Mental Health Indicators Research Articles

The relationship between physical activity and mental health: Is more always better?

The current study was designed to examine the relationship between physical activity and mental health. We investigated whether individuals who perceive themselves as physically inactive, recreationists, or active athletes differ in positive (positive affect, subjective well-being, unconditional self-acceptance) and negative mental health outcomes (depression, anxiety, stress, negative affect, conditional self-acceptance). Furthermore, we investigated whether the total level of leisure-time physical activity predicted different mental health indicators. Analysis revealed that physically active respondents (recreationists and active athletes) seem to have better overall mental health status than physically inactive ones. Precisely, physically inactive individuals scored higher on all measures of negative mental health indicators, and lower on all measures of positive mental health indicators, compared with the participants from the two other groups. At the same time, there were no significant differences in these measures between recreationists and active athletes. Besides, a positive association was found between the weekly frequency of leisure-time activity and only two positive indicators of mental health (positive affect and subjective well-being)of all tested. The obtained results suggest that it is often more relevant for mental health whether someone is physically active or not, in general, than how frequently they exercise.

Romantic attachment, LGB minority stress, and mental health

Introduction The impact of attachment styles on mental health has been widely examined across diverse groups, yet the unique roles of these styles within sexual minority populations have only recently begun to be explored. The present study investigated the mediating effect of attachment style on the relationship of one aspect of sexual minority stress (termed negative LGB identity) and two indicators of mental health (i.e., psychological distress, self-esteem). Method Data from 284 LGB participants from the United States were gathered from an online survey and assessed in the present study. Results Negative LGB identity was correlated positively with both avoidant and anxious attachment. Further, negative LGB identity was also correlated positively with psychological distress and negatively with self-esteem. Two mediation models were assessed simultaneously using Hayes’ PROCESS Macro. Conclusion After accounting for attachment style, there was no longer a significant direct effect of negative LGB identity on either psychological distress or self-esteem, indicating mediation. Such a finding highlights the importance of one’s attachment style on mental health for sexual minority people. Limitations and directions for future research were addressed.

Using crisis text messaging service data to measure the impact of the COVID-19 Pandemic on mental health in Ireland

ABSTRACT In 2020 and 2021, non-pharmaceutical interventions (NPIs) were implemented globally to mitigate the transmission of COVID-19. This study is aimed to assess the impact of NPIs on the public mental health in Ireland by drawing on two datasets: (1) data of 43,433 chats initiated at Text About It, a free text-based mental health crisis service in Ireland, and (2) emotional well-being indicators reported by respondents of the Amárach public opinion survey, carried out on behalf of the Department of Health, Ireland. Our analysis reveals that COVID-19-related chats drove overall volumes of chats to Text About It between June 2020 to July 2021. Surges in text volumes immediately prior to new restrictions in Ireland indicate an association between the announcements of the new restrictions and a sudden rise in mental health concerns. Through segmented regression, seven distinct breakpoints were identified across weekly chat volumes at Text About It, the majority of which co-occurred with dates when considerable changes in NPIs were made. Significant high cross-correlation is found between emotional well-being variables in the Amárach dataset and the number of weekly COVID-19 related texts to Text About It. This analysis confirms the value of Text About It as community surveillance indicator for population mental health.

How it feels to be “left on read”: Social surveillance on Snapchat and young individuals’ mental health

Research has shown that young individuals frequently turn to social networking sites (SNSs) to monitor others’ behaviors. This is especially likely with Snapchat, as this platform offers extensive monitoring options in real time, for instance through the use of the “snap map”. However, despite the growth of surveillance features, little is known about the use of these features and their possible association with individuals’ mental health. Consequently, this cross-sectional survey among 16- to 25-year-olds (N = 360, Mage = 19.51) examines (1) whether individuals with a higher need for popularity are more likely to engage in Snapchat surveillance behaviors, (2) whether these behaviors, in turn, are associated with indicators of individuals’ mental health, specifically feelings of loneliness and depressive symptoms, and (3) whether fear of missing out mediates the association between surveillance behaviors and these mental health indicators. The findings show that a higher need for popularity is associated with the monitoring of others through Snapchat, which, in turn, was associated with health indicators via fear of missing out. These associations were, however, not found for general Snapchat use, indicating that specific uses of this platform are more detrimental than others. Future research should, therefore, focus more thoroughly on the relationships between specific SNS behaviors and individuals’ mental health.

