Effects of volunteering over six months on loneliness, social and mental health outcomes among older adults: The HEAL-HOA Dual Randomized Controlled Trial

OBJECTIVE

To determine the beneficial effects of volunteering as lay counselor via telephone on own loneliness, social network engagement, perceived social support, stress, anxiety, and depressive symptoms among Chinese older adults in Hong Kong during the COVID-19 pandemic. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: "Helping Alleviate Loneliness in Hong Kong Older Adults" (HEAL-HOA), a dual randomized controlled trial, was implemented to test effects of telephone-based psychosocial interventions delivered by older-adult volunteers for low-income lonely older adults. To evaluate the effects of volunteering on loneliness, we randomized 375 individuals ages 50-70 into a volunteering condition versus an active control (psychoeducation with social gatherings). Following a 6-week training, participants in the volunteering condition, delivered tele-interventions to older intervention recipients.

MEASUREMENT

The primary outcome was loneliness measured with the UCLA Loneliness Scale. Secondary outcomes were loneliness measured with the De Jong Gierveld Scale (DJG), social network engagement, perceived social support, perceived stress, anxiety, and depressive symptoms. Assessments were completed before training (baseline) and immediately after the 6-month volunteering period.

RESULTS

Results from linear mixed models show significant positive effects of volunteering (significant interactions of condition × time) on both measures of loneliness (dppc2 = -0.41 ULCA Loneliness score, dppc2 = -0.70 total DJG score), social network engagement, stress and depressive symptoms as compared to control participants.

CONCLUSIONS

The HEAL-HOA trial demonstrates beneficial effects of volunteer-delivered tele-interventions on decreasing loneliness on the volunteer interventionists themselves. Communicating these benefits for volunteers may attract more older adults into volunteering. This effective tele-based volunteer program is scalable for wider implementation.

SUMMARY

This RCT tested effects of volunteering on loneliness in Hong Kong during the COVID-19-pandemic. Three hundred seventy-five individuals ages 50-70 were randomized into volunteering (delivering tele-interventions against loneliness) versus an active control condition. After 6 months, volunteers compared to controls, showed benefits on loneliness, social network engagement, stress and depressive symptoms. A program engaging lonely older adults in loneliness intervention delivery has beneficial effects on volunteers themselves and could be a scalable solution for our loneliness epidemic.

Study protocol of the 'HEAL-HOA' dual randomized controlled trial: Testing the effects of volunteering on loneliness, social, and mental health in older adults

Background

Interventions to reduce loneliness in older adults usually do not show sustained effects. One potential way to combat loneliness is to offer meaningful social activities. Volunteering has been suggested as one such activity - however, its effects on loneliness remain to be tested in randomized controlled trials (RCT).

Methods

This planned Dual-RCT aims to recruit older adults experiencing loneliness, with subsequent randomization to either a volunteering condition (6 weeks of training before delivering one of three tele-based loneliness interventions to older intervention recipients twice a week for 6 months) or to an active control condition (psycho-education with social gatherings for six months). Power analyses require the recruitment of N = 256 older adults to detect differences between the volunteering and the active control condition (128 in each) on the primary outcome of loneliness (UCLA Loneliness Scale). Secondary outcomes comprise social network engagement, perceived social support, anxiety and depressive symptoms, self-rated health, cognitive health, perceived stress, sleep quality, and diurnal cortisol (1/3 of the sample). The main analyses will comprise condition (volunteering vs. no-volunteering) × time (baseline, 6-, 12-, 18-, 24-months follow-ups) interactions to test the effects of volunteering on loneliness and secondary outcomes. Effects are expected to be mediated via frequency, time and involvement in volunteering.

Discussion

If our trial can show that volunteers delivering one of the three telephone-based interventions to lonely intervention recipients benefit from volunteer work themselves, this might encourage more older adults to volunteer, helping to solve some of the societal issues involved with rapid demographic changes.

