Family Social Support and Children’s Mental Health Resilience

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This entry is adapted from the peer-reviewed paper 10.3390/youth3020037

social support family resilience individual resilience child mental health COVID-19

1. Introduction

The role of the parents or guardians is crucial in caring for children and seeing to it that their requirements for food, clothes, education, shelter, and protection are addressed, particularly in times of crisis. In addition to these responsibilities, if the children suffer chronic psychological disorders or mental illness, this requires additional work and duties. The presence of the family thus becomes vital in ensuring that these children receive social assistance ^[1], particularly since researchers have confirmed that mothers of mentally ill children have a two to three times higher risk of developing depression than mothers of healthy children ^[2].

Many forms of solidarity, such as those between families, extended families, associations, and other institutions, appeared during the COVID-19 disaster. Disasters are generally defined as events that create significant disturbance to the daily lives of a large number of people. In addition to discussing various experiences about the collective trauma they produce, the research on the effects of disasters on children covered the operations of interactions linked to social support intended to assist the resilience and development of these children ^[3].

The social position of the children, their age, and the overall environment characterized by the risks of COVID-19 make these social strata, particularly those with mental health disorders, more vulnerable ^[4]. Given that there are circumstances that can exacerbate this vulnerability with the whole family, such as poverty, the growth of its members, divorce, and the parents’ low educational status, all of these situations are added to the confinement context concerning the needs of COVID-19; these conditions can negatively affect children’s abilities and well-being by making it difficult for parents or other caregivers to care for their health ^[5]. They may also make it difficult to obtain daily supplies and necessities, which may eventually result in abuse, neglect, and violence against children with mental illness ^[6]^[7].

Social support is significantly associated with resilience through psychosocial mechanisms for having the ability to cope with stress. Moreover, social support is one of the crucial key factors of individual resilience during COVID-19 ^[8]^[9]. Indeed, studies demonstrate that social support from family and other loved ones was associated with greater resilience ^[10]. The positive environment during COVID-19 provides a factor of satisfaction at the level of psychosocial needs such as affiliation with others, affection, and social support from family, friends, and peers ^[11]. Furthermore, social support services are correlated with improved well-being and positive family functioning and support the social integration of people with dementia, specifically at the level of reduced illness ^[12].

2. Social Support

Although many authors have used terminology that suggests they are discussing the idea of social support, after the term was adopted in the 1970s, questions about its content, the social context surrounding it, the spread of theoretical definitions, and discussions that refer to it emerged ^[13]^[14].

It was challenging to conceptualize, illustrate, or measure the diverse visions of social support. Despite the extensive studies that have been conducted on it, there has yet to be a consensus among theorists and researchers as to what it means in theory and practice. As a result, social support researchers ignored the complexity of this concept, used an explicit measurement method, and assumed that practically everything that necessitates social interaction qualifies as social support ^[14]^[15]. One study collects definitions of social support. It condensed them into two categories based on characteristics. The first category describes the dimensions of interpersonal relationships, including structure, size, reciprocity, accessibility, make-up, and intention. The second category defines the dimension of social ties, including access to, use of, homogeneity, motivations, and expectations. This study ends with one element, the social relationship that ties the two dimensions together. It is characterized by structure, type, and strength on the one hand, and reciprocity, accessibility, and reliability on the other ^[15].

In the definition provided by Shifeng Li and Qingying Xu, “social support is typically conceptualized as the emotional, informational, and instrumental assistance received from the social network” ^[16] (p. 2).In addition, Dunst, Trivette, and Cross confirm that “social support is a multidimensional construct that includes physical and instrumental assistance, attitude transmission, resource and information sharing and emotional and psychological support” ^[17] (p. 98).

To better understand the concept of social support, researchers suggest that it includes two fundamental components: perceived social support and received social support ^[18]. Each of these components corresponds to a unique perspective on social support. Received social support correlates with the view that social support results from each individual’s special characteristics. It is established through early interactions between parents and children. Moreover, it is characterized by temporal stability. This approach is founded on the fundamental idea that social support is directly related to intrapersonal processes and internal relational schemas or interactions that take place before the person in question asks for assistance: the interrogatory process ^[7]^[19]. By contrast, the second approach, which refers to received social support, considers social support due exclusively to transactions that concern the social environment or the resources the individual can access. This approach is based on the assumption that social support is interpersonal or interactions that take place following a request of support: the postrogatory process ^[7]^[19].

In measurement, the perceived social support originates in early family transactions that include caring, affection, and positive involvement which set the basis for supportive relational schemas. Furthermore, researchers have found a relationship between perceived social support and infant attachment, family environment, and social skills. Conversely, it also correlated to feelings of control, self-efficacy, and self-esteem. As for received social support, it is less dependent on the previous stage, which is related to the parents, but instead has to do with situational factors. This situation is characterized by the fact that the person concerned is under stress and needs help to cope ^[7]^[18]^[19].

