IJMPR 12.

2_crc 28/5/03 1:29 pm Page 65

International Journal of Methods in Psychiatric Research, Volume 12, Number 2 65

A new rating scale for adult resilience: what

are the central protective resources behind
healthy adjustment?

ODDGEIR FRIBORG, ODIN HJEMDAL, JAN H. ROSENVINGE, MONICA MARTINUSSEN, Department

of Psychology, University of Tromsø, Norway

ABSTRACT: Resources that protect against the development of psychiatric disturbances are reported to be a significant
force behind healthy adjustment to life stresses, rather than the absence of risk factors. In this paper a new scale for
measuring the presence of protective resources that promote adult resilience is validated. The preliminary version of the
scale consisted of 45 items covering five dimensions: personal competence, social competence, family coherence, social
support and personal structure.
The Resilience Scale for Adults (RSA), the Sense of Coherence scale (SOC) and the Hopkins Symptom Checklist
(HSCL) were given to 59 patients once, and to 276 normal controls twice, separated by four months.
The factor structure was replicated. The respective dimensions had Cronbach’s alphas of 0.90, 0.83, 0.87, 0.83 and
0.67, and four-month test-retest correlations of 0.79, 0.84, 0.77, 0.69 and 0.74. Construct validity was supported by
positive correlations with SOC and negative correlations with HSCL. The RSA differentiated between patients and healthy
control subjects. Discriminant validity was indicated by differential positive correlations between RSA subscales and SOC.
The RSA-scale might be used as a valid and reliable measurement in health and clinical psychology to assess the presence
of protective factors important to regain and maintain mental health.

Key words: resilience, scale development, validation, sense of coherence, psychiatric symptoms

Individuals who sustain normal development despite • family support and cohesion; and
long-term stress, adversity or maltreatment, are • external support systems.
frequently labelled ‘resilient’ (Garmezy and
Nuechterlein, 1972; Garmezy, 1981; Rutter, 1985; These are the most significant determinants of a
Steele, 1987; Zimrin, 1987; Cowen and Work, 1988; healthy adjustment to long-term stresses. The overall
Egeland, Carlson, Sroufe, 1993; Block and Kremen, aim of this study was to develop a valid scale for
1996). Longitudinal studies conducted over four measuring the presence of such protective resources
decades, such as the Kauai study (Werner, 1989, 1993, and to examine whether these resources differentiated
2001) and the Lundby study (Cederblad, 1996), point between patients and non-patients.
to several key features characterizing resilient people Most prospective studies report that resilient people
who overcome difficult life conditions. Generally, they draw heavily on favourable dispositional attitudes and
are more flexible than vulnerable people and cope by behaviours like internal locus of control, pro-social
using several protective resources either within behaviour and empathy, to face life stresses. They have
themselves or in their environment. Several authors a positive self-image and display great optimism for the
(Werner, 1989; Rutter, 1990; Werner, 1993; Garmezy, future (Werner and Smith, 1992; Cederblad, Dahlin,
1993) now classify these protective resources into Hagnell and Hansson, 1993; Cederblad, 1996; Blum,
1998). Moreover, resilient people seem to have a strong
• psychological/dispositional attributes; ability to organize their life (Clausen, 1993). Such
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66 Friborg et al.

