Longitudinal changes in coping strategies across midlife and older adulthood: findings from the midlife in the United States study.

OBJECTIVES: Most studies examining age differences in coping across adulthood come from cross-sectional studies and focus on the broader categories of problem- and emotion-focused coping. We aimed to establish a factor structure for coping items used in a national, longitudinal study of aging (MIDUS) and examine age patterns in coping strategies over 10 years. METHOD: We performed exploratory and confirmatory factor analysis, and factorial invariance testing. Next we conducted a series of multilevel models for each coping factor with participants from waves II and III of the MIDUS study (N = 2,661, Mage = 55, 58% women, 84% White). RESULTS: We found a four-factor solution: instrumental action; denial/disengagement; positive reappraisal; focus and venting of emotions. Invariance was established across time and age. At baseline, age was positively associated with the use of three strategies, though younger adults used more focus and venting of emotions. There was an overall decrease over 10 years in use of all strategies, which was moderated by age. Positive reappraisal declined more steeply among midlife participants, whereas the remaining strategies declined more for older participants. CONCLUSION: Results highlight the multi-dimensionality of MIDUS coping items and underscores the import of age in understanding changes in coping across midlife and older adulthood.

Stress appraisal and emotion regulation mediate the association between mindfulness and affect in cancer patients: Differential mechanisms for positive and negative affect.

OBJECTIVE: Cancer patients are at an increased risk for affective problems, including feelings of anxiety and depression. Mindfulness has been linked to an array of benefits for affective functioning in various populations including cancer patients, but the mechanisms underlying this relationship are still poorly understood. Based on emotion-regulation and stress-coping models, this study examined the potential mediating role of stress appraisal and coping strategies in the associations between mindfulness and cancer patients' positive and negative affect. METHODS: For this cross-sectional study, 245 cancer patients completed self-report questionnaires measuring mindfulness (FFMQ), positive and negative affect (PANAS), stress appraisal (SPSI-R:S), coping through positive reappraisal and positive refocusing (CERQ), rumination (RRQ), and distraction (COPE). Serial mediation analyses were conducted using the regression-based bootstrapping method. RESULTS: Higher levels of mindfulness were associated with higher levels of positive affect; this relationship was mediated via stress appraisal and positive reappraisal. We also found an indirect effect from mindfulness directly via positive reappraisal to positive affect. In addition, higher levels of mindfulness were negatively associated with negative affect; this relationship was mediated via stress appraisal and rumination, with also an indirect effect from mindfulness directly via stress appraisal to negative affect. CONCLUSIONS: Results suggest that stress appraisal and distinct coping strategies mediate the relationship between mindfulness and affect. Mindfulness may provide benefits for cancer patients' affect by allowing adaptive stress appraisal and ways of coping through more positive and less negative thinking.

Body image concerns and disordered eating among older women: Identifying variables of interest for integrated models.

OBJECTIVE: Research focused on developing risk and protective models of body image concerns and disordered eating among older women is scant. Models including biological, psychological, and sociocultural elements may be useful explanatory frameworks in this group. Thus, the aim of this study was to conduct formative research exploring the constructs that form part of biopsychosocial models of body image concerns and disordered eating among older women. METHOD: A sample of 184 women aged 60-75 years completed an online survey assessing media pressures, thin-ideal internalization, depression symptoms, weight and shape concerns, and disordered eating as well as positive reappraisal and acceptance of aging-related changes to appearance. RESULTS: After the addition of two supplemental pathways, the model revealed good fit to the data. In the final model, age, depression, and media pressure were associated with media internalization, that was in turn associated with weight and shape concerns, and then disordered eating. Depression was also directly associated with both weight and shape concerns and disordered eating. The model varied across older women with high versus low levels of positive reappraisal and acceptance of aging-related changes to appearance. Specifically, among those high on this trait, the pathways between depression and thin-ideal internalization, and between weight and shape concerns and disordered eating were significantly weaker. DISCUSSION: These findings support the usefulness of biopsychosocial models for grounding research on body image concerns and disordered eating among older women, and suggest positive reappraisal and acceptance of aging-related changes to appearance as a useful dimension to focus on.

Profiles of mindfulness in cancer patients and associations with psychological outcomes and coping strategies: A person-centered approach.

