Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-31T16:21:37.026Z Has data issue: false hasContentIssue false
  • English
  • Français

Resilience in children with chronic illness: Tests of the shift-and-persist and skin-deep resilience theories

Published online by Cambridge University Press:  21 June 2023

Edith Chen Open the ORCID record for Edith Chen [Opens in a new window] ,
Tao Jiang ,
Michelle A. Chen Open the ORCID record for Michelle A. Chen [Opens in a new window] ,
Rachel Y. Chiu  and
Gregory E. Miller
Edith Chen*
Affiliation:
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
Tao Jiang
Affiliation:
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
Michelle A. Chen
Affiliation:
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
Rachel Y. Chiu
Affiliation:
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
Gregory E. Miller
Affiliation:
Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, USA
*
Corresponding author: Edith Chen; Email: edith.chen@northwestern.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

This study investigated, and discusses the integration of, the shift-and-persist (SAP) and skin-deep resilience (SDR) theories. The SAP theory states that the combination of shifting (adjusting oneself to stressful situations through strategies like emotion regulation) and persisting (enduring adversity with strength by finding meaning and maintaining optimism) will be beneficial to physical health in children experiencing adversity. The SDR theory states that high striving/self-control will be beneficial to mental health but detrimental to physical health among those confronting adversity. This study investigated 308 children ages 8–17 experiencing the adversity of a chronic illness (asthma). SAP and SDR (striving/self-control) were assessed via questionnaires, and physical health (asthma symptoms, inflammatory profiles), mental health (anxiety/depression, emotional functioning), and behavioral (medication adherence, activity limitations, collaborative relationships with providers) outcomes were measured cross-sectionally. SAP was associated with better physical health, whereas SDR was associated with worse physical health. Both were associated with better mental health. Only SDR was associated with better behavioral outcomes. Implications of findings and discussion of how to integrate these theories are provided. We suggest that future interventions might seek to cultivate both SAP and SDR to promote overall better health and well-being across multiple domains in children experiencing adversity.

Keywords

copingmental healthphysical healthresilience
Type
Special Issue Article
Information
Development and Psychopathology , Volume 35 , Issue 5: Special Issue: Resilience in Development: Pathways to Multisystem Integration , December 2023 , pp. 2264 - 2274
Check for updates
Copyright
© The Author(s), 2023. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., & Rescorla, L. A. (2003). Manual for the ASEBA adult forms and profiles. University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
Bacharier, L. B., Strunk, R. C., Mauger, D., White, D., Lemanske, R. F., & Sorkness, C. A. (2004). Classifying asthma severity in children: Mismatch between symptoms, medication use, and lung function. American Journal of Respiratory and Critical Care Medicine, 170(4), 426–432. ISI: 000223217300017.CrossRefGoogle ScholarPubMed
Brody, G. H., Yu, T., Chen, E., Miller, G. E., Kogan, S. M., & Beach, S. R. H. (2013). Is resilience only skin deep? Rural African Americans’ preadolescent socioeconomic status-related risk and competence and age 19 psychological adjustment and allostatic load. Psychological Science, 24(7), 1285–1293.CrossRefGoogle Scholar
Brody, G. H., Yu, T., Miller, G. E., & Chen, E. (2016). Resilience in adolescence, health, and psychosocial outcomes. Pediatrics, 138(6), e20161042.CrossRefGoogle ScholarPubMed
