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The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan.
Methods
Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up.
Results
In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (p = .003), who perceived greater levels of microaggression (p < .001), and who had greater levels of problematic Internet use at baseline (p = .024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (p = .023).
Conclusion
Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.
Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations.
Aims
The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored.
Method
This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors.
Results
The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms.
Conclusions
Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.
Meningiomas are common brain neoplasms that can significantly influence health-related quality of life (HRQOL), yet the factors influencing HRQOL in adult patients remain unclear. We aimed to bridge this knowledge gap by determining these key factors.
Methods:
We conducted a systematic review, searching EMBASE, MEDLINE, CINAHL, Scopus and PsycINFO up to February 2024. We included original, peer-reviewed studies focusing on adult patients (>18 years) with current or past meningioma at any stage of treatment that measured HRQOL or its proxies in relation to patient-, tumour- and treatment-related factors. Two independent reviewers screened abstracts and full-texts, selecting studies with an acceptable risk of bias for data extraction and narrative synthesis. The protocol of this review was registered on PROSPERO (# CRD42023431097).
Results:
Of N = 3002 studies identified, N = 31 studies were included. Key factors found to influence HRQOL in adult meningioma patients include surgery, radiotherapy, neurological function, functional status, comorbidities, sleep quality, psychological impairment, age and employment. Factors related to tumour characteristics yielded inconsistent findings. Heterogeneity and inconsistencies in HRQOL measurement across studies hindered definitive conclusions about the impact of factors on HRQOL.
Conclusion:
Our review elucidates the multifaceted influences on HRQOL in meningioma patients, with significant variability due to patient-, tumour- and treatment-related factors. We emphasize the need for standardized, disease-specific HRQOL assessments in meningioma patients. Collaborative efforts towards consistent, large-scale, prospective research are essential to comprehensively understand and improve HRQOL, thereby enhancing tailored care for this population.
The primary aim of this research was to use a taxonomy of behavior change techniques (BCTTv1) to identify, map, and describe the active components of intervention and comparator groups in studies evaluating the psychological well-being (PWB) of motor neuron disease (MND) carers. Secondary aims were to (a) identify absent active ingredients and (b) explore whether variability in the effectiveness of interventions targeting the PWB of MND carers could be better explained through improved characterization of the active content of these interventions.
Methods
Mixed-methods systematic review based on Joanna Briggs Institute methodology for quantitative, qualitative, and mixed-methods reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Content-coding of interventions targeting the PWB of MND carers using BCTTv1 was conducted.
Results
Sixteen manuscripts describing 14 studies were included. Forty-one of the possible 93 behavior change techniques (BCTs, 44%) were identified as active ingredients, while 52 BCTs (56%) were absent. BCTs were identified in all 14 intervention groups and 4 control groups. Four of the 16 overall BCTTv1 categories were absent. Eleven of the 14 studies demonstrated PWB benefits from their interventions.
Significance of results
Identified and absent BCTs and BCTTv1 categories were mapped for all study groups, enabling a transparent characterization of active intervention content associated with positive PWB outcomes. Directions to improve interventions in this nascent field of research included the investigation of relevant untested BCTs in this population and the management of reporting and methodological quality issues.
The COVID-19 pandemic seems to have caused both declines in psychological well-being and increases in spirituality and religious coping. This paper explores the relationships of spiritual and psychological well-being in a sample of 3,403 Anglicans from the Episcopal Church (USA) who completed an online survey in 2021 during the COVID-19 pandemic. Spiritual well-being improved more among women than among men, among older than younger people, among Black or African Americans than among other ethnicities, among those who lived alone and among clergy than among lay people. Positive change in spiritual well-being was also associated with psychological type preferences for extraversion, intuition and feeling. Emotional volatility was associated with more negative changes in spiritual well-being. Multiple regression suggested that spiritual well-being was more closely associated with positive, rather than negative, psychological affect.
To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.
Methods:
This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.
