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The Power of Positives:
Galvanizing Resilience in
Clinical Practice
Christine Wekerle, Ph. D.,
Pediatrics,
Offord Centre for Child Studies
McMaster University
wekerc@mcmaster.ca
Learning Objectives
1. Introduce positive psychology and resilience
2. Provide evidence on key components for
resilience
3. Overview JoyPop App
Positive Psychology
• Moves beyond disorder
to optimal human functioning
(Sheldon, Fredrickson, Rathunde,
Csikszentmihalyi, & Halt, 2000)
• Positive experiences, states and personal traits
contribute to wellbeing
• Emphasizes the improvement of individual
(Fredrickson, 2003)
• Ask the question about what allows for resilience?
Earth Teach me to Remember (Ute Prayer)
-John Yellow Lark
Earth teach me quiet, as the grasses are still with new light.
Earth teach me suffering, as old stones suffer with memory.
Earth teach me humility, as blossoms are humble with
beginning.
Earth teach me caring, as mothers nurture their young.
Earth teach me courage, as the tree that stands alone.
Earth teach me limitation, as the ant that crawls on the
ground.
Earth teach me freedom, as the eagle that soars in the sky.
Earth teach me acceptance, as the leaves that die each fall.
Earth teach me renewal, as the seed that rises in the spring.
Earth teach me to forget myself, as melted snow forgets its
life.
Earth teach me to remember kindness, as dry fields weep
with rain.
Query the ratio of
negatives to
positives
in daily living
5 Pillars of Well-Being
PERMA
- Flow: task
absorption in
challenge (discovery;
neither
bored/overwhelmed)
- Mindfulness
(intention +
awareness)
- “Learned optimism”
(effort for joy)
- Post-traumatic
growth (reframing;
higher level of
purpose, meaning)
Mindfulness: “here and now” practice
Positive Psychology in Real Life
• https://youtu.be/7SoS8RPy2C8
• From 3:00 minute point
• Youth connecting to Positive Psychology
The Maltreatment Adolescent Pathways
(MAP) Study
• Goal: To assess the linkages between child maltreatment,
risk-taking behavior, and health outcomes in an adolescent
population involved with Child Welfare Services
• First Canadian longitudinal Child Welfare study (2.5 years)
• Participants randomly selected from three Child Welfare
agencies in Ontario
• 561 youth, ages 14-17 (mean age=16 years old)
• Approximately two-thirds of sample were Crown Wards
Findings
MAP Video
https://www.youtube.com/watch?v=OftzALSA5yQ
• Issues in ER: Using sex, drugs or alcohol to cope (Wekerle , Goldstein, Tanaka, &
Tonmyr, 2017; Hudson et al., 2017; Hudson, Wekerle, & Stewart, 2015,)
• Issues in Resilience : Self compassion, positive affect, cognitive
organization, self-expression (Tanaka, Wekerle, Schmuck, Paglia-Boak, & The Map Research
Team, 2011; Goldstein, Zhu, Kofler, & Wekerle, 2016)
• Teen Dating Violence (TDV):
(Wekerle et al., 2009;
 Influence of services and positive role models
Mindsets Matter for Resilience
• “Resilience is both the capacity of individuals to navigate their way to the
psychological, social, cultural, and physical resources that sustain their well-
being, and their capacity individually and collectively to negotiate for these
resources to be provided in culturally meaningful ways.” –Ungar, 2008, p.
