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JMIR Research Protocols Jul 2023Anxiety and alcohol use commonly co-occur. Previous research has demonstrated the bidirectional and mutually reinforcing nature of this relationship, with an increasing...
BACKGROUND
Anxiety and alcohol use commonly co-occur. Previous research has demonstrated the bidirectional and mutually reinforcing nature of this relationship, with an increasing body of research investigating the mediating and moderating mechanisms driving this association. Within the existing mediation and moderation research, however, there have been contrasting findings and, at times, null results among some population groups.
OBJECTIVE
This protocol outlines a systematic review and meta-analysis aiming to synthesize and clarify mediators and moderators in the anxiety-alcohol and alcohol-anxiety relationships.
METHODS
Systematic searches will be conducted in the electronic databases Medline, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science to identify studies that investigated mediators and moderators of the relationship between anxiety and alcohol use, including clinical and subclinical levels. Studies that look at the relationship between anxiety and alcohol use outcomes, as well as alcohol use and anxiety outcomes, will be included in order to capture an in-depth understanding of the mechanisms driving the association in either direction. No limits will be placed on study year or study language. Included study designs will be observational studies, including cohort, cross-sectional, and longitudinal studies, and secondary analyses of randomized controlled trials reporting quantitative results. Selected studies will also have their reference lists hand-searched for other relevant papers. Study quality will be assessed with the Joanna Briggs Institute Checklists for Analytical Cross-Sectional Studies and Cohort Studies. Mediators and moderators will be narratively synthesized in line with the biopsychosocial framework, where results will be grouped into biological, psychological, and social or environmental factors. If the data are sufficiently homogeneous, a meta-analysis will be conducted with mediation and moderation analyses synthesized separately. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework will also be used to assess the strength of cumulative evidence.
RESULTS
Electronic database searches were conducted in September 2022. After duplicates were removed, a total of 7330 titles and abstracts were screened. Full-text reviewing is currently under way, with the results expected to be available by the end of 2023.
CONCLUSIONS
Given the significant individual and societal impacts of co-occurring anxiety and alcohol use, this review will help clarify mechanisms linking these two concerns. Identified mechanisms, where possible, can then be targeted in prevention, early intervention, and treatment approaches to improve the outcomes for individuals experiencing co-occurring anxiety and alcohol use.
TRIAL REGISTRATION
PROSPERO CRD42023358402; https://tinyurl.com/2m2e3enp.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/48875.
PubMed: 37440283
DOI: 10.2196/48875 -
BMC Psychiatry Jan 2020The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the...
BACKGROUND
The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association.
METHODS
Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model.
RESULT
Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope.
CONCLUSION
We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.
Topics: Depression; Female; Hope; Humans; Male; Quality of Life; Resilience, Psychological; Schizophrenia; Surveys and Questionnaires
PubMed: 31941476
DOI: 10.1186/s12888-020-2436-5 -
Child Abuse & Neglect Apr 2023Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and...
INTRODUCTION
Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and sequelae of abuse supporting gender-specific analyses. To assist in circumventing poor outcomes associated with child abuse, this study examined fear of self (FoS) and self-compassion (SC) as risk and protective factors between child abuse and well-being.
METHOD
Australian women (N = 1302, M = 47.28 [13.63]) completed an online assessment of childhood abuse, psychological distress, perceived quality of life, SC, FoS. Moderated-moderation examined the different abuses as predictors of psychological distress and quality of life (QoL) and FoS and SC as primary and secondary moderators, respectively.
RESULTS
Physical abuse did not predict psychological distress or QoL. FoS and SC were independent predictors of distress and QoL. Similarly, childhood sexual abuse was not found to predict distress or QoL. FoS and SC were independent predictors of distress and QoL. There was also an interaction between childhood sexual abuse and SC in predicting QoL. A moderated-moderation was found for the relationship between child sexual abuse and distress. Psychological abuse predicted distress and QoL, and FoS and SC both moderated this relationship. Moreover, a moderated-moderation was observed for the relationship between psychological abuse and QoL.
CONCLUSIONS
Greater FoS is associated with poorer outcomes for child abuse survivors; SC may mitigate this impact. Psychological abuse was the strongest predictor of well-being. Interventions that increase SC and raise awareness of psychological abuse and its impacts are needed.
