Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention

Stress resilience is the maintenance of mental health despite adversity. Identifying factors that predict and promote good long-term mental health outcomes in stressor-exposed individuals is a first step towards developing more effective prevention programs. In two independent observational samples (N = 132, N = 1034), we find that a tendency to evaluate stressors in a realistic to slightly unrealistically positive fashion (positive appraisal style, PAS) is prospectively associated with resilient outcomes over several years. We also find that PAS is an integrative, proximal resilience factor that mediates the pro-resilience effects of other protective factors (e.g., social support). In an analysis of pre-specified exploratory outcomes of a randomized controlled trial comparing a behavioral intervention targeting a broad set of resilience factors against usual care in a sample of distressed healthcare workers (N = 232; trial registry: NCT04980326), we find that PAS is modifiable, with improvements in PAS mediating intervention-induced improvements in resilience. These results establish PAS as a proximal, plastic, and potentially causal resilience factor.

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Journal
Nature Communications
Published
2025-11-21
DOI
https://doi.org/10.1038/s41467-025-65147-7
Citations
1
Primary Topic
Resilience and Mental Health
Type
article
Field-Weighted Citation Impact
2.31

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article

Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention

Marit Sijbrandij, Alexandra Sebastian, Ulrike Basten, Ainoa Muñoz‐Sanjosé et al.
1 citations
Nature Communications
Resilience and Mental Health
2.31
article

Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention

Marit Sijbrandij, Alexandra Sebastian, Ulrike Basten, Ainoa Muñoz‐Sanjosé, Michael M. Plichta, Matthias Zerban, Mireia Félez-Nóbrega, Kenneth S.L. Yuen, Bianca Kollmann, Andrea Chmitorz, Josep María Haro, Marianna Purgato, David McDaid, Carmen Bayón, Corrado Barbui, Papoula Petri‐Romão, Alexandra Restrepo, Roberto Mediavilla, A‐La Park, Rebecca J. Neumann, Anita Schick, Kerry R. McGreevy, Andreas Reif, Lara Puhlmann, Michèle Wessa, Charlotte Schenk, José Luís Ayuso‐Mateos, Oliver Tuescher, Pierre Smith, Maria Melchior, Raffaël Kalisch, Kira F. Ahrens, Anke B. Witteveen, Klaus Lieb
article en
1 citations

Abstract

Stress resilience is the maintenance of mental health despite adversity. Identifying factors that predict and promote good long-term mental health outcomes in stressor-exposed individuals is a first step towards developing more effective prevention programs. In two independent observational samples (N = 132, N = 1034), we find that a tendency to evaluate stressors in a realistic to slightly unrealistically positive fashion (positive appraisal style, PAS) is prospectively associated with resilient outcomes over several years. We also find that PAS is an integrative, proximal resilience factor that mediates the pro-resilience effects of other protective factors (e.g., social support). In an analysis of pre-specified exploratory outcomes of a randomized controlled trial comparing a behavioral intervention targeting a broad set of resilience factors against usual care in a sample of distressed healthcare workers (N = 232; trial registry: NCT04980326), we find that PAS is modifiable, with improvements in PAS mediating intervention-induced improvements in resilience. These results establish PAS as a proximal, plastic, and potentially causal resilience factor.

Nature CommunicationsVol. 16(1)
Goethe University Frankfurt (DE), University of Verona (IT), Halle Institute for Economic Research (DE), Esslingen University of Applied Sciences (DE), Inserm (FR), German Cancer Research Center (DE), Johannes Gutenberg University Mainz (DE), Heidelberg University (DE), Hospital Universitario La Paz (ES), Instituto de Salud Carlos III (ES), University of Koblenz and Landau (DE), University Hospital Heidelberg (DE), Universidad de Antioquia (CO), Sorbonne Université (FR), Centro de Investigación Biomédica en Red de Salud Mental (ES), Leibniz Institute for Resilience Research (DE), University Medical Center of the Johannes Gutenberg University Mainz (DE), Hospital La Paz Institute for Health Research (ES), Central Institute of Mental Health (DE), Sant Joan de Déu Research Foundation (ES), Parc Sanitari Sant Joan de Déu (ES), Hospital Universitario de La Princesa (ES), University Hospital Frankfurt (DE), Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR), Sciensano (Belgium) (BE), University Medical Centre Mannheim (DE), Universidad Autónoma de Madrid (ES), Martin Luther University Halle-Wittenberg (DE), Universitat de Barcelona (ES), Columbia University (US), Technische Universität Dresden (DE), Vrije Universiteit Amsterdam (NL), London School of Economics and Political Science (GB), UCLouvain (BE)
European Commission, Deutsche Forschungsgemeinschaft, Technische Universität Dresden, Instituto de Salud Carlos III
Openalex Percentile: Top 9%
Resilience and Mental Health
2.31
DOIOpen Access PDFOpenAlex
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