Greater Emotional Distress Research Articles

Distinguishing criminal offenses committed in a state of great emotional distress from related corpus delicti of criminal offenses

The article examines the positions of scholars, as well as the provisions of current legislation and the draft Criminal Code of Ukraine in terms of distinguishing criminal offenses committed in a state of great emotional distress from related corpus delicti of criminal offenses.
 The author analyzes judicial and law enforcement practice for premeditated murder in a state of great emotional distress, by a mother of her newborn child, and in case of exceeding the limits of necessary defense or in case of exceeding the measures necessary to detain the person who committed the criminal offense.
 The author defines theoretical approaches to the qualification of acts committed in a state of great emotional distress and the position, taking into account the case law, on the distinguishing criminal offenses committed in a state of great emotional distress from related corpus delicti of criminal offenses. It is substantiated that for the correct qualification of crimes committed in a state of strong mental excitement, it is necessary to establish not only the features of the corresponding crimes, but also to distinguish them from the related corpus delicti of crimes, since the type and degree of responsibility of the person for the committed criminal offense, as well as the degree, depend on this punishment, which is imposed in case of finding a person guilty of committing a criminal offense.

Cross Sectional Study on Well-Being and Coping Strategies of Low Vision Patients Visiting Al-Shifa Eye Trust Hospital, Pakistan

Background: Visual impairment significantly impacts individuals' lives, affecting their ability to perform daily activities and influencing their emotional well-being. The Global Burden of Disease study highlights vision impairment as a leading cause of disability worldwide, necessitating a deeper understanding of its impacts and the coping strategies employed by those affected. Objective: This study aimed to assess the functional and emotional impacts of visual impairment on patients' well-being and explore the coping strategies used by individuals with low vision. The association between the severity of visual impairment and its impacts, alongside the effectiveness of various coping mechanisms, was examined. Methods: A cross-sectional study was conducted in the Low Vision Department of a Tertiary Eye Care Hospital over six months. A total of 400 participants diagnosed with low vision were recruited through internal and external referrals. Data were collected using the Impact of Visual Impairment (IVI) tool and the Coping Strategy Indicator (CSI), alongside demographic information. The IVI tool assessed functional and emotional well-being, while the CSI evaluated the coping strategies employed. Statistical analyses were performed using SPSS version 25, focusing on mean scores and the significance of differences across demographic and clinical variables. Results: The study found that the severity of visual impairment was significantly associated with worse functional (Mean±SD: 28.33±14.86) and emotional (Mean±SD: 14.92±7.14) well-being scores (P<0.001). Participants over 30 years and those residing in rural areas experienced a greater impact of visual impairment. Notably, employment status significantly correlated with the degree of impact, with unemployed individuals reporting higher functional and emotional distress. Avoidant coping strategies were linked with greater emotional distress, while problem-solving and seeking social support showed a mixed impact on patients' well-being. Conclusion: The severity of visual impairment adversely affects both the functional abilities and emotional well-being of individuals, with avoidant coping strategies exacerbating these impacts. Encouraging active coping mechanisms and enhancing support systems could mitigate the negative effects of visual impairment on patients' lives. These findings underscore the need for holistic approaches in the care and support of individuals with low vision.

Implications of Cardiac Scarring on Body Image Disturbance Among Young Adults With Congenital Heart Defects.

Many individuals with congenital heart disease (CHD) undergo open heart surgery, resulting in prominent scarring. However, little research has assessed the impact of surgical scarring on body image in this population. Within this cross-sectional study, associations between body image concerns, anxiety and depression symptoms, and health-related quality of life among individuals with CHD were evaluated. Young adults with CHD (N = 138) completed the Body Image Disturbance Questionnaire along with other patient-reported outcome measures. Scores on the Body Image Disturbance Questionnaire were lower (mean, 1.3 ± 0.5) than populations with diabetes amputations, craniofacial conditions, idiopathic scoliosis, and clinical controls. Higher Body Image Disturbance Questionnaire scores were reported among women (P = .003) and were associated with greater anxiety (P = .000) and depression (P = .13) after controlling for sex. Body image concerns related to cardiac surgery scarring are especially prominent in women and associated with greater emotional distress, suggesting potential clinical relevance for evaluating body image concerns in persons with CHD.

