Mental health and resilience at older ages: bouncing back after adversity in the British Household Panel Survey.
BACKGROUND
Resilience is having good outcomes despite adversity and risk and could be described in terms of preserving the same level of the outcome or rebounding back to that level after an initial set back. Using the latter definition, resilience as "bouncing back", this paper aims (1) to identify those members of a panel survey who demonstrated resilience, and (2) to identify the characteristics of the resilient individuals and the predictors of their resilience.


METHODS
The study subjects were the 3581 participants in the British Household Panel Survey, selected from waves 1-14, who satisfied three requirements: exposure to an adversity; availability of consecutive General Health Questionnaire (GHQ)-12 scores; aged 50 or more years. The primary outcome variable was resilience, operationalised as a GHQ-12 score that increased after exposure to adversity and returned to its pre-exposure level in the next (after 1 year) wave of the survey. The adversities were: functional limitation; bereavement or marital separation; poverty.


RESULTS
The prevalence of resilience, as defined, was 14.5%. After adjusting for regression to the mean, the GHQ-12 score of the resilient dropped by a mean of 3.6 points in the post-adversity period. Women predominated among the resilient, with this gender difference stronger among older women than younger women. The resilient were more likely to have high social support than the non-resilient, but otherwise were not different socioeconomically. High social support pre-adversity and during adversity increased the likelihood of resilience by 40-60% compared with those with low social support.


CONCLUSIONS
Resilience is relatively rare and favours older women. It is fostered by high levels of social support existing before exposure to adversity.
Research Fellow, Dept of Primary Care and Social Medicine, 3rd Floor, The Reynolds Building, St Dunstan's Road, London W6 8RP, UK. g.netuveli@ic.ac.uk
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Netuveli
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Wiggins
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Montgomery
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Hildon
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Blane
D000223:Adaptation, Psychological; D000368:Aged; D004522:Educational Status; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012044:Regression Analysis; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology