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Health Psychology - Vol 36, Iss 3



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
 



Health Psychology’s new (old) peer-review policy.

2017-02-27

Health Psychology’s peer-review policy has been revised. Consequently, authors are neither being asked nor allowed to de-identify the manuscripts that they submit to this journal. This article explains the rationale for our revised policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Correlates of self-efficacy for disease management in adolescent/young adult cancer survivors: A systematic review.

2016-12-08

Objective: The primary objective of this review was to summarize the literature regarding factors associated with self-efficacy for disease management (SEDM) in cross-sectional studies and the efficacy/effectiveness of psychosocial interventions that are designed to improve SEDM in adolescent and young adult (AYA) cancer survivors. The secondary aim was to assess the quality of included studies. Method: We conducted a systematic review using PsycINFO and PubMed to identify studies for review. Eligible studies were conducted in AYA cancer survivors ages 15 to 39; included a measure of SEDM assessed as an outcome or in a cross-sectional analysis; and were published in a peer-reviewed, English-language journal. Results: From the 2,910 records screened, 7 cross-sectional studies and 4 intervention studies met criteria for inclusion. Eleven of the 12 SEDM measures in the studies were author-constructed, limiting the ability to draw conclusions across studies. All cross-sectional studies met at least 21 of 26 relevant quality assessment criteria, and intervention studies met between 4 and 11 of 14 criteria. Cross-sectional findings indicate that SEDM is positively associated with health-promoting behaviors and inversely related to physical and mental health problems. The intervention studies demonstrated that behavioral and educational interventions have the potential to increase SEDM. Conclusion: Directions for research include the need for validated measures of SEDM for AYA cancer survivors, as well as interventions that target both the health care team’s and the patient’s role in promoting SEDM. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



High health satisfaction among emerging adults with diabetes: Factors predicting resilience.

2016-10-13

Objective: This study was conducted to identify factors contributing to health satisfaction outcomes among emerging adults (ages 18–25) with diabetes. Method: SEARCH for Diabetes in Youth study participants whose diabetes was prevalent in 2001 and were ≥18 years of age when they completed a 2008–2009 follow-up survey (n = 340) were included. We developed a health resilience model (HRM) to identify potentially modifiable factors (anticipatory guidance, social support, physical activity, quality of life) associated with health outcomes (satisfaction with health care, overall personal health, self-report of hemoglobin A1c [HbA1c]). Proportional odds logistic regression models were used to examine relationships between modifiable factors and health outcomes while adjusting for predetermined characteristics; linear regression models were used for reported HbA1c. Comparison of participants who reported HbA1c versus nonreporters was conducted. Results: A majority (70%) of participants rated satisfaction with health care ≥7 out of 10, and most (71%) rated overall health as good, very good, or excellent. Satisfaction with health care was independent of change in provider between the ages of 17 and 24. After controlling for predetermined characteristics, we found that the odds of increased satisfaction with health care and overall personal health were 1.3 and 1.2 greater, respectively, when participants discussed additional diabetes-related anticipatory guidance topics with a provider and 1.3 and 2.1, respectively, for each 10-unit change in quality of life score. Relationship between HbA1c level and modifiable factors was not significant; however, participants reporting HbA1c had higher ratings of health care and overall health versus nonreporters. Conclusions: HRM describes relationships between modifiable factors and patient-reported outcomes of satisfaction with health care and overall personal health among a cohort of ethnically and racially diverse emerging adults with longstanding diabetes, over half of whom experienced a change in provider. HRM may discern candidate areas for intervention, such as effective anticipatory guidance that can impact satisfaction with health care and overall health, to promote positive health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



An online skin cancer risk-reduction intervention for young adults: Mechanisms of effects.

