Measures Of Psychological Health Research Articles

Cognitive influences on biosecurity measure compliance during a global pandemic

IntroductionDuring the first years of the pandemic, COVID-19 forced governments worldwide to take drastic measures to reduce the spread of the virus. Some of these measures included mandatory confinements, constant use of masks, and social distancing. Despite these measures being mandatory in many countries and the abundance of evidence on their effectiveness at slowing the spread of the virus, many people failed to comply with them.MethodsThis research explored the role of cognitive factors in predicting compliance with COVID-19 safety measures across two separate studies. Building on earlier work demonstrating the relevance of cognitive processes in health behaviour, this study aimed to identify key predictors of adherence to safety guidelines during the pandemic. Utilising hierarchical regression models, we investigated the influence of age, sex, cognitive control, cognitive flexibility (Study 1), working memory, psychological health, and beliefs about COVID-19 (Study 2) on compliance to biosafety measures.ResultsDemographic variables and cognitive control were significant predictors of compliance in both studies. However, cognitive flexibility and working memory did not improve the models’ predictive capacities. In Study 2, integrating measures of psychological health and beliefs regarding COVID-19 severity significantly improved the model. Further, interaction effects between age and other variables also enhanced the predictive value.DiscussionThe findings emphasise the significant role cognitive control, age, psychological health, and perceptions about COVID-19 play in shaping compliance behaviour, highlighting avenues for targeted interventions to improve public health outcomes during a pandemic.

Abstract PO5-13-01: An App-Based Approach to Monitor Chemotherapy Symptoms

Abstract Introduction Patient-Reported Outcome Measures (PROM’s) are important tools that can enhance symptom management and patient quality of life in cancer treatment. Despite well-documented benefits, they are not often employed in routine care. This study aims to investigate the feasibility and acceptance of the integration of a dedicated mobile app for real-time symptom tracking and intervention using PROM’s among patients undergoing neoadjuvant or adjuvant chemotherapy for breast cancer. Methods We developed a dedicated mobile app for tracking PROM’s utilizing the NCI PRO-CTCAE to monitor 12 common chemotherapy-related symptoms. We aimed to evaluate patient acceptance and clinical feasibility of the app. Patient responses were directed to a personalized dashboard for designed for the clinical treatment team. We determined self-reported grade 3 or 4 vomiting, diarrhea, constipation, shortness of breath, cough, or peripheral neuropathy and grade 4 mucositis, nausea, or pain as symptoms severe enough to trigger an automatic alert requiring a phone call from our nursing staff for support. Each questionnaire generated up to 1 alert regardless of the number of severe symptoms. Symptomatic patients also received personalized automated instructions and video links for symptom management regardless of the severity of their symptoms. In response to staff feedback during the study, we added an additional assessment to determine whether patients with severe symptoms were interested in direct contact from the clinical staff when alerts were triggered. At baseline patients reported if they felt they were skillful at using smartphone apps. Quality of life, psychological and emotional health measures were collected at baseline, and weeks 6, 12, and 18. Categorical variable were described using percentages and compared using the chi squared test. Statistical analyses were performed by SPSS. Results: At the time of this analysis, 58 patients were recruited and found eligible for the study. All 58 patients self-reported as skilled with the use of smartphone apps. Eighteen patients (31%) withdrew from the study after receiving at least one questionnaire and their data was included up to their point of withdrawal. The different chemotherapy regimens given in the study are shown in table 1. Out of 772 questionnaires sent, 404 were returned, resulting in a 52% completion rate. These 404 completed questionnaires generated 126 (31%) alerts. After including feedback on the interest of direct contact from our nursing staff to manage alarming symptoms, only 23/102 (22.5%) alerts required clinical contact. Twenty-one patients (36%) did not complete even a single questionnaire. For the 37 (64%) patients who completed at least 1 questionnaire the completion rate was 74%. There was no significant difference in the alert rate of completed questionnaires between patients receiving TCHP, TC-AC-Pembro, and AC-T (38%, 38%, 29% p=NS). TC triggered significantly less alerts than AC-T (11% vs 29% p=0.01). Conclusion: The interim results of our ongoing study highlight the potential of a mobile app in real-time monitoring of chemotherapy-related symptoms. Our results suggest symptom monitoring using a dedicated mobile app is both acceptable and feasible for both patients and clinical personnel. The digital approach also seems effective in triggering alerts for severe symptoms, facilitating timely intervention. However, most alerts did not necessitate direct clinical contact, underscoring the role these interventions may play in allowing for patient self-care. However, over a third of patients did not utilize the app at all, emphasizing the need for further research examining the factors influencing the utilization of this technology for symptom monitoring. As the study continues, we hope to gain insights that can simplify and improve patient and clinician interaction with this tool, potentially improving symptom management for adjuvant breast cancer. Table 1 Chemotherapy Regimens DD AC-T dose dense doxorubicin cyclophosphamide paclitaxel, TCHP docetaxel carboplatin trastuzumab pertuzumab, TC-AC-Pembro paclitaxel carboplatin doxorubicin cyclophosphamide pembrolizumab, TC docetaxel cyclophosphamide,DD AC-T weekly dose dense doxorubicin cyclophosphamide paclitaxel weekly, TH paclitaxel trastuzumab, AC-THP doxorubicin cyclophosphamide paclitaxel trastuzumab pertuzumab, AC-TC doxorubicin cyclophosphamide paclitaxel carboplatin Citation Format: Opher Globus, Tal Sella, Amit Itay, Tali Shapira, Raisa Gold, Tami Modiano, Cecilia Oedegaard, Maya Krikli, Michal Bakalenik-Gavry, Beatrice Shaham, Alex Galper, Einav Nili-Gal Yam. An App-Based Approach to Monitor Chemotherapy Symptoms [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-13-01.

