004). Although Ego
resilience refers to the ability to adapt flexibly and with elasticity to
changing circumstances (Dugan & Coles, 1989), Resilience is conceptually
distinct from “ego-resilience,” a personality trait that refers to the flexibility
ϴϬ
of an individual’s character in response to changing situations (Block &
Block, 1980). The the terms ego-resiliency and resilience differ on two
major dimensions (Luthar, 1996): ego-resiliency is a personality
characteristic of the individual, whereas resilience is a dynamic
developmental process, moreover the first, ego-resiliency, does not
presuppose exposure to substantial adversity, whereas resilience does, by
definition.
6.7 Resilience as a dynamic process
The first paradigm shift from viewing resilience as a trait to viewing
resilience as a state or a process (Luthar et al., 2000) occurred when
scholars defined resilience as developable (e.g., Luthans et al., 2006;
Spreitzer et al., 2005). The interaction between trait-like factors such as
self-esteem and relational factors, such as relationships networks, are now
examined to understand how and why certain individuals are, for example,
more or less apt to seek out help and thus, cultivate positive, resilience-
enhancing relationships. Some scholars have argued that “resilience is
more process than product” (Walsh & Pianta, 1998, p. 411) and therefore
focus on the interactions between relationships and context. These
interactions are the protective factors that enable an individual to excel,
even in challenging circumstances and the dynamic process by which
learning and development occur through positive interactions with others
(e.g., Miller & Stiver, 1977). This approach to studying resilience runs
parallel to the coping literature, which also invokes the idea of adapting to
and growing from stress and crisis (Holohan, Moos, & Schaefer, 1996;
Harland et al., 2005). Both kinds of research focus on the process,
strategies and protective factors involved in bouncing back and then
examine outcomes that indicate improved health and competence
(Garmezy & Tellegen, 1984). Unfortunately, as Harland and colleagues
(2005) concluded, “despite the fact that resilience and coping are generally
defined in an outcome-focused fashion, these literatures do not actually use
scales that tap into resilience itself as an outcome in empirical research”
(p. 3).
ϴϭ
6.8 Family Resilience
Resilience, as the ability to withstand and rebound from crisis and
adversity, has been viewed as residing within the individual, while a
systemic view of resilience in ecological and developmental contexts, the
concept of family resilience, attends to interactional processes over time
that strengthen both the individual and the family (Walsh, 1996).
Understanding the normal family functioning, without dismissing it as
dysfunctional, offers a useful framework to identify and fortify key
processes that enable families to surmount crises and persistent stresses.
There are many pathways to resilience, varying to fit diverse family forms,
psychosocial challenges, resources, and constraints. A family resilience
approach aims to identify and strength key relational and interactional
processes that enable families to withstand and rebound from life
challenges and transitions (Walsh, 2006). Being a family is not a static
configuration, but a constantly evolving process requiring constant action
and maintenance. Families are neither strong nor troubles by default, but
will go through stages of strengths and instability (Silberberg, 2001). In
unstable times, some families lose sight of their strengths but when these
strengths are identified, they can become the foundation for continued
growth and positive change (DeFrain, 1999). Family resilience research
over the past 20 years has focused on addressing the central and complex
issues of determining what protective and recovery factors are critical to
family adjustment and adaptation in the face of specific risks, cluster of
risksaswellasfamilycrises. Thenature of family protective and recovery
factors has thus become a central concept of family resilience, and has
played a critical role in promoting the family’s ability to maintain its
established patterns of functioning after being challenged by crises.
According to McCubbin (1997), resilience apply to family system as the
ability to maintaining established patterns of functioning after being
challenged (elasticity) and to quick recovering from a crisis or transitional
event (buonancy). The protective factors sustaining the family in these
processes at different stages of its life cycle are: family accord, health,
support network and shared values around the use of leisure time. In 1999
the Family Action Center identified and incorporated into the framework
named the Australian Family Strengths Template, through both quantitative
ϴϮ
and qualitative findings, eight strengths: communication, sharing activities,
affection, support, acceptance, commitment, resilience (Silberberg, 2001).
Similarly, DeFrain and his colleagues (Olson & DeFrain 2000; Stinnett &
DeFrain 1985), have cross-culturally studied family strengths in 27
countries and developed a Family Circumplex Model. Their model is based
on the dimensions of cohesion, flexibility and communication and
consisting of six qualities: commitment to the family, appreciation and
affection for each other; positive communication patterns; enjoyable time
together; a sense of spiritual wellbeing and connections; and the ability to
successfully manage stress and crisis.
However, a second line of inquiry, focusing on recovery factors that
distinctly differ from protective factors depending on the context, has
identified self-esteem, self-confidence, recreation orientation, family
organization and optimism as having a direct relationship to promoting
wellness in families managing long-term care of chronically ill children.
Self-reliance, family meanings, and family schema seemed, on the other
hand, the more prominent for healthy functioning in the face of war
traumas of war and prolonged absence of a family member. All strengths
perspectives accept and acknowledge that resilience, as the ability to
endure extreme hardship and to survive seemingly insurmountable
problems, is relational. Family resilience can thus be nurtured and
mobilized using interventions ranging from family therapy to social policy
(Walsh, 1998). More recently, family resilience assessments and
interventions have been redirected from identifying the cause of problems
to amplifying existing and potential competencies (Walsh, 2002). However,
the focus has remained the search, conceptualization, measurement and
validation of factors operative in family systems in the effort to isolate
common denominators that appear in those families able to survive adverse
situation and aversive condition (MCubbin, 1997) rather than family
relational processes. In this perspective, only longitudinal process-focus
studies and multi-disciplinary, cross-cultural approaches can make family
resilience research possible for a more comprehensive understanding and
evaluation of the broader repertoire of resources and capabilities to adjust
and adapt to life’s normative and non-normative that changes would
probably be of greater value.
ϴϯ
Little empirical research on family resilience exists given limitations
in measuring the construct. Family resilience functioning has often been
inferred from individual members or defined by their judgment, while
assessing family competence (Patterson, 2002) is a fundamental
prerequisite for the conceptualization of family-level outcomes. Coyle
(2006) family resilience model conceptualizes family functioning as both a
protective factor and a mechanism that leads to resilience, rather than an
outcome, and supports seeking the views of multiple family members in
describing family processes, using the five family functioning variables
measured by the FAM III. Coyle (2006) in his studies on within-family
protective factors indicates the importance of assessing ethnic and cultural
influences when identifying family resilience processes. Similarly,
McCubbin (1995) has suggested the investigations of a cross section of
families from different social class, representing different ethnic groups, at
different stages of the family life cycle, and who have been exposed to a
cluster of risk factors known to increase the vulnerability of families. Hong
and others (2004) tested the theoretical framework for family resilience
developed by Walsh (2003) using empirical data in a second order
confirmatory factor analysis (CFA). Using 5-point likert scale items
tapping belief systems, organizational patterns, and
communication/problem solving criteria, they developed and validated an
empirically based construct of family resilience. Moreover, using the
structural equation modeling (SEM), they examine the potential mediating
and moderating impact of family resilience on physical child abuse and
adolescent dysfunctions. The Strengthening Family Program (SFP). For
example, evaluated in as many as 15 different research studies and also
available in Europe target for family resilience interventions family
relationships (conflict, communication cohesion organization), parenting
(style, discipline, monitoring self-efficacy) and children’s social skills
(peer influence, school bonding, academic competency, conduct self
regulation. Similarly, the Center for the Study of Social Policy (CSSP),
established in 1979 in the US as an independent nonprofit organization, has
developed a logic model for reducing child abuse and neglect based on
building resilience rather than reducing risk. The Doris Duke Program
works on key protective factors like parenting, social connections, and
ϴϰ
social and Emotional Competence in Children with an outcomes
accountability approach linked to results.
6.9 Resilience as an outcome
A second paradigm shift revolves around the association between
resilience and positive outcomes in literatures. Some scholars have turned
their attention to the factors that lead to positive outcomes—to “pathways
to resilience” (e.g., Luthans et al., 2006). They studied strategy for
psychologically fortifying individuals against risks (Luthans, 2004),
developing interventions for individuals in tough circumstances (Luthar,
1999; Masten, 2001), adding meaning to people’s lives (Spreitzer et
al.,2005) and developing and cultivating developmental strong networks
strong in terms of psychosocial support. The only logical way to
understand the process leading to resilience requires a clearly referenced
adversity and a clear, conceptually defensible outcome in response to that
adversity (Bonanno, 2004; Luthar et al., 2000). According to Bonanno
(2011) resilience is, in fact, a stable trajectory of healthy functioning in
response to a clearly defined event, rather than a personality characteristic,
the absence of psychopathology or an average level of psychological
adjustment. Using the term resilience to define the non-pathological state is
a conceptual redundancy and in a simple binary model of pathology versus
non-pathology, insights and fine-grained distinctions rare lost. Placing all
trauma exposed persons not showing pathology into a single resilience
category is incorrect as in samples with repeated assessments over time is
possible to map prototypical patterns of individual variation in coping with
the stress of extreme adversity (Bonanno, 2011). Moreover, resilience
needs to be measured concurrently with outcomes, as the use of
retrospective data makes it impossible to determine the course of a resilient
person’s functioning across time. Thus, Resilience scales used in the
absence of an actual acute stressor event narrow the research to personality
variables divorced from the actual context of coping with extreme adversity
(Bonanno, 2004). While complete stress resistance appears relatively rare,
transient stress associated with a stable trajectory of healthy functioning, or
resilience, is according typically the most common outcome observed
(Bonanno, 2011).
ϴϱ
6.10 Is resilience as personality trait, a dynamic process, or an
adaptive outcome?
To answer this fundamental theoretical and methodological question
we need to integrate and synthesize recent findings on resilience with its
earlier conceptualizations. First, resilience is a developable capacity or
competence, that can be strengthened and learned (Luthar, Cicchetti, &
Becker, 2000; Maddi & Khoshaba, 2005), thus it is more of a state than a
personality trait, as early childhood studies proposed, far more common
than originally believed (Bonanno, 2004; Masten, 2001). Second, recent
conceptualizations suggest that resilience may refer to bouncing back even
from positive events, requiring adjustment, in addition to or instead of
negative events (see Chapter on Life Events). Moreover, Luthans and
colleagues (2006), distinguish between “pure risks,” factors that lead to
unwanted outcomes if they do occur but have no negative effect if they do
not occur, and “pure assets,” which are factors that lead to positive
outcomes if they occur but have no positive effect if they do not occur
(Kraemer, et al., 1977). In terms of the empirical research on resilience, a
great deal of attention has been paid resilience as a predicto and to the
strategies individuals use when they face challenges. Third, scholars have
referred to resilience as a set of behavioral capacities that enable one to
bounce back from adverse situations (Spreitzer et al., 2005). Tusai and
Dyer (2004) after reviewing the evolution of the construct of resilience
from physiological and psychological research from the 1800’s to the
present, have already proposed the importance of a dynamic, interactive
and holistic perspective to resilience due to its complexity. Resilience is, in
fact, a process that can be developed at any time during lifespan, whose
domains are developmentally appropriate and change with different life
stages, which depends on the synergy shared between individuals and their
environments and experiences (Gillspie, Chaboyer, & Wallis, 2004) as it
waxes and wanes in response to contextual variables (Tusaie & Dyer,
2004). Research has proved and demonstrated that patterns of resilience
exists at the individual and family level (Beckett, 2008) and can be
examined trough relational processes (Walsh, 1998).
ϴϲ
6.11 Relational Resilience
In the wide literature on resilience, from child development to
education to organizational behavior, relationships are highlighted as an
important positive factor. Similarly, research on social support has long
suggested that close relationships reduce the stress associated with adverse
events (Gottlieb, 1983) and scholars have noted the connection between
supportive interpersonal relationships and positive attitudes associated with
resilience (Maddi & Khoshaba, 2005). However, research also need to
show how and when relationships are important in building one’s resilience
and competence (L’Abate, 2009). Simply growing enhancing positive
relationships does not seem enough and mostly scholars have focus on the
presence or absence of close significant others, peers, teachers, family, or
counselors (Masten et al., 1999), rarely examining the specific kinds of
support provided by those relationships and their quality. Scholars have
written extensively about the lasting influence of beginnings showing that
people who experience a high degree of connectivity develop a capacity for
exploring and creating new things (Losada & Heaphy, 2004). Relationships
such as these are expansive and can fuel a desire for further connectivity
(Miller & Stiver, 1977). Highly positive early-life relationships encourage
positive ways of interacting that may yield positive returns to future
interactions as well. Likewise, scholars have noted the connection between
supportive interpersonal relationships and positive attitudes associated with
resilience (e.g., Maddi & Khoshaba, 2005). Individuals experiencing
positive emotions report more overlap between their concept of themselves
and their concept of their best friend (Waugh & Fredrickson, 2006;
Waugh,Hejmadi, Otake, & Fredrickson, 2006), and become more
imaginative and attentive regarding things they could do for friends (Otake,
Waugh, & Fredrickson, 2010). When a close relationship does not yet exist,
induced positive emotions can increase trust (Dunn & Schweitzer, 2005),
and may underlie the creation of a wide variety of bonds and
interdependence opportunities (Cohn & Fredrickson, 2006; Gable, Reis,
Impett, & Asher, 2004). This broadened social attention takes the form of
enhanced attention to others and reduced distinctions between self and
other, or between different groups. In developmental psychology, research
on child development has focused on the lasting benefits of having strong
ϴϳ
early relationships with kin, teachers, role models, and peers. The evidence
from this work indicates that the mechanism at play is the socio-emotional
support that such relationships provide which enable others to later adapt,
overcome hardships, and excel despite the odds (Werner, 1993). In other
words, the perceived presence of a supportive social network enhances a
person’s capacity to deal with life’s challenges (Heatherton & Nichols,
1994; Wagnild & Young, 1993): social support is one of the best
predictors of psychological resilience (Blum, 1998). Kram (1985) found
that psychosocial support was related to resilience, which itself has been
associated with the restoration of self-efficacy (Luthans et al., 2006).
Increasing amounts of psychosocial supportovertimewereassociatedwith
greater hardiness, perceived ability to manage stress, and expectations for
success. Psychosocial support is indeed a mechanism that significantly
influences resilience but the multiplicity of help-providers and
combinations of support provided over time need to be considered,
especially its socio-emotional and instrumental nature, and how such
differentiated support is important with regard to different kinds of
resilience-related outcomes. Specifically, increasing amounts of
psychosocial support should provide individuals with the emotional support
necessary to withstand and grow from tensions. As Luthans and colleagues
(2006, p. 31) suggested, “resilience is what allows people to keep trying
and to restore their self-efficacy after it has been challenged.” Further, if a
developmental network increases in strength that is the amount of support
provided, the individual will benefit from the development of skills and
knowledge that will help him/ her explore new possibilities and solutions to
challenges. Increasing amounts of psychosocial support help bolster self-
efficacy (Kram, 1985), which encourage people to “keep trying”.
6.12 Social Networks and Social Support
Developing a variety of supportive relationship and sources of
pleasure could prove invaluable in sustaining an individual through a major
health crisis. (Davis, Zautra and Smith, 2005). Cummings & Higgins
(2005) have examined the dynamics of developmental networks looking at
how network density changes and influences outcomes over time. In
general, social network research has been cross sectional, examining how
ϴϴ
certain already existing network structures impact certain kinds of
outcomes. (Dobrow & Higgins, 2005), rather than how they evolve over
time (Gulati & Gargiulo, 1999), and such change influences resilience.
Social networks are indeed dynamic not only with respect to the amount of
people in it but also the support provided. With respect to the capacity for
resilience, in particular, social networks not to wane or stagnate, but rather
strengthen over time, despite the direction of the change. Relational
resources by creating a psychologically safe environment enable to take
risks and to explore new solutions and new selves (Spreitzer et al., 2005;
Edmondson, 1999; Roberts, Dutton, Spreitzer, Heaphy, & Quinn, 2005).
Social networks can build resilience and thus aid adaptation to unexpected
changes (Newman & Dale, 2005), but not all social networks are created
equal. Diversity enlarge the scope of vision necessary to make proactive
decisions that optimize future choices. Members of a network are bound
together by diverse ties, strong (bonding) and weak (bridging) (Putnam,
2000; Woolcock 2001). The outcomes of adaptive behaviors will depend,
in the ned, on the nature of the social capital present and the structure and
network dynamics that will either facilitate or constrain the ability to gather
information and innovate. Social ties can as well imprison in maladaptive
situations or facilitate undesiderable behaviors (Borgatti and Foster 2003),
as a densely developed social capital network can make excessive claims
on its members and restrict individual freedom (Portes, 1998). However,
because bridging networks brings new and potentially novel information
and bonding networks provides the resilience needed to absorb the benefit
of the bridging capital, the two capitals are complementary (Newman &
Dale, 2005). Thus a better understanding of the positive and negative
aspects of social networks (Newman & Dale, 2005) can give insight on the
process of building resilience. Relationships do indeed change over time
and the direction of this change, in term of quality of the relationship, type
of support, influence resilience. The impact of change in psychosocial
support over time on resilience is substantial. Not jus positive relationships
are important expecially in childhood and young adult lives but how and
when socio-emotional and/or instrumental support is provided, considering
the multiplicity of providers.
ϴϵ
6.13 Building relationships andresilienceintheworkplace:
mentoring.
Today, the study of resilience has been extended from the fields of
psychology, to organizational behavior, human resources management, and
leadership. In particular, resilience has been considered as a critical
component of psychological capital and strategic responses to crises
(Luthans, Vogelgesang, & Lester, 2006; Gittell, Cameron, Lim, & Rivas,
2006). The recent work of positive organizational scholars stresses the
“social embeddedness” of professional lives (Spreitzer et al., 2005) by
studying how developmental relationships influence resilience (Spreitzer,
Sutcliffe, Dutton, Sonenshein, & Grant, 2005; Luthans et al., 2004;
Harland, Harrison, Jones, & Reiter-Palmon, 2005). According to positive
organizational theorists, positive connections are both a source of
protection and a resource that can promote positive kinds of behaviors at
work such as exploration and heedful relating (Spreitzer et al., 2005). In
these respects, positive relationships in the workplace are likely to be
capacity-enhancing, particularly if they are based upon mutual respect and
trust (Dutton, 2003; Fletcher, 1996). As Sutcliffe and Vogus (2003, p. 255)
proposed, “organizations can increase their effectiveness by developing the
capability of resilience.”
Mentoring is a positive relationship with a senior individual within an
employing organization that provides both career support and psychosocial
support (Kram, 1985). Studies have found that mentoring is associated with
beneficial outcomes such as promotion and career advancement (Whitely,
Dougherty & Dreher, 1991; Zey, 1984). Over the years, distinctions have
emerged in the literature between “mentors” who provide high amounts of
both career and psychosocial support, “sponsors” who primarily provide
career support (Thomas & Kram, 1988), “friends” who primarily provide
psychosocial support, and “allies” who provide low amounts of both
psychosocial and career support (Cummings & Higgins, 2005; Higgins,
2007). Mentoring could thus be considered as a “developmental network”,
a full and potentially interconnected set of individuals who provide
psychosocial and career support to an individual at any one point in time
(Higgins & Kram, 2001). Developmental networks as content-specific
networks, are generally small in size, about five people (Podolny & Baron,
ϵϬ
1997). Studies have examined how network characteristics and
development influence individual outcomes such as organizational
commitment, work satisfaction, clarity of professional identity, and career
advancement (Dobrow & Higgins, 2005; Higgins, 2001; Higgins &
Thomas, 2001) and consequently how the dynamics of organizational
networks influence resilience.
High amounts of early career support, such as mentoring, sponsorship,
and coaching (Kram, 1985), buffer and protect from stressors and are
related to long-term career outcomes such as organizational commitment
(Higgins & Thomas, 2001), indicator of the ability to overcome challenges
and adapt.
ϵϭ
Chapter 7 - The assessment of Resilience.
Resilience itself is a complex construct not easily reducible to any
single trait or process and its complex relationship with posttraumatic
growth and other related variables complicates the determination of its
direction and effect. Although it is crucial to establish the presence of
resilience and thus to be able to measure it, and despite the fact that
numerous clinical scales have been developed to assess resilience or some
aspects of it, none today has gained wide acceptance or established primacy
and has fully accounted for its complexity (Connor, K. M., 2006). Defining
the mechanisms of resilience and measuring resilience processes has been
challenging and distinguishing between individual and family resilience
have lead to a proliferation of instruments measuring the construct in a
dichotomous way. Every empirical study on resilience published in
literature has relied on assessment procedures for describing and qualifying
the constructs of interest (Merrel, Felver-Gant & Tom, 2011). Several
instruments for use with adults, adolescents and children are available and
published with adequate psychometric properties. However, the majority
consist of a single informant, have a limited external and internal validity
and focus on relatively narrow constructs related to resilience, thus limiting
their ability to capture any important super ordinate construct. (Merrel,
Felver-Gant & Tom, 2011). Moreover, the association of resilience scales
to adjustment has commonly been measured using cross-sectional data, in
which case assumptions about causal relations between measures are
impossible to test (Bonanno, 2011). Finally, measure of resilience have
primarily focus on protective factors or resources within the individual
rather than assessing the processes involved in positive adaptation to
significant adversity or competence (Ahern, Kiehl, Sole & Byers, 2006).
The still ongoing debate regarding definitions of resilience (Gucciardi et al.
2011) reflects on assessment issues. Implicit within resilience
conceptualization, as previously seen, are two central conditions: exposure
to significant risk or adversity and positive adjustment or /competence.
The first refers to a range of factors faced by individuals either in isolation
or as accumulation of life events which typically are measured as acute or
chronicnegativelifeeventsorspecificand distinct risk indices. (Gucciardi
et al., 2011). Their assessment relates to the identification of absolute level
ϵϮ
of high risk, from normative data, as well as the validity of measures and
measurement confounds heterogeneity of risk items, and distinction
between chronic and acute incidents (Luthar, 1999). The second, positive
adaptation or competence, involves displaying normal functioning and
reaching developmentally salient tasks (Luthar, 2006). Its measurement
include multiple items, checklists, absente/presence of psychopathology
and multiple indices of adjustment. Resilience is clearly a multidimensional
construct that varies with context, time, age, gender, social support, family
environment and culture of origin as well as individual capacities and
competences. However, resilience scale that assess multi-dominions aspect
of resilience are rare as rare is the measurement of assets, resources,
factors and processes that increase positive outcomes and empower
children, individuals and families, (Merrel, Felver-Gant & Tom, 2011).
Despite social emotional assessment been historically tied to child
psychopathology, often neglecting the assessment of positive social-
emotional assets or competencies, today strengh-based assessment of
children and adolescents is an important emerging area in resilience
research (Merrel, Felver-Gant and Tom, 2011).
7.1 Resilience Measures: RSA, RAS, CD-RISC, RS-14, ARS and
SERI
Unlike instruments that rely on theoretical definitions, the Resilience
Scale currently available in literature are derived from interviews with
resilient individuals, but are still considered accurate instrument to measure
resilience. Friborg and others (2003) have proposed and validated a
multidimensional scale assessing factors as personal and social
competence, family coherence, social support and personal structure that
promote adult resilience. Their Resilience Scale for Adults (RSA) was
supported by positive correlations with the Sense of Coherence scale
(SOC) and negatively with the Hopkins Symptom Checklist (HSCL). The
Resiliency Attitudes Scale (RAS, Biscoe & Harris, 1994), a 72-item
psychometric test, measures the degree of protective mechanisms in the
process of negotiating risk situations (Rutter, 1990). Protective
mechanisms are described as the ability to use internal and external
resources successfully in resolving stage-salient developmental issues.
ϵϯ
They are mechanisms that moderate a person’s reaction to stressful
situations or chronic adversity in order to produce a more successful
outcome than would normally be present (Werner, 1995). These
mechanisms are defined as the presence of one or more of the seven
resiliency skills: insight, independence, relationship, initiative, creativity
and humour, morality, and general resiliency (Biscoe & Harris, 1994). The
RAS has demonstrated reliability and internal consistency in repeated
clinical treatment settings (Biscoe & Harris 1994). In some study results
(Maureen, 2011) indicated that the resilience characteristic of initiative
using Biscoe and Harris’s (1994) Resilience Attiture Scale (RAS)
significantly differed between completers of and Ed.D program in
educational leadership and non completers while in other subscales
students were equally resilient. Similarly, Connor and Davidson (2003)
has described a scale to assess resilience, the CD-RISC, that has sound
psychometric properties, distinguishes between greater and less resilience
and demonstrates that resilience is modifiable and can improve with
treatment. The focus of this scale is on personal resources deemed
appropriate for positive adaptation to adversity (Gucciardi et al. 2011). The
five factors model comprises personal competence, high standards,
tenacity, trust in one’s instinct, tolerance of negative affects, strengthening
effect of stress, positive acceptance of change, secure relationships, control,
and spiritual influences. Carli et al. (2010) in a study on 1265 males
detained in Italian penitentiaries found the risk for suicide ideation, suicide
attempt and self-mutilation significantly increased by higher depression
and decrease by higher resiliency measured using the CD-RISC in its
Italian validated version. Moreover, the suicide attempters were likely to
be victims of violent life events and were less resilient than the
nonattempters were. Resilience thus was a protective factor from suicidal
behavior, even in the presence of antecedent depression and victimization
by violent life events. In their study Carli et al. (2010) found resilience at
20 years to be a moderator between life time violent life events and
attemptedsuicideandeffectiveinthecontext of antecent depression. CD-
RISC is primary a measure of individual traits and dispositions.
The Resilience Scale (Wagnild & Young, 1993) is among those that
has received strong reliability and validity and has been used successfully
for over fifteen years by thousands of researchers all over the world. The
ϵϰ
14-item version of the Resilience Scale (RS-14; Wagnild & Young, 1993)
that the authors derived from reviewing related literature and then validated
via interviews with 24 American women, whowerejudgedtohave
successfully adapted to major life events, is intended to be applicable to
other populations, including males and younger people. The internal
consistency of the RS can be regarded as established and range from .76 to
.91 (Wagnild & Young, 1993). There are also reports on the Russian,
Spanish and the Swedish version. The scale has sound psychometric
properties, distinguishes between greater and less resilience and
demonstrates that resilience is modifiable and can improve with treatment.
The 14-item has been conceptualized as a one-dimension scale. Resnick
and Inguito (2011) provided additional support for the psychometric
properties of the Resilience Scale on two independent samples of older
Caucasian women age 80-90, widowed, single or divorced and with three
on average comorbid medical problems. However, they found a poor fit for
items 3-6, 9, 11, 20, 22 and 25 indicating that additional items are needed
to differentiate those who are particularly resilient. Van Schaick (2011)
explored the role of religion involvement in childhood and adolescence in
predicting resilience (Wagnild & Young, 1987) and well-being (Ryff,
1989) in early adulthood in a sample of 431 college freshmen. Both
hypothesis that family involvement in religious activities lead to resilience
and well–being and that resilience mediate the relationship between
religiousness and well-being were not supported. Although religiousness
was not significantly predictive of psychological well-being, resilience
significantly predicted psychological well-being. McCay et al. (2011)
found using a mixed-methods approach, a sample of 70 homeless, age 16-
24 to have high levels of mental health symptoms but moderately high
levels of resilience (M=130.27; SD=25.54) on the Resilience Scale
(Wagnild & Young, 1993) and self-esteem. The findings reveled that these
youth, the majority of whom were victims of abuse and were sleeping in
shelters, regarded leaving home as an important first step in taking care of
themselves and gaining self-respect, forming relationships with peers and
learning to manage obstacles. Self-esteem and resilience were significantly
negatively correlated with indicators of emotional acute distress
In a sample of 404 Albanian and Bulgarian immigrants and 376
Greeks citizens, Efrosyni and Kalantzi-Azizi (2008) examined relationships
ϵϱ
among acculturation, psychological resilience, social support and
symptoms of depression and distress and found very high scores of
depression and distress in immigrants related to a lower score in the
Resilience Scale. Choowattanapakorn et al. (2010) compared the level of
resilience in Sweden and Thailand on a sample of 422 and 200 respectively
adults 60 years and older using the Resilience Scale. Despite different
background characteristics, the mean score were almost the same, 144 for
Swedish and 146 for Thai participants. Amrita & Arora (2010)
investigated gender differences in the perception of academic adversity and
resilience in a sample of 560 Indian late adolescents, age 17-20 and found
significant gender differences, with males reporting more resilience than
females and a different use of resilience resources, reflected in internal
asset scores and measured with the resilience Scale (Mampane, 2005). In
their sample, 200 individuals experienced high adversity of which 115
reported high and 85 low scores on resilience, with females reporting more
academic adversity. Finally, the Adolescent Resilience Scale (ARS), which
measures the psychological features of resilient individuals, has also been
tested by Oshio and others (2003) for construct validity on Japanese
undergraduate students and yielded difference in scores from Vulnerable,
to Well Adjusted, and Resilient. Merrell and others (2011) recently
validated on a sample of 2356 parents of children and adolescents age 5-18
the Social-Emotional Assets and Resilience Scale (SEARS-P), parent form.
This strength-based 39-item measure include both narrow and broad factors
of social-emotional functioning (Self-regulation/Responsibility, Social
Competence and Empathy), multiple informant versions and strong
validity. A more recent and promising comprehensive measure of
protective factors, is the Social and Emotional Resources Inventory
(SERI,Mohr, 2012). Results indicated that the SERI has a 12-factor internal
structure (Intelligence, Parenting Practices, Parent Connections, Self-
Esteem, Talent, Faith, Money, Prosocial Adults, Kin Connections, Good
Schools, Prosocial Organizations and Resources) and good to excellent
reliability ranged from .84 to .97. Preliminary results suggest that the
Social and Emotional Resources Inventory is representative of the three
domains of protective factors: individual, community, and familial. As
such, this is the first comprehensive measure of protective factors
applicable to a general population, and has the potential to be useful in both
ϵϲ
research and clinical settings, for researchers or clinicians looking to
measure multiple domains or outcomes.
ϵϳ
Chapter 8 - Interventions
The focus on relational competence and developmental relationships
and the findings regarding psychosocial support offer a potentially useful
perspective on resilient individuals. From a practical perspective,
interventions should emphasize the development of capabilities, knowledge
and relationships. Emphasizing psychosocial support and the capacity to
build relationships is worthy more consideration, beyond other form of
support and training, even in the workplace (Gianesini, 2010).
Individual, families and organizational life are socially embedded, and this
paper have provided evidences that certain kinds of resources provided by
developmental networks are critical to building resilience in every context.
Social support do wane and strengthening networks is critical in developing
resilience at every stage of development. Overall, the ability to build
relationships, that is relational competence, and the strength and dynamics
of positive relationships and psychosocial support is fundamental. Resilient
individuals use the resources and skills available to their best, and are
capable of actively create and modify their own environment (Jowkar,
Friborg & Hjemdal, 2010). The experience of emotion always occurs in an
environmental and relational context. In a safe and predictable
environment, individuals are able to process information from multiple
sources, including emotional inputs, to develop an adaptive response. This
complex processing demands substantial resources but provides the
individual with a rich and nuanced assessment of environmental demands
and emotions which allows hinm/her maximal flexibility and an optimal
response at any given moment. During times of stress and uncertainty, the
need to process information rapidly takes over complex, time-consuming
processing of differentiated evaluation of stimuli. The individual’s
attention narrows on the immediate demands and potential threats to well-
being and judgments become more simplified and rapid, to quickly
alleviate the discomfort of the situation. In such contexts, negative
information are preferentially process at the expense of positive and PA
and NA fuse to become a simple bipolar dimension reflected in a high
inverse relationship between the two (Devis,Zautra and Smith, 2004).
Because resilience is a natural resultforindividualswith resources, it
cannot be directly "taught" through specialized programs (Bonanno, 2004)
ϵϴ
however, relational competence and emotion regulation can. Resilience is
a construct of preservation of good functioning and positive outcome
despite exposure to potentially traumatic events, not merely passive
adaptation to a stressor, and a process sustained by some level of
competence that make such successful adaptation possible (Bonanno,
2004).
The importance of providing on time, preventive, comprehensive, and
individualized services to individuals and family have been widely
recognized in literature and prevention strategies have evolved from risk-
focused to resource-focused to process-focused. The focus on competence
and resilience enhancement programs has shifted together with the
operationalization of the construct itself, from initially building a singular
or a set of skills, to more developmental, ecological and multi-causal
models and prevention initiatives process-focused. Many conventional
intervention approaches depend on the assumptions that affect states are
unidimensional, focus and privilege negative affective such as depression
and psychological distress and assume the underlying structure of affect
states is fixed and unchangeable (Zautra et al. 2004). Treatments based on
unidimensional models identify the source of distress and then apply
techniques that will maximize the person’s chances of recovery (Reich,
Zautra, & Davis, 2003). However, redirecting clinical and educational
practice to manipulate affect relationships, emotion regulatory processes
and relational competence appears to be a more fruitful avenue for
investigation (Reich, Zautra, & Davis, 2003). Effective programmatic and
intervention efforts need a strong theoretical and conceptual base, correctly
operationalized constructs, reliable assessment measures and practice-based
activities integrated into specific community contexts (Trask, 2005).
