Lise Solberg Nes

Dispositional Optimism and Coping: A Meta-Analytic Review

The relation between dispositional optimism and better adjustment to diverse stressors may be attributable to optimisms effects on coping strategies. A meta-analytic review (K = 50, N = 11,629) examined the impact of dispositional optimism on coping. Dispositional optimism was found to be positively associated with approach coping strategies aiming to eliminate, reduce, or manage stressors or emotions (r = .17), and negatively associated with avoidance coping strategies seeking to ignore, avoid, or withdraw from stressors or emotions (r = -.21). Effect sizes were larger for the distinction between approach and avoidance coping strategies than for that between problem and emotion-focused coping. Meta-analytic findings also indicate that optimists may adjust their coping strategies to meet the demands of the stressors at hand, and that the optimism-coping relationship is strongest in English-speaking samples.

Heart Rate Variability Reflects Self-Regulatory Strength, Effort, and Fatigue

Experimental research reliably demonstrates that self-regulatory deficits are a consequence of prior self-regulatory effort. However, in naturalistic settings, although people know that they are sometimes vulnerable to saying, eating, or doing the wrong thing, they cannot accurately gauge their capacity to self-regulate at any given time. Because self-regulation and autonomic regulation colocalize in the brain, an autonomic measure, heart rate variability (HRV), could provide an index of self-regulatory strength and activity. During an experimental manipulation of self-regulation (eating carrots or cookies), HRV was elevated during high self-regulatory effort (eat carrots, resist cookies) compared with low self-regulatory effort (eat cookies, resist carrots). The experimental manipulation and higher HRV at baseline independently predicted persistence at a subsequent anagram task. HRV appears to index self-regulatory strength and effort, making it possible to study these phenomena in the field as well as the lab.

Executive Functions, Self-Regulation, and Chronic Pain: A Review

BackgroundChronic pain conditions are complicated and challenging to live with. Capacity to adjust to such conditions may depend on the ability to self-regulate, that is, the ability to alter thoughts, feelings, and behaviors. Self-regulation appears to rely on executive cognitive functions, and the current review, therefore, sought to draw attention to the impact of self-regulatory capacity and executive functions on chronic pain.DiscussionChronic pain conditions present with complex interactions of cognitive, emotional, behavioral, and physiological components for which self-regulatory ability is crucial. The ability to self-regulate varies, and self-regulatory strength appears to be a limited resource that can be fatigued. The many challenges of chronic pain conditions could, therefore, tax self-regulatory strength, leading to self-regulatory deficits.ConclusionThe current review proposes a relationship among pain, self-regulatory capacity, self-regulatory demands, executive functions, and self-regulatory fatigue, suggesting that executive functions and self-regulatory deficits are indeed part of the etiology and maintenance of chronic pain conditions.

Engagement and Arousal: Optimism’s Effects During a Brief Stressor

Optimism is usually associated with better psychological and physiological adjustment to stressors, but some contradictory findings exist. The purpose of this study was to investigate how optimism could result in negative immunological changes following difficult stressors. Because optimists are likely to see positive outcomes as attainable, they may invest greater effort to achieve their goals. It is proposed that such engagement would be more physiologically demanding when pursuing difficult goals. Participants (N = 54) worked on 11 difficult or insoluble anagrams. Optimism when combined with high self-awareness increased time spent working on the anagrams and skin conductance and salivary cortisol during the recovery period. The results support the notion that the increased engagement that arises from optimism may lead to short-term physiological costs.

Self-regulatory deficits in fibromyalgia and temporomandibular disorders

&NA; Chronic pain conditions such as fibromyalgia (FM) and temporomandibular disorders (TMDs) are accompanied by complex interactions of cognitive, emotional, and physiological disturbances. Such conditions are complicated and draining to live with, and successful adaptation may depend on ability to self‐regulate. Self‐regulation involves capacity to exercise control and guide or alter reactions and behavior, abilities essential for human adjustment. Research indicates that self‐regulatory strength is a limited source that can be depleted or fatigued, however, and the current study aimed to show that patients with FM and TMD are vulnerable to self‐regulatory fatigue as a consequence of their condition. Patients (N = 50) and pain‐free matched controls (N = 50) were exposed to an experimental self‐regulation task followed by a persistence task. Patients displayed significantly less capacity to persist on the subsequent task compared with controls. In fact, patients exposed to low self‐regulatory effort displayed similar low persistence to patients and controls exposed to high self‐regulatory effort, indicating that patients with chronic pain conditions may be suffering from chronic self‐regulatory fatigue. Baseline heart rate variability, blood glucose, and cortisol predicted persistence, more so for controls than for patients, and more so in the low vs. high self‐regulation condition. Impact of chronic pain conditions on self‐regulatory effort was mediated by pain, but not by any other factors. The current study suggests that patients with chronic pain conditions likely suffer from chronic self‐regulatory fatigue, and underlines the importance of taking self‐regulatory capacity into account when aiming to understand and treat these complex conditions.

