Discussion
Social workers strive to make informed decisions about the interventions they implement. These decisions should be driven by what the research data say. As a result, social workers have been called to systematically evaluate the effectiveness of the interventions they implement. A common way to evaluate interventions is to use a single-subject design. This involves monitoring an outcome for an intervention implemented for one client. After a social worker works with the client to determine the outcome to be measured, the following steps to the evaluation might look like this:
- Administer the instrument before the intervention is implemented
- Implement the intervention
- Administer the same instrument, after a specified time period
- Monitor to determine if there have been any changes in the outcome
In this Discussion, you use the lens of resiliency theory when reflecting on a case from your fieldwork, and then you consider how to measure the effectiveness of a possible intervention.
To prepare, read this article listed in the Learning Resources:
- Smith-Osborne, A., & Whitehill Bolton K. (2013). Assessing resilience: A review of measures across the life course. Journal of Evidence-Based Social Work, 10(2), 111–126. doi:10.1080/15433714.2011.597305
Post:
- Reflect on your fieldwork experience, and identify a case where it would have been beneficial to employ resiliency theory. Describe the case in 2 sentences.
- Describe the presenting problem in one concise sentence.
- Describe an intervention you would implement to promote resiliency.
- Identify an instrument from the Smith-Osborne and Whitehill Bolton’s article that would be appropriate when employing a single-subject design to evaluate how effective the intervention is in increasing the client’s level of resiliency.
- Explain why you selected the instrument.
In other words, why would the instrument be appropriate? (Consider the age of the client and for whom the instrument was designed, how feasible it would be to administer the instrument such as cost, time to administer it, etc.).
Journal of Evidence-Based Social Work, 10:
111
–126, 201
3
Copyright © Taylor & Francis Group, LLC
ISSN: 1543-3714 print/1543-3722 online
DOI: 10.1080/15433714.2011.59730
5
Assessing Resilience:
A Review of Measures across the Life Course
Alexa Smith-Osborne and Kristin Whitehill Bolton
School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
Through this systematic review the authors analyze
scale
s used to measure resilience in individual
s
across the life course. The scales were obtained according to a priori inclusion criteria through searches
using electronic databases, cited references, and requests to human services researchers currentl
y
engaged in research utilizing a resiliency theory framework. Eleven measurement tools meeting study
inclusion criteria were located within the existing literature. Currently validated instruments measu
re
specific populations and vary in length and format. The need for an analytical approach to measurin
g
resilience is long overdue. This assessment is intended to aid social work practitioners working wit
h
populations that have faced adversity.
Keywords: Resilience, measurement, life course, vulnerable populations, social work practice, inter-
vention
research
Two divergent streams of research have operationalized the construct of resilience as either a
personality trait (or cluster of traits) or as a process of personal, interpersonal, and contextual
protective mechanisms, resulting in an anomalous, positive outcome in the face of adversi
ty
(Egeland, Carlson, & Sroufe, 1993; Greene, 2008, 2010; Werner, 1982; Werner & Smith, 1992).
Attention to the former appears to predominate; for example, a search of the keyword “resilience”
in the electronic database collection EBSCO showed that the database embedded this search term
within the larger category of “personality trait.” In contrast, use of the construct as a contextualize
d
process resulting in a positive outcome, rather than as an internal characteristic has been applied
in many fields. One example from another discipline, information management, is in application
to key confirmation protocols used in cryptographic computer security. In these applications
,
resilience is defined as the maintenance of the pre-existing system state or equilibrium after an
attack—in other words, the system’s function has not been disrupted by the attack (Mohammed,
Chen, Hsu, & Lo, 2010). As an illustrative comparison, this application highlights the construc
t
as both a dynamic protective process and a desirable outcome under adverse circumstances.
Operationalization of the construct as a dynamic process is particularly consistent with the
biopsychosocial, person-in-environment focus of the social work discipline, and the contexts of
adversity often experienced by social work clients, such as childhood abuse and neglect, domest
ic
violence, chronic illness, discrimination, and poverty (Fraser & Galinsky, 1997; Greene, 2007,
2010; Smith-Osborne, 2007).
