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
A
B
L
E
2
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s
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113
T
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d
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m
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to
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d
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ts
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ju
n
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h
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c
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ic
/o
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c
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se
tt
in
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s
(n
o
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a
ti
v
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sa
m
p
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);
c
li
n
ic
a
l
tr
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tm
e
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t
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c
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it
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s
(c
li
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)
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ig
h
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h
o
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l
st
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d
e
n
ts
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sy
c
h
o
m
e
tr
ic
p
ro
p
e
rt
ie
s
(C
ro
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a
c
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’s
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lp
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/t
e
st
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re
te
st
)
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7
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o
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o
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te
:
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7
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/.
8
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t
a
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7
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t
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b
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C
o
m
p
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te
:
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C
o
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p
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te
:
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/.
5
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*
D
e
n
o
te
s
a
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sc
e
n
t
a
n
d
c
h
il
d
in
st
ru
m
e
n
ts
.
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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