Article Text

  1. D. Helitzer,
  2. T. Warner,
  3. H. Pratt-Chavez,
  4. M. C. Frias-Kletecka
  1. Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM


Background Resilience is a set of coping skills people employ in times of stress. These skills can be acquired or modified through various interventions. Resilience may be a protective factor that mitigates the effects of adverse childhood events (ACE), which are risk factors for adult morbidity and mortality. We developed novel screening tools to elicit resiliency factors, the Comprehensive Resiliency Questionnaire (CRQ) and ACE (ACE Short-Form, ACE-SF). With this study, we will examine differences between and relationships of resiliency factors and ACE in two populations and validate the CRQ and the ACE-SF.

Methods We delivered the CRQ and ACE-SF to 167 subjects. The CRQ covers 3 constructs: external support systems during childhood, current external support systems and attitudes and personal strengths. The ACE-SF has questions about the occurrence of environmental stressors and abuse during childhood. We recruited subjects from two populations: (1) students and health care professionals at the University of New Mexico School of Medicine and (2) adults seen at clinics for families with environmental risk factors through the Pediatrics Department of UNM Hospital. We performed qualitative interviews with a subset of 22 of these subjects employing the cognitive technique to check the face validity of the CRQ and ACE-SF.

Results Population 1 (n = 103) had significantly greater childhood resilience factors than did the clinic patients (n = 43) (means = 46.3 vs 37.9; p < .0001). Similarly, Population 1 showed greater adulthood resilience factors than did Population 2 (means = 114.0 vs 89.5; p < .0001). Population 1 also reported significantly fewer adverse childhood adverse events than did clinic patients (means = 5.4 vs 10.0; p < .0001). The qualitative analysis supported face validity of both questionnaires.

Conclusions The CRQ and the ACE-SF have face validity and can discriminate between groups that theoretically are expected to have differential levels of resilience and ACE. Reported resilience factors are negatively related to reported ACE, consistent with the proposition that resilient individuals may interpret adverse events less adversely than nonresilient people do. Our instruments may be employed to guide interventions to increase resiliency factors and therefore reduce risk factors for morbidity and mortality.

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