Higher Levels Of Negative Affect Research Articles

Parasympathetic regulation and maternal parenting as longitudinal predictors of preschooler inhibitory control

AbstractMeasures of parasympathetic regulation, such as respiratory sinus arrhythmia (RSA), predict executive function outcomes, including inhibitory control, across childhood. Respiratory sinus arrhythmia augmentation tends to be associated with more maladaptive outcomes, compared to RSA suppression, but the literature regarding RSA profiles and inhibitory control development across infancy and early childhood is contradictory. The goal of our current study was to examine the longitudinal and interactive effects of infant RSA during a frustrating task with negative maternal characteristics on inhibitory control during early childhood. Participants included 410 children (209 girls, 77.6% White, 92.9% non‐Hispanic) and their mothers. With small to moderate effect sizes (r2 range from 0.124 to 0.143), we demonstrated that maternal negative affect when children were 36 months old moderated the association between 10‐month‐old RSA during a frustrating task and 48‐month‐old inhibitory control, such that RSA suppression predicted higher levels of inhibitory control, but only when mothers exhibited high levels of negative affect. Our results highlight the biosocial framework under which child inhibitory control develops.

A naturalistic assessment of the relationship between negative affect and loss of control eating over time following metabolic and bariatric surgery

Disordered eating behavior has been linked to suboptimal weight outcomes following metabolic and bariatric surgery (MBS), thereby threatening the most efficacious treatment for severe obesity. While up to 40% of patients may experience loss of control (LOC) eating following MBS, mechanisms driving this behavior are not fully understood. Preliminary evidence suggests that high levels of negative affect (NA) in the moment prompt LOC eating post-MBS; however, it remains unclear whether this momentary relationship is stable or changes over the first several years following surgery. Consequently, this study examined differences in the prospective relationship between NA and LOC eating severity over time post-MBS using three waves of ecological momentary assessment data collection. Participants (n = 143, 87% female), were asked to rate momentary levels of NA and LOC eating severity on their smartphone ≥5 times/day for 7 days at 1-, 2-, and 3-years post-MBS. Both NA and LOC eating were rated on a 1–5 Likert scale, with higher scores indicating more severe symptoms. NA was within- and between-person centered and used as a prospective predictor of LOC eating severity. Analyses evaluated if time post-MBS moderated the relationship. A generalized linear mixed model demonstrated that higher NA predicted more severe LOC eating at the next signal when centered within- and between-subjects. Time post-MBS moderated the within-NA to LOC eating severity effect, such that the relationship remained unchanged between years 1 and 2, but strengthened between years 2 and 3. Findings suggest that momentary NA becomes a more powerful predictor of LOC eating severity as time passes post-MBS, which has important implications for interventions aimed at reducing LOC eating and promoting optimal weight outcomes in the post-surgical period.

Affective Polarization Among Radical‐Right Supporters: Dislike Differentiation and Democratic Support

Partisan affective polarization describes the extent to which different partisans like or dislike each other. In Europe, affective dislike is strongest towards the radical-right, as mainstream voters tend to hold particularly negative affect towards radical-right supporters. This is an important pattern given the recent high levels of support for radical-right parties, for example in the Netherlands, France, and Italy. However, the perspective of radical-right supporters themselves has been largely neglected in existing work. To remedy this, we examine how radical-right supporters feel towards supporters of mainstream parties. We develop a new concept, dislike differentiation, which refers to the extent to which radical-right supporters differentiate in the dislike they harbor towards mainstream parties. We use two new studies that sampled 2,628 radical-right supporters in nine European polities. We find that some supporters reject all mainstream parties, whereas others follow more typical patterns of political competition along ideological lines. Dislike differentiation among radical-right supporters is linked to key socio-political phenomena, including party attachment, ideological extremism, satisfaction with democracy, and political tolerance. By creating a novel typology combining out-party dislike and dislike differentiation, we show that anti-system radical-right supporters, characterized by high out-party dislike and low dislike differentiation, are the least supportive of democracy. By centering our analysis on those voters that receive and radiate the highest levels of negative affect, we advance knowledge on what fosters polarized attitudes and intolerance in Europe’s multiparty systems in times when the electoral popularity of the radical-right is surging.

