Lower Levels Of Well-being Research Articles

Psychological Assessment of Primary Aldosteronism: A Controlled Study

Our objective was to investigate psychological correlates in a population with primary aldosteronism (PA) using methods found to be sensitive and reliable in psychosomatic research. Twenty-three PA patients (12 male, 11 female; mean age 50 ± 9 yr) were compared with 23 patients with essential hypertension (EH) (15 male, eight female; mean age 47 ± 8 yr) and 23 matched normotensive subjects. A modified version of the Structural Clinical Interview for DSM-IV, a shortened version of the structured interview for the Diagnostic Criteria for Psychosomatic Research, and two self-rating questionnaires, the Psychosocial Index and the Symptom Questionnaire, were administered. Twelve of 23 patients with PA (52.2%) suffered from an anxiety disorder compared with four of 23 with EH (17.4%) and one control (4.3%) (P < 0.001). Generalized anxiety disorder was more frequent in PA than in EH patients and controls (P < 0.05). As assessed by Diagnostic Criteria for Psychosomatic Research, irritable mood was more frequent in PA and EH compared with controls (P < 0.05) but did not differentiate PA from EH. According to Psychosocial Index results, patients with PA had higher levels of stress (P < 0.01) and psychological distress (P < 0.01) and lower level of well-being (P < 0.05) than controls. Compared with EH patients, PA patients had higher scores in stress subscale (P < 0.05). The Symptom Questionnaire showed higher levels of anxiety (P < 0.01), depression (P < 0.01) and somatization (P < 0.01) and lower physical well-being (P < 0.05) in PA than controls. A role of mineralocorticoid regulatory mechanisms in clinical situations concerned with anxiety and stress is suggested.

Disability in COPD and its relationship to clinical and patient-reported outcomes

Objective:To assess the presence of disability in chronic obstructive pulmonary disease (COPD) patients and its relationships with disease severity, comorbidities, and patient-reported outcomes.Research design and method:COPD outpatients completed validated questionnaires designed to investigate illness perception, well-being, quality of life, and stress, while physicians collected data concerning disability, dyspnea, and comorbidities (Charlson Index).Results:Of 164 patients, 37.3% exhibited a degree of disability and 67.7 % of them reported the loss of at least one relevant function in daily life (mean 2.34 ± 2.41). Although disability was associated with disease severity (χ2 = 8.292; p < 0.016), disability was present to some degree in all disease stages and in 44.9% of patients with moderate COPD. Barthel Index scores were related to MRC scores (r = 0.529; p < 0.001), GOLD stage (r = 0.223; p < 0.006), and Charlson Index (r = 0.163; p < 0.032). Disabled patients had a lower mean FEV1 value (50.96 ± 20.99 vs. 65.00 ± 23.63; p < 0.001) than self-sufficient patients (p < 0.001). The stepwise regression analysis showed that the MRC score was the most relevant factor in inducing COPD patient disability (F = 56.5; p = 0.001). Compared to self-sufficient patients, disabled patients reported lower levels of well-being and health status, increased levels of distress, and a different illness perception.Conclusions:Disability can be identified in each disease stage, with dyspnea serving as the most relevant inducing factor. Since disability substantially impacts patient perception of and experience with COPD, its presence must be taken into account during disease management.The cross-sectional nature of the study and the characteristics of the sample size represent a limitation in the possibility to generalize the results.

Loss of activities and its effect on the well-being of substance abusers

Aims. Participation in everyday activities positively influences well-being, but few have studied how participation in activities influences well-being among patients with substance use disorders. The authors examined the number of past, recent, and desired future activities of patients being admitted to five units for inpatient substance abuse treatment at a Norwegian university hospital. Major findings. The total number of activities had dropped significantly compared with before the respondents started abusing substances, and the respondents desired an increase in activities in the future. A lower level of well-being as measured by the WHO-5 was predicted by a more pronounced drop in number of activities from past to recent and by more severe use of alcohol and other substances. Principal conclusion. Substance abuse is associated with a change in number of activities. Losing activities may contribute to a decrease in well-being. Helping substance abuse patients regain positive activities could improve well-being.

