A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression.

OBJECTIVES: This trial investigated whether probiotics improved mood, stress and anxiety in a sample selected for low mood. We also tested whether the presence or severity of irritable bowel syndrome symptoms, and levels of proinflammatory cytokines, brain-derived neurotrophic factor and other blood markers, would predict or impact treatment response. METHOD: Seventy-nine participants (10 dropouts) not currently taking psychotropic medications with at least moderate scores on self-report mood measures were randomly allocated to receive either a probiotic preparation (containing Lactobacillus helveticus and Bifidobacterium longum) or a matched placebo, in a double-blind trial for 8 weeks. Data were analysed as intent-to-treat. RESULTS: No significant difference was found between the probiotic and placebo groups on any psychological outcome measure (Cohen's d range = 0.07-0.16) or any blood-based biomarker. At end-point, 9 (23%) of those in the probiotic group showed a ⩾60% change on the Montgomery-Åsberg Depression Rating Scale (responders), compared to 10 (26%) of those in the placebo group ([Formula: see text], p = ns). Baseline vitamin D level was found to moderate treatment effect on several outcome measures. Dry mouth and sleep disruption were reported more frequently in the placebo group. CONCLUSIONS: This study found no evidence that the probiotic formulation is effective in treating low mood, or in moderating the levels of inflammatory and other biomarkers. The lack of observed effect on mood symptoms may be due to the severity, chronicity or treatment resistance of the sample; recruiting an antidepressant-naive sample experiencing mild, acute symptoms of low mood, may well yield a different result. Future studies taking a preventative approach or using probiotics as an adjuvant treatment may also be more effective. Vitamin D levels should be monitored in future studies in the area. The results of this trial are preliminary; future studies in the area should not be discouraged.

Chocolate cake. Guilt or celebration? Associations with healthy eating attitudes, perceived behavioural control, intentions and weight-loss.

Food and eating are often associated with ambivalent feelings: pleasure and enjoyment, but also worry and guilt. Guilt has the potential to motivate behaviour change, but may also lead to feelings of helplessness and loss of control. This study firstly examined whether a default association of either 'guilt' or 'celebration' with a prototypical forbidden food item (chocolate cake) was related to differences in attitudes, perceived behavioural control, and intentions in relation to healthy eating, and secondly whether the default association was related to weight change over an 18month period (and short term weight-loss in a subsample of participants with a weight-loss goal). This study did not find any evidence for adaptive or motivational properties of guilt. Participants associating chocolate cake with guilt did not report more positive attitudes or stronger intentions to eat healthy than did those associating chocolate cake with celebration. Instead, they reported lower levels of perceived behavioural control over eating and were less successful at maintaining their weight over an 18month period. Participants with a weight-loss goal who associated chocolate cake with guilt were less successful at losing weight over a 3month period compared to those associating chocolate cake with celebration.

Self-compassion and health-related quality of life in individuals with endometriosis.

OBJECTIVE: International research highlights the detrimental impact of endometriosis on health-related quality of life (HRQoL), yet few studies have examined positive resources such as self-compassion and resilience as correlates. This cross-sectional study aimed to examine the relationship between self-compassion and HRQoL in individuals with endometriosis in Aotearoa New Zealand. Resilience and perceived symptom severity were examined as potential mediators. METHODS AND MEASURES: Six hundred and three individuals with endometriosis completed an online questionnaire measuring demographic and endometriosis-related information, endometriosis symptoms (number and severity), HRQoL, self-compassion and resilience. RESULTS: In line with international research, the current sample reported significant impairment in all aspects of HRQoL. As expected, those with higher levels of self-compassion reported less impairment in HRQoL, and this relationship was partially mediated by perceived symptom severity (all aspects of HRQoL). Resilience mediated the relationship between self-compassion and two aspects of HRQoL (emotional wellbeing and control/powerlessness). CONCLUSION: These findings confirm that HRQoL is significantly impaired in individuals with endometriosis in Aotearoa New Zealand and point to the potential role of self-compassion and resilience as protective factors in encouraging positive coping styles to manage symptoms and maintain high HRQoL. Interventions targeting self-compassion may be a promising tool to improve wellbeing in individuals with endometriosis.

Emotional eating and its effect on eating behaviour after a natural disaster.

Emotional eaters are hypothesised to overeat in response to negative emotions or stress. However, the empirical evidence for such a moderating role is mixed. This study examined the effect of emotional eating on eating behaviour before and after the occurrence of a natural disaster (an earthquake) in a sample of predominantly middle-aged and older women. As expected, women who scored high on emotional eating reported an increase in overeating after the earthquake. This effect was qualified by an interaction: emotional eaters who reported high levels of post-earthquake distress reported an increase in overeating, whereas non-stressed emotional eaters and non-emotional eaters did not.