225
• Resiliency Theory:
(Zimmerman, 2013)
 Examines the factors that intervene with the trajectory from risk to poor
health outcomes
 Contextual, Social, and Individual factors contribute to resilience
 Individual factors- “Promotive Factors”: Assets (i.e., factors within a
person; e.g., self-efficacy, motivation) and Resources (i.e., external factors;
e.g., support from parents, positive role models) (Fergus & Zimmerman, 2005)
Executive Functioning
• Executive function (EF): a set of higher-order processes in the brain that
allow an individual to respond to external stimuli with goal-oriented action
(Hughes, 2013)
• Positive relationships and nurturing environments foster healthy
development of executive functions
Cognitive Organization
• Management and utilization of knowledge in the brain (i.e., focus,
planning, categorizing, problem-solving, memory, flexibility, abstract
thinking, rule acquisition, utilization of senses)
• Child maltreatment and neglect contribute to toxic stress accumulation
which has the potential to impair the development of these executive
functioning skills (Nikulina & Widom, 2013; Gould et al., 2012; Mothes et al., 2015)
Emotion Regulation (ER)
• A set of processes that enable an individual to organize, manage, or
modify their emotions (to positively adapt to internal or external cues)
(Hilt, Hanson, & Pollak, 2011)
 Understanding emotional signals
 Acceptance of emotions
 Ability to control emotional impulses
 Use of strategies to alter emotional response to meet situational demands
(Gratz & Roemer, 2004)
• Emotion Dysregulation:
• Nonacceptance of emotions
• Difficulties engaging in goal- directed behavior
• Issues with controlling impulses
• Lack of awareness of emotions
• Little or no use of ER strategies
• Lack of emotional clarity
(Gratz & Roemer, 2004)
The JoyPop App
• Goals:
• (1) Enhance positive emotionality and activity;
• (2) Promote safe social connectedness
• (3) Daily tool to cope in higher stress periods (transitions)
• Dumont & Provost, 1999; Kitano & Lewis, 1997; Smith & Carlson, 1997; Ungar, 2011; Flett, Flett, &
Wekerle, 2015)
• Constructed from resilience-research, service
and youth input
• Recommended usage: At least one login per day,
preferably across the day
• If user is in distress, they are instructed to click telephone icon to
access live support via Kid’s Help Phone
Landing Page and Calendar
• Landing page allows
the user to access all
of the app features
• Track mood ratings,
journal entries,
appointments,
meetings and school
work inside the
calendar
(organizational tool)
Meeting with
Dr. Wekerle
Mood Ratings
• User is first asked to rate happiness by
sliding colour up or down with their
finger
• If rating is under 50% happy, user is
asked to rate how sad, angry, or ‘meh’
they feel
• JoyPop will provide a prompt for an
activity to increase mood
• Consistent mood imbalance and
emotional suppression can lead to poor
mental health, negative mindset,
resulting behavioral issues (Desmet,
Vastenburg, & Romero, 2016)
• Teaches the user to be better aware of
their emotions, identify and
differentiate emotions, and create
positive strategies to improve mood
(ER) (Hilt, Hanson, & Pollak, 2011)
Reflective Journaling
• Express thoughts, feelings, and emotions
through words (and emojis)
• User is able to journal free flowing thoughts,
or respond to a pre-populated question or
quote
• Research has demonstrated positive health
and behavioral outcomes after participating
expressive journaling interventions including
improvements in physical and mental health,
higher grades, elevated mood, and reductions
in distress symptoms (Pennebaker & Chung, 2007;
Frisina, Borod, & Lepore, 2004; Sloan & Marx, 2004;
Lumley & Provenzano, 2003; Smyth, 1998)
Positive Activities• Breathing Exercises:
 Teach user diaphragmatic breathing techniques to decrease
stress and restore body to a resting state
 Some evidence that focused breathing exercises may have
positive effects on the utilization of ER strategies (Arch &
Craske, 2006)
• Tetris:
• Strategy games have been linked to self-regulation when
played consistently over time (Gabbiadini & Greitemeyer, 2017)
• Has been shown to decrease traumatic memory flashbacks
(Holmes, James, Coode-Bate, & Deeprose, 2009; James et al., 2009)
• Positive effects on spatial working memory (Bikic, Christensen,
Leckman, Bilenberg, & Dalsgaard, 2017)
• Puzzles and Doodling Activities:
 Contribute to user’s executive functioning and ”flow”
 Doodling has been shown to have positive effects on
working memory and attention (Andrade, 2009; Schott, 2011)
 In an explorative study, sketching on a mobile device was
shown to help users express complex emotions that they
were unable to articulate (Cowan, Weibel, Pina, Hollan, & Griswold,
2011)
This breathing technique helps to
bring your body to a state of
equilibrium by achieving rhythmic
breathing.
This technique will slow your
breathing down, increase your
oxygen intake, and help you to
feel more relaxed.
