What drives preventative health behaviors one year into a pandemic? A replication and extension.

Objective: There is continued interest in understanding what leads people to engage in CDC-recommended COVID-19 prevention behaviors. We tested whether fear and COVID-19 worry would replicate as the primary drivers of six CDC recommended prevention behaviors. Methods and Measures: We recruited 741 adult participants during the second major peak of the COVID-19 pandemic in the United States (early 2021). Using very similar methods to the original study, participants completed a 10-day daily diary. Mixed effects models identified the strongest predictors of each individual prevention behavior as well as approach and avoidance behavior clusters. Results: At the between-person level, COVID-19 worry, COVID-19 perceived susceptibility, fear, and positive emotions all had positive zero-order associations with the prevention behaviors. However, with all predictors in the same model together, primarily COVID-19 worry remained significant for both the individual behaviors and behavior clusters. At the within-person level, only fear related to assessing oneself for COVID-19 and approach behaviors on the same day, but not the next day. Mediational analyses suggested COVID-19 worry, but not COVID-19 susceptibility, mediated the links between fear and approach/avoidance behaviors. Conclusion: Findings replicated worry about yourself or a loved one getting COVID-19 as the strongest predictor of prevention behaviors.

Can the positive buffer the negative? Testing the impact of protective childhood experiences on adjustment in adults following trauma exposure.

BACKGROUND: It is unclear if protective childhood experiences (PCEs), like emotional support and economic stability, exert influence on adulthood adjustment. Prior research suggests PCEs can promote childhood resilience through increased social connection. In contrast, research has demonstrated potential life-long negative impacts of adverse childhood experiences (ACEs) on psychological health. This study examined the role of PCEs and ACEs in psychological symptoms following potentially traumatic events (PTE) in adults. METHODS: Participants (N = 128) were adults admitted to two Level 1 Trauma Centers following violence, motor-vehicle crashes, or other accidents. Participants reported childhood experiences and completed assessments of depression, PTSD, and social support at one, four, and nine months post-PTE. RESULTS: Structural Equation Modeling was used to simultaneously model PCEs and ACEs as predictors of psychological symptoms over time, with potential mediation through social support. PCEs overall did not directly affect psychological symptoms nor indirectly through social support. However, the emotional support component of PCEs had an indirect effect on psychological symptoms at baseline through social support. ACEs predicted greater psychological symptoms at baseline and over time. CONCLUSION: PCEs consisting of childhood emotional support indirectly promote adjustment in adults after PTEs through initial social support, while ACEs exert direct effects on psychological symptoms.

Latent profile analysis of data from the brief inventory of neurocognitive impairment (BINI) to develop neuro-cognitive profiles among opioid-dependent patients in drug treatment.

BACKGROUND: Neurocognitive dysfunction is common among individuals with opioid use disorders (OUD) and can impede a range of treatment outcomes. We developed the 57-item Brief Inventory of Neuro-cognitive Impairment (BINI) to help detect and monitor neurocognitive dysfunction in the context of drug treatment settings. To date, no study has examined the possible presence of BINI subgroups among OUD patients, which could enhance our ability to tailor intervention strategies to meet individual treatment needs. The purpose of this study was to conduct a latent profile analysis to identify BINI subgroups that differ in terms of their reported and objective neurocognitive dysfunction. We hypothesized that subgroups would emerge, suggesting the potential benefit of implementing tailored strategies for optimal treatment outcomes. METHODS: Latent profile analyses included data from opioid-dependent patients (N = 177) enrolled in a methadone maintenance treatment program between July 2018 and October 2019. RESULTS: We found three profiles of self-reported neurocognitive symptoms, including those with 1) minimal concerns 2) moderate concerns, and 3) many concerns across multiple domains. CONCLUSIONS: If these results are confirmed, the BINI may be used to rapidly identify persons who require specific accommodation strategies to improve their drug treatment outcomes.

Self-care behaviors and affect during the early stages of the COVID-19 pandemic.

