Psychological Health Outcomes Research Articles

Children’s Social, Emotional, and Behavioral Outcomes in Military Families: A Rapid Review

AbstractIn light of ongoing global military conflicts, including the Israel-Hamas war and the Russia-Ukraine war, it is imperative to study the effects of parental military service and deployment on the health and well-being of children within military families. Emerging evidence suggests that children with a parent in service appear to face unique developmental challenges associated with the military lifestyle, which differ from those experienced by civilian children. However, there is currently limited systematic research that compares the developmental outcomes of children with serving parents to their civilian peers. Therefore, the aim of this review is to synthesize existing literature on the behavioral, social, emotional, and educational functioning of children with currently serving parents in defense forces, in comparison to their civilian counterparts. This rapid systematic review was conducted in accordance with the Joanna Briggs Institute methodology framework, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and Cochrane Rapid Review methodological recommendations The following databases were searched: Medline, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials. Relevant online databases were searched from February 2012 to 2022 to examine the contemporary literature. Fourteen identified published quantitative studies were identified. No qualitative studies were found, and no study reported on academic outcomes. Despite considerable sample heterogeneity across studies, military children of all ages appear to be a particularly vulnerable population. Findings suggest that children in military families experience substantially higher risk for negative psychological, social, and behavioral health outcomes than their civilian counterparts, with parental deployment increasing risk across all developmental stages (i.e., early, middle, and late childhood). Among these age groups, adolescents of currently serving members showed highest risk, particularly concerning suicidal ideation and suicidal behaviors. Implications are discussed in terms of early detection, preventative interventions, and support services for families and children with a serving parent. PROSPERO registration: CRD42022313999.

Investigating the Impact of Reproductive Coercion and Intimate Partner Violence on Psychological and Sexual Wellbeing.

Emerging research suggests that reproductive coercion and abuse (RCA), like intimate partner violence (IPV), is associated with poorer mental and sexual health outcomes, including greater symptoms of post-traumatic stress disorder (PTSD) and depression and poorer markers of physical and sexual health such as sexually transmitted infections, unplanned pregnancies and lowered sexual agency. Although victims/survivors of RCA report long-lasting impacts on future relationships, including fear and anxiety, little is known about impacts of RCA on anxiety and general wellbeing, nor emotional and mental components of sexual health that comprise a person's sexual self-concept. With community samples of participants in Australia, we conducted two studies to explore the impact of RCA and IPV on psychological (study 1) and sexual (study 2) health outcomes. Study 1 (n = 368) found that experiencing IPV and RCA both significantly and uniquely contributed to poorer mental health outcomes. After controlling for age and IPV, RCA significantly predicted symptoms of depression, anxiety, stress, PTSD, and reduced satisfaction with life. Study 2 (n = 329) found that IPV and RCA differentially predicted various components of sexual health. IPV predicted decreased sexual satisfaction and increased sexual anxiety, depression, and fear of sexual encounters. After controlling for age and IPV, RCA significantly and uniquely predicted lower levels of sexual assertiveness and increased sexual depression and fear of sexual encounters, but not sexual satisfaction or anxiety. We conclude that RCA is associated with significant psychological distress and a negative sexual self-concept that may impact future relationships. Screening for both IPV and RCA across settings is warranted.

THE EFFECTS OF EXERCSE ON PSYCHOLOGICAL HEALTH AND WELLBEING IN PEOPLE DIAGNOSED WITH CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

INTRODUCTION & AIMS The high psychological burden reported by adults diagnosed with cancer has a large impact on overall and cancer-specific health outcomes. Accumulating evidence indicates that psychological distress may accelerate tumour progression and increase risk of cancer mortality. Research has highlighted that exercise interventions are safe, feasible, and effective at improving both physical and psychological health for adults diagnosed with cancer. However, there are few systematic reviews that have evaluated psychological health as a primary outcome of interest or analysed the effects of different exercise prescriptions on specific psychological health outcomes. This systematic review aims to meta-analyse the available evidence and determine the effects of exercise on psychological health in individuals diagnosed with cancer. METHODS Systematic review with meta-analysis utilising a random effects model. Subgroups analysis was included, defined by psychological health outcomes and further stratified by the FITT principle: Frequency; Intensity; Time; and Type of exercise. RESULTS Seventy-eight studies met the inclusion criteria. One hundred and eighty-three individual effect sizes were obtained, which demonstrated small to moderate combined effects of exercise (d = 0.30, 95%CI 0.20; 0.40) across all psychological health outcome measures. CONCLUSION Exercise is an effective intervention to improve psychological health in adults diagnosed with cancer. The subgroup analysis revealed consistent effects across a range of specific psychological health outcomes, differences were observed between exercise prescriptions, thus highlighting a need for targeted exercise for each psychological health outcome.

