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Issues in Comprehensive Pediatric Nursing, 29:103–125, 2006Copyright © Taylor & Francis Group, LLCISSN: 0146-0862 print / 1521-043X onlineDOI: 10.1080/01460860600677643
103
UCPN0146-08621521-043XIssues in Comprehensive Pediatric Nursing, Vol. 29, No. 2, April 2006: pp. 0–0Issues in Comprehensive Pediatric Nursing
A REVIEW OF INSTRUMENTS MEASURING RESILIENCE
A Review of Instruments Measuring ResilienceN. R. Ahern et al. Nancy R. Ahern, MEd, MSN, RNErmalynn M. Kiehl, PhD, ARNP, CNS
Mary Lou Sole, PhD, RN, CCNS, FAANJacqueline Byers, PhD, RN, CNAA, CPHQ
University of Central Florida School of Nursing, Orlando, Florida
The objectives of the study were to evaluate the psychometric propertiesand appropriateness of instruments for the study of resilience in adoles-cents. A search was completed using the terms resilience and instru-ments or scales using the EBSCO database (CINAHL, PreCINAHL, andAcademic Search Premier), MEDLINE, PsychINFO and PsychARTI-CLES, and the Internet. After instruments were identified, a secondsearch was performed for studies reporting the psychometric developmentof these instruments. Using inclusion and exclusion criteria, six psycho-metric development of instrument studies were selected for a full review.A data extraction table was used to compare the six instruments.
Two of the six instruments (Baruth Protective Factors Inventory[BPFI] and Brief-Resilient Coping Scale) lacked evidence that they wereappropriate for administration with the adolescent population due tolack of research applications. Three instruments (Adolescent ResilienceScale [ARS], Connor–Davidson Resilience Scale, and Resilience Scale forAdults) had acceptable credibility but needed further study in adoles-cents. One instrument (Resilience Scale [RS]) was determined to be thebest instrument to study resilience in the adolescent population due topsychometric properties of the instrument and applications in a variety ofage groups, including adolescence.
Findings of this review indicate that the RS is the most appropriateinstrument to study resilience in the adolescent population. While otherinstruments have potential (e.g., ARS, BPFI) as they were tested in theadolescent and young adult populations, they lack evidence for their use atthis time. An evaluation of the review and recommendations are discussed.
Received 16 January 2006; accepted 26 February 2006.Address correspondence to Nancy R. Ahern, University of Central Florida School of Nursing,
Orlando, FL. E-mail: [email protected]
104 N. R. Ahern et al.
BACKGROUND
Adults have always expressed apprehension regarding adolescent behav-ior that puts them at risk (e.g., sexual behavior, drug experimentation).According to Erikson (1968), the developmental stage of “identity versusrole confusion” often results in risky behaviors in the adolescent. Risk isan essential component (or “factor”) in the formation of identity, as theadolescent “tries on” different roles (Erikson, 1968) (p. 96). Adolescentsparticipate in a variety of risk behaviors that compromise their health andwell-being (Rew & Horner, 2003). Results of the latest National YouthRisk Behavior Survey (Centers for Disease Control and Prevention, CDC,2004) report a variety of student behavior statistics, including alcohol/drug use, sexual behaviors, dietary behaviors, physical activity, andbehaviors contributing to injury. These risk behaviors, which may lead tohigher morbidity and mortality outcomes in middle and high schoolyouth, were reported most frequently in adolescents ages 12 to 17 years(CDC, 2004; Rew & Horner, 2003).
Little is known about how risk-taking and health-promoting behaviorsdevelop during childhood or how these behaviors are related to the health-risk behaviors manifested in adolescence (Rew & Horner, 2003). In addi-tion to risk factors, researchers have documented that protective resourcescan interact with existing risks to influence health-promoting behaviors(Davey, Eaker, & Walters, 2003; Haase, 2004; Hunter, 2001; Rew &Horner, 2003; Rew, Taylor-Sheehafer, Thomas, & Yockey, 2001). Theapproach of protecting youth from harm through a combination of riskreduction and promotion of protective factors has sparked great interest inresiliency-based research (Rutter, 1993).
Resilience is a concept that is viewed as a continuum of adaptation orsuccess (Hunter & Chandler, 1999; Tusaie & Dyer, 2004). The roots ofresilience are found in two bodies of literature: the psychological aspectsof coping and the physiological aspects of stress (Tusaie & Dyer, 2004).Researchers argue that the concept of resilience may be a set of traits(Jacelon, 1997), an outcome (Olsson, Bond, Burns, Vella-Brodrick, &Sawer, 2003; Vinson, 2002), or a process (Olsson et al., 2003). Resilienceis most often considered a personality characteristic that moderates thenegative effects of stress and promotes adaptation. Resilience is furtherdefined as the ability to successfully cope with change or misfortune(Wagnild & Young, 1993).
Several researchers and scholars have generated theories and devel-oped frameworks related to resilience. Polk (1997) developed a middlerange theory for this concept. More recently, Rew and Horner (2003)
A Review of Instruments Measuring Resilience 105
developed the Youth Resilience Framework to address individual andsociocultural risk factors and protective resources that enhance or hamperpositive and negative health outcomes in adolescence. Resilience repre-sents the interaction between risk factors (vulnerability) and protectiveresources (protection). Interventions to improve health outcomes are aimedat enhancing resiliency in the effort to decrease high-risk behaviors.
The Adolescent Resilience Model has been proposed by Haase andcolleagues (Haase, 2004; Haase, Heiney, Ruccione, & Stutzer, 1999). Thismodel was developed through triangulation research of adolescents withchronic illness, especially cancer. The components of this model includeindividual protective factors (courageous coping, hope and spiritualperspective), family protective factors (family atmosphere and family sup-port and resources), and social protective factors (health resources and socialintegration). According to the researchers, the outcome factors depicted bythe model include resilience (self-esteem, self-transcendence, and confi-dence/mastery) and quality of life (sense of well-being) (Haase et al., 1999).
Empirical evidence has thus led to the development of models of resil-ience and instruments that operationalize the concept. Resilience has enor-mous utility for nursing, as it has been demonstrated that resilientindividuals are individuals who have positive outcomes in the face ofadversity (Rew & Horner, 2003). An understanding of resilient character-istics and the processes that enhance resilience in individuals can enablenurses to promote such behaviors during life transitions and periods ofadversity. Reliable and valid instruments are necessary to assess resilience.
METHODS
Objective of the Review
A review was undertaken to identify instruments that measure resilience.The instruments were evaluated for their psychometric properties andappropriateness for the study of resilience in adolescents.
Key Questions
The research questions to be considered in the review included the following:
1. What instruments are available that measure resilience?2. What are the psychometric properties of the identified instruments?3. What are the applications of the instruments?4. Which instrument is most appropriate to measure resilience in the
adolescent population?
106 N. R. Ahern et al.
Inclusion and Exclusion Criteria
Based on these key questions, a list of inclusion and exclusion criteriawere developed (Table 1). Although adolescents are the target popula-tion, it was decided to evaluate instruments studied in all populations.All criteria had to be met in order for the study to be included in thereview.
Literature Search and Retrieval Process
A variety of search strategies were used to identify relevant studies for thesystematic review (Table 2). Search terms included Resilience AND ScaleOR Instrument. Limiters (where possible) included English language ANDhuman. PsychINFO and PsychARTICLES were searched to find studiesin the field of psychology, as many of the studies were conducted in this
Table 1. Literature searches: Inclusion and exclusion criteria
Inclusion Criteria Exclusion Criteria
1. Study population• All races, cultural, and ethnic groups• Individuals of any age
1. The study contains no original data.2. The study did not measure resilience, or a
construct of resilience, in study participants3. The study did not include the items from the
instrument.4. The article or manuscript could not be
retrieved.
2. Study settings• Any types of settings
3. Time period• Published from 1980 to present
4. Publication criteria• English only• Articles in print and unpublished manuscripts
identified that could be retrieved from the original author
5. Admissible criteria (study design and other criteria)• Original research study of the psychometric
development and/or evaluation of the instrument
• Study included presentation of instrument items• Eligible research studies include:
All types of study designsMinimum sample size of at least 50If longitudinal study, retention ≥ 70%When several studies from the same
research data were published, the original psychometric study was included.
A Review of Instruments Measuring Resilience 107
discipline. Secondly, the EBSCO database was searched to locate studiesin CINAHL, PreCINAHL, and Academic Search Premier. MEDLINEalso was searched for additional studies. The majority of articles werefound in this first search, with mainly duplications occurring when usingthe latter search strategies. Once original psychometric development stud-ies were retrieved, author names, instrument or scale names, and journalnames were searched for studies using the resilience instruments/scales.Lastly, an Internet search was made that only resulted in duplications. Notevident in the search are the attempts made to retrieve “gray” literature(e.g., unpublished sources or literature not available through usual biblio-graphic sources or databases). Where applicable, dissertation abstractswere located and attempts were made to contact the authors (n = 3). Inaddition, one author was contacted for further clarification on the instru-ment’s format, and requests for unpublished manuscripts were made (seeFigure 1).
An Evaluation of Quality and Strength of Evidence
One reviewer evaluated the study abstracts using the inclusion and exclu-sion criteria previously defined. The main reasons for exclusion includedno original data (50%), no reliability and/or validity values (8%), loss oftoo many study subjects during a longitudinal study (3%), and not being
Table 2. Literature search strategy: Yield and final article count
Database and search strategy
Total references identified
Articles excluded
Articles retained forfull review
Articles rejected after fullreview
Articlesincluded insystematic
review
PsychINFO and PsychARTICLES
123 110 13 8 5
EBSCO (CINAHL, PreCINAHL, AcademicSearch Premier)
181 173 8 7 1
MEDLINE 45 43 2 2 0Journal searches 3 3 0 0 0Author searches 18 9 9 9 0Internet—Google
search engine0 duplicates 0 0 0 0
Totals 370 338 32 26 6
Note: Numbers retained for review reflect deletion of duplications.
108 N. R. Ahern et al.
able to retrieve the article due to lack of response by the original author(e.g., dissertations and unpublished manuscripts; 39%).
Six psychometric development studies were selected for the in-depthreview. All of the studies retained for review were quantitative studiesthat described the initial psychometric development of the individual
Figure 1. Flow diagram of study selection process.
Key Search Terms = Resilience and Scales/Instruments
Limiters = English language and humans
Potentially relevant citations identified after screening of databases
(CINAHL, PreCINAHL, Academic Search Premier; PsychINFO,
PsychARTICLES; MEDLINE; 3 Journals; and 6 Authors) (n=370)
Citations excluded due to not being available
by study completion &/or did not meet
inclusion criteria (n=338)
Studies retrieved for more detailed
review (n=32)
Studies rejected after a full review due to not
completely meeting inclusion criteria (n=26)
Relevant studies included in
Systematic Review (n=6):
Baruth & Carroll, 2002
Connor & Davidson, 2003
Friborg et al., 2003
Oshio et al., 2003
Sinclair & Wallston, 2004
Wagnild & Young, 1993
tiAdditional studies reviewed for
application of instrument/scale
(n=23)
A Review of Instruments Measuring Resilience 109
instrument. The number of study participants ranged from 59 to 810.Target populations ranged from undergraduate students (n = 2) to adults(n = 4) in general and clinical populations. The majority of the studysubjects were female. The variety of ethnic backgrounds includedWhites, Norwegians, Japanese, and multiethnic groups (one did notreport specific ethnicity). One study was longitudinal (another used alongitudinal piece for the control group), and only one study usedcontrols. All of the instruments evaluated were self-report scales (e.g.,Likert, n = 5, and Semantic Differential, n = 1), which included reliabil-ity and validity values.
RESULTS
Data Extraction
Studies were reviewed with a data extraction coding tool. Table 3 dis-plays the categories of data extracted and related data for each of the sixstudies. All of the studies measured the construct of resilience eitherdirectly or indirectly. While only two studies designated a specific theo-retical basis, the remaining authors attributed their framework to resil-ience in some form. All studies included the full instrument and manyincluded scoring interpretations. Psychometric properties, such as norm-ing, scaling, reliability, and validity values, were reported in all of thestudies, many of which were within acceptable limits. When the reliabil-ity and validity values were minimal or unacceptable, this was addressedby the authors. In addition to reliability and validity calculations, descrip-tive statistics to describe the sample and/or further define the instrumentwere available, as were factor analyses. A discussion of the advantagesand disadvantages of the instrument and instrument application furtherassisted in the review of each of the instruments. The following sectioncontains a summary of the instruments reviewed.
Baruth Protective Factors Inventory
The Baruth Protective Factors Inventory (BPFI) is a 16-item 5-point (1–5)Likert Scale. The BPFI measures the construct of resilience by assessingfour primary protective factors: adaptable personality, supportive envi-ronments, fewer stressors, and compensating experiences. The authorsstate that the reliability and validity of the BPFI will need further testing,as the scale is refined further (Baruth & Carroll, 2002). There are noapplications of the BPFI in the literature.
110
Tab
le 3
.D
ata
extr
acti
on a
nd e
valu
atio
n of
the
inst
rum
ents
mea
suri
ng r
esili
ence
Inst
rum
ent
nam
e
Bar
uth
Pro
tect
ive
Fac
tors
Inv
ento
ry(B
PF
I)
Con
nor–
Dav
idso
nR
esili
ence
Sca
le(C
D-R
ISC
)
Res
ilien
ce S
cale
fo
r A
dult
s (R
SA)
Ado
lesc
ent
Res
ilien
ce S
cale
(AR
S)
Bri
ef-R
esili
ent
Cop
ing
Scal
e(B
RC
S)R
esili
ence
Sc
ale
(RS)
Aut
hor(
s)B
arut
h &
Car
roll,
20
02C
onno
r &
Dav
idso
n,
2003
Fri
borg
et a
l., 2
003
Osh
io, K
anek
o,
Nag
amin
e, &
N
akay
a, 2
003
Sin
clai
r &
Wal
lsto
n,20
04W
agni
ld &
You
ng,
1993
Dom
ain
or
cons
truc
t m
easu
red
Prot
ectiv
e fa
ctor
s th
at
supp
ort r
esili
ency
Ps
ycho
met
ric
deve
lopm
ent o
f in
stru
men
t
Res
ilien
ce a
s a
mea
sure
of
suc
cess
ful s
tres
s-co
ping
abi
lity
Psy
chom
etri
c de
velo
p-m
ent o
f in
stru
men
t
Cen
tral
pro
tect
ive
reso
urce
s of h
ealth
y ad
just
men
tPs
ycho
met
ric
deve
lopm
ent o
f in
stru
men
t
Ado
lesc
ent
resi
lienc
eC
onst
ruct
va
lidity
of
the
AR
S
Res
ilien
t cop
ing
beha
vior
s P
sych
omet
ric
eval
ua-
tion
of in
stru
men
t
Res
ilien
ce a
s a
posi
tive
pers
onal
ity
char
acte
rist
ic th
at
enha
nces
indi
vidu
al
adap
tatio
n P
sych
omet
ric
deve
lopm
ent o
f in
stru
men
tT
heor
etic
al b
asis
Res
earc
h su
ppor
t of
four
pro
tect
ive
fact
ors:
ada
ptiv
e pe
rson
ality
, sup
port
-iv
e en
viro
nmen
t, fe
wer
str
esso
rs, a
nd
com
pens
atin
g ex
peri
ence
s
Str
ess,
cop
ing,
and
ad
apta
tion
rese
arch
Adj
ustm
ent a
nd
cohe
renc
eR
esea
rch
supp
ort
of r
esili
ence
Pol
k’s
mid
dle
rang
e th
eory
of
resi
lienc
eR
esea
rch
supp
ort o
f the
co
nstr
uct o
f re
silie
nce
Tar
get p
opul
atio
n•
Num
ber
•A
ge•
Gen
der
•E
thni
city
Und
ergr
adua
te
psyc
holo
gy s
tude
nts
98 19–5
4 ye
ars
(pre
dom
inan
tly
youn
g)19
mal
e, 7
9 fe
mal
em
ultie
thni
c
Mul
ti-st
udy
sam
ple:
ge
nera
l pop
ulat
ion
(n =
577
), p
rim
ary
care
out
pati
ents
(n
= 1
39),
psyc
hiat
ric
outp
atie
nts
in
priv
ate
prac
tice
(n =
43)
, sub
ject
s in
a
stud
y on
gen
eral
ized
an
xiet
y di
sord
er
(n =
25)
,
Patie
nts
from
an
adul
t ou
tpat
ient
clin
ic59 M
ales
(n
= 1
4) a
ges
19 to
75
(mea
n =
33
.7);
fem
ales
(n
= 4
5) a
ges
18 to
75
(m
ean
= 3
6.2)
Und
ergr
adua
te
stud
ents
207
104
Mal
es10
3 Fe
mal
esA
ges
19 to
23
(mea
n =
20.
2 ye
ars)
Japa
nese
sam
ple
Tw
o sa
mpl
es o
f ad
ults
with
rhe
u-m
atoi
d ar
thri
tis
Gro
up 1
—90
fe
mal
es G
roup
2—
140
mal
es
and
fem
ales
G
roup
1—
mea
n ag
e 46
yea
rs G
roup
2—
57.8
yea
rs
Eth
nici
ty n
ot r
epor
ted
Ran
dom
sam
ple
of
read
ersh
ip o
f se
nior
ci
tizen
per
iodi
cal
810
adu
lts
Age
ran
ge—
53–9
5 (m
ean
= 7
1.1)
62.3
% f
emal
eC
auca
sian
(n
= 7
96)
Asi
an (
n =
7)
Eth
nici
ty n
ot
repo
rted
(n
= 7
)
111
subj
ects
in 2
clin
ical
tr
ials
on
post
-tra
umat
ic
stre
ss d
isor
der (
n =
22,
n
= 2
2) (
last
gro
up
only
use
d fo
r pa
rtia
l co
mpa
riso
ns; o
ther
gr
oups
tota
l n =
806
)M
ajor
ity f
emal
eM
ajor
ity w
hite
Nor
mal
con
trol
s (r
ando
mly
sele
cted
) co
nsis
ted
of 1
28
mal
es (
mea
n ag
e 37
.1)
and
162
fem
ales
(m
ean
age
35.6
)N
orw
egia
n sa
mpl
e
Stud
y se
ttin
gU
nive
rsit
yM
ulti
site
Adu
lt p
sych
iatr
ic
outp
atie
nt c
linic
an
d co
ntro
ls
Uni
vers
ityN
ot r
epor
ted
Mai
led
surv
ey
Stu
dy ty
pe a
nd
desi
gnQ
uant
itativ
e, e
xplo
r-at
ory,
psy
chom
etri
c de
velo
pmen
t
Qua
ntita
tive,
exp
lor-
ator
y, p
sych
omet
ric
deve
lopm
ent
Qua
ntita
tive,
qu
asi-
expe
rim
enta
l, lo
ngit
udin
al
com
pone
nt f
or
cont
rols
onl
y,
psyc
hom
etri
c de
velo
pmen
t
Qua
ntit
ativ
e,
expl
orat
ory,
ps
ycho
met
ric
deve
lopm
ent
Qua
ntita
tive
, lon
gitu
-di
nal,
psyc
hom
et-
ric
deve
lopm
ent
Qua
ntita
tive
,qu
asi-
expe
rim
enta
l, ps
ycho
met
ric
deve
lopm
ent
Len
gth
of
foll
ow-u
pN
/AN
/A4
mon
ths
for
cont
rol
grou
pN
/A3
mon
ths
N/A
Dro
p ou
tsno
neno
neR
espo
nse
rate
s fo
r bo
th g
roup
s re
port
ed
none
none
Res
