International Journal of Behavioral Medicine最新文献

Background

Understanding the biological processes underlying poor self-rated health (SRH) can inform prevention efforts. The COVID-19 pandemic highlighted the importance of using self-reported measures and self-collected biospecimens, such as saliva, to understand physiological functioning and assist with health surveillance and promotion. However, the associations between salivary analytes and SRH remain understudied. The current study addresses this gap.

Methods

In a laboratory-based study, 99 healthy adults (M_age = 23.8 years, SD = 4.5, 55% men, 43% non-Hispanic White) reported their SRH and provided saliva and blood samples that were assayed for adiponectin, C-reactive protein (CRP), uric acid (UA), and cytokines (IL‐1β, IL‐6, IL‐8, TNF-α). Principal component analyses assessed the component loadings and generated factor scores for saliva and serum analytes. Binary logistic regressions examined the associations between these components and poor SRH.

Results

Salivary analytes loaded onto two components (component 1: adiponectin and cytokines; component 2: CRP and UA) explaining 58% of the variance. Serum analytes grouped onto three components (component 1: IL-8 and TNF-α; component 2: CRP, IL-1β, and IL-6; component 3: adiponectin and UA) explaining 76% of the variance. Higher salivary component 1 scores predicted higher odds of reporting poor SRH (OR 1.53, 95%CI [1.10, 2.11]). Higher serum component 2 scores predicted higher odds of reporting poor SRH (OR 2.37, 95%CI [1.20, 4.67]). When examined in the same model, salivary component 1 (OR 1.79, 95%CI [1.17, 2.75]) and serum component 2 were associated with poorer SRH (OR 7.74, 95%CI [2.18, 27.40]).

Conclusions

In our sample, whether measured in saliva or serum, indices of inflammatory processes were associated with SRH.

Background

Co-occurring chronic pain and posttraumatic stress disorder (PTSD) is associated with poorer physical and mental functioning and well-being. Treatments often incorporate goal-setting around personally meaningful behaviors; however, it is unclear whether intentionally focusing on improving meaning and purpose in life (i.e., meaning-as-goal) may also serve as a helpful treatment target. The objective of the current study is to determine whether reported progress toward meaning-as-goal at 6 months is associated with pain severity and interference, physical and mental health functioning, and global meaning and purpose at 6- and 12-months.

Methods

Data were collected as part of an evaluation effort focused on VA’s Whole Health System implementation efforts. VA electronic health records were linked to survey data across three time points (baseline, 6 months, and 12 months) from Veterans with both chronic pain and PTSD across 18 VA sites. A total of 1341 Veterans met inclusion criteria (mean age = 62, SD = 11.7).

Results

Regression analyses showed that progress toward meaning-as-goal was significantly associated with all 6-month variables, with standardized coefficients ranging from − 0.14 (pain severity and interference) to .37 (global meaning and purpose), in addition to all 12-month variables, with standardized coefficients ranging from − .13 (pain severity and interference) to .31 (global meaning and purpose).

Conclusions

Efforts to intentionally promote meaning and purpose as part of evidence-based treatment for chronic pain and PTSD may lead to decreased pain and improved physical and mental health functioning and global meaning and purpose. With coefficients ranging from small to moderate effect sizes, more work is needed to better understand how best to maximize meaning-related goals.

Background

Coping flexibility is one’s ability to modify their coping strategies and adapt to the demands of stressful situations. However, limited studies have demonstrated that coping flexibility directly influenced sleep quality. This study examined the relationships between coping flexibility, subjective distress, and sleep quality. We hypothesized that coping flexibility would enhance sleep quality via subjective distress.

Methods

In total 99 male and 151 female college students completed questionnaires on coping flexibility, subjective distress, and sleep quality. Subsequently, they completed the questionnaire on sleep quality six months later.

Results

Structural equation modeling showed a significant indirect effect of coping flexibility, which indicated that higher coping flexibility was associated with higher sleep quality via reduced subjective distress.

Conclusions

Our findings suggested that subjective distress and lower coping flexibility were risk factors for poor sleep quality.

Background

Since obesity has emerged as a major public health concern, there is an urgent need to better understand factors related to weight gain and treatment success.

Methods

This study included 118 persons with obesity who participated in a multidisciplinary combined lifestyle intervention with cognitive-behavioral therapy at the outpatient clinic of the Obesity Center CGG at Erasmus University Medical Center, Rotterdam, The Netherlands. Neighborhood characteristics were assessed using a 13-item questionnaire. Multiple regression analyses were performed to examine the association between perceived safety, social cohesion, and the availability of facilities on relative changes in body mass index and waist circumference changes, adjusted for corresponding neighborhood socioeconomic status scores.

