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Objective Little is known about potential mechanisms of action linking protective positive psychological variables and functional disability in patients with rheumatic and musculoskeletal disease. The present study was undertaken to examine symptoms of psychopathology, including stress, depression, anxiety, and sleep quality, as serial mediators of the association between gratitude, self-compassion, self-forgiveness, and functional impairment. Methods We assessed risk and protective factors for functional disability in patients with fibromyalgia (FM), osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) who were recruited from an Austrian health care facility. Respondents completed online surveys, including the Gratitude Questionnaire 6-item form, the Self-Compassion Scale short form, the Self-Forgiveness and Forgiveness of Others Index, the Perceived Stress Scale 4, the Patient Health Questionnaire 2, the 2-item Generalized Anxiety Disorder Scale, the Sleep Condition Indicator, and the Health Assessment Questionnaire. Bivariate and serial mediation analyses were conducted. Results For our sample of 1,218 patients (52% female, n = 632; AS [37%], OA [34%], RA [14%], and FM [24%]), stress, depression, and anxiety, in parallel as first-order mediators, and sleep quality as a second-order mediator, explained the association between positive psychological variables and functional disability. Conclusion Positive psychological factors exert a beneficial downstream effect on mental well-being, sleep health, and health-related functional impairment. Therapeutic promotion of gratitude, self-compassion, and self-forgiveness may improve mental and physical health in patients with rheumatic and musculoskeletal disease.

Veterans are at particular risk for suicide due to psychopathological, emotional, and interpersonal risk factors. However, the presence of individual-level protective factors, such as self-compassion, may reduce risk, becoming more salient at increasing levels of distress and psychopathology, per theory. We examined the relation between self-compassion and suicide risk, and the moderating effects of depression, PTSD symptoms, anger, shame, and thwarted interpersonal needs. Our sample of US veterans (n = 541) in our cross-sectional study were mostly male (69.1%) with an average age of 49.90 (SD = 16.78), who completed online self-report measures: Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning Screening Tool, PTSD Checklist-Military Version, Differential Emotions Scale-IV, and the Interpersonal Needs Questionnaire. The linkage between self-compassion and suicidal behavior in our veteran sample was moderated by distress-evoking risk factors, including depression, anger, shame, and thwarted interpersonal needs, such that, as level of risk severity increases, the inverse association between self-compassion and suicidal behavior is strengthened. Our findings highlight an emergent protective process that may prevent suicide in times of distress. Therapeutically bolstering the ability for self-compassion may provide a proactive coping strategy that can be brought to bear in times of crisis, reducing suicide risk for veterans.

People often fail at following through with their health behaviour goals. How health goals are cognitively represented holds promise for understanding successful health behaviour change. Health-related possible selves (HPS) reflect cognitive representations of a future self that people may wish to achieve (hoped-for-HPS) or avoid (feared-HPS), that can promote health behaviour change. However, success depends on the strength of the efficacy and outcome expectancies for achieving/avoiding the HPS. Personality traits linked to poor self-regulation are often not considered when assessing the potential self-regulatory functions of HPS. The current study addressed this issue by examining the associations of trait procrastination with efficacy and outcome expectancies for hoped-for-HPS and feared-HPS, and health behaviour change intentions and motivations in a community sample (N = 191) intending to make healthy changes in the next 6 months. Trait procrastination was associated with weaker intentions and motivations for health behaviour change, and lower efficacy and outcome expectancies for hoped-for-HPS, but not feared-HPS. Bootstrapped multiple mediation analysis found significant indirect effects of procrastination on health behaviour intentions, through outcome, but not efficacy, expectancies for hoped-for-HPS. Results suggest that issues in imagining a hoped-for-HPS can be achieved are linked to weak intentions for health behaviour change for those with chronic self-regulation difficulties. Research into interventions that strengthen feeling connected to hoped-for-HPS is recommended.

The present study examined differences between fibromyalgia patients and healthy controls on anger rumination, mental health and quality of life and tested anger rumination as a mediator of patient-control differences in mental health and quality of life. Participants were a propensity score-matched sample of 58 fibromyalgia patients and 58 healthy controls. Participants completed measures of anger rumination, depression and anxiety and quality of life. Patients were higher than controls on all anger rumination scales and depression and anxiety and lower on quality of life. All anger rumination scales were related to poorer mental health and quality of life. Patient-control differences on mental health and quality of life were mediated by anger rumination. In multiple mediator models, the only subscale with unique mediating effects was anger memories. Anger rumination has potent associations with mental health and quality of life, and differences between patients and controls on mental health and quality of life are partially mediated by differences in anger rumination. Addressing tendencies to ruminate on anger experiences in the care of fibromyalgia patients may offer an important avenue to improved health and quality of life. © 2019 John Wiley & Sons, Ltd.

The present study examined the relationship between future orientation and fibromyalgia-related pain severity in a sample of 287 adults with fibromyalgia. Specifically, authors examined dimensions of self-compassion (for example, self-kindness, isolation, mindfulness) as possible mechanisms through which future orientation might be associated with pain severity. Results of conducting a multiple mediator test with 10,000 bootstraps indicated that the significant negative association between future orientation and pain severity was mediated through one specific self-compassion dimension, namely, isolation. The article concludes with a discussion of the implications of the present findings for working with fibromyalgia patients, specifically the potential value of social workers working with fibromyalgia patients to build future orientation as a resilience factor to combat pain severity. Also discussed is the value of working with patients to develop a sustainable social support system that can disrupt experiences of social isolation and disconnectedness from others, and which appear to contribute to greater pain severity.