personal dispositions and attitudes promote in return, study (Hjemdal, Friborg, Martinussen and Rosenvinge,
supportive relationships with family members and 2001). The resulting scale consisted of 45 items
friends. Conversely, the lack of social support that covering five dimensions labelled ‘personal compe-
many patients experience is related to their problem tence’ (16 items), ‘social competence’ (12 items),
with reciprocating social support from others ‘social support’ (nine items), ‘family coherence’ (five
(Kringlen, 1990). Resilient individuals also manage to items) and ‘personal structure’ (four items). This factor
distance themselves psychologically from the trouble solution was in accordance with the overall classifi-
that mentally ill parents inflict (Watt, 1995). cation of resilience (Werner, 1989; Rutter, 1990;
Compared to more troubled individuals, they generally Werner, 1993; Garmezy, 1993). The internal consis-
value siblings as a more important source of emotional tency (Cronbach’s alpha) was high for all dimensions,
support (Werner and Smith, 1992). They work harder ranging from 0.92 to 0.74 and for all the items
to resolve marital conflicts (Werner, 2001). Obviously, combined (total α = 0.93) as well.
resilience does not protect the individual from negative As it was desirable to level out the number of items
life events but resilient individuals seem to cope more along the dimensions, 21 new items were generated
functionally and flexible with stress. These character- under the following sub-dimensions: personal compe-
istics are developed early in life by the formation of a tence and social competence (one item, respectively),
secure attachment to other people, which may reduce family coherence (five items), and personal structure
the vulnerability to developing psychiatric disorders (four items). The initial factor solution excluded the
significantly (Svanberg, 1998). Gender differences in generated locus-of-control items. As the construct is
resilience have been investigated less often, but one considered highly important for a resilient outcome
consistent finding is that resilient women tend to elicit (Werner, Smith, 1992; Cederblad, Dahlin, Hagnell,
and provide more social support (Werner, 2001). In Hansson, 1993), 10 new items pertaining to
sum, resilience is considered a multi-dimensional internal/external control were generated for the present
construct (Luthar, Doernberger and Zigler, 1993). The study (for example, ‘if I succeed in school, it is because I
concept not only refers to important psychological am competent’ or ‘success comes from hard work’).
skills or abilities but also to the individual’s ability to The purposes of the present study were
use family, social and external support systems to cope
better with stress. Measurement scales for assessing • to test the original factor structure of the RSA after
overall improvements in mental health should thus adding new items, and to estimate new internal
include these factors. consistencies;
Two scales to measure resilience have appeared in • to study the test-retest reliability in a non-patient
the literature. Jew, Green and Kroger (1999) sample; and
developed a scale for children and adolescents from • to test important aspects of the instrument’s
the cognitive appraisal theory of Mrazek and Mrazek construct validity.
(1987), which emphasizes 12 essential skills that are
important for coping adequately with life stress. The All the subscales of the RSA were expected to correlate
other measure (Wagnhild and Young, 1990, 1993) was significantly and positively with a measure of psycho-
developed from interviews with 24 elderly American logical/personal adjustment – the Sense of Coherence
women who had successfully dealt with various losses scale (SOC) (Antonovsky, 1993, 1998). However, as
typical of old age. A follow-up study of the scale on SOC assesses personal adjustment skills, the social and
elderly people failed to validate the scale (Aroian, family subscales of the RSA were expected to correlate
Schappler-Morris, Neary, Spitzer and Tran, 1997). less positively with the SOC scale. Next, the RSA was
However, none of the scales included measurement of expected to correlate negatively with an inventory of
social factors (such as family/external support or social psychiatric symptoms (Hopkin’s Symptom Checklist,
competence) known to be essential to withstand life HSCL) (Nettelbladt, Hansson, Stefansson, Borgquist
stress. Age-specific features may also make these scales and Nordström, 1993).
inappropriate to measure resilience in the adult group. A widespread method in establishing construct
Hence, a preliminary version of the Resilience validity is to assess differences among variables known
Scale for Adults (RSA) was developed in an earlier to differentiate the groups (Streiner and Norman,
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A new rating scale for adult resilience 67

1995). As such, the RSA was expected to correlate Finally, and most importantly, the study investigated
positively with level of education and indices of whether the patient sample (N = 59) was systematically
occupational adaptation. It has been a consistent different, in terms of psychiatric diagnoses (Table 1),
finding that people with psychiatric problems report from the patients that were contacted (N = 183), and
less protective factors in their environment alleviating all patients that started in treatment during the year
stress and preventing maladjustment (Werner and 2000 (N = 398). Due to four cells with expected cell
Smith, 1992). Thus, it was expected that patients frequencies less than five, Fisher exact tests were run
seeking psychiatric treatment in an outpatient clinic instead of chi-square statistics. However, no significant
would report less degrees of available protective differences in the proportions of diagnoses emerged
resources in comparison to the control group. between the samples. The number of patients with two
psychiatric diagnoses was not significantly different
Method between the samples.
Normal controls were selected by Statistics Norway
Subjects at random (N = 977, 51% women and 49% men)
Patients were recruited from an adult outpatient clinic among inhabitants from 25–50 years (M = 37.0, SD =
in Tromsø, northern Norway. A total of 183 patients, 7.3) living in Tromsø. In all, 162 women (M = 35.6
117 women (63.9%) and 66 men (36.1%), offered years of age, SD = 7.5) and 128 men (M = 37.1 years of
psychotherapy for the first time, were contacted. age, SD = 7.3) responded. The response rate was 31%.
Altogether, 45 women between 18 and 75 years (M = There were no gender differences between the original
33.7, SD = 13.0) and 14 men between 19 and 75 years sample and those who participated (p > 0.05).
(M = 36.2, SD = 13.0) responded. The response rate Although those who participated (M = 36.9, SD =
was 32.2%. Several investigations were done to 7.3) were slightly older than the original sample (M =
examine whether the low response rate produced a 36.1, SD = 7.4), it was of no practical importance.
biased sample. The age differences between patients Four months later, 130 women (M = 36.0 years of age,
that participated (M = 34.6, SD = 12.8) and those who SD = 7.6) and 97 men (M = 37.4 years of age, SD =
refused (M = 34.8, SD = 13.5), was insignificant. 7.1) returned the second set of the questionnaires. The
However, the number of men who refused to participate response rate was 79%.
(41.9%) were significantly higher than the number who
did participate (23.7%) χ 2 (1, n = 183) = 5.75, Procedure
p < 0.05). As a t-test indicated no significant differences Information was collected once in the patient sample
in psychiatric symptoms between women and men, and twice in the control sample, with a four-month
however, this was considered of minor importance. follow-up. The random control sample was invited to

