Gender-linked personality traits predict mental health and functional status following a first coronary event

Theory of planned behavior explains males' and females' intention to receive COVID-19 vaccines differently

Uptake of COVID-19 vaccines is an important measure to curb the transmission of the coronavirus. Before the vaccines were available, numerous studies found that people had a moderate-to-high intention to receive the vaccines. Several studies have also used the theory of planned behavior (TPB) to predict people’s COVID-19 vaccination intention with three elements (i.e. attitudes, subjective norms, and perceived behavioral control) . However, the vaccination rate falters after the vaccines became available, and there were few updated data documenting people’s vaccination intention and how well TPB can explain their intention. In addition, studies investigating other outcomes found that the predictive utilities of TPB often varied across gender, but such gender differences received little consideration in the literature of COVID-19 vaccination intention. To help fill these gaps, we examined the associations between TPB elements and people’s intention to receive COVID-19 vaccines and the moderation of gender in the context of vaccination campaign. Participants were 405 Chinese citizens. They reported on the three TPB elements and intention to receive vaccines in the coming months. Descriptive results showed that participants’ vaccination intention was moderate. Results of path analysis showed that subjective norms and perceived behavioral control were positively related to vaccination intention for the whole sample. Furthermore, results of multigroup path analysis showed that attitudes were only related to males’, while subjective norms were only related to females’, intention. These findings enhance the utility of TPB in explaining people’s COVID-19 vaccination intention and inform gender-specific strategies to boost males’ and females’ vaccination intention.

Gender-based depression trajectories following heart disease onset: significant predictors and health outcomes

BACKGROUND

Using a nationally representative sample of U.S. older adults (50+), this study investigates gender-based depression trajectories following heart disease onset and associated risk of disability and mortality over an 8-year period.

METHOD

Six waves of longitudinal data from the Health and Retirement Study (2006-2016) were used (n = 1787). Heart disease onset was defined as self-reporting no heart disease at baseline but reporting a positive diagnosis in a subsequent wave. Growth Mixture Modelling identified depression trajectories. Multinomial logistic regression models determined significant predictors of depression trajectories. Cox proportional-hazards models examined the associated disability and mortality risks.

RESULTS

Three distinct depression trajectories were identified, including persistent minimal depression (men: 68.65%; women: 60.17%), moderate depression (women: 29.70%; men: 17.97%), and chronic depression (women: 10.12%) or emerging depression (men: 13.38%). Younger age and depression status at baseline were associated with women's chronic depression and men's emerging depression. Chronic/emerging and moderate depression were associated with higher disability risks than was minimal depression among both women and men (hazard ratios [HR] ranged from 2.12 to 3.92, p < 0.001). Only men's emerging depression was linked to higher mortality risk compared to minimal depression (HR = 2.03, p < 0.001).

CONCLUSION

Longitudinal course of depression following onset of heart disease is heterogeneous in later life. Unfavorable depression trajectories (i.e. moderate, chronic, and emerging) were associated with higher disability risk compared to the minimal depression trajectory. Study findings characterize risk stratification regarding depression after heart disease onset, which can inform the development of interventions to improve health outcomes among older adults with heart conditions.

Depressive symptoms and unmitigated communion in support providers

In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self‐neglect and externalized self‐evaluation. These characteristics appear to predispose individuals high in UC to experience depressive symptoms. As anticipated, we show that enacted supportive behaviour was negatively associated with depressive symptoms (Study 1 and 2), and enacted unsupportive behaviour was positively associated with depressive symptoms (Study 2), but only among individuals low in UC. Our findings are consistent with the idea that for high UC individuals, enacting supportive behaviour, or not enacting unsupportive behaviour, is insufficient to reduce their high levels of depressive symptoms. Copyright © 2009 John Wiley & Sons, Ltd.

Coping with caregiving: Humor styles and health outcomes among parents of children with disabilities

BACKGROUND

Parents of children with developmental disabilities experience greater stress and worse mental and physical health outcomes than parents of typically developing children. The use of various humor styles to cope with stressors has been associated with mental and, to a lesser extent, physical health outcomes in other populations, but has not been previously examined among parents of children with disabilities.

AIMS

To examine relations of adaptive vs. maladaptive humor styles with depression, daily affect, mental and physical functioning, somatic symptoms, and health behaviors, and to examine whether social support or positive reappraisal mediate relations of humor with health outcomes.

METHOD

80 parents of children with disabilities completed online surveys at T1. 40 parents completed T2 surveys 4 months later.

