Does positive affect influence health?

A Scoping Review of the Relationship between Running and Mental Health

Poor mental health contributes significantly to global morbidity. The evidence regarding physical benefits of running are well-established. However, the mental health impacts of running remain unclear. An overview of the relationship between running and mental health has not been published in the last 30 years. The purpose of this study was to review the literature on the relationship between running and mental health. Our scoping review used combinations of running terms (e.g., Run* and Jog*) and mental health terms (general and condition specific). Databases used were Ovid(Medline), Ovid(Embase), ProQuest and SportDiscus. Quantitative study types reporting on the relationships between running and mental health were included. Database searches identified 16,401 studies; 273 full-texts were analysed with 116 studies included. Overall, studies suggest that running bouts of variable lengths and intensities, and running interventions can improve mood and mental health and that the type of running can lead to differential effects. However, lack of controls and diversity in participant demographics are limitations that need to be addressed. Cross-sectional evidence shows not only a range of associations with mental health but also some associations with adverse mental health (such as exercise addiction). This review identified extensive literature on the relationship between running and mental health.

Long-term effects of the Montreal museum of fine arts participatory activities on frailty in older community dwellers: results of the A-Health study

PURPOSE

The study aims (1) to examine the long-term effects (i.e., at 12 months) of the Montreal museum of fine arts (MMFA) participatory art-based activities on frailty in a subset of participants of the Art and Health (A-Health) study and (2) to compare these long-term effects with short-term effects (i.e., at 3 months).

METHODS

The A-Health study is a pre-post intervention, single arm, prospective and longitudinal study. A subset of 101 participants (67.3%) who completed the 12-month follow-up assessment was selected for this study. The intervention consisted in one weekly structured participatory art-based workshop over a 3-month period. Participants were separated according to their frailty status: vigorous (i.e., no frailty) versus mild frailty, moderate frailty and frailty merging mild and moderate frailty. Frailty was assessed before the intervention (M0), at the end of the 3-month intervention (M3) and 12 months (M15) after the end of the intervention.

RESULTS

The mean value of frailty score was lower after the intervention compared to the beginning, regardless of the time of the assessments (i.e., M3 and M15). The proportion of vigorous participants increased and the proportion of mild frail participants decreased at the end of the intervention (i.e., M3) but no long-term effect was shown (i.e., M15) compared to M0. The proportion of moderate frail participants and frail participants at M15 were significantly lower compared to M0.

CONCLUSION

The MMFA participatory art-based activities improved frailty at short and long terms, suggesting that it could be an effective way to promote an active and healthy aging.

TRIAL REGISTRATION

NCT03557723; Title: Effect of Art Museum Activity Program for the Elderly on Health: A Pilot Study; First submission date: January 31, 2018; First posted date: June 15, 2018; prospectively registered.

Salivary Cortisol and α-Amylase Production at Awakening is Associated with Positivity (POS) Levels in Healthy Young Subjects

A large variety of positive outcomes including social adjustment, psychological well-being and health, have been recently closely associated with positivity (POS). On the assumption that differences in the POS degree might be associated with different individual neuroendocrine assets that enables people to cope effectively with stress, the present study examined the association between POS, salivary cortisol and α-Amylase (α-Amy) production in a group of healthy male volunteers university students, respectively scoring high (POS-H, N = 10) and low (POS-L, N = 10) in POS. Participants were selected from a larger sample of 300 students of the Medical School at Sapienza University of Rome on the basis of their positivity level: POS was analysed and the upper and lower 25% were invited to participate in this new study. The findings report a distinct salivary cortisol and α-Amy production in the study population: in comparison to the POS-H group, the POS-L subjects presented a lower salivary cortisol awake response (CAR) and a flattened α-Amy production at 30 and 60 min after awakening. In addition, salivary cortisol and α-Amy areas under the curve (AUCs), which were calculated as indicators of the two subclinical biomarkers production during the first hour after awakening, resulted significantly lower in the POS-L group in comparison to the POS-H group. Further studies on larger and different populations are needed to definitively confirm that the different cortisol and α-Amy secretion patterns between POS-H and POS-L individuals is associated with a potentially better capacity to preserving an adequate quality of life in individuals being equipped with a system apparently able to better respond to external and/or internal stimuli. Lastly, a better understanding of the biological correlates of POS is crucial to design psychological interventions able to take advantage of individuals’ assets and thus to integrate and strengthen the efficacy of traditional medications.

Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Ándalus Project

OBJECTIVE

To analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association.

DESIGN

Cross-sectional study in 420 women with fibromyalgia.

SETTING

Fibromyalgia associations from southern Spain.

METHODS

Physical fitness was measured by performance-based tests, and questionnaires were used to measure positive affect, negative affect, and different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). Age, body mass index, and current pain level were included as potential confounders in all analyses.

RESULTS

Physical fitness was independently associated with general fatigue, physical fatigue, and reduced activity (all P ≤ 0.02). Positive affect was independently associated with all fatigue dimensions (all P < 0.001). Negative affect was independently associated with general fatigue, physical fatigue, reduced motivation, and mental fatigue (all P ≤ 0.04). The interaction of overall physical fitness and positive affect was related to general fatigue and physical fatigue (all P ≤ 0.02). Women with fibromyalgia with higher levels of overall physical fitness and positive affect showed the lowest general fatigue and physical fatigue.

CONCLUSIONS

In women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.

Health Goal Attainment of Patients With Chronic Diseases in Web-Based Patient Communities: Content and Survival Analysis

Background

Activities directed at attaining health goals are a major part of the daily lives of those fighting chronic diseases. A proliferating population of patients with chronic diseases are participating in web-based patient communities, wherein they can exchange health information and pursue health goals with others virtually.

Objective

In this study, we aimed to understand the effect of participation in social media–enabled web-based patient communities on health goal attainment. In particular, we studied the antecedents of health goal attainment in terms of social support and self-reflection in web-based patient communities.

Methods

This data set consists of web-based health management activities of 392 patients across 13 health support groups, that is, groups with medical issues such as high blood pressure, diabetes, and breast cancer; the data of the activities were collected from a leading web-based patient community. Content analysis was used to code the social interactions among the patients on the web-based platform. Cox regression for survival analysis was used to model the hazard ratio of health goal attainment.

Results

Our analysis indicated that emotional support from web-based patient communities can increase patients’ probability of achieving their goals (hazard ratio 1.957, 95% CI 1.416-2.706; P<.001) while informational support does not appear to be effective (P=.06). In addition, health-related self-reflection increases the patients’ likelihood of goal attainment through web-based patient communities (hazard ratio 1.937, 95% CI 1.318-2.848; P<.001), but leisure-oriented self-reflection reduces this likelihood (hazard ratio 0.588, 95% CI 0.442-0.784; P<.001).

Conclusions

Social media–enabled web-based platforms assist health goal management via both social interaction and personal discipline. This study extends the understanding of web-based patient communities by investigating the effects of both social and cognitive factors on goal attainment. In particular, our study advocates that health goals relating to chronic conditions can be better managed when patients use the facilities of web-based health communities strategically.

