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Preview: Health Psychology - Vol 29, Iss 1

Health Psychology - Vol 35, Iss 10

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

Last Build Date: Sat, 24 Sep 2016 20:00:08 EST

Copyright: Copyright 2016 American Psychological Association

Implications of supportive and unsupportive behavior for couples with newly diagnosed diabetes.


Objective: To examine the relation between daily diary reports of diabetes-specific social interactions to patient and partner mood and patient self-care behaviors, and whether relations are moderated by unmitigated communion. Method: Participants were 70 couples in which 1 person had been diagnosed with Type 2 diabetes in the past 3 years. They were interviewed in-person at baseline and completed daily diary reports on an iPad. Daily diary questionnaires measured support, mood, and self-care behavior (patients only). Unmitigated communion, a personality trait characterized by an overinvolvement in others to the exclusion of the self, was measured at baseline. Results: Multilevel statistical modeling revealed that daily fluctuations in partner emotional support were related to daily fluctuations in happy mood, more exercise, and dietary compliance. Partner controlling behavior was related to poor mood but was unrelated to self-care. Relations of support and controlling behavior to mood were strongest for individuals high (vs. low) in unmitigated communion. Conclusion: Patients newly diagnosed with Type 2 diabetes who felt understood and cared for by partners reported a better mood and were more likely to take care of themselves on a daily basis, whereas patients whose partners were controlling on a daily basis reported poorer mood. Patients characterized by unmitigated communion were most affected by partner supportive and unsupportive behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Spouse confidence and physical function among adults with osteoarthritis: The mediating role of spouse responses to pain.


Objective: This study of adults with osteoarthritis and their spouses examined spouse responses to patients’ pain as mediators of the associations between spouse confidence in patients’ ability to manage arthritis and improvements in patients’ physical function and activity levels over time. Method: Participants were 152 older adults with knee osteoarthritis and their spouses. In-person interviews were conducted with patients and spouses (separately) at 3 time points: baseline (Time[T] 1), 6 months after baseline (T2), and 18 months after baseline (T3). At each time point, patients reported their self-efficacy for arthritis management, functional limitations, and time spent in physical activity; spouses reported their confidence for patients’ arthritis management and their empathic, solicitous, and punishing responses to patients’ pain. Multiple mediation regression models were used to examine hypothesized associations across 2 distinct time frames: 6 months (T1-T2) and 12 months (T2-T3). Results: Across 6 months, spouse confidence was indirectly related to improvements in patients’ functional limitations and activity levels through increased empathic responses to patient pain. Across 12 months, spouse confidence was indirectly related to improvements in patients’ functional limitations and activity levels through decreased solicitous responses to patient pain. Conclusions: This study adds to the literature on spousal influences on health by identifying 2 spouse behaviors that help to explain how spouse confidence for patients’ illness management translates into improvements in patients’ physical health over time. Findings can inform the development of couple-focused illness management interventions aiming to increase the positive influence of the spouse on patients’ health behaviors and outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Natural language use and couples’ adjustment to head and neck cancer.


Objective: This multimethod prospective study examined whether emotional disclosure and coping focus as conveyed through natural language use are associated with the psychological and marital adjustment of head and neck cancer patients and their spouses. Method: One-hundred twenty-three patients (85% men; age X¯ = 56.8 years, SD = 10.4) and their spouses completed surveys prior to, following, and 4 months after engaging in a videotaped discussion about cancer in the laboratory. Linguistic inquiry and word count (LIWC) software assessed counts of positive/negative emotion words and first-person singular (I-talk), second person (you-talk), and first-person plural (we-talk) pronouns. Using a grounded theory approach, discussions were also analyzed to describe how emotion words and pronouns were used and what was being discussed. Results: Emotion words were most often used to disclose thoughts/feelings or uncertainty about the future, and to express gratitude or acknowledgment to one’s partner. Although patients who disclosed more negative emotion during the discussion reported more positive mood following the discussion (p < .05), no significant associations between emotion word use and patient or spouse psychological and marital adjustment were found. Patients used significantly more I-talk than spouses and spouses used significantly more you-talk than patients (ps < .01). Patients and spouses reported more positive mood following the discussion when they used more we-talk. They also reported less distress at the 4-month follow-up when their partners used more we-talk during the discussion (p < .01). Conclusion: Findings suggest that emotional disclosure may be less important to one’s cancer adjustment than having a partner who one sees as instrumental to the coping process. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Dyadic coping and inflammation in the context of chronic stress.


