Low Positive Affect Research Articles

Recurrence of depression can be foreseen by monitoring mental states with statistical process control.

Detecting early signs of recurrence of psychopathology is key for prevention and treatment. Personalized risk assessment is especially relevant for formerly depressed patients, for whom recurrence is common. We aimed to examine whether recurrence of depression can be accurately foreseen by applying Exponentially Weighted Moving Average (EWMA) statistical process control charts to Ecological Momentary Assessment (EMA) data. Participants were formerly depressed patients (n = 41) in remission who (gradually) discontinued antidepressants. Participants completed five smartphone-based EMA questionnaires a day for 4 months. EWMA control charts were used to prospectively detect structural mean shifts in high and low arousal negative affect (NA), high and low arousal positive affect (PA), and repetitive negative thinking in each individual. A significant increase in repetitive negative thinking (worry, negative thoughts about the self) was the most sensitive early sign of recurrence: this was detected in 18 out of 22 patients (82%) before recurrence and in 8 out of 19 patients (42%) who stayed in remission. A significant increase in NA high arousal (stress, irritation, restlessness) was the most specific early sign of recurrence: this was detected in 10 out of 22 patients (45%) before recurrence and in 2 out of 19 patients (11%) who stayed in remission. These mean changes were detected at least a month before recurrence in the majority of the participants. The outcomes were robust across EWMA parameter choices, but not when using fewer observations per day. The findings demonstrate the value of monitoring EMA data with EWMA charts for detecting prodromal symptoms of depression in real-time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social anxiety inhibits needs repair following exclusion in both relational and non-relational reward contexts: The mediating role of positive affect

The pain of social exclusion can motivate people to capitalize on opportunities to reconnect with others and repair their self-esteem and feelings of belongingness. This effect is often diminished for those with high social anxiety (HSA). Prior research suggests this may be due to their diminished capacity for recognizing and emotionally responding to relational reward cues. We investigated whether non-relational success experiences in the aftermath of exclusion may be an alternative means of repairing threatened self-esteem and belongingness in HSA individuals. In a preregistered, online study, we threatened belongingness and self-esteem in 422 participants by excluding them in a Cyberball game and then assigned them to one of three conditions: Relational Repair, Non-Relational Repair, or a No-Repair control condition. Results showed that both repair contexts facilitated needs repair relative to the no-repair control condition, and mediation analyses suggested this effect was driven by increased positive affect (PA). HSA individuals were less likely to restore needs regardless of condition and this effect appeared to be driven by low PA. Findings emphasize the critical role of PA for restoring threatened needs in the aftermath of exclusion and suggest that HSA inhibits needs repair processes across both relational and non-relational reward contexts.

Optimists and Realists: A Latent Class Analysis of Students Graduating from High School during COVID-19 and Impacts on Affect and Well-Being.

The Novel Coronavirus Disease (COVID-19) pandemic has had profound effects on physical and mental health worldwide. Students transitioning out of high school were uniquely impacted at the onset of the pandemic, having missed the opportunity to properly mark the end of their final year in the K-12 school system. The adverse effects of this loss on this population are still unknown. The purpose of the current study was to examine stress, wellbeing, and affect in a sample of 168 students (N = 168; Mage = 17.0, SD = 0.46; 60% female; 40% male) who were completing their final year of high school during the early stages of the pandemic when emergency stay-at-home orders were in place. Participants completed an online survey assessing the impact of COVID-19 on their life satisfaction (pre-COVID19, during COVID-19, and anticipated five years from now), stress, positive affect, and negative affect. Latent class analysis (LCA) was used to create classes of participants based on their responses to the pandemic. A two-subgroup solution provided the best model for the life satisfaction outcome variable. Subgroup 1, optimists, comprised 24% (N = 40) of the sample and reported high life satisfaction ratings one year prior to COVID-19 and a slight decrease in life satisfaction during COVID-19, and they anticipated an increase in life satisfaction 5 years from now. This group was characterized by low stress, low negative affect, and high positive affect during the pandemic. Subgroup 2, realists, comprised 76% of the population (N = 128) and experienced similarly high retrospective ratings of pre-COVID life satisfaction but a larger decrease in life satisfaction during the pandemic and a smaller increase in five years. The realist group was characterized by low positive affect, high stress, and high negative affect during the pandemic. The findings suggest that during the pandemic, certain subsamples of adolescents had greater difficulty in managing this transitional period and experienced changes in mood and well-being (i.e., affect, stress) as compared to other adolescents (i.e., optimists). Future research should investigate the characteristics and coping mechanisms that are instrumental for increasing life satisfaction and positive affect while lowering stress in this population.

