Reduced social contact and attachment insecurity as predictors of loneliness during COVID-19: A two-month experience sampling study

The impact of reduced social contact on mental health during the COVID-19 pandemic has been identified as a major public health concern. While personality factors such as attachment style have been associated with psychological distress during the pandemic, the longitudinal relevance of these factors and the role of daily social contact in mitigating distress remains poorly understood. This study evaluated the impact of social contact and attachment style on changes in loneliness over an 8-week experience sampling period during the COVID-19 pandemic. A general adult sample (n = 184) recruited online completed measures of psychological distress, attachment, and loneliness via smartphone. Loneliness and daily social contact were assessed twice per week for eight weeks, yielding 1124 unique observations. During the experience sampling period, proximal increases in loneliness were associated with decreased daily in-person contact. In contrast, participants who described themselves as having fewer interactions via text, phone, or videoconferencing, as well as those with higher anxious and avoidant attachment traits, reported greater experiences of loneliness over time. These findings suggest the relevance of both enduring personality characteristics and daily social behaviors as risk factors for loneliness during the pandemic, pointing to potential targets for clinical intervention and future empirical study

Intolerance of aloneness as a prospective predictor of suicidal ideation during COVID-19

Background: Social distancing has been essential in mitigating the spread of the SARS-CoV-2 virus. Evidence regarding the impact of reduced social contact on mental health during the pandemic has been mixed, however, with studies suggesting that enduring personality traits and affect regulation impairments may together increase risk for suicidal distress during periods of lockdown. The present study utilized experience sampling and longitudinal follow-up methods to evaluate intolerance of aloneness (IA) as a predictor of suicidal ideation (SI) during the pandemic Methods: A general adult sample (n = 184) recruited online completed an 8-week experience sampling protocol via smartphone between April and September 2020. A subset of n = 69 participants completed a follow-up assessment of SI six months after the initial study period Results: IA was associated with suicidal ideation both at baseline and prospectively during the experience sampling period. Individuals with greater IA were more likely to report SI in the short-term context of reduced daily in-person social contact. Higher IA at baseline furthermore prospectively predicted the occurrence of SI during the 6-month follow-up period Limitations: The sample was relatively homogenous in terms of demographic characteristics and excluded individuals with limited access to communication technology. While statistical models accounted for current mental health treatment status, other factors that were not assessed (such as adverse events or psychiatric symptoms in non-treatment-seeking subjects) may have contributed to the development of SI Conclusions: Findings enhance understanding of how personality-based factors may contribute to suicide risk during periods of social distancing, informing both clinical treatment, risk assessment, and public health intervention approaches

Assessment of Psychological Pain in Clinical and Non-Clinical Samples: A Preliminary Investigation Using the Psychic Pain Scale

Psychological pain is an important contributing factor to suicide risk. The present study examined the psychometric properties of the Psychic Pain Scale (PPS), a new measure assessing unbearable negative affect as described in Maltsberger's theory of suicidality. The PPS was administered to n = 131 adult psychiatric patients as well as n = 953 undergraduate students. An initial factor analysis which replicated across both clinical and undergraduate samples identified two factors, affective deluge, and loss of control. These subscales were associated with risk factors including trauma history, severity of psychopathology, and decreased resilience, as well as a range of pathological personality traits. Findings support the utility of the PPS as a measure of psychological pain and point to future directions of empirical evaluation

Suicidality in High-Risk Psychiatric Patients: The Contribution of Protective Factors

Objective: This study's objective was determine the incremental association of reasons for living to the lifetime number of suicide attempts in relation to other known risk and protective factors in a sample of psychiatric patients with extensive psychopathology in residential treatment. Methods: Participants (n = 131) completed a demographic questionnaire that also asked for information about lifetime suicide history, psychiatric history, trauma, and abuse history. Additional measures of resilience, reasons for living (RFL), and impulsiveness were completed. Results: A history of sexual abuse was associated with an increasing lifetime number of suicide attempts, while a history of physical abuse and trait impulsiveness were not associated with the lifetime number of suicide attempts. Survival and coping beliefs, a subscale of the Reasons for Living Inventory (RFLI), was found to add incremental predictive validity to the number of lifetime suicide attempts. A composite fear variable, combining fear of suicide and fear of social consequences of suicide, was negatively correlated with lifetime number of attempts but did not add incremental validity to the prediction of lifetime number of suicide attempts. Conclusion: In a sample of participants with significant psychiatric impairment, the protective factor of survival and coping beliefs may be an important barrier to repeated suicide attempts and may be considered a suicide-specific resilience measure. Understanding the psychological processes contributing to the development of such protective factors as resilience, meaning in life, and coping resources is an important area of study and a potential avenue for targeted therapeutic intervention in high-risk populations

Ambient air pollution, lung function, and airway responsiveness in asthmatic children

Background: Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthma are lacking. Objective: To investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. Methods: We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide (NO2) and sulfur dioxide (SO2) levels in 1,003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to zip/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and FVC %predicted, FEV1/FVC and PC20, adjusting for seasonality and confounders. Results: Same-day and 1-week average CO levels were negatively associated with post-bronchodilator %predicted FEV1 (change(95%CI) per IQR: −0.33(−0.49, −0.16), −0.41(−0.62, −0.21), respectively) and FVC (−0.19(−0.25, −0.07), −0.25(−0.43, −0.07)). Longer-term four-month averages of CO were negatively associated with prebronchodilator %predicted FEV1 and FVC (−0.36(−0.62, −0.10), −0.21(−0.42, −0.01)). Four-month averaged CO and ozone levels were negatively associated with FEV1/FVC (p<0.05). Increased four-month average NO2 levels were associated with reduced post-bronchodilator FEV1 and FVC %predicted. Long-term exposures to SO2 were associated with reduced PC20 (%change(95%CI) per IQR:-6(-11,-1.5)). Treatment augmented the negative short-term CO effect on PC20. Conclusions: Air pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications may not protect but worsens the CO effects on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication