Resilience in the context of child
maltreatment
Christine Wekerle, Ph.D.
Associate Professor, Pediatrics, McMaster
University
wekerc@mcmaster.ca
Maslow’s (1954) Hierarchy of Needs
(Individual-level resilience)
Maslow’s (1962) Behaviours promoting
Self-actualization
• Child-like approach: playful, discovery, “zone”
• Evaluating experiences by listening to your own
feelings (self-valuing)
• Avoiding pretense ('game playing') and being
honest
• Being prepared to be unpopular if your views do
not coincide with those of the majority
• Taking responsibility and working hard
• Awareness of your defenses (win-win
preferences; acceptance & realism)
Bronfenbrenner’s Ecological Model:
Multiple-levels of Influences
Definition of Resilience
• Garmezy, Masten & Tellegen (1984) – emphasis on individual competence
“competence in children despite exposure to stressful events”
• Rutter (1985) – emphasis on personal and social competence
“self-confidence and social competence to increase through mastery and appropriate
responsibility”
• Masten (1994) – emphasis on adaptation
“pattern over time, …good eventual adaptation despite developmental risk, acute stressors, or
chronic adversities”
•
Ungar (2012) www.ccycnetwork.org - emphasis on capacity
•
In the context of exposure to significant adversity, resilience is both the capacity of
individuals to navigate their way to the psychological, social, cultural, and physical
resources that sustain their well-being, and their capacity individually and collectively to
negotiate for these resources to be provided in culturally meaningful ways.
•
….But What About Resilience Behaviours and Outcomes?
Maltreatment and Adolescent Pathways (MAP) Study
Principal Investigator:
Christine Wekerle, Ph.D. (wekerc@mcmaster.ca)
Co-Investigators:
Michael Boyle, Ph.D.; Harriet MacMillan, M.D. (McMaster)
Deborah Goodman, Ph.D.; Randy Waechter, Ph.D., Eman Leung, Ph.D. (University of Toronto)
Bruce Leslie, M.S. W.; Brenda Moody, M.B.A. (ON Children’s Aid Society)
Nico Trocmé, Ph.D. (McGill)
Collaborating Scientists:
Abby Goldstein, Ph.D. (University of Toronto)
Jonathan Weiss, Ph.D. (York University)
Stephen Ellenbogen, Ph.D. (Memorial University)
Tiffany Thornton, MSW (Health Canada)
Lil Tonmyr, Ph.D. (Public Health Agency of Canada)
Marlyn Bennett, Ph.D. (First Nations Child & Family Caring Society of Canada)
MAP Advisory Board:
Kong Chung, Lori Bell, Natasha
Budzarov, Darlaine Mathews, David Firang, Dan Cadman, Susan Gaines
Cherry Chan, Mario Giancola, Judith Wharton, Bervin Garraway, Carla Da Fonte, Jacqueline
Bittencourt
MANY THANKS to ALL the YOUTH and CASEWORKERS for their time and efforts!
Maltreatment and Adolescent Pathways
(MAP) Longitudinal Study
• 561 Adolescents (14-16) who were receiving
services from Children’s Aid Societies (63% Crown
Wards) followed over 2 years
• Testing every 6 months –many outcomes
• See publications, go to….
www2.oacas.org
Enter your full email as username
Enter mapguesttest as password
Self-Compassion Scale (SCS)
• 26-item self-report measure, with three SCS components:
– (1) Self-kindness: “I try to be loving towards myself when I’m
feeling emotional pain”
– (2) Common humanity: “When things are going badly for me, I
see the difficulties as part of life that everyone goes through”
– (3) Mindfulness: “When something upsets me I try to keep my
emotions in balance”
– Responses: (1) almost never to (5) almost always
– Reliability in study sample: α = .89
• Presently, a short-form available (12 items), shows good correlation
to outcomes as full scale (26 items) in MAP; also Compassion Towards
Others
– Neff, K. D. (2003). Development and validation of a scale to measure selfcompassion. Self and Identity, 2, 223-250.
– Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and
factorial validation of a short form of the Self-Compassion Scale. Clinical
Psychology & Psychotherapy. 18, 250-255.
Child & Youth Resilience Measure
– Standard stem (“To what extent…”) rating 30 items on a 5-point
scale from “Not at all” to “A lot”
– Total Resilience Score can be calculated from all 30 items
(Cronbach’s alpha MAP sample = .94)
– Three subscales have been used:
• Community (11 items)(e.g., “Do you feel supported by your friends?”)
(MAP sample Cronbach’s alpha = .86)
• Family (6 items)(e.g., “Do you feel that your parent(s) / guardian(s) watch
you closely?” (MAP sample Cronbach’s alpha = .84)
• Individual (9 items)(e.g., “Do you cooperate with people around you?”)
(MAP sample Cronbach’s alpha = .83)
* Ungar, Liebenberg, Boothroyd, Kwong, Lee, Leblanc, Duque, & Makhnach, 2008; 4- factor model, 13-19 year olds: (1) Individual: “I try to
finish what I start”; “I am aware of my own strengths”; (2) Relationships with caregivers: “My caregivers know a lot about me”; “If I am
hungry, there is enough to eat”; (3) Relationships with peers: ;”My friends stand by me during difficult times” “I have people to look up to”;
(4) Environmental context: “Spiritual beliefs are a source of strength for me”; “I think it is important to serve my community”; “I am
treated fairly by my community.”
