Roles of Loneliness, Stress, and Religiosity in Suicide Ideation Among Nigerian Older Adults.

Suicidal behavior in older adults is a fundamental public health problem globally and the highest suicide rates occur in low- and middle-income countries (LMICs). However, there is limited research on suicidality among older adults, especially in sub-Saharan Africa. We sought to find out whether loneliness, stress and religiosity would be associated with suicide ideation in a sample of sub-Saharan African older adults (N = 500; aged 51-70 years, Mage = 58.97, SD = 6.16; 45.6% women). They completed the Beck Suicidal Ideation Scale, the UCLA Loneliness Scale-version 3, Perceived Stress Scale, and Religiosity Scale. Regression results showed that whereas suicidal ideation could be increased by loneliness and stress, religious older adults were less likely to report suicidal ideation. Interventions aimed at managing and protecting the mental health of older adults during their transition to late adulthood should guard them against loneliness and buffer their resilience and coping strategies with the connectedness that religiosity offers.

Fifty Years After Nigerian Civil War: Social Support Is Associated with PTSD Symptoms Through Increased Self-Efficacy Among Biafran Veterans.

The Nigerian Civil War (or Nigerian-Biafran War, 1967-1970) was fought between the Nigerian federal government and the defunct Republic of Biafra. Biafra recruited young men and boys (child soldiers) to fight the war, but little attention has been given to understanding the mental health outcomes of the War on Biafran veterans. Although there are few studies on social support in relation to post-traumatic stress disorder (PTSD) symptoms in this older veteran population, the mechanism through which social support influences PTSD has not received much attention. Hence, we investigated whether self-efficacy explains the association between social support and PTSD symptoms in a sample of Biafran War veterans. They were recruited from the Veterans' association in south-east Nigeria (N = 250; Mage = 71.33 years, SD = 7.11), and completed self-report measures of social support, self-efficacy, and PTSD symptoms. Results showed that veterans with greater social support (ß = -.49, p < .001) and high self-efficacy reported less PTSD symptoms (ß = -.55, p < .001). Above all, social support predicted decreased PTSD symptoms risk through increased self-efficacy, 95% CI [-0.53, -0.29]. By implication, social support may be associated with lower PTSD symptoms because it enhances efficacy beliefs, and thereby leads to less PTSD symptoms.

Self-perception of health and physical activity levels among the youth and adults before and amidst the COVID-19 pandemic.

Background: Emerging research indicates that the COVID-19 pandemic and associated restrictions led to decreased physical activity levels and poorer health globally. However, most studies on this topic have focused on advanced countries, leaving a gap in understanding the impact in countries like Ghana. This study aimed to fill this gap by assessing self-perceived health status and physical activity levels among youth and adults in Ghana before, during, and after the COVID-19 restrictions. Understanding these dynamics is crucial for informing public health interventions and policies to promote well-being during and beyond the pandemic. Methods: A cross-sectional survey using online data collection methods was conducted, involving 937 participants. Data included demographic information, and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Analysis was done using SPSS version 25, with descriptive statistics and multinomial regression. Results: Most participants (89.6%) reported good health. Male participants were significantly more likely to engage in moderate (1.78 times) and high (3.17 times) physical activity during the COVID-19 period compared to females. Conclusion: This study highlights gender disparities in physical activity levels during the pandemic in Ghana. Addressing these disparities and promoting healthier lifestyles, especially during crises, is crucial for general and mental health. Further research should explore socio-demographic factors' role in health behaviors during pandemics.

Social Support, Health Behaviors, Self-Esteem, and Successful Aging in a Sub-Saharan African Sample of Older Adults: Test of a Sequential Mediation Model.