Risk Perception, Cooperation, and Emotional Distress During the COVID-19 Pandemic: Exploring Adaptive Risk Perception

During the COVID-19 pandemic, while risk perception may promote public cooperation with pandemic prevention, it may also increase emotional distress and thus endanger mental health. This study aimed to examine whether there is an adaptive risk perception pattern that fits both needs of pandemic control and mental health protection. Two waves of Chinese participants (N sample 1 = 1633, N sample 2 = 1899) completed the Scale of Pandemic Risk Perception, the Scale of Public Cooperation with Pandemic Prevention, the Epidemic Worry Scale, and the Positive and Negative Affective Schedule during Feb 3rd to 5th, and during Feb 18th to 20th, 2021 respectively. Four risk perception profiles were identified by using latent profile analysis based on pandemic risk perception. Regression mixture models found that individuals in the perceived-controllable-high-perceived-risk profile were the most cooperative and reported the least worries and negative affect. The perceived-uncontrollable-high-perceived-risk profile demonstrated high cooperation but serious worry and negative affect. Individuals in the ignoring-risk profile reported the least levels of cooperation and worry but the highest levels of negative affect. Finally, the perceived-moderate-perceived-risk profile reported moderate levels of both cooperation and emotional distress. These results were well repeated in two samples. Present findings point towards an adaptive risk perception pattern (the controllable-high-perceived-risk profile) which may optimize cooperation while also avoid serious emotional distress.

Differences in wayfinding inclinations among women and men: a matter of personality and affect, not just gender

Women report different levels of wayfinding inclinations than men. This study is an exploration of whether individual factors such as personality traits and affect can provide insights into the gender differences observed in wayfinding inclinations, such as in the attitudes toward exploring and spatial anxiety. The study involved 454 adults (271 women) who completed questionnaires on personality traits, affective state, attitudes toward exploring and spatial anxiety. Women reported lower positive attitudes toward exploring and higher spatial anxiety than men. Openness and positive affect were associated with positive attitudes toward exploring places in both genders whereas extraversion was associated with attitudes toward exploring places among men. Higher levels of extraversion were linked to lower spatial anxiety in both genders, higher levels of negative affect were associated with greater spatial anxiety among men, and lower levels of emotional stability were associated with greater spatial anxiety among women. Therefore, gender does not play a singular role in explaining differences in self-reported wayfinding inclinations. Instead, negative affect (at least for men) and low emotional stability (at least among women) tend to hinder such inclinations whereas openness and positive affect contribute to their promotion. These results provide insights into how the patterns of relationships among wayfinding inclinations, personality traits, and affect vary between men and women, with possible implications for assessment and intervention.

Remembering history: Autobiographical memory for the COVID-19 pandemic lockdowns, psychological adjustment, and their relation over time.

This longitudinal study examined age- and gender-related differences in autobiographical memory about the COVID-19 pandemic lockdowns and whether the content of these memories predicted psychological adjustment over time. A sample of 247 students (Mage = 11.94, range 8-16 years, 51.4% female, 85.4% White) was recruited from public and private schools in Denmark and assessed three times from June 2020 to June 2021. The findings showed that memories weakened over time in detail and emotional valence. Additionally, psychological well-being decreased over time, with adolescent females faring the worst. Critically, memories including higher levels of negative affect and factual information about COVID-19 and the lockdown predicted worse psychological well-being over time, underscoring aspects of autobiographical memory that might help attenuate the negative consequences of the lockdown.

Your coworkers can make you sick: An investigation of coworker undermining and employee health

AbstractAlthough mistreatment in the workplace has been widely acknowledged, the impact of coworker undermining has not been adequately explored in the literature. Using insights from the job demands–resources model, we suggest that coworker undermining is a job demand that is associated with negative affect and somatic complaints. In mitigation of this, we propose two personal resources (i.e. forgiveness and revenge cognitions) as buffers of the positive relationship between coworker undermining and somatic complaints via negative affect. We explore these relationships in a time‐lagged study involving 229 participants who responded to three surveys over a month‐long period. Our findings show that coworker undermining is related to high levels of negative affect in the following week, and that this spills over to somatic complaints. However, this is only true for victims of undermining who do not forgive their colleagues.

