Health Psychology and Behavioral Medicine最新文献

Background: Non-adherence to medication therapy in type 2 diabetes mellitus (DM2) is prevalent. Theoretical models have been used to identify the proximal determinants of behavior.

Aim: To identify the direct psychosocial predictors of adherence to insulin therapy based on Theory of Planned Behavior (TPB), among outpatients with DM2.

Methods: Longitudinal and predictive study, whose data was collected at baseline and 3-month follow-up. At baseline (n = 119), sociodemographic and clinical data, self-reported measures of insulin adherence, psychosocial variables of TPB and glycated hemoglobin (A1C) were collected. At 3-month follow-up (n = 70), measurements of insulin adherence and A1C were again measured. Multiple linear regression, via generalized linear models and Multiple Poisson regression, with robust variance analysis were used, for quantitative and categorical outcomes, respectively.

Results: One point in the Intention score led to a mean increase of 12.5% in the proportion of insulin doses, and there was a mean increase of 25% in the probability of the person taking insulin every day or practically every day. Attitude was a predictor of Intention. The moderation analysis demonstrated that higher levels of Perceived Behavioral Control weakened the effect of Attitude on Intention.

Conclusions: The results showed that Intention was predictor of behavioral measure of adherence and the proportion of insulin doses. Attitude was predictor of Intention and Perceived Behavioral Control moderated the effect of Attitude and Subjective Norm on Intention. These findings highlight the importance of developing interventions that prioritize motivational strategies to enhance insulin adherence in the clinical practice. However, future studies with larger sample sizes and the inclusion of belief assessments are recommended to optimize the understanding of the psychosocial determinants of insulin adherence among outpatients with DM2.

Introduction: Somatosensory amplification (SSA) refers to the tendency to experience body sensations as intense, noxious, and disturbing, and is associated with higher levels of anxiety and depression among cancer survivors. Body sensations among survivors are highly attributed to the possibility of cancer recurrence, thus triggering fear of cancer recurrence (FCR). Given that FCR itself is correlated with higher psychological distress, in this study we examined the mediating role of FCR in the relationship between SSA and symptoms of anxiety and depression among cancer survivors.

Materials and methods: One hundred and seventeen cancer survivors up to 10 years post-diagnosis took part in this cross-sectional study. Measures consisted of a demographic and medical questionnaire; the anxiety and depression domains of the Patient Reported Outcomes Measurement Information System (PROMIS); the Somatosensory Amplification Scale; and the Fear of Cancer Recurrence Inventory-Short Form. Mediation analyses were conducted to determine whether FCR mediated the relationships between SSA and both anxiety and depression.

Results: SSA was found to be positively correlated with anxiety, depression, and FCR, and FCR was found to be positively correlated with anxiety and depression. FCR was found to fully mediate the relationships between SSA and both anxiety and depression.

Conclusion: The findings suggest that FCR may serve as a mechanism linking SSA to psychological distress, highlighting the need to consider targeting FCR in interventions for cancer survivors.

Introduction: To promote mindful eating it may be relevant to take different eating profiles into account. This prospective study aimed to (i) identify the existence of potential respondent subgroups regarding mindful eating and (ii) compare these profiles on socio-demographic characteristics and social-cognitive beliefs about mindful eating using the I-Change Model (ICM).

Methods: Dutch adults (M_age = 52.6; 53% male) responded to an online survey at baseline (N = 615) and 3-months (n = 513) follow-up asking about social-cognitive beliefs about practicing mindful eating based on the ICM. Following a latent profile analysis of mindful eating facets, profiles at baseline were compared on social-cognitive beliefs at follow-up using a MANOVA with Tukey-adjusted post-hoc tests.

Results: Three profiles were identified (1. low awareness, high acceptance; 2. high awareness, low acceptance; 3. moderate awareness, moderate acceptance). These profiles significantly differed in their demographics and social-cognitive beliefs about mindful eating (e.g., knowledge, perceived pros and cons, self-efficacy, intention and planning to adopt mindful eating).

Discussion: Findings suggest the limitations of a one-size-fits-all approach to promoting mindful eating. Interventions may need to consider different recruitment and targeted strategies based on socio-demographic characteristics and social-cognitive beliefs to ensure different groups of individuals are represented in and can benefit from interventions in a safe and accessible way.

