Staying Strong Despite Adversity: Resilience in Children and Adolescents.

Resilience is a dynamic adaptation process defined as an individual's ability to overcome and recover from stress or unhappiness. A person's resilience is determined by the balance between risk factors and protective factors. Risk factors increase the likelihood of negative outcomes, whereas protective factors modify responses to the negative event, thereby avoiding potential negative outcomes. Studies on the neurobiology of resilience are heterogeneous and have associations in the structure, activity, and connectivity of prefrontal and subcortical areas. Chronic diseases, which have increased in frequency in children and adolescents over the years, are an important risk factor for resilience. Resilience in chronic diseases is closely related to both the course of physical illness and mental outcomes. In chronic diseases, family resilience is of great importance in addition to individual-level characteristics such as self-efficacy, selfconfidence, and coping strategies. The whole family in the child's life, which cannot exist alone, is affected by the disease and the process and affects each other. Family resilience mainly includes shared family belief systems, forms of family organization, and family members' open communication and problem-solving skills. Through the resilience they develop, families cope with the stress of chronic illness, thereby improving their children's ability to cope with stress. As a dynamic concept, resilience can change and be developed over time. Increasing resilience through community, family, and individual interventions at different levels can have a positive impact on medical and psychosocial outcomes.