Christian nationalism, religious struggles, and the structural amplification of emotional distress

AbstractObjectiveAlthough studies have linked Christian nationalist beliefs with greater emotional distress, little is known about the potential underlying mechanisms or subgroup variations. Informed by the strain‐struggles‐distress model and the concept of structural amplification, we tested whether religious/spiritual (R/S) struggles mediate and moderate the association between Christian nationalist beliefs and emotional distress.MethodsRegression models were conducted on national survey data collected in 2021 (n = 1704).ResultsResults suggested that respondents who reported stronger Christian nationalist beliefs also tended to report higher levels of R/S struggles, anger, and psychological distress. Mediation analyses revealed significant indirect effects of Christian nationalist beliefs on emotional distress through R/S struggles. Moderation analyses also indicated that the effects of Christian nationalist beliefs on emotional distress were amplified at higher levels of R/S struggles.ConclusionIn support of the strain‐struggles‐distress and structural amplification models, we find that the adverse emotional impacts Christian nationalism are explained and intensified by the cognitive vulnerabilities of R/S struggles.

Family Caregivers' Trajectories of Distress While Caring for a Person With Serious Mental Illness.

Serious mental illness (SMI) can significantly impact the lives of individuals and their families. These families often experience great emotional distress over time due to the early onset of SMI, which in turn leads to long-term trajectories and only partial recovery. However, we do not fully understand the emotional distress of family caregivers. Thus, our aim was to enrich the understanding of the lived experiences of family caregivers' emotional trajectories of distress while caring for persons with SMI. We conducted a secondary analysis using a hermeneutic approach to the narratives of seven family caregivers from a study on living with voices unheard by others. Participants' trajectories of emotional distress came forth as being thrust on an unpredictable, intensely worrisome, and indefinite journey. The following themes highlighted this tumultuous journey: fumbling in the dark trying to grasp the incomprehensible, "on your toes"-enduring unpredictability, facing different forms of fear, and battling waves of sadness and regret. Caregivers face multiple threats to their well-being and sometimes even to their health. Their distress appeared to vary according to their relationship with the person with SMI, whether they lived with the ill person, illness trajectory, and amount of violent or suicidal behavior. The results underscore the need for individualized and timely information, opportunities for dialogue with healthcare providers with and without the person with SMI, and inclusion in care planning. Caregivers who have experienced trauma, threats of violence, and rejection require special attention.

Mental and Physical Health-Related Cannabis Motives Mediate the Relationship between Childhood Trauma and Problematic Cannabis Use over Time among Emerging Adult Cannabis Users

Background While growing evidence has identified mental and physical health-related cannabis use motives as significant mechanisms between childhood trauma and problematic cannabis use (PCU) for emerging adults (EA), there is a need to understand the longitudinal stability of these pathways and how they impact PCU as cannabis users age into later adulthood. Methods The current study extends an analysis examining the impact of childhood trauma (e.g., emotional abuse, sexual abuse) on multiple indicators of PCU through a range of cannabis use motives. 339 medical cannabis patient and non-patient EA users from the Los Angeles area were sampled at baseline (mean age = 21.23; SD = 2.48). The present analysis used four waves of follow-up data collected from 2016 to 2018 (W3, W4) and 2019-2020 (W5, W6). Results Use of cannabis to cope with nausea, sleep, pain, and emotional distress mediated the relationships between some types of childhood abuse and PCU at W4, though most associations attenuated by later adulthood (W6). Specifically, greater emotional distress and nausea motives were associated with greater PCU in models of emotional abuse and neglect and sexual abuse, with emotional distress continuing to mediate at W6. Conversely, sleep and pain motives were associated with lower PCU in models for emotional neglect. Conclusions Mental and physical health-related motives reflect potential intervenable factors that predict PCU in emerging adulthood among EA cannabis users with histories of childhood trauma. Results highlight the importance of and value for assessing a wide range of motives and PCU outcomes to target and address areas for intervention.

