Psychological resilience in young and older adults

Social support and psychotherapy outcomes for international students in university/college counseling centers

Objective: To explore the relationship between international students' social support at intake and international student distress at end of treatment. Participants: Data was collected from participants (n = 40,085) from 90 United States universities using the Center for Collegiate Mental Health (CCMH) database. Methods: Participants completed measures of psychological distress and perceived social support. Using multilevel modeling, we predicted participants' distress at end of treatment by international student status, social support, race, and length of therapy. Results: We found that international students who reported lower social support at intake ended treatment with higher levels of psychological distress when distress at intake was controlled compared to United States peers. Conclusions: Understanding the significance of social support for international students can help to inform mental healthcare professionals' approach to psychotherapy.

Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic

Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June-July 2021), and after 6 months from T1 (T2- November-December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = -2.5, p < .05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.

The role of resilience in the development of depression, anxiety, and post-traumatic stress disorder after trauma in children and adolescents

This investigation, conducted within the Texas Childhood Trauma Research Network, investigated the prospective relationships between resiliency and emergent internalizing symptoms among trauma-exposed youth. The cohort encompassed 1262 youth, aged 8-20, from twelve health-related institutions across Texas, who completed assessments at baseline and one- and six-month follow-ups for resiliency, symptoms of depression, generalized anxiety, posttraumatic stress disorder (PTSD), and other demographic and clinical characteristics. At baseline, greater resilience was positively associated with older age, male (vs female) sex assigned at birth, and history of mental health treatment. Unadjusted for covariates, higher baseline resilience was associated with greater prospective depression and PTSD symptoms but not anxiety symptoms. Upon adjusting for demographic and clinical factors, higher baseline resilience was no longer associated with depression, PTSD, or anxiety symptoms. Our analyses demonstrate that the predictive value of resilience on psychopathology is relatively small compared to more readily observable clinical and demographic factors. These data suggest a relatively minor prospective role of resilience in protecting against internalizing symptoms among trauma-exposed youth and highlight the importance of controlling for relevant youth characteristics when investigating a protective effect of resilience on internalizing symptoms.

Validity and Reliability Study of the Turkish Version of the Orbach Mikulincer Mental Pain Scale-8 in a Clinical Population

Purpose

Suicide is a growing public health issue for all societies; identifying suicide risk is crucial. This study aims to evaluate the psychometric properties of the Turkish version of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8), which enables the assessment of suicidality in a short time.

Patients and Methods

We conducted this study with 148 individuals diagnosed with major depressive disorder and 130 healthy controls. We administered the Hamilton Depression Scale (HDRS), Beck Hopelessness Scale (BHS), Beck Scale for Suicidal Ideation (BSIS), and Mee Bunney Psychological Pain Assessment Scale (MBPPAS) to all participants.

Results

Cronbach's alpha values were 0.96, 0.97, and 0.98 for Factors 1, 2, and 3, respectively, and 0.92 for the entire scale. Exploratory (EFA) and confirmatory factor analyses (CFA) proved the 3-factor structure of the scale. The OMMP-8 total score and HDRS (r = 0.851), BSIS (r = 0.836), BHS (r = 0.825), and MBPPAS (r = 0.881) total scores were statistically significantly correlated, indicating convergent and concurrent validity of the scale. The scale successfully discriminated between depression and control groups (89.6%) and participants with and without suicide attempts in the depression group (82.4%).

Conclusion

This study demonstrates that the Turkish version of the OMMP-8 scale is valid and reliable for both individuals with depression and healthy controls and can be used in studies investigating suicide risk.

Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience

BACKGROUND

Multiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD.

METHODS

Data from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology.

RESULTS

Analysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology.

CONCLUSIONS

Difficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.

Impact of Cohabitation during Confinement on Older Adults' Negative Affect: What Specificity of Life as a Couple?

BACKGROUND

Social isolation is a risk factor for older adults' physical and psychological health. The beneficial effect of social connections in times of major health events is undeniable. Nevertheless, it remains unclear whether the positive effect of social support depends on the relationship type.

OBJECTIVES

This study aimed to investigate the influence of older adults' living conditions on the risk of experiencing negative affect during the first lockdown and post-lockdown.

DESIGN

An epidemiological study conducted during the COVID-19 crisis, at the time of the first lockdown, and 2 to 3 months following the lockdown.

SETTING

A subset sample of the PACOVID survey, a population-based survey of older adults.

PARTICIPANTS

Altogether, 277 participants were included into three groups depending on their living conditions: Group 1 "living alone" (n = 141); Group 2 "living with their spouse" (n = 106); Group 3 "living in cohabitation with relatives" (n = 30).

MEASUREMENTS

Mixed logistic regression analyses were used to study the change in the risk of experiencing negative affects over time according to the living conditions. The presence of negative affects during lockdown was assessed using three items from the 20-item Center for Epidemiologic Studies Depression Scale : «Do you feel sad?»; «Do you feel depressed?; «Do you feel lonely?

RESULTS

Participants living with their relatives or partner were significantly less likely to experience negative affect than those living alone during lockdown. Moreover, over time, only those living with their spouse had this lesser risk compared to those living alone.

CONCLUSIONS

These findings highlight the protective effect of social support over time and more specifically of that provided by the spouse. Couple functioning ought to be given consideration when studying the impact of health crisis situation on the mental health of older adults.

Pain catastrophizing in the elderly: An experimental pain study

OBJECTIVES

Pain catastrophizing in the aging population has not been studied in great detail. Existing investigations have reported conflicting results on the effects of age on pain catastrophizing in relation to pain responses. This study investigated the relationship between pain catastrophizing, and its individual components (rumination, magnification, and helplessness), and the responses to standardized experimental pain stimuli in old and young, healthy adults.

METHODS

Sixty-six volunteers (32 old: 65-87, 18 females; 34 young: 20-35, 17 females) participated in the study. Pain catastrophizing including the components of rumination, magnification, and helplessness was assessed with the pain catastrophizing scale (PCS). Experimental pain was induced by applying predefined pressure stimulations to the trapezius muscle. Pain intensity and unpleasantness were assessed using numerical rating scales. Pain catastrophizing levels and pain responses were statistically compared between the two age groups.

