The durability of beneficial health effects associated with expressive writing

Abstract

This study examined the durability of benefits associated with expressive writing. Sixty-eight college undergraduates completed measures of physical and psychological health at the beginning of their first year and were then randomized to either an expressive writing or a control writing condition. Changes in physical health, psychological health (i.e., depression, stress, and anxiety), and academic performance were assessed two, four, and six months later. Findings indicated that participants assigned to the expressive writing condition reported less depression symptom severity at the two-month follow-up assessment relative to participants assigned to the control condition. However, these symptom reductions were not observed at any of the subsequent follow-up assessments. No significant changes were reported for physical health complaints, stress symptoms, anxiety symptoms, or academic performance. These findings suggest that, among first-year college students, expressive writing may provide some short-term relief for certain symptoms.     

Parental reports of global physical health at ages 3 and 6 predict self‐reported depressive symptoms 17 years later

Research studies testing longitudinal relations between childhood physical health measures and adulthood sub‐clinical depressive symptoms are rare. In the Cardiovascular Risk in Young Finns Study, longitudinal relations of parental reports of the global physical health of the child (1 = good, 2 = moderately good, 3 = average/not good) and of absent days from daycare due to physical illness during the past year (1 = no absent days, 2 = 1–5 days, 3 = 6–10 days, 4 = 11 days or more) with self‐reported depressive symptoms (a modified version of the Beck Depression Inventory) were studied over 17 years. The sample was population‐based, consisting at the study entry of 3‐ and 6‐year‐olds (n = 567) free of any chronic physical or mental illnesses. The results indicated that parent‐reported global physical health of the child during the childhood period significantly predicted the participant's self‐reported depressive symptom scores at follow‐up 12 and 17 years from the baseline (ps < .03). The risk of having depressive symptom scores at the top quartile of age‐ and gender‐specific distributions at follow‐up 12 and 17 years from the baseline, and both follow‐ups simultaneously was 1.97‐ to 4.49‐fold (95% confidence intervals: 1.15–11.96) for participants with a moderately good to average/not good global physical health at the study entry relative to participants with a good global physical health. Absent days from daycare were not associated with depressive symptoms. Despite its subjectivity, the results support the validity of parental reports and suggest that parent‐reported global physical health rating of the child early in development may indicate a risk for later depressive symptoms.     

Non-binary and binary transgender youth: Comparison of mental health,self-harm,suicidality, substance use and victimization experiences

ABSTRACT

?Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.

Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB).

Methods: Online survey data from 677 participants from the “Youth Chances” community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)).

Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies.

Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.     

Life after Trauma: Personality and Daily Life Experiences of Traumatized People

In this study, we explored differences in personality and daily life experiences of traumatized (n= 26) versus nontraumatized (n= 30) college students. Study participants completed a variety of personality measures as well as a 28–day experience sampling study assessing daily activities, emotions, and physical health. Although not differing on general demographics, traumatized individuals reported more trait anxiety and lower self–esteem than nontraumatized individuals. They scored higher on Neuroticism, were more introverted, and were less emotionally stable than nontraumatized participants. Traumatized individuals also reported more cognitive disturbances, emotional blunting, and interpersonal withdrawal. They did not report being more depressed, but did endorse cognitive styles associated with heightened risk for depression. Earlier age of trauma was associated with more pathological outcomes: lower self–esteem and psychological well–being, more anxiety, more pessimism, and emotional constriction of positive mood. We compare this symptom profile to that of posttraumatic stress disorder.     

Framing gratitude journaling as prayer amplifies its hedonic and eudaimonic well-being,but not health,benefits

Abstract

Gratitude is commonly practiced as prayer, but experimental studies testing the ability of gratitude journaling interventions to increase well-being have only examined secular forms of thanksgiving. We hypothesized that framing gratitude journaling as prayer would amplify its well-being effects. Undergraduate participants (N = 196) were instructed to write 10 things for which they were grateful once a week for five weeks. Participants were randomly assigned to read their thanks aloud to themselves, read their thanks to another person, or pray their thanks aloud to God. Participants in the prayer condition experienced a decrease in negative affect, and participants in the prayer condition who also exerted high effort demonstrated gains in gratitude, positive affect, and hope. Results indicate that the prayer condition may have led to increased health symptoms. Non-significant effects for the social condition suggest that the mechanisms explaining the effects of prayer are related to the theistic and sacred elements of prayer rather than its social features.     

