Negative Affect Research Articles

Coaching entrepreneurs towards growth: an experimental design study of coaching effectiveness for business leaders’ psychological capabilities

ABSTRACT Coaching has a well-established history over the past two decades as a development tool and it can help entrepreneurs deal with the psychological challenges of building a venture. But there is a lack of understanding how coaching can support entrepreneurs on their journey. This study uses a coaching psychology framework to investigate the effectiveness of evidence-based (EB) coaching for entrepreneurs. The aim of this study was to understand how coaches can support cognition change, wellbeing, and accelerated performance improvement of entrepreneurs. The study used a within participant design, and data were collected using a pre and post coaching survey. The study involved n = 19 participants who were early-stage entrepreneurs. Pre and post surveys were assessed using paired sample t-tests. For cognitions, the results indicate higher levels in solution-focused thinking, hope sub-scales agency thinking and goal-orientation. No changes were found for sub-scales pathways thinking and self-efficacy. For Wellbeing, the findings show psychological wellbeing increased with sub-scales autonomy, self-acceptance, personal growth and purpose in life while relationship with others and environment mastery did not change. Negative emotions reduced while positive emotions did not change. For performance, the results show that participants progressed significantly towards attaining their coaching goals.

Изменения чувства юмора при аффективных расстройствах: «дефицит», «патологическая защита», «маска»

<p style="text-align: justify;">Relevance. The present article provides an analysis of changes in the sense of humor in patients with affective disorders. The necessity of this research is due to the emergence of new findings and the insufficient systematization of the scientific data in this field, despite the fact that methods of psychosocial rehabilitation using humor and laughter are being actively developed. The present research is aimed at summarizing and systematizing existing data on the characteristics of the sense of humor in patients with affective disorders. Results. Three theoretical approaches to understanding the specifics of humor’s changes in patients with affective disorders are proposed: «deficit», «pathological defense» and «mask». The «deficit» model describes humor’s characteristics accompanying depressive syndrome. The ones in the foreground are: a decreased affective response to humor, a reduced tendency to engage in humorous interaction with others and to use humor as a coping strategy. In manic and hypomanic states, humor functions as a «pathological defense», blocking negative emotions and stimulating positive ones. In «smiling» depression, the meaning of smiling and laughter can be characterized as a «mask»: their main goal here is to reduce the significance or to hide completely a patient’s inner feelings from others. Also, affective disorders are accompanied by an increased interest in depressive humor. Presumably, it functions as a compensation for a decrease in the use of humor in general as an emotion regulation strategy. Conclusions. Changes in the sense of humor in patients with affective disorders are heterogeneous. Understanding their specifics may be used to improve modern psychosocial therapy programs focused on humor interventions and techniques. It may also be used as an additional diagnostic tool.</p>

Person-specific dynamics between negative emotions and suicidal thoughts

IntroductionRecent technology has enabled researchers to collect ecological momentary assessments (EMA) to examine within-person correlates of suicidal thoughts. Prior studies examined generalized temporal dynamics of emotions and suicidal thinking over brief periods, but it is not yet known how variable these processes are across people. MethodWe use data EMA data delivered over two weeks with youth/young adults (N = 60) who reported past year self-injurious thoughts/behaviors. We used group iterative multiple model estimation (GIMME) to model group- and person-specific associations of negative emotions (i.e., fear, sadness, shame, guilt, and anger) and suicidal thoughts. Results29 participants (48.33%) reported at least one instance of a suicidal thought and were included in GIMME models. In group level models, we consistently observed autoregressive effects for suicidal thoughts (e.g., earlier thoughts predicting later thoughts), although the magnitude and direction of this link varied from person-to-person. Among emotions, sadness was most frequently associated with contemporaneous suicidal thoughts, but this was evident for less than half of the sample, while other emotional correlates of suicidal thoughts broadly differed across people. No emotion variable was linked to future suicidal thoughts in >14% of the sample, ConclusionsEmotion-based correlates of suicidal thoughts are heterogeneous across people. Better understanding of the individual-level pathways maintaining suicidal thoughts/behaviors may lead to more effective, personalized interventions.

