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James Dyson shares his thoughts on how the best ideas come from failure

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Resilience can mean different things to different people here are some perspectives of resilience for students

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Wellbeing needs a more global perspective

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Wellbeing needs a more global perspective

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It is an unhappy truism that we live in turbulent and troubled times. The COVID-19 pandemic has upended lives and destabilised societies the world over. In doing so, it has prompted much reflection and rethinking about how we ought to live and what matters to us. Such re-evaluation is perhaps particularly evident and necessary in western societies, in which there is some evidence - if one is feeling hopeful - of a shift in priorities towards more sustainable ways of being.

For people in relatively individualistic societies, we have been painfully reminded how precious and vital our relationships and communities are. In response to the numerous employees who have taken to working from home and would like to continue in some form, many companies are implementing longer term remote-working plans. And if the pandemic may have been in part caused by humans living in disharmony with nature, the importance of connecting sustainably with nature is increasingly recognised, with such engagement among the best predictors of how well people have coped with the situation.

For many years, voices around the world have been articulating the concerns that the pandemic is now highlighting with devastating effect: the fragility of modern civilisation, the importance of supportive relationships, the need to live more harmoniously with nature, and more besides. Given the current chaos, there is now perhaps greater receptivity to alternative ways of thinking and being - including embracing philosophies and practices from cultures other than our own.

Developing new perspectives

My own field of psychology has been animated by similar processes of reflection in recent years. Although the field aspires to universality, and is researched and practised the world over, it is relatively western-centric. An influential paper in Nature pointed out that much of the discipline's research is conducted by and on people from "WEIRD" places - western, educated, industrialised, rich, and democratic - the United States in particular. As such, the field has been influenced by American values and traditions such as individualism and self-determination.

When considering wellbeing, for instance, psychology has emphasised its more individualistic and self-assertive forms. This has meant focusing on outcomes like personal life satisfaction and what are known as "high arousal" positive emotions - those that are energised and intense - such as joy or excitement.

Of course, these experiences are not intrinsically American or western per se. They are found and valued globally, as captured by the annual Gallup World Poll, which in turn is the basis for the United Nations' World Happiness Report (which ranks countries in terms of citizens' self-reported life satisfaction).

But some cultures have also identified and valued other forms or aspects of wellbeing. For instance, eastern cultures tend to place greater emphasis on low arousal positive emotions such as peace, calmness and tranquillity, and on associated ideas around balance and harmony.

Similarly, in contrast to the relative individualism of the west, eastern cultures have also highlighted the importance of relationships and living in harmony with nature. It's not that these principles do not matter elsewhere, including in the west. Indeed, research shows they may be universally appreciated. But their importance has generally been accentuated in eastern cultures and downplayed in western ones.

Global wellbeing

In light of such considerations, people are making increasing efforts to redress the western-centric nature of psychology and develop more globally comprehensive and inclusive perspectives. One such example is a new Global Wellbeing Initiative (with which I have had the privilege of being involved), a collaboration between Gallup and Wellbeing for Planet Earth (a Japanese research foundation). Although Gallup has excelled in assessing wellbeing globally over recent years, its measures - relating to life satisfaction and high arousal positive emotions - are subject to the charges of western-centricity raised above.

In response to such criticism, this year's World Poll features several new items which reflect more eastern perspectives on wellbeing. These include questions around low-arousal positive emotions, balance and harmony, and our relationships and connections.

There are also even more ambitious plans to incorporate still other global perspectives in future. For instance, many cultures have traditions and ethics relating to deep notions of hospitality and generosity (including and even especially towards strangers), from the Māori ideal of manaakitanga to the Jewish principle of hachnassat orchim. These too can expand our conceptualisation and appreciation of the scope and dynamics of wellbeing.

Even though such ideas might be emphasised by specific cultures, we may well find they matter globally. The unprecedented turmoil of 2020 does seem to be heightening global appreciation for principles such as relational wellbeing, living in balance and harmony, and developing more sustainable relationships with the natural world. As we move forward, we will need to learn from one another in these kinds of ways to develop more sustainable visions and ways of life.

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Wellbeing needs a rethink - and a global outlook is the way to start

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It is an unhappy truism that we live in turbulent and troubled times. The COVID-19 pandemic has upended lives and destabilised societies the world over. In doing so, it has prompted much reflection and rethinking about how we ought to live and what matters to us.

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This link gives you lots more detail on the model of resilience that we looked at in the session.

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RForce.News - The 6 Domains of Resilience

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We are complex beings. Therefore, it makes sense that there are a great many different factors that contribute to resilience including: beliefs we hold of the world, of ourselves and others; information we have access to; biases, skills, and education; mental processes and behaviours.

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Why resilience is important to learn when training for a healthcare profession.

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Think about how to improve the 6 domains of resilience for you.

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This online quiz helps you to investigate how resilient you currently feel.

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Al Siebert, PhD
(1935 - 2009)

* Resiliency Quiz Interpretation

* Winner, 2006 Independent Publisher's Best Self-Help Book

How do you react to unexpected difficulties? Healthy, resilient people have stress-resistant personalities and learn valuable lessons from rough experiences. Resilience is the process of successfully adapting to difficult or challenging life experiences. Resilient people overcome adversity, bounce back from setbacks, and can thrive under extreme, on-going pressure without acting in dysfunctional or harmful ways. The most resilient people recover from traumatic experiences stronger, better, and wiser.

When hurt or distressed, resilient people expect to find a way to have things turn out well. They feel self-reliant and have a learning/coping reaction rather than the victim/blaming reaction that is so common these days.

Take the Quiz....

Before reading further, take this quiz created by the late Al Siebert, PhD.

The Resiliency Center was founded by the late Al Siebert who studied highly resilient survivors for over fifty years. He authored the award-winning book The Resiliency Advantage: Master Change, Thrive Under Pressure and Bounce Back From Setbacks (2006 Independent Publisher's Best Self-Help book), and best seller The Survivor Personality: Why Some People Are Stronger, Smarter, and More Skillful at Handling Life's Difficulties...and How You Can Be, Too.

If you are interested in using The Resiliency Quiz in your own organization, please see our sister page at Practical Psychology Press for pricing and usage information. (Also available in French, Spanish, and German language versions.) Thank you!

© Practical Psychology Press
PracticalPsychologyPress.com

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Resiliency Quiz: "How Resilient Are You?" from the Resiliency Center

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Al Siebert, PhD (1935 - 2009) * Resiliency Quiz Interpretation * Winner, 2006 Independent Publisher's Best Self-Help Book How do you react to unexpected difficulties? Healthy, resilient people have stress-resistant personalities and learn valuable lessons from rough experiences. Resilience is the process of successfully adapting to difficult or challenging life experiences.

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This article looks at the importance of our thinking in developing resilience.

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Learn more about resilience, or the art of rising to challenges, and how you can develop and improve your own resilience to cope better with life.

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This article is an accessible introduction to the importance of resilience at work and how to enhance yours.

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Have you ever found yourself wondering what makes someone successful at work?

Chances are, like many people you imagine that the key to success at work is intelligence or going above and beyond the demands of the role such as working extra long hours or taking on extra commitments.

However, in modern workplaces characterized by staff cutbacks, deadlines, rivalry and organizational change, success relies on an individual's capacity to cope and even thrive when faced with stress.

Broadly speaking, resilience is the ability to 'bounce back' when encountering the challenges that are an inevitable part of life. The workplace presents a different range of stressors to employees. What is resilience in the workplace? Why is it even important? Can individuals even become more resilient anyway?

The exciting thing about resilience is that it is a skill. Like any skill, with practice, resilience can be learned. This article describes resilience in the workplace and provides helpful tips about how people can be more resilient at work. It will define exactly what is meant by 'resilience in the workplace', describe some examples of developing personal resilience at work and then explore ways to enhance resilience.

Before you read on, we thought you might like to download our 3 Resilience Exercises for free. These engaging, science-based exercises will help you to effectively deal with difficult circumstances and give you the tools to improve the resilience of your clients, students or employees.

What is Resilience in the Workplace?

Research Done

Consider a workplace that is undergoing radical change. One may expect that the effects of this ongoing stress would be detrimental to staff. After all, their livelihood may be at stake. A research study by two management consultants studied this very phenomenon.

Over a period of twelve years, S. Maddi and D. Khoshaba studied employees of a large US telecommunications company during a time when this industry was being de-regulated. The company was constantly changing and jobs were at stake. However, what the research showed was most surprising.

During the twelve-year period in which the study took place, almost 50% of the employees lost their job and a further two-thirds experienced significant stressful life events (including divorce, mental health issues like depression and anxiety, and heart attacks). Despite this, one-third of the workers not only survived the tremendous challenge they faced, they actually flourished!

In their book, called ' Resilience at work: how to succeed no matter what life throws at you ' Maddi and Khoshaba (2006) report that of the individuals they studied, the employees who retained their positions rose to the top, whilst those who were unfortunate enough to lose their job either started their own companies or took 'strategically important' employment in other companies.

Resilience is Dynamic

What does this study show about resilience in the workplace? Put another way, what can we learn from this study? Well, resilience is an active, dynamic process. According to the Centre for Confidence and Wellbeing (2006):

' the good news is that although some people seem to be born with more resilience than others, those whose resilience is lower can learn how to boost their ability to cope, thrive and flourish when the going gets tough '. So, resilience can be enhanced!

The personality trait of has been found to buffer or lessen the negative effects of stressful events or adversity (Jackson, Frito, & Edenborough, 2007). It is possible to learn habits and strategies to increase hardiness. Furthermore, by developing effective strategies for reducing vulnerability to and the impact of adversity, it is possible to strengthen and develop personal resilience.

In order to understand what constitutes resilience in the workplace, perhaps the most accessible way to think about it is to consider what resilient employees do when faced with workplace adversity that sets them apart from the rest of the pack. What is it that these employees do differently?

Resilient Employees

Resilient employees build strong connections and relationships with others (Davis Laak, 2014). These high-quality relationships can be characterized by a number of features. Connections are characterized by effective communication in which an individual listens actively and is responsive to their colleague and their emotions (Davis Laak, 2014).

In positive workplace relationships, a resilient worker will do what they can to help another person to achieve success in the workplace. The resilient worker is a team-player who aims for a win-win with their fellow employees.

