Resilience after Childhood Maltreatment: The Establishment of a Resilience Network Model and the Investigation of Its Fluctuations over Time

Lead Research Organisation: University of Cambridge
Department Name: Psychiatry

Abstract

Resilience after Childhood Adversity:
The Establishment of a Resilience Network Model
PhD Candidate: Jessica Fritz MSc
Primary Supervisor: Dr. Paul O. Wilkinson
Associate Supervisor: Dr. Anne-Laura van Harmelen
Facing adversities in childhood is a serious environmental hazard with deleterious mental consequences over the subsequent lifecourse (Gilbert et al., 2009; Kessler, Davis, & Kendler, 1997). Up to 53.4% of the population suffers from at least one type of childhood adversities (CA; US National Comorbidity Replication Survey; Greif Green et al., 2010). Many studies have shown that CAs are highly associated with the development of psychopathology (e.g. Dunn et al., 2011; Greif Green et al., 2010; Heim, Shugart, Craighead, & Nemeroff, 2010; Hovens, Giltay, Spinhoven, van Hemert, & Penninx, 2015; Kessler et al., 1997; McLaughlin, Greif Green, Gruber, Berglund, et al., 2010; McLaughlin, Greif Green, Gruber, Sampson, et al., 2010; Scott, McLaughlin, Smith, & Ellis, 2012; Spinhoven et al., 2010). Yet, a strong network of interrelated resilience promoting factors (e.g. friendship support, impulse control, positive future orientation, daily life skills: Afifi & MacMillan, 2011; Kinard, 1998; Schultze-Lutter, Schimmelmann, & Schmidt, 2016) could potentially support mental health in these individuals.
Resilience can be described as beneficial adaptation following exposure to adverse experiences (Curtis & Cicchetti, 2007; Kalisch, Muller, & Tuscher, 2016; van der Werff, van den Berg, Pannekoek, Elzinga, & van der Wee, 2013; Zolkoski & Bullock, 2012) and should not be understood as exclusive capacity but as a concept of multiple resilience promoting factors (Afifi & MacMillan, 2011; Kinard, 1998; Schultze-Lutter et al., 2016). To date, resilience promoting factors have been studied on social (e.g. family support, social connectedness), behavioural (e.g. daily living skills, impulse control), cognitive (e.g. locus of control, future orientation) and emotional (e.g. low neuroticism, low self-blame) domains (e.g. Afifi & MacMillan, 2011; Aslan, in press; Curtis & Cicchetti, 2007; Dang, 2015; Folger & Wright, 2013; Holmes, Yoon, Voith, Kobulsky, & Steigerwald, 2015; Masten et al., 1999; Schultze-Lutter et al., 2016; van Harmelen et al., 2015; Williams & Nelson-Gardell, 2012). Importantly, resilience promoting factors do not function in isolation, rather, they have strong interrelationships (Afifi & MacMillan, 2011; Rutter, 1985). For instance, an individual with better self-regulation may be better company to be around and therefore may evoke better social support from others. To the best of our knowledge, no research has yet investigated the interconnectedness of these factors. I shall use cutting edge network analysis techniques (see Figure 1), to find the best fitting resilience network model which conceptualizes the interconnectedness of resilience promoting factors (Borsboom, & Cramer, 2010; Borsboom, Cramer, Schmittmann, Epskamp, & Waldorp, 2011; Costantini et al., 2015; Cramer et al., 2012; Cramer & Waldorp, 2010; Epskamp, Cramer, Waldorp, Schmittmann, & Borsboom, 2011; Freeman, 1978; Fried, Epskamp, Nesse, Tuerlinckx, & Borsboom, 2015; van Borkulo, Waldorp, Boschloo, Schoevers, & Borsboom, 2015).
I propose five projects for my PhD: Firstly, I shall establish the network structure of resilience factors in the general population. Next, I will validate the proposed network model of resilience factors, through establishing accuracy, stability, as well as external and predictive validity. Third, I intend to examine the network structure of resilience in individuals with a history of CA and to compare it to the resilience network of the general population. Moreover, I shall prospectively investigate whether resilience network structures are stable over time during the course of adolescence, to discover potential resilience network fluctuations. Finally, I aim to disentangle, whether resilience network fluctuations differ between
 
