The roles of French community pharmacists in palliative home care.

BACKGROUND: The World Health Organization identifies pharmacists as a key resource in palliative care. However, the roles of these professionals in end-of-life care at home remain poorly understood, and community pharmacists themselves sometimes struggle to recognize their true role in this care. The aim of our study was to analyze community pharmacists' representations of their roles in palliative care at home in France. METHODS: The methodology was qualitative and based on semi-structured interviews with community pharmacists (n = 26). The analysis of the interviews was carried out using a qualitative content approach with thematic and lexical analysis. RESULTS: Three main elements of the community pharmacist's role were identified: drug expertise, care management, and psychosocial support for patients and their families. CONCLUSIONS: This study highlights a wide variety of roles adopted by French community pharmacists in palliative care at home. Some of these roles, which are in line with WHO recommendations on palliative care, have been little described to date. These roles of community pharmacists in home-based palliative care could be better recognized, and the players better integrated into end-of-life care systems at home, in order to improve such care. TRIAL REGISTRATION: This work was carried out within the framework of a call for projects from the Fondation de France and has received the approval of the University Clermont Auvergne Research Ethics Committee (no. IRB00011540-2021-60).

Retrospective and prospective measures of post-traumatic growth reflect different processes: longitudinal evidence of greater decline than growth following a hematopoietic stem-cell transplantation.

BACKGROUND: This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. METHODS: This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) 5 months after HSCT and scales tapping into the five domains of PTGI during hospitalisation and 5 months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalisation. A PTSD scale was administered at the five-month follow-up. RESULTS: Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth. CONCLUSIONS: Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.

Mindfulness and equanimity moderate approach/avoidance motor responses.

A person's tendency to approach pleasant stimuli and to avoid unpleasant stimuli reflects a basic psychological phenomenon. The present research aimed to investigate the extent to which mindfulness practices and trait equanimity can attenuate this motivational process. In two studies, participants were asked to perform an Approach/Avoidance Task (AAT). In Study 1 (N = 84), prior to completing the AAT, participants were randomly assigned to one of two guided mindfulness-based meditation conditions (breathing or body-scan) or to an active control condition. In Study 2 (N = 71), which controlled for mindfulness practice, motor responses to the AAT were compared by level of equanimity of the participants (low vs. high). The results revealed that breathing meditation practice and trait equanimity significantly moderated participants' motor responses to the AAT, and that the body-scan meditation did not moderate these responses. Bayesian analyses showed that participants in the breathing meditation group (Study 1) and those with higher equanimity (Study 2) showed a reduction of bias in their motor responses to the AAT. These results suggest that meditation practice and trait equanimity may promote a decrease in automatic motivational approach and avoidance tendencies evoked by positive and negative stimuli.

Blood pressure and psychological distress among North Africans in France: The role of perceived personal/group discrimination and gender.

OBJECTIVES: The purpose of this study was to examine the associations between perceived ethnic discrimination and (physical and mental) health indicators among North African women and men living in France. METHODS: This study included 82 North Africans, aged 18-64 years. Perceived discrimination was measured at both group level (PGD) and personal level (PPD). The physical health indicator was blood pressure. The mental health indicator was self-reported psychological distress. RESULTS: Multiple regression analyses showed that higher levels of PGD predicted higher blood pressure. PPD was not related to blood pressure. PPD was positively related to psychological distress among women, but not among men. CONCLUSION: PPD and PGD are associated with physical and mental health indicators in different ways among North African women and men in France.

When the dissolution of perceived body boundaries elicits happiness: The effect of selflessness induced by a body scan meditation.

Drawing on the Self-centeredness/Selflessness Happiness Model (SSHM), we hypothesized that a reduction in the salience of perceived body boundaries would lead to increase optimal emotional experience. These constructs were assessed by means of self-report measures. Participants (n=53) were randomly assigned to either the selflessness (induced by a body scan meditation) condition or the control condition. As expected, the reduction in perceived body salience was greater in the body scan meditation condition than in the control condition. The change in perceived body salience was accompanied by a change in happiness and anxiety. Participants in the body-scan meditation condition reported greater happiness and less anxiety than participants in the control condition. Happiness increased when the salience of body boundaries decreased. Mediation analyses reveal that the change in happiness was mediated by the change in perceived body boundaries, which suggests that selflessness elicits happiness via dissolution of perceived body boundaries.

