Thursday, May 14, 2020

COVID-19 social distancing and sexual activity in a sample of the British Public

COVID-19 social distancing and sexual activity in a sample of the British Public. Louis Jacob et al. The Journal of Sexual Medicine, May 14 2020. https://doi.org/10.1016/j.jsxm.2020.05.001

ABSTRACT
Background: On 23rd March 2020 the UK government released self-isolation guidance to reduce the risk of transmission of SARS-Cov-2. The influence such guidance has on sexual activity is not known.

Aim: To investigate levels and correlates of sexual activity during COVID-19 self-isolation in a sample of the UK public.

Methods: This paper presents pre-planned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey.

Outcomes: Sexual activity was measured using the following question: “On average after self-isolating how many times have you engaged in sexual activity weekly?” Demographic and clinical data was collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model.

Results: 868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing.

Clinical Implications: In this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption.

Strength and Limitations: This is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic.

Conclusion: Interventions to promote health and wellbeing during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation and should target those with the lowest levels of sexual activity.

Key words: Sexual activityCOVID-19SARS-Cov-2Self-isolationUK


Discussion

In the present study in a sample of 868 individuals residing in the UK during COVID-19 self-isolation/social distancing 39.9% of the sample reported engaging in sexual activity at least once per week. Being male, a younger age, married, consuming alcohol, and a higher number of days in self-isolation/social distancing were all associated with greater sexual activity in comparison to their counter parts.
Findings from the present study for the first-time sheds light on sexual activity during COVID-19 self-isolation/social distancing among the UK public. Importantly, 60.1% of the sample studied reported to not be sexually active during self-isolation/social distancing. The promotion of consensual sexual activity among the UK adult population during self-isolation/social distancing may mitigate some of the detrimental consequences that self-isolation/social distancing may impose, particularly in relation to mental health. However, in order to do this correlates of sexual activity during self-isolation/social distancing need to be identified. The present study sheds light on this.
Indeed, the present study found that being male, a younger age, married, and consuming alcohol were all associated with greater sexual activity in comparison to their counter parts during COVID-19 self-isolation/social distancing. These findings correspond to the existing literature during non-pandemic times. [11,[19][20][21]] These findings suggest that interventions to promote good mental and physical health during the COVID-19 self-isolation/social distancing period should take into account positive sexual health as part of any messaging. Interventions might particularly focus on females, older adults, those not married, and those who abstain from alcohol consumption. A detailed discussion on potential strategies is beyond the scope of this paper. However, would likely include the promotion of respected websites such as [22], as well as platforms to provide advice and support in relation to sexual activity among older adult populations.
Interestingly, the present paper also found that number of days in self-isolation/social distancing was also associated with sexual activity. This may be explained by the simple fact that each day of self-isolation/social distancing would increase ones chances of engaging in sexual activity if they are sexually active or potentially sexual activity is being used for a means to ease stress and anxiety or overcome boredom which is likely to increase with increasing days of isolation. Moreover, in modern times people lead busy lives and may have little discretionary time to spend with their intimate partner. COVID-19 self-isolation may have disrupted daily activities that take time from one’s day, such as commuting to work, this time may be being spent with one’s partner allowing them to reconnect with increasing days of isolation and consequently engage in sexual activity. However, there is no literature to support these hypothesizes and future work of a qualitative nature is required.
This is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. However, the study findings must be interpreted in light of its limitations. First, participants were asked to self-report their sexual activity and thus potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic.
In conclusion, in this sample of 868 UK adults self-isolating/social distancing owing to the COVID-19 pandemic those at particular risk of lower levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption. Interventions to promote sexual activity during the COVID-19 pandemic may mitigate some of the detrimental health consequences in relation to self-isolation and should target those with the lowest levels of sexual activity.