Using Wearable Devices and Speech Data for Personalized Machine Learning in Early Detection of Mental Disorders: Protocol for a Participatory Research Study.

Early identification of mental disorder symptoms is crucial for timely treatment and reduction of recurring symptoms and disabilities. A tool to help individuals recognize warning signs is important. We posit that such a tool would have to rely on longitudinal analysis of patterns and trends in the individual's daily activities and mood, which can now be captured through data from wearable activity trackers, speech recordings from mobile devices, and the individual's own description of their mental state. In this paper, we describe such a tool developed by our team to detect early signs of depression, anxiety, and stress. This study aims to examine three questions about the effectiveness of machine learning models constructed based on multimodal data from wearables, speech, and self-reports: (1) How does speech about issues of personal context differ from speech while reading a neutral text, what type of speech data are more helpful in detecting mental health indicators, and how is the quality of the machine learning models influenced by multilanguage data? (2) Does accuracy improve with longitudinal data collection and how, and what are the most important features? and (3) How do personalized machine learning models compare against population-level models? We collect longitudinal data to aid machine learning in accurately identifying patterns of mental disorder symptoms. We developed an app that collects voice, physiological, and activity data. Physiological and activity data are provided by a variety of off-the-shelf fitness trackers, that record steps, active minutes, duration of sleeping stages (rapid eye movement, deep, and light sleep), calories consumed, distance walked, heart rate, and speed. We also collect voice recordings of users reading specific texts and answering open-ended questions chosen randomly from a set of questions without repetition. Finally, the app collects users' answers to the Depression, Anxiety, and Stress Scale. The collected data from wearable devices and voice recordings will be used to train machine learning models to predict the levels of anxiety, stress, and depression in participants. The study is ongoing, and data collection will be completed by November 2023. We expect to recruit at least 50 participants attending 2 major universities (in Canada and Mexico) fluent in English or Spanish. The study will include participants aged between 18 and 35 years, with no communication disorders, acute neurological diseases, or history of brain damage. Data collection complied with ethical and privacy requirements. The study aims to advance personalized machine learning for mental health; generate a data set to predict Depression, Anxiety, and Stress Scale results; and deploy a framework for early detection of depression, anxiety, and stress. Our long-term goal is to develop a noninvasive and objective method for collecting mental health data and promptly detecting mental disorder symptoms. DERR1-10.2196/48210.

Gendered Patterns in Manifest and Latent Mental Health Indicators Among Suicide Decedents: 2003-2020 National Violent Death Reporting System (NVDRS).

Objectives. To investigate differences in the documentation of mental health symptomology between male and female suicide decedents in the 2003-2020 US National Violent Death Reporting System (NVDRS). Methods. Using information on 271 998 suicides in the 2003-2020 NVDRS, we evaluated precoded mental health-related variables and topic model-derived latent mental health themes in the law enforcement and coroner or medical examiner death narratives compiled by trained public health workers. Results. Public health records of male compared with female suicides were less likely to include notations of mental health conditions or treatment interventions. However, topic modeling of death summaries revealed that male suicide decedents were more likely to evidence several subclinical cognitive and emotional indicators of distress. Conclusions. Suicide death records vary by gender, both in recorded evidence for mental health conditions at time of death and in accompanying narratives describing proximal circumstances surrounding these deaths. Our findings hint that patterns of subclinical mental health changes among men might be less well captured in commonly used mental health indicators, suggesting that prevention efforts may benefit from measures that also target assessment of subclinical distress. (Am J Public Health. 2024;114(S3):S268-S277. https://doi.org/10.2105/AJPH.2023.307427).

Progression of the COVID-19 pandemic, Brazilian healthcare workers' emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study.

Even though the long-term effects of the COVID-19 pandemic on healthcare workers' mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies. To assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths). The sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment). Brazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased. The lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic's chronic effects and the need for organizations to monitor these workers' mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.

Measuring Population-Level Adolescent Mental Health Using a Single-Item Indicator of Experiences of Sadness and Hopelessness: Cross-Sectional Study.

