Evaluating the mental health and well-being of Canadian healthcare workers during the COVID-19 outbreak.

During the COVID-19 pandemic, healthcare systems have been under extreme levels of stress due to increases in patient distress and patient deaths. While additional research and public health funding initiatives can alleviate these systemic issues, it is also important to consider the ongoing mental health and well-being of professionals working in healthcare. By surveying healthcare workers working in Canada during the COVID-19 pandemic, we found that there was an elevated level of depressive symptomatology in that population. We also found that when employees were provided with accurate and timely information about the pandemic, and additional protective measures in the workplace, they were less likely to report negative effects on well-being. We recommend that healthcare employers take these steps, as well as providing targeted mental health interventions, in order to maintain the mental health of their employees, which in turn will provide better healthcare at the population level.

The intersection of physical activity type and gender in patterns of disordered eating.

Although previous research has linked disordered eating to physical activity involvement, more recent studies suggest that sports participation may be protective against disordered eating; however, due to inconsistent findings on how physical activity affects disordered eating and limited research comparing types of physical activity across weight control behaviours, our aim was to validate physical activity categorization across disordered eating components in both men and women. In this online study, 209 men and 539 women completed questionnaires assessing various components of disordered eating and overall physical activity participation. Pearson correlation coefficients, independent samples t-tests, multiple response crosstabulations, and linear regressions were calculated to achieve the aims of this study. Participation in various types of physical activity significantly predicted various components of disordered eating attitudes, behaviours, and cognitions. Specifically, for women, purging and restricting eating were associated with participation in ball games, while a focus on muscle building was associated with both ball games and weight-class physical activity. For men, body dissatisfaction and excessive exercise were associated with weight-class physical activity participation, while cognitive restraint and muscle building were related to aesthetic sports participation. Purging was associated with both aesthetic and weight-class physical activity, whereas restricting eating was related to weight-class physical activity and ball games. These inconsistencies underscore the need for further research to fully elucidate the relationship between participation in different types of physical activity and the various components of disordered eating.

Working after cancer: psychological flexibility and the quality of working life.

PURPOSE: Our purpose was to examine the associations between the pillars of psychological flexibility (valued action, behavioural awareness, openness to experience) and aspects of quality of working life after a cancer. We examined how the pillars of psychological flexibility mediated the relationships between quality of working life and anxiety, depression, and overall life satisfaction. Examining psychological flexibility allows interventions to be targeted for cancer survivors and account for unique, individual needs. METHODS: In this cross-sectional study, 230 cancer survivors who were currently employed completed a questionnaire package that included demographic information and measures of physical health problems, satisfaction with life, quality of working life in cancer survivors, psychological flexibility, anxiety, and depression. RESULTS: The mediational analyses illustrated how specific pillars of psychological flexibility mediated the relationships between quality of working life and anxiety, depression, and overall satisfaction with life. Overall, psychological flexibility mediated the relationships between physical health and health-related work problems, quality of working life, and satisfaction with life. Further, the valued action pillar of psychological flexibility fully mediated the relationship between quality of working life and reported symptoms of depression and anxiety. CONCLUSIONS: Higher psychological flexibility was related to higher satisfaction with working life. Physical and psychological challenges during employment may be improved through interventions that improve psychological flexibility. Active engagement with activities aligned with personal values is related to more positive outcomes. IMPLICATIONS FOR CANCER SURVIVORS: The value of examining the pillars of psychological flexibility is that interventions can be targeted for this population, considering this population's unique needs.

Cancer, now what? A cross-sectional study examining physical symptoms, subjective well-being, and psychological flexibility.

