Giving to others and the association between stress and mortality

Informal Helping and Subsequent Health and Well-Being in Older U.S. Adults

BACKGROUND

Growing evidence suggests that informal helping (unpaid volunteering not coordinated by an organization or institution) is associated with improved health and well-being outcomes. However, studies have not investigated whether changes in informal helping are associated with subsequent health and well-being.

METHODS

This study evaluated if changes in informal helping (between t0;2006/2008 and t1;2010/2012) were associated with 35 indicators of physical, behavioral, and psychosocial health and well-being (at t2;2014/2016) using data from 12,998 participants in the Health and Retirement study - a national cohort of US adults aged > 50.

RESULTS

Over the four-year follow-up period, informal helping ≥ 100 (versus 0) hours/year was associated with a 32% lower mortality risk (95% CI [0.54, 0.86]), and improved physical health (e.g., 20% reduced risk of stroke (95% CI [0.65, 0.98])), health behaviors (e.g., 11% increased likelihood of frequent physical activity (95% CI [1.04, 1.20])), and psychosocial outcomes (e.g., higher purpose in life (β = 0.15, 95% CI [0.07, 0.22])). However, there was little evidence of associations with various other outcomes. In secondary analyses, this study adjusted for formal volunteering and a variety of social factors (e.g., social network factors, receiving social support, and social participation) and results were largely unchanged.

CONCLUSIONS

Encouraging informal helping may improve various aspects of individuals' health and well-being and also promote societal well-being.

The reciprocal relationship between prosocial behaviour and self-perceived physical health: The role of positive affect and openness to experience

The present study used a cross-lagged design to explore the bidirectional relationship between adolescents' prosocial behaviour and self-perceived physical health and to explore the mediating role of positive affect and the moderating role of openness to experience. A total of 1525 middle school students (Mage = 12.41, 47% male) in northern China were surveyed for 3 years. The results showed the following: (1) prosocial behaviour at T1 positively predicted self-perceived physical health at T3; and vice versa; and (2) this observed relation between prosocial behaviour and self-perceived physical health was explained by positive affect; (3) the mediating role of positive affect on the path from prosocial behaviour at T1 to self-perceived physical health at T3 was observed only among adolescents with high openness traits. This finding verified the protective effect of prosocial behaviour on the healthy development of the actor.

The Impact of Coping Styles on the Mental Health of Outstanding Physical Education Students in Shanghai During the Normalization Epidemic: The Chain Mediation Role of Meaning in Life and Prosocial Behavior

Purpose

The continuous spread of the epidemic has inflicted serious harm upon individual's mental well-being, and effective coping mechanisms are associated with positive mental health outcomes. Prosocial behavior and a sense of meaning in life can enhance individuals' subjective well-being, which can subsequently positively impact their mental health. Thus, in the context of epidemic prevention and control, this study investigates the relationship between the meaning in life, prosocial behavior, and coping styles of outstanding physical education students and the impact on their mental health.

Methods

The study involved a questionnaire survey on 498 outstanding physical education students, consisting of 297 boys (mean age = 13.16) and 201 girls (mean age = 12.87 years). Subsequently, the data was analyzed using the mediating effect and Bootstrap tests.

Results

The coping style positively predicted the meaning in life (β=0.294) and prosocial behavior (β=0.293). Conversely, mental health was predicted in a negative direction (β=-0.494). Mental health negatively predicted prosocial behavior (β=-0.810), although prosocial behavior positively predicted meaning in life (β=0.644). Finally, prosocial behavior negatively predicted mental health (β=-0.513). Additionally, the interplay between prosocial behavior and meaning in life is established in terms of both the individual and chain mediating roles.

Conclusion

This study demonstrates that coping styles during a normalized epidemic prevention and control situation directly impact the mental health of Shanghai's outstanding physical education students. Additionally, these coping styles indirectly influence mental health through the mediating effects of meaning in life and prosocial behaviors. Furthermore, meaning in life and prosocial behaviors act as chain mediators in this relationship.

Turning pain into strength: prosocial behaviours in coping with trauma

Background: Various coping strategies have been shown to alleviate the negative effects of trauma, yet the significance of prosocial behaviour in this realm has been notably underexplored. The present study explored the hypothesis that engaging in prosocial behaviour mitigates the impacts of trauma by promoting a sense of competence and relatedness, post-traumatic growth (PTG), and reconstruction of meaning.Methods: Three consecutive studies were conducted with college students to compare differences in consequence of prosocial behaviours between a trauma group and a control group. Study 1 (N = 96) used self-reported experiences of traumatic vs non-traumatic events; Study 2 (N = 43) used exposure vs. no exposure to video of an earthquake; Study 3 (N = 20) used a randomized controlled trial (RCT) of a prosocial-themed intervention vs. no intervention. Outcomes in all studies were assessed by self-report questionnaires.Results: Trauma damaged participants' sense of competence and meaningfulness. Prosocial behaviour relieved the impact of trauma on meaning, specifically manifested in the individuals' sense of meaningfulness and their search for meaning. Group interventions with a prosocial theme (based on effect size results) reduced post-traumatic stress disorder (PTSD) and enhanced PTG in victims. The promoting effect on PTG persisted a month later, and its enhancing effect on meaning manifested with a delay.Conclusion: Prosocial behaviour can potentially serve as a beneficial strategy for individuals coping with trauma because it helps enhance meaning and promotes PTG in victims. This conclusion is supported by laboratory experiments and a tentative small-scale intervention study, which provide an innovative perspective for future trauma interventions.

