Dynamic modelling of resilience: Observational multicenter study.

Stress-related disorders pose a significant burden on individuals, the economy,
and society in general. Each year, more than half a billion people around the
globe suffer from a mental disorder such as anxiety, post-traumatic stress
disorder, depression, or addiction that can to some extent be traced back to
the influence of exogenous or endogenous stressors (traumatic events,
challenging life circumstances or life transitions, or physical illness.
Despite huge efforts spent on investigating the pathophysiology of these
disorders and despite the big strides that have been made in developing
effective treatments, the extraordinarily high incidence of stress-related
disorders has not decreased over the past decades.

DynaMORE (Dynamic MOdelling of REsilience) aims to improve the prevention of
stress-related mental health problems by developing a dynamic in-silico model
of resilience. Resilience is maintenance and/or quick recovery of mental health
and well-being during and after times of adversity, such as trauma, difficult
life circumstances, challenging life transitions, or physical illness.

There is now ample evidence that individuals change while they successfully
cope with stressors, whether this manifests at the level of altered
perspectives on life , as emergence of new strengths or competences, as partial
immunization against the effects of future stressors , or also as epigenetic
alterations and modified gene expression patterns. Furthermore, neurobiological
studies indicate that such organismic adjustments are causal for the
preservation of mental health. Hence, resilience is not simply inertia, or
insensitivity to stressors, or merely a passive response to adversity. In the
same vein, resilience can no longer be understood simply as a stable, fixed
personality trait or predisposition (the *resilient personality*) that
guarantees long-term mental health and well-being whatever stressor the
organism is exposed to.

This contemporary view of resilience has the important consequence that
resilience cannot be measured through any one-time (cross-sectional) assessment
(e.g., a questionnaire, a brain scan, genotyping etc.) performed before
adversity occurs, as the outdated trait-like conceptualization of resilience
implies. Instead, we must closely follow the nature and time course of the
stressors an individual is exposed to as well as the changes in mental health
that these stressors may or may not induce.

As a prospective resilience study, DynaMOBS consists of a baseline assessment
of mental health, followed by mental health assessments during and after
stressor exposure. Stressor exposure is measured and quantified, such that
changes in mental health can be considered in relation to the adversity an
individual has encountered.

The primary objective of the study is to identify both modality-specific and
modality-spanning predictors of stressor reactivity, thereby guiding the
development of an in-silico model of resilience (secondary objective).

The study follows a longitudinal design consisting of an online-prescreening;
two on-site appointments for baseline measures; six months of ambulatory
monitoring (including six days of ecological momentary & physiological
assessments and biweekly measures of stressor experience and mental health) and
three online follow-ups.

Minimal risk is associated with this study. However, subjects may experience
slight discomfort when collecting various bio-samples (blood, saliva, and
stool), when participating in particular behavioral paradigms (inducing fear or
stress) and when filling out several psychological questionnaires. Moreover,
the MRI scanner may cause discomfort to some participants due to its noise and
confined space. There is no considerable residual risk in wearing the Chill+.
However, irritation at the site of the patch, is an undesirable side-effect
that does happen in a small percentage of the users.