Is dispositional optimism or dispositional pessimism predictive of ideal cardiovascular health? The Young Finns Study

Objective: We examined the independent association between dispositional optimism compared to dispositional pessimism and ideal cardiovascular health (defined by the American Heart Association).

Design: A prospective design with a study sample of 1113 participants aged 24–39 years from the longitudinal Young Finns Study.

Main outcome measures: Ideal cardiovascular health (comprised of seven ideal cardiovascular health metrics) was measured in 2001. The ideal cardiovascular health metrics were reassessed in 2007.

Results: Low pessimism rather than high optimism was a better predictor of ideal cardiovascular health in 2007. When examining the association between optimism and pessimism and the seven ideal cardiovascular health metrics in 2007 (BMI, diet, physical activity, smoking status, blood pressure, total cholesterol and plasma glucose), low pessimism predicted non-smoking status, ideal physical activity and eating a healthy diet, while high optimism was associated with eating a healthy diet.

Conclusion: Our findings suggest that low pessimism rather than high optimism is associated with ideal cardiovascular health, especially with health behaviours such as not smoking, being physically active and eating a healthy diet. Socio-economic status was the potential mediating or confounding factor. Future studies should examine the differential meaning of the optimism/pessimism concepts to further clarify their relation to health outcomes.     

Depression and marital status determine the 10-year (2004–2014) prognosis in patients with acute coronary syndrome: The GREECS study

Background: The aim of the present work was to examine the association of depression and marital status, with the long-term prognosis of acute coronary syndrome (ACS), among a Greek sample of cardiac patients.

Methods: From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 hospitals was enrolled. In 2013–2014, the 10-year follow-up was performed in 1918 participants. Depressive symptoms were evaluated using the validated CES-D score (range 0–60), while marital status was classified as: single, married/cohabitants, divorced and widowed at the time of entry to the study.

Results: Patients in the upper tertile of CES-D (>20 score) had 41% (95%CI 14%, 75%) higher risk of ACS incidence as compared with those in the lowest (<7 score). In contrary, married patients had 29% lower risk (95%CI 6%, 46%) of ACS mortality compared with single, widowed or divorced. Multi-adjusted analysis revealed that among the ‘not married’ patients, 1-point increase in the CES-D score was associated with 2% (p = .02) and 4% (p = .001) higher risk of having non-fatal and fatal cardiac events, respectively.

Conclusions: The present study highlights the important role of depression in the context of marital relationships among ACS patients. Secondary public health care intervention programmes are needed to improve patient outcomes and minimise disease burden in clinical and community setting.     

Developmental trajectories of multisite musculoskeletal pain and depressive symptoms: The effects of job demands and resources and individual factors

Objective: To investigate developmental paths in multisite musculoskeletal pain (MPS) and depressive symptoms (DPS) and the effects of job demands (JD), job resources (JR), optimism and health-related lifestyle on these paths. We expected to find four trajectories – Low Symptoms, High Pain, High Depression and High Symptoms – and hypothesised that high JDs, low JRs, low optimism and adverse lifestyle predict belonging to trajectories with high symptom levels.

Design: Data on Finnish firefighters (N = 360) were collected in 1996, 1999 and 2009. The effects of JDs (mental and physical workload), JRs (supervisory relations, interpersonal relations, task resources), optimism and lifestyle (alcohol consumption, smoking, physical exercise, sleeping) on MPS and DPS were assessed. Latent class growth modelling and multinomial logistic regression were applied.

Results: Three trajectories emerged: Low Symptoms; High Pain; and High Depression. In a multivariable model, high mental workload (OR 2.9, 95% CI 1.5–5.5), poor interpersonal relations (2.6, 1.4–5.0), sleeping problems (2.7, 1.4–5.2) and low optimism (2.0, 1.0–3.7) predicted belonging to High Depression. Alcohol consumption (2.4, 1.4–4.1) and sleeping problems (2.1, 1.3–3.6) were related to High Pain.

Conclusions: Different developmental paths in MPS and DPS are possible. Partly different factors predict the development of pain and depressive symptoms.     

Optimism buffers the detrimental effect of negative self-perceptions of ageing on physical and mental health

Objectives: First, to replicate previous findings on the detrimental effect of negative self-perceptions of ageing (SPA) on physical health outcomes and to expand them to the prediction of mental health; second, to test whether an optimistic outlook to the future can buffer the effect of negative SPA on physical and mental health outcomes.

