Journal of Behavioral Medicine最新文献

Firearm carriage poses a significant public health challenge, especially for youth (ages 14-24) living in predominantly Black communities that endured racial and economic segregation. Structural racism is a determinant of fatal and nonfatal firearm assaults, but the influence of structural racism on youth firearm carriage has received limited attention. Our study examines whether community violence exposure mediates the association between racialized economic segregation and youth firearm carriage. We analyzed data among 599 youths who sought emergency care and reported drug use within the past six months. Our mediation analysis revealed that increased racialized economic segregation was associated with higher perceived community violence. In turn, a heightened perception of community violence was associated with youth firearm carriage. Our findings advocate for upstream interventions that address the systemic marginalization of Black communities from economic isolation to mitigate community violence and, ultimately, reduce risk for youth firearm carriage.

Food-related decisions are one of the most frequently subject to self-control failure and play a significant role in regulating mood and emotions. Failure to exercise self-control itself is associated with negative outcomes, including poor mental health and happiness. As such, prior research examined the link between food related lack of self-control as a personality trait or experiences of loss of control in food choices with emotional states, general affect and mood, referred to as affective well-being. However, these studies often focused on either trait or state self-control. This study examines how individual differences in eating-related lack of self-control and daily experiences of loss control in food choices are jointly related to affective well-being, captured daily as feelings and dimensional affect. In a 21-day study among a non-clinical sample of adults (N = 97), baseline individual differences in lack of self-control over eating was positively associated with the proportion of days participants reported experiencing loss of self-control in food choices. These individual differences in lack of self-control were positively associated with daily feeling of distraction, boredom, shame, tiredness, loneliness, aimlessness, and negatively associated with positive affect averaged across 21-days. Daily experiences of loss of self-control in food choices were associated with feeling more distracted, ashamed, tired, and experiencing less positive affect on the next day. This study provides preliminary evidence of the complementary associations of trait self-control, daily experiences of loss of control around food selection and affective well-being in daily life.

Cancer patients' social networks, particularly their spouses or romantic partners, can promote or undermine their psychological adjustment. This study examined the relative associations of partner social support and social constraint with patients' psychological adjustment and further tested gender's moderating role in these associations. Participants were 124 patients newly diagnosed with colorectal cancer (M age = 56.6 years, 34% female), who completed questionnaires on perceived spousal social support and social constraint, depressive symptoms, and life satisfaction. Findings revealed that greater social constraint was significantly associated with lower life satisfaction regardless of gender; however, greater social constraint was only associated with greater depressive symptoms in male patients. No significant associations or interactions with social support were found. Findings highlight the importance for patients-especially male patients-with cancer to feel able to disclose cancer-related thoughts and feelings to their partners and call for more consistent operationalization and measurement when studying patients' social functioning.

Cancer worry and risk perception are relevant psychological factors that influence preventive health behaviors. Therefore, a thorough understanding of the factors that impact their occurrence and manifestation is critical. The objective of this study was to assess prevalence and factors associated with worry about prostate cancer (PCa) and absolute/comparative risk perception in a community-based sample of 45-year-old men. Data were collected within the German PCa screening trial PROBASE. Variables were assessed by self-report questionnaires and a clinical interview. Worry about PCa and absolute/comparative risk perception were assessed each on a 5-point-Likert scale. Multivariable logistic regression was used to identify factors associated with the outcomes of interest. Data were available for 33,476 (72.0%) of 46,495 men at enrollment. 7.3% had sometimes/(very) often worry about PCa. 3.7% and 9.9% perceived their absolute risk and comparative risk as somewhat high/very high and somewhat higher/much higher, respectively. 18.8% reported a positive PCa family history. Important factors of worry about PCa, absolute risk perception, and comparative risk perception were lower urinary tract symptoms (LUTS) (OR 3.00, 95% CI 2.63-3.42; OR 2.09, CI 1.71-2.56; OR 2.41, CI 2.10-2.76) and a positive PCa family history (OR 2.35, CI 2.08-2.65; OR 15.13, CI 12.73-17.97; OR 9.69, CI 8.76-10.72). A positive history of urological (OR 3.85, CI 2.63-5.63) and non-urological cancers (OR 1.97, CI 1.52-2.54) were associated with a higher comparative risk perception. In conclusion, worry about PCa and risk perception are influenced by non-cancer-related symptoms as well as by a positive PCa family history. These findings need to be addressed in risk communication with patients.

Background: Tobacco is an addictive substance associated with numerous serious health effects during pregnancy. Pregnant women who smoke face considerable social disapproval, which could be a barrier to seeking healthcare and ultimately to smoking cessation. This study explored how perceived stigma (i.e., smokers' beliefs about negative judgments of them) and internalized stigma (i.e., internalization of stigmatizing attitudes toward them) may be associated with smoking reduction during pregnancy, reactions to smoking health warnings, and the intention to discuss smoking with health professionals.

Methods: A total of 83 pregnant French women who smoke were recruited from maternity wards and online. Participants filled out self-administered online questionnaires assessing smoking dependance (Cigarette Dependance Scale, CDS-5), perceived and internalized smoking stigma (Pregnant Smoker Stigma Scale - Self Stigma, P3S-SS), depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS), reactance to smoking health warnings (shortened version of the Reactance to Health Warnings Scale), and intention to discuss smoking with health professionals (dedicated questionnaire).

