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Salsman JM, Murphy KM, Addington EL, Tooze JA, McLouth LE, Yang D, Sanford S, Wagner L, Bunch SC, Rosenberg AR, Valle CG, Zebrack B, Howard D, Roth M, Moskowitz JT. Optimization of a digital health intervention to enhance well-being among adolescent and young adult cancer survivors: Design and methods of the EMPOWER full factorial trial. Contemp Clin Trials 2025; 149:107783. [PMID: 39710338 PMCID: PMC11788047 DOI: 10.1016/j.cct.2024.107783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 11/15/2024] [Accepted: 12/17/2024] [Indexed: 12/24/2024]
Abstract
Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations and have not been routinely tested in AYA survivors. We are optimizing a web-based positive skills intervention for AYA cancer survivors called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) by: (1) determining which intervention components have the strongest effects on well-being and (2) identifying demographic and individual difference variables that mediate and moderate EMPOWER's efficacy. EMPOWER is a five-session online intervention that teaches behavioral and cognitive skills for increasing psychological well-being. Guided by the Multiphase Optimization Strategy (MOST), we assign two levels (yes, no) to each of five intervention components (positive events, capitalizing, & gratitude; mindfulness; positive reappraisal; personal strengths & goal-setting; acts of kindness), allowing us to evaluate the effects of individual and combined intervention components on positive affect in a full factorial design. Post-treatment AYA cancer survivors (N = 352) are recruited from participating NCI-designated comprehensive cancer centers and randomized to one of 32 experimental conditions. Our primary outcome is positive affect; potential mediating and moderating variables include coping self-efficacy and emotional support, respectively. Upon trial completion, we will have an optimized, digital health intervention to enhance psychological well-being among AYA cancer survivors. EMPOWER will be scalable and primed for a large, multi-site trial among AYAs who would otherwise not have access to supportive care interventions to manage distress and enhance well-being.
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Affiliation(s)
- John M Salsman
- Wake Forest University School of Medicine, Department of Social Sciences and Health Policy, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, USA.
| | | | - Elizabeth L Addington
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, USA
| | - Janet A Tooze
- Wake Forest University School of Medicine, Department of Biostatistics and Data Science, USA
| | - Laurie E McLouth
- Department of Behavioral Science, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY, USA
| | | | - Stacy Sanford
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, USA
| | - Lynne Wagner
- University of North Carolina at Chapel Hill, Gillings School of Medicine, Department of Health Policy and Management, USA
| | - Stephanie C Bunch
- Wake Forest University School of Medicine, Department of Social Sciences and Health Policy, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, USA
| | - Abby R Rosenberg
- Harvard Medical School, Department of Pediatrics, USA; Boston Children's Hospital, Department of Pediatrics, USA; Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, USA
| | - Carmina G Valle
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, USA
| | - Brad Zebrack
- University of Michigan, School of Social Work, USA
| | - Dianna Howard
- Wake Forest University School of Medicine, Department of Hematology and Oncology, USA
| | - Michael Roth
- University of Texas MD Anderson Cancer Center, Department of Pediatrics, USA
| | - Judith T Moskowitz
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, USA
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Amonoo HL, Daskalakis E, Lam JA, Deary EC, Guo M, Onyeaka HK, Newcomb RA, Barata A, Ghanime PM, Keane EP, Boardman AC, Cutler C, Pirl WF, Peteet JR, Gudenkauf LM, Lee SJ, Huffman JC, El-Jawahri A. Association between positive affect, flourishing, quality of life, and psychological distress in allogeneic hematopoietic stem cell transplantation. J Psychosoc Oncol 2024:1-16. [PMID: 39373353 PMCID: PMC11973235 DOI: 10.1080/07347332.2024.2410929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
PURPOSE To examine the associations between state positive psychological well-being (PPWB) constructs, mood, and quality of life (QOL) in hematopoietic stem cell transplantation (HSCT) survivors. DESIGN The study was a secondary analysis of cross-sectional data. SAMPLE/METHODS We analyzed self-report data assessing positive affect, flourishing, QOL, depression and anxiety, and PTSD symptoms from 158 allogeneic HSCT recipients at day-100 post-transplant enrolled in supportive care studies. FINDINGS Univariate analysis showed that factors associated with greater levels of various state PPWB constructs include older age, disability status, greater social support, and presence of graft-versus-host disease. Multivariate analysis showed that state PPWB constructs-greater levels of positive affect and flourishing-were significantly associated with better QOL and lower PTSD, anxiety, and depression symptomatology. IMPLICATIONS Our findings suggest that longitudinal studies are needed to examine the links between state PPWB constructs and HSCT outcomes, which may inform population specific interventions and opportunities to improve outcomes.
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Affiliation(s)
- Hermioni L. Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Jeffrey A. Lam
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA
| | - Emma C. Deary
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
| | - Michelle Guo
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Henry K. Onyeaka
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Richard A. Newcomb
- Harvard Medical School, Boston, MA, USA
- Mass General Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Anna Barata
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Pia Maria Ghanime
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Emma P. Keane
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Corey Cutler
- Harvard Medical School, Boston, MA, USA
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA, USA
| | - William F. Pirl
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - John R. Peteet
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Stephanie J. Lee
- Division of Medical Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - Jeff C. Huffman
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Areej El-Jawahri
- Harvard Medical School, Boston, MA, USA
- Mass General Cancer Center, Massachusetts General Hospital, Boston, MA, USA
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Painter JT, Pyne J, Curran G, Raciborski RA, Russell S, Fortney J, Gifford AL, Ohl M, Woodward EN. Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial. Implement Sci Commun 2024; 5:99. [PMID: 39285308 PMCID: PMC11404036 DOI: 10.1186/s43058-024-00639-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 09/08/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Depression is the most diagnosed mental health condition among people living with HIV. Collaborative care is an effective intervention for depression, typically delivered in primary care settings. The HIV Translating Initiatives for Depression into Effective Solutions (HITIDES) clinical intervention involves a depression care team housed off-site that supports depression care delivery by HIV care providers. In a randomized controlled trial, HITIDES significantly improved depression symptoms for veterans living with HIV and delivered cost savings. However, no HIV clinics in the Veterans Health Administration (VHA) have implemented HITIDES; as such, it is unclear what implementation strategies are necessary to launch and sustain this intervention. METHODS This hybrid type-3 effectiveness-implementation trial examines the implementation and effectiveness of HITIDES in 8 VHA HIV clinics randomly assigned to one of two implementation arms. Each arm uses a different implementation strategy package. Arm 1 includes an intervention operations guide; an on-site clinical champion who, with the help of a peer community of practice, will work with local clinicians and leadership to implement HITIDES at their site; and patient engagement in implementation tools. Arm 2 includes all strategies from Arm 1 with assistance from an external facilitator. The primary implementation outcomes is reach; secondary outcomes include adoption, implementation dose, depressive symptoms, and suicidal ideation. We will conduct a budget impact analysis of the implementation strategy packages. We hypothesize that Arm 2 will be associated with greater reach and adoption and that Arm 1 will be less costly. DISCUSSION Preliminary work identified implementation strategies acceptable to veterans living with HIV and HIV care providers; however, the effectiveness and cost of these strategies are unknown. While the depression care team can deliver services consistently with high quality, the ability of the depression care team to engage with HIV care providers at sites is unknown. Findings from this study will be used to inform selection of implementation strategies for a broad rollout to enhance depression and suicide care for people living with HIV. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05901272, Registered 10 May 2023, https://clinicaltrials.gov/study/NCT05901272.
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Affiliation(s)
- Jacob T Painter
- HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA.
- Evidence, Policy, and Implementation Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA.
- Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA.
- Central Arkansas Veterans Healthcare System, 900 S Shackleford Rd, Little Rock, AR, 72211, USA.
| | - Jeffrey Pyne
- HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA
| | - Geoffrey Curran
- Center for Implementation Research, Department of Pharmacy Practice, College of Pharmacy University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA
| | - Rebecca A Raciborski
- HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
- Evidence, Policy, and Implementation Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
- Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
| | - Shane Russell
- HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
| | - John Fortney
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
- VA Health Systems Research, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA
| | - Allen L Gifford
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA
- Department of Medicine, Section of General Internal Medicine, Boston University Chobanian & Adevisian School of Medicine and Boston Medical Center, 72 East Concord St, Boston, MA, 02118, USA
- School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA
| | - Michael Ohl
- Veterans Rural Health Resource Center - Iowa City Veterans Health Care System, 601 US-6 W, Iowa City, IA, 52246, USA
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, 601 US-6 W, Iowa City, IA, 52246, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, 375 Newton Rd, Iowa City, IA, 52242, USA
| | - Eva N Woodward
- HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, HSR&D Center of Innovation Center for Mental Healthcare and Outcomes Research, 2200 Fort Roots Dr, North Little Rock, AR, 72114, USA
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR, 72205, USA
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Pięta-Lendzion M, Rzeszutek M, Tsukayama E, Blackie LER, Gruszczyńska E. Daily emotional dynamics and changes in posttraumatic growth and posttraumatic depreciation among people living with HIV. J Psychosom Res 2024; 176:111552. [PMID: 37988937 DOI: 10.1016/j.jpsychores.2023.111552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 11/12/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE Posttraumatic growth (PTG), and its negative reflection, posttraumatic depreciation (PTD), are two aspects of response to trauma. This study explores whether daily emotional dynamics (inertia and innovation) can translate into positive versus negative changes among people living with HIV (PLWH) in the form of long-term changes in PTG or PTD. METHODS The study combined a classical longitudinal approach with two assessments of PTG and PTD within one year and a measurement burst diary design with three weekly electronic diaries. In total, 249 PLWH participated in this study, filling out an expanded version of the Posttraumatic Growth and Depreciation Inventory (PTGDI-X) and a survey of sociodemographic and clinical data. In addition, they assessed their positive affect (PA) and negative affect (NA) at the end of each day in online diaries using a shortened version of the PANAS-X. RESULTS Although we observed stable significant inertia and innovation of PA and NA across all bursts, these parameters of daily emotional dynamics were unrelated to the longitudinal changes in PTG and PTD. The same null results were also noted for the average levels of NA and PA. CONCLUSIONS The results indicated the relative stability of emotion regulation in PLWH over the course of one year and contributed to understanding its dynamic mechanisms in terms of trait-like characteristics. The null result of the relationship between the PTG and PTD change might suggest a weak role of emotion regulation in shaping these trajectories as well as a lack of validity of the PTG/PTD measures.
