OBJECTIVES:Breast cancer (BC) remains the most diagnosed cancer among women worldwide and its growing survivorship population faces numerous long-term physical and psychological challenges. Cancer support groups emerge as promising interventions to promote comprehensive management of the disease and survivorship needs, emotional well-being and social connection. Accordingly, this study aimed to analyse the acceptability and perceived impact of the Mind Support Group (MSG), a professionally led support group intervention designed for women with BC. DESIGN:A qualitative methodological approach was used to collect and analyse data. METHODS:Participants' feedback data were collected through a guided feedback discussion during the MSG final session and analysed using content and thematic analysis. RESULTS:The sample comprised 22 women diagnosed with BC (stages I-III). Findings showed high acceptability, with participants expressing satisfaction with several aspects of the intervention: interpersonal processes, content, group composition and perceived outcomes. Suggestions for improvement focused exclusively on the intervention dose (e.g., earlier access) and format (e.g., in-person delivery). Mechanisms of change and perceived outcomes also emerged from participants' feedback. Through social (e.g., shared information and experience), behavioural (e.g., self-disclosure) and psychological (e.g., emotional tension release) mechanisms, the MSG appeared to facilitate shifts toward more adaptive coping strategies, personal growth, a reduction in perceived isolation and alienation, and improved communication and self-management skills. CONCLUSIONS:These findings suggest that the MSG may serve as a valuable complement to medical treatment or, at minimum, inform the design of more comprehensive cancer care interventions integrating psychosocial support across the illness trajectory. TRIAL REGISTRATION:NCT05642897; NCT06212414.
OBJECTIVES:Individuals with visible differences often experience appearance-related stigma and discrimination, reinforced by negative media portrayals. In contrast, positive portrayals may challenge stereotypes and promote acceptance. This study examined whether exposure to positive, negative or neutral images of visible difference influences appearance-related stigma, body appreciation and broad conceptualizations of beauty. It was hypothesized that positive images would decrease stigma and increase body appreciation and broad conceptualizations of beauty, whereas negative images would increase stigma and reduce broad conceptualizations of beauty. DESIGN:An online randomized controlled experiment using a mixed repeated-measures design compared three conditions (positive, negative, neutral) across pre- and post-exposure. METHODS:A sample of 103 adults viewed 10 images of individuals with visible differences presented in one of three conditions: positive (positive captions), negative (villains with visible differences and negative captions) or neutral (without captions). Participants completed pre- and post-measures of appearance-related stigma, body appreciation and broad conceptualizations of beauty. Repeated-measures ANOVAs examined within- and between-group changes. RESULTS:Appearance-related stigma significantly increased in the negative condition, while remaining unchanged in the positive and neutral groups. Body appreciation significantly increased from pre- to post- across all conditions. No significant effects emerged for broad conceptualizations of beauty. CONCLUSIONS:Negative portrayals of visible difference may reinforce stigma, highlighting the need to discourage such depictions in media. While positive exposure did not significantly reduce stigma, viewing images of visible difference increased observers' body appreciation, indicating potential downward social comparison. Future research should explore strategies to strengthen stigma reduction and broaden conceptualizations of beauty.
OBJECTIVES:Discrepancies between self-rated health (SH) and physical health (PH) are linked to physical and psychological health outcomes in older adults. We investigate whether such discrepancies are also associated with self-reported overnight hospitalizations. DESIGN:A prospective, observational cohort design. METHODS:We followed 4373 older adults aged ≥60 years over a 6-year period in the Health and Retirement Study (2016-2022). Health asymmetry scores were computed by regressing baseline SH onto PH and extracting the residuals, reflecting the degree to which SH deviates from PH. Zero-inflated negative binomial mixed models, including a random intercept term, tested whether health asymmetry scores predicted (1) any overnight hospitalization and (2) the cumulative number of nights spent in hospital, adjusting for SH, PH and covariates. RESULTS:Over a 6-year follow-up, 55.34% of participants self-reported at least one overnight hospital stay. Higher health asymmetry scores (i.e., greater health optimism, where SH exceeded PH) were significantly associated with a lower expected number of nights spent in hospital (incidence ratio rate: 0.80; 95% confidence interval: 0.72, 0.89; p < .001), independent of SH and PH. However, health asymmetry was not significantly associated with the probability of belonging to the 'never hospitalized' group, in the zero-inflation component. CONCLUSIONS:Discrepancies between SH and PH predict the intensity of self-reported hospital use above and beyond SH and PH alone. Although health asymmetry did not distinguish those, who were never hospitalized, older adults' interpretations of their health still carry prognostic value and may represent an important psychosocial determinant of health care utilization.