RESULTS

Elderly individuals reported significantly (p = 0.028) lower scores of pain catastrophizing (Med = 5; interquartile range [IQR] = 14) than younger individuals; this difference was driven by the significantly lower components of rumination (Med = 2; IQR = 4; p = 0.017) and helplessness (Med = 2; IQR = 7; p = 0.049). A larger proportion of young (57.8%) rated pain catastrophizing at high levels, with scores above the 75th percentile (Med = 20). Additionally, elderly reported the lowest pain intensity (Med = 5; p = 0.034) and pain unpleasantness (Med = 4.5; p = 0.011) responses to the experimental pressure stimuli. In the elderly group, pain unpleasantness was positively and significantly associated with pain catastrophizing (r s = 0.416, p = 0.021), rumination (r s = 0.42, p = 0.019), and helplessness (r s = 0.434, p = 0.015), respectively. No associations were found in the young group.

CONCLUSIONS

Elderly reported lower PCSs than young adults. Rumination and helplessness were reduced in the elderly group. The elderly population showed positive correlations between catastrophizing levels and pain unpleasantness to standardized pressure pain stimuli. Results supported the view that elderly possess resilience over specific domains of pain catastrophizing that could counteract pain perception due to physiological decline.

Mitigating the impact of family burden on psychological health in parents of children with special needs: Buffering effects of resilience and social support

BACKGROUND AND AIMS

This study examined the link between perceived family burden among parents of children with moderate and severe disabilities and their psychological health, and the potential moderating roles of resilience and social support.

METHODS

256 parents completed an online questionnaire including Demographic Information Form, Family Burden Assessment Scale, General Health Questionnaire, Brief Resilience Scale, and Revised Parental Social Support Scale.

RESULTS

Results revealed negative associations between resilience, social support, and depression-anxiety symptoms. Both resilience and social support played moderating roles in the association between family burden and psychological health. Social support buffered the negative association between family burden and psychological health, alongside psychological resilience.

DISCUSSION AND CONCLUSION

The study highlights the negative effects of family burden on the psychological health of parents of children with disabilities, but also suggests that resilience and social support can mitigate these effects. Therefore, interventions should consider these factors to enhance the psychological well-being of parents.

Aging Makes the Heart Grow Fonder: Age Influences Hearing Ability and Interactions between Psychological Phenomena in Patients with Chronic Tinnitus

(1) Background: Risk factors for chronic tinnitus comprise interactions of individuals' hearing difficulties and psychological distress-including anxiety, depression, and perceived stress levels. Both groups of factors likely become more pronounced with age, although mixed literature has also suggested increases in psychological resilience over time. To this end, only a few studies have delineated direct and indirect effects of age on audiological and psychological variables that might influence tinnitus-related distress in patients with chronic tinnitus. (2) Methods: N = 678 patients with chronic tinnitus completed audiological assessments alongside self-report measures of psychological and tinnitus-related distress. Path analyses investigated the effect of age on patients' tinnitus-related distress via both audiological and psychological variables. (3) Results: Age was significantly associated with both hearing ability and psychological distress indices, with perceived stress and anxiety decreasing with aging. Different mediation models revealed that the association between age and tinnitus-related distress was mediated completely by hearing ability and partly by perceived stress and anxiety. (4) Conclusions: Whilst interactions of individuals' hearing ability and psychological distress levels maintain tinnitus-related distress across the age span, the weighting of these factors may shift with age. Treatment approaches should consider hearing ability across the lifespan. Psychological factors should be individually conceptualized, considering both distress-related and potential resilience factors in old age.

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

Introduction

The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

Objective

Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

Methods

Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

Results

The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

Conclusions

Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI  =  0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

Psychological health among older adult women in the United States during the COVID-19 pandemic

This study examined differences in mental health in older adult women before versus during the COVID-19 pandemic. Participants who were community dwelling (N = 227) included n = 67 women aged 60-94 in the pre-pandemic group and n = 160 women aged 60-85 in the peri-pandemic group who completed self-report measures assessing mental health and quality of life (QOL). We compared mental health and QOL indices across the pre- and peri-pandemic groups. Results indicated that the peri-pandemic group reported higher anxiety (F = 4.94, p = .027) than the pre-pandemic group. No other significant differences emerged. Given the differential effects in this pandemic across SES, we conducted exploratory analyses investigating differences by income group. Controlling for education and race, within the pre-pandemic group, women with lower income reported worse physical function compared to the mid- and high-income groups. Within the peri-pandemic group, women with lower income reported worse anxiety, poorer sleep, and poorer QOL (physical function, role limitations due to physical problems, vitality, and pain) than high-income individuals. Overall, women who reported lower income reported worse mental health and QOL than those with high-income, especially during the pandemic. This indicates that income might act as a buffer for older women against negative psychological outcomes of the COVID-19 pandemic.

The relationship between trait mindfulness and resilience: A meta-analysis

Resilience is a positive psychological resource that promotes health. Trait mindfulness was found to be related to resilience. However, previous studies on this relationship have shown contradictory results. The current meta-analysis explored the relationship between trait mindfulness and resilience based on a three-level random-effects meta-analysis model. A significant and positive relationship between trait mindfulness and resilience (r = 0.385; p < 0.0001) was revealed by analyzing 197 effect sizes from 103 studies. Furthermore, the subsequent moderator analysis found that the facet of mindfulness (e.g., awareness, nonjudging) (F(6, 190)  = 6.181; p < 0.001), measurement of mindfulness (e.g., the Mindful Attention Awareness Scale) (F(7, 191)  = 4.758; p < 0.001), aspect of resilience (e.g., family resilience) (F(5, 191)  = 3.455; p < 0.05), measurement of resilience (e.g., the Connor-Davidson Resilience Scale) (F(11, 185)  = 2.256; p < 0.05), and age (F(1, 150)  = 4.588; p < 0.05) acted as significant moderators. Overall, this study confirmed the positive relationship between trait mindfulness and resilience, suggesting that people with higher levels of trait mindfulness were more likely to have higher levels of resilience. The current findings provided insightful information for interventions targeted at improving resilience.

Euthymia scale as a protective factor for depressive symptoms: a one-year follow-up longitudinal study

OBJECTIVES

This study aimed to examine whether a high score on the euthymia scale (ES) predicts a low incidence of depressive symptoms one year later.

METHODS

The baseline online survey was conducted in February 2020, and a follow-up survey was done in February 2021. Japanese over 20 years old were enrolled. Respondents who answered both baseline and follow-up, and without depressive symptoms at baseline were included in the analysis. The euthymia scores at baseline was measured by the 10 items of the Japanese version of the ES. Depressive symptoms at follow-up were determined if participants showed either depressive feelings or anhedonia. The odds ratio (OR) was calculated using multivariate logistic regression analysis, adjusting for age, gender, marital status, educational attainment, and clinical visit for depressive episode before the baseline survey.

