Self-disgust, loneliness and mental health outcomes in older adults: An eye-tracking study

Is self-disgust an implicit or explicit emotional schema?

Self-disgust, a negative self-conscious emotional schema that is associated with mental health difficulties in both clinical and non-clinical populations, is typically assessed with self-reported measures that target physical and behavioural aspects of the self. The aim of the present research was to develop and validate a novel implicit self-disgust measure (ISDM) using an Implicit Association Task (IAT) paradigm, across three studies. Study 1 developed a list of disgust-related and positive words that were rated for emotional valence and arousal and informed the content of the ISDM. Study 2 developed and examined the ISDM using the single-target IAT in a non-clinical population and showed that scores in the ISDM were significantly associated with self-reported self-disgust. Study 3 partly replicated the findings of Study 2 among participants with trauma-related experiences and following a mood induction paradigm, showing a significant association between the ISDM and the physical aspect of self-reported self-disgust. These findings are significant because they have implications about the automaticity of self-disgust in people with traumatic experiences which can further inform clinical practice and interventions targeting self-disgust.

Loneliness and the COVID-19 pandemic: implications for practice

Loneliness is a complex universal human experience. A variety of evidence indicates that prolonged loneliness can have a negative effect on an individual's long-term physical and psychological outcomes. Empirical evidence and systematic reviews show strong links between loneliness and ill health, particularly cardiovascular disease and mental health. Loneliness is increasing in frequency and severity. The issue of loneliness has been part of UK Government mandates since 2018; however, evidence suggests that, due to the pandemic, the need to focus on the issue may be even more significant. Assessing for loneliness can be challenging and many people do not want to report their feelings of loneliness. Interventions should aim to be preventive and help people create meaningful interactions. Useful interventions include person-centred interventions, cognitive therapy and group intervention therapy. There is a need for more evidence-based loneliness interventions. A knowledge of local and voluntary sectors is vital so health professionals can effectively support their patients.

Looking into troubled waters: Childhood emotional maltreatment modulates neural responses to prolonged gazing into one's own, but not others', eyes

One of the most prevalent nonverbal, social phenomena known to automatically elicit self- and other-referential processes is eye contact. By its negative effects on the perception of social safety and views about the self and others, childhood emotional maltreatment (CEM) may fundamentally affect these processes. To investigate whether the socioaffective consequences of CEM may become visible in response to (prolonged) eye gaze, 79 adult participants (mean [M]age = 49.87, standard deviation [SD]age = 4.62) viewed videos with direct and averted gaze of an unfamiliar other and themselves while we recorded self-reported mood, eye movements using eye-tracking, and markers of neural activity using fMRI. Participants who reported higher levels of CEM exhibited increased activity in ventromedial prefrontal cortex to one's own, but not to others', direct gaze. Furthermore, in contrast to those who reported fewer of such experiences, they did not report a better mood in response to a direct gaze of self and others, despite equivalent amounts of time spent looking into their own and other peoples' eyes. The fact that CEM is associated with enhanced neural activation in a brain area that is crucially involved in self-referential processing (i.e., vmPFC) in response to one's own direct gaze is in line with the chronic negative impact of CEM on a person's self-views. Interventions that directly focus on targeting maladaptive self-views elicited during eye gaze to self may be clinically useful.

(No) Effects of a Self-Kindness Intervention on Self-Esteem and Visual Self-Perception: An Eye-Tracking Investigation on the Time-Course of Self-Face Viewing

Previous research has suggested a favorable impact of self-kindness on subjective well-being. The present experiment investigated the effects of an app-assisted self-kindness intervention for increasing self-esteem and self-face gaze, and for decreasing depression. We explored self-face processing via a time-course analysis of eye-tracking data. Eighty participants (56 female, 24 male; mean age: 23.2 years) were randomly allocated to one of two intervention groups, each receiving daily instructions to enhance either self-kindness or relaxation (active control). Following a one-week intervention period, both groups reported improved self-esteem (p = .035, ηpart2 = .068) and reduced depression (p < .001, ηpart2 = .17). The duration of self-face gaze increased in both groups (p < .001, ηpart2 = .21). Self-face processing was characterized by an early automatic attention bias toward the self-face, with a subsequent reduction in self-face bias, followed in turn by an attentional self-face reapproach, and then a stable self-face bias. We thus identified a complex temporal pattern of self-face inspection, which was not specifically altered by the intervention. This research sheds light on the potential for app-assisted interventions to positively impact psychological well-being, while also highlighting the complexity of self-face processing dynamics in this context. In the future, we propose the inclusion of personalized self-kindness statements, which may amplify the benefits of these interventions.