OBJECTIVE: Previous research confirmed the benefits of mindfulness for cancer patients' psychological well-being, but few studies considered the value of possible distinct combinations of mindfulness skills. This study aimed to (1) identify distinct mindfulness profiles in cancer patients, (2) examine socio-demographic predictors of patients with distinct profiles, and (3) examine associations of mindfulness profiles with psychological outcomes and coping strategies. METHODS: This cross-sectional study included 245 people with heterogeneous types of cancer. Latent profile analysis was applied to identify distinct profiles of mindfulness. The Bolck-Croon-Hagenaars method was used to examine how mindfulness profiles related to socio-demographic characteristics, psychological outcomes, and coping strategies. RESULTS: Four mindfulness profiles were identified: "average mindfulness" (50%), "judgmentally observing" (20%), "high mindfulness" (15%), and "non-judgmentally aware" (15%). Patients with "high mindfulness" profile tended to have higher educational attainment, and reported better psychological outcomes (i.e., low on depression and negative affect and high on positive affect) as well as better coping strategies (i.e., high positive reappraisal and low rumination). CONCLUSION: This study confirms the existence of distinct mindfulness profiles in cancer patients and suggest that patients high in mindfulness are the most adaptive.

USING THE POSITIVE REAPPRAISAL COPING INTERVENTION TO CHANGE STUDENTS APPRAISAL AND ATTITUDES TOWARD NURSING.

OBJECTIVE: The aim: This study aimed to evaluate the effect of positive reappraisal intervention model in changing nursing students' attitudes toward nursing profession. PATIENTS AND METHODS: Materials and methods: A quasi-experimental study design (one group pretest-posttest) to achieve the study objectives.The emotional regulation questionnaire (ERQ-10) and the students' attitudes scale were used pre and post applying the positive reappraisal intervention in a random sample of 165 undergraduate nursing students, male and female, in their sophomore level to senior level. The process of collecting student's data took place in July 2020 - February, 2021. RESULTS: Results: A statically significant difference in students' appraisal (t = -26.320, p < .0005) and their attitudes towards nursing (t = -15.460, p < .0001) were registered after applying (compared to the results before) the positive reappraisal intervention. CONCLUSION: Conclusions: The positive reappraisal coping intervention is proved as an easy model to apply and is highly effective in terms of changing students' cognitive appraisal, which in turns changes their attitudes toward nursing. This assumption is concluded, basing on the significant increase in the level of appraisal and attitudes of nursing students after applying the intervention model; their levels are increased to about (96%) positive appraisal and about (94%) positive attitude level.

Functional specificity of the left ventrolateral prefrontal cortex in positive reappraisal: A single-pulse transcranial magnetic stimulation study.

Neuroimage studies have yielded evidence for a correlation between the left ventrolateral prefrontal cortex (VLPFC) and a specific type of cognitive reappraisal strategy, positive reappraisal. However, evidence is still lacking for a direct relation. We used single-pulse transcranial magnetic stimulation (TMS) over the left VLPFC at different time points to investigate the functional specificity of the left VLPFC in the success of positive reappraisal and the timing at which the left VLPC was involved in positive reappraisal. Fifteen participants engaged in a baseline experiment and in TMS experiments. All participants successfully reduced their negative emotional ratings using positive reappraisal in the baseline experiment. In the TMS experiments, participants performed the same task as in the baseline experiment but single-pulse TMS was applied over the left VLPFC at 300 ms or/and 3,300 ms after stimulus onset, as well as over the vertex as a control stimulation. Valence ratings of negative stimuli increased (unpleasantness reduction) when participants reappraised negative stimuli with TMS stimulation over the left VLPFC, regardless of the timing of the stimulation at 300 ms or/and at 3,300 ms after the stimulus onset, relative to the vertex stimulation and the baseline experiment. Our study provided evidence of the functional specificity of the left VLPFC in regulation of negative emotions using positive reappraisal. The left VLPFC was believed to be involved in different stages of positive reappraisal. The prominent facilitation effect of TMS over the left VLPFC makes it possible to consider potential applications in clinical practice for mood disorders.

Mindfulness and wellbeing in older adults' survivors of herdsmen attack. The mediating effect of positive reappraisal.

Objective: The Fulani herdsmen are pastoralists who move from place to place in search of vegetation for their herds cattle. The random movement of cattle has frequently led to the destruction of crops belonging to farmers. This has resulted to violent clashes between the two groups. Such events are capable of impacting on the wellbeing of the older adult survivors and affected individuals may need adequate psychological resources such as mindfulness and positive emotions such as positive appraisal to be able to cope successfully. There is substantial evidence supporting the association of mindfulness and psychological wellbeing, but little is known about the mechanism through which mindfulness exert its influence on wellbeing. The present study aimed to examine the mediating role of positive reappraisal in the relation between mindfulness and wellbeing among older adult survivors of Fulani herdsmen attack.Methods: A sample of older adult survivors of Fulani herdsmen attack (N = 308, mean age = 59.72 years) were drawn from a community in southeast, Nigeria. Participants completed self-report measures of mindfulness, positive reappraisal, life satisfaction, perceived stress and depression.Results: Hierarchical multiple regression analysis showed that Mindfulness and positive reappraisal were independently associated with wellbeing (better life satisfaction, lower perceived stress and fewer depressive symptoms), yet this association was fully mediated by positive reappraisal.Conclusion: The findings underscore the potential value of mindfulness meditation intervention programs for the vulnerable as it is capable of promoting positive emotional live and wellbeing in late life.