Background: The impact of cancer extends beyond treatment and evaluating the adverse psychological effects in survivors is important. We examined: (1) the relationship between diagnosis, relapse, and subjective well-being using a short and a holistic measure of well-being, including comparisons between our sample and established norms; (2) if reported physical symptoms were related to components of subjective well-being; and (3) if increased psychological flexibility predicted overall subjective well-being. Methods: In total, 316 survivors completed online questionnaires to assess cancer, physical health (Edmonton Symptom Assessment Scale-R; ESAS-R), subjective well-being (Comprehensive Inventory of Thriving; CIT; Satisfaction with Life Scale; SWLS) and psychological flexibility (Comprehensive Assessment of Acceptance and Commitment Therapy). Results: Relative to ESAS-R cut-points (Oldenmenger et al., 2013), participants reported only moderate levels of tiredness and slightly elevated drowsiness, depression, and anxiety; participants reported more problems with psychological health. SWLS scores were lower than published norms (M = 18.23, SD = 8.23) and a relapse was associated with the lowest SWLS scores (M = 16.95, SD = 7.72). There were differences in thriving between participants and age-matched norms (Su et al., 2014). Participants reported lower community involvement, respect, engagement with activities, skill mastery, sense of accomplishment, self-worth, self-efficacy, autonomy, purpose, optimism, subjective well-being, and positive emotions coupled with higher loneliness and negative emotions. In regression analysis, two components of psychological flexibility, Openness to Experience, t = 2.50, p < 0.13, ß = -0.18, and Valued Action, t = 7.08, p < 0.001, ß = -0.47, predicted 28.8% of the variability in total CIT scores, beyond the effects of demographic and disease characteristics and reported physical symptoms. Conclusion: Cancer is an isolating experience, with the adverse psychological effects that impact subjective well-being continuing after the cessation of physical symptoms. Specific components of psychological flexibility may explain some variability in thriving beyond disease characteristics and may inform psychological intervention after diagnosis.

Access to Healthcare and Unmet Needs in the Canadian Lesbian-Gay-Bisexual Population.

Individuals who identify as a sexual minority, including those who are lesbian, gay, or bisexual (LGB), face barriers to healthcare as well as increased discrimination, stigmatization, and negative experiences during healthcare use. Further, few healthcare providers have education and training focused on the specific healthcare needs of individuals who are part of a sexual minority group. Given the limited research on Canadian healthcare access for sexual minorities, our purpose was to use data (n > 2,800) from the 2015-16 Canadian Community Health Survey (CCHS) to investigate the perceptions of healthcare access for LGB and non-LGB Canadians. Although non-LGB and LGB participants reported comparable access to a regular care provider and were equally likely to have consulted with a general practitioner in the past 12 months, LGB respondents were more likely to have seen a specialist and reported more unmet health needs. Although we expected the linear effects of both race and sex to vary by LGB status, this effect only occurred in one model. Current results have implications for addressing health inequalities for sexual minorities, including poorer health outcomes and greater discrimination.

Eat, pray, love: disordered eating in religious and non-religious men and women.

BACKGROUND: Despite the lack of research examining the relation between religiosity and disordered eating, at various points during the year, religious practices requiring changes in eating habits are typical. Few studies have identified how aspects of religiosity are associated with disordered eating attitudes and behaviours. Thus, we explored the interconnectedness of religiosity and gender on disordered eating attitudes and behaviours. METHODS: In total, 749 religious and non-religious participants completed online questionnaires assessing components of disordered eating and associated appearance-related pressures and internalizations (pressure from family, peers, and media, and internalization of the thin and muscular ideals). RESULTS: Among the 317 participants who identified as religious, 12.30% reported that their religious practice required a change in their eating habits, and 10.68% reported that they changed their eating habits for both religious purposes and as a method of weight loss/control. Overall, religious participants who indicated changing their eating habits for religious purposes experienced greater disordered eating and appearance-related pressures than theists who reported no change in their diet and non-religious respondents. Further, there was a significant interaction between gender and religiosity across the disordered eating variables. Results indicated that, compared to males who were not religious, those who were religious had higher scores on scales measuring disordered eating. Religious and non-religious women scored similarly on scales measuring other aspects of disordered eating (including Purging, Restricting, and Binge Eating). Further, compared to non-religious men, religious men, reported greater pressure from their family and peers; there was no difference in women. CONCLUSIONS: Future research should further explore gender differences across types and specific aspects of religiosity such as motivation to practice.

Studies have identified benefits and risks of aspects of religiosity in disordered eating. Our purpose was to explore the role of gender and religiosity in disordered eating. We found that, in males, religiosity was associated with increases in all aspects of disordered eating as well as increased pressure to maintain the thin ideal. Among religious and non-religious females, there were fewer differences in disordered eating attitudes and behaviours. Religious and non-religious females reported similar pressures to attain the thin ideal. Thus, future research should further examine the underlying factors of religiosity related to disordered eating in men and women.

Remember the past, plan for the future: How interactions between risk perception and behavior during the COVID-19 pandemic can inform future Canadian public health policy.