Resilience in residential care: A qualitative study based on the voices of adolescents

Young people placed in residential care are at an increased risk of a wide range of emotional and behavioral difficulties. Some of them deteriorate in psychological outcomes, some show no changes, and some show healthy psychological outcomes. Recent research has identified protective factors of adolescents’ psychological health outcomes in residential care, framed on the Resilience Portfolio Model. However, to the best of our knowledge, studies using qualitative designs are scarce.This qualitative study aimed to identify adolescents’ perspectives on the concept of resilience and identify their perspectives on protective factors for psychological health. Nineteen adolescents (12–17 years old;M = 14.21; 57.9 % male) from three non-specialized residential care settings in Portugal participated in this study, answering to a semi-structured interview. Data were analyzed using content analysis, and the results revealed that our participants identified specific factors in residential care (e.g., staff and peer support) and out-of-care (e.g., family) contexts that are relevant to their resilience outcomes. The childcare system should consider adolescents’ resilience portfolios by fostering individual assets and contextual protective factors to promote positive outcomes.

Psychological health among healthcare professionals during COVID-19 pandemic: An updated meta-analysis

Background: The coronavirus disease 2019 (COVID-19) pandemic outbreak created a challenge to manage the health, especially the mental health of various care providers involved in treating the patients infected with the virus. Previously published literature has shown a significant effect of the pandemic on the psychological health of healthcare workers (HCWs) globally; so, this study aimed to describe the psychological health outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Indian HCWs. Methods: An extensive literature search was conducted in databases including PubMed and Google Scholar. The search was restricted from the COVID-19 outbreak until June 2022. Cross-sectional studies and other studies (telephonic interviews and survey-based studies) reported the prevalence of anxiety and depression among frontline HCWs since the onset of the COVID-19 pandemic. All the studies were critically evaluated by two individual authors in terms of screening and methodological quality evaluation. A total of 16 studies were included in the final meta-analysis. Results: The prevalence of depression among n = 12231 participants of 14 studies was 0.37 CI 95% [0.28–0.48]; the prevalence of anxiety among n = 9467 participants of 12 studies was 0.39 CI 95% [0.29–0.49]. The results of the overall meta-analysis indicate that 37% and 39% of HCWs in this study experienced mild-to-severe depression and anxiety, respectively. During the COVID-19 pandemic, a significant number of HCWs developed mental health issues, with a reported prevalence of depression (37%) and anxiety (39%). Conclusion: Frontline HCWs’ mental health should get full consideration during public health emergencies, screening should be actively conducted, and specific steps should be taken to lower the fear associated with the risk of infections.

Psychological distress and mental health care utilization among Black survivors of adolescent and young adult cancer.

Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. National Health Interview Survey data (2010-2018) were analyzed that identified non-Hispanic Black (hereafter, Black) survivors of AYA cancer and age- and sex-matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR],1.64; p<.001), use mental health care (OR,1.53; p=.027), report an inability to afford mental health care (OR,3.82; p<.001), and use medication for anxiety and/or depression (OR,2.16; p=.001). Forty-one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18-39 years (vs. 40-64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population.

