Does positive affect influence health?

Preventing "tipping points" in high comorbidity patients: A lifeline from health coaches - rationale, design and methods

BACKGROUND

This paper describes an innovative cluster randomized controlled trial design to evaluate the comparative effectiveness of two approaches to preventing significant destabilization, leading to unplanned hospitalization and increased disability for patients with high comorbidity, that is, multiple chronic diseases defined by an enhanced Charlson Comorbidity Index ≥4.

METHODS

A total of 1974 patients were randomized in four waves at each of the sixteen Federally Qualified Health Centers (FQHCs) in four health systems -two in New York and two in Chicago. The two interventions compared 1) Patient-Centered Medical Home (PCMH) as implemented by the FQHCs (usual care control); or 2) PCMH plus a coaching intervention delivered by Health Coaches (experimental) helping patients identify life goals to encourage self-management enhanced by a positive affect/self-affirmation strategy. The two primary patient-centered clinical outcomes are 1) Unplanned hospitalizations; and 2) Within-patient changes in quality of life and disability, as measured by the World Health Organization Disability Assessment Scale 2 (WHODAS 2.0). The hypotheses are: 1) intervention patients will have a 5 % relative reduction in unplanned hospitalizations as compared to control patients; and 2) reduced disability measured by WHODAS2.0; 3) destabilization or 'tipping points' leading to hospitalization will be more often triggered by psychosocial issues than by medical Issues.

CONCLUSION

This cluster RCT has the potential to transform the care for patients with high comorbidity by helping motivate patients to engage in self-management and to successfully navigate the barriers, challenges, and stresses leading to destabilization, hospitalization, and increased disability.

CLINICALTRIALS

gov registration number: NCT04176510.

Positive life experiences and physical health: Associations and mediating pathways

Engagement in positive experiences in everyday life has been associated with better long-term survival, but research assessing associations with other measures of long-term physical health is limited. In the current study, data collected from the Midlife in the US Study (N=1,182) in 2004-2017 were used to examine whether frequency of engagement in a range of positive experiences is associated with three domains of health (subjective, functional, and morbidity) over an average seven-year follow-up period. Potential cognitive-affective and physiological mediators of these associations were assessed. Greater positive experience frequency was associated with better self-rated health (SRH), less difficulty in performing basic activities of daily living (BADLs), and lower comorbidity (count of dichotomous indicators assessing history of lung-related, autoimmune, blood pressure, blood glucose, and neurological disorders). Cognitive-affective factors (positive affect, depression, and perceived stress) mediated the associations with SRH and BADLs. Positive experiences may impact long-term physical health and warrant further study.

Exercise prescriptions for young people's emotional wellbeing: a systematic review of physical activity intensity, duration, and modality

Objective

Physical activity (PA) is beneficial to the body and effective in promoting mental health and social relationships, which is one of the most important ways to enhance the quality of life. This review investigated the effects of PA in intensity, duration, and exercise modality on young people's mood.

Methods

Adhering to PRISMA 2020 guidelines, this study conducted a meticulous search across the Web of Science, PubMed, PsycINFO, and Scopus from May to July 2024, and participants aged between 13 and 28 were specified for inclusion in the study. The search yielded 942 titles and abstracts, and subsequent screening according to the criteria led to the inclusion of 20 studies, with 11 focusing on exercise intensity, four on duration, and five on exercise modality.

Results

Exercise of different intensities and durations had different effects on mood, with moderate intensity having the most significant effect on mood. In terms of duration, exercise lasting 10-30 min was more effective in improving positive mood. In addition, the effects of different modalities of exercise on mood also vary, with current research focusing more on the effects of aerobic exercise on mood.

Conclusion

PA can have a positive impact on mental health that varies by intensity, duration, and modality of exercise; moderate intensity and 30 min of exercise tend to result in the most positive emotions. More research could be conducted in the future in different anaerobic exercises.

Psychosocial predictors of short-term glucose among people with diabetes: A narrative review

Type 1 and type 2 diabetes are metabolic disorders that require one to manage one's blood glucose levels on a daily basis through a series of behaviorally complex tasks. Research shows that psychosocial factors, including mood, stress, and social relationships, have a significant influence on one's ability to maintain these disease management routines and achieve healthy blood glucose levels. However, researchers have typically approached these questions from a between-person perspective. Here, we argue for greater consideration of short-term, within-person links of psychosocial factors-including mood, stress, and social interactions-to glucose outcomes. Drawing from existing social and health psychology theories, we put forth an organizing theoretical framework describing how psychosocial experiences may operate on glucose outcomes over subsequent hours. We then review the small but burgeoning literature of intensive longitudinal studies that have examined the short-term effects of negative affect, positive affect, stress, and social interactions on glucose outcomes. Findings showed somewhat stronger links for negative affect and stress compared to positive affect and social interactions, but studies varied greatly in their methodologies, making direct comparisons challenging. A number of findings, particularly in the social interaction literature, depended on dispositional or contextual factors, further complicating interpretation. There was little investigation of the mechanistic pathways that may connect psychosocial factors to glucose outcomes, and few studies conducted lagged analyses to probe the directionality of these links. We conclude by proposing best practices for future research that will address the key weaknesses in the extant literature.

Effect of happiness and functional disability on older people's survival

The aim was to investigate survival and risk of death within a ten-year period according to physical functioning and frequency of the feeling of happiness in older people, conducting an analysis of the possible mediating effect of happiness on the association between physical functioning and mortality. A retrospective longitudinal study was conducted with 1,519 older people (≥ 60 years) interviewed for the 2008/2009 Health Survey in Campinas. A linkage was made between the databank of the survey and the Campinas Mortality Information System, with active search for confirmation of deaths and non-deaths from 2008 to 2018. Variables of interest were physical functioning (absence/presence of limitations) and frequency of feeling happiness. Kaplan-Meier survival curves were plotted and Cox regression analysis was performed to estimate hazard ratios (HR). A mediation analysis was also conducted using the Karlson-Holm-Breen (KHB) method. In the adjusted analysis, severe functional limitation (HR = 2.8; 95%CI: 2.0-3.8) and low frequency of happiness (HR = 1.6; 95%CI: 1.3-2.0) increased the risk of death in the period. Low frequency of happiness mediated the association between functioning and mortality by 14%. The results underscore the importance of strategies to maintain physical functioning during aging. Moreover, a greater frequency of the feeling of happiness increased the survival of the population. The findings also show that happiness plays an important mediating role in the association between functioning and mortality in older people.

An EEG-based emotion recognition method by fusing multi-frequency-spatial features under multi-frequency bands

BACKGROUND

Recognition of emotion changes is of great significance to a person's physical and mental health. At present, EEG-based emotion recognition methods are mainly focused on time or frequency domains, but rarely on spatial information. Therefore, the goal of this study is to improve the performance of emotion recognition by integrating frequency and spatial domain information under multi-frequency bands.

NEW METHODS

Firstly, EEG signals of four frequency bands are extracted, and then three frequency-spatial features of differential entropy (DE) symmetric difference (SD) and symmetric quotient (SQ) are separately calculated. Secondly, according to the distribution of EEG electrodes, a series of brain maps are constructed by three frequency-spatial features for each frequency band. Thirdly, a Multi-Parallel-Input Convolutional Neural Network (MPICNN) uses the constructed brain maps to train and obtain the emotion recognition model. Finally, the subject-dependent experiments are conducted on DEAP and SEED-IV datasets.

RESULTS

The experimental results of DEAP dataset show that the average accuracy of four-class emotion recognition, namely, high-valence high-arousal, high-valence low-arousal, low-valence high-arousal and low-valence low-arousal, reaches 98.71 %. The results of SEED-IV dataset show the average accuracy of four-class emotion recognition, namely, happy, sad, neutral and fear reaches 92.55 %.

COMPARISON WITH EXISTING METHODS

This method has a best classification performance compared with the state-of-the-art methods on both four-class emotion recognition datasets.

