Lower Emotional Well-being Research Articles

Understanding fatigue among Japanese patients with inflammatory bowel disease: insights from international comparisons and meta-analysis.

Fatigue is a common symptom in patients with inflammatory bowel disease (IBD). The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale has demonstrated reliability and validity in assessing fatigue in patients with IBD and is used worldwide. This study aimed to examine the current state of fatigue among Japanese patients with IBD using the FACIT-F scale and to compare these findings with data from global studies through a systematic review. Data from 488 patients with IBD treated at a specialized IBD clinic were analyzed. Patient characteristics, such as sex, age, disease duration, disease activity, FACIT-F scores, and sleep duration, were collected. A literature search identified 8 studies that met our inclusion criteria for an international comparison. A meta-analysis was performed on the Fatigue Subscale (FS) scores of FACIT-F to estimate the pooled mean. The mean FACIT-F (FS) score in this study was 39.9 ± 8.6. Four variables were significantly associated with fatigue: low Emotional Well-Being subscale scores, sleep duration < 6 hours, albumin level below the reference value, and being unmarried. The meta-analysis revealed that the pooled mean score was 40.2 (95% confidence interval, 39.5-40.9), and between-study heterogeneity was moderate (I2 = 41%). The FACIT-F (FS) scores and related factors in Japanese patients with IBD demonstrated a similar trend to those in other countries. These findings can be used to identify patients in need of support and to consider interventions for modifiable factors. This study will help promote international collaborative research.

Smoking Among Healthcare Professionals in Australia: A Scoping Review.

Studies showed healthcare professionals who are non-smokers are more likely to deliver smoking cessation advice to their patients than those who are smokers. However, healthcare professionals continue to smoke across the globe. This scoping review assessed the available data on the prevalence and predictors of smoking among healthcare professionals in Australia. Following the PRISMA extension for the Scoping Review checklist, a systematic literature search was conducted on CINAHL, MEDLINE, APA PsycINFO, Scopus, Web of Science, and Cochrane Library in August 2024. Articles published between 1990 and 2024 were considered, and finally, 26 papers met the inclusion and exclusion criteria. Australian healthcare professionals showed varying smoking prevalence. For physicians, it was 10.2% in 1990 to 7.4% in 2013; among dentists, 6% in 1993 to 4.9% in 2004; and among nurses, 21.7% in 1991 and 10.3% during 2014-15. The highest smoking rates were observed among Aboriginal health workers (AHWs): 63.6% in 1995 to 24.6% in 2021. Age was a positive predictor for smoking among nurses, and so was male gender among dentists, physicians, and nurses; other predictors included area of specialty, lower emotional wellbeing, etc. This review highlighted a declining trend in smoking among healthcare professionals in Australia; however, it was not proportionate among the different health specialties.

Effects of pandemic on families, parenting stress, and emotional well-being of children in villages under Mugalur Subcentre, Sarjapur PHC, Bengaluru.

The COVID-19 pandemic has not only affected the health status of the population but has also had a serious impact on family dynamics, especially in the relationship between parents and children. Home confinement along with the closures of schools has had a strong negative impact on the psychosocial wellbeing of children. This study assesses the effects of the pandemic on families, parenting stress, and emotional well-being of children in villages under Mugalur Sub-centre, Sarjapur PHC, Bengaluru. A cross-sectional study was undertaken from January 2022 to April 2022 among parents having children in the age group of 4 to 10 years residing in villages under Mugalur Sub-center, Sarjapur PHC, Bengaluru District. The proportional allocation sampling method was followed to collect data from 210 participants using the effects of questionnaire, parent stress scale, and strength and difficulties questionnaire- parent version. Among 210 study participants, 105 (50%) were found to have moderate to high stress due to the pandemic. Parenting stress was found to be high in 40 (20%) parents and moderate in 63 (30%) parents. Assessment of the emotional well-being of children showed that 24 (11.5%) children have clinically significant problems. Significant associations were found between the effect of, parental stress and high parental stress correlated with low emotional well-being of children. This study emphasizes the urgent need for targeted mental health support for families, particularly during crises such as the pandemic. Interventions aimed at reducing parental stress and promoting children's emotional well-being are crucial for mitigating adverse effects and ensuring the long-term well-being of families and communities.