Description MRC DTP Flexible Supplement Funding
Amount £1,730 (GBP)
Organisation MRC Doctoral Training Program 
Sector Public
Country United Kingdom
Start 06/2017 
End 06/2017
 
Description Young Researcher Talk at the 3rd International Symposium on Resilience Research including a Travel Grant
Amount € 339 (EUR)
Organisation Johannes Gutenberg University of Mainz 
Sector Academic/University
Country Germany
Start 09/2017 
End 09/2017
 
Title Datasets: Data of the RESIST study 
Description RESIST (Resilience Study What Helps Students to Adapt to Exam Stress?) consists of three occasions and was performed with Cambridge University medical students. At all three occasions students were asked to complete an online questionnaire. RESIST has the main aim of disentangling which resilience factors predict better mental health during and after exam stress. 
Type Of Material Database/Collection of data 
Year Produced 2019 
Provided To Others? No  
Impact We are currently still working on computing meaningful index scores and validating some of the measures used. 
 
Description Anne Marijn de Graaff 
Organisation Free University of Amsterdam
Country Netherlands 
Sector Academic/University 
PI Contribution I (JF) was involved in the project as follows: PW, A-LvH, and JF were responsible for the study conception and the development of the study protocol. The literature screening (N = 1969) was conducted by AdG, HC, and JF. The literature re-screening (N = 220) was conducted by AdG and JF. Data extraction and quality ratings were conducted by AdG and JF. In case of disagreement or uncertainty PW was included in the discussion. Post hoc quality ratings for statistical analyses were conducted by PW and JF. JF led the conduction process of the review under the supervision of PW and A-LvH. The writing up was performed by JF under the supervision of PW and A-LvH. All authors contributed to and approved the final manuscript. PW was responsible for the funding of the review.
Collaborator Contribution Anne Marijn de Graaff (AdG) from the Free University of Amsterdam was involved in the project as follows: The literature screening (N = 1969) was conducted by AdG, HC, and JF. The literature re-screening (N = 220) was conducted by AdG and JF. Data extraction and quality ratings were conducted by AdG and JF. In case of disagreement or uncertainty PW was included in the discussion.
Impact Fritz, J., de Graaff, A. M., Caisley, H., van Harmelen, A.-L., & Wilkinson, P. O. (2018). A Systematic Review of Amenable Resilience Factors that Moderate and/ or Mediate the Relationship between Childhood Adversity and Mental Health in Young People. Frontiers in Psychiatry. Special Issue: Resilience, Life Events, Trajectories and The Brain, 9: 230. https://doi.org/10.3389/fpsyt.2018.00230
Start Year 2016
 
Description Helen Caisley 
Organisation Cambridgeshire and Peterborough NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution I (JF) was involvedin the project as follows: PW, A-LvH, and JF were responsible for the study conception and the development of the study protocol. The literature screening (N = 1969) was conducted by AdG, HC, and JF. The literature re-screening (N = 220) was conducted by AdG and JF. Data extraction and quality ratings were conducted by AdG and JF. In case of disagreement or uncertainty PW was included in the discussion. Post hoc quality ratings for statistical analyses were conducted by PW and JF. JF led the conduction process of the review under the supervision of PW and A-LvH. The writing up was performed by JF under the supervision of PW and A-LvH. All authors contributed to and approved the final manuscript. PW was responsible for the funding of the review.
Collaborator Contribution Helen Caisley (HC) from the Cambridgeshire and Peterborough NHS Foundation trust was involved int he project as follows: The literature screening (N = 1969) was conducted by AdG, HC, and JF.
Impact Fritz, J., de Graaff, A. M., Caisley, H., van Harmelen, A.-L., & Wilkinson, P. O. (2018). A Systematic Review of Amenable Resilience Factors that Moderate and/ or Mediate the Relationship between Childhood Adversity and Mental Health in Young People. Frontiers in Psychiatry. Special Issue: Resilience, Life Events, Trajectories and The Brain, 9: 230. https://doi.org/10.3389/fpsyt.2018.00230
Start Year 2016
 