OBJECTIVE: Self-care behaviors aimed at maintaining physical and mental health are often recommended during stressful contexts. We tested emotional predictors of self-care behaviors (healthy eating, exercise, engaging in a hobby, relaxation/meditation, time spent with a supportive person, talking online with friends/family) during the COVID-19 pandemic and their emotional consequences. We hypothesized a reciprocal within-person process whereby positive affect increases self-care behaviors (Hypothesis 1) and self-care behaviors increase positive affect while decreasing negative affect (Hypothesis 2). METHOD: A 10-day daily diary was completed by 289 adult participants in the United States during spring 2020 when counties in 40 out of 50 states had some form of stay-at-home orders. RESULTS: Lagged analyses for Hypothesis 1 suggested that positive affect did not significantly predict residualized change in self-care behaviors; however, more intense negative affect predicted increased self-care behaviors from one day to the next. Concurrent analyses for Hypothesis 2 indicated most self-care behaviors were associated with more positive affect and some with less negative affect on the same day. Lagged analyses for Hypothesis 2 indicated that self-care behaviors largely did not predict residualized change in positive or negative affect from one day to the next. At the between-person level, people who experienced more positive affect engaged in more self-care behaviors across the sampling period. CONCLUSION: Self-care behaviors continue to have mental health benefits during stressful environments such as the COVID-19 pandemic and stay-at-home orders. Negative affect can play an adaptive role during times of stress by facilitating self-care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Associations of Global and Daily Support with Marital Status.

The provision and receipt of emotional support demonstrates benefits for relationships; however, little research has investigated how either global or day-to-day spousal support influences marital stability. This project assessed how global perception of support from a partner and daily provision and receipt of emotional support over 1 week contributed to divorce 10 years later, accounting for demographic covariates. There were no significant associations of support variables with future divorce. Greater education attainment was the only factor significantly associated with decreased risk for divorce. Results suggest that despite potential short-term benefits, global and daily support may not predict long-term marital stability.

What Drives Preventive Health Behavior During a Global Pandemic? Emotion and Worry.

BACKGROUND & PURPOSE: Primary prevention of COVID-19 has focused on encouraging compliance with specific behaviors that restrict contagion. This investigation sought to characterize engagement in these behaviors in U.S. adults early during the pandemic and to build explanatory models of the psychological processes that drive them. METHODS: US adults were recruited through Qualtrics Research Panels (N = 324; 55% female; Mage = 50.91, SD = 15.98) and completed 10 days of online reports of emotion, COVID-19 perceived susceptibility and worry, and recommended behaviors (social distancing, hand washing, etc.). Factor analysis revealed behaviors loaded on two factors suggesting distinct motivational orientations: approach and avoidance. RESULTS: Changes in approach and avoidance behaviors over the 10 days indicated large individual differences consistent with three types of participants. Discrete emotions, including fear, guilt/shame, and happiness were associated with more recommended behaviors. Fear and COVID-19 worry indirectly influenced each other to facilitate more behavioral engagement. While emotions and worry strongly predicted individual differences in behavior across the 10 days, they did not predict as well why behaviors occurred on one day versus another. CONCLUSIONS: These findings suggest how daily affective processes motivate behavior, improving the understanding of compliance and efforts to target behaviors as primary prevention of disease.

Optimal well-being in the aftermath of anxiety disorders: A 10-year longitudinal investigation.

BACKGROUND: Although preliminary research has explored the possibility of optimal well-being after depression, it is unclear how rates compare to anxiety. Using Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) as exemplars of anxiety, we tested the rates of optimal well-being one decade after being diagnosed with an anxiety disorder. Based on reward deficits in depression, we pre-registered our primary hypothesis that optimal well-being would be more prevalent after anxiety than depression as well as tested two exploratory hypotheses. METHOD: We used data from the Midlife in the United States (MIDUS) study, which contains a nationally representative sample across two waves, 10 years apart. To reach optimal well-being, participants needed to have no symptoms of GAD, PD, or major depressive disorder (MDD) at the 10 year follow-up and exceed cut-offs across nine dimensions of well-being. RESULTS: The results failed to support our primary hypothesis. Follow-up optimal well-being rates were highest for adults previously diagnosed with MDD (8.7%), then PD (6.1%), and finally GAD (0%). Exploratory analyses revealed optimal well-being was approximately twice as prevalent in people without anxiety or depression at baseline and provided partial support for baseline well-being predicting optimal well-being after anxiety. Results were largely replicated across different classifications of optimal well-being. LIMITATIONS: Findings are limited by the somewhat unique measurement of anxiety in the MIDUS sample as well as the relatively high rate of missing data. CONCLUSIONS: We discuss possible explanations for less prevalent optimal well-being after anxiety vs. depression and the long-term positivity deficits from GAD.

