The mediating role of psychological flexibility in the relationship between resilience and distress and quality of life in people with multiple sclerosis

The purpose of this study is to investigate the role of psychological flexibility in mediating the beneficial effects of resilience on distress and quality of life (QoL) in people with MS (PwMS). The psychological flexibility framework underpinning acceptance and commitment therapy (ACT) was used to conceptualise psychological flexibility. A total of 56 PwMS completed an online survey that assessed global psychological flexibility and each of its six core sub-processes, resilience, distress, mental and physical health QoL, socio-demographics, and illness variables. Mediation analyses showed that, as hypothesised, higher levels of global psychological flexibility and its sub-processes were associated with increases in the positive impacts of resilience on distress and mental and physical health QoL via a mediational mechanism. These findings suggest that psychological flexibility skills build resilience capacities in PwMS. The psychological flexibility framework offers an ACT-based intervention pathway to build resilience and enhance mental health and QoL in PwMS

Identification of psychological flexibility and inflexibility profiles during the COVID-19 pandemic

BackgroundThe first coronavirus disease 2019 (COVID-19) wave and lockdown adversely affected the lives of people in diverse ways. AimsThis study used a person-centered approach to identify patterns of engagement in the 12 psychological flexibility (PF) and inflexibility (PI) processes to manage the first COVID-19 wave and lockdown hardships. Materials & MethodsA total of 1035 Italian adults completed an online survey. ResultsLatent profile analyses conducted on the 12 PI/PF processes measured by the Multidimensional Psychological Flexibility Inventory identified five profiles; three reflected gradations of high to low PF with corresponding inverse levels of PI, while two represented more complex relationships between PI and PF. After controlling for relevant socio-demographic and COVID-19/lockdown factors, the five profiles differed in mental health (depression, anxiety, and COVID-19 distress). Essentially a gradient of progressive decreases in all PI processes (except experiential avoidance) corresponded with increments in mental health across all profiles. Two profiles, which evidenced the highest levels of mental health (highly flexible and moderately flexible profiles), also had the greatest proportion of the sample 56.42% (n = 584), and the highest levels of PF and experiential avoidance. DiscussionFindings from this and similar studies suggest intersecting complex relationships among the PI/PF processes that are likely to shift in response to changing contexts. We suggest this network of relationships is better represented by a three-dimensional PF/PI hexaflex than a simplistic two-dimensional depiction of the model. ConclusionDistinguishing different PF/PI profiles identified groups most at risk for the adverse mental health impacts of the pandemic and exposed variations in the mental health protective and risk roles of PF and PI processes, respectively, that can inform ACT-based mental health promotion interventions

Parental cancer: mediating and moderating roles of psychological inflexibility in the links between illness severity and parental quality of life and family outcomes

The challenges of parental cancer while caring for young offspring are often neglected by researchers and healthcare providers. Focusing on parents with cancer, this cross-sectional study examines the mediating and moderating roles of a mal- leable risk factor, psychological inflexibility, in the relationships between perceived illness severity and parental quality of life (QoL) and family outcomes. Psychological inflexibility was conceptualized using the acceptance and commitment therapy (ACT) framework. A total of 86 parents with cancer caring for young offspring (aged 11–24 years; M=17.94, SD=3.68) completed a survey that assessed psychological inflexibility, parental mental and physical health QoL, family outcomes (family functioning, parenting concerns, and openness to discuss cancer), socio-demographics, and illness vari- ables. Mediation analyses indicated that higher perceived illness severity was associated with higher levels of psychologi- cal inflexibility, which in turn were related to higher detrimental impacts on parental QoL and family outcomes. Results of moderation analyses were non-significant. Findings highlight the detrimental impacts of illness severity on psychological inflexibility, suggesting that it is a psychosocial risk factor in parents dealing with cancer. ACT-based interventions which foster psychological flexibility are likely to enhance parental QoL and family outcomes

Internalizing Symptoms in Developmental Dyslexia: A Comparison Between Primary and Secondary School

Although the relationship between developmental dyslexia (DD) and the risk of occurrence of internalizing symptomatology has been widely investigated in the extant literature, different findings have been reported. In this study, two experiments with two general purposes are presented. The first study investigates whether the differences in the severity of internalizing symptoms between DD and controls are greater in students attending secondary school than in those attending primary school. Sixtyfive DD and 169 controls attending primary and secondary school took part in the first study. The diagnosis of dyslexia was obtained from standardized reading tests; internalizing symptom severity was assessed with the Self Administrated Psychiatric Scales for Children and Adolescents questionnaire. The results showed that adolescents with dyslexia had an increased level of self-perceived anxiety, depression and somatic symptoms, whereas no significant differences between DD and controls emerged in childhood. In the second study, a cohort of adolescents attending secondary school (DD = 44; controls = 51) was closely analyzed to clarify whether contextual and subjective factors could contribute toward exacerbating the risk of internalizing symptomatology at that age. Internalizing symptom severity was assessed with the Child Behavior Checklist, Youth Self Report questionnaire, decision-making factors were measured with the Melbourne Decision Making Questionnaire, and student\u2019s quality of life was gaged using the Clipper test. The results showed that high levels of internalizing symptoms in DD were associated with a low level of self-esteem and the tendency to react to problematic situations with hyperactivation. By contrast, positive relationships with peers were associated with low symptom severity. In conclusion, the intensified internalizing symptoms that could emerge in adolescents in association with the presence of dyslexia are predicted by social protective and risk factors that are associated with symptom severity. Accordingly, the results suggest that remediation programs for dyslexia should include implementing motivation strategies, self-esteem enhancement activities and building peers networks that, starting in childhood, can prevent the appearance of internalizing symptoms

Definition versus Measurement of Mental Pain: A Reply to Meerwijk and Weiss

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Editorial: Transgenerational Effects of Parental Physical and Mental Illnesses on Their Young Offspring's Adjustment: A Psychosomatic Perspective

Children and adolescents of parents with a chronic illness are at increased risk of negative outcomes, including mental and physical health problems, poorer health-related quality of life, educational, and employment difficulties that persist well into adulthood (1–4). Parental chronic illness has wide-ranging impacts on several aspects of young offspring’s life such as emotional dysregulation, internalizing and externalizing problems as well as stress-related somatic disorders, and weakened immune responses (3–5). Compared to their peers with “healthy” parents, young offspring of parents with chronic illnesses often experience emotions of shame and guilt, isolation, stigma, and perception of lacking social support (6). Children of parents with a chronic illness also tend to assume responsibilities associated with caring for their parents and are referred to as young carers (7, 8). Not only parental illness itself but also the level of caregiving responsibilities, experiences, and tasks have been associated with poorer outcomes in offspring (9). Hence, research must target the welfare of young offspring of parents with chronic illness. The papers in this Research Topic examined several of these issues by drawing attention to a lack of research on the transgenerational impact of parental chronic illness on young offspring