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Affiliation(s)
| | - Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Eli Tsukayama
- Business Administration Division, University of Hawai'i-West O'ahu, 91-1001 Farrington Hwy, Kapolei, HI 96707, United States
| | - Laura E R Blackie
- School of Psychology, University of Nottingham, East Dr, Nottingham NG7 2RD, United Kingdom
| | - Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03-815 Warsaw, Poland
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Waugh CE, Sali AW. Resilience as the Ability to Maintain Well-Being: An Allostatic Active Inference Model. J Intell 2023; 11:158. [PMID: 37623541 PMCID: PMC10455562 DOI: 10.3390/jintelligence11080158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Resilience is often characterized as the outcome of well-being maintenance despite threats to that well-being. We suggest that resilience can also be characterized as an emotional-intelligence-related ability to obtain this outcome. We formulate an allostatic active inference model that outlines the primary tools of this resilience ability as monitoring well-being, maintaining stable well-being beliefs while updating situational beliefs and flexibly prioritizing actions that are expected to lead to well-being maintenance or gathering the information needed to discern what those actions could be. This model helps to explain the role of positive emotions in resilience as well as how people high in resilience ability use regulatory flexibility in the service of maintaining well-being and provides a starting point for assessing resilience as an ability.
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Affiliation(s)
- Christian E. Waugh
- Department of Psychology, Wake Forest University, Winston-Salem, NC 27109, USA;
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Huffman JC, Feig EH, Zambrano J, Celano CM. Positive Psychology Interventions in Medical Populations: Critical Issues in Intervention Development, Testing, and Implementation. AFFECTIVE SCIENCE 2023; 4:59-71. [PMID: 37070006 PMCID: PMC10105001 DOI: 10.1007/s42761-022-00137-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/20/2022] [Indexed: 11/05/2022]
Abstract
Positive psychological well-being is prospectively associated with superior health outcomes. Positive psychology interventions have promise as a potentially feasible and effective means of increasing well-being and health in those with medical illness, and several initial studies have shown the potential of such programs in medical populations. At the same time, numerous key issues in the existing positive psychology literature must be addressed to ensure that these interventions are optimally effective. These include (1) assessing the nature and scope of PPWB as part of intervention development and application; (2) identifying and utilizing theoretical models that can clearly outline potential mechanisms by which positive psychology interventions may affect health outcomes; (3) determining consistent, realistic targets for positive psychology interventions; (4) developing consistent approaches to the promotion of positive psychological well-being; (5) emphasizing the inclusion of diverse samples in treatment development and testing; and (6) considering implementation and scalability from the start of intervention development to ensure effective real-world application. Attention to these six domains could greatly facilitate the generation of effective, replicable, and easily adopted positive psychology programs for medical populations with the potential to have an important impact on public health.
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Affiliation(s)
- Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, MB Boston, USA
| | - Emily H. Feig
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, MB Boston, USA
| | - Juliana Zambrano
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, MB Boston, USA
| | - Christopher M. Celano
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, MB Boston, USA
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Stump T, Ethier K, Hirschhorn L, Dakin A, Bouacha N, Freeman A, Bannon J, Gómez W, Moskowitz J, Bouris A. Development of an Implementation Facilitation Strategy to Link Mental Health Screening and eHealth Intervention for Clients in Ryan White-Funded Clinics in Chicago. J Acquir Immune Defic Syndr 2022; 90:S197-S205. [PMID: 35703772 PMCID: PMC9204837 DOI: 10.1097/qai.0000000000002980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To reduce the impact of depression on people living with HIV, we are implementing a clinic-based behavioral health screener and referral to Optimizing Resilience and Coping with HIV through Internet Delivery, an evidenced-based intervention. We used the Consolidated Framework for Implementation Research to identify contextual barriers and facilitators in advance of implementation. SETTING Sixteen Chicagoland area Ryan White Medical Case Management sites. METHODS We conducted a sequential mixed-methods study with medical case managers and supervisors. Participants completed an online survey assessing Consolidated Framework for Implementation Research domains, scored on a 1 (strongly disagree) to 5 (strongly agree) scale. Survey results informed a purposive sampling frame and interview protocol. Interviews were analyzed by rapid qualitative analysis. RESULTS On average, survey respondents (n = 58) slightly agreed with positive views of team culture, learning climate, and implementation readiness (mean = 3.80-3.87). Potential barriers included intervention complexity (mean = 3.47), needed human resources (mean = 2.71-3.33), and only slight agreement with relative advantage over existing screening/referral systems (mean = 3.09-3.71). Qualitative results (n = 15) identified low advantage for clinics with robust behavioral health systems but strong advantage in clinics without these services. Respondents identified system-wide training and monitoring strategies to facilitate implementation. CONCLUSIONS Ryan White Medical Case Management sites are a generally favorable context for the implementation of the interventions. As illustrated in an implementation research logic model, barriers will be addressed through deploying strategies proposed to impact clinic- and individual-level outcomes, including electronic prompts (reduce complexity), training on Optimizing Resilience and Coping with HIV through Internet Delivery as a complement to other behavioral health services (increase relative advantage), and feedback during implementation (strengthen rewards/incentives).
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Affiliation(s)
- Tammy Stump
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Kristen Ethier
- University of Chicago Crown Family School of Social Work, Policy and Practice, University of Illinois – Chicago
| | - Lisa Hirschhorn
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Andrea Dakin
- AIDS Foundation Chicago, University of Illinois – Chicago
| | - Nora Bouacha
- AIDS Foundation Chicago, University of Illinois – Chicago
| | - Angela Freeman
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Jacqueline Bannon
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois – Chicago
| | - Judith Moskowitz
- Northwestern University Feinberg School of Medicine, University of Illinois – Chicago
| | - Alida Bouris
- University of Chicago Crown Family School of Social Work, Policy and Practice, University of Illinois – Chicago
- Chicago Center for HIV Elimination
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Bower JE, Radin A, Kuhlman KR. Psychoneuroimmunology in the time of COVID-19: Why neuro-immune interactions matter for mental and physical health. Behav Res Ther 2022; 154:104104. [PMID: 35609375 PMCID: PMC9075982 DOI: 10.1016/j.brat.2022.104104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/25/2022] [Indexed: 01/12/2023]
Abstract
The brain and immune system are intricately connected, and perturbations in one system have direct effects on the other. This review focuses on these dynamic psychoneuroimmune interactions and their implications for mental and physical health in the context of the COVID-19 pandemic. In particular, we describe how psychological states influence antiviral immunity and the vaccine response, and how immune changes triggered by COVID (either via infection with SARS-CoV-2 or associated stressors) can influence the brain with effects on cognition, emotion, and behavior. We consider negative psychological states, which have been the primary focus of psychological research in the context of COVID-19 (and psychoneuroimmunology more generally). We also consider positive psychological states, including positive affect and eudaimonic well-being, given increasing evidence for their importance as modulators of immunity. We finish with a discussion of interventions that may be effective in improving immune function, the neuro-immune axis, and ultimately, mental and physical health.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA.
| | - Arielle Radin
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Kate R Kuhlman
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychological Science, UCI, Irvine, CA, USA
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Newcomb ME, Sarno EL, Bettin E, Conway A, Carey J, Garcia C, Hill R, Jozsa K, Swann G, Addington EL, Ciolino JD, Macapagal K, Moskowitz JT, Mustanski B, Whitton SW. Protocol for an attention-matched randomized controlled trial of 2GETHER: a relationship education and HIV prevention program for young male couples. Trials 2022; 23:514. [PMID: 35725624 PMCID: PMC9207885 DOI: 10.1186/s13063-022-06457-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Young men who have sex with men (YMSM) are disproportionately impacted by the HIV epidemic in the USA, and a large number of new infections among YMSM occur in the context of main or primary partnerships. At the same time, healthy romantic relationships promote health and wellbeing by improving social support and encouraging healthy behaviors. Thus, we created 2GETHER: a relationship education and HIV prevention program for young male couples. 2GETHER is delivered face-to-face in a university setting and is composed of two group sessions and two individualized skills coaching sessions. We observed strong support of the feasibility, acceptability, and preliminary efficacy of 2GETHER in a pilot trial. METHODS We are conducting an attention-matched randomized controlled trial (RCT) to test the efficacy of 2GETHER relative to a control condition based on a well-validated positive affect enhancement program. Enrollment occurred between August 2017 and March 2021 in Chicago and surrounding areas, and we enrolled and randomized 128 dyads (N = 256 individuals). Follow-up is ongoing and we will examine primary and secondary behavioral outcomes at 12 months post-intervention, with interim follow-up at 3, 6, and 9 months post-intervention. The primary biomedical outcome is sexually transmitted infection incidence at a 12-month follow-up. DISCUSSION 2GETHER is innovative in that it places an equal emphasis on relationship skill building and HIV prevention. Thus, the program has the potential to impact numerous health-related outcomes. Despite challenges related to the recruitment of couples and the COVID-19 pandemic, we were able to enroll a robust sample of young male couples with sufficient power to detect effects on study outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT03186534 .
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Affiliation(s)
- Michael E. Newcomb
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Elissa L. Sarno
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Emily Bettin
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Adam Conway
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - James Carey
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Christopher Garcia
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Ricky Hill
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
| | - Kyle Jozsa
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
| | - Gregory Swann
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Elizabeth L. Addington
- grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Jody D. Ciolino
- grid.16753.360000 0001 2299 3507Department of Preventive Medicine, Northwestern University, Chicago, IL USA
| | - Kathryn Macapagal
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Judith T. Moskowitz
- grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Brian Mustanski
- grid.16753.360000 0001 2299 3507Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
| | - Sarah W. Whitton
- grid.24827.3b0000 0001 2179 9593Department of Psychology, University of Cincinnati, Cincinnati, OH USA
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10
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刘 杰, 郭 超. [A prospective cohort study of the influence of positive/negative effectivity on the mortality risk of the Chinese elderly]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:255-260. [PMID: 35435188 PMCID: PMC9069032 DOI: 10.19723/j.issn.1671-167x.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the influence of positive/negative effectivity on the mortality risk of the Chinese elderly. METHODS Using the latest four surveys data of Chinese longitudinal healthy longevity survey in 2008, 2012, and 2014, as well as 2018 and selecting 10 993 elderly people who were aged 65 and above as research objects, this paper compared the positive/negative effectivity status and differences of the elderly in different gender and age groups. And then this paper analyzed the effect of positive/negative effectivity on elderly people' s mortality risk by constructing Cox proportional hazards model. RESULTS Compared with the female elderly, the male elderly had lower negative effectivity and higher positive effectivity. With the increase of age, the negative effectivity of the elderly increased, while the positive effectivity decreased. The results showed that after adjusting for the basic demographic characteristics, health status and living habits of the respondents in the baseline survey, in the positive effectivity dimension, "clean preference" (HR=0.922, 95%CI: 0.889-0.956), "autonomy" (HR=0.933, 95%CI: 0.914-0.952) and "sense of youth" (HR=0.948, 95%CI: 0.927-0.969), had a protective effect on the mortality risk of the elderly, while in the dimension of "open-minded view", there was no significant difference in the mortality risk of the elderly with different answers. In the negative effecti-vity dimension, "tension and fear" (HR=1.039, 95%CI: 1.014-1.065), "loneliness" (HR=1.053, 95%CI: 1.029-1.079) and "uselessness" had a harmful effect on the mortality risk of the elderly. The more positive effectivity, the lower the mortality risk of the elderly (HR=0.967, 95%CI: 0.956-0.978), while the more negative effectivity, the higher the mortality risk of the elderly (HR=1.024, 95%CI: 1.013-1.035). CONCLUSION The negative effectivity of the elderly in all dimensions may increase the mortality risk of elderly people. We ought to dredge the negative emotions of the elderly in time. In the health promotion of the elderly, we should also pay attention to the encouragement of positive effectivity in all dimensions, which requires the joint efforts of families, communities and governments.
