Self-regulation processes and health: the importance of optimism and goal adjustment

Life after meningitis: a qualitative study exploring survivors' experience of living with sequelae

BACKGROUND

Around twenty percent of meningitis survivors experience after-effects. However, very little research on their psychological impact has been conducted. This report details a small explorative investigation into these psychological impacts.

OBJECTIVE

To explore the impact sequelae have on the meningitis survivors affected.

METHODS AND MEASURES

Thematic analysis of one-hundred individual user's blog posts, self-reporting one or more sequelae after a diagnosis of meningitis.

RESULTS

Blog posters' experiences varied greatly. Common trends in experience were mapped onto three themes. 'Struggling to Adjust to the New Normal' captures blog posters' struggles in returning to their lives post-hospitalization. 'Navigating Possibilities for Positivity' explores how blog posters either reported positive change due to their illness experience or felt a pressure, or inability, to do so. 'The Impact of Knowledge and Support' overarching two sub-themes; 'Lack of Awareness Causing Further Suffering' and 'Validation Leads to Narrative Shift'. These sub-themes contrast differences in experience blog posters reported, with and without knowledge, of the cause of their symptoms and support in dealing with the resulting difficulties.

CONCLUSIONS

Consistent and structured after-care would benefit patients experiencing sequelae. Suggestions of a possible format this could take are put forward. In addition, self-regulatory models of illness perception help explain some variations in blog posters experiences, with possible intervention plans based on these models also suggested. However, limitations, including the comparatively small and highly selected sample, mean that further research is necessary to validate the findings and assess their validity, widespread applicability, and financial feasibility.

The computational structure of consummatory anhedonia

Anhedonia is a reduction in enjoyment, motivation, or interest. It is common across mental health disorders and a harbinger of poor treatment outcomes. The enjoyment aspect, termed 'consummatory anhedonia', in particular poses fundamental questions about how the brain constructs rewards: what processes determine how intensely a reward is experienced? Here, we outline limitations of existing computational conceptualisations of consummatory anhedonia. We then suggest a richer reinforcement learning (RL) account of consummatory anhedonia with a reconceptualisation of subjective hedonic experience in terms of goal progress. This accounts qualitatively for the impact of stress, dysfunctional cognitions, and maladaptive beliefs on hedonic experience. The model also offers new views on the treatments for anhedonia.

Psychometric Properties of a New Mexican Optimism Scale: Ethnopsychological Approach

BACKGROUND

In this paper, a Mexican Optimism Scale was constructed to investigate and estimate psychometric properties (reliability and validity based on the measurement model). The convergent validity and validity criterion were evaluated for a sample of young Mexicans.

METHODS

The scale was presented to 848 Mexican young people aged between 17 and 30 years from three different regions of Mexico. The scale was reduced to 20 items on the basis of CFA and analyses of internal consistency.

RESULTS

The confirmatory factor analysis (CFA) suggested a three-factor structure of optimism: affective resources, positive vision and hope. The data provided evidence for convergent validity with positive affect, negative affect and coping. Additionally, males scored higher on affective resources and positive vision than females. Finally, the results support the reliability of the instrument.

CONCLUSIONS

The psychometric properties of the Mexican Optimism Scale proved to be highly acceptable and allow for a novel assessment of optimism from an ethnopsychological perspective. Validity, reliability and invariance were determined, as well as percentiles for the practical use of the scale. This scale may be of crucial importance for future research on optimism and health.

Depression in Uveal Melanoma Survivorship: Examining Psychological Predictors of Adjustment in the First Year Following Diagnosis

BACKGROUND

A rare cancer, uveal melanoma (UM) affects 5 in 1 million adults annually. Research on predictors of mental health in UM survivors is scarce.

PURPOSE

In this prospective study, we tested models that postulate interactions between illness perceptions and coping processes in predicting depressive symptoms 1 year following UM diagnosis.

METHODS

Participants' approach- and avoidance-oriented coping processes and illness perceptions specific to control and chronicity were assessed. Participants (N = 107) completed assessments prior to diagnosis (T0), and 1 week (T1), 3 months (T2), and 12 months after UM diagnosis (T3).

RESULTS

At T1, a significant avoidance coping × chronicity perception interaction (b = 1.84, p = .03) indicated that the link between higher avoidance coping and greater T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions (b = 17.13, p < .001). Chronicity perceptions at T2 interacted significantly with approach-oriented coping at all time points; the link between higher approach coping and lower T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions at T2. Interactions between control perceptions and coping did not significantly predict T3 depressive symptoms.

CONCLUSIONS

Findings lend partial support to predictive models that consider the combined, interacting influence of chronicity perceptions and coping processes on depressive symptoms in survivors of eye cancer.

Shifting the perspective: how positive thinking can help diminish the negative effects of pain

OBJECTIVES

The field of pain psychology has taken significant steps forward during the last decades and the way we think about how to treat chronic pain has radically shifted from a biomedical perspective to a biopsychosocial model. This change in perspective has led to a surge of accumulating research showing the importance of psychological factors as determinants for debilitating pain. Vulnerability factors, such as pain-related fear, pain catastrophizing and escape/avoidant behaviours may increase the risk of disability. As a result, psychological treatment that has emerged from this line of thinking has mainly focused on preventing and decreasing the adverse impact of chronic pain by reducing these negative vulnerability factors. Recently, another shift in thinking has emerged due to the field of positive psychology, which aims to have a more complete and balanced scientific understanding of the human experience, by abandoning the exclusive focus on vulnerability factors towards including protective factors.

METHODS

The authors have summarised and reflected on the current state-of-the-art of pain psychology from a positive psychology perspective.

RESULTS

Optimism is an important factor that may in fact buffer and protect against pain chronicity and disability. Resulting treatment approaches from a positive psychology perspective are aimed at increasing protective factors, such as optimism, to increase resilience towards the negative effects of pain.

CONCLUSIONS

We propose that the way forward in pain research and treatment is the inclusion of both vulnerability and protective factors. Both have unique roles in modulating the experience of pain, a finding that had been neglected for too long. Positive thinking and pursuing valued goals can make one's life gratifying and fulfilling, despite experiencing chronic pain.

The effectiveness and equivalence of different versions of a brief online Best Possible Self (BPS) manipulation to temporary increase optimism and affect

BACKGROUND AND OBJECTIVES

The Best Possible Self (BPS) has been found to be an effective manipulation to temporarily improve optimism and affect. The BPS has been used in different formats. In some versions, participants just write about their best possible future, while in others this is combined with imagery. An imagery only version has not been tested yet. The aim of the current study was to examine the effectiveness of three different versions of the BPS and their equivalence in improving optimism and affect.

METHODS

In an online study format, participants (N = 141) were randomly assigned to one of four conditions: (1) writing and imagery BPS; (2) writing BPS; (3) imagery BPS; and (4) a typical day (TD) control condition.

