Ambulance ramping predicts poor mental health of paramedics.

OBJECTIVE: Ambulance ramping involves a patient remaining under paramedic care until a hospital emergency department bed becomes available. This study examined whether negative ramping experiences (verbal abuse, physical abuse, compromised patient care, and patient fatality) contribute to relatively high levels of depression, anxiety, stress, and posttraumatic stress disorder (PTSD) in paramedics. METHOD: Ninety Australian paramedics (Mage = 37.68, SD = 10.73; 52.2% male) completed an online survey. RESULTS: Path analysis found that negative ramping experiences were positively associated with symptoms of depression, anxiety, stress, and PTSD. Interactions indicated that negative ramping experiences predicted greater depression, stress, and PTSD among paramedics with higher, but not lower, work-related self-efficacy. All interactions with resilience were nonsignificant. CONCLUSIONS: These findings suggest that policymakers should aim to reduce ambulance ramping, and that future research could fruitfully investigate the mental health benefits of training programs that include strategies to minimize paramedics' feelings of powerlessness, frustration, and self-blame, during ramping. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-compassion, physical health, and health behaviour: a meta-analysis.

This meta-analysis investigated relationships between self-compassion and (1) physical health and (2) health-promoting behaviour in a large pooled sample (N = 29,588) sourced from 94 peer-reviewed articles. As hypothesised, omnibus analyses revealed positive associations between self-compassion and both physical health (r = .18) and health behaviour (r = .26). Moderation analyses using 290 effects found that both associations varied according to health domain, participant age, intervention duration, and self-compassion measure. Self-compassion predicted outcomes in most health domains, with the strongest effects observed on global physical health, functional immunity, composite health behaviour, sleep, and danger avoidance. It did not predict frailty, maladaptive bodily routines, and substance abuse. Multi-session interventions designed to boost self-compassion predicted increased physical health and health behaviour, thereby supporting causal links between self-compassion and health outcomes. The effects of single-session inductions were non-significant. The mean effect of self-compassion on physical health was non-significant for young participants (12.00-19.99) and its effect on health behaviour was weakest among older participants (40.00+). Results support the proposition that self-compassion can promote better physical health. Practical implications of these findings are discussed.

Self-compassion moderates the predictive effects of implicit cognitions on subjective well-being.

This study examined whether self-compassion may regulate the effects of implicit cognitions (automatic and preconscious responses) on the subjective well-being of Australian adults (N = 132). As hypothesized, self-compassion moderated the predictive effects of 2 implicit cognitions (positive attention bias and implicit self-esteem) on 2 indicators of subjective well-being (life satisfaction and depressive symptoms). Low implicit self-esteem and weak positive attention bias predicted more depressive symptoms and lower life satisfaction only for participants who were low in self-compassion. These results extend previous research knowledge by indicating that self-compassion may not only buffer the impact of explicit (deliberate and conscious) cognitive processes on well-being but may also regulate the effects of preconscious cognitive processes on mental health outcomes. Theoretical and treatment implications are discussed.

Upward counterfactual thinking and depression: A meta-analysis.

This meta-analysis examined the strength of association between upward counterfactual thinking and depressive symptoms. Forty-two effect sizes from a pooled sample of 13,168 respondents produced a weighted average effect size of r=.26, p<.001. Moderator analyses using an expanded set of 96 effect sizes indicated that upward counterfactuals and regret produced significant positive effects that were similar in strength. Effects also did not vary as a function of the theme of the counterfactual-inducing situation or study design (cross-sectional versus longitudinal). Significant effect size heterogeneity was observed across sample types, methods of assessing upward counterfactual thinking, and types of depression scale. Significant positive effects were found in studies that employed samples of bereaved individuals, older adults, terminally ill patients, or university students, but not adolescent mothers or mixed samples. Both number-based and Likert-based upward counterfactual thinking assessments produced significant positive effects, with the latter generating a larger effect. All depression scales produced significant positive effects, except for the Psychiatric Epidemiology Research Interview. Research and theoretical implications are discussed in relation to cognitive theories of depression and the functional theory of upward counterfactual thinking, and important gaps in the extant research literature are identified.

Thinking styles and decision making: A meta-analysis.

This meta-analysis examined whether tendencies to use reflective and intuitive thinking styles predicted decision performance (normatively correct responding) and decision experience (e.g., speed, enjoyment) on a range of decision-making tasks. A pooled sample of 17,704 participants (Mage = 25 years) from 89 samples produced small but significant weighted average effects for reflection on performance (r = .11) and experience (r = .14). Intuition was negatively associated with performance (r = -.09) but positively associated with experience (r = .06). Moderation analyses using 499 effect sizes revealed heterogeneity across task-theory match/mismatch, task type, description-based versus experience-based decisions, time pressure, age, and measure type. Effects of both thinking styles were strongest when the task matched the theoretical strengths of the thinking style (up to r = .29). Specific tasks that produced the largest thinking style effects (up to r = .35) were also consistent with system characteristics. Time pressure weakened the effects of reflection, but not intuition, on performance. Effect sizes for reflection on performance were largest for individuals aged either 12 to 18 years or 25+ (up to r = .18), and the effects of both reflection and intuition on experience were largest for adults aged 25+ (up to r = .27). Overall, our results indicate that associations between thinking styles and decision outcomes are context dependent. To improve decision performance and experience, decision architects and educators should carefully consider both individual differences in the decision maker and the nature of the decision task.