Furthermore, a shift from problem-focused and diagnostically driven theories and practice
models to the strengths perspective and resilience theoretical framework has been noted not
only in social work practice (Greene, 2010; Richardson, 2002; Smith-Osborne, 2007), but also
Address correspondence to Alexa Smith-Osborne, School of Social Work, University of Texas at Arlington, 211 S.
Cooper St., Box 19129, Arlington, TX 76019-0129. E-mail: alexaso@uta.edu
111
112 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON
in such diverse fields as military medicine (Bowles & Bates, 2010), nursing (Tusaie & Dyer,
2004), and international youth development (Unger & Liebenberg, 2007). Application of the
theory in a variety of disciplines has supported growing recognition and evidence that risk and
protective factors for resilience may operate differently at different points and trajectories across
the life course (Garmezy, 1991; Garmezy, Masten, & Tellegen, 1984), and for different types of
desired outcomes and adverse contexts (Bynner, 2000; Rudolph & Troop-Gordon, 2010; Rutter,
1979, 1985, 1990, 1995; Smith-Osborne, 2009a, 2009b). The need for an analytical approach
to measuring resilience is long overdue to support intervention research and practice (Luthar
&
Cicchetti, 2000; Luthar, Cicchetti, & Becker, 2000; Luthar & Cushing, 1999; Luthar & Zigler,
1991). Although reviews of resilience measures have been done over the last decade in the fields
of nursing (Ahern, Kiehl, Sole, & Byers, 2006) and education (O’Neal, 1999; Rak & Patterson,
1996), to our knowledge none have examined contrasting operationalizations of the construct in
these measures and none have been done to date in social work. This systematic assessment of
resilience measures of individuals across the life course is intended as a guide for social work
practitioners working with individuals having faced adversity.
METHOD
Systematic reviews of measures should account for variations in design, implementation, construct
operationalization, sample characteristics, settings, and psychometric analyses to produce bette
r
results for application in real life practice (Alderson, Green, & Higgins, 2003; Boruch, Petrosino,
& Chalmers, 1999; Chalmers, Hedges, & Cooper, 2002). Thus, operationalization of resilience
constructs are specified in Tables 1 and 2, sample, setting, and psychometrics in Table 3, and
study quality summarized in Table 4.
Operational Definitions
For inclusion criteria, resiliency was defined as a process of personal, interpersonal, and contextual
protective mechanisms, resulting in an anomalous, positive outcome in the face of adversity,
TABLE 1
Resilience Construct Operationalization of Child and Adolescent Instrumen
ts
Instrument (Authors) Factors Theoretical Basis
Number
of Items Scaling
RSAS (Jew, Green, &
Kroger, 1999
)
1. Active skill acquisition
2. Future orientation
3. Independence/risk taking
Past research by Mrazek
and Mrazek
35 items 5-point Likert
sca
le
ARS (Oshio et al.,
2003)
1. Novelty seeking
2. Emotional regulation
3. Positive future orientation
Drawn from past resilience
research
21 items 5-point rating
scale
READ (Hjemdal et al.,
2006)
1. Personal competence
2. Social competence
3. Structured style
4. Family cohesion
5. Social resources
Drawn from past research
on resilience
28 items 5-point Likert
scale
RSCA (
Prince-Embury,
2008)
1. Emotional reactivity
2. Sense of mastery
3. Sense of relatedness
Developmental theory and
past research on resilience
64 items 5-point Likert
scale
T
A
B
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RESILIENCE MEASURES 115
TABLE 4
Methodological Quality Summary following QUADAS Standards
Study First Author, Publication Year, and Life Stage
Jew, 1999,
Adolescents
Oshio, 2003, Older
Adolescents and
Young
Adults
Hjemdal,
2006,
Adolescents
Prince-Embury,
2008,
Adolescents
Representative sample spectrum C C C C
Reference standard C C C C
Time for adversity change during
testing limited
� C C C
Partial verification C C C C
Differential verification C C C C
Incorporation C C C C
Test review n.a. n.a. n.a. n.a.
Diagnostic review n.a. n.a n.a. n.a.
Clinical review C C C C
Uninterpretable results ? ? ? ?
Withdrawals C C C ?
