Lower Levels Of Mental Health Research Articles

Living in Camps Impacts on the Mental Health and Quality of Life of Displaced People in Northwest Syria

The research aimed to study the impact of living in displacement camps on mental health and Quality of life among Syrians in Northwest Syria. A descriptive and analytical approach was utilized, where two scales of mental health (SCL – 90 - R) and Quality of life (WHOQOL – BREF) were applied, with (306) participants. Results show that symptoms of mental health disorders appear at different levels, where the most common disorder is Depression, and the least common is Psychoticism. Quality of life results show that the most common issue was General Health, and the least common was environmental health. Differences between educational status and gender were statistically significant when studying the presence of mental health disorders, where it was lower in males than in females. Quality of life results showed significant differences between all demographic characteristics except the duration of stay in the camp. It was higher in females than in males. It was higher among the employed than the unemployed, and the age (under 18 years) had the highest Quality of life .Regarding marital status, it was highest in the (single and widowed). The Quality of life was highest among the university degree holders. There was a moderate and inverse correlation between Symptoms of mental health disorders and Quality of life, where the correlation coefficient was (-0.382), and this indicates a lower level of mental health with increasing deterioration in Quality of life. The results showed that Quality of life contributes to interpreting the variance in Symptoms of mental health disorders. The beta value (β = - 0.391) means that whenever Quality of life improved by one unit, Symptoms of mental health disorders decreased by (0.391) unit . To conclude, quality of life statistically significantly contributes to explaining mental health disorders among Syrians in displaced camps.

An exploration of the most frequent comorbidities in patients with mobile phone addiction

IntroductionMobile phone addiction (MPA) has been associated in the literature with various psychiatric comorbidities and psychological risk factors, which indicates the need to screen these patients for multiple disorders. However, a clear protocol for the evaluation of individuals with an MPA does not yet exist, therefore, investigating the most prominent risks for comorbidities is considered necessary from the perspective of developing structured methods of assessment.ObjectivesThe main objective of this review was to determine the available existence able to describe the most common comorbidities in individuals presenting with MPA.Methods Data regarding MPA were collected from the main medical electronic databases (PubMed, Cochrane, Clarivate/Web of Science), but also from other sources (main engines research and grey literature). All published papers between January 2000 and July 2023 were included in the primary selection, if they corresponded to the paradigm „mobile phone addiction”/”cell phone addiction”/”mobile phone dependence” and „comorbidity”/”dual diagnosis”.ResultsBased on the review of six papers, the most frequently reported comorbidity in MPA patients were substance use disorders (mainly nicotine and cannabis) and other behavioral addictions (especially problematic Internet use). Other symptoms or syndromes reported in the literature as co-occurring with MPA were anxiety, depression, high levels of stress-related pathology, sleep disturbances, emotional instability, and somatization. Overall lower levels of mental health were reported in patients with MPA. A heterogeneity in the results of these epidemiological studies was observed because of the different instruments administered and the populations explored.ConclusionsThe screening for detection of comorbid disorders or psychological problems in patients with MPA is important because the case manager should integrate all this information into a therapeutic strategy.Disclosure of InterestNone Declared

Mental Health, Subjective Well-Being, and Academic Performance in Chilean Schoolchildren Who Are Part and Are Not Part of the School Inclusion Program

Inclusive education acknowledges and values the capabilities and needs of every student. Exploring their perceptions of psychosocial variables and academic performance can significantly enhance inclusive practices and improve overall school performance, particularly for students with special educational needs (SEN). This study aimed to assess mental health, subjective well-being, and academic performance among students in the school inclusion program (SIP) and those not in the program. Conducted as an analytical cross-sectional study, this research endeavor entailed the utilization of a probabilistic, stratified sampling approach designed to ensure community representativeness. The study sample encompassed a cohort of 730 school students aged between 10 and 15 years (M = 12; SD = 1.3 years) representing five different public schools in the Biobío region, all integrating SIPs into their educational structure. Student assessments involved the Rosenberg Self-Esteem Scale, Beck Anxiety Inventory, and Subjective Happiness Scale. Additionally, their academic performance was measured based on grade point averages (GPAs) and final accumulated grades in language and literature as well as mathematics. Students enrolled in the SIP obtained lower scores in the self-esteem, anxiety, and happiness assessments along with poorer academic performance compared to their non-SIP counterparts. Consequently, students participating in the SIP displayed lower levels of mental health and subjective well-being along with inferior academic performance in contrast to their non-participating counterparts. These findings are alarming, as SIP implementation is a key strategy for promoting inclusive education in Chile and enhancing the learning of all students, especially those with SEN.

