Social identification-building interventions to improve health: a systematic review and meta-analysis

Effects of older adults' social identification on psychological flourishing and exercise program adherence

BACKGROUND

With the onset of the COVID-19 pandemic, many exercise programs moved online. The purpose of this study was to examine the extent to which older adults' social identification with other exercise program members contributed to their psychological flourishing and exercise program adherence.

METHODS

The study represented a secondary analysis of data derived from the Seniors COVID-19 Pandemic and Exercise (SCOPE) Trial, in which older adults were randomized to a waitlist control condition or one of two online (personal v group) exercise programs. Only data from participants in the trial intervention conditions (N = 162; Mage = 73.52 years; SD = 5.61) were utilized in this secondary analysis. We assessed psychological flourishing and social identification at baseline and every two weeks, as well as program adherence over each 2-week block, for 12 weeks.

RESULTS

Based on stepwise multilevel modeling the results revealed that older adults' social identification with others in their respective exercise program had a direct effect on psychological flourishing (ΔR2Unique Marginal = 0.063, p < .001) and program adherence (ΔR2Unique Marginal = 0.014, p = .03).

CONCLUSIONS

The results highlight the value of bolstering older adults' social identification with others in an online exercise program to support adherence and well-being.

A mixed method exploration of job morale of physicians working in public healthcare settings in Kazakhstan during the COVID-19 pandemic

BACKGROUND

Physicians faced increased workloads during the COVID-19 pandemic, which exposed them to considerable physical and psychological stress. Gaining insight into shapers of job morale of physicians can help healthcare administrators assess the effectiveness of current work conditions and support systems, enabling them to develop policies that improve work environments and prepare healthcare systems for future resurgences of COVID-19 and other future unknown challenges. Therefore, the present study aimed to improve the understanding of physicians' experiences of job morale in Kazakhstan during the COVID-19 pandemic.

METHODS

This was an explanatory sequential mixed method study that adopted an online structured questionnaire and semi-structured individual interviews as tools for data collection. The Warr-Cook-Wall scale, Maslach Burnout Inventory Human Services Survey for Medical Personnel, and Beck Depression Inventory were used to measure job morale indicators. The interview topic guide, in turn, covered two key areas: general views on physicians' job morale during the COVID-19 pandemic and specific experiences which worsened or improved job morale during the COVID-19 pandemic. Descriptive statistics and regression models were utilised to analyse the quantitative data, while thematic analysis was employed for the qualitative data.

RESULTS

A total of 2086 survey responses and 30 interviews were analysed. Although job motivation was moderate, physicians were rather satisfied with their jobs. The prevalence of burnout was 30.97%, and signs of severe depression symptoms were detected among 3.69% of participants. Four themes emerged from the thematic analysis: (1) fear of uncertainty; (2) media scrutiny; (3) resurgence in appreciation; and (4) heightened sense of duty.

CONCLUSIONS

Despite the significant challenges posed by the COVID-19 pandemic, physicians in Kazakhstan's public healthcare sector maintained generally positive job morale. This was mainly due to their strong sense of calling and a renewed appreciation for their role. Future research should rigorously examine longitudinal changes in job morale and the relationship between physicians' job morale and patient experiences.

An online delivered running and walking group program to support low-active post-secondary students' well-being and exercise behavior during the COVID-19 pandemic: a pilot randomized controlled trial

OBJECTIVE

Examine the feasibility and acceptability of a social identity-informed, online delivered, running and walking group program to support low-active post-secondary students' exercise behavior and well-being during the COVID-19 pandemic.

METHODS

A two-arm, non-blinded, parallel pilot randomized controlled trial was conducted whereby low-active post-secondary students at a Canadian university were equally randomized to an online delivered running/walking group program or an attention control condition. Primary feasibility and acceptability outcomes included program interest, study enrolment and retention, questionnaire completion, program attendance, program satisfaction, and affective exercise attitudes. Post-program interviews were conducted to ascertain participants' experiences with the program. Secondary outcomes included well-being, exercise behavior, social identity, social support, and exercise identity.

RESULTS

Ninety-two individuals were screened for eligibility, and 72 were equally randomized to the online group program or attention control condition. Recruitment exceeded the target sample size (60), study adherence and questionnaire completion were above 90%, program attendance was moderate (M = 5.03/8), self-report program satisfaction was moderate-to-high (M = 4.13/5), and there was no condition effect for affective attitudes. During interviews, participants expressed satisfaction with the program. They also discussed challenges with developing a shared sense of identity and social connection with group members via online platforms. There were small condition effects for exercise-related well-being and exercise identity and no condition effects for the remaining secondary outcomes. Social identity scores were moderate (M = 4.63/7).

CONCLUSIONS

The STRIDE program was feasible and acceptable but should be delivered and piloted in-person before a full-scale efficacy trial is conducted.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04857918; 2021-04-20.

Using Extended Reality to Enhance Effectiveness and Group Identification in Remote Group Therapy for Anxiety Disorders: A Critical Analysis

Group therapy is a scalable and effective treatment for anxiety disorders. However, when performed online, the reduced ability to identify with group members and the reduced interactivity can limit its appeal and effectiveness. Extended reality (XR) technology, including virtual reality and augmented reality, may help address these limitations, thereby enhancing the reach of online group therapy and the benefits that can be drawn from it. To understand how the incorporation of XR technology may improve online group therapy for anxiety disorders, this viewpoint paper examines evidence related to the treatment of anxiety disorders using offline group therapy, online group therapy, and virtual reality, as well as ways to increase social identification and interactivity with the platform, the therapist, and other users. This viewpoint paper suggests ways to integrate these research streams to leverage the strengths of XR platforms and improve group therapeutic offerings.

Does social isolation predict the emergence of psychotic-like experiences? Results from the experience sampling method study

BACKGROUND

Several studies have shown that social isolation and loneliness are associated with the occurrence of psychotic experiences. However, dynamics of these phenomena in people with subclinical experiences, commonly referred to as psychotic-like experiences (PLEs), remains largely unknown. Therefore, in this study we performed a temporal network analysis to model dynamic predictions between social isolation, loneliness, negative affect, social stress, and PLEs.

METHODS

A total of 77 drug-naïve individuals with PLEs from a transdiagnostic sample were enrolled. Data were obtained using the experience sampling method (ESM). The ESM questionnaires were delivered during 7 consecutive days (6 assessments per day). Therefore, 3234 data entries were analyzed.

RESULTS

Social isolation predicted next-moment emergence of PLEs through the effects on loneliness and negative affect. Also, PLEs appeared to predict next-moment loneliness, but not social isolation, through the effects on negative affect. Social stress did not predict any variables in the network. However, it was predicted by previous-moment PLEs and social isolation. Negative affect had the highest in-strength and out-strength centrality.

CONCLUSIONS

Findings from the present study indicate that social isolation might predict the emergence of PLEs through the effects of momentary loneliness and negative affect. Also, loneliness might be bidirectionally associated with PLEs. Interventions targeting negative affect and social isolation might be beneficial in people with PLEs.