Effects of post-acute COVID-19 syndrome on cerebral white matter and emotional health among non-hospitalized individuals.

Post-acute COVID syndrome (PACS) is a growing concern, given its impact on mental health and quality of life. However, its effects on cerebral white matter remain poorly understood, particularly in non-hospitalized cohorts. The goals of this cross-sectional, observational study were to examine (1) whether PACS was associated with distinct alterations in white matter microstructure, compared to symptom-matched non-COVID viral infection; and (2) whether microstructural alterations correlated with indices of post-COVID emotional health. Data were collected for 54 symptomatic individuals who tested positive for COVID-19 (mean age 41 ± 12 yrs., 36 female) and 14 controls who tested negative for COVID-19 (mean age 41 ± 14 yrs., 8 female), with both groups assessed an average of 4-5 months after COVID testing. Diffusion magnetic resonance imaging data were collected, and emotional health was assessed via the NIH emotion toolbox, with summary scores indexing social satisfaction, well-being and negative affect. Despite similar symptoms, the COVID-19 group had reduced mean and axial diffusivity, along with increased mean kurtosis and neurite dispersion, in deep white matter. After adjusting for social satisfaction, higher levels of negative affect in the COVID-19 group were also correlated with increased mean kurtosis and reduced free water in white matter. These results provide preliminary evidence that indices of white matter microstructure distinguish PACS from symptomatic non-COVID infection. Moreover, white matter effects seen in PACS correlate with the severity of emotional sequelae, providing novel insights into this highly prevalent disorder.

Social sharing and expressive suppression in major depressive disorder and borderline personality disorder: An experience sampling study

AbstractMajor depressive disorder (MDD) and borderline personality disorder (BPD) are characterized by disturbed patterns of emotional and interpersonal functioning, which might imply altered use of emotion regulation in interpersonal contexts. In the current study, we examined how individuals with MDD and/or BPD differ from healthy controls in (1) their overall daily life use of expressive suppression and social sharing and (2) their tendency to adjust the use of these strategies to the emotional context (i.e., preceding negative and positive affect). Thirty‐four individuals with MDD, 20 individuals with BPD, 19 individuals with comorbid MDD and BPD, and 40 healthy controls participated in a week of experience sampling during which they reported their use of expressive suppression, social sharing, and experienced negative and positive affect. The results indicated that all clinical groups reported more expressive suppression and social sharing in their daily lives than healthy controls. Group differences remained when controlling for differences in mean experienced affect, except for increased suppression for MDD and increased sharing for BPD and comorbid MDD and BPD, which seemed related to these participants' overall higher levels of negative affect. Additionally, associations between within‐person fluctuations in negative or positive affect and subsequent strategy use were equally strong for clinical and control participants, indicating that clinical groups did not differentially adjust the use of suppression and sharing to the emotional context. In conclusion, individuals with MDD and/or BPD showed increased use of suppression and sharing in daily life, which might contribute to, or follow from their emotional and interpersonal difficulties.

PREDICTORS OF THE ENJOYMENT AND MISSING EXPERIENCES OF MALAYSIAN STUDENTS IN HOME COUNTRY AND OVERSEAS

The purpose of this longitudinal study was to identify the predictors of the adaptation experiences of Malaysian students in home country and overseas, from two perspectives: missing and enjoyment experiences. At Time 1, 2090 responses were collected from a group of students who were enrolling at various overseas preparatory studying programmes (later termed as overseas students) and also first year students who were continuing their education at a public university in Malaysia (later termed as home country students). At Time 2, 628 of the participants were retained. The predictor variables were Time 1 well-being indicators (i.e. life satisfaction, positive and negative affect), importance and satisfaction of conservation and self-transcendence values, perceived success (measured by the Malaysian Certificate of Examination results and perceived English language fluency), personality, and parents’ level of education. The findings showed that overseas students who had a low level of English language fluency and a high level of importance of conservation and satisfaction of self-transcendence values tended to miss home. Similarly, overseas students who were less fluent in English were less likely to enjoy their life abroad. Whilst for the home country students, the high level of negative affect predicted their missing experience, and none of the predictor variables were found to be significant in contributing to enjoyment experience.

