Negative affectivity,coping, immune status,and disease progression in hiv iwected individuals

Abstract

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The partkipants were given self-administered questionnaires assessing behavioral, psychological, and psychdal variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disurse Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, sewn levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed.

The results showed that measure-s of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passivedefensive coping style. However, no amistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-pmblem related wping (e.g. Positive reappraisal, Seeking social support) and passivedefensive coping (i.e. Escape-Avoidance, Self-control).

The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.     

Longitudinal relations between psychological distress and moderate-to-vigorous physical activity: A latent change score approach

ObjectivesThe effect of physical inactivity on mental health risk is well established; however, less is known about about how psychological distress might deter participation in physical activity. Guided by advancements in the treatment of longitudinal data, the aim of this study was to examine patterns and predictors of change in moderate-to-vigorous physical activity (MVPA) and psychological distress (e.g., feeling nervous, worthless).Design methodAustralian adults (4944 females, M_age = 34.63 years ±5.34; 4322 males, M_age = 37.51 years ±6.14) provided baseline data as part of the Longitudinal Study of Australian Children (LSAC) and were followed for measurements every two years for 10 years.ResultsLatent change score analyses revealed support for a reciprocal effects model, whereby change in MVPA and psychological distress occurred as a function of individuals’ prior levels of, and/or prior change in these variables.ConclusionsThis investigation is the first to document that changes in MVPA and psychological distress are coupled temporally. Notably, we observed that individuals’ distress levels at a given time point predicted subsequent change on both MVPA and distress; a finding which provides novel and important insight into how adults’ activity levels and psychological distress fluctuate relative to one another.     

Retrospective coping strategies during sexual identity formation and current biopsychosocial stress

Background: Lesbian, gay men, and bisexual individuals (LGBs) often experience distress related to the recognition, self-acceptance, and disclosure of their sexual orientation. Objectives and Design: Retrospectively reported coping strategies enacted during sexual identity formation among LGBs were assessed in relation to current stress indices measured using environmental (frequency of perceived daily hassles), psychological (perceived distress), and biological (allostatic load [AL] levels representing physiological dysregulations) perspectives. Methods: Forty-six healthy LGBs between the ages of 18 and 45 (M = 23.91, SE = .80) participated. Questionnaires included the Ways of Coping Checklist adapted to disclosure milestones, Daily Hassles Inventory, and Perceived Stress Scale. AL was calculated using 21 biomarkers of neuroendocrine, immune, cardiovascular, and metabolic functioning. Results: Avoidance coping during sexual identity formation was positively associated with frequency of daily hassles (β = .598, p < .001), perceived stress (β = .361, p = .015), and AL (β = .405, p = .006). By contrast, seeking social support was negatively associated with perceived stress (β = –.598, p = .048). Conclusions: Emotion-focused coping strategies during LGB sexual identity development are associated with current indices of biopsychosocial stress.     

Prediction of end-of-life fears in COPD – hoping for the best but preparing for the worst

Objective: The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.

Design: A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.

Main outcome measures: The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.

Results: Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.

Conclusion: Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.     

Children Exposed to Intra-Familial Violence

Abstract

This investigation examined factors associated with attrition and retention within a sample of children with a history of intra-familial violence referred for outpatient services. The sample included 118 children, aged 4-17 years; of these 64% completed treatment, 20% did not engage in treatment and 16% terminated prematurely. Caregivers reporting high child-related parental distress (F(2, 32) = 3.9, p = 0.03) and high psychological distress (F(2, 70) = 3.3, p = 0.04) were less likely to engage in treatment. Making a child abuse report during assessment or treatment was not found to be associated with treatment engagement or attrition, χ² ₍₂₎= 0.4, p = 0.82. The implications of these findings for clinical practice and treatment outcome research are discussed.     

Hostility and the clinical course of outpatients with congestive heart failure

Objective: The role of depression and quality of life on clinical outcomes of congestive heart failure (CHF) is well recognised. However, there are fewer studies investigating the prognostic role of subclinical psychological distress and well-being impairments. The aims of this study were to evaluate clinical/subclinical psychological distress and well-being in CHF outpatients, and the influence of these psychological factors on adverse cardiac events (re-hospitalisation, cardiac death), at 4-year follow-up.

Design: Sixty-eight CHF outpatients underwent psychological assessment at baseline and, after 4 years, information about cardiac events was collected in 60 patients by means of clinical records.

Main outcome measures: Psychological assessment included structured clinical interview for DSM (major/minor depression), Interview for diagnostic criteria for psychosomatic research (demoralisation), symptom questionnaire, psychological well-being scales.

