Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field.

The regulation of emotion is vital for adaptive behavior in a social environment. Different strategies may be adopted to achieve successful emotion regulation, ranging from attentional control (e.g., distraction) to cognitive change (e.g., reappraisal). However, there is only scarce evidence comparing the different regulation strategies with respect to their neural mechanisms and their effects on emotional experience. We, therefore, directly compared reappraisal and distraction in a functional magnetic resonance imaging study with emotional pictures. In the distraction condition participants performed an arithmetic task, while they reinterpreted the emotional situation during reappraisal to downregulate emotional intensity. Both strategies were successful in reducing subjective emotional state ratings and lowered activity in the bilateral amygdala. Direct contrasts, however, showed a stronger decrease in amygdala activity for distraction when compared with reappraisal. While both strategies relied on common control areas in the medial and dorsolateral prefrontal and inferior parietal cortex, the orbitofrontal cortex was selectively activated for reappraisal. In contrast, the dorsal anterior cingulate and large clusters in the parietal cortex were active in the distraction condition. Functional connectivity patterns of the amygdala activation confirmed the roles of these specific activations for the 2 emotion regulation strategies.