Prospective associations between changes in mental health symptoms and health-related quality of life in veterans seeking posttraumatic stress disorder residential treatment

Background and Objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatment program for PTSD in the Veterans Health Administration. Methods: Patients completed the veteran-specific, 12-item Medical Outcomes Study Short Form, PTSD Checklist – Military version, and Beck Depression Inventory at pre-treatment, discharge, and a four-month follow-up. When accounting for demographic factors, combat exposure, and baseline scores on the respective outcome variables (e.g. mental health, physical health, PTSD, and depressive symptoms), a series of multivariate analyses were conducted for treatment-related changes in mental and physical health on the outcome measures. Results: Reductions in PTSD symptomatology during the treatment period were prospectively linked with better health-related outcomes at the four-month follow-up. In addition, improved physical health and psychological well-being during treatment were each similarly associated with better PTSD and depression outcomes in the months following treatment. Conclusions: Addressing concerns in mental and physical health might have synergistic effects across both domains, supporting the need for holistic models and integrated health care strategies for treating veterans with PTSD.     

Dimensions of Religiousness and Spirituality as Predictors of Well-Being in Advanced Chronic Heart Failure Patients

We examined relationships between seven dimensions of religion/spirituality (RS) (forgiveness, daily spiritual experiences, belief in afterlife, religious identity, religious support, public practices, and positive RS coping) and three dimensions of well-being (physical, mental, and existential) in a sample of 111 patients with advanced chronic heart failure. Participants completed questionnaires at baseline and 3 months later. Results showed that fairly high levels of RS were reported on all seven dimensions. Furthermore, RS dimensions were differentially related to well-being. No aspect of RS was related to physical well-being, and only a few aspects were related to mental well-being. Forgiveness was related to less subsequent depression, while belief in afterlife was related to poorer mental health. All aspects of RS were related to at least one aspect of existential well-being. In particularly, daily spiritual experiences were linked with higher existential well-being and predicted less subsequent spiritual strain. These results are consistent with the view that in advanced disease, RS may not affect physical well-being but may have potent influences on other aspects of well-being, particularly existential aspects.     

Workplace Deviance as a Possible “Maladaptive Coping” Behavior Displayed in Association with Workplace Stressors

ABSTRACT

The Threat Appraisal and Coping Theory suggests that in response to environmental stressors, individuals sometimes display “maladaptive coping” behaviors that may vent frustration immediately but worsen later psychosocial well-being. For example, employees exposed to workplace stressors may vent their frustration with workplace deviance including intentional poor performance, abuse of organizational resources, disrespect, and disruption of co-workers, but such workplace deviance may worsen their later psychological well-being. The present study examined workplace deviance as a possible “maladaptive coping” behavior displayed by 293 university employees (74.7% female; 90.4% White; mean age = 45.8 years; 43 administrators, 127 staff, 84 faculty). When three workplace stressors (high demand, low control, low support) were compared for their association with workplace deviance, only low support was significant. Furthermore, workplace deviance was significantly associated with negative psychosocial outcomes [poor self-esteem, health concerns, anger, post-traumatic stress disorder (PTSD) symptoms, poor job satisfaction, work-home conflict]. Finally, bootstrapping mediational analysis revealed that workplace deviance was a significant mediator between low support and each of the negative psychosocial outcomes. Results support the idea that workplace deviance is an example of “maladaptive coping” behavior that, when displayed in response to perceptions of low support from supervisors and co-workers, is associated with worse psychosocial outcomes for employees who display it. Stress reduction programs could educate employees that displaying workplace deviance in response to workplace stressors may harm their psychosocial well-being. Such programs could also guide employees to more “adaptive coping” behaviors in response to workplace stressors (such as seeking social support, exercise, and yoga).     

