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Journal of Evidence-Based Social Work, 10:111–126, 2013

Copyright © Taylor & Francis Group, LLC

ISSN: 1543-3714 print/1543-3722 online

DOI: 10.1080/15433714.2011.597305

Assessing Resilience:

A Review of Measures across the Life Course

Alexa Smith-Osborne and Kristin Whitehill Bolton

School of Social Work, University of Texas at Arlington, Arlington, Texas, USA

Through this systematic review the authors analyze scales used to measure resilience in individuals

across the life course. The scales were obtained according to a priori inclusion criteria through searches

using electronic databases, cited references, and requests to human services researchers currently

engaged in research utilizing a resiliency theory framework. Eleven measurement tools meeting study

inclusion criteria were located within the existing literature. Currently validated instruments measure

specific populations and vary in length and format. The need for an analytical approach to measuring

resilience is long overdue. This assessment is intended to aid social work practitioners working with

populations that have faced adversity.

Keywords: Resilience, measurement, life course, vulnerable populations, social work practice, inter-

vention research

Two divergent streams of research have operationalized the construct of resilience as either a

personality trait (or cluster of traits) or as a process of personal, interpersonal, and contextual

protective mechanisms, resulting in an anomalous, positive outcome in the face of adversity

(Egeland, Carlson, & Sroufe, 1993; Greene, 2008, 2010; Werner, 1982; Werner & Smith, 1992).
Attention to the former appears to predominate; for example, a search of the keyword “resilience”

in the electronic database collection EBSCO showed that the database embedded this search term

within the larger category of “personality trait.” In contrast, use of the construct as a contextualized

process resulting in a positive outcome, rather than as an internal characteristic has been applied
in many fields. One example from another discipline, information management, is in application

to key confirmation protocols used in cryptographic computer security. In these applications,

resilience is defined as the maintenance of the pre-existing system state or equilibrium after an

attack—in other words, the system’s function has not been disrupted by the attack (Mohammed,
Chen, Hsu, & Lo, 2010). As an illustrative comparison, this application highlights the construct

as both a dynamic protective process and a desirable outcome under adverse circumstances.

Operationalization of the construct as a dynamic process is particularly consistent with the

biopsychosocial, person-in-environment focus of the social work discipline, and the contexts of
adversity often experienced by social work clients, such as childhood abuse and neglect, domestic

violence, chronic illness, discrimination, and poverty (Fraser & Galinsky, 1997; Greene, 2007,

2010; Smith-Osborne, 2007).
Furthermore, a shift from problem-focused and diagnostically driven theories and practice

models to the strengths perspective and resilience theoretical framework has been noted not

only in social work practice (Greene, 2010; Richardson, 2002; Smith-Osborne, 2007), but also

Address correspondence to Alexa Smith-Osborne, School of Social Work, University of Texas at Arlington, 211 S.

Cooper St., Box 19129, Arlington, TX 76019-0129. E-mail: [email protected]

111

112 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON

in such diverse fields as military medicine (Bowles & Bates, 2010), nursing (Tusaie & Dyer,
2004), and international youth development (Unger & Liebenberg, 2007). Application of the

theory in a variety of disciplines has supported growing recognition and evidence that risk and

protective factors for resilience may operate differently at different points and trajectories across

the life course (Garmezy, 1991; Garmezy, Masten, & Tellegen, 1984), and for different types of
desired outcomes and adverse contexts (Bynner, 2000; Rudolph & Troop-Gordon, 2010; Rutter,

1979, 1985, 1990, 1995; Smith-Osborne, 2009a, 2009b). The need for an analytical approach

to measuring resilience is long overdue to support intervention research and practice (Luthar &

Cicchetti, 2000; Luthar, Cicchetti, & Becker, 2000; Luthar & Cushing, 1999; Luthar & Zigler,
1991). Although reviews of resilience measures have been done over the last decade in the fields

of nursing (Ahern, Kiehl, Sole, & Byers, 2006) and education (O’Neal, 1999; Rak & Patterson,

1996), to our knowledge none have examined contrasting operationalizations of the construct in

these measures and none have been done to date in social work. This systematic assessment of
resilience measures of individuals across the life course is intended as a guide for social work

practitioners working with individuals having faced adversity.

