Hyperactivity in preschool age is associated with higher fat-free mass and healthy lifestyle behaviours five years later: A longitudinal study of Swedish children.

BACKGROUND: There is evidence for a link between hyperactivity and obesity, especially among older children. Both conditions seem to be multifactorial in origin and hypotheses of common underlying issues, such as emotional dysregulation, have been suggested. However, studies of the co-occurrence of the two conditions in younger age groups have been inconclusive. OBJECTIVES: We aimed to study the longitudinal associations of psychological strengths and difficulties at 4 years of age with health behaviours, body composition, physical fitness, and cardiovascular disease (CVD) risk factors 5 years later. METHODS: Parents of 226 4-year-old children filled out the Strengths and Difficulties Questionnaire (SDQ). At 9 years of age, we assessed health behaviours, physical fitness, body composition, and CVD risk factors. Associations were examined with linear regression models that were adjusted for sex, age of the child at 9, and maternal education. RESULTS: In the adjusted models, hyperactivity at 4 was associated with higher fat-free mass (ß = 0.18, p = 0.007) and lower levels of sedentary behaviour (ß -0.14, p = 0.043) at 9 years. Furthermore, greater emotional problems at 4 were associated with lower intake of fruit and vegetables (ß -0.14, p = 0.038) at 9 years. However, there were no statistically significant associations between psychological difficulties and fat-mass index. CONCLUSIONS: Our novel data provide no evidence of an association between hyperactivity in preschool age and obesity or obesity-related behaviours in school age. Future studies examining how psychological factors relate to obesity development should consider a developmental perspective.

Digital multiple health behaviour change intervention targeting online help seekers: protocol for the COACH randomised factorial trial.

INTRODUCTION: Unhealthy lifestyle behaviours continue to be highly prevalent, including alcohol consumption, unhealthy diets, insufficient physical activity and smoking. There is a lack of effective interventions which have a large enough reach into the community to improve public health. Additionally, the common co-occurrence of multiple unhealthy behaviours demands investigation of efforts which address more than single behaviours. METHODS AND ANALYSIS: The effects of six components of a novel digital multiple health behaviour change intervention on alcohol consumption, diet, physical activity and smoking (coprimary outcomes) will be estimated in a factorial randomised trial. The components are designed to facilitate behaviour change, for example, through goal setting or increasing motivation, and are either present or absent depending on allocation (ie, six factors with two levels each). The study population will be those seeking help online, recruited through search engines, social media and lifestyle-related websites. Included will be those who are at least 18 years of age and have at least one unhealthy behaviour. An adaptive design will be used to periodically make decisions to continue or stop recruitment, with simulations suggesting a final sample size between 1500 and 2500 participants. Multilevel regression models will be used to analyse behavioural outcomes collected at 2 months and 4 months postrandomisation. ETHICS AND DISSEMINATION: Approved by the Swedish Ethical Review Authority on 2021-08-11 (Dnr 2021-02855). Since participation is likely motivated by gaining access to novel support, the main concern is demotivation and opportunity cost if the intervention is found to only exert small effects. Recruitment began on 19 October 2021, with an anticipated recruitment period of 12 months. TRIAL REGISTRATION NUMBER: ISRCTN16420548.

Mindfulness-Based Stress Reduction for Coronary Artery Disease Patients: Potential Improvements in Mastery and Depressive Symptoms.

Depressive symptoms after coronary events are associated with a worse prognosis. When changing the focus from psychopathology towards a resilience framework, treatments such as mindfulness meditation could offer novel ways to address psychological distress among coronary artery disease (CAD) patients. We studied the feasibility of mindfulness-based stress reduction (MBSR) for CAD patients with depressive symptoms. Seventy-nine CAD patients with elevated depressive symptoms were invited to an 8-week MBSR course. Twenty-four patients (30%) accepted and 16 (20%) completed MBSR. Depressive symptoms decreased immediately after the course (p = .006). After 12 months, this improvement remained, and Mastery scores increased (p = .005). A reference group of 108 CAD patients did not show any significant changes in depressive symptoms or Mastery between 1 and 12 months after a coronary event. MBSR thus appears to be a feasible alternative for CAD patients with elevated depressive symptoms. Future studies are warranted to study if MBSR can improve psychological functioning in CAD patients.Clinicaltrials.gov (Registration Number: NCT03340948).

Cultivating the Interpersonal Domain: Compassion in the Supervisor-Doctoral Student Relationship.