Results:
Out of 1,067 screened COVID-19 patients, 230 completed the 2-year follow-up (female, 53.5%; aged>40, 80.9%; native Italian, 94.9%; medical comorbidity, 53.5%; chronic medication, 46.3%; moderate to severe COVID-19, 24.9%; hospital admission, 28.7%; ICU, 5.2%). At follow-up, 9.1% had anxiety, 11.3% depression, 9.1% insomnia, 18.3% cognitive failure, and 39.1% fatigue, of clinical relevance. Headache (OR = 2.49, 95% CI = 1.01–6.16, p = 0.048), dyspnea (OR = 2.55, 95% CI = 1.03–6.31, p = 0.043), and number of symptoms (OR = 1.23, 95% CI = 1.01–1.51, p = 0.047) at onset were associated with anxiety at follow-up; dyspnea at onset was associated with depression at follow-up (OR = 2.80, 95% CI = 1.22–6.41, p = 0.015); number of comorbidities at onset was associated with insomnia at follow-up (OR = 1.48, 95% CI = 1.06–2.08, p = 0.022); female gender (OR = 2.39, 95% CI = 1.14–5.00, p = 0.020) and number of symptoms (OR = 1.20, 95% CI = 1.02–1.42, p = 0.026) at onset was associated with cognitive failure at follow-up; number of comorbidities (OR = 1.33, 95% CI = 1.03–1.73, p = 0.029) and symptoms (OR = 1.19, 95% CI = 1.04-1.37, p = 0.013) and raised interleukin 6 levels (OR = 4.02, 95% CI = 1.42–11.36, p = 0.009) at onset was associated with fatigue at follow-up.
Conclusions:
COVID-19 survivors, especially if female, with preexisting health problems, and with a more severe acute phase, may present with long-lasting neuropsychiatric sequalae, urging interventions to sustain recovery particularly in these higher risk individuals.
Three factors converge to underscore the heightened importance of evaluating the potential health/well-being effects of friendships in older adulthood. First, policymakers, scientists, and the public alike are recognizing the importance of social relationships for health/well-being and creating national policies to promote social connection. Second, many populations are rapidly aging throughout the world. Third, we currently face what some call a ‘friendship recession’. Although, growing research documents associations between friendship with better health and well-being, friendship can also have a ‘dark side’ and can potentially promote negative outcomes. To better capture friendship’s potential heterogeneous effects, we took an outcome-wide analytic approach.
Methods
We analysed data from 12,998 participants in the Health and Retirement Study (HRS) – a prospective and nationally representative cohort of U.S. adults aged >50, and, evaluated if increases in friendship strength (between t0; 2006/2008 and t1; 2010/2012) were associated with better health/well-being across 35 outcomes (in t2; 2014/2016). To assess friendship strength, we leveraged all available friendship items in HRS and created a composite ‘friendship score’ that assessed the following three domains: (1) friendship network size, (2) friendship network contact frequency and (3) friendship network quality.
Results
Stronger friendships were associated with better outcomes on some indicators of physical health (e.g. reduced risk of mortality), health behaviours (e.g. increased physical activity) and nearly all psychosocial indicators (e.g. higher positive affect and mastery, as well as lower negative affect and risk of depression). Friendship was also associated with increased likelihood of smoking and heavy drinking (although the latter association with heavy drinking did not reach conventional levels of statistical significance).
Conclusions
Our findings indicate that stronger friendships can have a dual impact on health and well-being. While stronger friendships appear to mainly promote a range of health and well-being outcomes, stronger friendships might also promote negative outcomes. Additional research is needed, and any future friendship interventions and policies that aim to enhance outcomes should focus on how to amplify positive outcomes while mitigating harmful ones.
Dietary intake of long-chain n-3 PUFA (n-3 PUFA), particularly EPA and DHA, has been associated with psychological well-being, but little is known about the n-3 PUFA intake of homeless youth. The current study determined the association between depression and anxiety symptoms and n-3 PUFA intake and erythrocytes status in homeless youth. Totally, 114 homeless youth aged 18–24 years were recruited from a drop-in centre. n-3 PUFA dietary intake was assessed using an FFQ, and erythrocytes status was determined by gas chromatography (GC). Linear regression models were used to determine the relationship between psychological well-being and n-3 PUFA intake and status. The mean intakes of EPA and DHA for all participants (0·06 ± 0·13 g/d and 0·11 ± 0·24 g/d) were well below recommended levels, and mean erythrocytes EPA + DHA (n-3 index) in the cohort (2·42 %) was lower than reported for healthy, housed adolescents and those with clinical depression. There was no association of n-3 PUFA intake and erythrocytes status with either depression or anxiety. However, the relationships of depression with dietary EPA (P = 0·017) and DHA (P = 0·008), as well as erythrocytes DHA (P = 0·007) and n 3-index (P = 0·009), were significantly moderated by sex even after adjusting for confounders. Specifically, among females, as the intake and status of these n-3 PUFA decreased, depression increased. Our findings show poor dietary intake and low erythrocytes status of n-3 PUFA among homeless youth, which is associated with depressive symptoms among females.
