Adaptation and virtual feasibility pilot of a mindfulness-based lifestyle program targeting modifiable dementia risk factors in older adults.

OBJECTIVES: We developed a group-based program (My Healthy Brain, MHB) to engage older adults at-risk for dementia in healthy lifestyles. We report on a two-part study to adapt MHB by incorporating mindfulness skills, using mobile health technology to monitor and reinforce behaviors, and delivering it via live video. METHODS: Participants were older adults (age ≥ 60) with subjective cognitive decline (SCD) and at least one lifestyle risk factor. In Aim 1 (n = 11, 2 groups), we conducted focus groups to obtain qualitative feedback on proposed adaptations. In Aim 2 (n = 10), we conducted a virtual open pilot with exit interviews to explore the feasibility and outcomes of the adapted MHB. RESULTS: Thematic analysis revealed: (1) barriers and facilitators to healthy lifestyles, (2) positive impressions of MHB, (3) interest in mindfulness skills, and (4) openness to study technologies. MHB met a-priori feasibility benchmarks and was associated with improvements in cognition, lifestyle (e.g. physical function), and proposed mechanisms (e.g. mindfulness). Exit interviews confirmed high feasibility and satisfaction. CONCLUSION: The integration of mindfulness, live video, and mobile health technologies was feasible and promising for improving healthier lifestyles. The results inform the next feasibility RCT of MHB to prepare for efficacy testing.Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2032600.

Psychosocial profiles of risk and resiliency in neurofibromatoses: a person-centered analysis of illness adaptation.

OBJECTIVES: We sought to characterize psychosocial profiles of adaptation to neurofibromatosis (NF). METHODS: Participants (N = 224) completed self-report measures of psychosocial functioning, including risk (i.e., perceived stress, depression, anxiety) and resiliency (i.e., gratitude, optimism, coping, social support, mindfulness, empathy). We used a TwoStep hierarchical cluster analysis to determine clusters reflecting adaptation to NF. RESULTS: The analysis revealed two distinct groups, with the "Low Adaptation" group defined by high emotional distress and low resiliency (n = 130; 57% of participants), and the "High Adaptation" group defined by low emotional distress and high resiliency (n = 85; 37% of participants). Clusters differed significantly across nearly all criterion variables, as well as quality of life and pain interference. CONCLUSION: Both risk and resiliency factors are important for understanding psychosocial adaptation to NF. Findings suggest that clinical providers should prioritize screening and intervention methods targeting these variables to promote positive adaptation to NF. TRIAL REGISTRATION: ClinicalTrials.gov NCT03406208; https://clinicaltrials.gov/ct2/show/NCT03406208 (Archived by WebCite at http://www.webcitation.org/72ZoTDQ6h ).

My Healthy Brain: Rationale and Case Report of a Virtual Group Lifestyle Program Targeting Modifiable Risk Factors for Dementia.

Nearly half of dementia cases may be explained by modifiable lifestyle risk factors. Multidomain interventions are needed to bypass cognitive decline (CD) and aging-related barriers to sustained healthy lifestyles in at-risk older adults. We iteratively developed  My Healthy Brain, a group-based lifestyle program (8 weeks, 90 min sessions) delivered via live video that applies behavioral principles to target multiple risk factors for dementia. We describe the program structure, virtual delivery, and outcomes for a group of older adults with subjective CD or mild cognitive impairment and lifestyle risk factors (e.g., sedentary, poor sleep or diet). We also conducted a group exit interview to qualitatively assess participant experiences and elicit feedback to improve My Healthy Brain. This case report demonstrates that delivering evidence-based brain health education and behavior change skills in a group setting via live video is feasible, acceptable, and has the potential to improve lifestyle, cognitive, and psychosocial outcomes in older adults with CD.

"Practice Makes Perfect"? Associations Between Home Practice and Physical and Emotional Function Outcomes Among Patients with Chronic Pain Enrolled in a Mind-Body Program.

Objectives: To summarize the characteristics of home practice adherence in patients with chronic pain randomized to a 10-week group mind-body activity program with (GetActive-Fitbit) and without (GetActive) a digital monitoring device, and test the association between home practice adherence and improvement in physical and emotional treatment outcomes. Methods: Data were collected in a pilot randomized controlled trial (RCT) of the GetActive (n = 41) and GetActive-Fitbit (n = 41) programs. Participants submitted weekly home practice logs depicting their daily physical activity and practice of relaxation and gratitude skills. Participants completed assessments of physical (patient-reported, performance-based, and accelerometer-measured) and emotional function outcomes both before and after the programs. Participants in both programs were combined due to the identical session and home practice content. Results: Participants reported engaging in physical activity on average 30.62 days (SD = 20.28, 48.6% of intervention days), relaxation skill practice on average 29.87 days (SD = 21.16, 47.4% of intervention days), and gratitude practice on average 32.10 days (SD = 22.12, 51.0% of intervention days). The average duration of physical activity and relaxation skill practice were 44.40 min a day (SD = 59.44) and 11.15 min a day (SD = 12.00), respectively. The duration of physical activity was significantly associated with decrease depression symptoms (p = 0.049, η2 = 0.056). No other association was found between home practice and change in outcomes. Conclusions: Patients with chronic pain are generally able and willing to engage in home practice during a mind-body activity intervention. Emphasizing longer duration of physical activity practice may contribute to an improvement in depression. Future fully powered RCTs with rigorous assessment of home practice adherence and dose-response designs may further elucidate the role of home practice in improvements in treatment outcomes. ClinicalTrials.gov identifier: NCT03412916.