Mental Health of Teachers during the First Wave of COVID-19 in Daegu, Korea: Challenges in Reopening Schools

This study conducted an in-depth analysis of the psychological states of teachers during the first outbreak of coronavirus disease 2019 (COVID-19) using data on school mental health projects related to COVID-19 in Daegu from May to June 2020. The participants comprised 811 (34.9%) male and 1,511 (65.1%) female teachers in 1,041 (44.8%) middle and 1,281 (55.2%) high schools. After schools reopened, the most common causes of unbearable stress were unusual experiences, fear of infection, and negative emotions. Moreover, 41.5%/40.4% reported experiencing anxiety/depression, out of which 25.1%/23.6%, 10.0%/14.0%, and 6.4%/2.8% exhibited mild, moderate, and severe levels, respectively. The study identified the following influencing factors of anxiety: being female (OR: 1.52), years of employment (≤5 and <15; OR: 1.36; reference: <5), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.69], 5,000,000 ≤ [OR: 0.67]; reference ≤1,000,000 and <3,000,000 won), depression (OR: 19.14), posttraumatic stress symptoms (OR: 11.65), job stress (OR: 9.13), resilience (OR: 0.37), and subjective well-being (OR: 0.45). We identified the following factors for depression: being female (OR: 1.51), aged 40s (OR: 1.70; reference: 20s), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.75], ≤5,000,000 [OR: 0.66]; reference: ≤1,000,000 and <3,000,000 won), anxiety (OR: 19.14), posttraumatic stress symptoms (OR: 4.03), job stress (OR: 14.04), resilience (OR: 0.29), and subjective well-being (OR: 0.33). The findings suggest a necessity for specific, systematic measures and psychological support to teachers vulnerable to the impact of disasters, such as the COVID-19 pandemic, to cope with disasters and improve school adaptation.

Nocturnal exposure to a preferred ambient scent does not affect dream emotionality or post-sleep core affect valence in young adults

Emotions experienced within sleep mentation (dreaming) affect mental functioning in waking life. There have been attempts at enhancing dream emotions using olfactory stimulation. Odors readily acquire affective value, but to profoundly influence emotional processing, they should bear personal significance for the perceiver rather than be generally pleasant. The main objective of the present sleep laboratory study was to examine whether prolonged nocturnal exposure to self-selected, preferred ambient room odor while asleep influences emotional aspects of sleep mentation and valence of post-sleep core affect. We asked twenty healthy participants (12 males, mean age 25 ± 4 years) to pick a commercially available scented room diffuser cartridge that most readily evoked positively valenced mental associations. In weekly intervals, the participants attended three sessions. After the adaptation visit, they were administered the odor exposure and odorless control condition in a balanced order. Participants were awakened five minutes into the first rapid eye movement (REM) stage that took place after 2:30 a.m. and, if they had been dreaming, they were asked to rate their mental sleep experience for pleasantness, emotional charge, and magnitude of positive and negative emotions and also to evaluate their post-sleep core affect valence. With rs < 0.20, no practically or statistically significant differences existed between exposure and control in any outcome measures. We conclude that in young, healthy participants, the practical value of olfactory stimulation with self-selected preferred scents for enhancement of dream emotions and post-sleep core affect valence is very limited.

