Journal of Health Psychology

Despite numerous studies observing a positive correlation between family resilience and psychological well-being during the COVID-19 pandemic, the strength of this association varied considerably in previous research. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderators of the association between family resilience and psychological well-being during the COVID-19 pandemic. Seventeen studies (65 effect sizes, 14,511 participants) were reviewed using a systematic literature search and the PRISMA approach. A three-level meta-analysis revealed a significant positive correlation (r = 0.504, p < 0.001) between family resilience and psychological well-being during the COVID-19 pandemic. Notably, education level significantly moderated this relationship, along with the type of psychological well-being and the measures used for assessment. These findings highlight the critical role of family resilience in enhancing psychological well-being and emphasize the importance of considering educational factors in designing interventions to improve psychological outcomes during pandemics.

Research into achieving Type 2 Diabetes Mellitus remission through weight loss efforts has grown steadily in the past decade. Most of this research has focused on the effectiveness of weight loss as a method to achieve remission, rather than considering individuals experiences of engaging with such change. This paper aims to review the qualitative research on individuals’ experience of proposed dietary modifications with a weight loss focus. Six databases were searched for qualitative and mixed-methods research studies, and studies were subject to analysis following Thomas and Hardin’s guidelines. The search yielded 2945 results, of which 47 were reviewed in full, and nine were included for analysis. Four analytical themes were identified; variability in support; choosing dietary change; re-negotiating the food relationship; and looking beyond weight loss. Providing tailored nutritional information that is comprehensible and culturally appropriate must be the premise of the interventions offered. Supporting patients to understand their relationship with food and identify meaningful goals beyond weight loss is an important starting point.

Sexual and gender minority (SGM) individuals smoke at higher rates than their heterosexual and cisgender peers. SGM persons, especially transgender and gender diverse (TGD) individuals, face unique, adverse health effects associated with smoking. As such, SGM individuals may benefit from smoking cessation interventions that are tailored to meet their needs. This systematic review aims to describe the ways in which these interventions have been tailored for SGM individuals and summarize available acceptability and efficacy data. Four databases were searched to identify smoking cessation interventions adapted for SGM populations. Thirteen articles were identified, with tailored aspects focusing on culturally tailored references, SGM-specific psychoeducation, and intra-community support strategies. No clear patterns of efficacy were identified, and only one study included bioverified abstinence. Preliminary evidence suggests that smoking cessation interventions can be acceptably tailored to SGM individuals, however, additional research is needed to determine if SGM-tailored interventions are more efficacious than non-tailored approaches.

Health, social care and emergency services staff, continue to feel the impact of Long-COVID. Using quantitative and qualitative methods, this study aims to evaluate the experience of UK health and social care staff who participated in a virtual Long-COVID peer support group between May 2021 and May 2023. The outcome measures (SWEMWBS and PHQ9) show an improvement in post-group scores, suggesting participation in the peer support group is linked to improved wellbeing. Thematic analysis identified five key themes: finding connectedness, reciprocity, effective facilitation, filling the gaps and virtual format. This evaluation shows how peer support groups provided space for reciprocity and the positive outcomes associated with this. This evaluation highlights the importance of co-produced, needs-based services providing Long-COVID peer support.

Explore the experiences of nursing professionals during the COVID-19 pandemic and the impact these experiences continue to have on their personal and professional lives. This qualitative study utilized Interpretative Phenomenological Analysis with nine nursing professionals from southern Brazil. Two main themes and five subthemes were developed. The first theme, “Ongoing trauma response,” had three subthemes: (a) Fear of dying and family dying, (b) Loneliness and isolation, and (c) My emotions don’t matter. The second theme highlights the “Continued problems with the larger healthcare system” and is made up of two subthemes: (a) We are humans, not superheroes, and (b) We are still invisible. Symptoms of trauma response continued to be a significant challenge among nursing professionals even after the end of the pandemic. Recommendations for improving working conditions and making mental health services more readily available are discussed.