RESULTS

Results showed that each BPS condition significantly improved optimism (i.e. increased positive future expectancies and decreased negative future expectancies) and affect (i.e. increased positive affect and decreased negative affect). Equivalence testing showed that all online BPS conditions were equivalent in increasing optimism and affect, thereby confirming that both the writing and imagery elements of the BPS can independently from each other increase optimism and positive affect in a healthy population.

LIMITATIONS

Only the immediate effects of the BPS formats on increasing optimism and affect were measured.

CONCLUSIONS

The BPS manipulation can be employed in different ways for potential future exploration, depending on the research question, design and context and/or E-mental health applications for the treatment of individuals suffering from psychological complaints.

Higher well-being individuals are more receptive to cultivated meat: An investigation of their reasoning for consuming cultivated meat

It is evident that over-consumption of meat can contribute to the emission of hazardous greenhouse gases. One viable way to address such climate impact is to make people become more aware of more sustainable diet options, such as cultivated meat. However, it is challenging to instigate change in people's meat-eating habit, and empirical works have been examining the psychological factors that are related to consumers' willingness to consume cultivated meat. Research has suggested that psychological well-being can play a role in the meaning-making of food consumption, with higher well-being individuals showing more recognition of other sociocultural benefits of consuming food beyond just fulfilling their sustenance needs. As existing works have yet to understand the link between well-being and consumption of novel foods, the current research set out to fill this gap by examining the relationship between people's psychological well-being and their willingness to consume cultivated meat via different reasons (mediators) for consuming cultivated meat. We recruited a representative sample of 948 adults in Singapore to complete an online survey. The study offered the first evidence that there is a positive relationship between people's psychological well-being and their willingness to consume cultivated meat. Further, results revealed that their higher willingness can be motivated by the perception that cultivated meat is as healthy and nutritious, as safe as, and has the same sensory quality as real meat, and is beneficial to the society. This investigation adds to the growing literature on consumer acceptance of cultivated meat by showing the novel finding that well-being and receptivity to cultivated meat is positively linked, and such a positive link can be explained by people's better recognition of the prospective benefits offered by this alternative food.

Development and validation of a measure of adolescent and young adult goal-based quality of life (MAYA-GQOL)

PURPOSE

We developed and validated a measure assessing quality of life (QOL) through importance, attainability, and discrepancy of life goals among adolescents and young adults (AYA) with and without cancer. A specific goal-based QOL measure for AYA fills a critical gap in knowledge for AYA who are at a unique life stage, which may include shifts in priorities and goals.

METHODS

Through review of our existing AYA databases on goals, the literature, and cognitive interviews we developed the MAYA-GQOL. Items were administered to AYA with cancer (on/off treatment) (n = 124) and healthy AYA controls (n = 103) aged 15-29 years old. Psychometric analyses for comparison with existing QOL measures and discrepancies in perceived importance/attainability of goals were examined.

RESULTS

An item pool of 700 goals, based on prior research, was refined to 173 goals across nine categories: academic, administrative, body, health, job, leisure, interpersonal, intrapersonal, and religion. Validation between the MAYA-GQOL and existing QOL measures was supported. AYA survivors reported fewer overall current goals and fewer administrative, interpersonal, leisure, and religious goals. AYA survivors rated body goal importance significantly higher than healthy controls and intrapersonal goal importance significantly lower. Little discrepancy in importance and attainability across AYA was found.

CONCLUSIONS

The MAYA-GQOL represents an innovative way of measuring QOL among AYA by focusing on the relative importance, attainability, and discrepancy of developmentally appropriate goals. The MAYA-GQOL can identify areas of resilience and competence via assessment of important and attainable goals and can further assess how AYA with chronic illness are functioning relative to peers on goal domains relevant to the AYA developmental period.

Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator

BACKGROUND

In the period of the global pandemic, psychophysical problems induced by the fear of COVID-19 among college students deserve attention since the dormitory environment in college greatly increases the possibility of COVID-19 infection.

METHODS

A hypothesized mediated moderation model was to be verified using a cross-sectional study among 2453 college students. Fear of COVID-19, insomnia, hope, and depression were assessed by using the relevant scales.

RESULTS

(1) The fear of COVID-19 was positively correlated to depression (β = 0.365, t = 5.553, 95% CI = [0.236, 0.494]); (2) hope moderated the influence of the fear of COVID-19 on depression (β = -0.093, t = -4.066, 95% CI = [-0.137, -0.048]), as well as on insomnia (β = -0.095, t = -4.841, 95% CI = [-0.133, -0.056]); and (3) the mediated moderation model with hope as the moderator and insomnia as the full mediating variable between fear of COVID-19 and depression was verified (β = -0.060, 95% CI = [-0.093, -0.028]).

CONCLUSIONS

The findings suggest that hope is a vital mechanism to explain the relationship between the fear of COVID-19 and depression in early adulthood. In practical application, mental health practitioners should focus on boosting hope and alleviating insomnia when addressing COVID-19-related depression issues among college students.

Core self-evaluations as resilience and risk factors of psychological distress during the COVID-19 pandemic

In view of the grave consequences of distress reactions to the COVID-19 pandemic, this study investigated CSE (Core Self-evaluations) - internal/external health locus of control, generalized self-efficacy and trait optimism - and intolerance of uncertainty as potential correlates of distress reactions. We conducted an online questionnaire-based cross-sectional study with 422 Israeli respondents. Pandemic-related distress was defined by perceived stress, negative and positive affect, and worries. Predictors were: health locus of control, generalized self-efficacy, trait optimism, and intolerance of uncertainty. The findings show that CSEs and intolerance of uncertainty added between 11% (to perceived stress) and 22% (to negative affect) of explained variance beyond the background variables. Specifically, higher trait optimism and generalized self-efficacy were associated with less distress, and greater intolerance of uncertainty was correlated with higher distress. In conclusion, the CSE framework is useful for explaining psychological distress during the COVID-19 pandemic. Beyond their theoretical contribution, the findings may have practical implications for increasing resilience and ameliorating distress during a pandemic.

You have to let go sometimes: advances in understanding goal disengagement

While research on tenacious goal pursuit and persistence has evoked a myriad of research efforts, research on goal disengagement has rather been neglected and has been focusing mainly on positive consequences of individual differences in goal disengagement capacities. In recent years, however, research on goal disengagement has seen an upsurge in studies, specifically addressing the conceptualization of goal disengagement, the processes involved, and factors facilitating or undermining it. However, many questions remain unanswered or only partly answered providing numerous opportunities for further investigation. With this special issue of Motivation and Emotion, we aim to stimulate such progress in research on goal disengagement. To this end, this special issue includes empirical studies with cross-sectional, prospective, longitudinal, and experimental designs with a wide range of personal and experimentally induced goals as well as invited commentaries from scholars across different psychological sub disciplines. In this introductory essay, we provide a brief review of the current state of goal disengagement research. We also provide an overview about the contributions to this special issue with reflections related to the current state of research and areas where further advancement in conceptualization and empirical studies is needed.