Fear of Falling Carries Over into Overprotection in Old Age: A Cross-Lagged Panel Analysis

Fear of falling might result in overprotection by one's social environment. In turn, feeling dependent could increase fear of falling. However, the association between fear of falling and perceived overprotection and its temporal order is unknown. This longitudinal study explores this potential mutual longitudinal association. This study presents secondary analyses from a larger trial. We tested the association between fear of falling and perceived overprotection in a cross-lagged path model controlled for falls, health-related quality of life, age, gender, and trial condition. N = 310 participants (M = 70 years, range: 64-92) completed self-reports at Time 1, 7 (Time 2), and 11 weeks (Time 3) after baseline assessment. We found a positive association from fear of falling to perceived overprotection (β = .12, 95% CI[0.02, 0.21], p = .02; β = .10; [0.01, 0.18], p = .03). The reversed cross-lagged paths were not significant. Findings suggest higher fear of falling translates into perceived overprotection, which may in turn increase loss of independence in old age.

Associations Between Implicit and Explicit Condom Use Measures With Condom Use Barriers: Relationships Make A Difference

OBJECTIVE

The association between explicit and implicit psychological measures might be affected by the similarity of the assessment method and by the overlap of the components of the constructs being assessed. This study examined the association between condom use barriers and explicit and implicit measurements of condom use and the moderating role of sexual intercourse in these associations.

DESIGN

This was a cross sectional correlational study. An analysis of baseline data from a randomized controlled trial including 149 university students was included.

MAIN MEASURES

These included a questionnaire assessing condom use barriers, an implicit condom use test (a structured semi-projective test), and an explicit condom use question. Hierarchical regressions and correlations were examined in the full sample and by groups of participants with and without sexual intercourse.

RESULTS

In those without sexual intercourse, all barriers sub-scales were significantly and negatively correlated with implicit condom use and unrelated to explicit condom use. In contrast, among those engaged in sexual intercourse, barriers were significantly and negatively correlated with the explicit condom use measure, and only barriers concerning partner and motivation correlated with implicit condom use tendencies.

CONCLUSION

Having a sexual partner plays a major role in the relations between barriers and implicit and explicit condom use measures. The pattern of the results is discussed in relation to cognitive and social factors.

Benefits of volunteering on psychological well-being in older adulthood: evidence from a randomized controlled trial

Objectives: Long-term volunteering has been associated with better physical, mental, and cognitive health in correlational studies. Few studies, however, have examined the longitudinal benefits of volunteering with randomized experimental designs (e.g., intervention studies). Even fewer studies have examined whether such benefits can be shown after short-term volunteering. To fill this gap, we conducted four 1-hour volunteering intervention sessions to promote volunteering among a group of older adults with limited volunteering experience and examined the impact of volunteering on depressive symptoms, meaning in life, general self-efficacy, and perceived autonomy.Methods: A total of 384 participants aged 50-96 years were assigned at random to either an intervention group to promote volunteering behaviors or an active control group to promote physical activity. The participants' monthly volunteering minutes, depressive symptoms, meaning in life, general self-efficacy and perceived autonomy were measured at baseline and six weeks, three months, and six months after the intervention.Results: Being in the volunteering intervention condition was not directly associated with depressive symptoms, meaning in life, general self-efficacy, or perceived autonomy at the 6-week, 3-month, or 6-month follow-ups after the intervention. However, there was an indirect effect of the intervention on depressive symptoms: participants in the intervention group, who had increased their volunteering at the 3-month follow-up, reported fewer depressive symptoms at the 6-month follow-up.Discussion: Our randomized controlled trial suggests that short-term volunteering does not reliably lead to short-term changes in psychosocial health measures as correlational studies would suggest. Efforts need to be made to encourage older adults to maintain long-term volunteering.

Perceived Physical Functioning and Gait Speed as Mediators in the Association Between Fear of Falling and Quality of Life in Old Age

Preserving Quality of Life (QoL) in old age gains in importance, but Fear of Falling (FoF) considerably limits QoL. The aim of our study was to understand how physical mediators may translate FoF to QoL. At Time 1, FoF, subjective leg strength, balance, QoL, and objective gait speed were assessed. QoL was reassessed after 6 months, at Time 2 (n = 125). A sequential mediation analysis examined whether the relationship between FoF and QoL could be mediated by leg strength, balance, and gait speed. FoF was directly associated with QoL (β = -.27; 95% CI [-0.007, -0.001]) as well as indirectly via leg strength, balance, and gait speed (specific sequential indirect effect: β = -.03; 95% CI [-0.06, -0.001]; R² = .40 in QoL; controlled for age, QoL at Time 1). An intervention approach could be to address FoF and foster physical functioning and gait speed to maintain QoL.

