Received 01/15/12

Revised 10/19/12
Accepted 10/25/12
DOI: 10.1002/j.1556-6676.2013.00095.x

Resilience:
A Meta-Analytic Approach
Ji Hee Lee, Suk Kyung Nam, A-Reum Kim, Boram Kim,
Min Young Lee, and Sang Min Lee
This study investigated the relationship between psychological resilience and its relevant variables by using a meta-
analytic method. The results indicated that the largest effect on resilience was found to stem from the protective factors,
a medium effect from risk factors, and the smallest effect from demographic factors.

Keywords: resilience, demographic factor, protective factor, risk factor, meta-analysis

Resilience has been referred to as the personal qualities
and skills that allow for an individual’s healthy/successful
functioning or adaptation within the context of significant
adversity or a disruptive life event (Connor & Davidson,
2003; Luthar, Cicchetti, & Becker, 2000; Masten & Ob-
radovic, 2006). Resilience may be an important factor
in explaining why some individuals cope with traumatic
injuries more successfully than others (White, Driver, &
Warren, 2010). After reviewing previous resilience litera-
ture, we found resilience to be a multidimensional variable
consisting of psychological and dispositional attributes,
such as competence, external support systems, and personal
structure (Campbell-Sills, Cohan, & Stein, 2006; Connor &
Davidson, 2003; Masten, 2001). Individuals who possess a
greater number of attributes associated with resilience are
more likely to successfully adapt to a disruptive event (e.g.,
traumatic injury, loss of job, and death of spouse), whereas
individuals who have fewer of these attributes will not adapt
as successfully (White et al., 2010).
There are two points of view that define resilience. The abil-
ity to “bounce back” is considered to be an individual trait in
the first view. Resilience as a trait is fixed and stable, referring
to a personality trait for negotiating, managing, and adapting to
significant sources of stress or trauma. Block and Block (1980)
defined resilience, in a psychoanalytic view, as ego resiliency
(Block & Kremen, 1996). According to some researchers (Asen-
dorpf & van Aken, 1999; Hart, Hofmann, Edelstein, & Keller,
1997; Robins, John, Caspi, Moffitt, & Stouthamer-Loeber, 1996),
resilience can be explained within the concept of the trait types:
resilient, overcontrolled, and undercontrolled.
However, the view of resilience as a fixed and stable indi-
vidual trait fails to account for the notion that adaptation is
derived from the whole interaction between individuals and the
environment around them, such as family, community, or the
social system. Roberts and Masten (2004) claimed that environ-
mental and contextual factors play important roles in shaping
personal resiliency. In this sense, the second view reflects the
notion of resilience as a dynamic process (e.g., Luthar et al.,
2000). Resilience is regarded as not fixed but dynamic, change-
able over time, and dependent on interactions among various
factors surrounding the individual (Dyer & McGuinness, 1996).
In this point of view, the concept of resilience fits well with the
evaluation of a change in response to related variables including
specific prevention or intervention strategies.
Recently, many researchers have defined resilience as a
developmental process (Luthar et al., 2000; Yates, Egeland, &
Sroufe, 2003). According to B. W. Smith et al. (2008), most
assessment instruments designed to measure resilience are
based on facets of resilience that might be facilitated by pro-
tective factors. A few scales have been developed to measure
resilience as a process, such as the Baruth Protective Factors
Inventory (Baruth & Carroll, 2002), the Resilience Scale for
Adults (Friborg, Hjemdal, Rosenvinge, & Martinussen, 2003),
the Resilience Scale (RS; Wagnild & Young, 1993), and the
Connor–Davidson Resilience Scale (CD-RISC; Connor &
Davidson, 2003). However, the Baruth Protective Factors
Inventory is limited by age and race generalizations. The
Resilience Scale for Adults also has generalization problems
because this scale was developed with a sample consisting
only of outpatients.
On the other hand, the RS has been validated in numerous
studies. This scale was widely applied with samples of all sexes,
as well as multiple ages and ethnic groups. The concurrent
validity support was shown by high correlations of the RS with
well-established validated measures on the constructs linked
with resilience (Ahern, Kiehl, Sole, & Byers, 2006). The CD-
RISC has been validated with clinical and general populations
(Gucciardi, Jackson, Coulter, & Mallett, 2011; Jung et al.,
2012) and with samples of adolescents (Jorgensen & Seedat,
2008), university students (Campbell-Sills et al., 2006), older
females (Lamond et al., 2008), and infertile women (Sexton,
Byrd, & von Kluge, 2010). In addition, the validation studies
of the scale were conducted in Asian countries (Baek, Lee,
Joo, Lee, & Choi, 2010; Khoshouei, 2009; Singh & Yu, 2010;
Yu & Zhang, 2007) as well as in Western countries (Connor
& Davidson, 2003; Gucciardi et al., 2011). Likewise, the RS

Ji Hee Lee, A-Reum Kim, Boram Kim, Min Young Lee, and Sang Min Lee, Department of Education, Korea University; Suk Kyung Nam,
Department of Psychology, Kyungnam University. Correspondence concerning this article should be addressed to Sang Min Lee, Depart-
ment of Education, College of Education, Korea University, Anam-dong, Seongbuk-gu, Seoul, South Korea (e-mail: leesang@korea.ac.kr).

© 2013 by the American Counseling Association. All rights reserved.