CONCLUSIONS

This EEG-based emotion recognition method fused multi-frequency-spatial features under multi-frequency bands, and effectively improved the recognition performance compared with the existing methods.

Investigating the relationship between goal orientation, self-efficacy, positive emotionality, and affective engagement among Chinese students

This study delved into the complex interplay between self-efficacy, achievement goals, positive emotions, and affective engagement among university students in China. To achieve this, a stratified random sampling technique was employed, resulting in a sample of 391 students from four geographically distinct universities across China. The data collection relied on self-reported questionnaires that measured academic self-efficacy, goal orientation (specifically focusing on mastery versus performance goals), positive emotions, and various aspects of affective engagement, including enjoyment, satisfaction, and interest in learning. Structural equation modeling (SEM) served as the primary statistical tool to analyze the hypothesized relationships between these variables. The analysis revealed a network of positive associations, indicating that students with higher levels of self-efficacy and positive emotionality reported experiencing greater affective engagement in their academic pursuits. Furthermore, a stronger mastery goal orientation was associated with increased enjoyment, satisfaction, and interest in learning. Self-efficacy and positive emotionality also indirectly influenced affective engagement through goal orientation, suggesting that students with higher self-belief and positive emotions were more likely to adopt mastery goals, leading to more positive learning experiences. This study highlights the importance of self-efficacy, positive emotionality, and goal orientation in shaping students' affective engagement. By fostering these factors, educators can create more positive and engaging learning environments for university students.

Association among parents' stress recovery experiences, parenting practices, and children's behavioral problems: a cross-sectional study

BACKGROUND

Parents can experience much stress from parenting, work, and household responsibilities. Parents' stress recovery experiences, or their lack thereof, can affect parenting practices and influence children's behavioral problems, which may thereby lead to difficulties for children later in life. Therefore, the relationships among these three factors deserve consideration. This study tested a model of the mediating role of parenting practices in the relationship between parents' stress recovery experiences and children's behavioral problems.

METHODS

Parents (N = 1,112) of 14-year-old children in the third year of junior high school in Japan completed a questionnaire, yielding 583 valid responses. To accurately determine the relationship among parents' stress recovery experiences, parenting practices, and children's behavioral problems, parents of children diagnosed with developmental disabilities and parents who did not respond to the required items in the questionnaire were excluded from the analysis. As a result, 536 of the 583 (89.0%) parents met the inclusion criteria. We conducted a path analysis, following the hypothesis that parents' stress recovery experiences, via their parenting practices, are associated with children's behavioral problems.

RESULTS

The path analysis results indicated that parents' stress recovery experiences of relaxation and mastery were positively associated with positive nurturing attitudes, whereas mastery and control were negatively associated with negative nurturing attitudes. Furthermore, positive nurturing attitudes were negatively associated with externalizing and internalizing problem behaviors, whereas negative nurturing attitudes were positively associated with externalizing and internalizing problem behaviors. In other words, the hypothesis that parents' stress recovery experiences of relaxation, mastery, and control reduce children's behavioral problems via promoting nurturing parental attitudes was supported.

CONCLUSIONS

The results indicate that the higher the level of parents' stress recovery experiences, the lower the level of reported children's behavioral problems. Parents' stress recovery experiences correlated with parenting practices, which partially mediated the relationship of the parents' stress recovery with children's behavioral problems. The suggestion is that increasing parents' stress recovery experiences, improving parenting practices and related behaviors, and strengthening the parent-child relationship are important measures that can be mutually beneficial for parents, children, and the overall family relationship.

Individual differences in wellbeing are supported by separable sets of co-active self- and visual-attention-related brain networks

How does the brain support 'wellbeing'? Because it is a multidimensional construct, it is likely the product of multiple co-active brain networks that vary across individuals. This is perhaps why prior neuroimaging studies have found inconsistent anatomical associations with wellbeing. Furthermore, these used 'laboratory-style' or 'resting-state' methods not amenable to finding manifold networks. To address these issues, we had participants watch a full-length romantic comedy-drama film during functional magnetic resonance imaging. We hypothesised that individual differences in wellbeing measured before scanning would be correlated with individual differences in brain networks associated with 'embodied' and 'narrative' self-related processing. Indeed, searchlight spatial inter-participant representational similarity and subsequent analyses revealed seven sets of co-activated networks associated with individual differences in wellbeing. Two were 'embodied self' related, including brain regions associated with autonomic and affective processing. Three sets were 'narrative self' related, involving speech, language, and autobiographical memory-related regions. Finally, two sets of visual-attention-related networks emerged. These results suggest that the neurobiology of wellbeing in the real world is supported by diverse but functionally definable and separable sets of networks. This has implications for psychotherapy where individualised interventions might target, e.g., neuroplasticity in language-related narrative over embodied self or visual-attentional related processes.

Boosting positive mood during stress: a Daily Coping Toolkit replication in college undergraduates

BACKGROUND

College students face significant mental health challenges that were exacerbated by the COVID-19 pandemic. Evidence suggests mental-health burdens are substantial and resources limited. We sought to replicate research supporting a one-time daily ambulatory intervention to facilitate regulation of negative emotion and increase generation of positive emotion. The Daily Coping Toolkit (DCT) was developed at the outset of the pandemic and was effective in boosting mood in front-line medical personnel in an open-trial (Coifman, K. G., et al. [2021]. Occupational and Environmental Medicine, 78(8), 555-557. https://doi.org/10.1136/oemed-2021-107427.

DESIGN

This investigation replicated the DCT against a control condition in college students returning to campus in early 2021. N = 125 college students were randomized to experimental conditions (two-prompt v. one-prompt) or the control condition. Data analysis was preregistered.

RESULTS

Analyses indicated students in experimental groups experienced significant decreases in negative and increases in positive emotion when compared to controls, providing evidence of efficacy. This was notable because a high proportion of participants reported prior mental illness. Although there was no difference by number of prompts (two-prompt v. one-prompt) on emotional reports, there was preliminary evidence the one-prompt condition was associated with greater self-care behaviors (e.g., exercise, social support seeking).

CONCLUSION

The results suggest the DCT is an efficacious emotion-regulation intervention that can boost mood during stress.

Influence of Gender Role on Resilience and Positive Affect in Female Nursing Students: A Cross-Sectional Study

Introduction: Women experience more social barriers, gender stereotypes, biases, and discrimination than men, which can increase their vulnerability to mental health problems. Therefore, it is essential to adopt a gender perspective in research on nursing students, examining the impact of these factors on their well-being and psychological resources like resilience. This study aims to analyze the relationship between gender roles in resilience and positive or negative affect among female nursing students. Methods: A cross-sectional study was conducted with first- and fourth-year female nursing students at a public university in Madrid, Spain. Sociodemographic variables, positive and negative affect (PANAS scale), resilience (CD-RISC scale), and gender roles (BRSI inventory) were analyzed. ANOVA, correlation analysis, and linear regression models were used to study the relationships between variables. Results: The study included 338 students with a mean age of 21.43 years, of which 80.2% had a high level of resilience, with a positive affect score of 31.96 (SD: 7.34) and a negative affect score of 22.99 (SD: 7.35). Overall, 48.5% had undifferentiated roles, 23.7% feminine roles, 14.2% androgynous roles, and 13.6% masculine roles. Female students with masculine and androgynous roles showed higher resilience levels (93.48% and 97.92%) compared to those with feminine and undifferentiated roles (81.25% and 70.73%) (p < 0.001). Female students with androgynous and masculine roles showed higher positive affect levels compared to those with feminine and undifferentiated roles (p < 0.001), with no differences in negative affect. These results were observed in both first- and fourth-year students. A high correlation was found between masculine roles and positive affect and resilience in both first- and fourth-year students. Conclusions: Gender roles influence positive affect and resilience in females. Among female nursing students, androgynous and masculine roles are associated with higher levels of resilience and positive affect compared to feminine and undifferentiated roles. Differences in psychological well-being may be related to socially constructed gender roles rather than biological sex, with masculine roles enhancing resilience and feminine roles correlating with greater vulnerability.

