Sleep as a mediator of the relationship between social class and health in higher education students

A substantial body of research indicates that higher education students from lower social class backgrounds tend to have poorer health than those from higher social class backgrounds. To investigate sleep as a potential mediator of this relationship, online survey responses of students from five large Australian universities, one Irish university and one large Australian technical college were analysed in three studies (Study 1 N = 628; Study 2 N = 376; Study 3 N = 446). The results revealed that sleep quality, sleep duration, sleep disturbances, pre-sleep worries and sleep schedule variability mediated the relationship between social class and physical and mental health. Sleep remained a significant mediator when controlling for related variables and other mediators. Thus, the findings suggest that sleep partly explains social class differences in health. We discuss the importance of addressing sleep issues among students from lower social class backgrounds.

A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates

INTRODUCTION

Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample.

METHOD

Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey.

RESULTS

Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries.

CONCLUSION

Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Associations of Spiritual Well-Being and Hope with Health Anxiety Severity in Patients with Advanced Coronary Artery Disease

Background and Objectives: Health anxiety is one of the most common problems in patients with coronary artery disease. The present study tested whether health anxiety severity could be predicted by spiritual well-being and hope in patients with advanced coronary artery disease. Materials and Methods: In a cross-sectional study, 100 patients with advanced coronary artery disease were recruited from hospitals and healthcare centers in Iran. Patients completed self-report scales, including the Spiritual Well-Being Scale, Adult Hope Scale, and Short Health Anxiety Inventory. Hierarchical multiple regression analyses were used to empirically explore the relations among variables. Results: Results indicated that patients who reported higher levels of hope (β = 0.42, p < 0.01) and spiritual well-being (β = 0.20, p < 0.05) reported lower levels of health anxiety. Agency (β = 0.58, p < 0.01) scores were a significant negative predictor of health anxiety severity. Additionally, religious spirituality scores (β = 0.28, p < 0.01) were shown to significantly negatively predict health anxiety level. However, the pathways components of hope and existential spirituality were not significant predictors. Conclusion: The findings of the present study indicate that spiritual well-being and hope could be important factors in determining health anxiety for adults with coronary artery disease, and their role is worthy of further exploration to help improve health anxiety for patients with coronary artery disease.

Pathway Linking Different Types of Childhood Trauma to Somatic Symptoms in a Subclinical Sample of Female College Students: The Mediating Role of Experiential Avoidance

ABSTRACT

Research has shown that women are more prone to childhood trauma and this state is associated with somatic symptoms. Also, people who have been exposed to traumatic experiences use experiential avoidance to reduce negative emotions. However, the mediating role of experiential avoidance in the relationship between childhood trauma and somatic symptoms is not clear, so, the present study investigated whether the relationships among different types of childhood trauma and somatic symptoms could be explained by experiential avoidance in female college students. In a cross-sectional study, 251 Iranian female college students with somatic symptoms were recruited from the University of Tabriz. Participants completed self-report scales, including the Persian version of Child Abuse Self-Reported Scale, Acceptance and Action Questionnaire-II (AAQ-II), and the Patient-health questionnaire (PHQ-15). A path analysis was used to empirically explore the relationships. Structural equation modeling analyses confirmed a partial mediation model. Study participants who had a higher level of emotional trauma reported higher levels of somatic symptoms. Emotional and neglect trauma showed significant positive relations with experiential avoidance. Bootstrapping results showed that experiential avoidance partially mediated the relationship between emotional trauma and somatic symptoms. Moreover, the association between neglect and somatic symptoms was fully mediated by experiential avoidance. These findings suggest that experiential avoidance might be one mechanism explaining how adverse emotional and neglect experiences influence somatic symptoms. Interventions addressing experiential avoidance through methods such as emotion-focused therapy and mindfulness are discussed as potential future directions for treating somatic symptoms in females who experienced emotional and neglect trauma.

A cross-country examination of emotional eating, restrained eating and intuitive eating: Measurement Invariance across eight countries

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures.

Pathway linking dispositional mindfulness to fatigue in oncology female nurses: Exploring the mediating role of emotional suppression

PURPOSE

Fatigue is a physical and emotional state associated with certain aspects of nursing practice. The current study aimed to investigate the indirect effect of dispositional mindfulness on fatigue via emotional suppression in oncology female nurses.