Journal of Counseling & Development  ■  July 2013  ■  Volume 91 269

and CD-RISC were identified as scales reflecting adequate
psychometric properties.
A higher level of resilience is linked not only to adaptive
behaviors but also to a physiologically and psychologically
balanced growth. Thus, the increase of resilience provides
opportunities for reintegration and homeostasis (Richardson,
2002). By understanding the various interrelated factors
that promote or interrupt resilience in individuals and com-
munities, we can better understand the nature of resilience
and acquire the methods or skills to promote and maintain
resilience (Muller, Ward, Winefield, Tsourtos, & Lawn,
2009). The factors related to resilience can be divided into
two broad categories: (a) demographic variables and (b)
psychological variables.
The demographic variables that are most frequently con-
nected to resilience are age and gender. Previous researchers
have found that equivocal results are regarded as demographic
variable effects. Whereas some studies have identified that
as people age, they become more resilient (Campbell-Sills,
Forde, & Stein, 2009; Gillespie, Chaboyer, & Wallis, 2009),
others have indicated a negative relationship between re-
silience and age (Beutel, Glaesmer, Decker, Fischbeck, &
Brahler, 2009; Lamond et al., 2008). Similarly, some stud-
ies have found that females are more resilient (Davidson et
al., 2005; McGloin & Widom, 2001), whereas others have
revealed that males are more resilient (Campbell-Sills et al.,
2009; Stein, Campbell-Sills, & Gelernter, 2009). The mixed
findings are likely to be associated with the fact that these
studies used small homogeneous samples.
The psychological factors associated with resilience
can be divided into two broad categories: (a) risk factors
and (b) protective factors. Risk is used to define factors
that increase the likelihood of maladaptation. A number of
studies have investigated the relationship between resilience
and risk factors. For example, people who have depressive
symptoms (Baek et al., 2010; Pietrzak, Johnson, et al., 2010)
and severe anxiety-related impairments (Norman, Cissell,
Means-Christensen, & Stein, 2006) had a lower level of
resilience. Moreover, previous researchers (Bruwer, Emsley,
Kidd, Lochner, & Seedat, 2008) have found that people who
have a high level of stress are less resilient. Although most
studies consistently report a negative relationship between
risk factors and resilience, the extent to which individual
risk factors have a negative relationship with resilience have
differed. For example, Humphreys (2003) stated that the
relationship between resilience and depressive symptoms
is much stronger than the relationship between resilience
and anxiety-related symptoms.
The other factor category is protective or promotive fac-
tors, which refers to those characteristics that enhance adapta-
tion. Research has identified a positive relationship between
resilience and a number of protective factors. These include
life satisfaction (Beutel et al., 2009; Wagnild, 2003; White
et al., 2010), optimism (Lamond et al., 2008; Lee, Brown,
270 Journal of Counseling & Development  ■  July 2013  ■  Volume 91
Lee et al.
Mitchell, & Schiraldi, 2008; Luthans, Avolio, Avey, & Nor-
man, 2007), positive affect (Burns & Anstey, 2010; Maguen
et al., 2008; B. W. Smith et al., 2008), self-efficacy (Gillespie,
Chaboyer, Wallis, & Grimbeek, 2007; Li, 2008; Li & Yang,
2009), self-esteem (Baek et al., 2010; Beutel et al., 2009; Lee
et al., 2008; Nishi, Uehara, Kondo, & Matsuoka, 2010), and
social support (Brown, 2008; Bruwer et al., 2008; Monteith
& Ford-Gilboe, 2002; Pietrzak, Goldstein, Malley, Rivers, &
Southwick, 2010; Wilks & Spivey, 2010).
There has been a wealth of literature examining the relation-
ship between resilience and various factors. However, as of now,
no attempt has been made to provide a systematic meta-analysis
of the demographic and psychological variables (i.e., risk and
protective factors) related to resilience levels. Meta-analyses can
be conducted when there is a high volume of data and research
that is sometimes contradictory, because meta-analysis can be
an effective tool for integrating such data. In this case, the use of
meta-analysis has the potential to identify the reason behind the
set of mixed result studies examining the relationship between
demographic variables and resilience. In addition, it can be
used to determine whether various risk and protective factors
are differentially associated with resilience variables. Therefore,
the aim of this study is to gather and meta-analytically integrate
data to form an exploratory review of the relationship between
resilience and demographic and psychological variables, includ-
ing resilience’s risk and protective factors.
Method
Literature Search Procedure
Data for this study came from online databases such as Web
of Science, ProQuest, EBSCO, PsycINFO, and ERIC. Litera-
ture searching was conducted for a period of approximately
6 months, starting on September 6, 2010. Keywords used to
track articles included resilience, resiliency, and resilient.
Through this process, 3,114 articles were identified for
potential study inclusion. We included only peer-reviewed
articles and dissertations because of the concern that unveri-
fied articles, such as newspapers and posters, would lessen
the accuracy of the present study. Furthermore, only English
language studies were included.
The first criterion for selecting articles to be included
was that the studies included a scale to measure resilience
as part of the research study. Although several scales have
been developed to measure resilience, we chose only stud-
ies that measured resilience using the CD-RISC and the
RS. Even though there are various resilience scales, the
CD-RISC and RS are the only validated measurements that
were identified in numerous studies. These scales were ap-
plied with multiple ages and ethnic groups with evidence
of support for the psychometric properties of the scales.
The internal consistency reliability of the CD-RISC is α =
.89 (Connor & Davidson, 2003), α = .88 (Gucciardi et al.,
2011), and α = .89 (Steinhardt & Dolbier, 2008). The RS
Resilience: A Meta-Analytic Approach
also functions as a very reliable and valid scale to assess
resilience with reliability coefficients consistently above
α = .91 (Wagnild & Young, 1993). The RS is a simple and
direct means of beginning to identify the more complex
nature of resilience (Wagnild & Collins, 2009). Other re-
silience instruments were excluded because of their lack of
validity, reliability, and popularity. In addition, we chose
the studies that used the total score of the scale rather
than the subscale scores of the instruments. Applying this
inclusion criterion resulted in 193 studies.
The second criterion for choosing articles was that the study
provided an evaluation of the relationship between resilience and
its related variables. We included studies that provided statistical
data. The statistical methods of data analysis were finding the
means, standard deviations, correlation coefficients, or t statistics.
Applying this inclusion criterion resulted in 90 studies.
The third criterion was that the studies used valid scales
measuring psychological factors. These scales provide evi-
dence for reliability and validity and were appropriate for the
definition of each psychological factor, as shown in Table 1.
The results of this study identified two demographic factors
(age and gender), six protective factors (life satisfaction, op-
timism, positive affect, self-efficacy, self-esteem, and social
support), and five risk factors (anxiety, depression, negative
affect, perceived stress, and posttraumatic stress disorder
[PTSD]) that influenced resilience. In addition, we included
psychological variables that had been previously examined by
more than three studies (Valentine, Pigott, & Rothstein, 2010);
other psychological variables, such as coping style, personality
(e.g., extraversion, agreeableness, neuroticism, openness, and
conscientiousness), spirituality, control, hope, and burnout,
were excluded. Applying this inclusion criterion resulted in 33
studies. Because of these stringent exclusion criteria, we finally
selected 33 empirical studies reporting a statistical result of
the relationship between resilience and psychological factors.
Coding of Studies
All selected empirical studies were coded for the (a) year of
publication and journal title, (b) number of participants, (c)
participants’ gender and age, (d) location of study, (e) resilience
measurement, (f) measurement of psychological factors, and
(g) statistical results (means, standard deviations, t statistics,
and correlation coefficients). The six authors from the current
study coded from each study. To reduce the possibility of cod-
ing errors, four authors (first, third, fourth, and fifth) entered
the codes, and then two authors (second and sixth) rechecked
them. The critical aspect was the agreement of measurement.
The resilience and psychological scales were chosen after
discussing the definitions of each variable and confirming the
item-level validity and reliability of the original scales.
Meta-Analytic Procedures
Effect size calculation. The majority of the studies that we
selected to meta-analytically explore resilience factors pro-
Journal of Counseling & Development  ■  July 2013  ■  Volume 91
vided correlation coefficients between resilience and related
factors. For this reason, we calculated r value (the correlation
coefficient) as the effect size measure. For the studies that did
not provide an r value, the effect size was calculated by means,
standard deviations, and sample size. In order to calculate the
correlations, the means, standard deviations, and sample size
were converted to the t value, and the t value was transformed
to the correlation coefficient r. For calculating the weighted
mean effect size, we transformed the correlation coefficient
r to Fisher’s z and then weighted it. After being weighted
and totalized, Fisher’s z scores that were transformed from r
were converted back to weighted average effect size r values.
Tests of homogeneity. We carried out homogeneity analy-
sis by applying the chi-square test suggested by Rosenthal
(1991). Moreover, we calculated the I2 statistic to represent
the heterogeneity of study results. The Q test is known to
be inadequate to observe true heterogeneity among studies.
Meta-analyses are often conducted using a small number
of studies, but the power of the test in such cases is poor
(Higgins, Thompson, Deeks, & Altman, 2003). Thus, the I2
statistic has been proposed as a means of better calculating
the degree of heterogeneity in a meta-analysis. A Monte
Carlo simulation confirmed that this statistic method is
more effective when the number and size of the studies are
small. For these reasons, we chose to use the I2 statistic as
well as the Q test. The following equation was applied to
test heterogeneity:
I2 = [(Q Q– df)] × 100%.
In general, a percentage of approximately 75% denotes
high heterogeneity, 50% denotes medium heterogeneity, and
25% denotes low heterogeneity. That is, a 0% score of I2
would indicate no heterogeneity, whereas a higher score of I2
would indicate a larger degree of heterogeneity. Whether we
conducted a fixed-effect analysis or a random-effect analysis
depended on the homogeneity result. We performed random-
effect analysis procedures when the data were heterogeneous.
On the other hand, we performed fixed-effect analysis if the
effect sizes had no meaningful differences (Prati & Pietran-
toni, 2009).
In addition, we calculated the statistical power (a sufficiently
high likelihood of yielding a statistically significant result) in
each of the studies because the results of a meta-analysis with
k < 20 studies are potentially underpowered (Cornwell, 1993;
Cornwell & Ladd, 1993). In the present study, the power across
13 variables ranged from 15% to 99.9%. According to the
criteria of Borenstein, Hedges, Higgins, and Rothstein (2009),
the demographic variables of age (15%) and gender (23%) have
little power to detect a significant correlation with resilience,
so the results should be interpreted with caution. The power of
the other 11 risk and protective variables was quite sufficient
to yield a statistically significant effect.
271
 Lee et al.

