Expanding research on the impact of financial hardship on emotional well-being: guidance of diverse stakeholders to the Emotional Well-Being and Economic Burden of Disease (EMOT-ECON) Research Network.

The Emotional Well-Being and Economic Burden (EMOT-ECON) Research Network is one of six research networks funded by the National Institutes of Health (NIH) to advance research about emotional well-being (EWB), and the only one that focuses on addressing how economic burden due to disease or illness affects EWB. The network convened researchers, patients, patient advocates, health care providers and other stakeholders from across the US to discuss the significance of addressing the impact of the economic burden of disease on EWB, the complexity of this prevalent problem for patients and families, and the research gaps that still need to be studied to ultimately develop strategies to reduce the impact of economic burden of disease on EWB and health. Participants identified some important future areas of research as those investigating: (i) prevalent and relevant emotions for patients experiencing economic burden of disease and financial hardship, and how their broader outlook on life is impacted; (ii) constructs and contexts that influence whether the economic burden is stressful; (iii) strategies to deal and cope and their positive or negative effects on EWB and health; and (iv) multi-level and multi-stakeholder interventions to address economic factors (e.g., costs, ability to pay), administrative burdens, education and training, and especially patients' emotional as well as financial status.

The association of negative mood with automatic and effortful facial expression mimicry.

The natural process of mimicking the facial expressions of others is well established, as are the deficits in this reflexive behavior for individuals with clinical disorders such as depression. This study examines the extent of this deficit in non-clinical individuals with high transient negative mood, and whether it extends to both automatic and effortful emotion expression behavior. One hundred and thirty-six participants were shown happy, sad, and neutral faces, while electromyography (EMG) recorded facial muscle responses. Automatic (reflexive) mimicry was assessed while participants simply viewed facially expressive photographs, while effortful mimicry was monitored when individuals were told to intentionally copy the expressions in the photographs. Results indicated that high levels of negative mood were primarily associated with deficits in effortful mimicry of happy expressions, although some similar evidence was found in automatic mimicry of happy faces. Surprisingly, there were also ties between negative moods and inaccuracies in effortful mimicry of sad expressions (but not automatic mimicry). Inaccurate automatic and effortful mimicry were also tied with lower self-reported social support and greater loneliness. These results indicate that even in healthy individuals, transient and minor changes in negative mood are tied to deficiencies in facial mimicry at both the automatic and effortful level.

Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health.

Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known prepandemic as well as contemporary research conducted during the pandemic. This focuses on the negative impact of the pandemic on psychosocial health and how this in turn has likely consequences for critically relevant viral and vaccination outcomes. We end by looking forward, highlighting the potential of psychosocial interventions that could be leveraged to support all people in navigating a postpandemic world and how a biopsychosocial approach to health could be incorporated into public health responses to future pandemics.

How and why could smiling influence physical health? A conceptual review.

ABSTRACTSmiling has been a topic of interest to psychologists for decades, with a myriad of studies tying this behavior to well-being. Despite this, we know surprisingly little about the nature of the connections between smiling and physical health. We review the literature connecting both naturally occurring smiles and experimentally manipulated smiles to physical health and health-relevant outcomes. This work is discussed in the context of existing affect and health-relevant theoretical models that help explain the connection between smiling and physical health including the facial feedback hypothesis, the undoing hypothesis, the generalized unsafety theory of stress, and polyvagal theory. We also describe a number of plausible pathways, some new and relatively untested, through which smiling may influence physical health such as trait or state positive affect, social relationships, stress buffering, and the oculocardiac reflex. Finally, we provide a discussion of possible future directions, including the importance of cultural variation and replication. Although this field is still in its infancy, the findings from both naturally occurring smile studies and experimentally manipulated smile studies consistently suggest that smiling may have a number of health-relevant benefits including beneficially impacting our physiology during acute stress, improved stress recovery, and reduced illness over time.

The subcomponents of affect scale (SAS): validating a widely used affect scale.