Resilience in Non-Offending Mothers of Children Who Have Reported Experiencing Sexual Abuse.

Growing evidence shows that non-offending mothers experience significant loss and trauma following their child reporting experiencing sexual abuse. Maternal support offered to sexually abused children following disclosure can be a crucial factor in children's recovery. Although mothers are often seen as playing a central role in facilitating the recovery of their sexually abused child, there has been little focus on their own needs and profiles. This present study aimed to increase our understanding of the diversity of profiles of non-offending mothers of sexually abused children by exploring the differences in psychosocial traits of non-offending mothers (N = 68; age range 28-67 years) reporting higher and lower resilience. The mediating role of these psychosocial factors on the relationship between resilience and psychological distress will also be explored. Results found that non-offending mothers in the higher resilience group reported higher levels of positive reappraisal, self-compassion, social support, and significantly lower levels of psychological distress compared to non-offending mothers in the lower resilience group. Additionally, multiple mediation analysis indicated positive reappraisal, self-compassion, and social support to be significant mediators of the relationship between resilience and psychological distress. Increased levels of self-compassion and social support were found to be predictive of lowered psychological distress, while increased positive reappraisal predicted increased psychological distress. The findings of the present study provide support for the targeting of the psychosocial factors such as self-compassion, social support, and positive reappraisal in interventions for non-offending mothers in an effort to promote resilience.

Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness.

PURPOSE: The degree to which conscientiousness contributes to well-being in Chinese cancer survivors and the mechanisms through which conscientiousness is associated with well-being remain unclear. Based on Lent's restorative well-being model [1], the current study tested a mediation model of the contribution of conscientiousness, positive reappraisal, and hopelessness to fear of cancer recurrence (FCR), and physical well-being in a sample of 238 Chinese cancer survivors. METHOD: Participants completed self-report questionnaires. Path analysis was used to analyze the linear relationships between the variables. RESULTS: The empirical model supported the mediator roles of positive reappraisal and hopelessness. Specifically, the results indicated that conscientiousness was first associated with positive reappraisal, which in turn was associated with decreased hopelessness, resulting in decreased FCR and improved physical well-being. In addition, the results showed that conscientiousness was associated with decreased hopelessness, which was then associated with decreased FCR and greater physical well-being. CONCLUSION: Conscientiousness confers benefits on FCR and physical well-being through the mechanisms of positive reappraisal and decreased hopelessness.

Mapping the interplay among cognitive biases, emotion regulation, and depressive symptoms.

Cognitive biases and emotion regulation (ER) difficulties have been instrumental in understanding hallmark features of depression. However, little is known about the interplay among these important risk factors to depression. This cross-sectional study investigated how multiple cognitive biases modulate the habitual use of ER processes and how ER habits subsequently regulate depressive symptoms. All participants first executed a computerised version of the scrambled sentences test (interpretation bias measure) while their eye movements were registered (attention bias measure) and then completed questionnaires assessing positive reappraisal, brooding, and depressive symptoms. Path and bootstrapping analyses supported both direct effects of cognitive biases on depressive symptoms and indirect effects via the use of brooding and via the use of reappraisal that was in turn related to the use of brooding. These findings help to formulate a better understanding of how cognitive biases and ER habits interact to maintain depressive symptoms.

The impact of positive reappraisal on positive (and negative) emotion among older adults.

BACKGROUND: Positive reappraisal is an important cognitive strategy for older adults associated with wide-ranging improvements in psychological well-being. However, little is known about the relationship between positive reappraisal and positive and negative emotion, anxiety and depression, and whether positive reappraisal is associated with continued increases in positive emotion over time. METHODS: In the first study, 61 participants aged 62 to 88 years (M = 72, SD = 5.8) completed current measures of cognitive emotion regulation, positive emotion, negative emotion, anxiety and depression regarding their most distressing aging-related adverse life event, and rated (retrospectively) positive reappraisal use at the time of the stressor. Utilizing a longitudinal design, in a second study 60 participants aged 62 to 88 years (M = 71.2, SD = 5.7) completed the same measures for a recent adverse life event and repeated the measures 3 and 6 months later. RESULTS: In the first study, positive reappraisal reported for both time periods was significantly correlated with current positive emotion, but not negative emotion with mixed findings for anxiety and depression, and positive reappraisal use increased with time since stressor onset. In the second study, positive reappraisal was significantly correlated with positive emotion and significantly predicted positive emotion from 3-month to 6-month follow-up, and was related to anxiety and depression but not general negative emotion. CONCLUSIONS: These findings indicate that positive reappraisal is related to positive emotion but not consistently with negative emotion, and continues to be beneficial over time in older adults who have experienced a stressor.

