Psychosocial Well-being Outcomes Research Articles

Effectiveness of spiritual care interventions among patients in the intensive care unit: A systematic review and meta-analysis.

Spiritual care interventions can be an important source of emotional support for patients in the intensive care unit (ICU). However, there is wide variation in the literature and no quantitative assessment to synthesize the results of these studies. To examine the effectiveness of spiritual care interventions on disease-related physiological parameter and treatment outcomes and psychosocial well-being outcomes among patients in the ICU. A comprehensive search was conducted across 11 databases from inception to 27 May 2024. Studies involving the implementation of spiritual care interventions for patients in the ICU were included. Cochrane's bias risk tool and JBI Critical Appraisal Checklist were used to examine the methodological quality of included studies. Review Manager 5.3 was used to conduct meta-analyses. A total of 18 studies were included. Meta-analysis showed that spiritual care interventions could significantly reduce mean arterial pressure (MAP) (MD: -12.12, 95% CI: [-23.68, -0.56], p = .04), length of stay in the ICU (MD: -5.49, 95% CI: [-8.99, -2.00], p = .002), and improved consciousness (MD: 3.91, 95% CI: [1.42, 6.39], p = .002), anxiety (SMD: -1.78, 95% CI: [-3.06, -0.50], p = .006), spiritual well-being (SMD: 1.57, 95% CI: [0.05, 3.08], p = .04) and comfort (MD: 15.53, 95% CI: [10.81, 20.25], p < .01) among patients in the ICU, but had no significant effects on heart rate (HR), respiratory rate (RR), pulse rate (PR), blood pressure (BP), oxygen saturation (SpO2), duration of ventilator use and pain. Spiritual care interventions could reduce MAP and length of stay in the ICU; improve consciousness, anxiety, spiritual well-being and comfort among patients in the ICU; and are still inconclusive for HR, RR, PR, BP, SpO2, duration of ventilator use and pain. Urgent efforts are needed to better integrate spiritual care interventions into clinical care to enhance patient well-being. Spiritual care interventions could improve well-being of patients in the ICU.

Preliminary Effectiveness of a One-Week Summer Day Camp for Improving Children's Health Behaviors and Psychosocial Well-Being Outcomes.

Summer day camp offers children opportunities to grow knowledge and skills, be physically active, and have fun. Compared to healthy children, at-risk children (i.e., overweight, or with obesity and chronic health conditions) typically display less optimal health behaviors and psychosocial well-being, especially during summer months. This study examined the preliminary effectiveness of an American-Diabetes-Association-sponsored summer day camp at improving children's health behaviors (i.e., physical activity, screen time, diet, sleep) and psychosocial well-being outcomes (i.e., quality of life [QoL], enjoyment, weight-related self-efficacy). The sample consisted of 39 participants, including 19 boys and 20 girls, with majority being overweight (n = 4 or 10%) or with obesity (n = 26 or 67%), who attended the day camp for one week. Significant improvements were observed in screen time, quality of life, and physical function. The results further showed significant time by gender interaction effect for overall QoL (p < 0.05, ηp2 = 0.15), physical health (a dimension of QoL; p < 0.05, ηp2 = 0.18), and significant time by household income for the psychosocial health (another dimension of QoL), favoring boys and those from higher income families. The findings indicate a positive preliminary effectiveness of the summer camp at reducing children's screen time and improving their QoL, especially in boys and those from higher-income families. Future research should focus on health disparities and expansion of this camp for the potential of longer-term and more robust effects related to wellness, nutrition literacy, physical activity promotion, and obesity prevention.

