Changes In Emotional Well-being Research Articles

LOWER INCOME IN CAREGIVERS PREDICTS LESS EMOTIONAL WELL-BEING IMPROVEMENT AFTER CAREGIVING ENDS

Abstract Lower income in familial caregivers has been shown to associate with increased distress, depression, and burden during active caregiving. However, findings are less clear on whether lower income associates with changes in well-being that occur after caregiving ends. To investigate this question further, we recruited familial caregivers (CGs) of people with neurodegenerative diseases (PWD; N=36). Emotional well-being was assessed using the SF-36 Emotional Well-being and Energy scales both during active caregiving and after caregiving had ended (predominantly due to the PWD’s death or transition to institutional care, ~10 years later). Household income was measured after active caregiving had ended. Overall, CG’s emotional well-being and energy improved between active caregiving and after caregiving had ended (emotional well-being change: t(35) = 2.22, p = .033; energy change: t(35) = 2.88, p = .007). However, this improvement associated with household income, such that when controlling for levels during active caregiving, income associated with worse emotional well-being (B = -6.72, t(33) = -4.56, p < .001) and energy (B = -8.07, t(33) = -4.99, p < .001) in caregivers after caregiving had ended. During the adjustment period after caregiving ends, lower income may limit opportunities for caregivers to take time away from work to mourn the loss of their loved one or address their own health concerns adequately. Thus, low-income caregivers may experience fewer of the benefits associated with these activities. These findings underscore the importance of providing support for lower income caregivers during the critical period after caregiving ends.

THE IMPACT OF SERVICE QUALITY ON THE EMOTIONAL WELL-BEING OF STUDENTS: A STUDY AMONGST COLLEGE STUDENTS IN KUALA LUMPUR, MALAYSIA

The emotional well-being and mental health of students in the higher education sector have been greatly researched over the past few years since students are increasingly subjected to various stressors in their daily lives. One element of such stressors would be the impact of service quality within the educational institution itself. However, previous studies had mainly focused on the influence of service quality regarding student satisfaction or motivation and completely overlooked their emotional well-being. The purpose of this study is to examine the effect of service quality on the emotional well-being of students in higher learning institutions by employing the HESQUAL model to discern on whether emotional well-being is affected by service quality and if so, the level of its impact. Primary data have been utilised and collected through a questionnaire created according to the model discussed, and were analysed with a sample size of 105 students. The findings of this study showed that Service Quality Factors such as Physical Environment Quality, Administrative Quality and Quality of Support Facilities has an effect on the emotional wellbeing of students, supporting the objective of this study. The data illustrates how each change in the level of service quality influences a change in emotional well-being. However, it is clear that further investigations are required in the future since there are variables that could be improved upon.

Intergenerational Reminiscence Approach in Improving Emotional Well-Being of Older Asian Americans in Early-Stage Dementia Using Virtual Reality: Protocol for an Explanatory Sequential Mixed Methods Study.

