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We investigated how covert narcissism influences depression through shame-focused coping strategies, and tested the moderating effect of self-compassion in this mediating link. Participants were 316 Chinese international students living in South Korea who completed a battery of measures, including the Hypersensitive Narcissism Scale, the Compass of Shame Scale, the depression items of the Symptom Checklist-90-Revised, and the Chinese Self-Compassion Scale. We found an association between covert narcissism and depression, and this link was mediated by the shame-focused coping strategies of attack self and withdrawal. Further, self-compassion had a significant moderating effect in the relationship between covert narcissism and the coping strategies of attack self or withdrawal. These findings support a moderated mediation model in which self-compassion buffered the relationship between covert narcissism and depression by mediating the link between covert narcissism and the attack self and withdrawal coping strategies. Our findings may be useful for understanding and helping individuals who have a high level of covert narcissism.

Web-based self-management programs have the potential to support patients with cardiovascular disease (CVD) in their self-management (eg, by focusing on behavior change and improving physical activity). The intervention mapping framework was used to develop a web-based program called Vascular View. The Vascular View program contained 6 modules (coping with CVD, setting boundaries, lifestyle, healthy nutrition, being physically active, interaction with health professionals) aiming to increase self-management behavior by tailoring to the perceived problems and (support) needs of patients after CVD. The aim was to test the effectiveness of Vascular View before embarking on a full-scale randomized clinical trial (RCT) by evaluating the potential effectiveness and effect sizes of the Vascular View program and identifying outcome measures most likely to capture the potential benefits. An explorative RCT was performed. Both control and intervention groups received care as usual and, in addition, the intervention group received 12 months of access to a web-based self-management program. Assessment occurred at baseline, 6 months, and 12 months. Outcome measures included general patient-reported outcome measurements: Illness Perception Questionnaire (IPQ), Rand-36, Patient Activation Measure, and patient self-efficacy. Module-specific patient-reported outcome measurements were Beliefs about Medicines Questionnaire, International Physical Activity Questionnaire, Dutch Healthy Diet Index, Fagerström Test for Nicotine Dependence (FTND), Alcohol Use Disorders Identification Test, and Perceived Efficacy in Patient-Physician Interaction. Linear mixed models for repeated measures using intention-to-treat and per-protocol analysis were applied to study differences between the patients in the intervention and control groups. Floor and ceiling effects were explored to give insight into the outcome measures most likely to capture the potential benefits. A total of 105 patients in the control group and 103 patients in the intervention group participated in the study. A positive direction of change between baseline and 12 months was shown for most outcome measurements in favor of the intervention group, of which 2 out of 10 outcomes showed a significant effect: attribution of cause of the disease to risk factors and immunity factors (IPQ) and dependency of nicotine (FTND). Floor and ceiling effects were seen in the IPQ, Rand-36, and the self-efficacy questionnaire. No conclusion for the efficacy of the Vascular View program or selection of outcome measurements can be taken yet. A process evaluation will be conducted to gain thorough insight into the working elements of the program, patient needs in eHealth, and the use of the program by patients. This can determine for whom web-based self-management programs will work and help to adapt the program. Dutch Trial Register NTR5412; https://www.trialregister.nl/trial/5303. RR2-10.2196/resprot.6352.