Physical Challenge Interventions and the Development of Transferable Skills for the Workplace: A Systematic Review and Meta-Analysis

This study presents a systematic review and meta-analysis synthesising the existing research on the effectiveness of interventions featuring physical challenges for developing transferable skills and psychological health outcomes. Results from 47 independent samples across 44 studies revealed that the overall proximal effects of the interventions were medium ( g = 0.51) and that effects gradually diminished over time ( g = 0.39). Analyses across individual outcomes revealed interventions positively influenced interpersonal ( g = 0.55), intrapersonal ( g = 0.53), and cognitive skills ( g = 0.53), as well as psychological health outcomes ( g = 0.56). Moderator analyses indicate interventions can be potentially beneficial irrespective of design and participants involved. However, the current state of the literature does not truly allow for thorough conclusions to be made regarding the appropriateness and effectiveness of physical challenge interventions for organizational settings.

The Association of Body Image Perceptions with Behavioral and Health Outcomes among Young Adults.

This study was conducted on 5 March 2024, by the Universidad Europea de Madrid. This study aims to explore how body image perceptions influence health behaviors and mental and physical health outcomes among a specific group of 605 young adults aged 20 to 35 engaged in strength training regimes. To measure these perceptions, the Multidimensional Body-Self Relations Questionnaire (MBSRQ) was employed, an advanced tool that assesses multiple dimensions of body image through its subscales, including feelings of physical attractiveness, investment in one's appearance, and satisfaction with different body areas. Participants were segmented into two groups based on a median split of their self-reported body image. The survey assessed a diverse array of variables, including demographic details, physiological data, resistance training routines, and psychological attributes. In this revision, we consistently use the term 'dietary habits' to ensure clear and uniform language when discussing eating patterns. Notable differences were observed in dietary habits and exercise engagement, influenced significantly by body image perceptions. Negative body image was linked to less healthy dietary habits, diminished physical activity, and worse psychological outcomes, such as increased anxiety and depression. Conversely, a positive body image was associated with healthier dietary habits, more frequent physical activity, and better psychological health. The findings suggest that interventions aimed at improving body image could be crucial for enhancing overall health within this specific demographic. Due to the non-representative nature of the study group, conclusions are cautiously presented as applicable only to similar populations engaged in strength training. This study underscores the need for holistic strategies that encourage positive body image to improve both physical and psychological health outcomes in young adults.

The intersection of adverse childhood experiences and neighborhood determinants of health: An exploratory spatial analysis.

Adverse childhood experiences (ACEs) are associated with elevated risk for poor physical and psychological health outcomes. Nearly all of the literature on the association between ACEs and poor health focuses on the individual and family level; the potential role of neighborhood environment is overlooked. Understanding the relationship between ACEs and characteristics of the neighborhood environment is a necessary first step in determining if and how place-based, trauma-informed interventions might mitigate the negative effects of ACEs. The purpose of this exploratory study was to describe the neighborhood environment of adults who have experienced ≥ 4 versus ≤ 3 ACEs. An exploratory secondary analysis of cross-sectional and geospatial data was conducted during 2021. Data sources included 2011/2012 Philadelphia ACE Survey data, a telephone survey of 1,784 randomly sampled Philadelphia adults, linked with geospatial data on 21 neighborhood-level determinants of health. Neighborhood was defined as participant's home census tract at the time of survey. The sample for this secondary analysis included the 1,679 Philadelphia ACE Survey participants for whom home census tract was available. Bivariate logistic regression examined differences between groups (≤ 3 ACEs vs. ≥ 4 ACEs). Individuals with ≥ 4 ACEs lived in neighborhoods with higher neighborhood poverty rates, less socioeconomic resources, worse food access, poorer perceived physical and mental health, more substance overdose deaths, higher crime, and less green space. Findings suggest future work may benefit from considering neighborhood environments when examining and intervening upon the association between ACEs and poor physical and psychological health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the association between post-critical incident intervention preferences and self-reported coping self-efficacy among firefighters.