Objective: Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak, such as the coronavirus pandemic, due to the demands of dealing with a public health emergency. This rapid systematic review examined the factors associated with psychological distress among HCW during an outbreak.Method: We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, and Ebola). Four electronic databases were searched (2000 to 15 November 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors linked to distress and psychiatric morbidity.Results: From the 4,621 records identified, 138 with data from 143,246 HCW in 139 studies were included. All but two studies were cross-sectional. The majority of the studies were conducted during COVID-19 (k = 107, N = 34,334) and SARS (k = 21, N = 18,096). Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk of contact with infected patients, and experiencing quarantine, were risk factors for psychological distress among HCW. Personal and organizational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training, and resources, were associated with less psychological distress.Conclusions: This review highlights the key factors to the identify HCW who are most at risk for psychological distress during an outbreak and modifying factors to reduce distress and improve resilience. Recommendations are that HCW at risk for increased distress receive early interventions and ongoing monitoring because there is evidence that HCW distress can persist for up to 3 years after an outbreak. Further research needs to track the associations of risk and resilience factors with distress over time and the extent to which certain factors are inter-related and contribute to sustained or transient distress.

© 2020 Elsevier Inc. We investigate whether the tendency to self-affirm in response to threat is associated with how people feel when they weigh themselves. People who were preoccupied with their weight anticipated feeling less negative (Studies 1a and 1b) and felt less negative (Study 2) when self-weighing if they typically affirmed their strengths. Study 3 experimentally manipulated self-affirmation. Although this intervention prompted affirmation of strengths it did not influence how participants felt when they subsequently weighed themselves. Together, the findings suggest that the tendency to spontaneously affirm strengths, but not values or social relations, is associated with the psychological outcomes of self-weighing and thus provide the basis for understanding how such individual differences might moderate how people respond in other self-evaluative contexts.

Shame and guilt are common during the course of parenting and can reflect feelings of “bad self “and “bad behaviour” in relation to parenting events. Self-compassion is known to be beneficial for well-being by reducing negative emotions, yet there is little research examining whether self-compassion might reduce parental guilt and shame. The current study examined the effects of dispositional and induced self-compassion on guilt and shame in a sample of 167 parents (Mage = 37.23, SD = 6.73, 83.1% female) of children 12 years and under recruited online. After completing baseline measures, parents were randomly assigned to recall a guilt versus shame provoking parenting event, and randomly allocated to either a self-compassion prompt versus a control condition. Analyses confirmed that those who received the self-compassion prompt reported higher levels of self-compassion, and reduced feelings of guilt and shame compared to the control group. Effects did not differ as a function of the guilt versus shame instructions. Multivariate analyses revealed that, when controlling for dispositional self-compassion, and baseline guilt and shame, differences between conditions were maintained for post-manipulation guilt and shame. Findings extend our understanding of the role of self-compassion for improving well-being when dealing with the challenges of parenting.

Background: Mediation studies test the mechanisms by which interventions produce clinical outcomes. Consistent positive mediation results have previously been evidenced (Hayes et al., 2006) for the putative processes that compromise the psychological flexibility model of acceptance and commitment therapy (ACT). Aims: The present review aimed to update and extend the ACT mediation evidence base by reviewing mediation studies published since the review of Hayes et al. (2006). Method: ACT mediation studies published between 2006 and 2015 were systematically collated, synthesized and quality assessed. Results: Twelve studies met inclusion criteria and findings were synthesized by (a) the putative processes under investigation, and (b) the outcomes on which processes were tested for mediation. Mediation results were found to be generally consistent with the psychological flexibility model of ACT. However, studies were limited in methodological quality and were overly focused on a small number of putative processes. Conclusions: Further research is required that addresses the identified methodological limitations and also examines currently under-researched putative processes.

The current study extended previous research on self-compassion and health behaviours by examining the associations of self-compassion to bedtime procrastination, an important sleep-related behaviour. We hypothesized that lower negative affect and adaptive emotion regulation would explain the proposed links between self-compassion and less bedtime procrastination. Two cross-sectional online studies were conducted. Study 1 included 134 healthy individuals from the community (mean age 30.22, 77.4% female). Study 2 included 646 individuals from the community (mean age 30.74, 68.9% female) who were screened for the absence of clinical insomnia. Participants in both studies completed measures of self-compassion, positive and negative affect and bedtime procrastination. Participants in study 2 also completed a measure of cognitive reappraisal. Multiple mediation analysis in study 1 revealed the expected indirect effects of self-compassion on less bedtime procrastination through lower negative affect [b = − .09, 95% CI = (− .20, − .02), but not higher positive affect. Path analysis in study 2 replicated these findings and further demonstrated that cognitive reappraisal explained the lower negative affect linked to self-compassion [b = − .011; 95% CI = (− .025; − .003)]. The direct effect of self-compassion on less bedtime procrastination remained significant. Our novel findings provide preliminary evidence that self-compassionate people are less likely to engage in bedtime procrastination, due in part to their use of healthy emotion regulation strategies that downregulate negative mood.

Following an unexpected geo-political event, such as the United Kingdom's June 2016 referendum vote to leave the European Union (“Brexit”), people will make counterfactuals that mentally undo the outcome and imagine what might have been had the outcome gone in the predicted direction. Yet little is known about how such counterfactuals may impact well-being, or the individual differences that might protect individuals from making potentially distressing upward counterfactuals. We examined the extent to which individual differences in enduring just-world beliefs shape the number of upward counterfactuals generated by British “Remain” voters, and the resulting effects on vote-related well-being. Participants who were directed to make counterfactuals reported the same levels of vote-related well-being as those who were not directed to make counterfactuals. Among those who made counterfactuals, making more upward counterfactuals was associated with reduced well-being. However, holding just-world beliefs limited the number of upward counterfactuals that were made and thus protected individuals from this distress. Our findings demonstrate that individual differences in enduring beliefs about the fairness of a vote may protect voter well-being when there will not be a second vote.

