Samuel M. Y. Ho

Optimism, positive affectivity, and salivary cortisol

OBJECTIVES Research on stress and salivary cortisol has focused almost exclusively on the effects of negative psychological conditions or emotional states. Little attention has been drawn to the impact associated with positive psychological conditions, which have been shown recently to have significant influences on neuroendocrine regulation. The aim of this study is to examine the impact of optimism and positive affect on salivary cortisol with the effects of their negative counterparts controlled for. DESIGN Optimism and pessimism, and positive and negative affectivity were studied in relation to the diurnal rhythm of salivary cortisol in a group of 80 Hong Kong Chinese, who provided six saliva samples over the course of a day on two consecutive days. The separate effects of optimism and positive affect on two dynamic components of cortisol secretion, awakening response, and diurnal decline were examined. METHODS Optimism and pessimism were measured using the Chinese version of the revised Life Orientation Test while generalized affects and mood states were assessed by the Chinese Affect Scale. An enzyme-linked immunoabsorbent assay kit (EIA) developed for use in saliva was adopted for the biochemical analysis of cortisol. Testing of major group differences associated with positive psychological conditions was carried out using two-way (group by saliva collection time) ANOVAs for repeated measures with negative psychological conditions and mood states as covariates. RESULTS Participants having higher optimism scores exhibited less cortisol secretion in the awakening period when the effect of pessimism and mood were controlled. This effect was more apparent in men than in women who had higher cortisol levels in the awakening period. Optimism did not have similar effect on cortisol levels during the underlying period of diurnal decline. On the other hand, higher generalized positive affect was associated with lower cortisol levels during the underlying period of diurnal decline after the effects of negative affect and mood states had been controlled. Generalized positive affect did not significantly influence cortisol secretion during the awakening period. CONCLUSIONS These findings suggest that positive psychological resources including optimism and generalized positive affect had higher impact on cortisol secretion than their negative counterparts, and point to the need for increased attention to the potential contribution of positive mental states to well-being.

Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: a latent class approach.

OBJECTIVE To examine trajectories of psychological functioning using latent class analysis on a sample of hospitalized survivors of the 2003 severe acute respiratory syndrome (SARS) epidemic in Hong Kong. DESIGN A longitudinal study of 997 survivors, recruited from among 1,331 individuals hospitalized for SARS, were interviewed at 6, 12, and 18 months after hospitalization. MAIN OUTCOME MEASURES Psychological and physical functioning at each time point was measured using the 12-item Medical Outcome Study Short-Form Health Survey (SF-12). RESULTS Four latent classes were identified--chronic dysfunction, delayed dysfunction, recovery, and resilience. All groups had better physical health than the chronic group. Resilient and recovered individuals had greater social support and less SARS-related worry, and resilient individuals were more likely to be male. The resilient group also had greater social support than the delayed group and better physical functioning than the recovered group. CONCLUSION This study demonstrated that longitudinal outcome trajectories following a major health-threat event in an Asian sample bear close resemblance to prototypical trajectories observed in trauma studies using Western samples. Unique predictors of the trajectories included factors observed in previous studies, such as social support, as well as factors of particular relevance to a major disease outbreak, such as SARS-related worry.

The valence of attentional bias and cancer‐related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer

Objective: To examine the effects of self‐reported attentional bias on posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) through the potential mediator of cancer‐related rumination.

The effects of rumination and negative cognitive styles on depression: A mediation analysis

Research on cognitive models of depression has identified negative cognitive styles and rumination as risk factors for depression. The present study examined the hypothesis that rumination mediates the effect of negative cognitive styles on depression. Specifically, we evaluated the differential effects of two aspects of rumination, characterized by brooding and reflection, on the relationship between negative cognitive styles and level of depressive symptoms. A total of 115 college students and 38 patients suffering from depressive disorders completed a battery of questionnaires measuring levels of depressive symptoms, brooding, reflection, and negative cognitive styles. The results support the notion that there exist two distinct dimensions of rumination and that, of the two, it is brooding and not reflection that mediates the relationship between negative cognitive styles and depression and contributes to its negative outcomes.

Risk factors of posttraumatic stress disorder among survivors after the 512 Wenchuan earthquake in China.

This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.

Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study

Background -Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC.Methods -A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points.Results -Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 ± 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression (B = -0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = 0.05 for anxiety).Conclusions -The current findings suggest that hopefulness may predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to the psychological adjustment of CRC genetic testing recipients.

Factor Structure of the Chinese Virtues Questionnaire

Objectives: The present study examined the factorial invariance and functional equivalence of the Values in Action Inventory of Strengths (VIA-IS) among the Chinese. Methods: A total of 839 undergraduate students completed the 240-item Simplified Chinese version of the VIA-IS online. Another 40 students participated in qualitative interviews to examine the meaning and function of the items in Chinese culture. Results: A total of 144 items were removed from the original version questionnaire (240-item) because of low item-loading and lack of cultural validity. A Chinese Virtues Questionnaire-96 (CVQ-96) in simplified Chinese containing 96 items (4 items per strength) was adopted. Three subscales (interpersonal, vitality, and cautiousness) were developed after exploratory factor analysis and confirmatory factor analysis. Conclusion: A theoretically meaningful 3-factor model of virtue, comparable to some virtue structures proposed in previous studies conducted in Western countries, was obtained. The inventories being developed can facilitate positive social work assessment and intervention.

The Experience of Chinese Bereaved Persons: A Preliminary Study of Meaning Making and Continuing Bonds

ABSTRACT This study explores the bereavement process of Chinese persons in Hong Kong, with the focus on how they make meaning of the death as well as how they maintain a bond with the deceased. A review of video- and audiotapes of 52 bereaved persons in bereavement counseling pointed to how these concepts are reflected in key themes that appeared throughout these interviews. The way this bereaved population found meaning in the death was reflected in how they understood the cause of death, their observations at the death moment, their understanding of the life of the deceased after the death, the life of the bereaved after the death, and the burial and mourning rituals that were followed. The continuing bond the bereaved felt with the deceased was experienced by the bereaved as either initiated by the deceased, for example by the deceased appearing in dreams or initiated by the bereaved themselves in their talking with the deceased. These 2 aspects of the bereavement process seem to be similar to those found in other societies, but the ways in which they were manifested were unique to the Chinese culture. Based on these findings, the authors conclude with implications for intervention with this bereaved population.

Psychometric Evaluation of the Chinese Virtues Questionnaire

Objectives: The present study examined the psychometric properties of the Chinese Virtues Questionnaire (CVQ). The reliability, factor structure, construct validity, and temporal stability of the inventory were examined. Method: A university student sample (n = 878) and a working adult sample (n = 153) were recruited. Participants were asked to complete the paper-and-pencil CVQ and a set of questionnaires to measure both their positive and negative psychological status. Results: The results supported the three-factor structure of the CVQ established earlier. Factorial invariants were found in different subsamples (students vs. workers; male vs. female). Each factor (interpersonal, vitality, and cautiousness) demonstrated satisfactory internal consistency (α = .87 to .92), test–retest reliability (r = .70 to .76), convergent validity, discriminant validity, incremental validity, temporal stability, and theoretical significance. Conclusions: The questionnaire with good psychometric characteristics and solid cultural foundations can facilitate positive social work assessment and intervention.

Psychological profile of Chinese with cleft lip and palate deformities

Objective: To assess the psychological well-being of patients with cleft lip and palate (CLP). Patients/setting: Ninety-four Chinese CLP subjects between 10 and 40 years of age were recruited from the Discipline of Oral and Maxillofacial Surgery, The University of Hong Kong, between June and December 2003. They were divided into two groups for comparison: adolescents (10–16 years old) and adults (17– 40 years old). A control group of 116 healthy non-CLP patients was also recruited during the same period. Interventions: All CLP and non-CLP patients were asked to complete a set of four questionnaires to assess their psychological status. The questionnaires included the Social Avoidance and Distress Scale, the Satisfaction with Life Scale, the Culture-Free Self-Esteem Inventory, and the Chinese Miller Behavioral Style Scale. Results: Chinese CLP patients exhibited levels of subjective well-being and social anxiety that were similar to the published levels of a group of British CLP patients. They also had significantly lower general and social self-esteem but higher parental self-esteem than the non-CLP control group. Conclusion: CLP patients were generally satisfied with life and did not exhibit more social anxiety than the non-CLP control group. They also had a good relationship with their parents. Gender and educational level had no influence on their psychological profile. However, these CLP patients had lower self-esteem than non-CLP patients.