Objective: Marital quality impacts inflammatory processes. Dyadic coping, a spousal support process in which members of a couple work together to cope with the stressors that 1 or both partners are facing, is associated with higher marital satisfaction and reduced psychological distress. The goal of the present study was to evaluate whether dyadic coping is also related to systemic inflammation among individuals facing chronic parenting stress. Method: Forty-four parents of children with an autism spectrum disorder completed self-report questionnaires on dyadic coping, marital satisfaction, perceived social support, and caregiving burden. They also provided a blood sample for C-reactive protein (CRP) analysis, a marker of systemic inflammation. Results: Higher positive dyadic coping was significantly associated with lower circulating CRP, while negative dyadic coping was unrelated to CRP. After adjusting for individual differences in marital satisfaction, perceived social support, and caregiving burden, positive dyadic coping became marginally associated with CRP. Conclusion: Positive dyadic coping is a specific interpersonal process that may modulate systemic inflammation among individuals exposed to chronic stress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study.


Objective: Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based intimacy enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review. Method: Three semistructured qualitative focus groups in partnered posttreatment breast cancer survivors (n = 15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naïve breast cancer survivors (n = 4) and expert review of materials were also incorporated in finalizing the intervention materials. Results: Qualitative findings centered on the impact of breast cancer and its treatment on women’s sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials. Conclusion: An intimacy enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Change in health-related quality of life in the context of pediatric obesity interventions: A meta-analytic review.


Objective: To quantitatively characterize change in health-related quality of life (HRQoL) in the context of behavioral (n = 16), surgical (n = 5), and pharmacological (n = 1) interventions for pediatric overweight and obesity. A secondary goal was to examine the relationship between change in HRQoL and change in body mass index (ΔBMI) by treatment type. The amount of weight loss necessary to observe a minimally clinically important difference (MCID) in HRQoL was determined. Method: Data were gathered from studies reporting on weight change and ΔHRQoL over the course of obesity interventions (N = 22) in youths (N = 1,332) with average ages between 7.4 and 16.5 years (M = 12.2). An overall effect size was calculated for ΔHRQoL. Moderation analyses were conducted using analysis of variance and weighted regression. MCID analyses were conducted by converting HRQoL data to standard error of measurement units. Results: The overall effect size for ΔHRQoL in the context of pediatric obesity interventions was medium (g = 0.51). A significant linear relationship was detected between ΔBMI and ΔHRQoL (R2 = 0.87). This relationship was moderated by treatment type, with medical (i.e., surgical) interventions demonstrating a stronger relationship. Results indicated that it takes a change of 0.998 BMI units to detect true change in HRQoL. Conclusion: This study provides the first known quantitative examination of changes in HRQoL associated with weight loss in pediatric interventions. Medical interventions appear to offer a more substantial increase in HRQoL per unit of BMI change. These results offer a concrete weight loss goal for noticing positive effects in daily life activities. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Emotion dysregulation and loss-of-control eating in children and adolescents.


Objective: To examine the associations among self-reported loss-of-control (LOC) eating, emotion dysregulation, body mass, and objective energy intake among youth. Emotion dysregulation may be 1 individual factor that promotes excess energy intake and increases in body mass among youth with LOC eating. Method: Children and adolescents (N = 230; 8 to 17 years) enrolled in a nonintervention study completed a structured interview to determine the presence or absence of self-reported LOC eating. Children’s emotion dysregulation was assessed via parent-report with the Child Behavior Checklist. Youth also completed 2 test meals to capture “binge” and “normal” eating. Body composition was examined using air displacement plethysmography. Results: After controlling for relevant covariates, youth with self-reported LOC eating had higher parent-reported emotion dysregulation than those without LOC. Parent-reported emotion dysregulation was also associated with greater observed energy intake (after accounting for body mass), as well as higher fat mass. Emotion dysregulation also moderated associations between LOC status/gender and body mass variables; among youth with self-reported LOC eating and girls, those with high parent-described emotion dysregulation (vs. low) had significantly higher fat mass and BMIz. Conclusions: Data from the current study suggest that emotion dysregulation may play a role in energy intake and obesity, particularly among youth with self-reported LOC eating and girls. Additional studies are needed to identify the prospective mechanisms linking poor emotion regulation and LOC eating. These mechanisms, in turn, may inform future interventions targeting excess energy intake and obesity in pediatric samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Effects of a physical activity intervention on autonomic and executive functions in obese young adolescents: A randomized controlled trial.