The ongoing COVID-19 pandemic necessitated the implementation of numerous temporary public health policies, including social distancing, masking, and movement limitations. These types of measures require most citizens to follow them to be effective at a population level. This study examined population adherence to emergency public health measures using early data collected in the Spring of 2020, when all Canadian jurisdictions were under relatively strict measures. In total, 1,369 participants completed an online questionnaire package to assess adherence, perceptions of government response, and perceptions of COVID-19 risk. Results indicated that most Canadians were pleased with the government's handling of the early phases of the pandemic and immediately engaged new public health mandates. Willingness to change behaviors was unrelated to satisfaction with the government response. Similarly, behavioral adherence was also unrelated to satisfaction with government, or personal risk perceptions; however, adherence to public health guidelines was related to elevated psychological distress. As the pandemic continues, public health officials must balance the mental health of the population with the physical health concerns posed by COVID-19 when applying public health mandates.

What is the mindful personality? Implications for physical and psychological health.

Given the paucity of research examining relationships between mindfulness and specific facets of personality, we conducted detailed analyses to explore associations between personality facets, dispositional mindfulness, and health. Overall, 781 participants completed the Five Factor Mindfulness Questionnaire (FFMQ), the Big Five Inventory-2 (BFI-2) to measure personality factors and facets, and the RAND 36-Item Health Survey 1.0 (RAND-36). As expected, BFI-2 factors and facets and FFMQ subscales, except Observing, were consistently correlated. Canonical correlations of BFI-2 facets and FFMQ subscales provided two statistically significant functions. Function 1, Self-Regulation, included FFMQ Acting with Awareness, Non-Judging, and Non-Reacting, as well as BFI-2 Negative Emotionality (Anxiety, Depression, Emotional Volatility), Conscientiousness (Productiveness, Responsibility), and Extraversion (Assertiveness, Energy). Function 2, Self-Awareness, comprised of FFMQ Describing and Observing, and all facets of Open-Mindedness. A latent profile analysis produced three latent profiles: Self-Regulation was defined by higher FFMQ subscales as well as higher Extraversion (all facets), Agreeableness (all facets), Conscientiousness (all facets), and lower Negative Emotionality (all facets); Self-Dysregulation was defined by lower scores on most FFMQ subscales, BFI-2 Extraversion facet scores, Agreeableness (Trust), Conscientiousness (Productiveness), and higher Negative Emotionality facets; and, an Average profile included midrange levels of mindfulness and personality facets. Further, there were statistically significant differences in RAND-36 physical and psychological health based on the latent profiles. The novel findings examining the facet-level relationship between personality and mindfulness contribute to prior inconclusive literature. These results presenting a nuanced understanding of the association between dispositional mindfulness and personality provide preliminary information suggesting that self-regulation can affect health.

Multiple trials may yield exaggerated effect size estimates.

Published psychological research attempting to support the existence of small and medium effect sizes may not have enough participants to do so accurately, and thus, repeated trials or the use of multiple items may be used in an attempt to obtain significance. Through a series of Monte-Carlo simulations, this article describes the results of multiple trials or items on effect size estimates when the averages and aggregates of a dependent measure are analyzed. The simulations revealed a large increase in observed effect size estimates when the numbers of trials or items in an experiment were increased. Overestimation effects are mitigated by correlations between trials or items, but remain substantial in some cases. Some concepts, such as a P300 wave or a test score, are best defined as a composite of measures. Troubles may arise in more exploratory research where the interrelations among trials or items may not be well described.

Exploring the Relationship Between Disordered Eating and Executive Function in a Non-Clinical Sample.

Previous research suggests that individuals diagnosed with eating disorders (ED) may experience executive functioning deficits that help maintain their ED. Although this relationship is reported consistently in clinical samples, it is important to consider whether it holds for individuals with sub-clinical ED symptoms. One hundred eighty-eight university students participated in the present study examining the relationship between executive function (EF) and disordered eating behaviors. Participants completed a demographics questionnaire, self-report questionnaires measuring atypical eating behaviors (EAT-26; EDI-3), and a self-report measure of EF (BRIEF-A). Correlational analyses demonstrated significant positive associations between ED behaviors and problems with emotional control, shifting, inhibition, and self-monitoring. Six hierarchical multiple regressions were conducted, using EF scores to predict scores on EAT-26 subscales (Dieting, Bulimia, Total ED Risk) and EDI-3 scales (Drive for Thinness, Bulimia, Risk Composite). In all regression analyses, BRIEF-A Emotional Control emerged as a significant predictor. As would be expected, EDI-3 Bulimia scores were also predicted by problems with inhibition. These results provide preliminary evidence of an association between non-clinical patterns of disordered eating and executive dysfunction, specifically including the ability to control one's emotions, suggesting that emotional control problems may help predict ED risk. Future research could examine how these factors predict the development of eating disorders.