Background Health coaching to address the escalated cardiometabolic risk in middle-aged adults in primary health care is underexplored. This study aimed to examine the feasibility and acceptability of a protection motivation theory-guided telehealth coaching program among middle-aged adults with cardiometabolic risks. Methods This was a pretest–posttest study. The three-month intervention included four nurse-facilitated telehealth sessions tailored to individual cardiometabolic risks. Results Thirty participants were recruited through social media and a community center. The eligibility and enrollment rates were 16.1% and 78.9%, respectively. Attrition at six months after enrollment was 33.3%, and intervention attendance was 82.5%. Most of the participants (76.7%) were satisfied with the program. Significant improvements were noted in the INTERHEART score for cardiometabolic risks, self-efficacy, anxiety, stress, and central obesity but not in health-promoting behaviors, depression, sleep quality, physical activity level, and physiological outcomes at six-month post-enrolment. Conclusion A theory-based telehealth coaching was feasible and well-accepted among middle-aged adults, with potential in reducing cardiometabolic risks among middle-aged adults in primary care. This study revealed significant improvement in cardiometabolic risk, self-efficacy, anxiety, stress, and central obesity but changes for health-promoting behaviors, depression, sleep quality, physical activity level, and physiological outcomes were not noted. Progression to a definitive trial was supported with implication for future trials, including lowering the threshold of cardiometabolic risk to improve subject recruitment, change of assessment sessions to promote adherence to fasting instruction, and use of digital recording to facilitate health coaching process. Trial registration : This trial was retrospectively registered on 05/07/2022 at ClinicalTrials.gov (identifier: NCT05444140).

Background Diabetic patients’ lifestyle adaptations to improve glycaemic control are not always followed by improvements in self-rated general health (SRH). The perceived impact of diabetes on patients’ daily lives may influence changes in their SRH. This paper examines the association of illness severity, treatment, behavioural, and coping-related factors with changes in SRH from diagnosis of type 2 diabetes until one year later, in a population-based sample of 599 patients aged 40 years or over who were treated in general practice. Methods Change in SRH was estimated by a cumulative probit model with the inclusion of covariates related to SRH (e.g. illness severity at diagnosis, behaviour, treatment, and the perceived impact of diabetes on patients’ daily lives one year later). Results At diagnosis, 11.6% of patients reported very good, 35.1% good, 44.6% fair and 8.5% poor SRH. Physical inactivity, many diabetes-related symptoms, and cardiovascular disease were related to lower SRH ratings. On average SRH improved by 0.46 (95% CI: 0.37; 0.55) during the first year after diagnosis without inclusion of covariates. Mental and practical illness burden was the only factor associated with change in SRH, independent of patients’ diabetes severity and medical treatment (p = 0.03, multivariate analysis). Compared to otherwise similar patients without illness burden, increase in SRH was marginally smaller among patients who expressed minor illness burden, but much smaller among patients with more pronounced illness burden. Conclusions Much as one would expect, many patients increased their SRH during the first year after diabetes diagnosis. This increase in SRH was not associated with indicators of illness severity or factors reflecting socio-demographic circumstances, but patients experiencing illness burden had a smaller increase than those who reported no illness burden. We suggest that during the diabetes consultation, general practitioners explore further how patients manage their illness burden. We further suggest that diabetes guidelines extend their current focus on clinical and social aspects of diabetes to include questions on patient’s perceived illness burden and SRH.

This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular, the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects. Results from a sample of 131 undergraduate students showed that, as a composite, life-management strategies fully mediated the relationship between planning and goal progress. More specifically, decomposing the effects demonstrated that only elective selection and compensation mediated the association between planning and greater progress on a personal physical activity goal. Results are discussed in light of their practical implications and contributions to the personal goal literature.

Objectives. This study aimed to explore the coping styles that agoraphobia sufferers adopt when attempting to cope with symptoms of anxiety and panic. It aimed to extend Watts's (1989) Coping with Anxiety Questionnaire (CAQ) by including items to assess self‐vigilance. It was hypothesized that agoraphobia sufferers would adopt consistent coping styles that would be related to symptom severity. Design. A factor analysis was performed on questionnaire data. Method. A postal questionnaire was completed by members (N=112) of a self‐help group for agoraphobia and panic sufferers. All participants completed the Beck Anxiety Inventory, an Agoraphobia Severity Scale and a slightly modified version of the CAQ. Coping styles were identified via factor analysis of the CAQ items. Results. Three coping styles were identified, which were labelled Effective Coping, Avoidant Coping and Self‐vigilance. The latter two coping styles were found to be correlated with increased levels of agoraphobic symptomatology and with higher levels of anxiety. Conclusions. The present results support the previous research on coping tactics in anxiety and are compatible with cognitive therapy accounts of the role of self‐vigilance in anxiety disorders.