Publications by authors named "Jenny J W Liu"

10 Publications

  • Page 1 of 1

Exploring the Well-being of Health Care Workers During the COVID-19 Pandemic: Protocol for a Prospective Longitudinal Study.

JMIR Res Protoc 2021 Sep 27;10(9):e32663. Epub 2021 Sep 27.

MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, St. Joseph's Health Care London, London, ON, Canada.

Background: Health care workers (HCWs) have experienced several stressors associated with the COVID-19 pandemic. Structural stressors, including extended work hours, redeployment, and changes in organizational mandates, often intersect with interpersonal and personal stressors, such as caring for those with COVID-19 infections; worrying about infection of self, family, and loved ones; working despite shortages of personal protective equipment; and encountering various difficult moral-ethical dilemmas.

Objective: The paper describes the protocol for a longitudinal study seeking to capture the unique experiences, challenges, and changes faced by HCWs during the COVID-19 pandemic. The study seeks to explore the impact of COVID-19 on the mental well-being of HCWs with a particular focus on moral distress, perceptions of and satisfaction with delivery of care, and how changes in work structure are tolerated among HCWs providing clinical services.

Methods: A prospective longitudinal design is employed to assess HCWs' experiences across domains of mental health (depression, anxiety, posttraumatic stress, and well-being), moral distress and moral reasoning, work-related changes and telehealth, organizational responses to COVID-19 concerns, and experiences with COVID-19 infections to self and to others. We recruited HCWs from across Canada through convenience snowball sampling to participate in either a short-form or long-form web-based survey at baseline. Respondents to the baseline survey are invited to complete a follow-up survey every 3 months, for a total of 18 months.

Results: A total of 1926 participants completed baseline surveys between June 26 and December 31, 2020, and 1859 participants provided their emails to contact them to participate in follow-up surveys. As of July 2021, data collection is ongoing, with participants nearing the 6- or 9-month follow-up periods depending on their initial time of self-enrollment.

Conclusions: This protocol describes a study that will provide unique insights into the immediate and longitudinal impact of the COVID-19 pandemic on the dimensions of mental health, moral distress, health care delivery, and workplace environment of HCWs. The feasibility and acceptability of implementing a short-form and long-form survey on participant engagement and data retention will also be discussed.

International Registered Report Identifier (irrid): DERR1-10.2196/32663.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/32663DOI Listing
September 2021

Examining Different Strategies for Stigma Reduction and Mental Health Promotion in Asian Men in Toronto.

Community Ment Health J 2021 05 19;57(4):655-666. Epub 2020 Oct 19.

Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada.

Mental illness stigma has detrimental effects on health and wellbeing. Approaches to address stigma in racialized populations in Western nations need to emphasize inclusivity, social justice, and sociocultural intersectionality of determinants of health. The current paper evaluates three intervention approaches to reduce stigma of mental illness among Asian men in Toronto, Canada. Participants received one of four group interventions: psychoeducation, Acceptance and Commitment Therapy (ACT), Contact-based Empowerment Education (CEE), and a combination of ACT+CEE. Self-report measures on stigma (CAMI, ISMI) and social change (SJS) were administered before and after the intervention. A total of 535 Asian men completed the interventions. Overall analyses found that all intervention approaches were successful in reducing stigma and promoting social change. Subscale differences suggest that CEE may be more broadly effective in reducing mental illness stigmatizing attitudes while ACT may be more specifically effective in reducing internalized stigma. More work needs to be done to elucidate mechanisms that contribute to socioculturally-informed mental illness stigma interventions for racialized communities and traditionally marginalized populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10597-020-00723-3DOI Listing
May 2021

Comprehensive meta-analysis of resilience interventions.

Clin Psychol Rev 2020 12 12;82:101919. Epub 2020 Sep 12.

