Resilience has never been more important. In recent years, the world has seen severe threats to society in the form of poverty, inequality, climate disaster, conflict, war, and terrorist attacks. Such adversity can negatively impact individuals in a myriad of ways, and has particularly strong effects on those growing up. Globally, more than half of all children and young people report having experienced some form of adversity whilst growing up. Adversity in childhood is one of the strongest predictors of problems in later life, including (mental) health problems, lower educational attainment, behavioral problems, crime and suicide1, 2. These problems often first emerge in the adolescent time-period. Adolescence is a period of rapid, dynamic change through school transitions, and often the first transition into the workplace. These changes require independence, and bring social and financial responsibilities and expectations. At the same time, adolescents start building their own social network, forging friendships and increasingly stronger and more reciprocal stable social bonds. The influence of peers becomes more and more important for their sense of self, opinions and behavior. As peers are so important, adolescent behavior is in part influenced by a tendency to avoid social rejection from peers3. These social changes coincide with major hormonal and brain developmental changes, with the brain networks that aid the regulation of stress and emotions becoming increasingly more efficient. Due to these major social and neurodevelopmental changes, adolescence can be seen as both a time of opportunity and of increased sensitivity. Sadly, an estimated 13% of young people globally suffer from a mental disorder4. The number of young people with mental health problems has increased in recent years, and particularly so in young people identifying as lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ+). Critically, suicide is a leading cause of death in young people. Mental health issues that arise in adolescence are often more severe and more recurrent and can trigger lifelong trajectories of further mental health problems, absenteeism, economic hardship, violence and crime. The burden of these problems is in a large part borne by youth who grow up in families affected by adversity in the form of poverty or childhood maltreatment5. As such, increasing resilience in young people with childhood adverse experiences should be prioritized as a critical public health priority. To boost resilience, the appropriate conceptualization is an important first step. In child development, the field of resilience science started with the pioneering work of, amongst others, E. Werner, M. Rutter and N. Garmezy. These researchers investigated the etiology of mental illness in children growing up in high-risk environments. One particularly influential study was the Children of Kauai Study led by E. Werner, in which almost 700 babies born in 1955 on the Island of Kauai were studied until age 326. About 200 of these children grew up in families struggling with poverty, discord, mental illness, or criminality. Strikingly, one-third of these children demonstrated academic success, social competence, and mental well-being in both adolescence and adulthood. Werner and colleagues subsequently shifted their attention to studying the factors that had helped these children show such resilience. Over the course of the next 50 years, many studies focusing on resilience in children growing up in difficult circumstances have followed. These studies have often used different ways to quantify resilience. To move the field forward, these conceptualizations have been brought together by a large group of researchers in the “resilience framework”7. In this framework, resilience refers to the dynamic process of maintaining or regaining mental health in response to significant adversity. Protective, or resilience, factors aid an individual's capacity to respond well to stress. Resilience mechanisms refer to the dynamic process of adaptation to stress, such as increased stress regulatory brain activity, lower pro-inflammatory cytokine responses to stress, or the re-appraisal of a stressor. Finally, resilient functioning refers to an outcome of good mental health in the aftermath of stress. Such resilient functioning outcomes are especially important in the context of childhood adversity, where the stressor has already taken place. Resilient functioning should then refer to functioning across a range of (stressor relevant) domains (such as thoughts, feelings, mood and behavior). Such functioning may be examined in comparison to others who have similar experiences, as well-being can be improved (e.g., stress inoculation) or decreased (e.g., stress sensitization, scarring) depending on the type or severity of the stressor experienced. Resilience science focuses on the identification of the protective factors and resilience mechanisms that aid resilient functioning outcomes. Protective or resilience factors are known to reside at multiple biological, psychological and sociocultural levels8. Resilience is aided by internal predispositions (such as genotype, brain structure and function, personality traits, self-efficacy skills, cognitive control of emotions, and executive functioning skills). In addition, there are critical external social and cultural influences that aid a child's capacity to respond well in the aftermath of adversity. Supportive family environments help shape resilience in the face of disaster when caregivers are warm and supportive, have clear routines, rules and expectations, model coping skills, and help build self-efficacy and self-esteem. Schools strengthen resilience in young people by providing structure, social connection, and essential cognitive skills such as language, aspects that are also crucial in the aftermath of crises such as war or environmental disasters. Community support systems aid resilience through access to health care, and by providing the infrastructure for food and safety, but also through societal values and belief systems which can provide hope and meaning. These factors are inextricably intertwined. For example, friendships can help increase self-esteem, and family support can lower stress perceptions and responses. As such, resilient children require resilient families, and are reliant on resilient societies, cultures and policy-making, and these systems influence each other in bidirectional dynamic ways9. Thus, a young person's ability to show resilience to childhood adversity relies on complex and dynamic interactions among a large number of internal and external factors. This explains why we cannot yet, with good accuracy, predict who will show resilience, despite the fact that many protective factors are well known – a phenomenon known as the “resilience paradox”. However, this also means that there are many aspects and nodes in the network that can be investigated and potentially targeted in our efforts to boost resilience in young people. To do so, large scale collaboration and integration across fields are needed to investigate multiple levels of biological and social cultural organization and their temporal dynamics in a longitudinal or prospective manner. In other words, just as it takes a village to raise a child, it takes a village of scientists, clinicians and communities to fully understand and support resilience in young people with a history of adversity.
Anne‐Laura van Harmelen (Fri,) studied this question.