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What accounts for these inconsistent skills, although it also aims to build a sup- MacPhail’s program worked. But those evalu-
outcomes? The factors that support mental port network for teens by training mentors ations lacked the scientific rigor of an inde-
health and resilience in one situation may be and creating community councils to consider pendently run randomized trial, which would
useless or even harmful in another, Tol says. children’s ongoing needs. Between 2014 and compare the intervention with another ac-
To pinpoint the ideal interventions for a 2016, more than 4000 young people with tivity or with no intervention at all. So the
community, researchers need to spend time mental health struggles and poor access to NGO approached Panter-Brick and Dajani
there, suggests Michael Pluess, a psychologist social services participated in similar Mercy for an outside assessment. “It takes guts to
at Queen Mary University of London. In re- Corps–run programs across the Middle East. let someone in to evaluate your program as
cent focus groups with Syrian refugee moth- The intensive program Panter-Brick and thoroughly as we did,” Panter-Brick says.
ers in Lebanon, for example, Pluess and his Dajani evaluated in Jordan lasted 2 months. Accomplishing that goal meant running
colleagues found that a popular ingredient Nubader and testing it simultaneously.
in many psychosocial programs—a concept Panter-Brick and Dajani invited 817 young
called “internal locus of control”—was prob- people living in Jordan, who had already
lematic among people anchored by religion. “It takes guts to let someone signed up for Nubader, to participate. They
An internal locus of control is the conviction in to evaluate your program included both Syrian refugees and at-risk
that success comes thanks to one’s own ef- Jordanian teens. The youths were randomly
forts, such as hard work, rather than external as thoroughly as we did.” assigned to the program or to a 2-month
factors. Although often seen as supporting Catherine Panter-Brick, Yale University waitlist, which served as a control group.
mental health, the concept didn’t resonate Dajani and Panter-Brick quickly found
with religious parents who believe that life In it, teenagers gathered at a youth center that their desire for rigor and clear outcomes
unfolds according to God’s will, Pluess says. twice a week to participate in group activities ran up against teenage inhibitions and logis-
Despite the mixed results of resilience pro- of their choosing, including soccer, sewing, tical snags. Plans for an expansive collection
grams, Tol is heartened by the learning curve and computer repair. Those activities were of biological samples, including cheek swabs
he sees. “I think the research is showing that meant to foster social bonds and build con- for DNA, dried blood spots to test immune Downloaded from
it is possible to teach resilience” to conflict- fidence and competence. Participants also function, and saliva for additional cortisol
affected children, he says. learned how chronic stress can affect the levels, had to be pared back. Many teens were
brain—for example, by impairing impulse too embarrassed to spit into the sample vials.
A MEDICAL ANTHROPOLOGIST at Yale, Panter- control. Coaches practiced relationship- Saliva was also hard to freeze and transport
Brick has navigated that learning curve her- building skills with the teenagers, such as in Jordan’s summer heat because electricity
self, traveling extensively to study resilience. expressing affection and empathy. was sporadic, Panter-Brick says.
She has visited Nepal and interviewed home- This neuroscience-based instruction, called Hair could be mailed cheaply in an enve-
less children. In Afghanistan, she probed the the Profound Stress and Attunement model, lope. Still, even gathering those samples “was http://science.sciencemag.org/
mental health of young people in the wake was developed by former Mercy Corps youth very tough” at first because of the tense re-
of war. Panter-Brick argues that for children, program director Jane MacPhail. It’s loosely lationship between Jordanians and the Syr-
resilience has three dimensions: individual based on emerging neurobiology research sug- ian refugees they were hosting, says Natasha
strengths, relationships with family and gesting that social relationships can buffer the Shawarib, the project manager for Mercy
peers, and community support. negative effects of chronic stress and trauma. Corps in Amman. Some refugee families
Nubader mainly targets the first. The pro- From its own before-and-after program feared their child’s data would be handed
gram nurtures an adolescent’s resources and evaluations, Mercy Corps believed that off to the Jordanian government, and they

NATURE’S STRATEGIES on March 1, 2018
Resilience by regeneration

umans should envy the axolotl (pictured, right). Our powers
of regeneration are limited: Broken bones knit, wounds
heal, and large parts of the liver can regenerate, but that’s
about it. But the axolotl—a large salamander also called the
H Mexican walking fish because it looks like a 20-centimeter
eel with stumpy legs—can replace an entire missing limb or even
its tail, which means regrowing the spinal cord, backbone, and
muscles. About 30 research teams are probing how these sala-
manders do it. In the axolotl, they’ve found, various tissues work
together to detect limb loss and coordinate regrowth. In the pro- cells are key, and a special set of genes active in muscles tells
cess, the animals reactivate the same genetic circuits that guided those stem cells what to do, activating growth and specialization
the formation of those structures during embryonic development, genes in the right cells at the right time. So the planarian can
causing generalist stem cells to specialize. rebuild itself almost from scratch, whereas the axolotl can rebuild
Axolotls are only one of several regenerators in the animal king- only if the main body axis is intact. This year, researchers took an-
dom. Flatworms called planarians are even more resilient—able other step toward detailing the molecules underlying regeneration PHOTO: DANTÉ FENOLIO/SCIENCE SOURCE
to surge back after losing 90% of their bodies. One small fragment by sequencing the genomes of those two species. The ultimate
of those 2-centimeter-long aquatic worms can rejuvenate the hope: One day, we’ll be able to coax injured humans to execute
brain, skin, gut, and all the other functional organs. Again, stem the same repairs. —Elizabeth Pennisi

978 2 MARCH 2018 • VOL 359 ISSUE 6379 sciencemag.org SCIENCE
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