IJCM_257A: Effect of quality of sleep on anxiety and cognitive functions in medical students

Background: In human life, periods of activity and rest alternate. To survive, human beings need to work and every day properly we need sleep. The quality of sleep strongly influences psychological and physical health and other measures of well-being. Methodology: This was a cross-sectional study done in Kasturba Medical College, Mangalore among 300 medical undergraduate students using a questionnaire that consisted of general participant information and PSQI to assess the quality of sleep, GAD-7 scale to assess the level of anxiety, need for cognition scale. The results were expressed in the form of tables and graphs using SPSS V 25.0. The association between quality of sleep and anxiety was analyzed by using the Chi-square test and a p-value <0.05 was considered statistically significant. Results: Out of the total 300 students, 106(35.5%) of the students had good quality sleep,112(37.3%) of them had minimal anxiety, 92(30.7%) had mild anxiety,57(19%) had severe anxiety and 39(13%) had moderate anxiety. It was seen that there is an increased number of students with mild, moderate, and severe anxiety among poor-quality sleepers than those with good-quality sleep. Conclusion: Most of the medical undergraduate students have poor- quality sleep. Students with poor-quality sleep have increased anxiety levels compared to those with good-quality sleep. The cognitive function in students with poor quality of sleep is found to be higher than those with good-quality sleep.

The Impact of COVID-19 on Health Behavior Engagement and Psychological and Physical Health Among Active Duty Military Enrolled in a Weight Management Intervention: An Exploratory Study.

The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military personnel may have been more vulnerable to stress during the pandemic because of job demands (e.g., work in close quarters). Our research group was conducting a randomized clinical trial of a weight management intervention in active duty military personnel with overweight or obesity when the COVID-19 pandemic struck. Thus, we collected additional pandemic-related data from participants enrolled during the COVID-19 pandemic and conducted exploratory analyses to understand how the pandemic affected their stress levels and perceived abilities to engage in health behaviors like exercise and healthy eating. The aims of this exploratory study were to: (1) assess associations between pandemic-related stress and health behaviors with body fat percentage (BF%) and psychological and physical health, and (2) explore how pandemic-related stress and health behaviors affected BF% during and after the intervention. A total of 29 active duty Navy personnel (55% female, 69% White) were enrolled after the onset of pandemic restrictions and completed measures assessing pandemic-related stress and health behaviors as well as measures of general psychological and physical health before the intervention. BF% was collected at 5 timepoints, including baseline, during, and following the intervention. Bivariate correlations assessed associations at baseline. Linearmixed-effects longitudinal models explored how pandemic-related stress and health behaviors affected BF%. Post-hoc analyses evaluated the effects of pandemic factors on BF% at each timepoint. Most participants perceived of the pandemic as increasing stress and detracting from their abilities to engage in health behaviors (i.e., exercise and healthy eating). Higher pandemic stress was significantly associated with reporting exercise and healthy eating as more difficult, worse overall health, and more anxiety and general stress. Reporting exercise as harder during the pandemic also was associated with more psychological distress at baseline. A linearmixed- effects model controlling for age, sex, and number of intervention sessions attended revealed endorsing "exercise as harder" was associated with higher BF%. Post-hoc regression analyses revealed rating "exercise as harder" significantly predicted higher BF% 3 months post-intervention (B = 0.65, P = .01), whereas pandemic stress was not significantly associated with higher BF% at 3 month (B =0.14, P = .08) or 6 month (B = 0.21, P = .09) follow-up. As expected, most participants perceived of the pandemic as heightening stress and interfering with engagement in health behaviors. It is possible that pandemic-related stress may have exacerbated weight gain-promoting behaviors and/or interfered with achievement of desired weight management outcomes. Outside the context of the pandemic, it may be beneficial for healthcare providers to screen individuals for stress and perceptions of ease of engagement in health behaviors before enrollment in a weight management intervention. Further, tailoring interventions to mitigate stress and promote perceptions of ease in engaging in health behaviors may promote better weight management outcomes.