Positive reappraisal in older adults: a systematic literature review.

OBJECTIVES: Positive reappraisal is a meaning-based cognitive emotion regulation strategy that is frequently used by older adults to deal with stressors. The strategy involves finding personally relevant positive meaning from an experience in the face of its negative reality. As positive reappraisal has not been previously systematically examined and appears to be particularly relevant to older adults, this paper reviews the research on positive reappraisal in older adult populations. METHOD: Database searches identified 302 studies, of which 22 addressed positive reappraisal in older adult samples. The findings were categorised into four core themes: use and value for older adults, effects on mental health, benefit for physical illness, and influence of cognitive functioning and gender. RESULTS: The literature indicates that positive reappraisal is an adaptive coping strategy for older adults with wide-ranging benefits. Specifically, positive reappraisal appears to be related to improved mental health for older adults, and particularly in the context of physical illness. CONCLUSION: Helping older adults find meaning in their negative experiences appears to be a worthwhile research area to pursue. Questions for future research on positive reappraisal in older adulthood are proposed.

Positive reappraisal coping mediates the relationship between parental abuse and lack of affection on adulthood generalized anxiety severity.

Exposure to parental abuse and lack of parental affection during childhood are risk factors for adulthood psychopathology. Tendency to engage in positive reappraisal may be a plausible mechanism underlying this relationship. The current study examined if positive reappraisal coping mediated the relationship between maternal/paternal abuse/affection and adulthood generalized anxiety disorder (GAD) symptoms. Participant data (N = 3294) from the Midlife Development in the United States study was collected in three waves, spaced nine years apart. Longitudinal structural equation mediation modeling examined whether positive reappraisal coping at Time 2 mediated the relationship between maternal/paternal abuse/affection at Time 1 and GAD symptoms at Time 3, controlling for GAD symptoms at Time 1. Positive reappraisal coping mediated maternal/paternal childhood abuse - GAD symptom severity and maternal/paternal childhood affection - GAD severity relations. Maternal and paternal abuse was associated with lower positive reappraisal tendencies, predicting increased GAD symptom severity. Conversely, higher maternal/paternal affection was associated with increased positive reappraisal, predicting lower GAD severity. Incremental prediction revealed that childhood abuse to GAD severity via positive reappraisal path was significant for maternal but not paternal abuse, whereas affection from both parents remained significant. Positive reappraisal coping may be a possible mechanism linking childhood experiences to adulthood GAD severity.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis.

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

The impact of cognitive emotion regulation strategies on math and science anxieties with or without controlling general anxiety.

It is well-established that general anxiety associates with the lower use of adaptive emotion regulation and the higher use of maladaptive emotion regulation. However, no study has previously investigated the impact of cognitive emotion regulation on academic anxieties. Using a sample of secondary school students (N = 391), this study examined the impact of cognitive emotion regulation on math and science anxieties. Math anxiety showed stronger correlations with adaptive than maladaptive emotion regulation, whereas general anxiety showed stronger correlations with maladaptive than adaptive emotion regulation. Hierarchical regression analyses showed that math anxiety was associated with the high uses of acceptance, rumination and other-blame and the low uses of positive reappraisal and putting into perspective. However, with controlling science and general anxieties, math anxiety was associated with the high use of rumination and the low use of positive reappraisal. In contrast, science anxiety was associated with the high uses of acceptance and other-blame and the low use of positive reappraisal. Importantly, however, with controlling math and general anxieties, those science anxiety associations did not remain. Accordingly, these results might provide important insights for the specificity, etiology, and intervention of math anxiety.

Cognitive reappraisal, emotional expression and mindfulness in adaptation to bereavement: a longitudinal study.

