A Systematic Review of Genetic Influence on Psychological Resilience.

When exposed to adversity, some individuals are at an increased risk of posttraumatic stress disorder, experiencing persistent biopsychosocial disturbances, whereas others adapt well, described as resilience. Resilience is a complex biopsychosocial phenomenon conceptualized as adaptation to adversity influenced by an individual's genetic variants, epistasis, epigenetics, and gene-by-environment interactions. Studies on psychological resilience have focused on behavioral and psychosocial variables with far less examination of the genetic contributions. The purpose of this review is to identify specific genetic variants contributing to the biological capacity for psychological resilience. PubMed and PsycINFO were searched using the following key words: psychological resilience AND genotype(s). Additional articles were identified from the Human Genome Epidemiology Navigator using the term resilience, psychological. Ten studies met the criteria. Six genes were empirically associated with psychological resilience: serotonin-transporter-linked polymorphic region ( 5-HTTLPR), dopamine receptor D4, brain-derived neurotrophic factor ( BDNF), corticotropin-releasing hormone receptor 1, oxytocin receptor and regulator of G-protein signaling 2 . The findings of this systematic review suggest that the L/L or L'/L' genotype of 5-HTTLPR and rs25531 in children/adolescents and the S/S or S'/S' genotype in adults are most frequently related to resilience. Additionally, the Val/Val genotype of rs6265 in BDNF in Caucasians was also associated with resilience. There are numerous factors contributing to the complexity of determining the genetic influence on resilience including analysis of rs25531, assumptions of the mode of inheritance, operationalization of resilience, demographic and population characteristics, sample size, and other types of genetic influence including epistasis and epigenetics. While current evidence is supportive, further investigation of the genetic influence on resilience is required.

A Concept Analysis of Resilience Integrating Genetics.

Although clinicians and researchers are interested in the phenomenon of resilience, there is no agreed-upon definition of resilience. Scientific evidence suggests that resilience is influenced by intrapersonal (e.g. personality traits) and environmental (e.g. social support) variables. A concept analysis was conducted to better understand the meaning of resilience. In this analysis, the antecedent of resilience was a potentially traumatic event; the defining attributes were ego-resiliency, emotion regulation, social support, and heredity; and the consequences were none to mild psychopathological symptoms and positive adaptation. This analysis can help nurses better understand resilience and its relationships to both intrapersonal and environmental variables.

The first anniversary: stress, well-being, and optimism in older widows.

The first anniversary for older widows (n = 47) has been explored during Months 11, 12, and 13. Concurrent correlations show that optimism inversely correlates with psychological (intrusion and avoidance) stress as measured with the Impact of Event Scale (r = -.52 to -.66, p < .005) and positively correlates with well-being (physical: r = .36 to .46, p < .025; psychosocial: r = .58 to .72, p < .005; spiritual: r = .50 to .69, p < .005). Lagged correlation patterns suggest that higher levels of optimism at a given time are associated with higher life satisfaction and spiritual well-being at later times. Psychological stress is higher at Month 12 when compared to Month 13, t(43) = 2.54, p = .01, but not when compared to Month 11, t(43) = 1.49, p > .10. There are no significant differences in physiologic stress (salivary cortisol) or well-being during the first anniversary of spousal bereavement.

Spousal bereavement assessment: a review of bereavement-specific measures.

The death of a spouse represents a common form of bereavement among adults and is associated with significant distress and adaptation. This 10-year review of the bereavement literature highlights 12 tools used to assess bereavement in spousally bereaved samples. Pertinent measurement foci and psychometric properties of each tool are presented. Applicability of each tool within the spousal bereavement process is discussed, and aspects of the spousal bereavement process not currently addressed or under-addressed provide direction for future tool development.

A review of instruments measuring two aspects of meaning: search for meaning and meaning in illness.

