Self-reported Health Measures Research Articles

Are dental visiting patterns and oral pain associated with dental disease among Norwegian adults? A cross-sectional study based on the Tromsø study.

The present study aims to describe the dental visiting patterns in a Norwegian adult population and their associations with sociodemographic and oral health variables, including oral pain. We further explore if the utilization of dental health services and oral pain predicts caries and periodontitis, the most common oral diseases. We use data from the seventh wave of the Tromsø study performed in 2015-2016. In this cross-sectional survey, all residents 40 years or older in Tromsø municipality in Norway were invited, of whom 21,083 (65%) participated. All participants answered questionnaires assessing sociodemographic characteristics, use of health services, and self-reported health measures, including pain. Almost 4000 participants underwent a dental examination with registration of caries and periodontitis. Associations of dental visiting patterns and utilization of dental services the past 12 months with sociodemographic-, self-reported-, and clinical oral health measures were analyzed by cross-tabulation and Pearson's χ2 tests, as well as with logistic regression analyses with caries and periodontitis as outcomes. A regular, annual dental visiting pattern was the most common, but among respondents with severe dental anxiety and poor dental health, visiting for acute problems only or never (symptomatic visiting) was the most common. Intervals of more than 24 months between visits and a symptomatic visiting pattern were associated with caries, whereas shorter than 12-month intervals and a symptomatic visiting pattern were associated with periodontitis. Many characteristics were shared among respondents with the lowest and the highest utilization of dental services, including oral pain, a difficult financial situation and poorer self-reported and clinical dental health. Regular dental visits at 12-24 month intervals were associated with beneficial oral health parameters, compared with more frequent, rarer, and symptomatic dental visiting patterns. Oral pain was an unreliable predictor of caries and periodontitis.

Helpful for all? Examining the effects of psychotherapy treatment history on outcomes of single session, transdiagnostic cognitive behavioral interventions for university students.

Brief, transdiagnostic interventions are an efficient form of mental health care for resource-limited settings like universities. Little research, however, has examined for whom these treatments are most effective. One important factor may be psychotherapy treatment history. Here, we evaluate if treatment history influences the effects of a single-session cognitive behavioral group intervention with optional digital follow-up support across two independent, university-based studies. Undergraduate (N = 143) and graduate (N = 51) students reported their psychotherapy treatment history and completed self-report measures of emotional health before and approximately 1-month following the intervention. Across both samples, psychotherapy treatment history did not moderate changes in depression, anxiety, or emotional avoidance following the intervention. However, participants who were currently receiving psychotherapy began the workshop with lower coping self-efficacy than peers with no prior psychotherapy and saw larger gains in coping self-efficacy at follow-up. Results suggest that regardless of whether a student has previously received psychotherapy, they may benefit from brief, group transdiagnostic interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and associations of temporomandibular disorders in older Brazilian adults.

The objective of the study was to estimate the prevalence of temporomandibular disorders (TMD) and describe associations in a representative sample of community-dwelling older Brazilian adults. TMD cause recurrent or chronic pain and dysfunction with substantial impacts on quality of life, but little is known of their occurrence and associated factors among older adults. This was a cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging, a nationally representative sample of older Brazilian adults aged 50 or older. The presence of temporomandibular disorder symptoms was measured by the Fonseca Anamnestic Index. Independent variables included sociodemographic characteristics, general health conditions and self-reported oral health measures. The association between the independent variables and TMD symptoms was evaluated using logistic regression models. Complete information for the variables of interest was available for 9391 individuals. The overall prevalence of TMD symptoms was 18.0% (95% CI 14.4-22.1). Relative to older adults aged 50-59 those in all age categories had lower odds of TMD symptoms. Individuals with depression, pain, sleep problems and self-reported poor general health had higher odds of reporting TMD symptoms. None of the oral health measures were related to TMD. The prevalence of TMD symptoms among Brazilian older adults is associated with demographic and general health conditions, but not with dentition status.

