Abstract
The objective of this research is to assess the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in order to contribute to the literature identifying validated resilience measures in low-resource settings where individuals face significant adversity. This cross-sectional study included 789 adolescent mothers who delivered at a maternity hospital in Lima, Peru. The Spanish version of the 10-item CD-RISC was used to measure resilience. Internal consistency and construct validity were assessed by evaluating individual item characteristics as well as the association of CD-RISC score with symptoms of depression, anxiety and sleep disturbance. Exploratory factor analysis (EFA) was performed to test the factorial structure of the CD-RISC. The CD-RISC was found to have good internal consistency (Cronbach’s alpha = 0.85). CD-RISC scores were positively associated with school attendance, financial hardship, and history of childhood abuse; scores were negatively associated with household dysfunction, depression, anxiety and poor sleep quality. The results of the EFA showed that the CD-RISC contained a two-factor solution, which accounted for 46% of the variance. Overall, these findings suggest that the Spanish-language version of the CD-RISC-10 is an adequate measure of resilience in this population. Further research is needed to incorporate culturally-specific constructs into resilience measures.
Similar content being viewed by others
References
Aloba, O., Olabisi, O., & Aloba, T. (2016). The 10-item Connor-Davidson resilience scale: Factorial structure, reliability, validity, and correlates among student nurses in southwestern Nigeria. Journal of the American Psychiatric Nurses Association, 22(1), 43–51. https://doi.org/10.1177/1078390316629971.
Arias Gonzalez, V. B., Crespo Sierra, M. T., Arias Martinez, B., Martinez-Molina, A., & Ponce, F. P. (2015). An in-depth psychometric analysis of the Connor-Davidson Resilience Scale: calibration with Rasch-Andrich model. Health Qual Life Outcomes, 13, 154. https://doi.org/10.1186/s12955-015-0345-y.
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(2), 109–115. https://doi.org/10.4306/pi.2010.7.2.109.
Banducci, A. N., Hoffman, E. M., Lejuez, C. W., & Koenen, K. C. (2014). The impact of childhood abuse on inpatient substance users: Specific links with risky sex, aggression, and emotion dysregulation. Child Abuse & Neglect, 38(5), 928–938. https://doi.org/10.1016/j.chiabu.2013.12.007.
Bardales, O., & Huallpa, E. (2005). Maltrato y abuso sexual en niños, niñas y adolescentes. Peru: Retrieved from Lima https://www.repositoriopncvfs.pe/wp-content/uploads/2015/07/maltrat_nna_smp.pdf.
Barrios, Y. V., Gelaye, B., Zhong, Q., Nicolaidis, C., Rondon, M. B., Garcia, P. J., Sanchez, P. A., Sanchez, S. E., & Williams, M. A. (2015). Association of childhood physical and sexual abuse with intimate partner violence, poor general health and depressive symptoms among pregnant women. PLoS One, 10(1), e0116609. https://doi.org/10.1371/journal.pone.0116609.
Betancourt, T. S., & Khan, K. T. (2008). The mental health of children affected by armed conflict: Protective processes and pathways to resilience. International Review of Psychiatry, 20(3), 317–328. doi:793972454 [pii]. https://doi.org/10.1080/09540260802090363.
Bezdijan, S., Schneider, K. G., Burchett, D., Baker, M. T., & Garb, H. N. (2017). Resilience in the United States Air Force: Psychometric properties of the Connor-Davidson Resilience Scal (CD-RISC). Psychological Assessment, 29(5), 479–485.
Blanco, V., Guisande, M. A., Sanchez, M. T., Otero, P., & Vazquez, F. L. (2019). Spanish validation of the 10-item Connor-Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers. Aging Ment Health, 23(2), 183–188. https://doi.org/10.1080/13607863.2017.1399340.
Burns, R. A., & Anstey, K. J. (2010). The Connor–Davidson resilience scale (CD-RISC): Testing the invariance of a uni-dimensional resilience measure that is independent of positive and negative affect. Personality and Individual Differences, 48(5), 527–531.
Buysse, D. J., Reynolds 3rd, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.
Campbell-Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the Connor-davidson resilience scale (CD-RISC): Validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20(6), 1019–1028. https://doi.org/10.1002/jts.20271.
Campbell-Sills, L., Forde, D. R., & Stein, M. B. (2009). Demographic and childhood environmental predictors of resilience in a community sample. Journal of Psychiatric Research, 43(12), 1007–1012. https://doi.org/10.1016/j.jpsychires.2009.01.013.
Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225. https://doi.org/10.1016/j.jad.2003.12.013.