Results: At follow-up, 39.7% of the baseline sample reported cardiovascular events (14 CHF-related re-hospitalisations and 13 cardiac deaths) and 5.9% other causes for death. Among the variables examined as potential risk factors for adverse cardiovascular outcomes, only hostility was significant, even after controlling for disease severity (hazard ratio = 2.38, 95%confidence interval: 1.04–5.45, p = .040).

Conclusion: In outpatients with CHF, psychological assessment should include both clinical and subclinical distress such as hostility, in order to better address psychological risk factors for cardiac outcomes.     

Perceptions of stressful life events as turning points are associated with self-rated health and psychological distress

Abstract

We test the hypothesis that changes in physical and psychological health are associated with construals of stressful life events. At two points in time, approximately 10 years apart, participants (n=1038) rated their physical health and psychological distress. At the second assessment, participants also reported their most stressful life event since the first assessment and indicated whether they considered the event a turning point and/or lesson learned. Lower self-ratings of health and higher ratings of psychological distress, controlling for baseline health and distress, and relevant demographic factors, were associated with perceiving the stressful life event as a turning point, particularly a negative turning point. The two health measures were primarily unrelated to lessons learned. How individuals construe the most stressful events in their lives are associated with changes in self-rated health and distress.     

The Gaussian Graphical Model in Cross-Sectional and Time-Series Data

We discuss the Gaussian graphical model (GGM; an undirected network of partial correlation coefficients) and detail its utility as an exploratory data analysis tool. The GGM shows which variables predict one-another, allows for sparse modeling of covariance structures, and may highlight potential causal relationships between observed variables. We describe the utility in three kinds of psychological data sets: data sets in which consecutive cases are assumed independent (e.g., cross-sectional data), temporally ordered data sets (e.g., n = 1 time series), and a mixture of the 2 (e.g., n > 1 time series). In time-series analysis, the GGM can be used to model the residual structure of a vector-autoregression analysis (VAR), also termed graphical VAR. Two network models can then be obtained: a temporal network and a contemporaneous network. When analyzing data from multiple subjects, a GGM can also be formed on the covariance structure of stationary means—the between-subjects network. We discuss the interpretation of these models and propose estimation methods to obtain these networks, which we implement in the R packages graphicalVAR and mlVAR. The methods are showcased in two empirical examples, and simulation studies on these methods are included in the supplementary materials.     

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.     

When is a cause the “same”? Incoherent generalization across contexts

A theory or model of cause such as Cheng's power (p) allows people to predict the effectiveness of a cause in a different causal context from the one in which they observed its actions. Liljeholm and Cheng demonstrated that people could detect differences in the effectiveness of the cause when causal power varied across contexts of different outcome base rates, but that they did not detect similar changes when only the cause–outcome contingency, ?p, but not power, varied. However, their procedure allowed participants to simplify the causal scenarios and consider only a subsample of observations with a base rate of zero. This confounds p, ?p, and the probability of an outcome (O) given a cause (C), P(O|C). Furthermore, the contingencies that they used confounded p and P(O|C) in the overall sample. Following the work of Liljeholm and Cheng, we examined whether causal induction in a wider range of situations follows the principles suggested by Cheng. Experiments 1a and 1b compared the procedure used by Liljeholm and Cheng with one that did not allow the sample of observations to be simplified. Experiments 2a and 2b compared the same two procedures using contingencies that controlled for P(O|C). The results indicated that, if the possibility of converting all contexts to a zero base rate situation was avoided, people were sensitive to changes in P(O|C), p, and ?p when each of these was varied. This is inconsistent with Liljeholm and Cheng's conclusion that people detect only changes in p. These results question the idea that people naturally extract the metric or model of cause from their observation of stochastic events and then, reasonably exclusively, use this theory of a causal mechanism, or for that matter any simple normative theory, to generalize their experience to alternative contexts.     