Cognitive difficulties following adversity are not related to mental health: Findings from the ABCD study.

Early life adversity is associated with differences in cognition and mental health that can impact on daily functioning. This study uses a hybrid machine-learning approach that combines random forest classification with hierarchical clustering to clarify whether there are cognitive differences between individuals who have experienced moderate-to-severe adversity relative to those have not experienced adversity, to explore whether different forms of adversity are associated with distinct cognitive alterations and whether these such alterations are related to mental health using data from the ABCD study (n = 5,955). Cognitive measures spanning language, reasoning, memory, risk-taking, affective control, and reward processing predicted whether a child had a history of adversity with reasonable accuracy (67%), and with good specificity and sensitivity (>70%). Two subgroups were identified within the adversity group and two within the no-adversity group that were distinguished by cognitive ability (low vs high). There was no evidence for specific associations between the type of adverse exposure and cognitive profile. Worse cognition predicted lower levels of mental health in unexposed children. However, while children who experience adversity had elevated mental health difficulties, their mental health did not differ as a function of cognitive ability, thus providing novel insight into the heterogeneity of psychiatric risk.

Post-traumatic responses to workplace violence among nursing professionals: a collaborative and comparative study in South Korea and Hong Kong

BackgroundWorkplace violence has had a significant and negative psychological impact on nursing professionals worldwide. Concerted worldwide efforts to improve work environments have not yet removed nursing professionals from the threat of violence. It is highly essential to conduct comparative research in various working environments where the nurses of each country have unique experiences of workplace violence. The aim of this study was to examine the differences in the rate, associated factors, and post-traumatic responses to workplace violence between South Korean and Chinese nurses in Hong Kong among East Asian countries.MethodsA cross-sectional, correlational study design recruited a total of 471 registered nurses (319 South Korean nurses and 152 Chinese nurses in Hong Kong; overall response rate = 78.5%) at online communities in South Korea and Hong Kong. The data were collected by conducting a Qualtrics survey from January 15, 2020, to July 24, 2021. A structured questionnaire was administered for data collection, including rate of workplace violence, perception of workplace violence, attitudes toward workplace violence, coping styles, post-traumatic cognitions, post-traumatic stress disorder, post-traumatic growth, and mental health indicators (depression, anxiety, and stress). T-test, chi-squared, and binary logistic regression analyses were conducted.ResultsIn our sample, 30.7% South Korean nurses and 31.6% Chinese nurses in Hong Kong had experienced workplace violence. South Korean and Chinese nurses in Hong Kong with experience of workplace violence had lower perceptions of it. Nurses with experience of workplace violence reported lower levels of mental health, and this trend was more prominent among South Korean nurses.ConclusionsOur study findings showed a positive association between workplace violence and post-traumatic responses in both settings. We found that the close monitoring of post-traumatic responses associated with workplace violence could be improved by enhancing nurses’ perception of workplace violence.

