The mediating role of hardiness in the relationship between perceived loneliness and depressive symptoms among older

Hardiness moderates the effects of COVID-19 stress on anxiety and depression

The COVID-19 pandemic has led to sharp increases in mental health problems around the world, most notably in anxiety and depression. The present study examines hardiness and age as potential protective factors against the mental health effects of COVID-related stress. A sample of Canadians balanced across age and gender, completed an online survey including measures of COVID related stressors, hardiness, depression, and anxiety, along with age, gender, and other demographics. Conditional PROCESS analysis showed that COVID stressors led to significant increases in anxiety and depression. Hardiness moderated these relations, with those high in hardiness showing less anxiety and depression. Age was negatively related to anxiety and depression, with highest levels observed among the younger respondents. At the same time, a moderating effect of age was found with respect to depression, with older people showing sharper increases in depression as COVID-related stress goes up. Gender was not a significant factor in any of these relations, meaning that the results apply equally well to both women and men. This study provides evidence that younger people who are also low in hardiness are most vulnerable to developing anxiety and depression while under COVID stress, and so would likely benefit from preventive intervention strategies. While anxiety and depression symptoms are highest among the young, older age groups appear more vulnerable to increasing rates of depression symptoms related to COVID stress. Clinicians and practitioners should thus be especially vigilant for COVID related increases in depression among older people, and those low in psychological hardiness.

The relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease: a cross-sectional study

Background

Providing long-term home care to older adults with chronic diseases may endanger the physical, mental, social, and spiritual health of caregivers and lead to care strain.

Objective

This study aimed to assess the relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease.

Methodology

This cross-sectional correlational study was conducted in 2020–2021 in Tehran. Participants were 230 family caregivers randomly recruited from 8 urban health care centers. Data were collected using a personal characteristics questionnaire, the Modified Caregiver Strain Index, Connor-Davidson Resilience Scale, Family Hardiness Index, and the data were analyzed by using SPSS 22 version. Pearson’s correlation coefficient was applied for data analysis. P-values ≤0.05 were considered significant.

Results

A total of 230 caregivers participated in the study. The mean age of participants was (46.65 ± 13.63) years and most of them were female (73.9%). Mean scores of caregiver strain, resilience, and hardiness in family caregivers were 16.23 ± 4.5, 39.89 ± 10.9, and 31.21 ± 7.79, respectively. Pearson correlation showed a significant and inverse correlation between caregiver strain and resilience (r = -0.310, P = 0.002), and also a significant and inverse relationship between caregiver strain and hardiness (r = -0.276, P = 0.001).

Conclusion

In this study, family caregivers had moderate caregiver strain, low resilience, and high hardness. Caregiver strain in family caregivers of older adults with chronic disease is an important health issue associated with resilience and hardiness. To promote health, effective adaptation to long-term care, and reduce caregiver strain, designing effective interventions to increase resilience and hardiness in family caregivers seems necessary.

Development and Validation of an Improved Hardiness Measure

Abstract. Previous research shows that psychological hardiness is an important factor contributing to stress resilience in individuals. Of the various instruments available to measure hardiness, the most commonly used is the Dispositional Resilience Scale (DRS). Despite its demonstrated utility, the DRS-15 still has a number of serious limitations, including low subscale reliability and limited construct validity. The present work aims to create a new hardiness scale that addresses these limitations. A pool of new items plus the original DRS item set was administered to a census-matched stratified sample of N = 2,021 men and women across the United States. Items for the new scale were selected based on item distribution characteristics, item response theory plots, scale reliabilities, item-total correlations, and confirmatory factor analysis (CFA). CFA results showed the best fitting model reflected a hierarchical structure with three factors (commitment, control, and challenge) nested under a broad hardiness factor. This factor structure is replicated in two independent validation samples and also holds invariant across gender and age. The new scale shows much improved reliability coefficients (e.g., Cronbach’s α of .93, .85, .84, and .89 for total hardiness, challenge, control, and commitment, respectively), as well as structural equivalence across gender and age. Validity is demonstrated in multiple samples via predictive associations of hardiness scores with theoretically relevant outcome measures, including coping, life satisfaction, anxiety, and depression. The Hardiness Resilience Gauge (HRG) possesses excellent reliability and validity and appears to be a more effective tool for measuring hardiness in adult populations.