Workplace humour, compassion, and professional quality of life among medical staff

Background: Professional quality of life pertains to the balance between compassion fatigue and compassion satisfaction. In recent years, there was an increase in compassion fatigue among medical staff due to the pandemic, all over the world, while compassion satisfaction was reported at a moderate level.Objectives: The aim of this study was to identify the relationship between workplace humour and professional quality of life among medical staff, as well as the moderating role of compassion in this relationship.Method: The sample consisted of 189 participants (Mage = 41.01; SD = 9.58). Of the total sample, 57.1% are physicians, 32.3% are nurses and 6.9% are clinical psychologists. The participants completed scales measuring compassion, workplace humour, and professional quality of life.Results: The results showed that self-enhancing and affiliative humour were positively related, while self-defeating humour was negatively related to compassion satisfaction. Burnout and secondary traumatic stress were negatively related to self-enhancing humour and positively related to self-defeating humour. Compassion moderated the relationship between affiliative humour and secondary traumatic stress.Conclusions: Encouraging coping strategies based on adaptive humour (i.e. affiliative humour, self-enhancing) and raising awareness about negative humour strategies (i.e. self-defeating) could contribute to an increase of quality of life among healthcare providers. Another conclusion derived from the present study sustains that compassion is a valuable personal resource positively related to compassion satisfaction. Compassion also facilitates the relationship between affiliative humour and low secondary traumatic stress. Thus, encouraging compassionate skills could be beneficial for the optimal professional quality of life.

Navigating the Shadows of Others' Traumas: An In-Depth Examination of Secondary Traumatic Stress and Psychological Distress among Rescue Professionals

Rescue workers, who often find themselves on the frontlines of traumatic events, face an increased risk of experiencing secondary traumatic stress (STS) and psychological distress (PD). The nature of their work, alongside professional factors, can influence the way these psychological aspects manifest and their level of severity. This study aimed to explore the relationship between STS and PD in rescue workers. Additionally, it sought to understand how factors such as age, years of experience, duration of work, training received and direct exposure to trauma explain significant variations in reporting to STS. To conduct this research, a cross-sectional study design was implemented involving a sample of 80 rescue workers from the Punjab province in Pakistan. Data was collected over eight weeks using the secondary traumatic stress scale (STSS-17) and the general health questionnaire (GHQ-12) as primary assessment tools. Participants' data was analyzed through Pearson correlation analysis, t-tests, and ANOVA. A strong positive correlation between STS and PD among rescue workers was established. Age significantly explains variation in scores, with older workers displaying reduced STS and PD symptoms. Rescue workers working for longer hours reported elevated STS compared to those working shorter shifts. Workers with more extended professional experience showcased lower STS, highlighting the potential resilience acquired over time. The study also underscored the importance of training duration: longer, well-structured training was associated with decreased STS and PD. Interestingly, longer exposure to trauma was found to be related to lower STS scores, albeit this warrants further investigation. This study underscores the intertwined nature of STS and PD among rescue workers and the various modulating factors. The study paves the way for more comprehensive research, expanding geographically and demographically.

Navigating Uncertainty: Experiences of Older Adults in Wuhan during the 76-Day COVID-19 Lockdown

The COVID-19 pandemic continues to affect the world. Wuhan, the epicenter of the outbreak, underwent a 76-day lockdown. Research has indicated that the lockdown negatively impacted the quality of life of older individuals, but little is known about their specific experiences during the confinement period. Qualitative interviews were conducted with 20 elderly residents of Wuhan, aged 65 to 85, who experienced mandatory isolation throughout the pandemic. The interviews centered around three stages of experiences: the Early Lockdown stage (the first week of lockdown after the government implemented the lockdown policy in January 2020), Infection During Lockdown stage (from February to April 2020 when participants were affected by the lockdown), and the Post-Lockdown stage (after April 2020 when the government lifted the lockdown policy). We found that older adults experienced different core themes during each lockdown stage. In the Early Lockdown stage, they felt nervousness and fear while searching for information. During the Lockdown and Infection Stage, they relied on reciprocal support and adjusted to new lifestyles. In the Post-Lockdown stage, they expressed cautions, trust, and gratitude. The finding highlights the evolving emotions and coping strategies of older adults throughout the lockdown phases. This study has yielded valuable insights into the adaptations of behavior and the importance of social interactions, specifically emphasizing the significance of healthcare among the elderly population.

The association between adverse events in later life and mortality in older individuals

Background

Stress can have adverse impacts on health, particularly when it is chronic or resulting from major adverse events. Our study investigated whether relatively common adverse events in older individuals were associated with an increased risk of death, as well as cause-specific death and potential gender differences.

Methods

Participants were 12896 community-dwelling Australians aged ≥70 years at enrolment into the ASPREE (ASPirin in Reducing Events in the Elderly) study and without known life-limiting disease. A questionnaire administered in the year after enrolment, collected information on ten adverse events experienced in the past year. Mortality status was verified by multiple sources including health records and the National Death Index across a maximum of 10 years. Underlying causes of death were determined using clinical information by two adjudicators. Cox-proportional hazards regression models were used to estimate mortality risk.

Results

Two of the ten adverse events were associated with an increased risk of mortality in fully adjusted models. A 69% increased risk of mortality was observed in participants who reported their spouse/partner had recently died (95% CI: 1.19-2.39, P < 0.01). Cancer-related but not cardiovascular deaths also increased. Participants with a seriously ill spouse/partner also had a 23% increased risk of mortality (HR: 1.23, 95% CI: 1.02-1.48, P = 0.03). There was a tendency for these associations to be stronger among men than women.

Limitations

Perceived stress and cortisol were not measured, thus limiting our understanding of the psychological and physiological impacts of adverse events.

Conclusions

Experiencing adverse events in later-life, especially the death of a spouse/partner, may be a risk factor for earlier mortality. These findings may increase public health awareness and better inform initiatives for particular groups, including bereaved men.

A Time of Healing: Can Social Engagement After Bereavement Reduce Trajectories of Depression After the Death of a Child?

OBJECTIVES

We work from a stress and life-course perspective to examine the mental health of parents who experienced the death of their child. We examine whether mental health eventually returns to pre-bereavement levels and how social engagement after bereavement may shape the recovery process of depressive symptoms.