Results – Child Maltreatment & Self-compassion
• Self-compassion Scale; Childhood Trauma Questionnaire
– Mean (SD): 3.10 (0.56)
SCS High
N = 56
CTQ score (SD )
Physical abuse
Sexual abuse
Emotional abuse
Physical neglect
Emotional
neglect
9.7 (5.7)
6.8 (4.3)
10.3 (5.4)
9.3 (4.4)
13.3 (5.4)
SCS Low
N = 62
11.9 (6.1)
8.2 (6.1)
13.2 (6.3)
9.9 (4.1)
16.0 (6.1)
Cohen’s
d
P
0.49
0.28
0.58
0.24
0.45
0.053
0.168
0.011
0.432
0.025
Results: Suicidality Outcomes over time (N=119)
Resilience (CYRM)
Total Score: M (SD)1
Community Score: M (SD)1
Family Score: M (SD)1
Individual Score: M (SD)1
Self-compassion (SCS)
Total Score: M (SD)1
(A) No suicidal
thought (n=76)
(B) Suicidal
thought, 1 timepoint (n=21)
(C) Suicidal
thought, 2+ timepoints (n=22)
3.85 (.73) *
4.01 (.76) *
3.58 (1.0) *
3.99 (.75) *
3.80 (.37)
3.96 (.40)
3.13 (.95)
4.16 (.42)
3.22 (.77) *
3.35 (.81) *
2.69 (1.0) *
3.48 (.75) *
3.30 (0.63) *
2.95 (0.47)
2.74 (0.41) *
Psychological Distress
GHQ-12 at 2-year follow-up
*15.4% *
* 40.0%
47.6% *
AUDIT = Alcohol problem at
2-year follow-up
10.8 %
10.0% *
38.1% *
Self-rated LGBT vs.
Heterosexual *
40.0%
33.3%
26.7%
68.5%
20.5%
11.0%
• *p ≤ .05; AUDIT – Alcohol Use Disorders Identification Test
(http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf)
• Continuous variables (log transformed; non-normal distribution) analyzed via ANCOVA and
Scheffé (unequal n’s) post-hoc tests, categorical (clinical cut-off) variables (%) analyzed via X2
1 Remained significant after using ANCOVA to control for child maltreatment
MAP Dating Violence (DV) - Prevalence by gender
• Among 136 (72 F; 64 M) who participated in all 4 time points
– MAJORITY - NO DATING VIOLENCE INVOLVEMENT
F Initial: 62.5% 6 Months: 63.9% 18 Months: 72.2% 24 Months: 56.9%
M Initial: 62.5% 6 Months: 76.6% 18 Months 64.1% 24 Months: 60.9%
DATING VIOLENCE INVOLVEMENT OVER 4 TIME POINTS
– MINORITY - DATING VIOLENCE INVOLVEMENT REPEATEDLY
F 1 DV: 29.2%
M 1 DV: 25.0%
2 DV: 22.2%
2 DV: 17.2%
3 DV: 12.5%
3 DV: 17.2%
4 DV: 8.3%
4 DV: 6.3%
– Analysis of DV continuity showed significantly more females than
males experienced DV two or more times during two years.
– For 2 or more DVs timepoints, DV consists of both roles as perpetrator
and victim – no pure group of victim only or perpetrator only
Results – Self-compassion & Dating Violence over
time
DV continuity measured by DV at 2 or more time points,
Continuity of dating SCS High, n=36 (%) SCS Low, n=41 (%)
violence
2+ times across 4
time points
No dating violence at
77.8
41.5
all time points
Both types at least 2
22.2
58.5
of 4 time points
-There was a group difference, χ2 (1, N = 77) = 10.4, p = .001
-There was no case with pure-type continuous dating violence.
Self-compassion Interventions
• Self-compassion relevant for maltreated adolescents
• Self-compassion represents a warm and accepting
attitude towards self (Neff, Kirkpatrick, & Rude,
2007)
• Need to conduct analyses to see if self-reported selfcompassion and resilience scores “explain” the link
between child maltreatment and outcomes
• Self-compassion as an intervention - Existing
programs in self-compassion Cognitive Behavior
Therapy (Gilbert et al.), self-compassion meditation
as part of or separate from yoga practice
• See Dr. Kristen Neff’s website for meditations and
articles and more…
http://www.self-compassion.org
What is resilience in the context of
maltreatment?
• Forming a coherent narrative that eliminates selfdisgust, self-blame, guilt, attributions of personal
responsibility or fault ….Enhancing selfcompassion.
• Recognizing and crafting safety – stable, secure,
predictable contexts….zero tolerance for violence
in partnerships
• Confirming strengths and social network –
maintain and build upon resources
• Voting for yourself! Because maltreatment was
about attention to others’ needs, not the child’s
Thank you for your attention!