Research Insights

A Systematic Review of Resilience in the Physically Ill

Citation: Stewart, D. E., & Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics52(3), 199-209.

Resilience: The capacity of individuals to successfully maintain or regain their mental health in the face of significant adversity or risk.

  • Research has identified common characteristics among resilient individuals (especially children and adolescents): self-esteem, optimism, mastery, hardiness, hope, spirituality, determination, effective coping strategies and strong social support.
  • It is important to better understand protective factors and positive adaptation in adversity rather than the focus on risk factors and psychopathology.

This article reviewed 52 research studies that looked at factors that are associated with or can predict or promote resilience in physical illness (e.g., Parkinson’s disease, cancer, multiple medical conditions, HIV/AIDS, diabetes, cardiovascular disease, arthritis, etc.).

Factors Associated with Resilience

Psychological Factors:

  • One’s ability to alter or control one’s perception of events and situations
    • Positively associated with family and social functioning, self-care, physical and psychological wellbeing
  • Perception of internal control (in contrast to relying only on external factors, such as others’ help)
    • Associated with better resilience, psychological adjustment, and positive life orientation
  • Self-esteem, Optimism and Mastery
    • Predictive of better psychological and physical well-being and resilience
  • Hardiness: specific set of attitudes toward challenge, commitment and control
    • Associated with better physiological, psychological and spiritual well-being
    • Associated with compliance with treatment, satisfaction and size of social support network, and mixed-focused coping strategies
  • Recurring themes reported by individuals who successfully live with chronic illness: hope, empowerment, acceptance of illnesses, and determination

Social support:

  • Associated with better psychological health, benefit-finding, hardiness, and self-esteem.
  • Rated as important by those successfully living with illness.

Coping Strategies:

  • Spirituality
    • Belief in God or having faith helped patients make sense of the illness and acted as a source of strength
    • Associated with better mental health and adjustment
  • Positive cognitive appraisal (managing our perspectives and interpretation of situations)
    • Associated with better psychological adjustment, physical health, and adherence to treatment
  • Positive life orientation; having a healthy and positive perspective on life in general
    • Associated with more personal control, better mood and recovery from challenges and medical problems
  • Ability to understand and handle illness-related uncertainties
    • Associated with better quality of life and mental health

Finding meaning and purpose in life and in situations:

  • Associated with better adjustment, lower morbidity, better spiritual and mental well-being


  • Older age tended to be associated with better adaptation
  • Studies on gender showed variable results


Specific psychological, social support and coping strategies emerged that can be useful for individuals to rely on when coping with illness. Individuals are encouraged to think about other challenging situations they have mastered to increase their sense of self-esteem and ability to adapt to current challenges. Individuals may benefit from realistic optimism, hope and mastery over their illness to help them cope. Social support and good, healthy coping strategies are also vital to enhance resilience. Some individuals may also benefit from discovering new-found strength and meaning, a concept often termed “post-traumatic growth,” which is the process of learning and finding positive meaning that contributes to personal growth in challenging times.

Click here to read the full article.


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