Stress appraisals influence athletic performance and psychophysiological response during 16.1 km cycling time trials

ObjectivesWe examined how stress appraisals were associated with emotions, coping behaviours, as well as subjective and objective measures of performance.DesignProspective field- and laboratory-based studies.MethodsIn Study 1, 192 athletes completed process-oriented psychometrics pertaining to the aforementioned constructs throughout a sporting competition. Study 2 utilised an experimental design to assess the causal influence of stress appraisals on performance, cortisol, and psychological variables. Thirty gender-matched athletes were randomly assigned to either a stress appraisal (e.g., challenge, threat, benefit, or harm/loss) or the control group. Participants completed three 16.1 km cycling time trials (TT) on a cycle ergometer, with their appropriate stress appraisal engendered via falsified performance feedback throughout the final TT. Salivary cortisol samples and psychometrics (e.g., appraisals, emotions, and coping) were collected before and after each TT.ResultsThe results of Study 1 revealed a sequential link between challenge stress appraisals and perceived goal attainment via pleasant emotions and task-oriented coping behaviours. Threat stress appraisals inversely related to goal attainment via unpleasant emotions and both distraction- and disengagement-oriented coping. In Study 2, no significant psychophysiological or performance differences were found across genders. The temporal orientation of stress appraisals influenced objective cycling TT performance. Benefit and harm/loss stress appraisals significantly facilitated or inhibited performance, respectively. Cortisol spikes were observed in the stress appraisal group’s threat, challenge, and benefit, with a decline detected within the harm/loss group. Whilst the process of winning is physiologically stressful, the fear of defeat may be more stressful than losing itself.ConclusionStress appraisals influence subjective and objective performance, as well as neuroendocrine and psychological responses to stress.     

Psychological Adjustment,Coping, and Emotion Regulation as Predictors of Posttraumatic Growth

Abstract

The present study examined factors contributing to reported benefits of traumatic experiences or posttraumatic growth (PTG) in a college sample. Specifically, we examined dimensions typically associated with trauma recovery (i.e., psychological functioning, coping, emotion regulation) and features of the trauma (i.e., number and recency of traumatic events, average, and maximal distress). Participants (N= 193) completed standardized questionnaires measuring these constructs. Results indicated that active coping and subjective well-being independently contributed to PTG, but social desirability and symptom distress were independent of growth. These results were consistent with study expectations. Although not specifically predicted, maximal trauma distress also uniquely predicted PTG. Contrary to expectations, effective emotion regulation did not contribute to PTG.     

The influence of an esports-adapted coping effectiveness training (E-CET) on resilience,mental health,and subjective performance among elite league of Legends players: A pilot study

ObjectiveThis study aimed to develop, and pilot esports-adapted coping effectiveness training (E-CET) and measure its influence on coping effectiveness (global and specific), subjective performance, mental health (psychological distress and wellbeing), and resilience.DesignFive elite male League of Legends players competing in the League of Legends Circuit Oceania participated in a mixed methods research design. The effects of E-CET were measured using a within-subjects quasi-experimental design (i.e., pre-to-post, no control group). To measure the effects of E-CET on specific stressors, a longitudinal diary design was used.MethodPlayers participated in a 2-h session of E-CET and a 45-min follow-up workshop. The 2-h workshop delivered content on two conceptual areas: (1) developing awareness of the stress and coping process; and (2) how to cope with stress. Players completed pre-intervention, post-intervention, and follow-up measures and twice-weekly stress journals.ResultsE-CET led to increases in players' perceived coping effectiveness and subjective performance, but there were no changes in psychological distress, psychological wellbeing, and resilience. However, the results indicate some positive signs for future coping interventions with League of Legends players and iterations of E-CET.ConclusionThe E-CET program appears to provide an opportunity to improve performance and mental health for esports players.     

Habit as both a direct cause of intention to use a condom and as a moderator of the attitude-intention and subjective norm-intention relations

Abstract

Undergraduates at an American university were asked questions about their attitudes, subjective norms, habits, and intentions towards using a condom during sexual intercourse. Consistent with previous research (Chan and Fishbein, 1993; Trafimow, 1994), intentions were well predicted by attitudes and subjective norms (r = 0.88 and r = 0.73, p < 0.01 in both cases). Intentions were also well predicted by habits (r = 0.77, p < 0.01). More interestingly, however, for participants who were in the habit of using condoms, attitudes and subjective norms were not significant predictors of intentions to use condoms in the future (r = 0.18 and r = 0.10, p<0.1 in both cases). In contrast, attitudes and subjective norms were strong predictors for participants who were not in the habit of using condoms (r = 0.81 and r = 0.61, p < 0.01 in both cases). These findings were replicated in a second study.     