This study validates the Turkish version of the Attitudes Toward Face Mask Use Scale (ATFMUS). This scale is crucial for understanding public attitudes toward mask usage in preventing the transmission of infectious diseases. The research was conducted between September 2023 and February 2024 with 530 students from a foundation university’s health sciences faculty. The study assessed the scale’s language equivalence, content validity, and factor structure through exploratory and confirmatory factor analyses. Reliability was examined via item-total correlations, Cronbach’s alpha coefficient, and test-retest reliability, indicating satisfactory internal consistency and stability over time. The results confirm the Turkish ATFMUS’s validity and reliability in measuring attitudes toward mask usage. This offers essential insights for formulating preventive initiatives within Turkish communities.

The COVID-19 pandemic brought different challenges to different populations. A less explored group was university students who generally suffered low mortality rates compared to other populations. Yet, they were affected by the psychological impact of lockdowns and limited access to education and socialization. This paper focuses on Slovakia, one of the least vaccinated EU countries. In November 2021 we conducted eight focus groups with 51 university students (45 women; 6 men; M = 23.67; SD = 3.43) and analyzed the data using reflexive thematic analysis. Our results identified the development of prevailing themes associated with COVID-19. Initially, COVID-19 was perceived as unreal but brought certain secondary benefits. We also identified themes of exaggerated disease, conspiracy, resignation, frustration, or adaptation to the disease. We divided the students into three groups based on their COVID-19 vaccine stance: accepting, hesitant, and rejecting. Insights from these groups could guide better communication strategies in the future.

The COVID-19 pandemic harmed children’s mental health, and limited therapy access exacerbates the issue. We studied positive expressive writing (EW) as a psychological intervention for teachers to reduce depression and social anxiety symptoms among schoolchildren. Altogether, 165 Chinese schoolchildren aged 10–15 were randomly assigned to positive EW, memory EW, or control group. EW groups wrote for 10 minutes weekly for 7 weeks about people and things they felt grateful for (positive EW) or memorable in the past week. The control group continued with regular weekly class meetings. All groups measured depression and social anxiety before and after the intervention. Positive EW significantly reduced depression and social anxiety symptoms compared to the control condition (both Cohen’s d = −0.45) and reduced social anxiety symptoms compared to memory EW (Cohen’s d = −0.32). Therefore, teachers can implement positive EW to support schoolchildren’s mental health recovery during and after disasters.

Regular testing using rapid antigen lateral flow tests (LFTs) was an important prevention strategy during the COVID-19 pandemic. However, falsification of home LFTs was a concern. Using a large quota-representative sample of adults (n = 1295) in England, we conducted a vignette survey consisting of four hypothetical scenarios of LFT falsification behaviours (FBs) to examine whether prosocial personality traits were associated with attitudes towards and intentions for falsifying home LFTs during the pandemic. Results show that higher levels of affective empathy for people vulnerable to COVID-19 and Honesty-Humility from the HEXACO model of Personality are associated with non-acceptability of LFT FBs and intentions to not engage with them. However, affective empathy explained more of the variation compared to the facet-level measures of Honesty-Humility for both attitude and intention. Public health communications aimed at encouraging personal protective behaviours should consider the role of empathy and prosocial messages.

In the context of the formidable challenges posed by the COVID-19 pandemic, healthcare professionals coped in various ways. This cross-sectional survey study sought to examine the protective role of satisfaction with life, sense of coherence, and resilience in the relationship between depression, social support, fear of COVID-19, and perceived vulnerability to disease among nurses in South Africa. Participants were a convenience sample of nurses (n = 264) working at four South African hospitals in the Western Cape. Data were collected by means of an electronic survey and analysed using structural equation modelling. Participants completed a comprehensive battery of psychological measures. We found that while higher levels of fear of COVID-19 robustly predicted depressive symptomology among nurses, factors such as sense of coherence, and social support emerged as protective resources. These protective factors have the potential to alleviate the mental health impacts of pandemic-related stressors among nurses.