Table 1. The proportion of psychiatric diagnoses among patients that participated (N = 59), all patients that were
contacted (N = 183), and all patients who started in treatment at the outpatient clinic during the year 2000 (N = 398)

ICD-10 diagnoses Patients % Total Contacted1 % All year 20002 %

(N = 59) (N = 183) (N = 398)

Schizophrenia (F20, F22) 1 1.7 4 2.2 22 5.5

Bipolar disorders (F31) 2 3.4 6 3.3 13 3.3
Depressive disorders (F32-F34) 24 40.7 67 36.6 105 26.4
Anxiety disorders (F40-F42, F45) 6 10.2 24 13.1 67 16.8
PTSD/adjustment disorders (F43) 14 23.7 35 19.1 111 27.9
Eating/personality disorders (F50/F60) 1+1 3.4 7+6 7.1 8+14 5.5
Other diagnoses 10 16.9 34 18.6 58 14.6

1
A Fisher exact test found no significant differences in the proportions of diagnoses between the patient sample
and the drop-outs (Fisher (6, n = 183 ) = 6.40, p = 0.37).
2
The same analysis found no differences between the patient sample and the total number of patients during the
year 2000 (Fisher (6, n = 398 ) = 10.31, p = 0.13).
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68 Friborg et al.

participate through postal invitations. The invitation Acquiescence bias is an unconscious tendency to agree
used the word ‘personal skills’ instead of ‘resilience’. or disagree independent of the content in the items.
For the clinical sample, appointments for starting The Norwegian short-version of the MCSDS (α =
psychotherapy and the invitations to participate in the 0.65) contains 10 items, of which five are reversed
study were mailed at the same time but in separate (Rudmin, 1999). The social desirability index was
envelopes. After returning the completed question- computed by reversing half of the items before calcu-
naires, the participants received a lottery ticket (value lating the mean. The acquiescence bias index was
$ 2.5). computed by calculating the mean of the 10 items
without reversing any scores.
Measurements
Demographic data were age, gender, level of Removal of participants
education, current employment status, years of work To ensure the data quality, participants who met the
experience. following criteria were deleted from the data pool:

Sense of Coherence Scale (SOC) • more than 10% missing data;

