The development and psychometric evaluation of the Brief Resilient Coping Scale

Wearing face masks when no longer mandatory: An exploratory study about attitudinal and psychological health factors in a large Italian sample

Throughout the Covid-19 pandemic, face masks emerged as a critical tool to control the virus transmission. While previous studies have investigated the positive and negative attitudes towards the use of face masks when mandatory, our study looks at a different phase: the era of discretionary mask use. Our investigation reached Italian participants (1151), aged 18-64, who underwent an online survey. The study explored the associations between demographic, attitudinal, psychological, and emotional factors that may be involved in the behaviour of wearing a face mask. Then, by using generalized mixed effects models, we explored the predictive role of those factors selected via backward elimination starting from a full model and selecting the model with the best goodness of fit balanced with complexity, and higher explained variance. Specifically, our exploratory study expected that emotional experience aroused by wearing a face mask, negative affectivity, Covid-19-related fear, and anxiety might be significant predictors of face mask wearing. However, only the emotional experience of feeling a sense of care and protected while wearing a face mask, and Covid-19-related fear were significant predictors of face mask-use. We discussed the importance of considering attitudes involved in compliance with healthy behaviours to guide future health interventions.

Psychological indicators for healthy aging: validation of the German short version of Ryff's scales of psychological well-being (SPWB)

BACKGROUND

The important roles of well-being as realization of one's true potential for healthy aging have been highlighted by literature of the recent decades. The Scales of Psychological Well-being (SPWB) are an internationally recognized measurement tool for psychological well-being. Yet, sound validation of the German SPWB 18-item version has been lacking to date. Therefore, the present study aims to (1) test the psychometric properties of the German SPWB 18-item version in terms of factorial validity and (2) determine construct validity by investigating its correlations with psychosocial variables, mental and physical health. (3) Sociodemographic characteristics of the SPWB in a middle to old age German population was explored.

METHODOLOGY

Data of N = 3,374 participants 45-85 years old of the 10-year follow-up (2017-2022) of the Gutenberg Health Study (GHS) were analyzed. Descriptive analyses and inference statistical analyses were performed to assess construct validity. In order to determine the psychometric properties, item characteristics and reliability coefficients were analyzed. Confirmatory factor analyses tested the proposed theoretical factorial structure.

RESULTS

Construct validity of the SPWB was established with respect to sociodemographic, psychosocial (social support and resilient coping), and health variables (sleeping problems, depression and anxiety symptoms, stress, loneliness, and somatic diseases). Analysis of the psychometric properties of the German SPWB 18-item version rendered support for the theoretically proposed multidimensional structure of psychological well-being in our sample rather than a one factorial structure. Bi-factor models that take the method effects of positively and negatively formulated items into account are highly recommended.

CONCLUSIONS

The German SPWB 18-item version shows comparable psychometric properties to previous large-scale studies from other countries. The SPWB provides psychological indicators for healthy aging.

The Moderation Effect of Resilience on the Relationship Between PTSD, Depression, and Life Satisfaction Among On-Duty Healthcare Professionals in Gaza

Psychological suffering of healthcare professionals, during War times, is ignored in literature. While struggling to provide ultimate care, HCP need support and psychological counseling. The purpose of this study was to examine the moderation effect of resilience on the relationship between life satisfaction, depression, and PTSD controlling for the sociodemographic and personal characteristics among on-duty healthcare professionals in Gaza. A convenience sample of 150 on-duty healthcare professionals filled out an online survey. The sample targeted a convenience sample of HCWs who are currently on duty in Gaza. Data collected regrading satisfaction with life, PTSD, depression, and resilience. Data collected from August to end of Sept 2024. Of the sample, 94.7% (n = 146) met criteria of PTSD, 85.3% (n = 128) reported a severe form of depression, 59.3% (n = 89) have a low level of resilience, and 74.7% (n = 112) reported that they are dissatisfied with their life. The analysis showed that resilience has no significant moderation effect on the relationship between psychological factors and PTSD controlling for demographic and personal characteristics as the R2 change of 0.011 in the model was not statistically significant (p = 0.09). Years of experience, age and having mental illness were significant risk factors to develop PTSD. There is a need to provide an urgent psychological counselling to healthcare professionals in Gaza. Online and face-to-face help groups and peer to peer support need to be established.

Dance-like state detection, curiosity, and decentering: A pilot study on artful movement and mindfulness

BACKGROUND

Curiosity and decentering are two constructs that represent momentary mindfulness. Dance is an art and complex physical activity mode, which may serve as a behavioral correlate of mindfulness.

OBJECTIVE

To characterize momentary mindfulness in relation to a novel, accelerometer-derived measure for characterizing human movement quality (i.e. "dance-like state" DLS scores).

METHODS

Adults (N = 41), ages 18-83 years old, engaged in the following conditions in a lab and completed questionnaires on mindfulness after each: (1) clipping their fingernails; (2) sitting, standing, and walking on a treadmill; and (3) dancing at self-determined reference intensities with and without music. Conditions 2-3 were monitored with accelerometers. DLS score summary statistics (i.e. median and median amplitude deviation [MAD]) were used in linear mixed effects models.

RESULTS

On average, curiosity [13.7(1.02)] was significantly associated with median DLS scores (β = 1.79, p = 0.007) over time; adults with a lower median DLS score reported higher levels of curiosity [16.2; 95%C.I. 13.3-19.0], on average, when compared [12.6; 95%C.I., 10.3-14.9] to adults with a higher median DLS score. On average, decentering [14.9(1.01)] was significantly associated with the DLS score MAD (β = 1.28, p = 0.035) over time; adults who had less variability in DLS scores across conditions reported greater experiences of decentering [15.9; 95%C.I. 13.7-18.1], on average, when compared [13.3; 95%C.I. 10.7-15.9] to adults with more variability in DLS scores across conditions.

CONCLUSIONS

Among ostensibly healthy adults, movement quality was correlated with momentary mindfulness. Additional research is needed to understand if DLS scores are differentially associated with momentary mindfulness among adults with Alzheimer's disease.

How does playfulness (re)frame the world? Evidence for selective cognitive and behavioral redirecting in times of adversity

Introduction

Do playful people perceive, approach, and respond to their environment and life events differently than less playful individuals? While playfulness has been theorized to affect how individuals frame or reframe situations, this widely accepted premise lacks theoretical specification and empirical validation. This study examined playfulness as a perceptual lens and its potential broader (re)framing effects spanning cognition, emotion, and behavior in the disruptive pandemic context.

Methods

Two groups with contrasting levels of playfulness (high vs. low as measured by the Adult Playfulness Trait Scale) were derived from a nationwide US adult sample (n = 503) and compared across 19 criterion variables representing diverse perceptual, emotional, and behavioral responses during COVID-19. Sequential analyses including MANOVA, ANOVA, and ANCOVA were performed to examine overall, univariate, and adjusted group differences, respectively, validated by sensitivity analysis across three group categorization methods.

Results

Three sets of contrasting findings evidenced selective playful (re)framing effects, wherein more playful individuals (1) shared similar perceptions of current risk and protective factors while adopting a more optimistic future outlook, (2) perceived similar levels of vulnerability and isolation but engaged in significantly higher levels of resilient coping and adaptive leisure, and (3) participated in similar categories and frequencies of leisure activities but with higher experiential quality, marked by greater immersion, activeness, and positive affect.

Discussion

Playfulness functions as a "color spotlight" rather than "rose-tinted glasses," with selective influence through "lemonading"-creatively imagining and pursuing positive possibilities to cultivate adaptive, enjoyable experiences while maintaining a clear-eyed realism about challenges. This advances a nuanced understanding of playful (re)framing as operating primarily through intrinsic goal-oriented cognitive and behavioral redirecting, underscoring playfulness' potential as an integrative resilience factor, experiential quality amplifier, and character strength for promoting individual flourishing.

Resilience-based interventions in the public sector workplace: a systematic review

BACKGROUND

Previous studies have advocated the benefits of resilience-based interventions for creating a healthy and sustainable workforce. However, resilience is defined and measured in diverse ways. Therefore, the aim of this systematic review is (1) to identify how resilience is defined within different workplace interventions, translated into intervention content, and measured in these interventions; and (2) to synthesize the effectiveness of these interventions.