Sponsoring precluded C C C C
Study First Author, Publication Year, and Life Stage
Wagnild,
1993,
Adults
Baruth,
2002,
Adults
Connor,
2003,
Adults
Friborg,
2003,
Adults
Sinclair,
2004
Ryan,
2009
Representative sample spectrum C C C C � C
Reference standard
C C C C C C
Time for adversity change during
testing limited
C C C C C C
Partial verification C C C C C C
Differential verification C C C C C C
Incorporation C C C C C C
Test review n.a. n.a. n.a. n.a. n.a. n.a.
Diagnostic review n.a. n.a n.a n.a n.a n.a
Clinical review C C C C C C
Uninterpretable results ? ? ? ? ? ?
Withdrawals C C C C C C
Sponsoring precluded C C C C C C
including a range of outcomes, such as health status, educational attainment, and vocational
success. Anomalous, positive outcomes were defined as those which were better than expected
from the empirical literature, given the adversity experienced.
Literature Search and Data Sources
Studies used in this review were obtained following the guidelines of the Cochrane Collabora-
tion (Reitsma et al., 2009) from electronic searches of the following databases through 2009:
Academic Search Complete, Alt HealthWatch, CINAHL Plus with Full Text, EBSCO Animals,
E-Journals, ERIC, Health Source: Nursing/Academic Edition, MasterFILE Premier, MEDLINE,
Professional Development Collection, PsycARTICLES, Psychology and Behavioral Sciences Col-
116 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON
lection, PsycINFO, PubMed, Social Work Abstracts, JSTOR, and Google Scholar. Keywords
entered were: resilience instruments, resilience/resiliency, resilience measures, protective mecha-
nisms, and scale validation.
The articles were scanned for references. Abstracts for additional references were obtained and
reviewed. Finally, requests for relevant articles and reviews were made to professionals involved
in resiliency intervention and research across disciplines, and results were evaluated for inclusion
criteria and to ensure that appropriate instruments had not been omitted.
Inclusion Criteria and Study Selection
Inclusion criteria specified peer-reviewed journal articles published in English up to 2009 reporting
high quality (see below) validation of resiliency instruments for children, adolescents, adults,
or older adults. Statistical conclusion validity was assessed initially to exclude studies which
reported insufficient statistical data or used inappropriate statistical methods or validation criteria
to determine psychometric properties, including specification of procedures used to determine
statistical properties of some dimensions of both validity and reliability.
The two researchers, working independently, reviewed the retrieved abstracts and compared
their results (Moher, Liberati, Tetzlaff, & Altman, 2009). Differences were discussed and recorded
until consensus was reached. Full text articles were retrieved for those remaining abstracts, and
the same independent review process followed (see Figure 1).
FIGURE 1 Flow chart of resilience instrument validation studies retrieval process following Preferred Reporting
Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
RESILIENCE MEASURES 117
Data Extraction
Studies that met inclusion criteria had data extracted by one author, followed by review by
the other. Population, Intervention, Comparison, and Outcome (PICO) criteria, as recommended
by Gambrill (2006), were applied to all studies. The answers to PICO questions define the
population under study, the specified measure and its use of extrinsic, contextual, as well as
intrinsic, intrapsychic, protective mechanisms, the comparison instrument if any, and specified
outcomes, all with an element of time (e.g., how old are the participants, when is the outcome
measured). Finally, quality of evidence was considered during the data synthesis phase as well,
as recommended by Boruch et al. (1999) and Gambrill (2006).
Quality Assessment
We used the validity framework approach (Cook & Campbell, 1979; Wortman, 1994; Reitsma
et al., 2009) for this study both as inclusion criteria and to evaluate the quality of included
studies. With reference to construct validity, studies were evaluated to determine degree of
match with the operationalization of resilience defined above. External validity was assessed for
sample characteristics and sampling method, life course applicability, and relevance to social work
practice. Then internal validity was assessed, excluding studies with fewer than two validity and
reliability analyses and insufficient sample size to meet measure validation criteria of 2 participants
per item for sample size (Nunnally, 1978) and 5–30:1 for participant to variable ratio when factor
analytic methods were used (Osborne & Costello, 2004), since both issues may introduce excessive
threats to internal validity. Statistical conclusion validity was assessed to verify use of appropriate
statistical methods and validation criteria.