College student expression on Twitter during the COVID-19 pandemic.

Objective:The current study longitudinally examines college student Twitter patterns throughout initial phases of the COVID-19 pandemic. This study aims to better understand psychological impact and online personal communication during the pandemic.Participants:A dataset consisting of ∼720,000 tweets posted by students from universities throughout the United States during the 2020 spring semester was analyzed according to structural and sentimental analysis.Methods:Using a data-driven approach, three time periods emerged which reflected the transition to online learning.Results:Significant changes in structure and sentiment of tweets were observed across phases.Conclusions:Changes in Twitter patterns revealed important features of this unprecedented transition to online learning for college students.

Psychological Wellbeing, Worry, and Resilience-Based Coping during COVID-19 in Relation to Sleep Quality.

The current study evaluated the impact of psychological wellbeing on sleep quality during the onset of the COVID-19 pandemic. A novel empirical model tested variables that mediate and moderate this impact. First, a relationship was established between psychological wellbeing during the COVID-19 pandemic and sleep quality. Second, resilience-based coping associated with the COVID-19 pandemic was tested as a mediator of the impact of psychological wellbeing on sleep quality. Third, dispositional rumination, mindfulness, and worry were compared as moderators of the impact of psychological wellbeing on sleep quality. Fourth, a moderated mediated model was tested for each moderator. Online survey data was collected from 153 adults in the United States. Results demonstrated that coping with the COVID-19 pandemic partially mediated the impact of psychological wellbeing on sleep quality. Worry, but not rumination or mindfulness, moderated the impact. A moderated mediation model failed to demonstrate significance, indicating that the data are best represented by distinct mediation and moderation models. Thus, interventions aimed at improving sleep quality should prioritize concurrent reduction in worry and increase in resilience-based coping strategies. This study provides practical and theoretical contribution to the literature by demonstrating relationships between key variables and contextualizing how the model can be used for assessments and interventions during widespread crises.

The Effects of Group Membership on College Students' Social Exclusion of Peers and Bystander Behavior.

Bystanders represent one major avenue for reducing the incidence and severity of social exclusion, yet little research has examined behavioral measurement of bystander intervention. Utilizing the most common low risk form of exclusion, this study examined how group membership impacts college students' behavioral response to a peer's social exclusion through an Internet-based ball tossing game (N = 121). Participants played the game with three other virtual players, in which two of these players excluded the third player. Results demonstrated increased inclusive behavior towards the excluded peer across study conditions. This inclusion was strengthened when the excluded player was in the participant's in-group. Participants displayed an initial preference for in-group members, although attitudes towards all peers improved after the shared activity. Findings point to the interaction of social norms of inclusion, group membership, and changes in familiarity in determining bystander responses to social exclusion. In low-risk exclusion, group membership maintains an impact but does not provide sufficient motivation to counteract the social norm of inclusivity. The implication of bystander actions for promotion of community and future research are discussed.

Children Expressing Mixed Emotion in a Nonsocial Context.

Efforts to demonstrate children's ability to report experiencing mixed emotions have typically used an allocentric approach, asking children to report on emotions of other individuals in response to stories or movie clips demonstrating social themes. In contrast, literature examining children's personal experiencing and understanding of their own mixed emotions, typified as an egocentric approach, in nonsocial situations remains underdeveloped. The current study examined the development of children's reported understanding and experience of mixed emotions egocentrically. By examining a nonsocial context, this investigation extends existing gender- and age-related research on expressing egocentric mixed emotion. Using a computerized game with a disappointing wins paradigm, egocentric mixed emotional experience was elicited in 142 children (80 boys, 62 girls) aged 6 to 12 years. Results revealed that age, but not gender, was a statistically significant predictor of expressing egocentric mixed emotion experience and understanding. When studying mixed emotion development in a nonsocial context, gender did not contribute to differences in child reports. A significant positive relationship between egocentric mixed emotion experiencing and understanding also emerged. These findings contribute to our understanding of children's emotion development and offer future directions for examining the broad domain of nonsocial contexts in youth expression of mixed emotions.