Shared genetic architecture between mental health and the brain functional connectome in the UK Biobank

Psychiatric disorders are complex clinical conditions with large heterogeneity and overlap in symptoms, genetic liability and brain imaging abnormalities. Building on a dimensional conceptualization of mental health, previous studies have reported genetic overlap between psychiatric disorders and population-level mental health, and between psychiatric disorders and brain functional connectivity. Here, in 30,701 participants aged 45–82 from the UK Biobank we map the genetic associations between self-reported mental health and resting-state fMRI-based measures of brain network function. Multivariate Omnibus Statistical Test revealed 10 genetic loci associated with population-level mental symptoms. Next, conjunctional FDR identified 23 shared genetic variants between these symptom profiles and fMRI-based brain network measures. Functional annotation implicated genes involved in brain structure and function, in particular related to synaptic processes such as axonal growth (e.g. NGFR and RHOA). These findings provide further genetic evidence of an association between brain function and mental health traits in the population.

Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial.

Depressive symptoms are highly prevalent and have broad-ranging negative implications. Digital interventions are increasingly available in the workplace context, but supporting evidence is limited. This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of 3 digital interventions for depressive symptoms in a sample of UK-based working adults experiencing mild to moderate symptoms. This was a parallel, multiarm, pilot randomized controlled trial. Participants were allocated to 1 of 3 digital interventions or a waitlist control group and had 3 weeks to complete 6 to 8 short self-guided sessions. The 3 interventions are available on the Unmind mental health app for working adults and draw on behavioral activation, cognitive behavioral therapy, and acceptance and commitment therapy. Web-based assessments were conducted at baseline, postintervention (week 3), and at 1-month follow-up (week 7). Participants were recruited via Prolific, a web-based recruitment platform, and the study was conducted entirely on the web. Feasibility and acceptability were assessed using objective engagement data and self-reported feedback. Efficacy outcomes were assessed using validated self-report measures of mental health and functioning and linear mixed models with intention-to-treat principles. In total, 2003 individuals were screened for participation, of which 20.22% (405/2003) were randomized. A total of 92% (373/405) of the participants were retained in the study, 97.4% (295/303) initiated their allocated intervention, and 66.3% (201/303) completed all sessions. Moreover, 80.6% (229/284) of the participants rated the quality of their allocated intervention as excellent or good, and 79.6% (226/284) of the participants were satisfied or very satisfied with their intervention. All active groups showed improvements in well-being, functioning, and depressive and anxiety symptoms compared with the control group, which were maintained at 4 weeks. Hedges g effect sizes for depressive symptoms ranged from -0.53 (95% CI -0.25 to -0.81) to -0.74 (95% CI -0.45 to -1.03). All interventions were feasible and acceptable, and the preliminary efficacy findings indicated that their use may improve depressive symptoms, well-being, and functioning. The predefined criteria for a definitive trial were met. International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN13067492; https://www.isrctn.com/ISRCTN13067492.

Discrimination and Cortisol Dynamics among Older African Americans Adults

Discrimination has been found to predict self-report measures of general health as well as surrogate and clinical endpoints of various diseases. As the connection between discrimination and disease and pre-disease states became evident, research efforts started to include more investigations of the purported biological mediators. Dysregulation in the daily activity of the Hypothalamic-Pituitary-Adrenal (HPA) axis has been proposed as one of these mechanisms. The current study leverages data collected in the Health among Older Adults Living in Detroit project to investigate the relationship between three measures of discrimination (lifetime discrimination, habitual everyday discrimination, and daily everyday discrimination) and diurnal cortisol secretion in a sample of 203 older African Americans. Study results indicated that individuals reporting higher levels of lifetime discrimination experienced morning hypocortisolism and flatter diurnal cortisol slopes. Neither habitual (the estimated routine frequency of day-to-day experiences of unfair treatment) nor daily (the occurrence of discrimination experiences in a short and defined period – five days in our study) everyday discrimination were associated with cortisol secretion. However, exploratory analyses also showed that prior daily everyday discrimination was significantly associated with blunted cortisol awakening response (CAR) the next day. The link between lifetime discrimination and daily cortisol found in our study seems to support the stress accumulation model (stressors accumulate over time and have an additive effect on health processes and outcomes). Overall, our findings underline the role played by discrimination in modulating the activity of the HPA axis, whose regulation has critical implications for healthy aging.

