How positive emotions build physical health: perceived positive social connections account for the upward spiral between positive emotions and vagal tone

Effects of the use of autobiographical photographs on emotional induction in older adults: a systematic review

There is evidence to support the positive contribution of autobiographical recall based techniques on individuals' quality of life, mood and cognitive functioning. In this review, we analyzed the effects of the use of personal photographs in interventions based on autobiographical memory in older people with and without cognitive impairment. The PRISMA guidelines for systematic reviews were followed. The search was carried out in the electronic databases Web of Sciences (WOS), Medline (PubMed), SCIELO and PsycInfo (American Psychological Association). The articles based on clinical trials selected were evaluated using the PEDRo scale, which is specific to this type of article. Of the 1098 articles initially found, 6 met the inclusion criteria. The final articles focused their intervention on the use of autobiographical photographs as a means of stimulation. The results show that the use of photographs in different autobiographical recall stimulation techniques is associated with higher scores on well-being and quality of life, as well as with improvements in personal identity and cognitive functioning. This suggests that using personal photographs shows promise in enhancing the effect of these types of interventions in healthy or cognitively impaired older adults.

The Relationship Between Loneliness and Positive Affect in Older Adults

OBJECTIVE

To establish whether positive affect (PA) is uniquely associated with loneliness and other social functioning variables beyond negative affect (NA) among older adults.

METHODS

Four hundred and twenty-eight participants (aged 60+ years old, 82% White, and 48% female) were recruited using random digit-dialing and completed scales for loneliness (UCLA Loneliness Scale), companionship (PROMIS scale), satisfaction with discretionary social activities (PROMIS scale), PA (Center for Epidemiologic Studies [CES] Happiness Scale), and NA (CES-Depression scale and Brief Symptom Inventory-Anxiety Subscale).

RESULTS

Multiple linear regression models found PA to be a significant predictor of lower loneliness where the effect of PA on loneliness is dependent on the level of NA; a large effect size at the mean level of NA, which becomes attenuated when NA increases. Although the direction of effect of PA on loneliness will change for NA > 5.10, which is 5 standard deviations away from 0, based on the model estimates, the percent of subjects with this large NA levels is practically 0. Thus, higher PA is associated with lower loneliness, however this effect is attenuated for larger NA. Similarly, multiple linear regression models found that companionship was associated with PA and NA where the effect of PA is dependent on the level of NA; a medium effect size at the mean level of NA, which becomes attenuated when NA increases. As in the case of loneliness, the direction of effect of PA on companionship will change for NA > 3.52, which is 3.5 standard deviation away from 0, based on the model estimates, but the percent of subjects with this large NA levels is practically 0. Thus, higher PA is associated with increased companionship, aand this effect is attenuated with greater NA. Satisfaction with social activities was associated with PA only (medium effect size).

CONCLUSION

Results suggest PA appears to be uniquely associated with social functioning among older adults. These findings support the potential for treatments that target PA to decrease loneliness among older adults, or vice versa.

Emotional Wellbeing in Adolescents Living With Chronic Conditions: A Metasynthesis of the Qualitative Literature

Adolescents living with chronic conditions (ALWCCs) are at a higher risk of suicide (odds ratio: 4.3) than their peers. No consensus exists in the scientific community on a definition or conceptual elements of emotional well-being in this vulnerable population, hindering informed interventional research. This study investigated the meaning of emotional well-being in ALWCCs. A systematic metasynthesis of the qualitative literature was performed and structured using ENTREQ guidelines for reporting qualitative metasynthesis. A final sample of 11 primary qualitative studies met inclusion criteria and was critically analyzed using a team-based thematic synthesis and reciprocal translation approach. The meaning of emotional well-being in ALWCCs is having positive relationships that ease loss, foster hope and resilience, and promote self-efficacy and self-actualization. The role of healthcare providers as a safe, stable nurturing relationship which promotes hope and positive body image emerges an area for future research. Spirituality as it relates to emotional well-being in this population is scarce in the qualitative literature and should be further explored.

The effect of loving-kindness meditation on employees’ mindfulness, affect, altruism and knowledge hiding

Background

This study investigated the effects of the loving-kindness meditation (LKM) on employees’ mindfulness, affect, altruism and knowledge hiding.

Methods

In total, 100 employees were recruited from a knowledge-based enterprise in China and randomly divided into the LKM training group (n = 50) and the control group (n = 50). The LKM training group underwent LKM training for 8 weeks, while the control group did not. Seven main variables (mindfulness, altruism positive affect, negative affect, playing dumb, rationalized hiding, and evasive hiding) were measured both before (pre-test) and after (post-test) the LKM training intervention.

Results

The LKM intervention significantly increased participants’ altruism, and significantly reduced negative affect, playing dumb and evasive hiding, but did not significantly improve mindfulness, positive affect, and rationalized hiding.

Conclusions

LKM significantly improved employees’ altruism, and significantly reduce their negative affect, but did not significantly improve their mindfulness and positive affect. For knowledge hiding, LKM significantly reduced playing dumb and evasive hiding, but had no significant effect on rationalized hiding. These results further elucidate the psychological effects of LKM and suggest the possibility of reducing knowledge hiding in the workplace.

Trial registration

ChiCTR2200057460. Registered in Chinese Clinical Trial Registry (ChiCTR), 13 March 2022—Retrospectively registered.

Neural network involvement for religious experiences in worship measured by EEG microstate analysis

To date, not much is known about large-scale brain activation patterns in religious states of mind and previous studies have not set an emphasis on experience. The present study investigated the phenomenon of religious experiences through microstate analysis, and it was the first neurocognitive research to tackle the dimension of experience directly. Hence, a total of 60 evangelical Christians participated in an experiment where they were asked to engage in worship and try to connect with God. With a bar slider, people were able to continuously rate how strongly they sensed God's presence at any given moment. A selection of songs was used to help in the induction of the desired experience. With 64 electroencephalography (EEG) electrodes, the brain activity was assessed and analyzed with five clusters of microstate classes. First, we hypothesized that the neural network for multisensory integration was involved in the religious experience. Second, we hypothesized that the same was true for the Default Mode Network (DMN). Our results suggested an association between the auditory network and the religious experience, and an association with the salience network as well as with the DMN. No associations with the network thought to be involved with multisensory integration was detected.