Self-stigma, hope for future, and recovery: An exploratory study of men with early-onset substance use disorder

CONTEXT

The internalizing of experience of stigma among patients with substance use disorders (SUDs) can be debilitating to recovery. Individual factors such as self-regulation and abstinence self-efficacy can impact confidence in recovery and hope for future.

AIMS

The aim of the study was to explore relationship among self-stigma, self-regulation, self-efficacy, optimism, and confidence in recovery of patients with early-onset SUDs.

SETTINGS AND DESIGN

The study was carried out on a sample of 40 male patients with SUDs. The study had a single group exploratory design.

MATERIALS AND METHODS

The Self-Regulation Questionnaire, Drug Taking Confidence Questionnaire, Substance Abuse Self Stigma Scale, Revised Generalized Expectancy of Success (GES), and visual analog scale for craving were the measures used in the study.

STATISTICAL ANALYSIS

Pearson and spearman's correlation coefficient were used to test associations between the variables. Multiple regression models were drawn to examine predictors of generalized expectancy of success and confidence in recovery.

RESULTS

Self-regulation, generalized expectancy of success (optimism), and confidence in recovery were found to be significantly correlated with self-stigma dimensions. The multiple regression model revealed self-regulation and self-devaluation as significant predictors of optimism (GES), whereas abstinence self-efficacy and values disengagement dimension of self-stigma predicted patients' confidence in recovery.

CONCLUSIONS

Poor regulatory capacities along with internalized feelings of shame, guilt, and devaluation may lead to lower levels of optimism and poorer expectancies of success from future. Patient's self-efficacy in terms of abstaining from use behaviors and disengagement from pursuing life goals can lead to lower levels of confidence in recovery from SUDs and have implications for treatment seeking.

Effects of Induced Optimism on Subjective States, Physical Activity, and Stress Reactivity

This study examined effects of experimentally-induced optimism on physical activity and stress reactivity with community volunteers. Using an intervention to induce short-term optimism, we conducted two harmonized randomized experiments, performed simultaneously at separate academic institutions. All participants were randomized to either the induced optimism intervention or to a neutral control activity using essay-writing tasks. Physical activity tasks (Study 1) and stress-related physiologic responses (Study 2) were assessed during lab visits. Essays were coded for intensity of optimism. A total of 324 participants (207 women, 117 men) completed Study 1, and 118 participants (67 women, 47 men, 4 other) completed Study 2. In both studies, the optimism intervention led to greater increases in short-term optimism and positive affect relative to the control group. Although the intervention had limited effects on physical activity and stress reactivity, more optimistic language in the essays predicted increased physical activity and decreased stress reactivity.

Optimism and survival: health behaviors as a mediator-a ten-year follow-up study of Chinese elderly people

Background

Optimism—the generalized expectation that good things will happen—is a promising health asset. Mounting evidence indicates that there are specific associations between optimism and survival rates. However, for public health purposes, it is critical to consider whether the relationship between optimism and survival holds for older adults as a whole and to explore the role of health behaviors as potential mediators.

Methods

Prospective data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Optimism was measured in 2008, and survival was measured by survival time of the interviewees during the whole observation period from 2008 to 2018. Cox proportional hazard models were employed to evaluate the association between optimism and survival among the elderly. The mediating effect analysis method was used to explore the potential mediating role of health behaviors on the association between optimism and survival.

Results

Compared to less optimistic older adults, optimistic individuals were associated with lower odds of mortality (HR = 0.94, 95% CI = 0.89 − 0.99). Health behaviors are key elements that play a positive role in survival (HR = 0.95, 95% CI = 0.94 − 0.96). Health behaviors played an intermediary role in the relationship between optimism and mortality, and the mediating effect was -0.005.

Conclusions

Optimism and health behaviors were broadly and robustly associated with a lower risk of mortality. Health behaviors mediate the relationship between optimism and mortality. Appropriate intervention should be carried out on optimism and health behaviors among elderly people to improve the likelihood of health in aging.

The Relationship between Exercise and Mental Health Outcomes during the COVID-19 Pandemic: From the Perspective of Hope

The unexpected outbreak of COVID-19 triggered fear and anxiety in the general population. Exercise was one of the most widely promoted methods to improve body function when socially restricted. This study aims to examine the role of exercise in relieving stressful mental health outcomes (anxiety and depressive symptoms) during the COVID-19 pandemic and explore the underlying mechanism from the perspective of hope, using a combination of goal-directed planning (pathways) and motivation (agency). A cross-sectional online survey recruiting 2390 Chinese participants was conducted during the COVID-19 pandemic in China. A series of questions and scales, including the self-designed exercise questionnaire, the Adult Dispositional Hope Scale, the Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire-9, were used to measure exercise, hope, anxiety symptoms and depressive symptoms, respectively. A structural equation model was constructed to test the hypothesis that exercise benefits mental health outcomes through the mediating role of hope. Our results showed that exercise relieved stressful mental health outcomes via three paths: one direct path (β = −0.077, 95% CI = (−0.138, −0.017), p < 0.01), one indirect path through hope of pathways thinking (β = −0.046, 95% CI = (−0.064, −0.027), p < 0.001) and another indirect path through hope of agency thinking (β = −0.060, 95% CI = (−0.081, −0.039), p < 0.001). Our results showed that exercise could alleviate stressful mental health outcomes by promoting both hope of pathway thinking and agency thinking. It provided practical insights into psychological prevention and intervention by means of exercise during the COVID-19 pandemic.

Assessing preoperative hope and expectations related to functional neurosurgery: a new questionnaire

BACKGROUND

Despite successful functional neurosurgery, patients suffering from epilepsy or Parkinson's disease may experience postoperative psychological distress and social maladjustments. Difficulties in coping with postoperative changes, even positive ones, have shown to be related to patients' presurgery cognitive representations (i.e., expectations, hope). The aim of this study was to develop an instrument assessing various key features of surgery outcomes' representations, namely the Preoperative Hope and Expectations Questionnaire (PHEQ).

METHODS

Participants were patients (n = 50) diagnosed with Parkinson's disease (n = 25) or epilepsy (n = 25), candidates for functional neurosurgery (i.e., Deep brain stimulation, anterior temporal lobectomy). Two to three weeks before the planned surgery, they were administrated items assessing their actual state, preoperative expectations, and hope regarding surgery outcomes. They also completed measures assessing optimism, quality of life and mood.