Research progress regarding the diagnosis and treatment of mental stress-induced myocardial ischemia

Myocardial ischemia resulting from psychological stress [mental stress-induced myocardial ischemia (MSIMI)] refers to the condition wherein psychosocial and psychological stimulations cause myocardial ischemia in patients with coronary heart disease, which is different from drug-induced myocardial ischemia. Therefore, this condition often escapes diagnosis, portends clinical risk, and affects the quality of life of MSIMI survivors. MSIMI is closely related to the poor prognosis of cardiovascular diseases, especially in young women, according to recent randomized, controlled trials (RCTs) on MSIMI. These RCTs involved different sample sizes, interventional measures, and detection techniques. Moreover, differences exist regarding the prevalence rate, distribution characteristics, possible pathogenesis, and clinical significance. Nevertheless, currently, the diagnostic criteria, pathogenesis, and treatment of MSIMI are still in the clinical exploration stage. Hence, considering recent RCTs, this paper summarizes the research status of MSIMI from the aspects of pathogenesis, diagnosis, and treatment strategies to provide a theoretical basis for the follow-up diagnostic methods and treatment guidelines for MSIMI.

Suboptimal baseline mental health associated with 4-month premature all-cause mortality: Findings from 18 years of follow-up of the Canadian National Population Health Survey

OBJECTIVE

To investigate: 1) whether baseline non-flourishing mental health is associated with a higher probability of all-cause mortality over 18-year follow-up after controlling for many risk factors for premature mortality; and 2) what other factors, independent of mental health status, are associated with all-cause mortality after adjustment for known risk factors.

METHODS

Data were derived from waves 1 and 9 (1994/1995; 2010/2011) of the Canadian National Population Health Survey. An analytic sample of 12,424 participants 18 years and above was selected. Baseline information on flourishing and predictors of all-cause mortality was from wave 1 and mortality data was ascertained by the Canadian Vital Statistics-Death Database in wave 9. Mean time to all-cause mortality was estimated using Kaplan-Meir procedure. Cox proportional hazards models were used to assess the association of baseline non-flourishing mental health and potential predictors with time to all-cause mortality.

RESULTS

About one in five participants was classified as non-flourishing at baseline. At the end of the study period 2317 deaths were observed. Baseline non-flourishing mental health was associated with a 19% higher probability of all-cause mortality during 18-year follow-up (HR = 1.19; 95% CI 1.08-1.32), corresponding to a 4.7-month shorter survival time. After controlling for baseline chronic health conditions, past-year depression, sociodemographics, health behaviors, social support, pain and functioning, baseline non-flourishing mental health status was associated with a 14% higher probability of death (HR = 1.14; 95% CI 1.02-1.27).

CONCLUSIONS

Suboptimal mental health is associated with premature mortality even after accounting for many risk factors for early death. Future research should explore the physiological pathways through which non-flourishing influences mortality.

Health outcomes of tourism development: A longitudinal study of the impact of tourism arrivals on residents’ health

This study investigates the influence of the number of tourism arrivals on the physical health of local people in one of the most-visited destinations in the world. Although the literature traditionally describes the economic, social, and cultural impacts of tourism, there is a gap related to the effects of tourism on residents' health. The methodology involves applying the limited-information maximum likelihood instrumental variable approach. The results demonstrate that tourism arrivals negatively influence residents’ health in the short term, yet have positive impacts on long-term health outcomes. The study contributes to the theory and practice by offering a new approach to physical health outcomes of tourism, demonstrating the superiority of long-term positive impacts of tourism over short-term negative outcomes, and emphasizing the importance of evaluating the health impacts of tourism for destination marketing and management.

An At-home Positive Psychology Intervention for Individuals with Multiple Sclerosis: A Phase 1 Randomized Controlled Trial

Background

Positive psychology (PP) uses targeted activities to increase the frequency and intensity of positive feelings and may improve overall well-being in medically ill populations. In this phase 1 randomized controlled trial, we examined the feasibility, acceptability, and potential impact of a 5-week, telephone-delivered PP intervention for individuals with multiple sclerosis (MS).

Methods

Participants were randomized 1:1 to a 5-week at-home PP intervention or a waitlist control condition. Participants engaged in weekly telephone calls with a study trainer and completed one PP exercise, such as recalling a past success, each week. Feasibility was determined by the number of sessions completed, and acceptability was assessed by weekly postexercise participant ratings of ease and utility. Efficacy was explored by examining between-group differences in changes from baseline on psychological variables, health-related quality of life, and self-reported functional activities at 5 and 10 weeks.

Results

Of 30 patients enrolled in the study, 28 (93%) completed all exercises. Ease scores ranged from 7.7 to 8.7 of 10 and utility scores ranged from 8.2 to 8.7 of 10. The PP intervention was associated with significantly greater increases (P < .05) in positive affect, optimism, state and trait anxiety, general health, and resilience in the intervention group versus the control group. Approximately half of the PP participants maintained at least 50% of the improvement at 10 weeks.

Conclusions

This 5-week, telephone-based PP intervention was feasible and acceptable to individuals with MS. Larger randomized controlled trials are warranted to further investigate the utility of this intervention to improve well-being and other health outcomes in MS.

Constraints and Consequences of Online Teaching

In Romania, like in many other European countries, schools and universities were closed and classes were transferred entirely online at the beginning of March 2020, due to the new coronavirus SARS-CoV-2 (COVID-19) outbreak, declared as a pandemic by the World Health Organization (WHO). In the context of drastic changes and uncertainty, teachers across Romania had to face the challenges of transferring lectures online. The small window of time left to adapt to new technologies, along with other stressors, called into question their work engagement and performance, as key factors for the sustainability of the educational system. An approach based on the dimensions of induced stress, resilience behavior, professional support, and work engagement was implemented to highlight the impact of socio-professional changes during the COVID-19 on the activity of 400 teachers from Romania. The designed construct was validated and subsequently a model was proposed, by using factor analysis and Structural Equation Modeling (SEM). The article brings updated information on the complex relationship between stress and resilience in the case of employees from the area of education. Among other results, the present research highlights the structure of work engagement and the mediating role of professional support in the relationship between stressors and resilience mechanisms.

Effects of "Thursdays at the Museum" at the Montreal Museum of Fine Arts on the mental and physical health of older community dwellers: the art-health randomized clinical trial protocol

Background

Recently, we demonstrated that the Montreal Museum of Fine Arts’ (MMFA) participatory art-based activity, known as “Thursdays at the Museum,” improved the well-being, quality of life, and physical health (i.e., frailty) of older community dwellers by using a pre-post intervention, single arm, prospective and longitudinal experimental design. The present randomized clinical trial (RCT), known as the Art-Health RCT (A-Health RCT), aims to compare changes in well-being, quality of life, frailty, and physiological measures in older community dwellers who participate in “Thursdays at the Museum” (intervention group) and in their counterparts who do not participate in this art-based activity (control group).

Methods/design

The current unicenter, randomized, clinical, controlled, comparative trial recruits 150 older community dwellers to two parallel arms (75 participants in the intervention group and 75 participants in the control group). The intervention is a 3-month cycle of weekly “Thursdays at the Museum,” which are structured 2-h-long art-based workshops performed in a group setting at the MMFA. The control group is composed of participants who do not take part in art-based activities, receive their usual health and/or social services, and commit to report any other activity practiced during the same time. Assessments of the primary outcome (well-being) and the secondary outcomes (quality of life, frailty, and physiological measures including heart rate, daily step count, sleep duration, and its phases) are performed on six occasions: at baseline, at the beginning of the second and third months, at the end of the third month, as well as 6 and 12 months after the last workshop. Statistical analyses are performed with the intention to treat and per protocol. Comparisons of changes in outcome measures between intervention and control groups use repeated measures tests.

Discussion

Art-based activities carried out at museums have been receiving increased interest from researchers and policy-makers because of their benefits to mental and physical health. There are few robust studies, such as RCTs, that focus on older community dwellers or assess the efficacy of these participatory museum activities. The A-Health RCT study provides an opportunity to confirm the benefits of a participatory art-based museum activity on the elderly population and to show the key role played by museums in public health promotion.