After a dementia diagnosis, Asian Americans experience anxiety, feelings of shame, and other negative effects. Emotional well-being is not only an important aspect of mental health, but also a quality of resilience that helps people bounce back faster from difficulties. However, few studies have addressed issues in developing, implementing, and testing intervention strategies to promote emotional well-being among older adults. Intergenerational solidarity between grandparents and grandchildren has been emphasized in Asian families and is beneficial for the health of persons with dementia. Reminiscence and life review have been identified as potentially effective intervention strategies for helping depression and emotional well-being for older adults. This proposed study aims to develop and implement an intergenerational reminiscence approach and evaluate its potential feasibility and effectiveness in improving the emotional well-being of older Asian American adults who have a recent dementia diagnosis. An explanatory sequential mixed methods design will be used in which quantitative data will first be collected and analyzed to identify subsamples of participants who report the greatest and least change in emotional well-being; then, these subsamples will be interviewed to further understand why or why not this intervention works for them. Older adults will receive 6 sessions of life review with grandchildren in virtual reality (VR; 1-1.5 hours each week for 6 weeks), aided by pictures and virtually traveling to important places in their life using Google Earth to look around at those places and remember important times. Quantitative survey data will be collected pre- and postintervention and at a 3-month follow-up. Qualitative interviews with selected participants will also be integrated into the study design. The quantitative data from the surveys will be entered into SPSS (IBM Corp) and analyzed using descriptive analyses, Pearson chi-square tests, nonparametric Friedman tests, or nonparametric Wilcox signed-rank tests (2-tailed). The qualitative data will be transcribed by research assistants, coded by the investigators independently, and analyzed with guidance from content analysis software (Atlas.ti; Atlas.ti Scientific Software Development GmbH). The project was delayed due to the COVID-19 pandemic. Data collection started in late 2021, and 26 participants were recruited as of December 2022. While we are still cleaning and analyzing the quantitative data, the qualitative interviews showed promising results of this intergenerational reminiscence approach in improving emotional well-being among older Asian American adults who have cognitive impairment. Intergenerational reminiscence provided by grandchildren is promising in improving the emotional well-being of grandparents. VR technology is likely to be accepted by older adults. Future research may consider scaling up this pilot into a trackable, replicable model that includes more participants and develops a more rigorous study design with control groups to test the effectiveness of this intervention for older adults with dementia. DERR1-10.2196/48927.

Emotional State of Older Adults During the COVID-19 Pandemic: Insights from the Cognitive and Social Well-Being (CoSoWELL) Corpus

ABSTRACT Objectives In view of the fallout of the COVID-19 pandemic, psychologists face a challenge to document the pandemic-related change in emotional well-being of individuals and groups and evaluate the emotional response to this fallout over time. Methodsp We contribute to this goal by analyzing the new CoSoWELL corpus (version 2.0), an 1.8 million-word collection of narratives written by over 1,300 older adults (55+ y.o.) in eight sessions before, during and after the global lockdown. In the narratives, we examined a range of linguistic variables traditionally associated with emotional well-being and observed signs of distress, i.e., lower positivity and heightened levels of fear, anger, and disgust. Results In most variables, we observed a characteristic timeline of change, i.e., a delayed (by 4 months) and abrupt drop in optimism and increase in negative emotions that reached its peak about 7 months after the lockdown and returned to pre-pandemic levels one year after. Our examination of risk factors showed that higher levels of self-reported loneliness came with elevated levels of negative emotions but did not change the timeline of emotional response to the pandemic. Conclusions We discuss implications of the findings for theories of emotion regulation.

A community living experience: Views of people with intellectual disability with extensive support needs, families, and professionals

BackgroundDespite the benefits of community living for people with intellectual disabilities (ID) and extensive support needs, they remain highly institutionalized. AimsTo qualitatively analyze the perceptions of people with ID, including those with extensive support needs, professionals, and family members six months after the implementation of 11 community homes for 47 people in different regions of Spain MethodsThematic analysis of 77 individual interviews conducted with 13 people with ID, 30 professionals and 34 family members was performed using Nvivo12. ResultsSeven themes were found: (1) “the room as I like it”, (2) “sometimes I don’t obey”, (3) “here I do a bit of everything”, (4) “lots of people love me here”, (5) “all thanks to them, who have helped me” (6) “I miss my mom”, and (7) “I’m happy here”. ImplicationsTransitioning into the community has shown a clear positive change in emotional well-being, opportunities to participate in activities or exercise control over one's life. Nevertheless, certain restrictions were still present in people’s lives, which significantly limit their right to independent living. While many of these restrictions may disappear, professional practices typical of a medical model can be recreated in services located in the community.

COVID-19 lockdown: Impact on emotional well-being and relationship to habit and routine modifications

We examine the impact of the COVID-19 lockdown on emotional well-being and its relationship to habit and routine modifications in a sample of 584 participants aged 18-65 (M age = 35.3; 75.3% females) on lockdown in Spain. Participants assessed their perceived changes in emotional well-being during the lockdown. They reported a perceived increase in negative affect and a perceived decrease in positive affect during this period, compared to before. Regarding habits and routines, there was an increase in media and social media consumption, home cleaning and tidying up, eating and sleeping, cooking and baking, reading, talking or doing activities with other people in the home, and handwashing. Increases in media and social media use, eating, and doing nothing were significantly associated with an increase in negative affect and a decrease in positive affect. Overall, the results highlight the importance that leisure activities have in determining emotional well-being during the lockdown.