Child temperamental negative affectivity moderates the relation between interparental conflict and child cortisol recovery

AbstractThis study examined the relation between interparental conflict and cortisol recovery, with child temperamental negative affectivity as the moderator. Children (n = 118) ages 9–11 years observed an argument between their parents in the lab and provided saliva samples for cortisol assays. Children also reported levels of interparental conflict, and mothers reported their child's negative affectivity. Results showed that youths with high levels of negative affectivity experienced less cortisol recovery as interparental conflict levels increased. Further, demonstrating some support for differential susceptibility, youths with higher levels of negative affectivity exhibited less recovery at high levels of parental conflict but greater recovery at low levels of parental conflict, compared to peers with lower scores on negative affectivity. We also found that children with low levels of negative affectivity exhibited greater recovery as rates of interparental conflict increased. In summary, this study sheds light on sources of variability in cortisol recovery as it relates to interparental disharmony.

Negative Affect, Harassment and Problematic Alcohol Use in Young Adults

Background: While research suggests that both negative affect and alcohol use are impacted by exposure to harassment (i.e., sexual harassment, generalized harassment or bullying), less is known about the effect of harassment on negative affect subsequently leading to alcohol consumption, particularly in young adults. We examined the mediating role of negative affect on the relationships between sexual and generalized harassment at school and alcohol misuse. Methods: Participants were 2899 incoming freshmen in fall of 2011 who completed a Web-based survey assessing demographics (T0), sexual and generalized harassment at school (T0-T2), negative affect (T3), and problems associated with drinking, binge drinking, and drinking to intoxication (T0, T4, T5). Separate hybrid path models were fitted in Mplus v.8.8 for generalized harassment and sexual harassment and each outcome. Results: Mediation analyses showed a small but significant indirect effect for the sexual harassment model (beta = 0.05, S.E. = 0.01, p < 0.001) and generalized harassment (beta = 0.03, S.E. = 0.01, p < 0.01), indicating that negative affect partially mediated the associations between harassment early in students’ college experience and later problems associated with drinking. No significant indirect effects were found for the binge drinking or intoxication models. Conclusions: High levels of negative affect associated with harassment may contribute to longer term impact on problematic use of alcohol in young adults, providing evidence that the effects of harassment on drinking may partly stem from harassment’s lingering effects on negative affective pathways.

The role of social interaction modality for well-being in older adults.

It is well-established that more frequent social interaction is associated with higher well-being across the lifespan. The present study examines the role of frequency of interactions via different modalities on older adults' weekly well-being during the COVID-19 pandemic, where people had to adapt their communication behavior and reduce in-person contact due to precautionary measures. We use data from 98 participants (age: M = 71, SD = 5), who documented their weekly frequency of communication via four interaction modalities as well as their loneliness, positive affect, and negative affect over up to 64 weeks. Results show that participants with overall higher frequency of face-to-face, telephone, and text-based interaction than others report higher levels of positive affect and lower levels of negative affect and loneliness than others. Participants report higher levels of well-being during weeks when they report more frequent face-to-face, telephone, and text-based interaction than their individual average. Unexpectedly, participants report higher levels of negative affect during weeks with more video call interaction. Some effects of social interaction frequency on affect and loneliness are higher for face-to-face interactions versus other modalities. In addition, interaction effects at within-person level indicate that the effects of weekly telephone and text-based interaction frequency on loneliness are stronger in weeks with relatively few face-to-face interactions. Taken together, our findings suggest that social interactions via different modalities contribute to well-being, but that face-to-face interactions have the biggest effect. In addition, there is some evidence that telephone and text-based interaction may play a compensatory role. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Person-Centered Associations between High- and Low-Risk Personality Profiles and Psychological Adjustment in University Students