Background: Adults with Down syndrome (DS) are at an elevated risk of chronic health conditions (e.g. obesity, Alzheimer's disease). Although physical activity can mitigate the effects of these conditions, adults with DS spend more time sedentary relative to the adult general population. This study examined how daily fluctuations in two lifestyle factors, sleep and leisure, affect physical activity in adults with DS. Method: For 7 days, a sample of adults with DS (N = 109) wore a GT9X ActiGraph accelerometer to collect movement and sleep data and completed a daily diary to record leisure engagement. Movement variables included time spent sedentary, in light physical activity, and in moderate-to-vigorous physical activity. Sleep variables included total sleep time (TST) and sleep efficiency (SE). Time spent in and total count of cognitively stimulating leisure (e.g. reading, experiential activities) and social leisure (e.g. visiting friends, attending club meetings) were based on 22 items from the Victoria Longitudinal Study activity questionnaire. Mixed linear models examined between - and within-person associations for sleep and physical activity, and leisure and physical activity. Models controlled for sociodemographics, day of week, and weekend (vs. weekday). Results: At the between-person level, more TST was associated with more time sedentary (ps < .05) and less physical activity (ps < .001). More SE was associated with less time sedentary (ps < .001) and more physical activity (ps < .05). At the within-person level, participants with more physical activity than typical predicted greater TST (and less SE) that night (ps < .01). More cognitively stimulating and social leisure were associated with more physical activity at the within-person level (ps < .05). Conclusions: Findings can inform health programs seeking to increase physical activity in adults with DS. Interventions should consider the function of sleep and leisure in everyday life for long-term sustainability of physical activity.

Background: Insufficient sleep and circadian timing are both linked with obesity, primarily via unhealthy food choice, yet the cognitive mechanisms underpinning such relationships remain unclear.

Methods: Across two studies, we implemented an ecologically valid within-subjects at-home protocol. Study 1 (n = 118) involved a within-subjects examination of how sleep restriction (SR) versus well-rested (WR) sleep levels affect choices in a food-based approach-avoidance task (AAT) and go-no/go (GNG) task, a food liking task, a food-choice task, a psychomotor vigilance task (PVT), and a monetary choice task. Study 2 (n = 119) involved examining choices in the same set of tasks administered once in the afternoon (4pm) and once during the night (4am), which leveraged circadian influences on sleepiness and cognitive function.

Results: During the night, participants indicated steeper discounting rates relative to the afternoon. Furthermore, such rates predicted higher liking of high-calorie food choices regardless of time of day and when sleep restricted. Approach bias for low-calorie food interacted with the night condition in predicting both low- and high-calorie food choices.

Conclusion: Both delay discounting and approach bias may be important cognitive mechanisms predicting food liking and choice under sleep restricted and altered circadian timing conditions. Further research should replicate such results using real rewards.

Background: Breast cancer causes significant psychological and physical burden, with survivors often reporting persistent psychological symptoms, such as anxiety and depression, along with somatic symptoms like fatigue and pain. Psychological factors may protect from the development of long-term distress and help identify patients with greater needs for supervision and/or care. Here we aimed to study the predictive role of mindfulness as a trait in determining affective and somatic symptoms 12 months after cancer diagnosis.

Methods: Women with a diagnosis of breast cancer were recruited at the onset of systemic treatments and compared with healthy women from the general population. Over a 12-month period, participants were periodically assessed using the Mindfulness Attention Awareness Scale (MAAS), the Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 and the Positive and Negative Affect Scale. Regression models were employed to assess the predictive associations of baseline mindfulness trait with symptoms after 12 months.

Results: The study included 282 participants, 243 of whom contributed complete data for analysis. The Portuguese version of MAAS demonstrated adequate psychometric properties for patients with breast cancer, supporting its use to address our main aim. Mindfulness trait scores remained stable across time, did not differ significantly between patients and healthy participants, and were similarly stable across time for patients undergoing different treatments. Also in the clinical group, MAAS scores at baseline significantly predicted affective, but not somatic symptoms, 12 months later, with higher levels of mindfulness predicting more clinically significant distress.

Conclusions: In women with a recent diagnosis of breast cancer, mindfulness trait appears unaffected by diagnosis or its treatments, serving as a protective factor against affective, but not somatic, symptoms, in the first year following diagnosis.

Background: Noise-induced hearing loss is both irreversible and preventable. However, only a minority of adolescents and young adults engage in hearing protective behaviors (HPBs) that reduce their exposure to noise, such as wearing earplugs at music venues. To promote HPBs it is imperative to know the most influential, and potentially modifiable, psychological factors that in this age group stimulate or hinder these protective behaviors.