A Self-Guided Web-Based App (MyDiaMate) for Enhancing Mental Health in Adults With Type 1 Diabetes: Insights From a Real-World Study in the Netherlands.

MyDiaMate is a web-based intervention specifically designed for adults with type 1 diabetes (T1D) that aims to help them improve and maintain their mental health. Prior pilot-testing of MyDiaMate verified its acceptability, feasibility, and usability. This study aimed to investigate the real-world uptake and usage of MyDiaMate in the Netherlands. Between March 2021 and December 2022, MyDiaMate was made freely available to Dutch adults with T1D. Usage (participation and completion rates of the modules) was tracked using log data. Users could volunteer to participate in the user profile study, which required filling out a set of baseline questionnaires. The usage of study participants was examined separately for participants scoring above and below the cutoffs of the "Problem Areas in Diabetes" (PAID-11) questionnaire (diabetes distress), the "World Health Organization Well-being Index" (WHO-5) questionnaire (emotional well-being), and the fatigue severity subscale of the "Checklist Individual Strength" (CIS) questionnaire (fatigue). Two months after creating an account, study participants received an evaluation questionnaire to provide us with feedback. In total, 1008 adults created a MyDiaMate account, of whom 343 (34%) participated in the user profile study. The mean age was 43 (SD 14.9; 18-76) years. Most participants were female (n=217, 63.3%) and higher educated (n=198, 57.6%). The majority had been living with T1D for over 5 years (n=241, 73.5%). Of the study participants, 59.1% (n=199) of them reported low emotional well-being (WHO-5 score≤50), 70.9% (n=239) of them reported elevated diabetes distress (PAID-11 score≥18), and 52.4% (n=178) of them reported severe fatigue (CIS score≥35). Participation rates varied between 9.5% (n=19) for social environment to 100% (n=726) for diabetes in balance, which opened by default. Completion rates ranged from 4.3% (n=1) for energy, an extensive cognitive behavioral therapy module, to 68.6% (n=24) for the shorter module on hypos. There were no differences in terms of participation and completion rates of the modules between study participants with a more severe profile, that is, lower emotional well-being, greater diabetes distress, or more fatigue symptoms, and those with a less severe profile. Further, no technical problems were reported, and various suggestions were made by study participants to improve the application, suggesting a need for more personalization. Data from this naturalistic study demonstrated the potential of MyDiaMate as a self-help tool for adults with T1D, supplementary to ongoing diabetes care, to improve healthy coping with diabetes and mental health. Future research is needed to explore engagement strategies and test the efficacy of MyDiaMate in a randomized controlled trial.

Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors.

Familism, the cultural value that emphasizes feelings of loyalty and dedication to one's family, has been related to both positive and negative outcomes in Hispanic cancer survivors. One potential source of observed inconsistencies may be limited attention to the family environment, as familism may be protective in a cohesive family whereas it can exacerbate distress in a conflictive family. The current study explored the associations of familism with general and disease-specific health-related quality of life (HRQoL) in Hispanic men who completed prostate cancer (PC) treatment, and whether family cohesion may help explain these relationships. Hispanic men treated for localized PC (e.g., radiation, surgery) were enrolled in a randomized controlled stress management trial and assessed prior to randomization. Familism (familial obligation) was assessed using Sabogal's Familism Scale and family cohesion was measured using the Family Environment Scale (ranging from high to low). The sexual, urinary incontinence, and urinary obstructive/irritative domains of the Expanded Prostate Cancer Index Composite - Short Form measured disease-specific HRQoL. The physical, emotional, and functional well-being subscales of the Functional Assessment of Cancer Therapy - General captured general HRQoL. Hierarchical linear regression and the SPSS PROCESS macro were used to conduct moderation analyses, while controlling for relevant covariates. Participants were 202 older men on average 65.7 years of age (SD = 8.0) who had been diagnosed with PC an average of 22 months prior to enrollment. Familism was not directly associated with general and disease-specific HRQoL. Moderation analyses revealed that greater familism was related to poorer urinary functioning in the incontinence (p = .03) and irritative/obstructive domains (p = .01), and lower emotional well-being (p = .02), particularly when family cohesion was low. These findings underscore the importance of considering contextual factors, such as family cohesion, in understanding the influence of familism on general and disease-specific HRQoL among Hispanic PC patients. The combined influence of familism and family cohesion predicts clinically meaningful differences in urinary functioning and emotional well-being during the posttreatment phase. Culturally sensitive psychosocial interventions to boost family cohesion and leverage the positive impact of familistic attitudes are needed to enhance HRQoL outcomes in this population.

