Is waiting bad for subjective health?

Emotional, cognitive, and physical well-being during the wait for breast biopsy results

OBJECTIVE

This study is a replication and extension of previous work examining the well-being of patients at a breast biopsy appointment. Expanding on a previous study, we aim to identify predictors of well-being following the appointment (i.e. waiting for results).

DESIGN

In this longitudinal study, female patients (N = 197) were surveyed at their breast biopsy appointments and then completed daily surveys assessing distress and coping during the week-long wait for results.

MAIN OUTCOME MEASURES

Surveys asked about patient characteristics, subjective health, cancer history, support availability, outcome expectations, and distress.

RESULTS/CONCLUSIONS

Consistent with the previous study, health history and demographic factors were largely unassociated with distress, this time while waiting for biopsy results. Latina ethnicity emerged one of the few predictors of coping, pointing to opportunities for differential clinical interventions that take cultural factors into account. Finally, anxiety was highest at the beginning and end of the wait for biopsy results, suggesting that interventions may be most effective following a breast biopsy and the days prior to learning one's result.

Volatility in Expectations While Awaiting Important News

Waiting for important news is uniquely anxiety provoking, and expectations for one's outcome fluctuate throughout the wait. Emotional volatility is typically associated with negative outcomes, but little is known about volatility in expectations. In Study 1, law graduates (N = 248) estimated their chances of passing the bar exam every 2 weeks during the wait for results. Greater volatility in expectations, operationalized as the frequency with which outcome expectations changed during the wait, was associated with greater worry and more negative emotionality throughout the wait. Study 2 partially replicated these findings in a sample of Trump and Biden supporters (N = 444) awaiting the result of the 2020 presidential election. Study 2 also demonstrated a causal link between constrained (vs. volatile) expectations and worry. Our findings have implications for how best to manage one's expectations while awaiting important news, with the goal of minimizing worry and other negative emotions.

Within-person associations of optimistic and pessimistic expectations with momentary stress, affect, and ambulatory blood pressure

BACKGROUND AND OBJECTIVES

Although dispositional optimism and pessimism have been prospectively associated with health outcomes, little is known about how these associations manifest in everyday life. This study examined how short-term optimistic and pessimistic expectations were associated with psychological and physiological stress processes.

METHODS

A diverse sample of adults (N = 300) completed a 2-day/1-night ecological momentary assessment and ambulatory blood pressure (ABP) protocol at ∼45-minute intervals.

RESULTS

Moments that were more optimistic than typical for a person were followed by moments with lower likelihood of reporting a stressor, higher positive affect (PA), lower negative affect (NA), and less subjective stress (SS). Moments that were more pessimistic than typical were not associated with any affective stress outcome at the following moment. Neither optimism nor pessimism were associated with ABP, and did not moderate associations between reporting a stressor and outcomes.

DISCUSSION

These findings suggest that intraindividual fluctuations in optimistic and pessimistic expectations are associated with stressor appraisals.

Antecedents of Subjective Health among Korean Senior Citizens Using Archival Data

This study aimed to investigate the determinants of subjective health among South Korean senior citizens. Secondary data for the year 2018 was used from the Senior Citizen Research Panel data collected by the Korea Employment Information Service. A total of 3822 valid observations were analyzed. The dependent variable was subjective health, and the independent variables were religion participation, social gathering participation, economic activity, food expenditure, leisure expenditure, travel frequency, and art watching frequency. Descriptive analysis, correlation matrix, and independent t-test were carried out for data analysis. Multiple linear regression analysis was employed using assets, age, and gender as control variables to test the research hypotheses. The results indicate that all the proposed attributes have a significant positive impact on the subjective health of Korean senior citizens, with implications for policy making.

Preparing Silver Linings for a Cloudy Day: The Consequences of Preemptive Benefit Finding

Waiting for important news is stressful. In four studies, we assess the utility of preemptive benefit finding, a coping strategy in which people seek silver linings in bad news before receiving news, for emotional well-being across several waiting periods (waiting for bar exam results, the outcome of political elections, and results of a fictitious health risk assessment). Our findings support the effectiveness of preemptive benefit finding while waiting, such that identifying benefits in bad news while waiting predicts more positive emotions during the wait (Studies 3 and 4) and buffers people against the emotional consequences of bad news by boosting post-news positive emotions (Studies 2-4). Importantly, engaging in preemptive benefit finding does not backfire if a person ultimately receives good news (Studies 1, 3, and 4). We discuss results from a mini meta-analysis and consider implications of our findings for interventions to improve well-being while waiting and after news arrives.

The Psychological Experience of Awaiting Breast Diagnosis

BACKGROUND

Each year, over 1 million women in the USA undergo diagnostic breast biopsies, many of which culminate in a benign outcome. However, for many patients, the experience of awaiting biopsy results is far from benign, instead provoking high levels of distress.

PURPOSE

To take a multifaceted approach to understanding the psychological experience of patients undergoing a breast biopsy.

METHOD

Female patients (N = 214) were interviewed at an appointment for a breast biopsy, just prior to undergoing the biopsy procedure. Pertinent to the current investigation, the interview assessed various patient characteristics, subjective health and cancer history, support availability, outcome expectations, distress, and coping strategies.

RESULTS

The findings revealed a complex set of interrelationships among patient characteristics, markers of distress, and use of coping strategies. Patients who were more distressed engaged in more avoidant coping strategies. Regarding the correlates of distress and coping, subjective health was more strongly associated with distress and coping than was cancer history; perceptions of support availability were also reliably associated with distress.

CONCLUSION

Taken together, the results suggest that patients focus on their immediate experience (e.g., subjective health, feelings of risk, perceptions of support) in the face of the acute moment of uncertainty prompted by a biopsy procedure, relative to more distal considerations such as cancer history and demographic characteristics. These findings can guide clinicians' interactions with patients at the biopsy appointment and can serve as a foundation for interventions designed to reduce distress in this context.