Population-level monitoring of adolescent mental health is a critical public health activity used to help define local, state, and federal priorities. The Youth Risk Behavior Surveillance System includes a single-item measure of experiences of sadness or hopelessness as an indicator of risk to mental health. In 2021, 42% of high school students reported having felt sad or hopeless for 2 weeks or more during the past 12 months. The high prevalence of US high school students with this experience has been highlighted in recent studies and media reports. This study seeks to examine associations between this single-item measure of experiences of sadness or hopelessness with other indicators of poor mental health including frequent mental distress and depressive symptoms. We analyzed survey data from a national sample of 737 adolescents aged 15-19 years as a part of the Teen and Parent Surveys of Health. Participants were recruited from AmeriSpeak, a probability-based panel designed to be representative of the US household population. Feeling sad or hopeless was operationalized as a "yes" response to the item, "During the past 12 months, did you ever feel so sad or hopeless almost every day for 2 weeks or more in a row that you stopped doing some usual activities?" Unadjusted and adjusted prevalence ratios (aPRs) were calculated to examine associations between the single-item measure of having felt sad or hopeless almost every day for 2 weeks with moderate to severe depressive symptoms, frequent mental distress, and functional limitation due to poor mental health. Adjusted models controlled for age, race and ethnicity, sex assigned at birth, and sexual identity. Overall, 17.3% (unweighted: 138/735) of adolescents reported that they felt sad or hopeless for 2 weeks or more during the past 12 months, 30.2% (unweighted: 204/716) reported moderate to severe depressive symptoms, 18.4% (unweighted: 126/732) reported frequent mental distress, and 15.4% (unweighted: 107/735) reported functional limitation due to poor mental health. After adjusting for demographics, adolescents who reported that they felt sad or hopeless for 2 weeks or more were 3.3 times as likely to report moderate to severe depressive symptoms (aPR 3.28, 95% CI 2.39-4.50), 4.8 times as likely to indicate frequent mental distress (aPR 4.75, 95% CI 2.92-7.74), and 7.8 times as likely to indicate mental health usually or always interfered with their ability to do things (aPR 7.78, 95% CI 4.88-12.41). Associations between having felt sad or hopeless for 2 weeks or more and moderate to severe depressive symptoms, frequent mental distress, and functional limitation due to poor mental health suggest the single-item indicator may represent relevant symptoms associated with poor mental health and be associated with unmet health needs. Findings suggest the single-item indicator provides a population-level snapshot of adolescent experiences of poor mental health.

Molecular Biomarkers of Aging to Predict Clinical Frailty in Newly Diagnosed Hematologic Malignancy

Introduction: Older adults with hematologic malignancy (HM) are a growing demographic with wide-ranging therapeutic options. With aging, patient health and treatment decision-making are heterogenous. Treatment decisions are impacted by chronological age, performance status, and comorbidities. An approach to treating older adults based on objective measures of health may better personalize therapy by focusing on physiologic parameters. Here we examined the relationship of a blood-based aging biomarker, p16 INK4a (p16), with clinical frailty. Methods: Newly diagnosed patients with HM were enrolled in a prospective study capturing fitness measures and peripheral blood T lymphocyte (PBTL) p16 levels pre-treatment. Clinical phenotypes of fitness included 11 measures: ECOG performance status, Patient-Reported Outcome Measurement Information System (PROMIS) Global Health Scale Short Form v1, Older Americans Resources and Services (OARS) instrumental activities of daily living (IADL), Medical Outcomes Study (MOS) physical function, patient-reported Karnofsky Performance Status (KPS), social activity and social support (MOS) scores, Mental Health Index (MHI), and cognition (Blessed Orientation-Memory-Concentration). Physical function was measured using the Short Physical Performance Battery (SPPB). PBTL p16 was measured using the OSU_Senescence Nanostring CodeSet, which includes 74 additional T cell markers and five controls. PBTL were also examined for DNA methylation. PBTL were extracted, bisulfite converted, and methylation was quantified using the Illumina 850K EPIC methylation array at the TruDiagnostic core laboratory. Raw data was processed using the minfi pipeline, followed by normalization, batch correction, and KNN-based imputation using the GMQN and impute R packages. Principal-component (PC) PhenoAge measures were calculated using the processed methylation values. Results: Patients newly diagnosed with HM (n=33) (acute leukemia n=13, 39.5%, plasma cell dyscrasia n=13, 39.5%, lymphoma n=4, 12.1%, chronic lymphocytic leukemia=3, 9.1%) and complete p16 analysis with geriatric deficits were included. The mean p16 score was 32.6 (range 1.7-259.7). We quantified a composite deficit index defined as a frailty score higher than the third quartile using the aggregate score of the above fitness measures (range 0 to 11). Using a threshold for p16 ≥31.9, the model had 80% sensitivity and 79% specificity to identify frailty. The positive predictive value was 0.40, the negative predictive value was 0.96, and the accuracy was 0.76. The area under the ROC curve (AUC) for frailty versus p16 was 0.725. PBTL p16 was also explored in relation to other biomarkers of interest including epigenetic age (n=50). PBTL p16 correlated with PhenoAge r=0.38, p=0.0067. Conclusion: Aging biomarkers provide a novel means to quantify physiologic age in newly diagnosed HM. PBTL p16 levels showed a significant relationship with a composite metric of clinical fitness and accelerated aging in patients with different HM. PBTL p16 was both a sensitive and specific blood-based biomarker to identify clinical frailty in this preliminary analysis.

