The sustainability of resilience in older persons

Research project

Success breeds success? A mixed-methods study of the sustainability of resilience in older persons

Latest news

• Read the Dutch factsheet, summarizing the key findings of the project in a brief and visually attractive way
• Research paper: How sustainable is resilience? A mixed-methods study on the COVID-19-pandemic as a challenge to resilience resources of older adults who previously recovered from depression
• Research paper: The impact of COVID-19-pandemic-related adversity on mental health: longitudinal study in Dutch populations with and without mental health disorders.
• Research paper: Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022.

Project summary

To what degree and how do older adults who have previously persistently recovered from a depression, remain resilient during the Covid-19 pandemic? Based on 25 semi-structured interviews with NESDO respondents about an earlier depressive episode and follow-up interviews on how they fared during the Covid-19 pandemic, this project was primed to find out. In addition, we used quantitative data from NESDO and NESDA collected before and during the pandemic to answer the same question for a larger group of adults with and without psychiatric disorders.

The factsheet in Dutch explains the key findings of the study. An English summary is provided below.

1. Success does not necessarily lead to success

Of the respondents who previously recovered from depression within two years, almost half experienced a significant increase in depressive symptoms during the corona pandemic. Resilience was thus by no means enduring in everyone. The following comments and findings are important here:

• On average, there was hardly any increase in depressive symptoms during the Covid-pandemic. Although this could be evidence of resilience, based on our research on the extent to which people were exposed to Covid-pandemic-related adversity and the qualitative accounts, it also shows that most people probably did not require particularly high levels of mental resilience.
• The earlier episode of depression was experienced very differently from the Covid-pandemic. The main difference here was the internal/inward-looking nature of depression versus the external stressor of the pandemic, which the whole society faced.
• Despite the different nature of depression versus the pandemic, social, somatic and psychological resources were found to be important for resilience in both situations. The experience of older people themselves revealed that ownership and recognising and controlling thought patterns remained available and effective during the pandemic.
• However, staying mentally healthy during the Corona pandemic also required other resources and strategies. Having a partner, strong coping skills (agreeableness) and not having chronic diseases were found to be especially important during the Corona pandemic.

2. Resilience requires resource flexibility

People who are resilient in multiple situations appeal to different resources in different situations and use existing resources differently. Beneath the resilience of resilience therefore lies a dynamic adaptation process.

Recommendations for clinical practice

• Map patient resources broadly, as different situations require partially different resources.
• Explore the extent to which your clients draw positive lessons from the recovery process and how you can contribute to them. These lessons may later prove to be invaluable.
• Look for examples the patient can identify with. Feeling that the patient is in the same boat with others can be an important resilience factor.

Almar Kok, Silvia Klokgieters, Lieneke Glas, Didi Rhebergen and Brenda Penninx.