The 29-item SOC self-report scale uses a seven-point • non-serious responses;
Likert scale, with positive and negative semantic • obvious misunderstanding of the questionnaires;
phrases at each endpoint. Higher scores reflect • a z-score > 2 on the social desirability index, a z-
stronger SOC. Thirteen of the items are reversely score > 2 on the acquiescence index or a z-score
scored to avoid response set bias (acquiescence). The < 2 on the nay-saying-bias index.
scale is used worldwide and is highly reliable
(Cronbach’s alpha ranging from 0.82 to 0.95) and In sum, 35 participants were deleted (six patients and
valid as a measure of overall mental health adjustment 29 controls). This yielded a patient sample of 59
(Antonovsky, 1993, 1998). The SOC correlates participants and a control sample of 276 participants.
negatively with perceived stress, trait anxiety and Four months later, the control sample consisted of 230
current depression (Frenz, Carey and Jorgensen, 1993; participants.
Sammallahti, Holi, Komulainen and Aalberg, 1996).
Results
The Hopkins Symptom Check List-25 (HSCL)
The HSCL is a 25-item short version of the Symptom Replicative findings
Check List (SCL-90). It is a self-report inventory that Before subjecting the resilience items to factor
rates the presence of depression, anxiety and somati- analyses, we examined whether they correlated highly
zation. It uses a four-point scale ranging from one (‘not with indices for social desirability, acquiescence or
at all’) to four (‘very much’). Higher scores indicate nay-saying bias. Such correlations were small (range
more psychiatric/affective symptoms. A mean score of 0.11 to 0.27).
≥1.55 indicates a probable psychiatric problem, It was decided that each dimension of the factor
whereas a score of ≥1.75 indicates a probable need for structure should contain at least five items. An
psychiatric treatment (Nettelbladt, Hansson, exploratory principal components analysis with a
Stefansson, Borgquist and Nordström, 1993). The varimax rotation, instead of a confirmatory analysis,
scale has also proven highly reliable in Norwegian was preferred to further reduce the number of items.
samples (α = 0.91) (Lavik, Laake, Hauff and Solberg, The factor analysis was based on the control sample
1998; Moum, 1998). only (N = 276), as it would be theoretically contra-
dictory to include subjects with current psychological
Marlowe-Crowne Social Desirability Scale (MCSDS) problems for the selection of items. Factors with
The MCSDS was applied to identify biased answers, Eigenvalues less than 1 were excluded. This procedure
looking for the effects of social desirability and acqui- generated 13 dimensions explaining 63% of the
escence. Social desirability is a conscious choice to variance. However, the component solution was not
present oneself in an overly positive manner. acceptable as only two or three items loaded on the
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A new rating scale for adult resilience 69

sixth factor and beyond. The scree-plot was then Relationship with other tests
examined for a clear bend in the curve, which emerged A widely used and accepted method for assessing
at the fifth component. Inspecting the items in each construct validity (Streiner and Norman, 1995) is to
dimension, the five-component solution was the same examine associations with a convergent/similar scale
as in the previous study (Hjemdal, Friborg, (such as SOC) and a discriminant/dissimilar scale
Martinussen and Rosenvinge, 2001). This accounted (such as HSCL). The correlations between the
for 41 percent of the variance, and excluded 33 items. subscales of the RSA and the SOC were all positive
Six items with high side loadings (<0.30) on other (Table 5), ranging from 0.29 to 0.75 (all p <0.01). As
dimensions were also removed. One item from the expected, the ‘personal competence’ subscale corre-
fifth factor with a high side loading was, however, lated highest (r = 0.75, p < 0.01) with SOC, while the
retained to keep five items in the dimension. The other four subscales correlated less positively with the
factor solution and the factor loadings consisted of 37 SOC, ranging from r = 0.29 to r = .45 (p < 0.01). A
items (Table 2). The five dimensions were labelled similar pattern was found between the subscales of the
‘personal competence’, ‘social competence’, ‘family RSA and the HSCL, with the highest negative corre-
coherence’, ‘social support’ and ‘personal structure’. lation between ‘personal competence’ and HSCL (r =
Intercorrelations between the factors were low to –0.61, p < 0.01). The other subscales correlated less
moderate (r = 0.22 to 0.46, p < 0.01), except for a negatively with HSCL, ranging from –0.19 to –0.37
non-significant correlation between ‘social support’ (all p < 0.01). The correlation between the SOC and
and ‘personal structure’. the HSCL was thus negative (r = –0.75, p <0.01).
The RSA’s construct was further examined against
Reliability estimates (internal consistency and test-retest) three demographic variables expected to be associated
The internal consistency (Chronbach’s α) of all the with higher resilience:
contrast scales (SOC, HSCL, MCSDS) was satisfactory
high (Table 3), indicating adequate psychometric • number of years of education;
properties. The internal consistency of the subscales of • employment; and
the RSA was satisfactory, ranging from 0.67 to 0.90. • number of years in work.
The test-retest correlations were all satisfactory for the
subscales of RSA, ranging from 0.69 to 0.84 (p < 0.01). Using alpha-level <0.01 to reduce type I error, years of
Item-total correlations were calculated for every education were not associated with any of the RSA
subscale. The item-total correlations belonging to subscales. Concerning employment status (0 = not
‘personal competence’ ranged from 0.51 to 0.75, ‘social employed, 1 = employed), three of the subscales,
competence’ from 0.48 to 0.74, ‘family coherence’ ‘personal competence’, ‘social competence’ and ‘family
from 0.56 to 0.74, ‘social support’ from 0.43 to 0.70, coherence’, were positively and significantly correlated
and ‘personal structure’ from 0.37 to 0.48. with holding a job (r = 0.18, 0.22 and 0.17, respec-
tively, all p < 0.01).
Gender and age effects Number of years in work was positively and signifi-
All the subscales of the RSA were examined for gender cantly correlated with ‘family coherence’ and ‘personal
and age differences (Table 4). Analyses were only done structure’ (r = 0.17 and 0.17, respectively, p < 0.01).
on the control sample to reduce the number of subjects
with psychiatric symptoms in the group. The signifi- Differences between the patient and the control sample
cance-level was set to <0.01 to reduce type I error. A The study was examined whether the patient sample
t-test indicated that women reported significantly reported lower degrees of resiliency than the control
higher levels of ‘social support’ than men (t(273) = sample. Again, alpha level was set to p < 0.01. All the
4.27, p < 0.001), whereas men reported sub-signifi- subscales of the RSA differentiated between the
cantly higher levels of ‘prsonal competence than samples (Table 6), finding higher degrees of resilience
women (t(273) = –2.21, p = 0.03). Correlational in the normal control sample, except from ‘social
analyses on age differences, found ‘personal structure’ support’ that reached a sub-significant level (p < 0.04).
to be positively correlated with age (r = 0.17, p < 0.01). To ensure that the patient sample was compared to a
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70 Friborg et al.

Table 2. The factor solution for the non-clinical sample showing the distribution and loading of items in the five
dimensions; 1 = personal competence, 2 = social competence, 3 = family coherence, 4 = social support, and
5 = personal structure (N = 276)

Dimensions:
Translated items from Norwegian 1 2 3 4 5

I believe in my own abilities 0.77

Believing in myself helps me to overcome difficult times 0.69
I know that I succeed if I carry on 0.65
I know how to reach my goals 0.64
No matter what happens I always find a solution 0.61
a
I am comfortable together with other persons 0.60 0.52
My future feels promising 0.58
I know that I can solve my personal problems 0.58
I am pleased with myself 0.55
I have realistic plans for the future 0.54
I completely trust my judgements and decisions 0.47
a At hard times I know that better times will come 0.44 0.37
I am good at getting in touch with new people 0.87
I easily establish new friendships 0.75
It is easy for me to think of good conversational topics 0.66
a
I easily adjust to new social milieus 0.30 0.65
It is easy for me to make other people laugh 0.64
I enjoy being with other people 0.59
a I know how to start a conversation 0.36 0.55
I easily laugh 0.54
It is important for me to be flexible in social circumstances 0.51
a
I experience good relations with both women and men 0.39 0.34
There are strong bonds in my family 0.82
I enjoy being with my family 0.78
In our family we are loyal towards each other 0.72
In my family we enjoy finding common activities 0.66
Even at difficult times my family keeps a positive outlook on the future 0.65
In my family we have a common understanding of what’s important in life 0.64
There are few conflicts in my family 0.61
I have some close friends/family members who really care about me 0.82
I have some friends/family members who back me up 0.76
I always have someone who can help me when needed 0.67
I have some close friends/family members who are good at encouraging me 0.63
I am quickly notified if some family members get into a crisis 0.59
I can discuss personal matters with friends/family members 0.53
I have some close friends/family members who value my abilities 0.47
a
I regularly keep in touch with my family 0.46 0.46
There are strong bonds between my friends 0.39
Rules and regular routines make my daily life easier 0.69
I keep up my daily routines even at difficult times 0.67
I prefer to plan my actions 0.64
I work best when I reach for a goal 0.58
I am good at organizing my time 0.34 0.46

Variance explained (%) 21 7 5 4 4

Note: Total variance explained (41%). Factor-loadings < 0.30 are omitted. The table shows a crude English
translation of the Norwegian original version.
a
Items were removed due to side loading.
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A new rating scale for adult resilience 71

Table 3. The reliability estimates for all scales (the RSA, SOC and HSCL) based on the control sample (N = 217)

Internal consistency Test-retest (four months)

Dimensions Cronbach’s α r

1 Personal competence 0.90** 0.79**

2 Social competence 0.83** 0.84**
3 Family coherence 0.87** 0.77**
4 Social support 0.83** 0.69**
5 Personal structure 0.67** 0.74**
Total SOC 0.94** 0.86**
Total HSCL 0.92** 0.77**
MCSDS 0.67** 0.47**

Note. ** p < 0.01 (two-tailed).

Table 4. The differences in mean and standard deviations between women and men on resilience subscale
scores, based on the control sample (N = 273); the effect sizes indicate the magnitude of the differences.