For further assessment of quality of evidence, a summary score approach, using scales such as
the Downs and Black tool (Downs & Black, 1998), has been used recently for systematic reviews
of self-report diagnostic/screening measures such as this one (e.g., Gorber, Tremblay, Moher, &
Gorber, 2007). However, in 2009, Reitsma and collegues for the Cochrane Collaboration (Reitsma
et al., 2009) recommended against this approach, supporting in its place the qualitative approach of
a modified 11-item QUADAS (Quality Assessment of Diagnostic Test Accuracy Studies) checklist
tool (Whiting et al., 2006); therefore this approach has been used here. Items which pertain to
diagnostic measures rather than the type of measures of functioning examined here are indicated
as “not applicable.”
RESULTS
Ten scales met a priori inclusion criteria for this review. Eight scales were validated on American
samples, while two—the Resilience Scale for Adolescents and Adolescent Resilience Scale—were
originally validated on non-American samples and have been included due to their adherence to
inclusion criteria, availability in English, and good convergent and discriminant validity with scales
validated on American samples. Refer to Tables 1 and 2 for construct operationalization, Table 3
for psychometric properties, and Table 4 for study quality summary.
Child and Adolescent Scales
Resilience Scale for Adolescents. The Resilience Scale for Adolescents (READ) is a
28 item scale, rated on a 5-point Likert scale. Five factors are discerned: Personal Competence,
Social Competence, Structured Style, Family Cohesion, and Social Resources (Hjemdal, Friborg,
Stiles, Martinussen, & Rosenvinge, 2006). The READ was validated on 425 adolescents between
118 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON
the ages of 13 and 15 in Norway (Hjemdal et al., 2006). Currently, validation of the READ is
occurring on American and other non-Scandinavian populations (O. Hjemdal, personal commu-
nication, June 7, 2010). The scale is available
at no cost by request to the first author.
Resilience Scale for Children and Adolescents. The Resilience Scale for Children and
Adolescents (RSCA) was developed for use in preventive screening for psychological vulnerability
(Prince-Embury, 2008). The RSCA consists of three scales that assess for resilience in children
and adolescents: Sense of Mastery, Sense of Relatedness, and Emotional Reactivity (Prince-
Embury & Courville, 2008a). Sense of Mastery is a 20 item scale rated on a 5-point Likert
scale and consists of three content areas: optimism, self-efficacy, and adaptability. The Sense
of Relatedness consists of 24 items rated on a 5-point Likert scale and encompasses comfort
and trust in others, perceived access to support by others, and capacity to tolerate differences
in others. The Emotional Reactivity scale consists of 20 items rated on a 5-point Likert scale
and consists of sensitivity/threshold for and intensity of reaction, length of recovery time, and
impairment while upset. The RSCA validation consisted of normative samples of 226 chil-
dren aged 9 to 11 years, 224 adolescents aged 12 to 14 years, 200 adolescents between 15
and 18 years (Prince-Embury & Courville, 2008b), and a clinical sample of 169 adolescents
between ages of 15 and 18 years (Prince-Embury, 2008). This scale’s 3rd grade reading level
may be conducive to use with children and adolescents with special needs, although it has not
been validated with this population. The scale may be purchased online from the PsychCorp
Division of Pearson Assessments at http://psychcorp.pearsonassessments.com/HAIWEB/Cultures/
en-us/Productdetail.htm?PidD015-8006-186&ModeDsummary.
Adolescent Resilience Scale. The Adolescent Resilience Scale (ARS) for college-age youth
consists of a 5-point Likert 21 item scale, consisting of three factors: novelty seeking, emotional
regulation, positive future orientation. The construct validation on a Japanese population of 207
young adults between the ages of 19 and 23 (Oshio, Kaneko, Nagamine, & Nakaya, 2003)
differentiated among groups who were vulnerable (high stressors and psychopathology), resilient
(high stressors, low psychopathology), and well adjusted (low stressors, low psychopathology).
