Changes In Psychological Outcomes Research Articles

Changes in psychological outcomes and sleep quality following energy restriction with and without almonds

Associations between obesity and mental illness have been identified, but they are complex and bidirectional(1). Weight loss interventions have been proposed as a potential strategy to improve mental health in individuals with overweight or obesity, but the evidence remains inconclusive(2). Additionally, the role of specific foods in a weight loss diet and mental health outcomes is not well understood(3). This study aimed to explore the association between weight loss (with and without almonds) and self-administered psychological and sleep assessments, including the Profile of Mood States (POMS), the Perceived Stress Scale (PSS), the Zung Self-Rating Depression Scale (ZSDS), and the Pittsburgh Sleep Quality Index (PSQI). Participants (n = 140, 47.5 ± 10.8 years) with overweight or obesity (BMI: 30.7 ± 2.3 kg/m2) were randomised to an energy-controlled almond-enriched diet (AED) or nut-free diet (NFD). Psychological and sleep assessments were conducted at baseline, after 3 months of weight loss, and after 6 months of weight maintenance. Data were analysed using mixed-effects models and linear regression. For POMS, total mood disturbance score (TMDS) (60.2%, p = 0.01), fatigue-inertia (21.2%, p = 0.003), and vigor-activity (19.9%, p<0.001) improved over time (with no different between groups), with improvements associated with the magnitude of weight loss (TMDS: β = 0.059, p = 0.02; fatigue-inertia: β = 0.268, p = 0.016; vigor-activity: β=-0.194, p = 0.048). No significant changes were observed in tension-anxiety, depression-dejection, anger-hostility, or confusion-bewilderment. A significant group x time interaction (p = 0.048) was found for the PSS, which increased in the NFD group (10.1%) and decreased in the AED (1%) during the weight maintenance phase. No significant changes were observed for the ZSDS. The PSQI demonstrated significant improvement in both groups over time for sleep quality (11.3%, p<0.001), sleep latency (24.3%, p<0.001), sleep disturbance (39.2%, p = 0.04), and daytime dysfunction (290.4%, p<0.001), but not for sleep duration or habitual sleep efficiency. Summed scores, generating the global sleep score (GSS), demonstrated an overall significant improvement in both groups over time (33.5%, p<0.001), and these improvements were associated with weight loss (GSS: β = 0.863, p<0.001). The findings emphasise the importance of evaluating mental health outcomes in weight loss interventions and highlight the potential influence of weight management on mood and sleep quality. Further research is warranted to explore the impact of diet composition on perceived stress and other mental health outcomes.

Longitudinal increases in mindfulness practice quality are associated with changes in psychological outcomes and not vice versa - a brief report.

With research on mindfulness increasing exponentially, it is important to clarify factors that may influence the success of this approach. We examined the construct of mindfulness meditation practice quality using longitudinal data drawn from a randomized controlled trial testing low-dose mindfulness practices with novice mindfulness practitioners from the general population (N = 48). Results suggest that increases in mindfulness practice quality over time are associated with improvements in psychological outcomes (anxiety, stress, and mindfulness), but not vice versa. Findings join previous research supporting the notion that mindfulness practice quality is an important element of mindfulness training in higher-dose programs as well as low-dose and self-help mindfulness programs and practices. Therefore, this research contributes to finding further support of the importance of mindfulness practice quality as a cause of improvement in psychological distress. This needs to be explored further in future research.

Effects of web-based mindfulness training on psychological outcomes, attention, and neuroplasticity

