Day-to-day associations between mindfulness and perceived stress: insights from random intercept cross-lagged panel modeling.

Objective: Mindfulness is frequently seen as a protective factor of stress, but self-report measures of mindfulness may overlap with other related constructs, such as mental health, and could thus not only be a predictor, but also an outcome of stress. This study thus aimed to examine the longitudinal bidirectional associations between the use and perceived helpfulness of the four mindfulness facets Observe, Describe, Nonjudge, and Nonreact with daily perceived stress. Methods: Participants from a large (N = 1,276) mixed student and community group sample filled out a brief daily diary over the time span of 7 days. Bidirectional cross-lagged effects were investigated using the random-intercept cross-lagged panel model, an extension of the traditional cross-lagged panel model that allows to differentiate between stable between-unit differences and time-varying within-unit dynamics. In addition, we controlled for several baseline and sociodemographic confounders. Results: At the within-subject level, the use of Actaware was associated with higher perceived stress on the next day (ß = 0.03, p = 0.029). The use (ß = -0.04, p = 0.025) and perceived helpfulness (ß = -0.05, p = 0.014) of Nonreact were associated with lower perceived stress on the next day. In turn, perceived stress was associated with lower perceived helpfulness of Describe (ß = -0.04, p = 0.037) and Nonreact (ß = -0.03, p = 0.038) on the next day. In addition, there were several residual correlations between mindfulness facets and perceived stress within days. At the between-subject level, there was a positive association between the random intercept of Describe and daily stress (r = 0.15, p = 0.003). In addition, while baseline perceived stress was negatively associated with the random intercepts of the mindfulness facets, two baseline components of mindfulness were not associated with the random intercept of perceived stress. Conclusion: On the currently investigated time scale, our results challenge prior results and assumptions regarding mindfulness as a buffering and protective factor against daily stress. With the exception of Nonreact, mindfulness was either positively associated with perceived stress, or in turn perceived stress appeared to interfere with the ability to stay mindful in daily life.

Baseline trait mindfulness moderates the efficacy of mindfulness interventions and active controls: A meta-analysis of 177 randomised controlled trials.

Previous evidence suggests that benefits of mindfulness-based interventions (MBIs) may depend on individuals' baseline trait mindfulness (BTM) levels. This meta-analysis investigated moderating effects of BTM on changes in mental health outcomes and trait mindfulness in randomised controlled trials (RCTs) of MBIs. A total of 177 primary studies (total N = 13,486), comparing the treatment effects of MBIs against active, treatment-as-usual (TAU) and waitlist control groups, were synthesised via three-level meta-analysis. Lower BTM was associated with larger changes in mental health outcomes (B = -0.14, 95% CI [-0.21, -0.06], p < .001) and trait mindfulness (B = -0.09 [-0.16, -0.02], p = .009) in MBIs and active controls combined. These associations were significantly larger than from those in TAU and waitlist controls. Moderating effects were less tangible for changes in trait mindfulness in MBIs and active controls individually and less tangible in various sensitivity analyses which, however, were confounded by client type across the RCTs. Individuals low in BTM may, by a small effect size, benefit more from MBIs and active control interventions. BTM may thus affect the evaluation of treatment efficacy. MBIs and active interventions could be offered specifically to persons low in BTM.

The dynamics of experiencing Gestalt and Aha in cubist art: pupil responses and art evaluations show a complex interplay of task, stimuli content, and time course.