OBJECTIVES:Despite a growing evidence base indicating that trait procrastination increases risk for specific outcomes reflecting poor health, there is less evidence examining the implications of procrastination for overall health status, or investigating the contributing factors involved. Guided by the cognitive process model of self-rated health (SRH), and the procrastination-health model, the current study extended previous research and theory by quantifying the link between trait procrastination and SRH across multiple samples and testing the contributions of stress. Additionally, we explored the link between chronic procrastination and the SRH-future SRH discrepancy. METHODS:Thirty-six cross-sectional samples (N = 8603) completed measures of trait procrastination, current and future SRH. A subset completed measures of perceived stress. Random effects meta-analyses were conducted on the raw and semi-partial correlations of procrastination with SRH and FSRH, controlling for perceived stress. Moderator analyses were conducted where warranted. Procrastination scores were examined in relation to the discrepancy between current and future SRH. RESULTS:Trait procrastination was significantly associated with poor SRH (ravg = .21; 95% CIs [.19, .23]), and to a lesser extent, poor future SRH (ravg = .13; 95% CIs [.09, .18]). The semi-partial effects were reduced but significant for SRH, and non-significant for future SRH. Procrastination was modestly associated with the discrepancy between current and future SRH, reflecting an expectation that health would improve slightly over the next 10 years. CONCLUSIONS:The current findings indicate that chronic procrastination is associated with poor overall health status that can be explained in part by higher levels of stress.
OBJECTIVES:This research aimed to explore whether Adverse Childhood Experiences (ACEs) shape adults' engagement with cancer services, including satisfaction with care and whether services reflect trauma-informed principles. DESIGN:Mixed-method sequential explanatory design. Stage one used a cross-sectional online survey; stage two comprised semi-structured interviews informed by the survey findings. METHODS:Survey responses (N = 266) were analysed using descriptive statistics, correlations and mediation analysis. Qualitative data used inductive-deductive reflexive thematic analysis, guided by the Substance Abuse and Mental Health Services Administration trauma-informed care (TIC) framework. RESULTS:Childhood trauma was moderately negatively correlated with patient satisfaction (r = -.40), with illness perceptions mediating this relationship. Thematic analysis yielded four themes relating to experiences of cancer care: (1) 'Connecting the dots': Resonance of childhood memories and current experiences. (2) 'Nobody ever told me': Powerlessness & cancer-related losses. (3) 'I just wanted everyone else around me to be okay': Distributed effects of cancer through the social network. (4) 'It's down to bedside manner': Patient satisfaction is shaped by relational care. Patients only made connections back to their childhood trauma in Theme 1. CONCLUSIONS:Findings suggest ACEs may influence cancer care satisfaction through illness perceptions, supporting the clinical relevance of trauma-informed approaches to the cancer population. While the interview findings do not conclusively support this, it remains a significant clinical consideration that cancer services in the UK may benefit from adjustments to incorporate TIC for the UK cancer population.
