Diagnosis concealment is associated with psychosocial outcomes in persons with multiple sclerosis

Persons with multiple sclerosis (pwMS) frequently conceal their diagnosis, fearing professional and personal repercussions of disclosing. Associations of concealment behavior and expected consequences of disclosure with psychosocial outcomes were examined in 90 pwMS who completed validated self-report measures of diagnosis concealment, loneliness, social support, and self-efficacy. More frequent concealment was related to worse loneliness ( rp = 0.213, p = 0.045) and lower social support ( rp = −0.211, p = 0.047), controlling for depression. Higher anticipated negative consequences of disclosure were associated with worse loneliness ( rp = 0.263, p = 0.013), lower social support ( rp = −0.338, p < 0.001), and lower self-efficacy ( rp = −0.350, p < 0.001). Findings hold implications for the development of psychological support strategies addressing concealment/disclosure issues and their psychosocial consequences.

The Relationship Between Social Support And Social Withdrawal Of Left-Behind Adolescents: A Chain Mediating Model

Background: Nowadays, as more and more Chinese farmers in rural area went to city for work, they left their kids at home. These kids were left-behind adolescents and they developed without their parental accompany. The family function of left-behind adolescents was deficient, which may result in their social withdrawal in social situations. Therefore, in this study, in order to improve left-behind adolescents’ psychological and behavior problems, we aimed to investigate their level of social withdrawal and its impact factors. Method: There were 339 left-behind adolescents and 289 non-left-behind adolescents recruited from a Chinese junior high school. Their social withdrawal, social support, relative deprivation, and resilience were measured through questionnaires. Results: The results showed that compared with non-left-behind adolescents, left-behind adolescents had lower social support and resilience, but their social withdrawal and relative deprivation were higher; besides, left-behind adolescents’ social support negatively predicted social withdrawal, while relative deprivation and resilience played a chain mediating role between them. Conclusion: This study found that compared with none-left-behind adolescents, left-behind adolescents had difficulty in social adaptation. However, there was a “context-process-outcome” model in which social support negatively predicted social withdrawal, while relative deprivation and resilience played a chain mediating role between them. In sum, this study provided suggestions to promote the mental health and social behavioral development of left-behind adolescents.

Monitoring Australian parents’ shifting receptiveness to digital mental health interventions during the COVID-19 pandemic

Background: Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. Method: The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. Results: More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child’s mental health. Between-person baseline predictors of higher intention ratings were parent’s prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child’s education, lower social support and financial hardship. Conclusion: Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need.

Prevalent, Incident, and Persistent Insomnia in a Population-Based Cohort Tested Before (2018) and During the First-Wave of COVID-19 Pandemic (2020)

Study Objectives High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). Methods Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April-May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. Results The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% two years later. There was a significant worsening of sleep quality, fatigue, anxiety and depression (all ps &lt; 0.005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. Conclusions The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the the COVID-19.

Mental and Physical Health of Older Incarcerated Persons Who Have Aged in Place in Prison

This study describes physical and mental health of incarcerated males aged ≥50 years who spent at least 20 consecutive years in prison, comparing those with life sentences (“lifers”) with those expected to be released/paroled. Data included demographics, chronic medical conditions, self-reported and objective disabilities, depressive symptoms, suicidal ideation (SI), and social support. The 65 participants ( Mage = 56.9, SD = 6.6) were racially diverse (40% White, 51% Black, 9% Hispanic/Other), incarcerated for M = 26.6 ( SD = 4.5) years, and 34 (52%) were lifers. Among the 39 (60%) of participants with visitors, lifers had lower social support scores ( p = .005). After controlling for age, race, and chronic conditions, lifers reported disability in a higher number of activities ( p < .001), and had higher depressive symptoms ( p = .08) and SI scores ( p = .04). Health-related differences between lifers and those expected to be released have implications for prison systems including staff training, advance care planning, and need for expanding prison-based hospice programs.

High perceived isolation and reduced social support affect headache impact levels in migraine after the Covid-19 outbreak: A cross sectional survey on chronic and episodic patients

Background Psychosocial variables are key factors influencing psycho-physical equilibrium in migraine patients. Social isolation and vulnerability to stressors may prevent efficient psychological adjustment negatively affecting adaptation to life changes, as that imposed during Covid-19 lockdown. Here, we explored psychosocial dimensions and changes in clinical condition during Covid-19 lockdown in migraine patients, with regard to migraine type and headache impact. Methods Sixty-four migraine patients (32 episodic and 32 chronic) and 64 healthy control subjects were included in a case-control cross-sectional study. A two-step clustering procedure split patients into two clusters, based on the Headache Impact Test. Perceived global distress, loneliness, empathy, and coping levels were compared in groups, as well as changes in clinical condition. Results Migraine patients reported higher general loneliness and lower social support compared to healthy control subjects. Emotional loneliness was more marked in patients with higher headache impact. This subgroup of patients more frequently reported changes in the therapeutic and care paths as the perceived cause of the occurrence of motor or extra-motor symptomatology. Conclusions Migraine patients, especially those more severely affected, proved more vulnerable than healthy control subjects to Covid-19 lockdown. Long-lasting interruption of social interactions may be detrimental in fragile patients that are in need of structured support interventions to maintain psycho-physical wellbeing.