Promoting Volunteering Among Older Adults in Hong Kong: A Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Volunteering has consistently been associated with better mental, physical, and cognitive health in older adulthood. However, the volunteering rate of older adults in Hong Kong is much lower than in Western countries. Few studies have examined whether interventions can be effective in motivating older adults to volunteer in Hong Kong. To fill this gap, we conducted a randomized controlled trial to examine the impact of a theory-based social-cognitive intervention on volunteering.

RESEARCH DESIGN AND METHODS

A total of 264 community-dwelling older adults in Hong Kong (Mage = 69.95 years, SDage = 6.90 years, 81.06% female) were randomly assigned to either an experimental group or an active control group. Participants in the experimental group received 4 weekly 1-hr face-to-face volunteering intervention sessions. Those in the active control group received parallel sessions targeting physical activity instead of volunteering. The time spent on volunteering per month was self-reported and measured at baseline, 6 weeks, 3 months, and 6 months after the intervention. Self-efficacy, intention, action planning, and self-monitoring of volunteering were measured as mediators.

RESULTS

Monthly volunteering minutes increased among participants in the experimental group when compared with the active control group at 6-week, 3-month, and 6-month follow-ups. Self-efficacy, intention, and action planning consistently mediated the effect of the intervention on volunteering minutes.

DISCUSSION AND IMPLICATIONS

The findings demonstrate the effectiveness of the intervention on volunteering behavior in older adults in Hong Kong through well-established behavior change techniques.

The effects of psychological inoculation on condom use tendencies and barriers; a randomized controlled trial

OBJECTIVE

Condom use prevents the contraction of the HIV. Research shows limited effects of education on increasing condom use. Psychological inoculation (PI) has been found to be more effective in this domain, however, its mechanism is unknown. This study examined effects of PI versus education on condom use barriers and tendencies, and its relations with cognitive dissonance, using a fully automatized online system.

DESIGN

The study was a randomized controlled trial (RCT) and included 149 students from a German University randomly assigned to PI or a control condition.

MAIN OUTCOME MEASURES

An indirect condom use test (I-CUTE), a condom use barriers questionnaire, self-reported condom use, and cognitive dissonance estimations were all assessed at baseline and one-month post-intervention.

RESULTS

PI significantly increased I-CUTE scores when participants had sexual relations. Control participants increased in self-reported condom use and on I-CUTE scores in people without sexual relations. No changes in barriers were seen in either group. The cognitive dissonance tended to be higher in PI participants as compared to control participants.

CONCLUSIONS

PI increases I-CUTE scores compared to controls (based on effect sizes), and significantly in those with sexual relations. The role of relationship status and the mechanisms of PI should be further examined.

Study protocol of a multi-center RCT testing a social-cognitive intervention to promote volunteering in older adults against an active control

Background

Volunteering could be a win-win opportunity for older adults: Links between volunteering and societal improvements as well as older adults’ own health and longevity are found in several observational studies. RCTs to increase volunteering in older adults are however sparse, leaving the question of causality unanswered. This study protocol describes a theory-based social-cognitive intervention with multiple behavior change techniques to increase volunteering among community-dwelling older adults in Hong Kong.

Methods

In a parallel group, two-arm, randomized controlled trial, an initial N = 360 are assigned to receive either the volunteering intervention or the active control intervention (parallel content targeting physical activity). The primarily outcome measure is self-reported volunteering minutes per month at baseline, six weeks, three months and six months after the intervention. Participants in the treatment group are expected to increase their weekly volunteering minutes over time as compared to participants in the control group. Possible active ingredients of the intervention as well as mental and physical health outcomes of increased volunteering are investigated by means of mediation analyses.

Discussion

Like many industrialized nations, Hong Kong faces a rapid demographic change. An effective psychological intervention to encourage retirees to engage in formal volunteering would alleviate some of the societal challenges a growing proportion of older adults entails.