Trial registration

NCT03679715; Title: A-Health RCT: Effects of Participatory Art-Based Activity on Health of Older Community Dwellers; First posted date: September 20, 2018; prospectively registered.

Difficulties with health self-management by older adults: The role of well-being

The purpose of this study was to investigate the association between three aspects of well-being (positive and negative affect, self-realization, and self-efficacy and resilience) and disease self-management or difficulties in managing care. Logistic regression models were used to analyze data from a sample of community-dwelling Medicare beneficiaries 65-years or older who participated in the National Health and Aging Trends Study and responded to well-being and engagement in health care questions (n = 1663). All three aspects of well-being were significantly associated with reduced difficulties in care management for both the participants and their family and friends who assist them. Self-efficacy and resilience had the strongest association; older adults with higher levels of self-efficacy and resilience were more likely to handle care by self. Our findings highlight the importance of incorporating strategies to enhance well-being of older adults to reduce the difficulties of managing activities necessary to stay healthy.

A methodology for psycho-biological assessment of stress in software engineering

Stress pervades our everyday life to the point of being considered the scourge of the modern industrial world. The effects of stress on knowledge workers causes, in short term, performance fluctuations, decline of concentration, bad sensorimotor coordination, and an increased error rate, while long term exposure to stress leads to issues such as dissatisfaction, resignation, depression and general psychosomatic ailment and disease. Software developers are known to be stressed workers. Stress has been suggested to have detrimental effects on team morale and motivation, communication and cooperation-dependent work, software quality, maintainability, and requirements management. There is a need to effectively assess, monitor, and reduce stress for software developers. While there is substantial psycho-social and medical research on stress and its measurement, we notice that the transfer of these methods and practices to software engineering has not been fully made. For this reason, we engage in an interdisciplinary endeavor between researchers in software engineering and medical and social sciences towards a better understanding of stress effects while developing software. This article offers two main contributions. First, we provide an overview of supported theories of stress and the many ways to assess stress in individuals. Second, we propose a robust methodology to detect and measure stress in controlled experiments that is tailored to software engineering research. We also evaluate the methodology by implementing it on an experiment, which we first pilot and then replicate in its enhanced form, and report on the results with lessons learned. With this work, we hope to stimulate research on stress in software engineering and inspire future research that is backed up by supported theories and employs psychometrically validated measures.

Beyond Glucocorticoids: Integrating Dehydroepiandrosterone (DHEA) into Animal Welfare Research

Animal welfare researchers are committed to identifying novel measures for enhancing the quality of life of individual animals. Recently, welfare scientists have emphasized the need for tracking multiple indicators of an animal's behavioral, emotional and mental health. Researchers are currently focused on integrating non-invasive physiological biomarkers to gain insight into an individual's welfare status. Most commonly, the animal welfare community has analyzed glucocorticoid hormones and their metabolites as a measure of stress. While glucocorticoids provide valuable information about hypothalamic-pituitary-adrenal (HPA) axis activity, there are limitations to utilizing these hormones as the sole measure of long-term stress and welfare. Other biomarkers, such as dehydroepiandrosterone and its sulfate ester-collectively referred to as DHEA(S)-help provide a more complete picture of HPA activity. DHEA(S) counteracts the effects glucocorticoids by having anti-aging, immune-enhancing and neuroprotective properties. Recent studies have examined the ratio of glucocorticoids to DHEA(S) as a way to better understand how the HPA axis is functioning. There is evidence that this ratio serves as an indicator of immune function, mental health, cognitive performance and overall welfare. We review studies that employed the glucocorticoid:DHEA(S) ratio, outline methodological considerations and discuss how researchers can integrate glucocorticoids, DHEA(S) and the glucocorticoid:DHEA(S) ratio into welfare assessments.

A Systematic Review of Associations Between Interoception, Vagal Tone, and Emotional Regulation: Potential Applications for Mental Health, Wellbeing, Psychological Flexibility, and Chronic Conditions

Background: Interoception and heart rate variability have been found to predict outcomes of mental health and well-being. However, these have usually been investigated independently of one another.

Objectives: This systematic review aimed to explore a key gap in the current literature, that being, identifying whether HRV and interoception predict emotional regulation outcomes and strategies.

Methods: The process of article retrieval and selection followed the PRISMA guidelines. Databases PsychINFO, Web of Science, PubMed, CINAHL, and MEDLINE were scanned for papers published. Preliminary inclusion and exclusion criteria were specified following the PICO framework, whilst the CHARMS framework was used to help formulate the research question, and critically assess for bias.

Results: Two hundred and thirty-seven studies were identified after initial database searches. Of these, eight studies were included in the final selection. Six studies explored the associations between HRV and ER, whilst three investigated the associations between interoception and ER (one study included both). Results show that greater HRV and interoception are associated with better ER. Specifically, high parasympathetic activity largely predicted the use of adaptive ER strategies such as reappraisal, and better acceptance of emotions. High interoception, instead, was predictive of effective downregulation of negative emotions and handling of social uncertainty, there was no association with any specific ER strategy.

Conclusions: Awareness of one's own bodily feelings and vagal activation seem to be of central importance for the effective regulation of emotional responses. However, one limitation is the small sample of studies found, thus more studies in this area are needed in the future.

Psychological predictors of functional outcomes in service members with traumatic brain injury

PRIMARY OBJECTIVE

Research is increasingly demonstrating the significant impact that non-medical factors can have on outcomes of service members (SMs) with mild traumatic brain injury (mTBI). Thus, the current study examined which demographic, TBI-related factors, and psychological variables are most predictive of functional outcomes.

RESEARCH DESIGN

Retrospective database analysis from medical chart review.

METHODS AND PROCEDURES

One hundred forty-one patients who received rehabilitation services at an outpatient TBI military treatment facility between 2013 and 2018. Data collected included demographic variables, time since injury, neuropsychological measures, psychological diagnoses, Personality Assessment Inventory (PAI) scores, and Walter Reed Functional Impairment Scale (FIS). Hierarchical linear regression models were used to predict functional outcomes (measured by FIS total, work, social functioning scales).

MAIN OUTCOMES AND RESULTS

Results indicated that comorbid PTSD diagnosis and PAI Negative Impression Management (NIM) score were predictive of total functional, work, and social outcomes, over and above demographic and TBI-related factors.

CONCLUSIONS

Current findings confirmed the importance of evaluating and treating psychological factors, as well as exploring one's responding style (NIM), when managing chronic mTBI in SMs. Given ongoing findings of psychological underpinnings to mTBI outcome, there is further need to focus on early interventions to optimize psychological and functional outcomes for SMs.

Relationship between workplace spirituality, organizational justice and mental health: mediation role of employee engagement

Purpose

Workplace spirituality is presently a prominent research topic and is gaining recognition and importance among industry professionals and academicians. Workplace spirituality is defined as a sense of community, meaningful work and organizational values. The purpose of this research paper is to investigate the relationship between workplace spirituality and mental health, wherein employee engagement is considered as a mediator. Furthermore, this study examines the mediating role of employee engagement in the relationship between organizational justice and mental health.

Design/methodology/approach

Data were gathered from 344 information technology professionals working in India. Structural equation modelling was used to evaluate the model fit of workplace spirituality and its relationship to employee engagement, organizational justice and mental health.

Findings

The results revealed that workplace spirituality and organizational justice significantly and positively predict employee engagement, which is significantly related to employee mental health. The results also revealed that employee engagement significantly partially mediates the relationship between workplace spirituality and mental health as well as the relationship between organizational justice and mental health.