Being Perceived as a Vital Force or a Burden: The Social Utility-Based Acceptance/Rejection (SUBAR) Model.

This paper proposes a new theoretical model to explain the acceptance/rejection of agents (co-workers) and various social groups (people with mental disorders or disabilities, the elderly, the unemployed/poor, ethnic minorities) in a given social system: the social utility-based acceptance/rejection (SUBAR) Model. Based on a social utility approach, it is proposed that human social cognition evaluates and reacts to agents/groups in a social system on the basis of the perceived strengths and significant contributions they bring to the system (upward forces; e.g., skills, resources, willingness) and the perceived weaknesses that may harm the system (downward forces; e.g., use of social benefits, dependence). While the perception of upward forces for the system (i.e., vital forces) is accompanied by acceptance (positive attitudes and behaviors), the perception of downward forces (i.e., burdens on the system) promotes rejection (negative attitudes and behaviors). The combination of the two indicators predicts that low vital forces/high burden targets will be the most rejected and high vital forces/low burden targets will be the most accepted. The high burden/high vital forces and low vital forces/low burden targets should be evaluated at an intermediate level between the other two. This naive calculation of the forces exerted by agents/groups in a social system is moderated by various variables (scarcity of economic resources, values) and responds to a functional attempt to regulate individual and collective interests, themselves dependent on the efficiency of given systems. Finally, the relationship of the SUBAR model to other relevant theories will also be discussed.

Awe and time perception.

The aim of this study was to systematically examine the effect of awe-inducing stimuli on the judgment of time. Three experiments were conducted using temporal bisection tasks in which participants viewed awe-inducing and no awe-inducing images presented for different durations and were asked to judge whether their duration was similar to a short or long anchor duration. Images of panoramic landscapes and images of the faces of well-known and admired people were used in experiments 1 and 2, respectively. In experiment 3, they did not judge the duration of the images, but that of a neutral stimulus occurring during the presentation of images. In each experiment, participants rated the awe-inducing and no-awe-inducing images according to their components: admiration, beauty, awe, emotional valence, arousal, symbolic self-size, and full-body self-size. Results consistently showed significant time distortions when participants viewed the different awe-inducing images compared to the no-awe images, although the effect was weaker for the images of faces than for those of landscapes. Time distortion took the form of temporal lengthening in Experiments 1 and 2 and shortening in Experiment 3. These different temporal distortions are consistent with attention effects due to awe-inducing stimuli which capture attention to the detriment of time processing.

Cultivating Self-Transcendence Through Meditation Practice: A Test of the Role of Meta-Awareness, (Dis)identification and Non-Reactivity.

In this paper, we present a study comprising two distinct stages to examine the extent to which metacognitive processes of decentering facilitate the emergence of self-transcendence experiences in everyday life (i.e., the frequency of self-transcendent emotions, flow proneness, and adopting an interconnected identity). In the course of conducting this research, the first stage (N = 374) focused on assessing the structure and validity of the French version of the Metacognitive Processes of Decentering Scale (MPoD-t). Building on this, the second stage (N = 294) examined the potential relationship between meditative practices and psychological decentering processes (i.e., meta-awareness, (dis)identification with internal experiences, and (non)reactivity to thought content) and explored whether these mechanisms explain the association between meditative practices and the experience of self-transcendent states. Overall, the results demonstrated satisfactory psychometric properties of the French version of the MPoD and provided enhanced insights into the distinct mediating roles played by various decentering components in the manifestation of self-transcendence experiences in daily life. Indeed, the findings revealed that the relationship between practice and the occurrence of self-transcendent emotions or flow was mediated by the meta-awareness component, while the association between practice and the development of an interconnected identity was explained by the (dis)identification with internal experiences component. The implications of these findings are discussed.

