Showing papers in "Health Psychology in 2019"
TL;DR: Findings highlight the importance of self-efficacy in predicting health behavior in motivational and volitional action phases and are expected to catalyze future research including experimental studies targeting change in individual HAPA constructs, and longitudinal research to examine change and reciprocal effects among constructs in the model.
Abstract: Objective The health action process approach (HAPA) is a social-cognitive model specifying motivational and volitional determinants of health behavior. A meta-analysis of studies applying the HAPA in health behavior contexts was conducted to estimate the size and variability of correlations among model constructs, test model predictions, and test effects of past behavior and moderators (behavior type, sample type, measurement lag, study quality) on model relations. Method A literature search identified 95 studies meeting inclusion criteria with 108 independent samples. Averaged corrected correlations among HAPA constructs and multivariate tests of model predictions were computed using conventional meta-analysis and meta-analytic structural equation modeling, with separate models estimated in each moderator group. Results Action and maintenance self-efficacy and outcome expectancies had small-to-medium sized effects on health behavior, with effects of outcome expectancies and action self-efficacy mediated by intentions, and action and coping planning. Effects of risk perceptions and recovery self-efficacy were small by comparison. Past behavior attenuated the intention-behavior relationship. Few variations in model effects were observed across moderator groups. Effects of action self-efficacy on intentions and behavior were larger in studies on physical activity compared with studies on dietary behaviors, whereas effects of volitional self-efficacy on behavior were larger in studies on dietary behaviors. Conclusions Findings highlight the importance of self-efficacy in predicting health behavior in motivational and volitional action phases. The analysis is expected to catalyze future research including experimental studies targeting change in individual HAPA constructs, and longitudinal research to examine change and reciprocal effects among constructs in the model. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
236 citations
TL;DR: Depression is central in patterns of multimorbidity and is associated with incident disease for several of the most common chronic diseases, justifying the focus on screening and treatment of depression in those at risk for developing chronic disease.
Abstract: Objectives Depression frequently co-occurs with multiple chronic diseases in complex, costly, and dangerous patterns of multimorbidity. The field of health psychology may benefit from evaluating the temporal characteristics of depression's associations with common diseases, and from determining whether depression is a central connector in multimorbid disease clusters. The present review addresses these issues by focusing on 4 of the most prevalent diseases: hypertension, ischemic heart disease, arthritis, and diabetes. Method Study 1 assessed how prior chronic disease diagnoses were associated with current depression in a large, cross-sectional, population-based study. It assessed depression's centrality using network analysis accounting for disease prevalence. Study 2 presents a systematic scoping review evaluating the extent to which depression was prospectively associated with the onset of the 4 prevalent chronic diseases. Results In Study 1 depression had the fourth highest betweenness centrality ranking of 26 network nodes and centrally connected many existing diseases and unhealthy behaviors. In Study 2 depression was associated with subsequent incidence of ischemic heart disease and diabetes across multiple meta-analyses. Insufficient information was available about depression's prospective associations with incident hypertension and arthritis. Conclusions Depression is central in patterns of multimorbidity and is associated with incident disease for several of the most common chronic diseases, justifying the focus on screening and treatment of depression in those at risk for developing chronic disease. Future research should investigate the mediating and moderating roles of health behaviors in the association between depression and the staggered emergence over time of clusters of multimorbid chronic diseases. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
90 citations
TL;DR: It is indicated that interventions have a small but significant effect on physical activity among cancer survivors and offers insights into how the effectiveness of future interventions might be improved.
Abstract: Objective: We conducted a meta-analysis of physical activity interventions among cancer survivors in order to (a) quantify the magnitude of intervention effects on physical activity, and (b) determine what combination of intervention strategies maximizes behavior change.
Methods: Out of 32,626 records that were located using computerized searches, 138 independent tests (N = 13,050) met the inclusion criteria for the review. We developed a bespoke taxonomy of 34 categories of techniques designed to promote psychological change, and categorized sample, intervention, and methodological characteristics. Random effects meta-analysis and meta-regressions were conducted; effect size data were also submitted to Meta-CART analysis.
Results: The sample-weighted average effect size for physical activity interventions was d+ = .35, equivalent to an increase of 1,149 steps per day. Effect sizes exhibited both publication bias and small sample bias but remained significantly different from zero, albeit of smaller magnitude (d+ ≥ .20), after correction for bias. Meta-CART analysis indicated that the major difference in effectiveness was attributable to supervised versus unsupervised programs (d+ = .49 vs. .26). Greater contact time was associated with larger effects in supervised programs. For unsupervised programs, establishing outcome expectations, greater contact time, and targeting overweight or sedentary participants each predicted greater program effectiveness, whereas prompting barrier identification and providing workbooks were associated with smaller effect sizes.
Conclusion: The present review indicates that interventions have a small but significant effect on physical activity among cancer survivors, and offers insights into how the effectiveness of future interventions might be improved.
73 citations
TL;DR: These demographic and clinical variables can be used to identify women at higher risk of nonadherence and used as the basis for psychological interventions to improve adherence in this population of breast cancer survivors.
Abstract: Objective Previous research has shown that up to 50% of breast cancer survivors prescribed tamoxifen do not take it as recommended, which is associated with increased risk of recurrence and mortality. Little research has attempted to identify modifiable psychosocial factors associated with tamoxifen nonadherence. This study aimed to examine how tamoxifen adherence rates change over a year and to identify modifiable predictors of nonadherence. Method Three hundred and forty-five breast cancer survivors who were in their first year of tamoxifen prescription were sent questionnaires at 4 points over a 12-month period. Questionnaires assessed demographic and clinical factors, side effects, beliefs about the illness and medication, social support, distress and tamoxifen adherence. Adherence was assessed using the Medication Adherence Rating Scale. Latent Growth Modeling was used to identify predictors of tamoxifen nonadherence. Results Reported rates of nonadherence increased over time (37-48%). Several demographic, clinical, and psychosocial variables were associated with nonadherence. Women who were nonadherent were more likely to be from a minority ethnic group, to have more negative medication beliefs and to have lower confidence in their ability to take tamoxifen. Conclusions These demographic and clinical variables can be used to identify women at higher risk of nonadherence. The modifiable psychosocial variables can be used as the basis for psychological interventions to improve adherence in this population. Interventions should focus on both intentional and unintentional nonadherence. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
71 citations
TL;DR: This special report discusses the developments that led to the formation of the Behavioral Medicine Research Council, describes the BMRC's mission, and explains the methods that its members will use.
