Stomaching rejection: Self-compassion and self-esteem moderate the impact of daily social rejection on restrictive eating behaviours among college women

Objective: The present study examined whether having high self-esteem or a self-compassionate perspective help mitigate the impact of daily social rejection on negative affect and restrictive eating behaviours.

Design: Following a baseline survey assessing self-esteem and self-compassion, 121 college women completed online daily diaries for one week.

Main Outcome Measures: Negative affect and restrictive eating behaviours.

Results: On days when women reported more rejection, they also reported higher restrictive eating behaviours and greater negative affect. Effects were moderated by self-esteem and self-compassion, such that the lower participants were in self-esteem or self-compassion, the stronger the positive relation between rejection and negative affect and restrictive eating. However, only the common humanity/isolation dimension of self-compassion significantly moderated daily effects of rejection when controlling for self-esteem. Mediated moderation results reveal different mechanisms by which self-esteem and self-compassion buffer against rejections’ effects on affect and restrictive eating.

Conclusion: Self-compassion and self-esteem influence the complex impact that social rejection has on affect and restrictive eating. More than other dimensions of self-compassion or self-esteem, remembering one’s common humanity can result in a healthier response to social rejection.     

The mediating and moderating role of planning on mothers’ decisions for early childhood dietary behaviours

Objective: Examine the roles of action and coping planning on the intention–behaviour relationship for mothers’ decisions for their young children’s dietary behaviours.

Design: Prospective design with two waves of data collection, one week apart.

Main outcome measures: Mothers (N = 197, M_age = 34.39, SD = 5.65) of children aged 2–3 years completed a main questionnaire assessing planning constructs and intentions, and a one-week follow-up of the target behaviours – ‘healthy eating’ and ‘discretionary choices’.

Results: Intention was the strongest predictor of behaviour for both dietary behaviours. For healthy eating, intention moderated the indirect relationship between intention–behaviour via planning; coping planning was less important when intention was strong. Further, intention was not a direct predictor of behaviour when intention was relatively low. Action planning was not a direct predictor of either behaviour after accounting for intention and coping planning; action planning on behaviour was mediated by coping planning (only for healthy eating). Intention was not a direct predictor of coping planning; intention on coping planning was mediated by action planning. Neither type of planning predicted discretionary choices.

Conclusion: Current findings contribute novel information on the mechanisms underpinning the effect of action and coping planning on the intention–behaviour relationship.     

Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study

Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety.

Design: Semi-structured interviews of patient-caregiver dyads (N?=?21), coded using NVivo Software.

Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC.

Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms.

Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.     

How do loss- and restoration-oriented coping change across time? A prospective study on adjustment following spousal bereavement

Background and objectives: According to the Dual Process Model (DPM), shifting between loss-oriented (LO) and restoration-oriented (RO) coping is essential for adjustment following bereavement. Knowledge about how LO and RO coping change over time and how such changes are related to adjustment is missing. With a prospective design this study investigated (1) relations between levels of LO/RO coping and selected outcomes and (2) changes in LO/RO coping across time and their relations to adjustment.

Methods: A sample of 145 spousal bereaved individuals completed questionnaires measuring LO and RO coping, grief symptoms, positive affect, and attachment orientation approximately 2–3 months (baseline) and 7 months (follow-up) post-loss.

Results: High usage of LO coping was associated with poorer outcomes and high usage of RO coping was associated with better outcomes at both baseline and follow-up. Individuals generally shifted towards more RO coping across time and those who exhibited this shift showed lower levels of grief at follow-up compared to individuals who changed towards more LO coping across time.

Conclusions: Individuals showing more RO coping reported better adjustment both early and later in the bereavement process. Changes in coping orientation over time might be useful for understanding complicated grief reactions following loss.     

The detrimental effect of academic procrastination on subsequent grades: the mediating role of coping over and above past achievement and working memory capacity

Background: Academic procrastination is common among university students and its effect on their achievement is worrisome. Although procrastination is often depicted as self-regulation failure, research still needs to examine the self-regulatory mechanisms involved in the relationship between procrastination and achievement.