Social and psychological influences on satisfaction with life after brain injury.

BACKGROUND: In spite of the increased focus of education and awareness programs on prevention and safety surrounding Acquired Brain Injury (ABI), over 50,000 Canadians and 900,000 Americans sustain a brain injury every year. Given the psychological impact of an ABI, there is a growing body of literature examining the links between injury, mental health, and life satisfaction in brain injury survivors; specifically, changes in leisure activities, employment, and the struggles with injury related deficits contribute to increased social isolation, depression, and loneliness. OBJECTIVES: The current study examined personality characteristics, unmet needs, and psychosocial risk factors in survivors of brain injuries. METHODS: In this cross-sectional online study, 592 brain injury survivors completed questionnaires to assess psychological variables associated with their current life situation. RESULTS: We found high levels of depression among survivors, with 47.6% of participants reporting moderate or severe levels of depression and 41.2% reporting suicidal ideation. Although survivors reported lower life satisfaction than population norms, satisfaction was only slightly lower in those with a recent (less than two years) injury. Overall, regression models accounted for 50.1% of the variability in satisfaction with life. Increased engagement in leisure activities, higher emotional stability (p < .001) and sociability (p < .01) coupled with lower depression (p < .001) and romantic loneliness (p < .001) significantly predicted satisfaction with life. CONCLUSIONS: These results could aid in the development of policies and procedures surrounding the discharge of patients that includes a plan for increasing social leisure activities within the community and providing ongoing support for survivors when formal rehabilitation ceases.

Accuracy of effect size estimates from published psychological research.

A Monte-Carlo simulation was used to model the biasing of effect sizes in published studies. The findings from the simulation indicate that, when a predominant bias to publish studies with statistically significant results is coupled with inadequate statistical power, there will be an overestimation of effect sizes. The consequences such an effect size overestimation will then have on meta-analyses and power analyses are highlighted and discussed along with measures which can be taken to reduce the problem.

Symptoms of exercise dependence and physical activity in students.

Health professionals recognize the benefits of moderate physical activity and encourage clients to engage in some form of activity on a regular basis. In spite of these recognized benefits, there are growing concerns that some may exercise at levels detrimental to health. The term exercise dependence refers to those individuals whose extreme exercise schedules interfere with their social, occupational, and family lives. The purpose of this study was to examine the relationship between weekly exercise habits and scores on the Exercise Dependence Questionnaire in a sample of undergraduate students (213 women and 79 men). Overall, participants who reported high activity scored higher than those reporting low activity on subscales measuring interference with family and social life, positive reward, withdrawal, exercise for social reasons, exercise for health reasons, and stereotyped behavior.

Perception of linear and nonlinear trends: using slope and curvature information to make trend discriminations.

This study investigated several factors influencing the perception of nonlinear relationships in time series graphs. To model real-world data, the graphed data represented different underlying trends and included different sample sizes and amounts of variability. Six trends (increasing and decreasing linear, exponential, asymptotic) were presented on four graph types (histogram, line graph, scatterplot, suspended bar graph). The experiment assessed how these factors affect trend discrimination, with the overall goal of judging what types of graphs lead to better discrimination. Six participants (two psychology professors, four psychology graduate students) viewed graphs on a computer screen and identified the underlying trend. All participants were familiar with the types of trends presented and were aware of the purpose of the experiment. Analysis indicated higher accuracy when variability was lower and sample size was higher. Choice accuracy was higher for nonlinear trends and was highest when line graphs were used.

Graphs, Tables, and Scientific Illustrations: Visualisation as the Science of Seeing Gerontology.

Visual inscriptions (e.g., graphs, illustrations) are a defining feature of scientific discovery to aid in data analysis, interpretation, and communication (e.g., Latour, 1990; Lynch, 1985). Our purpose was to examine how visual inscriptions are used to present data in gerontology journals. We compared 357 articles sampled from 24 peer-reviewed gerontology journals published between 1995 and 2009. Approximately 11 per cent of page space was dedicated to data presentation with more page space occupied by tables (9.13%) than graphs (2.32%). Graph use in gerontology was lower than in psychology (6.6% of page space) and higher than in criminology and criminal justice (1.7% of page space). Following Latour (1990), we argue that visualisations provide an understandable summary of complex data by effectively presenting multifaceted results. When inscriptions are used in dissemination, researchers become less reliant on complex statistical jargon and can communicate easily with a diverse audience (researchers, health care practitioners, clients).

Perceived current and ideal body size in female undergraduates.

