Effect and Mechanism of an ACT-Based Psychological Resilience Intervention Targeting Students Failing in Postgraduate Entrance Examinations in China: A Randomized Controlled Trial

Abstract

The postgraduate entrance examination frenzy is a widespread and intense phenomenon in China. As the number of students who failed the examination surged, the ensuing mental health problems became prominent. This study aimed to evaluate the effectiveness of an online ACT-based group resilience course, which incorporated the six core components of ACT and integrated elements of Chinese culture, in alleviating psychological distress among students who failed the examination. It also explored the mechanism by which the intervention affected changes in psychological distress. A total of 61 participants were randomly assigned to the intervention group (n = 31) and the control group (n = 30). They attended an 8-day group course, with 2-h sessions each day. The study outcomes were psychological distress, resilience, psychological flexibility (PF), and psychological inflexibility (PI). These outcomes were measured at baseline, post-intervention, and 1-month follow-up. Linear mixed models (LMMs) showed significant group × time interactions for all outcome variables, except for stress, which showed a marginally significant interaction. Post hoc analyses revealed significant improvements in depression, resilience, and PF at both post-intervention and at the 1-month follow-up. Additionally, significant reductions in anxiety and a marginally significant reduction in stress were observed at the 1-month follow-up. However, no significant reduction was found in PI. The multiple mediation model showed that the intervention improved psychological distress by increasing resilience and PF. These findings suggest that online resilience group intervention is generally effective in enhancing resilience and alleviating psychological distress and is acceptable to students who have failed the postgraduate entrance examination, as evidenced by high participant engagement and satisfaction.

Keywords

acceptance and commitment therapy / online intervention / psychological distress / psychological resilience

References

[1] Aguirre-Camacho, A., G. Pelletier, A. González-Márquez, L. M. Blanco-Donoso, P. García-Borreguero, and B. Moreno-Jiménez. 2017. “The Relevance of Experiential Avoidance in Breast Cancer Distress: Insights From a Psychological Group Intervention.” Psycho-Oncology 26, no. 4: 469-475. https://doi.org/10.1002/pon.4162.

[2] Alvord, M. K., B. A. Rich, and L. H. Berghorst. 2016. “Resilience Interventions.” In APA Handbook of Clinical Psychology: Psychopathology and Health, edited by J. C. Norcross, G. R. VandenBos, D. K. Freedheim, and N. Pole, 505-519. Washington, DC: American Psychological Association.

[3] Ang, W. H. D., S. T. Lau, L. J. Cheng, et al. 2022. “Effectiveness of Resilience Interventions for Higher Education Students: A Meta-Analysis and Metaregression.” Journal of Educational Psychology 114, no. 7: 1670-1694. https://doi.org/10.1037/edu0000719.

[4] Ang, W. H. D., S. Shorey, V. Lopez, H. S. J. Chew, and Y. Lau. 2022. “Generation Z Undergraduate Students' Resilience During the COVID-19 Pandemic: A Qualitative Study.” Current Psychology 41, no. 11: 8132-8146. https://doi.org/10.1007/s12144-021-01830-4.

[5] Bastounis, A., P. Callaghan, A. Banerjee, and M. Michail. 2016. “The Effectiveness of the Penn Resiliency Programme (PRP) and its Adapted Versions in Reducing Depression and Anxiety and Improving Explanatory Style: A Systematic Review and Meta-analysis.” Journal of Adolescence 52: 37-48. https://doi.org/10.1016/j.adolescence.2016.07.004.

[6] Beck, K. C., H. L. Røhr, B. Reme, and M. Flatø. 2024. “Distressing Testing: A Propensity Score Analysis of High-Stakes Exam Failure and Mental Health.” Child Development 95, no. 1: 242-260. https://doi.org/10.1111/cdev.13985.

[7] Bond, F. W., S. C. Hayes, R. A. Baer, et al. 2011. “Preliminary Psychometric Properties of the Acceptance and Action Questionnaire-II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance.” Behavior Therapy 42, no. 4: 676-688. https://doi.org/10.1016/j.beth.2011.03.007.