The equivocal and debated findings from a 2007 meta–analysis, which viewed perfectionism as a unidimensional construct, suggested that perfectionism was unrelated to procrastination. The present meta–analysis aimed to provide a conceptual update and reanalysis of the procrastination–perfectionism association guided by both a multidimensional view of perfectionism and self–regulation theory. The random–effects meta–analyses revealed a small to medium positive average effect size ( r = .23; k = 43, N = 10 000; 95% confidence interval (95% CI) [0.19, 0.27]) for trait procrastination and perfectionistic concerns and a small to medium negative average effect size ( r = −.22; k = 38, N = 9544; 95% CI [−0.26, −0.18]) for procrastination and perfectionistic strivings. The average correlations remained significant after statistically accounting for the joint variance between the two perfectionism dimensions via semi–partial correlations. For perfectionistic concerns, but not perfectionistic strivings, the effects depended on the perfectionism measure used. All effects did not vary by the trait procrastination measure used or the respondent's sex. Our findings confirm that from a multidimensional perspective, trait procrastination is both positively and negatively associated with higher–order perfectionism dimensions and further highlights the value of a self–regulation perspective for understanding the cognitive, affective and behavioural dynamics that characterise these traits. Copyright © 2017 European Association of Personality Psychology

Objective: Gratitude, or thankfulness for positive aspects of life, is related to psychosocial well-being and decreased psychopathology, and may reduce suicide risk. We explored four potential hypotheses purported to explain the beneficial outcomes of gratitude (schematic, positive affect, broaden-and-build, and coping), hypothesizing that hopelessness (schematic), depression (positive affect), social support (broaden-and-build), and substance use (coping) would mediate the gratitude-suicide linkage. Participants: 913 undergraduate students from a mid-size, southeastern U.S. university. Methods: Respondents completed online self-report questionnaires including the Suicidal Behaviors Questionnaire-Revised, Gratitude Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory, Duke Social Support Index, Alcohol Use Disorders Identification Test, and Drug Abuse Screening Test. Results: Supporting theory and hypotheses, gratitude was related to less suicide risk via beneficial associations with hopelessness, depression, social support, and substance misuse. Conclusions: The linkage between gratitude and suicide risk appears to be predicated on the beneficial association of gratitude to negative mood and interpersonal functioning.

Trait procrastination is increasingly recognised as having relevance for a number of consequential outcomes, including health. However, research with clinical populations may be hindered by longer scales. The present research addresses this issue by developing and validating a short version of Lay's General Procrastination Scale (GPS), a widely used self-report measure of trait procrastination. Study 1 used factor analysis to reduce the 20-item GPS to 9 items across two large samples (N = 620, N = 920). In Study 2 the GPS-9 demonstrated very good internal consistency across 15 student, adult and chronic illness samples, with a meta-analysis of coefficient alpha finding an average reliability coefficient of 0.89 (Total N = 4492). The GPS-9 also demonstrated good test-retest reliability (r = 0.89), and the expected associations with variables known to be part of the nomological network of trait procrastination. Findings from the current research provide evidence that the GPS-9 is a brief, valid, and reliable measure of trait procrastination.

Background The study of resilient traits (RT) including self-compassion, self-forgiveness, forgiveness of others, and gratitude has garnered the attention of investigators involved in health and healthcare research (1, 2). Little is known about such RT in patients with AS, RA, and FM. Objectives To examine patient group differences in levels and mental and physical health correlates of self-compassion, self-forgiveness, forgiveness of others, and gratitude. Methods We conducted an online survey with patients attending the Gastein Healing Galleries in Bad Gastein, Austria. In this health facility, approximately 12,000 patients suffering from different diseases are treated annually. Of those, 6,465 patients were invited by email to participate anonymously. Socio-demographics and health-related variables including depression, pain, and current health status were measured in all respondents. Also measures of self-compassion, self-forgiveness, forgiveness of others, and gratitude were administered in a subset of participants. Results In total 2,017 patients responded (=31%) of which a subset of 562 patients with AS (44%), FM (38%), and RA (18%) completed measures of RT. Sex ratio (male/female) was 52%/48%, mean age 57 (SD=11) and level of education was: Elementary School 28%, Junior High School 22%, High School 20%, College 13%, and University 17%. Across patient groups, no differences emerged in levels of self-forgiveness, forgiveness of others, or gratitude (ps>.30), although FM patients reported lower levels of self-compassion compared to patients with AS and RA (p Conclusion We found that only self-compassion varied across patient groups, with FM patients reporting lower levels. All RT were consistently related to depression across the three patient groups, but gratitude was also related consistently across groups to both pain and health. RT may well vary according to patient diagnoses with some traits offering more support and resilience-building to the patient than other traits. An important key for treatment support and management may be to identify which traits are most useful to encourage the development of resilience and health in specific patient groups. References [1] Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and Identity, 14(3), 334-347. [2] Liu L, Xu X, Xu N, Wang L. Disease activity, resilience and health-related quality of life in Chinese patients with rheumatoid arthritis: a multi-center, cross-sectional study. Health Qual Life Outcomes. 2017Jul24;15(1):149. Disclosure of Interests None declared

Background: Patient education is an important part of the management of rheumatic and other diseases. Since patients do not have the same needs, it is crucial to assess needs of a targeted group to be able to tailor educational interventions. Objectives: To assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria. Methods: We conducted an online survey with patients attending the Gastein Healing Galleries in Bad Gastein, Austria. Approximately 12,000 patients with a variety of diseases are treated in the centre every year. Of those, 6,465 patients were invited by email to fill out an anonymous online survey. Socio-demographics and health outcomes were collected from all respondents. In addition, the Educational Needs Assessment Tool (Austrian version - OENAT) was administered to a subset of respondents. The OENAT (39 items) assesses 7 domains of educational needs: Managing Pain, Movement, Managing Feelings, Arthritis/Disease process, Treatments, Self Help Measures, Support Systems. Results: In total 2017 (31%) patients responded of which 516 had data on educational needs: AS (63%), RA (14%), and FM (24%). Their mean (SD) age was 56 (11), and 54% were male. Level of education was: Elementary School (32%), Junior High School (22%), High School (21%), College (12%), and University (14%). Table 1 presents differences in educational needs across disease groups. Across the groups, there were significant differences in following OENAT domains: Managing Pain, Feelings, Treatments, and Support Systems. There were no differences in the level of educational needs in Movements, Disease Process, and Self-Help Measures. Patients with FM had significantly lower needs for managing and higher needs for feeling education, compared to those with AS and RA (p Conclusion: Educational needs vary by disease groups and depend on the domain under consideration. Disclosure of Interests: None declared

Converging theory and evidence highlights procrastination as a form of self-control failure. However, the underlying neural correlates of how self-control is associated with procrastination remains unclear. As such we investigated the neural basis for self-control association with procrastination using voxel-based morphometry (VBM) and resting-state functional connectivity (FC) approaches. The VBM results showed a positive correlation between self-control and the gray matter volume of left dorsolateral prefrontal cortex (dlPFC). Then the FC of left dlPFC to lateral orbital frontal cortex (lOFC) and right dorsal medial frontal cortex (dMFC) were all negatively correlated to procrastination and showed a mediating effect. This indicates that brain functional communication involves in emotion regulation and valuation processing may account for the association between self-control and procrastination.