Results

Higher total scores, indicating more unfavorable neighborhood perceptions, were associated with less relative improvements in BMI and waist circumference after 1.5 years (β = 3.2, 95%CI 0.3–6.0; β = 3.4, 95%CI 0.3–6.6, respectively). Also, more neighborhood unsafety was associated with less relative improvements in BMI and waist circumference on the long term (β = 3.1, 95%CI 1.1–5.1; β = 2.8, 95%CI 0.6–5.1, respectively).

Conclusion

The results indicate that living in a neighborhood perceived as less favorable may lower the chances of successful weight loss in response to combined lifestyle interventions in persons with obesity.

Background: Psychological distress can significantly obstruct the treatment outcomes of patients with psoriasis. This meta-analysis aimed to examine the effects of psychological intervention on the mental health and functional capabilities in patients with psoriasis.

Method: PubMed, EMBASE, and Cochrane Library were searched for relevant studies published up to May 1, 2023. The primary outcome was a change in anxiety, depression, and quality of life (QoL). Standardized mean difference (SMD) was calculated, and 95% confidence interval (CI) was determined for the estimation.

Results: This meta-analysis involved 1048 subjects, including 515 patients who received psychological interventions and 533 patients in control groups who did not receive psychological interventions. The results showed that psychological intervention significantly improved anxiety symptoms (SMD - 0.41; 95%CI - 0.77, - 0.05; I² = 71.5%; P_{Heterogeneity} = 0 .001). There was no significant improvement in the symptoms of depression (SMD - 0.52; 95%CI - 1.13, 0.10; I² = 86%; P_{Heterogeneity} < 0 .001) and QoL (SMD - 0.05; 95%CI - 0.22, 0.11; I² = 39%; P_{Heterogeneity} = 0 .108) in patients who received psychological intervention compared with controls.

Conclusion: Psychological intervention ameliorated anxiety symptoms in patients with psoriasis but had no significant impact on depression or QoL.

Purpose: To test the effectiveness and feasibility of a remotely delivered intervention to increase physical activity (walking) in middle-aged and older adults.

Design: This study used a personalized (N-of-1) trial design.

Setting: This study took place at a major healthcare system from November 2021 to February 2022.

Subjects: Sixty adults (45-75 years, 92% female, 80% white) were recruited.

Intervention: A 10-week study comprising a 2-week baseline, followed by four 2-week periods where four behavior change techniques (BCTs) - self-monitoring, goal setting, action planning, and feedback - were delivered one at a time in random order.

Measures: Activity was measured by a Fitbit, and intervention components delivered by email/text. Average daily steps were compared between baseline and intervention. Participants completed satisfaction items derived from the System Usability Scale and reported attitudes and opinions about personalized trials.

Results: Participants rated personalized trial components as feasible and acceptable. Changes in steps between baseline and intervention were not significant, but a large heterogeneity of treatment effects existed, suggesting some participants significantly increased walking while others significantly decreased.

Conclusions: Our intervention was well-accepted but use of BCTs delivered individually did not result in a significant increase in steps. Feasibility and heterogeneity of treatment effects support adopting a personalized trial approach to optimize intervention results.

Background: Encouraging adolescents with overweight/obesity to accurately perceive their weight in the belief that this will improve their lifestyle behaviors (physical activity (PA), sedentary behavior (SB), eating behavior (EB)) may be detrimental to their psychological health. This study aimed to investigate associations between weight underestimation and lifestyle behaviors along with psychological health in French adolescents with overweight or obesity.

Method: Baseline data from adolescents who participated in a school-based trial were used. Lifestyle behaviors and psychological health (anxiety, depression, eating disorders, quality of life (QoL)) were self-reported. Weight underestimation was measured by matching objective and perceived weight status. Multilevel models were computed to investigate associations between weight underestimation and lifestyle behaviors and psychological health, by gender.