Low-Level Visual Features of Window Views Contribute to Perceived Naturalness and Mental Health Outcomes

Previous studies have shown that natural window views are beneficial for mental health, but it is still unclear which specific features constitute a ‘natural’ window view. On the other hand, studies on image analysis found that low-level visual features (LLVFs) are associated with perceived naturalness, but mainly conducted experiments with brief stimulus presentations. In this study, research on the effects of window views on mental health was combined with the detailed analysis of LLVFs. Healthy adults rated window views from their home and sent in photographs of those views for analysis. Content validity of the ‘ecological’ view assessment was evaluated by checking correlations of LLVFs with window view ratings. Afterwards, it was explored which of the LLVFs best explained variance in perceived percentage of nature and man-made elements, and in ratings of view quality. Criterion validity was tested by investigating which variables were associated with negative affect and impulsive decision-making. The objective and subjective assessments of nature/sky in the view were aligned but objective brightness was unreliable. The perceived percentage of nature was significantly explained by green pixel ratio, while view quality was associated with fractals, saturation, sky pixel ratio and straight edge density. The higher subjective brightness of rooms was associated with a lower negative affect, whereas results for impulsive decision-making were inconsistent. The research highlights the validity to apply LLVFs analysis to ecological window views. For affect, subjective brightness seemed to be more relevant than LLVFs. For impulsive decision-making, performance context needs to be controlled in future studies.

Psychophysiological effects of walking in forests and urban built environments with disparate road traffic noise exposure: study protocol of a randomized controlled trial

BackgroundStress is a widespread phenomenon and reality of everyday life, entailing negative consequences for physical and psychological wellbeing. Previous studies have indicated that exposure to greenspaces and nature-based interventions are promising approaches to reducing stress and promoting restoration. However, an increasing percentage of the population lives in urban regions with limited opportunities to spend time in greenspaces. In addition, urban settings typically feature increased levels of noise, which represents a major environmental stressor. Although various studies have compared the effects of exposure to greenspaces versus urban built environments, evidence of the effects of noise in this context is very limited. Psychophysiological benefits of exposure to greenspaces compared to urban built environments reported in earlier studies might be less (or at least not only) due to features of the greenspaces than to additional stressors, such as road traffic noise in the urban built environment. Hence, differences in the effects attributed to greenness in previous studies may also be due to potentially detrimental noise effects in comparison settings. This paper reports the study protocol for a randomized, controlled intervention study comparing the effects of walking in forest versus urban built environments, taking road traffic noise exposure during walks in the respective settings into account.MethodsThe protocol envisages a field study employing a pretest–posttest design to compare the effects of 30-min walks in urban built environments and forests with different road traffic noise levels. Assessments will consist of self-reported measures, physiological data (salivary cortisol and skin conductance), an attention test, and noise, as well as greenness measurements. The outcomes will be restoration, stress, positive and negative affect, attention, rumination, and nature connectedness.DiscussionThe results will inform about the restorative effect of walking in general, of exposure to different types of environments, and to different noise levels in these sites. The study will provide insights into the benefits of walking and nature-based interventions, taking into account the potential detrimental effects of noise exposure. It will thus facilitate a better understanding of low-threshold interventions to prevent stress and foster wellbeing.Trial registrationISRCTN48943261; Registered 23.11.2023.

The relationships among trait mindfulness, obsessive passion, and emotions in high school sport managers

Purpose Mindfulness emerges as a possible means to alleviate obsessive passion. Nevertheless, its application in sport leadership context remains understudied, despite the significant levels of stress and turnover that are common in this profession. This study aims to investigate the relationships among trait mindfulness, obsessive passion, and specific positive (e.g., happiness), neutral (e.g., calmness), and negative (e.g., anger) emotions in high school sport managers. Method In total, 358 high school sport managers ( Mage = 48.47, SD = 8.93) working in 46 states in the United States completed the online questionnaires measuring the proposed variables. Descriptive statistics, correlation analysis, confirmatory factor analysis, and structural equation modeling were utilized to examine the hypotheses. Result The results showed that trait mindfulness negatively predicted obsessive passion. Additionally, obsessive passion negatively predicted the feelings of happiness and calmness, while it positively predicted anger. The mediation analysis revealed that obsessive passion fully mediated the relationships between trait mindfulness and the three types of emotion. Conclusion These findings are significant because they demonstrate the buffering role of trait mindfulness in obsessive passion. Furthermore, the study provides meaningful insights into sport managers’ emotional experiences, particularly by empirically examining the effect of obsessive passion on different emotions.