Design: Data for this study comes from the 2008 and 2011 waves of the German Ageing Survey (DEAS; n?=?6205), a population-based representative survey of adults aged 40–85?years. Mean age of the participants was 61.50 (±12.1), 49.5% were women.

Main Outcome Measures: Self-rated health, physical functioning and depressive symptoms.

Results: Multiple regression analyses indicated that negative SPA predicted deterioration in the three health outcomes over a three-year period, controlling for demographics and illnesses. The most remarkable finding is the interaction with optimism: People who were prepared for physical losses (negative SPA), and who were nevertheless optimistic, were better able to maintain better physical functioning, and lower depressive symptoms.

Conclusion: A multidimensional perspective on ageing, considering both gains and losses at the same time, seems to be best for the maintenance of good health. Individual and societal positive views of ageing should be encouraged.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

Psychological Functioning of Partners of Australian Combat Veterans: Contribution of Veterans' PTSD Symptoms and Partners' Caregiving Distress

Previous research has found posttraumatic stress disorder (PTSD) symptoms in combat veterans to be associated with impaired psychological functioning in their partners. However, little is known about possible mediators of this association. The present study investigated the mediational properties of six dimensions of the revised Partners of Veterans' Distress Scale (MacDonell, Marsh, Hine, & Bhullar, 2010). Participants were 181 female partners of Australian combat veterans, age ranging from 43 and 83 years (M = 60.47, SD = 4.96), who completed measures assessing their caregiving distress levels, dyadic adjustment, mental health, and satisfaction with life. The combat veterans also completed a scale measuring their PTSD symptoms. Our results indicated that higher scores of veterans' PTSD were associated with lower levels of dyadic adjustment, mental health, and satisfaction with life in their partners. Partners reported that distress related to exhaustion and intimacy problems significantly mediated the relationship between veterans' PTSD symptoms and their partners' satisfaction with life, whereas partners' distress associated with intimacy problems was the sole significant mediator for their dyadic adjustment, and exhaustion was the only significant mediator for partners' mental health. Implications for programmes designed to address the significant needs of the partners of combat veterans are discussed.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Predictors of psychological outcomes in a longitudinal study of Latina breast cancer survivors

Objective: This study sought to investigate the unique contributions of socio-ecological, cultural and cancer treatment-related factors in predicting depressive symptoms and cancer-specific distress among Latinas. Design: Participants were 140 English or Spanish-speaking Latinas (M_age = 50.6) with non-metastatic breast cancer who were assessed within two years of diagnosis (Time 1) and three months later (Time 2).

Main Measures: Hierarchical regression analyses identified predictors of depressive symptoms and cancer-specific distress at Time 1 and 2.

Results: Most women scored above the clinical cut-offs for depressive symptoms and cancer-specific distress. After adjusting for socio-ecological factors, greater Latino enculturation, measured by Latino ethnic identity, was significantly associated with greater cancer-specific distress at Time 1 (β = .20, p < .05). A significant interaction (p < .01) revealed that among women high on Latino identity, lower English language use was associated with more cancer-specific distress than higher English language use. After adjusting for socio-ecological factors, greater satisfaction with surgical treatment predicted improved depressive symptoms and cancer-specific distress across time (β_s range from ?.31 to ?.18, p_s < .01).

Conclusions: Findings elucidate the complex relationship between culture and psychological outcomes in the breast cancer context and suggest that treatment satisfaction might be an important intervention target for Latinas.     

Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke

Abstract

Objective: To assess levels of self-efficacy for health-related behaviour change and its correlates in patients with TIA or ischemic stroke.

Methods: In this prospective cohort study, 92 patients with TIA or ischemic stroke completed questionnaires on self-efficacy for health-related behaviour change and fear, social support and depressive symptoms. Relations between fear, social support, depressive symptoms, cognitive impairment, vascular risk factors and history and demographic characteristics and low-self-efficacy were studied with univariable and multivariable logistic regression.

Results: Median total self-efficacy score at baseline was 4 (IQR 4–5). Older age (OR 1.05, 95% CI 1.01–1.09), depressive symptoms (OR 1.09, 95% CI 1.03–1.16), presence of vascular history (OR 2.42, 95% CI 0.97–6.03), higher BMI (OR 1.15, 95% CI 1.01–1.30), fear (OR 1.06, 95% CI 1.01–1.12) and low physical activity (OR 1.49, 95% CI 1.01–2.21) were significantly associated with low self-efficacy.

