Behavioral Disengagement Research Articles

Problematic Internet, Smartphone, and SMS Use among Adults: Shared and Unique Predictors.

Although a surge of interest has recently emerged in investigating the simultaneous problematic use of various technology-based tools, the findings are still inconclusive. The present web-based survey aimed at examining whether (a) personality traits, coping strategies, and sociodemographics are associated with problematic internet, smartphone, and SMS use among Greek users and (b) personality traits mediate the relationship between maladaptive coping strategies and problematic use of the three media. A cross-sectional study. A convenience and snowball sample of 1016 participants (84.4% female, mean age of 30.3 years) completed the Problematic Internet Use Questionnaire-9 (PIUQ-9), the Mobile Phone Problem Use Scale (MPPUS), the Self-Perception of Text Message Dependency Scale (STDS), the Personality Diagnostic Questionnaire 4+(PDQ-4+), and the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE). Shared predictors between problematic use of the three technology-based tools were younger age and low educational level, the coping strategy of substance use, and the narcissistic, avoidant, and dependent personality disorders. Predictors of problematic internet and smartphone use were coping strategies of emotional support, self-distraction, and behavioral disengagement. According to structural equation models (SEM) models, cluster C personality disorders fully mediate the relationship between maladaptive coping strategies and problematic use of technology-based tools. Addressing factors that predispose (i.e., personality traits), precipitate, or maintain problematic use (i.e., coping strategies) can lead to effective and cost-saving preventive (i.e., screening of vulnerable groups) and therapeutic efforts (i.e., teaching adaptive coping strategies).

Prevalence and Predictors of Anxiety among Stable Hospitalized COVID-19 Patients in Malaysia.

The COVID-19 pandemic has created anxiety among hospitalized SARS-CoV-2 patients. Therefore, this study aimed to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. Method: A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia’s leading COVID-19 hospitals from 15th April until 30th June 2020, who were chosen using quota sampling. The General Anxiety Disorders 7 items (GAD-7) scale, the Coping Orientation to Problems Experienced Inventory (Brief-COPE) and a socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. Result: The results showed that the prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female gender (p < 0.05), a fear of infection (p < 0.05), a lack of information (p < 0.05), a maladaptive coping mechanism of behavioral disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Meanwhile, adaptive coping mechanisms via instrumental support (p < 0.001) were a significant protective predictor of anxiety. Conclusions: COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provide baseline data on the prevalence of anxiety among stabilized COVID-19 inpatients in Malaysia. Despite the relatively low prevalence, the data have the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances.

Prevalence of loneliness and its correlates among patients with schizophrenia.

There are limited data on loneliness and its correlates in patients with schizophrenia. To evaluate prevalence and correlates of loneliness in patients with schizophrenia, currently in clinical remission. A total of 160 patients of schizophrenia in clinical remission were assessed on UCLA Loneliness Scale, Positive and Negative syndrome scale, Calgary Depression Scale for Schizophrenia (CDSS), Internalized Stigma of Mental Illness Scale, Rosenberg Self-esteem Scale, Brief COPE, Beck's Hopelessness Scale, Brief Dyadic Scale of Expressed Emotions, and Self-report Quality of Life Measure. The mean age of the study sample was 34.99 (SD = 9.13) years. The prevalence of loneliness in the study sample was 80%, with mean total UCLA-loneliness scale score of 30.04 (16.9).Compared to participants without loneliness, those with loneliness had had higher CDSS score, had poor quality of life, lower self-esteem, experienced higher level of stigma, more often used maladaptive coping strategies such as self-blaming and reported a higher level of hopelessness. In the correlation analysis, higher level of loneliness was associated higher severity of depression, higher level of stigma (except for stigma resistance) and discrimination, poorer quality of life, lower self-esteem, perception of a higher level of expressed emotions, higher use of maladaptive coping in the domains of behavioral disengagement, and self-blaming, and a higher level of hopelessness. In regression analysis, the maximum variance of loneliness was explained by quality of life score (29%), followed by hopelessness score (8.8%) and discrimination score (2%). There is a high prevalence of loneliness in patients with schizophrenia, and there is a need to routinely evaluate the patients of schizophrenia for loneliness and address the same.