Impact of the COVID-19 pandemic on the health of survivors of trafficking for sexual exploitation: a qualitative study in Spain

PurposeThe purpose of this paper was to explore the health of trafficking survivors in Spain, which is relatively unstudied (Sweileh, 2018). Therefore, the objectives of this study are to describe the health conditions, access to health-care facilities, COVID-19 protection and health challenges in relation to the COVID-19 pandemic reported by women survivors of human trafficking in Spain.Design/methodology/approachDue to the pandemic situation, limited research and the complexity of the issue, the authors took a qualitative approach. A cross-sectional study was carried out through interviews with women survivors of human trafficking for sexual exploitation in Spain. Prior to the interviews, the researchers conducted written interviews with social workers to understand the most important challenges that the women survivors were experiencing during confinement. As a result of these written interviews, the interview script for the survivors was modified.FindingsTo sum up, the COVID-19 situation poses several challenges, including social difficulties (food insecurity; violence; terrible housing conditions; working pressure; poor sleeping habits; and cultural, linguistic and religious challenges), medical insecurity (due to lockdowns, negative experiences in care, lack of official documents, collapse of hospitals, telephone monitoring and fear of contagion), great emotional distress reported by women (anxiety, fear, sadness, post-traumatic stress disorder, stigma and substance use) and physical health problems (serious weight loss, muscle pains, dental problems and sexual and reproductive health-care limitations).Research limitations/implicationsAs is usual in qualitative research, rather than obtain generalizable results, the main objective was to delve deeper into under-researched or complex issues (Polit and Beck, 2010). While this report provides a timely overview marked by COVID-19 of an important population, there are some limitations. The major limitation of this research was the sample representativity, because the sample was conducted with only one non-governmental organization and only individuals who voluntarily agreed to make the interview; as such, other victim profiles may not be represented.Practical implicationsThe findings can provide information for detecting victims of human trafficking for sexual exploitation and contribute to understanding the pandemic’s impact. Furthermore, the paper emphasizes the need to adopt measures for the recovery of victims, such as medical and psychological assistance, in accordance with the Palermo Protocol. As people transition out of the pandemic, it is crucial for Spain, along with other European countries, to guarantee that all residents, particularly the victims of human trafficking, have access to social and health-care protections during times of crisis.Social implicationsAs already mentioned, further investigation should be done to fill the gaps on health of human trafficking (Sweileh, 2018) and improve the recovery of victims of trafficking (García-Vázquez and Meneses-Falcón, 2023 0; Sweileh, 2018). The paper acknowledges the existing research gap in the field and emphasizes the importance of future studies to delve deeper into the challenges faced by victims, calling for a more nuanced understanding of health.Originality/valueThe Coronavirus pandemic has increased and reinforced the vulnerability of sex-trafficked victims, especially creating different mental health problems. One of the biggest concerns for this group has been the difficulty of access to basic goods such as food. Furthermore, psychological distress impacted the well-being of trafficking victims, and many suffered from eating disorders. Less than half of the women who were forced to continue in prostitution did not have the means to protect themselves against COVID-19 and did not have easy situations to overcome illness.

