Skin deep resilience

Much of the work at the Center for Family Research involves understanding so-called, “Skin deep resilience.” Below is a research digest on the topic as well as a video providing an overview. See also our summary of John Henryism which informed the development of our research on skin deep resilience.

Dr. Edith Chen explains skin-deep resilience in this six minute video

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Skin-deep Resilience Research Digest

Resilience among children and adults remains a key area of study for scholars in human development (Masten, 2018 JFTR; Luther, 2006 CD; Rutter, 2012 D&P). The general tone of most of this research has been optimistic. This framing is understandable, as most resilience research provides the type of findings and stories the public loves to hear, about individuals who “beat the odds,” climbed the ladder of social mobility, or achieved success despite significant adversity or hardship.

Moreover, most resilience research to date has tacitly assumed that resilience is rather uniform across developmental domains. That is, if a child growing up under adversity manages to thrive in terms of academics, mental health, or substance misuse, then this individual has avoided the consequences of adversity in other areas of life as well.

Is there a physical health cost to overcoming adversity?

However, data emerging from the Center for Family Research (CFR) and other research centers around the country have begun to challenge this assumption. Specifically, a growing consensus is emerging regarding a hidden cost to resilience, particularly as it relates to physical health. As summarized in this research brief, results of this body of research suggest that beating the odds and achieving upward social mobility may be associated with a tradeoff in which economic success and good mental health come at the expense of physical health. CFR scientists call this pattern skin-deep resilience because it suggests that, in readily observable domains (going to college, earning good incomes, having positive mental health), certain youth appear to be doing well, yet, in the less visible domain of physiological health, these seemingly resilient individuals may be struggling. Hence, their resilience may indeed be only “skin deep.”

Empirical Findings

The catalyst for this body of research is a 2013 study by Brody and colleagues. In a sample of nearly 500 rural African American youth, the authors observed that, among those from higher risk SES environments, individuals who in preadolescence evinced high self-control displayed better mental health and fewer externalizing behaviors at age 19 – classic resilience. However, results further indicated that these outwardly resilient youth also reported higher levels of allostatic load, a biological marker of wear-and-tear on multiple bodily systems. A 2015 study with the same sample provided additional support for this skin-deep phenomenon, observing that African American youth from more disadvantaged neighborhoods who attended college engaged in lower levels of substance use (again, indicative of resilience) but displayed higher levels of allostatic load compared with those from less disadvantaged neighborhoods who attended college, or with those who did not attend college at all.

The same skin-deep resilience pattern has been found in other samples of African American youth and young adults; health outcomes receiving attention include cellular aging, diabetes risk, metabolic syndrome, and respiratory infection, (Brody, Yu, Miller, & Chen, 2016; Duggan, Jennings, & Matthews, 2019; Gaydosh, Schorpp, Chen, Miller, & Harris, 2018; Miller, Cohen, Janicki-Deverts, Brody, & Chen, 2016; Miller, Yu, Chen, & Brody, 2015). (in Brody 20 Health Psych). This pattern has been most frequently demonstrated among individuals of color living in low-SES environments (Gaydosh et al., 2018; Brody et al., 2013; Miller, Cohen, Janicki-Deverts, Brody, & Chen, 2016a; Chen et al., 2019), (Chen et al., in press; Miller et al., 2020). In sum, the skin-deep resilience pattern suggests that, for low-income youth, the ability to maintain high self-control and to persist with efforts to succeed may act as a “double-edged sword,” facilitating academic success and adjustment while undermining physical health.

Current and Future Directions

Researchers at CFR and others around the country are actively investigating factors that may underlie the skin-deep resilience phenomenon. Psychologically, two hypothesized mechanisms include prolonged high levels of striving – particularly a form of high-intensity coping known as John Henryism (James, 1994) – and competition between the demands of the environments these individuals seek to enter and their environments of origin (see Chen et al., in press for additional discussion). These factors may lead these individuals to engage in unhealthful behavior (e.g., overeating of comfort foods) and to disengage from healthful behaviors (e.g., adequate sleep, exercise). (see Chen et al., in press for additional discussion)

Read more about our current research.

Key references:

Brody, G. H., Yu, T., Chen, E., Miller, G. E., Kogan, S. M., & Beach, S. R. (2013). Is resilience only skin deep? Rural African Americans’ socioeconomic status–related risk and competence in preadolescence and psychological adjustment and allostatic load at age 19. Psychological Science24(7), 1285-1293.

Chen, E., Yu, T., Siliezar, R., Drage, J. N., Dezil, J., Miller, G. E., & Brody, G. H. (2020). Evidence for skin-deep resilience using a co-twin control design: Effects on low-grade inflammation in a longitudinal study of youth. Brain, Behavior, and Immunity, 88, 661-667..

Chen, E., Brody, G. H., & Miller, G. E. (in press) What are the Health Consequences of Upward Mobility? Annual Review of Psychology.

Miller, G. E., Chen, E., Yu, T., & Brody, G. H. (2020). Youth who achieve upward socioeconomic mobility display lower psychological distress but higher metabolic syndrome rates as adults: Prospective evidence from the National Study of Adolescent Health and the Midlife in the United States Study. Journal of the American Heart Association9, e015698.

Miller, G. E., Cohen, S., Janicki-Deverts, D., Brody, G. H., & Chen, E. (2016). Viral challenge reveals further evidence of skin-deep resilience in African Americans from disadvantaged backgrounds. Health Psychology35, 1225-1234.