Mindfulness meditation training (MMT) reliably reduces stress and anxiety while also improving attention. The primary aim of this study was to investigate the relationship between MMT, stress and anxiety reduction, and its impact upon improvements in attention on the behavioral and neuronal levels. As a second aim, we sought to explore any relationship between MMT, attention, and modified states of mind such as flow. 118 healthy, meditation-naïve, participants were either assigned to a 31-day, web-based, MMT or an active control, health training (HT). Participants underwent functional magnetic resonance imaging while performing the attention network test (ANT) to assess functional and behavioural attentional changes, diffusion tensor imaging (DTI) to assess microstructural neuronal changes and completed relevant questionnaires to explore changes in psychological outcomes. Results confirmed a reduction in perceived stress and anxiety levels in the MMT group and significant improvements in the overall reaction time during the ANT, albeit no specific effects on the attentional components were observed. No statistically significant changes were found in the HT group. Interestingly, a significant group-by-time interaction was seen in flow experience. Functional data exhibited an increased activity in the superior frontal gyrus, posterior cingulate cortex, and right hippocampus during the alerting condition of the ANT after the MMT; decreased stress and trait anxiety were significantly correlated with the activation in the right hippocampus, and increased flow was also significantly correlated with all the aforementioned areas. DTI data showed increased fractional anisotropy values in the right uncinate fasciculus indicating white matter microarchitecture improvement between the right hippocampus and frontal areas of the brain. This study, therefore, demonstrates the effectiveness of web-based MMT on overall well-being and attentional performance, while also providing insight into the relationship between psychological outcomes, attention, and neuroplastic changes.

Changes in Psychological Outcomes after Cessation of Full Mu Agonist Long-Term Opioid Therapy for Chronic Pain

Improved understanding of psychological features associated with full mu agonist long-term opioid therapy (LTOT) cessation may offer advantages for clinicians. This preliminary study presents changes in psychological outcomes in patients with chronic, non-cancer pain (CNCP) after LTOT cessation via a 10-week multidisciplinary program which included treatment with buprenorphine. Paired t-tests pre- and post-LTOT cessation were compared in this retrospective cohort review of data from electronic medical records of 98 patients who successfully ceased LTOT between the dates of October 2017 to December 2019. Indicators of quality of life, depression, catastrophizing, and fear avoidance, as measured by the 36-Item Short Form Survey, the Patient Health Questionnaire-9-Item Scale, the Pain Catastrophizing Scale, and the Fear Avoidance Belief Questionnaires revealed significant improvement. Scores did not significantly improve for daytime sleepiness, generalized anxiety, and kinesiophobia, as measured by the Epworth Sleepiness Scale, the Generalized Anxiety Disorder 7-Item Scale, and the Tampa Scale of Kinesiophobia. The results suggest that successful LTOT cessation may be interconnected with improvements in specific psychological states.

Trait mindfulness, self-efficacy, and coping strategies during COVID-19

ABSTRACT Background The worldwide COVID-19 pandemic may have negative impacts on individuals’ mental health. At the same time, protective factors such as mindfulness, i.e., a moment-to-moment awareness of own experiences without judgment, may have positive effects on various psychological outcomes during the pandemic. Objectives The current study analyzed the associations between trait mindfulness and psychological outcomes during the COVID-19 pandemic at three measurement points, testing self-efficacy and coping strategies as further potential predictors. Design & Methods Altogether 207 students (85% female, mostly between 18 and 25 years old) participated in a longitudinal online survey from May to July 2020. At t1, t2, and t3, trait mindfulness, COVID-19-specific psychological well-being, depressiveness, anxiety, and stress were assessed. In addition, coping strategies were measured at t1 and self-efficacy at t2. Results Psychological outcomes at t1 were associated with trait mindfulness and coping strategies. The change in psychological outcomes between t2 and t3 was predicted by trait mindfulness and self-efficacy and to some extent by maladaptive coping. In a cross-lagged panel design, trait mindfulness was a better predictor of the psychological outcomes than vice versa. Conclusions Our results support the value of trait mindfulness for psychological outcomes during the COVID-19 pandemic.

Posttraumatic growth levels of healthcare workers in two periods with different intensities of COVID-19 pandemic.