Spousal Caregiving Types and Cognitive Trajectories Among Middle-Aged and Older Adults in China

Objectives: This study investigates the longitudinal association between spousal caregiving types and cognitive trajectories among middle-aged and older Chinese adults, with a focus on gender differences. Method: Data from the China Health and Retirement Longitudinal Study (CHARLS) (2011-2018) were analyzed, covering 4568 couples aged 45 and above. Caregiving types were Activities of Daily Living (ADLs) caregiving, Instrumental Activities of Daily Living (IADLs) caregiving, and both ADLs/IADLs caregiving. Cognitive function was assessed using tests of memory, orientation, numeric ability, and visuospatial ability. Latent growth curve modeling was used to examine associations between caregiving types and cognitive trajectories. Results: Spouses who only provided IADLs caregiving had slower cognitive decline compared to those who did not provide caregiving, regardless of gender. However, those who provided ADLs caregiving had faster cognitive decline compared to non-caregivers, especially in women. Discussion: These findings highlight the importance of caregiving types as well as the gendered effects of caregiving on cognitive trajectories.

Longitudinal associations between well-being, hair cortisol, and self-reported health

This pre-registered study examines the longitudinal relationships between well-being, hair cortisol (a biomarker linked to poor health), and self-reported health. Accumulated cortisol output over three months was determined quarterly over the course of one year using hair samples. Well-being was assessed as affective well-being (via experience sampling), cognitive well-being (i.e., life satisfaction), and eudaimonic well-being (via the Ryff Scales of Psychological Well-Being). Self-reported health was measured using one item on the current state of health. The longitudinal analyses allowed for disentangling initial between-person differences from within-person changes and were based on a large panel study of working-age people (N = 726). The results indicate that hair cortisol levels were generally not associated with any of the examined well-being facets, regardless of the level of analysis. Further, deviations from well-being trait levels were not linked to subsequent within-person changes in hair cortisol (and vice versa), challenging the notion that cortisol output is a key physiological pathway through which well-being improves health. In contrast, self-reported health was positively correlated with affective, cognitive, and eudaimonic well-being at both the trait and within-person levels, whereas deviations from well-being trait levels were generally not associated with subsequent within-person changes in self-reported health, and vice versa.

Association of personality and social support with subjective well-being among Japanese older adults

AIM

Although the association between personality and health has been well documented, the interaction between personality and health risk factors is understudied. This study examined (i) the relationship between the Big Five model of personality and subjective well-being and (ii) the buffering effect of social support on the relationship between personality and subjective well-being among Japanese older adults.

METHODS

The participants were 1265 adults aged 65-84 (499 men, 766 women). The Philadelphia Geriatric Center Morale Scale was used as an index of subjective well-being (the study outcome). As explanatory variables, the Japanese version of the NEO-Five Factor Inventory measured the five domains of personality traits, and the Multidimensional Scale of Perceived Social Support measured social support. Data on age, sex, years of education, living arrangements (living alone or with family), psychiatric problems, chronic illness, and instrumental activities of daily living dependence, which were used as covariates, were obtained to test the independent association of personality and social support with subjective well-being.

RESULTS

The multivariable regression analysis showed that neuroticism (β = -0.543), extraversion (β = 0.167), agreeableness (β = -0.099), social support (β = 0.143), and the interaction between social support and neuroticism (β = 0.058) were significantly associated with subjective well-being.

CONCLUSIONS

Our findings show that social support moderates the association between neuroticism and subjective well-being among older adults. Accordingly, for older adults who are higher in neuroticism, interventions that provide increased social support may help reduce the risk of poorer well-being. Geriatr Gerontol Int 2025; 25: 267-272.

Optimization of a digital health intervention to enhance well-being among adolescent and young adult cancer survivors: Design and methods of the EMPOWER full factorial trial

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 and have not been routinely tested in AYA survivors. We are optimizing a web-based positive skills intervention for AYA cancer survivors called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) by: (1) determining which intervention components have the strongest effects on well-being and (2) identifying demographic and individual difference variables that mediate and moderate EMPOWER's efficacy. EMPOWER is a five-session online intervention that teaches behavioral and cognitive skills for increasing psychological well-being. Guided by the Multiphase Optimization Strategy (MOST), we assign two levels (yes, no) to each of five intervention components (positive events, capitalizing, & gratitude; mindfulness; positive reappraisal; personal strengths & goal-setting; acts of kindness), allowing us to evaluate the effects of individual and combined intervention components on positive affect in a full factorial design. Post-treatment AYA cancer survivors (N = 352) are recruited from participating NCI-designated comprehensive cancer centers and randomized to one of 32 experimental conditions. Our primary outcome is positive affect; potential mediating and moderating variables include coping self-efficacy and emotional support, respectively. Upon trial completion, we will have an optimized, digital health intervention to enhance psychological well-being among AYA cancer survivors. EMPOWER will be scalable and primed for a large, multi-site trial among AYAs who would otherwise not have access to supportive care interventions to manage distress and enhance well-being.

Can Online Exercise Using Wearable Devices Improve Perceived Well-Being? A Study Among Patients with Coronary Artery Disease

Today, cardiovascular diseases contribute to approximately 17.9 million deaths annually worldwide. With reference to Europe, coronary artery disease (CAD) causes about 3.9 million deaths annually. Considering the positive physical and psychological outcomes of on-site exercise for CAD patients, this study aimed to expand the literature by examining the effects of a 6-month online exercise training program using wearable devices on CAD patients' perceived well-being, measured with the PERMA profiler. Individual well-being is considered today as an important prerequisite for healthy societies. Thirty patients with a recent myocardial infarction (i.e., <4 weeks) were randomly assigned to either the online home-based or the community-based exercise group. Both groups followed the same 24-week exercise-based cardiac rehabilitation program three times per week. Each session consisted of a 30-min aerobic, followed by a 15-min strength workout, and then a 15-min balance and flexibility training. The results of the Mann-Whitney U tests and the z scores indicated that the Meaning of Life, Health, Accomplishment, Engagement, and Positive Relationship dimensions of the PERMA were statistically improved, and Negative Emotions were decreased. These findings support the importance of cardiac telerehabilitation for patients' psychological health, demonstrating that online exercise using wearable devices can be a meaningful alternative to on-site exercise for patients with recent myocardial infarction. These results have policy implications as they provide arguments for providing online exercise for CAD patients as an alternative means for improving their psychological health.

Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults

Loneliness, social isolation, and living alone are significant risk factors for mortality, particularly in older adults. This systematic review and meta-analysis aimed to quantify their associations with all-cause and cause-specific mortality in older adults, broadening previous research by including more social factors. Comprehensive searches were conducted in PubMed, APA PsycINFO, and CINAHL until December 31, 2023, following PRISMA 2020 and MOOSE guidelines. Studies included were prospective cohort or longitudinal studies examining the relationship between loneliness, social isolation, living alone, and mortality. Quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses used random-effects models with the Restricted Maximum Likelihood method. Subgroup and meta-regression analyses explored the relationships further. Of 11,964 identified studies, 86 met the inclusion criteria. Loneliness was associated with increased all-cause mortality (HR 1.14, 95% CI 1.10-1.18), with substantial heterogeneity (I² = 84.0%). Similar associations were found for social isolation (HR 1.35, 95% CI 1.27-1.43) and living alone (HR 1.21, 95% CI 1.13-1.30). Subgroup analyses revealed variations based on factors like sex, age, region, chronic diseases, and study quality. Meta-regression identified longer follow-up, female sex, validated social network indices, adjustments for cognitive function, and study quality as significant predictors of mortality risks. These findings highlight the need for public health interventions to address these social factors and improve health outcomes in older adults. However, further research is needed due to variability and heterogeneity across studies. Also studying the cumulative effect of these factors on mortality risks will be of considerable interest.