Ancient medicine for a modern disease: traditional Amazonian medicine to treat substance use disorders

ABSTRACTBackground: There exists an underexploited opportunity to develop innovative therapeutic approaches to SUDs based upon the complementarity between modern and traditional health systems.Objectives: Illustrate the feasibility and potentiality of such an approach through the comprehensive description of Takiwasi Center’s treatment model and program, where health concepts and practices from traditional Amazonian medicine work synergistically with modern psychotherapy and medicine in an intercultural dialog to assist in the rehabilitation of people suffering from SUDs.Methods: The description was built from a review of the literature, institutional data, participatory observation and unstructured interviews with staff, researchers and patients during treatment.Results: Since the foundation of the Takiwasi Center in 1992 in the peruvian Amazon, more than a thousand patients with different socio-cultural, ethnic and religious backgrounds have received residential treatment. We present how traditional Amazonian medicine techniques and health concepts cooperate to complement modern psychology in a therapeutic community setting and propose some hypotheses about the neurobiological, psycho-emotional and spiritual healing mechanisms triggered by the program to help people identify and heal the roots of their substance misuse and addictive behavior. We also summarize quantitative outcomes during treatment showing significant improvements in a wide variety of mental health indicators.Conclusion: Takiwasi Center’s program is an option for people seeking non-conventional treatment who are sensitive to traditional Amazonian medicine practices and ready to explore the roots of their addiction. From this intercultural approach, some lessons could emerge toward a broader understanding of SUDs that may result in better patient care.

Smoking, Stress, and Health Risk Behaviors During the Early Phase of COVID-19 Lockdowns Among Residents of Flint, Michigan

Abstract: Food insecurity and smoking commonly co-occur in underserved populations, exacerbating health disparities. This study assesses smoking and its associations with mental health and health risk behaviors among residents of Flint, Michigan in the early phase of COVID lockdowns. The survey captured smoking status, mental health indicators, and health risk behaviors among 106 who had financial needs and limited mobility and received community nutritional services. Comparisons by demographics showed that those who lived alone, used marijuana, and had frequent alcohol drinking tended to smoke more than their counterparts. Results from logistic regression showed that those with high levels of stress, marijuana use, and alcohol consumption were more likely to smoke. Living alone was associated with smoking and health risk behaviors. This research suggests the need for smoking prevention and community health practices addressing stress, health risk behaviors, and circumstances that might drive the association with living alone such as loneliness.

Resilience and Suicidal Thoughts in Young People: Based on the Rafsanjan Youth Cohort Study.