RESULTS

Exploratory analysis resulted in a 14-item version of the PHEQ composed of two factors (abstract representations, including psychological well-being and concrete representations, such as direct surgery outcomes). The PHEQ demonstrated high internal consistency and good convergent validity. Patients were more prone to express postoperative improvements in terms of hope rather than expectations. They generally focused on concrete rather than abstract features, although patients with Parkinson's disease had higher abstract future-oriented representations.

CONCLUSIONS

The PHEQ presents satisfactory psychometric properties and may be considered as a reliable instrument for research and clinical practice.

Perceptions of the COVID-19 Pandemic among Women with Infertility: Correlations with Dispositional Optimism

People who are more optimistic may experience better psychological health during stressful times. The present study examined the perceptions and emotions surrounding the COVID-19 pandemic among American women who were experiencing fertility problems. We tested if dispositional optimism in these women was associated with less negative perceptions and emotions. We conducted a cross-sectional survey of patients from a single private infertility and reproductive clinic in an urban area in the Midwest, United States. Women, age 18 or older, primarily White and educated, who presented for an appointment to the clinic were invited to participate in an email-based survey. Respondents (N = 304) reported their perceived impact of the COVID-19 pandemic on fertility treatment, emotions associated with this impact, and perceived stress and depressive symptoms. They also completed measures of dispositional optimism and expectations for a future pregnancy. Findings indicated that women perceived an overall negative impact of the pandemic on their treatment plans, which was associated with more negative emotions, lower expectations of future pregnancy, and greater stress and depressive symptoms during the pandemic. However, further correlational analyses revealed that being higher in trait optimism was associated with perceiving a less negative impact of the pandemic, experiencing fewer negative emotions, and less overall stress and depressive symptoms. Although women with fertility problems have perceived the pandemic as negative and disruptive, those who are higher in optimism may be less affected.

Religious and Spiritual Practices: Association with Dispositional Optimism in an Underprivileged Population in Lascano, Uruguay

Optimism seems to foster the ability to manage adverse situations better-a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we studied the association between religious/spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America; this makes it particularly interesting for exploring the role of religious/spiritual practices in this context. We found that these practices were positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who did not. This association seems to be especially robust in the case of the poor and less educated: those with religious/spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that these practices may play in dispositional optimism in disadvantaged populations deserves more attention.

Healthy Behavior as a Mediator in the Relationship Between Optimism and Life Satisfaction in Health Sciences Students: A Cross-Sectional Study

Purpose

This study examines the indirect relationship between optimism and life satisfaction via healthy behavior among health sciences students.

Participants and Methods

The cross-sectional study involved 349 health sciences students, including 58% of women, ranging in age between 19 and 30 years (M = 22.15, SD = 1.83). Self-report questionnaires were used to measure dispositional optimism (the Life Orientation Test-Revised, LOT-R), life satisfaction (Satisfaction with Life Scale, SWLS), and health behaviors (Health Behavior Inventory, HBI), with four subscales: healthy diet (HD), preventive behavior (PB), positive mental attitudes (PMA), and healthy practices (HP). In addition, a single mediation model (with the total HBI as mediator) was compared with a parallel mediation model (with four subscales of the HBI). Gender was controlled as a confounding variable.

Results

Women scored higher in the total HBI (p < 0.01), HD (p < 0.001) and PB (p < 0.01) than men, while men scored slightly higher in dispositional optimism (p < 0.01). General health behavior (total HBI) completely mediates the relationship between dispositional optimism and life satisfaction, R² = 0.32. In the parallel model, only PMA was determined as a mediator of the association between dispositional optimism and satisfaction with life, R² = 0.36. The single mediation model showed perfect fit (X²/df = 0.00, RMSEA = 0.00, SRMR = 0.00, CFI = 1.00, IFI = 1.00, NFI = 1.00), better than the parallel mediation model (X²/df = 2.353, p = 0.095, RMSEA = 0.062, SRMR = 0.020, CFI = 0.995, IFI = 995, NFI = 991).

Conclusion

The interplay mechanism between personal resources and behavioral health-related habits may explain 32% of life satisfaction variance. The intervention focused on increasing optimistic expectancies and health behaviors should be implemented in universities to increase students’ well-being and prevent depression.

Dispositional Optimism and All-Cause Mortality in Older Adults: A Cohort Study

OBJECTIVE

Optimism is modifiable and may be associated with healthy aging. We aim to investigate whether dispositional optimism is associated with all-cause mortality in adults 70 years and older.

METHODS

Between 2010 and 2014, older adults free of serious cardiovascular disease and dementia were recruited through primary care physicians and enrolled in the Aspirin Reducing Events in the Elderly (ASPREE) clinical trial. Australian ASPREE participants were invited to participate in the ASPREE Longitudinal Study of Older Persons (ALSOP) that was running in parallel to ASPREE. Optimism was assessed at baseline using the Life Orientation Test-Revised. The association between optimism, divided into quartiles, and all-cause mortality was assessed using Cox proportional hazards models.

RESULTS

A total of 11,701 participants (mean [standard deviation] age = 75.1 [4.24] years; 46.6% men) returned the ALSOP Social questionnaire and completed the Life Orientation Test-Revised. During a median follow-up of 4.7 years, 469 deaths occurred. The fully adjusted model was not significant (hazard ratio = 0.78, 95% confidence interval = 0.58-1.06). There was evidence that age was an effect modifier of the association between optimism and longevity. Higher optimism was associated with lower mortality risk in the oldest individuals only (77+ years; hazard ratio = 0.61, 95% confidence interval = 0.39-0.96).

CONCLUSIONS

We observed no independent relationship between optimism and all-cause mortality in the total sample, although optimism seemed to be associated with lower risk among the oldest old (adults 77 years and older).

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018

Long-term health conditions can limit achievement of personal goals. We aimed to map and synthesize definitions of goal adjustment, theoretical underpinnings, associations with recovery and supportive interventions for adults with long-term conditions. We searched multiple databases (January 2007-June 2018) and identified peer-reviewed research relating to goal adjustment. Data were charted, mapped and synthesized using content analysis and descriptive summaries. Two stakeholder consultations informed the review. Ninety-one articles were included. A range of long-term conditions were represented including cancer (22%), stroke (12%) and mixed neurological conditions (8%). Goal adjustment was one available option when faced with unattainable goals; other options were goal disengagement and goal re-engagement. Most studies were quantitative (58%), reporting mainly positive associations between goal adjustment, disengagement, reengagement and recovery. The Dual Process Model, Goal Adjustment Model and Self-Regulation Theory were most cited underpinning models/theory. Five interventions were identified; only one (self-system therapy) was evaluated in a randomized controlled trial. Our review provides original and significant insights into goal adjustment definitions, theoretical underpinnings and association with recovery. Effective interventions to support goal adjustment, disengagement and reengagement are lacking. This research-practice gap warrants attention to ensure people with long-term conditions are optimally supported when facing unattainable goals.