The Impact of the Pandemic on Young People with Intellectual Disabilities Participating in a University Training Course for Employment in Spain

Spanish universities still face many barriers to the training of people with disabilities, especially with intellectual disabilities (ID). In general, continuing higher education courses are the main training response for the latter. Knowing the impact that confinement by COVID-19 has had on the students of these courses is a relevant element. The present investigation focused on analyzing the case of the confinement experience of 12 young students with ID who attended the continuing training program called Unidiversidad at the University of Alcalá (Spain). In particular, the implications on their emotional well-being, interpersonal relationships, and individual training were analyzed. Information was collected through a semi-structured interview with the students and a questionnaire with their relatives. The results reflect changes in emotional well-being linked to the increased concern of students for the health of their families. Interpersonal relationships were also affected, although participants tried to compensate for the lack of face-to-face interaction with instant messaging applications and video calls. The change in training to the online modality generated concern and uncertainty in students, although it also provided learning opportunities, which have been supported by peer tutoring and support from teachers.

Financial hardship and change in emotional well-being before to during COVID-19 pandemic among middle-aged and older Americans: Moderating effects of internal coping resources

ObjectiveThe purpose of this study was to investigate associations between financial hardship and change in emotional well-being—positive and negative affect—before to during the COVID-19 pandemic among middle-aged and older Americans and to examine the extent to which associations were moderated by internal coping resources—dispositional mastery and optimism. MethodData derived from the Leave-Behind Questionnaire in the 2016 and 2020 waves of the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults aged 51 and older (N = 1312). We estimated multivariate ordinary least squares regression models with interaction terms to evaluate prospectively the benefits of mastery and optimism as internal coping resources for middle-aged and older adults. ResultsDispositional mastery moderated the effects of financial hardship on changes in negative and positive affect, respectively, before to during the COVID-19 pandemic; however, optimism did not significantly moderate the effects of financial hardship on change in negative and positive affect before to during the COVID-19 pandemic. ConclusionsOur findings have implications for interventions aimed at improving middle-aged and older adults' emotional well-being by promoting internal coping resources. Specifically, interventions should focus on financial hardship and mastery for vulnerable middle-aged and older adults in the context of public health crises.

How the 2020 US Presidential election impacted sleep and its relationship to public mood and alcohol consumption

ObjectivesMajor sociopolitical events can influence the general public's affective state and other affect-related processes, such as sleep. Here, we investigated the extent that the 2020 US presidential election impacted sleep, public mood, and alcohol consumption. We also explored the relationship between affect and sleep changes during the peak period of election stress. ParticipantsUS-residing (n = 437) and non-US-residing (n = 106) participants were recruited online for participation in the study. MethodsA non-representative, convenience sample responded to daily assessments of their affect, sleep, and alcohol consumption during a baseline period (October 1-13, 2020) and in the days surrounding the 2020 US Election (October 30-November 12, 2020). ResultsAnalyses determined changes within and between US and non-US participants. Election Day evoked significantly reduced sleep amount and efficiency, coupled with heightened stress, negative affect, and increased alcohol use. While US participants were significantly more impacted in a number of domains, non-US participants also reported reduced sleep and greater stress compared to baseline. Across participants, disrupted sleep on Election Night correlated with changes in emotional well-being and alcohol consumption on Election Day. ConclusionThese results suggest that major sociopolitical events can have global impacts on sleep that may interact with significant fluctuations in public mood and well-being. Further, while the largest impact is on the local population, these results suggest that the effects can extend beyond borders. These findings highlight the potential impact of future sociopolitical events on public well-being.