Stress, positive affect, and sleep in older African American adults: a test of the stress buffering hypothesis

BACKGROUND

Although sleep disparities contribute to racial health disparities, little is known about factors affecting sleep among African Americans. One such factor may be positive affect, which could impact sleep directly (direct effect hypothesis) or indirectly by buffering the effects of stress (stress buffering hypothesis).

PURPOSE

We tested the direct effect and stress buffering effects of positive affect on sleep at three levels (day, week, trait) in a sample of 210 older African American adults, ranging in age from 50 to 89 years old.

METHOD

Daily positive affect, perceived stress, sleep quality, and sleep duration were collected for five consecutive days. Multilevel modeling was used to test the direct and stress buffering hypotheses both within-person (day level) and between-persons (week level). Trait positive affect, past five-year stress severity, and global sleep quality were assessed cross-sectionally. Regression was used to test the direct and stress buffering hypotheses at the trait level.

RESULTS

In line with the direct effect hypothesis, higher week-level positive affect predicted better sleep quality and sleep duration. Day-level positive affect was not significantly associated with daily sleep quality or daily sleep duration. Higher trait positive affect predicted better global sleep quality. However, neither day-level perceived stress nor past five-year stress severity significantly interacted with positive affect measures for any sleep outcome; no interaction effect was observed on week-level sleep duration. Positive affect and perceived stress interacted at the week level to predict sleep quality, but not in the hypothesized direction.

CONCLUSIONS

We found support for the direct effect hypothesis at the week- and trait-levels, but not at the day level. In contrast, we found no support for the stress buffering hypothesis.

Web-browsing patterns reflect and shape mood and mental health

Humans spend on average 6.5 hours a day online. A large portion of that time is dedicated to information-seeking. How does this activity impact mental health? We assess this over four studies (n = 1,145). We reveal that the valence of information sought affects mental health, which in turn influences the valence of information sought, forming a self-reinforcing loop. We quantified the valence of text on webpages participants chose to browse using natural language processing and found that browsing more negative information was associated with worse mental health and mood. By manipulating the webpages browsed and measuring mood and vice versa, we show that the relationship is causal and bidirectional. Finally, we developed an intervention that altered web-browsing patterns in a manner that improved mood. Together, the findings suggest that the information sought reflects mental state and shapes it, creating a loop that may perpetuate mental health problems. The results also provide a potential method for assessing and enhancing welfare in the digital age.

Components of joint health and wellbeing strategies: a pan-London review of all 33 local authorities

BACKGROUND

In the UK, Health and Wellbeing Strategies (JHWS) were introduced to identify and help address the health needs of local communities. JHWS translate a borough's Joint Strategic Needs assessment into actionable outcomes and prioritises areas of focus, but the content and approach of JHWS may vary across different local authorities (LAs) due to demographic and priority differences.

OBJECTIVE

Characterise the key health and wellbeing components of existing and emerging health and wellbeing strategies of 33 local authorities in London.

DESIGN

Scoping review study with content assessment.

METHODS

An online search was conducted to identify JHWS documents. This search was supplemented with outreach to health and wellbeing boards to ensure that the latest documents were retrieved. A set of 62 health and wellbeing themes and words to be captured spanning 13 categories was developed by a team of researchers, and data collection was independently carried out by two researchers. Occurrences of words in the strategy documents were recorded, and a configuration matrix was created and used to determine data trends across the local authorities. A broad search of the context in which the search terms appeared was also performed to understand the trends.

RESULTS

Thirty-three JHWS were analysed to identify key search term frequencies. The analysis encompassed strategies from 2015 to 2030, ranging from 7 to 94 pages. Mental health and youth terms emerged as the two top priorities across all strategies. Other frequent terms were related to access to healthcare, inequality, employment, smoking, housing, carers, and elderly individuals. Conversely, terms related to dental health, pollution, nutrition, sexual health, green spaces, breastfeeding, and climate were less cited.

CONCLUSION

This analysis provides insights into regional health priorities and a comprehensive overview of health and wellbeing strategies across London's local authorities. Despite certain limitations, the findings offer valuable insights for local authorities' strategic planning and future research.

Within- and Between-Person Correlates of Affect and Sleep Health Among Health Science Students

BACKGROUND/OBJECTIVES

To examine the relationships between state affect and sleep health at within- and between-person levels among health science students.

METHODS

A correlational design was used and 54 health science students were included. The participants completed baseline and 7-day ambulatory assessments in a free-living setting. Daily sleep and affect were measured using the Consensus Sleep Diary and Positive and Negative Affect Schedule. Mixed-effect models were used to examine the effects of affect on sleep health.

RESULTS

The participants were 19.8 (SD, 0.6) years and 92.6% were females. Approximately 40% had poor sleep quality. Controlling for the potential confounders (e.g., age, sex, and bedtime procrastination), higher within-person negative affect predicted shorter sleep duration, lower sleep efficiency, longer sleep onset latency, and less feeling rested. Higher between-person negative affect predicted shorter sleep duration. Higher within-person positive affect predicted longer sleep onset latency. Higher within- and between-person positive affect predicted more feeling rested.

CONCLUSIONS

Negative affect was most consistently associated with sleep health at the individual level. Affect regulation should be considered when delivering personalized interventions targeting sleep health among health science students.

Targeting Daily Positive Events to Improve Emotional and Functional Well-Being in Adults With Fibromyalgia: Insights From the LARKSPUR Randomized Controlled Trial

BACKGROUND

Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, affecting individuals across all age groups. Positive affect (PA) interventions have shown promise in enhancing emotional well-being and pain management in patients with diverse chronic pain conditions. However, the efficacy of internet-delivered PA interventions for individuals with fibromyalgia remains understudied.

OBJECTIVE

This randomized controlled trial investigated the efficacy of a web-based PA regulation intervention-Lessons in Affect Regulation to Keep Stress and Pain Under Control (LARKSPUR)-in enhancing emotional and functional well-being among adults with fibromyalgia syndrome.

METHODS

A total of 95 participants with fibromyalgia syndrome aged 50 years and older (89/95, 94% female) were randomized to one of two fully automated conditions: (1) LARKSPUR (n=49) or (2) emotion reporting/attention control (n=46). At the postintervention and 1-month follow-up time points, participants completed 7 consecutive, end-of-day, web-based reports capturing positive events (PE), pain, fatigue, PA, and negative affect.

RESULTS

Compared to control, LARKSPUR resulted in greater improvements in daily affective responsivity to PE at the postintervention time point, including greater reductions in negative affect (bL-bC=-0.06, 95% highest posterior density interval [HPD] -0.10 to -0.02) and increases in PA (bL-bC=0.10, 95% HPD 0.02-0.19). Furthermore, across the postintervention and 1-month follow-up time points, LARKSPUR led to greater reductions in pain (bL-bC=-0.20, 95% HPD -0.36 to -0.04) and fatigue (bL-bC=-0.24, 95% HPD -0.41 to -0.06) following PE.

CONCLUSIONS

This randomized controlled trial provides initial evidence that a web-based PA skills intervention can enhance emotional well-being and reduce pain and fatigue in aging adults with fibromyalgia.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04869345; https://clinicaltrials.gov/study/NCT04869345.

Promoting a foundation of resilience in older adults: pilot trial of a strengths-based positive psychology intervention for chronic low back pain

Introduction

Chronic low back pain (cLBP) is a global public health problem and a leading cause of disability among older adults. Recent years have seen a burgeoning interest in promoting resilience in individuals with chronic pain; however, therapeutic strategies that focus on positive psychological resources and individual strengths are understudied among older adult populations. The aim of this study was to examine the feasibility and acceptability of a resilience-promoting intervention among older adults with cLBP, and to assess preliminary treatment effects on pain severity, pain interference, and quality of life.

Methods

Participants included 50 adults, ages ≥50 years, with back pain rated (at minimum) of moderate intensity and having a significant impact on daily activities. This single-arm trial included seven weekly group sessions targeting positive psychology concepts and techniques that have established benefits in pain management.