Forgiveness and Health: Age Differences in a U.S. Probability Sample

Forgiveness is a variable closely related to religiousness and spirituality that has been hypothesized to be protective of mental and physical health. However, we do not clearly understand which aspects of forgiveness are most clearly associated with health outcomes, and the conditions under which these relationships occur. This study used national probability data to systematically examine age differences in the association between forgiveness, religiousness/ spirituality, and respondent reports of mental and physical health. Results showed age differences in the levels of forgiveness of others and feeling forgiven by God. In both cases, middle and old age adults showed higher levels of these forms of forgiveness than young adults. Furthermore, the relationship between forgiveness of others and respondent reports of mental and physical health varies by age. Forgiveness of others was more strongly related to self-reported mental and physical health for middle and old age adults than for young adults.     

Exploring well-being among US Hispanics/Latinos in a church-based institution: a qualitative study

Major theories informing conceptions of psychological well-being draw heavily from Western-centric perspectives, which often neglect culturally bound frameworks. We investigated how US Hispanics/Latinos conceptualize well-being, how psychosocial and behavioral aspects may increase well-being, and how psychosocial stressors may impact positive emotional states. Spanish-speaking Hispanic/Latino adults were recruited from a church in an urban city in the US and invited to participate in focus groups. Two groups of women (n = 19) and one group of men (n = 8) participated. The importance of harmonious social relationships emerged as a theme with the central family unit as the fundamental force influencing long-lasting emotional well-being. Additional correlates of well-being included: faith/religiosity; physical health; self-love and -esteem; effective/open communication with family and friends; and financial security. Programs aimed at increasing well-being may need to be adapted before administration in Hispanics/Latinos to include a heightened focus on interpersonal factors. Delivery in religious institutions may also be particularly beneficial.     

Application of the APA ethics code for psychologists working in integrated care settings: Potential conflicts and resolutions

ABSTRACT

Increasingly, there is evidence of the potential benefits of an integrated care model. In fact, the American Psychological Association (APA) supports the role of psychologists in integrated healthcare given the positive outcomes for patients in primary care settings such as increased access to mental health services, reduced mental illness stigma, and improved health associated with recognizing the impact of psychosocial factors on physical wellbeing. Less attention has been paid, however, to ethical dilemmas that may arise for psychologists working in integrated healthcare. This paper explores considerations for resolving potential ethical conflicts that may arise for psychologists working in integrated care settings.     

The Future of Psychology in Family Medicine

Psychology has been integral to the field of family medicine since its inception as a medical specialty in the 1960s. Psychologists and other behavioral scientists contribute to family medicine in teaching clinical skills, in defining research questions, in developing research methodology, and in creating integrated physical/mental health care delivery systems. Future developments in the field of psychology in family medicine are likely to emphasize development and evaluation of screening measures which identify mental health problems in primary care, development of early intervention for those mental health problems, and more precise measurement of process and quality of care and health outcomes. Psychologists have an important role to fulfill in educating physicians on alternatives to pharmacologic and medical interventions for common presenting problems in primary care. However, current economic forces shaping the practice of medicine may work against further enhancing the efficacy of the physician in dealing with psychosocial issues. The future role of psychology in family medicine is not yet delineated, and while the move toward parity of reimbursement for mental and physical health care delivery may enhance this collaboration, there is a need to continue to evaluate how the psychological well-being of patients is influenced in the evolution of new models of care delivery.     

Positive and negative affectivity,stress, and well-being in African-Americans: Initial demonstration of a polynomial regression and response surface methodology approach

Objective: The extent to which positive (PA) and negative (NA) affect conjointly impact well-being is not yet well understood. Additionally, research investigating the role of affectivity in maintaining well-being among ethnic and racial minorities is scant. The current research demonstrates how polynomial regression and response surface methodology (PR and RSM) may be used to better understand how PA and NA jointly influence stress and well-being.

Design: In Study 1, 291 African-American undergraduates (M_age = 22.91, SD = 6.91; 67% female) completed measures of affectivity and psychological well-being. In Study 2, a community sample of 117 African-Americans (M_age = 31.87, SD = 13.83; 69% female) completed affectivity measures and a laboratory-based social stressor task to assess links between affectivity and salivary cortisol reactivity.