Suicide is a serious public health problem, and suicide attempt is defined as one of the important indicators of mental health in a society. The present study investigated the relationship between resilience and suicidal thoughts in Rafsanjani youth. This cross-sectional descriptive study examined 3006 young people aged 15-35 who referred to Rafsanjan Cohort Study (RCS). Connor and Davidson's questionnaire was used to measure resilience. The data, including demographic characteristics and cases related to suicide, were extracted from the computer system, which is part of the Rafsanjan Youth Cohort Program. Independent t-test, one-way analysis of variance, Tukey's post-hoc test, Pearson's correlation coefficient and multiple linear regression model were used to analyze the data. A total of 3006 individuals were studied, of whom 1685 (56.1%) were women, and 1321 (43.9%) were men. The average age of the participants was 25.75±6.09 years. Men had a significantly higher average score of resilience (P<0.001) and suicidal thoughts (P=0.002) than women. In addition, the average score of suicidal thoughts in divorced and widowed people was significantly higher than single and married people (P=0.029). It was shown that older age groups had higher average resilience (P<0.001) and fewer suicidal thoughts (P=0.003), and people over 30 years had the lowest average suicidal thoughts. The results indicate an inverse and significant relationship between resilience and suicidal thoughts in both men and women. Therefore, more evaluations are necessary to investigate the factors affecting resilience and take measures to improve it among young people.

Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey

BackgroundEvidence on workplace bullying and harassment (WBH) in the UK has not used probability-sample surveys with robust mental health assessments. This study aimed to profile the prevalence and nature of WBH in England, identify inequalities in WBH exposure, and quantify adjusted associations with mental health. MethodsData were from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional probability-sample survey of the household population in England, interviewed with verbal informed consent. Criteria for inclusion in the secondary analysis were being aged 16–70 years and in paid work in the past month (n=3838). Common mental disorders were assessed using the Clinical Interview Schedule-Revised and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. Analyses were weighted. We examined associations between past-year WBH and current common mental disorders using multivariable regression modelling, adjusting for demographic and socioeconomic factors. Interaction terms tested for gender differences in associations. The study received ethics approval (ETH21220–299). FindingsOne in ten employees (10·6% (weighted), n=444/3838) reported past-year experience of WBH, with rates higher in women (12·2%, n=284/2189); those of mixed, multiple, and other ethnicity (21·0%, n=15/92); and people in debt (15·2%, n=50/281) or living in cold homes (14·6%, n=42/234). Most commonly identified perpetrators of WBH were line managers (53·6%, n=244/444) or colleagues (42·8%, n=194/444). Excessive criticism (49·3%, n=212/444), verbal abuse (42·6%, n=187/444), and humiliation (31·4%, n=142/444) were the most common types. WBH was associated with all adverse mental health indicators, including common mental disorders (adjusted odds ratio [aOR] 2·65, 95% CI 2·02–3·49), and 11 of 14 mental wellbeing indicators, including lower levels of confidence (aOR 0·57, 0·46–0·72) and of closeness to others (aOR 0·57, 0·46–0·72). Patterns of association between WBH and mental health were similar in men and women. InterpretationThese findings reinforce a need for more cohesive UK legislation at the national level; guidance on recognition of bullying behaviours for employees, managers, and human resources at the organisational level, focusing on prevention and early intervention, and increased awareness of the impact of WBH on mental health among health-service practitioners. Study limitations include reliance on cross-sectional data collected before pandemic-related and other major changes in workplace practices. Longitudinal data are needed to improve evidence on causality and the longevity of mental health impacts. FundingUK Prevention Research Partnership.

Risk and protective factors of mental health in children in residential care: A nationwide study from Luxembourg

BackgroundChildren who grow up in residential care are at high risk for mental health problems. Existing studies have focused on negative mental health indicators and risk factors. There has been less emphasis on identifying protective factors, particularly those associated with positive mental health outcomes. ObjectiveThis study explores positive and negative dimensions of mental health and their links to risk and protective factors in children who have experienced early adversity and trauma and have been placed in residential care. Participants and settingsChildren aged 11 to 18 (N = 264) were recruited from residential care homes in Luxembourg, a small, high-income European country. MethodsThe children completed self-report questionnaires on mental health, perceived stress, school pressure, and participation. Residential care workers provided information on demographic factors, developmental and care history, and pre-care experiences of early adversity and trauma. ResultsConfirmatory factor analysis indicated that subjective well-being, internalising problems, and externalising problems are separate yet interconnected components of mental health. Multiple Indicators Multiple Causes models showed that individual, contextual, and psychosocial predictors contribute differentially to positive and negative mental health outcomes. ConclusionsUsing a national sample of children in residential care in Luxembourg, this research indicates that subjective well-being, internalising problems, and externalising problems are distinct but related aspects of mental health. ‘Child participation’ and ‘school pressure’ displayed strong links with positive mental health outcomes and may serve as a potential path for improving public health interventions for children in care.