Development of a group-based behaviour change intervention for people with severe obesity informed by the social identity approach to health

INTRODUCTION

Interventions to support behaviour change in people living with chronic health conditions increasingly use patient groups as the mode of delivery, but these are often designed without consideration of the group processes that can shape intervention outcomes. This article outlines a new approach to designing group-based behaviour change interventions that prioritizes recipients' shared social identity as group members in facilitating the adoption of established behaviour change techniques (BCTs). The approach is illustrated through an example drawn from research focused on people living with severe obesity.

METHODS

A prioritization process was undertaken in collaboration with stakeholders, including behaviour change experts, clinicians, and a former patient to develop an evidence-based, group intervention informed by the social identity approach to health. Three phases of development are reported: (1) identification of the health problem; (2) delineation of intervention mechanisms and operationalization of BCTs for group delivery and (3) intervention manualization. The fourth phase, intervention testing and optimization, is reported elsewhere.

RESULTS

A group-based behaviour change intervention was developed, consisting of 12 group sessions and 3 one-to-one consultations. The intervention aimed to support the development of shared social identity among recipients, alongside the delivery of evidence-based BCTs, to improve the likelihood of successful intervention and health outcomes among people living with severe obesity.

CONCLUSIONS

A manualized intervention, informed by the social identity approach to health, was systematically designed with input from stakeholders. The development approach employed can inform the design of behavioural interventions in other health contexts where group-based delivery is planned.

A UK national cross-sectional survey of stroke support groups: exploring the role of social identification and group processes in reducing loneliness

BACKGROUND

Loneliness is a common experience following stroke. Stroke support groups may protect against loneliness, but little is known about how these groups exert their influence. This research drew upon current theorising on the role of groups for health and explored i) social identification as a potential mechanism for overcoming loneliness, and ii) psychological group resources (support, control, self-esteem), and functional group processes (clear goals, group autonomy, member continuity) which might structure social identification.

METHODS

Five hundred seventy-nine stroke survivors from 84 Stroke Association support groups across the UK completed a cross-sectional survey measuring: support group identification; psychological resources (given and received social support, control, self-esteem, identity centrality); functional processes (goal clarity, group autonomy, member continuity); and loneliness (3-item UCLA Loneliness Scale).

RESULTS

Greater support group identification was associated with reduced loneliness (β = -0.45, p < 0.001). Given (β = 0.17, p = 0.001) and received (β = 0.10, p < 0.001) social support, goal clarity (β = 0.17, p = 0.002), and group member continuity (β = 0.19, p < 0.001) were all associated with greater support group identification.

CONCLUSIONS

Social identification with the group may be a mechanism by which stroke support groups alleviate loneliness, potentially through facilitating attendance, mutual social support and the development of collective goals. Further research should explore how these processes influence social identification in newly formed groups, where social identity has not yet been established.

Lived experiences of Sri Lankan Tamil refugees in the UK: Migration and identity

Sri Lankan Tamil refugees (SLTRs) have lived in the United Kingdom in substantial numbers for about three decades. However, they remain under-represented in academic and public discourse, and little is known about their migration experiences. This study examined first-hand accounts of such experiences, with special attention paid to identity and acculturation. Data were collected through four semi-structured interviews and analysed using interpretative phenomenological analysis (IPA). The results suggest that SLTRs' experience of conflict as an imposed life disruption continues to shape their adaptation, identity, and meaning-making ("Afflicted life"). Changing social identities mediate protection from, as well as risk of, trauma. SLTRs try to remedy the socio-economic and emotional losses suffered in the conflict, but achieve only a partial compensation. Consequently their repair efforts are a source not only of positive emotions but also of dissatisfaction ("Living past"). Finally, participants' sense of belonging and quest for home represent a challenging socio-emotional process in which they continue to engage even decades after migration ("Continuing quest for home"). This nuanced analysis of how the past continues to shape lived experience, contributes to the under-developed literature on qualitative psychological investigations of acculturation, research on forced migration, and the establishment of IPA in social psychology.

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

Related metacognitions, desire thinking and identity differentially predict compulsion and withdrawal symptoms in problematic Instagram use

Work has identified that metacognitive thought results in desire-based thinking and perpetuates the magnitude and severity of maladaptive behaviour including problematic social media use, and also that one's ingroup identity is related to increasing problematic behaviour. No evidence has ascertained the relative contribution of these as related differential factors in the experience of problematic social media use. The current study explored the comparative importance of components of desire thinking, positive and negative metacognitions and dimensions of ingroup identity on degree of problematic use among 147 current Instagram users. Results showed that for predicting general problematic Instagram use negative metacognitive beliefs and the verbal perseverance component of desire-based thinking were significant. Importantly, however, different factors appeared to be important for predicting distinct aspects of problematic Instagram. For compulsivity indicators, negative metacognitions and verbal perseveration were essential, whereas for the withdrawal component identity centrality (and no other dimensions of identity) and imaginal prefiguration emerge as the sole independent predictors.

Flourishing in life in patients with Inflammatory Bowel Disease: The role of illness identity and health-related quality of life

Amidst chronic challenges in Inflammatory Bowel Disease (IBD), including physical symptoms, emotional stress, and social constraints, this study aimed to elucidate how patients' perceptions of their illness and its integration into their self-concept are related to their ability to flourish in life. We hypothesized that having a positive and integrative illness identity and social identification will predict higher flourishing, mediated by enhanced health-related quality of life (HRQoL). In an online survey with 244 German-speaking IBD adults (Mage = 36.62, 85% women), we found that lower engulfment (where the disease dominates one's identity) predicted higher levels of flourishing, mediated by higher HRQoL. Enrichment, reflecting personal growth from illness, directly predicted higher flourishing, while stronger social identification predicted higher subjective well-being, but not flourishing. The results highlight the potential of fostering positive illness identities and social connections to enhance flourishing in individuals with IBD or similar chronic conditions.

A stepped down physical activity support program for military service veterans: The Active Choices pilot study

ISSUE ADDRESSED

Referral to supervised physical activity (PA) programs is an effective treatment for military service veterans (MSVs) suffering from a range of chronic diseases. However, many MSVs fail to maintain PA regimes once discharged from supervision. This pilot study assessed Active Choices, a stepped-down program to support MSVs in the transition from allied health treatment to self-managed PA.

METHODS

Participants were 34 Australian MSVs (mean [SD] age = 61 [15.8] years) who were completing supervised referral to an exercise physiologist or physiotherapist. MSVs stepped-down to Active Choices and received a 12-week, evidence-based PA support program (2020-2021). Analyses compared within-group changes in accelerometer-assessed PA at three time points (Weeks 0, 12, and 24; linear mixed model). Program retention, PA choices, and allied healthcare service costs were also evaluated.