Table 1
Psychological Factor Definitions and Measures Used in the Meta-Analysis
No. of
Factor Studies Definition and Measures
Life satisfaction 5 Definition: A global assessment of a person’s quality of life according to his chosen criteria (Shin & Johnson,
1978, p. 478).
Measures: Satisfaction With Life Scale (SWLS; Diener et al., 1985), Life Satisfaction Index A (LSI-A; Neugarten et
al., 1961), Questions on Life Satisfaction (Henrich & Herschbach, 2000).
Optimism 6 Definition: The tendency to believe that one will generally experience good outcomes in life (Lee et al., 2008, p.
417).
Measures: Life Orientation Test (LOT; Scheier & Carver, 1985), Positive Psychological Capital (PsyCap; Luthans
et al., 2007), Life Orientation Test–Revised (LOT-R; Scheier et al., 1994).
Positive affect 3 Definition: The extent to which a person feels enthusiastic, active, and alert (Watson et al., 1988, p. 1063).
Measures: Positive and Negative Affect Schedule (PANAS; Watson et al., 1988).
Self-efficacy 3 Definition: People’s belief that they have control over their own functioning and over what occurs in the environment
(Bandura, 1977; Li, 2008, p. 2).
Measures: General Self-Efficacy Scale (GSE; Schwarzer & Jerusalem, 1995), Chinese adaptation of the GSE
(Zhang & Schwarzer, 1995).
Self-esteem 5 Definition: Judgments of self-worth, and/or the degree to which people like or dislike themselves (Lee et al., 2008,
p. 417).
Measures: Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965), Japanese version of the RSES (Mimura &
Griffiths, 2007), Schiraldi Self-Esteem Check-Up (Schiraldi & Brown, 2001).
Social support 5 Definition: The extent to which an individual believes that his/her needs for support, information, and feedback are
fulfilled (Procidano & Heller, 1983, p. 2).
Measures: Multidimensional Scale of Perceived Social Support (MSPSS; Zimet et al., 1988), shortened version of
the Perceived Social Support Scale (S-PSSS; Procidano & Heller, 1983), Health-Promoting Lifestyle Profile II
(HPLP II; Walker & Hill-Polrecky, 1996), Deployment Risk and Resilience Inventory (DRRI; King et al., 2006).
Anxiety 5 Definition: A transient emotional state characterized by subjectively experienced tension and increased activity
state of the autonomous nervous system (Van den Bergh et al., 2008).
Measures: Mental Health Inventory (Veit & Ware, 1983), Overall Anxiety Severity and Impairment Scale (OASIS;
Norman et al., 2006), Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992), Symptom Checklist–90–
Revised (SCL-90-R; Derogatis, 1994), Generalized Anxiety Disorder Scale–7 (GAD-7; Löwe et al., 2003).
Depression 12 Definition: A state in which persistent depressed mood or loss of interest occurs together with other reliable
physical and mental signs, such as difficulties sleeping, poor appetite, impaired concentration, and feelings of
hopelessness and worthlessness (Segal et al., 2002).
Measures: Beck Depression Inventory (BDI; Beck & Steer, 1984), Patient Health Questionnaire–9 (PHQ-9; Spitzer
et al., 1999), Mental Health Inventory (Veit & Ware, 1983), Profile of Mood States–Brief (POMS-B; McNair et
al., 1989), SCL-90-R (Derogatis, 1994), Center for Epidemiologic Studies Depression Scale (CES-D; Radloff,
1977), Patient Health Questionnaire–2 (PHQ-2; Löwe et al., 2005), Beck Depression Inventory–II (BDI-II; Beck
et al., 1996).
Negative affect 3 Definition: A general dimension of subjective distress that incorporates a variety of adverse mood states,
including anger, contempt, disgust, guilt, fear, and nervousness (Watson et al., 1988, p. 1063).
Measures: PANAS (Watson et al., 1988).
Perceived stress 8 Definition: The general concept of maladaptive psychological functioning in the face of stressful life events
(Abeloff et al., 2000, p. 556).
Measures: Perceived Stress Scale (PSS; S. Cohen et al., 1983), SCL-90-R (Derogatis, 1994), Student-Life Stress
Inventory (SSI; Gadzella, 1991), Stress of Conscience Questionnaire (SCQ; Glasberg et al., 2006).
Definition: A heterogeneous disorder with clusters of relatively disparate symptoms, including
PTSD 4 reexperiencing, avoidance/numbing, and hyperarousal (American Psychiatric Association, 2000).
Measures: Child PTSD Checklist (March et al., 1997), modified Post Traumatic Stress Disorder Checklist (PCL;
Weathers et al., 1991), Impact of Event Scale–Revised (IES-R; Weiss & Marmar, 1997), Posttraumatic Stress
Disorder Checklist–Military (PCL-M; Weathers et al., 1991).
Note. PTSD = posttraumatic stress disorder.

Results dency on different demographic and psychological variables,

The meta-analysis included 31,071 participants from 33 stud-
ies. All of the selected articles were published between 2001 and
2010. The articles were published in a diverse range of journals
including Issues in Mental Health Nursing, Psychology and
Mental Health, Nursing and Health Science, and Personality
and Individual Differences. Descriptive information about the
studies is presented in Table 2. Table 3 shows the statistical ele-
ments needed for the meta-analysis: the proportions of depen-
sample sizes, range of average effect size (confidence interval)
weighted r, average z for testing significance, the percentage
of variance accounted for by sampling error variance (Q), and
the percentage of total variance across studies (I2 %). The goal
was to discover whether the variables resulted in homogeneous
subgroups that could highlight significant aspects of the studies.
In Table 3, the Q test of homogeneity, the I2 statistic, and
prediction intervals were calculated to examine heterogene-
ity in effect sizes. The highly significant Q values show that

