Journal of Behavioral Medicine最新文献

Pain is a common medical experience, and patient access to pain management could be improved with novel intervention formats. Emerging evidence indicates brief, asynchronous, single-session interventions delivered in the clinic waiting room can improve patient outcomes, but only a few treatment modalities have been investigated to date. Breathwork is a promising approach to managing acute clinical pain that could be delivered asynchronously in the clinic waiting room. However, the direct impact of a breathwork intervention (e.g., brief cyclic sighing) on patients' pain and psychological distress (e.g., anxiety and depression symptoms) while waiting in the clinic waiting room remains unexamined. This single-site, pilot, randomized controlled trial examined the impact of a 4-minute, asynchronous, cyclic sighing intervention on participants' acute clinical symptoms in the x-ray waiting room of a walk-in orthopedic clinic relative to a time- and attention-matched injury management control condition. Pain unpleasantness, pain intensity, anxiety symptoms, and depression symptoms were measured in the study. Participants receiving the cyclic sighing intervention reported significantly less pain unpleasantness and pain intensity while waiting for an x-ray relative to controls. Anxiety symptoms and depression symptoms were not found to differ by condition. Results from this RCT indicate a brief, asynchronous, cyclic sighing intervention may be capable of quickly decreasing pain in the waiting room. Continued investigation is now needed to determine if embedding brief, asynchronous, cyclic sighing interventions in clinic waiting rooms has the potential to help people experiencing acute pain feel better faster. CLINICAL TRIAL REGISTRATIONS: NCT06292793.

This study examined associations between food insecurity (FI) severity, anxiety symptoms, and sleep duration among young adults in food-insecure households. We hypothesized that more severe FI and higher anxiety would independently predict shorter sleep duration, and that anxiety would amplify the FI-sleep duration relationship. Analysis was conducted on a subsample (n = 96) of the EAT 2010-2018 young adult cohort. Participants completed the U.S. Household Food Security Survey Module, Generalized Anxiety Disorder-7, and sleep assessment items. Linear regression models, controlling for demographics, showed that increased anxiety symptoms were associated with decreased sleep duration (p < .001), while FI severity was not significantly associated. A synergistic interaction between FI severity and anxiety (p = .04) revealed that individuals with severe FI and high anxiety had the shortest sleep duration. Results suggest that people struggling with both FI and anxiety may be at high risk of short sleep. Future interventions for individuals with FI should consider anxiety's role in influencing sleep disturbance.

Interest in the implicit processing of activity behaviors has been growing, but the psychometric properties of its measurement are often overlooked. This study examined the reliability and validity of two implicit association tests (IATs) designed to assess implicit affective and motivational processes. In the first session, 101 college students completed a Liking-IAT, a Wanting-IAT, and a survey on their attitudes and intentions regarding physical activity and sedentary screen-based recreational activities. One week later, participants reported their engagement in these activities, and 34 of them completed the IATs again. The psychometric evaluation revealed high split-half correlation coefficients and significant correlations with behavioral attitudes and intentions for both the IATs, indicating good split-half reliability and convergent validity. The Liking IAT but not the Wanting IAT demonstrated satisfactory test-retest reliability over a one-week interval and predictive potential for weekend physical activity and screen time. Divergence in psychometric performances suggests underlying differences in corresponding implicit processes, highlighting the need for further investigation into the temporal validity, sensitivity to change, and the interplay of various implicit processes.

Multimodal digital health assessments overcome the limitations of patient-reported outcomes by allowing for continuous and passive monitoring but remain underutilized in older adult lifestyle interventions for brain health. Therefore, we aim to (1) report ecological momentary assessment (EMA) and ActiGraph adherence among older adults during a lifestyle intervention; and (2) use dynamic data collected via EMA and ActiGraph to examine person-specific patterns of mindfulness, steps, and sleep throughout the intervention. We analyzed EMA and ActiGraph data from a pilot study of the 8-week My Healthy Brain program (N = 10) lifestyle group for older adults (60+) with subjective cognitive decline. EMA adherence metrics included proportion of EMA completed and the proportion of days with at least 10 mindfulness minutes. ActiGraph GT9X adherence metrics included the number of valid wear days (≥ 7 h) and the number of days participants achieved their step goal. We used linear mixed-effects models to examine person-specific patterns of step count, sleep efficiency, and mindfulness practice. On average, participants completed 39 of the 49 possible EMAs (80%) during the program. ActiGraph adherence was slightly higher than EMA (M = 61.40 days, 87.71%). Participants achieved the daily mindfulness goal (10 min/day) and step goal on 46.32% and 55.10% of days, respectively. Dynamic data revealed that on average, participant step counts increased by approximately 16.5 steps per day (b = 16.495, p = 0.002). However, some participants exhibited no changes while improvements made by other participants returned to baseline levels of activity. There was substantial heterogeneity in trajectories of mindfulness practice and sleep efficiency. EMA and ActiGraph are feasible for older adults enrolled in dementia risk reduction lifestyle interventions. Future studies are needed to better understand how mechanisms of lifestyle behaviors captured by EMA and ActiGraph are related to cognitive outcomes in older adults.