[8] Brislin, R. W.1970. “Back-Translation for Cross-Cultural Research.” Journal of Cross-Cultural Psychology 1: 185-216. https://doi.org/10.1177/135910457000100301.

[9] Brog, N. A., J. K. Hegy, T. Berger, and H. Znoj. 2022. “Effects of an Internet-Based Self-Help Intervention for Psychological Distress Due to COVID-19: Results of a Randomized Controlled Trial.” Internet Interventions 27: 100492. https://doi.org/10.1016/j.invent.2021.100492.

[10] Brown, F. L., K. Whittingham, and K. Sofronoff. 2015. “Parental Experiential Avoidance as a Potential Mechanism of Change in a Parenting Intervention for Parents of Children With Pediatric Acquired Brain Injury.” Journal of Pediatric Psychology 40, no. 4: 464-474. https://doi.org/10.1093/jpepsy/jsu109.

[11] Brown, M., A. Glendenning, A. E. Hoon, and A. John. 2016. “Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis.” Journal of Medical Internet Research 18, no. 8: e6200. https://doi.org/10.2196/jmir.6200.

[12] Bryan, C. J., B. Ray-Sannerud, and E. A. Heron. 2015. “Psychological Flexibility as a Dimension of Resilience for Posttraumatic Stress, Depression, and Risk for Suicidal Ideation Among Air Force Personnel.” Journal of Contextual Behavioral Science 4, no. 4: 263-268. https://doi.org/10.1016/j.jcbs.2015.10.002.

[13] Campbell-Sills, L., and M. B. Stein. 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, no. 6: 1019-1028. https://doi.org/10.1002/jts.20271.

[14] Cao, C., C. Zhu, and Q. Meng. 2021. “Chinese International Students' Coping Strategies, Social Support Resources in Response to Academic Stressors: Does Heritage Culture or Host Context Matter?” Current Psychology 40, no. 1: 242-252. https://doi.org/10.1007/s12144-018-9929-0.

[15] Cao, J., Y. Ji, and Z. H. Zhu. 2013. “Reliability and Validity of the Chinese Version of the Acceptance and Action Questionnaire-Second Edition (AAQ-II) in College Students.” Chinese Mental Health Journal 27, no. 11: 873-877.

[16] Ceary, C. D., J. J. Donahue, and K. Shaffer. 2019. “The Strength of Pursuing Your Values: Valued Living as a Path to Resilience Among College Students.” Stress and Health 35, no. 4: 532-541. https://doi.org/10.1002/smi.2886.

[17] Chen, Z., and X. Tang. 2023. “Constraints and Breakthroughs Under Postgraduate Entrance Exam Failure: A Narrative Study Based on Life Course Theory.” Education and Teaching Research 37, no. 10: 14-27. https://doi.org/10.13627/j.cnki.cdjy.2023.10.001.

[18] Cheng, C. X. 2020. “A Study of Interpretative Phenomenological Psychology on the Experience of Failure in Postgraduate Entrance Examination,” Master's Dissertation, Nanjing Normal University. https://kns.cnki.net/KCMS/detail/detail.aspx?dbname=CMFD202101&filename=1021517927.nh.

[19] Cohen, J., P. Cohen, S. G. West, and L. S. Aiken. 2002. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. 3rd ed. New York: Routledge.

[20] Daks, J. S., J. S. Peltz, and R. D. Rogge. 2020. “Psychological Flexibility and Inflexibility as Sources of Resiliency and Risk During a Pandemic: Modeling the Cascade of COVID-19 Stress on Family Systems With a Contextual Behavioral Science Lens.” Journal of Contextual Behavioral Science 18: 16-27. https://doi.org/10.1016/j.jcbs.2020.08.003.

[21] Dray, J., J. Bowman, E. Campbell, et al. 2017. “Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting.” Journal of the American Academy of Child and Adolescent Psychiatry 56, no. 10: 813-824. https://doi.org/10.1016/j.jaac.2017.07.780.

[22] Ernst, M. M., and M. W. Mellon. 2016. “Acceptance and Commitment Therapy (ACT) to Foster Resilience in Pediatric Chronic Illness.” In Child and Adolescent Resilience Within Medical Contexts: Integrating Research and Practice, edited by C. DeMichelis and M. Ferrari, 193-207. Switzerland: Springer International Publishing. https://doi.org/10.1007/978-3-319-32223-0_11.

