Depression, perceived disability and unemployment are associated with reduced life satisfaction in anorexia nervosa

Responding to "Terminal anorexia nervosa: three cases and proposed clinical characteristics"

The treatment of eating disorders raises many ethical debates given the pervasiveness with which this illness impacts individuals, especially as the length of time with the illness increases. A recent case study supported the appropriateness of pursuing medical aid in dying for individuals with eating disorders who wish to end their fight with their disorder. This correspondence raises concerns related to this controversial proposal as the current authors dispute that the use of medical aid in dying for individuals with eating disorders is ethically judicious or appropriate. Additionally, this correspondence highlights additional treatment implications that should be considered when trying to provide individuals with eating disorders with the best evidence-based care possible, with the goal of promoting steps toward recovery.

How did the COVID-19 pandemic affect older adults? Investigation in terms of disability, state-trait anxiety and life satisfaction: Samsun, Turkey example

BACKGROUND

The COVID-19 pandemic has adversely affected the physical and mental health of individuals. The elderly are a special group that is affected by this condition. The aim of this study was to investigate the effect of the COVID-19 pandemic on older adults in terms of disability, state-trait anxiety and life satisfaction.

METHODS

The population of this cross-sectional study consisted of individuals aged 65 and over who presented to a family health centre in Samsun a province of Turkey on the Black Sea coast (N = 3950). The study data were collected with the following five forms: Personal Information Form, Quality of Life Questionnaire, State-Trait Anxiety Inventory, Brief Disability Questionnaire and Life Satisfaction Scale. In the analysis of the study data, descriptive statistics, Student's t-test, paired t-test, analysis of variance, Pearson correlation and multiple regression analysis were used.

RESULTS

The mean age of the participants was 70.88 ± 4.818 years. There was a significant difference between the participants' pre- and post-pandemic health status and quality of life levels. In the study, a significant relationship was determined between the scores obtained from the State-Trait Anxiety Inventory, and the Brief Disability Questionnaire and between the scores obtained from the State-Trait Anxiety Inventory and the variables such as income and marital status (P < 0.05).

CONCLUSION

A significant result of the study is that the older adults' perceptions of health status and quality of life were adversely affected by the pandemic. Another significant result is that disability increased the level of anxiety. The other significant result of the study is that socioeconomic status was an important determinant of anxiety.

Financial Hardship, Hope, and Life Satisfaction Among Un/Underemployed Individuals With Psychiatric Diagnoses: A Mediation Analysis

BACKGROUND

Individuals with psychiatric diagnoses who are unemployed or underemployed are likely to disproportionately experience financial hardship and, in turn, lower life satisfaction (LS). Understanding the mechanisms though which financial hardship affects LS is essential to inform effective economic empowerment interventions for this population.

AIM

To examine if subjective financial hardship (SFH) mediates the relationship between objective financial hardship (OFH) and LS, and whether hope, and its agency and pathways components, further mediate the effect of SFH on LS among individuals with psychiatric diagnoses seeking employment.

METHODS

We conducted structured interviews with participants (N = 215) of two peer-run employment programs using indicators of OFH and SFH and standardized scales for hope (overall hope, hope agency, and hope pathways) and LS. Three structural equation models were employed to test measurement models for OFH and SFH, and mediational relationships. Covariates included gender, age, psychiatric diagnosis, race/ethnicity, education, income, employment status, SSI/SSDI receipt, and site.

RESULTS

Confirmatory factor analysis (CFA) for items measuring OFH and SFH supported two separate hypothesized factors. OFH had a strong and significant total effect on SFH [standardized beta (B) = 0.68] and LS (B = 0.49), and a weak-to-moderate effect on hope (B = -0.31). SFH alone mediated up to 94% of the effect of OFH on LS (indirect effect B = -0.46, p < 0.01). The effect of SFH on LS through hope was small (indirect effect B = -0.09, p < 0.05), primarily through hope agency (indirect effect B = -0.13, p < 0.01) and not hope pathways. Black and Hispanic ethno-racial identification seemed to buffer the effect of financial hardship on hope and LS. Individuals identifying as Black reported significantly higher overall hope (B = 0.41-0.47) and higher LS (B = 0.29-0.46), net of the effect of OFH and SFH.

CONCLUSION

SFH is a strong mediator of the relationship between OFH and LS in our study of unemployed and underemployed individuals with psychiatric diagnoses. Hope, and particularly its agency component, further mediate a modest but significant proportion of the association between SFH and LS. Economic empowerment interventions for this population should address objective and subjective financial stressors, foster a sense of agency, and consider the diverse effects of financial hardship across ethno-racial groups.

Psychometric properties of the Chinese version of the Courtauld Emotional Control Scale in women newly diagnosed with breast cancer

PURPOSE

Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer.

METHODS

The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status.

RESULTS

Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status.

CONCLUSIONS

The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.