Guilt, shame, and antiwar action in an authoritarian country at war

Guilt, shame, and antiwar action in an authoritarian country at war

Abnormal neural activation during negative emotion processing in anxiety disorders: a coordinate-based meta-analysis.

Abnormal neural activation during negative emotion processing in anxiety disorders: a coordinate-based meta-analysis.

Does Prospective Mental Imagery Predict Symptoms of Negative Affect and Anhedonia in Young People?

Adolescent depression is associated with unhelpful emotional mental imagery. Here, we investigated whether vividness of negative and positive prospective mental imagery predict negative affect and anhedonia in adolescents. 111 people from Israel completed measures of prospective mental imagery, negative affect, and anhedonia at two time-points approximately three months apart. Using three cross-lagged panel models, we showed once 'concurrent' (across-variable, within-time) and 'stability' paths (across-time, within-variable) were estimated, there were no significant cross-lag paths between: i) T1 prospective negative mental imagery and T8 negative affect (i.e. increased vividness of negative future imagery at Time 1 did not predict increased negative affect at Time 8); ii) T1 prospective positive mental imagery and T8 negative affect (i.e. reduced vividness of positive future imagery at Time 1 did not predict increased negative affect at Time 8); and iii) T1 prospective positive mental imagery and T8 anhedonia (i.e. reduced vividness of positive future imagery at Time 1 did not predict increased anhedonia at Time 8). Given high levels of attrition, future research should aim to explore these associations in a larger, more diverse population, as such data could inform on whether modifying earlier prospective mental imagery may influence later time/context-specific effects of prospective mental imagery on negative affect and anhedonia.

Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians

ABSTRACT Background Optimal cognitive functions, including working memory (WM), are crucial to enable trainee physicians to perform and excel in their clinical practice. Several risk factors, including on-call shifts, poor mental health, burnout, and sleep problems, can impair clinical practice in trainee physicians, potentially through cognitive impairment; however, these associations have not been fully explored. Objective This study investigated the effect of on-call shifts on WM among trainee physicians and its association with burnout, depression, anxiety, affect, and sleep. Materials and methods This cross-sectional study involved 83 trainee physicians (45% male). We measured demographic and training-related factors including on-call shifts and working hours. We also assessed depressive symptoms (PHQ-9), both state and trait anxiety (STAI total score), burnout (OLBI total score), positive and negative affect scores (PANAS), and sleep disturbances (PSQI total score). WM was evaluated using spatial working memory (SWM) strategy scores that reflected performance and total error counts. Results Trainee physicians with more on-calls per month had significantly worse depressive symptoms, burnout scores, and sleep, as well as more negative affect. While controlling for covariates, being on-call more times per month was significantly associated with worse WM. Worse depressive symptoms and burnout scores were also significantly associated with impaired WM. Conclusion Working more on-call shifts is associated with compromised WM. Trainee physicians who experienced more depressive symptoms and burnout had worse WM.

The Economic Cultures of Fear and Love

In earlier work, the author has studied the economic role of planning horizons in making a case for complementarity as the predominant feature of social interdependence. This paper compares the different choice strategies implied by substitution, opposition and conflicts of interest in an economics of fear with those arising from horizon effects, economic complementarity and concerts of interest in an economics based on love. The contrasting implications of a psychological literature on negative vs. positive emotions and their health effects, along with the findings in neurophysiological research about how humans are hard-wired for empathy and compassion leads to some fundamental changes in how we might address and revise social problems through economic analysis. The aim of this paper is to extend a horizonal case for complementarity in the author's previous work into its psychological links to research findings on healthy cognitive function and its emotional basis. An economics of substitution yields quite different conclusions about optimal institutional forms and how we address and frame social relations than are implied by an explicitly horizonal economics of complementary social relations. Recent psychological and neurophysiological studies support a horizonal case for complementarity in social relations, showing that our orthodox substitution assumptions and models of competitive equilibrium should be rejected for a renewed economic analysis based on horizonal models of complementarity and cooperation as a means to achieve greater social well-being in a healthier and more integrative form of social organization. The issues to be explored are not entertained within the currently existing frame of orthodox economics, so we must step beyond our standard habitual assumptions.