Circle of Trust
• Allows user to input up to six contacts to call
when they are in need of support
• May contain family, peers, social workers,
mental health professionals, and mentors
• Establishing positive relationships has been
shown to decrease stress symptoms and
increase relational learning (Wekerle, Waechter, &
Chung, 2012)
• Adult mentors help to shape “resilient identity”
of at-risk youth (Ungar, 2004)
 Youth need to know that they are trusted to
make decisions, but help is always available
when they need it
Christine Wekerle
wekerc@mcmaster.ca
• Twitter: @DrWekerle; @ResilienceInYou
https://twitter.com/drwekerle
https://twitter.com/ResilienceInYou
• Instagram: @resilienceinyouth
https://www.intstagram.com/resilienceinyouth
• YouTube: resilienceinyouth
https://www.youtube.com/channel/UCwb2FU5KNOmazMX175ALKFQ/featured
• Slideshare: Christine Wekerle
https://www.slideshare.net/ChristineWekerle
• LinkedIn: Christine Wekerle
https://www.linkedin.com/in/christine-wekerle-27603013/
THANK YOU FOR YOUR ATTENTION!
Access CIHRTeamSV publications on ResearchGate:
https://www.researchgate.net/project/Understanding
-health-risks-and-promoting-resilience-in-male-
youth-with-sexual-violence-experience-CIHR-Team-
Grant-TE3-138302
International Journal of Child and Adolescent
Resilience (Open Access): www.in-car.ca
References/Resources
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Bikic, A., Christensen, T. Ø., Leckman, J. F., Bilenberg, N., & Dalsgaard, S. (2017). A double-blind randomized pilot trial comparing
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The power of positives rjchc presentation

  • 1. The Power of Positives: Galvanizing Resilience in Clinical Practice Christine Wekerle, Ph. D., Pediatrics, Offord Centre for Child Studies McMaster University wekerc@mcmaster.ca
  • 2. Learning Objectives 1. Introduce positive psychology and resilience 2. Provide evidence on key components for resilience 3. Overview JoyPop App
  • 3. Positive Psychology • Moves beyond disorder to optimal human functioning (Sheldon, Fredrickson, Rathunde, Csikszentmihalyi, & Halt, 2000) • Positive experiences, states and personal traits contribute to wellbeing • Emphasizes the improvement of individual (Fredrickson, 2003) • Ask the question about what allows for resilience?
  • 4. Earth Teach me to Remember (Ute Prayer) -John Yellow Lark Earth teach me quiet, as the grasses are still with new light. Earth teach me suffering, as old stones suffer with memory. Earth teach me humility, as blossoms are humble with beginning. Earth teach me caring, as mothers nurture their young. Earth teach me courage, as the tree that stands alone. Earth teach me limitation, as the ant that crawls on the ground. Earth teach me freedom, as the eagle that soars in the sky. Earth teach me acceptance, as the leaves that die each fall. Earth teach me renewal, as the seed that rises in the spring. Earth teach me to forget myself, as melted snow forgets its life. Earth teach me to remember kindness, as dry fields weep with rain.
  • 5. Query the ratio of negatives to positives in daily living
  • 6.
  • 7. 5 Pillars of Well-Being PERMA - Flow: task absorption in challenge (discovery; neither bored/overwhelmed) - Mindfulness (intention + awareness) - “Learned optimism” (effort for joy) - Post-traumatic growth (reframing; higher level of purpose, meaning)
  • 8. Mindfulness: “here and now” practice
  • 9. Positive Psychology in Real Life • https://youtu.be/7SoS8RPy2C8 • From 3:00 minute point • Youth connecting to Positive Psychology
  • 10. The Maltreatment Adolescent Pathways (MAP) Study • Goal: To assess the linkages between child maltreatment, risk-taking behavior, and health outcomes in an adolescent population involved with Child Welfare Services • First Canadian longitudinal Child Welfare study (2.5 years) • Participants randomly selected from three Child Welfare agencies in Ontario • 561 youth, ages 14-17 (mean age=16 years old) • Approximately two-thirds of sample were Crown Wards
  • 11. Findings MAP Video https://www.youtube.com/watch?v=OftzALSA5yQ • Issues in ER: Using sex, drugs or alcohol to cope (Wekerle , Goldstein, Tanaka, & Tonmyr, 2017; Hudson et al., 2017; Hudson, Wekerle, & Stewart, 2015,) • Issues in Resilience : Self compassion, positive affect, cognitive organization, self-expression (Tanaka, Wekerle, Schmuck, Paglia-Boak, & The Map Research Team, 2011; Goldstein, Zhu, Kofler, & Wekerle, 2016) • Teen Dating Violence (TDV): (Wekerle et al., 2009;  Influence of services and positive role models
  • 12. Mindsets Matter for Resilience • “Resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well- being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways.” –Ungar, 2008, p. 225 • Resiliency Theory: (Zimmerman, 2013)  Examines the factors that intervene with the trajectory from risk to poor health outcomes  Contextual, Social, and Individual factors contribute to resilience  Individual factors- “Promotive Factors”: Assets (i.e., factors within a person; e.g., self-efficacy, motivation) and Resources (i.e., external factors; e.g., support from parents, positive role models) (Fergus & Zimmerman, 2005)
