Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients' illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline--cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?相似文献   

Living Well in Later Life: The Influence of Sense of Coherence,and Socio-Demographic,Lifestyle and Health-Related Factors on Older Adults’ Satisfaction with Life

This study aims at exploring a structural model of satisfaction with life’s (SWL) predictors in a cross-national sample of older adults. A quantitative approach was followed with a cross-sectional study design. A community-dwelling sample of 1,234 older adults from four different nationalities residing in Portugal, was assessed regarding SWL, sense of coherence (SOC) and socio-demographic, lifestyle and health-related characteristics. Sampling was performed in lifelong learning centres’ message boards and local community centres’ list-serves in the Lisbon metropolitan area and in the Algarve region. Structural equation modeling was used to investigate a structural model of the self-reported SWL, comprising SOC, socio-demographic characteristics (age, sex, education, marital and professional status, household, adult children, income, living setting and religion), as well as lifestyle and health-related characteristics (physical activity, recent disease and medication). Significant predictors are SOC (β?=?0.733; p?<?0.001), religion (β?=?0.725; p?<?0.001), income (β?=?0.551; p?<?0.001), adult children (β?=?0.546; p?<?0.001), education (β?=??0.403; p?<?0.001), living setting (β?=??0.292; p?<?0.001) and medication (β?=??. 197; p?<?0.001). The variables accounted for 24.8 % of the variability of SWL. Moreover, differences between the four nationality groups (F _{(3, 671)}?=?3.671, p?=?0.066) were not found concerning SWL. Sense of coherence is the strongest predictor of self-reported SWL. Other predictors are religion, income, adult children, education, living setting and medication. The four nationalities did not present significant differences, concerning SWL. This study points out the potential factors that influence older adults’ SWL, in particular SOC, religion and income, as promoters of aging well, within a salutogenic model of health for older populations.     

The shared and unique genetic relationship between mental well-being,depression and anxiety symptoms and cognitive function in healthy twins

Alterations to cognitive function are often reported with depression and anxiety symptoms, yet few studies have examined the same associations with mental well-being. This study examined the association between mental well-being, depression and anxiety symptoms and cognitive function in 1502 healthy adult monozygotic (MZ) and dizygotic (DZ) twins, and the shared/unique contribution of genetic (G) and environmental (E) variance. Using linear mixed models, mental well-being was positively associated (p?β?=?0.127), inhibition (β?=?0.096), cognitive flexibility (β?=?0.149), motor coordination (β?=?0.114) and working memory (β?=?0.156), whereas depression and anxiety symptoms were associated (p?β?=??0.134), inhibition (β?=??0.139), cognitive flexibility (β?=??0.116) and executive function (β?=??0.139). Bivariate twin modelling showed well-being shared a small environmental correlation with motor coordination and a small genetic correlation with working memory. Trivariate twin modelling showed well-being shared a small genetic correlation with inhibition, whereas depression and anxiety symptoms shared a small environmental correlation with inhibition. The remaining variance was mostly driven by unique G and/or E variance. Overall, well-being and depression and anxiety symptoms show both independent and shared relationships with cognitive functions but this is largely attributable to unique G or E variance and small shared G/E variance between pairs of variables.     

Does habit strength moderate the intention–behaviour relationship in the Theory of Planned Behaviour? The case of fruit consumption

The present study examined if habit strength moderated the influence of intention on fruit consumption in a Dutch adult sample (N?=?521, 46.3% males, mean age?=?34.50, SD?=?10.87), using the theoretical relations of the Theory of Planned Behaviour (TPB). TPB variables and habit strength were assessed at baseline. Fruit consumption was assessed with a validated questionnaire five weeks later. Three groups were created: low habit strength (n?=?180), medium habit strength (n?=?185) and high habit strength (n?=?156). Confirmatory factor analyses and multi-group path analyses were performed using AMOS 4.0. A good fit was obtained for the overall measurement model and the structural models. Multi-group path analyses showed that intention was a significant predictor of fruit consumption in the low habit (β?=?0.36, p?<?0.001) and medium habit group (β?=?0.30, p?<?0.001), but a non-significant predictor in the high habit group (β?=?0.05, p?=?0.596). Implications for information-based and motivation-based interventions are discussed.     

Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).

Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).

Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t?=??2.49, p?=?.013), anxiety (t?=??3.08, p?=?.002), and PTSD (t?=??2.94, p?=?.003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.

Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.     