Associations of Physical Activity and Sedentary Behavior with Optimism and Positive Affect in Older Women

Psychological well-being is linked to healthy aging in older women, but associations with health behaviors are not well understood. Our study aims to evaluate the relationships between objectively-measured physical behavior (including physical activity and sedentary behavior) with optimism and positive affect in a diverse sample of older women. Our cross-sectional study of 4168 American women (aged 63–99) with accelerometer-measured physical behavior from the Objective Physical Activity and Cardiovascular Health Study assessed associations using multiple linear regression. Effect modification by age, race and ethnicity, social support, and number of chronic conditions was examined as well. In unadjusted models, positive associations for physical activity and negative associations for sedentary behaviors were generally linear for optimism and positive affect. In adjusted models, every one-hour increment in weekly moderate-vigorous physical activity was associated with higher optimism by 0.4 score points [Revised 6-item Life Orientation Test, 95% CI = 0.2, 0.6] and positive affect by 0.6 score points [modified Differential Emotions Scale, 95% CI = 0.2, 0.9]. One-hour increments in light physical activity were associated with higher positive affect [0.2 score points; 95% CI = 0.03, 0.33] while one-hour increments in sedentary behavior patterns were associated with lower positive affect [-0.1 score points; 95% CI = − 0.10, − 0.02). Effect modification by age, race and ethnicity, social support, and number of chronic conditions was not observed. In conclusion, associations between physical behavior with optimism and positive affect were modest but suggest greater activity and less sedentary time are associated with greater psychological well-being in older women.

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.

Daily experiences and well-being of Chinese parents of children with autism.

The present study examined the influences of child-related stress, parental coping and social support on parental daily subjective well-being (i.e. positive and negative affect, life satisfactory) in Chinese families of children with autism spectrum disorder. For 14 days, a total of 76 parents (58 mothers) participated in the study and completed daily diaries. For mothers, child-related stress was related to lower life satisfaction; social support was related to higher life satisfaction that day. These daily relations were not found for fathers. Across all parents, avoidant coping was associated with higher negative affect and lower positive affect on the same day. Notably, daily positive coping was related to greater same-day positive affect as well as greater same-day and next-day life satisfaction. Interventions aimed at increasing positive coping and social support, and reducing child-related stress and avoidant coping are important to help parents maintain well-being, particularly for mothers of children with autism.

Moment-to-moment affective dynamics in schizophrenia and bipolar disorder.

Affective disturbances in schizophrenia and bipolar disorder may represent a transdiagnostic etiological process as well as a target of intervention. Hypotheses on similarities and differences in various parameters of affective dynamics (intensity, successive/acute changes, variability, and reactivity to stress) between the two disorders were tested. Experience sampling method was used to assess dynamics of positive and negative affect, 10 times a day over 6 consecutive days. Patients with schizophrenia (n=46) and patients with bipolar disorder (n=46) were compared against age-matched healthy controls (n=46). Compared to controls, the schizophrenia group had significantly more intense momentary negative affect, a lower likelihood of acute changes in positive affect, and reduced within-person variability of positive affect. The bipolar disorder group was not significantly different from either the schizophrenia group or the healthy control group on any affect indexes. Within the schizophrenia group, level of depression was associated with weaker reactivity to stress for negative affect. Within the bipolar disorder group, level of depression was associated with lower positive affect. Patients with schizophrenia endured a more stable and negative affective state than healthy individuals, and were less likely to be uplifted in response to happenings in daily life. There is little evidence that these affective constructs characterize the psychopathology of bipolar disorder; such investigation may have been limited by the heterogeneity within group. Our findings supported the clinical importance of assessing multiple facets of affective dynamics beyond the mean levels of intensity.