Associations between subjective time perception and well-being during stressful waiting periods

The passage of time is a subjective experience and can be easily distorted by concurrent emotions. Specifically, time seems to move particularly slowly when people are in a negative emotional state. The aim of the current studies was to evaluate the bidirectional relationship between subjective time perception and distress during stressful waiting periods, during which the slow passage of time may be particularly distressing. Across studies of undergraduate students awaiting a midterm exam grade (Study 1) and law graduates awaiting bar exam results (Studies 2 and 3), results revealed consistent links between distress and time perception across the waiting periods, with tentative evidence for bidirectional relationships between these experiences. That is, people who perceived time as moving slowly while they waited tended to report greater distress across the waiting period (particularly worry, anxiety, negative emotion, and poor coping), and people who reported greater distress tended to perceive time as moving more slowly. The links between distress and time perception suggest the possibility of downward spirals during stressful waiting periods, such that distress makes time seem to slow down, which then exacerbates distress. We discuss avenues for future research and potential remedies to derail the spiral of distress and time perception.

Preemptively finding benefit in a breast cancer diagnosis

Objective: The current mixed-method investigation seeks to discover if and how people engage in preemptive benefit finding (i.e. seeking silver linings in a potential future outcome), specifically in the context of awaiting a breast biopsy result. Design: A total of 201 patients were interviewed just prior to undergoing a breast biopsy at a county hospital. Main outcome measures and results: A qualitative analysis identified themes in women's descriptions of preemptive benefit finding. A majority of participants (76%) reported engaging in preemptive benefit finding at their appointment, a week or more before learning their result. Patients identified two categories of benefits - self- and other-focused - and eight subcategories: health benefits, personal growth, appreciation for life, physical change, strengthening relationships, spreading awareness, supporting others, and role modelling. We also identify differences between those who engaged in self-focused and other-focused preemptive benefit finding. Conclusion: Benefit finding begins long before bad news arrives, and people find a variety of benefits in even the most dire of anticipated news. Clinicians who interact with patients during the diagnostic process (e.g. mammography technicians) may find it useful to know that their patients are already grappling with the possibility of a diagnosis, including the positive reappraisal process of identifying potential silver linings.

Fulfilling psychological needs predicts less sleep disruption and worry while awaiting uncertain news

Research on self-determination theory suggests that people have fundamental needs to feel autonomous, competent, and socially connected and that fulfilling these needs is critical for well-being. In the present study, we examined whether fulfilling psychological needs is associated with physical and psychological well-being-specifically sleep disruption and worry, two key indicators of well-being during waiting periods-while managing the unique stress of awaiting uncertain news. In a study of law graduates during the 4 months while they awaited their California bar exam (the exam one is required to pass before practicing law) results, personal increases in need fulfilment related to temporally congruent reductions in sleep disruption and worry. In addition, those whose needs were most fulfilled during the waiting period responded less negatively to failing the bar exam. The picture for need frustration was mixed; only autonomy frustration was associated with concurrent increases in worry, although those whose needs were more frustrated in general also experienced greater worry and sleep disruption on average. On the whole, our findings suggest that self-determination theory needs may be a fruitful target for interventions that can protect well-being while people wait and even once their uncertainty is resolved.

Healthier and Happier? A 3-Year Longitudinal Investigation of the Prospective Associations and Concurrent Changes in Health and Experiential Well-Being

Global well-being is positively correlated with health. Moreover, studies suggest that health and global well-being predict changes in one another across time. Fewer studies, however, have examined the extent to which health is associated with daily emotional experiences-especially longitudinally. The present study examined the longitudinal associations between health and both global and experiential well-being, assessed 4 times across 3 years. Moreover, we used advanced analyses-random-intercept cross-lag models-which address limitations of traditional cross-lag models. Results revealed health and well-being generally did not prospectively predict changes in one another across 1 year. In contrast, year-to-year changes in health were correlated with simultaneous changes in well-being-with effect sizes being largest for global well-being. These findings suggest that health and well-being change together in processes that unfold relatively quickly. Finally, using traditional cross-lag models, numerous potentially illusory prospective associations between health and well-being emerged, underscoring the importance of using appropriate longitudinal statistical models.

On the Experience of Awaiting Uncertain News

At some point in life, everyone must wait for important news—whether the news from college applications, job interviews, medical tests, academic exams, or even romantic overtures. Until recently, the psychological literature on stress and coping had largely overlooked these common and often distressing experiences. However, the past 5 years have seen significant advances in the understanding of waiting experiences, revealing insights into the nature, time course, and consequences of distress during waiting periods; individual differences in these experiences; and effective and ineffective strategies for coping with this type of uncertainty. This article reviews the emerging findings from this growing literature and provides suggestions for future research in this area.

Even Optimists Get the Blues: Interindividual Consistency in the Tendency to Brace for the Worst

OBJECTIVE

The present research examined whether the tendency to brace for the worst by becoming pessimistic as news approaches varies across people, namely, people who differ in their trait-like outlooks on the future (dispositional optimism, defensive pessimism).

METHOD

Across nine studies in laboratory and field settings, we examined the roles of dispositional optimism and defensive pessimism in the propensity to brace for the worst when awaiting uncertain news. The studies used a variety of paradigms, including predictions about performance on the bar exam, peer ratings of attractiveness, and feedback on an intelligence test.

RESULTS

Results from these studies consistently failed to support individual differences in the tendency to brace for the worst.

CONCLUSIONS

Trait-like differences in future outlooks seem to influence only the level and not trajectories of outcome predictions, pointing to relative commonalities in the development of the tendency to brace for the worst.