Mining heritage gone wrong: A study of disappointed tourists at China’s national mine parks

ABSTRACT Mine parks are a late twentieth-century addition to the global heritage repertoire. To date, most studies of visitor experiences at mining heritage sites focus on tourists who appreciate their outings. Yet mine parks do not satisfy all those who visit. What goes wrong for those who visit these destinations and feel disappointed, and how do they express their displeasure? We answer this question by scrutinising the online negative reviews of tourists from seven Chinese national mine parks. Our analysis indicates ‘disgruntled tourists’ want the sites of former resource extraction to include a sight and meet their expectations for hospitable, accessible, and knowledgeable service. When mine parks fail to deliver, they become disappointed, dissatisfied, and angry. They overwhelmingly articulate their unhappiness using a language of ‘lack’ or deficiency and talking about ‘value for money’. The reviews further suggest that disappointed visitors write online reviews to vent negative emotions, warn other tourists, and punish site staff. Drawing on the broader literature on mining tourism, heritage tourism, and visitor experiences, we indicate strategies that mining heritage professionals could use to remedy disgruntled tourists’ sense of deficiency, while also contributing to scholarly discussions about what makes tourism meaningful.

The impact of negative affects on the high prevalence of anxiety, depression and stress in healthcare professionals.

Psychiatric disorders are the conditions that most contribute to incapacity worldwide. While many healthcare professionals adapt in dealing with various demands, others do not. How much of these conditions is associated with affective experience needs to be studied. Assess the prevalence of anxiety, depression, and stress while investigating the relationship between the presence of positive and negative affect in healthcare professionals. This study's convenience sample consisted of 975 providers (including nursing, physicians, and multidisciplinary team) and administrative professionals (service and supervision teams) working at a general private hospital in Brazil. Data were collected in 2019 through a socio-demographic questionnaire, the Depression Anxiety and Stress Scale (DASS-21), and the Positive and Negative Affect Schedule (PANAS-X). The results are shown through multinomial regression with odds ratio, 95% confidence interval, and P-value. The prevalence of depression, anxiety, and stress was 49.4%, 46.1%, and 49.8%, respectively, showing high prevalence. It was observed that a high presence of negative affect is associated with a greater likelihood of developing anxiety, depression, and stress, while a high presence of positive affect is associated with a lower likelihood of depression and stress prevalence. The high prevalence of anxiety, depression and stress in healthcare professionals is associated with the presence of negative affects. Mental disorders should be measured, and practices adopted to ensure well-being and job performance.

Moderator role of Type D personality traits between depressive symptoms and job satisfaction among teachers

BackgroundType D personality is characterized by negative affect (NA) and social suppression (SI). It has been indicated Type D personality is associated with depression, anxiety, and burnout. Depressive complaints and social inhibition negatively affect job satisfaction. The aim of this study is to investigate the moderating role of Type D personality structure between the severity of depressive complaints and job satisfaction in teachers.Methods939 teachers, who constitute the sample of the study, completed the sociodemographic form, Type D personality scale (DS-14), Beck Depression Inventory (BDI) and Minnesota Satisfaction Scale Short Form with an online survey.ResultsWhile a negative relationship was found between teachers’ NA scores and their intrinsic and extrinsic job satisfaction (r = −0.28 and r = −0.19, respectively), a negative relationship was detected between SI scores and intrinsic and extrinsic job satisfaction (r = −0.22 and r = −0.21, respectively). NA and SI had partial moderating roles in the relationship between BDI score and intrinsic job satisfaction. SI played a partial moderating role in the relationship between BDI and extrinsic job satisfaction.ConclusionIt can be said Type D personality traits has a moderating role between the severity of teachers’ depressive complaints and job satisfaction.