Social perceptions and the stigmatization towards fifteen mental illnesses in France: a preliminary study on the role of vital force and burden.

Introduction: This study examined social perceptions and rejection towards fifteen mental illnesses, as well as a preliminary test of the SUBAR model, that hypothesized perceptions of both vital forces and burden would be negatively and positively related to social rejection, respectively. Methods: Using an online survey with participants from France (n = 952), social rejection was assessed using a feeling thermometer and a social distance scale, while social perceptions were measured using visual analog scales. Results: A stigma map for these different disorders is drawn up, revealing the social perceptions and levels of stigmatization specific to certain mental illnesses. Controlling for relevant social perceptions (i.e., danger, warmth, competence), we found that perception of burden was positively and significantly associated to social distance and negative feeling for 73% and 67% of mental illnesses, respectively. The perception of vital force was negatively and significantly related to social distance and negative feeling for 87% and 20% of mental illnesses, respectively. The change in R2 between model 1 (i.e. perception of danger, warmth, competence) and model 2 (i.e. model 1 + perceptions of vital force and burden) significantly improved in 100% of cases for social distance and 67% of cases for negative feeling. Conclusion: These preliminary data provide support for the SUBAR model and call for further investigations to better understand the social rejection of people with mental illnesses.

The Prospective Effects of Coping Strategies on Mental Health and Resilience at Five Months after HSCT.

OBJECTIVES: Hematopoietic stem cell transplantation (HSCT) is a stressful event that engenders psychological distress. This study examines the prospective effects of coping strategies during hospitalization on resilience and on various mental-health dimensions at five months after transplantation. METHODS: One hundred and seventy patients (Mage = 52.24, SD = 13.25) completed a questionnaire assessing adjustment strategies during hospitalization, and 91 filled out a questionnaire five months after HSCT (Mage = 51.61, SD = 12.93). RESULTS: Multiple regression analyses showed that a fighting spirit strategy positively predicted resilience (p < 0.05), whereas anxious preoccupations predicted anxiety (p < 0.05), poorer mental QoL (p < 0.01), and were associated with an increased risk of developing PTSD (OR = 3.27, p < 0.01; 95% CI: 1.36, 7.84) at five months after transplantation. Hopelessness, avoidance, and denial coping strategies were not predictive of any of the mental health outcomes. Finally, the number of transplantations was negatively related to a fighting spirit (p < 0.01) and positively related to hopelessness-helplessness (p < 0.001): Conclusions: These results highlight the importance of developing psychological interventions focused on coping to alleviate the negative psychological consequences of HSCT.

Perceived discrimination based on the symptoms of covid-19, mental health, and emotional responses-the international online COVISTRESS survey.

BACKGROUND: Despite the potential detrimental consequences for individuals' health and discrimination from covid-19 symptoms, the outcomes have received little attention. This study examines the relationships between having personally experienced discrimination based on the symptoms of covid-19 (during the first wave of the pandemic), mental health, and emotional responses (anger and sadness). It was predicted that covid-19 discrimination would be positively related to poor mental health and that this relationship would be mediated by the emotions of anger and sadness. METHODS: The study was conducted using an online questionnaire from January to June 2020 (the Covistress network; including 44 countries). Participants were extracted from the COVISTRESS database (Ntotal = 280) with about a half declaring having been discriminated due to covid-19 symptoms (N = 135). Discriminated participants were compared to non-discriminated participants using ANOVA. A mediation analysis was conducted to examine the indirect effect of emotional responses and the relationships between perceived discrimination and self-reported mental health. RESULTS: The results indicated that individuals who experienced discrimination based on the symptoms of covid-19 had poorer mental health and experienced more anger and sadness. The relationship between covid-19 personal discrimination and mental health disappeared when the emotions of anger and sadness were statistically controlled for. The indirect effects for both anger and sadness were statistically significant. DISCUSSION: This study suggests that the covid-19 pandemic may have generated discriminatory behaviors toward those suspected of having symptoms and that this is related to poorer mental health via anger and sadness.