RESULTS

Relative to baseline (64 [26] min/day), mean (SD) moderate-to-vigorous PA increased (74 [28] min/day; p < .05) and was maintained (62 [28] min/day) at weeks 12 and 24, respectively. Retention in the program was high (86% [29/34 participants] completion rate at 12 weeks), with water-based group activities the most popular PAs of choice (14/24 activities). Average allied healthcare service costs during the study were lower than typical costs for MSVs (60.51 vs. 97.06 AUD/week).

CONCLUSION

The findings highlight the potential of Active Choices to support MSVs in the transition from supervised to self-managed MVPA. SO WHAT?: The program could promote the health of veterans and reduce costs for ongoing referral if impact is replicated at scale.

Social group connections support mental health following wildfire

PURPOSE

As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources.

AIMS

We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters.

METHODS

We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires.

RESULTS

We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress.

CONCLUSIONS

We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.

Effectiveness of identity-building interventions on recovery identity and patient-reported health outcomes in chronic diseases: A meta-analysis

This meta-analysis aimed to assess the impact of identity-building interventions on recovery identity and patient-reported health outcomes in chronic disease patients. We identified 15 relevant empirical studies (comprising 2261 patients) from 989 records through extensive keyword searches and manual screening conducted between March 2nd and March 13th, 2023. Utilizing the Cochrane tool, meta-regression, and the GRADE approach, we evaluated these studies for their characteristics, findings, and quality. The analysis revealed that identity-building interventions, encompassing recovery-oriented group, interest group, and linguistic approaches, positively influenced identity synthesis and had varying effects on health outcomes. Notably, multiple regression analysis demonstrated that identity synthesis significantly predicted health outcomes. However, the study identified mild heterogeneity, a high attrition bias risk, and insufficient data on selection and detection bias as limitations. Overall, identity-building interventions proved influential in enhancing recovery identity, a vital predictor of patient-reported health outcomes in chronic disease patients.

Exploring the Comparability Between EQ-5D and the EQ Health and Wellbeing in the General Australian Population

OBJECTIVES

The EQ Health and Wellbeing (EQ-HWB) is a novel measure that conceptually overlaps with the 5-level EQ-5D (EQ-5D-5L) while capturing broader dimensions of health and well-being. This study aimed to explore the extent to which the EQ-HWB and EQ-5D-5L capture overlapping or complementary constructs and to explore the discriminative ability of the EQ-HWB Short version (EQ-HWB-S) as a multiattribute utility instrument in the Australian setting.

METHODS

A secondary analysis of data from a nationally representative cross-sectional survey of 2002 Australian adults was performed. The survey included socioeconomic questions and health characteristics and the EQ-HWB and EQ-5D-5L instruments. Convergent and known-group validity were evaluated through Spearman rank correlation and multivariable regression analyses, respectively. An exploratory factor analysis was also performed to explore the underlying constructs of the 2 measures.

RESULTS

Correlation coefficients varied from moderate to strong (rs ≥ 0.40) between the EQ-5D-5L and the corresponding EQ-HWB dimensions (all P < .001). Based on the exploratory factor analysis, both instruments measure similar underlying constructs, with the EQ-HWB capturing broader aspects of well-being. The known-group analysis demonstrated the relative discriminative ability of the EQ-HWB-S in capturing broader aspects of health and well-being.

CONCLUSIONS

The EQ-HWB was at least moderately correlated with the EQ-5D-5L in overlapping domains/dimensions and demonstrated greater sensitivity in participants with mental health problems versus the EQ-5D-5L. Our findings support future research exploring the value of the EQ-HWB-S as a multiattribute utility instrument for the general Australian population.

Understanding and Improving Athlete Mental Health: A Social Identity Approach

Understanding and positively influencing athlete mental health have become key goals for researchers and sporting stakeholders (e.g. coaches, support staff, clubs and governing bodies). In this article, we outline a novel perspective for tackling these challenges, drawing on an influential theory of group processes. This social identity approach can, we argue, help explain when and why the characteristics and demands of sport, which is typically a collective endeavour, pose a threat to athlete mental health and provide a guiding framework for efforts to protect and enhance athlete mental health. Here, we seek to illustrate the value of a social identity analysis of athlete mental health through three key points that speak to its analytical and practical value. Specifically, we propose: (1) that social identities can act as psychological resources that support athlete mental health, (2) that social identities are critical to athlete mental health during and after sporting transitions and (3) that leadership informed by a social identity approach can facilitate athlete mental health. With a view to maximising the value of our analysis both for those working with athletes and for researchers, we also identify practical steps that relevant stakeholders could take to support athlete mental health, and key avenues for future research to further test our propositions and advance understanding. Our analysis provides a new lens through which all those invested in understanding and supporting athlete mental health can approach these challenges, and a foundation for novel solutions.

Modelling Age-Varying Associations among Group Memberships, Neighborhood Connectedness, and Well-Being

Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers

BACKGROUND

Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship.

METHODS

A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology.

RESULTS

Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes.

DISCUSSION

Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups.

Street soccer and homelessness: Exploring social identities, health, and well-being

Membership in social and physical activity groups has the potential to help people with a range of physical and mental health challenges. The purpose of this study was to examine the experiences of members of a unique physical activity group: people who were formerly or currently homeless participating in a street soccer program in Western Canada. Ten participants in the Vancouver Street Soccer League (VSSL) were interviewed about the extent to which this program fostered a sense of community, social connectivity, and quality of life among people with experience of homelessness. Interviews were augmented with a Social Identity Mapping activity and observations from the first author who took part in weekly practice with the VSSL for over a year. The data were analysed using thematic analysis, in which four themes were developed to reflect the findings. These included (1) Coming together through soccer, (2) Dynamics motivating continued involvement in the league, (3) Leaders and leadership: Social influence in the league, and (4) The league and health outcomes. The findings provide insight into how a street soccer program which fostered shared social identity, psychological safety, friendly competition, and social support contributed to the well-being of people impacted by homelessness, various traumas, and marginalisation.

Group Belonging and Social Identities in the Transition of Asylum-Seekers in Greece: Longitudinal Pathways to Adjustment

Millions of forced migrants settling in host countries often struggle to adjust to their new life. As their inclusion and adjustment within receiving societies has become a global social challenge, studying the factors that support their successful transition is an important topic of research inquiry. The present three-wave longitudinal study examined the role of group belonging and social identification in facilitating the transition of 60 sub-Saharan African asylum-seekers to Greece. Drawing upon the Social Identity Model of Identity Change (SIMIC), we investigated how multiple group memberships before migration, social identity continuity, and social identity gain related to their adjustment over 8 months. On the between-person level, multiple group belonging before migration indirectly contributed to better person-average levels of sociocultural adjustment, physical health functioning and satisfaction, psychological distress, and life satisfaction, by way of higher person-average levels of social identity continuity and/or social identity gain. However, multiple groups before migration also had a direct negative effect on the overall levels of psychological distress. On the within-person level, positive changes in social identity continuity and gain were related to positive changes in different adjustment-related outcomes over time. Our findings are consistent with SIMIC and highlight the importance of group belonging and associated social identities in forced migrants' transition, in ways that may pave the way for the development of social identity interventions to promote their health, well-being, and successful integration. Future longitudinal and experimental evidence with larger and more diverse samples of forced migrants is needed to establish the generalizability and causality of the observed associations.