OBJECTIVE: There is a need for a brief affect scale that also encompasses different components of affect relevant for researchers interested in physiological and health outcomes. The Subcomponents of Affect Scale (SAS) meets this need. This 18-item scale has nine positive and nine negative affect items encompassing six subscales (calm, well-being, vigour, depression, anxiety, anger). Previous research using the SAS has demonstrated its predictive validity, but no work has tested its subscale structure or longitudinal validity. DESIGN: Data from the Common Cold Project in which individuals (N = 610) completed the SAS over the course of seven days were used. RESULTS: Confirmatory factor analysis demonstrated the reliability of the subscale structure of the SAS across seven days (positive affect subscale structure: CFIs ≥ 0.98; negative affect subscale structure: CFIs ≥ 0.94 with day 6 CFI = 0.91) and tests of factorial invariance showed the scale is valid to use over time. CONCLUSIONS: These results confirm the psychometric validity of the subscale structure of the SAS and imply that the subscales can be used longitudinally, allowing for its use in health research as well as non-health research that can benefit from its subscale structure and longitudinal capabilities.

Does an Online Positive Psychological Intervention Improve Positive Affect in Young Adults During the COVID-19 Pandemic?

Meta-analyses indicate that positive psychological interventions are effective at increasing positive affect, as well as reducing anxiety and depression; however, it is unclear how well these effects generalize during periods of high stress. Therefore, the current study tested whether a 2-week online positive psychological intervention delivered during the COVID-19 pandemic, a naturalistic stressor, (1) increased positive affect; (2) improved psychological well-being, optimism, life satisfaction, perceived social support, and loneliness; (3) and reduced negative affect in college students, a group known to have high pandemic distress. Participants (N = 250; 76.9% female) ages 18-45 were recruited from the University of Pittsburgh undergraduate subject pool between September and November of 2020. Participants were randomized to the online positive psychological intervention or active control condition and stratified by trait positive affect, sex, and year in college. Participants in both conditions completed one writing activity every other day for two consecutive weeks. Control participants documented their activities for that day (e.g., meals, going to gym). Intervention participants chose from six positive psychology activities. All outcome variables were assessed pre- and post-intervention by validated questionnaires. Across both conditions, positive and negative affect decreased from pre- to post-intervention. No other psychological factor differed by condition, time, or their interaction. The current null findings are in line with a more recent meta-analysis indicating that positive psychological interventions may have smaller effects on psychological well-being and depressive symptoms than was reported pre-pandemic. Study findings may suggest reduced efficacy of virtual positive psychological interventions under highly stressful circumstances. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00148-z.

A multi-lab test of the facial feedback hypothesis by the Many Smiles Collaboration.

Following theories of emotional embodiment, the facial feedback hypothesis suggests that individuals' subjective experiences of emotion are influenced by their facial expressions. However, evidence for this hypothesis has been mixed. We thus formed a global adversarial collaboration and carried out a preregistered, multicentre study designed to specify and test the conditions that should most reliably produce facial feedback effects. Data from n = 3,878 participants spanning 19 countries indicated that a facial mimicry and voluntary facial action task could both amplify and initiate feelings of happiness. However, evidence of facial feedback effects was less conclusive when facial feedback was manipulated unobtrusively via a pen-in-mouth task.

Do Positive Psychological Factors Equally Predict Resistance to Upper Respiratory Infections in African and European Americans?

Research has consistently shown that positive psychological constructs are linked to better physical health, but few studies have examined the role that race plays in this connection. We explored whether positive self-evaluations were equally protective against upper respiratory infection for 271 African American adults and 700 European American adults in a series of virus-exposure studies. Participants were assessed at baseline for psychological functioning and physical health, quarantined and exposed experimentally to a respiratory virus, and then monitored for infection and symptoms. Regression analyses revealed significant interactions between race and multiple positive psychological factors; several factors that were helpful to European Americans were unhelpful or even harmful to African Americans. Building on past work showing cross-cultural variation in the health correlates of affect, this study provides evidence that the health benefits of positive psychological constructs may not be universal and points to the need to explore factors that underpin these observed differential patterns.