METHODS

We analyze discontinuous growth curve models to assess the association between a child's death and trajectories of parents' depressive symptoms from the 1998-2016 Health and Retirement Study. The sample includes 16,182 parents aged 50 years and older.

RESULTS

Those who transitioned to bereavement experienced an elevation in depressive symptoms and a relatively long recovery time (e.g., 7 years) to their pre-bereavement mental health in our findings. However, when engaging in volunteer work after their loss, depressive symptoms reduce more quickly to their pre-bereavement levels. Volunteering offsets up to 3 years of the negative consequences of child loss.

DISCUSSION

The death of a child is a traumatic event with extensive health consequences, but research should more fully examine the dynamic nature and potential mitigation of these health consequences over time. Our findings expand the temporal lens to encompass healing processes after bereavement, incorporating the importance of social engagement.

Living with chronic headaches: A qualitative study from an outpatient pain clinic in Norway

BACKGROUND

Although headache is considered a frequently experienced type of pain, the challenges, experiences, and perceptions of people suffering from chronic headaches are poorly understood. The aim of this study was to gain subjective information regarding these aspects in daily life, in order to answer the research question "What is life like with a chronic headache?"

METHODOLOGY

Semi-structured, in-depth interviews were conducted with 16 patients who suffered from chronic headaches. Five main domains were explored: emotions related to headaches; trauma/stressful events; behavioural changes, relationships, and coping mechanisms.

ANALYSIS AND INTERPRETATION

Participants reported that pain restricted their lives in many ways, including not being able to work, loss of status, identity, freedom, intimate relationships and friends. The majority believed that psychological and/or physiological trauma was the reason for their headaches. New information that emerged from this study was how common life events not usually considered major traumas, initiated and maintained symptoms. Shame and feelings of stigmatization appeared to be strongly associated with chronic pain, leading to a scenario where thriving, contentment and enjoyment were often lacking.

MAIN RESULTS

This study provided an in-depth understanding of how chronic headache adversely affects the lives of sufferers. Chronic headaches restrict sufferers' lives, resulting in emotional and behavioural changes and a high level of disability. The complexity of chronic headaches in clinical practice is hugely underestimated, and poorly understood by society in general.

The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults

OBJECTIVES

This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults.

METHODS

This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults' complete network maps across an entire village in 2011-2012. Participants' deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment.

RESULTS

In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively.

CONCLUSIONS

The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.

Childhood adversity and later life prosocial behavior: A qualitative comparative study of Irish older adult survivors

Objective

Although childhood adversity can have lasting effects into later life, positive adaptations have also been observed, including an increased tendency toward prosocial behavior. However, little is known about the link between childhood adversity and later life prosocial behavior, with a particular scarcity of research on intrafamilial childhood adversity. Therefore, this study aimed to examine older adult's experiences of childhood adversity and identify mechanisms linked to prosocial behavior. Two adversity contexts (intrafamilial and extrafamilial) were compared to explore individual, as well as broader cultural and contextual mechanisms linking childhood adversity and later life prosocial behavior.

Method

Semi-structured interviews (60–120 min) were conducted with N = 29 Irish (older) adult survivors of childhood adversity: n = 12 intrafamilial survivors (mean age: 58 years, range: 51–72), n = 17 institutional survivors (mean age: 61 years, range: 50–77). Interviews were analyzed using the framework analysis method, with reference to the conceptual model of altruism born of suffering.

Results

Five themes were identified on prosocial mechanisms, with three themes in both survivor groups (enhanced empathy, self-identity, amelioration), and two group-specific themes (compassion fatigue in intrafamilial survivors; denouncing detrimental social values in institutional survivors).

Conclusion

Results identified motivational processes and volitional factors linked to later life prosocial behavior. Connections to caring roles, (lack of) support, and social norms in childhood, as well as the need for a sense of purpose and meaning from the adversities in adulthood, highlight potential targets for psychotherapeutic intervention to promote prosocial responding and positive adaptation for childhood adversity survivors.

Civic Engagement in Socially Excluded Young Adults Promotes Well-Being: The Mediation of Self-Efficacy, Meaning in Life, and Identity Exploration

Civic engagement is thought to contribute to well-being among young adults. However, less is known about the ways in which civic engagement promotes well-being in general and in particular in socially excluded populations. This study investigated whether civic engagement contributes to life satisfaction and hope in a sample of 127 socially excluded young Israeli women who participated in social activism programs for a period of eight months. A mediation model incorporating self-efficacy, meaning in life, and identity exploration was used to examine the contribution of positive attitudes toward civic engagement, civic engagement skills, and political awareness to the participants' life satisfaction and hope. Indirect effects were found between positive attitudes toward civic engagement, civic engagement skills, and political awareness and the participants' life satisfaction and hope via self-efficacy. Positive attitudes toward civic engagement and political awareness also predicted the participants' life satisfaction via meaning in life. A positive direct effect was found between political awareness and hope. However, contrary to the hypothesis, a negative direct effect was found between positive attitudes toward civic engagement and life satisfaction. Civic engagement skills and political awareness also predicted identity exploration. These findings underscore the need for clinicians to be aware of the potential benefits of civic engagement for the well-being of socially excluded populations.

Identifying pathways to increased volunteering in older US adults

While growing evidence documents strong associations between volunteering and improved health and well-being outcomes, less is known about the health and well-being factors that lead to increased volunteering. Using data from 13,771 participants in the Health and Retirement Study (HRS)—a diverse, longitudinal, and national sample of older adults in the United States—we evaluated a large range of candidate predictors of volunteering. Specifically, using generalized linear regression models with a lagged exposure-wide approach, we evaluated if changes in 61 predictors spanning physical health, health behaviors, and psychosocial well-being (over a 4-year follow-up between t₀; 2006/2008 and t₁; 2010/2012) were associated with volunteer activity four years later (t₂; 2014/2016). After adjusting for a rich set of covariates, certain changes in some health behaviors (e.g., physical activity ≥ 1x/week), physical health conditions (e.g., physical functioning limitations, cognitive impairment), and psychosocial factors (e.g., purpose in life, constraints, contact with friends, etc.) were associated with increased volunteering four years later. However, there was little evidence that other factors were associated with subsequent volunteering. Changes in several indicators of physical health, health behaviors, and psychosocial well-being may predict increased volunteering, and these factors may be novel targets for interventions and policies aiming to increase volunteering in older adults.