Psychological resources and flexibility predict resilient mental health trajectories during the French covid-19 lockdown.

The implementation of lockdowns and the Covid-19 pandemic situation have negatively impacted mental health (anxiety, depression). However, little is known about individual differences in the longitudinal reactions to lockdown. We designed a longitudinal study (a) to identify the various trajectories of symptoms of depression and anxiety in the general population during and after lockdown; (b) to determine which positive psychological resources prevent individuals from falling into groups with the most severe trajectories; (c) to test the mediating role of psychological flexibility. We collected and analysed longitudinal data on a sample of French participants (N = 1399, Mage = 43.4; SDage = 12; 87.8% women) during the end of the first lockdown. Participants were asked to report their psychological resources and (in)flexibility at baseline and symptoms of anxiety and depression at each measurment occasion (five weekly observations from 17 March to 11 May 2020, including baseline). Using growth mixture modelling, seven dynamic profiles of symptoms were identified: four for depression and three for anxiety. Resilience emerged as the most frequent trajectory. Wisdom, optimism, hope, self-efficacy and peaceful disengagement significantly prevented individuals from belonging to the symptomatic groups. Moreover, psychological flexibility emerged as a significant mediator of these effects. This study highlights the importance of cultivating protective factors and psychological flexibility to prevent mental health damage during potentially traumatic events (PTE) and to favour resilience trajectories.

Authoritarian attitudes are associated with higher autonomic reactivity to stress and lower recovery.

Right-wing authoritarianism (RWA) and social dominance orientation (SDO) both predict generalized prejudice, dehumanization, intergroup discrimination, oppression, violence, right-wing political party preference, and generally punitive attitudes. Authoritarian attitudes have been theorized to involve maladaptive emotional, cognitive, and social self-regulation. However, there is no study of authoritarianism using the functioning of the parasympathetic nervous system (PNS) as a physiological index of self-regulation, thus leaving it unclear whether regulation is "impaired" with authoritarian attitudes per se. PNS functioning is commonly assessed by examining tonic and phasic heart rate variability (HRV). These two components are recognized to be important in terms of adaptation to stress. Decreased HRV has been associated with hypoactive prefrontal regulation, hyperactive subcortical structures, maladaptive self-regulation, hyper-vigilance, decreased prosocial tendencies, defensiveness, impulsive behaviors, and aggression. Previous research suggests that self-regulatory failure may favor hostile attitudes and prejudicial intergroup behaviors. In a first study, we found that high RWA was associated with lower tonic HRV at rest. In a second study, stress-induced autonomic reactivity and poststress autonomic recovery were examined as potential pathways linking authoritarian attitudes to self-regulation. We found that high RWA and high SDO were associated with (i) lower tonic HRV during stress, (ii) greater autonomic reactivity during stress, and (iii) lower autonomic recovery. Overall, our results suggest that autonomic dysregulation during and following stress is a plausible physiological pathway connecting RWA and SDO to self-regulation. Implications of such results for research on political attitudes are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measuring and Assessing Fluctuating and Authentic-Durable Happiness in Italian Samples.

On the basis of the self-centeredness and selflessness model, a new instrument assessing two distinct dimensions of happiness, fluctuating and authentic-durable, was developed. The current research aimed at examining the factor structure of the Italian version of the instrument, its psychometric properties and construct validity. To this end, two studies were carried out. Study 1 (N = 544) examined different measurement models, from unidimensional to multidimensional, from a fully symmetrical bifactor solution to a bifactor (S-1) solution. Findings indicated better and adequate fit indices for the last model. Using various samples (n = 1274) Study 2 confirmed the bifactor (S-1) structure and analysed psychometric properties, convergent and divergent validity and temporal stability of the instrument. Findings generally gave evidence of the multidimensional conceptualization of the construct, good levels of reliability values and adequate convergent validity of both scales. Discriminant validity showed mixed results from no association of age with authentic-durable happiness to weak and negative association with fluctuating happiness. Test-retest reliability displayed an adequate value of correlation coefficient for the two set scores of the authentic dimension and a value below the recommended cut-off criteria for the fluctuating dimension, where significant differences in the mean scores emerged. Future studies should aim to replicate the results of this research and attempt to overcome its limitations.

