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      Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience

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          Abstract

          Purpose: The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose a model with two paths: the first through social identification and collective action and the second via resilience. Method: A total of 288 Spanish people with physical disability aged between 18 and 82 years (46.4% males; mean [SD] of age = 45.1 [12.3] responded to the questionnaire. Data were collected for three months through an online survey. Results: The tested model adequately fit the data. We found that the relationship between internalized stigma and the psychological quality of life of people with physical disability was mediated by resilience. However, neither social identification nor collective action mediated the association between internalized stigma and quality of life among our participants. Conclusions: The results confirmed the negative association between internalized stigma and quality of life in the population with physical disability. The results show that some interactive processes, such as resilience, may contribute to decreasing the negative effects of internalized stigma. In contrast, no effects of identification with the group or collective action intention were found.

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          Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

          Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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            Psychological Resilience

            The purpose of this paper is to review and critique the variety of definitions, concepts, and theories of psychological resilience. To this end, the narrative is divided into three main sections. The first considers how resilience has been defined in the psychology research literature. Despite the construct being operationalized in a variety of ways, most definitions are based around two core concepts: adversity and positive adaptation. A substantial body of evidence suggests that resilience is required in response to different adversities, ranging from ongoing daily hassles to major life events, and that positive adaptation must be conceptually appropriate to the adversity examined in terms of the domains assessed and the stringency of criteria used. The second section examines the conceptualization of resilience as either a trait or a process, and explores how it is distinct from a number of related terms. Resilience is conceptualized as the interactive influence of psychological characteristics within the context of the stress process. The final section reviews the theories of resilience and critically examines one theory in particular that is commonly cited in the resilience literature. Future theories in this area should take into account the multiple demands individuals encounter, the meta-cognitive and -emotive processes that affect the resilience-stress relationship, and the conceptual distinction between resilience and coping. The review concludes with implications for policy, practice, and research including the need to carefully manage individuals’ immediate environment, and to develop the protective and promotive factors that individuals can proactively use to build resilience.
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              Resilience and mental health.

              The relationship between disease and good health has received relatively little attention in mental health. Resilience can be viewed as a defence mechanism, which enables people to thrive in the face of adversity and improving resilience may be an important target for treatment and prophylaxis. Though resilience is a widely-used concept, studies vary substantially in their definition, and measurement. Above all, there is no common underlying theoretical construct to this very heterogeneous research which makes the evaluation and comparison of findings extremely difficult. Furthermore, the varying multi-disciplinary approaches preclude meta-analysis, so that clarification of research in this area must proceed firstly by conceptual unification. We attempt to collate and classify the available research around a multi-level biopsychosocial model, theoretically and semiotically comparable to that used in describing the complex chain of events related to host resistance in infectious disease. Using this underlying construct we attempt to reorganize current knowledge around a unitary concept in order to clarify and indicate potential intervention points for increasing resilience and positive mental health. 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                10 March 2020
                March 2020
                : 17
                : 5
                : 1802
                Affiliations
                Faculty of Psychology, National University for Distance Education (UNED), 28040 Madrid, Spain; mdpsilvan@ 123456psi.uned.es (P.S.-F.); reciop@ 123456psi.uned.es (P.R.); fmolero@ 123456psi.uned.es (F.M.)
                Author notes
                [* ]Correspondence: enouvilas@ 123456psi.uned.es ; Tel.: +34-913-987-955
                Author information
                https://orcid.org/0000-0002-6839-4267
                https://orcid.org/0000-0002-0530-4404
                Article
                ijerph-17-01802
                10.3390/ijerph17051802
                7084512
                32164278
                cb2d3e13-7bec-41d2-a216-386fdacb0cc4
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 17 December 2019
                : 06 March 2020
                Categories
                Article

                Public health
                resilience,internalized stigma,collective action,disability,quality of life
                Public health
                resilience, internalized stigma, collective action, disability, quality of life

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