Emotional Distress, Anxiety, and General Health Status in Patients With Newly Identified Small Pulmonary Nodules: Results From the Watch the Spot Trial

Anxiety and emotional distress have not been studied in large, diverse samples of patients with pulmonary nodules. How common are anxiety and distress in patients with newly identified pulmonary nodules, and what factors are associated with these outcomes? This study surveyed participants in the Watch the Spot Trial, a large, pragmatic clinical trial of more vsless intensive strategies for radiographic surveillance of patients with small pulmonary nodules. The survey included validated instruments to measure patient-centered outcomes such as nodule-related emotional distress (Impact of Event Scale-Revised) and anxiety (Six-Item State Anxiety Inventory) 6 to 8weeks following nodule identification. Mixed-effects models were used to compare outcomes between study arms following adjustment for potential confounders and clustering within enrollment site, while also examining a limited number of prespecified explanatory factors, including nodule size, mode of detection, type of ordering clinician, and lack of timely notification prior to contact by the study team. The trial enrolled 34,699 patients; 2,049 individuals completed the baseline survey (5.9%). Respondents and nonrespondents had similar demographic and nodule characteristics, although more respondents were non-Hispanic and White. Impact of Event Scale-Revised scores indicated mild, moderate, or severe distress in 32.2%, 9.4%, and 7.2%of respondents, respectively, with no difference in scores between study arms. Following adjustment, greater emotional distress was associated with larger nodule size and lack of timely notification by a clinician; distress was also associated with younger age, female sex, ever smoking, Black race, and Hispanic ethnicity. Anxiety was associated with lack of timely notification, ever smoking, and female sex. Almost one-half of respondents experienced emotional distress 6 to 8weeks following pulmonary nodule identification. Strategies are needed to mitigate the burden of distress, especially in younger, female, ever smoking, and minoritized patients, and those with larger nodules. ClinicalTrials.gov; No.: NCT02623712; URL: www. gov.

Does social capital matter? A study of hit-and-run in US counties

We investigate the relationship between social capital and a decision that has dire health consequences: fleeing after a road accident. This event is unplanned, and the decision is taken under great emotional distress and time pressure, thus providing a test of whether social capital matters for behaviour in extreme conditions. We merge data from the universe of fatality accidents involving pedestrians in the US over the period 2000–2018 with a dataset on social capital measures at the county level. Using within-state-year variation, our results show that one standard deviation increase in social capital is associated with a reduction in the probability of hit-and-run of around 10.5%. Several falsification tests based on differences in social capital endowment between the county where the accident occurs and the county where the driver resides are suggestive of a causal interpretation of this evidence. Our findings show the importance of social capital in a new context, suggesting a broad impact on pro-social behaviour and adding to the positive returns of promoting civic norms.

Sleep quality and sex-related factors in adult patients with immune-mediated diabetes: a large cross-sectional study

AimTo analyze sleep quality and its relationships with clinical and biochemical features in a large cohort of adults with autoimmune diabetes.MethodsWe administered to 553 patients with autoimmune diabetes the questionnaires: Pittsburgh Sleep Quality Index (PSQI), diabetes distress scale, diabetes-related quality of life and diabetes treatment satisfaction questionnaire. We excluded patients with missing HbA1c ± 4 months from PSQI administration or incorrect PSQI compilation (n = 110).ResultsAltered sleep quality was recorded in 142/443 subjects (32%), insufficient total sleep time in 177/443 (40%). The altered sleep quality group had higher HbA1c (median 56 mmol/mol [interquartile range-IQR 49–62] vs 59 [IQR 52–68]; P < 0.001), higher average HbA1c in the previous 36 months (59 mmol/mol [IQR 54–68] vs 56 [IQR 51–62]; P < 0.001), and more individuals with HbA1c > 53 mmol/mol (74.6% vs 62.8%; P = 0.014). Diabetes duration (P = 0.63), type of insulin delivery (P = 0.48) and glucose monitoring (P = 0.35) were uninfluential. Patients with altered sleep quality showed higher prevalence of autoimmune (42 vs 28%; P = 0.005) and mental diseases (12 vs 4%; P = 0.002); there were greater emotional distress, and lower quality of life and treatment satisfaction (P < 0.001 for all), irrespective of sex. Men with altered sleep quality had higher HbA1c and prevalence of autoimmune diseases. Women showed greater prevalence of psychiatric disorders. Average HbA1c of the previous 36 months, autoimmune or psychiatric disorders were independent predictive factors for altered sleep quality.ConclusionOne-third of the patients with autoimmune diabetes showed altered sleep quality, which associates with worse glycemic control, and autoimmune and mental disorders, with sex-specific differences.