Objective: The present study aims to offer a systematic literature overview of psychological correlates of HPBs in persons aged 12 to 25 years, and identify the correlates with most potential as behavioral intervention targets.

Conclusions: A total of 82 studies were included in the present review, of which data of 24 studies could be used to assess the strength of the association between one or more psychological factors and HPB. Heterogeneity between studies hindered synthesis. In particular, psychological constructs and HPBs were rarely defined and measured in a uniform manner. Studies were further characterized by a lack of research on psychological factors related to other HPBs than earplug use, such as sound volume control (e.g. the use of a volume limiter). Due to this relative absence of data, associations could not be assessed for specific HPB, and HPBs were aggregated in one variable. Taking into account both the strength of their associations with HPB and their univariate distributions, five psychological factors possessed the greatest potential as behavioral intervention targets: attitude toward recreational noise, perceived barriers, capacity, perceived norms, and perceived threat susceptibility. These results can help the development of new interventions. Additional research is however needed.

Background: Smartphone Addiction (SA) is a rising global behavioral issue among adolescents. Extant studies rarely explore interventions to lower the risk of SA and increase resilience for adolescents.

Objective: To investigate the feasibility of the study protocol designed with a cluster-RCT and examine the preliminary effect of the first 4-week group mindfulness-based cognitive program (MBCP) on Smartphone Addiction risk and resilience in young adolescents.

Methods: A quasi-experimental approach was used. Two primary schools were randomly allocated into two study groups. 23 and 28 aged 10-11 adolescents were recruited for waitlist control and intervention groups, respectively. Intervention group received the first 4 weeks of the MBCP. The risk of Smartphone Addiction was measured by Smartphone Addiction Scale-Short Version. Smartphone behavior was evaluated by daily time spent on smartphone and frequency of using smartphone functions. Resilience was evaluated by Connor-Davidson Resilience Scale. Data was collected before intervention (T0) and after the fourth session (week 4,T1).

Results: Attrition rate, participation rate, and compliance with daily home practice were 10.7%, 80%, and 64%, respectively. There were no significant differences in outcome variables between groups. In within-group comparison, the posttest resilience score was significantly greater than that of the pretest in intervention group (Z = -2.37, p = 0.02), with a moderate effect size (d) of 0.52. No significant within-group differences were found for all smartphone behavioral outcomes (p > 0.05). However, the within-group effect size (d) of total smartphone addiction score in the intervention(I) group was larger than that of the control(C) (d _I =-0.13; d _C = 0.06). It gives clue to the potential influence of mindfulness practice on adolescents' smartphone behavior.

Discussion and conclusions: The preliminary findings suggest that MBCP may be a potential intervention to manage smartphone addiction problems in young adolescents in Hong Kong's school context. Further refinement of intervention protocol to boost parents' participation and compliance with daily practice is needed to ensure practice adherence.

Episodic future thinking (EFT), an intervention in which participants vividly imagine their future, has been explored as a cognitive intervention to reduce delay discounting and decrease engagement in harmful health behaviors. In these studies, participants generate text descriptions of personally meaningful future events. The content of these text descriptions, or cues, is heterogeneous and can vary along several dimensions (e.g. references to health, celebrations, family; vividness; emotional valence). However, little work has quantified this heterogeneity or potential importance for EFT's efficacy. To better understand the potential impact of EFT content in the context of health behavior change (e.g. diet) among people with or at risk for obesity and related conditions, we used data from 19 prior EFT studies, including 1705 participants (mean body mass index = 33.1) who generated 9714 cues. We used natural language processing to classify EFT content and examined whether EFT content moderated effects on delay discounting. Cues most commonly involved recreation, food, and spending time with family, and least commonly involved references to health and self-improvement. Cues were generally classified as highly vivid, episodic, and positively valent (consistent with the intervention's design). In multivariate regression with model selection, EFT content did not significantly moderate the effect of the episodic thinking intervention. Thus, we find no evidence that any of the content characteristics we examined were important moderators of the efficacy of EFT in reducing delay discounting. This suggests that EFT's efficacy is robust against variability in these characteristics. However, note that in all studies, EFT methods were designed to generate high levels of vividness, episodicity, and emotional valence, potentially resulting in a ceiling effect in these content areas. Moreover, EFT content was not experimentally manipulated, limiting causal inference. Future studies should experimentally examine these and other content characteristics and evaluate their possible role in EFT's efficacy.