The theory of planned behavior is a social cognition theory that has been widely applied to identify the psychological determinants of intentions and behavior in health contexts. Our 2015 meta-analysis of theory applications in chronic illness contributed to a burgeoning evidence base comprising syntheses supporting theory predictions in health behavior. In this review, we identify limitations of prior meta-analyses of theory applications in health behavior and highlight salient evidence gaps, summarize how recent meta-analyses of the theory have addressed some of the limitations, outline outstanding research questions, and suggest future research syntheses, including those currently in progress, to resolve them. We point to recent and ongoing meta-analyses addressing theory hypotheses and assumptions not tested in previous syntheses, such as perceived behavioral control moderating effects and indirect effects of environmental (e.g., sociostructural variables) and intrapersonal (e.g., personality traits) determinants on health behavior mediated by theory constructs. We also highlight meta-analyses examining behavioral effects of constructs representing extended processes (e.g., habit, implicit cognition) in the context of the theory. Further, we summarize recent meta-analyses addressing directional and causal inferences in theory effects, including meta-analyses of longitudinal studies and experimental and intervention research. We also highlight attempts to test the mechanisms of action of interventions based on the theory including the change meta-analysis method and mediation analyses. We conclude by summarizing the advances that recent meta-analyses of the theory have made to the evidence base of health behavior determinants and interventions and highlighting suggestions for meta-analyses that will further progress the evidence base.

Here we present an updated systematic review identifying studies published 2019-2024, since our prior systematic review in 2020, that examine the association between minority stress and a biological outcome among sexual and gender minority (SGM) people. Pubmed, Web of Science, and Embase were queried to identify studies that examined an association between minority stress (including prejudice events and conditions, anticipation of rejection and discrimination, concealment or disclosure of SGM identity(ies), internalized stigma, or structural stigma) and a biological health outcome among SGM people. Included studies were coded for methodological approaches, study population, minority stress measure, biological outcomes, count of overall analyses, and count of analyses where an association was detected. Fifty-nine studies met inclusion criteria and included a total of 391 analyses between an element of minority stress and a biological outcome, among which 38% of analyses detected an association (44% detected this association when study outliers were removed). All elements of minority stress demonstrated associations with outcomes: multicomponent measures, prejudice events and conditions, and structural stigma demonstrated the highest proportion of associations. Associations with minority stress were detected for general physical health, sleep, immune, cardiovascular, metabolic, hormonal, brain health, allostatic load, epigenetic and transcriptional regulation. The highest proportion of associations were detected among sleep, immune, cardiovascular, and hormonal outcomes. These studies evidence associations between minority stress and biological outcomes among gender minority people in addition to evidence among sexual minority people. Future research should consider increasing rigor in methodology and expanding our understanding of moderators and mediators of these relationships.

Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages. Pediatric participants (early childhood n = 2074, M_age = 6.4 ± 0.9 y; middle childhood n = 3230, M_age = 9.6 ± 1.2 y; adolescence n = 1416, M_age = 15.2 ± 1.7 y) were part of the Environmental influences on Child Health Outcomes (ECHO) Program. They completed neurocognitive tasks measuring cognitive flexibility, behavioral inhibition, and working memory. Parent- and/or child-report measures of dietary intake, physical activity, sleep duration and quality, income, and positive parenting were also collected. Neighborhood crime and greenspace were calculated from publicly available census-tract level indices. After adjusting for study site, child body mass index, and demographics, working memory was related in the hypothesized direction to several dietary behaviors within all pediatric life stages. Working memory and cognitive flexibility were positively related to physical activity in middle childhood and adolescence. In adolescence, behavioral inhibition was positively related to physical activity and inversely related to sugar-sweetened beverage and total caloric intake. Associations with sleep were all non-significant. All significant associations reflected small effect sizes. Income, positive parenting, greenspace, and crime did not significantly influence any of the EF-health behavior associations. Findings highlight the need to consider EF domains, specific health behaviors, and developmental stage in creating intervention strategies that target EF to improve health behaviors. The small effect sizes reinforce the need for multi-tiered interventions to maximize health.