Associations between burnout symptoms and social behaviour: exploring the role of acute stress and vagal function

BACKGROUND

The study aimed to investigate the link between burnout symptoms and prosocial behaviour, as well as the role of acute stress and vagally-mediated heart rate variability (vmHRV) on this association.

METHODS

Seventy men were randomly assigned to either the stress or the control condition of the Trier Social Stress Test for Groups (TSST-G). Prosocial behaviour was assessed via a social decision-making paradigm during the respective TSST-G condition.

RESULTS

Correlation analyses revealed negative correlations between prosocial behaviour and burnout symptoms. Acute stress was also associated with reduced prosocial behaviour, whereas no interaction effects with burnout symptoms could be revealed. Exploratory analyses showed that vmHRV was negatively correlated with burnout symptoms during the social decision-making paradigm but did not mediate the link between burnout and prosocial behaviour.

CONCLUSION

In conclusion, we report first experimental evidence that burnout symptoms are negatively associated with prosocial behaviour. Further studies are needed to explore the causal relations.

Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore

INTRODUCTION

The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services.

METHODS

A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19.

RESULTS

A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19.

CONCLUSION

These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.

Coping With Uncertainty: Use of Contemplative Practices Amid the COVID-19 Pandemic in the United States

Scant research has attempted to understand the use and frequency of contemplative practices across social groups of older adults in the context of uniquely uncertain and stressful circumstances, such as the COVID-19 pandemic. Using data from a nationwide web-based survey (n = 1861), we examined the change in the frequency of contemplative practices and variation across sociodemographic, health, and psychological status and we documented a significant increase in the use of prayer and meditation since the beginning of the pandemic. Minority groups and those with lower income reported praying longer than their counterparts. Respondents who were unmarried, women, and more educated were more likely to meditate, whereas lower-educated respondents were more likely to pray during the pandemic. Greater use of these practices was found among participants with higher anxiety. Our study offers much-needed guidance for future intervention studies to improve psychological well-being among diverse groups of older adults facing stressful circumstances.

Dissociating the role of dACC and dlPFC for emotion appraisal and mood regulation using cathodal tDCS

Several neuroimaging studies have shown that a distributed network of brain regions is involved in our ability to appraise the emotions we experience in daily life. In particular, scholars suggested that the dorsal anterior cingulate cortex (dACC) may play a role in the appraisal of emotional stimuli together with subcortical regions, especially when stimuli are negatively valenced, and the dorsolateral prefrontal cortex (dlPFC) may play a role in regulating emotions. However, proofs of the causal role of these regions are lacking. In the present study, we aim at testing this model by stimulating both the dACC and the left dlPFC via cathodal tDCS. Twenty-four participants were asked to attend and rate the arousal and valence of negative and neutral emotional stimuli (pictures and words) in three different experimental sessions: cathodal stimulation of dACC, left dlPFC, or sham. In addition to the experimental task, the baseline affective state was measured before and after the stimulation to further assess the effect of stimulation over the baseline affective state after the experimental session. Results showed that cathodal stimulation of dACC, but not the left dlPFC, was associated with reduced arousal ratings of emotional stimuli, both compared with the sham condition. Moreover, cathodal stimulation of left dlPFC decreased participant's positive affective state after the session. These findings suggest for the first time, a dissociation between the dACC and dlPFC, with the former more involved in emotion appraisal, and the latter more involved in mood modulation.

Self-Compassion and Its Association With Ruminative Tendencies and Vagally Mediated Heart Rate Variability in Recurrent Major Depression

Background

Recurrent Major Depressive Disorder (MDD) is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility (indexed by a higher vagally mediated heart rate variability; vmHRV) in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion would associate with (1) lower ruminative tendencies and (2) higher vmHRV in a sample of adults with recurrent MDD.

Methods

We included a sample of 63 patients (46 females) between 20 and 71 years old (M = 40.24, SD = 12.8) with a history of three or more depressive episodes. They filled out the Self-Compassion Scale (SCS), Beck Depression Inventory (BDI), and Rumination Rating Scale (RRS). ECG (used to derive vmHRV) was acquired while resting and the square root of the mean squared differences of successive RR interval values (RMSSD) was calculated as measure of vmHRV.

Results

As hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses.

Conclusion

The results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response (as indexed by higher vmHRV). Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies.

Predictors and potentiators of psychedelic-occasioned mystical experiences

Mystical experiences are often described as being among the most profound and meaningful events of a person’s life. Their occurrence, while a normal but uncommon phenomenon, is reliably occasioned by psychedelic substances under the appropriate conditions, although care is needed around the context of usage to help ensure safe and beneficial experiences. The occurrence of mystical experiences in psychedelic sessions is a key mediator of the sustained psychological benefits reported in both healthy and clinical populations. Certain factors including set and setting, drug dosage, trait absorption, drug type, intention and states of surrender and acceptance all predict or influence the occurrence of mystical experiences. Various additional factors may further contribute to the occurrence and intensity of mystical experiences and enhance their long-term benefits, including music, meditation and spiritual practices and nature-based settings. This review examines these factors and considers how they might be optimised to increase the chances of a mystical experience occurring, while also considering factors that are negatively associated with mystical experiences with suggestions on how these might be mitigated where applicable. Finally, potential future research avenues for furthering our knowledge of psychedelic mystical experiences and how their benefits might be enhanced is suggested. Maximising the potential for the occurrence of mystical experiences is an important aspect of the beneficial application of psychedelics.