Emotion characteristics of older adults with MCI among a socially isolated cohort using NIH toolbox: I‐CONECT Study

AbstractBackgroundA diagnosis of Mild Cognitive Impairment (MCI) has been found to be associated with changes in emotional wellbeing and social relationships. Socially isolated older adults with MCI are at greater risk of developing Alzheimer's Disease and Related Dementias. Better understanding the emotional functioning of individuals with MCI could inform the development of behavioral health interventions. Within a socially isolated sample of older adults, this study compares psychosocial wellbeing of older adults with MCI to their cognitively normal counterparts.MethodsThis cross‐sectional study uses baseline data from the Internet‐based Conversational Engagement Clinical Trial (I‐CONECT, ClinicalTrials.gov: NCT02871921). Eligible participants were ages 75 or older and were socially isolated as defined by scoring <12 on the 6‐item Lubben Social Network Scale, engaging in conversations lasting 30 minutes ≦ twice per week, or answering "Often" to at least one question of the three‐item UCLA Loneliness Scale. MCI status was determined according to clinical diagnosis. This working sample includes the first 127 participants whose baseline emotion battery scores were available as of November 2020. Based on NIH Toolbox scoring instructions, three domain scores were calculated with the 17 emotion measures, i.e., negative affect, social satisfaction, and psychological wellbeing. Linear regressions were conducted for all 17 Emotion Battery measures and 3 domain scores, controlling for age, gender, education, and severe depressive symptoms. Severe depressive symptom was operationalized as scored ≧5 on the 15‐item Geriatric Depression Scale (GDS).ResultsParticipants' mean age was 81.1 (SD=4.6); 69.9% of the participants were female; and mean years of education was 15.2 (SD=2.3). 54% of the participants were diagnosed with MCI. The average GDS score was 2.3 (SD=1.8). For the three major emotion domains assessed, older adults with MCI had more negative affect, yet no difference was observed in social satisfaction and psychological wellbeing (see Table 2). More specifically, compared to cognitively normal older adults, individuals with MCI had higher levels of fear, perceived hostility, perceived stress, sadness, and lower self‐efficacy.ConclusionThe study's findings indicate that older adults with MCI experience more negative emotions than cognitively normal older adults. However, there were no between‐group differences observed in positive emotions.

Abstract 10320: Feasibility of the Telehealth Assessment and Skill-Building Kit for Stroke Family Caregivers

Introduction: Existing stroke family caregiver interventions are limited in the use of technology and lack focus on caregiver health. The Telehealth Assessment and Skill-Building Kit (TASK III) was optimized based on caregiver preferences for technology and goal setting to improve caregiver health. The purpose of this study was to test feasibility of the TASK III program compared with an Information, Support, and Referral group (ISR) for improving caregiver depressive symptoms, life changes, and unhealthy days. Methods: Using randomized control trial design and an intent-to-treat analysis, 74 stroke family caregivers were randomized to TASK III (n=36) or ISR (n=38). The TASK III Resource Guide was provided by hard copy, website, eBook, and USB drive. TASK III and ISR groups received an American Stroke Association (ASA) pamphlet, access to the ASA website, and 8 weekly calls from a nurse (telephone/videoconferencing), with a booster call a month later. Data trends from baseline to 8 and 12 weeks were explored for depressive symptoms (PHQ-9), life changes (Bakas Caregiving Outcomes Scale), and unhealthy days. Minutes on calls with the nurse were controlled in analyses. Results: Among caregivers with mild to severe depressive symptoms at baseline (PHQ-9 > 5) (n=31), TASK III showed a greater reduction in depressive symptoms relative to ISR from baseline to 8 and 12 weeks (Mean group difference in change scores -3.7, p=.02 at 8 weeks; -3.7, p=.04 at 12 weeks). Using the full sample (N=74), life changes improved for TASK III relative to ISR from baseline to 8 and 12 weeks (Mean 8.1, p=.03; 14.9, p<.01), and for specific life changes of emotional well-being (Mean 0.8, p=.05; 1.4, p=.01) and physical health (0.7, p=.07; 1.2, p<.01). No significant differences in rate ratios were found for unhealthy physical (Rate ratio 1.7, p=.17; 1.1, p=.74) and mental days (Rate ratio 1.4 p=.22; 1.4, p=.25). Conclusions: Data trends supported feasibility of TASK III relative to ISR for improving depressive symptoms and life changes, including changes in emotional well-being and physical health. Unhealthy days were highly skewed and not sensitive to change. Testing efficacy of TASK III relative to ISR is warranted in a future, well-powered trial.