pons
e ra
te r
epor
ted
Mis
sing
dat
aN
ot r
epor
ted
Mis
sing
dat
a av
aila
ble
for
gend
er a
nd e
thni
c st
atus
Not
rep
orte
dN
ot r
epor
ted
Not
rep
orte
dN
ot r
epor
ted
Num
ber
of it
ems
1625
3721
425
(Con
tinu
ed)
112
Tab
le 3
.D
ata
extr
acti
on a
nd e
valu
atio
n of
the
inst
rum
ents
mea
suri
ng r
esili
ence
(C
ontin
ued)
Inst
rum
ent
nam
e
Bar
uth
Pro
tect
ive
Fac
tors
Inv
ento
ry(B
PF
I)
Con
nor–
Dav
idso
nR
esili
ence
Sca
le(C
D-R
ISC
)
Res
ilien
ce S
cale
fo
r A
dult
s (R
SA)
Ado
lesc
ent
Res
ilien
ce S
cale
(AR
S)
Bri
ef-R
esili
ent
Cop
ing
Scal
e(B
RC
S)R
esili
ence
Sc
ale
(RS)
Psyc
hom
etri
c Pr
oper
ties
•Sc
alin
gFi
vepo
int L
iker
t Sca
leFi
vepo
int L
iker
t Sca
leN
ot in
dica
ted
Five
poin
t rat
ing
scal
eF
ivep
oint
rat
ing
skil
lS
even
poin
t Lik
ert s
cale
•D
imen
sion
alit
yFa
ctor
ana
lysi
s yi
elde
d 3
subs
cale
sFa
ctor
ana
lysi
s yi
elde
d 5
subs
cale
sFa
ctor
ana
lysi
s yi
elde
d 5
subs
cale
sFa
ctor
ana
lysi
s yi
elde
d 3
subs
cale
s
Uni
dim
ensi
onal
A
fac
tor
anal
ysis
did
no
t sup
port
mul
ti-di
men
sion
ality
of
the
scal
e
Fac
tor
anal
ysis
yie
lded
2
subs
cale
s
•N
orm
ing
Rep
orte
d w
ith th
is
orig
inal
psy
chom
et-
ric
deve
lopm
ent
Rep
orte
d w
ith th
is
orig
inal
psy
chom
etri
c de
velo
pmen
t
Rep
orte
d w
ith th
is
orig
inal
psy
chom
et-
ric
deve
lopm
ent
Rep
orte
d w
ith
this
inst
ru-
men
t dev
elop
-m
ent b
ut n
ot
desc
ribe
d
Rep
orte
d w
ith
this
ori
gina
l ps
ycho
met
ric
deve
lopm
ent
Rep
orte
d w
ith th
is
orig
inal
psy
chom
et-
ric
deve
lopm
ent
•A
dmin
istr
atio
n pr
oced
ure
Dir
ectio
ns f
or
com
plet
ion
Not
des
crib
edN
ot d
escr
ibed
Not
des
crib
edD
irec
tion
s fo
r co
mpl
etio
nD
irec
tion
s fo
r co
mpl
etio
n•
Scor
ing
proc
edur
eC
ombi
ne s
core
s of
all
item
s; h
ighe
r sc
ore
equa
ls h
ighe
r re
sil-
ienc
y fo
r to
tal s
cale
an
d su
bsca
les
Com
bine
sco
res
of a
ll it
ems;
hig
her
scor
e eq
uals
hig
her
resi
l-ie
nce
Not
des
crib
edT
otal
sca
le s
core
an
d su
bsca
le
scor
es o
btai
ned
by c
alcu
latin
g m
eans
Not
des
crib
edC
ombi
ne s
core
s of
all
ite
ms;
hig
her
scor
e eq
uals
hig
her
resi
lienc
e
113
•R
elia
bilit
yIn
tern
al c
onsi
sten
cy
for
tota
l sca
le
Cro
nbac
h’s
Alp
ha
(.83
) an
d su
bsca
les
(ada
ptiv
e pe
rson
al-
ity
.76,
sup
port
ive
envi
ronm
ent .
98,
few
er s
tres
sors
.55,
an
d co
mpe
nsat
ing
expe
rien
ces
.83)
us
ing
Inte
rnal
con
sist
ency
for
fu
ll sc
ale
Cro
nbac
h’s
Alp
ha .8
9 fo
r gr
oup
1 an
d ite
m-t
otal
cor
rela
-ti
ons
rang
ed f
rom
.30
to .7
0 T
est-
rete
st r
elia
bilit
y as
sess
ed fr
om s
ubje
cts
in g
roup
s fo
ur a
nd fi
ve
with
intr
acla
ss
corr
elat
ion
coef
fici
ent o
f .8
7
Inte
rnal
con
sist
ency
fo
r (C
ronb
ach’
s al
pha)
of
all
cont
rast
sca
les
indi
cate
ade
quat
e ps
ycho
met
ric
prop
erti
es.
Inte
rnal
con
sis-
tenc
y of
sub
scal
es
rang
ed f
rom
0.6
7 to
0.9
0.
Inte
rnal
con
sis-
tenc
y am
ong
all f
acto
rs o
f th
e A
RS
(r =
.72
to .7
5 fo
r su
bsca
le
rang
e)
Inte
rnal
con
sist
ency
fo
r C
ronb
ach’
s al
pha
relia
bilit
y fo
r th
e sc
ale
was
co
mpu
ted
for
grou
p 1
as 6
4 (f
irst
bas
elin
e), .
76
(sec
ond
base
line
),
.69
(end
of
inte
r-ve
ntio
n), a
nd .7
1 (3
mon
th
follo
w-u
p).
Aut
hors
cite
acc
epta
ble
relia
bilit
y fr
om
prev
ious
stu
dies
us
ing
the
RS
Rel
iabi
lity
coe
ffic
ient
al
pha
of .9
1 It
em-t
o-it
em
corr
elat
ions
ran
ged
from
.37
to .7
5 (m
ajor
ity b
etw
een
.50
and
.70,
p ≤
.001
Tes
t-re
test
cor
rela
-ti
ons
satis
fact
ory
for
subs
cale
s ra
ng-
ing
from
0.6
9 to
0.
84 (
p <
0.0
1)
Item
-tot
al c
orre
latio
ns
for
subs
cale
s: p
er-
sona
l com
pete
nce
(0.5
1 to
0.7
5),
soci
al c
ompe
tenc
e (0
.48
to 0
.74)
, fa
mily
coh
eren
ce
(0.5
6 to
0.7
4),
soci
al s
uppo
rt
(0.4
3 to
0.7
0), a
nd
pers
onal
str
uctu
re
(0.3
7 to
0.4
8)
Cro
nbac
h’s
alph
a re
liabi
lity
for
the
scal
e w
as c
om-
pute
d fo
r gr
oup
2 as
.68.
