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FUNDING INFORMATION | The study was funded by The Research Council of Norway. | PMC10099854 | ||
CONFLICT OF INTEREST | The authors declare no conflicts of interest. | PMC10099854 | ||
INFORMED CONSENT | Participants were informed with a written consent. | PMC10099854 | ||
ACKNOWLEDGEMENT | We thank the subjects for their time, effort, and cooperation during this project. The authors declare no conflicts of interest. The results of this study are presented clearly, honestly, and without fabrication falsification, or inappropriate data manipulation. The study was funded by The Research Council of Norway. | PMC10099854 | ||
DATA AVAILABILITY STATEMENT | The data that support the findings of this study are available from the corresponding author upon reasonable request. | PMC10099854 | ||
REFERENCES | PMC10099854 | |||
Background | mental illness, PLWS, psychiatric, schizophrenia, hopefulness | Hopefulness is a positive orientation or state of mind that can aid in the recovery and treatment of mental illness, as it can have significant impacts on clinical and psychosocial outcomes. As resource-constrained settings work to implement recovery-oriented care, there is a need to better understand hopefulness among... | PMC10339619 | |
Methods | PLWS, hopefulness | This study utilized baseline and immediate post-intervention data collected as part of a randomized controlled trial testing a culturally tailored model of Family Psychoeducation, KUPAA, in Tanzania. The Herth Hope Index was used to measure hopefulness among PLWS ( | PMC10339619 | |
Results | PLWS, lower disability | Better family functioning was associated with higher levels of hopefulness in PLWS and their caregivers. Lower levels of stigma, lower symptom severity, and lower disability were associated with higher levels of hopefulness in PLWS. For PLWS and their caregivers, actor effects from the APIM model were less than one (PL... | PMC10339619 | |
Conclusion | PLWS, hopefulness | Hopefulness is important to consider in family or caregiver-based treatments for PLWS because caregiver hopefulness may influence improvements in hopefulness among PLWS over time. Future studies should further explore the longitudinal dyadic relationship of hopefulness for these populations, as hope is a non-pharmacolo... | PMC10339619 | |
Trial registration | Clinical Trials #NCT04013932, July 10, 2019. | PMC10339619 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s12888-023-04990-8. | PMC10339619 | ||
Keywords | PMC10339619 | |||
Background | schizophrenia [Mental illness, PLWS, psychiatric, Schizophrenia, schizophrenia, hopefulness | DISORDER, SECONDARY | Schizophrenia is a severe psychiatric disorder that affects 21 million people worldwide [In low- and middle-income countries like Tanzania and high-income countries like the United States, there are high rates of relapse and rehospitalizations for schizophrenia, highlighting the urgent need for accessible, recovery-ori... | PMC10339619 |
Methods | PMC10339619 | |||
Study overview | Psychotic Disorders, ’ | All data used in this study were collected as part of the pilot individually randomized group treatment trial titled: “Family Psychoeducation for Adults with Psychotic Disorders in Tanzania” (KUPAA), funded by the National Institute of Mental Health (NIMH) [R34MH106663]. KUPAA is a Swahili word meaning ‘to soar’ and it... | PMC10339619 | |
Study setting | MZRH, psychiatric | The KUPAA study was conducted in Dar es Salaam and Mbeya regions, located in the East African country of Tanzania. The first study site was Muhimbili National Hospital (MNH), which is located in the major urban city of Dar es Salaam. MNH is the national referral hospital with a catchment area of about 4 million people.... | PMC10339619 | |
Participants | schizophrenia | DISEASE | A total of 66 dyads composed of individuals living with schizophrenia and their caregivers were included in the study. The study was powered for the primary aim of the clinical trial, which was to assess intervention efficacy, and not for the APIM analysis. All treatment-engaged patient participants had an ICD-10 (Inte... | PMC10339619 |
Procedures | schizophrenia | SYNDROME, POSITIVE | Baseline data collection took place in September and October of 2019, the intervention was delivered from November 2019 to February 2020, and immediate post-intervention follow-up data collection occurred from March through June of 2020. Written informed consent was obtained from all participants after being screened f... | PMC10339619 |