BACKGROUND AND OBJECTIVES: Maladaptive emotion regulation strategies increase prolonged grief and depressive symptoms following bereavement. However, less is known about the role of adaptive emotion regulation strategies in adaptation to loss. Therefore, we examined the concurrent and longitudinal associations of three putative adaptive emotion regulation strategies (cognitive reappraisal, emotional expression, and mindfulness) with prolonged grief and depression symptoms. DESIGN: A two-wave longitudinal survey. METHODS: A sample of 397 bereaved Dutch adults (89% female, mean age 54 years) completed validated questionnaires to assess trait cognitive reappraisal, emotional expression, mindfulness and prolonged grief and depression symptoms at baseline (T1) and 344 participants completed symptom measures again six months later (T2). RESULTS: Zero-order correlations demonstrated that mindfulness, cognitive reappraisal and emotional expression relate negatively to T1 and T2 prolonged grief and depression symptoms. In multiple regression analyses, controlling for relevant background variables, all emotion regulation strategies related negatively to T1 prolonged grief and depression symptoms. In multiple regression analyses, controlling for T1 symptoms and background variables, mindfulness predicted lower T2 depression symptoms. CONCLUSIONS: Adaptive emotion regulation strategies relate negatively to post-loss psychopathology symptoms, yet only mindfulness longitudinally predicts lower depression symptoms. Dispositional mindfulness may be a protective factor in psychological adaptation to bereavement.

Are reframing strategies more effective than empathy in processing trauma reports? A pilot study.

Listening to trauma reports can lead to the development of symptoms associated with secondary traumatization. This is particularly relevant for psychotherapists in practice, where psychologists need to estabilish effective strategies for processing and coping with such emotionally challenging events. This explorative study investigated adaptive reframing strategies for future therapists listening to trauma stories compared to feeling empathy for the client. In a mixed design, 42 postgraduate psychology students were randomly instructed to objectively distance themselves, reappraise, or feel empathetic while watching a video of a presumed trauma patient reporting a single violent act. An overall ANOVA did not reveal a difference between the reframing groups and the empathy group (between subjects manipulated) in their skin conductance level and heart rate variability during the video, as well as their change in state depression and state anxiety over the three measurements (before the video, after the video, and 2 days later). Nevertheless, an explorative t-test showed a significantly weaker rise in state depression and state anxiety from before the video to after the video in the reframing groups compared to the empathy group. This supports the suggestion that reframing strategies can be discussed as a protective factor against health issues such as secondary traumatization in therapists and should be examined in further studies in more detail.

Effects of positive reappraisal and self-distancing on the meaningfulness of everyday negative events.

Current work on meaning-making has primarily focused on major negative life events such as trauma and loss, leaving common daily adversities unexplored. This study aimed to examine how utilizing meaning-making strategies such as positive reappraisal and self-distancing (in isolation or in combination) can facilitate an adaptive processing of these daily negative experiences. Overall meaning and facets of meaning (coherence, purpose, and significance/mattering) were assessed at both global and situational levels. Results suggested that positive reappraisal was generally effective for enhancing situational meaning but not under all conditions. Specifically, when negative experiences were high on emotional intensity, reflecting on the experience from a distanced (third-person) perspective enhanced coherence and existential mattering more than engaging in positive reappraisal. However, when negative experiences were low on intensity, distanced reflection led to less coherence and mattering than positive reappraisal. The findings of this study elucidated the importance of examining the multidimensional construct of meaning at the facet level and highlighted the importance of applying different coping strategies to effectively make meaning out of daily negative experiences.

The Role of Emotional Regulation in the Relationship between Nurses' Creative Style and Innovation Behaviors: A Cross-Sectional Study.

Innovation is crucial to an effective healthcare system, and nurses are key figures in the innovation process. A potential factor behind innovation in nursing is the creative style of nurses. Creativity is an essential component of innovation. However, the relationship between creative style and innovation is complex and involves many different factors. Among them, given the nature of the nursing profession, we propose emotional regulation, or the ability to effectively manage one's emotions. In this study, we hypothesize that two specific emotion-regulation strategies, positive reappraisal and putting into perspective, play a role in the relationship between nurses' creative style and innovative behaviors. We tested a moderated mediation model using cross-sectional data from 187 nurses working in 3 university hospitals in Bojnord, Iran, in 2019. Our results show that positive reappraisal completely mediates the relationship between creative style and innovative behaviors, while putting into perspective moderates the relationship between positive reappraisal and innovative behaviors. These results suggest that nurses with a flair for creativity may be able to implement innovative behaviors in the workplace due to their ability to understand work-related situations and events positively. This may be especially true for nurses who can adopt alternative viewpoints. Our study discusses these findings by highlighting the importance of emotional regulation mechanisms in transforming nurses' creativity into effective innovation. Finally, we provide suggestions for healthcare organizations to promote innovation as an added value in the healthcare environment and services provided.

What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic.

Introduction: Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic. Method: We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners. Results: Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute ßs = 0.16-0.40; SRS: 15/18 RFs, absolute ßs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression. Discussion: Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.