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Affiliation(s)
- 杰 刘
- />北京大学人口研究所，北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 超 郭
- />北京大学人口研究所，北京 100871Institute of Population Research, Peking University, Beijing 100871, China
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11
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Ironson G, Verhagen R, da Rosa B, Hylton E. Interview-Rated Meaning and Survival Over 17 Years in People Living With HIV. Psychosom Med 2021; 83:671-678. [PMID: 34267088 DOI: 10.1097/psy.0000000000000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary purpose of this study was to determine whether meaning in life predicts survival in people living with HIV (PLWH) over 17 years. This study also examined whether interviewer- and transcript-rated meanings predict survival equivalently. A third purpose of the study was to investigate whether meaning in life adds to the prediction of survival over positive emotional expression. METHODS A diverse sample of people with HIV (n = 177) completed an interview on stress and coping at baseline and were followed up for survival up to 17 years. Meaning was measured by interviewer rating of four items (meaningful purpose, unfinished business, finding new meaning, and meaningful activities). Transcript-rated meaning was assessed by two independent raters. Cox proportional hazards regression was used to determine whether meaning predicted survival over 17 years. RESULTS Meaning in life predicted significantly greater survival, adjusting for biomedical and sociodemographic variables whether assessed by interviewer or by transcript raters. Hazard ratios suggest that the effect is moderate to large (2.66-3.45 for top versus bottom third; 2.05-2.49 for top versus bottom half). Significance was maintained after adjusting for positive emotion. CONCLUSIONS Meaning assessed by interview (by both interviewer and transcript ratings) predicted greater survival over 17 years in PLWH and did so above positive emotion. This adds to a literature that is primarily based on self-report questionnaires. Meaning may have beneficial effects for both psychological and physical health in PLWH.
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Affiliation(s)
- Gail Ironson
- From the Department of Psychology, University of Miami, Coral Gables, Florida
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12
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Bassett SM, Brody LR, Jack DC, Weber KM, Cohen MH, Clark TM, Dale SK, Moskowitz JT. Feasibility and Acceptability of a Program to Promote Positive Affect, Well-Being and Gender Empowerment in Black Women Living with HIV. AIDS Behav 2021; 25:1737-1750. [PMID: 33389322 PMCID: PMC7778488 DOI: 10.1007/s10461-020-03103-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
While programs and interventions intended to increase positive affect among people living with HIV (PLWH) and other chronic diseases have been associated with improved health outcomes, including decreased depression, programs have not been tailored specifically for Black women. We tailored a program designed to increase positive affect and to decrease depressive symptoms in PLWH to a group format for Black WLWH. We also added skills to increase gender empowerment. We then tested the acceptability and feasibility of this program with 8 Black WLWH. The program was acceptable and relatively feasible, as assessed by women’s participation and feedback about program clarity and helpfulness, which women rated above 9 on a 10-point scale. A few women suggested that optimal delivery point for some skills taught would be shortly after HIV diagnosis. A proof-of-concept program intended to bolster positive emotions and gender empowerment and decrease depression can be tailored for Black WLWH and is relatively feasible and acceptable. A randomized controlled trial is needed to assess the preliminary efficacy of this program on positive affect, depression, and other health outcomes for WLWH.
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Affiliation(s)
- S M Bassett
- Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | - L R Brody
- Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - D C Jack
- Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, WA, USA
| | - K M Weber
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - M H Cohen
- Department of Medicine, Rush University and Stroger Hospital of Cook County, Chicago, IL, USA
| | - T M Clark
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - S K Dale
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - J T Moskowitz
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
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13
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A three-arm randomised controlled trial to evaluate the efficacy of a positive psychology and social networking intervention in promoting mental health among HIV-infected men who have sex with men in China. Epidemiol Psychiatr Sci 2021; 30:e24. [PMID: 33736740 PMCID: PMC8061281 DOI: 10.1017/s2045796021000081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIMS There is a lack of mental health promotion and treatment services targeting HIV-positive men who have sex with men (HIVMSM) in China. The aim of this study was to evaluate the mental health promotion efficacy of an online intervention that combined Three Good Things (TGT) with electronic social networking (TGT-SN) and an intervention that used TGT only (TGT-only), compared with a control group. METHODS We conducted a randomised controlled trial among HIVMSM in Chengdu, China. The participants were randomly assigned to the TGT-SN, TGT-only, and control groups. The participants in the TGT-SN group were divided into five social network groups and asked to post brief messages to the group about three good things that they had experienced and for which they felt grateful. The participants in the TGT-only group were only required to write down their three good things daily without sharing them with others. The control group received information about mental health promotion once a week for a month. The primary outcome was probable depression. Secondary outcomes were anxiety, positive and negative affect, gratitude, happiness and social support. These outcomes were assessed at baseline, 1, 3, 6 and 12 months after the intervention. Repeated-measures analyses were conducted using generalised estimation equations. The study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003252). RESULTS Between June 2013 and May 2015, 404 participants were enrolled and randomly assigned to either the TGT-SN (n = 129), TGT-only (n = 139) or control group (n = 136). The main effects of TGT-SN (adjusted odds ratio (aOR) = 0.75, 95% CI 0.52-1.09; p = 0.131) and TGT-only (aOR = 0.83, 95% CI 0.57-1.21; p = 0.332) in reducing depression were statistically non-significant. The participants of the TGT-SN group showed significantly lower anxiety symptoms (aOR = 0.62, 95% CI 0.43-0.89; p = 0.009) and negative affect (β = -1.62, 95% CI 2.98 to -0.26; p = 0.019) over time compared with those of the control group. No significant main effect was found for any secondary outcomes for the TGT-only group. CONCLUSIONS The novel intervention combining the TGT exercise with electronic social networking was found effective in reducing anxiety and negative affect among HIVMSM.
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14
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How strongly connected are positive affect and physical exercise? Results from a large general population study of young adults. CLINICAL PSYCHOLOGY IN EUROPE 2020; 2:e3103. [DOI: 10.32872/cpe.v2i4.3103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/13/2020] [Indexed: 11/25/2022] Open
Abstract
Background
Previous research has shown a link between low positive affect (PA) and numerous physical and psychological well-being outcomes but, recent research has raised the possibility that this relationship may be driven by physical activity. Thus, we were interested in exploring the PA-exercise connection by examining this relationship across differing levels of body mass and athleticism. We also looked at whether the item “active” that is used in many PA assessments was responsible for this effect.
Method
Participants were part of the Norwegian SHoT2018 national survey of 50,054 young adults (mean age = 23.2, 68.9% women), who completed electronic surveys about their exercise levels (duration, frequency and intensity) and affect.
Results
There was a clear and strong dose-response association between current state PA and the duration, frequency and intensity of exercise. For example, duration, magnitude, and slope effects were strongly driven by regular exercisers who had more than a 20-fold greater likelihood of being in the highest PA deciles compared to the least frequent exercisers. These dose-response connections replicated across both healthy and overweight BMIs, as well as in elite athletes. Removing the word “active” from the PA measure substantially reduced the size of this association, although the dose-response relationship remained.
Conclusion
The observed strong connections have critical implications for health researchers and clinicians, and point to a need to carefully consider what types of activities are most strongly tied to well-being.
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15
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Positive and negative emotional expression measured from a single written essay about trauma predicts survival 17 years later in people living with HIV. J Psychosom Res 2020; 136:110166. [PMID: 32559504 DOI: 10.1016/j.jpsychores.2020.110166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine whether expression of positive and negative emotions measured within a single written trauma essay predicts survival over 17 years in people living with HIV. METHODS This is a longitudinal, observational study of a volunteer sample of HIV-seropositive individuals at the mid-range of disease (150-500 CD4-cells/mm3 with no prior AIDS-defining symptoms). Exclusion criteria included substance dependence, dementia, and/or psychosis. Baseline assessments occurred between 1997 and 1999 and survival data was collected in 2014 (17 year follow up). At baseline, participants wrote an essay about the most traumatic event in their life. Emotional expression was measured by the number of positive and negative emotional words in the essay. The primary study outcome measure was survival from baseline. Biomedical covariates included CD4 count, viral load, age, and antiretroviral medications. Sociodemographic covariates included gender, race, and education. RESULTS The sample was diverse in terms of age (M [SD] 37.60 [9.07]), sex (70.7% male), sexual orientation (55.5% gay or bisexual), and race/ethnicity (37.2% African American, 30.5% white, 28.0% Hispanic, and 4.3% other). Positive, negative, and total emotional expression predicted greater survival (ps < 0.015). Those in the top third of total emotional expression had 3.83 times the survival rate (95% CI: 1.62, 9.02) of those in the bottom third. Odds ratios were 1.85 for positive emotion expression and 2.18 for negative emotion expression. CONCLUSIONS Both positive and negative emotions expressed in a written trauma essay predict survival over 17 years in people living with HIV. Expressing emotions may have benefits for health.