RESULTS

The total of 624 participants were analyzed. A total of n = 63 (10.1%) presented depressive symptom at follow-up. A high ES score significantly predicted a lower incidence of depressive symptoms, after adjusting for covariates (aOR = 0.81 [95% confidence interval: 0.72-0.89]). Using the cutoff score retrieved from this data, a high ES score (7 or more) showed the same tendency, compared to a low ES score (< 7) (aOR = 0.46 [0.25-0.83]).

CONCLUSIONS

This study suggests the predictive usefulness of euthymia for subsequent depressive symptoms. Further investigation is needed by employing rigid diagnostic criteria.

Resilience in Older People: A Concept Analysis

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Psychosocial Perspective on Problem Gambling: The role of Social Relationships, Resilience, and COVID-19 Worry

The COVID-19 pandemic has amplified several psychosocial risks and problem behaviors among vulnerable individuals. Given that gambling has high addictive potential, it is important to consider the underlying mechanisms of problem gambling. This study examined psychosocial factors associated with pandemic-time problem gambling.Cross-sectional data were gathered via an online survey of 18-75-year-old Finnish, Swedish, and British respondents (n = 2,022) who reported having gambled at least occasionally during the pandemic. Measures included problem gambling, loneliness, COVID-19 worry, social support, and psychological resilience. Control variables included gender, age, and education. Structural equation modeling was used as an analytical technique.Loneliness was found to be associated with problem gambling. While COVID-19 worry was not directly associated with problem gambling, it predicted higher loneliness, which in turn was associated with problem gambling. Evidence was not found regarding the protective role of resilience or social support in problem gambling. However, social support was found to be associated with higher problem gambling severity. Male gender and younger age were associated with problem gambling.The results bring insight into underlying vulnerabilities regarding problem gambling during the pandemic. More focus should be placed on the quality and sources of social support, as well as on how psychosocial risk and protective factors might work differently among different populations of gamblers.

Resiliency Among Women's Health Initiative Women Aged 80 and Older by Race, Ethnicity, and Neighborhood Socioeconomic Status

OBJECTIVES

A comprehensive examination of resilience by race, ethnicity, and neighborhood socioeconomic status (NSES) among women aged ≥80 is needed, given the aging of the U.S. population, increasing longevity, and growing racial and ethnic diversity.

METHODS

Participants were women aged ≥80 enrolled in the Women's Health Initiative. Resilience was assessed with a modified version of the Brief Resilience Scale. Descriptive statistics and multiple linear regression examined the association of demographic, health, and psychosocial variables with resilience by race, ethnicity, and NSES.

RESULTS

Participants (n = 29,367, median age = 84.3) were White (91.4%), Black (3.7%), Hispanic (1.9%), and Asian (1.7%) women. There were no significant differences by race and ethnicity on mean resiliency scores (p = .06). Significant differences by NSES were observed regarding mean resiliency scores between those with low NSES (3.94 ± 0.83, out of 5) and high NSES (4.00 ± 0.81). Older age, higher education, higher self-rated health, lower stress, and living alone were significant positive correlates of resilience in the sample. Social support was correlated with resilience among White, Black, and Asian women, but not for Hispanic women. Depression was a significant correlate of lower resilience, except among Asian women. Living alone, smoking, and spirituality were significantly associated with higher resilience among women with moderate NSES.

DISCUSSION

Multiple factors were associated with resilience among women aged ≥80 in the Women's Health Initiative. Despite some differing correlates of resilience by race, ethnicity, and NSES, there were many similarities. These results may aid in the design of resilience interventions for the growing, increasingly diverse population of older women.

Effects of Locomotion Regulatory Mode on COVID-19 Anxiety: The Mediating Role of Resilience

The COVID-19 pandemic has exerted a significant impact on mental health globally. The uncertainty, fear, and stress associated with this crisis have contributed to a heightened prevalence of anxiety, depression, and various other mental health disorders. In this scenario, the present study aimed at investigating the relationship between locomotion regulatory mode, resilience, and COVID-19 anxiety. It is worth noting that previous extensive research has established a significant correlation between high levels of locomotion and diverse positive psychological conditions, such as optimism, reduced hopelessness, and a positive effect. A total of 243 participants completed measures of locomotion regulatory mode, resilience, and COVID-19 anxiety. In line with our hypotheses, individuals' locomotion regulatory mode was negatively, although non-significatively, associated with COVID-19 anxiety. Furthermore, resilience was found to mediate the relationship between the locomotion regulatory mode and COVID-19 anxiety, indicating that individuals displaying high locomotion may be better equipped to cope with the stress and uncertainty of the COVID-19 pandemic due to their greater levels of resilience. Taken together, these findings highlight the importance of considering both locomotion and resilience in managing anxiety related to COVID-19, and suggest that interventions aimed at enhancing resilience may be particularly beneficial for individuals with a low locomotion regulatory mode.

The relationship of coping skills with psychache in patients with depressive disorder

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

Anger and Aggression in Relation to Psychological Resilience and Alcohol Abuse among Health Professionals during the First Pandemic Wave

Mental health problems, behavior changes, and addictive issues have been consistently documented among healthcare workers during the pandemic. The objective of this study was to investigate the levels of anger and aggression in relation to psychological resilience and alcohol abuse among healthcare workers during the first wave of the COVID-19 pandemic. A total of 120 physicians and 123 nurses completed an online survey of the Dimensions of Anger Reactions-5 (DAR-5), the Brief Aggression Questionnaire (BAQ), the Brief Resilience Scale (BRS), and the Alcohol Screening questionnaire CAGE which is an acronym for the focus of the questions (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers). Demographic and professional data were also recorded. A total of 53 men and 190 women participated in the study. Almost one-third of the participants had a positive score on the DAR-5 scale and one out of ten respondents presented with current problematic alcohol use. Male participants demonstrated lower scores on the DAR-5 scale compared to females. Individuals with current problematic alcohol use displayed higher scores on the BAQ compared to those without alcohol use disorders. Regression analysis revealed that 16.4% of the variance in the BAQ scores can be attributed to scores on the DAR-5, 5.9% to the BRS scores, 2.1% to the CAGE scores, 1.7% to gender, and 1.2% to years of work experience. Mediation analysis highlighted the role of psychological resilience as a negative mediator in the DAR-5 and BAQ relationship. Professional experience and alcohol abuse emerged as positive and negative risk factors contributing to aggression and psychological resilience. The findings hold practical implications for implementing interventions to strengthen resilience in order to compensate for aggressive tendencies and discourage addictive issues.

The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic

The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly's mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.