The COVID-19 pandemic threatens health-care workers' (HCW) mental health and well-being. Although traumatic life events may result in psychiatric disorders, occasionally they give rise to positive changes, such as post-traumatic growth. Accordingly, the present study evaluated the traumatic stress, anxiety, and depression levels of HCWs and their post-traumatic growth levels during the pandemic. In addition, the study aimed to assess the changes in psychological outcomes during the pandemic. For this aim, the data were collected in two different periods. The first data-collection period was between May and July 2020, and the second period started in November 2020 and ended in January 2021. The sociodemographic data form, Impact of Events Scale-Revised (IES-R), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Post-traumatic Growth Inventory (PTGI) were used to collect data. Sixty-six HCWs participated in the study. No significant differences appeared between the baseline scores and 6-month follow-up in the depression, anxiety, and traumatic stress levels of HCWs. Furthermore, the PTGI scores decreased significantly over time. Although the change in the psychological distress scores was not statistically significant, the depression and post-traumatic stress scores increased over time. Previous research specified an inverse-parabolic relationship between traumatic stress and PTGI. Our results support previous research; as the exposure to the stressors continues, individual traumatic stress levels increase, psychiatric disorders become frequent, and affirmative changes (like post-traumatic growth) decline.

Effects of a Mindfulness-Based Weight Loss Intervention on Long-Term Psychological Well-Being Among Adults with Obesity: Secondary Analyses from the Supporting Health by Integrating Nutrition and Exercise (SHINE) Trial.

This study tested whether a mindfulness-based intervention for obesity that included components aimed at emotion regulation and mindful eating improved psychological outcomes including stress, anxiety, positive emotion, and depression, during the intervention period and at longer-term follow-up. Adults with obesity (N=194) were randomized to a 5.5-month diet-exercise weight loss intervention with or without mindfulness training focused on emotion regulation and mindful eating. Participants completed self-report measures of mindfulness and psychological well-being, which were planned secondary outcomes, at baseline, mid-intervention (3 months), and at 6-, 12-, and 18-months post-baseline (maintenance period). Mixed effects models and linear regression were used to test between- and within-group changes in psychological well-being. Finally, this study explored whether changes in mindfulness (from baseline to each 6- and 18-months post-baseline) mediated the effects of intervention arm on changes in psychological outcomes during those respective time periods. This study explored whether changes in mindfulness from baseline to 6 months mediated the effects of intervention arm on changes in psychological outcomes from baseline to 18 months. Participants randomized to the mindfulness arm had significant increases in positive emotions at all follow-up times compared to controls. There were statistically significant increases in mindfulness, psychological flexibility, and reflection, as well as decreases in anxiety and depressive symptoms at 12 months compared to control participants. These changes remained significant for psychological flexibility and reflection at 18 months. There were no significant differences in perceived stress. Among mindfulness participants, greater increases in mindfulness from 6-18 months was associated with greater positive emotions and psychological flexibility as well as lower perceived stress, anxiety, depressive symptoms, and rumination at 18 months, adjusting for 6-month values. Mediation analyses indicated that randomization to the mindfulness intervention arm was associated with 6-month increases in mindfulness, and these increases were in turn associated with improved psychological outcomes at 6 months and 18 months. Changes from baseline to 18 months did not mediate 18-month changes in psychological outcomes. Mindfulness training in emotion regulation and mindful eating may provide greater longer-term psychological well-being benefits in non-clinical populations with obesity compared to conventional diet-exercise interventions.

Probiotics for Reduction of Examination Stress in Students (PRESS) study: A randomized, double-blind, placebo-controlled trial of the probiotic Lacticaseibacillus rhamnosus HN001.

Studies suggest that bioactive compounds such as probiotics may positively influence psychological health. This study aimed to determine whether supplementation with the probiotic Lacticaseibacillus rhamnosus HN001 reduced stress and improve psychological wellbeing in university students sitting examinations. In this randomized, double-blind, placebo-controlled study, 483 undergraduate students received either the probiotic L. rhamnosus HN001, or placebo, daily during a university semester. Students completed measures of stress, anxiety, and psychological wellbeing at baseline and post-intervention before examinations. Mann Whitney U tests compared the change in psychological outcomes between groups. Of the 483 students, 391 (81.0%) completed the post-intervention questions. There was no significant difference between the probiotic and placebo supplemented groups in psychological health outcomes. The COVID19 pandemic restrictions may have influenced the typical trajectory of stress leading up to examinations. We found no evidence of significant benefit of probiotics on the psychological health of university students. These findings highlight the challenges of conducting probiotic trials in human populations where the potential for contextual factors such as COVID19 response, and participant adherence to the intervention may influence results.

