The longitudinal association of psychological resources with chronic conditions and the mediating roles of health behaviours and allostatic load

Acute Stress Symptoms, Intolerance of Uncertainty and Coping Strategies in Reaction to the October 7 War

BACKGROUND

On 7 October 2023, hundreds of armed Hamas fighters breached the security border fence and entered Israel from the Gaza Strip. More than 1400 Israeli citizens were murdered, and 239 individuals were kidnapped. Many Israeli citizens experienced these occurrences as psychologically traumatic events that caused stress and uncertainty.

OBJECTIVES

The present study aimed to examine the relationship between exposure to war (in more distant circles), intolerance of uncertainty (IU) and disengaged coping on acute stress symptoms (ASS). First, we examined whether exposure to war and IU were directly associated with ASS. Second, we tested the mediating role of disengaged coping in the relationship among war exposure, IU and ASS.

METHODS

This cross-sectional study involved 393 Israeli citizens. Participants answered questionnaires on exposure to war, IU, coping strategies and ASS.

RESULTS

The study results indicate that higher exposure and higher levels of IU were directly associated with more intensive ASS, and this association was partially mediated by higher use of disengaged coping strategies.

CONCLUSIONS

Individuals during wartime are at risk of experiencing high levels of ASS and developing ASD. However, degree of exposure to war alone was not associated with ASS, but it was related to personal resources and coping strategies.

Association Between Family History of Diabetes, Irrational Beliefs, and Health Anxiety with 10-Year Risk of Type 2 Diabetes Mellitus: the ATTICA Epidemiological Study (2002-2012)

BACKGROUND

This study aimed to examine the relationship between family history of diabetes, irrational beliefs, and health anxiety in the development of type 2 diabetes mellitus (T2DM).

METHOD

ATTICA is a prospective, cohort study (2002-2012). The working sample included 845 participants (18-89 years), free of diabetes at baseline. Α detailed biochemical, clinical, and lifestyle evaluation was performed, while participants' irrational beliefs and health anxiety were assessed through the Irrational Beliefs Inventory and the Whiteley index scale, respectively. We evaluated the association between the participants' family history of diabetes mellitus with the 10-year risk of diabetes mellitus, both in the total study's sample and separately according to their levels of health anxiety and irrational beliefs.

RESULTS

The crude 10-year risk of T2DM was 12.9% (95%CI: 10.4, 15.4), with 191 cases of T2DM. Family history of diabetes was associated with 2.5 times higher odds (2.53, 95%CI 1.71, 3.75) of T2DM compared to those without family history. Among participants with family history of diabetes, the highest likelihood of developing T2DM, regarding their tested psychological features (i.e., low/high irrational beliefs in the entire group, low/high health anxiety in the entire group, and low/high irrational beliefs, low/high healthy anxiety), had people with high irrational beliefs, low health anxiety (OR 3.70, 95%CI 1.83, 7.48).

CONCLUSIONS

The findings underline the important moderating role of irrational beliefs and health anxiety in the prevention of T2DM, among participants at increased risk of T2DM.

