Certain coping methods in dealing with beta-thalassemia major (BTM) may modulate the effects of defensive coping mechanisms in strengthening resilience among young adults with this disorder, according to a study published in BMC Psychology. 

BTM can cause complications that result in symptoms of anxiety, depression, hopelessness, and low self-esteem. Resilience is the ability to positively adapt to unfavorable circumstances and is multi-dimensional in nature. The long-term effects of resilience in chronic illness have not been fully explored. The authors of this study sought to assess how different responses to chronic disease interact to produce resilience among patients with BTM. 

The research team recruited 312 young adults and adolescents with BTM (between the ages of 12 to 24) from 2 thalassemia clinics in Iran. They conducted face-to-face surveys with participants between April 2022 to November 2022.

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Among the surveys used in this study were the Connor-Davidson Resilience Scale (CD-RISC), the Multidimensional Scale of Perceived Social Support (MSPSS), the Jalowiec Coping Scale (JCS), the Herth Hope Index (HHI), and the Uncertainty Scale. Together, these surveys assess how social support, hope, uncertainty, and defensive coping vs courageous coping mechanisms interact in painting a picture of one’s resilience towards the symptoms, complications, and treatment of BTM. 

The researchers discovered that all participants received blood transfusions twice weekly, while 36 (11.5%) had undergone a splenectomy. The research team reported that hope (r =0.153), social support (r =0.158), and courageous coping (r =0.193) were significantly correlated with resilience (P <0.01). 

Meanwhile, uncertainty (r =0.243) was significantly and negatively correlated with resilience (P <0.01). There was no significant correlation between defensive coping and resilience (r =-0.033, P =0.563). 

The researchers also sought to assess the mediating role of courageous coping, having theorized that courageous coping mediates the relationship between protective factors (hope and social support) and risk factors (uncertainty and defensive coping) with resilience. The research team found that this relationship was fully mediated, confirming their hypothesis. 

“Based on these findings, healthcare professionals…should consider promoting intervention strategies to improve resilience through enhancing positive coping strategies in adolescent populations with BTM,” the authors of the study concluded. 


Rambod M, Hamidizadeh S, Bazrafshan MR, et al. Risk and protective factors for resilience among adolescents and young adults with beta-thalassemia majorBMC Psychol. Published online August 11, 2023. doi:10.1186/s40359-023-01268-2