Social support plays an important role in workplace resilience (Jackson, Firtko, & Edenborough, 2007). It is beneficial to develop personal as well as professional networks, which can be a source of guidance and support during times of stress or simply to provide a nurturing relationship.

It is also helpful for employees to have contact with colleagues outside of their own immediate work setting. These people can provide validation to the worker, and can potentially be accessible to the individual when accessing support within their own work situation would make the employee vulnerable (Jackson et al., 2007).

Resilient employees nurture the work networks they have developed, consistently building trust with others. However, a surprising finding in the research was that resilient employees don't take the work environment too seriously. They introduce an element of 'play' to the workplace, which further fosters positive emotions amongst employees.

Modern workplaces are certainly typified by stress. Technology and access to the Internet mean that, for many, work is a constant presence. No longer does one establish a career which they then stay in for the duration of their working life. Resilient employees are able to manage stress effectively so it is not overwhelming and detrimental (Davis Laak, 2014). By actively engaging in self-care and nurturing themselves after a stressful incident, however minor, resilient employees avoid 'burnout'.

Another characteristic of a resilient employee is that the individual is true to their 'real' self (Davis Laak, 2014). They are authentic and behave in a way which is in alignment with their values and beliefs. If you like, they 'practice what they preach'. They show grit.

What is Grit?

Grit is that fighting spirit that sets some employees apart. It can be defined as 'having the passion and perseverance to pursue your long-term goals' (Davis Laak, 2014). However, if grit means that an employee is striving to achieve challenging goals, this will almost certainly mean that they will encounter obstacles. When this occurs, workers have the chance to show resilience, as resilience is needed to overcome these hurdles.

How resilient employees perceive their occupation and day-to-day tasks also sets them apart. These workers perceive their work as meaningful (Davis Laak, 2014). It is hardly surprising that those who feel like their toll is in an endeavor to achieve a valuable outcome are going to be better equipped to bounce back when work is particularly stressful.

Examples include medical practitioners, who see their work as leading to health outcomes for patients rather than 'fixing' a medical problem. Having a positive focus at work is a component of resilience.

Of course, it is not that resilient employees do not experience stress. Stress is an unavoidable aspect of life, and workplaces present a multitude of stressors. However, a characteristic of resilient workers is that they will monitor their own thoughts when they are under stress and duress (Davis Laak, 2014).

By acting mindfully, the employees who display resilience notice particular patterns in their thinking that may be impeding their chance at occupational success (Davis Laak, 2014). This awareness promotes a capacity to cope with stress and unexpected challenges.

Modern workplaces are typified by change. The climate of work imposes on employees a need to be flexible and adaptive. Resilient workers are seen to be more able to manage inevitable changes and deal with novel scenarios. They are also more skilled at dealing with setbacks and have the capacity to move on after they encounter a stumbling block.

5 Examples of Building Personal Resilience at Work

How can an individual build their personal resilience at work? In order to address this question, think back to Maddi and Khoshaba's study of the employees of the telecommunications company in the US. How is it that under such duress, many of the workers were able to thrive? How did they develop resilience?

Resilience is a multi-dimensional construct, and consists of a cluster of factors: behaviors, thoughts, actions, attitudes, and skills. In their study, Maddi and Khoshaba identified three variables associated with the individuals' ability to bounce back from the immense stress they faced. These were commitment, control, and challenge.

" Simply put these attitudes are commitment, control, and challenge. As time gets tough, if you hold these attitudes, you'll believe that it is best to stay involved with the people and events around you (commitment) rather than to pull out, to keep trying to influence the outcomes in which you are involved (control) rather than give up, and to try and discover how you can grow through the stress (challenge) rather than to bemoan your fate " (Maddi & Khoshaba, 2006). Let me explain further.

By committing themselves to their work, the employees were more able to dedicate themselves to the tasks at hand. This enabled the workers to make sense of what exactly was going on for them. Having a sense of control empowered the employees to enable them to behave in a way which had an influence over the changes that were happening. They also viewed change and stress as an inevitable part of life.

How can an individual build their resilience in the workplace? Jackson and colleagues (2007) argue that personal resilience can be strengthened and enhanced by developing a variety of effective strategies that reduce vulnerability and susceptibility to stress.

It can also help employees to develop and nurture skills for reducing the impact that adversity in the workplace has on them. This may include, but is not limited to, practicing mindfulness, developing mental agility, and taking regular breaks from work to 'detach'. Jackson et al. suggest the following:

1. Positivity

By taking a positive stance at work, employees are more able to adapt to adversity and also hold on to a sense of control over their work environment. Putting energy and motivation into work, or, having 'vigor' - as described by Shirom (2004) - is also associated with building personal resilience. It is the 'opposite' of burnout, which is characterized by emotional exhaustion, physical tiredness, and cognitive fatigue or 'weariness'.

Vigor is characterized by having the capacity to put in the maximum effort at work and thus further build personal resilience (Shirom, 2004).

2. Emotional Insight

Another example of building personal resilience at work is by developing and strengthening emotional insight. Insight is closely related to emotional intelligence. Individuals with a level of insight have a level of awareness about the full range of emotions they experience, from 'negative' through to 'positive'.

They will also consider the ramifications of their own reactions and behavior and the effects their own actions have on others. Psychologically resilient individuals can be described as emotionally intelligent (Tugade & Fredrickson, 2004).

3. Balance

Individuals can build personal resilience at work by achieving a healthy work-life balance. This is especially challenging in the world we are living in. Technology can mean that employees may have access to work 24 hours a day, 7 days a week.

In order to be able to bounce back from stressful situations, i.e. to be resilient, workers need to have the energy that can be easily depleted if a healthy work-life balance is not in place. Workers need time to relax, unwind and recuperate.

4. Spirituality

Having a sense of spirituality has been linked to developing resilience at work. This may be related to reducing vulnerability and the impact that adversity in the workplace has on the individual. Finding meaning in work, and feeling that this work is contributing to a greater good, can buffer against the effect of stress. It may also be because spirituality may lead employees to view even stressful situations as having positive aspects, or 'purpose', and appreciating potential benefits.

5. Reflection

Becoming more reflective is another way individuals can build resilience at work. In other words, being in tune with one's emotions and emotional reactions can serve to buffer against the effect of stress. Being aware of possible '' to stress can provide individuals with the opportunity to prepare and gather resources so they are better able to 'bounce back'. If an employee knows that a particular circumstance will be especially challenging, they can then implement coping strategies, such as seeking support.

Why is Resilience so Important?

Resilience is a critical life-skill that has roots in the key to humankind's survival. The ability to cope with stress and unexpected challenges, and even to thrive in such situations, is adaptive. This is not news to anyone! What about the workplace? Why is resilience so important in the work environment?

For starters, workplaces are embedded with stress. Occupational stress affects personal and performance outcomes (Rees, Breen, Cusack, and Hegney, 2015). Furthermore, workplace stress is correlated with high levels of depression and anxiety, and burnout (Rees et al, 2015).

As early as 1978, the effects of a stressful workplace were reported by Pines and Maslach, who introduced the term 'burnout' to describe a state whereby employees experience physical and emotional exhaustion, depersonalization, and a sense of low personal accomplishment.

Burnout has a heavy toll on workplaces, both productively and economically. Burnout is associated with increased rates of absenteeism and reduced productivity - not to mention the negative impact it has on employees. Psychologically resilient employees are better able to cope with stress, and less likely to suffer from 'burnout'. Clearly this is of benefit to the employer!

Resilience has been associated with various positive states, including optimism, zest, curiosity, energy and openness to experience (Tugade & Fredrickson, 2004). These positive emotional states are of tremendous value to the workplace. In addition to the more immediate value of positive states, Fredrickson (2004) put forward the argument that positive emotions lead to 'thought-action repertoires' which then result in an urge to think/act in a certain direction.

To put this simply, the experience of positive emotions (fostered by resilience) can expand activity, open an employees' eyes to a range of possibilities, and increase the likelihood of more creative solutions for workplace behaviors (Fredrickson, 2004).

Positive emotions also serve as a 'buffer' against workplace stress (Tugade & Fredrickson, 2004). How? Well, positive emotions enable individuals to make positive appraisals of what otherwise may have been a stressful situation.

Also, those who experience positive affect are more likely to use problem-focused coping which is of great benefit in the work environment. When individuals feel more positive, they tend to also interpret seemingly ordinary events and experiences as positive. Thus, positive emotions foster positivity in the workplace.

Resilience is not only important for its impact on psychosocial factors such as burnout, adaptive workplace behaviors and buffering against workplace stress. Resilience has also been implicated in physical wellbeing. Tugade and Fredrickson (2004) found that "the psychological mindset involved with resilience is reflected in the body as well".

Naturally, if employees have better physical wellbeing, they will have a greater capacity to undertake their work, and - in turn - be better placed to further adapt to adversity! It is a win-win situation.

Resilience in the Workplace Training

So, it is clear that resilience is highly important in the workplace. How can businesses encourage resilience in the workplace? What can be done?

Well, workplace training has been found to be effective. Studies support the positive impact of resilience training. But what does that exactly entail, and is resilience in the workplace training really beneficial to employees and businesses?

Resilience training has been found to have a positive impact on mental health and subjective wellbeing (Robertson, Cooper, Sarkar & Curran, 2015). Research suggests that resilience training may play an important part in public health and health prevention (Joyce, Shand, Bryant, Lal & Harvey, 2018). This is because resilience training has the power to protect the long-term health and wellbeing of employees.

Resilience training varies according to the content of the material presented, and the way in which the training is delivered. Resilience training may take a variety of forms - including online training, group-based training, one-to-one training and a combination of group-based and one-to-one training (Robertson et al., 2015).

The length of resilience in the workplace training varies widely, from a single 90-minute session to 13 weekly sessions. In a systematic review of resilience training in the workplace, the authors identified four broad categories of outcomes that were measured:

Mental health and subjective wellbeing outcomes

Physical/biological outcomes

Psychosocial outcomes

Performance outcomes

Robertson et al. (2015) reviewed 14 studies, and they found that 12 studies reported a beneficial effect of resilience training. However, a limitation of their review was that only 6 studies directly measured resilience (of which, three showed a significant, positive effect).