Objective: Although gratitude has been identified as a key clinically relevant trait for improving well-being, it is understudied within medical populations. The current study addressed this gap and extended previous and limited cross-sectional research by examining the longitudinal associations of gratitude to depression in two chronic illness samples, arthritis and IBD. Methods: Two chronic illness samples, arthritis (N = 423) and inflammatory bowel disease (IBD; N = 427), completed online surveys at Time 1 (T1). 163 people with arthritis and 144 people with IBD completed the six-month follow-up survey (T2). Depression, gratitude, illness cognitions, perceived stress, social support, and disease-related variables were assessed at T1 and T2. Results: At T2, 57.2 percent of the arthritis sample and 53.4 percent of the IBD sample met the cut off scores for significant depression. T1 gratitude was negatively associated with depressive symptoms at T1 and T2 in both samples (r’s from -.43 to -.50). Regression analyses revealed that T1 gratitude remained a significant and unique predictor of lower T2 depression after controlling for T1 depression, relevant demographic variables, illness cognitions, changes in illness-relevant variables, and another positive psychological construct, thriving, in both samples. Conclusion: As the first investigation of the longitudinal associations of gratitude to psychological well-being in the context of chronic illness, the current study provides important evidence for the relevance of gratitude for health-related clinical populations. Further intervention-based research is warranted to more fully understand the potential benefits of gratitude for adjustment to chronic illness.

Attachment theory posits that insecure attachment orientations reflect activation of the attachment behavioural system, and therefore deactivation of its complementary counterpart the exploration system, which is associated with feeling less energized. We hypothesized that less perceived social support and higher fatigue would prospectively explain the link between insecure attachment and well-being in emerging adulthood (ages 18–25), a period in which exploration and social relationships are critical. Participants aged 18–25 completed surveys initially and two weeks later ( N = 153). Temporal multiple mediation revealed that, at T1, both forms of insecure attachment (anxious and avoidant) were associated with lower T2 well-being, with less perceived social support and higher levels of fatigue each uniquely explaining these associations, after controlling for the effects of each form of attachment on the other. Our findings suggest that deactivation of the exploration system and information processing biases regarding the availability and trustworthiness of others may compromise well-being for emerging adults with an insecure attachment orientation.

Despite the relatively consistent finding that Conscientiousness, Agreeableness and low Neuroticism are associated with the practice of health-promoting behaviors, the reasons for these linkages are not well understood. This prospective study addressed this gap by taking a self-regulation resource perspective on why these traits relate to health-promoting behaviors by examining the role of higher positive relative to negative state affect. Students completed baseline (N = 330), and two week follow-up (N = 195) surveys. Bootstrapping analyses of the indirect effects of each of the three traits on Time 2 health behaviors were significant in the expected directions, with Kappa squares ranging from .11 to .13. In the full longitudinal analyses controlling for Time 1 health behaviors, the indirect effects of Conscientiousness and Agreeableness through affect balance on Time 2 health behaviors were positive and significant, whereas the indirect effects through Neuroticism were negative and significant after accounting for the Time 1 practice of health behaviors. These findings provide a process-oriented understanding of how Big Five traits are linked to health-promoting behaviors and extend previous research supporting a self-regulation resource perspective on personality and health behaviors.

Despite the theoretical and empirical accounts of trait procrastination as reflecting avoidance of aversive tasks as a means of mood repair, research documenting its links to coping is scarce and inconsistent. There is also little if any research to date examining whether coping strategies might explain the procrastination–stress relationship. The current research aimed to address these issues by integrating current research on procrastination and coping with our own data into a first meta–analysis of the associations of procrastination with adaptive and maladaptive coping and then testing the potential role of coping for understanding the procrastination–stress relationship. In Study 1, a literature search yielded five published papers and three theses, which were supplemented by seven unpublished data sets comprising 15 samples ( N = 4357). Meta–analyses revealed that procrastination was positively associated with maladaptive coping (average r = .31) and negatively associated with adaptive coping (average r = −.24). In Study 2, a meta–analysis of the indirect effects through coping across four samples revealed that the average indirect effects for maladaptive but not adaptive coping explained the link between procrastination and stress. These findings expand the nomological network of procrastination and highlight the role of maladaptive coping for understanding procrastinators‘ stress. Copyright © 2015 European Association of Personality Psychology

Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination-health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality, coping, and health outcomes. Logistic regression analysis controlling for demographic and higher order personality factors found that older age, lower education level and higher procrastination scores were associated with HT/CVD. Moderated mediation analyses with bootstrapping revealed that procrastination was more strongly associated with maladaptive coping behaviours in participants with HT/CVD than the healthy controls, and the indirect effects on stress through maladaptive coping were larger for the HT/CVD sample. Results suggest procrastination is a vulnerability factor for poor adjustment to and management of HT/CVD.

A recent review suggested that self-compassion promotes use of adaptive rather than maladaptive coping. Less is known about how self-compassion is linked to stress and coping in the context of a chronic stressor. Across two primarily female chronic illness samples, inflammatory bowel disease (N = 155) and arthritis (N = 164), a model linking self-compassion to lower stress through coping styles and coping efficacy was tested. Path analyses revealed significant indirect effects for adaptive coping styles (active, positive reframing, and acceptance), and negatively for maladaptive coping styles (behavioral disengagement and self-blame) in both samples. Findings suggest that the relative balance of adaptive and maladaptive coping strategies used by self-compassionate people is associated with better coping outcomes in the context of chronic illness.

