The Connor–Davidson Resilience Scale (CD-RISC) was developed by Kathryn M. Connor and Jonathan R.T. Davidson as a means of assessing resilience.Connor, K.M., & Davidson, J.R.T. (2003). Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety, 18(2), 76-82. The CD-RISC is based on Connor and Davidson's operational definition of resilience, which is the ability to "thrive in the face of adversity." Since its development in 2003, the CD-RISC has been tested in several contexts with a variety of populations (see Generalizability) and has been modified into different versions (see Forms).
Factor Structure
Development The CD-RISC was created to improve on existing measures of resilience (e.g., hardiness or perceived stress). Existing scales of resilience were considered inadequate because they lacked generalizability. With this in mind, the CD-RISC was tested using a variety of populations to increase the generalizability of the measure. These groups included a community sample, primary care outpatients, general psychiatric outpatients, a clinical trial of generalized anxiety disorder, and two clinical trials of PTSD.
The authors drew inspiration for the scale's content from the work of previous researchers of hardiness, most notably S.C. Kobasa Kobasa, S.C. (1979). Stressful life events, personality, and health: An inquiry into hardiness. Journal of Personality and Social Psychology, 37(1), 1-11. and M. Rutter.Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorders. The British Journal of Psychiatry, 147, 598-611. The CD-RISC consists of 25 items, which are evaluated on a five-point Likert scale ranging from 0 to 4: not true at all (0), rarely true (1), sometimes true (2), often true (3), and true nearly all of the time (4) – these ratings result in a number between 0–100, and higher scores indicate higher resilience.
Factor analysis of the original scale produced five factors:
Personal competence, high standards, and tenacity Trust in one's instincts, tolerance of negative affect, and strengthening effects of stress Positive acceptance of change and secure relationships Control Spiritual influences
The individual items are as follows (table adapted from Connor and Davidson 2003):
Item no. Description 1 Able to adapt to change 2 Close and secure relationships 3 Sometimes fate or God can help 4 Can deal with whatever comes 5 Past success gives confidence for new challenge 6 See the humorous side of things 7 Coping with stress strengthens 8 Tend to bounce back after illness or hardship 9 Things happen for a reason 10 Best effort no matter what 11 You can achieve your goals 12 When things look hopeless, I don't give up 13 Know where to turn to for help 14 Under pressure, focus and think clearly 15 Prefer to take the lead in problem solving 16 Not easily discouraged by failure 17 Think of self as strong person 18 Make unpopular or difficult decisions 19 Can handle unpleasant feelings 20 Have to act on a hunch 21 Strong sense of purpose 22 In control of your life 23 I like challenges 24 You work to attain your goals 25 Pride in your achievements
Validity
Construct validity There are a lack of studies that support the construct validity of the CD-RISC. In order for a measure to demonstrate good construct validity, it needs to be based on a complex, detailed theoretical construct (i.e., nomological network). If the measure has good construct validity, then it should "behave" as a measure of this complex concept should behave. The CD-RISC has been associated as expected (i.e., either positively or negatively) with various constructs, such as family functioning and depressive symptoms.Ni, M.Y., Li, T.K., Yu, N.X., Pang, H., Chan, B.H.Y., Leung, G.M., & Stewart, S.M. (2016). Normative data and psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) and the abbreviated version (CD-RISC2) among the general population in Hong Kong. Quality of Life Research, 25(1), 111-116. However, it needs to be tested in relation to a more complex theory to better establish construct validity.
Convergent validity Scores on the CD-RISC have been compared to several scales designed to measure the same or a similar construct. CD-RISC scores have been significantly positively correlated with a measure of hardiness. Also, the CD-RISC significantly negatively correlated with both the Perceived Stress Scale and the Sheehan Stress Vulnerability Scale. This indicates that the resilience scores obtained from the CD-RISC correspond to lower levels of perceived stress and perceived stress vulnerability, respectively. All of these findings indicate suggests good convergent validity of the CD-RISC.
Predictive validity Bezdjian and colleagues (2017) used the CD-RISC to examine the relationship between resilience and 6-month unsuitability attrition (i.e., separation from the military due to difficulties with mental health or behavioral adjustments) and between resilience and mental health diagnosis at 6 months after the start of basic training.Bezdjian, S., Schneider, K.G., & Burchett, D. (2017). Resilience in the United States Air Force: Psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC). Journal of Psychological Assessment, 29(5), 479-485. Results indicated that service members who were separated from the Air Force due to unsuitability had reported lower levels of resilience at basic training as compared to those who were not separated. Service members diagnosed with a mental disorder at 6 months of service had also reported lower levels of resilience at basic training as compared to those who were not diagnosed with a mental disorder. The effect size of both associations was medium, which points to moderate predictive validity of the CD-RISC.