Associations between fruit and vegetable (FV) consumption and mental health are suggested, largely from observational studies. This systematic review aimed to identify and summarise all published controlled intervention studies investigating the effects of FV consumption on mental health in adults. Four academic databases (Medline, PsycINFO, PubMed, Web of Science) were searched on 16 September 2022, over all years, for studies that used an intervention design; included FV consumption; included an appropriate non-FV-consumption control; used a validated measure of mental health and were conducted in healthy adults or adults with solely a depressive or anxiety-related condition. Study details were tabulated and combined using meta-analyses. Risk of bias was assessed using the domains of the Cochrane Collaboration. Six studies, enrolling 691 healthy adults and reporting on one or more mental health outcomes, were found. Meta-analyses found small and imprecise effects of FV consumption for: psychological well-being (4 studies, 289 participants) standardised mean difference (SMD) = 0·07 (95 % CI −0·17, 0·30), P = 0·58, I2 = 0 %; depressive symptomology (3 studies, 271 participants) SMD = –0·15 (95 % CI −0·40, 0·10), P = 0·23, I2 = 47 % and anxiety-related symptomology (4 studies, 298 participants) SMD = –0·15 (95 % CI −0·39, 0·08), P = 0·20, I2 = 71 %. Some benefit for psychological well-being was found in change-from-baseline data: SMD = 0·28 (95 % CI 0·05, 0·52), P = 0·02, I2 = 0 %. Risk of bias was high in many studies. Limitations include the consideration only of published studies and stem from the studies found. Given the few, limited studies available and the small size of effects, stronger evidence is needed before recommending FV consumption for mental health.
Non-Western literature on the core competencies of mental health peer supporters remains limited. Therefore, we used a three-round Delphi study with peer supporters, service users (i.e. someone using peer support services) and mental health professionals to develop a core competency framework for peer supporters in the Chinese context.
Results
The final framework included 35 core competencies, the conceptual origins of which were local (14.3%), Western (20%) and both local and Western (65.7%). They were grouped into five categories in ascending peer supporter role specificity: (1) self-care and self-development, (2) general work ethics, (3) work with others, (4) work with service users and (5) peer support knowledge.
Clinical implications
A culturally valid mental health peer support competency framework can minimise role confusion and refine training and practice guidelines. In a Chinese context, peer supporters were valued as generic support companions, whereas functions highlighted in the West, such as role modelling, were perceived as less critical.
We have seen that different species of parasites have markedly different impacts upon health. Some may kill their host and so reduce the population size, others cause chronic anaemia or malnutrition and so reduce their physical productivity, while the remainder may cause symptoms that reduce psychological well-being or cause no symptoms at all. If we use disability-adjusted life years to compare the impact of parasites upon different ancient civilizations, we can estimate the degree to which each were burdened by parasite infection. Using this approach would suggest that the civilizations with the heaviest health burden from parasites were (1) Egypt and Nubia; (2) Roman Empire; (3) Ancient China, Korea, and Japan; (4) South American Pacific Coast civilizations such as Maya, Moche, and Inca; and (5) the Ancient Near East. As many parasites impair the ability of labourers to complete physically arduous work, it is possible that the need for new, healthier workers to complete national infrastructure projects may have triggered military expeditions to neighbouring states to obtain prisoners to work as slaves in many of these civilizations.
Little has been done to comprehensively study the relationships between multiple well-being constructs at a time. Even less is known about whether child maltreatment and major depressive disorder (MDD) impact different well-being constructs. This study aims to examine whether maltreated or depressed individuals have specific impacts on well-being structures.
Methods
Data analyzed were from the Montreal South-West Longitudinal Catchment Area Study (N = 1380). The potential confounding of age and sex was controlled by propensity score matching. We used network analysis to assess the impact of maltreatment and MDD on well-being. The centrality of nodes was estimated with the ‘strength’ index and a case-dropping bootstrap procedure was used to test network stability. Differences in the structure and connectivity of networks between different studied groups were also examined.