Akciğer kanseri olan hastaların baş etme stratejileri ile yaşam kalitesi arasındaki ilişki

Objective: In this study, it is aimed to examine the coping strategies and quality of life of patients with lung cancer. In this context, the relationship between strategies for coping with lung cancer and the quality of life of patients is discussed. The effect of treatment duration on coping strategies and quality of life is also being examined.&#x0D; &#x0D; Method: The cross-sectional survey study and the convenience sampling method were used in the study. The World Health Organization Quality of Life- BREF (WHOQOL-Bref; 27 items) and Coping Orientation to Problems Experienced Inventory (Brief-COPE; 28 items) were used as scales. The data of this research were obtained from 201 patients diagnosed with lung cancer and undergoing treatment.&#x0D; &#x0D; Results: Research results show that 53.0% of the participants were women and 86.1% were married. In addition, the mean age of the participants was 57.19±7.01 (mean ± s. Deviation). A positive correlation emerged between each domain of the WHOQOL-BREF scale. As for the coping scale, it was determined that there were positive and weak relationships between problem-focused coping strategies and quality of life in active coping, planning and positive refraining strategies. It was determined that there was a positive and weak relationship between positive emotion-focused coping strategies and quality of life in all coping strategies. Finally, it was determined that negative emotion-focused coping strategies such as ventilation, behavioral disengagement, denial, and self-blame were affecting the patient’s quality of life negatively.&#x0D; &#x0D; Conclusion: In conclusion, lung cancer patients who used both problem-focused and positive emotion-oriented coping strategies achieved a higher quality of life. On the other hand, it is an important conclusion to consider that negative emotion focused coping strategies negatively affect patients’ quality of life. Finally, it can be expressed as another conclusion of this study that age, income and duration of treatment affect both the quality of life and coping strategies of lung cancer patients.

Longitudinal co-trajectories of depression and alcohol problems in adults during the COVID-19 pandemic.

The online version contains supplementary material available at 10.1007/s12144-022-04109-4.

Acculturation and school engagement: The case of Portuguese students with Roma background

There is well-documented evidence on the relationships between the perceived utility value of school, positive learning outcomes, and intention to pursue education. For students from ethnic marginalized or economically deprived backgrounds, beliefs and values on the utility of education are shaped by acculturation conditions and hassles they are often exposed to. Despite recognizing the value of education, students from the Roma community show disengagement behaviors and interrupted educational trajectories. This might contribute to disadvantaged positions in education, labor markets, healthcare, and political life. Grounded on the acculturation framework, this study investigated how and to what extent micro-level acculturation contexts – family and school – influence school-based outcomes (e.g., utility beliefs; School Engagement [SE]) of students with Roma background. The empirical data draws on a sample of 213 students collected in eleven schools across Portugal. Results are insightful, providing evidence of how different socialization agents bolster school engagement dimensions. Moreover, data provided evidence on the most effective forms of parental and teacher involvement to support the utility value of school and education. Together findings open avenues to challenge further deficit perspectives underscoring policies and educational interventions targeting the achievement gap among students with Roma background.

Predictors of Students’ Mental Health during the COVID-19 Pandemic: The Impact of Coping Strategies, Sense of Coherence, and Social Support

Young people and women seem to suffer more from social restrictions due to the COVID-19 pandemic than do others. Findings from pre-pandemic surveys identified students as a specific risk group for developing anxiety and depressive symptoms. Recent studies have indicated that students especially denoted a decrease in mental health during the pandemic. In a sample of n = 1938 university students (67.6% female), we investigated protective factors that are associated with mental health (defined as the absence of any mental disorder) and more specifically, the absence of major depression during the pandemic despite social restrictions. Investigated protective factors were social support, sense of coherence and situational coping strategies. The results of the multiple logistic regression analyses revealed that male gender, high sense of coherence and specific coping strategies could be identified to be associated with mental health in general and the absence of major depression. Protective coping strategies that were related to mental health in general were lower substance use, lower behavioral disengagement, higher positive reframing and lower self-blame. Protective coping strategies that were associated with the absence of major depression specifically were higher use of instrumental support, lower substance use, lower behavioral disengagement, higher positive reframing, higher emotional support, lower self-blame and lower humor. Social support was related to the absence of major depression, but not to mental health in general. Higher age in university students was associated with better mental health, but not with the absence of major depression specifically. These findings indicate that sense of coherence and situational coping strategies can buffer the adverse effect of social restrictions on mental health and thus, can serve as important resilience factors. Moreover, they highlight the political relevance of promoting specific coping strategies to foster mental health in students encompassing adverse events and social restrictions.