272 Journal of Counseling & Development  ■  July 2013  ■  Volume 91

Resilience: A Meta-Analytic Approach

Table 2 if r varies more than .5. In this study, the demographic factors
(age, r = .09, p < .01; gender, r = .12, p < .01) had a small but
Descriptive Information of Studies Included in
significant effect on resilience. There were significant large
the Meta-Analysis
effect sizes for all protective factors (life satisfaction, r = .43,
Characteristic n % Sample
p < .001; optimism, r = .42, p < .001; positive affect, r = .59,
Year of publication p < .001; self-efficacy, r = .61, p < .001; self-esteem, r = .55, p
2001–2005 5 15.2
2006–2010 28 84.8 < .001; social support, r = .41, p < .001) and relatively medium
Region in which study was conducted effect sizes for all risk factors (anxiety, r = –.38, p < .001; de-
Africa 1 3.0 pression, r = –.39, p < .001; PTSD, r = –.29, p < .001; negative
Asia 4 12.1
Australia 3 9.1 affect, r = –.27, p < .001; perceived stress, r = –.36, p < .001).
North America 21 63.6 Overall, the average effect size for self-efficacy (r = .61, p < .001)
Western Europe 4 12.1 was the largest, followed by positive affect and self-esteem. For
Sample size
≤100 7 21.2 the psychological variables, protective (positive) factors were
101–300 11 33.3 related more strongly to resilience than risk (negative) factors.
301–500 7 21.2
501–800 5 15.2 Measurement of Sampling Bias
1,000–2,000 2 6.1
>2,001 1 3.0 In this meta-analysis, both significant and nonsignificant
Mean participant age results were examined. According to Cox, Kenardy, and
Under 20 6 18.2
21–30 7 21.2 Hendrikz (2008), however, sampling bias may exist because
31–40 7 21.2 researchers focus on positive results, choosing to keep the
41–50 7 21.2 negative ones inside their file drawers. We calculated the
Over 60 5 15.2
Not reported 1 3.0 number of studies (X) needed to overturn the results using
Sex Rosenthal’s (1991) recommended equation:
100% female 9 27.3
80%–99% female 8 24.2
60%–79% female 4 12.1 X = 19s – n,
40%–59% female 3 9.1
10%–30% female 4 12.1 where s represents the number of significant studies and n
0% female 4 12.1
Not reported 1 3.0 represents the number of nonsignificant studies at the .05
DV scale level. Upon calculating for X, one should compare it to the
CD-RISC tolerance level with the following equation:
 CD-RISC-25 15 45.5
  Short version of the CD-RISC 2 6.1
RS Tolerance = 5k + 10,
 RS-25 10 30.3
  Short version of the RS 6 18.2
where k represents the number of studies in the meta-analysis. If the
Note. N = 33. DV = dependent variable; CD-RISC = Connor–Davidson
number of additional studies exceeds the tolerance level, the results
Resilience Scale (Connor & Davidson, 2003); RS = Resilience
Scale (Wagnild & Young, 1993). should not be overturned by studies showing contrary results. When
we applied this method for detecting sampling bias, we found that,
this could not be explained by sampling error alone because with the exception of age and gender, the predictors were robust
the variance in the majority of effect sizes was distributed variables, as shown in Table 4. This means the findings could not
heterogeneously. The I2 statistic showed high heterogeneity be easily overturned by contrary results. On the other hand, for age
in most of the variables (anxiety, I2 = 70.26; depression, I2 and gender, the results should be interpreted with caution.
= 71.26; gender, I2 = 70.53; optimism, I2 = 67.41; perceived
stress, I2 = 71.72; PTSD, I2 = 91.15; self-esteem, I2 = 91.42; Discussion
social support, I2 = 79). Age, life satisfaction, positive affect,
self-efficacy, and negative affect were not significantly het- This meta-analysis began with a systematic exploration of
erogeneous. As a result, most variables were analyzed using the strength and predictive power of demographic and psy-
the random-effect model to draw the weighted average effect chological factors’ impact on resilience levels. The results
sizes (r and Fisher’s z), excluding the homogeneous variables from 33 studies indicated that there were different degrees
(age, I2 = 0; life satisfaction, I2 = 0; positive affect, I2 = 32.63; of effect among factors in correlation with resilience, de-
self-efficacy, I2 = 0; negative affect, I2 = 0). pending on the Cohen’s d effect. As we expected, in general,
According to J. Cohen (1988, 1992), the effect size is low the largest effect on resilience was found to come from the
if the value of r varies around .1. The effect size is called protective factors, the medium effect came from risk factors,
medium if r varies around .3, and the effect size is called large and the smallest effect was allied to demographic factors.

Journal of Counseling & Development  ■  July 2013  ■  Volume 91 273

 Lee et al.

Table 3
Meta-Analytical Summary of Resilience
No. of 95% CI Weighted Average
Factor Studies N LL UL r z Q I2%
Demographic factors
Age 6 2,204 .05 .13 .09 4.20* 1.84 0.00
Gender 5 1,868 .03 .21 .12 2.59* 13.57* 70.53
Protective factors
Life satisfaction 5 2,962 .40 .46 .43 25.79** 3.46 0.00
Optimism 6 2,428 .34 .50 .42 10.71** 15.34* 67.41
Positive affect 3 2,231 .56 .62 .59 34.42** 2.97 32.63
Self-efficacy 3 1,317 .57 .65 .61 27.82** 1.46 0.00
Self-esteem 5 3,916 .44 .66 .55 9.71** 46.63** 91.42
Social support 5 1,140 .29 .53 .41 6.48** 19.05** 79.00
Risk factor
Anxiety 5 2,868 –.50 –.25 –.38 5.89** 13.45* 70.26
Depression 12 5,022 –.45 –.33 –.39 12.76** 38.28** 71.26
Negative affect 3 2,231 –.31 –.23 –.27 13.19** 1.11 0.00
Perceived stress 8 2,338 –.44 –.28 –.36 9.28** 24.75** 71.72
PTSD 4 1,678 –.44 –.13 –.29 3.63** 33.90** 91.15
Note. CI = confidence interval; LL = lower limit; UL = upper limit; Q = test for homogeneity of effect sizes; I 2% = percentage of total
variance across studies; PTSD = posttraumatic stress disorder.
*p < .01. **p < .001.

There were further differences in the degree to which there self-efficacy, positive affect, self-esteem) are strongly correlated
was an effect between individual factors of a given category with resilience indicates that the resilience construct is composed
and resilience. Self-efficacy was the strongest positively related mainly of these factors. Additionally, it supports Masten, Best,
variable to resilience compared with the other variables (e.g., life and Garmezy’s (1990) suggestion that resilience can be defined
satisfaction, optimism). That is, a greater level of self-efficacy by the presence of protective factors or processes, which moder-
was closely related to an increase in an individual’s resilience, ate the relationship between stress and risk.
for example, having the ability to cope with change and to use The medium effect size of the relationship between
a repertoire of problem-solving skills, evidence that was also resilience and risk factors also had been supported by
supported by previous studies (Tusaie & Dyer, 2004). In ad- previous studies. Among risk factors, depression was the
dition, the result showed that positive affect was strongly cor- strongest negatively related variable to resilience com-
related with resilience, which indicated that resilient individuals pared with the other variables (e.g., PTSD and negative
are able to use positive affect to protect themselves against the affect). In addition, anxiety had nearly the same effect
effect of traumatic life events. The fact that such variables (i.e., size. In regard to this similarity of effect size between
Table 4
Statistical Power and Sampling Bias
No. of Studies Tol.
Factor Studies % Power Sig. Nonsig. to OR Level Robust
Total 33 61 9 1,150 175 Yes
Demographic factors
Age 6 14.5 1 5 14 40 No
Gender 5 22.7 1 4 15 35 No
Protective factors
Life satisfaction 5 99.0 5 0 95 35 Yes
Optimism 6 98.7 6 0 114 40 Yes
Positive affect 3 99.9 3 0 57 25 Yes
Self-efficacy 3 99.9 3 0 57 25 Yes
Self-esteem 5 99.9 5 0 95 35 Yes
Social support 5 98.4 5 0 95 35 Yes
Risk factor
Anxiety 5 96.5 5 0 95 35 Yes
Depression 12 97.4 12 0 228 70 Yes
Negative affect 3 76.9 3 0 57 25 Yes
Perceived stress 8 95.1 8 0 152 50 Yes
PTSD 4 82.0 4 0 76 30 Yes
Note. Sig. = significant; Nonsig. = nonsignificant; Studies to OR = number of studies needed to overturn results; Tol. Level = tolerance
level; PTSD = posttraumatic stress disorder.