Main outcome measures: Study 1 included life satisfaction, perceived stress and self-reported depressive symptoms. Study 2 included salivary cortisol reactivity.

Results: Across both studies, PA ascendency (i.e. high PA combined with low NA) was associated with better well-being, while NA ascendancy (i.e. high NA combined with low PA) was associated with poorer outcomes.

Conclusion: PR and RSM may provide new insight into the conjoint influence of PA and NA on health and well-being. We discuss potential implications for affectivity research, including race-related explorations.     

Beyond emotional benefits: Physical activity and sedentary behaviour affect psychosocial resources through emotions

Physical activity is known to improve emotional experiences, and positive emotions have been shown to lead to important life outcomes, including the development of psychosocial resources. In contrast, time spent sedentary may negatively impact emotional experiences and, consequently, erode psychosocial resources. Two studies tested whether activity independently influenced emotions and psychosocial resources, and whether activity indirectly influenced psychosocial resources through emotional experiences. Using cross-sectional (Study 1a) and longitudinal (Study 1b) methods, we found that time spent physically active independently predicted emotions and psychosocial resources. Mediation analyses suggested that emotions may account for the relation between activity and psychosocial resources. The improved emotional experiences associated with physical activity may help individuals build psychosocial resources known to improve mental health. Study 1a provided first indicators to suggest that, in contrast, sedentary behaviour may reduce positive emotions, which could in turn lead to decrements in psychosocial resources.     

How professional pilots perceive interactions of working conditions,rosters, stress,sleep problems,fatigue and mental health. A qualitative content analysis

IntroductionSo far, no qualitative content analysis (QCA) has analysed pilots’ experiences and perceptions regarding weaknesses of fatigue risk management (FRM), flight time limitations (FTL), rosters, fatigue-severity, sleep problems, and how they relate to pilots’ mental health and well-being.ObjectiveThis research analyses pilots’ described perceptions of stress, fatigue, aviation safety and how regulations like FTL can affect their health and well-being.MethodIn total, 119 international pilots described their perceptions of FTL, rosters, aviation safety, and how they relate to fatigue and health. The QCA was conducted to analyse interactions of working conditions, stressors, fatigue, sleep problems and mental health of EASA-based and Australian pilots.ResultsAlthough pilots were rostered for only 60.8% to 62.5% of the legally allowed duty and flight hours/month, 78.6% reported severe or very high fatigue, 22.8% significant depression, 12.3% significant anxiety symptoms, 10.5% reported significant depression and anxiety symptoms. Pilots uttered severe concerns about FTL, sleep restrictions associated with early starts, minimum rest, etc. Pilots also expressed distinct fears regarding more fatigue-related crashes, and how adverse working conditions, work-related and psychosocial stress could impair their health.ConclusionsThis QCA provided valuable insights into interactions of working conditions, fatigue, sleep restrictions, physical and mental health. Progressive health impairment due to lack of sleep and accumulated fatigue promote burnout, mental and physical health problems, which not only threaten flight safety, but also sustainability of aviation.     

宽恕心理的行为测量及认知神经机制

宽恕是一个复杂的心理过程,被认为是对冒犯者的亲社会化转变的过程,包括认知、情绪、动机和行为上的改变。本文回顾了国内外宽恕心理的行为测量范式和认知神经机制研究相关的成果,发现宽恕心理的行为测量范式能够揭示宽恕相关的心理过程;认知神经机制的研究发现宽恕心理过程主要涉及负责社会认知、共情和认知控制等功能的脑区。未来的研究应关注宽恕心理行为测量范式的有效性和揭示内容的一致性、宽恕心理的认知和脑神经基础。     

Lifespan Differences in a Self Determination Theory Model of Eudaimonia: A Cross-Sectional Survey of Younger,Middle-Aged,and Older Adults

