Health Psychology最新文献

Objective: Differences in automatic cognitive processes exist among individuals with overweight and obesity, thus there is a need to expand our conceptualization of overweight and obesity to emphasize the predictive utility of these automatic processes, rather than focusing solely on behavioral outputs. Implicit association tests (IATs) may afford a noninvasive method of examining automatic preferences that might contribute to overweight and obesity; namely, preferences for unhealthy foods and sedentary behavior versus healthy foods and physical activity. The purpose of the current study was to examine whether implicit attitudes toward foods and physical activity differed based on body mass index (BMI) status. The relationships between implicit attitudes and key psychosocial factors and health behaviors were also examined.

Method: Participants (N = 127) included undergraduate students with an average age of 19.05 years old (SD = 1.52). Average BMI of the sample was 24.20 (SD = 4.93); 33.8% met criteria for overweight or obesity. Participants completed an IAT and questionnaires.

Results: There were no differences in implicit preferences based on BMI or BMI status. Overall, the sample demonstrated implicit preferences for healthy foods and active words, and preferences were not linked to the corresponding behavioral outputs, though preferences were linked to various indices of emotion and emotion regulation.

Conclusions: Future research should explore an extended model to examine how implicit preferences might impact intentions to engage in protective versus risky obesity-related health behaviors, and the various psychosocial factors that might impact the translation of those preferences and intentions in actual behavioral outputs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden of mental and physical symptoms. Across illnesses, patients' subjective illness beliefs (i.e., illness perceptions [IPs]) correlate with psychological and physical health status. Despite this, IPs in NSCLC patients are understudied. To address this gap, previous research identified three profiles characterizing IPs of newly diagnosed NSCLC patients: "coping" (those more positive perceptions of NSCLC); "coping but concerned" (similar positive perceptions but high concern); and "struggling" (uniformly negative perceptions; Valentine et al., 2022). This extension seeks to determine if IPs are predictive. Would patients' psychological and physical health trajectories differ by IP profile?

Method: Patients with Stage IV NSCLC (N = 186) from a prospective cohort (2017-2019; NCT03199651) enrolled at diagnosis participated and completed an IP measure and anxiety, depression, physical symptom, and health status outcome measures monthly for 8 months. Linear mixed models tested profile membership (see above) as predictive of outcome trajectories, with those "struggling" having the poorest outcomes.

Results: Eight-month trajectories for anxiety and some physical symptoms showed significant improvement, whereas depression, dyspnea, pain, and self-rated health did not. As anticipated, profile membership was predictive: "struggling" profile patients reported significantly worse anxiety and depression symptoms, physical symptoms, and health compared to "coping" patients. There were no interactions between profile and time. Generalization to samples from U.S. states with greater racial/ethnic diversity is unknown.

Conclusion: Novel data show "struggling" profile patients to have uniformly negative outcomes and specify IP content relevant for inclusion in cognitive behavioral therapies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: High rates of undiagnosed Type 2 diabetes mellitus (T2DM) necessitate additional efforts to increase risk awareness, particularly among marginalized and immigrant populations. We examined the association of acculturation with the likelihood of accurate perception of T2DM risk in a large nationally representative sample of adults at risk for T2DM.

Method: Participants were 5,034 adults, M (SD) age: 53 (23) years, 48% female. Acculturation was operationalized as length of time in the United States, and whether participants predominantly spoke English or their native language at home. Adults were considered to have accurate risk perception if they (a) met American Diabetes Criteria for prediabetes, and (b) self-reported their risk.

Results: Less than half of the sample (33%) accurately perceived their T2DM risk. Logistic regression models adjusting for age, race, sex, education, insurance status, smoking, alcohol use, waist circumference, and family history of T2DM revealed that adults living in the United States up to 15 years were 1.35-2.33 times (ps < .04) as likely to inaccurately perceive their risk for T2DM compared to adults living in the United States > 15 years and United States-born adults. Adults with lower versus higher English proficiency had a 41% (p = .03) increased likelihood of misperceiving their T2DM risk.