"I'm a good mother; I play with her; I love her": The motherhood experience of women with intellectual disabilities from empowering and intersectional approaches

BACKGROUND

Despite the growing recognition of the right of women with disabilities to become mothers, this right remains significantly under-fulfilled among women with intellectual disabilities (ID). Whereas the voice of mothers with ID has begun being heard in research, most studies still focus on the barriers to motherhood and the difficulties associated with childrearing.

OBJECTIVE

The study aims to understand and describe the subjective experiences of mothers with ID, focusing on positive aspects from empowering and intersectional approaches.

METHOD

Semi-structured interviews were conducted with 11 mothers with ID who live in the community and raise their children.

RESULTS

Four themes emerged from the interviews: (1) A dream that came through; (2) Motherhood as an empowering process; (3) The intersection between the disability identity and the motherhood identity; (4) Family involvement as a resource and a challenge.

CONCLUSIONS

The findings highlight the need to meet the mothers' twofold identity in an empowering way by constructing a more positive disability identity and further cultivating their motherhood identity. They also highlight the important role of the family in supporting mothers with ID. A positive disability identity and family support are needed to increase these women's emotional well-being and overall quality of life.

Disciplinary differences in the study of the relationship between social variables and mental health: A systematic mapping review

There has been sustained interest in the intersection between social constructs and mental health from diverse disciplines including psychiatry, sociology and public health. However, no systematic attempt has been made to catalogue what is meant by 'social' by different researchers, how variables deemed 'social' constructs are linked to mental health, nor whether these patterns differ by academic discipline. Understanding interdisciplinary differences and commonalities may reveal opportunities for interdisciplinary collaboration to enhance our understanding of how social factors relate to mental health. This article presents a prospectively registered systematic map of social approaches to mental health using an innovative synthesis methodology (coding all sentences from a random selection of N = 287 articles). Results indicated that although approaches are diverse, disciplinary overlap is substantial. Psychology and psychiatry led articles tend to focus on social skills or emotions as features of mental (ill-)health, while public health and social sciences led articles tend to focus on social relationships, status or context as determinants of mental (ill-)health. Medicine led articles were most likely to focus on social outcomes of mental (ill-)health. Potential growth areas are noted, particularly the relative dearth of intervention research drawing upon social approaches. The findings are discussed with a view towards enabling more effective interdisciplinary collaboration.

Midwives' and Diabetes Nurses' Experience of Screening and Care of Women with Gestational Diabetes Mellitus: A Qualitative Interview Study

Background

Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies.

Aim

The aim of this study was to explore midwives' and diabetes nurses' experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines.

Method

Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman.

Results

The analysis of the interviews resulted in the overall theme "An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care." Difficulties in carrying out the important task of handling GDM while at the same time keeping the pregnancy in focus were central. Women were described as highly motivated to maintain a healthy lifestyle during pregnancy with the baby in mind, but it seemed difficult to maintain this after delivery, and compliance with long-term follow-up with the aim of reducing the risk of T2DM was low. The women came to the first follow-up but did not continue with later contact. This was at a time when the women felt healthy and were focusing on the baby and not themselves. A lack of cooperation and easy access to a dietician and physiotherapist were pointed out as well as a wish for resources such as group activities and multiprofessional teams.

Therapists who foster social identification build stronger therapeutic working alliance and have better client outcomes

BACKGROUND

For decades we have known that therapeutic working alliance is a key contributor to client engagement and positive outcomes in therapy. However, we have made little progress in narrowing down its determinants, which is critical in supporting trainees to optimize such alliance. We make a case for the value of incorporating social psychological frameworks into models of alliance and explore the role of social identity processes in the development of therapeutic alliance.

METHOD

Across two studies, over 500 psychotherapy clients completed validated measures of alliance, social identification with their therapist, positive therapy outcomes, and a range of client and therapist characteristics.

FINDINGS

Social identification strongly predicted alliance in both samples, whereas client and therapist characteristics showed few such associations. Alliance mediated the relationship between social identification and positive therapy outcomes. In addition, we found evidence that (a) personal control is a key psychological resource in therapy that arises from social identification, and (b) therapists who engage in identity leadership (i.e., who represent and build a social identity that they share with clients) are more likely to foster social identification and its downstream benefits.

INTERPRETATION

These data show that social identity processes are key to the emergence of working alliance. We conclude with a discussion of how recent social identity and identity leadership interventions might be adapted to train therapists in relevant identity-building skills.

Measuring "we-ness" in couple relationships: A social identity approach

Research on couple relationships has increasingly focused on the concept of "we-ness", the subjective closeness of the couple bond, as crucial to predicting relationship outcomes including satisfaction and dissolution. However, diverging perspectives on the definition, terminology, and measurement of this concept persist. We drew upon social identity theorizing to clarify the nature of we-ness and investigate its predictive utility. Participants were 375 members of the general community in long-term intimate relationships. The sample were aged 18-74 (M = 37.22; SD = 12.00) and 69% were women. Participants completed seven measures of we-ness drawn from both the couple literature and the social identity literature. We used exploratory factor analyses to establish the latent structure of we-ness, and regression analyses to examine the utility of each we-ness factor in predicting relationship satisfaction and likelihood of dissolution. A four-factor solution was extracted and the factors were labeled couple identity, partner liking, relationship orientation, and partner similarity. Each of the four factors explained unique variance in relationship quality, with couple identity being most strongly associated with positive outcomes. We conclude that couple research can fruitfully draw upon social identity theorizing in conceptualizing we-ness. This has implications both for more effectively measuring key concepts and for more precisely targeting interventions in couple therapy.

PROTOCOL: Group-based interventions for posttraumatic stress disorder: A systematic review and meta-analysis of the role of trauma type

This is the protocol for a Campbell systematic review. The primary objective is to assess the effects of group-based treatments on posttraumatic stress disorder (PTSD) symptomology in people diagnosed with PTSD (by a clinician or screening instrument) or referred to a PTSD treatment group for their symptoms by a medical professional. We will also examine a range of moderators that may affect the efficacy of group-based treatments, including the nature of the trauma (interpersonal, stigmatized) and the group fit (in terms of gender and shared vs. unshared trauma). Further, we will also explore what, if any, group-based and social identity factors are recorded and how they relate to PTSD outcomes.

Health Care Utilization Following Interventions to Improve Social Well-Being: A Systematic Review and Meta-analysis

Importance

It has been suggested that interventions that aim to improve social well-being may contribute to decreased health care use; however, such evidence has not been fully systematically synthesized.

