Changes in Resilience Predict Function in Adults With Physical Disabilities: A Longitudinal Study.

TitleChanges in Resilience Predict Function in Adults With Physical Disabilities: A Longitudinal Study.
Publication TypeJournal Article
AuthorsEdwards KA, Alschuler KA, Ehde DM, Battalio SL, Jensen MP
JournalArch Phys Med Rehabil
Date Published2017 Feb

OBJECTIVES: (1) To determine if resilience exhibits similar stability across time as depression, fatigue, and sleep quality; and (2) to determine if changes in resilience over a period of 1 year are associated with changes in depression, fatigue, sleep quality, and physical function over the same time period.

DESIGN: Observational longitudinal survey study with measures administered 2 times, 1 year apart.

SETTING: Community-based population sample.

PARTICIPANTS: Adults with physical disabilities (N=893).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Primary outcomes were measures of resilience (Connor-Davidson Resilience Scale), depression (Patient Health Questionnaire-9), fatigue (Patient-Reported Outcomes Measurement Information System [PROMIS] Fatigue Short Form), sleep quality (PROMIS Sleep Disturbance), and physical function (8-item PROMIS Physical Functioning).

RESULTS: Resilience (r=.71, P<.001) exhibited similar stability over 1 year to depression (r=.71, P<.001), fatigue (r=.79, P<.001), and sleep quality (r=.68, P<.001). A decrease in resilience was associated with an increase in depression (F1,885=70.23; P<.001; R(2)=.54) and fatigue (F1,885=25.66; P<.001; R(2)=.64), and an increase in resilience was associated with improved sleep quality (F1,885=30.76; P<.001; R(2)=.48) and physical function (F1,885=16.90; P<.001; R(2)=.86) over a period of 1 year, while controlling for age, sex, and diagnosis.

CONCLUSIONS: Resilience exhibits similar test-retest stability as other important domains that are often treatment targets. Changes in resilience were associated with changes in depression, fatigue, sleep quality, and physical functioning over the course of 1 year. Further longitudinal and experimental research is warranted to investigate the potential causal effect of changes in resilience on quality of life in individuals with physical disabilities.

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What was this research about?

Individuals with injuries and chronic conditions may be more likely to experience high levels of stress and changes in mood than others. However, they are also likely to be resilient, or able to remain emotionally stable, when dealing with stress. In this study, we looked at how resilience changes over one year, and how those changes may be associated with depression, fatigue, sleep problems, and physical functioning.

What did the researchers do?

We sent two surveys about a year apart to about 900 people with multiple sclerosis, spinal cord injuries, muscular dystrophy, or post-polio syndrome. On the first survey, we asked questions about resilience, mood, fatigue, trouble sleeping, and physical functioning. We sent another survey about one year later with the same questions, to find out if respondents’ levels of resilience changed, and how that may have affected their daily life.

What did the researchers find?

Resilience did not change much over one year. However, increases in resilience were associated with small changes in positive function such as sleep quality and physical activity, and decreases in resilience were associated with small reduction in function such as increased depression and fatigue. We concluded that it may be that interventions aimed to increase resilience could also be effective in improving other function. 

How can you use this research?

It may be that increasing your resilience will lead to improved mood, less fatigue, better sleep, and high reported physical function.  Further research is needed.


  • Mindfulness meditation can help reduce stress and improve your sleep.
  • Physical activity can help reduce stress and improve physical health.
  • Building a strong social network can also help reduce stress and provide support for difficult situations.
  • Counseling, such as cognitive-behavioral therapy, can help you manage emotions and thoughts in difficult situations.

What you should know:

People with chronic conditions often face stressful situations. To learn more about building your resilience, take a look at our fact sheet on How to Bounce Back.

PubMed ID27776921