Research limitations/implications

Results of research guide HR professionals, employee mental health concerns can be addressed by promoting workplace spirituality, improving employee engagement strategies and implementing organizational justice policies that are perceived to be fair. This study makes a significant contribution to the extant literature regarding mental health issues in the IT sector.

Originality/value

Findings of this research contribute to the area of human resource management and employee engagement. The current study fills a gap in the extant literature by investigating employee engagement intervening mechanism between organizational justice, workplace spirituality and mental health.

Psychological Wellbeing and Aortic Stiffness: Longitudinal Study

This study investigated 2 distinct aspects of positive wellbeing: affective wellbeing and eudaimonia with progression of aortic stiffness, an index of subclinical cardiovascular disease. A total of 4754 participants (mean age 65.3 years, 3466 men, and 1288 women) from the Whitehall II cohort study provided data on affective and eudaimonic wellbeing using subscales from the control, autonomy, self-realization and pleasure-19 questionnaire. Aortic stiffness was measured by aortic pulse wave velocity (PWV) at baseline (2008-2009) and 5 years later (2012-2013). Linear mixed models were used to measure the effect of affective and eudaimonic wellbeing on baseline PWV and 5-year PWV longitudinal change. A 1-SD higher eudaimonic wellbeing was associated with lower baseline PWV in men (β=-0.100 m/s [95% CI=-0.169 to -0.032]), independent of social, behavioral, and biological factors. This association persisted over 5 years. No such association was found in women (β=-0.029 m/s [95% CI=-0.126 to 0.069]). We did not find any association of positive wellbeing with change in PWV over time in either men or women. In older men, higher levels of eudaimonic wellbeing were associated with lower long-term levels of arterial stiffness. These findings support the notion that the pattern of association between positive wellbeing and cardiovascular health outcomes involves eudaimonic rather than affective wellbeing and is sex-specific.

Does laughing have a stress-buffering effect in daily life? An intensive longitudinal study

Positive affect is associated with alleviating mental and physiological stress responses. As laughter is a common physiological operationalization of positive affect, we investigated whether the effects of experiencing a stressful event on stress symptoms is lessened by frequency and intensity of daily laughter. Using an intensive longitudinal design, we ambulatory assessed the self-reported experience of stressful events, stress symptoms and the frequency as well as the intensity of laughter in university students' daily lives. Our hierarchical ecological momentary assessment data were analyzed with multilevel models. The results support the stress-buffering model of positive affect: We found that the frequency of laughter attenuated the association between stressful events and subsequent stress symptoms. The level of intensity of laughter, however, was found to have no significant effect. Future studies should use additional psychophysiological indicators of stress and straighten out the differential contributions of frequency and intensity of daily laughter.

Aging-Related Changes in the Association between Negative Affect and Response Time Inconsistency in Older Adulthood

Negative affect (NA) and positive affect (PA) are established modifiable psychosocial correlates of cognitive health and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach. Previous research has shown NA is associated with increased response time inconsistency (RTI), an early performance-based indicator of cognitive health and aging. It is unclear, however, whether PA is associated with RTI, and whether affect-RTI associations exist within persons over time or change as individuals get older. We utilized data from a measurement burst study (Cognition, Health and Aging Project) to explore within- and between-person associations between affect and RTI in community-dwelling older adults (N=111, M=80.04 years, SD=6.30). Affect and RTI were assessed on six days over a two-week period, every six months for two years. Results revealed a significant association between NA-low arousal and RTI within persons over time. RTI was higher on sessions when NA-low arousal was higher than usual (b=0.21, 95%CI=0.08 to 0.35, p<.01). This association decreased in magnitude over time (b=-0.09, 95%CI=-0.14 to - 0.03, p<.001), ultimately resulting in increased NA-low arousal being associated with decreased RTI two years later (b=-.14, 95%CI=-0.27 to -0.01, p<.05). No PA-RTI associations emerged. The results suggest efforts focused on maximizing resource allocation and personalizing cognitive health efforts should consider for whom and when mitigating NA may be maximally beneficial to daily cognition, whereas additional work is needed to determine influences from PA.

Positive emotions and favorable cardiovascular health: A 20-year longitudinal study

No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period. Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated assessment through 2010. CVH was defined by blood pressure, lipids, body mass index, diabetes, and smoking status. Primary analyses used linear mixed effects models adjusting for potential confounders; secondary analyses stratified by race and sex. Controlling for sociodemographic factors, greater baseline positive emotions were associated with better CVH across time (β = 0.03, 95% confidence interval = 0.007-0.06). However, positive emotions were unrelated to rate of change in CVH across time. Baseline CVH was also associated with greater average positive emotions across time (β = 0.09, 95% confidence interval = 0.02-0.15), but not rate of change. Positive emotions' association with CVH was stronger for women than men, but race did not modify associations. Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.

Emotions matter: The role of emotional approach coping in chronic pain

BACKGROUND

Emotional approach coping (EAC) is a potentially adaptive emotion-focused coping style that involves understanding or processing one's emotions and expressing them appropriately. Although EAC has been studied in various populations, little is known about this construct among people with chronic pain, including potential mediators such as negative affect, which might link EAC to pain-related variables, and moderators of these relationships.

METHODS

Participants (N = 670; 76% women; 30% older adults-age 60 or over) with chronic pain completed online the Emotional Approach Coping Scale and measures of pain severity, pain interference and negative affect. Analyses correlated EAC to pain severity and interference and tested whether gender and age group (older adults versus young/middle-age adults) moderated the mediated relationships of EAC with pain-related variables through negative affect.

RESULTS

Findings reveal that higher EAC was associated with lower pain intensity through lower negative affect in the young/middle-age portion of the sample, but not older adults. Also, higher EAC was associated with lower pain interference through lower negative affect among women in the sample, but not men. The associations of EAC to pain intensity and interference are small in magnitude, however, and should be considered preliminary.

CONCLUSION

EAC is associated with lower pain intensity in young/middle-age adults and lower pain interference in women, and lower negative affect mediates these relationships. These results suggest the potential value of assessing and bolstering emotional approach coping processes in some people with chronic pain.

Randomized Trial of a Positive Psychology Intervention for Adolescents With Type 1 Diabetes

OBJECTIVE

To evaluate the effects of a positive psychology intervention for adolescents with type 1 diabetes (T1D) on adherence, glycemic control, and quality of life.

METHODS

Adolescents with T1D (n = 120) and their caregivers were randomized to either an Education (EDU) (n = 60) or Positive Affect (PA) intervention (n = 60). Adolescents in the PA group received the intervention reminders (gratitude, self-affirmation, parental affirmation, and small gifts) via text messages or phone calls over 8 weeks. Questionnaires were completed by adolescents and caregivers and clinical data (glucometer and HbA1c) were collected at baseline 3 and 6 months. Data were analyzed using generalized linear modeling.

RESULTS

After adjusting for covariates, adolescents in the PA group demonstrated significant improvement in quality of life at 3 months, compared to the EDU group, but this was not sustained at 6 months. Similarly, the PA group showed a significant decrease in disengagement coping at 3 months but not at 6 months. There was no significant intervention effect on blood glucose monitoring, but the odds of clinically significantly improvement (checking at least one more time/day) were about twice as high in the PA group as the EDU group. No significant effects were found for glycemic control.

CONCLUSIONS

A positive psychology intervention had initial significant, positive effects on coping and quality of life in adolescents with T1D. A more intensive or longer-lasting intervention may be needed to sustain these effects and to improve adherence and glycemic control.