0684 Improving Psychological Distress for Better Sleep During the Covid-19 Pandemic: Analyses of Data From a Pilot Randomized Controlled Trial

Abstract Introduction Psychological distress has been associated with sleep problems. Emerging evidence suggests positive psychological well-being is associated with better sleep. However, most of these studies are cross-sectional and do not provide information on the effect that changes in psychological outcomes have on sleep. The aim of this secondary analysis was to test whether changes in distress and well-being following a 7-week intervention to improve sleep and mental health were associated with changes in sleep among adults reporting poor sleep quality (Pittsburgh Sleep Quality Index [PSQI]>5) and moderate distress (Perceived Stress Scale [PSS]≥14) during the COVID-19 pandemic. Methods Thirty individuals (age 40.7±12.9y, 80% female, 50% racial/ethnic minority) completed a pilot study testing a well-being and sleep hygiene intervention vs. sleep hygiene alone. Questionnaires were administered at baseline and post-intervention to assess distress (PSS and the Symptom Questionnaire), well-being (Psychological Well-Being scales), and sleep (PSQI and Insomnia Severity Index). A sleep diary was administered to collect information on total sleep time (TST), variability in TST, sleep onset latency, wake time after sleep onset, bedtime, and variability in bedtime. Change scores were calculated for each variable as the difference between post-intervention and baseline. Separate linear regression models were estimated with psychological variables as predictors and sleep variables as outcomes. Analyses were adjusted for intervention group, baseline scores of predictors and outcomes, age, and sex. Results Reductions in anxiety were associated with improvements in insomnia (B=0.6±0.2 (SE), p=0.008) and TST (B=-10.1±3.5, p=0.009); reductions in depression, somatization, and hostility were each associated with improvements in sleep quality (B=0.2±0.1, p=0.007), TST (B=-10.3±4.5, p=0.03), and earlier bedtime (B=8.8±3.0, p=0.008), respectively; and reductions in perceived stress were associated with improvements in sleep quality (B=0.2±0.1, p=0.005) and insomnia (B=0.3±0.1, p=0.02). No associations were found between changes in well-being and sleep. Conclusion Our findings suggest that reductions in distress following well-being and sleep hygiene or sleep hygiene alone interventions predict improvements in sleep. Focusing interventions on improving distress may be relevant to ameliorate sleep quality in the context of psychological distress. The association between well-being and sleep should be further delineated to determine the role of well-being in sleep promotion. Support (If Any)

A longitudinal study of the psychological impact of the COVID-19 pandemic on frontline perioperative healthcare staff in an Australian tertiary public hospital.

ObjectiveThis longitudinal study examined changes in psychological outcomes of perioperative frontline healthcare workers at one of Australia’s most COVID-19 affected hospitals, following the surge and decline of a pandemic wave.MethodA single-centred longitudinal online survey was conducted between 26 May and 17 November 2020. Recruitment was via poster advertisement and email invitation. The survey was sent out every 4 weeks, resulting in seven time-points.ResultsIn total, 385 survey results were analysed from 193 staff (about 64% response rate), 72 (37%) of whom completed the survey more than once. The prevalence of moderate-to-severe anxiety and depressive symptoms peaked at 27% and 25%, respectively, during the pandemic surge. Up to 35% displayed post-traumatic stress disorder (PTSD) symptoms. Although not statistically significant, the trend of depressive and PTSD symptoms worsened over time, especially among females and anaesthetic/surgical trainees, despite subsidence of the pandemic curve. Technicians and anaesthetic/scrub nurses were the at-risk groups with worst psychological outcomes.ConclusionWe found persistent mental health impacts on frontline perioperative HCWs despite subsidence of the pandemic wave. Further research is needed to determine the extent and trajectory of such impacts with larger sample sizes to determine generalisability to frontline HCWs in general.