METHODS

A systematic literature search was conducted and included articles from 2013 - 2023. Twenty-four studies met the inclusion criteria, covering a total of 26 unique interventions. Definitions were categorized as: resilience as a trait, process, or outcome. Cohen's D was calculated to depict the effect sizes within the intervention groups from pre-test to post-test and, when possible, from pre-test to 3-month follow-up.

RESULTS

Included studies applied a wide range of definitions; most definitions fitted within the trait-orientation, conceptualizing resilience as an individual characteristic or ability, or the process-orientation, conceptualizing resilience as a dynamic process. No studies solely used the outcome-orientation, but some did combine elements of all three orientations. Various definitions, measures and intervention strategies were applied, however, almost half of the studies (46%) showed inconsistencies within these choices. Furthermore, findings show that most resilience-based interventions in the workplace have a positive impact. While educational workshops with a higher frequency and duration had medium to large effects, solely digital interventions had small effects, changing to small to medium when combined with non-digital elements.

CONCLUSIONS

Findings suggest that resilience-based can benefit employees by enhancing their psychological well-being. This, in turn, can lead to improved work-related outcomes such as productivity, thereby offering advantages to employers as well. This underscores the growing recognition that resilience should be viewed as a shared responsibility between the individual and the organization. Further advancement in the field of resilience-based interventions in the workplace calls for future research to focus on maintaining consistency when choosing a definition of resilience, developing intervention content, and choosing an outcome measure.

PREREGISTRATION

The search protocol was preregistered in the Open Science Framework, see Hollaar et al. (2023). https://doi.org/10.17605/OSF.IO/UKYF7 .

[Role and function of social support in family post-caregivers of dependent persons]

INTRODUCTION AND OBJECTIVE

Social support appears to have a positive impact on the mental health and well-being of post-caregivers. Therefore, the aim of this paper is to examine the perceived social support network and its role in post-caregiving.

MATERIALS AND METHODS

56 family post-caregivers of older people participated in a semi-structured interview. In addition, the Social Support Questionnaire -MOS- and qualitative measures were applied. Descriptive analyses of the relationship between variables were carried out. At the qualitative level, we worked with a phenomenological design using the NVIVO program. Finally, data were triangulated using the mixed concurrent triangulation design methodology (DITRIAC).

RESULTS

Post-care adjustment was positively associated with the dimensions of the perceived social support scale. The network of friends was found to be supportive during the loss, generating spaces for leisure and recreation that allowed post-caregivers to resume their social life. The family unit can move closer or further away. Children played a role of support and companionship for the post-caregivers and are also a source of motivation to cope and adapt to the loss of the cared-for relative. Participants emph asised the need to feel listened to and welcomed. 64.3% of participants referred to not having received psychological care.

CONCLUSIONS

It is essential to carry out interventions that favor the development and maintenance of the family caregiver.

Participation as a Pillar of Active Ageing: The Role of Eudaimonic Psychological and Health Factors

Background/Objectives: With ageing population projections, promoting positive ageing trajectories is critical. While health is often emphasised, eudaimonic psychological factors remain underexamined. A qualitative study presented throughout the main text highlighted the importance of psychological factors like purpose in life and resilience in fostering participation and subjective well-being, even amidst declining health. This model bridges the most recent updates from governmental organisations-the International Longevity Center, Brazil and the World Health Organization. Building on this model, the current research seeks to empirically assess the impact of health and eudaimonic psychological factors on the frequency and satisfaction of participation among older adults. Methods: This study involved 289 participants (56.74% women) aged 65+ in Madrid. Data on participation, self-perceived health, and eudaimonic factors were collected through an online survey. Hierarchical regression and cluster analyses explored the predictors and profiles of participation. Results: Resilience, positive relationships, and autonomy explained 8.8% of variance in participation frequency. Satisfaction was influenced by health, meaning in life, and autonomy, accounting for 11% of variance. Profiles showed the highest participation and satisfaction in individuals with high eudaimonic scores, despite moderate health. Conclusions: Eudaimonic factors significantly influence participation and mitigate health limitations, reinforcing the qualitative study model mentioned. By uniting updates from governmental organisations proposals, this model underscores the role of psychological well-being in active ageing. Future research should explore hedonic well-being as a key outcome of active ageing.

COping with Rheumatic Stressors (CORS) questionnaire: validated German translation and cross-cultural adaptation for patients with axSpA

BACKGROUND

Patients with Rheumatic and Musculoskeletal Diseases, including axial spondyloarthritis (axSpA), may suffer from stressors like pain and functional impairments leading to limitations in their self-perceived health status. The COping with Rheumatic Stressors (CORS) questionnaire was developed to analyze how patients cope with these stressors. The CORS is currently not available in German.

OBJECTIVE

First, to translate, cross-culturally adapt and to linguistically validate the original Dutch CORS into German. Second, to test the pre-final German translation through cognitive debriefing in patients with axSpA.

METHODOLOGY

The original Dutch CORS underwent a multistep cross-cultural adaptation process, as described by Beaton. It was first independently translated into German by bilingual Dutch-German lay and expert translators. Subsequently, it was translated back from the German version into Dutch. Remaining discrepancies were resolved by a scientific committee, resulting in a pre-final German version. This version was then tested through cognitive debriefing by 10 patients with axSpA across a broad spectrum of sociodemographic backgrounds.

RESULTS

Forward and backward translations of the CORS revealed minor discrepancies, mainly based on the degree of formal versus informal language usage, minor semantic errors or unusual syntax, which led to minor modifications in the wording. Reviewed by the scientific committee, the pre-final consensus German version was linguistically validated by cognitive debriefing by 10 patients with axSpA. Cognitive debriefing confirmed and ensured closest linguistic validity for German in Germany and highest equivalence to the Dutch original version.

CONCLUSION

The German CORS was shown to have high cross-cultural and face validity for the assessment of coping with rheumatic stressors.

Negative effects of adverse childhood experiences and absence of positive childhood experiences on healthcare employees: survey findings built on 10 years of trauma-informed development

Introduction

Existing data on how history of trauma and adversity affects healthcare professionals is limited. This study sought to describe the prevalence of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) and their association with present-day workplace and wellbeing outcomes among a sample of healthcare teammates overall, as well as specifically among nurses. The paper also describes local trauma-informed care initiatives that supported study feasibility.

Methods

Cross-sectional online survey data were collected in conjunction with promoting hospital-wide trauma-informed care training opportunities on two campuses that are part of an academic health system. Scales and items assessed independent variables PCEs and ACEs, and dependent variables including burnout, compassion fatigue, organizational belonging, adult resilience, access to support, and workplace violence (WPV). Demographic data were not collected to limit identifiability and encourage participation. Multivariable, hierarchical models regressed categorized total ACEs (ref 0, 1-3, 4-10) and total PCEs (ref 6-7, 3-5, 0-2) together on dichotomized dependent variables. Sub-analyses also adjusted for whether the participant was a nurse or reported serving in a different role.

Results

Participants included 349 clinical and non-clinical employees, of whom 61.1% had at least one reported ACE, but 24.9% reported 4-10 ACEs. 29.9% reported only having 3-5 PCEs in their childhood, while 23.2% reported 0-2 positive childhood experiences. Even when adjusting for ACEs, having 0-2 PCEs was associated with significantly reduced odds of getting needed emotional or social support (AOR = 0.14, 95% CI: 0.07, 0.29). Having 0-2 PCEs relative to 6-7 PCEs was also significantly associated with greater odds of past 2-week compassion fatigue, a lower resilience score, and decreased odds of reported organizational belonging measures. Adjusting for ACEs and PCEs, nurses reported lower resilience and higher workplace violence compared to all other participant roles combined.

Discussion

Teammate history of adversity was widespread and having fewer PCEs was associated with poorer adult workplace outcomes. These findings point to the value of a trauma-informed approach in healthcare, which offers healthcare organizations a framework for recognizing how trauma experiences affect wellbeing and intersect with the healthcare system, as well as how to create environments that are supportive of patients, staff, and providers.

"Infertility frightened me": Violence among infertile couples in Jordan

BACKGROUND

Women in couples experiencing infertility are at heightened risk for intimate partner violence (IPV) from husbands and domestic violence (DV) from family. Couples experiencing infertility in Jordan, a patriarchal culture with high rates of IPV and DV, are particularly vulnerable. This article explores the gendered similarities and differences in the experiences of mental health, social support, exclusion, and IPV.

