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What Resilience Is, What Not, And Why It Is So Important

The problem

After decades of research on stress-related disorders and massive improvements in their treatment, we still haven’t been able to reduce their frequency. Still, each year, more than half a billion people in the world are affected by anxiety, post-traumatic stress disorder (PTSD), depression, or addiction, that is, conditions that often occur as a consequence of exposure to stressors, such as traumatic events, challenging life circumstances or life transitions, or physical illness . 

Still, each year, more than half a billion people in the world are affected by a stress-related disorder.

In the year 2013, major depression was found to be the second leading cause of disability in the world; anxiety disorders ranked 9th . Behind these numbers, there is much individual suffering, heavy burden on families, friends, colleagues as well as on health  systems - and important economic consequences. So, in Europe alone, stress-related disorders are believed to cause direct and indirect economic costs in the range of €200 billion every year . 

The ten leading causes of disability

The ten leading causes of disability in 2013, world-wide, adapted from

Prevalence of common mental disorders world-wide (WHO)

Prevalence (frequency) of depression and anxiety disorders, adapted from WHO Global Health Estimates 2017

An alternative strategy

As resilience researchers, we are intrigued by the observation that we make again and again and that has been confirmed by studies in different countries, cultures, and circumstances: most people maintain good mental health although they are exposed to severe psychological or physical adversity . Hence, we try to understand why some people do not, or only temporarily, develop stress-related mental dysfunction when life hits them, whereas the same kind of challenges cause long-term dysfunction in other people. Our thinking is: If we can find out what protects resilient people against disease, we might use this knowledge to develop new methods to also prevent disease in people who are at a particular risk of developing stress-related mental disorders. Improving prevention could be a genuine contribution to reducing the prevalence of these disorders and could be more efficient than trying to treat a disorder at a stage where significant individual suffering and other costs have already occurred . For these reasons, CRC 1193 has set itself the overarching goal to operate a paradigm shift away from investigating mechanisms of disease towards investigating mechanisms of health. 

Paradigm shift

Related paper:

For a detailed conceptual discussion, see our resilience review and theory paper in Behavioral and Brain Sciences.

Paper Behavioral and Brain Sciences

What resilience is, and what not

It is frequently believed that resilience is a fixed trait or individual characteristic or predisposition that, if you have it, will protect you against the negative consequences of stressor exposure . However, individuals change while they successfully cope with stressors. This sometimes manifests at the level of altered perspectives on life , as emergence of new strengths or competences , as partial immunization against the effects of future stressors , or even as epigenetic alterations and modified gene expression patterns . What this probably means is that the maintenance or quick recovery of mental health results from some kind of positive adaptation to stressors. 

Recent animal studies strongly support the idea that organisms learn to cope with adversity when they meet adversity, and that such adaptive changes are the immediate cause of why an organism maintains its function . This also means that resilience is not simply insensitivity to stressors, or inertia, or passivity, but a consequence of an active and dynamic process of adaptation .

Related paper:

A detailed discussion of the definition, operationalization and measurement of resilience can soon be found in our position paper in Nature Human Behaviour.

Paper Nature Human Behaviour

CRC 1193 therefore has the primary goal to identify and understand the processes, or mechanisms, that protect individuals against stress-related dysfunction. In line with this process-oriented perspective, we define resilience as the maintenance or quick recovery of mental health during and after periods of adversity, resulting from a dynamic process of adaptation .

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