METHOD

Systematic reviews of measures should account for variations in design, implementation, construct

operationalization, sample characteristics, settings, and psychometric analyses to produce better

results for application in real life practice (Alderson, Green, & Higgins, 2003; Boruch, Petrosino,
& Chalmers, 1999; Chalmers, Hedges, & Cooper, 2002). Thus, operationalization of resilience

constructs are specified in Tables 1 and 2, sample, setting, and psychometrics in Table 3, and

study quality summarized in Table 4.

Operational Definitions

For inclusion criteria, resiliency was defined as a process of personal, interpersonal, and contextual
protective mechanisms, resulting in an anomalous, positive outcome in the face of adversity,

TABLE 1

Resilience Construct Operationalization of Child and Adolescent Instruments

Instrument (Authors) Factors Theoretical Basis

Number

of Items Scaling

RSAS (Jew, Green, &

Kroger, 1999)

1. Active skill acquisition

2. Future orientation

3. Independence/risk taking

Past research by Mrazek

and Mrazek

35 items 5-point Likert

scale

ARS (Oshio et al.,

2003)

1. Novelty seeking

2. Emotional regulation

3. Positive future orientation

Drawn from past resilience

research

21 items 5-point rating

scale

READ (Hjemdal et al.,

2006)

1. Personal competence

2. Social competence

3. Structured style

4. Family cohesion

5. Social resources

Drawn from past research

on resilience

28 items 5-point Likert

scale

RSCA (Prince-Embury,

2008)

1. Emotional reactivity

2. Sense of mastery

3. Sense of relatedness

Developmental theory and

past research on resilience

64 items 5-point Likert

scale

T
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114

RESILIENCE MEASURES 115

TABLE 4

Methodological Quality Summary following QUADAS Standards

Study First Author, Publication Year, and Life Stage

Jew, 1999,

Adolescents

Oshio, 2003, Older

Adolescents and

Young Adults

Hjemdal,

2006,

Adolescents

Prince-Embury,

2008,

Adolescents

Representative sample spectrum C C C C

Reference standard C C C C

Time for adversity change during

testing limited

� C C C

Partial verification C C C C

Differential verification C C C C

Incorporation C C C C

Test review n.a. n.a. n.a. n.a.

Diagnostic review n.a. n.a n.a. n.a.

Clinical review C C C C

Uninterpretable results ? ? ? ?

Withdrawals C C C ?

Sponsoring precluded C C C C

Study First Author, Publication Year, and Life Stage

Wagnild,

1993,

Adults

Baruth,

2002,

Adults

Connor,

2003,

Adults

Friborg,

2003,

Adults

Sinclair,

2004

Ryan,

2009

Representative sample spectrum C C C C � C

Reference standard C C C C C C

Time for adversity change during

testing limited

C C C C C C

Partial verification C C C C C C

Differential verification C C C C C C

Incorporation C C C C C C

Test review n.a. n.a. n.a. n.a. n.a. n.a.

Diagnostic review n.a. n.a n.a n.a n.a n.a

Clinical review C C C C C C

Uninterpretable results ? ? ? ? ? ?

Withdrawals C C C C C C

Sponsoring precluded C C C C C C

including a range of outcomes, such as health status, educational attainment, and vocational

success. Anomalous, positive outcomes were defined as those which were better than expected

from the empirical literature, given the adversity experienced.

Literature Search and Data Sources

Studies used in this review were obtained following the guidelines of the Cochrane Collabora-

tion (Reitsma et al., 2009) from electronic searches of the following databases through 2009:

Academic Search Complete, Alt HealthWatch, CINAHL Plus with Full Text, EBSCO Animals,
E-Journals, ERIC, Health Source: Nursing/Academic Edition, MasterFILE Premier, MEDLINE,

Professional Development Collection, PsycARTICLES, Psychology and Behavioral Sciences Col-

116 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON

lection, PsycINFO, PubMed, Social Work Abstracts, JSTOR, and Google Scholar. Keywords
entered were: resilience instruments, resilience/resiliency, resilience measures, protective mecha-

nisms, and scale validation.

The articles were scanned for references. Abstracts for additional references were obtained and

reviewed. Finally, requests for relevant articles and reviews were made to professionals involved
in resiliency intervention and research across disciplines, and results were evaluated for inclusion

criteria and to ensure that appropriate instruments had not been omitted.