The authors also found that resilience training was especially effective for positive mental health and subjective wellbeing outcomes (including stress, depression, anxiety, and negative mood/affect/emotion).

An example of a resilience training program was developed at the University of Pennsylvania, called the Pennsylvania Resilience Program (PRP). This particular program aimed to enhance protective factors associated with resilience in the workplace, including optimism, self-efficacy, problem-solving, self-regulation, flexibility, emotional awareness, empathy and the development of strong relationships (Robertson et al., 2015).

What does a resilience training program look like? Resilience training may consist of skills-based coaching, developmental/executive coaching or mindfulness and compassion-based practices (Robertson et al., 2015).

Researchers in the field of resilience have turned their attention to evidence-based therapies from which to develop resilience training. For example, research training has been developed from ACT (Acceptance and Commitment Therapy), CBT (Cognitive Behavior Therapy), Mindfulness-based Cognitive Therapy, and Mindfulness-based Stress Reduction (Joyce et al., 2018). A more novel approach to resilience training has seen workers utilize technology to self-regulate stress responses (Robertson et al., 2015).

Studies have supported the role of mindfulness training on psychological resilience, therefore making it a helpful intervention in resilience training in the workplace (Joyce et al., 2018). Mindfulness-based resilience training typically involves the teaching of cognitive strategies, mindfulness training, provision of psycho-educational material, and goal setting (Joyce et al., 2018).

The findings from one study of resilience training were reported by Joyce and colleagues (2018). Their resilience training was delivered to 29 full-time firefighters. The training, called "Resilience @ Work" (RAW) consisted of 6 internet-based sessions. The training was mindfulness-based and was delivered to the participants online. Compared to baseline measures, participants were found to have increased resilience after the RAW training.

This finding was valuable, as many resilience training programs are delivered via multiple face-to-face sessions. Most commonly, resilience training is delivered to groups over a 10 - 11-week period. This mode of delivery is disruptive to business and is extremely costly both in time and in resources. The success of Joyce et al.'s intervention offers promise for more cost-effective resilience training options available to workplaces.

At face value, it appears that resilience training is an effective way to increase employees' capacity to deal effectively with stress and overcome challenges. However, it should be kept in mind that the effectiveness of training - like any educational program - is moderated by the nature of the training.

How to Build Resilient Teams

There is a range of possible ways to develop resilience in work-teams. Resilient teams are able to withstand and overcome difficulties whilst sustaining performance and cohesion of the team, or even strengthen the team. Some ways to build resilient teams, described by Alliger and colleagues (2015), that can be applied for any type of team, are described below:

1. Checklists and Guides

Some common challenges and stressors can be anticipated at work. To develop resilience in team-members, checklists and guides are a helpful way to provide employees with a resource they can turn to when dealing with the challenge. The resource can be a 'go-to' guide for staff. The resource might include tips for troubleshooting, guidelines for escalation (if necessary) and the key questions to consider in difficult situations.

A good idea is also to document 'standard operating procedures' for the workplace. As well as providing invaluable information for new staff, having these procedures written down and accessible means that the team can maintain their basic work tasks as efficiently as possible. Therefore, when unexpected challenges arise, the staff have freed up some capacity to deal with the stressor.

In any team, experts may at times need to be called upon. A valuable resource is a table/spreadsheet that contains the names and contact details for people who are in the position to support the team when particular challenges arise.

2. Training

In order to develop the resilience of any team, it is worthwhile to conduct team resilience training (as was described in the previous section), such as facilitated group sessions. The benefit of training for a team is that it helps the team members develop a group understanding, which promotes cohesion of the team and promotes positive team coordination.

Some tasks that are physical in nature can be practiced, by handling simulated challenges. This sort of training has been used extensively in training of medical professionals. It is also good for team-members to consider any resilience behaviors that they displayed during the simulation, and an observer may also be involved to provide feedback to individuals.

Obviously, due to practicalities and safety reasons, it may not be possible to 're-create' a challenge. In this circumstance, cognitive tasks may be helpful. For example, the person in charge of training could provide the team with a scenario for a possible event (i.e. an emergency) and ask them to think about the problem and discuss what they would do in the scenario. Again, feedback is helpful throughout this process.

3. Debriefing Sessions

After any challenge or stressful event, it is valuable for a workplace to offer its' employees 'post-challenge' debriefing. These sessions will encourage reflection about the experience. It is also helpful to facilitate team discussion about the challenge and how employees coped. This also facilitates team members supporting one another. This process can also include action planning for the team.

As well as being a helpful process following a particularly stressful event, team debriefing can also be a valuable thing to do after a period of time when there has been a string of low-level chronic challenges, which tend to deplete teams and are draining.

4. Work Culture

Finally, the culture of a team is a key to promoting resilience. This forms the basis for "team resilience". It is the responsibility of a team-leader, or supervisor, to create the right atmosphere for his/her team. They can facilitate the development of positive work culture by consistently demonstrating behaviors (described shortly) and also reinforce the behaviors in employees.

A culture of resilience includes team members being encouraged to:

Speak up, and ask any questions

Openly share bad news, and report early warning signs of potential problems

Maintain composure during 'emergencies' and times of heightened stress

In case of needing further support, seek out expertise rather than simply relying on another worker's rank or seniority

Keep an eye on one's work colleagues, and be there to offer support throughout the challenge - before (to minimize the impact of the stressor), during (to manage the heightened stress) and after the stressor (to 'mend' once the stress has passed)

Be able to express when there is a need in the workplace to switch to and from 'emergency' modes of operating.

Lastly, but importantly, once the challenge has passed, to encourage resilience team members to thank others for their help, and discuss any other challenges.

By putting these strategies into place, a resilient team can slowly but surely be developed.

Developing Resilience for Social Work Practice (book)

Louise Grant and Gail Kinman edited this handbook, which was published in 2014. It is designed for social work students and practitioners, to provide them with tools and strategies they can use to maintain wellbeing in an emotionally demanding profession. It aims to help students and practitioners alike to build the skills which will help develop emotional resilience.

Whilst traditionally in social work resilience has been studied in relation to those who have survived trauma, especially children, it is now understood that social workers also need a range of skills in order to effectively manage the emotional demands of their job. In other words, social workers need to be resilient!

This book is an engaging text that provides social workers and students with practical tools and strategies which can be used by the reader to manage their own wellbeing and to develop resilience.

The book is grounded in theory and practice. The interventions and strategies introduced are evidence-based, and because it is written by practitioners, the audience is in a position where they are more likely to relate to the issues and themes introduced. A feature of this text is the case-studies included throughout, which really bring the book to life for its' readers.

Included in the text are a range of topics relevant to social work students and practitioners. For example, some of the issues explored include boundaries, personal organization, and time management. The book also looks at the role of critical reflection and reflective supervision in developing resilience.

It explores Cognitive Behavior-based strategies, and the chapter on mindfulness can also help readers develop skills for coping with a highly stressful work environment. It covers peer support, peer coaching, and how to increase self-knowledge, develop coping skills and stress resistance. Finally, the book presents an integrated approach to resilient individuals and organizations.

Louise Grant has spent the last seven years teaching both qualifying and post-qualifying social workers. She is the principal lecturer at The University of Bedfordshire. From her experience, Louise has developed an awareness of the complexities of social work practice, its' demanding nature and what is required to achieve wellbeing and develop emotional resilience in practice.

Gail Kinman is a psychologist, with a particular interest in the area of Occupational Health Psychology. She is involved in a variety of research projects. However, her most significant focus is on the wellbeing of people who work in emotionally demanding professions.

How to be Tough at Work During Layoffs

Perhaps one of the most stressful situation workers can encounter is when layoffs are imminent. At this time, more than ever, the need to be resilient is tremendous.

Even workplaces that are generally quite friendly become super competitive when staff are being made redundant. Staff may begin gossiping, and engage in self-promotion - even at the expense of others.

However, although this situation is undoubtedly extremely challenging, Lynze Wardle Lenio has come up with some suggestions for things that employees can do to survive a layoff, or, to cope if they are in the unfortunate position of losing their job:

1. Prepare

Preparation is the key to dealing with so many stressful situations. After all, if we mentally prepare by planning for the 'worst-case scenario' this can help us develop coping strategies. It helps employees to cope with the stress of layoffs if they are ready to 'bounce back' should they actually lose their job.

It can help employees to have a plan of action, a 'plan B'. It is always a good idea to have a back-up plan! It is also helpful for staff to ensure they are up-to-date professionally in case they need to look for a new position. This may involve updating profiles, such as 'LinkedIn' and other social networks. It is invaluable to have personal and professional connections when seeking employment.

It is also a good idea for employees to review their skills in order to be competitive. This may also involve taking part in additional training or certification or completing professional development.

If the employee is fortunate enough not to lose their position, these extra qualifications and skills look impressive on the CV regardless!

It is wise during times of layoffs for workers to be financially cautious... 'just in case'. It is sensible to avoid spending money on unnecessary 'extras' or big-ticket items. At this time, Wardle Lenio advises employees to be especially responsible with their money and using credit cards carefully.

2. Maintain Positive Relationships at Work

Even if under extreme pressure in the workplace, it is advisable for employees to avoid toxic workplace discussions and gossip. Even if stressed, it is probably also better to avoid talking at any length about layoffs to your superiors.

Engaging in 'worry talk' at work will only strengthen the experience of stress and anxiety. It is best for workers to continue fostering positive engagement with colleagues and aim to protect their professional network.

It can be helpful for employees to remind themselves of the reason they are at work... in other words, to do their job. They should do their best to try not to waste time at work worrying about something that may not even happen. At work, an employee's first priority needs to be doing the job they are being paid to do!

3. Prove your Worth

At this time, employees may be under scrutiny. It is therefore worthwhile for employees to prove that they 'earn their keep' and that they are a valuable asset to the business. By making hard-work and dedication to performance their number one priority, this will actually help reduce stress in the workplace.

It is great for workers to make success their focus - to ensure that they work thoroughly and conscientiously, and to make sure they meet any deadlines. Furthermore, employees can prove their worth by going the extra mile and taking the initiative to complete extra work.