Ambikile and Outwater measured received social support through three needs that parents and guardians require in their relationship with children with mental disorders: psychological needs, which include disturbing thoughts, emotional disturbance, unavoidable situations, and communication problems; social needs, which include social service, stigma, caring responsibilities, public awareness, social support, and social life; and economic necessities, which refer to poverty, interference with various income-generating activities, and extra expenditure due to the illness ^[1].

Schaefer and his colleagues distinguished between three functions of support: Emotional support, which includes intimacy, affection, consolation, and the ability to trust and rely on others—all of this contributes to the person being valued, cared for, and a member of the group rather than a stranger; tangible support, which includes direct assistance or services such as caring for people in need or doing their routine work, as well as loans, financial assistance, or goods; and informational support, which refers to delivering information and suggestions to help the person solve the problem and give feedback on his performance ^[20]. Note that researchers have proved that emotional support is more critical than informational support and tangible support, as it contributes significantly to maintaining good health and a sense of well-being ^[19]^[20].

Research on adults reveals that among the most effective indicators of long-term mental and physical health after a traumatic experience are the availability of dependable social support and community-based resources (such as employment chances). However, there has been limited empirical study on the impact of family coping mechanisms on adolescents exposed to significant disasters regarding posttraumatic distress. One possibility is that parents may be forced to choose between different coping behaviors due to their limited time and energy. For example, they may have to choose between offering their children higher levels of intimate social support (such as talking about their feelings) and seeking agent-based, logistical support (such as professional counseling, job training, housing assistance, and the like) ^[21].

3. Resilience

Invulnerability was the first concept in this area to emerge. It grew in popularity in the mental health field in the 1970s. This idea is seen as a logical progression from the psychological consequences of what was once called Stressful Life Events and Circumstances (SLE-Cs). The invulnerability was applied to a small sample that defies the odds in a group of well-adjusted and healthy black children raised in the community that they could tolerate despite the extreme stress brought on by deprivation, poverty, and prejudice. Although this concept’s first formulation is just the beginning of its examination, the idea has proven helpful as a predictive tool for highlighting similarities among various datasets ^[22]^[23].

The concept of resilience has replaced the idea of invulnerability because it does not help to expand the research; it gives the impression that the person concerned is safe and would not be exposed to risks and that it is the personal characteristics that protect him. It also gives the impression that he covers all risks by dealing with vulnerability as a constant characteristic; it fails to account for the dynamics of the social environment and the different personalities ^[24]^[25].

Scientists and clinicians have sought to learn more about how adversity impedes human adaptation and how to reduce risks such as those left over from World War II ^[24].

Understanding the factors that encourage healthy coping or reduce the impact of risk or adversity was critical to the Child and Family Study scientists, who confirmed that some individuals or families appeared more vulnerable to problems. They also note that some people have better protection or recovery than those who have experienced trauma or crisis ^[26].

Definitions of resilience have evolved over decades of research on psychosocial resilience, reflecting a general theoretical movement toward developmental systems models in conceptualizing and studying human adaptability and development. It spans a variety of interactions, starting at the molecular level and moving on to social and ecological systems ^[27]. According to Virginia O’Leary, the first definition of resilience originated in the physical sciences—it refers to how solid materials react to the direct treatments they receive—but the second definition is psychological and is more widely accepted by social scientists ^[28].

Resilience has not been used consistently in the scientific literature despite its intuitive appeal, leading to inconsistent definitions among researchers: definitions have included academic achievement and social competence ^[23], overcoming difficulty and surpassing disadvantage ^[29], the positive adaptation in the difficult conditions, achievement of social expectations, and the capacity to change behavior in response to various demands. In the end, Werner and R.S. Smith (1982) focus on the ability to handle stress ^[28].

Indeed, this is what Masten noted when she confirmed that even for research on individual resilience in young people, there are inconsistencies in the body of research on resilience due to the complexity of the processes involved ^[27].

Resilience was conceptualized by Rutter (1987) as a protective mechanism that fosters effective adaptation in the face of psychological or environmental stressors. The four roles that resilience serves are to (a) lessen risk impact; (b) stop adverse domino effects; (c) build and preserve self-esteem and efficacy; and (d) improve opportunities ^[29].

Garmezy mentioned that “Resilience means the skills, abilities, knowledge, and insight that accumulate over time as people struggle to surmount adversity and meet challenges. It is an ongoing and developing fund of energy and skill that can be used in current struggles” ^[30] (p. 298).

4. Family Resilience

Few studies thought of the family as a potential source of resilience, even though individual resilience has increasingly come to be understood in terms of the interaction between nature and nurture ^[31]. Indeed, it has been emphasized by some researchers that only since the 1970s studies and research have started to examine families’ support for each other, their capacities, and roles for coping and adaptation ^[32].

