Author: Tyler Phillips, Research Psychologist and Lead Content Specialist
Globally, adolescent mental health is in a state of crisis. In the USA, for example, mental health problems were already identified as the leading cause of death and disability for children before the COVID-19 pandemic – which, of course, exacerbated these problems. In South Africa, 70% of 15-to-24-year-olds report needing mental health support, and depression and anxiety are flagged as the leading cause of disease burden here as well.
Thankfully, we know that developing resilience reduces mental health burdens such as depression and anxiety. However, the majority of this research has been conducted among adults, not adolescents. Although we can be quite sure that the relationship between resilience and mental health is generally the same, adolescence is a unique developmental phase. It is simultaneously a period of higher risk for psychological troubles and of greater opportunity for growth and adaptation. Resilience may therefore look different among teenagers than it does among adults – and so, it may need to be measured differently.
As it happens, there are a few scales (with good psychometric properties) out there for measuring adolescent resilience. At the same time, there is no ‘gold standard’, and even when it comes to one of the most adequate and commonly used scales – the Child and Youth Resilience Measure (CYRM) – different factors that make up resilience emerge among different populations, such as between Canadian youth and indigenous youth from New Zealand. This means that the validity of measuring adolescent resilience in different populations and settings needs to be strengthened – and so, there remains a call for further scale development.
Given this background, Neurozone® set out to develop a new measure of adolescent resilience. Our initial drafting of the questions drew on the content and structure of the adult Neurozone® Resilience Index, for two reasons. Firstly, even though there are differences in life stages between adults and adolescents, the two populations used in developing each scale overlapped quite significantly in their key demographic, cultural, and socioeconomic factors. Secondly, critical components of the adult Neurozone® Resilience Index (i.e. toxic stress and early-life stability), appear to be missing from existing scales of adolescent resilience. These components may be quite important to include, especially considering populations from low-to-middle-income countries (LMICs) where toxic stress and caregiving instability tend to be higher.
The process of drafting the scale was iterative and underwent a few levels of refinement. An expert panel of psychologists adapted the questions from the adult scale so that they were relevant and appropriate for adolescents. They also drafted questions for a few additional components (not included in the adult Index) that current science indicates may be important for adolescent resilience. The whole list of questions was then run by community educators to ensure that it was accessible, appropriate, and adequately sensitive to the adolescent sample under study.
That sample consisted of 652 pupils enrolled at government schools in Cape Town, South Africa. Their ages ranged between 12 and 18 years, with an average of 15. Regarding gender, around 30% identified as boys/men, 68% as girls/women, 1% as non-binary, and 1% chose not to disclose their gender identity.
After the adolescent sample completed this new resilience measure, rigorous statistical procedures were conducted to (1) explore and confirm its factor structure, (2) retain only those questions that explained significant variance in the global score, and (3) test its reliability and validity.
Firstly, three factors of adolescent resilience emerged, which quite closely reflect the three factors of the adult Index. Where the latter’s factors are Positive Affect, Stress Mastery, and Early-Life Stability, those of the adolescent measure are Psychosocial Positivity, Stress Mastery, and Social Safety. The Stress Mastery factors are very similar (hence named the same), as they both focus on experiences and dispositional factors that influence how overwhelming or manageable stress feels to a person. Psychosocial Positivity resembles Positive Affect in that it also entails positive emotional orientations (e.g. gratitude), but it has a slightly stronger focus on the interpersonal aspects of them (e.g. altruism). Social Safety and Early-Life Stability both focus on the perceived available emotional and instrumental support from caregivers and community while growing up, but adults rate this retrospectively, while adolescents rate their current experience along these lines.
Secondly, 19 of the original 53 questions remained, making it a concise measure relative to the 28-item adult Neurozone® Resilience Index. Thirdly, reliability testing delivered robust results. For example, each factor was found to fall within the ideal range of Cronbach’s alpha values. Validity testing was also favorable, revealing, for example, that this measure has a high correlation (an indication of concurrent validity) with the CYRM.
The Neurozone® Adolescent Resilience Index (NARI), therefore, is a statistically sound, new comprehensive measure of psychological resilience in adolescents that can reliably and inclusively be used across different income settings. With this measure, we may be able to assess more accurately the degree of available psychological resources with which adolescents across the globe can successfully overcome challenges and stressors, and protect their mental health. Going forward, we may begin uncovering measurable ways to increase scores on the NARI – in other words, to build resilience and reduce psychological stress in adolescents.