The Many Faces of Stress: Three Factors that Predict Physical Illness in Young Adults

Three studies examined how various forms of stress uniquely contribute to physical illness. We compared negative affect and perceived stress in Study 1, neuroticism and perceived stress in Study 2, and negative affect, neuroticism, and perceived stress in Study 3. We also controlled for health-related covariates (i.e., exercise, nutrition, substance use, and BMI). In all three studies (ns = 271, 577, and 300), participants completed online surveys for course credit. The results of Study 1 demonstrated that both negative affect and perceived stress predicted physical illness. In Study 2, neuroticism and perceived stress each predicted illness symptoms, and an additional interaction between neuroticism and perceived stress, were found. In Study 3, where all three stress factors were included, only negative affect predicted illness symptoms. Taken together, these results suggest that negative affect uniquely explains most of the variance in physical illness symptoms while controlling for other forms of stress.

Does Happiness Improve Health? Evidence From a Randomized Controlled Trial

Happier people are healthier, but does becoming happier lead to better health? In the current study, we deployed a comprehensive, 3-month positive psychological intervention as an experimental tool to examine the effects of increasing subjective well-being on physical health in a nonclinical population. In a 6-month randomized controlled trial with 155 community adults, we found effects of treatment on self-reported physical health—the number of days in the previous month that participants felt healthy or sick, as assessed by questions from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Questionnaire. In a subsample of 100 participants, we also found evidence that improvements in subjective well-being over the course of the program predicted subsequent decreases in the number of sick days. Combining experimental and longitudinal methodologies, this work provides some evidence for a causal effect of subjective well-being on self-reported physical health.

Longitudinal and Reciprocal Relationships Between Psychological Well-Being and Smoking

INTRODUCTION

Smoking cessation treatments currently succeed at a rate of approximately 20%-30%, underscoring the importance of exploring factors that might increase intervention effectiveness. Although negative affect has been studied extensively in relation to smoking cessation, psychological well-being (PWB; eg, life satisfaction, optimism, positive affect, purpose in life) has received little attention. This study tested longitudinal and reciprocal relationships between PWB and smoking status in older adults.

METHODS

Panel data were obtained from the biennial, longitudinal Health and Retirement Study. Using structural equation modeling, we developed cross-lagged models to examine the relationships of PWB in 2006 with smoking status in 2010 and of smoking status in 2006 with PWB in 2010 while controlling for covariates (Ns = 2939-4230, 55% women, 89% white, mean age = 64 years, mean years of education = 13, 25% smokers in 2006 and 21% smokers in 2010). Separate cross-lagged models were developed for each of the PWB variables: life satisfaction, optimism, positive affect, and purpose in life.

RESULTS

Greater life satisfaction (standardized path coefficient = -0.04), optimism (standardized path coefficient = -0.07), and positive affect (standardized path coefficient = -0.08) in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction (standardized path coefficient = -0.25), optimism (standardized path coefficient = -0.10), positive affect (standardized path coefficient = -0.10), and purpose in life (standardized path coefficient = -0.13) in 2010.

CONCLUSIONS

Findings warrant further exploration of the relationships between PWB and smoking, and support the incorporation of PWB-boosting components into existing treatments.

IMPLICATIONS

Given the relatively low success rate of current smoking cessation treatments, the present results suggest that increasing PWB might promote abstinence and therefore warrant consideration as a focus of future cessation treatment research. Moreover, these results suggest that smoking might inhibit PWB, illuminating a negative consequence of smoking not previously identified. Helping smokers increase their PWB may benefit them beyond promoting cessation and contribute to a flourishing society. These results warrant further investigation of PWB and smoking, and support the continued evaluation of PWB-boosting components in smoking cessation treatments.

Positive and Negative Affect and Salivary Markers of Inflammation Among Young Adults

BACKGROUND

Emerging evidence suggests that higher circulating levels of inflammatory biomarkers in blood are associated with higher negative affect (NA) and lower positive affect (PA). To our knowledge, the unique associations between NA and PA in daily life and salivary biomarkers of inflammation have not been examined. This study examined these associations in young adults.

METHODS

Measures of NA and PA were created from aggregated daily measures of affect (morning and evening ratings averaged across 14 days). We investigated associations between these measures and salivary C-reactive protein (CRP) and interleukin (IL)-6 in a sample of 108 young adults (60% female, mean age = 20.45 ± 1.47), a subset of whom had self-reported chronic back pain (n = 49). CRP and IL-6 were determined from saliva obtained at the end of the daily diary period.

RESULTS

After covarying for age, gender, body mass index, chronic pain status, salivary flow rate, and NA, higher PA was associated with lower salivary CRP (β = - 0.02, 95% CI (- 0.03, - 0.00) sr2 = .06, p = .01) but not IL-6; removing NA from this model did not change results. In a model with the same covariates (and PA), NA was not significantly related to CRP or IL-6. Chronic back pain status and gender did not moderate results.

CONCLUSIONS

Findings suggest that higher PA may be associated with lower salivary CRP in young adults, even after accounting for NA and demographic characteristics. Findings highlight the utility of assessing emotional states in relation to salivary markers of inflammation in future biobehavioral research.

Understanding and effectively addressing disparities in obesity: A systematic review of the psychological determinants of emotional eating behaviours among Black women

Emotional eating may be a particularly important contributor to differences in body weight and weight loss response to behavioural interventions among non-Hispanic Black women. We performed a systematic review on the impact of psychological factors (stress, anxiety, depression, and discrimination) upon emotional eating and weight among non-Hispanic Black women, applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis for relevant studies. The initial search yielded 4593 articles with 15 accepted for review. Based on this review, there is a suggestion that negative emotions, in particular, perceived stress, may be predictive of emotional eating among non-Hispanic Black women. Results from the only two longitudinal studies identified by the review indicate that stress influences emotional eating, and emotional eating predicts weight gain over time. Findings from this review highlight the need for more studies that examine various negative emotions that may lead to emotional eating and weight gain among non-Hispanic Black women. Findings from this review also highlight the need for more rigorous studies to differentiate the effects of emotional eating from that of the physiologic (ie, activation of the hypothalamic-pituitary axis) responses to stress and its impact on high-risk groups.

A Web-Based, Positive Emotion Skills Intervention for Enhancing Posttreatment Psychological Well-Being in Young Adult Cancer Survivors (EMPOWER): Protocol for a Single-Arm Feasibility Trial

BACKGROUND

Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs.

OBJECTIVE

The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being.

METHODS

The intervention development and testing are taking place in 3 phases. In phase 1, we adapted the content of an existing, Web-based positive emotion intervention so that it would be suitable for AYAs. EMPOWER targets 8 skills (noticing positive events, capitalizing, gratitude, mindfulness, positive reappraisal, goal setting, personal strengths, and acts of kindness) and is delivered remotely as a 5-week, Web-based intervention. Phase 2 consisted of a pilot test of EMPOWER in a single-arm trial to evaluate feasibility, acceptability, retention, and adherence and to collect data on psychosocial outcomes for proof of concept. In phase 3, we are refining study procedures and conducting a second pilot test.

RESULTS

The project was part of a career development award. Pilot work began in June 2015, and data collection was completed in March 2019. The analysis is ongoing, and results will be submitted for publication by May 2020.

CONCLUSIONS

If this intervention proves feasible and acceptable, EMPOWER will be primed for a subsequent large, multisite randomized controlled trial. As a scalable intervention, it will be ideally suited for AYA survivors who would otherwise not have access to supportive care interventions to help manage posttreatment distress and enhance well-being.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/17078.

Risk of cognitive declines with retirement: Who declines and why?

Retiring is associated with increased risk of cognitive decline (e.g., Bonsang, Adam, & Perelman, 2012; Wickrama, O'Neal, Kwag, & Lee, 2013). However, little is known about the moderating role of motivational and demographic factors that are implicated in adaptive development and the retirement transition process. We used data from the Midlife in the United States Study (n = 732, Mage = 57, SD = 5.76, 50% female) to examine whether the association between retirement and cognitive decline depended on a key motivation factor (goal disengagement) in propensity score matched samples of older retirees and employees. We explored whether these effects were further moderated by gender. Results showed that those who retired (vs. remained employed) experienced steeper 9-year declines in episodic memory (b = -.41, p = .001) only if they were high in goal disengagement and female. Findings are consistent with theories of lifespan development and cognitive aging and provide initial evidence that retirement may be associated with increased cognitive declines for only certain individuals prone to disengage from highly challenging activities and goal pursuits. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The longitudinal association of psychological resources with chronic conditions and the mediating roles of health behaviours and allostatic load

Objective: To investigate the association of psychological resources with the prevalence of chronic conditions up to 10 years later, and the mediating roles of health behaviours and allostatic load. Design: Participants from the Midlife in the United States study (N = 850) completed surveys and biomarker assessments over the course of 10 years. Main Outcome Measures: Primary outcome was the prevalence of chronic conditions later in life, controlling for baseline chronic conditions. Secondary outcomes were health behaviours and allostatic load. Direct and indirect associations between psychological resources and chronic conditions were examined. Results: Psychological resources were negatively associated with chronic conditions directly (ƅ = -.177, p < .05) and indirectly through health behaviours (ƅ = -.026, p < .05), but not through allostatic load (ƅ = -.000, p > .05). Psychological resources were positively associated with health behaviours (ƅ = .130, p < .01), but no association was found between psychological resources and allostatic load (ƅ = -.002, p > .05). Health behaviours were negatively associated with chronic conditions (ƅ = -.201, p < .01), and allostatic load was positively associated with chronic conditions (ƅ = .197, p < .05). Conclusion: Findings highlight the beneficial influence of psychological resources on chronic conditions, and the mediating role of health behaviours.

The significance of resilience in mental health promotion of marriage immigrant women: a qualitative study of factors and processes

BACKGROUND

This study explores a series of processes in which marriage immigrant women achieve positive mental health status after experiencing various marriage- and migrant-related difficulties through the framework of resilience theory. As marriage immigrant women face greater barriers to public health services than non-immigrant women, it is necessary to understand the related factors, process, and context to address these barriers and strengthen available assets.

METHODS

A qualitative case study design was used with the phenomenological approach. Eleven mental health promotion program managers and 12 marriage immigrant women from who experienced resilience were recruited from four public-funded multicultural community centers in Seoul and Gyeonggi-do, South Korea, between December 2015 and March 2016. Using data from in-depth semi-structured face-to-face interviews, the author applied theme analysis informed by the resilience theory in order to identify factors that affect resilience and its development process.

RESULTS

Findings indicated that the process of resilience follows enduring difficulties, collapse of stability, access to professional help, professional and social support, and experience of growth. A combination of the staged process of growth, absence of partner support, children as a driving force for change, the need for economic activity, factors affecting difference in growth: satisfaction levels of women's need for recognition, respect, and reward, and level of spousal support were identified as factors affecting marriage immigrant women's resilience.

CONCLUSIONS

Spouses, children, and economic activity play key roles in resilience in positive and negative ways. The existing information barrier should be addressed at a structural level to improve the mental health of marriage immigrant women, and the optimum time for intervention is suggested within 2 years post-migration. Efforts to build supportive relationships with Korean spouses and meet the women's needs for recognition, respect, and reward may also help promote these women's resilience.

Affect variability and inflammatory markers in midlife adults

OBJECTIVE

Higher affect variability (the extent to which individuals vary in their affect over time) has been associated with poorer health indicators, but associations with inflammation are less well understood. The purpose of the present study was to examine whether affect variability was associated with inflammation in ways consistent with the stability theory or the fragile positive affect theory, and whether associations were linear or nonlinear.

METHOD

In a racially diverse sample (N = 231; Aged 25-65; 65% female; 62% Black; 25% Hispanic), we examined whether positive affect (PA) and negative affect (NA) variability exhibited linear or quadratic associations with circulating inflammatory cytokines (a composite measure comprised of IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ), and C-reactive protein (CRP) and whether person-mean affect moderated these associations. Affective states were assessed using ecological momentary assessments (EMAs) 5 times per day for 2 weeks, with a blood draw at the end of the EMA period. Individual standard deviations of affective states indexed affect variability.

RESULTS

A quadratic association indicated that moderate NA variability was associated with lower CRP. There was evidence of significant moderation by linear associations with PA only: For those with higher person-mean PA, PA variability was positively associated with the cytokine composite. Both person-mean PA and person-mean NA moderated quadratic associations, such that for those with high person-mean affect, both high and low affect variability was associated with systemic inflammation.

CONCLUSION

Results are in line with fragile affect theory suggesting that associations between affect variability and health indicators may vary by person-mean affect. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Genes-in-Dyads: A Study of Relationship Quality

OBJECTIVES

Using dyadic genetic information on older couples, this study queried associations of a polygenic score for well-being with one's own as well as a partner's relationship experiences.

METHOD

Data were from the 2010 wave of the U.S. Health and Retirement Study. Analysis was through structural equation modeling.

RESULTS

Especially among women, the genetic score was associated with individuals' own relationship experiences. Genetic externalities-linkages of one's genes with a partner's experiences-were also observed. No significant gender variations emerged.

DISCUSSION

Contrary to conceptions implicit in much of existing genetics literature-which focuses on individuals' own gene-trait associations-the interpersonal environments most crucial to life course and health outcomes are shaped by the genes of all involved actors. Genetic externalities are a central component. Implications for the life course and gene-environment literatures are discussed.

European Psychiatric Association (EPA) guidance on prevention of mental disorders

There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions. Since a large proportion of lifetime mental illness starts before adulthood, such interventions are particularly important during childhood and adolescence. Prevention is important for the sustainable reduction of the burden of mental disorder since once it has arisen, treatment can only reduce a relatively small proportion of such burden. The challenge for clinicians is to incorporate such interventions into non-clinical and clinical practice as well as engaging with a range of other service providers including public health. Similar strategies can be employed in both the European and global contexts. Promotion of mental well-being can prevent mental disorder but is also important in the recovery from mental disorder. This guidance should be read in conjunction with the EPA Guidance on Mental Health Promotion. This guidance draws on preparatory work for the development of England policy on prevention of mental disorder which used a wide range of sources.