Gender differences Though Connor and Davidson (2003) did not find gender differences in their sample when developing the CD-RISC, subsequent findings regarding gender differences within the CD-RISC have supported two other conclusions:
Higher Resilience in Men Campbell-Sills, Forde, and Stein (2009) found that in a large-scale community sample, men report higher levels of resilience than women when assessed with the CD-RISC.Campbell-Sills, L., Forde, D.R., & Stein, M.B. (2009). Demographic and childhood environmental predictors of resilience in a community sample. Journal of Psychiatric Research, 43 (12), 1007-1012. One explanation for this trend is that women report higher rates of psychiatric disorders that have a stress-related component (e.g., PTSD). Additionally, this difference may be due to a reporting bias – in other words, men more than women may be more concerned with being seen as able to handle stress and adversity, so they report higher scores on the CD-RISC.
Higher Resilience in Women In a sample of over 50,000 Air Force Service Members, female participants scored higher on average than their male counterparts on the CD-RISC. Women self-reported higher average levels of resilience on all but three items. One reason given for this difference (as compared to findings from previous civilian studies) is that the women in this study volunteered to join the military, and those who do this may be more likely to have higher initial levels of resilience. However, research looking at the average resilience levels in military populations have not specifically examined gender differences.Green, K.T., Calhoun, P.S., Dennis, M.F., Mid-Atlantic Mental Illness Research, Education and Clinical Center Workgroup, & Beckham, J.C. (2010). Exploration of the resilience construct in posttraumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001. Journal of Clinical Psychiatry, 71(7), 823-830. Pietrzak, R.H., Johnson, D.C., Goldstein, M.B., Malley, J.C., Rivers, A.J., Morgan, C.A., & Southwick, S.M. (2010). Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support. Journal of Affective Disorders, 120(1-3), 188-192. Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depression and Anxiety, 26, 745–751.
Forms CD-RISC2
An abbreviated, two-item version of the CD-RISC, the CD-RISC2, was created in 2005 to reduce administration time. It assessed resilience in members of the general population as well as patients with post-traumatic stress disorder, depression, and anxiety.Vaishnavi, S., Connor, K., & Davidson, J.R.T. (2007). An abbreviated version of the Connor-Davidson Resilience Scale (CD-RISC), the CD-RISC2: Psychometric properties and applications in psychopharmacological trials. Psychiatry Research, 152:2-3, 293-297. The two items used for this scale are item 1 ("Able to adapt to change") and item 8 ("Tend to bounce back after illness or hardship"). These items were chosen because Connor and Davidson deemed them capable of "etymologically capturing the essence of resilience." After analysis of test-retest reliability, convergent validity, and divergent validity, the CD-RISC2 demonstrated "significant correlation" with both the CD-RISC as a whole and with the individual items of the CD-RISC. The authors argue that since the CD-RISC2 sufficiently represents the original measure, the 2-item CD-RISC2 can be utilized in place of the 25-item CD-RISC.
10-item CD-RISC Campbell-Sills and Stein (2007) refined the original 25-item CD-RISC and validated a 10-item version of the measure, called the CD-RISC-10.Campbell-Sills, L., & Stein, M.B. (2007). Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): Validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20(6), 1019-1028. The authors recognized the 25-item version's acceptable demonstration of reliability and validity but were concerned about the measure's 5-factor structure. They were confused about the conceptual relationships between items that appeared in the same factors (e.g., positive acceptance and secure relationships) and questioned the statistical analyses used to reach the conclusions. In light of these concerns, the authors worked to establish the factor structure of the CD-RISC using a more systematic approach. Additionally, they hoped to analyze the measure's construct validity to further validate it.
Using factor analysis and three independent samples, the authors concluded that modifying the original scale to only include 10-items would improve the validity of the scale. They deleted items that, theoretically, would make sense to include in a measure of resilience but that did not carry enough statistical weight to still be included (e.g. measures of social support). They used exploratory factor analysis and confirmatory factor analysis to justify these deletions. The 10 items included in this abridged scale assess one's ability to endure difficult experiences, including "change, personal problems, illness, pressure, failure, and painful feelings." The authors found that scores on the 10-item CD-RISC correlated highly with score on the original 25-item CD-RISC.