OBJECTIVES

The objectives of this study are to understand both men and women's perspectives on their experiences of infertility and to develop intervention strategies to reduce IPV among married couples experiencing infertility.

DESIGN

This study is a descriptive, observational study.

METHODS

Through quantitative surveys and in-depth qualitative interviews, we examined key themes including: challenges to mental health and well-being; reproductive health and fertility care-seeking; experiences of shame, isolation, and discrimination; coping skills; sources of support; and challenges within spousal and family relationships.

RESULTS

In this article, we analyze primary areas of gender discordance and discuss how gendered experiences can shape implementation of psychosocial support intervention programs to prevent IPV. Our findings provide important insight into facilitators and barriers to prevention of IPV in this vulnerable group.

CONCLUSION

We conclude that providing both women and men with culturally appropriate support during fertility treatment-seeking can improve psychosocial health and couple functioning and ultimately to reduce the occurrence of IPV in this vulnerable population.

Evaluating the Impact of Coaching Through the Transition to Residency

BACKGROUND

Coaching has been proposed to support the transition to residency. Clarifying its impact will help define its value and best use.

OBJECTIVE

To explore the experiences of residents working with coaches through the residency transition.

DESIGN

A cohort comparison survey compared experiences of a coached resident cohort with coaches to the prior, uncoached cohort.

PARTICIPANTS

Post-graduate year (PGY)-2 residents in internal medicine, obstetrics and gynecology, emergency medicine, and pathology at a single academic center.

INTERVENTIONS

Faculty trained as coaches had semi-structured meetings with graduating medical students and residents throughout the PGY-1 year.

MAIN MEASURES

An online anonymous survey assessed effects of coaching on measures of self-directed learning, professional development, program support and impact of coaching using existing scales (2-item Maslach Burnout Inventory, Brief Resilient Coping Scale, 2-item Connor-Davidson Resilience Scale, Stanford Professional Fulfillment Inventory), and novel measures adapted for this survey. Bivariate analyses (t-tests and chi-square tests) compared cohort responses. MANOVA assessed the effects of coaching, burnout and their interactions on the survey domains.

KEY RESULTS

Of 156 PGY2 residents, 86 (55%) completed the survey. More residents in the "un-coached" cohort reported burnout (69%) than the "coached" cohort (51%). Burnout was significantly and negatively associated (F = 3.97 (df 7, 75); p < .001) with the learning and professional development outcomes, while being coached was significantly and positively associated with those outcomes (F = 5.54 (df 9, 75); p < .001). Significant interaction effects were found for goal-setting attitudes, professional fulfillment, and perceived program career support such that the positive differences in these outcomes between coached and un-coached residents were greater among burned out residents. Coached residents reported a positive impact of coaching across many domains.

CONCLUSIONS

Residents experiencing coaching reported better professional fulfillment and development outcomes, with more pronounced differences in trainees experiencing burnout. Coaching is a promising tool to support a fraught professional transition.

Third-Wave CBT Online Intervention for Older Adults Inspired by ACT Principles: An Evaluation of Feasibility and Preliminary Effectiveness in Adults Age 75 and Older

OBJECTIVES

This study assessed the feasibility and efficacy of "Online Resilience," a three-lesson online intervention based on third-wave cognitive behavioral therapy (CBT) principles, inspired by acceptance and commitment therapy (ACT), designed for emotionally healthy adults aged 75 and older.

METHODS

A randomized controlled study with 62 participants (mean age = 81) divided into Experimental and Control groups. Outcomes included resilience, well-being, mood, and sleep quality, measured pre-, post-, and at one-month follow-up.

RESULTS

The intervention showed feasibility among emotionally healthy older adults with higher baseline resilience and well-being, with attrition rates comparable to similar programs. Resilience improvements were significant post-intervention but diminished by follow-up. Sleep quality improved significantly at follow-up, though control group data was unavailable for comparison. Mood stability was maintained in the intervention group while declining in controls.

CONCLUSION

"Online Resilience" shows promise for promoting resilience, mood stability, and sleep quality in older adults, though limited long-term effects and high attrition warrant program refinements.

CLINICAL IMPLICATIONS

Brief, self-guided online interventions like this can enhance access to mental health support for older adults, serving as cost-effective preventive tools. However, future programs should address attrition and target individuals with varying baseline psychological resources.

A longitudinal study of healthcare workers' mental health during Western Australia's unique policy response to COVID-19

BACKGROUND

Western Australia's response to the COVID-19 pandemic was swift and effective in implementing public health protections and preventing the spread of the virus for the first 2 years. However, healthcare staff continued to be at increased risk of mental health concerns.

AIMS

To investigate the longitudinal patterns of post-traumatic stress symptoms (PTSS), depression and anxiety among healthcare workers in Western Australia, and the risk and protective factors associated with changes in status during the first wave.

METHOD

Participants comprised 183 healthcare staff working at tertiary hospitals and major clinics across Perth, for whom longitudinal data were available. Questionnaire data were collected before Western Australia's first major COVID-19 community wave in early 2022 and following the first wave in late 2022. Online surveys comprised validated measures assessing psychological symptoms, risk and protective factors, and original measures of workplace factors.

RESULTS

Overall rates of PTSS, depression and anxiety remained stable across the two assessment points. However, latent growth models revealed that those with lower PTSS, depression or anxiety symptoms at baseline reported a larger increase in symptoms over time, and those with higher symptoms at baseline had a smaller decline over time, indicating a 'catch-up' effect. Workplace stressors, sleep difficulties and trauma exposure were key risk factors for changes in psychological symptoms from baseline, and workplace and social supports played protective roles.

CONCLUSIONS

Improvements in systemic workplace factors are needed to support healthcare workers' mental health during periods of acute stress, even in settings with high levels of emergency preparedness.

Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK

OBJECTIVE

Recent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors.

METHODS

Staff approached age 18-24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021-5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats).

RESULTS

Across sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %-16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault.

CONCLUSIONS

Violence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.

Are In-the-Moment Resilience Processes Predicted by Questionnaire-Based Measures of Resilience?

Research on resilience is a growing field, and resilience has been conceptualized and operationalized in multiple ways. The aim of this study was to compare the Brief Resilient Coping Scale (BRCS), a conventional measure of resilience, with within-person process indicators derived from experience sampling method (ESM). A sample of 177 teachers from southern Finland participated in the study, commencing with a startup session followed by an 8-day ESM period. Through twice-daily prompts, participants reported their immediate positive and negative affect as well as recent stressors encountered, such as workload and challenging social interactions. As expected, within-person variation in affect was predicted by stressors. However, contrary to expectations, individual differences in affective reactivity to stressors were not predicted by BRCS (βpositive affect [95% CI] = -.20, [-.51, .11]; βnegative affect = .33, [-.07, .69]). Item response theory analyses of the BRCS revealed problems with precision. The results call into question the validity of measuring resilience using single administrations of retrospective self-report questionnaires such as the BRCS.

Measurement of Psychological Resilience to Support Therapy Interventions for Clients in the Clinical Mental Healthcare Setting: A Scoping Review

Waves of psychological research over 50 years have resulted in the development of scales to measure psychological resilience. Multiple psychological resilience definitions and factors have emerged during this time, making its measurement complex. The overall aim of the review was to identify and describe developments in the measurement of psychological resilience in the clinical mental healthcare setting. Specific objectives included (1) consideration of the validity and reliability of psychological resilience scales, (2) the effectiveness of the scales in clinical mental healthcare settings and (3) to identify the scope that resilience factors are addressed in the included scales. It provides a timely update regarding psychological resilience measurement tools and considers further developments that may be required. Between 2011 and 2024, databases were searched, and English-language, peer-reviewed papers with full text were extracted. Eligible studies were those reporting validated existing resilience measures or the outcomes of new measures for use in clinical mental healthcare settings. Seventeen studies met the inclusion criteria. The review demonstrated that psychological resilience measures require further development, particularly focusing on the utility of measurement tools in clinical mental healthcare settings. In this review, we highlight an existing gap in resilience measurement and underscore the need for a new measure of psychological resilience that can effectively assess individuals' subjective experience of their psychological resilience in clinical mental healthcare settings. The currently available psychological resilience measures included in this review do not directly reflect all the factors that might impact a client's depression or anxiety and warrant further research.