Objective

To systematically review and meta-analyze available evidence on the associations between psychosocial interventions and health care utilization.

Data Sources

Medline, Embase, PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, Scopus, Google Scholar, and reference lists of systematic reviews were searched from inception until November 31, 2022.

Study Selection

Included studies were randomized clinical trials reporting on both health care utilization and social well-being outcomes.

Data Extraction and Synthesis

The reporting of the systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Full-text and quality assessments were conducted by 2 reviewers independently. Multilevel random-effects meta-analyses were used to synthesize the data. Subgroup analyses were conducted to examine the characteristics associated with decreased health care use.

Main Outcomes and Measures

The outcome of interest was health care utilization, including primary, emergency, inpatient, and outpatient care services. Social well-being was measured as social support, social participation, social relationships, community support, social integration, or loneliness.

Results

A total of 41 studies were retrieved from 18 969 citations; 37 studies were eligible for meta-analysis. Data were analyzed for 7842 participants, including 2745 older adults, 1579 young women considered to be at risk of social and mental health disadvantages, 1118 people with chronic illnesses, 1597 people with mental illnesses, and 803 caregivers. The odds ratio (OR) random-effects model showed an overall reduction in health care use (OR, 0.75; 95% CI, 0.59 to 0.97), but the standardized mean difference (SMD) random effect model showed no association. An improvement in health care utilization was observed in association with social support interventions (SMD, 0.25; 95% CI, 0.04 to 0.45) but not in loneliness interventions. Subgroup analysis indicated a reduced length of inpatient visits (SMD, -0.35; 95% CI, -0.61 to -0.09) and number of emergency care visits (OR, 0.64; 95% CI, 0.43 to 0.96) following the intervention. However, an increase in outpatient care associated with psychosocial interventions was observed (SMD, 0.34; 95% CI, 0.05 to 0.62). The largest reductions in health care use were associated with interventions among caregivers (OR, 0.23; 95% CI, 0.07 to 0.71) and individuals with mental illnesses (OR, 0.31; 95% CI, 0.13 to 0.74).

Conclusions

These findings suggest that psychosocial interventions were associated with most measures of health care utilization. As the association differed by participant and intervention delivery characteristics, these characteristics should be considered in the design of future interventions.

Effective interventions to reduce loneliness in big cities

PURPOSE OF REVIEW

Loneliness is a state of distress or discomfort between the desired and experienced level of connectedness to others. These feelings may be particular salient in urban environments that seemingly offer more opportunities for social contact, highlighting the discrepancy. The topic of loneliness has received increased attention because of its negative impact on mental and physical health combined with concerns of increased loneliness due to lockdowns and social distancing regulations during the coronavirus disease 2019 pandemic. We provide a bibliometric and random-effects meta-analysis of clinical trials published since 2020 and available via PubMed.

RECENT FINDINGS

Loneliness interventions have predominantly focused on elderly in the community. Adolescents and young adults as a second group at risk have received much less attention. On average across 44 effect sizes studied in 38 trials, interventions show moderate levels of effectiveness but are characterized by high heterogeneity and trials are often underpowered and use low quality designs. Multidimensional interventions show promise for alleviating loneliness, but the intervention context needs greater attention.

SUMMARY

Scalable and effective interventions for the general population and at-risk groups of loneliness are still scarce. Some promising interventions have been trialled and merit further attention.

The Influence of Family Communication Patterns and Identity Frames on Perceived Collective Psychological Ownership and Intentions to Share Health Information

An experimental study exposed participants (N = 299) to different message frames to investigate whether Family Communication Patterns (FCP) and message characteristics influenced willingness to communicate about Family Health History (FHH). Message frames were either collective (our), individual (mine), or control (no pronouns). Afterward, participants were asked about their perceived collective psychological ownership of health information, attitudes, subjective norms, and FHH communication intentions. Although the message frames had no impact on perceived collective psychological ownership of health information, conversation orientation and conformity orientation (respecting parental authority) were positively associated with perceived collective psychological ownership of health information. Additionally, perceived collective psychological ownership, attitudes, and subjective norms were found to have indirect effects between FCP and FHH communication intentions. These findings provide further support that FCP influences how health message appeals are processed and suggest interventions could be tailored to FCP orientations for effective FHH behaviors.

Intragroup contact with other mothers living in the same neighborhood benefits mothers' life satisfaction: The mediating role of group identification and social support

Becoming a mother is often accompanied by a loss of social connections, which can reduce the availability of social support. This can increase maternal stress with negative health outcomes. Therefore, we examined how mothers' social contact with other mothers living in the same neighborhood can form a compensative source of social support and wellbeing. Data was collected from mothers (N = 443) of a child under school age while visiting the public maternity and child health clinics located in two neighborhoods in Helsinki, Finland. We found that mothers' frequent and positive contact with other local mothers was positively related with their life satisfaction through identification-based social support. Contact also had a specific indirect effect on life satisfaction through social support. Frequent positive contact with other local mothers can serve to scaffold the emergence of social identification, which in turn unlocks further social support with positive health effects.

The group mechanism in treatment: group identification and cohesion contributes to reducing chronic lower back pain by increasing personal control

PURPOSE

There is increasing recognition of the contribution that group processes, particularly identification and cohesion, make to outcomes of group delivered health treatments. This study examined the role that these particular group processes play in the treatment of lower back pain, and a theorised mechanism of personal control through which group treatment might enhance outcomes.

METHODS

Participants (N = 85) elected to either receive NeuroHAB^®, a defined functional movement therapy of 8 weeks duration, or continue with treatment-as-usual (TAU). Pain intensity and disability were assessed at baseline (T1) and post-intervention or 8 weeks later (T2), as well as at a 1-month follow-up (T3). Only the NeuroHAB^® participants additionally completed weekly questionnaires that measured treatment group identification, cohesion, and personal control.

RESULTS

NeuroHAB^® was significantly more effective than TAU in reducing pain intensity and disability at T2 and T3. Furthermore, among NeuroHAB^® recipients, stronger treatment group identification and cohesion early in the program predicted better pain outcomes over time, and this relationship was fully mediated by perceptions of personal control.

CONCLUSION

These data provide further support for the role of group identification and cohesion as a contributing mechanism of change in group-based treatments and extend this to the domain of pain management.Implications for RehabilitationA focus on defined functional movement therapy, as offered by the NeuroHAB^® group program, was found to improve pain outcomes in patients with lower back pain.A key ingredient in the NeuroHAB^® rehabilitation program was its group delivery.Group delivery supported treatment group identification and cohesion which, through enhancing the perception of personal control, reduced pain intensity and disability.