Women (N = 153) Men (N = 120)

Dimensions No. items M SD M SD t Hedge’s
d

1 Personal competence 10 5.28 0.96 5.51 0.77 –2.21* –0.29

2 Social competence 7 5.19 1.02 5.14 1.01 0.47 0.05
3 Family coherence 7 5.13 1.26 5.13 0.98 0.05 0.00
4 Social support 8 5.91 0.88 5.45 0.86 4.27*** 0.53
5 Personal structure 5 5.11 0.97 5.10 0.91 0.09 0.01

Note. * p < 0.05 (two-tailed), *** p < 0.001 (two-tailed).

Table 5. The correlations between the subscales of the RSA, the SOC and the HSCL Scales (N = 335)

Scales SOC HSCL

1 Personal competence 0.75** –0.61**

2 Social competence 0.44** –0.32**
3 Family coherence 0.45** –0.37**
4 Social support 0.29** –0.19**
5 Personal structure 0.33** –0.21**

Note. ** p < 0.01 (two-tailed).

psychological healthy sample, all control subjects with of psychiatric problems (HSCL). The mean symptom-
symptom-scores above 1.55 were removed. New score in the patient sample (2.24) was far above the
comparisons between the patient and the healthy cut-off value (>1.75), which indicates a probable
sample confirmed the results by indicating somewhat treatment need (Nettelbladt et al., 1993). In contrast,
greater differences. The effect size of the differences the symptom score in the control sample (1.42) was
between the samples was greatest for ‘personal compe- lower than the cut-off value (<1.55) indicating a
tence’ (Hedge’s d = 1.59) and ‘family coherence’ probable psychiatric problem (Nettelbladt et al., 1993).
(Hedge’s d = 1.06). Finally, the proportion of subjects in the control
Control subjects also reported significantly higher sample who reported experiencing critical life events
degrees of sense of coherence (SOC) and less symptoms at the second data collection, was calculated. Out of
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72 Friborg et al.

Table 6. The differences in mean and standard deviations between the patient (n = 59) and the control sample
(N = 276), the patient and the psychological healthy sample (n = 199); the effect sizes indicate the magnitude of the
differences

Scales Patient sample Control sample Healthy Sample1

(N = 59) (N = 276) (N = 199)
M SD M SD t, Hedge’s d M SD t, Hedge’s d

Personal competence 4.11 1.30 5.39 0.88 7.08***, 1.33 5.56 0.76 8.07***, 1.59
Social competence 4.67 1.07 5.17 1.01 3.30**, 0.49 5.25 1.00 4.02***, 0.57
Family coherence 4.22 1.42 5.13 1.14 4.45***, 0.76 5.37 0.97 5.64***, 1.06
Social support 5.41 1.02 5.71 0.90 2.12*, 0.33 5.80 0.83 2.79**, 0.44
Personal structure 4.58 0.99 5.10 0.95 3.38***, 0.54 5.14 0.93 3.84***, 0.59
SOC 3.82 0.86 4.85 0.75 8.56***, 1.34 5.10 0.63 10.50***, 1.86
HSCL 2.25 0.57 1.42 0.37 -10.55***, 2.01 1.24 0.14 -13.32***, 3.37

Note. * p < 0.05, ** p < 0.01, *** p < 0.001 (two-tailed).

1
The psychologically healthy sample was derived by removing control subjects with a mean symptom-score (HSCL)
above 1.55.