0233 Racial/ethnic Residential Segregation - a Component of Structural Racism - and Sleep Health by Neighborhood-level Poverty

Abstract Introduction Racial/ethnic residential segregation may contribute to sleep disparities by concentrating poverty and impairing sleep among minoritized groups. Yet, due to racism, equitable access to sleep-promoting resources may not occur in integrated neighborhoods. Further, social/cultural factors within ethnic enclaves could be protective. Methods To investigate whether relationships between racial/ethnic residential segregation and sleep vary by census tract-level poverty among US adults, we linked nationally-representative National Health Interview Survey data (2011-2017) to 2012 and 2017 American Community Survey census tract-level data. We used the local Getis-Ord Gi* statistic to categorize residential segregation (high, medium, low [reference]), considering differences between racial/ethnic composition within a census tract to the surrounding county. Survey-weighted, Poisson regressions with robust variance estimation were stratified by race/ethnicity and approximate census tract-level poverty tertile (high [>16.9% of residents below poverty level], medium [>7.9%-16.9%], low [0%-7.9%]) to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for self-reported sleep health measures. Results Among 126,539 participants (mean age±SE=46±0.1 years), non-Hispanic (NH)-Black and Latino adults were most likely to report short sleep (41%) and non-restorative sleep (37%), respectively. Racial/ethnic residential segregation was most common among NH-Black (38%), followed by non-Mexican Latino (34%) and NH-Asian adults (34%), and was least prevalent among NH-White adults (17%) but was not associated with sleep among Mexican, non-Mexican Latino, or NH-Black adults. Among NH-Asian adults, high segregation was marginally associated with a higher prevalence of short sleep (< 7-hours vs. recommended [7-9 hours]) in low-poverty neighborhoods (PR=1.17 [95% CI:0.97-1.42]) but was associated with recommended sleep in medium-poverty neighborhoods (PRshort sleep=0.79 [0.63-0.99]). Among NH-White adults, high residential segregation was associated with more restorative sleep only in high-poverty (PR=1.13 [1.06-1.20]) and low-poverty (PR=1.03 [1.00-1.07]) neighborhoods. Conclusion Associations between racial/ethnic residential segregation and sleep health varied by neighborhood-level poverty among NH-Asian and NH-White adults. The lack of differences among most minoritized groups may be related to the close proximity of higher-income and lower-income neighborhoods due to structural racism. Future studies including spatial analyses are warranted. The findings/conclusions in this research are those of the authors and do not necessarily represent the views of the Research Data Center, National Center for Health Statistics, or CDC. Support (if any)

The Google Health Digital Well-Being Study: Protocol for a Digital Device Use and Well-Being Study.

The impact of digital device use on health and well-being is a pressing question. However, the scientific literature on this topic, to date, is marred by small and unrepresentative samples, poor measurement of core constructs, and a limited ability to address the psychological and behavioral mechanisms that may underlie the relationships between device use and well-being. Recent authoritative reviews have made urgent calls for future research projects to address these limitations. The critical role of research is to identify which patterns of use are associated with benefits versus risks and who is more vulnerable to harmful versus beneficial outcomes, so that we can pursue evidence-based product design, education, and regulation aimed at maximizing benefits and minimizing the risks of smartphones and other digital devices. The objective of this study is to provide normative data on objective patterns of smartphone use. We aim to (1) identify how patterns of smartphone use impact well-being and identify groups of individuals who show similar patterns of covariation between smartphone use and well-being measures across time; (2) examine sociodemographic and personality or mental health predictors and which patterns of smartphone use and well-being are associated with pre-post changes in mental health and functioning; (3) discover which nondevice behavior patterns mediate the association between device use and well-being; (4) identify and explore recruitment strategies to increase and improve the representation of traditionally underrepresented populations; and (5) provide a real-world baseline of observed stress, mood, insomnia, physical activity, and sleep across a representative population. This is a prospective, nonrandomized study to investigate the patterns and relationships among digital device use, sensor-based measures (including both behavioral and physiological signals), and self-reported measures of mental health and well-being. The study duration is 4 weeks per participant and includes passive sensing based on smartphone sensors, and optionally a wearable (Fitbit), for the complete study period. The smartphone device will provide activity, location, phone unlocks and app usage, and battery status information. At the time of submission, the study infrastructure and app have been designed and built, the institutional review board of the University of Oregon has approved the study protocol, and data collection is underway. Data from 4182 enrolled and consented participants have been collected as of March 27, 2023. We have made many efforts to sample a study population that matches the general population, and the demographic breakdown we have been able to achieve, to date, is not a perfect match. The impact of digital devices on mental health and well-being raises important questions. The Digital Well-Being Study is designed to help answer questions about the association between patterns of smartphone use and well-being. DERR1-10.2196/49189.