The literature assessment reveals at least two analytical frameworks that combine family and resilience ^[33]. Sometimes, the family is considered a risk factor for resilience because it is the source of stress; simultaneously, it is seen as a protective factor since it is the individual’s source of resilience ^[34].

The idea of the family as a source of resilience is related to the concept of the family environment, which is made up of two elements: total family stress, which is defined as the number of life events the family experiences in a given period (such as unemployment, illness, and financial crises); and total family functioning as a positive factor (minimal conflict in the home during infancy; absence of divorce during adolescence) ^[35], which refers to the family as a whole and not just one person or a small system. Moreover, the fathers may participate in achieving resilience through their contribution to the childcare in the family ^[36]^[37].

Finally, in some cases, the family is considered a risk factor for children, as it can participate in specific behaviors linked to the emergence of mental illness and crime in children such as via severe marital conflict, maternal mental illness, crowded housing, and limited parenting skills ^[38]^[39].

5. Individual Resilience

Individual resilience depends on the qualities of people who have overcome adversity and on the consideration that some have an advanced level of resilience. Therefore, resilience is typically seen as the personality traits and coping mechanisms that allow a child or adult to overcome traumatic life experiences. Accordingly, resilience is typically seen as inborn, as if resilient people were raised as such from birth and always had it—i.e., biological hardiness—or acquired it on their initiative and through good luck. The term “vulnerable child” has been used, contributing to the perception that fragile survivors of abusive home contexts are resistant to stress due to their internal resilience or personal armor ^[31]^[40].

Studies have revealed that characteristics such as a cheerful and composed temperament and high intelligence are advantageous but not necessary for developing resilience. Most importantly, these characteristics lead to increased self-esteem, defined by a realistic feeling of hope and personal control ^[31]^[35].

According to Kobasa and colleagues, people with hardy personalities share three traits in common: the conviction that they have some degree of control or influence over the circumstances of their lives; the capacity to feel intensely invested in or committed to their daily activities; and the expectation that change presented an exciting opportunity for personal growth ^[10].

Polk (1997) looked into four methods to empirically assess individual resilience. The first, the dispositional pattern, refers to the biological and ego-related psychosocial attributes that contribute to the manifestation of resilience. The second, the relational pattern, concerns the person’s social obligations and interactions with others. These roles and connections involve close, personal relationships and more societal connections. The third pattern is the situational pattern; it deals with the elements that concern the connection between a person and a difficult circumstance. This can include the person’s capacity for problem-solving, evaluation of conditions and possible answers, and action in the face of challenge The final type of resilience, the philosophical pattern, is a person’s perspective on the world or way of living. This can contain various resilience-promoting ideas, such as the conviction that there is positive significance to be discovered in every experience, the importance of self-improvement, and the belief that life has meaning ^[32].

6. Children's Resilience

Breda has noted that the initial research on individual resilience concentrated on children’s capacity ^[7]. Taking into account that epidemiological studies are concerned with health and disease in human populations, the contemporary notion of risk in biological and behavioral studies in particular focuses on the factors at the person’s disposal for mental and physical health. Indeed, the research on life stress and risk established the foundation for the later theoretical framework for resilience ^[26].

Biological risk factors have been the main reason behind studies in the 1930s about children exposed during prenatal and postnatal periods, including nutritional deprivation, low birth weight, infections, and schizophrenia ^[41]^[42]. Additionally, environmental risk factors, including stress studies, were a focus of research in the 1950s to examine how children and adolescents develop in response to naturally occurring stressors ^[28].

Resilience was emphasized in the 1970s when academics redirected their attention from the negative effects of risk to beneficial outcomes such as adaptation, protection, competence, and invulnerability. The concept of “resilience” was first used by Gramezy and Nuechterlein (1972) to describe a small group of competent African-American children living in the ghetto. These children could cope despite facing severe social and environmental difficulties such as poverty, prejudice, and unfavorable living conditions ^[28].

Resilient children are defined as children who manage to overcome these challenges under such circumstances. “Resiliency in children is the capacity of those who are exposed to identifiable risk factors to overcome those risks and avoid negative outcomes such as delinquency and behavioral problems, psychological maladjustment, academic difficulties, and physical complications” ^[43] (p. 368).

On the Hawaiian island of Kauai, 700 native children born in 1955 were the subjects of longitudinal research by Warner and R.S. Smith in 1982. This study expanded on earlier investigations into infant development. The 10% of people the researchers classified as resilient shared four key traits: the first is an active approach to problem-solving; the second is a propensity to see their experiences as beneficial, even when these experiences result in pain or suffering; the third component is the capacity, beginning in infancy, to attract the favorable attention of others; the fourth key is a firm reliance on faith to maintain an optimistic outlook on a meaningful life ^[44].

The studies cited in this entry focus on social support or individual or family resilience and its relationship with risk. Only some studies, to the researchers' knowledge, deal with all its components explicitly concerning COVID-19.

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