Optimizing geriatric palliative care in Egypt: Comprehensive patient and family perspectives.

In Egypt, palliative care for geriatric patients is understudied, necessitating exploration for service optimization. Amidst rising chronic illnesses and aging, understanding perspectives of geriatric patients and families is crucial for targeted improvements. This study aims to explore geriatric patients' and their families' perspectives on palliative care in Egypt, seeking opportunities to optimize service delivery for the elderly. Employing a cross-sectional design with 110 geriatric patients and an equal number of family caregivers from the Damietta Oncology Institute and the pain treatment clinics for cancer patients at Zagazig University Hospital, the study focuses on a specialized pain clinic. Validated tools (Palliative Care Outcome Scale, Family Satisfaction with End-of-Life Care [FAMCARE] Scale, Edmonton Symptom Assessment System [ESAS], Caregiver Strain Index [CSI]) assess quality of life, family satisfaction, symptom severity, and caregiver strain. Geriatric patients (mean age: 65.0 ± 8.1 years; 45.5% male, 55.5% female) have diverse diagnoses (e.g., breast cancer 22%). Palliative care outcomes reveal challenges: low emotional well-being (2.6 ± 0.0) and alarming overall quality of life (1.8 ± 0.0). Family dissatisfaction (FAMCARE) is pervasive (total mean score 2.6 ± 0.5). Symptom severity (ESAS) is high, and caregiver strain (CSI) is notable (8.5 ± 2.2). The findings underscore the significance of the challenges faced by geriatric patients and caregivers in palliative care. Patients confront considerable symptom burdens and emotional distress, while caregivers experience notable strain. Urgently needed are targeted interventions designed to enhance patient well-being, alleviate caregiver burden, and elevate satisfaction. The critical importance of implementing these interventions promptly is highlighted, as they are instrumental in improving the overall care experience for geriatric patients and their caregivers. Moreover, the results underscore the imperative of developing comprehensive support mechanisms to address the intricate dimensions of palliative care, ultimately contributing to a more compassionate and effective care continuum.

Impacts of sociodemographic factors, identities and neighbourhood safety on the relationship between urban green space and adolescent mental well-being: Findings from Tāmaki Makaurau Auckland, Aotearoa New Zealand

This study explored the relationship between green space accessibility (GSA) in residential area and adolescents’ mental well-being, and whether the relationship was moderated by sociodemographic factors (sex, ethnicity, neighbourhood deprivation), identities (gender and sexuality minority, disability) and perceived neighbourhood safety simultaneously. Data from 3813 adolescents who lived in Tāmaki Makaurau Auckland, Aotearoa New Zealand were obtained from the Youth19 Rangatahi Smart Survey. A Gaussian-based two-step floating catchment area method was employed to measure the spatial accessibility to green space at the neighbourhood level. The World Health Organization-5 Well-being Index was used to assess emotional well-being (EW), and the Reynolds Adolescent Depression Scale-short form was employed to measure depressive symptoms (DS). Through moderation analyses, results showed that perceived neighbourhood safety plays a vital role in the GSA – mental well-being association, with a negative trend in adolescents who reported being less safe in neighbourhoods. Adverse associations of GSA were found in gender and sexuality minority, disabled, Asian and Pacific adolescents, under the condition of not feeling safe in neighbourhoods all the time. The results showed marginalised adolescents tended to feel less safe in neighbourhoods, have lower EW and a higher level of DS. Additionally, the results from bivariate correlations showed there were inequalities in GSA for adolescents who lived in most deprived neighbourhoods and adolescents of Māori ethnicity. This study provides novel evidence of the importance of safe and inclusive green space for effectively promoting mental health and mitigating health inequalities of adolescents in urban areas.