This study examined relationships among lifetime trauma exposure, perceived social support, and anxiety during the first year of the COVID-19 pandemic. The sample included 246 diverse adults (59.8% women, M age = 44.39 [SD = 12.96]) living in Ohio who completed questionnaires on trauma exposure, perceived social support, and anxiety symptoms. Latent class analysis identified four distinct classes based on patterns of potentially traumatic event exposure: Low, Moderate-Low, Moderate, and High. Further analyses using the BCH method demonstrated that the High Exposure class was associated with significantly higher anxiety than other classes. Perceived social support buffered anxiety symptoms for the Low Exposure and Moderate-Low Exposure classes. This study highlights how trauma exposure impacts psychological and mental health in the context of a public health crisis and underscores the role of social relationships as a protective factor, with implications for trauma-informed mental health planning and programing to address disparities.

Living with diabetes has been linked with an increased prevalence of psychological distress. Psychological problems may interfere diabetes-related foot complication (DRFC) self-management. We aimed to characterise psychological functioning in DRFC, and identify clinical factors that may be associated with psychological problems. Eighty-one participants (mean age = 62.8, SD = 11.3, range = 30–87) with DRFC were recruited from The Royal Melbourne Hospital. Each participant completed a battery of psychological questionnaires. DRFC participants endorsed an elevated prevalence of depression, anxiety, post-traumatic stress and diabetes distress. There were also maladaptive personality traits, differences in emotion regulation skills and negative illness perceptions. Previous mental health disorder, higher HbA1C levels and diabetes-related complications were also associated with greater psychological symptoms. Elevated prevalence of psychological symptoms is apparent in DRFC. Our study highlights the need to use targeted interventions to address psychological difficulties to help DRFC patients cope better with their condition.

Type 2 diabetes (T2D) is a common, chronic condition. People with T2D often report poor mental wellbeing and treatment engagement, especially when stressed. Coping mechanisms may help manage stress, but it is crucial to identify which strategies are most common and (mal)adaptive. Using a psychometrically-informed approach and a series of pilot studies (n = 570) to develop and test the structural validity of a final item pool of coping strategies, a final study recruited 503 people with T2D through Prolific. Participants reported on coping, mental wellbeing (stress, anxiety and depressive symptoms), and treatment engagement (adherence, self-efficacy, A1C). All seven coping strategies (humor, self-blame, avoidance, support-seeking, positive mindset, religion/spirituality, and accessing resources) were psychometrically distinct and were associated with at least one indicator of treatment engagement, but fewer with wellbeing. After controlling for other variables, self-blame, avoidance, and positive mindset were the most robust predictors of both wellbeing and treatment engagement.

Type 2 diabetes patients often experience distress that adversely impacts their health-related quality of life (HRQoL). However, studies remain scarce on the pathways explaining the poor health outcomes. This study investigated the mediating link between diabetes distress (DD) and HRQoL through mindfulness and the moderating role of social support in this link. Utilizing a cross-sectional design, 276 type 2 diabetes patients completed measures of relevant variables. Results of moderated mediation analysis showed that social support moderated the mediating effect of mindfulness in the link between DD and HRQoL. Intervention may integrate mindfulness-based therapies with targeted support enhancements to improve patients’ health.

This study evaluated the hypothesis that positive emotions attenuate associations between negative emotions with adaptive coping and adherence, as well as explored evidence of the hypothesis of an indirect effect association between adaptive coping and adherence via positive emotions. The sample was 202 gbMSM with HIV who use substances (mean age [standard deviation] = 47.15 [12.26]; 34% Black, 14% Hispanic, and ≥50% with annual income ≤$20,000). Positive emotions were a moderator: negative emotions were not associated with approach coping at low positive emotions but were associated with more adaptive coping at high positive emotions (b = 0.32, p = 0.01). There was also an indirect effect association between adaptive coping with better adherence via high positive emotions (indirect effect: 0.29, 95% Confidence Interval = 0.004–0.39). Findings support the likely benefit of experiencing positive emotions, and investment in intensive longitudinal studies on how emotions, coping, and health behaviors are related to inform behavioral intervention development.