Coping with Workplace Incivility in Hospital Teams: How Does Team Mindfulness Influence Prevention- and Promotion-Focused Emotional Coping?

Incivility is a growing concern for researchers and practitioners alike, yet we know little about how the team context is related to the way that employees respond to it. In this study, we examined the role of team mindfulness and its direct and buffering effects on individual-level promotion- and prevention-focused emotional coping. We also examined how these forms of coping were related to individual work engagement. In a temporally lagged study of 73 hospital teams (involving 440 team members), multi-level analyses showed that team mindfulness was directly negatively associated with individual-level prevention-focused emotional coping (behavioral disengagement, denial, and venting); however, it was not positively related to individual-level promotion-focused forms of coping (positive reframing and acceptance). In addition, a cross-level interaction effect was identified whereby team mindfulness reduced the positive relationship between incivility and venting, meaning there was less individual-level venting following incivility in the context of higher team mindfulness. These findings may have implications for work engagement, which was shown to be negatively related to venting and behavioral disengagement. Our findings are useful for managers of teams that regularly experience customer incivility as it uncovers how they can develop a team context that discourages ineffective coping responses.

Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes.

Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4-year follow-up. Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow-up 4 years later. During MIDUS, 2 participants (N=513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points. Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p=.050) and depressed affect (p=.033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status. This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.

Perceived Stress and Loneliness During the COVID‐19 Pandemic in a Cognitive Aging Cohort

AbstractBackgroundThe COVID‐19 pandemic has had disproportionate effects on the health and well‐being of older adults. Little is known about the effects of isolation and social distancing measures on the mental health of older adults with cognitive impairment.Method194 participants from the Wake Forest Alzheimer’s Disease Research Center (ADRC) Clinical Core cohort adjudicated as cognitively normal (CN, n = 129), and mild cognitive impairment (MCI, n = 65) were given questionnaires cross‐sectionally measuring loneliness, perceived stress, well‐being, and coping style. We created multivariable regression models (adjusted for age, sex, race, and education) to assess relationships among dependent variables, loneliness and perceived stress, and independent variables of interest, well‐being and coping style (Table 2).ResultOverall, the mean age was 72±8 years. Table 1 lists baseline demographic and study measures for CN and MCI groups. Table 2 shows associations between dependent variables (perceived stress, loneliness) and independent variables of interest. Participants with MCI had significantly higher levels of loneliness (B = 3.30; p = 0.03) than CN participants. Participants who reported lower eudaimonic and hedonic well‐being had higher levels of perceived stress and loneliness (p &lt; 0.01), and those who endorsed using self‐blame and behavioral disengagement to cope with stress had higher perceived stress (B = 3.06, = &lt; 0.01) and loneliness (B = 7.84, p &lt; 0.01). There was no interaction by cognitive diagnosis.ConclusionParticipants with MCI had higher levels of loneliness, but not perceived stress, than those with normal cognition. We found that participants expressing high feelings of well‐being had significantly lower, and participants reporting a coping style with self‐blame and behavioral disengagement had significantly higher perceived stress and loneliness. Next steps involve exploring associations of neuroimaging and Alzheimer’s disease biomarkers with perceived stress and loneliness and evaluating transcriptional measures of stress measured concurrently.

Consumers' coping strategies when they feel negative emotions in the face of forced deconsumption during the Covid-19 pandemic lockdowns.