Successful resilience intervention involves balanced emphasis on both
contextual and environmental risk and personal or family processes as a
resource. Key relational and family processes that facilitate strengths and
outcomes need to be used to empower families and build resilience. Rather
than looking at the family or social network structure and stability with
pathologizing frame of reference, it is better to support individuals in all
types of relationships, and help them fulfill parental functions competently,
resolve disputes constructively and ensure community attachment
(Kinnear ,2002) in their ride along with the ups and downs of life
ϵϵ
(Joinking, 2003). In spite of adversity, individuals and families have
valuable knowledge to share (Tusaie and Dyer, 2004) and that the potential
for change and function above the norm exists across the life course. The
full potential of intervention can only be realized integrating knowledge of
normal development, relational competence and resilience. As relationships
are the foundation of human adaptation and development, forming the
basis for both social and cognitive competence, practitioners should make
them the heart of interventions, from childhood on” (Masten and
Coatsworth, 1998). Early interventions targeting indiscriminately at people
immediately after exposure to a PTE, like traditional grief programs, are
not only ineffective but also may exacerbate trauma reactions by interfering
with natural recovery processes. In fact, for most people, intrinsic recovery
processes will restore equilibrium relatively soon after exposure without
treatment (Bonanno & Mancini, 2010). An appropriate assessment of
individual and relational resources, and a diagnosis of genuine dysfunction,
observed longitudinally over time, is central before any referral for
treatment. As the ability to experience positive emotions in the context of
stress is adaptive, then interventions designed to bolster individuals’
capacity for seeing the complexity of emotions inherent in everyday
stressful situations may prove to be beneficial. Zautra (2003) cited evidence
that mindfulness-based approaches to stress reduction may offer a means of
broadening emotional awareness and thus help to sustain positive
emotional engagement under stressful conditions. In addition, interventions
that facilitate the processing of emotions with greater complexity might
also foster adaptive coping and adjustment to chronic stress and illness
(Reich et al., 2003).
8.1 Relational Competence versus Incompetence: Interventions
RC is defined specifically by skills needed for interpersonal success
amomg which assertiveness, affective management (anger, sadness, and
anxiety), cognitive decision-making, problem-solving, brainstorming,
bargaining, positive thinking, interpersonal awareness, and issues of
intimacy and sexuality. A more generic definition, views RC as a
repertoire of verbal and non-verbal behaviors by which individuals affect,
positively or negatively, the behavior of others, intimates and non-intimates
ϭϬϬ
(peers, parents, siblings, teachers, partners, and co-workers). These
behaviors influence the immediate and long-term environment by obtaining
desirable and removing or avoiding undesirable outcomes, either within the
family or within other settings and context (school, work, leisure time).
Higgins (1997) suggested an important distinction that is very relevant to
an improvement of Relational competence (RC) in general and the
treatment of incompetence in particular. Starting with the distinction
between approach and avoidance, Higgins suggested that we approach
pleasure (promotion), and avoid pain (prevention). Approach deals with
promotion of physical and mental health while Avoidance deals with the
prevention of physical and mental sickness. The extent to which individuals
are successful in obtaining desirable outcomes and avoiding or escaping
undesirable ones, without inflicting pain or suffering on others, defines RC
(L’Abate, 2011). In this perspective, psycho-educational social training
interventions need to be designed to correct specific areas where the level
of competence needs to be raised. However, one single approach is not
sufficient to change from incompetence to competence (L’Abate, 2011), as
all interventions need to be differentiated according to level and type of
functionality. RCT look at maladjustment and deviant behavior as
incompetence, straightforward skill deficits rather than amplifications of
inferred conscious and unconscious motivations or internal states or traits.
Hence, individuals with RC deficits need training or coaching rather than
"therapy." This training consists of specific concepts presented through
verbal and written instruction, lectures, rehearsals, manuals, corrective
verbal/written feedback, homework assignments, relaxation training, self-
reinforcement, and printed course materials to acquire new skills, with
repetition and open and direct discussion, active participation, and
generalization from the practice setting to real life settings, like home, work
place, or leisure-time activities (Appendix 4). Colesso and L’Abate (2011)
have found that individuals with higher levels of RC functioning, both
quantitatively and qualitatively, evidenced higher levels of intimacy with
their partners. In general, mutual communication of personal values and
respect for each other’s personal feelings enhanced mutual capacities, the
ability to forgive partner’s fault, sharing of hurt feelings, and mutual
acceptance of personal limitations. They concluded that RC is a teachable
ability that empowers individuals on their own resources, their ability to
ϭϬϭ
process relevant information and to enhance relational functioning. This
multi-dimensional ability to function successfully in relationships implies
commitments, inevitable physical and emotional closeness, and
unavoidable interdependence. It’s ultimately expressed in the ability to
laugh and to cry, sharing joys and hurt feelings, and is found differently
worded in all models of Relational Competence Theory (L’Abate,
Cusinato, Maino, Colesso, & Scilletta, 2010; L’Abate and Cusianto, 2011).
According to George Bonanno (2009), positive emotions do have a better
interpersonal function as “positive states do more than propel us out of
sadness; they also reconnect us to those around us, Laughter in particular,
has a contagious effect on other people, and in our research we’ve shown
this to be true even during bereavement. Laughter makes other people feel
better and pulls them towards us, in a way rewarding them for having
bothered to stay with us trough the painful moments (p. 199). While the
function of sadness is to turn our attention inward, promote deeper and
more effective reflection, become more detail-oriented, accurate (in
evaluating our abilities and performances), and less biased (toward others).
It is an intrapersonal “essential tool that help us accept and accommodate
to the loss” (p.31) that “dampens our biological systems so that we can pull
back” (p. 32) but comes “equipped with a building safety mechanism”(p.
21), facial emotion expression, that also serves as “compelling signal to
others that we may need help”. Individuals evoke positive emotions in
different context, both positive and negative, to cope more adaptively with
unexpected challenges. Emotions are short-terms reactions, “personal and
raw” (Bonanno, 2009, p. 36) to immediate demands, and their usefulness
depends on its context. The function of laughing and e smiling is to “give
us a break, a temporary respite from the pain of loss (…) come up for air,
(...) breathe” (p. 39). When negative emotion, like sadness, become too
strong, overwhelming, pernicious and dysfunctional they lock others out
causing withdraw from the world, a lost of focus in life, and confusion
about personal identity. L’Abate introducesthatalsotheratiobetween
positive and negative emotions matters, as well as their frequency, nature,
intensity, and rate and whom they are shared with, intimate versus
nonintimate others. If hurts offset joys, in fact, psychopathology emerges.
Inevitably, it varies over time under prolonged stress and distress.
Relationally competent and resilient individuals have the ability to use
ϭϬϮ
avoidance and distraction as coping strategies, and a broader flexibility to
adjust to the shifting demands of different situation.
ϭϬϯ
Chaptert 9 – Final Discussion and Conclusions
Positive emotion and its expression are both signs of resilience and
successful coping with adverse life events. Showing genuine laughter and
smiling, rather than crying, is a healthy response to a loss or stressor event.
Non-genuine laughing, however, could be a predictor of less successful
social adjustment due to difficulties regulating emotions in social
situations, which could contribute to long-term adjustment problems
(Bonanno, 2005). During times of pain and stress, when positive and
negative affect are strongly related, the ability to continue to laugh and
experience pleasure may counterbalance the powerful negative emotions
that can be overwhelming. However, during times of low pain and stress,
when positive and negative affect represent separate dimensions (Zautra et
al., 2004) , the ability to enhance positive emotions could serve to “broaden
and build” the resources for coping and increase overall life satisfaction
(Fredrickson, 1998). The more positive emotions an individual experience,
the more likely is to adapt to different situations, in both a psychological
and physical sense. Experiencing positive emotions like joy, contentment
and gratitude, boost health and wellbeing. Positive emotions are mind and
body events as they improves the way we learn and make decisions, but
also our immunity and cardiovascular health, and our emotional connection
to others, which in turn boosts other aspects of our physical health and
psychological well-being (Fredrickson, 2007). Experiencing positive
emotions, however, is not just it. Sharing negative emotions and sincere
crying produces intimacy and improves intimate relationships (L’Abate,
2011). Crying is a release of emotions that connects to humanity-feelings
and express anger, sadness, physical injury, overtiredness, need but also
happiness, surprise, sympathy, empathy, and sentimentality, thus involving
positive and/or negative emotions. Emotions are the stimuli and the
response on which perceptions are built, repeated, compounded, and
developed. Hurt feelings, unpleasant, painful, and harmfully experiences
and life events can be alleviated by sharing them with others, while
creating intimacy in a process that implies and involves mutual reciprocity
and social support. Social engagement derives from needs that arise from
both affective systems, because individuals seek contact for both
enjoyment and alleviation of suffering (Davis, Zautra & Smith, 2004). In
ϭϬϰ
fact, how individuals evoke positive emotions in different context, both
positive and negative, and how do they respond to positive and negative
emotions within interpersonal interactions elicit positive responses in other
people thus encouraging social affiliation and making social resources
available for coping with adversities. The ability to sustain affective
differentiation are skills related to emotion regulation and play a role in
resilience, including the ability to identify, understand, process, and express
emotions. A developmental perspective of resilience must consider
multiple processes that may vary over time. Most forms of stress are a
long-term complex set of changing conditions (Rutter, 1987).The
experience of stress during adversity is related to a loss of resources and the
positive emotional response in face of adversity promote individual and
relational resources, fostering the ability to modulate emotional responses
and expressions, which is a fundamental component of resilience. The
knowledge, skills, and abilities necessary, regardless of environment, to
regulate emotional expression allow the individual to act and react, and
disassociate if necessary. The skills to be able to read a situation and act
either into or out of it, allow to handle situations and conflicts directly
correlate to the individual’s feelings of security, and his/her future
reactions to similar exposure (Bonanno, 2005). In sociology this theory of
self-identification through perception is based upon the theory of self by
actions of another (the looking glass self). George Herbert Mead theorized
that individuals identify themselves by how they perceive another to look
at them, react to what they say, react to their presence, and therefore this is
how and where individuals place themselves with in or on the outsides of
the culture in which we they are raised (Scott & Marshall, 2005). How an
individual experienced her/himself in the relationship (Garfat, 2010)
determines the action and the reaction. Emotions vary person to person,
society to society, and culture to culture. In recent years interest in positive
emotions has grown, thanks to a change in focus from negative to positive
(Seligman & Csikszentmihalyi, 2000). It is acknowledged that stressful life
events may affect psychological and physical health and there is a growing
interest in humor and in the role it plays in helping to relax, improve
relationships with others, and reduce negative emotions. People with a
greater sense of humor are less prone to developing symptoms such as
distress, anxiety and depression and are more able to face stressful events
ϭϬϱ
through humor, which can increase their self-efficiency, transform their
mood and support in finding constructive solutions to problems (Lefcour &
Martin, 1986). Smiling and laughing in front of the adversity could be
helpful in restructuring a situation and humor can help with both emotion-
focused and problem-focused coping strategies. Humor has also a positive
role in cognitive appraisal of threatening and stressful, situations. It is a
cognitive-affective shift or a restructuring of the situation with a
concomitant release of emotion associated with the perceived threat (Dixon
1980; Martin et al. 1993) and reduction in physiological arousal (Shurcliff
1968). Remaining positive and optimistic is more easily accomplished
with humor and laughter, seeing the brighter side and foster more creative
and effective problem solving. Moreover, a hearty laugh relieves physical
tension and stress, decreases stress hormones and increases immune cells
and infection-fighting antibodies, triggers the release of endorphins, and
protects the heart improving the function of blood vessels and increases
blood flow (Fry, 2001). Both positive and negative life events bring
significant changes in people’s life, family composition, status and
interactions. Significant permanent life change elicit both positive
(excitement, novelty) and negative (fear, worries) or mixed emotions in the
context of required adjustment, depending on the degree of control over the
situation (Fitzpatrick and Kostina-Ritchey, 2011). Emotion are short-terms
reactions, “personal and raw” (Bonanno, 2009, p. 36) to immediate
demands, and their usefulness depends on its context. Positive emotions
have a better interpersonal function, while the function of sadness is to turn
our attention inward, promote deeper and more effective reflection, become
more detail-oriented, accurate in evaluating our abilities and performances,
and less biased toward others (Bonanno, 2009).
9.1 Conclusions
In the past 20 years numerous models of resilience have been
proposed that emphasise ecological and psychological contexts and has
classified resilience either as predictor of good outcome in high-risk
groups, moderator able to enhance or reduce the effect of adversity , or
pattern of recovery from trauma (Masten, Best & Garmezy, 1990). As the
construct is relevant to a number of fields and it is applicable at the
ϭϬϲ
individual, family, group and organisational level, the volumes of studies
on resilience has exponentially grown in the last years (O’Neal, 1999).
Fortunately, contemporary research has progressed from focusing on
descriptive issues, risk and protective factors, to exploring the processes
underlying resilience like self-regulatory systems for modulating positive
and negative emotion, arousal and behaviour (Gucciardi et al., 2011), social
relationships, networking and support to determine its multiple pathways as
outcome. To these changes in the operational definition of the construct
has corresponded a proliferation of assessment measures often misused
(Bonanno, 2011) and with no clear theory of reference (L’Abate, 2011).
While personality models or a combination of personality measures, only
accounts for a moderate amount of variance in resilience and subjective
well been (Costa & McCrae’s, 1984), other variables, including social
networks, emotion regulatory abilities and life events (positive and
negative) need to be adequately included (Headey & Wearing, 1989).
Displaying emotions, in fact, either positive or negative, elicits positive
responses in other people thus encouraging social affiliation and making
social resources available for coping with adversities (Bonanno, 2009).
When feelings emerge and are shared they transform themselves into
emotions, facilitate close relationships which are inner resources,
connections and bonds are culturally different and contextually adaptive
(L’Abate, 2011). A resilient response to adversity does not requires high
level of material, individual and relational resources, but simply a broader
repertoire of behavioral strategies and more flexible way to modulate
emotional responses and adjust to the shifting demands of different
situation. (Bonanno, 2011). A methodologically sounds study of resilience
should consequently meet numerous criteria: a clear operationalization
and a subjective evaluation of the aversive events and their temporal
bounds; a multidimensional information processing assessment of
individual emotional and relational resources and longitudinal
measurement of outcomes obtained at multiple points in time explicitly
categorized. Investigating resilience as a relational and emotion regulatory
construct result in assessment measure that target resources, processes and
competences and in specific intervention strategies aimed at assisting both
individual and families in managing the turbulences and transitions of their
life stages as well as unexpected potentially traumatic events. The first part
ϭϬϳ
of this book aimed at proposing an integrated, theoretically and empirically
grounded understanding of resilience, named Relational and Emotion
Regulatory Resilience (RERR), as an innovative contribution to the field,
which may be used to develop assessment measures and preventative
intervention models in various contexts, integrating a relational approach
with emotion regulatory processes, and multiple pathways of outcomes.
Relational Competence (RCT, L’Abate, 2011), emotion regulatory
processes (Tugate & Fredickson, 2007), positive and negative events and
everyday hassles (Zautra et al. 2004) can better explain the construct of
resilience. Multiple patterns of resilience exist (Bonanno, 2005), and can be
demonstrated at the relational level and examined trough key relational
and emotion regulatory processes that can be used to empower individual,
families and communities.
In the second part of this book, “Empirical Evidences” empirical
support for the proposed relational and emotion regulatory model of
resilience is presented across several studies and samples.
.
ϭϬϴ
Part 2: Empirical Evidences
ϭϬϵ
Chapter 10 - Empirical Evidences
In the first part of this book I have explored, presented and integrated the
theoretical contributes of Relational Competence theory (RCT, L’Abate,
1995), the Broaden-and Built Theory of Positive Emotions (Tugade &
Fredrickson, 2007), the Dynamic Model of Affect (Zautra, 2004) and the
Multiple trajectories of outcome approach (Bonanno, 2008; 2011) into a
relational and emotion regulatory model of resilience (RERR). Resilience
defined, explained and measured as a relational and emotion regulatory
process accounts for its interpersonal, emotional and cognitive components
and processes as well as the heterogeneity of responses (outcomes) while
resolving the issues and controversies about the different conceptualization,
operationalization and definition of the construct at different levels of
analysis (individual, group and family). In this second part, Empirical
Evidences, I present a series of studies aimed at empirically testing the
model across several samples, measures and methodologies. The findings
provided support for a relational resilience model and a competence-based
approach and the results demonstrated that patterns of resilience can be
examined trough relational and emotion regulatory processes, in light of a
comprehensive and integrated theoretical approach that makes its
definitions, characteristics, domains, and assessment measures more
consistent. Although some of these results were previously published or
presented (see references), here they are briefly summarized following the
exact order in which they were conducted during a 3-year period, to test
and further explain the model. All relevant constructs investigated in the
following studies (i.e. Alexithymia, resilience, parenting styles) have been
thoroughly introduced and examined in the first part of this book.
1) Study 1: The influence of emotional and relational resources
on parenting quality on a sample of 324 parents recruited at elementary
schools in Switzerland.
Reference: Gianesini, G. (2012). Alexithymia Dimensions and
Emotional Perceived Parenting Styles. In L’Abate L. & Cusinato
M.(Ed.). Advances in Relational Competence Theory. New York:
Nova Publishers. ISBN: 1621005992
ϭϭϬ
2) Study 2: Resilience and its shielding effect on relationship
quality and life satisfaction (N = 318)
References: Gianesini G. (2011). Resilience and its shielding
effect on relationship quality and life satisfaction. In: 69th
Annual ICP Conference (International Council of
Psychologists), July 29-August 1-2, Washington D.C.
Gianesini G. (2013). Negotiating Family Challenges by
Transforming Traditional Gender Roles in New Identities: How
patterns of resilience vary by gender, employment status and
age of first child. In Lee Blair (Ed) Contemporary Perspective
in Family Research, Emerald.
3) Study 3: Relational Resilience and Pro-social behavior in
working adults (N = 339).
Reference: Gianesini G. (2010). Resilience as a relational
Competence. CSV. Vicenza.
4) Study 4:The effects of Resilience on adolescent’s substance
abuse and treatment (N= 429)
Reference: Gianesini G. (2013). Adolescents’ adaptive
outcomes and resilience. The importance of a comprehensive,
multidimensional assessment of assets and competencies.
International Conference on Life Design and Career
Counseling: Building Hope and Resilience, June 20-21-22,
Padua, Italy.
ϭϭϭ
Chapter 10 - Study 1: The influence of emotional and relational
resources on parenting quality
There is little evidence in research on whether emotional and
relational competence have a moderating effect on parenting, shielding its
quality from negative influences. Parent’s ways of interacting with the
children are not a separate set of capabilities, but part of the fundamental
identity of the person which is affected by his/her psychological resources
(Leinonen, Solartau & Punamak, 2002). Consequently, the impact of risk
factors such as economic hardship on parenting quality might be expected
to be dependent on the relational and emotional resources (i.e.
competences) of each parent. I then examined the mediating paths between
economic hardship, emotional and relational competence, resilience and
parenting. In this empirical model, the effect of economic hardship on
parenting quality was addressed singling out three nodal points: emotional
competence, relational competence and resilience. The initial question was
whether relational competence, negatively correlated to affect dysfunction
(alexithymia) and implying emotional competence, was powerful enough to
moderate the effect of economic hardship on parenting. Subsequently, I
explored how and whether the three main dimensions of Alexithymia
(affective, cognitive and social) were meaningfully linked to the five
relational competence dimensions of Relational Competence Theory
(ERAAwC model, L’Abate, 1990) and Gottman’s (1996) four parenting
styles. Finally, I analyzed the mediating and moderating effects of
psychological resilience on parenting styles and its relation with emotional
and relational competences
10.1 Emotional competence, Parenting Styles & Alexithymia
Emotional functioning is based on Emotional Competence, which
involves a wide range of skills including the ability to detect one’s own
emotional state, an effective analysis of their causes, and consequences
(Meerum et al., 1989; Saarni, 1999). In social contexts , the use of adaptive
emotion regulation strategies facilitate interpersonal interactions and is
associated with healthier pattern of physical and psychologically
functioning (John & Gross, 2004). The type of parenting children receive
ϭϭϮ
play an important role in their social development, health and problematic
behavior (Lagacé-Sèguin & d’Entremont, 2006). Gottman (1996) proposed
that parents who internalize versus those who express the “emotional”
knowledge of themselves and their children exhibit distinct parenting
characteristics: Emotion Coach, Dismissing, Disapproving, Laissez Faire
(see Chapter 1.2, page. 30). According to Lazarus (2006), emotions can
impair or facilitate psychological adaptation, the accuracy of judgment and
task performance. The adaptive function of emotions deals with attention to
environmental stimuli, internal clues about the interaction with the
environment, priming bodily responses and communication (Schultz et al.,
2005). The attenuated or inappropriately modulate expression of positive
and negative emotions indicate a lack of behavioral responsiveness to
change in the emotional environment, called emotion context-insensibility
(Rottember & Gotlib, 2004). These themes could be used to understand the
relationship between emotion expression and social impairment. In many
contexts, this emotional impoverishment, or lack of emotional competence,
may violate other’s expectations about the interaction as a lack of
emotional-expressive reciprocity and may frustrate, disrupt and erode
interpersonal coordination and relationship quality (Rottember & Vaughan,
2008). Moreover, rigid and unchanging emotional behavior in social
interactions could frustrate the other person desire for dynamic feedback on
their own performance and the state of their relationship. Alexithymia
describes problems in affect regulations, such as difficulties with
recognizing; processing and regulating emotions (see Chapter 1.2, page.
25). Generally, health problems are more pronounced in alexithymic people
whose emotion regulation system have been challenged by strain life
events.
10.2 Participants and procedure
A non-clinical sample of parents (n = 324) with children age 3 to 10 was
recruited in two school districts in Switzerland (Ticino Canton, Riva San
Vitale and Mendrisio) with a participation rate of 40.5%. An overall 800
questionnaire were distributed (400 in each school) to the children, through
their teachers, in a single envelope. Each envelope contained: a) the
authorization from the school principal and the deadline for returning the
ϭϭϯ
questionnaire (13 days later), b) informed consent, c) instructions, and d) two
questionnaires, one for each parent, in two additional envelopes. The parents
who agreed to participate in the study, returned the envelopes to their
children’s teacher. The researchers collected all returned questionnaires at the
school principal office. All material was in Italian language.
10.3 Measures
Relational Competence. Parents’ interpersonal level of functionality
was assessed with the Relational Answer Questionnaire (RAQ, version
2001, Cusinato & Corsi, 2005; Cusinato & Colesso, 2008). This 66 item, 7
factor scale measures the adequacy of the relational answer defined as a
balanced level and use of all five components of the ERAAwC model.
When the single scores for each components are too high or too low, or
scores are not balanced across components, relational competence may be
inadequate and dysfunctional. Its reliability and concurrent validity has
been well established in previous studies (Cusinato & Colesso, 2008;
Cusinato, 2009; Gianesini, 2010 ) and presented in detail in Chapters 1.1
(page 12) of this book. The reliability coefficients for all RAQ subscales in
this study were acceptable, ranging from .76 to .80. (E
feeling,
Į= .80; E
expressed,
Į= .78; R, Į= .86; A, Į= .77; Aw
relational,
Į= .77; Aw
feedback,
Į= .77; C, Į=
.76).
Alexithymia.Parents’ difficulties in experiencing, identifying and
expressing feelings were measure with the Toronto Alexithymia Scale (TAS–
20, Parker, Taylor, & Bagby, 2003). The 20 item, 3 factor scale has been
translated and validated into Italian language in previous studies (Scilletta,
2009; Maino, 2009: Gianesini, Bedini, & Basso, 2009) with reliability
coefficients ranging from .63 to .79. Emotional functioning involves a wide
range of adaptive emotion regulation strategies, including the ability to detect
one’s own emotional state, an effective analysis of their causes, and
consequences (Meerum et al., 1989; Saarni, 1999). These skills in social
contexts facilitate interpersonal interactions and are associated with healthier
pattern of physical and psychologically functioning (John & Gross, 2004)
both in parents and their children . The overall scale reliability for the TAS-20
this study was .70, the alpha for the three subscale were respectively:
TAS
identifying,
difficulties in identifying feelings, Į= .78; TAS
describing,
difficulties
ϭϭϰ
verbalizing feelings, Į= .74; TAS
escaping,
externally oriented style of thinking,
Į= .60.
Parenting styles.The Emotion-Related Parenting Styles Self-Test
(ERPS), an Italian adaptation (Cusinato et al., 2005) of Gottman’s
parenting’s styles (Gottman, Declaire, & Goleman, 1997) was used to have
parents evaluate their perceived emotional responsiveness, warmth and
support toward their children. The type of parenting children receive, and
especially the lack of affection in the child-parent bond, play an important
role in their social development, health and problematic behavior (Lagacé-
Sèguin & d’Entremont, 2006). The Emotion-related Parenting Styles Self-
Test is a 54-item, 4 factor scale measuring four distinct parenting
characteristics: ERPS
emotion coach
, ERPS
dismissing
, ERPS
lassez-fare
, ERPS
disapproving
according to the categorization proposed by Gottman (1996) on
parents who internalize versus those who express and exhibit the emotional
knowledge of themselves and their children. The scale is a revision of a
previous Parenting Style Questionnaire by Cusinato et al. (2000) that
evaluated on a 5 step Likert scale 40 items derived from the 81 originally
proposed by Gottman (1997) on a true-false scale. The Parenting Style
Questionnaire (PSQ), culturally and linguistically adapted to the Italian
population, was validated on a sample of 872 participants from the north-
east of Italy with a reliability coefficient ranging from .62 to .70. It has also
been used, in a 43-item version, in a subsequent study on 402 parents
(Cusinato & Maino, 2008) with a Cronbach alpha ranging from .67 to .91.
The alpha coefficient for the four subscales in this study ranged from .62 to
.75, indicating acceptable reliability (ERPS
disapproving
Į= .75, ERPS
emotion
coach
Į= .75, ERPS
dismissing
Į= 74, and ERPS
lassez-fare
Į= .62).
Resilience.The 2 items version of the Connor-Davidson Resilience
Scale (CD-RIS2, Vaishnavi, Connor and Davidson, 2008) was used in this
study to assess psychological resilience. In the two item version (CD-
RISC2, Į= .78), items 1 and 8 were selected by the authors as the
etymologically capture the essence of resilience. The authors’ items choice
was arbitrary and not empirically based and the sample used to validate the
scale was clinical. The reliability of the CD-RISC in its 25-item original
version (Į= .89) translated into Italian has been established in previous
studies (Gianesini, 2010; Sarchiapone et al. 2009) with a coefficient alpha
of .94 and .80 respectively.
ϭϭϱ
10.4 Results
Thedemographiccharacteristicsofthesamplearesummarizedin
Table 2.1.1. Parents’ age ranged from26to66(M=41.1, SD=5.3), witha
higher participation rate for mothers (n=201, 62%) than fathers (n=123,
38%).
Table 2.1.1. Demographic Characteristic of the sample (N=324).
Range % (n) Mean DS
Age 26-66 41.1 5.3
Fathers 29-66 43.1 5.7
Mothers 26-52 39.8 4.6
Gender
Female 62%(201)
Male 38% (123)
Marital status
Married 84.9% (275)
Cohabiting 5.9% (19)
Divorced Single 3.7% (12)
Divorced Remarried 3.1% (10)
Divorced Cohabiting 1.2%(4)
Single 1.2%(4)
Education
Elementary school 0.3% (1)
Middle school 4.0% (13)
Vocational 41.0% (133)
High school 33.4% (108)
Some College 13.3% (43)
College degree 8.0% (26)
Work
Manager/CEO 25.3% (82)
Self-employed 4.6% (16)
White collar 35.5% (115)
Blue collar 9.3% (30)
Unemployed 1.2% (4)
Housewife 23.8% (77)
ϭϭϲ
The mean age for fathers was 43.1 (SD=5.7, range 29-66) and for
mothers 39.8 (SD=4.6, range 26-52). The highest proportion of the
participants (84.9%) were married, a small portion (5.9%) were cohabiting,
and the remaining divorced currently single (3.7%), divorced and remarried
(3.1%), divorced and cohabiting (1.3%) or single parents (1.2%). Parents’
education ranged from primary school (0.3%) to middle school (4.0%) and
graduate school (21.3%), with 33.3% having an high school diploma and
41.0% a vocational degree. A very low percentage of parents were
unemployed (1.2%), 23.8% were housewife, 9.3% had a blue collar job,
4.6% was self-employed, while the majority (35.5%) has a white collar job
or were business owners, managers/CEO (25.3%).
Table 2.1.2. Children’s Characteristics in the sample (N = 476)
Position Male Female M(years) SD Range
1st child 52.% (171) 47.2% (153) 9.77 4.43 2-40
2nd child 49.5% (151) 50.5% ( ) 7.17 4.38 1-37
3rd child 33.3% (20) 66.7% (40) 7.56 4.17 1-18
4th child 81.8% (2) 18.2% (7) 7.00 3.32 1-11
Total 53.3% (253) 46.7% (222) 8.48 4.55 1-40
Their children’ characteristics are summarized in Table 2.1.2. Age
ranged from 1 to 40 (M=8.5;SD = 4.5), with 53.3% males and 46.7%
females. The number of children ranged from 1 to 4. The majority of
parents (60.3%) had 2 children, 21.5% only 1 child, while 14.3 % had 3
children and 3.8% up to 4 children. The mean and standard deviation of
children’s age were similar: 9.77 for the first child (SD = 4.43, range 2-40),
7.17 for the second (SD=4.38, range 1-37), 7.56 for the third (SD =4.17,
range 1-18), 7 for the fourth (SD=3.32, range 1-11). The gender
distribution for the first child 52,8% and 47,2% (M=171, F=153), for the
second 49,5% and 40,5% (males 150, females 102), for the third 33.3%
and 66,7% (males 20, females 40), and for the fourth 18,2% and 81,8%
(males 2, females 7). The descriptive statistics for all variables and scores
are reported in Table 2.1.3.
ϭϭϳ
The mean scores for the five dimensions of the ERAAwC model in
the whole sample were: 47.8 (SD =8.45)forEmotionality (E
feeling
); and
37.9 (SD = 5.61) for Emotionality (E
expressed
); 36.93 (SD =5.71)for
Rationality; 41.06 (SD=8.34) for Action; 38.65 (SD = 5.17) for Awareness
(Aw
relational
) and 21.64 (SD =4.0)forAwareness (Aw
feedback
) and 32.22 (SD
=6.14)forContext. ThehighestscoresarefoundfortheEmotionality
(E
feeling
), Action and Awareness (Aw
feedback
) dimensions, although all five
components resulted quite balanced. The mean score for Resilience on the
CD-RISC2 was 6.25 (SD = 1.63) (Figure 2.1.4), consistent with the mean
CD-RISC2 of 6.91 found in the general population by Vaishnavi, Connor,
and Davidson (2008).
Table 2.1.3. Descriptive statistics for Relational Competence (ERAAwC,
Resilience (CD-RISC2), Alexithymia (T1, T2, T3 and TAS-20) and perceived parenting
styles (ERPS
)
Mean SD Possible Range
Efeeling 47.80 8.45 10-50
Eexpressed 37.39 5.61 10-50
Rationality 36.93 5.71 10-50
Action 41.06 8.34 10-50
Awrelational 38.65 5.71 10-50
Awfeedback 21.64 4.00 6-30
Context 32.22 6.14 10-50
CD-RISC2 6.25 1.63 0-8
TASidentifying 13.36 5.25 7-35
TASdescribing 11.85 4.27 5-25
TASescaping 18.20 4.7 8-40
TAS-20 43.42 11.3 20-100
ERPS dismissing 38.97 5.91 14-56
ϭϭϴ
ERPS emotion coach 22.97 4.88 14-56
ERPS disapproving 31.67 4.99 13-52
ERPS laissez-faire 39.20 5.62 13-52
As for Alexithymia, which is a normally distributed dimensional
phenomenon, the cutoff score (61) for classifying subjects provided the
opportunity to study its incidence in the sample. 7.7% (25) of the parents in
the sample were Alexithymic, 15.7% (51) were classified as possible
Alexithymic and the majority, 76.5% (248), as non Alexithymia (Figure
2.1.5).