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16
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Wilson TE, Massiah C, Radigan R, DeHovitz J, Govindarajulu US, Holman S, Melendez M, Yusuff J, Taylor T. The positive affect, promoting Positive Engagement, and Adherence for Life (APPEAL) feasibility trial: Design and rationale. Health Psychol 2020; 39:767-775. [PMID: 32833478 DOI: 10.1037/hea0000880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To describe development of the Positive Affect, Promoting Positive Engagement, and Adherence for Life (APPEAL) program. METHOD APPEAL is intended to increase HIV medication adherence through promotion of positive affect, and was developed through an iterative process involving 6 focus groups (N = 34) that elicited feedback on intervention content, followed by an individually administered prepilot of the entire intervention (N = 7). RESULTS Participants provided feedback on important potential moderator variables, including depression, on mode of intervention administration, and on anticipated barriers and benefits to participation. Insights gained were used to finalize study procedures in preparation for a feasibility trial. For the feasibility trial, a total of 80 participants who, in the past 6 months have had at least one plasma HIV RNA >200 copies/mL, will be randomized to receive APPEAL or standard of care (N = 40 per group). Intervention group participants will receive 3 monthly, individually administered sessions, and all participants will have their medication adherence monitored and complete structured interviews at baseline and at 3 and 6 months. CONCLUSION The APPEAL program is innovative in that it focuses on promoting self-regulation of positive emotions, an understudied approach to promoting chronic disease self-management behaviors such as HIV medication adherence. Findings from the feasibility trial will gauge suitability of the APPEAL intervention and evaluation methods for subsequent testing in a confirmatory trial and will examine changes in positive affect, the primary mechanism of change targeted in the intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Tracey E Wilson
- Department of Community Health Sciences and Medicine, State University of New York, Downstate Health Sciences University
| | - Chanée Massiah
- Department of Epidemiology and Biostatistics, State University of New York, Downstate Health Sciences University
| | - Rachel Radigan
- Department of Epidemiology and Biostatistics, State University of New York, Downstate Health Sciences University
| | - Jack DeHovitz
- Department of Medicine, State University of New York, Downstate Health Sciences University
| | - Usha S Govindarajulu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai
| | - Susan Holman
- Department of Medicine, State University of New York, Downstate Health Sciences University
| | - Michelle Melendez
- Department of Medicine, State University of New York, Downstate Health Sciences University
| | - Jameela Yusuff
- Department of Medicine, State University of New York, Downstate Health Sciences University
| | - Tonya Taylor
- Department of Medicine, State University of New York, Downstate Health Sciences University
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17
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Addington EL, Cheung EO, Moskowitz JT. Who is most likely to benefit from a positive psychological intervention? Moderator analyses from a randomized trial in people newly diagnosed with HIV. JOURNAL OF POSITIVE PSYCHOLOGY 2020; 15:605-612. [PMID: 32905459 DOI: 10.1080/17439760.2020.1789702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Intervention for those Recently Informed of their Seropositive Status (IRISS) and other positive psychological interventions (PPIs) have demonstrated psychological and physical health benefits. However, meta-analyses suggest that PPIs may have differential effects depending on participants' sociodemographic and psychological characteristics. We therefore examined potential moderators of effects of IRISS for adults newly diagnosed with HIV (N=159). While IRISS had similar effects on positive emotion across most subgroups (age, race, education, stress), depression was a significant moderator for positive emotion. When examining effects of IRISS on antidepressant use, age, race, education, depression, and perceived stress emerged as significant moderators. Neither optimism nor life events significantly moderated effects of IRISS on any outcome. Results have clinical implications that practitioners can use to inform which patients are most likely to benefit from PPI.
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Affiliation(s)
- Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Elaine O Cheung
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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18
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Salsman JM, McLouth LE, Cohn M, Tooze JA, Sorkin M, Moskowitz JT. A Web-Based, Positive Emotion Skills Intervention for Enhancing Posttreatment Psychological Well-Being in Young Adult Cancer Survivors (EMPOWER): Protocol for a Single-Arm Feasibility Trial. JMIR Res Protoc 2020; 9:e17078. [PMID: 32463014 PMCID: PMC7290453 DOI: 10.2196/17078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs. OBJECTIVE The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being. METHODS The intervention development and testing are taking place in 3 phases. In phase 1, we adapted the content of an existing, Web-based positive emotion intervention so that it would be suitable for AYAs. EMPOWER targets 8 skills (noticing positive events, capitalizing, gratitude, mindfulness, positive reappraisal, goal setting, personal strengths, and acts of kindness) and is delivered remotely as a 5-week, Web-based intervention. Phase 2 consisted of a pilot test of EMPOWER in a single-arm trial to evaluate feasibility, acceptability, retention, and adherence and to collect data on psychosocial outcomes for proof of concept. In phase 3, we are refining study procedures and conducting a second pilot test. RESULTS The project was part of a career development award. Pilot work began in June 2015, and data collection was completed in March 2019. The analysis is ongoing, and results will be submitted for publication by May 2020. CONCLUSIONS If this intervention proves feasible and acceptable, EMPOWER will be primed for a subsequent large, multisite randomized controlled trial. As a scalable intervention, it will be ideally suited for AYA survivors who would otherwise not have access to supportive care interventions to help manage posttreatment distress and enhance well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17078.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Laurie E McLouth
- Department of Behavioral Science, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Michael Cohn
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Mia Sorkin
- Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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19
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Ready RE, Boileau NR, Barton SK, Lai JS, McCormack MK, Cella D, Fritz NE, Paulsen JS, Carlozzi NE. Positive Affect and Well-Being in Huntington's Disease Moderates the Association Between Functional Impairment and HRQOL Outcomes. J Huntingtons Dis 2020; 8:221-232. [PMID: 31045519 DOI: 10.3233/jhd-180341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Positive affect is associated with resiliency and beneficial health outcomes, but little is known about associations between positive affect and health-related quality of life (HRQOL) in Huntington's disease (HD). OBJECTIVE This longitudinal study determined the association between positive affect and several HRQOL outcomes in persons with HD. Functional status was examined as a moderator of the association between positive affect and HRQOL. METHODS Participants, with premanifest (i.e., genetically at risk but no clinical diagnosis, n = 50) and manifest HD (early-stage n = 171; late-stage n = 101), completed a measure of positive affect and well-being and several HRQOL measures at baseline, 12-, and 24-month follow-ups. UHDRS Functional Assessment scale indicated functional status. RESULTS Positive affect was associated with better HRQOL for persons with premanifest and manifest HD over the 24-month time frame. These associations were moderated by functional status. For persons with higher functional status, positive affect was associated with better HRQOL, including less depression, lower anxiety, less anger, better social role satisfaction, better executive functions, greater upper extremity function, less dyscontrol, and less concern with death and dying. For persons with lower functional status, positive affect was not associated with HRQOL. CONCLUSIONS Positive affect predicted better self-reported HRQOL over a 24-month period in persons with premanifest and manifest HD, particularly when participnats had better functional status. Interventions to enhance positive affect in HD may have beneficial effects on HRQOL.
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Affiliation(s)
- Rebecca E Ready
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Nicholas R Boileau
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Stacey K Barton
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael K McCormack
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA.,Department of Pathology, Rowan-SOM, Stratford, NJ
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nora E Fritz
- Physical Therapy Program, Wayne State University, Detroit, MI, USA
| | - Jane S Paulsen
- Departments of Neurology, Psychiatry, and Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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20
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Zheng ZW, Yang QL, Liu ZQ, Qiu JL, Gu J, Hao YT, Song C, Jia ZW, Hao C. Associations Between Affective States and Sexual and Health Status Among Men Who Have Sex With Men in China: Exploratory Study Using Social Media Data. J Med Internet Res 2020; 22:e13201. [PMID: 32012054 PMCID: PMC7053714 DOI: 10.2196/13201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/24/2019] [Accepted: 11/29/2019] [Indexed: 01/16/2023] Open
Abstract
Background Affective states, including sentiment and emotion, are critical determinants of health. However, few studies among men who have sex with men (MSM) have examined sentiment and emotion specifically using real-time social media technologies. Moreover, the explorations on their associations with sexual and health status among MSM are limited. Objective This study aimed to understand and examine the associations of affective states with sexual behaviors and health status among MSM using public data from the Blued (Blued International Inc) app. Methods A total of 843,745 public postings of 377,610 MSM users located in Guangdong were saved from the Blued app by automatic screen capture. Positive affect, negative affect, sexual behaviors, and health status were measured using the Simplified Chinese Linguistic Inquiry and Word Count. Emotions, including joy, sadness, anger, fear, and disgust, were measured using the Weibo Basic Mood Lexicon. A positive sentiment score and a positive emotion score were also calculated. Univariate and multivariate linear regression models on the basis of a permutation test were used to assess the associations of affective states with sexual behaviors and health status. Results A total of 5871 active MSM users and their 477,374 postings were finally selected. Both positive affect and positive emotions (eg, joy) peaked between 7 AM and 9 AM. Negative affect and negative emotions (eg, sadness and disgust) peaked between 2 AM and 4 AM. During that time, 25.1% (97/387) of negative postings were related to health and 13.4% (52/387) of negative postings were related to seeking social support. A multivariate analysis showed that the MSM who were more likely to post sexual behaviors were more likely to express positive affect (beta=0.3107; P<.001) and positive emotions (joy: beta=0.027; P<.001), as well as negative emotions (sadness: beta=0.0443; P<.001 and disgust: beta=0.0256; P<.001). They also had a higher positive sentiment score (beta=0.2947; P<.001) and a higher positive emotion score (beta=0.1612; P<.001). The MSM who were more likely to post their health status were more likely to express negative affect (beta=0.8088; P<.001) and negative emotions, including sadness (beta=0.0705; P<.001), anger (beta=0.0058; P<.001), fear (beta=0.0052; P<.001), and disgust (beta=0.3065; P<.001), and less likely to express positive affect (beta=−0.0224; P=.02). In addition, they had a lower positive sentiment score (beta=−0.8306; P<.001) and a lower positive emotion score (beta=−0.3743; P<.001). Conclusions The MSM social media community mainly expressed their positive affect in the early morning and negative affect after midnight. Positive affective states were associated with being sexually active, whereas negative affective states were associated with health problems, mostly about mental health. Our finding suggests the potential to deliver different health-related intervention strategies (eg, psychological counseling and safe sex promotion) on a social media app according to the affective states of MSM in real time.
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Affiliation(s)
- Zhi-Wei Zheng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qing-Ling Yang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhong-Qi Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jia-Ling Qiu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Health Information Research Center, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yuan-Tao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Health Information Research Center, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Chao Song
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhong-Wei Jia
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Health Information Research Center, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
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21
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Castro-Schilo L, Fredrickson BL, Mungas D. Association of Positive Affect with Cognitive Health and Decline for Elder Mexican Americans. JOURNAL OF HAPPINESS STUDIES 2019; 20:2385-2400. [PMID: 31798315 PMCID: PMC6889886 DOI: 10.1007/s10902-018-0053-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The goal of this study was to investigate the linkages of positive affect (PA) with cognitive health and its decline among elder Mexican Americans. We conducted secondary analysis of longitudinal data from the Sacramento Area Latino Study on Aging (SALSA). We used the structural equation modeling framework to achieve three specific aims: (1) identify a valid measure of PA, (2) describe within-person trajectories of PA and cognitive health, and (3) test the inter-relations of these two processes over time. Results showed that, on average, PA and cognitive ability (including verbal memory) decreased over time. Yet, there was significant variability in these patterns of change. Bivariate latent growth curve models showed significant correlations of baseline levels and rates of change of PA and cognitive ability even after controlling for age, education, sex, bilingualism, and depression. Results support the hypothesis that increases and decreases in PA tend to be related to increases and decreases in cognitive health at old age among Mexican Americans.