230 subjects, 32 (13.9%) confirmed that they had The second category, ‘family cohesion/warmth’, was
been experiencing stressors that considerably influ- comprised by the dimension ‘family coherence’ that
enced the ability to cope with everyday demands. measured amount of family conflict, cooperation,
support, loyalty and stability.
Discussion The third and last category ‘external support
The factor structure and the reliability from the systems’ was comprised of the dimension ‘social
original RSA-study (Hjemdal, Friborg, Martinussen support’ that measured access to external support from
and Rosenvinge, 2001) were successfully replicated. friends and relatives, intimacy, and the individual’s
Due to the low-to-moderate intercorrelations between ability to provide support.
the subscales of the RSA, the dimensions should be In summary, the five-dimensional scale corresponds
regarded as subscales measuring different, but all well with the overall categorization of resilience,
various and positive aspects of the concept of recapitulated as characterized by (i) personal/disposi-
resilience. This supports the theoretical understanding tional attributes, (ii) family support and (iii) external
of resilience as a multidimensional phenomenon support systems (Werner, 1989; Rutter, 1990; Werner,
(Cicchetti and Garmezy, 1993; Garmezy, 1993; Luthar, 1993; Garmezy, 1993).
Doernberger and Zigler, 1993). Along with the satis-
factory test-retest reliability, the RSA seems to be Reliability and validity
satisfactorily operationalized. In contrast to the The internal consistency of the RSA subscales was high,
existing resilience scales (Wagnhild and Young, 1990, although the last dimension was in the lower part of the
1993; Jew, Green and Kroger, 1999), the RSA covers recommended range (Streiner and Norman, 1995).
all three of the main categories of resilience. Although the reliability was satisfactory, it was
The first category of ‘dispositional attributes’ was somewhat lower than the original study (Hjemdal,
comprised by the three dimensions ‘personal compe- Friborg, Martinussen and Rosenvinge, 2001). This may
tence’, ‘social competence’ and ‘personal structure’. be explained by the lower number of items in the present
‘Personal competence’ measured level of self-esteem, RSA-scale, as compared to the previous version, which
self-efficacy, self-liking, hope, determination and a generally reduce the Cronbach’s alphas (Cronbach,
realistic orientation to life. ‘Social competence’ 1990). The item-total correlations for all subscale were
measured extraversion, social adeptness, cheerful moderate to high, further indicating adequate reliability,
mood, an ability to initiate activities, good communi- except for the last factor, ‘personal structure’, in which
cation skills and flexibility in social matters. ‘Personal one item total correlation dropped below 0.40.
structure’ measured the ability to uphold daily All three explorations of the construct validity were
routines, to plan and organize. strongly supported. First, all the RSA subscales were
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A new rating scale for adult resilience 73

positively related to the SOC and negatively related to this have been found essential for successful
the HSCL. Discriminant validity between the RSA adaptation (Werner, 2001).
and the SOC was also established by finding differing
correlation coefficients between the RSA subscales Gender and age differences
and the SOC. A high sense of coherence indicates Women reported significantly more access to social
how confident an individual feels that the outcome of support than men, whereas men reported more
a stressful situation will be favourable (Antonovsky, personal competence than women. Although the last
1998). This is promoted by the ability to comprehend, difference was much weaker, it was still not negligible.
manage and find meaning in life challenges In scale development such gender differences are
(Antonovsky, 1993). Such an ability is more generally unwanted. However, these results match
indicative of a personal competence than of, for Werner’s longitudinal results (Werner, 1989),
example, social support. As expected, ‘personal indicating that men feel personally more competent
competence’ correlated highest with the SOC, than women and that women generally are more
whereas the other subscales correlated poorly to skilled in using social support. Similar findings come
moderately with SOC. As a stronger sense of from a meta-analysis that found higher self-esteem and
coherence also foster stronger feelings of coherence in assertiveness among men, than among women.
family and social matters (for example, that other Women, on the other hand, reported more extra-
people’s behaviour is understandable), the moderate version, trust, gregariousness and nurturance
correlations with ‘social competence’ and ‘family (Feingold, 1994). In another overview (Cross, Marcus,
coherence’ indicate tentative convergent validity for 1993), women were more socially sensitive and
these subscales as well. Still, the study did not include showed greater signs of stress than men when intimate
other established scales to confirm the convergent persons experienced straining life situations. As these
validity of the social and family subscale, and conse- differences are common findings in the literature,
quently, further validation studies are needed. these items were retained in the RSA.
Secondly, like previously developed scales The only subscale to be positively associated with
(Wagnhild and Young, 1990, 1993; Jew, Green and age, was ‘personal structure’. The ability to organize,
Kroger, 1999), the RSA differentiated between a plan and maintain important structures and routines
patient and randomly chosen sample from the normal to succeed with career and educational goals, along
population of Tromsø. Patients reported less access to with a careful planning choice of spouse, is one central
protective factors within all five resilience dimensions. characteristic of resilient individuals (Werner, 2001).
It has been a consisted finding in earlier studies The present results support the importance of
(Werner, 2001) that individuals with psychological organizing and planning for adult resilience, and that
troubles have fewer personal, social and external these characteristics may take more time to develop.
resources available to protect them from stress than
more resilient individuals have. ‘Social support’ was Sample limitations
the only subscale that reached a sub-significant level. As it was difficult to reach a sample consisting of
The lower effect size for this subscale may be explained individuals that had successfully adapted and dealt
by the high number of women in the patient sample with long-term stress and difficulties, a random sample
(76.3%), and thereby elevating the ‘social support’ from the population of Tromsø was contacted instead.
scores. Third, current employment status (holding a This may raise doubts about the external validity of
job) was moderately and positively associated with the scale. The control sample may, however, resemble
higher levels of self-reported ‘Personal competence’, a resilient group as the majority of the population
‘social competence’ and ‘family coherence’. ‘Years of generally overcomes several stressors, like loss of family
work experience’, on the other hand, were positively members, disease, troubled relatives or financial
associated with ‘family coherence’ and ‘personal problems, without developing difficulties. Indeed 32 of
structure’. These findings are in line with previous the 230 subjects in the control sample reported experi-
results from longitudinal findings (Werner, 1993). encing taxing stressors during the four-month period,
Surprisingly, though, ‘years of education’ was not such as serious somatic diseases, loss of significant
associated with higher degrees of resilience, although persons (death, separation, conflicts) and children in
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74 Friborg et al.