This paper explores consumers' coping strategies when they feel negative emotions due to forced deconsumption during the Covid-19 pandemic lockdowns. The tool used for data collection is the questionnaire. It was made using the LimeSurvey software. A total of 621 complete observations were analyzed. The findings demonstrate that anger positively influences the activation of seeking social support, mental disengagement, and confrontive coping strategies. Besides, disappointment activates mental disengagement but only marginally confrontive coping and not behavioral disengagement. Furthermore, regret is positively related to confrontive coping, behavioral disengagement, acceptance, and positive reinterpretation. Finally, worry positively impacts behavioral disengagement, self-control, seeking social support, mental disengagement, and planful problem-solving. The study's originality lies in its investigation of consumers' coping strategies when experiencing negative emotions due to forced deconsumption in the context of the Covid-19 pandemic.

Parental Assistance with Emotion Regulation Moderates Link Between COVID-19 Stress and Child Mental Health

ABSTRACT Objective The COVID-19 pandemic has severely impacted children’s mental health. All children have not been affected equally, however, and whether parental emotion socialization might buffer or exacerbate the impact of COVID-19 on children’s mental health remains an important question. Method During the first peak of the COVID-19 pandemic in the U.S. N = 200 parents of children ages 0–17 (52.5% female) completed questionnaires related to parental assistance with children’s emotion regulation, symptomatology, and exposure to COVID-19-related stress. Parents were 74% Non-Hispanic/Latino/a White, 13% Asian, 4.5% Hispanic/Latino/a, 4% Black/African American, 2.5% Native American, and 1.5% bi/multiracial; 0.5% of participants preferred not to state their race/ethnicity. In a series of linear regression analyses, we examined whether parental assistance with children’s execution of emotion regulation strategies – across a variety of prototypically-adaptive and -maladaptive strategies – moderates the association between children’s exposure to COVID-19-related stress and symptomatology. Results Results suggest that parental assistance with the execution of prototypically-adaptive strategies (i.e., acceptance, problem solving, behavioral disengagement) and prototypically-maladaptive strategies (i.e., suppression, rumination) may buffer or exacerbate, respectively, the impact of COVID-19-related stress on youth mental health. Conclusions Though interpretation of findings is constrained by limitations inherent in collecting data during a pandemic, results highlight the importance of supporting parents – who play a critical role of supporting children – during public health emergencies that affect family life. Interventions designed to improve child wellbeing during the ongoing pandemic may benefit from training parents to assist their children with specific emotion regulation strategies.

In Their Own Words: A Qualitative Study of Coping Mechanisms Employed By Patients with Acute Myeloid Leukemia

