Psychosocial and
Physical Resilience: The
Will to Bounce Back
Barbara Resnick, PhD, CRNP
University of Maryland School of Nursing
Definition of Resilience
• The word ‘resilience’ comes from the Latin world ‘salire,’ which
means to spring up and the word ‘resilire’ which means to spring
back.
• Resilience is defined as the ability to spring back or recover from a
physical, emotional, financial, or social challenge.
• Being resilient means that the individual has the ability to adjust or
deal with trauma, adversity, hardship, and ongoing significant life
stressors.
• Resilient individuals are able to respond appropriately to changes
and challenges encountered and adapt and adjust their behavior.
• Individuals who are resilient are able to move beyond the challenge,
regain equilibrium and gain knowledge, experience and a stronger or
better sense of well-being following the challenge.
• Resilient individuals will also be less likely to succumb to illness,
including both mental and physical illnesses.
Psychosocial and Physical Resilience
• Psychosocial resilience is focused on
being able to maintain a positive affect
regardless of the situation.
• Physical resilience is the ability to
recover or optimize function in the face
of age related losses or disease. Physical
resilience results in the perseverance
and determination to overcome physical
challenges encountered by a physically
stressful event (e.g, hip fracture;
deconditioning).
Resilience
• Is a component of the individual’s personality although it
develops and changes over time through ongoing interactions
with the physical and social environment and the challenges
that one encounters through the life course.
• From a physiologic perspective resilience has been associated
with the individual’s flexibility in his or her neurochemical
stress response systems and the neural circuitry involved in
stress responses.
• Exposure to stress causes alterations in brain structures
associated with cognition, mood and behavior within the
hypothalamic pituitary-adrenocortical (HPA) axis. The response
to stress impacts neurotransmitters, neuropeptides and
hormones and some individuals respond with resilience while
others decompensate when exposed to the same type and level
of stress.
Genetics and Resilience
• In a study including 172 men and women post hip fracture we
noted there were significant associations between resilience
and SNPs from the following genes: GRM1, NTRK1, NTRK2,
GNB3, NPY and SLC6A15.
• Genetic variability was indirectly associated with exercise and
function through resilience.
• Additional research has shown associations between
resilience and brain-derived neurotrophic factor (BDNF);
corticotropin-releasing hormone receptor 1 (CRHR1); peptidylprolyl cis-trans isomerase (FKBP5); glutamate receptor
metabotropic 1 (GRM1); solute carrier family 6 member 15
(SLC6A15); and solute carrier family 6 member 4
;neuropeptide Y (NYP), neurotrophic tyrosine receptor kinase1 and 2 (NTRK-1; NTRK-2); and guanine nucleotide binding
protein beta polypeptide 3 (GNB3)
Qualities of Resilient Individuals
• positive interpersonal relationships,
• building social connectedness with a willingness to
work with others,
• strong internal resources,
• having an optimistic or positive perspective about life
and challenges encountered throughout the lifespan,
• maintaining realistic expectations,
• setting achievable goals and working towards those
goals consistently,
• high self-esteem,
• high self-efficacy,
• determination,
• spirituality which includes a sense of purpose of life,
• maintaining a sense of community and a belief in a
higher power,
• being creative,
• having the ability to use humor
Interventions to Build
Resilience
• Interventions generally
address four areas:
• (1) developing disposition
attributes of the individual such
as vigor, optimism, and physical
robustness;
• (2) allowing in and engaging
with social supports;
• (3) strengthening self-efficacy,
self-esteem, and motivation
through interpersonal
interactions as well as
experiences; and
• (4) creative engagementkeeping busy!
Future Research Needs
• Two major areas needed:
• Development and testing of interventions to strengthen
psychosocial or physical resilience-helping patients when
resilience plummets as it will during the recovery period
• Ongoing research to establish the impact of personality/genetics
versus ways in which to strengthen resilience via interventions.
These are the Experts in Resilience!
Not bad for 100!
I will make it yet!
Bet you can’t show off these legs!
Not bad for 98!
These folks make resilience happen!