  • 13. Executive Functioning • Executive function (EF): a set of higher-order processes in the brain that allow an individual to respond to external stimuli with goal-oriented action (Hughes, 2013) • Positive relationships and nurturing environments foster healthy development of executive functions
  • 14. Cognitive Organization • Management and utilization of knowledge in the brain (i.e., focus, planning, categorizing, problem-solving, memory, flexibility, abstract thinking, rule acquisition, utilization of senses) • Child maltreatment and neglect contribute to toxic stress accumulation which has the potential to impair the development of these executive functioning skills (Nikulina & Widom, 2013; Gould et al., 2012; Mothes et al., 2015)
  • 15. Emotion Regulation (ER) • A set of processes that enable an individual to organize, manage, or modify their emotions (to positively adapt to internal or external cues) (Hilt, Hanson, & Pollak, 2011)  Understanding emotional signals  Acceptance of emotions  Ability to control emotional impulses  Use of strategies to alter emotional response to meet situational demands (Gratz & Roemer, 2004) • Emotion Dysregulation: • Nonacceptance of emotions • Difficulties engaging in goal- directed behavior • Issues with controlling impulses • Lack of awareness of emotions • Little or no use of ER strategies • Lack of emotional clarity (Gratz & Roemer, 2004)
  • 16. The JoyPop App • Goals: • (1) Enhance positive emotionality and activity; • (2) Promote safe social connectedness • (3) Daily tool to cope in higher stress periods (transitions) • Dumont & Provost, 1999; Kitano & Lewis, 1997; Smith & Carlson, 1997; Ungar, 2011; Flett, Flett, & Wekerle, 2015) • Constructed from resilience-research, service and youth input • Recommended usage: At least one login per day, preferably across the day • If user is in distress, they are instructed to click telephone icon to access live support via Kid’s Help Phone
  • 17. Landing Page and Calendar • Landing page allows the user to access all of the app features • Track mood ratings, journal entries, appointments, meetings and school work inside the calendar (organizational tool) Meeting with Dr. Wekerle
  • 18. Mood Ratings • User is first asked to rate happiness by sliding colour up or down with their finger • If rating is under 50% happy, user is asked to rate how sad, angry, or ‘meh’ they feel • JoyPop will provide a prompt for an activity to increase mood • Consistent mood imbalance and emotional suppression can lead to poor mental health, negative mindset, resulting behavioral issues (Desmet, Vastenburg, & Romero, 2016) • Teaches the user to be better aware of their emotions, identify and differentiate emotions, and create positive strategies to improve mood (ER) (Hilt, Hanson, & Pollak, 2011)
  • 19. Reflective Journaling • Express thoughts, feelings, and emotions through words (and emojis) • User is able to journal free flowing thoughts, or respond to a pre-populated question or quote • Research has demonstrated positive health and behavioral outcomes after participating expressive journaling interventions including improvements in physical and mental health, higher grades, elevated mood, and reductions in distress symptoms (Pennebaker & Chung, 2007; Frisina, Borod, & Lepore, 2004; Sloan & Marx, 2004; Lumley & Provenzano, 2003; Smyth, 1998)
  • 20. Positive Activities• Breathing Exercises:  Teach user diaphragmatic breathing techniques to decrease stress and restore body to a resting state  Some evidence that focused breathing exercises may have positive effects on the utilization of ER strategies (Arch & Craske, 2006) • Tetris: • Strategy games have been linked to self-regulation when played consistently over time (Gabbiadini & Greitemeyer, 2017) • Has been shown to decrease traumatic memory flashbacks (Holmes, James, Coode-Bate, & Deeprose, 2009; James et al., 2009) • Positive effects on spatial working memory (Bikic, Christensen, Leckman, Bilenberg, & Dalsgaard, 2017) • Puzzles and Doodling Activities:  Contribute to user’s executive functioning and ”flow”  Doodling has been shown to have positive effects on working memory and attention (Andrade, 2009; Schott, 2011)  In an explorative study, sketching on a mobile device was shown to help users express complex emotions that they were unable to articulate (Cowan, Weibel, Pina, Hollan, & Griswold, 2011) This breathing technique helps to bring your body to a state of equilibrium by achieving rhythmic breathing. This technique will slow your breathing down, increase your oxygen intake, and help you to feel more relaxed.