Feasibility, psychological outcomes and practical use of a stress-preventive leadership intervention in the workplace hospital: the results of a mixed-method phase-II study

ObjectivesHospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility...

Covid-19 and changes in sleep health in the Blackfeet Community

We examined changes in psychological outcomes related to the COVID-19 pandemic (ie psychological stress, perceived control, and perceived ability to cope) and changes in sleep health in the American Indian Blackfeet community over 4 months (August 24, 2020–November 30, 2020). American Indian adults residing on the Blackfeet reservation (n = 167) completed measures of perceived control over contracting COVID-19, perceived ability to cope with pandemic stressors, psychological stress linked to the pandemic, and a measure of sleep health each month. Linear-effects mixed models were used to examine changes in our outcomes. Community members who reported more control over contracting the virus had better sleep health relative to those who reported less control (B = 0.72, SE = 0.29, p = 0.015). Further, during months when individuals felt they had more control over contracting the virus compared to their average perceived control levels, they had better sleep health relative to their own average (B = 1.06, SE = 0.13, p < 0.001). Average sleep health was the lowest in October, 2020, the month during which COVID-19 incidence was at its highest on the reservation. Declines in sleep health linked to low levels of control over contracting COVID-19 may exacerbate high incidence of chronic mental and physical health conditions in tribal communities. Interventions which highlight strategies known to reduce risk of contracting the virus, may increase perceived control and sleep health, and thus may improve downstream health outcomes for this at-risk population.

The National Veterans Summer Sports Clinic: Change and duration of psychological outcomes

IntroductionRecreational and adaptive sports programs are often provided to veterans with a variety of psychological and physical conditions; however, limited data exist regarding the outcomes of these programs. The current study evaluated the psychological outcomes of attendees of the 2017 and 2018 National Veterans Summer Sports Clinic (NVSSC) in San Diego, California. MethodSeventy-four veteran participants completed self-report assessments before and after the week-long program, as well as 3 months following program completion. In addition, participants completed brief assessments before and after each of the daily recreational activities (cycling, surfing, sailing, kayaking, and archery/pickleball). ResultsFindings showed that depression, anxiety, social functioning, and positive and negative affect significantly improved from pre-to postprogram, but returned to baseline levels at 3-month follow-up. Within sessions, depression/anxiety and positive affect significantly improved each day, with no differences in the amount of change across days. Depression/anxiety and positive affect also significantly improved within each activity, regardless of order, with no differences in the magnitude of change across activities. ConclusionsThe NVSSC produced significant changes in psychological outcomes among veteran participants within immediate and short-term time periods; however, gains were not maintained longer-term. Follow-on engagement in exercise activities is likely necessary for continued benefit; future research, including studies with control groups, would provide greater clarity.

From famine to therapeutic weight loss: Hunger, psychological responses, and energy balance-related behaviors.

Understanding physiological and behavioral responses to energy imbalances is important for the management of overweight/obesity and undernutrition. Changes in body composition and physiological functions associated with energy imbalances provide the structural and functional context in which to consider psychological and behavioral responses. Compensatory changes in physiology and behavior are more pronounced in response to negative than positive energy balances. The physiological and psychological impact of weight loss (WL) occur on a continuum determined by (i) the degree of energy deficit (ED), (ii) its duration, (iii) body composition at the onset of the energy deficit, and (iv) the psychosocial environment in which it occurs. Therapeutic WL and famine/semistarvation both involve prolonged EDs, which are sometimes similar in magnitude. The key differences are that (i) the body mass index (BMI) of most famine victims is lower at the onset of the ED, (ii) therapeutic WL is intentional and (iii) famines are typically longer in duration (partly due to the voluntary nature of therapeutic WL and disengagement with WL interventions). The changes in psychological outcomes, motivation to eat, and energy intake in therapeutic WL are often modest (bearing in mind the nature of the measures used) and can be difficult to detect but are quantitatively significant over time. As WL progresses, these changes become more marked. It appears that extensive WL beyond 10%-20% in lean individuals has profound effects on body composition and physiological function. At this level of WL, there is a marked erosion of psychological functioning, which appears to run in parallel to WL. Psychological resources dwindle and become increasingly focused on alleviating escalating hunger and food seeking behavior. Functional changes in fat-free mass, characterized by catabolism of skeletal muscle and organs may be involved in the drive to eat associated with semistarvation. Higher levels of body fat mass may act as a buffer to protect fat-free mass, functional integrity and limit compensatory changes in energy balance behaviors. The increase in appetite that accompanies therapeutic WL appears to be very different to the intense and all-consuming drive to eat that occurs during prolonged semistarvation. The mechanisms may also differ but are not well understood, and longitudinal comparisons of the relationship between body structure, function, and behavior in response to differing EDs in those with higher and lower BMIs are currently lacking.