Diving into Health: A Mixed Methods Study on the Impact of Scuba Diving in People with Physical Impairments

The impacts of scuba diving on people with physical impairments are unknown. Grounded on the social identity approach to health, the aim of this study was to test and describe the relationships between scuba diving social identity, self-efficacy, social health, psychological health, physical health, health-related quality of life (HRQOL), and disability level among recreational scuba divers with physical impairments. A mixed methods explanatory sequential design was employed. The quantitative strand used an 80-item cross-sectional survey, with the data analyzed via a path analysis. The qualitative strand used 1:1 interviews across 3 case study groups; the data were analyzed using deductive and inductive analyses. Mixing occurred via a joint display with meta-inferences. The quantitative results (n = 78) indicated that self-efficacy was a significant predictor of social health, psychological health, physical health, HRQOL, and disability level. The qualitative findings (n = 15) consisted of six themes, whereby participants described scuba as a positive social identity that provides them with meaning, purpose, and belonging. Furthermore, they described scuba diving as a positive contributor to their self-efficacy, social health, psychological health, physical health, and quality of life. During the mixing of data, the quantitative and qualitative results did not match on the influence of scuba diving social identity on self-efficacy, social health, psychological health, physical health, HRQOL, and disability level. A further analysis revealed that the range restriction impaired the conclusive quantitative evidence on the scuba diving social identity variable. The meta-inferences derived from the data integration suggest that scuba diving plays a role in the self-efficacy, health, HRQOL, and disability level among scuba divers with physical impairments. The findings point to the potential of scuba diving as a health promotion recreational activity and rehabilitation modality for people with physical impairments.

Prevalence and associated factors of depressive and anxiety symptoms among healthcare workers in the post-pandemic era of COVID-19 at a tertiary hospital in Shenzhen, China: A cross-sectional study

Background

Healthcare workers were at high risk of psychological problems during the COVID-19 pandemic, but it remains not well-investigated in the post-pandemic era of COVID-19, with regular epidemic prevention and control embedded in burdened healthcare work. This study aimed to investigate the prevalence and potential risk factors of the symptoms of depression and anxiety among healthcare workers at a tertiary hospital in Shenzhen.

Method

Our cross-sectional study was conducted among 21- to 64-year-old healthcare workers in December 2021 at a tertiary hospital in Shenzhen, using a simple random sampling strategy. A wide range of socio-demographic characteristics, individual information, and psychological condition of the subjects were extracted. Healthcare workers' psychological conditions were tested with the Center for Epidemiologic Studies Depression (CESD-10), General Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Work-Family Conflict Scale (WFCS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and 17-item of Maslach's Burnout Inventory-Human Services Survey (MBI-HSS-17). Data were collected based on these questionnaires. Descriptive statistics were used to assess the difference between healthcare workers with depressive and anxiety symptoms among different groups. Hierarchical logistic regression analyses were conducted to investigate the association between focused variables and mental health outcomes.

Results

A total of 245 healthcare workers were enrolled. The proportion of depressive symptoms, anxiety symptoms and their co-occurrence were 34.7, 59.6, and 33.1%, respectively. Logistic regression showed that for the three outcomes, no history of receiving psychological help and self-rated good or higher health were protective factors, whereas more severe insomnia and job burnout were risk factors. Junior or lower job title and higher psychological resilience were related to a lower prevalence of depressive symptoms, while relatively longer working hours and larger work-family conflict were positively associated with the anxiety symptoms. Psychological resilience was inversely associated with the co-occurrence of depressive and anxiety symptoms.

Conclusions

Our study revealed a high proportion of psychological problems and proved that several similar factors which were significant during the pandemic were also associated with the symptoms of depression and anxiety among healthcare workers in the post-pandemic era of COVID-19. These results provide scientific evidence for psychological interventions for healthcare workers.

Building Work Engagement in Organizations: A Longitudinal Study Combining Social Exchange and Social Identity Theories

Starting from the insights of social identity theory and social exchange theory, the present study aimed to understand how social support and organizational identification relate to work engagement. Moreover, it sought to verify if social support and organizational identification interact with each other to explain work engagement three months later. A longitudinal study was conducted on a sample of 150 employees, in which organizational identification, social support, and work engagement were measured through a questionnaire. The results show that when employees can count on their supervisors' and colleagues' support, they will be more engaged in their work. In addition, when an employee strongly identifies with their organization, the employee's evaluation of the social support received from colleagues and supervisors becomes less critical in determining their work engagement. These results confirm our hypotheses and extend the findings of previous research on withdrawal behaviors. From a practical point of view, it seems important for organizations to invest in increasing identification, as well as in building a high-quality social exchange relationship, especially when levels of organizational identification are low or decreasing.

The reciprocal relationship between social identification and social support over time: A four-wave longitudinal study

It has been argued that the positive effect of a shared social identity on health and well-being critically hinges on the interplay between social identity and social support. This interplay, however, is poorly understood. Building on Haslam et al., we argue that their relationship can be conceptualized as being reciprocal and dynamic with each variable influencing the other. The present study is the first to examine how the reciprocal relationship between social identification and perceived social support unfolds over time. In a sample of university freshmen (N_T1  = 172), we examined this reciprocal relationship in a four-wave survey study spanning over a period of 13 months. In line with Haslam et al., the results revealed a self-reinforcing cycle with social identification at T1 being positively related to perceived social support at T2, which, in turn, was positively related to social identification at T3, which predicted perceived social support at T4. In conclusion, our study advances knowledge regarding the interplay between social identity and social support over time and, hence, contributes to our understanding of the mechanisms underlying the social cure effect.

A community-led intervention to build neighbourhood identification predicts better wellbeing following prolonged COVID-19 lockdowns

Introduction

A growing body of research supports the importance of social cohesion for population wellbeing. However, the majority of this research has been correlational, and rarely have interventions been evaluated.

Method

We conducted a two-timepoint study investigating the role of Neighbour Day, a grass-roots, community-led intervention that seeks to build social cohesion across the population. Among a sample of 843, 125 were Neighbour Day participants while the remainder were not.

Results

We found that, compared to non-participants, Neighbour Day participants had significantly higher neighbourhood identification, experienced greater social cohesion, and had larger neighbourhood social networks. Between timepoints, the majority of the sample experienced prolonged lockdowns to prevent COVID-19 transmission, and so unsurprisingly, wellbeing declined and psychological distress increased. However, Neighbour Day participants were protected against these negative mental health effects of lockdown. These benefits of Neighbour Day participation were mediated via neighbourhood identification.

Discussion

Overall, the findings speak to the promise of large-scale interventions to build social identity, particularly due to their capacity to build resilience and protect people's wellbeing during times of collective change or crisis.