Mapping the mental space of emotional concepts through kinematic measures of decision uncertainty.

Emotional concepts and their mental representations have been extensively studied. Yet, some ecologically relevant aspects, such as how they are processed in ambiguous contexts (e.g., in relation to other emotional stimuli that share similar characteristics), are incompletely known. We employed a similarity judgement of emotional concepts and manipulated the contextual congruency of the responses along the two main affective dimensions of hedonic valence and physiological activation, respectively. Behavioural and kinematics (mouse-tracking) measures were combined to gather a novel 'similarity index' between emotional concepts, to derive topographical maps of their mental representations. Self-report (interoceptive sensibility, positive-negative affectivity, depression) and physiological measures (heart rate variability, HRV) have been collected to explore their possible association with emotional conceptual representation. Results indicate that emotional concepts typically associated with low arousal profit by contextual congruency, with faster responses and reduced uncertainty when contextual ambiguity decreases. The emotional maps recreate two almost orthogonal axes of valence and arousal, and the similarity measure captures the smooth boundaries between emotions. The emotional map of a subgroup of individuals with low positive affectivity reveals a narrower conceptual distribution, with variations in positive emotions and in individuals with reduced arousal (such as those with reduced HRV). Our work introduces a novel methodology to study emotional conceptual representations, bringing the behavioural dynamics of decision-making processes and choice uncertainty into the affective domain. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Introducing a Real-Time Method for Identifying the Predictors of Noncompliance with Event-Based Reporting of Tobacco Use in Ecological Momentary Assessment.

Little is known about the factors that bias event-based (i.e., self-initiated) reporting of health behaviors in ecological momentary assessment (EMA) due to the difficulty inherent to tracking failures to self-initiate reports. To introduce a real-time method for identifying the predictors of noncompliance with event-based reporting. N = 410 adults who used both cigarettes and e-cigarettes completed a 1-week EMA protocol that combined random reporting of current contexts with event-based reporting of tobacco use. Each random assessment first asked if participants were currently using tobacco and, if so, the assessment converted into a "randomly captured" event report-indicating failure to self-initiate that report. Multilevel modeling tested predictors of failing to complete random reports and failing to self-initiate event reports. On the person level, male sex, higher average cigarette rate, and higher average cigarette urge each predicted missing random reports. The person-level predictors of failing to self-initiate event reports were older age, higher average cigarette and e-cigarette rates, higher average cigarette urge, and being alone more on average; the moment-level predictors were lower cigarette urge, lower positive affect, alcohol use, and cannabis use. Strikingly, the randomly captured events comprised more of the total EMA reports (28%) than did the self-initiated event reports (24%). These report types were similar across most variables, with some exceptions, such as momentary cannabis use predicting the random capture of tobacco events. This study demonstrated a method of identifying predictors of noncompliance with event-based reporting of tobacco use and enhancing the real-time capture of events.

The dimensional structure of internalizing psychopathology: Relation to diagnostic categories.

Recent approaches aim to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested sub-dimensions within internalizing psychopathology. This study tests pre-registered models of the dimensional structure of internalizing psychopathology, and their relations with current and lifetime depressive and anxiety disorders diagnostic data, in adult samples harmonized across three sites (n=427). Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.

Different trajectories of depression, anxiety and anhedonia symptoms in the first 12 months of the COVID-19 pandemic in a UK longitudinal sample.