If it is at all possible, workers are wise to make the hard work they are doing known about! During layoffs, it is worthwhile for employees to prove that they are a valuable employee.

Many reasons lie behind why layoffs are made, and many are out of our control. However, workers can give themselves the best chance of retention by being the best employee they possibly can. It is best to prepare thoroughly, maximize relationships in the workplace and in the professional network and, finally, to work hard. At the end of the day, this will put employees in good to stead to achieve the career goals they have for themselves.

10 Books to Read on Resilience at Work

Would you like to read more on the topic of resilience at work? There are some excellent books available! Here are a few:

Career resilience in a changing workplace. Betsy Collard. 1996 (Google)

Building resilience at work. Kathryn McEwen. 2011 (Amazon)

Resilience at work: how to succeed no matter what life throws at you. Salvatore Maddi & Deborah Khoshaba. 2005 (Amazon)

Building resilience for success: a resource for managers and organizations. C. Cooper, J Flint-Taylor, M Pearn. 2013 (Amazon)

The mindful workplace: developing resilient individuals and resonant organizations with MBSP. Michael Chaskalson. 2011 (Amazon)

Fearless at work: timeless teachings for awakening confidence, resilience, and creativity in the face of life's demands. Michael Carroll. 2012 (Amazon)

The authority guide to emotional resilience in business: strategies to manage stress and weather storms in the workplace. Robin Hills. 2016 (Amazon)

Happiness at work: be resilient, motivated and successful - no matter what. Srikumar S. Rao. 2010 (Amazon)

The resilient employee: the essential guide to coping with change and thriving in today's workplace. Rosalind Cardinal. 2016 (Amazon)

Resilience at work: practical tools for career success. Kathryn Jackson. 2018 (Amazon)

Most Relevant YouTube Videos

Still keen to learn more?! These are a few relevant YouTube videos. Enjoy!

Resilience in the Workplace - short video:

Resilience in the Workplace:
Resilience, Wellbeing and Performance in the Workplace:

A Take Home Message

I hope that you have found this article relevant and interesting. The importance of resilience in the workplace cannot be underestimated! Given that we spend roughly one-third of our day at work, this means that being able to 'bounce back' when presented with the inevitable challenges work presents is a very important issue to consider.

Having the capacity to deal with ongoing stress at work, to adapt efficiently to change, to cope with the threat of job loss, and to handle the pressure of deadlines is important not only for succeeding at work but also contributes to our overall health and wellbeing.

Hopefully this article has shed light on what it means to be resilient at work and provided helpful tips to becoming more resilient at work. Maybe now would be a good time to reflect upon your own resilience in the workplace. What could you do to cope more effectively with workplace stress?

Feel free to refer to this piece when considering how not only to cope at work, but ideally, to thrive! Comments and ideas about resilience at work are welcomed.

We hope you enjoyed reading this article. Don't forget to download our 3 Resilience Exercises for free.

If you wish to learn more, our Realizing Resilience Masterclass© is a complete, science-based, 6-module resilience training template for practitioners that contains all the materials you'll need to help your clients overcome adversity in a more resilient way.

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Resilience in the Workplace: How to be More Resilient at Work

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Have you ever found yourself wondering what makes someone successful at work? Chances are, like many people you imagine that the key to success at work is intelligence or going above and beyond the demands of the role such as working extra long hours or taking on extra commitments.

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Find out more about the 7 essential mental nutrients

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This is a podcast with a sports psychologist where he talks about why resilience is important to success.

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Don't Tell Me The Score - Ian Price: Resilience - BBC Sounds

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Catch up on your favourite BBC radio show from your favourite DJ right here, whenever you like. Listen without limits with BBC Sounds.

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Listen to a recap of the main points we covered

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You can download or print them to help with note taking

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Mind

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Taking steps to look after your wellbeing can help you deal with pressure, and reduce the impact that stress has on your life. This is sometimes called developing emotional resilience. Resilience is not just your ability to bounce back, but also your capacity to adapt in the face of challenging circumstances, whilst maintaining a stable mental wellbeing. Resilience isn't a personality trait - it's something that we can all take steps to achieve.

For example, you can:

(For more tips on building your emotional resilience, see our pages on improving your wellbeing, and increasing your self-esteem.)

Make some lifestyle changes

There are some general changes that you can make to your lifestyle that could help you feel more able to cope with pressure and stressful situations.

Practise being straightforward and assertive in communicating with others. If people are making unreasonable or unrealistic demands on you, be prepared to tell them how you feel and say no. (The organisation Mind Tools provides tips on assertiveness on their website.)

Use relaxation techniques. You may already know what helps you relax, like having a bath, listening to music or taking your dog for a walk. If you know that a certain activity helps you feel more relaxed, make sure you set aside time to do it. (See our pages on relaxation for lots more ideas.)

Develop your interests and hobbies. Finding an activity that's completely different from the things causing you stress is a great way to get away from everyday pressures. If stress is making you feel lonely or isolated, shared hobbies can also be a good way to meet new people.

Make time for your friends. When you've got a lot on this might seem hard, but it can help you feel more positive and less isolated. Chatting to friends about the things you find difficult can help you keep things in perspective - and you can do the same for them. Laughing and smiling with them will also produce hormones that help you to relax.

Find balance in your life. You may find that one part of your life, such as your job or taking care of young children, is taking up almost all of your time and energy. Try making a decision to focus some of your energy on other parts of your life, like family, friends or hobbies. It's not easy, but this can help spread the weight of pressures in your life, and make everything feel lighter.

When I'm stressed, I take myself away from everyone, into another room or somewhere quiet - even just for five minutes - and sing to myself. Not full on belting out a tune, but just quietly or even humming to myself, really calms me down.

Look after your physical health

Taking steps to look after your physical health can help you to look after your mental health and reduce feelings of stress.

Get enough sleep. Stress can often make it difficult to sleep, and can cause sleep problems. Getting enough sleep can help you feel more able to deal with difficult situations.

Be active. Being physically active is important for both our physical and mental health. Even making small changes such as going for a regular walk outside may help you to feel less stressed.

Eat healthily. When you're stressed, it can be tempting to skip meals or eat too much of the wrong kinds of food. But what you eat, and when you eat, can make a big difference to how well you feel. (See our pages on food and mood for more tips.)

Give yourself a break

Learning to be kinder to yourself in general can help you control the amount of pressure you feel in different situations, which can help you feel less stressed.

Reward yourself for achievements - even small things like finishing a piece of work or making a decision. You could take a walk, read a book, treat yourself to food you enjoy, or simply tell yourself "well done".

Get a change of scenery. You might want to go outside, go to a friend's house or go to a café for a break - even if it's just for a short time.

Take a break or holiday. Time away from your normal routine can help you relax and feel refreshed. Even spending a day in a different place can help you feel more able to face stress.

Resolve conflicts, if you can. Although this can sometimes be hard, speaking to a manager, colleague or family member about problems in your relationship with them can help you find ways to move forward.

Forgive yourself when you feel you have make a mistake, or don't achieve something you hoped for. Try to remember that nobody's perfect, and putting extra pressure on yourself doesn't help.

I distract myself from my [...] worry by doing a puzzle or playing a game.

Build your support network

Remember that whatever you're going through that's causing you stress, you don't have to cope with it alone.

Friends and family. Sometimes just telling the people close to you how you're feeling can make a big difference - and they might be able to help you out in other ways too.

Support at work, such as your line manager, human resources (HR) department, union representatives, or employee assistance schemes. Try not to worry that talking to your manager or colleagues about stress will be seen as a sign of weakness - your wellbeing is important and responsible employers will take it seriously. If you're worried that the culture in your workplace might not be very supportive, you might find it helpful to take a look at:

Support at university or college, such as your tutors, student union or student services. (See our pages on how to cope with student life for more tips on accessing support as a student.)

Peer support. Sometimes sharing your experiences with people who've been through something similar can help you feel less alone. Elefriends and Big White Wall both offer supportive online communities where you can talk openly about stress and your mental health. (For guidance on using these services safely, see our pages on staying safe online.)

Specialist websites and organisations. For example:

Your GP. If you feel like you need some professional support, you can speak to your doctor. They can check your overall health, and help you access support and treatments. They could also recommend that you take some time off work, university or college, and sign a medical note for you.

Your local Mind. You might find your local Mind branch runs a course to help you look after your wellbeing, build resilience or manage stress. Or they may offer another service that could help you. Find your local Mind here.

[It helps me to] hug, fuss and play with my kittens!

This information was published in November 2017 - to be revised in 2020. References are available on request. If you would like to reproduce any of this information see our page on permissions and licensing .

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Developing resilience | Mind, the mental health charity - help for mental health problems

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Taking steps to look after your wellbeing can help you deal with pressure, and reduce the impact that stress has on your life. This is sometimes called developing emotional resilience. Resilience is not just your ability to bounce back, but also your capacity to adapt in the face of challenging circumstances, whilst maintaining a stable mental wellbeing.

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Abstract

Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma, and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of posttraumatic stress disorder (PTSD), depression and other psychiatric disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, and are thus thought to be resilient. Resilience as successful adaptation relies on effective responses to environmental challenges and ultimate resistance to the deleterious effects of stress, therefore a greater understanding of the factors that promote such effects is of great relevance. This review focuses on recent findings regarding genetic, epigenetic, developmental, psychosocial, and neurochemical factors that are considered essential contributors to the development of resilience. Neural circuits and pathways involved in mediating resilience are also discussed. The growing understanding of resilience factors will hopefully lead to the development of new pharmacological and psychological interventions for enhancing resilience and mitigating the untoward consequences.

Keywords: resilience, stress, neurobiology, depression, PTSD

Introduction

Resilience is the capacity and dynamic process of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning (Russo et al., 2012; Rutter, 2012b; Southwick and Charney, 2012). Every individual experiences stressful events and the majority are exposed to trauma at some point during life. Therefore, understanding how one can develop and enhance resilience is of great relevance to not only promoting coping mechanisms but also mitigating maladaptive coping and stress response in psychiatric illnesses such as depression and posttraumatic stress disorder (PTSD). Although the understanding of resilience is overall still at an early stage, recent investigations have identified mechanisms encompassing genetic, epigenetic, developmental, psychological, and neurochemical factors that underlie the development and enhancement of resilience and factors that predict vulnerability to stress and susceptibility to psychiatric disorders in the face of stress and trauma. This review outlines discoveries from recent years from studies that have considerably advanced our understanding of resilience to stress and trauma and will likely move forward the development of pharmacological and psychological interventions for enhancing resilience.