Introduction: Gestalt perception refers to the cognitive ability to perceive various elements as a unified whole. In our study, we delve deeper into the phenomenon of Gestalt recognition in visual cubist art, a transformative process culminating in what is often described as an Aha moment. This Aha moment signifies a sudden understanding of what is seen, merging seemingly disparate elements into a coherent meaningful picture. The onset of this Aha moment can vary, either appearing almost instantaneously, which is in line with theories of hedonic fluency, or manifesting after a period of time, supporting the concept of delayed but more in-depth meaningful insight. Methods: We employed pupillometry to measure cognitive and affective shifts during art interaction, analyzing both maximum pupil dilation and average dilation across the trial. The study consisted of two parts: in the first, 84 participants identified faces in cubist paintings under various conditions, with Aha moments and pupil dilation measured. In part 2, the same 84 participants assessed the artworks through ratings in a no-task free-viewing condition. Results: Results of part 1 indicate a distinctive pattern of pupil dilation, with maximum dilation occurring at both trial onset and end. Longer response times were observed for high-fluent, face-present stimuli, aligning with a delayed but accurate Aha-moment through recognition. Additionally, the time of maximum pupil dilation, rather than average dilation, exhibited significant associations, being later for high-fluent, face-present stimuli and correct detections. In part 2, average, not the time of maximum pupil dilation emerged as the significant factor. Face-stimuli and highly accessible art evoked stronger dilations, also reflecting high clearness and negative valence ratings. Discussion: The study underscores a complex relationship between the timing of recognition and the Aha moment, suggesting nuanced differences in emotional and cognitive responses during art viewing. Pupil dilation measures offer insight into these processes especially for moments of recognition, though their application in evaluating emotional responses through artwork ratings warrants further exploration.

Associations of Suicide Referents With Different Moral Connotation With Actual Suicides.

Background: Different words used for suicide (so-called suicide referents) have different moral connotations, and neutral referents are recommended in media reporting guidelines. Aims: To assess how different referents in media reports are related to actual suicides. Method: Austrian news articles for each month between 2000 and 2021 (n = 276 months) were obtained from the Austrian Press Agency. Time series were modeled for media items referring to suicide as a crime [Selbstmord], an act of freedom [Freitod], or neutral connotation [Suizid]. Temporal associations with suicides in the month before, during, and after the reporting were examined. Results: Terminology referring to suicide as an act of free will [Freitod] was weakly associated with increases in total, male, and female suicides and with suicides in up to 64-year-olds in the same month. No other statistically significant associations were found. Limitations: No detailed content analysis of media reports was done. Conclusion: During times of prevalent use of referents suggesting suicide to be an act of freedom, there are small-sized increases in suicides. The simultaneous occurrence of this referent and suicides might reflect effects of a societal framing present in both the media and the community rather than a sheer media effect.

Positive self-beliefs mediate the association between body appreciation and positive mental health.

Previous work has supported direct, positive associations between body appreciation and positive mental health, but has largely neglected to examine possible indirect mechanistic pathways. Here, we propose one relevant mediational pathway, wherein body appreciation is associated with positive mental health via positive self-beliefs (i.e., cognitions that lead individuals to view themselves, their lives, and/or their futures under a positive outlook). To test this hypothesis, we asked an online sample of 496 adults (249 women, 247 men) from the United Kingdom to complete measures of body appreciation, positive self-beliefs, and positive mental health. Participants also completed measures of self-efficacy and resilience, and provided their demographic information. Correlational analysis revealed significant, positive, and strong associations between body appreciation and facets of positive self-beliefs and positive mental health, respectively. Structural equation modelling showed that positive self-beliefs mediated the association between body appreciation and positive mental health after controlling for self-efficacy and resilience. This model was robust across women and men separately, and the mediational effects remained intact in sensitivity and robustness analyses. We discuss ways in which greater body appreciation may help individuals develop and maintain positive self-beliefs, which in turn shape mental health outcomes.

The fraternal birth-order effect as a statistical artefact: convergent evidence from probability calculus, simulated data, and multiverse meta-analysis.

The fraternal-birth order effect (FBOE) is a research claim which states that each older brother increases the odds of homosexual orientation in men via an immunoreactivity process known as the maternal immune hypothesis. Importantly, older sisters supposedly either do not affect these odds, or affect them to a lesser extent. Consequently, the fraternal birth-order effect predicts that the association between the number of older brothers and homosexual orientation in men is greater in magnitude than any association between the number of older sisters and homosexual orientation. This difference in magnitude represents the main theoretical estimand of the FBOE. In addition, no comparable effects should be observable among homosexual vs heterosexual women. Here, we triangulate the empirical foundations of the FBOE from three distinct, informative perspectives, complementing each other: first, drawing on basic probability calculus, we deduce mathematically that the body of statistical evidence used to make inferences about the main theoretical estimand of the FBOE rests on incorrect statistical reasoning. In particular, we show that throughout the literature researchers ascribe to the false assumptions that effects of family size should be adjusted for and that this could be achieved through the use of ratio variables. Second, using a data-simulation approach, we demonstrate that by using currently recommended statistical practices, researchers are bound to frequently draw incorrect conclusions. And third, we re-examine the empirical evidence of the fraternal birth-order effect in men and women by using a novel specification-curve and multiverse approach to meta-analysis (64 male and 17 female samples, N = 2,778,998). When analyzed correctly, the specific association between the number of older brothers and homosexual orientation is small, heterogenous in magnitude, and apparently not specific to men. In addition, existing research evidence seems to be exaggerated by small-study effects.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age.