Oral cancer knowledge and screening behavior among smokers and non-smokers in rural communities

Background Research suggests having an oral and pharyngeal cancer (OPC) examination for early diagnosis can increase survival rate. However, the OPC screening rate is low in certain populations. To improve OPC screening rate, this study identified factors that are associated with having an OPC examination. Methods Participants with landlines and aged 25 years and older were recruited from six northern Florida counties. Bivariate and logistic regressions were used to predict the outcome of whether the participants had ever had an OPC examination as well as whether participants had ever heard of an OPC examination. Results Of 2260 participants with a mean age of 55.9 ± 15.0 years, the majority of participants never smoked (53.4%), self-identified as Whites (70.6%), and had some college or 2-year degree education (30.3%). Smokers were significantly less likely to have ever heard of an OPC examination than those who never smoked. Significant interaction between smoking status and race, and smoking status and social support interaction were found. Whites who never smoked were more likely to have had an OPC examination than non-Whites who never smoked. Former and current smokers with greater social support were more likely to have had an OPC examination than those with lower social support. Conclusion The findings from this study inform the need to enhance the awareness of having an OPC examination among smokers and to reduce barriers for racial minority populations to receive an OPC examination. Future research is warranted to develop interventions to target certain populations to improve the rate of OPC examination.

Examination of Food Insecurity, Socio-Demographic, Psychosocial, and Physical Factors among Residents in Public Housing

Objectives: Understanding associations between psychosocial and physical factors among those who experience food insecu­rity could help design effective food insecu­rity programs for improved cardiovascular health among low-income populations. We examined differences in psychosocial and physical factors between those who were food secure compared with food insecure among public housing residents.Methods: Data were from the baseline survey of a randomized controlled trial of a weight management intervention in Boston, Massachusetts from 2016-2017. Food insecurity and psychosocial and physical factors, including perceived stress, personal problems, social support, and physical symptoms, were measured via interviewer-administered screeners.Results: Mean age of the sample (N=102) was 46.5 years (SD=11.9). The majority were Hispanic (67%), female (88%), with ≤high school degree (62%). Nearly half were food insecure (48%). For psychosocial vari­ables, those who were food insecure had higher ratings of perceived stress (adjusted mean difference 3.39, 95% CI:2.00,4.79), a higher number of personal problems (ad­justed mean difference 1.85, 95% CI: 1.19, 2.51), and lower social support (adjusted mean difference -0.70, 95% CI:-1.30,-0.11) compared with those who were food se­cure. For physical variables, those who were food insecure had higher odds of reporting negative physical symptoms (aOR 4.92, 95% CI:1.84,13.16).Conclusion: Among this sample of public housing residents, food insecurity was as­sociated with higher stress, more personal problems, higher experiences of physical symptoms, and lower social support. Ethn Dis. 2021;31(1):159-164; doi:10.18865/ed.31.1.159

Social support and health among older adults – the Singapore Chinese Health Study

While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.

Relationship among anxiety, depression, social and self-efficacy in night-shift nurses

Night shift disturbs normal circadian rhythm, thus leads to several psychological problems. We aim to investigate the anxiety, depression, social support and self-efficacy of night-shift nurses compared with day-shift nurses and explore the association between emotional status and social support as well as the combined influence of social support and self-efficacy on emotional status. We conducted this quantitative comparative study in a hospital from January 1, 2019 to August 31, 2020, using the Hospital Anxiety and Depression Scale (HADS), Perceived Social Support Scale (PSSS), and General Self-Efficacy Scale (GSES). The HADS-A and HADS-D scores were higher for the night-shift nurses than for the day-shift nurses (7.38 ± 3.228 vs. 5.81 ± 3.180 and 6.79 ± 3.444 vs. 5.43 ± 3.155, respectively, P < 0.01). The family support, friend support, other support and total social support scores were lower for the night-shift nurses than for the day-shift nurses. In both groups, these scores were lower for nurses with suspected anxiety than for those without anxiety (61.16 ± 12.208 vs. 66.35 ± 9.976, P < 0.01) and were lower for nurses with suspected depression than for those without depression (59.91± 11.606 vs. 66.77 ± 10.320, P < 0.01). The item scores, total scores and total mean score for the night-shift nurses were significantly lower than those for the day-shift nurses (P < 0.01). Social support and self-efficacy had noticeable regression effects on nurses’ anxiety and depression, and both variables had significant negative effects on anxiety and depression. This study suggests that night-shift nurses may have higher anxiety and depression than day-shift nurses. Nurses with suspected anxiety and depression nurses may have lower social support than those without anxiety and depression.