Critical incident stress debriefing (CISD) is a commonly utilized intervention in the fire service that aims to minimize psychological harm and adverse mental health outcomes after a potentially traumatic incident. This study aimed to explore firefighter preferences regarding CISD and alternative post-critical incident interventions in relation to firefighter coping self-efficacy (FFCSE) and trauma coping self-efficacy (CSE-T). Firefighters (N = 241) completed an online survey and provided complete data. Most participants were White (n = 203, 84.2%), non-Hispanic (n = 221, 91.7%) men (94.2%; n = 227). CISD was the most preferred intervention among firefighters (n = 113, 46.9%) as compared to informal peer support (n = 31, 12.9%), formal one-on-one counseling (n = 29, 12.0%), and no intervention (n = 68, 28.2%). Firefighters who preferred CISD had statistically significant lower levels of FFCSE, R2 =.033-.044, ps =.012-.030, and CSE-T, R2 =.035-.061 ps =.017-.024, compared to those who preferred no intervention. Firefighters who preferred formal one-on-one counseling had statistically significantly lower levels of FFCSE, R2 =.033-.044, ps =.003-.011, and CSE-T, R2 =.035-0.061, p <.001-p =.002, compared to those who preferred no intervention. The findings from this study may guide future research to increase knowledge on firefighter intervention preferences and the association between preference and coping self-efficacy.

Beyond Parental Acceptance and Rejection: A Commentary on the Findings From Empirical Studies on Forgiveness and Vengeance in the Muslim World

Drawing on the framework of interpersonal acceptance-rejection theory (IPARTheory), this special issue edited by Ronald P. Rohner, Sumbleen Ali, and Jennifer E. Lansford explores forgiveness and vengeance within the context of the Muslim world. Examination of the precursors of forgiveness and vengeance holds significance because vengeance typically correlates with adverse physical and psychological health outcomes. We suggest ways to advance research outlined in the special issue, such as assessing cross-cultural invariance and using diverse research designs. Moreover, increasing the diversity of socioeconomic status in studies conducted in the Muslim world and exploring hypotheses in high-income countries are necessary for contextually nuanced research. Overall, this special issue offers valuable insights into the dynamics of forgiveness and vengeance and highlights the role of culture and gender on psychological well-being across diverse contexts.

Influence of leisure experiences on smartphone addiction and emotional distress

ABSTRACT Smartphone use has substantially increased among college students in the U.S. Previous researchers have found excessive smartphone use to be one of several antecedents to negative behavioural and psychological health outcomes. However, there has been little research on the influences of various factors related to leisure experiences (i.e. leisure awareness, boredom, challenge, and distress) on negative behavioural and emotional problems. Therefore, we examined the effects of leisure experiences on smartphone addiction and emotional distress. Utilizing responses from undergraduate students (n = 601), a structural analysis was implemented to determine several hypothetical relationships. Results revealed that leisure awareness, boredom, and challenge significantly influenced the occurrence of smartphone addiction, but leisure distress did not. These results imply the important role of leisure experiences among college students. Leisure professionals should consider promoting various resources and activities to hold students’ interest in leisure activities and improve their psychological well-being.

Job stressors and turnover intention of IT executives in Malaysia: The mediating role of employee well-being.

Fear of losing psychological resources can lead to stress, impacting psychological health and behavioral outcomes like burnout, absenteeism, service sabotage, and turnover. The study examined the impact of job stressors (time pressure, role ambiguity, role conflict) on employee well-being and turnover intentions. The study also investigated the mediating role of employee well-being between job stressors and turnover intention based on the conservation of resources (COR) theory. Data from 396 IT executives in Malaysian IT firms were analyzed using the Partial Least Squares - Structural Equation Modeling (PLS-SEM) technique. Results confirmed a significant negative correlation between time pressure (-0.296), role ambiguity (-0.423), role conflict (-0.104), and employee well-being. Similarly, employee well-being showed a significant negative relationship with turnover intentions (-0.410). The mediation analysis revealed that employee well-being mediates the relationship between time pressure (0.121), role ambiguity (0.173), role conflict (0.043), and turnover intentions. This paper aims to manifest the importance of designing employee well-being policies by firms to retain employees. Findings reflect the role of the managerial approach towards ensuring employee well-being for employee retention, thereby reducing recruitment and re-training costs.

Loneliness in older adults with diabetes mellitus: a scoping review

ABSTRACT This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling.

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.