  • 21. Circle of Trust • Allows user to input up to six contacts to call when they are in need of support • May contain family, peers, social workers, mental health professionals, and mentors • Establishing positive relationships has been shown to decrease stress symptoms and increase relational learning (Wekerle, Waechter, & Chung, 2012) • Adult mentors help to shape “resilient identity” of at-risk youth (Ungar, 2004)  Youth need to know that they are trusted to make decisions, but help is always available when they need it
  • 22. Christine Wekerle wekerc@mcmaster.ca • Twitter: @DrWekerle; @ResilienceInYou https://twitter.com/drwekerle https://twitter.com/ResilienceInYou • Instagram: @resilienceinyouth https://www.intstagram.com/resilienceinyouth • YouTube: resilienceinyouth https://www.youtube.com/channel/UCwb2FU5KNOmazMX175ALKFQ/featured • Slideshare: Christine Wekerle https://www.slideshare.net/ChristineWekerle • LinkedIn: Christine Wekerle https://www.linkedin.com/in/christine-wekerle-27603013/
  • 23. THANK YOU FOR YOUR ATTENTION! Access CIHRTeamSV publications on ResearchGate: https://www.researchgate.net/project/Understanding -health-risks-and-promoting-resilience-in-male- youth-with-sexual-violence-experience-CIHR-Team- Grant-TE3-138302 International Journal of Child and Adolescent Resilience (Open Access): www.in-car.ca
  • 24. References/Resources Andrade, J. (2010). What does doodling do? Applied Cognitive Psychology, 24, 100-106. doi:10.1002/acp.1561 Bikic, A., Christensen, T. Ø., Leckman, J. F., Bilenberg, N., & Dalsgaard, S. (2017). A double-blind randomized pilot trial comparing computerized cognitive exercises to Tetris in adolescents with attention deficit/hyperactivity disorder. Nordic Journal of Psychiatry, 71(6), 455-464. doi:10.1080/08039488.2017.1328070 Cowan, L. G., Weibel, N., Pina, L. R., Hollan, J. D., & Griswold, W. G. (2011). Ubiquitous sketching for social media. MobileHCI '11 Proceedings of the 13th International Conference on Human Computer Interaction with Mobile Devices and Services, 395-404. doi:10.1145/2037373.2037433 Daigneault, I., Bourgeois, C., Vézina-Gagnon, P., Alie-Poirier, A., Dargan, S., Hébert, M., & Frappier, J. (2017). Physical and mental health of sexually abused boys: A 5 year matched-control and cohort study. Journal of Child and Adolescent Trauma, 10(1), 9-17. doi: 10.1007/s40653-016-0120-1 Desmet, P. M. A., Vastenburg, M. H., & Romero, N. (2016). Mood measurement with Pick-A-Mood: Review of current methods and design of a pictorial self-report scale. Journal of Design Research, 14(3), 241-279. doi:10.1504/JDR.2016.079751 Dumont, M., & Provost, M. A. (1999). Resilience in adolescents: Protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence, 28(3), 343-363. doi: 10.1023/A:1021637011732 Fergus, S. & Zimmerman, M. A. (2005). Adolescent resilience: A framework for understanding healthy development in the face of risk. Annual Review of Public Health, 26(1), 399-419. doi:10.1146/annurev.publhealth.26.021304.144357 Flett, G., Flett, A., & Wekerle, C. (2015). A conceptual analysis of interpersonal resilience as a key resilience domain: Understanding the ability to overcome child sexual abuse and other resilience interpersonal contexts. International Journal of Child and Adolescent Resilience, 3(1), 4-33. Retrieved from: http://in-car.ca/ijcar/issues/vol3/2015/Flett_et_al_pp_4-33.pdf