Racial Discrimination and Resilience in African American Young Adults: Examining Racial Socialization as a Moderator

Research has indicated that racial discrimination places African Americans at risk for psychological distress, in which they experience low levels of well-being. Yet many African Americans are resilient, or have preserved well-being, when faced with this adversity. Using a strength-based approach, this study determined whether racial socialization messages preserved African Americans’ resilience when experiencing racial discrimination. Results with a sample of 290 young adult African American college students indicated that overall racial socialization messages, as well as specific messages to appreciate cultural legacy, moderated the relationship between racial discrimination and resilience. As expected, racial discrimination was negatively related to resilience for students who reported fewer racial socialization messages, and racial discrimination was no longer negatively associated with resilience for students reporting a greater number of these messages. Additionally, racial socialization messages predicted unique variance in resilience.

The association of well-being, productivity and resource use among community-dwelling patients with schizophrenia using atypical antipsychotics

Objective The aim of the current study was to examine levels of well-being and productivity and the interrelationships between them in community-dwelling patients with schizophrenia who use atypical antipsychotic medications. Methods A mixed methodology (online and paper surveys) was implemented to recruit patients in the USA over the age of 18 years who were diagnosed with schizophrenia by a healthcare professional and who were able to read and write English. Patients who were currently being treated with an atypical medication and provided well-being data (n = 745) were included in the analyses. Logistic and negative binomial regressions were used to determine the effect of well-being on productivity and resource use. Key findings Almost two-thirds of patients taking atypical antipsychotics reported low levels of well-being (63%). After controlling for demographic and patient characteristics, patients with low levels of well-being were significantly less likely to be employed and productive than patients with moderate or high levels of well-being (P < 0.05). Similarly, patients with low levels of well-being were significantly more likely to be hospitalized or visit the emergency room relative to patients with high levels of well-being (P < 0.05). Conclusions The results suggest that there may be an unmet need among patients with schizophrenia who use atypical antipsychotic medications. Overall levels of well-being were low in these community-dwelling patients. Further, low levels of well-being were found to be significantly related to worse productivity and, to a certain extent, additional resource use, after controlling for a variety of confounding variables. Although additional research is necessary, improved disease management and use of innovative antipsychotic medications, such as long-acting injectables, may benefit these patients by improving well-being, productivity and resource use.

UK Unemployment in the Great Recession

This paper considers some of the implications of the increase in UK unemployment since the beginning of the Great Recession. The major finding is that the sharp increase in unemployment and decrease in employment is largely concentrated on the young. This has occurred at a time when the size of the youth cohort is large. As a response to a lack of jobs there has been a substantial increase in applications to university, although there has only been a small rise in the number of places available. Further we find evidence that the unemployed have particularly low levels of well-being, are depressed, have low levels of life satisfaction, have difficulties paying their bills and are especially likely to be in financial difficulties.

Well-being in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

Studies on well-being and its possible determinants are rare in the international literature, and almost non-existent in Brazil, particularly among youth. The present study focused on the epidemiology of well-being among adolescents belonging to a birth cohort. Well-being was measured using face-to-face interviews, with a question whose answer was based on a graphic scale of faces. 4,452 adolescents were interviewed. Approximately half (49.4%) classified themselves as very happy (face 1); this proportion was higher among girls than boys. Poorer adolescents were more likely than their wealthier peers to identify with the happiest face (number 1), but were also more likely to report moderate to low levels of well-being (faces 3-7). Body mass index was inversely associated with well-being. Among girls, physical activity was directly associated with well-being.

Happiness and the Welfare State

Does a more generous welfare state make people happier and increase their life satisfaction? Available empirical research gives a clear and positive answer to this question. This goes counter to many arguments that the welfare state creates a culture of dependency, leads to heavy-handed bureaucratic intrusions into private life, creates problems concerning personal integrity, is bad for economic growth, implies stigmatization of the poor, and crowds out civil society and voluntarism. This counterintuitive result is explained by to which degree programs are universal in the coverage and structure. Four common misunderstandings of universal welfare states are discussed and refuted: This it is too costly for the economy, that it cannot be combined with individual choice, that it does not redistribute in favour of the poor and that it should be detrimental to economic growth. Using a social mechanism approach, it is argued that the relation between subjective well-being and universal welfare states operates in a complicated causal pattern with two other variables, the degree of corruption and the level of trust in society. This approach is used to explain why empirically, countries tend to cluster so that countries with large and mostly universal welfare state programs also have low levels of corruption, a high degree of trust, and high levels of happiness and well-being. And vice versa, why countries with smaller welfare systems tend to be higher on corruption, have lower levels of trust, and lower levels of well-being.