Home-based lifestyle intervention for breast cancer survivors: A surprising improvement in the quality of life during the first year of COVID-19 pandemic.

The COVID-19 pandemic induced an extraordinary impact on public mental health to a degree not completely understood, especially in vulnerable populations such as breast cancer (BC) survivors. In this study, we described the short- (after 3-month) and long- (after 12-month) term effects of a multidisciplinary home-based lifestyle intervention in Italian women BC survivors during the first year of COVID-19 pandemic. In total, 30 Italian BC survivors with risk factors for recurrence took part in the ongoing MoviS trial (protocol: NCT04818359). Between January 2020 and January 2021, a 3-month lifestyle intervention based on psychological counseling, nutrition, and exercise was carried out. Participants were asked to fill out psychological questionnaires for the assessment of quality of life (QoL) indicators (European Organization for Research and Treatment of Cancer QoL, EORTC-QLQ-C30) and psychological health measures such as fatigue (Brief Fatigue Inventory, BFI), distress (Distress Thermometer, DT and Psychological Distress Inventory, PDI), cancer-related fatigue (Verbal Rating Scale, VRS), and mood states (Profile of Mood States Questionnaire, POMS). IBM SPSS Statistical Software version 27.0 and R Project for Statistical Computing version 4.2.1 were used to process data. All participants were assessed at four time points: T0 (baseline), T1 (3-month), and follow-up at T2 and T3 (6- and 12-month, respectively) to measure primary (quality of life indicators) and secondary (psychological health) outcomes. Friedman non parametric test and Wilcoxon signed rank test (with Bonferroni correction) were conducted to investigate the statistically significant differences in psychometric scores and between assessment times. Compared to baseline (T0), at T1 most of the QoL indicators (i.e., symptoms of fatigue and general health) were improved (p < 0.017) with the exception of a worsening in participants' social functioning ability. Also, perception of severity of fatigue, distress, cancer-related fatigue, depression, and anger enhanced. Compared to baseline (T0), at T3 we mainly observed a stable condition with T0-T1 pairwise comparison, however other secondary outcomes (i.e., fatigue mood state, confusion, and anxiety) significantly improved. Our preliminary findings support the proposal of this lifestyle intervention for BC survivors. Despite the home-confinement due to the COVID-19 pandemic, the intervention surprisingly improved QoL indicators and psychological health of the participants.

Impact ofthe COVID-19 Pandemic onIndicators ofPsychological Health andSuicidal Ideation Within an Active Duty U.S. Military Population.

The COVID-19 pandemic has had a significant impact on the psychological health of individuals. The pandemic has contributed to increased anxiety, elevated rates of depression, and worsening suicidal ideation among civilians. Reported rates of burnout are also elevated as employees and employers adapted to ever-changing work environments, finding it increasingly difficult to maintain a work-life balance. The objective of this study is to determine how the COVID-19 pandemic impacted the psychological health and rates of suicidal ideation of active duty military personnel in the USA. A total of 2055 military personnel and military-adjacent employees stationed at a U.S. Air Force base completed a self-report survey that was administered six times from January 2020 to December 2021. Validated scales assessed measures of psychological health and suicidal ideation. General Estimating Equations were used to examine how indicators of time and psychological health predicted suicidal ideation in a military population. Life satisfaction, happiness, feeling life is worthwhile, depression severity, and suicidal ideation did not statistically change across the six time points. Worry (P < .01) and depression (P < .001) did decrease significantly, while burnout (P = .01) significantly increased across these time points. Feeling life is worthwhile significantly predicted reduced suicidal ideation (B = -.19; SE = 0.05), while depression (B = 0.11; SE = 0.03), depression severity (B = 0.24; SE = 0.05), worry (B = 0.06; SE = 0.02), and burnout (B = 0.15; SE = 0.07) predicted increased suicidal ideation. The rates of depression and worry decreased throughout the pandemic for those in the study while rates of suicidal ideation remained constant, demonstrating the potential resilience of military personnel and military-adjacent employees in response to the COVID-19 pandemic. However, burnout increased and significantly predicted elevated rates of suicidal ideation, highlighting the importance of focusing on reducing workplace stressors for military personnel.

