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Preview: Health Psychology - Vol 29, Iss 1

Health Psychology - Vol 36, Iss 8



Health Psychology is a scholarly journal devoted to furthering an understanding of scientific relationships between behavioral principles on the one hand and physical health and illness on the other. The readership has a broad range of backgrounds, intere



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Do multiple health events reduce resilience when compared with single events?

Mon, 20 Mar 2017 04:00:00 GMT

Objective: The impact of multiple major life stressors is hypothesized to reduce the probability of resilience and increase rates of mortality. However, this hypothesis lacks strong empirical support because of the lack of prospective evidence. This study investigated whether experiencing multiple major health events diminishes rates of resilience and increases rates of mortality using a large population-based prospective cohort. Method: There were n = 1,395 individuals sampled from the Health and Retirement Study (HRS) and examined prospectively from 2 years before 4 years after either single or multiple health events (lung disease, heart disease, stroke, or cancer). Distinct depression and resilience trajectories were identified using latent growth mixture modeling (LGMM). These trajectories were compared on rates of mortality 4 years after the health events. Results: Findings indicated that 4 trajectories best fit the data including resilience, emergent postevent depression, chronic pre-to-post depression, and depressed prior followed by improvement. Analyses demonstrate that multiple health events do not decrease rates of resilience but do increase the severity of symptoms among those on the emergent depression trajectory. Emergent depression increased mortality compared with all others but among those in this class, rates were not different in response to single versus multiple health events. Conclusions: Multiple major stressors do not reduce rates of resilience. The emergence of depression after health events does significantly increase risk for mortality regardless of the number of events. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Musculoskeletal complaints, anxiety–depression symptoms, and neuroticism: A study of middle-aged twins.

Mon, 13 Mar 2017 04:00:00 GMT

Background: Musculoskeletal (MS) complaints are reported commonly, but the extent to which such complaints reflect the severity of site-specific pathology or a more generalized susceptibility to feel pain/discomfort is uncertain. Both site-specific and more widespread MS conditions have been shown to be linked to anxiety and depression, but the nature of this relationship is poorly understood. In the present study the role of neuroticism as a shared risk factor that may possibly explain the co-occurrence between anxiety–depression and MS complaints was investigated. Method: The sample consisted of 746 monozygotic and 770 dizygotic twins in the age group of 50–65 years (M = 57.11, SD = 4.5). Using Cholesky modeling, genetic and environmental influences on neuroticism, anxiety–depression and MS symptoms, and the associations among these phenotypes were determined. Results: A single factor accounted for about 50% of the overall variance in MS symptom reporting. The best-fitting biometric model included sex-specific additive genetic and individual-specific environmental effects. All 3 phenotypes were strongly influenced by genetic factors, heritability (h2) = 0.41–0.56. Furthermore, while there was a considerable overlap in genetic risk factors among the 3 phenotypes, a substantial proportion of the genetic risk shared between MS complaints and anxiety–depression was independent of neuroticism. Conclusion: Evidence for a common underlying susceptibility to report MS symptoms, genetically linked to both neuroticism and anxiety–depression symptoms, was found. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Are vital exhaustion and depression independent risk factors for cardiovascular disease morbidity?