Acceptability and Feasibility of an Intervention to Enhance Social Group Belonging: Evidence From Three Trials of Groups 4 Health

Groups 4 Health (G4H) is a group psychotherapy program that targets social group disconnection. An emerging evidence base supports its efficacy in reducing loneliness, depression, and social anxiety. However, to date there has been no formal analysis of its acceptability to clients and therapists, nor an investigation of its feasibility for wider implementation. This input from end users is crucial to ensure the program's wider suitability and to contribute to its improvement. This study drew data from three clinical trials, including 266 G4H clients and 68 G4H therapists. From the Phase III trial only, additional data were available from 90 clients in a dose-controlled cognitive-behavioral therapy (CBT) comparison group, and focus groups/interviews with 6 therapists and 13 clients. Client satisfaction was high, with all average ratings &gt;7/10, significantly exceeding the CBT comparison group. Therapist satisfaction with each module was &gt;5/7. Retention was &gt;80%. Homework completion was high, with &lt;10% of clients saying that they had not attempted the homework. Therapists and clients both emphasized the benefits arising from G4H, and the contribution of the group context itself as a vehicle to achieve positive outcomes.

Team identification relates to lower burnout-Emotional and instrumental support as two different social cure mechanisms

Team identification is associated with less exhaustion and disengagement through more social support and higher collective self-efficacy. However, previous studies did not distinguish between emotional and instrumental support, even though both forms of support may relate differently to collective self-efficacy. By distinguishing between both support forms, we expected an indirect effect-the 'supportive structure' mechanism-of team identification on burnout mediated via emotional support. For a second mechanism-the 'supportive action' mechanism-we expected an indirect effect serially mediated by instrumental support and collective self-efficacy. We tested our hypotheses among N _T1  = 567 employees in a four-wave study with 3-month time lags between measurement points. Partially in line with our expectations, emotional support (T2) mediated the relation between team identification (T1) and disengagement (T4), but not emotional exhaustion (T4). Moreover, as expected, the results showed an indirect association between team identification (T1) and emotional exhaustion and disengagement (T4) via instrumental support (T2) and collective self-efficacy (T3). Accordingly, employees benefit from both support forms but through different mechanisms. We discuss our findings and implications for future research.

A group-based behavioural intervention for weight management (PROGROUP) versus usual care in adults with severe obesity: a feasibility randomised controlled trial protocol

Background

Approximately 15 million people in the UK live with obesity, around 5 million of whom have severe obesity (body mass index (BMI) ≥35kg/m²). Having severe obesity markedly compromises health, well-being and quality of life, and substantially reduces life expectancy. These adverse outcomes are prevented or ameliorated by weight loss, for which sustained behavioural change is the cornerstone of treatment. Although NHS specialist ‘Tier 3’ Weight Management Services (T3WMS) support people with severe obesity, using individual and group-based treatment, the current evidence on optimal intervention design and outcomes is limited. Due to heterogeneity of severe obesity, there is a need to tailor treatment to address individual needs. Despite this heterogeneity, there are good reasons to suspect that a structured group-based behavioural intervention may be more effective and cost-effective for the treatment of severe obesity compared to usual care. The aims of this study are to test the feasibility of establishing and delivering a multi-centre randomised controlled clinical trial to compare a group-based behavioural intervention versus usual care in people with severe obesity.

Methods

This feasibility randomised controlled study is a partially clustered multi-centre trial of PROGROUP (a novel group-based behavioural intervention) versus usual care. Adults ≥18 years of age who have been newly referred to and accepted by NHS T3WMS will be eligible if they have a BMI ≥40, or ≥35 kg/m² with comorbidity, are suitable for group-based care and are willing to be randomised. Exclusion criteria are participation in another weight management study, planned bariatric surgery during the trial, and unwillingness or inability to attend group sessions. Outcome assessors will be blinded to treatment allocation and success of blinding will be evaluated. Clinical measures will be collected at baseline, 6 and 12 months post-randomisation. Secondary outcome measures will be self-reported and collected remotely. Process and economic evaluations will be conducted.

Discussion

This randomised feasibility study has been designed to test all the required research procedures and additionally explore three key issues; the feasibility of implementing a complex trial at participating NHS T3WMS, training the multidisciplinary healthcare teams in a standard intervention, and the acceptability of a group intervention for these particularly complex patients.

Trial registration

ISRCTN number 22088800.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01167-0.

The impact of a positive autism identity and autistic community solidarity on social anxiety and mental health in autistic young people

LAY ABSTRACT

Autism is a diagnosis given to individuals by professionals but is also increasingly seen as an identity which an individual can choose for themselves. We wanted to explore how having autism as an identity affects autistic young people. There is evidence that autistic adults have better psychological well-being when they feel more solidarity with other autistic people and feel positively about being autistic. We know that autistic teenagers often feel anxious in social situations. Having a positive autism identity might help alleviate social anxiety associated with being autistic. We wanted to find out if autistic young people who felt more solidarity with other autistic people, and had more positive feelings about autism, had better psychological well-being and less social anxiety. We asked 121 autistic people aged 15-22 years to complete some questionnaires. These questionnaires asked about the young person's autism traits, social anxiety, and psychological well-being. The questionnaires also asked how satisfied they felt to be autistic (satisfaction) and how much solidarity they felt with the autism community (solidarity). We found that autistic young people who had higher autism satisfaction had better psychological well-being and lower social anxiety. Young people who felt more solidarity with other autistic people had higher psychological well-being. There was no association between autism solidarity and social anxiety. We conclude that is important to support autistic young people to develop positive feelings about autism and to feel solidarity with other autistic people.

Individual differences in selective attentional bias for healthy and unhealthy food-related stimuli and social identity as a vegan/vegetarian dissociate "healthy" and "unhealthy" orthorexia nervosa

Previous work identified the operation of an attentional bias (AB) towards healthy food related stimuli among those with increasing tendencies towards orthorexia nervosa (ON) using a modified Stroop task. The current work aimed to replicate and extend our understanding of this effect by incorporating alternative measures of AB (i.e., the dot probe task) and ON (i.e., the Teruel Orthorexia Scale [ToS]) in a sample of self-defined vegans/vegetarians. The theoretical assertion of the ToS is the conceptual broadening of orthorexia with differentiable dimensions - one characterised as a "healthy" preoccupation with healthy food/eating patterns (HeOr) and the other by a more underlying pathology (OrNe). This study also aimed to examine the pattern of responding across these two dimensions according to factors known to predict ON. Eighty-six participants (mean age = 33.0 years; 20 males, 66 females) completed measures of obsessive compulsivity, perfectionism, state/trait anxiety and ToS as well as a dot probe designed to measure AB for healthy and unhealthy-related food stimuli, threat ratings of each of words utilised and perceived identity centrality as a vegan/vegetarianism. Results showed a dissociation of predicted determinants for "healthy" ON (HeOr) and pathological ON (OrNe). HeOr was predicted by increasing identity centrality whereas OrNe was predicted by increased OCD and perfectionism, and increased interference for healthy-related food words (in particular slowed disengagement) and not unhealthy related food words. Threat-related ratings of unhealthy food words was shown to be common across both dimensions. This pattern highlights cognitive and individual differences-based correlates of pathological and non-pathological ON.