Effect of Mindfulness Versus Loving-kindness Training on Leukocyte Gene Expression in Midlife Adults Raised in Low-Socioeconomic Status Households

Objectives

People raised in low socio-economic status (SES) households are at an increased risk for physical illness in adulthood. A shift in gene expression profiles in the immune system is one biological mechanism thought to account for elevated disease susceptibility, with a frequently-investigated profile being the conserved transcriptional response to adversity (CTRA), characterized by increased expression of proinflammatory genes and decreased expression of antiviral and antibody-related genes.

Methods

The present study investigated, in a sample of at-risk midlife adults (N = 88), whether those randomized to learn loving-kindness meditation (LKM) in a 6-week workshop, would show a reduction in CTRA gene expression, compared to those randomized to learn mindfulness meditation (MM). We assessed emotions daily and hypothesized positive emotions to account for the expected effect of LKM on gene expression.

Results

Results showed significant group differences from pre- to post-intervention, yet in the opposite direction as hypothesized: Participants randomized to the MM group showed significant declines in CTRA gene expression, whereas those in the LKM group showed significant increases in CTRA gene expression. Both groups showed increases over the 6 weeks in daily reports of positive emotions, b=.007, p <.001 alongside decreases in negative emotions b=-.005, p <.001. Thus, positive emotions were not pursued as a candidate mediator of observed group effects.

Conclusion

This study is the first to examine whether the biological impact of childhood low-SES can be reversed in mid-life through meditation interventions. Results suggest mindfulness meditation may be a viable option for improving health outcomes in this at-risk population. Trial Registration: ClinicalTrials.gov NCT02400593.

Seeing Is Believing: Making Wellbeing More Tangible

Positive Psychology has been instrumental in promoting wellbeing science in the modern era. However, there are still ways in which positive psychology interventions and positive education programmes can be improved to achieve more robust and sustained effects. One suggested method is to make wellbeing more salient and tangible through the use of objective tools that assess the relationship between psychological and physiological wellbeing, and enable wellbeing status and change to be seen. With the addition of an interdisciplinary team, as well as technology-enabled and pedagogically sound learning tools and approaches, the potential for positive outcomes and impact increases exponentially. Monitoring wellbeing progress in this way can provide evidence, motivation and belief in positive psychology and wellbeing interventions. This can lead to engaged learning, sustained benefits and systemic impact. Positive psychology needs to strategically extend on the emerging work in this field to help everyone, including policy makers, notice and value wellbeing.

The causal role of the bilateral ventrolateral prefrontal cortices on emotion regulation of social feedback

The ventrolateral prefrontal cortices (VLPFC) are crucial regions involved in voluntary emotion regulation. However, the lateralization of the VLPFC in downregulating negative emotions remains unclear; and whether the causal role of the VLPFC is generalizable to upregulating positive emotions is unexplored. This study used transcranial magnetic stimulation (TMS) to examine the causal relationship between the left/right VLPFC and social emotion reappraisal. One hundred and twenty participants were randomly assigned to either active (left and right VLPFC groups, n = 40/40) or sham (vertex, n = 40) TMS groups. Participants were instructed to passively receive social feedback or use reappraisal strategies to positively regulate their emotions. While the subjective emotional rating showed that the bilateral VLPFC facilitated the reappraisal success, the electrophysiological measure of the late positive potential (LPP) demonstrated a more critical role of the right VLPFC on social pain relief (decreased LPP amplitudes) and social reward magnification (enhanced LPP amplitudes). In addition, the influence of emotion regulation on social evaluation was found to be mediated by the memory of social feedback, indicating the importance of memory in social behavioral shaping. These findings suggest clinical protocols for the rehabilitation of emotion-regulatory function in patients with affective and social disorders.

Hope, fear, and consumer behavioral change amid COVID-19: Application of protection motivation theory

Using protection motivation theory (PMT), this study investigates the influence of cognitive assessment and affective response on customers' behavioral intention amid COVID-19 in the context of restaurants. More specifically, this research draws attention to (1) the influence of protection motivation (i.e., perceived vulnerability, perceived severity, maladaptive reward, response efficacy, self-efficacy, response cost) on hope and fear, (2) hope and fear as mediators between protection motivation and behavioral intention, and (3) diverse customer behavioral intentions that have emerged during the COVID-19 pandemic (i.e., health-focused behavior, conscious consumption, and the supporting of local businesses and products). A total of 473 completed responses were obtained through an online survey. Structural equation modeling (SEM) was employed to test the hypothesized relationships. The research model proposed in the study successfully explained the process in which individuals commit to hygienic behaviors, prioritize local restaurants, and engage in conscious consumption under the threat of COVID-19. The proposed model can be utilized in examining consumer behaviors in the hospitality industry, especially in the COVID-19 era.

Does perceived social mobility affect health? Evidence from a fixed effects approach

RATIONALE

The question as to whether changing one's socioeconomic position over the life course affects health has not been answered in a conclusive manner. At the same time, it has been established that individuals who think of themselves that they are higher in the social hierarchy are healthier than those who think otherwise.

OBJECTIVE

In this study, we focus on perceived social mobility to shed new light on the issue of how social mobility affects health. We examine whether perceived social mobility, i.e., an individual's appraisal of doing better or worse than their parents, affects health by analyzing longitudinal data from Poland.

METHODS

Using a fixed effects approach to account for all time-invariant and important time-varying confounders, we analyze the Polish Panel Survey which has been collecting data on participants' social mobility perceptions along with information on their self-reported physical health and psychological wellbeing.

RESULTS

We find that perceived social mobility is a significant predictor of self-reported physical health and psychological wellbeing, even in models that adjust for a host of theoretically relevant control variables. The results demonstrate that upward subjective mobility has a consistent and strong positive effect on health outcomes. The effect of perceived social mobility is stronger for males and for those with less advantageous social origins.

CONCLUSIONS

Our findings are in line with the "from rags to riches" theoretical perspective, emphasizing the positive implications of upward social mobility on health through various psychological mechanisms. Based on our findings, we call for greater scholarly attention to subjective aspects of social mobility in research on health outcomes.

ISIEA: An image database of social inclusion and exclusion in young Asian adults

Human beings have a fundamental need to belong. Evaluating and dealing with social exclusion and social inclusion events, which represent negative and positive social interactions, respectively, are closely linked to our physical and mental health. In addition to traditional paradigms that simulate scenarios of social interaction, images are utilized as effective visual stimuli for research on socio-emotional processing and regulation. Since the current mainstream emotional image database lacks social stimuli based on a specific social context, we introduced an open-access image database of social inclusion/exclusion in young Asian adults (ISIEA). This database contains a set of 164 images depicting social interaction scenarios under three categories of social contexts (social exclusion, social neutral, and social inclusion). All images were normatively rated on valence, arousal, inclusion score, and vicarious feeling by 150 participants in Study 1. We additionally examined the relationships between image ratings and the potential factors influencing ratings. The importance of facial expression and social context in the image rating of ISIEA was examined in Study 2. We believe that this database allows researchers to select appropriate materials for socially related studies and to flexibly conduct experimental control.

Caudate hyperactivation during the processing of happy faces in borderline personality disorder

BACKGROUND

Emotion dysfunction and anhedonia are main problems in borderline personality disorder (BPD). In the present functional magnetic resonance imaging (fMRI) study, we investigated neural activation during the processing of happy faces and its correlates with habitual emotion acceptance in patients with BPD.

METHODS

22 women with BPD and 26 female healthy controls watched movie clips of happy and neutral faces during fMRI without any instruction of emotion regulation. To associate neural activation with habitual emotion acceptance, we included individual scores of the Emotion Acceptance Questionnaire (EAQ) as a covariate in brain data analysis.

RESULTS

All participants showed amygdala, temporal and occipital activation during the processing of happy compared to neutral faces. Compared with healthy controls, patients with BPD showed significantly more activation within the bilateral caudate. We did not find significant correlations with emotion acceptance.

CONCLUSIONS

Our results indicate caudate hyperactivation in patients with BPD during the processing of happy faces. Although patients reported significantly less emotion acceptance of positive emotions, an association with neural activation was not detectable.

Good Theories in Need of Better Data: Combining Clinical and Social Psychological Approaches to Study the Mechanisms Linking Relationships and Health

The study of intimate relationships and health is a fast-growing discipline with numerous well-developed theories, many of which outline specific interpersonal behaviors and psychological pathways that may give rise to good or poor health. In this article, we argue that the study of relationships and health can move toward interrogating these mechanisms with greater precision and detail, but doing so will require a shift in the nature of commonly used research methods in this area. Accordingly, we draw heavily on the science of behavior change and discuss six key methodologies that may galvanize the mechanistic study of relationships and health: dismantling studies, factorial studies, experimental therapeutics, experimental mediation research, multiple assessments, and recursive modeling. We provide empirical examples for each strategy and outline new ways in which a given approach may be used to study the mechanisms linking intimate relationships and health. We conclude by discussing the key challenges and limitations for using these research strategies as well as novel ideas about how to integrate this work into existing paradigms within the field.

Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis-going beyond treat to target

This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures-according to individual need-designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.

Increasing Heart Rate Variability through Progressive Muscle Relaxation and Breathing: A 77-Day Pilot Study with Daily Ambulatory Assessment

The aim of this study was to examine whether it is possible to gradually increase heart rate variability (HRV) in healthy individuals (21 participants, M = 21.24 years, SD = 1.57, range 19 to 26) through regular exercises of average resonance frequency training (RFT; 6 breaths/min; 5 min each day) and progressive muscle relaxation (PMR; three times a week for 20 min). The effects were tested against an active control group using a linear mixed effect model with random slopes (day), random intercepts (participants) and an autoregressive error term. The special feature of this pilot study is that HRV was measured every day in an ambulatory assessment over 77 days, so that graduate long-term effects on HRV can be mapped. The results indicated that the PMR group significantly increased their HRV compared to the active control group. However, no effect was observed for the RFT group. Possible explanations for these results and important recommendations for subsequent studies are provided.

The role of the vagus nerve in fibromyalgia syndrome

Fibromyalgia (FM) syndrome is a common illness characterized by chronic widespread pain, sleep problems, fatigue, and cognitive difficulties. Dysfunctional neurotransmitter systems that influence the body's endogenous stress response systems are thought to underlie many of the major FM-related symptoms. A model of FM pathogenesis suggests biological and psychosocial variables interact to influence the genetic predisposition, but the precise mechanisms remain unclear. The Polyvagal Theory provides a theoretical framework from which to investigate potential biological mechanisms. The vagus nerve (VN) has anti-inflammatory properties via its afferent and efferent fibers. A low vagal tone (as assessed by low heart rate variability), has been observed in painful and inflammatory diseases, including FM, while the ventral branch of the VN is linked to emotional expression and social engagement. These anti-inflammatory and psychological (limbic system) properties of the VN may possess therapeutic potential in treating FM. This review paper summarizes the scientific literature regarding the potential role of the VN in transducing and/or therapeutically managing FM signs and symptoms.

Adaptability and Resilience in Aging Adults (ARIAA): protocol for a pilot and feasibility study in chronic low back pain

Background

Chronic low back pain (cLBP) is the leading cause of disability among older adults and one of the top reasons for seeking healthcare, resulting in significant decrements in physical functioning. Because older adults are among the fastest growing cohorts in the USA, both the incidence and burden of cLBP are expected to increase considerably, rendering geriatric pain management a top health priority. Resilience is defined as a process allowing individuals to adapt and recover from adverse and stressful conditions, and it has been highlighted as a crucial factor in positive health-related functioning. While a growing body of literature supports the use of resilience-based interventions in chronic pain, research examining their effectiveness in older adults with cLBP remains limited. The primary aims of the study are to assess the feasibility and acceptability of a psychologically oriented resilience intervention among aging adults with cLBP.