Investigating resilience in patients with IBD: preliminary insights for understanding disease-specific resilience skills

Introduction

Inflammatory bowel diseases (IBDs) significantly impact patients' quality of life. While research highlights the potential role of psychological resilience to enhance overall health and well-being in patients with chronic conditions, its specific role in the context of IBD remains underexplored. This study aimed to identify key components of resilience, while serving as a precursor to the development of a disease-specific Resilience Scale for IBD (RISE-IBD).

Methods

In semi-structured focus groups and individual interviews, fifteen patients with IBD discussed their perspectives on the construct of resilience, particularly in terms of the diverse strategies they employed to overcome IBD-related challenges. Patients also deliberated on the relevance of themes identified in two widely used and validated resilience measures. Four analysts coded the transcripts using MAXQDA. Selected items for the drafted measure were refined based on constructive feedback from an additional focus group with study participants and six multidisciplinary IBD professionals, thus establishing face and content validity.

Results

The qualitative analysis revealed critical themes of resilience for IBD including: (1) seeking physical and emotional support from others, (2) developing personal coping mechanisms to manage stress, and (3) employing strategic disease-management techniques. These themes led to the identification of 17 items, which were categorized into three domains: interpersonal fortitude, individual character strengths, and logistical strategies.

Discussion

This study highlights the critical role of resilience, a core concept in positive psychology, in the effective self-management of IBD. The findings underscore the importance of building upon resilience strategies to help patients bolster the psychological potencies needed to manage their condition more effectively. Future research will focus on the psychometric validation of items identified for the scale. By incorporating resilience-building strategies into IBD care, we can support patients in developing a more positive outlook and improved life satisfaction.

Attitude toward physical activity among Asian American family caregivers of persons living with dementia

This qualitative study aimed to explore attitudes toward physical activity behaviors in the context of dementia caregiving among Asian Indian, Chinese, Korean, and Vietnamese American family caregivers of persons living with dementia. We used qualitative data from verbatim transcripts of current caregivers (N = 21) from focus groups and individual interviews. Ethnically or linguistically matched moderators facilitated focus groups and interviews in four languages. Finalized themes included: (1) Physical activity and exercise are different.; (2) Exercise has many benefits.; (3) Health issues and stress from caregiving demotivate engaging in regular exercise.; (4) Prioritizing and planning exercises are necessary; and (5) Social support is essential to engage in physical activity. Caregiving limits the type of exercise some can do, depending on care recipients' conditions. Efforts to help caregivers prioritize exercise and seek social support from others, including healthcare professionals, would be greatly needed to promote physical activity among this population.

Resilient Coping Levels and Psychometric Properties of the Brief Resilient Coping Scale Among Nursing Professionals in Saudi Arabia

OBJECTIVES

This cross-sectional survey assessed resilient coping levels and their relationship with the sociodemographic characteristics of nursing professionals in Saudi Arabia.

METHODS

Adult (≥18 years) registered nurses who had been practicing for ≥1 year were included in the study. Resilient coping levels (as assessed via a 4-item Brief Resilience Coping Scale; BRCS) and the data of sociodemographic and other characteristics were collected. Descriptive analysis and ordinal logistic regression were used to analyze the data. Furthermore, the psychometric properties of the BRCS are also reported.

RESULTS

Overall, 216 nursing professionals were included. The mean BRCS score was 14.6 (standard deviation = 3.6), with most nursing professionals (62.5%) reporting medium-to-high resilience coping levels. The ordinal logistic regression model demonstrated that nurses with increasing age (p = 0.002), best overall health (p = 0.001), and in the outpatient department (p = 0.049) and intensive care unit (p = 0.032) had significantly high resilient coping levels. The internal consistency of the BRCS was good (Cronbach's alpha = 0.80). The results of the exploratory factor analysis and confirmatory factor analysis clearly indicate a unidimensional solution with one factor.

CONCLUSIONS

In summary, most nursing professionals in Saudi Arabia showed medium-to-high resilience coping levels. Moreover, this study suggests that the BRCS was found to be a psychometrically reliable and adequate tool for assessing resilience coping levels and provides valuable insights into the relationship between resilient coping levels and the sociodemographic characteristics of nursing professionals in Saudi Arabia.

Psychometric properties of an Arabic translation of the resilience scale for older adults

OBJECTIVES

A significant gap currently exists in the availability of reliable and scientifically rigorous measures for evaluating resilience among older Arabic-speaking populations. The primary objective of this study was to assess the psychometric properties of an Arabic adaptation of the 15-item Resilience Scale of Older Adults (RSOA) in a sample of Arabic-speaking Egyptian older adults.

METHOD

Using a cross-sectional design and a convenience sample of 539 Egyptian older adults, with 60.7% aged between 65 and 75 years (50.3% females), participants completed an online Google form-based anonymous questionnaire, including sociodemographic information, the RSOA, and the 10-item CD-RISC. To ensure accurate translation, the forward-backward translation method was employed. Confirmatory factor analysis (CFA) and gender invariance in the RSOA were analyzed. McDonald's ω and Cronbach's α were calculated to assess internal consistency.

RESULTS

The results demonstrate that the Arabic RSOA and its subscales exhibit high internal consistency, with McDonald's ω and Cronbach's α values ranging from 0.83 to 0.93. CFA analysis revealed that the four-factor model fit of RSOA was acceptable. Measurement invariance was supported across genders. Furthermore, both genders exhibited no significant differences in all four RSOA dimensions. Convergent validity was supported by demonstrating that the four RSOA sub-scores and total scores correlated positively and significantly with the 10-item CD-RISC.

CONCLUSION

While further cross-cultural validation involving other Arab countries and communities is necessary, this study suggests that the Arabic RSOA may be used to measure resilience among broader Arabic-speaking older adults in clinical and research contexts.

Measuring Caribbean stress and resilient coping: Psychometric properties of the PSS-10 and BRCS in a multi-country study during the COVID-19 pandemic

Caribbean health research has overwhelmingly employed measures developed elsewhere and rarely includes evaluation of psychometric properties. Established measures are important for research and practice. Particularly, measures of stress and coping are needed. Stressors experienced by Caribbean people are multifactorial, as emerging climate threats interact with existing complex and vulnerable socioeconomic environments. In the early COVID-19 pandemic, our team developed an online survey to assess the well-being of health professions students across university campuses in four Caribbean countries. This survey included the Perceived Stress Scale, 10-item version (PSS-10) and the Brief Resilient Coping Scale (BRCS). The participants were 1,519 health professions students (1,144 females, 372 males). We evaluated the psychometric qualities of the measures, including internal consistency, concurrent validity by correlating both measures, and configural invariance using confirmatory factor analysis (CFA). Both scales had good internal consistency, with omega values of 0.91 for the PSS-10 and 0.81 for the BRCS. CFA suggested a two-factor structure of the PSS-10 and unidimensional structure of the BRCS. These findings support further use of these measures in Caribbean populations. However, the sampling strategy limits generalizability. Further research evaluating these and other measures in the Caribbean is desirable.

Conceptual Considerations for Understanding Resilience in Healthcare Students

AIMS

Increasing attention has been given to the concept resilience in the context of healthcare especially during and post the COVID pandemic. Much of the inquiry and evidence reported has focused on promoting or enhancing resilience in healthcare for improving the quality of care and reducing medical negligence. This discursive paper aims to highlight how resilience is conceptualised and identify any potential limitations or gaps in the context of healthcare students, acknowledging considerations for further development and research into this topic.

DESIGN AND METHODS

This discursive discussion draws on relevant theoretical underpinnings from the fields of adjustment and coping psychology, and research and evidence from health sciences, for facilitating an understanding of resilience in supporting healthcare students to adapt into professional practice.

RESULTS

Investigation of resilience in healthcare students is mainly identified at an individual level as personal traits or skills for working within complex healthcare systems and clinical environments. Less attention has been given to examining resilience at the organisation or systemic level. This is primarily because of limited frameworks for investigating resilience from a multidimensional perspective recognising a wider systemic level influenced by external factors including socioecological determinants, for example, available support services for healthcare students.

