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Scandinavian Journal of Child and Adolescent Psychiatry and Psychology 
Vol. 7(1):1-2 (2019) DOI 10.21307/sjcapp-2019-004 
 
Editorial  
 
 
 
 
“Resilience” – is this the new black in psychiatric health care  
and prevention? 
 
Pernille Darling Rasmussen 
 
 
 
 
 
“Blessed are the hearts that can bend; they shall never be 
broken.” ―Saint Francis de Sales 
 
 
Thousands of children have watched the Disney 
cartoons in which the main character mourns the loss 
of a loving and caring parent. A perilous and difficult 
time lies ahead during which the main character 
almost succumbs, but then meets friends and 
succeeds in the formation of healthy and enduring 
relationships. This is the turning point. In the end, 
the main character grows up to become a strong 
adult with a bright future. It is hardly conscious, but 
Disney has produced several movies that confirm an 
emerging realization in the research regarding 
resilience: a strong correlation exists between the 
relationships we have with our parents (or, in some 
cases, “significant others”) and how resilient we 
become to deal with life’s injustices later in life. In a 
review and concept analysis, resilience was defined as 
“the process of effectively negotiating, adapting to, or managing 
significant sources of stress or trauma. Assets and resources 
within the individual, their life and environment facilitate this 
capacity for adaptation and ‘bouncing back’ in the face of 
adversity” (1). It has further been suggested that 
adversity in itself is a vital part of developing a 
resilient mindset (2,3). Bell-Tolliver and colleagues 
(4) state that the “capacity to rebound from adversity, 
misfortune, trauma or other transitional crises” 
results in children who are “strengthened and more 
resourceful.” Altogether, this indicates that research 
may have focused too much on risk factors, and 
putting increased focus on potential protective 
factors may help identify the factors responsible for 
the appearance and facilitation of resilience.  
                                                     
 Variant translation: “Blessed are the hearts which bend, they 
never break” - The beauties of St. Francis de Sales, selected and 
This may prove to be one of the more important 
points of the literature to consider; life does not have to 
be without adversity to turn out well.  
However, resilience has played a less significant 
supporting role in psychiatric treatment strategies up 
until now, which may at least partly be due to 
difficulties in the process of defining and 
conceptualizing. Hence, resilience as a concept has 
also been subjected to criticism (5). To mention one 
problem, there is overlap between resilience and 
related psychosocial concepts, which suggests a need 
for improved uniformity in terminology (6,7). 
It was previously believed that some children had 
a particular aptitude for overcoming adversity, 
leaving little or no room to work with the concept 
for clinical purposes. However, when reviewing the 
literature, Rutter (8) found that no combination and 
no severity of risk factors seems to cause negative 
developmental trajectories in more than half of 
children. Nevertheless, reviewing theories on 
resilience, Fletcher and Sarkar found most 
definitions to be based on two key concepts: 
adversity and positive adaptation (9). Hence, what 
lies ahead is exploring the potential key factors of the 
ability for positive adaptation. 
Turning back to this question of what may be the 
determinant of the ability to adapt to adversity and 
continue a positive developmental trajectory, we may 
find inspiration from existing research such as from 
Emery and Forehand. They state that individual 
characteristics in a child are unlikely to develop 
without a relationship with at least one adult in which 
they feel worthy and loveable (10). Inspired by this, 
Nicola Atwoll has conducted a narrative review 
asking the question of whether it is time to view 
translated from the writings of John Peter Camus (1829), p. 49. 
This quote is sometimes misattributed to Albert Camus. 
 
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attachment theory and theory on resilience as 
complementary rather than in parallel (11). 
Important key features in attachment behavior 
include proximity seeking behavior and the use of the 
primary caregivers as a secure base from which the 
world can be explored. The securely attached child 
will rest assured in the parents to provide a safe 
haven for them to return to in need, whereas the 
insecurely attached child will have more negative 
expectations. 
More clinical and epidemiological research 
exploring the processes underlying resilience is 
needed if the concept is to be included effectively in 
clinical settings and in the development of preventive 
measures. However, findings suggest that in the near 
future we may be able to asses some key factors in 
resilient development (12). 
What you give to a child you can expect to come 
back tenfold—for better and for worse. This does 
not apply only to the typically developing child but 
also to children with innate vulnerabilities. Hence, 
future treatment strategies should include factors 
other than the somewhat narrow symptom-based 
approach we have had for many years. Resilience 
research may signify a change in perspective and a 
time to broaden our focus in child psychiatric 
treatment strategies.  
 
 
References 
 
1. Windle G. What is resilience? A review and concept analysis. Rev 
Clin Gerontol 2011;21(02):152–69.  
 
2. Bugental DB, Beaulieu D, Fowler E, O’Brien E, Cayan L. Reactivity 
to stress: When does a history of medical adversity foster resilience 
versus vulnerability? J Appl Soc Psychol 2010;40(6):1385–99.  
 
3. Bugental DB. Thriving in the face of childhood adversity. New 
York, NY: Psychology Press; 2003.  
 
4. Bell-Tolliver L, Burgess R, Brock LJ. African American therapists 
working with African American families: an exploration of the 
strengths perspective in treatment. J Marital Fam Ther 
2009;35(3):293–307.  
 
5. Bodin P, Wiman BLB. Resilience and other stability concepts in 
ecology : notes on their origin, validity and usefulness. ESS Bull 
2004;2(2):33–43.  
 
6. Born M, Chevalier V, Humblet I. Resilience, desistance and 
delinquent career of adolescent offenders. J Adolesc 
1997;20(6):679–94.  
 
7. Garmezy N. Stress-resistant children: The search for protective 
factors. In: Stevenson JE (ed.). Recent research in developmental 
psychopathology: J Child Psychol Psychiatry (Book Suppl.). Oxford: 
Pergamon; 1985;4:213–233.  
 
8. Rutter M. Resilience, competence, and coping. Child Abuse Negl 
2007;31(3):205–9.  
 
9. Fletcher D, Sarkar M. Psychological resilience: A review and critique 
of definitions, concepts and theory. Eur Psychol 2013;18(1):12–23.  
 
10. Emery RE, Forehand R. Parental divorce and children’s well-being: 
A focus on resilience. In: Haggerty RJ, Sherrod LR, Garmezy N, 
Rutter (eds.). Stress, risk and resilience in children and adolescents 
processes, mechanisms and interventions. Cambridge: Cambridge 
University Press; 1994. p. 66–94.  
 
11. Atwool N. Attachment and resilience: Implications for children in 
care. Child Care Pract 2006;12(4):315–30.  
 
12. Rasmussen PD, Storebø OJ, Løkkeholt T, Gaunø LV, Shmueli-
Goetz Y, Bojesen AB, et al. Attachment as a core feature of 
resilience: A systematic review and meta-analysis. Psychol Rep 2018 
June;33294118785577 
 


“Resilience” – is this the new black in psychiatric health care and prevention?

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