RESULTS

As predicted, the adaptive humor styles - self-enhancing and affiliative - were associated with enhanced mental health outcomes, and these relations were mediated by social support and, to a lesser extent, positive reappraisal. Self-defeating humor was associated with worse mental health, greater symptoms, and worse health behavior; these relations were mediated by social support.

CONCLUSION

Adaptive humor use may facilitate caregivers' ability to garner support from others and reframe stressors, which ultimately may contribute to mental and physical resilience to stress.

Communal motivation in couples coping with vulvodynia: Sexual distress mediates associations with pain, depression, and anxiety

OBJECTIVE

To examine the role of a novel motivational perspective-sexual communal motivation-in women's pain during intercourse and both partners' distress in couples coping with vulvodynia, a prevalent gynecological pain condition. Our goal was to test whether sexual communal strength (i.e., motivation to meet a partner's sexual needs) and unmitigated sexual communion (i.e., prioritization of a partner's sexual needs in neglect of one's own needs) were indirectly associated with pain, depression, and anxiety via sexual distress.

METHODS

Couples (N=101) completed daily surveys about their sexual communal motivation, sexual distress, anxiety, depression, and women reported on their pain during intercourse. Using multilevel modeling, we examined how daily fluctuations in sexual communal motivation were directly and indirectly (via sexual distress) associated with pain and psychological distress.

RESULTS

On days when women with vulvodynia reported higher sexual communal strength, they reported less pain and anxiety, and on days when they reported higher unmitigated sexual communion, they reported more pain, more anxiety, and both partners reported more depressive symptoms. Daily associations between women's unmitigated sexual communion and greater pain, depression and anxiety were mediated by sexual distress.

CONCLUSIONS

Being motivated to meet a partner's sexual needs was associated with less pain and anxiety for women with vulvodynia, but when this motivation excluded a focus on one's own needs, there were detrimental consequences for women's pain and both partners' depressive symptoms. Interventions for improving women's pain and the psychological well-being of affected couples should target motivational factors and sexual distress.

Humor Use Moderates the Relation of Stressful Life Events With Psychological Distress

Three studies examined humor and adjustment to stressful events. In Study 1, patients with fibromyalgia syndrome ( N = 22) reported on mental and physical adjustment, social interaction, and reappraisal of their illness. Dispositional humor was associated with reduced distress and fewer physical symptoms. Study 2 ( N = 109) examined undergraduates’ reports of stressful events. Dispositional, self-enhancing, affiliative, and self-defeating humor showed direct effects on distress, which were mediated by social interaction and reappraisal. Moreover, dispositional and aggressive humor showed stress-buffering effects. Study 3 ( N = 105) examined undergraduates’ adjustment to the September 11, 2001, attacks at 1 and 3 months postattack. At T1, affiliative humor showed a stress-buffering effect on distress. Social interaction mediated the relation of self-enhancing humor with reduced T1 distress, and mediated relations of aggressive and self-defeating humor with greater distress. Relations of T1 dispositional and self-defeating humor to changes in T2 distress were mediated by reappraisal.

Does personality affect health-related quality of life? A systematic review

Background

Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear.

Methods

This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study.

Results

Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%.

Conclusions

Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation.

An Alternative View of Psychological Well-Being in Cardiac Rehabilitation: Considering Temperament and Character

BACKGROUND

Research suggests that personality is related to recovery from cardiac events, yet few conceptions of personality provide hope or possibility of improvement for patients with the least adaptive personality types. Psychobiological theory of personality has potential in this regard, but, to date, no research has investigated temperament and character in cardiac settings.

AIM

To explore relationships between temperament, character and psychological well-being among cardiac patients.

METHOD

Self-report questionnaires were distributed to a convenience sample of 81 cardiac patients to obtain data on personality (TCI [Cloninger CR, Przybeck T, Svrakic D, & Wetzel RD. The Temperament and Character Inventory (TCI): A guide to its development and use. St Louis (MO), Center for Psychobiology of Personality, Washington University;1994]), anxiety and depression (HADS [Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6): 361-70]) and satisfaction with life [Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess 1985;49(1):71-5].

RESULTS

The interaction of two personality dimensions (harm avoidance and self-directedness) was significantly related to measures of psychological well-being. Patients with low self-directedness combined with high harm avoidance reported significantly higher levels of anxiety, depression and lower levels of satisfaction with life.

CONCLUSION

This exploratory study suggests that psychobiological theory of personality may be useful for practitioners in cardiac rehabilitation seeking to identify patients at risk of poor psychological well-being.

