Changes in Resilience Predict Function in Adults With Physical Disabilities: A Longitudinal Study

Objectives: (1) To determine if resilience exhibits similar stability across time as depression, fatigue, and sleep quality; and (2) to determine if changes in resilience over a period of 1 year are associated with changes in depression, fatigue, sleep quality, and physical function over the same time period.

Design: Observational longitudinal survey study with measures administered 2 times, 1 year apart.

Setting: Community-based population sample.

Participants: Adults with physical disabilities (N=893).

Interventions: Not applicable.

Main outcome measures: Primary outcomes were measures of resilience (Connor-Davidson Resilience Scale), depression (Patient Health Questionnaire-9), fatigue (Patient-Reported Outcomes Measurement Information System [PROMIS] Fatigue Short Form), sleep quality (PROMIS Sleep Disturbance), and physical function (8-item PROMIS Physical Functioning).

Results: Resilience (r=.71, P<.001) exhibited similar stability over 1 year to depression (r=.71, P<.001), fatigue (r=.79, P<.001), and sleep quality (r=.68, P<.001). A decrease in resilience was associated with an increase in depression (F_1,885=70.23; P<.001; R²=.54) and fatigue (F_1,885=25.66; P<.001; R²=.64), and an increase in resilience was associated with improved sleep quality (F_1,885=30.76; P<.001; R²=.48) and physical function (F_1,885=16.90; P<.001; R²=.86) over a period of 1 year, while controlling for age, sex, and diagnosis.

Conclusions: Resilience exhibits similar test-retest stability as other important domains that are often treatment targets. Changes in resilience were associated with changes in depression, fatigue, sleep quality, and physical functioning over the course of 1 year. Further longitudinal and experimental research is warranted to investigate the potential causal effect of changes in resilience on quality of life in individuals with physical disabilities.