Kate Rocklein Kemplin, DNP, RN; Olimpia Paun, PhD, PMHCNS-BC; Dan Godbee, MD, FACEP; Jonathan Brandon, MD4
References
Kate Rocklein Kemplin, DNP, RN; Olimpia Paun, PhD, PMHCNS-BC; Dan Godbee, MD, FACEP; Jonathan Brandon, MD
References
| Reference number |
Authors | Sample | Methods | Framework Measurement |
Summary of Findings |
Level of Evidence |
| 64 | Abu-Ras W, Hosein S. Understanding resiliency through vulnerability: Cultural meaning and religious practice among Muslim military personnel. Psychology of Religion and Spirituality. 2015;7(3):179-191 | American Muslim Military personnel | Grounded theory methodology | Grounded thematic analysis | Participants reported significant stress from constant mistreatment by their superiors when time was requested for prayers or due to their accent, ethnicity, being Muslim. Felt need to prove loyalty to the United States. Several stated faith system enabled resilience, particularly after converting to Islam; community was a protective factor as well. | 6 |
| 34 | Bartone PT. Hardiness protects against war-related stress in Army Reserve forces. Consulting Psychology Journal: Practice and Research. 1999;51(2):72-82. | 787 American National Guard personnel | Quantitative cross-sectional | DRS-15 | Half were deployed to Persian Gulf; proximity to the battlefield associated with higher levels of stress; many experienced stress without negative consequences. Hardiness at most could partly explain stress responses. |
4 |
| 48 | Bartone PT, Hystad SW, Eid J, Brevik JI. Psychological hardiness and coping style as risk/resilience factors for alcohol abuse. Military Medicine. 2012 May 1;177(5):517-24. | 7,555 military/defense workers in Scandinavia | Quantitative cross-sectional | DRS-15 | Participants low in resilience and high in avoidance had poor coping mechanisms and were at higher risk for alcohol abuse | 4 |
| 35 | Bartone, P. T., Roland, R. R., Picano, J. J., & Williams, T. J. (2008). Psychological hardiness predicts success in US Army Special Forces candidates. International Journal of Selection and Assessment, 16(1), 78-81. | 1,138 SF candidates | Quantitative cross-sectional | DRS-15 | Cross-sectional study used to predict longitudinal success. Hardiness significantly predicted graduation in the course; no controls for confounders, no mention of injuries or other contributors to success/failure, no reports of data nor models other than p values and Cohen's D. Referred to participants as a branch of SF, did not control for their prior experiences and/or occupations. All candidates reportedly scored higher than other military and nonmilitary, though those scores not reported. | 4 |
| 46 | Carr W, Bradley D, Ogle AD, Eonta SE, Pyle BL, Santiago P. Resilience training in a population of deployed personnel. Military Psychology. 2013;25(2):148-155. | 143 Deployed military personnel | Quantitative cross-sectional | CD-RISC | Resilience scores decreased after receiving resilience training but also decreased throughout duration of deployment. | 4 |
| 60 | Chen JA, Granato H, Shipherd JC, Simpson T, Lehavot K. A qualitative analysis of transgender veterans’ lived experiences. Psychology of Sexual Orientation and Gender Diversity. 2017;4(1):63-74. | Resilience among transgendered veterans | Minority stress theory | Social media recruitment w/open-ended questions about transgendered veteran experience | Focused on lived experiences but used thematic analysis; resilience was associated with increased activism, social/community supports, higher self-esteem, but found significant repercussions from stress of being minority group member | 6 |
| 45 | De La Rosa GM, Webb-Murphy JA, Johnston SL. Development and validation of a brief measure of psychological resilience: An adaptation of the response to stressful experiences scale. MilitaryMedicine. 2016 Mar 1;181(3):202-8. | Sample 1, n = 1,453; sample 2, n = 681; sample 3, n = 466; sample 4, n = 32 sailors & 36 civilians | Quantitative comparative | RSES | Authors abbreviated RSES to a four-item tool, but original study with largest sample (sample 1) included multiple measures such as burnout, PTSD, brief resilience scale, and others. Only results of RSES-4 relation to sample 4 (smallest sample) was provided to show correlations to other instruments. Eliminated spirituality as measure. | 4 |
| 51 | Escolas SM, Pitts BL, Safer MA, Bartone PT. The protective value of hardiness on military posttraumatic stress symptoms. Military Psychology. 2013;25(2):116-123. doi:10.1037/h0094953. | 561 Servicemembers across several branches | Quantitative cross-sectional | DRS-15 and PCL-M | Mentions that GAT predictive value not established; asserts MRT is tailored to Soldiers' scores; participants with low hardiness had higher PTSD symptom reporting and time in service. Higher resilience negated time in service or PTSD symptomology. Resilience and number of deployments were not significantly correlated unless low resilience was present to begin with. Resilience did not affect/modify relationship between PTSD and deployment history. States resilience is "trainable." | 4 |
| 53 | Gayton SD, Kehoe EJ. Character strengths and hardiness of Australian Army Special Forces applicants. Military Medicine. 2015 Aug 1;180(8):857-62. | 95 Australian SF candidates | Quantitative cross-sectional | 24 Character traits | Traits reflecting hardiness did not differentiate successful and unsuccessful candidates; no combination of character strengths increased discrimination between the successful and unsuccessful applicants. Hardiness scores not significantly associated with the top-ranked strengths of team worker, integrity, or persistence. Teamwork appeared to be strongest predictor of success. | 4 |