Unit Cohesion,Resilience, and Mental Health of Soldiers in Basic Combat Training

Military unit cohesion has been shown to correlate with physical and psychological outcomes. However, little is known about the development of cohesion in the early days of military service during Basic Combat Training (BCT) and how it relates to positive support and the negative stressors of training. The current study assessed the development of unit cohesion across the 10-week BCT period (N = 1,939), and the relation of cohesion to stress, resilience, mental health measures, and BCT outcomes (graduation, passing the Army Physical Fitness Test, and final Basic Rifle Marksmanship scores). The sample was primarily male (62%), under age 25 (88%), and unmarried (88%). All putative mediators showed significant change over time. Unit cohesion increased over time (slope 0.22; p < .001), and these increases were associated with decreases in psychological distress (p < .001), sleep problems (p < .001), and tolerance of BCT stressors (p < .001), as well as increases in resilience (p < .001), confidence managing stress reactions (p < .001), and positive states of mind (p < .001). Unit cohesion was indirectly associated with successful graduation and passing the Army Physical Fitness Test through cohesion-related improvement in psychological distress, resilience, and confidence managing reactions to stress. Sleep problems also mediated BCT graduation. Cohesion effects on the Basic Rifle Marksmanship scores were mediated by psychological distress and tolerance of BCT stressors only. These results suggest that unit cohesion may play a key role in the development of psychological health among new soldiers.     

Minority stress and health: Implications for lesbian,gay, bisexual,transgender, and questioning (LGBTQ) young people

Historically, the pathologization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) orientations shaped research and professional practice, while the impact of stigma was not considered. Within a minority stress conceptualization however, stigma-related prejudice and discrimination experienced by LGBTQ people constitute chronically stressful events that can lead to negative health outcomes. Minority stress has been linked to psychological distress among gay men and lesbians and may contribute to elevated rates of distress frequently observed among LGBTQ youth. This study explored the impact of minority stress on psychological distress among LGBTQ youth in Ireland. Measures assessing three components of minority stress (sexual identity distress, stigma consciousness, and heterosexist experiences) were administered online to LGBTQ youth aged 16–24 years (N = 301). Each minority stressor had a significant independent association with distress. Stepwise regression analyses identified the linear combination of minority stressors as significantly predictive of distress [F(3,201) = 30.80, p ≤ 0.001]. Results suggest that the oppressive social environment created through sexual/transgender identity-related stigma negatively impacts on the well-being of LGBTQ youth. These findings have implications for health professionals and policy makers interested in the concerns of LGBTQ youth experiencing difficulties related to minority status and will facilitate the development and tailoring of interventions aimed at reaching those most at risk.     

Does a self management intervention lower distress in woman diagnosed with breast cancer?1

Psychological distress is particularly common with any cancer diagnosis. This paper examined the psychological distress in a cohort of women newly diagnosed with breast cancer and postulates on the underlying theory. A longitudinal study of a cohort of women (n = 147) diagnosed with breast cancer (within the past 1 year), was conducted at University Malaya Medical Centre, Kuala Lumpur. Data were collected at baseline and at post 4‐week intervention. Analysis of variance was conducted to examine for any significant differences in the change‐scores between the experimental group (n = 69) and the control group (n = 78). Using the change scores, analyses of variance showed significant differences between groups for stress, F(1, 140) = 13.68, p < .0001, anxiety F(1, 140) = 8.44, p < .004, and depression, F(1, 140) = 11.57, p < .0001. Levels of stress, anxiety and depression generally decreased significantly in the experimental groups, p < .05, but either maintained or increased in the control group. This study indicates that the level of psychological distress of women with breast cancer can be ameliorated with a 4‐week self‐management intervention. Lower stress levels were also found in women who reported engagement in higher physical activity than women with low physical activity.     

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.     

Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress

Objective: The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress.

Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis.

Results: Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample.

Conclusions: Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine.     

The Influence of Sex,Gender, Self-Discrepancies,and Self-Awareness on Anger and Verbal Aggressiveness Among U.S. College Students

Abstract

Among a sample of 445 U.S. college students, the authors examined the extent to which individual differences (e.g., sex, gender, self-discrepancies, self-awareness) explained anger tendencies and verbal aggressiveness. Regression analyses showed that (a) the tendency to repress anger (anger-in) was explained by masculinity, desire to be masculine, and public self-awareness, R ² = .19, F(11, 433) = 8.44, p < .001; (b) the tendency to express anger (anger-out) was explained by sex, masculinity, and public self-awareness, R ² = .17, F(11, 433) = 7.38, p < .001; and (c) willingness to be verbally aggressive was explained by sex, femininity, and private self-awareness, R ² = .32, F(11, 433) = 16.94, p < .001. In addition, different types of individual difference variables accounted for anger tendencies and verbal aggressiveness across sex and gender categories, suggesting that anger and verbal aggressiveness may be driven by different psychological processes across types of participants.