Some people living with HIV experience weight gain or loss after initiating or switching antiretroviral therapy (ART) regimens. There is limited research on how perceptions of weight change affect health behaviors in this population. We interviewed 61 people living with HIV (aged 23–65; 51% cisgender men, 36% cisgender women, 13% transgender/nonbinary; 87% Black and/or Hispanic) in New York City about their feelings about weight change. Using an inductive thematic approach, we identified four themes: weight changes were attributed to external and internal factors; weight management was seen as an individual responsibility; feeling in control of one’s health was linked to body image satisfaction; and one’s sense of control related to health behaviors in divergent ways. Low perceived control could interfere with recommended behaviors, but some long-term survivors focused on controlling what they could. Healthcare providers should consider HIV patients holistically and be aware of ART’s impact in their daily lives.

Men who have sex with men (MSM) living with HIV tend to experience a range of mental health issues, in particular generalised anxiety disorder (GAD), often caused and maintained by psychosocial variables including HIV stigma, discrimination, self-esteem issues, substance abuse and loneliness. This is particularly problematic in countries like Nigeria where same sex activity is illegal and can result in up to 14 years imprisonment. An important psychological variable that may contribute to the experience of GAD are metacognitive beliefs. Participants (N = 311) completed measures to examine the relationship between these variables. Results indicated that metacognition was associated with, and significantly predicted, GAD in this population. Moderation analysis showed that the effect of HIV stigma on GAD was explained by the proposed interaction with metacognition. Findings suggest that metacognition may be an important variable in explaining GAD symptoms in MSM living with HIV in Nigeria.

Extant literature has consistently documented the adverse impact of fear of COVID-19 on the health-related quality of life (HRQoL) of people living with HIV (PLWHIV), as they are more prone to being infected with this deadly disease than the normal population. However, studies on the mechanism that could mitigate this adverse impact are lacking. We investigated whether self-compassion could buffer the negative impact of fear of COVID-19 on HRQoL among PLWHIV. Utilizing a cross-sectional design, 241 outpatients (41.5% male, 58.5% female) from two Nigerian healthcare facilities were conveniently sampled. Results showed that heightened fear of COVID-19 was associated with poorer HRQoL across four domains. Unexpectedly, self-compassion neither predicted HRQoL nor buffered the impact of fear of COVID-19 on HRQoL. Practical interventions should prioritize reducing fear of COVID-19 and addressing broader psycho-social factors to enhance HRQoL in this vulnerable population.

The present study examined gender differences in attentional bias of body images. Using an experimental design, 58 young adults aged 18–29 years (mean age = 20.53) completed self-report measures of body satisfaction, eating pathology and trait appearance comparison before viewing whole body images of thin/muscular and large men/women through an eye tracker. After viewing the images, participants completed self-report measures of body satisfaction and state appearance comparison, BMI was also recorded. Results revealed that higher BMI was associated with reduced body satisfaction. Problematic eating attitudes were associated with greater engagement in appearance comparison, which was linked to lower levels of body satisfaction. Exposure to idealised body images negatively impacted individuals with lower body satisfaction leading to lower levels of body satisfaction post-experiment. Findings provide support for the positive association between body dissatisfaction and attentional bias to idealised bodies in both women and men in a Chinese context.