Does negative emotion differentiation influence how people choose to regulate their distress after stressful events? A four-year daily diary study.

Much is known about the types of strategies people use to regulate emotions. Less is known about individual differences that influence emotion regulation strategy selection. In this study, we tested the moderating role of negative emotion differentiation (NED; i.e., the ability to label and describe subtle differences among negative emotions) on the relationship between the intensity of stressful daily events and the strategies used to regulate distress arising from these events. Prior research shows that NED is associated with low endorsement of disengagement emotion regulation (e.g., substance use), but less is known about the link to engagement regulation (e.g., problem-solving, seeking social support). Participants were college students (N = 502) completing a 30-day daily diary survey for each of four college years. We preregistered hypotheses that 1) the intensity of each day's most stressful event would be associated with greater use of disengagement and engagement regulation strategies, and 2) people higher in NED would be less likely to use disengagement and more likely to use engagement strategies when highly stressed. Results suggest that higher stress intensity is associated with greater use of all regulation strategies. Greater NED is associated with less use of disengagement regulation strategies, whereas NED was unrelated to engagement regulation strategies and did not moderate the relationship between stress and engagement strategies. The majority of hypothesized moderation effects of NED were nonsignificant, prompting a reconsideration of whether, when, and how NED plays a role in stress responding. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Boosting positive mood in medical and emergency personnel during the COVID-19 pandemic: preliminary evidence of efficacy, feasibility and acceptability of a novel online ambulatory intervention.

OBJECTIVES: The aim of this project was to test the efficacy of a brief and novel online ambulatory intervention aimed at supporting psychological health and well-being for medical personnel and first responders during the COVID-19 pandemic. METHODS: Interested participants, n=28, actively employed as medical personnel, support staff and emergency responders, in the Midwestern USA in May-June of 2020, provided informed consent and were randomised to complete either low-dose or high-dose intervention, one time daily for 1 week via smartphone application. Each daily intervention included expressive writing, adaptive emotion regulation activity and (one vs two) positive emotion-generation activities, lasting 3-6 min a day. Ratings of negative and positive emotion were provided before and after each activity daily. Analyses tested compliance, acceptability, as well as efficacy at increasing positive emotion and decreasing negative emotion with each use and across time. RESULTS: The results indicated a 13% increase in positive emotion, t(25)=2.01, p=0.056; and decrease in negative emotion by 44%, t(25)=-4.00, p=0.001 across both doses. However, there was a clear advantage for individuals in the high-dose condition as daily boosts in positive emotion were significantly greater (an additional 9.4%) B=0.47, p=0.018. Overall, compliance was good. Acceptability ratings were good for those who completed the follow-up assessment. CONCLUSION: Front-line personnel, including medical staff and emergency responders, are experiencing unprecedented psychological stress during the COVID-19 pandemic. This investigation suggests both feasibility and efficacy for a brief, daily, ambulatory intervention which could provide essential psychological support to individuals at risk in the workplace.

The momentary benefits of positive events for individuals with elevated social anxiety.

Understanding how individuals with varying levels of social anxiety respond to daily positive events is important. Psychological processes that increase positive emotions are being widely used as strategies to not only enhance well-being but also reduce the symptoms and impairment tied to negative emotional dispositions and conditions, including excessive social anxiety. At present, it is unclear whether and how levels of social anxiety impact the psychological benefits derived from momentary positive events. We used ecological momentary assessment to examine the impact of trait social anxiety on momentary changes in emotions, sense of belonging, and social approach versus avoidance motivation following positive events in daily life. Over the course of a week, people with elevated social anxiety experienced greater momentary anxiety and social avoidance motivation and lower momentary happiness and sense of belonging on average. Despite these impairments, individuals with elevated social anxiety experienced greater psychological benefits-in the form of reduced anxiety and motivation to avoid social situations, and an increased sense of belonging-following positive events during the past hour that were rated as particularly intense. This pattern of findings was not specific to social anxiety, with evidence of similar effects for other forms of internalizing psychopathology (general anxiety and depression). These observations detail circumstances in which individuals with social anxiety, and other emotional disturbances, can thrive-creating potentially important targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Math matters: A novel, brief educational intervention decreases whole number bias when reasoning about COVID-19.