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22
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Salsman JM, Pustejovsky JE, Schueller SM, Hernandez R, Berendsen M, McLouth LES, Moskowitz JT. Psychosocial interventions for cancer survivors: A meta-analysis of effects on positive affect. J Cancer Surviv 2019; 13:943-955. [PMID: 31741250 DOI: 10.1007/s11764-019-00811-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/21/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Positive affect has demonstrated unique benefits in the context of health-related stress and is emerging as an important target for psychosocial interventions. The primary objective of this meta-analysis was to determine whether psychosocial interventions increase positive affect in cancer survivors. METHODS We coded 28 randomized controlled trials of psychosocial interventions assessing 2082 cancer survivors from six electronic databases. We calculated 76 effect sizes for positive affect and conducted synthesis using random effects models with robust variance estimation. Tests for moderation included demographic, clinical, and intervention characteristics. RESULTS Interventions had a modest effect on positive affect (g = 0.35, 95% CI [0.16, 0.54]) with substantial heterogeneity of effects across studies ([Formula: see text]; I2 = 78%). Three significant moderators were identified: in-person interventions outperformed remote interventions (P = .046), effects were larger when evaluated against standard of care or wait list control conditions versus attentional, educational, or component controls (P = .009), and trials with survivors of early-stage cancer diagnoses yielded larger effects than those with advanced-stage diagnoses (P = .046). We did not detect differential benefits of psychosocial interventions across samples varying in sex, age, on-treatment versus off-treatment status, or cancer type. Although no conclusive evidence suggested outcome reporting biases (P = .370), effects were smaller in studies with lower risk of bias. CONCLUSIONS In-person interventions with survivors of early-stage cancers hold promise for enhancing positive affect, but more methodological rigor is needed. IMPLICATIONS FOR CANCER SURVIVORS Positive affect strategies can be an explicit target in evidence-based medicine and have a role in patient-centered survivorship care, providing tools to uniquely mobilize human strengths.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, 27157, USA.
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Mark Berendsen
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Laurie E Steffen McLouth
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, 27157, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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23
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Petrie KJ, Pressman SD, Pennebaker JW, Øverland S, Tell GS, Sivertsen B. Which Aspects of Positive Affect Are Related to Mortality? Results From a General Population Longitudinal Study. Ann Behav Med 2019; 52:571-581. [PMID: 29860364 DOI: 10.1093/abm/kax018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Previous research has shown a link between low positive affect and mortality, but questions remain about how positive affect is related to mortality and how this differs by gender and age. Purpose To investigate the relationships between positive affect, negative affect, and mortality in a general population sample, and to examine whether these relationships were related to age, sex, or cause-specific mortality. Methods We used data from 5,554 Norwegian participants aged 47-49 and 71-74 years who completed the Positive and Negative Affect Schedule (PANAS) and also provided data on demographics, health behaviors, and physical health as part of the Hordaland Health Study. The primary outcome was mortality after an average follow-up period of 16.5 years. Results Participants in the lowest positive affect tertile had a near twofold increased mortality risk, compared to those in the highest positive affect tertile. This association was driven primarily by the PANAS "active" item and persisted, even after controlling for activity-related confounds and other positive affect items. No significant associations were found between negative affect and mortality. The relationship between positive affect and mortality was not significantly attenuated by age or sex. Although low positive affect was associated with an increased risk of mortality, it was not related to a specific cause of death. Conclusions Low positive affect was significantly associated with mortality risk. The relationship was driven by the PANAS active item and not associated with cause-specific mortality. Findings suggest future research should examine the association between feeling inactive, sedentary behavior, and subsequent mortality.
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Affiliation(s)
- Keith J Petrie
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Sarah D Pressman
- Department of Psychology and Social Behavior, University of California, Irvine, California
| | | | - Simon Øverland
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Grethe S Tell
- Division for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
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24
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Moskowitz JT, Addington EL, Cheung EO. Positive psychology and health: Well-being interventions in the context of illness. Gen Hosp Psychiatry 2019; 61:136-138. [PMID: 31757566 DOI: 10.1016/j.genhosppsych.2019.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America.
| | - Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America
| | - Elaine O Cheung
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America
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25
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Greer S, Ramo D, Chang YJ, Fu M, Moskowitz J, Haritatos J. Use of the Chatbot "Vivibot" to Deliver Positive Psychology Skills and Promote Well-Being Among Young People After Cancer Treatment: Randomized Controlled Feasibility Trial. JMIR Mhealth Uhealth 2019; 7:e15018. [PMID: 31674920 PMCID: PMC6913733 DOI: 10.2196/15018] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/05/2019] [Accepted: 09/24/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Positive 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. OBJECTIVE This 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. METHODS Young 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. RESULTS Data 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. CONCLUSIONS The 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.
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Affiliation(s)
| | - Danielle Ramo
- Hopelab, San Francisco, CA, United States.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | | | - Michael Fu
- Hopelab, San Francisco, CA, United States
| | - Judith Moskowitz
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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26
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Hill M, Huff A, Chumbler N. "I'm Gonna Get Busy Living": Examining the Trajectories of Affect, Behavioral Health, and Psychological Resilience Among Persons Living With HIV in a Southeastern U.S. Health District. Glob Qual Nurs Res 2019; 6:2333393619834937. [PMID: 31069249 PMCID: PMC6492360 DOI: 10.1177/2333393619834937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/02/2019] [Accepted: 02/04/2019] [Indexed: 11/16/2022] Open
Abstract
Internal psychological states and coping processes are significant determinants
of resilience. The primary aim of this qualitative work is to provide further
insight into how core affect influences the adaptability of persons living with
HIV (PLWH) after diagnosis. In-depth interviews were conducted with a diverse
group of PLWH in a health district located in the Southeastern United States. A
deductive-inductive approach was taken while coding and analyzing,
N = 18 participant narratives concerning the psychological
and coping processes surrounding diagnosis and engagement in care. Active
behavioral and cognitive coping after diagnosis was exhibited by PLWH expressing
salient attributes of positive affect, whereas the salience of negative affect
among PLWH was associated with avoidant coping and heightened distress. Our
findings illuminate the beneficial role of positive affect and active coping on
the health and well-being of PLWH. The study implications extend to the
development and enhancement of programs designed to fortify psychological
resilience.
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Affiliation(s)
| | - Amber Huff
- University of Sussex, Brighton, United Kingdom
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27
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Chiorean A, Savoy C, Schmidt LA, Morrison K, Saigal S, Van Lieshout RJ. Childhood Motor Coordination and Adult Affective Experience Among Extremely Low Birth Weight Survivors. Percept Mot Skills 2019; 126:656-674. [PMID: 31067210 DOI: 10.1177/0031512519846769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor motor coordination in childhood has been associated in adulthood with more negative affect, less positive affect, and an increased risk of psychopathology. While survivors of extremely low birth weight (ELBW; < 1,000 grams) are more likely to manifest poor motor coordination than people born at normal birth weight (NBW; > 2,500 g), they have had better mental health outcomes than those with NBW who have motor difficulties. How emotion is experienced is an important risk factor for mental illness; yet, little is known about the affective experience of survivors of ELBW who also have poor motor coordination. In this longitudinal study, we examined interactions between birth weight status and childhood motor coordination on affective experience among 88 ELBW and 89 NBW participants. We first assessed childhood motor coordination at eight years of age, using the Bruininks-Oseretsky Test of Motor Proficiency, and we later gathered self-report data regarding affective style, using the Positive and Negative Affect Scedule and the Affective Styles Questionnaire, when these participants were 30-35 years of age. We found a statistically significant interaction between motor coordination and birth weight status. As motor coordination worsened among ELBW survivors, positive affect increased, while we observed the opposite trend in NBW participants (p < 0.05). There was no interaction for negative affect. Positive affect may contribute to previous findings of better relative adult mental health among ELBW survivors with poor childhood motor coordination. Strategies aimed at optimizing positive affect may be fruitful for optimizing mental health outcomes among preterm survivors and others with reduced motor proficiency.
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Affiliation(s)
- Andreea Chiorean
- 1 Department of Bachelor of Health Sciences (Honours) Program, McMaster University, ON, Canada
| | - Calan Savoy
- 2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, ON, Canada
| | - Louis A Schmidt
- 3 Department of Psychology, Neuroscience & Behaviour, McMaster University, ON, Canada
| | | | - Saroj Saigal
- 4 Department of Pediatrics, McMaster University, ON, Canada
| | - Ryan J Van Lieshout
- 2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, ON, Canada
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28
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Moskowitz JT, Cheung EO, Snowberg KE, Verstaen A, Merrilees J, Salsman JM, Dowling GA. Randomized controlled trial of a facilitated online positive emotion regulation intervention for dementia caregivers. Health Psychol 2019; 38:391-402. [PMID: 31045422 PMCID: PMC6501812 DOI: 10.1037/hea0000680] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To test the effects of Life Enhancing Activities for Family Caregivers (LEAF), a 6-week positive emotion regulation intervention, on outcomes of positive emotion, depression, anxiety, and physical health as measured by the Patient-Reported Outcomes Measurement Information System® (PROMIS®). METHOD A randomized controlled trial (N = 170) comparing LEAF (N = 86) to an emotion reporting/waitlist condition (N = 84) in dementia caregivers. LEAF was individually delivered online by trained facilitators. Participants in the control condition completed daily online emotion reports and then crossed over into the intervention condition after 6 weeks. The study was registered with Clinicaltrials.gov (NCT01825681) and funded by R01NR014435. RESULTS Analyses of difference in change from baseline to 6 weeks demonstrated significantly greater decreases in PROMIS® depression (d = -.25; p = .02) and Quality of Life in Neurological Disorders (NeuroQOL) anxiety (d = -.33; p < .01), as well as improvements in PROMIS® physical health (d = .24; p = .02) in the intervention condition compared to the emotion reporting/waitlist control. The intervention also showed greater improvements in positive emotion (d = .58; p < .01) and positive aspects of caregiving (d = .36; p < .01). Increases in positive emotion significantly mediated the effect of LEAF on depression over time. CONCLUSIONS This randomized controlled trial of the online-facilitated positive emotion regulation intervention in dementia caregivers demonstrated small to medium effect sizes on caregiver well-being and shows promise for remotely delivered programs to improve psychological well-being in caregivers of people with dementia and other chronic illnesses. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Elaine O Cheung
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Karin E Snowberg
- Department of Physiological Nursing, University of California, San Francisco
| | - Alice Verstaen
- Department of Psychology, University of California, Berkeley
| | | | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - Glenna A Dowling
- Department of Physiological Nursing, University of California, San Francisco
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29
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Nelis S, Bukowski WM. Daily Affect and Self-Esteem in Early Adolescence: Correlates of Mean Levels and Within-Person Variability. Psychol Belg 2019; 59:96-115. [PMID: 31328013 PMCID: PMC6625554 DOI: 10.5334/pb.467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/30/2019] [Indexed: 11/20/2022] Open
Abstract
Emotions and self-esteem are critical components of well-being and adaptation during adolescence. People differ in their average levels of affect and self-esteem, as well as in how much their affect and self-esteem fluctuate from moment to moment. Fluctuations in affect in particular have not been extensively examined in relation to adolescent-relevant variables. The present study investigates internalizing symptoms, social functioning, and overt and relational aggression as correlates of average levels and within-person variability in daily positive and negative affect (PA and NA) and self-esteem. Crucially, unique association were examined controlling for the other variables. Early adolescents (mean age 10.8 years, N = 94) completed daily diaries across four days on PA, NA, and self-esteem. They also completed general questionnaires, as did peers. Some key findings were that more internalizing symptoms were significantly associated with more variability in NA. The importance of peer relationships for adolescents' daily mean levels of PA and NA were shown. Peer-perceived social functioning was associated with less fluctuations in self-esteem. Some unexpected, non-significant, findings for aggression appeared. Finally, higher mean NA were associated with more NA fluctuations, whereas higher mean PA and self-esteem were associated with less fluctuations.