Brody, G. H., Yu, T., Miller, G. E., Ehrlich, K. B., & Chen, E. (2018). John Henryism coping and metabolic syndrome among young Black adults. Psychosomatic Medicine, 80(2), 216–221.CrossRefGoogle ScholarPubMed
Busse, W. W., & Lemanske, R. F. (2001). Advances in immunology: Asthma. New England Journal of Medicine, 344(5), 350–362.CrossRefGoogle Scholar
Chen, E. (2012). Protective factors for health among low socioeconomic status individuals. Current Directions in Psychological Science, 21(3), 189–193.CrossRefGoogle Scholar
Chen, E., Brody, G. H., & Miller, G. E. (2022). What are the health consequences of upward mobility? Annual Review of Psychology, 73(1), 599–628.CrossRefGoogle ScholarPubMed
Chen, E., Debrosse, R., Ham, P. J., Hoffer, L. C., Leigh, A. K. K., & Destin, M. (2021). Effects of social support in an academic context on low-grade inflammation in high school students. Journal of Behavioral Medicine, 44(6), 803–810.CrossRefGoogle Scholar
Chen, E., McLean, K. C., & Miller, G. E. (2015). Shift-and-persist strategies: Associations with socioeconomic status and the regulation of inflammation among adolescents and their parents. Psychosomatic Medicine, 77(4), 371–382. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve CrossRefGoogle Scholar
Chen, E., & Miller, G. E. (2012). Shift-and-persist, strategies: Why being low in socioeconomic status isn’t always bad for health. Perspectives on Psychological Science, 7(2), 135–158.CrossRefGoogle ScholarPubMed
Chen, E., Shalowitz, M. U., Story, R. E., Ehrlich, K. B., Levine, C. S., Hayen, R., Leigh, A. K. K., & Miller, G. E. (2016). Dimensions of socioeconomic status and childhood asthma outcomes: Evidence for distinct behavioral and biological associations. Psychosomatic Medicine, 78(9), 1043–1052.CrossRefGoogle ScholarPubMed
Chen, E., Shalowitz, M. U., Story, R. E., Hayen, R., Leigh, A. K. K., Hoffer, L. C., Austin, M. A., Lam, P. H., Brody, G. H., Miller, G. E. (2019). The costs of high self-control in Black and Latino youth with asthma: Divergence of mental health and inflammatory profiles. Brain Behavior and Immunity, 80, 120–128.CrossRefGoogle ScholarPubMed
Chen, E., Strunk, R. C., Trethewey, A., Schreier, H. M., Maharaj, N., & Miller, G. E. (2011). Resilience in low-socioeconomic-status children with asthma: Adaptations to stress. Journal of Allergy and Clinical Immunology, 128(5), 970–976. https://doi.org/10.1016/j.jaci.2011.06.040 CrossRefGoogle ScholarPubMed
Chen, L., Li, X., Imami, L., Lin, D., Zhao, J., Zhao, G., & Zilioli, S. (2019). Diurnal cortisol in a socioeconomically disadvantaged sample of Chinese children: Evidence for the shift-and-persist hypothesis. Psychosomatic Medicine, 81(2), 200–208.CrossRefGoogle Scholar
Christophe, N. K., & Stein, G. L. (2022). Shift-and-persist and discrimination predicting depression across the life course: An accelerated longitudinal design using MIDUS I-III. Development and Psychopathology, 34(4), 1544–1559.CrossRefGoogle Scholar
Christophe, N. K., Stein, G. L., Martin Romero, M. Y., Chan, M., Jensen, M., Gonzalez, L. M., & Kiang, L. (2019). Coping and culture: The protective effects of shift-&-persist and ethnic-racial identity on depressive symptoms in Latinx youth. Journal of Youth And Adolescence, 48(8), 1592–1604.CrossRefGoogle ScholarPubMed
Chung, K. F., & Barnes, P. J. (1999). Cytokines in asthma. Thorax, 54(9), 825–857.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Garmezy, N. (1993). Prospects and promises in the study of resilience. Development and Psychopathology, 5(4), 497–502.CrossRefGoogle Scholar
Corrigan, C. J., & Kay, A. B. (1990). CD4 T-lymphocyte activation in acute severe asthma: Relationship to disease severity and atopic status. American Review of Respiratory Disease, 141(4_pt_1), 970–977.CrossRefGoogle ScholarPubMed
