Table 3.

Overview of each research tradition, detailing key shifts in the theoretical orientations, conceptual focus, and methodological approaches applied to the study of resilience among transition-age youth with SMI

Research Traditions		Theoretical Orientation	Conceptual Focus	Methodological / Instrumental Approach
Overview & Approach	Author	Definition	Purpose	Study Design	Operationalization & Measures
Stress Adaptation (n = 6) Guiding Frameworks: Integrative frameworks of stress [77–80] Main resilience theorists: Rutter (interactive) [81], Masten (developmental) [82] Conceptualized resilience as: A process of positive adaptation determined through integrated biological, psychological, social, and environmental factors Focus: Emphasized personal protective factors that promote adaptation Approach: Variable-centred	Seok et al. (2012) [55]	The personal characteristics that enable one to adapt to environmental challenges and to overcome adversities or stressors	To investigate the relationships between early life stress and resilience factors with depressive symptom severity	Quantitative Cross-sectional study	Personal resilience factors CD-RISC [83] 5 Subscales: self-efficacy, self-confidence, optimism, self-control, spirituality / autonomy
	Fischer et al. (2018) [56]	The process of adapting well in the face of significant sources of stress and bouncing back from difficult life experiences	To investigate neural markers of resilience to depression, and the modulatory role of positive / negative life events	Quantitative Longitudinal study	Personal (neurobiological) resilience factors
	Konradt et al. (2018) [57]	The ability to adapt successfully in the face of stress and adversity, maintaining normal psychological and physical functioning	To assess the effects of resilience on severity of depressive and anxious symptoms after psychotherapy	Quantitative Clinical follow-up study nested in a randomized clinical trial	A mechanism and an outcome RS [84] Global Score
	De Berardis et al. (2020) [58]	The adaptive ability to cope with adversity or trauma	To examine the relationships between alexithymia, somatic sensations, resilience, and suicidal ideation	Quantitative Cross-sectional study	Personal resilience factors CD-RISC [83] Global Score
	Vieira et al. (2020) [59]	The ability to maintain relatively healthy and stable levels of physical and psychological functioning in the wake of traumatic experiences	To examine the mediating effect of resilience on the relationship between childhood trauma and mood disorder / depressive symptom severity	Quantitative Cross-sectional study	A mechanism RS [84] Global Score
	Peters et al. (2021) [60]	A person’s ability to adapt successfully to acute stress, trauma, or chronic forms of adversity	To explore clinical and biological correlates of resilience, and differences in therapeutic effects based on genetic markers	Quantitative Randomized clinical trial aSGBA	Personal (genetic) resilience factors, and an outcome RS [84] Global Score
Person-Environment Interactions (n = 9) Guiding Frameworks: Psychosocial theories (narrative medicine [85], social-emotional learning framework [86], tripartite model of depression and anxiety [87], Yalom’s 12 therapeutic factors [88], neurodevelopmental model of resilience [89]) Main resilience theorists: Rutter (interactive) [81, 90, 91], Masten (developmental) [82, 92, 93], Luthar (multidimensional) [22] Conceptualized resilience as: A complex and transactional process dependent on both personal and environmental factors Focus: Increased emphasis on external protective factors and transactional processes between each person and their immediate environment Approach: Variable-centred Person-centred Life-course	Fergusson et al. (2003) [61]	A set of protective factors that may mitigate risk of developing suicidal behaviors	To explore factors that may contribute to vulnerability or resiliency to suicidal behaviors among young people	Quantitative Longitudinal cohort study aSGBA	Personal / environmental (individual, familial, school, peer-related) resilience factors
	Gralinski-Bakker et al. (2004) [26]	Successful adaptation among individuals who faced challenging or threatening circumstances	To examine early adult indicators of psychosocial adjustment as predictors of adult markers of resilience (functioning and well-being) over time	Quantitative Longitudinal study aSGBA	A process over time, and personal / environmental resilience factors
	Hauser et al. (2007) [62]	Unexpected adaptation in the face of serious adversity	To understand how resilient development unfolds among young people who have experienced SMI, and how protective processes change over the life-course	Qualitative Narrative follow-back study	A process over time, and “resilient functioning” as an outcome
	Tan et al. (2015) [63]	The capacity of an individual to mobilise health-sustaining resources from a myriad sources – family, community and culture	To examine the efficacy of a mindfulness-based group intervention for adolescents with mixed mental health disorders	Quantitative Randomized controlled trial	An outcome RSCA [94] Global Score
	Marvin et al. (2017) [64]	A set of skills (e.g., social and emotional competencies) that can be taught and/or strengthened	To evaluate the Strong Teens social-emotional learning curriculum among adolescent girls in a residential treatment center	Quantitative Non-equivalent quasi-experimental wait-list control	An outcome SEARS [95] Global Score
	Hauber et al. (2019) [65]	The belief that one can cope with stressful life events	To identify therapeutic factors in adolescents’ written narratives, and relate these to changes in symptoms after treatment	Mixed-methods study	A process over time, and personal / environmental (therapeutic) resilience factors
	Hadebe et al. (2020) [66]	The ability of an individual to function completely in the face of adversity or stress	To explore young adults’ resilience and social support networks	Qualitative Exploratory study	Environmental (social support) resilience factors