Involvement in self-care and psychological well-being of Spanish family caregivers of relatives with dementia

The provision of continuous care to a dependent person can lead to a lack of self-care by the caregiver themselves with corresponding low levels of well-being. This well-being has been analysed mostly from within the perspective of the hedonic tradition, with the development of personal growth often being overlooked. This study aims to increase the understanding of the connection between this type of psychological well-being and involvement in self-care activities, and to be a starting point for the determination of categories that may serve in the screening of potential participants in social-health interventions where it is being promoted. Taking the hypothesis of a probable positive connection between psychological well-being and involvement in self-care, an observational study was carried out on 45 caregivers of relatives with dementia. In those caregivers showing greater dedication to self-care, a higher score was obtained on the well-being scales connected to personal significance and positive emotions and experiences. These findings were further reinforced by the identification of other positive connections, the involvement in self-care and the six dimensions of wellness contemplated by Ryff. It is possible to envisage the existence of a virtuous circle in respect of the caregiver, whereby a greater involvement in self-care is related to a higher psychological well-being, which in turn is related to greater self-care, and so on.

Parental Catastrophizing and Goal Pursuit in the Context of Child Chronic Pain: A Daily Diary Study

Background: Despite daily variability in children's chronic pain experiences, little is known about how parents' emotions and goals toward their child's pain are influenced by these daily changes. This diary study examined how daily child pain intensity (as perceived by parents) moderates the associations between parental catastrophic thoughts about child pain on the one hand, and daily parental distress and parents' goals with regard to their child's pain (pain control vs. activity engagement) on the other hand.

Method: Participants were 25 parents of 20 different children (N = 18; 90% girls). Children, aged 8–14 years (M = 9.5, SD = 2.09), experienced either chronic headache or functional abdominal pain with an average pain duration of 22.5 months (SD = 24.5 months). Daily parental responses (i.e., perceived child pain intensity, distress and goal endorsement) were collected through a 3-week daily diary (resulting in 413 valid diary reports). Parents completed the Pain Catastrophizing Scale for Parents prior to starting the diary (PCS-P general) and a daily measure (PCS-P daily) included in the diary. To account for the interdependence of the data, the data were analyzed using multilevel modeling.

Results: Perceived daily child pain intensity moderated the impact of parental general and daily catastrophic thoughts on parents' daily distress. Only for parents experiencing low general catastrophic thoughts an increase in distress was observed on days when they perceived their child's pain intensity as high. For all parents, high levels of perceived child pain intensity were related to more distress on days where parents reported high levels of catastrophic thinking (i.e., PCS-P daily). Perceived daily child pain intensity also moderated the impact of parental general catastrophic thinking on parents' daily endorsement of goals. Parents with high levels of general catastrophic thinking reported a lower focus on child pain control on days when child pain intensity was perceived to be low. Parents with low general catastrophic thinking reported lower endorsement of the activity engagement goal on days where the child's pain intensity was perceived to be low.

Conclusion: These findings highlight the complexity of daily fluctuations in parental distress and goals regarding their child's pain. Clinical implications and future directions are critically assessed.

Physical Activity during the First Lockdown of the COVID-19 Pandemic: Investigating the Reliance on Digital Technologies, Perceived Benefits, Barriers and the Impact of Affect

The measures to fight the spread of the COVID-19 pandemic have been concentrated on inviting people to stay at home. This has reduced opportunities to exercise while also shedding some light on the importance of physical health. Based on an online survey, this paper investigated physical activity behaviours of a Belgians sample (n = 427) during the lockdown period between the end of May 2020 and the beginning of June 2020 and found that, during this period, the gap between sufficiently and insufficiently active individuals widened even more. This paper analysed important moderators of physical activity behaviours, such as barriers and benefits to exercise, digital support used to exercise, and individuals’ emotional well-being. Descriptive analysis and analyses of variance indicated that, generally, individuals significantly increased their engagement in exercise, especially light- and moderate-intensity activities, mostly accepted the listed benefits but refused the listed barriers, increased their engagement in digital support and did not score high on any affective measures. A comparison between sufficiently active and insufficiently active individuals during the lockdown showed that the former engaged even more in physical activity, whereas the latter exercised equally (i.e., not enough) or even less compared to before the lockdown. By means of a logistic regression, five key factors of belonging to the sufficiently active group were revealed and discussed. Practical implications for government and policies are reviewed.

Resilient Aging: Psychological Well-Being and Social Well-Being as Targets for the Promotion of Healthy Aging

Population aging is one of the most important social trends of the 21st century and in the United States, the number of people aged ≥65 is projected to increase by nearly 50% in the next 15 years. Most biomedical and public health efforts have focused on reducing harmful risk factors when targeting chronic disease—an approach that has contributed greatly to prevention and treatment programs. However, evidence suggests that the number of years lost to disability is increasing and historic gains we have made in life expectancy are eroding, and even reversing in some groups. As our society ages and grapples with these issues, expanding the focus to include resilience, as well as psychosocial assets in our prevention and treatment programs might help inform the multidisciplinary response effort we need. Here we synthesize research evaluating associations between different dimensions of psychological well-being (e.g., purpose in life, optimism, life satisfaction) and social well-being (e.g., structural, functional, quality) with chronic conditions. We also evaluate evidence around three biopsychosocial pathways hypothesized to underlie these associations. These factors are meaningful, measurable, and potentially modifiable; thus, further pursuing this line of inquiry might unveil innovative paths to enhancing the health of our rapidly aging society.

Physiotherapeutic intervention to promote self-care: exploratory study on Spanish caregivers of patients with dementia

The caregivers of dependent persons should benefit from social-health interventions that empower them. Physiotherapists can play an important role as facilitators of self-care learning by boosting the mind-body interaction. The aim of this study was to analyse the efficacy of a physiotherapeutic intervention centered on the promotion of self-care within a sample of caregivers, members of four Spanish Associations of Relative of Alzheimer's and other dementias. To fulfill the study goal, a pre-experimental study was developed with two different groups. Group 1 participated in four training sessions based exclusively on the communication of information and which addressed, among other aspects, the most frequent health problems in caregivers and the powerful role of self-care to face such problems. Group 2 received the same theoretical information as group 1, followed by 10 sessions of practical training in several concrete strategies of body-mind self-care. The results obtained support the usefulness of combining theoretical and practical training in mind-body strategies (relaxation, self-massage and stretching), as such combination managed to favor their implication to self-care and certain dimensions of psychological well-being, while attenuating the burden. Conversely, training based solely on theoretical approaches was not beneficial. Besides evidencing the usefulness of combining passive and active methodologies to favor self-care, the data provided calls for greater consideration of aspects close to philosophical perspectives like personal growth.

Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association

As clinicians delivering health care, we are very good at treating disease but often not as good at treating the person. The focus of our attention has been on the specific physical condition rather than the patient as a whole. Less attention has been given to psychological health and how that can contribute to physical health and disease. However, there is now an increasing appreciation of how psychological health can contribute not only in a negative way to cardiovascular disease (CVD) but also in a positive way to better cardiovascular health and reduced cardiovascular risk. This American Heart Association scientific statement was commissioned to evaluate, synthesize, and summarize for the health care community knowledge to date on the relationship between psychological health and cardiovascular health and disease and to suggest simple steps to screen for, and ultimately improve, the psychological health of patients with and at risk for CVD. Based on current study data, the following statements can be made: There are good data showing clear associations between psychological health and CVD and risk; there is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD; the preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health; simple screening measures can be used by health care providers for patients with or at risk for CVD to assess psychological health status; and consideration of psychological health is advisable in the evaluation and management of patients with or at risk for CVD.

Understanding Unemployment Normalization: Individual Differences in an Alternative Experience With Unemployment

Unemployment is a major concern of societies and people around the world. In addressing this phenomenon, the literature has suggested a change in unemployed people’s perceptions of this transition period. In this paper, we apply a differential approach to explore the concept of unemployment normalization, an individual emotional regulation process. The results show how the global socioeconomic context and some individual and psychological variables influence the normalization of unemployment. Thus, the age of the person but also work involvement, coping strategies, locus of control, and level of self-esteem have indirect differential effects, mediated by unemployment normalization dimensions, on unemployed people’s perceived health. Only neuroticism has a direct link to subjective well-being. These results offer a new understanding of the perception of unemployment and are also discussed in the area of career and vocational counseling.

A new measure for dispositional optimism and pessimism in young children

We describe here a new test for dispositional optimism and pessimism in young children, the Parent‐rated Life Orientation Test of children (the PLOT) and assess its psychometric properties. Two hundred and twenty one mother–father pairs rated their children's (mean age = 8.1, SD = 0.3 years) dispositional optimism and pessimism using a new scale, the PLOT, including four optimism and four pessimism items. We associated the PLOT with parent‐rated self‐esteem (Behavioral Rating Scale of Presented Self‐Esteem in Young Children), social competence (Social Competence and Behaviour Evaluation Scale, the SCBE‐30), psychiatric symptoms (Child Behaviour Checklist, the CBCL) and temperament (Children's Behaviour Questionnaire, the CBQ) of the child. A confirmatory factor analysis (CFA) of the mother‐ and father‐rated PLOT revealed a significantly better fit for a two‐ over a one‐factor solution (p < 0.001). The optimism and pessimism subscales displayed good reliabilities, inter‐parental agreement and modest to moderate associations, in the expected direction, with the measures of self‐esteem, social competence, temperament and behaviour problems. To conclude, the PLOT shows good construct and convergent validity and reliability. The findings encourage its use to assess early emerging generalized expectancies of positive and negative outcomes in young children. Copyright © 2009 John Wiley & Sons, Ltd.

How Dispositional Optimists and Pessimists Evaluate their Past, Present and Anticipated Future Life Satisfaction: A Lifespan Approach

Dispositional optimism is typically conceptualized with respect to generalized positive expectancies for personal future outcomes. The present work draws on lifespan development theory to evaluate how dispositional optimists and pessimists from across the lifespan evaluate their past, present and anticipated future life satisfaction (LS). Using data from an American probability sample (n = 3871, ages = 30–84 years, 55% female), I compared dispositional optimists and pessimists across six age decades. Subjective LS trajectories reflected in mean trends in ratings of past, present and future LS were contoured by lifestage, revealing inclining trajectories among young dispositional optimists and pessimists and declining trajectories among older optimists and pessimists. After adjusting for age–specific normative trends, however, differences between dispositional optimists and pessimists in subjective LS trajectories were consistent across lifestage, revealing a single dissociative pattern wherein optimists rated their past, present and anticipated future LS more positively than did pessimists. Of the three temporal perspectives, evaluations of present (rather than past or future) LS were most consistently related to dispositional optimism. Copyright © 2012 John Wiley & Sons, Ltd.

Optimism and Cardiovascular Health: Longitudinal Findings From the Coronary Artery Risk Development in Young Adults Study

OBJECTIVE

Favorable cardiovascular health is associated with greater longevity free of cardiovascular disease. Although the prevalence of cardiovascular health decreases with age, less is known about protective factors that promote and preserve it over time. We investigated whether optimism was associated with better cardiovascular health over a 10-year period.

METHODS

Participants included 3188 Black and White men and women from the Coronary Artery Risk Development in Young Adults study. Self-reported optimism was assessed in 2000 (this study's baseline) with the revised Life Orientation Test. Favorable cardiovascular health was defined by healthy status on five components of cardiovascular functioning that were repeatedly assessed through 2010 either clinically or via self-report (blood pressure, lipids, body mass index, diabetes, and smoking status). Linear mixed-effects models examined whether optimism predicted cardiovascular health over time, adjusting for covariates such as sociodemographic characteristics, health behaviors, health status, and depression diagnosis.

RESULTS

In models adjusting for sociodemographic characteristics, optimism was associated with better cardiovascular health across all time points (β = 0.08, 95% confidence interval = 0.04-0.11, p ≤ .001) but not with rate of change in cardiovascular health. Findings were similar when adjusting for additional covariates. Optimism did not interact significantly with race (p = .85) but did with sex, such that associations seemed stronger for women than for men (p = .03).

CONCLUSIONS

Optimism may contribute to establishing future patterns of cardiovascular health in adulthood, but other factors may be more strongly related to how slowly or quickly cardiovascular health deteriorates over time.

Evaluation of a Text Messaging Intervention to Support Self-Management of Diabetes During Pregnancy Among Low-Income, Minority Women: Qualitative Study

Background

Given the growing burden of diabetes in underserved communities and the complexity of diabetes self-management during pregnancy, the development of interventions to support low-income pregnant women with diabetes is urgently needed.

Objective

This study aims to develop and pilot test a theory-driven curriculum of SMS text messaging for diabetes support and education during pregnancy.

Methods

This was a prospective pilot investigation of a novel SMS text messaging intervention offered to pregnant women with pregestational or gestational diabetes mellitus and publicly funded prenatal care. Prior work yielded a conceptual model of diabetes self-management barriers and support factors in this population, which was used to guide curriculum development along with health behavior theories. Participants received three supportive or educational one-way text messages per week during pregnancy. In-depth semistructured interviews were performed at study exit to solicit feedback on the program. Narrative data were analyzed using the constant comparative technique to identify themes and subthemes.

Results

Participants (N=31 enrolled and n=26 completed both interviews) consistently reported that SMS text messaging provided enhanced motivation for diabetes self-care, reduced diabetes-related social isolation, increased perceived diabetes-associated knowledge, enhanced comfort with the health care team, and reduced logistical burdens of diabetes during pregnancy. Participants requested enhanced interactive and customizable features in future intervention iterations.

