Interventionen zur Steigerung der Resilienz

ZUSAMMENFASSUNG

Resilienz beschreibt die Aufrechterhaltung oder rasche Wiederherstellung der psychischen Gesundheit trotz starker Belastung oder widriger Lebensumstände. Aufgrund der prinzipiellen Modifizier- und Trainierbarkeit von Resilienz wurden zahlreiche Interventionsprogramme entwickelt. Ein Vergleich verschiedener Interventionen zur Steigerung der Resilienz macht konzeptionelle, methodische und designspezifische Besonderheiten deutlich. Es zeigen sich Unterschiede in den Resilienzdefinitionen, der Operationalisierung und Messung der Resilienz sowie methodische Limitationen im Studiendesign. Dies erschwert die Vergleichbarkeit der Studien und die zusammenfassende Betrachtung der Effekte. Die veröffentlichten systematischen Übersichtsarbeiten und Metaanalysen über den Effekt von Resilienzinterventionen weisen auf geringe bis moderate Effekte im Hinblick auf eine Steigerung der Resilienz, die Abnahme psychiatrisch relevanter Symptome sowie eine Verminderung des subjektiven Stresserlebens hin. Aufgrund der Heterogenität der Studien ist die Evidenzlage als gering gesichert bzw. vertrauenswürdig einzustufen. Aspekte zur Verbesserung der Studiendesigns und -durchführung von zukünftigen Resilienzinterventionsstudien zielen auf die Verbesserung der Evidenzsicherung ab. Der vorliegende Beitrag zeigt die konzeptionellen, methodischen und designspezifischen Besonderheiten von Resilienzinterventionsstudien auf und gibt einen narrativen Überblick über die Ergebnisse systematischer Übersichtsarbeiten über die Wirksamkeit von Resilienzinterventionen bei erwachsenen Zielgruppen.

ABSTRACT

Resilience refers to the maintainance of mental health despite significant burden or aversive circumstances. Nowadays, resilience is considered as modifiable, which has stimulated research on training programs to foster resilience. However, current resilience intervention studies are based on a variety of different concepts, methods and designs, resulting in heterogeneous resilience definitions, operationalisations and assessment instruments applied, as well as methodological limitations in study design. This has an effect on the comparability between and calculation of pooled effects accross intervention studies. Published systematic reviews and metaanalysis provide evidence for a small to moderate effekt of resilience interventions to foster resilience, decrease stress-related psychiatric symptoms and perceived stress. Due to the heterogeneity of the studies, the level of evidence certainty is considered very low. Measures to improve study design and conduct in future resilience studies to improve the level of evidence are discussed. This paper summarizes the conceptional, methodological and design-specific aspects of resilience interventions and provides a narrative overview of results reported in systematic reviews on the effect of resilience interventions in adult populations.