Conclusion: Patients with recent TIA or ischemic stroke report high self-efficacy scores for health-related behaviour change. Age, vascular history, more depressive symptoms, higher BMI, less physical activity and fear were correlates of low self-efficacy levels.

Practice implications: These correlates should be taken into account in the development of interventions to support patients in health behaviour change after TIA or ischemic stroke.     

An exercise in nostalgia: Nostalgia promotes health optimism and physical activity

Objective: Previous research has shown that nostalgia, a sentimental longing for the past, leads to greater feelings of optimism, with other work demonstrating that optimistic thinking (general & health-orientated) is associated with better physical and psychological health. Integrating these two lines of research, the current studies examined whether nostalgia-induced health optimism promotes attitudes and behaviours associated with better physical well-being.

Methods: Participants, in three experiments, were randomly assigned to write about either a nostalgic or ordinary event. Following this, everyone completed a measure of health optimism (Studies 1–3), measures of health attitudes (Study 2) and had their physical activity monitored over the course of 2 weeks (Study 3).

Results: The results revealed that, in comparison to control conditions, nostalgic reverie led to greater health optimism (Studies 1–3). Further, heightened health optimism following nostalgic reflection led to more positive health attitudes (Study 2), and increased physical activity over a two-week period (i.e. Fitbit activity trackers; Study 3).

Conclusions: These findings highlight the importance of nostalgia on health attitudes and behaviours. Specifically, this work suggests that nostalgia can be used as a mechanism to increase the importance, perceived efficacy and behaviour associated with better physical health.     

Predictors Of Self-Reported Physical Symptoms in Low-Income, Inner-City African American Women: The Role of Optimism, Depressive Symptoms, and Chronic Illness

In this study we examined the association of optimism and depressive symptoms with self-reported physical symptoms in 241 low-income, inner-city African American women with or without a chronic illness (HIV). Although optimism was not a unique predictor of self-reported physical symptoms over and above depressive symptoms, optimism interacted with depressive symptoms and health status. In the community sample, but not the chronically ill sample, optimism buffered the association between depressive symptoms and self-reported physical symptoms. Clinical implications and directions for future research are discussed.     

A latent profile analysis of coping responses to individuals’ most traumatic event: associations with adaptive and maladaptive mental health outcomes

ABSTRACT

Background & Objectives: This study explores how empirically-derived coping response patterns influence mental health.

Design: Emerging adults, currently enrolled in college and aged 18–24 (N?=?432; M_age?=?19.66; SD?=?1.65), completed self-report measures of trauma exposure, coping responses to self-selected most traumatic event (MTE), resilience, posttraumatic growth (PTG), depressive symptoms, and posttraumatic stress symptoms (PTSS).

Methods: Eight coping subscales were included as indicators in a latent profile analysis. Then, associations between established profiles and mental health outcomes were examined, covarying for demographic and trauma-related variables.

Results: Considering fit statistics, class size, profile patterns, and theory, the four-class model was deemed most appropriate: High Overall Coping (HCOPE; n?=?146, 34%), Low Overall Coping (LCOPE; n?=?92, 22%), High Engagement Coping (HENG; n?=?115, 27%), and High Disengagement Coping (HDIS; n?=?73, 17%). HENG participants endorsed above-average resilience and PTG, coupled with below-average depressive symptoms and PTSS. Compared to the sample average, HDIS participants endorsed lower resilience and PTG, coupled with higher depressive symptoms and PTSS. LCOPE participants endorsed low levels of all outcomes. HCOPE participants endorsed high levels of all outcomes.

Conclusions: Findings suggest that clinicians who promote engagement coping and discourage disengagement coping among trauma-exposed individuals may engender the most desirable constellation of mental health outcomes.     

An Examination of Distress Intolerance in Undergraduate Students High in Symptoms of Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) engage in maladaptive coping strategies to reduce or avoid distress. Evidence suggests that uncertainty and negative emotions are triggers for distress in people with GAD; however, there may also be other triggers. Recent conceptualizations have highlighted six types of experiences that people report having difficulty withstanding: uncertainty, negative emotions, ambiguity, frustration, physical discomfort, and the perceived consequences of anxious arousal. The present study examined the extent to which individuals high in symptoms of GAD are intolerant of these distress triggers, compared to individuals high in depressive symptoms, and individuals who are low in GAD and depressive symptoms. Undergraduate students (N = 217) completed self-report measures of GAD symptoms, depressive symptoms, and distress intolerance. Individuals high in GAD symptoms reported greater intolerance of all of the distress triggers compared to people low in symptoms of GAD and depression. Individuals high in GAD symptoms reported greater intolerance of physical discomfort compared to those high in depressive symptoms. Furthermore, intolerance of physical discomfort was the best unique correlate of GAD status, suggesting that it may be specific to GAD (versus depression). These findings support continued investigation of the transdiagnosticity and specificity of distress intolerance.     