Results

Results suggest high credibility and engagement in the intervention program. Participants found the weekly session content to be beneficial and global treatment satisfaction was high. Pain intensity (-4.3 [-6.14, -2.54]), pain interference (-3.3 [-4.83, -1.80]), depression (-1.6 [-3.16, -0.04]) and QoL-health satisfaction (0.3 [0.01, 0.55]) improved from pre- to post-intervention. At the 3-month follow-up, improvements were also observed for pain intensity (-2.1 [-9.29, -5.04]), pain interference (-5.3 [-6.54, -2.86]), and QoL-physical health (0.9 [0.11, 1.74]).

Discussion

Results support the feasibility, acceptability, and potential efficacy of a resilience intervention for older adults with cLBP. These findings may be a step toward the advancement of therapeutic pain modalities and provide a foundation for future research on resilience-promoting interventions for aging populations with chronic pain.

Positive affect longitudinally buffers the negative effect of health anxiety on gastrointestinal symptoms

People with significant health anxiety may experience brain-gut dysregulation, leading to increased visceral sensitivity and greater gastrointestinal (GI) symptoms. Positive affect (PA), on the other hand, may serve as a protective characteristic, buffering the negative impact of health anxiety on GI symptoms. This study investigated interrelationships between health anxiety, PA, and GI symptoms. Longitudinal data were collected on health anxiety, PA, and GI symptoms via an online survey from 861 adults at two timepoints, 4 weeks apart. Regression models were conducted to examine the moderating effect of PA at baseline on future GI symptoms. Greater health anxiety at baseline predicted GI symptoms at follow-up, whereas higher levels of PA predicted reduced GI symptoms at follow-up. Post hoc testing revealed that PA significantly moderated the relationship between health anxiety and GI symptoms over time, such that higher levels of PA attenuated the effect of health anxiety on belly pain, nausea and vomiting, and reflux at follow-up. This study provides preliminary evidence PA may buffer the negative impact of health anxiety on GI symptoms. Future studies should explore whether the promotion of PA through interventions similarly attenuates health related anxiety's impact on GI symptoms.

The interplay of job embeddedness, collective efficacy, and work meaningfulness on teacher well-being: a mixed-methods study with digital ethnography in China

Introduction

This study examines the influence of teacher job embeddedness, collective efficacy, and work meaningfulness on the psychological well-being of Chinese teachers. The focus is on understanding how these constructs contribute to teacher well-being through a mixed-methods approach.

Methods

A two-stage structural equation modeling (SEM) analysis was conducted using quantitative data collected from 406 in-service Chinese teachers. The study also incorporated a qualitative phase involving digital ethnography within online teaching communities to provide deeper insights into teachers' experiences.

Results

The quantitative analysis revealed significant positive direct effects of job embeddedness, collective efficacy, and work meaningfulness on psychological well-being, with work meaningfulness showing the strongest effect. The mediating role of work meaningfulness partially explained the relationships between job embeddedness, collective efficacy, and teacher well-being. The qualitative findings supported and expanded upon these results, emphasizing the role of a supportive school community and strong administrative leadership.

Discussion

The results suggest that enhancing job embeddedness, collective efficacy, and work meaningfulness can significantly contribute to teachers' psychological well-being. These findings provide actionable insights for school leaders and policymakers in the Chinese educational system to foster environments that promote teacher well-being.

Stability and change in maternal wellbeing and illbeing from pregnancy to three years postpartum

PURPOSE

Motherhood affects women's mental health, encompassing aspects of both wellbeing and illbeing. This study investigated stability and change in wellbeing (i.e., relationship satisfaction and positive affect) and illbeing (i.e., depressive and anxiety symptoms) from pregnancy to three years postpartum. We further investigated the mutual and dynamic relations between these constructs over time and the role of genetic propensities in their time-invariant stability.

DATA AND METHODS

This four-wave longitudinal study included 83,124 women from the Norwegian Mother, Father, and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. Data were collected during pregnancy (30 weeks) and at 6, 18 and 36 months postpartum. Wellbeing and illbeing were based on the Relationship Satisfaction Scale, the Differential Emotions Scale and Hopkins Symptoms Checklist-8. Genetics were measured by the wellbeing spectrum polygenic index. Analyses were based on random intercept cross-lagged panel models using R.

RESULTS

All four outcomes showed high stability and were mutually interconnected over time, with abundant cross-lagged predictions. The period of greatest instability was from pregnancy to 6 months postpartum, followed by increasing stability. Prenatal relationship satisfaction played a crucial role in maternal mental health postpartum. Women's genetic propensity to wellbeing contributed to time-invariant stability of all four constructs.

CONCLUSION

Understanding the mutual relationship between different aspects of wellbeing and illbeing allows for identifying potential targets for health promotion interventions. Time-invariant stability was partially explained by genetics. Maternal wellbeing and illbeing develop in an interdependent way from pregnancy to 36 months postpartum.

The role of positive affect in asthma control and symptom severity in adolescents

INTRODUCTION

We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity.

METHODS

Adolescents with asthma (N = 66, ages 12-17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day. Asthma control and psychological asthma triggers were assessed at the end of the 7 days.

RESULTS

Positive affect moderated the association between stress and asthma control (b = -0.33, p = 0.009) as well as the association between psychological triggers and asthma control (b = -0.74, p = 0.007). When assessing the positive affect arousal components, calm and wellbeing seemed to be driving these effects. Additionally, calm moderated the association between stress and asthma symptom severity (b = -0.33, p = 0.036) as well as the association between psychological triggers and asthma symptom severity (b = -0.75, p = 0.021).

CONCLUSIONS

When considering patient stress (e.g., general stress, psychological asthma triggers), positive affect and its arousal components of calm and wellbeing may be helpful for patients with higher levels of stress and/or for patients experiencing greater numbers of psychological triggers.

A hybrid type II effectiveness-implementation trial of a positive emotion regulation intervention among people living with HIV engaged in Ryan White Medical Case Management: protocol and design for the ORCHID study

BACKGROUND

The Ryan White Medical Case Management System, which serves more than half of people living with HIV (PLWH) in the USA, is an opportune setting for identifying and addressing depression among PLWH. A growing body of research suggests that interventions that promote positive emotion may lessen symptoms of depression and improve physical and psychological well-being among people experiencing a variety of health-related stress, including living with HIV. Research on how best to integrate standardized mental health screening and referral to evidence-based interventions in Ryan White Medical Case Management settings has the potential to improve the health and wellbeing of PLWH.

METHODS

This mixed-methods study will enroll up to N = 300 Ryan White clients who screen positive for depressive symptoms in ORCHID (Optimizing Resilience and Coping with HIV through Internet Delivery), a web-based, self-guided positive emotion regulation intervention. The study will be conducted in 16 Ryan White Medical Case Management clinics in Chicago, IL. Following pre-implementation surveys and interviews with Medical Case Managers (MCMs) and Supervisors to develop an implementation facilitation strategy, we will conduct a hybrid type 2 implementation-effectiveness stepped wedge cluster randomized trial to iteratively improve the screening and referral process via interviews with MCMs in each wedge. We will test the effectiveness of ORCHID on depression and HIV care outcomes for PLWH enrolled in the program. RE-AIM is the implementation outcomes framework and the Consolidated Framework for Implementation Research is the implementation determinants framework.

DISCUSSION

Study findings have the potential to improve mental health and substance use screening of Ryan White clients, decrease depression and improve HIV care outcomes, and inform the implementation of other evidence-based interventions in the Ryan White Medical Case Management System.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05123144. Trial registered 6/24/2021.

The Role of Online Well-Being Therapy in Overcoming Allostatic Overload in Medical Workers: A Pilot Randomized Controlled Study

INTRODUCTION

Stress may lead to allostatic overload. Well-being therapy (WBT) might mitigate it by enhancing psychological well-being and protecting from psychological symptoms. Since no reports are available on the use of WBT in allostatic overload, we evaluated online WBT effects in reducing allostatic overload in medical workers during the coronavirus pandemic.