Results
Autonomy and daily life and social relations were the most central nodes for the MDD and maltreated groups [MDD group: strength coefficient (SC)autonomy = 1.50; SCdaily life and social relations = 1.34; maltreated group: SCautonomy = 1.69; SCdaily life and social relations = 1.55]. Both maltreatment and MDD groups had statistical differences in terms of the global strength of interconnectivity in their networks. Network invariance differed between with and without MDD groups indicating different structures of their networks. The non-maltreatment and MDD group had the highest level of overall connectivity.
Conclusions
We discovered distinct connectivity patterns of well-being outcomes in maltreatment and MDD groups. The identified core constructs could serve as potential targets to maximize the effectiveness of clinical management of MDD and also advance prevention to minimize the sequelae of maltreatment.
Developing, elaborating, and consolidating positive views of the self is a plausible route to increased psychological well-being. We set out to provide an assessment of positive self-beliefs that could be used in research and clinical practice.
Methods
A non-probability online survey was conducted with 2500 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. Exploratory factor analysis of a 94-item pool – generated with guidance from people with lived experience of mental health difficulties – was conducted to develop the Oxford Positive Self Scale (OxPos). The item pool was further reduced using regularised structural equation modelling (SEM) before confirmatory factor analysis. Optimal cut-off scores were developed using receiver operating characteristic curves. Additional validations were carried out with two further general population cohorts (n = 1399; n = 1693).
Results
A 24-item scale was developed with an excellent model fit [robust χ2 = 995.676; df = 246; CFI = 0.956; TLI = 0.951; RMSEA = 0.049 (0.047, 0.052); SRMR = 0.031]. The scale comprises four factors: mastery; strength; enjoyment; and character. SEM indicated that the scale explains 68.6% of variance in psychological well-being. The OxPos score was negatively correlated with depression (r = −0.49), anxious avoidance (r = −0.34), paranoia (r = −0.23), hallucinations (r = −0.20), and negative self-beliefs (r = −0.50), and positively correlated with psychological well-being (r = 0.79), self-esteem (r = 0.67), and positive social comparison (r = 0.72). Internal reliability and test–retest reliability were excellent. Cut-offs by age and gender were generated. A short-form was developed, explaining 96% of the full-scale variance.
Conclusions
The new open access scale provides a psychometrically robust assessment of positive cognitions that are strongly connected to psychological well-being.
This chapter investigates the association between frontline manager behavior and employee psychological and physical well-being. Based on the results of a comprehensive literature review of empirical research, we summarize the links between leadership and employee well-being using two broad categories – constructive (e.g., transformational, leader-member exchange) and destructive (e.g., abusive supervision) leadership. We define key concepts and consider the similarities and differences between micro, macro, and meso-level moderators and mediating mechanisms that have been studied in the last decade of scholarly research. Areas for future research are discussed, and promising directions for this area of study are suggested.
This chapter explores the broader topic of creativity and positive outcomes, of which positive emotions are one. The other positive outcomes we focus on include socialization, personal growth, meaning/legacy, and flow. We first describe the various models of well-being that feature these outcomes, such as subjective well-being (SWB; Diener, 1984), psychological well-being (Ryff, 1995), flourishing (Seligman, 2011), and self-determination theory (Ryan & Deci, 2017). In the bulk of this chapter, we discuss the existing research in the creativity field related to each of these five outcomes. Major progress on this topic has been made in recent years, offering much to discuss.
For captive primates, environmental enrichment may improve psychological well-being, as indicated by changes in the frequency of species-typical and abnormal behaviours. The effects of enrichment on physical well-being have also been examined, but little attention has been devoted to the relationship between enrichment and animal health. We therefore studied the health records of 98 rhesus macaques (Macaca mulatta) to measure the effects that enrichment and social housing manipulations had on the number of veterinary treatments and days of therapy required by the monkeys. Subjects were housed singly, in pairs and in groups. Half of the subjects in each housing condition were enriched and the others were controls. Control and enriched subjects did not differ in the number of treatments they required, but enriched subjects received longer therapies than did controls. Neither treatments nor days of therapy were frequent or randomly distributed across housing conditions; pair-housed subjects required the least treatment and therapy, whereas singly-housed subjects were treated slightly more frequently for diarrhoea-related problems, and group-housed subjects for trauma-related problems. Subject age, however, was a potential confounding factor. Because subjects were part of a specific pathogen-free breeding programme, they spent only certain ages in each housing condition. Results suggest that inanimate enrichment neither diminishes nor improves the health of young macaques, but that enriched monkeys may require longer periods of therapy than do controls. Pair housing may be an effective housing strategy from both veterinary and behavioural points of view, necessitating relatively few treatments, but providing some social enrichment opportunities.