Methods

In this article, we describe the rationale and design of the Adaptability and Resilience in Aging Adults (ARIAA) study, a single-arm intervention in which 60 participants (ages ≥ 60 years) with cLBP will be recruited to participate in a 7-week group-based program aimed at enhancing psychological resilience. Intervention sessions will target positive psychology concepts (e.g., positive affect, pain acceptance, hopeful thinking, pain self-efficacy) and cognitive behavioral techniques that have established benefits in pain management. Primary study outcomes include intervention feasibility and acceptability as measured by treatment engagement, intervention credibility and satisfaction, ability to meet recruitment and retention metrics, and the feasibility of questionnaire and home activity completion. Outcomes will be assessed at baseline, immediately at posttreatment, and at the 3-month follow-up period.

Discussion

This study will establish the feasibility and acceptability of a novel intervention aimed at enhancing positive, psychological functioning, and resilience in older adults with cLBP. Achievement of these aims will provide a rich platform for future intervention research targeting improvements in pain and disability among geriatric populations and will serve as a foundation for a fully powered trial to examine treatment efficacy of the proposed intervention.

Trial registration

Clinicaltrials.gov, identifier NCT04068922. Registered 28 August 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00923-y.

Rewards of Compassion: Dispositional Compassion Predicts Lower Job Strain and Effort-Reward Imbalance Over a 11-Year Follow-Up

Dispositional compassion has been shown to predict higher well-being and to be associated with lower perceived stress and higher social support. Thus, compassion may be a potential individual factor protecting from job strain. The current study examines (i) whether dispositional compassion predicts job strain and effort-reward imbalance (ERI) or does the predictive relationship run from job strain and ERI to dispositional compassion and (ii) the effect of dispositional compassion on the developmental trajectory of job strain and ERI over a 11-year follow-up. We used data from the Young Finns study (n=723) between 2001 and 2012. The direction of the predictive relationships was analyzed with cross-lagged panel models. Compassion’s effect on the trajectories of job strain, ERI, and their components was examined with multilevel models. First, the cross-lagged panel models demonstrated there was no evidence for the predictive pathways between compassion and job strain or its components. However, the predictive pathways from high dispositional compassion to low ERI and high rewards had better fit to the data than the predictive pathways in the opposite direction. In addition, multilevel models showed that high compassion predicted various job characteristics from early adulthood to middle age (lower job strain and higher job control as well as lower ERI and higher reward). Compassion did not predict job demand/effort. The findings were obtained independently of age, gender, and socioeconomic factors in childhood and adulthood. These findings indicate that compassion may be beneficial in work context. Further, compassion might be useful in the management or prevention of some aspects of strain. Our study provides new insight about the role of compassion in work life.

A Powerful Antidote to Physician Burnout: Intensive Healthy Lifestyle and Positive Psychology Approaches

Burnout rates among physicians are rapidly rising. Leaders in the movement to address burnout have made the case that health care workplaces need to foster a culture of well-being, including trusting coworker interactions, collaborative and transparent leadership, work-life balance, flexibility, opportunities for meaningful work and for professional development, and effective 2-way communication. The rationale for focusing on organizational change to prevent burnout has pointed to persistent symptoms of burnout even when individual healthy lifestyle interventions are adopted. However, a case can be made that the lifestyle interventions were not implemented at the level of intensity recommended by the lifestyle medicine evidence-base to secure the desired improvement in physical and mental health when facing significant personal and environmental stressors. The lifestyle medicine community has the ethical mandate to advocate for intensive healthy lifestyle approaches to burnout prevention, in conjunction with organizational supports. By combining comprehensive and intensive lifestyle changes with organizational cultures of well-being, we can more effectively turn the tide of physician burnout.

Investigating the Influence of Self-Compassion-Focused Interventions on Posttraumatic Stress: A Systematic Review and Meta-Analysis

Objectives

Self-compassion-focused interventions may be able to decrease posttraumatic stress symptoms. However, previous studies demonstrated mixed effects in which a series of confounders were not systematically quantified. In this study, a systematic review with meta-analysis was conducted to quantify the effects of self-compassion-focused therapies on posttraumatic stress disorder.

Methods

Twelve eligible studies were included after a systematic search of databases. Outcome measures were extracted for posttraumatic stress disorder.

Results

Our data indicated a medium protective effect on posttraumatic stress symptoms (SMD =  − 0.65), with most of the studies (8/12) coming from clinical settings. More importantly, longer interventions were associated with better posttraumatic stress outcomes (p < 0.001). Baseline or changes in self-compassion scores were not associated with posttraumatic stress outcomes post-interventions.

Conclusions

Overall, findings from this meta-analysis quantified the complex influence of self-compassion-focused interventions on posttraumatic stress symptoms and may provide insights for optimizing intervention strategies. 

Systematic Review and Meta-analysis Registration: PROSPERO CRD42020208663.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-021-01732-3.

Healthcare students' mental and physical well-being during the COVID-19 lockdown and distance learning

BACKGROUND

The sudden shift into distance learning during the coronavirus (COVID-19) lockdown might have impacted university students' well-being.

OBJECTIVE

This study aimed to investigate undergraduate healthcare university students' health-related quality of life (HRQoL) and its predictors during COVID-19.

METHODS

A cross-sectional study used an online self-administered questionnaire. The study targeted undergraduate medical, dental, pharmacy, and nursing students at Jordanian universities. Data collected included demographics,12-item Short Form health survey (SF-12), students' evaluation of distance learning, Neck Disability Index (NDI), Depression Anxiety Stress Scale (DASS21), and the International Physical Activity Questionnaire (IPAQ). Descriptive analyses were conducted to summarize primary outcome measures data. Predictors of HRQoL were determined using a multiple variable regression analysis.

