Abstract
BACKGROUND: Resilience has been recognized as a potential outcome for preserving mental health and preventing postpartum depression. Social connection and emotional regulation have been identified as possible factors in resilience from social and cultural perspectives. Therefore, it is necessary to develop a scale that is adapted to the Japanese cultural milieu. OBJECTIVE: To establish the validity and reliability of the new resilience scale, questionnaires were administered to mothers raising children aged 0-5 years. METHODS: The Japan Resilience Scale (J-RS) is a newly created, 25-item, self-report scale designed to assess resilience. The J-RS includes six subscales (Joy, Anger, Apprehension, Grief, Fear, and Social connection) that are rated on a 5-point Likert scale (0-4). To validate the J-RS, data were collected from 238 mothers (mean age 35.3 ± 4.7 years), and its relationships with other measures, such as the Resilience Scale (RS) and the Center for Epidemiologic Studies Depression (CES-D) scale, were examined. Internal consistency (reliability) of the J-RS was assessed using Cronbach's alpha coefficient, and the final model was determined via confirmatory factor analysis (CFA). Multiple logistic regression analysis was then used to identify depressive symptoms using the CES-D. RESULTS: A total of 238 mothers, with 18.5% exhibiting depressive symptoms, were analyzed. The mean J-RS score was 61.3 ± 14.2. J-RS was positively correlated with RS (r = 0.71, p < 0.01) and negatively with CES-D (r = -0.62, p < 0.01). These results demonstrate the construct validity of the J-RS. CFA confirmed the six-factor model's good fit for emotion and social connection. The J-RS was effective in distinguishing individuals at risk of depression (AUC = 0.83, 95% CI: 0.75-0.91). At a cutoff of 59/60, sensitivity, specificity, positive predictive value, and negative predictive value were 84.1%, 63.9%, 34.6%, and 94.7% respectively. CONCLUSIONS: The J-RS appears to be the optimal index for assessing resilience, and would allow screening for postpartum depression among Japanese mothers. This study also showed that emotional control and social connectedness are important components of resilience.