Figure 2.1.4. Resilience scores distribution (N=324)
ϭϭϵ
Figure 2.1.5. Alexithymia scores distribution (N = 324)
The Alexithymia frequency in the sample was much below the rate of
12.8% showed by Salminen et al. (1999) in a sample of 1,285 working-age
subjects and the rate of 10.3% found by Kokkonen et al (2001) in a
population cohort of 5,028 young adults. The distribution for parenting
styles showed the highest score on the four subscales on disapproving
(49.1%) parenting style, followed by dismissing (43,8%) and laissez-faire
(4.9%) while the emotion coach only accounted for a 2.2% of the parents
(Figure 2.1.6). This results also include equal scores in more than one
subscale and are confirmed by the frequency of the less used parenting
style (lowest score on the four subscales) which resulted to be the emotion
coach (91.1%), followed by the disapproving (5.2%), dismissing (2.2%)
and laissez-faire (1.5%).
ϭϮϬ
1=dismissing;2=emotion coach, 3= laissez-faire, 4=disapproving
Figure 2.1.6. Perceived Emotional Parenting Styles distribution
10.5 Perceived Emotional Parenting Styles and Socio-
demographic Variables
The means, standard deviations and difference between fathers and
mothers for the variable in the study indicate that in the sample fathers are
older than mothers (r=-.30;p< .01), and the older the parents, the higher
the mean age of their children (r= .43; p< .01). Men had better qualified
jobs than women (r= .40; p< .01), and the highest educational level
correspondent the more qualified professional occupation (r=-.23;p<
.01). A t-test analysis run to evaluate gender differences in parenting styles
(Table 2.1.4 e 2.1.9) showed a significant difference for the dismissing and
emotion coach style between groups: men seemed to adopt a disapproving
or dismissing parentingstylewhilewomentendtobeemotion coaches.
ϭϮϭ
Table 2.1.4. Gender differences (1=male; 2=female) in Parenting Styles
tg.l. pMean diff. Cohen’s d
ERPS disapproving
3.41 322 0.001 2.27 0.39
ERPS emotion
coach -4.51 322 0.000 -2.45 -0.52
ERPS laissez-faire -0.53 322 0.596 -0.29 -0.06
ERPS dismissing 4.27 322 0.000 2.54 0.49
d<.20noeffect; .20d < .50 small effect; .50 d < .80 medium
effect; d .80 large effect
To explore the relation between parenting styles and education, the
sample was divided into three groups based on the educational level
attened: elementary and middle school (1), high school (2) and college (3).
Results of the means and variance analyses for the four subscale of the
ERPS, in relation to the educational level are shown in Table 2.1.5.
Table 2.1.5. Perceived Parenting Styles and Education
Education NMean DS
ERPS disapproving 1 147 31.88 5.88
2 107 31.28 5.66
3 69 28.81 5.90
ERPS emotion coach 1 147 46.21 4.99
2 107 48.00 4.63
3 69 47.30 4.82
ERPS laissez-faire 1 147 31.96 4.90
2 107 32.89 4.81
3 69 31.17 4.82
ERPS dismissing 1 147 28.71 5.25
2 107 28.22 5.13
3 69 26.19 5.52
1 = elementary/middle school; 2 = high school; 3 = college
ϭϮϮ
Significant difference were found, but with a small effect, between
groups for the disapproving, dismissing and emotion coach parenting styles
(Table 2.1. 6). The majority of disapproving and dismissing parents have
completed elementary or middle school, while emotion coach parents have
at least finished high school. This findings suggest that education does
influence the quality of parenting, the higher the level the more likely the
parent is to listen to the child, to empathize with soothing words and
affection, to offer guidance on regulating emotions, to set limits and teach
acceptable expression of emotions and problem-solving skills.
Table 2.1.6. ANOVA Perceived Parenting Styles and Education
g.l. FpȘ2partial
ERPS disapproving 322 6,70 0.001 0.04
ERPS emotion coach 322 4,41 0.013 0.03
ERPS laissez-faire 322 2,72 0.067 0.02
ERPS dismissing 322 5,53 0.004 0.03
Ș2 < .06 small; .06 Ș2< .14medium;Ș2 .14 large
No significant differences were found between age and parenting style
when the sample was divided into two groups (below or above 40) and the
mean differences analyzed, as shown in Table 2.1.7.
Table 2.1. 7. T-test Perceived Parenting Styles and Age
tg.l. pMean diff.
ERPS disapproving -0.91 322 0.363 -0.60
ERPS emotion coach 0.57 322 0.569 0.31
ERPS laissez-faire -0.43 322 0.670 -0.23
ERPS dismissing -1.64 322 0.102 -0.97
ϭϮϯ
10.6 Alexithymia and Perceived Emotional Parenting styles
In line with previous research (Gottman & DeClaire, 1997; Gottman,
Katz, & Hooven, 1996; Schwartz, Thigpen, & Montgomery, 2006) and the
hypothesis of the study, the correlations between Parenting Styles and
Alexithymia (Table 2.1.8) were all significant except for emotion coach
and T1 (difficulties in identifying feelings).
The disapproving parenting style was positively correlated with
TAS
identifying
(r= .26
**
), TAS
describing
(r= .29
**
)andTAS
escaping
(r= .46
**
), to
indicate that parents with difficulties in identifying and describing emotions
are more likely to judges and criticizes the child’s emotional expression.
This parent’s thinking is mostly externally oriented (TAS
escaping
)with
restricted imagination and concrete, realistic, logical thinking, often to the
exclusion of emotional responses to problems. The correlation between
disapproving and the overall TAS-20 scoresisalsopositive(r= .42
**
).
The emotion coach parenting style inversely correlates with two
subscales of the TAS-20, TAS
describing
(r=-.23
**
), TAS
escaping
(r=-.38
**
)
and the overall score (r=.-28**) as this type of parents is sensitive to the
child’s emotional states, respects the child’s emotions even when they are
subtle, and is not confused or anxious about the child’s emotional
expression.
The dismissing parenting style positively correlates with all three
subscale (TAS
describing,
r= .21
**
;TAS
describing,
r= .29
**
;TAS
escaping,
r= .38
**
)
and the overall score of the TAS-20 (r= .37). This findings confirm that
this type of parents lack awareness of emotions in self and others,
minimize the child’s feelings, downplaying the events that led to the
emotion, feels uncertain about what to do with the child’s emotions and
sees the child’s emotions as a demand to fix things.
Finally, the laissez-faire parenting style correlates positively with all
subscales of the TAS-20 (TAS
describing,
r= .21
**
;TAS
describing,
r= .18
**;
T
3
, r
= .14
**
) and its overall score (r= .23
**
) indicating that all dimensions of
alexithymia contribute to the parenting attitude to freely accept all
emotional expression from the child, and to manage negative emotions as
just a matter of release.
ϭϮϰ
Table 2.1.8. Correlations between ERPS and TAS-20
TASdescribing TASdescribing TASescaping TAS-20
ERPS disapproving .26** .29** .46** .42**
ERPS emotioncoach
-.23** -.38** -.28**
ERPS dismissing .21** .29** .38** .37**
ERPS laissez-faire .21** .18** .14** .23**
10. 7 Resilience and Perceived Emotional Parenting Styles
As expected, the disapproving (r=-.14
*
), and dismissing (r=-.12
*
)
parenting style were significantly and inversely correlate with Resilience,
while the emotion coach parenting style was positively correlated with
Resilience (r= .17). No significant correlation was found between the
laissez-faire parenting style and resilience (Table 14.9). These finding
suggest that parents who fear being out-of-control emotionally, tend to
focus more on how to get over emotions than on their meaning, and
believes negative emotions are harmful show lower level of Resilience.
This seem to further confirm that emotion regulation and emotion-focused
coping strategies enhance the development of more appropriate parenting
styles, that may facilitate resilience in both parents and children.
Table 2.1. 9. Correlations between ERPS and Resilience (CD-RISC)
ERPS: CD-RISC
ERPS disapproving -.14*
ERPS emotioncoach
.17**
ERPS dismissing -.12*
ERPS laissez-faire
ϭϮϱ
The dimensions of the Information Processing model (ERAAwC)
resulted correlated to parenting styles in the direction expected (Table
1.4.10). The disapproving style was inversely correlated with both
subscales of Emotionality (E
feeling,
r= -.21**and E
expressed,
r= -.22**)
suggesting that inadequate or inappropriate access to and regulation of
emotions in a relational context, as in Alexithymia, is reflected in an
ineffective and less-responsive parenting. The correlation with Action (A)
resulted positive (r= .16**), as disapproving parents revolve around issues
of control, productivity and conformity to behavioral standards. This type
of parenting, in fact, shows a greater tendency to respond to relational
stimuli especially with actions and words. Finally, disapproving parenting
style and self-Awareness (Aw
relational
) were inversely correlated (r= -.17**)
to prove that this type of parent not only lack awareness of emotions in self
and others but is also unaware of his own relational answer. These findings
further confirm the existing literature (Gottman & DeClaire, 1997) also
with respect to Alexithymia, as this type of parent privileges externally
oriented thinking, with focus on reality, facts and tangible events. Emotion
Coach parenting style, on the other hand, positively correlates with both
E
feeling
(r= .26**) and E
expressed
(r= .28**), suggesting that an individual
able to trust her own feeling and regulate her own emotions is a parent not
confused or anxious about her own child’s emotional expression of positive
and negative feelings. This is the only parenting style positively correlated
with Rationality (R, r= .20**) to indicate that the cognitive component, a
proper emotion regulation, acceptable expression of emotions, and
problem-solving, is fundamental to a relational answer. The emotion coach
parenting style, in fact, also correlate positively with Action (A, r= .14**)
and Awareness (Aw
1,
r= .30** and Aw
2,
r= .30**). Emotion coach parents
can elaborate on their behavior and the consequences of their actions can
learn from past relational experiences and correct their relational answer
after a feedback. Finally, dismissing parenting style correlates negatively
with Emotionality (E
feeling,
r= -.26** and E
expressed,
r= -.23**) and
Awareness (r= -.13*) and positively only with Action (r= .12*), while
laissez-faire inversely correlate with expressed emotions E
expressed
(r=-
.13*). No significant correlations were found between perceived emotional
parenting styles and Context, as the former are not directly influenced by
contextual factors.
ϭϮϲ
Table 2.1.10. Correlations between ERPS and ERAAwC
ERPS Efeeling Eexpressed R A Awrelational Awfeedback C
ERPS
disapproving -.21** -.22** .16** -.17**
ERPS
emotion coach .26** .28** .20** .14** .30** .30**
ERPS
dismissing -.26** -.23** .12* -.13*
ERPS
laissez-faire -.13*
p< .05;**p< .01
Context, in fact, which is processed affectively, intellectually, and at
various levels of awareness (L’Abate, 2009) and its influence on perceived
emotional parenting styles is not direct but rather mediated by emotionality,
rationality and awareness according to the ERAAwC model. A denial of
context may indicate rigid relational boundaries, with a minimum overlap
and a maximum separation among the five components. On the other
extreme, over intrusion of context indicate permeable boundaries. The
construct of context implies a certain temporal stability to evaluate how
resources are utilized. The overall findings suggest that parenting is a
complex social competence whose important elements of both
responsiveness and demandingness (Maccoby & Martin, 1983) seem based
on emotional recognition and expression, self-regulation and behavioral
control, recognition of child autonomy, awareness and context sensitivity,
as accounted by Relational Competence.
ϭϮϳ
Table 2.1.11. Gender differences
FATHERS
(n=123)
M
OTHERS
(n=201) F Sig.
DISMISSING M=40,29
SD=5,03
M=37,41
SD=6,09
4,75 ,000
EMOTION COACH M=22,04
SD=4,48
M=24,49
SD=5,15
5,13 ,000
DISAPPROVING M=39,84
SD=5.68
M=37,56
SD=6.02
,624 ,001
EMOTIONALITY
Expressed (E2)
M=38,83
SD=7,54
M=42,42
SD=8,53
1,92 ,000
EMOTIONALITY
Experienced (E1)
M=42,83
SD=8.04
M=50,89
SD=7,15
2,47 ,000
Constricted imaginal
p
rocesses
M=19,91
SD=4,58
M=17,15
SD=4,46
,048 ,000
Difficulty in describing
f
eelings
M=12,86
SD=4,20
M=11,23
SD=4,20
,092 ,001
10.8 Structural equation modeling for Relational Competence and
Parenting styles
The interaction effects and the independent contribution of the five
components of the Relational Competence on the dependent variables,
perceived emotional parenting styles, were tested with structural equation
modeling (Figure 2.1.11) using LISREL. The model showed that the
emotion coach parenting style is significantly influenced by Awareness
(Aw
relational
)andEmotionality (E
feeling
), moderated by Awareness
(Aw
feedback
). The disapproving parenting style is positively moderated by
Action (A) but negatively by Awareness (A), while the dismissing
parenting style is negatively influenced by expressed Emotionality
(E
expressed
). Considering the influences among the perceived emotional
styles, it is evident that emotion coach parenting is linked to the least
functional laissez-faire whichisinfluencedbythedismissing parenting
ϭϮϴ
style that reinforces the disapproving style. Because parenting styles are a
typology, differences styles in parenting represents distinct tendencies
towards children emotions. The higher the score in any of the scale the
more the tendency toward that style. However, there is a considerable
amount of overlap between them (Gottman, 1997). The behavior of
dismissing and disapproving parents have much in common and have the
same effects on children, who have not the chance to experience their
emotions and deal with them effectively and will grow up unprepared to
face life’s challenges. Laissez-faire parents, on the other hand, are filled
with empathy and acceptance of their children’s emotions but are over
permissive and their unconditional acceptance will let the children get
away with inappropriate or unfitted expressions of emotions. Their children
end up in much the same position as the children of disapproving and
dismissing parents, lacking in emotional intelligence and unequipped for
the future (Gottman, 1997). In some way emotion coaching parents aren’t’
different from laissez-faire parents, as both appear to accept their children’
feelings unconditionally, without ignoring, denying or belittling their
children’s emotional expression. However, emotion coaching parents go
beyond acceptance to set limits on how to regulate feelings, find
appropriate outlets and solve problem.
As previously noted, there is NO direct link between Context and
perceived parenting styles as contexts are processed affectively,
intellectually, and at various levels of awareness and therefore mediated by
Emotionality, Rationality and Awareness. Contexts represents the
subjective meaning of where an individual has spent a great deal of time in
interactions with others, and where an inevitable emotional attachment has
developed. The construct of context implies a certain temporal stability to
evaluate the utilization of resources and the positive and negative
experiences that determines how the individual feels about a particular
setting. Therefore, the meaning of a context is defined by whether it
implies important relationships, but the level of RC in different settings
determines how the individual perceives that context. Settings, and the
resources exchanged in social interactions, can be used to distinguish
superior, from adequate, to mediocre or inadequate functioning (L’Abate,
2009).
ϭϮϵ
Figure 2.1.12. Relational Competence (ERAAwC) and Parenting
Styles (ERPS) Model
Finally, the model confirm that the dimension of Emotionality and
Awareness are fundamental elements for functional parenting (emotion
coach) and define parenting quality thus confirming that relational
competence includes and accounts for emotional intelligence and for an
adequate relational style with children. Emotional reactions are triggered
when an individual encounter a meaningful relational stimuli (Rottember
& Vaughan, 2008), are regulated by the other components of the model and
expressed during social interactions. Attitude toward emotional expression
may vary depending on what emotion is expressed (Gottman, 1997) and
families may hold different family members to different standards.
However, parents that have strong awareness of their own and their
children’s emotions, even those considered negative, and know how to
R
E
feeling
E
expressed
Aw
feedback
A
C
Aw
relational
ERPS
disapproving
ERPS
emotion coach
ERPS
lassez-fare
ERPS
dismissing
+.14
+.20
+.41
+.15
+.35
+.44
+.71
+.15
–.29
–
.19
–
.92
–.20
+.18
+.12
+.54
+.33
+.35
FIT Indices:
Ȥ² =.55.05
df = 50
p-value = .38
GFI = .98
CFI = 1.0 0
RMSEA = .012
ϭϯϬ
regulate them possess a creative and energizing force, a key human skill,
called emotional intelligence.
10.9 Discussion
As expected, Relational Competence was associated to functional
parenting styles. Emotionality and Awareness seem to be the foundation of
functional parenting probably because strong emotions have a powerful
influence on activating automatic cognitive processes and behaviors that
are likely to undermine parenting practices. Parents who are able to identify
both their own and their child’s emotions by bringing emotional awareness
to the interaction will be able to make conscious choices about how to
respond, rather than react, to those experiences (Dishion, Burraston & Liu,
2003). Relational competence can reflect the parents’ willingness and
ability to endure strong emotions through decentering, noting that feelings
are just feelings, thus allowing them to be more fully present with their
child (Ahern, Kiehl, Sole, & Bywers, 2006). The emotional awareness that
emerges in the social context of parent–child relationships has important
implications for understanding healthy parent–child relationships and for
improving family-focused preventive interventions. Parents who can
remain aware and accepting of their child’s needs and emotions can create
a family context that allows for more enduring satisfaction and enjoyment
in the parent–child relationship and can develop higher quality
relationships with their children and more often avoid cycles of
maladaptive parenting styles (Duncan, L., Coatsworth, J., and Greenberg,
M. (2009).
10.10 Conclusion
Beyond the Emotionality element of Relational Competence, whose
fundamental role in this study had been confirmed, functional parenting
also need to account for a full attention to emotional awareness, and a
certain degree of self-regulation necessarily required in the relationship
context. It involves that in parenting functioning the impulse to display
negative affect, anger, or hostility is felt (E
feeling
) and expressed (E
expressed
),
but the relationally competent parent can pause before reacting in parenting
ϭϯϭ
interactions (R) and behaviors (A). The ways in which parents respond to
their own and child’s emotions and express such emotions have an
important socializing effect (Eisenberg et al.1998). Parents who are tolerant
and supportive and do not dismiss or meet their child’s displays of negative
affect with their own negative affect promote more emotionally and
socially competent youth (Eisenberg et al. 1998; Katz et al. 1999). They
learn to trust their feelings, regulate their own emotions, solve-problems,
have high self-esteem and go along well with others. The effective and
relationally competent parents promote empathizing and encourage the
expression of emotions strengthening the bond with their children
(Gottman et al. 1997). Relational competent parenting comprises the five
interrelated elements described in model ERAAwC, but also reflectes the
different intra-psychic and interpersonal processes within the dynamic
parent–child relationship. When parents bring their relational competence
in the parent–child interactions, they cultivate an enhanced capacity for a
balanced, emotionally responsive, and adequately demanding parenting
that consistently will recognize the child autonomy. Relational competence
enhance an affective parent–child relationship, characterized not only by
greater trust and emotional sharing, but also by flexibility and
responsiveness within the dynamic exchanges of parent–child relations.
This leads to a decreased level of parenting stress, wiser use of parenting
strategies, and in return to greater children well-being. For this reason
relationally competent parenting can be seen as a psychological resource in
stress and coping processes (Lazarus and Folkman, 1984; Folkman 1997)
as it enhances the use of more adaptive coping avoiding potentially
disruptive influences from contextual or parenting-related stress. The
central role of emotion expression in adaptation has been investigated by
many psychologists (Ekman, 1993; Fridlund, 1992) interested in
connecting impaired social functioning to clinical disorders (Keltner &
Kring, 1998; Rottember & Johnson, 2007) mostly depression. Depressed
individuals, in facts, express emotions inflexibility and in ways that are
inappropriate to dynamically changing environmental contexts. The
attenuated or inappropriately modulate expression of positive and negative
emotions indicate a lack of behavioral responsiveness to change in the
emotional environment, called emotion context-insensibility (Rottember &
Gotlib, 2004). In many contexts, this emotional impoverishment, or lack of
ϭϯϮ
emotional and relational competence, may violate other’s expectations
about the interaction and the emotional-expressive reciprocity and may
frustrate, disrupt and erode interpersonal coordination and relationship
quality (Rottember & Vaughan, 2008). Rigid and unchanging emotional
behavior in social interactions could frustrate the other person desire for
dynamic feedback on their own performance and the state of their
relationship. Emotion coaching is a framework for emotional
communication between parents and children that teach them to handle
problems effectively and to form strong, healthy relationships. They learn
to experience fewer negative and more positive feelings, be better able to
soothe themselves, bounce back from distress and carry on productive
activity. The results of this study also indicate that psychological resilience
is significantly accounted for by Relational Competence in parents, and is
specifically influenced by expressed Emotionality (E
expressed
), which
facilitates Action (A), and greatly influenced by Awareness (Aw
relational
and
Aw
feedback
), thus it involves learning processes over a life-time from
continued interactions with intimates and non-intimate others.
10.11 Limits and Future Research
In this study, I investigated the personal and individual characteristics
and resources of each parent. Further research is needed to explore the
couple’s relational (relationship quality, stability and satisfaction) and
circumstantial (number of siblings, age of parents, age of first transition to
parenthood, age difference among children, co-parenting) moderating
effects on parenting quality and their interactions (Cowan, 1991).
Moreover, as children’s developmental stages may moderate the influences
of parental styles particularly in early childhood and adolescence, further
research (in progress) is also needed to investigate those influences. Other
dimensions of Alexithymia should be explained by the components of the
ERAAwC model and resilience levels should be assessed with different
measures. Further research is also necessary to investigate the specific role
of Rationality and Context in enhancing and developing appropriate
parenting styles by paying greater attention to the interaction between
internal and external circumstances and refining the specific predictions
about how input variables influence components.
ϭϯϯ
Chapter 11 - Study 2. Resilience and its shielding effect on
relationship quality and life satisfaction.
In this second study, I investigated whether Resilience moderates the
influence of negative life events on marriage quality and life satisfaction,
shielding it from negative effects. The underlying relationship between
adult psychological resilience (Resilience Scale,RS-14, Wagnild & Young
,1993; Connor-Davidson Resilience Scale, CD-RISC, Connor & Davidson,
2008), marriage quality (Intimacy Anxiety Scale, IAS, Descutner &
Thelen, 1991; Salvo, 1998) and life satisfaction (Satisfaction with Life
Scale, SLC, Diener et al., 1985) was tested in a non-clinical sample of
heterosexual couples (N=159) , age 23-78 (M=45.4, SD = 11.2).
Moreover, I further verify whether the impact of negative life events (Life
Events Scale, LES, Adapted from Holmes-Rahe Social Readjustment
Rating Scale, 1967) on both relationship quality and life satisfaction could
be dependent on the resilience levels of each partner and their ratio.
Finally, individual ability to share “hurt feelings” (Sharing of hurt feelings,
SHF, L’Abate, 2010), that is unpleasant, painful, and harmfully affects
experienced from negatively perceived life events could foster intimacy
within couples, strengthen their resilience and improve their life
satisfaction. Results confirmed these hypotheses at the individual level,
showing no direct correlation between negative life events and resilience.
However, work situation and age of first child interacted and affected
Resilience unexpected ways. At the couple level, findings evidenced how
resilience and the ability to share hurt feelings differently affect life
satisfaction and intimacy for husbands and wives. Traumatic life events had
a significant and negative influence on Life satisfaction and the ability to
Share Hurt Feelings only for husbands.
11. 1 Introduction
Normally marriage quality and life satisfaction depends on numerous
individual, relational and contextual variables. Resilience has been studied
with reference to potentially traumatic events, which can affect the
individual wellbeing as well as their intimate partners. I planned this study
building on the assumption that resilience is a relational resource and thus
ϭϯϰ
need to be evaluated in both partners at the same time to account for its
mediating effects on relationship quality and life satisfaction. Moreover,
individual who experience potentially traumatic events may need to
reorganize their life as well as their significant relationships. It becomes
necessary, then, to account not only for each partner resilience in face of
past and future adversities, but also for the ratio of such resiliencies within
the couple. Each partner‘s ability to preserve their own identity and
wellness and, at the same time, to develop intimate relationships is a mean
to ease the many difficulties of life. Relationship quality and life
satisfaction are functional and natural outcomes for resilient couples. Our
tested the hypothesis 1) the impact of negative life events on relationship
quality and life satisfaction dependents on the resilience levels of each
partner and their ratio.; 2) the individual ability to share “hurt feelings”
within a couple fosters intimacy, strengthens resilience and improves life
satisfaction.
11.2 Participants and procedure
A self-report questionnaire was administered to a non-clinical sample
of heterosexual couples (N=159) recruited in the Northeast part of Italy.
Participants were all legally married, age 23-78 (M=45.4, SD= 11.2), with
at least one child (n= 127, age range 2-54, mean=21,44, SD=10,40) or
childfree (n=32), Their educational level was above the country average
with 36.5 % having a high school diploma, 23,6% a middle school
diploma, and 6.4% a college degree. They were employed as white
(20.1%) or blue collar (24.2%) with an 18.9% represented by non-working
partners (student, homemaker or retired). I then calculated the resilience
levels of each partner, their ratio, the power of their difference and the
differences in number of negative live events experienced by each partner.
11.3 Measures
The Resilience Scale (RS-14) by Wagnild and Young (1993) and the
Connor-Davidson Resilience Scale, CD-RISC (2008) were selected to
assess adult psychological resilience. Marriage quality was measures using
the Intimacy Anxiety Scale, IAS, by Descutner e Thelen (1991) and the
Sharing of Hurt Feeling Scale by L’Abate (2010) as the ability to share
ϭϯϱ
unpleasant, painful, and harmfully experiences fosters intimacy. Life
satisfaction was assessed using Satisfaction with Life Scale, SLC by Diener
et al. (1985) while the number of negative life events, potentially traumatic,
was calculated using the Life Events Scale, LES, adapted from Holmes-
Rahe Social Readjustment Rating Scale (1967). Participants were also
asked about their current involvement with associations of volunteers, as a
measure of prosocial behavior.
11.4 Results
Resilience resulted significantly and positively correlated with the
ability to share hurt feelings, as a measure of intimacy, and life satisfaction,
while was negatively related to fear of intimacy. The number of traumatic
life events experienced by the individual was correlated significantly with
the ability to share hurt feelings and negatively with fear of intimacy. Also,
resilience resulted significantly and positively correlated to pro-social
behavior (volunteerism), work, educational level and age. The number of
traumatic life events was significantly and negatively correlated to
education while there was no direct relationship between negative life
events and resilience (Table 11.1).
Table 11.1: Correlations between variables of interest
Sharing of Hurt
Feelings
Satisfaction
with Life
Fear of
Intimacy
Resilience (RS-14) 0,29** 0,59** -0,41**
Resilience (CDRISC) 0,09 0,55** -0,34**
Traumatic Life Events (LES) 0,15** 0,12* -0,16**
ϭϯϲ
11.5 Individual Level of analysis
Resilience was significantly and positively correlated with the ability
to share hurt feelings (RS14=0,29**) and life satisfaction (RS14=0,59**,
CDRISC=0,55**) and negatively with fear of intimacy RS14=-0,41**;
CDRISC=-0,34**). The number of traumatic life events experienced by the
individual is correlated significantly with the ability to share hurt feelings
(0,15**) and negatively with fear of intimacy (-0,16**). Resilience
resulted significantly and positively correlated to pro-social behavior
(volunteerism), work, educational level and age. The number of traumatic
life events was negatively correlated to education while there was no direct
relationship between negative life events and resilience.
11.5.1 Resilience and Employment
The two Resilience Scales employed in this study (CD-RISC and RS-
14) seemed to measure the same construct, although the CD-RISC scale
registeredamoresensitivechangebetween white (2) and blue (3) collar
workers. Professionals with responsibilities or self-employed (1) showed
the higher level of Resilience, while retired individuals (5) had the lowest.
As both white-collar workers, unemployed, student or homemakers
exhibited similar level of resilience, significantly lower than professional
but significantly, higher than retired individuals, I could assume having a
sample of married couples that those in this category had somehow still
access to resources through their partners, probably belonging to category 1
or 2. Retirement, on the other hand, for one or both partners, seemed to
correspond to dramatically low levels of resilience (Figure 11.1).
ϭϯϳ
Figure 11.1: Resilience & Employment (n=254)
Legenda: Occupation: 1 = CEO 2= white collar 3=blue collar
4=unemployed, student, housewife
5=retired
11.5.1 Age of first child
Unexpectedly, the age of the first child (range 2-54, M=21.4,
SD=10.4) significantly interacted with resilience and employment. Changes
in resilience level according to the age of the first child strongly vary
depending on the occupation of the parents. The lowest level was found
for parents with blue-collar jobs, growing a teen or a young adult.
ϭϯϴ
Figure 11.2 Resilience, Employment & Age of First Child (n=254)
Legenda: Age first child (F1eta5) : 1= 2-12 2=13-18 3=19-30
4=31-45
ϭϯϵ
The age of the first child (F1AGE, range 2-54, M=21.4, SD=10.4)
significantly interacted with resilience and work, and in this case the two
scales (CDRISC and RS-14) registered different resilience levels, although
similar patterns. When the first child of the couple was already a mature
ϭϰϬ
adult (purple line, age 31-45) resilience levels interacted with profession
following the pattern previously seen in Figure 11.1. However, this
pattern changed dramatically according to the child age, with resilience
initial base-line levels gradually increasing with the age of the first child,
thus starting with the lowest point when the child was still in childhood
(blue line, age 2-12) and reaching the highest when the first child was a
mature adult (purple line), as previously reported. These changes in
resilience level according to the age of the first couples’ child also strongly
varied depending on the occupation of the parents. The lowest level was
found for parents with blue-collar jobs having a teen (green line, age 13-18)
or a young adult (golden line, age 19-30) as first child.
11.6 Couple Level of Analysis
116.1 Resilience
On the CDRISC scale, husband (51.6%) score higher than their wife
than on the RS14 scale where wife scored higher (45%). A higher
percentage of balanced scored (11.9%) was also found for the RS14
compared to the CDRISC scale (only 3.8%). A higher resilience difference
between partners, despite its direction, negatively affect life satisfaction
only for wives (-,161) and the ability to share hurt feelings and create
intimacy for both partners equally (-,161). On the RS14 scale a resilience
imbalance in the couple at the husband disadvantage was related to a lower
life satisfaction for both partners (-.216 for wife and -.336 for husband) and
difficulties in sharing hurts feeling and thus creating intimacy for husbands
(-,200). A greater resilience difference or imbalance (as absolute value)
between partners, despite its direction, affected life satisfaction only for
wives (-,293), the ability to share hurt feelings thus creating intimacy for
both partners (-,230;-,213) and increased fear of intimacy for both partners
(,215; ,355). On both the CDRISC and the RS14 resilience scales, the
percentage of imbalanced couples was high (57.9% and 47.8%
respectively). Such difference in resilience levels at the husbands
disadvantage was related to a lower life satisfaction (-,354) and a higher
fear of intimacy (,158) only for the husbands. (Figure 11.3).
Figure 2. Effect of Sharing of Hurt Feelings in partners on Satisfaction with Life, Fear of Intimacy and Resilience
142
11.6.2 Traumatic life events
The number of live events has a significant and negative influence on
Life Satisfaction (-0.388) and the ability to Share Hurt Feelings (-0.215) for
husbands, but NOT wives. Negative life events influenced relationship
quality (ability to share hurt feelings, fear of intimacy and intimacy
anxiety) life satisfaction and resilience levels reciprocally. Significant
gender differences were found (more effects for husbands). The ability to
share hurt feelings improves life satisfaction and decrease the fear of
intimacy for both partners, fostering it, although at different degrees. The
wife’s ability to share hurt feeling and fostering intimacy in the couple
strengthens both her and her husband resilience while the husband’s ability
to share hurt feeling seem to have NO effect on the resilience levels of
either partner.
11.6.3 Sharing of hurt feelings
Sharing of hurt feeling for wives contributes significantly to the
satisfaction with life for wives (t = 3.543, p = .001) with a significant effect
at the p < .001 level [F (2,156) = 8.971, p =.000]. Sharing of hurt feeling
for husbands contributes significantly to the satisfaction with life for
husbands (t = 2.157, p = .033) with significant effect at the p < .05 level [F
(2,156) = 3.756, p = .026].