Toward a Multidimensional Perspective on Wisdom and Health—An Analogy With Depression Intervention and Neurobiological Research

Toward a Multidimensional Perspective on Wisdom and Health—An Analogy With Depression Intervention and Neurobiological Research. Charles F. Reynolds III, Dan G. Blazer. JAMA Psychiatry, May 13, 2020. doi:10.1001/jamapsychiatry.2020.0642

The article by Lee and colleagues1 in this issue of JAMA Psychiatry explores 3 domains or components of wisdom: prosocial relations, emotional regulation, and spirituality. The authors’ basic hypothesis is that interventions may enhance these domains of wisdom (although they found no eligible studies that addressed wisdom as an inclusive or unitary construct). Interventions ranged widely, from mindfulness to emotional intelligence training. The literature contains many approaches to measuring wisdom as reviewed by the authors.1 One helpful distinction is between theoretical wisdom (understanding the deep nature of reality and humans’ place in it) and practical wisdom (also known as phronesis: making good decisions or doing the right thing, at the right time, for the right reasons), as delineated by Jeste and colleagues in a previous article.2 Both can be measured, yet practical wisdom is perhaps more easily captured via a questionnaire than theoretical wisdom. In the current study, the authors1 combine domains characterized as practical (prosocial behavior and emotional regulation) and theoretical (spirituality). They do not include other domains, such as decisiveness and the tolerance of and ability to deal with uncertainty, because of a dearth of intervention studies in these domains.3 Therefore, the reader should focus on the 3 domains examined as components of a much larger and more complex construct of wisdom, a construct that may be beyond the boundaries of empirical exploration or at least pose considerable challenges thereto.

Regardless, the 3 components measured have been studied frequently in the extant literature, and scales have been developed that provide a foundation for intervention trials. In other words, the data from these intervention trials are fair game for this meta-analysis. However, the serious reader must take advantage of the Supplement to gain a clear understanding of the range of studies included, the scales for measuring outcome, and the approaches to intervention.1 In this spirit, we offer the following perspective and address the importance of defining wisdom as a unitary construct.

In their meta-analysis of 57 published studies, the authors1 found that interventions can enhance prosocial behaviors, emotional regulation, and spirituality. Effect sizes did not vary by component, but for prosocial behaviors and spirituality, larger effect sizes were associated with older mean ages of participants. Estimates of benefits for prosocial behavior and spirituality survived correction for publication bias, but emotional regulation did not. Forty-seven percent of studies reported a significant improvement in one component or another, while the remaining studies did not. Only 40% of studies included an active control group, while many used a waiting list or another inactive control group. The authors suggest that the modern behavioral epidemics of social isolation, loneliness, suicide, and opioid abuse point to a growing need for wisdom-enhancing interventions that promote individual and societal well-being—a behavioral vaccine, as it were.

Part of the heuristic value of the study1 is that it raises important questions. Some pertain to the construct and predictive validity of the wisdom domains analyzed, others to concurrent validity, and still others to scalability and population outcomes. Regarding construct and predictive validity, the authors acknowledge a need to assess well-being and other health-associated measures by objective means (in addition to but not in place of self-reports), such as reports by close associates and hence to determine if enhancements in components of wisdom generalize to everyday life, over longer follow-up periods, to promote individual and population well-being. With respect to concurrent validity, neurobiological assessments with appropriate comparator conditions could examine if there is specific neurocircuitry activation for specific components of wisdom. Using interventional platforms, one could investigate whether there are brain-based mechanisms that mediate improvement in wisdom and/or in its specific components. If so, one could further investigate whether targeted neurostimulation techniques selectively activate neurocircuits associated with components of wisdom, facilitating adaptation as a result of specific, learning-based interventions. This approach bears analogy to emerging research testing the ability of behavioral and neurocognitive interventions to activate specific neurocircuits that in turn relieve depressive symptoms.4 Ultimately, one would like to know if interventions can be simplified, sustained, and scaled up—by analogy with depression, for example, through the use of lay counselors or digital platforms. As with depression, it may be that different interventions better fit the needs and values of individuals depending on sociodemographic, developmental, cultural, and clinical characteristics.

Now to revisit the basic question as to whether wisdom is a unitary construct with multiple components or dimensions: Lee and colleagues1 believe this to be the case and analogize wisdom to a syndrome, that is, a condition characterized by several medical signs and symptoms that more or less consistently occur together and are associated with a common entity (ie, a latent construct). The authors’ San Diego Wisdom Scale (SD-WISE) scale measures individual components, such as prosocial behaviors (empathy and compassion), emotional regulation, and self-reflection.3 In different samples, they have found that subscales of SD-WISE measuring these components correlate with the total composite SD-WISE score, and the total score correlates in cross-sectional studies with measures of overall well-being.1 In their search for the neurobiological correlates of individual components of wisdom (or their opposite, such as with antisocial personality or impulsivity, as in the case of Phineas Gage, or in cases of frontotemporal dementia), the authors have found evidence implicating prefrontal cortex and limbic striatum.5 This is certainly plausible, if relatively nonspecific.