The scale is available at no cost from the first author’s website at http://psy.isc.chubu.ac.jp/�oshio
lab/index_e.html
Resilience Skills and Abilities Scale. The Resilience Skills and Abilities Scale (RSAS),
originally developed as the Adolescent Resiliency Belief System Scale (Jew, 1997), consists of
35 items rated on a 5-point Likert scale (Jew, Green, & Kroger, 1999). Validation of this measure
took place through four studies of high school students. Initially, the RSAS was comprised of four
sub-scales. During the fourth validation study, two of the subscales were merged, reducing the
number of subscales to three: Active Skill Acquisition, Future Orientation, and Independence/Risk
Taking. Thus, this scale operationalizes resilience in a psychological context, of characteristics
that individuals use in stressful contexts, drawing heavily on the cognitive appraisal theory of
Mrazek and Mrazek (1987). This scale is available at no cost from the first author.
Validity and reliability issues. Quality indicators of sufficient sample size and type, appro-
priate validation criteria, and appropriate statistical methods were required for study inclusion.
Sample sizes used for validation of instruments were adequate for the instruments reviewed.
Sample sizes exceeded 100, with the largest samples used for the RSCA (n D 819) for the child
and adolescent instruments (see Table 3).
Studies reporting psychometric properties of the instruments did not cover all aspects of validity
and reliability, but did report internal reliability, test–retest/stability reliability and construct,
factorial, convergent, divergent, and/or predictive validity, albeit with the resilience construct was
RESILIENCE MEASURES 119
limited to intrapsychic, individual traits in all instruments except the READ, limiting their utility
for social workers. Studies generally reported a level of internal reliability that was acceptable
at Cronbach’s alpha D .70 or above (Nunnally, 1978). An intraclass correlation coefficient of
.50 for test–retest reliability from pre-test to post-test may be considered an acceptable level of
stability reliability (Fleiss, 1981), and the RSCA and RSAS reported at least that level. However,
the statistic used to calculate test–retest reliability was not always specified, making it difficult
to assess the meaning of the stability reliability coefficients reported. Simple correlations, in
particular, may be more affected by temporal instability and measurement error (Heise, 1969).
Length of time between test–retest was 6 months for RSAS and not specified for the RSCA.
Results for the RSCA indicate that all three measures exhibit strong internal consistency
and construct validity. Prince-Embury identifies the need for additional research to accompany
preliminary findings to increase sample size and enhance understanding of RSCA scores associated
with psychological symptoms (Prince-Embury, 2008).
The initial validation study of the ARS (Oshio, Nakaya, Kaneko, & Nagamine, 2002) found
acceptable internal reliability. The scale has shown good convergent and discriminant validity with
the American-validated scale of the Big Five Personality Inventory (Nakaya, Oshio, & Kaneko,
2006). However, test–retest reliability was not reported in published studies.
The RSAS appears both reliable and valid, showing acceptable intraclass correlations indicating
test–retest reliability (.36–.70) and internal consistency (.68–.95). The authors call for further
research to refine the instrument and increase the instrument’s relevance to resilience as a construct
(Jew et al., 1999). However, later use of the instrument has been confined to a dissertation (Bass,
2006).
The only identified child/adolescent measure utilizing the full construct was the READ. The
READ scale shows good discriminant validity with the Short Mood and Feeling Questionnaire and
Social Phobia Anxiety Index for Children, both American-validated scales (Hjemdal, 2007) and
good predictive validity relevant to prevention efforts (Hjemdal, Aune, Reinfjell, Stiles, & Friborg,
2007). The READ appears both reliable and valid. Further studies should replicate the validation of
this scale, since the initial age group only spanned two years. A Norwegian validation of a shorter,
23-item version of the scale was recently reported as yielding acceptable psychometric properties
(von Soest, Mossige, Stefansen, & Hjemdal, 2010). This scale not only has the advantage of
measuring the full resilience construct, but also has been co-developed with an adult version,
the Resilience Scale for Adults, making them particularly useful for longitudinal research and
treatment monitoring (RSA; see below).
Predictive validity was established for the READ, the RSCA, and the RSAS. For a method-
ological quality summary, see Table 4.