RESULTS

In total, 485 university students successfully completed this study with a mean age of 20.6 (±2.0). Participants' HRQoL level measured by SF-12 mean scores were 66.5 (±20.2) for physical health component and 44.8 (±21.2) for mental health component. The regression model explained 65.5% of the variation (r2 = 0.655, F = 127.8, P < 0.001) in participants' HRQoL. Factors significantly associated with HRQoL included depression, neck disability index score, stress, health self-evaluation, average of satisfaction with distance learning, IPAQ score, and weekly studying hours.

CONCLUSIONS

This study showed that healthcare students had a relatively low level of HRQoL during COVID-19 pandemic in Jordan. Academic and non-academic factors associated with HRQoL were identified and should be considered by healthcare educational institutions for better academic planning in future similar pandemics.

Coping with the COVID-19 pandemic: Contemplative practice behaviors are associated with better mental health outcomes and compliance with shelter-in-place orders in a prospective cohort study

Psychosocial health can influence the development and experience of several chronic diseases, and has been negatively affected for many individuals amid the COVID-19 global pandemic. To understand the impact of contemplative practices on emotional and mental health during COVID-19, the Stanford WELL for Life Study (US component), incorporated a series of additional surveys into its ongoing study. A total of 1,097 participants residing in California who responded to at least one of three COVID-19 surveys were included in this analysis. Linear and generalized mixed-effects regression models were used to investigate relationships between individual contemplative practice behaviors (CPB) (embodied observing meditation, non-reactive mindfulness meditation, self-compassion cultivation, cultivation of compassion for others) and four psychosocial outcomes measured in the original WELL questionnaire (resilience, dealing with stress, positive emotions, and negative emotions). In addition, the associations between CPB and depression, distress, and compliance with local Shelter-In-Place orders were also investigated. Participants who engaged in any contemplative practice reported significantly more resilience and positive emotions, dealing better with stress, lower distress, and were less likely to report an experience with depression in the last week. Similar findings held when CPB was modeled as a continuous variable. Significant interactions between the duration of the SIP and CPB were also observed for resilience and SIP compliance outcomes, indicating that steeper declines were observed among participants with little or no CPB across the study period. Further investigation into the potential protective benefits of CPB during times of major disruption and uncertainty is warranted.

Positive psychology in health care: defining key stakeholders and their roles

Lifestyle-related diseases have common risk factors: physical inactivity, poor diet, inadequate sleep, high stress, substance use, and social isolation. Evidence is mounting for the benefits of incorporating effective methods that promote healthy lifestyle habits into routine health care treatments. Research has established that healthy habits foster psychological and physiological health and that emotional well-being is central to achieving total well-being. The Happiness Science and Positive Health Committee of the American College of Lifestyle Medicine aims to raise awareness about strategies for prioritizing emotional well-being. The Committee advocates for collaborative translational research to adapt the positive psychology and behavioral medicine evidence base into methodologies that address emotional well-being in nonmental health care settings. Another aim is to promote health system changes that integrate evidence-based positive-psychology interventions into health maintenance and treatment plans. Also, the Committee seeks to ameliorate health provider burnout through the application of positive psychology methods for providers' personal health. The American College of Lifestyle Medicine and Dell Medical School held an inaugural Summit on Happiness Science in Health Care in May 2018. The Summit participants recommended research, policy, and practice innovations to promote total well-being via lifestyle changes that bolster emotional well-being. These recommendations urge stakeholder collaboration to facilitate translational research for health care settings and to standardize terms, measures, and clinical approaches for implementing positive psychology interventions. Sample aims of joint collaboration include developing evidence-based, practical, low-cost behavioral and emotional assessment and monitoring tools; grants to encourage dissemination of pilot initiatives; medical record dashboards with emotional well-being and related aspects of mental health as vital signs; clinical best practices for health care teams; and automated behavioral programs to extend clinician time. However, a few simple steps for prioritizing emotional well-being can be implemented by stakeholders in the near-term.

Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults' depressive symptoms

The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory. Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.

Protectors of Wellbeing During the COVID-19 Pandemic: Key Roles for Gratitude and Tragic Optimism in a UK-Based Cohort

The COVID-19 pandemic has presented a global threat to physical and mental health worldwide. Research has highlighted adverse impacts of COVID-19 on wellbeing but has yet to offer insights as to how wellbeing may be protected. Inspired by developments in wellbeing science and guided by our own theoretical framework (the GENIAL model), we examined the role of various potentially protective factors in a sample of 138 participants from the United Kingdom. Protective factors included physical activity (i.e., a health behaviour that helps to build psychological wellbeing), tragic optimism (optimism in the face of tragedy), gratitude (a prosocial emotion), social support (the perception or experience of being loved, cared for, and valued by others), and nature connectedness (physical and psychological connection to nature). Initial analysis involved the application of one-sample t-tests, which confirmed that wellbeing (measured by the Warwick-Edinburgh Mental Well-being scale) in the current sample (N = 138; M = 46.08, SD = 9.22) was significantly lower compared to previous samples (d = -0.36 and d = -0.41). Protective factors were observed to account for up to 50% of variance in wellbeing in a hierarchical linear regression that controlled for a range of sociostructural factors including age, gender, and subjective social status, which impact on wellbeing but lie beyond individual control. Gratitude and tragic optimism emerged as significant contributors to the model. Our results identify key psychological attributes that may be harnessed through various positive psychology strategies to mitigate the adverse impacts of hardship and suffering, consistent with an existential positive psychology of suffering.

Variety is the spice of life: How emotional diversity is associated with better student engagement and achievement

BACKGROUND

Past studies on emotions have mostly focused on mean levels of positive and negative emotions. In recent years, the concept of emotional diversity (emodiversity) which refers to the variety and relative abundance of emotions was introduced and was found to have important implications for mental and physical health. However, its role in the educational context is unexplored.

AIMS

The current study aimed to examine how emodiversity is associated with indicators of optimal school functioning including engagement and achievement.