Despite the myriad physical, cognitive, and social losses that are increasingly common as we age, a growing body of evidence suggests that aging is positively associated with mental health and well-being. The majority of this evidence is in the form of mental health, personality, and subjective/hedonic well-being outcomes; far less is known about lifespan differences in eudaimonic well-being. The objective of this study was to examine differences across three age groups in a relatively recent model of eudaimonia informed by self-determination theory that focuses on the process of living well, but also acknowledges outcomes of that process. In comparison to young (n = 66) and middle-aged adults (n = 66), older adults (n = 66) were especially likely to be living eudaimonically (i.e., to have intrinsic aspirations, goal autonomy, mindfulness, and basic psychological need fulfillment). The effect of age on well-being outcomes was mixed; the oldest group reported the highest levels of life satisfaction (hedonic well-being) but the lowest levels of purpose and growth (eudaimonic well-being) in comparison to their younger counterparts. As predicted by the model, basic psychological need fulfillment mediated the relationship between motivational constructs and well-being outcomes. Furthermore, the model applied equally well to younger, middle-aged, and older adults. Our results are consistent with recent theoretical models emphasizing the socioemotional benefits of aging, as well as potential challenges to well-being that exist in later life.     

Forgiveness and mental health variables: Interpreting the relationship using an adaptational-continuum model of personality and coping

The present paper uses an adaptational-continuum model of personality, based on Ferguson’s (2001) health psychology model integrating Eysenck personality factors and coping style, to provide a context for examining the relationship between forgiveness and mental health. Three hundred and twenty respondents completed measures of personality, coping style, forgiveness (forgiveness of self, others, likelihood, presence of positive forgiveness, absence of negative forgiveness), general health, stress, positive and negative affect and life satisfaction. Among respondents, all measures of forgiveness, bar one, load negatively on a neuroticism-coping factor. The remaining measure of forgiveness (presence of positive forgiveness) loaded on an extraversion-coping factor. The relationship of the neuroticism-coping-forgiveness factor was associated with poorer mental health, suggesting forgiveness is associated with better mental health within the context of this personality-coping factor. Significant positive relationships were found between the extraversion-coping-forgiveness factor and two measures of positive mental health outcomes (positive affect and life satisfaction) suggesting forgiveness is associated with some aspects of mental health within the context of this personality-coping factor. The present findings suggest that forgiveness, or failure to forgive, can be conceptualised within an adaptational-continuum model of personality.     

Gratitude,Psychopathology and Subjective Well-Being: Results from a 7.5-Month Prospective General Population Study

Gratitude is considered an important source of human strength in achieving and maintaining good mental health. Although complete mental health encompasses the absence of psychopathology and the presence of subjective well-being, no studies to date have examined relations between gratitude and both mental health dimensions together. Moreover, most studies focused on specific samples with a restricted demographic range. Our study, therefore, examined (a) demographic variability in the grateful trait, and (b) prospective associations between gratitude and both dimensions of mental health: psychopathology and subjective well-being. Using a four wave prospective survey design in a large (N = 706) sample of Dutch adults (M age = 44, SD age = 14, Range = 18–80), we measured gratitude with the SGRAT, symptoms of psychopathology with the SCL-90, and subjective well-being with the PANAS and SWLS. Gratitude was significantly associated with age, gender, education level, and employment status. Multilevel time-lagged regression analyses showed that the grateful trait did not predict symptoms of psychopathology, but was a significant albeit weak predictor of subjective well-being, when adjusting for the effects of demographic factors, and prior levels of subjective well-being and psychopathology. Our findings indicate that the grateful trait is associated with demographic factors, and shows complex connections with the presence of well-being and absence of psychopathology. These dynamics should be taken into consideration when studying the role of gratitude in mental health, and developing, applying, and evaluating gratitude interventions with the aim of enhancing subjective well-being and/or reducing psychopathology.     

