The resilience framework as a strategy to combat stress-related disorders

Consistent failure over the past few decades to reduce the high prevalence of stress-related disorders has motivated a search for alternative research strategies. Resilience refers to the phenomenon of many people maintaining mental health despite exposure to psychological or physical adversity. Instead of aiming to understand the pathophysiology of stress-related disorders, resilience research focuses on protective mechanisms that shield people against the development of such disorders and tries to exploit its insights to improve treatment and, in particular, disease prevention. To fully harness the potential of resilience research, a critical appraisal of the current state of the art — in terms of basic concepts and key methods — is needed. We highlight challenges to resilience research and make concrete conceptual and methodological proposals to improve resilience research. Most importantly, we propose to focus research on the dynamic processes of successful adaptation to stressors in prospective longitudinal studies.

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Acknowledgements

The following colleagues were helpful in proof-reading and approving the submitted manuscript: D. Hermans, F. Raes and J. Vlaeyen (all University of Leuven, Belgium), B. Berninger, H. Luhmann, R. Nitsch, K. Radyushkin, S. Ryu, M. Schreckenberger, S. Schweiger, A. Stroh, U. Zechner (all at the University Medical Center of the Johannes Gutenberg University Mainz), A. Acker-Palmer, S. Duvarci, J. Roeper, T. Sigurdsson (all at Goethe University), J. Letzkus, E. Schuman (both at Max Planck Institute for Brain Research) and V. Tiwari (Institute for Molecular Biology). In preparing this Perspective, U.B. was supported by the Deutsche Forschungsgemeinschaft (DFG CRC 1193, subproject C06); G.A.B. by the United States-Israel Binational Science Foundation (project 2013067), David and Maureen O’Connor, and the Rockefeller Foundation (2012-RLC 304); A.C. by DFG CRC 1193, subproject C04; E.B. by the European Union’s Horizon 2020 Programme (EU H2020/705217); C.J.F. by DFG CRC 1193, subprojects C03 and C06, DFG FI 848/5-1, and the European Research Council (ERC-CoG 617891); I.G.-L. by the National Institute of Mental Health (K01MH102415); S.G. by DFG CRC 1193, subproject B05; E.J.H. by the ERC (ERC-CoG682591); R.K. by DFG CRC 1193, subprojects B01 and C01, and the State of Rhineland-Palatinate (project 1080, MARP); K.L. by DFG CRC 1193, subproject Z03, and the State of Rhineland-Palatinate (project 1080, MARP); B.L. by DFG CRC 1193, subprojects A02, B03, and Z02; M.B.M. by DFG CRC 1193, subprojects A03 and Z02; R.J.M. by the Swiss National Science Foundation (SNF 100014-143398; project no. un 8306); A.R. by DFG CRC 1193, subprojects C07 and Z03, and EU H2020/2014-2020 (643051 (MiND) and 667302 (CoCA)); K.R. by the ERC (ERC_StG2012_313749) and the NWO (NWO VICI no. 453-12-001); B.P.F.R. by the NWO (NWO VENI no. 916-11-086); D.S. by the SNF (SNF 100014-143398, project no. un 8306); O.T. by DFG CRC 1193, subproject C04, and the State of Rhineland-Palatinate (project 1080, MARP); A.-L.v.H. by the Royal Society (DH150176); C.H.V. by the Netherlands Brain Foundation (Fellowship F2013(1)-216) and the NWO (NWO VENI no. 451-13-001); T.D.W. by the National Institute of Health (NIH); M.We. by DFG CRC 1193, subprojects C05 and C07; and M.Wi. by DFG CRC 1193, subproject C04. The authors thank A. Kline and J. L. Jenness for providing unpublished results.

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Correspondence to Raffael Kalisch.

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All authors report to have no financial and non-financial actual or perceived competing interests. A.R. has received a research grant from Medice and speakers honoraria from neuraxpharm and Boehringer. H.W. has received a speaker’s honorarium from Servier. All other authors report no financial relationships with commercial interests.

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Kalisch, R., Baker, D.G., Basten, U. et al. The resilience framework as a strategy to combat stress-related disorders. Nat Hum Behav 1, 784–790 (2017). https://doi.org/10.1038/s41562-017-0200-8

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