Profile of Self-Care Capacity and Alcohol Use in Elderly Brazilians during the COVID-19 Outbreak: An Online Study

Background: Preventive and positive online coping strategies are essential for harm reduction associated with alcohol abuse among older adults in pandemic and social isolation scenarios. The objectives were to examine the relationship between alcohol use/abuse and physical capacity/self-care to perform the physical activities of daily living or impairment of the functional capacity of the elderly in the COVID-19 pandemic. Methods: An online cross-sectional survey was carried out. One hundred and one elderly people in the city of São Paulo, Brazil, participated in a community program. Results: Most participants (52.5%) showed excellent self-care skills. Approximately 12% of participants reported problems related to alcohol use/abuse. There was no association between self-care ability and abuse and probable alcohol dependence. Conclusions: Although most participants have excellent self-care and functional capacity and have not evidenced alcohol use/abuse, health professionals need to systematically provide information to prevent alcohol abuse, especially in scenarios of great emotional distress, such as in a pandemic. In addition, the online meetings held by the UAPI program were shown to be opportunities for social interaction and were essential to minimize the negative effects of the possible presence of alcohol use/abuse and the deteriorating performance of physical activities of daily living during a pandemic outbreak for the elderly.

Cardiovascular Service Line Chaplain at an Academic Medical Center: Creation, Implementation, and Establishment

Problem Statement: As health care providers and organizations have become complex and specialized, efforts to address the spiritual needs of patients and care team members are often absent. Background: Medical advances, life-saving treatments, and increased efficiency of patient care have all come at a cost to patients and health care providers. We appropriately measure our care team’s performance with disease- and procedure-specific data on morbidity and mortality. However, these measurements come at the risk of rewriting Hippocrates’ endeavor from “cure sometimes, relieve often, comfort always” to “cure always.” The suggestion that failure is not an option is an unattainable expectation with a high price, namely the spiritual distress of care team members, patients, and their families. In 2018, The Joint Commission addressed the issue of unmet spiritual needs, stating that these needs can be associated with greater emotional distress, pain, and anxiety; higher medical care costs; and poorer quality of life. Application: In 2015, the cardiovascular service line at an academic medical center implemented a spiritual care provider position to address the unmet spiritual needs of patients and care team staff. In this article, we describe (1) the evolution of the spiritual care provider’s role and (2) the impact of this resource on the healing of patients and as a support for the personal and professional well-being of health care providers.

Serotonin transporter gene methylation and emotional regulation in preschool children born preterm: A longitudinal evaluation of the role of negative emotionality in infancy.

The aim of the study was to assess the contribution of negative emotionality at 3 months (T1) and serotonin transporter gene (SLC6A4) DNA methylation at 4.5 years of age (T2) to emotion regulation in pre-schoolers born very preterm and full-term. Forty one children (n=21 born very preterm, n=20 born full-term) participated in the study. Fretful behavior was assessed at T1 in response to the Face-to-FaceStill-Face (FFSF) paradigm. At T2, SLC6A4 DNA methylation was analyzed and emotion regulation was assessed using an observational procedure (i.e., the Pre-schooler Regulation of Emotional Stress, PRES). The very preterm group displayed higher emotion dysregulation during the PRES Reactivity phase than the full-term group. Higher levels of fretful behavior at 3 months were associated with greater emotional distress only for very preterm children with higher methylation at T2. No significant associations emerged in the full-term group. Despite current findings cannot be generalized owing to the relatively small sample size, this work provides preliminary longitudinal evidence about the link between negative emotionality during infancy, stress-linked epigenetic status at 4.5 years and emotion dysregulation in preschoolers born preterm.