Conclusions: Findings suggest that acculturation plays an important role in shaping T2DM risk perceptions among both nonimmigrant and immigrant populations. Increased cognizance of acculturation status (e.g., by healthcare providers) may be warranted to promote early T2DM risk detection and prevention at the population level. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: We tested whether an intervention's dosage influences health behavior change. Intervention dosage was indexed by the duration of the intervention, the number of sessions, and total contact time in treatment arms of trials to promote physical activity.

Method: The research comprised two studies. In Study 1, we synthesized 161 meta-analyses of physical activity interventions to examine the relationship between intervention dosage and intervention impact on physical activity. Study 2 comprised a reanalysis of primary studies.

Results: The relationship between the indices of dosage and intervention effect sizes was assessed in 23.6% of meta-analyses, and associations did not differ from zero in 70%-85% of tests (Study 1). In Study 2, we retrieved 838 tests for duration, 370 tests for the number of sessions, and 167 tests for contact time. Duration had a very small negative association with effect sizes (b = -.002, 95% confidence interval [-.003, -.001]); number of sessions and contact time were not related to intervention effectiveness. An exploratory study (N = 50) indicated that health psychology researchers overestimated the association between dosage and effect sizes (r_estimates > .25).

Conclusions: Although physical activity interventions with a higher dosage are expected to be more effective, the findings showed no relationship between dosage and intervention impact. Intervention dosage may moderate the influence of intervention content rather than directly determine physical activity change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To examine the rates as well as the interdependence of depressive symptoms and sleep problems in patients with cancer and their intimate partner family caregivers.

Method: Patients diagnosed with cancer (69.3 years old, 56.9% male) and their intimate family caregivers (63.8 years old, 30.7% male) were enrolled in the study (n = 188 dyads). Both patients and intimate partner family caregivers completed the Center for Epidemiological Studies-Depression and the Pittsburgh Sleep Quality Index. Descriptive statistics and Actor-Partner Interdependence Modeling were used to test the hypotheses.

Results: The rates of depressive symptoms in the clinical range were 39% for patients and 33% in intimate partner family caregivers. A mean of 6.3 (SD = 1.9) and 6.5 (SD = 1.5) hours of sleep was reported by patients with cancer and intimate partner family caregivers. The mean sleep efficiency (76.6% and 81.3%) and sleep quality (8.25 and 7.2) were poor for both partners. After covarying for age, sex, body mass index, smoking status, pain, and cancer stage, patients' depressive symptoms were associated with their own shorter sleep duration. Patient depressive symptoms were associated with their own and their partners' f poorer sleep efficiency and poorer sleep quality. Caregivers' depressive symptoms were also associated with their own poorer sleep quality.

Conclusions: The mood of both partners affect on sleep, and potentially health, was underscored by the findings. The development of dyadic interventions is warranted to improve both mood and sleep in both the patient and caregivers in the context of cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: When people receive information about the benefits and harms of mammography screening, they do not always accept it at face value and instead express skepticism. The purpose of this research was to identify the psychological drivers of this skepticism. Two theory-driven hypotheses were considered: One hypothesis proposes that skeptical reactions reflect a psychological defense against information that is emotionally aversive. Another proposes that skeptical reactions reflect a normative probabilistic inference that information that conflicts with prior beliefs is unlikely to be true. This work also identified the potential consequences of skepticism for people's screening preferences.

Method: A nationally representative sample of female participants ages 39-49 received information about the benefits and harms of mammography screening. Skepticism toward information about screening benefits and harms was measured, as well as hypothesis-relevant predictors of that skepticism. Participants' preferred age to have regular mammograms was also assessed.

Results: The results did not support the hypothesis that skepticism reflects an emotional defense. Instead, skepticism was associated with experiencing the information as conflicting with beliefs and past screening messages. Expressing more skepticism toward screening harms was associated with preferring to start screening at a younger age.

Conclusions: These data suggest that people express skepticism toward mammography evidence not because it is aversive information, but instead because it conflicts with other things they believe and have been told. Consistent, coordinated messages from health experts about mammography evidence may therefore help to reduce skepticism, and help promote an informed patient population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Behavioral intentions are one of the strongest predictors of health behavior. The current research explored the factors predicting action in those with already strong intentions (i.e., those with the most extreme intention scores).