Does Exercise Influence Kynurenine/Tryptophan Metabolism and Psychological Outcomes in Persons With Age-Related Diseases? A Systematic Review.

Background:The kynurenine (KYN) pathway has been implicated in many diseases associated with inflammation and aging (“inflammaging”). Targeting the kynurenine pathway to modify disease outcomes has been trialled pharmacologically, but the evidence of non-pharmacological means (ie, exercise) remains unclear.Objective:We aim to assess the evidence of the effects of exercise on the kynurenine pathway and psychological outcomes.Methods:Under Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a systematic literature search was performed in MEDLINE, EMBASE, EMCARE, and the Cochrane Central Registry of Controlled Trials. The main outcomes were changes in kynurenine pathway metabolite levels and psychological outcomes.Results:Six studies were analyzed (total n = 379) with exercise demonstrating significant concomitant effects on kynurenine pathway metabolite levels and associated psychological outcomes in domains of somatization, anxiety, and depression.Conclusion:Exercise has significant concomitant effect on kynurenine pathway metabolite levels and psychological outcomes. However, clear limitations exist in determining if the changes in the kynurenine pathway can fully explain the changes in psychological outcomes, or whether different diseases and exercise interventions act as confounding factors.

The role of long-term psychodynamic psychotherapy in improving attachment patterns, defense styles, and alexithymia in patients with depressive/anxiety disorders.

Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders. To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP. In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments. The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up. Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.

A longitudinal evaluation of an intensive residential intervention (camp) for 12–16 year olds living with HIV in the UK: evidence of psychological change maintained at six month follow-up

ABSTRACTThere are large numbers of young people with HIV globally, the majority of whom have perinatally acquired HIV (PAH). Despite evidence of lower levels of wellbeing in young people with PAH compared to HIV unaffected peers, there are few psychosocial interventions for this population. Residential interventions (camps) for young people with HIV have the potential for enhancing well-being and improving HIV-related outcomes. There have not been any quantitative evaluations of camps for young people with HIV. This study evaluated a week-long intensive residential intervention for 12–16 year olds living with HIV in the UK. A quantitative repeated measures design was used. Forty nine participants completed assessments before and immediately after the intervention (post-intervention) and at six month follow-up (73% retention rate; 28 (57%) female; median age 14 years, IQR 13–15 years). Self-report measures suggested improvements in both HIV knowledge and pro HIV disclosure affect and cognitions post-intervention, maintained at six month follow-up. There were improvements in antiretroviral adherence beliefs from baseline to six month follow-up, and in self-perception from baseline to post-intervention. These changes are important in their own right but may also be mediators of other outcomes such as increased ART adherence and reduced onward HIV transmission risk. The study suggests that brief residential interventions have the potential to facilitate sustained change in psychological outcomes. Research and practice implications are outlined.

Personal resilience resources predict post-stem cell transplant cancer survivors' psychological outcomes through reductions in depressive symptoms and meaning-making

ABSTRACTThis longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = −0.07, p = 0.005), mediated by reductions in depressive symptoms (b = −0.01, 95% CI: −0.027, −0.003) and in searching for a reason for one's illness (b = −0.01, 95% CI: −0.034, −0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p < 0.001), mediated by reductions in depressive symptoms (b = 0.02, 95% CI: 0.003, 0.033). Having greater personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.