Abstract 17819: Latent Class Analysis of Heart Health in a Marginalized Black Community

BACKGROUND Mounting evidence associates Black American’s experiences of chronic stress with younger age hypertension (HTN) onset, higher prevalence rates, and poorer treatment outcomes. Epigenetic research findings attribute these trends to DNA methylation, commonly referred to as stress related premature biological aging. Guided by the current American Heart Association (AHA) Science Statement on heart health, this health equity study aims to examine positive Black identity as a measure of positive psychological health in Black adults. METHODS Our community-engagement survey measured self-reports of: (1) environmental wellbeing, positive self-regard, spirituality, chronic stress, Black identity, anxiety, depression, anger, and five AHA essential cardiovascular health (CVH) factors: (2) physical activity, fruit, vegetables, smoking tobacco, and sleep. Multivariable linear regressions examined psychological health and CVH as predictors of systolic blood pressure. Latent class analysis (LCA), using ordinal indicators, assessed for latent sample profiles as statistical probabilities of similar responses and sample heterogeneity. RESULTS In a community sample (N=201) of Black adults (age M=46.7, SD=15.9), primarily female (N=141, 69.5%), increases in systolic blood pressure (Mean=134, SD=20.9) were associated with more chronic stress and less environment wellbeing; decreases were associated with less expressed anger. The LCA results show a four-class statistical solution with greater heterogeneity in spirituality, anger, anxiety, and depression. Among the four profiles, two theoretical latent classes for high and low systolic blood pressure were distinct. Low systolic blood pressure is associated with higher levels of environmental wellbeing, physical activity, and self-regard, both more and less spirituality, more positive Black identity, moderate anger, anxiety, and depression, and checking your BP. CONCLUSION In addition to emotion regulation, physical activity, and self-care, our findings support CVH promotion strategies in marginalized communities of Black Americans designed to reduce chronic stress, improve environmental wellbeing, and support positive Black identity.

Enhancing the effectiveness of CBT for patients with unipolar depression by integrating digital interventions into treatment: A pilot randomized controlled trial

Objective Blended cognitive behavioral therapy (bCBT) combines face-to-face therapy with digital elements, such as digital health apps. This pilot study aimed to explore the effectiveness and safety of a novel bCBT application for treating unipolar depression in adults combined with cognitive behavioral therapy (CBT) compared to CBT alone in routine care. Methods Patients (N = 82) were randomly assigned to bCBT (n = 42) or CBT (n = 40) over 12 weeks. bCBT consisted of weekly CBT sessions accompanied by the elona therapy depression module (a bCBT application for unipolar depression) for use between sessions. Standard CBT consisted of weekly CBT sessions. Outcomes (6,12 weeks) were analyzed with linear mixed models. Results Improvements in depressive symptoms (BDI-II, PHQ-9) were descriptively larger for the bCBT group. Yet, this difference did not reach statistical significance. bCBT was superior to standard CBT in secondary outcome measures of psychological health (d = .50) and generalized anxiety symptoms (d = -.45). In other secondary outcomes (BAI, PSWQ, GSE, WHOQOL-BREF), improvements were descriptively larger for bCBT compared to CBT. Conclusion This pilot study provided preliminary evidence that bCBT might be advantageous in comparison to CBT alone in the treatment of depression, but larger RCTs of the bCBT application are needed.

Meta-Analyses of the Relationships between Family Systems Practices, Parents' Psychological Health, and Parenting Quality.

(1) Background: Family systems theories include assertations that both personal and environmental factors are determinants of parents' psychological health, well-being, and parenting quality. Applied family systems theories focus on determinants that can be operationalized as intervention practices. The analyses described in this paper focused on the direct and indirect effects of four family systems practices (family needs, resources, supports, and strengths), parents' psychological health (depression, well-being, etc.), and parenting quality (parenting beliefs, involvement, and practices) in families of children with identified disabilities, medical conditions, or at-risk conditions for poor outcomes; (2) Methods: Data from previously completed meta-analyses of the relationships between family systems practices and parents' psychological health outcomes and parenting quality outcomes were reanalyzed. Next, a meta-analysis of the relationships between parents' psychological health and parenting quality was completed to identify which predictors were related to which parenting quality outcomes. Both main effects and mediated effects were examined; (3) Results: The four family systems practices were each related to six different psychological health measures and three parenting quality measures. The six different parental psychological health measures were also related to the three parenting quality measures. The relationships between family systems practices and parenting quality were partially mediated by parents' psychological health; (4) Conclusions: The effects of family systems practices and parents' psychological health on parenting quality were primarily direct and independent. The relationships between family systems practices and parenting quality were partially mediated by parents' psychological health. Future research should focus on the identification of other mediator variables found to be important for explaining the indirect effects of family systems practices measures on parenting beliefs, behavior, and practices.