P
oole
d sa
mpl
e al
pha
was
.69
Tes
t-re
test
rel
iabi
lity
for
grou
p 1
was
.7
1 (n
= 8
7,
p <
.001
) du
ring
ba
selin
e an
d .6
8 (n
= 8
3, p
<. 0
01)
at 3
mon
ths
foll
ow-u
p
(Con
tinu
ed)
114
Tab
le 3
.D
ata
extr
acti
on a
nd e
valu
atio
n of
the
inst
rum
ents
mea
suri
ng r
esili
ence
(C
ontin
ued)
Inst
rum
ent
nam
e
Bar
uth
Pro
tect
ive
Fac
tors
Inv
ento
ry(B
PF
I)
Con
nor–
Dav
idso
nR
esili
ence
Sca
le(C
D-R
ISC
)
Res
ilien
ce S
cale
for
Adu
lts
(RSA
)
Ado
lesc
ent
Res
ilien
ce S
cale
(AR
S)
Bri
ef-R
esili
ent
Cop
ing
Scal
e(B
RC
S)R
esili
ence
Sc
ale
(RS)
• V
alid
ityC
onte
nt v
alid
ity—
expe
rt
Con
stru
ct v
alid
ity—
esta
blis
hed
by c
om-
pari
son
with
oth
er
esta
blis
hed
tool
s to
de
term
ine
corr
ela-
tions
of
subs
cale
s
Con
verg
ent a
nd d
iscr
im-
inan
t val
idity
wer
e as
sess
ed b
y co
rrel
atin
g th
e sc
ores
of
this
sca
le
wit
h ot
her
mor
e es
tab-
lish
ed in
stru
men
ts
Con
verg
ent v
alid
ity—
pres
ent
Dis
crim
inan
t val
idit
y—no
t pre
sent
Con
stru
ct v
alid
ity
repo
rted
as
high
(n
o st
atis
tics
re
port
ed)
Dis
crim
inan
t val
idity
w
as in
dica
ted
by
diff
eren
tial p
osi-
tive
cor
rela
tions
be
twee
n sc
ale,
the
Sen
se o
f C
oher
-en
ce S
cale
, and
the
Hop
kins
Sym
ptom
C
heck
list
Coe
ffic
ient
s al
pha
for
tota
l sc
ale
scor
e .8
5; s
ubsc
ales
N
ovel
ty s
eek-
ing
(.75
),
emot
iona
l reg
-ul
atio
n (.
77),
po
sitiv
e fu
ture
or
ient
atio
n (.
81)
Con
stru
ct
valid
ity w
as
repo
rted
with
co
mpa
riso
n of
m
ean
scor
es to
th
ose
of tw
o ot
her
esta
b-lis
hed
scal
es
Con
tent
val
idity
—pa
nel o
f ex
pert
sP
redi
ctiv
e va
lidity
re
port
ed th
at th
e B
RC
S s
core
s co
rrel
ated
in th
eo-
retic
ally
pre
dict
ed
dire
ctio
ns w
ith
scor
es f
rom
a
vari
ety
of o
ther
m
easu
res
A p
rior
i con
tent
val
idity
(d
urin
g co
nstr
uctio
n of
sca
le, i
tem
s w
ere
sele
cted
that
re
flec
ted
gene
rall
y ac
cept
ed d
efin
itio
ns
of r
esili
ence
fro
m
inte
rvie
ws
with
re
silie
nt in
divi
dual
s an
d w
ith a
n ex
pert
pa
nel)
A
utho
rs c
ite a
ccep
tabl
e va
lidity
fro
m p
revi
-ou
s st
udie
s us
ing
the
RS
Con
curr
ent v
alid
ity
supp
ort w
as s
how
n by
hig
h co
rrel
atio
ns
of th
e R
S w
ith
wel
l-es
tabl
ishe
d va
lid m
easu
res
of
the
cons
truc
ts li
nked
w
ith r
esil
ienc
e an
d ou
tcom
es o
f re
silie
nce
(dep
res-
sion
r =
−.3
7), l
ife
sati
sfac
tion
(r =
.30)
, m
oral
e (r
= .2
8), a
nd
heal
th (
r =
−.2
6)
115
Stud
y re
sults
The
rel
iabi
lity
and
valid
ity
of th
e sc
ale
need
to b
e fu
rthe
r in
vest
igat
ed to
in
sure
the
accu
racy
an
d pr
ecis
ion
of th
e sc
ale
in th
e as
sess
-m
ent o
f pr
otec
tive
fact
ors
The
sca
le d
emon
stra
ted
good
psy
chom
etri
c pr
oper
ties
with
a f
ac-
tor
anal
ysis
yie
ldin
g 5
fact
ors.
Sca
le
dem
onst
rate
s th
at
resi
lienc
e is
m
odif
iabl
e an
d ca
n im
prov
e w
ith
trea
tmen
t.
The
sca
le m
ay b
e us
ed a
s a
vali
d an
d re
liabl
e m
easu
re-
men
t in
heal
th a
nd
clin
ical
psy
chol
-og
y to
ass
ess
the
pres
ence
of
prot
ec-
tive
fac
tors
impo
r-ta
nt to
reg
ain
and
mai
ntai
n m
enta
l he
alth
.
The
sca
le c
or-
rect
ly re
flec
ts
psyc
holo
gica
l fe
atur
es o
f in
divi
dual
s w
ho s
how
re
silie
nce
afte
r fa
cing
neg
a-tiv
e lif
e ev
ents
.
The
sca
le d
emon
-st
rate
d to
pos
sess
ad
equa
te re
liabi
lity
and
valid
ity. T
he
BC
RS
may
be
use-
ful f
or id
entif
ying
in
divi
dual
s in
nee
d of
inte
rven
tions
de
sign
ed to
en
hanc
e re
silie
nt
copi
ng s
kill
s
The
stu
dy s
uppo
rts
the
inte
rnal
con
sist
ency
re
liabi
lity
and
con-
curr
ent v
alid
ity o
f th
e R
S as
an
inst
ru-
men
t to
mea
sure
re
silie
nce.