Mental health and quality of life of patients undergoing hematopoietic stem cell transplantation (HSCT) prior to hospitalization: a cross-sectional complete state health study.

OBJECTIVE: The main goal of this cross-sectional study was to examine the relationships between negative/positive psychological dispositions, mental health, and quality of life (QoL) prior to hospitalization among patients undergoing hematopoietic stem cell transplantation (HSCT). METHOD: A total of 187 patients (Mage = 52.07 years) completed a questionnaire 19.6 days before an allograft. Several positive psychological dispositions (i.e. mindfulness, optimism, and acceptance) and a negative psychological disposition (i.e. experiential avoidance) were assessed. Our dependent variables were mental health (i.e. happiness, depression, and anxiety) and QoL. RESULTS: In the sample, 56.8% of patients were characterized by an impaired QoL and 56.9% and 21% had, respectively, anxiety and depression levels above the critical threshold (i.e. a score above seven on the Hospital Anxiety and Depression Scale). Anxiety, depression, and happiness were significantly related to the mental component of QoL, whereas physical QoL was only related to depression and happiness. Providing additional support for a complete state health approach, several positive and negative psychological dispositions (i.e. optimism, acceptance, and experiential avoidance) were robustly related to mental illness/wellness and QoL. CONCLUSIONS: These results highlight the importance of improving psychological health and QoL among HSCT patients prior to hospitalization by both promoting positive psychological and health factors and alleviating negative ones.

Basic human values during the COVID-19 outbreak, perceived threat and their relationships with compliance with movement restrictions and social distancing.

This study examines the evolution of Schwartz's Basic Human Values during the COVID-19 outbreak, and their relationships with perceived threat, compliance with movement restrictions and social distancing. An online questionnaire was administered to a heterogeneous sample of French citizens (N = 1025) during the first French lockdown related to the outbreak. Results revealed a significant evolution of values; the conservation value was higher during the outbreak than usual, and both self-enhancement and openness-to-change values were lower during the COVID-19 outbreak than usual. Conservation and perceived threat during the outbreak were robustly and positively related to both compliance with movement restrictions and social distancing. Conservation during the outbreak emerged as a significant partial mediator of the relationship between perceived threat and outcomes (i.e., compliance with movement restrictions and social distancing). Implications of these results for the malleability of values and the COVID-19 modelling are discussed.

Effects of Mindfulness Meditation on Self-Transcendent States: Perceived Body Boundaries and Spatial Frames of Reference.

OBJECTIVES: Mindfulness training is believed to encourage self-transcendent states, but little research has examined this hypothesis. This study examined the effects of mindfulness training on two phenomenological features of self-transcendence: 1) perceived body boundary dissolution, and 2) more allocentric spatial frames of reference. METHODS: A sample of healthy, young adults (n=45) were randomized to five sessions of mindfulness training or an active listening control condition. RESULTS: Results indicated mindfulness training decreased perceived body boundaries (F 4,172=6.010, p<.001, η 2=.12) and encouraged more allocentric frames of reference (F 4,168=2.586, p=.039, η 2=.06). The expected inverse relationship was observed between perceived body boundaries and allocentric frames of reference ((ß=-.58, p=.001)), and path analysis revealed the effect of mindfulness training on allocentric frames of reference was mediated by decreased perceived body boundaries (ß=.24, se=.17, CI: 0.11 to 0.78). CONCLUSIONS: Taken together, study results suggest that mindfulness training alters practitioners' experience of self, relaxing the boundaries of the self and extending the spatial frame of reference further beyond the physical body. Future studies are needed to explore the psychophysiological changes that co-occur with phenomenological reports of self-transcendence and the behavioral consequences following self-transcendent experiences.