Objective: College students may be at heightened risk for suicide and suicidal behavior due to maladaptive cognitive-emotional factors and failure to practice basic health behaviors. However, self-compassion and wellness behaviors may protect against risk. The relation between self-compassion and suicidal behavior and the contributing roles of depressive symptoms and wellness behaviors was examined. Participants: Participants were 365 undergraduate students. Data was collected in April 2015. Methods: A cross-sectional, survey design was employed. Participants completed measures assessing self-compassion, depressive symptoms, wellness behaviors, and suicidal behavior. Serial mediation analyses were conducted covarying age, sex, and ethnicity. Results: Self-compassion was inversely related to suicidal behavior, and this relationship was serially mediated by depressive symptoms and wellness behaviors. Conclusions: Self-compassion may protect against suicidal behavior, in part, due to reduced depressive symptoms and heightened engagement in wellness behaviors. Individual and campus-wide strategies promoting self-compassion and wellness behaviors may reduce suicide risk on college campuses.

Growing evidence indicates that self-compassion is associated with better physical health, but the pathways that mediate this relationship are not well understood. This study tested a serial mediation model that linked self-compassion, perceived stress, health behaviors, and a comprehensive index of physical health. A sample of 176 individuals completed an online survey posted on Amazon’s Mechanical Turk. Self-compassion had an indirect effect on physical health via both mediators as well as through the sequential pathway, suggesting that taking a kind, accepting and mindful stance toward one’s flaws and failures may have benefits for reducing stress and promoting health behaviors.

Introduction Both theoretical and empirical evidence suggests that time perspective is likely to influence self-regulatory processes and outcomes. Despite the theoretical and practical significance of such relations, the relationship between time perspective and self-regulatory processes and outcomes across different measures, samples and life domains, including health, has yet to be explored. Methods and analysis The proposed review will develop a taxonomy for classifying measures according to the self-regulatory process, ability or outcome that they are likely to reflect. Electronic scientific databases will be searched, along with relevant conference abstract booklets and citation lists. Additionally, a call for unpublished data will be submitted to relevant bodies. To be eligible for inclusion, studies must include a measure of time perspective and a measure of at least one self-regulatory process, ability and/ or outcome. Eligibility will not be restricted by publication date, language, type of sample or setting. The bivariate correlations will be extracted (or calculated) and submitted to a random-effects meta-analysis. The sample-weighted average effect size, heterogeneity, risk of bias and publication bias will be calculated, and the effects of categorical and continuous moderator variables on the effect sizes will be determined. Ethics and dissemination The proposed meta-analysis will synthesise previously conducted research; thus, ethical approval is not required. The findings will be submitted for publication in an international peer-reviewed journal and reported as part of the first author’s PhD thesis. The findings will also be disseminated to the research community and, where appropriate, to other interested parties through presentations at relevant academic and non-academic conferences.

Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls. Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics. Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables. Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.

Whether viewed as a domain-specific behavior or as an enduring tendency, procrastination is a common form of self-regulation failure that is increasingly recognized as having implications for health-related outcomes. Central to procrastination is the prioritization of reducing immediate negative mood at the cost of decisions and actions that provide long-term rewards, such as engaging in health behaviors. Because people tend to procrastinate on tasks they find difficult, unpleasant, or challenging, many health-promoting behaviors are possible candidates for procrastination. As modifiable risk factors for the prevention of disease and disability, health behaviors are often the target of health risk communications aimed at health behavior change and reducing health procrastination. Research has consistently demonstrated the deleterious effects of chronic procrastination on health outcomes, including poor physical health, fewer health promoting behaviors, and higher stress in healthy adults and those already living with a chronic health condition. Examining the factors and psychological characteristics associated with chronic procrastination can provide insights into the processes involved in procrastination more generally, as well as the qualities of the health messages that can promote or prevent procrastination of the targeted behaviors. Low future orientation, avoidant coping, low tolerance for negative emotions, and low self-efficacy need to be considered when designing effective health risk communications to reduce procrastination of health behaviors. Yet, health risk communications aimed at reducing procrastination of important health behaviors such as healthy eating, regular physical activity, screening behaviors, and cessation of risky health behaviors often use fear appeals to motivate taking protective actions to reduce health risks. Such approaches may not be effective because they amplify the negative feelings towards the health behaviors, which can engender maladaptive coping responses and motivate procrastination rather than adaptive responding. This is especially likely among individuals prone to procrastination more generally, or specifically with respect to health. Health risk communication approaches that minimize the negative emotions associated with risk messages and instead highlight short-term benefits of engaging in health behaviors may be necessary to reduce further health behavior procrastination among individuals prone to this form of self-regulation failure.

Recent theory suggests that trait procrastination is a form of temporal self–regulation failure that reflects a disjunction between the present and future self. Yet research to date is sparse and inconsistent regarding the nature of the associations of procrastination with time perspective. The current study aimed to meta–analytically summarize the evidence to date to address the question of how procrastination is linked to future and present time perspective, and to test whether stress and positive affect explained the link between procrastination and future time perspective. A search of the available literature yielded six published studies and three unpublished studies, which were combined with five unpublished data sets for a total of 14 samples with 4312 participants. The meta–analysis revealed that procrastination had a moderate and significant negative association with future time perspective, and a small but significant positive association with present time perspective. Mediation analyses across two of the samples found that high stress and low positive affect explained in part the association between procrastination and future time perspective. Overall, these findings support the notion that procrastinators focus less on the future and highlight the dynamic interrelations of affect and cognition that underlie procrastinators’ intertemporal choices. Copyright © 2014 European Association of Personality Psychology

Summary Objectives To prospectively investigate how health-related self-perceptions are associated with use of provider-based CAM in two chronic inflammatory diseases, arthritis and inflammatory bowel disease (IBD). Design and setting A prospective online survey was administered to convenience samples of individuals with arthritis or inflammatory bowel disease, and a follow-up survey completed 6 months later. Participants were recruited via online ads, through national organizations, and support groups. Main outcome measures Surveys included measures of demographics, use of provider-delivered CAM, disease-related factors, self-perceptions of having a healthy lifestyle and being able to handle stress, and trait resilience. Results 325 people (170 with arthritis and 155 with IBD) completed the initial and follow-up surveys. Rates of CAM use were 43.2% and 45.9% for the arthritis and IBD groups, respectively. T -tests revealed significant differences on healthy lifestyle self-perceptions and trait resilience for both illness groups. Differences in self-perceptions about handling stress were only significant in the IBD group. Multivariate logistic regression controlling for demographics and health-related variables revealed that seeing oneself as having a healthy lifestyle predicted CAM use in both illness groups. Being resilient predicted CAM use only in the IBD group, and self-perceptions about handling stress predicted CAM use only in the arthritis group. Conclusions This study provides insights into how health-related self-perceptions are prospectively linked to provider-based CAM use in patients with chronic inflammatory disease. This information is important for both health-care practitioners and researchers as it has implications for maximizing the health-promoting aspects of CAM use and understanding CAM adherence.

