What about resilience and wellbeing? The flipside of mental illness

Dr Justine Gatt is an NHMRC Research Fellow who has recently joined the NeuRA team. Her research focuses on understanding the flipside of mental illness: why some people are more resilient to stress than others. It is hoped that these characteristics can be promoted in people who may be less resilient.

Dr Justine Gatt

Dr Justine Gatt

In Australia, nearly half of the population experience a mental disorder at some point in their lifetime, with the most common disorders being anxiety or depression. These disorders can occur in anyone, at any age, but adolescents and young adults are particularly vulnerable as their brain is still undergoing the final stages of development. Exposure to trauma or adversity during childhood or adulthood can often trigger symptoms of these disorders. On the other hand, the presence of certain protective factors may make an individual more resilient to the effects of stress and adversity. Notably, the absence of mental illness does not necessarily imply the presence of optimal mental health, and only a small proportion of people who have no mental illness symptoms are actually functioning optimally and are resilient.

Most psychiatric research has focused on understanding mechanisms of risk for different mental disorders and ways to diagnose and treat them. In comparison, there are very few studies that try to understand the mechanisms of resilience. Our research program aims to understand mental health using a new framework. This includes defining the neural underpinnings of resilience using techniques such as magnetic resonance imaging (MRI) and electroencephalography (EEG) measures of brain function. We also examine the genetics of resilience using saliva samples for DNA analysis.

I am currently analysing data from over 1,600 healthy adult twins who participated in the TWIN-E Study of Emotional Wellbeing. Our team has developed a new questionnaire called COMPAS-W to measure wellbeing. It measures qualities, such as composure, positivity, self-worth and mastery over one’s environment, that are self-reported by study subjects. The questionnaire has been validated against objective psychological tests for symptoms of depression and anxiety. Using measures from this broad source base is helpful when linking biological variables like genetics and brain function, and allows us to explore how innate and environmental factors may moderate our wellbeing, with twin heritability estimates at 48%. The good news is that this means that wellbeing is malleable and can be promoted with intervention.

Comparing between twins allows us to determine the relative contribution of genetics and environment to changes in the volume of grey matter in different parts of the brain. Changes are highlighted in colour. (Gatt et al 2012, Twin Research and Human Genetics)

Comparing identical and non-identical twins allows us to determine the relative contribution of genetics and environment to differences in the volume of grey matter in different parts of the brain. Differences are highlighted in colour. (Gatt et al 2012, Twin Research and Human Genetics)

Another aspect of our research tests how interventions work to promote resilience. We are working with industry partners to test different e-health tools. One of these tools, called MyBrainSolutions, provides targeted, personalised emotional and cognitive solutions over the Internet. To measure resilience, we are testing games that promote positivity (e.g., gratitude training and positive affirmations) and stress management (e.g., the negative thought challenger and MyCalmBeat), as well as executive control games that aim to boost working memory, attention, and goal setting.

Understanding the biology of resilience is the first step towards personalised health solutions. It provides the foundation of features that could be nurtured in low-resilient individuals in order to prevent psychiatric illness. This ‘resilience bio-signature’ could be used as a diagnostic tool for predicting risk for developing mental illness following trauma. At-risk children or adults could then be provided with simple tools to train them to better adapt to life stressors and make them more resilient for the future.

Justine was recently awarded a competitive National Health and Medical Research Council (NHMRC) Career Development Fellowship to conduct this research program. As evidence of innovation and research excellence, Justine was lucky enough to receive the Commonwealth Health Minister’s Award for Excellence in Health and Medical Research in June 2014. The TWIN-E study was a collaborative study with Prof Leanne Williams (Stanford University, previously University of Sydney) as Chief Investigator and co-investigators Prof Peter Schofield (NeuRA), A/Prof Anthony Harris (University of Sydney), Prof Richard Clark (Flinders University), and Dr Justine Gatt (previously as ARC APDI postdoctoral research fellow, University of Sydney) and supported by an Australian Research Council Linkage (LP 0883621) grant with Brain Resource as industry partner.