Physical activity level and quality of life in long term lung cancer survivors

PURPOSE Lung cancer is associated with a multitude of challenges, and lung cancer survivors report significantly lower quality of life (QOL) than other cancer survivors. METHODS This study aimed to examine the relationship between physical activity level and QOL in a large sample of long term lung cancer survivors (N=1937). Average age at diagnosis was 65 years, 92% were Caucasian, and 51% male. Surveys were completed at lung cancer diagnosis and then average 4.2 years post-diagnosis. RESULTS Most survivors reported having a sedentary lifestyle at both timepoints. However, 256 survivors reported a change in physical activity level from diagnosis to follow-up. Decreased physical activity (n=140) was associated with decreased overall, mental, physical, emotional, social, and spiritual QOL (all ps<.001) and decreased symptom control as seen in reported pain, dry coughing, coughing with phlegm, shortness of breath, and level of fatigue (all ps<.05). In contrast, increased physical activity (n=116) was associated with improved QOL (all ps<.05), and improved symptom control as seen in frequency and severity of pain (p<.01). For all participants, those engaging in regular physical activity (30 min or more per day, at least five days per week) reported significantly higher QOL scores (all ps<.001), and better symptom control than more sedentary survivors. CONCLUSIONS Results indicate a significant association between change in physical activity and QOL and symptom control for long term lung cancer survivors, and research exploring interventions designed to improve activity level for lung cancer survivors is further warranted.

Individual differences and self-regulatory fatigue: optimism, conscientiousness, and self-consciousness

Ability to self-regulate varies and self-regulatory strength is a limited source that can be depleted or fatigued. Research on the impact of individual differences on self-regulatory capacity is still scarce, and this study aimed to examine whether personality factors such as dispositional optimism, conscientiousness, and self-consciousness can impact or buffer self-regulatory fatigue. Participants were patients diagnosed with chronic multi-symptom illnesses (N = 50), or pain free matched controls (N = 50), randomly assigned to either a high or low self-regulation task, followed by a persistence task. Higher optimism predicted longer persistence (p = .04), and there was a trend towards the same effect for conscientiousness (p = .08). The optimism by self-regulation interaction was significant (p = .01), but rather than persisting despite self-regulatory effort, optimists persisted longer only when not experiencing self-regulatory fatigue. The effects of optimism were stronger for controls than patients. There was also a trend towards a similar conscientiousness by self-regulation interaction (p = .06). These results suggest that the well-established positive impact of optimism and conscientiousness on engagement and persistence may be diminished or reversed in the presence of self-regulatory effort or fatigue, adding an important new chapter to the self-regulation, personality, and pain literature.

Self-regulatory Fatigue in Hematologic Malignancies: Impact on Quality of Life, Coping, and Adherence to Medical Recommendations

BackgroundHematopoietic stem cell transplantation (HSCT) is an intensive cancer therapy entailing numerous physical, emotional, cognitive, and practical challenges. Patients’ ability to adjust and cope with such challenges may depend on their ability to exert control over cognitive, emotional, and behavioral processes, that is, ability to self-regulate. Self-regulatory capacity is a limited resource that can be depleted or fatigued (i.e., “self-regulatory fatigue”), particularly in the context of stressful life events such as cancer diagnosis and treatment.PurposeThis is one of the first studies to examine self-regulatory fatigue in a cancer population. The current study aimed to (1) extract items for a specific scale of self-regulatory capacity and (2) examine the impact of such capacity on adaptation in patients with hematologic malignancies preparing for HSCT.MethodsFactor analysis of four existing scales gauging psychological adjustment and well-being in 314 patients preparing for HSCT (63% male and 89% Caucasian) identified 23 items (α = 0.85) related to self-regulatory control or fatigue. This measure was then examined using existing clinical data obtained from 178 patients (57% male and 91% Caucasian) undergoing treatment for hematologic malignancies in relationship to quality of life, coping, and self-reported adherence to physicians’ recommendations.ResultsControlling for pain severity, physical fatigue, and depression, self-regulatory fatigue scores were incrementally associated with decreased quality of life, use of avoidance coping strategies, and decreased adherence to physicians’ recommendations.ConclusionThese results emphasize the potential role of self-regulatory capacity in coping with and adjusting to hematologic cancers and future research is warranted.

Self-Regulatory Fatigue, Quality of Life, Health Behaviors, and Coping in Patients with Hematologic Malignancies

BackgroundSelf-regulatory fatigue may play an important role in a complex medical illness.PurposeExamine associations between self-regulatory fatigue, quality of life, and health behaviors in patients pre- (N = 213) and 1-year post-hematopoietic stem cell transplantation (HSCT; N = 140). Associations between self-regulatory fatigue and coping strategies pre-HSCT were also examined.MethodPre- and 1-year post-HSCT data collection. Hierarchical linear regression modeling.ResultsHigher self-regulatory fatigue pre-HSCT associated with lower overall, physical, social, emotional, and functional quality of life pre- (p’s < .001) and 1-year post-HSCT (p’s < .01); lower physical activity pre-HSCT (p < .02) and post-HSCT (p < .03) and less healthy nutritional intake post-HSCT (p < .01); changes (i.e., decrease) in quality of life and healthy nutrition over the follow-up year; and use of avoidance coping strategies pre-HSCT (p’s < .001).ConclusionThis is the first study to show self-regulatory fatigue pre-HSCT relating to decreased quality of life and health behaviors, and predicting changes in these variables 1-year post-HSCT.

Self-Regulatory Fatigue: A Missing Link in Understanding Fibromyalgia and Other Chronic MultiSymptom Illnesses

Patients with chronic multisymptom illnesses such as fibromyalgia syndrome (FMS) are experiencing a multitude of physical and mental challenges. Facing such challenges may drain capacity to self‐regulate, and research suggests patients with these illnesses may experience self‐regulatory fatigue (SRF). This study sought to examine whether SRF can be associated with quality of life (QoL) in patients with FMS.