Emotion-regulation perspectives on procrastination highlighting the primacy of short-term mood-regulation focus mainly on negative affect. Positive affect, however, has received much less attention, and has not been considered with respect to social temptations. To address this issue we examined how trait procrastination was linked to positive and negative affect in the context of social temptations across two prospective studies. Action Control Theory, Personality Systems Interactions Theory, and a mood-regulation theory of procrastination served as guiding conceptual frameworks. In Study 1, moderated mediation analyses revealed that low positive affect explained the link between trait procrastination and time spent procrastinating on academic tasks over a 48-hour period in a student sample (N = 142), and this effect was moderated by the presence of social temptations. Parallel results for goal enjoyment assessed at Time 2 were found in Study 2 with a community sample (N = 94) attempting to make intended health behaviour changes over a six-month period. Our findings indicate that procrastinators are at risk for disengaging from intended tasks when social temptations are present and positive task-related affect is low.

Although previous research has demonstrated that procrastinators experience high levels of stress, less is known about why procrastination is linked to stress. This study is the first to investigate self-compassion as a mediator of the relationship between trait procrastination and stress. Across four samples (145 undergraduates, 339 undergraduates, 190 undergraduates, and 94 community adults) trait procrastination was associated with lower levels of self-compassion and higher levels of stress. A meta-analysis of these effects revealed a moderate negative association of procrastination with self-compassion. In all four samples, self-compassion mediated the relationship between stress and procrastination. These findings suggest that lower levels of self-compassion may explain some of the stress experienced by procrastinators and interventions that promote self-compassion could therefore be beneficial for these individuals.

Procrastination is a common and pervasive problem associated with a range of negative outcomes across a variety of life domains that often occurs when people are faced with tasks that are seen as aversive. In this paper, we argue that as a form of self-regulation failure, procrastination has a great deal to do with short-term mood repair and emotion regulation. Moreover, we contend that a temporal understanding of self and the mood-regulating processes involved in goal pursuit is particularly important in understanding procrastination, because the consequences of procrastination are typically borne by the future self. After summarizing the research on the priority of short-term mood regulation in procrastination, we then draw the connection between the focus on short-term mood repair and the temporal disjunction between present and future selves. We present research that exemplifies these intra-personal processes in understanding temporal notions of self characterized by procrastination, and then link these processes to the negative consequences of procrastination for health and well-being. We conclude with a discussion of possible avenues for future research to provide further insights into how temporal views of the self are linked to the dynamics of mood regulation over time in the context of procrastination. © 2013 Blackwell Publishing Ltd.

OBJECTIVES: We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. MATERIALS AND METHODS: A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. RESULTS: Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. DISCUSSION: Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being. ispartof: The Clinical Journal of Pain vol:33 issue:6 pages:528-534 ispartof: location:United States status: published

In this study, we extend previous work documenting links between procrastination, stress, and physical health by examining the potential role of mindfulness in explaining the high stress and poor health reported by procrastinators. A sample of 339 students (81% female) completed an on-line survey that included measures of trait procrastination, mindfulness, perceived stress, and perceived health. Univariate analyses revealed that procrastination was associated with low mindfulness, high stress, and poor perceived health. Structural equation modelling was used to test the role of mindfulness in explaining the links between procrastination and stress, and between procrastination and perceived health. The overall measurement model indicated a good fit to the data. Tests of the nested mediation models revealed that the effects of procrastination on stress and health were mediated by mindfulness, and bootstrapping analyses confirmed the significance of these effects. Our findings are consistent with previous research and theory on the salutatory effects of mindfulness for health and well-being and indicate that for procrastinators, low mindfulness may be a risk factor for poor emotional and physical well-being.

Background Psoriasis adversely impacts patients' quality of life, yet few studies have explored patients' experiences at diagnosis, a pivotal though largely negative time for any patient suffering from chronic disease. Objective Our objective was to identify potential shortcomings in the content and process of information delivery from the patient's perspective. Methods Twenty-three psoriasis patients completed an online survey regarding information they considered valuable at diagnosis and, in retrospect, content they would like to have received. Results Responses were subjected to a qualitative content analysis that revealed several themes: need for information and options, discussion of time and effort to find the right treatment, for providers to offer hope, and discussion of the psychosocial impact of psoriasis. Conclusions Many patients perceived negative actual experiences at diagnosis that were incongruent with their desired experiences. Psoriasis patients wanted information about disease and management, acknowledgement of psychosocial impact, and an empathetic mode of communication.

The quality of the patient-provider relationship is well-recognized as having a key role in therapeutic outcomes irrespective of treatment effects. Yet there is a lack of scales to assess aspects of complementary and alternative medicine (CAM) provider support.The objectives of this study were to develop and psychometrically evaluate scales to measure patients' perceptions of provider support, patient-centered care, and empowerment as predictors of health outcomes.Based on five focus groups with CAM clients, we developed the following three scales: Perceived Provider Support, Patient-Centered Care (PCC), and Empowerment. The scales were cognitively tested with 6 CAM users and then pilot-tested with 216 respondents. Confirmatory factor analyses, item response theory analyses, and Cronbach's alphas were conducted to evaluate their psychometric properties. Bootstrapping techniques and structural equation modeling were used to evaluate Empowerment as a mediator of the relationship of Perceived Provider Support and PCC with symptom relief.All three scales demonstrated high internal consistency with Cronbach's alphas of 0.85 to 0.90 and confirmatory factor analyses supported a one-factor solution for each scale. Controlling for demographics, presenting problem, and main CAM provider used in the past 12 months, each of the scales had a positive and significant relationship with overall symptom relief for the patient's primary presenting problem (p.01). Bootstrapped Sobel tests were significant (p.01), supporting the role of empowerment as a mediator of the impact of PCC and provider support on symptom relief. A structural equation model combining PCC and provider support into a single latent variable representing quality of patient-provider interactions and including empowerment as a mediator fit well.From a holistic perspective, CAM treatment effects can arise in part from sources related to the therapeutic relationship, as well as the philosophy of healing and specific techniques designed to reduce symptoms. This analysis provides conceptual support for this perspective, a means to evaluate aspects of the therapeutic relationship and to measure its impact on outcomes of CAM treatment across conditions and therapies.

The purpose of this study was to examine the benefits associated with complementary and alternative medicine (CAM) treatments from the patients’ perspective using a whole systems research approach as a guiding framework. We conducted five focus groups of six to eight participants each, with users of CAM recruited through experienced CAM providers and clinics. Eligible participants were aged 21 or older, had used CAM in the last 12 months, and believed the treatment to be beneficial. The focus group discussions were digitally recorded, transcribed, and analyzed through a qualitative content analysis. Responses were inductively coded for common themes, and then placed into broader conceptual categories reflecting the CAM outcome domains suggested by Verhoef and colleagues. Participants described physical health benefits including symptom relief and improved function, and positive psychological benefits such as improved coping and resilience. Social health benefits that arose from the positive aspects of the patient-practitioner relationship were also reported, including support and advocacy. In addition, participants identified empowerment, increased hope and spiritual growth as results of receiving CAM treatments. A new behavioral health outcome domain emerged as participants reported that CAM use had fostered behavioral changes such as increased exercise, smoking cessation and improving their diets. These patient-reported benefits of CAM treatment are consistent with the outcome model proposed by Verhoef and colleagues, and extend this model by identifying a new outcome domain—behavioral health outcome. The findings provide insight and direction for the development of outcome and process measures to evaluate CAM treatment effects.

As interest in and use of complementary and alternative medicine (CAM) providers continues to grow, it is important to understand which characteristics incline people to experiment with and become frequent consumers of CAM practitioners. The purpose of this study was to examine how personality, as assessed by the five-factor model, was related to the breadth, frequency, and types of provider-based CAM use. Relationships between the personality factors (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and motives for consulting CAM providers were also explored.A convenience sample of 184 current CAM clients recruited through the offices of 12 conventional medicine and 17 CAM practitioners completed a survey package including measures of health status, CAM use, personality, and motivations for using CAM.Only Openness and Agreeableness were consistently linked to different dimensions of CAM use, with each associated with consultations with CAM practitioners, and homeopaths and naturopaths in particular. After controlling for sociodemographic and health status variables in the stepwise multiple regressions, Openness was associated with the variety of CAM providers tried, whereas Agreeableness was linked to both the breadth and frequency of CAM consultations. Holistic and proactive health motivations were associated with both personality factors, and Agreeableness was also associated with motives reflecting a desire for shared decision-making.Findings indicate that individuals who are open and agreeable, as described by the five-factor model of personality, consult CAM practitioners to a greater extent. The motives involved suggest a congruency between CAM and their own perspectives regarding health and patient-provider interactions, which may have implications for understanding treatment adherence and outcomes.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) Background: Research on continued CAM use has been largely atheoretical and has not considered the broader range of psychological and behavioral factors that may be involved. The purpose of this study was to test a new conceptual model of commitment to CAM use that implicates utilitarian (trust in CAM) and symbolic (perceived fit with CAM) in psychological and behavioral dimensions of CAM commitment. Methods: A student sample of CAM consumers, (N = 159) completed a survey about their CAM use, CAM-related values, intentions for future CAM use, CAM word-of-mouth behavior, and perceptions of being an ongoing CAM consumer. Results: Analysis revealed that the utilitarian, symbolic, and CAM commitment variables were significantly related, with r’s ranging from .54 to .73. A series hierarchical regression analyses controlling for relevant demographic variables found that the utilitarian and symbolic values uniquely accounted for significant and substantial proportion of the variance in each of the three CAM commitment indicators (R2 from .37 to .57). Conclusions: The findings provide preliminary support for the new model that posits that CAM commitment is a multi-dimensional psychological state with behavioral indicators. Further research with large-scale samples and longitudinal designs is warranted to understand the potential value of the new model.

Objective This study tested a self-regulation resource model (SRRM) of self-compassion and health-promoting behavior intentions in emerging adults. The SRRM posits that positive and negative affect in conjunction with health self-efficacy serve as valuable self-regulation resources to promote health behaviors. Methods An online survey was completed by 403 emerging adults recruited from the community and a Canadian University in late 2008. Multiple meditation analyses with bootstrapping controlling for demographics and current health behaviors tested the proposed explanatory role of the self-regulation resource variables (affect and self-efficacy) in linking self-compassion to health behavior intentions. Results Self-compassion was positively associated with intentions to engage in health-promoting behaviors. The multiple mediation model explained 23% of the variance in health behavior intentions, with significant indirect effects through health self-efficacy and low negative affect. Conclusion Interventions aimed at increasing self-compassion in emerging adults may help promote positive health behaviors, perhaps through increasing self-regulation resources., Highlights • A new self-regulation resource model was tested in a sample of emerging adults. • Self-compassion was associated with health-promoting behavior intentions. • Health-self-efficacy and low negative affect explained this association. • Self-regulation resources link self-compassion to health behavior intentions.

In this chapter, we explore how procrastination functions as an emotion-regulation strategy that provides short-term mood repair. We begin by explaining the link between emotion regulation and procrastination, drawing on more general research on self-regulation that demonstrates how regulating moods and feeling states can lead to a failure of self-control. Here we explain how, when faced with aversive tasks, the priority of mood repair results in the task avoidance we label procrastination. Having established the link between emotion regulation and procrastination, we then turn to the rapidly expanding research literature on emotion regulation with a particular emphasis on the conceptual frameworks developed by Gross (2013, 2014) and Koole (2009). We summarize how both process and function perspectives allow us to understand why it is that the present self engages in self-defeating delay at the expense of the future self. Situating procrastination as a form of emotion regulation that provides a short-term hedonic shift helps us to understand the paradoxical conflict between the present self and the future self when we procrastinate. Based on this emotion-regulation perspective, we then discuss avenues for future research with a focus on well-being and health.

In this final chapter of the edited volume, we look back through the chapters to identify the themes that unify the research to date on the consequences of procrastination for health and well-being. We highlight three central themes—failure to regulate behavior, emotion-regulation difficulties, and the temporal aspects of procrastination—and discuss their significance for understanding how and why the unnecessary delay of important intended tasks can take a toll on both physical and psychological health. More importantly, we also take a look ahead to what future research might help address the gaps in the current literature on procrastination, health, and well-being. We discuss four issues related to: (1) the conceptualization of procrastination as a trait, state, or coping strategy; (2) methodological limitations of the existing research; (3) procrastination in relation to other forms of delay; and (4) intervention-based advances that might be fruitful to pursue to further our understanding of this important topic. We make recommendations throughout that might help guide future research.

Emerging research suggests that procrastination may be an important epidemiological factor for understanding the development and management of not only acute but also chronic health issues, due in part to its links with stress and poor health behaviors. In this chapter, I present and review current evidence for the procrastination-health model and then outline a temporal extension of this model that can serve as a guiding conceptual lens from which to better understand how procrastination may create vulnerability for chronic illness. Temporal myopia is presented as a key concept that characterizes procrastination and contributes to a pattern of reacting and behaving that creates vulnerability for both short- and long-term health consequences. I then review evidence suggesting how these characteristic ways of responding can further compromise healthy adjustment and disease management in individuals already living with chronic disease, and the subsequent downstream effects on health and well-being. The chapter concludes with a discussion of potentially fruitful areas of research to better understand and address the long-term health consequences of chronic procrastination.

This chapter introduces a norm-based model to explain procrastination and its impact on health and well-being. It examines procrastination as a failure to engage in self-regulation that leads to the transgression of sociocultural norms. It proposes that procrastination leads to a unique type of transgression that signals to others potential problems with the person’s ability to engage in self-control. As such, the model suggests that procrastination is likely to give rise to shame, an emotion that signals the person is a “bad person” who cannot be trusted to reciprocate favors, with well-documented negative impact on health and well-being. The model offers a novel perspective on procrastination, distinct from the more common dispositional ones and from the focus on guilt as a social emotion important to understanding procrastination. The chapter presents an initial study to support key tenets of this model. It also discusses the implications for understanding procrastination as a collective problem resulting from normally occurring normative processes, as opposed to an individual problem. Finally, the chapter discusses other emotional responses, which may be more functional in terms of procrastination.

This introductory chapter of the first volume on how procrastination relates to health and well-being outlines the ways in which our understanding of the implications of procrastination for health and well-being have evolved over time. After outlining the two different traditions that have been most used by researchers for understanding the nature of well-being, I provide a brief review of the research to date on how procrastination may relate to each of these components of well-being and their dimensions with the aim of demonstrating how these conceptualizations may be useful for organizing, understanding, and addressing gaps in the research on procrastination and well-being. Next we turn to the issue of procrastination and physical health and present a brief overview of how theory and research directed at understanding the implications of procrastination for health has developed over the past decades. A central development of this research is the introduction of the procrastination-health model, which provides a useful conceptual lens from which to view the direct and indirect ways in which procrastination is linked to outcomes related to physical health.

Initial investigations into the links between procrastination and health in student samples implicated stress-related and behavioural pathways. However, it is unknown if these relations are the same for community-dwelling adults, or if alternative measures of procrastination and health behaviors will yield the same results. To replicate and extend previous findings 254 adults recruited from the community and the Internet completed self-report measures of procrastination, health, stress, wellness and household safety behaviours. Consistent with previous work, procrastination was associated with higher stress, more acute health problems, and the practice of fewer wellness behaviours. Procrastinators also reported fewer household safety behaviours, and less frequent dental and medical check-ups. The structural equation modeling analyses revealed that stress fully mediated the procrastination–health relationship, but health behaviours did not when the combined effect with stress was considered. These findings suggest that in addition to hindering a variety of health-related behaviours, procrastination may confer additional risk for increased stress, and consequently more health problems.

The relations between 3 types of perceived control, symptom severity, and 2 adaptational outcomes, depressive symptoms and psychological well-being, were examined in a sample of 319 people with tinnitus. Consistent with previous studies of control and adjustment to chronic health conditions, general health and symptom control were associated with better psychological adjustment, and retrospective control was associated with worse psychological adjustment. Only symptom control emerged as a significant moderator in the symptom severity-adjustment relationship, such that stronger beliefs in one's ability to control symptoms were most strongly associated with better adjustment among those with more severe tinnitus symptoms. These findings were consistent with coping perspectives and cognitive adaptation theory and suggest that symptom-related perceptions of control may be an effective coping resource to nurture in chronic health contexts with severe symptoms.

The present study sought to extend previous research suggesting a relationship between trait procrastination and health behaviors by examining the behavioral intentions of procrastinators. Two cognitive variables (self-efficacy and the consideration of future consequences) were proposed to mediate the procrastination-intentions relationship. Students (n=182) were administered personality and health-related questionnaires and then asked to recall a past illness episode along with health behaviors that may have improved or prevented this experience. Intentions to actually perform one of the listed behaviors in the near future were then rated. A negative relation between trait procrastination and intentions to engage in health behaviors was found. Further, the weak intentions of procrastinators were mediated by a lower health-specific self-efficacy. The consideration of future consequences did not play a role in the procrastination-intentions relationship although it was moderately and negatively related to trait procrastination. These findings were consistent with the role of self-efficacy in intentions as theoretically proposed, and with previous work suggesting that procrastination is associated with low perceived behavioral control. © 2003 Elsevier Ltd. All rights reserved.