CONCLUSIONS

The link between resilience and its function to mitigate against associated neuropsychological distress and subsequent pathopsychological disorders in healthcare student cohorts is recognised; however, greater understanding of resilience as a multidimensional construct is warranted.

RELEVANCE TO CLINICAL PRACTICE

A multidimensional investigation of resilience is critical for the preparation and readiness of healthcare structures and organisations in facilitating the needs of healthcare students entering challenging and diverse healthcare working environments.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

A new measure of professional caregiver coping in long-term care: The LTC COPE

INTRODUCTION

The professional caregiver workforce (nursing assistants and personal care aides) is critical to quality of care and quality of life in nursing home (NH) and assisted living (AL) settings. The work is highly stressful, so improving responses to stress in this workforce could contribute to satisfaction and retention. This research developed a coping measure appropriate for the diverse professional caregiver workforce.

METHODS

A multistage process identified and refined existing and new items. Ten racially and ethnically diverse professional caregivers advised on item selection and refinement. Subsequently, using an online QR code-accessed questionnaire, data were collected from 391 professional caregivers from 10 NHs and 3 AL communities in three states, yielding a sample that was 87% female, widely distributed in age and experience, and racially/ethnically diverse (42% Black, non-Hispanic/Latinx; 25% White, non-Hispanic/Latinx; 20% Hispanic/Latinx; 7% Asian, non-Hispanic/Latinx; and 21% born outside the United States). Analyses examined psychometric properties and principal components analysis identified factors within which items and scales aggregated.

RESULTS

The final instrument, named the Long-Term Care Cope (LTC Cope), includes 26 items aggregated into six factors, which explained 60% of the variance: avoidance (five items, loadings 0.58-0.76); adaptive psychological strategies (six items, loadings 0.33-0.89); active engagement (five items, 0.47-0.89); maladaptive psychological strategies (three items, loadings 0.90-0.93); actions to minimize emotional impact (four items, loadings 0.28-0.74); and substance use (three items, loadings 0.61-0.88). Respondents often reported using multiple items within multiple factors when responding to stressful situations at work.

DISCUSSION

The coping strategies of professional caregivers are highly individual, with caregivers tending to utilize multiple strategies. The LTC Cope instrument and its component subscales are promising for future research to improve understanding of stress-related coping in this diverse workforce and inform and evaluate interventions.

Highlights

A new measure was developed to help us better understand how professional caregivers (nursing assistants and personal care aides) deal with work-related stress.Professional caregivers in nursing homes and assisted living tend to use multiple approaches to deal with job stress.Ways professional caregivers cope with stress vary widely-some address problems directly, some try to deal with the emotional toll of the work, and others involve avoiding the problems or their emotional consequences.

A follow-up study with a double-blinded, randomized controlled vitamin D supplementation trial in patients with major depressive episode (DepFuD): A study protocol and baseline characteristics

Promising initial studies on vitamin D (VD) supplementation as an adjunct treatment for major depressive disorder (MDD) require rigorously designed randomized controlled trials (RCTs). We aim to investigate the effects of augmenting standard MDD treatment with VD supplementation and examine factors influencing the treatment outcome. This article describes the study design, measures, and baseline characteristics. This multicenter RCT compares the efficacy of a six-month VD intervention at 100 micrograms/day versus 10 micrograms/day (μg/day) (4000 IU (international units)/day vs. 400 IU/day) added to a standard treatment in outpatients aged 20-61 years with MDD. The primary outcome is change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score. Secondary outcomes are other indicators of mental health and functionality (BDI, SOC, 15-D, PSS10, LS-4, LOT-R, YSQ-S2-extended, CORE-OM, TAS-20, BRCS, TADS, SCL-90, DIAD, GAF), and circulating biomarkers. Intervention assessments are conducted at baseline, 3, and 6 months, and follow-ups at 18 months and 6 years post-baseline. The baseline sample had 319 subjects (74% women; median age 31 (inter-quartile range (IQR) 15), mean MADRS score 21.38 (SD 6.04)), with 281 assigned to the RCT. At present, the study continues as a follow-up study. DepFuD project will provide extensive information regarding the potential benefits of VD and enables to identify various biopsychosocial depression-associated risk factors.

Psychological resilience, resilient coping, and health behaviors among adults in Puerto Rico after multiple adverse events

Objective: Residents of Puerto Rico have recently experienced multiple adverse events, including hurricanes, earthquakes, and political unrest. Such adversity is associated with worse mental and physical health. Psychological resilience and effective coping may mitigate these relations by fostering positive health behaviors, like consuming a high-quality diet and being physically active. However, empirical evidence for these relationships is limited. Methods: We assessed psychological resilience, resilient coping, and health behaviors among two groups of adults in Puerto Rico, before and during the pandemic, in 2019-2023 (total N = 1,342). Resilience and resilient coping were assessed using the Brief Resilience Scale and Brief Resilient Coping Scale. Diet quality was defined by the Alternate Healthy Eating Index from a food frequency questionnaire. We collected data on sleep, physical activity, alcohol intake, and tobacco use using validated questionnaires. Results: Adjusting for confounders, higher resilience z-scores were associated with being in the highest category of diet quality [OR: 1.25, 95 % CI: 1.04, 1.50]; getting 7-8 h of sleep per night [OR: 1.15, 95 % CI: 1.02,1.30]; and reporting moderate or heavy physical activity (vs. light or sedentary) [OR: 1.17, 95 % CI: 1.02,1.34]. The same patterns were observed for higher resilient coping z-scores, and for categorical measures of resilience and resilient coping. These relationships were stronger among participants interviewed during (vs. before) the COVID-19 pandemic, suggesting that resilience and resilient coping may be particularly relevant during an ongoing stressor. Conclusion: Identifying supportive strategies to cultivate resilience and effective coping mechanisms may contribute to healthier behaviors, particularly in a vulnerable population.

The effect of social media use on mental health of college students during the pandemic

Social media is viewed to be a key contributor to worsening mental health in adolescents, as most recently reflected in a public health advisory by the US Surgeon General. We provide new evidence on the causal effects of social media on mental health of college students during the Covid-19 pandemic, exploiting unique, longitudinal data collected before the Covid-19 pandemic began and at two points during the pandemic. We find small insignificant effects of social media 4 months into the pandemic during a period of social distancing, but large statistically significant negative effects 18 months into the pandemic when colleges were mostly back to normal operations. Using rich data on substance use, exercise, sleep, stress, and social support, we find some evidence of substitution away from activities that better support mental health at later stages of the pandemic but not at early stages. We find that the negative effects of social media are mostly concentrated among socially-isolated students. Both social support and resilience protect students from the negative effects of social media use. Policy implications include regulating social media while also bolstering social support and resilience as important protective factors.

Suicidality Trajectory, Hopelessness, Resilience, and Self-Efficacy Among Patients With Treatment-Resistant Depression in Vietnam

BACKGROUND

Patients with treatment-resistant depression (TRD) have higher rates of suicidal ideation and a higher suicide attempt prevalence than patients with other types of depression.

PURPOSE

This study was designed to study the suicidality trajectory and relationships between hopelessness, resilient coping, and self-efficacy, respectively, and suicidal ideation and suicide attempts in patients with TRD during hospitalization and at 3 months after discharge.

METHODS

A longitudinal survey of 53 psychiatric inpatients with TRD was conducted. Suicidality, hopelessness, resilient coping, self-reported medication adherence, and self-efficacy were assessed at Weeks 1 and 2 (T0 and T1) after hospitalization and Week 1 and Months 1 and 3 after discharge. Data were analyzed using a Cox regression model.

RESULTS

Suicidality varied across the five time points, with a downward trend observed between T0 and T1 (reflecting the initial effects of inpatient treatment) and an upward trend observed across the 3-month follow-up. Antidepressant overdose was the most common method used for suicide. The risk of high suicidal ideation during follow-up was 1.63, 2.63, and 1.14 times higher, respectively, in participants with a high level of hopelessness, low level of resilient coping, and low self-efficacy. Also, having a higher level of hopelessness and being younger in age increased the risk of attempting suicide by 3.07 times and over 6 times, respectively, compared to older participants.