Background and Objectives: Previous research demonstrates that social support facilitates successful aging across all cultures. However, the factors that potentially mediate the link between social support and successful aging remain unclear. This study examined whether a healthy lifestyle and self-esteem mediate the association between social support and successful aging. It was hypothesized that the relationship between social support (family, friends, and significant other) and successful aging would be serially mediated by both healthy lifestyle and self-esteem. Research Design and Methods: Participants were 479 Nigerian retirees (53.4% female) aged 60 to 90 years (Mage = 64.81, SD = 6.86). They provided information on relevant demographic variables and completed the following measures: Fantastic Lifestyle Checklist (Fitness Appraisal), Rosenberg Self-esteem Scale, Multidimensional Scale of Perceived Social Support Scale, and Successful Aging Inventory. Three separate regression models (family, friends, and significant other dimensions of social support) were conducted using the Hayes PROCESS macro for SPSS with 5,000 bootstrap estimates. Results: Controlling for age and sex, family support, significant other support, friends support, healthy lifestyle, and self-esteem were directly associated with successful aging. The association between family support and successful aging was mediated by healthy lifestyle; and this was also seen for friends' support and significant other support. The sequential path from social support to successful aging through healthy lifestyle, and then via improved self-esteem, was significant for family support and significant other support, but not friends support. Discussion and Implications: Findings suggest that middle-aged to older adults who have strong support from their families and significant others may be more likely to engage in healthy behaviors and, in turn, experience higher levels of self-esteem, thereby aging well.

Is Geropsychology "Forever Young" on the Mother Continent? Addressing the Limited Research on Psychology of Aging in Africa.

OBJECTIVES: Our paper highlights areas of interest to psychologists studying aging in Africa and what has already been learned about aspects of psychological aging from studies done in the African context. We also considered whether there are issues that are unique about aging in the African context that might challenge how aging is typically considered in psychology research. METHODS: We reviewed articles recently published in major gerontology journals focusing on African older adults, with the goal of identifying key themes of current geropsychology in Africa. RESULTS: We identified a number of dominant themes including: subjective aging, psychosocial impact of widowhood at old age, aging in place, stress and caregiving, cognitive aging, interrelations between HIV and aging, and successful aging. DISCUSSION: The themes of psychological aging research identified as especially relevant in Africa provide a starting point for psychological aging researchers in general to engage with the African context. Many African countries may be facing common challenges, but the existing studies are not fully representative of the aging population in the continent. Creating a framework for organizing and coordinating funding will help to address the limited research on geropsychology in Africa. Collaborative research projects/programs, joint classrooms, and fellowships that support African geropsychology scholars will be helpful. Geropsychology will benefit from more engagement with the African context by applying innovative approaches such as the adoption of longitudinal designs, mixed-method research, Experience Sampling Methods, translation of measures into indigenous languages, involvement of rural samples, and implementation science and community-engaged research.

Mediating role of emotion regulation in the relationship between mindfulness and mental well-being among formal caregivers of psychiatric patients.

Professional caregivers of psychiatric patients are often exposed to circumstances and environments that threaten their mental well-being in the course of carrying out their professional duties. In this study, we examined the mediating role of emotion regulation in the association between mindfulness and mental well-being among professional caregivers of psychiatric patients. Three hundred and seven professional caregivers of psychiatric patients whose ages ranged between 22 and 63 years (mean age = 39.21 years; SD = 10.09 years) participated in the study. They completed measures of mindfulness, emotion regulation and mental well-being in addition to supplying relevant demographic information. Results of mediation analysis showed that expressive suppression dimension of emotion regulation mediated the relationship between mindfulness and mental well-being. This indicates that mindfulness was associated with increased mental well-being via the pathway of reduced expressive suppression. These findings suggest that expressive suppression may represent an effective way to strengthen the link between mindfulness and mental well-being among professional caregivers and ultimately provide a means to improve their well-being.

Addressing the unmet mental health needs of people living with HIV: a scoping review of interventions in sub-Saharan Africa.

Some mental health interventions have addressed mental health among people living with HIV (PLWH) using a variety of approaches, but little is known about the details of such interventions in sub-Saharan Africa (SSA), a region that bears the largest burden of HIV in the world. The present study describes mental health interventions for PLWH in SSA regardless of the date and language of publication. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, we identified 54 peer-reviewed articles on interventions addressing adverse mental health conditions among PLWH in SSA. The studies were conducted in 11 different countries, with the highest number of studies in South Africa (33.3%), Uganda (18.5%), Kenya (9.26%), and Nigeria (7.41%). While only one study was conducted before the year 2000, there was a gradual increase in the number of studies in the subsequent years. The studies were mostly conducted in hospital settings (55.5%), were non-pharmacologic (88.9%), and interventions were mostly cognitive behavioural therapy (CBT) and counselling. Task shifting was the primary implementation strategy used in four studies. Interventions addressing the mental health needs of PLWH that incorporates the unique challenges and opportunities in SSA is highly recommended.

