Psychosomatic Medicine最新文献

Objective: In daily life, we must dynamically and flexibly deploy strategies to regulate our emotions, which depends on awareness of emotions and internal bodily signals. Variability in emotion-regulation strategy use may predict fewer negative emotions, especially when people pay more attention to their bodily states-or have greater "interoceptive attention" (IA). Using experience sampling, this study aimed to test whether IA predicts variability in strategy use and whether this variability and IA together predict negative affect.

Methods: University student participants ( n = 203; 165 females; Mage = 20.68, SD age = 1.84) completed trait questionnaires and reported state levels of IA, emotional awareness, negative affect, and emotion-regulation strategies, seven times daily for 1 week.

Results: State IA significantly predicted between-strategy variability, which was mediated by emotional awareness (indirect effect = 0.002, 95% confidence interval = <0.001-0.003). Between-strategy variability was associated with lower negative affect, particularly when individuals had higher state IA (simple slope = -0.83, t = -5.87, p < .001) versus lower IA (simple slope = -0.31, t = -2.62, p = .009).

Conclusions: IA appears to facilitate adaptative emotion regulation and help alleviate negative affect. Findings underscore the key roles of IA and emotion-regulation flexibility in mental health.

Objective: Expectations are highlighted as a key component in placebo effects. However, there are different approaches to whether and how placebo studies should account for expectations, and the direct contribution has yet to be estimated in meta-analyses. Using different methodological approaches, this meta-analysis and systematic review examines the extent to which expectations contribute to pain in placebo studies.

Methods: The databases PubMed, PsycINFO, Embase, and Web of Science were searched for placebo analgesia mechanism studies with numerical measures of both expectations and pain. Thirty-one studies, comprising 34 independent study populations (1566 subjects: patients and healthy participants) were included. Two meta-analyses were conducted: meta-analysis 1, using study-level data, estimated the effect of expectation interventions without taking measures of expectations into account (expectations assumed); and meta-analysis 2, using individual-level data, estimated the direct impact of participants' expectations on pain (expectations assessed). Risk of bias was assessed using the Cochrane risk-of-bias tool.

Results: Meta-analysis 1 showed a moderate effect of expectation interventions over no expectation intervention on pain intensity (Hedges g = 0.45, I2 = 54.19). Based on 10 studies providing individual-level data, meta-analysis 2 showed that expectations predicted pain intensity in placebo and control groups ( b = 0.36, SE = 0.05), although inconsistently across study methodologies.

Conclusions: Participants' expectations contributed moderately to pain in placebo analgesia studies. However, this may largely be influenced by how we measure expectations and how their contribution is conceptualized and analyzed-both within and across studies.

Objective: American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique sociocultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional sociocultural factors, and pain among urban AI/AN emerging adults.

Methods: AI/AN participants aged 18-25 years ( N = 417) were recruited via social media. Regression models tested associations between socioeconomic disadvantage (income and ability to afford health care) and pain as well as additional sociocultural factors (discrimination, historical loss, cultural pride and belonging, visiting tribal lands) and pain. Multigroup regression models tested whether associations between sociocultural factors and pain differed between participants who were socioeconomically disadvantaged and those who were less disadvantaged.

Results: In the full sample, lower income ( b = 1.00-1.48, p < .05), inability to afford health care ( b = 1.00, p = .011), discrimination ( b = 0.12, p = .001), and historical loss ( b = 0.24, p = .006) were positively associated with pain, whereas visiting tribal lands was negatively associated with pain ( b = -0.86 to -0.42, p < .05). In the multigroup model, visiting tribal lands 31+ days was negatively associated with pain only among the less socioeconomically disadvantaged group ( b = -1.48, p < .001).

Conclusions: Socioeconomic disadvantage may, in part, drive pain disparities among AI/AN emerging adults and act as a barrier to benefitting from visiting tribal lands. Results support a biopsychosocial approach to targeting pain in this population, including addressing socioeconomic challenges and developing culturally informed, strengths-based interventions.

Objective: Antibody response to vaccination is a powerful paradigm for studying the effects of chronic stress on immune function. In the present study, we used this paradigm to examine the interaction between caregiving (as a type of chronic stress) and sex on the antibody response to a single dose of a COVID-19 vaccination; recent research has called for examination of sex differences on health outcomes among family caregivers. A three-way interaction between caregiving, sex, and psychological distress was also examined.