P15 - Changing care for parents in subsequent pregnancies following stillbirth or neonatal death in Australia: Exploring support for optimising psychosocial wellbeing outcomes

P15 - Changing care for parents in subsequent pregnancies following stillbirth or neonatal death in Australia: Exploring support for optimising psychosocial wellbeing outcomes

Marital transitions during earlier adulthood and subsequent health and well-being in mid- to late-life among female nurses: An outcome-wide analysis

Comparing outcomes for individuals remaining married to those for single or divorced individuals might overstate the positive effects of the decision to marry, since marriage carries an inherent risk of divorce and its associated negative outcomes. While a growing literature has examined marital transitions, confounding by past marital history remains a concern and only a limited set of outcomes have been examined. To address these issues, this study examined incident first-time marriage and incident divorce/separation in relation to multiple subsequent physical health, health behavior, psychological distress, and psychosocial well-being outcomes in a large sample of female nurses in the U.S.. Data from the Nurses' Health Study II were studied (1993 to 2015/2017 questionnaire wave, Nmarriage analyses = 11,830, Ndivorce/separation analyses = 73,018, interquartile range of baseline age = 35 to 42 years). A set of regression models were used to regress each outcome on marital transition status, adjusting for a wide range of initial health and wellbeing status in addition to other covariates. Bonferroni correction was performed to account for multiple testing. Among the initially never married, those who became married had lower mortality (RR = 0.65, 95%CI = 0.50, 0.84), lower risks of cardiovascular diseases (e.g., RRstroke = 0.64, 95%CI = 0.50, 0.82), greater psychological wellbeing and less psychological distress (e.g., ßdepressive symptoms = −0.10, 95%CI = -0.15, −0.06). Among the initially married, those who became divorced/separated had lower social integration (β = −0.15, 95%CI = -0.19, −0.11), greater psychosocial distress (e.g., RRdepression = 1.23, 95%CI = 1.10, 1.37), and possibly greater risks of mortality, cardiovascular diseases, and smoking. Future research could study similar questions using data from more recent cohorts, examine potential mechanisms and heterogeneity, and also examine alternative social relationship types.

Examining the use of decision trees in population health surveillance research: an application to youth mental health survey data in the COMPASS study.

In population health surveillance research, survey data are commonly analyzed using regression methods; however, these methods have limited ability to examine complex relationships. In contrast, decision tree models are ideally suited for segmenting populations and examining complex interactions among factors, and their use within health research is growing. This article provides a methodological overview of decision trees and their application to youth mental health survey data. The performance of two popular decision tree techniques, the classification and regression tree (CART) and conditional inference tree (CTREE) techniques, is compared to traditional linear and logistic regression models through an application to youth mental health outcomes in the COMPASS study. Data were collected from 74 501 students across 136 schools in Canada. Anxiety, depression and psychosocial well-being outcomes were measured along with 23 sociodemographic and health behaviour predictors. Model performance was assessed using measures of prediction accuracy, parsimony and relative variable importance. Decision tree and regression models consistently identified the same sets of most important predictors for each outcome, indicating a general level of agreement between methods. Tree models had lower prediction accuracy but were more parsimonious and placed greater relative importance on key differentiating factors. Decision trees provide a means of identifying high-risk subgroups to whom prevention and intervention efforts can be targeted, making them a useful tool to address research questions that cannot be answered by traditional regression methods.

THE RELATIONSHIP BETWEEN SOCIOECONOMIC DISADVANTAGE AND DEMENTIA CAREGIVER BURDEN

Abstract More than 16 million people provide unpaid care to someone with Alzheimer’s disease or a related dementia (ADRD) in the United States. These caregivers frequently report experiencing psychological and physical burden. Prior research shows that socioeconomic disadvantaged neighborhoods have higher rates of ADRD, but little is known about caregiver burden. We hypothesized more socioeconomic disadvantage is associated with higher caregiver burden. We performed a secondary analysis using baseline data on dementia caregivers (n=132) enrolled in the Indiana University Telephone Acceptance and Commitment Therapy for Caregivers (TACTICs) pilot trials. Mean (SD) caregiver age was 61.6 (11.6) years; 83.3% women; 78.8% white; 19.7% black. Seventy-two percent of the caregivers lived with the care recipient and 50.8% reported moderate dementia severity. A linear regression model examined the relationship between caregiver’s national Area Deprivation Index (ADI) score (ranging from 1–100 with higher scores indicating greater socioeconomic disadvantage) and caregiver burden. The following covariates were included: age, sex, race, education, shared residence with care-recipient, health status, anxiety, depression, and dementia severity of care recipient. Higher ADI was associated with lower caregiver burden (β=-0.222, p &amp;lt; 0.001). Caregiver burden has a significant negative relationship with ADI and dementia severity (p&amp;lt;-.001 and 0.046, respectively) and positive relationship with anxiety (p=0.014) controlling other covariates in the model. Although we found no support for the hypothesis, further research should examine these factors with how caregiver’s ADI may impact other psychosocial wellbeing outcomes. Discussion will highlight the need for caregivers to have access to resources that can aid them through their experience.

