Elsevier

Clinical Psychology Review

Volume 52, March 2017, Pages 19-42
Clinical Psychology Review

Review
Resilience to emotional distress in response to failure, error or mistakes: A systematic review

https://doi.org/10.1016/j.cpr.2016.11.007Get rights and content

Highlights

  • Psychological factors can buffer the impact of failure on emotional distress.

  • Key resilience factors are self-esteem, attributional style and low perfectionism.

  • Academic self-worth and trait emotion suppression do not confer resilience.

Abstract

Perceptions of failure have been implicated in a range of psychological disorders, and even a single experience of failure can heighten anxiety and depression. However, not all individuals experience significant emotional distress following failure, indicating the presence of resilience. The current systematic review synthesised studies investigating resilience factors to emotional distress resulting from the experience of failure. For the definition of resilience we used the Bi-Dimensional Framework for resilience research (BDF) which suggests that resilience factors are those which buffer the impact of risk factors, and outlines criteria a variable should meet in order to be considered as conferring resilience. Studies were identified through electronic searches of PsycINFO, MEDLINE, EMBASE and Web of Knowledge. Forty-six relevant studies reported in 38 papers met the inclusion criteria. These provided evidence of the presence of factors which confer resilience to emotional distress in response to failure. The strongest support was found for the factors of higher self-esteem, more positive attributional style, and lower socially-prescribed perfectionism. Weaker evidence was found for the factors of lower trait reappraisal, lower self-oriented perfectionism and higher emotional intelligence. The majority of studies used experimental or longitudinal designs. These results identify specific factors which should be targeted by resilience-building interventions.

Resilience; failure; stress; self-esteem; attributional style; perfectionism

Introduction

A large body of research suggests that experiencing failure has marked emotional and psychological consequences across a range of individuals and settings. Longitudinal studies indicate that academic failure in adolescents increases risk for clinical depression in adulthood (McCarty et al., 2008, Reinherz et al., 1999), and in those who are depressed, perceived failure has been associated with suicide attempts (Bulik, Carpenter, Kupfer, & Frank, 1990). Even a single experience of failure in non-clinical groups can have significant emotional sequelae. In athletes, match failure has been linked with elevated feelings of depression, humiliation and guilt (Jones and Sheffield, 2007, Wilson and Kerr, 1999), and in healthcare professionals, involvement in medical errors or patient safety failures is reported to result in feelings of shame, depression and anxiety, which can then increase the risk of further errors (Sirriyeh et al., 2010, West et al., 2009). The reliable impact of failure experiences on mood makes false failure feedback tasks suitable for use as negative mood inductions in experimental settings (Nummenmaa & Niemi, 2004). Studies employing these tasks have found that manipulated failure feedback consistently increases feelings of sadness, defeat and frustration (Johnson et al., 2011a, Johnson et al., 2008b, Nummenmaa and Niemi, 2004) and may have a detrimental impact upon cognitive functioning such as reducing the accuracy of memory recall (Johnson et al., 2008b).

However, not all individuals experience significant emotional distress in response to failure, and several psychological models highlight the role of psychological responses to failure in the development of failure-related distress and emotional disorder. For example, cognitive models of suicide have emphasised the role of situation appraisals, suggesting that suicidal thoughts occur when individuals appraise their circumstances in terms of failure (termed ‘defeat’) and entrapment (Johnson et al., 2008a, Williams, 1997). Yet such models have been criticised for their acceptance of an overly negative, disorder-based approach to understanding mental health (Johnson & Wood, 2015). By focusing on the development of mental health problems rather than mental wellbeing, it has been suggested that such approaches fail to identify and capitalise on natural coping mechanisms (Johnson & Wood, 2015). As such, they may be missing potential points for psychological interventions to target and develop.

An alternative to these models are resilience-based approaches (Bonanno, 2004, Masten, 2001, Masten and Powell, 2003). These aim to understand the factors that enable individuals to withstand stressors and avoid psychological distress rather than focusing on the mechanisms that lead to distress and disorder. Resilience-based approaches have the potential to highlight skills and tendencies that individuals can develop to maintain psychological health, leading to a more positively oriented approach to wellbeing. However, this body of literature has suffered from two main limitations.

First, there has been a lack of clarity concerning the criteria for identifying a ‘resilient’ outcome. The common definition of resilience as factors which reduce negative outcomes in the face of adversity would suggest that resilience variables are those which moderate or attenuate the association between risk factors and negative outcomes. In contrast, many studies of resilience have used a correlational approach. These studies have assumed that resilience variables are those which are ‘positive’, and have investigated whether high levels of a proposed resilience variable (e.g., high perceived social support) is directly associated with lower levels of a negative outcome (e.g., suicidal thoughts). However, as has been highlighted elsewhere (Johnson and Wood, 2015, Johnson et al., 2011b), every negative variable exists on a continuum with its positive inverse. Returning to the above example, using this approach, it could just as easily be suggested that low perceived social support is a risk factor for suicidal thoughts.

Second, this research failed to lead the field towards more nuanced understandings of resilience. A common approach has been to propose a concept of resilience, develop a questionnaire to measure this, and to investigate the association of this variable in relation to various outcome variables in different populations. This approach does not enable the proposed resilience variable itself to evolve in order to accommodate new research findings. Indeed, despite fifty years of resilience research, key questions regarding the nature of resilience remain, which may be linked to the limitations of this approach. These concern i) whether factors which confer resilience vary depending on the outcome under consideration (i.e., whether resilience to general mental wellbeing is similar to resilience to negative behavioural outcomes such as suicidality), and ii) whether factors which confer resilience vary according to the risk factor/adversity individuals are facing.