Perceptions of Mental Health and Exploring the Role of Social Activism Among African Americans Exposed to Media Coverage of Police Brutality and Protests.

This study explored the role of social activism in the association of exposure to media coverage of police brutality and protests with perceptions of mental health. Data for this study came from a sample of African Americans (N = 304) who responded to an online survey. Perceptions of mental health were assessed using a single item developed by the research team. Exposure to police brutality and protests was measured by asking how often they had seen or heard about African Americans being victims of police brutality and seen or heard about protests on television, social media, or other outlets. Participants were also asked about the extent to which these events caused them emotional distress. Social activism was assessed by asking participants if they had ever participated in political activities, such as calling their representative. Moderation and mediation analyses were conducted using linear regression. Moderation analyses showed that greater emotional distress from watching media coverage of police brutality and protests was associated with worse perceptions of mental health only when engagement in social activism was low. In contrast, mediation analyses indicated that greater frequency of and emotional distress from exposure to media coverage was indirectly associated with worse perceptions of mental health through increased engagement in social activism. Social activism may be an important method for coping with emotional distress from watching media coverage of police brutality and protests, but more research is needed to understand how African Americans might engage in social activism without adversely impacting mental health.

Unravelling the complex interactions between self-awareness, cognitive change, and mood at 6-months post-stroke using the Y-shaped model

ABSTRACT We investigated the relationships between cognitive change following stroke, awareness of cognitive impairments, and mood to further understanding of change processes influencing psychological outcomes post-stroke in line with the “Y-shaped” process model. Patients (n = 143; M age = 73 years, SD = 13.73; 74 males) were assessed at 3-weeks (T1) and 6-months (T2) post-stroke and had completed the Oxford Cognitive Screen (T1 and T2), the Cognitive Failures Questionnaire (CFQ; T2), and the Hospital Anxiety and Depression Scale (HADS; T2). An ANCOVA controlling for disability relating to activities of daily living (ADL) revealed that awareness of cognitive impairment was significantly lower in participants with moderate-severe cognitive impairment. Regression analysis indicated that greater awareness of cognitive impairment and reduced independence in ADL were associated with greater emotional distress at T2. Cognitive improvement was associated with lower emotional distressat T2. Contrary to the awareness hypothesis, moderation analyses suggest that this effect was largest for those most cognitively impaired at T1. Findings emphasize the importance of monitoring stroke patients’ capacity to be self-aware when assessing and formulating long-term post-stroke distress and have potential implications for improving long-term emotional status in those most cognitively impaired post-stroke, e.g., through psychoeducation, cognitive rehabilitation, and emotional support.

Interpersonal trauma histories and relationship functioning among LGB Veteran couples seeking PTSD treatment

ABSTRACT Lesbian, gay, and bisexual (LGB) Veterans report greater emotional distress, trauma exposure, and PTSD rates than both LGB civilians and non-LGB Veterans. Traumatic experiences impact intimate relationships, potentially placing LGB Veterans at higher risk of relationship dysfunction secondary to trauma and PTSD. However, limited research has examined links between relationship functioning and trauma histories among couples with one or more LGB-identifying partners. In this exploratory study, participants include 21 couples from a larger treatment study comprising a PTSD-diagnosed Veteran and their significant other in which at least one partner identified as LGB. Variables included trauma experiences, PTSD symptom severity, and relationship satisfaction. A descriptive analysis revealed high relationship satisfaction despite high interpersonal trauma rates among both PTSD-diagnosed Veterans and their partners. Further, we found different patterns of relationship functioning depending on whether a participant had experienced sexual assault. These initial analyses present novel data on trauma in treatment-seeking LGB veteran couples and provide an important basis for future research on couple-based mental health treatments for this population.

