Resiliencia: ¿Es posible medirla e influir en ella?

SUMMARYThe objective of this work is to present a review about the concept ofresilience, its biological aspects, the way we can try to measure itand some possible interventions.In Spanish, the term resiliencia is taken from the English wordresilience or resiliency, term originally used in thermodynamics. Inbiological sciences, resilience is defined as «the capability of anecosystem or organism to recover its steadiness after it has sufferedan alteration». In psychosocial research, Rutter defines resilience as«the relative resistance to the psychosocial experiences of risk». For the resilience process to take place, it is necessary thatindividuals become exposed to an important stress and adversity load,and their efforts to contend them result in a positive adaptation in spiteof suffering aggressions throughout the developmental process.When facing significant stress, three potential responses can beanticipated: 1. That individuals at risk show a better evolution thanexpected; 2. That a positive adaptation remains in spite of stressingexperiences; or 3. That individuals reach an acceptable recovery aftera trauma.The physiological response to the acute stress involves severalneurotransmitters, neuropeptides and hormones, which havefunctional interactions that may produce a psychobiological responsein the face of the acute stress and long term psychiatric consequencesbecause they mediate mechanisms and neuronal paths that regulatereward, fear conditioning and social behavior. Cortisol, corticotropin-releasing hormone, norepinephrine, galanin, neuropeptide Y,dopamine and serotonin are some of the substances (physiological[or stress] mediators) implicated.After important stress exposure, we can say that a person has aresilient profile if his/her dehydroepiandrosterone (DHEA),neuropeptide Y, galanin, testosterone, 1A serotonin receptor (5HT1A)and benzodiazepine receptor levels are increased at the time that thehypothalamic-pituitary-adrenal axis (HPAA) and the locus coeruleussystem functions are diminished.The biological factors associated with the acute and chronicstress can be considered a measure of resilience. For this purpose,the term allostasis, defined as the adaptive physiological responseagainst the acute stress, has been proposed. Ideally, once the acutestress is suppressed, the individual is capable of recovering the stateof homeostasis. However, if this does not occur and adaptive responseagainst the acute stress persists or decreases only partially, it resultsin a harmful cumulative effect on the physiological and psychologicalfunctions of the individual. This phenomenon is denominated«allostatic load». To evaluate the allostatic load it is necessary to incorporateinformation on the «usual» levels of each individual’s allostasis, andto evaluate the dynamics of the systems and the parameters of themain regulation systems.The parameters to evaluate the allostatic load are: a) Arterialsystolic pressure >148 mmHg and arterial diastolic pressure >83mmHg, which are the cardiovascular activity index; b) Waist-hipindex > 0.94, that reflects the chronic metabolism function and thedisposition of body fat; c) The total cholesterol/high density lipids(HDL)relation in serum >5.9, related with the development ofatherosclerosis; d) Glycosylated hemoglobin levels >7.1%, to identifythe average of plasma glucose concentration over prolonged periodsof time; e) Dehydroepiandrosterone sulfate (DHEA-S) 25.7 ug/g creatinine, which measures the 12 hoursHPAA activity; g) Nocturnal urinary adrenaline >48 ug/g creatinine,and noradrenaline excretion >5 ug/g creatinine; this test integratesthe 12-hours indexes of the sympathetic nervous system activity.The appropriate study of resilience requires consideration toother aspects influencing its nature besides the biological ones. Someof them are: a) The risk factors, defined as events or conditions ofadversity associated with the presence of psychopathology ordysfunctional development; b) The vulnerability factors, that is, thefeatures, genetic biases and environmental or biological deficiencieswhich increase the stress and risk factors response; and c) Theprotective factors, described as features, contextual characteristicsand interventions that promote the resistance, or moderate the effects,to the risk factors. The protective factors are associated with healthand functional development; therefore, they promote resilience andoffer new options to cope with the event.These factors are studied in three areas: those characteristic ofchildren, in the family atmosphere and in the community.The characteristic factors of children are: intelligence,temperament, flexibility, sense of humor and self-esteem. Related tothese a number of annotations have been made. For instance, incertain individual intelligence is modified due to a sequence of stressexposure, like family violence. Individuals with a «resistant» personalityexperience more trust and are better prepared to apply their abilitiesand take advantage of their social support; likewise, cooperativeness,kindliness and tolerance are characteristics that could help the childto deal with the presence of harsh conditions; and finally, peoplewith a high opinion of themselves seem to be more resistant tostressing events.The factors of the family atmosphere are: maltreatment, parentalloss, attachment and support, discipline and surveillance, carefulnessActualizacion por temas