Measures | schizophrenia, disability | REGRESSION, SYNDROME, POSITIVE | This study includes measures for PLWS and their caregivers. The World Health Organization’s four-step translation and cultural validation process, namely, forward-translation, back-translation, pre-testing, and finalization with expert consensus, was implemented for all scales in the study [Hopefulness, our dependent v... | PMC10339619 |
Results | PMC10339619 | |||
Participant characteristics | Table Table | PMC10339619 | ||
Correlates of hopefulness | REGRESSION | Supplemental Table Results of univariable and multivariable linear regression models estimating mean hopefulness for PLWSTable Results of univariable and multivariable linear regression models estimating mean hopefulness for caregivers | PMC10339619 | |
APIM analysis | The results of the APIM analysis are depicted in Fig. Results of APIM analysis. Time 0 is baseline data collection and time 1 is data collection immediately post-interventionIn an APIM model, the joint effect, or the additive effect of both actor and partner baseline HHI score on follow-up actor HHI score, differs depe... | PMC10339619 | ||
Discussion | mental illness, illness, PLWS [A, cancer, PLWS, disability, hopefulness | CANCER, RECRUITMENT | The current study examined the independent and dyadic associations between hopefulness and selected predictors within the PLWS-caregiver relationship. Hopefulness in our study population exhibits interdependence meaning dyad partners influence one another’s level of hope over time. To the best of our knowledge, there i... | PMC10339619 |
Conclusion | schizophrenia, PLWS hopefulness | The results of our study suggest that hopefulness may be important to consider in PLWS treatment regimens as caregiver hopefulness is associated with improvements in PLWS hopefulness over time. Dyads of this nature are complex, and members are continuously influencing each other’s outcomes. Neither schizophrenia nor ho... | PMC10339619 | |
Acknowledgements | We thank our colleagues at the Muhimbili National Hospital and Mbeya Zonal Referral Hospital in Tanzania for supporting this clinical trial. We are also incredibly grateful to the affected individuals that gave their time and energy to our study. | PMC10339619 | ||
Authors’ contributions | AM wrote the first draft of the manuscript. AM, JRE, and JNB contributed to the design, implementation, and analysis of the study and edited the first draft. All authors revised drafts and approved the final manuscript. | PMC10339619 | ||
Funding | Funding was received from the National Institute of Mental Health (NIMH; award 5R34MH106663). | PMC10339619 | ||
Availability of data and materials | SECONDARY | The dataset generated and analyzed during the current study is not publicly available per IRB requirements, but it is available from the senior author (JRE) on reasonable request, with permission from study PIs, and with IRB approval for secondary analyses to maintain confidentiality. | PMC10339619 | |
Declarations | PMC10339619 | |||
Consent for publication | Not applicable. | PMC10339619 | ||
Competing interests | None. | PMC10339619 | ||
References | PMC10339619 | |||
1. Introduction | Ten percent of Americans are food-insecure. Few known studies have accessed college food insecurity via random sampling. An online cross-sectional survey (Food insecurity is a global health concern. A total of 13.5 million Americans (10.2%) have experienced food insecurity at some point within the last year [The USDA d... | PMC10005036 | ||
2. Materials and Methods | PMC10005036 | |||
2.1. Sample | A self-administered online survey via Qualtrics was sent to a simple random sample of 5000 currently enrolled University of Florida (UF) undergraduate students. The total undergraduate population at UF was 35,043 (female: 19,355 (55.2%), male: 15,688 (44.8%)). A request was made to the UF Office of Institutional Planni... | PMC10005036 | ||
2.2. Measure of Food Insecurity | The six-item food security scale is an instrument created by the USDA developed to determine the level of food security of individuals [There are six-items from the USDA Food Security Short Form which measure food insecurity experienced within the last 12 months. These six items are:“In the last 12 months, the food tha... | PMC10005036 | ||