Medicine in Motion: Addressing Physician Burnout Through Fitness, Philanthropy, and Interdisciplinary Community Building

Physician burnout is a public health crisis. Although recent studies underscore its prevalence, there are few rigorous studies examining its prevention, especially among medical students and residents. Prior interventions have centered on mindfulness techniques and flexible workload scheduling, yielding limited success. However, interventions that combine fitness with philanthropy and community building may be more effective. The purpose of this report is 2-fold: first, to provide a review of physician burnout and potential prevention mechanisms and, second, to present a case study of how Medicine in Motion (MiM) addresses these issues. MiM facilitates various athletic workouts, competitions, and other events for students and professionals in medicine, dentistry, nursing, and physical therapy to support wellness and charitable initiatives. This analysis identifies 4 barriers to physicians and those in the health care profession from participating in wellness activities: (1) insufficient awareness, (2) logistical challenges, (3) lack of purpose, and (4) absence of perceived support. To overcome these barriers, MiM provides a model toolkit for starting a grassroots movement against physician burnout that other health care institutions may emulate. Institutions should provide financial support for these wellness programs. Future research is needed to evaluate these combined exercise, philanthropic, and community building efforts.

Healing in Health Care: Mental Health Promotion, Advocacy, and Voluntarism in Response to COVID-19

The COVID-19 pandemic increased many known risk factors for mental health problems. In the context of overwhelmed health systems and resource and staffing shortages, the mental health needs of frontline health care workers (HCWs) gained attention as a major public health concern and a threat to high-quality care delivery. In response, mental health promotion initiatives were quickly developed to meet the demands of the public health crisis. Two years later, the context for psychotherapy has changed, especially as it pertains to the health care workforce. Particularly salient experiences-grief, burnout, moral injury, compassion fatigue, and racial trauma-have become routinely discussed as part of everyday clinical practice. Service programs have become more responsive to the needs, schedules, and identities of HCWs. In addition, mental health and other HCWs have contributed to advocacy and volunteer initiatives promoting health equity, culturally responsive care, and access to care across a range of settings. In this article, the authors review the benefits of these activities to individuals, organizations, and communities and summarize example programs. Many of these initiatives began in response to the acute public health crisis; however, engaging in these ways and spaces holds promise for increasing connection and prioritizing equity and structural change over the long term.

Association Between Mobile App Use and Caregivers’ Support System, Time Spent on Caregiving, and Perceived Well-being: Survey Study From a Large Employer

Background

Mobile technology to address caregiver needs has been on the rise. There is limited evidence of effectiveness of such technologies on caregiver experiences.

Objective

This study evaluates the effectiveness of ianacare, a mobile app, among employees of a large employer. ianacare mobilizes personal social circles to help with everyday tasks. Through the use of ianacare, we evaluate the associations between coordinating caregiving tasks among a caregiver’s personal support network and outcomes related to the caregiver’s support system, time use, perceived productivity, and perceived health and well-being. Caregiver tasks include tasks such as meal preparation, respite care, pet care, and transportation. Time use is the measure of a caregiver’s time spent on caregiving tasks and how much time they had to take off from work to attend planned or unplanned caregiving tasks.

Methods

We conducted 2 surveys to assess within-participant changes in outcomes for the unpaid, employed, caregivers after 6 weeks of using the mobile app (n=176) between March 30, 2020, and May 11, 2020. The surveys contained questions in three domains: the caregiver’s support system, time use and perceived productivity, and perceived health and well-being. The results of the linear probability models are presented below.

Results

App use was significantly associated with decreasing the probability of doing most caregiving tasks alone by 9.1% points (SE 0.04; P=.01) and increasing the probability of at least one person helping the primary caregiver by 8.0% points (SE 0.035; P=.02). App use was also associated with improving the time use of the primary caregiver who took significantly less time off work to attend to caregiving duties by 12.5% points (SE 0.04; P=.003) and decreased the probability of spending more than 30 hours weekly on caregiving by 9.1% points (SE 0.04; P=.02). Additional findings on the positive impact of the app included a decrease in the probability of reporting feeling overwhelmed by caregiving tasks by 12.5% points (SE 0.04; P=.003) and a decrease in the probability of reporting negative health effects by 6.8% points (SE 0.04; P=.07) because of caregiving. Although subjects reported that COVID-19 increased their stress attributed to caregiving and prevented them from requesting help for some caregiving tasks, using the app was still associated with improvements in receiving help and lessening of the negative effects of caregiving on the caregivers.

Conclusions

App use was associated with improvements in 7 of 11 caregiver outcomes across three main categories: their support system, time spent on caregiving, and perceived health and well-being. These findings provide encouraging evidence that the mobile app can significantly reduce caregiver burden by leveraging a caregiver’s support network despite the additional challenges brought by COVID-19 on caregivers.

The health advantage of volunteering is larger for older and less healthy volunteers in Europe: a mega-analysis

There is a vast literature on the health benefits associated with volunteering for volunteers. Such health advantages are likely to vary across groups of volunteers with different characteristics. The current paper aims to examine the health advantages of volunteering for European volunteers and explore heterogeneity in the association between volunteering and health. We carry out a mega-analysis on microdata from six panel surveys, covering 952,026 observations from 267,212 respondents in 22 European countries. We provide open access to the code we developed for data harmonization. We use ordinary least squares, fixed effects, first difference, and fixed effect quantile regressions to estimate how volunteering activities and changes therein are related to self-rated health for different groups. Our results indicate a small but consistently positive association between changes in volunteering and changes in health within individuals. This association is stronger for older adults. For respondents 60 years and older, within-person changes in volunteering are significantly related to changes in self-rated health. Additionally, the health advantage of volunteering is larger for respondents in worse health. The advantage is largest at the lowest decile and gradually declines along the health distribution. The magnitude of the association at the first decile is about twice the magnitude of the association at the ninth decile. These results suggest that volunteering may be more beneficial for the health of specific groups in society. With small health advantages from year to year, volunteering may protect older and less healthy adults from health decline in the long run.

