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Health Psychology - Vol 36, Iss 7

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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Copyright: Copyright 2017 American Psychological Association

The role of social closeness during tape stripping to facilitate skin barrier recovery: Preliminary findings.


Objective: Social support is known to reduce the negative effects of stress on health, but there is mixed evidence for the effects of social support on wound healing. This study aimed to investigate whether undergoing a task designed to promote social closeness with a fellow participant and being paired with that person during a tape-stripping procedure could reduce stress and improve skin barrier recovery compared to going through tape stripping alone. Method: Seventy-two healthy adults were randomized to either a social closeness condition where participants completed a relationship-building task and tape stripping in pairs or a control condition where they completed tape stripping alone. Skin barrier recovery was measured using transepidermal water loss. Salivary cortisol and alpha-amylase were collected at four time points as markers of the endocrine and autonomic stress response. Results: Social closeness had a beneficial effect on skin barrier recovery compared to the control condition, t(54) = 2.86, p = .006, r = .36. Social closeness significantly reduced self-reported stress. The effects of the intervention on skin barrier recovery were moderated by self-reported stress reduction (p = .035). There were no significant differences in cortisol between groups, but alpha-amylase increased significantly more from baseline to after tape stripping in the control group compared to the intervention group. Conclusions: This is the first study to show that social closeness with a person going through a similar unfamiliar procedure can positively influence wound healing. Future research needs to replicate these findings in other wound types and in clinical settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Randomized clinical trial of expressive writing on wound healing following bariatric surgery.


Objective: Writing emotionally about upsetting life events (expressive writing) has been shown to speed healing of punch-biopsy wounds compared to writing objectively about daily activities. We aimed to investigate whether a presurgical expressive writing intervention could improve surgical wound healing. Method: Seventy-six patients undergoing elective laparoscopic bariatric surgery were randomized either to write emotionally about traumatic life events (expressive writing) or to write objectively about how they spent their time (daily activities writing) for 20 min a day for 3 consecutive days beginning 2 weeks prior to surgery. A wound drain was inserted into a laparoscopic port site and wound fluid analyzed for proinflammatory cytokines collected over 24 hr postoperatively. Expanded polytetrafluoroethylene tubes were inserted into separate laparoscopic port sites during surgery and removed after 14 days. Tubes were analyzed for hydroxyproline deposition (the primary outcome), a major component of collagen and marker of healing. Fifty-four patients completed the study. Results: Patients who wrote about daily activities had significantly more hydroxyproline than did expressive writing patients, t(34) = −2.43, p = .020, 95% confidence interval [−4.61, −0.41], and higher tumor necrosis factor–alpha, t(29) = −2.42, p = .022, 95% confidence interval [−0.42, −0.04]. Perceived stress significantly reduced in both groups after surgery. Conclusions: Expressive writing prior to bariatric surgery was not effective at increasing hydroxyproline at the wound site 14 days after surgery. However, writing about daily activities did predict such an increase. Future research needs to replicate these findings and investigate generalizability to other surgical groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Associations between observed parenting behavior and adolescent inflammation two and a half years later in a community sample.


Objective: Family environments have an effect on physical health during adolescence, and a possible underlying mechanism is inflammation. However, little is known about the association between observed parenting behaviors and immune system functioning. The current study examined whether positive and negative emotional parental behaviors observed during family interactions were associated with inflammation in adolescents. Method: Sixty-one parent-adolescent dyads (37 male adolescents, 60.6%; 15 male parents, 24.6%) were observed during 2 laboratory-based interaction tasks designed to elicit positive and conflictual emotional behaviors, respectively. Frequency of aggressive and positive parental behavior was coded. Adolescents were followed up approximately 2.5 years later and salivary concentrations of the inflammatory biomarker C-reactive protein (sCRP) were measured. Results: Controlling for BMI and depressive symptoms, lower sCRP was associated both with greater frequency of positive parental behaviors, t = −3.087, p = .003 and less frequency of aggressive parental behavior (t = 2.087, p = .041) in the conflictual task. Trend associations between positive behavior during the positive task and lower sCRP were also found. Conclusions: This is the first study to show that observed positive parenting is associated with lower levels of inflammation in adolescents. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Associations between spontaneous parental perspective-taking and stimulated cytokine responses in children with asthma.