At the onset of the coronavirus disease (COVID-19) global pandemic, our interdisciplinary team hypothesized that a mathematical misconception-whole number bias (WNB)-contributed to beliefs that COVID-19 was less fatal than the flu. We created a brief online educational intervention for adults, leveraging evidence-based cognitive science research, to promote accurate understanding of rational numbers related to COVID-19. Participants from a Qualtrics panel (N = 1,297; 75% White) were randomly assigned to an intervention or control condition, solved health-related math problems, and subsequently completed 10 days of daily diaries in which health cognitions and affect were assessed. Participants who engaged with the intervention, relative to those in the control condition, were more accurate and less likely to explicitly mention WNB errors in their strategy reports as they solved COVID-19-related math problems. Math anxiety was positively associated with risk perceptions, worry, and negative affect immediately after the intervention and across the daily diaries. These results extend the benefits of worked examples in a practically relevant domain. Ameliorating WNB errors could not only help people think more accurately about COVID-19 statistics expressed as rational numbers, but also about novel future health crises, or any other context that involves information expressed as rational numbers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress.

Psychological flexibility (PF), defined as the ability to pursue valued life aims despite the presence of distress, is a fundamental contributor to health (Kashdan & Rottenberg, 2010). Existing measures of PF have failed to consider the valued goals that give context for why people are willing to manage distress. Using 4 independent samples and 3 follow-up samples, we examined the role of PF in well-being, emotional experience and regulation, resilience, goal pursuit, and daily functioning. We describe the development and psychometric properties of the Personalized Psychological Flexibility Index (PPFI), which captures tendencies to avoid, accept, and harness discomfort during valued goal pursuit. Correlational, laboratory, and experience-sampling methods show that the PPFI measures a trait-like individual difference dimension that is related to a variety of well-being and healthy personality constructs. Unlike existing measures of PF, the PPFI was shown to be distinct from negative emotionality. Beyond trait measures, the PPFI is associated with effective daily goals and life strivings pursuit and adaptive emotional and regulatory responses to stressful life events. By adopting our measurement index, PF may be better integrated into mainstream theory and research on adaptive human functioning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Optimal Well-Being after Major Depression.

Can people achieve optimal well-being and thrive after major depression? Contemporary epidemiology dismisses this possibility, viewing depression as a recurrent, burdensome condition with a bleak prognosis. To estimate the prevalence of thriving after depression in United States adults, we used data from the Midlife Development in the United States (MIDUS) study. To count as thriving after depression, a person had to exhibit no evidence of major depression, and had to exceed cut offs across nine facets of psychological well-being that characterize the top 25% of US nondepressed adults. Overall, nearly 10% of adults with study documented depression were thriving ten years later. The phenomenon of thriving after depression has implications for how the prognosis of depression is conceptualized and for how mental health professionals communicate with patients. Knowing what makes thriving outcomes possible offers new leverage points to help reduce the global burden of depression.

Is grit relevant to well-being and strengths? Evidence across the globe for separating perseverance of effort and consistency of interests.

OBJECTIVE: Researchers conceptualize grit as the combination of two facets: perseverance of effort and consistency of interests toward long-term goals. We tested the reliability of grit facet scores across the globe and examined how differently each grit facet related to well-being and personality strengths. METHOD: An international sample of 7,617 participants from six of the seven continents (excluding Antarctica) completed an online survey. RESULTS: Confirmatory factor analyses and omega reliability coefficients indicated that the 12 items from the original Grit Scale were multidimensional and reliably measured perseverance of effort and consistency of interests. Concurrent validity analyses showed that perseverance of effort was moderately to strongly related to subjective well-being, beliefs about well-being, and personality strengths, whereas consistency of interests had weak or negative correlations with these outcomes. The stronger relations with perseverance of effort were replicated across seven regions of the world. The presence of overall grit was supported in individualistic countries, but not collectivistic countries (i.e., those in Latin America and Asia). CONCLUSIONS: We discuss the multidimensionality of grit, including a conceptual understanding of overall grit and how it may differ across cultures. We suggest well-being and strengths researchers study grit facets separately due to their differential validity.

The Curious Neglect of High Functioning After Psychopathology: The Case of Depression.