Interpersonal Linkage in Positive and Negative Emotional Behaviors, Emotional Well-Being, and Physical Functioning in Dementia Caregivers

Caring for a person with dementia (PWD) can produce declines in caregivers’ emotional well-being and physical functioning, which could result from disruptions in the emotional linkage between PWDs and caregivers. We examined the effects of interpersonal linkage in emotional behaviors on emotional well-being and physical functioning in caregivers and control partners. Forty-five PWD–caregiver dyads and 12 control dyads had a 10-min unrehearsed conflict conversation in the laboratory. We quantified positive and negative emotional linkage as the covariation between objectively coded positive and negative emotional behaviors during the conversation. Caregivers and one partner in the control dyads completed questionnaires concerning their emotional well-being and physical functioning. We found that lower positive emotional linkage was associated with lower emotional well-being in caregivers and control partners. We did not find similar effects with negative emotional linkage or for physical functioning. We offer possible explanations for these findings and implications for assessing caregiver risk.

Teachers' psychological stress and wellbeing during a pandemic: Exploring latent profiles.

Teacher stress is at an all-time high. The COVID-19 pandemic created unprecedented challenges for teachers, which resulted in a record number of teachers intending to leave the classroom citing stress as a contributing factor. Understanding teachers' positive and negative psychological experiences, or well-being, during the height of the COVID-19 pandemic will inform teacher wellness interventions intended to keep teachers in the classroom. Two hundred forty-six teachers from a suburban school district participated in a survey of well-being indicators, including affect, perceived stress, teaching self-efficacy, and preventive coping. A latent profile analysis identified four patterns of well-being: strained, resilient, lower teaching self-efficacy, and lower emotional well-being. While many teachers were resilient during the crisis, approximately two-thirds experienced global or isolated areas of strain. Additionally, the Classroom Appraisal of Resources and Demands-Revised, a theory-driven assessment of teachers' workplace appraisal of demands and resources, was associated with teachers' strained and resilient well-being profiles, making it a suitable screening tool for these groups. Layered screening and tailored intervention, based on teachers' well-being patterns, may help minimize teacher attrition during and postcrises. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Well-being and stress vulnerability in ovarian cancer survivors during the COVID-19 pandemic

Objective: This study was designed to examine (1) whether ovarian cancer (OC) survivors would have greater well-being vs. elevated distress compared to community members during a universal health stressor (COVID-19) and (2) how resources and risk factors at diagnosis predicted vulnerability to a subsequent health-related stressor. Methods: One hundred seventeen OC survivors were recruited from two academic medical centers and compared to a community-based sample on COVID-related distress and disruption. Latent class analysis identified differentially impacted groups of survivors. Results: Survivors reported lower distress than community members. Predictors of higher distress included shorter-term survivorship, greater disruption, and poorer emotional well-­being (EWB) at diagnosis. Survivors were divided into high- and low-COVID-19-impact subgroups; high-impact individuals endorsed higher perceived stress and lower EWB at diagnosis. Conclusion: Survivors reported lower COVID-related distress than community participants. While depression at diagnosis did not predict later distress, EWB was a strong predictor of response to a novel health-related stressor.

The impact of sleep quality on health, participation and employment outcomes in people with spinal cord injury: Analyses from a large cross-sectional survey.

Poor sleep is common in people with spinal cord injury (SCI), yet little is known about its impact on employment and participation outcomes. This study aimed to (1) describe the sleep quality of a large sample of Australians with SCI and compare the results to data from an adult control and other clinical populations; (2) examine associations between sleep quality and participant characteristics; and (3) explore the relationship between sleep and outcomes. Cross-sectional data from the Australian arm of the International Spinal Cord Injury (Aus-InSCI) survey from 1579 community-dwelling people aged >18 years with SCI were analysed. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Relationships between participant characteristics, sleep quality and other outcomes were examined with linear and logistic regression. The PSQI was completed by 1172 individuals; 68% reported poor sleep (global PSQI score >5). Subjective sleep quality in people with SCI was poor (mean PSQI=8.5, SD 4.5) when compared to adults without SCI (PSQI=5.00, SD 3.37) and with traumatic brain injury (PSQI=5.54, SD 3.94). Financial hardship and problems with secondary health conditions were significantly associated with worse sleep quality (p<0.05). Poor sleep quality was strongly associated with lower emotional wellbeing and energy, and greater problems with participation (p<0.001). Individuals engaged in paid work reported better sleep quality (mean PSQI=8.1, SD 4.3) than unemployed individuals (mean PSQI=8.7, SD 4.6; p<0.05). Following adjustment for age, pre-injury employment, injury severity and years of education, better sleep quality remained strongly associated with being employed (OR 0.95, 95% CI 0.92 to 0.98; p=0.003). This study demonstrated pervasive and impactful relationships between sleep quality and important SCI outcomes. Poor sleep quality was strongly associated with worse emotional wellbeing and vitality, unemployment and lower participation. Future studies should aim to determine whether treating sleep problems can improve outcomes for people living with SCI.

