Interventions to Modify Psychological Well-Being: Progress, Promises, and an Agenda for Future Research

Psychological well-being and job performance of nurses and midwives amidst COVID-19 in Ghana; a multi-group analysis

The purpose of this study was to examine the effect of psychological well-being on job performance among nurses and midwives in rural and urban hospitals in Ghana amidst COVID-19. The study adopted a purely quantitative approach, using the explanatory research design. Data were collected from 262 nurses and midwives in two selected hospitals in the Central Region of Ghana. The Structural Equation Modelling was used to analyze the data collected. The results revealed that the levels of psychological well-being and job performance were high in both hospitals amidst the pandemic. Further, it was observed that although psychological well- being had significant influence on job performance among the nurses and midwives in both rural and urban communities, the effect was more significant in the urban settlements. Given these findings, the study recommended that in order to effectively improve the job performance of nurses and midwives, management must adopt policies such as, flexible work arrangements, leave policy, and counselling services to support their psychological well-being.

A review of the literature on wellbeing and modifiable dementia risk factors

Wellbeing-defined broadly as experiencing one's life as enjoyable and fulfilling-has been associated with lower risk for Alzheimer's disease and related dementias. The mechanisms underlying this association are largely unknown. However, prior research and theory suggest that wellbeing impacts health behaviors and biological systems that are relevant to cognitive and brain health. Several of these factors have also been identified by the 2020 Lancet Commission on Dementia Prevention, Intervention, and Care as modifiable dementia risk factors. In the current review, we summarize and evaluate the evidence for associations between wellbeing and each of the 12 Lancet Commission risk factors. We found relatively consistent evidence for associations between higher wellbeing and lower levels of most of the risk factors: physical inactivity, social isolation, smoking, depression, hypertension, diabetes, hearing loss, traumatic brain injury, and air pollution. By contrast, we found evidence for only modest associations between wellbeing and education and mixed evidence for associations of wellbeing with alcohol use and body weight. Although most of the reviewed evidence was observational, longitudinal and experimental evidence suggests that many of the observed associations are likely bidirectional. These findings suggest that modifiable dementia risk factors may be mediators (i.e., intermediate steps in the causal chain) and/or confounders (i.e., variables that impact both wellbeing and dementia, and thus could induce a spurious association) of the association between wellbeing and dementia. We conclude by discussing next steps to test mediation hypotheses and to account for potential confounding in the relation between wellbeing and dementia.

Purpose in life as a resilience factor for brain health: diffusion MRI findings from the Midlife in the U.S. study

Introduction

A greater sense of purpose in life is associated with several health benefits relevant for active aging, but the mechanisms remain unclear. We evaluated if purpose in life was associated with indices of brain health.

Methods

We examined data from the Midlife in the United States (MIDUS) Neuroscience Project. Diffusion weighted magnetic resonance imaging data (n=138; mean age 65.2 years, age range 48-95; 80 females; 37 black, indigenous, and people of color) were used to estimate microstructural indices of brain health such as axonal density, and axonal orientation. The seven-item purpose in life scale was used. Permutation analysis of linear models was used to examine associations between purpose in life scores and the diffusion metrics in white matter and in the bilateral hippocampus, adjusting for age, sex, education, and race.

Results and discussion

Greater sense of purpose in life was associated with brain microstructural features consistent with better brain health. Positive associations were found in both white matter and the right hippocampus, where multiple convergent associations were detected. The hippocampus is a brain structure involved in learning and memory that is vulnerable to stress but retains the capacity to grow and adapt through old age. Our findings suggest pathways through which an enhanced sense of purpose in life may contribute to better brain health and promote healthy aging. Since purpose in life is known to decline with age, interventions and policy changes that facilitate a greater sense of purpose may extend and improve the brain health of individuals and thus improve public health.

Involvement of Personality and Health Status in the Psychological Wellbeing of Subjects with Chronic Disease

(1) Background: Psychological wellbeing correlates with improved physical and psychological health, as this construct plays a fundamental role in disease recovery and health maintenance. Hence, for healthcare professionals, understanding the factors that predict psychological wellbeing is of great interest. Thus, the objective of this study was to determine whether health status and personality traits influence psychological wellbeing. (2) Methods: The total sample (N = 600) consisted of HIV patients, individuals with diabetes, and healthy subjects from the Salamanca Clinical Hospital. The instruments used for data collection included a sociodemographic questionnaire, Ryff's Psychological Wellbeing Scale, and the Spanish version of the Big Five Taxonomy to measure personality. (3) Results: Specific personality traits, such as Emotional Stability, Extraversion, Responsibility, and Integrity were significant predictors of different dimensions of psychological wellbeing. Regarding health status, individuals with diabetes and healthy subjects, compared to HIV+ subjects, were associated with higher levels of psychological wellbeing dimensions. (4) Conclusions: Individual differences in personality traits and the diagnosis of a chronic condition may play a fundamental role in psychological wellbeing. These conclusions are of great interest for developing strategies aimed at individuals with chronic illnesses and specific personality traits associated with poorer psychological wellbeing.

Psychological wellbeing in Chinese university students: insights into the influences of academic self-concept, teacher support, and student engagement

Objective

This study investigates the complex interplay between academic self-concept, teacher support, student engagement, and psychological wellbeing among Chinese university students. We aimed to elucidate the mediating role of student engagement in these relationships.