Introduction: Acute Myeloid Leukemia (AML) is a heterogeneous disease affecting over 20,000 adults in the U.S. each year. People diagnosed with AML experience a period of shock compounded by the need to make quick treatment decisions. Coping not only with the direct symptoms of disease and treatment (e.g., fatigue, nausea, pain), but also lifestyle changes (e.g., inability to live independently, inability to conduct usual activities) is integral to the patient experience. Coping has also been shown to mediate the impact of integrated palliative care on improving outcomes. While several studies analyze coping mechanisms in AML using predetermined scales, less is known about how patients themselves describe their coping strategies when asked open-ended questions about their experience. We aimed to explore patients' coping methods, through their own words, using qualitative methods. Methods: We enrolled patients with high-risk AML admitted to Duke Hospital's inpatient hematologic malignancy service for high dose chemotherapy treatment. This study is a secondary analysis of previously collected longitudinal qualitative data, with patient interviews conducted between February 2014 and March 2015 (up to three semi-structured interviews per patient). Interviews were coded in NVivo using open and axial coding to identify coping mechanisms. Coping mechanisms were divided into two broader categories: approach-oriented coping (acceptance, positive reframing, meaning-focused coping, relying on faith, active coping, and social coping) and avoidant coping (behavioral disengagement, self-blame, and denial). Results: Of the 32 patients in the study, the mean age was 61.8 years. Similar proportions of patients in the study had normal karyotype (53.1%, n=17) and complex karyotype (46.9%, n=15) and most patients were newly diagnosed (68.8%, n=22). One approach-oriented coping strategy employed by patients was acceptance-accepting one's prognosis, consequent lifestyle changes, and new normal: "[I will] be monitored, y'know continuously for the rest of my life. I accept that." Others accepted the uncertainty of AML: "You don't know what to expect. You just go with the flow. There is no expectation with cancer." Many patients used positive reframing by keeping perspective, either by hypothesizing about how it could be worse or comparing their situation to others: "There are millions and millions of people who have so much less than I do, who are in such pain, who don't have roofs over their head." Other patients found greater admiration for activities previously taken for granted: "[AML] made me want to go back and appreciate some of the things that I didn't appreciate. Just a good long walk, working in the garden, being with my friends." Another coping strategy included deriving meaning from their own experience, either by focusing on lessons learned or feeling that they could help others. Finally, social coping fell into two categories: patients feeling support from their medical team and from their community. Notably, some also felt guilt for being a "burden" on family members who drive them to medical appointments and take care of them. Avoidant coping mechanisms were present in the form of behavioral disengagement-pulling away from loved ones or feeling "numb," as well as self-blame when treatment did not work. However, the most common avoidant coping mechanism patients discussed was denial, either in the form of emotional suppression or manipulation of the truth, as is the case with a patient who stated, "I call it cured. Doctor said it's in remission, but I don't know. I call it cured." Yet, there were instances in which avoidance of full information appeared to be adaptive, for example if the patient decided to break their treatment into more manageable subsections: "If there's going to be several stages, let's focus on Stage 1 and get through it; there's a mile marker to get to where we are and then we will go on from there." Conclusion: These results demonstrate the diverse applications of coping mechanisms in the wake of an AML diagnosis. Specifically, within broad categories of coping strategies (e.g., positive reframing), important subdivisions exist, and must be understood in order to best support patients. Future research should aim to further elucidate these nuances and how they affect the emotional wellbeing of patients. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Effects of replay and rehearsal expressive writing on mental health: a randomized controlled trial

Background: Expressive writing about previous interactions has been found to improve mental health, but the effect of expressive writing about future imagined interactions has not been explored. Methods: To examine the effects of rehearsal expressive writing on mental health, we recruited 132 people, and 100 (76%) completed writing tasks (31 control, 34 replay, and 35 rehearsal). Each group was measured at baseline, after the 4th consecutive day of 15-minute-per-day writing, and at 1-month follow-up. Measures included psychological adjustment (Mental Health Inventory-18, MHI), self-perceived stress, PROMIS depression and anxiety, work and social adjustment, loneliness, coping (Brief COPE), and daily writing expressiveness. Repeated measures ANOVA examined time and time-by-group effects. Results: Significant time effects were found for MHI, self-perceived stress, depression and anxiety symptoms, and self-blame. Marginally significant group-by-time effects on behavioural disengagement and venting, subscales of the coping measure, were found, with rehearsal associated with decreased disengagement and increased venting compared to the replay group. The rehearsal group consistently reported significantly higher perceived writing expressiveness than the other groups over time. Rehearsal and replay expressive writing showed different effects on writing expressiveness and coping via behavioural disengagement and venting. Conclusion: This study established rehearsal as a promising extension to the affordable therapeutic expressive writing paradigm.

Minimization of release bearing load loss in a clutch system for high-speed rotations using the differential evolution algorithm

Abstract Diaphragm spring is a critical part of a clutch system because it affects the release bearing load characteristics directly and that determines the quality of disengagement. Bearing load provides required clamping for coupling however it may vary significantly during the engagement/disengagement process. A significant drop in bearing load may be experienced especially for high engine velocities for certain bearing displacement due to centrifugal forces occurring on the fingertips of diaphragm springs. The falling in release bearing load is undesirable for comfortable driving and clutch performance. This problem has not been addressed clearly in technical literature. In this study, the diaphragm spring for a C-segment passenger car is optimized using a differential evolutionary algorithm, and an optimized diaphragm was manufactured for testing. The load-bearing characteristics of the optimized diaphragm were compared with those of the currently available diaphragm spring. Loss of bearing load occurring in high-speed rotations was significantly reduced for the optimized diaphragm. Parameters influencing the performance were identified using parameter influence analysis, and a robust disengagement behavior was actualized using the optimization process.