Effectiveness of Therapeutic Community Rehabilitation Program for Drug Abuse in Social Institutions

This research conducts an evaluation of the Therapeutic Community (TC) Program implemented for residents grappling with drug abuse within social institutions. The study aims to assess the program's effectiveness, the impact on participants, and its implications for social institutions and the broader field of substance abuse treatment. Through a mixed-methods approach, the research scrutinizes quantitative data to measure changes in substance abuse levels, mental health, and readiness for reintegration, coupled with qualitative insights from participant experiences. The outcomes reveal significant reductions in substance abuse levels, improvements in mental health indicators, and positive behavioral changes among participants. The study highlights the pivotal role of peer support and community integration in residents' recovery journeys. The implications of the findings encompass enhanced recovery pathways for individuals, reinforcing the value of community support, while calling for sustained support mechanisms and comprehensive approaches within social institutions. This evaluation underscores the dynamic nature of substance abuse interventions and underscores the importance of continuous assessment, innovation, and adaptive strategies for improved rehabilitation initiatives.

Mental Health of Immigrant Children and Adolescents (6-17 Years) in Canada: Evidence from the Canadian Health Measures Survey.

Studies indicate a higher prevalence of mental health problems among immigrants, but findings on immigrant children and adolescents are mixed. We sought to understand the magnitude of differences in mental health indicators between immigrant and non-immigrant children and adolescents in Canada and the influence of age, sex, household income, and household education. We completed a secondary analysis of data from the Canadian Health Measures Survey, using a pooled estimate method to combine data from four survey cycles. A weighted logistic regression was used to estimate the unadjusted and adjusted odds ratios with 95% confidence intervals. We found an association between the mental health of immigrant versus non-immigrant children and adolescents (6-17 years) as it relates to emotional problems and hyperactivity. Immigrant children and adolescents had better outcomes with respect to emotional problems and hyperactivity/inattention compared to non-immigrant children and adolescents. Lower household socioeconomic status was associated with poorer mental health in children and adolescents. No significant differences in overall mental health status were evident between immigrant and non-immigrant children and adolescents in Canada but differences exist in emotional problems and hyperactivity. Sex has an influence on immigrant child mental health that varies depending on the specific mental health indicator.

An Innovative Approach to Measure Mental Resilience and Wellbeing at the Individual and Societal Level Using the “Human Condition-4 – Satisfaction Index”

The concept of resilience is one aspect of mental health and coping mechanism that is paramount to understand the relationship between physical and mental health. However, in recent decades, there is a growing dissatisfaction among healthcare professionals with the traditional clinically driven resilience assessment tool. This is largely due to the fact that most resilience measures are unidimensional, with very long questionnaires and fails to address the complex underlying determinates of health. Resilience is a complex multidimensional construct with multiple interacting factors such as epigenetic, socio-economic, cultural, and environmental factors; all play critical roles in developing and modulating resilience in an integrated way. In recognition of that, this paper proposed an easy-to-use diagnostic resilience assessment tool that is person-centred and encompasses personal, community, and societal aspects of individual life. The four proposed domains for measuring resilience are (1) Control – self-determination, (2) Connectedness – social significance, (3) Cohesion – meaning and over-individual context, and (4) “Cherished” – identity and integrity. Furthermore, we propose a four-step guideline for the application of the proposed resilience assessment tool, which is applicable at the individual and societal levels. The overall aim is to support individuals and vulnerable populations by enhancing resilience and mitigating the untoward consequences. The assessment tool and the four-step guidelines can facilitate informed decision-making strategies that are feasible and support sustainable lifestyle changes and improve negatively correlated mental health indicators such as life and suffering, helplessness, social significance, identity, and meaning.