The Comparison of Contact with Inmates, Risk Perception, and Mental Health of Officers in a Correctional Institution with Different Levels of Security

Introduction: Correctional institutions (LP) have various levels of security that are adjusted to the characteristics of the inmates accommodated in it. This level of security includes minimum, medium, and maximum prisons and often includes special prisons for prisoners with special needs or high danger. Differences in security levels present unique dynamics and challenges in contact between officers and inmates, perceptions of risk, and their impact on officers' mental health.
 Methods: This study is an analytic observational study with a cross-sectional approach. A total of 116 research subjects participated in this study. This study observes contact between officers and inmates using the contact with inmate scale. Perception of risk is measured by a scale compiled by Ferdik. The mental health assessment of correctional worker participants used the mental health inventory (MHI-38) made by Veit and Ware.
 Results: Officers in medium-security level penitentiaries have more positive contact with inmates than in maximum and super-maximum security level penitentiaries. Likewise, the aspect of officer risk perception in medium-security level penitentiaries shows a lower score than in maximum and super-maximum security level penitentiaries. However, super-maximum security level penitentiary officers show a lower level of mental health than medium security level penitentiaries.
 Conclusion: There are differences in correctional officers' contact with inmates, risk perception, and mental health of correctional officers in prisons with different levels of security.

Determinants of parent-reported child mental health status in San Diego public schools during the height of the COVID-19 omicron outbreak: A serial cross-sectional study.

Despite extensive debate on the effects of COVID-19 mitigation measures in school settings, little evidence exists on trends in school children's mental health over the course of the COVID-19 pandemic. The objective of this paper was to identify factors affecting parent reports of school children's mental health during COVID-19 Omicron variant outbreak in a cohort of high-risk, socially vulnerable children attending public elementary schools. We analyzed four waves of cross-sectional, online-administered surveys completed by parents of children attending public elementary schools in San Diego between November 2021 and March of 2022. Children (n = 684) ranged in age from 2-17 years. We used multilevel linear mixed effects models to assess determinants of parent-reported child mental health status. The outcome was child mental health, as reported by the parent. Parents consistently rated their children's mental health as very good, though parents who experienced recent COVID-related challenges and who had older children reported lower levels of mental health in their children. Children's mental health was generally considered to be very good, as judged by their parents during a period of constant in-school masking and the Omicron variant outbreak. Structural support mechanisms aimed at mitigating COVID-related challenges for adults may offer benefit to children's mental health.

Sources of empowerment and mental health among retired men and women: An ecological perspective

Aims The overarching goal of the present study was to examine the contribution of various sources of empowerment to mental health during retirement with an added emphasis on gender differences. The empowerment sources that were examined corresponded with three distinct ecological systems: (1) Chronosystem—resource gains from the pre- to post-retirement period and satisfaction with the prior working period; (2) Microsystem—marital power dynamics (measured by the division of household labor and decision-making in the marital relationship) and the presence of a confidant; (3) Ontogenetic system—a sense of meaning in one’s life during the retirement period and an assessment of absolute resources. Method The research sample consisted of 160 Israeli retirees (78 women and 82 men) who had retired within the previous eight years. Data were collected by the Panels Research Institute in Israel using the institute’s database of members. Participants completed an online questionnaire accessible via a website link. Statistical processing was performed using ANOVA and hierarchical regression analysis. Results The results indicated that retirees’ reports of resource gains after retirement, their sense of meaning in life, their satisfaction with their working period prior to retirement, and their perceived level of absolute resources were all associated with mental health. Additionally, the more participants (both men and women) rated that the husband was involved in household labor, the better retirees reported their mental health to be. Gender differences were found in regard to some empowerment sources during retirement: retired women reported lower levels of mental health and prior work satisfaction compared to retired men, and men’s assessments of their participation in household labor and decision-making were higher than women’s assessments of their husbands’ involvement. The proportion of men who reported that their wives were their confidants was higher than the proportion of women who reported that their husbands were their confidants. Summary and conclusions Overall, men experienced more sources of empowerment than women during retirement, but findings suggest that men’s emotional dependence on their wives is greater than women’s emotional dependence on their husbands. Based on the study’s findings, recommendations are offered to professionals who work with retirees.