Method: Across four studies on different types of health behavior (physical activity, bowel screening, smoking initiation, COVID-19 protection behaviors), attitudes, norms, perceived behavioral control and past behavior (plus habit in Study 4) were tested as prospective predictors of action in the subsample of participants with extreme (strong) intentions.

Results: In Studies 1 (N = 392) and 2 (N = 808) among strong intenders, norms and past behavior were consistent predictors of engaging in objectively assessed physical activity and bowel screening, respectively. In Studies 3 (N = 4,148) and 4 (N = 445) among strong intenders, affective attitudes (only Study 3), descriptive norms, capacity/autonomy, and past behavior were predictors of resisting smoking initiation and engaging in COVID-19 protection behaviors, respectively. Study 4 also showed habit to be a significant predictor of action in strong intenders.

Conclusion: This research identifies factors that might be useful targets to promote engagement with health behaviors in those with already strong intentions to act. Future research could usefully test whether targeting these same variables translates into behavior change in those with already strong intentions to act. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Despite the recognized importance of posttraumatic growth (PTG) in the recovery process, the mechanisms that promote PTG in spinal cord injury (SCI) patients and their spouses, especially the roles of dyadic coping (DC) and resilience, have not been fully explored. This study aimed to assess the PTG of patients with SCI and their spouses and to investigate the interrelationships among DC, resilience, and PTG within the dyadic context.

Method: A total of 154 SCI patient-spouse dyads were recruited from a rehabilitation hospital in China. All participants completed questionnaires about DC, resilience, and PTG. Our study was based on the actor-partner interdependence mediation model (APIMeM).

Results: SCI patients and their spouses experienced comparable PTG level, M_(patients) = 56.05 ± 14.09, M_(spouses) = 54.74 ± 15.31. In the APIMeM, the patients' and their spouses' DC exerted actor effects on their own resilience, β_(patients) = .418, p < .001; β_(spouses) = .409, p < .01, and their own resilience also exerted actor effects on their own PTG, β_(patients) = .416, p < .001; β_(spouses) = .431, p < .001. The mediating effects of resilience on the impact of patients' and spouses' own DC on their own PTG were confirmed.

Conclusions: Our research offers new insight into the PTG of SCI patients and their spouses at the individual and dyadic levels. Resilience partially mediates the relationship between DC and PTG in couples coping with SCI. Specifically, DC between SCI patient-spouse dyads can not only directly influence the level of PTG but also impact PTG through resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear.

Method: We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis.

Results: Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p < .01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p < .001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results.

Conclusions: Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Does loneliness predict premature death? Much prior research suggests so, but this evidence draws primarily on populations from individualistic societies, such as North America and Western Europe. Here, we aimed to extend this evidence by testing a hypothesis that loneliness would predict greater mortality risk in collectivistic societies, where social interdependence is normatively sanctioned.

Method: Using a harmonized dataset from two individualistic (England and the United States) and two collectivistic (Korea and Mexico) countries (combined N = 41,869), we tested whether cultural contexts moderate the extent to which loneliness predicts 10-year all-cause mortality.

Results: After adjustment of demographic variables and health behaviors, loneliness was associated with increased 10-year mortality in all four countries, with hazard ratios (HRs) of 1.13 in England, 1.21 in the United States and Mexico, and 1.51 in Korea. When health conditions were additionally controlled, this association became negligible in two individualistic countries, with HRs of 0.98 for both England and the United States. In contrast, the HR remained highly significant in Korea (HR = 1.27). Curiously, the mortality risk of loneliness in Mexico (HR = 1.03), another collectivistic country, was no different from the risks in England and the United States.

Conclusions: When people feel that they are chronically isolated from social networks, this perception can be fatal in Korea, but it is less so in the other three countries. Discussion focuses on other cultural factors, besides the cultural dimension of individualism-collectivism, that may account for the current finding. (PsycInfo Database Record (c) 2024 APA, all rights reserved).