THEORETICAL IMPLICATIONS AND IMPACT OF SELF-COMPASSION IN CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA

Abstract Caregivers of people living with dementia often report greater symptoms of depression, anxiety, and burden. Guided by the Stress Process Model, the study examined the impact of self-compassion on these key psychosocial well-being outcomes in a sample of dementia caregivers (N=99). Participants were 66.7% female, 67.7% White, and 74% were children/in law or grandchildren/in law, with a mean age of 38.61. Findings indicated self-compassion was a significant and unique predictor of symptoms of depression (β = -.25, p = .03), anxiety (β = -.36, p = .01), and burden (β = -.25, p = .02). Additional analyses found support for dysfunctional coping meditating the relationship between self-compassion and caregiver burden ((B = -.20, SE = .06, 95%CI[-.3242, -.0924] dysfunctional coping mediating the relationship between self-compassion and anxiety (B = -.16, SE = .05, 95%CI[-.2257, -.0302] and emotion-focused coping meditating the relationship between self-compassion and depression (B = -.06, SE = .03, 95%CI[-.1388, -.0045]. Results demonstrate the important role of self-compassion along with the impact of coping style on psychosocial well-being outcomes. Discussion will highlight the theoretical implications of these findings along with how these results can be used to develop efficacious interventions for caregivers of persons with dementia. Specifically, tailoring an intervention for dementia caregivers grounded in self-compassion theory as well as Compassion Focused Therapy and Mindful Self-Compassion Therapy may assist caregivers in developing a self-compassionate mindset and skills to more effectively cope with caregiving challenges.

IMPACT OF A SOCIAL CONNECTION PROGRAM ON OLDER ADULTS DURING THE COVID-19 PANDEMIC

Abstract Background Research demonstrates social connections decrease loneliness and improves life satisfaction among older adults. However, the COVID-19 pandemic limited social connectedness, specifically for older adults. Thus, programs aimed to increase social connectedness among older adults are integral to their well-being. Purpose: The primary objective of this study was to determine if the telephonic Peer-to-Peer (P2P) program could improve social connectedness and reduce loneliness among older adults. A secondary objective was to improve life satisfaction and social support. Methods Eligible older adults (age 65+) were recruited via outbound calls and/or a mailer. Participants were mailed a T1 survey, completed intervention training, and matched into a dyad. The matched dyad engaged in weekly telephone calls for 12 weeks. Post 12 weeks, participants completed a T2 survey, and a T3 four weeks later. Results A total of 475 participants completed a T1, and 125 dyads (250 individuals) completed a T3. Older females were more likely to participate (77% female, 44% 75+ old). Individuals who were lonelier at baseline showed a significant improvement in loneliness throughout the program, as well as improvement in social support, life satisfaction, and subjective happiness. Conclusion Results from this program showed significant improvement in psychosocial well-being outcomes for lonely older adults. This program took place during the initial months of the COVID-19 pandemic and demonstrated success for lonely older adults with limited technology who may have been socially isolated during this time.

Living in Liquid Times: The Relationships among Job Insecurity, Life Uncertainty, and Psychosocial Well-Being.