Objectives: Cognitive empathy in parents—reflecting the extent to which one considers the perspectives and emotions of others—is hypothesized to contribute to family social environments in ways that affect youths’ physical health. Using a novel assessment technique for cognitive empathy, the current study examined associations between spontaneous parental perspective-taking and key inflammatory processes implicated in pediatric asthma. Method: One hundred thirty children (ages 9–17) with physician-diagnosed asthma, along with 1 parent, participated in the current study. Parents completed an interview from which statements of perspective-taking were coded and youths provided blood samples. Results: Youths whose parents demonstrated greater spontaneous perspective-taking during the interview had cells that mounted smaller inflammatory responses to stimulation by nonspecific, asthma-specific, and viral analogue ligands, as well as cells that showed greater sensitivity to the anti-inflammatory effects of glucocorticoids. These results were not accounted for by parental warmth or parent or youth depressive symptoms, nor by covariates of race, age, gender, parental education level, use of asthma medications over the past week, or asthma severity. Conclusions: These findings suggest that parental perspective-taking may have implications for biological processes relevant to childhood asthma. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Does socioeconomic status mediate racial differences in the cortisol response in middle childhood?


Objective: Race/ethnicity and socioeconomic status are both associated with stress physiology as indexed by cortisol. The present study tested the extent to which racial/ethnic disparities in cortisol reactivity are explained by socioeconomic status. Method: The sample consisted of 296 racially and socioeconomically diverse children ages 8–11 (47% boys). Mothers reported on children’s stressors and socioeconomic status; salivary cortisol levels were assessed before and after the Trier Social Stress Test. Results: Results demonstrated that racial group differences in cortisol reactivity were partially accounted for by differences in socioeconomic status, but racial group differences in cortisol recovery were not. Conclusions: These findings suggest that cumulative effects of stress and disadvantage may result in differences in stress response physiology as early as middle childhood, and that race-specific mechanisms account for additional variance in cortisol reactivity and recovery. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Socioeconomic status and parenting during adolescence in relation to ideal cardiovascular health in Black and White men.


Objective: American Heart Association (AHA) developed a new metric to evaluate ideal cardiovascular health based on optimal levels of 7 cardiovascular risk factors and health behaviors. We evaluated the relationships of parenting characteristics and academic achievement in adolescence in relation to ideal cardiovascular health in midlife men. Method: We measured cardiovascular risk factors in 171 Black and 136 White men and their ideal cardiovascular health score was constructed based on AHA guidelines. When the participants were 13–16 years old, annual measures of parent–child communication, positive relationship, parental monitoring, family cohesion, boys’ involvement in family activities, and academic achievement were recorded and averaged. Results: Confirmatory factor analysis of adolescent parenting measures revealed a single Parenting Composite. Multiple linear regressions showed a significant Race by Parenting Composite interaction term, β = −.19, p = .03; better parenting was significantly related to more ideal cardiovascular health in Blacks only, β = −.23, p = .004, which remained after adjustments for adolescent and adult socioeconomic status (SES). Academic achievement was related to ideal cardiovascular health, β = −.13, but was no longer significant after controls for adult SES. Adult SES was a strong correlate of ideal cardiovascular health in Black and White men. Conclusions: Black men exposed to positive parenting during adolescence had more ideal cardiovascular health based on AHA guidelines. Improving academic achievement in adolescence may indirectly benefit adult cardiovascular health through improving adult SES. This is the first study of adolescent family predictors of the extent of ideal cardiovascular health. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Subjective social status, life course SES, and BMI in young adulthood.


Objective: Socioeconomic status (SES) is associated with many aspects of health and well-being, including body mass index (BMI). Most research in this area has focused on objective indicators of SES such as education and income, but recent work suggests that subjective social status (SSS) is also important. This study contributes to a growing body of research on SSS and BMI. Method: Data from Waves I and IV the National Longitudinal Study of Adolescent to Adult Health (Add Health), a study of 14,780 individuals followed from adolescence to young adulthood, were analyzed. Results: Analyses showed that (a) SSS was inversely associated with BMI among young adults, (b) objective SES in both adulthood and early life explained about half of this relationship, (c) SSS appeared to offer a partial explanation for the association between SES (in both adulthood and early life) and BMI, (d) health behaviors, psychological characteristics, self-rated health, and perceived stress explained part of the relationship between SSS and BMI after controlling for SES and other covariates, and (e) SSS had a residual association with BMI that was not accounted for by any of the variables in the full model. Conclusions: This work shows that SSS is important because it (a) has an independent association with BMI net of SES, which suggests that it captures unique aspects of social and economic conditions missed by objective indicators of SES and (b) may help link SES with BMI through perceptions of one’s place in the status hierarchy of society. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Syndemic conditions and HIV transmission risk behavior among HIV-negative gay and bisexual men in a U.S. national sample.