Comparing the Psychological Effects of Manikin-Based and Augmented Reality-Based Simulation Training: Within-Subjects Crossover Study.

BACKGROUND: Patient simulators are an increasingly important part of medical training. They have been shown to be effective in teaching procedural skills, medical knowledge, and clinical decision-making. Recently, virtual and augmented reality simulators are being produced, but there is no research on whether these more realistic experiences cause problematic and greater stress responses as compared to standard manikin simulators. OBJECTIVE: The purpose of this research is to examine the psychological and physiological effects of augmented reality (AR) in medical simulation training as compared to traditional manikin simulations. METHODS: A within-subjects experimental design was used to assess the responses of medical students (N=89) as they completed simulated (using either manikin or AR) pediatric resuscitations. Baseline measures of psychological well-being, salivary cortisol, and galvanic skin response (GSR) were taken before the simulations began. Continuous GSR assessments throughout and after the simulations were captured along with follow-up measures of emotion and cortisol. Participants also wrote freely about their experience with each simulation, and narratives were coded for emotional word use. RESULTS: Of the total 86 medical students who participated, 37 (43%) were male and 49 (57%) were female, with a mean age of 25.2 (SD 2.09, range 22-30) years and 24.7 (SD 2.08, range 23-36) years, respectively. GSR was higher in the manikin group adjusted for day, sex, and medications taken by the participants (AR-manikin: -0.11, 95% CI -0.18 to -0.03; P=.009). The difference in negative affect between simulation types was not statistically significant (AR-manikin: 0.41, 95% CI -0.72 to 1.53; P=.48). There was no statistically significant difference between simulation types in self-reported stress (AR-manikin: 0.53, 95% CI -2.35 to 3.42; P=.71) or simulation stress (AR-manikin: -2.17, 95% CI -6.94 to 2.59; P=.37). The difference in percentage of positive emotion words used to describe the experience was not statistically significant between simulation types, which were adjusted for day of experiment, sex of the participants, and total number of words used (AR-manikin: -4.0, 95% CI -0.91 to 0.10; P=.12). There was no statistically significant difference between simulation types in terms of the percentage of negative emotion words used to describe the experience (AR-manikin: -0.33, 95% CI -1.12 to 0.46; P=.41), simulation sickness (AR-manikin: 0.17, 95% CI -0.29 to 0.62; P=.47), or salivary cortisol (AR-manikin: 0.04, 95% CI -0.05 to 0.13; P=.41). Finally, preexisting levels of posttraumatic stress disorder, perceived stress, and reported depression were not tied to physiological responses to AR. CONCLUSIONS: AR simulators elicited similar stress responses to currently used manikin-based simulators, and we did not find any evidence of AR simulators causing excessive stress to participants. Therefore, AR simulators are a promising tool to be used in medical training, which can provide more emotionally realistic scenarios without the risk of additional harm.

Associations Between Gut Microbes and Social Behavior in Healthy 2-Year-Old Children.

OBJECTIVE: Emerging research has connected abundances of specific bacteria to differences in psychosocial behaviors in animals and adult humans. However, research assessing mind-microbiome associations in children is sparse with extant work primarily focused on populations with autism, making it unclear whether links are also present in typically developing children. The current study fills this gap by examining associations between prosocial-self-regulating temperaments (effortful control; EC) and the gut microbiome in typically developing children. METHODS: Maternal ratings of temperament were assessed in 77 toddlers 18 to 27 months of age (46.7% female, mean age = 23.14 months). Next-generation pyrosequencing of the V1-V3 region of the 16S rRNA gene was used to classify children's gut microbial composition from fecal samples. EC included the following subcategories: cuddliness, attentional focusing, attentional shifting, inhibitory control, and low-intensity pleasure. RESULTS: After adjusting for covariates, EC was positively associated with relative abundances of Akkermansia (Δ R2 = 0.117, b = 0.022, SE = 0.007, p = .002), with cuddliness (i.e., joy and ease of being held) driving the relation. Furthermore, attentional focusing was negatively associated with Alistipes (Δ R2 = 0.062, b = -0.011, SE = 0.005, p = .028). Permutational analysis of variance revealed no significant differences in community structure between high and low EC groups on the phylum level ( R2 = 0.00372, p = .745) or the genus level ( R2 = 0.01559, p = .276). CONCLUSIONS: Findings suggest that certain microbes may be linked to prosocial behaviors used to regulate emotion in typically developing children. Further research is needed to test whether these observations replicate in larger samples.