2016-11-07

Objective: The study’s purpose was to investigate moderator, implementation, and mediator variables related to the efficacy of UV4.me, an Internet intervention that decreased ultraviolet radiation (UV) exposure and increased skin protection behaviors among young adults. Method: A total of 965 18–25 year olds at risk for skin cancer were recruited nationally online. Participants were randomized to an experimental website (UV4.me), a control website, or assessment only. Participant characteristics (moderators), engagement with and perceptions of interventions (implementation measures), and exposure and protection attitudinal variables (mediators) were assessed. Linear regression and mediation analyses were conducted. Results: Intervention effects on skin protection were greater for participants with a family history of skin cancer (p = .01). Intervention effects on UV exposure were greater among recent indoor tanners (p = .04). Improvements in skin protection (but not UV exposure) were associated with perceiving the interventions as satisfying or helpful (ps < .01). The experimental group had better outcomes if they completed more modules (ps < .01) or set more behavioral goals (ps < .01). Knowledge and exposure decisional balance mediated intervention effects for UV exposure (ps < .05), and protection decisional balance, self-efficacy, and intentions mediated intervention effects for protection (ps < .05). Conclusions: The experimental intervention was more efficacious for certain high risk groups. The more individuals liked and engaged with the interventions (e.g., by setting goals), the better their outcomes. Mediation results inform theory about change mechanisms and differed by behavioral outcome. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Mindful eating reduces impulsive food choice in adolescents and adults.

2016-11-03

Objective: The present study tested the extent to which age and obesity predicted impulsive choices for food and monetary outcomes and tested how a brief mindful-eating training would alter delay discounting for food and money choices compared with control groups. Method: First, 172 adolescents (Mage = 13.13 years) and 176 (Mage = 23.33 years) adults completed the Food Choice Questionnaire (FCQ) and Monetary Choice Questionnaire (MCQ) as measures of food and money delay discounting, respectively. Then, participants returned to the lab and were randomly assigned to complete a brief mindful-eating training, watch a DVD on nutrition, or serve as a control. Participants completed the FCQ and MCQ again as a postmanipulation measure. Results: Participants with high percent body fat (PBF) were more impulsive for food than those with low PBF. Adults with high PBF were also more impulsive for money compared with adults with low PBF; no PBF-related differences were found for adolescents. Participants in the mindful-eating group exhibited more self-controlled choices for food, but not for money. The control conditions did not exhibit changes. Conclusion: The study suggests that individuals with high PBF make more impulsive food choices relative to those with low PBF, which could increase the risk of obesity over time. It also is the first to demonstrate shifts in choice patterns for food and money using a brief mindful-eating training with adolescents. Mindful eating is a beneficial strategy to reduce impulsive food choice, at least temporarily, that may impede weight gain. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Avoidant coping and diabetes-related distress: Pathways to adolescents’ Type 1 diabetes outcomes.

2016-11-03

Objective: Adolescents with Type 1 diabetes (T1D) are vulnerable to diabetes-related distress and often struggle to complete self-management tasks needed to maintain blood glucose values in target range. One way that youth with T1D handle problems is through avoidant coping. The current study examined cross-time associations between avoidant coping style and diabetes outcomes and tested the possible mediating role of diabetes-related distress. Method: Adolescents with T1D (N = 264) were assessed 4 times over 1 year to measure avoidant coping style, diabetes-related distress, adherence (on the basis of glucometer data and self-report), and glycemic control (hemoglobin A1c). Mediation and direct effects were tested across time using time-lagged autoregressive path models, making use of the repeated measurement of all constructs. Results: The hypothesized mediation effect was found for all 3 diabetes outcomes. Higher levels of avoidant coping style were associated with greater diabetes-related distress at the subsequent time point, which was related in turn to fewer blood glucose checks, less frequent self-care behaviors, and poorer glycemic control (higher A1c) at the next assessment. Conclusions: In the context of diabetes, an avoidant coping style may contribute to greater diabetes-specific distress followed by deterioration in self-management and glycemic control over time. Maladaptive coping styles are modifiable factors that offer an entry point into intervention before further difficulties can take hold. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Parental influence on driver licensure in adolescence: A randomized controlled trial.