Child Maltreatment, Mental Health, and Self-Reported Health Among Adolescent Girls in Child Welfare: Mediating Pathways.

Child maltreatment is common in the US and has been shown to be associated with physical and psychological health problems in adolescence and adulthood. Based on the allostatic load theory, this study examined the association between different types of child maltreatment (emotional, physical, and sexual abuse, and physical neglect) and self-rated health, and the mediating roles of post-traumatic stress and depression in these relationships. Participants were 249 girls involved in the child welfare system, ages 12-19 years, the majority of whom were African American. A one item self-reported general health measure, the Child Trauma Questionnaire-Short Form (CTQ-SF), Child PTSD Symptom Scale (CPSS) and the Child Depression Inventory (CDI) measured self-reported health, child maltreatment,and posttraumatic and depression symptoms, respectively. Higher levels of emotional, physical, and sexual abuse, and physical neglect were significantly associated with poorer ratings of health. PTSD and depression were significant mediators between histories of childhood emotional, physical, and sexual abuse and physical health. In conclusion, results indicate that the pathways from child abuse to physical health problems in adolescents are through psychological distress. Trauma focused interventions to reduce symptoms of PTSD and depression among this vulnerable group of adolescents are essential to improve health.

Self-reported health measures in burn survivors undergoing burn surgery following acute hospitalization: A burn model system national database investigation

Health Related Quality of Life (HRQoL) surveys such as PROMIS-29 may facilitate shared decision-making regarding surgery after burn injury. We aimed to examine whether scar revision and contracture release surgery after index hospitalization was associated with differences in HRQoL. Patient and PROMIS-29 Profile v2.0 data were extracted from the Burn Model System (BMS) at 6-, 12-, and 24-months after burn. PROMIS-29 measures 7 health-related domains. Linear regression was performed to identify associations between independent burn patient variables (e.g. scar-related surgery) and PROMIS-29 scores. Socio-demographic and injury variables were analyzed using logistic regression to determine the likelihood of undergoing burn-related surgery. Of 727 participants, 201 (27.6%) underwent ≥1 scar/contracture operation within 24 months of injury. Number of operations at index hospital admission and range of motion (ROM) deficit at discharge were correlated with an increased likelihood of undergoing subsequent scar/contracture surgery (p<0.05). Participants undergoing scar/contracture surgery and those that were Medicaid insured reported significantly worse HRQoL for PROMIS domains: anxiety, depression, and fatigue (p<0.05). After adjusting for burn severity and available confounders, participants who underwent scar-related burn reconstructive surgery after index hospitalization reported overall worse Health-Related Quality of Life (HRQoL) in multiple domains.

Summary of Research: Development and Validation of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ).

This is a summary of the original article 'Development and Validation of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ)'. Individuals with insomnia are best positioned to assess the impact of insomnia on their quality of life. Patient reported outcomes (PROs) are self-reported health measures created to allow people to record their experience of their disease. Chronic insomnia has a major impact on daytime functioning for patients, and on their quality of life. This summary of research provides an overview of a previously published article detailing the development and evaluation of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ), as a tool to allow people with insomnia to report their experience of the impact on their daytime functioning.