Examining how framing obesity as disease vs. food addiction influences stigma among fitness practitioners.

OBJECTIVE: To determine if framing the etiology of obesity as a disease, food addiction, or caloric imbalance would increase or decrease anti-fat attitudes (AFA) and challenge the belief that obesity is caused by a lack of personal responsibility or willpower. METHODS: Two hundred and forty-nine fitness practitioners (Mage = 37.49 years) were randomly assigned to one of four experimental conditions and asked to read a short article describing obesity as either: (a) food addiction, (b) disease, or (c) caloric imbalance, while a control group read an unrelated article. All practitioners then completed a measure of AFA. RESULTS: Practitioners in the food addiction condition recorded significantly lower AFA than practitioners in the disease condition, specifically on the subscale relating to the belief that obesity is a matter of personal responsibility and willpower, or lack thereof. The differing etiologies of obesity had no impact on fitness practitioners' dislike for people with obesity or their personal fears about gaining weight CONCLUSION: Presenting the etiology of obesity as a food addiction may be more effective than the disease or caloric imbalance etiologies at reducing obesity stigma relating to the belief that obesity results from a lack of willpower. Such an understanding can help reduce obesity stigma and may encourage governments to implement obesity reduction policies as recommended by organisations such as the WHO.

Stress, eating and weight change in first year students: the moderating role of self-compassion.

OBJECTIVE: The current study sought to examine the drivers of weight change in first-year university students. The study examined the moderating role of self-compassion in the relationship between stress, eating and weight change. Specifically, we expected that students low in self-compassion would respond to stress with unhealthy eating resulting in weight gain. We expected students high in self-compassion to be buffered from the negative effects of stress (moderated mediation model). METHODS: First-year university students in New Zealand (N = 136) completed measures of healthy and unhealthy food intake and BMI at the beginning and end of the academic year. Self-compassion was measured at baseline only, and perceived stress was averaged over four time points across the year. RESULTS: Students gained a significant 1.45 kg (SD 3.67 kg) of body weight. Self-compassion moderated the relationship between stress and changes in: (a) unhealthy (but not healthy) food intake, and (b) body weight. For those with low self-compassion, perceived stress was significantly related to an increase in BMI and, unexpectedly, to a decrease in unhealthy food intake. Changes in food intake did not explain changes in BMI. CONCLUSION: Wellbeing interventions for university students to reduce negative effects of stress should incorporate concurrent training in self-compassion.

Recruitment and retention of participants in longitudinal studies after a natural disaster.

Climate change and population growth will increase vulnerability to natural and human-made disasters or pandemics. Longitudinal research studies may be adversely impacted by a lack of access to study resources, inability to travel around the urban environment, reluctance of sample members to attend appointments, sample members moving residence and potentially also the destruction of research facilities. One of the key advantages of longitudinal research is the ability to assess associations between exposures and outcomes by limiting the influence of sample selection bias. However, ensuring the validity and reliability of findings in longitudinal research requires the recruitment and retention of respondents who are willing and able to be repeatedly assessed over an extended period of time. This study examined recruitment and retention strategies of 11 longitudinal cohort studies operating during the Christchurch, New Zealand earthquake sequence which began in September 2010, including staff perceptions of the major impediments to study operations during/after the earthquakes and respondents' barriers to participation. Successful strategies to assist recruitment and retention after a natural disaster are discussed. With the current COVID-19 pandemic, longitudinal studies are potentially encountering some of the issues highlighted in this paper including: closure of facilities, restricted movement of research staff and sample members, and reluctance of sample members to attend appointments. It is possible that suggestions in this paper may be implemented so that longitudinal studies can protect the operation of their research programmes.

Impact of panic disorder upon self-management educational goals in chronic obstructive pulmonary disease?

The rationale for introducing self-management plans for the whole chronic obstructive pulmonary disease (COPD) population is uncertain. This study's aim was to investigate whether people with panic disorder (PD), compared to non-panic-disordered (NPD), derived additional educational or psychological benefits from having a self-management plan. The 24-week prospective study followed 76 participants hospitalized with an exacerbation of COPD. Participants completed mental health questionnaires including psychological measures of self-management plan impact. Subsequently, a nurse provided education for using a self-management plan. All participants were Plan naïve irrespective of their PD status. Self-management knowledge was assessed before introducing the Plan (baseline), 1 week post discharge and at 24 weeks. At baseline 28 (37%) of participants met the criteria for PD and this group had higher scores (better knowledge) for an impending (p < 0.05) and severe exacerbation (p < 0.05) and capacity to act during a severe exacerbation (p < 0.01). No interaction effect was found between PD and NPD scores over time, indicating that the PD's knowledge did not improve or deteriorate over time relative to the NPD. Evidence was mixed regarding the Plan's psychological impact. Self-management confidence improved in both groups. Amongst the PD group, perceived control of self-management tasks increased but so did body vigilance and distress about having COPD. There is mixed evidence regarding educational and psychological benefits of COPD self-management plans for people with PD. No additional educational advantages were found for the PD group. Plans may increase confidence and control over self-management but may also increase body vigilance and distress about having COPD.