Duggan, K. A., Jennings, J. R., & Matthews, K. A. (2019). Prospective associations of adolescent conscientiousness with psychological resources and metabolic syndrome in Black and White men. Psychosomatic Medicine, 81(4), 341–351.CrossRefGoogle ScholarPubMed
Dunkel Schetter, C., & Dolbier, C. (2011). Resilience in the context of chronic stress and health in adults. Social and Personality Psychology Compass, 5(9), 634–652.CrossRefGoogle Scholar
Ehrlich, K. B., Miller, G. E., Shalowitz, M., Story, R., Levine, C., Williams, D., Le, V., & Chen, E. (2019). Secure base representations in children with asthma: Links with symptoms, family asthma management, and cytokine regulation. Child Development, 90(6), 718–728.CrossRefGoogle ScholarPubMed
Finn, P. W., & Bigby, T. D. (2009). Innate immunity and asthma. Proceedings of the American Thoracic Society, 6(3), 260–265. https://doi.org/10.1513/pats.200807-064RM CrossRefGoogle ScholarPubMed
Gemou-Engesëth, V., Kay, A. B., Bush, A., & Corrigan, C. J. (1994). Activated peripheral blood CD4 and CD8 T-lymphocytes in child asthma: Correlation with eosinophilia and disease severity. Pediatric Allergy and Immunology, 5(3), 170–177.CrossRefGoogle Scholar
Humphrey, L. L. (1982). Children’s and teacher’s perspectives on children’s self-control: The development of two rating scales. Journal of Consulting & Clinical Psychology, 50(5), 624–633.CrossRefGoogle ScholarPubMed
Jackson, D. J., Gangnon, R. E., Evans, M. D., Roberg, K. A., Anderson, E. L., Pappas, T. E., Printz, M. C., Lee, W. M., Shult, P. A., Reisdorf, E., Carlson-Dakes, K. T., Salazar, L. P., DaSilva, D. F., Tisler, C. J., Gern, J. E., Lemanske, R. F. (2008). Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children. American Journal of Respiratory and Critical Care Medicine, 178(7), 667–672. ISI: 000259585600005.CrossRefGoogle ScholarPubMed
James, S. A., Keenan, N. L., Strogatz, D. S., Browning, S. R., & Garrett, J. M. (1992). Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt County Study. American Journal of Epidemiology, 135(1), 59–67.CrossRefGoogle ScholarPubMed
James, S. A., Strogatz, D. S., Wing, S. B., & Ramsey, D. L. (1987). Socioeconomic status, John Henryism, and hypertension in blacks and whites. American Journal of Epidemiology, 126(4), 664–673.CrossRefGoogle ScholarPubMed
Juniper, E. F., Guyatt, G. H., Feeny, D. H., Ferrie, P. J., Griffith, L. E., & Townsend, M. (1996). Measuring quality of life in children with asthma. Quality of Life Research, 5(1), 35–46.CrossRefGoogle ScholarPubMed
Kallem, S., Carroll-Scott, A., Rosenthal, L., Chen, E., Peters, S. M., McCaslin, C., & Ickovics, J. R. (2013). Shift-and-persist: A protective factor for elevated BMI among low socioeconomic status children. Obesity, 21(9), 1759–1763.CrossRefGoogle ScholarPubMed
Lam, P. H., Chen, E., Chiang, J. J., & Miller, G. E. (2022). Socioeconomic disadvantage, chronic stress, and pro-inflammatory phenotype: An integrative data analysis across the lifecourse. PNAS Nexus, 1, 1–9.CrossRefGoogle Scholar
Lam, P. H., Miller, G. E., Chiang, J. J., Levine, C. S., Le, V., Shalowitz, M. U., Story, R. E., & Chen, E. (2018). One size does not fit all: Links between shift-and-persist on asthma in youth are moderated by perceived family social status and experience of unfair treatment. Development and Psychopathology, 30(5), 1699–1714.CrossRefGoogle Scholar
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. ISI: 000088659900001.CrossRefGoogle ScholarPubMed
Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227–238.CrossRefGoogle ScholarPubMed
Masten, A. S. (2007). Resilience in developing systems: Progress and promise as the fourth wave rises. Development and Psychopathology, 19(3), 921–930. ISI: 000249005100014.CrossRefGoogle ScholarPubMed
Masten, A. S., Lucke, C. M., Nelson, K. M., & Stallworthy, I. C. (2021). Resilience in development and psychopathology: Multisystem perspectives. Annual Review of Clinical Psychology, 17(1), 521–549.CrossRefGoogle ScholarPubMed