Relationship between Dating Violence and Mental Health of Young Victims and Perpetrators: A Systematic Review

The objective of this study was to systematize knowledge from studies of the relationship between dating violence and mental health of victims and perpetrators. A systematic review of articles published from 1981 to 2021, with a population aged 12 to 29 years and English, Spanish, French, and Portuguese as the publication languages, was performed. The search was carry out in seven information sources: EBSCO, PsycINFO, PUBMED, ProQuest, ScienceDirect, SCOPUS, and WOS. Of the 2925 articles that were found, 27 studies were included (10 of which were longitudinal). An impact of dating violence on the mental health of adolescent victims was detected, with depression as the most frequently triggered effect in young people,followed by anxiety, suicidal ideation, low self-esteem, and low emotional well-being. The results indicate the need to design, implement, and evaluate different alternatives for the prevention of DV. In addition, in longitudinal studies, physical, psychological, and sexual dating violence victimization is associated with depressive symptoms, post-traumatic stress, suicidal ideation, and anxiety. In perpetrators of psychological dating violence, it is related todepressive symptoms, anxiety, and hostility. The findings of the present study can contribute to the creation of future research programs for promoting healthy couple relationships among adolescents and young people.

Psychological, endocrine and polygenic predictors of emotional well-being during the COVID-19 pandemic in a longitudinal birth cohort

The COVID-19 pandemic severely affected the lives of families and the well-being of both parents and their children. Various factors, including prenatal stress, dysregulated stress response systems, and genetics may have influenced how the stress caused by the pandemic impacted the well-being of different family members. The present work investigated if emotional well-being during the COVID-19 pandemic could be predicted by developmental stress-related and genetic factors. Emotional well-being of 7–10 year-old children (n = 263) and mothers (n = 241) (participants in a longitudinal German birth cohort (POSEIDON)) was assessed during the COVID-19 pandemic using the CRISIS questionnaire at two time periods (July 2020–October 2020; November 2020–February 2021). Associations of the children’s and mothers’ well-being with maternal perceived stress, of the children’s well-being with their salivary and morning urine cortisol at 45 months, and polygenic risk scores (PRSs) for depression, schizophrenia, loneliness were investigated. Lower emotional well-being was observed in both children and mothers during compared to before the pandemic, with the children’s but not the mothers’ emotional well-being improving over the course of the pandemic. A positive association between the child and maternal emotional well-being was found. Prenatally assessed maternal perceived stress was associated with a lower well-being in children, but not in mothers. Cortisol measures and PRSs were not significantly associated with the children’s emotional well-being. The present study confirms that emotional well-being of children and mothers are linked, and were negatively affected by the COVID-19 pandemic, with differences in development over time.

POSITIVE EMOTIONAL CONNECTION AND CAREGIVER WELL-BEING IN BEHAVIORAL-VARIANT FRONTOTEMPORAL DEMENTIA

Abstract Behavioral-variant frontotemporal dementia (bvFTD) is characterized by impairment in socioemotional functioning. Spouses caring for individuals with bvFTD often experience profound health/well-being declines, compared to Alzheimer’s disease (AD) caregivers and non-caregiving older adults. We hypothesized that disrupted positive emotional connections between spousal caregivers and individuals with bvFTD contribute to caregivers’ lower emotional well-being. 23 bvFTD-caregiver, 23 AD-caregiver, and 17 control dyads had a 10-minute conflict conversation in the laboratory. Positive emotional connections were measured as the covariation of partners’ positive emotional behaviors during the conversation. Caregiver emotional well-being was assessed via questionnaire (SF-36). We found that bvFTD caregivers had lower emotional well-being than AD caregivers and controls (who did not differ from each other, t=.80, p=.43), c=-.70, p&amp;lt;.01. Importantly, this effect was fully mediated by bvFTD caregivers' lower positive emotional connections, c’=-.38, n.s. We speculate that lower positive emotional connections can cause social isolation and contribute to bvFTD caregivers’ health/well-being declines.