Objectives: In this prospective study, we sought to (a) unravel the unique effect of academic procrastination on university grades, (b) examine the mediating role of task-oriented and disengagement-oriented coping as a self-regulatory pathway toward achievement, (c) control for the potential confounding influence of past achievement and working memory capacity.

Methods: A sample of 258 university students completed self-report measures of academic procrastination and coping, and performed tests of working memory. Their semester grade point average was collected at the end of the semester.

Results: Results of structural equation modeling showed that academic procrastination negatively predicted subsequent academic achievement, even after controlling for high school achievement and working memory capacity. Furthermore, indirect effects revealed that task- and disengagement-oriented coping explained 70% of the total effect.

Conclusion: These findings outline that the effect of academic procrastination cannot be reduced to a history of academic difficulties or limited cognitive ability and that coping plays an important role in the procrastination – achievement relationship.     

Big Five personality traits and allostatic load in midlife

Objective: To examine the cross-sectional associations of Big Five personality traits with midlife allostatic load, including the role of sex, socio-demographic factors and health-related behaviours.

Design: Cross-sectional analyses of 5512 members of the Copenhagen Aging and Midlife Biobank, aged 49–63 years, 69% men.

Main outcome measure: Allostatic load (AL) based on 14 biomarkers representing the inflammatory, cardiovascular and metabolic system.

Results: Due to significant sex?×?trait interactions, analyses were stratified by sex. Openness and Conscientiousness were inversely associated with AL in both sexes, and Extraversion was positively associated with AL in men. Adjusting for socio-demographic factors significantly attenuated the association of Openness in both sexes and of Extraversion in men, for whom the inverse association of Agreeableness with AL was strengthened. Further adjusting for health-related behaviours, the Conscientiousness-AL association was attenuated but remained significant, and Agreeableness remained significantly associated with AL in men.

Conclusion: Results imply that higher levels of Agreeableness (in men) and Conscientiousness are associated with lower levels of AL above and beyond socio-demographic factors and health-related behaviours. The study further contributes by demonstrating the relevance of sex?×?trait and trait?×?trait interactions in the personality-health literature.     

Interpersonal effects of parents and adolescents on each other’s health behaviours: a dyadic extension of the theory of planned behaviour

Objective: Interpersonal relationships are important predictors of health outcomes and interpersonal influences on behaviours may be key mechanisms underlying such effects. Most health behaviour theories focus on intrapersonal factors and may not adequately account for interpersonal influences. We evaluate a dyadic extension of the Theory of Planned Behaviour by examining whether parent and adolescent characteristics (attitudes, subjective norms, perceived behavioural control and intentions) are associated with not only their own but also each other’s intentions/behaviours.

Design: Using the Actor-Partner Interdependence Model, we analyse responses from 1717 parent-adolescent dyads from the Family Life, Activity, Sun, Health, and Eating study.

Main Outcome Measures: Adolescents/parents completed self-reports of their fruit and vegetable consumption, junk food and sugary drinks consumption, engagement in physical activity, and engagement in screen time sedentary behaviours.

Results: Parent/adolescent characteristics are associated with each other’s health-relevant intentions/behaviours above the effects of individuals’ own characteristics on their own behaviours. Parent/adolescent characteristics covary with each other’s outcomes with similar strength, but parent characteristics more strongly relate to adolescent intentions, whereas adolescent characteristics more strongly relate to parent behaviours.

Conclusions: Parents and adolescents may bidirectionally influence each other’s health intentions/behaviours. This highlights the importance of dyadic models of health behaviour and suggests intervention targets.     

The effects of a short-term mindfulness meditation intervention on coping flexibility

Background and objectives: Mindfulness meditation (MM) training promotes health and well-being. One potential mechanistic link between MM and health may be coping flexibility, (e.g., the ability to monitor and modify coping strategies based on situational needs and strategy effectiveness). We hypothesized that MM training would increase coping flexibility and also explored whether gains in coping flexibility continued to increase after training, or whether they were maintained or lost with time.