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials.

BACKGROUND: Mindfulness-based mobile apps have become popular tools for enhancing well-being in today's fast-paced world. Their ability to reduce geographical, financial, and social barriers makes them a promising alternative to traditional interventions. OBJECTIVE: As most available apps lack a theoretical framework, this review aimed to evaluate their effectiveness and assess their quality. We expected to find small sample sizes, high dropout rates, and small effect sizes in the included studies. METHODS: A systematic literature search was conducted using PsycInfo, PsycNet, PubMed, an institutional search engine (u:search), and Google Scholar. Randomized controlled trials assessing the impact of mobile mindfulness apps on well-being in nonclinical samples were included. Study selection, risk of bias (using the version 2 of the Cochrane risk-of-bias tool for randomized trials), and reporting quality (using selected CONSORT [Consolidated Standards of Reporting Trials] statement criteria) assessments were performed by 2 authors independently and discussed until a consensus was reached. RESULTS: The 28 included randomized controlled trials differed in well-being measures, apps, and intervention duration (7 to 56 days; median duration 28 days). A wide range of sample sizes (12 to 2282; median 161) and attrition rates (0% to 84.7%; median rate 23.4%) were observed. Most studies (19/28, 68%) reported positive effects on at least one aspect of well-being. The effects were presented using different metrics but were primarily small or small to medium in size. Overall risk of bias was mostly high. CONCLUSIONS: The wide range of sample sizes, attrition rates, and intervention periods and the variation in well-being measures and mobile apps contributed to the limited comparability of the studies. Although most studies (16/28, 57%) reported small or small to medium effects for at least one well-being outcome, this review demonstrates that the generalizability of the results is limited. Further research is needed to obtain more consistent conclusions regarding the impact of mindfulness-based mobile apps on well-being in nonclinical populations.

Support for weight-related anti-discrimination laws and policies: Modelling the role of attitudes toward poverty alongside weight stigma, causal attributions about weight, and prejudice.

In the present study, we sought to position support for weight-related anti-discrimination laws and policies within a broader political and socioeconomic context. Specifically, we hypothesised that individualistic (rather than structural) anti-poverty attitudes would provide the basis for negative weight-related dispositions. To test this hypothesis, we asked 392 respondents from the United Kingdom to complete measures of support for weight-related anti-discrimination laws and policies, attributions about the causes of being larger-bodied, and weight-related stigma and prejudice. Path analysis with robust maximum likelihood estimation indicated that greater individualistic anti-poverty attitudes were significantly and directly associated with lower support for weight-related anti-discrimination laws and policies. This direct association was also significantly mediated by weight-related stigma and via a serial mediation involving both weight-related stigma and prejudice. Although greater individualistic anti-poverty attitudes were significantly associated with greater personal attributions for being larger-bodied, the latter did not emerge as a significant mediation pathway. The present findings highlight the importance of considering broader political and socioeconomic contextual factors that may provide a basis for the development, maintenance, and manifestation of negative weight-related dispositions.

Only Small Effects of Mindfulness-Based Interventions on Biomarker Levels of Inflammation and Stress: A Preregistered Systematic Review and Two Three-Level Meta-Analyses.