Table 2. Couple level Pearsons’ correlation coefficients, t-test and ANOVA
ϭϰϯ
Sharing of hurt feeling for wives contributes significantly to decrease
fear of intimacy for wives (t = -7.191, p = .000) with a significant effect at
the p < .001 level [F (2,156) = 28.780, p = .000]. The sharing of hurt
feelings for wives (t=-4.927, p= .000) and husbands (t=-.3.352, p=-001)
both contributed significantly at the p < .001 level [F (2,156) = 22. 411, p =
.000] to decrease the fear of intimacy for husbands. Sharing of hurt feeling
for wives contributed significantly to Resilience RS14 for wives (t = 6.404,
p = .000) with a significant effect at the p < .001 level [F (2,156) = 22.612,
p = .000]. Sharing of hurt feelings for wives contributed significantly to
resilience RS14 for husband (t=3.553,p=.001) with a significant effect at
the p < .01 level [F (2,156) = 7.777, p = .001]. There wasn’t a significant
effect of sharing of hurt feeling for wives and sharing of hurt feeling for
husbands on Resilience CDRISC for wives at the p < .10 level [F (2,156) =
1.121, p = .329]. However, sharing of hurt feelings for wives contributed
significantly to resilience CDRISC for husbands (t=2.619,p=.010) ) at the p
< .01 level [F (2,156) = 4.869, p = .009].
11.7 Conclusions
Data confirmed that the impact of negative life events on relationship
quality and life satisfaction dependents on the resilience levels of each
partner and their ratio. The ability to share hurt feelings within a couple
improves life satisfaction for both partners ONLY if possess by both
partners. The ability to share hurt feeling in each partner in the couple
diminishes the fear of intimacy for both husbands and wives thus fostering
it, although at different degrees (Hypothesis 2). The wife’s ability to share
hurt feeling and fostering intimacy in the couple strengthens their own
resilience level only when measured by the RS14 and the resilience levels
of their husband when measured by both the CDRISC and the RS14 scale.
On the contrary, the husbands’ ability to share hurt feeling seem to have no
effect on the resilience levels of either partner.
ϭϰϰ
Chapter 12 – Study 3. Relational Resilience and Pro-social
behavior
As the relational and social dimension of Resilience have been widely
recognized in literature (Walsh, 2010), in this third study I attempted to
capture the link between resilience (Connor-Davidson Resilience Scale,
CD-RISC, Connor & Davidson, 2008; Resilience Attitude Scale, RAS,
Biscoe & Harris,1994) and relational competence (RAQ, Relational
Answer Questionnaire, L’Abate & Cusinato, 2010) while evaluating their
incidence in the general population. Data from a sample of 339 adults age
17 to 74 (M= 40.7, SD = 13.1), with and without children, recruited at
different
Working sites through participating companies and organizations of
volunteers were analyzed through multiple regression and structural
equation modeling and compared based on their pro-social behavior
(volunteering). Results further indicated that resilience was significantly
accounted for by Relational Competence and that high level of Relational
Competence corresponded to high levels of Resilience, which involves
emotional, cognitive, social and learning processes over a lifetime from
continued interactions with intimates and non-intimate. Results also
showed a significant difference between the two groups. For volunteers, in
facts, the ability to express emotions and an increased awareness
contributed to Resilience. However, awareness could also decrease
resilience while it was positively influence by it, in a reciprocal interaction.
Resilience also appeared to moderate the effect of contextual influence as
well.On the other hand, for non-volunteers behavior (Action) contributed
in building Resilience, which in this case was negatively influenced by
contextual influences and not only awareness. Finally, findings confirmed
that the incidence of Relational Competence and Resilience were both high
as in the selected sample the majority of participants (54.3%,) were both
resilient and relationally competent .This study represented a new and
challenging line of inquiry on Resilience focusing on its relational factors
and its dependence on the context in a non-clinical sample.
ϭϰϱ
12.1 Introduction
Data from a sample of 339 adults, aged 17 to 74, collected among
employees of corporations and organizations of volunteers*, were used to
analyze resilience in light of Relational Competence Theory (RCT, L’
Abate, 2010). Results confirmed that resilient individuals have excellent
emotional and cognitive abilities, are aware of both their strengths and
limitations, and take actions that benefi t others without any expectation for
later reward. They can elaborate and learn from previous relational
experiences, even negative, but this process seems to both enhance and
reduce their resilience. This study proved that resilience needs to be looked
at not only as an individual resource (high versus low scores), but also as a
relational process that varies from individual to individual, in different
contexts, and in facing different challenges. The fi ndings bring new light
to the understanding of the interpersonal processes involved in the ability to
withstand and rebound from adversities, the nature and components of
resilience, and the mechanisms behind it. study proves that resilience need
to be looked at not only as an individual resource (high versus low scores),
but also as a relational process that varies from individual to individual, in
different contexts, and facing different challenges. The findings bring new
light to the understanding of the interpersonal processes involved in the
ability to withstand and rebound from adversities, the nature and
components of resilience, and the mechanisms behind it, but also open new
challenging questions on the optimal level of relational competence and
resilience that better predict more adequate different trajectories of
adjustment in face of actual adversity. Considering its dynamic,
contextual, and also attributional nature, we believe that resilience needs a
competence-based approach, grounded in a developmental systemic
perspective that emphasizes collaborative processes, strengths, resources,
and context. This article will explore and empirically verify the contribute
of relational competence theory to resilience research focusing on those
interpersonal characteristics that support efforts to promote harmony and
balance during developmental transitions, changes over time, crisis and
prolonged challenges.
ϭϰϲ
12.2 Relational Resilience
Whether it is best to consider resilience as a single, underlying
psychological quality or a series of related, but distinct qualities remains a
major theoretical and measurement issue. Current evidences suggest that
the idea of overall resilience is of questionable utility. Indeed domain
specificity seems more useful in research and practice applications than a
global definition of resilience (Neill & Dias, 2000). I proposed model
ERAAwC of relational competence theory, a multidimensional construct
consisting of a hierarchy of specific abilities and skills (emotions,
cognitions, actions, awareness, and context sensibility), as the conceptual
framework for relational resilience (Cusinato & L’Abate, 2010; L’Abate,
2005, 2008; L’Abate & Cusinato, 2007; L’Abate, Cusinato, Maino,
Colesso, & Scilletta, 2010). Model ERAAwC, is a circular, internal process
for understanding the development of personality socialization from Eto C
(L'Abate, 1986, 1994, 1997). It describes an almost invariant sequence of
steps in an information processing that starts with Emotionality (expressing
and sharing feelings), progresses to Rationality (negotiation and problem-
solving about pros and cons of possible courses of action), finds agreement
or consensus about which particular course of action (A) to follow, and
verifies its effectiveness (Aw for Awareness). It takes place as a dialogue
within the self and the overarching influence of Awareness as a change
agent and the acknowledgment, denial, or ignorance of context (C).
Without the consideration of such contextual influence, Awareness may
remain a futile, redundant exercise in rumination and obsessive-compulsive
thinking (L’Abate, 2009). This model and its theory are presented in details
in Chapter 1.
12.3 Participants and procedures
The sample (N. 339) was collected in the period February 19th –
September 30th 2010 at different sites in the northeast part of Italy,
province of Vicenza, and very much depended on the level of cooperation
elicited by the companies and organizations which agreed to participate to
the project, on their employees and associates. The questionnaires and
ϭϰϳ
inform consents were distributed by hand to each employee and associate
by their employers. An electronic version on the questionnaire was also
posted online on the Department of Applied Psychology’ web site
(www.unipd.dpa), the Interdisciplinary Research Center for Family
Studies’ web site (www.dpss.psy.unipd.it/cirf), and a local Observatory for
Social Policies (www.ops.provincia.vicenza.it). The “organizational”
subsample, consisting of data collected at participating companies had a
return rate of about 45% , with 167 participants (49.3%), while the “social”
subsample, collected online and through CSV among its volunteers,
represented 50.7% (172) of the overall sample.
13.4 Demographic Characteristics of the sample
The demographic characteristic of the sample are reported in Table
13.1 Age ranged from 17 to 74 (M= 40.7, SD = 13.1), with 161 males
(48,06%) and 174 females (52.94%). The highest proportion of
participants (61.66%) were cohabiting or married, a smaller portion (25,95)
were single, and the remaining engaged (3.7%), divorced and remarried
(3.1%), divorced and cohabiting (1.3%) or single (1.2%). Participants’
education ranged from primary school (0.6%) to graduate school (6.8%),
with 16.8% having completed middle school, 13.6% vocational school,
18.6% some college, 13.9% having a college degree and the majority a
high school diploma (39.6%). In term of employment status, a very low
percentage of participants were housewives (1.21%) or unemployed
(2.4%), 4.5 % were students, 5.7% self-employed, 9.4% professionals,
business owner or CEO, while the majority were white (36.6%) and blue
(25.7%) collar and a 14.2% retired. The majority of participants (34%,
n=90) had no children, 21.2% (n=72) had one child, 20.6% (n=70) had two
children, while 9.1% (n=31) had 3, and only a 0.5% (n=1) had four and five
children. The number of children range from zero to five, with a mean of
1.18 (SD=1.07), their age ranged from one to 41 (M=8.5;SD =4.5),
53.3% were males and 46.7% females. The mean and standard deviation of
children’s age were 18.13 for the first child (SD = 11.56, range 1-41), 16.42
for the second (SD= 10.05, range 1-43), 15.21 for the third (SD = 10.04,
range 2-36), 11.66 for the fourth (SD = 12.66, range 2-26), 4 for the fifth
(SD = 2.82, range 2-6). The sample seemed representative of an adult non-
ϭϰϴ
clinical population, for gender, age, employment status, education and
number of children. However, the sample has to be considered someone
privileged in term of marriage stability, being that the majority of the
subjects at their first marriage or cohabitation.
Table 12.1. Demographic Characteristics of the sample (N=339).
13.5 Measures
Cronbach’s alpha was used to determine the internal consistency of
the overall scale, which yielded a satisfactory reliability for the Resilience
Scale (RS, Į=. 87) and the Relational Answer Questionnaire (RAQ, Į=.
ϭϰϵ
87). The reliability of the RAQ scales in this study were all acceptable,
ranging from .76 to .80. (E1,Į= .80; E2, Į= .78; R, Į=.86; A, Į= .77;
Aw1, Į= .77; Aw2, Į= .77; C, Į= .76). The internal consistency of the
Resilience Attitude Scale for the overall scale (RAS, Į= . 64) was not
satisfactory so the General Resilience subscale only as used (.74). Due to
the low internal consistency of the RAS scale, it was not include in the
SEM analysis. The questionnaire items were first recoded and then the total
resiliency scores for RS-14, RAS and RAQ were computed by adding up
responses to each item to obtain the respondent's raw score. The RAS
Resiliency index (RI) was obtained multiplying the total score obtained
adding the scores of the 72 items, by 10 and then dividing it by 36.
13.6 Results
Descriptive statistics for all variable of interest are reported in Tables
13. 2 and 13.3. The mean scores for model ERAAwC’s dimensions in the
sample were 46.6 (SD =4.56)forEmotionality (E1), 38.7 (SD =3.7)for
Emotionality (E2); 32.86 (SD=3.38)forRationality;29.94(SD =3.52)for
Action; 30.73(SD =3.80) for Awareness (Aw1)and 21.32 (SD =2.63)for
Awareness (Aw2) and 30.49 (SD =3.70)forContext. The highest scores
were found for the Emotionality (E1 and E2), Awareness (Aw1) and
Context dimensions, the lowest score for Aw2 and Action although all five
components resulted balanced.
Table 13.2. Relational Competence Scores (Model ERAAwC) (N=339)
Efeeling Eexpressed Rrelational Aperformance Awrelational Awfeedback Csensitivenes
Median 46.62 39.00 33.00 30.00 31.00 21.00 30.00
SD 4.56 3.76 3.38 3.52 3.80 2.63 3.70
Variance 20.82 14.14 11.47 12.43 14.45 6.92 13.70
Skewness -.03 .15 -.23 .09 2.5 .15 .13
Minimum 34.00 26.00 20.00 21.00 22.63 15.00 20.00
Maximum 59.00 52.00 42.00 40.00 67.00 29.00 41.00
ϭϱϬ
The mean score for Resilience on the RS-14 was 50.70 (SD =6.10)
while on the RAS was 251.27 (SD = 20.59). The mean Resiliency Index for
the RAS scale was 69.79 (SD = 5.72), a little higher than the 65.5 reported
by the scale authors (Biscoe & Harris, 1994) on a clinical sample and a
little below the mean score of 71.94 (SD =4.40) reported by Haslee Sharil
Lim Abdullah (2003) on a sample of 615 Malaysian counselors. In that
sample the RI was normally distributed with a skewness of .10 and the
minimum and maximum were respectively 55.81 and 86.45 with males
scoring slightly higher (72.16) than females (71.65). In the current study,
the minimum and maximum values for the RI were 56.94 and 86.67, for the
overall RAs 205 and 312 and for the RS-14 28 and 65 respectively and the
distribution normal. The number of subjects having a Resiliency Index of
below 70, operationally considered NON-resilient, were 155 (45.7%) while
54.4 % (184) were resilient (see Table 13.3).
Table 13.3. Resilience Scores (RAS and RS-14) (N=339)
Resilience Minimum Maximum Mean SD
Resilience
Index (RI)
56,94 86,67 69,79 5,72
RAS
overall
205,00 312,00 251,27 20,59
RS-14 28,00 65,00 50,70 6,10
ϭϱϭ
13.6.1 Volunteerism, Sample Type, Gender and Resilience
Resilience levels, as expected, were different for subjects who
reported involvement in social volunteering (n= 196) and among them I
found the higher percentage of resilient individuals (59.7%, n=117).
Resilience levels were also different for subjects in the organizational (n=
167) versus social (n= 172) subsample. In the organizational subsample
the percentage of non-resilient subjects was higher (59.9%, n=100)than
the resilient (40.1%, n= 67) while in the social subsample I found more
resilient (68%, n= 117) than non-resilient (32.0%, n= 55) individuals.
Gender differences both also emerged for resilience and volunteerism.
Participation in social volunteering was higher for women (60.9%, n= 106)
than men (53.4%, n= 86) and women were more resilient (51.3%, n=174)
than their male counterpart (47.5%, n= 161).
13.6.2 Relational Answer Factors (RAQ) & Resilience (RS-14)
To further analyze the relationship between Resilience and Relational
Competence, for each factor of the ERAAwC model I computed high and
low scores considering one standard deviation above the mean values for
that factor as HIGH score, and below that value as low. I then examined
how resilience (RI row scores above 70) on the RAS scale were related to
high/low scores on Relational Competence factors. All (100%) resilient
subjects scored high on all ERAAwC factors but Emotionality (E2).
Interestingly, those who scored high on expressed Emotionality (E2)
resulted to be mostly non-resilient (86.4%, n= 159), while only the
remaining 13.6% (n= 25) scored above the cutoff of 70 on the RAS. The
mean value for resilient individuals on the Factor E1 was 46.64 (SD =
4.51), with a range 36-59, very similar to the mean and standard deviation
of the whole sample but with a different range 34-59. The mean value for
resilient individuals on the factor E2 was 38.89 (SD = 3.63), with a range
30-52 different from the distribution for the whole sample just in the range
26-52. Individuals scoring high on Rationality (R) resulted to be all
resilient (100%, n= 184). The mean value for resilient individuals on the
factor R was 32.91 (SD = 3.42), with a range 20- 42 as for the whole
sample. Individuals scoring high on Action (A) also resulted resilient
ϭϱϮ
(100%, n= 184) with a mean value on the factor A of 29.3 (SD = 3.45), and
a range 21-40 as in the whole sample. All individuals scoring high on
Awareness (Aw1) were also resilient (100%, n= 184). The mean value for
Resilient individuals on Factor A was 31.72 (SD = 4.07), with a range 22-
67, similar to the whole sample. Individuals scoring high on Awareness
(Aw2) were all Resilient (100%, n =184). The mean value for resilient
individuals on the Factor A was 21.92 (SD = 2.60), with a range 15-29
similar to the whole sample. Individuals scoring high on Context (C)
resulted all Resilient (100%, n= 184). The mean value for Resilient
individuals on the Factor A was 29.25 (SD = 3.56), with a range 20-41.
13.6.3 Correlations between demographics characteristics and
outcome variables.
In this study only Resilience raw scores on the RS-14 were positively
correlated to gender (r= 0.20, p< .001). Resilience Attitude raw scores
(RAS) were positively correlated with age (r= .20, p< .001), number of
children (r=0.18, p< .01), and negatively with sample type (r=-0.16, p<
.01 ), indicating a higher resilience score on the RAS for the organizational
subsample. The overall row RS and RAS scores were also positively
correlated (r= 0.25, p< .001) with each other. Sample type (organizational
vs. social) was positively related to Relational Competence factors
Rationality (r= .24) and Action (r= .11), and Resilience scores (RS, r=
.19; RI, r= .26) indicating higher scores for the social sub-sample but
negatively to Volunteering (r= -.37), thus indicating a greater participation
in social volunteering among organizational workers. Volunteering was
significantly and positively correlated with cohabiting with other members
of the extended family (r= .13) and negatively with age (r=-.21),
education (r= -.22), and number of children (r= .-13) indicating that
individuals who are pro-socially active are younger, less educated, and with
less children. Among the seven factors of Relational Competence,
Emotionality (E2) correlated positively only with the overall RS-14 score (r
= 0.17). Rationality and Action resulted significantly and positively
correlated to the overall RS-14 (r= 0.127) scores. Awareness (Aw1 and
Aw2) were correlated with measures of Resilience. Context was negatively
correlated with the Resilience overall scores RS-14. These results seem to
ϭϱϯ
show that Relational Competence factors account for different aspects of
Resilience at various degrees and with different weights. However,
Awareness (Aw 1 and Aw2) ,as expected, is the most important dimension
involved in Resilience, followed by Rationality and expressed Emotionality
(E2). On the contrary, Context sensitivity and influence seem to decrease
the individual ability to rebound from adversities.
13.6.4 T-test for equality of means
Tests of Between-subjects Effects revealed educational level
differences for ERAAwC factors Rationality, Action and Awareness
(Aw1), Resilience overall scores (RAS and RS-14) and all RAS subscales.
Differences for number of children also emerged in ERAAwC factors
Rationality, Action, Awareness and Context.. Significant differences were
also found for volunteering on factors Emotionality (E1 and E2), Context,
and Resilience (RS-14). Similarly, volunteers differed from non-volunteers
on Relational Competence factors Emotionality (E1 and E2) and Context,
and RS-14 resilience score with higher scores volunteers. A t-test analysis
run to evaluate gender differences in Relational Competence and Resilience
scores showed a positive significant difference for both RS-14 and RAS
scores, and all Relational Competence factors but Awareness (Aw2) with
higher scores for women on Emotionality (E1), expressed Emotionality
(E2), Resilience (RAS and RS-14), and higher scores for men on ERAAwC
factors Rationality, Action, Awareness and Context.
13.6.5 Structural equation Modeling
To investigate whether the separate dimensions of relational
competence make a meaningful contribution to resilience two different path
analysis, one for volunteers and one for non-volunteers were performed
using LISREL. In accordance with the hypothesis of the study, the results
suggested that the components of Relational Competence capture important
aspects of resilience. Specifically, Expressed Emotionality (E2), Rationality
(R), Action (A) and Awareness (Aw1) at various degrees define Resilience
while Awareness as feedback (Aw2) and Contextual influences (C2)
seemed to strongly moderate it. In return, resilience increased Awareness as
ϭϱϰ
feedback, while expressed Emotionality (E2) influenced Action (A) in
terms of performance. Interestingly, the information processing model
ERAAwC resulted quite different for volunteers (Figure 13.1) and non-
volunteers (Figure 13.2).
Figure 13.1. Relational Competence factors (Model ERAAwC) and resilience
(RS-14) in Volunteers (n=196).
For volunteers elicited Emotionality (E1) was directly and positively
connected to Action (A), expressed Emotionality (E2) and Context (C). On
the other hand, expressed Emotionality (E2) was only positively related to
Awareness (Aw1) and resilience. There was a direct link between both
Rationality (R) and elicited Emotionality (E1) on Action (A) although the
relationship was stronger for the former than the latter. Both Awareness
(Aw1) of own resources and expressed Emotionality (E2) were positively
connected to resilience, while Awareness as a feedback from others (Aw2)
negatively influenced resilience. Both resilience and expressed
Emotionality (E2) were negatively related to Context (C). Therewasno
direct link between Action (A) and Resilience, neither between expresses
Emotionality (E2) and Action (A), as in this case it was elicited
Emotionality (E1) that had a direct influence on both Action (A) and
expressed Emotionality (E2).
ϭϱϱ
Figure 13.2 Relational Competence factors (Model ERAAwC) and resilience (RS-
14) in NON Volunteers (n=136).
For non-volunteers there was no direct connection between
Rationality (R) and Context (C) as mostly it was connected to Awareness
(both Aw1 and Aw2) and Action (A). Expressed Emotionality (E2) had no
an impact on Context (C) but rather on Action (A), Awareness of own
resources (Aw1) and resilience. Similarly, there was no direct influence of
elicited Emotionality (E1) on Action (A) as expressed Emotionality (E2)
mediated it. There was a direct connection between Action (A) and
Resilience, while the latter seemed to be negatively influenced by Context
(C). It was Awareness of self-resources (Aw1) to negatively influence
Contexts (C) rather than expresses Emotionality (E2). Awareness (Aw2) as
feedback also had a stronger negative influence on Resilience than for
volunteers (-0.98 versus -0.69). Similarly, Action (A, 0.58) and expressed
Emotionality (E2, 0.76) seemed more strongly connected to Resilience
(0.58) in non-volunteers. Specifically, for volunteers, the first emotional
response in relationship with others (E1) was strongly (.65) connected to
the expression of such emotions (E2), the consequent behavior of choice
(A) and its impact on others (C). The Awareness of self and own resources
(Aw1)resultedinResiliencewhiletheAwareness originated from external
feedback (Aw2) seemed on one side to influence Resilience negatively
while it was also positively influence by it. Resilience appeared to
ϭϱϲ
moderate the effect of Context. Action (A) was not an influential factor in
the model, while Rationality (R) guided Awareness (Aw1), Action (A) and
Context sensibility (C). In the case of volunteers, thus Resilience was
enhanced by Awareness of self and own relational resources (Aw1),
sustained by the ability to express emotions (E2) and was primary utilized
to moderate contextual influences (Context) and increase the ability to
elaborate the feedback from previous experiences. The relational
dimensions Rationality (R) and Emotionality (E1) emerged as fundamental
to individuals involved in pro-social activities as they both lead to Action
(A), the first also facilitating awareness (both Aw1 and Aw2) and the
second the ability to express emotions (E2) and to account for contextual
influences (C).
On the other hand, for non-volunteers, Resilience seemed to result
from Awareness of self and own resources (Aw1), Action and emotion
expression (E2) but was negatively influenced by both contextual
influences ( C ) and the Awareness as feedback (Aw2). Thus resilience
seemed to be enhanced by activity (A), but negatively affected by feedback
from previous experience (Aw2) and contextual influences (Context)andit
had only the function of increasing the ability to elaborate the feedback
from previous experiences. The relational dimensions Rationality (R) and
Emotionality
(E1) emerged as fundamental to individuals not involved in pro-social
activities as they both lead to Action (A), the first also facilitated awareness
(Aw1 and Aw2) as for volunteers and the second the ability to express
emotions and to account for contextual influences. However, in the case of
non-volunteers, action (A) seemed induced by the ability to express
emotions (E2) rather than the ability to experience them (E1) and lead to
Resilience.
13.7 Conclusions
In conclusion, in volunteers the ability to experience emotions (E1) is
fundamental, leads to action, even if less strongly that rationality (R), and
indirectly, through the ability to express the emotions experienced, to
resilience. For nonvolunteers, on the other hand, the relationship between
the ability to experience emotions (E1) and action (A) is mediated by the
ϭϱϳ
ability to express them (E2). In both groups, resilience emerged as the
combined results of an increased ability to expressed emotions and a
greater self-awareness of individual and relational resources, although at
different degrees, as for volunteers the cognitive influence (Aw1, 0.70) was
higher than the emotional (E2, 0.21) while for non-volunteers the opposite
was true (Aw1, 0.57 and E2, 0.76). In both cases awareness from previous
experiences (Aw2) negatively affected resilience, even though such
influence was stronger in non-volunteers (0.98 vs. 0.68) then in volunteers
and in return, resilience facilitated such awareness. However, while for
volunteers it was resilience that reduced the influence of context (C)
together with the ability to expressed emotions (E2), for non-volunteers
contextual influences ( C) were only reduced by awareness of self
resources (Aw1) and it was the context, in fact, that negatively influenced
resilience (0.44). Moreover, in non-volunteers action lead to resilience
whilenodirectconnectionbetweenaction(A)andresiliencewasfoundin
volunteers. These qualitative differences in the ERAAwC information
processing for the two groups seemed to indicate that for volunteers both
cognitive and emotional resources are involved in resilience, through
awareness and the ability to express emotions, but action as overt behavior
derived directly from both cognitive and emotional resources, not
resilience. Resilience, in fact, has the function of enhancing the feedback
from previous experiences and decreasing the influence of context. In
individuals that do not help others altruistically, at least not in an organized
way, both cognitive and emotional resources are involved in resilience,
through awareness and the ability to express emotions, but action which
also in this case derived directly from both cognitive and emotional
resources, lead to resilience as well. Thus resilience in this case seemed
more a result of action taking (the more I do the more I am resilient), rather
than an activator of action (the more resilient I am the more I do)andit
was negatively influenced by contextual influences, rather than
functioning as protective factors against them. These findings bring new
light to the understanding of the interpersonal processes involved in the
ability to face different challenges, the nature and components of resilience,
and the mechanisms behind its use.
ϭϱϴ
13.8 Limits
Data were collected at multiple sites and in an economically
privileged area of Italy. RAS and RS-14 items translated from English into
Italian language need further validation. Only RS-14 data were used in the
structural equation models, thus the study needs to be replicated including
other measures of resilience.
ϭϱϵ
Chapter 14 – Study 4. Resilience and substance abuse treatment
In this fourth study I investigated weather resilience (Resilience Scale
,RS-14, Wagnild & Young, 1993; CD-RISC ,Connor & Davidson, 2003),
moderate the impact of live events (Adapted from Holmes-Rahe Social
Readjustment Rating Scale, 1967) on traumatic stress (PSTD Checklist,
Weathers et al, 1993) in a sample of young drug addicts under treatment (N
= 180) with a control group (N= 249). Specifically, I explored weather
positive emotions foster self-regulation by helping to reduce the deleterious
physiological and emotional consequences of negative affects (Positive and
Negative Affect Schedule, PANAS, Watson, Clark & Tellegen, 1988; Italian
validation in Terracciano, McCrae & Costa, 2003). This should allow for a
more flexible, efficient coping during adverse experiences (PACT,
Perceived Ability to Cope with Trauma scale, Bonanno, Pat-Horenczyk, &
Noll, 2011), thus predicting better long-term adjustment after exposure to
stressful life events. Finally, I was interested in how stress and resilience
are related to drug abuse characteristics (type of substance, onset, and
latency) and treatment (type, length, outcomes). Theoretical models and
empirical research suggest that negative affect plays an important role in
the onset of substance abuse and may compromise successful treatment. It
seemed crucial to explore separately the role of positive and negative
affect, and the general ability to regulate emotions while evaluating
concurrently actual exposure to potentially traumatic events (PTE), PSTD
signs and symptoms, and the participants’ perceived ability to cope with
trauma (PACT, Bonanno et. al, 2010). Results confirmed the hypothesis
showing significant differences between the clinical and the control group
in terms of number of live events, PSTD symptoms, trauma focus coping
orientation and negative affect. This study made a significant contribution
to the field by examining the relationship between indicators of negative
affect and drug abuse, the role of positive and negative emotions, traumatic
and positive life events, emotion regulation and resilience and the different
trajectories of substance use, treatments and outcomes.
ϭϲϬ
14.1 Substance abuse
The nature of adolescents’ and young adults’ drug abuse is
multivariate and challenging, for some of its secretive aspects (Liddle,
2010). Because multiple pathways of adjustment and deviation may unfold
from any developmental milestone, failure and stressful experience,
emphasis is placed on competence and resilience. Change itself is
multifaceted and multi-determined and emerges from interaction among
systems, people, domains, and intrapersonal and interpersonal processes.
Risks and protective factors frameworks identify antecedents of
dysfunction and resilience from different domains of functioning.
Theoretical models and empirical research suggest that negative affect may
play an important role in the onset of substance abuse. According to the
negative-affect regulation model, substance use is a mean of coping, with
the specific goal to reduce negative affect (Schuckit et al. 2006). There are
evidences suggesting a relationship between depression (particularly
sadness) and adolescent substance use (Kaplow et al., 2001; Stice et al.,
2004; Windle & Windle, 2001). Pardini et al. (2004) examined the relations
between different indicators of negative affect (depressed mood, fear, and
anger) and the onset of alcohol use and found that anger was significantly
related to alcohol-use initiation, whereas depressed mood and fear were
not. This seems to suggest the existence of differential relations of specific
components of negative affect (sadness, guilt, fear, and hostility) with
alcohol and drug abuse. Fear, for example, has been consistently found
unrelated to alcohol use (Hussong et al., 2001). Ohannessian, and
Hesselbrock (2009) found sadness and fear were not significantly related to
substance-use initiation. Consistent with previous research (McCreary &
Sadava, 2000), hostility was found to be significantly related to marijuana.
The deviance proneness model of vulnerability (Sher, 1991) suggests that
the relationship between parental alcoholism and substance use may be
mediated by the offspring’s temperament characteristics and delinquency
may play an additional mediating role. Research showed, in fact, that
adolescents who have a parent with a substance abuse disorder have an
elevated risk of using alcohol of drug and developing drug addiction
(Chassin et al. 2003). Children of alcoholics experience drugs at a younger
age than their peers (Dawson, 2000) and adolescents who have an early
ϭϲϭ
onset of substance use are significantly more likely to develop a substance
abuse disorder than those who initiate later (Chassin & Ritter, 2001). Thus,
examining the underlying processes involved in the onset of substance
abuse is of particular relevance. A comprehensive, multidimensional
assessment of drug abuse can only be obtained with a unique combination
of weaknesses and assets, a contextualized portrait of strengths and
weaknesses in terms of parenting knowledge, skills, quality and beliefs and
emotional connection among family members (Pardini et al. 2004).
Multiple therapeutic alliances are required to create individualized
interventions that foster developmental competencies and focus on
continuity.
14.2 Participants and procedures
The clinical group, 180 drug addicts under treatment (80 males & 100
females), age 16-30 (M=23;SD = 2.97 similar for both genders) was
recruited at an Italian public treatment center (Ser.T). The control group
with an overall 249 participants (94 males & 155 females, age 14-30 (M=
22; SD = 3.19) was recruited at local high schools and public events before
a training intervention on the effects of drug abuse. Participants were asked
to complete a paper-and-pencil questionnaire including all scales of interest
and freely report the family composition listing each family member with
age, gender and relationship with the participant. Drug addiction (onset,
latency, age of first use, substance) and treatment (type of abuser, type of
treatment, outcome) data were obtained directly from the Treatment Center
Staff
14.3 Demographic Characteristics of the sample
In the clinical group (N= 180) 55.5% were females (n= 100) and
44.5% males. The majority were single 49.5% (n = 89), 32.2% (n=58)
engaged, 12.2% (n= 22) in a steady cohabiting relationship and only 6.1%
(n= 11) married. In terms of educational level, the majority completed high
school (48.3%, n= 87) or were currently a high school student, 25.5% (n=
46) had a Bachelor degree or were college students and 19.4% (n=35)had
a vocational degree. As for employment status, 30% (n= 54) worked full-
ϭϲϮ
time, 30.5% (n= 55) had a part-rime job, 27.8% (n=50)werestudents
and 11.7% (n= 21) were unemployed. In the control group (N=249)
62.3% were females (n= 155) and 37.7% were males (n=94). The
majority of the participants were single (49.8%, n= 124), 40.4% (n=101)
were engaged and only a small percentage were cohabiting (5.2%, n= 13)
or married (4.4%, n= 11). In terms of education, the majority of them had a
high school diploma (50.4%, n= 126) or were high school students, a
vocational degree (34%, n= 85), or a bachelor degree (88.8%, n= 22). As
for employment, 44% (n= 110) were students, 39.8% (n= 99) had a full
time job, 14 % (n = 35) had a part-time time and only 2% (n=5)were
unemployed.
14.4Familycomposition
In the control group 48.4% (n=121)ofparticipantswerepartofa4-
member household, 20.8% (n= 52) reported 3 family members, while
17.2% (n= 43) belonged to a 5-member family and only 7.2% (n= 18) of
participants indicated only another member excluding him/herself and
l6.4% (n= 16) 6 members. The mean age for fathers was 55 (SD =6)and
for mothers 51 (SD = 5). Data showed that 70% (n=175)ofparticipants
came from intact family with no divorced parents. The majority of the
participants in the control group (82%, n= 205) reported the father as first
family member, 70.4% (n= 176) of participants cohabited with the father
while 11.6% (n= 26) did not. The mother was indicated first only by 7.2%
of participants (n= 18) and 6% (n=15)reportedherpresenceinthe
household while only for 1.2% (n= 3) was not cohabiting with the mother.