Social Interactions and Cardiovascular Reactivity during Problem Disclosure among Friends

The authors examined the relations of social interactions with cardiovascular response in the context of two friends disclosing a problem. They also examined the relations of the sex composition of the dyad and partner gender-related traits (communion/agency) with social interactions. Same-sex and opposite-sex dyads (N = 79) came to the lab. One friend disclosed a real-life problem while the partner provided support; cardiovascular response was monitored. Women provided more emotional support than men, and this sex difference was due to women's higher levels of communion. Agency was linked with greater advice, whereas unmitigated communion was linked with greater negative interactions. Negative interactions predicted slower diastolic blood pressure (DBP) recovery, whereas advice predicted slower heart rate (HR) recovery. Sex composition of dyad moderated some of these effects.

Gender Roles and Mental Health in Women With and at Risk for HIV

Predominantly low-income and African American women from the same community, HIV-infected (n = 100; HIV+) and uninfected (n = 42; HIV-), were assessed on reported gender roles in sexual and other close relationships-including levels of self-silencing, unmitigated communion, and sexual relationship power-at a single recent study visit during 2008-2012. Recent gender roles were investigated in relation to depressive symptoms and health-related quality of life assessed both at a single visit during 2008-2012 and averaged over semiannual visits (for depressive symptoms) and annual visits (for quality of life) occurring between 1994 and 2012. Compared to HIV- women, HIV+ women reported significantly higher levels of several aspects of self-silencing, unmitigated communion, and multi-year averaged depressive symptoms as well as lower levels of sexual relationship power and recent and multi-year averaged quality of life. For both HIV+ and HIV- women, higher self-silencing and unmitigated communion significantly related to recent or multi-year averaged higher depressive symptoms and lower quality of life. Intervention strategies designed to increase self-care and self-advocacy in the context of relationships could potentially minimize depressive symptoms and enhance quality of life in women with and at risk for HIV.

Gender-related personality traits, self-efficacy, and social support: How do they relate to women’s waist circumference change?

This study investigated whether gender-role related traits agency and communion contribute to successful health behavior change, in an interplay with domain-specific psychosocial factors, namely, agency, mediated by health-related self-efficacy, and communion, moderated by social support. Data from women ( N = 282) participating in the GOAL Lifestyle Implementation Trial were analyzed using structural equation modeling. Agency and increase in self-efficacy both independently predicted waist circumference reduction in the 1-year follow-up. Individuals high in communion succeeded in waist reduction only if they received social support. Initial self-efficacy increase predicted 3-year waist reduction. Gender-role orientation, together with social environment, influences behavior change intervention outcomes.

Gender-related traits, quality of life, and psychological adjustment among women with irritable bowel syndrome

OBJECTIVE

Irritable bowel syndrome (IBS) is a functional illness associated with significant impairment in quality of life. Compared to men, women are more likely to meet criteria for IBS, to seek treatment, and experience greater detriments in quality of life. In addition to physiological factors, psychosocial factors may contribute to such gender differences. We examined whether traits associated with masculine (agentic) and feminine (communal) gender roles were linked with adjustment to IBS.

METHODS

Women with IBS (N = 144) completed online self-report measures of gender-related traits (agency, communion, unmitigated agency, unmitigated communion, lack of agency, lack of communion), IBS-specific quality of life (IBS-QOL), and psychological adjustment (negative and positive affect).

RESULTS

Agency was positively associated with all dimensions of IBS-QOL and psychological adjustment. Select dimensions of IBS-QOL were lower among women higher in unmitigated agency (social reactions, body image) or unmitigated communion (interference with activity), and both traits were associated with increased negative affect. Lack of agency was associated with increased IBS-QOL (food avoidance) and decreased positive affect. Communion and lack of communion were not associated with either IBS-QOL or psychological adjustment.

CONCLUSIONS

Findings may help elucidate psychosocial factors contributing to quality of life among women with IBS.

The effects of unmitigated communion and life events among women with fibromyalgia syndrome

This study examined the effects of the personality trait of unmitigated communion (UC) within the context of positive and negative relationship events. Ninety-one women diagnosed with fibromyalgia syndrome completed initial measures of UC as well as weekly measures of positive and negative relationship events and positive and negative affect. Positive events were related to positive affect while negative events were related to negative affect. Negative and positive affect were also predicted from the interaction of UC and negative events. These results suggest the interrelationships among UC and relationship events can combine in meaningful ways to predict psychological well-being.