Schlüsselwörter

Resilienz - Intervention - Training - Stress

Key words

Resilience - intervention - training - stress

Publication History

Article published online:
01 April 2021

• Literatur

• 1 Bonanno GA, Westphal M, Mancini AD. Resilience to loss and potential trauma. Annu Rev Clin Psychol 2011; 7: 511-35
• 2 Feder A, Charney D, Collins K. Neurobiology of resilience. In: Resilience and Mental Health. Cambridge: University Press; 2011
• 3 Sapienza JK, Masten AS. Understanding and promoting resilience in children and youth. Curr Opin Psychiatry 2011; 24 (04) 267-73
• 4 Connor KM, Davidson JRT, Lee L-C. Spirituality, resilience, and anger in survivors of violent trauma: a community survey. J Trauma Stress 2003; 16 (05) 487-94
• 5 Hu T, Zhang D, Wang J. A meta-analysis of the trait resilience and mental health. Pers Individ Differ 2015; 76: 18-27
• 6 Kalisch R, Baker DG, Basten U. et al The resilience framework as a strategy to combat stress-related disorders. Nature Human Behaviour 2017; 1: 784-90
• 7 Bonanno GA, Diminich ED. Annual Research Review: Positive adjustment to adversity – trajectories of minimal–impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry 2013; 54 (04) 378-401
• 8 Masten AS. Ordinary magic. Resilience processes in development. Am Psychol 2001; 56 (03) 227-38
• 9 Fletcher D, Sarkar M. Psychological Resilience. European Psychologist 2013; 18 (01) 12-23
• 10 Reivich K, Shatté A. The resilience factor: seven essential skills for overcoming life’s inevitable obstacles. New York: Broadway Books; 2002
• 11 Southwick SM, Charney DS. Resilience: The science of mastering life’s greatest challenges. Cambridge: Cambridge University Press; 2012
• 12 Chmitorz A, Kunzler A, Helmreich I. et al Intervention studies to foster resilience – A systematic review and proposal for a resilience framework in future intervention studies. Clin Psychol Rev 2018; 59: 78-100
• 13 Joyce S, Shand F, Tighe J. et al Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open 2018; 8 (06) e017858
• 14 Kunzler AM, Helmreich I, Chmitorz A. et al Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 05 2020; 7: CD012527
• 15 Kunzler AM, Helmreich I, König J. et al Psychological interventions to foster resilience in healthcare students. Cochrane Database of Systematic Reviews 2020
• 16 Leppin AL, Bora PR, Tilburt JC. et al The efficacy of resiliency training programs: a systematic review and meta-analysis of randomized trials. PLoS ONE 2014; 9 (10) e111420
• 17 Macedo T, Wilheim L, Gonçalves R. et al Building resilience for future adversity: a systematic review of interventions in non-clinical samples of adults. BMC Psychiatry 2014; 14 (01) 227
• 18 Robertson IT, Cooper CL, Sarkar M. et al Resilience training in the workplace from 2003 to 2014: A systematic review. J Occup Organ Psychol 2015; 88: 533-566
• 19 Vanhove AJ, Herian MN, Perez ALU. et al Can resilience be developed at work? A meta-analytic review of resilience-building programme effectiveness. J Occup Organ Psychol 2016; 89 (02) 278-307
• 20 Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1993; 1 (02) 165-78
• 21 Windle G, Bennett KM, Noyes J. A methodological review of resilience measurement scales. Health Qual Life Outcomes 2011; 9: 8
• 22 Connor KM, Davidson JRT. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003; 18 (02) 76-82
• 23 Smith BW, Dalen J, Wiggins K. et al The brief resilience scale: assessing the ability to bounce back. Int J Behav Med 2008; 15 (03) 194-200
• 24 Amat S, Subhan M, Jaafar WMW. et al Evaluation and Psychometric Status of the Brief Resilience Scale in a Sample of Malaysian International Students. Asian Social Science 2014; 10 (18) 240
• 25 Chmitorz A, Wenzel M, Stieglitz R-D. et al Population-based validation of a German version of the Brief Resilience Scale. PLoS ONE 2018; 13 (02) e0192761
• 26 De Holanda Coelho GL, Hanel PHP. et al Brief Resilience Scale: Testing its factorial structure and invariance in Brazil. Univ Psychol 2016; 15 (02) 397-408
• 27 Rodríguez-Rey R, Alonso-Tapia J. et al Reliability and validity of the Brief Resilience Scale (BRS) Spanish Version. Psychol Assess 2016; 28 (05) e101-110
• 28 Veer I, Riepenhausen A, Zerban M. et al Psycho-social factors associated with mental resilience in the Corona lockdown. 2020 psyarxiv.com/4z62t
• 29 Ahern NR, Kiehl EM, Sole ML. et al A review of instruments measuring resilience. Issues Compr Pediatr Nurs 2006; 29 (02) 103-25
• 30 Pangallo A, Zibarras L, Lewis R. et al Resilience through the lens of interactionism: a systematic review. Psychol Assess 2015; 27 (01) 1-20