Abstract: The Behavioral Medicine Research Council (BMRC) is a new, autonomous joint committee of 4 of the leading behavioral medicine research organizations, including the Academy of Behavioral Medicine Research, the American Psychosomatic Society, the Society for Health Psychology, and the Society of Behavioral Medicine. The BMRC's work has important implications for the science and practice of behavioral medicine. The distinguished senior scientists who comprise this new committee will identify a series of strategic research goals for behavioral medicine and promote systematic, interdisciplinary efforts to achieve them. This special report discusses the developments that led to the formation of the BMRC, describes the BMRC's mission, and explains the methods that its members will use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
61 citations
TL;DR: This randomized controlled trial of the online-facilitated positive emotion regulation intervention in dementia caregivers demonstrated small to medium effect sizes on caregiver well-being and shows promise for remotely delivered programs to improve psychological well- Being in caregivers of people with dementia and other chronic illnesses.
Abstract: OBJECTIVE To test the effects of Life Enhancing Activities for Family Caregivers (LEAF), a 6-week positive emotion regulation intervention, on outcomes of positive emotion, depression, anxiety, and physical health as measured by the Patient-Reported Outcomes Measurement Information System® (PROMIS®). METHOD A randomized controlled trial (N = 170) comparing LEAF (N = 86) to an emotion reporting/waitlist condition (N = 84) in dementia caregivers. LEAF was individually delivered online by trained facilitators. Participants in the control condition completed daily online emotion reports and then crossed over into the intervention condition after 6 weeks. The study was registered with Clinicaltrials.gov (NCT01825681) and funded by R01NR014435. RESULTS Analyses of difference in change from baseline to 6 weeks demonstrated significantly greater decreases in PROMIS® depression (d = -.25; p = .02) and Quality of Life in Neurological Disorders (NeuroQOL) anxiety (d = -.33; p < .01), as well as improvements in PROMIS® physical health (d = .24; p = .02) in the intervention condition compared to the emotion reporting/waitlist control. The intervention also showed greater improvements in positive emotion (d = .58; p < .01) and positive aspects of caregiving (d = .36; p < .01). Increases in positive emotion significantly mediated the effect of LEAF on depression over time. CONCLUSIONS This randomized controlled trial of the online-facilitated positive emotion regulation intervention in dementia caregivers demonstrated small to medium effect sizes on caregiver well-being and shows promise for remotely delivered programs to improve psychological well-being in caregivers of people with dementia and other chronic illnesses. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
57 citations
TL;DR: It is suggested that acceptance skills training may be a necessary active ingredient and support the value of integratingaccept skills training into stress-reduction interventions.
Abstract: Objective Mindfulness interventions have been shown to reduce stress; however, the mechanisms driving stress resilience effects are not known. Mindfulness interventions aim to teach individuals how to: (a) use attention to monitor present moment experiences; with (b) an attitude of acceptance and equanimity. A randomized controlled dismantling trial (RCT) was conducted to test the prediction that the removal of acceptance skills training would eliminate stress-reduction benefits of a mindfulness intervention. Method This preregistered RCT randomly assigned stressed community adults to 1 of 3 conditions: (a) Monitor and Accept (MA) mindfulness training, a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention that provided explicit instruction in developing both monitoring and acceptance skills; (b) Monitor Only (MO) mindfulness training, a well-matched 8-week MBSR intervention that taught monitoring skills only; or (c) No Treatment (NT) control. Stress and nonjudgment were measured using ecological momentary assessment (EMA) for 3 days at baseline and 3 days at postintervention. Results Consistent with predictions, MA participants increased in nonjudgment and decreased in both stress ratings and the proportion of assessments that they reported experiencing feelings of stress in daily life, relative to both MO and NT participants. Conclusions This RCT provides one of the first experimental tests of the mechanisms linking mindfulness interventions with stress resilience. These findings suggest that acceptance skills training may be a necessary active ingredient and support the value of integrating acceptance skills training into stress-reduction interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
50 citations
TL;DR: Perceived social circle vaccine coverage is associated with own vaccination behavior in the current and subsequent flu season, establishing behavior patterns that may persist into the future.
Abstract: OBJECTIVE Flu vaccinations are recommended for almost everyone, but uptake may vary because of perceived social norms. We aimed to examine the relationship between perceived social circle vaccine coverage (including family, friends, and acquaintances) and own vaccination behavior as well as potential mediators. METHODS In 2011, 357 participants from RAND's American Life Panel reported perceived social circle vaccine coverage for the 2010-2011 flu season, own vaccination behavior for the 2009-2010 and 2010-2011 flu seasons, perceived flu risk without and with vaccination, and perceived vaccine safety. In 2012 and 2016, respectively, participants returned to report their own vaccination behavior for the 2011-2012 flu season (N = 338) and 2015-2016 flu season (N = 216). RESULTS Perceiving greater percentage of 2010-2011 social circle vaccine coverage was associated with a greater likelihood of getting vaccinated in the 2010-2011 flu season (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01, 1.04) and the subsequent 2011-2012 flu season (OR = 1.02, 95% CI = 1.01, 1.03) but not the 2015-2016 flu season (OR = 1.00, 95% CI = .99, 1.01), as seen in logistic regressions that controlled for demographics and 2009-2010 vaccination behavior. All significant relationships between social circle vaccine coverage and own vaccination behavior were mediated by perceived flu risk without vaccination. CONCLUSIONS Perceived social circle vaccine coverage is associated with own vaccination behavior in the current and subsequent flu season, establishing behavior patterns that may persist into the future. People's vaccination decisions may be informed by their perceptions of their peers' beliefs and behaviors. We discuss intervention strategies for promoting vaccine uptake by counteracting negative and promoting positive perceived social norms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
47 citations
TL;DR: Autonomy support from main health supporters is significantly associated with better diabetes related attitudes, self-care, and glycemic control after adjusting for relationship and patient characteristics.