Therapeutic Recreation Activities Combined with a 12-Step Faith-Based Program for Adults Experiencing Addiction, Mental Health, and Homelessness: A Case Study

ABSTRACT The aim of this case study was to explore the changes in emotional well-being for 12 adult (13 males, 1 female) residents with addiction, mental health, and homelessness issues who participated in a program that combined recreation therapy complementary physical and creative arts activities followed by a 12-step Christian meeting, twice a week for 2 hours over a 6-week period. Results revealed a 27% reduction in anxiety and a decrease in perceived stress of 24%. Negative mood symptoms also reduced by 13%. Resiliency, positive mood, and enjoyment showed 9%, 4%, and 13% improvements respectively. Depression remaining unchanged. This program showed promise in improving common symptoms for adults experiencing addiction, mental health, and homelessness issues.

Adults Who Stutter and Their Motivation for Attending Stuttering Support Groups: A Pilot Study

Purpose While the benefits of participating in stuttering support groups are well known, the factors that motivate adults who stutter (AWS) to continue attending these meetings are not documented. The purpose of this exploratory study is to investigate the narratives of AWS and identify their individual motivations for regularly attending stuttering support groups. Method Seven AWS, ages 23–54 years, who attended more than one stuttering support group meeting participated in a semistructured interview about their stuttering and their experiences participating in a stuttering support group. Thematic analysis procedures were followed to investigate descriptions of motivating factors in each participant's narrative. Result Four major themes emerged from the data including “Mutual Understanding and Common Ground,” “Support Group Format,” “Positive Changes,” and “Give and Take of the Support Group.” The support group served as a place to gain new perspectives by watching others who stutter more severely communicate while also creating a sense of not being “alone.” Opportunities to speak and/or stutter freely as well as the role chapter leaders take in facilitating conversation were motivating factors in terms of the support group format. Positive changes in emotional well-being and socialization were reported. Participants also stated that they attend support groups because the group provides them with an opportunity to help others and learn from others. Conclusion This exploratory study uncovered particular aspects of support groups, including group members and the structure of meetings, that motivate AWS to attend. Findings support the literature in that participants reported benefiting from participating in support groups.

The Strength of Weaker Ties: An Underexplored Resource for Maintaining Emotional Well-Being in Later Life.

ObjectivesThe purpose of this study was to examine dynamic links between changes in social ties and changes in emotional well-being.MethodTrivariate dual-change score models were used to test whether a large number of close ties would be more strongly associated with low levels of depressed affect than a large number of weaker ties, and a large number of weaker ties would be more strongly associated with high levels of positive affect compared to a large number of close ties, across three waves of a large, regionally representative sample of U.S. adults aged 40 and older (N = 802).ResultsWe found that a greater number of weaker ties was associated with having more close ties over time, and that the number of weaker ties was more strongly predictive of positive age-related changes in both aspects of well-being (i.e., more positive affect and less depressed affect) than the number of close ties.DiscussionContrary to popular theoretical orientations in gerontology, weaker ties may offer older adults a more effective avenue for promoting emotional well-being over time than close ties, and may have the additional benefit of compensating for losses in the number of close ties.

The mindful adolescent: Developmental changes in nonreactivity to inner experiences and its association with emotional well-being.

Little is known about the naturalistic development of mindfulness in adolescence and how it relates to changes in emotional well-being. The current longitudinal study examined the development of one dimension of mindfulness, nonreactivity to difficult inner experience (or in more colloquial terms, being able to notice, but "take a step back" from distressing thoughts), in a racially and socioeconomically diverse sample (N = 1,657) during the transition from middle school to high school. Students participated in up to four assessment waves, from fall of 8th grade through spring of 9th grade, in which they completed self-report measures assessing nonreactivity, perceived stress, and positive and negative affect. Latent growth curve models indicated that levels of nonreactivity increased during the 2-year study period. Developmental change in nonreactivity varied minimally by gender, socioeconomic status (SES), and race/ethnicity. Parallel process latent growth curve models showed that changes in nonreactivity were associated with concomitant reductions in perceived stress and negative affect, and increases in positive affect. Random intercept cross-lagged panel models showed that within-person nonreactivity prospectively predicted changes in perceived stress and positive affect, but not negative affect. This study is among the first to track the naturalistic development of mindfulness during adolescence. Results suggest that the nonreactivity dimension of mindfulness is associated with aspects of emotional well-being during the transition from middle school to high school. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Online Screening of X-System Music Playlists Using an Integrative Wellbeing Model Informed by the Theory of Autopoiesis