METHODS

In a cross-sectional study, 137 female oncology nurses were recruited from several hospitals to complete baseline questionnaires. Emotional suppression, dispositional mindfulness and fatigue were assessed with the Weinberger Adjustment Inventory (WAI), Five Facet Mindfulness Questionnaire (FFMQ) and the Multidimensional Fatigue Inventory (MFI) respectively. A Mediation model was tested using structural equation modelling.

FINDINGS

Dispositional mindfulness was negatively associated with emotional suppression (β = -0.69, p = 0.000). In addition, emotional suppression was positively associated with fatigue (β = 0.32, p = 0.014). The mediation path was significant with emotional suppression fully mediating the relationship between dispositional mindfulness and fatigue (b = -0.20 [CI: -0.01, -0.25].

DISCUSSION

These results support the proposed model, and the assumption that emotional suppression may help facilitate the onset of fatigue or maintain it in female oncology nurses. The findings have implications for the use of brief mindfulness interventions aimed at the effective regulation of emotion in oncology nurses to aid in well-being and optimal nursing practice.

Translational aspects of body image research for obesity-related quality of life and weight loss maintenance post-bariatric surgery

Background

The Aim of the study was to examine obesity health-related quality of life and body image satisfaction in a group of individuals having undergone bariatric surgery.

Methods

One hundred and forty-two persons who had undergone bariatric surgery answered an online survey which included measures of well-being and body image. The Multidimensional Body Self-Relations Questionnaire-Appearance Scales (MBSRQ-AS 34) was used to assess body image in relation to appearance evaluation (AE), appearance orientation (AO), overweight preoccupation (OP), self-classified weight (SCW), and body areas satisfaction (BASS). Obesity-related quality of life was assessed with the obesity related well-being scale (Orwell 97).

Results

Hierarchical multiple regression indicated that 50.2% of the variance in well-being post-surgery was explained by body image variables [F(6,84) =18.54, P<0.01], with the strongest predictor being satisfaction with body areas (B=−0.360, P<0.01). Regression analysis of the data for the group of patients who had received the vertical sleeve surgery was also significant, [F(6,56) =10.16, P<0.001] with satisfaction with different body areas being the best predictor of well-being (B=−0.365, P<0.05), followed by OP (B=0.313, P<0.05) and SCW (B=0.281, P<0.05).

Conclusions

Body image concerns are more important predictors for well-being post bariatric surgery than weight lost. Psychological factors such as the perception of body areas, continued weight preoccupation and SCW rather an objective weight were better predictors of well-being, symptoms that impacted on well-being and on the subjective relevance of the symptoms to well-being. Recommendations for the translation of the present research findings for the surgical preparation of the bariatric patient and for post-surgery care are suggested.

Dental anxiety in patients attending a student dental clinic

Background

This study investigated the expectations and experiences of a sample of new patients visiting an Australian regional university Student Dental Clinic with regard to anxiety provoking and alleviating stimuli in the clinical environment. Differences in anxiety levels were examined by age, gender and the type of procedure undergone.

Methods

The number of dental patients who participated in the study was 102 (56 males, 43 females). The study used a pre-treatment/post-treatment design to assess the effect of the dental procedure on anxiety levels of patients. The Modified Dental Anxiety Scale (MDAS) was used to measure anxiety levels in patients at pre-treatment. Questions were also asked about factors which may increase (length of the appointment, invasiveness of procedure) or decrease (perceived student interpersonal skills and clinical ability) dental fear.

Results

Females reported higher total MDAS scores (M = 11.93) compared to males (M = 9.94). Younger patients (M = 12.15) had higher dental anxiety than older patients (M = 9.34). There was a reduction in dental anxiety from pre-treatment (M = 1.92) to post-treatment (M = 1.23) on the single item anxiety measure though most of the treatment being undergone by patients was for less complex procedures.

Conclusions

Patients’ anticipatory experience of anxiety was higher than the anxiety experience after having undergone treatment at the student dental clinic. Student interpersonal skills and clinical ability as perceived by the patient can lessen dental anxiety in patients. Clinical Supervisor-student ratios need to be more equivalent in order to reduce the time length of appointments which currently are associated with increased patient anxiety levels in student dental clinics.