Genetic factors in resilience

Genetic factors contribute significantly to resilient responses to trauma and stress. A range of human genes and polymorphisms associated with NPY, HPA axis, noradrenergic, dopaminergic and serotonergic systems, and BDNF have been linked to resilient phenotypes (Table ) (Feder et al., 2009; Russo et al., 2012).

Table 1

FK506-binding protein 5 gene ( FKBP5)

Predicted severity of adult PTSD symptoms and onset of depression in individuals with childhood trauma.

Binder et al., 2008; Zimmermann et al., 2011

Noradrenergic and Dopaminergic

Catechol-O-Methyltransferase gene ( COMT)

Influenced the risks of developing PTSD and deficits in stress response and emotional resilience.

Heinz and Smolka, 2006; Skelton et al., 2012

Dopamine receptor genes (e.g., DRD2, DRD4)

Induced differential emotional processing and variability in brain responses to emotional stimuli; Influenced vulnerability to stress and trauma and risk of developing PTSD.

Blasi et al., 2009; Ptacek et al., 2011

Serotonin receptor genes (e.g., HTR1A, HTR3A, HTR2C)

Interacted with environment to mediate stress response and to predict susceptibility to depression.

Gatt et al., 2010; Kim et al., 2011a; Brummett et al., 2012

BDNF

Brain-derived neurotrophic factor gene ( BDNF)

Interacted with early life stress to predict syndromal depression and anxiety; no clear evidence of association between the Val ⁶⁶ Met polymorphism and anxiety disorders.

Frustaci et al., 2008; Gatt et al., 2009

Neuropeptide Y (NPY)

NPY is a neuropeptide that produces anxiolytic effects and promotes protective responses in the face of stress (Wu et al., 2011). Several studies in humans showed that genetic variations of NPY contribute to individual susceptibility to stress. One recent study found that two NPY haplotypes represented by three single nucleotide polymorphisms (SNPs) correlated with increased susceptibility to anxiety disorders after childhood adversity, and suggested that such behavioral effects can be mediated by altered NPY expression and subsequently dampened HPA-axis responsiveness under the influence of the genetic variation (Donner et al., 2012). Other studies also demonstrated that NPY release was substantially mediated by genetic variations in the NPY locus, especially in the promoter region, and that lower haplotype-driven NPY expression predicted weakened resilient response to stress (Zhou et al., 2008; Zhang et al., 2012).

HPA axis (hypothalamic-pituitary-adrenal axis)

Alterations in genes that regulate HPA-axis functions play an important role in shaping resilience. Polymorphisms in two key HPA-axis genes, CRHR1 [corticotropin-releasing hormone (CRH) receptor 1 gene] and FKBP5 (FK506-binding protein 5 gene), have been found to interact with early life stress to predict susceptibility to psychiatric illnesses in adults (Gillespie et al., 2009). One study identified, in two independent populations, significant gene × environment interactions with several individual SNPs of the CRHR1 gene that influenced the risk of developing adult depressive symptoms in individuals with a history of child abuse (Bradley et al., 2008). The FKBP5 gene, which is involved in the modulation of glucocorticoid receptor (GR) activity and thereby glucocorticoid signaling, was also found to interact with child abuse through its four SNPs to predict severity of adult PTSD symptoms (Binder et al., 2008). A more recent study showed that interactions between genetic variants of FKBP5 and early life trauma strongly predicted the onset of depression later in life (Zimmermann et al., 2011).

Noradrenergic and dopaminergic systems

Polymorphisms in the noradrenergic and dopaminergic systems have also been associated with vulnerability to depression and PTSD. Catechol-O-Methyltransferase (COMT) is an enzyme that metabolizes catecholamines including norepinephrine, epinephrine and dopamine. The COMT Val ¹⁵⁸Met polymorphism has been linked to deficits in stress response and emotional resilience, and was found to influence the risk for development of PTSD (Heinz and Smolka, 2006; Skelton et al., 2012). In an important study, Kolassa and colleagues showed that, predictably, higher numbers of different lifetime traumatic event types led to a higher prevalence of lifetime PTSD but that this effect was, in a typical gene-environment interaction fashion, modified by gene polymorphism (Kolassa et al., 2010). Compared to Val ¹⁵⁸Met polymorphism, the low-activity Met/Met homozygotes, with higher levels of norepinephrine and dopamine, exhibited a higher risk for PTSD. Children carrying the Met allele showed a higher cortisol response to stress. However, children who had more stressful life events showed a smaller increase in cortisol, implying that they might be more resilient (Armbruster et al., 2012). This study demonstrated differential effects of genetic and environmental factors on reaction to stress. Polymorphisms in the dopamine receptor genes, including DRD2 and DRD4, and in the dopamine transporter gene DAT1, have also been implicated in stress responsivity, emotion processing, and susceptibility to PTSD and depression (Segman et al., 2002; Dunlop and Nemeroff, 2007; Blasi et al., 2009; Ptacek et al., 2011; Skelton et al., 2012).

Serotonergic system

Studies of polymorphic traits of the serotonin transporter gene SLC6A4 and receptor genes have led to several discoveries regarding the effects of gene × environment interactions on resilience. A recent meta-analysis of 54 human studies confirmed that the interaction of stress exposure and the polymorphism in the promoter region of the serotonin transporter gene ( 5-HTTLPR) is strongly associated with stress sensitivity and risk for depression, with the short, less transcriptionally efficient s-allele being linked to increased stress sensitivity and risk of developing depression upon stress exposure (Karg et al., 2011). A particularly strong association between the s-allele and risk of developing depression was found in the group with a history of childhood maltreatment (Karg et al., 2011; Southwick and Charney, 2012). The s-allele of the 5-HTTLPR gene was also found, in two independent populations, to interact with childhood and adult traumatic experiences to increase the risk for PTSD (Xie et al., 2009). Polymorphisms in several serotonin receptor genes, such as HTR1A, HTR3A, and HTR2C, have been shown to interact with stressful life environment as well as polymorphisms from other genes (e.g., Val ⁶⁶Met in the BDNF gene) to predict susceptibility to depression (Kim et al., 2007, 2011a; Gatt et al., 2010), and to mediate HPA-axis activation and emotional response to stress (Brummett et al., 2012).

Brain-derived neurotrophic factor (BDNF)

The role of the BDNF Val ⁶⁶Met polymorphism in stress response and resilience has not been clarified. A meta-analysis of seven studies found no significant association between the Val ⁶⁶Met polymorphism and anxiety disorders (Frustaci et al., 2008). Specifically, two case-control studies of PTSD found no significant association between the Val ⁶⁶Met polymorphism and PTSD diagnosis (Rakofsky et al., 2012). One study, however, showed that the Val ⁶⁶Met polymorphism interacted with early life stress to predict syndromal depression and anxiety, with higher depression in Met carriers (Met/Met and Met/Val) and higher anxiety in Val/Val genotype, indicating that both alleles, interacting with exposure to early life stress, may contribute to mechanisms of distinct risks (Gatt et al., 2009).

The field of genetics is now moving rapidly to genome-wide studies on large populations to examine the complex genetic contributions to resilience, with additional genetic polymorphisms, gene-by-gene and gene-by-environment interactions being currently identified. As the genetic underpinnings of resilience become better illuminated, it is anticipated that gene and drug therapies can be developed specifically for genetic profiles of low resilience.

Epigenetic factors in resilience

Epigenetics refers to functional modifications to the genome without change in the DNA sequence. Such modifications serve to regulate gene expression and phenotype through mechanisms such as DNA methylation and demethylation, as well as histone modifications including methylation, acetylation, and phosphorylation. Epigenetic differences can be a consequence of exposure to stress-related factors during critical periods of development, and hence contribute to susceptibility to psychiatric disorders (Tsankova et al., 2007; Dudley et al., 2011).

Several animal studies have found that histone acetylation or phosphoacetylation in several subregions of the hippocampus increased after exposure to acute stressors (social defeat stress, forced swim stress, and predator stress) in both mice and rats, suggesting an adaptive role of these epigenetic changes in memory formation and stress response (McGowan et al., 2011; Sun et al., 2013). Intracerebral or systemic administration of histone deacetylase inhibitors (HDACi), alone or combined with antidepressants, resulted in antidepressant-like responses in several animal models (Sun et al., 2013). Histone methyltransferases (e.g., GLP, SUV39H1, G9a) are down-regulated in the nucleus accumbens of susceptible mice exposed to chronic social defeat stress, while these molecules were up-regulated in resilient mice exhibiting low depression-like responses, suggesting that histone methylation may be adaptive in the face of stress and protect against development of depression (Covington et al., 2011). Maternal care was found to influence stress response through epigenetic alterations, with offspring of high maternal care showing increased hippocampal GR expression and enhanced glucocorticoid negative feedback sensitivity, and hence more modest HPA response to stress, through hypomethylation at the NGFI-A nerve growth factor-inducible protein A (NGFI-A) binding site of a GR promoter (Weaver et al., 2004).

Human studies have begun to identify the effects of epigenetic changes on the regulation of the stress response. Suicide victims with childhood abuse had increased methylation of a GR ( NR3C1) promoter in the hippocampus, and thereby decreased hippocampal GR expression, compared to suicide victims without childhood abuse and to control subjects (victims of sudden, accidental death without childhood abuse) (McGowan et al., 2009). This finding is consistent with those from animal studies showing that history of early adversity is associated with GR expression and stress response in adulthood. Another study showed that DNA methyltransferase (DNMT) expression was altered in a region-specific manner in the brains of suicide victims compared to controls who died of causes other than suicide (Poulter et al., 2008). This study found increased DNMT-3B expression in the prefrontal cortex (PFC), and an associated increase in DNA methylation of the promoter region of the γ-aminobutyric acid (GABA) A receptor subunit alpha-1 gene ( GABRA1), the product of which was previously demonstrated to be down-regulated in the brains of suicide victims (Merali et al., 2004). Higher methylation of MAN2C1, a gene that encodes α-mannosidase, was shown to interact with greater exposure to potentially traumatic events to predict an increased risk of lifetime PTSD (Uddin et al., 2011). A number of epigenetic studies in animal models and humans investigating the association between epigenetic changes and risk for maladaptive stress responses and mental illnesses have recently been published (Radley et al., 2011; Schmidt et al., 2011; Murgatroyd and Spengler, 2012; Rusiecki et al., 2012).