Inclusion Criteria and Study Selection

Inclusion criteria specified peer-reviewed journal articles published in English up to 2009 reporting

high quality (see below) validation of resiliency instruments for children, adolescents, adults,
or older adults. Statistical conclusion validity was assessed initially to exclude studies which

reported insufficient statistical data or used inappropriate statistical methods or validation criteria

to determine psychometric properties, including specification of procedures used to determine

statistical properties of some dimensions of both validity and reliability.
The two researchers, working independently, reviewed the retrieved abstracts and compared

their results (Moher, Liberati, Tetzlaff, & Altman, 2009). Differences were discussed and recorded

until consensus was reached. Full text articles were retrieved for those remaining abstracts, and
the same independent review process followed (see Figure 1).

FIGURE 1 Flow chart of resilience instrument validation studies retrieval process following Preferred Reporting

Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

RESILIENCE MEASURES 117

Data Extraction

Studies that met inclusion criteria had data extracted by one author, followed by review by

the other. Population, Intervention, Comparison, and Outcome (PICO) criteria, as recommended

by Gambrill (2006), were applied to all studies. The answers to PICO questions define the

population under study, the specified measure and its use of extrinsic, contextual, as well as
intrinsic, intrapsychic, protective mechanisms, the comparison instrument if any, and specified

outcomes, all with an element of time (e.g., how old are the participants, when is the outcome

measured). Finally, quality of evidence was considered during the data synthesis phase as well,

as recommended by Boruch et al. (1999) and Gambrill (2006).

Quality Assessment

We used the validity framework approach (Cook & Campbell, 1979; Wortman, 1994; Reitsma

et al., 2009) for this study both as inclusion criteria and to evaluate the quality of included
studies. With reference to construct validity, studies were evaluated to determine degree of

match with the operationalization of resilience defined above. External validity was assessed for

sample characteristics and sampling method, life course applicability, and relevance to social work

practice. Then internal validity was assessed, excluding studies with fewer than two validity and
reliability analyses and insufficient sample size to meet measure validation criteria of 2 participants

per item for sample size (Nunnally, 1978) and 5–30:1 for participant to variable ratio when factor

analytic methods were used (Osborne & Costello, 2004), since both issues may introduce excessive

threats to internal validity. Statistical conclusion validity was assessed to verify use of appropriate
statistical methods and validation criteria.

For further assessment of quality of evidence, a summary score approach, using scales such as

the Downs and Black tool (Downs & Black, 1998), has been used recently for systematic reviews
of self-report diagnostic/screening measures such as this one (e.g., Gorber, Tremblay, Moher, &

Gorber, 2007). However, in 2009, Reitsma and collegues for the Cochrane Collaboration (Reitsma

et al., 2009) recommended against this approach, supporting in its place the qualitative approach of

a modified 11-item QUADAS (Quality Assessment of Diagnostic Test Accuracy Studies) checklist
tool (Whiting et al., 2006); therefore this approach has been used here. Items which pertain to

diagnostic measures rather than the type of measures of functioning examined here are indicated

as “not applicable.”

RESULTS

Ten scales met a priori inclusion criteria for this review. Eight scales were validated on American
samples, while two—the Resilience Scale for Adolescents and Adolescent Resilience Scale—were

originally validated on non-American samples and have been included due to their adherence to

inclusion criteria, availability in English, and good convergent and discriminant validity with scales

validated on American samples. Refer to Tables 1 and 2 for construct operationalization, Table 3
for psychometric properties, and Table 4 for study quality summary.

Child and Adolescent Scales

Resilience Scale for Adolescents. The Resilience Scale for Adolescents (READ) is a
28 item scale, rated on a 5-point Likert scale. Five factors are discerned: Personal Competence,
Social Competence, Structured Style, Family Cohesion, and Social Resources (Hjemdal, Friborg,

Stiles, Martinussen, & Rosenvinge, 2006). The READ was validated on 425 adolescents between

118 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON

the ages of 13 and 15 in Norway (Hjemdal et al., 2006). Currently, validation of the READ is
occurring on American and other non-Scandinavian populations (O. Hjemdal, personal commu-

nication, June 7, 2010). The scale is available at no cost by request to the first author.

