Introducing Resilience In Health And Disease (2024)

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This blog summarises a paper entitled Resilience In Health And Disease, which you can find here.

What Is Resilience In Health And Disease?

Resilience in health and disease is not easy to define and there is no simple definition since the term covers a very wide range of features

In materials science, resilience is related to the capability of the material to revert to its original form after being bent or pressed (“the strength or capability of reverting to original form or position after bending, compression or stretching”). Many researchers agree that resilience is a very complex phenomenon which is shifting through time and circumstances, and which can not be regarded as a one-dimensional construct.

In psychology, resilience is generally defined as the capability of an individual to overcome stress and unhappiness, and to recover. Psychologists dealing with personality psychology usually studied resilience as an individual attribute or characteristic. (source)

Can You Improve Your Resilience, Or Is It Predetermined?

Resilience is not innate, every person possesses resilience and can strengthen it.

What Does Resilience Consist Of?

Resilience in health and disease consists of seven columns, which are:

1. Optimism.
2. Acceptance.
3. Focus on problem solving.
4. Defence mechanisms.
5. Forgiveness.
6. Responsibility.
7. Acquaintance and planning future.

Resilient persons tend to be optimistic, tend to view everything what is happening to them from the perspective of useful experience, focus on personal advantages and qualities, use constructive criticism, develop close relationships with others, have developed social skills and are aware of their emotions.

It is in significant connection with the general developmental processes, relationships with significant others and the specific life circumstances of a person. Resilience development is closely linked to personality development as a whole, and is deeply individual as personality development

Three Kinds

The term resilience in health and disease is very often used in psychologic literature by researchers to describe three different kinds of phenomenon:

Positive result despite risk status.

ie. existence of risk of negative or poor result

Continuous positive status and functioning despite unfavourable circumstances

That is “confrontation or maintaining competent functioning” in the presence of chronic or major acute life stressors (ie. divorce and similar). Resilience in unfavourable situations implies efficient confrontation which includes efforts to rebuild or maintain internal or external balance under a significant threat through means of human activities such as thoughts and actions.

Recovery after trauma

ie. adverse and/or damaging experiences and influences. This third concept of resilience is defined as ‘successful adaptation despite unhappiness’.

In the context of Comorbidity

In the context of comorbidity, it is important to bear in mind that there are different forms of resilience in health and disease and that, in accordance with the cascade model, certain factors of resilience may contribute to development of others. It is useful to have in mind personal and group resilience (Fletcher 2013, Jakovljevi 2015), physiological, psychological, social and spiritual resilience (Jakovljevi 2019), and primary, secondary and tertiary resilience.

Psychological and spiritual resilience

Actually represent psychological and spiritual defence mechanisms in crisis states, stress states and trauma. Psychological and spiritual resilience include hope, activity, purpose and meaning, community, gratitude and joy, which overcome vulnerability that includes despair, helplessness, absurdity, isolation, anger and sadness. In other words, resilience on a psychosocial level represents and includes different kinds of psychological, mental, social and spiritual capital.

Primary resilience

Is linked to maintenance of balance, equilibrium and health, which ensure welfare and prevent stress-related diseases.

Secondary resilience

Denotes the factors and processes which enable us to successfully cope with crises and illnesses and to re-stablish health and psychosomatic harmony.

Tertiary resilience

Represents the ability of some person to live happily, creatively and productively despite the presence of one or more chronic illnesses, that is, a person actively and positively adapts to objective restrictions in older age.

From the aforementioned, primary resilience enables good health, physical, psychological, social and spiritual welfare, secondary resilience enables healing and personal recovery, and tertiary resilience enables quality life and a sense of wellbeing despite chronic disease. Appropriate resilience is a prerequisite for successful aging. Every human is a unique and responsible person who strives for self-realisation, self-understanding and self-transcendence, its own integrity, self-control and management of its own life. The good news is that resilience can be increased and maintained by learning and training

A Note On Optimism

Optimism as a personality trait plays a very important role in resilience in health and disease, and is associated with activity of neural circuits of the reward system. Positive emotions, capacity for self-regulation, social competence, social support, close connections to helpers, lower level of denial, avoiding behaviour and retreat, greater flexibility of thinking and open-mindedness, dispositional optimism, are very important components of resilience, that is, the resistance to unfavourable events.