Research suggests that music has a powerful effect on the human mind and body. This article explores the impact of music as an intervention. For this purpose, the X-System technology is used to curate relaxing and enlivening music playlists designed to positively impact wellbeing and emotional state during the COVID-19 pandemic. A wellbeing model grounded in autopoietic theory of self-organisation in living systems is developed to inform the evaluation of the impact of the intervention and ensure the reliability of the data. More specifically, data quality is enhanced by focusing the participants’ awareness on their immediate embodied experience of physical, emotional and relational wellbeing and sense of pleasure/displeasure prior to and after listening to a preferred playlist. The statistical analysis shows significant positive changes in emotional wellbeing, valence and sense of meaning ( $p ) with a medium effect size. It also reveals a statistically significant change for physical wellbeing ( $p=0.009$ ) with a small effect size. With the relaxing playlists leading to decrease in arousal levels and the enlivening playlists to an increase in activation, it is also concluded that appropriately curated playlists may be able to lead the listener to positive relaxation or activation states or indeed to positive mood change that may have health benefits.

Personality Promotion: The Impact of Coaching and Behavioral Activation on Facet Level Personality Change and Health Outcomes

The expectancy-value theory (EVT) and the control theory both provide a framework for explaining how personality facets might be impacted. In two pilot studies, (bottoms-up interventions) were used to determine if facets of personality could change. Study one examined the impact of brief Behavioral Activation training on facets of Conscientiousness. Study two examined the impact of instructional feedback and monitoring (coaching) on facets relating to the big five personality traits. Findings showed a 5-week Behavioral Activation training increased both logical thinking and preparedness (facets of conscientiousness). Additionally, 12-weeks of coaching lead to changes in four of the big five personality traits. In both studies, these behavioral changes were significantly related to changes in emotional well-being and physical health perceptions.

Changed Body Image as Perceived by Jordanian Women Undergoing Breast Cancer Treatment

Background:Breast cancer is the most common cancer affecting women worldwide. The purpose of this study was to generate an understanding of women’s perceptions of changes to their body image due to breast cancer treatment.Method:A phenomenological qualitative approach was taken and semi-structured interviews conducted with 20 women who underwent breast cancer treatment at a public hospital in Jordan.Results:Data were analyzed following Colaizzi’s methodology, yielding a core theme (“Broken things cannot be repaired”) and four subthemes: changes in physical wellbeing (“my body fall apart”), changes in emotional wellbeing (“broken heart”), changes in social wellbeing (“broken future”), and coping strategies (“repairing what has been broken”). Religion and family support were major factors helping the women cope with their condition.Conclusion:Nurses and other healthcare providers need to be aware of body image changes of women with breast cancer to initiate timely, and culturally sensitive nursing intervention and support. Therefore, nurses should support patients in finding their own sources of strength to facilitate their healing process.

Social determinants of emotional well-being in new refugees in the UK.