Body image dissatisfaction and disordered eating attitudes and behaviors are pervasive problems in Western society, particularly for females. The female "thin-ideal" is a potent contributor to the growing discontent with the female body and research has shown that even females who are normal or underweight, perceive themselves as overweight. The goal of the current study was to examine correlates of body image satisfaction and the perception of the female body. One hundred and sixty six female undergraduates (Mean Age=21.40 years) completed self-report measures pertaining to disordered eating (EAT-26) and body dissatisfaction (BIQ and ABS). Body image perception and satisfaction were measured using ratings of female bodies on a weight perception scale (PFRS). Overall, disordered eating was related to a lower ideal body size and greater body dissatisfaction. In support of previous research, the most common ideal female body had a BMI categorized as underweight. Although females in the current sample reported an ideal that was smaller than their current size, participants underestimated their current body size, which, given the amount of dieting and weight pressure in present Western society, seems counterintuitive. It is possible that thin ideal portrayed in the media is increasingly different from and at odds with the average female body.

Constructing knowledge. The role of graphs and tables in hard and soft psychology.

Because graphs provide a compact, rhetorically powerful way of representing research findings, recent theories of science have postulated their use as a distinguishing feature of science. Studies have shown that the use of graphs in journal articles correlates highly with the hardness of scientific fields, both across disciplines and across sub-fields of psychology. In contrast, the use of tables and inferential statistics in psychology is inversely related to subfield hardness, suggesting that the relationship between hardness and graph use is not attributable to differences in the use of quantitative data in subfields or their commitment to empiricism. Enhanced "graphicacy" among psychologists could contribute to the progress of psychological science by providing alternatives to significance testing and by facilitating communication across subfields.

Accuracy of effect size estimates from published psychological experiments involving multiple trials.

The reporting of exaggerated effect size estimates may occur either through researchers accepting statistically significant results when power is inadequate and/or from repeated measures approaches aggregating, averaging multiple items, or multiple trials. Monte-Carlo simulations with input of a small, medium, or large effect size were conducted on multiple items or trials that were either averaged or aggregated to create a single dependent measure. Alpha was set at the .05 level, and the trials were assessed over item or trial correlations ranging from 0 to 1. Simulations showed a large increase in observed effect size averages and the power to accept these estimates as statistically significant increased over numbers of trials or items. Overestimation effects were mitigated as correlations between trials increased but still remained substantial in some cases. The implications of these findings for meta-analyses and different research scenarios are discussed.

Multiple addictive behaviors in young adults: student norms for the Shorter PROMIS Questionnaire.

The Shorter PROMIS Questionnaire (SPQ; Christo, Jones, Haylett, Stephenson, Lefever & Lefever, 2003) is a multidimensional self report that measures 16 addictive behaviors. This study examined the psychometric properties of the SPQ and collected normative data from 948 students at two Canadian universities. Factor analysis confirmed the existence of two categories of addictive behavior, which Haylett and her colleagues (2004) labelled hedonistic and nurturant. The hedonistic categories included behaviors such as the use of prescription drugs, gambling, caffeine, illegal drugs, alcohol, tobacco and compulsive sex. The nurturant group included behaviors such as compulsive helping, work, relationships, shopping, disordered eating and exercise. Men (N=250) scored higher than women on dominant relationships, exercise, gambling, illegal drugs, alcohol, tobacco and sex. Women (N=698) scored higher on compulsive shopping, food binging and starving. These results suggest that the SPQ may be a useful index of multiple addictive behaviors in college-age people.

Female students' disordered eating and the big five personality facets.

Female undergraduate students at two Canadian universities (N = 378) completed the NEO PI-R (Costa, P.T. & McCrae, R.R. (1992). NEO PI-R Professional Manual. Lutz, FL: Psychological Assessment Resources) and the Eating Attitudes Test (EAT-26; Garner, D. M., Olmstead, M. P., Bohr, Y. & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878.). Eating disorder symptomatic (N = 43) and nonsymptomatic (N = 335) women differed on facets of Neuroticism, Extraversion, and Agreeableness. Among symptomatic women, the Oral Control subscale of the EAT-26 was correlated significantly with facets of Neuroticism, Agreeableness and Conscientiousness. Specifically, the Impulsivity facet of Neuroticism was positively correlated with the Bulimia and Food Preoccupation subscale of EAT-26, but negatively correlated with the Oral Control and Dieting subscales. Overall, results suggest that high scores on Neuroticism may be a risk factor for development of disordered eating behavior and that the degree of Impulsiveness may predict the eating disorder subtype to which one is most susceptible.