Trial registration

Primary Registry and Trial Identifying Number ChiCTR-IIC-17010349, secondary CCRB trial number CUHK_CCRB00543, registration date 2016/12/28.

Electronic supplementary material

The online version of this article (10.1186/s12877-019-1034-1) contains supplementary material, which is available to authorized users.

Dietary planning, self-efficacy, and outcome expectancies play a role in an online intervention on fruit and vegetable consumption

OBJECTIVE

An online intervention to improve fruit and vegetable (FV) intake examines the role of planning, outcome expectancies, self-efficacy and gender. Women are not only expected to eat more FV than men, but they are also expected to be more responsive to nutritional advice and benefit more from treatment.

METHOD

A two-arm digital intervention with 269 men and 395 women (M_age = 41.2, SD_age = 11.45; range: 19-66 years) was conducted in Italy, Spain and Greece, followed up at three and six months, comparing a static with a dynamic, feedback-intensive platform.

RESULTS

Linear mixed models yielded an increase in FV consumption in both the dynamic and the static intervention arms. In men, outcome expectancies were positively related to follow-up FV intake. Dietary planning interacted with self-efficacy on behavioural outcomes.

CONCLUSION

FV intake increased overall, and being a woman and involvement in planning facilitated behaviour change. Women seemed to be more engaged in the dynamic platform resulting in a higher amount of planning. Initial motivation, as indicated by outcome expectancies, seemed to be beneficial for men. Self-efficacious individuals benefitted from their engagement in planning, but self-efficacy did not compensate for failing to plan.

Perceived somatic and affective barriers for self-efficacy and physical activity

According to Bandura's social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults' physical activity levels.

Short-Term Buffers, but Long-Term Suffers? Differential Effects of Negative Self-Perceptions of Aging Following Serious Health Events

Objectives

Large longitudinal studies show that negative self-perceptions of aging can be detrimental for health outcomes. However, negative self-perceptions of aging (i.e., associating aging with physical losses) might be adaptive because they prepare individuals for serious health events (SHEs), resulting in short-term positive effects as opposed to long-term negative effects on well-being and health.

Method

Longitudinal data from 309 older adults (aged 65 and older) were analyzed. Short-term (6 months) and long-term (2.5 years) effects after a SHE of negative self-perceptions of aging on functional limitations (FLs) and negative affect (NA) were investigated.

Results

Results show that in the case of a SHE, individuals with more negative self-perceptions of aging reported less NA after 6 months but more FLs after 2.5 years. In contrast, individuals with less negative self-perceptions of aging reported more NA in the short-run but less FLs later on.

Discussion

People with more negative self-perceptions of aging may be mentally prepared for health events or may have habituated to health declines. Individuals with more positive self-perceptions, in contrast, may invest a lot in coping efforts immediately after the health event. Similarities to research on unrealistic optimism are discussed.

The Role of Self-Efficacy and Friend Support on Adolescent Vigorous Physical Activity

Objectives. Physical activity, including some form of vigorous activity, is a key component of a healthy lifestyle in young people. Self-efficacy and social support have been identified as key determinants of physical activity; however, the mechanism that reflects the interplay of these two factors is not well understood. The aim of the current study was to test social cognitive theory’s notion that self-efficacy relates to intention that translates into behavior and to investigate whether friend support and self-efficacy synergize, interfere, or compensate for one another to predict vigorous physical activity in adolescents—a population at risk of rapid decreases in physical activity. Method. A survey at two points in time was conducted in 226 students aged 12 to 16 years. In a conditional process analysis, friend support and physical activity self-efficacy were specified as interacting predictors of intention. The latter was specified as a mediator between self-efficacy and later vigorous physical activity, controlling for sex and age. Results. Self-efficacy emerged as the dominant predictor of intention, followed by friend support, and an interaction between support and self-efficacy. In adolescents with high self-efficacy, intention was independent of support. In those with low self-efficacy, receiving friend support partly compensated for lack of self-efficacy. The effect of self-efficacy on vigorous physical activity was mediated by intention. Conclusions. Adolescent vigorous physical activity was indirectly predicted by self-efficacy via intention, and this mediation was further moderated by levels of friend support, indicating that friend support can partly buffer lack of self-efficacy.

Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial

OBJECTIVE

A randomised controlled trial (RCT) was conducted to evaluate a three-hour face-to-face physical activity (PA) intervention in community-dwelling older German adults with four groups: The intervention group (IG) received behaviour change techniques (BCTs) based on the health action process approach plus a views-on-ageing component to increase PA. The second intervention group 'planning' (IGpl) contained the same BCTs, only substituted the views-on-ageing component against an additional planning task. An active control group received the same BCTs, however, targeting volunteering instead of PA. A passive control group (PCG) received no intervention.

DESIGN

The RCT comprised 5 time-points over 14 months in N = 310 participants aged 64+.

MAIN OUTCOME MEASURES

Self-reported as well as accelerometer-assessed PA.

RESULTS

Neither PA measure increased in the IG as compared to the other groups at any point in time. Bayes analyses supported these null-effects.

CONCLUSION

A possible explanation for this null-finding in line with a recent meta-analysis is that some self-regulatory BCTs may be ineffective or even negatively associated with PA in interventions for older adults as they are assumed to be less acceptable for older adults. This interpretation was supported by observed reluctance to participate in self-regulatory BCTs in the current study.

Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses

Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy.

Sources of self-efficacy for physical activity

OBJECTIVE

The effects of self-efficacy beliefs on physical activity are well documented, but much less is known about the origins of self-efficacy beliefs. This article proposes scales to assess the sources of self-efficacy for physical activity aims and to comparatively test their predictive power for physical activity via self-efficacy over time to detect the principal sources of self-efficacy beliefs for physical activity.

METHOD

A study of 1,406 German adults aged 16-90 years was conducted to construct scales to assess the sources of self-efficacy for physical activity (Study 1). In Study 2, the scales' predictive validity for self-efficacy and physical activity was tested in a sample of 310 older German adults.

RESULTS

Short, reliable and valid instruments to measure six sources of self-efficacy for physical activity were developed that enable researchers to comparatively test the predictive value of the sources of self-efficacy.

CONCLUSION

The results suggest that mastery experience, self-persuasion, and reduction in negative affective states are the most important predictors of self-efficacy for physical activity in community-dwelling older adults.

Interactive effects of social support and social conflict on medication adherence in multimorbid older adults

With increasing age and multimorbidity, medication regimens become demanding, potentially resulting in suboptimal adherence. Social support has been discussed as a predictor of adherence, but previous findings are inconsistent. The study examines general social support, medication-specific social support, and social conflict as predictors of adherence at two points in time (6 months apart) to test the mobilization and social conflict hypotheses. A total of 309 community-dwelling multimorbid adults (65-85 years, mean age 73.27, 41.7% women; most frequent illnesses: hypertension, osteoarthritis and hyperlipidemia) were recruited from the population-representative German Ageing Survey. Only medication-specific support correlated with adherence. Controlling for baseline adherence, demographics, physical fitness, medication regimen, and attitude, Time 1 medication-specific support negatively predicted Time 2 adherence, and vice versa. The negative relation between earlier medication-specific support and later adherence was not due to mobilization (low adherence mobilizing support from others, which over time would support adherence). Social conflict moderated the medication-specific support to adherence relationship: the relationship became more negative, the more social conflict participants reported. Presence of social conflict should be considered when received social support is studied, because well-intended help might have the opposite effect, when it coincides with social conflict.

Contextual and individual predictors of physical activity: Interactions between environmental factors and health cognitions

OBJECTIVE

Although health behavior theories assume a role of the context in health behavior self-regulation, this role is often weakly specified and rarely examined. The two studies in this article test whether properties of the environment (districts) affect if and how health-related cognitions are translated into physical activity.

METHODS

Multilevel modeling was used to examine the assumed cross-level interactions. Study 1 is a large-scale survey representative of the German adult population (N = 6,201). Gross domestic product (GDP) on the level of administrative districts was used to indicate environmental opportunities and barriers. Study 2 examined cross-level interactions of proximal predictors of physical activity (intentions, action planning, and coping planning) in older adults with multiple illnesses (N = 309), a high-risk group for health deteriorations.