Emodiversity, health, and well-being in the Midlife in the United States (MIDUS) daily diary study

Emodiversity, or the variety and relative abundance of emotions experienced, provides a metric that can be used to understand emotional experience and its relation to well-being above and beyond average levels of positive and negative affect. Past research has found that more diverse emotional experiences, both positive and negative, are related to better mental and physical health outcomes. The present research aimed to test the relationship between positive and negative emodiversity across the span of 8 days with measures of health and well-being using 2 samples of the Midlife in the United States study (http://midus.wisc.edu/). Participants (N = 2,788) reported emotional states (14 negative, 13 positive) once each day for 8 days. Emodiversity scores were computed for each day using an adaptation of Shannon's biodiversity index and averaged across the days. All models included average affect and demographic covariates. Greater positive emodiversity was associated with fewer symptoms of depression and anxiety and fewer physical health symptoms but was not related to eudaimonic well-being nor cognitive functioning. In contrast to previous research, greater negative emodiversity was related to more symptoms of depression and anxiety and more physical health symptoms. Greater negative emodiversity was only associated with one positive outcome: better executive functioning. These findings illustrate inconsistencies across studies in whether negative emodiversity is associated with better or worse outcomes and raise further questions about how the construct of emodiversity can be better refined. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Measuring eudemonic well-being at work: a validation study for the 24-item the University of Tokyo Occupational Mental Health (TOMH) well-being scale among Japanese workers

Although the eudemonic perspective seems to be a promising in considering vocational identity among working population, well-being at work has been discussed primarily in terms of subjective/hedonic well-being. This study aimed to develop a new tool to measure eudemonic well-being at work (The University of Tokyo Occupational Mental Health [TOMH] well-being 24 scale)and investigate its validity in a collectivist culture. Two online surveys were conducted with a total of 1,760 workers in Japan. We created 89 potential items from existing scales. An exploratory factor analysis indicated eight factors for the dimensions of measurement. After item selection based on item response theory, the factor structure with three items from each of the eight dimensions indicated an excellent fit for another sample. Cronbach's α and intra-class coefficients ranged from 0.671 to 0.845. The scores of the tool were more strongly associated with subjective well-being in the work context rather than well-being in general. In addition, the participants in the group demonstrating a higher risk for mental illness and a more stressful work environment indicated significantly lower scores, even after adjusting for general eudemonic well-being. The new measurement may be useful both for academic and practical applications for measuring eudemonic well-being at work, independent from general eudemonic well-being.

Prescribing Placebos: An Experimental Examination of the Role of Dose, Expectancies, and Adherence in Open-Label Placebo Effects

Background

Recent evidence indicates that placebo effects can occur even when patients know that they are taking a placebo, termed the open-label placebo effect.

Aim

To assess whether placebo dose (one pill per day vs. four pills per day), treatment expectancies, and adherence contribute to open-label placebo effects.

Method

Healthy undergraduate participants were randomly assigned to take one or four open-label placebo pills per day or to a no-treatment control group. Placebo-treated participants took a 5-day course of an open-label placebo described as enhancing physical (symptoms and sleep) and psychological (positive and negative emotional experience) well-being. Expectancies about placebo effectiveness and well-being were assessed at baseline, and well-being and adherence were assessed after the 5-day course of treatment.

Results

Medium-to-large open-label placebo effects were evidenced in all well-being outcomes including sleep quality. Dose did not influence these effects. Both treatment expectancies and adherence were significant independent predictors of enhanced well-being in the two psychological well-being outcomes and the experience of physical symptoms, but sleep quality improved independently.

Conclusions

This is the first study to demonstrate the effect of open-label placebos in improving well-being and sleep quality and to show that open-label placebo reposes do not appear to be dose-dependent, but for most well-being outcomes are independently predicted by both positive expectancies and treatment adherence.

Editor choice: Let it rest: Sleep and health as positive correlates of forgiveness of others and self-forgiveness

Objective: The present study examined forgiveness of others, self-forgiveness, sleep, and health in a nationally representative sample of United States adults. It was hypothesised that sleep would mediate the associations of forgiveness of others and self-forgiveness with health.Design: A nationally representative survey of 1,423 United States adults.Main Outcome Measures: Measures included forgiveness of others, self-forgiveness, sleep quantity, sleep quality, psychological distress, life satisfaction, and self-rated physical health.Results: Forgiveness of others (β = .20, p < .001) and self-forgiveness (β = .11, p < .01) were associated with sleep and forgiveness of others (β = .24, p < .001) and self-forgiveness (β = .27, p < .001) were associated with health. Sleep was associated with health (β = .45, p < .001) and also acted as a mediator of the associations of forgiveness of others (β = .09, p < .01) and self-forgiveness (β = .05, p < .01) with health.Conclusions: Forgiveness of others and self-forgiveness may attenuate emotions such as anger, regret, and rumination and provide a buffer between one's own and others' offenses occurring during the day and offer a restful mental state that supports sound sleep which, in turn, is associated with better health.

Feeling excited or taking a bath: Do distinct pathways underlie the positive affect-health link in the U.S. and Japan?

Feeling good is linked to better health in Western contexts. Recent studies show, however, that the affect-health link is not consistent across cultures. We suggest two reasons for such inconsistency. The first follows from research showing that North American (vs. East Asian) cultures tend to value high arousal positive (HAP) states, for example, excited, more than low arousal positive (LAP) states, for example, calm. The second is one we propose for the first time. Positive affective experience is manifest in internal feelings but also in affective practices, such as taking a bath (a highly valued affective experience in Japan) or a fitness workout (a highly valued affective experience in the United States). We hypothesized that the HAP feelings/practices-health link would be stronger in the United States versus Japan, and the LAP feelings/practices-health link would be stronger in Japan versus the United States. Using survey samples from the United States (N = 640) and Japan (N = 382), we examined how health outcomes are shaped by positive affective feelings and practices varying in arousal. In a first set of analyses, HAP feelings predicted better physical and biological health in the United States but not in Japan. No cultural differences were consistently found for the effect of LAP feelings on health. In addition, engaging in HAP practices predicted better physical and biological health in the United States whereas engaging in LAP practices predicted better physical health in Japan but not in the United States. These findings suggest that the pathways underlying the culture-health link are culturally variable. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Effectiveness of stress-relieving strategies in regulating patterns of cortisol secretion and promoting brain health

Stress leads to ill-health and disease, and with today's fast-pace western society, engaging in strategies to relieve stress is crucial for good health across the life-course. Activities such as focusing on positive characteristics, art/music therapies, mindfulness, yoga and engaging with nature and/or physical activity have been shown to reduce stress and enhance well-being. It is thought that patterns of cortisol secretion, which are regulated by the brain, are a key mediator of stress-disease and well-being-health links. Measurement of cortisol in saliva is a non-invasive and ecologically valid tool for detecting early changes in brain health, as well as evaluating the effectiveness of strategies in relieving stress and improving brain health as well as monitoring stress-related brain changes. This chapter will review the evidence that engaging in stress-relieving strategies promotes regulation and/or restoration of patterns of cortisol secretion. If such strategies are found to be effective in healthy populations, they could potentially inform ways of promoting brain health and the prevention or delay of clinical disorders involving disorders in the brain (e.g., Parkinson's disease) and symptoms experienced with such disorders. To inform this field of research, recommendations are provided for the use of salivary cortisol as a marker of early monitoring of brain health and effectiveness of stress-alleviating interventions.

Relationship between life satisfaction and preventable hospitalisations: a population-based cohort study in Ontario, Canada

OBJECTIVE

To examine if low life satisfaction is associated with an increased risk of being hospitalised for an ambulatory care sensitive condition (ACSC), in comparison to high life satisfaction DESIGN AND SETTING: Population-based cohort study of adults from Ontario, Canada. Baseline data were captured through the Canadian Community Health Survey (CCHS) and linked to health administrative data for follow-up information.

PARTICIPANTS

129 467 men and women between the ages 18 and 74.

MAIN OUTCOME MEASURES

Time to avoidable hospitalisations defined by ACSCs.