Department of Psychology, Ryerson University, Toronto, Canada. Electronic address:

Background/rationale: There is no current consensus on operational definitions of resilience. Instead, researchers often debate the optimal approach to understanding resilience, while continuing to explore ways to enhance and/or promote its qualities in various populations. The goal of the current meta-analysis is to substantiate existing evidence examining the promotion of resilience through various interventions. Particular emphasis was placed upon the factors that contribute to variability across interventions, such as age, gender, duration of intervention, intervention approaches and risk exposure of targeted population.

Method: The literature search was conducted on May 28, 2019. Search terms included "resilience intervention" OR "promoting resilience" OR "promoting resiliency" OR "resilience-based intervention". A total of 268 studies, with 1584 independent samples, were included in the meta-analysis. In addition to overall efficacy, outcome-based analyses were conducted for intervention outcomes based on action, biophysical, coping, emotion, resilience, symptoms, and well-being. Finally, moderators of age, gender, length of intervention, intervention approach, intervention target, and the level of risk exposure of the sampled population were examined as moderators.

Results: The multi-level meta-analysis indicated that resilience-promoting interventions yielded a small, but statistically significant overall effect, Hedges's g = 0.48 (SE = 0.04, 95% CI = [0.40, 0.56]. The variability in study effect sizes within and between studies was significant, p < .001, with many falling short of the threshold for practical significance.

Discussion: Findings lend some support for the overall efficacy of resilience interventions. However, empirical results should be cautiously interpreted in tandem with their theoretical relevance and potential advancements to the construct of resilience. Variabilities across findings reflect the current ambiguities surrounding the conceptualization and operationalization of resilience. Directions for future research on resilience as well as practical considerations are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cpr.2020.101919DOI Listing
December 2020

Advancements to the Multi-System Model of Resilience: updates from empirical evidence.

Heliyon 2020 Sep 14;6(9):e04831. Epub 2020 Sep 14.

Department of Psychiatry, Centre for Mental Health, University Health Network, Canada.

In this paper, we discuss further advancements to the Multi-System Model of Resilience through examining empirical factor structures of the Multi-System Model of Resilience Inventory along with other measures of resilience. Evidence from multiple sampled populations provided support for the three-systems organization of the model and highlight its similarities and differences in relation to other measures of resilience. The MSMR conceptualizes resilience as a capacity that enables functioning across a continuum from vulnerability to resilience, whereby internal and external resources interface with dynamic coping processes in response to varying needs and goals. Meaningful applications of this model and future steps in model and measurement developments are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.heliyon.2020.e04831DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492804PMC
September 2020

The importance of bereavement cognitions on grief symptoms: Applications of cognitive processing therapy.

Death Stud 2021 7;45(7):552-562. Epub 2019 Oct 7.

Department of Psychology, Ryerson University, Toronto, Canada.

The experience of bereavement and trauma share some overlapping features, such as changes in the cognitive processing of information. This article explored the extent to which cognitive processes during bereavement influence coping outcomes in relation to grief in a sample of university students who had been previously bereaved ( = 104). First, we examined differences in bereavement outcomes based on whether cognitive processes associated with the bereavement were accommodated ( = 55), over-accommodated ( = 25), or assimilated ( = 24). Results indicate that grief-related outcomes significantly differed as a result of cognitive processes. We then compared the degree to which these cognitive processes accounted for grief outcomes in individuals with high and low grief symptoms. In individuals with low grief levels, both depressive symptoms and grief cognitions significantly accounted for grief levels. However, in individuals with high grief levels, only cognitive processes significantly accounted for levels of grief. Results from this study underscore the importance of examining cognitive processes during bereavement. Future research should further examine the underlying mechanisms that contextualize both the bereavement and cognitive processes surrounding the loss. Finally, results from this study highlight the associated cognitive processing of information as a potential topic for targeted treatment in bereavement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/07481187.2019.1671537DOI Listing
October 2019

Exploring mental illness stigma among Asian men mobilized to become Community Mental Health Ambassadors in Toronto Canada.

Ethn Health 2019 Jul 24:1-19. Epub 2019 Jul 24.

c Daphne Cockwell School of Nursing, Ryerson University , Toronto , ON , Canada.