METHODS

Sixty-six participants with allostatic overload were enrolled and randomly assigned to eight sessions of online WBT (n = 32) or eight sessions of an online psychoeducation program on healthy lifestyle (CON) (n = 34). The primary outcome was the prevalence rate of allostatic overload in the two groups at session 8 (T2). Secondary analyses were performed on changes in the PsychoSocial Index (PSI) and Psychological Well-Being (PWB) scales scores at the same time points. Generalized estimating equation models were employed.

RESULTS

The WBT group showed a significantly lower rate of allostatic overload at T2 than the CON group (28.13% vs. 70.59%, p < 0.001); similar results were found at T1, T3, and T4 (p < 0.001). Compared to CON, WBT produced a significant decrease in psychological distress (p < 0.001) and abnormal illness behavior (p = 0.031), as well as a significant improvement in PWB autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance (p < 0.001).

CONCLUSION

Online WBT may be an effective non-pharmacological therapeutic strategy for individuals with allostatic overload. These findings need to be further validated in different clinical populations.

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.

Affect variability and cortisol in context: The moderating roles of mean affect and stress

Positive and negative affect have been shown to have implications for hormones like cortisol but how moment to moment changes in affect (i.e., affect variability) influence cortisol secretion is less well understood. Additionally, context characteristics such as mean affect and stress may influence the association between affect variability and cortisol output. In the current study, we examined affect, stress, and cortisol data from 113 participants (age range = 25-63, M = 35.63, SD = 11.34; 29% male; 42% White/Caucasian, 37% Asian or Pacific Islander, 13% Hispanic/Latino, 4% Black/African American, 1% Native American, Eskimo, or Aleut, 4% selected "other" for their race/ethnicity). Participants completed ecological momentary assessments assessing positive and negative affect and stress four times per day for five days and provided saliva samples at each time point. Saliva was assayed for cortisol, and area under the curve with respect to ground was computed. In a three-way interaction, both positive affect mean level and stress moderated the association between positive affect variability and cortisol (b = -1.55, t(100) = -3.29, SE = 0.47, p <.01, β = -4.05). When breaking down this three-way interaction, in the context of low stress and high mean positive affect, variability was positively related to total cortisol output. In contrast, in the context of high stress and high mean positive affect, variability was negatively related to total cortisol output. While greater positive affect variability is generally worse for health-relevant outcomes (as prior research has shown and as we show here at low levels of stress), at high levels of stress, fluctuation in affect may be adaptive. For someone experiencing a high stress week, having fluctuations in positive affect may mean that they are adaptively changing to meet their environmental needs especially when they typically report high mean positive affect levels. There were no associations between negative affect variability and cortisol secretion nor did mean negative affect or stress play a moderating role for negative affect variability. This study provides evidence that positive affect variability's association with cortisol secretion throughout the day may vary based on stress and mean positive affect levels.

The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment

Introduction: Emotional functioning in older adults is influenced by normal aging and cognitive impairment, likely heterogeneous across positive versus negative aspects of emotional functioning. Little is known about positive emotional experiences at the early stages of cognitive impairment. Methods: We assessed different aspects of emotional functioning among 448 participants aged 65+ (Normal Control (NC) = 276, Mild Cognitive Impairment (MCI) = 103, and mild dementia of the Alzheimer type (mild DAT) = 69) and tested moderators. Results: Compared to NC, older adults with MCI and mild DAT have maintained many positive aspects of emotional functioning, despite higher levels of negative affect, sadness, and loneliness. Among the oldest-old, the mild DAT group experienced higher fear and lower self-efficacy. Discussion: Older adults at early stages of cognitive impairment can experience positive aspects of emotional functioning, such as positive affect, purpose, and life satisfaction, all of which are important buildable psychological resources for coping.

The reciprocal relationship between prosocial behaviour and self-perceived physical health: The role of positive affect and openness to experience

The present study used a cross-lagged design to explore the bidirectional relationship between adolescents' prosocial behaviour and self-perceived physical health and to explore the mediating role of positive affect and the moderating role of openness to experience. A total of 1525 middle school students (Mage = 12.41, 47% male) in northern China were surveyed for 3 years. The results showed the following: (1) prosocial behaviour at T1 positively predicted self-perceived physical health at T3; and vice versa; and (2) this observed relation between prosocial behaviour and self-perceived physical health was explained by positive affect; (3) the mediating role of positive affect on the path from prosocial behaviour at T1 to self-perceived physical health at T3 was observed only among adolescents with high openness traits. This finding verified the protective effect of prosocial behaviour on the healthy development of the actor.

The role of positive emotion in harmful health behavior: Implications for theory and public health campaigns

Meta-analyses have concluded that positive emotions do not reduce appetitive risk behaviors (risky behaviors that fulfill appetitive or craving states, such as smoking and excessive alcohol use). We propose that this conclusion is premature. Drawing on the Appraisal Tendency Framework and related theories of emotion and decision-making, we hypothesized that gratitude (a positive emotion) can decrease cigarette smoking, a leading cause of premature death globally. A series of multimethod studies provided evidence supporting our hypothesis (collective N = 34,222). Using nationally representative US samples and an international sample drawn from 87 countries, Studies 1 and 2 revealed that gratitude was inversely associated with likelihood of smoking, even after accounting for numerous covariates. Other positive emotions (e.g., compassion) lacked such consistent associations, as expected. Study 3, and its replication, provided further support for emotion specificity: Experimental induction of gratitude, unlike compassion or sadness, reduced cigarette craving compared to a neutral state. Study 4, and its replication, showed that inducing gratitude causally increased smoking cessation behavior, as evidenced by enrollment in a web-based cessation intervention. Self-reported gratitude mediated the effects in both experimental studies. Finally, Study 5 found that current antismoking messaging campaigns by the US Centers for Disease Control and Prevention primarily evoked sadness and compassion, but seldom gratitude. Together, our studies advance understanding of positive emotion effects on appetitive risk behaviors; they also offer practical implications for the design of public health campaigns.

Well-being in parents of children with cancer: illness perceptions' mediating role for hope and social support

Introduction

Parents of children with cancer may experience enormous physical and emotional pressures. During such times, perception of the situation can be important in mediating the link between one's basic resources (mainly cognitive and social) and the well-being one attains as an emotional and cognitive response. This study aimed to explore the role of illness impact perceptions in mediating the link between hope, social support and subjective well-being in parents of children with cancer.

Methods

The cross-sectional study included 108 parents of children aged 7-18 diagnosed with cancer at least 6 months prior to the study. The parents completed one questionnaire comprising five instruments: perceived impact of illness, hope, social support, positive and negative affect (the emotional component of well-being) and life satisfaction (the cognitive component of well-being). Descriptive statistics and Pearson correlations were conducted for all study variables. SEM analysis was performed to examine the study's theoretical model.

Results

The current sample included 108 parents of children with cancer recruited from two pediatric hematology-oncology wards in two different hospitals in central Israel. Most participants were mothers (70.4%), and the mean age was 44.46. The main results indicated that hope and social support correlated negatively with perceptions of the illness' impact. Illness impact perceptions mediated the relations between hope, social support and positive emotions, which means that when the parents perceived their child's illness as less impactful on the family, they experienced higher levels of emotional well-being.

Conclusion

A parent with social support resources and higher levels of hope experiences higher levels of positive perceptions regarding their child's illness. Higher levels of positive perceptions allow the parent to express more positive than negative emotions, thus maintaining a more optimal level of subjective emotional well-being. The findings offer implications for healthcare teams to enhance sensitivity to parents' needs and to help parents attain more resources, positive perceptions, and well-being.