The medicalization of life: An interdisciplinary approach

In recent years, consumption of antidepressant and psychotropic drugs has skyrocketed and, although contemporary life clearly involves countless conflicts, the same can be said of human beings throughout their respective historical moments. Part of the human condition is recognizing that we are vulnerable and dependent beings, thus philosophical reflection brings us to an important ontological point of consideration. The World Health Organization has expressed its regarding the medicalization of life, as have many renowned psychiatrists who subscribe to the philosophical idea of naturally overcoming life's conflicts through resilience. In this paper, we analyze the anthropological view of the human being as a being in need, the problem of the medicalization of emotional life in contemporary society, and the psychological position of resilience. We conclude that psychology and philosophy hold similar personal development tools for people without significant psychiatric or psychological problems in order to face the problems of human existence with self-government.

Associations between Social Support Dimensions and Resilience Factors and Pathways of Influence in Depression and Anxiety Rates in Young Adults

Emerging adulthood is an important developmental period, associated to mental health risk. Resilience research points to both social and personal protective factors against development of psychopathology, but there is paucity with their comprehensive study in young adults. This study provides and initial integrative approach to model multiple dimensions of perceived social support (i.e., from family, friends, significant others) and personal factor of trait resilience (i.e., coping and persistence during stress, tolerance to negative affect, positive appraisals, trust) and their hypothesized contributions to reducing depression and anxiety rates. The study was conducted with a sample of 500 Spanish emerging adults (18 to 29 years old). Regression analyses and multiple mediation models were performed to test our hypotheses. Results showed that social support from family was the dimension with the highest strength relating individual differences in resilience. Furthermore, analyses supported a differential mediating role of specific resilience factors (coping and persistence during stress, tolerance to negative affect, positive appraisals, trust) in partially accounting for the association between higher social support from family and lower depression and anxiety levels in young adults. These results may inform new programs of mental health during emerging adulthood via the promotion of different sources of social support and their related resilience pathways contributing to low emotional symptomatology at this stage of development.

Pandemic Depression: COVID-19 and the Mental Health of the Self-Employed

We investigate the effect of the COVID-19 pandemic on self-employed people’s mental health. Using representative longitudinal survey data from Germany, we reveal differential effects by gender: whereas self-employed women experienced a substantial deterioration in their mental health, self-employed men displayed no significant changes up to early 2021. Financial losses are important in explaining these differences. In addition, we find larger mental health responses among self-employed women who were directly affected by government-imposed restrictions and bore an increased childcare burden due to school and daycare closures. We also find that self-employed individuals who are more resilient coped better with the crisis.

What factors explain the changes in major depressive disorder symptoms by age group during the COVID-19 pandemic? A longitudinal study

BACKGROUND

Data collected during the COVID-19 pandemic suggest an increase in major depressive disorder (MDD) among younger adults. The current study aims to assess the association of age groups and MDD risk before and during the COVID-19 pandemic and quantify the effect of potential mediating variables such as loneliness, social support, resilience, and socioeconomic factors.

METHODS

A representative sample of Spanish adults was interviewed before (2019, N = 1880) and during (2020, N = 1103) the COVID-19 pandemic. MDD was assessed using the CIDI, loneliness through the UCLA scale, social support through the OSSS-3, resilience with the 6-BRS, and worsened economic circumstances and unemployment through a single question. Mixed-models were used to study changes in MDD by age group. Regression models were constructed to quantify the association between age and potential mediators, as well as their mediating effect on the association between age group and MDD.

RESULTS

Among the younger age cohorts (18-29 and 30-44 years) the probability of having MDD during the pandemic increased from 0.04 (95 % CI: 0.002-0.09) to 0.25 (0.12-0.39) and from 0.02 (-0.001-0.03) to 0.11 (0.04-0.17), respectively. Some 36.6 % of the association between age and risk of MDD during the pandemic was explained by loneliness (12.0 %), low resilience (10.7 %), and worsened economic situation (13.9 %).

LIMITATIONS

Reliance on self-report data and generalizability of the findings limited to the Spanish population.

CONCLUSIONS

Strategies to decrease the impact of a pandemic on depressive symptoms among young adults should address loneliness, provide tools to improve resilience, and enjoy improved financial support.

Religiosity and Social Support Predict Resilience in Older Adults After a Flood

In this study, we examined religiosity and social support as predictors of resilience after a devastating flood. Three flood exposure groups of primarily middle-aged and older adults were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in the 2016 flood, and (3) twice-flooded adults who had relocated inland because of prior catastrophic losses in the 2005 Hurricanes Katrina and Rita and then flooded again in 2016. Resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC). Correlation analyses confirmed that older age was correlated with higher religiosity, charitable work done for others, and resilience. Regression analyses indicated that religious beliefs and coping, social support, and charitable work done for others were associated with higher levels of resilience, whereas flood damage was unrelated to resilience. Implications for current views on post-disaster adversity and resilience in later life are discussed.

Impact of Age and Gender on Quality of Life Among General Otolaryngology Patients

OBJECTIVES

The combined effects of age and gender on health-related quality of life (HRQoL) in otolaryngology patients are unclear. This study tested the hypothesis that the effect of age on HRQoL differs by gender in otolaryngology patients.

METHODS

Patients seen in a general otolaryngology clinic were included in this retrospective chart review. HRQoL was measured by the SF-6D score. Patient characteristics, including demographics and category of chief otolaryngology complaint, were extracted from medical records. A multivariable linear regression analysis was used to analyze the combined effect of age and gender on HRQoL. The model was adjusted for race, ethnicity, number of complaint categories, and number of medications.

RESULTS

The study included 728 patients (age mean = 52, SD = 18; 48% male). Multivariable linear regression models found a significant interaction effect between age and gender (β = 0.213, p < 0.05). For younger patients, female gender was protective; however, at age greater than 35 years, female gender was a risk factor for decreased HRQoL. Compared to Black patients, Asian and other race patients reported significantly greater HRQoL (β = 0.207, p < 0.05 for Asian; β = 0.126, p < 0.05 for other races). Additionally, an antagonistic interaction effect was found between age and number of category of otolaryngology complaints in moderating HRQoL (β = 0.468, p < 0.001).

CONCLUSION

Age affects HRQoL differently in men than in women. Among otolaryngology patients, women experience a greater decrease in HRQoL as they age.

LEVEL OF EVIDENCE

4 Laryngoscope, 133:801-806, 2023.

[Sociodemographic and social correlates of self-reported resilience in old age-results from the population-based LIFE-Adult-Study]

INTRODUCTION

Resilience describes good adaptation to adversity and is a significant factor for well-being in old age. Initial studies indicate a high relevance of social resources. So far, only few studies have investigated resilience patterns in the elderly population. Therefore, the present study aims to investigate sociodemographic and social correlates of resilience in a large population-based sample aged 65 years and older.