An online Trier social stress paradigm to evoke affective and cardiovascular responses.

In response to the COVID-19 pandemic, prior studies have modified the Trier Social Stress Test to be conducted remotely. The current study aimed to extend these studies to test whether a remote Trier Social Stress Test (rTSST) can elicit (a) affective, (b) blood pressure, and (c) heart rate responses relative to a control condition and whether these responses were reliable when assessed 1 week later. Participants (N = 99, 19.7 ± 3.5 years, 55% female) were randomized to a control or stress condition. Participants received blood pressure monitors in person. Controls completed easier versions of the tasks with a single, friendly researcher. Stress participants performed more difficult versions of the task in front of two judges who participants believed were rating their performance. Blood pressure and heart rate were measured every 2 min throughout, while affect was assessed at baseline, after the final task, and following recovery. The rTSST was feasible to administer with minimal technical issues reported. Participants reported lower positive affect and higher negative affect during the tasks in the stress condition relative to controls. Similarly, stress participants had higher cardiovascular responses during the tasks relative to controls, except that blood pressure was not elevated during mental arithmetic in stress participants relative to controls. Cardiovascular responses demonstrated good test-retest reliability when assessed 1 week later, especially when computed using area under the curve methods. Overall, a rTSST can be used to elicit affective and cardiovascular reactivity and provides an opportunity to increase the accessibility of research participation among diverse populations.

Smile (or grimace) through the pain? The effects of experimentally manipulated facial expressions on needle-injection responses.

Smiling has been previously shown to improve stress responses. We replicated and expanded this work by testing whether smiling helps with a potent real-world stressor: a vaccination-like needle injection. We also extended past research by examining grimacing, a facial expression known to naturally occur during stress and pain and one that shares some of the same facial action units as smiling. Participants (n = 231; [M]age = 19.2) were randomized to hold either a Duchenne smile, a non-Duchenne smile, a grimace, or a neutral expression while receiving a 25-gauge needle injection of saline solution. Expression was covertly manipulated via cover story and chopstick placement in the mouth. Heart rate (HR) and electrodermal activity (EDA) were collected continuously alongside self-reports of pain, emotion, and distress. Repeated-measures analysis of variance (ANOVA) indicated a between-subjects effect of facial condition on self-reported pain as well as a Condition × Time effect. Probing each time point revealed the strongest effect to be at needle injection, where the Duchenne smile and grimace groups reported approximately 40% less needle pain versus the neutral group. Repeated-measures ANOVAs also revealed differences between conditions for both HR and EDA. In post hoc analyses, only the Duchenne smile group exhibited significantly lower HR than neutral, with marginal Duchenne benefits found for EDA. Together, these findings indicate that both smiling and grimacing can improve subjective needle pain experiences, but Duchenne smiling may be better suited for blunting the stress-induced physiological responses of the body versus other facial expressions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Oxytocin, cortisol, and cognitive control during acute and naturalistic stress.