Cumulative risk exposure and emotional symptoms among early adolescent girls

BackgroundFrom early adolescence, girls and women report the highest rates of emotional symptoms, and there is evidence of increased prevalence in recent years. We investigate risk factors and cumulative risk exposure (CRE) in relation to emotional symptoms among early adolescent girls.MethodsWe used secondary data analysis, drawing on data capturing demographic information and self-reported emotional symptoms from 8327 girls aged 11–12 years from the 2017 baseline data collection phase of the HeadStart evaluation. We used structural equation modelling to identify risk factors in relation to self-reported emotional symptoms, and collated this into a CRE index to investigate associations between CRE and emotional symptoms.ResultsFour risk factors were found to have a statistically significant relationship with emotional symptoms among early adolescent girls: low academic attainment, special educational needs, low family income, and caregiving responsibilities. CRE was positively associated with emotional symptoms, with a small effect size.ConclusionsResults identify risk factors (outlined above) that are associated with emotional symptoms among early adolescent girls, and highlight that early adolescent girls experiencing a greater number of risk factors in their lives are likely to also experience greater emotional distress. Findings highlight the need for identification and targeted mental health intervention (e.g., individual or group counselling, approaches targeting specific symptoms), for those facing greater risk and/or with emergent symptoms.

Keeps me awake at night: The potential of the COVID-19 pandemic to affect sleep quality among sexual minority men in the U.S.A.

Sleep health, a crucial component and predictor of physical and mental health, has likely been adversely impacted by the stress and disruption wrought by the COVID-19 pandemic. This brief report sought to assess self-reported sleep quality among sexual minority men across the U.S.A. in the early months of the pandemic. In a cross-sectional online survey of a racially-diverse sample of 477 sexual minority men (mean age of 41.2; range 18-75 years) recruited from popular geo-social networking apps in early May 2020, participants reported on their recent experiences regarding sleep and mental health (anxiety, depression, and pessimistic repetitive future thinking). Almost 75% endorsed some level of restless sleep in the past week, 203 (42.6%) reported worse-than-usual sleep quality since the pandemic, and 77 (16.1%) reported sleeping longer than usual but not feeling better rested. Further, of the 280 reporting worse-than-usual sleep or feeling not rested, almost 85% reported that worry about the pandemic had been contributing to their troubles with falling or staying asleep. Rates of worsened sleep were highest among those whose financial situation had been adversely affected and those not in full-time employment, whereas restless sleep was highest among those in the Northeast region of the U.S.A., which, during the study's timeframe of late April and early May 2020, was the most severely affected by the pandemic. Greater emotional distress was associated with each sleep variable. Addressing and improving sleep health is critical to overall health and requires particular attention during the COVID-19 pandemic.

P095 The impact of COVID-19 lockdown on clinical care, self-management, and mental health in patients with inflammatory arthritis