Adult Scales
Resilience Scale. The Resilience Scale (RS) is a 25-item scale rated on a 7-point Likert scale
measuring two factors: personal competence, and acceptance of self and life; it was originally
developed on a sample of older women (Wagnild, & Young, 1990). The RS was validated on
810 adults between 53 and 95 years (Wagnild & Young, 1993). Following the validation of the
RS, numerous studies have used this instrument on individuals of all ages and ethnic backgrounds,
and a 14 item version was developed and validated (Wagnild, 2009). The scale is written at a
6th grade reading level. The Resilience Scale is available at no cost, and the User’s Guide for
purchase, from http://www.resiliencescale.com.
Connor-Davidson Resilience Scale. The Connor-Davidson Resilience Scale (CD-RISC)
consists of 25 items rated on a 5-point Likert scale that address 5 factors: personal competence,
120 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON
high standards, and tenacity; trust in one’s instinct, tolerance of negative effects, and strengthening
effects; positive acceptance of change and secure relationships; control; and spiritual influences.
The validation sample of the CD-RISC consisted of 6 groups (general population, primary care,
psychiatric outpatients, generalized anxiety disorder, and PTSD) with a total of 827 participants
(Connor & Davidson, 2003). The validation of CD-RISC suggested that health influences resilience
and resilience can improve through treatment when psychiatric disorders constitute the ongoing
context of adversity (Connor & Davidson, 2003; Davidson et al., 2005; Vaishnavi, Connor, &
Davidson, 2007). This scale is available at no cost from the first author.
Baruth Protective Factors Inventory. The Baruth Protective Factors Inventory (BPFI) con-
sists of 16 items rated on a 5-point Likert scale, addressing four factors: adaptable personality,
supportive environment, fewer stressors, and compensating experiences. The BPFI was validated
on 98 undergraduate students in a Human Development course between the ages of 19 and 74
(Baruth & Carroll, 2002). The BPFI should be validated on a larger sample prior to use in
assessing for the protective factors that contribute to the presence of resilience. Furthermore, the
initial researchers had predominantly female Hispanic and Anglo-American participants in the
initial validation and suggest that further research is needed to validate the instrument for other
populations. The scale was modified to generate a family scale (Gardner, Huber, Steiner, Vazquez,
& Savage, 2008), but has had no further validation studies to date. The scale may be found in the
appendix to the validation article.
Resilience in Midlife. The Resilience in Midlife Scale (RIM) consists of 25-items, rated on
a 5-point Likert scale and contains four factors: self-efficacy, family/social networks, persever-
ance, internal locus of control, coping and adaptation. The RIM was validated on an Australian
population of 130 adults between the ages of 35 and 60 (Ryan & Caltabiano, 2009). The RIM
is the only peer reviewed instrument focusing on midlife present in the literature to date. Further
research should be done to demonstrate the effectiveness of the RIM in assessing for resilience
in individuals during midlife. The scale is available at no cost by request to the first author.
Resilience Scale for Adults. The Resilience Scale for Adults (RSA) was originally validated
on 183 adults between the ages of 18 and 75 living in Scandinavia (Hjemdal, Friborg, Martinussen,
& Rosenvinge, 2001; Friborg, Hjemdal, Rosenvinge, & Martinussen, 2003). After the initial
validation, the original researchers continued to modify and validate the RSA and publishing the
updates in the academic literature (Friborg, Hjemdal, Martinussen, & Rosenvinge, 2009; Friborg
et al., 2005). Currently, the RSA consists of 33-items that address six factors: positive perception
of self, positive perception of future, social competence, structured style, family cohesion, and
social resources. Thus, this scale operationalizes resilience in both psychological and ecological/
contextual terms. Currently, in the United States, the RSA is in the process of validation on an
American population (O. Hjemdal, personal communication, June 7, 2010). The scale is available
at no cost by request to the first author.
Brief Resilient Coping Scale. The Brief Resilient Coping Scale (BRCS) is a brief assess-
ment aimed at identifying one’s ability to cope with stress. There are four items; the response
format is a 5-point Likert scale and measures one factor, Adaptive Coping (Sinclair & Wallston,
2004). The scale is available at no cost by request to the first author.