LIMITED FUTURE TIME PERSPECTIVE IS ASSOCIATED WITH LOWER EMOTIONAL WELL-BEING DURING THE COVID-19 PANDEMIC

Abstract Socioemotional selectivity theory postulates that limited future time perspective (FTP) motivates older adults to prioritize emotionally meaningful goals, explaining documented age advantages in emotional well-being. During the early months of the COVID-19 pandemic, we collected data from 945 community dwelling adults and 156 assisted living facilities residents living in the United States (N= 1101, age-range: 18-98). Participants reported their FTP using the scale developed by Carstensen and Lang (1996), as well as the frequency and intensity of sixteen positive and thirteen negative emotions. Age association with limited FTP was comparable to past studies. Contrary to our hypotheses, limited FTP was associated with lower emotional well-being across ages and suppressed (rather than mediated) a general trend towards higher emotional well-being in older ages. Findings suggest that there may be conditions under which perceptions of limited time horizons have negative implications. Theoretical implications are discussed.

THE IMPACT OF A FACILITATED DISCUSSION SERIES IN IMPROVING DEMENTIA CAREGIVER STRESS, RESILIENCY, AND WELL-BEING

Abstract Emotional stress stemming from the complex grief associated with dementia care takes a greater toll on a family caregiver’s health than the physical effort of providing care. Finding Meaning and Hope, a 10-week workshop for caregivers of persons with dementia designed to promote understanding of grief and teach self-care concepts that mitigate stress. Each session features a video of a dementia care expert sharing strategies, followed by a facilitator-led discussion. Home practice activities help caregivers incorporate focal self-care strategies into their lives. This evaluation research assessed the association between workshop participation and caregiver outcomes in stress and well-being. 208 caregivers, 83 percent age 60 and older, completed the workshops between 2019 and 2021. Two standardized instruments were administered before and after workshop participation: the 12-item Caregiver Self-Assessment Questionnaire (American Medical Association, 2015) and the 11-item Sense of Competence Questionnaire (Vernooij-Dassen, 2008). Multivariate Linear Regression was used to assess factors associated with participant outcomes. Participation in more than half the sessions had a positive impact on stress management, emotional well-being, and coping, but fewer gains were made by caregivers with health limitations and those who began the workshops with lower emotional well-being ( F = 15.923, p &amp;lt; .001). Given that family caregivers’ mental and emotional health has been negatively impacted by the COVID-19 pandemic (Czeisler et al. 2020), strategies to manage stress and bolster well-being are vital in enabling them to continue care provision when isolation may exacerbate the challenges they encounter. Finding Meaning and Hope offers a promising approach.

POSITIVE AFFECT IN DEMENTIA CARE DYADS

Abstract Positive affect is important for physical health, well-being, and relationships. Yet, most studies of dementia care dyads have focused on negative outcomes, such as depression and caregiver burden. We present findings from studies that address this important research gap. The first two speakers present findings from actor partner interdependence models using secondary data from a randomized controlled trial of persons with early-stage dementia (PWD) and their spouses. Specifically, Dr. Monin will show that actor quality of life is significantly related to positive affect cross-sectionally, controlling for functional status of each partner and PWD behavioral symptoms. Ms. Piechota will present longitudinal findings demonstrating that when spouses were high in difficulty regulating emotions, the PWD’s positive affect decreased over three months, controlling for intervention arm and covariates. The second two speakers will present findings from two different studies of persons living with behavioral-variant frontotemporal dementia (bvFTD), Alzheimer’s disease (AD), and controls that engaged in laboratory conflict discussions. Dr. Brown will show that caregivers of individuals with bvFTD reported greater decreases in positive emotion across the discussion relative to caregivers of individuals with AD and language variants. She will also discuss how caregivers who reported greater decreases in positive emotion had higher levels of depressive symptoms, controlling for their partner’s diagnosis and level of cognitive impairment. Finally, Dr. Chen will provide evidence that bvFTD caregivers had lower emotional well-being according to the SF-36 than AD caregivers and controls, and this effect was fully mediated by bvFTD caregivers' lower positive emotional connections.