As for other family members reported in first position, 4.4% (n=11)
indicated a generic romantic partner, 4% (n= 10) the husband, 0.8% (n=2)
the brother, 0.8% (n= 2) the sister, 0.4% (n=1)thewifeand0.4%(n=1)
a stepfather. The mother was reported as the second family member by
89.6% (n= 208) of participants although for 7.3% (n= 17) she is not
cohabiting, 2.5% (n=6)indicatedthefather, 1.7%(n=4)asisteror
brother (1.2%, n= 3), children (3%, n= 7), stepfather (0.8%, n=2),
fiancée or nephew (0.4%, n = 1). The third family member reported the
most was a brother (53.3%, n= 96), sister (41.6%, n= 75) or son (2.2%, n
=4), whileonlyasmallpercentage1.1%(n= 2) indicated father, fiancée or
ϭϲϯ
stepfather in this position. As fourth and fifth family member, a sister is
reported most often (45.6%, n= 27) followed by a brother, in laws and
grandmother.
In the clinical group, family was composed in 17.8% (n = 32) of cases
by two additional members, 31.1% (n = 56) by 3, 36.7% (n = 66) by 4,
11.7% (n = 21) by 5 and 2.8% (n = 5) by 6. The mean age for fathers was
55 (SD = 6) and for mothers 51 (SD = 5). Household with cohabiting
parents were 49.4% (n = 89) of the clinical group. The relationship reported
first was the father (70.5%, n= 127) although in 15% (n=27)ofthecases
he was not cohabiting with the participant. An intimate partner
was reported as second (12.2%, n= 22), followed by mother (7.8%, n
= 14), husband (5%, n= 9), stepfather (1.7%, n= 3), grandfather (1.1%, n
= 2), wife (1.1%, n= 2) and uncle (0.5%, n=1). Thesecond relationship
mostly reported was the mother (83.8%, n= 124) who was not cohabiting
with the participant in 8.1% (n= 12) of the cases, followed by son (7.4%, n
= 11), brother (4%, n=6)orsister(3.3%, n= 5), stepfather (0.67%, n=1)
and grandfather (0.67%, n= 1). As third family relationship the majority of
the clinical group indicated a brother (54.2%, n = 51) followed by a sister
(42.5%, n= 40) and rarely (n=1) son, mother and grandmother. A brother
and a sister were ranked as fourth and fifth members. The two samples
significantly differ in term of family members’ ranking only for the first
and second position (Table 2.4.1) referring to parents.
In the control group parents (father, first, 82% and mother (second,
89.6%) were reported as the most important family members, mostly
cohabiting with the participants. In the clinical group the traditional role of
the father as head of the household (first 79.5%) jointly with the mother
(second 83.8%) was somehow missing (with mother listed first) and/or
substituted by other close family members (partner first).
ϭϲϰ
Table 14.1 Family members ranking: difference between clinical (N=180) and
control group (N=249).
14.5 Measures
To evaluate resilience levels in this study the Resilience Scale
(Wagnild & Young, 1993) and the Connor and Davidson Resilience Scale
(CD-RISC, Connor and Davidson, 2003) were used as they measure
different aspect of the same construct. The CD-RISC is the ideal tool to
measure in clinical samples how resilience changes in respond to
pharmacological or psychological treatment while the RS evaluates the
dispositional characteristic moderating negative affects caused by stress. To
understand the relevance of both positive and negative affect in adaptive
coping I used the Positive (PA) and Negative (NA) Affect scale (PANAS,
Watson, Clark, & Tellegen, 1988). The two scales are independent
(Watson & Clark; 1994; Watson, Clark & Tellegen, 1988) and factorial
analysis confirmed the two main factors (PA e NA) explaining 62,8% of
the variance in the situational form and 68,7% in the dispositional form.
The Italian version by Terraciano, McCrae e Costa (2003) replicated the
result and reliability of the original scale. To assess stressful life
experiences in the last 12 months, both positive and negative, 37 life events
were selected from the Holmes and Rahe (1967) Social Readjustment
Rating Scale (SRRS) that best fitted the sample. For each events in addition
to its “life change unit” or LCU, indicating the risk for stress from low (>
150) to moderate (150-299) and high (>300), a measure of its positive
(from +1 to +3), negative from (-1 to -3) or null (0) perceived impact was
Family Composition FSig.
1^ Member 12.67 .00
2^ Member 16.20 .00
3^ Member .02 .86
4^ Member .39 .53
5^ Member .59 .45
ϭϲϱ
also reported by the participants. To evaluate the effect of these potentially
traumatic events, the PTSD Checklist (Weathers et al, 1993) was employed
to assess the presence of post-traumatic symptoms according to DSM-IV
criteria and similarly to SCL 90 R (Derogatis, 1983) from “not at all” to
“extremely”. Finally, to evaluate coping flexibility in face of potentially
traumatic events I selected the PACT scale (Bonanno, 2010; Bonanno &
Mancini, 2008) with the subscales Trauma Focus and Forward Focus. All
scales used proved to have good psychometric properties and a reliability
coefficient ranging from 75 a .94 (RS-14 Į= .91; CD-RISC Į= .94; PACT
Į=.90; PANAS Į= .89).
14.6 Results
Data analysis revealed demographic difference between samples that
need to be accounted for in terms of gender (F= 0.01 p <0.05), relationship
status (F= 0.02 p <0.05), employment (F= 0.00 con p <0.001), family
composition (F= 0.00 con p <0.01) and ranking of family members. In the
clinical sample 70.5% (n= 127) indicate the father first and 12.2% (n=22)
the partner, while the mother is indicated second by 83.8% (n=124)of
participants and by 7.4% (n= 11) the son. In the control group the father
(82%, n= 205) and the mother 7.2% (n= 17) are indicated first while she is
the most reported as second family member 89.6% (n=207).
14.6.1 Correlations
Pearson coefficients evidenced (Table 14.2) substantial difference
between control and clinical group, in the clinical group the number of life
events (r = .37, p <0.01) correlated positively with level of stress (r = .35, p
<0.01), negative emotions (r = .37, p <0.01) and post-traumatic symptoms
(r = .64, p <0.01). It correlated negatively with resilience (RS-14 r =-.72, p
<0.01; CD-RISC r = -.71, p <0.01), coping flexibility (TF r =-.54, p <0.01;
FF r =-.51, p <0.01) and positive emotions (r = -.35, p <0.01). Moreover, a
negative correlation was found between age and number of life events (r = -
.24, p <0.01), and age and stress (r = -.21, p <0.01). Gender correlated
positively with live events r = .15, p <0.01) and stress (r = .09, p <0.01), to
indicate that men reported or experienced more life events and stress that
ϭϲϲ
women. Education positively correlated with resilience (r = .17, p <0.01; r
= .16, p <0.01) and negatively with life events (r = -.21, p <0.01), stress (r
= -.14, p <0.01), negative emotions (r = -.13, p <0.01) and post-traumatic
symptoms (r = -.15, p <0.01). The number of family member correlated
positively with resilience (RS-14, r = .21,p<0.01; CD-RISC, r = .20, p
<0.01), the Forward Focus subscale of PACT (r = .16, p <0.01) and
positive affect PA) (PANAS, r = .15, p <0.01), while it correlated
negatively with the Post Traumatic Checklist (r = -.11, p <0.05). At this
phase of the family life, young adults, family relations and education level
seemed to be the most important protective factor when facing potentially
stressful and traumatic events.
Table 14.2 Significant Pearsons’ correlations among variables (N= 429).
* p< 0.05 ** p< 0.01
Sample Age Gender Education Family
Potential Traumatic Event .37** -.24** .15** -.21**
Stress .35** -.21** .09* -.14**
Resilience RS-14 -.72**
.17** .21**
Resilience CD-RISC -.71**
.16** .20**
Coping Forward Focus -.54** .16**
Coping Trauma Focus -.51**
Negative Affect .37**
-.13**
Positive Affect -.35** .15**
PSTD Checklist .64**
.15** -.11*
ϭϲϳ
14.6.2 Life Events
The distribution of negative life events is presented in Table 14.3 . As
expected, the number of life events correlated negatively with resilience
(RS-14 r = -.22 p <0.01; CD-RISC r = -.26 p <0.01) and coping flexibility
(FFr=-.20p<0.01;TFr=-.10p<0.05) and negatively with negative
emotions (r = .21 p<0.01) and post-traumatic symptoms (r = .41 p <0.01).
The subjective impact of live events both positive and negative, correlated
positively with resilience (RS-14 r = .30 p <0.01; CD-RISC r = .35
p<0.01), coping flexibility (FF r = .29 p <0.01¸TF r = .19 p <0.01) and
positive emotions (r = .11 p <0.05) and negatively with negative emotions
(r = -.29 p <0.01) and post-traumatic symptoms (r = -.38 p <0.01).
Figure 14.3 Distribution of negative life events (N= 429).
Negative life events correlate negatively with resilience (RS-14 r = -
.31p<0.01;CD-RISCr=-.36p<0.01), coping flexibility (FF r = -.28 p
<0.01; TF r = -.16 p <0.01) and positively with negative emotions (r = .29 p
<0.01) and post traumatic symptoms i (r = .48 p <0.01). Positive Life
Events correlate positively with resilience (RS-14 r = .10 p <0.05; CD-
RISC r = .10 p <0.05) and positive emotions (r = .09 p <0.05) (Table 14.4).
ϭϲϴ
Table 14.4 Pearson significant correlation between Life Events and variable of
interest (N = 429).
14.6.3 Difference between samples (Clinical and Control group)
A t-test for independent samples showed difference between the
clinical (M=-4.87, SD = 9.88) and control group (M=0.06, SD =7.66)in
terms of life events impact and number (control M= 1.94, SD =2.38;
Clinical M=4.16, SD = 3.34). In table 14.4 are presented the most reported
life events and the difference between samples. Table 14.5 showed all
significant differences between control and clinical group.
Table 14.5 Most frequent life events and difference significant between the
clinical and control group
.
LIFE
EVENTS
CONTROL
GROUP
N=249
CLINICAL
GROUP
N=180
LCU n % F Sig.
Drug or alcohol
use
M=-.01
SD=.58
M=-1.1
SD=1.57
50 222 51.7 228.599 .000
Outstanding
personal
M=.00
SD=.00
M=.0056
SD=.32
46 176 41 7.433 .007
Resilience
RS14
Resilience
CD-RISC
Forward
Focus
PACT
Trauma
Focus
PACT
Negative
Affect
PANAS
Positive
Affect
PANAS PSTD
Life
Events
Impact
.30** .35** .29** .19** -.29** .11*-.38**
Number
of Life
Events
-.22** -.26** -.207** -.10* .21** .41**
Negative
Life
Events
-.31** -.36** -.288** -.16** .29** .48**
Positive
Life
Events
.10* .10* .09*
ϭϲϵ
Achievement
Breaking up with
partner
M=-.27
SD=1.13
M=-.46
SD=1.45
53 157 36.6 20.113 .000
Change in health 44 146 34 .017
Change in peers
acceptance
67 126 29.4 2.092
Change in parents
financial
status
M=-.11
SD=.95
M=-.33
SD=.93
45 107 24.9 5.293 .022
Sexual difficulties M=-.17
SD=.73
M=-.51
SD=1.01
39 105 24.5 49.194 .000
Failing a grade or
exam
59 102 23.8 3.415
Increased
arguments with
parents
47 89 20.7 2.306 .
It is important here to notice that the most frequently reported life
events are age relevant and part of normative live experiences. In term of
alcohol and drug abuse, 51.7% (n= 222) of participants in both groups
reported having experienced it, of which only 42 were from the control
group (M= .23 SD = 1.41). The impact of this specific life event has been
evaluated very differently: negatively by 9.6% (n= 41) of participants,
moderately negative by 13.8% (n= 59), null by 7.7% (n= 33), positive by
16.6% (n= 71), moderately positive by 2.8% (n= 12) and very positive by
1.4% (n=6).
In the overall sample, 29.6% (n= 127) exhibited a low risk
for stress, 35.9% (n= 154) a moderate risk and 34.5% (n= 148) a high risk.
In the control group, the majority of participants are distributed on low risk
for stress 24% (n= 103), 21.2% (n= 91) on moderate while only 12.8% (n
= 55) showed high risk for stress. In the clinical group the situation is the
opposite: only 5.6% (n= 24) is exposed to low risk, while the majority,
63% (n= 63) showed moderate to high level of risk (21.7%, n=93). The
clinical and control group also significantly differ in terms of post-
traumatic symptoms, with the control group showing lower value (M=
40.5, SD = 13.47), compared with the clinical group (M= 62.13 SD =
ϭϳϬ
11.10). Table 14.5 presents and overall summary of all differences
betweenthetwogroups.
Table 14.5 A summary of all differences between the clinical and control group
SOCIO-
DEMOGRAPHICS
VARIABLES
CONTROL
GROUP
N=249
CLINICAL
GROUP
N=180
FSig
GENDE
R
:
Male
Female
37.7% (n=94)
62.3% (n= 155)
44.5% (n= 80)
55.5% (n= 100)
6.24 0.01
AGE’M=22SD =3.19 M=23SD =2.97
STATUS:
Single
Engaged
Cohabiting
Married
49.8% (n= 124)
40.4% (n= 101)
5.2% (n= 13)
4.4% (n= 11)
49.5% (n = 89)
32.2% (n = 58)
12.2 (n = 22)
6.1% (n = 11)
5.01 0.02
EDUCATION:
Middle School
Vocational School
High School
Bachelor
Master
1.2% (n=3)
5.2% (n= 12)
50.4% (n= 126)
34% (n= 85)
8.8% (n = 22)
6.1% (n= 11)
19.4% (n=35)
48.3% (n= 87)
25.5% (n=46)
0.5% (n=1)
PROFESSIONE:
Full time
Part-time
Unemployed
Student
39.8% (n= 99)
14% (n= 35)
2% (n=5)
44% (n= 110)
30% (n= 54)
30.5% (n= 55)
11.75 (n=21)
27.8% (n= 50)
41.95 0.00
NUCLEO
FAMILIARE:
2members
3members
4members
5members
6members
Father’s age
Mother’s age
7.2% (n= 18)
20.8% (n= 52)
48.4% (n= 121)
17.2% (n= 43)
6.4% (n= 16)
M=55SD =6
M=51 SD =5
17.8% (n= 32)
31.1% (n= 56)
36.7% (n= 66)
11.7% (n= 21)
2.8% (n=5)
M=55SD =6
M=51SD =5
9.48 0.00
Resilience RS-14 M= 58.10 SD =7.17 M= 41.97 SD =
8.24
Resilience CD-RISC M= 91.46 SD =12.55 M= 65.25 SD =
ϭϳϭ
12.99
Coping Trauma Focus M= 10.23 SD =0.55 M= 9.56 SD =
0.57
Coping Forward Focus M = 3.37 SD = 0.65 M = 2.53 SD =
0.63
Positive Affect PANAS M= 35.47 SD =36 M= 31.03 SD =
31
10.81 0.00
Negative Affect PANAS M= 26.38 SD =27 M= 32.25 SD =32
Levels of stress risk :
Low
Moderate
High
M= 26.38 SD =27
24% (n= 103)
21.2% (n= 91)
12.8% (n= 55)
M= 32.25 SD =32
5.6% ( n = 24)
14.7 % (n = 63)
21.7% (n = 93)
Post Traumatic Checklist M= 40.5 SD = 13.47 M= 62.13 SD =
11.10
12.45 0.00
Total Life Change Unit
(LCU)
M=205.66SD=153.20 M= 348.16 SD =
200.75
9.11 0.00
Impact of the event M= 0.06 SD =7.66 M= -4.87 SD =
9.88
11.55 0.00
No events M= 32.93 SD =3.01 M= 30.36 SD =
3.71
Number of life events M=5.07SD =3.01 M= 7.64 SD =3.71
Events with no impact M=0.34SD =0.73 M= 0.54 SD =
0.92
Positive Life events M=1.78SD =2 M=1.93SD =2.28
Negative Life Events M= 1.94 SD = 2.38 M= 4.16 SD = 3.34 20.84 0.00
Event 22: alcohol or drug
use
M=0.23SD =1.41 M= -0.76 SD
=.1.81
29.90 0.00
14.6. 4 Drug Addiction & Treatment Data
Drug addiction data were obtained for the clinical sample by the
treatment center staff and are summarized in Table 14.6. The majority of
participants in the clinical sample (30.1%, n= 129) were already under
treatment, 9.8% (n= 42) were newly admitted and 2.1% (n=9)were
returning after being previously discharged. The majority of the sample
was referred to treatment by social services (24.7%, n=106), 4.4%(n=
19) by other treatment facilities, 0.9% (n= 4) by law enforcement and
11.9% (n= 51) had seek treatment spontaneously. The most abused
substance was cocaine (18.6%, n= 80), followed by heroin (14.5%, n=
ϭϳϮ
62), alcohol (2.6%, n= 11) and cannabis (1.4%, n= 6), although
participants reported the use of a combination of drugs, up to 4, including
opiates. Pharmacological treatment resulted prevalent (31.2%, n=134),
followed by psychotherapy (10.5%, n= 45), other form of psychological
support (0.4%, n= 2) and a combination of treatments methods (19.6 %, n
= 84). Methadone was the most common substance used in
pharmacological treatment (24.5%, n= 105), followed by Naltrexone
(0.7%, n= 3) and Subutex (6.1%, n= 26). Treatment length ranged from
middle (51%) to long (36.6%), with an average of 1-2 years. The majority
of the sample (86.6%) reported their first drug use before the age of 17,
while 12% between 18 and 21 and only 1.4 above the age of 21. Only 0.5
contracted HIV or hepatitis (1.2%), while the majority was in good health.
Latency was less than 5 years for the majority of clinical participants. Only
4.9% (n= 21) reported a latency greater than 5 years, while 14% (n= 60)
between 2 and 5 years, 11.2% (n= 48) between 1 and 2 years, and 11.9%
(n= 51) less than one year. Urine test also evidenced that 12.6% (n= 54) of
the clinical sample during treatment were NOT observing abstinence, while
19.8% (n= 85) registered a deferred abstinence.
Different types of substance dependency were diagnosed in the
clinical sample: 7.9% (n= 77) sociopath, 13.8% (n= 59) a traumatic, 6.3%
(n= 27) transitional and 4% (n= 17) neurotic. In 25.9% (n=111)ofthe
cases the addiction was serious (toxic), 9.3% (n= 40) habitual, 6.3% (n=
27) compulsive-dependent and 0.5% (n= 2) occasional. In terms of
familiarity, 34% (n= 146) of clinical participants reported having no
family history of drug abuse while 7.9% (n= 34) reported one or more
family members with an addiction problem, either a parent, brother, sister,
or uncle from the father side.
ϭϳϯ
Table 14.6 Drug addiction data (clinical group, N=249)
PATIENT
New
Returning
Current
9.8% (n= 42)
2.1% ( n=9)
30.1% (n= 129)
REFERRAL
Social services
Spontaneous
Treatment center
Prison
24.7% ( n= 106)
11.9% (n= 51)
4.4% (n= 19)
0.9% (n=4)
SUBSTANCE
Cocaine
Heroin
18.6% (n = 80)
14.5% (n = 62)
TYPE OF
TREATMENT
Pharmacological
Psychotherapy
31.2% (n= 134)
10.5% (n= 455)
Psychological Support 14% (n= 60)
MEDICATION
Metadone
Naltrexone
Subutex
24.5% (n = 105)
3.3% (n = 14)
7% (n = 30)
TREATMENT
LENGHT
Long term
Medium term
36.6% (n= 157)
5.1% (n=22)
ABSTINENCE
Continued
Intermitted
Use
9.6% (n= 41)
19.8% (n= 85)
12.6% (n= 54)
ONSET M= 16 SD =2.64
LATENCY
1years
2-5 years
11.9% (n=51)
14% (n= 60)
LENGHT OF STAY
AT FACILITY
24 months
36 months
48 months
5.8% (n=25)
6.1% (n= 26)
5.4% (n= 23)
SEVERITY
Occasional
Habitual
Compulsive-dependent
Toxic
0.5% (n=2)
9.3% (n=40)
6.3% (n= 27)
25.9% (n= 111)
FAMILIARITY
Yes
No
7.9% (n= 34)
34% (n= 146)
ϭϳϰ
14.6.5 Structural Equation Modeling
In this study I assumed that specific individual resources like
resilience, emotion regulation skills and coping flexibility could determine
the positive or negative appraisal of life events (either positive or negative)
and their impact in term of outcome (PTSD) and represented important
factors in the etiology of substance abuse and the efficacy of its treatment.
According to the negative affect regulation model, the development of
psychopathology, in this case drug abuse, depends on a use of individual
and family resources as mediators and protective factors. Specifically,
resilience was expected to be higher in individuals experimenting positive
emotions in face of adversity, showing fewer post-traumatic symptoms and
no substance abuse dependency requiring treatment. To further investigate
the relationship between life events and post traumatic symptoms and the
moderating effects of resilience, coping flexibility, and positive and
negative emotions two different path analyses were performed, one for the
control group (Figure 14.1) and one for the clinical group (Figure 14.2)
using LISREL. In accordance with the hypothesis, results suggested
significant differences at different levels for the two groups and two
different models better fitted the data for the two samples.
In the clinical group, a direct straightforward positive relationship
emerged between stress risk (total number of LCU), negative emotions
(NA), trauma focus coping style (TF) and posttraumatic symptoms (PTSD).
The perceived impact of live events, however, in this group was negatively
associated with negative outcomes (PTSD), indicating that a positive
appraisal of life events can still diminish traumatic symptoms. As expected,
positive affects (PA) increased resilience (0.55), while negative affect (NA)
negatively influenced it (-0.39). Similarly, negative affect (NA) facilitated
the Trauma Focus coping style (1.47) while positive affect (PA) enhanced
the use of a Forward Focus strategy, with a stronger power (2.08).
Resilience appeared to have no direct influence on posttraumatic symptoms
(PTSD), but on the other hand fostered both coping strategies positively
(TF, 1.52; FF 2.97), although at different degrees. The two coping
strategies (TF & FF) were positively and reciprocally related (0.37).
Results also showed that the perceived impact of life events in the clinical
group had a direct ameliorative effect onPTSD(-0.25)andanindirect
ϭϳϱ
effect through NA (-0.21), thus reducing posttraumatic symptoms in face of
adversity and even everyday hassles.
These results seem to suggest a tripartite etiology of PTSD,
proportionate to the level of stress directly caused by number and type of
life events in terms of changes units (LCU) but increased by a coping style
trauma oriented and decreased by the perceived impact of life events,
which could also be positive. Positive emotions (PA) seem to play a central
role in fostering both resilience and a coping style future oriented.
However, as positive emotions (PA), coping forward focus (FF) and
Resilience had no connection with PTSD, it appeared that these resources,
although available, were useless in alleviating PTSD symptoms.
In the control group, PTSDwasonlydeterminedbynegativeaffect
(NA) but reduced by the perceived impact of life events (-0.22) and
resilience (-0.20). Resilience was enhanced by positive affect (PA, 1.13)
and decreased by negative affect (NA, -1.23) but in this group also by a
Forward Focused coping style (FF, -0.07). On the other hand, Resilience,
as in the clinical group, fostered both coping strategies (TF, 2.93; FF 6.18),
Trauma and Forward focused, although the second more strongly. For this
group, Resilience also had an ameliorating effect on posttraumatic
symptoms (PTSD,-0.29) while it was positively associated to negative
emotions (NA, 0.26). These results indicate that in the control group,
posttraumatic symptoms were not related to the number and type of life
events in terms of LCU, although they were less in this sample. Only
negative affect (NA) were accosiated with posttraumatic symptoms, futher
fostered by a Trauma Focus coping style, and decreased by the perceived
impact of the events, probably more positive, and by resilience.
Interestingly, positive emotions derived from the number and type of life
events in terms of changes unit, probably because less negative and
interpreted as challenges, and in return fostered resilience. Similarly, a
forward focus coping strategy fostered resilience, as positive emotions did.
Negative emotions, on the other hand, reduced resilience (-1.23) but were
somehow increased by resilience (0.36) in a reciprocal double loop. In both
sample PA and NA were not correlated, the risk of stress derived from the
number of live events and their change units (LCU) were independent of
the perceived impact of the events, whereas FF and TF were not
independent subscales.
ϭϳϲ
In conclusion, in the control group PTSD, symptoms were fewer, and
the use of positive emotions and resilience as resources seemed to facilitate
adaptation to stressful events. On the contrary, in the clinical group PTSD
symptoms were more frequent, the risk of stress was higher, more negative
life events were reported, whose impact was also evaluated more
negatively, and resilience, as a resource did not moderate the process of
adapting well to potentially traumatic or stressful events.
14.7 Conclusions
The aim of this empirical research was a better understanding of the
actual relationship between life events and dysfunctional outcomes like
drug addiction weighting both the potential stress derived from the events
(LCU) and their perceived subjective impact. Specifically, we investigated
the influence of resilience, emotion regulation (positive and negative) and
coping flexibility on substance abuse and its characteristics (onset, latency,
gravity) and treatment (type, length, outcome). The theoretical model
applied considered life events as potentially stressful and traumatic,
depending on the individual’s experience and life context, and requiring
life adjustments that if not met, can lead to dysfunctional behavior like drug
addiction. Results showed, interestingly, that the most frequent life events
reported in both samples (clinical and control) were not the highest in term
of change unit (LCU) and mostly referred to “normative” life events in late
adolescence and young adulthood, such as breaking up with partner or
increased arguments with parents.
Nevertheless, the clinical and control group differed in terms of life
events appraisal (how positive or negative the events was evaluated by
participants), coping flexibility, emotion regulation (the preferential use or
positive vs. negative emotions) and resilience. In fact, in the control group,
both negative and positive events were handled with positive emotions and
a forward focus coping style, which decreased post-traumatic symptoms. In
the clinical group, on the other hand, was prevalent the use of negative
emotions and a trauma focus coping style, further facilitated by family risk
factors.
ϭϳϳ
Figure 14.1 Structural equation graph with LISREL for the clinical group.
>ŝĨĞǀĞŶƚƐ
/DWd
>ŝĨĞǀĞŶƚƐ
^dZ^^
Wd^
Z^/>/E
Z^Ͳϭϰ
WŽƐŝƚŝǀĞ
ŵŽƚŝŽŶƐ
W
EĞŐĂƚŝǀĞ
ŵŽƚŝŽŶƐ
E
dƌĂƵŵĂ&ŽĐ ƵƐ
WdͲd&
&ŽƌǁĂƌĚ
&ŽĐƵƐ WdͲ
&&
Ϭ͘ϭϲ
-0.Ϯϭ
0.ϬϮ
Ϯ.0ϴ
-0.ϯϵ
0.ϳϱ
0.ϱϱ
-0.Ϯϱ
Ϯ.ϵϳ
0.0ϰ
ϭ.ϰϳ
ϭ.ϱϮ
0.ϯϳ
Chi-Square=19.35, df=17, P-close=0.30863,
RMSEA=0.024
Figure 14.2 Structural equation graph for the control group.
I
>ŝĨĞǀĞŶƚƐ
/DWd
>ŝĨĞǀĞŶƚƐ
^dZ^^
Wd^
Z^/>/E
Z^Ͳϭϰ
WŽƐŝƚŝǀĞ
ŵŽƚŝŽŶƐ
W
EĞŐĂƚŝǀĞ
ŵŽƚŝŽŶƐ
E
dƌĂƵŵĂ &ŽĐƵƐ
WdͲd&
&ŽƌǁĂƌĚ
&ŽĐƵƐ WdͲ
&&
ͲϬ͘ϯϮ
-0.ϮϮ
0.Ϭϭ
ϭ.13
-1.23
6.18
0.36
0.Ϯϰ ͲϬ͘Ϯϵ
-0.07
0.06
Ϯ.93
0.44
Chi-Square=17.34, df=17, P-close=0.43164,
RMSEA=0.0114
.
ϭϳϴ
References
Abdullah, H. S. L. (2003). Malaysian school counselor resilience.
Malaysian Journal of Education, 23, 89-99.
Acitelli, L. K. (1993). You, me, and us. Perspective on relationship
awareness. In S. Duck (Ed.), Individuals in relationships (pp 121-174).
Thousand Oaks, CA: Sage.
Ahern, N. R., Kiehl, E. M., Sole, M. L. & Bywers J. (2006). A
review of instruments measuring resilience.
Ainsworth, M. S., Blehar, M. C., Waters, E., & Wall, (1978).
Patterns of attachment: A psychological study of the Strange Situation.
Hillsdale, NJ: Erlbaum.
Almedom, A. M. (2005). Resilience, hardiness, sense of coherence,
and posttraumatic growth: All paths leading to “light at the end of the
tunnel”? Journal of Loss and Trauma, 10(3), 253-265.
Astin J. A. (1997). Stress reduction through mindfulness meditation:
Effects on psychological symptomatology, sense of control, and spiritual
experiences. Psychotherapy and Psychosomatics, 66, 97–106.Athabasca
University Governing Council. Master thesis.
Atwool, N. (2006). Attachment and Resilience: Implications for
Children in Care' in Child Care. Practice Journal, 12, 315-330.
Axford, K. M. (2007). Attachment, affect regulation, and resilience
in undergraduate students. Dissertation Abstract International: Section B:
The Sciences and Engineering, 68 (2-B), 1358.
Atchison, M., & McFarlane, A.C. (1994). A review of dissociation
and dissociative disorders. Australian and New Zealand Journal of
Psychiatry, 28, 591-599.
Bahira Sherif T. (2005). Strengthening low-income families through
community- based family support initiatives. Family Strengths and
Resilience. FF28, Minneapolis, MN: National Council on Family
Relations.
Bakan, D. (1968). Disease, pain, and sacrifice – Toward a
psychology of suffering. Chicago: Beacon Press. Barnett, R. C., Marshall,
N. L., & Singer, J. D. (1992). Job experiences over time, multiple roles,
and women's mental health: A longitudinal study. JournalofPersonality
and Social Psychology, 62(4): 634-644.
ϭϳϵ
Barber, B. K. (1996). Parental psychological control: Revisiting a
neglected construct. Child Development, 67(6), 3296-3319.
Barrett, F. (2004). Coaching for resilience. Organization
Development Journal, 22(1), 93-96.
Bartholomew, K. & Horowitz, L.M. (1991). Attachment styles
among young adults: A test of a four-category Model. Journal of
Personality and Social Psychology, 61, 226- 244.
Bartone, P.T. (1995,). Development and validation of a short
hardiness measure. Paper presented at the Annual Convention of the
American Psychological Association, New York, N.Y.
Batson, C. D. (1991) The altruism question: Towards a social social-
psychological answer, Hillsdale, NJ: Erlbaum.
Baumrind, D. (1991). The influence of parenting style on adolescent
competence and substance use. Journal of Early Adolescence, 11(1), 56-
95.
Baumrind, D. (1966). Effect of authoritative parental control on child
behavior. Child Development, 37, 887- 907.
Baumrind, D. (1971). Current patterns of parental authority,
Developmental Psychology Monographs, 4(2), 1-103.
Beckett, C. (2008). Family theory as a framework for assessment.
Northern Arizona University. Online lesson n.3.
Belsky, J. (2010) The determinants of parenting in GxE Perspective:
a case of differential susceptibility? In: Booth, A. McHale, S.M.and
Landale, N.S.(eds.) Biosocial Foundations of Family Processes. National
Symposium on Family Issues. New York, U.S.: Springer, pp. 61-68.
Benson, J. B, & Marshall, M. H. (2009). Social and emotional
development in infancy and early development. Riverport, MO: Academic
Press.
Berenbaum, H., & James, T. (1994). Correlates and retrospectively
reported antecedents of Alexithymia. Psychosomatic Medicine, 56, 345-
352.
Berenbaum, H. (1996). Childhood abuse, Alexithymia and
personality disorder. Journal of Psychosomatic Research, 41, 585-595.
Bermond, B. (1997). Brain and Alexithymia. In A. Vingerhoets, F.
Bussel, & J. Boelhouwer (Eds.), The (non)expression of emotions in
ϭϴϬ
health and disease. (pp.115-130) Tilburg, The Netherlands: Tilburg
University Press.
Bernstein, E.M., & Putnam, F. W. (1986). Development, reliability,
and validity of a dissociation scale. Journal of Nervous and Mental
Disorders, 174, 727-735.