Methods and design: One hundred thirteen students (71 female, M_age?=?18.97) were randomly assigned to a waitlist control or MM condition. Participants in the MM condition were trained by a certified MM instructor and given guided recordings for one-week of at-home practice. Participants provided reports of coping flexibility over a three-week span.

Results: Results from multilevel modeling indicated that MM increased coping flexibility among those in the MM condition and among those who spent relatively more time meditating. Results further suggested that the gains in coping flexibility that were evident at post-test were not only maintained but increased in the two weeks after the intervention.

Conclusions: This study provides preliminary support for the assertion that MM increases the ability to monitor and modify coping strategies during times of stress.     

Is avoidance of illness uncertainty associated with distress during oncology treatment? A daily diary study

Objective: The aim of this study was to explore the daily relationship between illness uncertainty, avoidance of uncertainty, well-being and treatment-related distress among patients with cancer receiving treatment with curative intent. It was hypothesised that daily illness uncertainty, daily avoidance of uncertainty and daily treatment-related distress would be negatively associated with daily well-being. It was also hypothesised that daily illness uncertainty and daily avoidance of uncertainty would be positively associated with daily treatment-related distress.

Design: Thirty-one patients receiving oncology treatment with curative intent completed a daily diary for seven consecutive days. Data were analysed using multilevel modelling.

Main outcome measures: Daily illness uncertainty, avoidance of illness uncertainty, treatment-related distress and well-being.

Results: As hypothesised, on days when patients with cancer reported heightened treatment-related distress they experienced diminished well-being. And on days when patients reported more experiential avoidance of illness uncertainty, they also experienced heightened levels of treatment-related distress. No other daily associations were significant.

Conclusion: These findings indicate that patients with cancer experience day-to-day fluctuations in distress and well-being throughout oncology treatment. Avoidance of illness uncertainty-related thoughts and/or emotions are associated with daily distress, but not daily well-being.     

How resilience is strengthened by exposure to stressors: the systematic self-reflection model of resilience strengthening

Background: Exposure to demands is normally considered to drain resources and threaten wellbeing. However, studies have indicated a resilience-strengthening role for stressors.

Objectives: This paper introduces a unifying model, including five testable hypotheses regarding how resilience can be strengthened progressively via exposure to life-stressors.

Methods: We review and synthesize relevant scholarship that underpins the Systematic Self-Reflection model of resilience-strengthening.

Results: The model highlights the importance of a specific meta-cognitive skill (self-reflection on one’s initial stressor response) as a mechanism for strengthening resilience. The Systematic Self-Reflection model uniquely proposes five self-reflective practices critical in the on-going adaptation of three resilient capacities: (1) coping resources, (2) usage of coping and emotional regulatory repertoire, and (3) resilient beliefs. The self-reflective process is proposed to strengthen a person’s resilience by developing insight into their already-present capacities, the limitations of these capacities, and by stimulating the search for person-driven alternative approaches.

Conclusion: This model extends the existing scholarship by proposing how the experience of stressors and adversity may have resilience-strengthening opportunities. The implication of this model is that engaging with stressors can have positive consequences for longer-term healthy emotional development if scaffolded in adaptive reflective practices.     

No pain,no gain: cross-lagged analyses of posttraumatic growth and anxiety,depression, posttraumatic stress and prolonged grief symptoms after loss

Background and objectives: Major negative life-events including bereavement can precipitate perceived positive life-changes, termed posttraumatic growth (PTG). While traditionally considered an adaptive phenomenon, it has been suggested that PTG represents a maladaptive coping response similar to cognitive avoidance. To clarify the function of PTG, it is crucial to establish concurrent and longitudinal associations of PTG with post-event mental health problems. Yet, longitudinal studies on this topic are scarce. The present study fills this gap in knowledge.