OBJECTIVES:Congenital melanocytic naevi (CMN) and arteriovenous malformations (AVM) are rare, severe and incurable birthmark conditions associated with lifelong visible difference and complex medical needs. Despite the importance of early health care experiences for parental and child adjustment in general, these remain unexplored in this context. This study aimed to explore parental experiences of raising a child with rare severe birthmarks, the role of specialist care in parental adjustment, and to develop recommendations for clinical care. DESIGN:Reflective thematic analysis (RTA) was used to analyse semi-structured narrative-style interviews conducted with 23 parents of children aged ≤12 years recruited sequentially from a specialized NHSE Rare Disease Collaborative Network (RDCN) outpatient clinic in London, UK. METHODS:Interviews were conducted virtually via telephone or Zoom and analysed using RTA using NVivo software (version 13). Reflexivity was achieved through the keeping of a reflexive journal and debriefing with the research team. RESULTS:Through RTA, three themes were generated which highlight the challenges faced by parents of children with rare birthmarks. Firstly, parents' experiences before coming to the first appointment, secondly 'learning to belong' in the health care system and thirdly 'making room' for the condition. These themes and respective subthemes provide new insights into the importance of specialist centres in relation to parental adjustment to rare birthmarks. CONCLUSIONS:Findings underscore the pivotal role of specialist care in parental adjustment to rare, appearance-altering conditions. Practical care recommendations are presented to support families across care pathways.
OBJECTIVES:Self-rated health (SRH) is a widely used measure of health, but debate persists over how its subjective component should be interpreted. This study tests whether dispositional optimism reflects a time-stable source of subjectivity in SRH or an adaptive evaluative filter through which changing health is interpreted. DESIGN:Using longitudinal data from the US Health and Retirement Study, 16,902 adults aged 50+ were analysed with threshold-specific latent growth curve models. SRH was modelled across four positive-health thresholds: 'Excellent,' 'Very Good+,' 'Good+' and 'Fair+.' Stable optimism was examined as a predictor of SRH persistence, H1, and as a moderator of health changes, including depressive symptoms, new diagnoses, mobility limitations and ADLs, H2. RESULTS:Stable optimism significantly predicted higher odds of positive SRH across thresholds per H1. Evidence for H2 was insufficient: optimism did not consistently weaken the association between worsening health and lower odds of positive SRH. SRH remained responsive to depressive symptoms, chronic conditions and functional limitations across thresholds. CONCLUSION:Optimism contributes to SRH primarily as a stable evaluative anchor rather than as a consistent buffer against health decline. SRH's subjectivity should not be read merely as unreliable; it appears internally structured enough to be interpreted alongside observed health indicators.
OBJECTIVES:People with type 2 diabetes (T2DM) are more likely to develop breast and bowel cancers. Despite this, cancer screening participation is lower among women with diabetes than among women without diabetes, indicating diabetes-related barriers to screening, but little research has examined this. This study aimed to identify and understand diabetes-related barriers to cancer screening, and potential ways to address these, among women with T2DM. DESIGN:In-depth qualitative interviews. METHODS:Semi-structured interviews with 25 women with T2DM, aged 50 to 74 years, living in England. Participants were recruited via diabetic eye screening clinics and community advertisement. Data were analysed to develop themes, using the framework method. RESULTS:Women with T2DM were often living with an accumulated high burden of illness and its treatment, due to diabetes and comorbidities, which reduced their capacity to participate in cancer screening (e.g. physical and psychological capacities; practical resources). Having diabetes could complicate taking part in screening tests for some people (e.g. physical difficulties during screening related to diabetes, its treatment, complications or comorbidities; having to consider glycaemic control during appointments). There appeared to be underappreciation of the T2DM-increased risk of cancer, and limited cancer screening promotion within diabetes care. CONCLUSIONS:Despite self-reported cancer screening uptake being high among study participants, having diabetes appeared to heighten common barriers to cancer screening (e.g. travel-related, logistical and scheduling barriers), whilst also posing additional unique barriers (e.g. diabetes-related stigma and embarrassment). Several potential strategies are suggested to improve cancer screening informed decision-making and participation among people with T2DM.
OBJECTIVES:Despite the important role partners of those who have received metabolic and bariatric surgery (MBS) play, research on their experiences is limited, often concentrating on the couple as a whole rather than on the partner specifically. Additionally, much of this research relies on quantitative methods that offer less opportunity for in-depth exploration. This qualitative study therefore aimed to investigate the experiences of current or previous partners of people who have had MBS. DESIGN:Current partners of people who have had MBS (N = 10) participated in semi-structured interviews. METHODS:The data were analysed using an inductive approach to reflexive thematic analysis. RESULTS:Three main themes were derived from the data: Adjusting to a Changing Partner, Navigating an Evolving Relationship and Becoming a Better Version of Myself as a Partner. CONCLUSIONS:Partners can struggle with changes after MBS, which can impact their relationship in both positive and negative ways. They find it easier to provide support if they have been involved in the decision-making process before surgery and viewed it as a 'tandem' journey. These findings underscore the need to include partners pre- and post-MBS and for psychoeducational interventions to help partners navigate the stresses that MBS can place on their relationship.
INTRODUCTION:The Healthy Gut Diet Study (HGD) was a pilot randomized controlled trial aiming to prevent gestational diabetes mellitus (GDM) through a gut-friendly diet from early to mid-pregnancy (11-18 weeks' gestation). The intervention was co-designed with women with a lived experience of GDM and incorporated behaviour change techniques to support adherence to gut-friendly dietary habits. This study aimed to investigate the enablers and barriers women faced in initiating and maintaining dietary behaviour changes during and after pregnancy. METHODS:This qualitative study used semi-structured interviews with women 12 weeks postpartum who had been randomized to the intervention arm of the HGD study. Themes and subthemes were identified through an inductive reflexive thematic analysis. These were subsequently deductively mapped to the Theoretical Domains Framework, the COM-B model/the Behaviour Change Wheel and specific Behaviour Change Techniques. RESULTS:Seventeen interviews were conducted with participants with a mean age of 33 (SD 4.9) years, and 30% of whom were first-time mothers. Five key themes were generated: (1) Empowering for Autonomy, (2) Building confidence and Competence, (3) Creating Capacity, (4) Navigating Physical Realities and (5) Sustaining Momentum. These themes each had their own descriptive sub-themes. CONCLUSIONS:Pregnancy can serve as a "teachable moment" for dietary behaviour change, but sustainable behaviour change requires the use of person-centred care, access to credible education, early initiation, continuous reinforcement and shared social support.
OBJECTIVES:To develop and validate a comprehensive treatment adherence questionnaire grounded in the theory of planned behaviour (TPB) for patients with end-stage renal disease (ESRD) undergoing haemodialysis in Pakistan. DESIGN:An exploratory sequential mixed-method design was employed, comprising qualitative item generation followed by quantitative scale validation. METHODS:Phase 1 involved qualitative exploration for item development through an extensive literature review and four focus group discussions. An initial pool of 130 items was generated, which was refined through expert evaluation and redundancy removal, resulting in 87 Likert-type items. Phase 2 consisted of exploratory factor analysis (EFA) conducted on data from 350 purposively recruited ESRD patients to identify the underlying factor structure. In Study 2, confirmatory factor analysis (CFA) was performed on an independent sample of 300 patients to confirm the model and evaluate psychometric properties. RESULTS:EFA revealed four adherence domains: medication, fluid, diet and haemodialysis, aligned with TPB components including attitude, subjective norms, perceived behavioural control and intentions. CFA demonstrated good model fit indices, and all items showed strong factor loadings, supporting structural validity. Internal consistency was satisfactory with Cronbach's alpha values above .70. Convergent validity was confirmed with average variance extracted values above .50, while discriminant validity was supported as AVE exceeded maximum shared variance. CONCLUSION:The TPB-based treatment adherence questionnaire for ESRD is a reliable and valid instrument for assessing adherence behaviours among haemodialysis patients. It offers a theory-driven tool with strong potential for research and clinical interventions aimed at improving treatment adherence.