SAMPLE(S)

Four hundred four Filipino high school students (M = 14.34, SD = 1.47; 55% female) and 10 class teachers participated in the study.

METHODS

Students completed surveys measuring their emotions, emodiversity, and engagement, while class teachers rated their students' engagement. Finally, grades from the school were obtained at the end of the semester.

RESULTS

Positive emodiversity-diversity of positive emotional experiences-was an independent predictor of academic engagement and school achievement over and above mean levels of positive and negative emotions. These results were found to generalize to self-reported and teacher-reported outcomes as well as more objective measures of achievement. Moreover, findings remained robust after controlling for demographic variables such as gender and year level.

CONCLUSIONS

Positive emodiversity is associated with higher engagement and achievement suggesting the importance of emodiversity in the educational context.

Systemic inflammation is associated with differential neural reactivity and connectivity to affective images

Systemic inflammation is increasingly appreciated as a predictor of health and well-being. Further, inflammation has been shown to influence and be influenced by affective experiences. Although prior work has substantiated associations between inflammatory and affective processes, fewer studies have investigated the neurobiological correlates that underlie links between systemic, low-grade inflammation and affective reactivity. Thus, the current study examined whether markers of systemic inflammation (i.e. interleukin-6, C-reactive protein) are associated with differential patterns of neural activation and connectivity in corticolimbic regions in response to affective images. We investigated this question in a sample of 66 adults (44 women, M age = 54.98 years, range = 35–76) from the Midlife in the United States study. Higher levels of inflammation were associated with lower activity in limbic regions (i.e. amygdala, hippocampus, anterior insula, temporal pole) when viewing positive (vs neutral) images. Higher levels of inflammation were also associated with greater connectivity between the hippocampus and the medial prefrontal cortex in response to positive images. Inflammatory markers were not associated with significant differences in activation or connectivity to negative images. These findings highlight the utility of health neuroscience approaches in demonstrating that physiological processes such as inflammation are related to how our brains respond to affective information.

Safety Culture and Workforce Well-Being Associations with Positive Leadership WalkRounds

BACKGROUND

Interventions to decrease burnout and increase well-being in health care workers (HCWs) and improve organizational safety culture are urgently needed. This study was conducted to determine the association between Positive Leadership WalkRounds (PosWR), an organizational practice in which leaders conduct rounds and ask staff about what is going well, and HCW well-being and organizational safety culture.

METHODS

This study was conducted in a large academic health care system in which senior leaders were encouraged to conduct PosWR. The researchers used data from a routine cross-sectional survey of clinical and nonclinical HCWs, which included a question about recall of exposure of HCWs to PosWR: "Do senior leaders ask for information about what is going well in this work setting (e.g., people who deserve special recognition for going above and beyond, celebration of successes, etc.)?"-along with measures of well-being and safety culture. T-tests compared work settings in the first and fourth quartiles for PosWR exposure across SCORE (Safety, Communication, Operational Reliability, and Engagement) domains of safety culture and workforce well-being.

RESULTS

Electronic surveys were returned by 10,627 out of 13,040 possible respondents (response rate 81.5%) from 396 work settings. Exposure to PosWR was reported by 63.1% of respondents overall, with a mean of 63.4% (standard deviation = 20.0) across work settings. Exposure to PosWR was most commonly reported by HCWs in leadership roles (83.8%). Compared to work settings in the fourth (< 50%) quartile for PosWR exposure, those in the first (> 88%) quartile revealed a higher percentage of respondents reporting good patient safety norms (49.6% vs. 69.6%, p < 0.001); good readiness to engage in quality improvement activities (60.6% vs. 76.6%, p < 0.001); good leadership accessibility and feedback behavior (51.9% vs. 67.2%, p < 0.001); good teamwork norms (36.8% vs. 52.7%, p < 0.001); and good work-life balance norms (61.9% vs. 68.9%, p = 0.003). Compared to the fourth quartile, the first quartile had a lower percentage of respondents reporting emotional exhaustion in themselves (45.9% vs. 32.4%, p < 0.001), and in their colleagues (60.5% vs. 47.7%, p < 0.001).

CONCLUSION

Exposure to PosWR was associated with better HCW well-being and safety culture.

Exploring neural mechanisms of the health benefits of gratitude in women: A randomized controlled trial

BACKGROUND

Gratitude has received growing interest as an emotion that can bring greater happiness and health. However, little is known about the effects of gratitude on objective measures of physical health or the neural mechanisms that underlie these effects. Given strong links between gratitude and giving behavior, and giving and health, it is possible that gratitude may benefit health through the same mechanisms as giving to others. Thus, this study investigated whether gratitude activates a neural 'caregiving system' (e.g., ventral striatum (VS), septal area (SA)), which can downregulate threat responding (e.g., amygdala) and possibly cellular inflammatory responses linked to health.

METHODS

A parallel group randomized controlled trial examined the effect of a six-week online gratitude (n = 31) vs. control (n = 30) writing intervention on neural activity and inflammatory outcomes. Pre- and post-intervention, healthy female participants (ages 35-50) reported on support-giving behavior and provided blood samples to assess circulating plasma levels and stimulated monocytic production of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)). Post-intervention, participants completed a gratitude task and a threat reactivity task in an fMRI scanner.

RESULTS

There were no significant group differences (gratitude vs. control intervention) in neural responses (VS, SA, or amygdala) to the gratitude or threat tasks. However, across the entire sample, those who showed larger pre- to- post-intervention increases in self-reported support-giving showed larger reductions in amygdala reactivity following the gratitude task (vs. control task). Additionally, those who showed larger reductions in amygdala reactivity following the gratitude task showed larger pre-to-post reductions in the stimulated production of TNF-α and IL-6. Importantly, gratitude-related reductions in amygdala reactivity statistically mediated the relationship between increases in support-giving and decreases in stimulated TNF-α production.