Loneliness is not a homogeneous experience: An empirical analysis of adaptive and maladaptive forms of loneliness in the UK

Understanding loneliness is pivotal to informing relevant evidence-based preventive interventions. The present study examined the prevalence of loneliness in the UK, during the COVID-19 pandemic, and the association between loneliness, mental health outcomes, and risk and protective factors for loneliness, after controlling for the effects of social isolation. It was estimated that 18.1% of the population in our study experienced moderately high to very high loneliness. We also found that loneliness was positively associated with self-disgust and social inhibition, and negatively associated with trait optimism and hope. Cluster analysis indicated that two distinct groups emerged among those experiencing higher levels of loneliness: "adaptive" and "maladaptive" loneliness groups. The maladaptive loneliness group displayed psychological characteristics like self-disgust and social inhibition including symptoms of depression and anxiety that can potentially undermine their ability to connect with others and form meaningful social relationships. These findings suggest that not all people experience loneliness in the same way. It is possible that a one-size-fit-all approach to reducing loneliness, may be less effective because it does not take into account the differential psychological profiles and characteristics of lonely people, relevant to their capacity to connect with others.

The network of psychosocial health in middle-aged and older adults during the first COVID-19 lockdown

PURPOSE

Psychosocial health problems, such as social isolation, loneliness, depression and anxiety, have gained attention during the COVID-19 pandemic and are commonly co-occurring. We investigated the network of psychosocial health constructs during the COVID-19 pandemic.

METHODS

This study included 4553 participants (mean age: 68.6 ± 11.2 years, 56% women) from the prospective Rotterdam Study, who filled out a questionnaire between April and July 2020, the time of the first COVID-19 wave in the Netherlands. Psychosocial health constructs included were depressive symptoms (Center for Epidemiological Studies Depression scale), anxiety symptoms (Hospital Anxiety and Depression scale), loneliness (University of California, Los Angeles loneliness scale), social connectedness (five items) and pandemic-related worry (five items). We estimated mixed graphical models to assess the network of items of these constructs and whether age and sex affected the network structure.

RESULTS

Within the network of psychosocial constructs, a higher depressive symptoms score was particularly associated with items of loneliness and social connectedness, whereas overall anxiety was particularly associated with items of pandemic-related worry. Between people from different sex and age, the network structure significantly altered.

CONCLUSION

This study demonstrates that within the same network of psychosocial health constructs, depressive symptom score is particularly associated with loneliness and social connectedness, whereas anxiety symptom score is associated with pandemic-related worry during the first COVID-19 lockdown. Our results support that psychosocial constructs should be considered in conjunction with one another in prevention and treatment efforts in clinical care, and that these efforts need to be tailored to specific demographic groups.

Effects of Self-Esteem on Self-Viewing: An Eye-Tracking Investigation on Mirror Gazing

While some people enjoy looking at their faces in the mirror, others experience emotional distress. Despite these individual differences concerning self-viewing in the mirror, systematic investigations on this topic have not been conducted so far. The present eye-tracking study examined whether personality traits (self-esteem, narcissism propensity, self-disgust) are associated with gaze behavior (gaze duration, fixation count) during free mirror viewing of one's face. Sixty-eight adults (mean age = 23.5 years; 39 females, 29 males) viewed their faces in the mirror and watched a video of an unknown person matched for gender and age (control condition) for 90 s each. The computed regression analysis showed that higher self-esteem was associated with a shorter gaze duration for both self-face and other-face. This effect may reflect a less critical evaluation of the faces.

Social distancing and anxiety among female caregivers of children ages zero-to-five during coronavirus disease (COVID-19) lockdown in the United States

Background

Past studies have linked measures of social isolation to mental health among caregivers of children. As people across the world adjust to social distancing measures, there is a need to understand consequences of social distancing measures on mental health. Thus, the objective of this study is to examine the association between adherence to social distancing measures and feeling worried/anxious among female caregivers of children ages zero-to-five.

Methods

Data for this study came from an online survey that was administered between May and June 2020 to understand stress and mental health among caregivers of children during the COVID-19 pandemic. A sample of 358 female caregivers was analyzed using binary logistic regression with feeling worried/anxious as the outcome variable.

Results

More than a third of the female caregivers (35.2%) reported feeling worried/anxious during the past month and about 42% reported strictly adhering to social distancing measures. Controlling for the effect of other factors, caregivers who reported strictly adhering to social distancing had 1.86 times higher odds of feeling worried/anxious when compared caregivers who were not strictly adhering to social distancing (AOR=1.86, 95% C.I.=1.07–3.24). Caregivers who felt bothered by withdrawal from activities of interest had 4.11 times higher odds of reporting feeling worried/anxious (AOR=4.11, 95% C.I.=2.32–7.24).

Conclusions

As COVID-19 pandemic continues to evolve, it is important to build community response to better support caregivers of infants and young children. Implications for practice, policy, and research as they relate to caregiver's mental health are discussed.

The Impact of a Digital Intervention (Happify) on Loneliness During COVID-19: Qualitative Focus Group

BACKGROUND

Loneliness is a growing area of concern, attracting attention as a public health concern due to its association with a variety of psychological and physical health problems. However, interventions targeting loneliness are less common than interventions for other mental health problems, such as depression and anxiety, and existing interventions focus primarily on building social skills and increasing opportunities for social interaction despite research suggesting these techniques are not the most effective. Furthermore, although there is an increasing need for scalable and convenient interventions, digital interventions for loneliness are even less common.