RESULTS

Study 1 showed that on the individual level, health attitudes (B = .11) and education (B = .71) were significantly associated with physical activity. GDP moderated the attitudes-behavior relation (B = .01), with higher attitude-behavior relations in districts with higher GDP. Study 2 finds that intention (B = .16), action planning (B = .17), and coping planning (B = .13) significantly predict activity. In addition, district-level GDP significantly moderated the relations between action planning and coping planning, but not intention, on physical activity.

CONCLUSIONS

Results suggest that the effects of health attitudes and planning on physical activity are moderated by environmental factors. Districts with higher GDP provide better contextual opportunities for the enactment of concrete if-then plans for physical activity. This has implications for both theory and health promotion.

Changes in functional health, changes in medication beliefs, and medication adherence

OBJECTIVE

Medication adherence often lies below recommendations although it is crucial for effective therapies, particularly in older adults with multiple illnesses. Medication beliefs are important factors for individual adherence, but little is known about their origin. We examine whether changes in functional health predict changes in medication beliefs, and whether such changes in beliefs predict subsequent medication adherence.

DESIGN

At three points in time over a 6-month period, 309 older adults (65-85 years) with multiple illnesses were assessed. Latent true change modeling was used to explore changes in functional health and medication beliefs. Adherence was regressed on changes in beliefs.

MAIN OUTCOME MEASURES

Medication beliefs were measured by the Beliefs About Medicines Questionnaire; medication adherence by the Reported Adherence to Medication Scale.

RESULTS

Functional health and medication beliefs changed over time. Increasing physical limitations predicted increases in specific necessity and specific concern beliefs, but not in general beliefs. Changes in specific necessity beliefs predicted intentional adherence lapses, changes in general overuse beliefs predicted unintentional adherence lapses.

CONCLUSIONS

Medication beliefs partly depend on health-related changes, and changes in beliefs affect individual adherence, suggesting to target such beliefs in interventions and to support older adults in interpreting health changes.

Maintaining autonomy despite multimorbidity: self-efficacy and the two faces of social support

Multimorbidity-the co-occurrence of multiple illnesses-is a frequent condition in older adults and poses serious threats to autonomy. In order to identify resources for autonomy despite multimorbidity, our longitudinal study tested main and interaction effects of personal and social resources (self-efficacy and social support) on maintaining autonomy. Three hundred and nine individuals (aged 65-85 years) with multiple illnesses completed measures of self-efficacy beliefs, received instrumental social support and perceptions of autonomy. Data were analyzed using structural equation modeling. Cross-sectionally, individuals with lower perceptions of autonomy received more support from their networks. Longitudinally, the relation of received support with autonomy was moderated by self-efficacy: Simple slopes analyses showed that social support compensated for lower levels of self-efficacy, whereas in individuals with higher self-efficacy the resources interfered. Receiving social support bolstered autonomy in lower self-efficacious individuals, but in highly self-efficacious individuals support threatened autonomy. This has implications for both theory and practice, as it suggests differential effects of social resources depending on personal resources.

Giving and Taking —Differential Effects of Providing, Receiving and Anticipating Emotional Support on Quality of Life in Adults with Multiple Illnesses

Multimorbidity challenges quality of life (QoL) in old age. Anticipating and providing social support have been shown to promote QoL whereas receiving support often had detrimental effects. Little is known about which psychological processes explain these effects. This study examines the effects of receiving, anticipating and providing emotional support on QoL, with control beliefs and self-esteem as simultaneous mediators in an elderly multimorbid sample ( N = 1415). Anticipating and providing support positively predicted QoL, mediated through self-esteem and control beliefs. Received support negatively predicted QoL, without mediation. Self-esteem and control beliefs can help to explain the relation between QoL and support.