We address a key issue at the intersection of emotion, psychopathology, and public health-the startling lack of attention to people who experience benign outcomes, and even flourish, after recovering from depression. A rereading of the epidemiological literature suggests that the orthodox view of depression as chronic, recurrent, and lifelong is overstated. A significant subset of people recover and thrive after depression, yet research on such individuals has been rare. To facilitate work on this topic, we present a generative research framework. This framework includes (a) a proposed definition of healthy end-state functioning that goes beyond a reduction in clinical symptoms, (b) recommendations for specific measures to assess high functioning, and (c) a road map for a research agenda aimed at discovering how and why people flourish after emotional disturbance. Given that depression remains the most burdensome health condition worldwide, focus on what makes these excellent outcomes possible has enormous significance for the public health.

Predicting help-seeking behavior: The impact of knowing someone close who has sought help.

OBJECTIVES: This study sought to replicate and extend research on social facilitators of college student's help seeking for psychological problems. PARTICIPANTS: We collected data on 420 ethnically diverse college students at a large public university (September 2008-May 2010). METHODS: Students completed a cross-sectional online survey. RESULTS: We found that students who were aware of close others' (eg, family, friends) help seeking were two times more likely to have sought formal (eg, psychologist) and informal (eg, clergy) help themselves. Tests of moderation revealed the incremental effect (ie, controlling for help-seeking attitudes, internalizing symptoms, cultural demographics) of close others' formal help seeking was strong and significant for men (R2 = 0.112), while it was negligible and nonsignificant for women (R2 = .002). CONCLUSIONS: We discuss the importance for students-particularly men-to learn about close others' help seeking for facilitating their own help seeking during times of distress.

A brief peer gatekeeper suicide prevention training: Results of an open pilot trial.

OBJECTIVE: The purpose of the present study was to test a 1-hour peer suicide gatekeeper training for students from the broad college community in the context of an open pilot trial. METHOD: Two-hundred and thirty-one college students were recruited university-wide, Mage  = 20.7, 65.4% female, and completed a peer suicide prevention gatekeeping training program. Assessments were completed at pre-training and post-training as well as 3-month follow-up. RESULTS: This brief peer suicide gatekeeper training program was associated with increases in suicide prevention knowledge. It was also associated with an increase in the number of students who identified suicidal youth and made mental health referrals, as well as total number of referrals made, over the course of three months. Females reported greater improvement in suicide prevention skills and knowledge post-training than males. CONCLUSIONS: Offering peer suicide gatekeeper training to students from the general college population may hold promise in suicide prevention efforts.

Personality Strengths as Resilience: A One-Year Multiwave Study.

We examined how personality strengths prospectively predict reactions to negative life events. Participants were 797 community adults from 42 countries. At five points over the course of 1 year, participants completed a series of questionnaires measuring seven personality strengths (hope, grit, meaning in life, curiosity, gratitude, control beliefs, and use of strengths), subjective well-being, and frequency and severity of negative life events. Using hierarchical linear modeling with assessment periods nested within participants, results from lagged analyses found that only hope emerged as a resilience factor. To illustrate the importance of using appropriate lagged analyses in resilience research, we ran nonlagged analyses; these results suggest that all seven personality strengths moderated the effect of negative life events on subjective well-being, with greater strengths associated with healthier outcomes. To provide evidence that personality strengths confer resilience, a prospective examination is needed with the inclusion of events and responses to them. The use of concurrent methodologies and analyses, which is the norm in psychology, often leads to erroneous conclusions. Hope, the ability to generate routes to reach goals and the motivation to use those routes, was shown to be particularly important in promoting resilience.

Effectiveness of a self-administered intervention for criminal thinking: Taking a Chance on Change.

The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. (PsycINFO Database Record

Psychometric validation of a simplified form of the PICTS for low-reading level populations.

The Psychological Inventory of Criminal Thinking Styles (PICTS) is one of the most widely used measures of criminal thinking. Although the PICTS has adequate psychometric qualities with many general population inmates, the measurement confound of reading ability may decrease its construct validity in low-literacy inmates. To help resolve this confound, we present psychometric evaluation of a simplified version of the PICTS (PICTS-SV) in which item language was simplified but item content was preserved. We first conducted Lexile analyses to confirm the reading level of the PICTS-SV is significantly lower than the original PICTS (i.e., sixth grade versus ninth grade). We then tested a bifactor model to confirm the PICTS-SV contains the same two factors as the original PICTS: proactive and reactive criminal thinking. These PICTS-SV results are commensurate with the factor structure of the original PICTS. Results suggest the PICTS-SV is a valid alternative for assessing criminal thinking in inmates with low reading ability.