Cool and independent or foolish and undisciplined? Adolescents' prototypes of (un)healthy eaters and their association with eating behaviour.

PURPOSE: The Prototype/Willingness model states that adolescents' willingness to engage in health-related behaviours is determined by the favourability of prototypes of persons engaging in this behaviour. The objective of the present study is to systematically investigate the content and evaluation of adolescents' prototypes of (un)healthy eaters and examine their associations with eating behaviour. METHODS: Four studies (including a pilot study) were conducted that addressed the salience (N=79), the characteristics (N=287), and the evaluation (N=167) of eater prototypes, and their association with eating behaviour (N=97), respectively. RESULTS: These studies revealed that (1) adolescents hold salient and distinct images of typical (un)healthy eaters; (2) the healthy eater prototype mostly consists of positive traits whereas the unhealthy eater prototype reflects mostly negative traits; (3) eater-specific prototypes are distinct from generic risk prototypes and unrelated to age, bodyweight, and social desirability; and (4) unhealthy eater prototypes are significantly associated with unhealthy eating behaviour. CONCLUSION: Adolescents hold relatively unfavourable social images of unhealthy eaters and relatively favourable images of healthy eaters. Only unhealthy eater prototypes are associated with actual food consumption, suggesting that addressing unhealthy eater prototypes may be an important and novel ingredient of interventions aimed at changing adolescents' unhealthy eating habits.

Daily negative interactions and mood among patients and partners dealing with multiple sclerosis (MS): the moderating effects of emotional support.

Negative interactions with intimate partners may have adverse consequences for well-being, especially for individuals dealing with chronic illness. However, it is not clear whether negative interactions affect both dimensions of positive and negative well-being and factors that may moderate this effect have not been well-described. The aim of the present study was to examine the association between daily received negative responses from the partner and end-of-day positive and negative mood in patients with multiple sclerosis (MS) and their intimate partners. Further, the moderating role of receiving emotional support from the partner on the same day was examined. Sixty-one MS patients and their intimate partners were approached via one MS centre and the neurology department of one hospital in the Netherlands and completed computerized diaries for 14 days. Both partners filled out diaries at the end of each day, recording received negative responses, emotional support and end-of-day positive and negative mood. In line with a domain specific model, patients or partners who reported receiving negative responses on a day had higher end-of-day negative mood, whereas received negative responses were unrelated to end-of-day positive mood. Further, for both patients and partners, the adverse effect of received negative responses on end-of day mood was moderated by receiving emotional support on the same day.

Effects of an intervention promoting proactive coping competencies in middle and late adulthood.

PURPOSE: We tested the effectiveness of a brief educational program that is based on proactive coping theory. The program entails a four-session group intervention for people aged between 50 and 75 years and was intended to improve proactive coping competencies. Furthermore, we investigated the positive as well as negative side effects and differential effectiveness of the program. DESIGN AND METHODS: A total of 158 middle aged and older men and women participated in the study. In a prospective randomized control trial with an experimental group and a waiting control group, we collected questionnaire data at three points (baseline, after completion of the program, and 3 months postintervention). RESULTS: The program improved proactive coping competencies significantly. Three months after completion of the intervention, these results remained stable. Nearly all effect sizes in the experimental group were medium or higher. The program did not have negative side effects in terms of worrying or negative mood, and it did not change levels of self-efficacy. Demographic characteristics of participants did not predict changes in proactive competencies. Differential effectiveness could only be shown for a few psychological characteristics: Lower levels of well-being, higher levels of proactive orientation, and lower levels in the consideration of future consequences of one's own behavior predicted an increase in proactive coping competencies. Participants who formulated personal goals in concrete terms also profited more from the intervention. IMPLICATIONS: Conceptualizing proactive coping as a set of competencies allows the translation of this approach into interventions. Competencies that facilitate future-oriented self-regulation can be improved by a brief educational program in middle and late adulthood.

Weathering the storm? The impact of trauma on romantic relationships.