The long-term and complex supervisor-doctoral student relationship is often characterised by tension and frictions. In higher education research, models, and interventions that take the potential beneficial interpersonal effects of compassion into account seem to be scarce. Hence, the aim of this study was to conceptualise the potential role compassion could have in the cultivation of an affiliative and sustainable supervisor-doctoral student relationship. The concept of compassion was investigated and analysed in relation to a contemporary model of supervisor behaviours. Furthermore, a systematic literature search in the scientific databases PubMed, PsychInfo, ScienceDirect, and Google Scholar was performed. The conceptual analysis revealed that the interpersonal domain, in which compassion could afford a shared sense of warmth, is neglected in previous definitions. Furthermore, the integration of compassion into a model of adaptive supervisor behaviour indicates a strong case for a salutary role for compassion in the supervisor-doctoral student relationship. However, the literature review showed that empirical data are lacking, and more studies are needed. The role of compassion deserves to be investigated empirically in this particular interpersonal context.

Hyperactivity is associated with higher fat-free mass and physical activity in Swedish preschoolers: A cross-sectional study.

AIM: We investigated psychological strengths and difficulties in a Swedish population of preschool children and analysed how these behavioural variables were related to body composition, cardiorespiratory fitness, physical activity levels, sedentary behaviour and diet. METHODS: Three hundred and fifteen boys and girls were recruited during 2014-2015. Body composition was measured using air-displacement plethysmography, and anthropometric measures were taken. Parents responded to questions about age, sex and educational attainment, diet, physical activity levels and smoking habits, as well as the Strengths and Difficulties Questionnaire (SDQ). Regression models were created to analyse associations between psychological variables, body composition and health behaviours. RESULTS: Hyperactivity scores were positively related to fat-free mass (ß = 0.20, P = .001) and moderate-to-vigorous physical activity (ß = 0.16, P = .003) and negatively associated with sedentary behaviours (ß = 0.18, P = .001), but showed no statistically significant associations with fat mass. CONCLUSION: Our findings suggest that the adverse health consequences of hyperactivity on obesity and obesity-related health behaviours may be established after the preschool period. Questions about the time frame of contributing and modulating factors in obesity development are discussed.

A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis.

BACKGROUND: Psychological distress with symptoms of depression and anxiety is common and unrecognized in patients with coronary artery disease (CAD). Efforts have been made to treat psychological distress in CAD with both conventional methods, such as antidepressant drugs and psychotherapy, and non-conventional methods, such as stress management courses. However, studies focusing on the experiences of mindfulness training in this population are still scarce. Therefore, the aim of this study was to explore immediate experiences of mindfulness practice among CAD patients with depressive symptoms. METHODS: A qualitative content analysis of diary entries, written immediately after practice sessions and continuously during an 8-week long Mindfulness Based Stress Reduction course (MBSR), was applied. RESULTS: Twelve respondents participated in the study. The main category: a journey through chaos and calmness captured the participants' concurrent experiences of challenges and rewards over time. This journey appears to reflect a progressive development culminating in the harvesting of the fruits of practice at the end of the mindfulness training. Descriptions of various challenging facets of mindfulness practice - both physical and psychological - commonly occurred during the whole course, although distressing experiences were more predominant during the first half. Furthermore, the diary entries showed a wide variety of ways of dealing with these struggles, including both constructive and less constructive strategies of facing difficult experiences. As the weeks passed, participants more frequently described an enhanced ability to concentrate, relax and deal with distractions. They also developed their capacity to observe the content of their mind and described how the practice began to yield rewards in the form of well-being and a sense of mastery. CONCLUSIONS: Introducing MBSR in the aftermath of a cardiac event, when depressive symptoms are present, is a complex and delicate challenge in clinical practice. More nuanced information about what to expect as well as the addition of motivational support and skillful guidance during the course should be given in accordance with the participants' experiences and needs. TRIAL REGISTRATION: The trial was retrospectively registered in clinicaltrials.gov (registration number: NCT03340948 ).

Inverted items and validity: A psychobiological evaluation of two measures of psychological resources and one depression scale.

Psychological resources and risk factors influence risk of coronary heart disease. We evaluated whether inverted items in the Self-esteem, Mastery, and Center for Epidemiological Studies Depression scales compromise validity in the context of coronary heart disease. In a population-based sample, validity was investigated by calculating correlations with other scales (n = 1004) and interleukin-6 (n = 374), and by analyzing the relationship with 8-year coronary heart disease risk (n = 1000). Negative items did not affect the validity of the resource scales. In contrast, positive items from Center for Epidemiological Studies Depression showed no significant relationships with biological variables. However, they had no major impact on the validity of the original scale.

Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample.

BACKGROUND: A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources. PURPOSE: The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort. METHODS: The cohort consisted of 484 men and 497 women, aged 45-69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms. RESULTS: A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD, p = 0.003), self-esteem (HR 0.64, p = 0.004), and sense of coherence (HR 0.70, p = 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46, p = 0.014), hopelessness (HR 1.59, p = 0.003), and depressive symptoms (HR 1.45, p = 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67, p = 0.034), self-esteem (HR 0.69, p = 0.048), and hopelessness (HR 1.48, p = 0.023). CONCLUSIONS: The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.