Background/Aims COVID-19 lockdown affected access to clinical care for many vulnerable patients, including those with inflammatory arthritis (IA). It also had the potential to alter self-management behaviours. These changes could in turn impact mental health, especially given that IA patients are already at higher risk of mental health disorders. Thus, the aims of this study were to determine how IA care and self-management were affected by lockdown and assess the impact of these changes on disease outcomes and mental health. Methods Online questionnaires were completed by 338 participants between June and July 2020. The questionnaires assessed demographics, IA condition, IA self-management, COVID-19 clinical information, quality of life, and mental health. Visual analogue scale (VAS) scores for patient global assessment (PGA) of disease activity, pain, fatigue, and emotional distress were completed relating to the previous week and retrospectively for pre-lockdown (March) and early-lockdown (April). Improvement/worsening in each VAS was considered as a change of 10 points or more from pre-lockdown to the current rating. Linear regressions were conducted to determine factors associated with worse outcomes, controlling for potential confounders including self-reported pre-lockdown status. Results Mean VAS scores worsened during lockdown for all outcome measures, with over half reporting a more than 10-point worsening (Table 1). Changes to clinical care affected 87% of patients. The most commonly affected services were hospital outpatient appointments (77%), GP appointments (59%), and blood tests (53%). Changes to clinical care were significantly associated with worse PGA (b = 8.95, p=0.01), pain (b = 7.13, p=0.05), fatigue (b = 17.01, p<0.00) and emotional distress (b = 12.78, p<0.01). Regarding self-management, 64% of patients reported changes to diet while 51% reduced physical activity. Change in diet was not significantly associated with any of the outcomes, whereas physical activity was associated with PGA (b=-2.42, p<0.01), pain (b=-2.43, p<0.01), fatigue (b=-2.5, p < 0.01), and emotional distress (b=-2.41, p<0.01). Conclusion Most patients (87%) had at least one area of clinical care affected by the lockdown. These changes in IA clinical care were associated with worse disease outcomes across all measures and greater emotional distress. In self-management, reduced physical activity was associated with worse outcomes in all physical and mental health measures. P095 Table 1:Mean VAS (0-100) scores and percent changesPGAMarch April June/JulyMean (SD) 44.51 (23.70) 53.18 (24.67) 57.69 (25.29)Better Same WorsePercent 7.9936.6855.33[95% CI] [5.33-11.41][31.54-42.07][49.85-60.71]PainMarch April June/July42.60 (25.60) 51.11 (26.01) 56.66 (26.40)Better Same Worse7.6937.8754.44[5.09-11.07] [32.68-43.28][48.96-59.84]FatigueMarch April June/July46.86 (26.17) 57.11 (25.83) 61.35 (26.51)Better Same Worse10.0634.0255.92[7.07-13.77] [28.98-39.35][50.44-61.29]Emotional DistressMarch April June/July30.96 (26.28) 49.06 (29.09) 48.75 (29.15)Better Same Worse8.2833.14 58.58[5.58-11.75] [28.14-38.43][53.12-63.88] Disclosure M. Sweeney: None. L. Carpenter: None. S. de Souza: None. H. Chaplin: None. H. Tung: None. E. Caton: None. J. Galloway: None. A. Cope: None. M. Yates: None. S. Norton: None.

A 16-week concurrent exercise program improves emotional well-being and emotional distress in middle-aged women: the FLAMENCO project randomized controlled trial.

To analyze the influence of a supervised concurrent exercise program on emotional well-being and emotional distress in middle-aged women. This randomized controlled trial included 150 middle-aged women recruited for the FLAMENCO project. Participants were allocated into counseling (n = 75) or exercise (n = 75) groups. The counseling group attended conferences on healthy lifestyle (including diet and physical activity topics). The exercise group followed a 60-min concurrent (aerobic + resistance) exercise training 3 days/wk for 16 weeks. Emotional health was assessed with the Positive and Negative Affect Schedule (PANAS) in two diverse timeframes, state (PANAS-S) and trait (PANAS-T) ranging from 10 to 50, where higher scores reflect greater affective emotional health/experience (positive affect subscale) and greater emotional distress (negative affect subscale). The differences between the counseling and exercise groups in PANAS were analyzed by linear regression. The total number of women for the per-protocol analyses was 111 divided into the counseling (n = 53) and exercise (n = 58) groups. After adjusting for body mass index and Mediterranean diet adherence, PANAS-S and PANAS-T-positive affect scores increased by 3.81 and 3.02, respectively, in the exercise group whereas they decreased by 0.15 and increased by 0.51 in the counseling group (both, P < 0.05). PANAS-T negative affect decreased by 4.10 in the exercise group whereas only decreased by 0.9 in the counseling group (P < 0.05). A 16-week concurrent exercise program improved emotional experience in middle-aged women. Specifically, women in the exercise group significantly improved their emotional well-being and emotional distress through greater changes in positive affect and negative affect compared with the counseling group.