Inst
rum
ent
adva
ntag
esT
he s
cale
can
be
usef
ul
for
educ
ator
s an
d co
unse
lors
(w
ith
furt
her
refi
nem
ent
of th
e sc
ale)
. Pr
esen
ce o
f re
vers
ed
scor
ed it
ems
Tes
ted
in g
ener
al p
opu-
lati
on a
nd in
cli
nica
l sa
mpl
es
Goo
d in
tern
al c
onsi
s-te
ncy
and
test
-ret
est
relia
bilit
y V
alid
ity d
emon
stra
ted
with
oth
er m
easu
res
of
stre
ss a
nd h
ardi
ness
re
flec
ting
dif
fere
nt
leve
ls o
f re
silie
nce
4 ite
m L
iker
t-fo
rced
re
spon
se to
pos
itive
or
neg
ativ
e
Goo
d co
nstr
uct a
nd
disc
rim
inan
t va
lidi
ty
Pres
ence
of
reve
rsed
sc
ored
item
s
Res
ults
sup
port
th
e co
nstr
uct
of a
dole
scen
t re
silie
nce
Eas
y to
adm
inis
ter
(4 it
ems)
S
uffi
cien
t int
erna
l co
nsis
tenc
y an
d st
abili
ty f
or a
4-
item
sca
leS
cale
can
eas
ily b
e ad
min
iste
red
mul
tiple
tim
es in
a
long
itud
inal
stu
dy
Mul
tiple
app
licat
ions
of
the
scal
e in
bot
h se
xes,
mul
tiple
age
s,
and
ethn
ic g
roup
s w
ith g
ood
relia
bilit
y an
d va
lidity
are
av
aila
ble.
Inst
rum
ent
disa
dvan
tage
sO
ther
fac
tors
not
m
easu
red
can
affe
ct
resi
lienc
e R
elia
bilit
y an
d va
lid-
ity n
eed
furt
her
inve
stig
atio
n C
anno
t gen
eral
ize
find
ings
to a
ll ag
es
and
ethi
c gr
oups
Ass
esse
s ch
arac
teri
stic
s of
res
ilien
ce b
ut d
oes
not a
sses
s th
e re
sil-
ienc
y pr
oces
sL
ack
of a
dmin
istr
atio
n pr
oced
ure
desc
ript
ion
and
deta
iled
sco
ring
pr
oced
ure
No
reve
rsed
sco
red
item
s (r
isk
for
ratin
g bi
as)
Que
stio
nabl
e ex
tern
al
relia
bilit
y of
sca
le
due
to n
on-r
ando
m
sam
ple
and
low
re
spon
se ra
te
Find
ings
may
be
only
ge
nera
lizab
le to
N
orw
egia
n ad
ults
se
ekin
g ps
ychi
atri
c tr
eatm
ent
Find
ings
onl
y ge
nera
lizab
le
to J
apan
ese
adol
esce
nts
One
pub
lish
ed
appl
icat
ion
of
inst
rum
ent (
in
Japa
nese
)
Scal
e m
eets
min
imal
re
liabi
lity
stan
dard
s (.7
0) S
cale
bre
vity
(4
item
s) c
an a
ffec
t in
tern
al c
onsi
sten
cy
Lac
k of
adm
inis
trat
ion
proc
edur
e de
scri
p-tio
n an
d de
taile
d sc
orin
g pr
oced
ure
Tes
t-re
test
rel
iabi
lity
need
s fu
rthe
r ev
alua
tion
Initi
al w
ordi
ng o
f ite
ms
wer
e co
mpi
led
from
wom
en’s
st
atem
ents
onl
y Fu
rthe
r pilo
ting
of it
em
wor
ding
is n
eede
d
(Con
tinu
ed)
116
Tab
le 3
.D
ata
extr
acti
on a
nd e
valu
atio
n of
the
inst
rum
ents
mea
suri
ng r
esili
ence
(C
ontin
ued
)
Inst
rum
ent
nam
e
Bar
uth
Pro
tect
ive
Fac
tors
Inv
ento
ry(B
PF
I)
Con
nor–
Dav
idso
nR
esili
ence
Sca
le(C
D-R
ISC
)
Res
ilien
ce S
cale
fo
r A
dult
s(R
SA)
Ado
lesc
ent
Res
ilien
ce S
cale
(AR
S)
Bri
ef-R
esili
ent
Cop
ing
Scal
e(B
RC
S)R
esili
ence
Sc
ale
(RS)
Poss
ibly
sm
all
sam
ple
size
Lac
k of
adm
inis
trat
ion-
proc
edur
e de
scri
p-tio
n an
d de
taile
d sc
orin
g pr
oced
ure
Lac
k of
adm
inis
tra-
tion
pro
cedu
re
desc
ript
ion
and
deta
iled
sco
ring
pr
cedu
re
No
reve
rsed
sco
red
item
s (r
isk
for
ratin
g bi
as)
Lac
k of
adm
in-
istr
atio
n pr
oced
ure
desc
ript
ion
and
deta
iled
scor
ing
proc
edur
e
No
reve
rsed
sco
red
item
s (r
isk
for
rati
ng b
ias)
Que
stio
nabl
e as
to
whe
ther
the
cons
truc
t is
uni
dim
ensi
onal
or
mul
tidim
ensi
onal
Lac
k of
adm
inis
trat
ion-
proc
edur
e de
scri
p-tio
n an
d de
taile
d sc
orin
g pr
oced
ure
No
reve
rsed
sco
red
item
s (r
isk
for
ratin
g bi
as)
App
licat
ions
for
us
e of
the
mea
sure
men
t in
stru
men
t
Scal
e m
ay b
e us
eful
fo
r ed
ucat
ors
and
coun
selo
rs
No
stud
ies
usin
g in
stru
men
t rep
orte
d in
the
liter
atur
e
Des
igne
d fo
r us
e w
ith
in m
enta
l hea
lth
clin
ical
site
s T
hree
app
licat
ions
in th
e lit
erat
ure
(men
tal
heal
th)
Ass
essm
ent o
f po
st-t
raum
atic
str
ess
diso
rder
(C
onno
r &
D
avid
son,
200
1)Po
st-t
raum
atic
str
ess
diso
rder
(D
avid
son,
P
ayne
, & C
onno
r,
2005
)T
reat
men
t of
anxi
ety
diso
rder
s (P
olla
ck,
Mur
ray,
& D
avid
son,
20
04)
One
app
lica
tion
in
the
liter
atur
e w
ith
the
sam
e sa