Momentary reductions of attention permit greater processing of irrelevant stimuli

Momentary reductions of attention can have extremely adverse outcomes, but it remains unclear whether increased distraction from irrelevant stimuli contributes to such outcomes. To investigate this hypothesis, we examined trial-by-trial relationships between brain activity and response time in twenty healthy adults while they performed a cross-modal selective attention task. In each trial, participants identified a relevant visual letter while ignoring an irrelevant auditory letter, which was mapped either to the same response as the visual letter (congruent trials) or to a different response (incongruent trials). As predicted, reductions of attention (i.e., increases of response time) were associated not only with decreased activity in sensory regions that processed the relevant visual stimuli, suggesting a failure to enhance the processing of those stimuli, but also with increased activity in sensory regions that processed the irrelevant auditory stimuli, suggesting a failure to suppress the processing of those stimuli. Reductions of attention were also linked to larger increases of activity in incongruent than in congruent trials in anterior cingulate regions that detect response conflict, suggesting that failing to suppress the sensory processing of the irrelevant auditory stimuli during attentional reductions allowed those stimuli to more readily activate conflicting responses in incongruent trials. These findings indicate that heightened levels of distraction during momentary reductions of attention likely stem, at least in part, from increased processing of irrelevant stimuli.

Identitätsbedrohung durch positives schulisches Leistungsfeedback

Zusammenfassung. In zwei Experimenten wurde die Annahme überprüft, dass positive Leistungsrückmeldungen im schulischen Kontext unter Umständen für Jugendliche eine Bedrohung von wichtigen Identitätsaspekten (von Erwachsenen unabhängig sein; die eigene Geschlechtsrolle ausfüllen) implizieren, weshalb sie positives Feedback zurückweisen. In beiden Studien wurde nach einem Leistungstest falsches Feedback gegeben. In Studie 1 (N = 132 15-Jährige) wurde variiert, ob bei einem sehr positiven fachunspezifischen Leistungsfeedback dem Feedback-Empfänger im Beisein von Klassenkameraden gleichzeitig eine besondere Nähe zur Lehrkraft unterstellt wurde oder nicht. Erwartungsgemäß gaben die Jugendlichen nach der Unterstellung einer großen Nähe zur Lehrkraft an, weniger Hausaufgaben zu machen. In Studie 2 (N = 135 15-Jährige) wurde variiert, ob Jugendlichen eine sehr große oder nur durchschnittliche Begabung für ein geschlechtstypisiertes Schulfach (Physik) zurückgemeldet wurde. Erwartungskonform äußerten nur Jungen nach der Rückmeldung einer großen Physik-Begabung größeres Interesse an physikbezogenen Themen als nach dem durchschnittlichen Leistungsfeedback, wohingegen Mädchen kein Interesse an physikbezogenen Themen, nur an typischen “Mädchenthemen“ äußerten.

The neural mechanisms for minimizing cross-modal distraction

The neural circuitry that increases attention to goal-relevant stimuli when we are in danger of becoming distracted is a matter of active debate. To address several long-standing controversies, we asked participants to identify a letter presented either visually or auditorily while we varied the amount of cross-modal distraction from an irrelevant letter in the opposite modality. Functional magnetic resonance imaging revealed three novel results. First, activity in sensory cortices that processed the relevant letter increased as the irrelevant letter became more distracting, consistent with a selective increase of attention to the relevant letter. In line with this view, an across-subjects correlation indicated that the larger the increase of activity in sensory cortices that processed the relevant letter, the less behavioral interference there was from the irrelevant letter. Second, regions of the dorsolateral prefrontal cortex (DLPFC) involved in orienting attention to the relevant letter also participated in increasing attention to the relevant letter when conflicting stimuli were present. Third, we observed a novel pattern of regional specialization within the cognitive division of the anterior cingulate cortex (ACC) for focusing attention on the relevant letter (dorsal ACC) versus detecting conflict from the irrelevant letter (rostral ACC). These findings indicate novel roles for sensory cortices, the DLPFC, and the ACC in increasing attention to goal-relevant stimulus representations when distracting stimuli conflict with behavioral objectives. Furthermore, they potentially resolve a long-standing controversy regarding the key contribution of the ACC to cognitive control.