Above and beyond: helping behaviors among nurses in positive and negative reciprocity relationships

Purpose

The purpose of this paper is to explore antecedents of helping behaviors among nurses using a social exchange framework. The paper reports an investigation into the effects of reciprocity, perceived coworker efficacy and stress on active and passive helping behaviors.

Design/methodology/approach

To test hypotheses, the authors performed random coefficient modeling on Mplus with data from 155 full-time nurses.

Findings

Nurses were willing to help coworkers regardless of perceived reciprocity levels in the relationship. Rather, their perceptions of the coworker's efficacy and previous behavior predicted helping.

Originality/value

This manuscript contributes to the literature in a number of ways. First, it provides empirical evidence that individuals will suppress or ignore reciprocity norms during an interdependent task. This lends credence to the idea that social exchanges may need to be examined in light of other variables or at other levels of analysis. Second, it demonstrates that investment behaviors (i.e. helping) can and do occur in exchange relationships despite low reciprocity. Overall, the data suggest that individuals are willing to maintain relationships despite a lack of returns.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Resilience and Social Support-Giving Scales: Conceptual and Empirical Validation

OBJECTIVES

This report introduces National Social Life, Health, and Aging Project (NSHAP) data users to 2 new measures-one that assesses older adults' resilience, defined as personal attributes that indicate an adaptive reserve that can be drawn on during adversity, and a second that expands on existing measures of social support received from others to also assess social support given to close others.

METHOD

Data from 4,604 NSHAP respondents born 1920-1965 were used to conduct psychometric analyses and validation of our measures of resilience and social support-giving.

RESULTS

Scale reliabilities were acceptable for the 4-item resilience scale, and the 2-item scales for family support-giving and friend support-giving. The 2 spousal support-giving items did not cohere well as a single scale. The resilience scale exhibited significant correlations with criterion validation variables, even after adjusting for correlated personality traits. The support-giving scales, and the spousal support-giving items, also exhibited significant correlations with criteria, and with the resilience scale, even after adjusting for social support receipt. Scale means exhibited demographic differences.

DISCUSSION

The resilience and social support-giving measures have acceptable psychometric characteristics (with the exception of spousal support-giving), convergent validity, and predictive utility net of related variables. NSHAP data users are offered several suggestions (key points) in the use of these measures in future research.

The benefits of giving: Effects of prosocial behavior on recovery from stress

Individuals regularly face stress, and the manner in which they cope with that stress is a crucial component in predicting stress recovery. While many engage in self-rewarding behaviors to feel better, these behaviors can come with a cost. The current study tested the effect of engaging in a different behavior after experiencing stress-prosocial behavior. Given the health benefits associated with giving to others, it is plausible that engaging in prosocial behavior is more successful in reducing the psychological and physiological responses to stress. To test this, participants underwent the Trier Social Stress Test and then either sent a gift card to a person of their choosing, received a gift card for themselves, or selected the more aesthetically pleasing gift card. Measures of self-reported mood, heart rate, blood pressure, salivary alpha-amylase, and cortisol were collected throughout the session. While the manipulation did not elicit differences in psychological or hormonal measures, the giving group showed a significantly greater downregulation of their heart rate, diastolic blood pressure, and mean arterial pressure while recovering from the stressor. Additionally, those in the giving group who evidenced greater prosocial sentiment showed a larger reduction in diastolic blood pressure and mean arterial pressure. A follow-up study suggested that these behaviors may be engaging different reward components, as those who gave a gift card reported greater "liking" while those who received a gift card reported greater "wanting". Overall, the findings show that engaging in prosocial behavior following a stressor can help to downregulate physiological stress responses.

Online Mindfulness May Target Psychological Distress and Mental Health during COVID-19

Background

The COVID-19 pandemic has dramatically affected mental health, creating an urgent need for convenient and safe interventions to improve well-being. Online mindfulness interventions show promise for improving depression, anxiety, and general well-being.

Objective

To assess: 1) the impact of online mindfulness on psychological distress, 2) altruistic efforts, and 3) the quantity, quality, and availability of online mindfulness resources during the COVID-19 pandemic.

Methods

233 participants (203 U.S.; 20 international; 10 unknown) participated in this prospective, single-arm, non-randomized clinical trial of a single online mindfulness meditation session with pre- and post-surveys.

Main Outcome Measures

(a) Mindfulness session helpfulness, online platform effectiveness, and immediate pre- to post-session changes in momentary stress, anxiety, and COVID-19 concern; (b) qualitative themes representing how people are helping others during the pandemic; (c) absolute changes in quantity of mindfulness-oriented web content and free online mindfulness resource availability from May to August 2020.

Results

Most participants felt the online mindfulness session was helpful and the electronic platform effective for practicing mindfulness (89%, 95% CI: [82 to 93%]), with decreased momentary anxiety (76%; 95% CI: [69 to 83%]), stress (80%; [72 to 86%]), and COVID-19 concern (55%; [46 to 63%]), (p < 0.001 for each measure). Participants reported helping others in a variety of ways during the pandemic, including following public health guidelines, conducting acts of service and connection, and helping oneself in hopes of helping others. "Mindfulness + COVID" search results increased by 52% from May to August 2020. Most (73%) Academic Consortium for Integrative Medicine and Health member websites offer free online mindfulness resources.