Background: Stigma of mental illness contributes to silence, denial and delayed help seeking. Existing stigma reduction strategies seldom consider gender and cultural contexts.

Purpose: The Strengths in Unity study was a multi-site Canadian study that engaged Asian men in three stigma reduction interventions (ACT, CEE, psychoeducation) and mobilized them as Community Mental Health Ambassadors. Our participants included both men living with or affected by mental illness (LWA) as well as community leaders (CL). This paper will: (1) describe the baseline characteristics of the Toronto participants including their sociodemographic information, mental illness stigma (CAMI and ISMI), attitudes towards social change (SJS), and intervention-related process variables (AAQ-II, VLQ, FMI, Empowerment); (2) compare the differences among these variables between LWA and CL; and (3) explore factors that may correlate with socio-economic status and mental health stigma.

Results: A total of 609 Asian men were recruited in Toronto, Canada. Both CL and LWA had similar scores on measures of external and internalized stigma and social change attitudes, except that LWA had more positive views about the acceptance and integration of those with mental illness into the community on the CAMI, while CL had a higher level of perceived behavioral control on the SJS. Group differences were also observed between LWA and CL in some process-related variables. Exploratory analysis suggests that younger and more educated participants had lower stigma.

Conclusion: Our findings underscore the importance of engaging both community leaders and people with lived experience as mental health advocates to address stigma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13557858.2019.1640350DOI Listing
July 2019

The efficacy of stress reappraisal interventions on stress responsivity: A meta-analysis and systematic review of existing evidence.

PLoS One 2019 27;14(2):e0212854. Epub 2019 Feb 27.

Department of Psychology, Ryerson University, Toronto, Ontario, Canada.

Background: The beliefs we hold about stress play an important role in coping with stressors. Various theoretical frameworks of stress point to the efficacy of reframing stress-related information through brief reappraisal interventions in order to promote adaptive coping.

Purpose: The goal of the current meta-analysis and systematic review is to substantiate the efficacy of reappraisal interventions on stress responsivity compared to control conditions. Differences in experimental methodologies (e.g., type of stressor used, timing of reappraisal intervention, and content of intervention instructions) will be examined to further delineate their effects on intervention outcomes.

Methods: The literature searches were conducted on May 16, 2018 using PsycINFO, ProQuest Dissertations and Theses, and PILOTS databases with no date restriction. The search terms included stress, reframing, reappraisal, mindset and reconceptualising. A total of 14 articles with 36 independent samples were included in the meta-analysis, while 22 articles with 46 independent samples were included in the systematic review. Random-effects model was used to test the null hypothesis using two-tailed significance testing. Fisher's Z value was reported for each corresponding test. Heterogeneity tests are reported via Cochran's Q-statistics.

Results: Findings from both the meta-analysis and systematic review revealed that overall, reappraisal interventions are effective in attenuating subjective responsivity to stress. Standard differences in means across groups are 0.429 (SE = 0.185, 95% CI = 0.067 to 0.791; z = 2.320, p = .020). However, reappraisal intervention groups did not outperform control groups on measures of physiological stress, with standard differences of -0.084 (SE = 0.135, 95% CI = -0.349 to 0.180; z = -0.627, p = .531). Moderator analysis revealed heterogeneous effects suggesting large variability in findings.

Conclusions: On one hand, findings may suggest a promising avenue for the effective management of self-reported stress and optimization of stress responses. However, more research is needed to better elucidate the effects, if any, of reappraisal interventions on stress physiology. Implications for the use of reappraisal interventions on stress optimization are discussed in the context of theoretical frameworks and considerations for future studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212854PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392321PMC
December 2019

Subjective and physiological responses to the 35% carbon dioxide challenge in healthy and non-clinical control populations: a meta-analysis and systematic review.

Anxiety Stress Coping 2019 03;32(2):216-230

a Department of Psychology , Ryerson University , Toronto , Canada.