Development and validation of the medical social self-efficacy scale for use in culturally diverse communities

This study developed a new scale, The Medical Social Self-efficacy Scale (MSSES), to assess social self-efficacy within a medical context for patients of diverse cultural and linguistic backgrounds. Validation of the MSSES with a sample of 113 persons indicated that the scale has good internal consistency, with a Cronbach's alpha coefficient of .85. A factor analysis yielded two factors (confidence in seeking medical information, confidence in stating my view) which accounted for 64% of the total variance. Split-half reliability of the MSSES was .84. Predictive validity of the MSSES and its factorial structure was found for the mental component summary and general health subscale of the 12-item Short-Form Health Survey. Evidence of concurrent validity was found with the active coping, planning and positive reframing subscales of the Brief COPE. Concurrent validity was also found for the MSSES and its factors, in regard to the emotion-focused coping composite subscale of the Brief COPE. The results indicate that the MSSES appears to be a psychometrically sound instrument.

Dispositional factors, coping and adaptation during menopause

The objective of the study was to examine the direct and indirect influences of dispositional factors, namely optimism, health-related hardiness (HRH) and sense of coherence (SOC), on the symptom experiences of peri- and postmenopausal women. Indirect effects of dispositional factors were examined via attitudes to the menopause and coping (emotion-versus problem-focused). A survey methodology was employed to assess the research objective for 176 peri- and postmenopausal women recruited from menopause clinics and family planning centers in Queensland, Australia. Emotional stability of the subjects was statistically controlled to eliminate any possible confounding effect on symptom reporting. The results indicated that optimism and SOC affect menopausal health directly, as evidenced by fewer symptoms reported by women scoring highly on these dispositions. Any indirect effect of HRH, optimism and SOC appears to be exerted via problem-focused coping rather than emotion-focused coping or through attitudes. It was concluded that dispositional factors are important to the experience of the menopause and how women adapt to their midlife transition. Psychologists and professionals working in menopause clinics may need to promote feelings of optimism and a sense of coherence in menopausal women, to facilitate better adaptation to this important transitional phase in women's lives.

Palatability versus healthiness as determinants of food preferences in young adults: a comparison of nomothetic and idiographic analytic approaches

Past research on adults has found that the sensory appeal or taste of foods is a primary determiner of food consumption and how people think about food. The nomothetic nature of this research may have underestimated the impact of health considerations on food choice. This study compared 'nomothetic' and 'idiographic' modes of analysis in 1) determining the relative influence of palatability and perceived healthiness of foods, on preference for the food, and 2) assessing the relationship between palatability and evaluations of healthiness. Additionally, gender differences were examined in relation to within-person correlations between the concepts of preference, palatability and healthiness. Subjects (n = 139) rated 81 foods on preference, palatability and healthiness. Findings from both the idiographic and nomothetic analyses indicated that palatability rather than health considerations determined preferences in young adults. The within-person correlational analysis indicated a large number of persons, mostly female, who preferred unhealthy food. The sample was equally split in their evaluations of healthy food as palatable or not.

Relationship between exhaustion and postnatal depression

The period after the birth of a child may be characterized by occasions of physical exhaustion. Mothers who self-reported having experienced postnatal depression in the past year and physical exhaustion were examined.

Self-esteem, body-image and weight in noneating-disordered women

The self-esteem of 69 women attending weight-loss centres was examined in relation to attitudes towards body and weight, actual weight, number of diets undergone and weight fluctuations. Rosenberg's Self-esteem Scale was used to measure self-esteem. Attitudes towards the body and weight were assessed using Freedman's Body-Love Questionnaire. The Body Mass Index was used as a weight-range classification for the women. Body image was assessed using the silhouette chart of Bell, Kirkpatrick, and Rinn. Women with stable weight had the highest self-esteem. The number of diets undertaken was associated with lowered self-esteem. High scores on evaluation of appearance were positively correlated with scores on self-esteem. No association was found between self-esteem and either eating restraint or significant others' attitudes. There was good agreement between the women's perceptions of their own bodies and independent raters' perceptions indicating a lack of body-image distortion for this non-eating-disordered group.

Factors affecting the progression towards burnout: a comparison of professional and volunteer counsellors

This study compared professional and volunteer counsellors on a number of key variables in the progression to burnout, namely, stressors, strain, defensive coping, social support, Type A personality, and breakdown. Job stressors unique to each group were identified but there was overwhelming evidence for professionals and volunteers belonging to a homogeneous counselling population as evidenced by similarity across major constructs. Path analysis supported theoretical formulations on burnout by Maslach and Cherniss, and gave support to Lin, Dean, and Ensel's argument that social support may act as a buffer to burnout.