AIM: This paper is a report of narrative review of psychosocial instruments measuring two aspects of meaning: the search for meaning and meaning in illness. BACKGROUND: Studies have shown that meaning has significance for well-being, particularly for those experiencing illness/negative events. Understanding a person's ascription of meaning to a stressful event can facilitate planning of supportive nursing interventions. METHOD: A literature search was conducted using Medline, PsycInfo, PsycArticles, CINAHL, ProQuest, Ebsco and MasterFile Premier for the period 1956-2006. The search terms were: meaning instruments, search for meaning, meaning in illness, significance of meaning and positive meaning. Only studies that employed measurement of one of these two aspects of meaning were included. FINDINGS: Twelve instruments were retrieved from the search. Five were measures of search for meaning and seven were measures of meaning in illness. With a few exceptions these instruments were conceptually and operationally congruent and had acceptable psychometric properties. Limiting factors were the infrequent use of some of the instruments clinically or in research, and lack of evidence that cultural or age-specific factors had been considered in the development of the instruments. CONCLUSION: Progress with research into meaning and clinical use of meaning instruments may be augmented by refinement of instruments in the areas of conceptual clarity, operational congruence, psychometric properties and cultural and age-specific considerations. Good quantitative assessment will facilitate analysis of the relationship between ascriptions of meaning and psychosocial functioning, and lead to improved nursing interventions.

Meaning in heart disease: measuring the search for meaning.

The purpose of this study was to test the psychometric properties of a new measure, the Meaning in Heart Disease instrument (MHD), in persons who underwent percutaneous coronary intervention (PCI). Within 1 year of PCI, 232 persons completed the MHD and construct validity measures (SF-36v2, Hospital Anxiety and Depression Scale). Study aims were examined using reliability analysis, factor analysis, and correlations. After factor analysis, four scales reflecting the theoretical concepts central to the conceptual framework of the instrument emerged--Disrupted Meaning (alpha = .93), Refocusing Global Meaning (alpha = .92), Searching for Answers (alpha = .82), and Ignoring Heart Disease (alpha = .77). Convergent and divergent validity was supported, in part, for all scales. The MHD had strong support for its validity and will be useful in testing nursing interventions aimed at helping individuals integrate heart disease into the life experience.

Searching for meaning in negative events: concept analysis.

AIM: The aim of this paper was to synthesize the literature related to meaning and present a conceptual analysis of searching for meaning in unexpected, significant, negative events. BACKGROUND: Events or situations that are perceived as unexpected and negative (e.g. chronic and/or life-threatening illness) can disrupt life plans and lead to emotional distress. Nurses are in a key position to aid in the coping process by assisting individuals to integrate the meaning of an unexpected, negative event into the life experience. METHODS: In May 2004, a comprehensive literature search using the terms meaning, search for meaning, meaning-making, making meaning, life change events, adaptation-psychological, stress, and coping was carried out. Of 339 possible references, 86 were included in the analysis. FINDINGS: Global meaning refers to an individual's beliefs, values, and purpose/goals. Situational meaning refers to the meaning the individual attaches to a situation. When the meaning attached to the situation is not congruent with global meaning, meaning is considered shattered and a search for meaning ensues. In the search for meaning, people may attempt to change the meaning of the event (through reattributions or creating illusions) or change global meaning (through positive reappraisal, problem-solving coping, or revaluing ordinary events). CONCLUSION: Nurses are in a key position to assist people through negative events. The process of searching for meaning provides a solid foundation for the development of nursing interventions to assist individuals through difficult times. Research is needed to develop nursing interventions based on the process of the search for meaning, as well as measures reflective of the search for meaning.

Coping style and women's participation in breast and gynecological screening.

The purpose of this project was to determine the role of coping style in women's practice of breast and gynecological screening behaviors. Women were classified into one of four coping groups based on measures of vigilance and screening distress. Data were analyzed from a subset of 85 U.S. women who participated in a larger longitudinal study designed to examine self-reported screening participation. Results indicate frequency of screening participation and importance of obtaining immediate mammography feedback differed across coping style groups. Women characterized as high in vigilance and screening distress were most at risk for nonparticipation in screening.

Women's satisfaction with breast and gynecological cancer screening.

PURPOSES: This study examined women's satisfaction with their breast and gynecological (GYN) cancer screening, clinical breast examination (CBE), mammogram (MAM), and pelvic examination (PE). Selected predictors (characteristics of the exam and characteristics of the health care provider) of satisfaction with their screening exams also were assessed. METHODS: Women (N = 242) ages 19 years and older were recruited from a residential mailing list, and from church and community organizations. Participants completed questionnaires in their homes or in the community setting where they had been recruited. Descriptive statistics were used to describe the level of women's satisfaction with their most recent exams. Hierarchical multiple regression was used to determine the influence of exam and health care provider characteristics on women's satisfaction with exams. RESULTS: We found that women were very satisfied with care received during all three screening exams. Women were more satisfied during CBE and PE if they perceived these exams as informative, clear and complete and if they perceived the provider as informative and responsive to them when they ask questions. Women also were more satisfied with all three exams when the provider was perceived as relaxed during these exams.