Nudging is a subtle behavioral intervention that has been successful in various domains such as healthy eating and energy conservation, yet its application in mental health remains underexplored. This study examines the effect of nudging to increase engagement with online mental health resources in a university setting. We assigned 2539 first-year undergraduate and graduate students in China to either a nudging group, which received course information augmented with behavioral cues (including framing effects and social norms), or a control group, which received only basic course information. Outcomes measured included self-reported willingness to enroll, willingness to recommend enrollment, and actual enrollment actions. Results indicated that students in the nudging group demonstrated significantly higher engagement levels than those in the control group across all metrics. These findings suggest the potential of nudging strategies to effectively enhance college students’ participation in online mental health education.

Neck dystonia is a neurological condition, characterised by involuntary movements of the neck muscles, causing twisted head positions and often pain and head tremor. Ten participants with neck dystonia were interviewed and the data was analysed using an Interpretative Phenomenological Analysis approach. Three themes were constructed: (1) dismissed by others for having an unfamiliar condition; (2) negotiating a new social identity; and (3) managing the stigma of a visible condition. It is proposed that psychological support could benefit people with neck dystonia who experience difficulties arising from identity management and stigma. Systemic interventions, such as education campaigns, are also proposed to help address stigmatising attitudes.

Venous leg ulcers have impact on people’s lives far beyond that of a skin lesion but these impacts have not been explored from an Indigenous perspective. We used a Māori-centered narrative approach to interview 13 Māori in Aotearoa New Zealand with venous leg ulcers. Data analysis was informed by a reflexive thematic approach and four themes were identified: Ko waewae ahau (I wear the leg); Ngā mea hōhā (annoying things); Ka tangi te ngākau (heartfelt grief); and Mamae (pain, sore, hurt). Recognizing patients’ expertise in their condition, the inclusion of whānau (family) in care planning and provision, while providing consistent advice and resource access, would all enhance the experience of venous ulcer management. Training in venous leg ulcer care needs to move beyond a focus on the leg and toward a more holistic approach that encompasses a broader understanding of patient experiences and cultural contexts when managing venous ulcers.

This study identified the control factors of inappropriate supplement intake to support public agencies in preventing health problems. We used an exploratory sequential mixed-method design with the integrated behavioral model (IBM). Control factors in the IBM were identified with 95 participants. The highest impact behavioral change was established for the following two out of 19 control factors: “I trust others’ blogs as a source of information when they post the bad as well as the good” (r = −0.324, p < 0.001) and “I can control any health problems by adjusting the amount and frequency of my supplement intake” (r = −0.308, p < 0.001). The findings suggest that when providing safety information on supplement use, it is important to: (1) disseminate information to online communities of supplement users who share knowledge based on real experiences and (2) effectively demonstrate the risks associated with continued supplementation.

Exercise is recommended for people with Parkinson’s (PwP) but clinical exercise-based interventions are generally ineffective. Social, cultural and environmental factors can influence exercise behaviours, but these topics are under-researched. We interviewed 18 PwP using a narrative approach to identify factors influencing their exercise behaviours throughout their lives. Thematic analysis identified three themes: (1) Why I exercise, (2) What helps and (3) Exercise with Parkinson’s. Participants had consistent core motivations to exercise: mood and well-being, body image, competition, and camaraderie. Having active partners, supportive work, and varied exercise options were among the important facilitators of long-term exercise. Participants believed strongly in the benefits of exercise for Parkinson’s, but experienced guilt about not exercising enough and frustration when symptoms made it harder to continue. This study illustrates how narrative interviews can reveal important social, cultural and environmental influences on exercise behaviour, offering potential to develop more individualised and effective exercise interventions.

Systemic lupus erythematosus (SLE) has a high detrimental impact on individuals’ quality of life. Identifying key factors associated with SLE adjustment is crucial for intervention development, yet there is no previous research exploring the perspectives of individuals with SLE regarding illness adjustment’ facilitating or hindering factors. In this qualitative study, 16 individual semi-structured interviews with Portuguese adults with SLE (13 women) were conducted to explore perceived facilitators and barriers to illness adjustment. A reflexive thematic analysis revealed that efforts toward maintaining a normal life, optimism, keeping engaged in meaningful activities, accessing reliable illness-related information, and having supportive relationships were core facilitators of SLE adjustment. Main barriers included inability to maintain normality, engaging in excessive activity, pessimism, being unsupported or stigmatized, and not having access to reliable illness-related information. These findings unveil potential targets for psychosocial and behavioral interventions aimed at enhancing the quality of life for individuals with SLE.