The mediating role of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease

With the application of positive psychology in health management, many studies have confirmed the close relationship between post-traumatic growth, psychological capital and uncertainty in illness. However, there is still a lack of attention to the positive psychology of patients with Parkinson's disease, and previous studies have not clarify the specific relationship. Therefore, the present study sought to explore the multiple mediating roles of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease. We conducted a cross-sectional survey, a total of 268 patients with Parkinson's disease were investigated by the Post-Traumatic Growth Inventory, the Positive Psychological Capital Questionnaire and the Mishel Uncertainty in Illness Scale - Adults from November 2021 to June 2022 in the Parkinson's specialist outpatient department of three 3a-grade hospitals in Tianjin, China. The results showed that the score of post-traumatic growth was (51.78±17.872), the score of uncertainty in illness was (68.08±17.555), and the score of self-efficacy, resilience, hope, and optimism dimensions of psychological capital were (28.93±10.511), (28.79±11.553), (27.57±8.558) and (25.35±9.768). Post-traumatic growth was negatively correlated with uncertainty in illness and positively correlated with all four dimensions of psychological capital (p < 0.01), and uncertainty in illness was negatively correlated with all four dimensions of psychological capital (p < 0.01). Bootstrap test showed that the direct effect of post-traumatic growth on uncertainty in illness of patients with Parkinson's disease was not significant; the total indirect effect of psychological capital between post-traumatic growth and uncertainty in illness was significant. The mediating effects of resilience and hope were significant, accounting for 53.07% and 19.41% of the total indirect effects, respectively. Based on the research results, psychological capital played a completely mediating role between post-traumatic growth and uncertainty in illness of patients with Parkinson's disease. Post-traumatic growth affected uncertainty in illness through two dimensions: resilience and hope. Healthcare professionals should pay attention to the level of psychological capital of patients with Parkinson's disease and implement targeted positive psychological interventions focusing on the two dimensions of resilience and hope, to enhance post-traumatic growth and reduce the level of uncertainty in illness.

Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles

Background

Physical frailty and cognitive decline are two major consequences of aging and are often in older individuals, especially in those with multimorbidity. These two disorders are known to usually coexist with each other, increasing the risk of each disorder for poor health outcomes. Mental health disorders, anxiety and depression, are common in older people with multimorbidity, in particular those with functional or sensory deficits, and frailty.

Purpose

The aim of this study was to show how physical frailty, cognitive impairments and mental disorders, cluster in the real life setting of older primary care (PC) patients, and how these clusters relate to age, comorbidities, stressful events, and coping strategies. Knowing that, could improve risk stratification of older individuals and guide the action plans.

Methods

Participants were older individuals (≥60, N = 263), attenders of PC, independent of care of others, and not suffering from dementia. For screening participants on physical frailty, cognitive impairment, and mental disorders, we used Fried‘s phenotype model, the Mini-Mental State Examination (MMSE), the Geriatric Anxiety Scale (GAS), and the Geriatric Depression Scale (GDS). For testing participants on coping styles, we used the 14-scale Brief-Coping with Problems Experienced (Brief-COPE) questionnaire. To identify clusters, we used the algorithm fuzzy k-means. To further describe the clusters, we examined differences in age, gender, number of chronic diseases and medications prescribed, some diagnoses of chronic diseases, the number of life events, body mass index, renal function, expressed as the glomerular filtration rate, and coping styles.

Results

The most appropriate cluster solution was the one with three clusters, that were termed as: functional (FUN; N = 139), with predominant frailty or dysfunctional (DFUN; N = 81), and with predominant cognitive impairments or cognitively impaired (COG-IMP; N = 43). Participants in two pathologic clusters, DFUN and COG-IMP, were in average older and had more somatic diseases, compared to participants in cluster FUN. Significant differences between the clusters were found in diagnoses of osteoporosis, osteoarthritis, anxiety/depression, cerebrovascular disease, and periphery artery disease. Participants in cluster FUN expressed mostly positive reframing coping style. Participants in two pathological clusters were represented with negative coping strategies. Religion and self-blame were coping mechanisms specific only for cluster DFUN; self-distraction only for cluster COG-IMP; and these two latter clusters shared the mechanisms of behavioral disengagement and denial.

Conclusion

The research approach presented in this study may help PC providers in risk stratification of older individuals and in getting insights into behavioral and coping strategies of patients with similar comorbidity patterns and functional disorders, which may guide them in preparing prevention and care plans. By providing some insights into the common mechanisms and pathways of clustering frailty, cognitive impairments and mental disorders, this research approach is useful for creating new hypotheses and in accelerating geriatric research.

A longitudinal analysis of the relationship between housing insecurity and physical health among midlife and aging adults in the United States

Rationale

A large body of work demonstrates the impact of housing instability on health by exploring the effects of evictions and homelessness on psychological wellbeing of young adults and children. However, limited research leverages national longitudinal data to examine whether and how experiences of a range of housing insecurity events, rather than just eviction or homelessness, affect physical health among midlife and older adults.