Effect of Smartphone Usage during Night Time on Sleep Patterns of Young Adults: A Cross-sectional Observational Study

Introduction: Excessive smartphone usage among adolescents and young adults has been consistently linked to poor sleep. Moreover, smartphone overuse has been associated with daytime tiredness, longer sleeps latency, and reduced sleep duration. The significance of addressing poor sleep among adolescents and young adults is underscored by recent research linking it to adverse physical and psychological health outcomes, such as mood disturbances, impaired cognitive function, and increased risk incidence of hypertension and diabetes. Aim: To evaluate the effects of smartphone usage on sleep quality among individuals using Pittsburgh Sleep Quality Index (PSQI) and hypnogram data. Materials and Methods: In this cross-sectional observational study, sleep patterns were assessed using the PSQI questionnaire and Prime Nap sleep tracker app (version 1.1.4). The study was conducted by Deccan College of Medical Sciences, Hyderabad, Telangana, India. The data was collected in the form of a hypnogram and the study was conducted in the participants’ homes (under domicile conditions) in the city of Hyderabad, Telangana, India from March 2020 to April 2020. A total of 60 participants (both male and female) in the age group of 15-25 years were recruited and divided into two groups: one comprising 30 individuals with regular prolonged exposure to smartphone screens at night, and the other consisting of 30 individuals who experienced minimal or no smartphone exposure once they prepared to sleep. Descriptive statistics were applied to the collected data using Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS) for Windows version 25.0. Results: Adding up the average scores of the seven factors gives a global PSQI score from 0 to 21, with 0-4 indicating good sleep and 5-21 indicating poor sleep. Among those who used smartphones regularly at night time, 20 participants (66.67%) had PSQI score &gt;5 and poor sleep quality, 24 participants (80%) had prolonged sleep latency, 18 participants (60%) had poor sleep duration, 27 participants (90%) had sleep disturbances, and 22 participants (73.33%) had increased daytime dysfunction. Hypnogram abnormalities were seen in &gt;15 participants (50%) of subjects. Conclusion: The prevalence of smartphone addiction is widely acknowledged in the medical literature, highlighting the need for its assessment, especially among adolescents and young adults. The study reveals that poor sleeping habits among participants were attributable either to a lack of awareness or neglect. By recognising the importance of adequate sleep, improvement in the quality of daily activities can be made by reducing daily screen time, consequently alleviating both physical and mental stress. Furthermore, the findings have implications for individuals whose work involves prolonged exposure to computer screens, especially during night time.

An adaptive text message intervention to promote psychological well-being and reduce cardiac risk: The Text4Health controlled clinical pilot trial

ObjectiveIn a two-arm pilot trial, we examined the feasibility, acceptability, and preliminary efficacy of a 12-week, adaptive text message intervention (TMI) to promote health behaviors and psychological well-being in 60 individuals with multiple cardiac risk conditions (i.e., hypertension, hyperlipidemia, and/or type 2 diabetes) and suboptimal adherence to exercise or dietary guidance. MethodsParticipants were allocated to receive the TMI or enhanced usual care (eUC). The TMI included daily adaptive text messages promoting health behaviors, twice-weekly messages to set goals and monitor progress, and monthly phone check-ins. Feasibility (primary outcome) and acceptability were measured by rates of successful text message delivery and daily participant ratings of message utility (0–10 Likert scale). We also assessed impact on health behavior adherence, psychological health, and functional outcomes. ResultsThe TMI was feasible (99.3% of messages successfully sent) and well-accepted (mean utility = 7.4/10 [SD 2.6]). At 12 weeks, the TMI led to small-sized greater improvements in moderate to vigorous physical activity (d = 0.37), overall physical activity (d = 0.23), optimism (d = 0.20), anxiety (d = −0.36), self-efficacy (d = 0.22), and physical function (d = 0.20), compared to eUC. It did not impact other outcomes substantially at this time point. ConclusionThis 12-week, adaptive TMI was feasible, well-accepted, and associated with small-sized greater improvements in health behavior and psychological outcomes. Though larger studies are needed, it has the potential to be a scalable, low-intensity program that could be used in clinical practice.ClinicalTrials.govregistration:NCT04382521

TRANSITIONS TO LIVING ALONE AND PSYCHOLOGICAL WELL-BEING OF OLDER ADULTS IN THE U.S: ARE THERE ANY RACE DISPARITIES?