Resilience Scale for Children and Adolescents. The Resilience Scale for Children and
Adolescents (RSCA) was developed for use in preventive screening for psychological vulnerability

(Prince-Embury, 2008). The RSCA consists of three scales that assess for resilience in children
and adolescents: Sense of Mastery, Sense of Relatedness, and Emotional Reactivity (Prince-

Embury & Courville, 2008a). Sense of Mastery is a 20 item scale rated on a 5-point Likert

scale and consists of three content areas: optimism, self-efficacy, and adaptability. The Sense

of Relatedness consists of 24 items rated on a 5-point Likert scale and encompasses comfort
and trust in others, perceived access to support by others, and capacity to tolerate differences

in others. The Emotional Reactivity scale consists of 20 items rated on a 5-point Likert scale

and consists of sensitivity/threshold for and intensity of reaction, length of recovery time, and

impairment while upset. The RSCA validation consisted of normative samples of 226 chil-
dren aged 9 to 11 years, 224 adolescents aged 12 to 14 years, 200 adolescents between 15

and 18 years (Prince-Embury & Courville, 2008b), and a clinical sample of 169 adolescents

between ages of 15 and 18 years (Prince-Embury, 2008). This scale’s 3rd grade reading level

may be conducive to use with children and adolescents with special needs, although it has not
been validated with this population. The scale may be purchased online from the PsychCorp

Division of Pearson Assessments at http://psychcorp.pearsonassessments.com/HAIWEB/Cultures/

en-us/Productdetail.htm?PidD015-8006-186&ModeDsummary.

Adolescent Resilience Scale. The Adolescent Resilience Scale (ARS) for college-age youth
consists of a 5-point Likert 21 item scale, consisting of three factors: novelty seeking, emotional
regulation, positive future orientation. The construct validation on a Japanese population of 207

young adults between the ages of 19 and 23 (Oshio, Kaneko, Nagamine, & Nakaya, 2003)

differentiated among groups who were vulnerable (high stressors and psychopathology), resilient
(high stressors, low psychopathology), and well adjusted (low stressors, low psychopathology).

The scale is available at no cost from the first author’s website at http://psy.isc.chubu.ac.jp/�oshio

lab/index_e.html

Resilience Skills and Abilities Scale. The Resilience Skills and Abilities Scale (RSAS),
originally developed as the Adolescent Resiliency Belief System Scale (Jew, 1997), consists of
35 items rated on a 5-point Likert scale (Jew, Green, & Kroger, 1999). Validation of this measure

took place through four studies of high school students. Initially, the RSAS was comprised of four

sub-scales. During the fourth validation study, two of the subscales were merged, reducing the

number of subscales to three: Active Skill Acquisition, Future Orientation, and Independence/Risk
Taking. Thus, this scale operationalizes resilience in a psychological context, of characteristics

that individuals use in stressful contexts, drawing heavily on the cognitive appraisal theory of

Mrazek and Mrazek (1987). This scale is available at no cost from the first author.

Validity and reliability issues. Quality indicators of sufficient sample size and type, appro-
priate validation criteria, and appropriate statistical methods were required for study inclusion.
Sample sizes used for validation of instruments were adequate for the instruments reviewed.

Sample sizes exceeded 100, with the largest samples used for the RSCA (n D 819) for the child

and adolescent instruments (see Table 3).

Studies reporting psychometric properties of the instruments did not cover all aspects of validity
and reliability, but did report internal reliability, test–retest/stability reliability and construct,

factorial, convergent, divergent, and/or predictive validity, albeit with the resilience construct was

RESILIENCE MEASURES 119

limited to intrapsychic, individual traits in all instruments except the READ, limiting their utility
for social workers. Studies generally reported a level of internal reliability that was acceptable

at Cronbach’s alpha D .70 or above (Nunnally, 1978). An intraclass correlation coefficient of

.50 for test–retest reliability from pre-test to post-test may be considered an acceptable level of

stability reliability (Fleiss, 1981), and the RSCA and RSAS reported at least that level. However,
the statistic used to calculate test–retest reliability was not always specified, making it difficult

to assess the meaning of the stability reliability coefficients reported. Simple correlations, in

particular, may be more affected by temporal instability and measurement error (Heise, 1969).