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30
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Rzeszutek M, Gruszczyńska E. Positive and Negative Affect Change among People Living with HIV: a One-Year Prospective Study. Int J Behav Med 2019; 26:28-37. [PMID: 30097904 PMCID: PMC6435620 DOI: 10.1007/s12529-018-9741-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The aim of this study was to investigate the heterogeneity of changes in affective states, i.e., positive (PA) and negative (NA) affect, as well as the sociodemographic and clinical covariates of these changes among people living with HIV (PLWH) in a 1-year prospective study. METHOD Participants were 141 ambulatory patients (15% female) with a confirmed diagnosis of HIV infection who were undergoing antiretroviral treatment. Their affective states were assessed three times, with 6-month intervals, using the positive and negative general affect scale (PANAS-X). Sociodemographic (gender, age, relationship status, education, employment) and clinical variables (CD4 count assessed via self-report, HIV/AIDS status, time since HIV diagnosis and antiretroviral treatment duration) were also obtained. RESULTS Heterogeneity of changes was present only for NA, whereas PA decreased gradually in the whole sample. Time since diagnosis was unrelated to baseline affect levels as well as affect level changes. Additionally, the trajectories of NA and PA were independent of each other. The significant correlates of trajectories were gender and CD4 counts, both baseline CD4 levels and CD4 changes. CONCLUSION This study adds to the literature by describing affect changes among PLWH and identifying potential correlates of these changes, particularly CD4 count and gender. As such, these findings point to the potential clinical significance of further research on the roles of these variables.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Ewa Gruszczyńska
- Faculty of Psychology, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815 Warsaw, Poland
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31
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Pressman SD, Jenkins BN, Moskowitz JT. Positive Affect and Health: What Do We Know and Where Next Should We Go? Annu Rev Psychol 2019; 70:627-650. [DOI: 10.1146/annurev-psych-010418-102955] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Positive affect (PA) is associated with better health across a wide range of physical health outcomes. This review reflects on why the study of PA is an essential component of our understanding of physical health and expands on pathways that connect these two variables. To encourage forward movement in this burgeoning research area, measurement and design issues in the study of PA and health are discussed, as are the connections between PA and a range of different health outcomes. Plausible biological, social, and behavioral pathways that allow for positive feelings to get under the skin and influence physical wellness are detailed and framed in the context of several theoretical models. Finally, new directions for the field and important methodological and interpretative considerations that are essential to moving this important research area forward are explored.
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Affiliation(s)
- Sarah D. Pressman
- Department of Psychological Science, University of California, Irvine, California 92697, USA
| | - Brooke N. Jenkins
- Department of Psychology, Chapman University, Orange, California 92866, USA
| | - Judith T. Moskowitz
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
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32
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Amonoo HL, Barclay ME, El-Jawahri A, Traeger LN, Lee SJ, Huffman JC. Positive Psychological Constructs and Health Outcomes in Hematopoietic Stem Cell Transplantation Patients: A Systematic Review. Biol Blood Marrow Transplant 2018; 25:e5-e16. [PMID: 30308327 DOI: 10.1016/j.bbmt.2018.09.030] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/24/2018] [Indexed: 01/15/2023]
Abstract
Positive psychological constructs (eg, optimism, positive affect) have been independently associated with superior health outcomes across many medical populations. However, there has been little synthesis of the literature examining these associations among patients with hematologic malignancies receiving hematopoietic stem cell transplantation (HSCT). To address this gap we completed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of studies examining relationships between positive psychological constructs and health-related outcomes (eg, psychiatric symptoms, function, health-related quality of life [HRQoL], or treatment compliance) after HSCT. Eighteen eligible studies (N = 4201; 47% women; mean age, 47.1) were identified. Optimism (n = 12 studies) was the most frequently studied positive construct and HRQoL (examined in n = 11 studies) the most common outcome. All 17 studies with quantitative analyses found a significant (P < .05) association between a positive psychological construct and a health outcome; most but not all controlled for 1 or more relevant covariates. Among patients with hematologic malignancies who receive HSCT, positive psychological constructs appear to be associated with improved HRQoL and other health outcomes. Further work is warranted to more comprehensively understand the independent effects of positive psychological constructs on a variety of health outcomes and to develop interventions to promote well-being that are adapted to the needs of this population.
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Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Brookline, Massachusetts.
| | - Margot E Barclay
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Areej El-Jawahri
- Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Lara N Traeger
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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33
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Hecht FM, Moskowitz JT, Moran P, Epel ES, Bacchetti P, Acree M, Kemeny ME, Mendes WB, Duncan LG, Weng H, Levy JA, Deeks SG, Folkman S. A randomized, controlled trial of mindfulness-based stress reduction in HIV infection. Brain Behav Immun 2018; 73:331-339. [PMID: 29842903 PMCID: PMC7656978 DOI: 10.1016/j.bbi.2018.05.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/05/2018] [Accepted: 05/18/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e. CD4+ T-cell counts) and psychological outcomes in persons with HIV-1 infection. METHODS We randomly assigned participants with HIV-1 infection and CD4 T-cell counts >350 cells/μl who were not on antiretroviral therapy in a 1:1 ratio to either an MBSR group (n = 89) or an HIV disease self-management skills group (n = 88). The study was conducted at the University of California at San Francisco. We assessed immunologic (CD4, c-reactive protein, IL-6, and d-dimer) and psychological measures (Beck Depression Inventory for depression, modified Differential Emotions Scale for positive and negative affect, Perceived stress-scale, and mindfulness) at 3, 6 and 12 months after initiation of the intervention; we used multiple imputation to address missing values. RESULTS We observed statistically significant improvements from baseline to 3-months within the MBSR group in depression, positive and negative affect, perceived stress, and mindfulness; between group differences in change were significantly greater in the MBSR group only for positive affect (per item difference on DES-positive 0.25, 95% CI 0.049, 0.44, p = .015). By 12 months the between group difference in positive affect was not statistically significant, although both groups had trends toward improvements compared to baseline in several psychological outcomes that were maintained at 12-months; these improvements were only statistically significant for depression and negative affect in the MBSR group and perceived stress for the control group. The groups did not differ significantly on rates of antiretroviral therapy initiation (MBSR = 39%, control = 29%, p = .22). After 12 months, the mean decrease in CD4+ T-cell count was 49.6 cells/μl in participants in the MBSR arm, compared to 54.2 cells/μl in the control group, a difference of 4.6 cells favoring the MBSR group (95% CI, -44.6, 53.7, p = .85). The between group differences in other immunologic-related outcomes (c-reactive protein, IL-6, HIV-1 viral load, and d-dimer) were not statistically significant at any time point. CONCLUSIONS MBSR improved positive affect more than an active control arm in the 3 months following the start of the intervention. However, this difference was not maintained over the 12-month follow-up and there were no significant differences in immunologic outcomes between intervention groups. These results emphasize the need for further carefully designed research if we are to translate evidence linking psychological states to immunological outcomes into evidence-based clinical practices.
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Affiliation(s)
- Frederick M. Hecht
- Osher Center for Integrative Medicine, University of California San Francisco, USA,Department of Medicine, University of California San Francisco, USA
| | | | - Patricia Moran
- Osher Center for Integrative Medicine, University of California San Francisco, USA
| | - Elissa S. Epel
- Health Psychology, University of California San Francisco, USA
| | - Peter Bacchetti
- Epidemiology and Biostatistics, University of California San Francisco, USA
| | - Michael Acree
- Osher Center for Integrative Medicine, University of California San Francisco, USA
| | | | - Wendy B. Mendes
- Health Psychology, University of California San Francisco, USA
| | | | - Helen Weng
- Osher Center for Integrative Medicine, University of California San Francisco, USA
| | - Jay A. Levy
- Department of Medicine, University of California San Francisco, USA
| | - Steven G. Deeks
- Department of Medicine, University of California San Francisco, USA
| | - Susan Folkman
- Osher Center for Integrative Medicine, University of California San Francisco, USA
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Nelis S, Bastin M, Raes F, Bijttebier P. How do my parents react when I feel happy? Longitudinal associations with adolescent depressive symptoms, anhedonia, and positive affect regulation. SOCIAL DEVELOPMENT 2018. [DOI: 10.1111/sode.12318] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sabine Nelis
- Faculty of Psychology and Educational Sciences, School Psychology and Development in Context KU Leuven Leuven Belgium
| | - Margot Bastin
- Faculty of Psychology and Educational Sciences, School Psychology and Development in Context KU Leuven Leuven Belgium
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, School Psychology and Development in Context KU Leuven Leuven Belgium
| | - Patricia Bijttebier
- Faculty of Psychology and Educational Sciences, School Psychology and Development in Context KU Leuven Leuven Belgium
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Rzeszutek M. A longitudinal analysis of posttraumatic growth and affective well-being among people living with HIV: The moderating role of received and provided social support. PLoS One 2018; 13:e0201641. [PMID: 30080882 PMCID: PMC6078301 DOI: 10.1371/journal.pone.0201641] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 07/19/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The aim of this one-year longitudinal study was to examine the temporal relationship between the level of posttraumatic growth (PTG) and affective well-being, measured by the presence of positive and negative affect among people living with the HIV (PLWH). In addition, the moderating effects of received and provided support with respect to the above-mentioned relationship were investigated. Method Study participants completed the following psychometric inventories: the Posttraumatic Growth Inventory (PTGI), the Positive and Negative Affect Schedule (PANAS-X), and the Berlin Social Support Scales (BSSS). Three assessments were performed: 129 patients were recruited for the first assessment, 106 patients agreed to participate in the second assessment, and 82 of the initial 129 participants (63.6%) participated in all three assessments. Results An indirect association between PTG and positive affect was observed. However, no association was found between PTG and negative affect. Received support, but not provided support, completely moderated the relationship between PTG and positive affect. Conclusions This study adds to the literature by examining the temporal relationship between PTG and affective-wellbeing among PLWH. It appears from the results that in this patient group, PTG may enhance the positive affect over time. However, receiving support is vital in this process.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki, Warsaw, Poland
- * E-mail:
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Roy B, Riley C, Sears L, Rula EY. Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature. Am J Health Promot 2018; 32:1800-1813. [PMID: 30079743 DOI: 10.1177/0890117118791993] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To propose collective well-being as a holistic measure of the overall "health" of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain's association with health outcomes and community characteristics' associations with collective well-being. METHODS We came to consensus on topics describing each component of our conceptual model. Because "well-being" is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles. RESULTS Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being. CONCLUSIONS The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.