Transcultural adaptation to Spain of the CDPQOL questionnaire specific for coeliac children.

This study aimed to translate, cross-culturally adapt, and validate the CDPQOL questionnaire, a coeliac disease (CD)-specific paediatric health-related quality of life (HRQoL) instrument (CDPQOL), in Spanish children with CD. The CDPQOL questionnaire has two versions for children aged 8-12 and 13-18. Translation and linguistic validation were performed following an international consensus process. Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients, and convergent validity was assessed with average variance extracted (AVE). Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), when necessary, were carried out to assess the construct validity. A total of 235 children were included. In the 8-12 age group, a change in the distribution of items to a new structure of three dimensions (negative emotions, food feelings and social interaction) was required. In this new model, CFA supported the fit of the model (χ2/gl = 1.79, RMSEA = 0.077 (IC 95% 0.05-0.100), CFI = 0.969, TLI 0.960, SRMR = 0.081) and Cronbach's alpha and McDonald's omega coefficients were > 0.7 in all three dimensions. In the 13-18 age group, CFA showed that all fit indexes were acceptable (χ2/gl = 1.702, RMSEA = 0.102 (IC 95% 0.077-0.127), p < 0.001, CFI = 0.956, TLI = 0.947, SRMR = 0.103) and Cronbach's alpha and McDonald's omega coefficients were > 0.7 in all three dimensions, except for uncertainty dimension.    Conclusions: The Spanish version of the CDPQOL questionnaire is a useful instrument to assess quality of life in coeliac children whose native language was Spanish spoken in Spain, with changes in item distribution in the younger age group questionnaire. What is Known: • The first specific questionnaire for coeliac children, Dutch Coeliac Disease Questionnaire (CDDUX), which focuses on diet, was translated into Spanish and validated allowing to evaluate the HRQoL of Spanish coeliac children. • Spanish Children and parents feel the disease had no substantial negative impacts on patient HRQoL using this questionnaire, similar to that observed with other countries. What is New: • The age specific for CD children (CDPQOL) was elaborated in the USA and focuses on other aspects not evaluated by CDDUX such as emotional and social issues related to living with CD. • The CDPQOL was translated into Spanish and validated allowing it to be used to assess Spanish coeliac children's QoL.

Evaluation of a High Intensity Interval Training (HIIT) Program for Military Personnel Receiving Inpatient Treatment for a Substance Use Disorder

This study aimed to evaluate a high intensity interval training (HIIT) program delivered in an inpatient treatment setting serving military personnel. This recreational therapy (RT) program assessed the impact of a single session (60-minute) HIIT program on participant affect and state-anxiety. Using a single-group pretest-posttest design, 58 data sets were collected from participants (N = 20). Results indicated an increase in positive affect (z = -.6.52, p &lt; .001), a decrease in negative affect (z = -2.64, p &lt; .01), and a significant reduction in anxiety, t (57) = 1.99, p = .05 following the intervention. The program also resulted in a significant elevation in heart rate, t (57) = -25.89, p &lt; .001 with most participants reaching moderate to high intensity physical activity levels. On a scale of 1–10, participants rated their likelihood of participating in HIIT post-discharge at 6.28 (SD = 2.43). Additional qualitative data provides valuable insight on the perceived benefits to participants and offers suggestions for future program development and research in this area.