The study1 thus prompts us to ask also which components of wisdom are most important for health and well-being. It is plausible that a combination of wisdom components is more likely to be associated with measures of health and well-being than any individual component. Which specific components should be considered in mechanistic studies to optimize the development of interventions? Our view is that adopting a multidimensional approach to ascertain associations between wisdom and health or well-being may provide greater, more nuanced information about risk for health than the considerations of individual components alone. We suggest another analogy with depression intervention research, where a combination of interventions is often needed to achieve and sustain optimal outcomes.6 Again, it may be that, as with depression treatment or prevention, one size does not fit all. Different interventions or combinations of interventions may better fit the needs of a person depending on sociodemographic, cultural, developmental, and clinical characteristics. By this logic, no single construct (such as prosocial behavior) should automatically be conflated with wisdom as a whole. Higher levels of spirituality, for example, may rate lower in interventions to promote practical wisdom. To be effective against the current epidemics of loneliness, social isolation, opiate addiction, and suicide, a multicomponent, so-called behavioral vaccine, as well as changes in the health care delivery system (to be more collaborative and integrated) may been needed.7

We concur with the authors1 that wisdom is a complex human characteristic with a number of specific components, such as those they have delineated using Delphi methods, resulting in a mixture of pragmatic and theoretical components. More than 1 component may be needed to optimize health effects and elucidate mechanisms of action and underlying neurobiology.

As the authors1 in their wisdom readily acknowledge, the science of wisdom is still at an early stage. Like them, we anticipate that more precise answers will emerge as empirical research, grounded in theory, deepens and widens.


How do people behave when disasters strike? Popular media accounts depict panic and cruelty, but in fact, individuals often cooperate with and care for one another during crises

Catastrophe Compassion: Understanding and Extending Prosociality Under Crisis. Jamil Zaki. Trends in Cognitive Sciences, May 14 2020. https://doi.org/10.1016/j.tics.2020.05.006

ABSTRACT: How do people behave when disasters strike? Popular media accounts depict panic and cruelty, but in fact, individuals often cooperate with and care for one another during crises. I summarize evidence for such “catastrophe compassion,” discuss its roots, and consider how it might be cultivated in more mundane times.


Roots of Catastrophe Compassion

Psychologists have pinpointed a number of mechanisms that might underlie catastrophe compassion. One pertains to the powerful nature of social identity. Each of us identifies with multiple groups, for instance based on our generation, ideology, and profession , and commonly expresses loyalty, care, and prosociality towards members of our own groups .

Social identity is also malleable. You might be an Ohioan and a tuba player, but those identities will vary in salience depending on whether you’re at band practice or a Buckeyes game. Even new identities created in a lab can take on importance, and shift one’s tendency to act prosocially towards people in novel groups. Identities also tend to matter most when they contain certain characteristics, including shared goals and shared outcome s .

When disasters strike, victims might suddenly be linked in the most important de novo groups to which they’ve ever belonged. Strangers on a bus that is bombed might experience a visceral, existential sense of shared fate, and might thus quickly not be strangers any longer—but rather collaborators in a fight for their lives. As described by Drury [8], an elevated sense of shared identity is indeed common to disaster survivors, and a potent source of cooperative behavior .

A second source of catastrophe compassion is emotional connection. Empathy—sharing, understanding, and caring for others’ emotional experiences —predicts prosocial behavior across a range of settings. Consistent with this connection, a recent study found that individuals’ empathy for those affected by the COVID -19 pandemic tracked their willingness to engage in physical distancing and related protective behaviors, and that inducing empathy for vulnerable people increased intention to socially distance [9].

Emotional connection can also comprise mutual sharing of affect across people. After disclosing emotional experiences with each other, individuals tend to feel more strongly affiliated to one another. Such disclosures are also a powerful way to recruit supportive behavior in during difficult times and thus buffer individuals against stress [10]. However, individuals often avoid disclosing negative experiences —for instance because they imagine others will judge or stigmatize them—and thus miss out on the benefits of affect sharing [11].