Validity and reliability issues. Quality indicators of sufficient sample size and type, appropri-
ate validation criteria, and appropriate statistical methods were required for study inclusion. Sample
RESILIENCE MEASURES 121
sizes used for validation of adult instruments were adequate for the instruments reviewed. Sample
sizes generally exceeded 100, with the exception of the BPFI (n D 89), with the largest samples
used for the RS (n D 810) for the adult instruments. All adult instruments but the BCRS addressed
the full operationalization of the construct. As in the case of the child instruments, studies reporting
psychometric properties of the adult instruments did not cover all aspects of validity, but did report
internal reliability, test–retest/stability reliability and construct, factorial, convergent, divergent,
and/or predictive validity. Discriminant and convergent validity were established for all instruments
but the BPFI and RS. Predictive validity was established for the RSA, CD-RISC, and BRCS.
In summary, results of the BPFI and RIM validations revealed sound psychometric properties,
including good split-half reliability and internal consistency. The BRCS meets the minimal stan-
dard for reliability and validity of a resilience instrument; however, it operationalizes resilience
primarily in terms of intrapsychic traits. Further research needs to be conducted in order to solidify
the reliability and validity of these three measures. However, lack of subsequent replication of the
BPFI, BRCS, and RIM to date limits support for their use by social workers.
Stronger results supported by repeated validation studies characterized the RS, the CD-RISC,
and the RSA. The RS presented strong internal consistency reliability, concurrent validity, and
construct validity (Wagnild & Young, 1993). The RS is adequate in measuring different ages
and races (Wagnild, 2009). For the CD-RISC, subsequent validation study with young adults
(Campbell-Sills & Stein, 2007) and cross-cultural validation studies (Yu & Zhang, 2008; Bitsika,
Sharpely, & Peters, 2010; Singh & Yu, 2010) found acceptable psychometric properties for use in
intervention. The RSA continues to demonstrate sound psychometric properties, and good internal
consistency and reliability with general and clinical Scandinavian samples (Friborg, Barlang,
Martinussen, Rosenvinge, & Hjemdal, 2005; Friborg et al., 2009; Hjemdal, 2007) and in cross-
cultural validation and intervention studies (Jowkar, Friborg, & Hjemdal, 2010; Lever & Gomez,
2010; Mikolajczak, Roy, Luminet, & de Timary, 2008), showing good convergent, discriminant,
and predictive validity.
Test–retest reliability was only reported for the RSA (4 months) and the CD-RISC (unreported
length) among the adult instruments. These differences become important to consider when
selecting the most reliable instruments to use in longitudinal research and to evaluate outcomes in
longer-term therapy/intervention, since a reduced time interval between tests is known to reduce
variance in the scores and may introduce recall threats to reliability (Fleiss, 1981; Heise, 1969).
However, with the exception of the BPFI, reliability estimates of the included test scores have
been studied in several different investigations, contributing to support for the robustness of these
measures’ test score reliability.
Methodological quality of instruments included in this review was assessed as high during
interpretation of study results (see Table 4), as expected, since QUADAS quality standards were
adopted as part of inclusion criteria. Use of these criteria both in inclusion criteria and as a standard
for interpretation of review results is recommended by the Cochrane Collaboration (Reitsma et al.,
2009).
DISCUSSION
Validated resilience instruments now exist for children, adolescents, and adults, normed on a
variety of populations. These populations include adults over age 65, healthy adults, adults with
chronic health conditions, college students, teens, and children ages 9 to 12. Only one instrument
for children under age 13, the trait-focused RSCA, was included in this review, although some
instruments are being used for Head Start and middle school populations (including grade 5)
without formal, published validation studies (e.g., the Devereaux Early Childhood Initiative,
n.d., and see LeBuffe & Naglieri, 1999; the Resilience and Youth Development Module of the
122 A. SMITH-OSBORNE AND K. WHITEHILL BOLTON
California Healthy Kids Survey, n.d.; and see Benard, 2004). Psychometric properties for these
child resilience measures have not yet been published in peer reviewed journals and so did not
meet the inclusion criteria for this review.