Mental health in undergraduate students several months into the COVID-19 pandemic compared to before the pandemic

Objective To compare mental health indicators among undergraduates in Fall 2019, before the COVID-19 pandemic, and Fall 2020, when many students returned to campus amidst restrictions on in-person contact. Participants Analyses included 26,881 undergraduate students, aged 18–24, from 70 U.S. institutions. Methods Students completed the National College Health Assessment-III survey in Fall 2019 or Fall 2020. Results The prevalences of high stress, loneliness, a low flourishing score, and serious psychological distress increased in 2020 compared to 2019. Serious psychological distress increased substantially in 2020 among students not living with family (adjusted prevalence ratio (aPR)=1.36, 95% CI 1.29–1.45) but not among students living with family (aPR = 1.09, 95% CI 0.95–1.26). Conclusions These results suggest prevalences of several indicators of poor mental health were elevated among U.S. undergraduates several months into the pandemic. The pandemic may have had greater impact on mental health among students not living with family.

Adaptation of the Bergen Social Media Addiction Scale (BSMAS) in Spanish

The impact of social networks on people's daily lives is worrisome, particularly in adolescents and young people, who seem to exceed the limits of normal use. Constant excessive use can lead to pathological behaviors linked to social media addiction (SMA). Our objectives were to 1) adapt the Bergen Social Media Addiction Scale (BSMAS) to Spanish and 2) evaluate its psychometric properties in a young population. The BSMAS was adapted to Spanish, involving experts on social media addiction and people from the target population during the adaptation process. For the psychometric evaluation, 650 Peruvian college students responded to the Spanish version (53.5 % women aged 18 to 40, M = 21.5 SD = 2.7). The one-dimensional measurement model proposed for the original BSMAS was confirmed for our version (X2(9) = 23.9315, CFI = 0.994, TLI = 0.990, SRMR = 0.032, RMSEA = 0.061). The reliability was good (α = 0.863; 95 % CI: 0.848–0.870; ω = 0.864; 95 % CI: 0.846–0.844), and the measurement invariance was confirmed for sex and age by fitting models. The concurrent validity with external social media addiction and mental health indicators was also confirmed. This study provides new and relevant information on the BSMAS validity and allows its application to Spanish-speaker college students from Peru and similar countries.

Assessing real-world implementability of a multimodal group-based tele-prehabilitation program in cancer care: a pragmatic feasibility study.

Multimodal prehabilitation is intended to optimize a patient's mental and physical health prior to surgery. Most multimodal prehabilitation interventions are delivered on a one-on-one format, which may limit benefits associated with social interactions that can be achieved in a group context, and are delivered in-person, which may limit the accessibility. The purpose of this study was to develop a group-based, multimodal, tele-prehabilitation intervention for individuals diagnosed with cancer (iACTIF) and assess its implementability in a "real-world" clinical setting by measuring feasibility, acceptability, fidelity, and preliminary effects. A prospective, single-group, pragmatic feasibility study was conducted with assessments at baseline, pre-surgery, and 12-weeks post-surgery. iACTIF consisted of three 90-min live videoconference sessions per week, including exercise and educational components. Descriptive statistics were used to document feasibility, acceptability, and fidelity indicators. Paired t-test, Wilcoxon test, and Cohen's D-test were conducted to assess changes in health-related outcomes. A total of 25 participants (mean age ± SD= 60.2 ± 14.0) were recruited. The feasibility assessment revealed a low referral rate (31.4%) and a high study retention (98%) and program attendance [session attended/possible session] (70.2%), with a prehabilitation window of 32.7 days (SD= 20.9, median= 28). Acceptability was high (84%-100%) according to satisfaction, utility and safety, delivery modality, and intention to continue physical activity and to recommend iACTIF to a relative. Pre-post-intervention assessments suggest positive changes on physical functional capacity based on the 2-min step test (mean difference= +18.9 steps, p=0.005), the 30-s sit-to-stand (mean difference= +1.1 repetition, p=0.011), and volume of moderate intensity physical activity per week (mean difference= +104.8 min, p<0.001). Fidelity was supported by conformity and coherence, with only minimal adjustments required to meet participants' needs. iACTIF implementability in a "real-world" clinical setting is promising, and preliminary outcomes suggest moderate benefits on physical health and small increase in mental health indicators.