274 Journal of Counseling & Development  ■  July 2013  ■  Volume 91

Resilience: A Meta-Analytic Approach
depression and anxiety, it is possible that several mea-
surement factors may contribute to their relationship with
resilience. That is, especially with samples from the clini-
cal population, self-report measures of depression and
anxiety often included very similar items; therefore, the
relationship between depression and resilience, and its
similarity to the relationship between anxiety and resil-
ience, may be attributed to “contamination” due to shared
item content. Anxiety symptoms also often co-occur with
depression, which could explain this phenomenon. Com-
pared with the protective and risk psychological factors,
demographic factors did not have a significant effect size
in correlation with resilience. The results of the meta-
analysis have shown that the correlation between risk
factors and resilience is less than the correlation between
positive factors and resilience. This could be because
resilience in itself is considered a type of positive factor.
The results of this meta-analysis further imply that re-
silience could be part of a protective process active against
depression, anxiety, PTSD, and other psychiatric disorders,
and it is strongly associated with positive affect and opti-
mism, which in turn are positively related to self-efficacy
and self-esteem. Resilience can be thought of as a dynamic
process that both protects an individual in adverse situations
and enhances his or her therapeutic outcomes against risk
factors (e.g., depression and anxiety; Tusaie & Dyer, 2004).
Although this study has provided a useful summary of
a wide range of data derived from previous studies, there
are several limitations. The vast majority of the studies
included in this meta-analysis were not diverse in terms of
participants’ cultural backgrounds (e.g., gender, age, educa-
tion, ethnicity, and years of employment), with most studies
having been conducted using a White American population.
Resilience protects individuals against adversity, and the
concept of resilience is thought to be universal. However,
individual and cultural differences arise due to distinct
historical, social, and geographical environments, and the
concept of resilience may differ across individuals and
cultures. Also, an individual’s employment background and
work environment have been shown to influence workplace
adaptation through acquisition, showing differences related
to the degree and strength of employment stressors they may
face. Therefore, further research using samples from more
diverse cultural backgrounds and demographics should be
conducted. In addition, this study also did not consider the
intensity and/or nature of trauma even though resilience
would change depending on whether trauma was long term
(e.g., childhood abuse) or short term (e.g., a traffic accident).
Future research should more specifically investigate which
protective factors are associated with resilience contingent
on the intensity and/or nature of the trauma. In addition,
longitudinal research is also necessary to evaluate the protec-
tive factors in regard to resilience against the onset or later
development of trauma. Finally, many of the studies ana-
Journal of Counseling & Development  ■  July 2013  ■  Volume 91
lyzed also used correlational designs, which are mute with
regard to the exact processes that underlie the relationship
between various factors and resilience. Further studies could
therefore benefit from using more experimental designs so
that a better examination of the causal links between factors
and resilience could be made. In addition, an examination
of the mediatory and moderating factors influencing resil-
ience is necessary.
This study has important implications for research and
practice. The results of this study indicated that enhancing
the protective factors (e.g., self-efficacy, positive affect, and
self-esteem) is more effective than reducing the risk factors
(e.g., depression and anxiety) to improve resilience. There-
fore, counselors must be aware of the characteristics that
compromise the resilience of clients and should develop and
provide intervention strategies to maximize protective fac-
tors for enhancing a client’s chance of fulfillment (Werner &
Smith, 1992; William, Roberta, Karina, Heidi, & Richard,
2009). It is also important for counselors to study populations
that have experienced and overcome trauma or adversity to
accurately assess the factors associated with effective resil-
ience. A better understanding of these factors would allow
for improved education, training, and clinical programs that
can increase resilience and coping strategies for individuals.
Moreover, the protective factor associated with resilience
interacts with a stressor to reduce the likelihood of negative
outcomes (Masten et al., 1990; C. Smith & Carlson, 1997).
Several internal and external resources as protective factors
have been suggested as ways to cope with stress (Lazarus &
Folkman, 1984; Zeitlin & Williamson, 1994). In a counseling
session, a counselor should use specific intervention methods
that help enhance a client’s resilience and strength. For example,
focusing on internal resources (e.g., self-efficacy, self-esteem,
positive affect, self-worth), which enhance clients’ resilience,
should be considered first. During the individual therapy ses-
sion, the counselor, in a nurturing manner (e.g., unconditional
positive regard), could empower clients to put their difficulties
aside and maintain an optimistic outlook by identifying clients’
potential talents. In addition, the counselor may help clients
to cope better by enhancing the most prominent traits in them
(E. J. Smith, 2006).
Interventions using external resources, such as social
supports from family, should also be considered to enhance
clients’ resilience. That is, building support systems from
a client’s family and other community members could be
an important step for buffering the possible environmen-
tal risks. This also implies that investigating internal and
external resources of resilience should be considered in
counseling research as well as counseling practice. That is,
resilience needs to be studied by considering a multifaceted
combination of individual, family, and social factors and
how they interact with one another, which would facilitate
an understanding of how the outcome produces various
adaptations over time.
275