Depressive Symptoms are Associated with More Negative Global Metacognitive Biases in Combat Veterans, and Biases Covary with Symptom Changes over Time

Metacognitive awareness, insight into one’s abilities, is thought to be disrupted in depression and posttraumatic stress disorder (PTSD), with more negative metacognitive biases and reduced awareness, respectively. However, studies have rarely examined global aspects of metacognitive awareness in depression and PTSD, instead using task-specific measures. In 467 trauma-exposed post-9/11 veterans, we administered assessments of PTSD and depression, self-report and objective measures of cognitive functioning (neuropsychological battery of memory, attention, and executive function measures), and self-report and objective measures of general health (index of five cardiometabolic factors). We used self-report/objective correlations to measure metacognitive sensitivity and 'self-report minus objective' scores to measure bias. We also examined associations between changes in metacognitive awareness and changes in PTSD and depression over time. Metacognitive sensitivity was comparable between individuals with and without PTSD and depression. However, metacognitive bias was significantly more negative in those with greater depressive symptoms (i.e., underconfidence) across cognition and health, independent of PTSD symptoms. Notably, metacognitive bias changes covaried with depressive and PTSD symptom changes two years later. This shows that, in trauma-exposed veterans, negative metacognitive biases are specifically related to depressive symptoms and these biases may be relatively domain general. Further, our longitudinal results suggest that, rather than being a stable trait, metacognitive biases change with PTSD/depressive symptoms over time.

Barriers to oral health care for transgender and gender nonbinary populations

BackgroundDespite health disparities and barriers to medical care being well documented in the literature, transgender and gender nonbinary (TGNB) people’s experiences and expectations with regard to oral health care remain understudied. The authors examined gender identity–related factors influencing experiences in the dental setting, aspects of subjective oral health, and avoidance of oral health care. MethodsOne-hundred eighteen TGNB people aged 13 through 70 years completed a 32-item questionnaire designed for this study. Data analysis relied on descriptive methods and bivariate comparisons using a conventional P < .05 statistical significance criterion. Qualitative description analysis was used to identify emerging themes from responses to an open-ended question. ResultsOne-third of participants reported misgendering (that is, had been addressed by their incorrect name and pronouns in the dental setting). Although refusal of oral health care was rare in this sample of TGNB participants, more than one-half felt that their usual source of oral health care was not equipped to provide gender-appropriate care. Participants’ avoidance due to gender identity was significantly associated with measures of self-reported suboptimal oral health. Common themes related to participants’ oral health care experiences included gender insensitivity, awkward interactions, avoidance of care, and lack of gender-affirming providers. ConclusionsDiscrepancies between TGNB patients’ expectations and actual experiences suggest that their needs are often unmet in the dental setting, possibly contributing to gender identity–associated dental avoidance and oral health disparities. Practical ImplicationsAlthough these results need to be verified in larger and more diverse samples, they provide actionable information for improvement to this population’s oral health and management.

Psychological caring climate at work, mental health, well-being, and work-related outcomes: Evidence from a longitudinal study and health insurance data

Psychological climate for caring (PCC) is a psychosocial factor associated with individual work outcomes and employee well-being. Evidence on the impacts of various psychological climates at work is based mostly on self-reported health measures and cross-sectional data. We provide longitudinal evidence on the associations of PCC with subsequent diagnosed depression and anxiety, subjective well-being, and self-reported work outcomes. Employees of a US organization with a worker well-being program provided data for the analysis. Longitudinal survey data merged with data from personnel files and health insurance claims records comprising medical information on diagnosis of depression and anxiety were used to regress each outcome on PCC at baseline, adjusting for prior values of all outcomes and other covariates. PCC was found to be associated with lower odds of subsequent diagnosed depression, an increase in overall well-being, mental health, physical health, social connectedness, and financial security, as well as a decrease in distraction at work, an increase in productivity/engagement and possibly in job satisfaction. There was little evidence of associations between PCC and subsequent diagnosed anxiety, character strengths, and work-family conflict. Work policies focused on improving PCC may create a promising pathway to promoting employee health and well-being as well as improving work-related outcomes.

Trends in Language Use During the COVID-19 Pandemic and Relationship Between Language Use and Mental Health: Text Analysis Based on Free Responses From a Longitudinal Study.