• 31 Cosco TD, Kaushal A, Richards M. et al Resilience measurement in later life: a systematic review and psychometric analysis. Health Qual Life Outcomes 2016; 14: 16
• 32 Kalisch R, Müller MB, Tüscher O. Transdiagnostisch, multisystemisch, quantitativ: Einige grundsätzliche Überlegungen zu Strategien und Studiendesigns in der modernen Resilienzforschung. PTT – Persönlichkeitsstörungen 2014; 18 (04) 203-14
• 33 Kalisch R, Müller MB, Tüscher O. A conceptual framework for the neurobiological study of resilience. Behav Brain Sci 2015: 1-49
• 34 Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979; 9 (01) 139-45
• 35 Asselmann E, Wittchen H-U, Lieb R. et al A 10-year prospective-longitudinal study of daily hassles and incident psychopathology among adolescents and young adults: interactions with gender, perceived coping efficacy, and negative life events. Soc Psychiatry Psychiatr Epidemiol 2017: 1-10
• 36 Caspi A, Moffitt TE, Thornton A. et al The life history calendar: A research and clinical assessment method for collecting retrospective event-history data. Int J Methods Psychiatr Res 1996; 6 (02) 101-14
• 37 Chmitorz A, Kurth K, Mey LK. et al Assessment of Microstressors in Adults: Questionnaire Development and Ecological Validation of the Mainz Inventory of Microstressors. JMIR Ment Health 2020; 7 (02) e14566
• 38 Lazarus RS, Folkman S. Manual for the Hassles and Uplifts Scale – Research Edition. Paolo Alto: Consulting Psychologists Press; 1989
• 39 Swann J, Hodson SE. A psychometric analysis of the Traumatic Stress Exposure Scale – Revised (TSES-R). Canberra (AUST): Commonwealth Departmen of Defence; 2004
• 40 Sarason IG, Johnson JH, Berberich JP. et al Helping police officers to cope with stress: a cognitive-behavioral approach. Am J Community Psychol 1979; 7 (06) 593-603
• 41 Thompson SR, Dobbins S. The Applicability of Resilience Training to the Mitigation of Trauma-Related Mental Illness in Military Personnel. J Am Psychiatr Nurses Assoc 2018; 24 (01) 23-34
• 42 Luthans F, Avey JB, Patera JL. Experimental analysis of a web-based training intervention to develop positive psychological capital. Academy of Management Learning & Education 2008; 7 (02) 209-21
• 43 Loprinzi CE, Prasad K, Schroeder DR. et al Stress Management and Resilience Training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial. Clin Breast Cancer 2011; 11 (06) 364-8
• 44 Adler AB, Bliese PD, McGurk D. et al Battlemind debriefing and battlemind training as early interventions with soldiers returning from iraq: Randomization by platoon. J Consult Clin Psychol 2009; 77 (05) 928-40
• 45 Castro CA, Adler AB, McGurk D. et al Mental health training with soldiers four months after returning from Iraq: randomization by platoon. J Trauma Stress 2012; 25 (04) 376-83
• 46 Weckesser LJ, Dietz F, Schmidt K. et al The psychometric properties and temporal dynamics of subjective stress, retrospectively assessed by different informants and questionnaires, and hair cortisol concentrations. Sci Rep 2019; 9 (01) 1098
• 47 Melnyk BM, Morrison-Beedy D, Moore SM. Nuts and Bolts of Designing Intervention Studies [Internet]. Springer Publishing Company 2020 https://connect.springerpub.com/content/book/978-0-8261-5571-9/part/part02/chapter/ch05
• 48 National Institutes of Health (NIH). NIH clinical trials research and you [Internet] 2016 https://www.nih.gov/health-information/nih-clinical-research-trails-you/basics
• 49 Linz S, Helmreich I, Kunzler A. et al Interventions to promote resilience in adults: A narrative review. PPmP: Psychotherapie Psychosomatik Medizinische Psychologie 2020; 70 (01) 11-21
• 50 Bernburg M, Groneberg DA, Mache S. Mental Health Promotion Intervention for Nurses Working in German Psychiatric Hospital Departments: A Pilot Study. Issues Ment Health Nurs 2019; 40 (08) 706-11
• 51 Kocalevent R-D, Mierke A, Brähler E. BRCS – Brief Resilient Coping Scale. In: Kemper CJ, Brähler E, Zenger M (Hrsg.) Psychologische und sozial-wissenschaftliche Kurzskale. Berlin: Medizinisch Wissenschaftliche Verlagsanstalt; 2014
• 52 Sinclair VG, Wallston KA. The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment 2004; 11 (01) 94-101
• 53 Khoshnazary S, Hosseini MA, Khoshknab M. et al The effect of emotional intelligence (EI) training on nurses’ resiliency in department of psychiatry. Iranian Journal of Psychiatric Nursing 2016; 3 (04) 29-37
• 54 Mache S, Vitzthum K, Klapp BF. et al Evaluation of a Multicomponent Psychosocial Skill Training Program for Junior Physicians in Their First Year at Work: A Pilot Study. Fam Med 2015; 47 (09) 693-8
• 55 Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol 2008; 4: 1-32