2016-12-12

Objective: Newly licensed adolescent drivers have skill deficits that increase risk for motor vehicle crashes. Development of programs targeted to prelicensed adolescents has been hindered by concerns about encouraging overconfidence and early licensure. The study had 2 primary objectives: (a) determine whether an Internet-based intervention designed to improve parent-supervised practice (TeenDrivingPlan [TDP]) influenced adolescents’ time to licensure and parents’ perceptions of adolescents’ driving skill, expertise, and safety and (b) evaluate the association of these perceptions and practice diversity (number of different environments where practiced occurred) with time to licensure. Method: A randomized controlled trial was used to compare TDP with a control condition. Participants (N = 295 parent–adolescent dyads) completed periodic surveys over 24 weeks and were subsequently followed for up to a year to determine adolescents’ licensure status. Results: TDP did not influence time to licensure and did not affect parents’ perceptions of skill, expertise, and safety. Practice diversity was associated with faster licensure. A more favorable perception of adolescents’ skill in comparison to peers was associated with faster licensure. Conclusions: Targeting parents’ beliefs about adolescents’ safety in relation to other road users may not be conducive to altering licensing trajectories, whereas sensitizing parents to their adolescents’ emerging skills might be more effective in promoting safe entry into licensure. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Personality and sedentary behavior: A systematic review and meta-analysis.

2016-10-13

Objective: Too much sitting is associated with an increased risk of chronic disease and premature death. This investigation aimed to systematically review the evidence for personality as a correlate of time spent in sedentary pursuits. Method: Electronic databases (PubMed; Science Direct; PsycINFO, PsycARTICLES, and SPORTDiscus via EBSCO; Web of Science; MEDLINE via Ovid; Scopus; ProQuest) were searched in December 2015 for studies reporting an association between at least 1 personality trait and time spent in at least 1 sedentary behavior. Pooled mean effect sizes were computed using inverse-variance weighted random effects meta-analysis. Results: Twenty-six studies (28 samples, 110 effect sizes) met inclusion criteria. Higher levels of sedentary behavior were associated with higher levels of neuroticism (r+ = .08, 95% confidence interval [CI: .05, .10]) and lower levels of conscientiousness (r+ = −.08, 95% CI [−.11, −.06]). Nonsignificant associations were observed for extraversion (r+ = .00, 95% CI [−.07, .06]), openness (r+ = −.02, 95% CI [−.05, .02]), and agreeableness (r+ = −.04, 95% CI [−.09, .00]). Effects for neuroticism and extraversion were moderated by measurement of sedentary behavior, and effects for openness and agreeableness were moderated by participant age and gender. Conclusions: Findings appear consistent with personality trait associations with other health-related behaviors. More objective measures of sedentary behavior are required to make more definitive conclusions about the contribution of personality to a sedentary lifestyle. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Activity patterns in response to symptoms in patients being treated for chronic fatigue syndrome: An experience sampling methodology study.

2016-11-07

Objective: Cognitive–behavioral models of chronic fatigue syndrome (CFS) propose that patients respond to symptoms with 2 predominant activity patterns—activity limitation and all-or-nothing behaviors—both of which may contribute to illness persistence. The current study investigated whether activity patterns occurred at the same time as, or followed on from, patient symptom experience and affect. Method: Twenty-three adults with CFS were recruited from U.K. CFS services. Experience sampling methodology (ESM) was used to assess fluctuations in patient symptom experience, affect, and activity management patterns over 10 assessments per day for a total of 6 days. Assessments were conducted within patients’ daily life and were delivered through an app on touchscreen Android mobile phones. Multilevel model analyses were conducted to examine the role of self-reported patient fatigue, pain, and affect as predictors of change in activity patterns at the same and subsequent assessment. Results: Current experience of fatigue-related symptoms and pain predicted higher patient activity limitation at the current and subsequent assessments whereas subjective wellness predicted higher all-or-nothing behavior at both times. Current pain predicted less all-or-nothing behavior at the subsequent assessment. In contrast to hypotheses, current positive affect was predictive of current activity limitation whereas current negative affect was predictive of current all-or-nothing behavior. Both activity patterns varied at the momentary level. Conclusions: Patient symptom experiences appear to be driving patient activity management patterns in line with the cognitive–behavioral model of CFS. ESM offers a useful method for examining multiple interacting variables within the context of patients’ daily life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Intergenerational transmission of socioeconomic position and ideal cardiovascular health: 32-year follow-up study.