Abstract: OBJECTIVE Effective diabetes self-management can prevent long-term health complications but is often complex and difficult to achieve. Health care professionals' support for patients' autonomy (autonomy support) in managing their diabetes contributes to better diabetes self-care and glycemic control. Most adults with diabetes also receive self-management support from informal health supporters. Yet, the role of autonomy support from these informal health supporters has not been explored. We examined patients' perceived autonomy support from their main health supporter (family member or friend) in relation to their diabetes distress, self-efficacy, self-monitoring of blood glucose (SMBG), medication adherence, and hemoglobin A1c (HbA1c). METHOD Three hundred twenty-six veterans with Type 2 diabetes at high risk for complications, who identified a main health supporter, were surveyed using self-report measures of social support, diabetes distress, self-efficacy, and self-care. HbA1c and prescription fill data were extracted from VA electronic records for the 12-months before and after the survey. Linear regression and linear mixed models examined the associations of autonomy support with diabetes distress, self-efficacy, SMBG, medication adherence, and glycemic control, controlling for participant-supporter relationship characteristics and patient-factors. RESULTS In adjusted models, greater autonomy support was associated with lower diabetes distress (B = -.323, SE = .098, p = .001), greater self-efficacy (B = .819, SE = .148, p < .001), more frequent SMBG (B = .297, SE = .082, p < .001), and better subsequent 12-month glycemic control (B = .257, SE = .085, p = .003) but not with medication adherence (B = .001, SE = .020, p = .994). CONCLUSIONS Autonomy support from main health supporters is significantly associated better diabetes related attitudes, self-care, and glycemic control after adjusting for relationship and patient characteristics. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
44 citations
TL;DR: Findings support research conceptualizations that early life stress due to racial discrimination lead to sustained negative affective states continuing into young adulthood that confer risk for accelerated aging and possibly premature disease and mortality in African Americans.
Abstract: Objective This study examined the role of depressive symptoms in mediating the relationship between early life experiences of racial discrimination and accelerated aging in adulthood for African Americans (i.e., prediction over a 19-year period, from ages 10 to 29) after adjusting for gender and health behaviors. Method Longitudinal self-report data over 7 waves of data collection from the Family and Community Health Study were utilized. The sample included 368 African Americans with usable gene expression data to compute accelerated aging, as well as complete data on all self-report variables including racial discrimination (Schedule of Racist Events) and depression (Diagnostic Interview Schedule for Children-Version 4). Blood was collected by antecubital blood draws from participants at age 29. The proposed model was tested by path analysis. Results Findings revealed that high discrimination at ages 10-15 was associated with depression at ages 20-29 (β = .19, p = .001), controlling for depression at ages 10-15, which, in turn, was related to accelerated cellular-level aging (β = .11, p = .048) after controlling for gender, alcohol consumption, and cigarette use. The indirect effect of racial discrimination on aging through depression at ages 20-29 was significant (β = .021, 95% confidence interval [.001, .057]), accounting for 32.3% of the total variance. Conclusion These findings support research conceptualizations that early life stress due to racial discrimination lead to sustained negative affective states continuing into young adulthood that confer risk for accelerated aging and possibly premature disease and mortality in African Americans. These findings advance knowledge of potential underlying mechanisms that influence racial health disparities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
43 citations
TL;DR: In this first study examining the molecular correlates of SSS, experiences of low social status are associated with transcriptional effects similar to those previously observed for objective adversity conditions such as low SES, social isolation, and chronic stress.
Abstract: Objective There exists a well-established link between low perceived social status and poorer health outcomes. However, the molecular mechanisms associated with this link remain unclear. This study begins to fill this gap by investigating the effects of low perceived subjective social status on health-related gene expression. Method Participants were 47 healthy heterosexual women (mean age 20.5 years) from a large American university. Participants gave 10 mL of peripheral blood and completed questionnaires assessing subjective social status (SSS), perceived childhood socioeconomic status (SES), health, and relevant demographics. Putatively associated genes were subject to TELiS promoter-based bioinformatic analysis to assess activity of proinflammatory, anti-inflammatory, and antiviral transcription factors. Results In analyses controlling for perceived childhood socioeconomic status (SES) and other covariates, 84 transcripts showed >1.5-fold difference in average expression across the range of SSS. TELiS bioinformatics analyses implicated the proinflammatory transcription factors, NF-κB and AP-1, in driving expression of genes that were up-regulated in low-SSS individuals. Results also indicated increased activity of CREB family transcription factors but no differential activity of the anti-inflammatory glucocorticoid receptor of interferon response factors. Transcript origin analysis implicated monocytes and dendritic cells as cellular mediators. Conclusion In this first study examining the molecular correlates of SSS, experiences of low social status are associated with transcriptional effects similar to those previously observed for objective adversity conditions such as low SES, social isolation, and chronic stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: A composite score of trauma, economic hardship, and stress was significantly associated with worse neurocognitive performance and functional declines among PLWH and no significant relationships were observed between TES and cognitive domains nor ADL declines among HIV− individuals.