Conclusions

Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis. Kindness and altruism are being demonstrated during the pandemic. The consolidated online mindfulness resources provided may help guide clinicians and patients.

Social support, nutrition and health among women in rural Bangladesh: complex tradeoffs in allocare, kin proximity and support network size

Malnutrition among women of reproductive age is a significant public health concern in low- and middle-income countries. Of particular concern are undernutrition from underweight and iron deficiency, along with overweight and obesity, all of which have negative health consequences for mothers and children. Accumulating evidence suggests that risk for poor nutritional outcomes may be mitigated by social support, yet how social support is measured varies tremendously and its effects likely vary by age, kinship and reproductive status. We examine the effects of different measures of social support on weight and iron nutrition among 677 randomly sampled women from rural Bangladesh. While we find that total support network size mitigates risk for underweight, other results point to a potential tradeoff in the effects of kin proximity, with nearby adult children associated with both lower risk for underweight and obesity and higher risk for iron deficiency and anaemia. Social support from kin may then enhance energy balance but not diet quality. Results also suggest that a woman's network of caregivers might reflect their greater need for help, as those who received more help with childcare and housework had worse iron nutrition. Overall, although some findings support the hypothesis that social support can be protective, others emphasize that social relationships often have neutral or negative effects, illustrating the kinds of tradeoffs expected from an evolutionary perspective. The complexities of these effects deserve attention in future work, particularly within public health, where what is defined as 'social support' is often assumed to be positive. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Incorporating Volunteering Into Treatment for Depression Among Adolescents: Developmental and Clinical Considerations

Volunteering, or taking part in unpaid work for the benefit of others, can be a powerful positive experience with returns to both individual well-being and community projects. Volunteering is positively associated with mental health in observational studies with community samples but has not been systematically examined as a potential part of treatment interventions with clinical adolescent samples. In this manuscript, we review the empirical evidence base connecting volunteerism to mental health and well-being, outline potential mechanisms based in the theoretical literature from developmental science, and discuss the existing clinical approaches that support community volunteering as a part of treatment. Drawing on this review, we propose that including volunteering as a component of clinical treatment approaches for adolescent depression can be a powerful intervention for adolescents.

The cardiovascular response to acute psychological stress is related to subjectively giving and receiving social support

The pathways linking giving and receiving emotional and instrumental social support, and cardiovascular reactivity (CVR) are not yet fully understood. Eight-two healthy young adults completed psychometric measures of giving and receiving emotional and instrumental social support and participated in a standardised laboratory stress task. Cardiovascular and hemodynamic parameters were monitored throughout. Both giving and receiving emotional support were positively associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), such that those reporting giving and receiving more emotional support had higher reactivity. Only receiving instrumental was associated with DBP, with those receiving more instrumental support having higher reactivity. Moreover, while the significant association between giving social support and CVR withstood adjustment for several confounding factors (e.g., BMI, sex) it was abolished when receiving support was controlled for. These findings are novel and extend the literature on social support and CVR. Taken together, these findings suggest that receipt of support, rather than giving, may be more influential in this context.

The relative contributions of behavioral, biological, and psychological risk factors in the association between psychosocial stress and all-cause mortality among middle- and older-aged adults in the USA

Evidence of an association between psychosocial stress and mortality continues to accumulate. However, despite repeated calls in the literature for further examination into the physiological and behavioral pathways though which stress affects health and mortality, research on this topic remains limited. This study addresses this gap by employing a counterfactual-based mediation analysis of eight behavioral, biological, and psychological pathways often hypothesized to play a role in the association between stress and health. First, we calculated the survival rate of all-cause mortality associated with cumulative psychosocial stress (high vs. low/moderate) using random effects accelerated failure time models among a sample of 7108 adults from the Midlife in the United States panel study. Then, we conducted a multiple mediator mediation analysis utilizing a counterfactual regression framework to determine the relative contributions of each mediator and all mediators combined in the association between stress and mortality. Exposure to high psychosocial stress was associated with a 0.76 times reduced survival rate over the follow-up period 1995-2015, while adjusting for age, sex, race, income, education, baseline health, and study design effects. The mediators accounted for 49% of this association. In particular, smoking, sedentary behavior, obesity/BMI, and cardiovascular disease displayed significant indirect effects and accounted for the largest reductions in the total effect of stress on mortality, with natural indirect effects of 14%, 12%, 11%, and 4%, respectively. In conclusion, traditional behavioral and biological risk factors play a significant role in the association between psychosocial stress and mortality among middle and older adults in the US context. While eliminating stress and the socioeconomic disparities that so often deliver people into high-stress scenarios should be the ultimate goal, public health interventions addressing smoking cessation, physical activity promotion, and cardiovascular disease treatment may pay dividends for preventing premature mortality in the near-term.

Individual differences in resting-state connectivity and giving social support: implications for health

There is a growing appreciation for the health benefits of giving support, though variability in such behavior exists. Based on the possibility that the dorsomedial (DMPFC) default network subsystem is associated with social thinking and behavior, integrity of this subsystem may facilitate giving support to others. The current study tested associations between DMPFC subsystem connectivity at rest and tendencies related to giving support. During a functional magnetic resonance imaging session, 45 participants completed an emotional social cues task, a resting-state scan and self-report measures of social support. Supportive behavior during the month following the scan was also assessed. Greater DMPFC subsystem connectivity at rest was associated with greater support giving (though not receiving or perceiving support) at the time of the scan and one month later. Results held after adjusting for extraversion. In addition, greater resting-state DMPFC subsystem connectivity was associated with attenuated dorsal anterior cingulate cortex, anterior insula and amygdala activity to others’ negative emotional social cues, suggesting that DMPFC subsystem integrity at rest is also associated with the dampened withdrawal response proposed to facilitate care for others in need. Together, results begin to hint at an additional role for the ‘default’ social brain: giving support to others.