Mindfulness-based interventions (MBIs) have a positive effect on biomarkers of inflammation and stress in patients with psychiatric disorders and physical illnesses. Regarding subclinical populations, results are less clear. The present meta-analysis addressed the effects of MBIs on biomarkers in psychiatric populations and among healthy, stressed, and at-risk populations. All available biomarker data were investigated with a comprehensive approach, using two three-level meta-analyses. Pre-post changes in biomarker levels within treatment groups (k = 40 studies, total N = 1441) and treatment effects compared to control group effects, using only RCT data (k = 32, total N = 2880), were of similar magnitude, Hedges g = -0.15 (95% CI = [-0.23, -0.06], p < 0.001) and g = -0.11 (95% CI = [-0.23, 0.001], p = 0.053). Effects increased in magnitude when including available follow-up data but did not differ between type of sample, MBI, biomarker, and control group or duration of the MBI. This suggests that MBIs may ameliorate biomarker levels in both psychiatric and subclinical populations to a small extent. However, low study quality and evidence of publication bias may have impacted on the results. More large and preregistered studies are still needed in this field of research.

Differential associations of the two higher-order factors of mindfulness with trait empathy and the mediating role of emotional awareness.

Empathy enables us to understand the emotions of others and is an important determinant of prosocial behavior. Investigating the relationship between mindfulness and empathy could therefore provide important insights into factors that promote interpersonal understanding and pathways that contribute to prosocial behavior. As prior studies have yielded only inconsistent results, this study extended previous findings and investigated for the first time the associations of two important factors of mindfulness (Self-regulated Attention [SRA] and Orientation to Experience [OTE]) with two commonly proposed components of empathy (cognitive empathy and affective empathy). Using a community sample of N = 552 German-speaking adults, the two mindfulness factors were differentially associated with cognitive and affective empathy. SRA correlated positively with cognitive empathy (r = 0.44; OTE: r = 0.09), but OTE correlated negatively with affective empathy (r = - 0.27; SRA: r = 0.11). This negative association was strongest for one specific aspect of affective empathy, emotional contagion. Revisiting previously reported mediating effects of emotion regulation, we found that emotional awareness mediated the associations with both components of empathy, but only for SRA. Together, these findings imply that mindfulness benefits the cognitive understanding of others' emotions via two distinct pathways: by promoting emotional awareness (SRA) and by limiting the undue impact of others' emotions on oneself (OTE).

The process of replication target selection in psychology: what to consider?

Increased execution of replication studies contributes to the effort to restore credibility of empirical research. However, a second generation of problems arises: the number of potential replication targets is at a serious mismatch with available resources. Given limited resources, replication target selection should be well-justified, systematic and transparently communicated. At present the discussion on what to consider when selecting a replication target is limited to theoretical discussion, self-reported justifications and a few formalized suggestions. In this Registered Report, we proposed a study involving the scientific community to create a list of considerations for consultation when selecting a replication target in psychology. We employed a modified Delphi approach. First, we constructed a preliminary list of considerations. Second, we surveyed psychologists who previously selected a replication target with regards to their considerations. Third, we incorporated the results into the preliminary list of considerations and sent the updated list to a group of individuals knowledgeable about concerns regarding replication target selection. Over the course of several rounds, we established consensus regarding what to consider when selecting a replication target. The resulting checklist can be used for transparently communicating the rationale for selecting studies for replication.

Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018.

OBJECTIVE: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION: As Predicted, #66922, 26 May 2021.

In COVID-19 Health Messaging, Loss Framing Increases Anxiety with Little-to-No Concomitant Benefits: Experimental Evidence from 84 Countries.

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., "If you do not practice these steps, you can endanger yourself and others") or potential gains (e.g., "If you practice these steps, you can protect yourself and others")? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions.

No Effects of a Brief Mindfulness Intervention on Controlled Motivation and Amotivation, but Effect Moderation Through Trait Mindfulness: a Randomized Controlled Trial.