Resolving the Unique Situation: Consequences for Identity and Psychological Well-Being

Teen pregnancy regularly brings about numerous changes in the life of the young mother. The most salient problem for teenage mothers, for example, is the lack of a supportive community. First, we will attempt to explain how little support from a community can lead to low levels of well-being. Secondly, we suggest solutions to overcome this problem. We propose that the young mothers perceive their situation as a Unique Situation. We advance the idea that the perception of living through a Unique Situation brings the young mothers to compare their situation to the one before their pregnancy, resulting in a decrease in well-being. This paper theorizes that by sharing a Unique Situation with others living through a similar situation, social comparisons will become available and consequently higher levels of well-being will be experienced.

Human Well-being in the Pacific Island Mini States

Azmat Gani argues that most Pacific Island mini states are off track to achieve satisfactory levels of well-being. Poverty levels are high; children under the age of five years are underweight; immunization rates are deteriorating; maternal mortality rates are high; and gender gaps are increasing. He looks at what data is available in order to show the low levels of well-being and what gaps need to be filled if these mini states are to achieve the Millennium Development Goals (MDGs).

Exploring the Link between Religious Attitudes and Subjective Well-Being in Chronic Pain Patients

The aim of the present study was to explore the relations between religious attitudes and subjective well-being in a sample of chronic pain (CP) patients and to investigate whether these associations would differ from those obtained with healthy controls. A total of 155 CP patients (72% women) and 166 healthy controls (72% women) completed questionnaires on pain, religious attitudes, and subjective well-being. The religious attitudes focused both on religiosity as such (Inclusion vs Exclusion of Transcendence) as on the cognitive approach of religious contents (Symbolic vs Literal). Mean-level analyses showed significant differences between the CP and control samples on subjective well-being and Literal Exclusion. Mediation analyses found a direct influence of sample (CP vs control) on subjective well-being as well as an indirect effect via Literal Exclusion. Correlation analyses revealed that Literal Exclusion correlated negatively with well-being in both samples, whereas Literal Inclusion did not. The differential variable between the two samples was the symbolic approach of religion (Symbolic Inclusion and Exclusion), which was significantly associated with higher levels of well-being only in the CP sample. A literal approach toward religion in combination with a rejection of religion (Literal Exclusion) was, in general-both for CP patients as for healthy controls-associated with lower levels of well-being. In CP patients (but not in healthy controls), a symbolic approach toward religion (regardless of Inclusion or Exclusion of religion) was significantly associated with higher levels of subjective well-being.

The Subjective Well-Being of Immigrants Aged 50 and Older in Israel

The present study evaluated the integration of elderly people who migrated to Israel during their lifetimes. Subjective well-being, as measured by the immigrants' perception of quality of life, satisfaction with life and emotional state, served as a general indicator of integration. The integration of elderly immigrants has not received adequate attention in the literature. A unique database (SHARE-Israel) that was recently released has made study of this topic possible. The current study sample was composed of former migrants aged 50 and older (n = 930). The analytic model examined ethnic origin and migration variables in relation to the respective subjective outcomes, controlling for sociodemographic background, human and social capital and health. The findings show that in general, ethnic origin seems to matter less for the evaluation of immigrants' subjective well-being than other socio economic factors such as economic status, social capital and health status. However, recent arrivals from the Former Soviet Union do differ from all other immigrant groups in their lower levels of well-being. In addition, the study points to the importance of language proficiency as a central means for integration in the destination country.

Happy States of America: A state-level analysis of psychological, economic, and social well-being

Cross-national research indicates that well-being is comparatively high in wealthy nations where importance is placed on freedom, self-expression, and independence. The present research aimed to replicate and extend previous work by examining the geographic distribution and correlates of well-being within the US. Links between the Gallup Organization’s Well-being Index and state-level indicators of wealth, class structure, education, social diversity, and personality were examined. Results suggested that residents of states with high levels of well-being were wealthier, better educated, more tolerant, and emotionally stable compared to residents of states with comparatively low levels of well-being. Analyses indicated that connections between well-being and class structure, diversity, and personality remained after controlling income. Causes and consequences of regional differences in well-being are discussed.