McQuaid, E. L., Walders, N., Kopel, S. J., Fritz, G. K., & Klinnert, M. D. (2005). Pediatric asthma management in the family context: The Family Asthma Management System Scale. Journal of Pediatric Psychology, 30(6), 492–502. ISI: 000231222000004.CrossRefGoogle ScholarPubMed
Miller, G. E., & Chen, E. (2010). Harsh family climate in early life presages the emergence of a proinflammatory phenotype in adolescence. Psychological Science, 21(6), 848–856. https://doi.org/10.1177/0956797610370161 CrossRefGoogle ScholarPubMed
Miller, G. E., Chen, E., Fok, A. K., Walker, H., Lim, A., Nicholls, E. F., Cole, S., & Kobor, M. S. (2009). Low early-life social class leaves a biological residue manifested by decreased glucocorticoid and increased proinflammatory signaling. Proceedings of the National Academy of Sciences, 106(34), 14716–14721. https://doi.org/10.1073/pnas.0902971106 CrossRefGoogle Scholar
Miller, G. E., Chen, E., & Parker, K. J. (2011). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychological Bulletin, 137(6), 959–997. https://doi.org/10.1037/a0024768 CrossRefGoogle Scholar
Miller, G. E., Chen, E., Yu, T., & Brody, G. H. (2020). Youth who achieve upward socioeconomic mobility display lower psychological distress but higher metabolic syndrome rates as adults: Prospective evidence from the National Study of Adolescent Health and the Midlife in the United States Study. Journal of the American Heart Association, 9(9), e015698.CrossRefGoogle Scholar
Miller, G. E., Cohen, S., Janicki-Deverts, D., Brody, G. H., & Chen, E. (2016). Viral challenge reveals further evidence of skin-deep resilience in African Americans from disadvantaged backgrounds. Health Psychology, 35(11), 1225–1234.CrossRefGoogle ScholarPubMed
Miller, G. E., Gaudin, A., Zysk, E., & Chen, E. (2009). Parental support and cytokine activity in childhood asthma: The role of glucocorticoid sensitivity. Journal of Allergy and Clinical Immunology, 128(5), 970–976. https://doi.org/10.1016/j.jaci.2008.12.019 Google Scholar
Miller, G. E., Yu, T., Chen, E., & Brody, G. H. (2015). Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth. Proceedings of the National Academy of Sciences, 112(33), 10325–10330. https://doi.org/10.1073/pnas.1505063112 CrossRefGoogle ScholarPubMed
Sigurs, N., Gustafsson, P. M., Bjarnason, R., Lundberg, F., Schmidt, S., Sigurbergsson, F., & Kjellman, B. (2005). Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13. American Journal of Respiratory and Critical Care Medicine, 171(2), 137–141. ISI: 000226258400009.CrossRefGoogle ScholarPubMed
Simpson, J. L., Brooks, C., & Douwes, J. (2008). Innate immunity in asthma. Paediatric Respiratory Reviews, 9(4), 263–270. ISI: 000261853600005.CrossRefGoogle ScholarPubMed
Stein, G. L., Jensen, M., Christophe, N. K., Cruz, R. A., Romero, M. M., & Robins, R. (2022). Shift and persist in Mexican American youth: A longitudinal test of depressive symptoms. Journal of Research on Adolescence, 32(4), 1433–1451.CrossRefGoogle ScholarPubMed
Sullivan, P., Ghuschchyan, V. G., Navaratnam, P., Friedman, H. S., Kavati, A., Ortiz, B., & Lanier, B. (2018). School absence and productivity outcomes associated with childhood asthma in the USA. Journal of Asthma, 55(2), 161–168.CrossRefGoogle ScholarPubMed
Wright, R. J., Visness, C. M., Calatroni, A., Grayson, M. H., Gold, D. R., Sandel, M. T., Lee-Parritz, A., Wood, R. A., Kattan, M., Bloomberg, G. R., Burger, M., Togias, A., Witter, F. R., Sperling, R. S., Sadovsky, Y., Gern, J. E. (2010). Prenatal maternal stress and cord blood innate and adaptive cytokine responses in an inner-city cohort. American Journal of Respiratory and Critical Care Medicine, 182(1), 25–33. https://doi.org/10.1164/rccm.200904-0637OC CrossRefGoogle Scholar
Zautra, A. J., Hall, J. S., & Murray, K. E. (2008). Resilience: A new integrative approach to health and mental health research. Health Psychology Review, 2(1), 41–64.CrossRefGoogle Scholar