Unmitigated communion and health among adolescents with and without diabetes: the mediating role of eating disturbances

The authors examined the implications of unmitigated communion--a focus on others to the exclusion of the self--for psychological and physical health among adolescents with (n = 132) and without (n = 131) diabetes times/during a 1-year period. Unmitigated communion predicted greater psychological distress and lower levels of competence cross-sectionally and longitudinally, controlling for sex, pubertal status, and communion. Health status moderated some longitudinal relations, such that relations held only for adolescents with diabetes. In addition, unmitigated communion was associated with poor metabolic control and predicted a deterioration in metabolic control over the year for adolescents with diabetes. Unmitigated communion also was associated with disturbed eating behavior cross-sectionally and longitudinally, and disturbed eating behavior explained some of the relations of unmitigated communion to psychological but not physical health outcomes.

Übersetzung und Validierung der Skala zur Erfassung übermäßiger Communion von Helgeson und Fritz

Zusammenfassung. Übermäßige Communion (UC) ist durch Überinvolvierung in die Probleme anderer Menschen und Vernachlässigung eigener Bedürfnisse zu Gunsten der Bedürfnisse anderer gekennzeichnet. In der vorliegenden Arbeit wurde die UC-Skala von Helgeson und Fritz (1998) ins Deutsche übertragen und in drei Studien validiert. Die deutsche UC-Skala war zur Originalskala konvergent und vergleichbar konsistent, jedoch faktoriell komplexer. In der interpersonalen Konstruktanalyse wurde die vorherrschende thematische Qualität der UC-Skala im interpersonalen Eigenschafts- und Problem-Circumplex als submissiv-freundlich ausgewiesen. Überinvolvierung in die Probleme anderer und Vernachlässigung eigener Bedürfnisse ließen sich auf Item-Ebene im interpersonalen Eigenschafts-Circumplex differenzieren. Das Fünf-Faktoren-Modell klärte 22% der UC-Skalenvarianz auf und hing differenziell mit Überinvolvierung und Vernachlässigung eigener Bedürfnisse zusammen.

Prädiktoren des Belastungserlebens im Lehrerberuf

Zusammenfassung: Ausgehend von einem Modell der Selbstregulation werden in einer Längsschnittstudie Determinanten des lehrerspezifischen Belastungserlebens bei N = 266 Lehrkräften der Mathematik untersucht. Nach dem Examen wurden das Selbstkonzept (Instrumentalität, Expressivität), berufliche Selbstwirksamkeitserwartungen und Zielvorstellungen zur Berufsausübung (Karriereorientierung, Integrationsorientierung, Teilzeitorientierung) erhoben, während des Referendariats wurde das allgemeine berufliche Belastungserleben erfasst, und vier Jahre nach dem Examen wurden wiederum das allgemeine Belastungserleben, die berufliche Selbstwirksamkeitserwartung und das lehrerspezifische Belastungserleben gemessen. Darüber hinaus wurden Geschlecht der Lehrkraft, Lehrdeputat und Elternschaft erfragt. Die Vorhersagen wurden mit einem pfadanalytischen Modell getestet. Hohe Instrumentalität reduzierte das Belastungserleben sowohl direkt als auch indirekt vermittelt über berufliche Selbstwirksamkeitserwartungen. Hohe berufliche Selbstwirksamkeit reduzierte ebenfalls das Belastungserleben. Eine berufliche Teilzeit-Zielorientierung erhöhte dagegen das Lehrerbelastungserleben, ähnlich auch eine Integrationszielorientierung. Es gab keine Unterschiede im Belastungserleben von weiblichen und männlichen Lehrkräften. Wir diskutieren die Nützlichkeit eines Selbstregulationsansatzes, der neben dem allgemeinen Selbstkonzept Selbstwirksamkeitserwartungen und berufsbezogene Zielvorstellungen bei der Analyse erlebter Belastung im Lehrerberuf berücksichtigt, und leiten einige anwendungsbezogene Folgerungen ab.

Health psychology: psychological adjustment to chronic disease

Chronic diseases carry important psychological and social consequences that demand significant psychological adjustment. The literature is providing increasingly nuanced conceptualizations of adjustment, demonstrating that the experience of chronic disease necessitates adaptation in multiple life domains. Heterogeneity in adjustment is apparent between individuals and across the course of the disease trajectory. Focusing on cancer, cardiovascular disease, and rheumatic diseases, we review longitudinal investigations of distal (socioeconomic variables, culture/ethnicity, and gender-related processes) and proximal (interpersonal relationships, personality attributes, cognitive appraisals, and coping processes) risk and protective factors for adjustment across time. We observe that the past decade has seen a surge in research that is longitudinal in design, involves adequately characterized samples of sufficient size, and includes statistical control for initial values on dependent variables. A progressively convincing characterization of risk and protective factors for favorable adjustment to chronic illness has emerged. We identify critical issues for future research.