Influence of physical exercise on negative emotions in college students: chain mediating role of sleep quality and self-rated health

BackgroundNegative emotions in college students are a significant factor affecting mental health, with suicide behaviors caused by negative emotions showing an annual increasing trend. Existing studies suggest that physical exercise is essential to alleviate negative feelings, yet the intrinsic mechanisms by which it affects negative emotions have not been fully revealed.ObjectiveNegative emotions in college students represent a significant issue affecting mental health. This study investigates the relationship between physical exercise and negative emotions among college students, incorporating sleep quality and self-rated health (SRH) as mediators to analyze the pathway mechanism of how physical exercise affects students’ negative emotions.MethodsA cross-sectional study design was utilized, employing online questionnaires for investigation. The scales included the Physical Activity Rating Scale-3 (PARS-3), the Depression Anxiety Stress Scales-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the 12-Item Short Form Health Survey (SF-12), resulting in the collection of 30,475 valid questionnaires, with a validity rate of 91%. Chain mediation tests and Bootstrap methods were applied for effect analysis.ResultsThe proportions of university students engaged in low, medium, and high levels of physical exercise were 77.6, 13.1, and 9.3%, respectively. The proportions of students experiencing “very severe” levels of stress, anxiety, and depression were 4.5, 10.9, and 3.6%, respectively. Physical exercise was significantly positively correlated with self-rated health (r = 0.194, p &amp;lt; 0.01), significantly negatively correlated with sleep quality (r = −0.035, p &amp;lt; 0.01), and significantly negatively correlated with stress, anxiety, and depression (r = −0.03, p &amp;lt; 0.01; r = −0.058, p &amp;lt; 0.01; r = −0.055, p &amp;lt; 0.01). Sleep quality was significantly negatively correlated with self-rated health (r = −0.242, p &amp;lt; 0.01). Mediation effect testing indicated that sleep quality and self-rated health partially mediated the relationship between physical exercise and negative emotions, with total effect, total direct effect, and total indirect effect values of −1.702, −0.426, and − 1.277, respectively.ConclusionCollege students primarily engage in low-intensity physical activity. Sleep quality and self-rated health mediate the impact of physical exercise on students’ negative emotions. A certain level of physical activity can directly affect students’ emotional states and indirectly influence their negative emotions via sleep and self-rated health. Regular engagement in physical activities primarily positively impacts emotional states by enhancing mood stability and overall emotional resilience.

Within-person fluctuations of fatigue in patients with a clinical diagnosis of systemic sclerosis and its relationship with mood, pain, sleep and physical activity

Objectives: To explore the within-person fluctuations of fatigue in systemic sclerosis and its association with negative affect, positive affect, pain, perceived exertion of physical activity and quality of sleep. Methods: We performed an ecological momentary assessment study in adult patients with a clinical diagnosis of systemic sclerosis. During 14 days, patients completed daily assessments of fatigue severity, negative affect, positive affect, pain, quality of sleep and perceived exertion of physical activity at four fixed time points. The day-to-day fluctuations in fatigue were quantified by the intra-individual variance and probability of acute change, capturing the magnitude and frequency of clinical relevant within-person day-to-day fluctuations, respectively. Using multilevel models, the within-person association between fatigue and the daily assessments were analysed. Results: Fifty-seven patients with systemic sclerosis participated. The mean (standard deviation) intra-individual variance was 1.08 (0.42) and the probability of acute change was mean (standard deviation) 0.40 (0.14), ranging from 0.08 to 0.77. For fatigue, a within-person variation of 51% was observed. Multilevel analyses showed that higher average levels and daily increases in negative affect, pain and perceived exertion of physical activity were associated with more fatigue, while the opposite was observed for positive affect and quality of sleep. Positive affect demonstrated the strongest association with fatigue fluctuations. Conclusion: This is the first quantitative study showing that fatigue in systemic sclerosis is characterized by a dynamic course and that approximately half of the day-to-day fluctuations within persons are clinically meaningful. Furthermore, our results indicate that integrating activities with positive impact on mood into fatigue treatment strategies might reduce the frequency of fatigue fluctuations.