Online mindfulness training for older adults during the COVID-19 pandemic: a randomized controlled trial using a multi-method assessment approach

Objectives The COVID-19 pandemic drastically accelerated the need for studies examining the effectiveness of programs to bolster psychological well-being, particularly for at-risk groups, such as older adults (OAs). Mindfulness Training (MT) has been suggested as a well-suited program for this purpose. The present study examined the impact of a 4-week online, trainer-led MT course tailored for OAs during the early months of the COVID-19 pandemic. Methods Fifty-three OAs were randomly assigned to either Group A or Group B. Group A received the online MT course during the 4-week interval between the first (T1) and second (T2) testing sessions, while Group B received the same MT course during the interval between T2 and the third testing session (T3). The testing sessions included measures of mindfulness, emotional well-being, psychological health, and cognitive performance. In addition, a very brief survey was sent every week during the T1–T2 and T2–T3 intervals to assess weekly emotional well-being. Results The findings revealed that MT may improve some, albeit not all, aspects of mindfulness and well-being, while no significant results were noted for outcomes measuring psychological health and cognitive performance. Conclusions These findings are discussed in the context of the evolving COVID-19 situation.

Forest bathing diminishes anxiety in undergraduate students: a pilot study in the Valdivian temperate rainforest

ABSTRACT Urban life has generally resulted in lifestyles characterised by high stress and anxiety, all which has increased the pervasiveness of mental disorders. University students, a group highly vulnerable to these problems, are likely to develop mental pathologies associated with anxiety and substance abuse. Forest bathing is one nature-oriented intervention aimed at improving physical as well as psychological well-being by reducing anxious symptomatology and stress. Here we evaluated the healing impact of forest bathing on the stress and anxiety of undergraduate students at one local university. We also included others key aspects of psychological mental health that have received scarce attention in forest bathing research like mindfulness, wellbeing and self-regulated learning. Twenty-one students belonging to the Universidad Austral de Chile were randomly assigned to the city or forest groups and took part in an intervention consisting in a low-impact 30 minute walk and a 15-minute contemplation afterwards. Five instruments to evaluate overall mental health (and blood pressure) were applied before and after the intervention. Our results showed that a rather short session of forest bathing is enough to reduce anxiety in undergraduate university students. The other measures of psychological or physiological health showed no statistical differences before and after the intervention (between city and forest) or time effects (within the forest or city treatment). A potential reason for this might be related to the short duration of the intervention itself. Our results are encouraging regarding mental health therapy, as this type of intervention could easily be implemented on campus.

The Impact of Dance Movement Interventions on Psychological Health in Older Adults without Dementia: A Systematic Review and Meta-Analysis.

Lifestyle-based multimodal interventions that integrate physical, sensory, cognitive and social enrichment are suggested to promote healthy mental aging and resilience against aging and Alzheimer's disease (AD). This meta-analysis examined the efficacy of dance movement interventions (DMI) as an integrated mind-body activity on outcomes of psychological health in older adults. Pre-registration was carried out with PROSPERO (CRD42021265112). PubMed, Web of Science and PsycINFO were searched for randomized controlled trials (RCT) evaluating the effects of DMI (>4 weeks' duration) compared to comparators on measures of psychological health (primary outcome) and cognitive function (additional outcome) among older adults without dementia (aged ≥55). Data of 14 primary RCT (n = 983, n-DMI = 494, n-control = 489) were synthesized using a random effects meta-analysis with robust variance estimation. DMI had a small positive effect on overall psychological health (g = 0.30; 95% confidence interval [CI]: 0.06, 0.53; p = 0.02, I2= 65.04) compared to control conditions. Small effects of DMI on positive and negative psychological domains as well as quality of life were not statistically significant. DMI had a medium positive effect on general cognitive function (g = 0.50; 95% CI: 0.12, 0.89, p = 0.02, I2= 79.61) over comparators. None of the primary intervention studies evaluated measures of neuroplasticity. We found that DMI was effective in promoting mental health amongst older adults without dementia, suggesting that the multimodal enrichment tool is a potential strategy for health promotion and prevention of AD. High-quality intervention studies are needed to expand evidence on DMI-induced changes in specific psychological domains and identify underlying neurophysiological correlates.

Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-16) with an older Norwegian population

Emotion regulation is proposed to have a salient role in optimal aging. However, currently used measures of emotion regulation have not been validated for older adults. Therefore, we evaluated the psychometric properties of the Difficulties in Emotion Regulation Scale—short form (DERS-16) in a large Norwegian sample consisting of individuals between 70 and 95 years (n = 2525). Tests of internal consistency, reliability, assessment of intra-domain correlations, and confirmatory factor analyses were performed. Construct validity was further investigated by assessing concurrent associations between DERS-16 and well-established measures of psychological disorders, psychological health, and well-being (five-item version of Geriatric Depression Scale, Geriatric Anxiety Inventory—short form, and OECD guidelines on measuring subjective well-being). All subscales derived from the instrument showed adequate internal consistency. Furthermore, we obtained a theoretically consistent factor structure, in which a bifactor model combining a general emotion regulation factor and five additional domain-specific facet-factors had superior model fit. As expected, difficulties in emotion regulation correlated positively with symptoms of depression and anxiety, and negatively with psychological health and well-being. Associations were generally of moderate strength. We can thus conclude that the DERS-16 demonstrates excellent psychometric properties when used in samples with older adults and may safely be employed in studies of emotion regulation difficulties in the older segment of our population.

Association of nutrition with psychological health and quality of life among older adults with advanced cancer.

12043 Background: Impaired nutrition is associated with greater treatment toxicity and reduced overall survival in patients with advanced cancer. We aimed to evaluate the association of impaired nutrition with psychological health and quality of life among older adults with advanced cancer who were starting cancer treatment with palliative intent. Methods: This secondary analysis was performed on baseline data from a nationwide cluster randomized clinical trial (ClinicalTrials.gov identifier: NCT02107443; PI: Mohile; funding NCI UG1CA189961). Adults age ≥70 with advanced cancer and≥1 geriatric assessment impairment were enrolled from 2014 to 2017. Patients with BMI &lt; 21 kg/m2, &gt; 10% involuntary weight loss in the past 6 months, or Mini Nutritional Assessment Short Form (MNA-SF) score of ≤11 were considered to have impaired nutrition. We used separate multivariable linear regressions to evaluate the association of impaired nutrition with each measure of psychological health and quality of life, which included Geriatric Depression Scale (GDS-15, range 0-15), Generalized Anxiety Disorder-7 (GAD-7, range 0-21), NCCN Distress Thermometer (NCCN DT, range 0-10) and Functional Assessment of Cancer Therapy-General (FACT-G, range 0-108). Analyses were adjusted for baseline patient demographics, clinical characteristics, and geriatric assessment. Results: Among 541 patients, mean age was 77 (range 70-96) and 60% had impaired nutrition. Among the 326 patients with impaired nutrition, 95% had MNA-SF ≤11, 23% had &gt; 10% weight loss in the last six months, and 20% had BMI &lt; 21 kg/m2. Mean baseline GDS-15 was 3.1 (standard deviation [SD] 2.7), GAD-7 was 2.9 (SD 4.0), NCCN DT was 2.9 (SD 2.7), and FACT-G was 80 (SD 14). In the adjusted model, compared to those with normal nutrition, older adults with impaired nutrition had greater depression (mean 0.65 points higher on the GDS-15, p &lt; 0.01) and lower quality of life (mean 6.0 points lower on the FACT-G, p &lt; 0.01). There was insufficient evidence of an association between nutrition and anxiety (β = 0.67, p = 0.06) or distress (β = 0.26, p = 0.28). Conclusions: Recognition of malnutrition by oncology providers is crucial for older adults with advanced cancer. Impaired nutrition is associated with greater depression and lower quality of life among older adults with advanced cancer. Tailored resources to improve psychological health and quality of life are needed to support older adults with impaired nutrition receiving cancer treatment.

0292 Development and Validation of the Sleep Conflict Scale in Couple Relationships

Abstract Introduction Although there is considerable sleep concordance between partners in couple relationships, less is known about sleep practices between them and if there is conflict around sleep habits, preferences, and behaviors. Past empirical work suggests that couples who share the same sleep-wake preferences (i.e., morning vs. night people) report higher marital adjustment and less relational conflict. And yet the mechanism through which this occurs is yet unknown. One such mechanism is sleep-related conflict whereby partners disagree about their partners' sleep rituals causing sleep-related conflict. Methods The present study utilizes two samples to validate the Sleep Conflict Scale (SCS), one in individuals in relationships and the other sample of paired partners (dyadic data). The sleep conflict scale is a 5-item measure and includes items such as "My partner and I disagree about sleep routines and habits" and "Our relationship is negatively affected by our sleep differences". In order to identify the underlying factor structure of the SCS, several criteria was assessed to determine suitability for factor analysis, including bivariate correlations, the Kaiser-Meyer-Olkin Measure of Sampling Adequacy, and Bartlett’s test of Sphericity. Composite scores were computed and internal consistency was assessed by conducting Cronbach Alpha reliability estimates. We tested convergent validity by identifying associations between the SCS and relational and psychological health measures. Finally, using the dyadic sample, we also tested a structural equation model using the SCS on both partners' sleep hygiene and sleep quality. Results Results revealed that the SCS fit a one factor solution of five items and that a summed or mean score can be used. The SCS demonstrated excellent internal reliability and external validity when compared to other relational and psychological measures. Finally, higher sleep conflict was associated with worse sleep hygiene and poorer sleep quality for both partners. Conclusion The analyses provided support that the SCS scale is a psychometrically sound measure, in that it demonstrates a single factor structure, is highly reliability, and is qualitatively different than other couple or sleep-related measures. The SCS can be used in both primary and secondary care settings to identify couples who would benefit from relational intervention especially when sleep adherence is low. Support (if any)