While studies from the start of the COVID-19 pandemic have described initial negative effects on mental health and exacerbating mental health inequalities, longer-term studies are only now emerging. In total, 34 465 individuals in the UK completed online questionnaires and were re-contacted over the first 12 months of the pandemic. We used growth mixture modelling to identify trajectories of depression, anxiety and anhedonia symptoms using the 12-month data. We identified sociodemographic predictors of trajectory class membership using multinomial regression models. Most participants had consistently low symptoms of depression or anxiety over the year of assessments (60%, 69% respectively), and a minority had consistently high symptoms (10%, 15%). We also identified participants who appeared to show improvements in symptoms as the pandemic progressed, and others who showed the opposite pattern, marked symptom worsening, until the second national lockdown. Unexpectedly, most participants showed stable low positive affect, indicating anhedonia, throughout the 12-month period. From regression analyses, younger age, reporting a previous mental health diagnosis, non-binary, or self-defined gender, and an unemployed or a student status were significantly associated with membership of the stable high symptom groups for depression and anxiety. While most participants showed little change in their depression and anxiety symptoms across the first year of the pandemic, we highlight the divergent responses of subgroups of participants, who fared both better and worse around national lockdowns. We confirm that previously identified predictors of negative outcomes in the first months of the pandemic also predict negative outcomes over a 12-month period.

Variability in state authenticity predicts daily affect and emotion regulation.

Authenticity can be defined as congruence between one's outer behavior and one's feelings or sense of self. People can experience moments of lower congruence in their day-to-day lives. Authenticity variability refers to fluctuations over time in momentary congruence. We propose that authenticity variability is linked to lower emotional well-being (i.e., more negative affect and less positive affect) and greater need for emotion regulation. College students (N = 174) participated in an experience sampling study (4×/day for 7 days) assessing state-level authenticity, affect, and emotion regulation during social interactions. State authenticity demonstrated greater within-person than between-person variability, underscoring the importance of considering how experiences of authenticity vary across contexts rather than focusing on individual differences in authenticity. At the within-person level, heightened state authenticity was associated with lower negative affect, higher positive affect, and lower emotion regulation efforts. In contrast, authenticity variability predicted greater negative affect, lower positive affect, and greater effort to regulate emotions, as expected. The variability effects became nonsignificant, however, when controlling for mean state authenticity. Overall, these findings suggest authenticity is highly variable over time and linked to key affective processes in daily life. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neighbourhood socio-economic status and positive affectivity among older residents in Germany: a cross-sectional analysis with data from the Heinz Nixdorf Recall Study

BackgroundPhysical and social neighbourhood characteristics can vary according to the neighbourhood socio-economic status (SES) and influence residents’ perceptions, behaviours and health outcomes both positively and negatively. Neighbourhood SES has been shown to be predictive of mental health, which is relevant for healthy ageing and prevention of dementia or depression. Positive affectivity (PA) is an established indicator of mental health and might indicate a positive emotional response to neighbourhood characteristics. In this study, we focussed on the association of neighbourhood SES with PA among older residents in Germany and considered social integration and environmental perceptions in this association.MethodsWe used questionnaire-based data of the ongoing population-based Heinz Nixdorf Recall Study for our cross-sectional analysis, complemented by secondary data on social welfare rates in the neighbourhood of residents’ address. PA was assessed using the Positive and Negative Affect Schedule (PANAS) in 2016. Linear regression models were performed to estimate the associations and adjusted for socio-demographic variables.ResultsHigher social welfare rates were associated with lower PA scores. The strongest negative association from the crude model (b = −1.916, 95%-CI [−2.997, −0.835]) was reduced after controlling for socio-demographic variables (b = −1.429, 95%-CI [−2.511, −0.346]). Social integration factors (b = −1.199, 95%-CI [−2.276, −0.121]) and perceived environmental factors (b = −0.875, 95%-CI [−1.971, 0.221]) additionally diminished the association of social welfare rates with PA in the full model (b = −0.945, 95%-CI [−2.037, 0.147]).ConclusionOur results suggest that neighbourhoods have an influence on the occurrence and the extent of PA. Public health interventions that address socio-economic disadvantage in the neighbourhood environment could be an effective and far-reaching way to reduce the risk of depression and depressive symptoms due to low PA in older residents.