Although stress is a strong risk factor for poor health, especially for women, it remains unclear how stress affects the key neurohormones cortisol and oxytocin, which influence stress-related risk and resilience. Whereas cortisol mediates energy mobilization during stress, oxytocin has anti-inflammatory, anxiolytic, and analgesic effects that support social connection and survival across the lifespan. However, how these neurohormones interrelate and are associated with cognitive control of emotional information during stress remains unclear. To address these issues, we recruited 37 college-aged women (Mage = 19.19, SD = 1.58) and randomly assigned each to a one-hour experimental session consisting of either an acute stress (emotionally stressful video) or control (non-stressful video) condition in a cross-sectional manner across the semester. Salivary cortisol and oxytocin samples were collected at baseline and after the video, at which point participants also completed measures assessing affect and an emotional Stroop task. As hypothesized, the emotional stressor induced negative emotions that were associated with significant elevations in cortisol and faster Stroop reaction times. Moreover, higher baseline oxytocin predicted greater positive affect after the stressor and also better cognitive accuracy on the Stroop. Analyses examining the naturalistic stress effects revealed that basal oxytocin levels rose steeply three weeks before the semester's end, followed by rising cortisol levels one week later, with both neurohormones remaining elevated through the very stressful final exam period. Considered together, these data suggest that women's collective experiences of stress may be potentially buffered by a synchronous oxytocin surge that enhances cognitive accuracy and reduces stress "when the going gets tough".

Maternal expressions of positive emotion for children predicts children's respiratory sinus arrhythmia surrounding stress.

The aim of this study is to assess whether positive emotional exchanges (i.e., emotion coregulation) within the mother-child dyad play a protective role in children's physiological response to a distressing task. Specifically, we test whether positive emotion coregulation among mothers and their preschool-aged children is associated with children's respiratory sinus arrhythmia (RSA) at baseline, during, and following a frustration task. One hundred Singaporean mother-child dyads (Mchildage  = 3.5 years) participated in a standardized "Laughing Task" in which positive emotional constructs were measured. Children also participated in a frustration task while RSA was continuously monitored. Hierarchical linear regressions revealed that greater maternal positive emotional responses to children were associated with child RSA at baseline and in recovery from frustration, but not during frustration. These findings have implications for the important role that positive emotion responsivity from mothers may play in children's developing autonomic response systems, and underscore the need for longitudinal work on this topic.

Temporal Links Between Self-Reported Sleep and Antibody Responses to the Influenza Vaccine.

BACKGROUND: Growing evidence suggests that sleep plays an important role in immunological memory, including antibody responses to vaccination. However, much of the prior research has been carried out in the laboratory limiting the generalizability of the findings. Furthermore, no study has sought to identify sensitive periods prior to or after vaccination where sleep may have a stronger influence on antibody responses. METHODS: Eighty-three healthy young adults completed 13 days of sleep diaries and received the trivalent influenza vaccine on day 3 of the study. Measures of self-reported sleep duration, sleep efficiency, and subjective sleep quality were assessed on each day. Antibody levels to the influenza viral strains were quantified at baseline and 1 and 4 months following influenza vaccination. RESULTS: Shorter sleep duration, averaged over the collection period, was associated with fewer antibodies to the A/New Caledonia viral strain 1 and 4 months later, independent of baseline antibodies, age, sex, and cohort year. Analyses focused on nightly sleep on the days preceding and after the vaccination revealed that shorter sleep duration on the two nights before the vaccination predicted fewer antibodies 1 and 4 months later. Measures of self-reported sleep efficiency and subjective quality were unrelated to antibody responses to the influenza vaccination. CONCLUSION: These findings provide further support for an association between sleep duration and antibody responses to the influenza vaccine and suggest that perhaps sleep on nights prior to vaccination are critical. If replicated, these findings may support sleep as a target for enhancing vaccination efficacy.

Vacation's lingering benefits, but only for those with low stress jobs.

BACKGROUND: Vacationing provides potential recovery from work stress and is associated with cardiovascular disease morbidity and mortality. This study considered psychological variables that might change as a vacation is approaching (fade-in) or after a vacation ends (fade-out) and how these associations might vary as a function of ongoing work stress. Methods: Sixty workers eligible for paid time off were recruited from the community. Multiple assessments occurred during an 8- to 10-week period spanning the period before and after a vacation. A piecewise random coefficient model compared changes over time (slopes) for pre- and post-vacation periods. Outcomes included affect, aggression, social support, and work stress. Results: Hostile affect, negative affect, stress, and physical aggression all declined significantly during the post-vacation period (relative to no change during the pre-vacation period). In addition, these changes in pre- versus post-vacation periods differed as a function of work stress, with some vacation benefits observed specifically among workers with low work stress. Conclusions: Findings indicate that vacations produced psychological benefits that persist beyond the vacation period. Vacation-associated benefits may serve as mechanisms underlying associations between vacations and slow developing disease. However, work stress appears to spillover and can thereby undermine a vacation's fade-in and fade-out benefits.