Embodied time and the out-of-body experience of the self.

Using an out-of-body paradigm, the present study provided further empirical evidence for the theory of embodied time by suggesting that the body-self plays a key role in time judgments. Looking through virtual reality glasses, the participants saw the arm of a mannequin instead of their own arm. They had to judge the duration of the interval between two (perceived) touches applied to the mannequin's body after a series of strokes had been viewed being made to the mannequin and tactile strokes had been administered to the participants themselves. These strokes were administered either synchronously or asynchronously. During the interval, a pleasant (touch with a soft paintbrush) or an unpleasant stimulation (touch with a pointed knife) was applied to the mannequin. The results showed that the participants felt the perceived tactile stimulations in their own bodies more strongly after the synchronous than the asynchronous stroking condition, a finding which is consistent with the out-of-body illusion. In addition, the interval duration was judged longer in the synchronous than in the asynchronous condition. This time distortion increased the greater the individual out-of-body experience was. Our results therefore highlight the importance of the awareness of the body-self in the processing of time, i.e., the significance of embodied time.

Attentional bias modification with a new paradigm: The effect of the Detection Engagement and Savoring Positivity (DESP) task on eye-tracking of attention.

BACKGROUND AND OBJECTIVES: We tested the effect of a new Attentional Bias Modification (ABM) task - the Detection Engagement and Savoring Positivity (DESP) task - on attentional biases. The DESP is innovative in that it involves a procedure of savoring the positivity of various pictures. METHODS: Participants were randomly assigned to the DESP or to a placebo control condition (experiment 1; n = 38) or a condition controlling for savoring (experiment 2; n = 54) in a pre-post/training experimental design. During one week, the participants completed the DESP or the control task once a day between three and six times. We assessed the effects of the DESP task on various attentional biases (i.e. positive, negative and threat) by computing dwell time from an eye-tracking technology before and after the training, and also one week after the post-training session in experiment 2. RESULTS: In both experiments, the attentional bias toward positive stimuli between the pre- and the post-training increased significantly more in the DESP task condition than in the control conditions. Negative and threat attentional biases were not significantly affected by the experimental manipulations. Experiment 2 revealed that the DESP task - including the savoring instruction - increased significantly more the positive attentional bias than a task excluding this step and that this effect remained significant one week after the post-training session. LIMITATIONS: Our samples were mainly composed of women participants. This prevents generalization of the findings. CONCLUSIONS: The DESP task offers promising perspectives for sustainably improving attention to positive information.

Reliability and validity of an equanimity questionnaire: the two-factor equanimity scale (EQUA-S).

BACKGROUND: Many studies have revealed the positive impact of mindfulness training on mental health and proposed equanimity as a general outcome in contemplative research. Despite recent interest, relatively few studies have empirically examined equanimity and measurement instruments are still lacking. The main goal of this study was to develop an Equanimity Scale (the EQUA-S) in a Western population with or without meditation experience, based on previous definitions of equanimity, in order to investigate its relations with the relevant psychological constructs and health outcomes. METHODS: Adults from the general population (N = 265; M age = 34.81) completed various measures: the EQUA-S, mindfulness, hyper-sensitivity, avoidance and fusion, impulsivity, personality, alexithymia, sensitivity to punishment and reward and frequency of problematic addictive behaviors. The dimensionality of the EQUA-S was examined using Factor Analyses. The convergent validity of this new scale was investigated using Pearson's Correlations. RESULTS: The results of a factor analysis revealed two dimensions of equanimity: an even-minded state of mind (E-MSM) and a hedonic independence (HI) component. While the E-MSM was positively related to emotional stability, adaptive emotional regulation and several mindfulness-related abilities, HI was found to correlate negatively with addictive issues. DISCUSSION: The relations with personality constructs and possible related cognitive processes are discussed.