Ambient air pollution exposure and depressive symptoms: Findings from the French CONSTANCES cohort

Background and AimFew studies have reported the association between air pollution exposure with different dimensions of depression. We aimed to explore this association across different dimensions of depressive symptoms in a large population. MethodsData from the enrollment phase of the French CONSTANCES cohort (2012–2020) were analyzed cross-sectionally. Annual concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) from the land-use regression models were assigned to the residential addresses of participants. Total depressive symptoms and its four dimensions (depressed affect, disturbed interpersonal relations, low positive affect, somatic complaints) were measured using Centre of Epidemiologic Studies Depression questionnaire (CES-D). We reported results of negative binomial regression models (reported as Incidence Rate Ratio (IRR) and 95 % confidence interval (CI) for an interquartile range (IQR) increase in exposure), for each pollutant separately. Stratified analyses were performed by sex, income, family status, education, and neighborhood deprivation. ResultsThe study included 123,754 participants (mean age, 46.50 ± 13.61 years; 52.4 % women). The mean concentration of PM2.5, BC and NO2 were 17.14 µg/m3 (IQR = 4.89), 1.82 10-5/m (IQR = 0.88) and 26.58 µg/m3 (IQR = 17.41) respectively. Exposures to PM2.5, BC and NO2 were significantly associated with a higher CES-D total (IRR = 1.022; 95 % CI = 1.002: 1.042, IRR = 1.027; 95 % CI = 1.013: 1.040, and IRR = 1.029; 95 % CI = 1.015: 1.042 respectively), and with depressed affect, and somatic complaints. For all pollutants, a higher estimate was observed for depressed affect. We found stronger adverse associations for men, lower-income participants, low and middle education groups, those living in highly deprived areas, and single participants. ConclusionOur finding could assist the exploration of the etiological pathway of air pollution on depression and also considering primary prevention strategies in the areas with air pollution.

Solitude and affect during emerging adulthood: When, and for whom, spending time alone is related to positive and negative affect during social interactions

The present study examines within- and between-person associations between emerging adults’ daily time spent alone and their positive/negative affect during social interactions. We also consider whether motivations for seeking solitude (shyness, unsociability, avoidance) moderate these associations. Participants were 411 emerging adults (ages 18–26 years; 51% female; 52% ethnic minority) who reported on their motivations for solitude and completed daily reports of their time spent alone and positive/negative affect experienced during social interactions for 7 consecutive days. Among the results, multi-level modeling indicated that on days when emerging adults spent more time alone than usual, they experienced increased levels of high and low arousal positive affect when they interacted with others. Interactions between shy and avoidant motivations and change in time spent alone also emerged, with follow-up analyses indicating that for highly and moderately shy and avoidant emerging adults, days with more time spent alone than usual were associated with greater reports of anxious affect during social interactions. Findings suggest that although many emerging adults may find social interactions more enjoyable on days with increased time alone, those who actively seek solitude as an escape from perceived stressful or unpleasant social circumstances may not.

Bi-Directional Associations of Affective States and Diet among Low-Income Hispanic Pregnant Women Using Ecological Momentary Assessment

Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Women (N = 57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI.

Affective Profiles and Psychosocial Adjustment among Chinese Adolescents and Adults with Adverse Childhood Experiences: A Person-Centered Approach.

PurposeTwo studies were conducted to explore the patterns of positive affect (PA) and negative affect (NA) while considering collectivist cultural specificity (dialecticism) and to examine the associations of affective profiles with psychosocial adjustment.MethodsWe used two Chinese samples, one comprising adults with adverse childhood experiences (N = 488) and one comprising ordinary adolescents (N = 635). The participants completed scales on PA, NA, and psychosocial adjustment, including mental health problems (depressive symptoms, anxiety), personal strengths (self-esteem, gratitude, resilience), and life satisfaction.ResultsThree profiles were identified through latent profile analysis: well-adjusted (high PA, low NA), low affective (low PA, low NA), and moderate affective (moderate PA, moderate NA). Participants in the well-adjusted profile had the fewest mental health problems (depressive symptoms, anxiety) and scored highest on personal strengths (self-esteem, gratitude, resilience) and life satisfaction. Participants in the low affective profile had fewer mental health problems than those in the moderate affective profile.ConclusionIndividual differences and cultural variations should be considered when exploring affective profiles. Future interventions aimed at promoting affective well-being should accommodate dialecticism and individual differences in the target population.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10902-022-00566-7.