METHODS

Analyses were conducted on n = 2410 people aged 65 years and older from the follow-up survey of the LIFE-Adult-Study. The survey included the variables resilience (Resilience Scale - RS-11), social support (ENRICHD Social Support Inventory - ESSI), and social network (Lubben Social Network Scale - LSNS-6). The association of sociodemographic and social variables with resilience was analyzed using multiple linear regression analysis.

RESULTS

The age of 75 years and older was associated with lower resilience compared with the age of 65-74 years. Further, widowed marital status was related to higher resilience. Better social support and a larger social network were significantly associated with higher resilience. No association was found for gender and education.

DISCUSSION

The results reveal sociodemographic correlates of resilience in the elderly population that can help identify at-risk groups with lower resilience. Social resources are significant in older age for resilient adaptation and represent a starting point for deriving preventive measures. Social inclusion of older people should be promoted to strengthen resilience in this population and provide favorable conditions for successful aging.

The Association between Cognitive Reserve and Depressive Mood in Older Inpatients: Gender and Age Differences

Cognitive Reserve (CR) plays a protective role in neurological and acute/chronic diseases. Its effect on mood, however, is still unclear, although it may be relevant in a hospital setting. We aimed to explore the relationship between CR and depressive mood in older inpatients, evaluating possible gender- and age-related differences. This study involved 86 inpatients aged ≥65 years with an MMSE ≥15. Participants underwent a multidimensional evaluation that included the assessment of CR with the Cognitive Reserve Index questionnaire, divided into three sections (Education, Working Activity, and Leisure Time). Depressive mood was assessed with the 15-item Geriatric Depression Scale (GDS). The relationship between CR and GDS was evaluated by multivariable linear regressions. Significant inverse associations between CR and GDS scores emerged in the total sample (β = -0.03 [SD = 0.02], p = .047), especially in men (β = -0.05 [SD = 0.02], p = .005) and in individuals aged <85 years (β = -0.07 [SD = 0.03], p = .01). Among the single CRI sections, CRI-Leisure Time was significantly associated with GDS in the total sample, in men, and participants <85 years. CR seems to be inversely associated with depressive mood in older inpatients. This relationship is particularly marked for CR related to Leisure Time, which may be modifiable even in older age through social support and interaction.

Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone

Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.

Mechanisms of Physical Exercise Effects on Anxiety in Older Adults during the COVID-19 Lockdown: An Analysis of the Mediating Role of Psychological Resilience and the Moderating Role of Media Exposure

The purpose of this study was to explore the effects of physical exercise on anxiety in older adults during the COVID-19 pandemic lockdown, as well as the mediating role of psychological resilience and the moderating role of media exposure. An online questionnaire was used to survey older adults in Chengdu, Southwest China. A total of 451 older adults aged 60 years and older participated in the study (209 males and 242 females). The results suggest that physical exercise negatively influenced anxiety symptoms in older adults; psychological resilience mediated the effect of physical exercise on anxiety in older adults and negatively predicted it; furthermore, media exposure moderated the effects of physical exercise and psychological resilience on anxiety, and low levels of media exposure strengthened these effects. This study suggests that participation in physical exercise and reduced media exposure during the COVID-19 pandemic lockdown may have reduced anxiety in older adults.

Postoperative Pain after Different Transscleral Laser Cyclophotocoagulation Procedures

BACKGROUND

As the number of surgical options in glaucoma treatment is continuously rising, evidence regarding distinctive features of these surgeries is becoming more and more important for clinicians to choose the right surgical treatment for each individual patient.

METHODS

For this retrospective data analysis, we included glaucoma patients treated with either continuous wave (CW-TSCPC) or micropulse transscleral cyclophotocoagulation (MP-TSCPC) in an inpatient setting. Pain intensity was assessed using a numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst imaginable pain) during hospitalization. CW-TSCPC was performed using OcuLight^® Six (IRIDEX Corporation, Mountain View, CA, USA) and MP-TSCPC was performed using the IRIDEX^® Cyclo-G6 System (IRIDEX Corporation, Mountain View, CA, USA).

RESULTS

A total of 243 consecutive cases of TSCPC were included. Of these, 144 (59.26%) were treated with CW-TSCPC and 99 (40.74%) with MP-TSCPC. Using the univariable model, the risk for postoperative pain was observed to be lower in MP-TSCPC compared with CW-TSCPC (unadjusted: OR 0.46, 95% CI 0.24-0.84, p = 0.017), but this did not hold using the multivariable model (adjusted: OR 0.52, 95% CI 0.27-1.02, p = 0.056). Simultaneously conducted anterior retinal cryotherapy was associated with a higher risk for postoperative pain (OR 4.41, 95% CI 2.01-9.69, p < 0.001).

CONCLUSIONS

We found that the occurrence of postoperative pain was not different in CW-TSCPC compared with MP-TSCPC in a multivariable model. In cases of simultaneous anterior retinal cryotherapy, the risk for postoperative pain was significantly higher.

Relation between resilience and personality traits: The role of hopelessness and age

Resilience refers to the process by which individuals use the ability to cope with challenges to successfully adapt to adverse situations, inclining towards the future and hope. The main aim of this study was to analyze the relation between resilience, personality traits, and hopelessness. Furthermore, we conducted comparisons between two age groups: young and older adults. The sample comprised 439 Spanish participants (66.7% women; M = 43.73, SD = 26.41; age range = 18-98 years). The Connor-Davidson Resilience Scale, NEO-Five Factor Inventory, and Beck Hopelessness Scale were used to measure the main study variables. The results revealed a negative relation between resilience and neuroticism, and a positive association with the other personality traits. Additionally, levels of resilience were found to be negatively related to hopelessness. The group of older adults showed significantly lower resilience levels than the young adults, although age was not a significant predictor of resilience. Neuroticism, extraversion, openness, and hopelessness were the only predictors of resilience for the current study. This work contributes to the study of resilience and related factors, by attempting to understand the role of resilience and resistance to risk and how individuals tackle challenges over time, with important implications for mental health.

Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience

OBJECTIVES

This study aimed to investigate the mediating role of self-esteem in the relationship between physical disability and suicidal ideation, and whether the mediation effect was moderated by resilience among nursing home residents.

METHODS

Participants were 538 nursing home residents recruited from 37 nursing homes in Jinan, China (mean age = 78.13 years, SD = 8.72). The Lawton and Brody Activities of Daily Living Scale, Rosenberg Self-Esteem Scale, 10-item version of the Connor-Davidson Resilience Scale, and Beck Suicidal Ideation Inventory-Chinese Version were used. Mediation and moderated mediation analyses were performed using Models 4 and 15 of the PROCESS macro for SPSS.