National identification, a social cure for COVID-19? Evidence from 67 countries

BACKGROUND

Social distancing and mass quarantines were implemented worldwide in response to the current COVID-19 pandemic. Prior research has shown that such measures bear negative consequences for population mental health and well-being. Conversely, a growing body of evidence suggests that feeling positively identified with a group is associated with physical and mental health benefits.

AIMS

This study tested whether national identification could promote wellbeing and physical health during the COVID-19 pandemic.

METHOD

We used survey data conducted among 67 countries (N = 46,450).

RESULTS

Mixed-model analyses revealed that national identity was associated with wellbeing - despite adjustment on social belonging, COVID-19 perceived risk, exposure and ideology. This effect did not extend to physical health.

CONCLUSIONS

These results suggest that the mere feeling of belonging to a national group may have mental health benefits. We discuss the implications of our findings within the social cure framework and their relevance for population mental health under COVID-19.

Ease of Mind or Ties That Bind? Costs and Benefits of Disclosing Daily Hassles in Partnerships

People often tell others about recent daily hassles. Such social sharing of emotion is often assumed to support affect repair, but empirical evidence points to the contrary. We tested the notion that social sharing primarily serves relationship closeness, rather than immediate affect repair. Using dyadic experience sampling with N = 100 couples, we captured social sharing in everyday contexts and assessed socioemotional implications for speakers and listeners. Across M = 87 individual measurement occasions, both partners reported potential social-sharing episodes following daily hassles and rated their momentary negative affect and relationship closeness. Global evaluations of relationship closeness were assessed at baseline and 2.5 years later. Social sharing involved both affective benefits and costs, but it predicted momentary and long-term increases in partners’ relationship closeness. These results suggest that sharing bad news in relationships may not primarily serve immediate affect–repair functions. Rather, it may be a catalyst for creating and nourishing relationship closeness.

Leading the way together: a cluster randomised controlled trial of the 5R Shared Leadership Program in older adult walking groups

BACKGROUND

With a rapidly ageing society, healthy ageing has become a key challenge. Engagement in physical activity, and particularly walking, is a key strategy that contributes to healthy ageing amongst older adults. The purpose of the present study was to evaluate the efficacy of a group walking program for older adults that incorporates the 5R Shared Leadership Program (5R^S). By implementing a structure of shared leadership and strengthening peer leaders' identity leadership, 5R^S aims to cultivate a shared social identity amongst participants, which has in other contexts been associated with greater performance and well-being.

METHODS

A cluster randomised controlled trial was conducted to test the efficacy of the 5R^S group walking program on group identification, group cohesion, walking activity, and well-being, compared to a regular group walking program for older adults. Nineteen older adult walking groups (i.e., the clusters; N = 503; M_age = 69.23 years, SD = 6.68) all participated in a 12-week structured group walking program. Nine walking groups (n = 304) were randomly assigned to the intervention in which participants received the 5R^S program in addition to regular group walking.

RESULTS

5R^S was successful in strengthening the identity leadership qualities of the appointed peer leaders. Multilevel regressions showed that 5R^S succeeded in increasing group cohesion and walking activity to a greater extent than a regular group walking program, while participants' group identification and well-being increased to a similar extent in both conditions. Furthermore, structural equation modelling revealed that group identification mediated the impact of peer leaders' identity leadership on group cohesion and well-being (but not walking activity).

CONCLUSION

By harnessing the capacity of the group and its peer leaders, the 5R^S program offers a promising intervention to engage older adults in physical activity.

TRIAL REGISTRATION

The study was retrospectively registered as clinical trial on 9 September 2021 ( NCT05038423 ).

Factors Influencing Men's Experiences and Engagement with the Rugby Fans in Training-New Zealand Pilot Trial: A Healthy Lifestyle Intervention for Men

Health promotion programs designed specifically to support men to improve their lifestyle behaviours are required to improve men's health. This study explored factors that influenced men's experiences of, and engagement with, the Rugby Fans in Training-New Zealand pilot trial, a professional sport-based healthy lifestyle intervention for overweight men. Thirty-five men (mean age = 45, SD = 10 years) who completed the 12-week intervention participated in one of eight semi-structured focus groups. Using inductive thematic analysis, five themes represented the meanings in the data. First, a group of like-minded men all in the same boat recognised the importance of being in similar life situations and having similar reasons for joining the programme. Second, the men described the importance of the support and motivation provided by the team atmosphere created through the programme. Third, the motivational coach recognised the characteristics, skills and knowledge of the coach delivering the programme which created engagement with it. Fourth, the education sessions were valued for the knowledge gained and underpinning philosophies that guided them. Finally, the involvement of the rugby franchise influenced commitment to the programme and created initial interest. These results provide evidence for the key components that should be incorporated into the future development of and improvement to healthy lifestyle interventions for men.

What reduces prejudice in the real world? A meta-analysis of prejudice reduction field experiments

Despite advances to promote acceptance and equity in many countries, prejudice remains a significant social problem. Promoting intergroup harmony requires knowledge about what works to reduce prejudice in community settings. This meta-analysis of field experiments reveals the most effective intervention types and conditions for reducing negative attitudes towards minority groups in real-world settings. Across 69 intervention arms and 24,378 participants, results reveal that prejudice reduction interventions are effective at improving attitudes towards minority groups in real-world settings (d = 0.51, 95% CI [0.33; 0.68]). The prediction interval was -0.90 to 1.92. In this case, the prediction interval was particularly wide because of the high degree of heterogeneity detected in effect size. Subgroup analyses indicate that less commonly explored approaches, such as perceived variability, may have larger effect sizes than contact-based interventions. Still, more research is needed to confirm the effects of these less-researched approaches. Additionally, results show that interventions are more effective for school and college cohorts than for adults, and that the effects of prejudice reduction interventions endure over time.

Research on psychological stress and mental health of medical staff in COVID-19 prevention and control

BACKGROUND

The characteristics of COVID-19, such as the long incubation period, the fast transmission speed, the high demand for treatment, and the lack of prior treatment experience, have brought tremendous psychological stress to the medical staff involved in the epidemic prevention and control, seriously affecting the mental health of medical staff. Therefore, this paper conducts a discussion on the psychological stress and mental health of medical staff.

METHODS

(1)Interview 28 medical staff fighting against COVID-19 from Wuhan Central Hospital and Hubei Provincial Hospital of Traditional Chinese medicine. They have worked as doctors in mental health departments, surgery departments and emergency departments, nurses and management staffs; (2)Based on interviews and literature, the questionnaire survey is conducted among 528 medical personnel from all over the country who have participated in the fight against COVID-19 in Wuhan; (3)Use the structural equation modeling to explore the influence mechanism of medical staff's psychological stress and mental health in the prevention and control of COVID-19. Results: The epidemic severity in hospital and the work intensity are the important psychological stressors for the front-line medical staff. Self-risk perception has a mediating effect on the severity of epidemic in hospitals and mental health of medical staff. Social identification has no moderating effect between the self-risk perception and the mental health.