Refugees are most vulnerable to mental health problems of all migrant groups, and an understanding of the role of postdisplacement social factors in refugee emotional well-being can help to shape the future interventions for this group. We aimed to investigate the effect of social determinants, such as employment, language ability and accommodation, on mental health in refugees in the UK. This prospective longitudinal cohort study was set in the UK. The study population of new UK refugees was drawn from an existing data set of the Longitudinal Survey of New Refugees (n=5678), in which all new UK refugees (2005-2007) were sent a postal questionnaire at four time points across 2 years. Ordered logistic regression models were used to evaluate associations between social determinants and the dependent variables, emotional well-being or change in emotional well-being, using a question from the Short Form-36 Health Survey Questionnaire. Refugees who were unemployed in the UK, could not speak English well or were unsatisfied with their accommodation had significantly higher odds of poorer emotional well-being in the cross-sectional analysis (P<0.05at all time points measured). Postdisplacement social factors, including language ability, employment status and accommodation satisfaction, were important determinants of refugee emotional well-being. Changes in these social determinants have the potential to improve refugee mental health, making them legitimate, modifiable targets for important public health interventions. Accounting for this, further research into how to improve refugee well-being is crucial given the increase in refugee numbers around the developed world.

The Relationship Between Emotional Distress and Understanding of Prognosis in Patients with Acute Myeloid Leukemia (AML)

Background: Patients with AML face considerable distress from physical symptoms. However, little is known about their emotional well-being, and its relationship with prognostic understanding. We hypothesized that greater (more accurate) prognostic awareness would be associated with more emotional distress.Methods: We conducted a prospective, observational study of AML patients receiving chemotherapy. We enrolled patients within 1 week of initiation of chemotherapy, either at diagnosis or relapse, from the clinics and inpatient hematologic malignancies ward at Duke University Hospital. We followed patients for at least 6 months or until death. While hospitalized, subjects completed weekly electronic surveys about their symptoms, prognosis, and treatment goals, or completed monthly surveys as outpatients. We examined the relationship between patients' perceptions of their prognosis and various domains of distress as measured by the Functional Assessment of Cancer Therapy general quality of life questionnaire (FACT-G). We used a modified random-effects model structure for this analysis, with predictors for between-patient difference in mean values of well-being; this "hybrid" model allows for the estimation of time-invariant characteristics (like patient sex and race), while controlling for unobserved heterogeneity across individuals and surveys (as in a fixed-effects approach).Results: 50 patients completed 455 total surveys (385 with FACT-G responses), with an average of 9.1 surveys per patient. Of 50 enrollees, 43 (86%) received an induction regimen, and 7 (14%) received either ahypomethylating agent or a clinical trial drug. Most patients (n=37; 74%) had a poor prognosis owing to age >59, relapsed/refractory disease, or a complex karyotype and/or FLT3 mutation. Evidence suggests that the chance of cure in high-risk AML cases like these is 10-25% at best, yet patients in the study rated their chance of cure at 90% or better in 183 surveys (40.2%) and 50% or better in 104 surveys (22.8%). Thus most patients grossly overestimated their prognosis.The range of within-patient emotional well-being score (EWB) means was 6.9 to 28, on the 0-28 FACT-EWB subscale. Patients' perceptions of prognosis did not change significantly over time. In multivariable modeling, FACT-EWB was significantly associated with patients' perception of their prognosis (beta=0.114; p=0.018). This relationship persisted even after controlling for clinical variables that we expected would impact perception of prognosis, including relapsed disease, and the receipt of a palliative-intent treatment. In fact, these covariates explained only 1% of the variance in EWB scores in the model (R2=0.01). We also controlled for other potentially important covariates, including: overall FACT-G score, hospital and treatment visits between surveys, number of surveys completed,Charlson Comorbidity Score, sex and race.Patients with worse EWB more often estimated their likelihood of cure between 25% and 50%, while those with better EWB were more likely to report a prognostic estimate between 75% and 90%. We also tested for direction of effects using time-lagged EWB scores; the EWB score in a given survey was significantly associated with a patient's self-assessed prognosis two surveys later (beta=0.028, p=0.006), suggesting that changes in emotional well-being precede changes in self-assessed prognosis, rather than vice versa.Conclusions: Patients with AML overestimate their prognosis, and exhibit widely-varying emotional responses to their disease. Patients' emotional well-being is strongly associated with their understanding of prognosis, such that patients who are more emotionally distressed have a more accurate understanding of their prognosis. These findings point to two important areas of unmet need in AML care. First, efforts are needed to improve patients' understand of their prognosis. Second, among patients who more accurately understand their prognosis, more psychosocial support and attention to emotional distress is needed. [Display omitted] [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.