RESULTS

The prevalence of suicidal ideation among the nursing home residents was 14.90%. The mediation analysis showed that self-esteem partially mediated the association between physical disability and suicidal ideation. Resilience was a protective factor for suicidal ideation and moderated the relationship between physical disability and suicidal ideation, and between self-esteem and suicidal ideation.

CONCLUSION

Both physical disability and lower self-esteem are important in understanding the development of suicidal ideation among nursing home residents. Improving resilience may be crucial for suicide prevention.

Nursing Home Residents' Perceptions of Challenges and Coping Strategies during COVID-19 Pandemic in China

Older people in nursing homes are at a high risk of being infected by coronavirus disease 2019 (COVID-19). They also experienced nursing home lockdowns that harm their psychological wellbeing. Better support for this vulnerable population requires understanding their perceptions of challenges and coping strategies during the COVID-19 pandemic. A qualitative descriptive study was conducted using semi-structured interviews. Thematic analysis approach was used to analyze the data. Participants were recruited from six nursing homes in three cities in Hunan Province, China. Fourteen nursing home residents participated in the study. Four themes were identified from interviews and described as: mental stress and coping strategies, self-regulation to respond to lockdown, the lack of social connection and coping strategies, and the need for medical care services and coping strategies. This study revealed that nursing home residents perceived stress during the nursing home lockdown, but they reported initiating activities to maintain health and connections with their families and peers. Resilience improvement interventions are necessary to enable residents' autonomy and develop their resilience in coping with difficulties and hardship during crises. The findings also indicate that a supportive environment with interactions from families, peers, and staffs played a key role in enabling residents' positive health and wellbeing during the lockdown.

Depression and quality of life among Macau residents in the 2022 COVID-19 pandemic wave from the perspective of network analysis

Background

In the summer of 2022, Macau experienced a surge of COVID-19 infections (the 618 COVID-19 wave), which had serious effects on mental health and quality of life (QoL). However, there is scant research on mental health problems and QoL among Macau residents during the 618 COVID-19 wave. This study examined the network structure of depressive symptoms (hereafter depression), and the interconnection between different depressive symptoms and QoL among Macau residents during this period.

Method

A cross-sectional study was conducted between 26th July and 9th September 2022. Depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9), while the global QoL was measured with the two items of the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Correlates of depression were explored using univariate and multivariate analyses. The association between depression and QoL was investigated using analysis of covariance (ANCOVA). Network analysis was used to evaluate the structure of depression. The centrality index "Expected Influence" (EI) was used to identify the most central symptoms and the flow function was used to identify depressive symptoms that had a direct bearing on QoL.

Results

A total 1,008 participants were included in this study. The overall prevalence of depression was 62.5% (n = 630; 95% CI = 60.00-65.00%). Having depression was significantly associated with younger age (OR = 0.970; p < 0.001), anxiety (OR = 1.515; p < 0.001), fatigue (OR = 1.338; p < 0.001), and economic loss (OR = 1.933; p = 0.026). Participants with depression had lower QoL F (1, 1,008) =5.538, p = 0.019). The most central symptoms included PHQ2 ("Sad Mood") (EI: 1.044), PHQ4 ("Fatigue") (EI: 1.016), and PHQ6 ("Guilt") (EI: 0.975) in the depression network model, while PHQ4 ("Fatigue"), PHQ9 ("Suicide"), and PHQ6 ("Guilt") had strong negative associations with QoL.

Conclusion

Depression was common among Macao residents during the 618 COVID-19 wave. Given the negative impact of depression on QoL, interventions targeting central symptoms identified in the network model (e.g., cognitive behavioral therapy) should be developed and implemented for Macau residents with depression.

An Interaction Effect of Life-Threatening Experience, Self-Efficacy, and Financial Resources on Quality of Life Among Chinese Middle-Aged and Older Women

The current study explores the interaction effect of adversities and self-efficacy at baseline on quality of life (QoL) at follow-up among middle-aged and older Chinese women. 531 women were interviewed in 2008 and 226 of them were re-interviewed a year later using Quality of Life Ladder (QoLL), General Self-Efficacy Scale (GSE), List of Threatening Experiences (LTE), Somatic Complaint Scale, and self-rated health. Respondents' mean age at baseline was 55.7 (SD = 4.7, range: 50-78). Over a year's time, respondents had a decline in quality of life and self-rated health (p < .001), experienced more life-threatening events (p < .05) and somatic complaints. The hierarchical multiple regression model, employed in the study, identifies three predictors of future quality of life after adding the interaction term 'Previous LTE × Previous GSE × Previous household income' - previous quality of life (β = .492, p < .001), previous LTE (β = -.292, p < .001), and the interaction term (β = .221, p < .05). This model explains 34.1% of the variance of future quality of life (Adjusted R² = .341, p < .001). The findings suggests that respondents' good self-appraisal of coping resources could moderate the impact of adversities on their future quality of life. Interventions for promoting positive psychological growth among middle-aged and older adults should cover four domains, i.e. event-related factors, environmental factors, personal factors, and cognitive and coping responses. Traditional Chinese wisdom emphasizes the importance of understanding the bad ('Yin'-the shady side) and the good ('Yang'-the sunny side) aspect of life events. Future research may explore the Yin Yang perspective on life-threatening experiences and its applications in cross-cultural quality of life studies in the era of globalization.

Correlations to and potential implications of resilience among certified pharmacy technicians

OBJECTIVES

To assess resilience among a sample of certified pharmacy technicians in the United States and evaluate associations between resilience and various personal and work-related characteristics and conditions, including coworker support and pharmacist leadership behaviors, and to assess the relationship between technicians' resilience and support from coworkers and commitment to their organization.

METHODS

This study employed the use of a self-administered questionnaire survey electronically in a cross-sectional design. The questionnaire was delivered with a response portal open for approximately 6 weeks during the spring of 2022 to a sample of 3000 technicians certified through the National Healthcareer Association. The questionnaire consisted of items comprising the Brief Resilience Scale, an adapted version of the Multifactorial Leadership Questionnaire (A-MLQ), and items measuring aspects of coworker support, future uncertainty, commitment, and turnover, in addition to demographic and practice site-related questions.

RESULTS

Usable responses were acquired from 822 respondents, who reported relatively high levels of resilience. Resilience was observed to be positively correlated with pharmacy transformative leadership behaviors measured on the A-MLQ and with coworker support and negatively correlated with future uncertainty. Respondents indicating the highest level of profession commitment reported a statistically higher level of resilience than did others. There were very few relationships observed between resilience and technicians' personal characteristics.