Examining Reactivity and Recovery Patterns of Pain-Evoked Cortisol and Alpha-Amylase Trajectories: Relations Between Psychological Markers of Risk and Resilience

Chronic low back pain (cLBP) is one of the leading causes of disability globally and represents an enormous burden to aging adults. While numerous factors contribute to cLBP, dysregulation in the hypothalamic-pituitary-adrenal axis and autonomic nervous system functioning have been implicated in its pathogenesis. It is well documented that negative psychological states can modulate biological stress responsivity in chronic pain; however, little is known regarding the influence of positive psychological factors in this relationship. The aim of this study was to examine the association between psychological risk and resilience factors with patterns of physiological stress reactivity and recovery in 60 older adults with cLBP. Participants completed measures of hope, optimism, pain catastrophizing, and perceived stress, and underwent psychophysical pain testing assessing responses to painful pressure, heat, and cold stimuli. Salivary samples were obtained prior to pain induction and at 7 time points spanning 90 minutes after pain testing terminated. To examine reactivity and recovery profiles in hypothalamic-pituitary-adrenal axis and autonomic nervous system function, samples were assayed for cortisol and alpha-amylase, respectively. Results revealed higher levels of hope and optimism were associated with increased cortisol reactivity (p's < .003) and more rapid recovery (p's = .001). Further, pain catastrophizing and perceived stress were associated with cortisol reactivity, with lower levels of these factors predicting larger increases in cortisol from baseline to peak levels (p's < .04). No significant differences in reactivity or recovery patterns emerged for alpha-amylase. Overall, findings highlight the role of psychological risk and resilience factors in modulating physiological stress reactivity. PERSPECTIVE: This article investigated whether psychosocial risk and resilience factors were associated with stress reactivity and recovery in response to laboratory-based pain testing in older adults with chronic low back pain. Results indicate that high resilience factors may be protective by modulating adrenocortical reactivity and recovery profiles.

The Emotional Impact of a Cancer Diagnosis: A Qualitative Study of Adolescent and Young Adult Experience

The biographical disruption that occurs in adolescents and young adults following a cancer diagnosis can affect various important psychosocial domains including relationships with family and friends, sexual development, vocational and educational trajectories, and physical and emotional wellbeing. While there is evidence of the physical impact of cancer during this period, less is known about the impact on emotional wellbeing and especially on the barriers for young people accessing help and support. We aimed to obtain a more in-depth understanding of young people's experiences of their diagnosis, treatment, psychological impact, and range of resources they could or wanted to access for their mental health. We conducted an in-depth qualitative study using semi-structured interviews with 43 young people who had developed cancer aged 16 to 39 years and were either within 6 months of diagnosis or 3-5 years after treatment had ended. Framework analysis identified three themes: the emotional impact of cancer (expressed through anxiety, anger, and fear of recurrence); personal barriers to support through avoidance; and support to improve mental health through mental health services or adolescent and young adult treatment teams. We showed the barriers young people have to access care, particularly participant avoidance of support. Interrupting this process to better support young people and provide them with flexible, adaptable, consistent, long-term psychological support has the potential to improve their quality of life and wellbeing.

Development and Validation of the Subjective Well-Being Resources Scale

Subjective well-being (SWB) is an important construct of positive psychology and it is known that these resources should be supported to prevent mental health disorders. However, there is no measurement tool to assess individual differences concerning SWB resources. The present study aims to develop a valid and reliable scale to measure SWB resources. For this aim, two studies were conducted. As a result, the five-factor (personal, religious, health, social, and external resources) construct explaining 45.3% of the variance was derived and validated with both exploratory and confirmatory factor analysis. The factors were related to mental health indicators and personality as expected. The internal consistency coefficient of the scale was .83), and the test re-test reliability was .88. As a result of the analysis, it is concluded that the Subjective Well-Being Resources Scale is valid and reliable and can be used to measure SWB resources.

The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis

BACKGROUND

Gardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs.

METHODS

Electronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted.

RESULTS

This umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001).

CONCLUSIONS

Evidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.

Positive Psychological Well-Being in Early Palliative Care: A Narrative Review of the Roles of Hope, Gratitude, and Death Acceptance

In the advanced cancer setting, low psychological functioning is a common symptom and its deleterious impact on health outcomes is well established. Yet, the beneficial role of positive psychological well-being (PPWB) on several clinical conditions has been demonstrated. Early palliative care (EPC) is a recent value-based model consisting of the early integration of palliative care into standard care for solid tumors and hematologic malignancies. While the late palliative care primary offers short-term interventions, predominantly pharmacological in nature and limited to physical symptom reduction, EPC has the potential to act over a longer term, enabling specific interventions aimed at promoting PPWB. This narrative review examines nine English studies retrieved from MEDLINE/PubMed, published up to October 2023, focusing on EPC and three dimensions of PPWB: hope, gratitude, and death acceptance. These dimensions consistently emerge in our clinical experience within the EPC setting for advanced cancer patients and appear to contribute to its clinical efficacy. The choice of a narrative review reflects the novelty of the topic, the limited existing research, and the need to incorporate a variety of methodological approaches for a comprehensive exploration.

Interparental Positivity Spillover Theory: How Parents' Positive Relational Interactions Influence Children

Interparental interactions have an important influence on child well-being and development. Yet prior theory and research have primarily focused on interparental conflict as contributing to child maladjustment, which leaves out the critical question of how interparental positive interactions-such as expressed gratitude, capitalization, and shared laughter-may benefit child growth and development. In this article, we integrate theory and research in family, relationship, and affective science to propose a new framework for understanding how the heretofore underexamined positive interparental interactions influence children: interparental positivity spillover theory (IPST). IPST proposes that, distinct from the influence of conflict, interparental positive interactions spill over into children's experiences in the form of their (a) experience of positive emotions, (b) beneficially altered perceptions of their parents, and (c) emulation of their parents' positive interpersonal behaviors. This spillover is theorized to promote beneficial cognitive, behavioral, social, and physiological outcomes in children in the short term (i.e., immediately after a specific episode of interparental positivity, or on a given day) as well as cumulatively across time. As a framework, IPST generates a host of novel and testable predictions to guide future research, all of which have important implications for the mental health, well-being, and positive development of children and families.

Positive Well-Being, Work-Related Rumination and Work Engagement among Chinese University Logistics Staff

Logistics personnel in Chinese universities are facing unbalanced costs and benefit from overloaded work with minimum wages, which impede school development and their well-being. However, the logistics staff population has been neglected in past investigations pertaining to psychological health conditions. The present study aimed to examine the positive well-being, work-related rumination, and work engagement of logistics staff, their correlations, and the factors affecting well-being in 282 Chinese university logistics staff via the Smith Well-being Questionnaire, the Work-Related Rumination Questionnaire, and the Utrecht Work Engagement Scale. The results indicated low levels of well-being and high levels of work-related rumination and work engagement among Chinese university logistics staff. The presence of positive attitudes towards life and work and high levels of work engagement predicts enhanced well-being, while the presence of negative characteristics and work-related rumination predicts decreased well-being. In situations where the working hours and work duties are challenging to change, universities can regularly schedule psychological counselling sessions for logistics staff to improve their well-being.

The combination of physical activity with fruit and vegetable intake associated with life satisfaction among middle-aged and older adults: a 16-year population-based cohort study

BACKGROUND

Life satisfaction (LS) is part of a positive psychological feeling that protects individuals from a physical decline in old age. A healthy lifestyle, including physical activity (PA) and a healthy diet, such as the intake of fruits and vegetables (F&V), can lead to a better experience of LS in older adults. However, the association between PA and F&V intake habits when occurring together in older adults is still unclear for LS. The study aimed to investigate the combined association of PA and F&V intake on LS among a cohort of older Taiwanese adults.

METHODS

Five waves of population-based data gathered by the Taiwan Longitudinal Survey on Aging between 1999 and 2015 were analyzed. The year 1999 was set as the baseline, and the number of respondents was 4,440. The independent variables included the frequency, duration, and intensity of PA and the frequency of F&V intake. LS was assessed by using the Life Satisfaction Index. We performed generalized estimating equations (GEE) analysis with adjustment for covariates of health behaviors and health indicators.