The costs of anticipating and perseverating about racism: Mechanisms of the associations between racial discrimination, anxious arousal, and low positive affect.

The goal of this study was to test a new etiological model of how racial discrimination is associated with anxious arousal and low positive affect. The overarching model posits that racial discrimination will be associated with anxious arousal and low positive affect through prolonged activation of race-related stress processes (i.e., anticipatory race-related fear and race-related rumination), the effects of which are conditioned on attention bias to threat. A total of 326 Black participants (72.4% women) completed the study. For anxious arousal, the indirect effect of racial discrimination through anticipatory race-related fear depended on degree of attention bias, with the effect only reaching statistical significance at mean and relatively higher levels of attention bias to threat. For low positive affect, the indirect effect of racial discrimination through race-related rumination only reached a statistical significance at mean and relatively lower levels of attention bias to threat. Racial discrimination is indirectly associated with anxious arousal and low positive affect through the effects of anticipatory race-related fear and race-related rumination, respectively. Implications for etiology and treatment of anxious arousal and low positive affect are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact of childhood trauma and daily life experiences on emotional and psychotic symptom intensity in psychosis: An experience sampling study

Adverse childhood experiences create vulnerability to psychosis through biological and cognitive changes, and that may be observed as an increased emotional and psychotic response to daily life experiences in adulthood. This study aims to examine the effects of childhood maltreatment on psychotic patients' daily stress and emotional and psychotic intensity related to various experiences throughout the day. Daily activities and events, and emotional and psychotic intensity of forty-one psychotic patients were assessed with the Experience Sampling Method. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood adversities. Multilevel regression analyses showed that all trauma subtypes, except for sexual abuse, were associated with increased psychosis and event-stress. Emotional maltreatment was the most associated trauma type with high negative and low positive affect and increased daily stress. Patients reported the highest stress and negative affect related to internal experiences but the lowest stress related to recreational actions. Social activities were also associated with higher positive affect and lower stress and psychosis, with the high CTQ group having greater stress in those activities. Our study demonstrates the negative impact of childhood trauma, especially emotional maltreatment, on daily stress and emotional and psychotic intensity in psychotic patients via different daily experiences.

Muffins and Meditation: Combatting Burnout in Surgical Residents

To quantify the prevalence of burnout in our surgical residency program and to assess the impact of a weekly wellness program for surgical residents through validated tools measuring mindfulness, self-compassion, flourishing, and burnout. Our hypothesis was that participants with more frequent attendance would: (1) be more mindful and self-compassionate and (2) experience less burnout and more flourishing. An optional one-hour weekly breakfast conference was facilitated by a senior surgical faculty member with the time protected from all clinical duties. Following a guided meditation, participants were given time for reflection and dialogue about their training experiences or led in a wellness exercise. TRANCE (tolerance, respect, anonymity, nonretaliation, compassion, egalitarianism) principles were utilized to create a safe and open environment. Residents were surveyed at the end of the study period, which was from March 2017 through June 2018. The conference and data analysis was conducted at Denver Health Medical Center, affiliated with the University of Colorado School of Medicine. This study analyzed survey responses from 85 surgical residents. Following the wellness program, when answering the 2-question Maslach Burnout Inventory, 35.7% of residents reported feeling burned out by their work once a week or more, and 29.7% reported feeling more callous toward people once a week or more. After multivariate analysis, the only independent predictors of increased burnout were "not being married or in a committed relationship," lower positive affect, and higher negative affect. Written feedback was overwhelmingly positive, and residents expressed gratitude for the conference, the opportunity for self-reflection, and open dialogue with attendings and colleagues. The prevalence of burnout is high among surgical residents. Allowing time to practice a mindfulness meditation while providing space for residents to share their experiences may be protective, and efforts should be made to reduce barriers to participation.