CONCLUSION

The observed relationships suggest that gratitude may benefit health (reducing inflammatory responses) through the threat-reducing effects of support-giving.

The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis

OBJECTIVE

Heart rate variability (HRV) is a marker of autonomic nervous system function associated with both physical and mental health. Many studies have suggested that mindfulness and meditation-based interventions (MBIs) are associated with improvements in HRV, but findings are mixed, and to date, no comprehensive meta-analysis has synthesized results.

METHODS

Systematic literature searches were conducted using PsycINFO, Embase, Medline, CINAHL, ERIC, and Scopus to identify randomized controlled trials (RCTs) investigating the effects of predominantly seated MBIs on resting-state vagally mediated HRV. Risk of bias was judged using the Cochrane Risk of Bias tool.

RESULTS

Nineteen RCTs met the criteria for inclusion in the meta-analysis. Random-effects meta-analysis found that MBIs were not efficacious in increasing vagally mediated resting-state HRV relative to control conditions (Hedges g = 0.38, 95% confidence interval [CI] = -0.014 to 0.77). When removing an outlier (g = 3.22), the effect size was reduced, CI narrowed, and findings remained nonsignificant (g = 0.19, 95% CI = -0.02 to 0.39). High heterogeneity in results (I2 = 89.12%) could not be explained by a priori-determined moderators including intervention duration, study setting, and control type.

CONCLUSIONS

There is currently insufficient evidence to indicate that MBIs lead to improvements in vagally mediated HRV over control conditions. Future large, well-designed RCTs with low risk of methodological bias could help add to the current evidence to elucidate any role MBIs might play in impacting HRV.

Moving Beyond Disciplinary Silos Towards a Transdisciplinary Model of Wellbeing: An Invited Review

The construct of wellbeing has been criticised as a neoliberal construction of western individualism that ignores wider systemic issues such as inequality and anthropogenic climate change. Accordingly, there have been increasing calls for a broader conceptualisation of wellbeing. Here we impose an interpretative framework on previously published literature and theory, and present a theoretical framework that brings into focus the multifaceted determinants of wellbeing and their interactions across multiple domains and levels of scale. We define wellbeing as positive psychological experience, promoted by connections to self, community and environment, supported by healthy vagal function, all of which are impacted by socio-contextual factors that lie beyond the control of the individual. By emphasising the factors within and beyond the control of the individual and highlighting how vagal function both affects and are impacted by key domains, the biopsychosocial underpinnings of wellbeing are explicitly linked to a broader context that is consistent with, yet complementary to, multi-levelled ecological systems theory. Reflecting on the reciprocal relationships between multiple domains, levels of scale and related social contextual factors known to impact on wellbeing, our GENIAL framework may provide a foundation for a transdisciplinary science of wellbeing that has the potential to promote the wellbeing of individuals while also playing a key role in tackling major societal challenges.

Effects of Loving-Kindness Meditation on Doctors' Mindfulness, Empathy, and Communication Skills

Background: In the context of increasing doctor–patient tensions in China, the objective of this study was to explore and examine the effects of loving-kindness meditation (LKM) on doctors’ mindfulness, empathy, and communication skills. Methods: A total of 106 doctors were recruited from a hospital in China, and randomly divided into an LKM training group (n = 53) and waiting control group (n = 53). The LKM training group received 8 weeks of LKM training intervention, whereas the control group received no intervention. Three major variables (mindfulness, empathy, and communication skills) were measured before (pre-test) and after (post-test) the LKM training intervention. Results: The empathy and communication skills of the LKM group were significantly improved compared with those of the control group, but the level of mindfulness did not significantly change. Conclusions: The results suggested that LKM may contribute to improving physicians’ empathy and communication skills. However, the mechanisms that underlie the effects of the LKM on mindfulness, empathy, and communication skills and other psychological constructs needs further elucidation.

Gratitude, social support and cardiovascular reactivity to acute psychological stress

The pathways linking gratitude to cardiovascular reactivity (CVR) to acute stress are not fully understood. We examine whether this association is mediated by social support. Healthy adults (N = 178) completed measures of trait gratitude and perceived social support and participated in a standardised mental arithmetic and speech stress testing protocol. Their CVR (i.e., systolic and diastolic blood pressure [SBP, DBP], heart rate [HR], cardiac output [CO] and total peripheral resistance [TPR]) were monitored throughout. Gratitude was positively associated with SBP, DBP and TPR reactivity, with those reporting higher gratitude showing higher CVR. Social support was positively associated with TPR to the maths task. The association between gratitude and TPR was mediated by social support but this was only evident in response to the maths task and not the speech task. These novel findings suggest that CVR may be a potential mechanism underlying the gratitude-physical health link.

Within-family patterns of intergenerational emotional closeness and psychological well-being of older parents in China

Objectives: There may be a substantial difference in the intergenerational emotional closeness among offspring in a multi-child family, both regarding the overall level as well as the extent to which older parents differentiate emotional closeness between their children. This study addressed different within-family patterns based on the average level and differentiation of older parent-child emotional closeness. It also examined the associations between these distinct patterns and the psychological well-being of older parents in China.Method: We derived a final sample of 4247 older parents (aged 60+) with 14,461 children from the baseline wave (2010) of the China Family Panel Studies. A latent profile analysis was applied to classify within-family patterns based on two indicators: within-family mean level and differentiation of parent-child emotional closeness among offspring. Ordered logistic regression and ordinary least square (OLS) regression were used to investigate the associations between these patterns and older adults' life satisfaction and depression, respectively.Results: Two family patterns of parent-child emotional closeness were identified: tight-knit (91.50%) and highly ambivalent (8.50%). Compared with the former, older parents having highly ambivalent relationships across multiple offspring tended to have lower life satisfaction and higher levels of depression.Conclusion: This study highlighted the importance of capturing different within-family dynamics of intergenerational emotional closeness in Chinese families. It also pointed out the negative effects of collective ambivalence for older adults' psychological well-being.