The social behaviour, ranging, and stereotypic behaviours of four red ruffed lemurs (one female, three males) was observed during group formation and release into a 2.25ha natural habitat enclosure at the Duke University Primate Center (DUPC). The female was immediately dominant to all males and there was no female-male affiliation during the initial stages of group formation. The group became identifiable as a unit after release to free-ranging when affiliation and group vocalizations began. Affiliation and vocalizations continued during subsequent recagings. Male dominance rank reflected relative age, but was subject to reversals. The stresses involved in release and group formation, however, can temporarily produce new aberrant behaviours which are soon replaced by normal behaviours. Once released into the large enclosure, stereotypic behaviours became infrequent but did not disappear. Other novel behaviours such as catatonic huddle and all male huddles were observed during release. Natural habitat enclosures can be important tools in the psychological well-being of captive primates.
Mammals are unique among vertebrates in experiencing a need to carry out behaviours which are not necessary for their immediate survival. This poses questions as to the nature of these behavioural needs, how they evolved and their implications for the welfare of mammals in captivity. Evidence is provided to show that mammals carry out daily programmes of activity which meet four kinds of requirement, namely, for security, appropriate environmental complexity, novelty and opportunities for achievement. Within their programmes mammals perform two kinds of activity: work, which relates to day to day survival, and leisure, in the form of curiosity or play, which provides experience which may prove to be of value in the long term.
The existence of behavioural needs is consistent with our knowledge of mammalian evolution. Even the earliest known mammals, living over 120 million years ago, differed from reptiles in having brain to body size ratios four to five times greater. The increase in brain size resulted largely from the massive expansion of a region of the cerebral cortex, known as the neopallium, which acts as a co-ordinating centre for sensory data, and creates a model of the world which determines subsequent action. During the 60 million year tertiary era, relative brain size increased in most orders of eutherian mammals, so that only the more intelligent survived.
Because mammals rely for their survival on collecting and analyzing data and acting intelligently, they need facilities to search for information to establish and monitor their concept of the real world; their psychological well-being depends on an environment which offers such facilities. There are two kinds of behavioural needs; psychological needs, which appear to be unique to mammals, and ethological needs which are experienced by all vertebrates. It is concluded that environmental quality for captive mammals should not just be assessed negatively, by the absence of abnormal behaviours, but more positively by the extent to which it meets their psychological needs.
Captive primates rarely have to spend as much time searching for, obtaining and processing food as do their wild counterparts. Enrichment techniques designed to encourage captive primates to spend more species-appropriate amounts of time in foraging behaviours have been successful. The present study measured the behavioural effects of four feeding enhancements: two devices (mats and puzzles) and two foods (produce and frozen juice), on four cohorts (n = 63) of single-caged, yearling rhesus macaques (Macaca mulatta). Devices required considerable manipulation to retrieve rewards, whereas enrichment foods required additional processing. Analyses compared periods when one of the enhancements was available to interim periods when no enhancements were available. Planned comparisons revealed that subjects spent more time feeding, and less time inactive, self-grooming, exploring and behaving socially when feeding enrichment was available. Significantly more time was spent feeding when enrichment foods were provided, but more time was spent playing and using enrichment when devices were in the cage. More time was spent self-grooming and exploring with the acrylic puzzle than with the artificial turf mat. Subjects spent significantly more time feeding when produce was available than when frozen juice was available. Feeding enhancements resulted in more species-typical patterns of activity for single-caged, yearling rhesus. Since feeding devices were used in species-typical activities in addition to feeding, devices may be more valuable than foods. Feeding enrichment programmes which combine stimulating devices with foods that are novel and require processing can positively affect the behaviour of captive primates.