References
Note. References marked with an asterisk indicate studies
included in the meta-analysis.
Abeloff, M. D., Armitage, J. O., Lichter, A. S., & Niederhuber, J. E.
(2000). Clinical oncology. New York, NY: Churchill Livingstone.
Ahern, N. R., Kiehl, E. M., Sole, M. L., & Byers, J. (2006). A review
of instruments measuring resilience. Issues in Comprehensive
Pediatric Nursing, 29, 103–125.
American Psychiatric Association. (2000). Diagnostic and statisti-
cal manual of mental disorders (4th ed., text rev.). Washington,
DC: Author.
Asendorpf, J. B., & van Aken, M. A. G. (1999). Resilient, overcon-
trolled, and undercontrolled personality prototypes in childhood:
Replicability, predictive power, and the trait-type issue. Journal
of Personality and Social Psychology, 77, 815–832.
*Baek, H.-S., Lee, K.-U., Joo, E.-J., Lee, M.-Y., & Choi, K.-S. (2010).
Reliability and validity of the Korean version of the Connor-
Davidson Resilience Scale. Psychiatry Investigation, 7, 109–115.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of
behavioral change. Psychological Review, 84, 191–215.
Baruth, K. E., & Carroll, J. J. (2002). A formal assessment of resil-
ience: The Baruth Protective Factors Inventory. The Journal of
Individual Psychology, 58, 235–244.
Beck, A. T., & Steer, R. A. (1984). Internal consistencies of the
original and revised Beck Depression Inventory. Journal of
Clinical Psychology, 40, 1365–1367.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II, Beck
Depression Inventory: Manual. Boston, MA: Harcourt Brace.
*Beutel, M. E., Glaesmer, H., Decker, O., Fischbeck, S., & Brahler,
E. (2009). Life satisfaction, distress, and resiliency across the
life span of women. The Journal of North American Menopause
Society, 16, 1132–1138.
Block, J. H., & Block, J. (1980). The role of ego-control and ego-
resiliency in the organization of behavior. In W. A. Collins (Ed.),
Minnesota symposium on child psychology (Vol. 13, pp. 39–101).
Hillsdale, NJ: Erlbaum.
Block, J., & Kremen, A. M. (1996). IQ and ego resiliency: Con-
ceptual and empirical connections and separateness. Journal of
Personality and Social Psychology, 70, 349–361.
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H.
R. (2009). Introduction to meta-analysis. Chichester, United
Kingdom: Wiley.
*Brown, D. L. (2008). African American resiliency: Examining racial
socialization and social support as protective factors. Journal of
Black Psychology, 34, 32–48.
*Bruwer, B., Emsley, R., Kidd, M., Lochner, C., & Seedat, S. (2008).
Psychometric properties of the Multidimensional Scale of Perceived
Social Support in youth. Comprehensive Psychiatry, 49, 195–201.
*Burns, R. A., & Anstey, K. J. (2010). The Connor-Davidson Resil-
ience Scale (CD-RISC): Testing the invariance of a unidimensional
resilience measure that is independent of positive and negative
affect. Personality and Individual Differences, 48, 527–531.
276 Journal of Counseling & Development  ■  July 2013  ■  Volume 91
Lee et al.
Campbell-Sills, L., Cohan, S. L., & Stein, M. B. (2006). Relationship
of resilience to personality, coping, and psychiatric symptoms
in young adults. Behavior Research and Therapy, 44, 585–599.
*Campbell-Sills, L., Forde, D. R., & Stein, M. B. (2009). Demo-
graphic and childhood environmental predictors of resilience
in a community sample. Journal of Psychiatric Research, 43,
1007–1012.
*Choowattanapakorn, T., Alex, L., Lundman, B., Norberg, A., &
Nygren, B. (2010). Resilience among women and men aged 60
years and over in Sweden and in Thailand. Nursing and Health
Sciences, 12, 329–335.
Cohen, J. (1988). Statistical power analysis for the behavioral sci-
ences (2nd ed.). Hillsdale, NJ: Erlbaum.
Cohen, J. (1992). Statistical power analysis. Current Directions in
Psychological Sciences, 1, 98–101.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global mea-
sure of perceived stress. Journal of Health and Social Behavior,
24, 385–396.
Connor, K. M., & Davidson, J. R. T. (2003). Development of a new
resilience scale: The Connor–Davidson Resilience Scale (CD-
RISC). Depression and Anxiety, 18, 76–82.
Cornwell, J. M. (1993). Monte Carlo comparisons of three tests
for homogeneity of independent correlations. Educational and
Psychological Measurement, 53, 605–618.
Cornwell, J. M., & Ladd, R. T. (1993). Power and accuracy of the
Schmidt and Hunter meta-analytic procedures. Educational and
Psychological Measurement, 53, 877–895.
Cox, C. M., Kenardy, J. A., & Hendrikz, J. K. (2008). A meta-analysis
of risk factors that predict psychopathology following accidental
trauma. Journal for Specialists in Pediatric Nursing, 13, 98–110.
Davidson, J. R. T., Payne, V. M., Connor, K. M., Foa, E. B., Rothbaum,
B. O., Hertzberg, M. A., & Weisler, R. H. (2005). Trauma, resil-
ience and saliostasis: Effects of treatment in post-traumatic stress
disorder. International Clinical Psychopharmacology, 20, 43–48.
Derogatis, L. R. (1994). The Symptom Checklist-90-R: Administra-
tion, scoring and procedures manual. Minneapolis, MN: National
Computing Systems.
Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985).
The Satisfaction With Life Scale. Journal of Personality Assess-
ment, 49, 71–75.
Dyer, J. G., & McGuinness, T. M. (1996). Resilience: Analysis of the
concept. Archives of Psychiatric Nursing, 10, 276–282.
Friborg, O., Hjemdal, O., Rosenvinge, J. H., & Martinussen,
M. (2003). A new rating scale for adult resilience: What are
the central protective resources behind healthy adjustment?
International Journal of Methods in Psychiatric Research,
12, 65–76.
Gadzella, B. M. (1991). Student-Life Stress Inventory. Commerce,
TX: Author.
*Gillespie, B. M, Chaboyer, W., & Wallis, M. (2009). The influence
of personal characteristics on the resilience of operating room
nurses: A predictor study. International Journal of Nursing
Studies, 46, 968–976.
Resilience: A Meta-Analytic Approach
*Gillespie, B. M., Chaboyer, W., Wallis, M., & Grimbeek, P. (2007).
Resilience in the operating room: Developing and testing of a
