Approaches used in the study of resilience

1. Approaches used in the study of resilience Gopal Netuveli International Centre for Life Course Studies in Society and Health Department of Primary Care and Social Medicine Imperial College London

2. MRC Resilience Network Meeting, Bangor

3. Resilience From Latin resilerre, “to jump back” or “to rebound” First discussed in detail by Holling (1973) • the ability to return to the original state after perturbation and • the ability to persist in the face of perturbation. Similarly defined in the study of children: • rebounding from adversity (Gramerzy 1993); • preserving competence in the face of adversity (Werner 1994); • good outcomes despite adversity and risk (Masten 2001). MRC Resilience Network Meeting, Bangor

4. Resilience in cross sectional & longitudinal studies Cross-sectional approach BHPS Waves 1-14 ELSA Wave 1 Longitudinal approach

5. Definitions used • Cross sectional analysis: “Flourishing despite adversity” • Longitudinal analysis “Bouncing back after adversity” MRC Resilience Network Meeting, Bangor

6. Identifying resilience cross-sectionally MRC Resilience Network Meeting, Bangor

7. Identifying resilience longitudinally Bouncing back: as a sequence of GHQ-12 scores in which the GHQ-12 score at the post-adversity time point was within the 95% confidence interval of the GHQ-12 score at the pre-adversity time point, after being elevated at the adversity time point to above the pre-adversity 95% confidence interval. - Netuveli et al. 2008 MRC Resilience Network Meeting, Bangor

8. Differences between approaches Treatment of Adversity: CS: Same as risk LS: Using CS approach there are four possibilities: • 1)Negative change in outcome after exposure persisting for a long period after exposure: ‘True adversity’; No resilience; • 2) No change: Not an adversity? lack of vulnerability, or hardiness? • 3) Positive change: Not an adversity? flourishing? • 4) Negative change in outcome after exposure and recovery later: True adversity; Resilience as bouncing back or flourishing. Using LA only 1 and 4 are relevant MRC Resilience Network Meeting, Bangor

9. Differences between approaches Treatment of multiple adversities: CSA: • Each adversity is treated as identical and independent. Additive model. LA: • Dependency between adversities can be studied. Multiplicative model. MRC Resilience Network Meeting, Bangor

10. Differences in the methods used ELSA: Classification scheme Interaction to test resilience factors BHPS: • Analytical strategy: Three time points: pre-event (t0), event (t1), post-event (t2) MRC Resilience Network Meeting, Bangor

11. Discussion points from our studies • Resilience is scarce in older ages. Prevalence of 15%. Not the ‘ordinary magic’ described in children. • Different from successful ageing: resilience increased with age. • ‘Gender paradox’: probability of exposure to adversity and resilience are both higher for women. • Adversity and resilience are influenced differently by the same factors (e.g. tenure in BHPS) • Social support before and during the adversity time point was the only significant predictor. • Resilience was not adaptation MRC Resilience Network Meeting, Bangor

12. Our conclusions • Resilience is a social process that converts social goods into good outcomes. • It is to be found in the warp and woof of family and society. • Policy implication: • Resilience can be nurtured through social policies that foster social support at the population level. However to be useful policy makers should adopt a preventative approach implementing policies before adversity has been experienced. MRC Resilience Network Meeting, Bangor