RESULTS

Life satisfaction was measured at baseline through the CCHS and follow-up information on ACSC hospitalisations were captured by linking participant respondents to hospitalisation records covered under a single payer health system. Within the study time frame (maximum of 14 years), 3037 individuals were hospitalised. Older men in the lowest household income quintile were more likely to be hospitalised with an ACSC. After controlling for age, sex, socioeconomic status (SES) and other behavioural factors, low life satisfaction at baseline had a strong relationship with future hospitalisations for ACSCs (HR 2.71; 95% CI 1.87 to 3.93). The hazards were highest for those who jointly had the lowest levels of life satisfaction and low household income (HR 3.80; 95% CI 2.13 to 6.73). Results did not meaningful change after running a competing risk survival analysis.

CONCLUSIONS

This study demonstrates that poor life satisfaction is associated with hospitalisations for ACSCs after adjustment for several confounders. Furthermore, the magnitude of this relationship was greater for those who were more socioeconomically disadvantaged. This study adds to the existing literature on the impact of life satisfaction on health system outcomes by documenting its impact on avoidable hospitalisations in a universal health system.

Effect of Discrimination on Presenteeism among Aging Workers in the United States: Moderated Mediation Effect of Positive and Negative Affect

This study aimed to examine how perceived everyday discrimination influences presenteeism and how conscientiousness moderates the relationship between discrimination and positive affect among older workers. Structural equation modeling (SEM) was used to examine the mediating effect. The moderated mediation model was examined by PROCESS. The results of the final SEM model showed that discrimination was directly positively associated with presenteeism. Furthermore, positive affect was significantly inversely correlated with discrimination and presenteeism. In addition, negative affect was significantly positively correlated with discrimination and presenteeism. The significant indirect effect between perceived everyday discrimination and positive affect was significantly mediated by positive and negative affect. In addition, the results of the moderated mediation model indicate that positive affect was more likely to be influenced by perceived everyday discrimination among older workers with less conscientiousness, as compared with those with greater conscientiousness. To enhance work outcomes of aging workers in the United States, managers should foster highly conscientious aging workers, award those who are hardworking and goal-oriented, and combine personal goals and organizational goals through bonuses, holidays, and benefits. Policymakers should be mindful of the negative impact of discrimination on presenteeism and should target lowly conscientious older workers.

Dance for Health: the impact of creative dance sessions on older people in an acute hospital setting

Background: This service evaluation examined the impact of Dance for Health, a programme of weekly group dance sessions for older patients, which took place on wards in an acute hospital setting.Methods: Qualitative and quantitative observations using the ArtsObs scale were undertaken of 64 dance sessions over a 12-week period involving seven different hospital wards encompassing 313 patient attendances.Results: Statistically significant improvements were observed in the mood of the majority of patients taking part. People engaged mentally and physically with the activity were distracted from their medical condition and from what was happening on the ward. Patients appeared relaxed and were willing to express themselves creatively.Conclusion: The Dance for Health programme had a positive impact on group participants, promoting movement and physical activity for older patients. It is a meaningful and enjoyable activity, which encourages social interaction and provides respite from the medical environment.

The Effectiveness of Attachment Security Priming in Improving Positive Affect and Reducing Negative Affect: A Systematic Review

: Attachment security priming has been extensively used in relationship research to explore the contents of mental models of attachment and examine the benefits derived from enhancing security. This systematic review explores the effectiveness of attachment security priming in improving positive affect and reducing negative affect in adults and children. The review searched four electronic databases for peer-reviewed journal articles. Thirty empirical studies met our inclusion criteria, including 28 adult and 2 child and adolescent samples. The findings show that attachment security priming improved positive affect and reduced negative affect relative to control primes. Supraliminal and subliminal primes were equally effective in enhancing security in one-shot prime studies (we only reviewed repeated priming studies using supraliminal primes so could not compare prime types in these). Global attachment style moderated the primed style in approximately half of the studies. Importantly, repeated priming studies showed a cumulative positive effect of security priming over time. We conclude that repeated priming study designs may be the most effective. More research is needed that explores the use of attachment security priming as a possible intervention to improve emotional wellbeing, in particular for adolescents and children.

Pilot Test of an Appreciative Inquiry Intervention in Hypertension Self-management

We implemented an Appreciative Inquiry (AI) intervention to assist people with hypertension improve diet, physical activity, and blood pressure. In a two-group randomized controlled trial conducted over 12 weeks, 50 participants were recruited at an urban outpatient health care clinic. The intervention used participants' high peak positive experiences to promote behavior change, during two face-to-face individual sessions and three coaching telephone calls. Data were analyzed using test of differences between groups and analysis of covariance controlling for confounding variables. The intervention group had significantly higher levels of ideal self, positive emotions, and self-efficacy for chronic disease management than the control group. No significant group differences in physical activity, diet, or blood pressure. Findings provide empirical evidence about the underlying processes by which AI may promote health behavior change. Future research should examine the effectiveness of this AI intervention in a larger sample of patients and over a longer intervention period.

The relationship between subjective happiness and sleep problems in Japanese adolescents

OBJECTIVES

Low sleep quality in adolescents is an important public health concern, as it relates to both their current and future physical and mental health. Furthermore, subjective happiness is also often regarded as a major life goal. Although Japan is an economically powerful country, the reported levels of subjective happiness among Japanese adolescents is low. Thus, this study aims to examine the relationship between subjective happiness and sleep problems in Japanese adolescents.

METHODS

We conducted a nationally representative cross-sectional study of adolescents enrolled in junior and senior high schools in Japan. We used a questionnaire to determine the prevalence of sleep problems (eg, insomnia, short sleep duration (SSD) and poor sleep quality) and to evaluate the participants' reported levels of subjective happiness. Multivariable logistic regression analyses were used to examine the associations between subjective happiness and sleep problems. Adjusted variables were basic demographic characteristics (eg, gender and school grade), lifestyle behaviors, and mental health status.

RESULTS

Data from 64,329 students were analyzed (age range 12-18 years, mean age 15.7 years, 53.9% male). The results indicated that reported levels of subjective happiness were strongly associated with the prevalence of sleep problems. Linear relationships can be observed between sleep problems and subjective happiness scores. The multivariable logistic regression analysis showed that dose-response association of subjective happiness score was observed with all three sleep problems.

CONCLUSIONS

Due to these findings, we recommend that policy makers and school officials educate adolescents on the importance of both subjective happiness and good sleep hygiene.

Circadian Rhythm of Salivary Immunoglobulin A and Associations with Cortisol as A Stress Biomarker in Captive Asian Elephants (Elephas maximus)

Salivary immunoglobulin A (sIgA) has been proposed as a potential indicator of welfare for various species, including Asian elephants, and may be related to adrenal cortisol responses. This study aimed to distinguish circadian rhythm effects on sIgA in male and female Asian elephants and compare patterns to those of salivary cortisol, information that could potentially have welfare implications. Subjects were captive elephants at an elephant camp in Chiang Mai province, Thailand (n = 5 males, 5 females). Salivette^® kits were used to collect saliva from each elephant every 4 h from 06:00 to 22:00 h for 3 consecutive days (n = 15 samples/elephant). Enzyme immunoassays were used to quantify concentrations of IgA and cortisol in unextracted saliva. Circadian rhythm patterns were determined using a generalized least-squares method. Both sIgA and cortisol followed a circadian rhythm, although the patterns differed. sIgA displayed a daily quartic trend, whereas cortisol concentrations demonstrated a decreasing linear trend in concentrations throughout the day. There was no clear relationship between patterns of sIgA and salivary cortisol, implying that mechanisms of control and secretion differ. Results demonstrate for the first time that circadian rhythms affect sIgA, and concentrations follow a daily quartic pattern in Asian elephants, so standardizing time of collection is necessary.