resilience model. Journal of Advanced Nursing, 59, 427–438.
Glasberg, A. L., Eriksson, S., Dahlqvist, V., Lindahl, E., Strandberg,
G., Soderberg, A., . . . Norberg, A. (2006). Development and
initial validation of the Stress of Conscience Questionnaire.
Nursing Ethics, 13, 633–648.
*Glasberg, A. L., Eriksson, S., & Norberg, A. (2008). Factors as-
sociated with ‘stress of conscience’ in healthcare. Scandinavian
Journal of Caring Sciences, 22, 249–258.
Gucciardi, D. F., Jackson, B., Coulter, T. J., & Mallett, C. J.
(2011). The Connor-Davidson Resilience Scale (CD-RISC):
Dimensionality and age-related measurement invariance with
Australian cricketers. Psychology of Sport and Exercise, 12,
423–433.
Hart, D., Hofmann, V., Edelstein, W., & Keller, M. (1997). The
relation of childhood personality types to adolescent behavior
and development: A longitudinal study of Icelandic children.
Developmental Psychology, 33, 195–205.
*Heilemann, M. V., Lee, K., & Kury, F. S. (2003). Psychometric
properties of the Spanish version of the Resilience Scale. Journal
of Nursing Measurement, 11, 61–72.
Henrich, G., & Herschbach, P. (2000). Questions on life satisfaction
(FLZ M): A short questionnaire for assessing subjective quality of
life. European Journal of Psychological Assessment, 16, 150–159.
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003).
Measuring inconsistency in meta-analyses. BMJ, 327, 557–560.
*Humphreys, J. (2003). Resilience in sheltered battered women.
Issues in Mental Health Nursing, 24, 137–152.
Jorgensen, I. E., & Seedat, S. (2008). Factor structure of the Connor–
Davidson Resilience Scale in South African adolescents. Inter-
national Journal of Adolescent Medicine and Health, 20, 23–32.
Jung, Y. E., Min, J. A., Shin, A. Y., Han, S. Y., Lee, K. U., Kim, T.
S., . . . Chae, J. H. (2012). The Korean Version of the Connor–
Davidson Resilience Scale: An extended validation. Stress and
Health, 28, 319–326. doi:10.1002/smi.1436
Khoshouei, M. (2009). Psychometric evaluation of the Connor–
Davidson Resilience Scale (CD-RISC) using Iranian students.
International Journal of Testing, 9, 60–66.
King, L. A., King, D. W., Vogt, D. S., Knight, J., & Samper, R. E.
(2006). Deployment Risk and Resilience Inventory: A collection
of measures for studying deployment-related experiences of mili-
tary personnel and veterans. Military Psychology, 18, 89–120.
*Lamond, A. J., Depp, C. A., Allison, M., Langer, R., Reichstadt, J.,
Moore, D. J., . . . Jeste, D. V. (2008). Measurement and predictors
of resilience among community-dwelling older women. Journal
of Psychiatric Research, 43, 148–154.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping.
New York, NY: Springer.
*Lee, H. S., Brown, S. L., Mitchell, M. M., & Schiraldi, G. R.
(2008). Correlates of resilience in the face of adversity for Ko-
rean women immigrating to the US. Journal of Immigrant and
Minority Health, 10, 415–422.
Journal of Counseling & Development  ■  July 2013  ■  Volume 91
*Li, M. (2008). Helping college students cope: Identifying predic-
tors of active coping in different stressful situations. Journal of
Psychiatry, Psychology and Mental Health, 2, 1–15.
*Li, M., & Yang, Y. (2009). Determinants of problem solving, social
support seeking, and avoidance: A path analytic model. Interna-
tional Journal of Stress Management, 16, 155–176.
Löwe, B., Gräfe, K., Zipfel, S., Spitzer, R. L., Herrmann-Ligen,
C., Witte, S., & Herzog, W. (2003). Detecting panic disorder in
medical and psychosomatic outpatients: Comparative validation
of the Hospital Anxiety and Depression Scale, the Patient Health
Questionnaire, a screening question, and physicians’ diagnosis.
Journal of Psychosomatic Research, 55, 515–519.
Löwe, B., Kroenke, K., & Gräfe, K. (2005). Detecting and monitor-
ing depression with a two-item questionnaire (PHQ-2). Journal
of Psychosomatic Research, 58, 163–171.
*Luthans, F., Avolio, B. J., Avey, J. B., & Norman, S. M. (2007).
Positive psychological capital: Measurement and relationship with
performance and satisfaction. Personnel Psychology, 60, 541–572.
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of
resilience: A critical evaluation and guidelines for futures work.
Child Development, 71, 543–562.
*Maguen, S., Turcotte, D. M., Peterson, A. L., Dremsa, T. L., Garb,
H. N., McNally, R. J., & Litz, B. T. (2008). Description of risk
and resilience factors among military medical personnel before
deployment to Iraq. Military Medicine, 173, 1–9.
March, J. S., Amaya-Jackson, L., Terry, R., & Costanzo, P. (1997).
Posttraumatic symptomatology in children and adolescents after
an industrial fire. Journal of the American Academy of Child and
Adolescent Psychiatry, 36, 1080–1088.
Masten, A. S. (2001). Ordinary magic: Resilience processes in
development. American Psychologist, 56, 227–238.
Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and
development: Contributions from the study of children who
overcome adversity. Development and Psychology, 2, 425–444.
Masten, A. S., & Obradovic, J. (2006). Competence and resilience
in development. Annals of the New York Academy of Sciences,
1094, 13–27.
McGloin, J. M., & Widom, C. S. (2001). Resilience among abused
and neglected children grown up. Development and Psychopa-
thology, 13, 1021–1038.
McNair, D., Lorr, M., Heuchert, J., & Droppleman, L. (1989).
Profile of Mood States technical update. North Tonawanda, NY:
Multi-Health Systems.
Mimura, C., & Griffiths, P. (2007). A Japanese version of the Rosen-
berg Self-Esteem Scale: Translation and equivalence assessment.
Journal of Psychosomatic Research, 62, 589–594.
*Monteith, B., & Ford-Gilboe, M. (2002). The relationships among
mother’s resilience, family health work, and mother’s health-
promoting lifestyle practices in families with preschool children.
Journal of Family Nursing, 8, 383–407.
Muller, R., Ward, P. R., Winefield, T., Tsourtos, G., & Lawn, S. (2009).
The importance of resilience of primary care practitioners: An inter-
active psycho-social model. Australasian Medical Journal, 1, 1–15.
277

