Making Sense of a Pandemic: Mindsets Influence Emotions, Behaviors, Health, and Wellbeing During the COVID-19 Pandemic

Zion, Sean R.; Louis, Kengthsagn; Horii, Rina; Leibowitz, Kari; Heathcote, Lauren C.; Crum, Alia J.

doi:10.21203/rs.3.rs-559447/v1

Cited by 4 publications

(13 citation statements)

References 7 publications

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“…Mindsets also differ from beliefs in that a mindset is not necessarily held to be true, but rather, is understood to be a selective viewpoint that may be useful in a given context. By using the term “mindset” we capture these nuances (e.g., while cancer may have negative impacts, it is something that can be accepted, dealt with, and to some degree controlled with medical intervention; Zion, 2021; Zion, Schapira, et al, 2019).…”

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confidence: 99%

“…In cancer survivors, illness mindsets have been related to physical, social, and emotional functioning, independent of disease characteristics (e.g., cancer stage) and psychological traits (e.g., trait optimism; Zion, 2021; Zion, Schapira, et al, 2019). Prior work suggests that mindsets may play an important role in the psychosocial outcomes of cancer survivors (Gutkin et al, 2020; Heathcote et al, 2020; Zion, Schapira, et al, 2019), who suffer disproportionate symptom burden compared with the general population (Lokich, 2019; Okonji & Ring, 2016).…”

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confidence: 99%

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Association of illness mindsets with health-related quality of life in cancer survivors.

Zeidman¹,

Benedict²,

Zion³

et al. 2022

Health Psychology

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Objective: This study aimed to examine the association between mindsets-established, but mutable beliefs that a person holds-and health-related quality of life in survivors of breast and gynecologic cancer. Method: A cross-sectional survey study was conducted with breast and gynecologic cancer survivors. Measures included the Illness Mindset Questionnaire and Functional Assessment of Cancer Therapy-General (FACT-G). Results: Two hundred seventy-three survivors (74% breast/26% gynecologic) who were on average 3.9 years post-diagnosis (SD = 4.2), M age 55 (SD = 12) completed the survey (response rate 80%). Of the survivors, 20.1% (N = 55) endorsed ("agree" or "strongly agree") that Cancer is a Catastrophe, 52.4% (N = 143) endorsed that Cancer is Manageable, and 65.9% (N = 180) endorsed that Cancer can be an Opportunity (not mutually exclusive). Those who endorsed a maladaptive mindset (Cancer is a Catastrophe) reported lower health-related quality of life (HRQOL) compared with those who did not hold this belief (p , .001). Alternatively, those who endorsed more adaptive mindsets (Cancer is Manageable or Cancer can be an Opportunity) reported better HRQOL compared with those who disagreed (all p-values , .05). All three mindsets were independent correlates of HRQOL, explaining 6-15% unique variance in HRQOL, even after accounting for demographic and medical factors. Conclusions: Mindsets about illness are significantly associated with HRQOL in cancer survivors. Our data come from a one-time evaluation of cancer survivors at a single clinic and provide a foundation for future longitudinal studies and RCTs on the relationship between mindsets and psychosocial outcomes in cancer survivors.

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confidence: 99%

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confidence: 99%

Association of illness mindsets with health-related quality of life in cancer survivors.

Zeidman¹,

Benedict²,

Zion³

et al. 2022

Health Psychology

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“…Prior to the pandemic, divergent thinking was associated with fewer depressive symptoms (Liknaitzky et al, 2018) and increasing divergent thinking in the context of the pandemic decreased anxiety symptoms (Zuo et al, 2021). Also, recent work has shown that mindsets about the pandemic had a selffulfilling pattern of quality of life 6 months later, such that stronger endorsement of a mindset that "the pandemic can be an opportunity" was protective (Zion et al, 2022). Efforts to increase divergent thinking, and tolerance of ambiguity, could also benefit from the cognitive behavioral and constructivist therapeutic approaches (Neimeyer, 2009;Hofmann et al, 2012) which have explicit goals of challenging undesirable perceptions of events to train increasingly functional ways of viewing the world.…”

Section: Discussionmentioning

confidence: 99%

Public mental health during and after the SARS-CoV-2 pandemic: Opportunities for intervention via emotional self-efficacy and resilience

et al. 2023

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ImportanceDuring the pandemic, the number of United States adults reporting clinically significant symptoms of anxiety and depression sky-rocketed, up from 11% in 2020 to more than 40% in 2021. Our current mental healthcare system cannot adequately accommodate the current crisis; it is therefore important to identify opportunities for public mental health interventions.ObjectiveAssess whether modifiable emotional factors may offer a point of intervention for the mental health crisis.Design, setting, and participantsFrom January 13 to 15, 2022, adults living in the United States were recruited via Amazon Mechanical Turk to complete an anonymous survey.Main outcomes and measuresLinear regressions tested whether the primary outcomes during the SARS-CoV-2 pandemic (depressive and anxiety symptoms, burnout) were associated with hypothesized modifiable risk factors (loneliness and need for closure) and hypothesized modifiable protective factors (the ability to perceive emotions and connect with others emotionally; emotion-regulation efficacy; and resilience, or the ability to “bounce back” after negative events).ResultsThe sample included 1,323 adults (mean [SD] age 41.42 [12.52] years; 636 women [48%]), almost half of whom reported clinically significant depressive (29%) and/or anxiety (15%) symptoms. Approximately 90% of participants indicated feeling burned out at least once a year and nearly half of participants (45%) felt burned out once a week or more. In separate analyses, depressive symptoms (Model A), anxiety symptoms (Model B), and burnout (Model C) were statistically significantly associated with loneliness (βModel A, 0.38; 95% CI, 0.33–0.43; βModel B, 0.30; 95% CI, 0.26–0.36; βModel C, 0.34; 95% CI, 0.28–0.41), need for closure (βModel A, 0.09; 95% CI, 1.03–1.06; βModel B, 0.13; 95% CI, 0.97–0.17; βModel C, 0.11; 95% CI, 0.07–0.16), recent stressful life events (βModel A, 0.14; 95% CI, 0.10–0.17; βModel B, 0.14; 95% CI, 0.11–0.18; βModel C, 0.10; 95% CI, 0.06–0.15), and resilience (βModel A, −0.10; 95% CI, −0.15 to −0.05; βModel B, −0.18; 95% CI, −0.23 to −0.13; βModel C, −0.11; 95% CI, −0.17 to −0.05). In addition, depressive and anxiety symptoms were associated with emotional self-efficacy (βModel A, −0.17; 95% CI, −0.22 to −0.12; βModel B, −0.11; 95% CI, −0.17 to −0.06), and beliefs about the malleability of emotions (βModel A, −0.08; 95% CI, −0.12 to −0.03; βModel B, −0.09; 95% CI, −0.13 to −0.04). Associations between loneliness and symptoms were weaker among those with more emotional self-efficacy, more endorsement of emotion malleability beliefs, and greater resilience, in separate models. Analyses controlled for recent stressful life events, optimism, and social desirability.Conclusion and relevancePublic mental health interventions that teach resilience in response to negative events, emotional self-efficacy, and emotion-regulation efficacy may protect against the development of depressive symptoms, anxiety, and burnout, particularly in the context of a collective trauma. Emotional self-efficacy and regulation efficacy may mitigate the association between loneliness and mental health, but loneliness prevention research is also needed to address the current mental health crisis.

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“…Cancer mindsets were measured using the cancer version of the Illness Mindset Inventory (IMI), a 9‐item measure of mindsets about illness, which was developed by experts in mindset research (including authors Zion, Dweck and Crum) 5 . The cancer version of the IMI consists of 3 subscales: cancer as a catastrophe, cancer as manageable, and cancer as an opportunity.…”

Section: Methodsmentioning

confidence: 99%

“…The impact of mindsets about intelligence, stress, diet, and exercise on performance, health, and wellbeing outcomes of non‐clinical populations is well‐documented 2–4 . For patients with cancer, mindsets about the meaning of cancer and the role of the body may be similarly impactful 5,6 . By shaping a patient's cognitive, emotional, and physiological responses to both the illness and the subsequent treatment, these mindsets may influence multiple aspects of overall quality of life 2 .…”

Section: Introductionmentioning

confidence: 99%

Changing cancer mindsets: A randomized controlled feasibility and efficacy trial

Zion,

Schapira,

Berek

et al. 2023

Psycho-Oncology

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ObjectiveA cancer diagnosis and subsequent treatment can disrupt the full spectrum of physical, social, emotional, and functional quality of life. But existing psychological treatments are focused primarily on specific psychological symptoms as opposed to improving the overall patient experience. We studied the feasibility and efficacy of a novel digital intervention targeting patient mindsets—core assumptions about the nature and meaning of illness—designed to improve overall health‐related quality of life (HRQoL) in newly diagnosed cancer patients undergoing treatment with curative intent.MethodsRecently diagnosed (≤150 days) adult patients with non‐metastatic cancers undergoing systemic treatment (N = 361) were recruited from across the United States to participate in this decentralized clinical trial. Patients were randomized 1:1 to receive the Cancer Mindset Intervention (CMI) or Treatment as Usual (TAU). Participants in the CMI group completed seven online modules over 10 weeks (2.5 h total) targeting mindsets about cancer and the body. The primary outcome was overall HRQoL, and secondary outcomes were coping behaviors and symptom distress.ResultsPatients in the CMI group reported significant (p < 0.001) improvements in adaptive mindsets about cancer and the body over time. Compared with the TAU condition, the CMI group reported significant improvements in overall HRQoL (B = 0.60; 95% CI 0.34–0.85; p < 0.001), increased engagement in adaptive coping behaviors (B = 0.03; 95% CI 0.02–0.04; p < 0.001), and reduced distress from physical symptoms (B = −0.29; 95% CI −0.44 to −0.14; p < 0.01). Effect sizes of these changes ranged from d = 0.42–d = 0.54.ConclusionA brief mindset‐focused digital intervention was effective at improving physical, social, emotional, and functional HRQoL. increasing adaptive coping behaviors, and reducing physical symptom distress in newly diagnosed cancer patients.

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Making Sense of a Pandemic: Mindsets Influence Emotions, Behaviors, Health, and Wellbeing During the COVID-19 Pandemic

Cited by 4 publications

References 7 publications

Association of illness mindsets with health-related quality of life in cancer survivors.

Association of illness mindsets with health-related quality of life in cancer survivors.

Public mental health during and after the SARS-CoV-2 pandemic: Opportunities for intervention via emotional self-efficacy and resilience

Changing cancer mindsets: A randomized controlled feasibility and efficacy trial

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