Mental health of single mothers in Australia

PurposeThis study aims to examine mental health amongst two cohorts of single mothers in Australia before and after major social welfare reforms, which limited single parents’ access to welfare payments to encourage labour market participation.Design/methodology/approachThe study analyses The Australian Longitudinal Study on Women’s Health, which surveyed 9,145 women born in the 1970s in 2003, and 8,346 women born in the 1990s in 2019.FindingsCompared with other women of similar age, single mothers reported a higher prevalence of depression, anxiety, self-harm and suicidal thoughts and lower levels of mental health, although the magnitude varied between age groups and cohorts. This difference disappeared after controlling for socio-demographic characteristics. Mental health of single mothers improved relative to that of other women between cohorts (1970s cohort surveyed in 2003, aged 25–30 versus 1990s cohort surveyed 2019, aged 24–30) and within the same 1970s cohort (surveyed 2003 and 2018), all else equal. Single mothers from the 1970s cohort aged 40–45 years and those in the 1990s cohort aged 24–30 years old were more qualified and held better jobs than the 1970s cohort at aged 25–30. Stress-related to money, ability to manage on available income and experiencing domestic violence were negatively associated with mental health across all cohorts and ages. Social support had a strong positive association with mental health.Originality/valueThe study suggests low welfare payment to encourage greater labour market participation is associated with financial distress linked to poor mental health.

The Relationship between Occupational Stress, Mental Health and COVID-19-Related Stress: Mediation Analysis Results

The COVID-19 pandemic led to serious psychological consequences that negatively affect workers’ mental health, leading to post-traumatic symptoms. In this scenario, employees may be exposed to multiple stressors that ultimately drain their resources. Drawing on the Conservation of Resources Theory (COR) and the stress–strain perspective, we analyzed the relationship between different dimensions of work-related stress and psychological distress in a sample of 294 workers in the industrial sector. Specifically, we hypothesized a series of mediation models in which the dimensions of work-related stress are associated with a lower level of mental health directly and indirectly through higher levels of COVID-19-related post-traumatic symptoms. The results partially support the hypotheses, showing that COVID-19-related trauma plays a mediating role between the stress experienced and the resulting decrease in mental health, except in the case of job control and colleague support. These results will hopefully offer insights into possible organizational interventions for the promotion of workers’ well-being in the postpandemic setting.

Associations Among Gender-Affirming Hormonal Interventions, Social Support, and Transgender Adolescents' Mental Health

PurposeWe aimed to examine the concurrent associations of gender-affirming hormonal interventions (i.e., puberty blockers, testosterone, estrogen), as well as family and friend social support, on transgender and nonbinary (TNB) adolescents' reports of anxiety symptoms, depressive symptoms, nonsuicidal self-injury (NSSI), and suicidality. We hypothesized that gender-affirming hormonal interventions and greater social support would be associated with lower levels of mental health concerns. MethodsParticipants (n = 75; aged 11–18; Mage = 16.39 years) were recruited for this cross-sectional study from a gender-affirming multidisciplinary clinic. Fifty-two percent were receiving gender-affirming hormonal interventions. Surveys assessed anxiety and depressive symptoms, NSSI and suicidality in the past year, and social support from family, friends, and significant others. Hierarchical linear regression models examined associations between gender-affirming hormonal interventions and social support (i.e., family, friend) with mental health while accounting for nonbinary gender identity. ResultsRegression models explained 15%–23% of variance in TNB adolescents' mental health outcomes. Gender-affirming hormonal interventions were associated with fewer anxiety symptoms (β = −0.23; p < .05). Family support was associated with fewer depressive symptoms (β = −0.33; p = .003) and less NSSI (β = −0.27; p = .02). Friend support was associated with fewer anxiety symptoms (β = −0.32; p = .007) and less suicidality (β = −0.25; p = .03). DiscussionTNB adolescents had better mental health outcomes in the context of receiving gender-affirming hormonal interventions and having greater support from family and friends. Findings highlight the important role of quality family and friend support for TNB mental health. Providers should aim to address both medical and social factors to optimize TNB mental health outcomes.