Topics: Male; Humans; Female; Child; Middle Aged; Quality of Life; Self-Compassion; Australia; Child Abuse; Fear; Child Abuse, Sexual
PubMed: 36764171
DOI: 10.1016/j.chiabu.2023.106089 -
International Journal of Environmental... Nov 2022Smartphone addiction (SPA) is prevalent in college students and harms their healthy development, and perceived stress (PS) has been a well-documented risk factor of SPA....
Smartphone addiction (SPA) is prevalent in college students and harms their healthy development, and perceived stress (PS) has been a well-documented risk factor of SPA. People often experienced boredom during COVID-19; however, its effect on behavioral/mental health during the pandemic has been rarely tested. We investigated the prospective association between SPA and PS before and during COVID-19, as well as the moderation of boredom. A total of 197 college students participated in four-wave surveys from December 2018 to June 2020 in China. The cross-lagged model was developed to investigate the prospective association between SPA and PS from T1 to T4. Boredom was added to the model at T4 as a moderator to explore the moderating role of boredom during COVID-19. The results showed that the pandemic changed PS's prediction on SPA. During COVID-19, boredom significantly affected SPA and PS and moderated the link from PS at T3 to PS at T4. The results suggest that the prospective associations between SPA and PS varied before and during COVID-19. Prevention of SPA should be conducted for new students and should be used to enhance their stress coping capacity. Intervention programs for eliminating boredom may be effective for reducing stress and SPA during COVID-19.
Topics: Humans; Boredom; Internet Addiction Disorder; COVID-19; China; Stress, Psychological
PubMed: 36430074
DOI: 10.3390/ijerph192215355 -
BMC Psychiatry Dec 2022According to data from the National Health Commission in 2018, more than 30 million children and adolescents in China suffered from mental health problems of varying...
BACKGROUND
According to data from the National Health Commission in 2018, more than 30 million children and adolescents in China suffered from mental health problems of varying degrees, with depression accounting for the largest proportion. Life events occur at every stage of child and adolescent development. Many studies have found a relationship between life events and depression in children and adolescents, but few studies have further explored the mediating and moderating variables that influence this relationship. Based on theoretical and empirical research on social support and cognitive styles, this study established a two-stage moderated mediating model to test whether social support mediates life events to depression, and cognitive style moderates the two mediating pathways.
METHODS
We recruited 3540 participants from primary and secondary schools in Chongqing and collected 2814 valid data. All the participants completed self-report measures of life events, depression, social support and cognitive styles. The moderated mediation model was examined using SPSS PROCESS model 58.
RESULTS
(1) There were significant positive correlations between life events and depression. (2) Social support mediates the relationship between life events and depression in children and adolescents. (3) Cognitive style moderates life events to social support and social support to depression.
LIMITATIONS
This is a cross-sectional study and the questionnaire is self-reported.
CONCLUSIONS
In children and adolescents, life events can influence depression through the mediating role of social support and cognitive styles could moderate its two mediating pathways.
Topics: Humans; Child; Adolescent; Depression; Cross-Sectional Studies; Social Support; China; Cognition
PubMed: 36544175
DOI: 10.1186/s12888-022-04454-5 -
Integrative Cancer Therapies 2023We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant characteristics, research methodologies, and features of interventions.
METHODS
We systematically searched 12 databases through November 2022 without date restrictions using the following search terms: (mindful* or meditation) AND (cancer OR neoplasm) AND (depress*). Studies included were primary studies evaluating MBIs in women with breast cancer who also had depression. Studies were included if they used a control group and were written in English. We used a random-effects model to compute effect sizes (ESs) using Hedges' g, forest plot, and Q and statistics as measure of heterogeneity. We also requested moderator analyses.
RESULTS
We found 19 studies with 2139 participants (49.4 ± 8.3 years old) that met inclusion criteria for this meta-analysis and systematic review. Overall, women in MBI groups demonstrated significantly lower levels of depression ( = 0.48, 95% CI:0.159, 0.792, < .001) compared to women in control groups. Regarding moderators, providing MBIs with a home assignment component showed a significantly greater effect on decreasing depressive symptoms ( = 1.75) compared to MBIs without a home assignment component ( = 0.20). When researchers used concealed allocation technique, the interventions demonstrated lower effects on depression than when concealed allocation ( = 0.11vs = 1.33, ≤ .001) was not reported. Additionally, when researchers reported high rates of sample attrition, they found a lower effect size on depression (β = -.019, = 3.97, = .046) indicating that attrition moderates the effect.