Personality traits are considered potential risk or protective factors for learning and psychological adjustment. This is a concern in higher education settings, which comprise mostly youth in emerging adulthood. The purpose of this study is to apply a person-centered approach to identify personality profiles of university students based on their character traits and then evaluate whether some clusters predict differences in emotional distress and coping strategies. We conducted a cross-sectional web-based survey with 467 southern Italian undergraduate university students (M=21.8, SD=3.69). Students completed an anonymous online survey and self-report questionnaires measuring sociodemographic characteristics, personality traits (Personality Inventory for DSM-5), emotional distress (General Anxiety Disorders-7, Patient Health Questionnaire-9), and coping strategies (Brief-COPE). Two distinct clusters were identified, differing in relation to maladaptive personality traits. One was characterized by high maladaptive personality traits, comprising 45.6% of the sample population. This high-risk profile evidenced higher levels of negative affect, detachment, psychoticism, antagonism, and disinhibition. A second cluster, with low maladaptive personality traits, represented the remainder of the sample. Participants featuring high maladaptive personality traits reported lower functioning in terms of avoidant coping strategies in comparison to the second low-risk cluster. Generating profiles of latent traits, such as in cluster analysis, can enhance a more profound theoretical understanding of underlying patterns within personality traits. This can enable higher education settings to meet variations in student needs by adapting their support services and interventions. Students can be trained to use coping strategies more effectively and efficiently.

If looks could talk: Threat and familiarity influence with whom and how infants interact in ambiguous situations

AbstractWe investigated how apparent threat of an ambiguous stimuli modulates infants’ looking to interaction partners of varying familiarity (mother, familiar experimenter, unfamiliar experimenter). We hypothesized a preference for familiar informants under higher apparent threat, but a preference for unfamiliar informants under lower apparent threat. The informant encouraged infants (N = 104, 8–13 months) to cross a visual cliff in one of two apparent threat conditions (lower vs. higher drop‐off). Under lower threat, infants looked equally long to all informants, but switched gazes more often between their mother and the cliff. Infants explored the cliff more and crossed more often in the mother condition compared to the other two conditions. They also expressed less negative affect in the presence of the mother compared to the unfamiliar experimenter, but not compared to the familiar experimenter. Under high threat, a similar pattern emerged, except that looking duration to the unfamiliar informant was shorter compared to the low threat condition. Heart rate acceleration appeared when infants were placed on the cliff compared to a baseline phase. Higher levels of negative affectivity (but not higher arousal) were observed under higher compared to lower threat. Overall, we found little evidence of the influence of threat within the visual cliff task. We argue that infants may have perceived the cliff as quite challenging even in the lower threat condition and call for more research on the situational embeddedness of early social learning processes.

Where I'm Livin’ and How I'm Feelin’: Associations among community stress, gender, and mental-emotional health among Black Americans

RationaleStructural racism is a primary avenue for the perpetuation of racial health disparities. For Black Americans, both historically and contemporarily, the neighborhood context serves as one of the most striking examples of structural racism, with stressful neighborhood contexts contributing to the well-documented inequalities in psychological functioning among this population. ObjectiveThus, in this study, we adapted an intersectional-ecological framework to investigate the links between community stress and multiple dimensions of mental-emotional health for Black men and women. MethodsDrawing on cross-sectional data from 842 Black Americans from the Milwaukee area, we tested both objective (Area Deprivation Index; ADI) and subjective (perceived neighborhood disadvantage; PND) indicators of community stress as simultaneous predictors of negative and positive affect and the odds of psychological disorder (depression, anxiety) in multilevel models, examining gender differences in these linkages. ResultsResults showed greater objective community stress was related to lower levels of negative affect for both men and women and lower odds of psychological disorder for women specifically. Greater subjective community stress was related to higher levels of negative affect and lower levels of positive affect for both men and women and to higher odds of psychological disorder for women specifically. ConclusionsFindings highlight the complex intersectional nature of the links between community stress and Black Americans' mental-emotional health. Specifically, findings demonstrate the pernicious psychological effects of perceived community stress and allude to Black Americans', particularly women's, active resistance and resilience to objective disadvantage, potentially through investing in social relationships in their neighborhoods.