Objectives: The primary goals of this study were to determine the effects of a physical activity intervention on the set-shifting aspect of executive function and to explore the potential mechanistic role of cardiac autonomic control, as assessed by heart rate variability (HRV), in the relationship between physical activity and executive function in obese young adolescents. Method: Obese young adolescents were randomized either to participate in a physical activity program (n = 25) or to serve as the wait-list control (n = 25) for a 3-month intervention. Outcome measures included physical fitness, obesity status, executive function, and HRV; these measures were assessed at baseline and within 1 week of the conclusion of the intervention. Results: The physical activity program improved the participants’ physical fitness and obesity status. The program also improved executive function–related set-shifting performance, as measured by the total number of errors, and increased the HRV indices of normalized low frequency (nLF) and normalized high frequency (nHF). A positive correlation between the nHF time changes and the total number of errors was also observed. Conclusion: These findings suggest that 3 months of a physical activity intervention effectively increase physical fitness and improve the set-shifting aspect of executive function in obese young adolescents. Furthermore, the physical activity–related alterations in cardiac autonomic control, particularly the parasympathetic response, may be associated with enhanced executive function. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Social support and moment-to-moment changes in treatment self-efficacy in men living with HIV: Psychosocial moderators and clinical outcomes.


Objective: For people living with HIV, treatment adherence self-efficacy is an important predictor of treatment adherence and, therefore, of clinical outcomes. Using experience sampling method (ESM), this study aimed to examine: (1) the within-person association between moment-to-moment changes in social support and HIV treatment self-efficacy; (2) the moderators of this within-person association; (3) the concordance between questionnaire and ESM measurement of treatment self-efficacy; and (4) the utility of each approach (ESM and questionnaire) in predicting adherence to medication, adherence to clinic visits, CD4 counts, and viral load. Method: Men living with HIV (N = 109) responded to the same set of ESM questions 3 times a day for 7 days via a smart phone given to them for the study. They also completed cross-sectional questionnaires and their clinic data was extracted from medical records to examine predictors and consequences of state and trait treatment self-efficacy. Results: In within-person hierarchical linear modeling (HLM) analyses, receipt of recent social support predicted higher current ESM treatment self-efficacy. This association was stronger for individuals reporting higher avoidance coping with HIV. The correlation between ESM and questionnaire measures of treatment self-efficacy was r = .37. ESM measure of average treatment self-efficacy predicted medication adherence, visit adherence, CD4 counts, and viral load, while questionnaire-based self-efficacy did not predict these outcomes. Conclusion: Interventions aimed at improving treatment adherence may target social support processes, which may improve treatment self-efficacy and adherence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Developmental timing of suicide attempts and cardiovascular risk during young adulthood.


Objective: Self-control/self-regulation has received increased attention in health research. Suicide attempts index severe dysregulation in emotional, behavioral, and/or physiological domains. The current study tested whether own and/or others’ suicide attempts during the early life course predicted cardiovascular risk by young adulthood and whether developmental timing of suicide attempts, sex of the person, and source of suicide attempts exposure modified these associations. Method: Data came from the National Longitudinal Study of Adolescent to Adult Health (Add Health). At each assessment during Waves I–IV (covering approximately ages 12–32 years), participants reported whether they and/or a friend/family member had attempted suicide. At Wave IV, trained interviewers assessed participants’ obesity and hypertension and collected bloodspots from which high-sensitivity C-reactive protein (hs-CRP) was assayed. Sample sizes in the present analyses ranged from n = 7,884 to n = 8,474. Results: Exposure to own and others’ suicide attempts during adolescence was relatively common. In males, suicide attempts during adolescence (∼age 15 years) were associated with hypertension and elevated inflammation more than 1 decade later. Associations among suicide attempts by others and cardiovascular risk also emerged. Conclusions: Exposure to one’s own or others’ severe dysregulation in the form of suicide attempts during the early life course signals risk for cardiovascular health problems by the late twenties. Adolescent males who attempted suicide and individuals exposed to suicide attempts in their social network may benefit from a dual focus on mental and physical health in care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Automatic effects of illness schema activation on behavioral manifestations of illness.