The current paper reviews the recent literature examining the impact of trauma on romantic relationships. We introduce the Dyadic Responses to Trauma (DRT) Model as a framework for organizing existing research and guiding future research. A traumatic event affects romantic relationships for the better or for the worse depending on the diverse trauma-related experiences people can have, influencing the way partners interact with each other and ultimately the quality of the relationship. In addition, recent research demonstrates how romantic partners can demonstrate resiliency in spite of a negative trauma experience depending on how they interpret and cope with the experience individually and as a couple.

Standing on shaky ground? Dyadic and longitudinal associations between posttraumatic stress and relationship quality postearthquake.

In the current study, we took a unique dyadic approach to examine how people's relationship quality following an earthquake was associated with their and their partner's posttraumatic stress symptoms (PTSS) and whether support exchanges in the relationship protected relationship quality in the face of this adversity. Ninety-nine heterosexual couples were studied over 4 time points for approximately 15 months following the Canterbury, New Zealand, earthquakes. The data were analyzed using moderated growth-curve modeling in an Actor-Partner Interdependence Model framework. In line with predictions, both partners' PTSS scores were associated with lower relationship quality at Time 1 (the first assessment postearthquake). These associations, however, were attenuated by more frequent provisions of support between relationship partners, especially for men, at least in the short term. The associations, however, changed across time, suggesting that coping in a relationship context post trauma is a dynamic, fluid process. These findings demonstrate the importance of adopting a dyadic perspective and examining effects across time. They also highlight the importance of examining resources within the relationship context to more fully understand how PTSS affects relationships. (PsycINFO Database Record

Caregiver burden is increased in Parkinson's disease with mild cognitive impairment (PD-MCI).

BACKGROUND: There is limited evidence on caregiver outcomes associated with mild cognitive impairment in patients with Parkinson's disease (PD-MCI) and the coping strategies used by these caregivers. METHODS: To investigate this relationship, we examined levels of burden, depression, anxiety, coping strategies and positive aspects of caregiving in the informal caregivers of 96 PD patients. The PD patients were classified using MDS-Task Force Level II criteria as showing either normal cognition (PD-N; n = 51), PD-MCI (n = 30) or with dementia (PDD; n = 15). RESULTS: Mean Zarit Burden Interview (ZBI) score increased significantly between carers of PD-N (M = 13.39, SD = 12.22) compared to those of PD-MCI patients (M = 22.00, SD = 10.8), and between carers of PD-MCI and PDD patients (M = 29.33, SD = 9.59). Moreover, the proportion of carers showing clinically significant levels of burden (ZBI score ≥ 21) also increased as the patients' cognitive status declined (18% for PD-N; 60% for PD-MCI; and 80% for PDD) and was mirrored by an increasing amount of time spent providing care by the caregivers. Caregiver ZBI score was independent of patient neuropsychiatric symptoms, motor function, disease duration and time that caregivers spent caregiving. Caregiver use of different coping strategies increased with worsening cognition. However, we found only equivocal evidence that the use of problem-focused, emotion-focused and dysfunctional coping mediated the association between patient cognitive status and caregiver burden, because the inverse models that used caregiver burden as the mediator were also significant. CONCLUSIONS: The study highlights the impact of Parkinson's disease on those providing care when the patient's cognition is poor, including those with MCI. Caregiver well-being has important implications for caregiver support, nursing home placement and disease course.

Perceived stress and freshman weight change: the moderating role of baseline body mass index.

The transition from high-school to university is a critical period of weight change. Popular media suggest that freshman students gain 15 lb (6.80 kg) of body weight during their first year at university (i.e., the freshman 15). In contrast, a recent meta-analysis calculated freshman weight gain to be 1.75 kg, with statistics suggesting that only a proportion of freshman students are prone to gain weight. Researchers are beginning to investigate how certain variables and interactions between such variables predict freshman weight status. The current study focused on body mass index (BMI) and psychological stress. In isolation, previous research has tested how these two variables predict freshman student's weight status. However, because BMI and stress interact to predict weight gain and weight loss in adult samples, the current study tested the interaction between student's baseline BMI and baseline stress levels to predict weight change in a New Zealand sample of freshman students (N=65). Participants completed two separate online surveys in March and October 2012 (i.e., New Zealand's academic year). Although only three students gained over 6.80 kg (i.e., the freshman 15), participants did gain a statistically significant 1.10 kg of body weight during the year. Consistent with previous research, students with a higher baseline BMI gained a higher amount of body weight. However, this main effect was qualified by an interaction between stress and BMI. Students who entered university with high levels of stress gained weight if they also had high BMIs; if they had lower BMIs then they lost weight. In order to reduce unhealthy levels of freshman weight change, vulnerable students need to be taught stress-reduction techniques and coping strategies early in the academic year.