The impact of the early stages of COVID-19 on mental health in the United States, Germany, and the United Kingdom.

The impact of COVID-19 on people's physical health is well documented. But how did COVID-19-with all the uncertainty and disruption of daily life it entailed-impact people's mental health? We used ecologically momentary assessments from 22,562 individuals (largely young adults) across the United States, Germany, and the United Kingdom to study the impact of the early stages of COVID-19 on mental health. Exploring within-person trajectories of mood (4,471,810 observations) and depression (274,911 observations) between January 1 and September 30 of 2020, and comparing them to those observed for the same time period in 2019, we provide evidence that people-on average-show high levels of resilience. While the United States saw momentary decreases in mood and increases in depression that quickly returned to baseline, Germany and the United Kingdom did not experience observable negative effects on mental health. In a small subsample of U.S. users, we show that the mental health trajectories appear to be relatively consistent across different sociodemographics groups. Investigating the impact of social distancing on people's mental health within-person, we demonstrate that social distancing-on average-was associated with a decline in mental health. However, our findings also highlight that not all COVID-19 experiences were created equal. While individuals who experienced social distancing as burdensome reported lower levels of mental health, those who did not, indicated normal or even elevated levels of mental health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Understanding the relations between exposure to the positive self-portrayals of others on social media and emerging adults’ mental health during a COVID-19 imposed lockdown

Social media fulfil emerging adults’ self-presentation needs, and young people often selectively present positive self-portrayals on social media (i.e., exciting social life, successful professional life, and being happy). Yet, being exposed to the positive self-portrays of others can sometimes relate to mental health pressures. In exceptional times of social deprivation (e.g., the COVID-19 pandemic), such relations may differ. This cross-sectional study among 415 emerging adults (Mage = 24.27, SD = 3.19; Women = 64.10%) examined the interrelations between exposure to the positive self-portrayals of others on social media and mental health during an intense COVID-19 lockdown period. The study revealed that exposure to such content related to lower levels of mental health. No support emerged for the moderating role of experiencing negative life events, specifically the experience with COVID-19 illnesses in one’s environment, or a three-way interaction with such experience and gender. These results provide evidence to suggest that specific social circumstances may lead exposure to positive self-portrayals on social media to relate to lower mental health. Specifying such circumstances can help the field to move away from the current inconsistent findings concerning social media/mental health relations.

Gender Gap in Mental Health during the COVID-19 Pandemic in South Korea: A Decomposition Analysis.

The economic and social effects of the COVID-19 pandemic have been widespread but unevenly distributed among genders. The pandemic may have also affected men's and women's mental health differently. This study examined whether the pandemic had stronger adverse effects on women's mental health than on that of men given that the decline of the labor market was greater for women than for men. Using data from South Korea (June/September/December 2020, N = 3000), we investigated the gender gap in mental health during the first year of the COVID-19 pandemic and its association with gender differences in labor market experiences. We employ the Blinder-Oaxaca decomposition method for this analysis. Although depression and anxiety increased among employed women and men during COVID-19, women showed lower levels of mental health than men. A significant portion of this gender gap is explained by women experiencing greater job loss, income reduction, and prohibition of remote work than men. We also find that women in their 30s experienced greater mental health problems than men of the same age even after controlling for other conditions. Overall, our findings show that a greater proportion of employed women than men experienced poor labor market conditions and increased family burdens during the COVID-19 pandemic, which contributed to women reporting worse mental health than men.

The Role of Psychological Resilience and Family Dysfunction in the Relationship Between Parental Behavioural Addictions and Adult Mental Health

The current study assesses the mediating role that family dysfunction and psychological resilience have in the relationship between growing up with a parent with parental addictions and developing mental health difficulties and/or addiction in adulthood. Participants included 292 adults (76.1% women), who completed an online questionnaire reporting on whether their parent(s) had behavioural addictions, their family environment during childhood, the degree of substance and behaviours dependence, and psychological symptoms and psychological resilience in the present. It was found that parental behavioural addictions were linked to more disruptive family environments during childhood and that disruptive family environments were then linked to reduced levels of psychological resilience, which in turn were linked to lower levels of mental health. Overall, the results suggest that a disruptive family environment during childhood together with psychological resilience seem to play a key role when looking at long–term negative impact of parental behavioural addictions.

