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The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies
Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444985/ https://www.ncbi.nlm.nih.gov/pubmed/34539510 http://dx.doi.org/10.3389/fpsyg.2021.710493 |
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author | Kalisch, Raffael Köber, Göran Binder, Harald Ahrens, Kira F. Basten, Ulrike Chmitorz, Andrea Choi, Karmel W. Fiebach, Christian J. Goldbach, Nele Neumann, Rebecca J. Kampa, Miriam Kollmann, Bianca Lieb, Klaus Plichta, Michael M. Reif, Andreas Schick, Anita Sebastian, Alexandra Walter, Henrik Wessa, Michèle Yuen, Kenneth S. L. Tüscher, Oliver Engen, Haakon |
author_facet | Kalisch, Raffael Köber, Göran Binder, Harald Ahrens, Kira F. Basten, Ulrike Chmitorz, Andrea Choi, Karmel W. Fiebach, Christian J. Goldbach, Nele Neumann, Rebecca J. Kampa, Miriam Kollmann, Bianca Lieb, Klaus Plichta, Michael M. Reif, Andreas Schick, Anita Sebastian, Alexandra Walter, Henrik Wessa, Michèle Yuen, Kenneth S. L. Tüscher, Oliver Engen, Haakon |
author_sort | Kalisch, Raffael |
collection | PubMed |
description | Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E–P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure (“stressor reactivity,” SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research. |
format | Online Article Text |
id | pubmed-8444985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84449852021-09-17 The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies Kalisch, Raffael Köber, Göran Binder, Harald Ahrens, Kira F. Basten, Ulrike Chmitorz, Andrea Choi, Karmel W. Fiebach, Christian J. Goldbach, Nele Neumann, Rebecca J. Kampa, Miriam Kollmann, Bianca Lieb, Klaus Plichta, Michael M. Reif, Andreas Schick, Anita Sebastian, Alexandra Walter, Henrik Wessa, Michèle Yuen, Kenneth S. L. Tüscher, Oliver Engen, Haakon Front Psychol Psychology Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E–P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure (“stressor reactivity,” SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research. Frontiers Media S.A. 2021-08-26 /pmc/articles/PMC8444985/ /pubmed/34539510 http://dx.doi.org/10.3389/fpsyg.2021.710493 Text en Copyright © 2021 Kalisch, Köber, Binder, Ahrens, Basten, Chmitorz, Choi, Fiebach, Goldbach, Neumann, Kampa, Kollmann, Lieb, Plichta, Reif, Schick, Sebastian, Walter, Wessa, Yuen, Tüscher and Engen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychology Kalisch, Raffael Köber, Göran Binder, Harald Ahrens, Kira F. Basten, Ulrike Chmitorz, Andrea Choi, Karmel W. Fiebach, Christian J. Goldbach, Nele Neumann, Rebecca J. Kampa, Miriam Kollmann, Bianca Lieb, Klaus Plichta, Michael M. Reif, Andreas Schick, Anita Sebastian, Alexandra Walter, Henrik Wessa, Michèle Yuen, Kenneth S. L. Tüscher, Oliver Engen, Haakon The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title | The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title_full | The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title_fullStr | The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title_full_unstemmed | The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title_short | The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies |
title_sort | frequent stressor and mental health monitoring-paradigm: a proposal for the operationalization and measurement of resilience and the identification of resilience processes in longitudinal observational studies |
topic | Psychology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444985/ https://www.ncbi.nlm.nih.gov/pubmed/34539510 http://dx.doi.org/10.3389/fpsyg.2021.710493 |
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