Neugarten, B. L., Havighurst, R. J., & Tobin, S. S. (1961). The
measurement of life satisfaction. Journals of Gerontology, 16,
134–143.
*Nishi, D., Uehara, R., Kondo, M., & Matsuoka, Y. (2010). Reli-
ability and validity of the Japanese version of the Resilience Scale
and its short version. BioMedical Central Research Notes, 3, 310.
*Norman, S. B., Cissell, S. H., Means-Christensen, A. J., & Stein,
M. B. (2006). Development and validation of an Overall Anxi-
ety Severity and Impairment Scale (OASIS). Depression and
Anxiety, 23, 245–249.
Peterson, R. A., & Reiss, S. (1992). The Anxiety Sensitivity Index
manual. Worthington, OH: International Diagnostic Systems.
*Pietrzak, R. H., Goldstein, M. B., Malley, J. C., Rivers, A. J.,
& Southwick, S. M. (2010). Structure of posttraumatic stress
disorder symptoms and psychosocial functioning in Veterans of
Operations Enduring Freedom and Iraqi Freedom. Psychiatry
Research, 178, 323–329.
*Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C.,
Rivers, A. J., Morgan, C. A., & Southwick, S. M. (2010). Psy-
chosocial buffers of traumatic stress, depressive symptoms, and
psychosocial difficulties in veterans of Operations Enduring Free-
dom and Iraqi Freedom: The role of resilience, unit support, and
postdeployment social support. Journal of Affective Disorders,
120, 188–192. doi:10.1016/j.jad.2009.04.015
Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and
coping strategies as factors contributing to posttraumatic growth:
A meta-analysis. Journal of Loss and Trauma, 14, 364–388.
Procidano, M. E., & Heller, K. (1983). Measures of perceived social
support from friends and from family: Three validation studies.
American Journal of Community Psychology, 11, 1–24.
Radloff, L. S. (1977). Depressed woman: A study in social relation-
ships. Sex Roles, 3, 405–407.
*Rew, L., Taylor-Seehafer, M., Thomas, N. Y., & Yockey, R. D.
(2001). Correlates of resilience in homeless adolescents. Journal
of Nursing Scholarship, 33, 33–40.
Richardson, G. E. (2002). The metatheory of resilience and resil-
iency. Journal of Clinical Psychology, 58, 307–321.
Roberts, J. M., & Masten, A. S. (2004). Resilience in context. In R.
DeV. Peters, R. McMahon, & B. Leadbeater (Eds.), Resilience
in children, families, and communities: Linking context to prac-
tice and policy (pp. 13–25). New York, NY: Kluwer Academic/
Plenum.
Robins, R. W., John, O. P., Caspi, A., Moffitt, T. E., & Stouthamer-
Loeber, M. (1996). Resilient, overcontrolled, and undercontrolled
boys: Three replicable personality types. Journal of Personality
and Social Psychology, 70, 157–171.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton,
NJ: Princeton University Press.
Rosenthal, R. (1991). Meta-analytic procedures for social research.
Newbury Park, CA: Sage.
*Roy, A., Sarchiapone, M., & Carli, V. (2007). Low resilience in
suicide attempters: Relationship to depressive symptoms. De-
pression and Anxiety, 24, 273–274.
278 Journal of Counseling & Development  ■  July 2013  ■  Volume 91
Lee et al.
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health:
Assessment and implications of generalized outcome expectan-
cies. Health Psychology, 4, 219–247.
Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguish-
ing optimism from neuroticism (and trait anxiety, self-mastery,
and self-esteem): A reevaluation of the Life Orientation Test.
Journal of Personality and Social Psychology, 67, 1063–1078.
Schiraldi, G. R., & Brown, S. L. (2001). Primary prevention for
mental health: Results of an exploratory cognitive-behavioral
college course. Journal of Primary Prevention, 22, 55–67.
*Schultz, P., Roditti, M., & Gillette, M. (2009). Resilience, social
support, and psychological disturbance in Hispanic women re-
siding in a battered women’s shelter on the U.S./Mexico border.
Hispanic Health Care International, 7, 224–230.
Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy
Scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures
in health psychology: A user’s portfolio (pp. 35–37). London,
United Kingdom: NFER-NELSON.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Preventing
depression: Mindfulness-based cognitive therapy. New York,
NY: Guilford Press.
Sexton, M. B., Byrd, M. R., & von Kluge, S. (2010). Measuring
resilience in women experiencing infertility using the CD-RISC:
Examining infertility related stress, general distress, and coping
styles. Journal of Psychiatric Research, 44, 236–241.
Shin, D. C., & Johnson, D. M. (1978). Avowed happiness as an
overall assessment of the quality of life. Social Indicators Re-
search, 5, 475–492.
Singh, K., & Yu, X. (2010). Psychometric evaluation of the Connor-
Davidson Resilience Scale (CD-RISC) in a sample of Indian
students. Journal of Psychology, 1, 23–30.
*Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P.,
& Bernard, J. (2008). The Brief Resilience Scale: Assessing
the ability to bounce back. International Journal of Behavioral
Medicine, 15, 194–200.
Smith, C., & Carlson, B. (1997). Stress, coping, and resilience in
children and youth. Social Service Review, 71, 231–256.
Smith, E. J. (2006). The Strength-Based Counseling Model. The
Counseling Psychologist, 34, 13–79.
*Smith, P. R. (2009). Resilience: Resistance factor for depressive
symptom. Journal of Psychiatric and Mental Health Nursing,
16, 829–837.
Spitzer, R. L., Kroenke, K., & Williams, J. B. W. (1999). Validation
and utility of a self-report version of PRIME-MD: The PHQ
primary care study. Journal of the American Medical Associa-
tion, 282, 1737–1744.
*Stein, M. B., Campbell-Sills, L., & Gelernter, J. (2009). Genetic
variation in 5HTTLPR is associated with emotional resilience.
American Journal of Medical Genetics Part B: Neuropsychiatric
Genetics, 150B, 900–906.
Steinhardt, M., & Dolbier, C. (2008). Evaluation of a resilience interven-
tion to enhance coping strategies and protective factors and decrease
symptomatology. Journal of American College Health, 56, 445–453.
Resilience: A Meta-Analytic Approach
Tusaie, K., & Dyer, J. (2004). Resilience: A historical review of the
construct. Holistic Nursing Practice, 18, 3–10.
Valentine, J. C., Pigott, T. D., & Rothstein, H. R. (2010). How many
studies do you need? A primer on statistical power for meta-
analysis. Journal of Educational and Behavioral Statistics, 35,
215–247.
Van den Bergh, B. R. H., Van Calster, B., Pinna Puissant, S., & Van
Huffel, S. (2008). Self-reported symptoms of depressed mood,
trait anxiety and aggressive behavior in post-pubertal adoles-
cents: Associations with diurnal cortisol profiles. Hormones and
Behavior, 54, 253–257.
Veit, C. T., & Ware, J. E. (1983). The structure of psychological
distress and well-being in general populations. Journal of Con-
sulting and Clinical Psychology, 51, 730–742.
*Wagnild, G. (2003). Resilience and successful aging: Comparison
among low and high income older adults. Journal of Gerontologi-
cal Nursing, 29, 42–49.
Wagnild, G., & Collins, J. (2009). Assessing resilience. Journal of
Psychosocial Nursing and Mental Health Services, 47, 28–33.
Wagnild, G., & Young, H. (1993). Development and psychometric
evaluation of the Resilience Scale. Journal of Nursing Measure-
ment, 1, 165–178.
Walker, S. N., & Hill-Polrecky, D. (1996, June). Psychometric
evaluation of the Health-Promoting Lifestyle Profile II. In
Proceedings of the 1996 Scientific Session of the American
Nurses Association’s Council of Nurse Researchers, Wash-
ington, DC.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and
validation of brief measures of positive and negative affect: The
PANAS scales. Journal of Personality and Social Psychology,
54, 1063–1070.
Weathers, F., Huska, J., & Keane, T. (1991). The PTSD Checklist
Military version (PCL-M). Boston, MA: National Center for
PTSD.
Journal of Counseling & Development  ■  July 2013  ■  Volume 91
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event
Scale–Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing
psychological trauma and PTSD: A handbook for practitioners
(pp. 399–411). New York, NY: Guilford Press.
Werner, E. E., & Smith, R. S. (1992). Overcoming the odds: High risk
children from birth to adulthood. Ithaca, NY: Cornell University Press.
*White, B., Driver, S., & Warren, A. M. (2010). Resilience and
indicators of adjustment during rehabilitation from a spinal cord
injury. Rehabilitation Psychology, 55, 23–32.
*Wilks, S. E. (2008). Psychometric evaluation of the shortened Re-
silience Scale among Alzheimer’s caregivers. American Journal
of Alzheimer’s Diseases & Other Dementias, 23, 143–149.
*Wilks, S. E., & Spivey, C. A. (2010). Resilience in undergraduate
social work students’ social support and adjustment to academic
stress. Social Work Education, 29, 276–288.
William, P., Roberta, E., Karina, R., Heidi, M., & Richard, C. (2009).
Academic resilience among undocumented Latino students.
Hispanic Journal of Behavioral Sciences, 31, 149–181.
Yates, T., Egeland, B., & Sroufe, L. A. (2003). Rethinking resilience.
A developmental process perspective. In S. Luthar (Ed.), Resil-
ience and vulnerability: Adaptation in the context of adversity
(pp. 243–266). New York, NY: Cambridge University Press.
Yu, X., & Zhang, J. (2007). Factor analysis and psychometric evalu-
ation of the Connor-Davidson Resilience Scale (CD-RISC) with
Chinese people. Social Behavior and Personality, 35, 19–30.
Zeitlin, S., & Williamson, G. G. (1994). Coping in young children:
Early intervention practices to enhance adaptive behavior and
resilience. Baltimore, MD: Brookes Publishing.
Zhang, J. X., & Schwarzer, R. (1995). Measuring optimistic self-
beliefs: A Chinese adaptation of the General Self-Efficacy Scale.
Psychologia, 38, 174–181.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988).
The Multidimensional Scale of Perceived Social Support. Journal
of Personality Assessment, 52, 30–41.
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