Narratives of resilience in medical students following the 3/11 triple disaster: Using thematic analysis to examine paths to recovery

In March of 2011, a 9.0 magnitude earthquake, tsunami, and nuclear explosion damaged northeastern Japan. While nine years have passed, the memory of this disaster continues to linger. This qualitative study had three main goals. First it aimed to explore the reactions and interpretations of adolescents living in areas affected by the disaster. Second, it sought to examine the behaviors and beliefs that enabled these students to not only recover but thrive. Third, it strived to build a more global and dynamic framework of resilience. A convenience sample of 18 students participated in semi-structured face-to-face interviews. Their narratives were qualitatively analyzed using thematic content analysis. Overall, four themes, each with four codes or sub-themes, emerged as sources of resilience including social support (social networks, role models, and community service), hopeful future orientation (cognitive reappraisal, optimism, and motivation to be physician), active emotions (rational compassion, luck, and suppression) and sense of purpose or duty (sharing of personal story, motivation to educate others, and Fukushima image). These findings reveal the experiences of highly resilient youth facing trauma and the connection between childhood adversity and career choices. They also begin to uncover the unique ways that culture, society, and tradition impact processes of recovery.

IS IT HELPFUL TO HELP OTHERS WHILE GRIEVING?

Introduction: In the current study, we assessed self-reported and behavioral measures of support provided to others and examined their longitudinal relationship to grief and depression symptoms.

Methods: Hierarchical regressions that controlled for initial grief symptoms and support received from others indicated that providing support to others during bereavement had negative effects on psychological functioning, especially for those experiencing high levels of grief at the time of giving.

Results: Across all participants, those who reported providing instrumental support to others at T1 tended to have greater depression symptoms at T2. Furthermore, choosing to donate to bereavement organizations in a laboratory experiment predicted higher levels of grief symptoms at T2, but primarily for participants experiencing high levels of grief at T1.

Conclusion: Additional research is needed to replicate and extend these findings. and determine why helping others during periods of transition and loss may increase one's risk for depression and/or grief.

Till Death Do Us Part: Intersecting Health and Spousal Dementia Caregiving on Caregiver Mortality

OBJECTIVE

We consider whether it is the healthiest dementia caregivers who experience a mortality benefit and whether a protective association is consistent for leading causes of mortality.

METHOD

Using the Health and Retirement study (2000-2012), Cox survival models predict time to death for dementia caregivers, including an interaction between dementia caregiver status and self-rated health. The nationally representative sample consisted of 10,650 married adults aged 51 or older (917 dementia caregivers).

RESULTS

A significant interaction between dementia caregiver status and self-rated health suggested that relative to noncaregivers, dementia caregivers had reduced mortality, with this effect particularly strong at lower levels of self-rated health. The protective effect of dementia caregiver status was consistent across death by heart disease, cancer, and cerebrovascular disease.

DISCUSSION

These findings add to a growing body of literature suggesting that caregiving may provide a mortality benefit and a reason to maintain health.

Daily Stressors Facilitate Giving and Receiving of Emotional Support in Adulthood

The aims of the present study were to examine whether daily stressors are associated with engagement in emotional support and whether these associations differ by gender. Analyses were conducted using Wave 2 of Midlife in the United States data and its subproject National Study of Daily Experiences. The sample consisted of adults aged 33 to 84 (N = 1,622). Using multinomial multilevel analysis, we looked at the associations between lagged and concurrent daily stressors with engagement in emotional support. For concurrent associations, people who experienced stressors were more likely to both give and receive, solely give, and solely receive emotional support compared with those who did not have any stressors. Women were more likely to engage in both giving and receiving of emotional support compared with men when they experienced stressors during the same day. In terms of the lagged associations, both men and women who experienced stressors during the previous day were more likely to both give and receive emotional support the next day compared with those who did not experience any stressors during the previous day. These results suggest that experiencing daily stressors facilitates giving and receiving of emotional support at daily level in adulthood.

Effect of reduced formal care availability on formal/informal care patterns and caregiver health: a quasi-experimental study using the Japanese long-term care insurance reform

BACKGROUND

It is unclear how formal long-term care (LTC) availability affects formal /informal caregiving patterns and caregiver health. We tested the impact of reduced formal LTC availability on formal LTC service use, intensity of informal caregiving, and caregiver health.

METHODS

Using a representative, repeated cross-sectional sample of Japanese caregivers providing care to co-resident family members from 2001 to 2016, we applied a difference-in-differences approach by observing caregivers before and after the major reform of the public Japanese LTC insurance (LTCI) in 2006. The reform reduced coverage benefits for non-institutionalized older persons with low care needs, but not for those with high care needs. We analyzed 12,764 caregivers aged ≥30 years (mean age 64.3 ± 11.8 years, 73.5% women) and measured indicators of formal LTC use, hours of informal caregiving, and caregiver self-reported health outcomes after propensity score matching to balance caregivers' background characteristics.

RESULTS

We found the 2006 LTCI reform relatively reduced the use of formal LTC services and relatively increased the percentage of experiencing long hours of informal caregiving (> 3 h per day) among the caregivers for seniors with low care needs compared to those for seniors with high care needs. The effects of the LTCI reform for the caregivers for seniors with low care needs were 2.2 percentage point higher on caregivers' experiencing poor self-rated health (95% confidence interval [CI]: 0.7-3.7; p = 0.01), 2.7 percentage point higher on experiencing symptoms of a depressive state (95%CI: 0.5-4.8; p = 0.03), and 4.7 percentage point higher on experiencing symptoms of musculoskeletal diseases (95%CI, 3.6-5.7; p < 0.001), compared to those for seniors with high care needs.

CONCLUSIONS

Reduced formal care availability under the Japanese LTCI reform increased hours of informal caregiving corresponding to reduced use of formal LTC and deteriorated multiple dimensions of caregiver health. Our findings may highlight the importance of enhancing the availability of formal LTC services for caregiver health.