The relative importance of psychological acceptance and emotional intelligence to workplace well-being

Psychological acceptance (acceptance) and emotional intelligence (EI) are two relatively new individual characteristics that are hypothesised to affect well-being and performance at work. This study compares both of them, in terms of their ability to predict various well-being outcomes (i.e. general mental health, physical well-being, and job satisfaction). In making this comparison, the effects of job control are accounted for; this is a work organisation variable that is consistently associated with occupational health and performance. Results from 290 United Kingdom workers showed that EI did not significantly predict any of the well-being outcomes, after accounting for acceptance and job control. Acceptance predicted general mental health and physical well-being but not job satisfaction, and job control was associated with job satisfaction only. Discussion focuses on the theoretical and applied implications of these findings. These include support for the suggestion that not controlling one's thoughts and feelings (as advocated by acceptance) may have greater benefits for mental well-being than attempting consciously to regulate them (as EI suggests).     

Dorian Gray without his portrait: Psychological,social, and physical health costs associated with the Dark Triad

We examined how the Dark Triad (i.e., narcissism, psychopathy, and Machiavellianism) traits—as different social strategies—were associated with various health outcomes. In samples of American undergraduates (N = 1389), Australian high school students (N = 2023), and British undergraduates (N = 280), we examined the physical, social, and psychological costs associated with the Dark Triad traits. Narcissism was linked to few mental and physical ailments, suggesting it may provide a social buffer from negative health outcomes (Studies 1 and 2). Psychopathy (Studies 1 and 2) and Machiavellianism (Study 2) were linked to a number of psychological and physical health conditions. In addition, psychopathy was related to diminished life expectancy, whereas narcissism was related to enhanced life expectancy (Study 3). Our findings provide evidence that each of these personality traits is linked to various psychosocial tradeoffs and different methods of coping with stress and adaptive problems.     

Physical and mental health trajectories of cancer patients and caregivers across the year post-diagnosis: a dyadic investigation

Objective: Evidence suggests interdependence between cancer patients’ and their caregivers’ physical and mental health. However, the extent to which caregivers’ health relates to their patients’ recovery, or patients’ health affects their caregivers’ outcomes, is largely unknown. This dyadic investigation reports the relations between cancer patients’ and their caregivers’ physical and mental health trajectories during the year following diagnosis.

Design: Ninety-two colorectal cancer patient–caregiver dyads completed questionnaires at 2, 6 and 12 months post-diagnosis.

Outcome measures: Self-reported physical and mental health using the Medical Outcomes Study Short Form Health Survey-12.

Results: Patients reported improved physical health over the year following their diagnosis, whereas caregivers reported declining physical health. Patients with lower mental health at diagnosis had stagnated physical health recovery. Caregivers’ physical health declined most noticeably among those reporting low mental health at diagnosis and whose patients reported low physical health at diagnosis.

Conclusion: Findings suggest targeting health interventions to cancer patients and caregivers reporting poor mental health at diagnosis may mitigate their long-term physical morbidity. Limited evidence of dyadic interdependence between patients’ and caregivers’ physical and mental health trajectories suggests future studies are warranted to identify psychosocial and medical characteristics moderating the relations between patients’ and caregivers’ health.     

A comparison of health disparities among transgender adults in Colorado (USA) by race and income

Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) Are transgender people of color more likely than White transgender individuals to experience poor health outcomes? and (b) Is lower annual household income among transgender adults associated with poorer health outcomes? The study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the western United States using multiple linear regression and logistic regression models. Results showed that transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or asthma but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research.     

Midlife Women’s Physical Activity Goals: Sociocultural Influences and Effects on Behavioral Regulation

A better understanding of midlife women’s exercise goals could offer insight into the psychosocial facilitators and barriers to their participation. A random sample of US working women (40–60 years) was taken, and resulted in 262 participants. Cluster analysis identified participants’ most important physical activity goal. A five goal cluster solution was identified: (1) sense of well-being; (2) weight loss; (3) health benefits; (4) stress reduction; and (5) weight maintenance/toning. The goal cluster solution was validated and suggested relevant sociocultural influences and potential effects on behavioral regulation (p?<?.05). Data showed that weight- and health-related goals have sociocultural influences and are associated with more extrinsic and less intrinsic behavioral regulation compared to stress reduction and sense of well-being goals.