OBJECTIVES:This study examined daily associations between experiencing health-related social control (persuasion and pressure) from a close other and moderate-to-vigorous physical activity (MVPA), smoking abstinence, reactance-related behaviours (oppositional behaviour), and positive and negative affect. Additionally, we investigated whether daily and person-mean preference for self-reliance moderated these associations. DESIGN:A secondary analysis of two 21-day daily-diary studies was conducted: one tracked MVPA in patients after cardiac rehabilitation (n = 137), and another investigated adults' attempts to quit smoking (n = 71). METHODS:Participants completed daily questionnaires. Minutes of MVPA were measured using hip-worn accelerometers, and smoking abstinence was assessed dichotomously with carbon monoxide monitors. Bayesian multilevel models tested within-person effects. RESULTS:Across both studies, higher daily pressure was linked to increased odds of above-average reactance-related behaviours. Pressure was further unfavourably associated with MVPA and affect in the cardiac rehabilitation sample, but unrelated to smoking abstinence and affect in the smoking cessation study. Daily persuasion only showed a small favourable association with positive affect in the smoking cessation sample. However, exploratory moderation analyses indicated it might be more effective for improving health behaviour when coming from a romantic partner. Neither daily nor person-mean preference for self-reliance moderated any associations, but the latter displayed unfavourable associations with affect and reactance-related behaviour in the smoking cessation study. CONCLUSIONS:Daily pressure appears consistently counterproductive. Associations for persuasion may be more nuanced, potentially shaped by factors like the message source. Although preference for self-reliance did not moderate any associations, its unfavourable direct associations warrant further investigation.
OBJECTIVES:Adolescents with inflammatory bowel disease (IBD) experience disruptions to normal adolescent development. Lack of preparation for transition from paediatric to adult care can have negative biopsychosocial outcomes. We aimed to explore adolescents' perspectives on how IBD affects their lives. Additionally, we aimed to understand adolescents and their parents' views on transition from paediatric to adult IBD care. DESIGN:Qualitative study. Adolescents and parents participated in semi-structured interviews together. METHODS:Participants included eight adolescents with IBD (four females; four with Crohn's disease, two with ulcerative colitis and two with IBD-U; mean age = 16) and their parent(s) (n = 9). Data were analyzed using template thematic analysis. RESULTS:Three themes were identified that reflected how IBD conflicts with typical adolescent development because of the need for careful planning to manage the disease and its symptoms (e.g., loss of bowel control, fatigue). They also described the active role parents currently play in managing their child's IBD, from managing medication to organizing appointments and communicating with healthcare professionals. Anxiety and apprehension of adolescent participants towards transitioning from adolescent to adult care were also captured. CONCLUSIONS:Healthcare providers and carers must work together with adolescents with IBD to ensure they are ready for adult care, where they will need to take sole responsibility for managing their chronic condition.
PURPOSE:Chronic pain impairs work participation. Psychological interventions can support people with chronic pain to work, yet little is known about which components are most effective. A systematic review and meta-analysis assessed the effectiveness of interventions targeting sick leave, return to work, work ability and work-related self-efficacy in chronic pain populations. Intervention content was analysed to identify effective components. METHODS:A search strategy was developed and applied to six databases from inception until 2nd March 2023, being updated in December 2024: PsychInFO, Medline, Cinahl, Web of Science, Cochrane Library and Embase. Intervention descriptions were coded for intervention functions, theoretical domains and behaviour change techniques. Risk of bias was assessed using the ROB-2 tool. RESULTS:51 randomized controlled trials were identified. Study quality was poor overall. Meta-analysis showed that psychological interventions were complex, that is, contained multiple components delivered alongside other interventions, which together were associated with reduced sick leave (SMD -.41, 95% CI: -.64 to -.18) and a small increase in those working at long-term follow-up (>12 months) (RR 1.03, 95% CI: 1.01-1.06; I2 = 0%) but not work ability/capacity (SMD -.02, 95% CI: -.12-.08, I2 = 0%) or return to work (RR .98, 95% CI: .91-1.05, I2 = 0%). No intervention components appeared most effective, but five common components were identified: education, skills/training, social support, emotional regulation, and confidence building. CONCLUSION:Complex psychological interventions can positively influence work outcomes for people with chronic pain. Future research should prioritize high-quality studies and incorporate the five components to enhance work-focussed support.