Biscoe, B., & Harris, B. (1994). Adolescent resiliency attitudes scale
manual. Oklahoma City, OK: Eagle Ridge Ins.
Block, J. H., & Block, J. (1980). The role of ego-control and ego-
resilience in the organization of behavior. In W. A. Collins (Ed.), The
Minnesota Symposia on Child Psychology Vol. 13 (pp. 39-101). Hillsdale,
NJ: Lawrence Erlbaum Associates.
Block, J. & Kremen, A. M. (1996). IQ and ego-resiliency:
Conceptual and empirical connections and separateness. Journal of
Personality and Social Psychology, 70,349-361.
Block, N. (1995). On a confusion about a function of consciousness.
Brain and Behavioural Science, 18, 227-287.
Block, N. (2007). Consciousness, function, and representation.
Collected papers, Vol. 1. Cambridge: Massachusetts Institute of
Technology.
Blum, D. (1998). Finding the strength to overcome anything.
Psychology Today,May/June, 32-72.
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have
we underestimated the human capacity to thrive after extremely aversive
events? American Psychologist, 59 (1): 20-28.
Bonanno, G. A., Wortman, C. B., & Nesse, R. M. (2004).
Prospective patterns of resilience and maladjustment during widowhood.
Psychology and Aging, 19, 260-271.
Bonanno, G. A. (2005). Resilience in the face of potential trauma.
Current Direction in Psychological Science, 14(3):135-138.
Bonanno, G.A., Moskowitz, J.T., Papa, A., & Folkman, S. (2005).
Resilience to loss in bereaved spouses, bereaved parents, and bereaved
gay men. Journal of Personality and Social Psychology, 88(5), 827-843.
Bonanno, G. A., Papa, A., O’Neil, K., Westpal, M., & Confman K.,
(2005). The importance of being flexible. The ability to enhance and
suppress emotional expression predicts long-terms Adjustment.
Psychological Science.
ϭϴϭ
Bonanno, G. A., Rennicke, C., & Dekel, S. (2005). Self-
enhancement among high-exposure survivors of the September 11th
terrorist attack: Resilience or social maladjustment? Journal of
Personality and Social Psychology, 88, 984–998.
Bonanno, G. A., Colak, D. M., Keltner, D., Shiota, M. N., Papa, A.,
Noll, J. G., Putnam, F. W., & Trickett, P. K. (2007). Context matters:
The benefits and costs of expressing positive emotion among survivors of
childhood sexual abuse. Emotion, 7(4): 824-837.
Bonanno, G. A., Mancini, A. D. (2008). The human capacity to
thrive in the face of potential trauma. Pediatrics, 121, 369-375.
Bonanno, G. A. (2009). The Other Side of Sadness. What the New
Science of bereavement Tell Us about Life after Loss. New York: Basic
Books. New York
Bonanno, G.A., Brewin, C. R., Kaniasty, K. and La Greca, A. M.
(2010). Weighing the cost of disaster: Consequences, risk, and resilience
in individuals, families, and communities. Psychological Science in the
Public Interest, 11(1), 1-49.
Bonanno, G. Pat-Horenczyk, R., Noll, J. (2011) “Coping Flexibility
and Trauma: The Perceived Ability to Cope with Trauma (PACT) Scale.
Psychological Trauma: Theory, Research, Practice and Policy, 3(2), 117-
129.
Bonanno G. A. and Mancini, A. D. (2012). Beyond resilience and
PTSD: Mapping the heterogeneity of responses to potential trauma.
Psychological Trauma: Theory, Research, Practice, and Policy, 4(1),
74-83.
Borgatti, S., and P. Foster. 2003. The network paradigm in
organizational research: a review and typology. Journal of Management
29(6):991–1013.
Bowlby, J. (1969). Attachment and loss. Vol. 1: Attachment. New
York: Basic Books.
Boyce, W.T., & Ellis, B.J. (2005). Biological sensitivity to context: I.
An evolutionary-developmental theory of the origins and functions of
stress reactivity. Development & Psychopathology, 17, 271–301
Bagby, R.M., Quilty, L. C., Taylor, G. J., Grabe, H. J., Luminet, O.,
Verissimo, R., De Grootte, I., & Vanheule, S. (2009). Are there subtypes
of alexithymia? Personality and Individual Difference, 47, 413-418.
ϭϴϮ
Braud, W. G., & Anderson, R. (1998). Transpersonal research
methods for the social sciences: Honoring human experience. Thousand
Oaks, CA: Sage.
Brehm, S. S, Miller, R. S., Perlman, D., & Campbell, S. (2002).
Intimate relationships (3
rd
Ed.). Boston: McGraw-Hill.
Breslau, N., Kessler, R., Chilcoat, H., Schultz, L., Davis, G., &
Andreski, P. (1998). Trauma and posttraumatic stress disorder in the
community: The 1996 Detroit Area Survey of Trauma. Archives of
General Psychiatry, 55, 626-632.
Brewin, C. R., Andrews, B., Valentine, J.D. (2000). Meta-analysis of
risk factors for Posttraumatic Stress Disorder in trauma-exposed adults.
Journal of Consulting and Clinical Psychology, 68, 748- 766.
Bryan, J. H., & London, P. (1970). Altruistic behavior by children.
Psychological Bulletin, 73, 200-211.
Brown, P. J., Stout, R. L., & Mueller, T. (1999). Substance use
disorder-posttraumatic stress disorder comorbidity: Addiction and
psychiatric treatment rates. Psychology of Addictive Behaviors, 13, 115-
122.
Brunner, R., Parzer, P., Schuld, V., & Resch, F. (2000). Dissociative
symptomatology and traumatogenic factors in adolescent psychiatric
patients. Journal of Nervous and Mental Disease, 188, 71-77.
Buhler, K. & G. Heim (2001): “General Introduction to the
Psychotherapy of Pierre Janet”, in American Journal of Psychotherapy,
55(1):122-129.
Burns, R. A., & Anstey, K. J. (2010). The Connor-Davidson
resilience scale (CD-RISC): Testing the invariance of a uni-dimensional
resilience measure that is independent of positive and negative affect.
Personality and Individual Differences, 48(5), 527-531.
Buss, A. (1980). Self-Consciousness and social anxiety. San
Francisco: Freeman
Buss, A., & Scheier, M. F. (1975). Self-consciousness, self-
awareness, and self-attribution. Journal of Research in Personality, 10,
463-468.
Cacioppo, J. T., & Berntson, G. G. (1994). Relationships between
attitudes and evaluative space: A critical review, with emphasis on the
separability of positive and negative substrates. Psychological Bulletin,
ϭϴϯ
115, 401– 423.
Cacioppo. J. T., Garner, W.L., & Berntson, G.G. (1999). The affect
system has parallel and integrative processing components: Form follows
function. Journal of personality and Social Psychology, 76, 839-855.
Campbell-Sills, L. and Stein, M. B. (2007) Psychometric Analysis
and Refinement of the Connor-Davidson Resilience Scale (CD-RISC):
Validation of a 10-Item Measure of Resilience, JournalofTraumatic
Stress, 20(6), 1019-1028.
Canli, T., Desmond, J.E., Zhao, Z., Glover, G., and Gabrieli, J.D.E.
(1998). Hemispheric asymmetry for emotional stimuli detected with
fMRI. Neuroreport, 9 , 3233-3239
Canli, T., Zhao, Z., Desmond, J.E., Kang, E., Gross, J., and Gabrieli,
J.D.E. (2001). An fMRI study of personality influences on brain reactivity
to emotional stimuli. Behavioral Neuroscience, 115 , 33-42
Caprara, G. V., Barbarelli, C., & Borgogni, L. (1993). Big Five
Questionnaire (BFQ). Firenze: Organizzazioni Speciali.
Cardeña, E. (1994). The domain of dissociation. In S.J. Lynn, & J.W.
Rhue (Eds.), Dissociation: Clinical and theoretical perspectives (pp. 15-
31). New York: Guilford Press.
Carli, V., Jovanovic N., Podlesek A., Roy A., Rihmer Z., Maggi S.,
Murusic D., Cesaro C., Marusic A. and Sarchiapone M. (2010). The role
of impulsivity in self-mutilators, suicide ideators and suicide attempters.
A study of 1265 male incarcerated individuals. Journal of Affective
Disorders, 123, pp. 116-122.
Carpenter, K.M., & Addis, M.E. (2000). Alexithymia, gender, and
responses to depressive symptoms. Sex Roles, 43, 629-644.
Carrion, V.G., & Steiner, H. (2000). Trauma and dissociation in
delinquent adolescents. Journal of the American Academy of Child and
Adolescent Psychiatry, 39, 353-359.
Carver, C. S., & Glass, D. C. (1976). The Self-consciousness scale: a
discriminant validity study. Journal of Personality Assessment, 40, 169-
172.
Carver, C. S., Scheier, M. F., & Wienstraub, J. K. (1989). Assessing
coping strategies: A theoretically based approach. Journal of Personality,
56, 267-283.
ϭϴϰ
Carver, C. S., & White, T. L. (1994). Behavioral inhibition,
behavioral activation, and affective responses to impending reward and
punishment: The BIS/BAS scales. Journal of Personality and Social
Psychology, 67, 319-333
Carver, C.S. (1998). Resilience and thriving: Issues, models, and
linkages. JournalofSocialIssues, 54(2), 245-266.
Chabot, D., & Licht, C. (2006). The Chabot Emotionally
Differentiation Scale: A theoretically and psychometrically sound
instrument for measuring Bowen’s intrapsichic aspect of differentiation.
Journal of Marriage and Family Therapy, 32(2), 167-180.
Chassin, L., & Ritter, J. (2001). Vulnerability to substance use
disorders in childhood and adolescence. In E. Rick & J. M. Price
(Eds.), Vulnerability to psychopathology: Risk across the lifespan (pp.
107–134). New York: Guilford Press.
Chassin, L., Ritter, J., Trim, R. S., & King, K. M. (2003). Adolescent
substance abuse disorders. In E.L. Mash, & R.A. Barkley (Eds), Child
psychopathology (2nd ed.). (pp. 199–230). New York, NY, US: Guilford
Press.
Cheng, C. (2001). Assessing coping flexibility in real-life and
laboratory settings: A multimethod approach. Journal of Personality and
Social Psychology, 80, 814–833.
Chilcoat, H. D., & Menard, C. (2003). Epidemiological
investigations: Comorbidity of posttraumatic stress disorder and
substance use disorder. In P. Ouimette & P. J. Brown (Eds.), Trauma and
substance abuse: Causes, consequences, and treatment of comorbid
disorders (pp. 9-28). Washington DC: American Psychological
Association.
Charney, D. S. (2004) Psychobiological mechanisms of resilience
and vulnerability: implications for successful adaptation to extreme stress.
American Journal of Psychiatry, 161, 195-216.
Charuvasta A. and Cloitre M. (2008). Social Bonds and
Posttraumatic Stress Disorder 305, Annual Review of Psychology, 59:301-
328.
Chorpita BF, Albano AM, Barlow DH. The structure of negative
emotions in a clinical sample of children and adolescents.Journal of
Abnormal Psychology, 107(1):74–85.
ϭϴϱ
Chow, S., Hamagani, F. and Nesselroade, J. R. (2007) Age
differences in dynamical emotion-cognition linkages. Psychology and
Aging, 22(4):765-780
Chu, J.A., & Dill, D.L. (1990). Dissociative symptoms in relation to
childhood physical and sexual abuse. American Journal of Psychiatry,
147, 7, 887-892.
Chu, J.A., Mathews, J.A., Frey, L.M., & Ganzel, B. (1996). The
nature of traumatic memories of childhood abuse. Dissociation, 9, 1, 3-17.
Clark, M.S., & Mills, J. (1979). Interpersonal attraction in exchange
and communal relationships. Journal of Personality and Social
Psychology, 37, 12-24.
Clark, S. C. and Kinkel E. J. (2005) Willingness to express emotions:
The impact of relationship type, communal orientation, and their
interaction. Personal Relationship, 12, 169-180.
Clayton, K. (2004). The Interrelatedness of Disconnection: The
Relationship between Dissociative Tendencies and Alexithymia.
Unpublished manuscript.
Cohen, S., Gottlieb, B., & Underwood, L. (2000). Social
relationships and health. In S. Cohen, L. Underwood, & B. Gottlieb
(Eds.), Measuring and intervening in social support (pp. 3–25). New
York: Oxford University Press.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the
buffering hypothesis. Psychological Bulletin, 98, 310 –357.
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J.
M., Jr. (1997). Social ties and susceptibility to the common cold. Journal
of the American Medical Association, 277, 1940-1944.
Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM (1997).
Social ties and susceptibility to the common cold. JAMA, 277, 1940-4.
Cohen, S. (1991). Social supports and physical health: Symptoms,
health behaviors, and infectious diseases. In A. L. Greene, E. M.,
Cummings, & K. H. Karraker (Eds.), Life-span develop-mental
psychology: Perspectives on stress and coping (pp. 213-234). Hillsdale,
NJ: Erlbaum.
Cohen, S., & Williamson, G.M. (1988). Perceived stress in a
probability sample of the United States. In S. Spacapan and S. Oskamp
(Eds.), The social psychology of health (31-67). Newbury Park, CA: Sage.
ϭϴϲ
Coifman, K. G., and Bonanno, G. A. (2010). When distress does not
become depression: Emotion context sensitivity and recovery from
bereveamen. Journal of Abnormal Psychology, 119, 479-490.
Coifman, K. G., Bonanno, G. A., Ray, R. D., Gross, J. J. (2007).
Does repressive coping promote resilience? Affective-autonomic response
discrepancy during bereavement. Journal of Personality and Social
Psychology, 92(4), 745-758.
Coyle, J. P. (2006). An exploratory study of the nature of family
resilience. Paper presented at the Council on Social Work Education
Annual Program Meeting, Chicago, IL.
Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development
of emotion regulation and deregulation: A clinical perspective.
Monographs of the Society for Research in Child Development, 59, 73-
100.
Colesso, W. & L’Abate, L. (2011). Spaces of Relational Creativity:
reachable competence or fancy? In A. M. Columbus (Ed.), Advanced in
Psychological Research. Volume 83 (pp. 79-97). New York: Nova
Publisher.
Congard, A., Dauvier B., Antoine P. Gilles P. (2011) . Integrating
personality, daily life events and emotion: Role of anxiety and positive
affect in emotion regulation dynamics. Journal of Research in Personality
45 (2011) 372–384
Connor, K. M. (2006). Assessment of resilience in the aftermath of
trauma. Journal of Clinical Psychiatry, 67, 46-49.
Connor, K. M, & Davidson, J. R. T. (2003).Development of a new
resilience scale: The Connor-Davidson Resilience Scale (CD-RISC).
Depression and Anxiety, 18, 76-82.
Connor, K. M, Davison, J. R., Lee, L. C. (2003). Spirituality,
resilience, and anger in survivors of violent trauma: A community survey.
Journal of Trauma Stress 16, 487-494.
Connor, K. M., Zhang, W. (2006). Resilience: Determinants,
measurement, and treatment responsiveness. CNS Spectrum International
Journal of Neuropsychiatric, 11,15-12
Costa, P. T. & McCrae, R. R. (1992). Normal Personality
Assessment in clinical practice: The NEO Personality Inventory.
Psychological Assessment, 4,5-13.
ϭϴϳ
Coutu, D.L. (2002). How resilience works. Harvard Business
Review, 80(5), 46-55.
Coward, L. A., & Sun, R. (2004). Criteria for an affective theory of
consciousness and same preliminary attempts. Consciousness and
Cognition, 13, 268-301.
Cummings, J., & Higgins, M.C. (2005). Relational instability at the
core: Support dynamics in developmental networks. Social Networks,
28(1), 38-55.
Cusinato M., Frosi F., Bertuola L., Rosolen S., Scilletta C. (2002).
Bisogni e Risorse delle famiglie trevigiane. Treviso, Provincia di Treviso,
2002.
Cusinato M., & Corsi, M. (2005). Questionario di Risposta
Relazionale (Qrr) [Relational Answers Questionnaire (RAQ)]. Famiglia,
Interdisciplinarità, Ricerca, 10, 49-75.
Cusinato, M., Colesso, W., Barbon, M. (2006). Questionario di
Attaccamento fra Adulti (Q.A.A.). Rivista di Studi Familiari, 3, 267-288.
Cusinato M. & L’Abate L.(Eds.) (2011). Advances in relational
competence theory: With special attention to Alexithymia. New York:
Nova Science Publishers.
Damasio, A.R. (1994). Descartes’ Error. New York: G.P. Putnam’s
Sons.
Das Cherbuin, N., Tan, X, Anstey, K. J., Easteal, S. (2011) DRD4-
exonIII-VNTR Moderates the Effect of Childhood Adversities on
Emotional Resilience in Young-Adults. PLoS ONE 6(5): e20177.
doi:10.1371/journal.pone.0020177
Davidson, R. J. (2000). Affective style, psychopathology, and
resilience: Brain mechanisms and plasticity. American Psychologist, 55,
1196–1214.
Davidson, R.J., Jackson,D.C. & Kalin,N.H.(2000). Emotion,
plasticity, context and regulation: Perspectives from affective
neuroscience. Psychological Bulletin, 126, 90-906.
Davis M.E, Zautra A.J, and Smith B.W (2004). Dynamic model of
affect relationships within interpersonal relations. Journal of Personality
72:1105–1132.
ϭϴϴ
Davis, M. C, Affleck, G. , Zautra, A. J and Tennen H. (2006). Daily
Interpersonal Events in Pain Patients Applying Action Theory to Chronic
Illness. Journal of Clinical Psychology; 62(9): 1097–1113.
De Genova, M. K., & Rice, F. P. (2005).Intimate relationships,
marriages and families (6th Edition). Boston: McGraw-Hill.
De Panfilis, P. Salvatore, C. Marchesi, R. Cazzolla, M. Tonna, C.
Maggini.(2008). Parental bonding and personality disorder: the mediating
role of alexithymia. JournalofPersonalityDisorders, 22(5):496-508
Descutner, C. L, & Thelen, M. H. (1991) Development and
validation of a Fear-of- Intimacy Scale. Psychological Assessment, 3(2),
218-225.
De Rick A. and Vanheule S. (2006). The relationship between
perceived parenting, adult attachment style and alexithymia in alcoholic
inpatients. Addictive Behaviors, 31,1265-1270
Derogatis, L.R. (1983). SCL-90R Administration, Scoring and
Procedures Manual. Towson, MD: Clinical Psychometric Research.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The
Satisfaction With Life Scale. Journal of Personality Assessment, 49, 71-
75.
Dishion TJ, Burraston B, Poulin F. (2001). Peer group dynamics
associated with iatrogenic effects in group interventions with high-risk
young adolescents. In: Erdley C, Nangle DW, editors. Damon’s New
Directions in Child Development: The Role of Friendship in
Psychological Adjustment. San Francisco: Jossey-Bass; pp. 79–92.
Dishion, T. J., Burraston, B., & Li, F. (2003). A multimethod and
multitrait analysis of family management practices: Convergent and
predictive validity. In B. Bukoski & Z. Amsel (Eds.), Handbook for drug
abuse prevention theory, science, and practice. New York: Plenum.
Dixon, N. F. (1980), Humor: A cognitive alternative to stress.In I.
G. Sarason, C. D. Spielberg (Eds.), Stress and anxiety, hemisphere. Vol.
VII: Hemisphere (pp. 281-289). Washington DC: Wiley.
Dobrow, S., & Higgins, M.C. (2005). Developmental networks and
professional identity: A longitudinal study. Career Development
International, 10(6-7), 567- 583.
Doi, S. C., & Thelen, M. H. (1993). The Fear-of-Intimacy Scale:
Replication and extension. Psychological Assessment, 5(3), 377-383
ϭϴϵ
Dreher, G.F., & Ash, R.A. (1990). A comparative study of mentoring
among men and women in Resilience and Relationships 31 managerial,
professional, and technical positions. Journal of Applied Psychology,
75(5), 539-547.
Dutton, J.E. (2003). Energize your workplace: How to create and
sustain high-quality connections at work. San Francisco, CA: Jossey-Bass.
Edmondson, A.C. (1999). Psychological safety and learning behavior
in work teams.Administrative Science Quarterly, 44, 350-383.
Ekman, P. (1993). Facial expression and emotion. American
Psychologist, 48, 384–392.
Ekman, P. (1992). An argument for basic emotions. Cognition and
Emotion, 6, 169–200.
Engel, C.C. (2000). Unexplained physical symptoms: Medicine’s
“dirty little secret” and the need for prospective studies that start in
childhood. Psychiatry, 63, 153-159.
Farber, B. A., Brink, D. C., Raskim, P. M. (1998). The psychotherapy
of Carl Rogers: Cases and commentary. New York: Guilford Press.
Fenigstein, A., Scheier, M. F., & Buss, A. (1975). Public and private
self-consciousness: Assessment and theory. Journal of Consulting and
Clinical Psychology, 43, 522-527.
Feeney, B. C. (2004). A secure base: Responsive support of goal
strivings and exploration in adult intimate relationships. Journal of
Personality and Social Psychology, 87, 631-648.
Feeney, B. C. (2007). The dependency paradox in close
relationships: Accepting dependence promotes independence. Journal of
Personality and Social Psychology, 92, 268-285.
Fonagy, P., Gergely, G., Jurist, E. & Target, M. (2002). Affect
regulations, mentalization, and the development of the self. New York:
Other Press.
Keltner, D., & Kring, A.M. (1998). Emotion, social function, and
psychopathology. Review of General Psychology, 2, 320–342.
Keltner, D., Gruenfeld, D.H., & Anderson, C. (2003). Power,
approach, and inhibition. Psychological Review, 110, 265–284.
Fincham, F. D. (2000). The kiss of the porcupines: From attributing
responsibility to forgiving. Personal Relationships, 7, 1–23.
Fincham, F. D., & Beach, S. R. (2002). Forgiveness in marriage:
ϭϵϬ
Implications for psychological aggression and constructive
communication. Personal Relationships, 9, 239–251
Finkel, D., & McGue, M. (1997). Sex differences and nonadditivity
in heritability of the Multidimensional Personality Questionnaire scales.
Journal of Personality and Social Psychology, 72, 929-938.
Fletcher, J.K. (1996). A relational approach to the protean worker. In
D.T. Hall (Ed.), Thecareerisdead–longlivethe career: A relational
approach to careers (p. 101- 131). San Francisco: Jossey-Bass.
Fredrickson, B. L. (1998). What good are positive emotions? Review
of General Psychology, 2, 300-319.
Fredrickson, B. L. (2001). The role of positive emotions in positive
psychology: The broadenand-build theory of positive emotions. American
Psychologist, 56, 218-226.
Fredrickson, B. L., Tugate M. M., Waugh, C. E., Larkin, G. (2003).
What good are positive emotions in crisis? A prospective study of
resilience and emotions following the terrorist attacks in the United States
on September 11
th
, 2001. Journal of Personality and Social Psychology,
84, 365-376.
Friborg, O., Hjemdal O., Rosenvinge, J. H., Martinussen M. (2003).
A new Rating Scale for Adult Resilience: What are the Central Protective
Resources behind Healthy? International Journal of Methods and
Psychiatric Research, 1(2):65-76.
Fridlund, A. J. (1992). Darwin's anti-darwinism and the Expression
of the Emotions in Man and Animals. In K. T. Strongman
(Ed.), International Review of Emotion (Vol. 2) (Pp. 117-137). New York:
Wiley.
Friesen, M. D., Fletcher, G. J. O., & Overall, N. C. (2005). A dyadic
assessment of forgiveness in intimate relationships. Personal
Relationships, 12, 61-77.
Fry, W. (2001). Una dolce follia. L’umorismo e i suoi paradossi [A
gentle madness. The humor and its paradoxes]. Raffaello Cortina, Milano.
Gable, S. L., Reis, H. T., & Elliot, A. J. (2000). Behavioral activation
and inhibition in everyday life. Journal of Personality and Social
Psychology, 78, 1135-1149.
Gable, P. A., & Harmon-Jones, E. (2008). Approach-motivated
positive Affect reduces breadth of attention. Psychological Science, 19,
ϭϵϭ
476 – 482.
Gable, S. L., Reis, H. T., Impett, E. A., & Asher, E. R. (2004). What
Do You Do When Things Go Right? The Intrapersonal and Interpersonal
Benefits of Sharing Positive Events. Journal of Personality and Social
Psychology, 87(2), 228-245.
Gardner, H. (1993).Multiple intelligences: The theory in
practice. New York: BasicBooks.
Garfat, T. (2010). The truth in their experience: The evidence from
youth and families. Relationship Beachheads. 19(2), 55-57.
Garmezy, N. (1971). Vulnerability research and the issue of primary
prevention. American Journal of Orthopsychiatry, 41, 101-116.
Garmezy, N. (1974). The study of competence in children at risk for
severe psychopathology. In E.J. Anthony & C. Koupernik (Eds.), The
child in his family: Children at psychiatric risk III (pp. 77-97). New York:
Wiley.
Garmezy, N., & Tellegen, A. (1984). Studies of stress-resistant
children: Methods, variables, and preliminary findings. In F.J. Morrison,
C. Lord, & D.P. Keating (Eds.), Applied developmental psychology:
Vol. 1 (231-287). New York: Academic Press.
Gervai, J., Nemoda, Z., Lakatos, K., Ronai, Z, Toth, I, Ney, K, et al.
(2005). Transmission disequilibrium tests confirm the link between DRD4
gene polymorphism and infant attachment. American Journal of Medical
Genetics, 132B, 126-130.
Gianesini, G. (2009). Dieci anni di resilienza familiare: nuove
prospettive teoriche ed operative. Rivista Di Studi Familiari, 2:37-53.
Gianesini, G., Cusinato, M., and Colesso, W. (2010). Resilience as a
relational competence construct. In: Book of Abstracts of the Pathways to
Resilience II: The Social Ecology of Resilience, Dalhousie University,
Halifax, Nova Scotia, Canada, June 7-10, 2010.
Gianesini, G. (2011a). Alexithymia dimensions and perceived
emotional parenting styles. In M. Cusinato and L. L’Abate (Eds.).
Advances in relational competence theory: With special attention to
alexithymia (pp. 00-00). New York: NOVA.
Gianesini (2011b). Smiling, Laughing or crying in the face of
adversity? How our emotions impact us and those around us.
Interdisciplinary Journal of Family Studies,1,124-131
ϭϵϮ
Gianesini, G. (2012). Alexithymia Dimensions and Emotional
Perceived Parenting Styles. In L’Abate L. & Cusinato M.(Ed.). Advances in
Relational Competence Theory. New York: Nova Publishers.
Gillespie, B. M., Chaboye, W., and Wallis, M. (2004). Development
of a theoretically derived model of resilience through concept analysis.
Contemporary Nurses, 25(1- 2), 124-35.
Gillespie, B. M., Chaboye, W., & Wallis, M. (2007). Development of
a theoretically derived model of resilience through concept analysis.
Contemporary Nurse Contemporary Nurse, 25(1-2), 124-135.
Gittell, J.H., Cameron, K., Lim, S., & Rivas, V. (2006).
Relationships, layoffs, and organizational resilience: Airline industry
responses to September 11. The Journal of Applied Behavioral Science,
42(3), 300-329.
Goldstein MD, Strube MJ. Independence revisited: The relation
between positive and negative affect in a naturalistic setting. Personality
and Social Psychology Bulletin. 1994;20:57–64.
Goleman, D. (1995). Emotional intelligence. New York: Bantam
Books.
Gottlieb, B.H. (1983). Social support strategies: Guidelines for
mental health practice. Beverly Hills: Sage.
Gottman, J. M., & Declaire, J. (1996) Raising and emotionally
intelligent child: The heart of parenting. New York: Fireside.
Gottman, J. (1997). Raising an emotionally intelligent child. New
York: Fireside: Simon and Schuster, Inc.
Gottman, J. M., Katz, L. F., & Hooven, C. (1997) Meta-emotion:
How families communicate emotionally. Mahwah, NJ: Lawrence Erlbaum
Associates
Govern J. M., & Marsh, L. A. (2001). Development and validation of
the Situational Self-Awareness Scale. Consciousness and Cognition, 10,
(3), 366-378.
Grabe, H.J. Spitzer, C., & Freyberger, H.J. (2001). Alexithymia and
the temperament and character model of personality. Psychotherapy and
Psychosomatics, 70, 261-267.
Granovetter, M. 1973. The strength of weak ties. The American
Journal of Sociology 78(6):1360–1380.
ϭϵϯ
Gray, Matt J. and Slagle, David M.(2006). Selecting a Potentially
Traumatic Event Screening Measure. Journal of Trauma Practice, 5:2, 1
—19
Gross, J., & Levenson, R. (1993). Emotional suppression:
Physiology, self-report, and expressive behavior. Journal of Personality
and Social Psychology, 64, 970-986.
Gross, J. (1998). The emerging field of emotion regulation: An
integrative review. Review of General Psychology, 2(3), 271-299.
Grotberg, E. (2003). Resilience for today: Gaining strength from
diversity. Westport, CT: Prager.
Grunert, S. L (2009). The relationship between adult attachment style
and resilience factors of hope and positive affect. Dissertation Abstract
International: Section B: The Sciences and Engineering, 69(8-B), 5075.
Gucciardi, D. F., Jackson, B, Coulter, T, J., Mallett C. J. (2011). The
Connor-Davidson Resilience Scale (CD-RISC): Dimensionality and age-
related measurement invariance with Australian cricketer. Psychology and
Sports, 1:1-11.
Gulati, R., & Garguilo, M. (1999). Where do inter-organizational
networks come from? The American Journal of Sociology, 104(5), 1439-
1493.
Hackman, J.R., Wageman, R. (2005). A theory of team coaching.
Academy of Management Review, 30(2), 269-287.
Haines VA, Hurlbert JS. Network range and health. Journal of
Health and Social Behavior. 1992;33:254–266.
Hale, D.H., Fiedler, L.R., & Cochran, C.D. (1992). The revised
generalized expectancy for success scale: A validity and reliability study.
Journal of Clinical Psychology, 48(4),517-521.
Hall, D.T., & Chandler, D.E. (2005). Psychological success: When
the career is a calling. Journal of Organizational Behavior, 26(2), 177-
202.
Halpern, D.F. (2005). Psychology at the intersection of work and
family: Recommendations for employers, working families, and
policymakers. American Psychologist, 60(5), 397-409.
Hansen, J. C., & L’Abate, L. (Eds.). (1982).Values, ethics, legalities,
and the family therapist. Rockville, MD: Aspen System Corporation.
ϭϵϰ
Harland, L., Harrison, W., Jones, J.R., & Reiter-Palmon, R. (2005).
Leadership behaviors and subordinate resilience. Journal of Leadership
and Organizational Studies, 11(2), 2-14.
Hathaway, S. R., & McKinley, J. C. (1940). A multiphasic
personality schedule (Minnesota): I. Construction of the schedule. Journal
of Psychology , 10 , 249–254.
Hayes, M. Linehan, & V. Follette (Eds.), Mindfulness and
acceptance: Expanding the cognitivebehavioral tradition
(pp. 66–95). New York: Guilford.
Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as
an attachment process. Journal of Personality and Social Psychology, 52,
511-524.
Heatherton, T. F., & Nichols, P. A. (1994). Personal accounts of
successful versus failed attempts at life change. Personality and Social
Psychology Bulletin, 20, 664- 675.
Haslee Sharil Lim Abdullah (2006). A Comparison Ofmalaysian
Counselor Resilience between School Types, Jurnal Pendidikan,
Universiti Malaya
Higgins, M.C. (2001). Changing careers: The effects of social
context. Journal of Organizational Behavior, 22, 595-617.
Higgins, M.C., & Kram, K.E. (2001). Reconceptualizing mentoring
at work: A developmental network perspective. Academy of Management
Review, 26(2), 264-288.
Higgins, M.C., & Thomas, D.A. (2001). Constellations and careers:
Toward understanding the effects of multiple developmental relationships.
Journal of Organizational Behavior, 22,223-247.
Higgins, M.C. (2005). Career imprints: Creating leaders across an
industry. San Francisco: Jossey-Bass.
Higgins, M.C. (2007). A contingency perspective on developmental
networks. In J. Dutton and B.R. Ragins (Eds.), Exploring Positive
Relationships at Work: Building a Theoretical and Research Foundation
(pp. 207-224). Hillsdale, NJ: Lawrence Erlbaum Associates.
Hinde, R. A., Finkenauer, C., &Auhagen, A. E. (2001). Relationships
and the self-concept. Personal Relationships, 8, 187-204.