Comparing Psychological Wellbeing and Work-Related Quality of Life between Professional Groups within Health and Social Care during the COVID-19 Pandemic in the UK

This paper shared the compared results on the psychological wellbeing and work-related quality of life amongst health and social care workers during the COVID-19 pandemic in the UK. Health and social care professionals within nursing, midwifery, allied health professions, social care and social work occupations working in the United Kingdom (UK) during the pandemic were recruited. Repeated cross-sectional online surveys were conducted during two time periods of the pandemic (May–July 2020 and May−July 2021). A total of 4803 respondents completed the survey. The findings revealed that over the pandemic, psychological wellbeing (SWEWBS measure) and work-related quality of life (WRQoL scale) scores significantly decreased in all five occupations (p &lt; 0.001) with midwives having the lowest scores on both scales at all time points. Respondents were found to significantly (p &lt; 0.001) use of negative coping strategies such as behavioural disengagement and substance usage. Analysis of variance revealed a statistical difference between occupations and wellbeing across 2020 and 2021, while work-related quality of life was only statistically significantly different in 2021. The findings revealed that due to this decrease, there is a distinct need for more support services and flexible working conditions within health and social care services, to improve wellbeing and work-related quality of life.

Ways of Coping with Stress among Patients with Depressive Disorders.

Experiencing stressful life events and ways of coping with them can predispose to the onset of depressive mood disorders, while depression itself can be responsible for severe stress and can weaken resilience to stressors. Thus, variables relevant to the onset of depressive episodes and the course of depression have significant relationships with coping strategies to stressors. The aim of this research was to evaluate the most commonly used stress-coping strategies in patients treated for depression compared to patients with anxiety disorders and to healthy subjects. The multidimensional coping inventory (COPE Inventory) by C. S. Carver, M. F. Scheier, and J. K. Weintraub, covering 15 stress response strategies included in more general and overarching coping styles, was used in the study. Patients with depression differed from the healthy subjects in a statistically significant way. Statistical analysis showed that people with depression are less likely than healthy subjects to use Active Coping, Planning, Seeking of Instrumental and Emotional Social Support, Suppression of Competing Activities, and Positive Reinterpretation. In contrast, they are more likely to use Denial, Mental Disengagement, and Behavioral Disengagement compared to those not treated for mental disorders. The patients with depressive disorders, compared to the group of patients with anxiety disorders, scored significantly differently on stress coping strategies in only two types of actions taken in stressful situations. The patients with depression differed from the healthy subjects in terms of the highest number of the stress coping strategies assessed. Compared to the healthy individuals, a tendency toward an avoidant behavior style was prevalent among the depressed patients. There was no statistically significant difference between the patients with the first episode of the disease and recurrent depressive disorders in terms of stress coping strategies.

Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles.