In line with these broader limitations, despite a large growth of interest in resilience, and an increasing awareness of the emotional impact of failure experiences, very few studies have aimed to investigate resilience to emotional distress in response to failure in particular. Of the two studies we identified which have explicitly focused on this, the first investigated whether learning orientation buffered state self-esteem in response to a test result in students, but no significant effect was found (Niiya, Crocker, & Bartmess, 2004). The second investigated the impact of explanatory style on response to sports failure in children, using heart rate acceleration as an indicator of emotional arousal (Martin-Krumm, Sarrazin, Peterson, & Famose, 2003). This suggested that individuals with a pessimistic explanatory style showed a greater increase in heart rate following failure than individuals with an optimistic explanatory style. However, all individuals in the study were exposed to failure, and no analyses investigated whether explanatory style acted as a buffer or moderator of the association between failure and heart rate response.

Given that failure and failure-related distress have been implicated in the development of a range of mental health disorders (Bulik et al., 1990, Johnson et al., 2008a, Reinherz et al., 1999), a fuller and more detailed understanding of resilience in relation to failure could have important implications for psychological interventions. This knowledge could be particularly important for groups likely to experience significant failure events in their occupations, such as health professionals, most of whom will be involved in patient safety failure and clinical errors during their career (Sirriyeh et al., 2010). It could also be pertinent for young adults in the education system, which has been criticised for becoming increasingly assessment focused (Putwain, 2008), with the pressure of failure cited as contributing to increasing rates of mental health problems in this group (McManus, Bebbington, Jenkins, & Brugha, 2016).

The Bi-dimensional Framework for investigating resilience (BDF; Johnson, 2016, Johnson et al., 2014, Johnson et al., 2011b) was proposed to address these criticisms of the field of resilience research, and to enable the development of evidence-based concepts of resilience. The BDF outlines clear criteria that a variable should meet in order to be considered as conferring resilience. In line with common definitions of resilience, it suggests that resilience factors are those which interact with (or statistically moderate) the likelihood that risk will lead to negative outcomes (Johnson et al., In press). Individuals who are low on resilience will show increasing evidence of negative outcomes with increasing risk, but high resilience individuals will maintain low levels of a given negative outcome, despite risk exposure (see Fig. 1). As such, it purports that any investigation of resilience should include three variables, i) the risk factor, ii) the resilience factor, and iii) the outcome variable, and studies directly investigating associations between a predictor variable and an outcome are insufficient to establish a resilience effect. In line with the observations that all variables lie on a continuum from positive to negative, the BDF proposes that all factors can be viewed as ‘bipolar’, and whether they are framed in positive or negative terms is essentially arbitrary (see Fig. 2). As such, unlike previous resilience approaches the emphasis of the BDF is not upon identifying ‘positive’ factors which are inversely linked with negative outcomes, but upon identifying psychological factors which can alter the impact of risk.

A particular strength of the framework is that it offers a way to aggregate and review existing studies based on i) a particular outcome of interest (e.g., emotional/behavioural outcome), ii) whether a risk factor has been included, and iii) whether a psychological factor has been examined as a moderator of a risk factor. Importantly, studies that meet these criteria may not have self-identified as having investigated ‘resilience’. As such, although there have been very few studies which have explicitly aimed to investigate resilience to failure, by using the framework, it is possible to define failure experiences as the risk variable of interest, measures of emotional distress as the outcome variable, and psychological factors as the potential resilience variable, and to use these terms to search the literature. This approach offers a systematic route to identifying factors which confer resilience to emotional distress/dysfunction in response failure. Given the centrality of emotional distress to most mental health disorders, results from this review could have broad relevance to psychological interventions. The BDF was initially developed to investigate resilience to suicidality (Johnson et al., 2010a, Johnson et al., 2010b), and underpinned a systematic review in this area. This review suggested that attributional style, sense of agency and lower perfectionism and hopelessness conferred resilience. However, risk factors investigated in these studies varied and only two investigated resilience to failure, neither of which reported on emotional distress/dysfunction as an outcome, instead focusing on suicidal related thoughts (Priester and Clum, 1992, Priester and Clum, 1993).

We undertook a systematic review and evidence synthesis on resilience to failure and error, aiming:

  • To investigate whether there are psychological factors which confer resilience to emotional distress in response to failure, error and mistakes

  • To evaluate and compare the evidence for different types of psychological variables in conferring resilience

Section snippets

Methods

Methods and results are reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher, Liberati, Tetzlaff, & Altman, 2009).

Results

Overall, 5071 titles and abstracts were screened for eligibility. Following screening, 38 papers (reporting 46 relevant studies) met the inclusion criteria (see PRISMA flow chart displayed in Fig. 3).

Discussion

The first objective of the current review was to investigate whether there are psychological constructs which can buffer the association between experiences of failure, errors or mistakes, and emotional distress or dysfunction. The second objective was to identify specific psychological factors which may have this buffering effect, and which can be regarded as conferring resilience to failure. The review used the Bi-dimensional Framework for resilience research (BDF; Johnson et al., 2011b)

Conclusion

This is the first systematic review to identify resilience factors that may buffer emotional distress or dysfunction resulting from failure, mistakes or errors. Results suggested that higher self-esteem, more positive attributional style and lower levels of socially prescribed perfectionism may confer resilience to emotional distress in response to failure, and that academic self-worth and trait emotion suppression are not linked with resilience. These results suggest that these factors may be

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