September 14, 2025 Journal article Open Access

Biruk Beletew Abate; Ashenafi Kibret Sendekie; Abay Woday Tadesse; Tesfaye Engdaw; Ayelign Mengesha; Alemu Birara Zemariam; Addis Wondmagegn Alamaw; Gebremeskel Abebe; Molla Azmeraw

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    <subfield code="u">Department of Clinical  Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia</subfield>
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    <subfield code="u">College  of Medicine and Health Sciences, Samara University, Samara, Ethiopia,  and Curtin School of Population  Health, Curtin University, Perth, WA, Australia</subfield>
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    <subfield code="u">College of Medicine and Health Science, Woldia University, Woldia, Ethiopia</subfield>
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    <subfield code="u">College of Medicine and Health Science, Woldia University, Woldia, Ethiopia</subfield>
    <subfield code="a">Biruk Beletew Abate</subfield>
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    <subfield code="a">Resilience after adversity: an  umbrella review of adversity  protective factors and resilience promoting interventions</subfield>
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    <subfield code="a">&lt;p&gt;Introduction: Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions. Objective: To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context. Methods: The study included English language articles sourced from PubMed, Embase, Scopus, Webof Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. Results: A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 (p &amp;lt; 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversitywere0.31 (p &amp;lt; 0.001) and 0.42 (p &amp;lt; 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively&amp;nbsp;Conclusion: The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness based interventions, and mixed interventions, to enhance resilience promotion programs&lt;/p&gt;</subfield>
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