2.3. Measure of Government Assistance | Respondents were asked “if their family ever obtained government assistance during childhood (government housing, free/reduced lunch in school, SNAP, Women, Infants, and Children (WIC), and food banks)”. Respondents had the option to “choose all that apply” from the listed options. | PMC10005036 | ||
2.4. Measures of Food Shortage Contacts | For the last item, respondents were asked to “choose all that apply” as to whether they felt comfortable discussing with a parent, roommate, counseling and wellness personnel, advisor/mentor, resident assistant, or professor if they were running short on food. | PMC10005036 | ||
2.5. Data Analysis | The data for this study were analyzed using JMP Pro 12 (SAS Institute Inc., Cary, NC, USA, 1989–2021) software. Descriptive statistical analyses were used to provide group percentages and compare differences among the individual variables. Sociodemographic characteristics that were measured include: current college cla... | PMC10005036 | ||
3. Results | PMC10005036 | |||
3.1. Sample Characteristics | The mean age for college students was 20.77 ± 3.43. Most (78.1%, | PMC10005036 | ||
3.1.1. Food Insecurity | Students responded to a total of six items to measure their individual level of food insecurity. Out of 1087 total responses to all items, 36.1% (Food insecurity differences were found based on race. Most of the students that were food-insecure were non-white (59.6%, | PMC10005036 | ||
3.1.2. Food Insecurity and Food Bank Usage | Over half of all college students (56.5%, | PMC10005036 | ||
3.1.3. Campus Meal Plan | Most students did not have a campus meal plan (52.3%, | PMC10005036 | ||
3.1.4. GPA | The average GPA was 3.45 ± 0.39 for all participants. The mean GPA of all food-insecure students was 3.36 ± 0.42. Significant differences in GPA were found based on food security status (t(1039) = 34.78; | PMC10005036 | ||
3.1.5. Student Employment and Volunteer Activities | Most students (53.7%, College students reported that they participated in volunteer activities for on average 8.64 ± 6.63 h per week. Food-insecure students were significantly more likely to participate in volunteer activities compared to food-secure students (9.42 ± 6.96 vs. 7.58 ± 6.03; t(719) = 13.73; | PMC10005036 | ||
3.1.6. Student Financial Aid and Debt | Most students were currently receiving financial aid (65.1%, | PMC10005036 | ||
3.1.7. Marital Status | Most students were single (97.4%, | PMC10005036 | ||
3.1.8. US Citizenship | Most students were born in the US (86.0%, | PMC10005036 | ||
3.1.9. First-Generation Student | Most (67.3%, | PMC10005036 | ||
3.1.10. Online/Distance Education | Most students were not in an online/distance education program (94.9%, | PMC10005036 | ||
3.1.11. Current Residence | Most students lived off-campus (74.2%, | PMC10005036 | ||
3.1.12. Fraternity/Sorority | Most students were not members of a fraternity/sorority (80.9%, | PMC10005036 | ||
3.2. Food Insecurity and Government Assistance | Participants were asked to “choose all that apply” based on five government assistance programs participated in during childhood. Most students never lived in government housing (94.8%, | PMC10005036 | ||
3.3. Food Insecurity and Food Shortage Contacts | Participants were asked to “choose all that apply” based on who they were comfortable telling that they were short on food. Most students reported they were comfortable telling a parent (79.8%, | PMC10005036 | ||
4. Discussion | PMC10005036 | |||
4.1. Prevalence of Food Insecurity | In the current study, 36.1% of college students were found to be food-insecure. The prevalence of food-insecure college students at this university was nearly four times greater compared to the entire state of Florida (36.1% vs. 9.9%), and three times greater than the food-insecure population in Alachua County, Florida... | PMC10005036 | ||
4.2. Profile of a Food-Insecure College Student | The current study found many differences in the demographics of food-insecure students compared to the total sample. Food-insecure college students in this study were significantly more likely to be non-white, on financial aid, employed, with lower GPAs, and first-generation college students compared to those that were... | PMC10005036 | ||
4.2.1. Employment among Food-Insecure College Students | Employment status and hours volunteered per week were found to have significant differences in food security status in the current study. Similarly, one study found that college students were more likely to be food-insecure if they were employed while in school and averaged 18 h of work per week [ | PMC10005036 | ||