| 47 | Hernandez SHA, Morgan BJ, Parshall MB. Resilience, stress, stigma, and barriers to mental healthcare in US Air Force nursing personnel. Nursing Research. 2016;65(6):481-486. | 141 military RNs and 104 medical technicians | Quantitative cross-sectional | Self-report survey (CD-RISC) | Authors did not report specific resilience results; RNs reported higher levels of stigma (embarrassment in seeking mental health care, concerns about command/subordinate opinions) and resilience and lower levels of stress compared with medical technicians. Demographics had little bearing on resilience, stigma, etc. and deployments did not either. Stigma was more strongly correlated with stress than with resilience | 4 |
| 32 | Hystad SW, Eid J, Johnsen BH, Laberg JC, Thomas Bartone P. Psychometric properties of the revised Norwegian dispositional resilience (hardiness) scale. Scandinavian Journal Of Psychology. 2010 Jun;51(3):237-45. | 7,280 Norwegian Servicemembers | Quantitative cross-sectional | DRS-15 revised | In high-stress contexts, focusing on challenge better than control or commitment as challenge and control were low-level factors of resilience in this large sample. Hardy Servicemembers should next be studied with emphasis on future, humor, forgiveness, and avoiding resentment; forgiveness and ability to release grudges promising. | 4 |
| 43 | Johnson DC, Polusny MA, Erbes CR, et al. Response to Stressful Experiences Scale. Military Medicine. 2011;176(2):161-169. | 870 active-duty and reserve components of military and veterans (224 Marine Expeditionary Unit; 446 members of an Army National Guard Infantry; 200 soldiers assigned to an Army National Guard Aviation) | Quantitative, descriptive | RSES | Samples separated into different measurement arms to test different elements of scale. Scale psychometrically sound, determined five protective factors. Converged with other measures, RSES “accounted for” PTSD symptom variance in samples. Reported as valid measure of cognitive, emotional, behavioral responses to stress; introduction leads with “resilience” so stress response connection may indicate coping vs actual resilience. |
4 |
| 31 | Lee JE, Sudom KA, McCreary DR. Higher-order model of resilience in the Canadian forces. Canadian Journal of Behavioural Science/Revue Canadienne des sciences du comportement. 2011 Jul;43(3):222. | 5,650 Canadian forces recruits | Quantitative cross-sectional | Canadian Forces Recruit Health Questionnaire | Social support factor load highly correlated with measures of resilience; social structures likely have indirect effects: promoting internal resources, such as self-esteem or mastery. Resilient individuals demonstrated high tendencies toward personal master, and may generate positivity in others as well as themselves. | 4 |
| 40 | Lee JEC, Sudom KA, Zamorski MA. Longitudinal analysis of psychological resilience and mental health in Canadian military personnel returning from overseas deployment. Journal of Occupational Health Psychology. 2013;18(3):327-337. doi:10.1037/a0033059. | 1,584 Canadian soldiers | Quantitative cross-sectional | Canadian Forces Recruit Health Questionnaire | High agreeableness had worse mental health after deployment - possible shock conflicting with their positive worldview/jadedness. "Positive" attributes indicating resilience had unexpected inverse correlations to actual resilience and mental health. | 4 |
| 52 | Lester P, Stein JA, Saltzman W, et al. Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience. Military Medicine. 2013;178(8):838-845. doi:10.7205/MILMED-D-12-00502. | 280 active-duty American military personnel and families | Quantitative longitudinal | Brief Symptom Inventory, PTSD Checklist- Military [PCL-M], Strengths and Difficulties Questionnaire, and McMaster Family Assessment Device | Family adjustment measures predicted reduced distress and describe some inverse relationships between distress and program adherence, investigators stated the intervention program was specifically designed to improve resilience | 4 |
| 50 | Bue SL, Taverniers J, Mylle J, Euwema M. Hardiness Promotes Work Engagement, Prevents Burnout, and Moderates Their Relationship. Military Psychology (American Psychological Association). 2013;25(2):105-115. doi:10.1037/h0094952. | 252 Belgian soldiers | Quantitative cross-sectional | Norwegian hardiness scale, Utrecht burnout and work engagement scales | Hardiness was positively related to dedication and vigor, and negatively to cynicism and emotional exhaustion. Our results further suggest that work engagement and burnout are the opposite ends of a continuum. However, analyses concerning the moderation effect of hardiness suggest that individual differences could imply different processes in the relationship between work engagement and burnout | 4 |
| 41 | Peterson C, Park N, Castro CA. Assessment for the US army comprehensive soldier fitness program: The global assessment tool. American Psychologist. 2011 Jan;66(1):10. | 8000 Army soldiers | Quantitative cross-sectional | Global Assessment Tool (GAT) | Alphas of 'over .80' and 'good factors' described, but in narrative/qualitative terms. No description of how content validity and similar were established. | 4 |