Abstract: Author(s): Watson, Caitlin Wei-Ming; Sundermann, Erin E; Hussain, Mariam A; Umlauf, Anya; Thames, April D; Moore, Raeanne C; Letendre, Scott L; Jeste, Dilip V; Morgan, Erin E; Moore, David J | Abstract: ObjectiveThe causes of neurocognitive and everyday functioning impairment among aging people living with HIV (PLWH) are multifactorial. Exposure to stress and trauma can result in neurocognitive deficits via activation of neurological and other biological mechanisms.MethodPLWH (n = 122) and persons without HIV (n = 95), 35-65 years of age, completed four questionnaires that were used to generate a trauma, economic hardship (food insecurity and low socioeconomic status), and stress composite variable (TES). Participants also completed a comprehensive neuropsychological battery and standardized self-reports of activities of daily living (ADLs). We examined the independent and interactive effects of TES and HIV status on neurocognitive performance and ADL declines.ResultsPLWH had more traumatic events, more food insecurity, lower socioeconomic status, and higher perceived stress compared with HIV- individuals (all ps l .0001). Among PLWH, a higher composite TES score was associated with worse executive functioning (p = .02), worse learning (p = .02), worse working memory (p = .02), and more ADL declines (p l .0001), even after controlling for relevant demographic, psychiatric, substance use, and HIV disease covariates. On their own, individual TES components did not predict these outcomes. Conversely, no significant relationships were observed between TES and cognitive domains nor ADL declines among HIV- individuals.ConclusionsA composite score of trauma, economic hardship, and stress was significantly associated with worse neurocognitive performance and functional declines among PLWH. These adverse experiences may contribute to neurocognitive and daily functioning difficulties commonly observed among PLWH. Longitudinal studies are needed to elucidate the relationships between economic/psychosocial adversities and cognitive/functional outcomes over time, and examine potential mediators, such as inflammatory biomarkers. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
TL;DR: While stakeholder engagement appears promising as a strategy to increase the impact of behavior change research, evidence is sparse and more guidance, tools, and training are needed.
Abstract: Objective There is powerful evidence that changing people's health-related behavior can impact the leading causes of mortality and morbidity. However, despite the significant potential to improve health and clinical outcomes, behavior change interventions frequently fall short of expected reach or impact. Method Stakeholder engagement, which refers to the active involvement of public, patients, health professionals, and other decision makers throughout the research process, has been proposed as a strategy to improve the quality, reach, and impact of research. A user-centered "reverse translation" approach makes it more likely that behavior change interventions are relevant to users' needs, better designed, more likely to be implemented, and, ultimately, more effective. Results In this article, the key concepts of stakeholder engagement are introduced and critically evaluated. Three studies, providing examples of stakeholder engagement, are described and critically evaluated. These include (1) a research prioritization project that sought the views of people with diabetes, services providers, and policy makers to identify research priorities in behavioral diabetes research; (2) a "core outcome set" study, in which consensus methods were used to identify outcomes considered important by patients and health professionals for trials of interventions targeting self-management among young adults with Type 1 diabetes; and (3) an intervention development study, where the intervention targeting self-management among young adults with Type 1 diabetes was coproduced with input from members of a "young adult panel." Conclusions While stakeholder engagement appears promising as a strategy to increase the impact of behavior change research, evidence is sparse and more guidance, tools, and training are needed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: A review of the multimorbidity measures that have been published in the literature to date and that are available for use in future research studies to help inform the careful use of these tools by researchers moving forward.
Abstract: Overview The presence of multiple concurrent medical conditions (also known as multimorbidity) is now a common phenomenon, hence the importance of its measurement. Objective The purpose of this paper is to review the multimorbidity measures that have been published in the literature to date and that are available for use in future research studies. Method Two main groups of measures of multimorbidity could be distinguished. The first group of measures is constituted by a simple count from various lists of chronic conditions. The second group of measures introduces a weighting for included chronic conditions thus creating a "weighted index" of multimorbidity. These groups are not mutually exclusive as the list of medical conditions in some weighted indices can be used as a list of conditions without weighting. This article includes a review of the multimorbidity literature to date that has reported these groups of measurements, showing the variety of existing measurements and highlighting their differences to provide an overview of the possibilities that are available to a researcher intending to measure multimorbidity. Conclusion Finally, we outline some guidelines for the choice of a measurement of multimorbidity for research studies. We hope that this review of the existing literature will help inform the careful use of these tools by researchers moving forward. In addition to this review, it is advised that readers attempt to keep updated on the ever-increasing multimorbidity literature. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children, but the effect sizes are small, and it remains unclear which qualitative components offamily meals contribute to these positive health outcomes.
Abstract: OBJECTIVE A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children. However, the effect sizes are small, and it remains unclear which qualitative components of family meals contribute to these positive health outcomes. This meta-analysis synthesizes studies on social, environmental, and behavioral attributes of family meals and identifies components of family meals that are related to better nutritional health in children. METHOD A systematic literature search (50 studies; 49,137 participants; 61 reported effect sizes) identified 6 different components of healthy family mealtimes. Separate meta-analyses examined the association between each component and children's nutritional health. Age (children vs. adolescents), outcome type (BMI vs. diet quality), and socioeconomic status (SES; controlled vs. not controlled for SES) were examined as potential moderators. RESULTS Positive associations consistently emerged between 5 components and children's nutritional health: turning the TV off during meals (r = .09), parental modeling of healthy eating (r = .12), higher food quality (r = .12), positive atmosphere (r = .13), children's involvement in meal preparation (r = .08), and longer meal duration (r = .20). No moderating effects were found. CONCLUSIONS How a family eats together shows significant associations with nutritional health in children. Randomized control trials are needed to further verify these findings. The generalizability of the identified mealtime components to other contexts of social eating is also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Individuals with strong purpose may be less likely to experience conflict-related regulatory burden during health decision-making, which may in turn allow them to accept conflicting yet beneficial health messages.