Length of time between test–retest was 6 months for RSAS and not specified for the RSCA.
Results for the RSCA indicate that all three measures exhibit strong internal consistency

and construct validity. Prince-Embury identifies the need for additional research to accompany

preliminary findings to increase sample size and enhance understanding of RSCA scores associated

with psychological symptoms (Prince-Embury, 2008).
The initial validation study of the ARS (Oshio, Nakaya, Kaneko, & Nagamine, 2002) found

acceptable internal reliability. The scale has shown good convergent and discriminant validity with

the American-validated scale of the Big Five Personality Inventory (Nakaya, Oshio, & Kaneko,

2006). However, test–retest reliability was not reported in published studies.
The RSAS appears both reliable and valid, showing acceptable intraclass correlations indicating

test–retest reliability (.36–.70) and internal consistency (.68–.95). The authors call for further

research to refine the instrument and increase the instrument’s relevance to resilience as a construct

(Jew et al., 1999). However, later use of the instrument has been confined to a dissertation (Bass,
2006).

The only identified child/adolescent measure utilizing the full construct was the READ. The

READ scale shows good discriminant validity with the Short Mood and Feeling Questionnaire and
Social Phobia Anxiety Index for Children, both American-validated scales (Hjemdal, 2007) and

good predictive validity relevant to prevention efforts (Hjemdal, Aune, Reinfjell, Stiles, & Friborg,

2007). The READ appears both reliable and valid. Further studies should replicate the validation of

this scale, since the initial age group only spanned two years. A Norwegian validation of a shorter,
23-item version of the scale was recently reported as yielding acceptable psychometric properties

(von Soest, Mossige, Stefansen, & Hjemdal, 2010). This scale not only has the advantage of

measuring the full resilience construct, but also has been co-developed with an adult version,

the Resilience Scale for Adults, making them particularly useful for longitudinal research and
treatment monitoring (RSA; see below).

Predictive validity was established for the READ, the RSCA, and the RSAS. For a method-

ological quality summary, see Table 4.

Adult Scales

Resilience Scale. The Resilience Scale (RS) is a 25-item scale rated on a 7-point Likert scale
measuring two factors: personal competence, and acceptance of self and life; it was originally
developed on a sample of older women (Wagnild, & Young, 1990). The RS was validated on

810 adults between 53 and 95 years (Wagnild & Young, 1993). Following the validation of the

RS, numerous studies have used this instrument on individuals of all ages and ethnic backgrounds,

and a 14 item version was developed and validated (Wagnild, 2009). The scale is written at a
6th grade reading level. The Resilience Scale is available at no cost, and the User’s Guide for

purchase, from http://www.resiliencescale.com.

Connor-Davidson Resilience Scale. The Connor-Davidson Resilience Scale (CD-RISC)
consists of 25 items rated on a 5-point Likert scale that address 5 factors: personal competence,

120 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON

high standards, and tenacity; trust in one’s instinct, tolerance of negative effects, and strengthening
effects; positive acceptance of change and secure relationships; control; and spiritual influences.

The validation sample of the CD-RISC consisted of 6 groups (general population, primary care,

psychiatric outpatients, generalized anxiety dis , and PTSD) with a total of 827 participants

(Connor & Davidson, 2003). The validation of CD-RISC suggested that health influences resilience
and resilience can improve through treatment when psychiatric dis s constitute the ongoing

context of adversity (Connor & Davidson, 2003; Davidson et al., 2005; Vaishnavi, Connor, &

Davidson, 2007). This scale is available at no cost from the first author.

Baruth Protective Factors Inventory. The Baruth Protective Factors Inventory (BPFI) con-
sists of 16 items rated on a 5-point Likert scale, addressing four factors: adaptable personality,
supportive environment, fewer stressors, and compensating experiences. The BPFI was validated

on 98 undergraduate students in a Human Development course between the ages of 19 and 74

(Baruth & Carroll, 2002). The BPFI should be validated on a larger sample prior to use in

assessing for the protective factors that contribute to the presence of resilience. Furthermore, the
initial researchers had predominantly female Hispanic and Anglo-American participants in the

initial validation …

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