Associations of social support and alexithymia with psychological distress in Finnish young adults

Alexithymia and negative emotions among nursing students: a moderated mediation model

Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.

Youth Perceived Social Support and Symptom Distress: A Random-Intercept Cross-Lagged Panel Model

Although social support and mental health associations have been extensively investigated, their reciprocal relations in vulnerable youth remain understudied. This study investigated the relations between perceived social support and symptom distress over time whilst differentiating between support from caregivers and significant others. The sample included 257 youth (79% self-identified women, Mage = 19.2, SD = 2.5) who were receiving mental health treatment. Using a Random-Intercept Cross-Lagged Panel Model, results revealed no significant concurrent associations, between-person effects, or cross-lagged effects. The autoregressive effects suggested that perceived social support from caregivers was relatively stable over time, while symptom distress and support from a significant other were not. In all, this study challenged the validity of the social causation and social erosion models in the context of perceived social support and symptom distress among vulnerable youth, revealing an absence of significant reciprocal associations. The stable nature of perceived social support from caregivers compared to support from significant others was highlighted. The study design, hypotheses, and target analyses were preregistered under https://osf.io/f4qpg .

The Evolution of Psychological Distress Levels in University Students in Spain during Different Stages of the COVID-19 Pandemic: Risk and Protective Factors

The present study assesses the evolution of stressful events and psychological distress in male and female students over three different time periods of the COVID-19 pandemic in Spain: the initial "lockdown", with no face-to-face teaching; the "new normality" period, when classes were resumed; and two years after the first wave of the pandemic. The participants were 1200 Spanish university students who were assessed for psychological distress, COVID-19-associated stressful events, social support, and self-esteem. Female students reported more stressful events and higher levels of psychological distress than male students during the "lockdown" and "new normality" time periods of the first wave of the pandemic. However, these differences disappeared in the third period tested, two years after the first wave of the pandemic, with female and male students showing no differences in psychological distress or in the number of stressful events. The main risk predictors of psychological distress during the first wave of the pandemic were lower self-esteem and having suffered a high number of stressful events. The last variable, number of stressful events associated with COVID-19, lost most its effect two years later, when only self-esteem presented a strong and highly significant predictive role.

Gender, life events, and mental well-being in emerging adulthood

BACKGROUND

Emerging adulthood is a critical period of life involving many life transitions that may generate stress and compromise health and mental well-being.

AIMS

To know the most frequent life events of women and men in emerging adulthood, analyzing also the relevance that such stressors have on their psychological well-being and life satisfaction. A second aim is to determine the relevance of age, educational level, most frequent life events, coping styles, and perceived social support as risk and protective factors for well-being.

METHOD

The sample consisted of 2,000 individuals from the general Spanish population (55% women), aged between 18 and 29, who were assessed using five questionnaires and scales measuring life events, coping styles, life satisfaction, psychological well-being, and social support.

RESULTS

The findings showed that 90% of the sample had experienced one or more life events during the previous year and that a higher number of life events experienced over the past year was associated with lower mental well-being. Multiple regression analyses made clear that, although some events experienced in the previous year (namely, family conflicts and change in the relationship with parents) were associated with lower women's and men's well-being, the most important determinants of well-being in either gender were coping styles; however, some predictors of women's well-being proved different from those of men. In the case of women, family and intimate partner conflicts predicted lower life satisfaction and psychological well-being was lower in the case of family conflicts. As for men, work or academic life events predicted lower life satisfaction.

CONCLUSION

These research findings are relevant for the design of programs and strategies to improve mental well-being in emerging adulthood.

Factors Associated with Depression, Anxiety, and Somatic Symptoms among International Salespeople in the Medical Device Industry: A Cross-Sectional Study in China

BACKGROUND

The physical and mental health of corporate employees is equally important, especially for international salespeople in the in vitro diagnostic (IVD) medical device industry. The rapid growth of the IVD market is driven by the increasing prevalence of chronic and infectious diseases. This study aims to determine the prevalence of depression, anxiety, and somatic symptoms among international salespeople in China's IVD industry and identify the association of socio-demographic, occupational, organizational, and psychosocial factors with mental health outcomes for depression, anxiety, and somatic symptoms in Chinese IVD international salespeople.