Abstract: Objective Having a strong sense of purpose in life is associated with positive health behaviors. However, the processes through which purpose leads to health are unclear. The current study compared neural activity among individuals with higher versus lower purpose while they made health-related decisions in response to messages promoting health behavior change. Method A total of 220 adults with a sedentary lifestyle who were likely to feel conflicted in response to health messages underwent functional MRI while viewing messages encouraging physical activity and indicated the self-relevance of the messages. We focused on activity within dorsal anterior cingulate cortex (dACC), anterior insula (AI), dorsolateral prefrontal cortex (DLPFC), and ventrolateral prefrontal cortex (VLPFC) as identified by meta-analytically defined maps of regions previously implicated in conflict-related processing, while participants considered the self-relevance of the messages. Results Individuals with higher (vs. lower) purpose showed less activity in dACC, AI, DLPFC, and VLPFC while making health-decisions. Lower brain response in these regions mediated the effect of higher purpose on greater endorsement of the messages. Conclusions Individuals with strong purpose may be less likely to experience conflict-related regulatory burden during health decision-making, which may in turn allow them to accept conflicting yet beneficial health messages. Reduced brain reactivity in dACC, AI, DLPFC, and VLPFC may reflect reduced conflict-related processing during health decision-making relevant to longer term lifestyle goals. This adds to mounting evidence linking purpose and a range of positive health-related outcomes, as well as evidence suggesting that dACC, AI, DLPFC, and VLPFC track conflict-related processes relevant to longer term goals and values. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Poorer FS was observed in subjects with depressive symptoms, and these subjects benefited most from prehabilitation intervention, which could examine whether severity of depression and co-occurrence of anxiety differentially impact FS and whetherPrehabilitation can improve psychological symptoms and quality of life.
Abstract: Objective Depression and poor functional status (FS) frequently co-occur. Though both predict adverse surgical outcomes, research examining preoperative functional performance (FP; self-reported) and functional capacity (FC; performance-based) measures in depressed cancer patients is lacking. Prehabilitation, a preoperative intervention including exercise, nutrition, and stress-reduction, may improve FC; however, whether depressed patients benefit from this intervention remains unknown. The primary objectives were to (a) assess differences in FP and FC and (b) explore the impact of prehabilitation on FC in individuals with depressive symptoms versus those without. Method A secondary analysis was conducted on 172 colorectal cancer patients enrolled in three studies comparing prehabilitation with a control group (rehabilitation). Measures were collected at 4 weeks pre- and 8 weeks postoperatively. FP, FC, and psychological symptoms were assessed using the 36-Item Short Form Health Survey, Six-Minute Walk Distance (6MWD), and Hospital Anxiety and Depression Scale (HADS), respectively. Subjects were divided into three groups according to baseline psychological symptoms: no psychological-symptoms (HADS-N), anxiety-symptoms (HADS-A), or depressive-symptoms (HADS-D). Main objectives were tested using analyses of variance, chi-square tests, and multivariate logistic regression. Results At baseline, HADS-D reported lower FP, had shorter 6MWD, and a greater proportion walked ≤ 400 m. Prehabilitation was associated with significant improvements in 6MWD in HADS-D group but not in HADS-N or HADS-A groups. Conclusion Poorer FS was observed in subjects with depressive symptoms, and these subjects benefited most from prehabilitation intervention. Future research could examine whether severity of depression and co-occurrence of anxiety differentially impact FS and whether prehabilitation can improve psychological symptoms and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: A weak association between FCR and health behaviors was found, with individuals in the high FCR group reporting less health behaviors, and future research should assess the direction of this relationship over time to inform intervention targets within this subgroup.
Abstract: Objective The goal of this study was to examine fear of cancer recurrence (FCR) and 2 health behaviors, physical activity and fruit and vegetable intake, from early to long-term survivorship in a large cohort of mixed cancer survivors. Method Group-based trajectory analyses and repeated measures analysis of variance were conducted on data collected in the American Cancer Society's Studies of Cancer Survivorship-I. Two thousand three hundred thirty-seven survivors of 10 cancers completed the survey at 3 time points (M = 1.3, 2.2, and 8.8 years postdiagnosis). Results The current study found 3 FCR trajectories clustering cancer survivors by FCR severity: low (33.6%), moderate (58.1%), and high (8.3%). FCR significantly decreased over time and remained distinct for each trajectory group. Patient characteristics prevalent in the high FCR group were being female, of younger age, Hispanic ethnicity, having advanced cancer stage (II to III) and non-Hodgkin lymphoma, and low adherence to physical activity and fruit and vegetable intake recommendations. The high FCR group also reported significantly fewer of these health behaviors compared with the other groups, albeit the effect size was small. Conclusions Across the survivorship trajectory, FCR severity decreased but remained distinct for the 3 trajectory groups. Future investigations should inquire about the specific needs of each FCR group to subsequently develop targeted interventions. A weak association between FCR and health behaviors was found, with individuals in the high FCR group reporting less health behaviors. Future research should assess the direction of this relationship over time to inform intervention targets within this subgroup. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Many parents experienced significant T1D-specific distress for a period of time following their child’s initial diagnosis and this distress appears to be exacerbated by parental depressive symptoms.