Stress research has widely documented how uncertainty represents a strong stressor that, in general, is negatively associated with well-being. While the literature on job insecurity about this topic is extensive and exhaustive, empirical research on the outcomes of life uncertainty, namely the perception and feeling of precariousness regarding the present and future of one's own life, is yet to be fully explored. In the present paper, we aimed to investigate the relationships among job insecurity, life uncertainty, and psychosocial well-being outcomes, specifically, with a focus on job satisfaction and burnout. The participants were 357 workers (M = 146 and F = 211), with an average age of 41.78 y.o. (SD = 13.49), who completed an online questionnaire containing, in addition to sociodemographics information, measures of the study variables, namely job insecurity, life uncertainty, job satisfaction, and burnout. The results pointed out negative relationships of both job insecurity and life uncertainty with individual well-being, as they were negatively associated with job satisfaction and positively related to burnout. In a path analysis with latent variables, life uncertainty proved to fully mediate the relationship between job insecurity and psychosocial well-being.

Patient-reported outcome measurements in post-mastectomy implant-based breast reconstruction and radiotherapy: Analysis of BREAST-Q data.

Breast reconstruction has become a standard of care in patients undergoing mastectomy, greatly improving their quality of life. An increasing number of patients-reported outcome measurements (PROMs) have been developed over the years to better analyze patients' subjective overall experience. BREAST-Q is the PROMs for breast surgery introduced in our practice to assess patients' experiences when undergoing implant-based breast reconstruction and radiotherapy along with the use of Peak Plasma Blade and acellular dermal matrix. The pre-operative version of the Reconstruction BREAST-Q was administered to all 88 patients enrolled between December 2017 and December 2018 in the Plastic Reconstructive Surgery Unit at Fondazione IRCCS Istituto Nazionale Tumori Milano through person-to-person interviews, while the post-operative version was administered to the 75 patients who completed a 12-month follow-up (four patients died during one-year follow-up and nine patients had major complications). The survey areas highlighted were: satisfaction with breast, psychosocial well-being, physical well-being and sexual well-being. From BREAST-Q questions regarding Satisfaction With The Appearance Of The Breast and Psychosocial Well-Being outcomes showed significant improvement from pre-operative data, as well as with Satisfaction With Overall Care, with the exception of Physical Well-Being Chest. BREAST-Q allows the assessment of patients' perception, not only for surgical results, but also for the overall experience with surgeons and medical staff.The women enrolled in our study reported an overall good patient satisfaction in most of the analyzed fields.

Ethnic-racial socialization as a moderator of associations between discrimination and psychosocial well-being among African American and Caribbean Black adolescents.

Discrimination can have debilitating effects on Black adolescents' psychosocial well-being. Ethnic-racial socialization (ERS) is crucial in helping youth manage racial discrimination and its adverse effects. However, little is known about how ERS can be beneficial against discrimination for subgroups of Black youth, despite evidence that culture and nationality may influence how adults prepare youth for discrimination. The present study examined if associations between discrimination and psychosocial well-being outcomes, and the moderating effects of ERS, varied by ethnicity for African American (AA) and Caribbean Black (CB) adolescents. Participants were 1,170 Black adolescents, 810 (AA); 360 (CB), who participated in the National Survey of American Life Adolescent supplement study. Multigroup analysis was applied to examine the moderating effects of ERS for AA and CB adolescents. For CB adolescents who reported high preparation for bias, discrimination was associated with fewer mastery beliefs, and the positive association between discrimination and perceived stress was stronger at higher levels of preparation for bias. Additionally, the negative association between discrimination and John Henryism active coping was stronger for youth who reported high egalitarian messages. Findings indicate that preparation for bias messages differentially influences the effects of discrimination on stress and mastery for AA and CB adolescents. The results highlight the importance of exploring ethnic heterogeneity of ERS. Implications for psychosocial well-being are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Illness Experience of Veterans With Dementia: Perceived Measures Related to Depressive Symptoms