Mon, 03 Apr 2017 04:00:00 GMT

Objective: The aim of this study was to examine the concurrent effects of vital exhaustion and depression on the development of cardiovascular disease (CVD) morbidity. Method: The sample of this representative, 4-year longitudinal study comprised 2,725 participants (43.56% male, Mage = 58.39 years, SDage = 14.39 years). Individuals being treated for hypertension (n = 277) and cardio- and/or cerebrovascular incidents (n = 131) for the first time during the follow-up period were compared with participants never treated for CVD (n = 2,317). Joint principal component analysis was conducted on the items of the vital exhaustion (shortened Maastricht Questionnaire) and depression (shortened Beck Depression Inventory) measures simultaneously resulting in 3 components representing depression, vital exhaustion, and sleep difficulties. The role of these 3 components in predicting the incidence of CVD morbidity was examined using logistic regression—controlling for traditional risk factors such as sex, age, education, body mass index, smoking, alcohol use, and physical inactivity. Results: In the multivariate analyses, vital exhaustion (OR = 1.20, CI = 1.03–1.39, p = .021) and sleep-related problem (OR = 1.16, CI = 1.00–1.33, p = .044) scores proved to be independent predictors of treatment initiation for hypertension, while sleep-related difficulties predicted CVD event incidence (OR = 1.27, CI = 1.06–1.52, p = .009). However, depressive symptomatology factor scores were not associated with either cardiovascular outcome in the regression analyses. Conclusions: Vital exhaustion and depressive symptomatology showed a different pattern in their relationship with CVD incidence, with vital exhaustion being the more robust predictor. These results suggest that the 2 constructs are not identical and that vital exhaustion deserves consideration when planning and implementing interventions to reduce CVD risk. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Symptoms of stress and depression effect percentage of body fat and insulin resistance in healthy youth: LOOK longitudinal study.

Thu, 25 May 2017 04:00:00 GMT

Objective: This study examined the longitudinal and cross-sectional effects of both psychosocial stress and depressive symptoms on insulin resistance and percentage body fat in a cohort of healthy Australian children, following them from childhood into adolescence. Method: Participants were 791 healthy, initially Grade 2 children (7–8 years; 394 girls), selected from the general community. Psychosocial stress was assessed using the Children’s Stress Questionnaire, while depressive symptoms were assessed using the Children’s Depression Inventory. Fasting blood samples for serum insulin and plasma glucose were collected to calculate the homeostasis model assessment—insulin resistance (HOMA-IR). Other measurements were height, weight, percentage body fat (dual energy x-ray absorptiometry), physical activity (pedometers), and pubertal maturation (Tanner score). Results: Boys who reported more symptoms of depression had higher insulin resistance, irrespective of adiposity (p = .016); and longitudinally, we found a trend for boys who developed more depressive symptoms to develop higher insulin resistance (p = .073). These findings did not extend to girls. Furthermore, boys and girls with higher depressive symptoms had a higher percentage of body fat (p = .011 and .020, respectively); and longitudinally, boys whose depressive symptoms increased became fatter (p = .046). Conclusion: Our data provide evidence that early symptoms of depression increase insulin resistance, independent of adiposity. Our evidence that early symptoms of depression may lead to overweight, and obesity provides further reason to suggest that early attention to children with depression, even in preclinical stages, may reduce risk of chronic disease in later life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



The Dietary Inflammatory Index, shift work, and depression: Results from NHANES.

Mon, 29 May 2017 04:00:00 GMT

Objectives: Abnormal physiology (e.g., inflammation), brought on by environmental exposures (e.g., diet or shift work [SW]), can affect numerous bodily systems, including the brain, and may be associated with depressive symptomatology. The study examined the associations between SW and depressive symptoms and diet-related inflammation (estimated by the Dietary Inflammatory Index [DII]) and depressive symptoms. Additionally, diet was examined as a mediator between SW and depressive symptoms. Method: Data were obtained from the U.S. National Health and Nutrition Examination Survey (Centers for Disease Control and Prevention, 2013). SW data were based on self-report. Dietary data were collected using 24-hr dietary recalls for DII calculation. Depressive symptoms were defined using a cut-point of 10 (moderate) on the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to estimate odds ratios and 95% confidence intervals (95% CI) for depressive symptoms by SW and DII quartiles. Results: DII scores were associated with depressive symptoms among women. Women in DII quartile 4 were 30% more likely to report depressive symptoms than women in quartile 1 (95% CI [1.00–1.68]). There was no association between symptoms and SW when using a PHQ-9 cut-point of 10. When using a cut-point of 5 (mild depressive symptoms), those working any form of SW were more likely to suffer from mild symptoms than day workers (odds ratio = 1.22; 95% CI [1.04–1.43]). There was some evidence for mediation by the DII between SW and depressive symptoms. Conclusions: Future longitudinal studies should examine effects of reductions in inflammation through diet on depressive symptoms, especially among shift workers, to elucidate the role of diet on depression among these groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Effects of caregiving status and changes in depressive symptoms on development of physical morbidity among long-term cancer caregivers.