METHODS

The study was a cross-sectional survey of international salespeople (ISs) in IVD companies officially registered in China. An online survey was designed to collect data through email contact with IVD companies and social media between August 2022 and March 2023. Measured factors included effort-reward imbalance (ERI), health-promoting leadership (HPL), health climate (HC), inner strength (IS), and perceived social support (PSS). Mental health outcomes assessed using the Core Symptom Index (CSI) were depression, anxiety, and somatic symptoms.

RESULTS

A total of 244 salespeople responded to the survey. CSI scores indicated that 18.4% (n = 45) and 10.2% (n = 25) of the respondents had symptoms of major depression and anxiety, respectively. ERI was positively correlated, while the IS and PSS were negatively correlated with major depression, anxiety, and somatic symptoms (p < 0.01). The health climate was negatively correlated with major depression (p < 0.05). Education background was associated with somatic symptoms (p < 0.05). ERI, IS, and gender were significant predictors of major depression, anxiety, and somatic symptoms (p < 0.05).

CONCLUSION

The prevalence of depression and anxiety in China's IVD international salespeople was considered low compared with the prevalence in Chinese populations during COVID-19 but higher than those before the pandemic. Effort-reward imbalance, inner strength, and gender were significant factors in major depression, anxiety, and somatic symptoms among IVD international salespeople.

Constructing and Verifying an Alexithymia Risk-Prediction Model for Older Adults with Chronic Diseases Living in Nursing Homes: A Cross-Sectional Study in China

Alexithymia is a critical global public health concern. This questionnaire-based cross-sectional study explored the risk factors of alexithymia in older adults living in nursing homes with chronic diseases. It also developed and evaluated an alexithymia risk-prediction model. A total of 203 older adults with chronic diseases were selected from seven nursing homes in Changsha, China, using simple random and cluster sampling. The participants were surveyed using the Toronto Alexithymia Scale (TAS-20), Geriatric Depression Scale-15 (GDS-15), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and a socio-demographic characteristics questionnaire. The alexithymia total score was 43.85 ± 9.570, with an incidence rate of 8.9%. Alexithymia had a partial mediating effect on the relationship between social support and psychological resilience (the effect value was 0.12), accounting for 19.04% of the total effect. Gender, depression, and psychological resilience were the main independent influencing factors of alexithymia (p < 0.05). The area under the receiver operating characteristic (AUC-ROC) curve of the risk-prediction model was 0.770. The participants, especially those who were male and depressed, exhibited a certain degree of alexithymia. Additionally, it partially mediated the association between social support and psychological resilience, which is a protective factor against alexithymia. The risk-prediction model showed good accuracy and discrimination. Hence, it can be used for preliminary screening of alexithymia in older adults with chronic diseases living in nursing homes.

The Impact of Resilience, Alexithymia and Subjectively Perceived Helplessness of Myocardial Infarction on the Risk of Posttraumatic Stress

The aim of this study was to investigate the impact of resilience, alexithymia and the subjectively perceived severity (fear of death, pain intensity, helplessness) of myocardial infarction (MI) on posttraumatic symptom severity (PTSS) after MI. Patients were assessed with the Posttraumatic Diagnostic Scale (PDS), Resilience Scale (RS-11) and Toronto Alexithymia Scale (TAS-20). Subjectively perceived severity of MI was measured with three items on a 10-point Likert scale. To test our hypothesis, we applied Pearson correlations as well as multiple hierarchical linear regression analyses. A higher resilience score was significantly associated with lower (r =  - .39, p < .001) PTSS. Higher scores of alexithymia (r = .38, p < .01) and subjectively perceived helplessness (r = .42, p < .001) were associated with higher PTSS. Multiple hierarchical linear regression analyses revealed that resilience, the TAS-20 subscale difficulty identifying feelings (DIF) and especially subjectively perceived helplessness were independent significant predictors for the PTSS, adjusted R² = .29, F(5, 102) = 9.57, p < .001. Our results suggest that resilience reduces the PTSS whereas alexithymia and subjectively perceived helplessness increase the risk. Especially the subjectively perceived helplessness explains a high degree of variance of PTSS and should be assessed to hindering further mental health burden.