BACKGROUND:Multiple sclerosis (MS) affects approximately 2.8 million people worldwide. Twenty-five per cent of people with MS report that their romantic relationship is negatively affected by MS. However, partnered individuals with MS also report lower levels of disability, and several studies have found that patient and partner well-being are correlated. Therefore, examining coping with MS from a dyadic perspective is warranted. The objectives of this study were to explore (1) individual and (2) conjoint dyadic coping strategies in couples high and low in relationship functioning. METHODS:People diagnosed with MS (n = 9) and their partners (n = 9) completed quantitative measures, and purposive sampling was used to recruit couples high and low in relationship functioning. Relationship functioning was operationalized as comprising dyadic satisfaction, cohesion and consensus, consistent with Spanier, 1976, in addition to the degree of illness-related interference within the relationship. Interviews were conducted with each member of the dyad separately, and the results were analysed using thematic analysis and later content analysis. RESULTS:Differences were found between high and low relationship functioning couples. High relationship functioning couples generally engaged in more positive coping strategies, such as active engagement, illness acceptance and conceptualizing MS as a shared issue with their partner. Low relationship functioning couples generally engaged in more negative strategies, including avoidance, ineffective communication and conceptualizing MS as an individual issue. CONCLUSIONS:Our findings highlight the significant impact that romantic relationships have on the physical and psychosocial well-being of individuals with MS.
OBJECTIVES:This study examines the association between divorce conflict and medicine prescriptions, primary care visits and hospitalisations, over a 10-year period around juridical divorce. DESIGN:A longitudinal observational study was conducted using a cohort of 1784 Danes who divorced between 2015 and 2017. Conflict was measured with the validated Divorce Conflict Scale, and health outcomes were obtained from national registers. METHODS:Negative binomial and logistic regression models examined the relationship between divorce conflict and health outcomes, controlling for prior health status, demographic factors and socioeconomic variables. Analyses included sensitivity tests to explore pre- and post-divorce health patterns, and an exploratory analysis of health trajectories based on conflict levels. RESULTS:A one-standard deviation increase in divorce conflict was associated with a significant 28% increase in medicine prescriptions, a 5% increase in primary care visits, and 13% higher odds of hospitalisation in the 5 years following juridical divorce. Sensitivity analyses showed that these associations were robust but also varied depending on the pre-divorce health period, highlighting the importance of pre-divorce health in explaining outcomes. Exploratory analyses indicated that high-conflict divorcees had consistently elevated health trajectories across all outcomes, with a significantly steeper increase in primary care visits before divorce compared to those with average or low conflict. CONCLUSIONS:High-conflict divorcees experienced consistently worse health outcomes, including more medicine prescriptions, primary care visits and hospitalisations, both before and after divorce. These findings stress the importance of conceptualising divorce as a process and addressing conflict during the divorce process to mitigate long-term health consequences.
OBJECTIVES:To evaluate the contribution of health anxiety, mental defeat and fear of recurrence and progression (FRP) as variables in the adjustment process following cardiac events and subsequent wellbeing, adjustment and rehabilitation. DESIGN:A two-part study was conducted: cross-sectionally examining psychological factors shortly following a cardiac event and longitudinally examining how these variables were associated with adherence and physical/psychological outcomes of cardiac rehabilitation. METHODS:A UK-based sample of post-cardiac event patients (N = 176, Mage = 66.1, SD = 10.0) was categorized as high health anxiety with depression and/or anxiety, depression or anxiety only, or neither health anxiety nor depression/anxiety. Mental defeat and FRP were compared across groups pre-rehabilitation and examined in relation to adherence to, and outcomes of, an 8-session cardiac rehabilitation programme. RESULTS:Analyses indicated significantly higher mental defeat and FRP in those with health anxiety than in the other groups. However, regression analyses showed that neither health anxiety, mental defeat, nor FRP was significantly associated with rehabilitation adherence or outcomes. CONCLUSIONS:This study identified mental defeat and FRP as important factors in health-anxious cardiac patients, with implications for the coping and adjustment process and rehabilitative efforts. No linear association between these variables and rehabilitation adherence and outcomes was found, suggesting that more nuanced approaches to identifying their impact on rehabilitation may require development.