CONCLUSION
MBIs are moderately effective interventions to reduce depressive symptoms among women with breast cancer. Clinicians might consider encouraging MBIs as adjunct/alternative treatments for women with breast cancer to manage symptoms of depression. Interventions that incorporat home assignments for practicing mindfulness are likely to have a greater effect on reducing depressive symptoms. Additionally, methods including concealed allocation and attrition rate were moderators of the effects of MBIs on depression in women with breast cancer.
Topics: Adult; Female; Humans; Middle Aged; Breast Neoplasms; Depression; Meditation; Mindfulness; Southern African People
PubMed: 38140816
DOI: 10.1177/15347354231220617 -
The Gerontologist Sep 2020We examined whether technology-mediated communication has functional or emotional equivalence to face-to-face (FtF) contact in familial relationships, by scrutinizing...
BACKGROUND AND OBJECTIVES
We examined whether technology-mediated communication has functional or emotional equivalence to face-to-face (FtF) contact in familial relationships, by scrutinizing the effects of phone, text/e-mail, and video contact on isolation and loneliness.
RESEARCH DESIGN AND METHODS
We tested whether FtF contact with a relative would mediate the pathway between proximity to family and (i) isolation and (ii) loneliness. We then tested hypotheses that telephone, text/e-mails, and video contact would moderate this mediated pathway. We compared models for younger (<75) and older (≥75) cohorts, expecting to observe moderation effects for text/e-mail and video contact in the younger cohort only. Data were drawn from Wave 2 of CFAS Wales (United Kingdom) study (N = 2,099).
RESULTS
Proximity to a relative had a significant indirect effect on isolation and loneliness through the mediating variable FtF contact. Phone and text/e-mail contact moderated the effect of FtF contact on isolation for all samples. None of the technologies moderated the impact of FtF contact on loneliness for the full sample. Telephone contact had a moderating influence on loneliness for the younger cohort only. Video calls had no significant moderation effect.
DISCUSSION AND IMPLICATIONS
Telephone and text/e-mail contact have functional equivalence to FtF contact in familial relationships. None of the forms of technological communication have emotional equivalence to the "gold standard" of embodied presence. The study demonstrates the importance of theorizing about the pathways to isolation and loneliness to better understand the likelihood of implementing successful interventions using technology-mediated communication within families.
Topics: Communication; Family Relations; Humans; Loneliness; Social Isolation; Technology; United Kingdom
PubMed: 32369112
DOI: 10.1093/geront/gnaa040 -
Journal of Medical Internet Research Mar 2020Individuals in stressful work environments often experience mental health issues, such as depression. Reducing depression rates is difficult because of persistently... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Individuals in stressful work environments often experience mental health issues, such as depression. Reducing depression rates is difficult because of persistently stressful work environments and inadequate time or resources to access traditional mental health care services. Mobile health (mHealth) interventions provide an opportunity to deliver real-time interventions in the real world. In addition, the delivery times of interventions can be based on real-time data collected with a mobile device. To date, data and analyses informing the timing of delivery of mHealth interventions are generally lacking.
OBJECTIVE
This study aimed to investigate when to provide mHealth interventions to individuals in stressful work environments to improve their behavior and mental health. The mHealth interventions targeted 3 categories of behavior: mood, activity, and sleep. The interventions aimed to improve 3 different outcomes: weekly mood (assessed through a daily survey), weekly step count, and weekly sleep time. We explored when these interventions were most effective, based on previous mood, step, and sleep scores.
METHODS
We conducted a 6-month micro-randomized trial on 1565 medical interns. Medical internship, during the first year of physician residency training, is highly stressful, resulting in depression rates several folds higher than those of the general population. Every week, interns were randomly assigned to receive push notifications related to a particular category (mood, activity, sleep, or no notifications). Every day, we collected interns' daily mood valence, sleep, and step data. We assessed the causal effect moderation by the previous week's mood, steps, and sleep. Specifically, we examined changes in the effect of notifications containing mood, activity, and sleep messages based on the previous week's mood, step, and sleep scores. Moderation was assessed with a weighted and centered least-squares estimator.