Vacation frequency is associated with metabolic syndrome and symptoms.

Objective: To examine the extent to which vacationing behavior is associated with metabolic outcomes. Specifically, we consider how total vacation episodes and total vacation days from the past 12 months relate to metabolic syndrome and metabolic symptoms.Design: Sixty-three workers eligible for paid vacation attended a lab visit during which their blood was drawn and they completed an interview assessing vacationing behavior in the past 12 months.Main outcome measures: Metabolic syndrome and metabolic symptoms are the main outcome measures.Results: Over the past 12 months, participants took approximately five vacations (M = 5.44, SD = 3.16) and used about 2 weeks of their paid vacation days (M = 13.80, SD = 7.25). Participants rated vacations positively, expressing low levels of travel-, childcare- and financial burden-related stress. As vacation episodes increased, metabolic syndrome incidence (OR = 0.76, p = 0.051) and number of metabolic symptoms met (IRR = 0.92, p = 0.035) decreased. Notably, risk for metabolic syndrome decreased by nearly a quarter with each additional vacation taken by participants.Conclusions: Overall, vacations are experienced as positive events. This positive subjective experience may translate into physical health benefits given that vacation frequency may protect against metabolic syndrome and symptoms.

Do vacations alter the connection between stress and cardiovascular activity? The effects of a planned vacation on the relationship between weekly stress and ambulatory heart rate.

Objective: To examine how the association between psychological stress and ambulatory heart rate varies in the weeks before and after a planned vacation. We hypothesized that the impact of stress on heart rate would weaken in the weeks leading up to the vacation and return to normal levels in the weeks following the vacation.Method: Fifty-four workers eligible for paid vacation time were recruited; stress ratings obtained via weekly surveys and ambulatory heart rate readings obtained via a wrist-worn consumer device were collected before and after the vacation.Results: A statistically significant interaction was observed between weekly stress and the time period leading up to the vacation on ambulatory heart rate (b = -0.51, SE = 0.21, 95% CI = -0.91, -0.10, p = 0.01). A plot of predicted values demonstrated that the relationship between weekly stress and heart rate was stronger when the vacation was further away in the future and imparted less of an effect as the vacation approached.Conclusions: Vacations may have physical health benefits that extend beyond the vacation experience by reducing the association between stress and ambulatory heart rate in the weeks leading up to a planned vacation.

Affect variability and predictability: Using recurrence quantification analysis to better understand how the dynamics of affect relate to health.

Changes in affect over time have been associated with health outcomes. However, previously utilized measurement methods focus on variability of affect (e.g., standard deviation, root mean squared successive difference) and ignore the more complex temporal patterns of affect over time. These patterns may be an important feature in understanding how the dynamics of affect relate to health. Recurrence quantification analysis (RQA) may help alleviate this problem by assessing temporal characteristics unassessed by past methods. RQA metrics, such as determinism and recurrence, can provide a measure of the predictability of affect over time, indexing how often patterns within affective experiences repeat. In Study 1, we first contrasted RQA metrics with commonly used measures of variability to demonstrate that RQA can further differentiate among patterns of affect. In Study 2, we analyzed the associations between these new metrics and health, namely, depressive and somatic symptoms. We found that RQA metrics predicted health above and beyond mean levels and variability of affect over time. The most desirable health outcomes were observed in people who had high mean positive affect, low mean negative affect, low affect variability, and high affect predictability. These studies are the first to demonstrate the utility of RQA for determining how temporal patterns in affective experiences are important for health outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).