Parenting Stress in Mothers of Children With Autism Spectrum Disorders

The purpose of this paper is to describe the sources of parenting stress in mothers of children with Autism Spectrum Disorders (ASD) and examine the relationship between parenting stress and maternal psychological status (depression and well-being). A descriptive correlational design was used. Data were collected via mailed questionnaires. Behavioral symptoms were the primary source of parenting stress for mothers. There was no relationship between child characteristics and parenting stress. Mothers reporting more parenting stress had more depressive symptoms and lower levels of well-being. Our findings have implications for interventions with mothers to help them manage their children's behavior and focus on stress reduction and well-being.

Life Satisfaction, Self-Esteem, and Subjective Age in Women Across the Life Span

A study of 320 women, ages 21 to 69, explored the relations among relationship status, subjective age, self-esteem, and life satisfaction. Women in married or partnered relationships had higher levels of life satisfaction than did single women. Women in their 30s and 40s had significantly lower levels of life satisfaction than did other age groups. ********** Recent population estimates place the number of baby boomers between 40 and 60 years of age at approximately 78 million (American Association of Retired Persons, 2004). As the average age of the U.S. population increases, it is imperative for mental health professionals to be prepared to meet the needs of a maturing population. Although it may be expected that theory and understanding of adult development during these years are well formed, there is a noticeable gap in the existing literature related to the development of midlife women (Degges-White & Myers, 2006a). In part, this may be attributed to the fact that midlife is a relatively new phase of life that emerged as a result of increased longevity and the trend for a couple to spend a significant portion of their life together after their children have achieved independence (Quadagno, 2001, as cited in Degges-White & Myers, 2006a). Although strides have been made in increasing the understanding of midlife women's physiological development (Finkler, 2007), specifically regarding menopause, much less research has been concerned with nonbiological changes that occur in midlife women's attitudes and feelings. The mass media have become a growing source of information about women's midlife transitions, especially the menopause transition (Carlson, Li, & Holm, 1997; Gannon & Stevens, 1998); however, the facts presented are often highly colored by editorial opinion. With few empirically supported theoretical paradigms of women's midlife development (Degges-White & Myers, 2006a), mental health professionals may feel unprepared to serve this population and women may be unsure about what is normal. Unfortunately, the media and our society in general tend to hold and promote many negative stereotypes regarding aging, such as the widely broadcast belief that signs of aging are problems that require correction. These messages may negatively influence women's attitudes and feelings both about themselves and the aging process as well as their overall well-being (Chornesky, 1998; McQuaide, 1998). Mental health professionals need sound information about this population to help women navigate this phase of life and to help them offset these negative messages. It is important to expand the research and understanding of women at midlife in an effort to generate improved theories of midlife development. LIFE SATISFACTION Because women are often reminded by the media and culture that aging is a foe, maturing women may feel uncomfortable and ill at ease during their middle years. An individual's level of life satisfaction, the temporal measure of the amount of happiness people feel in their life at a specific moment, may be negatively influenced by these messages. In fact, Ryff (1989) concluded that the midlife years are times of changing roles and identity ambiguity and that these processes in themselves often affect women's life satisfaction. Some researchers have presented evidence suggesting that midlife women are maladjusted, have lower levels of well-being, and a have a higher risk of suicide (Girard, 1993; Waskel & Phelps, 1995). Other research has found that midlife is not necessarily a negative time in women's lives. For example, Degges-White and Myers (2006b) found that women who have supportive people in their life may experience greater life satisfaction than do those who live a more solitary life. A friendship network or the presence of a confidant have both been noted for their importance to women's mental health (Baruch & Brooks-Gunn, 1984). Howell (2001) explored the experiences of midlife women and found that participants in her study emphasized the importance of relationships, as evidenced by the amount of time focus group participants devoted to this topic and the high percentage of participants who engaged in discussion of relationships. …

Acne vulgar e bem-estar em acadêmicos de medicina

FUNDAMENTOS - Observa-se comorbidade psiquiátrica em 40% dos pacientes dermatológicos adultos, sendo a acne vulgar de interesse da psicodermatologia por ter entre suas complicações seqüelas psicossociais. OBJETIVOS - Estabelecer a relação entre acne e o status de bem-estar. MÉTODOS - Estudo de caso-controle com dados coletados a partir do Índice de Bem-Estar da Organização Mundial da Saúde, por meio de entrevistas com dois grupos de 50 acadêmicos de medicina, sendo um com acne e outro sem acne. RESULTADOS - Foi verificado que 26% dos acadêmicos do grupo de casos e 24% do grupo controle apresentaram de 0 a 4 pontos em pelo menos um dos itens questionados. CONCLUSÕES - Apesar de a maioria dos pacientes apresentar atitudes e sentimentos desencadeados pela acne, não se demonstrou associação estatisticamente significativa entre essa dermatose e baixo nível de bem-estar.