Thu, 22 Jun 2017 04:00:00 GMT

Objective: Cancer caregiving burden is known to vary across the survivorship trajectory and has been linked with caregivers’ subsequent health impairment. Little is known, however, regarding how risk factors during long-term survivorship relate to vulnerability to caregivers’ health during that period. This study examined effects of caregiving status and depressive symptoms on development of physical morbidity by 5 years postdiagnosis. Method: Family caregivers (N = 491; Mage = 55.78) completed surveys at 2 (Time 1 [T1]) and 5 years (T2) after their care recipients’ cancer diagnosis. Demographic and caregiving context variables known to affect caregivers’ health were assessed at T1. Self-reported depressive symptoms and a list of physical morbid conditions were assessed at T1 and T2. Caregiving status (former, current, or bereaved) was assessed at T2. Results: Hierarchical negative binomial regression revealed that current caregivers at T2 (p = .02), but not those bereaved by T2 (p = .32), developed more physical morbid conditions between T1 and T2 compared with former caregivers, controlling for other variables. Independently, caregivers reporting either newly emerging or chronically elevated depressive symptoms at T2 (ps < .03), but not those whose symptoms remitted at T2 (p = .61), showed greater development of physical morbidity than did those reporting minimal depressive symptoms at both T1 and T2. Conclusions: Results highlight the roles of long-term caregiving demands and depressive symptoms in cancer caregivers’ premature physical health decline. Clinical attention through the long-term survivorship trajectory should be emphasized for caregivers of patients with recurrent or prolonged illness and to address caregivers’ elevated depressive symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Posttraumatic stress symptom severity and health service utilization in trauma-exposed parents.

Mon, 22 May 2017 04:00:00 GMT

Objective: Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSSs) are common for parents of children with life-threatening illnesses or injuries. The impact of these psychological sequelae on parents’ personal use of health services is unknown. The present study aimed to investigate whether PTSS severity prospectively predicts increased health service utilization (HSU), and to examine the relative importance of other predisposing and enabling factors in predicting HSU. Method: The sample comprised 106 parents of children with various life threatening illnesses, who completed a resource use questionnaire at 19 months following their child’s diagnosis or admission. HSU was assessed as reported general practitioner and psychologist visits. Results: Parent PTSS severity at 7 months following their child’s diagnosis or hospital admission predicted being in higher service utilization categories in the following 12 months; as PTSS score increased, the odds of being in higher categories increased. Hierarchical ordinal logistic regression procedures indicated predisposing and enabling factors failed to further explain HSU. Conclusions: These findings highlight the importance of PTSSs to HSU and are consistent with studies of samples experiencing other forms of trauma, such as war or natural disaster. Our results also suggest that an individuals’ need, in terms of the severity of their PTSSs, appears most important in predicting their health service engagement. Although this is positive, the effectiveness of this service use, in terms of cost and outcomes, remains unclear. Further, despite the levels of PTSSs observed in the present sample, a minority of individuals sought psychosocial care. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



An initial application of a biopsychosocial framework to predict posttraumatic stress following pediatric injury.

Mon, 26 Jun 2017 04:00:00 GMT

Objective: Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association. Method: Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses. Results: Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS. Conclusion: Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Does personality predict health and well-being? A metasynthesis.