trouble with the law. People in the normal population • dispositional optimism (Scheier and Carver, 1985),
are resilient in the sense that most individuals hold which is a central aspect of resilience, to see how
positive views of themselves (positivity bias), display these co-vary and interact in the prediction of
optimism for the future and an illusion of control mental health;
(Taylor and Brown, 1988). To increase the probability • health locus of control (Levenson, 1973) to inves-
of comparing the patient sample against a psychologi- tigate how resilience is associated with causal
cally healthy and thus more resilient sample, subjects attributions/beliefs about what influence good
in the control sample with elevated symptom scores health;
were removed. New comparison between these • social intelligence (Silvera, Matinussen and Dahl,
samples confirmed the results by finding somewhat 2001) to test if self-reported social competence in
greater effect size differences. The probability of the RSA co-variates with self reported social skills;
reaching individuals with resilient characteristics in • coping styles (Lazurus, 1993) to see if resilient
this sample was therefore considered acceptable. In people cope more actively (for example, solve
future studies the probability of reaching a truly problems and seek information), rather than
resilient sample (those who have experienced taxing passively (for example, avoidance or wishful
stressors but still managed to cope) may be increased thinking) with life problems;
by including life-event scales together with resilience • life events, to examine how strongly the RSA
and coping scales to identify the subgroup of people predicts individual differences in adaptational and
that have experienced adversities but still managed to coping capacity when adversities/life problems
cope effectively. occur.
For both samples, the mean age was representative
for an adult population (25 and 50 years). The response Clinical use and implications
rate was low, but still comparable with that of previous General resilient characteristics are presumed to be
survey studies (Green and Boser, 1998), particularly more stable over time, than, for example, psychiatric
when using repeated measures. Although the response symptoms. They might therefore be more prognostic of
rate was within the expected range, a low response rate psychological growth during psychotherapy, as well as
threatens the external validity if the sample is systemat- providing better predictions of relapse rate and
ically biased. This was not the case for the patient patients’ ability to cope with present and coming diffi-
sample in terms of age and psychiatric diagnoses, with culties. This contention comes from several studies on
the last being the most important indicator. The developmental psychopathology, claiming that under-
proportions of psychiatric diagnoses in the patient lying developmental level on social/emotional and
sample were not significantly different from the patients cognitive indices (pre-morbid functioning) is a consid-
who were invited to participate, and all patients in erable predictor of good prognostic outcome (for an
treatment during the year 2000. The patient sample overview, see Glick, 1997). In these studies, pre-morbid
may thus be regarded as representative of the patients social functioning has been found to be the most
that seek psychiatric services at this particular clinic. potent predictor of clinical outcome variables. As the
In sum, then, the age distribution, response rate, the RSA scale not only measures social competence but
small differences in the dropout characteristics, as well also other important protective resources, one would
as a successful replication of the factor structure, expect similar, or perhaps better, predictive ability.
indicate acceptable generalizability of the scale. In clinical and health psychology, it may be used as
an assessment tool of protective factors important to
prevent maladjustment and psychological disorders. For
Further validation the practitioner it points out key areas of psychological
In upcoming studies on construct validity of the RSA, and psychosocial interventions to help patients building
the scale will be compared with other establishment strength, by fostering protective resources known to
instruments, such as an inventory for: strengthen patients’ adaptability and self-reliance.
• personality (Costa and McCrae, 1985), to examine Acknowledgement
how resilience is related to, for example, We are grateful for the financial aid that the Psychiatric
neuroticism, which is a significant parameter for Research Center for the Counties of Finnmark and Tromsø
predicting long-term psychological functioning; provided to support the project.
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A new rating scale for adult resilience 75

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