The Interplay of Emotions, Executive Functions, Memory and Language: Challenges for Refugee Children

Refugee children tend to show low emotional well-being and weak executive functions that may have consequences on language and therefore complicate a potential diagnosis of Developmental Language Disorder (DLD) in this population. We assessed the performance of 140 children living in Switzerland aged 5 to 8 (20 monolinguals, 86 non-refugee bilinguals, 34 refugee bilinguals) on LITMUS language tasks (nonword repetition, sentence repetition, parental questionnaire), standardized language tasks, memory and executive function tasks. Parents also filled in the Child Behavior Checklist providing a measure of their child’s emotional well-being. Results indicate that refugee children are more emotionally vulnerable and show weaker performance in memory and executive functions tasks compared to non-refugee children, in line with the existing literature. Moreover, when compared to non-refugee bilingual children with similar length of exposure to French, refugee children are disadvantaged on all language tasks. Whereas emotional well-being does not predict language performance, memory and executive functions show up as predictors of both LITMUS and standardized language tasks, although in an unsystematic way. It is concluded that refugee children are at risk across the board and that a better understanding of the complex interplay between well-being, executive functions, memory and language is needed in order to build more appropriate diagnostic tools for these children.

Time trends in emotional well-being and self-esteem in children and adolescents during the COVID-19 pandemic

ObjectiveGiven their unique COVID-19 pandemic experience, it is necessary to evaluate the mental health of youth beyond the initial stages of the pandemic, in relation to the stringency of the social distancing measures. We aimed to describe long-term trends in emotional well-being and self-esteem among youth in Japan during the pandemic.MethodUsing serial cross-sectional data from April 2020 to December 2021, we evaluated the trends in emotional well-being and self-esteem of youth aged 6–17 years using the self-report KINDL questionnaire, weighted to represent the age and gender distributions in the Japanese population. We then tested the associations between emotional well-being and self-esteem and stringency of social distancing policies, measured using the Oxford COVID-19 Stringency Index. Analyses were also stratified by gender and age group.ResultsThe emotional well-being and self-esteem of youth improved transiently in 2020, followed by a slight worsening trend into 2021. While emotional well-being stayed lower compared to initial levels nearly 2 years into the pandemic, self-esteem began to improve by late 2021. 12–17 year-olds had lower emotional well-being and self-esteem compared to 6–11 year-olds throughout the study period. Females had lower emotional well-being than males in May 2020 and lower self-esteem than males in May and September/October 2020. More stringent social distancing measures were associated with lower emotional well-being and self-esteem, especially 6–11 year-olds’ self-esteem and females’ emotional well-being.ConclusionDuring the COVID-19 pandemic, older youth tended to have lower emotional well-being and self-esteem than younger youth. Younger and female youth were especially vulnerable to stringent social distancing measures.

O046 Poor sleep quality is associated with unemployment and lower levels of participation in people living with spinal cord injury

Abstract Introduction Poor sleep is common among people with spinal cord injury (SCI), yet little is known about its impact on employment and participation outcomes. This study aimed to describe the sleep quality of a large sample of Australians with SCI; examine associations between sleep quality and participant characteristics; and explore the relationship between sleep and outcomes. Methods Cross-sectional Australian survey, including 1579 community-dwelling people with SCI, aged 18 years and over. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Relationships between participant characteristics, sleep and other outcomes were examined with linear and logistic regression. Results The PSQI was completed by 1172 individuals; 68.4% reported poor sleep (PSQI&amp;gt;5). Subjective sleep quality in people with SCI was poor (mean(SD) PSQI global score=8.5(4.5). Financial hardship and problems with other secondary health conditions were significantly associated with worse sleep quality (p&amp;lt;0.05). Poor sleep quality was strongly associated with lower emotional wellbeing and energy, and greater problems with participation (p&amp;lt;0.001). Individuals engaged in paid work reported better sleep quality than unemployed individuals (mean(SD) PSQI=8.1(4.3) vs 8.7(4.6), p&amp;lt;0.05). Following adjustment for age, pre-injury employment, injury severity and years of education, better sleep quality remained strongly associated with being employed (OR=0.95, 95% CI=0.92-0.98), p=0.003). Conclusions This study has demonstrated pervasive and impactful relationships between sleep quality and important SCI outcomes. Poor sleep quality was strongly associated with worse emotional wellbeing and vitality, unemployment and lower participation. Determining whether treating sleep problems can improve outcomes for people living with SCI deserves more attention.