Health Sci 1110A - lecture 2

What is resilience?

multiple definitions

overcoming negative effects of risk exposure, adapting or coping successfully with traumatic experiences, and avoiding negative trajectories associated with risk

is a process

Promotive and protective factors and processes (PPFPs)

* positive impacts of PPFPs on resilience
* resilience is facilitated by multiple PPFPs at systemic levels
* an outcome and a process
* can happen in different ways an contexts
* promotive factors = more characteristics can exert more impact depending on other characteristics
* challenges the way we think about resilience in a universal perspective/construct

Promotive factors

2 kinds:

* assets
* reside within the individual, such as competence, coping skills, and self-efficacy
* resources
* what’s available to the individual, accessibility
* parental support, adult mentoring, or community organizations

Categories of resilience models

1. compensatory
2. protective
3. challenge

compensatory resilience model

where a resilience factor contracts a risk factor

has a direct effect on the outcome

one that is dependent of the effect of the risk factor

protective resilience model

assets or resources influence or reduce the effects of a risk on a negative outcome

protective factors may neutralize the effects of risks, weaken, but not completely remove them, or enhance positive effect of another promotive factor in producing an outcome

protective-stabilizing model

completely reduces the impact

no increase risk

get rid of the risk

with increasing risk, the amount of the negative outcome stays the same

protective-reactive model

the protective factor is decreasing the risk factor and negative outcome

doesn’t completely remove it, there is still a relationship

with increasing risk, even if the protective factor is present, there is still an increase of negative outcome

Challenge model

exposures to both low and high levels of a risk factor are associated with negative outcomes, but moderate levels of the risk are related to less negative outcomes

if you are exposed to moderate levels of risk, opportunity to overcome them

time limited period

low risks and high risks = negative outcome

inoculation model

through repeated exposure to low levels of a risk factor, individuals are able to overcome more significant risks

ongoing, developmental process, use resources when exposed to adversities

life period

resilience is content specific

individuals may be resilient when they are faced with one specific adversity but for a different risk they may not be able to overcome that kind of context

different assets and resources are needed

difficult to identify universal promoter factors that can help

resilience is culture and context specific

process of resilience may be different to different groups

resilience requires risk factors

there needs to be an exposure to a risk factor for there to be resilience

Not all stressors are the same

there can be acute stressors

may have immediate acute effects or long term effects

toxic stress

a little bit of stress → help to cultivate positive skills

too much stress → toxic stress, and can lead to negative impacts

type of events, timing, number of events, duration causes effects

* biological
* ex; malnutrition, infectious disease, and injury and disability
* psychosocial
* ex; witnessing violence, maltreatment, extreme poverty and stigmatization

there are physical and behavioural impacts:

* physical
* ex; somatic symptoms, headaches, asthma
* behavioural
* ex; early use of illicit drugs or alcohol

as well as long-term impacts and effects

* physical
* ex; skeletal fractures, cancer and CVD
* behavioural
* ex; suicide attempts or ideas & cannabis use

The social ecological model of risk and protection for children affected by armed conflict - individual

* genetic predisposition
* age
* gender
* faith
* some factors that are protective: internal locus of control, empathy and community connection

The social ecological model of risk and protection for children affected by armed conflict - microsystem

* child-family and child-school relationships
* religious practices
* supportive relationships and social ties
* feelings of belonging

The social ecological model of risk and protection for children affected by armed conflict - mesosystem/exosystem

* family-school relationship
* neighbourhood, religious institutions
* school-based intervention has important role
* provides social support for children, new opportunities and provides support

The social ecological model of risk and protection for children affected by armed conflict - macrosystem

* political, economic, religious, cultural contexts
* political dynamics have played a role in creating conflict
* locate them with larger context

Context of Afghanistan

* methods
* in 2006, school-based survey of 11-16 yr old students and their caregivers
* findings
* 5% of adults and 10% of children cited no major worries in life
* hope: cultural values → faith, family unity, service, effort, morals, honour
* suffering: everyday adversity → economy, education, housing, relationships, health, governance
* entrapment: structural impediments vs. social obligations, aspirations, cultural dictates

Everyday stressors and social suffering

poverty and broken economy

housing and homelessness

social relationships

ill health

governance and social justice