En Route to Depression: Self-Esteem Discrepancies and Habitual Rumination.

Dual-process models of cognitive vulnerability to depression suggest that some individuals possess discrepant implicit and explicit self-views, such as high explicit and low implicit self-esteem (fragile self-esteem) or low explicit and high implicit self-esteem (damaged self-esteem). This study investigated whether individuals with discrepant self-esteem may employ depressive rumination in an effort to reduce discrepancy-related dissonance, and whether the relationship between self-esteem discrepancy and future depressive symptoms varies as a function of rumination tendencies. Hierarchical regressions examined whether self-esteem discrepancy was associated with rumination in an Australian undergraduate sample at Time 1 (N = 306; M(age) = 29.9), and whether rumination tendencies moderated the relationship between self-esteem discrepancy and depressive symptoms assessed 3 months later (n = 160). Damaged self-esteem was associated with rumination at Time 1. As hypothesized, rumination moderated the relationship between self-esteem discrepancy and depressive symptoms at Time 2, where fragile self-esteem and high rumination tendencies at Time 1 predicted the highest levels of subsequent dysphoria. Results are consistent with dual-process propositions that (a) explicit self-regulation strategies may be triggered when explicit and implicit self-beliefs are incongruent, and (b) rumination may increase the likelihood of depression by expending cognitive resources and/or amplifying negative implicit biases.

Profiles of psychological well-being in a sample of Australian university students.

The present study identified psychological well-being profiles in a sample of Australian university students (N = 207, Mean age = 30.16 years; SD = 11.90). Respondents completed two measures: Ryff's (1989) Psychological Well-Being (PWB) scale and Lovibond and Lovibond's (2002) Depression, Anxiety and Stress Scales-21 (DASS-21) assessing their levels of PWB and depression. Latent profile analysis was applied to six indices of positive functioning derived from PWB scale: self-acceptance, purpose in life, environmental mastery, positive relations with others, personal growth and autonomy. An optimal 5-profile solution, reflecting significant incremental shifts from very low to very high PWB, was interpreted. As predicted, profile membership distinguished participants on depression. Importantly, profiles indicating moderate to very high PWB, particularly with the presence of above average autonomy, reported significantly lower levels of depression. Our results suggest prevention of, and treatment efficacy for, mental health problems may be improved by incorporating strategies that address positive functioning attributes, particularly associated with a sense of autonomy.

Exploring the factor structure of implicit and explicit cognitions associated with depression.

Dual-process models of cognitive vulnerability to depression propose that implicit (automatic) and explicit (effortful) processes are involved in depression. The current study investigated the underlying structure of four implicit and four explicit cognitive biases associated with depression in an undergraduate sample (N = 355). An exploratory principal-axis factor analysis of implicit and explicit measures of self-esteem, dysfunctional beliefs, and memory for positive and negative stimuli produced a three-factor solution that was inconsistent with the dual process (two factor) account. Subsequent confirmatory factor analyses of biases exhibited by a hold-out sample also failed to support the hypothesized dual-process model and supported a three-factor solution. Overall, the results indicate that the latent structure of measures investigated in this study is not characterized by a clear differentiation between implicit and explicit cognition and that alternative models and measurement strategies should be investigated.

Self-compassion: a resource for positive aging.

OBJECTIVES: Self-compassion has been associated with psychological health in young and multigenerational samples. This study investigated whether self-compassion may be associated with subjective well-being (positive affect [PA] and negative affect [NA]) and psychological well-being (ego integrity and meaning in life) in older adults. It also assessed the structure of the Self-Compassion Scale (SCS; Neff, 2003a) in older adults. METHOD: A total of 185 adults aged 65 and older (M age = 73.42) completed several self-report measures, including the SCS. RESULTS: Path analysis revealed that self-compassion was significantly positively associated with PA, ego integrity, and meaning in life, and negatively associated with NA. Factor analyses indicated that the SCS structure identified among undergraduates was not observed in our older sample. Instead, two factors emerged which provided predictive utility. DISCUSSION: These results extend research knowledge, inform strategies to enhance well-being in older adults, and indicate that self-compassion may represent a valuable psychological resource for positive aging.

Implicit cognition and depression: a meta-analysis.

This study examined the relationship between negative self-referential implicit cognition and depression. A meta-analysis of 89 effect sizes from a pooled sample of 7032 produced a weighted average effect size of r=.23. Moderator analyses, using an expanded set of 202 effect sizes, indicated that effect sizes relating to all facets of cognition, study designs and sample types significantly predicted depression. Significant heterogeneity was observed in effect sizes across facets of cognition, cognitive manipulations and measurement strategies. Studies that assessed interpretation and self-beliefs, utilized mood and cognitive load manipulations, and employed the Self-Descriptiveness Judgement Task produced the largest effect sizes. The transfer-appropriate processing view of implicit memory was supported and significant biases were observed at both early and late stages of attention. Overall, results support cognitive models of depression and suggest that implicit cognition reliably predicts past, current, and future depression. Consequently, treatment efficacy may be improved by incorporating strategies that target implicit processes.