Objective: Relatively little research has directly evaluated the schematic nature of illness representations proposed by the common sense model of illness. Four studies tested the hypothesis that illness schema activation leads directly and automatically to behavioral manifestations of illness. Method: Study 1 was a survey (N = 970) that evaluated the proposition that the mental representation of common cold symptom experience includes functional deviation from the usual prototypical self. Studies 2 and 3 were experiments that tested effects of cold schema activation using a subliminal priming paradigm on walking speed (Study 2, N = 53) and free recall in a memory task (Study 3, N = 30). Study 4 (N = 65) used a 2 (cold prime vs. control) × 2 (alternate self vs. control) experimental design to investigate attenuation of the effect of the cold prime on free recall. Results: Study 1 confirmed the multifactorial nature of functional self-deviations representing the common cold symptomology. Studies 2 and 3 showed that participants primed with the common cold schema walked more slowly and performed worse on a memory recall task relative to controls in whom the schema was not activated. These effects were automatic in the sense that participants were not aware of the prime or of this influence. In Study 4, priming an alternative self-identity overcame the deleterious effect of automatic common cold schema activation on free recall in a memory task. Conclusions: Subliminal activation of a schematic representation of illness automatically activates behavioral manifestations of illness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Cognitive reappraisal ability buffers against the indirect effects of perceived stress reactivity on Type 2 diabetes.


Objective: Stress contributes to poor health outcomes; importantly, a stress reaction begins with the negative appraisal of a situation. The ability to use cognitive reappraisal, an emotion regulation strategy that involves reinterpreting an initial appraisal to change its emotional impact, could be a protective factor against the health consequences of stress reactivity. The present study investigated (a) if cognitive reappraisal ability (CRA) acts as a stress buffer against a body mass index (BMI) indicative of being overweight (≥25 kg/m2) or obese (≥30 kg/m2), and (b) if this buffering effect persists against the indirect influences of perceived stress reactivity (PSR) on Type 2 diabetes. Method: One hundred fifty participants (54% female; mean age = 40.4 years ± 12.4 years) completed an online CRA task, self-report measures of PSR, height, weight, and Type 2 diabetes diagnosis on Amazon’s Mechanical Turk. Results: Results revealed that CRA significantly interacted with PSR to predict BMI, which indirectly predicted Type 2 diabetes. Individuals with higher PSR and higher CRA exhibited BMIs within a normal weight range and lower incidence of Type 2 diabetes. In contrast, individuals with higher PSR and lower CRA were overweight or obese, with a higher incidence of Type 2 diabetes. Interestingly, higher CRA was not protective in those who had lower levels of PSR. Conclusions: Findings from this study suggest that emotion regulation interventions can be developed to indirectly target Type 2 diabetes and similar obesity-related illnesses, and that emotion regulation interventions should be tailored to the individual. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Enhancing the effectiveness of alcohol warning labels with a self-affirming implementation intention.


Objective: Excess alcohol consumption extorts significant social and economic costs that are increasing despite the presence of mandatory warning labels on packaged alcoholic beverages. We used a novel approach by adding a brief statement based on self-affirmation theory to alcohol warning labels. Method: In two studies (N = 85 and N = 58), we randomized regular wine drinkers recruited from university campuses to complete a wine-pouring task with bottles that had standard labeling or bottles that added a self-affirming implementation intention to the standard labeling. Alcohol consumption, behavioral intention, and self-efficacy were measured premanipulation; message acceptance was measured postmanipulation; and alcohol consumption, behavioral intention, and self-efficacy were measured again at follow-up. Results: In both studies, the self-affirming implementation intention significantly reduced subsequent alcohol consumption (ds = 0.70 and 0.91, respectively). However, message acceptance, behavioral intention, and self-efficacy did not significantly mediate the observed effects. Conclusions: Self-affirming implementation intentions augmented the effect of alcohol warning labels to reduce subsequent alcohol consumption, but—consistent with the broader self-affirmation literature—it was not clear what mediated the effects. Further research is required to examine the effects of self-affirming implementation intentions on other kinds of public health–related labeling. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

The impact of negative family–work spillover on diurnal cortisol.


Objective: Both dimensions of the work-family interface, work-to-family and family-to-work spillover, have important implications for health and well-being. Despite the importance of these associations, very little is known about the physiological mechanisms through which the interplay between family and work experiences are translated into long-lasting consequences for health. Method: This study investigated both positive and negative aspects of each spillover dimension on diurnal cortisol secretion patterns in a large panel study of working adults between the ages of 33 and 80. Results: Greater negative family-to-work (NFW) spillover predicted lower wake-up cortisol values and a flatter (less “healthy”) diurnal cortisol slope. This effect was evident even after controlling for the effects of the other spillover dimensions. Conclusions: These findings indicate that not all aspects of the work-family interface might impact stress physiology to the same extent and suggest that diurnal cortisol may be an important pathway through which negative aspects of the work-family interface leave their mark on health. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)