CONCLUSIONS

Immutable characteristics (e.g., race/ethnicity, sex, and age) played a very small role in describing resilience among pharmacy technicians. Instead, organizational characteristics of the workplace were shown to be highly associative with resilience of technicians, adding further evidence that organizations and the profession can help facilitate resilience among these important pharmacy support personnel.

The Association of Age With Depression, Anxiety, and Posttraumatic Stress Symptoms During the COVID-19 Pandemic in Spain: The Role of Loneliness and Prepandemic Mental Disorder

OBJECTIVE

Older adults may be at lower risk of common mental disorders than younger adults during the coronavirus disease 2019 (COVID-19) pandemic. Previous research has shown shown differences by age in psychosocial well-being during the pandemic and have highlighted the moderating effect of prepandemic mental disorders on that association. In this line, we examined the association of age with self-reported symptoms of loneliness, depression, anxiety, and posttraumatic stress, as well as potential roles of loneliness symptoms and prepandemic mental disorders on the association between age and mental disorder symptoms.

METHODS

Cross-sectional data of 2000 adults in Spain interviewed by telephone during the COVID-19 pandemic (February-March 2021) were analyzed. Depression, anxiety, and posttraumatic stress were measured with the eight-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the four-item checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), respectively. Loneliness was measured with the three-item University of California at Los Angeles Loneliness Scale. Several regression models were constructed to assess factors related to loneliness and mental disorders.

RESULTS

According to cutoff points used, 12.4% of participants revealed depression, 11.9% revealed anxiety, and 11.6% revealed posttraumatic stress. Age was negatively related to mental disorder symptoms and loneliness. Loneliness was associated with higher levels of mental disorder symptoms. This association was stronger in younger adults without prepandemic mental disorders and in older adults with them. The association between age and loneliness was stronger in those with prepandemic mental disorders. Loneliness mediated the association of age with mental disorder symptoms.

CONCLUSIONS

Interventions focused on loneliness could alleviate the impact of the COVID-19 pandemic on mental health.

Does the self-reported playfulness of older adults influence their wellbeing? An exploratory study

Aim: Older adults represent a growing demographic in Australia who are at an increased risk of isolation, loneliness, and experiencing poorer overall health. Thus, the need for understanding factors that influence older adults' wellbeing is important. Emergent research into adult playfulness has shown positive associations with indicators of wellbeing, but limited research has been conducted in older adults (60+). This study investigated whether types of playfulness present in Australian older adults (60+) were predictive of their wellbeing.Method: An online survey was administered (n = 123) using the Other-directed, Light-hearted, Intellectual, Whimsical (OLIW) Playfulness Scale and the PERMA-Profiler wellbeing measure to explore playfulness types and its influence on self-reported wellbeing. Multiple linear regression analysis with bootstrapping was completed to determine if any significant relationships between OLIW and PERMA-Profiler subscales existed.Results: Playfulness was a significant predictor of wellbeing. The OLIW Other-directed subscale (enjoyment of others, using playfulness in tense situations) was the greatest predictor of PERMA-Profiler subscales with OLIW Intellectual and Whimsical subscales making smaller contributions.Conclusion/implications: Playfulness was shown to be a significant contributor to wellbeing in older adults and should be used as a part of occupational therapy intervention, especially when considering social activities.

Is musical engagement enough to keep the brain young?

Music-making and engagement in music-related activities have shown procognitive benefits for healthy and pathological populations, suggesting reductions in brain aging. A previous brain aging study, using Brain Age Gap Estimation (BrainAGE), showed that professional and amateur-musicians had younger appearing brains than non-musicians. Our study sought to replicate those findings and analyze if musical training or active musical engagement was necessary to produce an age-decelerating effect in a cohort of healthy individuals. We scanned 125 healthy controls and investigated if musician status, and if musical behaviors, namely active engagement (AE) and musical training (MT) [as measured using the Goldsmiths Musical Sophistication Index (Gold-MSI)], had effects on brain aging. Our findings suggest that musician status is not related to BrainAGE score, although involvement in current physical activity is. Although neither MT nor AE subscales of the Gold-MSI are predictive for BrainAGE scores, dispositional resilience, namely the ability to deal with challenge, is related to both musical behaviors and sensitivity to musical pleasure. While the study failed to replicate the findings in a previous brain aging study, musical training and active musical engagement are related to the resilience factor of challenge. This finding may reveal how such musical behaviors can potentially strengthen the brain's resilience to age, which may tap into a type of neurocognitive reserve.

Psychological Health of Surgeons in a Time of COVID-19: A Global Survey

OBJECTIVE

To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic.

SUMMARY OF BACKGROUND DATA

The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19.

METHODS

We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the depression anxiety stress scale-21 and Impact of Event Scale-Revised scores.

RESULTS

A total of 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9%, and 24.0% screened positive for depression, anxiety, stress, and PTSD respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress, and PTSD (OR 1.3, 1.6, 1.4, 1.7 respectively, all P < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress, and PTSD (OR 1.2, 1.2, and 1.3 respectively, all P < 0.05). Surgical specialties that operated in the head and neck region had higher psychological distress among its surgeons. Deployment for COVID- 19-related work was not associated with increased psychological distress.

CONCLUSIONS

The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

The mediating role of psychological resilience between social participation and life satisfaction among older adults in China

BACKGROUND

A significant correlation has been discovered between social participation and older adults' life satisfaction, but the relationships among social participation, psychological resilience, and life satisfaction remain to be confirmed. Therefore, this study aims to identify the relationship between social participation and life satisfaction for Chinese older adults and to analyse the possible mediating role of psychological resilience between these two aspects.

METHODS

Data on 15,779 people aged 65 years and above were extracted from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Social participation was classified into two levels: low-level involvement activities and high-level involvement activities. Hierarchical regression analysis was applied to analyse the correlations between the two levels of social participation and older adults' life satisfaction as well as the mediating effects of psychological resilience on this association.

RESULTS

The results indicate that two levels of social participation were each positively correlated with life satisfaction. Specifically, high-level involvement activities (β = 0.070, P < 0.001) were more strongly associated with life satisfaction than low-level involvement activities (β = 0.051, P < 0.001). Moreover, psychological resilience was found to partially mediate the association between low-level involvement activities and high-level involvement activities and life satisfaction.

CONCLUSION

A higher level of life satisfaction for older adults is related to participation in high-level involvement activities. Psychological resilience has a mediating effect on the association between two levels of older adults' social participation and life satisfaction. These findings suggest that the government and society should establish a more concrete understanding of the psychological resilience of older adults.