Negative Affect and Drinking among Indigenous Youth: Disaggregating Within- and Between-Person Effects

Negative affect (depression/anxiety) and alcohol use among Indigenous youth in Canada remain a concern for many communities. Disparate rates of these struggles are understood to be a potential outcome of colonization and subsequent intergenerational trauma experienced by individuals, families, and communities. Using a longitudinal design, we examined change in alcohol use and negative affect, and reciprocal associations, among a group of Indigenous adolescents. Indigenous youth (N = 117; 50% male; Mage=12.46–16.28; grades 6–10) from a remote First Nation in northern Quebec completed annual self-reported assessments on negative affect (depression/anxiety) and alcohol use. A Latent Curve Model with Structured Residuals (LCM-SR) was used to distinguish between- and within-person associations of negative affect and alcohol use. Growth models did not support change in depression/anxiety, but reports of drinking increased linearly. At the between-person level, girls reported higher initial levels of depression/anxiety and drinking; depression/anxiety were not associated with drinking. At the within-person level, drinking prospectively predicted increases in depression/anxiety but depression/anxiety did not prospectively predict drinking. When Indigenous adolescents reported drinking more alcohol than usual at one wave of assessment, they reported higher levels of negative affect than expected (given their average levels of depression/anxiety) at the following assessment. Our findings suggest that when Indigenous youth present for treatment reporting alcohol use, they should also be screened for negative affect (depression/anxiety). Conversely, if an Indigenous adolescent presents for treatment reporting negative affect, they should also be screened for alcohol use.

COVID-19 on mind: Daily worry about the coronavirus is linked to negative affect experienced during mind-wandering and dreaming.

Despite a surge of studies on the effects of COVID-19 on our well-being, we know little about how the pandemic is reflected in people's spontaneous thoughts and experiences, such as mind-wandering (or daydreaming) during wakefulness and dreaming during sleep. We investigated whether and how COVID-19-related general concern, anxiety, and daily worry are associated with the daily fluctuation of the affective quality of mind-wandering and dreaming, and to what extent these associations can be explained by poor sleep quality. We used ecological momentary assessment by asking participants to rate the affect they experienced during mind-wandering and dreaming in daily logs over a 2-week period. Our preregistered analyses based on 1,755 dream logs from 172 individuals and 1,496 mind-wandering logs from 152 individuals showed that, on days when people reported higher levels of negative affect and lower levels of positive affect during mind-wandering, they experienced more worry. Only daily sleep quality was associated with affect experienced during dreaming at the within-person level: on nights with poorer sleep quality people reported experiencing more negative and less positive affect in dreams and were more likely to experience nightmares. However, at the between-person level, individuals who experienced more daily COVID-19 worry during the study period also reported experiencing more negative affect during mind-wandering and during dreaming. As such, the continuity between daily and nightly experiences seems to rely more on stable trait-like individual differences in affective processing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predicting pointing from early socioemotional communication with mothers, fathers, and strangers through the lens of temperamental reactivity.

Socioemotional and referential communication are primary expressions of interpersonal engagement in infancy and beyond. Early socioemotional communication in dyadic interactions may form a foundation for triadic referential communication and gesture production, yet the role of temperament in moderating their association has not been examined. We investigated whether early socioemotional communication behaviors, and infant temperamental reactivity, were associated with later pointing production. Participants were 51 infants (45% girls) and both their parents (86.5% Dutch). Early infant socioemotional communication (production of smile, vocalizations, and gaze) was observed during separate home-based face-to-face interactions with mothers, fathers, and strangers at 4 and 8 months. At both ages, mothers and fathers reported on infant temperamental surgency and negative affectivity, and overall means were calculated. Referential communication (declarative pointing) was measured during structured lab-based observations at 12 and 15 months. Socioemotional and referential communication behaviors were microanalytically coded second by second. Poisson multilevel regression analyses indicated interaction effects between temperament and smile, vocalizations, and gazes to the adult's face with each partner in predicting pointing. High levels of infant temperamental surgency tended to enhance positive associations between early socioemotional communication behaviors with mothers and fathers and pointing. By contrast, high levels of negative affectivity tended to dampen associations between early communication behaviors with strangers and pointing. Results highlight the importance of infant socioemotional communication with diverse partners and the moderating role of temperamental reactivity in predicting referential communication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychosocial markers of pre-hospital delay in patients with diabetic foot: A cross-sectional survey.

This study aimed to determine the psychosocial markers associated with pre-hospital delay among patients with diabetic foot (DF). This study has a cross-sectional design. The participants completed a questionnaire including pre-hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale-14. Bivariate and multivariate analyses were conducted to explore independent associations with pre-hospital delay. Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self-management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China.