7.4 BUILDING RESILIENCE AT SCHOOL IN AT-RISK ADOLESCENTS IN COLOMBIA

Objectives: The goal of this session is to understand the association between resilience and mental illness and identify a school-based intervention to enhance resilience in at risk youth living in urban low-income neighborhoods, with significant community violence. Colombia's armed conflict has led to widespread violence and forced displacement of people to marginalized neighborhoods surrounding major cities in which children are victims of both the armed conflict and community violence, with no access to mental health services. Building resilience in childhood may reduce psychopathology, particularly in at risk populations and in resource-poor environments such as the ones observed in this study. Methods: We conducted a cross-sectional study of resilience and psychopathology in school children (ages 12-18 years) attending five public schools in low-income marginalized neighborhoods, with significant community violence in Bogota. Over 500 adolescents completed self-report questionnaires on resilience, anxiety, depression, and substance abuse. We also conducted a systematic review of the literature to identify school-based interventions aimed at enhancing psychological resilience to identify, adapt, and implement an effective evidence-based intervention. Results: Pairwise correlations of the measures showed statistically significant negative correlations between our resilience measure and all clinical measures as follows: resilience and anxiety (r = -0.29, P < 0.0001); resilience and depression (r = -0.69, P < 0.0001); and resilience and substance abuse (r = -0.32, P < 0.0001). The systematic review identified 17 school-based interventions in different settings around the world. Although study designs had varied in rigor, some studies indicated promising results in enhancing resilience with effect sizes ranging from 0.05 to 0.50. Conclusions: Our findings indicate that higher resilience scores are associated with lower anxiety and depression symptoms and less substance abuse. We also identified several school-based, resilience-building interventions that can be delivered in low-income settings. These data highlight the value of resilience as an area of focus for preventive interventions in mental health and the need for randomized controlled trials to assess efficacy, which our team is actively developing.