Design: A two-wave longitudinal survey was conducted.

Methods: Four-hundred and twelve bereaved adults (87.6% women) filled out scales assessing PTG and symptoms of depression, anxiety, prolonged grief, and posttraumatic stress at baseline and 6 months later.

Results: The baseline concurrent relationships between all symptom levels and PTG were curvilinear (inverted U-shape). Cross-lagged analyses demonstrated that symptom levels did not predict levels of PTG 6 months later, or vice versa.

Conclusions: Findings suggest PTG after loss has no substantive negative or positive effects on mental health. Development of specific treatments to increase PTG after bereavement therefore appears premature.     

Moderating effects of the valence of social interaction on the dysfunctional consequences of perseverative cognition: an ecological study in major depression and social anxiety disorder

Background and Objectives: Major depression disorder (MDD) and social anxiety disorder (SAD) are characterized by the use of perseverative cognition (PC) as a dysfunctional coping strategy. We sought to investigate the dysfunctional physiological and psychological consequences of PC and how the valence of social interactions moderates such consequences in these psychopathological conditions.

Design/Methods: The study combined 24-hour heart rate variability (HRV) and ecological momentary assessments in 48 individuals with MDD, SAD, and sex-matched controls.

Results: In all participants, PC was associated with mood worsening and reduced ability of the parasympathetic nervous system, mainly the vagus, to inhibit sympathetic arousal (i.e., reduced HRV). Individuals with SAD had the highest frequency of daily PC, while those with MDD reported that PC interfered more with their ongoing activities. In SAD, daily PC was associated with significantly lower HRV after negative social interactions. Individuals with MDD reported higher levels of sadness during PC irrespective of the valence of the preceding social interaction but higher levels of anxiety and efforts to inhibit PC following positive interactions.

Conclusions: Results highlight the need to account for important moderators like the valence of social interaction when looking at the physiological consequences of maladaptive emotion regulation strategies.     

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.     

Living with painful diabetic neuropathy: insights from focus groups into fears and coping strategies

Objective: Painful diabetic neuropathy (PDN) is known to negatively affect quality of life. Being physically active is a crucial part of successful diabetes self-management, but regimen adherence is often low. Coping strategies and fears have shown to be related to less physical activity (PA). The aim of the present study was to obtain more in-depth information on psychological risk factors leading to less PA in persons with PDN.

Design: Three semi-structured focus group interviews were conducted with a representative sample of persons with PDN (N?=?12). Data were transcribed verbatim and analysed using a hybrid method of thematic analyses and a grounded theory approach.

Main Outcome Measures: Fears and coping strategies related to PA in persons with PDN.

Results: Several specific fears were identified; fear of hypoglycaemia, fear of pain increase, fear of total exhaustion, fear of physical injury, fear of falling, fear of loss of identity, and fear of negative evaluation by others. To cope with these fears, avoidance, remaining active, cognitive distraction, and acceptance strategies were described.

Conclusion: In persons with PDN, diabetes-related fears and pain-related fears play a role in less engagement in PA, indicating the need for new methods for improving self-management in persons with PDN.     

Are self-perceptions of ageing modifiable? Examination of an exercise programme with vs. without a self-perceptions of ageing-intervention for older adults

Objective: Longitudinal studies have consistently shown beneficial effects of positive self-perceptions of ageing (SPA) on health. However, SPA are more often negative than positive, particularly in older adults. For this reason, the present study tested the effectiveness of an intervention to promote more positive SPA in the context of an exercise programme for older adults.

Design: Eighty-four community-dwelling older adults (66-88 years; M(SD)=76.8(5.29)) were randomly assigned to a group-based exercise programme over 12 weeks with (n?=?46) or without (n?=?38) a psychological intervention to change SPA, consisting of four intervention units over the programme period.

Main Outcome Measures: A gain- and a loss-related domain of SPA were assessed at baseline, after the first half of the programme, directly after the programme and in a follow-up four weeks later.