Abstract: Objective To examine trajectories of two types of type 1 diabetes (T1D) specific distress (i.e., daily T1D management and worries about the future and long-term complications) and the moderating role of parental depression in parents of children newly diagnosed with T1D. Method A total of 126 families of 5- to 9-year-olds with new-onset T1D enrolled in the study. One-hundred twenty-five families completed study measures at baseline, 102 at 6-month follow-up, and 89 at 12-month follow-up. Parents completed measures of depression and T1D-specific distress concerning daily T1D management and worries about the future and long-term complications at baseline and at 6- and 12-month follow-ups. We used multilevel modeling to examine 12-month trajectories of daily and long-term T1D-specific distress and to examine if parental depression modified these trajectories. Results Results showed a significant reduction in daily T1D-specific distress from baseline to 6-month follow-up and maintenance of daily T1D-specific distress from 6- to 12-month follow-up. The significant interaction of baseline parental depression and time indicated that parents with depressive symptoms had a smaller reduction in daily T1D-specific distress from baseline to 6-month follow-up compared to parents without depressive symptoms. Findings for long-term T1D-specific distress indicated that parents with depressive symptoms reported higher distress across all assessment points, with peak long-term T1D-specific distress for parents with depressive symptoms occurring at 6-month follow-up. Conclusion Many parents experienced significant T1D-specific distress for a period of time following their child's initial diagnosis and this distress appears to be exacerbated by parental depressive symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Interventions using conceptual frameworks tested in methodologically robust trials are needed to enhance the provision of mental health care for people of all ages with childhood-onset heart disease.
Abstract: Objective Guidelines recommend psychological intervention for children, adolescents, and adults with childhood-onset heart disease and their families, yet a comprehensive review of interventions is lacking. We aimed to determine the efficacy of psychological interventions for this population. Method We searched 6 electronic databases until August, 2017 for English-language, controlled trials of psychological interventions for children, adolescents, or adults with congenital heart disease, inherited arrhythmias, or cardiomyopathies, or their family members. Outcomes of interest included: anxiety, depression, psychological stress and distress, health-related quality of life, coping and adjustment, developmental outcomes, physical health, and parent and family outcomes. Results Of 7,660 identified articles, 11 articles reporting on 9 unique interventions met inclusion criteria. Four interventions included adolescents or adults with congenital heart disease, 2 of which also included individuals with cardiomyopathies, valvular heart conditions, or inherited arrhythmias. Five interventions targeted parents, predominantly mothers, of children with congenital heart disease. Clinical and methodological diversity was observed across trials. Parent-focused interventions demonstrated some improvements in maternal mental health, including anxiety and worry, coping, and family functioning. Evidence for the efficacy of interventions for adolescents and adults was limited. Most trials (8/9) were at "high" or "serious" risk of bias. Conclusions Despite an established evidence-base for psychological interventions in other chronic illness populations, evidence of efficacy for children and adults with childhood-onset heart disease and their families was limited. Interventions using conceptual frameworks tested in methodologically robust trials are needed to enhance the provision of mental health care for people of all ages with childhood-onset heart disease. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: An overview of research on inflammation as a predictor of disease risk in healthy adults and of adverse outcomes in those with multimorbidity is provided, and the discussion of inflammation is situated in the context of biopsychosocial influences on health.
Abstract: Objective Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses on disease-specific phenomena, such as diminished lung capacity in chronic obstructive pulmonary disease, which can result in functional limitations. This review takes a different approach by highlighting the potential role of a biological process-inflammation-that is common to many chronic medical conditions and thus, from a medical perspective, relatively disease nonspecific. Method Beginning with a description of inflammation and its measurement, this paper will provide an overview of research on inflammation as a predictor of disease risk in healthy adults and of adverse outcomes (e.g., disability) in those with multimorbidity. Results The discussion of inflammation is then situated in the context of biopsychosocial influences on health, as inflammation has been shown to be sensitive to a wide range of social and psychological processes that are thought to contribute to healthy aging, including successful adaptation to multimorbidity and reduced risk of disability. Conclusions Finally, implications of this broader perspective for interventions to improve outcomes in aging adults with multimorbidity are briefly considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Findings highlight delay discounting as a useful metric for predicting whether individuals’ engagement in variety of healthy physical and financial behaviors, as a function of their temporal window.
Abstract: Objective Excessive delay discounting, the rapid devaluation of future rewards, is often demonstrated by individuals suffering from substance use disorders, including chronic cigarette smokers. This constricted temporal window not only produces increased valuation of immediate unhealthy rewards (e.g., cigarettes) but also a decreased valuation of both future healthy rewards (e.g., increased energy) and future consequences (e.g., lung cancer). Moreover, in addition to cigarettes, smokers tend to engage in other behaviors that elicit immediate rewards and negative future consequences such as overconsuming alcohol, unhealthy eating, physical inactivity, and/or irresponsible spending. The present study sought to determine whether smokers' discounting rate would predict the frequency of engagement in other poor health and financial behaviors, independent of cigarette smoking. Method A total of 303 daily smokers were asked to complete a delay discounting task and then answer how frequently they typically engaged in health and finance related behaviors. Results A structural equation model was used to group the questions into highly significantly latent factors of "Drug Use," "Finances," "Fitness," "Food," "Health," "Household Savings," "Personal Development," and "Safe Driving." When regressed on the model, delay discounting significantly predicted engagement all of the factors, except "Safe Driving," independent of smoking status. Conclusion In sum, these findings highlight delay discounting as a useful metric for predicting whether individuals' engagement in variety of healthy physical and financial behaviors, as a function of their temporal window. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
TL;DR: Evidence is provided of a bidirectional association between self-monitoring and weight change across intervention and tracking modalities, and better self- Monitoring was consistently associated with better weight loss across Intervention and Tracking modalities.
Abstract: OBJECTIVE The current study is a secondary analysis of the Live SMART trial, a randomized controlled trial comparing a behavioral weight loss (BWL) condition delivered via smartphone (SMART) to a group-based BWL condition (GROUP) and a control condition (CONTROL). Given the established importance of self-monitoring for weight loss, the aims were to evaluate bidirectional associations between adherence to self-monitoring and weight change and to examine the moderating effect of treatment condition on these associations. METHOD Adults with overweight/obesity (n = 276; 83% women; 92.8% White; Mage = 55.1 years; Mbody mass index = 35.2 kg/m2) were instructed to self-monitor dietary intake, daily weight, and physical activity minutes via paper diaries in GROUP and CONTROL and via a smartphone application in SMART. All participants were weighed monthly at the research center. Adherence to self-monitoring was assessed via examination of self-monitoring records. RESULTS Generalized linear mixed models revealed that adherence to self-monitoring of dietary intake, self-weighing, and physical activity for each month was associated with weight change throughout that month, such that increased frequency of self-monitoring led to greater weight loss (ps < .001). For the GROUP condition only, poorer weight losses in 1 month were prospectively associated with poor adherence to self-monitoring the following month (ps ≤ .01). CONCLUSIONS Results provide evidence of a bidirectional association between self-monitoring and weight change. Better self-monitoring was consistently associated with better weight loss across intervention and tracking modalities. Poorer weight loss was prospectively associated with poorer self-monitoring in group treatment, suggesting that social influences could drive adherence in this form of treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: It is indicated that current smoking cessation interventions for cancer survivors are ineffective and high-quality and effective interventions are needed.