Clemmens, D. A. (2002). Adolescent mothers' depression after the birth of their babies: Weathering the storm. Adolescence, 37(147), 551–565.
Coates, E. E., Phares, V., & Dedrick, R. F. (2013). Psychometric properties of the Connor-Davidson Resilience Scale 10 among low-income, African American men. Psychol Assess, 25(4), 1349–1354. https://doi.org/10.1037/a0033434.
Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113.
Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the adverse childhood experiences study. Jama, 286(24), 3089–3096.
Duong, C., & Hurst, C. P. (2016). Reliability and validity of the Khmer version of the 10-item Connor-Davidson resilience scale (Kh-CD-RISC10) in Cambodian adolescents. BMC Research Notes, 9, 297. https://doi.org/10.1186/s13104-016-2099-y.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.
Frans, O., Rimmo, P. A., Aberg, L., & Fredrikson, M. (2005). Trauma exposure and post-traumatic stress disorder in the general population. Acta Psychiatrica Scandinavica, 111(4), 291–299. https://doi.org/10.1111/j.1600-0447.2004.00463.x.
Goins, R. T., Gregg, J. J., & Fiske, A. (2013). Psychometric Properties of the Connor-Davidson Resilience Scale With Older American Indians: The Native Elder Care Study. Res Aging, 35(2), 123–143. https://doi.org/10.1177/0164027511431989.
Goldstein, A. L., Faulkner, B., & Wekerle, C. (2013). The relationship among internal resilience, smoking, alcohol use, and depression symptoms in emerging adults transitioning out of child welfare. Child Abuse & Neglect, 37(1), 22–32. https://doi.org/10.1016/j.chiabu.2012.08.007.
Guerrero, G., & Rojas, V. (2016). Understanding children's experiences of violence in Peru: Evidence from young lives. Florence: UNICEF Office of Research - Innocenti Working Paper.
Jung, Y. E., Min, J. A., Shin, A. Y., Han, S. Y., Lee, K. U., Kim, T. S., et al. (2012). The Korean version of the Connor-Davidson resilience scale: An extended validation. Stress and Health, 28(4), 319–326. https://doi.org/10.1002/smi.1436.
Karairmak, O. (2010). Establishing the psychometric qualities of the Connor-Davidson Resilience Scale (CD-RISC) using exploratory and confirmatory factor analysis in a trauma survivor sample. Psychiatry Res, 179(3), 350–356. https://doi.org/10.1016/j.psychres.2009.09.012.
Khoshouei, M. S. (2009). Psychometric evaluation of the Connor-Davidson resilience scale (CD-RISC) using Iranian students. International Journal of Testing, 9(1), 60–66.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Kwan, Y. H., Ng, A., Lim, K. K., Fong, W., Phang, J. K., Chew, E. H., et al. (2019). Validity and reliability of the ten-item Connor-Davidson resilience scale (CD-RISC10) instrument in patients with axial spondyloarthritis (axSpA) in Singapore. Rheumatology International, 39(1), 105–110. https://doi.org/10.1007/s00296-018-4217-8.
Lahti, M., Savolainen, K., Tuovinen, S., Pesonen, A. K., Lahti, J., Heinonen, K., et al. (2017). Maternal depressive symptoms during and after pregnancy and psychiatric problems in children. Journal of the American Academy of Child and Adolescent Psychiatry, 56(1), 30–39 e37. https://doi.org/10.1016/j.jaac.2016.10.007.
Laliberte Durish, C., Yeates, K. O., & Brooks, B. L. (2018). Convergent and divergent validity of the Connor-Davidson resilience scale in children with concussion and orthopaedic injury. Brain Injury, 32(12), 1525–1533. https://doi.org/10.1080/02699052.2018.1502471.
Lara, M. A., Berenzon, S., Juarez Garcia, F., Medina-Mora, M. E., Natera Rey, G., Villatoro Velazquez, J. A., & Gutierrez Lopez, M. L. (2012). Population study of depressive symptoms and risk factors in pregnant and parenting Mexican adolescents. Revista Panamericana de Salud Pública, 31(2), 102–108.
Lauridsen, L. S., Willert, M. V., Eskildsen, A., & Christiansen, D. H. (2017). Cross-cultural adaptation and validation of the Danish 10-item Connor-Davidson resilience scale among hospital staff. Scandinavian Journal of Public Health, 45(6), 654–657. https://doi.org/10.1177/1403494817721056.
Levey, E. J., Gelaye, B., Koenen, K., Zhong, Q. Y., Basu, A., Rondon, M. B., Sanchez, S., Henderson, D. C., & Williams, M. A. (2018). Trauma exposure and post-traumatic stress disorder in a cohort of pregnant Peruvian women. Archives of Women's Mental Health, 21(2), 193–202. https://doi.org/10.1007/s00737-017-0776-z.