OBJECTIVE

Using a qualitative approach, we explore how adults (18-64 years of age) who express wanting to be more connected to others experience loneliness and react to a digital mental health intervention targeting loneliness.

METHODS

A total of 11 participants were recruited from a pilot randomized controlled trial exploring the impact of a digital mental health intervention, Happify Health, on loneliness among adults aged 18-64 years who indicated wanting to feel more connected to others when signing up for the platform. Participants were invited to participate in a 3-day asynchronous focus group about their experiences with loneliness, with Happify Health, and with social distancing during the COVID-19 pandemic. All 11 participants completed the focus group in May 2020.

RESULTS

Participants' responses were coded using thematic analysis, which led to identifying five themes, each with separate subthemes, that could be applied across the 3-day focus group: loneliness, relationships, social distancing, skill acquisition, and coping. Overall, we observed variability across participants in terms of the source of their loneliness, their perceptions of their social connections, and their motivation to reduce feelings of loneliness; however, participants commonly referred to negative self-perceptions as a cause or consequence of loneliness. Participants also varied in the extent to which they felt social distancing increased or decreased feelings of loneliness. In regard to the intervention, participants showed evidence of adopting skills they used to address their loneliness, particularly mindfulness and gratitude, and then using these skills to shift toward more active coping strategies following the intervention, including during the COVID-19 pandemic.

CONCLUSIONS

The heterogeneity in participants' experiences with loneliness described during this focus group emphasizes the subjective and complex nature of loneliness. This highlights the importance of developing loneliness interventions that use a variety of strategies, including both direct and indirect strategies for reducing loneliness. However, based on our data, a key component to loneliness interventions is incorporating strategies for addressing underlying negative self-perceptions that stem from, but also contribute to, loneliness. This data also provides preliminary evidence that digital platforms may be an effective tool for disseminating loneliness interventions while providing the added benefit of offering a productive distraction when feeling lonely.

Compulsive Internet Pornography Use and Mental Health: A Cross-Sectional Study in a Sample of University Students in the United States

Background

The sustained rise in negative mental health reports among university students is a source of continued global concern, and investigation continues into potential contributors to this rise. This includes the increased prevalence of risky sexual behaviors. Related is the increased prevalence of pornography use. Our study sought to explore the potential relationship between compulsive use of pornography and mental health in university students.

Methods

Our sample consisted of university students (N = 1031; 34% male, 66% female) from Franciscan University of Steubenville, Steubenville, Ohio. An anonymous survey was sent to all students at the university over the age of 18. The survey was comprised of the following: (1) demographic questions, (2) questions on pornography use and perception, (3) a modified version of the Compulsive Internet Use Scale (mCIUS) assessing various factors associated with compulsive internet pornography use, (4) questions assessing emotional and sexual states relative to pornography use (EmSS), and (5) the 21-question version of the Depression, Anxiety and Stress Scale (DASS-21).

Results

Our results indicate that 56.6% of those surveyed reported lifetime pornography use, with a significantly higher proportion of males than females reporting such use. The majority of students reported accessing pornography through internet-related technologies. Additionally, 17.0, 20.4, and 13.5% of students reported severe or extremely severe levels of depression, anxiety and stress, respectively, with compulsive pornography use significantly affecting all three mental health parameters in both sexes. Exploratory Factor Analysis identified three factors suggesting emotional coping, dependence and preoccupation for the mCIUS items and three factors reflecting interoceptive, impotent, and extrinsic characteristics for the EmSS items. Regression analysis indicated that various demographics, items pertaining to reduced control and social impairment, and other variables pertaining to pornography use predicted mental health outcomes. Faith, morals and personal motivation were the primary variables reported to help reduce pornography use.

Conclusion

Our analyses indicate a significant relationship between mental health and pornography use, including behaviors reflecting behavioral addictions, highlighting the necessity for a better understanding and consideration of the potential contribution of internet pornography to negative mental health among university students.

Self-Disgust Is Associated With Loneliness, Mental Health Difficulties, and Eye-Gaze Avoidance in War Veterans With PTSD

In the present study, we examined, for the first time, the association between self-disgust, loneliness, and mental health difficulties in war veterans diagnosed with PTSD. For this purpose, we used a mixed methods design, incorporating surveys and a novel eye-tracking paradigm, and compared the findings from the PTSD veteran group (n = 19) to those from a general population group (n = 22). Our results showed that the PTSD veteran group reported almost three times higher scores in self-disgust, and significantly higher scores in loneliness and mental health difficulties (anxiety and depression), compared to the general population. Furthermore, self-disgust mediated the association between loneliness and anxiety symptoms in both groups. The results from the eye-tracking paradigm further showed that veterans with PTSD displayed a self-avoidance gaze pattern, by looking significantly more toward pictures of faces of unknown others and away from their own face—a pattern that was not replicated in the general population group. Higher self-disgust scores were significantly associated with longer total gaze to the pictures of others (vs. the self). Our findings have implications for the role of self-disgust in the mental health of war veterans.