RESULTS
We found that the previous week's mood negatively moderated the effect of notifications on the current week's mood with an estimated moderation of -0.052 (P=.001). That is, notifications had a better impact on mood when the studied interns had a low mood in the previous week. Similarly, we found that the previous week's step count negatively moderated the effect of activity notifications on the current week's step count, with an estimated moderation of -0.039 (P=.01) and that the previous week's sleep negatively moderated the effect of sleep notifications on the current week's sleep with an estimated moderation of -0.075 (P<.001). For all three of these moderators, we estimated that the treatment effect was positive (beneficial) when the moderator was low, and negative (harmful) when the moderator was high.
CONCLUSIONS
These findings suggest that an individual's current state meaningfully influences their receptivity to mHealth interventions for mental health. Timing interventions to match an individual's state may be critical to maximizing the efficacy of interventions.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03972293; http://clinicaltrials.gov/ct2/show/NCT03972293.
Topics: Female; Humans; Internship and Residency; Male; Telemedicine
PubMed: 32229469
DOI: 10.2196/15033 -
Journal of Clinical Child and... 2021: This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information... (Review)
Review
: This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information on "for whom" a specific treatment may work best.: We used Google Scholar, PubMed, PsycInfo, and manual search of relevant reference lists to identify eligible peer-reviewed publications from January 2005 to December 2019.: We summarize 21 published studies (including meta-analyses, randomized clinical trials, and correlational work) testing moderators and/or predictors of adolescent SUD treatment outcomes. Conclusions are, thus, limited by the relatively small number of studies. Results suggest that, for adolescents with co-occurring externalizing pathology or those higher in SUD severity, more intensive treatment appears to be more effective. Other findings were often inconsistent (e.g., examining sex or race/ethnicity as a moderator) between studies, making it challenging to provide clear recommendations for personalizing SUD treatment choice.: Future research may need to shift focus from exploring often unchangeable moderators (e.g., race/ethnicity) to factors that are potentially modifiable with treatment. Additionally, testing models that include mediators of treatment effects-that is, factors that help to explain "how" treatment works-along with moderators (moderated-mediation) may provide the most benefit in understanding both "for whom" and "how" to tailor SUD treatment to optimally meet an adolescent's personal needs.
Topics: Adolescent; Humans; Substance-Related Disorders
PubMed: 32716211
DOI: 10.1080/15374416.2020.1790379 -
Annals of Behavioral Medicine : a... Nov 2021Everyday discrimination holds pernicious effects across most aspects of health, including a pronounced stress response. However, work is needed on when discrimination...
BACKGROUND
Everyday discrimination holds pernicious effects across most aspects of health, including a pronounced stress response. However, work is needed on when discrimination predicts sleep outcomes, with respect to potential moderators of these associations.
PURPOSE
The current study sought to advance the past literature by examining the associations between everyday discrimination and sleep outcomes in an ethnically diverse sample, allowing tests of moderation by ethnic group. We also examined the role of sense of purpose, a potential resilience factor, as another moderator.
METHODS
Participants in the Hawaii Longitudinal Study of Personality and Health (n = 758; 52.8% female; mage: 60 years, sd = 2.03) completed assessments for everyday discrimination, sleep duration, daytime dysfunction due to sleep, sleep quality, and sense of purpose.
RESULTS
In the full sample, everyday discrimination was negatively associated with sleep duration, sleep quality, and sense of purpose, while positively associated with daytime dysfunction due to sleep. The associations were similar in magnitude across ethnic groups (Native Hawaiian, White/Caucasian, Japanese/Japanese-American), and were not moderated by sense of purpose, a potential resilience factor.
CONCLUSIONS
The ill-effects on health due to everyday discrimination may operate in part on its role in disrupting sleep, an issue that appears to similarly impact several groups. The current research extends these findings to underrepresented groups in the discrimination and sleep literature. Future research is needed to better disentangle the day-to-day associations between sleep and discrimination, and identify which sources of discrimination may be most problematic.
Topics: Ethnicity; Female; Humans; Longitudinal Studies; Male; Sleep; Sleep Quality; White People
PubMed: 33760911
DOI: 10.1093/abm/kaab012