Attachment, psychological health and interpersonal functioning: a comparison of clinical and non-clinical groups of people with intellectual disability

PurposeInsecure and unresolved attachments have been linked to poorer psychological health and interpersonal functioning for people with intellectual disabilities (IDs), but research in this area is limited, especially for adults. Studies using the Adult Attachment Projective (AAP) have been restricted to clinical samples, where insecure and unresolved attachments are typically more prevalent. The purpose of this study is to compare clinical and non-clinical groups of adults with IDs on the AAP, plus measures of psychological health and interpersonal functioning, to investigate whether group differences found in the typically developing population are also present for adults with IDs.Design/methodology/approachA cross-sectional, between-group design was used. Adults with IDs (clinical group n = 11 and non-clinical group n = 13) completed measures of attachment, psychological distress/positive well-being and interpersonal functioning. Attachment classifications were compared in the clinical versus non-clinical groups. Measures of psychological distress, positive well-being and interpersonal functioning were compared between those with insecure-organised versus unresolved classifications.FindingsNo participants were classified as secure, and there were high rates of unresolved attachment. There were no differences between clinical and non-clinical groups with regards to the distribution of insecure-organised (i.e. dismissing or preoccupied) versus unresolved classifications. There were no differences between groups with regards to psychological distress, positive well-being or interpersonal functioning. The authors consider limitations in the method of group differentiation and suggest further research to better understand the development of internal working models of attachment in this population.Originality/valueTo the best of the authors’ knowledge, this study is one of only three to examine attachment state of mind in adults with IDs using the AAP and the first to examine differences between clinical and non-clinical groups.

Sleep timing, sleep regularity, and psychological health in early late life women: Findings from the Study of Women's Health Across the Nation (SWAN)

ObjectivesTo examine the associations of actigraphy-assessed sleep timing and regularity with psychological health in early late life women, whose circadian rhythms may be impacted by aging. DesignCross-sectional. ParticipantsA racially/ethnically diverse sample of 1197 community-dwelling women (mean age 65 years) enrolled in the Study of Women's Health Across the Nation. MeasuresActigraphy-assessed sleep measures included timing (mean midpoint from sleep onset to wake-up) and regularity (standard deviation of midpoint in hours). Psychological health measures included a composite well-being score, the Center for Epidemiological Studies Depression Scale, and the Generalized Anxiety Disorder-7 Scale. Linear and logistic regression models, adjusted for covariates (including sleep duration), tested associations between sleep and psychological health measures. ResultsAfter covariate adjustment, a sleep midpoint outside of 2:00-4: 00 AM was significantly associated with depressive symptoms (β = 0.88, 95% CI = 0.06, 1.70) and scoring above the cut-point for clinically significant depressive symptoms (OR = 1.72, 95% CI = 1.15, 2.57). Sleep irregularity was significantly associated with lower psychological well-being (β = -0.18, 95% CI = −0.33, −0.03), depressive (β = 1.36, 95% CI = 0.29, 2.44) and anxiety (β = 0.93, 95% CI = 0.40, 1.46) symptoms, and scoring above the cut-point for clinically significant depressive (OR = 1.68, 95% CI = 1.01, 2.79) and anxiety (OR = 1.62, 95% CI = 1.07, 2.43) symptoms. ConclusionAbove and beyond sleep duration, a sleep midpoint outside of 2:00-4:00 AM was associated with depressive symptoms while sleep irregularity was associated with multiple psychological health domains in late life women.