Objective

The current study examines (1) prevalence of housing insecurity among midlife and older adults by age and race, (2) linkages between housing insecurity experiences and facets of physical health, and (3) age and race moderations on these effects.

Method

This study employs regression models to examine whether experiences of housing insecurity affect self-rated physical health and chronic physical conditions among midlife and older adults (N = 2598) leveraging two waves of the National Study of Midlife in the United States (MIDUS).

Results

Models revealed that housing insecurity experiences predicted poorer self-rated physical health and additional chronic conditions, even when controlling for previous physical health. Moderation analyses indicated that housing insecurity has a stronger relationship with chronic conditions among midlife adults as compared to older adults, and among Black adults as compared to white adults. These results suggest that experiences of housing insecurity leave adults vulnerable to compromised physical health, and that housing insecurity experiences may be particularly detrimental to the health of midlife Black adults.

Conclusions

This research adds to the extant literature by introducing a comprehensive measure of housing insecurity experiences, and contributes to a life course perspective regarding how housing insecurity can affect physical health. This research has implications for policy that addresses housing insecurity as a public health concern, especially in the aftermath of the 2008 recession and the economic and housing crisis caused by the COVID-19 pandemic.

Life Satisfaction Prevents Decline in Working Memory, Spatial Cognition, and Processing Speed: Latent Change Score Analyses Across 23 Years

Background

Within-person growth in life satisfaction (LS) can protect against declines in cognitive functioning, and, conversely, over time. However, most studies have been cross-sectional, thereby precluding causal inferences. Thus, we used bivariate dual latent change score modeling to test within-person change-to-future change relations between LS and cognition.

Method

Community adults completed in-person tests of verbal working memory (WM), processing speed, spatial cognition, and an LS self-report. Five waves of assessment occurred across 23 years.

Results

Reduction in LS predicted future decreases in spatial cognition, processing speed, and verbal WM (|d | = 0.150–0.354). Additionally, depletion in processing speed and verbal WM predicted a future decrease in LS (d  = 0.142–0.269). However, change in spatial cognition did not predict change in LS (|d | = 0.085).

Discussion

LS and verbal WM and processing speed predicted one another across long durations. Evidence-based therapies can be augmented to target LS and cognition.

Evaluating the Psychometric Properties of the Psychological Capital Questionnaire (PCQ) in Patients with Parkinson's Disease

BACKGROUND

Positive personality resources have demonstrated the ability to positively impact health outcomes.

OBJECTIVE

To examine the psychometric properties of the original Psychological Capital Questionnaire (PCQ-24) in patients with Parkinson's disease (PD).

METHODS

A sample of 114 individuals with PD completed the PCQ-24, and via a latent factor modeling framework exploratory and confirmatory factor analyses were conducted to evaluate the psychometric properties in people with PD.

RESULTS

Exploratory factor analysis (EFA) revealed that both the efficacy and hope scales were reliable (Cronbach's alpha = 0.87 and 0.86, respectively) and had statistically acceptable validity with strong factor loadings all above the practical threshold of 0.60. The resilience and optimism scales were also reliable (Cronbach's alpha = 0.78 and 0.73, respectively) but had only moderately acceptable validity in part due to three reverse-scored items (i.e., No. 13, 20, & 23) with weak factor loadings of 0.26, 0.46, and 0.50, respectively. After excluding these at-risk items, the overall factor loadings for resilience and optimism were significantly improved at the acceptable above 0.60. The CFA results confirm a statistically acceptable model fit for the modified version (only 21-items) of the PCQ in the PD sample.

CONCLUSION

Both EFA and CFA analyses provide statistical evidence supporting the modified PCQ version and demonstrate better test validity and reliability in the PD population. The refined PCQ form is both effectively shorter and psychometrically superior to the original and has promise in investigating health outcomes in people with PD.