ϭϵϱ
Hippe, J. (2004).Self-Awareness: A Precursor to Resiliency.
Reclaiming Children and Youth: The Journal of Strength-based
Interventions, 12(4):240-243.
Hoffman, M.L. (1981). The Development of Empathy, In: J. P.
Rushton and R. M. Sorrentino (Eds.), Altruism and helping behavior (pp.
41-63). Hillsdale: Lawrence Erlbaum Associates.
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating
scale. Journal of Psychosomatic Research, 11, 213-218.
Holohan, C.J., Moos, R.H., & Schaefer, J.A. (1996). Coping, stress
resistance, and growth: Conceptualizing adaptive functioning. In M.
Zeidner & N. S. Endler (Eds.), Handbook of coping (pp. 24-43). New
York: John Wiley & Sons.
Hong, S., Huang, B., Tajima, E. A., Herrenkohl, T. I., Whitney, S. D.
(2004). Testing a family resilience framework as a protective mechanism
for the impact of physical child abuse: A structural equation model (SEM)
analysis. Paper presented at the meeting of the Society for Social Work
and Research, January 2004, New Orleans, LA.
http://www.sswr.org/papers2004/301.htm.
Huisman, M. & Snijders, T.A.B. (2003). Statistical analysis of
longitudinal network data with changing composition. Sociological
Methods & Research, 32(2), 253-287.
Irwin, H.J. (1999). Pathological and non-pathological dissociation:
The relevance of childhood trauma. Journal of Psychology, 133, 157-164.
Izard, C. E., Dougherty, F. E., Bloxom, B. M., & Kotsch, W. E.
(1974). The differential emotions scale: A method of measuring the
subjective experience of discrete emotions. Unpublished manuscript.
Nashville, TN: Vanderbilt University.
Jackson, J. D (2006). Trauma, attachment, and coping: Pathways to
resilience. Dissertation Abstract International: Section B: The Sciences
and Engineering, 67 (1-B), 547.
Janoff-Bulman, R. (1992). Shattered Assumptions. New York: Free
Press.
Janoff-Bulman, R. (2006). Schema change perspectives on
posttraumatic growth. In L. G. Calhoun and R. G. Tedeshi (Eds.)
Handbook of posttraumatic growth. Mahwah, NJ: Lawrence Erlbaum.
ϭϵϲ
Jew, C. L., Green, K. E., & Kroger, J. (1999). Development and
validation of a measure of resiliency. Measurement and Evaluation in
Counseling and Development, 32, 75- 89.
Joinking, A. (2003). Building resilient families. Australian Social
Policy Conference, 9-11 July 2003 - Papers. Sydney, NSW: Social
Policy Research Centre, University of New South Wales, Online only.
John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion
regulation: personality processes, individual differences, and life span
development. Journal of Personality, 72, 1301-1333.
Jowkar, B., Friborg Od., Hjemdal, O. (2010). Cross-cultural
validation of the Resilience Scale for Adults (RSA) in Iran. Scandinavian
Journal of Psychology, 51(5):418-425
Jula, A., Salminen, J.K., & Saarijarvi, S. (1999). Alexithymia: A
facet of essential hypertension. Hypertension, 33, 4, 1057-1061.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G.,
Fletcher, K., Pbert, L., Linderking, W., & Kessler, R., Sonnega, A.,
Bromet, E., & Nelson, C.(1995). Posttraumatic stress disorder in the
National Comorbidity Survey.Archives of General Psychiatry, 52, 1048-
1060.
King, J.L. (2000). Family environment and alexithymia in clients and
non-clients. Psychotherapy Research, 10, 78-86.
Kinnear, P. (2002) New families for changing times. The Australia
Institute, Discussion Paper N, 47.
Kinnear, P. (2002). New families for changing times. The Australia
Institute Discussion Paper No 47. Reference Group on Welfare Reform
(McClure Report).
Kleim, B. and Ehlers A. (2009). Evidence for a curvilinear
relationship between posttraumatic growth and post-trauma depression
andPTSDinassaultsurvivors. Journal of Traumatic Stress, 22, 1:45-52.
Klein, G. K. (1959). Consciousness in psychoanalytic theory: Some
implications for current research in perception. Journal of the American
Psychoanalytic Association, 7, 5-34.
Kobasa, S. C. (1979). Stressful life events, personality, and health:
An inquiry into hardiness. Journal of Personality and Social Psychology,
37, 1-11.
ϭϵϳ
Kobasa, S., Maddi, S. & Kahn, S. (1982). Hardiness and health: A
prospective study. Journal of Personality and Social Psychology, 42 (1),
168-177.
Kooiman, C. G., Vellinga, S., Spinhover, Ph., Draijer, N., Triisburg,
R. W., & Rooijmans. H. G. M. (2004). Childhood adversities as risk
factors for alexithymia and other disorders of affect deregulation in
adulthood. Psychotherapy and Psychosomatics, 73(2), 107-507.
Kraemer, H.C., Kazdin, A.E., Offord, D.R., Kesler, R.C., Jensen,
P.S., & Kupfer, D.J. (1977). Coming to terms with the terms of risk.
Archives of General Psychiatry, 54, 337-343.
Kram, K.E. (1985). Mentoring at work: Developmental relationships
in organizational life. Glenview, IL: Scott Foresman.
Krystal, J.H. (1998). Integration and self-healing:Affect, trauma,
alexithymia. Hillsdale, NJ: Analytic Press.
L’Abate, L. (1986). Systematic family therapy. New York:
Brunner/Mazel.
L’Abate, L. (1994). A theory of personality development. New York:
Wiley.
L’Abate, L. (1997). The self in the family: A classification of
personality, psychopathology, and criminality. New York: Wiley.
L’Abate, L., & De Giacomo, P. (2003). Intimate relationships and
how to improve them: Integrating theoretical models with prevention and
psychotherapy. Westpost, CT: Praeger.
L’Abate, L. (2005). Personality in intimate relationships.
Socialization and psychopathology. New York: Springer.
L’Abate, L., & Cusinato, M. (2007). Linking theory with practice:
Theory derived interventions on prevention and psychotherapy. The
Family Journal: Counseling and Therapy for Couples and Families, 15,
318-327.
L’Abate L. (2008). A hierarchical framework for relational
competence theory. Psychologia Rozwojowa, 13, 9-19.
L’Abate, L. (2008). Applications of relational competence theory to
prevention and psychotherapy. In K. Jordan (Ed.). The quick theory
reference guide: Aresource for expert and novice mental health
professionals (pp. 475-492). Hauppauge, NY: Nova Science Publishers
ϭϵϴ
L’Abate, L. (2009). Relational competence theory: Research and
mental health applications. New York: Springer.
L’Abate, L. (2009). A theory-derived structured interview for
intimate relationships. The Family Psychologist,
L’Abate, L., Cusinato, M., Maino, E., Colesso, W., & Scilletta, C.
(2010). Relational competence theory: Research and mental health
applications. New York: Springer.
L’Abate, L. (2010). Resilience: a construct in search of a theory.
Rivista di Studi Familiari, 2, 1-20.
L’Abate, L. (2011). Hurth feelings: Theory, research, and
application in intimate relationships. New York: Cambridg University
Press.
Laible, D. J., Carlo, G., Raffaelli, M. (2000). The differential impact
of parent and peer attachment on adolescent adjustment. Journal of Youth
and Adolescent, 29, 45-59.
Laible, D. J., Carlo, G., Roesch S. C. (2004). Pathways to self-
esteem in late adolescence: The role of parent and peer attachment,
empathy, and social behaviours. Journal of Adolescence, 27, 703-716.
Lalande K. and Bonanno A. G. (2011). Retrospective Memory Bias
for the Frequency of Potentially Traumatic Events: A Prospective Study.
Psychological Trauma, 32:165-170.
Lamond, A. J, Depp, C. A, Allison, M, Langer, R, Reichstadt, J,
Moore, D. J, Golshan, S, Ganiats, T. G., Jeste (2008). Measurement and
predictors of resilience among community-dwelling older women.
Journal of Psychiatric Research, 43(2o), 148-54.
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1998). Emotion and
motivation: Measuring affective perception. Journal of Clinical
Neurophysiology, 15, 397-408.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping.
New York: Springer.
Lecomte, J. 2002. What is resilience? A falsely simple question, a
necessarily complex response. Pratique Psicholoquie, 1:7-14
Lefcourt, H. M. & Martin, R. A. (1986). Humor and Life Stress:
Antidote to Adversity. New York: Springer-Verlag.
ϭϵϵ
Legacè-Segùn, D., d’Entremont, M. L. (2006). The role of child
negative affect in the relations between parenting styles and play. Early
child development and care, 186(5), 461-477.
Leontopoulou, S. (2010). An exploratory study of altruism in Greek
children: Relations with empathy, resilience, and classroom
climate. Psychology 1, 5, 377-385.
Lepore, S. J., Silver, R. C., Wortman, C. B., and Wayment, H. A.
(1996). Social constraints, intrusive thoughts, and depressive symptoms
among bereaved mothers. Journal of Personality and Social Psychology,
70(2),271-282.
Leslie, M. S., Andy, D. (2006). Psychosocial vulnerability and
resilience measures for national-level monitoring of orphans and other
vulnerable children: Recommendations for revision of the UNICEF
Psychological Indicator. Report prepared for UNICEF. Retrieved online
at:
http://www.childinfo.org/files/PsychosocialMeasures_Final06.pdf
Letzring T. D., Block J. and Funder, D. C. (2004) .Ego-control and
ego-resiliency: Generalization of self-report scales based on personality
descriptions fromacquaintances, clinicians, and the self. Journal of
Research in Personality
Levinson, D., Darrow, C., Klein, E., Levinson, M., & Mckee, B.
(1978). The seasons of a man’s life. New York: Knopf.
Lifton, R. J. (1988). Understanding the traumatized self: Imagery,
symbolization and trasformation. Plenum Press, New York.
Lifton, R. J. (1993). The protean self: Human resilience in an age of
transformation. New York: Basic Books.
Linsley, P. A. (2003). Positive adaptation to trauma: Wisdom as both
process and outcome. Journal of Trauma and Stress, 16 (6), 601-610.
Linsley P.A. (2004). Positive Change Following Trauma and
Adversity: a Review. Journal of Trauma and Stress, 17(1):11-21.
Losada, M., & Heaphy, E. (2004). The role of positivity and
connectivity in the performance of business teams: A non-linear dynamics
model. American Behavioral Scientist, 47, 740-765.
Lumley, M.A., Mader, C., Grzmsown, J., & Papneau, K. (1996).
Family factors related to alexithymia characteristics. Psychosomatic
Medicine, 58, 203-210.
ϮϬϬ
Luthans, F. (2002). The need for and meaning of positive
organizational behavior. Journal of Organizational Behavior, 23, 695-
706.
Luthans, F., Luthans, K.W., & Luthans, B.C. (2004). Positive
psychological capital : Beyond human and social capital. Business
Horizons, 47(1), 45-50.
Luthans, F., Vogelgesang, G.R., & Lester, P.B. (2006). Developing
the psychological capital of resilience. Human Resource Development
Review, 5(1), 25-44.
Luthar, S.S. (1991). Vulnerability and resilience: A study of high-
risk adolescents. Child Development, 62, 600-616.
Luthar, S.S. (1999). Poverty and children’s adjustment. Newbury
Park, CA: Sage.
Luthar, S.S., Cicchetti, D., & Becker. B. (2000).The construct of
resilience: A critical evaluation and guidelines for future work. Child
Development, 71(3), 543-562.
Luthar, S.S., D’Avanzo, K., & Hites, S. (2003). Maternal drug abuse
versus other psychological disturbances: Risks and resilience among
children. In S.S. Luthar (Ed.), Resilience and vulnerability: Adaptation in
the context of childhood adversities (pp. 104-129). Cambridge, UK:
Cambridge University Press.
Maccoby, E. E., & Martin, J. A. (1983). Socialization in the context
of the family: Parent–child interaction. In P. H. Mussen (Ed.) & E. M.
Hetherington (Vol. Ed.), Handbook of child psychology: Vol.
4. Socialization, personality, and social development (4th ed., pp. 1-101).
New York: Wiley.
Maddi, S.R., & Khoshaba, D.M. (2005). Resilience at work: How to
succeed no matter what life throws at you. New York: Amacom.
Maddi, S.R., Harvey, R.H., Khoshaba, D.M., Lu, J.L., Persico, M., &
Brow, M. (2006). The personality construct of hardiness, III:
Relationships with repression, innovativeness, authoritarianism, and
performance. Journal of Personality, 74(2), 575-598.
Maddi, S. R. (1996). Personality theories: A comparative analysis.
New York: Brooks/Cole.
Mannion, J. (2006). Essentials of philosophy: The basic concepts of
the world. New York, NY: all River Press.
ϮϬϭ
Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and
development: Contributions from the study of children who overcome
adversity. Development and Psychopathology, 2, 425-444.
Masten, A. S, Coatsworth, J. D., Neemann, J., Gest, S. D, Tellegen,
A., & Garmezy, N. (1995). The structure and coherence of competence
from childhood through adolescence. Child Development, 66, 1635-
1659.
Masten, A. S., & Coatsworth, J. D. (1998). The development of
competence in favorable and unfavorable environments. Lessons from
research on successful children. American Psychologist, 53, 205-220.
Masten, A.S., Hubbard, J.J., Gest, S.D., Tellegen, A., Garmezy, N.,
& Ramirez, M. (1999). Competence in the context of adversity: Pathways
to resilience and maladaptation from childhood to late adolescence.
Development and Psychopathology, 11, 143-169.
Masten, A. (2001) Ordinary Magic. Resilience Processes in
Development. American Psychologist, 56(3):227-238.
McCall, M.W. (1998). High flyers: Developing the next generations
of leaders. Boston: Harvard Business School Press.
McCrae, R. R., & Costa, P. T. (1997) Personality trait structure as a
human universal. American Psychologist, 52, 509-516.
McCubbin, H. I., Thompson, A. I., McCubbin, M. (1996). Family
assessment: Resiliency, coping, and adaptation. Madison, WI: University
of Wisconsin System.
McCubbin H. I., McCubbin, M. A, Thompson, A. I., Sae-Young H.,
Chad A.T. (1997). Families under stress: What makes them Resilient?
American Association of Family and Consumer Sciences Commemorative
Lecture, June 22, 1997, Washington D.C.
McGregor, I., et al. (2009). Threat, high self-esteem, and reactive
approach-motivation: Electroencephalographic evidence. Journal of
Experimental Social Psychology.
McGregor, Nash and Inzlicht (2009). Threat, high self-esteem, and
reactive approach-motivaton. Electoencephalograhic evidence. Journal of
Experiemental Social Psychology,
Meerum T. M., Koops, M., Oosterhoff, T., & Olthof, T. (1989).
Development in processing of multiple emotional situations. Journal of
General Psychology, 113, 109 –119.
ϮϬϮ
Miller, J.B., & Stiver, I.P. (1977). The healing connection: How
women form relationships in therapy and in life. Boston: Beacon Press.
Miozzi, E. (2007). Risorse personali di competenza relazionale.
Applicazione del QRR a 276 soggetti [Personal resources of relational
competence. Application of the QRR to 276 subjects]. Unpublished
degree dissertation. University of Padua, Italy.
Monroe, S. M., & Simons, A. D. (1991). Diathesis-stress theories in
the context of life stress research: Implications for the depressive
disorders. Psychological Bulletin, 119(3), 406-425.
Moos, R. H., & Moos, B. S. (1976). A typology of family social
environment. Family Process, 15, 357-372.
Moormann, P. P., Bermond, B., Vorst, H. C. M., Bloemendaal, F. T.,
Tejin, S. M., & Rood, L. (2008). New avenues in alexithymia research:
The creation of alexithymia types. In: J. J., M. Vingenhoets and I.
Nyklíƙk, and J. Denollet (Eds.), Emotion regulation. Conceptual and
clinical issues (pp. 27-42). New ork, Springer.
Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1999). A clinical
profile of women with posttraumatic stress disorder and substance
dependence. Psychology of Addictive Behaviors, 13, 98-104.
Neill, J. T., & Dias, K. L. (2000). Adventure education and
resilience: The double- edged sword. Unpublished master’s thesis,
University of New Hampshire, USA.
Neill, J. T., & Dias, K. L. (2001). Adventure education and
resilience: The double-edged sword. Journal of Adventure Education and
Outdoor Learning, 1(2), 35-42.Nemiah, J. C., Freyberger, H., & Sifneos,
P. E. (1976) Alexithymia: A view of the psychosomatic process. In O. W.
Hill (Ed.), Modern trends in psychosomatic medicine (pp. 430-439.
London: Butterworths.
Newman & Dale (2005). Promoting resilience in at-risk youth: The
development of a therapeutic model. Dissertation Abstract International:
Section B: The Sciences and Engineering, 65(10-B), 5416.
Nijenhuis, E.R.S., & Van der Hart, O. (1999). Forgetting and
reexperiencing trauma. In J. Goodwin & R. Attias (Eds.), Splintered
reflections: Images of the body in treatment (pp. 39-65). New York: Basic
Books.
ϮϬϯ
Norris, F. H., & Hamblen, J. L. (2004). Standardized self-report
measures of civilian trauma and posttraumatic stress disorder. In J. P.
Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD
(2nd ed., pp. 63-102). New York: Guilford.
Norris, F. H. (1992). Epidemiology of trauma: Frequency and impact
of different potentially traumatic events on different demographic
groups. Journal of Consulting and Clinical Psychology, 60, 409–418.
Nijenhuis, E R.S. (1999). Somatoform dissociation: Phenomena,
measurement and theoretical issues. Assan, The Netherlands: Van
Gorcum.
Nyklicek, I., & Vingerhoets, J.J.M. (2000). Alexithymia is associated
with low tolerance to experimental painful stimulation. Pain, 85, 471-475.
O’Connor, D., & Wolfe, D.M. (1991). From crisis to growth at
midlife: Changes in Resilience and Relationships 34 personal paradigm.
Journal of Organizational Behavior, 12(4), 323-340.
Ogawa, J.R., Sroufe, L.A., Weinfield, N.S., Carlson, E.A. &
Egeland, B. (1997). Development and the fragmented self: A
longitudinal study of dissociative symptomatology in a non-clinical
sample. Development and Psychopathology, 9, 855-879.
Olson, D. H., & DeFrain, J. (2000). Marriage and family diversity
and strengths. Mayfield, Mountain View, CA: Mayfield Publishing
Ong, A., Bergeman, C. S., & Bisconti, T. L. (2006). The role of daily
positive emotions during conjugal bereavement. Journal of Gerontology:
Psychological Sciences, 59B, P158-167.
O’Neal, M. R. (1999). Measuring resilience. Paper presented at the
annual meeting of the Mid-South Educational Research Association.
Point Clear, AL.
Orsillo, S.M., Roemer, L., Block Lerner, J., Tull, M. T. (2004).
Acceptance, mindfulness, and cognitive-behavioral therapy: Comparisons,
contrasts and applications to anxiety. In S. C. Hayes, V. M. Follette, and
M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the
cognitive-behavioral tradition. New York: Guilford Press.
Oshio A., Kaneko H., Nagamine, S., Nakaya, M. (2003). Construct
validity of the Adolescent Resilience Scale. Psychological Reports. 93
(3), 1212-1222.
ϮϬϰ
Otake, K., Shimai, S., Tanaka-Matsumi, J., Otsui, K., & Fredrickson,
B. L. (2006). Happy people become happier though kindeness: A counting
blessings intervention. Journal of happiness Studies, 7, 361-375.
Ouimette, P. C., Ahrens, C., Moos, R. H., & Finney, J. W. (1997).
Posttraumatic stress disorder in substance abusing patients: Relationship
to 1-year post- treatment outcomes. Psychology of Addictive Behaviors,
11, 34-47.
Park, C. L, Aldwin, C. M., Fenster, J. R. and Snyder, L. B. (2008) .
Pathways to posttraumatic growth versus posttraumatic stress: coping and
emotional reactions following the September 11, 2001, terrorist attacks.
American Journal of Orthopsychiatry, 78, 3:300-312
Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2003). The twenty-
item Toronto Alexithymia Scale--III. Reliability and factorial validity in a
community population. Journal of Psychosomatic Research, 55, 269-275.
Parker, J.D.A; Taylor, G.J., and Bagby, R.M (2001). "The
Relationship Between Emotional Intelligence and Alexithymia".
Personality and Individual Differences 30: 107–115.
Patterson, J. M. (2002). Understanding family resilience. Journal of
Clinical Psychology, 58 (3), 233-246.
Pluess M., & Belsky, J. (2010). Children’s differential susceptibility
to effects of parenting. Family Science, 1(1), 14-25.
Podolny, J.M., & Baron, J.N. (1997). Relationships and resources:
Social networks and mobility in the workplace. American Sociological
Review, 62, 673-693.
Portes, A. 1998. Social capital: its origins and applications in modern
sociology. Annual Review of Sociology 24:1–24.
Posse, M., & Hallstrom, T. (1998). Alexithymia personality
characteristics and somatization tendency in different physical diseases.
European Journal of Personality, 7, 221-232.
Putnam, F.W., Carlson, E.B., Ross, C.A., Anderson, G., Clark, P.,
Torem, M., Bowman, E.S., Coons, P., Chu, J.A., Dill, D.L., Loewenstein,
R.J., & Braun, B.G. (1996). Patterns of dissociation in clinical and
nonclinical samples. Journal of Nervous and Mental Diseases, 184, 673-
679.
Putnam, R. 2000. Bowling alone: the collapse and revival of
American community. Simon and Schuster, New York, New York, USA.
ϮϬϱ
Richardson, G. E., (2002). The metatheory of resilience and
resiliency. Journal of Clinical Psychology, 58, 307-321.
Richardson, G. E., Waite, P. J. (2002). Mental health promotion
through resilience and resiliency education. International Journal of
Emergent Mental Health, 4, 65-75.
Roberts, L.M., Dutton, J.E., Spreitzer, G., Heaphy, E., & Quinn, R.E.
(2005). Composing the reflected best self: Building pathways for
becoming extraordinary in workorganizations. Academy of Management
Review, 30(4), 712-736.
Robins, L., & Rutter, M. (1990). Straight and devious pathways from
childhood to adulthood. Cambridge: Cambridge University Press.
Roemer, L. & Orsillo, S. M. (2002). Expanding our
conceptualization of and treatment for generalized anxiety disorder:
Integrating mindfulness/acceptance-based approaches with existing
cognitive-behavioral models. Clinical Psychology: Science and Practice,
9, 54–68.
Rose, D. (2006). Consciousness. Philosophical, Psychological and
Neural Theories. New York: Oxford University Press.
Rosemberg, M. (1985). Self-concept and psychological well-being in
adolescence. In R. L. Leahy (Ed.), The development of self (pp. 205-246).
New York: Academic.
Rosenthal, D. M. (2002). How many kinds of consciousness?
Consciousness and Cognition, 11, 4, 653-665.
Rutter, M. (1987). Psychosocial resilience and protective
mechanisms. American Journal of Ortho-psychiatry, 57(3), 316-331.
Rutter, M. (1987). Psychosocial resilience and protective
mechanisms. American Journal of Orthopsychiatry, 57, 316-331.
Ryff, C. D., Singer, B., Dienberg Love, G., & Essex, M. J. (1998).
Resilience in adulthood and later life. In J. Lomaranz (Ed.), Handbook of
aging and mental health: An integrative approach (pp. 69-96). New York:
Plenum Press.
Saarni, C. (1989). Children understands of strategic control of
emotional expression in social transactions. In C. Saarni & P. L. Harris
(Eds.), Children understands of emotion. New York: Cambridge
University Press
ϮϬϲ
Sackheim HA, Weber SL. Functional brain symmetry in the
regulation of emotion: Implication for bodily manifestations of stress. In:
Goldberger L, Breznitz S, editors.Handbook of stress: Theoretical and
clinical aspects. Free Press; New York: 1982. pp. 183–199.
Salminen, J.K., Saarijarvi, S., Aarela, E., Toikka, T., & Kauhanen, J.
(1999). Prevalence of alexithymia and its association with
sociodemographic variables in the general population of Finland. Journal
of Psychosomatic Research, 46, 75-82.
Salvo, R. (1998). Attachment theory for studying couple
relationships. Unpublished Ph.D. dissertation. University of Padua, Italy.
Sameroff, A. J. Systems of development: Contexts and evolution. In
W. Kessen (Ed.), History, theories and methods (Vol. 1), of P. H. Mussen
(Ed.), Handbook of child psychology (Vol. 4). New York: Wiley, 1983.
Sandonà, C. (2006). Influence of family context on adolescent
development and relational competence. Unpublished degree dissertation.
University of Padua, Italy.
Santorelli, S.F. (1992). Effectiveness of a meditation-based stress
reduction program in the treatment of anxiety disorders. American Journal
of Psychiatry, 149, 936–943.
Sarason, I., Johnson, J., & Siegel, J. (1978). Assessing the Impact of
Life Changes: Development of the Life Experiences Survey. Journal of
Consulting and Clinical Psychology, 46(5), 932-946.
Sarchiapone, M., Jovanovic, N., Roy, A., Podlesek, A., Carli, V.,
Amore, M., Mancini, M., & Marusica, A. (2009) Relations of
psychological characteristics to suicide behavior. Results from a large
sample of male prisoners. Journal of Personality and Individual
Differences, 47, 250-255.
Schütte, N. S., Malouff, J. M., Hall, L. E., Haggerty, D. J., Cooper, J.
T., Golden, C.J., et al. (1998). Development and validation of a measure
of emotional intelligence. Personality and Individual Differences, 25,
167-177.
Segerstrom, S. C., Taylor, S. E, Kemeny, M. E., Fahey, J. L. (1998).
Optimism is associated with mood, coping and immune change in
response to stress. Journal of personality and Social Psychology, 74 (6),
1646.1655.
ϮϬϳ
Seligman, M.E.P., & Csikszentmihalyi, M. (2000). Positive
psychology: An introduction.American Psychologist, 55(1), 5-14.
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of
mindfulness-based stress reduction on medical and premedical students.
Journal of Behavioral Medicine, 21, 581–599.
Shaver, P. R., & Mikulincer, M. (2007). Adult attachment strategies
and the regulation of emotion. In J. J. Gross (Ed.), Handbook of emotion
regulation (pp. 446-465).
Shiota, M. N., & Keltner, D. (2002). The Differential positive affect
scale: Trait experience of eleven affects. Unpublished manuscript. Shrout
PE, Fleiss JL.
Shurcliff, A., 1968. Judged humor, arousal and the relief theory.
Journal of Personality and Social Psychology, 8: 360-363.
Shuettler, D. and Boals, A. (2011). The path to posttraumatic growth
versus posttraumatic stress disorser: Contribution of event centrality and
coping. Journal of Loss and Trauma, 16, 194.
Schultz, R.T., 2005. Developmental deficits in social perception in
autism: the role of the amygdala and fusiform face area. International
Journal of Developmental Neuroscience 23 (2–3), 125–141.
Schütte, N. S., Malouff, J. M., Hall, L. E., Haggerty, D. J., Cooper, J.
T., Golden, C.J., et al. (1998). Development and validation of a measure
of emotional intelligence. Personality and Individual Differences, 25,
167-177.
Sifneos, P.E. (1973). The prevalence of “alexithymic” characteristics
in psychosomatic patients. Psychotherapy and Psychosomatics, 22, 255-
262.
Silberberg, S. (2001). Searching for family resilience. Family
Matters, 58, 52-57.
Singer, J. D. & Willett, J. B. (2003). Applied Longitudinal Data
Analysis: Modeling Change and Event Occurrence. Oxford; New York:
Oxford University Press.
Smedslund, J. (1991a). The pseudoempirical in psychology and the
case for psychologic. Psychological Inquiry, 2, 325-338.
Smedslund, J. (1997). The structure of psychological common sense.
Mahwah: Lawrence Erlbaum Associates.
ϮϬϴ
Smith, B. C., Dalen J., Wiggins, K., Tooley, E., Christopher P., and
Bernard J. (2008). The Brief Resilience Scale: Assessing the ability to
Bounce Back. International Journal of Behavioral Medicine, 15:194-200.
Snell, W. E. (1998). The Relational Awareness Scale: Measuring
relational-consciousness, relational-monitoring, and relational-anxiety.
Contemporary Social Psychology, 18, 23-49.
Snell, W. E. (1998). The Relationship Awareness Scale: Measuring
Relational-Consciousness, Relational Monitoring, and Relational Anxiety.
Contemporary Social Psychology, 18, 23-49.
Spielberger, C. D., Reheiser, E. R., & Sydeman, S. J. (1995).
Measuring the experience, expression, and control of anger. In H.
Kassinove (Ed.), Anger disorders: Definition, diagnosis, and treatment
(pp. 49-67). Philadelphia, PA: Taylor & Francis.
Spreitzer, G., Sutcliffe, K., Dutton, J., Sonenshein, S., & Grant, A.M.
(2005). ASocially embedded model of thriving at work. Organization
Science, 16(5), 537-549.
Stinnet, N., DeFrain, J. (1995). Secrets of Strong Families. Boston:
Little Brown.
Stone, L.A. & Nielson, K.A. (2001). Physiological response to
arousal and impaired emotional expression in alexithymia. Psychotherapy
and Psychosomatics, 70, 92-102.
Storm, C. Storm, T. (1987). A taxonomic study of the vocabulary of
emotions.Journal of Personality and Social Psychology, 53, 805-816.
Strader, T., Collins, D., Noe, T. (2000). Building healthy individuals,
families, and communities: Creating lasting connections. New York:
Kluwer Academic/Plenum.
Strask, B. S. (2005). Strengthening low-income families through
community-based family support initiatives. Family Strengths and
Resilience. National Council on Family Relations, 28, 12-22.
Strengthening Families Program. University of Utah, Department of
Health Promotion and Education, UK. In
www.strngtheningfamiliesprogram.org.
Sutcliffe, K.M., & Vogus, T.J. (2003). Organizing for resilience. In
K.S. Cameron, J.E. Dutton, & R. E. Quinn (Eds.), Positive organizational
scholarship (pp. 94-110). San Francisco:Berrett-Koehler.
Sutton, S. K., & Davidson, R. J. (1997). Prefrontal brain asymmetry:
ϮϬϵ
A biological substrate of the behavioral approach and inhibition systems.
Psychological Science, 8,204–210
Swendsen JD, Tennen H, Carney MA, Affleck G, Willard A, Hromi
A. Mood and alcohol consumption: An experience-sampling test of the
self- medication hypothesis.Journal of Abnormal Psychology:109:198–
204.
Taylor, G.J., Bagby, R.M., & Parker, J.D.A. (1997). Disorders of
affect regulation: Alexithymia in medical and psychiatric illness.
Cambridge, UK: Cambridge University Press.
Tebes, J. K, Irish, J. T., Puglisi Vasquez, M. J., Perkins, D. V.
(2004). Cognitive transformation as a marker of resilience. Substance
Abuse and Misuse, 39 (5), 769-788.
Thomas, D.A., & Kram, K.E. (1988). Promoting career-enhancing
relationships in organizations: The role of the human resource
professional. In M. London & E. Mone (Eds.), The human resource
professional and employee career development (pp. 46-66). New York:
Greenwood.
Tiberi, E., & Pedrabissi, L. (1988). Caratteristiche emozionali degli
italiani. Ricerca empirica sulla frequenza delle emozioni [Emotional
characteristics of Italians. Empirical research on the frequency of
emotions.]. Milan. Giuffré.
Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals
use positive emotions to bounce back from negative emotional
experiences. Journal of and Social Psychology, 86, 320-333.
Tugade, M. M., & Fredrickson, B. L. (2007). Regulation of positive
emotions: Emotion regulation strategies that promote resilience. Journal
of Happiness Studies, 8, 311-333.
Tugade, M. M., Fredrickson, B. L., Barrett, L. F (2004).
Psychological resilience and positive emotional granularity on coping and
stress. Journal of Personality 72, 1161-1190.
Tusaie, Kathleen and Dyer, Janyce (2004). Resilience: A Historical
Review of the Construct. Holistic Nursing Practice, 18(1):3-10
Tusai, K., & Dyer J. (2004) Resilience: A historical review of the
construct. Holistic Nursing Practice, 18, 3-8.
Valera, E.M., & Berenbaum, H. (2001). A twin study of alexithymia.
Psychotherapy and Psychosomatics, 70, 239-246.
ϮϭϬ
Van Ijzendoorn, M. H., & Schuengel, C. (1996). The measurement
of dissociation in normal and clinical populations: Meta-analytic
validation of the dissociative experiences scale (DES). Clinical
Psychology Review, 16, 365–382
Weissberg, R. P., & Greenberg, M. T. (1998). School and community
competence-enhancement and prevention programs. In I. E. Siegel & K.