Description Prof. Eiko Fried 
Organisation University of East Anglia
Department Clinical Psychology
Country United Kingdom 
Sector Academic/University 
PI Contribution I (J.F.) was involved in the project as follows: I.G. was responsible for the conduction of the longitudinal Roots study. J.F. formulated the study proposal under the supervision of P.W., A.L.v.H., and I.G. J.F. performed the analyses under the supervision of A.L.v.H., P.W. and E.F. The writing up was performed by J.F. under the supervision of A.L.v.H., P.W., I.G. and E.F. All authors contributed to and approved the final manuscript.
Collaborator Contribution Eiko Fried (E.F.) form Leiden University was involved in the project as follows: J.F. performed the analyses under the supervision of A.L.v.H., P.W. and E.F. The writing up was performed by J.F. under the supervision of A.L.v.H., P.W., I.G. and E.F. All authors contributed to and approved the final manuscript.
Impact Fritz, J., Fried, E. I., Goodyer, I. M., Wilkinson, P. O., van Harmelen, A.-L. (2018). A Network Model of Resilience Factors for Adolescents with and without Exposure to Childhood Adversity. Scientific Reports, 8: 15774.
Start Year 2017
 
Description Prof. Ian Goodyer 
Organisation University of Cambridge
Department Department of Psychiatry
Country United Kingdom 
Sector Academic/University 
PI Contribution I (J.F.) was involved in the project as follows: I.G. was responsible for the conduction of the longitudinal Roots study. J.F. formulated the study proposal under the supervision of P.W., A.L.v.H., and I.G. J.F. performed the analyses under the supervision of A.L.v.H., P.W. and E.F. The writing up was performed by J.F. under the supervision of A.L.v.H., P.W., I.G. and E.F. All authors contributed to and approved the final manuscript.
Collaborator Contribution Ian Goodyer (I.G.) from the University of Cambridge was involved in the project as follows: I.G. was responsible for the conduction of the longitudinal Roots study. J.F. formulated the study proposal under the supervision of P.W., A.L.v.H., and I.G. The writing up was performed by J.F. under the supervision of A.L.v.H., P.W., I.G. and E.F. All authors contributed to and approved the final manuscript.
Impact Fritz, J., Fried, E. I., Goodyer, I. M., Wilkinson, P. O., van Harmelen, A.-L. (2018). A Network Model of Resilience Factors for Adolescents with and without Exposure to Childhood Adversity. Scientific Reports, 8: 15774.
Start Year 2017
 
Description I was in the organization committee for the symposium on: Examining Resilience in Longitudinal Cohort Studies using Multi-Modal Data Analysis 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Fritz, J., Kalisch, R., & van Harmelen, A.L. (2016, December). Examining Resilience in Longitudinal Cohort Studies using Multi-Modal Data Analysis. Symposium conducted at the University of Cambridge, Cambridge, United Kingdom. We discussed with an international group of researchers, with a specific interest in resilience research, novel ways of how to go forward in terms of multivariate data analysis and complex models.
Year(s) Of Engagement Activity 2016
 
Description I was part of the organization committee of the 1st International Spring School on Resilience Research (May 21 - 25, 2018, Seeon Abbey, Germany) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact I was part of the organization committee of the 1st International Spring School on Resilience Research (May 21 - 25, 2018, Seeon Abbey, Germany). see: https://www.german-resilience-center.uni-mainz.de/1st-international-spring-school-on-resilience-research/ . At the spring school about 25 postgraduate students and about 5 lecturers/ Professors participated and/or held workshops in topics related to cutting-edge resilience research.
Year(s) Of Engagement Activity 2018
URL https://www.german-resilience-center.uni-mainz.de/1st-international-spring-school-on-resilience-rese...
 
Description Mental Health MOOC for adolescents (Massive Open Online Course, led by the University of Groningen) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I wrote parts of Dr. Anne-Laura van Harmelen's resilience module of a Mental Health MOOC for adolescents (Massive Open Online Course, led by the University of Groningen). Available at: https://www.futurelearn.com/courses/young-people-mental-health#section-topics
Year(s) Of Engagement Activity 2018
URL https://www.futurelearn.com/courses/young-people-mental-health#section-topics