CONCLUSIONS/IMPLICATION FOR PRACTICE

Suicidality was shown to fluctuate between the in-hospital treatment phase and the first 3 months following discharge in this sample of patients with TRD. Younger age, feelings of hopelessness, low resilience, and low self-efficacy were the top four factors contributing to postdischarge suicide risk. These findings highlight the need for regular patient monitoring and assessment to identify those with TRD who are at high risk of suicide as well as the importance of focusing on hopelessness, resilience, and self-efficacy as predictors of suicide ideation and attempts. Nurses should help patients with TRD, especially those who are younger, and improve and maintain their hope, resilience, and self-efficacy both during hospitalization and shortly after discharge.

A multisector community-engaged collaborative for mental health integration in primary care and housing developments: Protocol for a stepped-wedge randomized controlled trial (the Harlem Strong Program)

BACKGROUND

Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation.

METHODS

In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers' needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization.

DISCUSSION

We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide.

TRIAL REGISTRATION

NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023.

Post-traumatic stress disorder among military personnel admitted at the Northwest Command Level Three Military Hospital, Bahir Dar, Ethiopia, 2022: an institution-based cross-sectional study

Background

Post-traumatic stress disorder (PTSD) is one of the most common mental health problems that military personnel encounter. It could be lifelong and affect every aspect of military personnel, including their mental and physical health, family and social interactions, and their work. However, in Ethiopia, the magnitude and its associated factors have not been well investigated.

Objective

This study aimed to determine the prevalence of PTSD and its associated factors among military personnel, who were admitted at the Northwest Command Level Three Military Hospital, Bahir Dar, Northwest, Ethiopia, 2022.

Methods

An institution-based cross-sectional study was conducted from 21 June to 21 July 2022, at the Northwest Command Level Three Military Hospital. A computer-generated simple random sampling technique was used to select a total of 627 participants. The 17-item Military Version Checklist was utilized to measure PTSD. The Patient Health Questionnaire, Brief Resilience Coping, and Critical War Zone Experience scale were utilized to measure depression, resilience, and combat exposure, respectively. Descriptive, bivariate, and multivariate binary logistic regressions with odds ratios and a 95% confidence interval were used. The level of significance of the association was determined at a p-value < 0.05.

Results

A total of 612 respondents participated, with a response rate of 97.6%. The prevalence of PTSD in this study was 21.9% (95% CI: 18.6, 25.2). In multivariable regression, female sex [adjusted odds ratio (AOR) = 2.3, 95% CI; 1.3, 3.87], combat personnel (AOR = 2.75, 95% CI; 1.44, 6.36), handling dead bodies (AOR = 2.5, 95% CI,1.24, 5.02), having 4-5 deployments (AOR = 2.94, 95% CI, 1.63, 5.32), having ≥6 deployments (AOR = 3.4, 95% CI, 1.95, 6.17), low resilience coping (AOR = 2.02, 95% CI; 1.16, 3.53), poor social support (AOR = 2.46, 95% CI, 1.39, 4.35), very high combat exposures (AOR = 4.8, 95% CI, 2.03, 11.93), and depression (AOR = 2.8, 95% CI, 1.68, 4.67) were significantly associated with PTSD.

Conclusion

PTSD is markedly prevalent among the Ethiopian military population, with key risk factors identified as being female, poor social support, low resilience coping skills, handling dead bodies, multiple deployments (four or more), high combat experiences, and depression. Healthcare professionals must prioritize the early diagnosis and intervention of PTSD in vulnerable groups of military personnel.

Protected Time for Self-Care for Veterans Health Administration Employees

OBJECTIVES

Employee Whole Health (EWH) empowers VA employees to take charge of their well-being by integrating self-care into their workday, but employees lack time to participate.

METHODS

Employees at three VA medical centers participated in a 12-month feasibility cohort study to protect 60 minutes of time per week for self-care. Questionnaire data were collected at three time points and qualitative data at two time points. Pilot offerings included education and complementary and integrative health modalities for well-being.

RESULTS

Employees enrolled spring 2021 ( n = 312). Complete-case regression analyses indicated significant improvements in wellness culture, resiliency, self-efficacy, perceived stress, and flourishing at 12 months. Multiple imputation analyses confirmed improvements except for self-efficacy. Qualitative findings supported quantitative findings.

CONCLUSIONS

Providing protected time for self-care was feasible and supported improvements in well-being. However, high workload was identified as an ongoing barrier to participation.

Psychometric evaluation of the Brief Resilient Coping Scale (BRCS) over the course of the pandemic in a large German general population sample

BACKGROUND

The Brief Resilience Coping Scale (BRCS) is a brief instrument suitable for epidemiological studies. The aims of this paper were to analyze changes in BRCS depending on time, sex, age group, relationship status, as well as risk of poverty, to test the psychometric properties including test-retest reliability and measurement invariance, and to determine associations with psychosocial stress, depressiveness, anxiety, social support, as well as subjective mental and physical health. As the data from this study was collected during the pandemic, an additional sensitivity analysis was performed with pre-pandemic data.

METHODS

A longitudinal study of resilience and distress in a large-sized community sample was performed at one pre-pandemic (T0) and three pandemic time points (T1-3). Resilient coping was assessed by the 4-Item short form of the BRCS, distress by the PHQ-9 and GAD-2.

RESULTS

BRCS decreased between the first and the second and increased at the third pandemic time point. The scale had a good internal consistency. Test-retest correlation coefficients ranged from 0.527 to 0.589. Higher resilient coping was found in younger participants, participants not at-risk-of-poverty and in males. Stability was higher in those with a partner, and at-risk-of-poverty. Significant negative associations with psychosocial stress, loneliness, depressiveness, anxiety, social support, as well as subjective and physical health and SES underscored the construct validity.

CONCLUSION

Overall, findings underscore that resilient coping is a dynamic construct with considerable stability. The scale showed good psychometric properties including test-retest reliability over four months to two years. We found that it is not only important to describe the level of resilient coping, but also its stability.

Preventing violence and enhancing mental health among clients of an invitro fertilization clinic in Jordan: results of a pre/post pilot test of the use of cognitive behavioral therapy

INTRODUCTION

Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan.

METHODS

Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes.

RESULTS

At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved.

CONCLUSION

Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status.

Individual and contextual predictors of young Ukrainian adults' subjective well-being during the Russian-Ukrainian war

The Russian invasion of Ukraine is accompanied by horrific losses among civilians. This study investigates various individual (hope, optimism, resilience, post-traumatic growth, and coping strategies) and contextual predictors (experience of life under occupation, actively hostile home environment, and frequent moves) of subjective well-being among the youth living in Ukraine. A total sample of 593 students from several universities participated in the study using surveys that contained questions about sociodemographic characteristics, life satisfaction, hope, optimism, personal post-traumatic growth, resilience, and coping strategies. Data were analyzed using JAMOVI software. The level of dissatisfaction with their own lives was 34.7%; most of the respondents had a higher incidence of minimal/mild hopelessness (88.7%) and high/moderate level of optimism (60.9%). The majority of participants had moderate and high levels of post-traumatic growth (51.9% and 6.7%, respectively) and resilience (46.0% and 14.5%, respectively). Optimism, hope, resilience, post-traumatic growth, using emotional support, and life in occupation predicted life satisfaction among the study sample.

Resilience and successful aging: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis investigates the relationship between successful aging (SA) and resilience in older adults, focusing on individuals aged 60 and above, to address a significant gap in understanding how resilience contributes to SA.

METHODS

Following the Cochrane review guidelines, we conducted searches in databases such as Web of Science, PsycNet, and PubMed up to December 2021 and used PRISMA as a tool for reporting the results. Our inclusion criteria were studies on psychological resilience and SA in older adults aged 60 and above. Exclusion criteria included studies on physical resilience, medical outcomes of SA, other indicators not used in screened studies (e.g., prevalence, means), populations with suicidal ideation or chronic/palliative illnesses, studies considering resilience as an indicator of SA, and qualitative studies on the association between resilience and SA.

RESULTS

A total of 21 studies were included and assessed for risk of bias using funnel plot and trim-and-fill methods. The meta-analysis revealed a medium effect size indicating a positive relationship between resilience and SA. However, high heterogeneity warrants a cautious interpretation of these results. No significant differences were found between older adults in the general population and those in retirement communities, nor were geographical variations (Asia, Europe, America) found to moderate this relationship.