Locating event centrality in associations of emotion regulation with posttraumatic stress disorder symptoms and posttraumatic growth in emerging adults.

Previous research suggests that cognitive reappraisal (CR) and expressive suppression (ES) strategies of emotion regulation (ER) are associated with posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). How the patterns of these associations may vary in the context of event centrality (EC) however requires investigation to help delineate groups for whom the impact of event centrality may be more salient. We examined whether EC would moderate the associations of CR and ES with PTSD symptoms clusters and PTG domains among 388 emerging adults (18-30 year-olds) of Tiv ethnic group who were survivors of armed attack by Fulani herdsmen and were temporarily sheltered in two internally displaced persons' (IDPs') camps in North-central Nigeria. They completed self-report measures of the variables. Results indicated that EC strengthened the negative associations of CR and the positive associations of ES with avoidance, hyper-arousal and total PTSD symptoms, but not intrusion symptoms. For the PTG domains, EC only strengthened the positive association between CR and personal strength and weakened the association of ES with greater appreciation of life. These findings suggest that primary intervention programs that incorporate training of armed attack survivors in cognitive reappraisal strategy centered on the traumatic event could be effective in controlling PTSD but be less critical in engendering PTG. They also show that the psychological processes that underlie PTSD and PTG are related but involve nuances even within PTSD, and do not seamlessly set into the Janoff-Bulman's "strength through suffering" model of PTG. More research is required to test the model.

Building a national framework for multicentre research and clinical trials: experience from the Nigeria Implementation Science Alliance.

There is limited capacity and infrastructure in sub-Saharan Africa to conduct clinical trials for the identification of efficient and effective new prevention, diagnostic and treatment modalities to address the disproportionate burden of disease. This paper reports on the process to establish locally driven infrastructure for multicentre research and trials in Nigeria known as the Nigeria Implementation Science Alliance Model Innovation and Research Centres (NISA-MIRCs). We used a participatory approach to establish a research network of 21 high-volume health facilities selected from all 6 geopolitical zones in Nigeria capable of conducting clinical trials, implementation research using effectiveness-implementation hybrid designs and health system research. The NISA-MIRCs have a cumulative potential to recruit 60 000 women living with HIV and an age-matched cohort of HIV-uninfected women. We conducted a needs assessment, convened several stakeholder outreaches and engagement sessions, and established a governance structure. Additionally, we selected and trained a core research team, developed criteria for site selection, assessed site readiness for research and obtained ethical approval from a single national institutional review board. We used the Exploration, Preparation, Implementation, Sustainment framework to guide our reporting of the process in the development of this network. The NISA-MIRCs will provide a nationally representative infrastructure to initiate new studies, support collaborative research, inform policy decisions and thereby fill a significant research infrastructure gap in Africa's most populous country.

The Age-Related Positivity Effect and Emotion Regulation: Assessing Downstream Affective Outcomes.

While substantial literature suggests that positive preferences are in the service of emotion regulation pursuits, little evidence has directly linked positivity "processes" with well-being "outcomes." The current study examined age-related differences in negative gaze preferences and how such preferences are related to subsequent regulatory outcomes. Participants were 79 older adults and 72 younger adults. They first provided a baseline mood assessment, which was followed by a standardized emotional video clip for three minutes during which visual fixation preferences were recorded via an eye tracker. Mood was again assessed after the film, which was followed by a standardized video recovery task, and completion of a recovery mood measure. Older adults fixated less on negative portions of the emotional video clip relative to younger adults, indicative of an age-related positivity effect. The indirect effect of age on mood recovery through fixation was not supported.

An international study on psychological coping during COVID-19: Towards a meaning-centered coping style.

