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aggressive response by themselves will achieve their goal. They are poorer
at generating solutions to hypothetical social problems, and in real-life
social encounters display fewer prosocial skills and less ability to deploy
constructive, positive behaviours and strategies. They are especially poor at
negotiating interpersonal differences and conflict of wishes. Many of these
perceptions and response styles are entirely understandable in the light of
the children’s experiences, and indeed may have been necessary to sur-
vive. However, they do not lead to success in new relationships and tasks.
In summary, ongoing adversities are not just distressing; they often
damage the growing child’s social, cognitive and emotional capacities.
Children who are relatively immune to these stresses usually have pro-
tective factors present that enable them to develop adequate emotional
regulation, secure attachments and appropriate social skills.
Clinical implications
Assessment of children with psychological problems should include ap-
praisal of protective factors as well as characterising the nature and
intensity of adversities. The formulation should describe explicitly the
child’s strengths and capabilities. Wherever possible, steps should be taken
to ameliorate adverse circumstances. In any case, and especially when
adversities cannot all be corrected, helping the child develop competencies
is likely to mitigate the impact of psychiatric disorders and improve
confidence and self-esteem. Thus, for example, in a conduct-disordered
boy who is reasonably good at football, encouraging the parents to take
him to an afterschool training club may be beneficial; in a depressed girl
with dancing ability, helping this develop through classes may likewise
improve confidence and sometimes symptoms. For some children, par-
ticularly where both home and school experiences are unpleasant, such
activities may be the main or only positive experience in the week.
More formally, there are social skills and problem-solving interventions
that teach children how to develop these general abilities. For particular
circumstances, such as living with chronic medical conditions, there is a
range of psychological interventions. They are proven to work in clinical
trials, but unfortunately are often not easily available.
Subject review
Jenkins J. (2008) Psychosocial adversity and resilience.In: Rutter Met al.
(eds)Rutter’s Child and Adolescent Psychiatry, 5th edn. Wiley-Blackwell,
Chichester, pp. 377–391.
Luthar S. (2006). Resilience in development: A synthesis of research across
five decades. In: Cicchetti D, Cohen D (eds)Developmental Psychopathology,
2nd edn, Vol. 3:Risk, Disorder, and Adaptation. John Wiley & Sons, Inc.,
Hoboken, NJ, pp. 739–795.