A. Renninger (Vol. Eds.), Handbook of child psychology: Vol. 4. Child
psychology in practice (5th ed., pp. 877–954). New York: Wiley.
van Ijzendoorn, M. H. & Schuengel, C. (1996). The measurement of
dissociation in normal and clinical populations: Meta-analytic validation
oftheDissociativeExperiencesScale(DES). Clinical Psychology Review,
16: 365-382.
van der Kolk, B. A., Pelcovitz, D., Roth, S., Mandel, F. S.,
McFarlane, A. & Herman, J. L. (1996).Dissociation, somatization, and
affect dysregulation: The complexity of adaptation to trauma. American
Journal of Psychiatry, 153: 83-93.
Van Heck, G. L., & den Oudsten, B. L. (2008). Emotional
intelligence: Relationships to stress, health, and well-being. In: J. J., M.
Vingenhoets and I. Nyklíƙk, and J. Denollet (Eds.), Emotion regulation.
Conceptual and clinical issues (pp. 97-124). New York, Springer.
Vangelisti, A. & Beck, G.(2007). Intimacy and Fear of Intimacy. In
L. L’Abate (Ed.) Handbook of Low-cost Interventions to Promote
Physical and Mental Health: Theory, Research, and Practice (pp. 395-
414). New York, NY: Springer.
Vangelisti, A. L. (2001). Making sense of hurtful interactions in
close relationships: When hurt feelings create distance. In V. Manusov &
J. H. Harvey (Eds.), Attribution, communication behavior, and close
relationships: Advances in personal relations (pp. 38-58). New York:
Cambridge University Press.
Vangelisti, A. L., Young, S. L., Carpenter-Theune, K., & Alexander,
A. L. (2005). Why does it hurt? The perceived causes of hurt feelings.
Communication Research, 32, 443–477.
Vingerhoets, A., Nyklíƙk, I. & Denollet J. (Eds.). (2008). Emotion
regulation. Conceptual and clinical issues. New York, Springer.
Vingerhoets, A. J. J. M., Boelhouwer, A. J. W., Van Tilburg, M. A.
L., & Van Heck, G. L.(2001). The situational and emotional context of
Ϯϭϭ
adult crying. In A. J. J. M. Vingerhoets & R. R. Cornelius (Eds.). Adult
crying: A biopsychosocial approach (pp. 71–90). Hove, UK: Brunner-
Routledge.
Vingerhoets, A. J. J. M., Cornelius, R. R., Van Heck, G. L., & Becht,
M. C. (2000). Adult crying: A model and review of the literature. Review
of General Psychology, 4,354–377.
Vingerhoets, A. J. J. M., Rottenberg, J., Cevaal, A., & Nelson, J. K.
(2007). Is there a relationship between depression and crying? A review.
Acta Psychiatrica Scandinavica, 115:140–151.
Vorst, H.C.M., & Bermond, B. (2001). Validity and reliability of the
Bermond Vorst Alexithymia Questionnaire. Personality and Individual
Differences, 30, 413-434.
Wagnild, G. M., & Young, H. M. (1993). Development and
psychometric evaluation of the Resilience Scale. Journal of Nursing
Measurement, 1, 165-178.
Waaktaar T., & Torgersen, S. (2010). How resilient are resilience
scale? The Big Five scales outperform resilience scales in predicting
adjustment in adolescents. Scandinavian Journal of Psychology, 52, 157-
163.
Waller, N.G., Putnam, F.W., & Carlson, E.B. (1996). Types of
dissociation and dissociative types: A taxometric analysis of dissociative
experiences. Psychological Methods, 1, 300-321.
Walsh, F. (2003). Family Resilience: A framework for clinical
practise. Family Process, 42(1), 1-18.
Walsh, F. (2005). Systemic Training for Healthcare Professionals:
The Chicago Center for Family Health Approach, Family Process, 44(3),
283-301.
Walsh, F. (2006). Strengthening Family Resilience. 2
nd
Ed New
York: Guilford.
Walsh, F. (2007). Traumatic loss and major disasters: Strengthening
family and community resilience. Family process, 46, 207-227.
Walsh, D.J., & Pianta, R.C. (1998). Applying the construct of
resilience in schools: Cautions from a Developmental systems
perspective. School Psychology Review, 27(3), 407-418.
Walsh, F. (2002). A family resilience framework: Innovative practice
application. Family Relations, 51(2): 130-137.
ϮϭϮ
Walsh, F. (1996). The concept of family resilience: cross and
challenge. Family Process, 35, 261-281.
Walsh, F. (2010). Spiritual diversity: Multi-faith perspectives in
family therapy. Family Process, 49(3): 330-348.
Wagnild, G. M., & Young, H. M. (1993). Development and
psychometric evaluation of the resilience scale. Journal of Nursing
Measurement, 1,165-178.
Watson, D., L., Clark, A., & Tellegen, A. (1988). Development and
validation of brief measures of positive and negative affect: The PANAS
scales. Journal of Personality and Social Psychology, 54, 1063-1070.
Watson, D., Clark, L.A., Tellegen, A. (1984). Cross-cultural
convergence in the structure of mood: A japanese replication and a
comparison with u.S. Findings. Journal of Personality and Social
Psychology, 47, 127-144.
Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. (1993).
The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility.
Paper presented at the Annual Convention of the International Society for
Traumatic Stress Studies, San Antonio, TX.
Werner, E. E., & Smith, R. S. (1982). Vulnerable but invincible:A
study of resilient children. New York: McGraw-Hill.
Werner, E. E., (1993). Risk, resilience, and recovery: Perspectives
from the Kauai Longitudinal Study. Development and Psychopathology, 5,
503-515.
Werner, E. E. (1989). High-risk children in young adulthood: A
longitudinal study from birth to 32 years. American Journal of
Orthopsychiatry, 59, 72-81.
Werner, E.E., & Smith, R.S. (1992). Overcoming the odds: High-risk
children from birth to adulthood. Ithaca, NY: McGraw-Hill.
Westphal, M., Seivert, N. H., & Bonanno, G. A. (2010). Expressive
flexibility. Emotion, 10(1), 92-100.
Wyman, P. A., Cowen, E. L., Work W. C., Hoyt-Meyers, L.,
Magnus, K. B., & D.B. Fagen (1999). Caregiving and developmental
factors differentiating young at-risk urban children showing resilient
versus stress-affected outcomes. Child Development, 70,645-659.
Whitely, W., Dougherty, T.W., & Dreher, G.F. (1991). Relationship
of career mentoring and socioeconomic origin to managers and
Ϯϭϯ
professionals’ early career progress. Academy of Management Journal,
34, 331-351.
Willett, J. B. (1989). Questions and answers in the measurement of
change. Journal of Research in Education, 15, 345-422.
Wise, T.N., Mann, L. S., & Sheridan, M.J. (2000). Relationship
between alexithymia, dissociation and personality in psychiatric
outpatients. Psychotherapy and Psychosomatics, 69, 123-129.
Woolcock, M. 2001. The place of social capital in understanding
social and economic outcomes. Canadian Journal of Policy Research
2(1):11–17.
Young, S. L. (2004). Factors that influence recipients’ appraisals of
hurtful communication. Journal of Social and Personal Relationships, 21,
291-303
Yehuda, R. (2000). Biology of post traumatic stress disorder. Journal
of Clinical Psychiatry, 61 (Suppl. 7), 14-21.
Yule, W. (2000). Disturbo post traumatico da stress: Aspetti clinici e
terapia. Milano: McGraw-Hill.
Zahn-Waxler, C, Radke-Yarrow, M., Wagner, E., & Chapman, M.
(1992). Development of concern for others. Developmental Psychology,
28, 126-136.
Zanardini, C. (2007). Relational competence of the criminal
population. Unpublished degree dissertation. University of Padua, Italy.
Zautra, A. J., Berkhof, J., & Nicolson, N. A. (2002). Changes in
affect interrelations as a function of stressful events. Cognition &
Emotion, 16, 309-318.
Zautra A.J, Potter P.T, Reich J.W., Lawton M.P, and Schaie K.W
(1997). The independence of affects is context-dependent: An integrative
model of the relationship between positive and negative affect.Annual
Review of Gerontology and Geriatrics 17:75–103.
Zautra A.J, Johnson L, and Davis M.E (2005). The role of positive
affect in chronic pain: Applications of a dynamic affect model.Journal of
Consulting and Clinical Psychology.
Zautra (2003). Emotions, Stress and Health. Oxford University Press
Zautra A.J, Reich J.W, Schultz A.S (200). The role of everyday
events in depressive symptoms for older adults. In: Williamson GM,
Parmelee PA, Shaffer DR, editors. Physical Illness and Depression: A
Ϯϭϰ
Handbook of Theory, Research, and Practice. Plenum; New York: pp.
65–92.
Zautra A.J, Reich J.W, Schultz A.S (2000). The role of everyday
events in depressive symptoms for older adults. In:
Williamson GM, Parmelee PA, Shaffer DR, editors.Physical Illness and
Depression: A Handbook of Theory, Research, and Practice. Plenum;
New York: pp. 65–92.
Zautra Z.J, Guarnaccia C.A, Dohrenwend B.P (1986). Measuring
small life events. American Journal of Community Psychology 14:629–
655
Zey, M. (1984). The mentor connection. Homewood, Il.: Dow Jones-
Irwin
Zelaso, M. Moscovitch, & E. Thompson (Eds). The Cambridge
Handbook of Consciousness. New York: Cambridge University Press.
Zimet, G. D. Dahlem, N. W., Zimet, S. G.., & Farley, G.. K. (1988).
The Multidimensional Scale Support. Journal of Personality Assessment,
52, 30-41.
Zucker, R.A., Wong, M.M., Puttler, L.I., & Fitzgerald, H.E. (2003).
Resilience and vulnerability among sons of alcoholics: Relationship to
development outcomes between early childhood and adolescence. In S.S.
Luthar (Ed.), Resilience and vulnerability: Adaptation in the context of
childhood adversities (pp. 76-103). Cambridge, UK: Cambridge
University Press.
Zucherman, M. (1999). Vulnerability to psychopathology: A bio-
social model. Washington, Dc: American Psychological Association.
Zuliani, D. (2004). Relational competence and traumatic war
experiences. Research study with Croatioan refugees. Unpublished degree
dissertation. University of Padua, Italy.
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APPENDIX
Relational Answer Questionnaire, Ed. 2011 (italian version)
Scale “A” Activation
1 Nel contatto con gli altri esprimo me stesso/a soprattutto quando
agisco.
2 Nelle relazioni preferisco le azioni concrete ai progetti ideali.
3 Evito le persone continuamente indecise sul da farsi.
4 Mi sento a disagio se non posso agire.
5 Nei contatti personali amo più la concretezza delle azioni che i
ragionamenti sottili.
6 Nelle relazioni per me valgono più i fatti che le parole.
7 Confrontandomi con gli altri, sono portato ad agire di fronte alle
cose che non vanno.
8 Nelle relazioni evito le discussioni che non portano alla
concretezza dell'agire.
9 Quando sono con la gente Š per me una sofferenza stare a guardare
senza agire.
10 Confrontandomi con le persone, mi interessa ciò che porta ad
agire concretamente.
Scale “Aw
1
” Meta-Awareness
1 Nelle discussioni non mi rendo conto di come ragiono.
2 Nel rapporto con gli altri non so prevedere le mie reazioni emotive.
3 Sono consapevole di come mi comporto e/o rispondo alle persone
con cui sono in rapporto.
4 Nel rispondere agli altri uso la testa e ci ragiono.
5 Nel rispondere agli altri rifletto bene sulle circostanze in cui mi
trovo.
6 Nei rapporti con le persone sono consapevole di come mi sto
comportando.
Ϯϭϲ
7 Nelle relazioni mi rendo pienamente conto di come rispondo agli
altri.
8 Quando mi metto in relazione cerco di avere il pieno controllo
della situazione.
9 Mi rendo conto di quello che sento dentro quando mi rapporto con
gli altri.
10 Nel rapportarmi con gli altri sono consapevole di ciò che provo
nei loro confronti.
Scale “Aw
2
” Feedback Awareness
1 L'esperienza fatta mi serve per affrontare i rapporti con le persone.
2 Penso spesso alle relazioni gi… vissute per gestire i rapporti con
gli altri.
3 Gli sbagli del passato mi servono per cercare di agire meglio nei
contatti con gli altri.
4 Le esperienze avute mi permettono di capire le aspettative degli
altri.
5 Le relazioni vissute mi hanno insegnato ad usare la testa nelle
discussioni.
6 Ci• che ho imparato in passato mi Š utile per gestire i rapporti
attuali.
Scale “C” Context
1 Mi lascio facilmente convincere dalle altre persone.
2 I commenti degli altri mi toccano molto poco.
3 Sono influenzato dalle persone del mio ambiente.
4 Non mi preoccupo delle chiacchiere altrui che mi riguardano.
5 Non mi interessa ciò che gli altri pensano della mia persona.
6 Sono sensibile ai giudizi altrui.
7 Mi sento libero dai condizionamenti altrui.
8 Sono attento a ciò che le persone pensano di me.
9 Non mi lascio influenzare dalle pressioni altrui.
10 Mi preoccupo abbastanza dell'idea che gli altri hanno di me.
Ϯϭϳ
Scale “E
1
” Base Emotionality
1 Sono attento a ciò che accade alle persone con cui sono in
relazione.
2 Mi è difficile nascondere le mie emozioni quando mi relaziono con
gli altri.
3 Gli altri dicono che sono come un libro aperto.
4 Nei contatti con le persone mi commuovo facilmente fino alle
lacrime.
5 Nelle relazioni con gli altri esprimo me stesso/a soprattutto con le
espressioni emotive.
6 Mi commuovono i gesti di affetto delle persone con cui sono in
contatto.
7 Le sofferenze delle persone con cui vengo a contatto mi fanno
piangere.
8 Esprimo liberamente la mia sofferenza se mi sento ferito/a da
qualcuno.
9 Nelle relazioni mi faccio prendere dalle emozioni.
10 Nelle confidenze con le persone mi vien voglia di piangere.
Scale “E
2
” Expressed Emotionality
1 Manifesto apertamente le mie emozioni.
2 Solitamente esprimo agli altri ciò che sento dentro.
3 Nei rapporti esprimo liberamente ciò che provo.
4 Manifesto senza difficoltà agli altri i miei stati d'animo.
5 Nelle relazioni non mi preoccupo di nascondere i miei sentimenti.
6 Dico apertamente agli altri le cose senza nascondere i miei limiti.
7 Non ho difficoltà ad esprimere tutto il mio affetto agli altri.
8 Faccio in modo che gli altri capiscano ciò che provo nei loro
confronti.
9 Ô per me importante poter esprimere agli altri le mie emozioni.
10 Nei contatti con gli altri non mi interessa nascondere le mie
emozioni.
Ϯϭϴ
Scale “R” Rationality
1 Nel rapporto con gli altri affronto le situazioni in modo razionale.
2 Nel contatto con gli altri calcolo ogni situazione con cura per
evitare gli imprevisti.
3 Ragiono sulle difficoltà che incontro con gli altri.
4 Nei rapporti esamino bene le cause di ciò che va storto.
5 Gli altri riconoscono che sono preciso e meticoloso.
6 Nei rapporti con gli altri, prima di fare una scelta, soppeso i pro e i
contro.
7 Nei rapporti con gli altri sono uno che si controlla molto.
8 Pondero bene le conseguenze che possono avere le mie azioni sugli
altri.
9 Nei rapporti con gli altri rifletto sulle loro aspettative.
10 Riesco a trovare il modo più appropriato di rispondere alle richieste
degli altri.
Ϯϭϵ
Relational Answer Questionnaire, Ed. 2011
1. I express myself especially when I act___
2. I let myself be easily convinced by others___
3. I find it difficult to hide my emotions from others___
4. I deal with situations in a rational way___
5. I prefer concrete actions to ideal projects___
6. I feel excluded by others___
7. I carefully plan every situation to avoid difficulties___
8. My main need is to be logical___
9. Past experiences are important for avoiding mistakes___
10. Others say I am like an open book___
11. I avoid people who are always undecided about what to do___
12. I feel uncomfortable if I can't act___
13. I seek the approval of those close to me___
14. I am keener on concrete actions than subtle reasoning___
15. I am easily moved to tears___
16. When I make decisions I carefully consider the
consequences___
17. IreasonalotonthedifficultiesIencounter___
18. I believe facts are worth more than words___
19. I have no time to reflect on what I am experiencing___
20. I find it difficult to deal with new situations___
21. In complex situations I find it important to evaluate everything
well___
22. I find myself in unpleasant situations even though I don't want
to___
23. I express myself especially through my emotions___
24. My intentions are misunderstood___
25. I feel at ease with people who love reasoning above all___
26. I deal calmly even with unexpected situations___
27. I am influenced by people of my own environment (setting)___
28. I am spontaneous with others___
29. Signs of affection move me___
30. When things don't work, my impulse is to act___
31. I feel I own to others___
ϮϮϬ
32. I openly express my love to those close to me___
33. People say I am someone who reasons a lot over things___
34. I carefully examine the reasons why things do go wrong___
35. People's suffering makes me cry___
36. I hate abstract discussions not leading to action___
37. In relationships with others I tend to repeat the same
mistakes___
38. I feel conditioned by the environment I live in___
39. In new situations I feel uncertain___
40. I find it difficult to match my personal needs to those of
others___
41. If I am contradicted I freeze and withdraw___
42. Even with no clear reason (For no reason) , I get tired of people
around me___
43. I think others are better than me___
44. Others acknowledge that I am precise and meticulous___
45. I openly express my pain if I get hurt by others___
46. Looking on without acting is painful to me___
47. I feel guilty toward people of my own environment___
48. I am interested in proposals leading to concrete actions___
49. Before I make a choice I carefully weigh the pros and cons___
50. Igetcarriedawaybymyemotions___
ϮϮϭ
1) Convergent and Construct Validities for Model
15
Intimacy
References Participants Tests(*) Research
Questions Results
Parmigiani,
1983
N=81males,
&N=81
females
PAIR
&WSS
Convergent
validity
between
PAIR &
WSS
Emotional Intimacy:
Social Utility t(160) =
2.37, p= .01; Stress t
(160) = 3.79, p= .001
Sexual Intimacy: Stress
t(160) = 4.10, p= .001
Mental Intimacy: Work
Variety t(160) = 2.30, p
= .05; Stress t(160) =
3.65, p= .001
Recreational Intimacy:
Social Utility t(160) =
2.28, p= .05, Economic
Satisfaction t(160) =
3.17, p= .001
Stevens &
L’Abate,
1989
N=79
undergraduates
SHS,
PAIR,
IRS,
WIQ
Construct
and
convergent
validity
SHS Constructs: N = 42
items for five factors
with alpha (A)all
significant at p< .001:
Private Values, (A=
,68, r-. 68);
Vulnerability (A= .75, r.
69), Social Desirability
(A= .82, r =.66);
Imperfection (A=.66;
r=.49), Sharing Hurts
(A=.81, r=.68; Conflict
Resolution (A=.48, r-
63). Concurrent
validities among SHS,
PAIR, IRS were also
significant (p<. o5 or
better), Among the
WIQ scales only
Affection reached
significant (p<.0001)
correla-tions with the
other three tests
ϮϮϮ
Raveani,
1991
N=41
nonclinical
married
couples:
(1) n=41
husbands (1);
n=41wives
(2)
MIQ Construct
validity
(1) Affirming
respective
Potentialities: Sharing
of hurts r= .52, p=
.001
(2) Affirming
Respective
Potentialities:
Respecting Each
Other’s Feelings r=
.36, p= .01; Sharing of
Hurts r= .45, p= .001
Rossi,
1991
N= 164
nonclinical
married
couples: n=
164 husbands
(1); n= 164
wives (2)
MIQ Construct
validity
(1) Communicating
Personal Values:
Accepting Personal
Limitations r= .38, p=
.001; Affirming
Respective
Potentialities r= .30, p
= .01; Sharing of Hurts
r= .37, p= .001;
Forgiving of Errors r=
.31, p= .001
Accepting of Personal
Limitations:
Affirming Respective
Potentialities r= .48, p
= .001; Sharing of
Hurts r= .31, p= .01;
Forgiving of Errors r=
.28, p= .01
Sharing of Hurts:
Forgiving of Errors r=
.56, p= .001
(2) Communicating
Personal Values:
Accepting Personal
Limitations r= .27, p=
.01; Sharing of Hurts r
= .34, p= .001;
Forgiving of Errors r=
.33, p= .001
ϮϮϯ
Accepting Personal
Limitations: Affirming
Respective
Potentialities r= .44, p
= .001
Sharing of Hurts:
Forgiving of Errors: r=
.51, p= .001
Salvo,
1998
N= 126
fiancés (males
& females)
(1); N= 236
non clinical
husband &
wives (2)
MJQr,
AAQ,
IASr
Convergent
validity of
MJQr &
AAQ in (1)
Sadness/Fear:
Preoccupied ȕ= .49, t
(125) = 5.63, p= .001,
R2= .41; Avoidance ȕ=
-.22, t(125) = -3.11, p
= .01, R2= .41; Fearful
ȕ= .22, t(125) = 2.46,
p= .05, R2= .41;
Anger: Fearful R2= .06,
ȕ= .29, t(126) = 2.73,
p= .01
Closeness Pursuit:
Preoccupied R2= .13, ȕ
= .36, t(126) = 4.25, p
= .001
Convergent
validity of
IASr &
AAQ in (2)
Intimacy Anxiety:
Secure r= -.29, p<
.001; Preoccupied r=
.32, p< .001;
Avoidance r= .22, p<
.001; Fearful r= .33, p
< .001
Cusinato,
Aceti, &
L’Abate,
1997
N= 36 married
couples
MIQ Construct
validity
through
intervention
Respect Each Other’s
Feelings: pre-test <
post-test, p< .02
Sharing of Hurts: pre-
test < post-test, p< .05
Forgiving Errors: pre-
test < post-test, p< .09
Maino,
2004
N= 12 married
couples: n=6
experimental
married
couples (1); n
MIQ,
SCI,
OAS
Construct
validity
through
intervention
comparing
Pre-test: Possible
Break-up Scale F(1,20)
= 4.71, p= .042;
Communicating
Personal Values F
ϮϮϰ
= 6 control
married
couples (2)
(1) & (2) (1,20) = 6.62, p= .018;
Respect Each Other’s
Feelings F(1,20) =
4.86, p= .039;
Accepting Personal
Limitations F(1,20) =
4.43, p= .036;
Affirming Respective
Potentialities F(1,20) =
8.05, p= .010
Post-test: Possible
Break-up Scale F(1,20)
= 13.23, p= .002;
Communicating
Personal Values F
(1,20) = 8.35, p= .009
Maino,
2005
N=95married
couples: n=15
couples with
children – age
1-16 – affected
by infantile
cerebral palsy
(1); n=40
couples with
children – age
1-16 – affected
by
malformation
syndrome (2); n
= 40 couples of
healthy children
(at least one
aged 1-16) (3)
MIQ,
SCI,
OAS
Convergent
validity of
QMI & SCI
in (1)
SCI: Communicating
Personal Values R2=
.48, F(1,28) = 25.30, ȕ
= .69, p=.001
Emotional Detachment
Scale:
Sharing of hurts R2=
.25, F(1,28) = 9,55, ȕ=
-.50, p=.004
Possible Break-up
Scale: Communicating
of Personal Values R2=
.14, F(1,28) = 4.54, ȕ=
-.38, p= .042
Convergent
validity of
MIQ & OAS
in (1)
OAS: Forgiving Errors
R2= .71, F(1,28) =
69.09, ȕ= .84, p= .001;
Sharing of Hurts R2=
.76, F(1,28) = 41.56, ȕ
= .37, p=.001
Convergent
validity of
MIQ & SCI
in (2)
SCI: Affirming
Respective
Potentialities R2= .40,
F(1,78) = 52.98, ȕ=
.64, p=.001
Emotional Detachment
ϮϮϱ
Scale: Affirming
Respective
Potentialities R2= .27,
F(1,78) = 23.82, ȕ=-
.52, p= .001
Possible Break-up
Scale: Affirming
Respective
Potentialities R2= .12,
F(1,78) = 10.31, ȕ=-
.34, p= .002
Convergent
validity of
MIQ & OAS
in (2)
OAS: Accepting of
Personal Limitations R2
= .56, F(1,78) = 99.08,
ȕ= .75, p= .001;
Respecting Personal
Feelings R2= .64, F
(1,78) = 68.88, ȕ= .40,
p= .001; Sharing of
Hurts R2= .68, F(1,78)
= 53.25, ȕ= .28, p=
.001
Convergent
validity of
MIQ & SCI
in (3)
SCI: Communicating
Personal Values R2=
.14, F(1,78) = 12.43, ȕ
= .37, p= .001
Emotional Detachment
Scale: Forgiving Errors
R2= .13, F(1,78) =
12.01, ȕ= -.37, p= .001
Convergent
validity of
MIQ & OAS
in (3)
OAS: Communicating
Personal Values R2=
.12, F(1,78) = 10.18, ȕ
= .34, p= .002; Sharing
of Hurts R2= .17, F
(1,78) = 7.66, ȕ= -.30,
p=. 001; Accepting
Personal Limitations R2
= .23, F(1,78) = 7.35, ȕ
= .37, p= .001
ϮϮϲ
Legenda: SCI = Stanley’s Commitment Inventory; OAS = Optimistic
Attitude Scale; MIQ = Marital Intimacy Questionnaire; PAIR = Personal
Assessment of Intimacy in Relationships; WSS = Work Satisfaction
Scales; AAQ = Adult Attachment Questionnaire; IASr = Intimacy
Anxiety Scale, revised; MJQr = Marital Jealousy Questionnaire, revised.
ϮϮϳ
Disorders of Internalization
Children and Youth
Anxiety: This interactive practice exercise is based on the scale by
the same name developed by Newcomer, Barenbaum, and Bryant (1994).
Anxiety, Depression, and Fears: This interactive practice exercise is
based on the work by Chorpita, Albano, and Barlow (1998).
Asperger Disorder: The list of symptoms used for this interactive
practice exercise was taken from the Diagnostic Statistical Manual f or
Mental Disorders-IV (DSM-IV). Washington, DC: American Psychiatric
Association.
Depression: This interactive practice exercise is based on the
RCscale by the same name developed by Newcomer, Barenbaum, and
Bryant (1994).
Post-Traumatic Stress: This interactive practice exercise is based on
the work of Anthony, Lonigan, and Hecht (1999).
Separation Anxiety: This interactive practice exercise is based on the
list of symptoms found in the DSM-IV, Washington, DC: American
Psychiatric Association.
Adults
Anxiety: The list of symptoms used for this interactive practice
exercise was taken from the Diagnostic Statistical Manual f or Mental
Disorders-IV (DSM-IV). Washington, DC: American Psychiatric
Association.
Depressive Personality: This interactive practice exercise is based on
the research by Hartlage, Arduino, and Alloy (1998) about depressive
characteristics.
Loneliness: Although loneliness is not a psychiatric dimension or
category, this condition affects a great many people who suffer also from
other conditions. One could say that loneliness is a concomitant of many
psychiatric and non-psychiatric conditions, especially in youth. These are
the reasons for including this interactive practice exercise in this Section.
This interactive practice exercise was developed from the work of Hurtug,
Audy, and Cohen (1998) and of Peplau and Perlman (1982). A
ϮϮϴ
questionnaire found in Peplau and Perlman could be administered before
and after completion of this interactive practice exercise.
Phobias: This interactive practice exercise was developed from the
combined work of Levinson (1986) and Henley (1987).
Post-Traumatic Stress Disorder: This interactive practice exercise is
based on the factor analysis of research performed by King, Leskin, King,
and Weathers (1998) as well as by Taylor, Koch, Koch, Crockett, &
Passey (1998).
Procrastination: This interactive practice exercise was derived from
the work of Ferrari, Johnson, and McCown (1995).
Signs of Depression: This interactive practice exercise was based on
a variety of clinical and research sources.
Disruptive Developmental Disorders
Anger: This interactive practice exercise is based on the factor
analysis of Lahey, Frick, Loeber, Tannenbaum et al. (1990) and the work
of Feindler (1995).
Conduct Disorder: The list of symptoms used for this interactive
practice exercise was taken from the Diagnostic Statistical Manual f or
Mental Disorders-IV (DSM-IV). Washington, DC: American Psychiatric
Association.
Hyperactive/Attention Deficit: The list of symptoms used for this
interactive practice exercise was taken from the Diagnostic Statistical
Manual f or Mental Disorders-IV (DSM-IV). Washington, DC: American
Psychiatric Association.
Juvenile Troublemaking: This interactive practice exercise is based
on the Child Troublemaking Scale developed by Lynam (1997).
Oppositional Defiant: The list of symptoms used for this interactive
practice exercise was taken from the Diagnostic Statistical Manual for
Mental Disorders-IV (DSM-IV). Washington, DC: American Psychiatric
Association.
ϮϮϵ
Disorders of Externalization in Adults
Addendum to Relational Training: This interactive practice exercise
is an elaboration of the original interactive practice exercise on Social
Training (L’Abate, 1992).
Anger, Hostility, Aggression: This interactive practice exercise is
based on the work by Eckhardt and Deffenbacher (1995) and by
Spielberger, Reheiser, and Sydeman (1995).
Troublemaking: This interactive practice exercise is based on the
research by Kosson, Steuerwald, Forth, and Kirkhart (1997).
Interactive practice exercises for Conflicting Couples and Families
Children and Families
Bing Eating: This interactive practice exercise was developed in
collaboration with Monique Gray and published with her kind permission.
Divorce Adjustment in Children: This interactive practice exercise
was developed by Karin B. Jordan, Ph. D., and published here with her
kind permission Domestic Violence: This interactive practice exercise was
developed in collaboration with Fran Greenfield and published here with
her kind permission.
Lying: This interactive practice exercise was developed in
collaboration with Maureen O’Toole and published here with her kind
permission.
Shyness: This interactive practice exercise was developed in
collaboration with Sue Matthews and published here with her kind
permission.
Stealing: This interactive practice exercise was developed in
collaboration with Ernestine Williams and published here with her kind
permission.
Temper Tantrums: This interactive practice exercise is a substantial
revision of a previously published interactive practice exercise (L’Abate,
1992).
ϮϯϬ
Time Out: This interactive practice exercise is based on the first
author’s clinical experience and one of the first interactive practice
exercises developed for children and their families.
Verbal Abuse: This interactive practice exercise was developed from
the first author’s clinical experiences and considered as part of the
Abusive-Apathetic (AA) style in RCT.
Couples
A theory-derived interactive practice exercise for intimate couples.
This interactive practice exercise is derived from a structured interview
covering the 16 models of RCT.
Arguing or Fighting: This interactive practice exercise was
developed from clinical experience and is based on a model of
paradoxical psychotherapy presented by Weeks and L’Abate (1982;
L’Abate, 2002, pp.124-125).
Complaints: This interactive practice exercise is based on the
research by Coyne, Thompson, and Palmer (2003)
Depression: This interactive practice exercise is based on relational
model of depression developed by L’Abate (1986).
Difficulties: This interactive practice exercise was developed jointly
by Keith Stanford and Luciano L’Abate from Sanford’s research (2004).
Intimacy: This interactive practice exercise is based on a relational
Model
15
of intimacy developed by Cusinato (1992).
Sexuality: The contents of this interactive practice exercise were
taken from the vast literature on sexuality, with no primary source being
more relevant than others.
Violence: This interactive practice exercise is based on the research
by Eckhardt, Barbour, and Davison (1998).
Ϯϯϭ
Families
Hurt Feelings: This interactive practice exercise is based on a model
developed 30 years after this construct was developed (L’Abate, 1977),
evaluated (L’Abate, Frey, & Holly, 1979) and resurrected by the research
of Vangelisti and her students (Vangelisti, in press; Vangelisti and Beck
(2007) and a chapter in her handbook (L’Abate, in press; L’Abate, 2007).
Intimacy: This interactive practice exercise is based on a relational
Model
15
of intimacy developed by L’Abate (1986, 1997, 2005).
Negotiation: This interactive practice exercise is based on a
relational model of negotiation developed by L’Abate (1986, 1997, 2005).
When Parents Argue: From the Child’s Eyes: This interactive
practice exercise was developed from the research by Weston, Boxer, and
Heatherington (1998).
When Parents and Child Argue: From the Child's Eyes: This
interactive practice exercise was developed from the research by Weston,
Boxer, and Heatherington (1998).
Adapted from L’Abate, 2009abc.