mpl
e po
pula
tion
and
pri
-m
ary
auth
orR
esili
ence
, pe
rson
alit
y, a
nd
inte
llige
nce:
co
nver
gent
and
di
scri
min
ate
vali
d-it
y w
ell s
uppo
rted
; lo
wer
rel
iabi
lity
than
pre
viou
sly
supp
orte
d (F
ribo
rg, B
arla
ng,
Mar
tinu
ssen
, R
osen
ving
e, &
H
jem
dal,
2005
)
Has
onl
y be
en
used
with
the
sam
e po
pula
-tio
n w
ith o
ne
appl
icat
ion
in
the
liter
atur
e (b
y th
e sa
me
auth
or a
nd
only
ava
ilabl
e in
Jap
anes
e)
May
be
easy
to u
se
(due
to li
mite
d ite
ms)
, esp
ecia
lly
in th
e cl
inic
al
men
tal-
heal
th
setti
ngN
o ap
plic
atio
ns o
f us
e in
the
liter
atur
e
Num
erou
s ap
plic
atio
ns
in th
e lit
erat
ure,
in
clud
ing
both
sex
es
and
all a
ges,
and
et
hnic
gro
ups
Rus
sian
imm
igra
nts:
re
liabi
lity
88;
cons
truc
t val
idity
.4
6–.8
1 (A
rori
an &
N
orri
s, 2
000)
P
sych
omet
ric
eval
uatio
n of
the
Rus
sian
ver
sion
RA
: in
tern
al c
onsi
sten
cy
.87
(Aro
ian,
Sc
happ
ler-
Mor
ris,
N
eary
, Spi
tzer
, &
Tra
n, 1
997)
117
Ado
lesc
ent m
othe
rs:
Cro
nbac
h’s
alph
a re
liabi
lity
.85
(Bla
ck
& F
ord-
Gilb
oe, 2
004)
Ir
ish
imm
igra
nts
(Chr
isto
pher
, 200
0)R
esili
ence
and
old
er
wom
en (
Fel
ten
&
Hal
l, 20
01)
Alz
heim
er f
amily
car
e-gi
vers
(G
arit
y, 1
997)
Mex
ican
wom
en a
nd
depr
essi
on: i
nter
nal
cons
iste
ncy
reli
abil-
ity
.90–
.92,
mod
ifie
d ve
rsio
n .7
4–.7
7(H
eile
man
n, L
ee, &
K
ury,
200
2)
Psy
chom
etri
c ev
alua
-tio
n of
Spa
nish
ve
rsio
n of
RS
: C
hron
bach
’s a
lpha
.9
3 (H
eile
man
n,
Lee
, & K
ury,
200
3)S
helte
red
batte
red
wom
en: C
hron
-ba
ch’s
alp
ha .9
4 (H
umph
reys
, 200
3)A
dole
scen
ts: a
lpha
co
effi
cien
t .72
(H
unte
r &
C
hand
ler,
199
9)
(Con
tinu
ed)
118
Tab
le 3
.D
ata
extr
acti
on a
nd e
valu
atio
n of
the
inst
rum
ents
mea
suri
ng r
esili
ence
(C
ontin
ued)
Inst
rum
ent
nam
e
Bar
uth
Pro
tect
ive
Fac
tors
Inv
ento
ry(B
PF
I)
Con
nor–
Dav
idso
nR
esili
ence
Sca
le(C
D-R
ISC
)
Res
ilien
ce S
cale
fo
r A
dult
s (R
SA)
Ado
lesc
ent
Res
ilien
ce S
cale
(AR
S)
Bri
ef-R
esili
ent
Cop
ing
Scal
e(B
RC
S)R
esili
ence
Sc
ale
(RS)
Low
inco
me
youn
g M
exic
an A
mer
ican
s (L
inde
rber
g,
Solo
rzan
o, B
ear,
St
rick
land
, Gal
vis,
&
Pitt
man
, 200
2)M
iddl
e-ag
e So
viet
U
nion
wom
en:
Chr
onba
ch’s
alp
ha
.91
(Mill
er &
C
hand
ler,
200
2)
Mot
hers
: Chr
onba
ch’s
al
pha
.85
(Mon
teith
&
Gil
boe,
200
2)
You
ng a
dult
s an
d ad
vent
ure
educ
atio
n (N
eill
& D
ias,
200
1)H
omel
ess
adol
esce
nts:
C
ronb
ach’
s al
pha
.91
(Rew
, Tay
lor-
Shee
ha-
fer,
& T
aylo
r, 20
02)
Mili
tary
mot
hers
: C
hron
bach
’s a
lpha
.86
(Sch
achm
an, L
ee, &
L
eder
man
, 200
4R
esili
ence
and
old
er
wom
en (
Wag
nild
, 19
90)
Res
ilien
ce a
nd o
lder
ad
ults
: rel
iabi
lity
coef
-fic
ient
alp
ha .7
6–.9
4 (W
agni
ld, 2
003)
119
Wag
nild
and
You
ng
repo
rt fi
ve a
ddit
iona
l st
udie
s per
form
ed b
y ot
her
rese
arch
ers
afte
r th
eir
initi
al
wor
k w
ith th
e in
stru
-m
ent b
ut p
rior
to
thei
r ps
ycho
met
ric
eval
uatio
n (e
.g. c
are-
give
rs o
f sp
ouse
sw
ith A
lzhe
imer
’s,
grad
uate
stu
dent
s,
firs
t-tim
e m
othe
rs
retu
rnin
g to
wor
k,
resi
dent
s in
pub
lic
hous
ing,
and
pre
gnan
t an
d po
stpa
rtum
w
omen
). A
ll ar
e un
publ
ishe
d m
anu-
scri
pts.
Whe
n re
ques
ted,
Wag
nild
(p
erso
nal c
omm
uni-
catio
n, N
ovem
ber 2
4,
2005
) rep
orte
d th
at
thes
e da
ta d
id n
ot
cont
ribu
te fu
rthe
r to
the
rese
arch
find
ings
Qua
lity
rati
ng1
22
21
3
Key
: 1—
Indi
cate
s th
at t
here
is
not
acce
ptab
le v
alid
ity f
or t
he u
se t
o st
udy
resi
lienc
e in
the
ado
lesc
ent
popu
latio
n. D
ue t
o lim
ited
or n
o ap
plic
atio
ns o
f th
ein
stru
men
t, co
ncer
n re
gard
ing
relia
bilit
y or
val
idity
, or
inst
rum
ent u
se, f
urth
er s
tudy
is n
eede
d fo
r us
e w
ith a
dole
scen
ts.
2—In
dica
tes
that
the
re m
ay b
e ac
cept
able
val
idity
for
the
use
to
stud
y re
silie
nce
in t
he a
dole
scen
t po
pula
tion.