Thu, 09 Mar 2017 05:00:00 GMT

Objective: To derive a robust and comprehensive estimate of the overall relation between Big Five personality traits and health variables using metasynthesis (i.e., second-order meta-analysis). Method: Thirty-six meta-analyses, which collectively provided 150 meta-analytic effects from over 500,000 participants, met criteria for inclusion in the metasynthesis. Information on methodological quality as well as the type of health outcome, unreliability adjustment, population sampled, health outcome source, personality source, and research design was extracted from each meta-analysis. An unweighted model was used to aggregate data across meta-analyses. Results: When entered simultaneously, the Big Five traits were moderately associated with overall health (multiple R = .35). Personality–health relations were larger when examining mental health outcomes than physical health outcomes or health-related behaviors and when researchers adjusted for measurement unreliability, used self-report as opposed to other-report Big Five scales, or focused on clinical as opposed to nonclinical samples. Further, effects were larger among agreeableness, conscientiousness, and neuroticism than extraversion or openness to experience. Conclusions: This metasynthesis provides among the most compelling evidence to date that personality predicts overall health and well-being. In addition, it may inform research on the mechanisms by which personality impacts health as well as research on the structure of personality. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



Revisiting the lack of association between affect and physiology: Contrasting between-person and within-person analyses.

Thu, 09 Mar 2017 05:00:00 GMT

Objective: Despite experimental manipulations that reliably elicit affective and physiological responses, the relationship between the two frequently appears small or nonexistent. We propose that this is, at least in part, due to a mismatch between the nature of the question being asked and the analytic methods applied. For example, to test if levels of affect reliably covary with physiology over time—a within-person question—one cannot apply analytic approaches that test whether people are similarly reactive across domains—a between-person question. The purpose of this paper is to compare within-person and between-person analyses testing the association between affect and physiology. Method: Participants (N = 60) recalled an event from their lives that made them angry. Self-reported anger and objective blood pressure levels were recorded at baseline, after the recall, and 5 times during recovery. Results: Between-person correlations between anger and blood pressure were nonsignificant across all phases of the study, suggesting that those least/most reactive for anger were not least/most reactive for blood pressure. These null findings held regardless of whether linear or nonlinear assumptions were modeled. In contrast, within-person multilevel modeling indicated a clear relationship, suggesting that when a person was angrier that person’s blood pressure was higher compared with when that person was less angry. Conclusion: Results suggest the importance of appropriately matching analytic strategy to the nature of the question regarding the relationships between affect and physiology. Implications for past and future research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)



The costs and benefits of sexual communal motivation for couples coping with vulvodynia.

Mon, 06 Feb 2017 05:00:00 GMT

Objective: Most women with vulvodynia—a prevalent, chronic, vulvovaginal pain condition—engage in intercourse with their partners despite experiencing pain. Their motivation for doing so appears to be interpersonally oriented (e.g., to meet their partners’ sexual needs), but the costs and benefits of such motivations are unknown. We tested whether sexual communal strength (being responsive to a partner’s sexual needs) and unmitigated sexual communion (focusing on a partner’s sexual needs to the exclusion of one’s own needs) were associated with sexual function, and sexual and relationship satisfaction in couples with coping with vulvodynia. Method: In an 8-week daily experience study, 95 women diagnosed with vulvodynia and their partners reported on sexual communal strength, unmitigated sexual communion, sexual function, and sexual and relationship satisfaction on days when sexual activity occurred. Results: On days when women reported higher sexual communal strength, both they and their partners reported greater sexual function and satisfaction, and their partners reported greater relationship satisfaction. When women’s partners reported higher sexual communal strength, both they and the women reported better sexual function, partners reported greater sexual satisfaction, and women reported greater relationship satisfaction. On days when women reported higher unmitigated sexual communion, they reported poorer sexual function and lower sexual satisfaction, and both the women and partners reported lower relationship satisfaction. When women’s partners reported higher unmitigated sexual communion, they reported poorer sexual function. Conclusions: These novel aspects of sexual motivation should be targeted in psychological interventions aimed to improve the sexual and relationship well-being of affected couples. (PsycINFO Database Record (c) 2017 APA, all rights reserved)