4.2.2. Off-Campus Food-Insecure College Students’ Food Access | Off-campus students represented most of the college students within the study. Off-campus college students represented three times as many of the food-insecure students within the study compared to on-campus students (75% vs. 25%). Off-campus students could possibly experience food insecurity due to a number of factors... | PMC10005036 | ||
4.2.3. Food-Insecure Students’ Food Shortage Contacts | Being a college student often comes with the notion of the “silent struggle”, representing the stereotypical college student that might be short on food or barely surviving on limited options [One Canadian study of food-insecure college students found that nearly 76% received food from a relative or went to a relative’... | PMC10005036 | ||
Author Contributions | Conceptualization, C.H.II and D.C.S.J.; methodology, C.H.II; software, D.C.S.J.; validation, C.H.II and D.C.S.J.; formal analysis, C.H.II; investigation, C.H.II; resources, D.C.S.J.; data curation, C.H.II; writing—original draft preparation, C.H.II, D.C.S.J. and A.B.; writing—review and editing, C.H.II, D.C.S.J. and A.... | PMC10005036 | ||
Institutional Review Board Statement | The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of the University of Florida (IRB#201601763, approved 15 September 2016). | PMC10005036 | ||
Informed Consent Statement | Informed consent was obtained from all subjects involved in the study. | PMC10005036 | ||
Data Availability Statement | The data presented in this study are available upon request from the corresponding author. The data are not publicly available due to FERPA regulations. | PMC10005036 | ||
Conflicts of Interest | The authors declare no conflict of interest. | PMC10005036 | ||
References | Student responses to the USDA Food Security Short Form.Chi-square analysis of childhood access to government assistance based on food security status of undergraduate college students.* Chi-square analysis of contacts for college students if experiencing a food shortage, by food security status.* | PMC10005036 | ||
Introduction | ambiguous social situations, depression, anxiety disorder, anxiety | DISEASE | According to the 2016 Psychological Disease Dynamics Survey released by the Ministry of Health and Welfare of Korea, the demographic distribution of the annual prevalence rate of social anxiety disorder in 2016 was 1.0% in the age group of 18–29 years, and this figure is about twice as high as the below 0.5% for other ... | PMC10653471 |
Method | PMC10653471 | |||
Participants | A total of 114 undergraduate and graduate students completed an online screening survey using the Center for Epidemiological Studies-Depression(CES-D), Social Avoidance Distress Scale (SADS), and Brief version of Fear of Negative Evaluation Scale (B-FNE). Participants who scored under 16 points on the CES-D, < 99 point... | PMC10653471 | ||
Questionnaires | PMC10653471 | |||
Center for Epidemiological Studies-Depression (CES-D) | The CES-D [ | PMC10653471 | ||
Social Avoidance and Distress Scale (SADS) | The SADS [ | PMC10653471 | ||
Brief Version of Fear of Negative Evaluation Scale (B-FNE) | The B-FNE [ | PMC10653471 | ||
Visual Analogue Scale (VAS) | pain | To assess participants’ state mood, they were asked to rate their mood before and after the training and the first filler task. The VAS was used as a self-report measure of current emotions and pain. The VAS is a simple tool that allows individuals to rate their subjective state [ | PMC10653471 | |
Six-item short version of the state-trait anxiety inventory (STAI-6) | STAI-6 [ | PMC10653471 | ||
Training | PMC10653471 | |||
Imagery training | Imagery practice of approximately 10 minutes was conducted for the participants before the CBM-I training. Imagery practice was based on Oxford Imagery Generation (OxIGen) used by Blackwell and colleagues [ | PMC10653471 | ||
Cognitive Bias Modification-Interpretation (CBM-I) | CBM-I was structured on interpretation training with imagery used by previous studies [Salemink, Kindt [ | PMC10653471 | ||
Test phase | PMC10653471 | |||
Similarity Rating Task (SRT) | The SRT was used in this study to assess the participants’ interpretation bias after CBM training. The procedure and format of the SRT were based on the previous studies [<Presentation of liberal arts class>You give a presentation in a liberal arts class.After the presentation, some people ask you questions.As you answ... | PMC10653471 | ||