DISCUSSION

The findings highlight the intrinsic link between older adults' attitudes towards aging, their subjective evaluations, and their level of psychological resilience. Resilience acts as a protective factor against psychological and physical adversities, underscoring the importance of resilience-enhancing strategies in interventions aimed at promoting SA. The conclusions drawn from this analysis should be approached with caution due to the heterogeneity of the included studies.

Substance Use Among Illinois Farmers

BACKGROUND

 People in agriculture face unique stressors and occupational hazards, and relatively little is known about substance use in this population. The purpose of this study was to describe substance use among farmers in Illinois.

METHODS

 We conducted a mail survey of Illinois farmers that included the Brief ASSIST to assess substance use for lifetime and past three-month use of ten different substances. The survey also included questions about farming characteristics, mental health, stress, coping, social support, and demographic characteristics. We used chi-square and non-parametric tests to assess group differences.

RESULTS

 Alcohol, tobacco, cannabis, and sedatives were most reported as used for a lifetime and in the past three months. About three-quarters of the sample had recently used alcohol. Recent tobacco use was associated with not being married, less education, and less concern about climate-related farm stress. Recent sedative use was associated with greater concern about isolation-related farm stress. People who reported multiple substance use were at a greater risk for suicide and were more likely to meet the criteria for generalized anxiety disorder. None of the participants reported recent use of cocaine, heroin, inhalants, or hallucinogens.

CONCLUSION

 Specific social and cultural aspects of farming and farm communities may contribute to substance use among people working in agriculture. Future research can help to better understand this intersection and make recommendations for programs and resources to promote adaptive coping strategies.

Compassion fatigue, secondary traumatic stress, and coping strategies of mental health professionals

Background

The prevalence of compassion fatigue (CF) and secondary traumatic stress (STS) has been studied with a predominant focus on medical care professionals, indicating a significant presence of STS and CF among them. The present study has identified a dearth in the representation of mental healthcare professionals (MHPs), grouped by psychiatrists, clinical psychologists, psychiatry nurses, and psychiatric social workers within the Indian context.

Aim

To assess the degree of CF and STS and the subsequent coping mechanisms adopted by MHPs.

Materials and Methods

This study followed a cross-sectional research design. There were 75 participants selected using purposive sampling and administered scales that measured CF, STS, and coping strategies adopted by the participants.

Results

There is a strong presence of CF in MHPs along with problem-focused coping as the preliminary approach to STS. Participants with average or higher scores in STS had higher intrusion scores. Higher STS scores tend to have avoidant coping styles in comparison to the larger sample. Female participants indicated higher levels of CF and STS than their male counterparts.

Conclusion

The study emphasizes on the immediate requirement to address and manage CF levels among the MHPs and focus on the factors that continue to aggravate STS.

Inpatients with a history of suicide attempts in routine clinical care exhibit specific characteristics regarding sociodemographics, life events, personality, and symptom burden

Research indicates that patients with a lifetime history of suicide attempts are particularly burdened. However, investigations of their characteristics and comparisons with other patients are scarce. This study aimed to fill this research gap, using routine clinical data and guided by theoretical models. Data of N = 706 patients (54.4% women) was collected at the psychosomatic inpatient/day-clinic unit of a German university clinic. It comprised sociodemographic data and information about previous experiences (e.g., childhood abuse and neglect), symptom measures (e.g., the PHQ-9) and individual differences (e.g., the level of personality functioning assessed with the OPD-SQS). Groups were compared using independent t-tests or χ2-tests. Of the total sample, 118 patients (16.7%) reported suicide attempts. Those with a history of suicide attempts were more likely to have a migration background and a lower level of education, smoke (heavily) and use illegal substances. They reported lower levels of personality functioning, more current symptoms and traumatic previous experiences of abuse and neglect. Screening for previous suicidal behavior as well as associated factors can yield valuable information for clinical practice. Many group differences map onto previously observed specific risk factors for suicidal behavior, supporting the conceptual models and underscoring their relevance among clinical populations as well.

Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period: evidence from a cross-sectional study

BACKGROUND

The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally.

METHODS

An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations.

RESULTS

A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping.

CONCLUSIONS

Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

Psychological Factors Associated with Functional Tic-like Behaviours during the COVID-19 Pandemic

Functional tic-like behaviours (FTLB) are a female predominant functional neurological disorder that escalated in incidence during the SARS CoV2 pandemic. This study compared social and adaptive functioning, social media use, pandemic experiences, and psychiatric comorbidities between FTLB (n = 35), Tourette Syndrome (TS) (n = 22), and neurotypical (NT) (n = 25) participants ages 11 to 25 years. The psychiatric comorbidity burden for participants with FTLB was formidable, with frequencies ranging from 1.5 to 10 times higher for major depressive disorder and panic disorder compared to TS and NT participants. Borderline personality disorder (BPD), agoraphobia, social anxiety disorder, and generalized anxiety disorder were also significantly more common in FTLB compared to NT participants. Vulnerable attachment scores, social phobia and social interaction anxiety symptoms were higher in participants with FTLB than NT but not TS. Overall distress tolerance, resilient coping, suggestibility, hours on social media, and exposure to tic and TS content were not significantly different between groups. FTLB participants rated their mental health declined more severely during the pandemic than both TS and NT participants and were more likely to experience trouble sleeping, loneliness, and difficulty affording housing and food than NT participants. Participants with FTLB were significantly more likely to identify as gender minority people than TS and NT, though there were no significant differences based on gender identity in the study variables within the FTLB group. The association and potential pathways explaining how psychiatric disorders may be contributing to FTLB, and why certain groups appear at particular risk are discussed.

Longitudinal Outcomes of Resilience, Quality of Life, and Community Integration in Treatment-Resistant Depression: A Two-Group Matched Controlled Trial

BACKGROUND

Current evidence of nonpharmacological intervention for patients with treatment-resistant depression (TRD) is lacking. AIMS: To examine whether an 8-week nurse-led cognitive-behavioral based group intervention would enhance resilient coping and life quality among community-based patients with TRD.

METHOD

The participants were randomly sampled from a cohort of TRD recruited from two general teaching hospitals. The two groups were assessed with multiple outcome measures at baseline (T0); 8-week post-baseline (T1); and at 3, 6, and 9 months after T1 (T2-4). Psychoeducation was nested in the cognitive behavioral group intervention to facilitate discussion.

RESULTS

Of the 23 participants (mean age 56 years, 69.6% female) in the experimental group, higher resilient coping and lower mental distress levels at T1 as well as later improved quality of life and community integration at T2-4 were observed compared to the controls across COVID-19 (T3). Overall, the scores of resilience and community integration were higher throughout the four follow-up points of observations for the experimental group.

CONCLUSION

The findings indicated that an 8-week nurse-led cognitive-behavioral based group intervention may enhance the TRD patients' resilient coping and mental distress levels while providing the potentials for community reintegration after mental health psychoeducation engagement. It is imperative for the nurses caring for patients with TRD to extend from clinical-based intervention to community-based self-care approach, with the importance of short-term stress management and healthy lifestyle development highlighted during the community reintegration trajectory.

A Study on the Psychological Profile and Coping With the Disease in Patients With Lymphangioleiomyomatosis

Introduction

Lymphangioleiomyomatosis (LAM) is a rare disease that affects women almost exclusively. We aimed to determine the psychological profile in patients with LAM, and their potential association with sociodemographic and clinical features, and to know their role in coping with the disease.

Material and methods

Cross-sectional and descriptive study in collaboration with the Spanish Association of LAM (AELAM). The variables measured were: socio-demographic, psychological (anxiety, depression, demoralization, spirituality, resilience, social support), clinical (treatment) and health-related quality of life.

Results

We studied 87 LAM patients, with a mean (SD) age of 47.7 (7.7) years, and time since diagnose was 10.1 (5.4) years. 75.9% of patients were receiving sirolimus or everolimus, and oxygen therapy was required in 34.5% of patients. Anxiety was found in 46% of patients, depression in 55%, while only 2% presented demoralization and 14% deficit in spirituality. Social support and resilience were adequate. The "non-severe" group (without oxygen therapy) presented worse results in anxiety. A structural equation model to explore association between variables, showed very adequate fit indices: χ2(14) = 29.743 (p = .074); CFI = .983; TLI = .967; SRMR = .058; RMSEA = .075[.000-.128]. The model identifies resilience, spirituality and social support as "protective factors" from anxiety, depression, and demoralization.