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.
Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Frameworks for research, practice, and translational synergy. Development and Psychopathology, 23(2), 493–506. https://doi.org/10.1017/S0954579411000198.
Mealer, M., Schmiege, S. J., & Meek, P. (2016). The Connor-Davidson Resilience Scale in Critical Care Nurses: A Psychometric Analysis. J Nurs Meas, 24(1), 28–39. https://doi.org/10.1891/1061-3749.
Ni, M. Y., Li, T. K., Yu, N. X., Pang, H., Chan, B. H., Leung, G. M., & Stewart, S. M. (2016). Normative data and psychometric properties of the Connor-Davidson resilience scale (CD-RISC) and the abbreviated version (CD-RISC2) among the general population in Hong Kong. Quality of Life Research, 25(1), 111–116. https://doi.org/10.1007/s11136-015-1072-x.
Notario-Pacheco, B., Solera-Martinez, M., Serrano-Parra, M. D., Bartolome-Gutierrez, R., Garcia-Campayo, J., & Martinez-Vizcaino, V. (2011). Reliability and validity of the Spanish version of the 10-item Connor-Davidson resilience scale (10-item CD-RISC) in young adults. Health and Quality of Life Outcomes, 9, 63. https://doi.org/10.1186/1477-7525-9-63.
Panter-Brick, C. (2014). Health, risk and resilience: Interdisciplinary concepts and applications. Annual Review of Anthropology, 43, 431–448.
Pedersen, D., Tremblay, J., Errazuriz, C., & Gamarra, J. (2008). The sequelae of political violence: Assessing trauma, suffering and dislocation in the Peruvian highlands. Social Science & Medicine, 67(2), 205–217. https://doi.org/10.1016/j.socscimed.2008.03.040.
R Foundation for Statistical Computing. (2015). R software (Version 3.1.2). Vienna, Austria.
Scali, J., Gandubert, C., Ritchie, K., Soulier, M., Ancelin, M. L., & Chaudieu, I. (2012). Measuring resilience in adult women using the 10-items Connor-Davidson resilience scale (CD-RISC). Role of trauma exposure and anxiety disorders. PLoS One, 7(6), e39879. https://doi.org/10.1371/journal.pone.0039879.
Seery, M. D., Holman, E. A., & Silver, R. C. (2010). Whatever does not kill us: Cumulative lifetime adversity, vulnerability, and resilience. Journal of Personality and Social Psychology, 99(6), 1025–1041. https://doi.org/10.1037/a0021344.
Sharma, S., Pathak, A., Abbott, J. H., & Jensen, M. P. (2018). Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain. Health and Quality of Life Outcomes, 16(1), 56. https://doi.org/10.1186/s12955-018-0884-0.
Serrano-Parra, M. D., Garrido-Abejar, M., Notario-Pacheco, B., Bartolome-Gutierrez, R., Solera-Martinez, M., & Martinez-Vizcaino, V. (2012). Validity of the Connor-Davidson resilience scale(CD-RISC) in people from 60-75 years old. International Journal of Psychological Research, 5(2), 2011–2084.
Shin, G. S., Choi, K. S., Jeong, K. S., Min, Y. S., Ahn, Y. S., & Kim, M. G. (2018). Psychometric properties of the 10-item Conner-Davidson resilience scale on toxic chemical-exposed workers in South Korea. Annals of Occupational and Environmental Medicine, 30, 52. https://doi.org/10.1186/s40557-018-0265-5.
Simeon, D., Yehuda, R., Cunill, R., Knutelska, M., Putnam, F. W., & Smith, L. M. (2007). Factors associated with resilience in healthy adults. Psychoneuroendocrinology, 32(8–10), 1149–1152. https://doi.org/10.1016/j.psyneuen.2007.08.005.
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(1), 23–30.
Solano, J. P., Bracher, E. S., Faisal-Cury, A., Ashmawi, H. A., Carmona, M. J., Lotufo-Neto, F., & Vieira, J. E. (2016). Factor structure and psychometric properties of the Connor-Davidson resilience scale among Brazilian adult patients. Sao Paulo Medical Journal doi:https://doi.org/10.1590/1516-3180.2015.02290512
Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Jama, 282(18), 1737-1744. https://doi.org/10.1001/jama.282.18.173
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
Suarez, E. B. (2013). Two decades later: The resilience and post-traumatic responses of indigenous Quechua girls and adolescents in the aftermath of the Peruvian armed conflict. Child Abuse & Neglect, 37(2–3), 200–210. https://doi.org/10.1016/j.chiabu.2012.09.011.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18.