Associating a prototypical forbidden food item with guilt or celebration: relationships with indicators of (un)healthy eating and the moderating role of stress and depressive symptoms.

The increase in obesity and the many educational messages prompting us to eat a healthy diet have heightened people's concerns about the effects of food choice on health and weight. An unintended side effect may be that such awareness fuels feelings of guilt and worry about food. Although guilt has the potential to motivate behaviour change, it may also lead to feelings of helplessness and loss of control. The current study examined the relationship between a default association of either 'guilt' or 'celebration' with a prototypical forbidden food item (chocolate cake), indicators of healthy eating and choosing food for mood regulation reasons. Following a 'diathesis-stress' perspective, the moderating roles of depressive symptoms and stress were examined. Although a default association of guilt was found to be harmless under some circumstances (i.e. under low stress), those who associated chocolate cake with guilt (vs. celebration) reported unhealthier eating habits and lower levels of perceived behavioural control over healthy eating when under stress, rated mood regulation reasons for food choice as important irrespective of their current affective state, and did not have more positive attitudes towards healthy eating. Implications for public health messages and interventions will be discussed.

Measuring Dietary Restraint Status: Comparisons between the Dietary Intent Scale and the Restraint Scale.

The measurement of young women's self-reported dietary restraint status is complex. Compared to Herman and Polivy's commonly utilized Restraint Scale (RS), Stice's Dietary Intent Scale (DIS) is less understood. Because the DIS is becoming a popular research tool, it is important to understand how this scale compares to more traditional measures of restraint. We conducted two correlational studies (Study 1 N = 110; Study 2 N = 216) to ascertain the similarities and the differences between the DIS and - as a comparison measure - the well-researched RS. We explored how the two scales were related to several body image variables (e.g., thin-ideal internalization); with a range of self-regulatory variables (e.g., dispositional self-control); with observed food intake during a taste test; and with 18-month weight change (Study 2 only). Participants were female University students and were not selected for dieting or disordered eating. Unlike RS scores, DIS scores were not significantly correlated with the majority of variables tapping into unsuccessful self-regulation. However, our data also highlighted similarities between the two restraint scales (e.g., association with 18-month weight-loss) and demonstrated that not only were participants' DIS scores un-related to unsuccessful self-regulatory variables, neither were they related to the variables tapping into successful self-regulation.

Trajectories of posttraumatic growth and depreciation after two major earthquakes.

This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a "no growth or depreciation" class and smaller proportions were grouped into either a "posttraumatic depreciation" or "posttraumatic growth" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the "posttraumatic growth" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the "posttraumatic depreciation" class. Sex was the only predictor of the relationship classes: No men were assigned to the "high posttraumatic growth" class. Implications and future directions are discussed.

Development, content, and process evaluation of a short self-management intervention in patients with chronic diseases requiring self-care behaviours.

Many patients with asthma, diabetes, and heart failure do not succeed in integrating the required self-management behaviours into their lives, and fail to attain optimal disease control. The purpose of this study was to describe the development of a theory-driven intervention to enhance self-management that would be appreciated and accepted by participants and providers. Based on self-regulation theory and proactive coping, the program emphasised goal-setting and the planning of behaviour. In five 2h group sessions, participants first decided upon their own goal and behaviours they wanted to change. Next, they wrote an action-plan to implement these behavioural intentions. Behavioural rehearsal and self-monitoring took place between the sessions. Participants and nurse providers evaluated the intervention positively. Evaluations were unrelated to patients' health at baseline, or to feelings of self-efficacy regarding self-management. But patients of older age, lower education, or no current employment responded best to the intervention.

The relation between perceived inequity, marital satisfaction and emotions among couples facing cancer.

The central aim of the present study was to examine if equity theory still applies to intimate relationships when couples are confronted with a serious illness. Equity concerns were examined among 68 cancer patients and their partners. Contrary to our expectations, only male patients on average felt overbenefited in their relationship, whereas female patients on average felt equitably treated. Moreover, it was found that the partners of these patients did not, as was expected, feel underbenefited in their relationship. The main focus of the present study was on the association between perceived equity on the one hand and relationship satisfaction and emotions on the other. It was found that in general patients seemed most sensitive to underbenefit (i.e. they felt least satisfied), and experienced on average least positive and most negative affect when they felt underbenefited. Particularly, patients who were physically impaired felt dissatisfied and angry when underbenefited. The partners of these patients were in general equally sensitive to inequity in both directions, regardless of their ill partner's physical condition.