Abstract: OBJECTIVE: We conducted a meta-analysis of randomized controlled trials designed to promote smoking cessation among cancer survivors to (a) assess how effective interventions are at increasing quit rates, and (b) determine which intervention strategies are associated with effect sizes. METHODS: Out of 10,848 records that were located using computerized searches and informal sources, 21 interventions met the inclusion criteria for the review. We developed a bespoke taxonomy of 36 categories of techniques designed to change smoking behavior, and coded sample, intervention, and methodological characteristics. Random effects meta-analysis and metaregressions were conducted. RESULTS: The sample-weighted average effect size for smoking cessation was d+ = .030, and was not significantly different from zero (95%CI = -.042 to .101). Effect sizes exhibited both publication bias and small sample bias. Metaregressions indicated that, out of the many potential moderators that were tested, just a single intervention feature was associated with effect sizes. Interventions delivered solely by nurses exhibited larger effects compared to interventions from other sources. CONCLUSION: The present review indicates that current smoking cessation interventions for cancer survivors are ineffective. High-quality and effective interventions are needed. We offer suggestions regarding promising intervention strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: It is suggested that anxiety and depression are as strongly predictive of poor future physical health as obesity and smoking and that anxiety is independently linked to poor physical health.
Abstract: Objective Anxiety and depression predict poor physical health longitudinally, but are neglected in primary care settings compared to other risk factors such as obesity and smoking. Further, anxiety has been less commonly studied than depression, and whether anxiety has unique predictive effects for physical health is unknown. We compared anxiety and depression to obesity and smoking as predictors of physical health indices and examined unique predictive effects of anxiety and depression. Method Using data from the Health and Retirement study, a US population-based cohort study of older adults, we tested longitudinal associations of anxiety and depression symptoms with onset of self-reported physical health indices (N = 15,418; M age = 68). Medical illnesses (heart disease, stroke, arthritis, high blood pressure, diabetes, and cancer) and somatic symptoms (stomach problems, shortness of breath, dizziness, back pain, headache, pain, and eyesight difficulties) were assessed on two occasions over four years. Anxiety and depression were measured at the initial time point and tested as predictors of medical illness and somatic symptom onset. Results Anxiety and depression symptoms predicted greater incidence of nearly all medical illnesses and somatic symptoms. Effects were as strong as or stronger than those of obesity and smoking, and anxiety and depression independently increased risk for most physical health indices assessed. Conclusions Findings suggest that anxiety and depression are as strongly predictive of poor future physical health as obesity and smoking and that anxiety is independently linked to poor physical health. Greater attention should be paid towards these conditions in primary care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: It is posited that these 4 principles of exercise provide a framework for the successful development of exercise guidance for people with comorbidity or multimorbidality.
Abstract: Objective: Exercise is effective in producing a wide range of beneficial health outcomes. To ensure safe and effective exercise, guidance has been developed for seemingly healthy people and for people with a single disease. Unfortunately, similar guidance is not yet available for people with comorbidity in addition to the index disease or for people with multimorbidity. However, researchers have recently started to explore the application of exercise in people with comorbidity or multimorbidity, and these innovative applications of exercise have produced encouraging results: Exercise was shown to be safe and effective. The objective of the present article is to identify the underlying principles of exercise in people with comorbidity or multimorbidity. Method: We perform a narrative review of applications of exercise in people with comorbidity or multimorbidity. Results: Principles of exercise in people with comorbidity or multimorbidity appear to include (a) a rigorous assessment of health status, (b) the adaptation of exercise to comorbidity or multimorbidity, (c) the application and integration of behavior change techniques into the exercise plan, and (d) clinical reasoning to support the application of exercise by health professionals. Conclusions: We posit that these 4 principles provide a framework for the successful development of exercise guidance for people with comorbidity or multimorbidity.
TL;DR: Findings offer novel evidence that experiencing weight stigma during pregnancy and in the early postpartum period is prospectively associated with adverse mental and physical health outcomes for women after birth, implicating weight stigma as a potential maternal health threat.
Abstract: Author(s): Incollingo Rodriguez, Angela C; Tomiyama, A Janet; Guardino, Christine M; Dunkel Schetter, Christine | Abstract: ObjectiveWeight stigma adversely affects the health of the general population, but almost no studies have examined possible negative consequences of weight stigma in the context of pregnancy. The present study tested whether experiencing weight stigma in pregnancy is inversely related to mental and physical health in mothers during the first postpartum year.MethodThis study examined associations between weight-related experiences of discrimination in everyday life, measured at 1 month after the birth of a child, and physical and mental health outcomes measured concurrently and at 6 months and 1 year postpartum in a sample of 214 women in the Community Child Health Network study. Outcomes of interest were postpartum depressive symptoms, pregnancy weight gain, postpartum weight retention, and two biomarkers of maternal stress (blood pressure and salivary cortisol).ResultsAfter adjusting for covariates including race/ethnicity and prepregnancy body mass index, weight-related everyday discrimination was associated with greater postpartum depressive symptoms at 1 month postpartum. Weight-related everyday discrimination was also associated with greater pregnancy weight gain and greater weight gain in excess of the recommendations set by the Institute of Medicine. Additionally, weight-related discrimination prospectively predicted greater postpartum depressive symptoms and weight retention at 1 year postpartum. Weight-related everyday discrimination was not associated with blood pressure or cortisol.ConclusionsThese findings offer novel evidence that experiencing weight stigma during pregnancy and in the early postpartum period is prospectively associated with adverse mental and physical health outcomes for women after birth, implicating weight stigma as a potential maternal health threat. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: The analysis supports the criterion validity of PROMIS-CF-Concerns for cognitive complaints, which covaries with self-reports of co-occurring anxiety, depression, and negative mood and exhibited high internal consistency.