[23] Fang, S., D. Ding, P. Ji, M. Huang, and K. Hu. 2022. “Cognitive Defusion and Psychological Flexibility Predict Negative Body Image in the Chinese College Students: Evidence From Acceptance and Commitment Therapy.” International Journal of Environmental Research and Public Health 19, no. 24: 16519. https://doi.org/10.3390/ijerph192416519.

[24] Faul, F., E. Erdfelder, A. G. Lang, and A. Buchner. 2007. “G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences.” Behavior Research Methods 39, no. 2: 175-191. https://doi.org/10.3758/BF03193146.

[25] Fung, K.2015. “Acceptance and Commitment Therapy: Western Adoption of Buddhist Tenets?” Transcultural Psychiatry 52, no. 4: 561-576. https://doi.org/10.1177/1363461514537544.

[26] Giovannetti, A. M., A. Solari, and K. I. Pakenham. 2022. “Effectiveness of a Group Resilience Intervention for People With Multiple Sclerosis Delivered via Frontline Services.” Disability and Rehabilitation 44, no. 22: 6582-6592. https://doi.org/10.1080/09638288.2021.1960441.

[27] Glick, D. M., D. J. Millstein, and S. M. Orsillo. 2014. “A Preliminary Investigation of the Role of Psychological Inflexibility in Academic Procrastination.” Journal of Contextual Behavioral Science 3, no. 2: 81-88. https://doi.org/10.1016/j.jcbs.2014.04.002.

[28] Gong, H., and H. Tian. 2023. “Entering the Postgraduate Entrance Exam Cycle: Examining College Students' Decision-Making Behavior From a Bounded Rationality Perspective.” Academic Degrees and Graduate Education 7: 54-61. https://doi.org/10.16750/j.adge.2023.07.009.

[29] Gong, X., X. Y. Xie, R. Xu, and Y. J. Luo. 2010. “Psychometric Properties of the Chinese Versions of DASS-21 in Chinese College Students. Chinese.” Journal of Clinical Psychology 18, no. 4: 443-446. https://doi.org/10.16128/j.cnki.1005-3611.2010.04.020.

[30] Hasson, F., S. Keeney, and H. McKenna. 2000. “Research Guidelines for the Delphi Survey Technique.” Journal of Advanced Nursing 32, no. 4: 1008-1015. https://doi.org/10.1046/j.1365-2648.2000.t01-1-01567.x.

[31] Hayes, A. F.2017. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford Publications.

[32] Hayes, S. C., K. D. Strosahl, and K. G. Wilson. 2011. Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. New York: Guilford Press.

[33] He, H. J., M. R. Hu, J. Wang, Y. Chen, and L. X. Lai. 2017. “The Comparative Analysis of Acceptance Commitment Therapy and Taoist Cognitive Therapy.” Psychological Techniques and Applications 5, no. 7: 427-432. https://doi.org/10.16842/j.cnki.issn2095-5588.2017.07.006.

[34] Hjemdal, O., P. A. Vogel, S. Solem, K. Hagen, and T. C. Stiles. 2011. “The Relationship Between Resilience and Levels of Anxiety, Depression, and Obsessive-Compulsive Symptoms in Adolescents.” Clinical Psychology and Psychotherapy 18, no. 4: 314-321. https://doi.org/10.1002/cpp.719.

[35] Hou, Y., and Y. Zhao. 2023. “The ‘Involution’ and ‘Confusion’ of Postgraduate Entrance Exams: An Analysis and Adjustment of College Students' Learning Motivation.” Youth Journal 2: 82-87.

[36] Howell, A. J., and K. M. Demuynck. 2021. “Psychological Flexibility and Psychological Inflexibility Are Independently Associated With Both Hedonic and Eudaimonic Well-Being.” Journal of Contextual Behavioral Science 20: 163-171. https://doi.org/10.1016/j.jcbs.2021.04.002.