Background/rationale: The carbon dioxide (CO) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations.

Method: A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review.

Results: Both the meta-analysis and systematic review found the CO challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling.

Discussion: Findings highlight the CO challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO challenge and its anticipated effects in healthy and non-clinical control populations are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10615806.2019.1570803DOI Listing
March 2019

Sex differences in salivary cortisol reactivity to the Trier Social Stress Test (TSST): A meta-analysis.

Psychoneuroendocrinology 2017 Aug 24;82:26-37. Epub 2017 Apr 24.

Department of Psychology, Ryerson University, Toronto, Ontario, Canada; Institute for Stress and Wellbeing Research, Ryerson University, Toronto, Ontario, Canada. Electronic address:

Some, but not all studies using the Trier Social Stress Test (TSST) have demonstrated evidence in support of sex differences in salivary cortisol. The aim of the current meta-analysis is to examine sex differences in salivary cortisol following exposure to the TSST. We further explored the effects of modifications to the TSST protocol and procedural variations as potential moderators. We searched articles published from January, 1993 to February, 2016 in MedLine, PsychINFO, and ProQuest Theses and Dissertations. This meta-analysis is based on 34 studies, with a total sample size of 1350 individuals (640 women and 710 men). Using a random effects model, we found significant heterogeneity in salivary cortisol output across sexes, such that men were observed to have higher cortisol values at peak and recovery following the TSST compared to women. Modifications to the sampling trajectory of cortisol (i.e., duration of acclimation, peak sampling time, and duration of recovery) significantly moderated the heterogeneity across both sexes. Further, there are observed sex differences at various time points of the reactive cortisol following the TSST. Lastly, current results suggest that these sex differences can be, at least in part, attributed to variations in methodological considerations across studies. Future research could advance this line of inquiry by using other methods of analyses (e.g., area under the curve; AUC), in order to better understand the effects of methodological variations and their implications for research design.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psyneuen.2017.04.007DOI Listing
August 2017

Re-conceptualizing stress: Shifting views on the consequences of stress and its effects on stress reactivity.

PLoS One 2017 8;12(3):e0173188. Epub 2017 Mar 8.

Department of Psychology, Ryerson University, Toronto, Ontario, Canada.

Background: The consequences of stress are typically regarded from a deficit-oriented approach, conceptualizing stress to be entirely negative in its outcomes. This approach is unbalanced, and may further hinder individuals from engaging in adaptive coping. In the current study, we explored whether negative views and beliefs regarding stress interacted with a stress framing manipulation (positive, neutral and negative) on measures of stress reactivity for both psychosocial and physiological stressors.

Method: Ninety participants were randomized into one of three framing conditions that conceptualized the experience of stress in balanced, unbalanced-negative or unbalanced-positive ways. After watching a video on stress, participants underwent a psychosocial (Trier Social Stress Test), or a physiological (CO2 challenge) method of stress-induction. Subjective and objective markers of stress were assessed.

Results: Most of the sampled population regarded stress as negative prior to framing. Further, subjective and objective reactivity were greater to the TSST compared to the CO2 challenge. Additionally, significant cubic trends were observed in the interactions of stress framing and stress-induction methodologies on heart rate and blood pressure. Balanced framing conditions in the TSST group had a significantly larger decrease in heart rate and diastolic blood pressure following stress compared to the positive and negative framing conditions.

Conclusion: Findings confirmed a deficit-orientation of stress within the sampled population. In addition, results highlighted the relative efficacy of the TSST compared to CO2 as a method of stress provocation. Finally, individuals in framing conditions that posited stress outcomes in unbalanced manners responded to stressors less efficiently. This suggests that unbalanced framing of stress may have set forth unrealistic expectations regarding stress that later hindered individuals from adaptive responses to stress. Potential benefits of alternative conceptualizations of stress on stress reactivity are discussed, and suggestions for future research are made.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173188PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342217PMC
September 2017
-->