Theron, L. C., Liedenberg, L., & Ungar, M. (2015). Youth resilience and culture. Dordrecht: Netherlands.
Tol, W. A., Song, S., & Jordans, M. J. (2013). Annual research review: Resilience and mental health in children and adolescents living in areas of armed conflict--a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry, 54(4), 445–460. https://doi.org/10.1111/jcpp.12053.
Tsigkaropoulou, E., Douzenis, A., Tsitas, N., Ferentinos, P., Liappas, I., & Michopoulos, I. (2018). Greek version of the Connor-Davidson resilience scale: Psychometric properties in a sample of 546 subjects. In Vivo, 32(6), 1629–1634. https://doi.org/10.21873/invivo.11424.
Ungar, M. (2013). Resilience, trauma, context, and culture. Trauma Violence Abuse, 14(3), 255–266. https://doi.org/10.1177/1524838013487805.
Wang, L., Shi, Z., Zhang, Y., & Zhang, Z. (2010). Psychometric properties of the 10-item Connor-Davidson resilience scale in Chinese earthquake victims. Psychiatry and Clinical Neurosciences, 64(5), 499–504. https://doi.org/10.1111/j.1440-1819.2010.02130.x.
WHO. (2005). WHO multi-country study on women's health and domestic violence against women: Summary report of initial results on prevalence, health outcomes, and women's responses. Switzerland: Retrieved from Geneva http://www.who.int/gender/violence/who_multicountry_study/summary_report/summary_report_English2.pdf.
WHO. (2014). Global status report on violence prevention. Retrieved from http://www.who.int/violence_injury_prevention/violence/status_report/2014/en/
Windle, G., Bennett, K. M., & Noyes, J. (2011). A methodological review of resilience measurement scales. Health and Quality of Life Outcomes, 9, 8. https://doi.org/10.1186/1477-7525-9-8.
Xie, Y., Peng, L., Zuo, X., & Li, M. (2016). The psychometric evaluation of the Connor-Davidson resilience scale using a Chinese military sample. PLoS One, 11(2), e0148843. https://doi.org/10.1371/journal.pone.0148843.
Ye, Z. J., Qiu, H. Z., Li, P. F., Chen, P., Liang, M. Z., Liu, M. L., et al. (2017). Validation and application of the Chinese version of the 10-item Connor-Davidson resilience scale (CD-RISC-10) among parents of children with cancer diagnosis. European Journal of Oncology Nursing: the official journal of European Oncology Nursing Society, 27, 36–44. https://doi.org/10.1016/j.ejon.2017.01.004.
Yu, X. N., Lau, J. T., Mak, W. W., Zhang, J., Lui, W. W., & Zhang, J. (2011). Factor structure and psychometric properties of the Connor-Davidson resilience scale among Chinese adolescents. Comprehensive Psychiatry, 52(2), 218–224. https://doi.org/10.1016/j.comppsych.2010.05.010.
Zhong, Q. Y., Gelaye, B., Rondon, M. B., Sanchez, S. E., Simon, G. E., Henderson, D. C., et al. (2015a). Using the patient health questionnaire (PHQ-9) and the Edinburgh postnatal depression scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Archives of Women's Mental Health, 18(6), 783–792. https://doi.org/10.1007/s00737-014-0481-0.
Zhong, Q. Y., Gelaye, B., Zaslavsky, A. M., Fann, J. R., Rondon, M. B., Sanchez, S. E., & Williams, M. A. (2015b). Diagnostic validity of the generalized anxiety disorder - 7 (GAD-7) among pregnant women. PLoS One, 10(4), e0125096. https://doi.org/10.1371/journal.pone.0125096.
Acknowledgments
This research was supported by awards from the National Institutes of Health (K23-MH-115169 and T37-MD0001449). The NIH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Materno Perinatal, Peru for their expert technical assistance with this research.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Disclosure of potential conflicts of interest: No disclosures.
Research Involving Human Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study. The institutional review boards of the INMP, Lima, Peru, and the Harvard T.H. Chan School of Public Health Office of Human Research Administration, Boston, MA, USA, approved all procedures used in this study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 17 kb)
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Levey, E.J., Rondon, M.B., Sanchez, S. et al. Psychometric properties of the Spanish version of the 10-item Connor Davidson Resilience Scale (CD-RISC) among adolescent mothers in Peru. Journ Child Adol Trauma 14, 29–40 (2021). https://doi.org/10.1007/s40653-019-00295-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-019-00295-9