Abstract: OBJECTIVE The Patient-Reported Outcomes Measurement Information System Cognitive Function-Concerns® (PROMIS®-CF-Concerns) assesses self-reported cognitive complaints. Construct validity data for the CF-Concerns are few. To add to the literature, an analysis of criterion validity for cognitive complaints (European Organisation for Research and Treatment of Cancer-Cognitive Functioning subscale [EORTC-CF]) and cognitive performance (neuropsychological tests of memory [NIH Toolbox Auditory Verbal Learning Test] and verbal fluency [Controlled Oral Word Association Test]) and discriminant validity (self-reports of negative emotions of anxiety, depression, negative mood) are provided. A two-group comparison design was used. METHOD Forty-four patients with chronic lymphocytic leukemia (CLL) and 44 age- and gender-matched noncancer controls completed self-report measures and neuropsychological tests. Spearman's rank correlations (rs) and independent-samples t tests were used. RESULTS Regarding criterion validity, PROMIS®-CF-Concerns significantly correlated with the EORTC-CF (rs = 0.77, p < .001), although not with tests of memory (-0.19) or verbal fluency (0.16). As expected, patients with CLL performed lower than did controls on neuropsychological tests (ps < .05) yet did not differ from controls on PROMIS®-CF-Concerns. PROMIS®-CF-Concerns was reliably and significantly correlated with negative emotions, with rs ranges across measures of -0.42 to -0.69 for the CLL group and -0.53 to -0.78 for controls. CONCLUSIONS PROMIS®-CF-Concerns exhibited high internal consistency. Criterion validity was evidenced for cognitive complaints though not for cognitive performance as assessed here. In summary, the analysis supports the criterion validity of PROMIS®-CF-Concerns for cognitive complaints. It also covaries with self-reports of co-occurring anxiety, depression, and negative mood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: New evidence of an interaction between pregnancy anxiety and sleep duration in the prediction of the timing of delivery is revealed, and avenues to better understand and potentially ameliorate risk for PTB are pointed to.
Abstract: Author(s): Tomfohr-Madsen, Lianne; Cameron, Emily E; Dunkel Schetter, Christine; Campbell, Tavis; O'Beirne, Maeve; Letourneau, Nicole; Giesbrecht, Gerald F | Abstract: ObjectivePreterm birth (PTB) is a prevalent public health concern. Pregnancy anxiety, poor sleep quality, and short sleep duration have been associated with an increased risk of PTB. Theoretically, sleep variables could moderate the strength of the relationship between pregnancy anxiety and PTB; investigating this question was the primary aim of this study.MethodThe sample consisted of 290 pregnant women who were assessed at 2 time points in pregnancy: Time 1 (l 22 weeks gestational age [GA]; MGA = 15.04, SD = 3.55) and Time 2 (32 weeks GA; MGA = 32.44, SD = 0.99). Pregnancy anxiety was assessed with the Pregnancy-Related Anxiety Scale, sleep quality was assessed by the Pittsburgh Sleep Quality Index, and sleep duration was assessed via actigraphy. Data on gestational age at birth were obtained from the electronic medical record.ResultsAfter adjustment for relevant covariates, higher levels of pregnancy anxiety were associated with shorter gestational length and an increased risk of PTB. There were no direct associations between sleep quality or sleep duration and gestational length or PTB. Pregnancy anxiety interacted with sleep duration such that pregnancy anxiety was significantly associated with shorter gestational length and PTB only when women had relatively shorter sleep duration (approximately l 8.3 hr).ConclusionsThis study reveals new evidence of an interaction between pregnancy anxiety and sleep duration in the prediction of the timing of delivery. The findings point to avenues to better understand and potentially ameliorate risk for PTB. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: In this paper, the authors examined associations between memories of early caregiving experiences and trajectories of depressive symptoms and physical health in 2 large samples of middle-aged and older adults, and found that memories of higher parental affection in early childhood were associated with better self-rated health and lower depressive symptoms over intervals of approximately 6 and 18 years.
Abstract: Objective Perceptions of early caregiving experiences are hypothesized to be influential across the life span. However, previous research testing this hypothesis focuses primarily on young adults and use mostly cross-sectional designs. The current study examined associations between memories of early caregiving experiences and trajectories of depressive symptoms and physical health in 2 large samples of middle-aged and older adults. Method Sample 1 consisted of participants from the National Survey of Midlife Development in the United States (n = 7,108) followed for 18 years (from 1995/1996 until 2013/2014). Sample 2 consisted of participants from the Health and Retirement Study (n = 15,234) followed over a 6-year period. Memories of caregiver support before age 18 were retrospectively assessed in middle and older adulthood; associations between these memories and changes in self-rated health, chronic health conditions, and depressive symptoms over time were examined. Results Memories of higher parental affection in early childhood were associated with better self-rated health and lower depressive symptoms over intervals of approximately 6 and 18 years, in both samples; the results for chronic health conditions was more mixed. These associations persisted over time and were not moderated by time. Conclusion Associations between perceptions of caregiver support and health persisted over time, underscoring the importance of memories of close relationships for health and depressive symptoms across the life span, even into late life. Findings are discussed in relation to models that link perceptions of early life experiences to later life outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).