Results: Of the 1245 adolescents included (15.3 ± 0.7 years), 15.8% underestimated their objective weight (boys 24.2%; girls 8.2%). Boys with underestimation had higher vigorous PA energy expenditure (β = 372.7 MET-min/week, 95%CI [25.1;720.4]), and lower daily sugar-sweetened beverages and foods consumption (β =  - 0.3 points, 95%CI [- 0.7; - 0.0]) than those with accurate perception. Girls with weight underestimation had lower eating disorder (β =  - 6.0 points, 95%CI [- 9.6; - 2.5]), anxiety (β =  - 7.8 points, 95%CI [- 13.8; - 1.9]), and higher QoL (β = 3.3 points, 95%CI [0.0; 6.5]) scores than girls with accurate perception.

Conclusion: Weight underestimation among adolescents with overweight or obesity was associated with healthier lifestyle behaviors in boys, and better psychological health (eating disorder, anxiety and QoL) in girls. Accurate perception of weight status may not be a relevant lever to improve lifestyle behaviors and psychological health.

Objective: Inflammatory bowel diseases (IBD) are accompanied by symptoms that can vastly affect patients' representations of their bodies. The aim of this study was to investigate alterations in body evaluation and body ownership in IBD and their link to interoceptive sensibility, gastrointestinal-specific anxiety, and history of childhood maltreatment.

Methods: Body evaluation and ownership was assessed in 41 clinically remitted patients with IBD and 44 healthy controls (HC) using a topographical self-report method. Interoceptive sensibility, gastrointestinal-specific anxiety and a history of childhood maltreatment were assessed via self-report questionnaires.

Results: Patients reporting higher interoceptive sensibility perceived their bodies in a more positive manner. Higher gastrointestinal-specific anxiety was linked to a more negative body evaluation particularly of the abdomen in patients with IBD. Childhood maltreatment severity strengthened the positive association between interoceptive sensibility and body ownership only in those patients reporting higher trauma load.

Conclusion: Altered body representations of areas associated with abdominal pain are linked to higher symptom-specific anxiety and lower levels of interoceptive sensibility in IBD. Particularly in patients with a history of childhood maltreatment, higher levels of interoceptive sensibility might have a beneficial effect on the patients' sense of body ownership.

Background: Perceived weight discrimination is associated consistently with worse health outcomes. Coping strategies may be one mechanism of this association. The present research examined the association between perceived weight discrimination and strategies used to cope with general stress (not weight-specific) and whether these strategies accounted for part of the association with markers of health.

Method: Participants (N = 1882) completed a cross-sectional survey with a comprehensive measure of coping strategies and reported on their perceived experience of weight discrimination and markers of physical, mental, and social health.

Results: Perceived weight discrimination was associated with greater use of disengaged coping strategies (β = .19, p < .01) and was unrelated to active and support coping strategies. Disengaged coping mediated the association between weight discrimination and worse physical, mental, and social health (proportion of mediation ranged from 14 to 47%). This pathway was independent of body mass index (BMI). Individuals in the obesity weight category (BMI ≥ 30 kg/m²) were less likely to use active (β =  - .11, p < .01) and support (β =  - .09, p < .01) coping strategies, which did not consistently mediate the association with health.

Conclusion: Perceived experiences of weight discrimination are associated with disengaged coping strategies to manage stressful experiences, and these strategies are one mechanism that may contribute to the worse health associated with unfair treatment due to weight.

Background: Social media is one of the major platforms for disseminating essential health messages. The present study examined the effect of message framing (self-interest motive, prosocial motive) on an online platform for parental intention to vaccinate against COVID-19. It also examined how the effect may vary across participants' levels of parental identity centrality/salience and community orientation before the vaccine was officially available.

Methods: Six hundred and sixty-three Hong Kong Chinese parents were recruited, and a total of 278 valid responses were retained in the analyses. Participants were randomly assigned to one of the three conditions: self-interest motive, prosocial motive, and control. Participants in the self-interest motive condition and the prosocial motive condition read a condition-specific message about the COVID-19 vaccine. Then, they reported their levels of intention to vaccinate against COVID-19, including parent-vaccination, child-vaccination, and medical information-seeking.

Results: A significant group effect on child-vaccination was found. Participants in the self-interest motive condition reported a higher intention to vaccinate their children against COVID-19 compared with the other two conditions. Results of moderation analyses indicated that communal orientation moderated the effect of a self-interest-motive-emphasized message on parental intention to vaccinate against COVID-19. The effect of a self-interest-motive-emphasized message appeared to be stronger on parent-vaccination, child-vaccination, and medical information-seeking among parents who reported lower levels of communal orientation.

Conclusion: These findings provided some initial evidence of the effectiveness of message-framing in promoting parents' intention to vaccinate their children on online platforms.