	Gårdvik et al. (2021) [67]	Positive adaptation to risk exposure, and a more positive psychological outcome than would be expected in case of high levels of environmental adversities	To examine whether resilience factors and treatment procedures among adolescents first presenting at mental health clinics were related to psychiatric symptom load three years later	Quantitative Prospective longitudinal cohort study aSGBA	Personal / environmental resilience factors READ [96] Global Scale & 5 Subscales: personal competence, social competence, structured style, family cohesion, social resources
	Zimmermann et al. (2021) [68]	A positive outcome despite adversity	To investigate movement synchrony in relation to therapeutic outcomes during psychotherapy treatment	Quantitative Observational study	Personal / environmental (movement synchrony) resilience factors
Recovery-Focused (n = 4) Guiding Frameworks: Recovery models of mental health [97–99], transdiagnostic treatment model [100] Main resilience theorists: Aranda (interpretivist) [101], Luthar (multidimensional) [22, 102], Bottrell (social theory) [103], Richardson (metatheory) [104], Bonanno (recovery vs. resilience distinction) [105, 106] Masten (developmental / multi-systems) [92, 93] Conceptualized resilience as: A dynamic and multidimensional process which promotes functioning and recovery Focus: Adaptive strengths and processes in the context of youth’s recovery Approach: Person-centred	Henderson et al. (2015) [69]	A dynamic process wherein individuals display positive adaptation despite experiences of significant adversity or trauma	To explore young people’s experience of a first episode of psychosis over time and to develop a substantive theory of their responses and behaviors	Qualitative Grounded theory study	A process over time
	Las Hayas et al. (2016) [70]	A dynamic process in which psychological, social, environmental, and biological factors interact to enable an individual at any stage of life to develop, maintain, or regain his/her mental health despite exposure to adversity [107]	To explore the role of resilience in recovery from eating disorders (EDs), and to develop a model of resilience in women with EDs	Qualitative Grounded theory study	A process over time, and personal / environmental resilience factors
	Grob et al. (2020) [71]	A set of complex, subjective processes through which individuals negotiate their complicated journey toward clarified identity and life purpose	To explore how participants' depression impacted their transition from adolescence to emerging adulthood, and built their capacity to form a coherent identity and find a purpose in life	Qualitative Grounded theory study bEDI cYouth engagement (consultation)	A process over time
	Luther et al. (2020) [72]	The capacity of a dynamic system to withstand or recover from significant challenges that threaten its stability, viability, or development	To examine whether resilience differs among those with early vs. prolonged psychosis, and the associations between resilience scores and specific symptom domains	Quantitative Cross-sectional study	Personal resilience factors RS [84] Global Score & 2 Subscales: personal competence, acceptance of self and life
Critical and Cultural Perspectives (n = 5) Guiding Frameworks: Social-ecological frameworks (capital theory [108], ecological systems theory [52]) and recovery models of mental health [109, 110] Main resilience theorists: Bottrell (social theory) [103], Ungar (social-ecological) [23], Luthar (multidimensional) [22], Masten (developmental) [92], Richardson (metatheory) [104] Rutter (interactive) [91] Conceptualized resilience as: A process that unfolds over time, dependent on one’s culture and the supportive capacity of the environment Focus: Increased emphasis on service-related factors, systemic barriers, macro-level environment, and culture Approach: Person-centred	Delman et al. (2017) [73]	The employee’s ability to rebound and manage their health in the face of challenges and adversity that affect their work	To examine facilitators of young adult peer provider success in community mental health treatment settings	Qualitative Exploratory study cYouth engagement (partnership)	A process over time, personal / environmental resilience factors
	Lal et al. (2017) [74]	A process of an individual’s efforts to navigate and negotiate towards resources considered meaningful for well-being in the presence of adversity, and the environment’s concurrent capacity to support individual efforts	To understand how mental health and related services support and hinder resilience in young people diagnosed with first episode psychosis	Qualitative Grounded theory and narrative inquiry bEDI	A process over time
	Rayner et al. (2018) [75]	A unique youth recovery process that enabled young people to take on the various challenges in life despite systemic (i.e., lack of employment opportunities or social exclusion) and mental health adversity	To develop a thematic model of youth recovery utilising the experiences of young people with severe mental illness	Qualitative Narrative study	A process over time
	Shalanski et al. (2019) [14]	A dynamic process in which positive adaptation is achieved despite significant adversity	To explore resilience from the perspective of teenage girls recovering from mental illness, and to provide an alternative view de- pathologizing psychiatric diagnoses	Qualitative Interpretive phenomenological study	A process over time
	Kim et al. (2020) [76]	The dynamic process of adaptation to challenging life conditions that could be protective against mental problems	To investigate the clinical characteristics and psychosocial factors associated with depression in patients with early psychosis according to stage of illness	Quantitative Cross-sectional study aSGBA	Personal resilience factors BRS [111] Global Score

CD-RISC Connor-Davidson Resilience Scale [83], RS The Resilience Scale [84], RSCA Resiliency Scales for Children and Adolescents [94], SEARS The Social Emotional Assets and Resilience Scale [95], READ Resilience Scale for Adolescents [96], BRS Brief Resilience Scale [111]

^aSGBA, sex- and gender-based analyses

^bEDI, used recruitment strategies to maximize diversity and inclusion among participants

^cEngaged youth as research advisors or partners