Sleep disturbance and work-related mental strain: A national prospective cohort study of the prediction of subsequent long-term sickness absence, disability pension and mortality

Aims: Sleep disturbances and work-related mental strain are linked to increased sickness absence and disability pension (DP), but we have no information on synergy effects. The aim of this study was to examine the combined (and separate) association of the two predictors with subsequent long-term work disability and mortality. Methods: A total of 45,498 participants aged 16–64 years were interviewed in the Swedish Surveys of Living Conditions between 1997 and 2013, and were followed up on long-term sickness absence (LTSA; >90 days/year), DP and mortality via national registers until 2016. Crude and multivariable Cox analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: For LTSA, the HRs for sleep disturbances and work-related mental strain were 1.6 (95% CI 1.5–1.7) and 1.3 (95% CI 1.2–1.4), respectively. For DP, the HRs were 2.0 (95% CI 1.8–2.2) and 1.4 (95% CI 1.2–1.5). Mortality was only predicted by sleep disturbances (HR=1.2, 95% CI 1.1–1.4). No synergy effect was seen. Conclusions: Work-related mental strain and, in particular, sleep disturbances were associated with a higher risk of subsequent LTSA and DP, but without synergy effects. Sleep disturbances were also associated with mortality. Exposure to interventions tackling sleep disturbance and prevention of workplace stress may reduce work disability.

Is Family Caregiving Associated With Inflammation or Compromised Immunity? A Meta-Analysis

BACKGROUND AND OBJECTIVES

Family caregiving stress has been widely reported to have negative effects on circulating biomarkers of immune system function and inflammation. Our goals were to systematically review this literature and conduct a meta-analysis on the extracted effects.

RESEARCH DESIGN AND METHODS

A systematic search of published studies comparing caregivers and noncaregivers on biomarkers measured from blood samples was conducted in the PubMed, Embase, and Cochrane databases. This search identified 2,582 articles and abstracts. After removing duplicative papers and studies not meeting inclusion criteria, 30 articles were identified that reported analyses on 86 relevant biomarkers from 1,848 caregivers and 3,640 noncaregivers.

RESULTS

Random-effects models revealed an overall effect size across all biomarkers of 0.164 SD units (d). A slightly larger overall effect (d = 0.188) was found for dementia caregivers only. Immune system comparisons yielded somewhat larger differences than inflammation comparisons. Most studies used small convenience samples, and effect sizes were larger for studies with moderate or high bias ratings than for studies with low bias ratings. No significant associations were found in studies that used population-based samples.

DISCUSSION AND IMPLICATIONS

Caregivers had small but significantly reduced immune system functioning and greater inflammation than noncaregivers, but associations were generally weak and of questionable clinical significance. The absence of clear associations from low bias studies and population-based studies underscores concerns with possible selection biases in many of the convenience samples. Population-based studies that assess biomarkers before and after the onset of caregiving might add much clarity to this literature.

Longitudinal Stress-Buffering Effects of Social Integration for Late-Life Functional Health

Stress can negatively affect multiple aspects of health, including functional health, among older adults, who are likely to face unique, age-related stressful experiences. Previous research has addressed the protective effects of social relations (i.e., social ties, social participation, and social integration) for physical and mental health outcomes, yet few studies have examined functional health. This study aimed to investigate the longitudinal stress-buffering effects of social integration on late-life functional health. Using three-wave data from 399 older adults (aged older than 60 years), two-level hierarchical linear modeling analysis was conducted and the results indicated that in addition to its main effect on functional (activity of daily living) limitations, social integration moderated the negative effect of stress on the longitudinal trajectory of functional limitations. The findings suggest important directions of future research to identify the mechanisms of such buffering effects over time and develop effective interventions to enhance late-life functional health while promoting social integration.

Health Benefits Associated With Three Helping Behaviors: Evidence for Incident Cardiovascular Disease

Objective

The purpose of this study was to investigate the association between three helping behaviors and incident cardiovascular disease (CVD; heart attack, stroke; fatal and nonfatal), with an exploration of gender differences. The study is framed within the caregiving system model. Helping others is argued to be an evolved characteristic of humans that yields beneficial health effects.

Methods

Data were taken from the 2004-2014 waves of the Health and Retirement Study. The three forms of helping others considered were formal volunteering, informal helping, and caregiving for a parent or spouse. Cox proportional hazards models were estimated for gender-stratified samples.

Results

Women who volunteered showed a lower risk of incident CVD compared to women who did not volunteer. Men who informally helped others in the community exhibited a lower risk of incident CVD compared to men who did not provide this form of help. Caregiving status was generally not associated with incident CVD for women or men.

Discussion

The results demonstrated that specific types of prosocial behavior may be beneficial for women and men. However, tests for effect differences showed that gender did not moderate the relationships between these helping behaviors and CVD risk.

Longitudinal Associations Between Provision of Autonomy Support and Well-Being in Spouses of Individuals With Chronic Pain

BACKGROUND

Caregiving spouses of individuals with chronic pain often experience poor well-being.

PURPOSE

The current study aimed to examine the association between chronic pain-related provision of autonomy support and well-being in support providers (spouses) of individuals with chronic pain.

METHODS

Spouses of individuals with a diagnosed musculoskeletal chronic pain condition (N = 172) were recruited for a five-time point longitudinal study. Participants completed the questionnaires once every 6 months across 2 years. In a follow-up diary study, participants (N = 41) completed daily records of provision of autonomy support and well-being.

RESULTS

Multilevel analyses showed that provision of autonomy support was associated with greater well-being in support providers at both within-person and between-person levels. Longitudinal cross-lagged analyses also provided some evidence that it is provision of autonomy support that predicts well-being, and not the opposite. These effects held true in the follow-up diary study; however, some findings also suggested that the short-term associations between provision of autonomy support and well-being could be reciprocal.

CONCLUSIONS

Current findings extend the existing literature by suggesting provision of autonomy support as a beneficial type of support for the provider within the chronic pain context and lay the groundwork for caregiver-focused interventions.