Mental health and life satisfaction in East and West Germany: Effects of generation and migration of citizens.

The reunification of Germany after the separation between 1949 and 1990 has offered a unique chance of studying the impact of socialization, political transformation, and migration on mental health. The purpose of this article was to compare mental distress, resources, and life satisfaction (1) between residents of East and West Germany and migrants who have fled from East to West Germany before reunification and (2) between three generations. We assessed anxiety, depression, resilience, self-esteem, and life satisfaction, comparing groups based on their residency and migration, as well as three different birth cohorts. Using a representative survey of 2006, analyses of variance show the differences between these groups. Based on a representative survey (N = 4,530), the effects of gender (53.6% women), residency/migration (74.4% grown up in the West, 20.4% in the East, 5.3% migrants from the East to the West) from three generations (32% born until 1945, 39% until 1967, and 29% to 1989), and positive and negative mental health indicators were analyzed. Women reported higher distress and lower resilience. Residents of the Western states reported the lowest burden of distress (depressive and anxiety symptoms) and the highest overall life satisfaction, exceeding residents from the Eastern states and migrants from the Eastern to the Western states. Migrants from the Eastern to the Western states, however, reported the lowest resilience and self-esteem. They reported lower satisfaction with income, living conditions (compared to the Western residents), and the lowest levels of satisfaction with family (compared to East and West). Overall, our data point to inequalities between the Eastern and Western states regarding mental health 16 years after reunification favoring the residents of the Western states by lower distress and life satisfaction. Our data attest to the stresses and adjustments associated with migration from the Eastern to the Western states before reunification. A lower level of mental health and life satisfaction in the oldest generation may be related to the sequelae of World War II and also to aging.

The association between non-parental childcare intensity and parental mental health across Europe.

Young children are spending an increasing amount of time in non-parental childcare. Despite this trend, few studies have examined how the intensity of non-parental childcare associates with mental health in parents, particularly taking the institutional context concerning childcare into account. Data from the European Union Statistics on Income and Living Conditions EU-SILC (2013) were used to develop a multi-level linear regression model. The sample was restricted to parents in dual-earner couples and with at least one child below the age of three (N=6709). Mental health was assessed using the Mental Health Inventory-5. Highest levels of mental health were found in parents who use a moderate level of non-parental childcare, while full-time childcare was associated with lower levels of mental health. Working parents reported better mental health in countries where spending on formal childcare was higher, or where using formal childcare use was more widespread for this age group. While this study does not allow to establish a causal relationship between the researched indicators, it does indicate that mental-health problems are not randomly distributed among parents but tend to cluster more densely within parents who use higher intensities of childcare and in countries with less supportive childcare policies. Research that ignores social contexts might therefore be limited in terms of generalisation.

Associations between smartphone use and mental health and well-being among young Swiss men

Background and aimsIntense use of smartphones is associated with mental health problems and low well-being. However, little is known about the mental health and well-being of non- and low-level users. This study investigated the possibly non-linear associations between time spent using a smartphone, including non-users, and mental health and well-being among young adults. MethodsBetween 2016 and 2018, 5315 young Swiss men (M = 25.45 years old, SD = 1.25) completed a questionnaire assessing smartphone use, daily time spent using a smartphone, mental health and well-being (i.e. depression, social anxiety, attention deficit hyperactivity disorder, life satisfaction, stress) and potential confounding variables (social capital, personality, education). The associations of smartphone use and time spent using a smartphone (linear and quadratic associations) with mental health and well-being were tested using regression models. ResultsNon-users (4.3%) reported worse mental health and well-being than smartphone users on all outcomes. Time spent using a smartphone was linearly associated with higher rates of social anxiety, depression, attention deficit hyperactivity disorder and lower levels of life satisfaction. The association with stress was non-linear, with significant linear and quadratic coefficients of time spent using a smartphone. Associations were partially attributable to confounding variables (i.e. social capital, personality, and education). ConclusionsNon-users and intense users of smartphones have lower levels of mental health and well-being than low-level users. Although society and mental health professionals are deeply concerned about the potentially negative consequences of the ever-increasing use of smartphones, the present study suggested that not using a smartphone may also indicate problems.