Benefit-Finding Among Patients with Rheumatoid Arthritis: Positive Effects on Interpersonal Relationships

This longitudinal study of patients with rheumatoid arthritis used mixed methods to identify and describe the positive effects of illness on relationships, examine correlates of benefit-finding, and test the relationship between benefit-finding and adjustment outcomes. When asked about interpersonal benefits of their illness, 71.3% of the respondents described interpersonal benefits, whereas 16.2% reported another type of benefit, and 12.5% reported no benefits. The most frequently described benefit was appreciation of support received from loved ones. Less pain, lower psychological distress, and perceiving fewer social constraints were related to finding interpersonal benefits in the illness experience. Interpersonal benefit-finding predicted lower levels of disability at a 12-month follow-up. Findings are discussed with regard to conceptual issues, methodological recommendations, and implications for interventions.

Personality and attempted suicide in depressed adults 50 years of age and older: a facet level analysis

We examined the contribution of personality traits to attempted suicide, the number of suicidal attempts, and suicidal ideation in a sample of depressed inpatients. Personality was assessed via the Revised NEO Personality Inventory (NEO-PI-R). Bivariate analyses showed that suicide attempters were more self-conscious, self-effacing, impulsive, and vulnerable to stress, and less warm, gregarious, and inclined to experience positive emotions. Multivariate regression analyses controlling for age, gender, severity of depression, and psychiatric comorbidity showed that patients with a lifetime history of attempted suicide were less inclined to experience positive emotions and be more self-effacing. Patients with more severe suicidal ideation were less warm and more self-effacing. Results indicated that specific personality traits confer risk for suicidal behaviors in middle age and older adults. Interventions tailored to specific personality profiles in this high-risk group should be developed, and their efficacy examined.

Prospective study of perceived stress in cardiac patients

BACKGROUND

Psychological stress is known to have a negative effect on the health and well-being of coronary artery disease (CAD) patients. Although the study of stress CAD samples has received considerable attention, few studies have examined the effects of gender and age, had multiple follow-ups over an extended period, and had extensive baseline assessment batteries.

PURPOSE

In this study, demographic, clinical, social, and personality variables were evaluated as predictors of nine repeated assessments of stress over a 2-year period in 322 CAD patients (33.2% female).

METHODS

At baseline, perceived social support, coping style, and social conflict were associated with stress ratings. Mixed models were used to evaluate predictors of reported stress during the subsequent 2 years.

RESULTS

The results showed that higher stress was present in patients who were female and young. Follow-up stress was also found in patients with moderate income, congestive heart failure, high social conflict, low social support, and negative coping style.

CONCLUSIONS

These findings may help clinicians identify patients who are likely to experience higher levels of stress over a prolonged period following a diagnosis of CAD and may also suggest which patients may benefit most from stress reduction interventions.

How do female and male cardiac patients and their spouses share responsibilities after discharge from the hospital?

This study explored sex differences in household and employment responsibilities among cardiac patients (N = 63; 46 men) and spouses during the 5 months following discharge from the hospital. Results showed that both patients and partners maintained traditional sex-typed activities. As patients or spouses, women tended to assume greater responsibility for domestic tasks such as laundry, cleaning, and cooking than their husbands. Men as patients or spouses tended to assume greater responsibility for household repair and maintenance tasks. Husbands also worked more for pay outside the home than did wives, except in couples where the male patient was high risk. Correlations for male patients indicated that reports of more cardiac symptoms were associated with assuming fewer responsibilities. In contrast, among women, the correlations between symptoms and activities were more complex and suggested that female patients might not be heeding signs of overexertion.

A comparison of physical activity in men and women with cardiac disease: do gender roles complicate recovery?

Fifty-four male and twenty-six female married cardiac patients were studied for five months post-hospital discharge. Participants completed activity diaries for three days at 5, 10, 15, and 20 weeks. Reported activities were converted to METs. Patients increased activity across the five-month study period. Patients also tended to engage in higher levels of activity in the morning hours. Men and women did not differ in average total METs expended. Comparisons for specific activities indicated that women consistently expended more energy on domestic responsibilities, such as cleaning and laundry. Men engaged more in repairs, yardwork and carrying, but these activities were performed sporadically and involved low METs requirements. The concentrated domestic activity assumed by women early in recovery may pose a risk of complications.