Developmental factors in resilience

Developmental environment is another crucial contributor to resilience (Rende, 2012). Severe adverse events in childhood can negatively affect the development of stress response systems, in some cases causing long-lasting damage. Numerous rodent and primate studies suggest that animals abused by their mothers in the first few weeks of life show both delayed independence and decreased stress management skills in adulthood (Feder et al., 2011). These changes are reflected in abnormally high anxiety levels, increased HPA axis activity, and increased basal CRH levels in the cerebrospinal fluid (CSF) (Strome et al., 2002; Claes, 2004; McCormack et al., 2006). It is important to note that non-human primates, who have suffered childhood abuse, resulting in damaged stress response systems, may be more likely to abuse their own children (Maestripieri et al., 2007). In this way, the cycle of abuse is continued through generations.

Similar long-lasting alterations, including changes in the central nervous system (CNS) circuits, have been found in studies of human survivors of childhood trauma (Heim et al., 2010). Prenatal stress and childhood trauma have been linked to a hyperactive HPA axis with attendant risk of negative effects of chronic hypercortisolemia later in life (Frodl and O'Keane, 2012). Furthermore, severe early life stress leads to hyperfunctioning of the locus coeruleus-norepinephrine (LC-NE) system in adulthood (Feder et al., 2011). One study of police recruits with a history of childhood trauma found that in contrast to controls, the police subjects had significantly higher levels of a salivary metabolite of norepinephrine when watching aversive videos (Otte et al., 2005). Childhood abuse can lead to a reduction of hippocampal volume, which is frequently seen in patients with mood disorders (Janssen et al., 2007; Davidson and McEwen, 2012). As the hippocampus is one of the most plastic regions of the brain, there is hope that pharmacological treatments, such as antidepressants, may be able to reverse this decrease in volume by increasing neural progenitor cells (Boldrini et al., 2012). PET studies have also revealed decreased activation in the hippocampus during memory tests in patients with a history of childhood abuse (Heim et al., 2010). Other brain areas seem to be affected by childhood abuse as well. For instance, a recent study suggests that childhood maltreatment has a pronounced effect on two separate neuroimaging markers-reduced hippocampal volume and amygdala responsiveness to negative facial expressions (Dannlowski et al., 2012). Chronic, unmanageable social and psychological stress, and maltreatment, especially early in life, are also linked to shorter telomeres, which have been associated with increased risk of developing somatic diseases such as cancer, diabetes and heart diseases, and psychiatric disorders, particularly depression (Blackburn and Epel, 2012; Price et al., 2013).

Certain factors play major roles in determining whether a childhood traumatic event will lead to vulnerability or instead, to resilience. One of these factors is the degree of control that the person has over the stressor (Feder et al., 2011). Episodes of early uncontrollable stress can lead to "learned helplessness," where a person is conditioned to believe that they are unable to change the circumstances of their situation (Overmier and Seligman, 1967). Learned helplessness is also used as a model for depression in animals. When administered inescapable and erratic shocks, animals tend to develop heightened anxiety states and fear responses (Overmier and Seligman, 1967). Furthermore, their active coping is reduced when faced with later stressors. Learned helplessness in animals is also believed to lead to dysregulation of serotonergic neurons in the dorsal raphe nuclei (Greenwood et al., 2003), as well as a reduction of cell proliferation in the hippocampus (Ho and Wang, 2010). These dysregulations are likely to have severe negative repercussions on both cognition and mood.

On the other hand, when animals are administered shocks that are avoidable by behavioral modification, learned helplessness does not seem to develop (Seligman and Maier, 1967). In this same way, humans that have been able to successfully master a mild or moderate stressor (for example, the end of a friendship or illness of a parent) appear to be resilient to a variety of other later stressors (Feder et al., 2009; Russo et al., 2012). This phenomenon is called "stress inoculation," and occurs when the person develops an adaptive stress response and a higher-than-average resilience to negative effects of subsequent, uncontrollable stressors (Southwick and Charney, 2012). Stress inoculation is a form of immunity against later stressors, much in the same way that vaccines induce immunity against disease (Rutter, 1993). Research in rodents supports the stress inoculation hypothesis and has suggested that this protection against some of the later negative effects may be due to neuroplasticity in the PFC induced by stress inoculation (Southwick and Charney, 2012). In one study, young monkeys were presented with a controllable stressor (periodic short maternal separations) over a course of 10 weeks (Parker et al., 2004). These monkeys experienced acute stress during the separation periods, illustrated by agitation as well as temporary increased levels of cortisol. Yet, at 9 months of age, they experienced less anxiety and lower basal stress hormone levels than monkeys who did not undergo the separations. Additionally, at later time points, the group of stress-inoculated monkeys showed higher cognitive control, higher curiosity in a stress-free situation and larger ventromedial PFC volume (Parker et al., 2005; Lyons et al., 2009).

It is important to note that although research has outlined numerous ways in which developmental environment can negatively impact a person, resilience is in fact a common trait, following even the most severe adversities. Between 50 and 60% of the general population experience a severe trauma during their lifetime, yet the prevalence of PTSD is estimated at 7.8% (Russo et al., 2012). Other studies have found that neural circuits involved in resilience can be modified for many years after adversity. For instance, the majority of adolescents whose development was stunted in childhood due to trauma were able to developmentally "catch-up" when relocated to a supportive, loving environment (Masten, 2001; Rutter, 2012a). The fact that not all animals or humans exposed to uncontrollable traumatic experiences develop stress-related disorders clearly implies that environmental factors interact with genetic endowment and together, affect resilience. In fact, resilient genes may be sufficient to help a person overcome the most traumatic developmental events in some cases (Feder et al., 2011).

Implications for promoting resilience in child rearing

The findings that the developmental environment has significant effects on building and enhancing resilience from a young age impart clear messages for child rearing. Several large-scale longitudinal studies have investigated resilience in participants from childhood or adolescence through the transition to adulthood. Results from these studies strongly indicated that key factors including positive family functioning and peer relationships, connections to supportive adults and prosocial romantic partners, planfulness, self-discipline, and cognitive ability, all contribute to a more successful transition to adulthood and more resilient functioning (Burt and Paysnick, 2012). Interventional paradigms in the form of foster care, adoption, and parent training can improve the quality of parenting, family function, and attachment relationship, and in turn promote adaptive functioning and resilience in children and youth (Sapienza and Masten, 2011).

Children with a history of maltreatment showed lower resilient functioning than those without maltreatment (Cicchetti and Rogosch, 2012). Children with exposure to war and related traumatic experiences (e.g., child soldiers, rape, bombing, forced displacement) showed increased risks for PTSD as well as other medical conditions such as cardiovascular diseases in adulthood (Werner, 2012). Protective factors against deleterious impact of war-related adversities in children include a strong, positive bond between the primary caregiver and the child, the social support from teachers and peers, a shared sense of values, religious beliefs that find meaning in suffering, and humor and altruism as defense mechanisms (Werner, 2012). Besides children from an abusive and life-threatening environment, a newly identified group at risk is youth from affluent families, who may face higher risk of adjustment problems (e.g., substance use, depression, and anxiety) (Luthar and Barkin, 2012). Parents' lax repercussions on discovering substance use was shown to be a major vulnerability factor. Moreover, the levels of teens' symptoms (rule breaking, anxious-depressed, and somatic symptoms) were found to correlate more strongly with the teens' relationships with mothers than with fathers, which may in part reflect greater amount of time spent with mothers, who are generally the primary caregivers of their children. Therefore, positive changes in parenting for affluent youth are of critical importance, including adopting a strict zero-tolerance policy regarding students' law breaking, remaining vigilant about their children's activities outside school, and engaging in talks and workshops for families in distress and holding support groups particularly for mothers (Luthar and Barkin, 2012).

A review of efficacy of different interventions for children and adolescents with a history of trauma exposure indicates that cognitive-behavioral treatment, in both individual and group formats, is effective in reducing psychological harm such as anxiety and depressive disorders and symptoms (Wethington et al., 2008). Stress inoculation training (SIT), a preventive and interventional cognitive-behavioral paradigm, has been shown to be helpful in reducing anxiety and stress-related symptoms in adolescents (Maag and Kotlash, 1994). School-based interventions, including SIT, can improve adaptive coping skills and decrease the likelihood of developing PTSD symptoms in children exposed to war (Werner, 2012).

In summary, it is critical to provide children with a loving, healthy and supportive environment as they grow up, to avoid exposing them to repeated unmanageable stress, and to offer them chances to embrace and conquer life challenges so as to develop mastery of critical life stressors and acquire "stress inoculation" (Southwick and Charney, 2012). Education on successful parenting should be able to help to foster children in a resilience-promoting environment and to minimize occurrence of impaired stress response through generations. Moreover, training programs for children that focus on constructing and maintaining supportive social networks, enhancing prosocial behavior and cognitive reappraisal, and promoting coping self-efficacy and self-esteem, can all contribute to resilience building from an early age (Figure ).

Psychological factors in resilience

Significant research has been done on the psychosocial factors of stress tolerance and resilience building (Duryea et al., 1990; Chemtob et al., 1997; Pietrzak et al., 2010). Cognitive processes, personality traits, and active coping mechanisms, among others, contribute to resilience. These qualities also interact with biological factors to enhance adaptation in the face and aftermath of traumatic events, and confer resilience (Charney, 2004).

Individual characteristics and behaviors

Characteristics such as high level of intellectual functioning, efficient self-regulation, active coping styles, optimism, and secure attachment were observed in youth who had faced adverse situations and settings, yet did not succumb to the adverse impact of extreme stress (Richardson, 2002).