Abstract Recent work has examined how individuals with dementia (IWDs) experience their illness, although few studies have looked at IWDs who report heightened depressive symptoms, a key well-being outcome. Stressing the ability of IWDs to self-report and guided by the Stress Process Model for Individuals with Dementia, this study examined the relationships between depressive symptoms and various aspects of the illness experience including objective cognition, perceived memory difficulty, perceived functional difficulty, and dyadic relationship strain. The sample includes IWDs with mild to severe dementia who are veterans (N=69). Significant positive correlations emerged between depressive symptoms and several measures of the illness experience: perceived cognition (r=.48, p&amp;lt;.001), perceived function (r =.43, p&amp;lt;.001), and dyadic relationship strain (r=.32, p=.01). In contrast, objective cognition, measured by a modified version of the Blessed Orientation Memory Concentration test, was not significant (r =-.06, p=.63). A multiple regression found the total variance explained by all independent variables was 32% (R2=.32, F(4,68)=7.58, p&amp;lt;.001), with perceived memory difficulty (B=.26, p&amp;lt;.01) and dyadic relationship strain (B=.25, p=.04) accounting for unique and significant variance in depressive symptoms. A mediation analysis indicated perceived memory difficulty fully mediated the relationship between perceived functional difficulty and depressive symptoms. Findings highlight the importance of IWDs perceptions of their illness experience for psychosocial well-being outcomes, such as depressive symptoms. Findings add to the literature by showing the importance of IWDs perceptions of their illness and their impact on well-being outcomes. Results also demonstrate the utility and feasibility of including self-reported data from IWDs in research studies.

The Illness Experience of Veterans With Dementia: Perceived Measures Related to Depressive Symptoms

Recent work has examined how individuals with dementia (IWDs) experience their illness, although few studies have looked at IWDs who report heightened depressive symptoms, a key well-being outcome. Stressing the ability of IWDs to self-report and guided by the Stress Process Model for Individuals with Dementia, this study examined the relationships between depressive symptoms and various aspects of the illness experience including objective cognition, perceived memory difficulty, perceived functional difficulty, and dyadic relationship strain. The sample includes IWDs with mild to severe dementia who are veterans (N=69). Significant positive correlations emerged between depressive symptoms and several measures of the illness experience: perceived cognition (r=.48, p<.001), perceived function (r =.43, p<.001), and dyadic relationship strain (r=.32, p=.01). In contrast, objective cognition, measured by a modified version of the Blessed Orientation Memory Concentration test, was not significant (r =-.06, p=.63). A multiple regression found the total variance explained by all independent variables was 32% (R2=.32, F(4,68)=7.58, p<.001), with perceived memory difficulty (B=.26, p<.01) and dyadic relationship strain (B=.25, p=.04) accounting for unique and significant variance in depressive symptoms. A mediation analysis indicated perceived memory difficulty fully mediated the relationship between perceived functional difficulty and depressive symptoms. Findings highlight the importance of IWDs perceptions of their illness experience for psychosocial well-being outcomes, such as depressive symptoms. Findings add to the literature by showing the importance of IWDs perceptions of their illness and their impact on well-being outcomes. Results also demonstrate the utility and feasibility of including self-reported data from IWDs in research studies.

The relationship between mental well-being and dysregulated gaming: a specification curve analysis of core and peripheral criteria in five gaming disorder scales.

Gaming disorder (also known as dysregulated gaming) has received significant research and policy attention based on concerns that certain patterns of play are associated with decreased mental well-being and/or functional impairment. In this study, we use specification curve analysis to examine analytical flexibility and the strength of the relationship between dysregulated gaming and well-being in the form of general mental health, depressive mood and life satisfaction. Dutch and Flemish gamers (n = 424) completed an online survey containing five unique dysregulated gaming measures (covering nine scale variants) and three well-being measures. We find a consistent negative relationship; across 972 justifiable regression models, the median standardized regression coefficient was −0.39 (min: −0.54, max: −0.19). Data show that the majority of dysregulated gaming operationalizations converge upon highly similar estimates of well-being. However, variance is introduced by the choice of well-being measure; results indicate that dysregulated gaming is more strongly associated with depressive mood than with life satisfaction. Weekly game time accounted for little to no unique variance in well-being in the sample. We argue that research on this topic should compare a broad range of psychosocial well-being outcomes and explore possible simplifications of the DSM-5 gaming disorder criteria. Given somewhat minute differences between dysregulated gaming scales when used in survey-based studies and largely equivalent relationships with mental health indicators, harmonization of measurement should be a priority.