Methods

A sample of 597 Chinese undergraduate students from diverse universities participated in the study. We employed structured questionnaires to assess academic self-concept, teacher support, student engagement, and psychological wellbeing. Confirmatory factor analyses and structural equation modeling were used to test our hypothesized model.

Results

Structural equation modeling indicated that the partial mediation model, which considered both direct and indirect effects, outperformed full mediation and direct effect models. Student engagement significantly mediated the relationships between academic self-concept, teacher support, and psychological wellbeing. Importantly, teacher support demonstrated a direct impact on psychological wellbeing, even when accounting for the mediating role of student engagement.

Conclusion

This study underscores the pivotal role of student engagement as a mediator in the relationship between academic self-concept, teacher support, and psychological wellbeing among Chinese university students. While student engagement plays a substantial mediating role, our findings also recognize the persistent direct influence of teacher support on psychological wellbeing. These insights have implications for educators and policymakers aiming to enhance the wellbeing of university students by fostering positive academic self-concept and teacher support while recognizing the importance of student engagement.

The role of psychosocial well-being and emotion-driven impulsiveness in food choices of European adolescents

BACKGROUND

It is unclear whether a hypothetical intervention targeting either psychosocial well-being or emotion-driven impulsiveness is more effective in reducing unhealthy food choices. Therefore, we aimed to compare the (separate) causal effects of psychosocial well-being and emotion-driven impulsiveness on European adolescents' sweet and fat propensity.

METHODS

We included 2,065 participants of the IDEFICS/I.Family cohort (mean age: 13.4) providing self-reported data on sweet propensity (score range: 0 to 68.4), fat propensity (range: 0 to 72.6), emotion-driven impulsiveness using the UPPS-P negative urgency subscale, and psychosocial well-being using the KINDLR Questionnaire. We estimated, separately, the average causal effects of psychosocial well-being and emotion-driven impulsiveness on sweet and fat propensity applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). Further, we investigated a potential indirect effect of psychosocial well-being on sweet and fat propensity mediated via emotion-driven impulsiveness using a causal mediation analysis.

RESULTS

If all adolescents, hypothetically, had high levels of psychosocial well-being, compared to low levels, we estimated a decrease in average sweet propensity by 1.43 [95%-confidence interval: 0.25 to 2.61]. A smaller effect was estimated for fat propensity. Similarly, if all adolescents had high levels of emotion-driven impulsiveness, compared to low levels, average sweet propensity would be decreased by 2.07 [0.87 to 3.26] and average fat propensity by 1.85 [0.81 to 2.88]. The indirect effect of psychosocial well-being via emotion-driven impulsiveness was 0.61 [0.24 to 1.09] for average sweet propensity and 0.55 [0.13 to 0.86] for average fat propensity.

CONCLUSIONS

An intervention targeting emotion-driven impulsiveness, compared to psychosocial well-being, would be marginally more effective in reducing sweet and fat propensity in adolescents.

Sarcoidosis and frailty: recognizing factors that foster holistic resilience

PURPOSE OF REVIEW

Sarcoidosis is a multiorgan system disease exerting significant impact on biophysical, social, psychological and emotional well-being. Mortality and disability correlate to accessible, timely, expert care for sarcoidosis and its related complications. Across health conditions, positive healthcare interactions and interventions can rehabilitate unfavourable factors tied to concepts of 'frailty'. Here, we set out to introduce concepts related to frailty and their impact in the context of sarcoidosis.

RECENT FINDINGS

Studies examining frailty across other multiorgan and single organ-based diseases that mirror organ involvement in sarcoidosis demonstrate findings that bear relevance in sarcoidosis. Namely, factors predisposing a person to frailty are a multifactorial phenomenon which are also reflected in the lived experience of sarcoidosis; and that early diagnosis, intervention and prevention may alter a course towards more favourable health outcomes.

SUMMARY

Factors predisposing to frailty in other health conditions may also signal a risk in sarcoidosis. In turn, proactive health preservation - regardless of age - may lead to improved biopsychosocial reserve and health-related quality of life. Fortifying holistic resilience in sarcoidosis is anticipated to reduce risk of the occurrence and prolongation of health-related complications, and facilitate swifter recovery from biophysical complications as well as from psychosocial and emotional stressors.

Introduction to Special Issue: Interventions to Modify Psychological Well-Being and Population Health

Psychological ill-being is on the rise, with 1 in 5 Americans suffering from a mental disorder in any given year. Additional evidence demonstrates that psychological well-being has also decreased over time. These trends are particularly worrisome given the substantial and growing body of evidence demonstrating that psychological ill-being (e.g., depression, anxiety, anger) is associated with an elevated risk of developing chronic diseases and premature mortality, while aspects of psychological well-being (e.g., positive affect, sense of purpose and meaning, life satisfaction) are independently associated with improved physical health outcomes. An underexplored but promising approach to enhancing both psychological and physical health is through developing a set of tools that specifically target psychological well-being (often referred to as positive psychological interventions (PPIs) although many interventions developed outside the field of positive psychology also achieve these goals). Such interventions hold promise as a strategy for improving population health. However, critical knowledge gaps hold us back, and we have not yet developed a robust set of intervention strategies that can improve psychological well-being in meaningful, durable, and scalable ways that would also have downstream effects on physical health. The goal of this special issue is to help address these knowledge gaps by bringing together current conceptual frameworks, critical examination of key constructs, and novel empirical evidence needed to identify and examine interventions that can modify psychological well-being, particularly those that have the potential to be scaled at the population level and with durable effects.