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

Objective: Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health.

Design: The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384).

Main Outcome Measures: The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood.

Results: The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood.

Conclusions: Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.     

Reduced autobiographical memory specificity affects general distress through poor social support

ABSTRACT

Sharing specific autobiographical events is likely to influence the support people give us; a person who shares little detail of their lives may be unlikely to attract social support and this may in turn contribute towards anxious and depressive symptoms. Participants (N?=?142) reported memories evoked by negative and positive cue words and these memories were coded for whether or not they referred to a specific event lasting less than 24?h. At this time (T1) and one year later (T2), participants also completed the UCLA Life Stress Interview (LSI), which includes a measure of social support, and measures of depression and anxiety comprising a general distress latent construct. The tendency to recall fewer specific memories was associated with lower social support given by friends and romantic partners and this was in turn associated with elevated general distress at T2, even when accounting for T1 social support and general distress. Our findings contribute to the literature regarding the social function of memory and suggest another route via which reduced specificity contributes to emotional disorders.     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

Internalised HIV-stigma,loneliness, depressive symptoms and sleep quality in people living with HIV

Objective: People living with HIV (PLWH) commonly report sleep disturbances which are associated with long-term health consequences, including disease progression. PLWH also experience internalised stigma as a result of their HIV status, which can be associated with increased loneliness and depression. Little attention focuses on the impact of these factors on sleep. Therefore, we examined whether internalised HIV-stigma was indirectly related to poorer sleep quality through higher levels of loneliness and depressive symptoms.

Design: 181 PLWH from across the United States completed an online survey.

Main Study Measures: Internalised HIV-stigma was assessed using the HIV-Stigma Scale, loneliness was assessed using the UCLA-Loneliness Scale-Short Form, depressive symptoms were assessed with the Center for Epidemiologic Studies–Depression Index, and Sleep Quality was assessed using the Pittsburgh Sleep Quality Index.

Results: Internalised HIV-stigma was indirectly associated with poorer global sleep quality and daytime sleep dysfunction through both loneliness and depressive symptoms.

Conclusions: PLWH who experience HIV-related stigma may experience greater feelings of loneliness, which are related to increased depressive symptoms and poorer sleep quality. Interventions focused on improving sleep in PLWH should focus on multiple factors that influence sleep, including psychosocial factors such as stigma, social isolation and depressive symptoms.     

Partner Discrepancies in Distressed Marriages

ABSTRACT

Spousal discrepancy theory posits that partners with wide personality differences are at risk for marital distress. In this study, we assessed links between partner personality and interpersonal characteristics and marital distress in 244 couples who sought marital therapy. The sample was divided into three subgroups according to marital duration. Longer-married couples reflected significantly less impulsive, exploitive, and insensitive characteristics than couples in either shorter or intermediate marriages. Couples' marital distress was linked to larger discrepancies in personal distress, impulsivity, interpersonal insensitivity, and self-centered characteristics. While husbands' marital distress was linked to partner differences in personal distress and to impulsive, narcissistic, and competitive characteristics, wives' marital distress was primarily linked to partner discrepancies in self-centeredness.     

Selective review,optimism and HIV risk perception

Abstract

Research suggests that review of risk factors increases optimism about health. The present experimental study explored the effects of reviewing risk increasing and risk decreasing factors on HIV risk perception (own risk, others' risk, optimism), self efficacy and behavioural intentions. 164 heterosexual subjects completed a questionnaire concerning their beliefs about HTV and their sexual behaviour. Subjects were allocated to either the risk increasing condition (eg. since being sexually active how often have you asked your partners HIV status?), the risk decreasing condition (eg. since being sexually active how often have you tried to select your sexual partners carefully?), or a control group. The results suggest that review of risk decreasing factors increased optimism and that this change in optimism was related to an increase in perceived others' risk. The results are discussed in terms of theories of selective focus and egocentricism in risk perception and the implications for health promotion.     

Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea

Abstract

Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality.

Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process.

Results: Korean trans women and trans men mean (mean age?=?26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts.

Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people’s internalized negative beliefs about their gender identity.