Abstract We extend the existing literature on living alone and psychological well-being in older adults by focusing on the transition process from other living arrangements to living alone. We examine how transitioning to living alone is associated with psychological well-being scores (measured by 21-item Ryff Measures of Psychological Well-being) and how the associations vary across racial and ethnic groups. Using data from 2016 and 2020 Health and Retirement Study, we specify the transitions to living alone from four living arrangements: living with spouse/partner only, living with spouse/partner and older parents, living with a spouse/partner, children, and parents, and living with others. Respondents consistently living alone were the reference group. Our analysis involves adults aged 50 and above (n=3160). After controlling for final psychological well-being scores and adjusting for age, gender, marital status, and education in 2016, results from multiple linear regression models suggest that the transitions from living with spouse/partner only to living alone are associated with significantly lower scores of psychological well-being (β= -1.71, p&amp;lt;.01) than those consistently living alone. However, no statistically significant differences were observed between individuals transitioning from the other three living arrangements to living alone and those consistently living alone. The moderation effect shows that older Blacks experienced increased psychological well-being when transitioning from living with a spouse/partner to living alone (β=2.26) while their White counterparts had decreased psychological well-being during the same transition. This underscores the significance of the transition experience and emphasizes race disparities in its association with psychological health outcomes.

REVISITING POSITIVE AFFECT: THE ROLE OF AFFECT MEAN LEVELS AND VARIABILITY ON DEPRESSION IN MID AND LATER LIFE

Abstract Recent research suggests that affect dynamics (e.g., variability) combined with mean levels are important predictors of psychological and physical health outcomes. This study explores the joint effect of affect levels and variability on depression across 10 years among middle-aged and older adults. We used the data from the second and third waves of Midlife in the United States (MIDUS) study. During telephone interviews, daily positive (PA) and negative affect (NA) were assessed across eight consecutive evenings. Daily affect mean levels were calculated by averaging daily affect across interview days, and daily affect variability was calculated as the individual’s standard deviation (iSD). Depression status was assessed using the Composite International Diagnostic Interview-Short form at baseline and 10-year follow-up. The final analytic sample includes 1,499 adults aged 55 years old on average (age range = 34-83; 55.7% female; 93% white). Logistic regression analysis was performed to test the interaction effect of daily affect mean levels and variability on depression. We found a significant interaction effect between PA mean levels and variability on depression status at follow-up. For individuals with high PA levels, higher PA variability was associated with higher odds of developing depression, after adjusting for depression and anxiety disorder at baseline. For NA, we only found main effects where higher NA variability was associated with higher odds of depression at follow-up. Findings suggest fragile high PA (i.e., variable high PA) may be a significant predictor of depression, highlighting the need for understanding PA as multidimensional construct.

Individualized Coordination and Empowerment for Care Partners of Persons with Dementia (ICECaP): Study rationale and protocol

The majority of care for >10 million older adults with dementia (PWD) in the United States depends on at least on 11 million unpaid care partners (CPs). CPs are at greater risk of adverse physical, psychological, and cognitive health outcomes relative to non-caregiving peers. The goal of this paper is to establish the rationale, design, and protocol for a pilot randomized control trial to test the efficacy of the CP-focused intervention, ICECaP: Individualized Coordination and Empowerment for Care Partners of Persons with Dementia. ICECaP involves the assignment of a trained dementia care coordinator to a CP. The care coordinator maintains at least monthly contact with the CP with hybrid delivery (in-person, phone, e-mail, and video calls) and provides individualized support with care coordination for the CP navigating the PWD's care in a complex healthcare system, as well as supportive counseling, psychoeducation, and skills training for the CP. This trial will compare outcomes from baseline to 12-months among CPs who receive ICECaP versus routine care (controls). Outcomes include CP depression, burden, anxiety, and quality of life; CPs' reactions to the behavioral symptoms of dementia; and use of support services for the PWD. This trial will also assess mechanisms of intervention efficacy including changes in CP dementia knowledge, caregiving preparedness, self-efficacy, and optimism. Publication of this intervention protocol will benefit other dementia care teams seeking to support CPs and PWDs.