One Perspective On Resilience

According to some, resilience in health and disease is associated with a force which drives a person to grow through suffering, stress, trauma, disorder or disease. Posttraumatic growth and resilience are two associated, but still different terms. Mental disorders often have the function to encourage the patient to transform his wrong beliefs, to give up his wrong goals and life values and find new and authentic values, to revise his loser story and reveal his authentic life mission through different roles thus shaping his new identity.

Resilience And Illness

Good resilience impedes and prevents the onset of illness, provides good health, physical, psychological, social and spiritual wellbeing, facilitates and accelerates healing and personal recovery, and provides a quality life and well-being despite chronic illness. Numerous studies have highlighted the importance of resistance in various diseases. In their work Colon cancer and resilience, Franji D et al. conclude that individuals with higher levels of resilience are more likely to cope with the disease and that such individuals have a faster recovery and healing process from colon cancer (Franji et al. 2019).

Numerous other studies show that the introduction of interventions aimed at enhancing resilience in oncology facilities is very important to accelerate the recovery process of colon cancer patients. Resilience-enhancing interventions can significantly help patients more readily cope with end-stage colon cancer (Hwang et al. 2018, Solano et al. 2016).

Several authors cite the need for different strategies to enhance resilience in patients (Choi et al. 2012, Mosher et al. 2016) in the future for better treatment and faster recovery from cancer, and have conducted a research to examine the impact of a computer system on the monitoring of cancer patients’ resilience in colon cancer patients and found that a computer-based system for monitoring the health status of oncological patients had a positive effect on the development and growth of resilience (Kim 2019). Some studies indicate that resilience-enhancing interventions develop a sense of hope in terminal cancer patients (33.34). Many organic and mental disorders are often co-morbid, which significantly affects the outcome of treatment.

Numerous studies have shown an association between the presence of depression and low resilience (Loprinzi et al. 2011, Somasundaram 2016), as well as the importance and correlation of resistance and cardiovascular disease: hypertension (Colquhoun et al. 2013, Hare et al. 2014), heart failure (Surtees et al. 2003, Crump et al. 2016, Daniels et al. 2012), and ischemic heart disease (Qiu 2019, Robertson 2017).

Moral Resilience

Moral resilience is also important to help people maintain and restore their moral integrity in response to moral distress and in response to moral suffering caused by moral conflicts, doubts, internal and external constraints (Borove ki 2019).

Physical Activity And Resilience

Increasing scientific evidence point that, in addition to resistance, adequate exercise (Babi et al. 2018, 2019, Kati et al. 2018) is important for maintaining good health and preventing disease, as well as many other factors.

How Do You Assess Resilience?

There are numerous methods available to assess resilience in health and disease. Some of them can be found in the free downloads section of my website.

For the purpose of resilience research, the most commonly used so far is the Connor-Davidson scale, which is validated and reliable and has satisfactory psychometric features in relation to the general population, primary health care, general psychiatric patients, and individuals undergoing cancer treatment.

The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0–4), with higher scores reflecting greater resilience.

Concluding Thoughts

In medicine, resilience in health and disease refers to one’s capability to recover when having an illness or disease. Resilience may be defined as a collection of protective factors that mediate the relationship between a stressful event, e.g. disease, and positive outcomes. It is an indivisible part of mental health and health in general, well-being and quality of life. Resilience is considered as a dynamic and modifiable process, gradually developed through the life span, by the facing and overcoming of adversary events. Individuals may be resilient in one domain and not in others, or they may be resilient at one spell of time and not at other periods of their lives (Jakovljevi 2017).