Theoretical and Operational Consideration of Mindfulness, Resilience, and Resourcefulness.

Mindfulness, resilience, and resourcefulness are theoretically distinct but related constructs critical for improving psychosocial well-being outcomes for informal caregivers and others. Our aims were to evaluate the theoretical and operational distinctions among these constructs. Measures of mindfulness (Decentering Scale), resilience (Connor-Davidson Scale) and resourcefulness (Resourcefulness Scale) were collected from a national sample of 348 grandmother caregivers. We conducted exploratory factor analysis and examined correlation patterns. Inter-correlations ranged from r= .26 (resourcefulness and resilience) to r= .73 (resilience and mindfulness). Factor analyses and scree plots indicated unidimensional factors for resilience and for mindfulness, and two factors for resourcefulness (personal and social). When items from all measures were analyzed together, the four factors remained. Distinct relationships were found between mindfulness, resilience, and resourcefulness with relevant external variables. Our results support the conceptual distinctions among the constructs, providing support for interventions targeting these constructs to improve psychosocial outcomes in caregivers.

Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts.

BackgroundReligious-service attendance has been linked with a lower risk of all-cause mortality, suicide and depression. Yet, its associations with other health and well-being outcomes remain less clear.MethodsUsing longitudinal data from three large prospective cohorts in the USA, this study examined the association between religious-service attendance and a wide range of subsequent physical health, health behaviour, psychological distress and psychological well-being outcomes in separate cohorts of young, middle-aged and older adults. All analyses adjusted for socio-demographic characteristics, prior health status and prior values of the outcome variables whenever data were available. Bonferroni correction was used to correct for multiple testing.ResultsEstimates combining data across cohorts suggest that, compared with those who never attended religious services, individuals who attended services at least once per week had a lower risk of all-cause mortality by 26% [95% confidence interval (CI): 0.65 to 0.84], heavy drinking by 34% (95% CI: 0.59 to 0.73) and current smoking by 29% (95% CI: 0.63 to 0.80). Service attendance was also inversely associated with a number of psychological-distress outcomes (i.e. depression, anxiety, hopelessness, loneliness) and was positively associated with psychosocial well-being outcomes (i.e. positive affect, life satisfaction, social integration, purpose in life), but was generally not associated with subsequent disease, such as hypertension, stroke, and heart disease.ConclusionsDecisions on religious participation are generally not shaped principally by health. Nevertheless, for individuals who already hold religious beliefs, religious-service attendance may be a meaningful form of social integration that potentially relates to greater longevity, healthier behaviours, better mental health and greater psychosocial well-being.

Nonorganizational Religious Involvement and Psychosocial Well-Being Among African American and Caribbean Black Youth

Often cited as a developmental and cultural resource, religion has been widely studied. However, few studies have explored the relationship between nonorganizational religious involvement (NRI) and psychosocial well-being among Black youth or within ethnic groups of Black youth. This study examined this relationship among 1,170 African American and Caribbean Black youth who participated in the National Survey of American Life–Adolescent Supplement study. Moderated hierarchical regression results showed significant main effects of NRI on life satisfaction, self-esteem, coping, and depressive symptoms after accounting for study covariates (i.e., age, gender, family income, denomination, ethnicity, religious service attendance, and religious socialization). No significant interaction effects were observed between NRI and ethnicity on any of the psychosocial well-being outcomes. Results illuminate a promotive effect of NRI in this sample. Though no significant ethnicity and religiosity interaction effects were observed, findings suggest the importance of NRI as a key intervention target to support better psychosocial well-being among Black youth, in an effort to promote overall youth development.