BACKGROUND/OBJECTIVE: This study examined the role of different psychological coping mechanisms in mental and physical health during the initial phases of the COVID-19 crisis with an emphasis on meaning-centered coping. METHOD: A total of 11,227 people from 30 countries across all continents participated in the study and completed measures of psychological distress (depression, stress, and anxiety), loneliness, well-being, and physical health, together with measures of problem-focused and emotion-focused coping, and a measure called the Meaning-centered Coping Scale (MCCS) that was developed in the present study. Validation analyses of the MCCS were performed in all countries, and data were assessed by multilevel modeling (MLM). RESULTS: The MCCS showed a robust one-factor structure in 30 countries with good test-retest, concurrent and divergent validity results. MLM analyses showed mixed results regarding emotion and problem-focused coping strategies. However, the MCCS was the strongest positive predictor of physical and mental health among all coping strategies, independently of demographic characteristics and country-level variables. CONCLUSIONS: The findings suggest that the MCCS is a valid measure to assess meaning-centered coping. The results also call for policies promoting effective coping to mitigate collective suffering during the pandemic.

ANTECEDENTES/OBJETIVO: Este estudio examinó el papel de diferentes estrategias de afrontamiento psicológico en la salud mental y física durante las fases iniciales de la crisis de COVID-19. MÉTODO: 11,227 personas de 30 países representando todos los continentes participaron en el estudio y completaron medidas de malestar psicológico (depresión, estrés y ansiedad), soledad, bienestar, salud física, medidas de afrontamiento centrado en el problema y en la emoción, y una medida denominada Escala del Afrontamiento Centrado en el Sentido (MCCS) que fue desarrollada en este estudio. El análisis de validación de la MCCS se realizó en todos los países, y los datos se evaluaron mediante un modelo multinivel. RESULTADOS: La MCCS mostró una estructura unifactorial en 30 países con buenos resultados de validez test-retest, concurrente y divergente. Los análisis mostraron resultados mixtos en cuanto a las estrategias de afrontamiento centradas en la emoción y en el problema. La MCCS fue el predictor positivo más fuerte de salud física y mental, independientemente de las características demográficas y las variables a nivel de país. CONCLUSIONES: Los resultados sugieren que la MCCS es un insrumento fiable para medir afrontamiento centrado en el sentido. Estos resultados pueden servir para dirigir políticas que promuevan un afrontamiento eficaz con el fin de mitigar el sufrimiento colectivo durante la pandemia.

Understanding the health needs of internally displaced persons: A scoping review.

We seek to strengthen understanding of the health needs of internally displaced persons (IDPs) in contexts of conflict or violence. Based upon a scoping review, our paper identified limited evidence on IDP health, but nevertheless indicates that IDPs tend to experience worse health outcomes than other conflict-affected populations across a range of health issues; and this is due to the particularly vulnerable situation of IDPs relative to these other populations, including reduced access to health services. Further research is required to better understand these needs and the interventions that can most effectively address these needs.

Bullying and Suicide Ideation: Testing the Buffering Hypothesis of Social Support in a Sub-Saharan African Sample.

Substantial evidence indicates that adolescents and young adults have a disproportionately high incidence of most forms of violence, including suicide. Suicidality often includes suicidal ideation. The present study examined the relationship between bullying and suicidal ideation, and further tested whether social support moderates the association between the dimensions of bullying (verbal bullying, physical bullying, and bullying victimization) and suicidal ideation among adolescent secondary school students. A cross-sectional design was adopted for the study. Participants were 394 students (249 boys, 145 girls) drawn from two secondary schools in Nsukka semi-urban area, in southeast Nigeria. Participants completed the Illinois Bully Scale, the Columbia-Suicide Severity Rating Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Hayes' regression-based PROCESS macro was used to analyze the data. Verbal bullying, physical bullying, and victimization were independently positively associated with suicidal ideation. Social support was not independently significantly associated with suicidal ideation, but it moderated the relationship between victimization and suicidal ideation. The positive relationship between victimization and suicidal ideation was strongest for adolescents who had low social support, compared to those who had moderate or high social support. This finding is consistent with the buffering hypothesis of social support, suggesting that supportive relationships for victims can mitigate suicidal ideation.

Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS).

BACKGROUND: School health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). METHOD: The exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi's method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools. RESULTS: The coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff's health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach's alpha for all subscales > .93). The test-retest reliability was satisfactory-the intraclass correlation coefficient pooled was .95 (99% CI [.91-.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs' positions at schools. CONCLUSION: The SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff's health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version.

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n = 63, 31.3%, women, n = 138, 68.7%, mean age = 40.1, SD = 10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

Anxiety sensitivity and psychological distress among hypertensive patients: the mediating role of experiential avoidance.

Hypertension is often associated with adverse psychosocial outcomes and psychological factors have been advanced for better explanatory models and to enhance the development of effective interventions in the treatment of hypertensive patients. Although the link between anxiety sensitivity (AS) and poor mental health outcomes has been established, the mechanism through which it results in psychological distress (PD) is not yet well understood. In addition to investigating the direct associations of AS and experiential avoidance (EA) to PD, the present study examines whether AS predicts adverse mental health outcomes via EA. Hypertensive patients (N = 240; women = 135; Mean age = 41.09, SD = 9.11 years) drawn from cardiology unit of a Nigerian teaching hospital completed the following measures: Psychological Distress Scale, Anxiety Sensitivity Index - 3, and Acceptance and Action Questionnaire. Results showed that that greater AS and greater EA predicted increased PD, even when controlling for age and gender. The mediation hypothesis was further supported suggesting that the association between AS with increase in PD was a function of heightened EA. These findings are consistent with the notion that acceptance of daily experiences may serve to buffer against the potential adverse mental health outcomes and may be a critical target for interventions to ameliorate PD in patients with chronic health conditions such as hypertension. Psychological interventions that deals with experiential avoidance could be used in the management of distressed hypertensive patients.

Commentary on the coronavirus pandemic: Nigeria.

About a week after the confirmation of Nigeria's index case of COVID-19 on February 27, 2020, the Nigerian federal government set up a 12-member Presidential Task Force for the Control of the Coronavirus. The country's borders were closed on March 23, and the lockdown of cities was also implemented. The unanticipated disruption of scholarly or professional advancement for the 94% of university students who are not currently learning may increase the burden of mental illness among these students and predispose them to social vices. Two suicide deaths occurred during the lockdown. Poverty, lack of trust in the government, ignorance, denial and misplaced religious zealotry negatively impact on the behavior of Nigerians. Fear-induced behavioral changes such as consuming lemon, ginger, garlic, local herbs, and other substances for protection have also become rampant. Loss of income due to the lockdown and the accompanying destitution can also be a pathfinder for numerous other sicknesses and deaths. For the benefit of enhanced prevention and control of infection, only government-funded hospitals and a few designated privately owned hospitals have been permitted to provide continued services at this time. The number of shifts in these hospitals were adjusted such that there are fewer health care professionals in the hospital at a given time. This strategy has inhibited treatment and care for certain groups of people who are not COVID-19 patients. Efforts are being made to develop telehealth services, but most rural residents may not benefit from them. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Roles of Religious Commitment, Emotion Regulation and Social Support in Preoperative Anxiety.

Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.

Dependent Personality, Mindful Awareness, and Marital Satisfaction and their Association with Postpartum Psychological Distress in Two Tertiary Hospitals, Southeast Nigeria.

This study assessed dependent personality, marital satisfaction, and mindful awareness and their association with postpartum depression and anxiety. It was a cross-sectional study of nursing mothers, within 6-14 weeks postpartum, at the postnatal and children's welfare clinics of two tertiary hospitals in Enugu, southeastern Nigeria. The nursing mothers responded to different questionnaires that measure each of these variables. Correlations and multiple regression analyses were used to measure the strength of association between the variables in the study and to identify predictors for the outcome variables of interest, respectively. Low mindful attention awareness, poor marital satisfaction, and low dependency predicted an increased risk of postpartum depression and anxiety, with low mindful attention awareness as the strongest predictor. The findings from the study carry significant implications for the roles of dependent personality, marital satisfaction, and mindful awareness in the etiology of postpartum depression and anxiety in Southeast Nigeria.