Psychological Antecedents and Consequences of Maximal Fitness Testing Among Firefighters

Little is known about psychological correlates of maximal aerobic and strength performance or psychological responses to maximal fitness testing among firefighters, a high-stress occupational group frequently exposed to psychological and physical stressors. PURPOSE:To examine the psychological correlates of and acute responses to maximal fitness testing among firefighters. METHODS: Twenty-seven male firefighters, aged 31-53 years (42.3±6.8), currently working in Ireland completed measures of positive and negative affect (PANAS), mood (POMS), and state anxiety (STAI-Y1) before and 10-min after maximal fitness testing, including an isometric mid-thigh pull test followed by a maximal treadmill test. Multiple regression adjusted for age quantified associations between psychological variables and maximal aerobic capacity and full body force. Paired t-tests and standardized mean differences (SMD) quantified change in psychological outcomes in response to maximal aerobic and strength tests. RESULTS: Mean VO2max was 42.6±7.3 mL · min-1 · kg-1. Mean full body force was 2782.3±507.6 N. A significant inverse association was found between age and VO2max (r=-0.42, p≤0.03). No outcomes were significantly associated with VO2max (β: -0.14 to 0.25; all p>0.17) or maximal full body force (β: -0.24 to 0.35; all p>0.07). Though statistically nonsignificant, the direction of correlations with both VO2max and maximal strength was consistent (i.e., positive or negative for both) for positive affect, feelings of energy, and state anxiety. Feelings of tension (p≤0.01) and anger (p≤0.04) were significantly improved, and feelings of confusion (p≤0.07) and energy (p≤0.09) were nominally improved. Exercise effects ranged from small-to-moderate for positive (SMD=0.15) and negative affect (SMD=0.27), feelings of depression (SMD=0.25), energy (SMD=0.31), confusion (SMD=0.36), anger (SMD=0.43), and tension (SMD=0.55), total mood disturbance (SMD=0.24), and state anxiety (SMD=0.27). CONCLUSIONS: Mood, affect, and state anxiety did not significantly predict maximal aerobic capacity or strength among firefighters. Differential associations with aerobic capacity and strength were suggested. Acute maximal aerobic and strength testing resulted in small-to-moderate improvements in psychological outcomes.

Effect Of 24-weeks Low Vs High Intensity On Anxiety, Depression And Self-esteem In Obese Adolescents

PURPOSE: To compare the effects of low vs. high intensity training on symptoms of anxiety and depression as well as on self-esteem in obese adolescents. METHODS: Sixty-two obese adolescents (age=15.03±1.48; BMI=34.87±4.22 kg/m2) were randomized into high intensity training (HIT, n = 31) or low intensity (LIT, n = 31) groups for 24 weeks. All participants also received the same nutritional, psychological and clinical counseling. Pre- and post-intervention symptoms of depression, anxiety and self-esteem were assessed by questionnaires and body composition by DXA. Statistical analysis was conducted using mixed models for repeated measures and effect size (Cohen´s d). RESULTS: Depressive symptoms were reduced in both groups (p = 0,006) with higher effect size to HIT (d = 1.16) compared to LIT (d = 0.45). Trait anxiety were reduced in HIT (p = 0.002; d = 0.81) and LIT (p = 0.002; d = 0.31). No changes were observed for self-esteem and anxiety state.Table 1: Effect of low vs high intensity training on self-esteem, depressive and anxiety symptoms in obese adolescents.BDI: Beck Depression Inventory; STAI: Spielberger State-Trait Anxiety Inventory; RSES: Rosenberg Self-Esteem Scale; HIT: High Intensity Training group; LIT: Low Intensity Training group; *vs baseline (p<0.05); G: group; T: time. Conclusion: The results from the present study suggested that in obese adolescents the positive changes in psychological outcomes are independent of the intensity of exercise training. Supported by CNPq (grant 477955/2009-6) and FACEPE (grant 0928-4.9/08)