Objective: The syndemics framework has been used to explain the high rates of HIV infection among gay and bisexual men. However, most studies have relied primarily on urban or otherwise limited (e.g., single location) samples. We evaluated the prevalence of syndemics—here, depression, polydrug use, childhood sexual abuse, intimate partner violence, and sexual compulsivity—among gay and bisexual men from across the United States, including nonurban areas. Method: Using data from a national sample of 1,033 HIV-negative gay and bisexual men, demographic differences in the prevalence of each syndemic condition and associations with HIV transmission risk behavior were examined. Results: More than 62% of men reported at least 1 syndemic condition. Prevalence did not vary by U.S. region—however, a larger proportion of nonurban men and those with lower income and education levels were above the median number of syndemic conditions. In bivariate analyses, HIV transmission risk behavior was associated with each syndemic condition except for childhood sexual abuse, whereas in multivariate analyses, it was associated with polydrug use, sexual compulsivity, being Latino, and being single and was highest among those reporting 3 or more syndemic conditions. Conclusions: Rates of syndemic conditions among this national sample of gay and bisexual men were generally comparable to previous studies, however elevated rates in nonurban men suggest the need for targeted intervention and support. Links observed between syndemics and HIV transmission risk behavior highlight the ongoing need to address psychosocial concerns among gay and bisexual men in order to reduce their disproportionately high rates of HIV infection. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Perception of partner sexual history: Effects on safe-sex intentions.


Objective: Sexual intercourse is a dyadic activity, and intentions to engage in safe sex vary across partners. Because pregnant and newly parenting adolescents and young adults are at high risk for sexually transmitted infections (STIs), it is important to understand sexual decision-making in this population. Method: This cross-sectional study examined how participants’ own risk behavior and their partners’ risk behavior influence perceptions of partner risk, and the impact of risk perceptions on condom use intentions and monogamy intentions in 296 pregnant adolescent and young adult couples (MAgeFemale = 18.71 years; MAgeMale = 21.33 years). Results: Participants’ behavior and their partners’ behavior both related to increased perceptions of partner risk. Male participants’ perceptions were more strongly influenced by female partners’ behavior than participants’ own behavior. Perceiving a partner as having a history of more risk behaviors trended toward a negative relationship with condom use intentions and monogamy intentions. For females, more previous sex partners related negatively to condom use intentions and positively to monogamy intentions. Having a male partner with more previous sex partners related positively to condom use intentions and monogamy intentions. Conclusions: Perceptions of partner risk did not significantly relate to condom use intentions and monogamy intentions, however, trends suggest that risk perception could reflect similarity bias and ongoing risk engagement. Differences in partner perception by gender suggest that females may communicate more openly about risks. Interventions to reduce STI transmission in couples should work to interrupt trajectories of risky behavior and enhance risk communication. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Relational underpinnings of condom use: Findings from the project on partner dynamics.


Objective: To examine how relational qualities, including commitment to a sexual partner, are associated with condom use among young heterosexual adults at increased risk for sexually transmitted infections. Guided by the investment model of commitment processes, we hypothesized that sexual partner commitment is a function of satisfaction with, alternatives to, and investments in the relationship. Commitment to a sexual partner is, in turn, associated with reduced perceptions of vulnerability to sexually transmitted infection acquisition, which results in lowered condom use intentions and use. Method: We tested the hypothesized model using data from the Project on Partner Dynamics (POPD), a 4-wave, 1-year longitudinal study featuring a Time 1 sample of 538 African American, Hispanic, and White young adult from East Los Angeles, California, who provided data on all their sexual relationships over the year. Results: Findings from hierarchical path models supported the hypotheses, with relational qualities significantly linked to condom use via commitment, perceived vulnerability to harm from partner and intentions to use. Conclusion: These findings have implications for improving the health of high-risk individuals, including suggesting the importance of raising awareness of relational qualities that may give rise to unsafe sexual practices. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)