University freshmen's excessive smartphone use and psychological safety during the COVID-19 pandemic

Although excessive smartphone use has been confirmed as being associated with specific representations of mental health (e. g., anxiety, depression, wellbeing, etc.) throughout the COVID-19 pandemic, the relationship between excessive smartphone use and cognitive representations of mental health (i.e., psychological safety) is not yet fully understood. This study aimed to identify the association between excessive smartphone use and psychological safety among university freshmen during the COVID-19 pandemic; in addition, we examined the mediation effects of hardiness and interpersonal distress in this relationship. In this study, 1,224 university freshmen were selected at random from several universities in Guizhou Province of China. The Psychological Safety Scale was used to evaluate the mental health of university freshmen; the Mobile Phone Dependence Scale was used to evaluate excessive smartphone use; the Hardiness Questionnaire was used to evaluate hardiness; and the Interpersonal Relation Synthetic Diagnose Test was used to evaluate interpersonal distress. The findings showed that: (1) the greater the degree of excessive smartphone use, the more serious respondents' interpersonal distress and the lower their hardiness; (2) excessive smartphone use was not only directly related to the psychological safety of university freshmen but also indirectly related to their psychological safety through the independent mediation of hardiness and interpersonal distress, as well as through the chain mediation of hardiness and interpersonal distress. In general, excessive smartphone use in university freshmen could lead to a decline in their psychological safety. Also, hardiness and interpersonal distress play a complex role in this relationship. During the COVID-19 pandemic, interventions on the mental health of college freshmen should not only provide guidance on how to use their smartphone responsibly but also to provide them with support and guidance for the enhancement of their hardiness and improvement of their interpersonal relationships.

Risk and Protective Factors of Loneliness among Older Adults: The Significance of Social Isolation and Quality and Type of Contact

Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explored possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477). The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of "social distancing" under the COVID-19 pandemic.

The mediating effect of health-related hardiness on the degree of physical disability and perceived stress in Chinese female patients with neuromyelitis optica spectrum disorder

BACKGROUND

Neuromyelitis optica spectrum disorder (NMOSD) is a rare and chronic disease of the central nervous system. The characteristics and main symptoms of recurrent NMOSD lead to an increase in psychological stress and accelerate a decline in the patients' quality of life. The incidence of NMOSD in the Chinese population is much higher than that for other countries and the majority of NMOSD patients are female. In general, there are sex differences in the perception and management of stress, with females experiencing higher levels of perceived stress than males. Thus, we should be concerned about the psychological issues experienced by Chinese female NMOSD patients. Health-related hardness is a psychological adjustment factor that could affect perceptions of illness that impact on NMOSD patients. The objective of this study was to evaluate the mediating role of health-related hardiness on physical disability and perceived stress in Chinese NMOSD female patients.

METHODS

Participants were 68 females patients with NMOSD treated at the Department of Neurology, Huashan Hospital, Fudan University, China, between March and September 2018. Patients were evaluated for their degree of physical disability, perceived stress, and health-related hardiness. Measures included the Expanded Disability Status Scale (EDSS), Perceived Stress Scale (PSS), and Health-related Hardiness Scale (HRHS). Pearson's correlation analyses and stepwise multiple linear regression analysis were used.

RESULTS

Findings indicated a positive correlation between the PSS and EDSS (r = 0.735, P < 0.001) and a negative correlation between the PSS and HRHS total score (r = -0.441, P < 0.001). After adjusting for the confounding factors, the EDSS was found to have a positive predictive effect on the PSS (β = 2.743, P = 0.000), and the HRHS was found to have a negative predictive effect on the PSS (β = -0.152, P = 0.04). Mediation analysis showed a direct effect of the EDSS on the PSS, and as a mediating variable for health-related hardiness (α = -1.928, b = -0.152, c = 2.743, c' = 2.481), which was statistically significant (P < 0.05). The mediating effect of health-related hardiness accounted for 10.68% of the total effect.

CONCLUSIONS

As a mediating variable, health-related hardiness indirectly affected perceived stress caused by physical disability and improved health-related hardiness. This was beneficial in reducing psychological stress and promoting mental health in NMOSD female patients.

Association between depression and subsequent peptic ulcer occurrence among older people living alone: A prospective study investigating the role of change in social engagement

OBJECTIVE

To examine whether baseline depression predicts subsequent peptic ulcer disease (PUD) in older people living alone and whether social engagement plays a role in such an association.

METHODS

Between May 2010 and May 2015, 2, 850 older people living alone were recruited from eight Grade-A hospitals in the People's Republic of China and followed for up to 36 months. The Kaplan-Meier method was used to investigate how the incidence of PUD varied with depression and social engagement status. Multivariate Cox proportional hazards models were estimated to examine the association between depression and incidence of PUD and assess the role of social engagement in this relationship.

RESULTS

Kaplan-Meier curves indicated that the 36-month cumulative incidence of PUD was higher in depressed (10.1%) than non-depressed participants (5.3%). However, among the depressed participants, increased or continued social engagement reduced the incidence to 6.2% and 7.9%, respectively. Multivariate analyses showed that baseline depression was associated with subsequent PUD development (hazard ratio [HR] = 2.520, 95% confidence interval [CI]: 1.525-3.356). The incidence of PUD was similar in non-depressed and depressed participants who reported increased (HR = 1.956, 95% CI: 0.913-3.374) or continued social engagement (HR = 1.827, 95% CI: 0.918-3.690) during the follow-up period. However, depressed participants who reported decreased (HR = 2.485, 95% CI: 1.459-3.295) or no social engagement (HR = 2.896, 95% CI: 1.817-4.228) were more likely to develop PUD than those without depression.

CONCLUSIONS

Baseline depression was associated with subsequent incidence of PUD, but this association appears to be reduced by increased or continued social engagement.