[37] Howell, A. J., and H. A. Passmore. 2019. “Acceptance and Commitment Training (ACT) as a Positive Psychological Intervention: A Systematic Review and Initial Meta-Analysis Regarding ACT's Role in Well-Being Promotion Among University Students.” Journal of Happiness Studies 20: 1995-2010. https://doi.org/10.1007/s10902-018-0027-7.

[38] Husky, M. M., V. Kovess-Masfety, and J. D. Swendsen. 2020. “Stress and Anxiety Among University Students in France During Covid-19 Mandatory Confinement.” Comprehensive Psychiatry 102: 152191. https://doi.org/10.1016/j.comppsych.2020.152191.

[39] Kashdan, T. B., D. J. Disabato, F. R. Goodman, J. D. Doorley, and P. E. McKnight. 2020. “Understanding Psychological Flexibility: A Multimethod Exploration of Pursuing Valued Goals Despite the Presence of Distress.” Psychological Assessment 32, no. 9: 829-850. https://doi.org/10.1037/pas0000834.

[40] Kashdan, T. B., and J. Rottenberg. 2010. “Psychological Flexibility as a Fundamental Aspect of Health.” Clinical Psychology Review 30, no. 7: 865-878. https://doi.org/10.1016/j.cpr.2010.03.001.

[41] King, E. L., C. M. Spencer, and C. A. Meeks. 2021. “How the COVID-19 Pandemic Can and Must Expand Social Worker e-Interventions for Mental Health, Family Wellness, and Beyond.” Social Work 67, no. 1: 69-78. https://doi.org/10.1093/sw/swab043.

[42] Knoop, H., K. Van Kessel, and R. Moss-Morris. 2012. “Which Cognitions and Behaviors Mediate the Positive Effect of Cognitive Behavioral Therapy on Fatigue in Patients With Multiple Sclerosis?” Psychological Medicine 42, no. 1: 205-213. https://doi.org/10.1017/S0033291711000924.

[43] Kruger, L. J., C. Li, E. Kimble, R. Ruah, D. Stoianov, and K. Krishnan. 2016. “Impact of Repeatedly Failing a High School Exit Exam: Voices of English Language Learners.” Urban Review 48, no. 3: 463-483. https://doi.org/10.1007/s11256-016-0363-z.

[44] Kumle, L., M. L.-H. Võ, and D. Draschkow. 2021. “Estimating Power in (Generalized) Linear Mixed Models: An Open Introduction and Tutorial in R.” Behavior Research Methods 53, no. 6: 2528-2543. https://doi.org/10.3758/s13428-021-01546-0.

[45] Lakens, D.2013. “Calculating and Reporting Effect Sizes to Facilitate Cumulative Science: A Practical Primer for t-Tests and ANOVAs.” Frontiers in Psychology 4: 863. https://doi.org/10.3389/fpsyg.2013.00863.

[46] Lam, C. Y.2017. “The Hope Experience of Young Adults Who Fail in Public Examination.” Asia Pacific Journal of Counselling and Psychotherapy 8, no. 2: 131-149. https://doi.org/10.1080/21507686.2017.1348369.

[47] Landi, G., K. I. Pakenham, E. Crocetti, S. Grandi, and E. Tossani. 2021. “The Multidimensional Psychological Flexibility Inventory (MPFI): Discriminant Validity of Psychological Flexibility With Distress.” Journal of Contextual Behavioral Science 21: 22-29. https://doi.org/10.1016/j.jcbs.2021.05.004.

[48] Li, C.2020. “Employment of College Students Under the Impact of the Pandemic: Employment Pressure, Psychological Pressure, and Changes in Employment Choices.” Educational Research 7: 4-16.

[49] Lin, Y. Y., R. D. Rogge, and D. P. Swanson. 2020. “Cross-Cultural Flexibility: Validation of the Traditional Mandarin, Simplified Mandarin, and Japanese Translations of the Multidimensional Psychological Flexibility Inventory.” Journal of Contextual Behavioral Science 15: 73-84. https://doi.org/10.1016/j.jcbs.2019.11.008.

[50] Liu, J. J., N. Ein, J. Gervasio, M. Battaion, M. Reed, and K. Vickers. 2020. “Comprehensive Meta-Analysis of Resilience Interventions.” Clinical Psychology Review 82: 101919. https://doi.org/10.1016/j.cpr.2020.101919.