Walking versus biofeedback: a comparison of acute interventions for stressed students

Background: High rates of stress-related problems in college students and low utilization of treatment options demonstrate the need for effective stress-reducing interventions that can be self-regulated. This study compared the effect of brief paced-breathing with biofeedback and exercise interventions on heart rate variability, state anxiety and affect. Methods: Students (n?=?32) with high levels of perceived stress completed three 10-min interventions on separate days: paced-breathing with biofeedback (Biofeedback), a self-paced walk (Exercise), and an attention control condition of quiet studying (Quiet Study). Anxiety and affect were measured before (Pre), immediately after (Post0) and 15 mins after (Post15) the intervention. Heart rate variability was measured pre- and post-intervention using electrocardiogram. Results: Biofeedback reduced anxiety more than the exercise condition (Pre to Post0: Biofeedback d?=??0.48, Exercise d?=??0.13). Secondly, Exercise temporarily increased energy (Pre to Post0: d?=?0.67), whereas Biofeedback temporarily increased calmness (Pre to Post0: d?=?0.51). All conditions significantly increased total heart rate variability (p?Conclusions: Biofeedback and Exercise interventions improved emotional states in high-stress college students, but the type of change observed (i.e. energizing, calming or anxiety reducing) depended upon the condition.     

Do increases in physical activity encourage positive beliefs about further change in the ProActive cohort?

Effects of behaviour change on cognitions are rarely examined within the Theory of Planned Behaviour. We tested whether increases in physical activity resulted in more positive beliefs about further change among a cohort of sedentary adults participating in a behavioural intervention trial (ProActive). At baseline, 6 and 12 months, 365 adults completed questionnaires assessing physical activity and cognitions about becoming more active over the coming year. Objective activity was assessed at baseline and 12 months. Participants reporting larger increases in activity were no more positive about making further increases than those reporting less behaviour change (p-values > 0.05). Participants with larger increases in objective activity reported weaker perceived control (β?=??0.342; p?=?0.001) and more negative instrumental attitudes (β?=??0.230; p?=?0.017) at 12 months. Participants may have felt that they had changed enough or measures of perceived success may be more sensitive to behaviour change. Alternatively, long measurement intervals may have missed immediate cognitive and affective consequences of behaviour change, or such effects may require participants to consistently self-monitor or receive feedback on performance. Future studies could test the effect of such techniques on physical activity and a wider range of cognitive, affective and physiological consequences, using more frequent measurement intervals.     

Leisure activities,caregiving demands and catecholamine levels in dementia caregivers

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n?=?107; mean age?=?73.95?±?8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β?=?0.41; p?=?0.005) and EPI (β?=?0.44; p?=?0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β?=?–0.08; p?=?0.57) or EPI (β?=?0.23; p?=?0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers.     

Modelling decisions to undergo genetic testing for susceptibility to common health conditions: An ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25–40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

Relational spirituality and depression among married couples in Antigua

The World Health Organization indicates depression is the leading cause of disability worldwide. At the same time researchers have found religion/spirituality is inversely associated with depression. However, the mechanisms by which spirituality/religion impacts mental health have not been clearly identified particularly in non-western populations. Relational spirituality is a concept that focuses attention on the ways people relate to the sacred. This study examines whether different ways of relating to the sacred are implicated in levels of depression and whether marital partners affect each other’s level of relational spirituality and depression. Ninety-one (n?=?91) married heterosexual couples in the Caribbean Island of Antigua completed measures of relational spirituality and depression. Data were analysed using path analysis and through Actor Partner Interdependence Model methods. Results of the analysis showed wives’ and husbands’ depression scores covaried (COV?=?6.59, Pearson r?=?.28, p?β?=??.24, unstandardised B?=??3.23, se?=?1.30), and higher instability scores (β?=?.49, unstandardised B?=?5.46, se?=?.96). The husbands’ disappointment (β?=?.21, unstandardised B?=?2.17, se?=?.95) and instability (β?=?.54, unstandardised B?=?4.65, se?=?.72) were positively related to their depression scores. The results demonstrate relational spirituality is a useful framework for addressing depression in individuals as well as married couples.     

Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms

Background: Many women experience childbirth as traumatic and 2% develop post-traumatic stress disorder. This study examined the role of health practitioner support and personal control during birth as predictors of post-traumatic stress (PTS) symptoms, adjusting for vulnerability factors of prior trauma, depression, control beliefs and birth intervention. It also investigated interactions between support, prior trauma and birth intervention and their association with PTS symptoms.

Methods: A prospective longitudinal survey of 138 women recruited from UK NHS maternity clinics. Measures were taken in pregnancy, 3 weeks and 3 months after the birth.

Results: Support and control during birth were not predictive of postnatal PTS symptoms. However, support was predictive of PTS symptoms in a subset of women with prior trauma (β?=??0.41, R ²?=?16%) at both 3-weeks and 3-months postpartum. The interaction of birth intervention and support was associated with PTS symptoms 3 months after birth, the relationship between support and PTS symptoms was stronger in women experiencing more intervention.