Personality and health-related quality of life (HRQoL) of Hong Kong Chinese older people: resilience as a mediator and financial status as a moderator

Objectives: Personality can influence older adults' health and quality of life. However, the pathways are relatively less examined. This study aimed to understand the mediating effect of resilience in the relationship between two personality traits-neuroticism and extraversion-and Hong Kong Chinese older adults' health-related quality of life (HRQoL). Whether such effect varied across older adults in different financial conditions were also examined. Method: A purposive non-probability sample of 253 Hong Kong Chinese older adults aged 60 and above was recruited for a face-to-face questionnaire survey. Neuroticism and extraversion were measured using the subscales form the Big Five Inventory (BFI). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HRQoL was measured by the short-form 8 (SF- 8). Path analysis was conducted to examine the relationship between key variables. Multi-group path analysis was also performed to investigate whether the pathways differed by financial status. Indirect effects were computed in the path analyses to detect the mediatory role of resilience between personalities and HRQoL.Results: The findings included that after controlling for confounders, neuroticism, but not extraversion was significantly associated with HRQoL. The relationships were mediated by resilience. Moreover, the mediating role of resilience is more pronounced among the participants who live in a financially poor or fair condition, comparing to their wealthier peers.Conclusion: This study confirmed the important role of personality in shaping older adults' resilience and quality of life. Personality should be kept in mind in the identification of potential vulnerable groups for interventions, especially those in financial hardships who may face double disadvantages.

The Association of Resilience with Mental Health in a Large Population-Based Sample (LIFE-Adult-Study)

Resilience describes a good adaptation to adversity. Strengthening resilience is a promising approach in the prevention of mental health problems. Yet, research on the association of resilience with mental health symptoms in the general population is scarce. The aim of our study is to examine comprehensively the association of resilience with depressive symptoms, anxiety, and perceived stress in a large population-based sample. We analyzed data of n = 3762 participants from the follow-up assessment of the LIFE-Adult-Study, a population-based cohort study in Leipzig. Assessments included resilience (RS-11), depressive symptoms (CES-D), anxiety (GAD-7), and perceived stress (PSQ). The association of resilience with mental health symptoms was examined via multiple linear regression analyses. In our analyses, higher resilience predicted less mental health problems and contributed significantly to the explained variance in mental health outcomes. Women, individuals with previous mental disorders, and those without employment had higher mental health symptoms. Resilience is closely associated with mental health problems in the general population. Vulnerable groups should be targeted with public health measures. Strengthening resilience is a promising approach in the large-scale prevention of mental disorders.

The effect of age on resilience of health-related quality of life among polytrauma patients: a cross-sectional multicenter study

Purpose

The aim of this study was to determine the impact of age on patient-reported health-related quality of life (HRQoL) and the capacity to show resilience—i.e., the ability to adapt to stressful adverse events—after sustaining a polytrauma.

Methods

A cross-sectional multicenter cohort was conducted between 2013 and 2016 that included surviving polytrauma patients (ISS ≥ 16). HRQoL was obtained by the Short Musculoskeletal Function assessment and EuroQol (SMFA and EQ-5D-5L). The effect of age on HRQoL was tested with linear regression analysis. Next, the individual scores were compared with age- and sex-matched normative data to determine whether they showed resilience. Multivariate binary logistic regression was used to assess the effect of age on reaching the normative threshold of the surveys, correcting for several confounders.

Results

A total of 363 patients responded (57%). Overall, patients had a mean EQ-5D-5L score of 0.73. With higher age, scores on the SMFA subscales “upper extremity dysfunction,” “lower extremity dysfunction” and “daily activities” significantly dropped. Only 42% of patients were classified as being resilient, based on the EQ-5D-5L score. Patients aged 60–69 showed the highest resilience (56%), and those aged 80 + showed the lowest resilience (0%).

Conclusion

Sustaining a polytrauma leads to a serious decline in HRQoL. Aging is associated with a decline in the physical components of HRQoL. No clear relationship with age was seen on the non-physical components of quality of life. Octogenarians, and to a lesser extent septuagenarians and tricenarians, showed to be very vulnerable groups, with low rates of resilience after surviving a polytrauma.

College Student Resilience During COVID-19: Examining the Roles of Mindfulness, Compassion, and Prosocial Behavior

The present study examined factors associated with resilience in college students during the COVID-19 pandemic. Participants were undergraduates at a large Midwestern university in the USA (N = 848). Hierarchical linear regression analyses examined self-reported pandemic-related adversity, community COVID-19 case rates, mindfulness, compassion, and prosocialness to determine the strongest associates of resilience. Findings demonstrated that mindfulness was the only psychological process of interest significantly associated with resilience, so specific facets were further explored in a regression analysis. Specifically, higher levels of the following mindfulness skills were associated with greater resilience: ability to describe internal experiences, to remain aware while engaging in action, and to take a nonreactive stance toward internal experiences. Mindfulness-based interventions may be appropriate for promoting resilience in college students during the COVID-19 pandemic.

Resilience in relation to older adults with multimorbidity: A scoping review

The purpose of this scoping review is to identify conceptual and theoretical resilience models, types of resilience measures, and outcomes regarding resilience in relation to older adults with multimorbidity. PubMed, Embase, CINAHL, and PsycINFO were searched, and we identified 14 studies to July 2021. Most models operationalize resilience as dependent on the social and environmental context of older adults. Three of the five resilience measures in the included studies are used to evaluate general resilience. They are primarily psychological or psychosocial in nature, and measuring physical resilience therefore may help to better understand individuals' ability to cope with the physical challenges associated with various chronic diseases. Quality of life and physical activity were common outcomes in studies of resilience. Findings highlight the need for studies that incorporate physiological measures or physical properties of resilience and longitudinal studies that capture the dynamic process of resilience in older adults with multimorbidity.

Prosecution as a "Soul Crushing" Job: Emotional Labor and Secondary Trauma in Working Sexual Assault Cases

Prosecutors who work sex crimes face considerable legal constraints, for example, the need for corroborating evidence to prove their case, as well as extra-legal factors including biases that influence decision-making across the criminal justice system. Beyond these factors, sexual assault cases, especially those involving college students, present significant emotional trauma not only for victims, but also for prosecutors. This inductive study explores the ways prosecutors handle system constraints and how they experience and manage their response to emotionally difficult cases. Qualitative interview data revealed strategies that prosecutors use to mitigate the psychological impacts of participation in the courtroom experience on survivors of sexual assault and indicators of secondary trauma. In combination, this study's examination of legal and extra-legal factors, secondary and vicarious trauma, and emotional labor contribute to a theory of how prosecutors work campus sex crime cases, expanding our understanding of both prosecutors' roles and emotional labor, with implications for research, policy and practice.