Biphasic dose-related effects of morphine on dopamine release

The effects of morphine on extracellular dopamine levels in brain have never been studied over a wide range of doses within a single study. This has made it difficult to make definitive interpretations of drug interactions with morphine. An inhibition of morphine-induced increases in dopamine could be interpreted as either antagonism or potentiation depending the shape of the morphine dose-response curve. Accordingly, the aim of the present study was to determine the effects of a wide range of morphine doses (0, 5, 10, 20 and 30 mg/kg, i.p.) on extracellular dopamine, DOPAC and HVA levels in the nucleus accumbens and striatum of awake and freely moving female Sprague-Dawley rats. The results show that, in both brain regions, the dose-response curve for morphine-induced increases in dopamine is non-monotonic while the dose-response curve for morphine-induced increases in DOPAC and HVA is monotonic in the nucleus accumbens. The results of this study are discussed in terms of their implications for interpreting drug interactions with morphine and with relationship to morphine's mode of action at mu and kappa opioid receptors.

Rapamycin prolongs survival and arrests pathophysiologic changes in murine systemic lupus erythematosus

OBJECTIVE

To evaluate the effects of oral rapamycin (RAPA), a macrolide immunosuppressant that has been shown to interfere with T cell activation events, on the course of spontaneous disease progression in the MRL/MpJ/lpr/lpr (MRL/l) mouse model of lupus.

METHODS

RAPA treatment (6, 12, or 25 mg/kg 3 times per week) was evaluated by monitoring survival rates, autoantibody levels, and urinary albumin levels. Additionally, concanavalin A responsiveness, interleukin-2 (IL-2) production, lymphoid organ size, and histopathology were evaluated ex vivo.

RESULTS

RAPA prevented the typical rise in anti-double-stranded DNA antibody and urinary albumin levels and prolonged survival. Spleen and lymph node sizes were significantly decreased, inflammatory changes in the lung, liver, kidney, spleen, lymph node, and thymus were significantly reduced, and T cell mitogen-stimulated splenocyte proliferation and IL-2 production were restored.

CONCLUSION

Data from 3 independent experiments demonstrated that RAPA significantly reduced or prevented many pathologic features of lupus normally seen in the MRL/l mouse, and suggest that RAPA may be useful as a therapeutic agent in SLE in humans.

A modification of the in vivo mixed lymphocyte reaction and rapamycin's effect in this model

Rapamycin, a novel macrocyclic immunosuppressive agent, suppresses murine T cell activation in vitro by mechanisms distinct from cyclosporin A (CsA). This study was designed to examine rapamycin and CsA in the host vs graft popliteal lymph node (PLN) model, an in vivo system of T cell-dependent lymphocyte activation. The PLN procedure was modified by using irradiated CTLL-2 cells of C57BL/6 origin, instead of primary mouse splenocytes, as the allogeneic stimulus in C3H/HeN recipient mice. PLN cell proliferation was determined by [3H]-thymidine uptake. We found that the host lymphocyte proliferative response to CTLL-2 cells (H-2b) is greater than the response to mouse Balb/c splenocytes (H-2d). Rapamycin (ip or po) produced a dose-related inhibition of the in vivo mixed lymphocyte reaction. By contrast, the effects of CsA and FK-506 were not dose related within the same dose range (0.006-12 mg/kg). These data indicate that rapamycin is an effective immunosuppressive agent and confirm its ability to affect the allogeneic T cell response in vivo. Furthermore, the pharmacological data suggest that this PLN model utilizing irradiated CTLL-2 cells as an allogeneic stimulus provides a reproducible system to examine mixed lymphocyte reactions in vivo.

Type II collagen induced arthritis in mice. V. The role of the spleen cell response in the immune and arthritogenic reaction to type II collagen

The contribution of the spleen to the arthritogenic and immune response to type II collagen in mice was measured by a series of in vitro and in vivo experiments. Negligible antibody production and proliferative responses to collagen were measured in the spleen from immunized mice, compared to lymph node and peripheral blood. Further, splenectomized mice were found to be susceptible to collagen induced arthritis with a similar disease incidence to sham operated controls. There were no major differences in the sera antibody responses or the delayed-type hypersensitivity responses to collagen between the splenectomized and control mice. The primary regulation of the response to type II collagen in collagen induced arthritis was apparently independent of the spleen cell population.