Conclusions

This study performed on a large series of women with LAM describes their psychological profile, in addition to showing how they cope with the disease. We have found that other psychological constructs, such as perceived social support and resilience, are protective factors. Early psychological evaluation and intervention is necessary to reduce comorbidities and prevent mental health problems in women with LAM.

Physical and mental health predicts better adherence to exercise intervention in older women: A post-hoc analysis

Background

Adherence to exercise is crucial for promoting health and maintaining functioning.

Aims

To investigate predictors of adherence to exercise in the initially free supervised fall prevention RCT and its low-cost, self-sustained continuation among elderly women.

Methods

In the 2-year Kuopio Fall Prevention Study RCT, 457 women (aged 71-84) were offered a free initial 6-month supervised weekly training program (gym, Tai Chi) in the municipal facilities. Women's adherence during this period was categorized into high (≥80 %) and low (<80 %). In the next six months, their free access to the premises continued without supervision. For the second year, low-cost access was offered with unsupervised independent training in these facilities. The second-year adherence was based on purchasing(yes/no) a gym card to continue exercising. Information on baseline health, functioning, and lifestyle was obtained by mailed questionnaires and physical tests.

Results

For the first six months, over 60 % of the women had high adherence. Only 26 % continued into the second year. For both follow-up years, active training history was related to better adherence. Initial predictors were related to mental health i.e. having less often fear of falls limiting one's mobility, ability to cope with external, not internal hostility, and being in a loving relationship. In the second year, predictors were related to younger age, having less frequent fear of falls, better functional capacity i.e. better strengths (grip and leg extension) and faster Timed "Up and Go" -test.

Conclusion

Better mental and physical health, better functional capacity and active training background were associated with higher adherence to exercise intervention in older women.

Physical activity, anxiety, depression, and coping in Turkish men and women during the first wave of COVID-19

A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19's impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, and coping status of adults, although no significant gender-based difference was found regarding hope scores. Furthermore, physical activity directly influenced coping (β = 0.10), hope (β = 0.12), and anxiety (β = -0.08). Hope directly and positively influenced coping (β = 0.45) and directly and negatively influenced anxiety (β = -0.25) and depression (β = -0.28). Moreover, gender did not directly affect physical activity, but it was associated with decreased coping and increased depression and anxiety. Finally, gender had no effect on the relation between physical activity and hope, coping, depression, and anxiety (p > 0.01). These outcomes support the critical importance of physical activity and hope when coping with COVID-19 regardless of gender.

The Effect of Coping on the Relationship between Work-Family Conflict and Stress, Anxiety, and Depression

The challenges experienced in the context of the pandemic have required a significant reconciliation between work and family domains due to confinement and the need to spend more time at home, which may have increased the levels of stress, anxiety, and depression, making it necessary to use resilient coping strategies to overcome the difficulties felt. This study examined the effect of resilient coping on the relationship between work-family conflict and stress, anxiety, and depression in this context. Data were collected using a self-report protocol from a sample of Portuguese workers (N = 476). The results indicated that work-family conflict was positively associated with stress, anxiety, and depression. Resilient coping established a negative relationship with stress, anxiety, and depression. The moderation effect was not corroborated; it was found that in the presence of the moderating variable (resilient coping), the relationship between the variables of work-family conflict and stress, anxiety, and depression was strengthened. This study reinforces the importance of appropriate interventions in resilient coping in the work-family context, which helps control stress, anxiety, and resilience levels.

Social group connections support mental health following wildfire

PURPOSE

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

AIMS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Patient-reported predictors of postdischarge mortality after cardiac hospitalization

BACKGROUND

Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event.

METHODS

We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status. Cox survival analyses of mortality were conducted over a median of 3.5 years.

RESULTS

Among 2977 adults hospitalized for either acute coronary syndrome or acute decompensated heart failure, the mean age was 53 years, and 60% were male. After adjusting for demographic, clinical, and other psychosocial factors, mortality risk was greatest among patients who reported being unemployed (hazard ratio [HR]: 1.99, 95% confidence interval [CI]): 1.30-3.06), retired (HR: 2.14, 95% CI: 1.60-2.87), or unable to work due to disability (HR: 2.36, 95% CI: 1.73-3.21), as compared to those who were employed. Patient-reported perceived health competence (PHCS-2) and exercise frequency were also associated with mortality risk after adjusting for all other variables (HR: 0.86, 95% CI: 0.73-1.00 per four-point increase in PHCS-2; HR: 0.86, 95% CI: 0.77-0.96 per 3-day increase in exercise frequency, respectively).

CONCLUSIONS

Patient-reported measures of employment status, perceived health competence, and exercise frequency independently predict mortality after a cardiac hospitalization. Incorporating these brief, valid measures into hospital-based screening may help with prognostication and targeting patients for resources during post-discharge transitions of care.

A meta-analysis of cognitive reappraisal and personal resilience

Cognitive reappraisal, an adaptive emotion regulation strategy that involves subjectively reinterpreting stressful and adverse experiences in a more positive manner, can enhance personal resilience. Personal resilience is a constellation of attributes that facilitate successful coping and an expeditious return to adaptive functioning after exposure to stress or adversity. This meta-analysis evaluated the association between cognitive reappraisal and personal resilience. A systematic and exhaustive search identified 64 independent samples from 55 studies (N = 29,824) that examined the correlation between cognitive reappraisal and personal resilience. A random-effects model revealed a positive summary effect (r = 0.47, p < .001), indicating that higher cognitive reappraisal was associated with higher personal resilience. Six potential meta-moderators were tested: culture, age, name of the cognitive reappraisal measure, name of the personal resilience measure, study design, and publication period. After two extreme effect size outliers were omitted, tests of publication bias did not reveal any publication bias in this line of research. This quantitative synthesis offers compelling evidence showing that cognitive reappraisal skills operate as a protective strategy against stress and adversity and, therefore, enhance personal resilience. The protective benefits of cognitive reappraisal in relation to personal resilience are relatively robust, as the correlations were statistically significant for all subgroups in the meta-moderation analyses.

Reducing stigma and promoting HIV wellness/mental health of sexual and gender minorities: RCT results from a group-based programme in Nigeria

INTRODUCTION

High levels of HIV stigma as well as stigma directed towards sexual and/or gender minorities (SGMs) are well documented in the African setting. These intersecting stigmas impede psychosocial wellbeing and HIV prevention and care. Yet, there are few if any evidence-based interventions that focus on reducing internalized stigma and promoting mental health and HIV wellness for SGMs in Africa. We developed and evaluated a group-based intervention drawing on cognitive behavioural therapy (CBT) strategies for men who have sex with men (MSM) and transgender women (TGW) at risk for or living with HIV in Lagos, Nigeria.

METHODS

The intervention comprised four weekly in-person group sessions facilitated by community health workers. We conducted a delayed intervention group randomized controlled trial (April-September 2022), with pre-post surveys plus 3-month follow-up (immediate group only), as well as qualitative research with participants and programme staff. Outcomes included internalized stigma related to SGM and HIV status, depression, resiliency/coping and pre-exposure prophylaxis (PrEP)/HIV treatment use.

RESULTS

Mean age of the 240 participants was 26 years (range 18-42). Seventy-seven percent self-identified as MSM and 23% TGW; 27% were people with HIV. Most (88%) participants attended all four sessions, and 98% expressed high intervention satisfaction. There was significant pre-post improvement in each psychosocial outcome, in both the immediate and delayed arms. There were further positive changes for the immediate intervention group by 3-month follow-up (e.g. in intersectional internalized stigma, depression). While baseline levels of ever-PrEP use were the same, 75% of immediate-group participants reported currently using PrEP at 3 months post-intervention versus 53% of delayed-group participants right after the intervention (p<0.01). Participants post-intervention described (in qualitative interviews) less self-blame, and enhanced social support and resilience when facing stigma, as well as motivation to use PrEP, and indicated that positive pre-intervention changes in psychosocial factors found in the delayed group mainly reflected perceived support from the study interviewers.

CONCLUSIONS

This study demonstrated the feasibility and acceptability of a group-based CBT model for MSM and TGW in Nigeria. There were also some indications of positive shifts related to stigma, mental health and PrEP, despite issues with maintaining the randomized design in this challenging environment.