Evidence from the Residuals Approach to Studying Resilience to Childhood Adversity: A Systematic Review

• In Event: Poster Session 02
  In Poster Session: PS 02 Topic - Health, Growth, Injury

Abstract

Background: Millions of children worldwide experience the harms of early-life adversity, such as abuse, neglect, or household dysfunction. The study of resilience, or positive adaptation following adversity, has uncovered protective factors that promote children’s well-being. An innovative method for studying resilience is the residuals approach, a two-stage methodology that has received growing interest. First, the association between adversity and an outcome is modeled. The residuals of this model are extracted to create a resilience index, representing better-than-expected and worse-than-expected outcomes given levels of adversity. This resilience index is then used as the outcome in a follow-up model to assess potential protective factors. While existing reviews have synthesized some of the resilience literature (e.g., Fritz et al., 2018; Gartland et al., 2019), no review has yet been conducted of studies using the residuals approach to resilience.

Methods: This systematic review will complement past reviews by focusing exclusively on studies that have used the residuals approach to assess resilience to childhood adversity. The central research question is: In studies of individuals who have experienced adversity before age 18 years, what evidence has the residuals approach to resilience provided regarding protective factors? Unlike most existing reviews on the topic of resilience, our work will include protective factors at any level (e.g., individual, family), within any domain (e.g., cognitive, social), relating to any type of adversity, with respect to any individual-level outcome, and regardless of modifiability as currently conceived. We will conduct a systematic search in Scopus, Web of Science, and PsycINFO, using 12 known studies meeting the inclusion criteria to refine the search. We will also use snowballing, hand-searching of gray literature sources, and hand-searching of reference lists of all included studies. Two reviewers will independently screen all titles and abstracts resulting from the search strategy and will then assess the full text of potentially relevant studies against the eligibility criteria to determine the final list of included studies. We will extract relevant data, assess the risk of bias of individual studies as well as meta-bias (e.g., using a funnel plot, p-curve analysis), synthesize the findings, and determine confidence in the cumulative evidence. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines (Page et al., 2020 preprint).

Timeline: The systematic review protocol will be submitted for preregistration in the International Prospective Register of Systematic Reviews (PROSPERO) by October 2020, prior to screening of titles and abstracts. The study selection process will conclude with the final list of included studies by December 2020. Relevant data will be extracted, studies will be critically appraised for quality and bias, and findings will be synthesized by March 2021 in time for presentation of results and conclusions in April 2021.

Discussion: This systematic review will add to the literature by critically appraising and synthesizing studies of resilience using the residuals approach, an increasingly common methodology for assessing potential protective factors. The review holds promise in further elucidating factors that contribute to children’s well-being and guiding future research in the field of resilience.

Authors

• Stephen A. Metcalf, University of Cambridge
  Presenting Author

• Marinus H. van IJzendoorn, University College London (UCL)
  Non-Presenting Author

• Robbie Duschinsky, University of Cambridge
  Non-Presenting Author