Peritoneal mesothelioma is a rare life-limiting cancer that is likely to have an extremely negative impact on mental health; however, no studies to date have explored the impact and needs of those living with the condition. Ten individuals diagnosed with peritoneal mesothelioma (eight women, two men) participated in interviews and could share and discuss photographs to convey their illness experiences. Data analysis was informed by Interpretative Phenomenological Analysis. Two themes are presented: ‘Experiences of Care’ and ‘Psychological Distress’. Individuals experienced a lengthy diagnostic journey with little follow-up support. Women also reported negative impacts on body image due to abdominal swelling and scaring, diminished sexual ability and loss of fertility. Individuals recalled vivid feelings of anxiety and post-traumatic stress, and tried to cope by compartmentalising their fears and modifying diets. These findings demonstrate the need to further signpost services, help individuals manage gendered issues, and alleviate feelings of anxiety.

Several factors influence the adoption of health-protective behaviors, including anticipatory affective reactions like regret. The ability to anticipate regret matures with age, allowing individuals to make increasingly risk-averse decisions. This study examined the relationship between age and the adoption of health-protective behaviors to limit the spread of a virus from adolescence to adulthood, and the mediating effect of anticipated regret. A total of 410 French participants, aged 14–58, reported their compliance with health-protective behaviors (e.g., using surgical masks, handwashing, social distancing), along with their anticipated regret in the event of non-adherence to such behaviors leading to the contamination of themselves or others. The findings revealed that both the adoption of these behaviors and anticipated regret increased with age. Moreover, anticipated regret mediated the effect of age on health-protective behavior, encouraging higher compliance with preventive measures and reducing risk-taking.

Adolescents with type 1 diabetes (T1D) have elevated eating disorder risk. No studies have examined weight stigma as a potential factor associated with disordered eating. This study investigated cross-sectional associations among weight-based victimization, weight bias internalization, and disordered eating in adolescents with T1D. Adolescents (12–17 years; N = 166) self-reported experiences of weight-based victimization from peers, family members, and healthcare professionals. The Weight Bias Internalization Scale (WBIS) and Diabetes Eating Problems Survey (DEPS-R) assessed internalized weight bias and disordered eating, respectively. In a series of multiple hierarchical linear regression analyses (controlling for zBMI, diabetes duration, HbA1c, sex), weight bias internalization, weight-based victimization, and frequency of weight-based victimization by peers, family, and healthcare professionals were all positively associated with disordered eating. Weight stigma is an understudied but potentially important factor to address in adolescents with T1D. Reducing weight stigma may be a promising, novel target for eating disorder prevention in this population.

To examine the levels of patient self-advocacy in a sample of participants with Chiari Malformation (CM) and to explore how they relate to clinical outcomes. As part of a larger clinical trial addressing chronic pain in patients with CM, 111 participants completed the Patient Self Advocacy Scale (PSAS), the Depression, Anxiety, and Stress Scale (DASS-21), and the Brief Pain Inventory (BPI). PSAS scores indicated a moderately high level of patient self-advocacy (Mean = 3.86 SD = 0.50). The PSAS was not related to depression, anxiety, stress, pain intensity, or pain interference. There were no differences in PSAS according to surgical status (t(61.25) = 0.44, p = 0.66) or use of pain medication (t(109) = 1.05, p = .29). Participants in a clinical trial for CM have high levels of pre-existing patient self-advocacy. Research is needed to understand how patient self-advocacy contributes to the management of CM and how it could impact research of individuals with understudied conditions.