Results: In multiple regression analyses that controlled for depressive symptoms and dependance scores, perceived stigma was associated with more reactance (β = 0.35) and less smoking reduction (β = -0.31), whereas internalized stigma was associated with less reactance (β = - 0.0.28). Finally, reactance was associated with less intention to discuss smoking with healthcare professionals (β = -0.26).

Conclusions: These results suggest that perceived stigma may influence reactance to health warnings and smoking reduction during pregnancy, while also indicating that reactance could reduce the intention to consult healthcare professionals. Public health stakeholders should consider how to address the stigmatization of people who smoke, particularly pregnant women, in health communication strategies.

This study investigates the psychological mechanisms through which a removal of mentholated tobacco products from retail stores affects future smoking intentions among youth. Descriptive norms and injunctive norms were examined as candidate mediators. The study was conducted in the RAND StoreLab (RSL), a life-sized replica of a convenience store developed to evaluate how changing point-of-sale (POS) tobacco advertising influences tobacco use outcomes during simulated shopping experiences. Participants were assigned to shop randomly in the RSL under one of three experimental conditions that were (1) status quo condition in which all tobacco-, sweet-, and menthol-flavors were displayed; (2) tobacco/menthol condition in which only tobacco- and menthol-flavored tobacco products were displayed (sweet characterizing flavors other than tobacco or menthol/mint were removed from the display, effectively "banned"); and (3) tobacco-only condition in which only tobacco-flavored products were displayed (all sweet- and menthol-flavored products were removed). Results revealed that injunctive norms mediated the relationship between the removal of menthol cigarettes from the POS setting and increased intentions to smoke menthol-flavored cigarettes, whereas descriptive norms were not a significant mediator. These findings suggest that targeting injunctive smoking norms in public health communications may be a promising strategy to mitigate potential unintended consequences of a menthol ban on future smoking intentions for youth.

Risk perceptions are instrumental in predicting how people will process and react to threats. While social contexts have long been associated with changes in risk perception, whether and which social contexts alter risk perceptions is not well understood. This paper explores one such social context--support-giving--which has previous links to affect, cognition, and behavior, including how threats are processed. Using a tripartite model in which risk perceptions are split between deliberative (logical), affective (emotional), and experiential (lived) assessments, we used two studies, a longitudinal-correlational (Study 1) and experimental (Study 2), to explore whether support-giving relates to and impacts risk perceptions. Findings from Study 1 revealed that support-giving toward a close other at Time 1 was associated with an increase in affective risk perceptions at Time 2. Study 2 clarified the direction of this association, finding that there was an increase in affective and experiential risk perceptions for those randomly assigned to a support-giving condition, as compared to the control. Deliberative risk perceptions did not differ between conditions. Given that affective risk perceptions strongly predict behavior, support-giving may be a promising new avenue by which to inspire preventative behavior.

A significant number of gynecologic and breast cancer survivors report chronic issues with pain during sexual activity. The fear-avoidance (FA) model of chronic pain provides a potential framework for addressing chronic sexual pain. The purpose of this study is to investigate the relationships among components of the FA model (acute pain, anxiety, avoidance, and distress) among gynecologic and breast cancer survivors to help identify those who may be at risk for chronic sexual pain. Gynecologic and breast cancer patients (n = 97) completed baseline questionnaires as part of a psychosexual intervention. Linear regression model was used to test components of the FA model. Overall, 17-34% of female cancer survivors experienced pain related to sexual activity in the month prior to enrolling in a psychosexual intervention trial. Further, 51% of participants reported clinically significant levels of sexual distress. Results of a multiple linear regression show that sexual distress was significantly associated with acute sexual pain (Standardized β = 0.34, p <.01), anxiety (Standardized β = 0.28, p <.05), and avoidance of sexual activity (Standardized β = 0.28, p <.01) when controlling for sexual activity. Survivors of breast and gynecologic cancer entering a sexuality treatment study reported pain with sexual activity. Further, sexual distress was significantly associated with acute sexual pain, anxiety, and avoidance of sexual activity, pointing to contributions each of these FA model components have on sexual distress in this population. These findings point to the need for interventions to explicitly address anxiety and avoidance of chronic sexual pain among female cancer survivors.

Antiretroviral therapy (ART) is effective in reducing HIV transmission and mortality, yet daily adherence remains a challenge for many people with HIV (PWH). Suboptimal adherence can lead to virological failure and increased mortality, particularly among those with substance use disorders, such as cocaine use disorder (CUD). The Information-Motivation-Behavioral (IMB) skills model offers a framework to understand and enhance ART adherence by addressing individual and social barriers. In this study, we tested the IMB skills model among 80 cocaine-using PWH currently on ART, and found that behavioral skills significantly predicted adherence. In the extension of the IMB skills model, the addition of practical barriers altered the relationship by showing that motivational barriers such as treatment fatigue and practical barriers significantly affected ART adherence. The findings suggest that for PWH with substance use disorders, addressing practical barriers and motivational factors may be crucial for improving ART adherence, in addition to building behavioral skills.

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.