RESULTS

After adjusting for confounders, model 1 showed that moderate and high-PA levels significantly correlated with LS (odds ratio [OR] = 1.41, 95% CI = 1.12-1.79) and OR = 1.74, 95% CI = 1.50-2.02). Moreover, high-F&V intake significantly correlated with LS (OR = 2.07, 95% CI = 1.69-2.53). Regarding the combined association shown in model 2, compared with both the low PA and F&V intake group, there were significantly higher LS in the both-high-group (OR = 4.69, 95% CI = 3.49-6.31), only-high-F&V intake (OR = 2.87, 95% CI = 2.14-3.85), only-high-PA (OR = 2.48, 95% CI = 1.74-3.52).

CONCLUSIONS

Our findings show the significant combined association of PA and F&V intake on LS among older adults. In addition, older adults who engaged in higher frequency, duration, and intensity of daily PA combined more than seven times a week of F&V intake had significantly higher LS than those who only engaged in low PA or only intake less F&V. Adopting multiple healthy behaviors in daily life is a safe and effective approach to promote LS among older adults.

Subjective well-being patterns in older men and women without someone to confide in: a latent class analysis approach

Objective

This study aimed to identify the latent subtypes of subjective well-being (SWB) and associated factors in older adults without a confidant in China.

Methods

The data came from the most recent (seventh) wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cross-sectional study included 350 older adults who lacked a close confidant. We utilized latent class analysis and multiple logistic regression models to examine the latent SWB subtypes and associated factors.

Results

Three distinct patterns of SWB were identified: the very low SWB class (32%), the medium-low SWB class (46%), and the low evaluative and high affective SWB class (22%). The results indicated that compared to the low evaluative and high affective SWB class, respondents who self-rated their health as not good, currently drank alcohol and rated their financial status as poor/very poor were more likely to be in the very low SWB class, while those who participated in social activities were less likely to be in the very low SWB class. Respondents who had limitations in instrumental activity of daily living (IADL) and rated their financial status as poor/very poor were more likely to be in the medium-low SWB class. However, gender did not affect SWB patterns.

Conclusion

Our findings highlight awareness of the heterogeneity of SWB in older adults without close confidants and provide valuable information for the development of tailored intervention programs to improve their well-being.

The Association between Happiness and Cognitive Function in the UK Biobank

Feelings of happiness have been associated with better performance in creative and flexible thinking and processing. Less is known about whether happier individuals have better performance on basic cognitive functions and slower rate of cognitive decline. In a large sample from the UK Biobank (N=17,885; Age 40-70 years), we examine the association between baseline happiness and cognitive function (speed of processing, visuospatial memory, reasoning) over four assessment waves spanning up to 10 years of follow-up. Greater happiness was associated with better speed and visuospatial memory performance across assessments independent of vascular or depression risk factors. Happiness was associated with worse reasoning. No association was found between happiness and the rate of change over time on any of the cognitive tasks. The cognitive benefits of happiness may extend to cognitive functions such as speed and memory but not more complex processes such as reasoning, and happiness may not be predictive of the rate of cognitive decline over time. More evidence on the association between psychological well-being and different cognitive functions is needed to shed light on potential interventional efforts.

Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (β = .68, P < .001) and perceived stress (β = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (β = .65) * (β = .40); and social support (β = -.21) * (β = -.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.

The prospective association between psychological strengths and incident musculoskeletal injury in active duty Army soldiers

Extensive training, overuse, overexertion, and repetitive movements put Soldiers at increased risk for musculoskeletal injuries (MSIs). The present study investigated the prospective association between psychological strengths, physiological and social factors, and non-combat-related MSI in a sample of 24,746 active duty Army Soldiers. Over a mean follow-up period of 21.07 months (SD = 16.07), 65.42% of the Soldiers examined were treated for an MSI. Applying survival analysis techniques and adjusting for relevant physiological and social factors, we found greater baseline Optimism, Positive Affect, Coping, and Adaptability were each associated with a modest reduction in risk of MSI (4-8%). Additionally, being older, female, married, and having a higher BMI were each associated with an increased MSI risk, whereas being an officer (relative to enlisted) and obtaining post-secondary education were each associated with a decreased MSI risk. Future research should examine the mechanisms through which psychological-based interventions may impact Soldiers' risk of MSI.

Circulating Cell-Free Mitochondrial DNA and Depressive Symptoms Among Low-Active Adults Who Smoke

OBJECTIVES

Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings. This study examined cf-mtDNA and depressive symptoms in low-active adults who smoke.

METHODS

Participants were adults 18 to 65 years old ( N = 109; 76% female) with low baseline physical activity and depressive symptoms recruited for a smoking cessation study. Self-report measures assessed depression severity, positive and negative affect, and behavioral activation. Blood was collected and analyzed for cf-mtDNA. Relationships between depressive symptoms and cf-mtDNA were examined with correlations and linear regression.

RESULTS

Levels of cf-mtDNA were associated with categorically defined depression (Center for Epidemiologic Studies Depression Scale score >15), lower positive affect, and decreased behavioral activation ( p < .05). Relationships remained significant after adjustment for age, sex, and nicotine dependence. In a linear regression model including all depressive symptom measures as predictors, Center for Epidemiologic Studies Depression Scale group and lower positive affect remained significant.

CONCLUSIONS

This work suggests that mitochondrial changes are associated with depressive symptoms in low-active adults who smoke. Higher levels of cf-mtDNA in association with depression and with lower positive affect and decreased behavioral activation are consistent with a possible role for mitochondrial function in depressive symptoms.

Positive psychosocial factors and the development of symptoms of depression and posttraumatic stress symptoms following acute myocardial infarction

Introduction

Acute myocardial infarction (MI) is a potentially fatal condition, leading to high psychological distress and possibly resulting in the development of depressive symptoms and posttraumatic stress symptoms (PTSS). The aim of this study was to investigate the association of clusters of positive psychosocial factors (resilience, task-oriented coping, positive affect and social support) with both MI-induced depressive symptoms and PTSS, independent of demographic factors.

Methods

We investigated 154 consecutive patients with MI, 3 and 12 months after hospital discharge. All patients completed the short version of the German Resilience Scale, the Coping Inventory for Stressful Situations (CISS), the Enriched Social Support Inventory (ESSI) and the Global Mood Scale (GMS). The level of interviewer-rated MI-induced posttraumatic stress disorder (PTSD) symptoms at 3- and 12-months follow-up was evaluated through the Clinician-Administered PTSD Scale (CAPS). Depressive symptoms were assessed at 3- and 12-month follow-up with the Beck Depression Inventory (BDI-II).

Results

Three different clusters were revealed: (1) lonely cluster: lowest social support, resilience and average task-oriented coping and positive affect; (2) low risk cluster: highest resilience, task-oriented coping, positive affect and social support; (3) avoidant cluster: lowest task-oriented coping, positive affect, average resilience and social support. The clusters differed in depressive symptoms at 3 months (F = 5.10; p < 0.01) and 12 months follow-up (F = 7.56; p < 0.01). Cluster differences in PTSS were significant at 3 months (F = 4.78, p < 0.05) and 12 months (F = 5.57, p < 0.01) follow-up. Differences in PTSS subscales were found for avoidance (F = 4.8, p < 0.05) and hyperarousal (F = 5.63, p < 0.05), but not re-experiencing, at 3 months follow-up. At 12 months follow-up, cluster differences were significant for re-experiencing (F = 6.44, p < 0.01) and avoidance (F = 4.02, p < 0.05) but not hyperarousal.

Discussion

The present study contributes to a better understanding of the relationships among different positive psychosocial factors, depressive symptoms and PTSS following acute MI. Future interventions may benefit from taking into account positive psychosocial factors to potentially reduce patients' depressive symptoms and PTSS after MI.