The landscape of nicotine use in the United States (US) has continued to evolve, with electronic cigarette use (hereafter e-cigarette) becoming more evident in recent years. Patterns of dual nicotine use, or using combustible nicotine in conjunction with e-cigarettes, may increase dependence on nicotine, continued exposure to toxins, and corresponding health risks. One of the most prevalent health problems related to nicotine use is the experience of chronic pain. Past work has established a bidirectional relationship between nicotine use and pain, such that pain motivates nicotine use and nicotine use contributes to pain. However, no work has explored differences in negative mood and pain experience as a product of nicotine use type among adults with chronic low back pain. The current cross-sectional study examined whether dual cigarette/e-cigarette use was associated with greater anxiety, depression, and pain experience among a sample of adult nicotine users (cigarettes and/or e-cigarettes) with self-reported mild to severe chronic low back pain (N = 1034, 66.0% female, M_age= 44.47 years, SD = 11.63). Results indicated that, compared to exclusive combustible nicotine users, dual cigarette/e-cigarette users had statistically significantly higher anxiety, depression, and pain disability scores, beyond the effects of age, sex, education, and use of opioid medications for pain. No significant group differences emerged as a function of exclusive e-cigarette use. The current findings highlight that dual cigarette/e-cigarette use may serve to mark a subpopulation of persons with chronic low back pain who present more complicated clinical features that require comprehensive care.

Background: A few studies have examined psychological resilience as a predictor of physiological responses to acute stress; however, no studies have directly examined psychological resilience as a moderator of subjective responses to acute stress.

Methods: Adults were recruited to participate in an acute stress response study that was conducted remotely. Demographics, psychological resilience, nicotine use and desire to quit, and information related to cannabis use were measured during a medical screening session. Positive, stressed, and anxious moods were measured during baseline rest prior to acute stress, after performing acute stress tasks, and after 30- and 55-minutes of post-stress recovery during an acute stress session.

Results: Acute stress was successfully induced during the remote audio-video stress session. There were significant increases in stressed and anxious moods and significant decreases in positive mood immediately after the acute stress tasks, followed by a return to baseline levels of these moods. Moreover, psychological resilience was inversely related to stressed and anxious moods reported at baseline and immediately after acute stress. In addition, psychological resilience was positively related to positive mood.

Conclusion: The results are consistent with previous research linking psychological resilience to general reports of positive and negative affect. Further, the results demonstrate, for the first time, that psychological resilience may be a significant predictor of negative mood immediately after acute stress.

Type 1 and type 2 diabetes are metabolic disorders that require one to manage one's blood glucose levels on a daily basis through a series of behaviorally complex tasks. Research shows that psychosocial factors, including mood, stress, and social relationships, have a significant influence on one's ability to maintain these disease management routines and achieve healthy blood glucose levels. However, researchers have typically approached these questions from a between-person perspective. Here, we argue for greater consideration of short-term, within-person links of psychosocial factors-including mood, stress, and social interactions-to glucose outcomes. Drawing from existing social and health psychology theories, we put forth an organizing theoretical framework describing how psychosocial experiences may operate on glucose outcomes over subsequent hours. We then review the small but burgeoning literature of intensive longitudinal studies that have examined the short-term effects of negative affect, positive affect, stress, and social interactions on glucose outcomes. Findings showed somewhat stronger links for negative affect and stress compared to positive affect and social interactions, but studies varied greatly in their methodologies, making direct comparisons challenging. A number of findings, particularly in the social interaction literature, depended on dispositional or contextual factors, further complicating interpretation. There was little investigation of the mechanistic pathways that may connect psychosocial factors to glucose outcomes, and few studies conducted lagged analyses to probe the directionality of these links. We conclude by proposing best practices for future research that will address the key weaknesses in the extant literature.