BACKGROUND:Patients undergoing maintenance haemodialysis (MHD) are vulnerable to elevated mortality risk. The literature has predominantly focused on the link between psychological symptoms (e.g., depression) and mortality risk. However, whether positive psychological constructs, such as positive affect, could play a protective role for survival has yet to be examined among patients undergoing MHD. PURPOSE:To examine the association between positive affect and mortality risk in patients undergoing MHD. METHODS:A total of 160 patients were recruited from a haemodialysis centre in Shanghai, China. After the baseline survey in 2017, patients were re-surveyed annually until July 2021. The study outcome was overall survival by the end of July 2021. Positive and negative affect were assessed by the Positive and Negative Affect Schedule (PANAS). Time-varying Cox proportional hazards models were employed to examine the crude and adjusted association between positive affect and mortality risk. RESULTS:The sample was followed up for an average duration of 3.30 years (SD = 1.20). Forty-two patients (26.3%) died during the follow-up period. After adjustment for socio-demographic characteristics, comorbidities, physical functioning and negative affect, a 1-unit increase in positive affect score was associated with a 5% reduction in mortality risk (hazard ratio = .95, 95% CI = .91-.99, p = .011). CONCLUSIONS:This study indicated that positive affect was associated with improved survival in patients undergoing MHD. It suggests that interventions targeting the enhancement of positive affect may benefit patients and lead to a better prognosis.
OBJECTIVES:Previous studies in endometriosis have linked the experience and impact of pain to psychological distress and sexual dysfunction. However, little is known about how these factors interact over time or how underlying cognitive-emotional processes contribute to their complex interconnections. DESIGN:This study followed a Longitudinal Network Approach and explored the interconnections over time between pain (intensity and impact), psychopathological symptoms, sexual distress, and cognitive-emotional processes (cognitive fusion and difficulties in emotion regulation) in adult women with endometriosis. METHODS:Data was collected in a sample composed of N = 210 Portuguese cisgender women with endometriosis in a three-wave online assessment spanning 12 months. RESULTS:Using multilevel vector autoregressive network analysis, results showed significant temporal pathways in which pain intensity and pain impact predicted future increases in cognitive fusion, depression, and somatization, indicating a directional cascading effect of physical symptoms on psychological processes. Higher sexual distress over time was associated with decreases in cognitive fusion. Results also found strong positive associations among pain, anxiety, depression, and somatization at each time point, as well as between-subjects asymmetrical relationships, with anxiety and somatization more strongly predicting sexual distress than the reverse. CONCLUSIONS:Overall, these findings highlight the importance of targeting transdiagnostic cognitive-emotional processes in interventions to improve pain, mental health, and sexual outcomes in women with endometriosis.
OBJECTIVE:Emotional eating (EE), characterized by dysregulated food intake in response to emotional stimuli, is associated with adverse physical and psychological outcomes and has been linked to alterations in executive functioning and stress-related biological reactivity. This study aimed to investigate stress-induced changes in food-related inhibitory control, emotional working memory capacity (eWMC), appetite and fasting blood glucose (FBG) in individuals with high versus low EE. METHOD:Ninety adults (45 high EE, 45 low EE), aged 18-45, were assessed before and after the Trier Social Stress Test (TSST). Measures included food-related inhibitory control, eWMC, appetite and FBG. RESULTS:The main effect of time was significant for all variables except FBG. However, significant group × time interactions were observed for all outcomes. Specifically, compared with the lowEE group, the highEE group showed greater stress reactivity, with significant post-stress declines in inhibitory control (p < .001), increased appetite (p = .001), increased FBG (p = .043) and weaker eWMC (p < .001). The lowEE group only showed a significant post-stress decline in eWMC scores (p = .01). DISCUSSION:These findings highlight the importance of emotion regulation processes in stress-related eating and metabolic reactivity and may inform prevention and intervention strategies.