Together is better? Effects of relationship status and resources on young adults' well-being

This study examines differences in well-being among young adults across relationship status. Multilevel regression analyses on two waves of data of the Dutch Panel Study of Social Integration (N = 2818) show that singles have the lowest level of well-being, followed by young adults who are steady dating, and cohabitors. Married young adults have the highest level. These differences are partially mediated by differences between young adults in their access to valued material, personal and social resources. Furthermore, the availability of some resources is more important for the well-being of young adults in a certain relationship status than for those in another relationship status. Gender differences are also discussed.

Well-being in residency: Effects on relationships with patients, interactions with colleagues, performance, and motivation

Objective Previous studies about resident well-being have focused on negative aspects of well-being. We conducted this study to explore residents’ conceptions of well-being and how it affects their work. Methods One investigator conducted semi-structured interviews with residents at two hospitals during February–June 2005. Through random sampling stratified by program and gender, we invited 49 residents from internal medicine, psychiatry, surgery, emergency medicine, anesthesia, obstetrics/gynecology, and pediatrics. Using an editing analysis style, three investigators independently coded transcripts. Results 26 residents participated in 45-min interviews. Residents acknowledged that well-being affected four elements of their work: relationships with patients, interactions with colleagues, performance, and motivation. Residents described higher quality discussions with patients when their well-being was high and inappropriate exchanges when well-being was low. Residents attributed conflict with colleagues to lower states of well-being. Residents felt they had improved decision-making when their well-being was higher. Residents’ motivation in their daily work and career varied with fluctuating well-being. Five residents initially denied that their well-being affects their work, voicing concerns that this would be unprofessional. Conclusions Most residents felt that both high and low levels of well-being affected their work, particularly their work relationships. Practice implications The educational and patient care goals of residency training may be enhanced through interventions that promote resident well-being.

Methods for Tabulating Indices of Child Well-Being and Context: An Illustration and Comparison of Performance in 13 American States

The purpose of child well-being indices is to distill large amounts of data on children in ways that can be easily communicated to and used by policy makers and the public. Several major methods for creating indices exist: (1) a standard score method that assesses differences across geographic areas, (2) a micro-data tally method that assesses the number of problems children have, and (3) an average percentage change method that assesses change from year to year (compared either to a base year or a “model” year). We review each type of index and discuss some cross-cutting issues, including the use of micro- versus macro-data, the measurement of absolute versus relative levels of well-being, and the constructs of well-being and context. We then use data from a single source, the National Survey of America’s Families, to demonstrate the usage of indices, comparing the relative performance of 13 American states. We find that states tend to be ranked similarly with regard to well-being and to the combination of well-being and context, regardless of whether one is examining the average concentration of problems per child, relative status of children across states, or change over time. We find that the states with relatively lower levels of well-being, as well as states whose children have the highest average number of problems, tend to show the greatest improvement over time in well-being. We also find that states in which children are more likely to experience multiple problems tend to be the same states in which the overall levels of well-being and the condition of children are relatively poorer. Despite the fact that the literature has referred to different types of indices commonly as “child well-being indices,” the differences both in the purpose and in the results across tabulation methods illustrate the importance of balancing the simplicity of the presentation of index results with sufficient information to enable people to understand exactly what the index is assessing. Furthermore, our results highlight the value of using multiple types of indices to contextualize findings across the indices.

Well-Being of Mid-and Later-Life Mothers of Children with Developmental Disabilities

ABSTRACT This study examined the well-being of mid- and later-life mothers of developmentally disabled (DD) children. Mothers of DD children (n = 33) and mothers in a comparison group (n = 27) responded to a series of quantitative measures of well-being and open-ended questions. In general, quantitative results indicated lower levels of well-being for mothers of DD children. However, we examined these results within the contexts of educational and financial realities and access to adequate social support. Analysis of the qualitative data resulted in the themes of enhancements to well-being, challenges to well-being and normative experiences of being a parent. Results point to the need to further understand reciprocity in the mother-child relationships and the influence of severity of the developmental disability on mother's well-being.