Conclusions

Pregnant women with diabetes who were enrolled in this pilot study of an SMS text messaging curriculum for diabetes support described enhanced motivation, knowledge, and comfort with diabetes self-care activities as a result of the health education intervention. The next steps include enriching the interactive features of the intervention and investigating the effect of the intervention on perinatal outcomes.

How gender-specific are predictors of post-MI HRQoL? A longitudinal study

Purpose

Extant research shows that health-related quality of life (HRQoL) differs between female and male survivors of myocardial infarction (MI), but the reasons for this are not fully understood. We aimed to examine the predictors of HRQoL in female and male survivors during the first year after MI.

Methods

At timepoints 1 and 2, the sample comprised 222 MI survivors (59 women and 163 men; mean age 53.84 years, range 24–65) referred for in-patient cardiac rehabilitation. This number dropped to 140 participants (42 women and 98 men) at the third timepoint, approximately one year after the MI. We examined the gender differences in various predictors of physical and mental HRQoL: demographic factors (e.g., age, education, marital status), disease-related factors (pre- and post-MI), personality and coping with stress.

Results

Initially, both physical and mental HRQoL were lower in women than men, but the differences disappeared at timepoint 3. Stepwise regressions performed separately for men and women revealed that the factors shaping HRQoL were different in both genders; they also changed over time. Substantially fewer factors predicted physical HRQoL in women than in men. Trait anxiety seems to play a similarly negative role in both genders.

Conclusions

The psychosocial resources that influence HRQoL were different for women and men. There were also differences concerning predictors of HRQoL dimensions. Further studies with a different or broader range of predictors are needed, especially among women.

"What Should I Do First?" The Effect of Manipulated Goal Conflict on Affect, Motivation, and Helping Behavior in Chronic Pain Couples

Although support provision by a partner is an important resource for individuals with chronic pain (ICPs), it poses a challenge for partners because it competes with other important personal goals of partners. The current study examined the impact of experimentally induced goal conflict in partners on their motives for helping, quality of provided help, and on partners' and ICPs' affect. Sixty-eight couples, with at least one person having chronic pain, performed 2 series of household activities, with partners either asked to be simply available for help (ie, control condition) or to additionally work on a puzzle task (ie, goal conflict condition). Couples reported on interpersonal (eg, helping motives) and intrapersonal (eg, affect) outcomes. In addition, quality of partners' helping behavior and ICPs' pain behavior were videotaped and coded afterward. In the goal conflict condition, ICPs were less satisfied with the received help and they experienced more pain. Also, the quality of the provided help was lower and partners experienced less positive and more negative affect. Addressing partners' goal conflict in clinical practice may help to avoid its negative impact on both ICPs and partners. Perspective: This article provides a compelling argument to include partners in chronic pain treatment by demonstrating the detrimental effects of partners' experienced conflicts in goals upon the quality of help they provide, partners' affective functioning, and ICPs' pain-related outcomes.

Using vignettes to assess the contribution of goal adjustment in the adaptation to chronic musculoskeletal pain

PURPOSE

The quality of life of individuals with chronic musculoskeletal pain partly depends on their capacity to adjust their personal goals. Vignettes have been rarely used to assess this ability. Therefore, this study aimed to test the relationships between vignettes assessing different goal strategies and chronic pain adaptation (i.e., daily functioning, pain-related impairment, and psychological well-being).

METHODS

The sample comprised 258 individuals with chronic musculoskeletal pain who completed a series of questionnaires and vignettes. The vignettes presented a short description of a situation in which a person with chronic pain experienced a threat to a valued domain-specific goal and had to choose a possible goal management solution (i.e., goal persistence, flexibility reengagement, and disengagement). Hierarchical regression analyses were used to predict chronic pain adaptation using the selected vignette strategies as predictors.

RESULTS

After controlling for age, sex, pain intensity, and the responses to the dispositional goal management scales, persistence, reengagement, and disengagement goal strategies presented in the case scenarios predicted daily functioning (p < .001). Persistence, flexibility, disengagement (p < .001), and reengagement (p < .05) predicted pain-related impairment. Persistence, disengagement (p < .001), and flexibility (p < .05) predicted psychological well-being scores.

CONCLUSION

The use of vignettes could be useful to assess goal adjustment because this methodology enables respondents to provide more context-specific responses. The results of this approach could be used to improve clinical practice aimed at helping people with chronic musculoskeletal pain to better cope with this health condition.

Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women

Most research on exceptional longevity has investigated biomedical factors associated with survival, but recent work suggests nonbiological factors are also important. Thus, we tested whether higher optimism was associated with longer life span and greater likelihood of exceptional longevity. Data are from 2 cohorts, women from the Nurses' Health Study (NHS) and men from the Veterans Affairs Normative Aging Study (NAS), with follow-up of 10 y (2004 to 2014) and 30 y (1986 to 2016), respectively. Optimism was assessed using the Life Orientation Test-Revised in NHS and the Revised Optimism-Pessimism Scale from the Minnesota Multiphasic Personality Inventory-2 in NAS. Exceptional longevity was defined as survival to age 85 or older. Primary analyses used accelerated failure time models to assess differences in life span associated with optimism; models adjusted for demographic confounders and health conditions, and subsequently considered the role of health behaviors. Further analyses used logistic regression to evaluate the likelihood of exceptional longevity. In both sexes, we found a dose-dependent association of higher optimism levels at baseline with increased longevity (P trend < 0.01). For example, adjusting for demographics and health conditions, women in the highest versus lowest optimism quartile had 14.9% (95% confidence interval, 11.9 to 18.0) longer life span. Findings were similar in men. Participants with highest versus lowest optimism levels had 1.5 (women) and 1.7 (men) greater odds of surviving to age 85; these relationships were maintained after adjusting for health behaviors. Given work indicating optimism is modifiable, these findings suggest optimism may provide a valuable target to test for strategies to promote longevity.

Effect of Enhanced Medical Rehabilitation on Functional Recovery in Older Adults Receiving Skilled Nursing Care After Acute Rehabilitation: A Randomized Clinical Trial

IMPORTANCE

Enhanced medical rehabilitation (EMR) is a systematic and standardized approach for physical and occupational therapists to engage patients. Higher patient engagement in therapy might lead to improved functional recovery in rehabilitation settings, such as skilled nursing facilities (SNFs).

OBJECTIVE

To determine whether EMR improves older adults' functional recovery.

DESIGN, SETTING, AND PARTICIPANTS

A double-blind, parallel-group, randomized clinical trial was conducted from July 29, 2014, to July 13, 2018, in 229 adults aged 65 years or older admitted to 2 US SNFs. Participants were randomized to receive EMR (n = 114) vs standard-of-care rehabilitation (n = 115). Intention-to-treat analysis was used.