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.     

Event centrality prospectively predicts PTSD symptoms

Background: Recent evidence suggests that event centrality has a prominent association with post-traumatic stress disorder (PTSD) symptoms. However, evidence for this notion thus far has been mostly correlational. We report two studies that prospectively examined the relationship between event centrality and PTSD symptoms. Study 1 Methods: Participants (N?=?1438) reported their most stressful event (“prior event”), along with event centrality, PTSD symptoms, and neuroticism. At Time 2 participants reported their most stressful event since Time 1 (“critical event”), along with measures of event centrality and PTSD symptoms. Study 1 Results: Event centrality for the critical event predicted PTSD symptoms, after controlling for event centrality and PTSD symptoms of the prior event and neuroticism. Study 2 Methods: In the second study (N?=?161) we examined changes in event centrality and PTSD symptoms over a month. Study 2 Results: Using a cross-lagged panel design, results revealed event centrality at Time 1 significantly predicted PTSD symptoms at Time 2, but the reverse was not significant. Conclusions: In two studies, a prospective association between event centrality and PTSD symptoms, but not the reverse, emerged. This evidence implicates event centrality in the pathogenesis and/or maintenance of PTSD symptoms.     

When more is not merrier: shared stressful experiences amplify

ABSTRACT

Sharing experiences with others, even without communication, can amplify those experiences. We investigated whether shared stressful experiences amplify. Participants completed the Cold Pressor Task at the same time as a confederate, or while the confederate completed another task. Importantly, participants in the shared (vs. unshared) condition experienced more sensory pain characteristics and reported more stress over time in relation to the task. Importantly, they reported thinking more about the confederate’s thoughts and feelings. This mentalizing sometimes mediated effects, suggesting the task amplified when participants constructed mental representations of others’ CPT experience (e.g. that it hurts) and incorporated it into their own responses.     

Influences of habitual and situational bodily symptom focusing on stress responses

Evidence suggests that focusing on bodily symptoms increases perception of internal states. The interaction between situational (experimentally induced) symptom focusing and a disposition to focus on one's bodily symptoms is unclear. We assumed that situational symptom focusing increases perception of stress symptoms only in persons that usually do not focus on their bodily symptoms. Forty participants were divided into two groups (N=20) according to their disposition towards bodily symptom focusing (habitual symptom focusing, HSF+ and HSF?). Ten participants per group were instructed to focus on their neck muscle tension (situational symptom focusing, SSF+), while the others received a control instruction (SSF?). All participants underwent anticipation of a public speech, representing an emotional and mental stressor. There was a significant HSF×SSF interaction in reports on muscle tension and palpitation under stress. While HSF? participants reported more stress symptoms in the SSF+ condition, HSF+ participants reported less symptoms. However, no interaction was found in physiological measures including neck electromyogram, skin conductance reactions, heart rate and blood pressure. Our results indicate either that symptom perception is adjusted by symptom focusing, or that the instruction to use a habitual coping strategy reduces stress symptoms.     

Experimental test of a planning intervention for forming a ‘higher order’ health-habit

Abstract

Objective: Habit-formation interventions may help individuals initiate and maintain behaviour change. This paper proposes and empirically tests the idea that it is possible for individuals to form ‘higher-order habits’, or behaviours that can be executed in more than one way, and still be habitual.

Design: Participants (N?=?82) were healthy adults randomly assigned to an action-and-coping-planning intervention for forming a ‘higher-order habit’ of filling half of their dinner plates with fruits and vegetables or a control condition. Key measures were collected at baseline and 1, 2 and 3 weeks post-baseline. Participants submitted 3 pictures per week of their dinner plates via snapchat/email.

Main Outcome Measures: Intrinsic motivation, habit strength and behavioural frequency for filling half their dinner plates with fruits and vegetables.

Results: Intervention participants reported significantly greater habit strength at each follow-up time point. Controls did show some degree of habit formation, despite not fully forming a habit. Behavioural automaticity increased despite consuming a variety of fruits/vegetables; results did not depend on participants’ intrinsic motivation to consume fruits/vegetables.