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Affiliation(s)
- Brita Roy
- 1 Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Carley Riley
- 2 Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Cross MP, Pressman SD. Say cheese? The connections between positive facial expressions in student identification photographs and health care seeking behavior. J Health Psychol 2018; 25:2511-2519. [PMID: 30052098 DOI: 10.1177/1359105318790066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined whether positive facial expressions in student identification photographs were connected with a health-relevant behavior: visits to a health care center in the last year for preventive and non-preventive (e.g. illness, injury) purposes. Identification photographs were coded for degree of smile. Smiling participants were more likely to have sought preventive care versus those not smiling in their photographs, but there was no difference in non-preventive (i.e. ill health) visits. This study shows for the first time that smiling in photographs may be related to healthy behavior and complements past work connecting smiling to positive psychosocial and health outcomes.
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Rzeszutek M. Health-related quality of life and coping strategies among people living with HIV: the moderating role of gender. Arch Womens Ment Health 2018; 21:247-257. [PMID: 29256068 PMCID: PMC5940709 DOI: 10.1007/s00737-017-0801-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/05/2017] [Indexed: 02/04/2023]
Abstract
The aim of the study was to explore gender differences in the level of health-related quality of life (HRQoL) and coping strategies among people living with the human immunodeficiency virus (HIV) (PLWH). In particular, the moderating role of participants' gender on the relationship between coping strategies and HRQoL was explored, while controlling for socio-medical data. A total of 444 HIV-infected men and 86 HIV-infected women were recruited to participate in the study. This was a cross-sectional study with the HRQoL assessed by the World Health Organization (WHO) Quality of Life-BREF (WHOQOL-BREF) and the coping strategies measured by the Brief COPE inventory. Although the HIV-infected men and HIV-infected women differed in terms of some HRQoL domains, these differences disappeared in the regression analysis after controlling for socio-demographic data (employment and higher education). In addition, several statistically significant interactions between participants' gender and coping strategies in relation to HRQoL domains were observed. Future research on gender differences in HRQoL among PLWH should take into account unique differences between HIV-infected men and HIV-infected women across, not only in respect to socio-medical factors but also regarding psychosocial variables.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
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Theall KP, Felker-Kantor E, Wallace M, Zhang X, Morrison CN, Wiebe DJ. Considering high alcohol and violence neighborhood context using daily diaries and GPS: A pilot study among people living with HIV. Drug Alcohol Depend 2018; 187:236-241. [PMID: 29684891 PMCID: PMC5959796 DOI: 10.1016/j.drugalcdep.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 02/07/2023]
Abstract
Our understanding of how community-level context impacts care of persons living with HIV (PLWH), including antiretroviral therapy (ART) adherence and retention in care, is limited. The objective of this study was to characterize the activity spaces of PLWH from an urban area in Southeastern U.S., where the epidemic is among the nation's highest, and to examine how such activity spaces are associated with daily mood and health behaviors. In this small, pilot study, 11 participants were tracked with a global positioning system (GPS)-enabled application on their smartphones for 2 weeks. Activity spaces were created by connecting GPS points sequentially and adding buffers. Contextual exposure data (e.g., alcohol outlets) were connected to activity spaces. Participants also completed daily diary entry through texts 3 times per day regarding outcomes of substance use behaviors, mood, and medication adherence. This yielded a total of 18,007 GPS polyline records that we aggregated into 258 person-days that captured discrete occasions of exposure to contextual factors and subjects' behaviors and moods. On average, the participants spent 19% of their time awake during the 2-week periods in their residential census tract. Exposure to social and built environment factors such as alcohol outlets was greater when participants were outside versus inside their residential census tract. Exposures on daily routes were also significantly associated with ART adherence, alcohol consumption, and mood. Findings suggest substantial differences between activity spaces and residential contexts. Activity spaces are relevant for PLWH and may impact HIV care and behavioral outcomes such as ART adherence and substance use.
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Affiliation(s)
- Katherine P Theall
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA; Louisiana State University Health Sciences Center Comprehensive Alcohol Research Center (CARC), 1901 Perdido Street, New Orleans, LA, 70112, USA.
| | - Erica Felker-Kantor
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA; Louisiana State University Health Sciences Center Comprehensive Alcohol Research Center (CARC), 1901 Perdido Street, New Orleans, LA, 70112, USA
| | - Xiao Zhang
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA
| | - Christopher N Morrison
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Douglas J Wiebe
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
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40
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Juang LP, Hou Y, Bayless SD, Kim SY. Time-varying associations of parent-adolescent cultural conflict and youth adjustment among Chinese American families. Dev Psychol 2018; 54:938-949. [PMID: 29239636 PMCID: PMC7856688 DOI: 10.1037/dev0000475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine time-varying associations of parent-adolescent cultural conflict with depressive symptoms and grade point average (GPA) among Chinese Americans from ages 11-22. We pooled two independently collected longitudinal data sets (N = 760 at Wave 1) and used time-varying effect modeling (TVEM) to show that the frequency of parent-adolescent conflict increased during early adolescence (12 years), peaked at mid adolescence (16 years), and gradually decreased throughout late adolescence and young adulthood. In general, parent-adolescent conflict was associated with negative adjustment (more depressive symptoms and lower GPA) more strongly during mid- to late-adolescence (15 to 17 years) compared with other developmental periods. These time-varying associations differed slightly by gender, at least for GPA. Our findings provide important developmental knowledge of parent-adolescent conflict for Chinese American youth and suggest that attention to conflict and links to adjustment is especially relevant during mid to late adolescence. Our study also illustrates the usefulness of integrative data analysis and TVEM to investigate how the strength of conflict-adjustment associations might change throughout development. (PsycINFO Database Record
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Affiliation(s)
| | - Yang Hou
- Department of Human Development and Family Sciences, University of Texas at Austin
| | | | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin
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41
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Addington EL, Cheung EO, Moskowitz JT. Positive affect skills may improve pain management in people with HIV. J Health Psychol 2018; 25:1784-1795. [PMID: 29649914 DOI: 10.1177/1359105318769355] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Non-opioid pain management strategies are critically needed for people with HIV. We therefore conducted a secondary analysis of pain-related outcomes in a randomized controlled trial of a positive affect skills intervention for adults newly diagnosed with HIV (N = 159). Results suggest that, even if pain prevalence rises, positive affect skills may reduce pain interference and prevent increased use of opioid analgesics by people living with HIV. Future research should replicate and extend these findings by conducting trials that are specifically designed to target pain outcomes.
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Yang X, Garcia KM, Jung Y, Whitlow CT, McRae K, Waugh CE. vmPFC activation during a stressor predicts positive emotions during stress recovery. Soc Cogn Affect Neurosci 2018; 13:256-268. [PMID: 29462404 PMCID: PMC5836276 DOI: 10.1093/scan/nsy012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/09/2018] [Indexed: 12/20/2022] Open
Abstract
Despite accruing evidence showing that positive emotions facilitate stress recovery, the neural basis for this effect remains unclear. To identify the underlying mechanism, we compared stress recovery for people reflecting on a stressor while in a positive emotional context with that for people in a neutral context. While blood-oxygen-level dependent data were being collected, participants (N = 43) performed a stressful anagram task, which was followed by a recovery period during which they reflected on the stressor while watching a positive or neutral video. Participants also reported positive and negative emotions throughout the task as well as retrospective thoughts about the task. Although there was no effect of experimental context on emotional recovery, we found that ventromedial prefrontal cortex (vmPFC) activation during the stressor predicted more positive emotions during recovery, which in turn predicted less negative emotions during recovery. In addition, the relationship between vmPFC activation and positive emotions during recovery was mediated by decentering-the meta-cognitive detachment of oneself from one's feelings. In sum, successful recovery from a stressor seems to be due to activation of positive emotion-related regions during the stressor itself as well as to their downstream effects on certain cognitive forms of emotion regulation.
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Affiliation(s)
- Xi Yang
- Department of Psychology, Wake Forest University Winston-Salem, NC, USA
| | - Katelyn M Garcia
- Department of Psychology, Wake Forest University Winston-Salem, NC, USA
| | | | | | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Christian E Waugh
- Department of Psychology, Wake Forest University Winston-Salem, NC, USA
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Verstaen A, Moskowitz JT, Snowberg KE, Merrilees J, Dowling GA. Life Enhancing Activities for Family Caregivers of people with dementia: protocol for a randomized controlled trial of a positive affect skills intervention. OPEN ACCESS JOURNAL OF CLINICAL TRIALS 2018; 10:1-12. [PMID: 33981167 PMCID: PMC8112203 DOI: 10.2147/oajct.s150597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Given the increasing number of family caregivers of persons with dementia (PWD) and the associated burden and detriments to both physical and mental health, interventions that aim to improve such outcomes are important. Studies are increasingly demonstrating the unique importance of positive emotions in coping with stress, independent from the impact of negative emotions. However, none have examined the benefits of interventions that target positive emotions for caregivers of individuals with a chronic and debilitating disease such as dementia. This paper presents the design and methods for a randomized controlled trial (RCT) of a positive affect skills intervention for family caregivers of PWD. The RCT is of a skills-based intervention that seeks to increase the frequency and intensity of positive affect in order to improve outcomes such as well-being, coping, and physical and mental health. The skills are delivered by trained facilitators via five one-to-one Internet video sessions with family caregivers of persons diagnosed with dementia (eg, Alzheimer's disease, vascular dementia, unspecified). The control group is an emotion reporting/waitlist control. Follow-up assessments are conducted post-intervention and at 1, 3, and 6 months post-completion of the intervention. This study promises to be an important and needed step toward improving the lives of caregivers of PWD.