Examining Lifetime Abuse Experiences of People with Spinal Cord Injury

<h3>Research Objectives</h3> To examine lifetime abuse among people with SCI and its relation to demographic and disability characteristics and physical and psychological health. <h3>Design</h3> Cross-sectional survey study. <h3>Setting</h3> Online survey with alternate formats offered. <h3>Participants</h3> A diverse national sample of 346 people with SCI. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Lifetime abuse was examined using the Abuse Assessment Screen-Disability (AAS-D) which assesses physical, sexual, and disability-related abuse. We measured physical health with the SF-36 General Health Scale and the SCI Secondary Conditions Scale. We used the PHQ-8, GAD-7, PTSD Checklist-Civilian, and the Satisfaction with Life Scale to assess psychological health and well-being. <h3>Results</h3> More than a third of participants reported abuse. Physical abuse was most frequently reported (30%) followed by disability-related (17%) and sexual (9%) abuse. Few demographic or disability characteristics were related to abuse; however, women were significantly more likely to have experienced sexual abuse than men (20% versus 2%). Sexual abuse was also reported more often by those employed. Physical abuse was reported more often by those formerly married and was inversely related to income. Disability-related abuse was not related to any demographic characteristics but was significantly related to self-reported care needs. All three types of abuse were related to physical and psychological health. Entering all three abuse types in regression models, only disability abuse uniquely predicted all four measures of psychological health and well-being. <h3>Conclusions</h3> The SCI literature on abuse is extremely limited. Our results suggest a sizeable number of people with SCI have experienced abuse, and this experience may have health ramifications. Disability-related abuse, which differentially affects those with greater care needs, should not be underestimated in scope or impact. <h3>Author(s) Disclosures</h3> None.

Changes in household debt due to COVID-19 and mental health concerns among adults in Ontario, Canada.

Canadian households experienced unexpected changes in their economic well-being during the COVID-19 pandemic. The extent of the impact of the pandemic on household debt and its effect on health and mental health remains unknown. The aim of the study was to examine the associations of change in household debt due to COVID-19 with serious psychological distress (SPD) and general health measures. Data were from the 2020 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The 2020 cycle employed a web-based panel survey of 3,033 adults. The survey included measures of change in household debt due to the COVID-19 pandemic, mental and general health. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. Overall, 17.5% of respondents reported that their household debt increased due to the COVID-19 pandemic. Such an increase in household debt was significantly associated with SPD (OR = 2.92, 95% CI, 2.05-4.16), fair/poor mental health (OR = 2.02, 95% CI, 1.59-2.56), frequent mental distress days (OR = 1.80, 95% CI, 1.31-2.48), fair/poor general health (OR = 1.93, 95% CI, 1.47-2.52), and suicidal ideation (OR = 3.71, 95% CI, 2.41-5.70) after adjusting for potential confounders including education, income and employment. Household debt during the COVID-19 pandemic is an important determinant of health. Individuals who reported an increase in household debt due to COVID-19 were more likely to report serious mental health concerns including suicidal ideation. This suggests that debt-related interventions may be needed to alleviate the adverse effects of indebtedness on health.

Unique characteristics of patients who choose an intensive lifestyle medicine program to address chronic musculoskeletal pain.

Factors that motivate musculoskeletal patients to pursue an intensive, lifestyle medicine-based approach to care are poorly understood. To determine whether, compared to patients seeking musculoskeletal care through traditional pathways, patients who choose an intensive lifestyle medicine program for musculoskeletal pain endorse greater physical dysfunction, worse psychological health, and/or more biopsychosocial comorbidities. Cross-sectional analysis of existing medical records from 2018 to 2021. Orthopedic department of one academic medical center. Fifty consecutive patients who enrolled in an intensive lifestyle medicine program to address a musculoskeletal condition. Comparison groups were the following: (1) 100 patients who presented for standard nonoperative musculoskeletal care, and (2) 100 patients who presented for operative evaluation by an orthopedic surgeon and qualified for joint arthroplasty. Not applicable. Primary outcomes were age-adjusted, between-group differences in Patient-Reported Outcomes Measurement Information System (PROMIS) physical and psychological health measures. Secondary outcomes were between-group differences in sociodemographic and medical history characteristics. Patients who enrolled in the intensive lifestyle medicine program were more racially diverse (non-White race: lifestyle cohort 34% vs. comparison cohorts 16%-18%, p ≤ .029) and had a higher prevalence of obesity and diabetes than both comparison groups (mean body mass index: lifestyle cohort 37.6kg/m2 vs. comparison cohorts 29.3-32.0, p < .001; diabetes prevalence: lifestyle cohort 32% vs. comparison cohorts 12%-16%, p ≤ .024). Compared to standard nonoperative patients, there were no clear between-group differences in PROMIS physical or psychological health scores. Compared to standard operative evaluation patients, patients in the lifestyle program reported worse anxiety but less pain interference (PROMIS Anxiety: B=3.8 points [95% confidence interval, 0.1 to 7.4], p=.041; Pain interference: B=-3.6 [-6.0 to -1.2], p=.004). Compared to musculoskeletal patients who sought care through traditional pathways, patients who chose an intensive lifestyle medicine pathway had a higher prevalence of metabolic comorbidities, but there was substantial overlap in patients' physical, psychological, and sociodemographic characteristics.