Indicators of Resilience in Family Members of Adults with Serious Mental Illness

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Key points

  • Resilient family members of persons with mental illness can overcome the stress and burden that may otherwise compromise their health and quality of life.

  • Central constructs of resilience theory are risk/vulnerability factors, positive/protective factors, indicators of resilience, and outcomes of resilience.

  • Seven indicators of resilience, including acceptance, hardiness, hope, mastery, self-efficacy, sense of coherence, and resourcefulness, have been studied in family members of persons with

Resilience

Early writings on resilience came from researchers who focused on its development in children and adolescents.8, 9 More recently, there has been an increased interest in resilience in adults10 and families.11 The concept of resilience was described by Rutter12(p119) as “relative resistance to psychosocial risk experiences,” and by Luthar and colleagues13 as “a dynamic process encompassing positive adaptation within the context of significant adversity.” Richardson14(p308) defined resilience as

Risk/vulnerability factors

Risk factors have been conceptualized as events or conditions associated with adversity or factors that reduce one’s ability to resist stressors or overcome adversity.10 Vulnerability factors include traits, genetic predispositions, or environmental and biological deficits.10 Potential risk factors in caring for a family member with a serious mental illness include caregiver strain, feelings of stigma, client dependence, and family disruption; together, these factors can seriously compromise

Protective/positive factors

According to Rutter,44 protective factors reduce the impact of risk, decrease negative reactions to risk, promote resilience, and create opportunities for family caregivers to include strategies for maintaining a positive success. Protective factors identified in studies of family members of adults with mental illness reflect their appraisal of the caregiving situation itself and their personal beliefs. A positive appraisal of the situation18 and positive cognitions17 have both been linked to

Resilience in family caregivers

To date, 5 studies of resilience in family members of persons with mental illness have been published and 3 of them were conducted over a decade ago. Enns and colleagues46 collected data on family resources, perceptions, and overall adaptation of 111 family members of adults admitted to a psychiatric hospital to identify factors that might contribute to resilience in family members. The data collected on major study variables were compared with averages on similar measures in the general

Outcomes of resilience

Resilience and resilience indicators have been linked with several positive health outcomes for individuals and families.16 In the studies of family members of adults with mental illness included in this review, resilience indicators were found to be associated with, and, in some cases, to affect or predict outcomes indicative of mental and physical health and quality of life in individual family members and optimal family functioning. On the individual level, resilience indicators have been

Summary

Although resilience has been examined in studies of family caregivers, including family members of persons with autism78 and family members of persons with dementia,79 few studies have included family members of persons with serious mental illness.80 However, many researchers have examined characteristics of family members of persons with mental illness that may be considered indicators of resilience, including acceptance, hardiness, hope, mastery, self-efficacy, sense of coherence, and

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    This article is updated from its first appearance in Nurs Clin N Am 2010;45:613–26.

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