The COVID-19 pandemic and its associated restrictions have been a major stressor that has exacerbated mental health worldwide. Qualitative data play a unique role in documenting mental states through both language features and content. Text analysis methods can provide insights into the associations between language use and mental health and reveal relevant themes that emerge organically in open-ended responses. The aim of this web-based longitudinal study on mental health during the early COVID-19 pandemic was to use text analysis methods to analyze free responses to the question, "Is there anything else you would like to tell us that might be important that we did not ask about?" Our goals were to determine whether individuals who responded to the item differed from nonresponders, to determine whether there were associations between language use and psychological status, and to characterize the content of responses and how responses changed over time. A total of 3655 individuals enrolled in the study were asked to complete self-reported measures of mental health and COVID-19 pandemic-related questions every 2 weeks for 6 months. Of these 3655 participants, 2497 (68.32%) provided at least 1 free response (9741 total responses). We used various text analysis methods to measure the links between language use and mental health and to characterize response themes over the first year of the pandemic. Response likelihood was influenced by demographic factors and health status: those who were male, Asian, Black, or Hispanic were less likely to respond, and the odds of responding increased with age and education as well as with a history of physical health conditions. Although mental health treatment history did not influence the overall likelihood of responding, it was associated with more negative sentiment, negative word use, and higher use of first-person singular pronouns. Responses were dynamically influenced by psychological status such that distress and loneliness were positively associated with an individual's likelihood to respond at a given time point and were associated with more negativity. Finally, the responses were negative in valence overall and exhibited fluctuations linked with external events. The responses covered a variety of topics, with the most common being mental health and emotion, social or physical distancing, and policy and government. Our results identify trends in language use during the first year of the pandemic and suggest that both the content of responses and overall sentiments are linked to mental health.

Associations between self-reported sleep patterns and health, cognition and amyloid measures: results from the Wisconsin Registry for Alzheimer's Prevention.

Previous studies suggest associations between self-reported sleep problems and poorer health, cognition, Alzheimer's disease pathology and dementia-related outcomes. It is important to develop a deeper understanding of the relationship between these complications and sleep disturbance, a modifiable risk factor, in late midlife, a time when Alzheimer's disease pathology may be accruing. The objectives of this study included application of unsupervised machine learning procedures to identify distinct subgroups of persons with problematic sleep and the association of these subgroups with concurrent measures of mental and physical health, cognition and PET-identified amyloid. Dementia-free participants from the Wisconsin Registry for Alzheimer's Prevention (n = 619) completed sleep questionnaires including the Insomnia Severity Index, Epworth Sleepiness Scale and Medical Outcomes Study Sleep Scale. K-means clustering analysis identified discrete sleep problem groups who were then compared across concurrent health outcomes (e.g. depression, self-rated health and insulin resistance), cognitive composite indices including episodic memory and executive function and, in a subset, Pittsburgh Compound B PET imaging to assess amyloid burden. Significant omnibus tests (P < 0.05) were followed with pairwise comparisons. Mean (SD) sample baseline sleep assessment age was 62.6 (6.7). Cluster analysis identified three groups: healthy sleepers [n = 262 (42.3%)], intermediate sleepers [n = 229 (37.0%)] and poor sleepers [n = 128 (20.7%)]. All omnibus tests comparing demographics and health measures across sleep groups were significant except for age, sex and apolipoprotein E e4 carriers; the poor sleepers group was worse than one or both of the other groups on all other measures, including measures of depression, self-reported health and memory complaints. The poor sleepers group had higher average body mass index, waist-hip ratio and homeostatic model assessment of insulin resistance. After adjusting for covariates, the poor sleepers group also performed worse on all concurrent cognitive composites except working memory. There were no differences between sleep groups on PET-based measures of amyloid. Sensitivity analyses indicated that while different clustering approaches resulted in different group assignments for some (predominantly the intermediate group), between-group patterns in outcomes were consistent. In conclusion, distinct sleep characteristics groups were identified with a sizable minority (20.7%) exhibiting poor sleep characteristics, and this group also exhibited the poorest concurrent mental and physical health and cognition, indicating substantial multi-morbidity; sleep group was not associated with amyloid PET estimates. Precision-based management of sleep and related factors may provide an opportunity for early intervention that could serve to delay or prevent clinical impairment.

Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores.

Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health.