  • 25. Fredrickson, B. L. (2003). The value of positive emotions: The emerging science of positive psychology is coming to understand why it’s good to feel good. American Scientist, 91(4), 330-335. Retrieved from: https://www.jstor.org/stable/27858244 Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. The Journal of Nervous and Mental Disease, 192(9), 629-634. doi:10.1097/01.nmd.0000138317.30764.63 Gabbiadini, A., & Greitemeyer, T. (2017). Uncovering the association between strategy video games and self-regulation. Personality and Individual Differences, 104,129-136. doi:10.1016/j.paid.2016.07.041 Goldstein, A., L., Zhu, J.Y., Kofler, D. & Wekerle, C. (2016). Child maltreatment, altered self-capacities, and resilience: Testing a moderated mediation model of depression symptoms and alcohol problems in emerging adulthood. International Journal of Child and Adolescent Resilience, 4(1), 122-142. Retrieved from: http://in-car.ca/ijcar/issues/vol4/2016/8- IJCAR_V4_1_2016_Goldstein,%20et%20al,%20122-142.pdf Gould, F., Clarke, J., Heim, C., Harvey, P. D., Majer, M., & Nemeroff, C. B. (2012). The effects of child abuse and neglect on cognitive functioning in adulthood. Journal of Psychiatric Research, 46(4), 500-506. doi:10.1016/j.jpsychires.2012.01.005 Gratz, K. L. & Roemer, L. (2003). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54. Hilt, L. M., Hanson, J. L., & Pollak, S. D. (2011). Emotion dysregulation. Encyclopedia of Adolescence, 3, 160-169. Retrieved from: https://www2.waisman.wisc.edu/childemotion/pubs/2011_EmotionDeregulationHilt_Hanson_Pollak-1.pdf Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009) Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive-science. PloS ONE, 4(1), e4153. doi: 10.1371/journal.pone.0004153 Hughes, C. (2013). Executive function: Development, individual differences, and clinical insights. In J. L. R. Rubenstein & P. Rakic (Eds.), Neural Circuit Development and Function in the Brain (pp. 429-445). Oxford, UK: Academic Press. doi:10.1016/B978-0-12- 397267-5.00062-5 Hudson, A., Wekerle, C., Goldstein, A. L., Ellenbogen, S., Waechter, R., Thompson, K., Stewart, S. H. (2017). Gender Differences in Emotion-Mediated Pathways from Childhood Sexual Abuse to Problem Drinking in Adolescents in the Child Welfare System. Journal of Child and Adolescent Trauma, 10(1), 19-29. doi: 10.1007/s40653-016-0125-9
  • 26. Hudson, A., Wekerle, C., & Stewart, S. H. (2015). Associations between personality and drinking motives in adolescents involved in the child welfare system. Personality and Individual Differences, 81, 84-89. doi: 10.1016/j.paid.2014.12.008 James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2009). Computer game play reduces intrusive memories of experimental trauma via reconsolidation update mechanisms. Psychological Science, 26(8), 1201-1215. doi: 10.1177/0956797615583071 Kitano, M. K., & Lewis, R. B. (2005). Resilience and coping: Implications for gifted children and youth at risk. Roeper Review, 24(4), 200-205. doi: 10.1080/02783190509554319 Lumley, M. A., & Provenzano, K. M. (2003). Stress management through written emotional disclosure imporved academic performance among college students with physical symptoms. Journal of Educational Psychology, 95(3), 641-649. doi:10.1037/0022-0663.95.3.641 Mothes, L., Kristensen, C. H., Grassi-Oliveira, R., Fonseca, R. P., Argimon, I. I. L., & Irigaray, T. Q. (2015). Childhood maltreatment and executive functions in adolescents. Child and Adolescent Mental Health, 20(1), 56-62. doi:10.1111/camh.12068 Nikulina, V. & Widom, C. S. (2013). Child maltreatment and executive functioning in middle adulthood: A prospective examination. Neuropsychology, 27(4), 417-427. doi:10.1037/a0032811 Pennebaker, J. W., & Chung, C. K. (2007). Expressive Writing, Emotional Upheavals, and Health. In H. S. Friedman & R. C. Silver (Eds.), Foundations of Health Psychology (pp. 263-284). New York, NY, US: Oxford University Press. Schott, G. D. (2011). Doodling and the default network of the brain. The Lancet, 378(9797), 1133-1134. doi:10.1016/S0140- 6736(11)61496-7 Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York, NY: Free Press. Sheldon, K. M., Fredrickson, B., Rathunde, K., Csikszentmihalyi, M., & Haidt, J. (2000). Positive psychology manifesto. Manifesto presented at Akumal 1 conference and revised during the Akumal 2 meeting. Retrieved from: http://www.optimalfunctioning.com/featured/positive-psychology-manifesto.html
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