[51] Lovibond, S. H., P. F. Lovibond, and Psychology Foundation of Australia. 1995. Manual for the Depression Anxiety Stress Scales. 2nd ed. Australia: Psychology Foundation of Australia.

[52] Masten, A. S.2001. “Ordinary Magic: Resilience Processes in Development.” American Psychologist 56, no. 3: 227-238. https://doi.org/10.1037/0003-066X.56.3.227.

[53] Masten, A. S., J. Cutuli, J. E. Herbers, and M.-G. J. Reed. 2009. “Resilience in Development.” In The Oxford Handbook of Positive Psychology, edited by S. J. Lopez and C. Snyder, 2nd ed. New York, USA: Oxford University Press.

[54] Ministry of Education of the People's Republic of China. 2021. “The Ministry of Education: 2022 College Graduates Are Expected to Be 10.76 Million, an Increase of 1.67 Million.” http://www.moe.gov.cn/fbh/live/2021/53931/mtbd/202112/t20211229_591046.html.

[55] Morris, L., and W. Mansell. 2018. “A Systematic Review of the Relationship Between Rigidity/Flexibility and Transdiagnostic Cognitive and Behavioral Processes That Maintain Psychopathology. Journal of Experimental.” Psychopathology 9, no. 3: 2043808718779431. https://doi.org/10.1177/2043808718779431.

[56] Murrell, A. R., R. Jackson, E. G. Lester, and T. Hulsey. 2018. “Psychological Flexibility and Resilience in Parentally Bereaved College Students.” OMEGA-Journal of Death and Dying 76, no. 3: 207-226. https://doi.org/10.1177/0030222817693154.

[57] National Bureau of Statistics (NBS). 2023. “Statistical Communiqué of the People's Republic of China on the 2022 National Economic and Social Development.” http://www.stats.gov.cn/english/PressRelease/202302/t20230227_1918979.html.

[58] Osman, A., C. L. Bagge, P. M. Gutierrez, L. C. Konick, B. A. Kopper, and F. X. Barrios. 2001. “The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation With Clinical and Nonclinical Samples.” Assessment 8, no. 4: 443-454. https://doi.org/10.1177/107319110100800409.

[59] Pakenham, K. I.2015. “Effects of Acceptance and Commitment Therapy (ACT) Training on Clinical Psychology Trainee Stress, Therapist Skills and Atributes, and ACT Processes.” Clinical Psychology and Psychotherapy 22, no. 6: 647-655. https://doi.org/10.1002/cpp.1924.

[60] Pakenham, K. I., M. Mawdsley, F. L. Brown, and N. W. Burton. 2018. “Pilot Evaluation of a Resilience Training Program for People With Multiple Sclerosis.” Rehabilitation Psychology 63, no. 1: 29-42. https://doi.org/10.1037/rep0000167.

[61] Pan, J.-Y.2011. “A Resilience-Based and Meaning-Oriented Model of Acculturation: A Sample of Mainland Chinese Postgraduate Students in Hong Kong.” International Journal of Intercultural Relations 35, no. 5: 592-603. https://doi.org/10.1016/j.ijintrel.2011.02.009.

[62] Rogge, R. D., J. S. Daks, B. A. Dubler, and K. J. Saint. 2019. “It's all About the Process: Examining the Convergent Validity, Conceptual Coverage, Unique Predictive Validity, and Clinical Utility of ACT Process Measures.” Journal of Contextual Behavioral Science 14: 90-102. https://doi.org/10.1016/j.jcbs.2019.10.001.

[63] Rolffs, J. L., R. D. Rogge, and K. G. Wilson. 2018. “Disentangling Components of Flexibility via the Hexaflex Model: Development and Validation of the Multidimensional Psychological Flexibility Inventory (MPFI).” Assessment 25: 458-482. https://doi.org/10.1177/1073191116645905.

[64] Son, C., S. Hegde, A. Smith, X. Wang, and F. Sasangohar. 2020. “Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study.” Journal of Medical Internet Research 22, no. 9: e21279. https://doi.org/10.2196/21279.