Use of the Chatbot "Vivibot" to Deliver Positive Psychology Skills and Promote Well-Being Among Young People After Cancer Treatment: Randomized Controlled Feasibility Trial.

BackgroundPositive psychology interventions show promise for reducing psychosocial distress associated with health adversity and have the potential to be widely disseminated to young adults through technology.ObjectiveThis pilot randomized controlled trial examined the feasibility of delivering positive psychology skills via the Vivibot chatbot and its effects on key psychosocial well-being outcomes in young adults treated for cancer.MethodsYoung adults (age 18-29 years) were recruited within 5 years of completing active cancer treatment by using the Vivibot chatbot on Facebook messenger. Participants were randomized to either immediate access to Vivibot content (experimental group) or access to only daily emotion ratings and access to full chatbot content after 4 weeks (control). Created using a human-centered design process with young adults treated for cancer, Vivibot content includes 4 weeks of positive psychology skills, daily emotion ratings, video, and other material produced by survivors, and periodic feedback check-ins. All participants were assessed for psychosocial well-being via online surveys at baseline and weeks 2, 4, and 8. Analyses examined chatbot engagement and open-ended feedback on likability and perceived helpfulness and compared experimental and control groups with regard to anxiety and depression symptoms and positive and negative emotion changes between baseline and 4 weeks. To verify the main effects, follow-up analyses compared changes in the main outcomes between 4 and 8 weeks in the control group once participants had access to all chatbot content.ResultsData from 45 young adults (36 women; mean age: 25 [SD 2.9]; experimental group: n=25; control group: n=20) were analyzed. Participants in the experimental group spent an average of 74 minutes across an average of 12 active sessions chatting with Vivibot and rated their experience as helpful (mean 2.0/3, SD 0.72) and would recommend it to a friend (mean 6.9/10; SD 2.6). Open-ended feedback noted its nonjudgmental nature as a particular benefit of the chatbot. After 4 weeks, participants in the experimental group reported an average reduction in anxiety of 2.58 standardized t-score units, while the control group reported an increase in anxiety of 0.7 units. A mixed-effects models revealed a trend-level (P=.09) interaction between group and time, with an effect size of 0.41. Those in the experimental group also experienced greater reductions in anxiety when they engaged in more sessions (z=–1.9, P=.06). There were no significant (or trend level) effects by group on changes in depression, positive emotion, or negative emotion.ConclusionsThe chatbot format provides a useful and acceptable way of delivering positive psychology skills to young adults who have undergone cancer treatment and supports anxiety reduction. Further analysis with a larger sample size is required to confirm this pattern.

Cumulative Encouragement to Diet From Adolescence to Adulthood: Longitudinal Associations With Health, Psychosocial Well-Being, and Romantic Relationships

PurposeThe aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood. MethodsData from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998–1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016. ResultsAdolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p < .05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult. ConclusionsEncouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns.

Religiously or spiritually-motivated forgiveness and subsequent health and well-being among young adults: An outcome-wide analysis

ABSTRACTThis study performs an outcome-wide analysis to prospectively examine the associations of forgiveness (including forgiveness of others, self-forgiveness and divine forgiveness) with a range of psychosocial, mental, behavioral and physical health outcomes. Data from the Nurses’ Health Study II and the Growing Up Today Study (Ns ranged from 5,246 to 6,994, depending on forgiveness type and outcome) with 3 or 6 years of follow-up were analyzed using generalized estimating equations. Bonferroni correction was used to correct for multiple testing. All models controlled for sociodemographic characteristics, prior religious service attendance, prior maternal attachment and prior values of the outcome variables. All forgiveness measures were positively associated with all psychosocial well-being outcomes, and inversely associated with depressive and anxiety symptoms. There was little association between forgiveness and behavioral or physical health outcomes. Forgiveness may be understood as a good itself, and may also lead to better psychosocial well-being and mental health.