INTERVENTIONS

The intervention group received their physical and occupational therapy from therapists trained in EMR. Based on models of motivation and behavior change, EMR is a toolkit of techniques to increase patient engagement and therapy intensity. The control group received standard-of-care rehabilitation from physical and occupational therapists not trained in EMR.

MAIN OUTCOMES AND MEASURES

The primary outcome was change in function in activities of daily living and mobility, as assessed with the Barthel Index, which measures 10 basic activities of daily living or mobility items (scale range, 0-100), from SNF admission to discharge; secondary outcomes were gait speed for 10 m, 6-minute walk test, discharge disposition, rehospitalizations, and self-reported functional status at days 30, 60, and 90. To examine the rehabilitation process, therapists' engagement with patients and patient active time during therapy were measured for a sample of the sessions.

RESULTS

Of the 229 participants, 149 (65.1%) were women; 177 (77.3%) were white, and 51 (22.3%) were black; mean (SD) age was 79.3 (8.0) years. Participants assigned to EMR showed greater recovery of function than those assigned to standard of care (mean increase in Barthel Index score, 35 points; 95% CI, 31.6-38.3 vs 28 points; 95% CI, 25.2-31.7 points; P = .007). There was no evidence of a difference in the length of stay (mean [SD], 23.5 [13.1] days). However, there were no group by time differences in secondary outcome measures, including self-reported function after SNF discharge out to 90 days as measured on the Barthel Index (mean [SE] score: EMR, 83.65 [2.20]; standard of care, 84.67 [2.16]; P = .96). The EMR therapists used a median (interquartile range) of 24.4 (21.0-37.3) motivational messages per therapy session vs 2.3 (1.1-2.9) for nontrained therapists (P < .001), and EMR patients were active during a mean (SD) of 52.5 (6.6%) of the therapy session time vs 41.2 (6.8%) for nontrained therapists (P = .001).

CONCLUSIONS AND RELEVANCE

Enhanced medical rehabilitation modestly improved short-term functional recovery for selected older adults rehabilitating in SNFs. However, there was no evidence that the benefits persisted over the longer term. This study demonstrates the value of engaging and motivating older adults in rehabilitation therapy, but more work is needed to extend these benefits to longer-term outcomes after discharge home.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02114879.

Goal Adjustment and Well-Being: The Role of Optimism in Patients with Chronic Pain

Background

Chronic pain directly or indirectly interferes with valued personal goals. Goal adjustment plays a central role in patients’ adaptation. Studies on the relationship between optimism and goal regulation have shown that people with high dispositional optimism adjust their goals in a flexible way, and that flexible goal adjustment promotes quality of life.

Purpose

The aim of this study was to analyze the relationship among optimism, goal adjustment, and adaptation in patients with chronic pain.

Methods

A sample of 258 patients with chronic musculoskeletal pain completed questionnaires on optimism, reengagement, disengagement, flexibility, tenacity, rumination, purpose in life, well-being, pain intensity, daily functioning, and impairment.

Results

Structural equation modeling analysis showed that optimism had a positive association with reengagement, flexibility, and tenacity, and a negative association with disengagement. Disengagement was positively associated with rumination, whereas reengagement, flexibility, and tenacity were associated with higher levels of purpose in life, which were strongly associated with adaptation in patients with chronic pain.

Conclusions

This study supports the conclusions of previous research on the role of goal adjustment as a mediator variable between optimism and well-being.

Dispositional optimism and cognitive functioning following traumatic brain injury

Objective: The association of dispositional optimism with health-related factors has been well established in several clinical populations, but little is known about the role of optimism in recovery after traumatic brain injury (TBI). Given the high prevalence of cognitive complaints after TBI, the present study examined the association between optimism and cognitive functioning after TBI. Methods: 171 individuals with complicated mild, moderate or severe TBI completed a series of questionnaires via structured interview and self-report, including a self-report assessment of dispositional optimism, the revised Life Orientation Test (LOT-R), and an objective assessment of cognition, the Brief Test of Adult Cognition by Telephone (BTACT). Multiple hierarchical regression analysis was conducted to examine the relationships between optimism and cognitive functioning. Results: Dispositional optimism was significantly and positively associated with post-TBI cognitive functioning after controlling for the effects of age, race, injury severity, health status, and positive and negative affect. Conclusion: Dispositional optimism may promote higher levels of cognitive functioning in people who sustained a TBI. Research is warranted to examine whether interventions that promote optimism in clinical and social encounters can enhance cognitive recovery in individuals with TBI.

Goal reengagement is related to mental well-being, life satisfaction and acceptance in people with an acquired brain injury

OBJECTIVE

After an acquired brain injury (ABI), the achievement of previous life goals may no longer be feasible. This study examined whether self-reported disengagement from previous goals and reengagement towards new, more feasible goals, are associated with higher quality of life (QOL) and life satisfaction. We also examined whether acceptance mediated these relationships.

METHODS

Eighty-two individuals (18-68 years of age) with an ABI completed a battery of questionnaires. We investigated the relations between goal disengagement and reengagement on the one hand, and general QOL, disease-specific QOL, life satisfaction and acceptance, on the other hand. Rehabilitation psychologists provided estimates of self-awareness and the extent of motor, communicative and cognitive impairment.

RESULTS

Goal reengagement, but not goal disengagement, was positively associated with mental QOL and life satisfaction, after statistically controlling for demographic and impairments. Acceptance mediated the relationship between goal reengagement on the one hand, and mental QOL and life satisfaction, on the other hand.

CONCLUSION

After an ABI, reengagement in feasible goals is more important in explaining mental well-being and life satisfaction than disengagement from unattainable goals. Interventions aimed at identifying and pursuing new, feasible goals may be more helpful than strategies focusing on the loss of blocked goals.

Optimism for the Future in Younger and Older Adults

OBJECTIVES

Research has suggested that older adults are less optimistic about their future than younger adults; however, a limitation of prior studies is that younger and older adults were forecasting to different ages and stages of life. To address this, we investigated whether there are age differences in future optimism when people project to the exact same age. We also tested whether optimism differs when projecting one's own future versus another person's future.

METHOD

Participants were 285 younger and 292 older adults recruited from Amazon Mechanical Turk. Participants completed writing and word-rating tasks in which they imagined their own future in 15 years, their own future at age 85, or the average person's future at age 85.

RESULTS

Younger adults were more optimistic than older adults about their own future in 15 years. In contrast, both age groups were similarly optimistic about their future at age 85 and expected it to be more positive than others' future at age 85.

DISCUSSION

Contrary to previous research, younger and older adults had comparable future forecasts when projecting to the exact same age. These findings emphasize the need to consider age and stage of life when examining age differences in future optimism.