[65] Southwick, S. M., and D. S. Charney. 2012. “The Science of Resilience: Implications for the Prevention and Treatment of Depression.” Science 338, no. 6103: 79-82. https://doi.org/10.1126/science.1222942.

[66] Stabbe, O. K., J. L. Rolffs, and R. D. Rogge. 2019. “Flexibly and/or Inflexibly Embracing Life: Identifying Fundamental Approaches to Life With Latent Profile Analyses on the Dimensions of the Hexaflex Model.” Journal of Contextual Behavioral Science 12: 106-118. https://doi.org/10.1016/j.jcbs.2019.03.003.

[67] Steinhardt, M., and C. Dolbier. 2008. “Evaluation of a Resilience Intervention to Enhance Coping Strategies and Protective Factors and Decrease Symptomatology.” Journal of American College Health 56, no. 4: 445-453. https://doi.org/10.3200/JACH.56.44.445-454.

[68] Sun, J.2023. “Factors Influencing College Students' Career Choice in the Post-Pandemic Era and Positive Guidance: A Perspective Based on Social Ecological Systems Theory.” Beijing Youth Research 32, no. 1: 60-68.

[69] Tavakoli, N., A. Broyles, E. K. Reid, J. R. Sandoval, and V. Correa-Fernández. 2019. “Psychological Inflexibility as It Relates to Stress, Worry, Generalized Anxiety, and Somatization in an Ethnically Diverse Sample of College Students.” Journal of Contextual Behavioral Science 11: 1-5. https://doi.org/10.1016/j.jcbs.2018.11.001.

[70] Thompson, E. M., L. Destree, L. Albertella, and L. F. Fontenelle. 2021. “Internet-Based Acceptance and Commitment Therapy: A Transdiagnostic Systematic Review and Meta-Analysis for Mental Health Outcomes.” Behavior Therapy 52, no. 2: 492-507. https://doi.org/10.1016/j.beth.2020.07.002.

[71] Vahabi, M., J. Pui-Hing Wong, M. Moosapoor, A. Akbarian, and K. Fung. 2022. “Effects of Acceptance and Commitment Therapy (ACT) on Mental Health and Resiliency of Migrant Live-In Caregivers in Canada: Pilot Randomized Wait List Controlled Trial.” JMIR Formative Research 6, no. 1: e32136. https://doi.org/10.2196/32136.

[72] Vauclair, C. M., R. Fischer, M. C. Ferreira, et al. 2015. “What Kinds of Value Motives Guide People in Their Moral Attitudes? The Role of Personal and Prescriptive Values at the Culture Level and Individual Level.” Journal of Cross-Cultural Psychology 46, no. 2: 211-228. https://doi.org/10.1177/0022022114557487.

[73] Wang, X. L. 2022. “A Case Explores of Rational-Emotive Therapy to Alleviate the Psychological Problems of Unsuccessful Students in Postgraduate Entrance Examination,” Master's Dissertation, Gansu Political Science and Law Institute. https://kns.cnki.net/KCMS/detail/detail.aspx?dbname=CMFDTEMP&filename=1022547947.nh.

[74] Waters, C. S., N. Frude, P. E. Flaxman, and J. Boyd. 2018. “Acceptance and Commitment Therapy (ACT) for Clinically Distressed Health Care Workers: Waitlist Controlled Evaluation of an ACT Workshop in a Routine Practice Setting.” British Journal of Clinical Psychology 57, no. 1: 82-98. https://doi.org/10.1111/bjc.12155.

[75] Windle, G., K. M. Bennett, and J. Noyes. 2011. “A Methodological Review of Resilience Measurement Scales.” Health and Quality of Life Outcomes 9, no. 1: 8. https://doi.org/10.1186/1477-7525-9-8.

[76] Xu, L. M.2014. “An Investigation on the Psychological Status of Students Who Failed in Postgraduate Entrance Examination.” Policy Research and Exploration 3: 36-37.

[77] Zhang, D. M., M. Xiong, and Y. Z. Li. 2018. “The Reliability and Validity of 10-Item Connor-Davidson Resilience Scale in the Community-Dwelling Older Adults.” Chinese Journal of Behavioral Medicine and Brain Science 27, no. 10: 942-946.

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