Conclusions: Low support from health practitioners is predictive of postnatal PTS symptoms in women who have a history of trauma. Longer term effects of low support on postnatal PTS symptoms are also found in women who had more intervention during birth.     

Traumatic stress symptoms following a lower limb amputation in diabetic patients: a longitudinal study

Objective: Limited research has focussed on the development of traumatic stress symptoms following an amputation due to a chronic disease such as Diabetes. This study analysed whether coping strategies, anxiety and depression symptoms, sociodemographic and clinical variables were related to traumatic stress symptoms in a sample of patients who had undergone a lower limb amputation.

Design: A longitudinal design with three assessments, one month (T1), six (T2) and ten months after an amputation surgery (T3), included 144 patients.

Main outcome measures: IES-R, WOC and HADS.

Results: Traumatic stress symptoms were prevalent at T1 (M?=?15.65, SD?=?15.40) and probable PTSD was observed in 13.9% patients. Presence of pain, high level of anxiety symptoms and emotion-focused strategies contributed to traumatic stress symptoms, and the period between T1 and T2, was critical. Six to ten months (Λ?=?0.871, F (2,84) =6.245, p=. 003), after surgery, symptoms tended to decrease 0.122 units (SE?=?0.032, p?=?0.002) per assessment.

Conclusions: Findings raise awareness to the need of urgent identification of traumatic stress symptoms in medically ill patients who underwent a lower limb amputation, given the prevalence of traumatic stress symptoms right after surgery and in the following six months.     

Impact of End-of-Life Circumstances on the Adjustment of Bereaved Siblings of Children Who Died from Cancer

The aim of this study was to examine the impact of end-of-life (EoL) circumstances on grief and internalizing symptoms among bereaved siblings. Bereaved families (N?=?88) were recruited from three sites 3–12 months (M?=?11.57, SD?=?3.48) after their child’s death from cancer. One sibling per family aged 8–17 years (M?=?12.41, SD?=?2.64) was randomly selected to participate. Families completed measures of siblings’ grief and internalizing symptoms, as well as a structured interview about circumstances surrounding the death. Mother and sibling reports of EoL circumstances were generally concordant, except there was a discrepancy between mothers and children about whether or not children expected their sibling’s death (t(75)?=?1.52, p?=?.018). Mother reports of sibling internalizing symptoms were above the normative mean (t(83)?=?4.44, p?≤?.001 (M?=?56.01?±?12.48), with 39% (n?=?33) in the borderline/clinical range. Sibling opportunity to say goodbye was associated with greater grief-related growth (t(79)?=?? 1.95, p?=?.05). Presence at the death and wishing they had done something differently were both associated with greater grief (t(80)?=?? 2.08, p?=?.04 and t(80)?=?? 2.24, p?=?.028, respectively) and grief-related growth (t(80)?=?? 2.01, p?=?.048 and t(80)?=?? 2.31, p?=?.024, respectively). However, findings were primarily unique to sibling report, with few mother-reported effects. The adjustment of bereaved siblings may be affected by certain modifiable circumstances surrounding the death of their brother or sister. A proportion of bereaved siblings had elevated internalizing symptoms irrespective of circumstances at EoL. Further work is needed to understand predictors of adjustment among bereaved siblings to provide better support and optimize their outcomes.

     

Long-term adherence to a physical activity intervention: The role of telephone-assisted vs. self-administered coping plans and strategy use

Objective: This study investigated the role of coping plans and the use of selection, optimisation and compensation (SOC) strategies within an experimental evaluation of a 26-week physical exercise intervention.

Methods: Older women (N?=?86, M _age?=?73.7 years) were randomly assigned to a telephone-assisted or a self-administered coping planning intervention after 6 weeks’ participation in an exercise programme. The number of different coping plans formulated, exercise-specific SOC strategy use and their interaction were used to predict objectively measured long-term adherence to the intervention.

Results: The number of coping plans formulated (β?=?0.28) and goal-pursuit strategies reported (sum score of optimisation and compensation strategies, β?=?0.39) predicted adherence to the exercise programme over 20 weeks. The predictive strength of coping plans increased with decreasing numbers of goal-pursuit strategies (β?=??0.21). Women supported via telephone reported significantly more coping plans than did women in the self-administered coping planning group, F(1,80)?=?9.47, p?=?0.003.

Conclusion: Coping plans have a buffering effect on adherence levels when use of SOC strategies is low. Older women's adherence to physical activities may be improved if they are given direct support in generating coping plans involving strategies of selection, optimisation and compensation.     