The Relationship Between Alexithymia and Mobile Phone Addiction Among Mainland Chinese Students: A Meta-Analysis

Alexithymia and mobile phone addiction are common phenomena in daily life. Many studies have explored the internal relationship between them based on different theoretical perspectives, but the extent of the exact correlation is still controversial. To address this controversy and clarify the reasons for the divergence, a meta-analysis of 26 articles comprising 23,387 Chinese students was conducted. The results show that alexithymia was highly positively correlated with mobile phone addiction (r = 0.41, 95% CI = [0.37, 0.45]). Furthermore, the relationship was moderated by mobile phone addiction measurement tool and year of publication, with studies using the Mobile Phone Addiction Tendency Scale (MPATS) having higher correlation coefficients than those using the Mobile Phone Addiction Index (MPAI) or other measurement tools. Studies published in 2020-2021 yielded higher correlations than those published in 2014-2016 and 2017-2019. However, the relationship was not moderated by gender, region, or measures of alexithymia. Therefore, our meta-analysis of available published data indicated that alexithymia and mobile phone addiction in Chinese students are not only highly positively correlated but also affected by mobile phone addiction measurement tools and publication year. Longitudinal studies or experimental studies should be strengthened in the future to further establish the direction(s) of causality for the relation between alexithymia and mobile phone addiction.

Family Functioning and Multiple Sclerosis: Study Protocol of a Multicentric Italian Project

Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease, which not only affects physical functioning, but is also associated with cognitive impairments and great psychological distress. The combination of those symptoms may have negative consequences on the family functioning of patients with MS, with detrimental effects on both marital relationships and parental bonding. Furthermore, the presence of individual characteristics and of an adequate social support may also contribute to the quality and endurance of family relationships. Particularly, high levels of alexithymia, a personality trait that affects the recognition of a person's own emotions, have been associated with reduced interpersonal communication skills and enhanced anxiety/depressive symptoms. Therefore, the main aim of the present study is to provide an in-depth evaluation of family functioning and related factors in patients with MS and their families. In order to reach this goal, the perceived quality of family functioning, dyadic relationships, and parental bonding will be first investigated. Secondly, the possible associations between the quality of family relationships and the presence of alexithymia, psychological distress, and perceived social support will be examined. Patients with MS and their families who will consent to take part in the study will be asked to provide sociodemographic and clinical information, and to complete a series of questionnaires, presented and uploaded on an online dedicated platform. The final sample will be made up of 300 families, consecutively recruited from the Italian medical centers involved in the project. The results of the present study will shed light on the family functioning of patients with MS, through a comprehensive assessment of the main factors that are associated with family dynamics. A holistic evaluation of those aspects can help clinicians and researchers understand family dynamics in MS population better.

Stress and Psychological Distress in Emerging Adulthood: A Gender Analysis

Emerging adulthood is a critical period of life that entails many life transitions in living arrangements, relationships, education and employment, which can generate stress and psychological distress in the emerging adult. The aim of the present study was to assess the relevance of stress, coping styles, self-esteem and perceived social support in the distress of emerging adult women and men. The sample consists of 4816 people (50% females) from the Spanish general population, ranging in age from 18 to 29 years old. All participants were assessed through questionnaires and scales that assess psychological distress, stress, coping styles, self-esteem and social support. Women scored higher than men in psychological distress, chronic stress, minor daily hassles, emotional coping style and social support, whereas men scored higher than women in rational and detachment coping styles and in self-esteem. Psychological distress was significantly predicted in women and men by high emotional coping style, lower self-esteem, high number of life events, and less social support. Another statistically significant predictor in men was less detachment coping style, whereas in women it was high chronic stress. The results of this research are relevant to healthcare professionals interested in improving the mental health of the emerging adult.

Masculine/Instrumental and Feminine/Expressive Traits and Health, Well-Being, and Psychological Distress in Spanish Men

Many studies have explored the relationship between masculine norms and men's health outcomes. There are few recent studies published on the relationship between masculine/instrumental and feminine/expressive traits and men's health and well-being. The current cross-sectional study examines whether masculine/instrumental and feminine/expressive traits are associated to men's health and well-being. Participants were 1,870 Spanish men, aged 21 to 64 years. Results from hierarchical multiple regression analysis indicated that the masculine/instrumental trait and the feminine/expressive trait were positively related to men's psychological well-being and self-rated health, so that men whose self-concept includes both masculine/instrumental and feminine/expressive characteristics presented greater psychological well-being and better self-rated health. The feminine/expressive trait was associated with lower psychological distress yet only in case of men with low social support. Self-esteem and social support were important predictors of men's health, in such a way that men who had high self-esteem and social support reported higher ratings of psychological well-being, better self-rated health, and less psychological distress. The implications of these findings for promoting men's health and well-being are discussed.