2016-12-08

Objectives: Socioeconomic position (SEP) in childhood predicts cardiovascular health in adulthood but the underlying mechanisms remain unclear. Using a longitudinal study design, we examined the extent to which adult SEP acts as a pathway (mediator) connecting childhood SEP with adult cardiovascular health, and if upward social mobility mitigates the health-effects of early low SEP. Method: The sample comprised 697 participants from a prospective Finnish cohort followed during 32 years. Childhood SEP was assessed from the parents in 1980 (participant mean age 10.9) and adulthood SEP was examined in 2007 and 2012 (participant mean age 43.2 in 2012). Both childhood and adulthood SEP scores comprised education, income, occupational status, and occupational stability. Ideal cardiovascular health was assessed in 2007 and 2012 according to the American Heart Association’s guidelines. Results: Higher childhood SEP was associated with higher ideal cardiovascular health index in adulthood (β = 0.13, p < .001) independently of sex, age, childhood cardiovascular risk factors, and chronic conditions. Mediation analysis showed that adult SEP accounted for 33% of the association between childhood SEP and ideal cardiovascular health index. Upwardly mobile participants scored higher on ideal cardiovascular health in adulthood compared with participants staying in lower SEP (M = 4.05 vs. 3.56, p < .001). Conclusions: Transmission of SEP over generations is a predictor of health inequalities, which should be considered in cardiovascular prevention. Although upward social mobility mitigates some of the effect of early SEP disadvantage on later cardiovascular health, childhood SEP remains an important predictor of future health. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



Information processing in illness representation: Implications from an associative-learning framework.

2016-12-08

Objective: The common-sense model (Leventhal, Meyer, & Nerenz, 1980) outlines how illness representations are important for understanding adjustment to health threats. However, psychological processes giving rise to these representations are little understood. To address this, an associative-learning framework was used to model low-level process mechanics of illness representation and coping-related decision making. Method: Associative learning was modeled within a connectionist network simulation. Two types of information were paired: Illness identities (indigestion, heart attack, cancer) were paired with illness-belief profiles (cause, timeline, consequences, control/cure), and specific illness beliefs were paired with coping procedures (family doctor, emergency services, self-treatment). To emulate past experience, the network was trained with these pairings. As an analogue of a current illness event, the trained network was exposed to partial information (illness identity or select representation beliefs) and its response recorded. Results: The network (a) produced the appropriate representation profile (beliefs) for a given illness identity, (b) prioritized expected coping procedures, and (c) highlighted circumstances in which activated representation profiles could include self-generated or counterfactual beliefs. Conclusions: Encoding and activation of illness beliefs can occur spontaneously and automatically; conventional questionnaire measurement may be insensitive to these automatic representations. Furthermore, illness representations may comprise a coherent set of nonindependent beliefs (a schema) rather than a collective of independent beliefs. Incoming information may generate a “tipping point,” dramatically changing the active schema as a new illness-knowledge set is invoked. Finally, automatic activation of well-learned information can lead to the erroneous interpretation of illness events, with implications for [inappropriate] coping efforts. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)



A brief tool to differentiate factors contributing to insomnia complaints.

2017-02-27

Objective: A complaint of insomnia may have many causes. A brief tool examining contributing factors may be useful for nonsleep specialists. This study describes the development of the Insomnia Symptoms Assessment (ISA) for examining insomnia complaints. Method: ISA questions were designed to identify symptoms that may represent 1 of 8 possible factors contributing to insomnia symptoms, including delayed sleep phase syndrome (DSPS), shift work sleep disorder (SWSD), obstructive sleep apnea (OSA), mental health, chronic pain, restless leg syndrome (RLS), poor sleep hygiene, and psychophysiological insomnia (PI). The ISA was completed by 346 new patients. Patients met with a sleep specialist who determined primary and secondary diagnoses. Results: Mean age was 45 (18–85) years and 51% were male. Exploratory factor analysis (n = 217) and confirmatory factor analysis (n = 129) supported 5 factors with good internal consistency (Cronbach’s alpha), including RLS (.72), OSA (.60), SWSD (.67), DSPS (.64), and PI (.80). Thirty percent had 1 sleep diagnosis with a mean of 2.2 diagnoses per patient. No diagnosis was entered for 1.2% of patients. The receiver operating characteristics were examined and the area under the curves calculated as an indication of convergent validity for the primary diagnosis (N = 346) were .97 for SWSD, .78 for OSA, .67 for DSPS, .54 for PI, and .80 for RLS. Conclusion: The ISA demonstrated good internal consistency and corresponds well to expert diagnoses. Next steps include setting sensitivity/specificity cutoffs to suggest initial treatment recommendations for use in other settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)