Avoiding conflict assignment

Dennis S. Charney, MD, during his keynote address at the Anxiety Disorders Association of America’s 26th Annual Conference, noted that resilient patients possess the following: ??? A positive attitude ??? Cognitive flexibility ??? A personal moral compass (a set of core beliefs from which they cannot be shaken) ??? A role model to whom they can look up ??? An ability to face their fears ??? Active coping skills ??? A good social network Neuropsychiatry Review http://www. neuropsychiatryreviews. com/aug06/anxious. html (below) Dr.

Charney, a Professor at Mount Sinai School of Medicine in New York City, also discussed the psychobiology of resilience, noting that an interaction between neurotransmitters, neuropeptides, and hormones is known to be involved in the acute psychobiological responses to trauma. This model encompasses the psychobiologic underpinnings of fear, conditioning, reward, social behavior, reconsolidation, and extinction. DEVELOPMENT OF A RESILIENCE SCALE Because there has been an interest in resilience in adult populations, there was a push to develop a measure of resilience in adults.

The only exceptions were the Alcohol Frequency Scale and the Impact of Event Scale. Patients who had a CD-RISC score 1 standard deviation or more above the mean were classified as “ high resilient,” and those who had a CD-RISC score 1 standard deviation or more below the mean were classified as “ low resilient. ” These groups were further divided according to whether patients had a history of childhood abuse or maltreatment. The study found that individuals with high CD-RISC scores even in the face of childhood altreatment had lower scores in terms of symptom severity on all of the other measures. “ There were many limitations to this study, including lack of patients with acute stress or posttraumatic stress disorder. Also, we didn’t include any personality measures or measures of coping style, which are both important when looking at the issue of resilience,” Dr. Mancini said. Patients with a diagnosis of social phobia had lower resilience scores, and resilience scores negatively correlated with a number of severity measures.

Patients who had high resilience scores and were abused as children had significantly lower symptom severity scores. “ Given the multifacets of resilience, it may be important in the future to also include some psychobiological measures when looking at the whole construct,” she said. In addition, future research should examine whether premorbid levels of resilience influence the development or course of the anxiety disorder or whether the development of the anxiety disorder changes resilience.