Alexithymia as a possible specifier of adverse outcomes: Clinical correlates in euthymic unipolar individuals

BACKGROUND

Alexithymia is a disabling condition frequently linked to major depressive disorder (MDD) and able to enhance symptoms severity and suicide risk. This study aimed to clarify whether patients with and without alexithymia may differ concerning illness presentation and clinical course, which is a major gap in the scientific literature.

METHODS

The present sample included 381 euthymic outpatients with MDD recruited at the Department of Neuroscience (DINOGMI), University of Genoa. The Toronto Alexithymia Scale (TAS-20) and additional rating scales (Clinical Global Impression (CGI), Hamilton Anxiety Rating Scale (HAM-A), Intent Score Scale (ISS) were administered to all participants.

RESULTS

Alexithymic patients were more likely to have lower educational level (11.6 ± 3.2 vs. 12.4 ± 3.4, p ≤ .05), have used previous psychiatric drugs (85.7% vs. 72.8%, p =.001), use current antidepressants (84.7% vs. 69.4%, p = <.001), and have higher cardiological comorbid disorders (10.7% vs. 5.0%, p = ≤.05). After multivariate analyses, alexithymia was associated with lower educational level (OR=0.928, p = .05), and higher current antidepressants use (OR 2.302, p = .01); difficulties in identifying feelings were associated with lower educational level (p = ≤.005), higher psychiatric comorbidity (p = ≤.001), and previous psychiatric medications (p = .01). Furthermore, having a lower educational level remained the only factor associated with both difficulties in communicating feelings (p = ≤.001) and thoughts oriented to external context (p = ≤.005).

LIMITATIONS

The study is limited by the small sample size and its cross-sectional nature.

CONCLUSIONS

Alexithymia appears a useful specifier of adverse outcomes, associated with distinct socio-demographic and clinical characteristics. Its identification would allow to provide a more personalized care.

Stressors, psychological distress, and mental health problems amongst Brazilian medical students

In line with studies from around the world, several studies have shown equal or higher rates of anxiety, depression, alcohol and other drug use, and burnout in medical students in Brazil. The aim of the present study was to identify difficulties Brazilian medical students face regarding stressors, psychological distress, and psychiatric morbidity using standardized reliable and valid instruments. In addition, this study also investigated differences associated with sex. Students (n = 129) were asked to complete a one-off survey from January to June 2019, including demographics, previous mental health issues, CAGE, GHQ-12, and OLBI. A higher prevalence of previous mental disorders was found in comparison to during the medical course. This may suggest that perhaps students are under more stress or that they form a more vulnerable sub-population in medical school in comparison with the general population. However, the types of mental disorders before and during the undergraduate course appear to vary. During the course, they show higher levels of anxiety rather than that of depression. Before commencing the course, they showed higher levels of depression rather than anxiety. Cannabis and ecstasy experimentation levels were higher than those of students from other courses in previous studies. The opposite was true for stimulants. Just over a quarter reported alcohol abuse above the CAGE cut-off point. The levels of psychological distress and burnout were extremely high, and women had even higher levels. Male respondents were more likely to have a history of mental ill-health, but female subjects scored higher on burnout. Overall over 80% students reported burnout. These findings are discussed in the context of Brazilian culture.

Relevance of Gender and Social Support in Self-Rated Health and Life Satisfaction in Elderly Spanish People

Background: Gender and social support are important social determinants of health, but the relevance of such variables in older people’s health has raised less scholarly attention than in younger age groups. This study examines the relevance of gender and social support in the self-rated health and life satisfaction of elderly Spanish people. A cross-sectional study with a sample of 702 men and 754 women aged between 60 and 94 years was conducted. All participants were evaluated through questionnaires that assess gender role traits, social support, and life satisfaction. Results: Men scored higher than women in masculine/instrumental trait and in life satisfaction whereas women scored higher than men in feminine/expressive trait. Results from multiple regression analyses indicated that women and men presenting higher social support had better self-rated health and higher life satisfaction. High scores in masculine/instrumental trait also proved to be an important predictor of men’s and women’s high life satisfaction and of women’s better self-rated health, whereas the high feminine/expressive trait predicted better self-rated health in the men group. A high educational level was associated in the women’s group with better self-rated health and higher life satisfaction. Conclusions: We conclude that gender and social support are important social determinants of health among older people.