Moral compass

The existence of a moral compass or an internal belief system guiding values and ethics is commonly shared among resilient individuals (Southwick et al., 2005). Though religion or spirituality is often a facet in one's moral compass, the concept of a moral compass is grounded in a more innately human belief in morality. A study of 121 outpatients diagnosed with depression and/or an anxiety disorder showed that a low or lack of purpose in life and less frequent physical exercise were correlated with low resilience, but low spirituality prevailed as a leading predictor of low resilience (Min et al., 2012). Similarly, purpose in life was a key factor linked to resilience in a study of 259 primary care patients with a history of exposure to a range of severe traumatic events (Alim et al., 2008).

Neurochemical factors in resilience

A number of neurochemicals have been found to be involved in resilience. These neurochemicals have been shown to interact with and to balance each other to produce regulatory effects on acute and long-lasting adaptations to stress.

NPY

NPY is widely distributed in the brain (Wu et al., 2011; Sah and Geracioti, 2012). It counteracts anxiogenic effects of CRH in several brain regions that regulate stress and anxiety, including the hypothalamus, hippocampus, amygdala, and locus coeruleus (Sajdyk et al., 2004). Many studies on animal models and humans have confirmed the beneficial role of NPY in mediating resilience and vulnerability to stress and anxiety. Animals with PTSD-like behaviors showed a significant down-regulation of NPY in several brain regions including the amygdala and hippocampus, and centrally administered NPY reversed the negative behavioral effects of predator-scent stress (Cohen et al., 2012). Human studies found that, under uncontrollable stress induced by harsh military training, plasma NPY levels were markedly increased, and higher NPY levels were associated with better behavioral performance and stress response (Morgan et al., 2000, 2002). Higher plasma NPY levels were also found in combat-exposed veterans without PTSD than in those with PTSD (Yehuda et al., 2006). Significantly lower NPY levels in CSF were found in men with combat-related PTSD compared to healthy controls without PTSD (Sah et al., 2009). Thus, a wealth of studies indicate a positive correlation between NPY levels and resilience to deleterious effects of stress, and suggest a potential pharmacotherapeutic target for effectively reducing anxiety and enhancing resilience to adversity and stress. Studies are currently being conducted in this regard, using possibly effective delivery routes such as intranasal administration.

HPA axis

Upon stress exposure, CRH is released from the hypothalamus and acts on the pituitary gland, causing it to release adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal cortex to release cortisol and dehydroepiandrosterone (DHEA). Cortisol exerts negative feedback effects on the hypothalamus and pituitary, suppressing CRH and ACTH production, while DHEA is thought to have anti-glucocorticoid effects by inhibiting or blocking the effects of cortisol (Jones and Moller, 2011). This complex set of feedback interactions constitutes the HPA axis, which is a key neuroendocrine player modulating behavioral responses to stress (Russo et al., 2012).

Cortisol levels are linked to risk and resilience to stress-related psychiatric disorders, with higher levels associated with depression (Nemeroff and Vale, 2005), and lower levels with PTSD either as a possible trait that predisposes to the development of PTSD or as a consequence of trauma (Radley et al., 2011; Binder and Holsboer, 2012). DHEA together with DHEA sulfate (DHEA-S), have also been implicated in stress response and psychiatric disorders, with lower levels of DHEA(S) associated with depression, and elevated levels of DHEA(S) associated with PTSD (Maninger et al., 2009; Rasmusson et al., 2010). Of note, some studies have generated mixed findings (Hoge et al., 2007; Maninger et al., 2009). Because cortisol and DHEA(S) are released synchronously and function together through their antagonistic, dualistic homeostasis, the DHEA(S)/cortisol ratio has been found to be a crucial parameter that indicates differential stress vulnerability (Morgan et al., 2004; Markopoulou et al., 2009; Jones and Moller, 2011; ó Hartaigh et al., 2012).

CRH and its two receptors, CRHR-1 and CRHR-2, are important mediators of stress response (Southwick et al., 2005). In depression and PTSD, increased CRH levels in CSF have been found, which may relate to the dysregulation of signal transduction via the two receptors (Charney, 2004). CRHR-1 and CRHR-2 are differentially distributed in the brain, with CRHR-1 primarily found in the neocortex, basolateral amygdala, and hippocampus, and CRHR-2 in the lateral septum, medial and cortical nuclei of the amygdala, and dorsal raphe (Holsboer and Ising, 2010). CRHR-1 signaling plays a crucial role in anxiogenic circuits and contributes to anxiety-like response to stress. Consequently, preclinical and clinical studies have examined the antagonism of CRHR1 as a potential therapeutic intervention targeting aberrant CRH levels in mood and anxiety disorders and have generated some encouraging results (Paez-Pereda et al., 2011). CRHR-2 mainly modulates the effects of CRHR-1 signaling and can be either anxiolytic or anxiogenic depending on the circumstances (Hauger et al., 2009; Binder and Nemeroff, 2010).

Noradrenergic and dopaminergic systems

The noradrenergic system is activated upon stress, resulting in increased release of norepinephrine primarily from the locus coeruleus to its many projection sites that modulate stress responses and emotional behaviors, including the amygdala, hippocampus, hypothalamus and PFC, all of which constitute the LC-NE system (Aston-Jones and Cohen, 2005; Strawn and Geracioti, 2008). The activation of the LC-NE system under acute stress leads to generation and transmission of negative emotional memories starting from the amygdala, a process that can be inhibited by blocking norepinephrine activity (Charney, 2004). Hyperresponsiveness of the LC-NE system may result in chronic anxiety and fear (Feder et al., 2009). An imaging study in humans showed that disinhibited norepinephrine signaling may contribute to the etiology of PTSD by enhancing basolateral amygdala responses to fear stimuli (Onur et al., 2009). The norepinephrine transporter (NET) and receptors (α- and β-adrenoreceptors) involved in norepinephrine signaling have been implicated as biological mediators of stress-related psychiatric disorders and resilience (Krystal and Neumeister, 2009; Jhaveri et al., 2010). Dopamine release upon stress is increased in the PFC and inhibited in the nucleus accumbens, an area mainly associated with the reward pathway (Charney, 2004). Some studies have found decreased levels of circulating dopamine in depression and elevated urinary and plasma dopamine concentrations in PTSD (Charney, 2004; Dunlop and Nemeroff, 2007). A recent imaging study in humans showed that striatal dopamine transporter (DAT) density was higher in PTSD patients than in traumatized controls, suggesting a possible higher dopamine turnover in PTSD that can contribute to potentiation of exaggerated fear response to a stressful stimulus (Hoexter et al., 2012). Dopamine D ₁ and D ₂ receptors can form heterodimers by binding directly to each other, and these heterodimers were markedly elevated in the striatum in postmortem brains from patients with depression (Pei et al., 2010). Disrupting the coupling of D ₁ and D ₂ receptors has been shown to produce antidepressant-like effects, providing a possible novel target for antidepressant treatment (Pei et al., 2010; Wong and Liu, 2012).

Serotonergic system

Serotonin is one of the most studied neurotransmitters in relevance to mood and anxiety. Acute stress leads to increased serotonin turnover in multiple brain areas, including the amygdala, hypothalamus, PFC and nucleus accumbens (Feder et al., 2009). Serotonin affects the regulation of stress response and emotional behaviors through 5-HT 1−7 receptors in separate brain regions. The 5-HT 1A receptor is anxiolytic and may play an important role in the etiology of anxiety disorders. Animal studies have found anxiety-like behaviors after knocking out 5-HT 1A (Akimova et al., 2009). A few human imaging studies have also showed decreased 5-HT 1A binding and functioning in the amygdala, anterior cingulate cortex and raphe nuclei in patients with anxiety disorders compared to healthy controls (Akimova et al., 2009). The 5-HT 2A receptor, on the other hand, is thought to be anxiogenic, and 5-HT 2A antagonists prevent anxious behavior and dysregulated stress responses following early life stress (Benekareddy et al., 2011). Other serotonin receptors (such as 5-HT 1B and 5-HT 2C) have also been implicated in adaptive responses to stress (Krystal and Neumeister, 2009). For example, overexpressing 5-HT 1B in the caudal dorsal raphe nucleus led to reduced conditioned fear and helplessness in animal stress models (McDevitt et al., 2011).

BDNF

BDNF, a neurotrophic factor expressed in various brain regions including the amygdala, hippocampus, PFC and basal forebrain, is implicated in mood and anxiety disorders (Yamada and Nabeshima, 2003; Angelucci et al., 2005; Duman, 2009). BDNF supports neuronal proliferation, differentiation and growth during development, and promotes neuronal survival and functioning in adulthood (McAllister, 2002). Several studies have shown down-regulation of BDNF in the hippocampus after exposure of animals to various types of stress, and in postmortem studies of suicide-depression patients (Duman and Monteggia, 2006; Duman, 2009). Hippocampal BDNF expression contributed critically to resilient adaptations to chronic stress (Taliaz et al., 2011). BDNF acts through its two main receptors, TrkB and p75 (Castren and Rantamaki, 2010). The BDNF-TrkB pathway has been associated with both PTSD in humans and in animal models of fear conditioning, extinction and inhibitory learning (Mahan and Ressler, 2012). Central administration of BDNF has antidepressant-like effects and can enhance hippocampal neurogenesis (Li et al., 2008; Autry and Monteggia, 2012). Evidence from animal and human studies shows that administration of antidepressants can lead to increase of BDNF and TrkB expression in the hippocampus and PFC, suggesting a role of BDNF-TrkB signaling in the behavioral effects of antidepressants (Masi and Brovedani, 2011). Nevertheless, there is also evidence for antidepressant effects without changes in BDNF or neurogenesis (David et al., 2009; Petersen et al., 2009; Hansson et al., 2011). Much less work has been done regarding the exact role of the BDNF-p75 signaling pathway in resilience, probably due to the low affinity of p75 (Numakawa et al., 2010).

Glutamate, GABA, and endocannabinoids

Glutamate, GABA, and endocannabinoids have also been widely studied and implicated in the stress response, resilience, and pathophysiology of mood and anxiety disorders (Harvey and Shahid, 2012; Hill, 2012; Sanacora et al., 2012). The dysregulation of these systems can lead to profound deficits in successful adaptation to acute and chronic stress. Pharmacological studies targeting these systems in psychiatric disorders have begun to show promising results in achieving therapeutic effects (Hill and Gorzalka, 2009; Murrough and Charney, 2010; Kirilly et al., 2012; Mathew et al., 2012; Mathews et al., 2012).