Job satisfaction has differential associations with delay discounting and risk-taking

Low job satisfaction has been associated with both negative health and negative organizational outcomes. Knowledge on which factors influence job satisfaction remains limited. This study assesses the associations between job satisfaction and three personality traits related to cognitive- and inhibitory control: delay discounting, risk-taking and sensation seeking (DRS-traits). Delay discounting and sensation seeking were inferred using self-reported behavioral data and health measurements for 80,676 participants in the UK Biobank. Multiple linear regression analysis produced beta coefficients and confidence intervals for each DRS-trait and job satisfaction. Analyses were adjusted for age, socioeconomic status and sleep quality. A combination of the three DRS-traits (CDRS) was assessed as well. Delay discounting and risk-taking were associated with, respectively, lower and higher job satisfaction in both sexes. Sensation seeking had no significant association with job satisfaction for either sex. The combined score, CDRS, was only negatively associated with job satisfaction in females but not in males. We discuss that the negative association between delay discounting and job satisfaction may be due to career related delay discounting effects, but also highlight that low job satisfaction itself may also lead to increased delay discounting. Additionally, we discuss why increased risk-taking behavior may have a positive effect on job satisfaction.

Gulf War Illness: A Randomized Controlled Trial Combining Mindfulness Meditation and Auricular Acupuncture.

Many Gulf War (GW) Veterans report chronic symptoms including pain, fatigue, and cognitive impairment, commonly defined as Gulf War Illness (GWI). Complementary and integrative health (CIH) therapies may potentially improve multiple symptoms of GWI. To examine the effectiveness of combining 2 commonly available CIH therapies, mindfulness meditation and auricular acupuncture, in improving health-related functioning and multiple symptom domains of GWI (e.g., pain, fatigue). This study was a randomized controlled trial in which Veterans with GWI were randomly assigned to either the intervention group (n = 75), wherein they received 2 distinct CIH therapies - mindfulness meditation and auricular acupuncture, or the active control group, wherein they received a GW Health Education (GWHE) program (n = 74), each lasting 8weeks. Self-report health measures were assessed at baseline, endpoint, and 3month follow-up. In the intention-to-treat analyses, there were significant between-group differences for mental-health related functioning, fatigue, depression symptoms, and Kansas total severity scores for symptoms in which the CIH group had improved scores for these outcomes at endpoint compared to the GWHE group (all P ≤ .05). The CIH group also had significant reductions in pain interference at endpoint and follow-up compared to baseline (estimated marginal mean difference: -2.52 and -2.22, respectively; all P = .01), whereas no significant changes were observed in the GWHE group. For pain characteristics, the GWHE group had a worsening of pain at endpoint compared to baseline (estimated marginal mean difference: +2.83; P = .01), while no change was observed in the CIH group. Findings suggest a possible beneficial effect of combining 2 CIH therapies, mindfulness meditation and auricular acupuncture, in reducing overall symptom severity and individual symptom domains of fatigue, musculoskeletal, and mood/cognition in Veterans with GWI. Clinical Trials identifier NCT02180243.

Relationship between self-reported health and neuroticism in older adults: a scoping review

This scoping review aims to identify and map the existing literature regarding the relationship between neuroticism and self-reported health in community-dwelling older adults. We adopted the Joanna Briggs Institute Manual for Evidence Synthesis recommendations and followed the PRISMA-SCr when reporting it. The search was performed on ten different databases, including: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, PsycArticles, PsycInfo, United States National Library of Medicine, Scopus, Web of Science, Ageline and Biblioteca Virtual em Saúde/Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde databases until February 2021. Data screening and extraction were performed by two independent reviewers. We included primary studies with older adults (≥60 years) [participants] that adopted validated instruments to assess neuroticism and selfreported health [concept] in the community [context], published in Portuguese, English, or Spanish. We identified 3453 articles and included 15 studies in this review. We extracted the main categories of included studies, characteristics of the participants, methodological issues, and biopsychosocial factors. Outcomes were reported in three sections: Focus of studies; Definitions and measures of neuroticism and self-reported health; Associations with biopsychosocial factors. We found an association between high neuroticism and poor selfreported health. Some biopsychosocial factors may influence this relationship, such as chronic diseases, depression, social support, and a sense of control, which must be considered in future studies to shed light on this topic.