Objectives: Mindfulness is associated with the different forms of motivation according to self-determination theory (intrinsic, identified, and external motivation, and amotivation). However, causal evidence for reported negative associations of mindfulness with external motivation and amotivation is currently lacking. Therefore, this study investigated causal effects of a brief mindfulness intervention on motivation towards a personal goal. We differentiated distinct forms of motivation and also controlled for baseline motivation and trait mindfulness, which could act as a moderator of the interventional effects. Methods: Data of N = 91 participants were used, who were randomly assigned to either audio-guided meditation or a control condition. Situational motivation for a personal goal was assessed before and after the intervention. Trait mindfulness was measured with the Five Facet Mindfulness Questionnaire. Results: The intervention had a positive effect on the more autonomous forms of motivation (d = 0.48), which was, however, qualified by trait mindfulness; i.e., the effect was larger among participants low in trait mindfulness (d = 1.13 at 1 SD below the overall mean). There were no practically relevant effects on external motivation and amotivation. Conclusions: Mindfulness has a positive causal effect on more autonomous forms of motivation, but probably no relevant effects on external motivation and amotivation. Moderating effects of trait mindfulness need to be considered more systematically in this field of research, but also in research of mindfulness intervention more generally. Mindfulness interventions could be beneficially offered to persons low in trait mindfulness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01968-7.

Acute and Chronic Physical Activity Increases Creative Ideation Performance: A Systematic Review and Multilevel Meta-analysis.

BACKGROUND: Physical activity is a health-relevant lifestyle factor associated with various benefits on physical and mental health. Several meta-analyses indicated effects of acute and chronic physical activities on elementary cognitive functions such as executive control processes, memory, and attention. Meta-analytic evidence on the effects of physical activity on creative idea generation, which involves a conglomerate of these elementary cognitive functions, is largely missing. OBJECTIVE: A twofold approach was used to evaluate (1) if there is an association between habitual physical activity and creative ideation and (2) if physical activity interventions (acute and chronic) enhance creative ideation performance. METHODS: Multilevel meta-analytic methods were applied to (1) evaluate the cross-sectional association between creative ideation performance and measures of habitual physical activity and (2) the effect of physical activity on creative ideation performance. Indicators of creative ideation (fluency, flexibility, originality, elaboration, or composite score), creativity domain (verbal, figural), population (adults, children), gender, study quality, and publication year served as moderator variables for both meta-analyses. Analyses of intervention studies additionally examined the moderator variables study design (between, within), time of measurement (during, after), and implementation of intervention (acute, chronic). RESULTS: The applied meta-analytic multilevel analysis indicated a medium effect for cross-sectional studies (r = 0.22, SE = 0.06, p = 0.002, 95% CI [0.10-0.34]) based on 17 effects sizes from seven studies. The pooled effects of 28 intervention studies, providing 115 effect sizes, indicated a medium effect size of Hedges' g = 0.47 (SE = 0.09, p < 0.001, 95% CI [0.30-0.65]). Furthermore, a stronger effect was observed for chronic interventions of several days or weeks in comparison with acute interventions of one single bout. CONCLUSION: This study adds important new meta-analytic evidence on the beneficial role of physical activity beyond mental and physical health outcomes: Physical activity has a positive impact on creative ideation, which expands the literature on the role of physical activity in more elementary cognitive functions such as executive control, memory, and attention. Moderator analyses suggested that chronic interventions showed stronger effects than single bouts of physical activity. Rigorously conducted randomized controlled intervention studies and more cross-sectional studies are needed to broaden the evidence in this nascent field of research.

Social reputation influences on liking and willingness-to-pay for artworks: A multimethod design investigating choice behavior along with physiological measures and motivational factors.

Art, as a prestigious cultural commodity, concerns aesthetic and monetary values, personal tastes, and social reputation in various social contexts-all of which are reflected in choices concerning our liking, or in other contexts, our actual willingness-to-pay for artworks. But, how do these different aspects interact in regard to the concept of social reputation and our private versus social selves, which appear to be essentially intervening, and potentially conflicting, factors driving choice? In our study, we investigated liking and willingness-to-pay choices using-in art research-a novel, forced-choice paradigm. Participants (N = 123) made choices from artwork-triplets presented with opposing artistic quality and monetary value-labeling, thereby creating ambiguous choice situations. Choices were made in either private or in social/public contexts, in which participants were made to believe that either art-pricing or art-making experts were watching their selections. A multi-method design with eye-tracking, neuroendocrinology (testosterone, cortisol), and motivational factors complemented the behavioral choice analysis. Results showed that artworks, of which participants were told were of high artistic value were more often liked and those of high monetary-value received more willingness-to-pay choices. However, while willingness-to-pay was significantly affected by the presumed observation of art-pricing experts, liking selections did not differ between private/public contexts. Liking choices, compared to willingness-to-pay, were also better predicted by eye movement patterns. Whereas, hormone levels had a stronger relation with monetary aspects (willingness-to-pay/ art-pricing expert). This was further confirmed by motivational factors representative for reputation seeking behavior. Our study points to an unexplored terrain highlighting the linkage of social reputation mechanisms and its impact on choice behavior with a ubiquitous commodity, art.

Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis.

BACKGROUND: There is strong evidence that suicides increase after media stories about suicides by celebrities, particularly those that highlight the suicide method (the Werther effect). Much less is known about the Papageno effect-the protective effects of media stories of hope and recovery from suicidal crises. A synthesis of the retrievable evidence is lacking. We aim to summarise findings from randomised controlled trials about the effects of stories of hope and recovery on individuals with some degree of vulnerability to suicide. METHODS: For this systematic review and individual participant data meta-analysis, we searched PubMed (including MEDLINE), Scopus, Embase, PsycInfo, Web of Science, and Google Scholar published from inception to Sept 6, 2021, without language restrictions. We included trials that reported suicidal ideation (the primary outcome) or help-seeking attitudes or intentions (the secondary outcome) and tested a media narrative of hope and recovery. Studies were excluded if they did not feature a clearly positive story of hope and recovery, or had a control group exposed to suicide-related stimulus material. We contacted the lead or senior authors of all original studies to obtain participant-level data for this study. The primary analysis was restricted to individuals with some vulnerability to suicide. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomised trials. The study is registered with PROSPERO, number CRD42020221341. FINDINGS: Our search yielded 7347 records. 3920 records were screened by title and abstract, and 25 full-text records assessed for eligibility. There were eight eligible studies with 2350 participants for which individual participant data were sought. For suicidal ideation, six studies met the inclusion criteria for the primary analysis. Follow-up responses were available for 569 (90%) of 633 participants who were randomised with high vulnerability (345 [55%] allocated to the intervention group and 288 [45%] to the control group). The pooled standardised mean difference (SMD) indicated a small reduction in suicidal ideation of -0·22 (95% CI -0·39 to -0·04, p=0·017; six studies) in the intervention group. For help-seeking attitudes and intentions, four studies met the inclusion criteria and follow-up data were available for 362 (86%) of 420 participants (247 [59%] allocated to the intervention group and 173 [41%] to the control group). The pooled SMD showed no evidence of a difference between the groups (SMD=0·14, 95% CI -0·15 to 0·43, p=0·35; four studies). Low levels of cross-study heterogeneity effects were observed for both analyses (I2=5% [suicidal ideation] and I2=36% [help-seeking attitudes and intentions]). We found no evidence of publication bias. INTERPRETATION: Media narratives of hope and recovery from suicidal crises appear to have a beneficial effect on suicidal ideation in individuals with some vulnerability, but there is insufficient evidence regarding help-seeking attitudes and intentions. These findings provide new evidence about narratives for suicide prevention. FUNDING: None.

Developing a model linking self-reported nature exposure and positive body image: A study protocol for the body image in nature survey (BINS).

Exposure to natural environments has been shown to be associated with more positive body image, but much of the existing research is limited to Western European nations and little is known about the robustness of these associations in other national contexts. In this protocol paper, we present a conceptual model of the direct and indirect associations (i.e., via self-compassion, connectedness to nature, and restorative experiences in nature) between nature exposure and body appreciation. This model brings together conceptualisations from existing research, but also extends it in a number of important ways. The model will be tested through the Body Image in Nature Survey (BINS), a researcher-crowdsourced project involving researchers in multiple nations worldwide. Data collection began in December 2020 and is expected to be completed in February 2022. Data will be analysed to examine the extent to which our conceptual model is robust across nations, as well as other sociodemographic characteristics. We will also determine the extent to which key variables included in our survey are invariant across nations and associated with cultural, socioeconomic, and gender-related factors. The BINS will likely have important implications for the development of nature-based interventions to promote healthier body appreciation in diverse national contexts.