Mental health in the Chilean LGBT population in times of COVID-19

Introduction. There are few reports on mental health among the lesbian, gay, bisexual, and transgender (LGBT) population in the context of COVID-19, especially in South America. Objective. To describe the prevalence of symptoms associated with mental health disorders, as well as to analyze the risk of their occurrence, in different groups of the Chilean LGBT population in the context of COVID-19. Method. A total of 1,181 LGBT people, ranged from 18 to 64 years participated in an online survey, using the Depression Anxiety Stress Scales-DASS-21. The central tendency measures were analyzed, then cut-off points were used to establish prevalence according to sex and sexual orientation. Finally, the probability of symptoms was analyzed using odds ratio. Results. Lower levels of mental health were identified among the bisexual and other sexual orientations (pansexual, demisexual, asexual, etc.) population as compared with gays and lesbians, finding a greater presence of depressive symptoms (p = .000), anxious (p = .000) and related to stress (p#abr#.001). Similarly, bisexual women are more likely to present symptoms associated with mental health disorders than men, as lesbians do, as compared with gays in the case of anxiety. Gays are at a higher risk of stress than lesbians. Discussion and conclusion. Even though the pandemic affected the entire population, results give evidence of disparities among the various LGBT communities, showing the need to focus on preventive interventions and the implications of increased risk in bisexual population, particularly women, who are affected by various cross discriminations.

Physical function, psychological adjustment, and self-efficacy following sudden cardiac arrest and an initial implantable cardioverter defibrillator (ICD) in a social cognitive theory intervention: secondary analysis of a randomized control trial

BackgroundSudden cardiac arrest (SCA) survivorship results in unique issues in return to physical and psychological function. The purpose of the study was to compare recovery across the first year between SCA survivors and other arrhythmia patients who received a first-time implantable cardioverter defibrillator (ICD) for secondary prevention, participating in a social cognitive theory (SCT) intervention.Methods168 (129 males, 39 females) who received an ICD for secondary prevention (SCA N = 65; other arrhythmia N = 103) were randomized to one of two study conditions: SCT intervention (N = 85) or usual care (N = 83). Outcomes were measured at baseline hospital discharge, 1, 3, 6, & 12 months: (1) Physical Function: Patient Concerns Assessment (PCA), SF-36 (PCS); (2) Psychological Adjustment: State Trait Anxiety (STAI), CES-D depression, SF-36 (MCS); (3) Self-Efficacy: Self-Efficacy (SCA-SE), Self-management Behaviors (SMB), Outcome Expectations (OE). Outcomes were compared over 12 months for intervention condition x ICD indication using general estimating equations.ResultsParticipants were Caucasian (89%), mean age 63.95 ± 12.3 years, EF% 33.95 ± 13.9, BMI 28.19 ± 6.2, and Charlson Index 4.27 ± 2.3. Physical symptoms (PCA) were higher over time for SCA survivors compared to the other arrhythmia group (p = 0.04), ICD shocks were lower in SCA survivors in the SCT intervention (p = 0.01); psychological adjustment (MCS) was significantly lower in SCA survivors in the SCT intervention over 6 months, which improved at 12 months (p = 0.05); outcome expectations (OE) were significantly lower for SCA survivors in the SCT intervention (p = 0.008).ConclusionsSCA survivors had greater number of physical symptoms, lower levels of mental health and outcome expectations over 12 months despite participation in a SCT intervention.Trial registration Clinicaltrials.gov: NCT04462887.