Results: Latent change score models showed an improvement of participants’ SPA in the intervention group in both SPA domains after the programme, whereas SPA did not change in the control group. Both groups showed an improvement in physical performance, however, only the IG showed additional improvements in mental health.

Conclusion: The implementation of an SPA intervention is a promising approach in regular health promotion programmes for older adults.     

Optimising daily diary questionnaires about fatigue,psychological flexibility and well-being: perspectives of people with rheumatic disease

Objectives: The aim of this study was to understand the perspectives of people with rheumatic disease have about completing a pilot daily diary questionnaire on fatigue and well-being, with the objective of incorporating these perspectives into future daily studies.

Methods: Twenty-two participants with experience of rheumatic disease-related fatigue attended a focus group and/or an individual interview. Before the focus group or interview, participants completed a one-off quantitative diary about their fatigue and well-being that day. In the focus groups and interviews, participants were asked about their experience completing the questionnaire. Data were analysed using inductive thematic analysis.

Results: Three themes were identified. ‘Concerns about Misinterpretation and Ambiguity’ addressed the elements of the diary questionnaire that were confusing or unclear to participants. ‘Desire to Provide Useful and Accurate Information’ outlined participants’ uncertainty about how to report complex daily experiences. ‘Gaining Personal Insight through Diaries’ revealed the personal benefits participants gained, particularly the development of insight into their fatigue.

Conclusions: People with rheumatic disease are willing to complete a daily diary questionnaire, but emphasise it is important for diary questionnaires to have clear instructions, questionnaire items and response scales. Addressing these concerns will ensure the reliability and validity of quantitative diary data.     

Tortoise or hare? Supporting the chronotope preference of employees with fluctuating chronic illness symptoms

Objective: Our aim is to understand how to facilitate the job retention of employees with chronic illness. We focus on multiple sclerosis (MS) as a criterion chronic illness.

Design: An opportunity sample of 20 individuals of working age (13 female; 7 male) were recruited who had been in paid employment for over 28 months with a concurrent diagnosis of MS. Participants took part in one of three focus groups with a topic guide comprising keywords: work, coping, performance, support, future, expectations, sharing and symptoms. Data were analysed using dialogical analysis.

Main outcome measures: As a qualitative study, no outcome measure was used. However, the specific focus of interest was to search for differential patterns of ‘timespace’ – chronotope – that people with chronic illness utilise to manage their condition in the workplace.

Results: Participants oriented to two distinct chronotope types: unsustainable epic (characterised by condensed time) and temporary idyll (characterized by condensed space). Perceived managerial discretion was identified as possibly influencing participants’ chronotope preference.

Conclusion: Identifying chronotope preference has practical implications for health psychologists and related professionals who provide and advise on support to facilitate people with chronic illness to thrive in the workplace.     

‘I think a little bit of a kick is sometimes what you need’: Women’s accounts of whole-body scanning and likely impact on health-related behaviours

Objective: This study was designed to investigate whether whole-body scanning might promote healthy eating and physical activity in women, and to explore the effects of scanning on body image.

Design: Fourteen women aged 22–45 years without histories of eating disorders or whole-body scanning took part in semi-structured interviews before and after scanning. Data were analysed using inductive thematic analysis.

Results: Scans did not look as expected, and participants expressed ‘surprise’ and ‘shock’. Participants focused on perceived negative aspects of their bodies as revealed in scan images, and agreed that women with body concerns would find scans too ‘real’ and ‘raw’. Eleven women who met UK Government physical activity and healthy eating guidelines reported that the scan provided additional motivation to maintain, and in nine cases to increase, those behaviours. Two women who neither exercised nor ate healthily would not increase physical activity or change their diets significantly following scanning.

Conclusion: Whole-body scanning may enable maintenance or even acceleration of physical activity and healthy eating, but is unlikely to be useful in promoting initiation of these behaviours. Participants engaged in unhelpful body critique when viewing scans; scanning needs to be confined to contexts where support is provided, to avoid increasing body-related concerns.