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Investigating the biopsychosocial mechanisms of resilience

Primary Supervisor: Dr Renate Reniers, Institute of Clinical Sciences

Secondary supervisor: Dr Maria Dauvermann

PhD project title: Investigating the biopsychosocial mechanisms of resilience

University of Registration: University of Birmingham

Project outline:

Resilience can be operationally defined as the dynamic process of positive adaptation following trauma exposure (i.e. ‘resilience mechanism’) and can be evaluated based on an individual’s level of well-being in response to adversity (i.e. ‘resilient functioning’) (Kalisch et al., 2017). The final component of the proposed ‘resilient’ framework is an individual’s ability to deal with future stress which may be mediated by a variety of ‘resilience factors’ (Kalisch et al., 2017). An individual with low levels of resilience may be at a higher risk of developing psychiatric disorders (Ioannidis et al., 2019) following adversity in comparison to an individual with high levels of resilience who experiences the same stressor. An individual’s resilience is a complex and dynamic construct, which is thought to emerge from the interplay between an individual’s biology (i.e. genome, hormonal and inflammatory systems) and is formed by environmental experience. As such, it is likely governed by several neurobiological systems (Southwick and Charney 2012) that affect emotional, cognitive and developmental processes (Quidé et al. 2020).

Throughout life, an individual may be exposed to stressful events which impact their future resilience (i.e. positive adaptation and/or resilient functioning) (Karg et al., 2011). For example, exposure to childhood maltreatment (CM) has been associated with impairments in a variety of cognitive functions, such as cognitive flexibility (Quidé et al., 2020); such inflexibility may be associated with an increased risk of developing mental health conditions (Ram et al., 2019). CM is defined as “any act, or series of acts by a parent or care-giver that results in the potential for harms, or threat of harm, to a child” (Gilbert et al., 2009). Unfortunately, CM is widely prevalent; up to one third of children growing up today will experience some form of CM (Stoltenborgh et al., 2015). While CM increases the probability of that child developing mental health problems in the future, a large proportion of children who experience CM do not develop any such conditions and indeed flourish, i.e., function resiliently (Ioannidis et al., 2020). These factors make individuals who have experienced CM an ideal population to investigate resilience.

Currently, the field of resilience is restricted by several crucial methodological limitations. Firstly, studies tend to be liberal in their definition of ‘resilience’, with some authors examining resilient functioning in isolation and others even defining resilience without any reference to trauma (Kalisch et al., 2017). To combat such ambiguity, this project will follow the resilience framework (Kalisch et al., 2017) and investigate the three components of resilience; resilient functioning, resilience factors, and resilient mechanisms. Secondly, the majority of studies have applied either a biological, social, or psychological model of resilience. Finally, current resilience studies are limited by their cross-sectional nature; this project will include a longitudinal component that involves the creation of a resilient factor network for the CM participants. To overcome these limitations, this project aims to be more integrative and will apply a biopsychosocial model to all three components of resilience.

The study has three overarching aims:

  1. To elucidate the contribution of a wide array of possible risk and protective psychosocial factors to resilient functioning in people with and without a history of childhood maltreatment/adversities (CM/CA) and further, those with and without a mental health condition;
  2. To longitudinally investigate resilient functioning in individuals with and without a history of CM/CA via the creation of individualised dynamic networks.
  3. To examine the biological and psychological aspects of the resilience mechanism after a psychosocial stress task in people with a history of CM/CA and with and without a mental health condition.

BBSRC Strategic Research Priority: Integrated Understanding of Health: Ageing

Techniques that will be undertaken during the project:

The project has three overarching aims:

  • To elucidate the contribution of a wide array of possible risk and protective psychosocial resilience factors to resilient functioning in people with and without a history of CM/CA and further, those with and without a mental health condition (i.e., a 2x2 study design);
  • To longitudinally investigate resilient functioning in individuals with and without a history of CM/CA via the creation of individualised dynamic networks.
  • To examine the biological and psychological aspects of the resilience mechanism after a psychosocial stress task in people with a history of CM/CA and with and without a mental health condition.

In the first of three studies, participants will be asked to complete self-report questionnaires online. The battery will assess a range of domains including a mental and physical health screening, as well as an emotional health screening to identify psychosocial factors that are significantly associated with resilient functioning.

The second study aims to investigate the biological markers that may underlie the resilient functioning identified in the first study. Participants’ ability to deal with acute psychosocial stress will be assessed with the Trier Social Stress Test (TSST, Kirschbaum et al., 1993). In addition, we will also measure participants’ acute immune response to the psychosocial acute stress induction with interleukin-6 (IL-6), interleukin-10 (IL-10), C-reactive protein (CRP) levels. Salivary cortisol concentrations will be gathered from participants at six time points: -110 minutes (before TSST), -30 minutes, immediately before the TSST (baseline), +20 minutes following TSST, +35 minutes, and +80 minutes (protocol from Treadway et al., 2017). The cytokine response will be assessed by collecting plasma samples taken intravenously from participants at -10 minutes before the TSST, +45 minutes following the TSST, and +90 minutes following the TSST (protocol from Treadway et al., 2017).

Using the findings of the second study, the third study aims to investigate the resilience mechanism of 60 individuals with CM/CA who are diagnosed with mental health conditions compared to individuals with CM/CA but without a mental health diagnosis. Immediately following the psychosocial acute stress task, participants will be asked to undergo structural and functional magnetic resonance imaging (MRI) scanning to identify the neurobiological markers of the resilience mechanism (i.e. during the cognitive tasks). Cognitive correlates (emotion regulation, cognitive flexibility, and attentional control), which have been found to be positively associated with resilience, will be investigated.

This experimental timeline allows us to examine the complex interactions between psychosocial stressors, cognitive adaptive responses, brain function responses, and immune response levels in the same individuals.

Contact: Dr Renate Reniers, University of Birmingham