Neural circuitry of resilience

Animal and human studies have investigated the brain circuits implicated in mood and anxiety and have shown that dysregulated functions and interactions among these circuits can result in low resilience phenotypes (Feder et al., 2009; Franklin et al., 2012). The reward and fear circuits play critical roles in the development of resilient character traits and adaptive social responses to stress.

Neural circuitry of reward

Enhanced functioning of the reward circuitry contributes to resilience to stress and trauma (Charney, 2004). A key reward circuit is the mesolimbic dopamine pathway, which carries dopamine signaling from the ventral tegmental area of the midbrain to the nucleus accumbens in the limbic system, and also to other brain regions such as the amygdala, hippocampus, and medial PFC. The mesolimbic dopamine pathway is linked to behavioral responses to rewards (e.g., food, sex, and drugs of abuse), and functional abnormalities in this pathway can contribute notably to key depressive symptomatology such as anhedonia, decreased energy, and reduced motivation seen in individuals with depression (Nestler and Carlezon, 2006). Studies have shown that the onset of depression is likely to happen during adolescence, when reward functioning is generally higher than during childhood and adulthood, and that increased reactivity in the medial PFC and decreased reactivity in the striatum are implicated in adolescent depression (Forbes and Dahl, 2012). Children of depressed parents, therefore at high risk for depression, showed altered amygdala and nucleus accumbens activation to affective stimuli compared to those of non-depressed parents, therefore at low risk for depression (Monk et al., 2008). Depressed and PTSD patients showed weakened responses to rewards in the striatal areas including the nucleus accumbens (Sailer et al., 2008; Pizzagalli et al., 2009). Deep brain stimulation in the nucleus accumbens has antidepressant, anti-anhedonic and anxiolytic effects in patients with treatment-resistant depression, suggesting that modulating a dysfunctional reward system can lead to improvement of the core symptoms in depression (Schlaepfer et al., 2008; Bewernick et al., 2010). Although compelling evidence has shown that an enhanced, highly functional reward system may be beneficial for positive, adaptive response to stress, one study found that Special Forces soldiers of high resilience showed less activation in the subgenual PFC and nucleus accumbens under a high-reward condition compared to healthy civilian controls, suggesting that a potentially "sturdy" reward system may contribute to resilience (Vythilingam et al., 2009). The exact role of the reward system and the associated neurotransmitters in the development of resilience and pathophysiology and even etiology of stress-related psychiatric disorders needs further elucidation.

Neural circuitry of fear

Resilience to extreme stress entails the ability to avoid excessive overgeneralized fear responses and to enhance favorable reconsolidation and extinction processes related to fear memories (Charney, 2004). Several studies have identified the components of the neural circuitry of fear response, which includes the amygdala, hippocampus, medial PFC, nucleus accumbens, ventromedial hypothalamus, and a number of brain stem nuclei (Davis, 2006; Maren, 2008; Quirk and Mueller, 2008). These regions play key roles in fear processing including the fear learning/conditioning, perception of threat, execution of efferent components of fear response, and modulation of fear memories through potentiation, consolidation, reconsolidation, and extinction (Shin and Liberzon, 2010). Patients with PTSD showed hyperactivation in the amygdala and hypoactivation in the ventromedial PFC and anterior hippocampus, which may indicate reduced top-down inhibition of the amygdala and account for exaggerated fear responses (Etkin and Wager, 2007). Other brain regions such as the dorsal anterior cingulate cortex and insular cortex have also been implicated in the maladaptive regulation of fear responses in PTSD, with some studies showing hyperresponsiveness and some showing hyporesponsiveness of these regions (Shin and Liberzon, 2010). Compared to trauma victims without PTSD, individuals with PTSD demonstrated behavioral sensitization to stress, overgeneralization of the conditioned stimulus (CS)-unconditioned stimulus (US) response, impaired CS-US pairings and impaired fear inhibitory learning, all of which are thought to be characteristic of dysregulated fear responses and can result in the core symptoms seen in PTSD, such as intrusive memories and flashbacks, enhanced avoidance of reminders, and autonomic hyperarousal (Mahan and Ressler, 2012). One study found higher potentiation of the startle response to safety cues in patients with PTSD compared to traumatized controls, and that this impaired fear inhibition may be associated with altered HPA-axis functioning in PTSD (Jovanovic et al., 2010).

Animal studies have shown that proper fear conditioning and extinction learning require synaptic plasticity, and thus impaired synaptic plasticity may underlie impaired fear and extinction processes in PTSD (Mahan and Ressler, 2012). The BDNF-TrkB signaling pathway, a ligand-receptor system involved in synaptic plasticity, has been shown to be necessary for sustaining normal functioning of fear conditioning, extinction, and inhibitory learning in three brain regions, the amygdala, hippocampus, and medial PFC, all of which are associated with PTSD (Mahan and Ressler, 2012). Consolidation of fear conditioning and extinction was impaired when BDNF signaling was inhibited in the amygdala (Rattiner et al., 2004; Chhatwal et al., 2006). Heterogeneous BDNF knockout mice ( BDNF±) demonstrated malfunctioning contextual fear conditioning, which can be partially reversed with recombinant BDNF infusion into the hippocampus (Liu et al., 2004). Altered BDNF expression in the prelimbic and infralimbic areas of the medial PFC can also lead to functional changes in fear consolidation and expression, suggesting a role of BDNF as a key mediator of neural plasticity in these regions (Choi et al., 2010; Peters et al., 2010). Glutamatergic and GABAergic signaling pathways have also been implicated in the regulation of fear consolidation, expression and extinction (Mahan and Ressler, 2012). For instance, disrupting NMDA and AMPA receptor functioning impaired the extinction of fear conditioning (Dalton et al., 2008; Liu et al., 2009; Zimmerman and Maren, 2010). Other ligand-receptor signaling systems such as those involving norepinephrine, nitric oxide, endocannabinoids, dopamine and acetylcholine have also been shown to play a modulatory role in the consolidation and extinction of fear conditioning, primarily by modulating glutamatergic and GABAergic signaling (Mahan and Ressler, 2012). These neurochemical systems involved in the fear circuitry provide potential pharmacological targets for reducing dysregulated fear response in PTSD and enhancing resilience to inappropriate fear associations in individuals susceptible to stress-related psychiatric disorders.

Additional neural circuitry of resilience

Neural circuits underlying psychological characteristics that render adaptive social behavior and promote resilience in individuals have been examined. Psychobiological qualities important in prosocial behavior include emotion regulation, empathy, and altruism, among others (Charney, 2004; Feder et al., 2009). Animal and human studies have identified functional neural circuits and interactions among multiple brain regions, such as the amygdala, PFC and nucleus accumbens, that are involved in the regulation of adaptive psychobiological responses to stress and adversities (Charney, 2004; Feder et al., 2009; Kim et al., 2011b; Cusi et al., 2012; Morishima et al., 2012). Reduced Insular activation under stress has been linked to greater non-reactivity to inner experience, a key component of trait mindfulness which may protect against negative bias and reduce depression vulnerability (Paul et al., 2013). By potentially targeting the top-down and bottom-up regulation of these neural circuits, psychotherapeutic interventions including cognitive behavioral therapy with cognitive reappraisal, positive emotion exercises, coping skill training, well-being therapy, and mindfulness meditation, can be efficacious approaches to build and enhance resilient psychosocial responses to stress (Southwick and Charney, 2012).

Summary

Resilience is a complex multidimensional construct and the study of its neurobiology is a relatively young area of scientific investigation (Southwick and Charney, 2012). Multiple interacting factors including genetics, epigenetics, developmental environment, psychosocial factors, neurochemicals, and functional neural circuitry, play critical roles in developing and modulating resilience in an integrated way. For instance, genetic and epigenetic factors interact with each other and determine the biological characteristics and regulation of neurochemicals and receptors. Environmental factors influence these characteristics and regulation processes through gene and environment interactions throughout development, contributing to adaptive changes in gene regulation, plasticity in the growth and modulation of neurocircuits, and the shaping of psychological factors and behavioral endpoints that underlie the manifestation of resilience.

Our growing understanding of the neurobiology of resilience has significant implications for the prevention and treatment of stress-related psychiatric disorders. Pharmacological interventions targeting the neurochemical systems involving NPY, BDNF, CRH, and HPA axis, among others, are being investigated as potential treatments for depression and PTSD. For instance, pharmacological agents targeting the hyperactivity and malfunction of HPA axis and CRH can possibly reduce the likelihood of pathological response to stress. Also, for individuals with altered NPYergic system, enhancing NPY levels and function may help to improve stress and anxiety regulation and to minimize the anxiogenic effects of CRH (Southwick and Charney, 2012).

Behavioral training targeting psychosocial risk factors and related neural pathways is also likely to increase resilience to stress (Karatsoreos and McEwen, 2011). Practice and training on enhancing stress-protective factors can lead to augmented plasticity and regulation of neural circuits that modulate reward and motivation, fear response, learning memory, emotion regulation, attention, cognitive executive function, adaptive social behavior, and cognitive reappraisal, thereby result in improved adaptation to stress and trauma, increased speed of recovery from adversities, and decreased susceptibility to stress-related psychopathology throughout life (Southwick and Charney, 2012). Furthermore, maintaining a supportive environment and providing resilience-building classes for child rearing can be particularly beneficial, in that children can learn how to master life challenges and acquire "stress inoculation" while growing up, enabling them to adaptively react to and master future challenges and stressors, thereby reducing susceptibility to stress-related psychopathology.

How to apply what we currently know about resilience to further the promotion of resilience and the prevention and treatment of stress-related psychopathology is one of the most critical questions for future studies. In addition, multidisciplinary research on the neurobiology of resilience should help to further identify risk and protective factors as well as their complex interactions and thereby facilitate the development of evidence-based interventions for enhancing resilience and mitigating risk for stress-related psychiatric disorders.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We sincerely acknowledge the support from the Icahn School of Medicine at Mount Sinai, the Karolinska Institutet, and the Swedish Medical Research Council Grant 10414.

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Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma, and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of posttraumatic ...