The published measures have primarily been used for research to date, although many were
developed with intervention applications in mind. For example, the developers of the BPFI suggest
specific application of their instrument in individual and family therapy, via assessment of past
protective factors and goal-setting to target specific factors, re-administration of the instrument
to monitor practice outcomes, and assessment of family members’ individual score congruence
(Baruth & Carroll, 2002). Notably, the full construct measures which have been used to monitor
practice outcomes are the READ for adolescents, and the CD-RISC, the RSA, and RS for adults
(e.g., Smith-Osborne, 2012; Connor, Davidson, & Lee, 2003; Neill & Dias, 2001; Wagnild, 2003).
The purpose of the authors in this review is to support more extended use of these instruments
in practice, for assessment as well as in monitoring treatment interventions. Since the social work
profession historically works with vulnerable and disadvantaged populations, the construct of
resilience has particular salience in assessing social work clients and measuring the outcomes of so-
cial work prevention and treatment interventions. Inclusion of resilience in social work assessment
is consistent with the strengths-based perspective by permitting identification of strengths for sup-
port and enhancement in the intervention plan. Empirical evidence suggests that analysis of protec-
tive and risk factors within resiliency domains can be useful in setting measurable goals in the inter-
vention plan, since levels of resiliency have been found to affect treatment response across several
different types of adversity, such as divorce (Masten, 2001), poverty (Masten, Best, & Garmezy,
1990; Wagnild, 2003), school bullying (Martin & Marsh, 2009), and chronic illness, including
psychiatric disorders (Connor & Davidson, 2003; Connor et al., 2003; Davidson et al., 2005).
When should practitioners consider including a measure of resilience in initial assessment?
Since these results identified measures of high quality for adolescents and adults, the reviewers
recommend that clients of these life stages be assessed using full construct resilience measures
(e.g., RS, RSA, CD-RISC, READ) when an ongoing condition of adversity, rather than a single
stressor/event (consistent with the bulk of baseline theory and construct development to date),
can be clearly identified and when the goal of the assessment is not limited to diagnosis only,
but to development of a comprehensive prevention or intervention plan. Rather than measuring
levels of psychopathology, the resilience instruments reviewed in this study measure levels of
both intrapsychic and contextual protective factors. They therefore offer more to the social
work practitioner in determining specific protective domains for selective focus for enhancement
strategies as part of the intervention plan.
Use of resilience instruments in planning and monitoring intervention in cases of both ongoing
adversity and single stressors/events can direct the practitioner to targeted protective mechanisms
not only with reference to the individual client’s strengths, but also with reference to the strengths
of the client’s environment in directing salient resources to the client targeted to specific resilient
outcomes appropriate to life stage or trajectory. For example, in addressing the resilient outcome
of increased educational attainment for an at-risk population which is not identified for special
education services, informational social support may be more protective than emotional social
support, so the practitioner may use a resilience instrument to assess the levels of these different
types of protective factors and target intervention strategies accordingly (e.g., Dubow, Tisak,
Causey, Hryshko, & Reid, 1991; Martin & Marsh, 2009; Smith-Osborne, 2009a, 2009b).
In considering selection of instruments for practice, social workers may wish to consider
not only the age of the clients in question but also temporal issues and level of focus in the
operationalization of each instrument as it pertains to their client population. Temporally, some
instruments (e.g., RSCA, ARS) operationalize resilience in relation only or primarily to specific
time-specific stressors or traumatic events, usually outside the range of typical developmental stage
demands for adaptation or expected losses. Others (e.g., RSA, READ) operationalize resilience
RESILIENCE MEASURES 123
primarily in relation to ongoing or long term conditions of adversity. Practitioners, then, should
select the instrument which has good fit with the temporal nature of the adversity experienced
by the client. Another major issue being raised in resilience research now, which has affected the
development of measures, is the alternate focus either on primarily intrapsychic, personal traits
and states characteristic of resilient individuals, or on dynamic processes which include adverse
context and the provision of interpersonal and concrete resources by the family, community, and
society to the individual or group in adversity. Those instruments which include contextual items
and scales will provide a better fit with the profession’s focus on the person-in-environment and
transactional, ecological nature of issues which trigger help-seeking. Future research must address
the utility of such instruments in supporting intervention outcomes.
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