Heightened sensitivity to emotional expressions in generalised anxiety disorder,compared to social anxiety disorder,and controls

Few studies have examined potential differences between social anxiety disorder (SAD) and generalised anxiety disorder (GAD) in the sensitivity to detect emotional expressions. The present study aims to compare the detection of emotional expressions in SAD and GAD. Participants with a primary diagnosis of GAD (n?=?46), SAD (n?=?70), and controls (n?=?118) completed a morph movies task. The task presented faces expressing increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expressions. Participants used a slide bar to view the movie frames from left to right, and to stop at the first frame where they perceived an emotion. The frame selected thus indicated the intensity of emotion required to identify the facial expression. Participants with GAD detected the onset of facial emotions at lower intensity of emotion than participants with SAD (p?=?0.002) and controls (p?=?0.039). In a multiple regression analysis controlling for age, race, and depressive symptom severity, lower frame at which the emotion was detected was independently associated and GAD diagnosis (B?=?–5.73, SE?=?1.74, p?相似文献   

A Structural Model for Adjustment to Aging among Older Women in Breast Cancer Remission

This study aims to build a structural model to explore the predictors of adjustment to aging (AtA) reported by older women in breast cancer remission. A community-dwelling sample of 771 older women in breast cancer remission aged between 75 and 98 years answered a questionnaire to determine socio-demographic (age, income, marital status, education, household, and living setting), and health-related characteristics (self-reported functional limitations and disabilities, time since remission, other type of cancer, breast reconstruction, perceived health, recent disease and medication). Several measures were employed to assess AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables. Significant predictors of AtA are self-reported disability (β = .404; p < .001), time since remission (β = .371; p < .001), perceived health (β = .257; p < .001), other type of cancer (β = .231; p < .001), breast reconstruction (β = .153; p = .008), marital status (β = .141; p < .001), sense of coherence (β = .140; p < .001), and living setting (β = .139; p = .006). These variables accounted for 84.3% of the variability of AtA. Self-reported disability and time since remission were the strongest predictors of AtA. Our findings suggest that health care interventions with older women in breast cancer remission still living in the community may benefit from clearly including these predictors of AtA, as they are relevant for promoting older women’ s aging well.

     

The influence of religion on death anxiety and death acceptance

Parishioners (n?=?130) of an Episcopal church in New York City participated in a survey to explore the relationship between the religiosity, death acceptance, and death anxiety. Among the four different types of religiosity measured by the Rohrbaugh and Jessor scale, theological religiosity was the only one to have a significant effect on death acceptance and death anxiety. Belief in God’s existence (r?=??0.27), and belief in the afterlife (r?=??0.25) were both negatively correlated with death anxiety (p?<?0.01), and positively correlated with death acceptance (respectively, r?=?0.21 and r?=?0.22, p?<?0.05). The effects remained significant even after controlling for a number of demographic variables using multiple regression procedures. Being a woman was the only demographic variable that was significantly correlated with greater anxiety about death. On average, women displayed significantly higher levels of death anxiety (M?=?8.1, SD?=?2.8) than men (M?=?6.2, SD?=?2.9).     

Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b?=?0.034, SE?=?0.01, p?<?0.001), child ODD (b?=?0.053, SE?=?0.02, p?<?0.01), and caregiver depression (b?=?0.049, SE?=?0.02, p?<?0.01). Family rules significantly related to caregiver depression (b?=?0.228, SE?=?0.11, p?<?0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.

     

The relation of illness perceptions to stress,depression, and fatigue in patients with chronic lymphocytic leukaemia

Objective: Chronic lymphocytic leukaemia (CLL) is the most prevalent adult leukaemia and is incurable. The course and treatment of CLL is unique and characterised by repeated cycles of treatment, stable disease and relapse. Utilising a Self-Regulatory Model framework, we examined the relationship between patients’ illness perceptions and cancer-specific stress, depressive symptoms and fatigue. Our aim was to test illness perceptions as predictors of these outcomes when variance due to disease and treatment variables was controlled.

Design: Data were collected on 147 patients with relapsed/refractory CLL as they entered a phase II clinical trial of an investigational medication at a university affiliated, National Cancer Institute designated comprehensive cancer center.

Main outcome measures: Cancer-specific stress, depressive symptoms and fatigue interference.

Result:. Hierarchical multiple regression was used. Consequences and emotional representation were related to all outcomes (ps?p?p?Conclusion: Illness perceptions are related to cancer-specific stress, depressive symptoms and fatigue interference in relapsed/refractory CLL. Interventions targeted at restructuring maladaptive illness perceptions may have clinical benefit in this population.     

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N?=?65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β?=??1.760, p?<?0.001), while neighborhood support moderated the association between parenting stress (β?=?0.492, p?<?0.001) and academic functioning.