Due
to
lim
ited
use
of t
he i
nstr
umen
t, fu
rthe
rst
udy
of th
e in
stru
men
t is
need
ed to
det
erm
ine
relia
bilit
y an
d va
lidity
val
ues
and
appl
icat
ions
for
use
with
ado
lesc
ents
.3—
Indi
cate
s th
at t
here
is
an a
ccep
tabl
e va
lidity
for
use
to
stud
y re
silie
nce
in t
he a
dole
scen
t po
pula
tion
due
to p
sych
omet
ric
prop
ertie
s of
the
ins
trum
ent
and
appl
icat
ions
in a
var
iety
of
age
grou
ps, i
nclu
ding
ado
lesc
ence
.
120 N. R. Ahern et al.
Connor–Davidson Resilience Scale
The Connor–Davidson Resilience Scale (CD-RISC) contains 25 items,each of which is rated on a 5-point (0–4) scale with higher scores reflect-ing more resilience. The rating scale assessing resilience was evaluatedfor reliability, validity, and factor structure. Data analyses indicate thatthe CD-RISC has sound psychometric properties and distinguishesbetween those with lesser and greater resilience (Connor & Davidson,2003). The BPFI has been tested in the general population and in clinicalsettings, suggesting that there are numerous potential applications for itsuse. To date there are only three studies using the CD-RISC in the litera-ture using samples of patients with psychiatric disorders.
Resilience Scale for Adults
The Resilience Scale for Adults (RSA) is a 37-item, 5-point semantic dif-ferential scale (O. Friborg, personal communication, April 18, 2005). Thescale is intended to measure the protective resources that promote adultresilience. The RSA contains five factors: personal competence, socialcompetence, family coherence, social support, and personal structure.According to the authors (Friborg, Hjemdal, Rosenvinge, & Martinussen,2003), the RSA is a valid and reliable measure in health and clinical psy-chology to assess the presence of protective factors important to regainand maintain mental health. To date, there is one documented applicationin the literature using the RSA (written by Friborg).
Adolescent Resilience Scale
The Adolescent Resilience Scale (ARS) is a 21-item scale on a 5-pointrating scale (1–5) measuring the psychological features of resilient indi-viduals. The scale was designed for Japanese youth and is comprised ofthree factors: novelty seeking, emotional regulation, and positive futureorientation. Data analyses demonstrate acceptable reliability and validity.The results support the construct of adolescent resilience, but findingsmay be difficult to generalize to other populations (Oshio et al., 2002).There is one clinical application in the literature available only inJapanese.
Brief-Resilient Coping Scale
The Brief-Resilient Coping Scale (BRCS) is a 4-item scale on a 5-pointrating (1–5), which is designed to measure tendencies to cope with stressin a highly adaptive manner. Due to the scale’s brevity, it meets only min-imal standards for reliability and validity. The authors indicate a need for
A Review of Instruments Measuring Resilience 121
further testing but suggest that the scale may be useful for identifyingindividuals in need of interventions designed to enhance resilient copingskills, especially in longitudinal studies (Sinclair & Wallston, 2004).There are no applications of the BRCS in the literature.
Resilience Scale
The Resilience Scale (RS) is a 25-item scale using a 7-point rating (1–7).The scale has two factors, personal competence and acceptance of selfand life, which measure the construct of resilience. The authors state thattheir psychometric evaluation support the internal consistency reliabilityand concurrent validity of the scale (Wagnild & Young, 1993). Althoughoriginally tested with adult subjects, numerous studies have validated thatthe scale has worked well with samples of all ages and ethnic groups.
Data Synthesis
The six studies were reviewed, and data were abstracted related to popu-lation, settings, influencing factors, psychometric properties (includingreliability and validity values, etc.), advantages and disadvantages, appli-cations for use, and quality rating. Each instrument was scored based onthese criteria. Table 3 summarizes the instrument evaluation.
Instrument Scoring
Instruments were scored from 1 to 3 based on their credibility to study resil-ience in adolescents. A score of 1 denotes an instrument that is not accept-able for the study of resilience in adolescence. Additional psychometrictesting of the instrument or research studies are necessary to apply the instru-ment to the adolescent population. A score of 2 indicates that although theymay be acceptable in other populations, further study is needed to determinereliability and validity values and applications for use with adolescents. Ascore of 3 indicates that the instrument is acceptable to study resilience in theadolescent population due to psychometric properties of the instrument andapplications in a variety of age groups, including adolescence.
Two of the six instruments (BPFI and BRCS) received a score of 1 dueto a lack of evidence that they were appropriate for use with the adoles-cent population (see Table 3 for details). Three instruments (CD-RISC,RSA, and ARS) received a score of 2. Although they may be appropriatefor use in other settings, they were not appropriate for use with the targetpopulation (adolescents) at this time. Only one instrument (RS) received a
122 N. R. Ahern et al.
score of 3. Although it was preliminarily tested in adult women, the reli-ability and validity values reported by the authors and in subsequentapplications of the RS have been good. The RS has been used success-fully in the adolescent population to date in at least 18 published studies(see Table 3).
Principal Findings of the Review
Although each of the six instruments posses some limitations in terms oftheir psychometric properties, the findings of the review indicate that theRS may be the best to use with the adolescent population. While othersmay have more potential (e.g., ARS and BPFI), as they were tested in theadolescent and young adult populations, they lack convincing evidencefor their use at this time largely due to a lack of research applications.Further reporting of the use of these instruments would be helpful whenmaking a final decision.
Limitation of the Review
A limitation of the review was the inability of the reviewer to obtain allknown studies that used instruments measuring resilience. Several studiesfound were dissertation abstracts and/or unpublished manuscripts. Whilethe reviewer made attempts to contact the original authors, there was nosuccess. Some of the dissertation literature should be sought out in thefuture to provide a more thorough review of potential measurementinstruments for the concept of resilience.
DISCUSSION
Much can be learned from the work of others. The evaluation process forthe psychometric properties of an instrument is a complex and time-consuming endeavor. Reading the report of the psychometric evaluationthat an instrument developer has completed allows the novice to gain abetter understanding of what is necessary to scale, norm, standardize, andestablish acceptable reliability and validity statistics. Reviewing the psy-chometric development literature and other systematic reviews allows thenew researcher to critique such works. The recommendations made byresearchers can assist others with these complex procedures.
Suggestions can be made for current and future measurement research.Researchers completing current measurement research need to make surethat they follow the procedures necessary for the psychometric development
A Review of Instruments Measuring Resilience 123
of their instruments. In addition, they need to be aware of what is avail-able in the literature to measure their research concept or construct.Future measurement literature should include more published studies ofthe psychometric development and evaluation of instruments and scales,as well as published studies on the uses, adaptations, and translations ofmeasurement instruments. Such publications benefit all researchers. Thiscan only occur if researchers present their findings (positive and negative)through podium, poster, and written presentations. This knowledge canhelp to advance the science of nursing.
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