Conclusion: It may be possible for individuals to form ‘higher-order’ habits, which may be particularly important in health contexts, in which many target behaviours are complex and can be seen as higher-order.     

Cultural Influences in the Aetiological Beliefs of Saudi Arabian Primary Care Patients About Their Symptoms: The Association of Religious and Psychological Beliefs

Objective To develop a self-report questionnaire to measure the beliefs of Arabic primary care patients about the causes of their physical symptoms; to use this to quantify the beliefs of patients consulting their general practitioners (GPs) in Saudi Arabia; and to test whether patients with psychological problems differ from others in their beliefs, particularly religious and supernatural beliefs. Methods Consecutive patients (N = 224) completed a specially developed aetiological beliefs’ questionnaire. Patients were divided into two groups (cases and non-cases of emotional disorder) according to the GHQ-12. Results Religious and supernatural aspects of culture colour patients’ symptom beliefs: that their symptoms were a test or punishment from Allah’ was the most common belief. Even in non-cases, around half the patients also endorsed nerves and stress as a cause of their physical symptoms. Cases were more likely than non-cases to endorse items related to both religious and psychological factors. Conclusion There is no support for the view that Saudi Arabian patients explain symptoms supernaturally as a way of denying psychological factors. GPs and health professionals in Saudi primary care need to understand what patients believe to be the cause of their problems and to appreciate that religious and psychological beliefs are both very common. GPs should address psychological beliefs and concerns even with those patients who present physical symptoms.     

Social interactions and physical symptoms in daily life: quality matters for older adults,quantity matters for younger adults

Objective: The present study examined how the different attributes of daily social interactions (quality and quantity) were associated with physical health, and how these associations vary with age.

Method: Using an ecological momentary assessment approach, participants from an adulthood lifespan sample (n = 172; aged 20–79 years) reported their social interactions five times daily, and physical symptoms and symptom severity at the end of each day, for one week.

Main outcome measures: Number of physical symptoms and physical symptom severity.

Results: There was a within-person main effect of the quality (positivity), but not the quantity (frequency), of social interactions on the number of reported physical symptoms and their severity. Moderation analyses further revealed that the quality of daily social interactions predicted fewer physical symptoms for older adults, but not for younger adults; in contrast, the frequency of social interactions predicted less severe physical symptoms for younger adults, but not for older adults. Finally, the reported severity of physical symptoms predicted less frequent but more positive social interactions the next day.

Conclusions: Our findings point to the bidirectional associations between social interactions and health and highlight the importance of considering individuals' developmental context in future research and interventions.     

An Experimental Test of Cognitive Dissonance Theory in the Domain of Physical Exercise

The present study examined cognitive dissonance-related attitude change in the domain of exercise. Experimental participants made a decision to perform a boring exercise task (stepping on a bench/chair) under three different conditions: a free-choice condition (n = 33, Male = 17 female = 16, Age = 14.57), under a no-choice/control condition (n = 28, Male = 15, Female = 13, Age = 14.50), and under a condition that compelled participants to practice bench/chair stepping (forced-choice condition) (n = 31, Male = 15, Female = 16, Age = 14.61). Results showed that participants in the free-choice condition reported more positive attitudes than participants in the control condition and participants in the forced-choice condition. Ancillary analysis indicated that cognitive dissonance is experienced as an aversive state, and that the amount of frustration that participants experienced immediately after the free-choice paradigm predicted attitudes.     

Computerized attention retraining for individuals with elevated health anxiety

Background and Objectives: Current cognitive-behavioral theorists conceptualize hypochondriasis as excessive health anxiety (HA). Growing evidence suggests that elevated HA is associated with attentional bias (AB) toward potential health-threat information. Design: This study aimed to examine the effects of attention retraining among individuals with elevated HA, using the established attention modification programs (AMP) designed to train participants to disengage attention from ideographically chosen health-threat words. Methods: Thirty-six randomly assigned individuals with elevated HA completed eight twice-weekly sessions of the AMP (n = 18) or the attention control condition (ACC; n = 18). Results: Despite using the well-established AMP protocol widely used within the field of anxiety disorders, we did not find evidence for change in AB following training. Further, AMP did not outperform ACC in reducing HA and other relevant emotional symptoms. However, both AMP and ACC evidenced overall significant symptom reduction in most of the outcome measures, including overall HA, anxiety sensitivity, general depression and anxiety, and somatic complaints. Conclusions: Further research is needed to better understand the effects and mechanisms of AMP as a possible cognitive intervention for HA.     

Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients

Objective: Social support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.

Design: Community volunteers with asthma (n?=?97) or RA (n?=?31) responded to EMA prompts five times daily for one week.

Main outcomes: Baseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.

Results: Supporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.

Conclusion: Results suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.     

Beliefs about emotion: implications for avoidance-based emotion regulation and psychological health

People’s beliefs about their ability to control their emotions predict a range of important psychological outcomes. It is not clear, however, whether these beliefs are playing a causal role, and if so, why this might be. In the current research, we tested whether avoidance-based emotion regulation explains the link between beliefs and psychological outcomes. In Study 1 (N?=?112), a perceived lack of control over emotions predicted poorer psychological health outcomes (increased self-reported avoidance, lower well-being, and higher levels of clinical symptoms), and avoidance strategies indirectly explained these links between emotion beliefs and psychological health. In Study 2 (N?=?101), we experimentally manipulated participants’ emotion beliefs by leading participants to believe that they struggled (low regulatory self-efficacy) or did not struggle (high regulatory self-efficacy) with controlling their emotions. Participants in the low regulatory self-efficacy condition reported increased intentions to engage in avoidance strategies over the next month and were more likely to avoid seeking psychological help. When asked if they would participate in follow-up studies, these participants were also more likely to display avoidance-based emotion regulation. These findings provide initial evidence for the causal role of emotion beliefs in avoidance-based emotion regulation, and document their impact on psychological health-related outcomes.     

Reducing demand for ineffective health remedies: overcoming the illusion of causality

Abstract

Objective: We tested a novel intervention for reducing demand for ineffective health remedies. The intervention aimed to empower participants to overcome the illusion of causality, which otherwise drives erroneous perceptions regarding remedy efficacy.

Design: A laboratory experiment adopted a between-participants design with six conditions that varied the amount of information available to participants (N?=?245). The control condition received a basic refutation of multivitamin efficacy, whereas the principal intervention condition received a full contingency table specifying the number of people reporting a benefit vs. no benefit from both the product and placebo, plus an alternate causal explanation for inefficacy over placebo.

Main outcome measures: We measured participants’ willingness to pay (WTP) for multivitamin products using two incentivized experimental auctions. General attitudes towards health supplements were assessed as a moderator of WTP. We tested generalisation using ratings of the importance of clinical-trial results for making future health purchases.

Results: Our principal intervention significantly reduced participants’ WTP for multivitamins (by 23%) and increased their recognition of the importance of clinical-trial results.

Conclusion: We found evidence that communicating a simplified full-contingency table and an alternate causal explanation may help reduce demand for ineffective health remedies by countering the illusion of causality.     

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.     

Postpartum exuberance: Not all women in a highly positive emotional state in the postpartum period are denying depression and distress

The question addressed in this study was whether or not mothers who scored low on self-report depression scales—so-called “deniers”—were denying their symptoms and suffering from an illusion of mental health. The findings did not support the interpretation that low-scoring mothers were denying other symptoms. Rather, low-scoring mothers: 1) experienced a wide range of emotions and similar levels of positive emotions compared to mid-symptom mothers; 2) changed their reported levels of depressive symptoms over the course of the study; 3) reported a variety of symptoms at levels similar to those of mothers in the mid symptom range; and 4) were affected negatively by having a diagnosis of depression, in a manner similar to mothers in the mid and high symptom groups. Furthermore, low symptom mothers consistently reported the most positive profiles of maternal adaptation with higher levels of maternal self-esteem and a high ratio of self-reported positive to negative affect. Thus, they appeared to be experiencing a heretofore underdescribed highly positive normal postpartum state that we have labeled “postpartum exuberance.” Postpartum exuberance, as well as a compromise of affective functioning associated with any lifetime diagnosis of depression regardless of the mothers' current level of depressive symptoms, highlights the complexity of emotional reactivity during the postpartum period. © 1997 Michigan Association for Infant Mental Health