| 49 | Sandvik AM, Bartone PT, Hystad SW, Phillips TM, Thayer JF, Johnsen BH. Psychological hardiness predicts neuroimmunological responses to stress. Psychology, Health & Medicine. 2013;18(6):705-713. doi:10.1080/13548506.2013.772304. | 21 Norwegian navy cadets | Quantitative comparative | DRS-15 revised | Psychological hardiness (including commitment, control, and challenge) was measured two days before the exercise. While all subjects scored high in hardiness, some were high only in commitment and control, but relatively low in challenge. These “unbalanced” hardiness subjects were also more stress reactive, showing suppressed proinflammatory cytokines (IL-12), increased anti-inflammatory cytokines (IL-4, IL-10), and lower neuropeptide-Y levels as compared to the hardiness-balanced group. This study thus shows that being high in hardiness with a balanced profile is linked to more moderate and healthy immune and neuroendocrine responses to stress. | 4 |
| 59 | Scott W, McCone D, Sayegh L, Looney J, Jackson R. Mixed methods in a post-deployment study of US Army National Guard soldiers. Journal of Workplace Behavioral Health. 2011;26(4):275-295. doi:10.1080/15555240.2011.618430. | Resilience in 400+ ARNG soldiers in Colorado | Mixed-methods | CD-RISC & structured interviews | States they measured resilience but did not report quantitative results; two participant interviews discussed staying calm and dealing with stress but not resilience. Factor analysis confirmed scale-construct integrity. Resilience was found if participants reported they consciously decided to prevail over adversity but scores were not reported. Triangulation of quantitative and qualitative data not discussed specifically. | Mixed-methods |
| 61 | Somasundaram D, Sivayokan S. Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka. International Journal of Mental Health Systems. 2013;7(1):1-24. doi:10.1186/1752-4458-7-3. | Resilience in oppressed circumstances Northern Sri Lanka - over 30 years of conflict and participant displacement from their homes | ethnographic philosophical framework | ecological model to examine participant experiences | protective factors instrumental in resilience were families remaining intact, especially strong matriarchal influences, in addition to participants developing aesthetic narratives of their experience, which appeared to endow more hope in the participants | 6 |
| 63 | Song SJ, Tol W, Jong J. Indero: Intergenerational Trauma and Resilience between Burundian Former Child Soldiers and Their Children. Family Process. 2014;53(2):239-251. doi:10.1111/famp.12071. | Former child soldiers and their families - resilience and stress | grounded theory methodology | Structured interviews | No findings or examination of resilience; collected salient data for themes among traumatized intergenerational refugee participants, but no discussion nor results connected to the tenets of grounded theory; no examination of change in the phenomena over time was explicitly demarcated | 6 |
| 58 | Vaughan CA, Farmer CM, Breslau J, Burnette C. Evaluation of the operational stress control and readiness (OSCAR) program. Rand Health Quarterly. 2015 Nov 30;5(2). | 1,307 Marines | Quantitative experimental; quasi-experimental longitudinal | One arm compared Marines in OSCAR-trained and non–OSCAR-trained battalions on stress-related outcomes before and after deployment; another was longitudinal pre- and post- deployment survey of perceptions of OSCAR among Marines with OSCAR training | Found no evidence that OSCAR affected key outcomes; no support for continuing OSCAR in its current form. No evidence of effects on depression, stress, PTSD, substance abuse. Several mental health measures were worse in OSCAR-trained battalions than in control battalions. | 2 |
| 42 | Vie LL, Scheier LM, Lester PB, Seligman ME. Initial validation of the US Army global assessment tool. Military Psychology. 2016 Oct 6;28(6):468-87. | 40,000 Army soldiers | Quantitative cross-sectional descriptive; scale testing | GAT | Omitted family support measures & friendship measures. Divergence of resilience factors in fourth sample; analyzed 11 factors of traits based on positive psychology. Gender diverged on character strengths. Assert competence indicates coping skills. Several areas of analysis marginal in model fit. Some scales (emotion-focused coping, avoidance, optimism, loneliness) performed poorly. No comparison to baseline or mean resilience scores. Con/divergent validity <.65 overall. | 4 |
| 16 | Vyas KJ, Fesperman SF, Nebeker BJ, et al. Preventing PTSD and depression and reducing health care costs in the military: A call for building resilience among service members. Military Medicine. 2016;181(10):1240-1247. doi:10.7205/MILMED-D-15-00585. | 2171 Servicemembers seeking mental health services | Quantitative retrospective | RSES, PCL-M, PHQ | Estimated that increasing resilience across services could reduce odds of developing PTSD by orders of magnitude. Unclear on how this was calculated due to retrospective and not longitudinal nature of the study. Resilience was measured with RSES and odds calculated therefrom without discussion of how RSES specifically captures resilience or subscale elements. Population may be low in resilience and high in PTSD or low PHQ due to poor mental health as a population seeking treatment. All authors affiliated with Naval Center for Combat and Operational Stress control and findings support continued resilience programs in their center presumably provides. Published one year after 2015 RAND report stating program was ineffective. | 4 |