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Affiliation(s)
- Alice Verstaen
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karin E Snowberg
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Jennifer Merrilees
- UCSF Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Glenna A Dowling
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
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Wagstaff CRD, Leach J. The Value of Strength-Based Approaches in SERE and Sport Psychology. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - John Leach
- Center for the Study of Human Cognition, University of Oslo
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Murdock KW, LeRoy AS, Fagundes CP. Early-life Socio-economic Status and Adult Health: The Role of Positive Affect. Stress Health 2017; 33:190-198. [PMID: 27443423 PMCID: PMC5253328 DOI: 10.1002/smi.2696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/29/2022]
Abstract
The aim of this paper is to develop a further understanding of the relationship between early-life socio-economic status (SES) and adult health disparities. This was accomplished through evaluation of state indicators of positive and negative affect as mechanisms through which early-life SES was associated with susceptibility to a rhinovirus (i.e. the common cold). Analyses were conducted among 286 adults in a viral challenge study in which participants were exposed to a rhinovirus via nasal drops and cold symptoms were evaluated over a period of 5 days. Participant age, body mass index, sex, education, ethnicity, pre-challenge virus-specific antibody titres and subjective adult SES, along with virus type and season of participation, were included as covariates. Early-life SES was associated with cold incidence through state positive affect, but not state negative affect. In addition, contrast analysis indicated that the indirect effect through state positive affect was stronger than the indirect effect through state negative affect. Findings provide further support for early-life SES being an important variable associated with adult health, and that state self-reported positive affect may be an underlying mechanism associated with susceptibility to rhinoviruses. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Angie S. LeRoy
- Rice University, Houston, TX USA,University of Houston, Houston, TX USA
| | - Christopher P. Fagundes
- Rice University, Houston, TX USA,Correspondence: Christopher Fagundes, Rice University, BRC 780D, 6500 Main Street, Houston, TX 77005, USA.
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Rzeszutek M, Gruszczyńska E, Firląg-Burkacka E. Coping profiles and subjective well-being among people living with HIV: less intensive coping corresponds with better well-being. Qual Life Res 2017; 26:2805-2814. [PMID: 28584892 PMCID: PMC5597686 DOI: 10.1007/s11136-017-1612-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2017] [Indexed: 01/07/2023]
Abstract
Purpose The aim of this study was to investigate the relationship between coping strategies and subjective well-being (SWB) among people living with HIV (PLWH) using the latent profile analysis (LPA) with control for socio-medical covariates. Methods The sample comprised five hundred and thirty people (N = 530) with a confirmed diagnosis of HIV+. The study was cross-sectional with SWB operationalized by satisfaction with life (Satisfaction with Life Scale) and positive and negative affect (PANAS-X). Coping with stress was measured by the Brief COPE Inventory, enriched by several items that assessed rumination and enhancement of positive emotional states. Additionally, the relevant socio-medical variables were collected. Results The one-step model of LPA revealed the following: (1) a solution with five different coping profiles suited the data best; (2) socio-medical covariates, except for education, were not related to the profiles’ membership. Further analysis with SWB as a distal outcome showed that higher intensity coping profiles have significantly worse SWB when compared with lower intensity coping profiles. However, the lowest SWB was noted for mixed intensity coping profile (high adaptive/low maladaptive). Conclusions The person-centered approach adopted in this study informs about the heterogeneity of disease-related coping among PLWH and its possible reactive character, as the highest SWB was observed among participants with the lowest intensity of coping.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Ewa Gruszczyńska
- Health Psychology Department, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
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The Impact of Subjective Well-being on Mortality: A Meta-Analysis of Longitudinal Studies in the General Population. Psychosom Med 2017; 79:565-575. [PMID: 28033196 DOI: 10.1097/psy.0000000000000444] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of the study were to assess whether subjective well-being is a protective factor for mortality in the general population and to analyze the differential impact of evaluative, experienced, and eudaimonic well-being. METHODS Systematic review of articles in the PsycINFO, Web of Science, and PubMed databases. Data on the studies' characteristics, quality, and the effects of variables were extracted. A meta-analysis was conducted on the studies included in the systematic review. RESULTS A total of 62 articles that investigated mortality in general populations, involving 1,259,949 participants, were found, and added to those considered in a previously published review (n = 14). The meta-analysis showed that subjective well-being was a protective factor for mortality (pooled hazard ratio = 0.920; 95% confidence interval = 0.905-0.934). Although the impact of subjective well-being on survival was significant in both men and women, it was slightly more protective in men. The three aspects of subjective well-being were significant protective factors for mortality. The high level of heterogeneity and the evidences of publication bias may reduce the generalizability of these findings. CONCLUSIONS Our results suggest that subjective well-being is associated with a decreased risk of mortality. Longitudinal studies examining changing levels of well-being and their relationship to longevity would be required to establish a cause-effect relationship. Establishing such a causal relationship would strengthen the case for policy interventions to improve the population subjective well-being to produce longevity gains combined with optimizing quality of life.
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Nicholas CR, Hoscheidt SM, Clark LR, Racine AM, Berman SE, Koscik RL, Maritza Dowling N, Asthana S, Christian BT, Sager MA, Johnson SC. Positive affect predicts cerebral glucose metabolism in late middle-aged adults. Soc Cogn Affect Neurosci 2017; 12:993-1000. [PMID: 28402542 PMCID: PMC5472120 DOI: 10.1093/scan/nsx027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 03/01/2017] [Indexed: 11/13/2022] Open
Abstract
Positive affect is associated with a number of health benefits; however, few studies have examined the relationship between positive affect and cerebral glucose metabolism, a key energy source for neuronal function and a possible index of brain health. We sought to determine if positive affect was associated with cerebral glucose metabolism in late middle-aged adults (n = 133). Participants completed the positive affect subscale of the Center for Epidemiological Studies Depression Scale at two time points over a two-year period and underwent 18F-fluorodeoxyglucose-positron emission tomography scanning. After controlling for age, sex, perceived health status, depressive symptoms, anti-depressant use, family history of Alzheimer’s disease, APOE ε4 status and interval between visits, positive affect was associated with greater cerebral glucose metabolism across para-/limbic, frontal, temporal and parietal regions. Our findings provide evidence that positive affect in late midlife is associated with greater brain health in regions involved in affective processing and also known to be susceptible to early neuropathological processes. The current findings may have implications for interventions aimed at increasing positive affect to attenuate early neuropathological changes in at-risk individuals.
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Affiliation(s)
- Christopher R Nicholas
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Siobhan M Hoscheidt
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lindsay R Clark
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Annie M Racine
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sara E Berman
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - N Maritza Dowling
- Department of Biostatistics & Research, School of Nursing, George Washington University, Washington, DC, USA
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bradley T Christian
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mark A Sager
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Being present and enjoying it: Dispositional mindfulness and savoring the moment are distinct, interactive predictors of positive emotions and psychological health. Mindfulness (N Y) 2017; 8:1280-1290. [PMID: 29312472 DOI: 10.1007/s12671-017-0704-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Mindfulness and savoring the moment both involve presently occurring experiences. However, these scientific constructs are distinct and may play complementary roles when predicting day-to-day positive emotions. Therefore, we examined the unique and interactive roles of dispositional mindfulness and perceived ability to savor the moment for predicting daily positive emotions as well as related psychological health benefits. Participants completed a nine-week longitudinal field study. At baseline, dispositional mindfulness and perceived ability to savor the moment were assessed, along with three indicators of psychological health: depressive symptoms, psychological well-being, and life satisfaction. Each day for the subsequent nine weeks, participants reported on their emotions. At the end of the study, participants again completed the three psychological health measures. Results showed that baseline dispositional mindfulness and perceived ability to savor the moment interacted to predict mean positive emotion levels over the reporting period and, in turn, residualized changes in psychological health. Specifically, the relation between perceived ability to savor the moment and positive emotions and, in turn, residualized change in psychological health indicators, was amplified at greater levels of mindfulness and fell to non-significance at lower levels of mindfulness. Dispositional mindfulness only predicted positive emotions and, in turn, residualized changes in psychological health, for those very high in perceived ability to savor the moment. This research provides preliminary evidence that dispositional mindfulness and perceived ability to savor the moment, though related constructs, may serve unique and synergistic roles in predicting benefits for and through positive emotions.
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Moskowitz JT, Carrico AW, Duncan LG, Cohn MA, Cheung EO, Batchelder A, Martinez L, Segawa E, Acree M, Folkman S. Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV. J Consult Clin Psychol 2017; 85:409-423. [PMID: 28333512 DOI: 10.1037/ccp0000188] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV. METHOD One-hundred and fifty-nine participants who had received an HIV diagnosis in the past 3 months were randomized to a 5-session, in-person, individually delivered positive affect skills intervention or an attention-matched control condition. RESULTS For the primary outcome of past-day positive affect, the group difference in change from baseline over time did not reach statistical significance (p = .12, d = .30). Planned secondary analyses within assessment point showed that the intervention led to higher levels of past-day positive affect at 5, 10, and 15 months postdiagnosis compared with an attention control. For antidepressant use, the between group difference in change from baseline was statistically significant (p = .006, d = -.78 baseline to 15 months) and the difference in change over time for intrusive and avoidant thoughts related to HIV was also statistically significant (p = .048, d = .29). Contrary to findings for most health behavior interventions in which effects wane over the follow up period, effect sizes in IRISS seemed to increase over time for most outcomes. CONCLUSIONS This comparatively brief positive affect skills intervention achieved modest improvements in psychological health, and may have the potential to support adjustment to a new HIV diagnosis. (PsycINFO Database Record
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Affiliation(s)
- Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami
| | - Larissa G Duncan
- Human Development and Family Studies, University of Wisconsin-Madison
| | - Michael A Cohn
- Osher Center for Integrative Medicine, University of California San Francisco
| | - Elaine O Cheung
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Abigail Batchelder
- Osher Center for Integrative Medicine, University of California San Francisco
| | - Lizet Martinez
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Eisuke Segawa
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Michael Acree
- Department of Medicine, University of California San Francisco
| | - Susan Folkman
- Department of Medicine, University of California San Francisco
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