Disasters thrust people into a situation where their suffering is obviously shared with others. This could in turn lower psychological barriers to disclosure, thus creating opportunities for deeper connection, mutual help, and community. Consistent with this idea, in the wake of the 1989 Loma Prieta earthquake, individuals frequently talked about the disaster and its effects on them for about two weeks [12]. A similar elevation in emotional conversations was found among Spaniards following a 2004 terrorist bombing in Madrid [5]. Researchers further found that that sharing one week after the attacks predicted increases in solidarity, social support, as well as decreases in loneliness, seven weeks later.


Extending Catastrophe Compassion

As Solnit [2] observes, although few people would want a disaster to befall them, many survivors look back on disasters with a surprising amount of nostalgia. Floods, bombings, and earthquakes are horrific, but in their aftermath individuals glimpse levels of community, interdependence, and altruism that are difficult to find during normal times. Then, normal times return, and often so do the boundaries that typically separate people. Might catastrophe compassion outlast catastrophes themselves, and if so, how?

Some suggestive evidence emerges from the study of individuals who endure personal forms of disaster—adverse events such as severe illness, family loss, and victimization by crime. Such adversity often generates increases in prosocial behavior, which Staub and Vollhardt [13] have termed “altruism born of suffering .” Positive effects of adversity appear to extend in time. For instance, individuals’ experience of lifetime adversity reportedly tracks their willingness to help strangers and their ability to avoid “compassion collapse ,” by maintaining empathy even in the face of numerous victims [14].

Gender and Sexual Orientation of First-Year Philosophy Students in the U.S.

Gender and Sexual Orientation of First-Year Philosophy Students in the U.S. Eric Schwitzgebel, Morgan Thompson, and Eric Winsberg. The Splintered Mind Blog, May 13 2020. http://schwitzsplinters.blogspot.com/2020/05/gender-and-sexual-orientation-of-first.html

Among these 373,333 students, 0.36% (1132/315158 students, excluding undecided and unanswered) expressed an intention to major in Philosophy. This compares with Philosophy being either the first or second major of 0.39% of students receiving graduate degrees in the most recent available year (2018) in the NCES IPEDS database.[Note 1]

Two gender identity questions are included in the survey:

* Your sex (male, female)
* Are you transgender? (no, yes)

Although men were more likely than women to express an intention to major in philosophy, the ratio was closer to parity than we see among graduates in philosophy: 43% (485/1132) of intended philosophy majors were women (1%, or 7 total, declined to state), compared to 58% of first-year students overall.

Since the latest data from NCES show that among Bachelor's degree recipients, 36% are women, the HERI data are consistent with the "leaky pipeline" hypothesis about women in philosophy. (The leaky pipeline hypothesis holds that over the course of their education, women are more likely than men to leave philosophy.) We plan a more careful time course analysis of these data in the near future, with a close eye on potential non-response bias in the HERI dataset.[Note 2]

Nine percent (105/1132) of the philosophy majors declined to state whether they were transgender. Among philosophy major respondents, 8/1027 (0.8%) identified as transgender. Among students with other majors, 8% did not respond and 0.4% (1172/288989) identified as transgender. Note, however, that with such small proportions, a disproportionate representation of transgender students among those who decline to state (perhaps because they are not sufficiently "out" to want to reveal their transgender status on a questionnaire of this sort), could dramatically affect the results. Similar considerations apply to transgender students who might falsely state that they are not transgender. Given the small number of self-reported transgender students and these resulting interpretative difficulties, we are hesitant to draw conclusions about the proportion of students who are transgender or about whether philosophy students were more likely than other students to be transgender.

We examined five potential concerns related to COVID-19 infection as prospective predictors of social distacing practices over the next two weeks.

Leary, Angelina, Robert Dvorak, Ardhys De Leon, Roselyn Peterson, and Wendy Troop-Gordon. 2020. “COVID-19 Social Distancing.” PsyArXiv. May 13. osf.io/mszw2

Abstract: The current study had two aims. First, we tested three norm-based interventions to increase social distancing practices. Second, we examined five potential concerns related to COVID-19 infection as prospective predictors of social distancing practices over the next two weeks.