Methods: COVID-19 antibody data were extracted from 165 caregivers (98 females) and 386 non-caregivers (244 females) from the UK's Understanding Society COVID-19 study. Relevant sociodemographics, health and lifestyle, and distress variables were gathered as potential covariates.

Results: In a 2 × 2 ANOVA, we found that the interaction between caregiving and sex was significant; male caregivers had a lower antibody response to the vaccine compared to female caregivers ( F (1,547), =24.82, p < .001, η2p = 0.043). Following adjustment, male caregivers had the lowest antibody response relative to all other groups. The three-way interaction model, controlling for covariates, was also significant ( R2 = 0.013, p = .049); the conditional effects for the three-way interaction revealed that male caregivers, compared to the other groups, had a lower antibody response at both low and medium levels of psychological distress.

Conclusion: This study found evidence of a three-way interaction between caregiving, sex, and distress on antibody response. Male caregivers had poorer antibody response to a single shot of the COVID-19 vaccination than female caregivers and male and female non-caregivers, and this was evident at low and medium levels of distress. Our findings will be discussed in relation to the caregiver and sex interactions during the pandemic.

Objective: Multimorbidity or the co-occurrence of multiple health conditions is increasing globally and is associated with significant psychological complications. It is unclear whether digital mental health (DMH) interventions for patients experiencing multimorbidity are effective, particularly given that this patient population faces more treatment resistance. The goal of the current study was to examine the impact of smartphone-delivered DMH interventions for patients presenting with elevated internalizing symptoms that have reported multiple lifetime medical conditions.

Methods: This preregistered (see https://osf.io/vh2et/ ) retrospective cohort intent-to-treat study with 2819 patients enrolled in a therapist-supported DMH intervention examined the associations between medical multimorbidity (MMB) and mental health outcomes.

Results: Results indicated that more MMB was significantly associated with greater presenting mental health symptom severity. MMB did not have a deleterious influence on depressive symptom trajectories across treatment, although having one medical condition was associated with a steeper decrease in anxiety symptoms compared to patients with no medical conditions. Finally, MMB was not associated with time to dropout, but was associated with higher dropout and was differentially associated with fewer beneficial treatment outcomes, although this is likely attributable to higher presenting symptom severity, rather than lesser symptom reductions during treatment.

Conclusions: Overall, the Meru Health Program was associated with large effect size decreases in depressive and anxiety symptoms regardless of the number of MMB. Future DMH treatments and research might investigate tailored barrier reduction and extended treatment lengths for patients experiencing MMB to allow for greater treatment dose to reduce symptoms below clinical outcome thresholds.

Objective: Acute exercise elicits various biobehavioral and psychological responses, but results are mixed with regard to the magnitude of exercise-induced affective reactions. This meta-analysis examines the magnitude of general mood state, anxiety, and depressive symptom responses to acute exercise while exploring exercise protocol characteristics and background health behaviors that may play a role in the affective response.

Methods: A total of 2770 articles were identified from a MEDLINE/PubMed search and an additional 133 articles from reviews of reference sections. Studies had to have measured general mood before the acute exercise bout and within 30 minutes after exercise completion. Effect sizes were estimated using Hedges' g , with larger values indicating improvement in the outcome measure.

Results: A total of 103 studies were included presenting data from 4671 participants. General mood state improved from preexercise to postexercise ( g = 0.336, 95% confidence interval [CI] = 0.234-0.439). Anxiety ( g = 0.497, 95% CI = 0.263-0.730) and depressive symptoms ( g = 0.407, 95% CI = 0.249-0.564) also improved with exercise. There was substantial and statistically significant heterogeneity in each of these meta-analyses. This heterogeneity was not explained by differences in participants' health status. Meta-regression analyses with potential moderators (intensity of exercise, mode of exercise, usual physical activity level, or weight status of participants) also did not reduce the heterogeneity.

Conclusion: This meta-analysis shows significantly improved general mood, decreased anxiety, and lower depressive symptoms in response to an acute bout of exercise. There was substantial heterogeneity in the magnitude of the effect sizes, indicating that additional research is needed to identify determinants of a positive affective response to acute exercise.