Wednesday, August 3, 2011

Adversity: A path to vulnerability or resiliency? Depends on how much.

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Throughout my life I’ve been lucky to be friends with a diverse array of people, who have had quite varied past experiences. There are those few friends with "charmed" lives. Healthy family, happy home, found "the one" with little difficulty. There are others who have experienced major past adversity. The loss of a parent, a debilitating rejection, chronic poverty. This variability has often made me wonder about the relationship between past experiences and whether one responds to current life adversity with with vulnerability or resiliency. If faced with a new crisis, who will display the resilient response – 1) my friend who has never experienced any adversity or 2) my friend who has experienced too much adversity. There are convincing arguments to be made for either case. My friend who never experienced adversity might have a strong social support network and a positive outlook on life, but might lack necessary skills and toughness needed to get through a traumatic event. My friend who experienced too much adversity might be stressed and depleted from their past experiences, but might have developed that toughness and those skills that my “charmed” friend lacks. So what’s the answer?

In 2010 Mark Seery, a professor at the State University of New York at Buffalo, along with colleagues Alison Holman and Roxane Cohen Silver tackled this question. Specifically they assessed whether past adversity is associated with 1) worse mental health and well-being outcomes overtime, and 2) how one responds to a recent adverse event.
More specifically they were interested in distinguishing three groups of people (unlike my example above): those that experienced no past adversity, those that experienced some past adversity (the new group), and those that experienced a lot of past adversity. Seery and colleagues hypothesized that there would be a curvilinear, or U-shaped relationship between past adversity and later life outcomes/responses to acute stressors. That is, they hypothesized that both those who experienced no adversity and a lot of adversity would show worse outcomes than those who experienced some adversity (see the graph I made with pretend data as an example). Those that experienced some adversity would not be too stressed and depleted from past experiences, and would also have developed skills and toughness from the little adversity they did face.

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To answer their question Seery and colleagues followed a national sample of over 2,000 participants in the years 2001 to 2004. At the start of the study they asked participants to report their exposure to over 37 negative life events from 7 categories (e.g. own illness/injury, loved one's illness or injury, violence, bereavement, social/environmental stress, relationship stress, and national disasters). At each of their follow-up assessments they asked participants to look at that same list of negative events to say if any of them happened in the last 6 months. They evaluated whether the number of negative life events an individual endorsed was related to measures of global distress (such as depression and anxiety), functional impairment (difficulty with work or social activities), posttraumatic stress symptoms specifically with respect to the attacks on September 11, 2001, and life satisfaction.

As they predicted a U-shaped relationship emerged. Those individuals who experienced some life adversity had better mental health and well-being outcomes on the aforementioned variables than those participants who had experienced either a lot of adversity OR no adversity. In addition participants who experienced some life adversity were the least affected by a recent adverse event.

Although those that experienced some adversity had the best outcomes, the U-shaped relationship was actually not symmetrical – participants who experienced a lot of adversity did seem to fare worse than those who experienced absolutely no adversity - so the relationship looks more like a J than a U (see my graph above).

These results did not change when the researchers took into account various demographic factors, such as participants’ gender, ethnicity, age, income, education, or degree of exposure to 9/11.

In summary:

First – some adversity is not a bad thing. People who experienced some adversity seemed to fare better overtime and displayed a more resilient response to acute stress than those who experience no adversity at all.

Second, no adversity is still better than a lot of adversity. Those that experienced the most adversity showed the worst long-term outcomes and the least resilient responses to acute stress.

Unfortunately, this study did not evaluate the mechanisms that underlie the relationship between adversity and resiliency, such as the development of coping skills, a sense of mastery, self-efficacy beliefs, or the ability to find social support. What is too much past adversity? Why exactly do the benefits of some adversity decline when you reach that critical threshold? Future work should absolutely evaluate these questions in order to understand how to cultivate resiliency in those who have experienced lots of adversity and thus are the most vulnerable to negative outcomes.

That aside, Seery’s work does provide interesting and important pieces of the adversity – resiliency puzzle.


The article:
Seery MD, Holman EA, & Silver RC (2010). Whatever does not kill us: cumulative lifetime adversity, vulnerability, and resilience. Journal of personality and social psychology, 99 (6), 1025-41 PMID: 20939649


What might individuals “pick up” from adverse experiences that helps buffer them when future adversity appears? Why do those benefits decline when you go from some adversity to a lot of adversity?

2 comments:

  1. Take a look at C Fred Alford's work - Whistleblowers: Broken Lives and Organizational Power. The trajectory he found was almost universal early illness and premature death.

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  2. Hey aek-
    Thanks for the information! I will absolutely check out C Fred Alford's work. In line with what you describe, I do believe most prior research has found a linear relationship between past adversity and future resiliency (as past adversity went up, future resiliency went down). In the 2010 article, however, Seery and his colleagues argue that in this past work no one looked to see if there were other "shaped" relationships between adversity and resiliency - such as the U-shaped (curvilinear) relationship they found. Clearly lots of past adversity isn't good. What makes this article so interesting is that they show some past adversity seems to be "better" than no past adversity when looking at these future outcomes. Pretty crazy! Thanks for reading!
    Anna

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