Physical frailty and cognitive decline are two major consequences of aging and are often in older individuals, especially in those with multimorbidity. These two disorders are known to usually coexist with each other, increasing the risk of each disorder for poor health outcomes. Mental health disorders, anxiety and depression, are common in older people with multimorbidity, in particular those with functional or sensory deficits, and frailty. The aim of this study was to show how physical frailty, cognitive impairments and mental disorders, cluster in the real life setting of older primary care (PC) patients, and how these clusters relate to age, comorbidities, stressful events, and coping strategies. Knowing that, could improve risk stratification of older individuals and guide the action plans. Participants were older individuals (≥60, N = 263), attenders of PC, independent of care of others, and not suffering from dementia. For screening participants on physical frailty, cognitive impairment, and mental disorders, we used Fried's phenotype model, the Mini-Mental State Examination (MMSE), the Geriatric Anxiety Scale (GAS), and the Geriatric Depression Scale (GDS). For testing participants on coping styles, we used the 14-scale Brief-Coping with Problems Experienced (Brief-COPE) questionnaire. To identify clusters, we used the algorithm fuzzy k-means. To further describe the clusters, we examined differences in age, gender, number of chronic diseases and medications prescribed, some diagnoses of chronic diseases, the number of life events, body mass index, renal function, expressed as the glomerular filtration rate, and coping styles. The most appropriate cluster solution was the one with three clusters, that were termed as: functional (FUN; N = 139), with predominant frailty or dysfunctional (DFUN; N = 81), and with predominant cognitive impairments or cognitively impaired (COG-IMP; N = 43). Participants in two pathologic clusters, DFUN and COG-IMP, were in average older and had more somatic diseases, compared to participants in cluster FUN. Significant differences between the clusters were found in diagnoses of osteoporosis, osteoarthritis, anxiety/depression, cerebrovascular disease, and periphery artery disease. Participants in cluster FUN expressed mostly positive reframing coping style. Participants in two pathological clusters were represented with negative coping strategies. Religion and self-blame were coping mechanisms specific only for cluster DFUN; self-distraction only for cluster COG-IMP; and these two latter clusters shared the mechanisms of behavioral disengagement and denial. The research approach presented in this study may help PC providers in risk stratification of older individuals and in getting insights into behavioral and coping strategies of patients with similar comorbidity patterns and functional disorders, which may guide them in preparing prevention and care plans. By providing some insights into the common mechanisms and pathways of clustering frailty, cognitive impairments and mental disorders, this research approach is useful for creating new hypotheses and in accelerating geriatric research.

Assessing psychological resilience: translation and validation of the Chinese version of the resilience evaluation scale (RES)

ABSTRACT Background The Resilience Evaluation Scale (RES) is a novel and freely available measure of psychological resilience (factored into self-confidence and self-efficacy). To date, psychometric properties were evaluated in Dutch and American samples, but not yet in a Chinese sample. Objective We aimed to validate the RES in a Chinese sample by examining its factor structure, reliability, and construct validity. Methods The RES was translated into Chinese following a cross-cultural translation and adaptation procedure. Self-report questionnaires including the RES, exposure to potentially traumatic events (PTE's), the PTSD checklist for DSM-5 (PCL-5), and scales for conceptually related constructs of psychological resilience were then administered via an online survey. Results In total, 484 Chinese adults (females, 66.9%; age: 27.33 ± 6.86 years) participated. Parallel analysis results suggested a one-factor structure for the Chinese RES. The Chinese RES demonstrated good internal consistency (Cronbach's alpha = 0.88). Construct validity was demonstrated through significant associations with hypothesised related constructs and through a relation with lower levels of PTSD among the PTE-exposed subsample (n = 116) via the mediating role of avoidant coping strategies, i.e. behavioural disengagement and self-blame. Conclusion Our results suggest that the RES is a reliable and valid assessment of psychological resilience to use in Chinese, in addition to its Dutch and English versions. The RES could potentially be adopted to measure psychological resilience in cross-cultural contexts.

Coping with COVID-19: Exploring coping strategies, distress, and post-traumatic growth during the COVID-19 pandemic in Australia.

This study aimed to explore coping strategies, distress, and post-traumatic growth among Australians with and without a history of a mental health diagnosis during the COVID-19 pandemic. Australians (N = 381) completed an online survey between 4-August 2020 and 25-October-2020. Coping strategies, distress, and post-traumatic growth were ascertained via the Brief COPE, Depression Anxiety and Stress Scale (DASS-21), and Post-Traumatic Growth Inventory (PTGI), respectively. Linear regression was conducted to examine the relationship between the Brief COPE, DASS-21, and PTGI, adjusting for sociodemographic factors. Models were conducted separately for those with/without a history of a mental health diagnosis. Higher distress was found among those with a history of a mental health diagnosis. Significant differences in the types of coping strategies associated with distress and post-traumatic growth were identified between the groups, however, behavioral disengagement and self-blame consistently predicted depression, anxiety, and stress. For those with a history of a mental health diagnosis, positive reframing decreased anxiety. Self-distraction was associated with post-traumatic growth across both groups. There are important differences in the way people with and without a history of a mental health diagnosis cope with the COVID-19 pandemic.