Free recall task | To assess memory bias related to the scenarios, the free recall task used by Joormann, Waugh [The coding format used by Joormann, Waugh [ | PMC10653471 | ||
Past recollection task | MACLEOD | To examine whether there was a bias in not only recalling the scenario but also a memory from the participant’s actual past, the future thinking task used by MacLeod and Byrne [ | PMC10653471 | |
Procedure | SECONDARY | The present study was approved by the authors’ University’s Institutional Review Board (KWNUIRB-2017-05-006-003). Participants were recruited via internet communities and university bulletin boards. When the participants contacted the researchers, they received a preliminary screening survey link to complete. If the pa... | PMC10653471 | |
Flowchart of the experiment for positive and negative CBM-I. | Participants were randomly assigned to either a positive CBM-I group or a negative CBM-I group. They completed the VAS (happiness, sadness) for baseline measurement and participated in approximately 10 min of imagery training, followed by CBM-I training. Subsequently, the VAS and STAI-6 was completed. To minimize the e... | PMC10653471 | ||
Result | PMC10653471 | |||
General characteristics of groups and test of homogeneity | To investigate between-group differences in demographic variables and pre-test measurements, independent samples | PMC10653471 | ||
The effects of CBM-I on state mood | ’ mood | To examine the effects of CBM-I on participants’ mood states, we conducted a 2 (group: positive CBM-I, negative CBM-I) × 2 (time: Pre, Post) × 2 (valence: happiness, sadness) repeated ANOVA (dependent variables: pre- and post-levels of sadness and happiness). Analyses revealed the three-way interaction of group, time, ... | PMC10653471 | |
The effects of CBM-I on state anxiety | anxiety | To examine the effects of CBM-I on participants’ state anxiety, we conducted a 2 (group: positive CBM-I, negative CBM-I) × 2 (time: Pre, Post) repeated ANOVA (dependent variables: pre-post state anxiety measured with STAI-6). Results revealed that there were the main effect of group, | PMC10653471 | |
The effects of CBM-I on interpretation bias | To investigate the effects of CBM-I on interpretation bias (dependent variables: target positive, target negative, foil positive, foil negative), a generalized linear mixed model (GLMM) was conducted to investigate the interactions between group (positive CBM-I, negative CBM-I), sentence type (target, foil) and valence... | PMC10653471 | ||
Mean and standard deviation in each group for recognition task, free recall task, and past recollection task. | PMC10653471 | |||
GLMM for Effects of CBM-I training on interpretation bias. | SE | Group was coded as 1 for positive-CBM -I and 2 for negative CBM-I; The Sentence was coded as 1 for Target sentence and 2 for Foil sentence; Valence was coded as 1 for positive and 2 for negative. SE = Standard Error. | PMC10653471 | |
The effects of CBM-I on memory bias | PMC10653471 | |||
Free recall task | A generalized linear mixed models (GLMMs) were conducted to investigate whether CBM-I training affected the participants’ memory bias (see the results of the GLMM in | PMC10653471 | ||
Mean of neutral, positive, and negative memory intrusion made by each training group during the recall task. | Error bar represent 1 | PMC10653471 | ||
GLMM for Effects of CBM-I training on free recall and past recollection. | SE | Group was coded as 1 for positive-CBM -I and 2 for negative CBM-I; Valence was coded as 1 for positive, 0 for neutral, and -1 for negative. SE = Standard Error.For content, a significant two-way interaction between group and content valence was observed, The groups also differed in the number of errors: the negative gr... | PMC10653471 | |
Past recollection task | In addition to the memory bias for SRT scenarios, we investigated whether memory bias could be observed in past memories. A generalized linear mixed models(GLMMs) were conducted to investigate whether CBM-I training influenced the participants’ past memories. Specifically, a two-way interaction between group (positive ... | PMC10653471 | ||
Discussion | anxiety | The main purpose of the present study was to examine whether experimentally induced interpretation bias would affect biases in memory in Korean samples. In doing this, the present study used CBM scenarios that were auditory-specific and with a focus on social anxiety symptoms. The main results showed that interpretatio... | PMC10653471 |
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